Sample records for summary protocol umteap

  1. Clinical Investigation Program RCS-MED-300 (R1)

    DTIC Science & Technology

    1988-09-30

    34, pluse one letter to the editor, and one article published (1986 and 1987). . .. ..... .......... .. . • m mmm il lm9 DETAIL SUMMARY SHEET DATE: 1 ...SUMMARY SHEET DATE: 1 October 1988 PROTOCOL #: 87/08 STATUS: Completed TITLE: A Pilot Study on Effect of Nicotine and Cigarette Smoking on...Clinical Immunology, Anaheim, California in March 1988. 29 DETAIL SUMMARY SHEET DATE: 1 October 1988 PROTOCOL #: 87/12 STATUS: Terminated TITLE: Effect

  2. Development and Validation of a Porcine (Sus scrofa) Sepsis Model

    DTIC Science & Technology

    2018-03-01

    last IACUC approval, have any methods been identified to reduce the number of live animals used in this protocol? None 10. PUBLICATIONS...SUMMARY: (Please provide, in "ABSTRACT" format, a summary of the protocol objectives, materials and methods , results - include tables/figures, and...Materials and methods : Animals were anesthetized and instrumented for cardiovascular monitoring. Lipopolysaccharide (LPS, a large molecule present on the

  3. 15 CFR 785.7 - Summary decision.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Summary decision. 785.7 Section 785.7... INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS ENFORCEMENT § 785.7 Summary decision. The ALJ may render a summary decision disposing of all or part of a proceeding on the motion of...

  4. 78 FR 49693 - Speech-to-Speech and Internet Protocol (IP) Speech-to-Speech Telecommunications Relay Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-15

    ...] Speech-to-Speech and Internet Protocol (IP) Speech-to-Speech Telecommunications Relay Services...: This is a summary of the Commission's Speech-to-Speech and Internet Protocol (IP) Speech-to-Speech...), Internet Protocol Relay (IP Relay), and IP captioned telephone service (IP CTS) as compensable forms of TRS...

  5. Oncologists and Breaking Bad News-From the Informed Patients' Point of View. The Evaluation of the SPIKES Protocol Implementation.

    PubMed

    Marschollek, Paweł; Bąkowska, Katarzyna; Bąkowski, Wojciech; Marschollek, Karol; Tarkowski, Radosław

    2018-02-05

    The way that bad news is disclosed to a cancer patient has a crucial impact on physician-patient cooperation and trust. Consensus-based guidelines provide widely accepted tools for disclosing unfavorable information. In oncology, the most popular one is called the SPIKES protocol. A 17-question survey was administered to a group of 226 patients with cancer (mean age 59.6 years) in order to determine a level of SPIKES implementation during first cancer disclosure. In our assessment, the patients felt that the highest compliance with the SPIKES protocol was with Setting up (70.6%), Knowledge (72.8%), and Emotions (75.3%). The lowest was with the Perception (27.7%), Invitation (30.4%), and Strategy & Summary (56.9%) parts. There could be improvement with each aspect of the protocol, but especially in Perception, Invitation, and Strategy & Summary. The latter is really important and must be done better. Older patients felt the doctors' language was more comprehensible (r = 0.17; p = 0.011). Patients' satisfaction of their knowledge about the disease and follow-up, regarded as an endpoint, was insufficient. Privacy was important in improving results (p < 0.01). In practice, the SPIKES protocol is implemented in a satisfactory standard, but it can be improved in each area, especially in Perception, Invitation, and Summary. It is suggested that more training should be done in undergraduate and graduate medical education and the effectiveness of the disclosure continue to be evaluated and improved.

  6. A Methodology and Software Environment for Testing Process Model’s Sequential Predictions with Protocols

    DTIC Science & Technology

    1992-12-21

    in preparation). Foundations of artificial intelligence. Cambridge, MA: MIT Press. O’Reilly, R. C. (1991). X3DNet: An X- Based Neural Network ...2.2.3 Trace based protocol analysis 19 2.2A Summary of important data features 21 2.3 Tools related to process model testing 23 2.3.1 Tools for building...algorithm 57 3. Requirements for testing process models using trace based protocol 59 analysis 3.1 Definition of trace based protocol analysis (TBPA) 59

  7. Acute Delayed Neurotoxicity Evaluation of Two Jet Engine Oils using a Modified Navy and EPA Protocol

    DTIC Science & Technology

    1992-08-01

    Clinical Observations..................................................... 9 Sacrifice and Histopathology ...Single Dose ............... 13 5 Neural Histop.-Ohologic Incidence Summary (Repeated Assay) ..................... 15 6 Neural Histopathologic Lesions...Average Severity Scores (Repeated Assay) ......... 16 7 Neural Histopathologic Incidence Summary (Single-Dose Assay) .................. 17 8 Neural

  8. 77 FR 43538 - Misuse of Internet Protocol (IP) Relay Service; Telecommunications Relay Services and Speech-to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-25

    ... the Internet, this service has become subject to abuse. Among other things, persons have been using IP...] Misuse of Internet Protocol (IP) Relay Service; Telecommunications Relay Services and Speech-to-Speech.... ACTION: Final rule. SUMMARY: In this document, the Commission adopts a measure that prohibits Internet...

  9. Safety of a no-fast protocol for tracheotomy in critical care

    PubMed Central

    Hartl, Trevor; Anderson, Donald; Levi, Jasna

    2015-01-01

    Summary With modern anesthesia, aspiration is an exceedingly rare complication, and we have learned that a prolonged fast can result in serious adverse effects in critically ill patients. We discuss the no-fast protocol implemented at Vancouver General Hospital in 2007 for intubated, tube-fed adult patients who underwent elective open tracheotomy. PMID:25621914

  10. A method for meta-analysis of epidemiological studies.

    PubMed

    Einarson, T R; Leeder, J S; Koren, G

    1988-10-01

    This article presents a stepwise approach for conducting a meta-analysis of epidemiological studies based on proposed guidelines. This systematic method is recommended for practitioners evaluating epidemiological studies in the literature to arrive at an overall quantitative estimate of the impact of a treatment. Bendectin is used as an illustrative example. Meta-analysts should establish a priori the purpose of the analysis and a complete protocol. This protocol should be adhered to, and all steps performed should be recorded in detail. To aid in developing such a protocol, we present methods the researcher can use to perform each of 22 steps in six major areas. The illustrative meta-analysis confirmed previous traditional narrative literature reviews that Bendectin is not related to teratogenic outcomes in humans. The overall summary odds ratio was 1.01 (chi 2 = 0.05, p = 0.815) with a 95 percent confidence interval of 0.66-1.55. When the studies were separated according to study type, the summary odds ratio for cohort studies was 0.95 with a 95 percent confidence interval of 0.62-1.45. For case-control studies, the summary odds ratio was 1.27 with a 95 percent confidence interval of 0.83-1.94. The corresponding chi-square values were not statistically significant at the p = 0.05 level.

  11. Motor-based intervention protocols in treatment of childhood apraxia of speech (CAS)

    PubMed Central

    Maas, Edwin; Gildersleeve-Neumann, Christina; Jakielski, Kathy J.; Stoeckel, Ruth

    2014-01-01

    This paper reviews current trends in treatment for childhood apraxia of speech (CAS), with a particular emphasis on motor-based intervention protocols. The paper first briefly discusses how CAS fits into the typology of speech sound disorders, followed by a discussion of the potential relevance of principles derived from the motor learning literature for CAS treatment. Next, different motor-based treatment protocols are reviewed, along with their evidence base. The paper concludes with a summary and discussion of future research needs. PMID:25313348

  12. A habitat-based point-count protocol for terrestrial birds, emphasizing Washington and Oregon.

    Treesearch

    Mark H. Huff; Kelly A. Bettinger; Howard L. Ferguson; Martin J. Brown; Bob. Altman

    2000-01-01

    We describe a protocol and provide a summary for point-count monitoring of landbirds that is designed for habitat-based objectives. Presentation is in four steps: preparation and planning, selecting monitoring sites, establishing monitoring stations, and conducting point counts. We describe the basis for doing habitat-based point counts, how they are organized, and how...

  13. Short Review on Quantum Key Distribution Protocols.

    PubMed

    Giampouris, Dimitris

    2017-01-01

    Cryptographic protocols and mechanisms are widely investigated under the notion of quantum computing. Quantum cryptography offers particular advantages over classical ones, whereas in some cases established protocols have to be revisited in order to maintain their functionality. The purpose of this paper is to provide the basic definitions and review the most important theoretical advancements concerning the BB84 and E91 protocols. It also aims to offer a summary on some key developments on the field of quantum key distribution, closely related with the two aforementioned protocols. The main goal of this study is to provide the necessary background information along with a thorough review on the theoretical aspects of QKD, concentrating on specific protocols. The BB84 and E91 protocols have been chosen because most other protocols are similar to these, a fact that makes them important for the general understanding of how the QKD mechanism functions.

  14. Accelerating Coagulation in Traumatic Injuries Using Inorganic Polyphosphate-Coated Silica Nanoparticles in a Swine (Sus scrofa) Model

    DTIC Science & Technology

    2018-03-13

    all information . Use additional pages if necessary.) PROTOCOL #: FDG20160012A DATE: 13 March 2018 PROTOCOL TITLE: Accelerating Coagulation...Investigator Attachments: Attachment 1: Defense Technical Information Center (DTIC) Abstract Submission (Mandatory) 4 FDG20160012A...Attachment 1 Defense Technical Information Center (DTIC) Abstract Submission This abstract requires a brief (no more than 200 words) factual summary of the

  15. Determining the Cardiovascular Effect of Partial versus Complete REBOA in a Porcine (Sus scrofa) Model of Hemorrhagic Shock.

    DTIC Science & Technology

    2018-03-09

    all information . Use additional pages if necessary.) PROTOCOL #: FDG20170005A DATE: 9 March 2018 PROTOCOL TITLE: Determining...Investigator Attachments: Attachment 1: Defense Technical Information Center (DTIC) Abstract Submission (Mandatory) 4 FDG20170005A...Attachment 1 Defense Technical Information Center (DTIC) Abstract Submission This abstract requires a brief (no more than 200 words) factual summary of the

  16. Network, system, and status software enhancements for the autonomously managed electrical power system breadboard. Volume 1: Project summary

    NASA Technical Reports Server (NTRS)

    Mckee, James W.

    1990-01-01

    This volume (1 of 4) gives a summary of the original AMPS software system configuration, points out some of the problem areas in the original software design that this project is to address, and in the appendix collects all the bimonthly status reports. The purpose of AMPS is to provide a self reliant system to control the generation and distribution of power in the space station. The software in the AMPS breadboard can be divided into three levels: the operating environment software, the protocol software, and the station specific software. This project deals only with the operating environment software and the protocol software. The present station specific software will not change except as necessary to conform to new data formats.

  17. Functional and nonfunctional testing of ATM networks

    NASA Astrophysics Data System (ADS)

    Ricardo, Manuel; Ferreira, M. E. P.; Guimaraes, Francisco E.; Mamede, J.; Henriques, M.; da Silva, Jorge A.; Carrapatoso, E.

    1995-02-01

    ATM network will support new multimedia services that will require new protocols, those services and protocols will need different test strategies and tools. In this paper, the concepts of functional and non-functional testers of ATM networks are discussed, a multimedia service and its requirements are presented and finally, a summary description of an ATM network and of the test tool that will be used to validate it are presented.

  18. An Analysis of Transmission and Storage Gains from Sliding Checksum Methods

    DTIC Science & Technology

    1998-11-01

    analysed a protocol "rsync" for synchronising related files at different ends of a communications channel with a minimum of transmitted data. This report...Sliding Checksum Methods Executive Summary In a previous report we described, modelled and analysed a protocol "rsync" for synchronising related...collaborative writing of documentation and synchronisation of distributed databases in the situation where no one location is aware of the differences

  19. State Summary of Soil and Groundwater Cleanup Standards for Hydrocarbons

    DTIC Science & Technology

    1993-11-15

    821096-01 November 15, 1993 19970425 057 !DISTfRIBUTI STýA-TEM,_ Approved for public release; Distribution Unlbfited Product - Paranmeter/ Lab Test ...Env-mmenal Mantagemen, 20-270-5613 Product Parameter/ Lab Test Protocol Detection Notification Action Clean-up Level Constituent & Number Level Level...Envi-mnentai Managament, 205-270-.5613 Su m r of Alsk Clanu Sadr s fo Hyrcro Cotmiae Groundwater Product- - Parameter/ Lab Test Protocol ’Detection

  20. Packet flow monitoring tool and method

    DOEpatents

    Thiede, David R [Richland, WA

    2009-07-14

    A system and method for converting packet streams into session summaries. Session summaries are a group of packets each having a common source and destination internet protocol (IP) address, and, if present in the packets, common ports. The system first captures packets from a transport layer of a network of computer systems, then decodes the packets captured to determine the destination IP address and the source IP address. The system then identifies packets having common destination IP addresses and source IP addresses, then writes the decoded packets to an allocated memory structure as session summaries in a queue.

  1. Microcomputer Nurse-Practitioner Protocols

    PubMed Central

    Way, Anthony B.; Rowley, Blair A.; White, Melanie A.

    1982-01-01

    We have developed a set of protocols on a microcomputer to assist in the management of a geographically isolated nurse practitioner. If a mid-level practitioner is supervised by a physician, some system is needed to ensure that approved care is being provided. The currently available paper-based protocols do not adequately serve all the needs for training, auditing, and record keeping. Conversely, adequate systems based on large computers are not feasible for small clinics. We have therefore developed a microcomputer-based system of protocols for a small rural nurse-practitioner's clinic. Our programs are designed for direct use by the practitioners while the patient is in the clinic. The user is given immediate feedback about any errors. The supervisor is later provided with a summary of the protocol uses and errors, and a copy of any erroneous records. The system appears to be easy to use by the nurse practitioner. The protocols are quickly learned and auditing is facilitated.

  2. Key handling in wireless sensor networks

    NASA Astrophysics Data System (ADS)

    Li, Y.; Newe, T.

    2007-07-01

    With the rapid growth of Wireless Sensor Networks (WSNs), many advanced application areas have received significant attention. However, security will be an important factor for their full adoption. Wireless sensor nodes pose unique challenges and as such traditional security protocols, used in traditional networks cannot be applied directly. Some new protocols have been published recently with the goal of providing both privacy of data and authentication of sensor nodes for WSNs. Such protocols can employ private-key and/or public key cryptographic algorithms. Public key algorithms hold the promise of simplifying the network infrastructure required to provide security services such as: privacy, authentication and non-repudiation, while symmetric algorithms require less processing power on the lower power wireless node. In this paper a selection of key establishment/agreement protocols are reviewed and they are broadly divided into two categories: group key agreement protocols and pair-wise key establishment protocols. A summary of the capabilities and security related services provided by each protocol is provided.

  3. Research in parallel computing

    NASA Technical Reports Server (NTRS)

    Ortega, James M.; Henderson, Charles

    1994-01-01

    This report summarizes work on parallel computations for NASA Grant NAG-1-1529 for the period 1 Jan. - 30 June 1994. Short summaries on highly parallel preconditioners, target-specific parallel reductions, and simulation of delta-cache protocols are provided.

  4. Evaluation of warm mix asphalt for Alaska conditions : [summary].

    DOT National Transportation Integrated Search

    2010-09-01

    This project developed and tested protocols to determine concrete curing strength during the construction process, so that : building under very cold conditions can be performed safely and quickly. Researchers determined the laboratory strengthmaturi...

  5. Health surveillance under adverse ergonomics conditions--validity of a screening method adapted for the occupational health service.

    PubMed

    Jonker, Dirk; Gustafsson, Ewa; Rolander, Bo; Arvidsson, Inger; Nordander, Catarina

    2015-01-01

    A new health surveillance protocol for work-related upper-extremity musculoskeletal disorders has been validated by comparing the results with a reference protocol. The studied protocol, Health Surveillance in Adverse Ergonomics Conditions (HECO), is a new version of the reference protocol modified for application in the Occupational Health Service (OHS). The HECO protocol contains both a screening part and a diagnosing part. Sixty-three employees were examined. The screening in HECO did not miss any diagnosis found when using the reference protocol, but in comparison to the reference protocol considerable time savings could be achieved. Fair to good agreement between the protocols was obtained for one or more diagnoses in neck/shoulders (86%, k = 0.62) and elbow/hands (84%, k = 0.49). Therefore, the results obtained using the HECO protocol can be compared with a reference material collected with the reference protocol, and thus provide information of the magnitude of disorders in an examined work group. Practitioner Summary: The HECO protocol is a relatively simple physical examination protocol for identification of musculoskeletal disorders in the neck and upper extremities. The protocol is a reliable and cost-effective tool for the OHS to use for occupational health surveillance in order to detect workplaces at high risk for developing musculoskeletal disorders.

  6. The effectiveness of evidence summaries on health policymakers and health system managers use of evidence from systematic reviews: a systematic review.

    PubMed

    Petkovic, Jennifer; Welch, Vivian; Jacob, Maria Helena; Yoganathan, Manosila; Ayala, Ana Patricia; Cunningham, Heather; Tugwell, Peter

    2016-12-09

    Systematic reviews are important for decision makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which make them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision makers. This systematic review aimed to (1) assess the effectiveness of evidence summaries on policymakers' use of the evidence and (2) identify the most effective summary components for increasing policymakers' use of the evidence. We present an overview of the available evidence on systematic review derivative products. We included studies of policymakers at all levels as well as health system managers. We included studies examining any type of "evidence summary," "policy brief," or other products derived from systematic reviews that presented evidence in a summarized form. The primary outcomes were the (1) use of systematic review summaries in decision-making (e.g., self-reported use of the evidence in policymaking and decision-making) and (2) policymakers' understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We also assessed perceived relevance, credibility, usefulness, understandability, and desirability (e.g., format) of the summaries. Our database search combined with our gray literature search yielded 10,113 references after removal of duplicates. From these, 54 were reviewed in full text, and we included six studies (reported in seven papers) as well as protocols from two ongoing studies. Two studies assessed the use of evidence summaries in decision-making and found little to no difference in effect. There was also little to no difference in effect for knowledge, understanding or beliefs (four studies), and perceived usefulness or usability (three studies). Summary of findings tables and graded entry summaries were perceived as slightly easier to understand compared to complete systematic reviews. Two studies assessed formatting changes and found that for summary of findings tables, certain elements, such as reporting study event rates and absolute differences, were preferred as well as avoiding the use of footnotes. Evidence summaries are likely easier to understand than complete systematic reviews. However, their ability to increase the use of systematic review evidence in policymaking is unclear. The protocol was published in the journal Systematic Reviews (2015;4:122).

  7. A Survey on the Taxonomy of Cluster-Based Routing Protocols for Homogeneous Wireless Sensor Networks

    PubMed Central

    Naeimi, Soroush; Ghafghazi, Hamidreza; Chow, Chee-Onn; Ishii, Hiroshi

    2012-01-01

    The past few years have witnessed increased interest among researchers in cluster-based protocols for homogeneous networks because of their better scalability and higher energy efficiency than other routing protocols. Given the limited capabilities of sensor nodes in terms of energy resources, processing and communication range, the cluster-based protocols should be compatible with these constraints in either the setup state or steady data transmission state. With focus on these constraints, we classify routing protocols according to their objectives and methods towards addressing the shortcomings of clustering process on each stage of cluster head selection, cluster formation, data aggregation and data communication. We summarize the techniques and methods used in these categories, while the weakness and strength of each protocol is pointed out in details. Furthermore, taxonomy of the protocols in each phase is given to provide a deeper understanding of current clustering approaches. Ultimately based on the existing research, a summary of the issues and solutions of the attributes and characteristics of clustering approaches and some open research areas in cluster-based routing protocols that can be further pursued are provided. PMID:22969350

  8. A survey on the taxonomy of cluster-based routing protocols for homogeneous wireless sensor networks.

    PubMed

    Naeimi, Soroush; Ghafghazi, Hamidreza; Chow, Chee-Onn; Ishii, Hiroshi

    2012-01-01

    The past few years have witnessed increased interest among researchers in cluster-based protocols for homogeneous networks because of their better scalability and higher energy efficiency than other routing protocols. Given the limited capabilities of sensor nodes in terms of energy resources, processing and communication range, the cluster-based protocols should be compatible with these constraints in either the setup state or steady data transmission state. With focus on these constraints, we classify routing protocols according to their objectives and methods towards addressing the shortcomings of clustering process on each stage of cluster head selection, cluster formation, data aggregation and data communication. We summarize the techniques and methods used in these categories, while the weakness and strength of each protocol is pointed out in details. Furthermore, taxonomy of the protocols in each phase is given to provide a deeper understanding of current clustering approaches. Ultimately based on the existing research, a summary of the issues and solutions of the attributes and characteristics of clustering approaches and some open research areas in cluster-based routing protocols that can be further pursued are provided.

  9. Walter Reed Army Medical Center, Washington, DC Annual Progress Report FY-89. Volume 2. Part 1

    DTIC Science & Technology

    1990-01-02

    recurrent head and neck cancer who meet the eligibility requirements and consent to the protocol will have central venous catheter placed (if one is...DATE: 06/29/89 WORK UNIT # 6220 DETAIL SUMMARY SHEET TITLE: Epidemiology of HIV In Pediatric and Perinatal Patients - A Natural History Study...of HIV in clinical samples. 16 I I REPORT DATE: 04/04/89 WORK UNIT # 8804 DETAIL SUMMARY SHEET TITLE: The Natural History of HIV Infection and Disease

  10. DISE Summary Report (1992)

    DTIC Science & Technology

    1994-03-01

    Specification and Network Time Protocol(NTP) over the Implementation. RFC-o 119, Network OSI Remote Operations Service. RFC- Working Group, September...approximately ISIS implements a powerful model of 94% of the total computation time. distributed computation known as modelo Timing results are

  11. Hospital Casemix Protocol - Medibank Private Perspective.

    PubMed

    Szakiel, John

    2010-06-01

    Hospital Casemix Protocol data provide a brief summary outlining morbidity data and costs associated with an episode of care. Federal government legislation requires that hospitals report this information to private health insurers who, in turn, merge these data with benefit outlays and report their findings to the Department of Health and Ageing (DoHA). This article gives a brief outline of the collection, cleansing and processing of these data and subsequent reporting to DoHA by Medibank Private, which accounts for approximately 30% of collected data.

  12. Health surveillance under adverse ergonomics conditions – validity of a screening method adapted for the occupational health service

    PubMed Central

    Jonker, Dirk; Gustafsson, Ewa; Rolander, Bo; Arvidsson, Inger; Nordander, Catarina

    2015-01-01

    A new health surveillance protocol for work-related upper-extremity musculoskeletal disorders has been validated by comparing the results with a reference protocol. The studied protocol, Health Surveillance in Adverse Ergonomics Conditions (HECO), is a new version of the reference protocol modified for application in the Occupational Health Service (OHS). The HECO protocol contains both a screening part and a diagnosing part. Sixty-three employees were examined. The screening in HECO did not miss any diagnosis found when using the reference protocol, but in comparison to the reference protocol considerable time savings could be achieved. Fair to good agreement between the protocols was obtained for one or more diagnoses in neck/shoulders (86%, k = 0.62) and elbow/hands (84%, k = 0.49). Therefore, the results obtained using the HECO protocol can be compared with a reference material collected with the reference protocol, and thus provide information of the magnitude of disorders in an examined work group. Practitioner Summary: The HECO protocol is a relatively simple physical examination protocol for identification of musculoskeletal disorders in the neck and upper extremities. The protocol is a reliable and cost-effective tool for the OHS to use for occupational health surveillance in order to detect workplaces at high risk for developing musculoskeletal disorders. PMID:25761380

  13. Shuttle Payload Ground Command and Control: An Experiment Implementation Combustion Module-2 Software Development, STS-107

    NASA Technical Reports Server (NTRS)

    Carek, David Andrew

    2003-01-01

    This presentation covers the design of a command and control architecture developed by the author for the Combustion Module-2 microgravity experiment, which flew aboard the STS-107 Shuttle mission, The design was implemented to satisfy a hybrid network that utilized TCP/IP for both the onboard segment and ground segment, with an intermediary unreliable transport for the space to ground segment. With the infusion of Internet networking technologies into Space Shuttle, Space Station, and spacecraft avionics systems, comes the need for robust methodologies for ground command and control. Considerations of high bit error links, and unreliable transport over intermittent links must be considered in such systems. Internet protocols applied to these systems, coupled with the appropriate application layer protections, can provide adequate communication architectures for command and control. However, there are inherent limitations and additional complexities added by the use of Internet protocols that must be considered during the design. This presentation will discuss the rationale for the: framework and protocol algorithms developed by the author. A summary of design considerations, implantation issues, and learned lessons will be will be presented. A summary of mission results using this communications architecture will be presented. Additionally, areas of further needed investigation will be identified.

  14. Components of an Anticancer Diet: Dietary Recommendations, Restrictions and Supplements of the Bill Henderson Protocol

    PubMed Central

    Mannion, Cynthia; Page, Stacey; Bell, Laurie Heilman; Verhoef, Marja

    2010-01-01

    The use of complementary and alternative medicines including dietary supplements, herbals and special diets to prevent or treat disease continues to be popular. The following paper provides a description of an alternative dietary approach to the self-management and treatment of cancer, the Bill Henderson Protocol (BHP). This diet encourages daily intake of raw foods, a combination of cottage cheese and flaxseed oil and a number of supplements. Some foods and food groups are restricted (e.g., gluten, meat, dairy). Early background theory that contributed to the protocol’s development is presented as is a summary of relevant evidence concerning the anti-cancer fighting properties of the individual components. Supplement intake is considered in relation to daily recommended intakes. Challenges and risks to protocol adherence are discussed. As with many complementary and alternative interventions, clear evidence of this dietary protocol’s safety and efficacy is lacking. Consumers of this protocol may require guidance on the ability of this protocol to meet their individual nutritional needs. PMID:22254073

  15. Summary and Synthesis: How to Present a Research Proposal.

    PubMed

    Setia, Maninder Singh; Panda, Saumya

    2017-01-01

    This concluding module attempts to synthesize the key learning points discussed during the course of the previous ten sets of modules on methodology and biostatistics. The objective of this module is to discuss how to present a model research proposal, based on whatever was discussed in the preceding modules. The lynchpin of a research proposal is the protocol, and the key component of a protocol is the study design. However, one must not neglect the other areas, be it the project summary through which one catches the eyes of the reviewer of the proposal, or the background and the literature review, or the aims and objectives of the study. Two critical areas in the "methods" section that cannot be emphasized more are the sampling strategy and a formal estimation of sample size. Without a legitimate sample size, none of the conclusions based on the statistical analysis would be valid. Finally, the ethical parameters of the study should be well understood by the researchers, and that should get reflected in the proposal.

  16. Summary and Synthesis: How to Present a Research Proposal

    PubMed Central

    Setia, Maninder Singh; Panda, Saumya

    2017-01-01

    This concluding module attempts to synthesize the key learning points discussed during the course of the previous ten sets of modules on methodology and biostatistics. The objective of this module is to discuss how to present a model research proposal, based on whatever was discussed in the preceding modules. The lynchpin of a research proposal is the protocol, and the key component of a protocol is the study design. However, one must not neglect the other areas, be it the project summary through which one catches the eyes of the reviewer of the proposal, or the background and the literature review, or the aims and objectives of the study. Two critical areas in the “methods” section that cannot be emphasized more are the sampling strategy and a formal estimation of sample size. Without a legitimate sample size, none of the conclusions based on the statistical analysis would be valid. Finally, the ethical parameters of the study should be well understood by the researchers, and that should get reflected in the proposal. PMID:28979004

  17. Proposal for the Development of a Standardized Protocol for Assessing the Economic Costs of HIV Prevention Interventions

    PubMed Central

    Pinkerton, Steven D.; Pearson, Cynthia R.; Eachus, Susan R.; Berg, Karina M.; Grimes, Richard M.

    2008-01-01

    Summary Maximizing our economic investment in HIV prevention requires balancing the costs of candidate interventions against their effects and selecting the most cost-effective interventions for implementation. However, many HIV prevention intervention trials do not collect cost information, and those that do use a variety of cost data collection methods and analysis techniques. Standardized cost data collection procedures, instrumentation, and analysis techniques are needed to facilitate the task of assessing intervention costs and to ensure comparability across intervention trials. This article describes the basic elements of a standardized cost data collection and analysis protocol and outlines a computer-based approach to implementing this protocol. Ultimately, the development of such a protocol would require contributions and “buy-in” from a diverse range of stakeholders, including HIV prevention researchers, cost-effectiveness analysts, community collaborators, public health decision makers, and funding agencies. PMID:18301128

  18. 76 FR 80780 - Review of the Emergency Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ... Emergency Alert System AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: In this document, the Commission amends its rules governing the Emergency Alert System (EAS) rules to extend the deadline for EAS Participants to be able to receive Common Alerting Protocol (CAP)- formatted EAS alerts to...

  19. Comparison between L-CHOP and an L-CHOP protocol with interposed treatments of CCNU and MOPP (L-CHOP-CCNU-MOPP) for lymphoma in dogs.

    PubMed

    Rassnick, K M; Bailey, D B; Malone, E K; Intile, J L; Kiselow, M A; Flory, A B; Barlow, L L; Balkman, C E; Barnard, S M; Waite, A H

    2010-12-01

    An L-CHOP protocol with interposed treatments of CCNU and MOPP (L-CHOP-CCNU-MOPP) was evaluated in 66 dogs with stages III-V lymphoma. Results were compared with a historical group of 71 dogs treated with an L-CHOP protocol. Complete remission (CR) rates (85 and 80%, respectively) did not differ significantly between protocols (P = 0.48). First CR duration for dogs treated with L-CHOP-CCNU-MOPP was significantly longer: median, 317 days; 2-year CR rate, 35% versus median, 298 days; 2-year CR rate, 13%, P = 0.05). For the L-CHOP-CCNU-MOPP protocol, dogs in substage-b had a 4.3 times greater hazard of having a relapse than dogs in substage-a (P = 0.002). Frequency of adverse chemotherapy-associated gastrointestinal effects did not differ between protocols (P = 0.77). Neutropenia (primarily after CCNU) occurred more frequently in dogs treated with L-CHOP-CCNU-MOPP (P < 0.001). In summary, the L-CHOP-CCNU-MOPP protocol showed an improved duration of first CR as compared with an L-CHOP protocol, but the relevance of this finding might be subject to clinical judgement. © 2010 Blackwell Publishing Ltd.

  20. Electronic data collection for the analysis of surgical maneuvers on patients submitted to rhinoplasty

    PubMed Central

    Berger, Cezar; Freitas, Renato; Malafaia, Osvaldo; Pinto, José Simão de Paula; Mocellin, Marcos; Macedo, Evaldo; Fagundes, Marina Serrato Coelho

    2012-01-01

    Summary Introduction: In the health field, computerization has become increasingly necessary in professional practice, since it facilitates data recovery and assists in the development of research with greater scientific rigor. Objective: the present work aimed to develop, apply, and validate specific electronic protocols for patients referred for rhinoplasty. Methods: The prospective research had 3 stages: (1) preparation of theoretical data bases; (2) creation of a master protocol using Integrated System of Electronic Protocol (SINPE©); and (3) elaboration, application, and validation of a specific protocol for the nose and sinuses regarding rhinoplasty. Results: After the preparation of the master protocol, which dealt with the entire field of otorhinolaryngology, we idealized a specific protocol containing all matters related to the patient. In particular, the aesthetic and functional nasal complaints referred for surgical treatment (i.e., rhinoplasty) were organized into 6 main hierarchical categories: anamnesis, physical examination, complementary exams, diagnosis, treatment, and outcome. This protocol utilized these categories and their sub-items: finality; access; surgical maneuvers on the nasal dorsum, tip, and base; clinical evolution after 3, 6, and 12 months; revisional surgery; and quantitative and qualitative evaluations. Conclusion: The developed electronic-specific protocol is feasible and important for information registration from patients referred to rhinoplasty. PMID:25991979

  1. Catalyst-free and solvent-free Michael addition of 1,3-dicarbonyl compounds to nitroalkenes by a grinding method

    PubMed Central

    Xie, Zong-Bo; Wu, Ming-Yu; He, Ting; Le, Zhang-Gao

    2012-01-01

    Summary An environmentally benign, fast and convenient protocol has been developed for the Michael addition of 1,3-dicarbonyl compounds to β-nitroalkenes in good to excellent yields by a grinding method under catalyst- and solvent-free conditions. PMID:22563352

  2. 75 FR 62820 - Screening Framework Guidance for Providers of Synthetic Double-Stranded DNA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ... I. Summary Synthetic biology, the developing interdisciplinary field that focuses on both the design and fabrication of novel biological components and systems as well as the re-design and fabrication of... develop, maintain, and document protocols to determine if a sequence ``hit'' qualifies as a true...

  3. 76 FR 1592 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-11

    ...: Advanced Meat Recovery Systems. OMB Control Number: 0583-0130. Summary of Collection: The Food Safety and... Recovery (AMR) systems ensure that bones used for AMR systems do not contain brain, trigeminal ganglia, or... dorsal root ganglia (DRG); to document their testing protocols, to assess manner that does not cause...

  4. Department of Combat Medic Training-Technology Enhancement

    DTIC Science & Technology

    2011-04-15

    SAYS : ............................................................................................................................ 6 2 INTRODUCTION...determined to be exempt from IRB protocol per Appendix 1.3 What this report says : Section 1 – Executive Summary: (this section) Section 2...with automatic conversion to digital text (conversion of handwriting to text) or use pre-scripted comments from a drop-down menu. b. Validation of

  5. 76 FR 584 - Glen Canyon Dam Adaptive Management Program Work Group (AMWG)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... 2010 expenditures, (2) updates on High Flow Experimental Protocol and the Non-native Fish Control... Group (AMWG) AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of public meeting. SUMMARY: The... committee, the Adaptive Management Work Group (AMWG), a technical work group (TWG), a Grand Canyon...

  6. 77 FR 11997 - Consumer and Governmental Affairs Bureau Seeks To Refresh the Record Regarding Misuse of Internet...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-28

    ... legitimate relay calls, however, are not entitled to these transparency and confidentiality protections... Relay Service AGENCY: Federal Communications Commission. ACTION: Proposed rule. SUMMARY: In this... refresh the record regarding misuse of Internet Protocol relay service. Further comments are requested to...

  7. Validating Vegetable Production Unit (VPU) Plants, Protocols, Procedures and Requirements (P3R) using Currently Existing Flight Resources

    NASA Technical Reports Server (NTRS)

    Bingham, Gail; Bates, Scott; Bugbee, Bruce; Garland, Jay; Podolski, Igor; Levinskikh, Rita; Sychev, Vladimir; Gushin, Vadim

    2009-01-01

    Validating Vegetable Production Unit (VPU) Plants, Protocols, Procedures and Requirements (P3R) Using Currently Existing Flight Resources (Lada-VPU-P3R) is a study to advance the technology required for plant growth in microgravity and to research related food safety issues. Lada-VPU-P3R also investigates the non-nutritional value to the flight crew of developing plants on-orbit. The Lada-VPU-P3R uses the Lada hardware on the ISS and falls under a cooperative agreement between National Aeronautics and Space Administration (NASA) and the Russian Federal Space Association (FSA). Research Summary: Validating Vegetable Production Unit (VPU) Plants, Protocols, Procedures and Requirements (P3R) Using Currently Existing Flight Resources (Lada-VPU-P3R) will optimize hardware and

  8. The NINDS-Canadian stroke network vascular cognitive impairment neuropsychology protocols in Chinese.

    PubMed

    Wong, Adrian; Xiong, Yun-yun; Wang, Defeng; Lin, Shi; Chu, Winnie W C; Kwan, Pauline W K; Nyenhuis, David; Black, Sandra E; Wong, Ka Sing Lawrence; Mok, Vincent

    2013-05-01

    Vascular cognitive impairment (VCI) affects up to half of stroke survivors and predicts poor outcomes. Valid and reliable assessement for VCI is lacking, especially for the Chinese population. In 2005, the National Institute of Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) Harmonisation workshop proposed a set of three neuropsychology protocols for VCI evaluation. This paper is to introduce the protocol design and to report the psychometric properties of the Chinese NINDS-CSN VCI protocols. Fifty patients with mild stroke (mean National Institute of Health Stroke Scale 2.2 (SD=3.2)) and 50 controls were recruited. The NINDS-CSN VCI protocols were adapted into Chinese. We assessed protocols' (1) external validity, defined by how well the protocol summary scores differentiated patients from controls using receiver operating characteristics (ROC) curve analysis; (2) concurrent validity, by correlations with functional measures including Stroke Impact Scale memory score and Chinese Disability Assessment for Dementia; (3) internal consistency; and (4) ease of administration. All three protocols differentiated patients from controls (area under ROC for the three protocols between 0.77 to 0.79, p<0.001), and significantly correlated with the functional measures (Pearson r ranged from 0.37 to 0.51). A cut-off of 19/20 on MMSE identified only one-tenth of patients classified as impaired on the 5-min protocol. Cronbach's α across the four cognitive domains of the 60-min protocol was 0.78 for all subjects and 0.76 for stroke patients. The Chinese NINDS-CSN VCI protocols are valid and reliable for cognitive assessment in Chinese patients with mild stroke.

  9. Interplay between plasma hormone profiles, sex and body condition in immature hawksbill turtles (Eretmochelys imbricata) subjected to a capture stress protocol.

    PubMed

    Jessop, Tim S; Sumner, Joanna M; Limpus, Colin J; Whittier, Joan M

    2004-01-01

    We investigated plasma hormone profiles of corticosterone and testosterone in immature hawksbill turtles (Eretmochelys imbricata) in response to a capture stress protocol. Further, we examined whether sex and body condition were covariates associated with variation in the adrenocortical response of immature turtles. Hawksbill turtles responded to the capture stress protocol by significantly increasing plasma levels of corticosterone over a 5 h period. There was no significant sex difference in the corticosterone stress response of immature turtles. Plasma testosterone profiles, while significantly different between the sexes, did not exhibit a significant change during the 5 h capture stress protocol. An index of body condition was not significantly associated with a turtle's capacity to produce plasma corticosterone both prior to and during exposure to the capture stress protocol. In summary, while immature hawksbill turtles exhibited an adrenocortical response to a capture stress protocol, neither their sex nor body condition was responsible for variation in endocrine responses. This lack of interaction between the adrenocortical response and these internal factors suggests that the inactive reproductive- and the current energetic- status of these immature turtles are important factors that could influence plasma hormone profiles during stress.

  10. Economics of United States tuberculosis airline contact investigation policies: A return on investment analysis

    PubMed Central

    Coleman, Margaret S.; Marienau, Karen J.; Marano, Nina; Marks, Suzanne M.; Cetron, Martin S.

    2017-01-01

    Summary Background In 2011, the Centers for Disease Control and Prevention modified its 2008 protocol for flight-related tuberculosis contact investigation initiation. The 2011 Modified protocol was implemented and replaced the 2008 CDC protocol based on comparative epidemiologic and economic analyses; this publication reports the economic analysis results. Methods A return on investment model compared relative changes in tuberculosis disease treatment costs resulting from expenditures on tuberculosis contact investigations and latent tuberculosis infection treatment for the 2008 CDC and Modified protocols. Results At moderate/high rates of latent tuberculosis infection and tuberculosis disease, positive returns on investment indicated each $1.00 spent on tuberculosis contact investigations and latent tuberculosis treatment resulted in more than $1.00 of savings from reduced tuberculosis disease treatment costs. Low rates of latent tuberculosis infection and tuberculosis disease resulted in negative returns on investment, indicating economic losses from tuberculosis disease treatment costs. There were smaller economic losses at low latent tuberculosis infection and tuberculosis disease rates with the Modified protocol in comparison to the 2008 CDC protocol, while both identified comparable numbers of persons at risk for tuberculosis. Conclusion The Modified protocol for conducting flight-related tuberculosis contact investigations represents a better use of resources and protects public health. PMID:24262643

  11. Is it really good to talk? Testing the impact of providing concurrent verbal protocols on driving performance.

    PubMed

    Salmon, Paul Matthew; Goode, Natassia; Spiertz, Antje; Thomas, Miles; Grant, Eryn; Clacy, Amanda

    2017-06-01

    Questions have been raised regarding the impact that providing concurrent verbal protocols has on task performance in various settings; however, there has been little empirical testing of this in road transport. The aim of this study was to examine the impact of providing concurrent verbal protocols on driving performance. Participants drove an instrumented vehicle around a set route, twice whilst providing a concurrent verbal protocol, and twice without. A comparison revealed no differences in behaviour related to speed, braking and steering wheel angle when driving mid-block, but a significant difference in aspects of braking and acceleration at roundabouts. When not providing a verbal protocol, participants were found to brake harder on approach to a roundabout and accelerate more heavily coming out of roundabouts. It is concluded that providing verbal protocols may have a positive effect on braking and accelerating. Practical implications related to driver training and future research are discussed. Practitioner Summary: Verbal protocol analysis is used by ergonomists to understand aspects of cognition and decision-making during complex tasks such as driving and control room operation. This study examines the impact that it has on driving performance, providing evidence to support its continued use in ergonomics applications.

  12. Protocols development for security and privacy of radio frequency identification systems

    NASA Astrophysics Data System (ADS)

    Sabbagha, Fatin

    There are benefits to adopting radio frequency identification (RFID) technology, although there are methods of attack that can compromise the system. This research determined how that may happen and what possible solutions can keep that from happening. Protocols were developed to implement better security. In addition, new topologies were developed to handle the problems of the key management. Previously proposed protocols focused on providing mutual authentication and privacy between readers and tags. However, those protocols are still vulnerable to be attacked. These protocols were analyzed and the disadvantages shown for each one. Previous works assumed that the channels between readers and the servers were secure. In the proposed protocols, a compromised reader is considered along with how to prevent tags from being read by that reader. The new protocols provide mutual authentication between readers and tags and, at the same time, remove the compromised reader from the system. Three protocols are proposed. In the first protocol, a mutual authentication is achieved and a compromised reader is not allowed in the network. In the second protocol, the number of times a reader contacts the server is reduced. The third protocol provides authentication and privacy between tags and readers using a trusted third party. The developed topology is implemented using python language and simulates work to check the efficiency regarding the processing time. The three protocols are implemented by writing codes in C language and then compiling them in MSP430. IAR Embedded workbench is used, which is an integrated development environment with the C/C++ compiler to generate a faster code and to debug the microcontroller. In summary, the goal of this research is to find solutions for the problems on previously proposed protocols, handle a compromised reader, and solve key management problems.

  13. 75 FR 65636 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0541... Request; Guidance for Industry on Special Protocol Assessment AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing that a proposed collection...

  14. Reductive amination with zinc powder in aqueous media

    PubMed Central

    Imperio, Daniela; Penoni, Andrea; Palmisano, Giovanni

    2011-01-01

    Summary Zinc powder in aqueous alkaline media was employed to perform reductive amination of aldehydes with primary amines. The corresponding secondary amines were obtained in good yields along with minor amounts of hydrodimerization byproducts. The protocol is a green alternative to the use of complex hydrides in chlorinated or highly flammable solvents. PMID:21915212

  15. Space station data system analysis/architecture study. Task 5: Program plan

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Cost estimates for both the on-board and ground segments of the Space Station Data System (SSDS) are presented along with summary program schedules. Advanced technology development recommendations are provided in the areas of distributed data base management, end-to-end protocols, command/resource management, and flight qualified artificial intelligence machines.

  16. 40 CFR 63.788 - Recordkeeping and reporting requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... containers meet the standards as described in § 63.783(b)(2); and (vii) The results of any Method 24 of appendix A to 40 CFR part 60 or approved VOHAP measurement test conducted on individual containers of... summary of the number and total duration of incidents that the monitoring protocol failed to perform in...

  17. PROTOCOL - A COMPUTERIZED SOLID WASTE QUANTITY AND COMPOSITION ESTIMATION SYSTEM. Project Summary (EPA/600/S2-91/005)

    EPA Science Inventory

    The assumptions of traditional sampling theory often do not fit the circumstances when estimating the quantity and composition of solid waste arriving at a given location, such as a landfill site, or at a specific point in an industrial or commercial process. The investigator oft...

  18. 78 FR 48683 - Announcement of Requirements and Registration for Million Hearts® Hypertension Control Challenge

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-09

    .... The interview will include questions about the strategies employed by the individual or organization... protocol with the interviewer, respond to the interview questions, and review a summary data about the... participate in an interview to develop a success story that describes the systems and processes that support...

  19. Do evidence summaries increase policy-makers' use of evidence from systematic reviews: A systematic review protocol.

    PubMed

    Petkovic, Jennifer; Welch, Vivian; Tugwell, Peter

    2015-09-28

    Systematic reviews are important for decision-makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision-makers. This systematic review will assess the effectiveness of systematic review summaries on increasing policymakers' use of systematic review evidence and to identify the components or features of these summaries that are most effective. We will include studies of policy-makers at all levels as well as health-system managers. We will include studies examining any type of "evidence summary," "policy brief," or other products derived from systematic reviews that present evidence in a summarized form. The primary outcomes are the following: (1) use of systematic review summaries decision-making (e.g., self-reported use of the evidence in policy-making, decision-making) and (2) policy-maker understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We will conduct a systematic review of randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), controlled before-after studies (CBA), and interrupted time series (ITS) studies. The results of this review will inform the development of future systematic review summaries to ensure that systematic review evidence is accessible to and used by policy-makers making health-related decisions.

  20. National best management practices monitoring summary report, program phase-in period fiscal years 2013-2014

    Treesearch

    Joan Carlson; Pam Edwards; Todd Ellsworth; Michael Eberle

    2015-01-01

    The National BMP Program provides National Core BMPs, standardized monitoring protocols to evaluate implementation and effectiveness of the National Core BMPs, and a data management system to store and analyze the resulting monitoring data. BMP evaluations are completed by interdisciplinary teams of resource specialists and include assessments of whether BMP...

  1. Development of a simplified flexible pavement design protocol for New York State Department of Transportation based on the AASHTO Mechanistic-Empirical Pavement Design Guide : technical summary.

    DOT National Transportation Integrated Search

    2017-01-01

    This report summarizes the local calibration of the distress models for the Northeast (NE) region of the United States and the development of new design tables for new flexible pavement structures. Design, performance, and traffic data collected on t...

  2. Clinical protocol with digital cad/cam chairside workflow for the rehabilitation of severely worn dentition patients

    PubMed Central

    GERMANO, FED.; GERMANO, FRA.; PIRO, M.; ARCURI, C.; OTTRIA, L.

    2017-01-01

    SUMMARY Objectives The purpose of this paper is to investigate the effectiveness and to describe a clinical protocol with digital CAD CAM chairside workflow for the rehabilitation of severely compromised and worn dentitions. Methods This article reports 4 consecutive cases, where a clinical digital chairside workflow is used for the rehabilitation of severely compromised and worn dentitions. Advantages and limitations of this method compared with the traditional prosthetic protocol are also described and discussed. Results With all four patients treated with this protocol, we obtained a good aesthetic and functional result, improvement in chewing function, loss of cold sensitivity, better preservation of most of the left hard tissue and a good level of satisfaction. In a two-year follow-up, all patients also maintained the condition obtained with prosthetic chairside rehabilitation, resulting in almost 100% cumulative survival rate. Conclusion Within the limitations of this study, we can assert that the aforementioned restorative treatment with digital CAD/CAM chairside workflow represents a valid alternative to rehabilitate this kind of patients, because it is a safe, predictable and personalized procedure but also it seems easier, faster and cheaper than traditional protocols. PMID:29285327

  3. Standardized methods for Grand Canyon fisheries research 2015

    USGS Publications Warehouse

    Persons, William R.; Ward, David L.; Avery, Luke A.

    2013-01-01

    This document presents protocols and guidelines to persons sampling fishes in the Grand Canyon, to help ensure consistency in fish handling, fish tagging, and data collection among different projects and organizations. Most such research and monitoring projects are conducted under the general umbrella of the Glen Canyon Dam Adaptive Management Program and include studies by the U.S. Geological Survey (USGS), U.S. Fish and Wildlife Service (FWS), National Park Service (NPS), the Arizona Game and Fish Department (AGFD), various universities, and private contractors. This document is intended to provide guidance to fieldworkers regarding protocols that may vary from year to year depending on specific projects and objectives. We also provide herein documentation of standard methods used in the Grand Canyon that can be cited in scientific publications, as well as a summary of changes in protocols since the document was first created in 2002.

  4. Potential strategies and biosafety protocols used for dual-use research on highly pathogenic influenza viruses

    PubMed Central

    Du, Lanying; Li, Ye; Gao, Jimin; Zhou, Yusen; Jiang, Shibo

    2013-01-01

    Summary Influenza A viruses (IAVs), particularly the highly pathogenic avian influenza (HPAI) H5N1, have posed a substantial threat to public health worldwide. Although the laboratory generation of the mutant influenza virus H5N1 with airborne transmissibility among mammals, which has been considered as a dual-use research, may benefit the development of effective vaccines and therapeutics against the emerging infectious agents, it may also pose threats to national biosecurity, laboratory biosafety, and/or public health. This review introduces the classification and characterization of IAVs, pinpoints historic pandemics and epidemics caused by IAVs, emphasizes the significance and necessity of biosafety, summarizes currently established biosafety-related protocols for IAV research, and provides potential strategies to improve biosafety protocols for dual-use research on the highly pathogenic avian influenza viruses and other emerging infectious agents. PMID:22987727

  5. Near-shore and off-shore habitat use by endangered juvenile Lost River and Shortnose Suckers in Upper Klamath Lake, Oregon: 2006 data summary

    USGS Publications Warehouse

    Burdick, Summer M.; Wilkens, Alexander X.; VanderKooi, Scott P.

    2008-01-01

    We continued sampling juvenile suckers in 2006 as part of an effort to develop bioenergetics models for juvenile Lost River and shortnose suckers. This study required us to collect fish to determine growth rates and energy content of juvenile suckers. We followed the sampling protocols and methods described by Hendrixson et al. (2007b) to maintain continuity and facilitate comparisons with data collected in recent years, but sampled at a reduced level of effort compared to previous years (approximately one-third) due to limited funding. Here we present a summary of catch data collected in 2006. Bioenergetics models will be reported separately

  6. Monitoring bird migration in the Caribbean basin: multi-national cooperation can close the loop

    Treesearch

    Paul B. Hamel; Cecilia M. Riley; W. C. Hunter; Mark S. Woodrey

    2005-01-01

    The Gulf Coast Bird Observatory (GCBO) and the Southeastern Working Group of Partners in Flight have developed a protocol to monitor landbirds with volunteer observers performing avian censuses in the field. Field observations are compiled within a powerful internet database, and recording and summary capability is maintained by the GCBO. More than 100 observers have...

  7. Missouri Ozark Forest Ecosystem Project: site history, soils, landforms, woody and herbaceous vegetation, down wood, and inventory methods for the landscape experiment.

    Treesearch

    Stephen R. Shifley; Brian L., eds. Brookshire

    2000-01-01

    Describes vegetation and physical site conditions at the initiation (1991-1995) of the Missouri Ozark Forest Ecosystem Project (MOFEP) in the southeastern Missouri Ozarks. Provides detailed information on sampling protocols and summarizes initial conditions of the landscape experiment prior to harvest treatments. Summaries are by plot, by ~800-acre...

  8. Internet Protocol Over Telemetry Testing for Earth Science Capability Demo Summary

    NASA Technical Reports Server (NTRS)

    Franz, Russ; Pestana, Mark; Bessent, Shedrick; Hang, Richard; Ng, Howard

    2006-01-01

    The development and flight tests described here focused on utilizing existing pulse code modulation (PCM) telemetry equipment to enable on-vehicle networks of instruments and computers to be a simple extension of the ground station network. This capability is envisioned as a necessary component of a global range that supports test and development of manned and unmanned airborne vehicles.

  9. Ozone Therapy in Dentistry

    PubMed Central

    Domb, William C

    2014-01-01

    Summary The 21st century dental practice is quite dynamic. New treatment protocols and new materials are being developed at a rapid pace. Ozone dental therapy falls into the category of new treatment protocols in dentistry, yet ozone is not new at all. Ozone therapy is already a major treatment modality in Europe, South America and a number of other countries. What is provided here will not be an exhaustive scientific treatise so much as a brief general introduction into what dentists are now doing with ozone therapies and the numerous oral/systemic links that make this subject so important for physicians so that, ultimately, they may serve their patients more effectively and productively. PMID:25363268

  10. Organoid culture systems for prostate epithelial tissue and prostate cancer tissue

    PubMed Central

    Drost, Jarno; Karthaus, Wouter R.; Gao, Dong; Driehuis, Else; Sawyers, Charles L.; Chen, Yu; Clevers, Hans

    2016-01-01

    Summary This protocol describes a recently developed strategy to generate 3D prostate organoid cultures from healthy mouse and human prostate (either bulk or FAC-sorted single luminal and basal cells), metastatic prostate cancer lesions and circulating tumour cells. Organoids derived from healthy material contain the differentiated luminal and basal cell types, whereas organoids derived from prostate cancer tissue mimic the histology of the tumour. The stepwise establishment of these cultures and the fully defined serum-free conditioned medium that is required to sustain organoid growth are outlined. Organoids established using this protocol can be used to study many different aspects of prostate biology, including homeostasis, tumorigenesis and drug discovery. PMID:26797458

  11. Progress in satellite quantum key distribution

    NASA Astrophysics Data System (ADS)

    Bedington, Robert; Arrazola, Juan Miguel; Ling, Alexander

    2017-08-01

    Quantum key distribution (QKD) is a family of protocols for growing a private encryption key between two parties. Despite much progress, all ground-based QKD approaches have a distance limit due to atmospheric losses or in-fibre attenuation. These limitations make purely ground-based systems impractical for a global distribution network. However, the range of communication may be extended by employing satellites equipped with high-quality optical links. This manuscript summarizes research and development which is beginning to enable QKD with satellites. It includes a discussion of protocols, infrastructure, and the technical challenges involved with implementing such systems, as well as a top level summary of on-going satellite QKD initiatives around the world.

  12. Summary Report Panel 1: The Need for Protocols and Standards in Research on Underwater Noise Impacts on Marine Life.

    PubMed

    Erbe, Christine; Ainslie, Michael A; de Jong, Christ A F; Racca, Roberto; Stocker, Michael

    2016-01-01

    As concern about anthropogenic noise and its impacts on marine fauna is increasing around the globe, data are being compared across populations, species, noise sources, geographic regions, and time. However, much of the raw and processed data are not comparable due to differences in measurement methodology, analysis and reporting, and a lack of metadata. Common protocols and more formal, international standards are needed to ensure the effectiveness of research, conservation, regulation and practice, and unambiguous communication of information and ideas. Developing standards takes time and effort, is largely driven by a few expert volunteers, and would benefit from stakeholders' contribution and support.

  13. Statistical Requirements For Pass-Fail Testing Of Contraband Detection Systems

    NASA Astrophysics Data System (ADS)

    Gilliam, David M.

    2011-06-01

    Contraband detection systems for homeland security applications are typically tested for probability of detection (PD) and probability of false alarm (PFA) using pass-fail testing protocols. Test protocols usually require specified values for PD and PFA to be demonstrated at a specified level of statistical confidence CL. Based on a recent more theoretical treatment of this subject [1], this summary reviews the definition of CL and provides formulas and spreadsheet functions for constructing tables of general test requirements and for determining the minimum number of tests required. The formulas and tables in this article may be generally applied to many other applications of pass-fail testing, in addition to testing of contraband detection systems.

  14. How to construct an optimal interim report: What the data monitoring committee does and doesn't need to know.

    PubMed

    Neaton, James D; Grund, Birgit; Wentworth, Deborah

    2018-03-01

    Data monitoring committees for randomized clinical trials have the responsibility of safeguarding interests of trial participants. To do so, the data monitoring committee must receive reports on safety and efficacy to assess risk/benefit and on trial conduct to ensure that the study can achieve its goals. This article outlines the key components of reports to the data monitoring committee and the important role of the unblinded statistician in preparing those reports. Most data monitoring committee meetings include open and closed sessions. For each session, there is a report of interim results. The open session is attended by the sponsor and lead investigators, including the statistician(s) responsible for the trial design. These investigators are blinded to the interim treatment comparisons. The closed session is attended by the data monitoring committee members and by the statistician(s) who prepared the closed report. These individuals are unblinded to interim treatment comparisons and therefore are not involved in study design changes. The optimal content of data monitoring committee reports and qualifications of the unblinded statistician(s) are discussed. Open reports should include responses to data monitoring committee recommendations, a synopsis of the protocol, a review of the protocol history and amendments, and information on enrollment, baseline characteristics, completeness of follow-up, and data quality. The open report is also a vehicle through which the sponsor and investigators should inform the data monitoring committee of relevant external information. Data in the open report are pooled over the treatment groups. The open report should not include data summaries by treatment group. The closed report should include a written summary with references to key tables and figures and methods used to prepare them. Tables and figures should summarize baseline characteristics, follow-up completeness, treatment adherence, and major safety and efficacy outcomes by treatment group. Text summaries should accompany the tables and figures. The data monitoring committee monitoring history (e.g. treatment differences at previous meetings) should be summarized. The unblinded statistician preparing the closed report should be familiar with the protocol and data collection plan and be capable of customizing the report to the current stage of the trial. This includes anticipating questions that may arise during the data monitoring committee review and pro-actively including data summaries to address these questions. There is considerable variation in the quality of open and closed data monitoring committee reports. Open and closed data monitoring committee reports should be concise, up to date, and informative. To achieve this, unblinded statisticians responsible for preparing closed data monitoring committee reports should be familiar with the statistical methods, the trial protocol, and the data collection plan. They should be capable of anticipating questions from the data monitoring committee and responding to requests for additional analyses.

  15. Standard echocardiography versus handheld echocardiography for the detection of subclinical rheumatic heart disease: protocol for a systematic review

    PubMed Central

    Telford, Lisa H; Abdullahi, Leila H; Ochodo, Eleanor A; Engel, Mark E

    2018-01-01

    Introduction Rheumatic heart disease (RHD) is a preventable and treatable chronic condition which persists in many developing countries largely affecting impoverished populations. Handheld echocardiography presents an opportunity to address the need for more cost-effective methods of diagnosing RHD in developing countries, where the disease continues to carry high rates of morbidity and mortality. Preliminary studies have demonstrated moderate sensitivity as well as high specificity and diagnostic odds for detecting RHD in asymptomatic patients. We describe a protocol for a systematic review on the diagnostic performance of handheld echocardiography compared to standard echocardiography using the 2012 World Heart Federation criteria for diagnosing subclinical RHD. Methods and analysis Electronic databases including PubMed, Scopus, Web of Science and EBSCOhost as well as reference lists and citations of relevant articles will be searched from 2012 to date using a predefined strategy incorporating a combination of Medical Subject Heading terms and keywords. The methodological validity and quality of studies deemed eligible for inclusion will be assessed against review specific Quality Assessment of Diagnostic Accuracy Studies 2 criteria and information on metrics of diagnostic accuracy and demographics extracted. Forest plots of sensitivity and specificity as well as scatter plots in receiver operating characteristic (ROC) space will be used to investigate heterogeneity. If possible, a meta-analysis will be conducted to produce summary results of sensitivity and specificity using the Hierarchical Summary ROC method. In addition, a sensitivity analysis will be conducted to investigate the effect of studies with a high risk of bias. Ethics and dissemination Ethics approval is not required for this systematic review of previously published literature. The planned review will provide a summary of the diagnostic accuracy of handheld echocardiography. Results may feed into evidence-based guidelines and should the findings of this review warrant a change in clinical practice, a summary report will be disseminated among leading clinicians and healthcare professionals in the field. PROSPERO registration number CRD42016051261. PMID:29440164

  16. A developmental, biopsychosocial model for the treatment of children with gender identity disorder.

    PubMed

    Zucker, Kenneth J; Wood, Hayley; Singh, Devita; Bradley, Susan J

    2012-01-01

    This article provides a summary of the therapeutic model and approach used in the Gender Identity Service at the Centre for Addiction and Mental Health in Toronto. The authors describe their assessment protocol, describe their current multifactorial case formulation model, including a strong emphasis on developmental factors, and provide clinical examples of how the model is used in the treatment.

  17. Techniques of Psychosocial Epidemiology.

    DTIC Science & Technology

    1983-10-01

    autobiographical responses to biennial questionaires, interviews, summaries, psychological tests and protocols to record each man’s behavior in a... psychological impairment. Journal of Nervous and Mental Disease, 166, 307-316. Aneshensel, C. S., and Stone, J. 0. (1982) Stress and depression: a test of the...and Hoover, M. (1979) An alienation test . Journal of Humanistic Psychology , 19, 73-76. Mantel, N. end Haenszel, W. (1959) Statistical aspects of

  18. Policy summary: visualization and communication track

    NASA Astrophysics Data System (ADS)

    Gates, Harvey M.

    1994-03-01

    The goal of visualization and graphics oriented scientists, engineers, and educators is to electronically share their products with colleagues around the United States and the world. Thus, these specialists have dubbed their communication requirement as `100 megabits (per second) to the desktop.' This simply means that these high technology specialists would like to transmit and receive visual products in real-time, unimpeded by the network speed and interconnection protocols.

  19. Miniaturization of the Clonogenic Assay Using Confluence Measurement

    PubMed Central

    Mayr, Christian; Beyreis, Marlena; Dobias, Heidemarie; Gaisberger, Martin; Pichler, Martin; Ritter, Markus; Jakab, Martin; Neureiter, Daniel; Kiesslich, Tobias

    2018-01-01

    The clonogenic assay is a widely used method to study the ability of cells to ‘infinitely’ produce progeny and is, therefore, used as a tool in tumor biology to measure tumor-initiating capacity and stem cell status. However, the standard protocol of using 6-well plates has several disadvantages. By miniaturizing the assay to a 96-well microplate format, as well as by utilizing the confluence detection function of a multimode reader, we here describe a new and modified protocol that allows comprehensive experimental setups and a non-endpoint, label-free semi-automatic analysis. Comparison of bright field images with confluence images demonstrated robust and reproducible detection of clones by the confluence detection function. Moreover, time-resolved non-endpoint confluence measurement of the same well showed that semi-automatic analysis was suitable for determining the mean size and colony number. By treating cells with an inhibitor of clonogenic growth (PTC-209), we show that our modified protocol is suitable for comprehensive (broad concentration range, addition of technical replicates) concentration- and time-resolved analysis of the effect of substances or treatments on clonogenic growth. In summary, this protocol represents a time- and cost-effective alternative to the commonly used 6-well protocol (with endpoint staining) and also provides additional information about the kinetics of clonogenic growth. PMID:29510509

  20. Research and application of ARP protocol vulnerability attack and defense technology based on trusted network

    NASA Astrophysics Data System (ADS)

    Xi, Huixing

    2017-03-01

    With the continuous development of network technology and the rapid spread of the Internet, computer networks have been around the world every corner. However, the network attacks frequently occur. The ARP protocol vulnerability is one of the most common vulnerabilities in the TCP / IP four-layer architecture. The network protocol vulnerabilities can lead to the intrusion and attack of the information system, and disable or disable the normal defense function of the system [1]. At present, ARP spoofing Trojans spread widely in the LAN, the network security to run a huge hidden danger, is the primary threat to LAN security. In this paper, the author summarizes the research status and the key technologies involved in ARP protocol, analyzes the formation mechanism of ARP protocol vulnerability, and analyzes the feasibility of the attack technique. Based on the summary of the common defensive methods, the advantages and disadvantages of each defense method. At the same time, the current defense method is improved, and the advantage of the improved defense algorithm is given. At the end of this paper, the appropriate test method is selected and the test environment is set up. Experiment and test are carried out for each proposed improved defense algorithm.

  1. Physiological responses to simulated firefighter exercise protocols in varying environments.

    PubMed

    Horn, Gavin P; Kesler, Richard M; Motl, Robert W; Hsiao-Wecksler, Elizabeth T; Klaren, Rachel E; Ensari, Ipek; Petrucci, Matthew N; Fernhall, Bo; Rosengren, Karl S

    2015-01-01

    For decades, research to quantify the effects of firefighting activities and personal protective equipment on physiology and biomechanics has been conducted in a variety of testing environments. It is unknown if these different environments provide similar information and comparable responses. A novel Firefighting Activities Station, which simulates four common fireground tasks, is presented for use with an environmental chamber in a controlled laboratory setting. Nineteen firefighters completed three different exercise protocols following common research practices. Simulated firefighting activities conducted in an environmental chamber or live-fire structures elicited similar physiological responses (max heart rate: 190.1 vs 188.0 bpm, core temperature response: 0.047°C/min vs 0.043°C/min) and accelerometry counts. However, the response to a treadmill protocol commonly used in laboratory settings resulted in significantly lower heart rate (178.4 vs 188.0 bpm), core temperature response (0.037°C/min vs 0.043°C/min) and physical activity counts compared with firefighting activities in the burn building. Practitioner Summary: We introduce a new approach for simulating realistic firefighting activities in a controlled laboratory environment for ergonomics assessment of fire service equipment and personnel. Physiological responses to this proposed protocol more closely replicate those from live-fire activities than a traditional treadmill protocol and are simple to replicate and standardise.

  2. Human DNA extraction from whole saliva that was fresh or stored for 3, 6 or 12 months using five different protocols

    PubMed Central

    GARBIERI, Thais Francini; BROZOSKI, Daniel Thomas; DIONÍSIO, Thiago José; SANTOS, Carlos Ferreira; NEVES, Lucimara Teixeira das

    2017-01-01

    Abstract Saliva when compared to blood collection has the following advantages: it requires no specialized personnel for collection, allows for remote collection by the patient, is painless, well accepted by participants, has decreased risks of disease transmission, does not clot, can be frozen before DNA extraction and possibly has a longer storage time. Objective and Material and Methods This study aimed to compare the quantity and quality of human DNA extracted from saliva that was fresh or frozen for three, six and twelve months using five different DNA extraction protocols: protocol 1 – Oragene™ commercial kit, protocol 2 – QIAamp DNA mini kit, protocol 3 – DNA extraction using ammonium acetate, protocol 4 – Instagene™ Matrix and protocol 5 – Instagene™ Matrix diluted 1:1 using proteinase K and 1% SDS. Briefly, DNA was analyzed using spectrophotometry, electrophoresis and PCR. Results Results indicated that time spent in storage typically decreased the DNA quantity with the exception of protocol 1. The purity of DNA was generally not affected by storage times for the commercial based protocols, while the purity of the DNA samples extracted by the noncommercial protocols typically decreased when the saliva was stored longer. Only protocol 1 consistently extracted unfragmented DNA samples. In general, DNA samples extracted through protocols 1, 2, 3 and 4, regardless of storage time, were amplified by human specific primers whereas protocol 5 produced almost no samples that were able to be amplified by human specific primers. Depending on the protocol used, it was possible to extract DNA in high quantities and of good quality using whole saliva, and furthermore, for the purposes of DNA extraction, saliva can be reliably stored for relatively long time periods. Conclusions In summary, a complicated picture emerges when taking into account the extracted DNA’s quantity, purity and quality; depending on a given researchers needs, one protocol’s particular strengths and costs might be the deciding factor for its employment. PMID:28403355

  3. Statistical Requirements For Pass-Fail Testing Of Contraband Detection Systems

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

    Gilliam, David M.

    2011-06-01

    Contraband detection systems for homeland security applications are typically tested for probability of detection (PD) and probability of false alarm (PFA) using pass-fail testing protocols. Test protocols usually require specified values for PD and PFA to be demonstrated at a specified level of statistical confidence CL. Based on a recent more theoretical treatment of this subject [1], this summary reviews the definition of CL and provides formulas and spreadsheet functions for constructing tables of general test requirements and for determining the minimum number of tests required. The formulas and tables in this article may be generally applied to many othermore » applications of pass-fail testing, in addition to testing of contraband detection systems.« less

  4. Monitoring stream temperatures—A guide for non-specialists

    USGS Publications Warehouse

    Heck, Michael P.; Schultz, Luke D.; Hockman-Wert, David; Dinger, Eric C.; Dunham, Jason B.

    2018-04-19

    Executive SummaryWater temperature influences most physical and biological processes in streams, and along with streamflows is a major driver of ecosystem processes. Collecting data to measure water temperature is therefore imperative, and relatively straightforward. Several protocols exist for collecting stream temperature data, but these are frequently directed towards specialists. This document was developed to address the need for a protocol intended for non-specialists (non-aquatic) staff. It provides specific step-by-step procedures on (1) how to launch data loggers, (2) check the factory calibration of data loggers prior to field use, (3) how to install data loggers in streams for year-round monitoring, (4) how to download and retrieve data loggers from the field, and (5) how to input project data into organizational databases.

  5. Dynamic aftereffects in supplementary motor network following inhibitory transcranial magnetic stimulation protocols.

    PubMed

    Ji, Gong-Jun; Yu, Fengqiong; Liao, Wei; Wang, Kai

    2017-04-01

    The supplementary motor area (SMA) is a key node of the motor network. Inhibitory repetitive transcranial magnetic stimulation (rTMS) of the SMA can potentially improve movement disorders. However, the aftereffects of inhibitory rTMS on brain function remain largely unknown. Using a single-blind, crossover within-subject design, we investigated the role of aftereffects with two inhibitory rTMS protocols [1800 pulses of either 1-Hz repetitive stimulation or continuous theta burst stimulation (cTBS)] on the left SMA. A total of 19 healthy volunteers participated in the rTMS sessions on 2 separate days. Firstly, short-term aftereffects were estimated at three levels (functional connectivity, local activity, and network properties) by comparing the resting-state functional magnetic resonance imaging datasets (9min) acquired before and after each rTMS session. Local activity and network properties were not significantly altered by either protocol. Functional connectivity within the SMA network was increased (in the left paracentral gyrus) by 1-Hz stimulation and decreased (in the left inferior frontal gyrus and SMA/middle cingulate cortex) by cTBS. The subsequent three-way analysis of variance (site×time×protocol) did not show a significant interaction effect or "protocol" main effect, suggesting that the two protocols share an underlying mechanism. Secondly, sliding-window analysis was used to evaluate the dynamic features of aftereffects in the ~29min after the end of stimulation. Aftereffects were maintained for a maximum of 9.8 and 6.6min after the 1-Hz and cTBS protocols, respectively. In summary, this study revealed topographical and temporal aftereffects in the SMA network following inhibitory rTMS protocols, providing valuable information for their application in future neuroscience and clinical studies. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Installation Restoration Program Stage 3. McClellan Air Force Base, California. Remedial Investigation/Feasibility Study Groundwater Sampling and Analysis Program Data Summary

    DTIC Science & Technology

    1988-12-01

    and do not refer to monitoring zones at McClellSn AFB. b Priority poLutant metals analyses also included U.S. EPA Methods 206.2, 245.1 and 270.2. EW a...sampling protocol, and the laboratory is audited routinely. Therefore, no corrective action other than good training and supervision is necessary. The same

  7. Upgrading physical activity counselling in primary care in the Netherlands.

    PubMed

    Verwey, Renée; van der Weegen, Sanne; Spreeuwenberg, Marieke; Tange, Huibert; van der Weijden, Trudy; de Witte, Luc

    2016-06-01

    The systematic development of a counselling protocol in primary care combined with a monitoring and feedback tool to support chronically ill patients to achieve a more active lifestyle. An iterative user-centred design method was used to develop a counselling protocol: the Self-management Support Programme (SSP). The needs and preferences of future users of this protocol were identified by analysing the literature, through qualitative research, and by consulting an expert panel. The counselling protocol is based on the Five A's model. Practice nurses apply motivational interviewing, risk communication and goal setting to support self-management of patients in planning how to achieve a more active lifestyle. The protocol consists of a limited number of behaviour change consultations intertwined with interaction with and responses from the It's LiFe! monitoring and feedback tool. This tool provides feedback on patients' physical activity levels via an app on their smartphone. A summary of these levels is automatically sent to the general practice so that practice nurses can respond to this information. A SSP to stimulate physical activity was defined based on user requirements of care providers and patients, followed by a review by a panel of experts. By following this user-centred approach, the organization of care was carefully taken into account, which has led to a practical and affordable protocol for physical activity counselling combined with mobile technology. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. HIV patient retention: the implementation of a North Carolina clinic-based protocol.

    PubMed

    Keller, Jennifer; Heine, Amy; LeViere, Anna Finestone; Donovan, Jenna; Wilkin, Aimee; Sullivan, Kristen; Quinlivan, Evelyn Byrd

    2017-05-01

    Decreased visit attendance leads to poor health outcomes, decreased viral suppression, and higher mortality rates for persons living with HIV. Retention in care is an important factor in improving health status for people living with HIV but continues to be a challenge in clinical settings. This paper details the development and implementation of the NC-LINK Retention Protocol, a clinic-based protocol to locate and reengage out-of-care patients, as part of overall clinic retention efforts. The protocol was implemented as one of four interventions of the NC-LINK Systems and Linkages Project, a multi-site initiative funded by the HIV/AIDS Bureau and the Special Projects of National Significance. Lists of out-of-care patients who had not received HIV medical care in over nine months and did not have a future appointment were created each month. Patient navigators, case managers, and other staff then followed a standardized protocol to locate and reengage these patients in care. A total of 452 patients were identified for reengagement services. Of those, 194 (43%) returned to care, 108 (24%) had another definitive outcome (incarcerated, deceased, or relocated) and 150 (33%) were referred for additional follow-up to locate and reengage in care. In summary, 67% of patients were located through the efforts of the clinic staff. The results of this intervention indicate that it is possible to successfully integrate a protocol into the existing infrastructure of a clinic and reengage a majority of out-of-care patients into medical care.

  9. Pre-exercise β-hydroxy-β-methylbutyrate free-acid supplementation improves work capacity recovery: a randomized, double-blinded, placebo-controlled study.

    PubMed

    Correia, Ana Luiza Matias; de Lima, Filipe Dinato; Bottaro, Martim; Vieira, Amilton; da Fonseca, Andrew Correa; Lima, Ricardo M

    2018-02-08

    The purpose of this study was to investigate the effects of a single-dose of β-hydroxy-β-methylbutyrate free acid (HMB-FA) supplementation on muscle recovery after a high-intensity exercise bout. Twenty-three trained young males were randomly assigned to receive either a single-dose supplementation of 3g of HMB-FA (n = 12; age 22.8 ± 3.0 years) or placebo (PLA; n = 11; age 22.9 ± 3.1 years). A muscle damage protocol was applied 60 minutes after supplementation, and consisted of seven sets of 20 drop jumps from a 60-cm box with 2-min rest intervals between sets. Muscle swelling, countermovement jump (CMJ), maximal voluntary isometric torque (MVIT) and work capacity (WC) were measured before, immediately after, 24, 48 and 72 hours after the exercise protocol. Muscle swelling, CMJ and MVIT changed similarly in both groups after the exercise protocol (p < 0.001), but returned to pre-exercise levels after 24 hours in both groups. WC decreased similarly in both groups after the exercise protocol (p < 0.01). For HMB-FA, WC returned to pre-exercise level 24 hours after exercise protocol. However, on PLA, WC did not return to pre-exercise level even 72 hours after the exercise protocol. In summary, a single-dose of HMB-FA supplementation improved WC recovery after a high-intensity exercise bout. However, HMB-FA did not affect the time-course of muscle swelling, MVIT and CMJ recovery.

  10. Epigenome analysis of pluripotent stem cells

    PubMed Central

    Ricupero, Christopher L.; Swerdel, Mavis R.; Hart, Ronald P.

    2015-01-01

    Summary Mis-regulation of gene expression due to epigenetic abnormalities has been linked with complex genetic disorders, psychiatric illness and cancer. In addition, the dynamic epigenetic changes that occur in pluripotent stem cells are believed to impact regulatory networks essential for proper lineage development. Chromatin immunoprecipitation (ChIP) is a technique used to isolate and enrich chromatin fragments using antibodies against specific chromatin modifications, such as DNA binding proteins or covalent histone modifications. Until recently, many ChIP protocols required millions of cells for each immunoprecipitation. This severely limited analysis of rare cell populations or post-mitotic, differentiated cell lines. Here, we describe a low cell number ChIP protocol with next generation sequencing and analysis, that has the potential to uncover novel epigenetic regulatory pathways that were previously difficult or impossible to obtain. PMID:23546758

  11. Diversity-oriented synthesis of dihydrobenzoxazepinones by coupling the Ugi multicomponent reaction with a Mitsunobu cyclization

    PubMed Central

    Moni, Lisa; Banfi, Luca; Basso, Andrea; Brambilla, Alice

    2014-01-01

    Summary An operationally simple protocol for the synthesis of 2,3-dihydrobenzo[f][1,4]oxazepin-3-ones, based on an Ugi reaction of an ortho-(benzyloxy)benzylamine, glycolic acid, an isocyanide and an aldehyde, followed by an intramolecular Mitsunobu substitution was developed. The required ortho-(benzyloxy)benzylamines have been in situ generated from the corresponding azides, in turn prepared in high yields from salicylic derivatives. PMID:24605140

  12. The SED in the 1980’s -- New Program and Statutes for the Party

    DTIC Science & Technology

    1977-08-17

    cit., p 294. 85. Protocol, Vol 1, p 40. 86. " Scientific Communism," loc. cit., p 295. 87. Zatsepilin, V.G., "Sorevnovaniye dvukh mirovykh sistem ...Covered 14. 15. Supplementary Notes 16. Abstracts The report contains an analysis by the West German Federal Institute for Eastern Scientific ...for Eastern Scientific and International Studies] CONTENTS PAGE Summary -*- I. Historical Background 5 II. Discussion of Party Documents 6 1

  13. Comparison of butorphanol-detomidine versus butorphanol-azaperone for the standing sedation of captive greater one-horned rhinoceroses (Rhinoceros unicornis).

    PubMed

    Bapodra, Priya; Cracknell, Jonathan; Wolfe, Barbara A

    2014-03-01

    Three adult and two subadult greater one-horned rhinoceroses (Rhinoceros unicornis) were sedated a total of nine times using two different intramuscular sedative combinations in order to compare the effectiveness of these combinations in inducing consistent standing sedation in this species. The sedation protocols compared were butorphanol tartrate (50-60 mg) and detomidine hydrochloride (20-30 mg; BD) versus butorphanol tartrate (80-120 mg) and azaperone (80-120 mg; BA). Specific doses were adjusted according to age and sex class, and based on previous experience. Parameters compared included time to achieve defined levels of sedation, time to recovery following antagonism, physiological parameters including heart rate, respiratory rate, indirect arterial blood pressure, and venous blood gas values. A hydraulic restraint chute was utilized to mechanically restrain animals during the procedures, and blood collection and ophthalmic examinations were conducted on all animals. Both protocols resulted in standing sedation for > or = 22.3 +/- 2.9 min or until antagonists were administered. The BD protocol resulted in deeper and more consistent sedation, compared to the BA protocol. Naltrexone hydrochloride (250-300 mg) and tolazoline hydrochloride (1,500-2,000 mg) were administered intramuscularly to antagonize protocol BD, whereas naltrexone alone (200-500 mg) was used to antagonize BA. Time to full antagonism, defined as normal mentation and ambulation following administration of antagonists, was prolonged in the BD protocol (132.3 +/- 17.2 min) compared with the BA protocol (7.5 +/- 2.5 min). Venous blood gas analysis did not reveal any significant blood gas deviations during sedation when compared with either conscious equine or white rhinoceros (Ceratotherium simum) venous reference ranges. In summary, both combinations resulted in adequate standing sedation for minimally invasive procedures, although BD resulted in more profound and consistent sedation.

  14. NASA Exercise Physiology and Countermeasures Project Overview

    NASA Technical Reports Server (NTRS)

    Loerch, Linda; Ploutz-Snyder, Lori

    2009-01-01

    Efficient exercise countermeasures are necessary to offset or minimize spaceflight-induced deconditioning and to maximize crew performance of mission tasks. These countermeasure protocols should use the fewest crew and vehicle resources. NASA s Exercise Physiology and Countermeasures (ExPC) Project works to identify, collect, interpret, and summarize evidence that results in effective exercise countermeasure protocols which protect crew health and performance during International Space Station (ISS) and future exploration-class missions. The ExPC and NASA s Human Research Program are sponsoring multiple studies to evaluate and improve the efficacy of spaceflight exercise countermeasures. First, the Project will measure maximal aerobic capacity (VO2max) during cycle ergometry before, during, and after ISS missions. Second, the Project is sponsoring an evaluation of a new prototype harness that offers improved comfort and increased loading during treadmill operations. Third, the Functional Tasks Test protocol will map performance of anticipated lunar mission tasks with physiologic systems before and after short and long-duration spaceflight, to target system contributions and the tailoring of exercise protocols to maximize performance. In addition to these studies that are actively enrolling crewmember participants, the ExPC is planning new studies that include an evaluation of a higher-intensity/lower-volume exercise countermeasure protocol aboard the ISS using the Advanced Resistive Exercise Device and second-generation treadmill, studies that evaluate bone loading during spaceflight exercise, and ground-based studies that focus on fitness for duty standards required to complete lunar mission tasks and for which exercise protocols need to protect. Summaries of these current and future studies and strategies will be provided to international colleagues for knowledge sharing and possible collaboration.

  15. Reliability and criterion validity of an observation protocol for working technique assessments in cash register work.

    PubMed

    Palm, Peter; Josephson, Malin; Mathiassen, Svend Erik; Kjellberg, Katarina

    2016-06-01

    We evaluated the intra- and inter-observer reliability and criterion validity of an observation protocol, developed in an iterative process involving practicing ergonomists, for assessment of working technique during cash register work for the purpose of preventing upper extremity symptoms. Two ergonomists independently assessed 17 15-min videos of cash register work on two occasions each, as a basis for examining reliability. Criterion validity was assessed by comparing these assessments with meticulous video-based analyses by researchers. Intra-observer reliability was acceptable (i.e. proportional agreement >0.7 and kappa >0.4) for 10/10 questions. Inter-observer reliability was acceptable for only 3/10 questions. An acceptable inter-observer reliability combined with an acceptable criterion validity was obtained only for one working technique aspect, 'Quality of movements'. Thus, major elements of the cashiers' working technique could not be assessed with an acceptable accuracy from short periods of observations by one observer, such as often desired by practitioners. Practitioner Summary: We examined an observation protocol for assessing working technique in cash register work. It was feasible in use, but inter-observer reliability and criterion validity were generally not acceptable when working technique aspects were assessed from short periods of work. We recommend the protocol to be used for educational purposes only.

  16. Antibody Desensitization Therapy in Highly Sensitized Lung Transplant Candidates

    PubMed Central

    Snyder, L. D.; Gray, A. L.; Reynolds, J. M.; Arepally, G. M.; Bedoya, A.; Hartwig, M. G.; Davis, R. D.; Lopes, K. E.; Wegner, W. E.; Chen, D. F.; Palmer, S. M.

    2015-01-01

    As HLAs antibody detection technology has evolved, there is now detailed HLA antibody information available on prospective transplant recipients. Determining single antigen antibody specificity allows for a calculated panel reactive antibodies (cPRA) value, providing an estimate of the effective donor pool. For broadly sensitized lung transplant candidates (cPRA ≥ 80%), our center adopted a pretransplant multimodal desensitization protocol in an effort to decrease the cPRA and expand the donor pool. This desensitization protocol included plasmapheresis, solumedrol, bortezomib and rituximab given in combination over 19 days followed by intravenous immunoglobulin. Eight of 18 candidates completed therapy with the primary reasons for early discontinuation being transplant (by avoiding unacceptable antigens) or thrombocytopenia. In a mixed-model analysis, there were no significant changes in PRA or cPRA changes over time with the protocol. A sub-analysis of the median fluorescence intensity (MFI) change indicated a small decline that was significant in antibodies with MFI 5000–10 000. Nine of 18 candidates subsequently had a transplant. Posttransplant survival in these nine recipients was comparable to other pretransplant-sensitized recipients who did not receive therapy. In summary, an aggressive multi-modal desensitization protocol does not significantly reduce pretransplant HLA antibodies in a broadly sensitized lung transplant candidate cohort. PMID:24666831

  17. A novel workflow for computer guided implant surgery matching digital dental casts and CBCT scan

    PubMed Central

    DE VICO, G.; FERRARIS, F.; ARCURI, L.; GUZZO, F.; SPINELLI, D.

    2016-01-01

    SUMMARY Nowadays computer-guided “flap-less” surgery for implant placement using stereolithographic tem-plates is gaining popularity among clinicians and patients. The advantages of this surgical protocol are its minimally invasive nature, accuracy of implant placement, predictability, less post-surgical discomfort and reduced time required for definitive rehabilitation. Aim of this work is to describe a new protocol (Smart Fusion by Nobel Biocare), thanks to which is now possible to do a mini-invasive static guided implant surgery, in partially edentulous patients with at least 6 remaining teeth, without the use of a radiographic guide. This is possible thanks to a procedure named surface mapping based on the matching between numerous points on the surface of patient’s dental casts and the corresponding anatomical surface points in the CBCT data. The full protocol is examined focusing the attention on the clinical and laboratory procedures. Conclusions Also with some critical points and needing an adequate learning curve, this protocol allows to select the ideal implant position in depth, inclination and mesio-distal distance between natural teeth and or other implants enabling a very safe and predictable rehabilitation compared with conventional surgery. It represents a good tool for the best compromise between anatomy, function and aesthetic, able to guarantee better results in all clinical situations. PMID:28042429

  18. Firefighter exercise protocols conducted in an environmental chamber: developing a laboratory-based simulated firefighting protocol.

    PubMed

    Ensari, Ipek; Motl, Robert W; Klaren, Rachel E; Fernhall, Bo; Smith, Denise L; Horn, Gavin P

    2017-05-01

    A standard exercise protocol that allows comparisons across various ergonomic studies would be of great value for researchers investigating the physical and physiological strains of firefighting and possible interventions for reducing the demands. We compared the pattern of cardiorespiratory changes from 21 firefighters during simulated firefighting activities using a newly developed firefighting activity station (FAS) and treadmill walking both performed within an identical laboratory setting. Data on cardiorespiratory parameters and core temperature were collected continuously using a portable metabolic unit and a wireless ingestible temperature probe. Repeated measures ANOVA indicated distinct patterns of change in cardiorespiratory parameters and heart rate between conditions. The pattern consisted of alternating periods of peaks and nadirs in the FAS that were qualitatively and quantitatively similar to live fire activities, whereas the same parameters increased logarithmically in the treadmill condition. Core temperature increased in a similarly for both conditions, although more rapidly in the FAS. Practitioner Summary: The firefighting activity station (FAS) yields a pattern of cardiorespiratory responses qualitatively and quantitatively similar to live fire activities, significantly different than treadmill walking. The FAS can be performed in a laboratory/clinic, providing a potentially standardised protocol for testing interventions to improve health and safety and conducting return to duty decisions.

  19. Results from the 2001 National Household Survey on Drug Abuse. Volume I: Summary of National Findings [and] Volume II: Technical Appendices and Selected Data Tables [and] Volume III: Detailed Tables.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Office of Applied Studies.

    This document presents the technical appendices and selected data tables from the 2001 National Household Survey on Drug Abuse. Included are a description of the survey; statistical methods and limitations of the data; effects of changes in survey protocol on trend measurement; key definitions for the 1999-2001 survey years; and other sources of…

  20. Protelytic Regulation of the Intestinal Epithelial Barrier: Mechanisms and Interventions

    DTIC Science & Technology

    2015-09-01

    group) during the course of the DSS protocol to assess gut permeability by serum FITC- dextran concentration after gavage and by ex vivo TEER...TEER and by the flux of 4kDa FITC conjugated dextran across monolayers (months 1-3) Year 1 and 2 summary - Preliminary data showed that after treatment...macromolecular FITC- dextran . We have been able to consistently induce barrier disruption of T84 cultures using IL-13 in combination with the

  1. The relationship between childhood body weight and dental caries experience: an umbrella systematic review protocol.

    PubMed

    Carson, Susan J; Abuhaloob, Lamis; Richards, Derek; Hector, Mark P; Freeman, Ruth

    2017-10-25

    Obesity and dental caries are global public health problems which can impact in childhood and throughout the life course. In simple terms, childhood dental caries and body weight are linked via the common risk factor of diet. An association between dental caries and obesity has been described in a number of studies and reviews. However, similarly, a relationship has also been noted between low body weight and caries experience in children. This protocol will provide the framework for an umbrella review to address the following question: Does the available evidence support a relationship between dental caries experience and body weight in the child population? This review protocol outlines the process to carry out an umbrella systematic review which will synthesise previous reviews of childhood dental caries experience and body weight. An umbrella review methodology will be used to examine the methodological and reporting quality of existing reviews. The final umbrella review aims to aggregate the available evidence in order to provide a summary for policymakers and to inform healthcare interventions. PROSPERO CRD42016047304.

  2. Secure Communications

    NASA Astrophysics Data System (ADS)

    Bellac, Michel Le

    2014-11-01

    The first practical application of quantum physics examined in this book is quantum cryptography. Quantum cryptography is a relatively recent invention (it dates back from the mid 1980s) but I chose it because it allows me to illustrate the fundamental principles with a minimum number of intermediate steps. I shall begin with a short summary of classical cryptography, reviewing briefly the two systems which are currently used today: the secret key system and the public key system. Quantum cryptography is not a new method for dissimulating the meaning of a message, but it allows one to be certain that no spy has accessed it. There exist many quantum cryptography protocols and various experimental devices have been proposed for implementing them. The simplest device is based on polarization, a concept which will be introduced first in the case of of light polarization, and then in that of photon polarization. The use of photon polarization gives the simplest implementation of the protocol proposed in 1984 by Bennett and Brassard, which is known by the acronym formed with their initials, the BB84 protocol.

  3. Summary of: Regenerative endodontics.

    PubMed

    Clark, Stephen J

    2014-03-01

    Significant advances in our understanding of the biological processes involved in tooth development and repair at the cellular and molecular levels have underpinned the newly emerging area of regenerative endodontics. Development of treatment protocols based on exploiting the natural wound healing properties of the dental pulp and applying tissue engineering principles has allowed reporting of case series showing preservation of tissue vitality and apexogenesis. To review current case series reporting regenerative endodontics. Current treatment approaches tend to stimulate more reparative than regenerative responses in respect of the new tissue generated, which often does not closely resemble the physiological structure of dentine-pulp. However, despite these biological limitations, such techniques appear to offer significant promise for improved treatment outcomes. Improved biological outcomes will likely emerge from the many experimental studies being reported and will further contribute to improvements in clinical treatment protocols.

  4. Purification of Arp2/3 complex from Saccharomyces cerevisiae

    PubMed Central

    Doolittle, Lynda K.; Rosen, Michael K.; Padrick, Shae B.

    2014-01-01

    Summary Much of cellular control over actin dynamics comes through regulation of actin filament initiation. At the molecular level, this is accomplished through a collection of cellular protein machines, called actin nucleation factors, which position actin monomers to initiate a new actin filament. The Arp2/3 complex is a principal actin nucleation factor used throughout the eukaryotic family tree. The budding yeast Saccharomyces cerevisiae has proven to be not only an excellent genetic platform for the study of the Arp2/3 complex, but also an excellent source for the purification of endogenous Arp2/3 complex. Here we describe a protocol for the preparation of endogenous Arp2/3 complex from wild type Saccharomyces cerevisiae. This protocol produces material suitable for biochemical study, and yields milligram quantities of purified Arp2/3 complex. PMID:23868593

  5. Tissue-supported dental implant prosthesis (overdenture): the search for the ideal protocol. A literature review

    PubMed Central

    Laurito, Domenica; Lamazza, Luca; Spink, Michael J.; De Biase, Alberto

    2012-01-01

    Summary Aims The success of maxillary and mandibular tissue supported implant prostheses varies in the literature, and the ideal protocol may be elusive from given the numerous studies. The oral rehabilitation option is an alternative to conventional dentures and should improve function, satisfaction, and retention. The purpose of this review article is to clarify these questions. Methods The search of literature reviews English non-anecdotal implant overdentures articles from 1991 to 2011. Results The results display an aggregate comprehensive list of categorical variables from the literature review. Overall success of maxillary and mandibular implant overdenture was respectively, 86.6% and 95.8%. Conclusion The literature indicates that the implant overdenture prosthesis provides predictable results – enhanced stability, function and a high-degree of satisfaction compared to conventional removable dentures. PMID:22783448

  6. A novel combination of silane-coated silica colloid with hybrid RNA extraction protocol and RNA enrichment for downstream applications of spermatozoal RNA.

    PubMed

    Vijayalakshmy, K; Kumar, P; Virmani, M; Pawaria, S; Lalaji, N S; Sharma, P; Rajendran, R; Yadav, P S; Kumar, D

    2018-05-14

    Spermatozoa are specialised cells with low RNA content as compared to somatic cells. The suitable sperm RNA extraction and enrichment protocols for downstream applications are available for human, cattle, stallion and mouse but not for buffalo spermatozoa. Therefore, the present work was conducted to find out suitable colloidal solution for sperm purification and appropriate protocol for sperm RNA extraction and enrichment/amplification of RNA. For purification, we used PVP-coated silica colloidal solution (PVP-Si), silane-coated silica colloidal solution (Silane-Si) and iodixanol. Sperm recovery rate, total sperm motility and progressive sperm motility were significantly improved after separation by Silane-Si and iodixanol compared to PVA-Si method. The combined guanidinium thiocyanate-phenol-chloroform (GTPC) with silica matrix (SM)-based RNA extraction yielded more quantity of RNA in compared to individual method. The hybrid of SM and GTPC into a single protocol yielded 360-450 ng RNA from 30 million buffalo spermatozoa. For the first time, we adopted new way to enrich sperm RNA that increased the RNA concentration 4-5 times that was sufficient for downstream applications. The linear amplification of sperm RNA increased RNA concentration around 27-45 times. In summary, Silane-Si colloid for sperm separation, hybrid SM and GTPC protocol for sperm RNA extraction followed by enrichment or amplification of RNA was found suitable for high-throughput analyses of buffalo sperm RNA. © 2018 Blackwell Verlag GmbH.

  7. Review of techniques to prevent introduction of zebra mussels (Dreissena polymorpha) during native mussel (Unionoidea) conservation activities

    USGS Publications Warehouse

    Cope, W.G.; Newton, T.J.; Gatenby, C.M.

    2003-01-01

    Because of the declines in diversity and abundance of native freshwater mussels (superfamily Unionoidea), and the potential decimation of populations of native mussels resulting from the rapid spread of the exotic zebra mussel Dreissena polymorpha, management options to eliminate or reduce the threat of the zebra mussel are needed. Relocating native mussels to refugia (artificial and natural) has been proposed to mitigate the threat of zebra mussels to native species. Relocation of native mussels to refugia such as fish hatchery facilities or natural habitats within their historic range. Which are unlikely to be infested by zebra mussels, necessitates that protocols be developed to prevent the inadvertent introduction of zebra mussels. Several recent studies have developed Such protocols, and have assessed their effectiveness on the health and survival of native mussels during subsequent relocation to various refugia. The purpose of this project is to synthesize and evaluate the current protocols and to develop a set of procedures that resource managers and researchers should consider before conducting conservation activities in zebra mussel infested waters. We found that the existing protocols have many common points of concern, such as facility modification and suitability, zebra mussel risk assessment and management procedures, and health and disease management procedures. These conservation protocols may have broad applicability to other situations and locations. A summary and evaluation of the information in these main areas, along with recommended guidelines, are presented in this article.

  8. Assessment of Correlation of Distal Mean Arterial Pressure with Aortic Blood Flow during Partial Resuscitative Endovascular Balloon Aortic Occlusion (P-REBOA) in a Swine (Sus scrofa) Controlled Hemorrhage Model

    DTIC Science & Technology

    2017-11-06

    60th Medical Group (AMC), Travis AFB, CA INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC) FINAL REPORT SUMMARY (Please type all information. Use...Pressure with Aortic Blood Flow during Partial Resuscitative Endovascular Balloon Aortic Occlusion (P-REBOA) in a Swine (Sus scrofa) Controlled Hemorrhage...to Date Sus scrofa 8 8 2. PROTOCOL TYPE /CHARACTERISTICS: (Check all applicable terms in EACH column) _ Training: Live Animal Medical Readiness

  9. Tissue Preservation Assessment Preliminary Results

    NASA Technical Reports Server (NTRS)

    Globus, Ruth; Costes, Sylvain

    2017-01-01

    Pre-flight groundbased testing done to prepare for the first Rodent Research mission validation flight, RR1 (Choi et al, 2016 PlosOne). We purified RNA and measured RIN values to assess quality of the samples. For protein, we measured liver enzyme activities. We tested protocol and methods of preservation to date. Here we present an overview of results related to tissue preservation from the RR1 validation mission and a summary of findings to date from investigators who received RR1 teissues various Biospecimen Sharing Program.

  10. International Biodefense Enhancement Capabilities from a Policy Perspective

    DTIC Science & Technology

    2005-05-01

    Protection. Available at: http://www.proteccioncivil.gov.ar/ Accessed April 2005. Direcci6n de Defensa Civil / Municipalidad de C6rdoba. Memoria de...propuestas al sector piblico local, provincial y nacional. 19:15 Lectura de las notas finales de la Sesi6n 19:30 Sesi6n 4: Sintesis y acciones a corto ... plazo . Moderador de sesi6n: Presidencia del Encuentro 20:00 Coctail de cierre W8 I XWH-04-C-0006 APPENDIX H - IRB Protocol Summary Outline Form DREXEL

  11. Command/response protocols and concurrent software

    NASA Technical Reports Server (NTRS)

    Bynum, W. L.

    1987-01-01

    A version of the program to control the parallel jaw gripper is documented. The parallel jaw end-effector hardware and the Intel 8031 processor that is used to control the end-effector are briefly described. A general overview of the controller program is given and a complete description of the program's structure and design are contained. There are three appendices: a memory map of the on-chip RAM, a cross-reference listing of the self-scheduling routines, and a summary of the top-level and monitor commands.

  12. A Family of LIC Vectors for High-Throughput Cloning and Purification of Proteins1

    PubMed Central

    Eschenfeldt, William H.; Stols, Lucy; Millard, Cynthia Sanville; Joachimiak, Andrzej; Donnelly, Mark I.

    2009-01-01

    Summary Fifteen related ligation-independent cloning vectors were constructed for high-throughput cloning and purification of proteins. The vectors encode a TEV protease site for removal of tags that facilitate protein purification (his-tag) or improve solubility (MBP, GST). Specialized vectors allow coexpression and copurification of interacting proteins, or in vivo removal of MBP by TVMV protease to improve screening and purification. All target genes and vectors are processed by the same protocols, which we describe here. PMID:18988021

  13. Comparison between the standard and a new alternative format of the Summary-of-Findings tables in Cochrane review users: study protocol for a randomized controlled trial.

    PubMed

    Carrasco-Labra, Alonso; Brignardello-Petersen, Romina; Santesso, Nancy; Neumann, Ignacio; Mustafa, Reem A; Mbuagbaw, Lawrence; Ikobaltzeta, Itziar Etxeandia; 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; Guyatt, Gordon; Schünemann, Holger

    2015-04-16

    Systematic reviews represent one of the most important tools for knowledge translation but users often struggle with understanding and interpreting their results. GRADE Summary-of-Findings tables have been developed to display results of systematic reviews in a concise and transparent manner. The current format of the Summary-of-Findings tables for presenting risks and quality of evidence improves understanding and assists users with finding key information from the systematic review. However, it has been suggested that additional methods to present risks and display results in the Summary-of-Findings tables are needed. We will conduct a non-inferiority parallel-armed randomized controlled trial to determine whether an alternative format to present risks and display Summary-of-Findings tables is not inferior compared to the current standard format. We will measure participant understanding, accessibility of the information, satisfaction, and preference for both formats. We will invite systematic review users to participate (that is clinicians, guideline developers, and researchers). The data collection process will be undertaken using the online 'Survey Monkey' system. For the primary outcome understanding, non-inferiority of the alternative format (Table A) to the current standard format (Table C) of Summary-of-Findings tables will be claimed if the upper limit of a 1-sided 95% confidence interval (for the difference of proportion of participants answering correctly a given question) excluded a difference in favor of the current format of more than 10%. This study represents an effort to provide systematic reviewers with additional options to display review results using Summary-of-Findings tables. In this way, review authors will have a variety of methods to present risks and more flexibility to choose the most appropriate table features to display (that is optional columns, risks expressions, complementary methods to display continuous outcomes, and so on). NCT02022631 (21 December 2013).

  14. Does small-sided-games’ court area influence metabolic, perceptual, and physical performance parameters of young elite basketball players?

    PubMed Central

    Marcelino, PR; Aoki, MS; Arruda, AFS; Freitas, CG; Mendez-Villanueva, A

    2015-01-01

    The purpose of this study was to investigate the effect of court size on physiological responses and physical performance of young elite basketball players. Twelve male basketball players (18.6 ± 0.5 years; 88.8 ± 14.5 kg; 192.6 ± 6.5 cm) from an under-19 team performed two small-sided games (matches) with different court areas (28x15 m and 28x9 m; 28x15 and 28x9 protocols). The number of players (3x3) was kept the same in each protocol. The players performed a repeated-sprint ability (RSA) test before and after each match. Blood lactate concentration was collected before (pre) and after (post) the matches, and the session rating of perceived exertion (session-RPE) was determined 30 minutes after the match. Best and mean time in the RSA test were not different between the 28x15 and the 28x9 match protocols (p > 0.05). A significant difference was observed for lactate concentration from pre- to post-match (p < 0.05) in both protocols (28x15 and 28x9); however, there was no significant interaction between protocols. A similar session-RPE mean score (28x15: 7.2 ± 1.4 and 28x9: 6.6 ± 1.4) was detected for both protocols (p > 0.05, ES=0.41). In summary, the results of the current study suggest that the different court areas induced similar responses. Although there was no significant difference in effort perception, players tended to perceive a greater effort in the larger court size. PMID:26985132

  15. Excessive training impairs the insulin signal transduction in mice skeletal muscles.

    PubMed

    Pereira, Bruno C; da Rocha, Alisson L; Pinto, Ana P; Pauli, José R; de Moura, Leandro P; Mekary, Rania A; de Freitas, Ellen C; da Silva, Adelino S R

    2016-07-01

    The main aim of this investigation was to verify the effects of overtraining (OT) on the insulin and inflammatory signaling pathways in mice skeletal muscles. Rodents were divided into control (CT), overtrained by downhill running (OTR/down), overtrained by uphill running (OTR/up), and overtrained by running without inclination (OTR) groups. Rotarod, incremental load, exhaustive, and grip force tests were used to evaluate performance. Thirty-six hours after the grip force test, the extensor digitorum longus (EDL) and soleus were extracted for subsequent protein analyses. The three OT protocols led to similar responses of all performance evaluation tests. The phosphorylation of insulin receptor beta (pIRβ; Tyr), protein kinase B (pAkt; Ser473), and the protein levels of plasma membrane glucose transporter-4 (GLUT4) were lower in the EDL and soleus after the OTR/down protocol and in the soleus after the OTR/up and OTR protocols. While the pIRβ was lower after the OTR/up and OTR protocols, the pAkt was higher after the OTR/up in the EDL. The phosphorylation of IκB kinase alpha and beta (pIKKα/β; Ser180/181), stress-activated protein kinases/Jun amino-terminal kinases (pSAPK-JNK; Thr183/Tyr185), factor nuclear kappa B (pNFκB p65; Ser536), and insulin receptor substrate 1 (pIRS1; Ser307) were higher after the OTR/down protocol, but were not altered after the two other OT protocols. In summary, these data suggest that OT may lead to skeletal muscle insulin signaling pathway impairment, regardless of the predominance of eccentric contractions, although the insulin signal pathway impairment induced in OTR/up and OTR appeared to be muscle fiber-type specific. © 2016 Society for Endocrinology.

  16. Delivery room management of very low birth weight infants in Germany, Austria and Switzerland - a comparison of protocols

    PubMed Central

    2010-01-01

    Background Surveys from the USA, Australia and Spain have shown significant inter-institutional variation in delivery room (DR) management of very low birth weight infants (VLBWI, < 1500 g) at birth, despite regularly updated international guidelines. Objective To investigate protocols for DR management of VLBWI in Germany, Austria and Switzerland and to compare these with the 2005 ILCOR guidelines. Methods DR management protocols were surveyed in a prospective, questionnaire-based survey in 2008. Results were compared between countries and between academic and non-academic units. Protocols were compared to the 2005 ILCOR guidelines. Results In total, 190/249 units (76%) replied. Protocols for DR management existed in 94% of units. Statistically significant differences between countries were found regarding provision of 24 hr in house neonatal service; presence of a designated resuscitation area; devices for respiratory support; use of pressure-controlled manual ventilation devices; volume control by respirator; and dosage of Surfactant. There were no statistically significant differences regarding application and monitoring of supplementary oxygen, or targeted saturation levels, or for the use of sustained inflations. Comparison of academic and non-academic hospitals showed no significant differences, apart from the targeted saturation levels (SpO2) at 10 min. of life. Comparison with ILCOR guidelines showed good adherence to the 2005 recommendations. Summary Delivery room management in German, Austrian and Swiss neonatal units was commonly based on written protocols. Only minor differences were found regarding the DR setup, devices used and the targeted ranges for SpO2 and FiO2. DR management was in good accordance with 2005 ILCOR guidelines, some units already incorporated evidence beyond the ILCOR statement into their routine practice. PMID:21159574

  17. Lesson From the New York City Out-of-Hospital Uncontrolled Donation After Circulatory Determination of Death Program.

    PubMed

    Wall, Stephen P; Kaufman, Bradley J; Williams, Nicholas; Norman, Elizabeth M; Gilbert, Alexander J; Munjal, Kevin G; Maikhor, Shana; Goldstein, Michael J; Rivera, Julia E; Lerner, Harvey; Meyers, Chad; Machado, Marion; Montella, Susan; Pressman, Marcy; Teperman, Lewis W; Dubler, Nancy N; Goldfrank, Lewis R

    2016-04-01

    In 2006, the Institute of Medicine emphasized substantial potential to expand organ donation opportunities through uncontrolled donation after circulatory determination of death (uDCDD). We pilot an out-of-hospital uDCDD kidney program for New York City in partnership with communities that it was intended to benefit. We evaluate protocol process and outcomes while identifying barriers to success and means for improvement. We conducted a prospective, participatory action research study in Manhattan from December 2010 to May 2011. Daily from 4 to 12 pm, our organ preservation unit monitored emergency medical services (EMS) frequencies for cardiac arrests occurring in private locations. After EMS providers independently ordered termination of resuscitation, organ preservation unit staff determined clinical eligibility and donor status. Authorized parties, persons authorized to make organ donation decisions, were approached about in vivo preservation. The study population included organ preservation unit staff, authorized parties, passersby, and other New York City agency personnel. Organ preservation unit staff independently documented shift activities with daily operations notes and teleconference summaries that we analyzed with mixed qualitative and quantitative methods. The organ preservation unit entered 9 private locations; all the deceased lacked previous registration, although 4 met clinical screening eligibility. No kidneys were recovered. We collected 837 notes from 35 organ preservation unit staff. Despite frequently recounting protocol breaches, most responses from passersby including New York City agencies were favorable. No authorized parties were offended by preservation requests, yielding a Bayesian posterior median 98% (95% credible interval 76% to 100%). In summary, the New York City out-of-hospital uDCDD program was not feasible. There were frequent protocol breaches and confusion in determining clinical eligibility. In the small sample of authorized persons we encountered during the immediate grieving period, negative reactions were infrequent. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  18. Influenza A Virus Isolation, Culture and Identification

    PubMed Central

    Eisfeld, Amie J.; Neumann, Gabriele; Kawaoka, Yoshihiro

    2017-01-01

    SUMMARY Influenza A viruses (IAV) cause epidemics and pandemics that result in considerable financial burden and loss of human life. To manage annual IAV epidemics and prepare for future pandemics, improved understanding of how IAVs emerge, transmit, cause disease, and acquire pandemic potential is urgently needed. Fundamental techniques essential for procuring such knowledge are IAV isolation and culture from experimental and surveillance samples. Here, we present a detailed protocol for IAV sample collection and processing, amplification in chicken eggs and mammalian cells, and identification from samples containing unknown pathogens. This protocol is robust, and allows for generation of virus cultures that can be used for downstream analyses. Once experimental or surveillance samples are obtained, virus cultures can be generated and the presence of IAV can be verified in 3–5 days. Increased time-frames may be required for less experienced laboratory personnel, or when large numbers of samples will be processed. PMID:25321410

  19. Microwave-Assisted γ-Valerolactone Production for Biomass Lignin Extraction: A Cascade Protocol.

    PubMed

    Tabasso, Silvia; Grillo, Giorgio; Carnaroglio, Diego; Calcio Gaudino, Emanuela; Cravotto, Giancarlo

    2016-03-26

    The general need to slow the depletion of fossil resources and reduce carbon footprints has led to tremendous effort being invested in creating "greener" industrial processes and developing alternative means to produce fuels and synthesize platform chemicals. This work aims to design a microwave-assisted cascade process for a full biomass valorisation cycle. GVL (γ-valerolactone), a renewable green solvent, has been used in aqueous acidic solution to achieve complete biomass lignin extraction. After lignin precipitation, the levulinic acid (LA)-rich organic fraction was hydrogenated, which regenerated the starting solvent for further biomass delignification. This process does not requires a purification step because GVL plays the dual role of solvent and product, while the reagent (LA) is a product of biomass delignification. In summary, this bio-refinery approach to lignin extraction is a cascade protocol in which the solvent loss is integrated into the conversion cycle, leading to simplified methods for biomass valorisation.

  20. Immediate loading of four implants (BTLock®) in the maxilla and provisional restoration with guide-surgery (SimPlant, Materialise®): case report

    PubMed Central

    SPINELLI, D.; DE VICO, G.; SCHIAVETTI, R.; BONINO, M.; POZZI, A.; BOLLERO, P.; BARLATTANI, A.

    2010-01-01

    SUMMARY The severe atrophy of the jaws are a challenging therapeutic problem, since the increase in bone is necessary to allow the placement of a sufficient number of implants. Combining immediate functionalization with the concept of guided surgery they combine the advantages offered by the innovative surgical and prosthetic implant technique (All-on-Four®) with those of computer-assisted planning in cases of severe bone atrophy. The method used in this case report, combines these two concepts in a surgical and prosthetic protocol safe and effective for the immediate function of 4 implants to support a fixed prosthesis in completely edentulous subjects. The integration of technology with immediate function with the concept of computer-guided surgery for implant placement and rehabilitation of completely edentulous jaws is now a predictable treatment modality with implant survival comparable to the traditional protocols. PMID:23285381

  1. Classical conditioning through auditory stimuli in Drosophila: methods and models

    PubMed Central

    Menda, Gil; Bar, Haim Y.; Arthur, Ben J.; Rivlin, Patricia K.; Wyttenbach, Robert A.; Strawderman, Robert L.; Hoy, Ronald R.

    2011-01-01

    SUMMARY The role of sound in Drosophila melanogaster courtship, along with its perception via the antennae, is well established, as is the ability of this fly to learn in classical conditioning protocols. Here, we demonstrate that a neutral acoustic stimulus paired with a sucrose reward can be used to condition the proboscis-extension reflex, part of normal feeding behavior. This appetitive conditioning produces results comparable to those obtained with chemical stimuli in aversive conditioning protocols. We applied a logistic model with general estimating equations to predict the dynamics of learning, which successfully predicts the outcome of training and provides a quantitative estimate of the rate of learning. Use of acoustic stimuli with appetitive conditioning provides both an alternative to models most commonly used in studies of learning and memory in Drosophila and a means of testing hearing in both sexes, independently of courtship responsiveness. PMID:21832129

  2. Aspirin Allergy Desensitization in Cerebrovascular Disease

    PubMed Central

    Zuckerman, Scott L; Seder, David B; Tsujiura, Crystiana; Cushing, Deborah; Gallup, Holly; Mocco, J; Hanel, Richard A; Ecker, Robert D

    2014-01-01

    Summary Aspirin (ASA) is the mainstay of treatment in cerebrovascular and systemic vascular disease. ASA hypersensitivity can pose a challenge to achieving optimum medical management prior to and after neurointerventional treatment. Desensitization to ASA is well described in the allergy and cardiovascular literature, but there are no similar discussions specific to neurointervention. The purpose of our study was to describe our experience with ASA hypersensitivity management and review the relevant literature. Two cases of patients with symptomatic cerebrovascular disease requiring neurointervention who were successfully desensitized to their ASA hypersensitivity prior to treatment are described. The subsequent literature is reviewed. Several ASA desensitization protocols exist and have been proven to successfully treat ASA hypersensitivity and allow for ASA therapy to be safely initiated. We describe several previously published protocols. ASA desensitization is a safe and simple way to manage ASA hypersensitivity. We provide comprehensive management guidelines for the neurointerventionalist engaging in ASA desensitization. PMID:24556294

  3. The touchscreen operant platform for testing learning and memory in rats and mice

    PubMed Central

    Horner, Alexa E.; Heath, Christopher J.; Hvoslef-Eide, Martha; Kent, Brianne A.; Kim, Chi Hun; Nilsson, Simon R. O.; Alsiö, Johan; Oomen, Charlotte A.; Holmes, Andrew; Saksida, Lisa M.; Bussey, Timothy J.

    2014-01-01

    Summary An increasingly popular method of assessing cognitive functions in rodents is the automated touchscreen platform, on which a number of different cognitive tests can be run in a manner very similar to touchscreen methods currently used to test human subjects. This methodology is low stress (using appetitive, rather than aversive reinforcement), has high translational potential, and lends itself to a high degree of standardisation and throughput. Applications include the study of cognition in rodent models of psychiatric and neurodegenerative diseases (e.g., Alzheimer’s disease, schizophrenia, Huntington’s disease, frontotemporal dementia), and characterisation of the role of select brain regions, neurotransmitter systems and genes in rodents. This protocol describes how to perform four touchscreen assays of learning and memory: Visual Discrimination, Object-Location Paired-Associates Learning, Visuomotor Conditional Learning and Autoshaping. It is accompanied by two further protocols using the touchscreen platform to assess executive function, working memory and pattern separation. PMID:24051959

  4. Cervical spondylotic myelopathy: methodological approaches to evaluate the literature and establish best evidence.

    PubMed

    Skelly, Andrea C; Hashimoto, Robin E; Norvell, Daniel C; Dettori, Joseph R; Fischer, Dena J; Wilson, Jefferson R; Tetreault, Lindsay A; Fehlings, Michael G

    2013-10-15

    Review of methods. To provide a detailed description of the methods undertaken in the articles in this focus issue pertaining to cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) and to describe the process used to develop summary statements and clinical recommendations regarding factors associated with the mechanisms, diagnosis, progression, and treatment of CSM and OPLL. We present methods used in conducting the systematic, evidence-based reviews and development of expert panel summary statements and clinical recommendations of the mechanisms, diagnosis, progression, and treatment of CSM and OPLL. Our intent is that clinicians will combine the information from these systematic reviews, narrative reviews, and primary research studies with an understanding of their own capacities and experience to better manage patients with CSM or OPLL and consider future research for the diagnosis and treatment of these diseases. For the systematic reviews, which make up the bulk of the studies in this focus issue, a systematic search and critical review of the English language literature was undertaken for articles published on the mechanisms, diagnosis, progression, and treatment of CSM and OPLL. Articles were screened for relevance using a priori criteria and relevant articles were critically reviewed. Whether an article was included for review depended on whether the study question was descriptive, one of therapy, or one of prognosis. The strength of evidence for the overall body of literature in each topic area was determined by 2 independent reviewers considering risk of bias, consistency, directness, and precision of results using a modification of the Grading of Recommendation Assessment, Development and Evaluation criteria. Disagreements were resolved by consensus. Findings from articles meeting inclusion criteria were summarized. From these summaries, summary statements or clinical recommendations were formulated among subject experts through a modified Delphi process using the Grading of Recommendation Assessment, Development and Evaluation approach. Methods for the 2 primary research studies and the narrative reviews are also reviewed. Because of the nature of questions that needed to be addressed, not all studies in this focus issue were amenable to systematic review. As a result, this focus issue consists of several different article types, including 1 research protocol, 2 primary research studies, 2 narrative literature reviews, 7 systematic reviews, and 3 articles that combine a systematic review component with either a narrative section (n = 2) or a provider survey (n = 1). In general, the strength of evidence ratings ranged from insufficient to moderate. Summary statements or clinical recommendations were made according to available evidence and study type: 16 summary statements were made across 8 articles, and 17 clinical recommendations were made across 9 articles. Three articles had both summary statements and clinical recommendations, 5 had summary statements only, 6 had clinical recommendations only, and 1 (the research protocol) was not amenable to either. Systematic reviews, narrative reviews, and primary research studies were undertaken to understand the mechanisms, diagnosis, progression, and treatment of CSM and OPLL and to provide summary statements and clinical recommendations. This article reports the methods used in the studies in this focus issue. SUMMARY STATEMENTS: The objectives of this focus issue were met using a variety of article and study designs, each of which has some unique methodological aspects associated with it. The reader should refer to the full article in this issue for additional details specific to that topic. The methods for systematic review follow accepted standards for rigor and, together with the application of Grading of Recommendation Assessment, Development and Evaluation, are intended to allow for transparency in the process for creating the clinical recommendation.

  5. Standardisation of neonatal clinical practice.

    PubMed

    Bhutta, Z A; Giuliani, F; Haroon, A; Knight, H E; Albernaz, E; Batra, M; Bhat, B; Bertino, E; McCormick, K; Ochieng, R; Rajan, V; Ruyan, P; Cheikh Ismail, L; Paul, V

    2013-09-01

    The International Fetal and Newborn Growth Consortium for the 21(st) Century (INTERGROWTH-21(st) ) is a large-scale, population-based, multicentre project involving health institutions from eight geographically diverse countries, which aims to assess fetal, newborn and preterm growth under optimal conditions. Given the multicentre nature of the project and the expected number of preterm births, it is vital that all centres follow the same standardised clinical care protocols to assess and manage preterm infants, so as to ensure maximum validity of the resulting standards as indicators of growth and nutrition with minimal confounding. Moreover, it is well known that evidence-based clinical practice guidelines can reduce the delivery of inappropriate care and support the introduction of new knowledge into clinical practice. The INTERGROWTH-21(st) Neonatal Group produced an operations manual, which reflects the consensus reached by members of the group regarding standardised definitions of neonatal morbidities and the minimum standards of care to be provided by all centres taking part in the project. The operational definitions and summary management protocols were developed by consensus through a Delphi process based on systematic reviews of relevant guidelines and management protocols by authoritative bodies. This paper describes the process of developing the Basic Neonatal Care Manual, as well as the morbidity definitions and standardised neonatal care protocols applied across all the INTERGROWTH-21(st) participating centres. Finally, thoughts about implementation strategies are presented. © 2013 Royal College of Obstetricians and Gynaecologists.

  6. Quality assurance in the EORTC 22033-26033/CE5 phase III randomized trial for low grade glioma: the digital individual case review.

    PubMed

    Fairchild, Alysa; Weber, Damien C; Bar-Deroma, Raquel; Gulyban, Akos; Fenton, Paul A; Stupp, Roger; Baumert, Brigitta G

    2012-06-01

    The phase III EORTC 22033-26033/NCIC CE5 intergroup trial compares 50.4 Gy radiotherapy with up-front temozolomide in previously untreated low-grade glioma. We describe the digital EORTC individual case review (ICR) performed to evaluate protocol radiotherapy (RT) compliance. Fifty-eight institutions were asked to submit 1-2 randomly selected cases. Digital ICR datasets were uploaded to the EORTC server and accessed by three central reviewers. Twenty-seven parameters were analysed including volume delineation, treatment planning, organ at risk (OAR) dosimetry and verification. Consensus reviews were collated and summary statistics calculated. Fifty-seven of seventy-two requested datasets from forty-eight institutions were technically usable. 31/57 received a major deviation for at least one section. Relocation accuracy was according to protocol in 45. Just over 30% had acceptable target volumes. OAR contours were missing in an average of 25% of cases. Up to one-third of those present were incorrectly drawn while dosimetry was largely protocol compliant. Beam energy was acceptable in 97% and 48 patients had per protocol beam arrangements. Digital RT plan submission and review within the EORTC 22033-26033 ICR provide a solid foundation for future quality assurance procedures. Strict evaluation resulted in overall grades of minor and major deviation for 37% and 32%, respectively. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  7. Remote Sensing and the Kyoto Protocol: A Workshop Summary

    NASA Technical Reports Server (NTRS)

    Rosenqvist, Ake; Imhoff, Marc; Milne, Anthony; Dobson, Craig

    2000-01-01

    The Kyoto Protocol to the United Nations Framework Convention on Climate Change contains quantified, legally binding commitments to limit or reduce greenhouse gas emissions to 1990 levels and allows carbon emissions to be balanced by carbon sinks represented by vegetation. The issue of using vegetation cover as an emission offset raises a debate about the adequacy of current remote sensing systems and data archives to both assess carbon stocks/sinks at 1990 levels, and monitor the current and future global status of those stocks. These concerns and the potential ratification of the Protocol among participating countries is stimulating policy debates and underscoring a need for the exchange of information between the international legal community and the remote sensing community. On October 20-22 1999, two working groups of the International Society for Photogrammetry and Remote Sensing (ISPRS) joined with the University of Michigan (Michigan, USA) to convene discussions on how remote sensing technology could contribute to the information requirements raised by implementation of, and compliance with, the Kyoto Protocol. The meeting originated as a joint effort between the Global Monitoring Working Group and the Radar Applications Working Group in Commission VII of the ISPRS, co-sponsored by the University of Michigan. Tile meeting was attended by representatives from national government agencies and international organizations and academic institutions. Some of the key themes addressed were: (1) legal aspects of transnational remote sensing in the context of the Kyoto Protocol; (2) a review of the current and future and remote sensing technologies that could be applied to the Kyoto Protocol; (3) identification of areas where additional research is needed in order to advance and align remote sensing technology with the requirements and expectations of the Protocol; and 94) the bureaucratic and research management approaches needed to align the remote sensing community with both the science and policy communities.

  8. Investigation of the Study Characteristics Affecting Clinical Trial Quality Using the Protocol Deviations Leading to Exclusion of Subjects From the Per Protocol Set Data in Studies for New Drug Application: A Retrospective Analysis.

    PubMed

    Kohara, Norihito; Kaneko, Masayuki; Narukawa, Mamoru

    2018-01-01

    The concept of the risk-based approach has been introduced as an effort to secure the quality of clinical trials. In the risk-based approach, identification and evaluation of risk in advance are considered important. For recently completed clinical trials, we investigated the relationship between study characteristics and protocol deviations leading to the exclusion of subjects from Per Protocol Set (PPS) efficacy analysis. New drugs approved in Japan in the fiscal year 2014-2015 were targeted in the research. The reasons for excluding subjects from the PPS efficacy analysis were described in 102 trials out of 492 in the summary of new drug application documents, which was publicly disclosed after the drug's regulatory approval. The author extracted these reasons along with the numbers of the cases and the study characteristics of each clinical trial. Then, the direct comparison, univariate regression analysis, and multivariate regression analysis was carried out based on the exclusion rate. The study characteristics for which exclusion of subjects from the PPS efficacy analysis were frequently observed was multiregional clinical trials in study region; inhalant and external use in administration route; Anti-infective for systemic use; Respiratory system, Dermatologicals, and Nervous system in therapeutic drug under the Anatomical Therapeutic Chemical Classification. In the multivariate regression analysis, the clinical trial variables of inhalant, Respiratory system, or Dermatologicals were selected as study characteristics leading to a higher exclusion rate. The characteristics of the clinical trial that is likely to cause protocol deviations that will affect efficacy analysis were suggested. These studies should be considered for specific attention and priority observation in the trial protocol or its monitoring plan and execution, such as a clear description of inclusion/exclusion criteria in the protocol, development of training materials to site staff, and/or trial subjects as specific risk-alleviating measures.

  9. Translational Neuromodulation: Approximating Human Transcranial Magnetic Stimulation Protocols In Rats

    PubMed Central

    Vahabzadeh-Hagh, Andrew M.; Muller, Paul A.; Gersner, Roman; Zangen, Abraham; Rotenberg, Alexander

    2015-01-01

    Objective Transcranial magnetic stimulation (TMS) is a well-established clinical protocol with numerous potential therapeutic and diagnostic applications. Yet, much work remains in the elucidation of TMS mechanisms, optimization of protocols, and in development of novel therapeutic applications. As with many technologies, the key to these issues lies in the proper experimentation and translation of TMS methods to animal models, among which rat models have proven popular. A significant increase in the number of rat TMS publications has necessitated analysis of their relevance to human work. We therefore review the essential principles necessary for the approximation of human TMS protocols in rats as well as specific methods that addressed these issues in published studies. Materials and Methods We performed an English language literature search combined with our own experience and data. We address issues that we see as important in the translation of human TMS methods to rat models and provide a summary of key accomplishments in these areas. Results An extensive literature review illustrated the growth of rodent TMS studies in recent years. Current advances in the translation of single, paired-pulse, and repetitive stimulation paradigms to rodent models are presented. The importance of TMS in the generation of data for preclinical trials is also highlighted. Conclusions Rat TMS has several limitations when considering parallels between animal and human stimulation. However, it has proven to be a useful tool in the field of translational brain stimulation and will likely continue to aid in the design and implementation of stimulation protocols for therapeutic and diagnostic applications. PMID:22780329

  10. New secure communication-layer standard for medical image management (ISCL)

    NASA Astrophysics Data System (ADS)

    Kita, Kouichi; Nohara, Takashi; Hosoba, Minoru; Yachida, Masuyoshi; Yamaguchi, Masahiro; Ohyama, Nagaaki

    1999-07-01

    This paper introduces a summary of the standard draft of ISCL 1.00 which will be published by MEDIS-DC officially. ISCL is abbreviation of Integrated Secure Communication Layer Protocols for Secure Medical Image Management Systems. ISCL is a security layer which manages security function between presentation layer and TCP/IP layer. ISCL mechanism depends on basic function of a smart IC card and symmetric secret key mechanism. A symmetry key for each session is made by internal authentication function of a smart IC card with a random number. ISCL has three functions which assure authentication, confidently and integrity. Entity authentication process is done through 3 path 4 way method using functions of internal authentication and external authentication of a smart iC card. Confidentially algorithm and MAC algorithm for integrity are able to be selected. ISCL protocols are communicating through Message Block which consists of Message Header and Message Data. ISCL protocols are evaluating by applying to regional collaboration system for image diagnosis, and On-line Secure Electronic Storage system for medical images. These projects are supported by Medical Information System Development Center. These project shows ISCL is useful to keep security.

  11. COSPO/CENDI Industry Day Conference

    NASA Technical Reports Server (NTRS)

    1995-01-01

    The conference's objective was to provide a forum where government information managers and industry information technology experts could have an open exchange and discuss their respective needs and compare them to the available, or soon to be available, solutions. Technical summaries and points of contact are provided for the following sessions: secure products, protocols, and encryption; information providers; electronic document management and publishing; information indexing, discovery, and retrieval (IIDR); automated language translators; IIDR - natural language capabilities; IIDR - advanced technologies; IIDR - distributed heterogeneous and large database support; and communications - speed, bandwidth, and wireless.

  12. Conference Scene: novelties in immunotherapy.

    PubMed

    Mitsias, Dimitris I; Kalogiros, Lampros A; Papadopoulos, Nikolaos G

    2013-10-01

    The only method aiming to permanently cure allergic disorders is allergen immunotherapy. Over the last 20 years there has been great progress in understanding the mechanisms that govern allergen immunotherapy in order to meet three basic prerequisites: safety, effectiveness and compliance. In the present summary report from the European Academy of Allergology and Clinical Immunology-World Allergy Organization Congress held last June in Milan, we review key points concerning the main axes as diagnosis, novel modalities, routes and protocols, as well as two important immunotherapy fields: food and insect venom allergy.

  13. Effects of Optical Artifacts in a Laser-Based Spacecraft Navigation Sensor

    NASA Technical Reports Server (NTRS)

    LeCroy, Jerry E.; Howard, Richard T.; Hallmark, Dean S.

    2007-01-01

    Testing of the Advanced Video Guidance Sensor (AVGS) used for proximity operations navigation on the Orbital Express ASTRO spacecraft exposed several unanticipated imaging system artifacts and aberrations that required correction to meet critical navigation performance requirements. Mitigation actions are described for a number of system error sources, including lens aberration, optical train misalignment, laser speckle, target image defects, and detector nonlinearity/noise characteristics. Sensor test requirements and protocols are described, along with a summary of test results from sensor confidence tests and system performance testing.

  14. Effects of Optical Artifacts in a Laser-Based Spacecraft Navigation Sensor

    NASA Technical Reports Server (NTRS)

    LeCroy, Jerry E.; Hallmark, Dean S.; Howard, Richard T.

    2007-01-01

    Testing Of the Advanced Video Guidance Sensor (AVGS) used for proximity operations navigation on the Orbital Express ASTRO spacecraft exposed several unanticipated imaging system artifacts and aberrations that required correction, to meet critical navigation performance requirements. Mitigation actions are described for a number of system error sources, including lens aberration, optical train misalignment, laser speckle, target image defects, and detector nonlinearity/noise characteristics. Sensor test requirements and protocols are described, along with a summary ,of test results from sensor confidence tests and system performance testing.

  15. Factors that impact on the use of mechanical ventilation weaning protocols in critically ill adults and children: a qualitative evidence-synthesis.

    PubMed

    Jordan, Joanne; Rose, Louise; Dainty, Katie N; Noyes, Jane; Blackwood, Bronagh

    2016-10-04

    Prolonged mechanical ventilation is associated with a longer intensive care unit (ICU) length of stay and higher mortality. Consequently, methods to improve ventilator weaning processes have been sought. Two recent Cochrane systematic reviews in ICU adult and paediatric populations concluded that protocols can be effective in reducing the duration of mechanical ventilation, but there was significant heterogeneity in study findings. Growing awareness of the benefits of understanding the contextual factors impacting on effectiveness has encouraged the integration of qualitative evidence syntheses with effectiveness reviews, which has delivered important insights into the reasons underpinning (differential) effectiveness of healthcare interventions. 1. To locate, appraise and synthesize qualitative evidence concerning the barriers and facilitators of the use of protocols for weaning critically-ill adults and children from mechanical ventilation;2. To integrate this synthesis with two Cochrane effectiveness reviews of protocolized weaning to help explain observed heterogeneity by identifying contextual factors that impact on the use of protocols for weaning critically-ill adults and children from mechanical ventilation;3. To use the integrated body of evidence to suggest the circumstances in which weaning protocols are most likely to be used. We used a range of search terms identified with the help of the SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) mnemonic. Where available, we used appropriate methodological filters for specific databases. We searched the following databases: Ovid MEDLINE, Embase, OVID, PsycINFO, CINAHL Plus, EBSCOHost, Web of Science Core Collection, ASSIA, IBSS, Sociological Abstracts, ProQuest and LILACS on the 26th February 2015. In addition, we searched: the grey literature; the websites of professional associations for relevant publications; and the reference lists of all publications reviewed. We also contacted authors of the trials included in the effectiveness reviews as well as of studies (potentially) included in the qualitative synthesis, conducted citation searches of the publications reporting these studies, and contacted content experts.We reran the search on 3rd July 2016 and found three studies, which are awaiting classification. We included qualitative studies that described: the circumstances in which protocols are designed, implemented or used, or both, and the views and experiences of healthcare professionals either involved in the design, implementation or use of weaning protocols or involved in the weaning of critically-ill adults and children from mechanical ventilation not using protocols. We included studies that: reflected on any aspect of the use of protocols, explored contextual factors relevant to the development, implementation or use of weaning protocols, and reported contextual phenomena and outcomes identified as relevant to the effectiveness of protocolized weaning from mechanical ventilation. At each stage, two review authors undertook designated tasks, with the results shared amongst the wider team for discussion and final development. We independently reviewed all retrieved titles, abstracts and full papers for inclusion, and independently extracted selected data from included studies. We used the findings of the included studies to develop a new set of analytic themes focused on the barriers and facilitators to the use of protocols, and further refined them to produce a set of summary statements. We used the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) framework to arrive at a final assessment of the overall confidence of the evidence used in the synthesis. We included all studies but undertook two sensitivity analyses to determine how the removal of certain bodies of evidence impacted on the content and confidence of the synthesis. We deployed a logic model to integrate the findings of the qualitative evidence synthesis with those of the Cochrane effectiveness reviews. We included 11 studies in our synthesis, involving 267 participants (one study did not report the number of participants). Five more studies are awaiting classification and will be dealt with when we update the review.The quality of the evidence was mixed; of the 35 summary statements, we assessed 17 as 'low', 13 as 'moderate' and five as 'high' confidence. Our synthesis produced nine analytical themes, which report potential barriers and facilitators to the use of protocols. The themes are: the need for continual staff training and development; clinical experience as this promotes felt and perceived competence and confidence to wean; the vulnerability of weaning to disparate interprofessional working; an understanding of protocols as militating against a necessary proactivity in clinical practice; perceived nursing scope of practice and professional risk; ICU structure and processes of care; the ability of protocols to act as a prompt for shared care and consistency in weaning practice; maximizing the use of protocols through visibility and ease of implementation; and the ability of protocols to act as a framework for communication with parents. There is a clear need for weaning protocols to take account of the social and cultural environment in which they are to be implemented. Irrespective of its inherent strengths, a protocol will not be used if it does not accommodate these complexities. In terms of protocol development, comprehensive interprofessional input will help to ensure broad-based understanding and a sense of 'ownership'. In terms of implementation, all relevant ICU staff will benefit from general weaning as well as protocol-specific training; not only will this help secure a relevant clinical knowledge base and operational understanding, but will also demonstrate to others that this knowledge and understanding is in place. In order to maximize relevance and acceptability, protocols should be designed with the patient profile and requirements of the target ICU in mind. Predictably, an under-resourced ICU will impact adversely on protocol implementation, as staff will prioritize management of acutely deteriorating and critically-ill patients.

  16. Auditory fitness for duty: a review.

    PubMed

    Tufts, Jennifer B; Vasil, Kristin A; Briggs, Sarah

    2009-10-01

    Auditory fitness for duty (AFFD) refers to the possession of hearing abilities sufficient for safe and effective job performance. In jobs such as law enforcement and piloting, where the ability to hear is critical to job performance and safety, hearing loss can decrease performance, even to the point of being hazardous to self and others. Tests of AFFD should provide an employer with a valid assessment of an employee's ability to perform the job safely, without discriminating against the employee purely on the basis of hearing loss. The purpose of this review is to provide a basic description of the functional hearing abilities required in hearing-critical occupations, and a summary of current practices in AFFD evaluation. In addition, we suggest directions for research and standardization to ensure best practices in the evaluation of AFFD in the future. We conducted a systematic review of the English-language peer-reviewed literature in AFFD. "Popular" search engines were consulted for governmental regulations and trade journal articles. We also contacted professionals with expertise in AFFD regarding research projects, unpublished material, and current standards. The literature review provided information regarding the functional hearing abilities required to perform hearing-critical tasks, the development of and characteristics of AFFD protocols, and the current implementation of AFFD protocols. This review paper provides evidence of the need to institute job-specific AFFD protocols, move beyond the pure-tone audiogram, and establish the validity of test protocols. These needs are arguably greater now than in times past.

  17. Efficient ultrafiltration-based protocol to deplete extracellular vesicles from fetal bovine serum

    PubMed Central

    Kornilov, Roman; Puhka, Maija; Mannerström, Bettina; Hiidenmaa, Hanna; Peltoniemi, Hilkka; Siljander, Pia; Seppänen-Kaijansinkko, Riitta; Kaur, Sippy

    2018-01-01

    ABSTRACT Fetal bovine serum (FBS) is the most commonly used supplement in studies involving cell-culture experiments. However, FBS contains large numbers of bovine extracellular vesicles (EVs), which hamper the analyses of secreted EVs from the cell type of preference and, thus, also the downstream analyses. Therefore, a prior elimination of EVs from FBS is crucial. However, the current methods of EV depletion by ultracentrifugation are cumbersome and the commercial alternatives expensive. In this study, our aim was to develop a protocol to completely deplete EVs from FBS, which may have wide applicability in cell-culture applications. We investigated different EV-depleted FBS prepared by our novel ultrafiltration-based protocol, by conventionally used overnight ultracentrifugation, or commercially available depleted FBS, and compared them with regular FBS. All sera were characterized by nanoparticle tracking analysis, electron microscopy, Western blotting and RNA quantification. Next, adipose-tissue mesenchymal stem cells (AT-MSCs) and cancer cells were grown in the media supplemented with the three different EV-depleted FBS and compared with cells grown in regular FBS media to assess the effects on cell proliferation, stress, differentiation and EV production. The novel ultrafiltration-based protocol depleted EVs from FBS clearly more efficiently than ultracentrifugation and commercial methods. Cell proliferation, stress, differentiation and EV production of AT-MSCs and cancer cell lines were similarly maintained in all three EV-depleted FBS media up to 96 h. In summary, our ultrafiltration protocol efficiently depletes EVs, is easy to use and maintains cell growth and metabolism. Since the method is also cost-effective and easy to standardize, it could be used in a wide range of cell-culture applications helping to increase comparability of EV research results between laboratories. PMID:29410778

  18. Insulin Delivery Into the Peripheral Circulation: A Key Contributor to Hypoglycemia in Type 1 Diabetes

    PubMed Central

    Kraft, Guillaume; Scott, Melanie F.; Neal, Doss W.; Farmer, Ben; Smith, Marta S.; Hastings, Jon R.; Allen, Eric J.; Donahue, E. Patrick; Rivera, Noelia; Winnick, Jason J.; Edgerton, Dale S.; Nishimura, Erica; Fledelius, Christian; Brand, Christian L.; Cherrington, Alan D.

    2015-01-01

    Hypoglycemia limits optimal glycemic control in type 1 diabetes mellitus (T1DM), making novel strategies to mitigate it desirable. We hypothesized that portal (Po) vein insulin delivery would lessen hypoglycemia. In the conscious dog, insulin was infused into the hepatic Po vein or a peripheral (Pe) vein at a rate four times of basal. In protocol 1, a full counterregulatory response was allowed, whereas in protocol 2, glucagon was fixed at basal, mimicking the diminished α-cell response to hypoglycemia seen in T1DM. In protocol 1, glucose fell faster with Pe insulin than with Po insulin, reaching 56 ± 3 vs. 70 ± 6 mg/dL (P = 0.04) at 60 min. The change in area under the curve (ΔAUC) for glucagon was similar between Pe and Po, but the peak occurred earlier in Pe. The ΔAUC for epinephrine was greater with Pe than with Po (67 ± 17 vs. 36 ± 14 ng/mL/180 min). In protocol 2, glucose also fell more rapidly than in protocol 1 and fell faster in Pe than in Po, reaching 41 ± 3 vs. 67 ± 2 mg/dL (P < 0.01) by 60 min. Without a rise in glucagon, the epinephrine responses were much larger (ΔAUC of 204 ± 22 for Pe vs. 96 ± 29 ng/mL/180 min for Po). In summary, Pe insulin delivery exacerbates hypoglycemia, particularly in the presence of a diminished glucagon response. Po vein insulin delivery, or strategies that mimic it (i.e., liver-preferential insulin analogs), should therefore lessen hypoglycemia. PMID:26085570

  19. Validation of Test Weighing Protocol to Estimate Enteral Feeding Volumes in Preterm Infants.

    PubMed

    Rankin, Michael W; Jimenez, Elizabeth Yakes; Caraco, Marina; Collinson, Marie; Lostetter, Lisa; DuPont, Tara L

    2016-11-01

    To evaluate the accuracy of pre- and postfeeding weights to estimate enteral feeding volumes in preterm infants. Single-center prospective cohort study of infants 28-36 weeks' corrected age receiving gavage feedings. For each test weight, 3 pre- and 3 postgavage feeding weights were obtained by study personnel, blinded to feeding volume, via a specific protocol. The correlation between test weight difference and actual volume ingested was assessed by the use of summary statistics, Spearman rho, and graphical analyses. The relationship between categorical predictive variables and a predefined acceptable difference (±5 mL) was assessed with the χ 2 or Fisher exact test. A total of 101 test weights were performed in 68 infants. Estimated and actual feeding volumes were highly correlated (r = 0.94, P < .001), with a mean absolute difference of 2.95 mL (SD: 2.70; range: 0, 12.3 mL; 5th, 95th percentile: 0, 9.3); 85% of test weights were within ±5 mL of actual feeding volume and did not vary significantly by corrected age, feeding tube or respiratory support type, feeding duration or volume, formula vs breast milk, or caloric density. With adherence to study protocol, 89% of test weights (66/74) were within ±5 mL of actual volume, compared with 71% (19/27, P = .04) when concerns about protocol adherence were noted (eg, difficulty securing oxygen tubing). Via the use of a standard protocol, feeding volumes can be estimated accurately by pre- and postfeeding weights. Test weighing could be a valuable tool to support direct breastfeeding in the neonatal intensive care unit. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Sub-Symptomatic Aerobic Exercise for Patients with Post-Concussion Syndrome: A Critically Appraised Topic.

    PubMed

    Ritter, Katrina G; Hussey, Matthew J; Valovich McLeod, Tamara C

    2017-09-27

    Clinical Scenario: Patients who experience prolonged concussion symptoms can be diagnosed with Post-Concussion Syndrome (PCS) when those symptoms persist past 4 weeks. Aerobic exercise protocols have been shown to be effective in improving physical and mental aspects of health. Emerging research suggests that aerobic exercise maybe useful as a treatment for PCS, where exercise allows patients to feel less isolated and more active during the recovery process. Is aerobic exercise more beneficial in reducing symptoms than current standard care in patients with prolonged symptoms or PCS lasting longer than 4 weeks? Summary of Key Findings: After a thorough literature search, 4 studies were selected relevant to the clinical question. Of the 4 studies, 1 was a randomized control trial and 3 were case series. All 4 studies investigate aerobic exercise protocol as treatment for PCS. 1-4 Three articles demonstrated a greater rate of symptom improvement from baseline assessment to follow-up after a controlled sub-symptomatic aerobic exercise program. 2-4 One study showed a decrease in symptoms in the aerobic exercise group compared to the full body stretching group. 1 Clinical Bottom Line: There is moderate evidence to support sub-symptomatic aerobic exercise as a treatment of PCS, therefore it should be considered as a clinical option for reducing PCS and prolonged concussion symptoms. A previously validated protocol, such as the Buffalo Concussion Treadmill Test, Balke Protocol, or Rating of Perceived Exertion (RPE) as mentioned in this critically appraised topic should be used to measure baseline values and treatment progression. Strength of Recommendation: Level C evidence exists that aerobic exercise protocol is more effective than the current standard of care in treating PCS.

  1. Translating evidence-based protocol of wound drain management for total joint arthroplasty into practice: A quasi-experimental study.

    PubMed

    Tsang, Lap Fung; Cheng, Hang Cheong; Ho, Hon Shuen; Hsu, Yung Chak; Chow, Chiu Man; Law, Heung Wah; Fong, Lup Chau; Leung, Lok Ming; Kong, Ivy Ching Yan; Chan, Chi Wai; Sham, Alice So Yuen

    2016-05-01

    Although various drains have long been used in total joint replacement, evidence suggests inconsistent practice exists in the use of drainage systems including intermittently applying suction or free of drainage suction, and variations in the optimal timing for wound drain removal. A comprehensive systematic review of available evidence up to 2013 was conducted in a previous study and a protocol was adapted for clinical application according to the summary of the retrieved information (Tsang, 2015). To determine if the protocol could reduce blood loss and blood transfusion after operation and to develop a record form so as to enhance communication of drainage record amongst surgeons and nurses. A quasi-experimental time-series design was undertaken. In the conventional group, surgeons ordered free drainage if the drain output was more than 300 ml. The time of removal of the drain was based on their professional judgement. In the protocol group the method of drainage was dependant of the drainage output as was the timing of the removal of the drain. A standardized record form was developed to guide operating room and orthopaedic ward nurses to manage the drainage system. The drain was removed significantly earlier in the protocol group. Blood loss rate at the first hour of post-operation was extremely low in the protocol group due to clamping effect. Blood loss in volume during the first three hours in the protocol group was significantly lower than that in the conventional group. Only in 11.1% and 4% of cases was it necessary to clamp at the three and four hour post-operative hours. No clamping was required at the two and eight hour postoperative period. There was no significant difference in blood loss during the removal of the drain and during blood transfusion, which was required for patients upon removal of the drain in the two groups. This is the first clinical study to develop an evidence-based protocol to manage wound drain effectively in Hong Kong. Total blood loss and blood transfusions were not significantly different between the conventional and protocol groups. A standard documentation document is beneficial to enhance communication between doctors and nurses as well as to monitor and observe drainage effectively. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Oesophageal lumen pH in yearling horses and effects of management and administration of omeprazole.

    PubMed

    Wilson, C S; Brookes, V J; Hughes, K J; Trope, G D; Ip, H; Gunn, A J

    2017-05-01

    In human subjects, arytenoid chondritis can be caused by chemical trauma of mucosa attributable to gastro-oesophageal reflux. Although a similar process may be involved in the aetiopathogenesis of arytenoid chondritis in horses, the oesophageal lumen pH in this species is poorly understood. To determine if gastro-oesophageal reflux occurs in horses by characterising oesophageal lumen pH. Blinded, randomised, placebo-controlled, crossover, experimental study. Luminal oesophageal pH in six yearling horses was recorded over four 24 h periods using an ambulatory pH recorder attached to a catheter with two electrodes (proximal and distal) inserted into the oesophagus. Recordings of pH were made during three management protocols. Initially, horses grazed in a paddock (Protocol A). Horses were then moved to stables to simulate sale preparation of Thoroughbred yearlings, and were given either omeprazole (Protocol B) or placebo paste (Protocol C) orally once per day. Protocol A was repeated for each horse (after a 13 day washout period) between Protocols B and C. Summary statistics described pH range and frequency of pH changes. Associations with predictor variables were investigated using linear mixed-effects models. Data are presented as the mean ± s.d. Oesophageal lumen pH ranged from 4.90 to 9.70 (7.36 ± 0.27 and 7.18 ± 0.24 for the proximal and distal electrodes, respectively) and varied frequently (1.2 ± 0.9 changes/min and 0.8 ± 0.8 changes/min for the proximal and distal electrodes, respectively). Oesophageal lumen pH was associated with time since concentrate feeding, activity and time of day, but not with treatment of omeprazole. A small number of horses were used and measurement periods were limited. Gastro-oesophageal reflux occurs in clinically normal yearling horses. Although omeprazole had no detectable effect, oesophageal lumen pH recorded during this study did not fall within the therapeutic range of omeprazole. © 2016 EVJ Ltd.

  3. Proposed Requirements-driven User-scenario Development Protocol for the Belmont Forum E-Infrastructure and Data Management Cooperative Research Agreement

    NASA Astrophysics Data System (ADS)

    Wee, B.; Car, N.; Percivall, G.; Allen, D.; Fitch, P. G.; Baumann, P.; Waldmann, H. C.

    2014-12-01

    The Belmont Forum E-Infrastructure and Data Management Cooperative Research Agreement (CRA) is designed to foster a global community to collaborate on e-infrastructure challenges. One of the deliverables is an implementation plan to address global data infrastructure interoperability challenges and align existing domestic and international capabilities. Work package three (WP3) of the CRA focuses on the harmonization of global data infrastructure for sharing environmental data. One of the subtasks under WP3 is the development of user scenarios that guide the development of applicable deliverables. This paper describes the proposed protocol for user scenario development. It enables the solicitation of user scenarios from a broad constituency, and exposes the mechanisms by which those solicitations are evaluated against requirements that map to the Belmont Challenge. The underlying principle of traceability forms the basis for a structured, requirements-driven approach resulting in work products amenable to trade-off analyses and objective prioritization. The protocol adopts the ISO Reference Model for Open Distributed Processing (RM-ODP) as a top level framework. User scenarios are developed within RM-ODP's "Enterprise Viewpoint". To harmonize with existing frameworks, the protocol utilizes the conceptual constructs of "scenarios", "use cases", "use case categories", and use case templates as adopted by recent GEOSS Architecture Implementation Project (AIP) deliverables and CSIRO's eReefs project. These constructs are encapsulated under the larger construct of "user scenarios". Once user scenarios are ranked by goodness-of-fit to the Belmont Challenge, secondary scoring metrics may be generated, like goodness-of-fit to FutureEarth science themes. The protocol also facilitates an assessment of the ease of implementing given user scenario using existing GEOSS AIP deliverables. In summary, the protocol results in a traceability graph that can be extended to coordinate across research programmes. If implemented using appropriate technologies and harmonized with existing ontologies, this approach enables queries, sensitivity analyses, and visualization of complex relationships.

  4. Cancer biomarkers: the role of structured data reporting.

    PubMed

    Simpson, Ross W; Berman, Michael A; Foulis, Philip R; Divaris, Dimitrios X G; Birdsong, George G; Mirza, Jaleh; Moldwin, Richard; Spencer, Samantha; Srigley, John R; Fitzgibbons, Patrick L

    2015-05-01

    The College of American Pathologists has been producing cancer protocols since 1986 to aid pathologists in the diagnosis and reporting of cancer cases. Many pathologists use the included cancer case summaries as templates for dictation/data entry into the final pathology report. These summaries are now available in a computer-readable format with structured data elements for interoperability, packaged as "electronic cancer checklists." Most major vendors of anatomic pathology reporting software support this model. To outline the development and advantages of structured electronic cancer reporting using the electronic cancer checklist model, and to describe its extension to cancer biomarkers and other aspects of cancer reporting. Peer-reviewed literature and internal records of the College of American Pathologists. Accurate and usable cancer biomarker data reporting will increasingly depend on initial capture of this information as structured data. This process will support the standardization of data elements and biomarker terminology, enabling the meaningful use of these datasets by pathologists, clinicians, tumor registries, and patients.

  5. Fostering critical thinking and collaborative learning skills among medical students through a research protocol writing activity in the curriculum.

    PubMed

    Sahoo, Soumendra; Mohammed, Ciraj Ali

    2018-06-01

    This intervention was aimed to analyse the effect of academic writing and journal critiquing as educational approaches in improving critical thinking and collaborative learning among undergraduate medical students. A research proposal writing format was created for the 4th year medical students of Melaka Manipal Medical College, Malaysia during their ophthalmology clinical postings. The students worked in small groups and developed research protocols through an evidence based approach. This was followed by writing reflective summaries in academic portfolios about the activity undertaken. A mixed methods study was designed to explore the possible role of collaborative research proposal writing in enhancing critical thinking and collaborative learning. Analysis of reflections submitted by 188 medical students after the intervention indicate that majority of them found an improvement in their skills of critical thinking and collaborative learning as a result of research protocol writing. All participants agreed that the model helped in applying concepts to new situations in the form of designing their own study, which reflected in enhanced higher order cognitive skills. This study shows that the introduction of a structured module in the core medical curriculum that focuses on research writing skills embedded with collaborative and reflective practices can enhance collaborative learning, critical thinking, and reasoning among medical students.

  6. Acute and anticipatory emesis in breast cancer patients.

    PubMed

    Fernández-Marcos, A; Martín, M; Sanchez, J J; Rodriguez-Lescure, A; Casado, A; López Martin, J A; Diaz-Rubio, E

    1996-09-01

    A group of 90 breast cancer patients undergoing chemotherapy were assessed prospectively to estimate the prevalence of acute (post-treatment) and anticipatory emesis in the 1990s. For this purpose, two protocols of chemotherapy were analysed separately: cyclophosphamide/methotrexate/5-fluorouracil (CMF) and 5-fluorouracil/doxorubicin/cyclophosphamide (FAC). All patients were treated with antiemetic therapy, which included one corticoid plus ondansetron (in the FAC regimen), or one corticoid plus thiethylperazine (in the CMF regimen). For at least one cycle of chemotherapy 86.1% and 91.7% patients in the FAC protocol presented vomiting and nausea respectively: 11.1% had anticipatory vomiting and 30.6% had anticipatory nausea. In the CMF protocol, 79.6% had post-chemotherapy vomiting and 71.7% had post-chemotherapy nausea associated with at least one cycle. In this group, 7.4% had anticipatory vomiting and 16.6% had anticipatory nausea. A high proportion of patients suffered anticipatory anxiety in both groups (75% in FAC, 74.1% in CMF). The stimuli most frequently associated with the appearance of anticipatory emesis were olfactory stimuli and cognitive stimuli. In summary, as a result of the advances made in antiemetic control during the last decade, the severity of chemotherapy-induced emesis seems to have significantly decreased, but the prevalence of these symptoms along the course of the treatment still remains high.

  7. The Phyre2 web portal for protein modelling, prediction and analysis

    PubMed Central

    Kelley, Lawrence A; Mezulis, Stefans; Yates, Christopher M; Wass, Mark N; Sternberg, Michael JE

    2017-01-01

    Summary Phyre2 is a suite of tools available on the web to predict and analyse protein structure, function and mutations. The focus of Phyre2 is to provide biologists with a simple and intuitive interface to state-of-the-art protein bioinformatics tools. Phyre2 replaces Phyre, the original version of the server for which we previously published a protocol. In this updated protocol, we describe Phyre2, which uses advanced remote homology detection methods to build 3D models, predict ligand binding sites, and analyse the effect of amino-acid variants (e.g. nsSNPs) for a user’s protein sequence. Users are guided through results by a simple interface at a level of detail determined by them. This protocol will guide a user from submitting a protein sequence to interpreting the secondary and tertiary structure of their models, their domain composition and model quality. A range of additional available tools is described to find a protein structure in a genome, to submit large number of sequences at once and to automatically run weekly searches for proteins difficult to model. The server is available at http://www.sbg.bio.ic.ac.uk/phyre2. A typical structure prediction will be returned between 30mins and 2 hours after submission. PMID:25950237

  8. A highly sensitive protocol for microscopy of alkyne lipids and fluorescently tagged or immunostained proteins[S

    PubMed Central

    Gaebler, Anne; Penno, Anke; Kuerschner, Lars; Thiele, Christoph

    2016-01-01

    The demand to study the cellular localization of specific lipids has led to recent advances in lipid probes and microscopy. Alkyne lipids bear a small, noninterfering tag and can be detected upon click reaction with an azide-coupled reporter. Fluorescent alkyne lipid imaging crucially depends on appropriate azide reporters and labeling protocols that allow for an efficient click reaction and therefore a sensitive detection. We synthesized several azide reporters with different spacer components and tested their suitability for alkyne lipid imaging in fixed cells. The implementation of a copper-chelating picolyl moiety into fluorescent or biotin-based azide reagents strongly increased the sensitivity of the imaging routine. We demonstrate the applicability and evaluate the performance of this approach using different lipid classes and experimental setups. As azide picolyl reporters allow for reduced copper catalyst concentrations, they also enable coimaging of alkyne lipids with multiple fluorescent proteins including enhanced green fluorescent protein. Alternatively, and as we also show, microscopy of alkyne lipids can be combined with protein detection by immunocytochemistry. In summary, we present a robust, sensitive, and highly versatile protocol for the labeling of alkyne lipids with azide-coupled reporters for fluorescence microscopy that can be combined with different protein detection and imaging techniques. PMID:27565170

  9. Criteria for Evaluating Alternative Network and Link Layer Protocols for the NASA Constellation Program Communication Architecture

    NASA Technical Reports Server (NTRS)

    Benbenek, Daniel; Soloff, Jason; Lieb, Erica

    2010-01-01

    Selecting a communications and network architecture for future manned space flight requires an evaluation of the varying goals and objectives of the program, development of communications and network architecture evaluation criteria, and assessment of critical architecture trades. This paper uses Cx Program proposed exploration activities as a guideline; lunar sortie, outpost, Mars, and flexible path options are described. A set of proposed communications network architecture criteria are proposed and described. They include: interoperability, security, reliability, and ease of automating topology changes. Finally a key set of architecture options are traded including (1) multiplexing data at a common network layer vs. at the data link layer, (2) implementing multiple network layers vs. a single network layer, and (3) the use of a particular network layer protocol, primarily IPv6 vs. Delay Tolerant Networking (DTN). In summary, the protocol options are evaluated against the proposed exploration activities and their relative performance with respect to the criteria are assessed. An architectural approach which includes (a) the capability of multiplexing at both the network layer and the data link layer and (b) a single network layer for operations at each program phase, as these solutions are best suited to respond to the widest array of program needs and meet each of the evaluation criteria.

  10. Simple Tools to Facilitate Project Management of a Nursing Research Project.

    PubMed

    Aycock, Dawn M; Clark, Patricia C; Thomas-Seaton, LaTeshia; Lee, Shih-Yu; Moloney, Margaret

    2016-07-01

    Highly organized project management facilitates rigorous study implementation. Research involves gathering large amounts of information that can be overwhelming when organizational strategies are not used. We describe a variety of project management and organizational tools used in different studies that may be particularly useful for novice researchers. The studies were a multisite study of caregivers of stroke survivors, an Internet-based diary study of women with migraines, and a pilot study testing a sleep intervention in mothers of low-birth-weight infants. Project management tools were used to facilitate enrollment, data collection, and access to results. The tools included protocol and eligibility checklists, event calendars, screening and enrollment logs, instrument scoring tables, and data summary sheets. These tools created efficiency, promoted a positive image, minimized errors, and provided researchers with a sense of control. For the studies described, there were no protocol violations, there were minimal missing data, and the integrity of data collection was maintained. © The Author(s) 2016.

  11. GPCR-I-TASSER: A hybrid approach to G protein-coupled receptor structure modeling and the application to the human genome

    PubMed Central

    Zhang, Jian; Yang, Jianyi; Jang, Richard; Zhang, Yang

    2015-01-01

    SUMMARY Experimental structure determination remains very difficult for G protein-coupled receptors (GPCRs). We propose a new hybrid protocol to construct GPCR structure models that integrates experimental mutagenesis data with ab initio transmembrane (TM) helix assembly simulations. The method was tested on 24 known GPCRs where the ab initio TM-helix assembly procedure constructed the correct fold for 20 cases. When combined with weak-homology and sparse mutagenesis restraints, the method generated correct folds for all the tested cases with an average C-alpha RMSD 2.4 Å in the TM-regions. The new hybrid protocol was applied to model all 1026 GPCRs in the human genome, where 923 have a high confidence score that are expected to have correct folds; these contain many pharmaceutically important families with no previously solved structures, including Trace amine, Prostanoids, Releasing hormones, Melanocortins, Vasopressin and Neuropeptide Y receptors. The results demonstrate new progress on genome-wide structure modeling of transmembrane proteins. PMID:26190572

  12. Microneedle-based analysis of the micromechanics of the metaphase spindle assembled in Xenopus laevis egg extracts

    PubMed Central

    Shimamoto, Yuta; Kapoor, Tarun M.

    2014-01-01

    SUMMARY To explain how micron-sized cellular structures generate and respond to forces we need to characterize their micromechanical properties. Here we provide a protocol to build and use a dual force-calibrated microneedle-based set-up to quantitatively analyze the micromechanics of a metaphase spindle assembled in Xenopus laevis egg extracts. This cell-free extract system allows for controlled biochemical perturbations of spindle components. We describe how the microneedles are prepared and how they can be used to apply and measure forces. A multi-mode imaging system allows tracking of microtubules, chromosomes and needle tips. This set-up can be used to analyze the viscoelastic properties of the spindle on time-scales ranging from minutes to sub-seconds. A typical experiment, along with data analysis, is also detailed. We anticipate that our protocol can be readily extended to analyze the micromechanics of other cellular structures assembled in cell-free extracts. The entire procedure can take 3-4 days. PMID:22538847

  13. From embryonic stem cells to functioning germ cells: science, clinical and ethical perspectives.

    PubMed

    Kiatpongsan, Sorapop

    2007-10-01

    Embryonic stem cells have been well recognized as cells having a versatile potential to differentiate into all types of cells in the body including germ cells. There are many research studies focusing on the differentiation processes and protocols to derive various types of somatic cells from embryonic stem cells. However, germ cells have unique differentiation process and developmental pathway compared with somatic cells. Consequently, they will require different differentiation protocols and special culture techniques. More understanding and established in vitro systems for gametogenesis will greatly contribute to further progression of knowledge and technology in germ cell biology, reproductive biology and reproductive medicine. Moreover if oocytes can be efficiently produced in vitro, this will play an important role on progression in nuclear transfer and nuclear reprogramming technology. The present article will provide concise review on past important discoveries, current ongoing studies and future views of this challenging research area. An ethical perspective has also been proposed to give comprehensive summary and viewpoint for future clinical application.

  14. How Should Debriefing Be Undertaken in Web-Based Studies? Findings From a Randomized Controlled Trial

    PubMed Central

    Kypri, Kypros; Wilson, Amanda

    2012-01-01

    Background Internet research may raise older ethical issues in new forms or pose new issues. It has been recommended that debriefing information online be kept very short, with further information including study results made available if requested by participants. There are no empirical studies that compare possible alternative methods of debriefing in online studies. Objective To undertake a randomized controlled trial evaluating how to implement the recommended approach by assessing the effects of two different approaches on accessing of additional information. Methods All 11,943 participants in the Effects of Study Design and Allocation (ESDA) study, which employed deception, were randomly assigned to one of two methods of debriefing: Group A received the debriefing information in the body of an email with links to protocol and results pages; Group B was presented with these links after clicking on an initial link in the body of the email to view the debriefing information on a website. Outcomes assessed were the proportions clicking on the links to the protocol and results summary and the time spent on these pages by those accessing them. Results The group who were presented with no debriefing information in the body of the email and went to a website for this information (Group B) were approximately twice as likely to subsequently access the protocol and the results summary. These differences between the two groups were highly statistically significant. Although these differences are clear, the overall proportions accessing such information were low, and there were no differences in mean time spent reading these pages. Only one quarter of Group B actually accessed debriefing information. Conclusions In circumstances where the uptake of fuller information on study design, methods, and findings is deemed important, debriefing information may be better provided via a link and not included in the body of an email. Doing so may, however, reduce the extent of receiving any debriefing information at all. There is a wider need for high quality empirical studies to inform ethical evaluations. Trial Registration Australian New Zealand Clinical Trials Registry, ACTRN12610000846022 (http://www.anzctr.org.au/) PMID:23160103

  15. Orbiting Quarantine Facility. The Antaeus report, summary

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Requirements for handling extraterrestrial samples in an orbiting quarantine facility are examined. The major concepts and findings of the study are outlined. One approach that could be taken for receiving, containing, and analyzing samples returned from the surface of Mars in a mission analogous to the lunar return missions of the late 1960s and early 1970s is described. It constructs a general mission scenario and presents an overall systems design, including an approach to cost assessment. Particular attention is paid to the design of system hardware components and to the elaboration of an experimental protocol.

  16. Distant Healing Intention Therapies: An Overview of the Scientific Evidence

    PubMed Central

    Schlitz, Marilyn; Baur, Christopher

    2015-01-01

    This article provides a broad overview of “distant healing intention” (DHI) therapies, ie, intentional healing modalities claimed to transcend the usual constraints of distance through space or time. We provide a summary of previous reviews and meta-analyses that have explored a diverse array of DHI modalities, outcome measures, and experimental protocols. While some significant experimental effects have been observed, the evidence to date does not yet provide confidence in its clinical efficacy. The purported “nonlocal” nature of DHI raises significant methodological and theoretical challenges. We recommend several avenues for improving future research. PMID:26665044

  17. Role of imaging in testicular cancer: current and future practice.

    PubMed

    Barrisford, Glen W; Kreydin, Evgeniy I; Preston, Mark A; Rodriguez, Dayron; Harisighani, Mukesh G; Feldman, Adam S

    2015-09-01

    The article provides a summary of the epidemiologic and clinical aspects of testicular malignancy. Current standard imaging and novel techniques are reviewed. Present data and clinical treatment trends have favored surveillance protocols over adjuvant radiation or chemotherapy for low-stage testicular malignancy. This has resulted in increasing numbers of imaging studies and the potential for increased long-term exposure risks. Understanding imaging associated risks as well as strategies to minimize these risks is of increasing importance. The development, validation and incorporation of alternative lower risk highly efficacious and cost-effective imaging techniques is essential.

  18. Weather Information Communications (WINCOMM) Overview and Status

    NASA Technical Reports Server (NTRS)

    Martzaklis, K.

    2003-01-01

    The second annual project review of Weather Information Communications (WINCOMM) is presented. The topics of discussion include: 1) In-Flight Weather Information; 2) System Elements; 3) Technology Investment Areas; 4) NAS Information Exchange; 5) FIS Datalink Architecture Analyses; 6) Hybrid FIS Datalink Architecture; 7) FIS Datalink Architecture Analyses; 8) Air Transport: Ground and Satellite-based Datalinks; 9) General Aviation: Ground and Satellite-based Datalinks; 10) Low Altitude AutoMET Reporting; 11) AutoMET: Airborne-based Datalinks; 12) Network Protocols Development; and 13) FAA/NASA Collaboration. A summary of WINCOMM is also included. This paper is in viewgraph form.

  19. Land mobile satellite demonstration system

    NASA Technical Reports Server (NTRS)

    Gooch, Guy M.; Nicholas, David C.

    1988-01-01

    A land mobile satellite demonstration system is described. It ulilizes the INMARSAT MARECS B2 satellite at 26 degrees W. The system provides data transmission using a poll-response protocol with error detection and retransmission at 200 b/s rate. For most tests a 1.8 inch monopole antenna was used, along with a satellite EIRP normally used for four voice channels. A brief summary of the results are given and the overall system consisting of three elements in addition to the satellite (the mobile unit, the base station, and the office terminal and map display) is described. Throughput statistics from one trip are summarized.

  20. (CF3CO)2O/CF3SO3H-mediated synthesis of 1,3-diketones from carboxylic acids and aromatic ketones

    PubMed Central

    Kim, JungKeun; Shokova, Elvira; Tafeenko, Victor

    2014-01-01

    Summary A very simple and convenient reaction for 1,3-diketone preparation from carboxylic acids and aromatic ketones in TFAA/TfOH system is described. When the β-phenylpropionic acids were used as starting materials, they initially gave 1-indanones and then underwent further acylation with the formation of 2-(β-phenylpropionyl)-1-indanones as the main reaction products. In addition, the application of the proposed protocol allowed for the synthesis of selected polysubstituted pyrazoles in a one-pot procedure directly from acids and ketones. PMID:25298794

  1. Methow and Columbia Rivers studies: summary of data collection, comparison of database structure and habitat protocols, and impact of additional PIT tag interrogation systems to survival estimates, 2008-2012

    USGS Publications Warehouse

    Martens, Kyle D.; Tibbits, Wesley T.; Watson, Grace A.; Newsom, Michael A.; Connolly, Patrick J.

    2014-01-01

    The U.S. Geological Survey (USGS) received funding from the Bureau of Reclamation (Reclamation) to provide monitoring and evaluation on the effectiveness of stream restoration efforts by Reclamation in the Methow River watershed. This monitoring and evaluation program is designed to partially fulfill Reclamation’s part of the 2008 Biological Opinion for the Federal Columbia River Power System that includes a Reasonable and Prudent Alternative (RPA) to protect listed salmon and steelhead across their life cycle. The target species in the Methow River for the restoration effort include Upper Columbia River (UCR) spring Chinook salmon (Oncorhynchus tshawytscha), UCR steelhead (Oncorhynchus mykiss), and bull trout (Salvelinus confluentus), which are listed as threatened or endangered under the Endangered Species Act. Since 2004, the USGS has completed two projects of monitoring and evaluation in the Methow River watershed. The first project focused on the evaluation of barrier removal and steelhead recolonization in Beaver Creek with Libby and Gold Creeks acting as controls. The majority of this work was completed by 2008, although some monitoring continued through 2012. The second project (2008–2012) evaluated the use and productivity of the middle Methow River reach (rkm 65–80) before the onset of multiple off-channel restoration projects planned by the Reclamation and Yakama Nation. The upper Methow River (upstream of rkm 80) and Chewuch River serve as reference reaches and the Methow River downstream of the Twisp River (downstream of rkm 65) serves as a control reach. Restoration of the M2 reach was initiated in 2012 and will be followed by a multi-year, intensive post-evaluation period. This report is comprised of three chapters covering different aspects of the work completed by the USGS. The first chapter is a review of data collection that documents the methods used and summarizes the work done by the USGS from 2008 through 2012. This data summary was designed to show some initial analysis and to disseminate summary information that could potentially be used in ongoing modeling efforts by USGS, Reclamation, and University of Idaho. The second chapter documents the database of fish and habitat data collected by USGS from 2004 through 2012 and compares USGS habitat protocols to the Columbia Habitat Monitoring Program (CHaMP) protocol. The third chapter is a survival analysis of fish moving through Passive Integrated Transponder (PIT) tag interrogation systems in the Methow and Columbia Rivers. It examines the effects of adding PIT tags and/or PIT tag interrogation systems on survival estimates of juvenile steelhead and Chinook salmon.

  2. Prevention and assessment of infectious diseases among children and adult migrants arriving to the European Union/European Economic Association: a protocol for a suite of systematic reviews for public health and health systems

    PubMed Central

    Mayhew, Alain D; Morton, Rachael L; Greenaway, Christina; Akl, Elie A; Rahman, Prinon; Zenner, Dominik; Pareek, Manish; Tugwell, Peter; Welch, Vivian; Meerpohl, Joerg; Alonso-Coello, Pablo; Hui, Charles; Biggs, Beverley-Ann; Requena-Méndez, Ana; Agbata, Eric; Noori, Teymur; Schünemann, Holger J

    2017-01-01

    Introduction The European Centre for Disease Prevention and Control is developing evidence-based guidance for voluntary screening, treatment and vaccine prevention of infectious diseases for newly arriving migrants to the European Union/European Economic Area. The objective of this systematic review protocol is to guide the identification, appraisal and synthesis of the best available evidence on prevention and assessment of the following priority infectious diseases: tuberculosis, HIV, hepatitis B, hepatitis C, measles, mumps, rubella, diphtheria, tetanus, pertussis, poliomyelitis (polio), Haemophilus influenza disease, strongyloidiasis and schistosomiasis. Methods and analysis The search strategy will identify evidence from existing systematic reviews and then update the effectiveness and cost-effectiveness evidence using prospective trials, economic evaluations and/or recently published systematic reviews. Interdisciplinary teams have designed logic models to help define study inclusion and exclusion criteria, guiding the search strategy and identifying relevant outcomes. We will assess the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Ethics and dissemination There are no ethical or safety issues. We anticipate disseminating the findings through open-access publications, conference abstracts and presentations. We plan to publish technical syntheses as GRADEpro evidence summaries and the systematic reviews as part of a special edition open-access publication on refugee health. We are following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols reporting guideline. This protocol is registered in PROSPERO: CRD42016045798. PMID:28893741

  3. Criteria to assess human oocyte quality after cryopreservation.

    PubMed

    Coticchio, G; Bonu, M A; Bianchi, V; Flamigni, C; Borini, A

    2005-10-01

    Oocyte cryopreservation certainly represents one of the most attractive developments in the field of assisted reproduction, with the aim of preserving female fertility and circumventing the ethical and legal drawbacks associated with embryo freezing. Despite the achievement of the first pregnancy from frozen oocytes dating back as early as 1987, since then fewer than 150 pregnancies have been reported. Over a long period of time, application of oocyte storage on a large scale has been prevented by various factors, namely poor post-thaw survival. Fertilization rates remained low even after the introduction of intracytoplasmic sperm injection. Modifications of slow-freezing protocols, mainly based on the increase of the concentration of sucrose used as non-penetrating cryoprotectant (CPA) and the replacement of sodium with choline, appear to have decisively improved survival rates to over 80%. Investigations at the cellular level on thawed oocytes are largely lacking. Fertilization rates have also benefited from protocol modifications, reaching values indistinguishable from those normally obtained with fresh material. Vitrification protocols have also been tested, giving rise to improvements whose reproducibility is still uncertain. Data on the dynamics of fertilization and preimplantation development of embryos derived from frozen oocytes are extremely scarce. At the moment, clinical efficiency of oocyte cryopreservation cannot be precisely assessed because of the lack of controlled studies, although it appears to be considerably lower than that achieved with embryo freezing. In summary, encouraging advances have been made in the field of oocyte cryopreservation, but presently no protocol can ensure standards of success and safety comparable to those guaranteed by embryo storage.

  4. A Review of Cochrane Systematic Reviews of Interventions Relevant to Orthoptic Practice.

    PubMed

    Rowe, Fiona J; Elliott, Sue; Gordon, Iris; Shah, Anupa

    2017-09-01

    To present an overview of the range of systematic reviews on intervention trials pertinent to orthoptic practice, produced by the Cochrane Eyes and Vision group (CEV). We searched the 2016 Cochrane Library database (31.03.2016) to identify completed reviews and protocols of direct relevance to orthoptic practice. These reviews are currently completed and published, available on www.thecochranelibrary.com (free to UK health employees) or via the CEV website (http://eyes.cochrane.org/) . We found 27 completed CEV reviews across the topics of strabismus, amblyopia, refractive errors, and low vision. Seven completed CEV protocols addressed topics of strabismus, amblyopia, refractive errors, low vision, and screening. We found 3 completed Cochrane Stroke reviews addressing visual field loss, eye movement impairment, and age-related vision loss. The systematic review process presents an important opportunity for any clinician to contribute to the establishment of reliable, evidence-based orthoptic practice. Each review has an abstract and plain language summary that many non-clinicians find useful, followed by a full copy of the review (background, objectives, methods, results, discussion) with a conclusion section that is divided into implications for practice and implications for research. The current reviews provide patients/parents/carers with information about various different conditions and treatment options, but also provide clinicians with a summary of the available evidence on interventions, to use as a guide for both clinical practice and future research planning. The reviews identified in this overview highlight the evidence available for effective interventions for strabismus, amblyopia, refractive errors, and low vision or stroke rehabilitation as well as the gaps in the evidence base. Thus, a demand exists for future robust, randomized, controlled trials of such interventions of importance in orthoptic practice.

  5. [Summary: Scientific evaluation of EMDR psychotherapy].

    PubMed

    Haour, F; de Beaurepaire, C

    2016-06-01

    The evaluation of psychotherapy methods is made difficult by their practical and theoretical diversities as well as the increasing number of available therapies. Evaluation based on scientific criteria in randomized control trials is providing the highest level of proof and recognition by Health Agencies. A recently described integrative psychotherapy, eye movement desensitization and reprocessing (EMDR), developed by F. Shapiro since 1989, has been confronted with the validation procedure used in pharmacological treatment. It was of interest to review the scientific validation steps carried out for this EMDR psychotherapy and for its mechanisms of action. The practical and methodological protocol of the EMDR psychotherapy for trauma integration is reviewed as well as clinical results and mechanisms. This EMDR therapy, focused on the resolutions of traumas, was started by treating patients with post-traumatic stress disorders (PTSD). The integrative EMDR protocol obtained the highest level of efficiency, for PTSD treatment, twenty years after its first publication. The efficiency of the protocol is now under study and scientific evaluation for troubles in which the trauma experiences are triggers or factors of maintenance of the troubles: anxiety, depression, phobia, sexual troubles, schizophrenia, etc. This new integrative psychotherapy follows the pathways and the timing observed for the evaluation and the validation of other therapies. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  6. A review of designer anabolic steroids in equine sports.

    PubMed

    Waller, Christopher C; McLeod, Malcolm D

    2017-09-01

    In recent years, the potential for anabolic steroid abuse in equine sports has increased due to the growing availability of designer steroids. These compounds are readily accessible online in 'dietary' or 'nutritional' supplements and contain steroidal compounds which have never been tested or approved as veterinary agents. They typically have unusual structures or substitution and as a result may pass undetected through current anti-doping screening protocols, making them a significant concern for the integrity of the industry. Despite considerable focus in human sports, until recently there has been limited investigation into these compounds in equine systems. To effectively respond to the threat of designer steroids, a detailed understanding of their metabolism is needed to identify markers and metabolites arising from their misuse. A summary of the literature detailing the metabolism of these compounds in equine systems is presented with an aim to identify metabolites suitable for incorporation into screening protocols by anti-doping laboratories. The future of equine anti-doping research is likely to be guided by the incorporation of alternate testing matrices into routine screening, the improvement of in vitro technologies that can mimic in vivo equine metabolism, and the improvement of instrumentation or analytical methods that allow for the development of untargeted screening, and metabolomics approaches for use in anti-doping screening protocols. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. An Efficient Method for Generation of Knockout Human Embryonic Stem Cells Using CRISPR/Cas9 System.

    PubMed

    Bohaciakova, Dasa; Renzova, Tereza; Fedorova, Veronika; Barak, Martin; Kunova Bosakova, Michaela; Hampl, Ales; Cajanek, Lukas

    2017-11-01

    Human embryonic stem cells (hESCs) represent a promising tool to study functions of genes during development, to model diseases, and to even develop therapies when combined with gene editing techniques such as CRISPR/CRISPR-associated protein-9 nuclease (Cas9) system. However, the process of disruption of gene expression by generation of null alleles is often inefficient and tedious. To circumvent these limitations, we developed a simple and efficient protocol to permanently downregulate expression of a gene of interest in hESCs using CRISPR/Cas9. We selected p53 for our proof of concept experiments. The methodology is based on series of hESC transfection, which leads to efficient downregulation of p53 expression even in polyclonal population (p53 Low cells), here proven by a loss of regulation of the expression of p53 target gene, microRNA miR-34a. We demonstrate that our approach achieves over 80% efficiency in generating hESC clonal sublines that do not express p53 protein. Importantly, we document by a set of functional experiments that such genetically modified hESCs do retain typical stem cells characteristics. In summary, we provide a simple and robust protocol to efficiently target expression of gene of interest in hESCs that can be useful for laboratories aiming to employ gene editing in their hESC applications/protocols.

  8. Evaluation of the effectiveness of laser in situ keratomileusis and photorefractive keratectomy for myopia: a meta-analysis.

    PubMed

    Yang, Xin-Jun; Yan, Hong-Tao; Nakahori, Yutaka

    2003-08-01

    To evaluate the effectiveness of laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) for correcting myopia. Study selection, data extraction, and quality assessment were performed by two of authors independently. Summary odds ratios and 95% confidence intervals were calculated by DerSimonian & Laird random-effects model and Mantel-Haenszel (fixed-effects) model. All calculations were based on an intention-to-treat and per protocol analysis. Five hundred and eighty eyes (476 patients) from 5 randomized controlled trials were included in this study. At > or = 6 months follow-up, by random-effects model, the pooled odds ratios (OR, for LASIK vs. PRK) of postoperative uncorrected visual acuity (UCVA) of 20/20 or better for all trials were 1.31 (95% CI=0.77-2.22) by per protocol analysis and 1.18 (95% CI=0.74-1.88) by intention-to-treat analysis. In the refractive outcome, the pooled OR of the postoperative spherical equivalent refraction within +/-0.5 diopter (D) of emmetropia did not show any statistical significance, for which the OR were 0.75 (95% CI=0.48-1.18) by per protocol analysis and 0.70 (95% CI=0.47-1.04) by intention-to-treat analysis. LASIK and PRK were found to be similarly effective for the correction of myopia from -1.5 to -15.0 D in a greater than 6 month follow-up.

  9. A highly sensitive protocol for microscopy of alkyne lipids and fluorescently tagged or immunostained proteins.

    PubMed

    Gaebler, Anne; Penno, Anke; Kuerschner, Lars; Thiele, Christoph

    2016-10-01

    The demand to study the cellular localization of specific lipids has led to recent advances in lipid probes and microscopy. Alkyne lipids bear a small, noninterfering tag and can be detected upon click reaction with an azide-coupled reporter. Fluorescent alkyne lipid imaging crucially depends on appropriate azide reporters and labeling protocols that allow for an efficient click reaction and therefore a sensitive detection. We synthesized several azide reporters with different spacer components and tested their suitability for alkyne lipid imaging in fixed cells. The implementation of a copper-chelating picolyl moiety into fluorescent or biotin-based azide reagents strongly increased the sensitivity of the imaging routine. We demonstrate the applicability and evaluate the performance of this approach using different lipid classes and experimental setups. As azide picolyl reporters allow for reduced copper catalyst concentrations, they also enable coimaging of alkyne lipids with multiple fluorescent proteins including enhanced green fluorescent protein. Alternatively, and as we also show, microscopy of alkyne lipids can be combined with protein detection by immunocytochemistry. In summary, we present a robust, sensitive, and highly versatile protocol for the labeling of alkyne lipids with azide-coupled reporters for fluorescence microscopy that can be combined with different protein detection and imaging techniques. Copyright © 2016 by the American Society for Biochemistry and Molecular Biology, Inc.

  10. An siRNA-based method for efficient silencing of gene expression in mature brown adipocytes.

    PubMed

    Isidor, Marie S; Winther, Sally; Basse, Astrid L; Petersen, M Christine H; Cannon, Barbara; Nedergaard, Jan; Hansen, Jacob B

    2016-01-01

    Brown adipose tissue is a promising therapeutic target for opposing obesity, glucose intolerance and insulin resistance. The ability to modulate gene expression in mature brown adipocytes is important to understand brown adipocyte function and delineate novel regulatory mechanisms of non-shivering thermogenesis. The aim of this study was to optimize a lipofection-based small interfering RNA (siRNA) transfection protocol for efficient silencing of gene expression in mature brown adipocytes. We determined that a critical parameter was to deliver the siRNA to mature adipocytes by reverse transfection, i.e. transfection of non-adherent cells. Using this protocol, we effectively knocked down both high- and low-abundance transcripts in a model of mature brown adipocytes (WT-1) as well as in primary mature mouse brown adipocytes. A functional consequence of the knockdown was confirmed by an attenuated increase in uncoupled respiration (thermogenesis) in response to β-adrenergic stimulation of mature WT-1 brown adipocytes transfected with uncoupling protein 1 siRNA. Efficient gene silencing was also obtained in various mouse and human white adipocyte models (3T3-L1, primary mouse white adipocytes, hMADS) with the ability to undergo "browning." In summary, we report an easy and versatile reverse siRNA transfection protocol to achieve specific silencing of gene expression in various models of mature brown and browning-competent white adipocytes, including primary cells.

  11. Fostering critical thinking and collaborative learning skills among medical students through a research protocol writing activity in the curriculum

    PubMed Central

    2018-01-01

    Purpose This intervention was aimed to analyse the effect of academic writing and journal critiquing as educational approaches in improving critical thinking and collaborative learning among undergraduate medical students. Methods A research proposal writing format was created for the 4th year medical students of Melaka Manipal Medical College, Malaysia during their ophthalmology clinical postings. The students worked in small groups and developed research protocols through an evidence based approach. This was followed by writing reflective summaries in academic portfolios about the activity undertaken.A mixed methods study was designed to explore the possible role of collaborative research proposal writing in enhancing critical thinking and collaborative learning. Results Analysis of reflections submitted by 188 medical students after the intervention indicate that majority of them found an improvement in their skills of critical thinking and collaborative learning as a result of research protocol writing. All participants agreed that the model helped in applying concepts to new situations in the form of designing their own study, which reflected in enhanced higher order cognitive skills. Conclusion This study shows that the introduction of a structured module in the core medical curriculum that focuses on research writing skills embedded with collaborative and reflective practices can enhance collaborative learning, critical thinking, and reasoning among medical students. PMID:29860777

  12. Chapter 13: Assessing Persistence and Other Evaluation Issues Cross-Cutting Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

    Kurnik, Charles W; Violette, Daniel M.

    Addressing other evaluation issues that have been raised in the context of energy efficiency programs, this chapter focuses on methods used to address the persistence of energy savings, which is an important input to the benefit/cost analysis of energy efficiency programs and portfolios. In addition to discussing 'persistence' (which refers to the stream of benefits over time from an energy efficiency measure or program), this chapter provides a summary treatment of these issues -Synergies across programs -Rebound -Dual baselines -Errors in variables (the measurement and/or accuracy of input variables to the evaluation).

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

    Sabba, Dellilah

    This report, prepared by the SLAC National Accelerator Laboratory (SLAC) for the U.S. Department of Energy (DOE), SLAC Site Office (SSO), provides a comprehensive summary of the environmental program activities at SLAC for calendar year 2015. Annual Site Environmental Reports (ASERs) are prepared for all DOE sites with significant environmental activities, and distributed to relevant external regulatory agencies and other interested organizations or individuals. To the best of my knowledge, this report accurately summarizes the results of the 2015 environmental monitoring, compliance, and restoration programs at SLAC. This assurance can be made based on SSO and SLAC review of themore » ASER, and quality assurance protocols applied to monitoring and data analyses at SLAC.« less

  14. Assessing and Reporting Dancer Capacities, Risk Factors, and Injuries: Recommendations from the IADMS Standard Measures Consensus Initiative.

    PubMed

    Liederbach, Marijeanne; Hagins, Marshall; Gamboa, Jennifer M; Welsh, Thomas M

    2012-12-01

    This technical report of the Standard Measures Consensus Initiative of the International Association for Dance Medicine and Science (IADMS) describes the results of the committee’s multi-year effort to synthesize information regarding the tests and measures used in dance-related research, protocols for reporting injuries, and appropriate use of available technologies to aid in standardizing such matters. Specific recommendations are presented, with accompanying rationales, to facilitate consensus among members of the dance medicine and science community. An Executive Summary of this Technical Report, which contains implementation strategies and appendices, should soon be available on the IADMS website.

  15. The Influence of Age and Sexual Drive on the Predictive Validity of the Juvenile Sex Offender Assessment Protocol-Revised.

    PubMed

    Wijetunga, Charity; Martinez, Ricardo; Rosenfeld, Barry; Cruise, Keith

    2018-01-01

    The Juvenile Sex Offender Assessment Protocol-Revised (J-SOAP-II) is the most commonly used measure in the assessment of recidivism risk among juveniles who have committed sexual offenses (JSOs), but mixed support exists for its predictive validity. This study compared the predictive validity of the J-SOAP-II across two offender characteristics, age and sexual drive, in a sample of 156 JSOs who had been discharged from a correctional facility or a residential treatment program. The J-SOAP-II appeared to be a better predictor of sexual recidivism for younger JSOs (14-16 years old) than for older ones (17-19 years old), with significant differences found for the Dynamic Summary Scale and Scale III (Intervention). In addition, several of the measure's scales significantly predicted sexual recidivism for JSOs with a clear pattern of sexualized behavior but not for those without such a pattern, indicating that the J-SOAP-II may have greater clinical utility for JSOs with heightened sexual drive. The implications of these findings are discussed.

  16. An integrated dispersion preparation, characterization and in vitro dosimetry methodology for engineered nanomaterials

    PubMed Central

    DeLoid, Glen M.; Cohen, Joel M.; Pyrgiotakis, Georgios; Demokritou, Philip

    2018-01-01

    Summary Evidence continues to grow of the importance of in vitro and in vivo dosimetry in the hazard assessment and ranking of engineered nanomaterials (ENMs). Accurate dose metrics are particularly important for in vitro cellular screening to assess the potential health risks or bioactivity of ENMs. In order to ensure meaningful and reproducible quantification of in vitro dose, with consistent measurement and reporting between laboratories, it is necessary to adopt standardized and integrated methodologies for 1) generation of stable ENM suspensions in cell culture media, 2) colloidal characterization of suspended ENMs, particularly properties that determine particle kinetics in an in vitro system (size distribution and formed agglomerate effective density), and 3) robust numerical fate and transport modeling for accurate determination of ENM dose delivered to cells over the course of the in vitro exposure. Here we present such an integrated comprehensive protocol based on such a methodology for in vitro dosimetry, including detailed standardized procedures for each of these three critical steps. The entire protocol requires approximately 6-12 hours to complete. PMID:28102836

  17. Augmenting tendon and ligament repair with platelet-rich plasma (PRP)

    PubMed Central

    Yuan, Ting; Zhang, Chang-Qing; Wang, James H-C.

    2013-01-01

    Summary Tendon and ligament injuries (TLI) commonly occur in athletes and non-athletes alike, and remarkably debilitate patients’ athletic and personal abilities. Current clinical treatments, such as reconstruction surgeries, do not adequately heal these injuries and often result in the formation of scar tissue that is prone to re-injury. Platelet-rich plasma (PRP) is a widely used alternative option that is also safe because of its autologous nature. PRP contains a number of growth factors that are responsible for its potential to heal TLIs effectively. In this review, we provide a comprehensive report on PRP. While basic science studies in general indicate the potential of PRP to treat TLIs effectively, a review of existing literature on the clinical use of PRP for the treatment of TLIs indicates a lack of consensus due to varied treatment outcomes. This suggests that current PRP treatment protocols for TLIs may not be optimal, and that not all TLIs may be effectively treated with PRP. Certainly, additional basic science studies are needed to develop optimal treatment protocols and determine those TLI conditions that can be treated effectively. PMID:24367773

  18. Image processing and Quality Control for the first 10,000 brain imaging datasets from UK Biobank.

    PubMed

    Alfaro-Almagro, Fidel; Jenkinson, Mark; Bangerter, Neal K; Andersson, Jesper L R; Griffanti, Ludovica; Douaud, Gwenaëlle; Sotiropoulos, Stamatios N; Jbabdi, Saad; Hernandez-Fernandez, Moises; Vallee, Emmanuel; Vidaurre, Diego; Webster, Matthew; McCarthy, Paul; Rorden, Christopher; Daducci, Alessandro; Alexander, Daniel C; Zhang, Hui; Dragonu, Iulius; Matthews, Paul M; Miller, Karla L; Smith, Stephen M

    2018-02-01

    UK Biobank is a large-scale prospective epidemiological study with all data accessible to researchers worldwide. It is currently in the process of bringing back 100,000 of the original participants for brain, heart and body MRI, carotid ultrasound and low-dose bone/fat x-ray. The brain imaging component covers 6 modalities (T1, T2 FLAIR, susceptibility weighted MRI, Resting fMRI, Task fMRI and Diffusion MRI). Raw and processed data from the first 10,000 imaged subjects has recently been released for general research access. To help convert this data into useful summary information we have developed an automated processing and QC (Quality Control) pipeline that is available for use by other researchers. In this paper we describe the pipeline in detail, following a brief overview of UK Biobank brain imaging and the acquisition protocol. We also describe several quantitative investigations carried out as part of the development of both the imaging protocol and the processing pipeline. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  19. Quality-assurance procedures: Method 5G determination of particulate emissions from wood heaters from a dilution tunnel sampling location

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

    Ward, T.E.; Hartman, M.W.; Olin, R.C.

    1989-06-01

    Quality-assurance procedures are contained in this comprehensive document intended to be used as an aid for wood-heater manufacturers and testing laboratories in performing particulate matter sampling of wood heaters according to EPA protocol, Method 5G. These procedures may be used in research and development, and as an aid in auditing and certification testing. A detailed, step-by-step quality assurance guide is provided to aid in the procurement and assembly of testing apparatus, to clearly describe the procedures, and to facilitate data collection and reporting. Suggested data sheets are supplied that can be used as an aid for both recordkeeping and certificationmore » applications. Throughout the document, activity matrices are provided to serve as a summary reference. Checklists are also supplied that can be used by testing personnel. Finally, for the purposes of ensuring data quality, procedures are outlined for apparatus operation, maintenance, and traceability. These procedures combined with the detailed description of the sampling and analysis protocol will help ensure the accuracy and reliability of Method 5G emission-testing results.« less

  20. IEA-Task 31 WAKEBENCH: Towards a protocol for wind farm flow model evaluation. Part 2: Wind farm wake models

    NASA Astrophysics Data System (ADS)

    Moriarty, Patrick; Sanz Rodrigo, Javier; Gancarski, Pawel; Chuchfield, Matthew; Naughton, Jonathan W.; Hansen, Kurt S.; Machefaux, Ewan; Maguire, Eoghan; Castellani, Francesco; Terzi, Ludovico; Breton, Simon-Philippe; Ueda, Yuko

    2014-06-01

    Researchers within the International Energy Agency (IEA) Task 31: Wakebench have created a framework for the evaluation of wind farm flow models operating at the microscale level. The framework consists of a model evaluation protocol integrated with a web-based portal for model benchmarking (www.windbench.net). This paper provides an overview of the building-block validation approach applied to wind farm wake models, including best practices for the benchmarking and data processing procedures for validation datasets from wind farm SCADA and meteorological databases. A hierarchy of test cases has been proposed for wake model evaluation, from similarity theory of the axisymmetric wake and idealized infinite wind farm, to single-wake wind tunnel (UMN-EPFL) and field experiments (Sexbierum), to wind farm arrays in offshore (Horns Rev, Lillgrund) and complex terrain conditions (San Gregorio). A summary of results from the axisymmetric wake, Sexbierum, Horns Rev and Lillgrund benchmarks are used to discuss the state-of-the-art of wake model validation and highlight the most relevant issues for future development.

  1. Prevention and assessment of infectious diseases among children and adult migrants arriving to the European Union/European Economic Association: a protocol for a suite of systematic reviews for public health and health systems.

    PubMed

    Pottie, Kevin; Mayhew, Alain D; Morton, Rachael L; Greenaway, Christina; Akl, Elie A; Rahman, Prinon; Zenner, Dominik; Pareek, Manish; Tugwell, Peter; Welch, Vivian; Meerpohl, Joerg; Alonso-Coello, Pablo; Hui, Charles; Biggs, Beverley-Ann; Requena-Méndez, Ana; Agbata, Eric; Noori, Teymur; Schünemann, Holger J

    2017-09-11

    The European Centre for Disease Prevention and Control is developing evidence-based guidance for voluntary screening, treatment and vaccine prevention of infectious diseases for newly arriving migrants to the European Union/European Economic Area. The objective of this systematic review protocol is to guide the identification, appraisal and synthesis of the best available evidence on prevention and assessment of the following priority infectious diseases: tuberculosis, HIV, hepatitis B, hepatitis C, measles, mumps, rubella, diphtheria, tetanus, pertussis, poliomyelitis (polio), Haemophilus influenza disease, strongyloidiasis and schistosomiasis. The search strategy will identify evidence from existing systematic reviews and then update the effectiveness and cost-effectiveness evidence using prospective trials, economic evaluations and/or recently published systematic reviews. Interdisciplinary teams have designed logic models to help define study inclusion and exclusion criteria, guiding the search strategy and identifying relevant outcomes. We will assess the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. There are no ethical or safety issues. We anticipate disseminating the findings through open-access publications, conference abstracts and presentations. We plan to publish technical syntheses as GRADEpro evidence summaries and the systematic reviews as part of a special edition open-access publication on refugee health. We are following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols reporting guideline. This protocol is registered in PROSPERO: CRD42016045798. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. The effect of decreasing computed tomography dosage on radiostereometric analysis (RSA) accuracy at the glenohumeral joint.

    PubMed

    Fox, Anne-Marie V; Kedgley, Angela E; Lalone, Emily A; Johnson, James A; Athwal, George S; Jenkyn, Thomas R

    2011-11-10

    Standard, beaded radiostereometric analysis (RSA) and markerless RSA often use computed tomography (CT) scans to create three-dimensional (3D) bone models. However, ethical concerns exist due to risks associated with CT radiation exposure. Therefore, the aim of this study was to investigate the effect of decreasing CT dosage on RSA accuracy. Four cadaveric shoulder specimens were scanned using a normal-dose CT protocol and two low-dose protocols, where the dosage was decreased by 89% and 98%. 3D computer models of the humerus and scapula were created using each CT protocol. Bi-planar fluoroscopy was used to image five different static glenohumeral positions and two dynamic glenohumeral movements, of which a total of five static and four dynamic poses were selected for analysis. For standard RSA, negligible differences were found in bead (0.21±0.31mm) and bony landmark (2.31±1.90mm) locations when the CT dosage was decreased by 98% (p-values>0.167). For markerless RSA kinematic results, excellent agreement was found between the normal-dose and lowest-dose protocol, with all Spearman rank correlation coefficients greater than 0.95. Average root mean squared errors of 1.04±0.68mm and 2.42±0.81° were also found at this reduced dosage for static positions. In summary, CT dosage can be markedly reduced when performing shoulder RSA to minimize the risks of radiation exposure. Standard RSA accuracy was negligibly affected by the 98% CT dose reduction and for markerless RSA, the benefits of decreasing CT dosage to the subject outweigh the introduced errors. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. The Active for Life Year 5 (AFLY5) school-based cluster randomised controlled trial protocol: detailed statistical analysis plan.

    PubMed

    Lawlor, Debbie A; Peters, Tim J; Howe, Laura D; Noble, Sian M; Kipping, Ruth R; Jago, Russell

    2013-07-24

    The Active For Life Year 5 (AFLY5) randomised controlled trial protocol was published in this journal in 2011. It provided a summary analysis plan. This publication is an update of that protocol and provides a detailed analysis plan. This update provides a detailed analysis plan of the effectiveness and cost-effectiveness of the AFLY5 intervention. The plan includes details of how variables will be quality control checked and the criteria used to define derived variables. Details of four key analyses are provided: (a) effectiveness analysis 1 (the effect of the AFLY5 intervention on primary and secondary outcomes at the end of the school year in which the intervention is delivered); (b) mediation analyses (secondary analyses examining the extent to which any effects of the intervention are mediated via self-efficacy, parental support and knowledge, through which the intervention is theoretically believed to act); (c) effectiveness analysis 2 (the effect of the AFLY5 intervention on primary and secondary outcomes 12 months after the end of the intervention) and (d) cost effectiveness analysis (the cost-effectiveness of the AFLY5 intervention). The details include how the intention to treat and per-protocol analyses were defined and planned sensitivity analyses for dealing with missing data. A set of dummy tables are provided in Additional file 1. This detailed analysis plan was written prior to any analyst having access to any data and was approved by the AFLY5 Trial Steering Committee. Its publication will ensure that analyses are in accordance with an a priori plan related to the trial objectives and not driven by knowledge of the data. ISRCTN50133740.

  4. Revised Recommendations of the Consortium of MS Centers Task Force for a Standardized MRI Protocol and Clinical Guidelines for the Diagnosis and Follow-Up of Multiple Sclerosis

    PubMed Central

    Traboulsee, A.; Simon, J.H.; Stone, L.; Fisher, E.; Jones, D.E.; Malhotra, A.; Newsome, S.D.; Oh, J.; Reich, D.S.; Richert, N.; Rammohan, K.; Khan, O.; Radue, E.-W.; Ford, C.; Halper, J.; Li, D.

    2016-01-01

    SUMMARY An international group of neurologists and radiologists developed revised guidelines for standardized brain and spinal cord MR imaging for the diagnosis and follow-up of MS. A brain MR imaging with gadolinium is recommended for the diagnosis of MS. A spinal cord MR imaging is recommended if the brain MR imaging is nondiagnostic or if the presenting symptoms are at the level of the spinal cord. A follow-up brain MR imaging with gadolinium is recommended to demonstrate dissemination in time and ongoing clinically silent disease activity while on treatment, to evaluate unexpected clinical worsening, to re-assess the original diagnosis, and as a new baseline before starting or modifying therapy. A routine brain MR imaging should be considered every 6 months to 2 years for all patients with relapsing MS. The brain MR imaging protocol includes 3D T1-weighted, 3D T2-FLAIR, 3D T2-weighted, post-single-dose gadolinium-enhanced T1-weighted sequences, and a DWI sequence. The progressive multifocal leukoencephalopathy surveillance protocol includes FLAIR and DWI sequences only. The spinal cord MR imaging protocol includes sagittal T1-weighted and proton attenuation, STIR or phase-sensitive inversion recovery, axial T2- or T2*-weighted imaging through suspicious lesions, and, in some cases, postcontrast gadolinium-enhanced T1-weighted imaging. The clinical question being addressed should be provided in the requisition for the MR imaging. The radiology report should be descriptive, with results referenced to previous studies. MR imaging studies should be permanently retained and available. The current revision incorporates new clinical information and imaging techniques that have become more available. PMID:26564433

  5. Summary of the development the US Environmental Protection Agency's Medaka Extended One Generation Reproduction Test (MEOGRT) using data from 9 multigenerational medaka tests.

    PubMed

    Flynn, Kevin; Lothenbach, Doug; Whiteman, Frank; Hammermeister, Dean; Touart, Leslie W; Swintek, Joe; Tatarazako, Norihisa; Onishi, Yuta; Iguchi, Taisen; Johnson, Rodney

    2017-12-01

    In response to various legislative mandates, the US Environmental Protection Agency (USEPA) formed its Endocrine Disruptor Screening Program (EDSP), which in turn, formed the basis of a tiered testing strategy to determine the potential of pesticides, commercial chemicals, and environmental contaminants to disrupt the endocrine system. The first tier of tests is intended to detect the potential for endocrine disruption mediated through estrogen, androgen, or thyroid pathways, whereas the second tier is intended to further characterize the effects on these pathways and to establish a dose-response relationship for adverse effects. One of these tier 2 tests, the Medaka Extended One Generation Reproduction Test (MEOGRT), was developed by the USEPA for the EDSP and, in collaboration with the Japanese Ministry of the Environment, for the Guidelines for the Testing of Chemicals of the Organisation for Economic Co-operation and Development (OECD). The MEOGRT protocol was iteratively modified based on knowledge gained after the successful completion of 9 tests with variations in test protocols. The present study describes both the final MEOGRT protocol that has been published by the USEPA and the OECD, and the iterations that provided valuable insights into nuances of the protocol. The various tests include exposure to 17β-estradiol, 4-t-octylphenol, o,p'- dichlorodiphenyltrichloroethane, 4-chloro-3-methylphenol, tamoxifen, 17β-trenbolone, vinclozolin, and prochloraz. Environ Toxicol Chem 2017;36:3387-3403. Published 2017 Wiley Periodicals Inc. on behalf of SETAC. This article is a US government work and, as such, is in the public domain in the United States of America. Published 2017 Wiley Periodicals Inc. on behalf of SETAC. This article is a US government work and, as such, is in the public domain in the United States of America.

  6. Water- versus land-based exercise in elderly subjects: effects on physical performance and body composition

    PubMed Central

    Bergamin, Marco; Ermolao, Andrea; Tolomio, Silvia; Berton, Linda; Sergi, Giuseppe; Zaccaria, Marco

    2013-01-01

    The aim of this study was to assess the effectiveness of a 24-week exercise protocol carried out in geothermal spring water to improve overall physical function and muscle mass in a group of healthy elderly subjects. A further aim was to compare this water-based protocol with a land-based protocol and a control group. For this purpose, 59 subjects were recruited and randomly allocated to three groups: aquatic group (AG), land group (LG), and control group (CG). AG and LG followed a 6-month, twice-weekly, multimodality exercise intervention. AG underwent the protocol in hot-spring water (36°C) while LG did it in a land-based environment. After the intervention, knee-extension strength was maintained in AG and LG. The 8-foot up-and-go test showed a reduction in both exercise groups (AG −19.3%, P < 0.05; LG −12.6%, P < 0.05), with a significantly greater decrease in AG. The back-scratch test revealed an improvement only in AG (25.8%; P < 0.05), while the sit-and-reach test improved in all groups. Finally, AG reduced fat mass by 4% (P < 0.05), and dominant forearm fat decreased by 9.2% (P < 0.05). In addition, calf muscle density increased by 1.8% (P < 0.05). In summary, both water- and land-based activities were beneficial in maintaining strength and in improving lower-body flexibility. Aquatic exercise appeared a better activity to improve dynamic balance. Thermal swimming pools and the use of rating of perceived exertion as a method of exercise monitoring should be considered potentially useful tools to enhance physical performance and body composition in healthy elderly. PMID:24009416

  7. Treadmill Slope Modulates Inflammation, Fiber Type Composition, Androgen, and Glucocorticoid Receptors in the Skeletal Muscle of Overtrained Mice

    PubMed Central

    da Rocha, Alisson L.; Pereira, Bruno C.; Teixeira, Giovana R.; Pinto, Ana P.; Frantz, Fabiani G.; Elias, Lucila L. K.; Lira, Fábio S.; Pauli, José R.; Cintra, Dennys E.; Ropelle, Eduardo R.; de Moura, Leandro P.; Mekary, Rania A.; de Freitas, Ellen C.; da Silva, Adelino S. R.

    2017-01-01

    Overtraining (OT) may be defined as an imbalance between excessive training and adequate recovery period. Recently, a downhill running-based overtraining (OTR/down) protocol induced the nonfunctional overreaching state, which is defined as a performance decrement that may be associated with psychological and hormonal disruptions and promoted intramuscular and systemic inflammation. To discriminate the eccentric contraction effects on interleukin 1beta (IL-1β), IL-6, IL-10, IL-15, and SOCS-3, we compared the release of these cytokines in OTR/down with other two OT protocols with the same external load (i.e., the product between training intensity and volume), but performed in uphill (OTR/up) and without inclination (OTR). Also, we evaluated the effects of these OT models on the muscle morphology and fiber type composition, serum levels of fatigue markers and corticosterone, as well as androgen receptor (AR) and glucocorticoid receptor (GR) expressions. For extensor digitorum longus (EDL), OTR/down and OTR groups increased the cytokines and exhibited micro-injuries with polymorphonuclear infiltration. While OTR/down group increased the cytokines in soleus muscle, OTR/up group only increased IL-6. All OT groups presented micro-injuries with polymorphonuclear infiltration. In serum, while OTR/down and OTR/up protocols increased IL-1β, IL-6, and tumor necrosis factor alpha, OTR group increased IL-1β, IL-6, IL-15, and corticosterone. The type II fibers in EDL and soleus, total and phosphorylated AR levels in soleus, and total GR levels in EDL and soleus were differentially modulated by the OT protocols. In summary, the proinflammatory cytokines were more sensitive for OTR/down than for OTR/up and OTR. Also, the specific treadmill inclination of each OT model influenced most of the other evaluated parameters. PMID:29163473

  8. Therapeutic hypothermia for neonatal encephalopathy: JSPNM & MHLW Japan Working Group Practice Guidelines Consensus Statement from the Working Group on Therapeutic Hypothermia for Neonatal Encephalopathy, Ministry of Health, Labor and Welfare (MHLW), Japan, and Japan Society for Perinatal and Neonatal Medicine (JSPNM).

    PubMed

    Takenouchi, Toshiki; Iwata, Osuke; Nabetani, Makoto; Tamura, Masanori

    2012-02-01

    Neonatal encephalopathy (NE) secondary to intrapartum asphyxia remains a major cause of post-natal death and permanent neurological deficits worldwide. Supportive therapy has been the mainstay of the treatment until recent series of large clinical trials demonstrating benefit of therapeutic hypothermia (TH) in this high risk population. Now the International Liaison Committee on Resuscitation (ILCOR) recommends TH as a standard of care with the protocols used in the large clinical trials as tentative standard protocols. Our goal is to develop a nationwide consensus practice guideline not only consistent with the international standard protocols but also practical and compatible with the current medical system in Japan. In summary, TH should be offered to newborn infants born ≥36 weeks gestational age and birth weight ≥1800 g exhibiting clinical signs of moderate to severe NE as well as evidence of hypoxia-ischemia, i.e. 10 min Apgar score ≤5, a need for resuscitation at 10 min, blood pH<7.00, or base deficit ≥16 mmol/L. TH should be conducted in the NICUs capable of multidisciplinary care and under the standard protocols, i.e. utilization of cooling device, target (rectal or esophageal) temperatures at 33.5±0.5 and 34.5±0.5°C for whole body and selective head cooling respectively, duration of TH for 72 h, gradual rewarming not exceeding the rate of 0.5°C/h. Long term follow-up with multidisciplinary approach including standardized psychological assessment is warranted. Copyright © 2011 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  9. The Seamless Transfer-of-Care Protocol: a randomized controlled trial assessing the efficacy of an electronic transfer-of-care communication tool.

    PubMed

    Okoniewska, Barbara M; Santana, Maria J; Holroyd-Leduc, Jayna; Flemons, Ward; O'Beirne, Maeve; White, Deborah; Clement, Fiona; Forster, Alan; Ghali, William A

    2012-11-21

    The transition between acute care and community care represents a vulnerable period in health care delivery. The vulnerability of this period has been attributed to changes to patients' medication regimens during hospitalization, failure to reconcile discrepancies between admission and discharge and the burdening of patients/families to take over care responsibilities at discharge and to relay important information to the primary care physician. Electronic communication platforms can provide an immediate link between acute care and community care physicians (and other community providers), designed to ensure consistent information transfer. This study examines whether a transfer-of-care (TOC) communication tool is efficacious and cost-effective for reducing hospital readmission, adverse events and adverse drug events as well as reducing death. A randomized controlled trial conducted on the Medical Teaching Unit of a Canadian tertiary care centre will evaluate the efficacy and cost-effectiveness of a TOC communication tool. Medical in-patients admitted to the unit will be considered for this study. Data will be collected upon admission, and a total of 1400 patients will be randomized. The control group's acute care stay will be summarized using a traditional dictated summary, while the intervention group will have a summary generated using the TOC communication tool. The primary outcome will be a composite, at 3 months, of death or readmission to any Alberta acute-care hospital. Secondary outcomes will be the occurrence of post-discharge adverse events and adverse drug events at 1 month post discharge. Patients with adverse outcomes will have their cases reviewed by two Royal College certified internists or College-certified family physicians, blinded to patients' group assignments, to determine the type, severity, preventability and ameliorability of all detected adverse outcomes. An accompanying economic evaluation will assess the cost per life saved, cost per readmission avoided and cost per QALY gained with the TOC communication tool compared to traditional dictation summaries. This paper outlines the study protocol for a randomized controlled trial evaluating an electronic transfer-of-care communication tool, with sufficient statistical power to assess the impact of the tool on the significant outcomes of post-discharge death or readmission. The study findings will inform health systems around the world on the potential benefits of such tools, and the value for money associated with their widespread implementation. ClinicalTrials.gov NCT01402609.

  10. Measuring physical and mental health using the SF-12: implications for community surveys of mental health.

    PubMed

    Windsor, Timothy D; Rodgers, Bryan; Butterworth, Peter; Anstey, Kaarin J; Jorm, Anthony F

    2006-09-01

    The effects of using different approaches to scoring the SF-12 summary scales of physical and mental health were examined with a view to informing the design and interpretation of community-based survey research. Data from a population-based study of 7485 participants in three cohorts aged 20-24, 40-44 and 60-64 years were used to examine relationships among measures of physical and mental health calculated from the same items using the SF-12 and RAND-12 approaches to scoring, and other measures of chronic physical conditions and psychological distress. A measure of physical health constructed using the RAND-12 scoring showed a monotonic negative association with psychological distress as measured by the Goldberg depression and anxiety scales. However, a non-monotonic association was evident in the relationship between SF-12 physical health scores and distress, with very high SF-12 physical health scores corresponding with high levels of distress. These relationships highlight difficulties in interpretation that can arise when using the SF-12 summary scales in some analytical contexts. It is recommended that community surveys that measure physical and mental functioning using the SF-12 items generate summary scores using the RAND-12 protocol in addition to the SF-12 approach. In general, researchers should be wary of using factor scores based on orthogonal rotation, which assumes that measures are uncorrelated, to represent constructs that have an actual association.

  11. Openness to experience and adapting to change: Cardiovascular stress habituation to change in acute stress exposure.

    PubMed

    Ó Súilleabháin, Páraic S; Howard, Siobhán; Hughes, Brian M

    2018-05-01

    Underlying psychophysiological mechanisms of effect linking openness to experience to health outcomes, and particularly cardiovascular well-being, are unknown. This study examined the role of openness in the context of cardiovascular responsivity to acute psychological stress. Continuous cardiovascular response data were collected for 74 healthy young female adults across an experimental protocol, including differing counterbalanced acute stressors. Openness was measured via self-report questionnaire. Analysis of covariance revealed openness was associated with systolic blood pressure (SBP; p = .016), and diastolic blood pressure (DBP; p = .036) responsivity across the protocol. Openness was also associated with heart rate (HR) responding to the initial stress exposure (p = .044). Examination of cardiovascular adaptation revealed that higher openness was associated with significant SBP (p = .001), DBP (p = .009), and HR (p = .002) habituation in response to the second differing acute stress exposure. Taken together, the findings suggest persons higher in openness are characterized by an adaptive cardiovascular stress response profile within the context of changing acute stress exposures. This study is also the first to demonstrate individual differences in cardiovascular adaptation across a protocol consisting of differing stress exposures. More broadly, this research also suggests that future research may benefit from conceptualizing an adaptive fitness of openness within the context of change. In summary, the present study provides evidence that higher openness stimulates short-term stress responsivity, while ensuring cardiovascular habituation to change in stress across time. © 2017 Society for Psychophysiological Research.

  12. Steroid-induced diabetes: a clinical and molecular approach to understanding and treatment

    PubMed Central

    Hwang, Jessica L.; Weiss, Roy E.

    2014-01-01

    Summary Since the advent of glucocorticoid therapy for autoimmune disease in the 1940s, their widespread application has led to the concurrent therapy-limiting discovery of many adverse metabolic side effects. Unanticipated hyperglycemia associated with the initiation of glucocorticoids often leads to preventable hospital admissions, prolonged hospital stays, increased risks for infection and reduced graft function in solid organ transplant recipients. Challenges in managing steroid-induced diabetes stem from wide fluctuations in post-prandial hyperglycemia and the lack of clearly defined treatment protocols. The mainstay of treatment is insulin therapy coincident with meals. This article aims to review the pathogenesis, risk factors, diagnosis and treatment principles unique to steroid-induced diabetes. PMID:24123849

  13. The difference between “equivalent” and “not different”

    DOE PAGES

    Anderson-Cook, Christine M.; Borror, Connie M.

    2015-10-27

    Often, experimenters wish to establish that populations of units can be considered equivalent to each other, in order to leverage improved knowledge about one population for characterizing the new population, or to establish the comparability of items. Equivalence tests have existed for many years, but their use in industry seems to have been largely restricted to biomedical applications, such as for assessing the equivalence of two drugs or protocols. We present the fundamentals of equivalence tests, compare them to traditional two-sample and ANOVA tests that are better suited to establishing differences in populations, and propose the use of a graphicalmore » summary to compare p-values across different thresholds of practically important differences.« less

  14. Therapeutic Phlebotomy is Safe in Children with Sickle Cell Anaemia and can be Effective Treatment for Transfusional Iron Overload

    PubMed Central

    Aygun, Banu; Mortier, Nicole A.; Kesler, Karen; Lockhart, Alexandre; Schultz, William H.; Cohen, Alan R.; Alvarez, Ofelia; Rogers, Zora R.; Kwiatkowski, Janet L.; Miller, Scott T.; Sylvestre, Pamela; Iyer, Rathi; Lane, Peter A.; Ware, Russell E.

    2015-01-01

    SUMMARY Serial phlebotomy was performed on sixty children with sickle cell anaemia, stroke and transfusional iron overload randomized to hydroxycarbamide in the Stroke With Transfusions Changing to Hydroxyurea trial. There were 927 phlebotomy procedures with only 33 adverse events, all of which were grade 2. Among 23 children completing 30 months of study treatment, the net iron balance was favourable (−8.7 mg Fe/kg) with significant decrease in ferritin, although liver iron concentration remained unchanged. Therapeutic phlebotomy was safe and well-tolerated, with net iron removal in most children who completed 30 months of protocol-directed treatment. PMID:25612463

  15. Genevar: a database and Java application for the analysis and visualization of SNP-gene associations in eQTL studies

    PubMed Central

    Yang, Tsun-Po; Beazley, Claude; Montgomery, Stephen B.; Dimas, Antigone S.; Gutierrez-Arcelus, Maria; Stranger, Barbara E.; Deloukas, Panos; Dermitzakis, Emmanouil T.

    2010-01-01

    Summary: Genevar (GENe Expression VARiation) is a database and Java tool designed to integrate multiple datasets, and provides analysis and visualization of associations between sequence variation and gene expression. Genevar allows researchers to investigate expression quantitative trait loci (eQTL) associations within a gene locus of interest in real time. The database and application can be installed on a standard computer in database mode and, in addition, on a server to share discoveries among affiliations or the broader community over the Internet via web services protocols. Availability: http://www.sanger.ac.uk/resources/software/genevar Contact: emmanouil.dermitzakis@unige.ch PMID:20702402

  16. Intranet technology in hospital information systems.

    PubMed

    Cimino, J J

    1997-01-01

    The clinical information system architecture at the Columbia-Presbyterian Medical Center in New York is being incorporated into an intranet using Internet and World Wide Web protocols. The result is an Enterprise-Wide Web which provides more flexibility for access to specific patient information and general medical knowledge. Critical aspects of the architecture include a central data repository and a vocabulary server. The new architecture provides ways of displaying patient information in summary, graphical, and multimedia forms. Using customized links called Infobuttons, we provide access to on-line information resources available on the World Wide Web. Our experience to date has raised a number of interesting issues about the use of this technology for health care systems.

  17. A biphasic oxidation of alcohols to aldehydes and ketones using a simplified packed-bed microreactor

    PubMed Central

    Bogdan, Andrew

    2009-01-01

    Summary We demonstrate the preparation and characterization of a simplified packed-bed microreactor using an immobilized TEMPO catalyst shown to oxidize primary and secondary alcohols via the biphasic Anelli-Montanari protocol. Oxidations occurred in high yields with great stability over time. We observed that plugs of aqueous oxidant and organic alcohol entered the reactor as plugs but merged into an emulsion on the packed-bed. The emulsion coalesced into larger plugs upon exiting the reactor, leaving the organic product separate from the aqueous by-products. Furthermore, the microreactor oxidized a wide range of alcohols and remained active in excess of 100 trials without showing any loss of catalytic activity. PMID:19478910

  18. Construction and engineering of large biochemical pathways via DNA assembler

    PubMed Central

    Shao, Zengyi; Zhao, Huimin

    2015-01-01

    Summary DNA assembler enables rapid construction and engineering of biochemical pathways in a one-step fashion by exploitation of the in vivo homologous recombination mechanism in Saccharomyces cerevisiae. It has many applications in pathway engineering, metabolic engineering, combinatorial biology, and synthetic biology. Here we use two examples including the zeaxanthin biosynthetic pathway and the aureothin biosynthetic gene cluster to describe the key steps in the construction of pathways containing multiple genes using the DNA assembler approach. Methods for construct design, pathway assembly, pathway confirmation, and functional analysis are shown. The protocol for fine genetic modifications such as site-directed mutagenesis for engineering the aureothin gene cluster is also illustrated. PMID:23996442

  19. The Center for Space Telemetering and Telecommunications Systems

    NASA Technical Reports Server (NTRS)

    Horan, S.; DeLeon, P.; Borah, D.; Lyman, R.

    2003-01-01

    This report comprises the final technical report for the research grant 'Center for Space Telemetering and Telecommunications Systems' sponsored by the National Aeronautics and Space Administration's Goddard Space Flight Center. The grant activities are broken down into the following technology areas: (1) Space Protocol Testing; (2) Autonomous Reconfiguration of Ground Station Receivers; (3) Satellite Cluster Communications; and (4) Bandwidth Efficient Modulation. The grant activity produced a number of technical reports and papers that were communicated to NASA as they were generated. This final report contains the final summary papers or final technical report conclusions for each of the project areas. Additionally, the grant supported students who made progress towards their degrees while working on the research.

  20. [Myocardial perfusion scintigraphy - short form of the German guideline].

    PubMed

    Lindner, O; Burchert, W; Hacker, M; Schaefer, W; Schmidt, M; Schober, O; Schwaiger, M; vom Dahl, J; Zimmermann, R; Schäfers, M

    2013-01-01

    This guideline is a short summary of the guideline for myocardial perfusion scintigraphy published by the Association of the Scientific Medical Societies in Ger-many (AWMF). The purpose of this guideline is to provide practical assistance for indication and examination procedures as well as image analysis and to present the state-of-the-art of myocardial-perfusion-scintigraphy. After a short introduction on the fundamentals of imaging, precise and detailed information is given on the indications, patient preparation, stress testing, radiopharmaceuticals, examination protocols and techniques, radiation exposure, data reconstruction as well as information on visual and quantitative image analysis and interpretation. In addition possible pitfalls, artefacts and key elements of reporting are described.

  1. Population connectivity of the plating coral Agaricia lamarcki from southwest Puerto Rico

    NASA Astrophysics Data System (ADS)

    Hammerman, Nicholas M.; Rivera-Vicens, Ramon E.; Galaska, Matthew P.; Weil, Ernesto; Appledoorn, Richard S.; Alfaro, Monica; Schizas, Nikolaos V.

    2018-03-01

    Identifying genetic connectivity and discrete population boundaries is an important objective for management of declining Caribbean reef-building corals. A double digest restriction-associated DNA sequencing protocol was utilized to generate 321 single nucleotide polymorphisms to estimate patterns of horizontal and vertical gene flow in the brooding Caribbean plate coral, Agaricia lamarcki. Individual colonies ( n = 59) were sampled from eight locations throughout southwestern Puerto Rico from six shallow ( 10-20 m) and two mesophotic habitats ( 30-40 m). Descriptive summary statistics (fixation index, F ST), analysis of molecular variance, and analysis through landscape and ecological associations and discriminant analysis of principal components estimated high population connectivity with subtle subpopulation structure among all sampling localities.

  2. Summary of Coating Surveys on the Four Air Command Frigates (Zeven Provincien Class) (Onderzoek naar de conditie van de coatingsystemen op vier luchtcommandofregatten (Zeven Provincien Klasse))

    DTIC Science & Technology

    2008-03-26

    of these inspections have been drafted into the following extensive reports for each frigate: * TQS-RAP-07-855/ gge of March 30, 2007 for Hr.Ms...34Evertsen" (LCF 4) * TQS-RAP-07-856/ gge of March 30, 2007 for Hr.Ms. "Tromp" (LCF 2) • TQS-RAP-07-857/ gge of March 30, 2007 for Hr.Ms. "De Ruyter" (LCF 3...34 TQS-RAP-08-3316/ gge of January 10, 2008 for Hr.Ms. -Zeven Provincien" (LCF 1) Each report consists of a description of results and all protocols made

  3. Tests for predicting complications of pre-eclampsia: A protocol for systematic reviews

    PubMed Central

    Thangaratinam, Shakila; Coomarasamy, Arri; Sharp, Steve; O'Mahony, Fidelma; O'Brien, Shaughn; Ismail, Khaled MK; Khan, Khalid S

    2008-01-01

    Background Pre-eclampsia is associated with several complications. Early prediction of complications and timely management is needed for clinical care of these patients to avert fetal and maternal mortality and morbidity. There is a need to identify best testing strategies in pre eclampsia to identify the women at increased risk of complications. We aim to determine the accuracy of various tests to predict complications of pre-eclampsia by systematic quantitative reviews. Method We performed extensive search in MEDLINE (1951–2004), EMBASE (1974–2004) and also will also include manual searches of bibliographies of primary and review articles. An initial search has revealed 19500 citations. Two reviewers will independently select studies and extract data on study characteristics, quality and accuracy. Accuracy data will be used to construct 2 × 2 tables. Data synthesis will involve assessment for heterogeneity and appropriately pooling of results to produce summary Receiver Operating Characteristics (ROC) curve and summary likelihood ratios. Discussion This review will generate predictive information and integrate that with therapeutic effectiveness to determine the absolute benefit and harm of available therapy in reducing complications in women with pre-eclampsia. PMID:18694494

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

    PubMed

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

    2010-06-01

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

  5. Modifications of the G6G timed-AI protocol improved pregnancy per AI and reduced pregnancy loss in lactating dairy cows.

    PubMed

    Heidari, F; Dirandeh, E; Ansari Pirsaraei, Z; Colazo, M G

    2017-11-01

    In dairy cows, subjected to a G6G protocol, objectives were to determine effects of (1) extending the interval from prostaglandin F2α (PGF2α) to gonadotropin-releasing hormone (GnRH) during presynchronization; and (2) adding a second PGF2α treatment before artificial insemination (AI), on ovarian response, plasma progesterone (P4) concentrations and pregnancy per AI (P/AI). In a 2×2 factorial design, lactating cows were randomly assigned to one of four timed AI (TAI) protocols: (1) G6G (n=149), one injection of PGF2α, GnRH 2 days later and a 7-day Ovsynch (GnRH, 7 days, PGF2α, 56 h, GnRH, 16 h, TAI) was initiated 6 days later; (2) G6GP (n=144), an additional PGF2α treatment (24 h after the first) during Ovsynch of the G6G protocol; (3) MG6G, one injection of PGF2α, GnRH 4 days later before initiation of the G6G protocol; and (4) MG6GP, an additional PGF2α treatment (24 h after the first) during Ovsynch of the MG6G protocol. Blood samples were collected (subset of 200 cows) at first GnRH and PGF2α of the Ovsynch, and at TAI to measure P4. Ultrasound examinations were performed in a subset of 406 cows to evaluate ovarian response at various times of Ovsynch, and in all cattle to determine pregnancy status at 32 and 60 days after TAI. Extending the interval by 2 days between PGF2α and GnRH during presynchronization increased (P<0.01) ovulatory response to first GnRH of Ovsynch, circulating P4 during Ovsynch, and P/AI at 32 and 60 days after TAI. Adding a second PGF2α treatment before AI increased the proportion of cows with luteal regression (P=0.04), improved P/AI at 60 days after TAI (P=0.05), and reduced pregnancy loss between 30 and 60 days after TAI (P=0.04). In summary, extending the interval from PGF2α to GnRH during presynchronization increased response to first GnRH of Ovsynch and P4 concentrations during Ovsynch, whereas adding a second PGF2α treatment before AI enhanced luteal regression. Both modifications of the G6G protocol improved fertility in lactating dairy cows.

  6. Aerobic vs. resistance exercise in non-alcoholic fatty liver disease: A systematic review.

    PubMed

    Hashida, Ryuki; Kawaguchi, Takumi; Bekki, Masafumi; Omoto, Masayuki; Matsuse, Hiroo; Nago, Takeshi; Takano, Yoshio; Ueno, Takato; Koga, Hironori; George, Jacob; Shiba, Naoto; Torimura, Takuji

    2017-01-01

    Exercise is a first-line therapy for patients with non-alcoholic fatty liver disease (NAFLD). We sought to: 1) summarize effective aerobic and resistance exercise protocols for NAFLD; and 2) compare the effects and energy consumption of aerobic and resistance exercises. A literature search was performed using PubMed, Web of Science, and Scopas to January 28, 2016. From a total of 95 articles, 23 studies including 24 aerobic and 7 resistance exercise protocols were selected for the summary of exercise protocols. Twelve articles including 13 aerobic and 4 resistance exercise protocols were selected for the comparative analysis. For aerobic exercise, the median effective protocol was 4.8 metabolic equivalents (METs) for 40min/session, 3times/week for 12weeks. For resistance exercise, the median effective protocol was 3.5 METs for 45min/session, 3times/week for 12weeks. Aerobic and resistance exercise improved hepatic steatosis. No significant difference was seen in the duration, frequency, or period of exercise between the two exercise groups; however, %VO 2 max and energy consumption were significantly lower in the resistance than in the aerobic group (50% [45-98] vs. 28% [28-28], p=0.0034; 11,064 [6394-21,087] vs. 6470 [4104-12,310] kcal/total period, p=0.0475). Resistance exercise improves NAFLD with less energy consumption. Thus, resistance exercise may be more feasible than aerobic exercise for NAFLD patients with poor cardiorespiratory fitness or for those who cannot tolerate or participate in aerobic exercise. These data may indicate a possible link between resistance exercise and lipid metabolism in the liver. Both aerobic and resistance exercise reduce hepatic steatosis in non-alcoholic fatty liver disease (NAFLD) with similar frequency, duration, and period of exercise (40-45min/session 3times/week for 12weeks); however, the two forms of exercise have different characteristics. Intensity and energy consumption were significantly lower for resistance than for aerobic exercise. Resistance exercise may be more feasible than aerobic exercise for NAFLD patients with poor cardiorespiratory fitness or for those who cannot tolerate or participate in aerobic exercise. Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  7. Electronic and postal reminders for improving immunisation coverage in children: protocol for a systematic review and meta-analysis.

    PubMed

    Chachou, Martel J; Mukinda, Fidele K; Motaze, Villyen; Wiysonge, Charles S

    2015-10-15

    Worldwide, suboptimal immunisation coverage causes the deaths of more than one million children under five from vaccine-preventable diseases every year. Reasons for suboptimal coverage are multifactorial, and a combination of interventions is needed to improve compliance with immunisation schedules. One intervention relies on reminders, where the health system prompts caregivers to attend immunisation appointments on time or re-engages caregivers who have defaulted on scheduled appointments. We undertake this systematic review to investigate the potential of reminders using emails, phone calls, social media, letters or postcards to improve immunisation coverage in children under five. We will search for published and unpublished randomised controlled trials and non-randomised controlled trials in PubMed, Scopus, CINAHL, CENTRAL, Science Citation Index, WHOLIS, Clinicaltrials.gov and the WHO International Clinical Trials Platform. We will conduct screening of search results, study selection, data extraction and risk-of-bias assessment in duplicate, resolving disagreements by consensus. In addition, we will pool data from clinically homogeneous studies using random-effects meta-analysis; assess heterogeneity of effects using the χ(2) test of homogeneity; and quantify any observed heterogeneity using the I(2) statistic. This protocol does not need approval by an ethics committee because we will use publicly available data, without directly involving human participants. The results will provide updated evidence on the effects of electronic and postal reminders on immunisation coverage, and we will discuss the applicability of the findings to low and middle-income countries. We plan to disseminate review findings through publication in a peer-reviewed journal and presentation at relevant conferences. In addition, we will prepare a policymaker-friendly summary using a validated format (eg, SUPPORT Summary) and disseminate this through social media and email discussion groups. PROSPERO registration number CRD42014012888. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Racism as a determinant of health: a protocol for conducting a systematic review and meta-analysis.

    PubMed

    Paradies, Yin; Priest, Naomi; Ben, Jehonathan; Truong, Mandy; Gupta, Arpana; Pieterse, Alex; Kelaher, Margaret; Gee, Gilbert

    2013-09-23

    Racism is increasingly recognized as a key determinant of health. A growing body of epidemiological evidence shows strong associations between self-reported racism and poor health outcomes across diverse minority groups in developed countries. While the relationship between racism and health has received increasing attention over the last two decades, a comprehensive meta-analysis focused on the health effects of racism has yet to be conducted. The aim of this review protocol is to provide a structure from which to conduct a systematic review and meta-analysis of studies that assess the relationship between racism and health. This research will consist of a systematic review and meta-analysis. Studies will be considered for review if they are empirical studies reporting quantitative data on the association between racism and health for adults and/or children of all ages from any racial/ethnic/cultural groups. Outcome measures will include general health and well-being, physical health, mental health, healthcare use and health behaviors. Scientific databases (for example, Medline) will be searched using a comprehensive search strategy and reference lists will be manually searched for relevant studies. In addition, use of online search engines (for example, Google Scholar), key websites, and personal contact with experts will also be undertaken. Screening of search results and extraction of data from included studies will be independently conducted by at least two authors, including assessment of inter-rater reliability. Studies included in the review will be appraised for quality using tools tailored to each study design. Summary statistics of study characteristics and findings will be compiled and findings synthesized in a narrative summary as well as a meta-analysis. This review aims to examine associations between reported racism and health outcomes. This comprehensive and systematic review and meta-analysis of empirical research will provide a rigorous and reliable evidence base for future research, policy and practice, including information on the extent of available evidence for a range of racial/ethnic minority groups.

  9. Cryobanking of aquatic species.

    PubMed

    Martínez-Páramo, Sonia; Horváth, Ákos; Labbé, Catherine; Zhang, Tiantian; Robles, Vanesa; Herráez, Paz; Suquet, Marc; Adams, Serean; Viveiros, Ana; Tiersch, Terrence R; Cabrita, Elsa

    2017-04-01

    This review is focused on the applications of genome cryobanking of aquatic species including freshwater and marine fish, as well as invertebrates. It also reviews the latest advances in cryobanking of model species, widely used by the scientific community worldwide, because of their applications in several fields. The state of the art of cryopreservation of different cellular types (sperm, oocytes, embryos, somatic cells and primordial germ cells or early spermatogonia) is discussed focusing on the advantages and disadvantages of each procedure according to different applications. A special review on the need of standardization of protocols has also been carried out. In summary, this comprehensive review provides information on the practical details of applications of genome cryobanking in a range of aquatic species worldwide, including the cryobanks established in Europe, USA, Brazil, Australia and New Zealand, the species and type of cells that constitute these banks and the utilization of the samples preserved. This review compiles the last advances on germplasm cryobanking of freshwater and marine fish species and invertebrates, with high value for commercial aquaculture or conservation. It is reviewed the most promising cryopreservation protocols for different cell types, embryos and larvae that could be applied in programs for genetic improvement, broodstock management or conservation of stocks to guarantee culture production.

  10. The application of the comet assay to assess the genotoxicity of environmental pollutants in the nematode Caenorhabditis elegans.

    PubMed

    Imanikia, Soudabeh; Galea, Francesca; Nagy, Eszter; Phillips, David H; Stürzenbaum, Stephen R; Arlt, Volker M

    2016-07-01

    This study aimed to establish a protocol for cell dissociation from the nematode Caenorhabditis elegans (C. elegans) to assess the genotoxicity of the environmental pollutant benzo[a]pyrene (BaP) using the alkaline version of the single cell electrophoresis assay (comet assay). BaP genotoxicity was assessed in C. elegans (wild-type [WT]; N2, Bristol) after 48h exposure (0-40μM). Induction of comets by BaP was concentration-dependent up to 20μM; comet% tail DNA was ∼30% at 20μM BaP and ∼10% in controls. Similarly, BaP-induced DNA damage was evaluated in C. elegans mutant strains deficient in DNA repair. In xpa-1 and apn-1 mutants BaP-induced comet formation was diminished to WT background levels suggesting that the damage formed by BaP that is detected in the comet assay is not recognised in cells deficient in nucleotide and base excision repair, respectively. In summary, our study provides a protocol to evaluate DNA damage of environmental pollutants in whole nematodes using the comet assay. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

  11. Design of Secure and Lightweight Authentication Protocol for Wearable Devices Environment.

    PubMed

    Das, Ashok Kumar; Wazid, Mohammad; Kumar, Neeraj; Khan, Muhammad Khurram; Choo, Kim-Kwang Raymond; Park, YoungHo

    2017-09-18

    Wearable devices are used in various applications to collect information including step information, sleeping cycles, workout statistics, and health related information. Due to the nature and richness of the data collected by such devices, it is important to ensure the security of the collected data. This paper presents a new lightweight authentication scheme suitable for wearable device deployment. The scheme allows a user to mutually authenticate his/her wearable device(s) and the mobile terminal (e.g., Android and iOS device) and establish a session key among these devices (worn and carried by the same user) for secure communication between the wearable device and the mobile terminal. The security of the proposed scheme is then demonstrated through the broadly-accepted Real-Or-Random model, as well as using the popular formal security verification tool, known as the Automated Validation of Internet Security Protocols and Applications (AVISPA). Finally, we present a comparative summary of the proposed scheme in terms of the overheads such as computation and communication costs, security and functionality features of the proposed scheme and related schemes, and also the evaluation findings from the NS2 simulation.

  12. Pediatric Sepsis

    PubMed Central

    Mathias, Brittany; Mira, Juan; Larson, Shawn D.

    2016-01-01

    Purpose of Review Sepsis is the leading cause of pediatric death worldwide. In the United States alone, there are 72,000 children hospitalized for sepsis annually with a reported mortality rate of 25% and an economic cost estimated to be $4.8 billion. However, it is only recently that the definition and management of pediatric sepsis has been recognized as being distinct from adult sepsis. Recent Findings The definition of pediatric sepsis is currently in a state of evolution and there is a large disconnect between the clinical and research definitions of sepsis which impacts the application of research findings into clinical practice. Despite this, it is the speed of diagnosis and the timely implementation of current treatment guidelines that has been shown to improve outcomes. However, adherence to treatment guidelines is currently low and it is only through the implementation of protocols that improved care and outcomes have been demonstrated. Summary Current management of pediatric sepsis is largely based on adaptations from adult sepsis treatment; however, distinct physiology demands more prospective pediatric trials to tailor management to the pediatric population. Adherence to current and emerging practice guidelines will require that protocolized care pathways become commonplace. PMID:26983000

  13. Using an intervention mapping approach to develop a discharge protocol for intensive care patients.

    PubMed

    van Mol, Margo; Nijkamp, Marjan; Markham, Christine; Ista, Erwin

    2017-12-19

    Admission into an intensive care unit (ICU) may result in long-term physical, cognitive, and emotional consequences for patients and their relatives. The care of the critically ill patient does not end upon ICU discharge; therefore, integrated and ongoing care during and after transition to the follow-up ward is pivotal. This study described the development of an intervention that responds to this need. Intervention Mapping (IM), a six-step theory- and evidence-based approach, was used to guide intervention development. The first step, a problem analysis, comprised a literature review, six semi-structured telephone interviews with former ICU-patients and their relatives, and seven qualitative roundtable meetings for all eligible nurses (i.e., 135 specialized and 105 general ward nurses). Performance and change objectives were formulated in step two. In step three, theory-based methods and practical applications were selected and directed at the desired behaviors and the identified barriers. Step four designed a revised discharge protocol taking into account existing interventions. Adoption, implementation and evaluation of the new discharge protocol (IM steps five and six) are in progress and were not included in this study. Four former ICU patients and two relatives underlined the importance of the need for effective discharge information and supportive written material. They also reported a lack of knowledge regarding the consequences of ICU admission. 42 ICU and 19 general ward nurses identified benefits and barriers regarding discharge procedures using three vignettes framed by literature. Some discrepancies were found. For example, ICU nurses were skeptical about the impact of writing a lay summary despite extensive evidence of the known benefits for the patients. ICU nurses anticipated having insufficient skills, not knowing the patient well enough, and fearing legal consequences of their writings. The intervention was designed to target the knowledge, attitudes, self-efficacy, and perceived social influence. Building upon IM steps one to three, a concept discharge protocol was developed that is relevant and feasible within current daily practice. Intervention mapping provided a comprehensive framework to improve ICU discharge by guiding the development process of a theory- and empirically-based discharge protocol that is robust and useful in practice.

  14. A cluster randomised controlled trial of advice, exercise or multifactorial assessment to prevent falls and fractures in community-dwelling older adults: protocol for the prevention of falls injury trial (PreFIT)

    PubMed Central

    Lall, Ranjit; Withers, Emma J; Finnegan, Susanne; Underwood, Martin; Hulme, Claire; Sheridan, Ray; Skelton, Dawn A; Martin, Finbarr; Lamb, Sarah E

    2016-01-01

    Introduction Falls are the leading cause of accident-related mortality in older adults. Injurious falls are associated with functional decline, disability, healthcare utilisation and significant National Health Service (NHS)-related costs. The evidence base for multifactorial or exercise interventions reducing fractures in the general population is weak. This protocol describes a large-scale UK trial investigating the clinical and cost-effectiveness of alternative falls prevention interventions targeted at community dwelling older adults. Methods and analysis A three-arm, pragmatic, cluster randomised controlled trial, conducted within primary care in England, UK. Sixty-three general practices will be randomised to deliver one of three falls prevention interventions: (1) advice only; (2) advice with exercise; or (3) advice with multifactorial falls prevention (MFFP). We aim to recruit over 9000 community-dwelling adults aged 70 and above. Practices randomised to deliver advice will mail out advice booklets. Practices randomised to deliver ‘active’ interventions, either exercise or MFFP, send all trial participants the advice booklet and a screening survey to identify participants with a history of falling or balance problems. Onward referral to ‘active’ intervention will be based on falls risk determined from balance screen. The primary outcome is peripheral fracture; secondary outcomes include number with at least one fracture, falls, mortality, quality of life and health service resource use at 18 months, captured using self-report and routine healthcare activity data. Ethics and dissemination The study protocol has approval from the National Research Ethics Service (REC reference 10/H0401/36; Protocol V.3.1, 21/May/2013). User groups and patient representatives were consulted to inform trial design. Results will be reported at conferences and in peer-reviewed publications. A patient-friendly summary of trial findings will be published on the prevention of falls injury trial (PreFIT) website. This protocol adheres to the recommended SPIRIT Checklist. Amendments will be reported to relevant regulatory parties. Trial registration number ISRCTN 71002650; Pre-results. PMID:26781504

  15. A cluster randomised controlled trial of advice, exercise or multifactorial assessment to prevent falls and fractures in community-dwelling older adults: protocol for the prevention of falls injury trial (PreFIT).

    PubMed

    Bruce, Julie; Lall, Ranjit; Withers, Emma J; Finnegan, Susanne; Underwood, Martin; Hulme, Claire; Sheridan, Ray; Skelton, Dawn A; Martin, Finbarr; Lamb, Sarah E

    2016-01-18

    Falls are the leading cause of accident-related mortality in older adults. Injurious falls are associated with functional decline, disability, healthcare utilisation and significant National Health Service (NHS)-related costs. The evidence base for multifactorial or exercise interventions reducing fractures in the general population is weak. This protocol describes a large-scale UK trial investigating the clinical and cost-effectiveness of alternative falls prevention interventions targeted at community dwelling older adults. A three-arm, pragmatic, cluster randomised controlled trial, conducted within primary care in England, UK. Sixty-three general practices will be randomised to deliver one of three falls prevention interventions: (1) advice only; (2) advice with exercise; or (3) advice with multifactorial falls prevention (MFFP). We aim to recruit over 9000 community-dwelling adults aged 70 and above. Practices randomised to deliver advice will mail out advice booklets. Practices randomised to deliver 'active' interventions, either exercise or MFFP, send all trial participants the advice booklet and a screening survey to identify participants with a history of falling or balance problems. Onward referral to 'active' intervention will be based on falls risk determined from balance screen. The primary outcome is peripheral fracture; secondary outcomes include number with at least one fracture, falls, mortality, quality of life and health service resource use at 18 months, captured using self-report and routine healthcare activity data. The study protocol has approval from the National Research Ethics Service (REC reference 10/H0401/36; Protocol V.3.1, 21/May/2013). User groups and patient representatives were consulted to inform trial design. Results will be reported at conferences and in peer-reviewed publications. A patient-friendly summary of trial findings will be published on the prevention of falls injury trial (PreFIT) website. This protocol adheres to the recommended SPIRIT Checklist. Amendments will be reported to relevant regulatory parties. ISRCTN 71002650; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Comparison of Water Years 2004-05 and Historical Water-Quality Data, Upper Gunnison River Basin, Colorado

    USGS Publications Warehouse

    Spahr, Norman E.; Hartle, David M.; Diaz, Paul

    2008-01-01

    Population growth and changes in land use have the potential to affect water quality and quantity in the upper Gunnison River Basin. In 1995, the U.S. Geological Survey (USGS), in cooperation with the Bureau of Land Management, City of Gunnison, Colorado River Water Conservation District, Crested Butte South Metropolitan District, Gunnison County, Hinsdale County, Mount Crested Butte Water and Sanitation District, National Park Service, Town of Crested Butte, Upper Gunnison River Water Conservancy District, and Western State College, established a water-quality monitoring program in the upper Gunnison River Basin to characterize current water-quality conditions and to assess the effects of increased urban development and other land-use changes on water quality. The monitoring network has evolved into two groups of stations - stations that are considered long term and stations that are considered rotational. The long-term stations are monitored to assist in defining temporal changes in water quality (how conditions may change over time). The rotational stations are monitored to assist in the spatial definition of water-quality conditions (how conditions differ throughout the basin) and to address local and short-term concerns. Some stations in the rotational group were changed beginning in water year 2007. Annual summaries of the water-quality data from the monitoring network provide a point of reference for discussions regarding water-quality monitoring in the upper Gunnison River Basin. This summary includes data collected during water years 2004 and 2005. The introduction provides a map of the sampling sites, definitions of terms, and a one-page summary of selected water-quality conditions at the network stations. The remainder of the summary is organized around the data collected at individual stations. Data collected during water years 2004 and 2005 are compared to historical data, State water-quality standards, and Federal water-quality guidelines. Data were collected following USGS protocols.

  17. Comparison of 2002 Water Year and Historical Water-Quality Data, Upper Gunnison River Basin, Colorado

    USGS Publications Warehouse

    Spahr, N.E.

    2003-01-01

    Introduction: Population growth and changes in land-use practices have the potential to affect water quality and quantity in the upper Gunnison River basin. In 1995, the U.S. Geological Survey (USGS), in cooperation with local sponsors, City of Gunnison, Colorado River Water Conservation District, Crested Butte South Metropolitan District, Gunnison County, Mount Crested Butte Water and Sanitation District, National Park Service, Town of Crested Butte, and Upper Gunnison River Water Conservancy District, established a water-quality monitoring program in the upper Gunnison River basin to characterize current water-quality conditions and to assess the effects of increased urban development and other land-use changes on water quality. The monitoring network has evolved into two groups of stations, stations that are considered as long term and stations that are rotational. The long-term stations are monitored to assist in defining temporal changes in water quality (how conditions have changed over time). The rotational stations are monitored to assist in the spatial definition of water-quality conditions (how conditions differ throughout the basin) and to address local and short term concerns. Another group of stations (rotational group 2) will be chosen and sampled beginning in water year 2004. Annual summaries of the water-quality data from the monitoring network provide a point of reference for discussions regarding water-quality sampling in the upper Gunnison River basin. This summary includes data collected during water year 2002. The introduction provides a map of the sampling locations, definitions of terms, and a one-page summary of selected water-quality conditions at the network stations. The remainder of the summary is organized around the data collected at individual stations. Data collected during water year 2002 are compared to historical data (data collected for this network since 1995), state water-quality standards, and federal water-quality guidelines. Data were collected during water year 2002 following USGS protocols (U.S. Geological Survey, variously dated).

  18. Comparison of 2006-2007 Water Years and Historical Water-Quality Data, Upper Gunnison River Basin, Colorado

    USGS Publications Warehouse

    Solberg, P.A.; Moore, Bryan; Smits, Dennis

    2009-01-01

    Population growth and changes in land use have the potential to affect water quality and quantity in the upper Gunnison River basin. In 1995, the U.S. Geological Survey (USGS), in cooperation with the Bureau of Land Management, City of Gunnison, Colorado River Water Conservation District, Crested Butte South Metropolitan District, Gunnison County, Hinsdale County, Mount Crested Butte Water and Sanitation District, National Park Service, Town of Crested Butte, Upper Gunnison River Water Conservancy District, and Western State College established a water-quality monitoring program in the upper Gunnison River basin to characterize current water-quality conditions and to assess the effects of increased urban development and other land-use changes on water quality. The monitoring network has evolved into two groups of stations - stations that are considered long term and stations that are considered rotational. The long-term stations are monitored to assist in defining temporal changes in water quality (how conditions may change over time). The rotational stations are monitored to assist in the spatial definition of water-quality conditions (how conditions differ throughout the basin) and to address local and short-term concerns. Some stations in the rotational group were changed beginning in water year 2007. Annual summaries of the water-quality data from the monitoring network provide a point of reference for discussions regarding water-quality monitoring in the upper Gunnison River basin. This summary includes data collected during water years 2006 and 2007. The introduction provides a map of the sampling sites, definitions of terms, and a one-page summary of selected water-quality conditions at the network stations. The remainder of the summary is organized around the data collected at individual stations. Data collected during water years 2006 and 2007 are compared to historical data, State water-quality standards, and Federal water-quality guidelines. Data were collected following USGS protocols (U.S. Geological Survey, variously dated).

  19. Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC): a cluster randomised controlled trial.

    PubMed

    Middleton, Sandy; McElduff, Patrick; Ward, Jeanette; Grimshaw, Jeremy M; Dale, Simeon; D'Este, Catherine; Drury, Peta; Griffiths, Rhonda; Cheung, N Wah; Quinn, Clare; Evans, Malcolm; Cadilhac, Dominique; Levi, Christopher

    2011-11-12

    We assessed patient outcomes 90 days after hospital admission for stroke following a multidisciplinary intervention targeting evidence-based management of fever, hyperglycaemia, and swallowing dysfunction in acute stroke units (ASUs). In the Quality in Acute Stroke Care (QASC) study, a single-blind cluster randomised controlled trial, we randomised ASUs (clusters) in New South Wales, Australia, with immediate access to CT and on-site high dependency units, to intervention or control group. Patients were eligible if they spoke English, were aged 18 years or older, had had an ischaemic stroke or intracerebral haemorrhage, and presented within 48 h of onset of symptoms. Intervention ASUs received treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction with multidisciplinary team building workshops to address implementation barriers. Control ASUs received only an abridged version of existing guidelines. We recruited pre-intervention and post-intervention patient cohorts to compare 90-day death or dependency (modified Rankin scale [mRS] ≥2), functional dependency (Barthel index), and SF-36 physical and mental component summary scores. Research assistants, the statistician, and patients were masked to trial groups. All analyses were done by intention to treat. This trial is registered at the Australia New Zealand Clinical Trial Registry (ANZCTR), number ACTRN12608000563369. 19 ASUs were randomly assigned to intervention (n=10) or control (n=9). Of 6564 assessed for eligibility, 1696 patients' data were obtained (687 pre-intervention; 1009 post-intervention). Results showed that, irrespective of stroke severity, intervention ASU patients were significantly less likely to be dead or dependent (mRS ≥2) at 90 days than control ASU patients (236 [42%] of 558 patients in the intervention group vs 259 [58%] of 449 in the control group, p=0·002; number needed to treat 6·4; adjusted absolute difference 15·7% [95% CI 5·8-25·4]). They also had a better SF-36 mean physical component summary score (45·6 [SD 10·2] in the intervention group vs 42·5 [10·5] in the control group, p=0·002; adjusted absolute difference 3·4 [95% CI 1·2-5·5]) but no improvement was recorded in mortality (21 [4%] of 558 in intervention group and 24 [5%] of 451 in the control group, p=0·36), SF-36 mean mental component summary score (49·5 [10·9] in the intervention group vs 49·4 [10·6] in the control group, p=0·69) or functional dependency (Barthel Index ≥60: 487 [92%] of 532 patients vs 380 [90%] of 423 patients; p=0·44). Implementation of multidisciplinary supported evidence-based protocols initiated by nurses for the management of fever, hyperglycaemia, and swallowing dysfunction delivers better patient outcomes after discharge from stroke units. Our findings show the possibility to augment stroke unit care. National Health & Medical Research Council ID 353803, St Vincent's Clinic Foundation, the Curran Foundation, Australian Diabetes Society-Servier, the College of Nursing, and Australian Catholic University. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Thin film femtosecond laser damage competition

    NASA Astrophysics Data System (ADS)

    Stolz, Christopher J.; Ristau, Detlev; Turowski, Marcus; Blaschke, Holger

    2009-10-01

    In order to determine the current status of thin film laser resistance within the private, academic, and government sectors, a damage competition was started at the 2008 Boulder Damage Symposium. This damage competition allows a direct comparison of the current state of the art of high laser resistance coatings since they are tested using the same damage test setup and the same protocol. In 2009 a high reflector coating was selected at a wavelength of 786 nm at normal incidence at a pulse length of 180 femtoseconds. A double blind test assured sample and submitter anonymity so only a summary of the results are presented here. In addition to the laser resistance results, details of deposition processes, coating materials and layer count, and spectral results will also be shared.

  1. BDS thin film damage competition

    NASA Astrophysics Data System (ADS)

    Stolz, Christopher J.; Thomas, Michael D.; Griffin, Andrew J.

    2008-10-01

    A laser damage competition was held at the 2008 Boulder Damage Symposium in order to determine the current status of thin film laser resistance within the private, academic, and government sectors. This damage competition allows a direct comparison of the current state-of-the-art of high laser resistance coatings since they are all tested using the same damage test setup and the same protocol. A normal incidence high reflector multilayer coating was selected at a wavelength of 1064 nm. The substrates were provided by the submitters. A double blind test assured sample and submitter anonymity so only a summary of the results are presented here. In addition to the laser resistance results, details of deposition processes, coating materials, and layer count will also be shared.

  2. Vectorology and Factor Delivery in Induced Pluripotent Stem Cell Reprogramming

    PubMed Central

    2014-01-01

    Induced pluripotent stem cell (iPSC) reprogramming requires sustained expression of multiple reprogramming factors for a limited period of time (10–30 days). Conventional iPSC reprogramming was achieved using lentiviral or simple retroviral vectors. Retroviral reprogramming has flaws of insertional mutagenesis, uncontrolled silencing, residual expression and re-activation of transgenes, and immunogenicity. To overcome these issues, various technologies were explored, including adenoviral vectors, protein transduction, RNA transfection, minicircle DNA, excisable PiggyBac (PB) transposon, Cre-lox excision system, negative-sense RNA replicon, positive-sense RNA replicon, Epstein-Barr virus-based episomal plasmids, and repeated transfections of plasmids. This review provides summaries of the main vectorologies and factor delivery systems used in current reprogramming protocols. PMID:24625220

  3. Feasibility of dynamic models of the interaction of potential oil spills with bowhead and gray whales in the Bering, Chukchi, and Beaufort Seas

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

    Reed, M.; Bowles, A.E.; Anderson, E.L.

    1984-08-01

    Feasibility and design considerations for developing computer models of migratory bow-head and gray whales and linking such models to oil spill models for application in Alaskan Outer Continental Shelf areas were evaluated. A summary of all relevant bowhead and gray whale distributional and migration data were summarized and presented at monthly intervals. The data were, for the most part, deemed sufficient to prepare whale migration simulation models. A variety of whale migration conceptual models were devised and ranking was achieved by means of a scaling-weighted protocol. Existing oil spill trajectory and fate models, as well as conceptual models, were similarlymore » ranked.« less

  4. Groin pain syndrome: an association of different pathologies and a case presentation

    PubMed Central

    Bisciotti, Gian Nicola; Auci, Alessio; Di Marzo, Francesco; Galli, Roberto; Pulici, Luca; Carimati, Giulia; Quaglia, Alessandro; Volpi, Piero

    2015-01-01

    Summary Background groin pain affects all types of athletes, especially soccer players. Many diseases with different etiologies may cause groin pain. Purpose offer a mini review of groin pain in soccer accompanied by the presentation of a case report highlighting the possible association of more clinical frameworks into the onset of groin pain syndrome, in order to recommend that clinical evaluations take into account possible associations between bone, muscle and tendon such as inguinal canal disease. Conclusion the multifactorial etiology of groin pain syndrome needs to be examined with a comprehensive approach, with standardized clinical evaluation based on an imaging protocol in order to evaluate all possible diseases. Study design Mini review- Case report (Level V). PMID:26605198

  5. Adaptive harvest management: Adjustments for SEIS 2013

    USGS Publications Warehouse

    Boomer, Scott; Johnson, Fred A.; Zimmerman, Guthrie S.

    2015-01-01

    This report provides a summary of revised methods and assessment results based on updated adaptive harvest management (AHM) protocols developed in response to the preferred alternative specified in the Final Supplemental Environmental Impact Statement on the Issuance of Annual Regulations Permitting the Hunting of Migratory Birds (SEIS; U.S. Department of the Interior 2013). We describe necessary changes to optimization procedures and decision processes for the implementation of AHM for midcontinent, eastern and western mallards (Anas platyrhynchos), northern pintails (Anas acuta), and scaup (Aythya affinis, A. marila) decision frameworks. We present this final report for communication purposes, and acknowledge that any use of trade, firm, or product names is for descriptive purposes only and does not imply endorsement by the U.S. Government.

  6. Les Protheses d'Expansion dans le Traitement des Sequelles de Brulures

    PubMed Central

    Tourabi, K.; Ribag, Y.; Arrob, A.; Moussaoui, A.; Ihrai, H.

    2010-01-01

    Summary Les Auteurs présentent leur protocole pour l'expansion cutanée et rapportent quatre cas colligés au service des brûlures de leur hôpital au Maroc. Ils décrivent leur technique opératoire et les résultats obtenus. L'expansion cutanée reste la méthode de choix pour la couverture des pertes de substance étendues et la correction des séquelles de brûlure, et l'expérience rapportée par les Auteurs confirme les bons résultats que l'on peut obtenir avec cette technique, y compris les résultats esthétiques. PMID:21991194

  7. An integrative review of Reiki touch therapy research.

    PubMed

    Vitale, Anne

    2007-01-01

    Reiki touch therapy is a complementary biofield energy therapy that involves the use of hands to help strengthen the body's ability to heal. There is growing interest among nurses to use Reiki in patient care and as a self-care treatment, however, with little supportive empirical research and evidence to substantiate these practices. The purpose of this integrative review is to begin the systematic process of evaluating the findings of published Reiki research. Selected investigations using Reiki for effects on stress, relaxation, depression, pain, and wound healing management, among others is reviewed and summarized. A summary of Reiki studies table illustrates the study descriptions and Reiki treatment protocols specified in the investigations. Synthesis of findings for clinical practice and implications for future research are explored.

  8. INEL BNCT Research Program, March/April 1992

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

    Venhuizen, J.R.

    1992-09-01

    This report presents summaries for two months of current research for the Idaho National Engineering Laboratory (INEL) Boron Neutron Capture Therapy (BNCT) Program. Information is presented on development and murino screening experiments of low-density lipoprotein, carboranyl alanine, and liposome boron containing compounds. Pituitary tumor call culture studies are described. Drug stability, pharmacology and toxicity evaluation of borocaptate sodium (BSH) and boronopheoylalanine (BPA) are described. Treatment protocol development via the large animal (canine) model studies and physiological response evaluation in rats are discussed. Supporting technology development and technical support activities for boron drug biochemistry and purity, analytical and measurement dosimetry, andmore » noninvasive boron quantification activities are included for the current time period. Current publications for the two months are listed.« less

  9. Integrating human impacts and ecological integrity into a risk-based protocol for conservation planning

    USGS Publications Warehouse

    Mattson, K.M.; Angermeier, P.L.

    2007-01-01

    Conservation planning aims to protect biodiversity by sustainng the natural physical, chemical, and biological processes within representative ecosystems. Often data to measure these components are inadequate or unavailable. The impact of human activities on ecosystem processes complicates integrity assessments and might alter ecosystem organization at multiple spatial scales. Freshwater conservation targets, such as populations and communities, are influenced by both intrinsic aquatic properties and the surrounding landscape, and locally collected data might not accurately reflect potential impacts. We suggest that changes in five major biotic drivers-energy sources, physical habitat, flow regime, water quality, and biotic interactions-might be used as surrogates to inform conservation planners of the ecological integrity of freshwater ecosystems. Threats to freshwater systems might be evaluated based on their impact to these drivers to provide an overview of potential risk to conservation targets. We developed a risk-based protocol, the Ecological Risk Index (ERI), to identify watersheds with least/most risk to conservation targets. Our protocol combines risk-based components, specifically the frequency and severity of human-induced stressors, with biotic drivers and mappable land- and water-use data to provide a summary of relative risk to watersheds. We illustrate application of our protocol with a case study of the upper Tennessee River basin, USA. Differences in risk patterns among the major drainages in the basin reflect dominant land uses, such as mining and agriculture. A principal components analysis showed that localized, moderately severe threats accounted for most of the threat composition differences among our watersheds. We also found that the relative importance of threats is sensitive to the spatial grain of the analysis. Our case study demonstrates that the ERI is useful for evaluating the frequency and severity of ecosystemwide risk, which can inform local and regional conservation planning. ?? 2006 Springer Science+Business Media, Inc.

  10. MPLEx: a Robust and Universal Protocol for Single-Sample Integrative Proteomic, Metabolomic, and Lipidomic Analyses

    PubMed Central

    Nakayasu, Ernesto S.; Nicora, Carrie D.; Sims, Amy C.; Burnum-Johnson, Kristin E.; Kim, Young-Mo; Kyle, Jennifer E.; Matzke, Melissa M.; Shukla, Anil K.; Chu, Rosalie K.; Schepmoes, Athena A.; Jacobs, Jon M.; Baric, Ralph S.; Webb-Robertson, Bobbie-Jo; Smith, Richard D.

    2016-01-01

    ABSTRACT Integrative multi-omics analyses can empower more effective investigation and complete understanding of complex biological systems. Despite recent advances in a range of omics analyses, multi-omic measurements of the same sample are still challenging and current methods have not been well evaluated in terms of reproducibility and broad applicability. Here we adapted a solvent-based method, widely applied for extracting lipids and metabolites, to add proteomics to mass spectrometry-based multi-omics measurements. The metabolite, protein, and lipid extraction (MPLEx) protocol proved to be robust and applicable to a diverse set of sample types, including cell cultures, microbial communities, and tissues. To illustrate the utility of this protocol, an integrative multi-omics analysis was performed using a lung epithelial cell line infected with Middle East respiratory syndrome coronavirus, which showed the impact of this virus on the host glycolytic pathway and also suggested a role for lipids during infection. The MPLEx method is a simple, fast, and robust protocol that can be applied for integrative multi-omic measurements from diverse sample types (e.g., environmental, in vitro, and clinical). IMPORTANCE In systems biology studies, the integration of multiple omics measurements (i.e., genomics, transcriptomics, proteomics, metabolomics, and lipidomics) has been shown to provide a more complete and informative view of biological pathways. Thus, the prospect of extracting different types of molecules (e.g., DNAs, RNAs, proteins, and metabolites) and performing multiple omics measurements on single samples is very attractive, but such studies are challenging due to the fact that the extraction conditions differ according to the molecule type. Here, we adapted an organic solvent-based extraction method that demonstrated broad applicability and robustness, which enabled comprehensive proteomics, metabolomics, and lipidomics analyses from the same sample. Author Video: An author video summary of this article is available. PMID:27822525

  11. In vitro culturing and live imaging of Drosophila egg chambers: A history and adaptable method

    PubMed Central

    Peters, Nathaniel C.; Berg, Celeste A.

    2017-01-01

    Summary/Abstract The development of the Drosophila egg chamber encompasses a myriad of diverse germline and somatic events, and as such, the egg chamber has become a widely used and influential developmental model. Advantages of this system include physical accessibility, genetic tractability, and amenability to microscopy and live culturing, the last of which is the focus of this chapter. To provide adequate context, we summarize the structure of the Drosophila ovary and egg chamber, the morphogenetic events of oogenesis, the history of egg-chamber live culturing, and many of the important discoveries that this culturing has afforded. Subsequently, we discuss various culturing methods that have facilitated analyses of different stages of egg-chamber development and different types of cells within the egg chamber, and we present an optimized protocol for live culturing Drosophila egg chambers. We designed this protocol for culturing late-stage Drosophila egg chambers and live imaging epithelial tube morphogenesis, but with appropriate modifications it can be used to culture egg chambers of any stage. The protocol employs a liquid-permeable, weighted, “blanket” to gently hold egg chambers against the coverslip in a glass-bottomed culture dish so the egg chambers can be imaged on an inverted microscope. This setup provides a more buffered, stable culturing environment than previously published methods by using a larger volume of culture media, but the setup is also compatible with small volumes. This chapter should aid researchers in their efforts to culture and live image Drosophila egg chambers, further augmenting the impressive power of this model system. PMID:27557572

  12. An Overview and Empirical Comparison of Distance Metric Learning Methods.

    PubMed

    Moutafis, Panagiotis; Leng, Mengjun; Kakadiaris, Ioannis A

    2016-02-16

    In this paper, we first offer an overview of advances in the field of distance metric learning. Then, we empirically compare selected methods using a common experimental protocol. The number of distance metric learning algorithms proposed keeps growing due to their effectiveness and wide application. However, existing surveys are either outdated or they focus only on a few methods. As a result, there is an increasing need to summarize the obtained knowledge in a concise, yet informative manner. Moreover, existing surveys do not conduct comprehensive experimental comparisons. On the other hand, individual distance metric learning papers compare the performance of the proposed approach with only a few related methods and under different settings. This highlights the need for an experimental evaluation using a common and challenging protocol. To this end, we conduct face verification experiments, as this task poses significant challenges due to varying conditions during data acquisition. In addition, face verification is a natural application for distance metric learning because the encountered challenge is to define a distance function that: 1) accurately expresses the notion of similarity for verification; 2) is robust to noisy data; 3) generalizes well to unseen subjects; and 4) scales well with the dimensionality and number of training samples. In particular, we utilize well-tested features to assess the performance of selected methods following the experimental protocol of the state-of-the-art database labeled faces in the wild. A summary of the results is presented along with a discussion of the insights obtained and lessons learned by employing the corresponding algorithms.

  13. pROC-Chemotype Plots Enhance the Interpretability of Benchmarking Results in Structure-Based Virtual Screening.

    PubMed

    Ibrahim, Tamer M; Bauer, Matthias R; Dörr, Alexander; Veyisoglu, Erdem; Boeckler, Frank M

    2015-11-23

    Recently, we have reported a systematic comparison of molecular preparation protocols (using MOE or Maestro) in combination with two docking tools (GOLD or Glide), employing our DEKOIS 2.0 benchmark sets. Herein, we demonstrate how comparable settings of data preparation protocols can affect the profile and AUC of pROC curves based on variations in chemotype enrichment. We show how the recognition of different classes of chemotypes can affect the docking performance, particularly in the early enrichment, and monitor changes in this recognition behavior based on score normalization and rescoring strategies. For this, we have developed "pROC-Chemotype", which is an automated protocol that matches and visualizes ligand chemotype information together with potency classes in the pROC profiles obtained by docking. This tool enhances the understanding of the influence of chemotype recognition in early enrichment, but also reveals trends of impaired recognition of chemotype classes at the end of the score-ordered rank. Identifying such issues helps to devise score-normalization strategies to overcome this potential bias in an intuitive manner. Furthermore, strong perturbations in chemotype ranking between different methods can help to identify the underlying reasons (e.g., changes in the protonation/tautomerization state). It also assists in the selection of appropriate scoring functions that are capable to retrieve more potent and diverse hits. In summary, we demonstrate how this new tool can be utilized to identify and highlight chemotype-specific behavior, e.g., in dataset preparation. This can help to overcome some chemistry-related bias in virtual screening campaigns. pROC-Chemotype is made freely available at www.dekois.com.

  14. Exacerbated experimental autoimmune encephalomyelitis in mast-cell-deficient Kit W-sh/W-sh mice.

    PubMed

    Piconese, Silvia; Costanza, Massimo; Musio, Silvia; Tripodo, Claudio; Poliani, Pietro L; Gri, Giorgia; Burocchi, Alessia; Pittoni, Paola; Gorzanelli, Andrea; Colombo, Mario P; Pedotti, Rosetta

    2011-04-01

    Mast cell (MC)-deficient c-Kit mutant Kit(W/W-v) mice are protected against experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis, suggesting a detrimental role for MCs in this disease. To further investigate the role of MCs in EAE, we took advantage of a recently characterized model of MC deficiency, Kit(W-sh/W-sh). Surprisingly, we observed that myelin oligodendrocyte glycoprotein (MOG)(35-55)-induced chronic EAE was exacerbated in Kit(W-sh/W-sh) compared with Kit(+/+) mice. Kit(W-sh/W-sh) mice showed more inflammatory foci in the central nervous system (CNS) and increased T-cell response against myelin. To understand whether the discrepant results obtained in Kit(W-sh/W-sh) and in Kit(W/W-v) mice were because of the different immunization protocols, we induced EAE in these two strains with varying doses of MOG(35-55) and adjuvants. Although Kit(W-sh/W-sh) mice exhibited exacerbated EAE under all immunization protocols, Kit(W/W-v) mice were protected from EAE only when immunized with high, but not low, doses of antigen and adjuvants. Kit(W-sh/W-sh) mice reconstituted systemically, but not in the CNS, with bone marrow-derived MCs still developed exacerbated EAE, indicating that protection from disease could be exerted by MCs mainly in the CNS, and/or by other cells possibly dysregulated in Kit(W-sh/W-sh) mice. In summary, these data suggest to reconsider MC contribution to EAE, taking into account the variables of using different experimental models and immunization protocols.

  15. Zoonoses action plan Salmonella monitoring programme: an investigation of the sampling protocol.

    PubMed

    Snary, E L; Munday, D K; Arnold, M E; Cook, A J C

    2010-03-01

    The Zoonoses Action Plan (ZAP) Salmonella Programme was established by the British Pig Executive to monitor Salmonella prevalence in quality-assured British pigs at slaughter by testing a sample of pigs with a meat juice enzyme-linked immunosorbent assay for antibodies against group B and C(1) Salmonella. Farms were assigned a ZAP level (1 to 3) depending on the monitored prevalence, and ZAP 2 or 3 farms were required to act to reduce the prevalence. The ultimate goal was to reduce the risk of human salmonellosis attributable to British pork. A mathematical model has been developed to describe the ZAP sampling protocol. Results show that the probability of assigning a farm the correct ZAP level was high, except for farms that had a seroprevalence close to the cutoff points between different ZAP levels. Sensitivity analyses identified that the probability of assigning a farm to the correct ZAP level was dependent on the sensitivity and specificity of the test, the number of batches taken to slaughter each quarter, and the number of samples taken per batch. The variability of the predicted seroprevalence was reduced as the number of batches or samples increased and, away from the cutoff points, the probability of being assigned the correct ZAP level increased as the number of batches or samples increased. In summary, the model described here provided invaluable insight into the ZAP sampling protocol. Further work is required to understand the impact of the program for Salmonella infection in British pig farms and therefore on human health.

  16. Simulation of electron spin resonance spectroscopy in diverse environments: An integrated approach

    NASA Astrophysics Data System (ADS)

    Zerbetto, Mirco; Polimeno, Antonino; Barone, Vincenzo

    2009-12-01

    We discuss in this work a new software tool, named E-SpiReS (Electron Spin Resonance Simulations), aimed at the interpretation of dynamical properties of molecules in fluids from electron spin resonance (ESR) measurements. The code implements an integrated computational approach (ICA) for the calculation of relevant molecular properties that are needed in order to obtain spectral lines. The protocol encompasses information from atomistic level (quantum mechanical) to coarse grained level (hydrodynamical), and evaluates ESR spectra for rigid or flexible single or multi-labeled paramagnetic molecules in isotropic and ordered phases, based on a numerical solution of a stochastic Liouville equation. E-SpiReS automatically interfaces all the computational methodologies scheduled in the ICA in a way completely transparent for the user, who controls the whole calculation flow via a graphical interface. Parallelized algorithms are employed in order to allow running on calculation clusters, and a web applet Java has been developed with which it is possible to work from any operating system, avoiding the problems of recompilation. E-SpiReS has been used in the study of a number of different systems and two relevant cases are reported to underline the promising applicability of the ICA to complex systems and the importance of similar software tools in handling a laborious protocol. Program summaryProgram title: E-SpiReS Catalogue identifier: AEEM_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEEM_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: GPL v2.0 No. of lines in distributed program, including test data, etc.: 311 761 No. of bytes in distributed program, including test data, etc.: 10 039 531 Distribution format: tar.gz Programming language: C (core programs) and Java (graphical interface) Computer: PC and Macintosh Operating system: Unix and Windows Has the code been vectorized or parallelized?: Yes RAM: 2 048 000 000 Classification: 7.2 External routines: Babel-1.1, CLAPACK, BLAS, CBLAS, SPARSEBLAS, CQUADPACK, LEVMAR Nature of problem:Ab initio simulation of cw-ESR spectra of radicals in solution Solution method: E-SpiReS uses an hydrodynamic approach to calculate the diffusion tensor of the molecule, DFT methodologies to evaluate magnetic tensors and linear algebra techniques to solve numerically the stochastic Liouville equation to obtain an ESR spectrum. Running time: Variable depending on the task. It takes seconds for small molecules in the fast motional regime to hours for big molecules in viscous and/or ordered media.

  17. Limited capacity in US pediatric drug trials: qualitative analysis of expert interviews.

    PubMed

    Wasserman, Richard; Bocian, Alison; Harris, Donna; Slora, Eric

    2011-04-01

    The recently renewed Best Pharmaceuticals for Children and Pediatric Research Equity Acts (BPCA/PREA) have continued industry incentives and opportunities for pediatric drug trials (PDTs). However, there is no current assessment of the capacity to perform PDTs. The aim of this study was to deepen understanding of the capacity for US PDTs by assessing PDT infrastructure, present barriers to PDTs, and potential approaches and solutions to identified issues. Pediatric clinical research experts participated in semi-structured interviews on current US pediatric research capacity (February-July 2007). An initial informant list was developed using purposive sampling, and supplemented and refined to generate a group of respondents to explore emerging themes. Each phone interview included a physician researcher and two health researchers who took notes and recorded the calls. Health researchers produced detailed summaries, which were verified by the physician researcher and informants. We then undertook qualitative analysis of the summaries, employing multiple coding, with the two health researchers and the physician researcher independently coding each summary for themes and subthemes. Coding variations were resolved by physician researcher/health researcher discussion and consensus achieved on themes and subthemes. The 33 informants' primary or secondary roles included academia (n = 21), federal official (5), industry medical officer (8), pediatric research network leader (10), pediatric specialist leader (8), pediatric clinical pharmacologist (5), and practitioner/research site director (9). While most experts noted an increase in PDTs since the initial passage of BPCA/PREA, a dominant theme of insufficient US PDT capacity emerged. Subthemes included (i) lack of systems for finding, incentivizing, and/or maintaining trial sites; (ii) complexity/demands of conducting PDTs in clinical settings; (iii) inadequate numbers of qualified pediatric pharmacologists and clinician investigators trained in FDA Good Clinical Practice; and (iv) poor PDT protocol design resulting in operational and enrollment difficulties in the pediatric population. Suggested potential solutions for insufficient PDT capacity included (i) consensus-building among stakeholders to create PDT systems; (ii) initiatives to train more pediatric pharmacologists and educate clinicians in Good Clinical Practice; (iii) advocacy for PDT protocols designed by individuals sensitive to pediatric issues; and (iv) physician and public education on the importance of PDTs. Insufficient US PDT capacity may hinder the development of new drugs for children and limit studies on the safety and efficacy of drugs presently used to treat pediatric conditions. Further public policy initiatives may be needed to achieve the full promise of BPCA/PREA.

  18. INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support): summary and future directions.

    PubMed

    Kumanyika, S

    2013-10-01

    This supplement presents the foundational elements for INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support). As explained in the overview article by Swinburn and colleagues, INFORMAS has a compelling rationale and has set forth clear objectives, outcomes, principles and frameworks for monitoring and benchmarking key aspects of food environments and the policies and actions that influence the healthiness of food environments. This summary highlights the proposed monitoring approaches for the 10 interrelated INFORMAS modules: public and private sector policies and actions; key aspects of food environments (food composition, labelling, promotion, provision, retail, prices, and trade and investment) and population outcomes (diet quality). This ambitious effort should be feasible when approached in a step-wise manner, taking into account existing monitoring efforts, data sources, country contexts and capacity, and when adequately resourced. After protocol development and pilot testing of the modules, INFORMAS aims to be a sustainable, low-cost monitoring framework. Future directions relate to institutionalization, implementation and, ultimately, to leveraging INFORMAS data in ways that will bring key drivers of food environments into alignment with public health goals. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

  19. Surgical wound infection rates in Spain: data summary, January 1997 through June 2012.

    PubMed

    Díaz-Agero Pérez, Cristina; Robustillo Rodela, Ana; Pita López, María José; López Fresneña, Nieves; Monge Jodrá, Vicente

    2014-05-01

    The Indicadores Clínicos de Mejora Continua de la Calidad (INCLIMECC) program was established in Spain in 1997. INCLIMECC is a prospective system of health care-associated infection (HAI) surveillance that collects incidence data in surgical and intensive care unit patients. The protocol is based on the National Healthcare Safety Network (NHSN) surveillance system, formerly known as the National Nosocomial Infection Surveillance (NNIS) system, and uses standard infection definitions from the US Centers for Disease Control and Prevention. Each hospital takes part voluntarily and selects the units and surgical procedures to be surveyed. This report is a summary of the data collected between January 1997 and June 2012. A total of 370,015 patients were included, and the overall incidence of surgical wound infection (SWI) was 4.51%. SWI rates are provided by NHSN operating procedure category and NNIS risk index category. More than 27% of the patients received inadequate antibiotic prophylaxis, the main reason being unsuitable duration (57.05% of cases). Today, the INCLIMECC network includes 64 Spanish hospitals. We believe that an HAI surveillance system with trained personnel external to the surveyed unit is a key component not only in infection control and prevention, but also in a quality improvement system. Copyright © 2014. Published by Mosby, Inc.

  20. [Report quality evaluation of systematic review or Meta-analysis published in China Journal of Chinese Materia Medica].

    PubMed

    Zhang, Yan; Yu, Dan-Dan; Cui, De-Hua; Liao, Xing; Guo, Hua

    2018-03-01

    To evaluate the report quality of intervention-related systematic reviews or Meta-analysis published in China Journal of Chinese Materia Medica, we searched CNKI and China Journal of Chinese Materia Medica webpages to collect intervention-related systematic reviews or Meta-analysis since the first issue of the magazine. A total of 40 systematic reviews or Meta-analysis reports were included, including one network Meta-analysis. According to the PRISMA statement published in 2009, the report quality of the systematic reviews or Meta-analysis was evaluated. According to the results, 3 had the low quality, 30 had the medium quality, and 7 had the high quality. The average score for all of items was 30 points (21-30.5 points for the medium quality). The 17 high-quality (31-40 points) report items were title, rationale, objectives, information sources, study selection, data collection process, data items, risk of bias in individual studies, summary measures, risk of bias across studies, study selection, study characteristics, risk of bias within studies, results of individual studies, synthesis of results, risk of bias across studies and funding; the 4 medium-quality (21-30.5 points) reporting items were eligibility criteria, search, limitations and conclusions; and the 6 low-quality (<=20.5 points) reporting items were structured summary, protocol and registration, synthesis of results, additional analysis (No.16), additional analysis (No.23) and summary of evidence. Through the analysis, it is found that the report quality of intervention-related systematic reviews or Meta-analysis published in China Journal of Chinese Materia Medica is medium, and it is necessary to improve the quality standard of the report. Copyright© by the Chinese Pharmaceutical Association.

  1. Regulated Expression of Adenoviral Vectors-Based Gene Therapies

    PubMed Central

    Curtin, James F.; Candolfi, Marianela; Puntel, Mariana; Xiong, Weidong; Muhammad, A. K. M.; Kroeger, Kurt; Mondkar, Sonali; Liu, Chunyan; Bondale, Niyati; Lowenstein, Pedro R.; Castro, Maria G.

    2008-01-01

    Summary Regulatable promoter systems allow gene expression to be tightly controlled in vivo. This is highly desirable for the development of safe, efficacious adenoviral vectors that can be used to treat human diseases in the clinic. Ideally, regulatable cassettes should have minimal gene expression in the “OFF” state, and expression should quickly reach therapeutic levels in the “ON” state. In addition, the components of regulatable cassettes should be non-toxic at physiological concentrations and should not be immunogenic, especially when treating chronic illness that requires long-lasting gene expression. In this chapter, we will describe in detail protocols to develop and validate first generation (Ad) and high-capacity adenoviral (HC-Ad) vectors that express therapeutic genes under the control of the TetON regulatable system. Our laboratory has successfully used these protocols to regulate the expression of marker genes, immune stimulatory genes, and toxins for cancer gene therapeutics, i.e., glioma that is a deadly form of brain cancer. We have shown that this third generation TetON regulatable system, incorporating a doxycycline (DOX)-sensitive rtTA2S-M2 inducer and tTSKid silencer, is non-toxic, relatively non-immunogenic, and can tightly regulate reporter transgene expression downstream of a TRE promoter from adenoviral vectors in vitro and also in vivo. PMID:18470649

  2. The effect of wheelchair propulsion style on changes in time spent in extreme wrist orientations after a bout of fatiguing propulsion.

    PubMed

    Zukowski, Lisa A; Hass, Chris J; Shechtman, Orit; Christou, Evangelos A; Tillman, Mark D

    2017-10-01

    This study compared how wheelchair propulsion styles affect changes in percentage of time spent in extreme wrist orientations, which have been associated with median nerve injury, after a fatiguing bout of propulsion. Twenty novice, non-disabled adult males learned arcing (ARC) and semicircular (SEMI) propulsion styles and utilised each to perform a wheelchair fatigue protocol. ARC and SEMI did not significantly differ in terms of changes after the fatigue protocol in percentage of time spent in extreme flexion/extension or radial/ulnar deviation at the push phase beginning or end. A pattern was observed, although not significant, of greater increases in percentage of time spent in extreme wrist extension and ulnar deviation during the push phase beginning and ulnar deviation during the push phase end while utilising SEMI relative to ARC. This study evinces that individual differences are greater than observed changes in extreme wrist orientations for both propulsion styles. Practitioner Summary: How wheelchair propulsion styles change with fatigue in terms of extreme wrist orientations was examined. This study evinces that individual differences are greater than observed changes in extreme wrist orientations for both propulsion styles and point towards the need for future research on individual differences utilising propulsion styles.

  3. NEON Data Products: Supporting the Validation of GCOS Essential Climate Variables

    NASA Astrophysics Data System (ADS)

    Petroy, S. B.; Fox, A. M.; Metzger, S.; Thorpe, A.; Meier, C. L.

    2014-12-01

    The National Ecological Observatory Network (NEON) is a continental-scale ecological observation platform designed to collect and disseminate data that contributes to understanding and forecasting the impacts of climate change, land use change, and invasive species on ecology. NEON will collect in-situ and airborne data over 60 sites across the US, including Alaska, Hawaii, and Puerto Rico. The NEON Biomass, Productivity, and Biogeochemistry protocols currently direct the collection of samples from distributed, gradient, and tower plots at each site, with sampling occurring either multiple times during the growing season, annually, or on three- or five-year centers (e.g. for coarse woody debris). These data are processed into a series of field-derived data products (e.g. Biogeochemistry, LAI, above ground Biomass, etc.), and when combined with the NEON airborne hyperspectral and LiDAR imagery, are used support validation efforts of algorithms for deriving vegetation characteristics from the airborne data. Sites are further characterized using airborne data combined with in-situ tower measurements, to create additional data products of interest to the GCOS community, such as Albedo and fPAR. Presented here are a summary of tower/field/airborne sampling and observation protocols and examples of provisional datasets collected at NEON sites that may be used to support the ongoing validation of GCOS Essential Climate Variables.

  4. Rapid DNA transformation in Salmonella Typhimurium by the hydrogel exposure method.

    PubMed

    Elabed, Hamouda; Hamza, Rim; Bakhrouf, Amina; Gaddour, Kamel

    2016-07-01

    Even with advances in molecular cloning and DNA transformation, new or alternative methods that permit DNA penetration in Salmonella enterica subspecies enterica serovar Typhimurium are required in order to use this pathogen in biotechnological or medical applications. In this work, an adapted protocol of bacterial transformation with plasmid DNA based on the "Yoshida effect" was applied and optimized on Salmonella enterica serovar Typhimurium LT2 reference strain. The plasmid transference based on the use of sepiolite as acicular materials to promote cell piercing via friction forces produced by spreading on the surface of a hydrogel. The transforming mixture containing sepiolite nanofibers, bacterial cells to be transformed and plasmid DNA were plated directly on selective medium containing 2% agar. In order to improve the procedure, three variables were tested and the transformation of Salmonella cells was accomplished using plasmids pUC19 and pBR322. Using the optimized protocol on Salmonella LT2 strain, the efficiency was about 10(5) transformed cells per 10(9) subjected to transformation with 0.2μg plasmid DNA. In summary, the procedure is fast, offers opportune efficiency and promises to become one of the widely used transformation methods in laboratories. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. A novel integrated framework and improved methodology of computer-aided drug design.

    PubMed

    Chen, Calvin Yu-Chian

    2013-01-01

    Computer-aided drug design (CADD) is a critical initiating step of drug development, but a single model capable of covering all designing aspects remains to be elucidated. Hence, we developed a drug design modeling framework that integrates multiple approaches, including machine learning based quantitative structure-activity relationship (QSAR) analysis, 3D-QSAR, Bayesian network, pharmacophore modeling, and structure-based docking algorithm. Restrictions for each model were defined for improved individual and overall accuracy. An integration method was applied to join the results from each model to minimize bias and errors. In addition, the integrated model adopts both static and dynamic analysis to validate the intermolecular stabilities of the receptor-ligand conformation. The proposed protocol was applied to identifying HER2 inhibitors from traditional Chinese medicine (TCM) as an example for validating our new protocol. Eight potent leads were identified from six TCM sources. A joint validation system comprised of comparative molecular field analysis, comparative molecular similarity indices analysis, and molecular dynamics simulation further characterized the candidates into three potential binding conformations and validated the binding stability of each protein-ligand complex. The ligand pathway was also performed to predict the ligand "in" and "exit" from the binding site. In summary, we propose a novel systematic CADD methodology for the identification, analysis, and characterization of drug-like candidates.

  6. Quality Assurance of Real-Time Oceanographic Data from the Cabled Array of the Ocean Observatories Initiative

    NASA Astrophysics Data System (ADS)

    Kawka, O. E.; Nelson, J. S.; Manalang, D.; Kelley, D. S.

    2016-02-01

    The Cabled Array component of the NSF-funded Ocean Observatories Initiative (OOI) provides access to real-time physical, chemical, geological, and biological data from water column and seafloor platforms/instruments at sites spanning the southern half of the Juan de Fuca Plate. The Quality Assurance (QA) program for OOI data is designed to ensure that data products meet OOI science requirements. This overall data QA plan establishes the guidelines for assuring OOI data quality and summarizes Quality Control (QC) protocols and procedures, based on best practices, which can be utilized to ensure the highest quality data across the OOI program. This presentation will highlight, specifically, the QA/QC approach being utilized for the OOI Cabled Array infrastructure and data and will include a summary of both shipboard and shore-based protocols currently in use. Aspects addressed will be pre-deployment instrument testing and calibration checks, post-deployment and pre-recovery field verification of data, and post-recovery "as-found" testing of instruments. Examples of QA/QC data will be presented and specific cases of cabled data will be discussed in the context of quality assessments and adjustment/correction of OOI datasets overall for inherent sensor drift and/or instrument fouling.

  7. Non-Invasive Brain Stimulation in Children With Unilateral Cerebral Palsy: A Protocol and Risk Mitigation Guide

    PubMed Central

    Gillick, Bernadette T.; Gordon, Andrew M.; Feyma, Tim; Krach, Linda E.; Carmel, Jason; Rich, Tonya L.; Bleyenheuft, Yannick; Friel, Kathleen

    2018-01-01

    Non-invasive brain stimulation has been increasingly investigated, mainly in adults, with the aims of influencing motor recovery after stroke. However, a consensus on safety and optimal study design has not been established in pediatrics. The low incidence of reported major adverse events in adults with and without clinical conditions has expedited the exploration of NIBS in children with paralleled purposes to influence motor skill development after neurological injury. Considering developmental variability in children, with or without a neurologic diagnosis, adult dosing and protocols may not be appropriate. The purpose of this paper is to present recommendations and tools for the prevention and mitigation of adverse events (AEs) during NIBS in children with unilateral cerebral palsy (UCP). Our recommendations provide a framework for pediatric NIBS study design. The key components of this report on NIBS AEs are (a) a summary of related literature to provide the background evidence and (b) tools for anticipating and managing AEs from four international pediatric laboratories. These recommendations provide a preliminary guide for the assessment of safety and risk mitigation of NIBS in children with UCP. Consistent reporting of safety, feasibility, and tolerability will refine NIBS practice guidelines contributing to future clinical translations of NIBS. PMID:29616203

  8. LAN MAP: An Innovative Airborne Light at Night Mapping Project

    NASA Astrophysics Data System (ADS)

    Craine, Eric R.; Craine, B. L.; Craine, E. M.; Craine, P. R.

    2013-01-01

    Widespread installation of inefficient and misdirected artificial light at night (LAN) has led to increasing concerns about light pollution and its impact, not only on astronomical facilities but larger communities as well. Light pollution impacts scientific research, environmental ecosystems, human health, and quality of life. In recent years, the public policy response to light pollution has included formulation of government codes to regulate lighting design and installation. Various environmental groups now include light pollution among their rallying themes to protest both specific and general developments. The latter efforts are often conducted in the absence of any quantitative data and are frequently charged by emotion rather than reason. To bring some scientific objectivity, and quantitative data, to these discussions, we have developed a suite of tools for simultaneous photometric measurements and temporal monitoring of both local communities and the sky overhead. We have also developed novel protocols for the use of these tools, including a triad of airborne, ground mobile, and ground static photometric surveys. We present a summary of these tools and protocols, with special emphasis on the airborne systems, and discuss baseline and follow-up measurements of LAN environments in the vicinity of numerous observatories in Arizona, the home of the initial LAN MAP surveys.

  9. Cryobanking of aquatic species

    PubMed Central

    Martínez-Páramo, Sonia; Horváth, Ákos; Labbé, Catherine; Zhang, Tiantian; Robles, Vanesa; Herráez, Paz; Suquet, Marc; Adams, Serean; Viveiros, Ana; Tiersch, Terrence R.; Cabrita, Elsa

    2017-01-01

    This review is focused on the applications of genome cryobanking of aquatic species including freshwater and marine fish, as well as invertebrates. It also reviews the latest advances in cryobanking of model species, widely used by the scientific community worldwide, because of their applications in several fields. The state of the art of cryopreservation of different cellular types (sperm, oocytes, embryos, somatic cells and primordial germ cells or early spermatogonia) is discussed focusing on the advantages and disadvantages of each procedure according to different applications. A special review on the need of standardization of protocols has also been carried out. In summary, this comprehensive review provides information on the practical details of applications of genome cryobanking in a range of aquatic species worldwide, including the cryobanks established in Europe, USA, Brazil, Australia and New Zealand, the species and type of cells that constitute these banks and the utilization of the samples preserved. Statement of relevance This review compiles the last advances on germplasm cryobanking of freshwater and marine fish species and invertebrates, with high value for commercial aquaculture or conservation. It is reviewed the most promising cryopreservation protocols for different cell types, embryos and larvae that could be applied in programs for genetic improvement, broodstock management or conservation of stocks to guarantee culture production. PMID:29276317

  10. High-throughput transformation of Saccharomyces cerevisiae using liquid handling robots.

    PubMed

    Liu, Guangbo; Lanham, Clayton; Buchan, J Ross; Kaplan, Matthew E

    2017-01-01

    Saccharomyces cerevisiae (budding yeast) is a powerful eukaryotic model organism ideally suited to high-throughput genetic analyses, which time and again has yielded insights that further our understanding of cell biology processes conserved in humans. Lithium Acetate (LiAc) transformation of yeast with DNA for the purposes of exogenous protein expression (e.g., plasmids) or genome mutation (e.g., gene mutation, deletion, epitope tagging) is a useful and long established method. However, a reliable and optimized high throughput transformation protocol that runs almost no risk of human error has not been described in the literature. Here, we describe such a method that is broadly transferable to most liquid handling high-throughput robotic platforms, which are now commonplace in academic and industry settings. Using our optimized method, we are able to comfortably transform approximately 1200 individual strains per day, allowing complete transformation of typical genomic yeast libraries within 6 days. In addition, use of our protocol for gene knockout purposes also provides a potentially quicker, easier and more cost-effective approach to generating collections of double mutants than the popular and elegant synthetic genetic array methodology. In summary, our methodology will be of significant use to anyone interested in high throughput molecular and/or genetic analysis of yeast.

  11. Telemetry: Summary of concept and rationale

    NASA Astrophysics Data System (ADS)

    1987-12-01

    This report presents the concept and supporting rationale for the telemetry system developed by the Consultative Committee for Space Data Systems (CCSDS). The concepts, protocols and data formats developed for the telemetry system are designed for flight and ground data systems supporting conventional, contemporary free-flyer spacecraft. Data formats are designed with efficiency as a primary consideration, i.e., format overhead is minimized. The results reflect the consensus of experts from many space agencies. An overview of the CCSDS telemetry system introduces the notion of architectural layering to achieve transparent and reliable delivery of scientific and engineering sensor data (generated aboard space vehicles) to users located in space or on earth. The system is broken down into two major conceptual categories: a packet telemetry concept and a telemetry channel coding concept. Packet telemetry facilitates data transmission from source to user in a standardized and highly automated manner. It provides a mechanism for implementing common data structures and protocols which can enhance the development and operation of space mission systems. Telemetry channel coding is a method by which data can be sent from a source to a destination by processing it in such a way that distinct messages are created which are easily distinguishable from one another. This allows construction of the data with low error probability, thus improving performance of the channel.

  12. Motor Cortex Stimulation in Patients Suffering from Chronic Neuropathic Pain: Summary of Expert Meeting and Premeeting Questionnaire, Combined with Literature Review.

    PubMed

    Kurt, Erkan; Henssen, Dylan J H A; Steegers, Monique; Staal, Michiel; Beese, Ulrich; Maarrawi, Joseph; Pirotte, Benoit; Garcia-Larrea, Luis; Rasche, Dirk; Vesper, Jan; Holsheimer, Jan; Duyvendak, Wim; Herregodts, Patrick; van Dongen, Robert; Moens, Maarten

    2017-12-01

    Motor cortex stimulation (MCS) was introduced in the early 1990s by Tsubokawa and his group for patients diagnosed with drug-resistant, central neuropathic pain. Inconsistencies concerning the details of this therapy and its outcomes and poor methodology of most clinical essays divide the neuromodulation society worldwide into "believers" and "nonbelievers." A European expert meeting was organized in Brussels, Belgium by the Benelux Neuromodulation Society in order to develop uniform MCS protocols in the preoperative, intraoperative, and postoperative courses. An expert meeting was organized, and a questionnaire was sent out to all the invited participants before this expert meeting. An extensive literature research was conducted in order to enrich the results. Topics that were addressed during the expert meeting were 1) inclusion and exclusion criteria, 2) targeting and methods of stimulation, 3) effects of MCS, and 4) results from the questionnaire. Substantial commonalities but also important methodologic divergencies emerged from the discussion of MCS experts from 7 European Centers. From this meeting and questionnaire, all participants concluded that there is a need for more homogenous standardized protocols for MCS regarding patient selection, implantation procedure, stimulation parameters, and follow-up-course. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Gencrypt: one-way cryptographic hashes to detect overlapping individuals across samples

    PubMed Central

    Turchin, Michael C.; Hirschhorn, Joel N.

    2012-01-01

    Summary: Meta-analysis across genome-wide association studies is a common approach for discovering genetic associations. However, in some meta-analysis efforts, individual-level data cannot be broadly shared by study investigators due to privacy and Institutional Review Board concerns. In such cases, researchers cannot confirm that each study represents a unique group of people, leading to potentially inflated test statistics and false positives. To resolve this problem, we created a software tool, Gencrypt, which utilizes a security protocol known as one-way cryptographic hashes to allow overlapping participants to be identified without sharing individual-level data. Availability: Gencrypt is freely available under the GNU general public license v3 at http://www.broadinstitute.org/software/gencrypt/ Contact: joelh@broadinstitute.org Supplementary information: Supplementary data are available at Bioinformatics online. PMID:22302573

  14. Experimental Analysis of hFACT Action during Pol II Transcription in vitro

    PubMed Central

    Hsieh, Fu-Kai; Kulaeva, Olga I.; Studitsky, Vasily M.

    2016-01-01

    Summary FACT (facilitates chromatin transcription) is a histone chaperone that facilitates transcription through chromatin and promotes histone recovery during transcription. Here, we describe a highly purified experimental system that recapitulates many important properties of transcribed chromatin and the key aspects of hFACT action during this process in vitro. We present the protocols describing how to prepare different forms of nucleosomes, including intact nucleosome, covalently conjugated nucleosome, nucleosome missing one of the two H2A/2B dimers (hexasome) and tetrasome (a nucleosome missing both H2A/2B dimers). These complexes allow analysis of various aspects of FACT’s function. These approaches and other methods described below can also be applied to the study of other chromatin remodelers and chromatin-targeted factors. PMID:25665573

  15. Software Development Technologies for Reactive, Real-Time, and Hybrid Systems: Summary of Research

    NASA Technical Reports Server (NTRS)

    Manna, Zohar

    1998-01-01

    This research is directed towards the implementation of a comprehensive deductive-algorithmic environment (toolkit) for the development and verification of high assurance reactive systems, especially concurrent, real-time, and hybrid systems. For this, we have designed and implemented the STCP (Stanford Temporal Prover) verification system. Reactive systems have an ongoing interaction with their environment, and their computations are infinite sequences of states. A large number of systems can be seen as reactive systems, including hardware, concurrent programs, network protocols, and embedded systems. Temporal logic provides a convenient language for expressing properties of reactive systems. A temporal verification methodology provides procedures for proving that a given system satisfies a given temporal property. The research covered necessary theoretical foundations as well as implementation and application issues.

  16. Investigation of wheat coleoptile response to phototropic stimulations

    NASA Technical Reports Server (NTRS)

    Heathcote, David G.; Brown, Allen H.; Chapman, David K.

    1993-01-01

    This report provides a summary of the preparations for, and the conduct and post-flight data analysis of, the Spacelab flight investigation FOTRAN, which flew on the IML-1 mission (STS-42) in January, 1992. The investigation was designed to provide data on the responses of wheat seedlings to various blue-light stimuli given while the plants were exposed to orbital microgravity conditions. Before the flight, a number of hypotheses were established which were to be tested by the data from the flight and parallel ground studies. A description of the experiment protocol developed for the mission is provided, and an account of the activities supported during preparations for and support of the flight experiment is given. Details of the methods used to reduce and analyze the data from the flight are outlined.

  17. Enabling technologies and green processes in cyclodextrin chemistry

    PubMed Central

    Caporaso, Marina; Jicsinszky, Laszlo; Martina, Katia

    2016-01-01

    Summary The design of efficient synthetic green strategies for the selective modification of cyclodextrins (CDs) is still a challenging task. Outstanding results have been achieved in recent years by means of so-called enabling technologies, such as microwaves, ultrasound and ball mills, that have become irreplaceable tools in the synthesis of CD derivatives. Several examples of sonochemical selective modification of native α-, β- and γ-CDs have been reported including heterogeneous phase Pd- and Cu-catalysed hydrogenations and couplings. Microwave irradiation has emerged as the technique of choice for the production of highly substituted CD derivatives, CD grafted materials and polymers. Mechanochemical methods have successfully furnished greener, solvent-free syntheses and efficient complexation, while flow microreactors may well improve the repeatability and optimization of critical synthetic protocols. PMID:26977187

  18. Discussion on LDPC Codes and Uplink Coding

    NASA Technical Reports Server (NTRS)

    Andrews, Ken; Divsalar, Dariush; Dolinar, Sam; Moision, Bruce; Hamkins, Jon; Pollara, Fabrizio

    2007-01-01

    This slide presentation reviews the progress that the workgroup on Low-Density Parity-Check (LDPC) for space link coding. The workgroup is tasked with developing and recommending new error correcting codes for near-Earth, Lunar, and deep space applications. Included in the presentation is a summary of the technical progress of the workgroup. Charts that show the LDPC decoder sensitivity to symbol scaling errors are reviewed, as well as a chart showing the performance of several frame synchronizer algorithms compared to that of some good codes and LDPC decoder tests at ESTL. Also reviewed is a study on Coding, Modulation, and Link Protocol (CMLP), and the recommended codes. A design for the Pseudo-Randomizer with LDPC Decoder and CRC is also reviewed. A chart that summarizes the three proposed coding systems is also presented.

  19. A minority perspective in the diagnosis of child language disorders.

    PubMed

    Seymour, H N; Bland, L

    1991-01-01

    The effective diagnosis and treatment of persons from diverse minority language backgrounds has become an important issue in the field of speech and language pathology. Yet, many SLPs have had little or no formal training in minority language, there is a paucity of normative data on language acquisition in minority groups, and there are few standardized speech and language tests appropriate for these groups. We described a diagnostic process that addresses these problems. The diagnostic protocol we have proposed for a child from a Black English-speaking background characterizes many of the major issues in treating minority children. In summary, we proposed four assessment strategies: gathering referral source data; making direct observations; using standardized tests of non-speech and language behavior (cognition, perception, motor, etc.); and eliciting language samples and probes.

  20. A summary of recent developments in transportation hazard classification activities for ammonium perchlorate

    NASA Technical Reports Server (NTRS)

    Koller, A. M., Jr.; Hannum, J. A. E.

    1983-01-01

    The transportation hazard classification of Ammonium Perchlorate is discussed. A test program was completed and data were forwarded to retain a Class 5.1 designation (oxidizer) for AP which is shipped internationally. As a follow-on to the initial team effort to conduct AP tests existing data were examined and a matrix which catalogs test parameters and findings was compiled. A collection of test protocols is developed to standardize test methods for energetic materials of all types. The actions to date are summarized; the participating organizations and their roles as presently understood; specific findings on AP (matrix); and issues, lessons learned, and potential actions of particular interest to the propulsion community which may evolve as a result of future U.N. propellant transportation classification activities.

  1. Natriuretic Hormone: The Ultimate Determinant of the Preservation of External Sodium Balance

    PubMed Central

    Bricker, Neal S.; Cain, Christopher D.; Shankel, Stewart

    2014-01-01

    The present manuscript focuses on a putative natriuretic hormone. It includes the history of a long-term search for the pure molecule, ranging from partial purification to synthesis. It includes a description of seven different bioassay systems used, a resume of the sequential steps in purification, and a summary of a series of experimental protocols employed in the effort to define the biologic properties of the inhibitor of sodium (Na) transport. Two closely related molecules were purified and synthesized. Both are xanthurenic acid derivatives (xanthurenic acid 8-O-β-D-glucoside and xanthurenic acid 8-O-sulfate). It is concluded that one or both of these two low molecular weight compounds (MW: 368 and 284) meet many of the criteria for the final modulator of Na excretion. PMID:25566186

  2. Awake surgery between art and science. Part II: language and cognitive mapping

    PubMed Central

    Talacchi, Andrea; Santini, Barbara; Casartelli, Marilena; Monti, Alessia; Capasso, Rita; Miceli, Gabriele

    Summary Direct cortical and subcortical stimulation has been claimed to be the gold standard for exploring brain function. In this field, efforts are now being made to move from intraoperative naming-assisted surgical resection towards the use of other language and cognitive tasks. However, before relying on new protocols and new techniques, we need a multi-staged system of evidence (low and high) relating to each step of functional mapping and its clinical validity. In this article we examine the possibilities and limits of brain mapping with the aid of a visual object naming task and various other tasks used to date. The methodological aspects of intraoperative brain mapping, as well as the clinical and operative settings, were discussed in Part I of this review. PMID:24139658

  3. Evidence-Based Ethics for Neurology and Psychiatry Research

    PubMed Central

    Kim, Scott Y. H.

    2004-01-01

    Summary: American bioethics, historically arising out of theology and philosophy, has been dominated by the method of normative analysis. Ethics as policy, however, requires in addition a solid evidence base. This paper discusses the background conditions that make neurotherapeutics research particularly challenging. Three key ethical issues are discussed within an evidence-based ethics framework: the ethical challenges arising from changes in the financial incentive structures for academic researchers and their institutions, the challenges of risk-benefit analysis for neurotherapeutics protocols testing innovative interventions, and the evolving issues surrounding impaired decision-making capacity and surrogate consent for research. For each of these issues, selected empirical data are reviewed, areas for further inquiry are noted, and the need for development of novel methods for bioethics policy research is discussed. PMID:15717040

  4. Global Interconnectivity Between Mobile Satellite and Terrestrial Users: Call Signalling Issues and Challenges

    NASA Technical Reports Server (NTRS)

    Estabrook, Polly; Moon, Todd; Spade, Rob

    1996-01-01

    This paper will discuss some of the challenges in connecting mobile satellite users and mobile terrestrial users in a cost efficient manner and with a grade of service comparable to that of satellite to fixed user calls. Issues arising from the translation between the mobility management protocols resident at the satellite Earth station and those resident at cellular switches - either GSM (Group Special Mobile) or IS-41 (used by U.S. digital cellular systems) type - will be discussed. The impact of GSM call routing procedures on the call setup of a satellite to roaming GSM user will be described. Challenges facing provision of seamless call handoff between satellite and cellular systems will be given. A summary of the issues explored in the paper are listed and future work outlined.

  5. Simulation of n-qubit quantum systems. III. Quantum operations

    NASA Astrophysics Data System (ADS)

    Radtke, T.; Fritzsche, S.

    2007-05-01

    During the last decade, several quantum information protocols, such as quantum key distribution, teleportation or quantum computation, have attracted a lot of interest. Despite the recent success and research efforts in quantum information processing, however, we are just at the beginning of understanding the role of entanglement and the behavior of quantum systems in noisy environments, i.e. for nonideal implementations. Therefore, in order to facilitate the investigation of entanglement and decoherence in n-qubit quantum registers, here we present a revised version of the FEYNMAN program for working with quantum operations and their associated (Jamiołkowski) dual states. Based on the implementation of several popular decoherence models, we provide tools especially for the quantitative analysis of quantum operations. Apart from the implementation of different noise models, the current program extension may help investigate the fragility of many quantum states, one of the main obstacles in realizing quantum information protocols today. Program summaryTitle of program: Feynman Catalogue identifier: ADWE_v3_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADWE_v3_0 Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Licensing provisions: None Operating systems: Any system that supports MAPLE; tested under Microsoft Windows XP, SuSe Linux 10 Program language used:MAPLE 10 Typical time and memory requirements: Most commands that act upon quantum registers with five or less qubits take ⩽10 seconds of processor time (on a Pentium 4 processor with ⩾2 GHz or equivalent) and 5-20 MB of memory. Especially when working with symbolic expressions, however, the memory and time requirements critically depend on the number of qubits in the quantum registers, owing to the exponential dimension growth of the associated Hilbert space. For example, complex (symbolic) noise models (with several Kraus operators) for multi-qubit systems often result in very large symbolic expressions that dramatically slow down the evaluation of measures or other quantities. In these cases, MAPLE's assume facility sometimes helps to reduce the complexity of symbolic expressions, but often only numerical evaluation is possible. Since the complexity of the FEYNMAN commands is very different, no general scaling law for the CPU time and memory usage can be given. No. of bytes in distributed program including test data, etc.: 799 265 No. of lines in distributed program including test data, etc.: 18 589 Distribution format: tar.gz Reasons for new version: While the previous program versions were designed mainly to create and manipulate the state of quantum registers, the present extension aims to support quantum operations as the essential ingredient for studying the effects of noisy environments. Does this version supersede the previous version: Yes Nature of the physical problem: Today, entanglement is identified as the essential resource in virtually all aspects of quantum information theory. In most practical implementations of quantum information protocols, however, decoherence typically limits the lifetime of entanglement. It is therefore necessary and highly desirable to understand the evolution of entanglement in noisy environments. Method of solution: Using the computer algebra system MAPLE, we have developed a set of procedures that support the definition and manipulation of n-qubit quantum registers as well as (unitary) logic gates and (nonunitary) quantum operations that act on the quantum registers. The provided hierarchy of commands can be used interactively in order to simulate and analyze the evolution of n-qubit quantum systems in ideal and nonideal quantum circuits.

  6. Absolute quantification of DcR3 and GDF15 from human serum by LC-ESI MS

    PubMed Central

    Lancrajan, Ioana; Schneider-Stock, Regine; Naschberger, Elisabeth; Schellerer, Vera S; Stürzl, Michael; Enz, Ralf

    2015-01-01

    Biomarkers are widely used in clinical diagnosis, prognosis and therapy monitoring. Here, we developed a protocol for the efficient and selective enrichment of small and low concentrated biomarkers from human serum, involving a 95% effective depletion of high-abundant serum proteins by partial denaturation and enrichment of low-abundant biomarkers by size exclusion chromatography. The recovery of low-abundance biomarkers was above 97%. Using this protocol, we quantified the tumour markers DcR3 and growth/differentiation factor (GDF)15 from 100 μl human serum by isotope dilution mass spectrometry, using 15N metabolically labelled and concatamerized fingerprint peptides for the both proteins. Analysis of three different fingerprint peptides for each protein by liquid chromatography electrospray ionization mass spectrometry resulted in comparable concentrations in three healthy human serum samples (DcR3: 27.23 ± 2.49 fmol/ml; GDF15: 98.11 ± 0.49 fmol/ml). In contrast, serum levels were significantly elevated in tumour patients for DcR3 (116.94 ± 57.37 fmol/ml) and GDF15 (164.44 ± 79.31 fmol/ml). Obtained data were in good agreement with ELISA and qPCR measurements, as well as with literature data. In summary, our protocol allows the reliable quantification of biomarkers, shows a higher resolution at low biomarker concentrations than antibody-based strategies, and offers the possibility of multiplexing. Our proof-of-principle studies in patient sera encourage the future analysis of the prognostic value of DcR3 and GDF15 for colon cancer patients in larger patient cohorts. PMID:25823874

  7. Precise, High-throughput Analysis of Bacterial Growth.

    PubMed

    Kurokawa, Masaomi; Ying, Bei-Wen

    2017-09-19

    Bacterial growth is a central concept in the development of modern microbial physiology, as well as in the investigation of cellular dynamics at the systems level. Recent studies have reported correlations between bacterial growth and genome-wide events, such as genome reduction and transcriptome reorganization. Correctly analyzing bacterial growth is crucial for understanding the growth-dependent coordination of gene functions and cellular components. Accordingly, the precise quantitative evaluation of bacterial growth in a high-throughput manner is required. Emerging technological developments offer new experimental tools that allow updates of the methods used for studying bacterial growth. The protocol introduced here employs a microplate reader with a highly optimized experimental procedure for the reproducible and precise evaluation of bacterial growth. This protocol was used to evaluate the growth of several previously described Escherichia coli strains. The main steps of the protocol are as follows: the preparation of a large number of cell stocks in small vials for repeated tests with reproducible results, the use of 96-well plates for high-throughput growth evaluation, and the manual calculation of two major parameters (i.e., maximal growth rate and population density) representing the growth dynamics. In comparison to the traditional colony-forming unit (CFU) assay, which counts the cells that are cultured in glass tubes over time on agar plates, the present method is more efficient and provides more detailed temporal records of growth changes, but has a stricter detection limit at low population densities. In summary, the described method is advantageous for the precise and reproducible high-throughput analysis of bacterial growth, which can be used to draw conceptual conclusions or to make theoretical observations.

  8. Evaluating robustness in rank-based risk assessments of freshwater ecosystems

    USGS Publications Warehouse

    Mattson, K.M.; Angermeier, Paul

    2007-01-01

    Conservation planning aims to protect biodiversity by sustainng the natural physical, chemical, and biological processes within representative ecosystems. Often data to measure these components are inadequate or unavailable. The impact of human activities on ecosystem processes complicates integrity assessments and might alter ecosystem organization at multiple spatial scales. Freshwater conservation targets, such as populations and communities, are influenced by both intrinsic aquatic properties and the surrounding landscape, and locally collected data might not accurately reflect potential impacts. We suggest that changes in five major biotic drivers—energy sources, physical habitat, flow regime, water quality, and biotic interactions—might be used as surrogates to inform conservation planners of the ecological integrity of freshwater ecosystems. Threats to freshwater systems might be evaluated based on their impact to these drivers to provide an overview of potential risk to conservation targets. We developed a risk-based protocol, the Ecological Risk Index (ERI), to identify watersheds with least/most risk to conservation targets. Our protocol combines risk-based components, specifically the frequency and severity of human-induced stressors, with biotic drivers and mappable land- and water-use data to provide a summary of relative risk to watersheds. We illustrate application of our protocol with a case study of the upper Tennessee River basin, USA. Differences in risk patterns among the major drainages in the basin reflect dominant land uses, such as mining and agriculture. A principal components analysis showed that localized, moderately severe threats accounted for most of the threat composition differences among our watersheds. We also found that the relative importance of threats is sensitive to the spatial grain of the analysis. Our case study demonstrates that the ERI is useful for evaluating the frequency and severity of ecosystemwide risk, which can inform local and regional conservation planning.

  9. Use of Management Pathways or Algorithms in Children With Chronic Cough: Systematic Reviews.

    PubMed

    Chang, Anne B; Oppenheimer, John J; Weinberger, Miles; Weir, Kelly; Rubin, Bruce K; Irwin, Richard S

    2016-01-01

    Use of appropriate cough pathways or algorithms may reduce the morbidity of chronic cough, lead to earlier diagnosis of chronic underlying illness, and reduce unnecessary costs and medications. We undertook three systematic reviews to examine three related key questions (KQ): In children aged ?14 years with chronic cough (> 4 weeks' duration), KQ1, do cough management protocols (or algorithms) improve clinical outcomes? KQ2, should the cough management or testing algorithm differ depending on the duration and/or severity? KQ3, should the cough management or testing algorithm differ depending on the associated characteristics of the cough and clinical history? We used the CHEST expert cough panel's protocol. Two authors screened searches and selected and extracted data. Only systematic reviews, randomized controlled trials (RCTs), and cohort studies published in English were included. Data were presented in Preferred Reporting Items for Systematic Reviews and Meta-analyses flowcharts and summary tabulated. Nine studies were included in KQ1 (RCT = 1; cohort studies = 7) and eight in KQ3 (RCT = 2; cohort = 6), but none in KQ2. There is high-quality evidence that in children aged ?14 years with chronic cough (> 4 weeks' duration), the use of cough management protocols (or algorithms) improves clinical outcomes and cough management or the testing algorithm should differ depending on the associated characteristics of the cough and clinical history. It remains uncertain whether the management or testing algorithm should depend on the duration or severity of chronic cough. Pending new data, chronic cough in children should be defined as > 4 weeks' duration and children should be systematically evaluated with treatment targeted to the underlying cause irrespective of the cough severity. Copyright © 2016 American College of Chest Physicians. All rights reserved.

  10. Establishment of an Effective Radioiodide Thyroid Ablation Protocol in Mice.

    PubMed

    Schmohl, Kathrin A; Müller, Andrea M; Schwenk, Nathalie; Knoop, Kerstin; Rijntjes, Eddy; Köhrle, Josef; Heuer, Heike; Bartenstein, Peter; Göke, Burkhard; Nelson, Peter J; Spitzweg, Christine

    2015-09-01

    Due to the high variance in available protocols on iodide-131 ((131)I) ablation in rodents, we set out to establish an effective method to generate a thyroid-ablated mouse model that allows the application of the sodium iodide symporter (NIS) as a reporter gene without interference with thyroidal NIS. We tested a range of (131)I doses with and without prestimulation of thyroidal radioiodide uptake by a low-iodine diet and thyroid-stimulating hormone (TSH) application. Efficacy of induction of hypothyroidism was tested by measurement of serum T4 concentrations, pituitary TSHβ and liver deiodinase type 1 (DIO1) mRNA expression, body weight analysis, and (99m)Tc-pertechnetate scintigraphy. While 200 µCi (7.4 MBq) (131)I alone was not sufficient to abolish thyroidal T4 production, 500 µCi (18.5 MBq) (131)I combined with 1 week of a low-iodine diet decreased serum concentrations below the detection limit. However, the high (131)I dose resulted in severe side effects. A combination of 1 week of a low-iodine diet followed by injection of bovine TSH before the application of 150 µCi (5.5 MBq) (131)I decreased serum T4 concentrations below the detection limit and significantly increased pituitary TSHβ concentrations. The systemic effects of induced hypothyroidism were shown by growth arrest and a decrease in liver DIO1 expression below the detection limit. (99m)Tc-pertechnetate scintigraphy revealed absence of thyroidal (99m)Tc-pertechnetate uptake in ablated mice. In summary, we report a revised protocol for radioiodide ablation of the thyroid gland in the mouse to generate an in vivo model that allows the study of thyroid hormone action using NIS as a reporter gene.

  11. Establishment of an Effective Radioiodide Thyroid Ablation Protocol in Mice

    PubMed Central

    Schmohl, Kathrin A.; Müller, Andrea M.; Schwenk, Nathalie; Knoop, Kerstin; Rijntjes, Eddy; Köhrle, Josef; Heuer, Heike; Bartenstein, Peter; Göke, Burkhard; Nelson, Peter J.; Spitzweg, Christine

    2015-01-01

    Due to the high variance in available protocols on iodide-131 (131I) ablation in rodents, we set out to establish an effective method to generate a thyroid-ablated mouse model that allows the application of the sodium iodide symporter (NIS) as a reporter gene without interference with thyroidal NIS. We tested a range of 131I doses with and without prestimulation of thyroidal radioiodide uptake by a low-iodine diet and thyroid-stimulating hormone (TSH) application. Efficacy of induction of hypothyroidism was tested by measurement of serum T4 concentrations, pituitary TSHβ and liver deiodinase type 1 (DIO1) mRNA expression, body weight analysis, and 99mTc-pertechnetate scintigraphy. While 200 µCi (7.4 MBq) 131I alone was not sufficient to abolish thyroidal T4 production, 500 µCi (18.5 MBq) 131I combined with 1 week of a low-iodine diet decreased serum concentrations below the detection limit. However, the high 131I dose resulted in severe side effects. A combination of 1 week of a low-iodine diet followed by injection of bovine TSH before the application of 150 µCi (5.5 MBq) 131I decreased serum T4 concentrations below the detection limit and significantly increased pituitary TSHβ concentrations. The systemic effects of induced hypothyroidism were shown by growth arrest and a decrease in liver DIO1 expression below the detection limit. 99mTc-pertechnetate scintigraphy revealed absence of thyroidal 99mTc-pertechnetate uptake in ablated mice. In summary, we report a revised protocol for radioiodide ablation of the thyroid gland in the mouse to generate an in vivo model that allows the study of thyroid hormone action using NIS as a reporter gene. PMID:26601076

  12. Strategies for successful trauma registry implementation in low- and middle-income countries-protocol for a systematic review.

    PubMed

    Paradis, Tiffany; St-Louis, Etienne; Landry, Tara; Poenaru, Dan

    2018-02-21

    The benefits of trauma registries have been well described. The crucial data they provide may guide injury prevention strategies, inform resource allocation, and support advocacy and policy. This has been shown to reduce trauma-related mortality in various settings. Trauma remains a leading cause of mortality in low- and middle-income countries (LMICs). However, the implementation of trauma registries in LMICs can be challenging due to lack of funding, specialized personnel, and infrastructure. This study explores strategies for successful trauma registry implementation in LMICs. The protocol was registered a priori (CRD42017058586). A peer-reviewed search strategy of multiple databases will be developed with a senior librarian. As per PRISMA guidelines, first screen of references based on abstract and title and subsequent full-text review will be conducted by two independent reviewers. Disagreements that cannot be resolved by discussion between reviewers shall be arbitrated by the principal investigator. Data extraction will be performed using a pre-defined data extraction sheet. Finally, bibliographies of included articles will be hand-searched. Studies of any design will be included if they describe or review development and implementation of a trauma registry in LMICs. No language or period restrictions will be applied. Summary statistics and qualitative meta-narrative analyses will be performed. The significant burden of trauma in LMIC environments presents unique challenges and limitations. Adapted strategies for deployment and maintenance of sustainable trauma registries are needed. Our methodology will systematically identify recommendations and strategies for successful trauma registry implementation in LMICs and describe threats and barriers to this endeavor. The protocol was registered on the PROSPERO international prospective register of systematic reviews ( CRD42017058586 ).

  13. Development of a Web Portal for Physical Activity and Symptom Tracking in Oncology Patients: Protocol for a Prospective Cohort Study.

    PubMed

    Marthick, Michael; Dhillon, Haryana M; Alison, Jennifer A; Cheema, Birinder S; Shaw, Tim

    2018-05-15

    Significant benefits accrue from increasing physical activity levels in people with a history of cancer. Physical activity levels can be increased using behavioral change interventions in this population. Access to Web portals and provision of activity monitors to provide feedback may support behavior change by encouraging patient engagement in physical therapy. The Web portal evaluated in this study will provide a system to monitor physical activity and sleep, for use by both clinician and patient, along with symptom and health-related quality of life tracking capabilities. The aim of this study was to outline a protocol for a feasibility study focused on a Web-based portal that provides activity monitoring and personalized messaging to increase physical activity in people with cancer. Using a longitudinal cohort design, people with cancer will be serially allocated to 3 intervention cohorts of 20 participants each and followed for 10 weeks. Cohort 1 will be provided a wearable activity monitor and access to a Web-based portal. Cohort 2 will receive the same content as Cohort 1 and in addition will receive a weekly activity summary message. Cohort 3 will receive the same content as Cohorts 1 and 2 and in addition will receive a personalized weekly coaching message. Feasibility of the use of the portal is the primary outcome. Results are expected in early 2018. Outcome measures will include goal attainment and completion rate. This study will provide information about the feasibility of investigating eHealth initiatives to promote physical activity in people with cancer. RR1-10.2196/9586. ©Michael Marthick, Haryana M Dhillon, Jennifer A Alison, Birinder S Cheema, Tim Shaw. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 15.05.2018.

  14. Advances of the reverse lactate threshold test: Non-invasive proposal based on heart rate and effect of previous cycling experience

    PubMed Central

    2018-01-01

    Our first aim was to compare the anaerobic threshold (AnT) determined by the incremental protocol with the reverse lactate threshold test (RLT), investigating the previous cycling experience effect. Secondarily, an alternative RLT application based on heart rate was proposed. Two groups (12 per group-according to cycling experience) were evaluated on cycle ergometer. The incremental protocol started at 25 W with increments of 25 W at each 3 minutes, and the AnT was calculated by bissegmentation, onset of blood lactate concentration and maximal deviation methods. The RLT was applied in two phases: a) lactate priming segment; and b) reverse segment; the AnT (AnTRLT) was calculated based on a second order polynomial function. The AnT from the RLT was calculated based on the heart rate (AnTRLT-HR) by the second order polynomial function. In regard of the Study 1, most of statistical procedures converged for similarity between the AnT determined from the bissegmentation method and AnTRLT. For 83% of non-experienced and 75% of experienced subjects the bias was 4% and 2%, respectively. In Study 2, no difference was found between the AnTRLT and AnTRLT-HR. For 83% of non-experienced and 91% of experienced subjects, the bias between AnTRLT and AnTRLT-HR was similar (i.e. 6%). In summary, the AnT determined by the incremental protocol and RLT are consistent. The AnT can be determined during the RLT via heart rate, improving its applicability. However, future studies are required to improve the agreement between variables. PMID:29534108

  15. Analytical Measurement of Discrete Hydrogen Sulfide Pools in Biological Specimens

    PubMed Central

    Shen, Xinggui; Peter, Elvis A.; Bir, Shyamal; Wang, Rui; Kevil, Christopher G.

    2015-01-01

    Hydrogen sulfide (H2S) is a ubiquitous gaseous signaling molecule that plays a vital role in numerous cellular functions and has become the focus of many research endeavors including pharmaco-therapeutic manipulation. Amongst the challenges facing the field is the accurate measurement of biologically active H2S. We have recently reported that the typically used methylene blue method and its associated results are invalid and do not measure bonafide H2S. The complexity of analytical H2S measurement reflects the fact that hydrogen sulfide is a volatile gas and exists in the body in different forms, including a free form, an acid labile pool and as bound sulfane sulfur. Here we describe a new protocol to discretely measure specific H2S pools using the monobromobimane method coupled with RP-HPLC. This new protocol involves selective liberation, trapping and derivatization of H2S. Acid-labile H2S is released by incubating the sample in an acidic solution (pH 2.6) of 100 mM phosphate buffer with 0.1 mM DTPA, in an enclosed system to contain volatilized H2S. Volatilized H2S is then trapped in 100 mM Tris-HCl (pH 9.5, 0.1 mM DTPA) and then reacted with excess monobromobimane. In a separate aliquot, the contribution of bound sulfane sulfur pool was measured by incubating the sample with 1 mM TCEP (Tris(2-carboxyethyl)phosphine hydrochloride), a reducing agent to reduce disulfide bonds, in 100 mM phosphate buffer (pH 2.6, 0.1 mM DTPA), and H2S measurement performed in an analogous manner to the one described above. The acid labile pool was determined by subtracting the free hydrogen sulfide value from the value obtained by the acid liberation protocol. The bound sulfane sulfur pool was determined by subtracting the H2S measurement from the acid liberation protocol alone compared to that of TCEP plus acidic conditions. In summary, our new method protocol allows very sensitive and accurate measurement of the three primary biological pools of H2S including free, acid labile, and bound sulfane sulfur in various biological specimens. PMID:22561703

  16. Developing an evidence-based nursing protocol on wound drain management for total joint arthroplasty.

    PubMed

    Tsang, Lap Fung

    2015-05-01

    Although various drains have long been used for many years in total joint replacement, there is a paucity of evidence for the benefit of drain applications. Evidence suggests inconsistent practice in the use of drainage systems, whether intermittently applying suction or free of suction in the application of drainage systems, as well as the optimal timing for wound drain removal. It aimed to perform a systematic review to develop an evidence-based nursing protocol to manage wound drainage following total joint arthroplasty. A comprehensive systematic review of available evidence up to 2013. Searches of the EMBASE, Cochrane library, CINAHL, Medline electronic databases and an internet search by Yahoo and Google engine returned 2840 records, of which 11 met the inclusion criteria for this review. A further two papers were obtained through scanning the reference lists of those articles included from the initial literature search. Different clamping times were retrieved from the literature. A protocol was adapted for clinical application according to the summary of the retrieved information. It is suggested that clamping is performed 1 h after the insertion of suction drains post-operatively in the operating theatre. Wound drains should be clamped for 1 h if blood loss is more than 600 ml in 6 h in first 24 h. Wound drains should be clamped for 1 h if blood loss is more than 800 ml in 8 h thereafter. It is suggested that the drainage reservoir bottle should be mark and findings recorded in line with the principle of drain clamping. This means that the amount of drainage is measured and recorded every 6 h in first 24 h and every 8 h thereafter. It is suggested that wound drains should be remove before 48 h after TJR. If blood loss is less than 50 ml in past 6 h or less than 70 ml in past 8 h, the drain should be remove and the wound site should be monitored closely. This paper has guided nurses to develop an evidence-based protocol to improve patient care on wound drain management. Further study is necessary to evaluate the effectiveness of the protocol. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Evidence for the Selective Reporting of Analyses and Discrepancies in Clinical Trials: A Systematic Review of Cohort Studies of Clinical Trials

    PubMed Central

    Dwan, Kerry; Altman, Douglas G.; Clarke, Mike; Gamble, Carrol; Higgins, Julian P. T.; Sterne, Jonathan A. C.; Williamson, Paula R.; Kirkham, Jamie J.

    2014-01-01

    Background Most publications about selective reporting in clinical trials have focussed on outcomes. However, selective reporting of analyses for a given outcome may also affect the validity of findings. If analyses are selected on the basis of the results, reporting bias may occur. The aims of this study were to review and summarise the evidence from empirical cohort studies that assessed discrepant or selective reporting of analyses in randomised controlled trials (RCTs). Methods and Findings A systematic review was conducted and included cohort studies that assessed any aspect of the reporting of analyses of RCTs by comparing different trial documents, e.g., protocol compared to trial report, or different sections within a trial publication. The Cochrane Methodology Register, Medline (Ovid), PsycInfo (Ovid), and PubMed were searched on 5 February 2014. Two authors independently selected studies, performed data extraction, and assessed the methodological quality of the eligible studies. Twenty-two studies (containing 3,140 RCTs) published between 2000 and 2013 were included. Twenty-two studies reported on discrepancies between information given in different sources. Discrepancies were found in statistical analyses (eight studies), composite outcomes (one study), the handling of missing data (three studies), unadjusted versus adjusted analyses (three studies), handling of continuous data (three studies), and subgroup analyses (12 studies). Discrepancy rates varied, ranging from 7% (3/42) to 88% (7/8) in statistical analyses, 46% (36/79) to 82% (23/28) in adjusted versus unadjusted analyses, and 61% (11/18) to 100% (25/25) in subgroup analyses. This review is limited in that none of the included studies investigated the evidence for bias resulting from selective reporting of analyses. It was not possible to combine studies to provide overall summary estimates, and so the results of studies are discussed narratively. Conclusions Discrepancies in analyses between publications and other study documentation were common, but reasons for these discrepancies were not discussed in the trial reports. To ensure transparency, protocols and statistical analysis plans need to be published, and investigators should adhere to these or explain discrepancies. Please see later in the article for the Editors' Summary PMID:24959719

  18. Finding a better drug for epilepsy: The mTOR pathway as an antiepileptogenic target

    PubMed Central

    Galanopoulou, Aristea S.; Gorter, Jan A.; Cepeda, Carlos

    2012-01-01

    Summary The mTOR signaling pathway regulates cell growth, differentiation, proliferation and metabolism. Loss of function mutations in upstream regulators of mTOR have been highly associated with dysplasias, epilepsy and neurodevelopmental disorders. These include tuberous sclerosis, which is due to mutations in TSC1 or TSC2 genes, mutations in phosphatase and tensin homolog (PTEN) as in Cowden syndrome, polyhydramnios, megalencephaly, symptomatic epilepsy syndrome (PMSE) due to mutations in the STE20-related kinase adaptor alpha (STRADalpha), and neurofibromatosis type 1 attributed to neurofibromin 1 mutations. Inhibition of the mTOR pathway with rapamycin may prevent epilepsy and improve the underlying pathology in mouse models with disrupted mTOR signaling, due to PTEN or TSC mutations. However the timing and duration of its administration appear critical in defining the seizure and pathology-related outcomes. Rapamycin application in human cortical slices from patients with cortical dysplasias reduces the 4-aminopyridine induced oscillations. In the multiple-hit model of infantile spasms, pulse high dose rapamycin administration can reduce the cortical overactivation of the mTOR pathway, suppresses spasms and has disease-modifying effects by partially improving cognitive deficits. In post-status epilepticus models of temporal lobe epilepsy, rapamycin may ameliorate the development of epilepsy-related pathology and reduce the expression of spontaneous seizures, but its effects depend on the timing and duration of administration, and possibly the model used. The observed recurrence of seizures and epilepsy-related pathology after rapamycin discontinuation suggests the need for continuous administration to maintain the benefit. However, the use of pulse administration protocols may be useful in certain age-specific epilepsy syndromes, like infantile spasms, whereas repetitive pulse rapamycin protocols may suffice to sustain a long-term benefit in genetic disorders of the mTOR pathway. In summary, mTOR dysregulation has been implicated in several genetic and acquired forms of epileptogenesis. The use of mTOR inhibitors can reverse some of these epileptogenic processes although their effects depend upon the timing and dose of administration as well as the model used. PMID:22578218

  19. Effects of falls prevention interventions on falls outcomes for hospitalised adults: protocol for a systematic review with meta-analysis.

    PubMed

    Slade, Susan C; Carey, David L; Hill, Anne-Marie; Morris, Meg E

    2017-11-12

    Falls are a major global public health problem and leading cause of accidental or unintentional injury and hospitalisation. Falls in hospital are associated with longer length of stay, readmissions and poor outcomes. Falls prevention is informed by knowledge of reversible falls risk factors and accurate risk identification. The extent to which hospital falls are prevented by evidence-based practice, patient self-management initiatives, environmental modifications and optimisation of falls prevention systems awaits confirmation. Published reviews have mainly evaluated community settings and residential care facilities. A better understanding of hospital falls and the most effective strategies to prevent them is vital to keeping people safe. To evaluate the effectiveness of falls prevention interventions on reducing falls in hospitalised adults (acute and subacute wards, rehabilitation, mental health, operating theatre and emergency departments). We also summarise components of effective falls prevention interventions. This protocol has been registered. The systematic review will be informed by Cochrane guidelines and reported according to the Preferred Reporting Items for Systematic review and Meta-Analysis statement. randomised controlled trials, quasi-randomised trials or controlled clinical trials that evaluate falls prevention interventions for use by hospitalised adults or employees. Electronic databases will be searched using key terms including falls, accidental falls, prevention, hospital, rehabilitation, emergency, mental health, acute and subacute. Pairs of independent reviewers will conduct all review steps. Included studies will be evaluated for risk of bias. Data for variables such as age, participant characteristics, settings and interventions will be extracted and analysed with descriptive statistics and meta-analysis where possible. The results will be presented textually, with flow charts, summary tables, statistical analysis (and meta-analysis where possible) and narrative summaries. Ethical approval is not required. The systematic review will be published in a peer-reviewed journal and disseminated electronically, in print and at conferences. Updates will guide healthcare translation into practice. PROSPERO 2017: CRD 42017058887. Available from https://www.crd.york.ac.uk/prospero. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Racism as a determinant of health: a protocol for conducting a systematic review and meta-analysis

    PubMed Central

    2013-01-01

    Background Racism is increasingly recognized as a key determinant of health. A growing body of epidemiological evidence shows strong associations between self-reported racism and poor health outcomes across diverse minority groups in developed countries. While the relationship between racism and health has received increasing attention over the last two decades, a comprehensive meta-analysis focused on the health effects of racism has yet to be conducted. The aim of this review protocol is to provide a structure from which to conduct a systematic review and meta-analysis of studies that assess the relationship between racism and health. Methods This research will consist of a systematic review and meta-analysis. Studies will be considered for review if they are empirical studies reporting quantitative data on the association between racism and health for adults and/or children of all ages from any racial/ethnic/cultural groups. Outcome measures will include general health and well-being, physical health, mental health, healthcare use and health behaviors. Scientific databases (for example, Medline) will be searched using a comprehensive search strategy and reference lists will be manually searched for relevant studies. In addition, use of online search engines (for example, Google Scholar), key websites, and personal contact with experts will also be undertaken. Screening of search results and extraction of data from included studies will be independently conducted by at least two authors, including assessment of inter-rater reliability. Studies included in the review will be appraised for quality using tools tailored to each study design. Summary statistics of study characteristics and findings will be compiled and findings synthesized in a narrative summary as well as a meta-analysis. Discussion This review aims to examine associations between reported racism and health outcomes. This comprehensive and systematic review and meta-analysis of empirical research will provide a rigorous and reliable evidence base for future research, policy and practice, including information on the extent of available evidence for a range of racial/ethnic minority groups PMID:24059279

  1. Questions and answers about the effects of the depletion of the ozone layer on humans and the environment.

    PubMed

    Aucamp, Pieter J

    2007-03-01

    The ozone molecule contains three atoms of oxygen and is mainly formed by the action of the ultraviolet rays of the sun on the diatomic oxygen molecules in the upper part of the Earth's atmosphere (called the stratosphere). Atmospheric pollution near the Earth's surface can form localized areas of ozone. The stratospheric ozone layer protects life on Earth by absorbing most of the harmful ultraviolet radiation from the sun. In the mid 1970s it was discovered that some manmade products destroy ozone molecules in the stratosphere. This destruction can result in damage to ecosystems and to materials such as plastics. It may cause an increase in human diseases such as skin cancers and cataracts. The discovery of the role of the synthetic ozone-depleting chemicals such as chlorofluorocarbons (CFCs) stimulated increased research and monitoring in this field. Computer models predicted a disaster if no action was taken to protect the ozone layer. Based on this research and monitoring, the nations of the world took action in 1985 with the Vienna Convention for the Protection of the Ozone Layer followed by the Montreal Protocol on Substances that Deplete the Ozone Layer in 1987. The Convention and Protocol were amended and adjusted several times as new knowledge was obtained. The Meetings of the Parties to the Montreal Protocol appointed three Assessment Panels to review the progress in scientific knowledge on their behalf. These panels are the Scientific Assessment Panel, the Technological and Economic Assessment Panel and the Environmental Effects Assessment Panel. Each panel covers a designated area and there is a natural level of overlap. The main reports of the Panels are published every four years as required by the Meeting of the Parties. All the reports have an executive summary that is distributed more widely than the main report itself. It became customary to add a set of questions and answers--mainly for non-expert readers--to the executive summaries. This document contains the questions and answers prepared by experts who comprise the Environmental Assessment Panel. It is based mainly on the 2006 report of the Panel but also contains information from previous assessments. Readers who need detailed information on any question should consult the full reports for a more complete scientific discussion. This set of questions refers mainly to the environmental effects of ozone depletion and climate change. The report of the Scientific Assessment Panel contains questions and answers related to the other scientific issues addressed by that Panel. All these reports can be found on the UNEP website (http://ozone.unep.org).

  2. Human granulocyte colony stimulating factor (hG-CSF): cloning, overexpression, purification and characterization.

    PubMed

    Vanz, Ana Ls; Renard, Gaby; Palma, Mario S; Chies, Jocelei M; Dalmora, Sérgio L; Basso, Luiz A; Santos, Diógenes S

    2008-04-04

    Biopharmaceutical drugs are mainly recombinant proteins produced by biotechnological tools. The patents of many biopharmaceuticals have expired, and biosimilars are thus currently being developed. Human granulocyte colony stimulating factor (hG-CSF) is a hematopoietic cytokine that acts on cells of the neutrophil lineage causing proliferation and differentiation of committed precursor cells and activation of mature neutrophils. Recombinant hG-CSF has been produced in genetically engineered Escherichia coli (Filgrastim) and successfully used to treat cancer patients suffering from chemotherapy-induced neutropenia. Filgrastim is a 175 amino acid protein, containing an extra N-terminal methionine, which is needed for expression in E. coli. Here we describe a simple and low-cost process that is amenable to scaling-up for the production and purification of homogeneous and active recombinant hG-CSF expressed in E. coli cells. Here we describe cloning of the human granulocyte colony-stimulating factor coding DNA sequence, protein expression in E. coli BL21(DE3) host cells in the absence of isopropyl-beta-D-thiogalactopyranoside (IPTG) induction, efficient isolation and solubilization of inclusion bodies by a multi-step washing procedure, and a purification protocol using a single cationic exchange column. Characterization of homogeneous rhG-CSF by size exclusion and reverse phase chromatography showed similar yields to the standard. The immunoassay and N-terminal sequencing confirmed the identity of rhG-CSF. The biological activity assay, in vivo, showed an equivalent biological effect (109.4%) to the standard reference rhG-CSF. The homogeneous rhG-CSF protein yield was 3.2 mg of bioactive protein per liter of cell culture. The recombinant protein expression in the absence of IPTG induction is advantageous since cost is reduced, and the protein purification protocol using a single chromatographic step should reduce cost even further for large scale production. The physicochemical, immunological and biological analyses showed that this protocol can be useful to develop therapeutic bioproducts. In summary, the combination of different experimental strategies presented here allowed an efficient and cost-effective protocol for rhG-CSF production. These data may be of interest to biopharmaceutical companies interested in developing biosimilars and healthcare community.

  3. Human granulocyte colony stimulating factor (hG-CSF): cloning, overexpression, purification and characterization

    PubMed Central

    Vanz, Ana LS; Renard, Gaby; Palma, Mario S; Chies, Jocelei M; Dalmora, Sérgio L; Basso, Luiz A; Santos, Diógenes S

    2008-01-01

    Background Biopharmaceutical drugs are mainly recombinant proteins produced by biotechnological tools. The patents of many biopharmaceuticals have expired, and biosimilars are thus currently being developed. Human granulocyte colony stimulating factor (hG-CSF) is a hematopoietic cytokine that acts on cells of the neutrophil lineage causing proliferation and differentiation of committed precursor cells and activation of mature neutrophils. Recombinant hG-CSF has been produced in genetically engineered Escherichia coli (Filgrastim) and successfully used to treat cancer patients suffering from chemotherapy-induced neutropenia. Filgrastim is a 175 amino acid protein, containing an extra N-terminal methionine, which is needed for expression in E. coli. Here we describe a simple and low-cost process that is amenable to scaling-up for the production and purification of homogeneous and active recombinant hG-CSF expressed in E. coli cells. Results Here we describe cloning of the human granulocyte colony-stimulating factor coding DNA sequence, protein expression in E. coli BL21(DE3) host cells in the absence of isopropyl-β-D-thiogalactopyranoside (IPTG) induction, efficient isolation and solubilization of inclusion bodies by a multi-step washing procedure, and a purification protocol using a single cationic exchange column. Characterization of homogeneous rhG-CSF by size exclusion and reverse phase chromatography showed similar yields to the standard. The immunoassay and N-terminal sequencing confirmed the identity of rhG-CSF. The biological activity assay, in vivo, showed an equivalent biological effect (109.4%) to the standard reference rhG-CSF. The homogeneous rhG-CSF protein yield was 3.2 mg of bioactive protein per liter of cell culture. Conclusion The recombinant protein expression in the absence of IPTG induction is advantageous since cost is reduced, and the protein purification protocol using a single chromatographic step should reduce cost even further for large scale production. The physicochemical, immunological and biological analyses showed that this protocol can be useful to develop therapeutic bioproducts. In summary, the combination of different experimental strategies presented here allowed an efficient and cost-effective protocol for rhG-CSF production. These data may be of interest to biopharmaceutical companies interested in developing biosimilars and healthcare community. PMID:18394164

  4. Lipid profiles of follicular fluid from cows submitted to ovarian superstimulation.

    PubMed

    Santos, P H; Fontes, P K; Franchi, F F; Nogueira, M F G; Belaz, K R A; Tata, A; Eberlin, M N; Sudano, M J; Barros, C M; Castilho, A C S

    2017-05-01

    Ovarian superstimulation with exogenous gonadotropins has been extensively used to produce in vivo-derived embryos for embryo transfer in cattle. This process modifies the antral follicle microenvironment and affects oocyte and embryo quality as well the differentiation of granulosa cells. Lipids play significant roles in the cell, such as energy storage, cell structure, and fine-tuning of the physical properties and functions of biological membranes. The phospholipid (PL) contents as well as the effects of superstimulatory treatments on the PL profile of follicular fluid from cows, however, remain unknown. Therefore, to gain insight into the effects of superstimulation with follicle-stimulating hormone (FSH; P-36 protocol) or FSH combined with equine chorionic gonadotropin (eCG; P-36/eCG protocol) on the profile and abundance of PL from cows submitted or not submitted to superstimulatory protocols, were treated with these two superstimulatory protocols. As a control, non-superstimulated cows were only submitted to estrous synchronization. The follicular fluid was aspirated, the remaining cells removed and the follicular fluid stored at -80 °C until extraction. The lipid screening was performed by matrix-assisted laser desorption ionization mass spectrometry (MALDI-MS) and this technique allowed the identification of sphingomyelins (SM) and phosphatidylcholines (PC) and phosphoethanolamines (PE). The relative abundance of the ions observed in the three experimental groups was analyzed by multivariate and univariate statistical models. The phospholipid SM (16:0) and PC (36:4) and/or PC (34:1) were less (P < 0.05) abundant in the P-36 group compared to the control or P-36/eCG groups. However, the PC (34:2) was more (P < 0.05) abundant in both group of superstimulated cows compared to the control. In summary, ovarian superstimulation seems to modulate the PL content of bovine follicular fluid with a significant increase in PC (34:2), which jointly with others PC and SM, seems to offer a suitable biomarker involved with reproductive processes successful as ovary superstimulation response and embryo development. Copyright © 2017. Published by Elsevier Inc.

  5. Comparative effectiveness of light-microscopic techniques and PCR in detecting Thelohania solenopsae (Microsporidia) infections in red imported fire ants (Solenopsis invicta).

    PubMed

    Milks, Maynard L; Sokolova, Yuliya Y; Isakova, Irina A; Fuxa, James R; Mitchell, Forrest; Snowden, Karen F; Vinson, S Bradleigh

    2004-01-01

    The main goal of this study was to compare the effectiveness of three staining techniques (calcofluor white M2R, Giemsa and modified trichrome), and the polymerase chain reaction (PCR) in detecting the microsporidium Thelohania solenopsae in red imported fire ants (Solenopsis invicta). The effect of the number of ants in a sample on the sensitivity of the staining techniques and the PCR, and the effect of three DNA extraction protocols on the sensitivity of PCR were also examined. In the first protocol, the ants were macerated and the crude homogenate was used immediately in the PCR. In the second protocol, the homogenate was placed on a special membrane (FTA card) that traps DNA, which is subsequently used in the PCR. In the third protocol, the DNA was purified from the homogenate by traditional phenol-chloroform extraction. Except for PCR using FTA cards, the sensitivity (number of samples positive for T. solenopsae) of all detection techniques increased with the number of ants in the sample. Overall, Giemsa was the least sensitive of all detection techniques. Calcofluor was more sensitive than modified trichrome with ants from one site and was equally as sensitive as PCR with crude DNA or a FTA card with ants from both sites. Trichrome staining was equally as sensitive as PCR with a FTA card at both sites, but it was less sensitive than PCR with crude DNA at one site. PCR on FTA cards was less sensitive than PCR with crude DNA for ants from one site but not the other. There was no difference whether crude or phenol-chloroform purified DNA was used as template. In summary, the results of this study show that PCR based on a crude DNA solution is equal to or more sensitive in detecting T. solenopsae than the other detection techniques investigated, and that it can be used as a reliable diagnostic tool for screening field samples of S. invicta for T. solenopsae. Nevertheless, ant smear stained with calcofluor or modified trichrome should be used to buttress findings from PCR.

  6. Adaptation to transient postural perturbations

    NASA Technical Reports Server (NTRS)

    Andres, Robert O.

    1992-01-01

    This research was first proposed in May, 1986, to focus on some of the problems encountered in the analysis of postural responses gathered from crewmembers. The ultimate driving force behind this line of research was the desire to treat, predict, or explain 'Space Adaptation Syndrome' (SAS) and hence circumvent any adverse effects of space motion sickness on crewmember performance. The aim of this project was to develop an easily implemented analysis of the transient responses to platform translation that can be elicited with a protocol designed to force sensorimotor reorganization, utilizing statistically reliable criterion measures. This report will present: (1) a summary of the activity that took place in each of the three funded years of the project; (2) discussion of experimental results and their implications for future research; and (3) a list of presentations and publications resulting from this project.

  7. Computation of pH-Dependent Binding Free Energies

    PubMed Central

    Kim, M. Olivia; McCammon, J. Andrew

    2015-01-01

    Protein-ligand binding accompanies changes in the surrounding electrostatic environments of the two binding partners and may lead to changes in protonation upon binding. In cases where the complex formation results in a net transfer of protons, the binding process is pH-dependent. However, conventional free energy computations or molecular docking protocols typically employ fixed protonation states for the titratable groups in both binding partners set a priori, which are identical for the free and bound states. In this review, we draw attention to these important yet largely ignored binding-induced protonation changes in protein-ligand association by outlining physical origins and prevalence of the protonation changes upon binding. Following a summary of various theoretical methods for pKa prediction, we discuss the theoretical framework to examine the pH dependence of protein-ligand binding processes. PMID:26202905

  8. Toward Accurate and Quantitative Comparative Metagenomics

    PubMed Central

    Nayfach, Stephen; Pollard, Katherine S.

    2016-01-01

    Shotgun metagenomics and computational analysis are used to compare the taxonomic and functional profiles of microbial communities. Leveraging this approach to understand roles of microbes in human biology and other environments requires quantitative data summaries whose values are comparable across samples and studies. Comparability is currently hampered by the use of abundance statistics that do not estimate a meaningful parameter of the microbial community and biases introduced by experimental protocols and data-cleaning approaches. Addressing these challenges, along with improving study design, data access, metadata standardization, and analysis tools, will enable accurate comparative metagenomics. We envision a future in which microbiome studies are replicable and new metagenomes are easily and rapidly integrated with existing data. Only then can the potential of metagenomics for predictive ecological modeling, well-powered association studies, and effective microbiome medicine be fully realized. PMID:27565341

  9. Prospects for pluripotent stem cell therapies: into the clinic and back to the bench.

    PubMed

    Grabel, Laura

    2012-02-01

    Pluripotent stem cells, embryonic stem (ES) cells and induced pluripotent stem (iPS) cells, both hold great promise for the understanding and treatment of disease. They can be used for drug testing, as in vitro models for human disease progression, and for transplantation therapies. Research in this area has been influenced by the ever-changing political landscape, particularly in the United States. In this review, we discuss the prospects for clinical application using pluripotent cells, focusing on an evaluation of iPS cell potential, the continuing concern of tumor formation, and a summary of in vitro differentiation protocols and animal models used. We also describe the current clinical trials underway in the United States, as well as the ups and downs of funding for ES cell work. Copyright © 2011 Wiley Periodicals, Inc.

  10. A System for Information Management in BioMedical Studies—SIMBioMS

    PubMed Central

    Krestyaninova, Maria; Zarins, Andris; Viksna, Juris; Kurbatova, Natalja; Rucevskis, Peteris; Neogi, Sudeshna Guha; Gostev, Mike; Perheentupa, Teemu; Knuuttila, Juha; Barrett, Amy; Lappalainen, Ilkka; Rung, Johan; Podnieks, Karlis; Sarkans, Ugis; McCarthy, Mark I; Brazma, Alvis

    2009-01-01

    Summary: SIMBioMS is a web-based open source software system for managing data and information in biomedical studies. It provides a solution for the collection, storage, management and retrieval of information about research subjects and biomedical samples, as well as experimental data obtained using a range of high-throughput technologies, including gene expression, genotyping, proteomics and metabonomics. The system can easily be customized and has proven to be successful in several large-scale multi-site collaborative projects. It is compatible with emerging functional genomics data standards and provides data import and export in accepted standard formats. Protocols for transferring data to durable archives at the European Bioinformatics Institute have been implemented. Availability: The source code, documentation and initialization scripts are available at http://simbioms.org. Contact: support@simbioms.org; mariak@ebi.ac.uk PMID:19633095

  11. Capacity Management and Walkdown During LEO Cycling of Nickel-Hydrogen Cells and Batteries

    NASA Technical Reports Server (NTRS)

    Thaller, Lawrence H.; Zimmerman, Albert H.; To, Gloria

    2001-01-01

    This viewgraph presentation discusses the following topics: 1) Capacity walkdown defined and illustrated; 2) Importance of capacity walkdown: 3) Four approaches to understanding the phenomenon - Pressure Trend, Charging Curve, Electrochemical Voltage Spectroscopy, and Destructive Physical Analysis Studies; 4) Results of the interrelated studies; 5) Suggested mechanism for capacity walkdown; and 6) Charging protocols to avoid the problem. In summary: 1) capacity walkdown is a consequence of the inability to maintain a high state of charge; 2) Capacity loss is typically 35% which would be expected by the valence difference between gamma and beta nickel oxyhydroxide; 3) Cycling at -5 degrees facilitates the formation of the gamma phase; 4) Excessive overcharge can also facilitate gamma phase formation at the expense of cycle life; and 5) Conditions can now be suggested to help minimize capacity walkdown.

  12. A multidisciplinary prostate cancer clinic for newly diagnosed patients: developing the role of the advanced practice nurse.

    PubMed

    Madsen, Lydia T; Craig, Catherine; Kuban, Deborah

    2009-06-01

    Newly diagnosed patients with prostate cancer have various treatment options, and a multidisciplinary prostate cancer clinic (MPCC) can present all options in a single setting. An MPCC was started in 2004 at the University of Texas M.D. Anderson Cancer Center, and 258 patients with prostate cancer were evaluated in its first year. The clinic expanded in 2006 and an oncology advanced practice nurse (APN) was recruited to address specific objectives. The APN role was used to implement a quality-of-life protocol, provide detailed patient education (including a treatment summary and care plan), and serve as a single point of contact as patients move toward a treatment decision. Formal evaluation of the MPCC showed that patients were satisfied with this approach to the complex decision-making process in prostate cancer.

  13. The Giardia genome project database.

    PubMed

    McArthur, A G; Morrison, H G; Nixon, J E; Passamaneck, N Q; Kim, U; Hinkle, G; Crocker, M K; Holder, M E; Farr, R; Reich, C I; Olsen, G E; Aley, S B; Adam, R D; Gillin, F D; Sogin, M L

    2000-08-15

    The Giardia genome project database provides an online resource for Giardia lamblia (WB strain, clone C6) genome sequence information. The database includes edited single-pass reads, the results of BLASTX searches, and details of progress towards sequencing the entire 12 million-bp Giardia genome. Pre-sorted BLASTX results can be retrieved based on keyword searches and BLAST searches of the high throughput Giardia data can be initiated from the web site or through NCBI. Descriptions of the genomic DNA libraries, project protocols and summary statistics are also available. Although the Giardia genome project is ongoing, new sequences are made available on a bi-monthly basis to ensure that researchers have access to information that may assist them in the search for genes and their biological function. The current URL of the Giardia genome project database is www.mbl.edu/Giardia.

  14. Toward Accurate and Quantitative Comparative Metagenomics.

    PubMed

    Nayfach, Stephen; Pollard, Katherine S

    2016-08-25

    Shotgun metagenomics and computational analysis are used to compare the taxonomic and functional profiles of microbial communities. Leveraging this approach to understand roles of microbes in human biology and other environments requires quantitative data summaries whose values are comparable across samples and studies. Comparability is currently hampered by the use of abundance statistics that do not estimate a meaningful parameter of the microbial community and biases introduced by experimental protocols and data-cleaning approaches. Addressing these challenges, along with improving study design, data access, metadata standardization, and analysis tools, will enable accurate comparative metagenomics. We envision a future in which microbiome studies are replicable and new metagenomes are easily and rapidly integrated with existing data. Only then can the potential of metagenomics for predictive ecological modeling, well-powered association studies, and effective microbiome medicine be fully realized. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Considerations in reporting palliative care clinical trials: Standardizing information reported and authorship practices

    PubMed Central

    LeBlanc, Thomas W.; Abernethy, Amy P.; Currow, David C.; Kutner, Jean S.

    2014-01-01

    Purpose of Review The nature of palliative care practice, especially the reliance on referrals and differing models of service delivery, poses unique challenges for the creation and interpretation of an evidence base, frequently limiting the applicability of data to patient care. Here we discuss two core aspects of clinical trials reporting in palliative medicine: 1) proposed standards governing the collection and reporting of data, and 2) rules governing authorship and publication. Recent Findings Existing literature often inadequately describes the characteristics of patients, caregivers, clinicians, systems, and interventions included in studies, thereby limiting the utility of results. Summary A generalizability framework is needed to ensure a robust evidence base that advances practice. Lessons learned through the development of research cooperative groups in palliative care reinforce the importance of an authorship protocol for large trials and working groups. PMID:23080306

  16. Intraoperative Considerations for Treatment/Prevention of Prosthetic Joint Infection.

    PubMed

    Suleiman, Linda I; Mesko, Daniel R; Nam, Denis

    2018-06-23

    Innovative measures have recently been proposed to prevent periprosthetic joint infection following total hip and knee arthroplasty. We sought to review these recent innovations to determine the reported reduction in periprosthetic joint infection. The most recent literature demonstrates promising results in regard to hydrofiber dressings as an independent risk factor for primary prosthetic joint infection reduction, which in turn is also linked with cost savings. As our understanding of safe yet effective concentrations of antiseptic solutions develops, dilute betadine in particular has demonstrated encouraging efficacy which warrants continued investigation through controlled trials. In summary, we found that the application of a hydrofiber dressing may prove beneficial in decreasing the risk of prosthetic joint infection following primary total hip and knee arthroplasty. The gold standard for an infection prevention protocol continues to be explored and optimized.

  17. Cortical excitability and neurology: insights into the pathophysiology

    PubMed Central

    Badawy, Radwa A.B.; Loetscher, Tobias; Macdonell, Richard A.L.; Brodtmann, Amy

    2012-01-01

    Summary Transcranial magnetic stimulation (TMS) is a technique developed to non-invasively investigate the integrity of human motor corticospinal tracts. Over the last three decades, the use of stimulation paradigms including single-pulse TMS, paired-pulse TMS, repetitive TMS, and integration with EEG and functional imaging have been developed to facilitate measurement of cortical excitability. Through the use of these protocols, TMS has evolved into an excellent tool for measuring cortical excitability. TMS has high sensitivity in detecting subtle changes in cortical excitability, and therefore it is also a good measure of disturbances associated with brain disorders. In this review, we appraise the current literature on cortical excitability studies using TMS in neurological disorders. We begin with a brief overview of current TMS measures and then show how these have added to our understanding of the underlying mechanisms of brain disorders. PMID:23402674

  18. Near-infrared optical imaging of nucleic acid nanocarriers in vivo

    PubMed Central

    Rome, Claire; Gravier, Julien; Morille, Marie; Divita, Gilles; Bolcato-Bellemin, Anne-Laure; Josserand, Véronique; Coll, Jean-Luc

    2013-01-01

    Summary Non-invasive, real time optical imaging methods are particularly well suited for the in vivo follow up of the distribution of nucleic acids nanocarriers, their dissociation and finally the resulting gene expression or inhibition. Indeed, most small animal imaging devices are performing bioluminescence and fluorescence measurements without moving the animal, allowing a simple, rapid and cost effective method of investigation of several parameters at a time, in longitudinal experiments that can last for days or weeks. Here we propose to help the reader choosing adapted near-infrared (NIR) fluorophores or pairs of fluorophores for FRET assays, reporter genes as well as nanocarriers for in vivo gene and siRNA delivery. In addition, we present the labeling methods of these macromolecules, and of their payload and the protocols to detect them using bioluminescence and NIR fluorescence imaging in mice. PMID:23070763

  19. Bioactive calcium phosphate-based glasses and ceramics and their biomedical applications: A review.

    PubMed

    Islam, Md Towhidul; Felfel, Reda M; Abou Neel, Ensanya A; Grant, David M; Ahmed, Ifty; Hossain, Kazi M Zakir

    2017-01-01

    An overview of the formation of calcium phosphate under in vitro environment on the surface of a range of bioactive materials (e.g. from silicate, borate, and phosphate glasses, glass-ceramics, bioceramics to metals) based on recent literature is presented in this review. The mechanism of bone-like calcium phosphate (i.e. hydroxyapatite) formation and the test protocols that are either already in use or currently being investigated for the evaluation of the bioactivity of biomaterials are discussed. This review also highlights the effect of chemical composition and surface charge of materials, types of medium (e.g. simulated body fluid, phosphate-buffered saline and cell culture medium) and test parameters on their bioactivity performance. Finally, a brief summary of the biomedical applications of these newly formed calcium phosphate (either in the form of amorphous or apatite) is presented.

  20. Quality control in cone-beam computed tomography (CBCT) EFOMP-ESTRO-IAEA protocol (summary report).

    PubMed

    de Las Heras Gala, Hugo; Torresin, Alberto; Dasu, Alexandru; Rampado, Osvaldo; Delis, Harry; Hernández Girón, Irene; Theodorakou, Chrysoula; Andersson, Jonas; Holroyd, John; Nilsson, Mats; Edyvean, Sue; Gershan, Vesna; Hadid-Beurrier, Lama; Hoog, Christopher; Delpon, Gregory; Sancho Kolster, Ismael; Peterlin, Primož; Garayoa Roca, Julia; Caprile, Paola; Zervides, Costas

    2017-07-01

    The aim of the guideline presented in this article is to unify the test parameters for image quality evaluation and radiation output in all types of cone-beam computed tomography (CBCT) systems. The applications of CBCT spread over dental and interventional radiology, guided surgery and radiotherapy. The chosen tests provide the means to objectively evaluate the performance and monitor the constancy of the imaging chain. Experience from all involved associations has been collected to achieve a consensus that is rigorous and helpful for the practice. The guideline recommends to assess image quality in terms of uniformity, geometrical precision, voxel density values (or Hounsfield units where available), noise, low contrast resolution and spatial resolution measurements. These tests usually require the use of a phantom and evaluation software. Radiation output can be determined with a kerma-area product meter attached to the tube case. Alternatively, a solid state dosimeter attached to the flat panel and a simple geometric relationship can be used to calculate the dose to the isocentre. Summary tables including action levels and recommended frequencies for each test, as well as relevant references, are provided. If the radiation output or image quality deviates from expected values, or exceeds documented action levels for a given system, a more in depth system analysis (using conventional tests) and corrective maintenance work may be required. Copyright © 2017. Published by Elsevier Ltd.

  1. Exploring the Relationship between Beginning Science Teachers' Practices, Institutional Constraints, and Adult Development

    NASA Astrophysics Data System (ADS)

    Wilcox, Jesse Lee

    This year-long study explored how ten teachers--five first year, five second year--acclimated to their new school environment after leaving a master's level university science teacher preparation program known for being highly effective. Furthermore, this study sought to explore if a relationship existed between teachers' understanding and implementation of research-based science teaching practices, the barriers to enacting these practices--known as institutional constraints, and the constructive-developmental theory which explores meaning-making systems known as orders of consciousness. As a naturalistic inquiry mixed methods study, data were collected using both qualitative (e.g., semi-structured interviews, field notes) as well as quantitative methods (e.g., observation protocols, subject/object protocol). These data sources were used to construct participant summaries and a cross-case analysis. The findings from provide evidence that teachers' orders of consciousness might help to explain why understanding research-based science teaching practices are maintained by some new teachers and not others. Additionally, this study found the orders of consciousness of teachers relates to the perceptions of institutional constraints as well as how a teacher chooses to navigate those constraints. Finally, the extent to which teachers implement research-based science teaching practices is related to orders of consciousness. While many studies have focused on what meaning teachers make, this study highlights the importance of considering how teachers make meaning.

  2. Comparison of protocols for cryopreservation of rhesus monkey spermatozoa by post-thaw motility recovery and hyperactivation.

    PubMed

    Nichols, S M; Bavister, B D

    2006-01-01

    Cryopreservation of spermatozoa is useful for gene banking and for in vitro fertilisation (IVF). This study compared several published cryopreservation techniques to find the most efficient for rhesus macaques. Effectiveness was assessed by sperm longevity (post-thaw motility % and duration) and ability to hyperactivate in response to chemical activators (caffeine, dibutyryl cyclic AMP). Each ejaculate from three males was treated with four published cryopreservation protocols (Seier et al. 1993; Sanchez-Partida et al. 2000; Si et al. 2000; Isachenko et al. 2005). Upon thawing, each sub-sample was incubated either at 37 degrees C in 5% CO2 in air with or without activators or at approximately 22 degrees C in atmospheric air without activators for 0-24 h. Samples cryopreserved using one method showed zero motility and were not included in the 2 ;2 G-test statistical analysis. The other methods all demonstrated good immediate post-thaw motility rates (68%, 73% and 62% respectively) and underwent capacitation after exposure to activators. Sperm motility in each treatment decreased over time at both temperatures but overall, incubation at 22 degrees C preserved motility better in all three methods. In summary, cryopreservation of rhesus spermatozoa using the method published by Sanchez-Partida et al. or Seier et al. appeared best, potentially supporting gene banking as well as allowing for multiple IVF uses from the same sample.

  3. Formative research to develop theory-based messages for a Western Australian child drowning prevention television campaign: study protocol

    PubMed Central

    Denehy, Mel; Crawford, Gemma; Leavy, Justine; Nimmo, Lauren; Jancey, Jonine

    2016-01-01

    Introduction Worldwide, children under the age of 5 years are at particular risk of drowning. Responding to this need requires the development of evidence-informed drowning prevention strategies. Historically, drowning prevention strategies have included denying access, learning survival skills and providing supervision, as well as education and information which includes the use of mass media. Interventions underpinned by behavioural theory and formative evaluation tend to be more effective, yet few practical examples exist in the drowning and/or injury prevention literature. The Health Belief Model and Social Cognitive Theory will be used to explore participants' perspectives regarding proposed mass media messaging. This paper describes a qualitative protocol to undertake formative research to develop theory-based messages for a child drowning prevention campaign. Methods and analysis The primary data source will be focus group interviews with parents and caregivers of children under 5 years of age in metropolitan and regional Western Australia. Qualitative content analysis will be used to analyse the data. Ethics and dissemination This study will contribute to the drowning prevention literature to inform the development of future child drowning prevention mass media campaigns. Findings from the study will be disseminated to practitioners, policymakers and researchers via international conferences, peer and non-peer-reviewed journals and evidence summaries. The study was submitted and approved by the Curtin University Human Research Ethics Committee. PMID:27207621

  4. A randomized controlled trial of culturally adapted motivational interviewing for Hispanic heavy drinkers: Theory of Adaptation and Study Protocol

    PubMed Central

    Lee, Christina S.; Colby, Suzanne M.; Magill, Molly; Almeida, Joanna; Tavares, Tonya; Rohsenow, Damaris J.

    2016-01-01

    Background The NIH Strategic Plan prioritizes health disparities research for socially disadvantaged Hispanics, to reduce the disproportionate burden of alcohol-related negative consequences compared to other racial/ethnic groups. Cultural adaptation of evidence-based treatments, such as motivational interviewing (MI), can improve access and response to alcohol treatment. However, the lack of rigorous clinical trials designed to test the efficacy and theoretical underpinnings of cultural adaptation has made proof of concept difficult. Objective The CAMI2 (Culturally Adapted Motivational Interviewing) study design and its theoretical model, is described to illustrate how MI adapted to social and cultural factors (CAMI) can be discriminated against non-adapted MI. Methods and Design CAMI2, a large, 12 month randomized prospective trial, examines the efficacy of CAMI and MI among heavy drinking Hispanics recruited from the community (n=257). Outcomes are reductions in heavy drinking days (Time Line Follow-Back) and negative consequences of drinking among Hispanics (Drinkers Inventory of Consequences). A second aim examines perceived acculturation stress as a moderator of treatment outcomes in the CAMI condition. Summary The CAMI2 study design protocol is presented and the theory of adaptation is presented. Findings from the trial described may yield important recommendations on the science of cultural adaptation and improve MI dissemination to Hispanics with alcohol risk. PMID:27565832

  5. The PRECIS-2 tool has good interrater reliability and modest discriminant validity.

    PubMed

    Loudon, Kirsty; Zwarenstein, Merrick; Sullivan, Frank M; Donnan, Peter T; Gágyor, Ildikó; Hobbelen, Hans J S M; Althabe, Fernando; Krishnan, Jerry A; Treweek, Shaun

    2017-08-01

    PRagmatic Explanatory Continuum Indicator Summary (PRECIS)-2 is a tool that could improve design insight for trialists. Our aim was to validate the PRECIS-2 tool, unlike its predecessor, testing the discriminant validity and interrater reliability. Over 80 international trialists, methodologists, clinicians, and policymakers created PRECIS-2 helping to ensure face validity and content validity. The interrater reliability of PRECIS-2 was measured using 19 experienced trialists who used PRECIS-2 to score a diverse sample of 15 randomized controlled trial protocols. Discriminant validity was tested with two raters to independently determine if the trial protocols were more pragmatic or more explanatory, with scores from the 19 raters for the 15 trials as predictors of pragmatism. Interrater reliability was generally good, with seven of nine domains having an intraclass correlation coefficient over 0.65. Flexibility (adherence) and recruitment had wide confidence intervals, but raters found these difficult to rate and wanted more information. Each of the nine PRECIS-2 domains could be used to differentiate between trials taking more pragmatic or more explanatory approaches with better than chance discrimination for all domains. We have assessed the validity and reliability of PRECIS-2. An elaboration study and web site provide guidance to help future users of the tool which is continuing to be tested by trial teams, systematic reviewers, and funders. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Methodology of a systematic review.

    PubMed

    Linares-Espinós, E; Hernández, V; Domínguez-Escrig, J L; Fernández-Pello, S; Hevia, V; Mayor, J; Padilla-Fernández, B; Ribal, M J

    2018-05-03

    The objective of evidence-based medicine is to employ the best scientific information available to apply to clinical practice. Understanding and interpreting the scientific evidence involves understanding the available levels of evidence, where systematic reviews and meta-analyses of clinical trials are at the top of the levels-of-evidence pyramid. The review process should be well developed and planned to reduce biases and eliminate irrelevant and low-quality studies. The steps for implementing a systematic review include (i) correctly formulating the clinical question to answer (PICO), (ii) developing a protocol (inclusion and exclusion criteria), (iii) performing a detailed and broad literature search and (iv) screening the abstracts of the studies identified in the search and subsequently of the selected complete texts (PRISMA). Once the studies have been selected, we need to (v) extract the necessary data into a form designed in the protocol to summarise the included studies, (vi) assess the biases of each study, identifying the quality of the available evidence, and (vii) develop tables and text that synthesise the evidence. A systematic review involves a critical and reproducible summary of the results of the available publications on a particular topic or clinical question. To improve scientific writing, the methodology is shown in a structured manner to implement a systematic review. Copyright © 2018 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Patient-specific dose estimation for pediatric chest CT

    PubMed Central

    Li, Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P.

    2008-01-01

    Current methods for organ and effective dose estimations in pediatric CT are largely patient generic. Physical phantoms and computer models have only been developed for standard/limited patient sizes at discrete ages (e.g., 0, 1, 5, 10, 15years old) and do not reflect the variability of patient anatomy and body habitus within the same size/age group. In this investigation, full-body computer models of seven pediatric patients in the same size/protocol group (weight: 11.9–18.2kg) were created based on the patients’ actual multi-detector array CT (MDCT) data. Organs and structures in the scan coverage were individually segmented. Other organs and structures were created by morphing existing adult models (developed from visible human data) to match the framework defined by the segmented organs, referencing the organ volume and anthropometry data in ICRP Publication 89. Organ and effective dose of these patients from a chest MDCT scan protocol (64 slice LightSpeed VCT scanner, 120kVp, 70 or 75mA, 0.4s gantry rotation period, pitch of 1.375, 20mm beam collimation, and small body scan field-of-view) was calculated using a Monte Carlo program previously developed and validated to simulate radiation transport in the same CT system. The seven patients had normalized effective dose of 3.7–5.3mSv∕100mAs (coefficient of variation: 10.8%). Normalized lung dose and heart dose were 10.4–12.6mGy∕100mAs and 11.2–13.3mGy∕100mAs, respectively. Organ dose variations across the patients were generally small for large organs in the scan coverage (<7%), but large for small organs in the scan coverage (9%–18%) and for partially or indirectly exposed organs (11%–77%). Normalized effective dose correlated weakly with body weight (correlation coefficient:r=−0.80). Normalized lung dose and heart dose correlated strongly with mid-chest equivalent diameter (lung: r=−0.99, heart: r=−0.93); these strong correlation relationships can be used to estimate patient-specific organ dose for any other patient in the same size/protocol group who undergoes the chest scan. In summary, this work reported the first assessment of dose variations across pediatric CT patients in the same size/protocol group due to the variability of patient anatomy and body habitus and provided a previously unavailable method for patient-specific organ dose estimation, which will help in assessing patient risk and optimizing dose reduction strategies, including the development of scan protocols. PMID:19175138

  8. Patient-specific dose estimation for pediatric chest CT

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

    Li Xiang; Samei, Ehsan; Segars, W. Paul

    2008-12-15

    Current methods for organ and effective dose estimations in pediatric CT are largely patient generic. Physical phantoms and computer models have only been developed for standard/limited patient sizes at discrete ages (e.g., 0, 1, 5, 10, 15 years old) and do not reflect the variability of patient anatomy and body habitus within the same size/age group. In this investigation, full-body computer models of seven pediatric patients in the same size/protocol group (weight: 11.9-18.2 kg) were created based on the patients' actual multi-detector array CT (MDCT) data. Organs and structures in the scan coverage were individually segmented. Other organs and structuresmore » were created by morphing existing adult models (developed from visible human data) to match the framework defined by the segmented organs, referencing the organ volume and anthropometry data in ICRP Publication 89. Organ and effective dose of these patients from a chest MDCT scan protocol (64 slice LightSpeed VCT scanner, 120 kVp, 70 or 75 mA, 0.4 s gantry rotation period, pitch of 1.375, 20 mm beam collimation, and small body scan field-of-view) was calculated using a Monte Carlo program previously developed and validated to simulate radiation transport in the same CT system. The seven patients had normalized effective dose of 3.7-5.3 mSv/100 mAs (coefficient of variation: 10.8%). Normalized lung dose and heart dose were 10.4-12.6 mGy/100 mAs and 11.2-13.3 mGy/100 mAs, respectively. Organ dose variations across the patients were generally small for large organs in the scan coverage (<7%), but large for small organs in the scan coverage (9%-18%) and for partially or indirectly exposed organs (11%-77%). Normalized effective dose correlated weakly with body weight (correlation coefficient: r=-0.80). Normalized lung dose and heart dose correlated strongly with mid-chest equivalent diameter (lung: r=-0.99, heart: r=-0.93); these strong correlation relationships can be used to estimate patient-specific organ dose for any other patient in the same size/protocol group who undergoes the chest scan. In summary, this work reported the first assessment of dose variations across pediatric CT patients in the same size/protocol group due to the variability of patient anatomy and body habitus and provided a previously unavailable method for patient-specific organ dose estimation, which will help in assessing patient risk and optimizing dose reduction strategies, including the development of scan protocols.« less

  9. Assessment of Adverse Events in Protocols, Clinical Study Reports, and Published Papers of Trials of Orlistat: A Document Analysis.

    PubMed

    Schroll, Jeppe Bennekou; Penninga, Elisabeth I; Gøtzsche, Peter C

    2016-08-01

    Little is known about how adverse events are summarised and reported in trials, as detailed information is usually considered confidential. We have acquired clinical study reports (CSRs) from the European Medicines Agency through the Freedom of Information Act. The CSRs describe the results of studies conducted as part of the application for marketing authorisation for the slimming pill orlistat. The purpose of this study was to study how adverse events were summarised and reported in study protocols, CSRs, and published papers of orlistat trials. We received the CSRs from seven randomised placebo controlled orlistat trials (4,225 participants) submitted by Roche. The CSRs consisted of 8,716 pages and included protocols. Two researchers independently extracted data on adverse events from protocols and CSRs. Corresponding published papers were identified on PubMed and adverse event data were extracted from this source as well. All three sources were compared. Individual adverse events from one trial were summed and compared to the totals in the summary report. None of the protocols or CSRs contained instructions for investigators on how to question participants about adverse events. In CSRs, gastrointestinal adverse events were only coded if the participant reported that they were "bothersome," a condition that was not specified in the protocol for two of the trials. Serious adverse events were assessed for relationship to the drug by the sponsor, and all adverse events were coded by the sponsor using a glossary that could be updated by the sponsor. The criteria for withdrawal due to adverse events were in one case related to efficacy (high fasting glucose led to withdrawal), which meant that one trial had more withdrawals due to adverse events in the placebo group. Finally, only between 3% and 33% of the total number of investigator-reported adverse events from the trials were reported in the publications because of post hoc filters, though six of seven papers stated that "all adverse events were recorded." For one trial, we identified an additional 1,318 adverse events that were not listed or mentioned in the CSR itself but could be identified through manually counting individual adverse events reported in an appendix. We discovered that the majority of patients had multiple episodes of the same adverse event that were only counted once, though this was not described in the CSRs. We also discovered that participants treated with orlistat experienced twice as many days with adverse events as participants treated with placebo (22.7 d versus 14.9 d, p-value < 0.0001, Student's t test). Furthermore, compared with the placebo group, adverse events in the orlistat group were more severe. None of this was stated in the CSR or in the published paper. Our analysis was restricted to one drug tested in the mid-1990s; our results might therefore not be applicable for newer drugs. In the orlistat trials, we identified important disparities in the reporting of adverse events between protocols, clinical study reports, and published papers. Reports of these trials seemed to have systematically understated adverse events. Based on these findings, systematic reviews of drugs might be improved by including protocols and CSRs in addition to published articles.

  10. Solar Cell Calibration and Measurement Techniques

    NASA Technical Reports Server (NTRS)

    Bailey, Sheila; Brinker, Dave; Curtis, Henry; Jenkins, Phillip; Scheiman, Dave

    1997-01-01

    The increasing complexity of space solar cells and the increasing international markets for both cells and arrays has resulted in workshops jointly sponsored by NASDA, ESA and NASA. These workshops are designed to obtain international agreement on standardized values for the AMO spectrum and constant, recommend laboratory measurement practices and establish a set of protocols for international comparison of laboratory measurements. A working draft of an ISO standard, WDI 5387, 'Requirements for Measurement and Calibration Procedures for Space Solar Cells' was discussed with a focus on the scope of the document, a definition of primary standard cell, and required error analysis for all measurement techniques. Working groups addressed the issues of Air Mass Zero (AMO) solar constant and spectrum, laboratory measurement techniques, and the international round robin methodology. A summary is presented of the current state of each area and the formulation of the ISO document.

  11. Solar Cell Calibration and Measurement Techniques

    NASA Technical Reports Server (NTRS)

    Bailey, Sheila; Brinker, Dave; Curtis, Henry; Jenkins, Phillip; Scheiman, Dave

    2004-01-01

    The increasing complexity of space solar cells and the increasing international markets for both cells and arrays has resulted in workshops jointly sponsored by NASDA, ESA and NASA. These workshops are designed to obtain international agreement on standardized values for the AMO spectrum and constant, recommend laboratory measurement practices and establish a set of protocols for international comparison of laboratory measurements. A working draft of an ISO standard, WD15387, "Requirements for Measurement and Calibration Procedures for Space Solar Cells" was discussed with a focus on the scope of the document, a definition of primary standard cell, and required error analysis for all measurement techniques. Working groups addressed the issues of Air Mass Zero (AMO) solar constant and spectrum, laboratory measurement techniques, and te international round robin methodology. A summary is presented of the current state of each area and the formulation of the ISO document.

  12. Mesenchymal Stem Cells for Osteochondral Tissue Engineering

    PubMed Central

    Ng, Johnathan; Bernhard, Jonathan; Vunjak-Novakovic, Gordana

    2017-01-01

    Summary Mesenchymal stem cells (MSC) are of major interest to regenerative medicine, because of the ease of harvesting from a variety of sources (including bone marrow and fat aspirates) and ability to form a range of mesenchymal tissues, in vitro and in vivo. We focus here on the use of MSCs for engineering of cartilage, bone, and complex osteochondral tissue constructs, using protocols that replicate some aspects of the natural mesodermal development. For engineering of human bone, we discuss some of the current advances, and highlight the use of perfusion bioreactors for supporting anatomically exact human bone grafts. For engineering of human cartilage, we discuss limitations of current approaches, and highlight engineering of stratified, mechanically functional human cartilage interfaced with bone by mesenchymal condensation of MSCs. Taken together, the current advances enable engineering physiologically relevant bone, cartilage and osteochondral composites, and physiologically relevant studies of osteochondral development and disease. PMID:27236665

  13. A review on laser and light-based therapies for alopecia areata.

    PubMed

    Mlacker, Stephanie; Aldahan, Adam Souhail; Simmons, Brian James; Shah, Vidhi; McNamara, Colin Andrew; Samarkandy, Sahal; Nouri, Keyvan

    2017-04-01

    Alopecia areata is a form of non-scarring alopecia that results from a hyperactive immune response of T cells against hair follicles. Many patients with visible hair loss experience psychological and emotional distress, as a result of their cosmetic disfigurement, and frequently seek treatment. However, existing treatment methods, such as corticosteroids, topical irritants, sensitizing agents, immunosuppressants, and psoralen plus ultraviolet light A, may result in various adverse effects and often lack efficacy. Laser and light treatments offer a safe and effective alternative. This review aims to provide clinicians with a comprehensive summary of laser and light-based modalities used for the treatment of alopecia areata. Currently, the excimer laser is the most widely studied device and has shown positive results thus far. However, the development of future randomized controlled clinical trials will help determine the appropriate treatment protocols necessary, in order to achieve superior clinical outcomes.

  14. Site-specific incorporation of probes into RNA polymerase by unnatural-amino-acid mutagenesis and Staudinger-Bertozzi ligation

    PubMed Central

    Chakraborty, Anirban; Mazumder, Abhishek; Lin, Miaoxin; Hasemeyer, Adam; Xu, Qumiao; Wang, Dongye; Ebright, Yon W.; Ebright, Richard H.

    2015-01-01

    Summary A three-step procedure comprising (i) unnatural-amino-acid mutagenesis with 4-azido-phenylalanine, (ii) Staudinger-Bertozzi ligation with a probe-phosphine derivative, and (iii) in vitro reconstitution of RNA polymerase (RNAP) enables the efficient site-specific incorporation of a fluorescent probe, a spin label, a crosslinking agent, a cleaving agent, an affinity tag, or any other biochemical or biophysical probe, at any site of interest in RNAP. Straightforward extensions of the procedure enable the efficient site-specific incorporation of two or more different probes in two or more different subunits of RNAP. We present protocols for synthesis of probe-phosphine derivatives, preparation of RNAP subunits and the transcription initiation factor σ, unnatural amino acid mutagenesis of RNAP subunits and σ, Staudinger ligation with unnatural-amino-acid-containing RNAP subunits and σ, quantitation of labelling efficiency and labelling specificity, and reconstitution of RNAP. PMID:25665560

  15. Functionally defined white matter reveals segregated pathways in human ventral temporal cortex associated with category-specific processing

    PubMed Central

    Gomez, Jesse; Pestilli, Franco; Witthoft, Nathan; Golarai, Golijeh; Liberman, Alina; Poltoratski, Sonia; Yoon, Jennifer; Grill-Spector, Kalanit

    2014-01-01

    Summary It is unknown if the white matter properties associated with specific visual networks selectively affect category-specific processing. In a novel protocol we combined measurements of white matter structure, functional selectivity, and behavior in the same subjects. We find two parallel white matter pathways along the ventral temporal lobe connecting to either face-selective or place-selective regions. Diffusion properties of portions of these tracts adjacent to face- and place-selective regions of ventral temporal cortex correlate with behavioral performance for face or place processing, respectively. Strikingly, adults with developmental prosopagnosia (face blindness) express an atypical structure-behavior relationship near face-selective cortex, suggesting that white matter atypicalities in this region may have behavioral consequences. These data suggest that examining the interplay between cortical function, anatomical connectivity, and visual behavior is integral to understanding functional networks and their role in producing visual abilities and deficits. PMID:25569351

  16. Acute ankle sprain in dancers.

    PubMed

    Russell, Jeffrey A

    2010-01-01

    Ankle sprain is a common injury in dancers. Because of the relative frequency of this injury and its wide acceptance as a likely part of an active lifestyle, in many individuals it may not receive the careful attention it deserves. An extreme ankle range of motion and excellent ankle stability are fundamental to success in dance. Hence, following a proper treatment protocol is crucial for allowing a dancer who suffers an ankle sprain to return to dance as soon as possible without impaired function. This article reviews the basic principles of the etiology and management of ankle sprain in dancers. Key concepts are on-site examination and treatment, early restoration, dance-specific rehabilitation, and a carefully administered safe return to dance. Additionally, injuries that may occur in conjunction with ankle sprain are highlighted, and practical, clinically relevant summary concepts for dance healthcare professionals, dance scientists, dance teachers, and dancers are provided.

  17. Trends in Planetary Data Analysis. Executive summary of the Planetary Data Workshop

    NASA Technical Reports Server (NTRS)

    Evans, N.

    1984-01-01

    Planetary data include non-imaging remote sensing data, which includes spectrometric, radiometric, and polarimetric remote sensing observations. Also included are in-situ, radio/radar data, and Earth based observation. Also discussed is development of a planetary data system. A catalog to identify observations will be the initial entry point for all levels of users into the data system. There are seven distinct data support services: encyclopedia, data index, data inventory, browse, search, sample, and acquire. Data systems for planetary science users must provide access to data, process, store, and display data. Two standards will be incorporated into the planetary data system: Standard communications protocol and Standard format data unit. The data system configuration must combine a distributed system with those of a centralized system. Fiscal constraints have made prioritization important. Activities include saving previous mission data, planning/cost analysis, and publishing of proceedings.

  18. Complexities in Ferret Influenza Virus Pathogenesis and Transmission Models

    PubMed Central

    Eckert, Alissa M.; Tumpey, Terrence M.; Maines, Taronna R.

    2016-01-01

    SUMMARY Ferrets are widely employed to study the pathogenicity, transmissibility, and tropism of influenza viruses. However, inherent variations in inoculation methods, sampling schemes, and experimental designs are often overlooked when contextualizing or aggregating data between laboratories, leading to potential confusion or misinterpretation of results. Here, we provide a comprehensive overview of parameters to consider when planning an experiment using ferrets, collecting data from the experiment, and placing results in context with previously performed studies. This review offers information that is of particular importance for researchers in the field who rely on ferret data but do not perform the experiments themselves. Furthermore, this review highlights the breadth of experimental designs and techniques currently available to study influenza viruses in this model, underscoring the wide heterogeneity of protocols currently used for ferret studies while demonstrating the wealth of information which can benefit risk assessments of emerging influenza viruses. PMID:27412880

  19. Dissecting engineered cell types and enhancing cell fate conversion via CellNet

    PubMed Central

    Morris, Samantha A.; Cahan, Patrick; Li, Hu; Zhao, Anna M.; San Roman, Adrianna K.; Shivdasani, Ramesh A.; Collins, James J.; Daley, George Q.

    2014-01-01

    SUMMARY Engineering clinically relevant cells in vitro holds promise for regenerative medicine, but most protocols fail to faithfully recapitulate target cell properties. To address this, we developed CellNet, a network biology platform that determines whether engineered cells are equivalent to their target tissues, diagnoses aberrant gene regulatory networks, and prioritizes candidate transcriptional regulators to enhance engineered conversions. Using CellNet, we improved B cell to macrophage conversion, transcriptionally and functionally, by knocking down predicted B cell regulators. Analyzing conversion of fibroblasts to induced hepatocytes (iHeps), CellNet revealed an unexpected intestinal program regulated by the master regulator Cdx2. We observed long-term functional engraftment of mouse colon by iHeps, thereby establishing their broader potential as endoderm progenitors and demonstrating direct conversion of fibroblasts into intestinal epithelium. Our studies illustrate how CellNet can be employed to improve direct conversion and to uncover unappreciated properties of engineered cells. PMID:25126792

  20. New technology for food safety: role of the new technology staff in FSIS

    NASA Astrophysics Data System (ADS)

    Early, Howard

    2004-03-01

    The Food Safety and Inspection Service (FSIS) has implemented new procedures for meat and poultry establishments, egg products plants, and companies that manufacture and sell technology to official establishments to notify the Agency of new technology that they propose to use in meat and poultry establishments or egg products plants. If the new technology could affect FSIS regulations, product safety, inspection procedures, or the safety of Federal inspection program personnel, then the establishment or plant would need to submit a written protocol to the Agency. As part of this process, the submitter will be expected to conduct in-plant trials of the new technology. The submitter will need to provide data to FSIS throughout the duration of the in-plant trial for the Agency to examine. Data may take several forms: laboratory results, weekly or monthly summary production reports, and evaluations from inspection program personnel.

  1. Fabrication of flexible, multimodal light-emitting devices for wireless optogenetics

    PubMed Central

    Huang, Xian; Jung, Yei Hwan; Al-Hasani, Ream; Omenetto, Fiorenzo G.

    2014-01-01

    Summary The rise of optogenetics provides unique opportunities to advance materials and biomedical engineering as well as fundamental understanding in neuroscience. This protocol describes the fabrication of optoelectronic devices for studying intact neural systems. Unlike optogenetic approaches that rely on rigid fiber optics tethered to external light sources, these novel devices utilize flexible substrates to carry wirelessly powered microscale, inorganic light-emitting diodes (μ-ILEDs) and multimodal sensors inside the brain. We describe the technical procedures for construction of these devices, their corresponding radiofrequency power scavengers, and their implementation in vivo for experimental application. In total, the timeline of the procedure, including device fabrication, implantation, and preparation to begin in vivo experimentation, can be completed in approximately 3–8 weeks. Implementation of these devices allows for chronic (tested up to six months), wireless optogenetic manipulation of neural circuitry in animals experiencing behaviors such as social interaction, home cage, and other complex natural environments. PMID:24202555

  2. Generation of functional human pancreatic β cells in vitro

    PubMed Central

    Pagliuca, Felicia W.; Millman, Jeffrey R.; Gürtler, Mads; Segel, Michael; Van Dervort, Alana; Ryu, Jennifer Hyoje; Peterson, Quinn P.; Greiner, Dale; Melton, Douglas A.

    2015-01-01

    Summary The generation of insulin-producing pancreatic β cells from stem cells in vitro would provide an unprecedented cell source for drug discovery and cell transplantation therapy in diabetes. However, insulin-producing cells previously generated from human pluripotent stem cells (hPSC) lack many functional characteristics of bona fide β cells. Here we report a scalable differentiation protocol that can generate hundreds of millions of glucose-responsive β cells from hPSC in vitro. These stem cell derived β cells (SC-β) express markers found in mature β cells, flux Ca2+ in response to glucose, package insulin into secretory granules and secrete quantities of insulin comparable to adult β cells in response to multiple sequential glucose challenges in vitro. Furthermore, these cells secrete human insulin into the serum of mice shortly after transplantation in a glucose-regulated manner, and transplantation of these cells ameliorates hyperglycemia in diabetic mice. PMID:25303535

  3. Bioactive calcium phosphate–based glasses and ceramics and their biomedical applications: A review

    PubMed Central

    Islam, Md Towhidul; Felfel, Reda M; Abou Neel, Ensanya A; Grant, David M; Ahmed, Ifty; Hossain, Kazi M Zakir

    2017-01-01

    An overview of the formation of calcium phosphate under in vitro environment on the surface of a range of bioactive materials (e.g. from silicate, borate, and phosphate glasses, glass-ceramics, bioceramics to metals) based on recent literature is presented in this review. The mechanism of bone-like calcium phosphate (i.e. hydroxyapatite) formation and the test protocols that are either already in use or currently being investigated for the evaluation of the bioactivity of biomaterials are discussed. This review also highlights the effect of chemical composition and surface charge of materials, types of medium (e.g. simulated body fluid, phosphate-buffered saline and cell culture medium) and test parameters on their bioactivity performance. Finally, a brief summary of the biomedical applications of these newly formed calcium phosphate (either in the form of amorphous or apatite) is presented. PMID:28794848

  4. PubMed Central

    GIUNTINI, G.; NICASTRO, R.; CIABOTTI, A.; BRUSCHINI, L.; BERRETTINI, S.

    2016-01-01

    SUMMARY The implementation of regional protocols for newborn hearing screening and early audiologic diagnosis represent the first step of the entire diagnostic, rehabilitative and prosthetic programme for children with permanent hearing impairment. The maximum benefit of early diagnosis can indeed be obtained only by prompt rehabilitation aimed at fostering the child's communicative, linguistic and cognitive development. Within the framework of the CMM 2013 project of the Ministry of Health entitled "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the problems concerning the promotion of the global development of children with PHI throughan early rehabilitation project based on shared knowledge and scientific evidence. In this project, our specific aim was to define the features and modes of access to a precise and specialised rehabilitation project for the small hearing-impaired child within three months from audiologic diagnosis. Three main recommendations relative to assessment and rehabilitation aspects of early care emerged from the study. PMID:27054391

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

    Bamberger, Judith A.; Piepel, Gregory F.; Enderlin, Carl W.

    Understanding how uncertainty manifests itself in complex experiments is important for developing the testing protocol and interpreting the experimental results. This paper describes experimental and measurement uncertainties, and how they can depend on the order of performing experimental tests. Experiments with pulse-jet mixers in tanks at three scales were conducted to characterize the performance of transient-developing periodic flows in Newtonian slurries. Other test parameters included the simulant, solids concentration, and nozzle exit velocity. Critical suspension velocity and cloud height were the metrics used to characterize Newtonian slurry flow associated with mobilization and mixing. During testing, near-replicate and near-repeat tests weremore » conducted. The experimental results were used to quantify the combined experimental and measurement uncertainties using standard deviations and percent relative standard deviations (%RSD) The uncertainties in critical suspension velocity and cloud height tend to increase with the values of these responses. Hence, the %RSD values are the more appropriate summary measure of near-replicate testing and measurement uncertainty.« less

  6. Gene knockdown by morpholino-modified oligonucleotides in the zebrafish model: applications for developmental toxicology

    PubMed Central

    Timme-Laragy, Alicia R.; Karchner, Sibel I.; Hahn, Mark E.

    2014-01-01

    Summary The zebrafish (Danio rerio) has long been used as a model for developmental biology, making it an excellent model to use also in developmental toxicology. The many advantages of zebrafish include their small size, prolific spawning, rapid development, and transparent embryos. They can be easily manipulated genetically through the use of transgenic technology and gene knock-down via morpholino-modified antisense oligonucleotides (MOs). Knocking down specific genes to assess their role in the response to toxicant exposure provides a way to further our knowledge of how developmental toxicants work on a molecular and mechanistic level, while establishing a relationship between these molecular events and morphological, behavioral, and/or physiological effects (i.e. phenotypic anchoring). In this chapter we address important considerations for using MOs to study developmental toxicology in zebrafish embryos and provide a protocol for their use. PMID:22669659

  7. Ocular Tropism of Respiratory Viruses

    PubMed Central

    Rota, Paul A.; Tumpey, Terrence M.

    2013-01-01

    SUMMARY Respiratory viruses (including adenovirus, influenza virus, respiratory syncytial virus, coronavirus, and rhinovirus) cause a broad spectrum of disease in humans, ranging from mild influenza-like symptoms to acute respiratory failure. While species D adenoviruses and subtype H7 influenza viruses are known to possess an ocular tropism, documented human ocular disease has been reported following infection with all principal respiratory viruses. In this review, we describe the anatomical proximity and cellular receptor distribution between ocular and respiratory tissues. All major respiratory viruses and their association with human ocular disease are discussed. Research utilizing in vitro and in vivo models to study the ability of respiratory viruses to use the eye as a portal of entry as well as a primary site of virus replication is highlighted. Identification of shared receptor-binding preferences, host responses, and laboratory modeling protocols among these viruses provides a needed bridge between clinical and laboratory studies of virus tropism. PMID:23471620

  8. Innate immunity in HIV infection and implications for vaccine design: a summary of the workshop held at the National Institute of Allergy and Infectious Diseases, Bethesda on February 25-26, 2010.

    PubMed

    Bansal, Geetha P; Leitner, Wolfgang W

    2010-12-06

    The search for an effective HIV vaccine continues to be a challenge. Several candidates have been tested in preclinical protocols, and a few have been tested in clinical trials without resounding success. It is unclear why vaccine approaches to control HIV infection have been unsuccessful, but opportunities to dissect the causes for the failure have surfaced from recent work on the virology, immunology and pathogenesis of HIV and from analysis of vaccine studies. The significance of the innate immune system in HIV infection may provide new paths to discover effective approaches. This report summarizes a workshop held to discuss the role of selected aspects of innate immunity to viral infections and successful vaccines that may have important implications for designing effective HIV vaccines. Copyright © 2010. Published by Elsevier Ltd.. All rights reserved.

  9. Profiling plasma extracellular vesicle by pluronic block-copolymer based enrichment method unveils features associated with breast cancer aggression, metastasis and invasion

    PubMed Central

    Rosenow, Matthew; Xiao, Nick; Spetzler, David

    2018-01-01

    ABSTRACT Extracellular vesicle (EV)-based liquid biopsies have been proposed to be a readily obtainable biological substrate recently for both profiling and diagnostics purposes. Development of a fast and reliable preparation protocol to enrich such small particles could accelerate the discovery of informative, disease-related biomarkers. Though multiple EV enrichment protocols are available, in terms of efficiency, reproducibility and simplicity, precipitation-based methods are most amenable to studies with large numbers of subjects. However, the selectivity of the precipitation becomes critical. Here, we present a simple plasma EV enrichment protocol based on pluronic block copolymer. The enriched plasma EV was able to be verified by multiple platforms. Our results showed that the particles enriched from plasma by the copolymer were EV size vesicles with membrane structure; proteomic profiling showed that EV-related proteins were significantly enriched, while high-abundant plasma proteins were significantly reduced in comparison to other precipitation-based enrichment methods. Next-generation sequencing confirmed the existence of various RNA species that have been observed in EVs from previous studies. Small RNA sequencing showed enriched species compared to the corresponding plasma. Moreover, plasma EVs enriched from 20 advanced breast cancer patients and 20 age-matched non-cancer controls were profiled by semi-quantitative mass spectrometry. Protein features were further screened by EV proteomic profiles generated from four breast cancer cell lines, and then selected in cross-validation models. A total of 60 protein features that highly contributed in model prediction were identified. Interestingly, a large portion of these features were associated with breast cancer aggression, metastasis as well as invasion, consistent with the advanced clinical stage of the patients. In summary, we have developed a plasma EV enrichment method with improved precipitation selectivity and it might be suitable for larger-scale discovery studies. PMID:29696079

  10. A dosimetry technique for measuring kilovoltage cone‐beam CT dose on a linear accelerator using radiotherapy equipment

    PubMed Central

    Lawford, Catherine E.

    2014-01-01

    This work develops a technique for kilovoltage cone‐beam CT (CBCT) dosimetry that incorporates both point dose and integral dose in the form of dose length product, and uses readily available radiotherapy equipment. The dose from imaging protocols for a range of imaging parameters and treatment sites was evaluated. Conventional CT dosimetry using 100 mm long pencil chambers has been shown to be inadequate for the large fields in CBCT and has been replaced in this work by a combination of point dose and integral dose. Absolute dose measurements were made with a small volume ion chamber at the central slice of a radiotherapy phantom. Beam profiles were measured using a linear diode array large enough to capture the entire imaging field. These profiles were normalized to absolute dose to form dose line integrals, which were then weighted with radial depth to form the DLPCBCT. This metric is analogous to the standard dose length product (DLP), but derived differently to suit the unique properties of CBCT. Imaging protocols for head and neck, chest, and prostate sites delivered absolute doses of 0.9, 2.2, and 2.9 cGy to the center of the phantom, and DLPCBCT of 28.2, 665.1, and 565.3 mGy.cm, respectively. Results are displayed as dose per 100 mAs and as a function of key imaging parameters such as kVp, mAs, and collimator selection in a summary table. DLPCBCT was found to correlate closely with the dimension of the imaging region and provided a good indication of integral dose. It is important to assess integral dose when determining radiation doses to patients using CBCT. By incorporating measured beam profiles and DLP, this technique provides a CBCT dosimetry in radiotherapy phantoms and allows the prediction of imaging dose for new CBCT protocols. PACS number: 87.57.uq PMID:25207398

  11. An Optimized and Simplified System of Mouse Embryonic Stem Cell Cardiac Differentiation for the Assessment of Differentiation Modifiers

    PubMed Central

    Hartman, Matthew E.; Librande, Jason R.; Medvedev, Ivan O.; Ahmad, Rabiah N.; Moussavi-Harami, Farid; Gupta, Pritha P.; Chien, Wei-Ming; Chin, Michael T.

    2014-01-01

    Generating cardiomyocytes from embryonic stem cells is an important technique for understanding cardiovascular development, the origins of cardiovascular diseases and also for providing potential reagents for cardiac repair. Numerous methods have been published but often are technically challenging, complex, and are not easily adapted to assessment of specific gene contributions to cardiac myocyte differentiation. Here we report the development of an optimized protocol to induce the differentiation of mouse embryonic stem cells to cardiac myocytes that is simplified and easily adapted for genetic studies. Specifically, we made four critical findings that distinguish our protocol: 1) mouse embryonic stem cells cultured in media containing CHIR99021 and PD0325901 to maintain pluripotency will efficiently form embryoid bodies containing precardiac mesoderm when cultured in these factors at a reduced dosage, 2) low serum conditions promote cardiomyocyte differentiation and can be used in place of commercially prepared StemPro nutrient supplement, 3) the Wnt inhibitor Dkk-1 is dispensable for efficient cardiac differentiation and 4) tracking differentiation efficiency may be done with surface expression of PDGFRα alone. In addition, cardiac mesodermal precursors generated by this system can undergo lentiviral infection to manipulate the expression of specific target molecules to assess effects on cardiac myocyte differentiation and maturation. Using this approach, we assessed the effects of CHF1/Hey2 on cardiac myocyte differentiation, using both gain and loss of function. Overexpression of CHF1/Hey2 at the cardiac mesoderm stage had no apparent effect on cardiac differentiation, while knockdown of CHF1/Hey2 resulted in increased expression of atrial natriuretic factor and connexin 43, suggesting an alteration in the phenotype of the cardiomyocytes. In summary we have generated a detailed and simplified protocol for generating cardiomyocytes from mES cells that is optimized for investigating factors that affect cardiac differentiation. PMID:24667642

  12. Practicing Surgeons Lead in Quality Care, Safety, and Cost Control

    PubMed Central

    Shively, Eugene H.; Heine, Michael J.; Schell, Robert H.; Sharpe, J Neal; Garrison, R Neal; Vallance, Steven R.; DeSimone, Kenneth J.S.; Polk, Hiram C.

    2004-01-01

    Objective: To report the experiences of 66 surgical specialists from 15 different hospitals who performed 43 CPT-based procedures more than 16,000 times. Summary Background Data: Surgeons are under increasing pressure to demonstrate patient safety data as quantitated by objective and subjective outcomes that meet or exceed the standards of benchmark institutions or databases. Methods: Data from 66 surgical specialists on 43 CPT-based procedures were accessioned over a 4-year period. The hospitals vary from a small 30-bed hospital to large teaching hospitals. All reported deaths and complications were verified from hospital and office records and compared with benchmarks. Results: Over a 4-year inclusive period (1999–2002), 16,028 elective operations were accessioned. There was a total 1.4% complication rate and 0.05% death rate. A system has been developed for tracking outcomes. A wide range of improvements have been identified. These include the following: 1) improved classification of indications for systemic prophylactic antibiotic use and reduction in the variety of drugs used, 2) shortened length of stay for standard procedures in different surgical specialties, 3) adherence to strict indicators for selected operative procedures, 4) less use of costly diagnostic procedures, 5) decreased use of expensive home health services, 6) decreased use of very expensive drugs, 7) identification of the unnecessary expense of disposable laparoscopic devices, 8) development of a method to compare a one-surgeon hospital with his peers, and 9) development of unique protocols for interaction of anesthesia and surgery. The system also provides a very good basis for confirmation of patient safety and improvement therein. Conclusions: Since 1998, Quality Surgical Solutions, PLLC, has developed simple physician-authored protocols for delivering high-quality and cost-effective surgery that measure up to benchmark institutions. We have discovered wide areas for improvements in surgery by adherence to simple protocols, minimizing death and complications and clarifying cost issues. PMID:15166954

  13. Establishing a Mouse Model of a Pure Small Fiber Neuropathy with the Ultrapotent Agonist of Transient Receptor Potential Vanilloid Type 1.

    PubMed

    Lee, Yi-Chen; Lu, Shui-Chin; Hsieh, Yu-Lin

    2018-02-13

    Patients with diabetes mellitus (DM) or those experiencing the neurotoxic effects of chemotherapeutic agents may develop sensation disorders due to degeneration and injury of small-diameter sensory neurons, referred to as small fiber neuropathy. Present animal models of small fiber neuropathy affect both large- and small-diameter sensory fibers and thus create a neuropathology too complex to properly assess the effects of injured small-diameter sensory fibers. Therefore, it is necessary to develop an experimental model of pure small fiber neuropathy to adequately examine these issues. This protocol describes an experimental model of small fiber neuropathy specifically affecting small-diameter sensory nerves with resiniferatoxin (RTX), an ultrapotent agonist of transient receptor potential vanilloid type 1 (TRPV1), through a single dose of intraperitoneal injection, referred to as RTX neuropathy. This RTX neuropathy showed pathological manifestations and behavioral abnormalities that mimic the clinical characteristics of patients with small fiber neuropathy, including intraepidermal nerve fiber (IENF) degeneration, specifically injury in small-diameter neurons, and induction of thermal hypoalgesia and mechanical allodynia. This protocol tested three doses of RTX (200, 50, and 10 µg/kg, respectively) and concluded that a critical dose of RTX (50 µg/kg) is required for the development of typical small fiber neuropathy manifestations, and prepared a modified immunostaining procedure to investigate IENF degeneration and neuronal soma injury. The modified procedure is fast, systematic, and economic. Behavioral evaluation of neuropathic pain is critical to reveal the function of small-diameter sensory nerves. The evaluation of mechanical thresholds in experimental rodents is particularly challenging and this protocol describes a customized metal mesh that is suitable for this type of assessment in rodents. In summary, RTX neuropathy is a new and easily established experimental model to evaluate the molecular significance and intervention underlying neuropathic pain for the development of therapeutic agents.

  14. Treatment of Narcolepsy with Methamphetamine

    PubMed Central

    Miller, Merrill M.; Hajdukovic, Roza; Erman, Milton K.

    2008-01-01

    Summary Eight pairs of subjects (each consisting of a narcoleptic and a control matched on the basis of age, sex, educational background and job) were evaluated under the following double-blind, randomized treatment conditions: baseline, placebo, low dose and high dose methamphetamine. Subjects were drug-free for 2 weeks prior to beginning the protocol. Methamphetamine was the only drug taken during the protocol and was given in a single morning dose of 0, 20 or 40–60 mg to narcoleptics and 0, 5 or 10 mg to controls. The protocol was 28 days long, with each of the four treatment conditions lasting 4 days followed by 3 days of washout. Nighttime polysomnography and daytime testing were done during the last 24 hours of each treatment condition. Daytime sleep tendency was assessed with the multiple sleep latency test (MSLT). Daytime performance was assessed with performance tests including a simple, computer-based driving task. Narcoleptics’ mean MSLT sleep latency increased from 4.3 minutes on placebo to 9.3 minutes on high dose, compared with an increase from 10.4 to 17.1 minutes for controls. Narcoleptics’ error rate on the driving task decreased from 2.53% on placebo to 0.33% on high dose, compared with a decrease from 0.22% to 0.16% for controls. The effects of methamphetamine on nocturnal sleep were generally dose-dependent and affected sleep continuity and rapid eye movement (REM) sleep. Elimination half life was estimated to be between 15.9 and 22.0 hours. Mild side effects emerged in a dose-dependent fashion and most often involved the central nervous system and gastrointestinal tract. We concluded that methamphetamine caused a dose-dependent decrease in daytime sleep tendency and improvement in performance in both narcoleptics and controls. Methamphetamine at doses of 40–60 mg allowed narcoleptics to function at levels comparable to those of unmedicated controls. PMID:8341891

  15. A dosimetry technique for measuring kilovoltage cone-beam CT dose on a linear accelerator using radiotherapy equipment.

    PubMed

    Scandurra, Daniel; Lawford, Catherine E

    2014-07-08

    This work develops a technique for kilovoltage cone-beam CT (CBCT) dosimetry that incorporates both point dose and integral dose in the form of dose length product, and uses readily available radiotherapy equipment. The dose from imaging protocols for a range of imaging parameters and treatment sites was evaluated. Conventional CT dosimetry using 100 mm long pencil chambers has been shown to be inadequate for the large fields in CBCT and has been replaced in this work by a combination of point dose and integral dose. Absolute dose measurements were made with a small volume ion chamber at the central slice of a radiotherapy phantom. Beam profiles were measured using a linear diode array large enough to capture the entire imaging field. These profiles were normalized to absolute dose to form dose line integrals, which were then weighted with radial depth to form the DLPCBCT. This metric is analogous to the standard dose length product (DLP), but derived differently to suit the unique properties of CBCT. Imaging protocols for head and neck, chest, and prostate sites delivered absolute doses of 0.9, 2.2, and 2.9 cGy to the center of the phantom, and DLPCBCT of 28.2, 665.1, and 565.3mGy.cm, respectively. Results are displayed as dose per 100 mAs and as a function of key imaging parameters such as kVp, mAs, and collimator selection in a summary table. DLPCBCT was found to correlate closely with the dimension of the imaging region and provided a good indication of integral dose. It is important to assess integral dose when determining radiation doses to patients using CBCT. By incorporating measured beam profiles and DLP, this technique provides a CBCT dosimetry in radiotherapy phantoms and allows the prediction of imaging dose for new CBCT protocols.

  16. Measurement of health system performance at district level: A study protocol.

    PubMed

    Sharma, Atul; Prinja, Shankar; Aggarwal, Arun Kumar

    2017-12-13

    Limited efforts have been observed in low and middle income countries to undertake health system performance assessment at district level. Absence of a comprehensive data collection tool and lack of a standardised single summary measure defining overall performance are some of the main problems. Present study has been undertaken to develop a summary composite health system performance index at district level. A broad range of indicators covering all six domains as per building block framework were finalized by an expert panel. The domains were classified into twenty sub-domains, with 70 input and process indicators to measure performance. Seven sub-domains for assessing health system outputs and outcomes were identified, with a total of 28 indicators. Districts in Haryana state from north India were selected for the study. Primary and secondary data will be collected from 378 health facilities, district and state health directorate headquarters. Indicators will be normalized, aggregated to generate composite performance index at district level. Domain specific scores will present the quality of individual building block domains in the public health system. Robustness of the results will be checked using sensitivity analysis. The study presents a methodology for comprehensive assessment of all health system domains on basis of input, process, output and outcome indicators which has never been reported from India. Generation of this index will help identify policy and implementation areas of concern and point towards potential solutions. Results may also help understand relationships between individual building blocks and their sub-components.

  17. Voice Rest versus Exercise: A Review of the Literature

    PubMed Central

    Ishikawa, Keiko; Thibeault, Susan

    2010-01-01

    Voice rest is commonly prescribed after vocal fold surgery to promote wound healing of the vocal fold. Currently, there is no standard protocol that is established based on biological evidence. In orthopedic rehabilitation, long-term rest is found to be less effective for connective tissue healing than exercise. Connective tissue healing is also an important factor for successful voice rehabilitation; however, whether this concept can be extrapolated to voice rehabilitation is unknown. The purpose of this article is to review current clinical and basic science literature to examine the effect of voice rest in post-surgical rehabilitation. First, we present a summary of clinical literature that pertains to voice rest. Second, description of connective tissue that are involved in orthopedic and voice rehabilitation, specifically, ligament and lamina propria, respectively, and their wound healing process are offered. Third, a summary of the literature from orthopedic research on the effect of rest versus exercise is presented. Lastly, it summarizes in vitro and in vivo studies that examined the effect of mechanical stress on vocal fold tissue. Current literature suggests that there is a lack of clinical evidence that supports a specific type and duration of voice rest, and extrapolation of the findings from orthopedic research may be unreasonable due to the morphological and biochemical difference between the tissues. In order to determine the effect of voice rest, further elucidation of vocal fold wound healing process and the effect of mechanical stress on vocal fold tissue remodeling are needed. PMID:19660903

  18. Identifying additional studies for a systematic review of retention strategies in randomised controlled trials: making contact with trials units and trial methodologists.

    PubMed

    Brueton, Valerie; Tierney, Jayne F; Stenning, Sally; Rait, Greta

    2017-08-22

    Search strategies for systematic reviews aim to identify all evidence relevant to the research question posed. Reports of methodological research can be difficult to find leading to biased results in systematic reviews of research methodology. Evidence suggests that contact with investigators can help to identify unpublished research. To identify additional eligible randomised controlled trials (RCTs) for a Cochrane systematic review of strategies to improve retention in RCTs, we conducted a survey of UK clinical trials units (CTUs) and made contact with RCT methodologists. Key contacts for all UK CTUs were sent a personalised email with a short questionnaire and summary protocol of the Cochrane methodology review. The questionnaire asked whether a RCT evaluating strategies to improve retention embedded in a RCT had ever been conducted by the CTU. Questions about the stage of completion and publication of such RCTs were included. The summary protocol outlined the aims, eligibility criteria, examples of types of retention strategies, and the primary outcome for the systematic review. Personal communication with RCT methodologists and presentations of preliminary results of the review at conferences were also used to identify additional eligible RCTs. We checked the results of our standard searches to see if eligible studies identified through these additional methods were also found using our standard searches. We identified 14 of the 38 RCTs included in the Cochrane methodology review by contacting trials units and methodologists. Eleven of the 14 RCTs identified by these methods were either published in grey literature, in press or unpublished. Three remaining RCTs were fully published at the time. Six of the RCTs identified were not found through any other searches. The RCTs identified represented data for 6 of 14 RCTs of incentive strategies (52% of randomised participants included in the review), and 6 of 14 RCTs of communication strategies (52% of randomised participants included in the Cochrane review). Data were unavailable for two of the RCTs identified. Methodological evaluations embedded in RCTs may be unpublished, published in the grey literature or where published, poorly indexed in bibliographic databases. To identify such studies and minimise selection bias in systematic reviews of methodological evaluations, reviewers should consider contacting CTUs and trial methodologists.

  19. Epidemiology of chronic obstructive pulmonary disease in the global HIV-infected population: a systematic review and meta-analysis protocol.

    PubMed

    Bigna, Jean Joel R; Kenne, Angeladine Malaha; Asangbeh, Serra Lem

    2017-03-29

    Evidence suggests a relationship between human immunodeficiency virus (HIV) infection and chronic obstructive pulmonary disease (COPD). Although the high burden of COPD and the HIV disease is clearly demonstrated, to the best of our knowledge, there is a lack of summary and meta-analysis data on the epidemiology of COPD in the global HIV-infected population to date. The present protocol for a systematic review and meta-analysis intends to summarize existing data on the prevalence, incidence, and risk factors of COPD in the global HIV-infected population. The present review will include cohort, cross-sectional, and case-control studies conducted among HIV infected people, which report prevalence, incidence, and factors associated with COPD or enough data for their estimation. We will consider published and unpublished studies in English and French language, regardless of geographical location. Relevant records will be searched using PubMed/Medline, and Scopus from inception to December 31st, 2016. Reference lists of eligible papers and relevant review articles will be screened. Two investigators will independently screen, select studies, and extract data, with discrepancies resolved by consensus or arbitrarily by a third investigator. Risk of bias and methodological quality of the included studies will be assessed using the Newcastle-Ottawa Scale. Funnel-plots and Egger's test will be used to determine publication bias. The study-specific estimates will be pooled through a random-effects meta-analysis model to obtain an overall summary estimate. To keep the effect of studies with extremely small or extremely large estimates on the overall estimate to a minimum, the variance of the study-specific prevalence/incidence will be stabilized with the Freeman-Tukey single arc-sine transformation. The heterogeneity will be evaluated by the χ 2 test on Cochrane's Q statistic. Results will be presented by geographic region and by antiretroviral therapy status. We plan to summarize data on factors associated with COPD in narrative format. This systematic review and meta-analysis will give an overview of the epidemiology of COPD in the global HIV population to inform policy-makers and to provide accurate data that can underpin effective interventions for optimizing their detection and management. PROSPERO CRD42016052639 .

  20. A mobile application to support collection and analytics of real-time critical care data.

    PubMed

    Vankipuram, Akshay; Vankipuram, Mithra; Ghaemmaghami, Vafa; Patel, Vimla L

    2017-11-01

    Data collection, in high intensity environments, poses several challenges including the ability to observe multiple streams of information. These problems are especially evident in critical care, where monitoring of the Advanced Trauma Life Support (ATLS) protocol provides an excellent opportunity to study the efficacy of applications that allow for the rapid capture of event information, providing theoretically-driven feedback using the data. Our goal was, (a) to design and implement a way to capture data on deviation from the standard practice based on the theoretical foundation of error classification from our past research, (b) to provide a means to meaningfully visualize the collected data, and (c) to provide a proof-of-concept for this implementation, using some understanding of user experience in clinical practice. We present the design and development of a web application designed to be used primarily on mobile devices and a summary data viewer to allow clinicians to, (a) track their activities, (b) provide real-time feedback of deviations from guidelines and protocols, and (c) provide summary feedback highlighting decisions made. We used a framework previously developed to classify activities in trauma as the theoretical foundation of the rules designed to do the same algorithmically, in our application. Attending physicians at a Level 1 trauma center used the application in the clinical setting and provided feedback for iterative development. Informal interviews and surveys were used to gain some deeper understanding of the user experience using this application in-situ. Activity visualizations were created highlighting decisions made during a trauma code as well as classification of tasks per the theoretical framework. The attendings reviewed the efficacy of the data visualizations as part of their interviews. We also conducted a proof-of-concept evaluation by way of usability questionnaire. Two attendings rated 4 out of the usability 6 categories highly (inter-rater reliability: R = 0.87; weighted kappa = 0.59). This could be attributed to the fact that they were able to fit the use of the application into their regular workflow during a trauma code relatively seamlessly. A deeper evaluation is required to answer explain this further. Our application can be used to capture and present data to provide an accurate reflection of work activities in real-time in complex critical care environments, without any significant interruptions to workflow. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Protocols for the dosimetry of high-energy photon and electron beams: a comparison of the IAEA TRS-398 and previous international Codes of Practice

    NASA Astrophysics Data System (ADS)

    Andreo, Pedro; Saiful Huq, M.; Westermark, Mathias; Song, Haijun; Tilikidis, Aris; DeWerd, Larry; Shortt, Ken

    2002-09-01

    A new international Code of Practice for radiotherapy dosimetry co-sponsored by several international organizations has been published by the IAEA, TRS-398. It is based on standards of absorbed dose to water, whereas previous protocols (TRS-381 and TRS-277) were based on air kerma standards. To estimate the changes in beam calibration caused by the introduction of TRS-398, a detailed experimental comparison of the dose determination in reference conditions in high-energy photon and electron beams has been made using the different IAEA protocols. A summary of the formulation and reference conditions in the various Codes of Practice, as well as of their basic data, is presented first. Accurate measurements have been made in 25 photon and electron beams from 10 clinical accelerators using 12 different cylindrical and plane-parallel chambers, and dose ratios under different conditions of TRS-398 to the other protocols determined. A strict step-by-step checklist was followed by the two participating clinical institutions to ascertain that the resulting calculations agreed within tenths of a per cent. The maximum differences found between TRS-398 and the previous Codes of Practice TRS-277 (2nd edn) and TRS-381 are of the order of 1.5-2.0%. TRS-398 yields absorbed doses larger than the previous protocols, around 1.0% for photons (TRS-277) and for electrons (TRS-381 and TRS-277) when plane-parallel chambers are cross-calibrated. For the Markus chamber, results show a very large variation, although a fortuitous cancellation of the old stopping powers with the ND,w/NK ratios makes the overall discrepancy between TRS-398 and TRS-277 in this case smaller than for well-guarded plane-parallel chambers. Chambers of the Roos-type with a 60Co ND,w calibration yield the maximum discrepancy in absorbed dose, which varies between 1.0% and 1.5% for TRS-381 and between 1.5% and 2.0% for TRS-277. Photon beam calibrations using directly measured or calculated TPR20,10 from a percentage dose data at SSD = 100 cm were found to be indistinguishable. Considering that approximately 0.8% of the differences between TRS-398 and the NK-based protocols are caused by the change to the new type of standards, the remaining difference in absolute dose is due either to a close similarity in basic data or to a fortuitous cancellation of the discrepancies in data and type of chamber calibration. It is emphasized that the NK-ND,air and ND,w formalisms have very similar uncertainty when the same criteria are used for both procedures. Arguments are provided in support of the recommendation for a change in reference dosimetry based on standards of absorbed dose to water.

  2. Lack of effect of drinking water barium on cardiovascular risk factors.

    PubMed Central

    Wones, R G; Stadler, B L; Frohman, L A

    1990-01-01

    Higher cardiovascular mortality has been associated in a single epidemiological study with higher levels of barium in drinking water. The purpose of this study was to determine whether drinking water barium at levels found in some U.S. communities alters the known risk factors for cardiovascular disease. Eleven healthy men completed a 10-week dose-response protocol in which diet was controlled (600 mg cholesterol; 40% fat, 40% carbohydrate, 20% protein; sodium and potassium controlled at the subject's pre-protocol estimated intake). Other aspects of the subjects' lifestyles known to affect cardiac risk factors were controlled, and the barium content (as barium chloride) of the drinking water (1.5 L/day) was varied from 0 (first 2 weeks), to 5 ppm (next 4 weeks), to 10 ppm (last 4 weeks). Multiple blood and urine samples, morning and evening blood pressure measurements, and 48-hr electrocardiographic monitoring were performed at each dose of barium. There were no changes in morning or evening systolic or diastolic blood pressures, plasma cholesterol or lipoprotein or apolipoprotein levels, serum potassium or glucose levels, or urine catecholamine levels. There were no arrhythmias related to barium exposure detected on continuous electrocardiographic monitoring. A trend was seen toward increased total serum calcium levels with exposure to barium, which was of borderline statistical significance and of doubtful clinical significance. In summary, drinking water barium at levels of 5 and 10 ppm did not appear to affect any of the known modifiable cardiovascular risk factors. PMID:2384067

  3. The use of 3D surface scanning for the measurement and assessment of the human foot

    PubMed Central

    2010-01-01

    Background A number of surface scanning systems with the ability to quickly and easily obtain 3D digital representations of the foot are now commercially available. This review aims to present a summary of the reported use of these technologies in footwear development, the design of customised orthotics, and investigations for other ergonomic purposes related to the foot. Methods The PubMed and ScienceDirect databases were searched. Reference lists and experts in the field were also consulted to identify additional articles. Studies in English which had 3D surface scanning of the foot as an integral element of their protocol were included in the review. Results Thirty-eight articles meeting the search criteria were included. Advantages and disadvantages of using 3D surface scanning systems are highlighted. A meta-analysis of studies using scanners to investigate the changes in foot dimensions during varying levels of weight bearing was carried out. Conclusions Modern 3D surface scanning systems can obtain accurate and repeatable digital representations of the foot shape and have been successfully used in medical, ergonomic and footwear development applications. The increasing affordability of these systems presents opportunities for researchers investigating the foot and for manufacturers of foot related apparel and devices, particularly those interested in producing items that are customised to the individual. Suggestions are made for future areas of research and for the standardization of the protocols used to produce foot scans. PMID:20815914

  4. Advancing Toxicology Research Using In Vivo High Throughput Toxicology with Small Fish Models

    PubMed Central

    Planchart, Antonio; Mattingly, Carolyn J.; Allen, David; Ceger, Patricia; Casey, Warren; Hinton, David; Kanungo, Jyotshna; Kullman, Seth W.; Tal, Tamara; Bondesson, Maria; Burgess, Shawn M.; Sullivan, Con; Kim, Carol; Behl, Mamta; Padilla, Stephanie; Reif, David M.; Tanguay, Robert L.; Hamm, Jon

    2017-01-01

    Summary Small freshwater fish models, especially zebrafish, offer advantages over traditional rodent models, including low maintenance and husbandry costs, high fecundity, genetic diversity, physiology similar to that of traditional biomedical models, and reduced animal welfare concerns. The Collaborative Workshop on Aquatic Models and 21st Century Toxicology was held at North Carolina State University on May 5-6, 2014, in Raleigh, North Carolina, USA. Participants discussed the ways in which small fish are being used as models to screen toxicants and understand mechanisms of toxicity. Workshop participants agreed that the lack of standardized protocols is an impediment to broader acceptance of these models, whereas development of standardized protocols, validation, and subsequent regulatory acceptance would facilitate greater usage. Given the advantages and increasing application of small fish models, there was widespread interest in follow-up workshops to review and discuss developments in their use. In this article, we summarize the recommendations formulated by workshop participants to enhance the utility of small fish species in toxicology studies, as well as many of the advances in the field of toxicology that resulted from using small fish species, including advances in developmental toxicology, cardiovascular toxicology, neurotoxicology, and immunotoxicology. We also review many emerging issues that will benefit from using small fish species, especially zebrafish, and new technologies that will enable using these organisms to yield results unprecedented in their information content to better understand how toxicants affect development and health. PMID:27328013

  5. Diabetic Macular Edema: Options for Adjunct Therapy.

    PubMed

    Calvo, Pilar; Abadia, Beatriz; Ferreras, Antonio; Ruiz-Moreno, Oscar; Verdes, Guayente; Pablo, Luis E

    2015-09-01

    Diabetes mellitus (DM) is a chronic disease that affects 387 million people worldwide. Diabetic retinopathy (DR), a common complication of DM, is the main cause of blindness in the active population. Diabetic macular edema (DME) may occur at any stage of DR, and is characterized by vascular hyperpermeability accompanied by hard exudates within the macula. Medical and surgical therapies have dramatically reduced the progression of DR, and timely intervention can reduce the risk of severe vision loss by more than 90 %. In 2012, intravitreal ranibizumab became the first antivascular endothelial growth factor (anti-VEGF) agent approved for DME and, since then, many reports of the use of ranibizumab for DME have been promising. Randomized, prospective, multicenter clinical trials-most notably, RESOLVE, READ-2, RISE/RIDE, RESTORE, DRCR.net protocol I, and RETAIN-reported improvements in best-corrected visual acuity and decreased central retinal thickness as measured with optical coherence tomography in patients with DME. Similar treatment benefits have also been noted in clinical trials evaluating intravitreal aflibercept and bevacizumab (DAVINCI, VISTA/VIVID, and BOLT) and more recently DRCR.net protocol T. Intravitreal steroids (dexamethasone intravitreal implant and fluocinolone acetonide), particularly in refractory cases, also play a significant role in the management of DME (MEAD/CHAMPLAIN and FAMOUS/FAME studies). In summary, over the last 5 years, blocking VEGF and inflammation has been shown to improve visual outcomes in patients with macular edema due to DM, revolutionizing the treatment of center-involved DME and establishing a new standard of care.

  6. Lactate clearance as a useful biomarker for the prediction of all-cause mortality in critically ill patients: a systematic review study protocol

    PubMed Central

    Zhang, Zhongheng; Xu, Xiao; Chen, Kun

    2014-01-01

    Introduction Arterial lactate is a reflection of balance between lactate production and clearance. Accumulating lactate may be a marker of global hypoxia or hypoperfusion. Lactate clearance is the reduction of lactate concentrations with interventional strategies, and it has been associated with increased risk of death in critically ill patients. However, conflicting results exist, which mandates a systematic review to clarify the association between lactate clearance and clinical outcome. Methods and analysis Critically ill adult patients will be included in our analysis. This population will include heterogeneous study participants, including patients with sepsis or severe sepsis, trauma, surgical intensive care unit (ICU) patients, and so on. We will search four databases including EBSCO, PubMed, Scopus and ISI Web of knowledge from inception to February 2014. There will be no language restrictions in the electronic search for studies. Newcastle Ottawa Scale for cohort study will be employed to assess the reporting quality of included original studies. We will report pooled relative risk of death for those with lactate clearance and those without. The diagnostic performance of lactate clearance in predicting mortality will be explored by using the hierarchical summary receiver operating characteristic model. Ethics and dissemination The protocol for the systematic review has been registered in PROSPERO. The study will be disseminated electronically and in print. It will also be presented to conferences related to critical care medicine. Trial registration number: CRD42013006511. PMID:24860001

  7. Treatment options and barriers to case management of neonatal pneumonia in India: a protocol for a scoping review.

    PubMed

    Nair, N Sreekumaran; Lewis, Leslie Edward; Murthy, Shruti; Godinho, Myron Anthony; Lakiang, Theophilus; Venkatesh, Bhumika T

    2017-09-15

    India contributes to the highest neonatal deaths globally. Case management is said to be the cornerstone of pneumonia control. Much of the published evidence focuses on children aged 1 to 59 months. This scoping review, thus, aims to identify the treatment options for and barriers to case management of neonatal pneumonia in India. This protocol is part of a series of three reviews on neonatal pneumonia in India. Studies addressing treatment of or barriers to case management of neonatal pneumonia in Indian context, published in English in peer-reviewed and indexed journals will be eligible for inclusion. Electronic search will be conducted on nine databases. Hand searching and snowballing will be done for published and grey literature. Selection of studies will be done in title, abstract and full-text stages. A narrative summary will be performed to summarise the details of evidence. As this is a review involving analysis of secondary data which is available in the public domain and does not involve human participants, ethical approval was not required. The findings of the study will be shared with all stakeholders of this research. Knowledge dissemination workshops will be conducted with relevant stakeholders to ultimately transfer the evidence tailored to the stakeholder (eg, policy briefs, publications, information booklets and so on). PROSPERO 2016: CRD42016045449. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Field Guide to the Plant Community Types of Voyageurs National Park

    USGS Publications Warehouse

    Faber-Langendoen, Don; Aaseng, Norman; Hop, Kevin; Lew-Smith, Michael

    2007-01-01

    INTRODUCTION The objective of the U.S. Geological Survey-National Park Service Vegetation Mapping Program is to classify, describe, and map vegetation for most of the park units within the National Park Service (NPS). The program was created in response to the NPS Natural Resources Inventory and Monitoring Guidelines issued in 1992. Products for each park include digital files of the vegetation map and field data, keys and descriptions to the plant communities, reports, metadata, map accuracy verification summaries, and aerial photographs. Interagency teams work in each park and, following standardized mapping and field sampling protocols, develop products and vegetation classification standards that document the various vegetation types found in a given park. The use of a standard national vegetation classification system and mapping protocol facilitate effective resource stewardship by ensuring compatibility and widespread use of the information throughout the NPS as well as by other Federal and state agencies. These vegetation classifications and maps and associated information support a wide variety of resource assessment, park management, and planning needs, and provide a structure for framing and answering critical scientific questions about plant communities and their relation to environmental processes across the landscape. This field guide is intended to make the classification accessible to park visitors and researchers at Voyageurs National Park, allowing them to identify any stand of natural vegetation and showing how the classification can be used in conjunction with the vegetation map (Hop and others, 2001).

  9. Improvement of isometric dorsiflexion protocol for assessment of tibialis anterior muscle strength.

    PubMed

    Siddiqi, Ariba; Arjunan, Sridhar P; Kumar, Dinesh

    2015-01-01

    It is important to accurately estimate the electromyogram (EMG)/force relationship of triceps surae (TS) muscle for detecting strength deficit of tibalis anterior (TA) muscle. In literature, the protocol for recording EMG and force of dorsiflexion have been described, and the necessity for immobilizing the ankle has been explained. However, there is a significant variability of the results among researchers even though they report the fixation of the ankle. We have determined that toe extension can cause significant variation in the dorsiflexion force and EMG of TS and this can occur despite following the current guidelines which require immobilizing the ankle. The results also show that there was a large increase in the variability of the force and the RMS of EMG of TS when the toes were not strapped compared with when they were strapped. Thus, with the current guidelines, where there are no instructions regarding the necessity of strapping the toes, the EMG/force relationship of TS could be incorrect and give an inaccurate assessment of the dorsiflexor TA strength. In summary, •Current methodology to estimate the dorsiflexor TA strength with respect to the TS activity, emphasizing on ankle immobilization is insufficient to prevent large variability in the measurements.•Toe extension during dorsiflexion was found to be one source of variability in estimating the TA strength.•It is recommended that guidelines for recording force and EMG from TA and TS muscles should require the strapping of the toes along with the need for immobilizing the ankle.

  10. Efficacy of protocols for induction of chronic hyperthyroidism in male and female mice.

    PubMed

    Engels, Kathrin; Rakov, Helena; Zwanziger, Denise; Hönes, Georg Sebastian; Rehders, Maren; Brix, Klaudia; Köhrle, Josef; Möller, Lars Christian; Führer, Dagmar

    2016-10-01

    Protocols for induction of hyperthyroidism in mice are highly variable and mostly involve short-term thyroid hormone (TH) treatment. In addition, little is known about a possible influence of sex on experimental TH manipulation. Here we analyzed the efficacy of intraperitoneal vs. oral levothyroxine (T4) administration to induce chronic hyperthyroidism in male and female mice and asked which T4 dosing intervals are required to achieve stable organ thyrotoxicosis. T4 was administered intraperitoneally or orally over a period of 6/7 weeks. Assessment included monitoring of body weight, TH serum concentrations, and serial quantitative TH target gene expression analysis in liver and heart. Our results show that both intraperitoneal and oral T4 treatment are reliable methods for induction of chronic hyperthyroidism in mice. Thereby T4 injection intervals should not exceed 48 h and oral levothyroxine should be administered continuously during experiments and up to sacrifice to ensure a hyperthyroid organ state. Furthermore, we found a sex-dependent variation in levothyroxine-induced TH serum state, with significantly higher T4 concentrations in female mice, while expression of investigated classical TH responsive genes in liver and heart did not vary with animal's sex. In summary, our study shows that common approaches for rendering rodents thyrotoxic can also be used for induction of chronic hyperthyroidism in male and female mice. Thereby T4 dosing intervals are critical as are read-out parameters to verify a chronic thyrotoxic organ state.

  11. No effect of glucose administration in a novel contextual fear generalization protocol in rats

    PubMed Central

    Luyten, L; Schroyens, N; Luyck, K; Fanselow, M S; Beckers, T

    2016-01-01

    The excessive transfer of fear acquired for one particular context to similar situations has been implicated in the development and maintenance of anxiety disorders, such as post-traumatic stress disorder. Recent evidence suggests that glucose ingestion improves the retention of context conditioning. It has been speculated that glucose might exert that effect by ameliorating hippocampal functioning, and may hold promise as a therapeutic add-on in traumatized patients because improved retention of contextual fear could help to restrict its generalization. However, direct data regarding the effect of glucose on contextual generalization are lacking. Here, we introduce a new behavioral protocol to study such contextual fear generalization in rats. In adult Wistar rats, our procedure yields a gradient of generalization, with progressively less freezing when going from the original training context, over a perceptually similar generalization context, to a markedly dissimilar context. Moreover, we find a flattening of the gradient when the training-test interval is prolonged with 1 week. We next examine the effect of systemic glucose administration on contextual generalization with this novel procedure. Our data do not sustain generalization-reducing effects of glucose and question its applicability in traumatic situations. In summary, we have developed a replicable contextual generalization procedure for rats and demonstrate how it is a valuable tool to examine the neurobiological correlates and test pharmacological interventions pertaining to an important mechanism in the etiology of pathological anxiety. PMID:27676444

  12. An environmental scan of advance care planning decision AIDS for patients undergoing major surgery: a study protocol.

    PubMed

    Aslakson, Rebecca A; Schuster, Anne L R; Miller, Judith; Weiss, Matthew; Volandes, Angelo E; Bridges, John F P

    2014-01-01

    Patients who undergo major surgery are at risk for perioperative morbidity and mortality. It would be appropriate to initiate advance care planning with patients prior to surgery, but surgeons may experience difficulty initiating such conversations. Rather than focus on changing clinician behavior, advance care planning decision aids can be an innovative vehicle to motivate advance care planning among surgical patients and their families. The purpose of this paper is to describe a study protocol for conducting an environmental scan concerning advance care planning decision aids that may be relevant to patients undergoing high-risk surgery. This study will gather information from written or verbal data sources that incorporate professional and lay perspectives: a systematic review, a grey literature review, key informant interviews, and patient and family engagement. It is envisioned that this study will generate three outcomes: a synthesis of current evidence, a summary of gaps in knowledge, and a taxonomy of existing advance care planning decision aids. This environmental scan will demonstrate principles of patient-centered outcomes research, and it will exemplify a pioneering approach for reviewing complex interventions. Anticipated limitations are that information will be gathered from a small sample of patients and families, and that potentially relevant information could also be missing from the environmental scan due to the inclusion/exclusion criteria. Outcomes from the environmental scan will inform future patient-centered research to develop and evaluate a new decision aid.

  13. Evaluation of timings and outcomes in category-one caesarean sections: A retrospective cohort study

    PubMed Central

    Dunn, Clare Newton; Zhang, Qianpian; Sia, Josh Tjunrong; Assam, Pryseley Nkouibert; Tagore, Shephali; Sng, Ban Leong

    2016-01-01

    Background and Aims: A decision-to-delivery interval (DDI) of 30 min for category-one caesarean section (CS) deliveries is the standard of practice recommended by clinical guidelines. Our institution established a protocol for category-one (‘crash’) CS to expedite deliveries. The aim of this study is to evaluate DDI, factors that affect DDI and the mode of anaesthesia for category-one CS. Methods: This retrospective cohort study evaluated 390 women who underwent category-one CS in a tertiary obstetric centre. We analysed the factors associated with DDI, mode of anaesthesia and perinatal outcomes. Summary statistics were performed for the outcomes. The association factors were considered significant at P < 0.05. Results: The mean (standard deviation) DDI was 9.4 (3.2) min with all deliveries achieved within 30 min. The longest factor in the DDI was time taken to transfer patients. A shorter DDI was not significantly associated with improved perinatal outcomes. The majority (88.9%) of women had general anaesthesia (GA) for category-one CS. Of those who had an epidural catheter already in situ (34.4%), 25.6% had successful epidural extension. GA was associated with shorter DDI, but worse perinatal outcomes than regional anaesthesia (RA). Conclusions: Our ‘crash’ CS protocol achieved 100% of deliveries within 30 min. The majority (88.9%) of the patients had GA for category-one CS. GA was found to be associated with shorter anaesthesia and operation times, but poorer perinatal outcomes compared to RA. PMID:27601736

  14. Cycle cancellation and pregnancy after luteal estradiol priming in women defined as poor responders: a systematic review and meta-analysis

    PubMed Central

    Reynolds, Kasey A.; Omurtag, Kenan R.; Jimenez, Patricia T.; Rhee, Julie S.; Tuuli, Method G.; Jungheim, Emily S.

    2013-01-01

    STUDY QUESTION Does a luteal estradiol (LE) stimulation protocol improve outcomes in poor responders to IVF? SUMMARY ANSWER LE priming is associated with decreased cycle cancellation and increased chance of clinical pregnancy in poor responders WHAT IS KNOWN ALREADY Poor responders to IVF are one of the most challenging patient populations to treat. Many standard protocols currently exist for stimulating these patients but all have failed to improve outcomes. STUDY DESIGN, SIZE, DURATION Systematic review and meta-analysis including eight published studies comparing assisted reproduction technology (ART) outcomes in poor responders exposed to controlled ovarian hyperstimulation with and without LE priming. A search of the databases MEDLINE, EMBASE and PUBMED was carried out for studies in the English language published up to January 2012. PARTICIPANTS/MATERIALS, SETTING, METHODS Studies evaluating women defined as poor responders to ART were evaluated. These studies were identified following a systematic review of the literature and data were analyzed using the DerSimonian–Laird random effects model. The main outcomes of interest were cycle cancellation rate and clinical pregnancy. Although the definition of clinical pregnancy varied between studies, the principal definition included fetal cardiac activity as assessed by transvaginal ultrasonography after 5 weeks of gestation. MAIN RESULTS AND THE ROLE OF CHANCE A total of 2249 publications were identified from the initial search, and the bibliographies, abstracts and other sources yielded 11 more. After excluding duplications, 1227 studies remained and 8 ultimately met the inclusion criteria. Compared with women undergoing non-LE primed protocols (n = 621), women exposed to LE priming (n = 468) had a lower risk of cycle cancellation [relative risk (RR): 0.60, 95% confidence interval (CI): 0.45–0.78] and an improved chance of clinical pregnancy (RR: 1.33, 95% CI: 1.02–1.72). There was no significant improvement in the number of mature oocytes obtained or number of zygotes obtained per cycle. LIMITATIONS, REASONS FOR CAUTION These findings are limited by the body of literature currently available. As the poor responder lacks a concrete definition, there is some heterogeneity to these results, which merits caution when applying our findings to individual patients. Furthermore, the increased clinical pregnancy rate demonstrated when using the LE protocol may be principally related to the decreased cycle cancellation rate. WIDER IMPLICATIONS OF THE FINDINGS The LE protocol may be of some utility in the poor responder to IVF and may increase clinical pregnancy rates in this population by improving stimulation and thereby decreasing cycle cancellation. STUDY FUNDING/COMPETING INTERESTS NIH K12 HD063086 (ESJ, MGT), NIH T32 HD0040135-11 (KAR), F32 HD040135-10 NIH (KRO), 5K12HD000849-25 (PTJ). No competing interests. PMID:23887073

  15. Summary of selected U.S. Geological survey data on domestic well water quality for the Centers for Disease Control's National Environmental Public Health Tracking Program

    USGS Publications Warehouse

    Bartholomay, Roy C.; Carter, Janet M.; Qi, Sharon L.; Squillace, Paul J.; Rowe, Gary L.

    2007-01-01

    About 10 to 30 percent of the population in most States uses domestic (private) water supply. In many States, the total number of people served by domestic supplies can be in the millions. The water quality of domestic supplies is inconsistently regulated and generally not well characterized. The U.S. Geological Survey (USGS) has two water-quality data sets in the National Water Information System (NWIS) database that can be used to help define the water quality of domestic-water supplies: (1) data from the National Water-Quality Assessment (NAWQA) Program, and (2) USGS State data. Data from domestic wells from the NAWQA Program were collected to meet one of the Program's objectives, which was to define the water quality of major aquifers in the United States. These domestic wells were located primarily in rural areas. Water-quality conditions in these major aquifers as defined by the NAWQA data can be compared because of the consistency of the NAWQA sampling design, sampling protocols, and water-quality analyses. The NWIS database is a repository of USGS water data collected for a variety of projects; consequently, project objectives and analytical methods vary. This variability can bias statistical summaries of contaminant occurrence and concentrations; nevertheless, these data can be used to define the geographic distribution of contaminants. Maps created using NAWQA and USGS State data in NWIS can show geographic areas where contaminant concentrations may be of potential human-health concern by showing concentrations relative to human-health water-quality benchmarks. On the basis of national summaries of detection frequencies and concentrations relative to U.S. Environmental Protection Agency (USEPA) human-health benchmarks for trace elements, pesticides, and volatile organic compounds, 28 water-quality constituents were identified as contaminants of potential human-health concern. From this list, 11 contaminants were selected for summarization of water-quality data in 16 States (grantee States) that were funded by the Environmental Public Health Tracking (EPHT) Program of the Centers for Disease Control and Prevention (CDC). Only data from domestic-water supplies were used in this summary because samples from these wells are most relevant to human exposure for the targeted population. Using NAWQA data, the concentrations of the 11 contaminants were compared to USEPA human-health benchmarks. Using NAWQA and USGS State data in NWIS, the geographic distribution of the contaminants were mapped for the 16 grantee States. Radon, arsenic, manganese, nitrate, strontium, and uranium had the largest percentages of samples with concentrations greater than their human-health benchmarks. In contrast, organic compounds (pesticides and volatile organic compounds) had the lowest percentages of samples with concentrations greater than human-health benchmarks. Results of data retrievals and spatial analysis were compiled for each of the 16 States and are presented in State summaries for each State. Example summary tables, graphs, and maps based on USGS data for New Jersey are presented to illustrate how USGS water-quality and associated ancillary geospatial data can be used by the CDC to address goals and objectives of the EPHT Program.

  16. Efficacy of Pneumococcal Nontypable Haemophilus influenzae Protein D Conjugate Vaccine (PHiD-CV) in Young Latin American Children: A Double-Blind Randomized Controlled Trial

    PubMed Central

    Tregnaghi, Miguel W.; Sáez-Llorens, Xavier; López, Pio; Abate, Hector; Smith, Enrique; Pósleman, Adriana; Calvo, Arlene; Wong, Digna; Cortes-Barbosa, Carlos; Ceballos, Ana; Tregnaghi, Marcelo; Sierra, Alexandra; Rodriguez, Mirna; Troitiño, Marisol; Carabajal, Carlos; Falaschi, Andrea; Leandro, Ana; Castrejón, Maria Mercedes; Lepetic, Alejandro; Lommel, Patricia; Hausdorff, William P.; Borys, Dorota; Guiñazú, Javier Ruiz; Ortega-Barría, Eduardo; Yarzábal, Juan P.; Schuerman, Lode

    2014-01-01

    Background The relationship between pneumococcal conjugate vaccine–induced antibody responses and protection against community-acquired pneumonia (CAP) and acute otitis media (AOM) is unclear. This study assessed the impact of the ten-valent pneumococcal nontypable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) on these end points. The primary objective was to demonstrate vaccine efficacy (VE) in a per-protocol analysis against likely bacterial CAP (B-CAP: radiologically confirmed CAP with alveolar consolidation/pleural effusion on chest X-ray, or non-alveolar infiltrates and C-reactive protein ≥ 40 µg/ml); other protocol-specified outcomes were also assessed. Methods and Findings This phase III double-blind randomized controlled study was conducted between 28 June 2007 and 28 July 2011 in Argentine, Panamanian, and Colombian populations with good access to health care. Approximately 24,000 infants received PHiD-CV or hepatitis control vaccine (hepatitis B for primary vaccination, hepatitis A at booster) at 2, 4, 6, and 15–18 mo of age. Interim analysis of the primary end point was planned when 535 first B-CAP episodes, occurring ≥2 wk after dose 3, were identified in the per-protocol cohort. After a mean follow-up of 23 mo (PHiD-CV, n = 10,295; control, n = 10,201), per-protocol VE was 22.0% (95% CI: 7.7, 34.2; one-sided p = 0.002) against B-CAP (conclusive for primary objective) and 25.7% (95% CI: 8.4%, 39.6%) against World Health Organization–defined consolidated CAP. Intent-to-treat VE was 18.2% (95% CI: 5.5%, 29.1%) against B-CAP and 23.4% (95% CI: 8.8%, 35.7%) against consolidated CAP. End-of-study per-protocol analyses were performed after a mean follow-up of 28–30 mo for CAP and invasive pneumococcal disease (IPD) (PHiD-CV, n = 10,211; control, n = 10,140) and AOM (n = 3,010 and 2,979, respectively). Per-protocol VE was 16.1% (95% CI: −1.1%, 30.4%; one-sided p = 0.032) against clinically confirmed AOM, 67.1% (95% CI: 17.0%, 86.9%) against vaccine serotype clinically confirmed AOM, 100% (95% CI: 74.3%, 100%) against vaccine serotype IPD, and 65.0% (95% CI: 11.1%, 86.2%) against any IPD. Results were consistent between intent-to-treat and per-protocol analyses. Serious adverse events were reported for 21.5% (95% CI: 20.7%, 22.2%) and 22.6% (95% CI: 21.9%, 23.4%) of PHiD-CV and control recipients, respectively. There were 19 deaths (n = 11,798; 0.16%) in the PHiD-CV group and 26 deaths (n = 11,799; 0.22%) in the control group. A significant study limitation was the lower than expected number of captured AOM cases. Conclusions Efficacy was demonstrated against a broad range of pneumococcal diseases commonly encountered in young children in clinical practice. Trial registration www.ClinicalTrials.gov NCT00466947 Please see later in the article for the Editors' Summary PMID:24892763

  17. Telemonitoring and Protocolized Case Management for Hypertensive Community-Dwelling Seniors With Diabetes: Protocol of the TECHNOMED Randomized Controlled Trial.

    PubMed

    Padwal, Raj; McAlister, Finlay Aleck; Wood, Peter William; Boulanger, Pierre; Fradette, Miriam; Klarenbach, Scott; Edwards, Alun L; Holroyd-Leduc, Jayna M; Alagiakrishnan, Kannayiram; Rabi, Doreen; Majumdar, Sumit Ranjan

    2016-06-24

    Diabetes and hypertension are devastating, deadly, and costly conditions that are very common in seniors. Controlling hypertension in seniors with diabetes dramatically reduces hypertension-related complications. However, blood pressure (BP) must be lowered carefully because seniors are also susceptible to low BP and attendant harms. Achieving "optimal BP control" (ie, avoiding both undertreatment and overtreatment) is the ultimate therapeutic goal in such patients. Regular BP monitoring is required to achieve this goal. BP monitoring at home is cheap, convenient, widely used, and guideline endorsed. However, major barriers prevent proper use. These may be overcome through use of BP telemonitoring-the secure teletransmission of BP readings to a health portal, where BP data are summarized for provider and patient use, with or without protocolized case management. To examine the incremental effectiveness, safety, cost-effectiveness, usability, and acceptability of home BP telemonitoring, used with or without protocolized case management, compared with "enhanced usual care" in community-dwelling seniors with diabetes and hypertension. A 300-patient, 3-arm, pragmatic randomized controlled trial with blinded outcome ascertainment will be performed in seniors with diabetes and hypertension living independently in seniors' residences in greater Edmonton. Consenting patients will be randomized to usual care, home BP telemonitoring alone, or home BP telemonitoring plus protocolized pharmacist case management. Usual care subjects will receive a home BP monitor but neither they nor their providers will have access to teletransmitted data. In both telemonitored arms, providers will receive telemonitored BP data summaries. In the case management arm, pharmacist case managers will be responsible for reviewing teletransmitted data and initiating guideline-concordant and protocolized changes in BP management. Outcomes will be ascertained at 6 and 12 months. Within-study-arm change scores will be calculated and compared between study arms. These include: (1) clinical outcomes: proportion of subjects with a mean 24-hour ambulatory systolic BP in the optimal range (110-129 mmHg in patients 65-79 years and 110-139 mmHg in those ≥80 years: primary outcome); additional ambulatory and home BP outcomes; A1c and lipid profile; medications, cognition, health care use, cardiovascular events, and mortality. (2) Safety outcomes: number of serious episodes of hypotension, syncope, falls, and electrolyte disturbances (requiring third party assistance or medical attention). (3) Humanistic outcomes: quality of life, satisfaction, and medication adherence. (4) Economic outcomes: incremental costs, incremental cost-utility, and cost per mmHg change in BP of telemonitoring ± case management compared with usual care (health payor and societal perspectives). (5) Intervention usability and acceptability to patients and providers. The potential benefits of telemonitoring remain largely unstudied and unproven in seniors. This trial will comprehensively assess the impact of home BP telemonitoring across a range of outcomes. Results will inform the value of implementing home-based telemonitoring within supportive living residences in Canada. Clinicaltrials.gov NCT02721667; https://clinicaltrials.gov/ct2/show/NCT02721667 (Archived by Webcite at http://www.webcitation.org/6i8tB20Mc).

  18. Telemonitoring and Protocolized Case Management for Hypertensive Community-Dwelling Seniors With Diabetes: Protocol of the TECHNOMED Randomized Controlled Trial

    PubMed Central

    McAlister, Finlay Aleck; Wood, Peter William; Boulanger, Pierre; Fradette, Miriam; Klarenbach, Scott; Edwards, Alun L; Holroyd-Leduc, Jayna M; Alagiakrishnan, Kannayiram; Rabi, Doreen; Majumdar, Sumit Ranjan

    2016-01-01

    Background Diabetes and hypertension are devastating, deadly, and costly conditions that are very common in seniors. Controlling hypertension in seniors with diabetes dramatically reduces hypertension-related complications. However, blood pressure (BP) must be lowered carefully because seniors are also susceptible to low BP and attendant harms. Achieving “optimal BP control” (ie, avoiding both undertreatment and overtreatment) is the ultimate therapeutic goal in such patients. Regular BP monitoring is required to achieve this goal. BP monitoring at home is cheap, convenient, widely used, and guideline endorsed. However, major barriers prevent proper use. These may be overcome through use of BP telemonitoring—the secure teletransmission of BP readings to a health portal, where BP data are summarized for provider and patient use, with or without protocolized case management. Objective To examine the incremental effectiveness, safety, cost-effectiveness, usability, and acceptability of home BP telemonitoring, used with or without protocolized case management, compared with “enhanced usual care” in community-dwelling seniors with diabetes and hypertension. Methods A 300-patient, 3-arm, pragmatic randomized controlled trial with blinded outcome ascertainment will be performed in seniors with diabetes and hypertension living independently in seniors’ residences in greater Edmonton. Consenting patients will be randomized to usual care, home BP telemonitoring alone, or home BP telemonitoring plus protocolized pharmacist case management. Usual care subjects will receive a home BP monitor but neither they nor their providers will have access to teletransmitted data. In both telemonitored arms, providers will receive telemonitored BP data summaries. In the case management arm, pharmacist case managers will be responsible for reviewing teletransmitted data and initiating guideline-concordant and protocolized changes in BP management. Results Outcomes will be ascertained at 6 and 12 months. Within-study-arm change scores will be calculated and compared between study arms. These include: (1) clinical outcomes: proportion of subjects with a mean 24-hour ambulatory systolic BP in the optimal range (110-129 mmHg in patients 65-79 years and 110-139 mmHg in those ≥80 years: primary outcome); additional ambulatory and home BP outcomes; A1c and lipid profile; medications, cognition, health care use, cardiovascular events, and mortality. (2) Safety outcomes: number of serious episodes of hypotension, syncope, falls, and electrolyte disturbances (requiring third party assistance or medical attention). (3) Humanistic outcomes: quality of life, satisfaction, and medication adherence. (4) Economic outcomes: incremental costs, incremental cost-utility, and cost per mmHg change in BP of telemonitoring ± case management compared with usual care (health payor and societal perspectives). (5) Intervention usability and acceptability to patients and providers. Conclusion The potential benefits of telemonitoring remain largely unstudied and unproven in seniors. This trial will comprehensively assess the impact of home BP telemonitoring across a range of outcomes. Results will inform the value of implementing home-based telemonitoring within supportive living residences in Canada. Trial Registration Clinicaltrials.gov NCT02721667; https://clinicaltrials.gov/ct2/show/NCT02721667 (Archived by Webcite at http://www.webcitation.org/6i8tB20Mc) PMID:27343147

  19. The 9-day CIDR-PG protocol: Incorporation of PGF2α pretreatment into a long-term progestin-based estrus synchronization protocol for postpartum beef cows.

    PubMed

    Thomas, Jordan M; Bishop, Brianne E; Abel, Jillian M; Ellersieck, Mark R; Smith, Michael F; Patterson, David J

    2016-06-01

    A pilot experiment was designed to test the hypothesis that administration of PGF2α before progestin treatment would allow for a reduced duration of progestin treatment in a long-term progestin-based estrus synchronization protocol. A modified presynchronization treatment was compared with a standard long-term controlled internal drug release (CIDR) treatment, and treatments were compared on the basis of ovarian follicular dynamics, estrous response rate, synchrony of estrus expression, and pregnancy rates resulting from timed artificial insemination (TAI) in postpartum beef cows. Estrous was synchronized for 85 cows, with cows assigned to one of two treatments based on age, days postpartum, and body condition score. Cows assigned to the 14-day CIDR-PG protocol received a CIDR insert (1.38 g progesterone) on Day 0, CIDR removal on Day 14, and administration of PGF2α (25 mg im) on Day 30. Cows assigned to the 9-day CIDR-PG protocol received PGF2α concurrent with CIDR insertion on Day 5, PGF2α concurrent with CIDR removal on Day 14, and administration of PGF2α on Day 30. In both treatments, split-time AI was performed based on estrous response. At 72 hours after PGF2α (Day 33), cows having expressed estrus received TAI; cows that failed to express estrus by 72 hours received TAI 24 hours later (96 hours after PGF2α on Day 34), with GnRH (100 μg im) administered to nonestrous cows. Estrus-detection transmitters were used from CIDR removal until AI to determine onset time of estrus expression both after CIDR removal and after PGF2α. Ovarian ultrasonography was performed at CIDR removal on Day 14, PGF2α on Day 30, and AI on Days 33 or 34. At CIDR removal on Day 14, diameter of the largest follicle present on the ovary was similar between treatments. The proportion of cows expressing estrus after CIDR removal tended to be higher (P = 0.09) among cows assigned to the 9-day CIDR-PG treatment (93%; 40 of 43) than among cows assigned to the 14-day CIDR-PG treatment (81%; 34 of 42). After PGF2α, a significantly higher proportion (P = 0.02) of cows expressed estrus after synchronization with the 9-day CIDR-PG treatment (91%; 39 of 43) than the 14-day CIDR-PG treatment (69%; 29 of 42). Consequently, pregnancy rate to TAI tended to be increased (P = 0.09) among the 9-day CIDR-PG treatment (76.7%; 33 of 43) compared with the 14-day CIDR-PG treatment (59.5%; 25 of 42). In summary, a long-term CIDR-based estrous synchronization protocol for postpartum beef cows was enhanced through administration of PGF2α at CIDR insertion and CIDR removal. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Echinacea purpurea: A Proprietary Extract of Echinacea purpurea Is Shown to be Safe and Effective in the Prevention of the Common Cold.

    PubMed

    Ross, Stephanie Maxine

    2016-01-01

    The research study in this review represents the largest clinical trial to date that evaluated the safety and efficacy of Echinacea purpurea for prophylactic treatment of the common cold, in addition to investigating its risk-benefit in a long-term treatment period. The clinical application of the proprietary standardized Echinacea purpurea extract(Echinaforce) demonstrated efficacy as a preventive cold treatment option over a 4-month duration. This study showed that Echinacea’s long-term prevention was associated with a reduction in the total number of cold episodes, a reduction in the number of days with colds, and a reduction in cold episodes requiring additional medication. Furthermore, the Echinacea test agent inhibited virally confirmed colds, exhibited maximal effects on recurrent infections, and demonstrated that its preventive effects increased relative to therapy compliance and adherence to the protocol. In summary, Echinacea purpurea when taken as recommended for the prevention of the common cold appears to provide a positive risk to benefit ratio.

  1. Effect of risedronate on bone in renal transplant recipients.

    PubMed

    Coco, Maria; Pullman, James; Cohen, Hillel W; Lee, Sally; Shapiro, Craig; Solorzano, Clemencia; Greenstein, Stuart; Glicklich, Daniel

    2012-08-01

    Bisphosphonates may prevent or treat the bone loss promoted by the immunosuppressive regimens used in renal transplantation. Risedronate is a commonly used third-generation amino-bisphosphonate, but little is known about its effects on the bone health of renal transplant recipients. We randomly assigned 42 new living-donor kidney recipients to either 35 mg of risedronate weekly or placebo for 12 months. We obtained bone biopsies at the time of renal transplant and after 12 months of protocol treatment. Treatment with risedronate did not affect bone mineral density (BMD) in the overall cohort. In subgroup analyses, it tended to preserve BMD in female participants but did not significantly affect the BMD of male participants. Risedronate did associate with increased osteoid volume and trabecular thickness in male participants, however. There was no evidence for the development of adynamic bone disease. In summary, further study is needed before the use of prophylactic bisphosphonates to attenuate bone loss can be recommended in renal transplant recipients.

  2. The touchscreen operant platform for assessing executive function in rats and mice

    PubMed Central

    Mar, Adam C.; Horner, Alexa E.; Nilsson, Simon R.O.; Alsiö, Johan; Kent, Brianne A.; Kim, Chi Hun; Holmes, Andrew; Saksida, Lisa M.; Bussey, Timothy J.

    2014-01-01

    Summary This protocol details a subset of assays developed within the touchscreen platform to measure aspects of executive function in rodents. Three main procedures are included: Extinction, measuring the rate and extent of curtailing a response that was previously, but is no longer, associated with reward; Reversal Learning, measuring the rate and extent of switching a response toward a visual stimulus that was previously not, but has become, associated with reward (and away from a visual stimulus that was previously, but is no longer, rewarded); and the 5-Choice Serial Reaction Time (5-CSRT) task, gauging the ability to selectively detect and appropriately respond to briefly presented, spatially unpredictable visual stimuli. These methods were designed to assess both complimentary and overlapping constructs including selective and divided visual attention, inhibitory control, flexibility, impulsivity and compulsivity. The procedures comprise part of a wider touchscreen test battery assessing cognition in rodents with high potential for translation to human studies. PMID:24051960

  3. The Theory and Fundamentals of Bioimpedance Analysis in Clinical Status Monitoring and Diagnosis of Diseases

    PubMed Central

    Khalil, Sami F.; Mohktar, Mas S.; Ibrahim, Fatimah

    2014-01-01

    Bioimpedance analysis is a noninvasive, low cost and a commonly used approach for body composition measurements and assessment of clinical condition. There are a variety of methods applied for interpretation of measured bioimpedance data and a wide range of utilizations of bioimpedance in body composition estimation and evaluation of clinical status. This paper reviews the main concepts of bioimpedance measurement techniques including the frequency based, the allocation based, bioimpedance vector analysis and the real time bioimpedance analysis systems. Commonly used prediction equations for body composition assessment and influence of anthropometric measurements, gender, ethnic groups, postures, measurements protocols and electrode artifacts in estimated values are also discussed. In addition, this paper also contributes to the deliberations of bioimpedance analysis assessment of abnormal loss in lean body mass and unbalanced shift in body fluids and to the summary of diagnostic usage in different kinds of conditions such as cardiac, pulmonary, renal, and neural and infection diseases. PMID:24949644

  4. Clinical perspective: creating an effective practice peer review process-a primer.

    PubMed

    Gandhi, Manisha; Louis, Frances S; Wilson, Shae H; Clark, Steven L

    2017-03-01

    Peer review serves as an important adjunct to other hospital quality and safety programs. Despite its importance, the available literature contains virtually no guidance regarding the structure and function of effective peer review committees. This Clinical Perspective provides a summary of the purposes, structure, and functioning of effective peer review committees. We also discuss important legal considerations that are a necessary component of such processes. This discussion includes useful templates for case selection and review. Proper committee structure, membership, work flow, and leadership as well as close cooperation with the hospital medical executive committee and legal representatives are essential to any effective peer review process. A thoughtful, fair, systematic, and organized approach to creating a peer review process will lead to confidence in the committee by providers, hospital leadership, and patients. If properly constructed, such committees may also assist in monitoring and enforcing compliance with departmental protocols, thus reducing harm and promoting high-quality practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Velopharyngeal insufficiency: diagnosis and management

    PubMed Central

    Shprintzen, Robert J.; Marrinan, Eileen

    2009-01-01

    Purpose of Review Journal articles relevant to the diagnosis and treatment of velopharyngeal insufficiency (VPI) were reviewed. All articles ascertained by PubMed search were included. Recent Findings Articles reported on the application of magnetic resonance scanning, reliability tests of the International Working Group diagnostic protocol, the use of nasometry, and techniques designed to assess the function of the velopharyngeal mechanism. Treatment papers focused on outcomes in small samples of cases and complication rates from pharyngeal flap. One paper discussed ineffective speech therapy procedures. Summary There were relatively few papers this past year. Those that were published were hindered by small and heterogeneous sample sizes, and occasionally by inappropriate methods for assessing outcomes. None of the findings will have a major impact on the current state-of-the-art for diagnosis of VPI. The speech therapy paper has a very important message that should be taken to heart by all clinicians involved in the management of children with clefts and craniofacial disorders. PMID:19448542

  6. Exercise Countermeasures on ISS: Summary and Future Directions.

    PubMed

    Loerch, Linda H

    2015-12-01

    The first decade of the International Space Station Program (ISS) yielded a wealth of knowledge regarding the health and performance of crewmembers living in microgravity for extended periods of time. The exercise countermeasures hardware suite evolved during the last decade to provide enhanced capabilities that were previously unavailable to support human spaceflight, resulting in attenuation of cardiovascular, muscle, and bone deconditioning. The ability to protect crew and complete mission tasks in the autonomous exploration environment will be a critical component of any decision to proceed with manned exploration initiatives.The next decade of ISS habitation promises to be a period of great scientific utilization that will yield both the tools and technologies required to safely explore the solar system. Leading countermeasure candidates for exploration class missions must be studied methodically on ISS over the next decade to ensure protocols and systems are highly efficient, effective, and validated. Lessons learned from the ISS experience to date are being applied to the future, and international cooperation enables us to maximize this exceptional research laboratory.

  7. Peri-operative interventions producing better functional outcomes and enhanced recovery following total hip and knee arthroplasty: an evidence-based review

    PubMed Central

    2013-01-01

    The increasing numbers of patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA), combined with the rapidly growing repertoire of surgical techniques and interventions available have put considerable pressure on surgeons and other healthcare professionals to produce excellent results with early functional recovery and short hospital stays. The current economic climate and the restricted healthcare budgets further necessitate brief hospitalization while minimizing costs. Clinical pathways and protocols introduced to achieve these goals include a variety of peri-operative interventions to fulfill patient expectations and achieve the desired outcomes. In this review, we present an evidence-based summary of common interventions available to achieve enhanced recovery, reduce hospital stay, and improve functional outcomes following THA and TKA. It covers pre-operative patient education and nutrition, pre-emptive analgesia, neuromuscular electrical stimulation, pulsed electromagnetic fields, peri-operative rehabilitation, modern wound dressings, standard surgical techniques, minimally invasive surgery, and fast-track arthroplasty units. PMID:23406499

  8. Birds in Hawai'i Volcanoes National Park: Summary of the 2010 inventory and monitoring program survey

    USGS Publications Warehouse

    Camp, Richard J.; Judge, Seth W.; Hart, Patrick J.; Kudray, Greg; Gaudioso, Jacqueline M.; Hsu, Bobby H.

    2012-01-01

    The National Park Service (NPS) created the Inventory and Monitoring (I&M) Program in 1998 to establish baseline information and assess long-term trends in "vital signs" or key abiotic and biotic elements of National Parks (Fancy et al. 2009). The Pacific Island Network of the I&M Program developed a Landbirds Monitoring Protocol (LMP; Camp et al. 2011) to estimate species-specific status and monitor longterm trends in landbird distribution and abundance. Parks included in the LMP that harbor habitat critically important to native forest birds are Haleakala National Park (Maui Island), Hawai'i Volcanoes National Park (HAVO; Hawai'i Island), and the National Park of American Samoa (American Samoa). In 2010, the LMP was implemented in HAVO to survey landbird density and abundance. This implementation was the first anywhere in the Pacific Islands by the I&M Program, and continued monitoring is planned every five years in all three parks.

  9. Divergence in Defence against Herbivores between Males and Females of Dioecious Plant Species

    PubMed Central

    Avila-Sakar, Germán; Romanow, Cora Anne

    2012-01-01

    Defensive traits may evolve differently between sexes in dioecious plant species. Our current understanding of this process hinges on a partial view of the evolution of resistance traits that may result in male-biased herbivory in dioecious populations. Here, we present a critical summary of the current state of the knowledge of herbivory in dioecious species and propose alternative evolutionary scenarios that have been neglected. These scenarios consider the potential evolutionary and functional determinants of sexual dimorphism in patterns of resource allocation to reproduction, growth, and defence. We review the evidence upon which two previous reviews of sex-biased herbivory have concluded that male-biased herbivory is a rule for dioecious species, and we caution readers about a series of shortcomings of many of these studies. Lastly, we propose a minimal standard protocol that should be followed in any studies that intend to elucidate the (co)evolution of interactions between dioecious plants and their herbivores. PMID:23320247

  10. Chronic Achilles tendinopathy: a case study of treatment incorporating active and passive tissue warm-up, Graston Technique®, ART®, eccentric exercise, and cryotherapy

    PubMed Central

    Miners, Andrew L.; Bougie, Tracy L.

    2011-01-01

    Objective To describe the subjective pain and functional improvements of a patient with chronic Achilles tendinopathy following a treatment plan incorporating active and passive tissue warm-up, followed respectively by soft tissue mobilization utilizing both Graston Technique® and Active Release Techniques®, eccentric exercise, and static stretching in combination with cryotherapy. Background The primary characterization of chronic Achilles tendinopathy is gradual onset of pain and dysfunction focused in one or both Achilles tendons arising secondary to a history of repetitive use or excessive overload. Intervention and Outcome Conservative treatment is commonly the initial strategy for patient management. Tissue heating, soft tissue mobilization, eccentric training, and static stretching with cryotherapy were implemented to reduce pain and improve function. Summary A specific protocol of heat, soft tissue mobilization, eccentric exercise, stretching, and cryotherapy appeared to facilitate a rapid and complete recovery from chronic Achilles tendinopathy. PMID:22131563

  11. System services and architecture of the TMI satellite mobile data system

    NASA Technical Reports Server (NTRS)

    Gokhale, D.; Agarwal, A.; Guibord, A.

    1993-01-01

    The North American Mobile Satellite Service (MSS) system being developed by AMSC/TMI and scheduled to go into service in early 1995 will include the provision for real time packet switched services (mobile data service - MDS) and circuit switched services (mobile telephony service - MTS). These services will utilize geostationary satellites which provide access to mobile terminals (MT's) through L-band beams. The MDS system utilizes a star topology with a centralized data hub (DH) and will support a large number of mobile terminals. The DH, which accesses the satellite via a single Ku band beam, is responsible for satellite resource management, for providing mobile users with access to public and private data networks, and for comprehensive network management of the system. This paper describes the various MDS services available for the users, the ground segment elements involved in the provisioning of these services, and a summary description of the channel types, protocol architecture, and network management capabilities provided within the system.

  12. Palladium-based Mass-Tag Cell Barcoding with a Doublet-Filtering Scheme and Single Cell Deconvolution Algorithm

    PubMed Central

    Zunder, Eli R.; Finck, Rachel; Behbehani, Gregory K.; Amir, El-ad D.; Krishnaswamy, Smita; Gonzalez, Veronica D.; Lorang, Cynthia G.; Bjornson, Zach; Spitzer, Matthew H.; Bodenmiller, Bernd; Fantl, Wendy J.; Pe’er, Dana; Nolan, Garry P.

    2015-01-01

    SUMMARY Mass-tag cell barcoding (MCB) labels individual cell samples with unique combinatorial barcodes, after which they are pooled for processing and measurement as a single multiplexed sample. The MCB method eliminates variability between samples in antibody staining and instrument sensitivity, reduces antibody consumption, and shortens instrument measurement time. Here, we present an optimized MCB protocol with several improvements over previously described methods. The use of palladium-based labeling reagents expands the number of measurement channels available for mass cytometry and reduces interference with lanthanide-based antibody measurement. An error-detecting combinatorial barcoding scheme allows cell doublets to be identified and removed from the analysis. A debarcoding algorithm that is single cell-based rather than population-based improves the accuracy and efficiency of sample deconvolution. This debarcoding algorithm has been packaged into software that allows rapid and unbiased sample deconvolution. The MCB procedure takes 3–4 h, not including sample acquisition time of ~1 h per million cells. PMID:25612231

  13. An Adaptive QoS Routing Solution for MANET Based Multimedia Communications in Emergency Cases

    NASA Astrophysics Data System (ADS)

    Ramrekha, Tipu Arvind; Politis, Christos

    The Mobile Ad hoc Networks (MANET) is a wireless network deprived of any fixed central authoritative routing entity. It relies entirely on collaborating nodes forwarding packets from source to destination. This paper describes the design, implementation and performance evaluation of CHAMELEON, an adaptive Quality of Service (QoS) routing solution, with improved delay and jitter performances, enabling multimedia communication for MANETs in extreme emergency situations such as forest fire and terrorist attacks as defined in the PEACE project. CHAMELEON is designed to adapt its routing behaviour according to the size of a MANET. The reactive Ad Hoc on-Demand Distance Vector Routing (AODV) and proactive Optimized Link State Routing (OLSR) protocols are deemed appropriate for CHAMELEON through their performance evaluation in terms of delay and jitter for different MANET sizes in a building fire emergency scenario. CHAMELEON is then implemented in NS-2 and evaluated similarly. The paper concludes with a summary of findings so far and intended future work.

  14. Spatial and temporal patterning of bank vole demography and the epidemiology of the Puumala hantavirus in northeastern France

    PubMed Central

    AUGOT, D.; SAUVAGE, F.; BOUE, F.; BOULOY, M.; ARTOIS, M.; DEMERSON, J. M.; COMBES, B.; COUDRIER, D.; ZELLER, H.; CLIQUET, F.; PONTIER, D.

    2008-01-01

    SUMMARY Epidemiological data from bank voles, Myodes glareolus, naturally infected by the hantavirus Puumala (PUUV) were collected by a capture–mark–recapture protocol from 2000 to 2002 in the French department of Ardennes. Four monitored trapping sites were established in two forests located in two cantons (Flize and Monthermé). We captured 912 bank voles corresponding to 557 different individuals during 8820 trapping nights for an overall trapping success of 10·34%. The average PUUV seroprevalence was 22·4%. Characteristics of the system reported in North European countries are confirmed in France. PUUV seroprevalence and abundance of rodents appeared weakly linked. Adult voles were more frequently antibody-positive, but no difference between sexes was established. Anti-PUUV seropositive voles were captured and high seroprevalence was observed from both forests, without human infection reported in Flize canton during the study. One site among the four exhibited peculiar infection dynamics, where vole weight and infection risk were negatively correlated. PMID:18325126

  15. 4th Annual Predictive Toxicology Summit 2012.

    PubMed

    Cui, Zhanfeng

    2013-08-01

    This meeting report presents a brief summary on the 4th Annual Predictive Toxicology Summit 2012, which was held on 15 - 16 February 2012 in London. The majority of presentations came from global pharmaceutical companies, although small and medium enterprise (SME) and academic researchers were represented too. Major regulatory bodies were also present. The article highlights the summit, which was considered a good learning opportunity to catch up on the recent advances in predictive toxicology. Predictive toxicology has become more and more important due to social and economic pressure and scientific reasons. Technological developments are rapid, but there is a gulf between the technology developers and the pharmaceutical end users; hence, early engagement is desirable. Stem cell-derived cell-based assays as well as three-dimensional in vitro tissue/organ model development are within the reach now, but a lot needs to be done to optimise and validate the developed protocols and products. The field of predictive toxicology needs fundamental research of interdisciplinary nature, which requires much needed trained personnel and funding.

  16. Basal Ganglia Contributions to Motor Control: A Vigorous Tutor

    PubMed Central

    Turner, Robert S.; Desmurget, Michel

    2010-01-01

    SUMMARY OF RECENT ADVANCES The roles of the basal ganglia (BG) in motor control are much debated. Many influential hypotheses have grown from studies in which output signals of the BG were not blocked, but pathologically-disturbed. A weakness of that approach is that the resulting behavioral impairments reflect degraded function of the BG per se mixed together with secondary dysfunctions of BG-recipient brain areas. To overcome that limitation, several studies have focused on the main skeletomotor output region of the BG, the globus pallidus internus (GPi). Using single-cell recording and inactivation protocols these studies provide consistent support for two hypotheses: the BG modulates movement performance (“vigor”) according to motivational factors (i.e., context-specific cost/reward functions) and the BG contributes to motor learning. Results from these studies also add to the problems that confront theories positing that the BG selects movement, inhibits unwanted motor responses, corrects errors online, or stores and produces well-learned motor skills. PMID:20850966

  17. Isolation of adipose derived stem cells and their induction to a chondrogenic phenotype

    PubMed Central

    Estes, Bradley T.; Diekman, Brian O.; Gimble, Jeffrey M.; Guilak, Farshid

    2011-01-01

    Summary The ability to isolate, expand, and differentiate adult stem cells into a chondrogenic lineage is an important step in the development of tissue engineering approaches for cartilage repair or regeneration for the treatment of joint injury or osteoarthritis, or for application in plastic or reconstructive surgery. Adipose-derived stem cells (ASCs) provide an abundant and easily accessible source of adult stem cells for use in such regenerative approaches. This protocol describes the isolation of ASCs from liposuction aspirate, as well as cell culture conditions for growth factor based induction of ASCs into chondrocyte-like cells. These methods are similar to those used for bone marrow mesenchymal stem cells but distinct due to the unique properties of ASCs. Investigators can expect consistent ASC differentiation, allowing for slight variation due to donor and serum lot effects. Approximately 10–12 weeks are needed for ASC isolation and the characterization of chondrocyte-like cells, which is also described. PMID:20595958

  18. Burnet Project

    PubMed Central

    Masellis, A.; Atiyeh, B.

    2009-01-01

    Summary The BurNet project, a pilot project of the Eumedis initiative, has become true. The Eumedis (EUro MEDiterranean Information Society) initiative is part of the MEDA programme of the EU to develop the Information Society in the Mediterranean area. In the health care sector, the objective of Eumedis is: the deployment of network-based solutions to interconnect - using userfriendly and affordable solutions - the actors at all levels of the "health care system" of the Euro-Mediterranean region. The Bur Net project interconnects 17 Burn Centres (BC) in the Mediterranean Area through an information network both to standardize courses of action in the field of prevention, treatment, and functional and psychological rehabilitation of burn patients and to coordinate interactions between BC and emergency rooms in peripheral hospitals using training/information activities and telemedicine to optimize first aid provided to burn patients before referral to a BC. Shared procedure protocols for prevention and the care and rehabilitation of patients, both at individual and mass level, will help to create an international specialized database and a Webbased teleconsultation system. PMID:21991176

  19. Transparent data service with multiple wireless access

    NASA Technical Reports Server (NTRS)

    Dean, Richard A.; Levesque, Allen H.

    1993-01-01

    The rapid introduction of digital wireless networks is an important part of the emerging digital communications scene. The introduction of Digital Cellular, LEO and GEO Satellites, and Personal Communications Services poses both a challenge and an opportunity for the data user. On the one hand wireless access will introduce significant new portable data services such as personal notebooks, paging, E-mail, and fax that will put the information age in the user's pocket. On the other hand the challenge of creating a seamless and transparent environment for the user in multiple access environments and across multiple network connections is formidable. A summary of the issues associated with developing techniques and standards that can support transparent and seamless data services is presented. The introduction of data services into the radio world represents a unique mix of RF channel problems, data protocol issues, and network issues. These problems require that experts from each of these disciplines fuse the individual technologies to support these services.

  20. A qualitative analysis of an advanced practice nurse-directed transitional care model intervention.

    PubMed

    Bradway, Christine; Trotta, Rebecca; Bixby, M Brian; McPartland, Ellen; Wollman, M Catherine; Kapustka, Heidi; McCauley, Kathleen; Naylor, Mary D

    2012-06-01

    The purpose of this study was to describe barriers and facilitators to implementing a transitional care intervention for cognitively impaired older adults and their caregivers lead by advanced practice nurses (APNs). APNs implemented an evidence-based protocol to optimize transitions from hospital to home. An exploratory, qualitative directed content analysis examined 15 narrative case summaries written by APNs and fieldnotes from biweekly case conferences. Three central themes emerged: patients and caregivers having the necessary information and knowledge, care coordination, and the caregiver experience. An additional category was also identified, APNs going above and beyond. APNs implemented individualized approaches and provided care that exceeds the type of care typically staffed and reimbursed in the American health care system by applying a Transitional Care Model, advanced clinical judgment, and doing whatever was necessary to prevent negative outcomes. Reimbursement reform as well as more formalized support systems and resources are necessary for APNs to consistently provide such care to patients and their caregivers during this vulnerable time of transition.

  1. t4 Workshop Report

    PubMed Central

    Silbergeld, Ellen K.; Contreras, Elizabeth Q.; Hartung, Thomas; Hirsch, Cordula; Hogberg, Helena; Jachak, Ashish C.; Jordan, William; Landsiedel, Robert; Morris, Jeffery; Patri, Anil; Pounds, Joel G.; de Vizcaya Ruiz, Andrea; Shvedova, Anna; Tanguay, Robert; Tatarazako, Norihasa; van Vliet, Erwin; Walker, Nigel J.; Wiesner, Mark; Wilcox, Neil; Zurlo, Joanne

    2014-01-01

    Summary In October 2010, a group of experts met as part of the transatlantic think tank for toxicology (t4) to exchange ideas about the current status and future of safety testing of nanomaterials. At present, there is no widely accepted path forward to assure appropriate and effective hazard identification for engineered nanomaterials. The group discussed needs for characterization of nanomaterials and identified testing protocols that incorporate the use of innovative alternative whole models such as zebrafish or C. elegans, as well as in vitro or alternative methods to examine specific functional pathways and modes of action. The group proposed elements of a potential testing scheme for nanomaterials that works towards an integrated testing strategy, incorporating the goals of the NRC report Toxicity Testing in the 21st Century: A Vision and a Strategy by focusing on pathways of toxic response, and utilizing an evidence-based strategy for developing the knowledge base for safety assessment. Finally, the group recommended that a reliable, open, curated database be developed that interfaces with existing databases to enable sharing of information. PMID:21993959

  2. Head-to-head comparison of procalcitonin and presepsin for the diagnosis of sepsis in critically ill adult patients: a protocol for a systematic review and meta-analysis.

    PubMed

    Hayashida, Kei; Kondo, Yutaka; Hara, Yoshitaka; Aihara, Morio; Yamakawa, Kazuma

    2017-03-06

    Early diagnosis and immediate therapeutic intervention, including appropriate antibiotic therapy and goal-directed resuscitation, are necessary to reduce mortality in patients with sepsis. However, a single clinical or biological marker indicative of sepsis has not been adopted unanimously. Although procalcitonin and presepsin are promising biomarkers that can effectively differentiate between sepsis/infection and systemic inflammatory response syndrome of non-infectious origin, little is known about which marker is superior. We will conduct a systematic review and meta-analysis of procalcitonin and presepsin for the diagnosis of sepsis/infection in critically ill adult patients. The primary objective is to evaluate the diagnostic accuracy of these 2 biomarkers to a reference standard of sepsis/infection and to compare the diagnostic accuracy with each other. We will search electronic bibliographic databases such as MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials for retrospective and prospective diagnostic test studies. We will assign 2 reviewers to review all collected titles and associated abstracts, review full articles, and extract study data. We will use the Quality of Diagnostic Accuracy Studies-II tool to report study characteristics and to evaluate methodological quality. If pooling is possible, we will use bivariate random effects and hierarchical summary receiver operating characteristic (ROC) models to calculate parameter estimates to output summary ROCs, pooled sensitivity and specificity data, and 95% CIs around the summary operating point. We will also assess heterogeneity via clinical and methodological subgroup and sensitivity analyses. This systematic review will provide guidance on the triage of these tests, help to determine whether existing tests should be revised or replaced, and may also identify knowledge gaps in sepsis diagnosis that could direct further research in the field. Research ethics is not required for this review. The findings will be reported at conferences and in peer-reviewed publications. CRD42016035784. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Retaining Traditionally Hard to Reach Participants: Lessons Learned from Three Childhood Obesity Studies

    PubMed Central

    Buscemi, Joanna; Blumstein, Lara; Kong, Angela; Stolley, Melinda L.; Schiffer, Linda; Odoms-Young, Angela; Bittner, Cheryl; Fitzgibbon, Marian L.

    2015-01-01

    Retaining underserved populations, particularly low-income and/or minority participants in research trials, presents a unique set of challenges. In this paper, we describe initial retention strategies and enhanced retention strategies over time across three childhood obesity prevention trials. Hip Hop to Health Jr. (HH) was a randomized controlled trial (RCT) testing a preschool-based obesity prevention intervention among predominately African-American children. Retention was 89% at 14 weeks, 71% at 1-year, and 73% at 2-year follow up. Primary retention strategies for HH included: 1) collaboration with a community-based organization to enhance program credibility; 2) continuity of data collection locations; 3) collecting detailed contact information and provision of monetary compensation; and 4) developing a detailed tracking/search protocol. In a follow-up trial, Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial (HH Effectiveness), 95% of participants completed assessment at 14 weeks and 88% completed assessment at 1 year. For this trial, we emphasized staffing continuity in order to enhance participant relationship building and required data collection staff to have relevant community service experience. In a third study, we assessed dietary quality among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) across three time points following the WIC food package shift instituted nationally in 2009. Retention rates were 91% at 12 months and 89% at 18 months. For our WIC study, we augmented retention by developing a home data collection protocol and increased focus on staff diversity training. We conclude with a summary of key strategies and suggestions for future research. PMID:25847577

  4. Downhill Running-Based Overtraining Protocol Improves Hepatic Insulin Signaling Pathway without Concomitant Decrease of Inflammatory Proteins

    PubMed Central

    Pauli, José R.; Cintra, Dennys E.; de Souza, Claudio T.; Ropelle, Eduardo R.; R. da Silva, Adelino S.

    2015-01-01

    The purpose of this study was to verify the effects of overtraining (OT) on insulin, inflammatory and gluconeogenesis signaling pathways in the livers of mice. Rodents were divided into control (CT), overtrained by downhill running (OTR/down), overtrained by uphill running (OTR/up) and overtrained by running without inclination (OTR). Rotarod, incremental load, exhaustive and grip force tests were used to evaluate performance. Thirty-six hours after a grip force test, the livers were extracted for subsequent protein analyses. The phosphorylation of insulin receptor beta (pIRbeta), glycogen synthase kinase 3 beta (pGSK3beta) and forkhead box O1 (pFoxo1) increased in OTR/down versus CT. pGSK3beta was higher in OTR/up versus CT, and pFoxo1 was higher in OTR/up and OTR versus CT. Phosphorylation of protein kinase B (pAkt) and insulin receptor substrate 1 (pIRS–1) were higher in OTR/up versus CT and OTR/down. The phosphorylation of IκB kinase alpha and beta (pIKKalpha/beta) was higher in all OT protocols versus CT, and the phosphorylation of stress-activated protein kinases/Jun amino-terminal kinases (pSAPK-JNK) was higher in OTR/down versus CT. Protein levels of peroxisome proliferator-activated receptor-gamma coactivator 1alpha (PGC-1alpha) and hepatocyte nuclear factor 4alpha (HNF-4alpha) were higher in OTR versus CT. In summary, OTR/down improved the major proteins of insulin signaling pathway but up-regulated TRB3, an Akt inhibitor, and its association with Akt. PMID:26445495

  5. Role of oral candidiasis in TB and HIV co-infection: AIDS Clinical Trial Group Protocol A5253

    PubMed Central

    Shiboski, C. H.; Chen, H.; Ghannoum, M. A.; Komarow, L.; Evans, S.; Mukherjee, P. K.; Isham, N.; Katzenstein, D.; Asmelash, A.; Omozoarhe, A. E.; Gengiah, S.; Allen, R.; Tripathy, S.; Swindells, S.

    2014-01-01

    SUMMARY OBJECTIVE To evaluate the association between oral candidiasis and tuberculosis (TB) in human immunodeficiency virus (HIV) infected individuals in sub-Saharan Africa, and to investigate oral candidiasis as a potential tool for TB case finding. METHODS Protocol A5253 was a cross-sectional study designed to improve the diagnosis of pulmonary TB in HIV-infected adults in high TB prevalence countries. Participants received an oral examination to detect oral candidiasis. We estimated the association between TB disease and oral candidiasis using logistic regression, and sensitivity, specificity and predictive values. RESULTS Of 454 participants with TB culture results enrolled in African sites, the median age was 33 years, 71% were female and the median CD4 count was 257 cells/mm3. Fifty-four (12%) had TB disease; the prevalence of oral candidiasis was significantly higher among TB cases (35%) than among non-TB cases (16%, P < 0.001). The odds of having TB was 2.4 times higher among those with oral candidiasis when controlling for CD4 count and antifungals (95%CI 1.2–4.7, P = 0.01). The sensitivity of oral candidiasis as a predictor of TB was 35% (95%CI 22–48) and the specificity 85% (95%CI 81–88). CONCLUSION We found a strong association between oral candidiasis and TB disease, independent of CD4 count, suggesting that in resource-limited settings, oral candidiasis may provide clinical evidence for increased risk of TB and contribute to TB case finding. PMID:24903939

  6. Cardiorespiratory, neuromuscular and kinematic responses to stationary running performed in water and on dry land.

    PubMed

    Alberton, Cristine Lima; Cadore, Eduardo Lusa; Pinto, Stephanie Santana; Tartaruga, Marcus Peikriszwili; da Silva, Eduardo Marczwski; Kruel, Luiz Fernando Martins

    2011-06-01

    The purpose of this study was to analyze the cardiorespiratory, neuromuscular and kinematic responses obtained during the stationary running in aquatic and dry land environments. Twelve women took part in the experimental protocol. Stationary running was performed for 4 min at three submaximal cadences and for 15 s at maximal velocity, with the collection of kinematic (peak hip angular velocity (AV)), cardiorespiratory (oxygen uptake (VO(2))) and neuromuscular variables (electromyographic (EMG) signal from the rectus femoris (RF), vastus lateralis (VL), semitendinosus (ST) and short head of the biceps femoris (BF) muscles) in land-based and water-based test protocols. Factorial ANOVA was used, with an alpha level of 0.05. AV was significantly higher when the exercise was performed on land, and became significantly higher as the execution cadence increased. Similarly, VO(2) was significantly higher in the land-based exercise and rose as cadence increased. With the increase in the submaximal execution cadences, there was no corresponding increase in the EMG signal from the VL, BF, RF and ST muscles in either environment, though such a significantly increase was seen between the submaximal cadences and the maximal velocity. Dry land presented significantly greater EMG signal responses for all muscles at the submaximal cadences, except for the ST muscle. However, at the maximal velocity, all the analyzed muscle groups showed similar responses in both environments. In summary, for both environments, cardiorespiratory responses can be maximized by increasing the submaximal cadences, while neuromuscular responses are only optimized by using maximal velocity.

  7. A Tissue-Specific Approach to the Analysis of Metabolic Changes in Caenorhabditis elegans

    PubMed Central

    Pujol, Claire; Ipsen, Sabine; Brodesser, Susanne; Mourier, Arnaud; Tolnay, Markus; Frank, Stephan; Trifunović, Aleksandra

    2011-01-01

    The majority of metabolic principles are evolutionarily conserved from nematodes to humans. Caenorhabditis elegans has widely accelerated the discovery of new genes important to maintain organismic metabolic homeostasis. Various methods exist to assess the metabolic state in worms, yet they often require large animal numbers and tend to be performed as bulk analyses of whole worm homogenates, thereby largely precluding a detailed studies of metabolic changes in specific worm tissues. Here, we have adapted well-established histochemical methods for the use on C. elegans fresh frozen sections and demonstrate their validity for analyses of morphological and metabolic changes on tissue level in wild type and various mutant strains. We show how the worm presents on hematoxylin and eosin (H&E) stained sections and demonstrate their usefulness in monitoring and the identification of morphological abnormalities. In addition, we demonstrate how Oil-Red-O staining on frozen worm cross-sections permits quantification of lipid storage, avoiding the artifact-prone fixation and permeabilization procedures of traditional whole-mount protocols. We also adjusted standard enzymatic stains for respiratory chain subunits (NADH, SDH, and COX) to monitor metabolic states of various C. elegans tissues. In summary, the protocols presented here provide technical guidance to obtain robust, reproducible and quantifiable tissue-specific data on worm morphology as well as carbohydrate, lipid and mitochondrial energy metabolism that cannot be obtained through traditional biochemical bulk analyses of worm homogenates. Furthermore, analysis of worm cross-sections overcomes the common problem with quantification in three-dimensional whole-mount specimens. PMID:22162770

  8. Toward a public toxicogenomics capability for supporting predictive toxicology: survey of current resources and chemical indexing of experiments in GEO and ArrayExpress.

    PubMed

    Williams-Devane, ClarLynda R; Wolf, Maritja A; Richard, Ann M

    2009-06-01

    A publicly available toxicogenomics capability for supporting predictive toxicology and meta-analysis depends on availability of gene expression data for chemical treatment scenarios, the ability to locate and aggregate such information by chemical, and broad data coverage within chemical, genomics, and toxicological information domains. This capability also depends on common genomics standards, protocol description, and functional linkages of diverse public Internet data resources. We present a survey of public genomics resources from these vantage points and conclude that, despite progress in many areas, the current state of the majority of public microarray databases is inadequate for supporting these objectives, particularly with regard to chemical indexing. To begin to address these inadequacies, we focus chemical annotation efforts on experimental content contained in the two primary public genomic resources: ArrayExpress and Gene Expression Omnibus. Automated scripts and extensive manual review were employed to transform free-text experiment descriptions into a standardized, chemically indexed inventory of experiments in both resources. These files, which include top-level summary annotations, allow for identification of current chemical-associated experimental content, as well as chemical-exposure-related (or "Treatment") content of greatest potential value to toxicogenomics investigation. With these chemical-index files, it is possible for the first time to assess the breadth and overlap of chemical study space represented in these databases, and to begin to assess the sufficiency of data with shared protocols for chemical similarity inferences. Chemical indexing of public genomics databases is a first important step toward integrating chemical, toxicological and genomics data into predictive toxicology.

  9. Towards a unified sampling terminology: clarifying misperceptions.

    PubMed

    Thiex, Nancy; Paoletii, Claudia; Esbensen, Kim H

    2015-01-01

    International acceptance of data is a much-desired wish in many sectors to ensure equal standards for valid information and data exchange, facilitate trade, support food safety regulation, and promote reliable communication among all parties involved. However, this cannot be accomplished without a harmonized approach to sampling and a joint approach to assess the practical sampling protocols used. Harmonization based on a nonrepresentative protocol, or on a restricted terminology tradition forced upon other sectors would negate any constructive outcome. An international discussion on a harmonized approach to sampling is severely hampered by a plethora of divergent sampling definitions and terms. Different meanings for the same term are frequently used by the different sectors, and even within one specific sector. In other cases, different terms are used for the same concept. Before efforts to harmonize can be attempted, it is essential that all stakeholders can at least communicate effectively in this context. Therefore, a clear understanding of the main vocabularies becomes an essential prerequisite. As a first step, commonalities and dichotomies in terminology are here brought to attention by providing a comparative summary of the. terminology as defined by the Theory of Sampling {TOS) and those in current use by the International Organization for Standardization, the World Health Organization, the Food and Agriculture Organization Codex Alimentarius, and the U.S. Food and Drug Administration. Terms having contradictory meaning to the TOS are emphasized. To the degree possible, we present a successful resolution of some of the most important issues outlined, sufficient to support the objectives of the present Special Section.

  10. The impact of composite AUC estimates on the prediction of systemic exposure in toxicology experiments.

    PubMed

    Sahota, Tarjinder; Danhof, Meindert; Della Pasqua, Oscar

    2015-06-01

    Current toxicity protocols relate measures of systemic exposure (i.e. AUC, Cmax) as obtained by non-compartmental analysis to observed toxicity. A complicating factor in this practice is the potential bias in the estimates defining safe drug exposure. Moreover, it prevents the assessment of variability. The objective of the current investigation was therefore (a) to demonstrate the feasibility of applying nonlinear mixed effects modelling for the evaluation of toxicokinetics and (b) to assess the bias and accuracy in summary measures of systemic exposure for each method. Here, simulation scenarios were evaluated, which mimic toxicology protocols in rodents. To ensure differences in pharmacokinetic properties are accounted for, hypothetical drugs with varying disposition properties were considered. Data analysis was performed using non-compartmental methods and nonlinear mixed effects modelling. Exposure levels were expressed as area under the concentration versus time curve (AUC), peak concentrations (Cmax) and time above a predefined threshold (TAT). Results were then compared with the reference values to assess the bias and precision of parameter estimates. Higher accuracy and precision were observed for model-based estimates (i.e. AUC, Cmax and TAT), irrespective of group or treatment duration, as compared with non-compartmental analysis. Despite the focus of guidelines on establishing safety thresholds for the evaluation of new molecules in humans, current methods neglect uncertainty, lack of precision and bias in parameter estimates. The use of nonlinear mixed effects modelling for the analysis of toxicokinetics provides insight into variability and should be considered for predicting safe exposure in humans.

  11. Formative research to develop theory-based messages for a Western Australian child drowning prevention television campaign: study protocol.

    PubMed

    Denehy, Mel; Crawford, Gemma; Leavy, Justine; Nimmo, Lauren; Jancey, Jonine

    2016-05-20

    Worldwide, children under the age of 5 years are at particular risk of drowning. Responding to this need requires the development of evidence-informed drowning prevention strategies. Historically, drowning prevention strategies have included denying access, learning survival skills and providing supervision, as well as education and information which includes the use of mass media. Interventions underpinned by behavioural theory and formative evaluation tend to be more effective, yet few practical examples exist in the drowning and/or injury prevention literature. The Health Belief Model and Social Cognitive Theory will be used to explore participants' perspectives regarding proposed mass media messaging. This paper describes a qualitative protocol to undertake formative research to develop theory-based messages for a child drowning prevention campaign. The primary data source will be focus group interviews with parents and caregivers of children under 5 years of age in metropolitan and regional Western Australia. Qualitative content analysis will be used to analyse the data. This study will contribute to the drowning prevention literature to inform the development of future child drowning prevention mass media campaigns. Findings from the study will be disseminated to practitioners, policymakers and researchers via international conferences, peer and non-peer-reviewed journals and evidence summaries. The study was submitted and approved by the Curtin University Human Research Ethics Committee. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Excessive training induces molecular signs of pathologic cardiac hypertrophy.

    PubMed

    da Rocha, Alisson L; Teixeira, Giovana R; Pinto, Ana P; de Morais, Gustavo P; Oliveira, Luciana da C; de Vicente, Larissa Gaioto; da Silva, Lilian E C M; Pauli, José R; Cintra, Dennys E; Ropelle, Eduardo R; de Moura, Leandro P; Mekary, Rania A; de Freitas, Ellen C; da Silva, Adelino S R

    2018-05-24

    Chronic exercise induces cardiac remodeling that promotes left ventricular hypertrophy and cardiac functional improvement, which are mediated by the mammalian or the mechanistic target of rapamycin (mTOR) as well as by the androgen and glucocorticoid receptors (GRs). However, pathological conditions (i.e., chronic heart failure, hypertension, and aortic stenosis, etc.) also induce cardiac hypertrophy, but with detrimental function, high levels of proinflammatory cytokines and myostatin, elevated fibrosis, reduced adenosine monophosphate-activated protein kinase (AMPK) activation, and fetal gene reactivation. Furthermore, recent studies have evidenced that excessive training induced an inflammatory status in the serum, muscle, hypothalamus, and liver, suggesting a pathological condition that could also be detrimental to cardiac tissue. Here, we verified the effects of three running overtraining (OT) models on the molecular parameters related to physiological and pathological cardiac hypertrophy. C57BL/6 mice performed three different OT protocols and were evaluated for molecular parameters related to physiological and pathological cardiac hypertrophy, including immunoblotting, reverse transcription polymerase chain reaction, histology, and immunohistochemistry analyses. In summary, the three OT protocols induced left ventricle (LV) hypertrophy with signs of cardiac fibrosis and negative morphological adaptations. These maladaptations were accompanied by reductions in AMPKalpha (Thr172) phosphorylation, androgen receptor, and GR expressions, as well as by an increase in interleukin-6 expression. Specifically, the downhill running-based OT model reduced the content of some proteins related to the mTOR signaling pathway and upregulated the β-isoform of myosin heavy-chain gene expression, presenting signs of LV pathological hypertrophy development. © 2018 Wiley Periodicals, Inc.

  13. Assessing the Financial Value of Patient Engagement: A Quantitative Approach from CTTI's Patient Groups and Clinical Trials Project.

    PubMed

    Levitan, Bennett; Getz, Kenneth; Eisenstein, Eric L; Goldberg, Michelle; Harker, Matthew; Hesterlee, Sharon; Patrick-Lake, Bray; Roberts, Jamie N; DiMasi, Joseph

    2018-03-01

    While patient groups, regulators, and sponsors are increasingly considering engaging with patients in the design and conduct of clinical development programs, sponsors are often reluctant to go beyond pilot programs because of uncertainty in the return on investment. We developed an approach to estimate the financial value of patient engagement. Expected net present value (ENPV) is a common technique that integrates the key business drivers of cost, time, revenue, and risk into a summary metric for project strategy and portfolio decisions. We assessed the impact of patient engagement on ENPV for a typical oncology development program entering phase 2 or phase 3. For a pre-phase 2 project, the cumulative impact of a patient engagement activity that avoids one protocol amendment and improves enrollment, adherence, and retention is an increase in net present value (NPV) of $62MM ($65MM for pre-phase 3) and an increase in ENPV of $35MM ($75MM for pre-phase 3). Compared with an investment of $100,000 in patient engagement, the NPV and ENPV increases can exceed 500-fold the investment. This ENPV increase is the equivalent of accelerating a pre-phase 2 product launch by 2½ years (1½ years for pre-phase 3). Risk-adjusted financial models can assess the impact of patient engagement. A combination of empirical data and subjective parameter estimates shows that engagement activities with the potential to avoid protocol amendments and/or improve enrollment, adherence, and retention may add considerable financial value. This approach can help sponsors assess patient engagement investment decisions.

  14. Dexamethasone mimics aspects of physiological acclimatization to 8 hours of hypoxia but suppresses plasma erythropoietin

    PubMed Central

    Liu, Chun; Croft, Quentin P. P.; Kalidhar, Swati; Brooks, Jerome T.; Herigstad, Mari; Smith, Thomas G.; Dorrington, Keith L.

    2013-01-01

    Dexamethasone ameliorates the severity of acute mountain sickness (AMS) but it is unknown whether it obtunds normal physiological responses to hypoxia. We studied whether dexamethasone enhanced or inhibited the ventilatory, cardiovascular, and pulmonary vascular responses to sustained (8 h) hypoxia. Eight healthy volunteers were studied, each on four separate occasions, permitting four different protocols. These were: dexamethasone (20 mg orally) beginning 2 h before a control period of 8 h of air breathing; dexamethasone with 8 h of isocapnic hypoxia (end-tidal Po2 = 50 Torr); placebo with 8 h of air breathing; and placebo with 8 h of isocapnic hypoxia. Before and after each protocol, the following were determined under both euoxic and hypoxic conditions: ventilation; pulmonary artery pressure (estimated using echocardiography to assess maximum tricuspid pressure difference); heart rate; and cardiac output. Plasma concentrations of erythropoietin (EPO) were also determined. Dexamethasone had no early (2-h) effect on any variable. Both dexamethasone and 8 h of hypoxia increased euoxic values of ventilation, pulmonary artery pressure, and heart rate, together with the ventilatory sensitivity to acute hypoxia. These effects were independent and additive. Eight hours of hypoxia, but not dexamethasone, increased the sensitivity of pulmonary artery pressure to acute hypoxia. Dexamethasone, but not 8 h of hypoxia, increased both cardiac output and systemic arterial pressure. Dexamethasone abolished the rise in EPO induced by 8 h of hypoxia. In summary, dexamethasone enhances ventilatory acclimatization to hypoxia. Thus, dexamethasone in AMS may improve oxygenation and thereby indirectly lower pulmonary artery pressure. PMID:23393065

  15. Age-Dependent Effects of Topiramate on the Acquisition and the Retention of Rapid Kindling

    PubMed Central

    Mazarati, Andréy; Shin, Don; Auvin, Stéphane; Sankar, Raman

    2008-01-01

    Summary Purpose To examine antiepileptogenic, disease-modifying, and anticonvulsant effects of topiramate under conditions of rapid kindling at different stages of development. Methods Afterdischarge threshold (ADT) and duration (ADD) were examined in two-, three-, and five-week old Wistar rats before and after administration of topiramate (200 mg/kg). Animals underwent a rapid kindling protocol (sixty 10 second trains, bipolar 20 Hz square wave pulses delivered every five minutes). The progression of behavioral and electrographic seizures, and responses to test stimulations 24 hours after the protocol were compared between topiramate and vehicle treated control rats. In addition, rats that were previously given vehicle only prior to kindling, were then given topiramate to examine the effect on established kindled seizures. Results In two-week old animals, topiramate affected neither the baseline afterdischarge, nor the progression of kindled seizures. In three-week old rats, topiramate did not modify the baseline afterdischarge, but significantly delayed the occurrence of full motor seizures in response to repeated stimulations. Topiramate treatment of five-week old rats increased baseline ADT, shortened ADD, and delayed the progression of kindled seizures. Twenty four hours after the last kindling stimulation, animals of all ages exhibited a decreased ADT, an increase ADD, and developed behavioral seizures in response to threshold stimulation. Vehicle treated kindled rats that were then given topiramate displayed significantly attenuated behavioral seizures induced by the threshold stimulation. Conclusions Topiramate exhibited age-dependent disease-modifying effects under conditions of rapid kindling, but failed to block epileptogenesis. Topiramate also inhibited kindled seizures with equal efficacy across the three ages. PMID:17319916

  16. Template-based protein-protein docking exploiting pairwise interfacial residue restraints.

    PubMed

    Xue, Li C; Rodrigues, João P G L M; Dobbs, Drena; Honavar, Vasant; Bonvin, Alexandre M J J

    2017-05-01

    Although many advanced and sophisticated ab initio approaches for modeling protein-protein complexes have been proposed in past decades, template-based modeling (TBM) remains the most accurate and widely used approach, given a reliable template is available. However, there are many different ways to exploit template information in the modeling process. Here, we systematically evaluate and benchmark a TBM method that uses conserved interfacial residue pairs as docking distance restraints [referred to as alpha carbon-alpha carbon (CA-CA)-guided docking]. We compare it with two other template-based protein-protein modeling approaches, including a conserved non-pairwise interfacial residue restrained docking approach [referred to as the ambiguous interaction restraint (AIR)-guided docking] and a simple superposition-based modeling approach. Our results show that, for most cases, the CA-CA-guided docking method outperforms both superposition with refinement and the AIR-guided docking method. We emphasize the superiority of the CA-CA-guided docking on cases with medium to large conformational changes, and interactions mediated through loops, tails or disordered regions. Our results also underscore the importance of a proper refinement of superimposition models to reduce steric clashes. In summary, we provide a benchmarked TBM protocol that uses conserved pairwise interface distance as restraints in generating realistic 3D protein-protein interaction models, when reliable templates are available. The described CA-CA-guided docking protocol is based on the HADDOCK platform, which allows users to incorporate additional prior knowledge of the target system to further improve the quality of the resulting models. © The Author 2016. Published by Oxford University Press.

  17. Improvement of isometric dorsiflexion protocol for assessment of tibialis anterior muscle strength☆

    PubMed Central

    Siddiqi, Ariba; Arjunan, Sridhar P.; Kumar, Dinesh

    2015-01-01

    It is important to accurately estimate the electromyogram (EMG)/force relationship of triceps surae (TS) muscle for detecting strength deficit of tibalis anterior (TA) muscle. In literature, the protocol for recording EMG and force of dorsiflexion have been described, and the necessity for immobilizing the ankle has been explained. However, there is a significant variability of the results among researchers even though they report the fixation of the ankle. We have determined that toe extension can cause significant variation in the dorsiflexion force and EMG of TS and this can occur despite following the current guidelines which require immobilizing the ankle. The results also show that there was a large increase in the variability of the force and the RMS of EMG of TS when the toes were not strapped compared with when they were strapped. Thus, with the current guidelines, where there are no instructions regarding the necessity of strapping the toes, the EMG/force relationship of TS could be incorrect and give an inaccurate assessment of the dorsiflexor TA strength. In summary, • Current methodology to estimate the dorsiflexor TA strength with respect to the TS activity, emphasizing on ankle immobilization is insufficient to prevent large variability in the measurements. • Toe extension during dorsiflexion was found to be one source of variability in estimating the TA strength. • It is recommended that guidelines for recording force and EMG from TA and TS muscles should require the strapping of the toes along with the need for immobilizing the ankle. PMID:26150978

  18. Negative spot sign in primary intracerebral hemorrhage: potential impact in reducing imaging.

    PubMed

    Romero, Javier M; Hito, Rania; Dejam, Andre; Ballesteros, Laia Sero; Cobos, Camilo Jaimes; Liévano, J Ortiz; Ciura, Viesha A; Barnaure, Isabelle; Ernst, Marielle; Liberato, Afonso P; Gonzalez, Gilberto R

    2017-02-01

    Intracerebral hemorrhage (ICH) is one of the most devastating and costly diagnoses in the USA. ICH is a common diagnosis, accounting for 10-15 % of all strokes and affecting 20 out of 100,000 people. The CT angiography (CTA) spot sign, or contrast extravasation into the hematoma, is a reliable predictor of hematoma expansion, clinical deterioration, and increased mortality. Multiple studies have demonstrated a high negative predictive value (NPV) for ICH expansion in patients without spot sign. Our aim is to determine the absolute NPV of the spot sign and clinical characteristics of patients who had ICH expansion despite the absence of a spot sign. This information may be helpful in the development of a cost effective imaging protocol of patients with ICH. During a 3-year period, 204 patients with a CTA with primary intracerebral hemorrhage were evaluated for subsequent hematoma expansion during their hospitalization. Patients with intraventricular hemorrhage were excluded. Clinical characteristics and antithrombotic treatment on admission were noted. The number of follow-up NCCT was recorded. Of the resulting 123 patients, 108 had a negative spot sign and 7 of those patients subsequently had significant hematoma expansion, 6 of which were on antithrombotic therapy. The NPV of the CTA spot sign was calculated at 0.93. In patients without antithrombotic therapy, the NPV was 0.98. In summary, the negative predictive value of the CTA spot sign for expansion of ICH, in the absence of antithrombotic therapy and intraventricular hemorrhage (IVH) on admission, is very high. These results have the potential to redirect follow-up imaging protocols and reduce cost.

  19. Feasibility and utility of applications of the common data model to multiple, disparate observational health databases

    PubMed Central

    Makadia, Rupa; Matcho, Amy; Ma, Qianli; Knoll, Chris; Schuemie, Martijn; DeFalco, Frank J; Londhe, Ajit; Zhu, Vivienne; Ryan, Patrick B

    2015-01-01

    Objectives To evaluate the utility of applying the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) across multiple observational databases within an organization and to apply standardized analytics tools for conducting observational research. Materials and methods Six deidentified patient-level datasets were transformed to the OMOP CDM. We evaluated the extent of information loss that occurred through the standardization process. We developed a standardized analytic tool to replicate the cohort construction process from a published epidemiology protocol and applied the analysis to all 6 databases to assess time-to-execution and comparability of results. Results Transformation to the CDM resulted in minimal information loss across all 6 databases. Patients and observations excluded were due to identified data quality issues in the source system, 96% to 99% of condition records and 90% to 99% of drug records were successfully mapped into the CDM using the standard vocabulary. The full cohort replication and descriptive baseline summary was executed for 2 cohorts in 6 databases in less than 1 hour. Discussion The standardization process improved data quality, increased efficiency, and facilitated cross-database comparisons to support a more systematic approach to observational research. Comparisons across data sources showed consistency in the impact of inclusion criteria, using the protocol and identified differences in patient characteristics and coding practices across databases. Conclusion Standardizing data structure (through a CDM), content (through a standard vocabulary with source code mappings), and analytics can enable an institution to apply a network-based approach to observational research across multiple, disparate observational health databases. PMID:25670757

  20. Eradication of Methicillin-Resistant Staphylococcus aureus and of Enterobacteriaceae Expressing Extended-Spectrum Beta-Lactamases on a Model Pig Farm

    PubMed Central

    Kellner, Sophia Ricarda; Schulze-Geisthoevel, Sophia Veronika; Hack, Sylvia; Engelhart, Steffen; Bodenstein, Isabel; Al-Sabti, Nahed; Reif, Marion; Fimmers, Rolf; Körber-Irrgang, Barbara; Harlizius, Jürgen; Hoerauf, Achim; Exner, Martin; Bierbaum, Gabriele; Petersen, Brigitte

    2015-01-01

    Colonization of livestock with bacteria resistant to antibiotics is considered a risk for the entry of drug-resistant pathogens into the food chain. For this reason, there is a need for novel concepts to address the eradication of drug-resistant commensals on farms. In the present report, we evaluated the decontamination measures taken on a farm contaminated with methicillin-resistant Staphylococcus aureus (MRSA) and Enterobacteriaceae expressing extended-spectrum β-lactamases (ESBL-E). The decontamination process preceded the conversion from piglet breeding to gilt production. Microbiological surveillance showed that the decontamination measures eliminated the MRSA and ESBL-E strains that were detected on the farm before the complete removal of pigs, cleaning and disinfection of the stable, and construction of an additional stable meeting high-quality standards. After pig production was restarted, ESBL-E remained undetectable over 12 months, but MRSA was recovered from pigs and the environment within the first 2 days. However, spa (Staphylococcus aureus protein A gene) typing revealed acquisition of an MRSA strain (type t034) that had not been detected before decontamination. Interestingly, we observed that a farmworker who had been colonized with the prior MRSA strain (t2011) acquired the new strain (t034) after 2 months. In summary, this report demonstrates that decontamination protocols similar to those used here can lead to successful elimination of contaminating MRSA and ESBL-E in pigs and the stable environment. Nevertheless, decontamination protocols do not prevent the acquisition of new MRSA strains. PMID:26341200

  1. Eradication of methicillin-resistant Staphylococcus aureus and of Enterobacteriaceae expressing extended-spectrum beta-lactamases on a model pig farm.

    PubMed

    Schmithausen, Ricarda Maria; Kellner, Sophia Ricarda; Schulze-Geisthoevel, Sophia Veronika; Hack, Sylvia; Engelhart, Steffen; Bodenstein, Isabel; Al-Sabti, Nahed; Reif, Marion; Fimmers, Rolf; Körber-Irrgang, Barbara; Harlizius, Jürgen; Hoerauf, Achim; Exner, Martin; Bierbaum, Gabriele; Petersen, Brigitte; Bekeredjian-Ding, Isabelle

    2015-11-01

    Colonization of livestock with bacteria resistant to antibiotics is considered a risk for the entry of drug-resistant pathogens into the food chain. For this reason, there is a need for novel concepts to address the eradication of drug-resistant commensals on farms. In the present report, we evaluated the decontamination measures taken on a farm contaminated with methicillin-resistant Staphylococcus aureus (MRSA) and Enterobacteriaceae expressing extended-spectrum β-lactamases (ESBL-E). The decontamination process preceded the conversion from piglet breeding to gilt production. Microbiological surveillance showed that the decontamination measures eliminated the MRSA and ESBL-E strains that were detected on the farm before the complete removal of pigs, cleaning and disinfection of the stable, and construction of an additional stable meeting high-quality standards. After pig production was restarted, ESBL-E remained undetectable over 12 months, but MRSA was recovered from pigs and the environment within the first 2 days. However, spa (Staphylococcus aureus protein A gene) typing revealed acquisition of an MRSA strain (type t034) that had not been detected before decontamination. Interestingly, we observed that a farmworker who had been colonized with the prior MRSA strain (t2011) acquired the new strain (t034) after 2 months. In summary, this report demonstrates that decontamination protocols similar to those used here can lead to successful elimination of contaminating MRSA and ESBL-E in pigs and the stable environment. Nevertheless, decontamination protocols do not prevent the acquisition of new MRSA strains. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  2. Assessing the Financial Value of Patient Engagement

    PubMed Central

    Levitan, Bennett; Getz, Kenneth; Eisenstein, Eric L.; Goldberg, Michelle; Harker, Matthew; Hesterlee, Sharon; Patrick-Lake, Bray; Roberts, Jamie N.; DiMasi, Joseph

    2017-01-01

    Background: While patient groups, regulators, and sponsors are increasingly considering engaging with patients in the design and conduct of clinical development programs, sponsors are often reluctant to go beyond pilot programs because of uncertainty in the return on investment. We developed an approach to estimate the financial value of patient engagement. Methods: Expected net present value (ENPV) is a common technique that integrates the key business drivers of cost, time, revenue, and risk into a summary metric for project strategy and portfolio decisions. We assessed the impact of patient engagement on ENPV for a typical oncology development program entering phase 2 or phase 3. Results: For a pre–phase 2 project, the cumulative impact of a patient engagement activity that avoids one protocol amendment and improves enrollment, adherence, and retention is an increase in net present value (NPV) of $62MM ($65MM for pre–phase 3) and an increase in ENPV of $35MM ($75MM for pre–phase 3). Compared with an investment of $100,000 in patient engagement, the NPV and ENPV increases can exceed 500-fold the investment. This ENPV increase is the equivalent of accelerating a pre–phase 2 product launch by 2½ years (1½ years for pre–phase 3). Conclusions: Risk-adjusted financial models can assess the impact of patient engagement. A combination of empirical data and subjective parameter estimates shows that engagement activities with the potential to avoid protocol amendments and/or improve enrollment, adherence, and retention may add considerable financial value. This approach can help sponsors assess patient engagement investment decisions. PMID:29714515

  3. Multimodal biometrics for identity documents (MBioID).

    PubMed

    Dessimoz, Damien; Richiardi, Jonas; Champod, Christophe; Drygajlo, Andrzej

    2007-04-11

    The MBioID initiative has been set up to address the following germane question: What and how biometric technologies could be deployed in identity documents in the foreseeable future? This research effort proposes to look at current and future practices and systems of establishing and using biometric identity documents (IDs) and evaluate their effectiveness in large-scale developments. The first objective of the MBioID project is to present a review document establishing the current state-of-the-art related to the use of multimodal biometrics in an IDs application. This research report gives the main definitions, properties and the framework of use related to biometrics, an overview of the main standards developed in the biometric industry and standardisation organisations to ensure interoperability, as well as some of the legal framework and the issues associated to biometrics such as privacy and personal data protection. The state-of-the-art in terms of technological development is also summarised for a range of single biometric modalities (2D and 3D face, fingerprint, iris, on-line signature and speech), chosen according to ICAO recommendations and availabilities, and for various multimodal approaches. This paper gives a summary of the main elements of that report. The second objective of the MBioID project is to propose relevant acquisition and evaluation protocols for a large-scale deployment of biometric IDs. Combined with the protocols, a multimodal database will be acquired in a realistic way, in order to be as close as possible to a real biometric IDs deployment. In this paper, the issues and solutions related to the acquisition setup are briefly presented.

  4. First results of the CINDI-2 semi-blind MAX-DOAS intercomparison

    NASA Astrophysics Data System (ADS)

    Kreher, Karin; van Roozendael, Michel; Hendrick, Francois; Apituley, Arnoud; Friess, Udo; Lampel, Johannes; Piters, Ankie; Richter, Andreas; Wagner, Thomas; Cindi-2 Participants, All

    2017-04-01

    The second Cabauw Intercomparison campaign for Nitrogen Dioxide measuring Instruments (CINDI-2) took place at the Cabauw Experimental Site for Atmospheric Research (CESAR; Utrecht area, The Netherlands) from 25 August until 7 October 2016. The goals of this inter-comparison campaign are to support the creation of high-quality ground-based data sets (e.g. to provide reliable long-term time series for trend analysis and satellite data validation), to characterise and better understand the differences between a large number of MAX-DOAS and DOAS instruments and analysis methods, and to contribute to a harmonisation of the measurement settings and retrieval methods. During a time period of 17 days, from 12 to 28 September 2016, a formal semi-blind intercomparison was held following a detailed measurement protocol. The development of this protocol was based on the experience gained during the first CINDI campaign held in 2009 as well as more recent projects and campaigns such as the MADCAT campaign in Mainz, Germany, in 2013. Strong emphasis was put on the careful synchronisation of the measurement sequence and on exact alignment of the elevation angles using horizon scans and lamp measurements. In this presentation, we provide an overview and some highlights of the MAX-DOAS semi-blind intercomparison campaign. We will introduce the participating groups, their instruments and the measurement protocol details, and then summarize the campaign outcomes to date. The CINDI-2 data sets have been investigated using a range of diagnostics including comparisons of daily time series and relative differences between the data sets, regression analysis and correlation plots. The data products so far investigated are NO2 (nitrogen dioxide) in the UV and visible wavelength region, O4 (oxygen dimer) in the same two wavelength intervals, O3 (ozone) in the UV and visible wavelength region, HCHO (formaldehyde) and NO2 in an additional (smaller) wavelength range in the visible. The results based on the regression analysis are presented in summary plots and tables, addressing MAX-DOAS and twilight zenith sky measurements separately. Further information on instrumental details such as the alignment of the viewing direction and elevation and the field of view are also summarized and included in the overall interpretation.

  5. Global prevalence of diabetes mellitus in patients with tuberculosis: a systematic review and meta-analysis protocol.

    PubMed

    Tankeu, Aurel T; Bigna, Jean Joël; Nansseu, Jobert Richie; Endomba, Francky Teddy A; Wafeu, Guy Sadeu; Kaze, Arnaud D; Noubiap, Jean Jacques

    2017-06-09

    Diabetes mellitus (DM) is an important risk factor for active tuberculosis (TB), which also adversely affect TB treatment outcomes. The escalating global DM epidemic is fuelling the burden of TB and should therefore be a major target in the strategy for ending TB. This review aims to estimate the global prevalence of DM in patients with TB. This systematic review will include cross-sectional, case-control or cohort studies of populations including patients diagnosed with TB that have reported the prevalence of DM using one of the fourth standard recommendations for screening and diagnosis. This protocol is written in accordance with recommendations from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 statement. Relevant abstracts published in English/French from inception to 31 December 2016 will be searched in PubMed, Excerpta Medica Database and online journals. Two investigators will independently screen, select studies, extract data and assess the risk of bias in each study. The study-specific estimates will be pooled through a random-effects meta-analysis model to obtain an overall summary estimate of the prevalence of diabetes across the studies. Heterogeneity will be assessed, and we will pool studies judged to be clinically homogenous. On the other hand, statistical heterogeneity will be evaluated by the χ² test on Cochrane's Q statistic. Funnel-plots analysis and Egger's test will be used to investigate publication bias. Results will be presented by continent or geographic regions. This study is based on published data. An ethical approval is therefore not required. This systematic review and meta-analysis is expected to inform healthcare providers as well as general population on the co-occurrence of DM and TB. The final report will be published as an original article in a peer-reviewed journal, and will also be presented at conferences and submitted to relevant health authorities. We also plan to update the review every 5 years. PROSPERO International Prospective Register of Systematic Reviews (CRD42016049901). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Pathways: patient-centred decision counselling for women at risk of cancer-related infertility: a protocol for a comparative effectiveness cluster randomised trial.

    PubMed

    Woodard, Terri Lynn; Hoffman, Aubri S; Crocker, Laura C; Holman, Deborah A; Hoffman, Derek B; Ma, Jusheng; Bassett, Roland L; Leal, Viola B; Volk, Robert J

    2018-02-21

    National guidelines recommend that all reproductive-age women with cancer be informed of their fertility risks and offered referral to fertility specialists to discuss fertility preservation options. However, reports indicate that only 5% of patients have consultations, and rates of long-term infertility-related distress remain high. Previous studies report several barriers to fertility preservation; however, initial success has been reported using provider education, patient decision aids and navigation support. This protocol will test effects of a multicomponent intervention compared with usual care on women's fertility preservation knowledge and decision-making outcomes. This cluster-randomised trial will compare the multicomponent intervention (provider education, patient decision aid and navigation support) with usual care (consultation and referral, if requested). One hundred newly diagnosed English-speaking women of reproductive age who are at risk of cancer-related infertility will be recruited from four regional oncology clinics.The Pathways patient decision aid website provides (1) up-to-date evidence and descriptions of fertility preservation and other family-building options, tailored to cancer type; (2) structured guidance to support personalising the information and informed decision-making; and (3) a printable summary to help women prepare for discussions with their oncologist and/or fertility specialist. Four sites will be randomly assigned to intervention or control groups. Participants will be recruited after their oncology consultation and asked to complete online questionnaires at baseline, 1 week and 2 months to assess their demographics, fertility preservation knowledge, and decision-making process and quality. The primary outcome (decisional conflict) will be tested using Fisher's exact test. Secondary outcomes will be assessed using generalised linear mixed models, and sensitivity analyses will be conducted, as appropriate. The University of Texas MD Anderson Cancer Center provided approval and ongoing review of this protocol. Results will be presented at relevant scientific meetings and submitted for publication in a peer-reviewed journal. NCT03141437; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Differences in Reporting of Analyses in Internal Company Documents Versus Published Trial Reports: Comparisons in Industry-Sponsored Trials in Off-Label Uses of Gabapentin

    PubMed Central

    Vedula, S. Swaroop; Li, Tianjing; Dickersin, Kay

    2013-01-01

    Background Details about the type of analysis (e.g., intent to treat [ITT]) and definitions (i.e., criteria for including participants in the analysis) are necessary for interpreting a clinical trial's findings. Our objective was to compare the description of types of analyses and criteria for including participants in the publication (i.e., what was reported) with descriptions in the corresponding internal company documents (i.e., what was planned and what was done). Trials were for off-label uses of gabapentin sponsored by Pfizer and Parke-Davis, and documents were obtained through litigation. Methods and Findings For each trial, we compared internal company documents (protocols, statistical analysis plans, and research reports, all unpublished), with publications. One author extracted data and another verified, with a third person verifying discordant items and a sample of the rest. Extracted data included the number of participants randomized and analyzed for efficacy, and types of analyses for efficacy and safety and their definitions (i.e., criteria for including participants in each type of analysis). We identified 21 trials, 11 of which were published randomized controlled trials, and that provided the documents needed for planned comparisons. For three trials, there was disagreement on the number of randomized participants between the research report and publication. Seven types of efficacy analyses were described in the protocols, statistical analysis plans, and publications, including ITT and six others. The protocol or publication described ITT using six different definitions, resulting in frequent disagreements between the two documents (i.e., different numbers of participants were included in the analyses). Conclusions Descriptions of analyses conducted did not agree between internal company documents and what was publicly reported. Internal company documents provide extensive documentation of methods planned and used, and trial findings, and should be publicly accessible. Reporting standards for randomized controlled trials should recommend transparent descriptions and definitions of analyses performed and which study participants are excluded. Please see later in the article for the Editors' Summary PMID:23382656

  8. Managing the transition (ManTra): a resource for persons with secondary progressive multiple sclerosis and their health professionals: protocol for a mixed-methods study in Italy

    PubMed Central

    Giordano, Andrea; Pietrolongo, Erika; Confalonieri, Paolo; De Luca, Giovanna; Tortorella, Carla; Trojano, Maria; Messmer Uccelli, Michele; Torri Clerici, Valentina; Gitto, Lara; Köpke, Sascha; Borreani, Claudia; Heesen, Christoph; Solari, Alessandra

    2017-01-01

    Introduction 15 years after clinical onset, about 50% of patients with relapsing-remitting multiple sclerosis convert to secondary progressive multiple sclerosis (SPMS). Notwithstanding the importance of this transition, knowledge of the experiences and needs of patients and carers is fragmentary, and targeted interventions are not available. Managing the Transition to SPMS (ManTra) is a mixed methodology project to develop and test a user-led resource for newly diagnosed patients with SPMS. Here, we describe the developmental phase, consisting of a literature review and a new research study involving key stakeholders, in which we construct the resource. Methods and analysis Round 1: The literature review and study will be conducted in parallel. The latter will identify patient needs using a qualitative approach consisting of: personal semistructured interviews with >15 recently diagnosed patients with SPMS; three focus group meetings (one with significant others of patients, one with neurologists and one with other health professionals caring for patients with SPMS). An online survey (>200 recently diagnosed Italian patients with SPMS) will follow to verify needs in a larger independent sample. An expert panel will outline a set of candidate resources/interventions that aim to satisfy the needs thus identified. Round 2: Consensus on the final resource will be obtained in a 1-day meeting of recently diagnosed patients with SPMS, significant others, health professionals and other stakeholders, using the nominal group technique. The expert panel will refine the resource, identify the outcome measures to assess its efficacy and ascertain the most suitable comparator (ManTra Phase 2, not part of this protocol). Ethics and dissemination The study protocol was approved by the ethics committees of each of the involved centres: Foundation IRCCS Neurological Institute C Besta, Milan; G D’Annunzio University of Chieti-Pescara and the Aldo Moro University of Bari. The results will be published in peer-reviewed journals, presented at conferences and a lay summary sent to participants. PMID:28838904

  9. Quality assessment program for EuroFlow protocols: summary results of four-year (2010-2013) quality assurance rounds.

    PubMed

    Kalina, Tomas; Flores-Montero, Juan; Lecrevisse, Quentin; Pedreira, Carlos E; van der Velden, Vincent H J; Novakova, Michaela; Mejstrikova, Ester; Hrusak, Ondrej; Böttcher, Sebastian; Karsch, Dennis; Sędek, Łukasz; Trinquand, Amelie; Boeckx, Nancy; Caetano, Joana; Asnafi, Vahid; Lucio, Paulo; Lima, Margarida; Helena Santos, Ana; Bonaccorso, Paola; van der Sluijs-Gelling, Alita J; Langerak, Anton W; Martin-Ayuso, Marta; Szczepański, Tomasz; van Dongen, Jacques J M; Orfao, Alberto

    2015-02-01

    Flow cytometric immunophenotyping has become essential for accurate diagnosis, classification, and disease monitoring in hemato-oncology. The EuroFlow Consortium has established a fully standardized "all-in-one" pipeline consisting of standardized instrument settings, reagent panels, and sample preparation protocols and software for data analysis and disease classification. For its reproducible implementation, parallel development of a quality assurance (QA) program was required. Here, we report on the results of four consecutive annual rounds of the novel external QA EuroFlow program. The novel QA scheme aimed at monitoring the whole flow cytometric analysis process (cytometer setting, sample preparation, acquisition and analysis) by reading the median fluorescence intensities (MedFI) of defined lymphocytes' subsets. Each QA participant applied the predefined reagents' panel on blood cells of local healthy donors. A uniform gating strategy was applied to define lymphocyte subsets and to read MedFI values per marker. The MedFI values were compared with reference data and deviations from reference values were quantified using performance score metrics. In four annual QA rounds, we analyzed 123 blood samples from local healthy donors on 14 different instruments in 11 laboratories from nine European countries. The immunophenotype of defined cellular subsets appeared sufficiently standardized to permit unified (software) data analysis. The coefficient of variation of MedFI for 7 of 11 markers performed repeatedly below 30%, average MedFI in each QA round ranged from 86 to 125% from overall median. Calculation of performance scores was instrumental to pinpoint standardization failures and their causes. Overall, the new EuroFlow QA system for the first time allowed to quantify the technical variation that is introduced in the measurement of fluorescence intensities in a multicentric setting over an extended period of time. EuroFlow QA is a proficiency test specific for laboratories that use standardized EuroFlow protocols. It may be used to complement, but not replace, established proficiency tests. © 2014 International Society for Advancement of Cytometry. © 2014 International Society for Advancement of Cytometry.

  10. Intake Procedures in Colorado Animal Shelters

    PubMed Central

    Fagre, Anna; Olea-Popelka, Francisco; Ruch-Gallie, Rebecca

    2017-01-01

    Simple Summary Many animal shelters receive animals from different regions of the United States; particularly following natural disasters or other mass displacements. After Hurricane Katrina; Colorado experienced a surge of animal intakes from regions of the country possessing higher parasitic burden. Little is known about the extent to which shelters tailor their infectious disease screening procedures and other intake protocols based on animal origin. Using a questionnaire; shelter personnel from across the state of Colorado provided information on shelter characteristics including where they receive animals from; general intake procedures; and perceptions on infectious disease risk. We found that more shelters that take dogs in from out of state screen for heartworm and other parasitic diseases than do shelters that only take animals from within the state. No difference was seen for feline screening procedures. We also found that few shelters use widespread screening protocols and instead screen based on suspicion. Lastly; many vaccination protocols in shelters do not comply with The Association of Shelter Veterinarians Guidelines for Standards of Care in Animal Shelters. This study highlights the importance of tailoring animal intake procedures based on where the animal was transferred from. Abstract The purpose of this study was to describe intake procedures in Colorado animal shelters, compare infectious disease screening protocols in shelters taking in animals from out-of-state to shelters only accepting animals from Colorado, and analyze perceived risk of diseases in Colorado by responding shelter personnel. A questionnaire was designed and administered to shelter personnel across the state of Colorado via the survey tool SurveyMonkey© (http://www.surveymonkey.com) or a mailed hard copy. Information collected concerned general shelter characteristics and intake procedures performed in various circumstances as reported by responding shelter personnel. Only 12.5% (5/40) of respondents reported providing core vaccines to all animals upon intake at their shelter, with young age (65.0%; 26/40), pregnancy (55.0%; 22/40), and mild existing illness (40.0%; 16/40) being cited as the top reasons for not administering core vaccines. A significantly larger proportion of shelters taking animals in from around the U.S. screened for Dirofilaria immitis than shelters taking in animals only from within the state of Colorado (p = 0.001), though a majority of respondents considered cats and dogs to be at risk of heartworm and endoparasitic infection in the state of Colorado. Based on the results of this questionnaire, relatively few shelters test dogs and cats for infectious diseases and some of those utilize tests for diagnostic purposes rather than routine screening. Additionally, vaccination protocols in several shelters are not consistent with The Association of Shelter Veterinarians Guidelines for Standards of Care in Animal Shelters. This study provides important information on intake procedures in Colorado animal shelters and highlights the importance of educating shelter staff on varying risk of infection based on the history and origin of the animal being taken in. PMID:28475139

  11. 28 CFR 79.26 - Proof of medical condition.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... report; (C) Hematology summary or consultation report; (D) Medical oncology summary or consultation... report; (C) Hematology consultation or summary report; or (D) Medical oncology consultation or summary... discharge summary report; (C) Operative summary report; (D) Medical oncology summary or consultation report...

  12. 28 CFR 79.26 - Proof of medical condition.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... report; (C) Hematology summary or consultation report; (D) Medical oncology summary or consultation... report; (C) Hematology consultation or summary report; or (D) Medical oncology consultation or summary... discharge summary report; (C) Operative summary report; (D) Medical oncology summary or consultation report...

  13. 28 CFR 79.26 - Proof of medical condition.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... report; (C) Hematology summary or consultation report; (D) Medical oncology summary or consultation... report; (C) Hematology consultation or summary report; or (D) Medical oncology consultation or summary... discharge summary report; (C) Operative summary report; (D) Medical oncology summary or consultation report...

  14. Telemedicine in Space Flight - Summary of a NASA Workshop

    NASA Technical Reports Server (NTRS)

    Barsten, K. N.; Watkins, S. D.; Otto, C.; Baumann, D. K.

    2011-01-01

    The Exploration Medical Capability Element of the Human Research Program at NASA Johnson Space Center hosted the Telemedicine Workshop in January 2011 to discuss the medical operational concept for a crewed mission to a near-Earth asteroid (NEA) and to identify areas for future work and collaboration. With the increased likelihood of a medical incident on a long duration exploration mission to a near-Earth asteroid, as well as the fact that there will likely be limited medical capabilities and resources available to diagnose and treat medical conditions, it is anticipated that a more structured use of telemedicine will become highly desirable. The workshop was convened to solicit expert opinion on current telemedicine practices and on medical care in remote environments. Workshop Objectives: The workshop brought together leaders in telemedicine and remote medicine from The University of Texas Medical Branch, Henry Ford Hospital, Ontario Telemedicine Network, U.S. Army Institute of Surgical Research, University of Miami, American Telemedicine Association, Doctors Without Borders, and the Pan American Health Organization. The primary objectives of the workshop were to document the medical operations concept for a crewed mission to a NEA, to determine gaps between current capabilities and the capabilities outlined in the operations concept, to identify research required to close these gaps, and to discuss potential collaborations with external-to-NASA organizations with similar challenges. Summary of Discussions and Conclusions: The discussions held during the workshop and the conclusions reached by the workshop participants were grouped into seven categories: Crew Medical Officers, Patient Area in Spacecraft, Training, Electronic Medical Records, Intelligent Care Systems, Consultation Protocols, Prophylactic Surgical Procedures, and Data Prioritization. The key points discussed under each category will be presented.

  15. Summary of preliminary step-trend analysis from the Interagency Whitebark Pine Long-termMonitoring Program—2004-2013

    USGS Publications Warehouse

    Legg, Kristin; Shanahan, Erin; Daley, Rob; Irvine, Kathryn M.

    2014-01-01

    In mixed and dominant stands, whitebark pine (Pinus albicaulis) occurs in over two million acres within the six national forests and two national parks that comprise the Greater Yellowstone Ecosystem (GYE). Currently, whitebark pine, an ecologically important species, is impacted by multiple ecological disturbances; white pine blister rust (Cronartium ribicola), mountain pine beetle (Dendroctonus ponderosae), wildfire, and climate change all pose significant threats to the persistence of whitebark pine populations. Substantial declines in whitebark pine populations have been documented throughout its range.Under the auspices of the Greater Yellowstone Coordinating Committee (GYCC), several agencies began a collaborative, long-term monitoring program to track and document the status of whitebark pine across the GYE. This alliance resulted in the formation of the Greater Yellowstone Whitebark Pine Monitoring Working Group (GYWPMWG), which consists of representatives from the U.S. Forest Service (USFS), National Park Service (NPS), U.S. Geological Survey (USGS), and Montana State University (MSU). This groundbased monitoring program was initiated in 2004 and follows a peer-reviewed protocol (GYWPMWG 2011). The program is led by the Greater Yellowstone Inventory and Monitoring Network (GRYN) of the National Park Service in coordination with multiple agencies. More information about this monitoring effort is available at: http://science. nature.nps.gov/im/units/gryn/monitor/whitebark_pine.cfm. The purpose of this report is to provide a draft summary of the first step-trend analysis for the interagency, long-term monitoring of whitebark pine health to the Interagency Grizzly Bear Study Team (IGBST) as part of a synthesis of the state of whitebark pine in the GYE. Due to the various stages of the analyses and reporting, this is the most efficient way to provide these results to the IGBST.

  16. Comprehensive systematic review summary: Disease-modifying therapies for adults with multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.

    PubMed

    Rae-Grant, Alexander; Day, Gregory S; Marrie, Ruth Ann; Rabinstein, Alejandro; Cree, Bruce A C; Gronseth, Gary S; Haboubi, Michael; Halper, June; Hosey, Jonathan P; Jones, David E; Lisak, Robert; Pelletier, Daniel; Potrebic, Sonja; Sitcov, Cynthia; Sommers, Rick; Stachowiak, Julie; Getchius, Thomas S D; Merillat, Shannon A; Pringsheim, Tamara

    2018-04-24

    To review evidence on starting, switching, and stopping disease-modifying therapies (DMTs) for multiple sclerosis (MS) in clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), and progressive MS forms. Relevant, peer-reviewed research articles, systematic reviews, and abstracts were identified (MEDLINE, CENTRAL, EMBASE searched from inception to November 2016). Studies were rated using the therapeutic classification scheme. Prior published Cochrane reviews were also used. Twenty Cochrane reviews and an additional 73 full-text articles were selected for data extraction through an updated systematic review (completed November 2016). For people with RRMS, many DMTs are superior to placebo (annualized relapses rates [ARRs], new disease activity [new MRI T2 lesion burden], and in-study disease progression) (see summary and full text publications). For people with RRMS who experienced a relapse on interferon-β (IFN-β) or glatiramer acetate, alemtuzumab is more effective than IFN-β-1a 44 μg subcutaneous 3 times per week in reducing the ARR. For people with primary progressive MS, ocrelizumab is probably more effective than placebo (in-study disease progression). DMTs for MS have varying adverse effects. In people with CIS, glatiramer acetate and IFN-β-1a subcutaneous 3 times per week are more effective than placebo in decreasing risk of conversion to MS. Cladribine, immunoglobulins, IFN-β-1a 30 μg intramuscular weekly, IFN-β-1b subcutaneous alternate day, and teriflunomide are probably more effective than placebo in decreasing risk of conversion to MS. Suggestions for future research include studies considering comparative effectiveness, usefulness of high-efficacy treatment vs stepped-care protocols, and research into predictive biomarkers. © 2018 American Academy of Neurology.

  17. Standard Free Droplet Digital Polymerase Chain Reaction as a New Tool for the Quality Control of High-Capacity Adenoviral Vectors in Small-Scale Preparations

    PubMed Central

    Boehme, Philip; Stellberger, Thorsten; Solanki, Manish; Zhang, Wenli; Schulz, Eric; Bergmann, Thorsten; Liu, Jing; Doerner, Johannes; Baiker, Armin E.

    2015-01-01

    Abstract High-capacity adenoviral vectors (HCAdVs) are promising tools for gene therapy as well as for genetic engineering. However, one limitation of the HCAdV vector system is the complex, time-consuming, and labor-intensive production process and the following quality control procedure. Since HCAdVs are deleted for all viral coding sequences, a helper virus (HV) is needed in the production process to provide the sequences for all viral proteins in trans. For the purification procedure of HCAdV, cesium chloride density gradient centrifugation is usually performed followed by buffer exchange using dialysis or comparable methods. However, performing these steps is technically difficult, potentially error-prone, and not scalable. Here, we establish a new protocol for small-scale production of HCAdV based on commercially available adenovirus purification systems and a standard method for the quality control of final HCAdV preparations. For titration of final vector preparations, we established a droplet digital polymerase chain reaction (ddPCR) that uses a standard free-end-point PCR in small droplets of defined volume. By using different probes, this method is capable of detecting and quantifying HCAdV and HV in one reaction independent of reference material, rendering this method attractive for accurately comparing viral titers between different laboratories. In summary, we demonstrate that it is possible to produce HCAdV in a small scale of sufficient quality and quantity to perform experiments in cell culture, and we established a reliable protocol for vector titration based on ddPCR. Our method significantly reduces time and required equipment to perform HCAdV production. In the future the ddPCR technology could be advantageous for titration of other viral vectors commonly used in gene therapy. PMID:25640117

  18. Epidemiology of diabetic foot disease and diabetes-related lower-extremity amputation in Australia: a systematic review protocol.

    PubMed

    van Netten, Jaap J; Baba, Mendel; Lazzarini, Peter A

    2017-05-18

    Diabetic foot disease is associated with major morbidity, mortality, costs, and reduction of a person's quality of life. Investigating the epidemiology of diabetic foot disease is the backbone of diabetic foot research and clinical practice, yet the full burden of diabetic foot disease in Australia is unknown. This study aims to describe the protocol for a systematic review of the epidemiology of diabetic foot disease and diabetes-related lower-extremity amputation in Australia. The systematic review will be performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. PubMed and EMBASE will be searched for publications in any language and without restrictions to date. Two independent investigators will screen publications for eligibility, with publications reporting Australian population-based incidence or prevalence of diabetic foot disease or diabetes-related lower-extremity amputation to be included. Additionally, a forward literature search will be performed in Google Scholar, and a grey literature search will be performed to identify government publications. Quality assessment will be performed using customised checklists. The summary statistic used for each study will be an incidence or prevalence proportion of diabetic foot disease or diabetes-related lower-extremity amputation. The standard error for each proportion will be calculated. A meta-analysis will be performed when three or more publications of adequate quality, reporting on similar outcomes and in similar populations, are identified. The results of this systematic review can be used to adequately inform stakeholders in the field of diabetic foot disease on the extent of the problem in incidence and prevalence of diabetic foot disease in Australia, and to help guide appropriate use of resources to reduce the burden of this disease. PROSPERO CRD42016050740.

  19. System for verifiable CT radiation dose optimization based on image quality. part II. process control system.

    PubMed

    Larson, David B; Malarik, Remo J; Hall, Seth M; Podberesky, Daniel J

    2013-10-01

    To evaluate the effect of an automated computed tomography (CT) radiation dose optimization and process control system on the consistency of estimated image noise and size-specific dose estimates (SSDEs) of radiation in CT examinations of the chest, abdomen, and pelvis. This quality improvement project was determined not to constitute human subject research. An automated system was developed to analyze each examination immediately after completion, and to report individual axial-image-level and study-level summary data for patient size, image noise, and SSDE. The system acquired data for 4 months beginning October 1, 2011. Protocol changes were made by using parameters recommended by the prediction application, and 3 months of additional data were acquired. Preimplementation and postimplementation mean image noise and SSDE were compared by using unpaired t tests and F tests. Common-cause variation was differentiated from special-cause variation by using a statistical process control individual chart. A total of 817 CT examinations, 490 acquired before and 327 acquired after the initial protocol changes, were included in the study. Mean patient age and water-equivalent diameter were 12.0 years and 23.0 cm, respectively. The difference between actual and target noise increased from -1.4 to 0.3 HU (P < .01) and the standard deviation decreased from 3.9 to 1.6 HU (P < .01). Mean SSDE decreased from 11.9 to 7.5 mGy, a 37% reduction (P < .01). The process control chart identified several special causes of variation. Implementation of an automated CT radiation dose optimization system led to verifiable simultaneous decrease in image noise variation and SSDE. The automated nature of the system provides the opportunity for consistent CT radiation dose optimization on a broad scale. © RSNA, 2013.

  20. MycoKey Round Table Discussions of Future Directions in Research on Chemical Detection Methods, Genetics and Biodiversity of Mycotoxins.

    PubMed

    Leslie, John F; Lattanzio, Veronica; Audenaert, Kris; Battilani, Paola; Cary, Jeffrey; Chulze, Sofia N; De Saeger, Sarah; Gerardino, Annamaria; Karlovsky, Petr; Liao, Yu-Cai; Maragos, Chris M; Meca, Giuseppe; Medina, Angel; Moretti, Antonio; Munkvold, Gary; Mulè, Giuseppina; Njobeh, Patrick; Pecorelli, Ivan; Perrone, Giancarlo; Pietri, Amedeo; Palazzini, Juan M; Proctor, Robert H; Rahayu, Endang S; Ramírez, Maria L; Samson, Robert; Stroka, Jörg; Sulyok, Michael; Sumarah, Mark; Waalwijk, Cees; Zhang, Qi; Zhang, Hao; Logrieco, Antonio F

    2018-03-01

    MycoKey, an EU-funded Horizon 2020 project, includes a series of "Roundtable Discussions" to gather information on trending research areas in the field of mycotoxicology. This paper includes summaries of the Roundtable Discussions on Chemical Detection and Monitoring of mycotoxins and on the role of genetics and biodiversity in mycotoxin production. Discussions were managed by using the nominal group discussion technique, which generates numerous ideas and provides a ranking for those identified as the most important. Four questions were posed for each research area, as well as two questions that were common to both discussions. Test kits, usually antibody based, were one major focus of the discussions at the Chemical Detection and Monitoring roundtable because of their many favorable features, e.g., cost, speed and ease of use. The second area of focus for this roundtable was multi-mycotoxin detection protocols and the challenges still to be met to enable these protocols to become methods of choice for regulated mycotoxins. For the genetic and biodiversity group, both the depth and the breadth of trending research areas were notable. For some areas, e.g., microbiome studies, the suggested research questions were primarily of a descriptive nature. In other areas, multiple experimental approaches, e.g., transcriptomics, proteomics, RNAi and gene deletions, are needed to understand the regulation of toxin production and mechanisms underlying successful biological controls. Answers to the research questions will provide starting points for developing acceptable prevention and remediation processes. Forging a partnership between scientists and appropriately-placed communications experts was recognized by both groups as an essential step to communicating risks, while retaining overall confidence in the safety of the food supply and the integrity of the food production chain.

  1. The Lactate Minimum Test: Concept, Methodological Aspects and Insights for Future Investigations in Human and Animal Models

    PubMed Central

    Messias, Leonardo H. D.; Gobatto, Claudio A.; Beck, Wladimir R.; Manchado-Gobatto, Fúlvia B.

    2017-01-01

    In 1993, Uwe Tegtbur proposed a useful physiological protocol named the lactate minimum test (LMT). This test consists of three distinct phases. Firstly, subjects must perform high intensity efforts to induce hyperlactatemia (phase 1). Subsequently, 8 min of recovery are allowed for transposition of lactate from myocytes (for instance) to the bloodstream (phase 2). Right after the recovery, subjects are submitted to an incremental test until exhaustion (phase 3). The blood lactate concentration is expected to fall during the first stages of the incremental test and as the intensity increases in subsequent stages, to rise again forming a “U” shaped blood lactate kinetic. The minimum point of this curve, named the lactate minimum intensity (LMI), provides an estimation of the intensity that represents the balance between the appearance and clearance of arterial blood lactate, known as the maximal lactate steady state intensity (iMLSS). Furthermore, in addition to the iMLSS estimation, studies have also determined anaerobic parameters (e.g., peak, mean, and minimum force/power) during phase 1 and also the maximum oxygen consumption in phase 3; therefore, the LMT is considered a robust physiological protocol. Although, encouraging reports have been published in both human and animal models, there are still some controversies regarding three main factors: (1) the influence of methodological aspects on the LMT parameters; (2) LMT effectiveness for monitoring training effects; and (3) the LMI as a valid iMLSS estimator. Therefore, the aim of this review is to provide a balanced discussion between scientific evidence of the aforementioned issues, and insights for future investigations are suggested. In summary, further analyses is necessary to determine whether these factors are worthy, since the LMT is relevant in several contexts of health sciences. PMID:28642717

  2. Cervical Spondylotic Myelopathy Surgical (CSM-S) Trial: Randomized Controlled Trial Design and Rationale

    PubMed Central

    Ghogawala, Zoher; Benzel, Edward C.; Heary, Robert F.; Riew, K. Daniel; Albert, Todd J.; Butler, William E.; Barker, Fred G.; Heller, John G.; McCormick, Paul C.; Whitmore, Robert G.; Freund, Karen M.; Schwartz, J. Sanford

    2014-01-01

    Background Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in the world. There is significant practice variation and uncertainty as to the optimal surgical approach for treating CSM. Objective The primary objective is to determine if ventral surgery is associated with superior SF-36 Physical Component Summary (PCS) outcome at one year follow-up compared to dorsal (laminectomy/fusion or laminoplasty) surgery for the treatment of CSM. The study will also investigate whether post-operative sagittal balance is an independent predictor of overall outcome and will compare health resource utilization for ventral and dorsal procedures. Methods The study is a randomized, controlled trial with a nonrandomized arm for patients who are eligible but decline randomization. Two hundred fifty patients (159 randomized) with CSM from 11 sites will be recruited over 18 months. The primary outcome is the Short Form-36 PCS score. Secondary outcomes include disease specific outcomes, overall health-related quality of life (EuroQol-5D), and health resource utilization. Expected Outcomes This will be the first randomized controlled trial to compare directly the health-related quality of life outcomes for ventral versus dorsal surgery for treating CSM. Discussion An NIH-funded (1R13AR065834-01) investigator meeting was held prior to initiating the trial in order to bring multiple stakeholders together to finalize the study protocol. Study investigators, coordinators, and major stakeholders were able to attend and discuss strengths, limitations, and concerns regarding the study. The final protocol was approved for funding by PCORI (CE-1304-6173). The RCT began enrollment on April 1, 2014. PMID:24991714

  3. Lesson from the stoichiometry determination of the cohesin complex: a short protease mediated elution increases the recovery from cross-linked antibody-conjugated beads.

    PubMed

    Holzmann, Johann; Fuchs, Johannes; Pichler, Peter; Peters, Jan-Michael; Mechtler, Karl

    2011-02-04

    Affinity purification of proteins using antibodies coupled to beads and subsequent mass spectrometric analysis has become a standard technique for the identification of protein complexes. With the recent transfer of the isotope dilution mass spectrometry principle (IDMS) to the field of proteomics, quantitative analyses-such as the stoichiometry determination of protein complexes-have become achievable. Traditionally proteins were eluted from antibody-conjugated beads using glycine at low pH or using diluted acids such as HCl, TFA, or FA, but elution was often found to be incomplete. Using the cohesin complex and the anaphase promoting complex/cyclosome (APC/C) as examples, we show that a short 15-60 min predigestion with a protease such as LysC (modified on-bead digest termed protease elution) increases the elution efficiency 2- to 3-fold compared to standard acid elution protocols. While longer incubation periods-as performed in standard on-bead digestion-led to partial proteolysis of the cross-linked antibodies, no or only insignificant cleavage was observed after 15-60 min protease mediated elution. Using the protease elution method, we successfully determined the stoichiometry of the cohesin complex by absolute quantification of the four core subunits using LC-SRM analysis and 19 reference peptides generated with the EtEP strategy. Protease elution was 3-fold more efficient compared to HCl elution, but measurements using both elution techniques are in agreement with a 1:1:1:1 stoichiometry. Furthermore, using isoform specific reference peptides, we determined the exact STAG1:STAG2 stoichiometry within the population of cohesin complexes. In summary, we show that the protease elution protocol increases the recovery from affinity beads and is compatible with quantitative measurements such as the stoichiometry determination of protein complexes.

  4. Professional Rugby Union players have a 60% greater risk of time loss injury after concussion: a 2-season prospective study of clinical outcomes

    PubMed Central

    Cross, Matthew; Kemp, Simon; Smith, Andrew; Trewartha, Grant; Stokes, Keith

    2016-01-01

    Aim To investigate incidence of concussion, clinical outcomes and subsequent injury risk following concussion. Methods In a two-season (2012/2013, 2013/2014) prospective cohort study, incidence of diagnosed match concussions (injuries/1000 h), median time interval to subsequent injury of any type (survival time) and time spent at each stage of the graduated return to play pathway were determined in 810 professional Rugby Union players (1176 player seasons). Results Match concussion incidence was 8.9/1000 h with over 50% occurring in the tackle. Subsequent incidence of any injury for players who returned to play in the same season following a diagnosed concussion (122/1000 h, 95% CI 106 to 141) was 60% higher (IRR 1.6, 95% CI 1.4 to 1.8) than for those who did not sustain a concussion (76/1000 h, 95% CI 72 to 80). Median time to next injury following return to play was shorter following concussion (53 days, 95% CI 41 to 64) than following non-concussive injuries (114 days, 95% CI 85 to 143). 38% of players reported recurrence of symptoms or failed to match their baseline neurocognitive test during the graduated return to play protocol. Summary and conclusions Players who returned to play in the same season after a diagnosed concussion had a 60% greater risk of time-loss injury than players without concussion. A substantial proportion of players reported recurrence of symptoms or failed to match baseline neurocognitive test scores during graduated return to play. These data pave the way for trials of more conservative and comprehensive graduated return to play protocols, with a greater focus on active rehabilitation. PMID:26626266

  5. Acute effect of intermittent and continuous aerobic exercise on release of cardiac troponin T in sedentary men.

    PubMed

    Ranjbar, Rouhollah; Ahmadi, Mohammad Amin; Zar, Abdossaleh; Krustrup, Peter

    2017-06-01

    Studies have shown that acute exercise can increase serum concentrations of cardiac biomarkers, including cardiac troponin T (cTnT). We investigated the acute effects of intermittent (IE) and continuous (CE) exercise at the same cardiac workload on myocardial necrosis biomarkers in sedentary men. Eleven sedentary healthy men aged 22.3±1.9years completed the study. The subjects were divided into two groups and performed, in random order, IE (intensity alternating between 50% (2min) and 80% (1min) HRreserve) or CE (60% HRreserve). The study was designed as a single-blinded randomised crossover trial performed on two distinct experimental days separated by a 1-week washout period. Each session consisted of 40min of aerobic exercise, either IE or CE, on a treadmill. Blood samples were taken before (PRE), immediately after (POST) and 1h after (POST-1) each exercise session. hs-cTnT significantly increased immediately after exercise in both protocols and remained elevated at POST-1 (P<0.05). There was no significant difference between POST and POST-1 values(P>0.05). Neither CE nor IE caused any significant change in CK-MB (P>0.05). The results also showed that HR and RPP increased significantly following both exercise protocols (P=0.001). In summary, both CE and IE results in increased serum concentrations of hs-cTnT in sedentary men. However, this increase does not seem to be caused by the irreversible death of cardiomyocytes. CE resulted in a greater hs-cTnT concentration than IE. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Medical device procurement in low- and middle-income settings: protocol for a systematic review.

    PubMed

    Diaconu, Karin; Chen, Yen-Fu; Manaseki-Holland, Semira; Cummins, Carole; Lilford, Richard

    2014-10-21

    Medical device procurement processes for low- and middle-income countries (LMICs) are a poorly understood and researched topic. To support LMIC policy formulation in this area, international public health organizations and research institutions issue a large body of predominantly grey literature including guidelines, manuals and recommendations. We propose to undertake a systematic review to identify and explore the medical device procurement methodologies suggested within this and further literature. Procurement facilitators and barriers will be identified, and methodologies for medical device prioritization under resource constraints will be discussed. Searches of both bibliographic and grey literature will be conducted to identify documents relating to the procurement of medical devices in LMICs. Data will be extracted according to protocol on a number of pre-specified issues and variables. First, data relating to the specific settings described within the literature will be noted. Second, information relating to medical device procurement methodologies will be extracted, including prioritization of procurement under resource constraints, the use of evidence (e.g. cost-effectiveness evaluations, burden of disease data) as well as stakeholders participating in procurement processes. Information relating to prioritization methodologies will be extracted in the form of quotes or keywords, and analysis will include qualitative meta-summary. Narrative synthesis will be employed to analyse data otherwise extracted. The PRISMA guidelines for reporting will be followed. The current review will identify recommended medical device procurement methodologies for LMICs. Prioritization methods for medical device acquisition will be explored. Relevant stakeholders, facilitators and barriers will be discussed. The review is aimed at both LMIC decision makers and the international research community and hopes to offer a first holistic conceptualization of this topic.

  7. Protocol: A grounded theory of ‘recovery’—perspectives of adolescent users of mental health services

    PubMed Central

    Palmquist, Lucianne; Patterson, Sue; O'Donovan, Analise; Bradley, Graham

    2017-01-01

    Introduction Policies internationally endorse the recovery paradigm as the appropriate foundation for youth mental health services. However, given that this paradigm is grounded in the views of adults with severe mental illness, applicability to youth services and relevance to young people is uncertain, particularly as little is known about young people’s views. A comprehensive understanding of the experiences and expectations of young people is critical to developing youth mental health services that are acceptable, accessible, effective and relevant. Aim To inform development of policy and youth services, the study described in this protocol aims to develop a comprehensive account of the experiences and expectations of 12–17 year olds as they encounter mental disorders and transition through specialist mental health services. Data will be analysed to model recovery from the adolescents’ perspective. Method and analysis This grounded theory study will use quantitative and qualitative data collected in interviews with 12–17 year olds engaged with specialist Child/Youth Mental Health Service in Queensland, Australia. Interviews will explore adolescents’ expectations and experiences of mental disorder, and of services, as they transition through specialist mental health services, including the meaning of their experiences and ideas of ‘recovery’ and how their experiences and expectations are shaped. Data collection and analysis will use grounded theory methods. Ethics and dissemination Adolescents’ experiences will be presented as a mid-range theory. The research will provide tangible recommendations for youth-focused mental health policy and practice. Findings will be disseminated within academic literature and beyond to participants, health professionals, mental health advocacy groups and policy and decision makers via publications, research summaries, conferences and workshops targeting different audiences. Ethical and research governance approvals have been obtained from relevant Human Research Ethics committees and all sites involved. PMID:28729312

  8. Optimized Cryopreservation of Mixed Microbial Communities for Conserved Functionality and Diversity

    PubMed Central

    Hoefman, Sven; Ho, Adrian; Vilchez-Vargas, Ramiro; Pieper, Dietmar H.; Jauregui, Ruy; Vlaeminck, Siegfried E.; Van de Wiele, Tom; Vandamme, Peter; Heylen, Kim; Boon, Nico

    2014-01-01

    The use of mixed microbial communities (microbiomes) for biotechnological applications has steadily increased over the past decades. However, these microbiomes are not readily available from public culture collections, hampering their potential for widespread use. The main reason for this lack of availability is the lack of an effective cryopreservation protocol. Due to this critical need, we evaluated the functionality as well as the community structure of three different types of microbiomes before and after cryopreservation with two cryoprotective agents (CPA). Microbiomes were selected based upon relevance towards applications: (1) a methanotrophic co-culture (MOB), with potential for mitigation of greenhouse gas emissions, environmental pollutants removal and bioplastics production; (2) an oxygen limited autotrophic nitrification/denitrification (OLAND) biofilm, with enhanced economic and ecological benefits for wastewater treatment, and (3) fecal material from a human donor, with potential applications for fecal transplants and pre/probiotics research. After three months of cryopreservation at −80°C, we found that metabolic activity, in terms of the specific activity recovery of MOB, aerobic ammonium oxidizing bacteria (AerAOB) and anaerobic AOB (AnAOB, anammox) in the OLAND mixed culture, resumes sooner when one of our selected CPA [dimethyl sulfoxide (DMSO) and DMSO plus trehalose and tryptic soy broth (DMSO+TT)] was added. However, the activity of the fecal community was not influenced by the CPA addition, although the preservation of the community structure (as determined by 16S rRNA gene sequencing) was enhanced by addition of CPA. In summary, we have evaluated a cryopreservation protocol that succeeded in preserving both community structure and functionality of value-added microbiomes. This will allow individual laboratories and culture collections to boost the use of microbiomes in biotechnological applications. PMID:24937032

  9. Optimized cryopreservation of mixed microbial communities for conserved functionality and diversity.

    PubMed

    Kerckhof, Frederiek-Maarten; Courtens, Emilie N P; Geirnaert, Annelies; Hoefman, Sven; Ho, Adrian; Vilchez-Vargas, Ramiro; Pieper, Dietmar H; Jauregui, Ruy; Vlaeminck, Siegfried E; Van de Wiele, Tom; Vandamme, Peter; Heylen, Kim; Boon, Nico

    2014-01-01

    The use of mixed microbial communities (microbiomes) for biotechnological applications has steadily increased over the past decades. However, these microbiomes are not readily available from public culture collections, hampering their potential for widespread use. The main reason for this lack of availability is the lack of an effective cryopreservation protocol. Due to this critical need, we evaluated the functionality as well as the community structure of three different types of microbiomes before and after cryopreservation with two cryoprotective agents (CPA). Microbiomes were selected based upon relevance towards applications: (1) a methanotrophic co-culture (MOB), with potential for mitigation of greenhouse gas emissions, environmental pollutants removal and bioplastics production; (2) an oxygen limited autotrophic nitrification/denitrification (OLAND) biofilm, with enhanced economic and ecological benefits for wastewater treatment, and (3) fecal material from a human donor, with potential applications for fecal transplants and pre/probiotics research. After three months of cryopreservation at -80 °C, we found that metabolic activity, in terms of the specific activity recovery of MOB, aerobic ammonium oxidizing bacteria (AerAOB) and anaerobic AOB (AnAOB, anammox) in the OLAND mixed culture, resumes sooner when one of our selected CPA [dimethyl sulfoxide (DMSO) and DMSO plus trehalose and tryptic soy broth (DMSO+TT)] was added. However, the activity of the fecal community was not influenced by the CPA addition, although the preservation of the community structure (as determined by 16S rRNA gene sequencing) was enhanced by addition of CPA. In summary, we have evaluated a cryopreservation protocol that succeeded in preserving both community structure and functionality of value-added microbiomes. This will allow individual laboratories and culture collections to boost the use of microbiomes in biotechnological applications.

  10. Porcine uterus cryopreservation: an analysis of contractile function using different uterotonics.

    PubMed

    Schölch, Daniel; Schölch, Sebastian; Strahl, Olga; Hoffmann, Inge; Beckmann, Matthias W; Dittrich, Ralf

    2012-10-01

    Cryopreservation of whole organs has become increasingly successful in recent years, and establishing reliable methods for confirming the success of specific cryopreservation procedures has therefore become extremely important. On the assumption that methods such as histological evaluation do not provide definitive evidence of long-term cryopreservation and that clear signs of conserved function in an organ are good evidence of its viability, contractile function was analysed in porcine uteri (n=60), either after long-term (group A) or short-term (group B) cryopreservation and post-thaw treatment with three different uterotonics. A slow freezing protocol was used to preserve the organs. Fifteen fresh uteri were analysed similarly for contractile function, which was evaluated by measuring intrauterine pressure after administration of oxytocin, prostaglandin E(1) (PGE(1)), and carbachol. After cryopreservation, all but three uteri (95%) showed rhythmic contractions similar to those in fresh uteri except for differences in the heights of contraction peaks, with lower contractions in PGE(1) subgroup B (P<0.05). With the exception of three nonresponsive uteri in group A, there were no differences in contractility between uteri after long-term cryopreservation and fresh uteri. The results of this study thus contribute to the debate on whether slow freezing or vitrification techniques are best for whole-organ cryopreservation. In summary, (1) preservation of muscular function in porcine uteri is feasible with a slow freezing protocol; (2) measurement of contractile function following administration of uterotonics is a useful method of confirming functionality; and (3) long-term cryopreservation does not significantly impair post-thaw contractibility in comparison with fresh uteri. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Analysis of MicroRNA Expression in Newborns with Differential Birth Weight Using Newborn Screening Cards

    PubMed Central

    Rodil-Garcia, Patricia; Arellanes-Licea, Elvira del Carmen; Montoya-Contreras, Angélica; Salazar-Olivo, Luis A.

    2017-01-01

    Birth weight is an early predictor for metabolic diseases and microRNAs (miRNAs) are proposed as fetal programming participants. To evaluate the use of dried blood spots (DBS) on newborn screening cards (NSC) as a source of analyzable miRNAs, we optimized a commercial protocol to recover total miRNA from normal birth weight (NBW, n = 17–20), low birth weight (LBW, n = 17–20) and high birth weight (macrosomia, n = 17–20) newborns and analyzed the relative expression of selected miRNAs by stem-loop RT-qPCR. The possible role of miRNAs on the fetal programming of metabolic diseases was explored by bioinformatic tools. The optimized extraction of RNA resulted in a 1.2-fold enrichment of miRNAs respect to the commercial kit. miR-33b and miR-375 were overexpressed in macrosomia 9.8-fold (p < 0.001) and 1.7-fold, (p < 0.05), respectively and miR-454-3p was overexpressed in both LBW and macrosomia (19.7-fold, p < 0.001 and 10.8-fold, p < 0.001, respectively), as compared to NBW. Potential target genes for these miRNAs are associated to cyclic-guanosine monophosphate (cGMP)-dependent protein kinase (PKG), mitogen-activated protein kinase (MAPK), type 2 diabetes, transforming growth factor-β (TGF-β)and Forkhead box O protein (FoxO) pathways. In summary, we improved a protocol for analyzing miRNAs from NSC and provide the first evidence that birth weight modifies the expression of miRNAs associated to adult metabolic dysfunctions. Our work suggests archived NSC are an invaluable resource in the search for fetal programming biomarkers. PMID:29182561

  12. MycoKey Round Table Discussions of Future Directions in Research on Chemical Detection Methods, Genetics and Biodiversity of Mycotoxins

    PubMed Central

    Lattanzio, Veronica; Cary, Jeffrey; Chulze, Sofia N.; Gerardino, Annamaria; Liao, Yu-Cai; Maragos, Chris M.; Meca, Giuseppe; Moretti, Antonio; Munkvold, Gary; Mulè, Giuseppina; Njobeh, Patrick; Pecorelli, Ivan; Pietri, Amedeo; Proctor, Robert H.; Rahayu, Endang S.; Ramírez, Maria L.; Samson, Robert; Stroka, Jörg; Sumarah, Mark; Zhang, Qi; Zhang, Hao; Logrieco, Antonio F.

    2018-01-01

    MycoKey, an EU-funded Horizon 2020 project, includes a series of “Roundtable Discussions” to gather information on trending research areas in the field of mycotoxicology. This paper includes summaries of the Roundtable Discussions on Chemical Detection and Monitoring of mycotoxins and on the role of genetics and biodiversity in mycotoxin production. Discussions were managed by using the nominal group discussion technique, which generates numerous ideas and provides a ranking for those identified as the most important. Four questions were posed for each research area, as well as two questions that were common to both discussions. Test kits, usually antibody based, were one major focus of the discussions at the Chemical Detection and Monitoring roundtable because of their many favorable features, e.g., cost, speed and ease of use. The second area of focus for this roundtable was multi-mycotoxin detection protocols and the challenges still to be met to enable these protocols to become methods of choice for regulated mycotoxins. For the genetic and biodiversity group, both the depth and the breadth of trending research areas were notable. For some areas, e.g., microbiome studies, the suggested research questions were primarily of a descriptive nature. In other areas, multiple experimental approaches, e.g., transcriptomics, proteomics, RNAi and gene deletions, are needed to understand the regulation of toxin production and mechanisms underlying successful biological controls. Answers to the research questions will provide starting points for developing acceptable prevention and remediation processes. Forging a partnership between scientists and appropriately-placed communications experts was recognized by both groups as an essential step to communicating risks, while retaining overall confidence in the safety of the food supply and the integrity of the food production chain. PMID:29494529

  13. Evaluation of all African clinical practice guidelines for hypertension: Quality and opportunities for improvement.

    PubMed

    Okwen, Patrick Mbah; Maweu, Irene; Grimmer, Karen; Margarita Dizon, Janine

    2018-06-14

    Good-quality clinical practice guidelines (CPGs) provide recommendations based on current best-evidence summaries. Hypertension is a prevalent noncommunicable disease in Africa, with disastrous sequelae (stroke, heart, and kidney disease). Its effective management relies on good quality, current, locally relevant evidence. This paper reports on an all African review of the guidance documents currently informing hypertension management. Attempts were made to contact 62 African countries for formal guidance documents used nationally to inform diagnosis and management of hypertension. Their quality was assessed by using Appraisal of Guidelines for Research & Evaluation (AGREE) II, scored by 2 independent reviewers. Differences in domain scores were compared between documents written prior to 2011 and 2011 onward. Findings were compared with earlier African CPG reviews. Guidelines and protocols were provided by 26 countries. Six used country-specific stand-alone hypertension guidelines, and 10 used protocols embedded in Standard Treatment Guidelines for multiple conditions. Six used guidelines developed by the World Health Organization, and 4 indicated ad hoc use of international guidance (US, Portugal, and Brazil). Only 1 guidance document met CPG construction criteria, and none scored well on all AGREE domain scores. The lowest-scoring domain was rigour of development. There was no significant quality difference between pre-2011 and post-2011 guidance documents, and there were variable AGREE II scores for the same CPGs when comparing the African reviews. The quality of hypertension guidance used by African nations could be improved. The need for so many guidance documents is questioned. Adopting a common evidence base from international good-quality CPGs and layering it with local contexts offer 1 way to efficiently improve African hypertension CPG quality and implementation. © 2018 John Wiley & Sons, Ltd.

  14. Relationship Between Non-invasive Brain Stimulation-induced Plasticity and Capacity for Motor Learning.

    PubMed

    López-Alonso, Virginia; Cheeran, Binith; Fernández-del-Olmo, Miguel

    2015-01-01

    Cortical plasticity plays a key role in motor learning (ML). Non-invasive brain stimulation (NIBS) paradigms have been used to modulate plasticity in the human motor cortex in order to facilitate ML. However, little is known about the relationship between NIBS-induced plasticity over M1 and ML capacity. NIBS-induced MEP changes are related to ML capacity. 56 subjects participated in three NIBS (paired associative stimulation, anodal transcranial direct current stimulation and intermittent theta-burst stimulation), and in three lab-based ML task (serial reaction time, visuomotor adaptation and sequential visual isometric pinch task) sessions. After clustering the patterns of response to the different NIBS protocols, we compared the ML variables between the different patterns found. We used regression analysis to explore further the relationship between ML capacity and summary measures of the MEPs change. We ran correlations with the "responders" group only. We found no differences in ML variables between clusters. Greater response to NIBS protocols may be predictive of poor performance within certain blocks of the VAT. "Responders" to AtDCS and to iTBS showed significantly faster reaction times than "non-responders." However, the physiological significance of these results is uncertain. MEP changes induced in M1 by PAS, AtDCS and iTBS appear to have little, if any, association with the ML capacity tested with the SRTT, the VAT and the SVIPT. However, cortical excitability changes induced in M1 by AtDCS and iTBS may be related to reaction time and retention of newly acquired skills in certain motor learning tasks. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Maternal morbidity measurement tool pilot: study protocol.

    PubMed

    Say, Lale; Barreix, Maria; Chou, Doris; Tunçalp, Özge; Cottler, Sara; McCaw-Binns, Affette; Gichuhi, Gathari Ndirangu; Taulo, Frank; Hindin, Michelle

    2016-06-09

    While it is estimated that for every maternal death, 20-30 women suffer morbidity, these estimates are not based on standardized methods and measures. Lack of an agreed-upon definition, identification criteria, standardized assessment tools, and indicators has limited valid, routine, and comparable measurements of maternal morbidity. The World Health Organization (WHO) convened the Maternal Morbidity Working Group (MMWG) to develop standardized methods to improve estimates of maternal morbidity. To date, the MMWG has developed a definition and provided input into the development of a set of measurement tools. This protocol outlines the pilot test for measuring maternal morbidity in antenatal and postnatal clinical populations using these new tools. In each setting, the tools will be piloted on approximately 250 women receiving antenatal care (ANC) (at least 28 weeks pregnant) and 250 women receiving postpartum care (PPC) (at least 6 weeks postpartum). The tools will be administered by trained health care workers. Each tool has three modules as follows: 1. personal history - socio-economic information, and risk-factors (such as violence and substance abuse) 2. patient symptoms - WHO Disability Assessment Schedule (WHODAS) 12-item, and mental health questionnaires, General Anxiety Disorder, 7-item (GAD-7) and Personal Health Questionnaire, 9-item (PHQ-9) 3. physical examination - signs, laboratory tests and results. This pilot (planned for Jamaica, Kenya and Malawi) will allow for comparing the types of morbidities women experience between and across settings, and determine the feasibility, acceptability and utility of using a modified, streamlined tool for routine measurement and summary estimates of morbidity to inform resource allocation and service provision. As part of the post-2015 Sustainable Development Goals (SDGs) estimating and measuring maternal morbidity will be essential to ensure appropriate resources are allocated to address its impact and improve well-being.

  16. Feasibility and utility of applications of the common data model to multiple, disparate observational health databases.

    PubMed

    Voss, Erica A; Makadia, Rupa; Matcho, Amy; Ma, Qianli; Knoll, Chris; Schuemie, Martijn; DeFalco, Frank J; Londhe, Ajit; Zhu, Vivienne; Ryan, Patrick B

    2015-05-01

    To evaluate the utility of applying the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) across multiple observational databases within an organization and to apply standardized analytics tools for conducting observational research. Six deidentified patient-level datasets were transformed to the OMOP CDM. We evaluated the extent of information loss that occurred through the standardization process. We developed a standardized analytic tool to replicate the cohort construction process from a published epidemiology protocol and applied the analysis to all 6 databases to assess time-to-execution and comparability of results. Transformation to the CDM resulted in minimal information loss across all 6 databases. Patients and observations excluded were due to identified data quality issues in the source system, 96% to 99% of condition records and 90% to 99% of drug records were successfully mapped into the CDM using the standard vocabulary. The full cohort replication and descriptive baseline summary was executed for 2 cohorts in 6 databases in less than 1 hour. The standardization process improved data quality, increased efficiency, and facilitated cross-database comparisons to support a more systematic approach to observational research. Comparisons across data sources showed consistency in the impact of inclusion criteria, using the protocol and identified differences in patient characteristics and coding practices across databases. Standardizing data structure (through a CDM), content (through a standard vocabulary with source code mappings), and analytics can enable an institution to apply a network-based approach to observational research across multiple, disparate observational health databases. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  17. The effect of six weeks endurance training on dynamic muscular control of the knee following fatiguing exercise.

    PubMed

    Hassanlouei, H; Falla, D; Arendt-Nielsen, L; Kersting, U G

    2014-10-01

    The aim of the study was to examine whether six weeks of endurance training minimizes the effects of fatigue on postural control during dynamic postural perturbations. Eighteen healthy volunteers were assigned to either a 6-week progressive endurance training program on a cycle ergometer or a control group. At week 0 and 7, dynamic exercise was performed on an ergometer until exhaustion and immediately after, the anterior-posterior centre of pressure (COP) sway was analyzed during full body perturbations. Maximal voluntary contractions (MVC) of the knee flexors and extensors, muscle fiber conduction velocity (MFCV) of the vastus lateralis and medialis during sustained isometric knee extension contractions, and power output were measured. Following the training protocol, maximum knee extensor and flexor force and power output increased significantly for the training group with no changes observed for the control group. Moreover, the reduction of MFCV due to fatigue changed for the training group only (from 8.6% to 3.4%). At baseline, the fatiguing exercise induced an increase in the centre of pressure sway during the perturbations in both groups (>10%). The fatiguing protocol also impaired postural control in the control group when measured at week 7. However, for the training group, sway was not altered after the fatiguing exercise when assessed at week 7. In summary, six weeks of endurance training delayed the onset of muscle fatigue and improved the ability to control balance in response to postural perturbations in the presence of muscle fatigue. Results implicate that endurance training should be included in any injury prevention program. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Exercise training prevents skeletal muscle damage in an experimental sepsis model

    PubMed Central

    Coelho, Carla Werlang; Jannig, Paulo R; de Souza, Arlete B; Fronza, Hercilio; Westphal, Glauco A; Petronilho, Fabricia; Constantino, Larissa; Dal-Pizzol, Felipe; Ferreira, Gabriela K; Streck, Emilio E; Silva, Eliezer

    2013-01-01

    OBJECTIVE: Oxidative stress plays an important role in skeletal muscle damage in sepsis. Aerobic exercise can decrease oxidative stress and enhance antioxidant defenses. Therefore, it was hypothesized that aerobic exercise training before a sepsis stimulus could attenuate skeletal muscle damage by modulating oxidative stress. Thus, the aim of this study was to evaluate the effects of aerobic physical preconditioning on the different mechanisms that are involved in sepsis-induced myopathy. METHODS: Male Wistar rats were randomly assigned to either the untrained or trained group. The exercise training protocol consisted of an eight-week treadmill program. After the training protocol, the animals from both groups were randomly assigned to either a sham group or a cecal ligation and perforation surgery group. Thus, the groups were as follows: sham, cecal ligation and perforation, sham trained, and cecal ligation and perforation trained. Five days after surgery, the animals were euthanized and their soleus and plantaris muscles were harvested. Fiber cross-sectional area, creatine kinase, thiobarbituric acid reactive species, carbonyl, catalase and superoxide dismutase activities were measured. RESULTS: The fiber cross-sectional area was smaller, and the creatine kinase, thiobarbituric acid reactive species and carbonyl levels were higher in both muscles in the cecal ligation and perforation group than in the sham and cecal ligation and perforation trained groups. The muscle superoxide dismutase activity was higher in the cecal ligation and perforation trained group than in the sham and cecal ligation and perforation groups. The muscle catalase activity was lower in the cecal ligation and perforation group than in the sham group. CONCLUSION: In summary, aerobic physical preconditioning prevents atrophy, lipid peroxidation and protein oxidation and improves superoxide dismutase activity in the skeletal muscles of septic rats. PMID:23420166

  19. A cost minimization analysis of early correction of anterior crossbite—a randomized controlled trial

    PubMed Central

    Norlund, Anders; Petrén, Sofia; Bondemark, Lars

    2016-01-01

    Summary Objective: Economic evaluations provide an important basis for allocation of resources and health services planning. The aim of this study was to evaluate and compare the costs of correcting anterior crossbite with functional shift, using fixed or removable appliances (FA or RA) and to relate the costs to the effects, using cost-minimization analysis. Design, Setting, and Participants: Sixty-two patients with anterior crossbite and functional shift were randomized in blocks of 10. Thirty-one patients were randomized to be treated with brackets and arch wire (FA) and 31 with an acrylic plate (RA). Duration of treatment and number and estimated length of appointments and cancellations were registered. Direct costs (premises, staff salaries, material, and laboratory costs) and indirect costs (the accompanying parents’ loss of income while absent from work) were calculated and evaluated with reference to successful outcome alone, to successful and unsuccessful outcomes and to re-treatment when required. Societal costs were defined as the sum of direct and indirect costs. Interventions: Treatment with FA or RA. Results: There were no significant differences between FA and RA with respect to direct costs for treatment time, but both indirect costs and direct costs for material were significantly lower for FA. The total societal costs were lower for FA than for RA. Limitations: Costs depend on local factors and should not be directly extrapolated to other locations. Conclusion: The analysis disclosed significant economic benefits for FA over RA. Even when only successful outcomes were assessed, treatment with RA was more expensive. Trial registration: This trial was not registered. Protocol: The protocol was not published before trial commencement. PMID:25940585

  20. Medical device procurement in low- and middle-income settings: protocol for a systematic review

    PubMed Central

    2014-01-01

    Background Medical device procurement processes for low- and middle-income countries (LMICs) are a poorly understood and researched topic. To support LMIC policy formulation in this area, international public health organizations and research institutions issue a large body of predominantly grey literature including guidelines, manuals and recommendations. We propose to undertake a systematic review to identify and explore the medical device procurement methodologies suggested within this and further literature. Procurement facilitators and barriers will be identified, and methodologies for medical device prioritization under resource constraints will be discussed. Methods/design Searches of both bibliographic and grey literature will be conducted to identify documents relating to the procurement of medical devices in LMICs. Data will be extracted according to protocol on a number of pre-specified issues and variables. First, data relating to the specific settings described within the literature will be noted. Second, information relating to medical device procurement methodologies will be extracted, including prioritization of procurement under resource constraints, the use of evidence (e.g. cost-effectiveness evaluations, burden of disease data) as well as stakeholders participating in procurement processes. Information relating to prioritization methodologies will be extracted in the form of quotes or keywords, and analysis will include qualitative meta-summary. Narrative synthesis will be employed to analyse data otherwise extracted. The PRISMA guidelines for reporting will be followed. Discussion The current review will identify recommended medical device procurement methodologies for LMICs. Prioritization methods for medical device acquisition will be explored. Relevant stakeholders, facilitators and barriers will be discussed. The review is aimed at both LMIC decision makers and the international research community and hopes to offer a first holistic conceptualization of this topic. PMID:25336161

  1. Gender research in the National Institute on Drug Abuse National Treatment Clinical Trials Network: a summary of findings.

    PubMed

    Greenfield, Shelly F; Rosa, Carmen; Putnins, Susan I; Green, Carla A; Brooks, Audrey J; Calsyn, Donald A; Cohen, Lisa R; Erickson, Sarah; Gordon, Susan M; Haynes, Louise; Killeen, Therese; Miele, Gloria; Tross, Susan; Winhusen, Theresa

    2011-09-01

    The National Institute of Drug Abuse's National Drug Abuse Treatment Clinical Trials Network (CTN) was established to foster translation of research into practice in substance abuse treatment settings. The CTN provides a unique opportunity to examine in multi-site, translational clinical trials, the outcomes of treatment interventions targeting vulnerable subgroups of women; the comparative effectiveness of gender-specific protocols to reduce risk behaviors; and gender differences in clinical outcomes. To review gender-related findings from published CTN clinical trials and related studies from January 2000 to March 2010. CTN studies were selected for review if they focused on treatment outcomes or services for special populations of women with substance use disorders (SUDs) including those with trauma histories, pregnancy, co-occurring eating and other psychiatric disorders, and HIV risk behaviors; or implemented gender-specific protocols. The CTN has randomized 11,500 participants (41% women) across 200 clinics in 24 randomized controlled trials in community settings, of which 4 have been gender-specific. This article summarizes gender-related findings from CTN clinical trials and related studies, focusing on trauma histories, pregnancy, co-occurring eating and other psychiatric disorders, and HIV risk behaviors. These published studies have expanded the evidence base regarding interventions for vulnerable groups of women with SUDs as well as gender-specific interventions to reduce HIV risk behaviors in substance-using men and women. The results also underscore the complexity of accounting for gender in the design of clinical trials and analysis of results. To fully understand the relevance of gender-specific moderators and mediators of outcome, it is essential that future translational studies adopt more sophisticated approaches to understanding and measuring gender-relevant factors and plan sample sizes that are adequate to support more nuanced analytic methods.

  2. MetaSeq: privacy preserving meta-analysis of sequencing-based association studies.

    PubMed

    Singh, Angad Pal; Zafer, Samreen; Pe'er, Itsik

    2013-01-01

    Human genetics recently transitioned from GWAS to studies based on NGS data. For GWAS, small effects dictated large sample sizes, typically made possible through meta-analysis by exchanging summary statistics across consortia. NGS studies groupwise-test for association of multiple potentially-causal alleles along each gene. They are subject to similar power constraints and therefore likely to resort to meta-analysis as well. The problem arises when considering privacy of the genetic information during the data-exchange process. Many scoring schemes for NGS association rely on the frequency of each variant thus requiring the exchange of identity of the sequenced variant. As such variants are often rare, potentially revealing the identity of their carriers and jeopardizing privacy. We have thus developed MetaSeq, a protocol for meta-analysis of genome-wide sequencing data by multiple collaborating parties, scoring association for rare variants pooled per gene across all parties. We tackle the challenge of tallying frequency counts of rare, sequenced alleles, for metaanalysis of sequencing data without disclosing the allele identity and counts, thereby protecting sample identity. This apparent paradoxical exchange of information is achieved through cryptographic means. The key idea is that parties encrypt identity of genes and variants. When they transfer information about frequency counts in cases and controls, the exchanged data does not convey the identity of a mutation and therefore does not expose carrier identity. The exchange relies on a 3rd party, trusted to follow the protocol although not trusted to learn about the raw data. We show applicability of this method to publicly available exome-sequencing data from multiple studies, simulating phenotypic information for powerful meta-analysis. The MetaSeq software is publicly available as open source.

  3. A blinded randomised placebo-controlled trial investigating the efficacy of morphine analgesia for procedural pain in infants: Trial protocol.

    PubMed

    Slater, Rebeccah; Hartley, Caroline; Moultrie, Fiona; Adams, Eleri; Juszczak, Ed; Rogers, Richard; Norman, Jane E; Patel, Chetan; Stanbury, Kayleigh; Hoskin, Amy; Green, Gabrielle

    2016-11-15

    Infant pain has both immediate and long-term negative consequences, yet in clinical practice it is often undertreated. To date, few pain-relieving drugs have been tested in infants. Morphine is a potent analgesic that provides effective pain relief in adults, but there is inconclusive evidence for its effectiveness in infants. The purpose of this study is to establish whether oral morphine provides effective analgesia for procedural pain in infants. A blinded, placebo-controlled, parallel-group randomized, phase II, clinical trial will be undertaken to determine whether morphine sulphate administered orally prior to clinically-required retinopathy of prematurity (ROP) screening and heel lancing provides effective analgesia. 
156 infants between 34 and 42 weeks' gestational age who require a clinical heel lance and ROP screening on the same test occasion will be included in the trial. Infants will be randomised to receive either a single dose of morphine sulphate (100 μg/kg) or placebo. Each infant will be monitored for 48 hours and safety data will be collected during the 24 hours following drug administration. The primary outcome will be the Premature Infant Pain Profile-revised (PIPP-R) score 30 seconds after ROP screening. The co-primary outcome will be the magnitude of nociceptive-specific brain activity evoked by a clinically-required heel lance. Infant clinical stability will be assessed by comparing the number of episodes of bradycardia, tachycardia, desaturation and apnoea, and changes in respiratory support requirements in the 24-hour periods before and after the clinical intervention. In addition, drug safety will be assessed by considering the occurrence of apnoeic and hypotensive episodes requiring intervention in the 24-hour period following drug administration. This study has been published as an Accepted Protocol Summary by The Lancet .

  4. Adoption of a novel surgical innovation into clinical practice: protocol for a qualitative systematic review examining surgeon views.

    PubMed

    Lewis, Thomas L; Furness, Hugh N; Miller, George W; Parsons, Nicholas; Seers, Kate; Underwood, Martin; Metcalfe, Andrew J

    2018-04-17

    Efficient adoption of clinically effective novel surgical innovations has great potential benefits for patients. Factors affecting the adoption of surgical innovation are not well understood and proposed models of adoption do not accurately correlate with historical evidence. This protocol is for a systematic review that aims to identify the qualitative evidence relating to surgeon views regarding the adoption of novel surgical innovation into clinical practice. A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance will be performed. Two independent reviewers will search the following databases: MEDLINE, Embase, Science Direct, Scopus, Web of Science and the Cochrane Library of Systematic Reviews. Inclusion criteria are studies which report on the views of surgeons who adopt a novel surgical innovation into clinical practice. Each article will be screened for inclusion and assessed according to a Critical Appraisal Skills Programme tool. Data will be synthesised and analysed according to thematic analysis. Given the anticipated yield of a small heterogeneous body of evidence meeting the eligibility criteria for the review, a narrative-based summary is planned. This review does not require formal ethical approval as it does not involve direct patient contact or patient-identifiable data. The results of this review will be published in a peer-reviewed journal and presented at relevant conferences. The results will also inform an empirical qualitative study exploring surgeon and other stakeholder views regarding the introduction of novel surgical technology and procedures into clinical practice. CRD42017076715. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Assessment of the accuracy and consistency in the application of standardized surveillance definitions: A summary of the American Journal of Infection Control and National Healthcare Safety Network case studies, 2010-2016.

    PubMed

    Wright, Marc-Oliver; Allen-Bridson, Katherine; Hebden, Joan N

    2017-06-01

    The Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) surveillance definitions are the most widely used criteria for health care-associated infection (HAI) surveillance. NHSN participants agree to conduct surveillance in accordance with the NHSN protocol and criteria. To assess the application of these standardized surveillance specifications and offer infection preventionists (IPs) opportunities for ongoing education, a series of case studies, with questions related to NHSN definitions and criteria were published. Beginning in 2010, case studies with multiple-choice questions based on standard surveillance criteria and protocols were written and published in the American Journal of Infection Control with a link to an online survey. Participants anonymously submitted their responses before receiving the correct answers. The 22 case studies had 7,950 respondents who provided 27,790 responses to 75 questions during the first 6 years. Correct responses were selected 62.5% of the time (17,376 out of 27,290), but ranged widely (16%-87%). In a subset analysis, 93% of participants self-identified as IPs (3,387 out of 3,640), 4.5% were public health professionals (163 out of 3,640), and 2.5% were physicians (90 out of 3,640). IPs responded correctly (62%) more often than physicians (55%) (P = .006). Among a cohort of voluntary participants, accurate application of surveillance criteria to case studies was suboptimal, highlighting the need for continuing education, competency development, and auditing. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  6. MANAGEMENT OF DIABETES DURING AIR TRAVEL: A SYSTEMATIC LITERATURE REVIEW OF CURRENT RECOMMENDATIONS AND THEIR SUPPORTING EVIDENCE.

    PubMed

    Pavela, James; Suresh, Rahul; Blue, Rebecca S; Mathers, Charles H; Belalcazar, L Maria

    2018-02-01

    Individuals with diabetes are increasingly seeking pretravel advice, but updated professional recommendations remain scant. We performed a systematic review on diabetes management during air travel to summarize current recommendations, assess supporting evidence, and identify areas of future research. A systematic review of the English literature on diabetes management during air travel was undertaken utilizing PubMed and MEDLINE. Publications regarding general travel advice; adjustment of insulin and noninsulin therapies; and the use of insulin pumps, glucometers and subcutaneous glucose sensors at altitude were included. Gathered information was used to create an updated summary of glucose-lowering medication adjustment during air travel. Sixty-one publications were identified, most providing expert opinion and few offering primary data (47 expert opinion, 2 observational studies, 2 case reports, 10 device studies). General travel advice was uniform, with increasing attention to preflight security. Indications for oral antihyperglycemic therapy adjustments varied. There were few recommendations on contemporary agents and on nonhypoglycemic adverse events. There was little consensus on insulin adjustment protocols, many antedating current insulin formulations. Most publications advocated adjusting insulin pump time settings after arrival; however, there was disagreement on timing and rate adjustments. Glucometers and subcutaneous glucose sensors were reported to be less accurate at altitude, but not to an extent that would preclude their clinical use. Recommendations for diabetes management during air travel vary significantly and are mostly based on expert opinion. Data from systematic investigation on glucose-lowering medication adjustment protocols may support the development of a future consensus statement. CSII = continuous subcutaneous insulin infusion (device) DPP-4 = dipeptidyl peptidase 4 EGA = error grid analysis GDH = glucose dehydrogenase GOX = glucose oxidase GLP1 = glucagon-like peptide-1 NPH = neutral protamine Hagedorn SGLT2 = sodium-glucose cotransporter-2.

  7. Evidence Review Conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: Focus on Anesthesiology for Total Knee Arthroplasty.

    PubMed

    Soffin, Ellen M; Gibbons, Melinda M; Ko, Clifford Y; Kates, Stephen L; Wick, Elizabeth; Cannesson, Maxime; Scott, Michael J; Wu, Christopher L

    2018-06-08

    Enhanced recovery after surgery (ERAS) has rapidly gained popularity in a variety of surgical subspecialities. A large body of literature suggests that ERAS leads to superior outcomes, improved patient satisfaction, reduced length of hospital stay, and cost benefits, without affecting rates of readmission after surgery. These patterns have been described for patients undergoing elective total knee arthroplasty (TKA); however, adoption of ERAS to orthopedic surgery has lagged behind other surgical disciplines. The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute (AI) for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery. The program comprises a national effort to incorporate best practice in perioperative care and improve patient safety, for over 750 hospitals and multiple procedures over the next 5 years, including orthopedic surgery. We have conducted a full evidence review of anesthetic interventions to derive anesthesiology-related components of an evidence-based ERAS pathway for TKA. A PubMed search was performed for each protocol component, focusing on the highest levels of evidence in the literature. Search findings are summarized in narrative format. Anesthesiology components of care were identified and evaluated across the pre-, intra-, and postoperative phases. A summary of the best available evidence, together with recommendations for inclusion in ERAS protocols for TKA, is provided. There is extensive evidence in the literature, and from society guidelines to support the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery goals for TKA.

  8. Assessing immune competence in pigs by immunization with tetanus toxoid.

    PubMed

    Gimsa, U; Tuchscherer, A; Gimsa, J; Tuchscherer, M

    2018-01-01

    Immune competence can be tested by challenging organisms with a set of infectious agents. However, disease control requirements impose restrictions on the infliction of infections upon domestic pigs. Alternatively, vaccinations induce detectable immune responses that reflect immune competence. Here, we tested this approach with tetanus toxoid (TT) in young domestic pigs. To optimize the vaccination protocol, we immunized the pigs with a commercial TT vaccine at the age of 21 or 35 days. Booster immunizations were performed either 14 or 21 days later. TT-specific antibodies in plasma as well as lymphoproliferative responses were determined both 7 and 14 days after booster immunization using ELISA and lymphocyte transformation tests, respectively. In addition, general IgG and IgM plasma concentrations and mitogen-induced proliferation were measured. The highest TT-specific antibody responses were detected when blood samples were collected 1 week after a booster immunization conducted 21 days after primary immunization. The pigs' age at primary immunization did not have a significant influence on TT-specific antibody responses. Similarly, the TT-specific proliferative responses were highest when blood samples were collected 1 week after booster immunization, while age and time of primary and booster immunization were irrelevant in our setup. While general IgG and IgM plasma levels were highly age dependent, there were no significant age effects for TT-specific immune responses. In addition, mitogen-induced proliferation was independent of immunization as well as blood sampling protocols. In summary, our model of TT vaccination provides an interesting approach for the assessment of immune competence in young pigs. The detected vaccination effects were not biased by age, even though our data were acquired from immune systems that were under development during our tests.

  9. Determination of esophageal eosinophil counts and other histologic features of eosinophilic esophagitis by pathology trainees is highly accurate

    PubMed Central

    Rusin, Spencer; Covey, Shannon; Perjar, Irina; Hollyfield, Johnny; Speck, Olga; Woodward, Kimberly; Woosley, John T.; Dellon, Evan S.

    2017-01-01

    Summary Many studies of eosinophilic esophagitis (EoE) utilize expert pathology review, but it is unknown whether less experienced pathologists can reliably assess EoE histology. We aimed to determine whether trainee pathologists can accurately quantify esophageal eosinophil counts and identify associated histologic features of EoE, as compared to expert pathologists. We used a set of 40 digitized slides from patients with varying degrees of esophageal eosinophilia. Each of six trainee pathologists underwent a teaching session and used our validated protocol to determine eosinophil counts and associated EoE findings. The same slides had previously been evaluated by expert pathologists, and these results comprised the gold standard. Eosinophil counts were correlated, and agreement was calculated for the diagnostic threshold of 15 eosinophils per high-power field (eos/hpf) as well as for associated EoE findings. Peak eosinophil counts were highly correlated between the trainees and the gold standard (Rho ranged from 0.87–0.92; p<0.001 for all). Peak counts were also highly correlated between trainees (0.75–0.91; p<0.001), and results were similar for mean counts. Agreement was excellent for determining if a count exceeded the diagnostic threshold (kappa ranged from 0.83 to 0.89; p<0.001). Agreement was very good for eosinophil degranulation (kappa 0.54 to 0.83; p<0.01) and spongiosis (kappa 0.44–0.87; p<0.01), but was lower for eosinophil microabscesses (kappa 0.37–0.64; p<0.01). In conclusion, using a teaching session, digitized slide set, and validated protocol, the agreement between pathology trainees and expert pathologists for determining eosinophil counts was excellent. Agreement was very good for eosinophil degranulation and spongiosis, but less so for microabscesses. PMID:28041975

  10. Histological and Morphometric Analyses for Rat Carotid Artery Balloon Injury Studies

    PubMed Central

    Tulis, David Anthony

    2010-01-01

    i. Summary Experiments aimed at analyzing the response of blood vessels to mechanical injury and ensuing remodeling responses often employ the highly characterized carotid artery balloon injury model in laboratory rats. This approach utilizes luminal insertion of a balloon embolectomy catheter into the common carotid artery with inflation and withdrawal resulting in an injury characterized by vascular endothelial cell (EC) denudation and medial wall distension. The adaptive response to this injury is typified by robust vascular smooth muscle cell (SMC) replication and migration, SMC apoptosis and necrosis, enhanced synthesis and deposition of extracellular matrix (ECM) components, partial vascular EC regeneration from the border zones, luminal narrowing and establishment of a neointima in time-dependent fashion. Evaluation of these adaptive responses to blood vessel injury can include acute and longer-term qualitative and quantitative measures including expression analyses, activity assays, immunostaining for a plethora of factors and signals, and morphometry of neointima formation and gross mural remodeling. This chapter presents a logical continuation of Chapter    in this series that offers details for performing the rat carotid artery balloon injury model in a standard laboratory setting by providing commonly used protocols for performing histological and morphometric analyses in such studies. Moreover, procedures, caveats, and considerations included in this chapter are highly relevant for alternative animal vascular physiology/pathophysiology studies and in particular those related to mechanisms of vascular injury and repair. Included in this chapter are specifics for in situ perfusion-fixation, tissue harvesting and processing for both snap-frozen and paraffin-embedded protocols, specimen embedding and sectioning, slide preparation, several standard histological staining steps, and routine morphological assessment. Included in Notes are important caveats and considerations for practical use of these methods. PMID:18287663

  11. Can perceptual learning be used to treat amblyopia beyond the critical period of visual development?

    PubMed Central

    Astle, Andrew T.; Webb, Ben S.; McGraw, Paul V.

    2012-01-01

    Background Amblyopia presents early in childhood and affects approximately 3% of western populations. The monocular visual acuity loss is conventionally treated during the “critical periods” of visual development by occluding or penalising the fellow eye to encourage use of the amblyopic eye. Despite the measurable success of this approach in many children, substantial numbers of people still suffer with amblyopia later in life because either they were never diagnosed in childhood, did not respond to the original treatment, the amblyopia was only partially remediated, or their acuity loss returned after cessation of treatment. Purpose In this review, we consider whether the visual deficits of this largely overlooked amblyopic group are amenable to conventional and innovative therapeutic interventions later in life, well beyond the age at which treatment is thought to be effective. Recent findings There is a considerable body of evidence that residual plasticity is present in the adult visual brain and this can be harnessed to improve function in adults with amblyopia. Perceptual training protocols have been developed to optimise visual gains in this clinical population. Results thus far are extremely encouraging: marked visual improvements have been demonstrated, the perceptual benefits transfer to new visual tasks and appear to be relatively enduring. The essential ingredients of perceptual training protocols are being incorporated into video game formats, facilitating home-based interventions. Summary Many studies support perceptual training as a tool for improving vision in amblyopes beyond the critical period. Should this novel form of treatment stand up to the scrutiny of a randomised controlled trial, clinicians may need to re-evaluate their therapeutic approach to adults with amblyopia. PMID:21981034

  12. Impact of Short Daily Hemodialysis on Restless Legs Symptoms and Sleep Disturbances

    PubMed Central

    Schiller, Brigitte; Burkart, John M.; Daoui, Rachid; Kraus, Michael A.; Lee, Yoojin; Miller, Brent W.; Teitelbaum, Isaac; Williams, Amy W.; Finkelstein, Fredric O.

    2011-01-01

    Summary Background and objectives Restless legs syndrome (RLS) and sleep disturbances are common among in-center hemodialysis patients and are associated with increased morbidity/mortality. Design, setting, participants, & measurements The FREEDOM study is an ongoing prospective cohort study investigating the benefits of home short daily hemodialysis (SDHD) (6 times/week). In this interim report, we examine the long-term effect of SDHD on the prevalence and severity of RLS, as measured by the International Restless Legs Syndrome (IRLS) Study Group rating scale, and sleep disturbances, as measured by the Medical Outcomes Study sleep survey. Results 235 participants were included in this report (intention-to-treat cohort), of which 127 completed the 12-month follow-up (per-protocol cohort). Mean age was 52 years, 55% had an arteriovenous fistula, and 40% suffered from RLS. In the per-protocol analysis, among patients with RLS, the mean IRLS score improved significantly at month 12, after adjustment for use of RLS-related medications (18 versus 11). Among patients with moderate-to-severe RLS (IRLS score ≥15), there was an even greater improvement in the IRLS score (23 versus 13). The intention-to-treat analysis yielded similar results. Over 12 months, there was decline in the percentage of patients reporting RLS (35% versus 26%) and those reporting moderate-to-severe RLS (59% versus 43%). There was a similar and sustained 12-month improvement in several scales of the sleep survey, after adjustment for presence of RLS and use of anxiolytics and hypnotics. Conclusions Home SDHD is associated with long-term improvement in the prevalence and severity of RLS and sleep disturbances. PMID:21415315

  13. PHANTOM: A Monte Carlo event generator for six parton final states at high energy colliders

    NASA Astrophysics Data System (ADS)

    Ballestrero, Alessandro; Belhouari, Aissa; Bevilacqua, Giuseppe; Kashkan, Vladimir; Maina, Ezio

    2009-03-01

    PHANTOM is a tree level Monte Carlo for six parton final states at proton-proton, proton-antiproton and electron-positron colliders at O(αEM6) and O(αEM4αS2) including possible interferences between the two sets of diagrams. This comprehends all purely electroweak contributions as well as all contributions with one virtual or two external gluons. It can generate unweighted events for any set of processes and it is interfaced to parton shower and hadronization packages via the latest Les Houches Accord protocol. It can be used to analyze the physics of boson-boson scattering, Higgs boson production in boson-boson fusion, tt¯ and three boson production. Program summaryProgram title:PHANTOM (V. 1.0) Catalogue identifier: AECE_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AECE_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 175 787 No. of bytes in distributed program, including test data, etc.: 965 898 Distribution format: tar.gz Programming language: Fortran 77 Computer: Any with a UNIX, LINUX compatible Fortran compiler Operating system: UNIX, LINUX RAM: 500 MB Classification: 11.1 External routines: LHAPDF (Les Houches Accord PDF Interface, http://projects.hepforge.org/lhapdf/), CIRCE (beamstrahlung for ee ILC collider). Nature of problem: Six fermion final state processes have become important with the increase of collider energies and are essential for the study of top, Higgs and electroweak symmetry breaking physics at high energy colliders. Since thousands of Feynman diagrams contribute in a single process and events corresponding to hundreds of different final states need to be generated, a fast and stable calculation is needed. Solution method:PHANTOM is a tree level Monte Carlo for six parton final states at proton-proton, proton-antiproton and electron-positron colliders. It computes all amplitudes at O(αEM6) and O(αEM4αs2) including possible interferences between the two sets of diagrams. The matrix elements are computed with the helicity formalism implemented in the program PHACT [1]. The integration makes use of an iterative-adaptive multichannel method which, relying on adaptivity, allows the use of only a few channels per process. Unweighted event generation can be performed for any set of processes and it is interfaced to parton shower and hadronization packages via the latest Les Houches Accord protocol. Restrictions: All Feynman diagrams are computed al LO. Unusual features: Phantom is written in Fortran 77 but it makes use of structures. The g77 compiler cannot compile it as it does not recognize the structures. The Intel, Portland Group, True64 HP Fortran 77 or Fortran 90 compilers have been tested and can be used. Running time: A few hours for a cross section integration of one process at per mille accuracy. One hour for one thousand unweighted events. References:A. Ballestrero, E. Maina, Phys. Lett. B 350 (1995) 225, hep-ph/9403244; A. Ballestrero, PHACT 1.0, Program for helicity amplitudes Calculations with Tau matrices, hep-ph/9911318, in: B.B. Levchenko, V.I. Savrin (Eds.), Proceedings of the 14th International Workshop on High Energy Physics and Quantum Field Theory (QFTHEP 99), SINP MSU, Moscow, p. 303.

  14. Effect of initial GnRH and time of insemination on reproductive performance in cyclic and acyclic beef heifers subjected to a 5-d Co-synch plus progesterone protocol.

    PubMed

    Helguera, I López; Whittaker, P; Behrouzi, A; Mapletoft, R J; Colazo, M G

    2018-01-15

    This study evaluated the effect of initial GnRH and timing of AI in a 5-d Co-synch plus CIDR (device containing 1.38 g of progesterone) protocol on pregnancy per AI (P/AI) and pregnancy loss in beef heifers. A secondary objective was to determine if the effect of initial GnRH on reproductive performance was influenced by cyclicity. Crossbred beef heifers (n = 1068; 301-514 kg of body weight, and 13-15 mo of age) at three locations were assigned to either a 5-d Co-synch plus CIDR protocol with (CIDR5G) or without (CIDR5NG) an initial injection of 100 μg of GnRH at CIDR insertion (Day 0). All heifers received a single dose of 500 μg of cloprostenol at CIDR removal (Day 5) and were divided into two groups to receive GnRH and TAI at either 66 or 72 h (Day 8) after CIDR removal. All heifers were inseminated by one technician with frozen-thawed semen from 1 of 4 sires available commercially. Transrectal ultrasonography was performed on Day 0 to determine cyclicity (presence of CL) and normalcy of the reproductive track, and 27 d after TAI to determine pregnancy status. Non-pregnant heifers (n = 470) were assigned to either a CIDR5G or a CIDR5NG protocol with TAI at 72 h after CIDR removal. Twelve days after second AI, heifers were exposure to bulls for 20 d and pregnancy diagnoses were performed approximately 30 d after second TAI and 60 d after bulls were removed to diagnose bull pregnancies and determine pregnancy loss rate. The percentage of acyclic heifers was 20.3%. Overall P/AI after first TAI was 55.6% (594/1068) and did not differ between CIDR5G and CIDR5NG (56.1 vs. 55.1%), or between TAI66 and TAI72 (55.8 vs. 55.4%). However, cyclic heifers were more likely to become pregnant than acyclic ones (59.3 vs. 41.2%; P < 0.01). Moreover, acyclic heifers subjected to the CIDR5NG had fewer P/AI than those subjected to CIDR5G (P < 0.01). Overall P/AI after resynchronization was 55.1% and did not differ between CIDR5G and CIDR5NG (51.3 vs. 59.0%). Overall pregnancy loss after first and second TAI were 3.0% (18/594) and 3.9% (8/205), respectively. When pregnancy loss data were combined, synchronization protocol (4.1 vs. 2.3% for CIDR5NG and CIDR5G; P = 0.01), cyclicity (5.8 vs. 2.9% for acyclic and cyclic; P = 0.03) and the interaction between synchronization protocol and cyclicity (P = 0.04) were significant. The overall cumulative pregnancy at the end of the breeding season was 94.2% (1006/1068); acyclic heifers were less likely to be pregnant at the end of the breeding season (88.4 vs. 95.8%; P < 0.01). In summary, the initial GnRH administration in a 5-d Co-synch plus CIDR protocol that includes a single PGF treatment is necessary in acyclic beef heifers to optimize P/AI, but not in cyclic heifers. Moreover, omission of initial GnRH was associated to greater pregnancy losses, particularly in acyclic heifers. Timing of AI did not affect P/AI. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  15. 33 CFR 20.901 - Summary decisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Summary decisions. 20.901 Section....901 Summary decisions. (a) Any party may move for a summary decision in all or any part of the... after service of a motion for summary decision, may serve opposing affidavits or countermove for summary...

  16. 19 CFR 142.16 - Entry summary documentation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Entry summary documentation. 142.16 Section 142.16... TREASURY (CONTINUED) ENTRY PROCESS Entry Summary Documentation § 142.16 Entry summary documentation. (a) Entry summary not filed at time of entry. When the entry documentation is filed before the entry summary...

  17. Simulation of n-qubit quantum systems. IV. Parametrizations of quantum states, matrices and probability distributions

    NASA Astrophysics Data System (ADS)

    Radtke, T.; Fritzsche, S.

    2008-11-01

    Entanglement is known today as a key resource in many protocols from quantum computation and quantum information theory. However, despite the successful demonstration of several protocols, such as teleportation or quantum key distribution, there are still many open questions of how entanglement affects the efficiency of quantum algorithms or how it can be protected against noisy environments. The investigation of these and related questions often requires a search or optimization over the set of quantum states and, hence, a parametrization of them and various other objects. To facilitate this kind of studies in quantum information theory, here we present an extension of the FEYNMAN program that was developed during recent years as a toolbox for the simulation and analysis of quantum registers. In particular, we implement parameterizations of hermitian and unitary matrices (of arbitrary order), pure and mixed quantum states as well as separable states. In addition to being a prerequisite for the study of many optimization problems, these parameterizations also provide the necessary basis for heuristic studies which make use of random states, unitary matrices and other objects. Program summaryProgram title: FEYNMAN Catalogue identifier: ADWE_v4_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADWE_v4_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 24 231 No. of bytes in distributed program, including test data, etc.: 1 416 085 Distribution format: tar.gz Programming language: Maple 11 Computer: Any computer with Maple software installed Operating system: Any system that supports Maple; program has been tested under Microsoft Windows XP, Linux Classification: 4.15 Does the new version supersede the previous version?: Yes Nature of problem: During the last decades, quantum information science has contributed to our understanding of quantum mechanics and has provided also new and efficient protocols, based on the use of entangled quantum states. To determine the behavior and entanglement of n-qubit quantum registers, symbolic and numerical simulations need to be applied in order to analyze how these quantum information protocols work and which role the entanglement plays hereby. Solution method: Using the computer algebra system Maple, we have developed a set of procedures that support the definition, manipulation and analysis of n-qubit quantum registers. These procedures also help to deal with (unitary) logic gates and (nonunitary) quantum operations that act upon the quantum registers. With the parameterization of various frequently-applied objects, that are implemented in the present version, the program now facilitates a wider range of symbolic and numerical studies. All commands can be used interactively in order to simulate and analyze the evolution of n-qubit quantum systems, both in ideal and noisy quantum circuits. Reasons for new version: In the first version of the FEYNMAN program [1], we implemented the data structures and tools that are necessary to create, manipulate and to analyze the state of quantum registers. Later [2,3], support was added to deal with quantum operations (noisy channels) as an ingredient which is essential for studying the effects of decoherence. With the present extension, we add a number of parametrizations of objects frequently utilized in decoherence and entanglement studies, such that as hermitian and unitary matrices, probability distributions, or various kinds of quantum states. This extension therefore provides the basis, for example, for the optimization of a given function over the set of pure states or the simple generation of random objects. Running time: Most commands that act upon quantum registers with five or less qubits take ⩽10 seconds of processor time on a Pentium 4 processor with ⩾2GHz or newer, and about 5-20 MB of working memory (in addition to the memory for the Maple environment). Especially when working with symbolic expressions, however, the requirements on CPU time and memory critically depend on the size of the quantum registers, owing to the exponential growth of the dimension of the associated Hilbert space. For example, complex (symbolic) noise models, i.e. with several symbolic Kraus operators, result for multi-qubit systems often in very large expressions that dramatically slow down the evaluation of e.g. distance measures or the final-state entropy, etc. In these cases, Maple's assume facility sometimes helps to reduce the complexity of the symbolic expressions, but more often only a numerical evaluation is possible eventually. Since the complexity of the various commands of the FEYNMAN program and the possible usage scenarios can be very different, no general scaling law for CPU time or the memory requirements can be given. References: [1] T. Radtke, S. Fritzsche, Comput. Phys. Comm. 173 (2005) 91. [2] T. Radtke, S. Fritzsche, Comput. Phys. Comm. 175 (2006) 145. [3] T. Radtke, S. Fritzsche, Comput. Phys. Comm. 176 (2007) 617.

  18. Simulation of n-qubit quantum systems. V. Quantum measurements

    NASA Astrophysics Data System (ADS)

    Radtke, T.; Fritzsche, S.

    2010-02-01

    The FEYNMAN program has been developed during the last years to support case studies on the dynamics and entanglement of n-qubit quantum registers. Apart from basic transformations and (gate) operations, it currently supports a good number of separability criteria and entanglement measures, quantum channels as well as the parametrizations of various frequently applied objects in quantum information theory, such as (pure and mixed) quantum states, hermitian and unitary matrices or classical probability distributions. With the present update of the FEYNMAN program, we provide a simple access to (the simulation of) quantum measurements. This includes not only the widely-applied projective measurements upon the eigenspaces of some given operator but also single-qubit measurements in various pre- and user-defined bases as well as the support for two-qubit Bell measurements. In addition, we help perform generalized and POVM measurements. Knowing the importance of measurements for many quantum information protocols, e.g., one-way computing, we hope that this update makes the FEYNMAN code an attractive and versatile tool for both, research and education. New version program summaryProgram title: FEYNMAN Catalogue identifier: ADWE_v5_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADWE_v5_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 27 210 No. of bytes in distributed program, including test data, etc.: 1 960 471 Distribution format: tar.gz Programming language: Maple 12 Computer: Any computer with Maple software installed Operating system: Any system that supports Maple; the program has been tested under Microsoft Windows XP and Linux Classification: 4.15 Catalogue identifier of previous version: ADWE_v4_0 Journal reference of previous version: Comput. Phys. Commun. 179 (2008) 647 Does the new version supersede the previous version?: Yes Nature of problem: During the last decade, the field of quantum information science has largely contributed to our understanding of quantum mechanics, and has provided also new and efficient protocols that are used on quantum entanglement. To further analyze the amount and transfer of entanglement in n-qubit quantum protocols, symbolic and numerical simulations need to be handled efficiently. Solution method: Using the computer algebra system Maple, we developed a set of procedures in order to support the definition, manipulation and analysis of n-qubit quantum registers. These procedures also help to deal with (unitary) logic gates and (nonunitary) quantum operations and measurements that act upon the quantum registers. All commands are organized in a hierarchical order and can be used interactively in order to simulate and analyze the evolution of n-qubit quantum systems, both in ideal and noisy quantum circuits. Reasons for new version: Until the present, the FEYNMAN program supported the basic data structures and operations of n-qubit quantum registers [1], a good number of separability and entanglement measures [2], quantum operations (noisy channels) [3] as well as the parametrizations of various frequently applied objects, such as (pure and mixed) quantum states, hermitian and unitary matrices or classical probability distributions [4]. With the current extension, we here add all necessary features to simulate quantum measurements, including the projective measurements in various single-qubit and the two-qubit Bell basis, and POVM measurements. Together with the previously implemented functionality, this greatly enhances the possibilities of analyzing quantum information protocols in which measurements play a central role, e.g., one-way computation. Running time: Most commands require ⩽10 seconds of processor time on a Pentium 4 processor with ⩾2 GHz RAM or newer, if they work with quantum registers with five or less qubits. Moreover, about 5-20 MB of working memory is typically needed (in addition to the memory for the Maple environment itself). However, especially when working with symbolic expressions, the requirements on the CPU time and memory critically depend on the size of the quantum registers owing to the exponential growth of the dimension of the associated Hilbert space. For example, complex (symbolic) noise models, i.e. with several Kraus operators, may result in very large expressions that dramatically slow down the evaluation of e.g. distance measures or the final-state entropy, etc. In these cases, Maple's assume facility sometimes helps to reduce the complexity of the symbolic expressions, but more often than not only a numerical evaluation is feasible. Since the various commands can be applied to quite different scenarios, no general scaling rule can be given for the CPU time or the request of memory. References:[1] T. Radtke, S. Fritzsche, Comput. Phys. Commun. 173 (2005) 91.[2] T. Radtke, S. Fritzsche, Comput. Phys. Commun. 175 (2006) 145.[3] T. Radtke, S. Fritzsche, Comput. Phys. Commun. 176 (2007) 617.[4] T. Radtke, S. Fritzsche, Comput. Phys. Commun. 179 (2008) 647.

  19. RNA-SeQC: RNA-seq metrics for quality control and process optimization.

    PubMed

    DeLuca, David S; Levin, Joshua Z; Sivachenko, Andrey; Fennell, Timothy; Nazaire, Marc-Danie; Williams, Chris; Reich, Michael; Winckler, Wendy; Getz, Gad

    2012-06-01

    RNA-seq, the application of next-generation sequencing to RNA, provides transcriptome-wide characterization of cellular activity. Assessment of sequencing performance and library quality is critical to the interpretation of RNA-seq data, yet few tools exist to address this issue. We introduce RNA-SeQC, a program which provides key measures of data quality. These metrics include yield, alignment and duplication rates; GC bias, rRNA content, regions of alignment (exon, intron and intragenic), continuity of coverage, 3'/5' bias and count of detectable transcripts, among others. The software provides multi-sample evaluation of library construction protocols, input materials and other experimental parameters. The modularity of the software enables pipeline integration and the routine monitoring of key measures of data quality such as the number of alignable reads, duplication rates and rRNA contamination. RNA-SeQC allows investigators to make informed decisions about sample inclusion in downstream analysis. In summary, RNA-SeQC provides quality control measures critical to experiment design, process optimization and downstream computational analysis. See www.genepattern.org to run online, or www.broadinstitute.org/rna-seqc/ for a command line tool.

  20. Organ Preservation: Current Concepts and New Strategies for the Next Decade

    PubMed Central

    Guibert, Edgardo E.; Petrenko, Alexander Y.; Balaban, Cecilia L.; Somov, Alexander Y.; Rodriguez, Joaquín V.; Fuller, Barry J.

    2011-01-01

    Summary Organ transplantation has developed over the past 50 years to reach the sophisticated and integrated clinical service of today through several advances in science. One of the most important of these has been the ability to apply organ preservation protocols to deliver donor organs of high quality, via a network of organ exchange to match the most suitable recipient patient to the best available organ, capable of rapid resumption of life-sustaining function in the recipient patient. This has only been possible by amassing a good understanding of the potential effects of hypoxic injury on donated organs, and how to prevent these by applying organ preservation. This review sets out the history of organ preservation, how applications of hypothermia have become central to the process, and what the current status is for the range of solid organs commonly transplanted. The science of organ preservation is constantly being updated with new knowledge and ideas, and the review also discusses what innovations are coming close to clinical reality to meet the growing demands for high quality organs in transplantation over the next few years. PMID:21566713

  1. From pre-registration to publication: a non-technical primer for conducting a meta-analysis to synthesize correlational data

    PubMed Central

    Quintana, Daniel S.

    2015-01-01

    Meta-analysis synthesizes a body of research investigating a common research question. Outcomes from meta-analyses provide a more objective and transparent summary of a research area than traditional narrative reviews. Moreover, they are often used to support research grant applications, guide clinical practice, and direct health policy. The aim of this article is to provide a practical and non-technical guide for psychological scientists that outlines the steps involved in planning and performing a meta-analysis of correlational datasets. I provide a supplementary R script to demonstrate each analytical step described in the paper, which is readily adaptable for researchers to use for their analyses. While the worked example is the analysis of a correlational dataset, the general meta-analytic process described in this paper is applicable for all types of effect sizes. I also emphasize the importance of meta-analysis protocols and pre-registration to improve transparency and help avoid unintended duplication. An improved understanding this tool will not only help scientists to conduct their own meta-analyses but also improve their evaluation of published meta-analyses. PMID:26500598

  2. From pre-registration to publication: a non-technical primer for conducting a meta-analysis to synthesize correlational data.

    PubMed

    Quintana, Daniel S

    2015-01-01

    Meta-analysis synthesizes a body of research investigating a common research question. Outcomes from meta-analyses provide a more objective and transparent summary of a research area than traditional narrative reviews. Moreover, they are often used to support research grant applications, guide clinical practice, and direct health policy. The aim of this article is to provide a practical and non-technical guide for psychological scientists that outlines the steps involved in planning and performing a meta-analysis of correlational datasets. I provide a supplementary R script to demonstrate each analytical step described in the paper, which is readily adaptable for researchers to use for their analyses. While the worked example is the analysis of a correlational dataset, the general meta-analytic process described in this paper is applicable for all types of effect sizes. I also emphasize the importance of meta-analysis protocols and pre-registration to improve transparency and help avoid unintended duplication. An improved understanding this tool will not only help scientists to conduct their own meta-analyses but also improve their evaluation of published meta-analyses.

  3. Estimating Tissue Iron Burden: Current Status and Future Prospects

    PubMed Central

    Wood, John C.

    2015-01-01

    SUMMARY Iron overload is becoming an increasing problem as haemoglobinopathy patients gain greater access to good medical care and as therapies for myelodysplastic syndromes improve. Therapeutic options for iron chelation therapy have increased and many patients now receive combination therapies. However, optimal utilization of iron chelation therapy requires knowledge not only of the total body iron burden but the relative iron distribution among the different organs. The physiological basis for extrahepatic iron deposition is presented in order to help identify patients at highest risk for cardiac and endocrine complications. This manuscript reviews the current state of the art for monitoring global iron overload status as well as its compartmentalization. Plasma markers, computerized tomography, liver biopsy, magnetic susceptibility devices and magnetic resonance imaging (MRI) techniques are all discussed but MRI has come to dominate clinical practice. The potential impact of recent pancreatic and pituitary MRI studies on clinical practice are discussed as well as other works-in-progress. Clinical protocols are derived from experience in haemoglobinopathies but may provide useful guiding principles for other iron overload disorders, such as myelodysplastic syndromes. PMID:25765344

  4. A protocol for characterizing the impact of collateral flow after distal middle cerebral artery occlusion

    PubMed Central

    DeFazio, R. Anthony; Levy, Sean; Morales, Carmen L.; Levy, Rebecca V.; Dave, Kunjan R.; Lin, Hung W.; Abaffy, Tatjana; Watson, Brant D.; Perez-Pinzon, Miguel A.; Ohanna, Victoria

    2010-01-01

    I. SUMMARY In humans and in animal models of stroke, collateral blood flow between territories of the major pial arteries has a profound impact on cortical infarct size. However, there is a gap in our understanding of the genetic determinants of collateral formation and flow, as well as the signaling pathways and neurovascular interactions regulating this flow. Previous studies have demonstrated that collateral flow between branches of the anterior cerebral artery (ACA) and the middle cerebral artery (MCA) can protect mouse cortex from infarction after middle cerebral artery occlusion. Because the number and diameter of collaterals varies among mouse strains and after transgenic manipulations, a combination of methods is required to control for these variations. Here, we report an inexpensive approach to characterizing the cerebrovascular anatomy, and in vivo monitoring of cerebral blood flow as well. Further, we introduce a new, minimally invasive method for the occlusion of distal MCA branches. These methods will permit a new generation of studies on the mechanisms regulating collateral remodeling and cortical blood flow after stroke. PMID:21593993

  5. Validation of Metagenomic Next-Generation Sequencing Tests for Universal Pathogen Detection.

    PubMed

    Schlaberg, Robert; Chiu, Charles Y; Miller, Steve; Procop, Gary W; Weinstock, George

    2017-06-01

    - Metagenomic sequencing can be used for detection of any pathogens using unbiased, shotgun next-generation sequencing (NGS), without the need for sequence-specific amplification. Proof-of-concept has been demonstrated in infectious disease outbreaks of unknown causes and in patients with suspected infections but negative results for conventional tests. Metagenomic NGS tests hold great promise to improve infectious disease diagnostics, especially in immunocompromised and critically ill patients. - To discuss challenges and provide example solutions for validating metagenomic pathogen detection tests in clinical laboratories. A summary of current regulatory requirements, largely based on prior guidance for NGS testing in constitutional genetics and oncology, is provided. - Examples from 2 separate validation studies are provided for steps from assay design, and validation of wet bench and bioinformatics protocols, to quality control and assurance. - Although laboratory and data analysis workflows are still complex, metagenomic NGS tests for infectious diseases are increasingly being validated in clinical laboratories. Many parallels exist to NGS tests in other fields. Nevertheless, specimen preparation, rapidly evolving data analysis algorithms, and incomplete reference sequence databases are idiosyncratic to the field of microbiology and often overlooked.

  6. Microbial degradation of aflatoxin B1: Current status and future advances.

    PubMed

    Verheecke, C; Liboz, T; Mathieu, F

    2016-11-21

    Aflatoxin B1 (AFB1) is a natural toxin produced by many food-contaminant fungi and is a threat to human and animal health. This review summarizes current knowledge of the different ways to limit AFB1 in the food chain. We start by introducing current data and reviews available on the prevention of AFB1 occurrence, on AFB1 non-biological decontamination and biological adsorption. We then focus on microbial AFB1-degradation. The latter has already been well studied using living organisms, supernatants or purified enzymes. This review compiles information on the variety of protocols and the efficacy of the different sub-kingdoms or classes of microorganisms or their enzymes. We pay particular attention to publications closest to in vivo applications of microbial AFB1-degradation. In addition, this review also provides a summary of the currently known microbial degradation metabolites of AFB1 and their levels of toxicity, and provides recommendations on the most promising techniques to pursue the aim of minimizing ABF1 in the food supply. Copyright © 2016. Published by Elsevier B.V.

  7. Anisotropic nanomaterials: structure, growth, assembly, and functions

    PubMed Central

    Sajanlal, Panikkanvalappil R.; Sreeprasad, Theruvakkattil S.; Samal, Akshaya K.; Pradeep, Thalappil

    2011-01-01

    Comprehensive knowledge over the shape of nanomaterials is a critical factor in designing devices with desired functions. Due to this reason, systematic efforts have been made to synthesize materials of diverse shape in the nanoscale regime. Anisotropic nanomaterials are a class of materials in which their properties are direction-dependent and more than one structural parameter is needed to describe them. Their unique and fine-tuned physical and chemical properties make them ideal candidates for devising new applications. In addition, the assembly of ordered one-dimensional (1D), two-dimensional (2D), and three-dimensional (3D) arrays of anisotropic nanoparticles brings novel properties into the resulting system, which would be entirely different from the properties of individual nanoparticles. This review presents an overview of current research in the area of anisotropic nanomaterials in general and noble metal nanoparticles in particular. We begin with an introduction to the advancements in this area followed by general aspects of the growth of anisotropic nanoparticles. Then we describe several important synthetic protocols for making anisotropic nanomaterials, followed by a summary of their assemblies, and conclude with major applications. PMID:22110867

  8. Summary Protocol for a Multi-Centre Randomised Controlled Trial of Enteral Lactoferrin Supplementation in Newborn Very Preterm Infants (ELFIN).

    PubMed

    2018-06-11

    In a multi-centre randomised controlled trial (RCT), we are assessing whether giving very preterm (i.e., born at < 32 weeks' gestation) infants prophylactic enteral bovine lactoferrin supplementation (150 mg/kg/day) from shortly after birth until 34 weeks' post-menstrual age reduces the incidence of late-onset invasive infection (primary outcome), all-cause mortality, bronchopulmonary dysplasia, necrotising enterocolitis, retinopathy of prematurity, and the duration of antibiotic exposure, intensive care, and hospital admission. The trial is recruiting 2,200 participants from 37 neonatal care centres in the UK over 4 years. We will undertake an economic evaluation within the RCT to evaluate cost-effectiveness and provide an estimate of incremental costs for differences in the pre-specified outcomes in primary and subgroup analyses. If a statistically significant and clinically important effect on the primary outcome is detected, we will seek further funding and approval to assess the impact of enteral lactoferrin supplementation on rates of adverse neuro-developmental outcomes in the participating infants when they are 5 years old. © 2018 S. Karger AG, Basel.

  9. Conservative management of tendinopathies around hip

    PubMed Central

    Frizziero, Antonio; Vittadini, Filippo; Pignataro, Andrea; Gasparre, Giuseppe; Biz, Carlo; Ruggieri, Pietro; Masiero, Stefano

    2016-01-01

    Summary Background The anatomy of hip is widely complex and several anatomical structures interact and contribute to its functioning. For position and role, hip and the surrounding tendons, which have their insertion around, are overstressed and often overloaded, especially in athletes. This could lead to the developing of several tendinopathies, among which the differential diagnosis is often complicated. Many conservative treatments are used in clinical practice, while actually, no defined conservative protocol is recommended. Methods This is a review article. The aim of this manuscript is to evaluate the current evidences about the effectiveness of conservative management in hip tendinopathies. Conclusion Conservative treatment is effective in the management of hip tendinopathies and may be considered the first-line approach for patients affected. However, there is lack of evidences about which is the most effective treatment. Exercise therapy seems to provide long-term pain relief, but the literature is still lacking about the correct type, dose, posology, intensity of exercise prescribed. Further studies about different local approaches, as PRP or hyaluronic acid injections, may be encouraged. Level of evidence I. PMID:28066732

  10. Preservation of protein fluorescence in embedded human dendritic cells for targeted 3D light and electron microscopy

    PubMed Central

    HÖHN, K.; FUCHS, J.; FRÖBER, A.; KIRMSE, R.; GLASS, B.; ANDERS‐ÖSSWEIN, M.; WALTHER, P.; KRÄUSSLICH, H.‐G.

    2015-01-01

    Summary In this study, we present a correlative microscopy workflow to combine detailed 3D fluorescence light microscopy data with ultrastructural information gained by 3D focused ion beam assisted scanning electron microscopy. The workflow is based on an optimized high pressure freezing/freeze substitution protocol that preserves good ultrastructural detail along with retaining the fluorescence signal in the resin embedded specimens. Consequently, cellular structures of interest can readily be identified and imaged by state of the art 3D confocal fluorescence microscopy and are precisely referenced with respect to an imprinted coordinate system on the surface of the resin block. This allows precise guidance of the focused ion beam assisted scanning electron microscopy and limits the volume to be imaged to the structure of interest. This, in turn, minimizes the total acquisition time necessary to conduct the time consuming ultrastructural scanning electron microscope imaging while eliminating the risk to miss parts of the target structure. We illustrate the value of this workflow for targeting virus compartments, which are formed in HIV‐pulsed mature human dendritic cells. PMID:25786567

  11. A reliable user authentication and key agreement scheme for Web-based Hospital-acquired Infection Surveillance Information System.

    PubMed

    Wu, Zhen-Yu; Tseng, Yi-Ju; Chung, Yufang; Chen, Yee-Chun; Lai, Feipei

    2012-08-01

    With the rapid development of the Internet, both digitization and electronic orientation are required on various applications in the daily life. For hospital-acquired infection control, a Web-based Hospital-acquired Infection Surveillance System was implemented. Clinical data from different hospitals and systems were collected and analyzed. The hospital-acquired infection screening rules in this system utilized this information to detect different patterns of defined hospital-acquired infection. Moreover, these data were integrated into the user interface of a signal entry point to assist physicians and healthcare providers in making decisions. Based on Service-Oriented Architecture, web-service techniques which were suitable for integrating heterogeneous platforms, protocols, and applications, were used. In summary, this system simplifies the workflow of hospital infection control and improves the healthcare quality. However, it is probable for attackers to intercept the process of data transmission or access to the user interface. To tackle the illegal access and to prevent the information from being stolen during transmission over the insecure Internet, a password-based user authentication scheme is proposed for information integrity.

  12. Defining, Designing, Implementing, and Evaluating Phase 4 HIV Prevention Effectiveness Trials for Vulnerable Populations

    PubMed Central

    Kelly, Jeffrey A.; Spielberg, Freya; McAuliffe, Timothy L.

    2008-01-01

    Summary The efficacy of behavioral HIV prevention interventions has been convincingly demonstrated in a large number of randomized controlled phase 3 research outcome trials. Little research attention has been directed toward studying the effectiveness of the same interventions when delivered by providers to their own clients or community members, however. This article argues for the need to conduct phase 4 effectiveness trials of HIV prevention interventions that have been found efficacious in the research arena. Such trials can provide important information concerning the impact of interventions when applied in heterogeneous “real-world” circumstances. This article raises design issues and methodologic questions that need to be addressed in the conduct of phase 4 trials of behavioral interventions. These issues include the selection and training of service providers engaged in such trials, maintenance of fidelity to intervention protocol in provider-delivered interventions, determination of intervention core elements versus aspects that require tailoring, selection of relevant phase 4 study outcomes, interpretation of findings indicative of field effectiveness, sustainability, and other aspects of phase 4 trial design. PMID:18301131

  13. A Comparative Study on the Lot Release Systems for Vaccines as of 2016.

    PubMed

    Fujita, Kentaro; Naito, Seishiro; Ochiai, Masaki; Konda, Toshifumi; Kato, Atsushi

    2017-09-25

    Many countries have already established their own vaccine lot release system that is designed for each country's situation: while the World Health Organization promotes for the convergence of these regulatory systems so that vaccines of assured quality are provided globally. We conducted a questionnaire-based investigation of the lot release systems for vaccines in 7 countries and 2 regions. We found that a review of the summary protocol by the National Regulatory Authorities was commonly applied for the independent lot release of vaccines, however, we also noted some diversity between countries, especially in regard to the testing policy. Some countries and regions, including Japan, regularly tested every lot of vaccines, whereas the frequency of these tests was reduced in other countries and regions as determined based on the risk assessment of these products. Test items selected for the lot release varied among the countries or regions investigated, although there was a tendency to prioritize the potency tests. An understanding of the lot release policy may contribute to improving and harmonizing the lot release system globally in the future.

  14. Compilation of climate data from heterogeneous networks across the Hawaiian Islands

    PubMed Central

    Longman, Ryan J.; Giambelluca, Thomas W.; Nullet, Michael A.; Frazier, Abby G.; Kodama, Kevin; Crausbay, Shelley D.; Krushelnycky, Paul D.; Cordell, Susan; Clark, Martyn P.; Newman, Andy J.; Arnold, Jeffrey R.

    2018-01-01

    Long-term, accurate observations of atmospheric phenomena are essential for a myriad of applications, including historic and future climate assessments, resource management, and infrastructure planning. In Hawai‘i, climate data are available from individual researchers, local, State, and Federal agencies, and from large electronic repositories such as the National Centers for Environmental Information (NCEI). Researchers attempting to make use of available data are faced with a series of challenges that include: (1) identifying potential data sources; (2) acquiring data; (3) establishing data quality assurance and quality control (QA/QC) protocols; and (4) implementing robust gap filling techniques. This paper addresses these challenges by providing: (1) a summary of the available climate data in Hawai‘i including a detailed description of the various meteorological observation networks and data accessibility, and (2) a quality controlled meteorological dataset across the Hawaiian Islands for the 25-year period 1990-2014. The dataset draws on observations from 471 climate stations and includes rainfall, maximum and minimum surface air temperature, relative humidity, wind speed, downward shortwave and longwave radiation data. PMID:29437162

  15. The LISST-SL streamlined isokinetic suspended-sediment profiler

    USGS Publications Warehouse

    Gray, John R.; Agrawal, Yogesh C.; Pottsmith, H. Charles

    2004-01-01

    The new manually deployed Laser In Situ Scattering Transmissometer-StreamLined profiler (LISST-SL) represents a major technological advance for suspended-sediment measurements in rivers. The LISST-SL is being designed to provide real-time data on sediment concentrations and particle-size distributions. A pressure sensor and current meter provide real-time depth and ambient velocity data, respectively. The velocity data are also used to control pumpage across an internal laser so that the intake velocity is constantly adjusted to match the ambient stream velocity. Such isokinetic withdrawal is necessary for obtaining representative sedimentary measurements in streamflow, and ensures compliance with established practices. The velocity and sediment-concentration data are used to compute fluxes for up to 32 particle-size classes at points, verticals, or in the entire stream cross section. All data are stored internally, as well as transmitted via a 2-wire conductor to the operator using a specially developed communication protocol. The LISST-SL's performance will be measured and compared to published sedimentological accuracy criteria, and a performance summary will be placed on-line.

  16. HEMATOPOIETIC STEM CELL INFUSION/TRANSPLANTATION FOR INDUCTION OF ALLOGRAFT TOLERANCE

    PubMed Central

    Granados, Jose M. Marino; Benichou, Gilles; Kawai, Tatsuo

    2015-01-01

    Purpose of review This review updates the current status of basic, preclinical, and clinical research on donor hematopoietic stem cell infusion for allograft tolerance induction. Recent findings Recent basic studies in mice provide evidence of significant involvement of both central deletional and peripheral regulatory mechanisms in induction and maintenance of allograft tolerance effected through a mixed chimerism approach with donor hematopoietic stem cell infusion. The presence of heterologous memory T cells in primates hampers the induction of persistent chimerism. Durable mixed chimerism, however, now has been recently induced in inbred major histocompatibility complex-mismatched swine, resulting in tolerance of vascularized composite tissue allografts. In clinical transplantation, allograft tolerance has been achieved in human leukocyte antigen-mismatched kidney transplantation after the induction of transient mixed chimerism or persistent full donor chimerism. Summary Tolerance induction in clinical kidney transplantation has been achieved by donor hematopoietic stem cell infusion. Improving the consistency and safety of tolerance induction and extending successful protocols to other organs, as well as to organs from deceased donors, are critical next steps to bringing tolerance to a wider range of clinical applications. PMID:25563992

  17. Recommended Implementation of Arterial Spin Labeled Perfusion MRI for Clinical Applications: A consensus of the ISMRM Perfusion Study Group and the European Consortium for ASL in Dementia

    PubMed Central

    Alsop, David C.; Detre, John A.; Golay, Xavier; Günther, Matthias; Hendrikse, Jeroen; Hernandez-Garcia, Luis; Lu, Hanzhang; MacIntosh, Bradley J.; Parkes, Laura M.; Smits, Marion; van Osch, Matthias J. P.; Wang, Danny JJ; Wong, Eric C.; Zaharchuk, Greg

    2014-01-01

    This article provides a summary statement of recommended implementations of arterial spin labeling (ASL) for clinical applications. It is a consensus of the ISMRM Perfusion Study Group and the European ‘ASL in Dementia’ consortium, both of whom met to reach this consensus in October 2012 in Amsterdam. Although ASL continues to undergo rapid technical development, we believe that current ASL methods are robust and ready to provide useful clinical information, and that a consensus statement on recommended implementations will help the clinical community to adopt a standardized approach. In this article we describe the major considerations and tradeoffs in implementing an ASL protocol, and provide specific recommendations for a standard approach. Our conclusions are that, as an optimal default implementation we recommend: pseudo-continuous labeling, background suppression, a segmented 3D readout without vascular crushing gradients, and calculation and presentation of both label/control difference images and cerebral blood flow in absolute units using a simplified model. PMID:24715426

  18. Experiences in supporting the structured collection of cancer nanotechnology data using caNanoLab

    PubMed Central

    Gaheen, Sharon; Lijowski, Michal; Heiskanen, Mervi; Klemm, Juli

    2015-01-01

    Summary The cancer Nanotechnology Laboratory (caNanoLab) data portal is an online nanomaterial database that allows users to submit and retrieve information on well-characterized nanomaterials, including composition, in vitro and in vivo experimental characterizations, experimental protocols, and related publications. Initiated in 2006, caNanoLab serves as an established resource with an infrastructure supporting the structured collection of nanotechnology data to address the needs of the cancer biomedical and nanotechnology communities. The portal contains over 1,000 curated nanomaterial data records that are publicly accessible for review, comparison, and re-use, with the ultimate goal of accelerating the translation of nanotechnology-based cancer therapeutics, diagnostics, and imaging agents to the clinic. In this paper, we will discuss challenges associated with developing a nanomaterial database and recognized needs for nanotechnology data curation and sharing in the biomedical research community. We will also describe the latest version of caNanoLab, caNanoLab 2.0, which includes enhancements and new features to improve usability such as personalized views of data and enhanced search and navigation. PMID:26425409

  19. Securely Measuring the Overlap between Private Datasets with Cryptosets

    PubMed Central

    Swamidass, S. Joshua; Matlock, Matthew; Rozenblit, Leon

    2015-01-01

    Many scientific questions are best approached by sharing data—collected by different groups or across large collaborative networks—into a combined analysis. Unfortunately, some of the most interesting and powerful datasets—like health records, genetic data, and drug discovery data—cannot be freely shared because they contain sensitive information. In many situations, knowing if private datasets overlap determines if it is worthwhile to navigate the institutional, ethical, and legal barriers that govern access to sensitive, private data. We report the first method of publicly measuring the overlap between private datasets that is secure under a malicious model without relying on private protocols or message passing. This method uses a publicly shareable summary of a dataset’s contents, its cryptoset, to estimate its overlap with other datasets. Cryptosets approach “information-theoretic” security, the strongest type of security possible in cryptography, which is not even crackable with infinite computing power. We empirically and theoretically assess both the accuracy of these estimates and the security of the approach, demonstrating that cryptosets are informative, with a stable accuracy, and secure. PMID:25714898

  20. Toward a Public Toxicogenomics Capability for Supporting ...

    EPA Pesticide Factsheets

    A publicly available toxicogenomics capability for supporting predictive toxicology and meta-analysis depends on availability of gene expression data for chemical treatment scenarios, the ability to locate and aggregate such information by chemical, and broad data coverage within chemical, genomics, and toxicological information domains. This capability also depends on common genomics standards, protocol description, and functional linkages of diverse public Internet data resources. We present a survey of public genomics resources from these vantage points and conclude that, despite progress in many areas, the current state of the majority of public microarray databases is inadequate for supporting these objectives, particularly with regard to chemical indexing. To begin to address these inadequacies, we focus chemical annotation efforts on experimental content contained in the two primary public genomic resources: ArrayExpress and Gene Expression Omnibus. Automated scripts and extensive manual review were employed to transform free-text experiment descriptions into a standardized, chemically indexed inventory of experiments in both resources. These files, which include top-level summary annotations, allow for identification of current chemical-associated experimental content, as well as chemical-exposure–related (or

  1. CARs and other T cell therapies for MM: The clinical experience.

    PubMed

    Danhof, Sophia; Hudecek, Michael; Smith, Eric L

    2018-06-01

    Harnessing the endogenous immune system to eliminate malignant cells has long been an intriguing approach. After considerable success in the treatment of B-cell acute lymphoblastic leukemia, chimeric antigen receptor (CAR)-modified T cells have entered early clinical evaluation in the field of multiple myeloma (MM). The choice of suitable non-CD19 target antigens is challenging and a variety of myeloma-associated surface molecules have been under preclinical investigation. Most recent clinical protocols have focused on targeting B-cell maturation antigen (BCMA), and early results are promising. The trials differ in receptor constructs, patient selection, dosing strategies and conditioning chemotherapy and will thus pave the way to eventually define the optimal parameters. Other sources for autologous T-cell therapy of MM include affinity-enhanced T-cell receptor-modified cells and marrow infiltrating lymphocytes. In summary, adoptive T-cell transfer for the treatment of MM is still in its infancy, but if early response rates indicate durability, will be a paradigm changing therapeutic modality for the treatment of MM. Copyright © 2018. Published by Elsevier Ltd.

  2. Treating Locally Advanced Cervical Cancer With Concurrent Chemoradiation Without Brachytherapy in Low-resource Countries.

    PubMed

    Chuang, Linus; Kanis, Margaux J; Miller, Brigitte; Wright, Jason; Small, William; Creasman, William

    2016-02-01

    To summarize the literature on options of management of patients treated for locally advanced cervical cancers with a specific focus on resource-constrained settings where brachytherapy is not available. A Medline search was performed to summarize studies about treatment approaches including neoadjuvant chemotherapy, primary surgery for bulky cervical cancer, and chemoradiation followed by surgery. Summaries are by treatment approaches that are relevant to resource-constrained settings. There are a lack of studies performed on neoadjuvant chemotherapy in low-resource settings. Primary surgery followed by chemoradiation therapy for selected patients with bulky cervical cancer is a feasible option. The disadvantage is the potential increase in treatment complications. Chemoradiation without brachytherapy followed by surgery has been found to have equivalent outcomes and is associated with acceptable morbidity. In resource-constrained settings where brachytherapy is not available, performing radical hysterectomy after chemoradiation therapy without brachytherapy has been shown to produce equivalent outcomes. It seems reasonable to adopt a modified therapeutic protocol of chemoradiation followed by extrafascial hysterectomy as an alternative treatment option in low-resource countries where brachytherapy is not readily available.

  3. Known TCP Implementation Problems

    NASA Technical Reports Server (NTRS)

    Paxson, Vern (Editor); Allman, Mark; Dawson, Scott; Fenner, William; Griner, Jim; Heavens, Ian; Lahey, K.; Semke, J.; Volz, B.

    1999-01-01

    This memo catalogs a number of known TCP implementation problems. The goal in doing so is to improve conditions in the existing Internet by enhancing the quality of current TCP/IP implementations. It is hoped that both performance and correctness issues can be resolved by making implementors aware of the problems and their solutions. In the long term, it is hoped that this will provide a reduction in unnecessary traffic on the network, the rate of connection failures due to protocol errors, and load on network servers due to time spent processing both unsuccessful connections and retransmitted data. This will help to ensure the stability of the global Internet. Each problem is defined as follows: Name of Problem The name associated with the problem. In this memo, the name is given as a subsection heading. Classification one or more problem categories for which the problem is classified: "congestion control", "performance", "reliability", "resource management". Description A definition of the problem, succinct but including necessary background material. Significance A brief summary of the sorts of environments for which the problem is significant.

  4. Plasticity of Candida albicans Biofilms

    PubMed Central

    Daniels, Karla J.

    2016-01-01

    SUMMARY Candida albicans, the most pervasive fungal pathogen that colonizes humans, forms biofilms that are architecturally complex. They consist of a basal yeast cell polylayer and an upper region of hyphae encapsulated in extracellular matrix. However, biofilms formed in vitro vary as a result of the different conditions employed in models, the methods used to assess biofilm formation, strain differences, and, in a most dramatic fashion, the configuration of the mating type locus (MTL). Therefore, integrating data from different studies can lead to problems of interpretation if such variability is not taken into account. Here we review the conditions and factors that cause biofilm variation, with the goal of engendering awareness that more attention must be paid to the strains employed, the methods used to assess biofilm development, every aspect of the model employed, and the configuration of the MTL locus. We end by posing a set of questions that may be asked in comparing the results of different studies and developing protocols for new ones. This review should engender the notion that not all biofilms are created equal. PMID:27250770

  5. Compilation of climate data from heterogeneous networks across the Hawaiian Islands

    NASA Astrophysics Data System (ADS)

    Longman, Ryan J.; Giambelluca, Thomas W.; Nullet, Michael A.; Frazier, Abby G.; Kodama, Kevin; Crausbay, Shelley D.; Krushelnycky, Paul D.; Cordell, Susan; Clark, Martyn P.; Newman, Andy J.; Arnold, Jeffrey R.

    2018-02-01

    Long-term, accurate observations of atmospheric phenomena are essential for a myriad of applications, including historic and future climate assessments, resource management, and infrastructure planning. In Hawai'i, climate data are available from individual researchers, local, State, and Federal agencies, and from large electronic repositories such as the National Centers for Environmental Information (NCEI). Researchers attempting to make use of available data are faced with a series of challenges that include: (1) identifying potential data sources; (2) acquiring data; (3) establishing data quality assurance and quality control (QA/QC) protocols; and (4) implementing robust gap filling techniques. This paper addresses these challenges by providing: (1) a summary of the available climate data in Hawai'i including a detailed description of the various meteorological observation networks and data accessibility, and (2) a quality controlled meteorological dataset across the Hawaiian Islands for the 25-year period 1990-2014. The dataset draws on observations from 471 climate stations and includes rainfall, maximum and minimum surface air temperature, relative humidity, wind speed, downward shortwave and longwave radiation data.

  6. [Efficacy of Transdermal Patch of Bisoprolol for Paroxysmal Atrial Fibrillation after Open Heart Surgery].

    PubMed

    Yamamoto, Kenji; Yamada, Tomoyuki; Hamuro, Mamoru; Kawatou, Masahide; Enomoto, Sakae

    2017-11-01

    2014 American Association for Thoracic Surgery (AATS) guidelines recommend beta blocker for prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures. In recent years, transdermal patch of bisoprolol (TDPB) has become available in Japan. We examined the efficacy of TDPB for paroxysmal atrial fibrillation (PAF) after open heart surgery. Among 289 patients who had undergone open heart surgery in our hospital from December 2013 to April 2016, 48(16.6%)patients, for whom TDPB was used for PAF, were analyzed retrospectively. The summary of our PAF protocol:HR >80;a sheet of TDPB (4 mg) is pasted, HR≤60;TDPB is removed, HR >140 persisted;another sheet of TDPB is added. Eighteen of the 48 (37.5%) patients recovered sinus rhythm within 24 hours. Six patients( 12.5%), because of persistent tachycardia, shifted to continuous infusion of landiolol. Ten underwent electrical defibrillation during hospitalization. In 3 patients, TDPB was removed due to advanced bradycardia. TDPB could be used safely and feasibly for PAF after open heart surgery.

  7. Chlamydomonas as a model for biofuels and bio-products production

    PubMed Central

    Scranton, Melissa A.; Ostrand, Joseph T.; Fields, Francis J.; Mayfield, Stephen P.

    2017-01-01

    SUMMARY Developing renewable energy sources is critical to maintaining the economic growth of the planet while protecting the environment. First generation biofuels focused on food crops like corn and sugarcane for ethanol production, and soybean and palm for biodiesel production. Second generation biofuels based on cellulosic ethanol produced from terrestrial plants, has received extensive funding and recently pilot facilities have been commissioned, but to date output of fuels from these sources has fallen well short of what is needed. Recent research and pilot demonstrations have highlighted the potential of algae as one of the most promising sources of sustainable liquid transportation fuels. Algae have also been established as unique biofactories for industrial, therapeutic, and nutraceutical co-products. Chlamydomonas reinhardtii’s long established role in the field of basic research in green algae has paved the way for understanding algal metabolism and developing genetic engineering protocols. These tools are now being utilized in C. reinhardtii and in other algal species for the development of strains to maximize biofuels and bio-products yields from the lab to the field. PMID:25641390

  8. Using Dedal to share and reuse distributed engineering design information

    NASA Technical Reports Server (NTRS)

    Baya, Vinod; Baudin, Catherine; Mabogunje, Ade; Das, Aseem; Cannon, David M.; Leifer, Larry J.

    1994-01-01

    The overall goal of the project is to facilitate the reuse of previous design experience for the maintenance, repair and redesign of artifacts in the electromechanical engineering domain. An engineering team creates information in the form of meeting summaries, project memos, progress reports, engineering notes, spreadsheet calculations and CAD drawings. Design information captured in these media is difficult to reuse because the way design concepts are referred to evolve over the life of a project and because decisions, requirements and structure are interrelated but rarely explicitly linked. Based on protocol analysis of the information seeking behavior of designer's, we defined a language to describe the content and the form of design records and implemented this language in Dedal, a tool for indexing, modeling and retrieving design information. We first describe the approach to indexing and retrieval in Dedal. Next we describe ongoing work in extending Dedal's capabilities to a distributed environment by integrating it with World Wide Web. This will enable members of a design team who are not co-located to share and reuse information.

  9. Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions

    PubMed Central

    Ooi, Adrian SH; Song, David H

    2016-01-01

    Implant-based procedures are the most commonly performed method for postmastectomy breast reconstruction. While donor-site morbidity is low, these procedures are associated with a higher risk of reconstructive loss. Many of these are related to infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, and unsatisfactory results. This review combines a summary of the recent literature regarding implant-related breast-reconstruction infections and combines this with a practical approach to the patient and surgery aimed at reducing this risk. Prevention of infection begins with appropriate reconstructive choice based on an assessment and optimization of risk factors. These include patient and disease characteristics, such as smoking, obesity, large breast size, and immediate reconstructive procedures, as well as adjuvant therapy, such as radiotherapy and chemotherapy. For implant-based breast reconstruction, preoperative planning and organization is key to reducing infection. A logical and consistent intraoperative and postoperative surgical protocol, including appropriate antibiotic choice, mastectomy-pocket creation, implant handling, and considered acellular dermal matrix use contribute toward the reduction of breast-implant infections. PMID:27621667

  10. A conversation-based process tracing method for use with naturalistic decisions: an evaluation study.

    PubMed

    Williamson, J; Ranyard, R; Cuthbert, L

    2000-05-01

    This study is an evaluation of a process tracing method developed for naturalistic decisions, in this case a consumer choice task. The method is based on Huber et al.'s (1997) Active Information Search (AIS) technique, but develops it by providing spoken rather than written answers to respondents' questions, and by including think aloud instructions. The technique is used within a conversation-based situation, rather than the respondent thinking aloud 'into an empty space', as is conventionally the case in think aloud techniques. The method results in a concurrent verbal protocol as respondents make their decisions, and a retrospective report in the form of a post-decision summary. The method was found to be virtually non-reactive in relation to think aloud, although the variable of Preliminary Attribute Elicitation showed some evidence of reactivity. This was a methodological evaluation, and as such the data reported are essentially descriptive. Nevertheless, the data obtained indicate that the method is capable of producing information about decision processes which could have theoretical importance in terms of evaluating models of decision-making.

  11. Immunotherapy with myeloid cells for tolerance induction

    PubMed Central

    Rodriguez-García, Mercedes; Boros, Peter; Bromberg, Jonathan S.; Ochando, Jordi C.

    2013-01-01

    Purpose of review Understanding the interplay between myeloid dendritic cells and T cells under tolerogenic conditions, and whether their interactions induce the development of antigen-specific regulatory T cells (Tregs) is critical to uncover the mechanisms involved in the induction of indefinite allograft survival. Recent findings Myeloid dendritic cell–T-cell interactions are seminal events that determine the outcome of the immune response, and multiple in-vitro protocols suggest the generation of tolerogenic myeloid dendritic cells that modulate T-cell responses, and determine the outcome of the immune response to an allograft following adoptive transfer. We believe that identifying specific conditions that lead to the generation of tolerogenic myeloid dendritic cells and Tregs are critical for the manipulation the immune response towards the development of transplantation tolerance. Summary We summarize recent findings regarding specific culture conditions that generate tolerogenic myeloid dendritic cells that induce T-cell hyporesponsiveness and Treg development, and represents a novel immunotherapeutic approach to promote the induction of indefinite graft survival prolongation. The interpretations presented here illustrate that different mechanisms govern the generation tolerogenic myeloid dendritic cells, and we discuss the concomitant therapeutic implications. PMID:20616727

  12. Standard methods for fungal brood disease research

    PubMed Central

    Jensen, Annette Bruun; Aronstein, Kathrine; Flores, José Manuel; Vojvodic, Svjetlana; Palacio, María Alejandra; Spivak, Marla

    2013-01-01

    Summary Chalkbrood and stonebrood are two fungal diseases associated with honey bee brood. Chalkbrood, caused by Ascosphaera apis, is a common and widespread disease that can result in severe reduction of emerging worker bees and thus overall colony productivity. Stonebrood is caused by Aspergillus spp. that are rarely observed, so the impact on colony health is not very well understood. A major concern with the presence of Aspergillus in honey bees is the production of airborne conidia, which can lead to allergic bronchopulmonary aspergillosis, pulmonary aspergilloma, or even invasive aspergillosis in lung tissues upon inhalation by humans. In the current chapter we describe the honey bee disease symptoms of these fungal pathogens. In addition, we provide research methodologies and protocols for isolating and culturing, in vivo and in vitro assays that are commonly used to study these host pathogen interactions. We give guidelines on the preferred methods used in current research and the application of molecular techniques. We have added photographs, drawings and illustrations to assist bee-extension personnel and bee scientists in the control of these two diseases. PMID:24198438

  13. Computerized summary scoring: crowdsourcing-based latent semantic analysis.

    PubMed

    Li, Haiying; Cai, Zhiqiang; Graesser, Arthur C

    2017-11-03

    In this study we developed and evaluated a crowdsourcing-based latent semantic analysis (LSA) approach to computerized summary scoring (CSS). LSA is a frequently used mathematical component in CSS, where LSA similarity represents the extent to which the to-be-graded target summary is similar to a model summary or a set of exemplar summaries. Researchers have proposed different formulations of the model summary in previous studies, such as pregraded summaries, expert-generated summaries, or source texts. The former two methods, however, require substantial human time, effort, and costs in order to either grade or generate summaries. Using source texts does not require human effort, but it also does not predict human summary scores well. With human summary scores as the gold standard, in this study we evaluated the crowdsourcing LSA method by comparing it with seven other LSA methods that used sets of summaries from different sources (either experts or crowdsourced) of differing quality, along with source texts. Results showed that crowdsourcing LSA predicted human summary scores as well as expert-good and crowdsourcing-good summaries, and better than the other methods. A series of analyses with different numbers of crowdsourcing summaries demonstrated that the number (from 10 to 100) did not significantly affect performance. These findings imply that crowdsourcing LSA is a promising approach to CSS, because it saves human effort in generating the model summary while still yielding comparable performance. This approach to small-scale CSS provides a practical solution for instructors in courses, and also advances research on automated assessments in which student responses are expected to semantically converge on subject matter content.

  14. Particle Data Group - Downloads

    Science.gov Websites

    Particle Data Group HOME: pdgLive Summary Tables Reviews, Tables, Plots Particle Listings Errata ; inverted mass hierarchy Page 10 of Leptons Summary Table, Neutrino Mixing: Leptons Summary Tables (page 10 . Pages 3 and 63 of Mesons Summary Tables: Bottom Mesons Summary Tables (page 3) Mesons Summary Tables

  15. [Cryopreservation of mouse embryos in ethylene glycol-based solutions: a search for the optimal and simple protocols].

    PubMed

    Luo, Ming-Jiu; Liu, Na; Miao, De-Qiang; Lan, Guo-Cheng; Suo-Feng; Chang, Zhong-Le; Tan, Jing-He

    2005-09-01

    Although ethylene glycol (EG) has been widely used for embryo cryopreservation in domestic animals, few attempts were made to use this molecule to freeze mouse and human embryos. In the few studies that used EG for slow-freezing of mouse and human embryos, complicated protocols for human embryos were used, and the protocols need to be simplified. Besides, freezing mouse morula with EG as a cryoprotectant has not been reported. In this paper, we studied the effects of embryo stages, EG concentration, duration and procedure of equilibration, sucrose supplementation and EG removal after thawing on the development of thawed mouse embryos, using the simple freezing and thawing procedures for bovine embryos. The blastulation and hatching rates (81.92% +/- 2.24% and 68.56% +/- 2.43%, respectively) of the thawed late compact morulae were significantly (P < 0.05) higher than those of embryos frozen-thawed at other stages. When mouse late compact morulae were frozen with different concentrations of EG, the highest rates of blastocyst formation and hatching were obtained with 1.8mol/L EG. The blastulation rate was significantly higher when late morulae were equilibrated in 1.8 mol/L EG for 10 min prior to freezing than when they were equilibrated for 30 min, and the hatching rate of embryos exposed to EG for 10 min was significantly higher than that of embryos exposed for 20 and 30 min. Both rates of blastocyst formation and hatching obtained with two-step equilibration were higher (P < 0.05) than with one-step equilibration in 1.8 mol/L EG. Addition of sucrose to the EG-based solution had no beneficial effects. On the contrary, an increased sucrose level (0.4 mol/L) in the solution impaired the development of the frozen-thawed embryos. In contrast, addition of 0.1 mol/L sucrose to the propylene glycol (PG)-based solution significantly improved the development of the frozen-thawed embryos. Elimination of the cryoprotectant after thawing did not improve the development of the thawed embryos. The cell numbers were less (P < 0.05) in blastocysts developed from the thawed morulae than in the in vivo derived ones. In summary, embryo stage, EG concentration, duration and procedure of equilibration and sucrose supplementation had marked effects on development of the thawed mouse embryos, and a protocol for cryopreservation of mouse embryos is recommended in which the late morulae are frozen in 1.8 mol/L EG using the simple freezing and thawing procedures of bovine embryos after a two-step equilibration and the embryos can be cultured or transferred without EG removal after thawing.

  16. The Ideal Hospital Discharge Summary: A Survey of U.S. Physicians.

    PubMed

    Sorita, Atsushi; Robelia, Paul M; Kattel, Sharma B; McCoy, Christopher P; Keller, Allan Scott; Almasri, Jehad; Murad, Mohammad Hassan; Newman, James S; Kashiwagi, Deanne T

    2017-09-06

    Hospital discharge summaries enable communication between inpatient and outpatient physicians. Despite existing guidelines for discharge summaries, they are frequently suboptimal. The aim of this study was to assess physicians' perspectives about discharge summaries and the differences between summaries' authors (hospitalists) and readers (primary care physicians [PCPs]). A national survey of 1600 U.S. physicians was undertaken. Primary measures included physicians' preferences in discharge summary standardization, content, format, and audience. A total of 815 physicians responded (response rate = 51%). Eighty-nine percent agreed that discharge summaries "should have a standardized format." Most agreed that summaries should "document everything that was done, found, and recommended in the hospital" (64%) yet "only include details that are highly pertinent to the hospitalization" (66%). Although 74% perceived patients as an important audience of discharge summaries, only 43% agreed that summaries "should be written in language that patients…can easily understand," and 68% agreed that it "should be written solely for provider-to-provider communication." Compared with hospitalists, PCPs preferred comprehensive summaries (68% versus 59%, P = 0.002). More PCPs agreed that separate summaries should be created for patients and for provider-to-provider communication than hospitalists (60% versus 47%, P < 0.001). Compared with PCPs, more hospitalists believe that "hospitalists are too busy to prepare a high-quality discharge summary" (44% versus 23%, P < 0.001) and "PCPs have insufficient time to read an entire discharge summary" (60% versus 38%, P < 0.001). Physicians believe that discharge summaries should have a standardized format but do not agree on how comprehensive or in what format they should be. Efforts are necessary to build consensus toward the ideal discharge summary.

  17. Assessment of surgical discharge summaries and evaluation of a new quality improvement model.

    PubMed

    Stein, Ran; Neufeld, David; Shwartz, Ivan; Erez, Ilan; Haas, Ilana; Magen, Ada; Glassberg, Elon; Shmulevsky, Pavel; Paran, Haim

    2014-11-01

    Discharge summaries after hospitalization provide the most reliable description and implications of the hospitalization. A concise discharge summary is crucial for maintaining continuity of care through the transition from inpatient to ambulatory care. Discharge summaries often lack information and are imprecise. Errors and insufficient recommendations regarding changes in the medical regimen may harm the patient's health and may result in readmission. To evaluate a quality improvement model and training program for writing postoperative discharge summaries for three surgical procedures. Medical records and surgical discharge summaries were reviewed and scored. Essential points for communication between surgeons and family physicians were included in automated forms. Staff was briefed twice regarding required summary contents with an interim evaluation. Changes in quality were evaluated. Summaries from 61 cholecystectomies, 42 hernioplasties and 45 colectomies were reviewed. The average quality score of all discharge summaries increased from 72.1 to 78.3 after the first intervention (P < 0.0005) to 81.0 following the second intervention. As the discharge summary's quality improved, its length decreased significantly. Discharge summaries lack important information and are too long. Developing a model for discharge summaries and instructing surgical staff regarding their contents resulted in measurable improvement. Frequent interventions and supervision are needed to maintain the quality of the surgical discharge summary.

  18. 15 CFR 904.210 - Summary decision.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Summary decision. 904.210 Section 904... Hearing and Appeal Procedures General § 904.210 Summary decision. The Judge may render a summary decision... summary decision as a matter of law. ...

  19. 75 FR 19672 - Petition for Exemption; Summary of Petition Received

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-15

    ... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration [Summary Notice No. PE-2010-15] Petition for Exemption; Summary of Petition Received AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of petition for exemption received. SUMMARY: This notice contains a summary petition...

  20. A kind of universal quantum secret sharing protocol

    NASA Astrophysics Data System (ADS)

    Chen, Xiu-Bo; Dou, Zhao; Xu, Gang; He, Xiao-Yu; Yang, Yi-Xian

    2017-01-01

    Universality is an important feature, but less researched in quantum communication protocols. In this paper, a kind of universal quantum secret sharing protocol is investigated. Firstly, we design a quantum secret sharing protocol based on the Borras-Plastino-Batle (BPB) state. Departing from previous research, our protocol has a salient feature in that participants in our protocol only need projective measurement instead of any unitary operations. It makes our protocol more flexible. Secondly, universality of quantum communication protocols is studied for the first time. More specifically, module division of quantum communication protocols and coupling between different modules are discussed. Our aforementioned protocol is analyzed as an example. On one hand, plenty of quantum states (the BPB-class states and the BPB-like-class states, which are proposed in this paper) could be used as carrier to perform our protocol. On the other hand, our protocol also could be regarded as a quantum private comparison protocol with a little revision. These features are rare for quantum communication protocols, and make our protocol more robust. Thirdly, entanglements of the BPB-class states are calculated in the Appendix.

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