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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-09-15

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

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

PubMed

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

2017-06-01

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

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

PubMed

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

2004-11-01

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

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

PubMed

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

2008-01-01

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

Viking Software Data

DTIC Science & Technology

1977-05-01

RADC-TR-77-168 Final Technical Report M~ay 1977 ll VIKING SOF11WARE DATA Martin Marietta Corporation Approved for public release; distribution...practices employed on a large and complex system development by the Martin Marietta Corporation. The intent of the RADC program to which this document...the technique are described. The preparation of this report could not have been accomplished without considerable assistance from fellow Martin

Resourcing interventions enhance psychology support capabilities in special operations forces.

PubMed

Myatt, Craig A; Auzenne, J W

2012-01-01

This study provides an examination of approaches to United States Government (USG) resourcing interventions on a national scale that enhance psychology support capabilities in the Special Operations Forces (SOF) community. A review of Congressional legislation and resourcing trends in the form of authorizations and appropriations since 2006 demonstrates how Congress supported enhanced psychology support capabilities throughout the Armed Forces and in SOF supporting innovative command interests that address adverse affects of operations tempo behavioral effects (OTBE). The formulation of meaningful metrics to address SOF specific command interests led to a personnel tempo (PERSTEMPO) analysis in response to findings compiled by the Preservation of the Force and Families (POTFF) Task Force. The review of PERSTEMPO data at subordinate command and unit levels enhances the capability of SOF leaders to develop policy and guidance on training and operational planning that mitigates OTBE and maximizes resourcing authorizations. A major challenge faced by the DoD is in providing behavioral healthcare that meets public and legislative demands while proving suitable and sustainable at all levels of military operations: strategic, operational, and tactical. Current legislative authorizations offer a mechanism of command advocacy for resourced multi-functional program development that enhances psychology support capabilities while reinforcing SOF readiness and performance. 2012.

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

PubMed

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

2016-08-09

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

Supporting Persistent and Networked Special Operations Forces (SOF) Operations: Insights From Forward-Deployed SOF Personnel

DTIC Science & Technology

2017-01-01

network of people and technology to provide sustained, persistent, SOF-specific capabilities and capacities and increased persistent forward- deployed...phase 1 operational activities of forward-deployed SOF personnel and the factors that critically influence the outcomes of their tactical operations can...chronized network of people and technology that provides sustained, persistent, SOF- specific capabilities and capacities and increased persistent

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

PubMed

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

2016-01-01

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

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

PubMed

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

2008-01-01

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

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

PubMed

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

2011-01-01

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

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

PubMed

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

2017-11-23

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

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2017-01-01

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

A Call for Innovation: Reflective Practices and Clinical Curricula of US Army Special Operations Forces Medics.

PubMed

Rocklein, Kate

2014-01-01

Special Operations Forces (SOF) medics have written and published numerous practice reflections that intricately describe their practice environments, clinical dilemmas, and suggestions for teaching and practice. The lack of translation of SOF medics experiential evidence to their curriculum has created a gap in evidence-based curriculum development. This study analyzed SOF medics learning and practice patterns and compared it to the evidence in the interdisciplinary clinical literature. After framing the problem, the literature was reviewed to determine appropriate tools by which perceptions and attitudes toward reflection-centered curricula could be measured. A recognizable practice reflection was extracted from the published SOF clinical literature and presented in writing to self-identified SOF medics and medic instructors via a descriptive crossover design, to ensure possible biases were mitigated. To measure SOF medics perceptions of reflection-based curricula, the Dundee Ready Education Environment Measure survey instrument was used, as it has validated psychometric properties and is used worldwide. SOF medics averaged scores of perceptions of their medic education indicated positive but not completely statistically significant preferences toward reflection-based curricula over traditional curriculum. Special Operations, medics, reflective practice, curricula BACKGROUND Special Operations Forces (SOF) medics practice in environments that are violent, austere, clandestine, and far removed from definitive hospital facilities. What was true almost 20 years ago?". . . academic demands of [Special Forces medic training] are roughly equivalent to those of an upper-level undergraduate curriculum in science or perhaps to those of first year medical school"?is even more challenging today. During this study, medics, physicians, and educators within the SOF medical community publicly and privately (ergo, names were redacted) expressed the need for curricular changes to teach SOF medics about the worst of clinical scenarios, such as situations in which evacuation of critically injured Soldiers to higher echelons of care is not possible or is prolonged, due to combat engagements or other complications. These experts consistently describe the need for curriculum derived from experienced medics practices, to guide force-wide knowledge acquisition and augment student medics professional development. Given the investigator?s clinical familiarity with SOF medics practice and evidence, senior, enlisted SOF medics and SOF medic instructors proposed that a doctoral-prepared nurse, whose clinical specialty was trauma, could spearhead academic focus and publication on the experiences and curriculum of SOF medics. 2014.

SOF Integration with Conventional Forces: A Doctrine Gap?

DTIC Science & Technology

2011-12-01

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

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

NASA Technical Reports Server (NTRS)

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

1992-01-01

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

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

PubMed

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

2005-12-01

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

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

PubMed

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

2015-05-13

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

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

PubMed Central

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

2010-01-01

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

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

PubMed

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

2012-01-01

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

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

PubMed Central

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

2014-01-01

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

Special Operations Forces Language and Culture Needs Assessment Project: Training Emphasis: Language and Culture

DTIC Science & Technology

2010-02-25

gave significantly higher emphasis ratings (i.e., a statistically significant difference between SOF operators and SOF leaders). Responses were made...i.e., a statistically significant difference between SOF operators and SOF leaders). Responses were made on the following scale: 1 = No emphasis, 2...missions?” Means with an asterisk (*) indicate that the group gave significantly higher emphasis ratings (i.e., a statistically significant difference

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

DTIC Science & Technology

2016-10-01

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

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

DTIC Science & Technology

1976-11-11

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

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

PubMed Central

Focareta, Laura; Cole, Alison G.

2016-01-01

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

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

PubMed Central

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

2016-01-01

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

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

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

Antao, Sytle M.; Klincker, Allison M.

2014-02-20

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

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

PubMed

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

2015-02-01

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

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

PubMed

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

2018-01-01

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

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

PubMed

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

2017-09-01

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

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

DTIC Science & Technology

2011-08-31

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

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

PubMed

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

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

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

NASA Technical Reports Server (NTRS)

Choudhary, Abdur Rahim

1994-01-01

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

33 CFR 337.6 - Statement of Findings (SOF).

Code of Federal Regulations, 2012 CFR

2012-07-01

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

33 CFR 337.6 - Statement of Findings (SOF).

Code of Federal Regulations, 2011 CFR

2011-07-01

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

33 CFR 337.6 - Statement of Findings (SOF).

Code of Federal Regulations, 2014 CFR

2014-07-01

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

33 CFR 337.6 - Statement of Findings (SOF).

Code of Federal Regulations, 2013 CFR

2013-07-01

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

33 CFR 337.6 - Statement of Findings (SOF).

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

PubMed

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

1994-09-01

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

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

PubMed

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

2018-01-01

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

Superiority of Interferon-Free Regimens for Chronic Hepatitis C

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-01-01

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

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

PubMed

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

2017-02-01

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

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

PubMed

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

2013-09-01

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

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

PubMed Central

Sobhonslidsuk, Abhasnee; Thakkinstian, Ammarin; Teerawattananon, Yot

2015-01-01

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

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

PubMed

Givens, Melissa L; Deuster, Patricia

2015-01-01

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

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

PubMed

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

2018-05-22

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

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

PubMed

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

2018-02-16

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

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

PubMed

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

2017-10-01

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

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

PubMed

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

2014-08-01

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

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

PubMed Central

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

2017-01-01

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

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

DTIC Science & Technology

2014-06-01

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

Special Operations Forces Language and Culture Needs Assessment: General Use of Interpreters

DTIC Science & Technology

2010-11-04

strategic use of interpreters. This information can be used to examine and revise policies and everyday practice related to interpreter use, so that SOF...operators’ mission effectiveness can be improved. Examining the current state of interpreter use in the SOF community can highlight important...the other hand, those who received pre-deployment use of interpreter training found it effective. This training can teach SOF operators how to

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

PubMed

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

2009-01-01

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

Perception Is Reality: Special Operations Forces In the Gray Zone

DTIC Science & Technology

2016-06-01

politics, policy, bureaucracy, and military action is complex, for simplicity this research assumes all players are rational actors who will maximize...Gray Zone—the primary tool being Special Operation Forces (SOF). This research finds that policymakers and others outside of SOF have often misapplied...effect on the ability of the Unites States to reach its foreign policy goals. This research analyzes U.S. SOF employment in the Gray Zone, breaking down

Fixing the DOTMLPF Handicap: Effectively Integrating the Conventional Combat Air Force Into Special Operations Forces Missions

DTIC Science & Technology

2010-04-01

conventional aircrews pierce the veil of secrecy and truly learn about the SOF missions, capabilities, and limitations. These select aviators then walk...operators and 316 SOF banding together with local militias in Afghanistan and using airpower to defeat the Taliban and destroy Al Qaeda. 2 The...wing conventional aircraft. Named the Afghan Model, after its development in OEF, this strategy pairs SOF with indigenous fighters and overwhelming

USSOCOM Research Topics 2011

DTIC Science & Technology

2010-01-01

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

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

PubMed

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

2003-01-01

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

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

PubMed

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

2017-07-01

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

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

PubMed

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

2018-07-01

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

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

PubMed

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

2017-02-01

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

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

PubMed

Campbell, Barrett H; Alderman, Shawn M

2012-01-01

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

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2011-01-01

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

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

PubMed Central

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

2017-01-01

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

Special Operations Forces (SOF): An Integral Part of the Theater Operating System

DTIC Science & Technology

1994-02-08

Special Operations Forces (SOF) Operati’c-al MOUC Theater Operating Syst,:- Opelrational Fires G-eration Desert Sh.eld/;e sert Stormi Ccc.Tnd & cnrtrcl~ It...INTRODUCTION The classroom at the College of Naval Command & Staff was filled with field grade Army officers. The day’s lesson, part of the Army’s...service component SOF units; readers are inviter’ to turn to the many field manuals and publications which describe the characteristics of special

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

PubMed

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

2016-10-01

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

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

PubMed

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

2018-06-01

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

How Should SOF Be Organized?

DTIC Science & Technology

2011-06-01

186 Eric Micheletti, French Special Forces: Special Operations Command (Paris: Histoire & Collections, 1999), 16. 187 NSCC, NATO SOF...University, September 2008. Micheletti, Eric. French Special Forces: Special Operations Command. Paris: Histoire & Collections, 1999. Millet, Allan

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

PubMed

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

2016-08-01

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

Dietary Supplements for Musculoskeletal Pain: Science Versus Claims.

PubMed

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

2018-01-01

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

Comprehensive Performance Nutrition for Special Operations Forces.

PubMed

Daigle, Karen A; Logan, Christi M; Kotwal, Russ S

2015-01-01

Special Operations Forces (SOF) training, combat, and contingency operations are unique and demanding. Performance nutrition within the Department of Defense has emphasized that nutrition is relative to factors related to the desired outcome, which includes successful performance of mentally and physically demanding operations and missions of tactical and strategic importance, as well as nonoperational assignments. Discussed are operational, nonoperational, and patient categories that require different nutrition strategies to facilitate category-specific performance outcomes. Also presented are 10 major guidelines for a SOF comprehensive performance nutrition program, practical nutrition recommendations for Special Operators and medical providers, as well as resources for dietary supplement evaluation. Foundational health concepts, medical treatment, and task-specific performance factors should be considered when developing and systematically implementing a comprehensive SOF performance nutrition program. When tailored to organizational requirements, SOF unit- and culture-specific nutrition education and services can optimize individual Special Operator performance, overall unit readiness, and ultimately, mission success. 2015.

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

PubMed

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

2016-11-01

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

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

PubMed

McCown, Michael; Grzeszak, Benjamin

2010-01-01

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

The NATO SOF Air Wing: A Basing Decision

DTIC Science & Technology

2012-12-01

AND ADDRESS(ES) Naval Postgraduate School Monterey, CA 93943–5000 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING /MONITORING...NATO Special Operations Headquarters (NSHQ). NSHQ coordinates, trains, and employs NATO’s special operation forces. With the addition of organic SOF

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

PubMed

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

2017-10-01

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

Energy requirements of US Army Special Operation Forces during military training.

PubMed

Margolis, Lee M; Crombie, Aaron P; McClung, Holly L; McGraw, Susan M; Rood, Jennifer C; Montain, Scott J; Young, Andrew J

2014-05-12

Special Operations Forces (SOF) regularly engage in physically demanding combat operations and field training exercises, resulting in high daily energy expenditure, and thus increased energy requirements. However, the majority of studies assessing energy requirements of SOF have been conducted on soldiers going through intense SOF initiation training. The objective of the current investigation was to determine the energy expenditure of SOF conducting military training operations. Thirty-one soldiers taking part in Pre-Mission Training (PMT n = 15) and Combat Diver Qualification Courses (CDQC n = 16) volunteered to participate in this observational study. Energy expenditure was determined using doubly labeled water. Body weight (83 ± 7 kg) remained stable during both training periods. Overall energy expenditure adjusted for body composition was 17,606 ± 2326 kJ·day(-1). Energy expenditure was 19,110 ± 1468 kJ·day(-1) during CDQC and 16,334 ± 2180 kJ·day(-1) during PMT, with physical activity levels of 2.6 ± 0.2 and 2.2 ± 0.3 during CDQC and PMT, respectively. Compared to the Military Dietary Reference Intakes for energy (13,598 kJ·day(-1)), these data are in agreement with previous reports that energy requirement for SOF Soldiers exceed that of the average soldier.

Energy Requirements of US Army Special Operation Forces During Military Training

PubMed Central

Margolis, Lee M.; Crombie, Aaron P.; McClung, Holly L.; McGraw, Susan M.; Rood, Jennifer C.; Montain, Scott J.; Young, Andrew J.

2014-01-01

Special Operations Forces (SOF) regularly engage in physically demanding combat operations and field training exercises, resulting in high daily energy expenditure, and thus increased energy requirements. However, the majority of studies assessing energy requirements of SOF have been conducted on soldiers going through intense SOF initiation training. The objective of the current investigation was to determine the energy expenditure of SOF conducting military training operations. Thirty-one soldiers taking part in Pre-Mission Training (PMT n = 15) and Combat Diver Qualification Courses (CDQC n = 16) volunteered to participate in this observational study. Energy expenditure was determined using doubly labeled water. Body weight (83 ± 7 kg) remained stable during both training periods. Overall energy expenditure adjusted for body composition was 17,606 ± 2326 kJ·day−1. Energy expenditure was 19,110 ± 1468 kJ·day−1 during CDQC and 16,334 ± 2180 kJ·day−1 during PMT, with physical activity levels of 2.6 ± 0.2 and 2.2 ± 0.3 during CDQC and PMT, respectively. Compared to the Military Dietary Reference Intakes for energy (13,598 kJ·day−1), these data are in agreement with previous reports that energy requirement for SOF Soldiers exceed that of the average soldier. PMID:24824290

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

PubMed

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

2018-03-01

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

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

PubMed

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

2018-03-01

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

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2018-06-01

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

Toric Intraocular Lens for Astigmatism Correction in Cataract Patients.

PubMed

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

2017-01-01

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

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

PubMed

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

2018-06-16

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2017-07-01

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

A Shift From Resilience to Human Performance Optimization in Special Operations Training: Advancements in Theory and Practice.

PubMed

Park, Gloria H; Messina, Lauren A; Deuster, Patricia A

Within the Department of Defense over the past decade, a focus on enhancing Warfighter resilience and readiness has increased. For Special Operation Forces (SOF), who bear unique burdens for training and deployment, programs like the Preservation of the Force and Family have been created to help support SOF and their family members in sustaining capabilities and enhancing resilience in the face of prolonged warfare. In this review, we describe the shift in focus from resilience to human performance optimization (HPO) and the benefits of human performance initiatives that include holistic fitness. We then describe strategies for advancing the application of HPO for future initiatives through tailoring and cultural adaptation, as well as advancing methods for measurement. By striving toward specificity and precision performance, SOF human performance programs can impact individual and team capabilities to a greater extent than in the past, as well as maintaining the well-being of SOF and their families across their careers and beyond. 2017.

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

PubMed Central

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

2015-01-01

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

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

DTIC Science & Technology

2016-06-01

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

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

PubMed

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

1996-09-01

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

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

NASA Astrophysics Data System (ADS)

Dong, Guangzhong; Wei, Jingwen; Chen, Zonghai

2016-10-01

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

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

PubMed

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

2018-02-01

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

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

PubMed

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

2018-04-07

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

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

PubMed

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

2017-08-01

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

Mitigating the Cultural Challenges of SOF/Conventional Force Interdependence

DTIC Science & Technology

2013-03-01

Cultural Challenges of SOF / Conventional Force Interdependence 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...January 16, 2013. 31 Daniel French , “Integration of General Purpose Forces and Army Special Operations,” 1. 32 Edward L. Cardon , “Recognizing

Nonlinear aeroelastic analysis, flight dynamics, and control of a complete aircraft

NASA Astrophysics Data System (ADS)

Patil, Mayuresh Jayawant

The focus of this research was to analyze a high-aspect-ratio wing aircraft flying at low subsonic speeds. Such aircraft are designed for high-altitude, long-endurance missions. Due to the high flexibility and associated wing deformation, accurate prediction of aircraft response requires use of nonlinear theories. Also strong interactions between flight dynamics and aeroelasticity are expected. To analyze such aircraft one needs to have an analysis tool which includes the various couplings and interactions. A theoretical basis has been established for a consistent analysis which takes into account, (i) material anisotropy, (ii) geometrical nonlinearities of the structure, (iii) rigid-body motions, (iv) unsteady flow behavior, and (v) dynamic stall. The airplane structure is modeled as a set of rigidly attached beams. Each of the beams is modeled using the geometrically exact mixed variational formulation, thus taking into account geometrical nonlinearities arising due to large displacements and rotations. The cross-sectional stiffnesses are obtained using an asymptotically exact analysis, which can model arbitrary cross sections and material properties. An aerodynamic model, consisting of a unified lift model, a consistent combination of finite-state inflow model and a modified ONERA dynamic stall model, is coupled to the structural system to determine the equations of motion. The results obtained indicate the necessity of including nonlinear effects in aeroelastic analysis. Structural geometric nonlinearities result in drastic changes in aeroelastic characteristics, especially in case of high-aspect-ratio wings. The nonlinear stall effect is the dominant factor in limiting the amplitude of oscillation for most wings. The limit cycle oscillation (LCO) phenomenon is also investigated. Post-flutter and pre-flutter LCOs are possible depending on the disturbance mode and amplitude. Finally, static output feedback (SOF) controllers are designed for flutter suppression and gust alleviation. SOF controllers are very simple and thus easy to implement. For the case considered, SOF controllers with proper choice of sensors give results comparable to full state feedback (linear quadratic regulator) designs.

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

DTIC Science & Technology

2011-03-01

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

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

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

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

2017-01-01

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

2011 Special Operations Forces Industry Conference

DTIC Science & Technology

2011-05-19

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

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

PubMed

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

2015-03-01

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

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

PubMed

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

2017-09-01

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

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

PubMed

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

2018-04-01

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

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

PubMed

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

2011-04-21

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

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

PubMed Central

2011-01-01

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

The Health Clinic. School of the Future: Houston.

ERIC Educational Resources Information Center

Iscoe, Louise

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

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

DTIC Science & Technology

2009-05-21

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

Piracy: The Best Business Model Available

DTIC Science & Technology

2013-11-01

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

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

DTIC Science & Technology

2010-11-01

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

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

PubMed

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

2018-01-01

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

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

PubMed

Patel, Brijesh; Chhabra, Naveen; Jain, Disha

2016-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-11-01

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

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

PubMed

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

2017-12-01

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

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

PubMed

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

2016-05-11

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

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

PubMed Central

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

2011-01-01

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

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

ERIC Educational Resources Information Center

Iscoe, Louise K.

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

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

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

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

2014-10-06

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

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

PubMed

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

2017-05-01

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

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

PubMed

Kazemian, H B

2001-01-01

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

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

EPA Science Inventory

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

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

DTIC Science & Technology

2004-10-01

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

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

PubMed

Laing, Andrew C; Robinovitch, Stephen N

2009-05-01

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

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

PubMed

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

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

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

PubMed

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

2017-05-01

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

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

PubMed Central

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

2010-01-01

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

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

PubMed Central

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

2016-01-01

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

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

PubMed Central

Patel, Brijesh; Chhabra, Naveen; Jain, Disha

2016-01-01

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

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

DTIC Science & Technology

2007-10-01

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

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

DTIC Science & Technology

2017-12-01

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

Countering Enemy Special Purpose Forces. An Evolving Mission for United States Special Operations Forces

DTIC Science & Technology

2001-05-01

proper planning and preparation, our LOCs become lucrative high pay -off targets for our adversaries. Similar to United States doctrine, enemy SPF will...guerillas, saboteurs, terrorists, and special operations forces. This term will be used to differentiate between friendly SOF and enemy SOF. The author...Wellington’s proficient use of irregulars against the French Army during the Peninsular Campaign; and the Russian partisans that significantly

Military Review. Volume 83, Number 3, May-June 2003

DTIC Science & Technology

2003-06-01

the special operations liaison element to directly termi- nate an operational unit’s communications, which can reduce sensor-to- shooter times to...to- shooter operations. In Afghanistan, however, SOF had a dif- ferent role. With its Northern Alliance partners, SOF was a maneuver force requiring...exhibit a great amount of empathy toward children in war- torn counties. Consequently, engagements with child soldiers can be incredibly demoralizing for

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

DTIC Science & Technology

2017-03-21

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

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

DTIC Science & Technology

2016-12-07

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

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

DTIC Science & Technology

2015-01-01

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

Special Operations Research Topics 2014

DTIC Science & Technology

2014-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-02-01

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

Transient particle emission measurement with optical techniques

NASA Astrophysics Data System (ADS)

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

2008-06-01

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

A Graphics Editor for Structured Analysis with a Data Dictionary.

DTIC Science & Technology

1987-12-01

4-3 Human/Computer Interface Considerations 4-3 Screen Layout .... ............. 4-4 Menu System ..... .............. 4-6 Voice Feedback...central computer system . This project is a direct follow on to the 1986 thesis by James W. Urscheler. lie created an initial version of a tool (nicknamed...graphics information. Background r SADT. SADT is the name of SofTech’s methodology for doing requirement analysis and system design. It was first published

Analysis of Rotary Aircraft Alternatives for NATO SOF Organic Air Wing

DTIC Science & Technology

2012-06-01

analysis with an assumed program start in 2013 and an end in 2019 to determine the impact of short program duration on platform selection. D...FY12 GO\\ LR,~itl\\ l Sli LABOR H13 (J()VI R\\\\iFI\\TSE I AROR FY14 GOVLR\\\\iLI\\ I Sl:. LABOR H15 SI:.PO CSS FY II SII’O CSS FY 12 SEI’() CSS fY 13

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

DTIC Science & Technology

2012-02-15

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

Organizational Design for USSOCOM Rapid Acquisition

DTIC Science & Technology

2017-03-31

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

Use of Special Operations Forces in United Nations Missions: a Method to Resolve Complexity

DTIC Science & Technology

2015-05-21

physical stamina and psychological stability, followed by a rigorous training program are the imperatives to create SOF soldiers.42 Mark Bowden in...recommendation is that the United Nations should establish a Special Operations planning cell within the UN Department of Peacekeeping Operations. As of...now, the cell is nonexistent. This cell should be able to facilitate the integration of SOF into the overall peace operations concept. Finally, the

THOR3: Humans Are More Important Than Hardware

DTIC Science & Technology

2010-12-01

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

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

DTIC Science & Technology

2011-06-01

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

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

PubMed Central

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

2010-01-01

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

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

PubMed

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

2018-06-07

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

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

DTIC Science & Technology

2009-01-01

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

Ada Software Design Methods Formulation.

DTIC Science & Technology

1982-10-01

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

Special Operations Forces and Conventional Forces: Integration, Interoperability, and Interdependence

DTIC Science & Technology

2016-12-07

Phasing Model8 WESBROCK, HARNED, AND PLOUS 88 | FEATURES PRISM 6, no. 3 views on how to design, plan, and execute operat ions and campaigns. The...population-centric” operational environment. SOF views campaign design dif- ferently from the six-phase model in joint doc- trine depicted above.9...U.S. interests. This difference between SOF and CF views of cam- paigning can hamper integration from the start of an operation if components of the

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

PubMed

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

2016-06-18

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

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

PubMed

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

2012-01-01

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

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

PubMed

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

2014-03-01

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

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

PubMed

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

2016-06-01

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

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

PubMed

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

2016-10-01

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

In vivo chromatic aberration in eyes implanted with intraocular lenses.

PubMed

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

2013-04-12

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

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

PubMed

Enomoto, Takeshi; Matsumoto, Kazuhiko; Hagiwara, Rika

2011-12-14

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

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

PubMed

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

2018-03-05

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

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

PubMed

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

2016-11-01

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

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

PubMed

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

2017-11-01

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

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

PubMed

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

2017-06-01

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

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

PubMed Central

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

2017-01-01

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

The OSS Model and the Future of the SOF Warrior

DTIC Science & Technology

2011-11-01

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

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

DTIC Science & Technology

2013-04-15

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

Special Operations Forces Language Transformation Strategy Needs Assessment Project: Air Force Operator Survey Report

DTIC Science & Technology

2004-10-15

CAT III/IV Language More difficult languages to acquire for native English speakers. Examples: Cantonese , Japanese, Arabic, Dari, Pashto, Turkish...conversations on practical, social , and professional topics in my required AOR language. 64.1 62.0 68.8 SOF Language Transformation Strategy Needs...practical, social , and professional topics in the language required by my AOR assignment. 39 3.6 1.29 64.1 7.7 17.9 12.8 33.3 28.2 SOF

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

DTIC Science & Technology

2016-03-31

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

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

DTIC Science & Technology

2013-05-23

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

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

PubMed

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

2016-01-01

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

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

PubMed

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

2017-01-01

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

Training Community Modeling and Simulation Business Plan: 2009 Edition

DTIC Science & Technology

2010-04-01

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

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

DTIC Science & Technology

2016-09-01

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

A test of the Forest Inventory and Analysis Program’s down woody material indicator for regional fuel estimation in the Southern Appalachian Mountains (PROJECT SO-F-06-01)

Treesearch

G. Geof Wang; Zhi-Ping Wang; Aaron D. Stottlemyer; Thomas A. Waldrop

2013-01-01

Both the National Fire Plan (http://199.134.225.50/nwcc/t2_wa4/ pdf/RuralAssistance.pdf) and the Healthy Forest Initiative (http://www.fs.fed.us/projects/ hfi/2003/august/documents/hfi-fact-sheet. pdf) call for reduction of hazardous fuels. Consequently, estimations of forest fuel loading at various scales become necessary. The Forest Inventory and Analysis (FIA)...

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

PubMed

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

2017-03-01

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

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

PubMed

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

2018-02-14

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

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

PubMed

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

2018-02-14

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

The sensing mechanism of N-doped SWCNTs toward SF6 decomposition products: A first-principle study

NASA Astrophysics Data System (ADS)

Gui, Yingang; Tang, Chao; Zhou, Qu; Xu, Lingna; Zhao, Zhongyong; Zhang, Xiaoxing

2018-05-01

In order to monitor the insulation status of SF6-insulated equipment on-line, SOF2 and SO2F2, two typical decomposition products of SF6 under electric discharge condition, are chosen as the target gases to evaluate the type and severity of discharge. In this work, single N atom doping method is adopted to improve the gas sensitivity of single wall carbon nanotubes to SOF2 and SO2F2. Single and double gas molecules adsorptions are considered to completely analyze the adsorption properties of N-doped single wall carbon nanotubes. Calculation results show that N atom doping enhances the surface activity of carbon nanotubes. When gas molecules physically adsorbed on N-doped single wall carbon nanotubes, the weak interaction between gas molecules and N-doped single wall carbon nanotubes nearly not changes the electrical property according to analysis of the density of states and molecular orbitals. While the chemisorption between gas molecules and N-doped single wall carbon nanotubes distinctly decreases the conductivity of adsorption system.

Monetary Policy Delelgation and Transparency of Policy Targets: A Positive Analysis

DTIC Science & Technology

2011-06-01

International Outsourcing : Solving ihc Puzzle. February 2009 87 Riindshagcn Bianc.i. Zimmermann. Klaus sv Buchanan-Kooperarion und...through surprise inflation. In a framework with endogenous wage setting by unions. Sorensen (1991) shows that uncertainty of the policy maker’s...of ronsi i vatism in open economies . Hughes Hallett and Weymark (2004, 2005) or Lockwood et al. (1998) apply two-stage models of monetary policy

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

PubMed

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

2016-09-20

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

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

PubMed

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

2016-07-01

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

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

PubMed

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

2010-03-15

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

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

NASA Astrophysics Data System (ADS)

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

2016-04-01

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

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

PubMed

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

2017-01-01

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

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

PubMed

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

2016-12-01

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

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

PubMed Central

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

2011-01-01

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

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

PubMed

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

2012-01-01

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

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

PubMed

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

2018-01-01

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

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

DTIC Science & Technology

2013-04-01

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

What Is the Future for SOF in the Arctic?

DTIC Science & Technology

2014-12-01

Beaufort Sea) and the August values of the listed variables (two-month lead time). The variables are ranked by their R2 values (highest R2 listed first...refueling AA additional activities AJP Allied Joint Publication (NATO) ALCOM Alaska Command (U.S.) AKO Arktisk Kommando, Arctic command (DNK) AMC...capabilities. Although the scope is limited to the three nations, the overall analysis and recommendations will be of value to all states with a

Compilation of Abstracts of Theses Submitted by Candidates for Degrees

DTIC Science & Technology

1987-09-30

Paral- lel, Multiple Backend Database Systems Feudo, C.V. Modern Hardware Tochnololies 88 MAJ , USA 8nd. Sof ware Techniques for Online uatabase Storage...and itsApplication in the War- gaming , Reseamth and Analysis (W.A.R.) Lab Waltens erger, G.M. On Limited War, Escalation 524 CPT,, USRF Control, and...TECHNIQIUES FOR ONLINE DATABASE ,TORAGE AND ACCESS Christopher V. Feudo Ma or, United States Army B.S., United States Military Academy# 1972

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

DTIC Science & Technology

2015-05-01

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

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

PubMed

Cullin, Felix; Busch, Tobias; Lundström, Mats

2014-03-01

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

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

PubMed

Frisella, Margaret M

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

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

PubMed

Nagao, Azusa; Hanabusa, Hideji

2017-04-01

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

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

PubMed

Aihara, Makoto; Oshima, Hiromi; Araie, Makoto

2013-02-01

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

Investment Strategy for DoD Automatic Test Systems. Volume 2. Supporting Data

DTIC Science & Technology

1994-01-01

DESCOM Col Steve Dasher PM, TMDE Col William Deegan SAALC/LDA Mr. Don Desilets NVWC NPT (8314) Mr. W. Devers IDA Lt Col Easley HQ USAF (SOF) Mr. Bit Frank...OOALCJFISEA Mr. Craig Wall ASC/SMG Mr. Frank Wiilis OOALCMTISADC LCDR Patrick Witt NAWCADLKE 0 F- F-4 S Industry Participants (Briefings and Interviews...Effectiveness Analysis) COEA) Update (MSIIIB Report). January 1992 VXI Consortion. VXI (VXE Bus Extensions for Instrumentation) Briefing. Wall, Craig . ASD/ENEM

2012 Workplace and Gender Relations Survey of Active Duty Members: Nonresponse Bias Analysis Report

DTIC Science & Technology

2014-01-01

Control and Prevention ), or command climate surveys (e.g., DEOCS). 6 Table 1. Comparison of Trends in WGRA and SOFS-A Response Rates (Shown in...DMDC draws optimized samples to reduce survey burden on members as well as produce high levels of precision for important domain estimates by using...statistical significance at α= .05 Because paygrade is a significant predictor of survey response, we next examined the odds ratio of each paygrade levels

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

PubMed

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

2014-04-01

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

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

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

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

Analysis of the Sensitivity of K-Type Molecular Sieve-Deposited MWNTs for the Detection of SF6 Decomposition Gases under Partial Discharge

PubMed Central

Zhang, Xiaoxing; Li, Xin; Luo, Chenchen; Dong, Xingchen; Zhou, Lei

2015-01-01

Sulfur hexafluoride (SF6) is widely utilized in gas-insulated switchgear (GIS). However, part of SF6 decomposes into different components under partial discharge (PD) conditions. Previous research has shown that the gas responses of intrinsic and 4 Å-type molecular sieve-deposited multi-wall carbon nanotubes (MWNTs) to SOF2 and SO2F2, two important decomposition components of SF6, are not obvious. In this study, a K-type molecular sieve-deposited MWNTs sensor was developed. Its gas response characteristics and the influence of the mixture ratios of gases on the gas-sensing properties were studied. The results showed that, for sensors with gas mixture ratios of 5:1, 10:1, and 20:1, the resistance change rate increased by nearly 13.0% after SOF2 adsorption, almost 10 times that of MWNTs sensors, while the sensors’ resistance change rate with a mixture ratio of 10:1 reached 17.3% after SO2F2 adsorption, nearly nine times that of intrinsic MWNT sensors. Besides, a good linear relationship was observed between concentration of decomposition components and the resistance change rate of sensors. PMID:26569245

Analysis of the Sensitivity of K-Type Molecular Sieve-Deposited MWNTs for the Detection of SF₆ Decomposition Gases under Partial Discharge.

PubMed

Zhang, Xiaoxing; Li, Xin; Luo, Chenchen; Dong, Xingchen; Zhou, Lei

2015-11-11

Sulfur hexafluoride (SF6) is widely utilized in gas-insulated switchgear (GIS). However, part of SF6 decomposes into different components under partial discharge (PD) conditions. Previous research has shown that the gas responses of intrinsic and 4 Å-type molecular sieve-deposited multi-wall carbon nanotubes (MWNTs) to SOF2 and SO2F2, two important decomposition components of SF6, are not obvious. In this study, a K-type molecular sieve-deposited MWNTs sensor was developed. Its gas response characteristics and the influence of the mixture ratios of gases on the gas-sensing properties were studied. The results showed that, for sensors with gas mixture ratios of 5:1, 10:1, and 20:1, the resistance change rate increased by nearly 13.0% after SOF2 adsorption, almost 10 times that of MWNTs sensors, while the sensors' resistance change rate with a mixture ratio of 10:1 reached 17.3% after SO2F2 adsorption, nearly nine times that of intrinsic MWNT sensors. Besides, a good linear relationship was observed between concentration of decomposition components and the resistance change rate of sensors.

Prevalence of NS5B resistance-associated variants in treatment-naïve Asian patients with chronic hepatitis C.

PubMed

Yang, Song; Xing, Huichun; Feng, Shenghu; Ju, Wei; Liu, Shunai; Wang, Xiaomei; Ou, Weini; Cheng, Jun; Pan, Calvin Q

2018-02-01

There is little information on the association between baseline non-structural protein (NS) 5b resistance-associated variants (RAVs) and treatment failure in hepatitis C patients. This study examined the frequencies of natural hepatitis C virus (HCV) NS5B resistance-associated variants (RAVs) in an Asian cohort. Samples from Asian HCV patients enrolled between October 2009 and September 2014 were analyzed for NS5B RAVs within the region from amino acid 230 to 371. Serum samples were tested by PCR genotyping, with sequence alignment performed using the neighbor-joining method. NS5B was detected by Sanger sequencing followed by Geno2pheno analysis. NS5B RAVs were detected in 80.52% (1199/1489) of patients; 68.4% (1019/1489) and 79.7% (1186/1489) were associated with resistance to sofosbuvir (SOF) and dasabuvir (DSV), respectively. These RAVs were present in 95% (1004/1058) of genotype 1b patients. When genotypes 1b and 2a were compared, SOF-associated RAVs were detected at a higher frequency in genotype 1b (94.8% [1004/1058] vs. 2.9% [9/309]; χ 2 = 1054.433, P < 0.001), C316H/N was more common in genotype 1b (94.7% [1002/1058] vs. 0% [0/309]; χ 2 = 1096.014, P < 0.001), M289F/L/I/W/V had a higher frequency in genotype 2a (0.7% [7/309] vs. 2.3% [7/1058]; χ 2 = 4.589, P = 0.032), DSV-associated RAVs were most often found in genotype 1b (95.0% [1005/1058] vs. 40.1% 124/309]; χ 2 = 500.577, P < 0.001), and frequency of C316Y/H/N/W was higher in genotype 1b (94.7% [1002/1058] vs. 0% [0/309]; χ 2 = 1096.014, P < 0.001). In conclusion, baseline SOF and DSV RAVs are common in Asian HCV patients and predominantly occur in genotype 1b.

Nonlinear Modeling and Initial Condition Estimation for Identifying the Aerothermodynamic Environment of the Space Shuttle Orbiter.

DTIC Science & Technology

1983-12-01

8217°%. .. o..’% - * 2’ . *. -o- . *o.oo o ,o ;j ’:-’ List of Figures Figure Page 1. System Identification of the Aerothermodynamic Environment of... System (STS) has of fered the engineering community a unique opportunity to flight test a reentry, hypersonic vehicle. The key 4 to the Shuttle’s...of the system (Refs. 7,8,9,10). Although the initial test flights have now been completed, data analysis and expansion of the existing data base

Signal Classification in Fading Channels Using Cyclic Spectral Analysis

DTIC Science & Technology

2009-07-01

Classifier Design The proposed classifier is designed to classify AM, BFSK, OFDM, DS - CDMA , 4-ASK, 8-ASK, BPSK, QPSK, 8-PSK, 16-PSK, 16-QAM, and 64-QAM...five independent neural networks, each trained to classify a signal as either AM, BFSK, DS - CDMA , or a linear modulation scheme with a real-valued...in an SOF image that resembles those of QAM and PSK signals. Additionally, the DS - CDMA scheme can be thought to look like a BPSK signal. However, due

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

PubMed

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

2017-05-26

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

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

PubMed

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

2017-10-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

FIRE_AX_SOF_ARAT_FLT

Atmospheric Science Data Center

2015-11-25

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

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2015-02-01

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

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

PubMed

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

2016-02-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

FIRE_AX_SOF_SUR_MET

Atmospheric Science Data Center

2015-11-25

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

Quantifying antiviral activity optimizes drug combinations against hepatitis C virus infection.

PubMed

Koizumi, Yoshiki; Ohashi, Hirofumi; Nakajima, Syo; Tanaka, Yasuhito; Wakita, Takaji; Perelson, Alan S; Iwami, Shingo; Watashi, Koichi

2017-02-21

With the introduction of direct-acting antivirals (DAAs), treatment against hepatitis C virus (HCV) has significantly improved. To manage and control this worldwide infectious disease better, the "best" multidrug treatment is demanded based on scientific evidence. However, there is no method available that systematically quantifies and compares the antiviral efficacy and drug-resistance profiles of drug combinations. Based on experimental anti-HCV profiles in a cell culture system, we quantified the instantaneous inhibitory potential (IIP), which is the logarithm of the reduction in viral replication events, for both single drugs and multiple-drug combinations. From the calculated IIP of 15 anti-HCV drugs from different classes [telaprevir, danoprevir, asunaprevir, simeprevir, sofosbuvir (SOF), VX-222, dasabuvir, nesbuvir, tegobuvir, daclatasvir, ledipasvir, IFN-α, IFN-λ1, cyclosporin A, and SCY-635], we found that the nucleoside polymerase inhibitor SOF had one of the largest potentials to inhibit viral replication events. We also compared intrinsic antiviral activities of a panel of drug combinations. Our quantification analysis clearly indicated an advantage of triple-DAA treatments over double-DAA treatments, with triple-DAA treatments showing enhanced antiviral activity and a significantly lower probability for drug resistance to emerge at clinically relevant drug concentrations. Our framework provides quantitative information to consider in designing multidrug strategies before costly clinical trials.

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

NASA Astrophysics Data System (ADS)

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

2017-11-01

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

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

PubMed

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

2015-01-01

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

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

PubMed

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

2018-04-01

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

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

PubMed

Wittich, Arthur C

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

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

PubMed Central

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

2014-01-01

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

Drug Authorization for Sofosbuvir/Ledipasvir (Harvoni) for Chronic HCV Infection in a Real-World Cohort: A New Barrier in the HCV Care Cascade

PubMed Central

Liapakis, AnnMarie; Cohen, Elizabeth; Chau, Hong; Bertuccio, Claudia; Sapir, Dana; Wright, Jessica; Eggers, Carol; Drozd, Kristine; Ciarleglio, Maria; Deng, Yanhong; Lim, Joseph K.

2015-01-01

Background New treatments for hepatitis C (HCV) infection hold great promise for cure, but numerous challenges to diagnosing, establishing care, and receiving therapy exist. There are limited data on insurance authorization for these medications. Materials and Methods We performed a retrospective chart review of patients receiving sofosbuvir/ledipasvir (SOF/LED) from October 11-December 31, 2014 to determine rates and timing of drug authorization. We also determined predictors of approval, and those factors associated with faster decision and approval times. Results Of 174 patients prescribed HCV therapy during this period, 129 requests were made for SOF/LED, of whom 100 (77.5%) received initial approval, and an additional 17 patients (13.9%) ultimately received approval through the appeals process. Faster approval times were seen in patients with Child-Pugh Class B disease (14.4 vs. 24.7 days, p = 0.048). A higher proportion of patients were initially approved in those with Medicare/Medicaid coverage (92.2% vs. 71.4%, p = 0.002) and those with baseline viral load ≥6 million IU/mL (84.1% vs. 62.5%, p = 0.040). Linear regression modeling identified advanced fibrosis, high Model of End Stage Liver Disease (MELD) score, and female gender as significant predictors of shorter decision and approval times. On logistic regression, Medicare/Medicaid coverage (OR 5.96, 95% CI 1.66–21.48) and high viral load (OR 4.52, 95% CI 1.08–19.08) were significant predictors for initial approval. Conclusions Early analysis of real-world drug authorization outcomes between October-December 2014 reveals that nearly one in four patients are initially denied access to SOF/LED upon initial prescription, although most patients are eventually approved through appeal, which delays treatment initiation. Having Medicare/Medicaid and advanced liver disease resulted in a higher likelihood of approval as well as earlier decision and approval times. More studies are needed to determine factors resulting in higher likelihood of denial and to evaluate approval rates and times after implementation of restrictive prior authorization guidelines. PMID:26312999

Drug Authorization for Sofosbuvir/Ledipasvir (Harvoni) for Chronic HCV Infection in a Real-World Cohort: A New Barrier in the HCV Care Cascade.

PubMed

Do, Albert; Mittal, Yash; Liapakis, AnnMarie; Cohen, Elizabeth; Chau, Hong; Bertuccio, Claudia; Sapir, Dana; Wright, Jessica; Eggers, Carol; Drozd, Kristine; Ciarleglio, Maria; Deng, Yanhong; Lim, Joseph K

2015-01-01

New treatments for hepatitis C (HCV) infection hold great promise for cure, but numerous challenges to diagnosing, establishing care, and receiving therapy exist. There are limited data on insurance authorization for these medications. We performed a retrospective chart review of patients receiving sofosbuvir/ledipasvir (SOF/LED) from October 11-December 31, 2014 to determine rates and timing of drug authorization. We also determined predictors of approval, and those factors associated with faster decision and approval times. Of 174 patients prescribed HCV therapy during this period, 129 requests were made for SOF/LED, of whom 100 (77.5%) received initial approval, and an additional 17 patients (13.9%) ultimately received approval through the appeals process. Faster approval times were seen in patients with Child-Pugh Class B disease (14.4 vs. 24.7 days, p = 0.048). A higher proportion of patients were initially approved in those with Medicare/Medicaid coverage (92.2% vs. 71.4%, p = 0.002) and those with baseline viral load ≥ 6 million IU/mL (84.1% vs. 62.5%, p = 0.040). Linear regression modeling identified advanced fibrosis, high Model of End Stage Liver Disease (MELD) score, and female gender as significant predictors of shorter decision and approval times. On logistic regression, Medicare/Medicaid coverage (OR 5.96, 95% CI 1.66-21.48) and high viral load (OR 4.52, 95% CI 1.08-19.08) were significant predictors for initial approval. Early analysis of real-world drug authorization outcomes between October-December 2014 reveals that nearly one in four patients are initially denied access to SOF/LED upon initial prescription, although most patients are eventually approved through appeal, which delays treatment initiation. Having Medicare/Medicaid and advanced liver disease resulted in a higher likelihood of approval as well as earlier decision and approval times. More studies are needed to determine factors resulting in higher likelihood of denial and to evaluate approval rates and times after implementation of restrictive prior authorization guidelines.

SPECIAL ANALYSIS OF OPERATIONAL STORMWATER RUNOFF COVERS OVER SLIT TRENCHES

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

Collard, L; Luther Hamm, L

2008-12-18

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

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

PubMed

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

2015-05-19

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

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

PubMed

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

2018-06-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Combination of biodiesel-ethanol-diesel fuel blend and SCR catalyst assembly to reduce emissions from a heavy-duty diesel engine.

PubMed

Shi, Xiaoyan; Yu, Yunbo; He, Hong; Shuai, Shijin; Dong, Hongyi; Li, Rulong

2008-01-01

In this study, the efforts to reduce NOx and particulate matter (PM) emissions from a diesel engine using both ethanol-selective catalytic reduction (SCR) of NOx over an Ag/Al2O3 catalyst and a biodiesel-ethanol-diesel fuel blend (BE-diesel) on an engine bench test are discussed. Compared with diesel fuel, use of BE-diesel increased PM emissions by 14% due to the increase in the soluble organic fraction (SOF) of PM, but it greatly reduced the Bosch smoke number by 60%-80% according to the results from 13-mode test of European Stationary Cycle (ESC) test. The SCR catalyst was effective in NOx reduction by ethanol, and the NOx conversion was approximately 73%. Total hydrocarbons (THC) and CO emissions increased significantly during the SCR of NOx process. Two diesel oxidation catalyst (DOC) assemblies were used after Ag/Al2O3 converter to remove CO and HC. Different oxidation catalyst showed opposite effect on PM emission. The PM composition analysis revealed that the net effect of oxidation catalyst on total PM was an integrative effect on SOF reduction and sulfate formation of PM. The engine bench test results indicated that the combination of BE-diesel and a SCR catalyst assembly could provide benefits for NOx and PM emissions control even without using diesel particle filters (DPFs).

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

NASA Astrophysics Data System (ADS)

Karavalakis, George; Stournas, Stamoulis; Bakeas, Evangelos

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

Ledipasvir/sofosbuvir is effective and well tolerated in postkidney transplant patients with chronic hepatitis C virus.

PubMed

Morales, Amilcar L; Liriano-Ward, Luz; Tierney, Amber; Sang, Michelle; Lalos, Alexander; Hassan, Mohamed; Nair, Vinay; Schiano, Thomas; Satoskar, Rohit; Smith, Coleman

2017-05-01

Patients with end-stage renal diseases on hemodialysis have a high prevalence of hepatitis C infection (HCV). In most patients, treatment for HCV is delayed until postrenal transplant. We assessed the effectiveness and tolerance of ledipasvir/sofosbuvir (LDV/SOF) in 32 postkidney transplant patients infected with HCV. The group was composed predominantly of treatment-naïve (75%) African American (68.75%) males (75%) infected with genotype 1a (62.5%). Most patients received a deceased donor kidney graft (78.1%). A 96% sustained viral response (SVR) was reported (27/28 patients). One patient relapsed. One patient with baseline graft dysfunction developed borderline rejection. No graft loss was reported. Six HIV-coinfected patients were included in our analysis. Five of these patients achieved SVR 12. There were four deaths, and one of the deaths was in the HIV group. None of the deaths were attributed to therapy. Coinfected patients tolerated therapy well with no serious adverse events. Serum creatinine remained stable at baseline, end of therapy, and last follow-up, (1.351±.50 mg/dL; 1.406±.63 mg/dL; 1.290±.39 mg/dL, respectively). In postkidney transplant patients with HCV infection with or without coinfection with HIV, a combination of LDV/SOF was well tolerated and effective. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of Optical Quality: Ocular Scattering and Aberrations in Eyes Implanted with Diffractive Multifocal or Monofocal Intraocular Lenses.

PubMed

Liao, Xuan; Lin, Jia; Tian, Jing; Wen, BaiWei; Tan, QingQing; Lan, ChangJun

2018-06-01

To compare objective optical quality, ocular scattering and aberrations of eyes implanted with an aspheric monofocal intraocular lens (IOL) or an aspheric apodized diffractive multifocal IOL three months after surgery. Prospective consecutive nonrandomized comparative cohort study. A total of 80 eyes from 57 cataract patients were bilaterally or unilaterally implanted with monofocal (AcrySof IQ SN60WF) or multifocal (AcrySof IQ ReSTOR SN6AD1) IOLs. Respectively, 40 eyes of 27 patients were implanted with monofocal IOLs, and 40 eyes of 30 patients were implanted with multifocal IOLs. Ocular high-order aberration (HOA) values were obtained using Hartmann-Shack aberrometer; objective scatter index (OSI), modulation transfer function (MTF) cutoff, Strehl ratio (SR), and contrast visual acuity OV at 100%, 20%, and 9% were measured using Objective Quality Analysis System II (OQAS II). Ocular aberrations performed similar in both groups (p > 0.05). However, significantly higher values of OSI and lower values of MTF cutoff, SR and OV were found in the SN6AD1 group (p < 0.05). Both ocular scattering and wave-front aberrations play essential role in retinal image quality, which may be overestimated when only aberrations were taken into account. Combining the effect of ocular scattering with HOA will result in a more accurate assessment of the visual and optical quality.

SOF as a Learning Organization

DTIC Science & Technology

2012-06-01

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

AGARD Flight Test Techniques Series. Volume 9. Aircraft Exterior Noise Measurement and Analysis Techniques. (Le Bruit a l’Exterieur des Aeronefs: Techniques de Mesure et d’Analyse)

DTIC Science & Technology

1991-04-01

aircraft Fig. 4.6 Airborne test set-up to compare several microphone/nose-cone arrangements for self -noise generation on a glider plane Fig. 4.7 Comparison...of normalized self -noise spectra of ogive-nose-cone equipped condenser-microphones of different diameters F!g. 4.8 Frequency splitting in the noise...output is obtained at the last com-poet ot the sub-system. The electrical respose of the entire system is then the arithmetic Sof the ildividual respnsem

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

DTIC Science & Technology

1996-03-11

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

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

PubMed

Cariou, J-L

2007-08-01

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

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

PubMed

McCown, Michael; Grzeszak, Benjamin

2010-01-01

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

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

PubMed

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

2010-01-15

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

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

DOE Data Explorer

Kristin Persson

2014-07-09

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

Oxygen Toxicity and Special Operations Forces Diving: Hidden and Dangerous

PubMed Central

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

2017-01-01

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

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

PubMed

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

2016-06-01

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

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

PubMed

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

2015-01-01

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

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

PubMed

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

2018-06-01

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

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

PubMed

Ammar, David A; Kahook, Malik Y

2011-10-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Strontium Removal: Full-Scale Ohio Demonstrations

EPA Science Inventory

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

RAF and SOF Integration

DTIC Science & Technology

2015-02-01

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

Biochar Improves Performance of Plants for Mine Soil Revegetation

EPA Science Inventory

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2017-08-01

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

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

PubMed

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

2017-01-01

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

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

PubMed

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

2017-11-01

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

Steady-State Diffusion of Water through Soft-Contact LensMaterials

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

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

2005-01-31

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

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

PubMed Central

Goel, Amit; Singh, Atul; Gupta, Tarun

2017-01-01

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

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

PubMed

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

2018-06-19

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

Two-thirds of foods consumed on myplate contain SoFAS

USDA-ARS?s Scientific Manuscript database

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

Reorganizing SOF for Irregular Warfare

DTIC Science & Technology

2008-12-01

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

Out of the Blue: NATO SOF Air Wing

DTIC Science & Technology

2012-03-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-05-01

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

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

PubMed

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

2014-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-07-01

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

Surface geometry of three packable and one hybrid composite after polishing.

PubMed

Jung, Martin; Bruegger, Hilka; Klimek, Joachim

2003-01-01

This study evaluated the surface quality of four composite materials after polishing with six different polishing techniques. Eighty specimens were made using three packable composites (Definite/Degussa, SureFil/ Dentsply and Solitaire/Heraeus-Kulzer) and one hybrid composite (Herculite XRV/Kerr). Five specimens of each material were polished using flexible Sof-Lex discs. The remaining 75 specimens of each composite were prepared using three finishing protocols: a single 30 microm diamond (n = 25), two finishing diamonds (30/20 microm; n = 25) and a 30 microm diamond followed by a tungsten carbide finishing bur (n = 25). Final polishing of each of the three finishing groups was accomplished with SuperBuff, Diafix-oral, OneGloss, Astropol and HaWe Composite Polishers (n = 5, each). Surface roughness was evaluated quantitatively by laser-stylus profilometry. Average roughness (R(a)) was calculated; statistical analysis of the data was performed with two-way ANOVA and Scheffé post-hoc tests. The polished surfaces were examined qualitatively by SEM. The results showed significant effects on surface roughness from the different composites (p = 0.011) and polishing systems (p < 0.001). After polishing, the Solitaire surfaces (R(a) = 0.72 microm) were smoother than Definite (R(a) = 0.87 microm) and SureFil (R(a) = 0.89 microm) and significantly smoother than Herculite (R(a) = 0.92 microm; p = 0.011). Three of the polishing methods (SuperBuff, Diafix-oral and Astropol) achieved lower R(a)-values than Sof-Lex discs. The polishing quality of the one-step systems SuperBuff and Diafix-oral was strongly affected by the initial finishing protocol.

Joint Force Quarterly. Number 2, Autumn 1993

DTIC Science & Technology

1993-09-01

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

Registration of "MSU E5024" wheat

USDA-ARS?s Scientific Manuscript database

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

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

DTIC Science & Technology

2011-03-01

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

SOF: A Joint Force Integrator

DTIC Science & Technology

2007-04-05

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

Collective Defense of the Baltic States: A SOF Beginning

DTIC Science & Technology

2012-03-20

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

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

DTIC Science & Technology

2003-08-01

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

Roles for SOF in a Staggering Nigeria

DTIC Science & Technology

2009-04-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-07-01

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

Reliability and validity of abbreviated surveys derived from the National Eye Institute Visual Function Questionnaire: The Study of Osteoporotic Fractures

PubMed Central

Gergana, Kodjebacheva; Coleman, Anne L.; Ensrud, Kristine E.; Cauley, Jane A.; Yu, Fei; Stone, Katie L.; Pedula, Kathryn L.; Hochberg, Marc C.; Mangione, Carol M.

2010-01-01

Purpose To test the reliability and validity of questionnaires shortened from the National Eye Institute 25-item Vision Function Questionnaire (NEI VFQ-9 and NEI VFQ-8). Design A cross-sectional multi-center cohort study. Methods Reliability was assessed by Cronbach alpha coefficients. Validity was evaluated by studying the association of vision-targeted quality-of-life composite scores with objective visual function measurements. Study population: A total of 5,482 women between the ages of 65 and 100 years participated in the Year-10 clinic visit in the Study of Osteoporotic Fractures (SOF). A total of 3,631 women with complete data were included in the visual acuity (VA) and visual field (VF) analysis of the NEI VFQ-9, which is defined for those who care to drive. and 5,311 in the analysis of the NEI VFQ-8. To assess differences in prevalent eye diseases, which were ascertained for a random sample of SOF participants, 853 and 1,237 women were included in the NEI VFQ-9 and the NEI VFQ-8 analyses, respectively. Results Cronbach alpha coefficient for the NEI VFQ-9 scale was 0.83 and that of the NEI VFQ-8 was 0.84. Using both questionnaires, women with VA worse than 20/40 had lower composite scores compared to those with VA 20/40 or better (p<0.001). Participants with mild, moderate, and severe binocular VF loss had lower composite scores compared to those with no binocular VF loss (p<0.001).Compared to women without chronic eye diseases in both eyes, women with at least one chronic eye disease in at least one eye had lower composite scores. Conclusions Both questionnaires showed high reliability across items and validity with respect to clinical markers of eye disease Future research should compare the properties of these shortened surveys to those of the NEI VFQ-25. PMID:20103058

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

DTIC Science & Technology

2005-03-25

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

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

DTIC Science & Technology

2002-02-06

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

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

DTIC Science & Technology

2006-06-20

the Kamehameha (SSBN-642) — two older-generation SSBNs that were converted into SSNs specifically for supporting larger numbers of SOF personnel...The Polk was retired in 1999 at age 33; the Kamehameha was retired in 2002 at age 36. The report of the 2001 Quadrennial Defense Review, submitted to

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

DTIC Science & Technology

2008-05-22

the Kamehameha (SSBN-642) — two older-generation SSBNs that were converted into SSNs specifically for supporting larger numbers of SOF personnel. The...Polk was retired in 1999 at age 33; the Kamehameha was retired in 2002 at age 36. Trident SSGNs and Navy Transformation. The Bush Administration and

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

DTIC Science & Technology

2008-10-02

the Kamehameha (SSBN-642) — two older-generation SSBNs that were converted into SSNs specifically for supporting larger numbers of SOF personnel. The...Polk was retired in 1999 at age 33; the Kamehameha was retired in 2002 at age 36. Trident SSGNs and Navy Transformation. The Bush Administration and

Enduring Engagement Yes, Episodic Engagement No: Lessons for SOF from Mali

DTIC Science & Technology

2013-12-01

ammunition cans. Even the non- rusted ammunition failed to reliably ignite due to prolonged exposure to the elements. 59 Weapons in Mali fall under the...In the personnel protection category, body armor for the unit was cut to fifty pieces— barley enough for a third of the ground element. Examples such

East Europe Report, Political, Sociological and Military Affairs, No. 2175.

DTIC Science & Technology

1983-08-02

remained a working chemist. He has a small laboratory in the basement of his family home and produces toilet water and shampoo for the family’s...of 8 November 1982 the communique stated: "The premier and the primate made a survey of the present situation in the country and expressed common

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

PubMed

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

2013-01-01

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

[Experimental study on characteristics of biodiesel exhausted particle].

PubMed

Ge, Yun-shan; He, Chao; Han, Xiu-kun; Wu, Si-jin; Lu, Xiao-ming

2007-07-01

A particle emission experiment of a direct-injection turbocharged diesel engine with biodiesel and diesel was carried out. A pump of 80 L/min and fiber glass filters with diameter of 90 mm was used to sample engine particles in exhaust pipe. The size distribution, soluble organic fraction (SOF) and 16 polycyclic aromatic hydrocarbons (PAHs) of particles were analyzed by a laser diffraction particle size analyzer and GC-MS. The results indicate that the volume weighted size distribution of biodiesel particle is single-peak and its median diameter d(0.5) and mean diameter d32 are decreased with the increasing speed. At the high speed the d32 and d(0.5) of biodiesel are larger than those of diesel, and quite the contrary at the low speed. SOF mass concentration and mass percentage of biodiesel are 12.3 - 31.5 mg/m3 and 38.2% - 58.0% respectively, which are much higher than those of diesel. The total PAHs emission concentration of biodiesel is 2.9 - 4.7 microg/m3 lower than that of diesel as much as 29.1% - 92.4%.

Effectiveness of interferon-free therapy for the treatment of HCV-patients with compensated cirrhosis treated through the Irish early access program.

PubMed

Gray, E; O'Leary, A; Bergin, C; Cannon, M; Courtney, G; Crosbie, O; De Gascun, C F; Fanning, L J; Feeney, E; Houlihan, D D; Kelleher, B; Lambert, J S; Lee, J; Mallon, Pwg; McConkey, S; McCormick, A; McKiernan, S; McNally, C; Murray, F; Sheehan, G; Stewart, S; Walsh, C; Norris, S

2017-06-01

We investigated the real-world effectiveness of interferon-free regimens for the treatment of patients with compensated cirrhosis infected with hepatitis C virus (HCV). Using the Irish national HCV treatment registry, the effectiveness and safety of interferon-free regimens for HCV-infected patients treated between April 2015 and August 2016, was determined. A SVR12 was achieved in 86% of subjects treated with sofosbuvir/ledipasvir ± ribavirin (SOF/LDV±RBV), 93% treated with paritaprevir, ombitasvir and ritonavir combined with dasabuvir ± ribavirin (3D±RBV) and 89% treated with sofosbuvir/daclatasvir ± ribavirin (SOF/DCV±RBV). The discontinuation rate was 5% and the on-treatment mortality rate was 1%. The availability of interferon-free regimens represents a significant breakthrough for the treatment of HCV infection. Treatments options, with high SVR12 rates, are now available for patients with compensated cirrhosis who were unsuitable for treatment with interferon-based regimens. Data obtained from studies conducted in real world practice provide robust information fundamental for input into future economic evaluations for agents used for the treatment of HCV infection.

Influence of Finishing and Polishing Techniques and Abrasion on Transmittance and Roughness of Composite Resins.

PubMed

Carneiro, Pma; Ramos, T M; de Azevedo, C S; de Lima, E; de Souza, Shj; Turbino, M L; Cesar, P F; Matos, A B

The aim of this study was to evaluate the influence of finishing and polishing systems and toothbrush abrasion on transmittance (T) and surface roughness (Ra) of three composite resins (Filtek Z350 XT, Tetric N-Ceram, and IPS Empress Direct). Eighteen resin disks (10 mm diameter × 2 mm thick) finished by polyester strips had initial surface smoothness recorded, representing phase 1 (P1). Specimens were divided into three groups (n=6) according to the finishing/polishing instrument used (OneGloss, TopGloss, and Sof-Lex) to compose phase 2 samples (P2). Then specimens were subjected to 514 cycles of toothbrush simulation using a toothpaste slurry, with a constant load applied to soft bristles, and were then washed (phase 3=P3). After each phase, the specimens were examined by an optical profiler and spectrophotometer to measure Ra and T. Data were analyzed by analysis of variance, Tukey and Pearson tests. T values were statistically influenced by composite resin ( p=0.000) and phase of measurement ( p=0.000) factors, while the finishing/polishing system used ( p=0.741) did not affect T. On the other hand, Ra values were statistically affected by the factor finishing/polishing system ( p=0.000), but not by composite resin ( p=0.100) and phase of measurement ( p=0.451). Tetric N-Ceram and Empress Direct presented higher values of roughness when polished by OneGloss, while TopGloss and Sof-Lex showed a lower roughness. It can be concluded that composite resins transmitted more light after dental abrasion. Transmittance of composite resins was not modified by the distinct roughness created by finishing/polishing instruments.

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

PubMed

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

2015-01-01

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

The relationship between different settings of medical service and incident frailty.

PubMed

Bolzetta, Francesco; Wetle, Terrie; Besdine, Richard; Noale, Marianna; Cester, Alberto; Crepaldi, Gaetano; Maggi, Stefania; Veronese, Nicola

2018-07-15

Some studies have reported a potential association between usual source of health care and disability, but no one has explored the association with frailty, a state of early and potential reversible disability. We therefore aimed to explore the association between older persons' self-reported usual source of health care at baseline and the onset of frailty. Information regarding usual source of health care was captured through self-report and categorized as 1) private doctor's office, 2) public clinic, 3) Health Maintenance Organization (HMO), or 4) hospital clinic/emergency department (ED). Frailty was defined using the Study of Osteoporotic Fracture (SOF) index as the presence of at least two of the following criteria: (i) weight loss ≥5% between baseline and any subsequent follow-up visit; (ii) inability to do five chair stands; and (iii) low energy level according to the SOF definition. Multivariable Cox's regression analyses, calculating hazard ratios (HRs) with 95% confidence intervals (CIs), were undertaken. Of the 4292 participants (mean age: 61.3), 58.7% were female. During the 8-year follow-up, 348 subjects (8.1% of the baseline population) developed frailty. Cox's regression analysis, adjusting for 14 potential confounders showed that, compared to those using a private doctor's office, people using a public clinic for their care had a significantly higher risk of developing frailty (HR = 1.56; 95%CI: 1.07-2.70), similar to those using HMO (HR = 1.48; 95%CI: 1.03-2.24) and those using a hospital/ED (HR = 1.76; 95%CI: 1.03-3.02). Participants receiving health care from sources other than private doctors are at increased risk of frailty, highlighting the need for screening for frailty in these health settings. Copyright © 2018 Elsevier Inc. All rights reserved.

[Evaluation of Postoperative Astigmatism Correction and Postoperative Rotational Stability of Two Toric Intraocular Lenses].

PubMed

Grohlich, M; Miháltz, K; Lasta, M; Weingessel, B; Vécsei-Marlovits, V

2017-06-01

Background The aim of this retrospective study was to evaluate the rotational stability and the refractive outcome of two different toric IOLs. Methods This study included 41 eyes with corneal astigmatism greater than 1.5 diopters (D). All patients underwent surgery in the Department of Ophthalmology at Hietzing Hospital between 2010 and 2013. The study lenses were the Alcon AcrySof IQ Toric IOL and the Abbott Tecnis Toric Aspheric IOL. Measurements of corneal topography and aberrations were performed with the HOYA iTrace™. Determination of visual acuity was performed with ETDRS charts. Optical aberrations were represented by Zernike coefficients, and optical quality was assessed with the Strehl ratio. Results Mean rotation was 4.92° (standard deviation: ± 4.10°) in the Alcon group and 4.31° (± 4.59°) in the Abbott group. No significant difference was observed between the two toric intraocular lenses. Rotational stability was comparable to results from other studies. Astigmatism correction was visualised with a power-vector analysis, which demonstrated similar results in both lenses and a clear success of astigmatism correction. No statistically significant differences were found in residual refractive astigmatism, which was 0.85 ± 0.48 D in the Alcon group and 1.09 ± 0.66 in the Tecnis group. No significant difference between the two groups was found in the Strehl ratio. Conclusion Implantation of toric intraocular lenses (Alcon + Abbott) in patients with regular astigmatism is an effective and safe method, which should be offered to patients. Both the Tecnis and the AcrySof toric IOLs similarly reduced ocular astigmatism. Georg Thieme Verlag KG Stuttgart · New York.

Effect of astigmatism on visual acuity in eyes with a diffractive multifocal intraocular lens.

PubMed

Hayashi, Ken; Manabe, Shin-Ichi; Yoshida, Motoaki; Hayashi, Hideyuki

2010-08-01

To examine the effect of astigmatism on visual acuity at various distances in eyes with a diffractive multifocal intraocular lens (IOL). Hayashi Eye Hospital, Fukuoka, Japan. In this study, eyes had implantation of a diffractive multifocal IOL with a +3.00 diopter (D) addition (add) (AcrySof ReSTOR SN6AD1), a diffractive multifocal IOL with a +4.00 D add (AcrySof ReSTOR SN6AD3), or a monofocal IOL (AcrySof SN60WF). Astigmatism was simulated by adding cylindrical lenses of various diopters (0.00, 0.50, 1.00, 1.50, 2.00), after which distance-corrected acuity was measured at various distances. At most distances, the mean visual acuity in the multifocal IOL groups decreased in proportion to the added astigmatism. With astigmatism of 0.00 D and 0.50 D, distance-corrected near visual acuity (DCNVA) in the +4.00 D group and distance-corrected intermediate visual acuity (DCIVA) and DCNVA in the +3.00 D group were significantly better than in the monofocal group; the corrected distance visual acuity (CDVA) was similar. The DCNVA with astigmatism of 1.00 D was better in 2 multifocal groups; however, with astigmatism of 1.50 D and 2.00 D, the CDVA and DCIVA at 0.5m in the multifocal groups were significantly worse than in the monofocal group, although the DCNVA was similar. With astigmatism of 1.00 D or greater, the mean CDVA and DCNVA in the multifocal groups reached useful levels (20/40). The presence of astigmatism in eyes with a diffractive multifocal IOL compromised all distance visual acuities, suggesting the need to correct astigmatism of greater than 1.00 D. No author has a financial or proprietary interest in any material or method mentioned. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Moderate Sustained Virologic Response Rates With 6-Week Combination Directly Acting Anti-Hepatitis C Virus Therapy in Patients With Advanced Liver Disease.

PubMed

Kattakuzhy, Sarah; Wilson, Eleanor; Sidharthan, Sreetha; Sims, Zayani; McLaughlin, Mary; Price, Angie; Silk, Rachel; Gross, Chloe; Akoth, Elizabeth; McManus, Maryellen; Emmanuel, Benjamin; Shrivastava, Shikha; Tang, Lydia; Nelson, Amy; Teferi, Gebeyehu; Chavez, Jose; Lam, Brian; Mo, Hongmei; Osinusi, Anuoluwapo; Polis, Michael A; Masur, Henry; Kohli, Anita; Kottilil, Shyamasundaran

2016-02-15

Treatment of genotype 1 hepatitis C virus (HCV) infection with combination directly acting antivirals (DAA) for 8-24 weeks is associated with high rates of sustained virologic response (SVR). We previously demonstrated that adding a third DAA to ledipasvir and sofosbuvir (LDV/SOF) can result in high SVR rates in patients without cirrhosis. In this study, we investigated whether a similar regimen would yield equivalent rates of cure in patients with advanced liver fibrosis. Fifty patients were enrolled at the Clinical Research Center of the National Institutes of Health and associated healthcare centers. Enrollment and follow-up data from April 2014 to June 2015 are reported here. Eligible participants were aged ≥18 years, had chronic HCV genotype 1 infection (serum HCV RNA ≥2000 IU/mL), and stage 3-4 liver fibrosis. HCV RNA was measured using a reverse-transcription polymerase chain reaction assay. Of patients treated with LDV, SOF, and the NS3/4A protease inhibitor GS-9451 for 6 weeks, 76% (38 of 50; 95% confidence interval, 60%-85%) had SVR achieved 12 weeks after the end of treatment. There was no statistically significant difference in treatment efficacy between treatment-naive patients (72%, 18 of 25) and those with treatment experience (80%; 20 of 25) (P = .51). Overall, 11 patients (22%) experienced virologic relapse, and 1 (2%) was lost to follow-up at 4 weeks after treatment. No serious adverse events, discontinuations, or deaths were associated with this regimen. Adding a third DAA to LDV/SOF may result in a moderate SVR rate, lower than that observed in patients without cirrhosis. Significant liver fibrosis remains an impediment to achieving SVR with short-duration DAA therapy. CT01805882. Published by Oxford University Press for the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Ledipasvir/sofosbuvir regimens for chronic hepatitis C infection: Insights from a work productivity economic model from the United States.

PubMed

Younossi, Zobair M; Jiang, Yushan; Smith, Nathaniel J; Stepanova, Maria; Beckerman, Rachel

2015-05-01

Patients with chronic hepatitis C (CHC) exhibit reduced work productivity owing to their disease. Historically, most regimens indicated for CHC genotype 1 (GT1) patients were administered with pegylated interferon (Peg-IFN) and/or ribavirin (RBV), which further compromised work productivity during treatment. The aim of this study was to model the impact of LDV/SOF (ledipasvir/sofosbuvir), the first Peg-IFN- and RBV-free regimen for CHC GT1 patients, on work productivity from an economic perspective, compared to receiving no treatment. The WPAI-SHP (Work Productivity and Activity Index-Specific Health Problem) questionnaire was administered to patients across the ION clinical trials (N = 1,923 U.S. patients). Before initiation of treatment, patients with CHC GT1 in the ION trials exhibited absenteeism and presenteeism impairments of 2.57% and 7.58%, respectively. Patients with cirrhosis exhibited greater work productivity impairment than patients without cirrhosis. In total, 93.21% of U.S. patients in the ION trials achieved SVR; these patients exhibited absenteeism and presenteeism impairments of 2.62% (P = 0.76, when compared to baseline) and 3.53% (P < 0.0001), respectively. Monetizing these data to the entire U.S. population, our model projects an annual societal cost of $7.1 billion owing to productivity loss in untreated GT1 CHC patients. Our model projects that, when compared to no treatment, treating all CHC GT1 patients with a regimen with very high viral eradication rates (LDV/SOF) would translate to annual productivity loss savings of $2.7 billion over a 1-year time horizon. Patients with untreated HCV impose a substantial societal burden owing to reduced work productivity. As a result of improvements in work productivity, treatment of CHC GT1 patients with LDV/SOF-based regimens is likely to result in significant cost savings from a societal perspective, relative to no treatment. © 2015 by the American Association for the Study of Liver Diseases.

Tribal lands provide forest management laboratory for mainstream university students

Treesearch

Serra J. Hoagland; Ronald Miller; Kristen M. Waring; Orlando Carroll

2017-01-01

Northern Arizona University (NAU) faculty and Bureau of Indian Affairs (BIA) foresters initiated a partnership to expose NAU School of Forestry (SoF) graduate students to tribal forest management practices by incorporating field trips to the 1.68-million acre Fort Apache Indian Reservation as part of their silviculture curriculum. Tribal field trips were contrasted and...

The Project Coordinators: A Key to the School of the Future.

ERIC Educational Resources Information Center

Iscoe, Louise K.

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project. This booklet reports on one aspect of the…

Challenges and Realities: Evaluating a School-Based Service Project.

ERIC Educational Resources Information Center

Keir, Scott S.; Millea, Susan

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project to show the process used and the outcomes that…

Parent Volunteer Program. School of the Future: San Antonio.

ERIC Educational Resources Information Center

Iscoe, Louise

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project. This booklet focuses on the Parent Volunteer…

A Community Catalyst. School of the Future: Austin.

ERIC Educational Resources Information Center

Iscoe, Louise

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

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

DTIC Science & Technology

2011-04-28

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

Establish Best Practices for Supervision of Instructors

DTIC Science & Technology

2012-09-01

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

Field capture of Thyanta perditor with pheromone-baited traps and cross-attraction to other pentatomids

USDA-ARS?s Scientific Manuscript database

In Brazil, Thyanta perditor is one of the stink bugs attacking soybean and also could be found on others crops such as wheat, sunflower and sorghum. The objective of this work was to test the field attractiveness of traps baited with synthetic T. perditor pheromone. Two-liter transparent plastic sof...

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

DTIC Science & Technology

2016-06-01

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

[Breast augmentation by implants: a review of surgical practices. A study among French plastic surgeons].

PubMed

Chekaroua, K; Delay, E

2005-10-01

In the framework of the 2005 report on mammary implants prepared by the Société française de chirurgie plastique reconstructrice et esthétique (SOF.CPRE), we conducted a survey among french plastic surgeons involved in the field. We elaborated a questionnaire that we distributed twice to the 600 members of the society; a total of 261 responded. Analysis of the data collected provides information on the socioprofessional characteristics of the responding surgeons, and on the devices, products and techniques they use. Finally, the survey has permitted to identify their qualitative perception of breast implant products currently available. Ranking these items by order of frequency provides a snapshot of the current procedures and practices in use for breast augmentation surgery in France.

A Blueprint for School-Based Services. School of the Future: Dallas.

ERIC Educational Resources Information Center

Iscoe, Louise

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

Revisiting the School of the Future: The Evolution of a School-Based Services Project.

ERIC Educational Resources Information Center

Iscoe, Louise K.; Keir, Scott S.

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

China Report, Red Flag, Number 1, 1 January 1985

DTIC Science & Technology

1985-03-05

li0dSOf,the thlrd’ f°Urth’ and the fifth e^ elon . It is impossible for them to change. In recent times I have always told foreign guests that the...people sell hides, musk , and other articles to Han people in exchange for cloth and salt. The Yi costumes are completely different from the Han

Thickening the Global SOF Network

DTIC Science & Technology

2013-12-01

in thought, and regulate both positive and negative emotions in oneself and others. EI is a necessary, but not fully sufficient, quality Green...assimilate emotions in thought, and regulate both positive and negative emotions in oneself and others. EI is a necessary, but not fully sufficient...both positive and negative emotions in oneself and others. B. THE HISTORY AND CONTROVERSY SURROUNDING EMOTIONAL INTELLIGENCE Since its first

The Examination of the Aluminum Alloy 7017 as a Replacement for the Aluminum Alloy 7039 in Lightweight Armor Systems

DTIC Science & Technology

2016-07-01

ORGANIZATION REPORT NUMBER ARL-TR-7727 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10 . SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S...of 0.50-cal. FSP vs. AA7017 plate at 0° .......................................................................................................... 10 ... 10 List of Tables Table 1 Chemical composition, weight percent

STRUCTURES, ROTATION BARRIER AND THERMODYNAMIC PROPERTIES DHOF 298, SOF 298, AND CP(T) OF CHLORO-METHYL HYPOCHLORITES: CHO3CL, CH2CLOCL, CHCL2OCL AND CCL3OCL. (R824970)

EPA Science Inventory

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

USSOCOM Research Topics 2012

DTIC Science & Technology

2012-01-01

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

GRADE guidelines: 10. Considering resource use and rating the quality of economic evidence.

PubMed

Brunetti, Massimo; Shemilt, Ian; Pregno, Silvia; Vale, Luke; Oxman, Andrew D; Lord, Joanne; Sisk, Jane; Ruiz, Francis; Hill, Suzanne; Guyatt, Gordon H; Jaeschke, Roman; Helfand, Mark; Harbour, Robin; Davoli, Marina; Amato, Laura; Liberati, Alessandro; Schünemann, Holger J

2013-02-01

In this article, we describe how to include considerations about resource utilization when making recommendations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. We focus on challenges with rating the confidence in effect estimates (quality of evidence) and incorporating resource use into evidence profiles and Summary of Findings (SoF) tables. GRADE recommends that important differences in resource use between alternative management strategies should be included along with other important outcomes in the evidence profile and SoF table. Key steps in considering resources in making recommendations with GRADE are the identification of items of resource use that may differ between alternative management strategies and that are potentially important to decision makers, finding evidence for the differences in resource use, making judgments regarding confidence in effect estimates using the same criteria used for health outcomes, and valuing the resource use in terms of costs for the specific setting for which recommendations are being made. With our framework, decision makers will have access to concise summaries of recommendations, including ratings of the quality of economic evidence, and better understand the implications for clinical decision making. Copyright © 2013 Elsevier Inc. All rights reserved.

LMI-based adaptive reliable H∞ static output feedback control against switched actuator failures

NASA Astrophysics Data System (ADS)

An, Liwei; Zhai, Ding; Dong, Jiuxiang; Zhang, Qingling

2017-08-01

This paper investigates the H∞ static output feedback (SOF) control problem for switched linear system under arbitrary switching, where the actuator failure models are considered to depend on switching signal. An active reliable control scheme is developed by combination of linear matrix inequality (LMI) method and adaptive mechanism. First, by exploiting variable substitution and Finsler's lemma, new LMI conditions are given for designing the SOF controller. Compared to the existing results, the proposed design conditions are more relaxed and can be applied to a wider class of no-fault linear systems. Then a novel adaptive mechanism is established, where the inverses of switched failure scaling factors are estimated online to accommodate the effects of actuator failure on systems. Two main difficulties arise: first is how to design the switched adaptive laws to prevent the missing of estimating information due to switching; second is how to construct a common Lyapunov function based on a switched estimate error term. It is shown that the new method can give less conservative results than that for the traditional control design with fixed gain matrices. Finally, simulation results on the HiMAT aircraft are given to show the effectiveness of the proposed approaches.

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

PubMed

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

2017-03-01

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

Water's Way at Sleepers River watershed - revisiting flow generation in a post-glacial landscape, Vermont USA

Treesearch

James B. Shanley; Stephen D. Sebestyen; Jeffrey J. McDonnell; Brian L. McGlynn; Thomas Dunne

2015-01-01

The Sleepers River Research Watershed (SRRW) in Vermont, USA, has been the site of active hydrologic research since 1959 and was the setting where Dunne and Black demonstrated the importance and controls of saturation-excess overland flow (SOF) on streamflow generation. Here, we review the early studies from the SRRW and show how they guided our conceptual approach to...

Teamharmony: Employing Matchmaking Algorithms to Team-Building

DTIC Science & Technology

2017-12-01

Army1 A. HUMAN CHEMISTRY Within groups of people , there exists the powerful social phenomenon known as human chemistry. Although many definitions...which occur when two or more people interact, and cause the resulting relationship to be positively cohesive or toxic. Much like the weather, human...use experiential intuition when staffing teams. Apart from SOF units, there are no systems in place to gauge psychological makeup. Figure 2

Long-Term Counterinsurgency Strategy: Maximizing Special Operations and Airpower

DTIC Science & Technology

2010-02-01

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

The Strategic Rationale for Special Operations Forces Employment

DTIC Science & Technology

1991-06-07

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

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

DTIC Science & Technology

2010-04-01

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

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

DTIC Science & Technology

2011-06-01

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

Coast Guard SOF

DTIC Science & Technology

2006-02-01

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

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

DTIC Science & Technology

1998-12-01

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

A SOF Damage Control Resuscitation Cocktail

DTIC Science & Technology

2015-05-01

include Hextend for volume resuscitation and tissue perfusion, fibrinogen concentrate for hemostasis, and tranexamic acid for hemostasis. These...for hemostasis, and tranexamic acid for hemostasis. These components are tested in a combat-relevant swine polytrauma model of hemorrhagic shock with...HexVasoCntl HexVasoAlb Ctrl 4 4 would not allow adequate blood loss from the aortic tear, preventing testing of fibrinogen and tranexamic acid as

Prevention of Human Mammary Carcinogenesis.

DTIC Science & Technology

1996-07-01

eicosapentaenoic acid (EPA), indole-3-carbinol (13C), 0-carotene (P3-C), (-) epigallocatechin gallate ( EGCG ) and genistein (GEN) effectively down...Alteration in Cell Cycle Progression of 184-B5/HER Cells by (-) Epigallocatechin Gallate ( EGCG ) status % distribution of cellsb, c- ac Sof treatm enta... epigallocatechin gallate ( EGCG ,a green tea polyphenol), indole-3-carbinol (13C,a plant indole) and genistein (GEN,a soy isoflavone) showed differential

Military Review: SOF/LIC

DTIC Science & Technology

1991-06-01

ment strategic environment and concludes that the United States must "integratedly and direct- ly act.., when vital global balances are truly...recognizes no borders and underdeveloped countries. The euphoria in- respects no government. Increasingly, drug car- duced by improved relations with...respond if peaceful solu- balance far more dynamic than it has been for tions fail. more than 40 years. In addition, little has been The United States

Investigation of anti-Hepatitis C virus, sofosbuvir and daclatasvir, in pure form, human plasma and human urine using micellar monolithic HPLC-UV method and application to pharmacokinetic study.

PubMed

Zidan, Dalia W; Hassan, Wafaa S; Elmasry, Manal S; Shalaby, Abdalla A

2018-06-01

Simultaneous determination of sofosbuvir (SOF), and daclatasvir (DAC) in their dosage forms, human urine and human plasma using simple and rapid micellar high performance liquid chromatographic method coupled with UV detection (HPLC-UV) had been developed and validated. These drugs are described as co-administered for treatment of Hepatitis C virus (HCV). HCV is the cause of Hepatitis C and some cancers such as liver cancer (hepatocellular carcinoma) and lymphomas in humans. Separation and quantitation were carried out on anonyx™ C 8 monolithic (100 × 4.6 mm (i.d.) analytical column maintained at 25 °C. The mobile phase consisted of 0.1 M sodium dodecyl sulfate (SDS) solution containing 20% (V/V) n-propanolol and 0.3% (V/V) triethylamine and pH was adjusted to 6.5 using 0.02 M phosphoric acid, respectively. The retention times of SOF and DAC were 4.8 min, and 6.5 min, respectively. Measurements were made at flow rate of 0.5 mL/min with injection volume of 20 μL and ultraviolet (UV) detection at 226 nm. Linearity of SOF and DAC was obtained over concentration ranges of 50-400, and 40-400 ng/mL, respectively in pure form, 60-300 and 50-300 ng/mL, respectively for human plasma and over 50-400, and 40-400 ng/mL, respectively for human urine with correlation coefficient >0.999. The proposed method demonstrated excellent intra- and inter-day precision and accuracy. The suggested method was applied for determination of the drugs in pure, dosage form, and in real human plasma, real human urine and drug-dissolution test of their tablets. The obtained results have been statistically compared to reported method to give a conclusion that there is no significant differences. Copyright © 2018 Elsevier B.V. All rights reserved.

Real-world effectiveness of ledipasvir/sofosbuvir in 4,365 treatment-naive, genotype 1 hepatitis C-infected patients.

PubMed

Backus, Lisa I; Belperio, Pamela S; Shahoumian, Troy A; Loomis, Timothy P; Mole, Larry A

2016-08-01

Real-world effectiveness data are needed to inform hepatitis C virus (HCV) treatment decisions. The uptake of ledipasvir/sofosbuvir (LDV/SOF) regimens across health care settings has been rapid, but variations often occur in clinical practice. The aim of this study was to assess sustained virologic response (SVR) of LDV/SOF±ribavirin (RBV) in routine medical practice. This observational, intent-to-treat cohort was comprised of 4,365 genotype 1, treatment-naive, HCV-infected veterans treated with LDV/SOF±RBV. SVR rates were 91.3% (3,191/3,495) for LDV/SOF and 92.0% (527/573) for LDV/SOF+RBV (P = 0.65). African American race (odds ratio 0.70, 95% confidence interval 0.54-0.90, P  = 0.004) and FIB-4 >3.25 (odds ratio 0.56, 95% confidence interval 0.43-0.71, P < 0.001) were independently associated with decreased likelihood of SVR; age, sex, body mass index, decompensated liver disease, diabetes, genotype 1 subtype, and regimen did not predict SVR. In models limited to those who completed 12 weeks of treatment, African American race was no longer a significant predictor of SVR but FIB-4 >3.25 (odds ratio 0.35, 95% confidence interval 0.24-0.50, P < 0.001) remained. Among those without cirrhosis (defined by FIB-4 ≤3.25) and with baseline HCV RNA<6,000,000 IU/mL, SVR rates were 93.2% (1,020/1,094) for those who completed 8 weeks of therapy and 96.6% (875/906) for those who completed 12 weeks of therapy (P = 0.001). In this real-world cohort, SVR rates with LDV/SOF±RBV nearly matched the rates reported in clinical trials and were consistently high across all subgroups; those without cirrhosis but with HCV RNA<6,000,000 IU/mL were less likely to achieve SVR with 8 weeks compared to 12 weeks of therapy, although the numeric difference in SVR rates was small. (Hepatology 2016;64:405-414). Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Airborne measurements of ethene from industrial sources using laser photo-acoustic spectroscopy.

PubMed

De Gouw, J A; te Lintel Hekkert, S; Mellqvist, J; Warneke, C; Atlas, E L; Fehsenfeld, F C; Fried, A; Frost, G J; Harren, F J M; Holloway, J S; Lefer, B; Lueb, R; Meagher, J F; Parrish, D D; Patel, M; Pope, L; Richter, D; Rivera, C; Ryerson, T B; Samuelsson, J; Walega, J; Washenfelder, R A; Weibring, P; Zhu, X

2009-04-01

A laser photoacoustic spectroscopy (LPAS) instrument was developed and used for aircraft measurements of ethene from industrial sources near Houston, Texas. The instrument provided 20 s measurements with a detection limit of less than 0.7 ppbv. Data from this instrument and from the GC-FID analysis of air samples collected in flight agreed within 15% on average. Ethene fluxes from the Mt. Belvieu chemical complex to the northeast of Houston were quantified during 10 different flights. The average flux was 520 +/- 140 kg h(-1) in agreement with independent results from solar occultation flux (SOF) measurements, and roughly an order of magnitude higher than regulatory emission inventories indicate. This study shows that ethene emissions are routinely at levels that qualify as emission upsets, which need to be reported to regional air quality managers.

Can Reduced-Step Polishers Be as Effective as Multiple-Step Polishers in Enhancing Surface Smoothness?

PubMed

Kemaloglu, Hande; Karacolak, Gamze; Turkun, L Sebnem

2017-02-01

The aim of this study was to evaluate the effects of various finishing and polishing systems on the final surface roughness of a resin composite. Hypotheses tested were: (1) reduced-step polishing systems are as effective as multiple-step systems on reducing the surface roughness of a resin composite and (2) the number of application steps in an F/P system has no effect on reducing surface roughness. Ninety discs of a nano-hybrid resin composite were fabricated and divided into nine groups (n = 10). Except the control, all of the specimens were roughened prior to be polished by: Enamel Plus Shiny, Venus Supra, One-gloss, Sof-Lex Wheels, Super-Snap, Enhance/PoGo, Clearfil Twist Dia, and rubber cups. The surface roughness was measured and the surfaces were examined under scanning electron microscope. Results were analyzed with analysis of variance and Holm-Sidak's multiple comparisons test (p < 0.05). Significant differences were found among the surface roughness of all groups (p < 0.05). The smoothest surfaces were obtained under Mylar strips and the results were not different than Super-Snap, Enhance/PoGo, and Sof-Lex Spiral Wheels. The group that showed the roughest surface was the rubber cup group and these results were similar to those of the One-gloss, Enamel Plus Shiny, and Venus Supra groups. (1) The number of application steps has no effect on the performance of F/P systems. (2) Reduced-step polishers used after a finisher can be preferable to multiple-step systems when used on nanohybrid resin composites. (3) The effect of F/P systems on surface roughness seems to be material-dependent rather than instrument- or system-dependent. Reduced-step systems used after a prepolisher can be an acceptable alternative to multiple-step systems on enhancing the surface smoothness of a nanohybrid composite; however, their effectiveness depends on the materials' properties. (J Esthet Restor Dent 29:31-40, 2017). © 2016 Wiley Periodicals, Inc.

Nocturnal continuous glucose monitoring: accuracy and reliability of hypoglycemia detection in patients with type 1 diabetes at high risk of severe hypoglycemia.

PubMed

Bay, Christiane; Kristensen, Peter Lommer; Pedersen-Bjergaard, Ulrik; Tarnow, Lise; Thorsteinsson, Birger

2013-05-01

A reliable method to detect biochemical nocturnal hypoglycemia is highly needed, especially in patients with recurrent severe hypoglycemia. We evaluated reliability of nocturnal continuous glucose monitoring (CGM) in patients with type 1 diabetes at high risk of severe hypoglycemia. Seventy-two type 1 diabetes patients with recurrent severe hypoglycemia (two or more events within the last year) participated for 4 nights in blinded CGM recordings (Guardian(®) REAL-Time CGMS and Sof-Sensor(®); Medtronic MiniMed, Northridge, CA). Blood was drawn hourly from 23:00 to 07:00 h for plasma glucose (PG) measurements (gold standard). Valid data were obtained in 217 nights. The sensitivity of CGM was 65% (95% confidence interval, 53-77%) below 4 mmol/L, 40% (24-56%) below 3 mmol/L, and 17% (0-47%) below 2.2 mmol/L. PG and CGM readings correlated in the total measurement range (Spearman's ρ=0.82; P<0.001). In the normo- and hyperglycemic ranges CGM underestimated PG by 1.1 mmol/L (0.9-1.2 mmol/L) (P<0.001); in contrast, in the hypoglycemic range (PG<4 mmol/L) CGM overestimated PG levels by 1.0 mmol/L (P<0.001). The mean absolute relative differences in the hypo- (≤3.9 mmol/L), normo- (4-9.9 mmol/L), and hyperglycemic (≥10 mmol/L) ranges were 45% (37-53%), 23% (22-25%), and 20% (19-21%), respectively. Continuous glucose error grid analysis indicated a clinical accuracy of 56%, 99%, and 93% in the hypo-, normo-, and hyperglycemic ranges, respectively. The accuracy in the hypoglycemic range of nocturnal CGM data using Sof-Sensor is suboptimal in type 1 diabetes patients at high risk of severe hypoglycemia. To ensure clinical useful sensitivity in detection of nocturnal hypoglycemic episodes, an alarm threshold should not be lower than 4 mmol/L.

Modeling the fiscal costs and benefits of alternative treatment strategies in the United Kingdom for chronic hepatitis C.

PubMed

Connolly, Mark P; Kotsopoulos, Nikos; Ustianowski, Andrew

2018-01-01

Hepatitis C (HCV) infection causes substantial direct health costs, but also impacts broader societal and governmental costs, such as tax revenue and social protection benefits. This study investigated the broader fiscal costs and benefits of curative interventions for chronic Hepatitis C (CHC) that allow individuals to avoid long-term HCV attributed health conditions. A prospective cohort model, assessing the long-term fiscal consequences of policy decisions, was developed for HCV infected individuals, following the generational accounting analytic framework that combines age-specific lifetime gross taxes paid and governmental transfers received (i.e. healthcare and social support costs). The analysis assessed the burden of a theoretical cohort of untreated HCV infected patients with the alternative of treating these patients with a highly efficacious curative intervention (ledipasvir/sofosbuvir [LDV/SOF]). It also compared treating patients at all fibrosis stages (Stages F0-F4) compared to late treatment (Stage F4). Based on projected lifetime work activity and taxes paid, the treated cohort paid an additional £5,900 per patient compared to the untreated cohort. Lifetime government disability costs of £97,555 and £125,359 per patient for treated cohort vs no treatment cohort were estimated, respectively. Lifetime direct healthcare costs in the treated cohort were £32,235, compared to non-treated cohort of £26,424, with an incremental healthcare costs increase of £5,901 per patient. The benefit cost ratio (BCR) of total government benefits and savings relative to government treatment costs (including LDV/SOF) ranged from 1.8-5.6. Treating patients early resulted in 77% less disability costs, 43% lower healthcare costs, and 33% higher tax revenue. The ability to cure Hepatitis C offers considerable fiscal benefits beyond direct medical costs and savings attributed to reduced disability costs, public allowances, and improved tax revenue. Changes in parameters, such as productivity, wage growth, and tax rates, can influence the conclusions described here.

Surveillance of medium and high Earth orbits using large baseline stereovision

NASA Astrophysics Data System (ADS)

Danescu, Radu; Ciurte, Anca; Oniga, Florin; Cristea, Octavian; Dolea, Paul; Dascal, Vlad; Turcu, Vlad; Mircea, Liviu; Moldovan, Dan

2014-11-01

The Earth is surrounded by a swarm of satellites and associated debris known as Resident Space Objects (RSOs). All RSOs will orbit the Earth until they reentry into Earth's atmosphere. There are three main RSO categories: Low Earth Orbit (LEO), when the satellite orbits at an altitude below 1 500 km; a Medium Earth Orbit (MEO) for Global Navigation Satellite Systems (GNSS) at an altitude of around 20 000 km, and a Geostationary Earth Orbit (GEO) (also sometimes called the Clarke orbit), for geostationary satellites, at an altitude of 36 000 km. The Geostationary Earth Orbits and the orbits of higher altitude are also known as High Earth Orbits (HEO). Crucial for keeping an eye on RSOs, the Surveillance of Space (SofS) comprises detection, tracking, propagation of orbital parameters, cataloguing and analysis of these objects. This paper presents a large baseline stereovision based approach for detection and ranging of RSO orbiting at medium to high altitudes. Two identical observation systems, consisting of camera, telescope, control computer and GPS receiver are located 37 km apart, and set to observe the same region of the sky. The telescopes are placed on equatorial mounts able to compensate for the Earth's rotation, so that the stars appear stationary in the acquired images, and the satellites will appear as linear streaks. The two cameras are triggered simultaneously. The satellite streaks are detected in each image of the stereo pair using its streak-like appearance against point-like stars, the motion of the streaks between successive frames, and the stereo disparity. The detected satellite pixels are then put into correspondence using the epipolar geometry, and the 3D position of the satellite in the Earth Center, Earth Fixed (ECEF) reference frame is computed using stereo triangulation. Preliminary tests have been performed, for both MEO and HEO orbits. The preliminary results indicate a very high detection rate for MEO orbits, and good detection rate for HEO orbits, dependent on the satellite's rotation.

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

PubMed

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

2016-01-01

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

High proportions of foods recommended for consumption by United States Dietary Guidance contain solid fats and added sugar: Results from the National Health and Nutrition Examination Survey (2007-2008)

USDA-ARS?s Scientific Manuscript database

The 2010 Dietary Guidelines for Americans (DGA) recommend that individuals older than one year reduce intakes of solid fats (SoF) and added sugars (AS; together SoFAS). MyPlate, illustrates the proportions of five major food groups to promote healthy eating (Vegetables, Grains, Protein Foods, Fruit...

Effective SOF Employment: Mitigating Causes of Conflict

DTIC Science & Technology

2013-06-01

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

Analyzing Sanctuary Management in the Sahel

DTIC Science & Technology

2015-06-12

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

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

DTIC Science & Technology

2011-12-01

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

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

DTIC Science & Technology

2012-12-01

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

Organizing for Irregular Warfare: Implications for the Brigade Combat Team

DTIC Science & Technology

2007-12-01

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

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

DTIC Science & Technology

2016-06-01

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

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

DTIC Science & Technology

2013-05-23

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

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

DTIC Science & Technology

2010-11-12

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

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

DTIC Science & Technology

2014-06-17

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

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

DTIC Science & Technology

2010-01-01

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

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

DTIC Science & Technology

2017-06-09

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

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

DTIC Science & Technology

2016-12-01

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

The Changing Nature of Warfare, the Factors Mediating Future Conflict, and Implications for SOF

DTIC Science & Technology

2006-04-01

most commonly used vernacular today, one is describing the person’s sexual orientation.13 The English language is replete with other words that have...countries and those that are technologically more advanced, primarily due to labor cost differentials. Globaliza- tion has transmuted economics from a...fascination with forensic sci- ences, ala the acclaimed television pro- gram CSI, has transmuted from civilian criminal proceedings to microscopic

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

DTIC Science & Technology

2013-03-01

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

Smart Power and U.S. National Strategy

DTIC Science & Technology

2013-08-01

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

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

DTIC Science & Technology

1991-06-07

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

Influence of surface light scattering in hydrophobic acrylic intraocular lenses on laser beam transmittance.

PubMed

Shiraya, Tomoyasu; Kato, Satoshi; Minami, Keiichiro; Miyata, Kazunori

2017-02-01

The aim of this study was to experimentally examine the changes in the transmittances of photocoagulation lasers when surface light scattering increases in AcrySof intraocular lenses (IOLs). SA60AT IOLs (Alcon) were acceleratingly aging for 0, 3, 5, and 10 years to simulate surface light scattering, and the surface light-scattering intensities of both IOL surfaces were measured using a Scheimpflug photographer. The powers of laser beams that passed from a laser photocoagulator through the aged IOLs were measured at 532, 577, and 647 nm. Changes in the laser power and transmittance with the years of aging and the intensities of surface light scattering were examined. Although the intensity of surface light scattering increased with the years of aging, the laser power did not change with the years of aging (P > 0.30, Kruskal-Wallis test). There were no significant changes in the laser transmittance with the years of aging or the laser wavelength (P > 0.30 and 0.57, respectively). The intensity of surface light scattering revealed no significant association with the laser transmittance at any wavelength (P > 0.37, liner regression). The increases in the surface light scattering of the AcrySof IOLs would not influence retinal photocoagulation treatments for up to 10 years after implantation.

A pangenotypic, single tablet regimen of sofosbuvir/velpatasvir for the treatment of chronic hepatitis C infection.

PubMed

Weisberg, Ilan S; Jacobson, Ira M

2017-04-01

Hepatitis C virus (HCV) infects nearly 170 million people worldwide and is a leading cause of progressive liver damage, cirrhosis, and hepatocellular carcinoma. Curative therapies have historically relied on interferon-based treatments and were limited by significant toxicity and poor response rates, particularly among patients with prior treatment failure and advanced hepatic fibrosis. The recent advent of direct acting antiviral (DAA) agents which target key steps in the HCV viral life cycle has transformed the landscape of HCV treatment by offering highly effective and well tolerated interferon-free treatments. However, current therapies are genotype-specific and have variable efficacy amongst less prevalent HCV variants. Areas covered: This review covers the preclinical and clinical development of sofosbuvir/velpatasvir (SOF/VEL), an interferon-free, once daily, pangenotypic treatment for the treatment of chronic hepatitis C virus (HCV) infection. All relevant literature from 2014 through September of 2016 is included. Expert opinion: SOF/VEL offers the promise of a single tablet, interferon- and ribavirin-free treatment that has extremely high efficacy in persons with chronic HCV infection regardless of genotype, subtype, treatment history or fibrosis status. It is expected to play a major role on a global scale in the therapeutic armamentarium against this ubiquitous threat to human health.

Small angle neutron scattering applications in fuel science

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

Thiyagarajan, P.; Cody, G.D.; Hunt, J.E.

1995-08-01

A wide range of physical and chemical methods have been used to study complex, multicomponent systems in fuel chemistry (crude oil, coal), and we are still far from complete understanding. Since chemical modification and/or solvent extraction of coal result in a number of different systems, it is important to understand the products in terms of their colloidal properties as a function of the solvent type, as well as other physical conditions. This would be helpful in design of processing techniques. Another area of research where SANS can be useful is characterization of the synthetic and modified clays being developed formore » processing in the petroleum industry. Major limitations for performing SANS experiments are nonavailability/high cost sof certain deuterated solvents and the paucity of beam time at the neutron scattering centers. This paper reports briefly on analysis of coal and asphaltenes.« less

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

DTIC Science & Technology

2013-05-23

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

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

DTIC Science & Technology

2005-01-01

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

Journal of Special Operations Medicine, Volume 6, Edition 4

DTIC Science & Technology

2006-01-01

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

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

DTIC Science & Technology

2005-01-01

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

An Analytical Approach to Prioritizing the Development of Seabasing Components

DTIC Science & Technology

2007-04-05

high - speed ferries. The ships have served in intra-theater lift roles worldwide, as a staging platform for SOF during OIF, and as a ...testing. If Seabasing is to reach its full potential, a concerted effort needs to be made to develop a long-range, high - speed , heavy-lift cargo ...deck, high speed , containerized amphibious aircraft carriers) and aircraft (large, long range, naval airlift). A lot of money and energy will

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

DTIC Science & Technology

2007-12-01

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

Building Coalitions for Humanitarian Operations -- Operation Provide Comfort

DTIC Science & Technology

1992-04-15

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

Journal of Special Operations Medicine, Volume 7, Edition 1

DTIC Science & Technology

2007-01-01

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

The Deployment Life Study. Appendixes

DTIC Science & Technology

2014-01-01

dMdC SOFS x x immigration status Created for deployment Life Study x x Religious engagement or denomination FpnMAd (Trail and Karney, 2012) x x x x...Homefront Study (Chandra, Burns, et al., 2008; Chandra, Lara-Cinisomo, Jaycox, Tanielian, Han, et al., 2011) x (post) Health and well-being physical health...authorities. We will not be asking questions about sexual or physical | | | | | | | | | abuse of a child, but you should know that, if this information is

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

DTIC Science & Technology

2017-01-06

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

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

DTIC Science & Technology

2012-02-15

suggests a lack of “ advertising ”, i.e. the need for a clearing house of ideas. General Haase’s brief suggested the DoD did not have a defined...of debate. Still another avenue is the Capability Portfolio Management ( CPM ) system which seeks to optimize capability investments across the...defense enterprise.59 Though CPMs are charged to identify issues, priorities, and capability and resources mismatches, they have no independent decision

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

DTIC Science & Technology

2016-12-07

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

Special Operations Liaison Officer: Looking Back to See the Future

DTIC Science & Technology

2014-06-01

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

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

DTIC Science & Technology

2010-01-01

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

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

DTIC Science & Technology

2011-07-01

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

The Role of the Global SOF Network in a Resource Constrained Environment

DTIC Science & Technology

2013-11-01

backed by actions. Step Two: Matching Skill Sets with Individuals: Who Needs to Know What? This step sounds simple enough in theory . You need to...Training Finally, step five is the recognition that, like physical training and condition- ing, cognitive skills need to be continuously refreshed. These...and maintaining the data needed , and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other

Authorities and Options for Funding USSOCOM Operations

DTIC Science & Technology

2014-01-01

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

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

DTIC Science & Technology

2013-09-18

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

SOF/Convention Force Light Footprint Interdependence in Asia and Beyond

DTIC Science & Technology

2013-04-01

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

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

DTIC Science & Technology

2014-12-12

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

University of Kansas Research and Educational Support for U.S. Army Programs and Initiatives at Fort Leavenworth, Kansas

DTIC Science & Technology

2013-09-03

the flanking ranges are Cretaceous and Triassic igneous and metamorphic rocks . (O’Leary & Whitney, USGS Geologic Map of the Kandahar Region, 2005...focusing on interagency collaboration for US SOF officers who attend the Army’s Command and General Staff College; (2) a graduate business program...46. Holt, Christina; Fawcett, Stephen. “Supporting Transformative Community Change Efforts Using Online Technology.” 47. Holt, Christina; Fawcett

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

DTIC Science & Technology

2005-09-01

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

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

DTIC Science & Technology

2014-12-01

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

Granulocyte-macrophage colony stimulating factor (GM-CSF) enhances cumulus cell expansion in bovine oocytes

PubMed Central

2013-01-01

Background The objectives of the study were to characterize the expression of the α- and β-subunits of granulocyte-macrophage colony stimulating factor (GM-CSF) receptor in bovine cumulus cells and oocytes and to determine the effect of exogenous GM-CSF on cumulus cells expansion, oocyte maturation, IGF-2 transcript expression and subsequent competence for embryonic development. Methods Cumulus-oocyte complexes (COC) were obtained by aspirating follicles 3- to 8-mm in diameter with an 18 G needle connected to a vacuum pump at −50 mmHg. Samples of cumulus cells and oocytes were used to detect GM- CSF receptor by immunofluorescence. A dose–response experiment was performed to estimate the effect of GM-CSF on cumulus cell expansion and nuclear/cytoplasmic maturation. Also, the effect of GM-CSF on IGF-2 expression was evaluated in oocytes and cumulus cells after in vitro maturation by Q-PCR. Finally, a batch of COC was randomly assigned to in vitro maturation media consisting of: 1) synthetic oviductal fluid (SOF, n = 212); 2) synthetic oviductal fluid supplemented with 100 ng/ml of GM-CSF (SOF + GM-CSF, n = 224) or 3) tissue culture medium (TCM 199, n = 216) and then subsequently in vitro fertilized and cultured for 9 days. Results Immunoreactivity for both α and β GM-CSF receptors was localized in the cytoplasm of both cumulus cells and oocytes. Oocytes in vitro matured either with 10 or 100 ng/ml of GM-CSF presented a higher (P < 0.05) cumulus cells expansion than that of the control group (0 ng/ml of GM-CSF). GM-CSF did not affect the proportion of oocytes in metaphase II, cortical granules dispersion and IGF-2 expression. COC exposed to 100 ng/ml of GM-CSF during maturation did not display significant differences in terms of embryo cleavage rate (50.4% vs. 57.5%), blastocyst development at day 7 (31.9% vs. 28.7%) and at day 9 (17.4% vs. 17.9%) compared to untreated control (SOF alone, P = 0.2). Conclusions GM-CSF enhanced cumulus cell expansion of in vitro matured bovine COC. However, GM-CSF did not increase oocyte nuclear or cytoplasmic maturation rates, IGF-2 expression or subsequent embryonic development. PMID:23799974

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

DTIC Science & Technology

2004-01-01

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

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

DTIC Science & Technology

2002-01-01

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

Can SOF Assist USPACOM in Building a Stronger Link to China’s PLA?

DTIC Science & Technology

2014-05-15

April 27, 2014. 7 Leon E . Panetta, Sustaining U.S. Global Leadership: Priorities for 21 st Century Defense (Washington DC: Office of the Secretary...9 Leon E . Panetta, Sustaining U.S. Global Leadership: Priorities for 21 st Century Defense, p. 2. 10 Ibid, pp. 1-3. 11 Chuck Hagel...20 Leon E . Panetta, Military and Security Developments Involving the People’s Republic of China 2013 (Washington DC: Office of the Secretary

Study to Improve Airframe Turbine Engine Rotor Blade Containment

DTIC Science & Technology

1977-07-01

REPORT NO. FAA-RD-77-44 ( DOT-FA76WA-3843 JUNE 1976 STUDY TO IMPROVE AIRFRAME TURBINE ENGINE ROTOR BLADE CONTAINMENT C. 0. GUNDERSON SOF Tftj. -" So...both engines appeared to be able to marginally contain the 1 and 2 blade fragments in all compressor and turbine stages, but probably would rfiot have...adjacent blades including serrations from any stage. The investigation was made on high bypass ratio turbofan engines which power wide body transports

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

DTIC Science & Technology

2011-08-01

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

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

DTIC Science & Technology

2015-01-01

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

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

DTIC Science & Technology

2016-04-08

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

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

DTIC Science & Technology

2007-02-23

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

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

DTIC Science & Technology

2015-06-01

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

Rutting Performance of Cold-Applied Asphalt Repair Materials for Airfield Pavements

DTIC Science & Technology

2017-06-23

susceptibility of hot mix asphalt (HMA) using the asphalt pavement analyzer (APA). Designation T340- 10. Washington, DC: American Association of State...ER D C/ G SL T R- 17 -1 0 Rutting Performance of Cold-Applied Asphalt Repair Materials for Airfield Pavements G eo te ch ni ca l a nd S...of Cold-Applied Asphalt Repair Materials for Airfield Pavements Ben C. Cox, John F. Rushing, and Web Floyd Geotechnical and Structures Laboratory

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

DTIC Science & Technology

2004-01-01

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

Proceedings of the Irvine Workshop on Alternatives for the Environment, Certification, and Control of the DOD Common High Order Language, Held at California University, Irvine on 20-22 June 1978.

DTIC Science & Technology

1978-01-01

of the poet Lord Byron, and Babbage ’s "programmer." For reasons of historical accuracy, the use of the working title "DODi" has been retained in the...Surface Weapons Center Al Irvine, SofTech, Inc. Rob Kling, UC - Irvine John C. Knight, NASA Langley Research Center Charles L. Lawson, Jet Propulsion

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

DTIC Science & Technology

2002-01-01

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

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

DTIC Science & Technology

2016-06-10

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

Joint Force Quarterly. Number 33, Winter 2002-03

DTIC Science & Technology

2003-04-01

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

Compaction Control of Earth-Rock Mixtures

DTIC Science & Technology

1991-08-01

specifications have avoided dealing with the full-scale materials. For example, the specified range for water contenz and the value of minimum de - sired percent...Record Samples taken from that embankment or concerning the satisfactory result sof tets perfornt d on t lous. s c p s relative to de ~sgn r, q:.irements...precision of the compaction test provided that the lines of optimums of the families of curves are neatly de - fined. That is to say that the

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

DTIC Science & Technology

1989-05-19

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

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

DTIC Science & Technology

2012-02-01

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

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

DTIC Science & Technology

2013-01-28

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

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

DTIC Science & Technology

2012-06-01

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

Hsp47 mediates Cx43-dependent skeletal growth and patterning in the regenerating fin.

PubMed

Bhadra, Joyita; Iovine, M Kathryn

2015-11-01

Skeletal morphogenesis describes how bones achieve their correct shape and size and appropriately position joints. We use the regenerating caudal fin of zebrafish to study this process. Our examination of the fin length mutant short fin (sof (b123)) has revealed that the gap junction protein Cx43 is involved in skeletal morphogenesis by promoting cell proliferation and inhibiting joint formation, thereby coordinating skeletal growth and patterning. Here we demonstrate that serpinh1b is molecularly and functionally downstream of cx43. The gene serpinh1b codes for a protein called Hsp47, a molecular chaperone responsible for proper folding of procollagen molecules. Knockdown of Hsp47 in regenerating fins recapitulates the sof (b123) phenotypes of reduced fin length, reduced segment length and reduced level of cell proliferation. Furthermore, Hsp47 knockdown affects the organization and localization of the collagen-based actinotrichia. Together, our findings reveal that serpinh1b acts in a cx43 dependent manner to regulate cell proliferation and joint formation. We conclude that disruption of the collagen-based extracellular matrix influences signaling events required for cell proliferation, as well as the patterning of skeletal precursor cells that influences segment length. Therefore, we suggest that Hsp47 function is necessary for skeletal growth and patterning during fin regeneration. Copyright © 2015 Elsevier B.V. All rights reserved.

Reheating of soy oil is detrimental to bone metabolism in oestrogen deficient rats.

PubMed

Ima-Nirwana, S; Ahmad, S Nazrun; Yee, L J; Loh, H C; Yew, S F; Norazlina, M; Abdul, M T Gapor; Kamsiah, J

2007-03-01

The short-term and long- term effects of heated soy oil on bone metabolism in ovariectomised Sprague-Dawley rats were studied. Three-month-old female rats, were divided into five groups: normal control (NC); ovariectomised control (OVXC); ovariectomised and fed rat chow with added fresh soybean oil (SOF) or once-heated soy oil (SO1) or five-times-heated soy oil (SO5). Short-term parameters measured after one month were serum interleukin-6 (IL-6) and osteocalcin. Long-term parameters measured after six months were the structural bone histomorphometrical parameters. Vitamin E content in the soy oil subjected to the different heating treatments were also measured. Rats in the SO5 group had higher levels of IL-6 after one month compared to the other four groups. Osteocalcin levels in the SO1 and SO5 groups remained high after treatment, while those in the NC and SOF groups declined. After six months, bone mass declined in the SO5 group. Vitamin E assay in the oils showed that levels of alpha-tocopherol decreased after heating the oil once and five times, while levels of gamma- and delta-tocopherols only declined after heating five times. Repeated heating of soy oil destroyed the tocopherols causing raised serum IL-6 and osteocalcin levels, leading to increased bone resorption and osteoporosis in the long term.

Water's Way at Sleepers River watershed – revisiting flow generation in a post-glacial landscape, Vermont USA

USGS Publications Warehouse

Shanley, James B.; Sebestyen, Stephen D.; McDonnell, Jeffrey J.; McGlynn, Brian L.; Dunne, Thomas

2015-01-01

The Sleepers River Research Watershed (SRRW) in Vermont, USA, has been the site of active hydrologic research since 1959 and was the setting where Dunne and Black demonstrated the importance and controls of saturation-excess overland flow (SOF) on streamflow generation. Here, we review the early studies from the SRRW and show how they guided our conceptual approach to hydrologic research at the SRRW during the most recent 25 years. In so doing, we chronicle a shift in the field from early studies that relied exclusively on hydrometric measurements to today's studies that include chemical and isotopic approaches to further elucidate streamflow generation mechanisms. Highlights of this evolution in hydrologic understanding include the following: (i) confirmation of the importance of SOF to streamflow generation, and at larger scales than first imagined; (ii) stored catchment water dominates stream response, except under unusual conditions such as deep frozen ground; (iii) hydrometric, chemical and isotopic approaches to hydrograph separation yield consistent and complementary results; (iv) nitrate and sulfate isotopic compositions specific to atmospheric inputs constrain new water contributions to streamflow; and (v) convergent areas, or ‘hillslope hollows’, contribute disproportionately to event hydrographs. We conclude by summarizing some remaining challenges that lead us to a vision for the future of research at the SRRW to address fundamental questions in the catchment sciences.

Acquisition of a Memory Skill.

DTIC Science & Technology

1980-05-01

MONICA, CA 90406 1 Dr. Robert Sternberg 1 Dr. Walt W . Tornow Dept. of Psychology Control Data Corporation Yale University Corporate Personnel Research...AD-AGBV 7514 CARNEGIE-MELLON UNIV PITTSBURGH PA DEPT OF PSYCHOLOGY F/G 5/10 ACQUISITION OF A MEMORY SKILL.(U) MAY 80 W 6 CHASE, K A ERICSSON, S...of Mental Health. We thank J.R. Anderson, M.T.H. Chi, W . Jones, M. W . Schustack, and H.A. Simon for their valuable comments. Avasa Bei On For specia

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

DTIC Science & Technology

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

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

DTIC Science & Technology

2005-03-15

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

Financial Planning and Control for the Military Officer.

DTIC Science & Technology

1984-06-01

to take control and tV 00 W 43 60,1081 op I5.OET 1Vo sof~’ UNCLASSIFIED 5/N 0102- LPL 014- 6601 SE9CUIT CI.AS&IFICATIOPI OF THIS PAGE (menm bloo ...LL. June 1984 Thesis Advisor: John W . Creighton Approved for public release; distribution unlimited. Prepared for: SD A0 United States Naval Academy...By Annapolis, MD United States Marine Corps NAVAL POSTGRADUATE SCHOOL Monterey, California Commodore R. H. Shumaker David A. Schrady Superintendent

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

DTIC Science & Technology

2007-03-01

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

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

DTIC Science & Technology

2010-11-24

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

Journal of Special Operations Medicine, Volume 8, Edition 2

DTIC Science & Technology

2008-01-01

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

Designing Collaboration: How to Prepare SOF Augmentation Teams for Assignment to a U.S. Embassy Country Team

DTIC Science & Technology

2014-06-01

allegiance will remain to their parent organization. Country team members must accept their role as part of an organization, willing to put the country...country team may be tempted to hold onto and treat certain types of information as special to their parent organization and keep it “stove piped...prepare personnel to master their assigned specialty within their parent organization, but do not emphasize preparing these same personnel for their

U.S. Army Biomedical Research and Development Laboratory Bibliography FY91-FY80 (Reverse Order). Appendix

DTIC Science & Technology

1991-01-01

G.E. Toms. 1991. SOF sterilizer, 1st article test. Memorandum Report No. 1 -91. Hodge, J.W., and G.E. Toms. 1991. Sterilizer, surgical instruments and...for the performance of FETAX, Stillwater, OK: Oklahoma State University Press. 3 Burrows, E.P. 1991. Mass spectral fragmentation pathways of 1 ...potential of LP1846 liquid gun propellant to induce unscheduled DNA synthesis in the in vitro hepatocyte DNA repair assay. Final report, Project Order

Kernel Ada Programming Support Environment (KAPSE) Interface Team. Volume I. Public Report.

DTIC Science & Technology

1982-04-01

productivity. Unfortunately, * command procedures often are needed to insulate the users from a poorly engineered human interface. Bot ~h command...0-MMa CAf- ON OPERaTnS Figu; a~ 0AS.Hs SItraei nemerc ~ nertEvrnet 0 1.--x In the SofTech ALS the user comunicates with the KAPSE rather than with VMS...a close relationship requires the host vendor to disclose all of his plans to the APSE CCB and maintenance comunity . In the commercial world, secrecy

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

DTIC Science & Technology

1993-12-01

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

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

DTIC Science & Technology

2010-04-01

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

Interferon-Free Therapy in Elderly Patients With Advanced Liver Disease.

PubMed

Lens, Sabela; Fernández, Inmaculada; Rodríguez-Tajes, Sergio; Hontangas, Vanessa; Vergara, Mercedes; Forné, Montserrat; Calleja, Jose Luis; Diago, Moisés; Llaneras, Jordi; Llerena, Susana; Torras, Xavier; Sacristán, Begoña; Roget, Merce; Fernández-Rodríguez, Conrado Manuel; Navascués, Mari Carmen; Fuentes, Javier; Sánchez-Ruano, Juan-José; Simón, Miguel-Ángel; Sáez-Royuela, Federico; Baliellas, Carmen; Morillas, Rosa; Forns, Xavier

2017-09-01

Interferon-free therapies have an improved safety and efficacy profile. However, data in elderly patients, who have frequently advanced liver disease, associated comorbidities, and use concomitant medications are scarce. The im of this study was to assess the effectiveness and tolerability of all-oral regimens in elderly patients in real-life clinical practice. Retrospective analysis of hepatitis C virus (HCV) patients aged ≥65 years receiving interferon-free regimens within the Spanish National Registry (Hepa-C). Data of 1,252 patients were recorded. Of these, 955 (76%) were aged 65-74 years, 211 (17%) were aged 75-79 years, and 86 (7%) were aged ≥80 years at the start of antiviral therapy. HCV genotype-1b was predominant (88%) and 48% were previous non-responders. A significant proportion of patients had cirrhosis (922; 74%), of whom 11% presented decompensated liver disease. The most used regimens were SOF/LDV (33%), 3D (28%), and SOF/SMV (26%). Ribavirin was added in 49% of patients. Overall, the sustained virological response (SVR12) rate was 94% without differences among the three age categories. Albumin ≤3.5 g/dl was the only independent negative predictor of response (0.25 (0.15-0.41); P<0.01). Regarding tolerability, the rate of severe adverse events increased with age category (8.8, 13, and 14%; P=0.04). In addition, the main predictors of mortality (2.3%) were age ≥75 years (2.59 (1.16-5.83); P =0.02) and albumin ≤3.5 (17 (6.3-47); P <0.01). SVR rates with interferon-free regimens in elderly patients are high and comparable to the general population. Baseline low albumin levels (≤3.5 g/dl) was the only predictor of treatment failure. Importantly, the rate of severe adverse events and death increased with age. Elderly patients (≥75 years) or those with advanced liver disease (albumin ≤3.5) presented higher mortality. Thus a careful selection of patients for antiviral treatment is recommended.

Eight-week ledipasvir/sofosbuvir in non-cirrhotic, treatment-naïve hepatitis C genotype-1 patients with hepatitis C virus-RNA < 6 million: Single center, real world effectiveness and safety.

PubMed

Latt, Nyan L; Yanny, Beshoy T; Gharibian, Derenik; Gevorkyan, Rita; Sahota, Amandeep K

2017-07-14

To evaluate sustained viral response (SVR) of 8-wk ledipasvir/sofosbuvir therapy among non-cirrhotic, genotype-1 hepatitis C virus (HCV) patients with RNA < 6 million IU/mL. We performed a retrospective cohort study to examine SVR rates, predictors of treatment failure and safety analysis of 8-wk ledipasvir/sofosbuvir (LDV/SOF) therapy among non-cirrhotic, genotype 1 HCV patients with viral load < 6 million IU/mL. Primary outcome was an achievement of SVR at 12 wk after treatment. Secondary outcomes were identifying predictors of treatment failure and adverse events during treatment. Total 736 patients: 55% males, 51% Caucasians and 65% were genotype 1a. Non-cirrhotic state of 53% was determined by clinical judgment (imaging, AST, platelet count) and 47% had documented liver fibrosis testing (biopsy, vibration-controlled transient elastography, serum biomarkers). Overall SVR12 was 96%. No difference in SVR12 was seen between patients whose non-cirrhotic state was determined by clinical judgment and patients who had fibrosis testing. Age groups, gender, ethnicity and genotype 1 subtype did not predict SVR. Non-cirrhotic state determined by clinical judgment based on simple, non-invasive tests were not associated with lower SVR [OR = 1.02, 95%CI: 0.48-2.17, P = 0.962]. The AUROC for hepatitis C RNA viral load was 0.734 ( P < 0.001, 95%CI: 0.66-0.82). HCV RNA 2.2 million IU/mL was identified as the cutoff value with sensitivity 73% and specificity 64%. HCV RNA < 2.2 million IU/mL was associated with significantly higher SVR 98% with OR = 0.22 (95%CI: 0.1-0.49, P < 0.001) compared to SVR 92% in HCV RNA ≥ 2.2 million IU/mL. No death or morbidities were reported. Our outcomes validate safety and effectiveness of 8-wk LDV/SOF therapy in non-cirrhotic, untreated HCV genotype 1 patients with HCV RNA < 6 million IU/mL.

Eight-week ledipasvir/sofosbuvir in non-cirrhotic, treatment-naïve hepatitis C genotype-1 patients with hepatitis C virus-RNA < 6 million: Single center, real world effectiveness and safety

PubMed Central

Latt, Nyan L; Yanny, Beshoy T; Gharibian, Derenik; Gevorkyan, Rita; Sahota, Amandeep K

2017-01-01

AIM To evaluate sustained viral response (SVR) of 8-wk ledipasvir/sofosbuvir therapy among non-cirrhotic, genotype-1 hepatitis C virus (HCV) patients with RNA < 6 million IU/mL. METHODS We performed a retrospective cohort study to examine SVR rates, predictors of treatment failure and safety analysis of 8-wk ledipasvir/sofosbuvir (LDV/SOF) therapy among non-cirrhotic, genotype 1 HCV patients with viral load < 6 million IU/mL. Primary outcome was an achievement of SVR at 12 wk after treatment. Secondary outcomes were identifying predictors of treatment failure and adverse events during treatment. RESULTS Total 736 patients: 55% males, 51% Caucasians and 65% were genotype 1a. Non-cirrhotic state of 53% was determined by clinical judgment (imaging, AST, platelet count) and 47% had documented liver fibrosis testing (biopsy, vibration-controlled transient elastography, serum biomarkers). Overall SVR12 was 96%. No difference in SVR12 was seen between patients whose non-cirrhotic state was determined by clinical judgment and patients who had fibrosis testing. Age groups, gender, ethnicity and genotype 1 subtype did not predict SVR. Non-cirrhotic state determined by clinical judgment based on simple, non-invasive tests were not associated with lower SVR [OR = 1.02, 95%CI: 0.48-2.17, P = 0.962]. The AUROC for hepatitis C RNA viral load was 0.734 (P < 0.001, 95%CI: 0.66-0.82). HCV RNA 2.2 million IU/mL was identified as the cutoff value with sensitivity 73% and specificity 64%. HCV RNA < 2.2 million IU/mL was associated with significantly higher SVR 98% with OR = 0.22 (95%CI: 0.1-0.49, P < 0.001) compared to SVR 92% in HCV RNA ≥ 2.2 million IU/mL. No death or morbidities were reported. CONCLUSION Our outcomes validate safety and effectiveness of 8-wk LDV/SOF therapy in non-cirrhotic, untreated HCV genotype 1 patients with HCV RNA < 6 million IU/mL. PMID:28765697

Ketones and Human Performance.

PubMed

Scott, Jonathan M; Deuster, Patricia A

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

Pathological evaluation of postmortem human eyes implanted with a new single-piece hydrophobic acrylic lens.

PubMed

Izak, Andrea M; Werner, Liliana; Pandey, Suresh K; Apple, David J

2004-07-01

To report the pathological findings in 14 human cadaver eyes implanted with a single-piece AcrySof(Alcon Laboratories) posterior chamber intraocular lens (IOL). David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Fourteen human autopsy eyes implanted with a single-piece AcrySof (SA30AL) IOL were evaluated. The eyes were sectioned at the equatorial plane, and the anterior segment containing the IOL in the capsular bag was evaluated from a posterior perspective (Miyake-Apple view) and from an anterior perspective (surgeon's view) after removal of cornea and iris. They were then processed through paraffin, sectioned, and stained with hematoxylin-eosin, periodic acid-Schiff, and Masson's trichrome and examined under light microscopy. All IOLs had symmetric in-the-bag fixation. Slight decentration was measured in 1 eye, which also had an anterior capsule tear. Grade 1 anterior capsule opacification was present in 9 eyes. No central posterior capsule opacification or posterior capsule folds were observed in any eye. Soemmering's ring formation was observed in 5 eyes. Zonular stretch caused by different degrees of capsular bag contraction was present in 4 eyes without decentration of the IOL. Analyses of pseudophakic cadaver eyes from the posterior (Miyake-Apple) view, complemented by microscopic analyses, proved useful in the evaluation of IOL-capsular bag interaction. These studies are more important in cases of newly introduced lens designs.

Change in corneal aberrations after cataract surgery with 2 types of aspherical intraocular lenses.

PubMed

Marcos, Susana; Rosales, Patricia; Llorente, Lourdes; Jiménez-Alfaro, Ignacio

2007-02-01

To study the effect of cataract surgery through 3.2 mm superior incisions on corneal aberrations with 2 types of monofocal intraocular lenses (IOLs) with an aspherical design. Instituto de Optica, Consejo Superior de Investigaciones Científicas, and Fundación Jiménez Díaz, Madrid, Spain. Corneal topography of 43 eyes was obtained before and after small corneal incision cataract surgery. Twenty-two eyes had implantation of a Tecnis Z9000 silicone IOL (Advanced Medical Optics) and 21 had implantation of an AcrySof IQ SN60WF acrylic IOL (Alcon Research Labs) using the recommended injector for each IOL type. The intended incision size (3.2 mm) was similar in the 2 groups. Corneal aberrations were estimated using custom-developed algorithms (based on ray tracing) for 10.0 mm and 5.0 mm pupils. Comparisons between preoperative and postoperative measurements and across the groups were made for individual Zernike terms and root-mean-square (RMS) wavefront error. The RMS (excluding tilt and defocus) did not change in the AcrySof IQ group and increased significantly in the Tecnis group with the 10.0 mm and 5.0 mm pupil diameters. Spherical aberration and coma-like terms did not change significantly; however, vertical astigmatism, vertical trefoil, and vertical tetrafoil changed significantly with surgery with the 10.0 mm and 5.0 mm pupil diameters (P<.0005). The induced wave aberration pattern for 3rd- and higher-order aberrations consistently showed a superior lobe, resulting from a combination of positive vertical trefoil (Z(3)(-3)) and negative tetrafoil (Z(4)(4)). The mean vertical astigmatism increased by 2.47 microm +/- 1.49 (SD) and 1.74 +/- 1.44 microm, vertical trefoil increased by 1.81 +/- 1.19 microm and 1.20 +/- 1.34 microm, and tetrafoil increased by -1.10 +/- 0.78 microm and -0.89 +/- 0.68 microm in the Tecnis group and AcrySof IQ group, respectively. There were no significant differences between the corneal aberrations in the 2 postoperative groups, although there was a tendency toward more terms or orders changing statistically significantly in the Tecnis group, which had slightly higher amounts of induced aberrations. Cataract surgery with a small superior incision induced consistent and significant changes in several corneal Zernike terms (vertical astigmatism, trefoil, and tetrafoil), resulting in a significantly increased overall corneal RMS wavefront error. These results can be used to improve predictions of optical performance with new IOL designs using computer eye models and identify the potentially different impact of incision strategies on cataract surgery.

Silicon on ferroelectic insulator field effect transistor (SOF-FET) a new device for the next generation ultra low power circuits

NASA Astrophysics Data System (ADS)

Es-Sakhi, Azzedin D.

Field effect transistors (FETs) are the foundation for all electronic circuits and processors. These devices have progressed massively to touch its final steps in sub-nanometer level. Left and right proposals are coming to rescue this progress. Emerging nano-electronic devices (resonant tunneling devices, single-atom transistors, spin devices, Heterojunction Transistors rapid flux quantum devices, carbon nanotubes, and nanowire devices) took a vast share of current scientific research. Non-Si electronic materials like III-V heterostructure, ferroelectric, carbon nanotubes (CNTs), and other nanowire based designs are in developing stage to become the core technology of non-classical CMOS structures. FinFET present the current feasible commercial nanotechnology. The scalability and low power dissipation of this device allowed for an extension of silicon based devices. High short channel effect (SCE) immunity presents its major advantage. Multi-gate structure comes to light to improve the gate electrostatic over the channel. The new structure shows a higher performance that made it the first candidate to substitute the conventional MOSFET. The device also shows a future scalability to continue Moor's Law. Furthermore, the device is compatible with silicon fabrication process. Moreover, the ultra-low-power (ULP) design required a subthreshold slope lower than the thermionic-emission limit of 60mV/ decade (KT/q). This value was unbreakable by the new structure (SOI-FinFET). On the other hand most of the previews proposals show the ability to go beyond this limit. However, those pre-mentioned schemes have publicized a very complicated physics, design difficulties, and process non-compatibility. The objective of this research is to discuss various emerging nano-devices proposed for ultra-low-power designs and their possibilities to replace the silicon devices as the core technology in the future integrated circuit. This thesis proposes a novel design that exploits the concept of negative capacitance. The new field effect transistor (FET) based on ferroelectric insulator named Silicon-On-Ferroelectric Insulator Field Effect Transistor (SOF-FET). This proposal is a promising methodology for future ultra-low-power applications, because it demonstrates the ability to replace the silicon-bulk based MOSFET, and offers subthreshold swing significantly lower than 60mV/decade and reduced threshold voltage to form a conducting channel. The SOF-FET can also solve the issue of junction leakage (due to the presence of unipolar junction between the top plate of the negative capacitance and the diffused areas that form the transistor source and drain). In this device the charge hungry ferroelectric film already limits the leakage.

Invited review: A commentary on predictive cheese yield formulas.

PubMed

Emmons, D B; Modler, H W

2010-12-01

Predictive cheese yield formulas have evolved from one based only on casein and fat in 1895. Refinements have included moisture and salt in cheese and whey solids as separate factors, paracasein instead of casein, and exclusion of whey solids from moisture associated with cheese protein. The General, Barbano, and Van Slyke formulas were tested critically using yield and composition of milk, whey, and cheese from 22 vats of Cheddar cheese. The General formula is based on the sum of cheese components: fat, protein, moisture, salt, whey solids free of fat and protein, as well as milk salts associated with paracasein. The testing yielded unexpected revelations. It was startling that the sum of components in cheese was <100%; the mean was 99.51% (N × 6.31). The mean predicted yield was only 99.17% as a percentage of actual yields (PY%AY); PY%AY is a useful term for comparisons of yields among vats. The PY%AY correlated positively with the sum of components (SofC) in cheese. The apparent low estimation of SofC led to the idea of adjusting upwards, for each vat, the 5 measured components in the formula by the observed SofC, as a fraction. The mean of the adjusted predicted yields as percentages of actual yields was 99.99%. The adjusted forms of the General, Barbano, and Van Slyke formulas gave predicted yields equal to the actual yields. It was apparent that unadjusted yield formulas did not accurately predict yield; however, unadjusted PY%AY can be useful as a control tool for analyses of cheese and milk. It was unexpected that total milk protein in the adjusted General formula gave the same predicted yields as casein and paracasein, indicating that casein or paracasein may not always be necessary for successful yield prediction. The use of constants for recovery of fat and protein in the adjusted General formula gave adjusted predicted yields equal to actual yields, indicating that analyses of cheese for protein and fat may not always be necessary for yield prediction. Composition of cheese was estimated using a predictive formula; actual yield was needed for estimation of composition. Adjusted formulas are recommended for estimating target yields and cheese yield efficiency. Constants for solute exclusion, protein-associated milk salts, and whey solids could be used and reduced the complexity of the General formula. Normalization of fat recovery increased variability of predicted yields. Copyright © 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

31 CFR 21.300 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... technical services” shall be limited to advice and analysis directly applying any professional or technical... analysis directly applying their professional or technical expertise and unless the advice or analysis is... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Professional and technical services...

14 CFR 1271.300 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... technical services” shall be limited to advice and analysis directly applying any professional or technical... analysis directly applying their professional or technical expertise and unless the advice or analysis is... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Professional and technical services. 1271...

40 CFR 34.300 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... technical services” shall be limited to advice and analysis directly applying any professional or technical... analysis directly applying their professional or technical expertise and unless the advice or analysis is... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Professional and technical services. 34...

24 CFR 87.300 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... technical services shall be limited to advice and analysis directly applying any professional or technical... analysis directly applying their professional or technical expertise and unless the advice or analysis is... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Professional and technical services...

22 CFR 712.300 - Professional and technical services.

Code of Federal Regulations, 2011 CFR

2011-04-01

... technical services” shall be limited to advice and analysis directly applying any professional or technical... analysis directly applying their professional or technical expertise and unless the advice or analysis is... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Professional and technical services. 712.300...

22 CFR 311.300 - Professional and technical services.

Code of Federal Regulations, 2011 CFR

2011-04-01

... technical services shall be limited to advice and analysis directly applying any professional or technical... analysis directly applying their professional or technical expertise and unless the advice or analysis is... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Professional and technical services. 311.300...

45 CFR 604.300 - Professional and technical services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... technical services” shall be limited to advice and analysis directly applying any professional or technical... analysis directly applying their professional or technical expertise and unless the advice or analysis is... 45 Public Welfare 3 2011-10-01 2011-10-01 false Professional and technical services. 604.300...

Increasing Antimicrobial Resistance Monitored in Surveillance Analysis of Blood Stream Infections in Febrile Neutropenic Pediatric Oncology Patients.

PubMed

El-Mahallawy, Hadir A; Hassan, Safaa Shawky; El-Wakil, Mohamed; Moneer, Manar M; Shalaby, Lobna

2015-01-01

Continuous surveillance of pattern of blood stream infection is necessary in febrile neutropenia (FN)especially with the recent escalating trend in the management of pediatric cancer patients towards intensified regimens and with the increase in infections caused by resistant organisms limiting the choice of antibiotics. To monitor change in pattern of blood stream infections (BSI) in FN pediatric cancer patients. Surveillance of FN episodes with positive BSI was prospectively monitored and compared to a previous surveillance in the same pediatric oncology unit. A total of 232 BSI positive episodes were documented in 192 patients during a 6 months period. The results of recent surveillance analysis showed an increase in intensified regimens of chemotherapy, antimicrobial resistance, fungal infections, and prolonged duration of episodes when compared to previous surveillance, with p value sof <0.001, 0.005, 0.021, and <0.001, respectively. There was an apparent decrease in the crude mortality but this was not statistically significant, to 6% in 2011 from 10 % in 2006. The pattern of BSI at our institution is still inclining towards gram positive organisms but is showing a shift towards more antibiotic resistance and fungal infections.

[Malnutrition as a prognostic factor in elderly patients with hip fractures].

PubMed

Montero Pérez-Barquero, Manuel; García Lázaro, Milagros; Carpintero Benítez, Pedro

2007-05-19

Hip fracture occurs frequently in elderly patients, with devastating effects on the quality of life due to the high financial burden and the high mortality rate in patients with this condition. Malnutrition is prevalent in the elderly and it can negatively influence patients' recovery from hip fracture. Our proposal was to assess the relationship between malnutrition and the recovery of patients with hip fracture. A total of 110 patients with hip fractures who were admitted to the orthopedic unit at the Reina Sofía Hospital were reassessed one year after discharge. A prospective cohort design and logistic regression analysis was used. Mean age was 81.4, and 80% of patients were women. After one year 19.7% of patients had died. A multivariate analysis showed a significant relationship between a poor functional recovery and age (odds ratio [OR] = 1.19), caloric malnutrition (OR = 290), protein malnutrition (OR = 125); and there was a significant relationship between being confined to bed and a worse situation before fracture (OR = 10.02); caloric malnutrition (OR = 9.57) and protein malnutrition (OR = 15.23). Caloric and protein malnutrition were associated with a worse functional recovery in elderly patients with hip fracture.

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

DTIC Science & Technology

2017-01-01

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

A Numerical Model Study of the Effect of Channel Deepening on Shoaling and Salinity Intrusion in the Savannah Estuary

DTIC Science & Technology

1989-12-01

H tY) T , iv OFTECHNICAL REPORT HL-89-26 A NUMERICAL MODEL STUDY OF THE EFFECT SOF CHANNEL DEEPENING ON SHOALING AND SALINITY INTRUSION IN THE... Study of the Effect of Channel Deepening on Shoaling and Salinity Intrusion in the Savannah Estuary 12. PERSONAL AUTHOR(S) Johnson, B. H.; Trawle, M. J...a multiple-connected system of channels. Results from a study in the Savannah Estuary show good agreement with 1985 field data on tides, velocities

The Influence of Acidity on Microbial Fuel Cells Containing Shewanella Oneidensis (PREPRINT)

DTIC Science & Technology

2008-09-01

d a fi b i s a h t s p t o m d C H p F 8 ig. 4. Cyclic voltammetry of filter sterilized media after 4 days of growth of S. neidensis MR-1 or S...of autologous mediators in the rowthmedium changeswith pH.We analyzed filter sterilized cul- ure supernatants by cyclic voltammetry (Fig. 4), and HPLC...Marsili et al., 2008). Cyclic voltammetrywas used to detect redox-active compounds n growthmedia supernatants fromMR-1 andDSP10 cultures. Fig. 4 hows

29 CFR 93.300 - Professional and technical services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... technical services shall be limited to advice and analysis directly applying any professional or technical... analysis directly applying their professional or technical expertise and unless the advice or analysis is... 29 Labor 1 2011-07-01 2011-07-01 false Professional and technical services. 93.300 Section 93.300...

Common Genetic Variants in ARNTL and NPAS2 and at Chromosome 12p13 are Associated with Objectively Measured Sleep Traits in the Elderly

PubMed Central

Evans, Daniel S.; Parimi, Neeta; Nievergelt, Caroline M.; Blackwell, Terri; Redline, Susan; Ancoli-Israel, Sonia; Orwoll, Eric S.; Cummings, Steven R.; Stone, Katie L.; Tranah, Gregory J.

2013-01-01

Study Objectives: To determine the association between common genetic variation in the clock gene pathway and objectively measured acti-graphic sleep and activity rhythm traits. Design: Genetic association study in two population-based cohorts of elderly participants: the Study of Osteoporotic Fractures (SOF) and the Osteoporotic Fractures in Men (MrOS) study. Setting: Population-based. Participants: SOF participants (n = 1,407, 100% female, mean age 84 years) and MrOS participants (n = 2,527, 100% male, mean age 77 years) with actigraphy and genotype data. Interventions: N/A. Measurements and Results: Common genetic variation in 30 candidate genes was captured using 529 single nucleotide polymorphisms (SNPs). Sleep and activity rhythm traits were objectively measured using wrist actigraphy. In a region of high linkage disequilibrium on chromosome 12p13 containing the candidate gene GNB3, the rs1047776 A allele and the rs2238114 C allele were significantly associated with higher wake after sleep onset (meta-analysis: rs1047776 PADD = 2 × 10-5, rs2238114 PADD = 5 × 10-5) and lower LRRC23 gene expression (rs1047776: ρ = -0.22, P = 0.02; rs2238114: ρ = -0.50, P = 5 × 10-8). In MrOS participants, SNPs in ARNTL and NPAS2, genes coding for binding partners, were associated with later sleep and wake onset time (sleep onset time: ARNTL rs3816358 P2DF = 1 × 10-4, NPAS2 rs3768984 P2DF = 5 × 10-5; wake onset time: rs3816358 P2DF = 3 × 10-3, rs3768984 P2DF = 2 × 10-4) and the SNP interaction was significant (sleep onset time PINT = 0.003, wake onset time PINT = 0.001). A SNP association in the CLOCK gene replicated in the MrOS cohort, and rs3768984 was associated with sleep duration in a previously reported study. Cluster analysis identified four clusters of genetic associations. Conclusions: These findings support a role for common genetic variation in clock genes in the regulation of inter-related sleep traits in the elderly. Citation: Evans DS; Parimi N; Nievergelt CM; Blackwell T; Redline S; Ancoli-Israel S; Orwoll ES; Cummings SR; Stone KL; Tranah GJ. Common genetic variants in ARNTL and NPAS2 and at chromosome 12p13 are associated with objectively measured sleep traits in the elderly. SLEEP 2013;36(3):431-446. PMID:23449886

76 FR 43175 - Approval of Air Quality Implementation Plans; Indiana and Ohio; Disapproval of Interstate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... impact. EPA stated that the state's conclusion should be supported by an adequate technical analysis. EPA... by an adequate technical analysis. IDEM did not provide a technical analysis in its submittal, but... technical analysis and justification necessary to make that demonstration. Indiana did not provide any...

Effect of Various Finishing Procedures on the Reflectivity (Shine) of Tooth Enamel - An In-vitro Study.

PubMed

Patil, Harshal Ashok; Chitko, Shrikant Shrinivas; Kerudi, Veerendra Virupaxappa; Maheshwari, Amit Ratanlal; Patil, Neeraj Suresh; Tekale, Pawankumar Dnyandeo; Gore, Ketan Ashorao; Zope, Amit Ashok

2016-08-01

Reflectivity of an object is a good parameter for surface finish. As the patient evaluates finishing as a function of gloss/reflectivity/shine an attempt is made here to evaluate changes in surface finish with custom made reflectometer. The aim of the present study was to study the effect of various procedures during orthodontic treatment on the shine of enamel, using a custom made reflectometer. Sixty one extracted premolars were collected and each tooth was mounted on acrylic block. Reflectivity of the teeth was measured as compared to standard before any procedure. One tooth was kept as standard throughout the study. Sixty teeth were acid etched. Reflectivity was measured on custom made reflectometer and readings recorded. Same procedure was repeated after debonding. Then 60 samples were divided into three groups: Group 1 - Tungsten Carbide, Group 2 - Astropol, Group 3- Sof-Lex disc depending upon the finishing method after debonding and reflectivity was measured. The mean percentage of reflectivity after acid etching was 31.4%, debonding 45.5%, Tungsten carbide bur finishing (Group 1) was 58.3%, Astropol (Group 2) 72.8%, and Sof-Lex disc (Group 3) 84.4% as that to the standard. There was statistically very highly significant (p<0.001) difference in reflectivity restored by the three finishing materials in the study. Thus, the light reflection was better in Group 3> Group 2> Group 1. The primary goal was to restore the enamel to its original state after orthodontic treatment. The methods tested in this study could not restore the original enamel reflectivity.

Sulcus implantation of a 3-piece, 6.0 mm optic, hydrophobic foldable acrylic intraocular lens in phacoemulsification complicated by posterior capsule rupture.

PubMed

Brazitikos, Periklis D; Balidis, Miltiadis O; Tranos, Paris; Androudi, Sofia; Papadopoulos, Nick T; Tsinopoulos, Ioannis T; Karabatakis, Vasilios; Stangos, Nikolaos T

2002-09-01

To evaluate the safety of implanting a 3-piece, 6.0 mm optic, foldable acrylic intraocular lens (IOL) in cases of posterior capsule rupture during phacoemulsification. Department of Ophthalmology, Ahepa Hospital, Aristotle University Medical School, and Interbalkan Medical Center, Thessaloniki, Greece. This prospective noncomparative case series included 28 eyes (28 patients) having phacoemulsification complicated by extensive posterior capsule rupture with or without vitreous loss. In all eyes, a 3-piece, 6.0 mm optic, foldable acrylic IOL (AcrySof MA60BM, Alcon) was implanted in the sulcus. Postoperative examination included best corrected visual acuity (BCVA), anterior segment biomicroscopy, IOL centralization and position, intraocular pressure (IOP), and fundus biomicroscopy. The follow-up was 6 months. The most common postoperative complications were transient corneal edema in 12 eyes and increased IOP in 11 eyes. Slight asymptomatic decentralization from the center of the pupil (1.0 to 2.0 mm) and pseudophacodonesis were observed in 5 eyes each. Friction of the IOL with the iris occurred in 1 eye. Clinically significant cystoid macular edema occurred in 3 eyes. The final BCVA was between 20/15 and 20/25 in 18 patients, 20/30 in 2, between 20/40 and 20/50 in 4, and between 20/60 and 20/200 in 4. AcrySof IOL implantation in the sulcus during phacoemulsification complicated by posterior capsule rupture preserved the advantages of small-incision surgery. The postoperative behavior and centralization of the IOLs resembled those of poly(methyl methacrylate) lenses.

Assessment of modifications in thickness, curvatures, and volume upon the cornea caused by disposable soft contact lens wear.

PubMed

Del Águila-Carrasco, Antonio J; Domínguez-Vicent, Alberto; Pérez-Vives, Cari; Ferrer-Blasco, Teresa; Montés-Micó, Robert

2015-01-01

To assess the effect of different disposable soft contact lenses on several corneal parameters-thickness, anterior and posterior curvature, and volume-by means of a Scheimpflug imaging-based device (Pentacam HR). Diurnal variations of these parameters were taken into account. Twenty-one young, healthy subjects wore 4 different types of daily disposable soft contact lenses on 4 different days: Dailies AquaComfort Plus, SofLens, Dailies Total1, and Acuvue TruEye. The lenses had different material and water content. Pachymetry and curvature maps and corneal volume values were obtained using the Pentacam HR twice a day: one before putting the lens on and one after an 8-hour period of contact lens wear. Measurements were also taken without any contact lenses being worn. Regarding corneal thickness, the lens with the most similar behavior to the naked eye scenario was the Dailies Total1, causing a thickening of 0.2 ± 0.1% in the central zone and 0.6 ± 0.2% in the periphery. All 4 lenses caused a slight but not significant flattening in the anterior corneal curvature, whereas the posterior corneal curvature only experienced a significant but small steepening with the SofLens. The use of these lenses increased corneal volume slightly. Variations in corneal parameters seem to depend on the type of contact lens used (material, oxygen transmissibility, water content). However, the magnitude of the changes introduced by the use of soft contact lenses over the 8-hour period was small and probably not large enough to influence either visual acuity or comfort.

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

PubMed

Wright, Alexander D; Laing, Andrew C

2011-07-01

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

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

PubMed Central

Wright, Alexander D.; Laing, Andrew C.

2012-01-01

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

In Vitro Antiviral Activity and Resistance Profile Characterization of the Hepatitis C Virus NS5A Inhibitor Ledipasvir.

PubMed

Cheng, Guofeng; Tian, Yang; Doehle, Brian; Peng, Betty; Corsa, Amoreena; Lee, Yu-Jen; Gong, Ruoyu; Yu, Mei; Han, Bin; Xu, Simin; Dvory-Sobol, Hadas; Perron, Michel; Xu, Yili; Mo, Hongmei; Pagratis, Nikos; Link, John O; Delaney, William

2016-01-11

Ledipasvir (LDV; GS-5885), a component of Harvoni (a fixed-dose combination of LDV with sofosbuvir [SOF]), is approved to treat chronic hepatitis C virus (HCV) infection. Here, we report key preclinical antiviral properties of LDV, including in vitro potency, in vitro resistance profile, and activity in combination with other anti-HCV agents. LDV has picomolar antiviral activity against genotype 1a and genotype 1b replicons with 50% effective concentration (EC50) values of 0.031 nM and 0.004 nM, respectively. LDV is also active against HCV genotypes 4a, 4d, 5a, and 6a with EC50 values of 0.11 to 1.1 nM. LDV has relatively less in vitro antiviral activity against genotypes 2a, 2b, 3a, and 6e, with EC50 values of 16 to 530 nM. In vitro resistance selection with LDV identified the single Y93H and Q30E resistance-associated variants (RAVs) in the NS5A gene; these RAVs were also observed in patients after a 3-day monotherapy treatment. In vitro antiviral combination studies indicate that LDV has additive to moderately synergistic antiviral activity when combined with other classes of HCV direct-acting antiviral (DAA) agents, including NS3/4A protease inhibitors and the nucleotide NS5B polymerase inhibitor SOF. Furthermore, LDV is active against known NS3 protease and NS5B polymerase inhibitor RAVs with EC50 values equivalent to those for the wild type. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

In Vitro Antiviral Activity and Resistance Profile Characterization of the Hepatitis C Virus NS5A Inhibitor Ledipasvir

PubMed Central

Tian, Yang; Doehle, Brian; Peng, Betty; Corsa, Amoreena; Lee, Yu-Jen; Gong, Ruoyu; Yu, Mei; Han, Bin; Xu, Simin; Dvory-Sobol, Hadas; Perron, Michel; Xu, Yili; Mo, Hongmei; Pagratis, Nikos; Link, John O.; Delaney, William

2016-01-01

Ledipasvir (LDV; GS-5885), a component of Harvoni (a fixed-dose combination of LDV with sofosbuvir [SOF]), is approved to treat chronic hepatitis C virus (HCV) infection. Here, we report key preclinical antiviral properties of LDV, including in vitro potency, in vitro resistance profile, and activity in combination with other anti-HCV agents. LDV has picomolar antiviral activity against genotype 1a and genotype 1b replicons with 50% effective concentration (EC50) values of 0.031 nM and 0.004 nM, respectively. LDV is also active against HCV genotypes 4a, 4d, 5a, and 6a with EC50 values of 0.11 to 1.1 nM. LDV has relatively less in vitro antiviral activity against genotypes 2a, 2b, 3a, and 6e, with EC50 values of 16 to 530 nM. In vitro resistance selection with LDV identified the single Y93H and Q30E resistance-associated variants (RAVs) in the NS5A gene; these RAVs were also observed in patients after a 3-day monotherapy treatment. In vitro antiviral combination studies indicate that LDV has additive to moderately synergistic antiviral activity when combined with other classes of HCV direct-acting antiviral (DAA) agents, including NS3/4A protease inhibitors and the nucleotide NS5B polymerase inhibitor SOF. Furthermore, LDV is active against known NS3 protease and NS5B polymerase inhibitor RAVs with EC50 values equivalent to those for the wild type. PMID:26824950

Effectiveness and safety of ledipasvir/sofosbuvir±ribavirin in the treatment of HCV infection: The real-world HARVEST study.

PubMed

Flisiak, Robert; Łucejko, Mariusz; Mazur, Włodzimierz; Janczewska, Ewa; Berak, Hanna; Tomasiewicz, Krzysztof; Mozer-Lisewska, Iwona; Kozielewicz, Dorota; Gietka, Andrzej; Sikorska, Katarzyna; Wawrzynowicz-Syczewska, Marta; Nowak, Krzysztof; Zarębska-Michaluk, Dorota; Musialik, Joanna; Simon, Krzysztof; Garlicki, Aleksander; Pleśniak, Robert; Baka-Ćwierz, Barbara; Olszok, Iwona; Augustyniak, Krystyna; Stolarz, Wojciech; Białkowska, Jolanta; Badurek, Anna; Piekarska, Anna

2017-09-01

To evaluate the effectiveness and safety of ledipasvir/sofosbuvir (LDV/SOF)±ribavirin (RBV) regimen in a real-world setting. Patients received a fixed-dose combination tablet containing LDV and SOF with or without RBV, for 8, 12 or 24 weeks. Patients were assessed at baseline, end of treatment, and 12 weeks after the end of treatment. The primary effectiveness endpoint was sustained virologic response 12 weeks after the end of treatment (SVR12). Of the 86 patients, aged 20-80 years, 82.6% were HCV genotype 1b-infected and 50.0% were cirrhotic. More than half (52.3%) had previously followed pegylated interferon-containing (PEG-IFN) treatment regimens, and 38.5% were null-responders. SVR12 was achieved by 94.2% of patients. All non-responders were cirrhotic: two demonstrated virologic breakthrough and the remaining three relapsed. All patients treated with an 8-week regimen achieved SVR12 despite having high viral load at baseline (HCV RNA of >1 million IU/mL in 8/10 patients, including one with a viral load of >6 million IU/mL). Adverse events were generally mild and transient. Most frequently, fatigue (22.1%), headache (15.1%), and arthralgia (7.0%) were observed. Laboratory abnormalities included anemia and hyperbilirubinemia. Treatment with LDV/SOF±RBV is an effective and safe option for patients with HCV, including those with advanced liver disease or a history of non-response to PEG-IFN-based therapy. Copyright © 2017 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.

45 CFR 93.300 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... services shall be limited to advice and analysis directly applying any professional or technical discipline... analysis directly applying their professional or technical expertise and unless the advice or analysis is... 45 Public Welfare 1 2010-10-01 2010-10-01 false Professional and technical services. 93.300...

78 FR 27235 - Technical Guidance for Assessing Environmental Justice in Regulatory Analysis

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

... Justice in Regulatory Analysis.'' The purpose of this guidance is to provide EPA analysts with technical...-566-2363. Mail: Technical Guidance for Assessing Environmental Justice in Regulatory Analysis... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OA-2013-0320; FRL-9810-5] Technical Guidance for Assessing...

13 CFR 146.300 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... services shall be limited to advice and analysis directly applying any professional or technical discipline... analysis directly applying their professional or technical expertise and unless the advice or analysis is... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Professional and technical...

77 FR 47501 - Applications for New Awards; Technical Assistance on State Data Collection, Analysis, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-08

... Awards; Technical Assistance on State Data Collection, Analysis, and Reporting--National IDEA Technical Assistance Center on Early Childhood Longitudinal Data Systems; Notice #0;#0;Federal Register / Vol. 77 , No... for New Awards; Technical Assistance on State Data Collection, Analysis, and Reporting--National IDEA...

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

PubMed

Kemplin, Kate Rocklein; Bowling, F Young

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

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

DTIC Science & Technology

2013-03-01

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

An Introduction to a Reliability Shorthand.

DTIC Science & Technology

1981-03-01

II 00r.nt m 0 e@et IS. SUPPLEMENTARy NOTES It. KEY WORDS (CeMMle soewe" ad s it meomE, d aienf Iyp M mumbw) reliability system survival survival...function systems reliability shorthand redundant systems 20. ASISTRAGT (C411M en .MVm ideS if m I O 1411011010 IV N au11 l) -The determination of a system’s...OF TWOS IS 1 (Uim Urn. lincrl nqqi fi Pd "MTV C P06 L&a TIO 0 To oe 0S S e s O" M ef. Item 20, continued: Simple examples show the convenience of this

VizieR Online Data Catalog: Stellar mass of brightest cluster galaxies (Bellstedt+, 2016)

NASA Astrophysics Data System (ADS)

Bellstedt, S.; Lidman, C.; Muzzin, A.; Franx, M.; Guatelli, S.; Hill, A. R.; Hoekstra, H.; Kurinsky, N.; Labbe, I.; Marchesini, D.; Marsan, Z. C.; Safavi-Naeini, M.; Sifon, C.; Stefanon, M.; van de Sande, J.; van Dokkum, P.; Weigel, C.

2017-11-01

We utilize a sample of 98 newly imaged galaxy clusters from the RELICS (REd Lens Infrared Cluster Survey) survey within this study. The data were collected during six observing runs on three instruments over a period spanning from 2013 October to 2015 March. The instruments utilized were the SofI2 camera on the New Technology Telescope at the European Southern Observatory (ESO) La Silla Observatory in Chile, WHIRC3 on the WIYN telescope at the Kitt Peak National Observatory and LIRIS4 on the William Herschel Telescope (WHT) in La Palma, Spain. (2 data files).

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

DTIC Science & Technology

2013-04-18

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

Increased peripheral CD4+ regulatory T cells persist after successful direct-acting antiviral treatment of chronic hepatitis C.

PubMed

Langhans, Bettina; Nischalke, Hans Dieter; Krämer, Benjamin; Hausen, Annekristin; Dold, Leona; van Heteren, Peer; Hüneburg, Robert; Nattermann, Jacob; Strassburg, Christian P; Spengler, Ulrich

2017-05-01

CD4 + regulatory T cells (Tregs) expand during chronic hepatitis C virus (HCV) infection, inhibit antiviral immunity and promote fibrosis. Direct-acting antiviral agents (DAA) have revolutionized HCV therapy. However, it is unclear if Tregs are normalized after DAA-induced HCV elimination. We analyzed Tregs before (baseline), at end of therapy (EOT), 12 and 24weeks (SVR12, SVR24) and long-term (51±14weeks) after EOT in 26 genotype-1-infected patients who were successfully treated with sofosbuvir (SOF) plus interferon (IFN)/ribavirin (n=12) and IFN-free DAA regimens (SOF plus daclatasvir or simeprevir; n=14). Frequency, phenotype and suppressor function of peripheral Foxp3 + CD25 + CD4 + T cells were studied by multi-color flow cytometry and co-culture inhibition assays. Frequencies and activation status of Foxp3 + CD25 + CD4 + T cells remained elevated above those of normal controls in both treatment groups even long-term after HCV elimination. Co-culture assays indicated a dose-response relationship for functional inhibition of autologous CD4 + effector T cells and confirmed that activation of Tregs remained largely unchanged over the observation period. Unlike IFN-free regimens, SOF plus IFN/ribavirin induced a transiently increased frequency of Foxp3 + CD25 + CD4 + T cells at EOT (5.0% at baseline to 6.1% at EOT; p=0.001). These Foxp3 + CD25 + CD4 + T cells co-expressed the activation markers glycoprotein A repetitions predominant (GARP; p=0.012) and tumor necrosis factor receptor superfamily, member 4 (OX-40; p=0.001) but showed unchanged in vitro inhibitory activity. Although IFN-based DAA therapy induced transient expansion of activated Foxp3 + CD25 + CD4 + T cells, neither IFN-based nor IFN-free DAA regimens normalized frequencies and activation status of Tregs one year after viral elimination. Persistence of immunosuppressive Tregs may thus contribute to complications of liver disease even long-term after HCV cure. In chronic hepatitis C virus (HCV) infection, CD4 + regulatory T cells (Tregs) can reduce antiviral immune responses, promote liver fibrosis and may increase the risk for liver cancer, because they gradually expand during disease. Modern direct-acting antiviral agents (DAA) can "cure" hepatitis C in almost all treated patients. However, our study shows that DAA do not normalize the increased frequency and activation status of Tregs even long-term after HCV elimination. Tregs may persistently modulate functions of the immune system even after "cure" of hepatitis C. Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

DIY Solar Market Analysis Webinar Series: Solar Resource and Technical

Science.gov Websites

Series: Solar Resource and Technical Potential DIY Solar Market Analysis Webinar Series: Solar Resource and Technical Potential Wednesday, June 11, 2014 As part of a Do-It-Yourself Solar Market Analysis summer series, NREL's Solar Technical Assistance Team (STAT) presented a live webinar titled, "Solar

Rapid Development: A Content Analysis Comparison of Literature and Purposive Sampling of AFRL Rapid Reaction Projects

DTIC Science & Technology

2011-12-01

systems engineering technical and technical management processes. Technical Planning, Stakeholders Requirements Development, and Architecture Design were...Stakeholder Requirements Definition, Architecture Design and Technical Planning. A purposive sampling of AFRL rapid development program managers and engineers...emphasize one process over another however Architecture Design , Implementation scored higher among Technical Processes. Decision Analysis, Technical

Capsulorhexis ovaling and capsular bag stretch after rigid and foldable intraocular lens implantation: experimental study in pediatric human eyes.

PubMed

Pandey, Suresh K; Werner, Liliana; Wilson, M Edward; Izak, Andrea M; Apple, David J

2004-10-01

To compare the amount of capsulorhexis ovaling and capsular bag stretch produced by various intraocular lenses (IOLs) implanted in pediatric human eyes obtained post-mortem. David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, Salt Lake City, Utah, USA. In this nonrandomized comparative study, 16 pediatric human eyes obtained postmortem were divided into 2 groups: Eight eyes were obtained from children younger than 2 years (Group A), and 8 eyes were obtained from children older than 2 years (Group B). All eyes were prepared according to the Miyake-Apple posterior video technique. Six types of rigid and foldable posterior chamber IOLs manufactured from poly(methyl methacrylate) (single-piece), silicone (plate and loop haptics), and hydrophobic acrylic (single-piece and 3-piece AcrySof, Alcon Laboratories) biomaterials were implanted. The capsulorhexis opening and capsular bag diameters were measured before IOL implantation and after in-the-bag IOL fixation with the haptics (or the main axis) at the 3 to 9 o'clock meridian. The percentage of ovaling of the capsulorhexis opening was calculated by noting the difference in the opening's horizontal diameter before and after IOL implantation. The percentage of capsular bag stretch was also calculated by noting the difference in the horizontal capsular bag diameter before and after IOL implantation. All IOLs produced ovaling of the capsulorhexis opening and stretching of the capsular bag parallel to the IOL haptics. There were significant differences in capsulorhexis ovaling and capsular bag stretch (P<.001, analysis of variance) between the 6 IOL types in each group of eyes. The postimplantation difference was significant only between the single-piece hydrophobic acrylic IOL (AcrySof) and the other IOLs. The single-piece hydrophobic acrylic IOL was associated with significantly less capsulorhexis ovaling and capsular bag stretch in both groups (mean 12.06% +/- 0.59% [SD] and 7.6% +/- 1.47%, respectively). Modern rigid and foldable IOLs designed for the adult population implanted in the capsular bag of infants and children produced variable degrees of capsulorhexis ovaling and capsular bag stretch. The Miyake-Apple posterior video technique confirmed the well-maintained configuration of the capsular bag (with minimal ovaling) after implantation of a single-piece hydrophobic acrylic IOL because of its flexible haptic design.

Frailty Is a Major Related Factor for at Risk of Malnutrition in Community-Dwelling Older Adults.

PubMed

Chang, Shu-Fang

2017-01-01

We investigated the relationships among geriatric syndrome, physiological functions, and body composition in community-dwelling older people with varying nutritional statuses. Other factors correlated with nutritional status in community-dwelling older people were also explored. The World Health Organization has initiated preventive programs for addressing malnutrition. However, few studies have focused on the correlations among geriatric syndrome, physiological functions, and body composition in older people at risk of malnutrition. We conducted a cross-sectional study. Older people who lived in an urban Taiwanese community were recruited for this research study. The inclusion criteria were age 65 years or older, ability to communicate in Taiwanese, clear consciousness, and ability to communicate independently. The nutritional status of participants was evaluated with the Mini Nutritional Assessment-Short Form. The frailty status was assessed with the Study of Osteoporotic Fractures (SOF) index. The SOF index included the following three items: body weight loss of >5% within 1 year, difficulty in standing from a sitting position in a chair without an armrest five times, and feeling deprived of energy. Participants over 65 years of age, living in a community and without mental illness or acute disease were included in the study. Compared with well-nourished older adults, those at risk of malnutrition were predominantly male; presented with lower body weight, lower body mass index values, lower skeletal mass indices, and poorer muscle strength; and were unable to rise from a seated position in a chair without using the armrest five times. Subjects at risk of malnutrition were less energetic, were more commonly characterized as being sarcopenia, and demonstrated frailty. Body composition analysis demonstrated that a skeletal muscle index of approximately 9.93 and a body fat mass of less than 12.25 kg were related to an increased risk of malnutrition. Older people who were frail exhibited a particularly high risk of malnutrition. The results revealed that the evaluation of malnutrition risk should be conducted in older persons living in the community. Frailty in particular was identified as a major risk factor for malnutrition in community-dwelling elderly persons. Community nurses should pay attention to the nutritional conditions of community-dwelling elderly persons. Community nurses should assess the at-risk population and provide effective preventive strategies and programs to reduce the prevalence of malnutrition and frailty. © 2016 Sigma Theta Tau International.

SPECIAL ANALYSIS FOR SLIT TRENCH DISPOSAL OF THE REACTOR PROCESS HEAT EXCHANGERS

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

Hamm, L.; Collard, L.; Aleman, S.

2012-06-18

The Savannah River National Laboratory (SRNL), in response to a request from Solid Waste Management (SWM), conducted a Special Analysis (SA) to evaluate the performance of nineteen heat exchangers that are to be disposed in the E-Area low level waste facility Slit Trench 9 (ST 9). Although these nineteen heat exchangers were never decontaminated, the majority of the radionuclides in the heat exchanger inventory list were determined to be acceptable for burial because they are less than the 'generic' waste form inventory limits given in the 2008 Performance Assessment (PA) (WSRC, 2008). However, as generic waste, the H-3 and C-14more » inventories resulted in unacceptable sum-of-fractions (SOFs). Initial scoping analyses performed by SRNL indicated that if alterations were made to certain external nozzles to mitigate various potential leak paths, acceptable SOFs could be achieved through the use of a 'Special' waste form. This SA provides the technical basis for this new 'Special' waste form and provides the inventory limits for H-3 and C-14 for these nineteen heat exchangers such that the nineteen heat exchangers can be disposed in ST 9. This 'Special' waste form is limited to these nineteen heat exchangers in ST 9 and applies for H-3 and C-14, which are designated as H-3X and C-14X, respectively. The SA follows the same methodology used in the 2008 PA and the 2008 SA except for the modeling enhancements noted below. Infiltration rates above the heat exchangers are identical to those used in the 2008 PA; however, flow through the heat exchangers is unique. Because it is unknown exactly how sealed heat exchanger openings will perform and how surface and embedded contaminants will be released, multiple base cases or scenarios were established to investigate a set of performances. Each scenario consists of flow options (based on the performance of sealed openings) and a near-field release of contaminants (based on corrosion and diffusion performance). Two disposal configurations were analyzed where heat exchangers were assumed to be disposed four across and five lengthwise (the 4x5 configuration, with one empty) and three across and seven lengthwise (the 3x7 configuration, with two empty). A large range of conditions was considered. For example, peak well concentrations at the 100-m boundary for H-3 are shown in Figure ES-1 for a wide range of configurations (i.e. release mechanism and degree of sealing options). The maximum contaminant level (MCL) and a 10% SOF goal for H-3 are also shown. The 10% goal was based on an estimated volume fraction that these nineteen heat exchangers would consume in ST 9 and was solely used for scoping purposes to assess disposal feasibility and sealing requirements. Because various line breaks and poor sealing greatly exceeded that 10% goal, the determination was made that mitigating activities were needed, such as protection from line breaks and better sealing. An initial set of scenarios was run to assess the requirements for sealing the heat exchanger openings and the need to ensure that the sealed heat exchangers stayed sealed during transit and disposal operations. After discovering that such mitigating activities were required, additional scenarios were run that included the mitigating activities. Scenarios deemed to have a very low probability of occurrence were excluded from consideration for calculating inventory limits (for example, those scenarios that assumed an instantaneous release of contaminants along with poor sealing). The SA used the most recent K{sub d} values for the C-14 analyses and the most recent Dose Conversion Factors for H-3 and C-14 which have been updated since the 2008 PA was issued. This SA took into account the location and the disposal timing of these heat exchangers. The disposal location is within a small area of the overall Slit Trench unit (about 6% of the total) and is behind a line that is 200 ft from the down-gradient edge of ST 9. The disposal timing is assumed to be after July 1, 2012 (because disposals cannot occur until this document is approved and mitigating activities are completed) which means that the disposal occurs after the first time period for the 2008 PA beta-gamma pathway (that time period is from December 1995 until December 2007), thus that pathway time period is not considered. Table ES-1 provides new 'Special' waste form groundwater pathway inventory limits for C-14X and H-3X in the heat exchangers. Inventory limits for generic C-14 and H-3 in the West Slit Trenches are included for comparison. The lowest limit for generic C-14 is 1.9E-1 Ci, while for C-14X it is 2.7E0, an increase of more than 14 times. Because time windows are employed, at later times C-14X exhibits lower limits than those for generic C-14 because with its smaller K{sub d} the C-14 moves much faster. The lowest limit for generic H-3 is 3.6E0 Ci, while for H-3X it is 1.7E3, an increase of almost 500 times.« less

A Technical Analysis Information Fusion Approach for Stock Price Analysis and Modeling

NASA Astrophysics Data System (ADS)

Lahmiri, Salim

In this paper, we address the problem of technical analysis information fusion in improving stock market index-level prediction. We present an approach for analyzing stock market price behavior based on different categories of technical analysis metrics and a multiple predictive system. Each category of technical analysis measures is used to characterize stock market price movements. The presented predictive system is based on an ensemble of neural networks (NN) coupled with particle swarm intelligence for parameter optimization where each single neural network is trained with a specific category of technical analysis measures. The experimental evaluation on three international stock market indices and three individual stocks show that the presented ensemble-based technical indicators fusion system significantly improves forecasting accuracy in comparison with single NN. Also, it outperforms the classical neural network trained with index-level lagged values and NN trained with stationary wavelet transform details and approximation coefficients. As a result, technical information fusion in NN ensemble architecture helps improving prediction accuracy.

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

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

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

Profilometric analysis of two composite resins' surface repolished after tooth brush abrasion with three polishing systems.

PubMed

Uppal, Mudit; Ganesh, Arathi; Balagopal, Suresh; Kaur, Gurleen

2013-07-01

To evaluate the effect of three polishing protocols that could be implemented at recall on the surface roughness of two direct esthetic restorative materials. Specimens (n = 40) measuring 8 mm (length) × 5 mm (width) × 4 mm (height) were fabricated in an acrylic mold using two light-cured resin-based materials (microfilled composite and microhybrid composite). After photopolymerization, all specimens were finished and polished with one of three polishing protocols (Enhance, One Gloss, and Sof-Lex polishing systems). The average surface roughness of each treated specimen was determined using 3D optical profilometer. Next all specimens were brushed 60,000 times with nylon bristles at 7200 rpm using crosshead brushing device with equal parts of toothpaste and water used as abrasive medium. The surface roughness of each specimen was measured after brushing followed by repolishing with one of three polishing protocols, and then, the final surface roughness values were determined. The data were analyzed using one-way and two-factor analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD). Significant difference (P < 0.05) in surface roughness was observed. Simulated brushing following initial polishing procedure significantly roughened the surface of restorative material (P < 0.05). Polishing protocols can be used to restore a smooth surface on esthetic restorative materials following simulated tooth brushing.

Enhancing the Cassini Mission Through FP Applications After Launch

NASA Technical Reports Server (NTRS)

Morgan, Paula S.

2016-01-01

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

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

PubMed

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

2011-07-01

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

In vitro power profiles of daily disposable contact lenses.

PubMed

Belda-Salmerón, Lurdes; Madrid-Costa, David; Ferrer-Blasco, Teresa; García-Lázaro, Santiago; Montés-Micó, Robert

2013-10-01

To evaluate and compare the distribution of refractive power within the optic zone of different soft contact lenses and to investigate the effect of lens decentration on the power profiles. The Nimo TR1504 instrument was used to measure the optical power across different aperture diameters (from 1.5mm to 5.5mm in steps of 0.5mm) of four daily disposable contact lenses: DAILIES TOTAL1, Proclear 1-Day, SofLens daily disposable and 1-DAY ACUVUE MOIST. Measurements were performed using a wet cell. Power data were evaluated when contact lenses were in its centered position and after inducing different amounts of lens decentration (from 0.2mm to 1.0mm in steps of 0.2mm). All contact lenses showed an increase - more negative - in lens power with distance from the lens center. The amount of change varied depending on the lens. It was about 10% of lens power for DAILIES TOTAL1 (-0.29diopters (D)), SofLens daily disposable (-0.36D), and Proclear 1-Day (-0.32D) whereas 1-DAY ACUVUE MOIST showed a percentage variation of 3.3% (-0.10D). After inducing a lens decentration up to 1mm, the power curves were shifted in the negative direction. However, the change obtained in lens power compared with well-centered position was always lower than a quarter of diopter both for all the lenses and aperture diameters. Our results showed a variation of the refractive power from the lens center, becoming more negative toward the periphery, with a negligible effect of the decentration for all disposable contact lenses studied. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Comparison of astigmatism correction using either peripheral corneal relaxing incisions or toric intraocular lenses.

PubMed

Muftuoglu, Ilkay Kilic; Aydin Akova, Yonca; Aksoy, Sibel; Unsal, Erkan

2016-01-01

To compare the efficacy and short-term stability of toric intraocular lenses (tIOL) and peripheral cornea relaxing incisions (PCRI) during phacoemulsification. Patients with preexisting corneal astigmatism had cataract surgery either with tIOL (AcrySof Toric) (39 eyes of 35 patients) or standard intraocular lens (AcrySof) + PCRIs (38 eyes of 33 patients). Patients were retrospectively evaluated for manifest refraction, corneal topography, and uncorrected and corrected visual acuities preoperatively and at postoperative 1 and 6 months. The Alpins vectorial method was used to analyze the target induced astigmatism (TIA) and surgically induced astigmatism (SIA), magnitude of error (the difference between the magnitude of SIA and TIA) (ME), and correction index. Mean preoperative corneal astigmatism was 2.21 ± 1.32 D in the tIOL group and 2.24 ± 0.96 D in the PCRI group; the difference was not significant. The decrease in astigmatism was significant in both groups at last follow-up (64% tIOL group, 32% PCRI group, p<0.01, Wilcoxon signed rank test). The mean remaining refractive astigmatism was significantly higher in the PCRI group than in the tIOL group at 1-month (1.42 ± 1.22, 0.89 ± 0.68, respectively) and 6-month follow-ups (1.75 ± 1.37 D, 0.92 ± 0.72, respectively) (p<0.01). The mean ME was significantly lower (-0.35 versus -0.88) with a higher correction index (0.96 versus 0.56) in the tIOL group at 6 months postoperatively. Both tIOL implantation and using PCRI were effective methods to reduce preoperative astigmatism at the time of the cataract surgery. However, tIOLs provided better remaining astigmatism with a more stable refraction than PCRI.

In vivo longitudinal chromatic aberration of pseudophakic eyes.

PubMed

Siedlecki, Damian; Jóźwik, Agnieszka; Zając, Marek; Hill-Bator, Aneta; Turno-Kręcicka, Anna

2014-02-01

To present the results of longitudinal chromatic aberration measurements on two groups of pseudophakic eyes in comparison to healthy eyes. The longitudinal chromatic aberration of the eye, defined as chromatic difference of refraction with disabled accommodation, was measured with the use of a visual refractometer with a custom-designed target illuminator consisting of a narrow-band RGB diode (blue λb = 470 ± 15 nm; green λg = 525 ± 18 nm; red λr = 660 ± 10 nm). The measurements were performed on nine eyes implanted with AcrySof IQ SN60WF, 14 eyes implanted with AcrySof SA60AT, and 10 phakic eyes under cycloplegia. The mean values of the longitudinal chromatic aberration between 470 and 660 nm for the control group was 1.12 ± 0.14 D. For SA60AT group, it was 1.45 ± 0.42 D whereas for SN60WF it was 1.17 ± 0.52 D. The statistical test showed significant difference between SA60AT and the control group (p < 0.05) and no significant difference between SN60WF and the control groups (p = 0.64). The study showed that the longitudinal chromatic aberration in vivo can be easily and reliably estimated with an adapted visual refractometer. The two groups of pseudophakic eyes measured in this study showed different values of chromatic aberration. Its magnitude for SA60AT group was significantly larger than for the control group whereas for SN60WF the difference was not significant. The optical material used for intraocular lens design may have significant influence on the magnitude of the chromatic aberration of the pseudophakic eye, and therefore on its optical and visual performance in polychromatic light.

Effects of particulate oxidation catalyst on unregulated pollutant emission and toxicity characteristics from heavy-duty diesel engine.

PubMed

Feng, Xiangyu; Ge, Yunshan; Ma, Chaochen; Tan, Jianwei

2015-01-01

To evaluate the effects of particulate oxidation catalyst (POC) on unregulated pollutant emission and toxicity characteristics, polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs), soot, soluble organic fractions (SOF) and sulphate emissions emitted from a heavy-duty diesel engine retrofitted with a POC were investigated on a diesel bench. The particulate matter (PM) in the exhaust was collected by Teflon membrane, and the PAHs and VOCs were analysed by a gas chromatography/mass spectrometer (GC/MS). The results indicate that the POC exhibits good performance on the emission control of VOCs, PAHs and PM. The POC and the diesel particulate filters (DPF) both show a good performance on reducing the VOCs emission. Though the brake-specific emission (BSE) reductions of the total PAHs by the POC were lower than those by the DPF, the POC still removed almost more than 50% of the total PAHs emission. After the engine was retrofitted with the POC, the reductions of the PM mass, SOF and soot emissions were 45.2-89.0%, 7.8-97.7% and 41.7-93.3%, respectively. The sulphate emissions decreased at low and medium loads, whereas at high load, the results were contrary. The PAHs emissions were decreased by 32.4-69.1%, and the contributions of the PAH compounds were affected by the POC, as well as by load level. The benzo[a]pyrene equivalent (BaPeq) of PAHs emissions were reduced by 35.9-97.6% with the POC. The VOCs emissions were reduced by 21.8-94.1% with the POC, and the reduction was more evident under high load.

Compatible Models of Carbon Content of Individual Trees on a Cunninghamia lanceolata Plantation in Fujian Province, China

PubMed Central

Zhuo, Lin; Tao, Hong; Wei, Hong; Chengzhen, Wu

2016-01-01

We tried to establish compatible carbon content models of individual trees for a Chinese fir (Cunninghamia lanceolata (Lamb.) Hook.) plantation from Fujian province in southeast China. In general, compatibility requires that the sum of components equal the whole tree, meaning that the sum of percentages calculated from component equations should equal 100%. Thus, we used multiple approaches to simulate carbon content in boles, branches, foliage leaves, roots and the whole individual trees. The approaches included (i) single optimal fitting (SOF), (ii) nonlinear adjustment in proportion (NAP) and (iii) nonlinear seemingly unrelated regression (NSUR). These approaches were used in combination with variables relating diameter at breast height (D) and tree height (H), such as D, D2H, DH and D&H (where D&H means two separate variables in bivariate model). Power, exponential and polynomial functions were tested as well as a new general function model was proposed by this study. Weighted least squares regression models were employed to eliminate heteroscedasticity. Model performances were evaluated by using mean residuals, residual variance, mean square error and the determination coefficient. The results indicated that models with two dimensional variables (DH, D2H and D&H) were always superior to those with a single variable (D). The D&H variable combination was found to be the most useful predictor. Of all the approaches, SOF could establish a single optimal model separately, but there were deviations in estimating results due to existing incompatibilities, while NAP and NSUR could ensure predictions compatibility. Simultaneously, we found that the new general model had better accuracy than others. In conclusion, we recommend that the new general model be used to estimate carbon content for Chinese fir and considered for other vegetation types as well. PMID:26982054

Surgical Menopause and Nonvertebral Fracture Risk among Older U.S. Women

PubMed Central

Vesco, Kimberly K.; Marshall, Lynn M.; Nelson, Heidi D.; Humphrey, Linda; Rizzo, Joanne; Pedula, Kathryn L.; Cauley, Jane A.; Ensrud, Kristine E.; Hochberg, Marc C.; Antoniucci, Diana; Hillier, Teresa A.

2011-01-01

Objective To determine whether older postmenopausal women with a history of bilateral oophorectomy prior to natural menopause (surgical menopause) have a higher risk of nonvertebral, postmenopausal fracture than women with natural menopause. Methods We used 21 years of prospectively collected incident fracture data from the ongoing Study of Osteoporotic Fractures (SOF), a cohort study of community dwelling women without previous bilateral hip fracture who were age 65 or older at enrollment, to determine the risk of hip, wrist, and any nonvertebral fracture. Chi square and t-tests were used to compare the two groups on important characteristics. Multivariable Cox proportional hazards regression models stratified by baseline oral estrogen use status were used to estimate the risk of fracture. Results Baseline characteristics differed significantly between the 6,616 women within SOF who underwent either surgical (1,157) or natural (5,459) menopause, including mean age at menopause (44.3 ±7.4 versus 48.9 ±4.9 years, p<.001) and current use of oral estrogen (30.2% vs 6.5%, p<.001). Fracture rates were not significantly increased for surgical versus natural menopause, even among women who had never used oral estrogen (hip fracture, hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.63–1.21; wrist fracture HR 1.10, 95% CI 0.78–1.57; any nonvertebral fracture HR 1.11, 95% CI 0.93–1.32). Conclusion These data provide some reassurance that the long-term risk of nonvertebral fracture is not substantially increased for postmenopausal women who experienced premenopausal bilateral oophorectomy, compared to postmenopausal women with intact ovaries, even in the absence of postmenopausal estrogen therapy. PMID:22547252

Evaluation of rotation and visual outcomes after implantation of monofocal and multifocal toric intraocular lenses.

PubMed

Garzón, Nuria; Poyales, Francisco; de Zárate, Begoña Ortíz; Ruiz-García, Jose Luis; Quiroga, Juan Antonio

2015-02-01

To evaluate rotational stability and its influence on postoperative visual acuity of different monofocal and multifocal toric intraocular lenses (IOLs). A prospective interventional study was designed. Ninety-one patients with a mean age of 71.65 ± 11.82 years were implanted with toric IOLs after phacoemulsification. Three monofocal toric IOLs (the Lentis LT [Oculentis, Berlin, Germany], enVista [Bausch & Lomb, Rochester, NY], and AcrySof IQ [Alcon Laboratories, Inc., Fort Worth, TX]) and one multifocal toric IOL (AcrySof IQ ReSTOR; Alcon Laboratories, Inc.) were implanted. Preoperative and postoperative images were taken to calculate the misalignment due to the marking method. To evaluate rotation in the different follow-up visits, another photograph was taken 1 hour and 1, 7 and 30 days postoperatively. Refraction, uncorrected distance visual acuity (UDVA), and corrected distance visual acuity were measured 30 days postoperatively. Postoperative UDVA was 0.1 logMAR or better in 64.6% of eyes implanted with monofocal IOLs and 46.4% of eyes implanted with multifocal IOLs. The enVista toric IOL showed the best UDVA compared to the other monofocal IOLs, with 81% of eyes with 0.1 logMAR or better. The mean misalignment in the total group studied was 0.07° ± 0.60°; 69.6% of monofocal IOLs and 67.9% of multifocal IOLs showed less than 5° of rotation. A correlation was found between postoperative UDVA and rotation in the monofocal and multifocal IOLs implanted (r = 0.439 [P < .011] and = 0.787 [P = .001], respectively). At 1 month postoperatively, UDVA was slightly more affected by IOL rotation in multifocal than monofocal toric IOLs. The marking method was also effective. Copyright 2015, SLACK Incorporated.

Low incidence of hepatitis B virus reactivation and subsequent hepatitis in patients with chronic hepatitis C receiving direct-acting antiviral therapy.

PubMed

Tamori, A; Abiru, S; Enomoto, H; Kioka, K; Korenaga, M; Tani, J; Enomoto, M; Sugiyama, M; Masaki, T; Kawada, N; Yatsuhashi, H; Nishiguchi, S; Mizokami, M

2018-05-01

To determine the clinical characteristics of hepatitis B virus (HBV) reactivation in patients undergoing interferon-free antihepatitis C virus (HCV) therapy, we examined HBV DNA in 25 HBV co-infected patients and 765 patients with resolved HBV infection during and after treatment with direct-acting antiviral agents (DAAs). Among those with HCV genotype 1, asunaprevir plus daclatasvir was administered to 160 patients, sofosbuvir (SOF) plus ledipasvir to 438 patients and paritaprevir plus ombitasvir and ritonavir to 25 patients. In total, 167 patients with genotype 2 were treated with SOF plus ribavirin. Three patients with an HBV DNA level ≥2000 IU/mL were treated with entecavir before anti-HCV therapy, without reactivation of HBV. In 3 of 22 (12%) HBV surface antigen (HBsAg)-positive patients with an HBV DNA level <2000 IU/mL, the viral load increased during treatment. However, hepatitis flare did not occur in these patients. There was no significant difference in clinical history between patients with and without HBV reactivation. Among 765 patients with resolved HBV infection, HBV reactivation occurred in 1 (0.1%) patient after initial resolution, whose HBV DNA level spontaneously decreased after DAA therapy. We compared anti-HBs titres at baseline with those at post-DAA therapy in 123 patients without HBsAg. There was no significant difference in anti-HBs levels between the two points (P = .79). In conclusion, HBV reactivation was rare in HBsAg-negative patients treated with DAA therapy. Additionally, hepatitis did not occur in HBV-reactivated patients with a baseline HBV DNA level <2000 IU/mL before DAA therapy. © 2017 John Wiley & Sons Ltd.

Identification of a Novel Virulence Determinant with Serum Opacification Activity in Streptococcus suis

PubMed Central

Baums, Christoph G.; Kaim, Ute; Fulde, Marcus; Ramachandran, Girish; Goethe, Ralph; Valentin-Weigand, Peter

2006-01-01

Streptococcus suis serotype 2 is a porcine and human pathogen with adhesive and invasive properties. In other streptococci, large surface-associated proteins (>100 kDa) of the MSCRAMM family (microbial surface components recognizing adhesive matrix molecules) are key players in interactions with host tissue. In this study, we identified a novel opacity factor of S. suis (OFS) with structural homology to members of the MSCRAMM family. The N-terminal region of OFS is homologous to the respective regions of fibronectin-binding protein A (FnBA) of Streptococcus dysgalactiae and the serum opacity factor (SOF) of Streptococcus pyogenes. Similar to these two proteins, the N-terminal domain of OFS opacified horse serum. Serum opacification activity was detectable in sodium dodecyl sulfate extracts of wild-type S. suis but not in extracts of isogenic ofs knockout mutants. Heterologous expression of OFS in Lactococcus lactis demonstrated that a high level of expression of OFS is sufficient to provide surface-associated serum opacification activity. Furthermore, serum opacification could be inhibited by an antiserum against recombinant OFS. The C-terminal repetitive sequence elements of OFS differed significantly from the respective repeat regions of FnBA and SOF as well as from the consensus sequence of the fibronectin-binding repeats of MSCRAMMs. Accordingly, fibronectin binding was not detectable in recombinant OFS. To investigate the putative function of OFS in the pathogenesis of invasive S. suis diseases, piglets were experimentally infected with an isogenic mutant strain in which the ofs gene had been knocked out by an in-frame deletion. The mutant was severely attenuated in virulence but not in colonization, demonstrating that OFS represents a novel virulence determinant of S. suis. PMID:17057090

Streptococcal serum opacity factor promotes cholesterol ester metabolism and bile acid secretion in vitro and in vivo.

PubMed

Gillard, Baiba K; Rodriguez, Perla J; Fields, David W; Raya, Joe L; Lagor, William R; Rosales, Corina; Courtney, Harry S; Gotto, Antonio M; Pownall, Henry J

2016-03-01

Plasma high density lipoprotein-cholesterol (HDL-C) concentrations negatively correlate with atherosclerotic cardiovascular disease. HDL is thought to have several atheroprotective functions, which are likely distinct from the epidemiological inverse relationship between HDL-C levels and risk. Specifically, strategies that reduce HDL-C while promoting reverse cholesterol transport (RCT) may have therapeutic value. The major product of the serum opacity factor (SOF) reaction versus HDL is a cholesteryl ester (CE)-rich microemulsion (CERM), which contains apo E and the CE of ~400,000 HDL particles. Huh7 hepatocytes take up CE faster when delivered as CERM than as HDL, in part via the LDL-receptor (LDLR). Here we compared the final RCT step, hepatic uptake and subsequent intracellular processing to cholesterol and bile salts for radiolabeled HDL-, CERM- and LDL-CE by Huh7 cells and in vivo in C57BL/6J mice. In Huh7 cells, uptake from LDL was greater than from CERM (2-4X) and HDL (5-10X). Halftimes for [(14)C]CE hydrolysis were 3.0±0.2, 4.4±0.6 and 5.4±0.7h respectively for HDL, CERM and LDL-CE. The fraction of sterols secreted as bile acids was ~50% by 8h for all three particles. HDL, CERM and LDL-CE metabolism in mice showed efficient plasma clearance of CERM-CE, liver uptake and metabolism, and secretion as bile acids into the gall bladder. This work supports the therapeutic potential of the SOF reaction, which diverts HDL-CE to the LDLR, thereby increasing hepatic CE uptake, and sterol disposal as bile acids. Copyright © 2015 Elsevier B.V. All rights reserved.

10 CFR 52.157 - Contents of applications; technical information in final safety analysis report.

Code of Federal Regulations, 2013 CFR

2013-01-01

...; technical information in final safety analysis report. The application must contain a final safety analysis...) Information sufficient to demonstrate compliance with the applicable requirements regarding testing, analysis... 10 Energy 2 2013-01-01 2013-01-01 false Contents of applications; technical information in final...

10 CFR 52.157 - Contents of applications; technical information in final safety analysis report.

Code of Federal Regulations, 2012 CFR

2012-01-01

...; technical information in final safety analysis report. The application must contain a final safety analysis...) Information sufficient to demonstrate compliance with the applicable requirements regarding testing, analysis... 10 Energy 2 2012-01-01 2012-01-01 false Contents of applications; technical information in final...

10 CFR 52.157 - Contents of applications; technical information in final safety analysis report.

Code of Federal Regulations, 2014 CFR

2014-01-01

...; technical information in final safety analysis report. The application must contain a final safety analysis...) Information sufficient to demonstrate compliance with the applicable requirements regarding testing, analysis... 10 Energy 2 2014-01-01 2014-01-01 false Contents of applications; technical information in final...

10 CFR 52.157 - Contents of applications; technical information in final safety analysis report.

Code of Federal Regulations, 2011 CFR

2011-01-01

...; technical information in final safety analysis report. The application must contain a final safety analysis...) Information sufficient to demonstrate compliance with the applicable requirements regarding testing, analysis... 10 Energy 2 2011-01-01 2011-01-01 false Contents of applications; technical information in final...

28 CFR 69.300 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... limited to advice and analysis directly applying any professional or technical discipline. For example... their professional or technical expertise and unless the advice or analysis is rendered directly and... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Professional and technical services. 69...

22 CFR 138.205 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... to advice and analysis directly applying any professional or technical discipline. For example... their professional or technical expertise and unless the advice or analysis is rendered directly and... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Professional and technical services. 138.205...

44 CFR 18.300 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... and technical services” shall be limited to advice and analysis directly applying any professional or... and analysis directly applying their professional or technical expertise and unless the advice or... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Professional and technical...

38 CFR 45.300 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and technical services” shall be limited to advice and analysis directly applying any professional or... and analysis directly applying their professional or technical expertise and unless the advice or... technical services. 45.300 Section 45.300 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS...

38 CFR 45.205 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., “professional and technical services” shall be limited to advice and analysis directly applying any professional... provide advice and analysis directly applying their professional or technical expertise and unless the... technical services. 45.205 Section 45.205 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS...

22 CFR 227.205 - Professional and technical services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... to advice and analysis directly applying any professional or technical discipline. For example... their professional or technical expertise and unless the advice or analysis is rendered directly and... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Professional and technical services. 227.205...

22 CFR 519.205 - Professional and technical services.

Code of Federal Regulations, 2011 CFR

2011-04-01

... to advice and analysis directly applying any professional or technical discipline. For example... their professional or technical expertise and unless the advice or analysis is rendered directly and... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Professional and technical services. 519.205...

22 CFR 227.205 - Professional and technical services.

Code of Federal Regulations, 2011 CFR

2011-04-01

... to advice and analysis directly applying any professional or technical discipline. For example... their professional or technical expertise and unless the advice or analysis is rendered directly and... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Professional and technical services. 227.205...

44 CFR 18.300 - Professional and technical services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... and technical services” shall be limited to advice and analysis directly applying any professional or... and analysis directly applying their professional or technical expertise and unless the advice or... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Professional and technical...