Sample records for task force bmt

  1. Hydration status of Air Force military basic trainees after implementation of the back-mounted hydration system.

    PubMed

    Fogt, Donovan L; Brosch, Lorie C; Dacey, Danny C; Kalns, John E; Ketchum, Norma S; Rohrbeck, Patricia; Venuto, Margaret M; Tchandja, Juste B; Bunning, Mike L

    2009-08-01

    The Air Force makes an extraordinary effort to prevent heat-related illnesses associated with basic military training (BMT) in south Texas. However, inadequate hydration can still contribute to lost training time and qualified trainees leaving military service without completing BMT. The purpose of the present study was to determine whether equipping BMTs with back-mounted hydration systems (BM) is better than the standard-issue (SI) canteens with respect to hydration status. Male BMTs were randomly assigned to either BM (n = 40) or SI (n = 38) groups. Baseline values were assessed at week 0 before any physical readiness training (PRT). Subsequent data collection took place in the a.m. before PRT and in the p.m. before dinner the first 3 weeks, and during the 5 weeks of training. BMT total body water (TBW) and body composition were assessed by bioelectrical impedance. Saliva osmolality and total protein concentration were also determined. Hydration status increased daily in BM and SI and was well maintained over the duration of BMT. A significant hydration effect (p < 0.05) was observed for average daily increases in TBW and body weight with BM gaining more compared to SI. Average a.m. TBW was 0.3-0.8 L greater in SI versus BM (p < 0.05). Our findings demonstrate that adequate hydration status is maintained during Air Force BMT in a hot environment using either hydration mode and therefore do not support widespread issuance of the BM system on the premise of improved hydration during USAF BMT military training.

  2. A prospective cohort study on the impact of a modified Basic Military Training (mBMT) programme based on pre-enlistment fitness stratification amongst Asian military enlistees.

    PubMed

    Chai, Louis Y A; Ong, Kian Chung; Kee, Adrian; Earnest, Arul; Lim, Fabian C L; Wong, John C M

    2009-10-01

    This study objectively evaluates the effectiveness of a 6-week Preparatory Training Phase (PTP) programme prior to Basic Military Training (BMT) for less physically conditioned conscripts in the Singapore Armed Forces. We compared exercise test results of a group of less fi t recruits who underwent a 16-week modified-BMT (mBMT) programme (consisting of a 6-week PTP and 10-week BMT phase) with their 'fitter' counterparts enlisted in the traditional 10-week direct-intake BMT (dBMT) programme in this prospective cohort study consisting of 36 subjects. The main outcome measures included cardiopulmonary responses parameters (VO(2)max and V(O2AT)) with clinical exercise testing and distance run timings. Although starting off at a lower baseline in terms of physical fitness [VO(2)max 1.73 +/- 0.27 L/min (mBMT group) vs 1.97 +/- 0.43 L/min (dBMT), P = 0.032; V(O2AT) 1.02 +/- 0.19 vs 1.14 +/- 0.32 L/min respectively, P = 0.147], the mBMT group had greater improvement in cardiopulmonary indices and physical performance profiles than the dBMT cohort as determined by cardiopulmonary exercise testing [VO(2)max 2.34 +/- 0.24 (mBMT) vs 2.36 +/- 0.36 L/min (dBMT), P = 0.085; V(O2AT) 1.22 +/- 0.17 vs 1.21 +/- 0.24 L/min respectively, P = 0.303] and 2.4 kilometres timed-run [mBMT group 816.1 sec (pre-BMT) vs 611.1 sec (post-BMT), dBMT group 703.8 sec vs 577.7 sec, respectively; overall P value 0.613] at the end of the training period. Initial mean difference in fitness between mBMT and dBMT groups on enlistment was negated upon graduation from BMT. Pre-enlistment fitness stratification with training modification in a progressive albeit longer BMT programme for less-conditioned conscripts appears efficacious when measured by resultant physical fitness.

  3. Effect on injuries of assigning shoes based on foot shape in air force basic training.

    PubMed

    Knapik, Joseph J; Brosch, Lorie C; Venuto, Margaret; Swedler, David I; Bullock, Steven H; Gaines, Lorraine S; Murphy, Ryan J; Tchandja, Juste; Jones, Bruce H

    2010-01-01

    This study examined whether assigning running shoes based on the shape of the bottom of the foot (plantar surface) influenced injury risk in Air Force Basic Military Training (BMT) and examined risk factors for injury in BMT. Data were collected from BMT recruits during 2007; analysis took place during 2008. After foot examinations, recruits were randomly consigned to either an experimental group (E, n=1042 men, 375 women) or a control group (C, n=913 men, 346 women). Experimental group recruits were assigned motion control, stability, or cushioned shoes for plantar shapes indicative of low, medium, or high arches, respectively. Control group recruits received a stability shoe regardless of plantar shape. Injuries during BMT were determined from outpatient visits provided from the Defense Medical Surveillance System. Other injury risk factors (fitness, smoking, physical activity, prior injury, menstrual history, and demographics) were obtained from a questionnaire, existing databases, or BMT units. Multivariate Cox regression controlling for other risk factors showed little difference in injury risk between the groups among men (hazard ratio [E/C]=1.11, 95% CI=0.89-1.38) or women (hazard ratio [E/C]=1.20, 95% CI= 0.90-1.60). Independent injury risk factors among both men and women included low aerobic fitness and cigarette smoking. This prospective study demonstrated that assigning running shoes based on the shape of the plantar surface had little influence on injury risk in BMT even after controlling for other injury risk factors. Published by Elsevier Inc.

  4. Instrumenting free-swimming dolphins echolocating in open water.

    PubMed

    Martin, Stephen W; Phillips, Michael; Bauer, Eric J; Moore, Patrick W; Houser, Dorian S

    2005-04-01

    Dolphins within the Navy Marine Mammal Program use echolocation to effectively locate underwater mines. They currently outperform manmade systems at similar tasks, particularly in cluttered environments and on buried targets. In hopes of improving manmade mine-hunting sonar systems, two instrumentation packages were developed to monitor free-swimming dolphin motion and echolocation during open-water target detection tasks. The biosonar measurement tool (BMT) is carried by a dolphin and monitors underwater position and attitude while simultaneously recording echolocation clicks and returning echoes through high-gain binaural receivers. The instrumented mine simulator (IMS) is a modified bottom target that monitors echolocation signals arriving at the target during ensonification. Dolphin subjects were trained to carry the BMT in open-bay bottom-object target searches in which the IMS could serve as a bottom object. The instrumentation provides detailed data that reveal hereto-unavailable information on the search strategies of free-swimming dolphins conducting open-water, bottom-object search tasks with echolocation.

  5. Instrumenting free-swimming dolphins echolocating in open water

    NASA Astrophysics Data System (ADS)

    Martin, Stephen W.; Phillips, Michael; Bauer, Eric J.; Moore, Patrick W.; Houser, Dorian S.

    2005-04-01

    Dolphins within the Navy Marine Mammal Program use echolocation to effectively locate underwater mines. They currently outperform manmade systems at similar tasks, particularly in cluttered environments and on buried targets. In hopes of improving manmade mine-hunting sonar systems, two instrumentation packages were developed to monitor free-swimming dolphin motion and echolocation during open-water target detection tasks. The biosonar measurement tool (BMT) is carried by a dolphin and monitors underwater position and attitude while simultaneously recording echolocation clicks and returning echoes through high-gain binaural receivers. The instrumented mine simulator (IMS) is a modified bottom target that monitors echolocation signals arriving at the target during ensonification. Dolphin subjects were trained to carry the BMT in open-bay bottom-object target searches in which the IMS could serve as a bottom object. The instrumentation provides detailed data that reveal hereto-unavailable information on the search strategies of free-swimming dolphins conducting open-water, bottom-object search tasks with echolocation. .

  6. Manhattan transfer: lethal radiation, bone marrow transplantation, and the birth of stem cell biology, ca. 1942-1961.

    PubMed

    Kraft, Alison

    2009-01-01

    This study investigates how, in the late 1940s and 1950s, fears of nuclear accidents and nuclear warfare shaped postwar radiobiology. The new and intense forms of radiation generated by nuclear reactor technology, and which would be released in the event of a nuclear war, created concerns about a public-health hazard unprecedented in form and scale. Fears of inadvertent exposure to acute and potentially lethal radiation launched a search for anti-radiation therapies, out of which emerged the new technique of bone marrow transplantation (BMT). This study analyzes the use of BMT first as a research tool to explore the biological effects of ionizing radiation, and then as an adjunct to radiotherapy for the treatment of cancer. In highlighting how BMT became the province of different research and clinical constituencies, this study develops an understanding of the forces and contingencies that shaped its development. Exploring the emergence of BMT and the uses to which it was put, it reveals that BMT remained a technique in the making -- unstable and far from standardized, even as it became both a widely used research tool and rapidly made its way into the clinic. More broadly, it casts new light on one route through which the Manhattan Project influenced postwar radiobiology; it also affords new insights into one means by which radiobiology came to serve the interests of the Cold War state. In its focus on BMT this paper provides a new perspective on the evolving relationship between radiobiology and biomedicine in the postwar period.

  7. Setting up low-risk bone marrow transplantation for children with thalassemia may facilitate pediatric cancer care.

    PubMed

    Faulkner, Lawrence B

    2013-07-01

    In many South Asian countries there is shortage of centers providing care for pediatric malignancies. This report describes the experience of the Cure2Children Foundation (C2C) in supporting, both financially and professionally, the startup of two bone marrow transplant (BMT) centers, one in Pakistan and one in India, for the cure of transfusion-dependent thalassemia. Even though transplantation is generally considered as a more complex and advanced step relatively to basic pediatric cancer care, the authors argue that BMT for low-risk thalassemia patients with a matched sibling is a relatively simple procedure amenable to focused training. Since 2008 the C2C, an Italian Nongovernmental Organization (NGO), has supported a BMT network in Pakistan. The primary aim of this project was to assess feasibility, outcomes, and costs of matched-related BMT for thalassemia in young low-risk children employing a well established and quite tolerable strategy employed in Italy. This initiative relied primarily on focused training and task-shift strategies within a structured cooperation program. The initial success of that strategy led to its replication in India with 100 total BMTs performed over the past 4 years, 91 of which were for thalassemia major. Low-risk matched-related BMT in children younger than 5 years could deliver a 92% thalassemia-free survival with 100% performance score and no extensive chronic graft versus host disease (GVHD), for an average cost of 10,000 USD per BMT. Within an existing hospital facility, 50,000 USD were sufficient to renovate and fully equip a 2-3 bedded start up BMT unit capable of performing safe low-risk compatible marrow transplantation. In low resource settings matched-related low-risk BMT for thalassemia can be performed with outcomes comparable to richer countries and with a fraction of the costs. Within structured and intensive cooperation, good outcomes can be obtained from the very beginning. This observation may have important implications to increase access to cure for both nonmalignant and malignant.

  8. Biomimetic Signal Processing Using the Biosonar Measurement Tool (BMT)

    NASA Astrophysics Data System (ADS)

    Abawi, Ahmad T.; Hursky, Paul; Porter, Michael B.; Tiemann, Chris; Martin, Stephen

    2004-11-01

    In this paper data recorded on the Biosonar Measurement Tool (BMT) during a target echolocation experiment are used to 1) find ways to separate target echoes from clutter echoes, 2) analyze target returns and 3) find features in target returns that distinguish them from clutter returns. The BMT is an instrumentation package used in dolphin echolocation experiments developed at SPAWARSYSCEN. It can be held by the dolphin using a bite-plate during echolocation experiments and records the movement and echolocation strategy of a target-hunting dolphin without interfering with its motion through the search field. The BMT was developed to record a variety of data from a free-swimming dolphin engaged in a bottom target detection task. These data include the three dimensional location of the dolphin, including its heading, pitch roll and velocity as well as passive acoustic data recorded on three channels. The outgoing dolphin click is recorded on one channel and the resulting echoes are recorded on the two remaining channels. For each outgoing click the BMT records a large number of echoes that come from the entire ensonified field. Given the large number of transmitted clicks and the returned echoes, it is almost impossible to find a target return from the recorded data on the BMT. As a means of separating target echoes from those of clutter, an echo-mapping tool was developed. This tool produces an echomap on which echoes from targets (and other regular objects such as surface buoys, the side of a boat and so on) stack together as tracks, while echoes from clutter are scattered. Once these tracks are identified, the retuned echoes can easily be extracted for further analysis.

  9. "A day in my life" photography project: the silent voice of pediatric bone marrow transplant patients.

    PubMed

    Breitwieser, Carrie L; Vaughn, Lisa M

    2014-01-01

    A photovoice project was conducted with pediatric bone marrow transplant (BMT) patients to examine their coping skills and interpretation of their experience during a BMT, especially when hospitalized. We also wanted to determine how photovoice could be used within a pediatric BMT unit. Sixteen children (ages 4-14) and 2 young adults (ages 22 and 25) from a pediatric BMT unit participated in the project. Six BMT outpatients participated in the data analysis and evaluation phase. Fourteen clinical staff evaluated the impact of the project on their practice. Three primary themes emerged from the pre- and post-BMT photos, accompanying detailed notes, and BMT outpatient analysis of the photos: (a) BMT is "torture," (b) BMT is "time slipping away," and (c) BMT requires normalization, comfort, distraction, and support. BMT patients and staff concluded that photovoice helped express and release emotions regarding the challenges of BMT. BMT staff noted that the results of this project reminded them of the importance of being patient-centered and mindful of patient experience and the therapeutic relationship. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

  10. Randomized trial of betahistine mesilate tablets as augmentation for oxcarbazepine and carbamazepine in treating vestibular paroxysmia.

    PubMed

    Xue, Hui; Xiang, Wenping; Yu, Yichuan; Liu, Guorong; Chong, Yi; Zhou, Jiying

    2018-01-01

    Vestibular paroxysmia (VP) is a rare episodic peripheral vestibular disorder. This study was conducted to compare the efficacy and acceptability of carbamazepine (CBZ) plus betahistine mesilate tablets (BMT) (CBZ+BMT) and oxcarbazepine (OXC) plus BMT (OXC+BMT) in treating VP, and investigated whether the synergistic effect could be increased along with the increased dose of BMT. VP patients were recruited and randomly assigned to receive CBZ+BMT or OXC+BMT. The doses of CBZ and OXC were set to 200 and 300 mg/time, twice daily, respectively. The doses of BMT were set to 12 and 18 mg/time, twice daily. Half of the patients in each group received BMT 12 mg/time and the other half received BMT 18 mg/time. The treatment was continued for 12 weeks. The vertigo frequency, vertigo score, vertigo duration, response rate, and drug-related side effects were analyzed. In total, 92 patients in the CBZ+BMT group and 93 patients in the OXC+BMT group completed this trial. After 12 weeks of treatment, the two groups had similar average vertigo frequency, average vertigo score, average vertigo duration, and response rate. But the incidence of side effects was significantly higher in the CBZ+BMT group than in the OXC+BMT group ( p =0.04). Subgroup analysis found that patients receiving BMT (18 mg) had greater reductions in average vertigo frequency, average vertigo duration, and average vertigo score, and higher response rates than patients receiving BMT (12 mg). These results demonstrated that OXC+BMT may be suitable as an alternative method in VP patients with CBZ hypersensitivity, and the synergistic effect could be increased along with the increased dose of BMT.

  11. Preventing smoking initiation or relapse following 8.5 weeks of involuntary smoking abstinence in basic military training: trial design, interventions, and baseline data.

    PubMed

    Brandon, Thomas H; Klesges, Robert C; Ebbert, Jon O; Talcott, Gerald W; Thomas, Fridtjof; Leroy, Karen; Richey, Phyllis A; Colvin, Lauren

    2014-05-01

    Smoking cessation is a primary method of reducing excess mortality and morbidity. Unfortunately, the vast majority of cessation attempts end in eventual relapse. Relapse-prevention interventions have shown some success at improving the long-term maintenance of tobacco abstinence among individuals motivated to abstain. However, involuntary tobacco abstinence (e.g., military training, hospitalization, incarceration) presents another opportunity for intervention to prevent relapse. During basic military training (BMT), tobacco use is strictly forbidden in all service branches, but tobacco relapse (and initiation) following BMT is extremely high. This paper reports on the design, intervention development, and baseline characteristics of a randomized controlled trial testing minimal interventions designed to prevent tobacco relapse among United States Air Force (USAF) personnel following BMT. Participants are randomized by squadron to receive either a standard smoking-cessation booklet, a new motivation-based booklet designed specifically for USAF personal, or the latter booklet combined with a brief, face-to-face motivational session. Primary outcomes will be self-reported tobacco use at 12 and 24month follow-up. Given that the Department of Defense is the world's largest employer, the potential of leveraging involuntary tobacco abstinence during BMT into extended abstinence has substantial public health significance. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Discontinuation of Buprenorphine Maintenance Therapy: Perspectives and Outcomes

    PubMed Central

    Bentzley, Brandon S.; Barth, Kelly S.; Back, Sudie E.; Book, Sarah W.

    2015-01-01

    Buprenorphine maintenance therapy (BMT) is increasingly the preferred opioid maintenance agent due to its reduced toxicity and availability in an office-based setting in the United States. Although BMT has been shown to be highly efficacious, it is often discontinued soon after initiation. No current systematic review has yet investigated providers’ or patients’ reasons for BMT discontinuation or the outcomes that follow. Hence, provider and patient perspectives associated with BMT discontinuation after a period of stable buprenorphine maintenance and the resultant outcomes were systematically reviewed with specific emphasis on pre-buprenorphine-taper parameters predictive of relapse following BMT discontinuation. Few identified studies address provider or patient perspectives associated with buprenorphine discontinuation. Within the studies reviewed providers with residency training in BMT were more likely to favor long term BMT instead of detoxification, and providers were likely to consider BMT discontinuation in the face of medication misuse. Patients often desired to remain on BMT because of fear of relapse to illicit opioid use if they were to discontinue BMT. The majority of patients who discontinued BMT did so involuntarily, often due to failure to follow strict program requirements, and 1 month following discontinuation, rates of relapse to illicit opioid use exceeded 50% in every study reviewed. Only lower buprenorphine maintenance dose, which may be a marker for attenuated addiction severity, predicted better outcomes across studies. Relaxed BMT program requirements and frequent counsel on the high probability of relapse if BMT is discontinued may improve retention in treatment and prevent the relapse to illicit opioid use that is likely to follow BMT discontinuation. PMID:25601365

  13. Harm Reduction Agencies as a Potential Site for Buprenorphine Treatment.

    PubMed

    Fox, Aaron D; Chamberlain, Adam; Frost, Taeko; Cunningham, Chinazo O

    2015-01-01

    Harm reduction agencies complement addiction treatment by providing diverse services that improve the health of people who use drugs. Buprenorphine maintenance treatment (BMT) is an effective opioid addiction treatment that may be provided from flexible settings, potentially including harm reduction agencies. This study investigated attitudes toward different potential sites for BMT (harm reduction agencies, general medical clinics, and drug treatment programs) among harm reduction clients. Using computer-based interviews, participants indicated preferred potential site for BMT (harm reduction agency, drug treatment program, or general medical clinic), interest in BMT by potential site, motivation for treatment, and barriers to BMT. Multivariable logistic regression was used to determine factors associated with harm reduction agency preference. Of 102 opioid users, the most preferred potential site for BMT was a harm reduction agency (51%), whereas fewer preferred general medical clinics (13%), drug treatment programs (12%), or were not interested in BMT (25%). In multivariable analysis, experiencing ≥1 barrier to BMT was strongly associated with preferring harm reduction agencies (adjusted odds ratio [aOR] = 3.39, 95% confidence interval [CI]: 1.00-11.43). The potential to initiate BMT at harm reduction agencies is highly favorable among harm reduction clients, especially among those experiencing barriers to BMT. Offering BMT at harm reduction agencies could improve access to treatment, but studies are needed to determine safety and efficacy of this approach.

  14. SPACE-2: A Missed Opportunity to Compare Carotid Endarterectomy, Carotid Stenting, and Best Medical Treatment in Patients with Asymptomatic Carotid Stenoses.

    PubMed

    Eckstein, H-H; Reiff, T; Ringleb, P; Jansen, O; Mansmann, U; Hacke, W

    2016-06-01

    Because of recent advances in best medical treatment (BMT), it is currently unclear whether any additional surgical or endovascular interventions confer additional benefit, in terms of preventing late ipsilateral carotid territory ischemic stroke in asymptomatic patients with significant carotid stenoses. The aim was to compare the stroke-preventive effects of BMT alone, with that of BMT in combination with carotid endarterectomy (CEA) or carotid artery stenting (CAS) in patients with high grade asymptomatic extracranial carotid artery stenosis. SPACE-2 was planned as a three-armed, randomized controlled trial (BMT alone vs. CEA plus BMT vs. CAS plus BMT, ISRCTN 78592017). However, because of slow patient recruitment, the three-arm study design was amended (July 2013) to become two parallel randomized studies (BMT alone vs. CEA plus BMT, and BMT alone vs. CAS plus BMT). The change in study design did not lead to any significant increase in patient recruitment, and trial recruitment ceased after recruiting 513 patients over a 5 year period (CEA vs. BMT (n = 203); CAS vs. BMT (n = 197), and BMT alone (n = 113)). The 30 day rate of death/stroke was 1.97% for patients undergoing CEA, and 2.54% for patients undergoing CAS. No strokes or deaths occurred in the first 30 days after randomization in patients randomized to BMT. There were several potential reasons for the low recruitment rates into SPACE-2, including the ability for referring doctors to refer their patients directly for CEA or CAS outwith the trial, an inability to convince patients (who had come "mentally prepared" that an intervention was necessary) to accept BMT, and other economic constraints. Because of slow recruitment rates, SPACE-2 had to be stopped after randomizing only 513 patients. The German Research Foundation will provide continued funding to enable follow up of all recruited patients, and it is also planned to include these data in any future meta-analysis prepared by the Carotid Stenosis Trialists Collaboration. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  15. Efficacy and acceptability of oxcarbazepine vs. carbamazepine with betahistine mesilate tablets in treating vestibular paroxysmia: a retrospective review.

    PubMed

    Yi, Chong; Wenping, Xiang; Hui, Xue; Xin, He; Xiue, Li; Jun, Zhang; Shangyong, Geng

    2016-06-01

    Vestibular paroxysmia (VP) is a rare episodic peripheral vestibular disorder that can cause acute short attacks of vertigo. This study aimed to compare the efficacy and acceptability of carbamazepine (CBZ), CBZ plus betahistine mesilate tablets (BMT) and oxcarbazepine (OXC) plus BMT in treating VP within 12 weeks. A retrospective analysis of data from 196 VP patients treated in our hospital was conducted. There were 73 patients receiving CBZ, 65 patients receiving CBZ+BMT and 58 patients receiving OXC+BMT. The frequency of vertigo, vertigo duration, vertigo score, response rate (RR) and side effects were compared between groups to assess efficacy and acceptability at the end of 12(th) week. After 12 weeks' treatment, the CBZ+BMT group had a greater reduction in the frequency of vertigo, vertigo duration and vertigo score than the other two groups. The RR was highest in the CBZ+BMT group, second in the OXC+BMT group and lowest in the CBZ group. The incidence of side-effects was highest in the CBZ group, second in the CBZ+BMT group and lowest in the OXC+BMT group. Two patients in the CBZ group were withdrawn. These results indicated that using BMT as an augmentation for CBZ or OXC might be a good choice in treating VP.

  16. Characterization of regulatory dendritic cells that mitigate acute graft-versus-host disease in older mice following allogeneic bone marrow transplantation.

    PubMed

    Scroggins, Sabrina M; Olivier, Alicia K; Meyerholz, David K; Schlueter, Annette J

    2013-01-01

    Despite improvements in human leukocyte antigen matching and pharmacologic prophylaxis, acute graft-versus-host disease (GVHD) is often a fatal complication following hematopoietic stem cell transplant (HSCT). Older HSCT recipients experience significantly increased morbidity and mortality compared to young recipients. Prophylaxis with syngeneic regulatory dendritic cells (DCreg) in young bone marrow transplanted (BMT) mice has been shown to decrease GVHD-associated mortality. To evaluate this approach in older BMT recipients, young (3-4 months) and older (14-18 months) DCreg were generated using GM-CSF, IL-10, and TGFβ. Analysis of young versus older DCreg following culture revealed no differences in phenotype. The efficacy of DCreg treatment in older BMT mice was evaluated in a BALB/c→C57Bl/6 model of GVHD; on day 2 post-BMT (d +2), mice received syngeneic, age-matched DCreg. Although older DCreg-treated BMT mice showed decreased morbidity and mortality compared to untreated BMT mice (all of which died), there was a small but significant decrease in the survival of older DCreg-treated BMT mice (75% survival) compared to young DCreg-treated BMT mice (90% survival). To investigate differences between dendritic cells (DC) in young and older DCreg-treated BMT mice that may play a role in DCreg function in vivo, DC phenotypes were assessed following DCreg adoptive transfer. Transferred DCreg identified in older DCreg-treated BMT mice at d +3 showed significantly lower expression of PD-L1 and PIR B compared to DCreg from young DCreg-treated BMT mice. In addition, donor DC identified in d +21 DCreg-treated BMT mice displayed increased inhibitory molecule and decreased co-stimulatory molecule expression compared to d +3, suggesting induction of a regulatory phenotype on the donor DC. In conclusion, these data indicate DCreg treatment is effective in the modulation of GVHD in older BMT recipients and provide evidence for inhibitory pathways that DCreg and donor DC may utilize to induce and maintain tolerance to GVHD.

  17. Gonadal function and psychosexual adjustment in male long-term survivors of bone marrow transplantation.

    PubMed

    Molassiotis, A; van den Akker, O B; Milligan, D W; Boughton, B J

    1995-08-01

    Gonadal function and psychosexual adjustment were evaluated in 29 male patients after autologous and allogeneic BMT (mean post-BMT time 35.6 months). Patients were divided into groups according to their interval from transplant in order to evaluate gonadal function throughout the post-BMT years. Thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were normal throughout the post-BMT years. Follicle-stimulating hormone (FSH) and luteinising hormone (LH) were increased throughout the years after BMT, suggesting moderate compensated hypogonadism. Hyperprolactinaemia was observed only in the 2nd year post-BMT and testosterone levels were normal, suggesting that Leydig cells can withstand alkylating agents or TBI. Psychosexual functioning in BMT survivors was compared with that of a group of mixed-diagnosis cancer patients (n = 30) and a group of healthy young subjects (n = 119). Long-term BMT survivors had similar psychosexual adjustment to that of other cancer patients who had received less intensive chemotherapy. Half the patients were dissatisfied with their current sex life. Major problems included impotence/erectile difficulties (37.9%), low sexual desire (37.9%) and altered body image (20.7%). However, both BMT survivors and cancer patients had significantly higher psychosexual dysfunction compared with healthy subjects. The type of chemotherapy, TBI (either single-dose or fractionated), type of transplant and post-BMT time did not correlate with either gonadal or psychosexual functioning.

  18. CMV antigenemia following bone marrow transplantation: risk factors and outcomes.

    PubMed

    Osarogiagbon, R U; Defor, T E; Weisdorf, M A; Erice, A; Weisdorf, D J

    2000-01-01

    Cytomegalovirus (CMV) infection remains a major problem in blood and bone marrow transplant (BMT) recipients. Recent efforts have been directed at prevention, early diagnosis, and treatment of CMV disease following BMT. Assay for CMV early antigen pp65 on circulating leukocytes has been shown to be sensitive, and specific in detecting early CMV infection. We examined the frequency, risk factors, and outcomes of a positive CMV antigen assay in 118 consecutive BMT patients. Forty-three (36%) of the 118 patients developed CMV antigenemia a median of 26 days post-BMT (range, -6 to 209 days). The incidence of antigenemia in autologous, related donor, and unrelated donor BMT recipients was 15%, 50%, and 48%, respectively (P < .01) and was lower in CMV-seronegative patients (19% versus 51% in seropositive patients; P < .01). Patients with grade II to IV acute graft-versus-host disease (GVHD) had 2.2 times the risk of antigenemia of patients with no or only limited GVHD (P = .03). Age at transplantation, underlying disease, CMV prophylaxis regimen, and GVHD prophylaxis regimen did not affect the risk of CMV antigenemia. Ten of the 43 antigenemic patients, all CMV-seropositive allogeneic BMT (alloBMT) recipients, developed CMV organ disease a median of 101 days (range, 28-283 daya) post-BMT. These data suggest that CMV-seropositive alloBMT patients are at highest risk for CMV antigenemia and for organ disease as well. CMV disease may occur before antigenemia is detectable in leukopenic patients and may also develop late post-BMT, even in patients still receiving antiviral prophylaxis. In high-risk groups, intensive surveillance continuing for more than 6 months after BMT may be indicated.

  19. Less graft-versus-host disease after rabbit antithymocyte globulin conditioning in unrelated bone marrow transplantation for leukemia and myelodysplasia: comparison with matched related bone marrow transplantation.

    PubMed

    Atta, Elias Hallack; de Oliveira, Danielli Cristina Muniz; Bouzas, Luis Fernando; Nucci, Márcio; Abdelhay, Eliana

    2014-01-01

    One of the major drawbacks for unrelated donor (UD) bone marrow transplantation (BMT) is graft-versus-host disease (GVHD). Despite results from randomized trials, antithymocyte globulin (ATG) is not routinely included for GVHD prophylaxis in UD BMT by many centers. One of ways to demonstrate the usefulness of rabbit ATG in UD BMT is to evaluate how its results approximate to those observed in matched related (MRD) BMT. Therefore, we compared the outcomes between UD BMT with rabbit ATG (Thymoglobulin) for GVHD prophylaxis (n = 25) and MRD BMT (n = 91) for leukemia and myelodysplasia. All but one patient received a myeloablative conditioning regimen. Grades II-IV acute GVHD were similar (39.5% vs. 36%, p = 0.83); however, MRD BMT recipients developed more moderate-severe chronic GVHD (36.5% vs. 8.6%, p = 0.01) and GVHD-related deaths (32.5% vs. 5.6%, p = 0.04). UD BMT independently protected against chronic GVHD (hazard ratio 0.23, p = 0.04). The 6-month transplant-related mortality, 1-year relapse incidence, and 5-year survival rates were similar between patients with non-advanced disease in the MRD and UD BMT groups, 13.8% vs. 16.6% (p = 0.50), 20.8% vs. 16.6% (p = 0.37), and 57% vs. 50% (p = 0.67), respectively. Stable full donor chimerism was equally achieved (71.3% vs. 71.4%, p = 1). Incorporation of rabbit ATG in UD BMT promotes less GVHD, without jeopardizing chimerism evolution, and may attain similar survival outcomes as MRD BMT for leukemia and myelodysplasia especially in patients without advanced disease.

  20. Treatment options for patients with acute myeloid leukemia with a matched sibling donor: a decision analysis.

    PubMed

    Sung, Lillian; Buckstein, Rena; Doyle, John J; Crump, Michael; Detsky, Allan S

    2003-02-01

    The role of allogeneic bone marrow transplantation (BMT) in the consolidation of young adults with acute myeloid leukemia (AML) with matched sibling donors (MSD) is controversial. Although BMT is associated with increased event free survival compared with intensive chemotherapy (CT) consolidation, BMT also is associated with increased treatment-related mortality and likely decreased quality of life and life expectancy in patients who do not develop recurrent disease. The authors used decision analysis to compare three strategies for maximizing quality-adjusted life years (QALYs) in patients with AML in first remission with an MSD: BMT All, BMT None (consolidation CT only), or BMT in high-risk patients, as defined by baseline cytogenetic testing (Test strategy). A second decision-analysis tree was then constructed that compared BMT with CT specifically for patients with intermediate cytogenetics. Using expected QALYs as the outcome measure, the Test, BMT All, and BMT None strategies were associated with 20.10 QALYs, 19.63 QALYs, and 18.38 QALYs, respectively. Thus, the Test strategy, with CT for low-risk patients and BMT for intermediate risk and high-risk patients, was expected to be the optimal strategy. In the intermediate cytogenetic decision analysis, although the expected QALY for BMT recipients was higher compared with CT recipients (19.78 QALYs vs. 18.75 QALYs), because of uncertainty in variable estimates, the optimal choice was less clear. CT consolidation is a reasonable option for patients with AML who have favorable cytogenetics, even if an MSD is available. This model provides a framework from which patients with AML and their physicians can make decisions about consolidation therapy. Copyright 2003 American Cancer Society.DOI 10.1002/cncr.11098

  1. Characterization of Regulatory Dendritic Cells That Mitigate Acute Graft-versus-Host Disease in Older Mice Following Allogeneic Bone Marrow Transplantation

    PubMed Central

    Scroggins, Sabrina M.; Olivier, Alicia K.; Meyerholz, David K.; Schlueter, Annette J.

    2013-01-01

    Despite improvements in human leukocyte antigen matching and pharmacologic prophylaxis, acute graft-versus-host disease (GVHD) is often a fatal complication following hematopoietic stem cell transplant (HSCT). Older HSCT recipients experience significantly increased morbidity and mortality compared to young recipients. Prophylaxis with syngeneic regulatory dendritic cells (DCreg) in young bone marrow transplanted (BMT) mice has been shown to decrease GVHD-associated mortality. To evaluate this approach in older BMT recipients, young (3–4 months) and older (14–18 months) DCreg were generated using GM-CSF, IL-10, and TGFβ. Analysis of young versus older DCreg following culture revealed no differences in phenotype. The efficacy of DCreg treatment in older BMT mice was evaluated in a BALB/c→C57Bl/6 model of GVHD; on day 2 post-BMT (d +2), mice received syngeneic, age-matched DCreg. Although older DCreg-treated BMT mice showed decreased morbidity and mortality compared to untreated BMT mice (all of which died), there was a small but significant decrease in the survival of older DCreg-treated BMT mice (75% survival) compared to young DCreg-treated BMT mice (90% survival). To investigate differences between dendritic cells (DC) in young and older DCreg-treated BMT mice that may play a role in DCreg function in vivo, DC phenotypes were assessed following DCreg adoptive transfer. Transferred DCreg identified in older DCreg-treated BMT mice at d +3 showed significantly lower expression of PD-L1 and PIR B compared to DCreg from young DCreg-treated BMT mice. In addition, donor DC identified in d +21 DCreg-treated BMT mice displayed increased inhibitory molecule and decreased co-stimulatory molecule expression compared to d +3, suggesting induction of a regulatory phenotype on the donor DC. In conclusion, these data indicate DCreg treatment is effective in the modulation of GVHD in older BMT recipients and provide evidence for inhibitory pathways that DCreg and donor DC may utilize to induce and maintain tolerance to GVHD. PMID:24040397

  2. The costs and benefits of bone marrow transplantation.

    PubMed

    Beard, M E; Inder, A B; Allen, J R; Hart, D N; Heaton, D C; Spearing, R L

    1991-07-24

    The average direct costs of performing a bone marrow transplant (BMT), including the subsequent year, was found to be NZ$27,074 for 43 consecutive transplants. In 29 BMTs a full two year period of follow up was available and a quality of life analysis was carried out on these patients. It was calculated that 59 quality adjusted life years (QALYs) had been gained by the BMT procedure at the time of analysis. By combining these two analyses the cost of each QALY gained by BMT is NZ$13,272. The relatively low cost of BMT is partly due to the extremely low annual costs in second and subsequent years post BMT. In our patients this cost amounted to $195 per year. The costs and benefits of BMT compare very favourably with other complex medical procedures.

  3. Allogeneic BMT and patient eligibility based on psychosocial criteria: a survey of BMT professionals.

    PubMed

    Foster, L W; McLellan, L J; Rybicki, L A; Dabney, J; Welsh, E; Bolwell, B J

    2006-01-01

    BMT professionals were compared regarding their willingness to proceed with allogeneic BMT given select psychosocial issues. A questionnaire was sent to 660 physician members of ASBMT, 92 social work members of BMT Special Interest Group, Association of Oncology Social Work, and 626 nurse members of BMT Special Interest Group, Oncology Nursing Society; 597 responded with a response rate of 43.5%. Items included background information, followed by 17 case vignettes; each represented a different psychosocial issue to which respondents indicated whether or not they would recommend proceeding with allogeneic BMT. In every vignette, at least 10% of respondents indicated they would not proceed. In six vignettes, at least 64% indicated do not proceed: suicidal ideation (86.8%), uses addictive illicit drugs (81.7%), history of noncompliance (80.5%), no lay caregiver (69.3%), alcoholic (64.8%), and mild dementia/Alzheimer's (64.4%). In 10 vignettes, at least 73% indicated proceed. On four vignettes, professional subgroups differed in their recommendation on whether or not to proceed with allogeneic BMT. Qualitative data suggest that this decision is contingent on the perceived acuity, severity, and currency of the psychosocial issue, patient ability to comply with treatment given the issue, and its manageability as a risk factor for treatment related vulnerability and outcomes.

  4. The impact of pediatric blood and marrow transplant on parents: introduction of the parent impact scale.

    PubMed

    Heinze, Katherine E; Rodday, Angie Mae; Nolan, Marie T; Bingen, Kristin; Kupst, Mary Jo; Patel, Sunita K; Syrjala, Karen; Harris, Lynnette; Recklitis, Christopher; Schwartz, Lisa; Davies, Stella; Guinan, Eva C; Noll, Robert; Chang, Grace; Parsons, Susan K

    2015-04-09

    Parents often experience stress-related complications when their child requires blood and marrow transplant (BMT). Previous studies have described the emotional toll BMT places on parents during the acute phase of care and within the context of clinical complications. In this paper we introduce the Parent Impact Scale (PARimpact), designed to capture physical and emotional challenges of the child's health on the parent. The primary aim of this paper is to examine psychometric properties of PARimpact, and the secondary aim is to explore factors associated with PARimpact scores for further hypothesis generation. This analysis used a merged dataset of two longitudinal studies. Accompanying parents (n = 363) of children undergoing BMT were surveyed up to six times from pre-BMT baseline to one year after their child's BMT. For this analysis, pre-BMT baseline responses to PARimpact were used to examine the factor structure with Principal Component Analysis (PCA) and Exploratory Factor Analysis (EFA). Construct validity was assessed, and multivariable regression was used to examine relationships between PARimpact and BMT clinical variables. PCA and EFA revealed a one-factor solution with acceptable item loading; Cronbach's α was 0.83 at baseline. Hypothesized differences in known groups were detected for BMT complications with significantly higher PARimpact scores for those with vs. without each complication. In the adjusted multivariable regression models, acute graft versus host disease (b = 5.3; p = 0.03), end organ toxicity (b = 5.9; p < 0.01), and systemic infection (b = 9.1; p < 0.01) were associated with significantly higher mean PARimpact scores in the first 3 months following transplant. After the first 3 months to 1 year post BMT, systemic infection was associated with increased mean PARimpact scores (b = 19.2; p < 0.01). Initial results suggest that the PARimpact is valid and reliable. Our finding that clinical complications increase the impact of BMT on the caretaking parent indicates the need for BMT healthcare professionals to identify these events and help parents navigate the BMT course. Clinical application of the PARimpact scale should be considered to identify high-risk families and provide targeted interventions to augment care.

  5. Presence of human polyomavirus DNA in the peripheral circulation of bone marrow transplant patients with and without hemorrhagic cystitis.

    PubMed

    Bogdanovic, G; Ljungman, P; Wang, F; Dalianis, T

    1996-04-01

    In BMT patients, shedding of BK virus (BKV) in the urine has been strongly but not absolutely correlated to hemorrhagic cystitis (HC). The possible presence of human polyomaviruses in peripheral blood leukocytes (PBLs), plasma, serum and urine in BMT patients and an association with HC was investigated by a nested PCR assay. Samples from allogeneic BMT patients with and without HC as well as from autologous BMT patients were analyzed. Human polyomaviruses were detected in urine and blood samples of both allogeneic and autologous BMT patients with and without HC. An association between the presence of a specific human polyomavirus in blood and HC was thus not observed.

  6. BMT Roadmap: A User-Centered Design Health Information Technology Tool to Promote Patient-Centered Care in Pediatric Hematopoietic Cell Transplantation.

    PubMed

    Runaas, Lyndsey; Hanauer, David; Maher, Molly; Bischoff, Evan; Fauer, Alex; Hoang, Tiffany; Munaco, Anna; Sankaran, Roshun; Gupta, Rahael; Seyedsalehi, Sajjad; Cohn, Amy; An, Larry; Tewari, Muneesh; Choi, Sung Won

    2017-05-01

    Health information technology (HIT) has great potential for increasing patient engagement. Pediatric hematopoietic cell transplantation (HCT) is a setting ripe for using HIT but in which little research exists. "BMT Roadmap" is a web-based application that integrates patient-specific information and includes several domains: laboratory results, medications, clinical trial details, photos of the healthcare team, trajectory of transplant process, and discharge checklist. BMT Roadmap was provided to 10 caregivers of patients undergoing first-time HCT. Research assistants performed weekly qualitative interviews throughout the patient's hospitalization and at discharge and day 100 to assess the impact of BMT Roadmap. Rigorous thematic analysis revealed 5 recurrent themes: emotional impact of the HCT process itself; critical importance of communication among patients, caregivers, and healthcare providers; ways in which BMT Roadmap was helpful during inpatient setting; suggestions for improving BMT Roadmap; and other strategies for organization and management of complex healthcare needs that could be incorporated into BMT Roadmap. Caregivers found the tool useful and easy to use, leading them to want even greater access to information. BMT Roadmap was feasible, with no disruption to inpatient care. Although this initial study is limited by the small sample size and single-institution experience, these initial findings are encouraging and support further investigation. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  7. Distinctive Capillary Action by Micro-channels in Bone-like Templates can Enhance Recruitment of Cells for Restoration of Large Bony Defect.

    PubMed

    Oh, Daniel S; Koch, Alia; Eisig, Sidney; Kim, Sahng Gyoon; Kim, Yoon Hyuk; Kim, Do-Gyoon; Shim, Jae Hyuck

    2015-09-11

    Without an active, thriving cell population that is well-distributed and stably anchored to the inserted template, exceptional bone regeneration does not occur. With conventional templates, the absence of internal micro-channels results in the lack of cell infiltration, distribution, and inhabitance deep inside the templates. Hence, a highly porous and uniformly interconnected trabecular-bone-like template with micro-channels (biogenic microenvironment template; BMT) has been developed to address these obstacles. The novel BMT was created by innovative concepts (capillary action) and fabricated with a sponge-template coating technique. The BMT consists of several structural components: inter-connected primary-pores (300-400 µm) that mimic pores in trabecular bone, micro-channels (25-70 µm) within each trabecula, and nanopores (100-400 nm) on the surface to allow cells to anchor. Moreover, the BMT has been documented by mechanical test study to have similar mechanical strength properties to those of human trabecular bone (~3.8 MPa)12. The BMT exhibited high absorption, retention, and habitation of cells throughout the bridge-shaped (Π) templates (3 cm height and 4 cm length). The cells that were initially seeded into one end of the templates immediately mobilized to the other end (10 cm distance) by capillary action of the BMT on the cell media. After 4 hr, the cells homogenously occupied the entire BMT and exhibited normal cellular behavior. The capillary action accounted for the infiltration of the cells suspended in the media and the distribution (active migration) throughout the BMT. Having observed these capabilities of the BMT, we project that BMTs will absorb bone marrow cells, growth factors, and nutrients from the periphery under physiological conditions. The BMT may resolve current limitations via rapid infiltration, homogenous distribution and inhabitance of cells in large, volumetric templates to repair massive skeletal defects.

  8. Muscle-specific kinase-antibody-positive myasthenia gravis after autologous bone marrow transplantation.

    PubMed

    Grover, Kavita Mohindra; Sripathi, Naganand; Elias, Stanton Bernard

    2012-03-01

    A 44-year-old man presented with oculobulbar weakness approximately 5 years after autologous bone marrow transplantation (BMT). His workup led to the diagnosis of muscle-specific kinase-antibody-related myasthenia gravis (MG). There has been only one case report of muscle-specific kinase-antibody-positive MG after BMT, which was allogeneic. We report the first case of autologous BMT-associated MG with muscle-specific kinase antibody. The pathogenic mechanisms of immune dysregulation leading to MG after BMT are discussed.

  9. Comparative analysis of unrelated cord blood transplantation and HLA-matched sibling hematopoietic stem cell transplantation in children with high-risk or advanced acute leukemia.

    PubMed

    Zheng, Changcheng; Zhu, Xiaoyu; Tang, Baolin; Yao, Wen; Song, Kaidi; Tong, Juan; Geng, Liangquan; Liu, Huilan; Sun, Zimin

    2015-03-01

    The aim of this report was to present a clinical comparison of unrelated cord blood transplantation (CBT) and human leukocyte antigen (HLA)-matched sibling allogeneic peripheral blood stem cell or bone marrow transplantation (allo-PBSCT/BMT) in children with high-risk or advanced acute leukemia. A total of 115 consecutive pediatric patients received unrelated CBT (n = 90) or sibling allo-PBSCT/BMT (n = 25) between 2000 and 2012. Neutrophil and platelet recovery were significantly delayed after CBT compared to allo-PBSCT/BMT. There was no difference in the incidence of acute graft-versus-host disease (GVHD) or chronic GVHD between the two groups. The cumulative incidence of transplant-related mortality (TRM) was higher in the CBT group than in the allo-PBSCT/BMT group (32.5 vs 12.8 %) (p = 0.03). The cumulative incidence of relapse was 13.1 % after CBT, which was significantly lower than that of after allo-PBSCT/BMT (45.3 %) (p = 0.015). The overall survival (OS) and leukemia-free survival (LFS) in the CBT group were similar to those of the allo-PBSCT/BMT group; however, for acute myeloid leukemia (AML) patients, the 5-year LFS in the CBT group was slightly better than the allo-PBSCT/BMT group (55.7 % for CBT and 32.7 % for allo-PBSCT/BMT) (p = 0.08). Our comparisons suggest that for high-risk or advanced childhood acute leukemia, unrelated CBT has a higher TRM and similar long-term survival, but better antileukemia effect than HLA-matched sibling PBSCT/BMT. New strategies and better supportive care are required to decrease the TRM of CBT.

  10. Parental consent for bone marrow transplantation in the case of genetic disorders.

    PubMed

    Prows, C A; McCain, G C

    1997-01-01

    To describe the responses of mothers and fathers who were offered bone marrow transplantation (BMT) for their children with genetic disorders. Qualitative. Private hospital rooms/offices. Six mothers and 4 fathers of children with genetic disorders. The basic social-psychological problem confronting the parents was the conflicting alternatives of life versus death for their children. It was certain that these children would die from their genetic disorders but without having to endure the pain and suffering of a BMT. The BMT would be difficult, possibly resulting in death, but with a chance of survival. Parents believed that BMT was the only chance of survival for their children, leaving them no choice except to pursue the BMT treatment.

  11. The Meaning of Adolescents’ Eating Experiences During Bone Marrow Transplant Recovery

    PubMed Central

    Rodgers, Cheryl; Young, Anne; Hockenberry, Marilyn; Binder, Brenda; Symes, Lene

    2010-01-01

    Bone marrow transplant (BMT) is a common treatment option for adolescents with various diseases; however, the aggressive therapy often causes significant side effects that can lead to poor eating. There is little documentation of eating experiences and necessary support needed after the initial BMT hospitalization. This phenomenological study, guided by Martin Heidegger’s philosophical influences, revealed the meaning of adolescents’ eating experiences, eating strategies, and the impact of eating on the adolescents’ quality of life during the first 100 days post-BMT. Individual interviews were conducted at 50 and 100 days post-BMT. Data analysis used the hermeneutic circle and revealed 5 themes. Adolescents discussed the slow return of eating, barriers that affected their eating, personal eating strategies, significance of eating, and feelings regarding eating. Eating issues do not end when a BMT patient is discharged from the hospital, and caregivers need to have a better understanding of the ongoing issues affecting adolescents throughout the BMT recovery phase. PMID:20176916

  12. [AML(M7) associated with t(16;21)(p11;q22) showing relapse after unrelated bone marrow transplantation and disappearance of TLS/FUS-ERG mRNA].

    PubMed

    Fukushima, Y; Fujii, N; Tabata, Y; Nishimura, Y; Fusaoka, T; Yoshihara, T; Tsunamoto, K; Kasubuchi, Y; Morimoto, A; Hibi, S; Taketani, K; Hayashi, Y; Imashuku, S

    2001-06-01

    A 3-year-old boy with poorly prognostic acute megakaryoblastic leukemia (AML M7) showing t(16;21)(p11;q22) karyotype underwent unrelated bone marrow transplantation (U-BMT) during his first hematological remission. The conditioning regimen consisted of BU, VP-16 and L-PAM. Engraftment was smooth, but the patient developed grade I acute GVHD. During hematological remission before U-BMT, the TLS/FUS-ERG chimeric transcript of t(16;21)(p11;q22) was consistently detectable as minimal residual disease (MRD) by RT-PCR. However, after U-BMT it soon became undetectable. There was no detectable MRD until 7 months after U-BMT, but bone marrow relapse occurred 10 months after U-BMT. We consider that U-BMT is a promising treatment for t(16;21)(p11;q22) AML. However, an intensified conditioning regimen or modification of GVHD prophylaxis is needed.

  13. Overcoming psychosocial and developmental barriers to blood and marrow transplantation (BMT) in an adolescent/young adult (AYA) transgender patient with chronic myelogenous leukemia.

    PubMed

    Khazal, Sajad; Abdel-Azim, Hisham; Kapoor, Neena; Mahadeo, Kris M

    2014-11-01

    Adolescents/young adults (AYAs) afflicted with cancer face unique barriers to potentially standard curative therapies, such as blood and marrow transplantation (BMT). Transgender AYAs face additional barriers and there is a dearth of published literature regarding their oncology-related experience. We present the case of an AYA male-to-female (MTF) transgender patient on cross-sex hormone therapy, with a history of Chronic Myelogenous Leukemia (CML) and significant psychosocial barriers, which initially served as a barrier to BMT at two different centers; we modified our standard consent and education process and was able to successfully proceed with BMT and subsequently cure her CML. Despite unique challenges, AYA and transgender patients with significant psychosocial barriers may achieve successful outcomes with BMT. Research is needed regarding guidelines for cross-sex hormone therapy administration for patients undergoing BMT and other issues, which may be unique to the transgender experience.

  14. Reintegration after bone marrow transplantation.

    PubMed

    Baker, F; Zabora, J; Polland, A; Wingard, J

    1999-01-01

    This study examines the problems of bone marrow transplantation (BMT) survivors in returning to "normal" life in the community after BMT. Before being released from The Johns Hopkins Oncology Center, 84 recipients of BMT were interviewed regarding their quality of life and psychosocial adaptation. Survivors were reinterviewed at 6 months, and at 1 year post-BMT, producing considerable qualitative data regarding their problems in living. Eighty-four patients who had received BMT completed qualitative interviews and standardized measures before treatment, before the return home, and at 6 and 12 months post-BMT. The interviews were subjected to a content analysis methodology to establish units and categories to examine the body of material. Content analysis of these interviews from the first year after BMT identified three areas of psychosocial morbidity; 1) physical problems, which included fatigue, appearance, troubles in eating, and physical restrictions; 2) psychological problems, which included fears about the future, sense of loss of control, anxiety, and depression; and 3) community reintegration problems, which included difficulty in returning to former social roles, separation from home, family, and friends, difficulty in resuming social relations, dealing with stigmatization, problems with family and children, and financial and employment difficulties. Identification of these problems for BMT survivors can be used to guide the development of specific materials and services to prepare recipients of BMTs and their families for life after the transplant. These qualitative results can also be used to direct the development of assessment tools to identify potential patient and family problems.

  15. Targeting Histone Abnormality in Triple-Negative Breast Cancer

    DTIC Science & Technology

    2015-08-01

    Oncology Pediatric Hematology/Oncology BMT & CT Conference, Childrens Hospital of Pittsburgh, Pittsburgh, PA University of Pittsburgh, Winter...Release; Distribution Unlimited The views, opinions and/or findings contained in this report are those of the author( s ) and should not be construed as...ELEMENT NUMBER N/A 6. AUTHOR( S ) 5d. PROJECT NUMBER N/A Nancy E. Davidson, M.D. 5e. TASK NUMBER N/A E-Mail:davidsonne@upmc.edu 5f. WORK

  16. Repetitious appearance and disappearance of different kinds of clonal cytogenetic abnormalities after allogeneic bone marrow transplantation.

    PubMed

    Lin, Y W; Hamahata, K; Watanabe, K; Adachi, S; Akiyama, Y; Kubota, M; Nakahata, T

    2001-07-01

    We report a childhood case that showed the repeated appearance and disappearance of various kinds of cytogenetic abnormalities (CA) for 5.5 years after allogeneic bone marrow transplantation (BMT). The patient underwent allogeneic BMT from an HLA-matched unrelated donor during the second complete remission of acute lymphoblastic leukemia. The conditioning regimen for BMT consisted of etoposide, cyclophosphamide, anti-human thymocyte immunoglobulin, and total body irradiation. There were no leukemic relapses or secondary acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) since the BMT. The CA occurred from residual recipient cells, which were damaged by chemotherapy or radiation prior to BMT. Although previous studies about post-BMT CA had reported the continuous emergence of identical clones, the present case showed the appearance of one different type of clone after another. Although the appearance of different types of CA may mean that these clones did not obtain any growth advantages, it may be a sign of genomic instability, which is probably a risk factor for the development of secondary AML/MDS.

  17. Busulphan/cyclophosphamide conditioning for bone marrow transplantation may lead to failure of hair regrowth.

    PubMed

    Baker, B W; Wilson, C L; Davis, A L; Spearing, R L; Hart, D N; Heaton, D C; Beard, M E

    1991-01-01

    Following the introduction of bulsulphan and cyclophosphamide (BUCY) conditioning in our unit in 1987, a number of patients noted incomplete scalp hair regrowth following bone marrow transplantation (BMT). Between August 1987 and May 1989, 22 patients had undergone allogeneic or autologous BMT in our unit and we recalled for detailed assessment the 14 who were alive and well at least 6 months post grafting. Six patients had experienced incomplete hair regrowth of varying severity 7-27 months following BMT. All those affected had received BUCY conditioning and the four most severely affected were allogeneic BMT recipients. No patient had received any post-BMT chemotherapy or radiation. None of the patients had evidence of graft-versus-host disease. No laboratory test abnormalities distinguished the affected from the unaffected patients. Despite the relatively small number of patients, our results suggest that BUCY has caused permanent damage to the hair follicles of the affected patients. Prolonged alopecia may markedly impair the quality of life for long-term survivors of BMT and this unexpected complication also has significant medicolegal implications.

  18. The effect of dopants on the microwave dielectric properties of Ba(Mg{sub 0.33}Ta{sub 0.67})O{sub 3} ceramics

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

    Surendran, Kuzhichalil P.; Sebastian, Mailadil T.; Mohanan, Pezholil

    2005-11-01

    The effect of dopants with different valencies and ionic radii on the densification, structural ordering, and microwave dielectric properties of Ba(Mg{sub 1/3}Ta{sub 2/3})O{sub 3} (BMT) is investigated. It is found that dopants such as Sb{sub 2}O{sub 5}, MnO, ZrO{sub 2}, WO{sub 3}, and ZnO improve the microwave dielectric properties of BMT. Addition of trivalent dopants is detrimental to the cation ordering and dielectric properties of BMT. A correlation between the microwave dielectric properties of BMT and ionic radii of the dopant has been established. The variation of the dielectric properties of pure and doped BMT at cryogenic temperatures is alsomore » discussed.« less

  19. Improved disease-free-survival after transplantation of peripheral blood stem cells as compared with bone marrow from HLA-identical unrelated donors in patients with first chronic phase chronic myeloid leukemia.

    PubMed

    Elmaagacli, Ahmet H; Basoglu, Semiha; Peceny, Rudolf; Trenschel, Rudolf; Ottinger, Hellmut; Lollert, Andre; Runde, Volker; Grosse-Wilde, Hans; Beelen, Dietrich W; Schaefer, Ulrich W

    2002-02-15

    Outcomes after peripheral blood stem cell transplantation (PBSCT) for chronic phase chronic myeloid leukemia (n = 37) were compared with outcomes after bone marrow transplantation (BMT) (n = 54) in the HLA-compatible unrelated donor setting. Median follow-up was 17 months after PBSCT and 29 months after BMT. Both neutrophil and platelet recovery were faster after PBSCT (P <.05). PBSCT was associated with improved immune reconstitution, with higher peripheral blood naive (CD4(+)CD45RA(+)) and memory (CD4(+) CD45RO(+)) helper T cells at 3 months and 12 months after transplantation (P <.03). The cumulative incidence of acute (grades II-IV) and chronic graft-versus-host disease (GVHD) were similar, but BMT was associated with a higher cumulative incidence of severe, acute (grade III-IV) GVHD at 24% as compared with 8% with PBSCT (P <.05). Molecular relapse, defined by 2 consecutive positive polymerase chain reaction assays for bcr-abl within a 4-week interval, occurred in 12 of 45 evaluable patients (27%) after BMT and in 4 of 37 (11%) after PBSCT (not significant). Cytogenetic relapse occurred in 5 of 54 patients after BMT (9%) and in 1 of the 37 (3%) patients after PBSCT (not significant). Seventeen of the 54 patients died after BMT (31%), as compared with 2 of 37 patients after PBSCT (5%). Deaths in the BMT group were associated mainly with infections and severe, acute GVHD. The estimated probability of transplant-related mortality (TRM) and disease-free survival at 1000 days after receiving the transplant were 30% and 64% in the BMT group and 5% and 91% in the PBSCT group (P <.03). Overall survival 1000 days after receiving the transplant was 66% after BMT and 94% after PBSCT (P <.02). In the multivariate analysis, only acute GVHD significantly influenced TRM (P <.01).

  20. Primary BK virus (BKV) infection due to possible BKV transmission during bone marrow transplantation is not the major cause of hemorrhagic cystitis in transplanted children.

    PubMed

    Bogdanovic, G; Priftakis, P; Taemmeraes, B; Gustafsson, A; Flaegstad, T; Winiarski, J; Dalianis, T

    1998-11-01

    In allogeneic bone marrow transplanted (BMT) patients BK virus (BKV) reactivation has been associated with haemorrhagic cystitis (HC). However, it is far from obvious which patients will develop HC, since BKV, a human polyomavirus, is ubiquitious and infects children at an early age. To investigate if a primary BKV infection, as such or possibly due to transmission of BKV by the marrow graft during BMT, was correlated to the development of HC, 45 children were followed for possible BKV seroconversion and development of HC at different time points after BMT. Serum samples were collected from the 45 allogeneic BMT children and their donors before transplantation, and from the patients at 3, 6 and 12 months after BMT. These sera were analysed for the presence of specific antibodies towards BKV by hemagglutination inhibition (HAI) and by IgG- and IgM-class specific enzyme linked immunosorbent (ELISA) assays. Twelve of the 45 BMT children had a documented episode of HC or hematuria. All patients and 98% of the donors were HAI positive before BMT, while with ELISA 87% of the patients and 84% of the donors were positive. Moreover, most HC and hematuria children (11/12) were seropositive with both assays before BMT, making it impossible to investigate possible BKV transmission through the bone marrow graft during BMT by serology. Still, serological changes such as ELISA seroconversion, IgM antibodies and/or HAI titer increases were significantly (p=0.016) more common in patients with HC (58%) than without HC (24%), but these changes occured mainly after HC symptomatology had already resolved. However, there was a near significant difference (p=0.053) in BKV seroprevalence by ELISA among the donors of patients with HC or hematuria (67%) as compared to the donors (91%) of patients without HC.

  1. Modulation of left primary motor cortex excitability after bimanual training and intermittent theta burst stimulation to left dorsal premotor cortex.

    PubMed

    Neva, Jason L; Vesia, Michael; Singh, Amaya M; Staines, W Richard

    2014-03-15

    Bimanual visuomotor movement training (BMT) enhances the excitability of human preparatory premotor and primary motor (M1) cortices compared to unimanual movement. This occurs when BMT involves mirror symmetrical movements of both upper-limbs (in-phase) but not with non-symmetrical movements (anti-phase). The neural mechanisms mediating the effect of BMT is unclear, but may involve interhemispheric connections between homologous M1 representations as well as the dorsal premotor cortices (PMd). The purpose of this study is to assess how intermittent theta burst stimulation (iTBS) of the left PMd affects left M1 excitability, and the possible combined effects of iTBS to left PMd applied before a single session of BMT. Left M1 excitability was quantified using transcranial magnetic stimulation (TMS) in terms of both the amplitudes and spatial extent of motor evoked potentials (MEPs) for the extensor carpi radialis (ECR) before and multiple time points following (1) BMT, (2) iTBS to left PMd or (3) iTBS to left PMd and BMT. Although there was not a greater increase in either specific measure of M1 excitability due to the combination of the interventions, iTBS applied before BMT showed that both the spatial extent and global MEP amplitude for the ECR became larger in parallel, whereas the spatial extent was enhanced with BMT alone and global MEP amplitude was enhanced with iTBS to left PMd alone. These results suggest that the modulation of rapid functional M1 excitability associated with BMT and iTBS of the left PMd could operate under related early markers of neuro-plastic mechanisms, which may be expressed in concurrent and distinct patterns of M1 excitability. Critically, this work may guide rehabilitation training and stimulation techniques that modulate cortical excitability after brain injury. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. A Novel Health Information Technology Communication System to Increase Caregiver Activation in the Context of Hospital-Based Pediatric Hematopoietic Cell Transplantation: A Pilot Study.

    PubMed

    Maher, Molly; Hanauer, David A; Kaziunas, Elizabeth; Ackerman, Mark S; Derry, Holly; Forringer, Rachel; Miller, Kristen; O'Reilly, Dennis; An, Lawrence; Tewari, Muneesh; Choi, Sung Won

    2015-10-27

    Pediatric hematopoietic cell transplantation (HCT), commonly referred to as blood and marrow transplantation (BMT), is an intense treatment modality that requires the involvement of engaged caregivers during the patient's (child's) prolonged hospitalization. The ubiquity of electronic health records (EHRs) and a trend toward patient-centered care could allow a novel health information technology (IT) system to increase parental engagement. The paucity of research on acute care, hospital-based (inpatient) health IT applications for patients or caregivers provides an opportunity for testing the feasibility of such applications. The pediatric BMT population represents an ideal patient group to conduct an evaluation due to the lengthy inpatient stays and a heightened need for patient activation. The primary objective of this study is to assess the feasibility of implementing the BMT Roadmap in caregivers as an intervention during their child's inpatient hospitalization. The BMT Roadmap is an inpatient portal prototype optimized for tablet with a user-centered design. It integrates patient-specific laboratory and medication data from the EHR in real-time and provides support in terms of discharge goals, home care education, and other components. Feasibility will be proven if (1) the BMT Roadmap functions and can be managed by the study team without unexpected effort, (2) the system is accessed by users at a defined minimum threshold, and (3) the qualitative and quantitative research conducted provides quality data that address the perceived usefulness of the BMT Roadmap and could inform a study in a larger sample size. This will be a single-arm, nonrandomized feasibility study. We aim to enroll 10 adult caregivers (age ≥ 18 years) of pediatric patients (aged 0-25 years) undergoing autologous (self-donor) or allogeneic (alternative donor) BMT. Assenting minors (aged 10-18) will also be invited to participate. Recruitment of study participants will take place in the outpatient pediatric BMT clinic. After signing an informed consent, the research study team will provide participants with the BMT Roadmap, available on an Apple iPad, which will used throughout the inpatient hospitalization. To measure the study outcomes, approximately 6-8 semistructured qualitative interviews will be conducted periodically from pre-BMT to 100 days post-BMT and an additional 15-20 semistructured interviews will be conducted among BMT health care providers to assess perceived usefulness and usability of the system, as well as any associated workflow impacts. Quantitative survey instruments will only be administered to adult participants (age ≥ 18 years). Recruitment will begin in September 2015, and preliminary findings are expected in 2016. This protocol offers a framework for the design and analysis of a personalized health IT system that has the potential to increase patient and caregiver engagement in acute care, hospital-based contexts.

  3. Patterns of Hand Grip Strength and Detection of Strength Loss in Patients Undergoing Bone Marrow Transplantation: A Feasibility Study.

    PubMed

    Sayre, Cindy A; Belza, Basia; Shannon Dorcy, Kathleen; Phelan, Elizabeth; Whitney, JoAnne D

    2017-09-01

    To determine the feasibility of measuring hand grip strength (HGS) daily in a population of recipients of bone marrow transplantation (BMT), to describe changes in strength measured by HGS, and to describe relationships between laboratory values (hematocrit, hemoglobin, and absolute neutrophil count) and HGS.
. Prospective, longitudinal, repeated measures, within subject.
. Inpatient units at the University of Washington Medical Center in Seattle.
. 33 patients admitted in preparation for BMT or for complications from BMT.
. HGS measured on admission and daily.
. HGS, absolute neutrophil count, hemoglobin, and hematocrit.
. Participants found HGS testing to be relatively easy. Average time to complete testing was 7.2 minutes (SD = 1.95). Nineteen experienced 20% or greater decline in HGS during hospitalization, with nine experiencing decline during the conditioning phase. Age, gender, and hemoglobin correlated with HGS. Strength loss was more likely in those undergoing allogeneic compared to autologous BMT.
. A majority of patients experienced strength decline during BMT, with a subgroup declining during conditioning. A positive relationship existed between HGS and hemoglobin and hematocrit in participants admitted for conditioning for BMT.
. Weakness increases risk for falls. Patients may experience as much as 50% strength loss during the course of hospitalization for BMT. Strength loss occurs in the conditioning phase for some patients.

  4. Integrating Buprenorphine Treatment into Office-based Practice: a Qualitative Study

    PubMed Central

    Irwin, Kevin S.; Jones, Emlyn S.; Becker, William C.; Tetrault, Jeanette M.; Sullivan, Lynn E.; Hansen, Helena; O’Connor, Patrick G.; Schottenfeld, Richard S.; Fiellin, David A.

    2008-01-01

    BACKGROUND Despite the availability and demonstrated effectiveness of office-based buprenorphine maintenance treatment (BMT), the systematic examination of physicians’ attitudes towards this new medical practice has been largely neglected. OBJECTIVE To identify facilitators and barriers to the potential or actual implementation of BMT by office-based medical providers. DESIGN Qualitative study using individual and group semi-structured interviews. PARTICIPANTS Twenty-three practicing office-based physicians in New England. APPROACH Interviews were audiotaped, transcribed, and entered into a qualitative software program. The transcripts were thematically coded using the constant comparative method by a multidisciplinary team. RESULTS Eighty percent of the physicians were white; 55% were women. The mean number of years since graduating medical school was 14 (SD = 10). The primary areas of clinical specialization were internal medicine (50%), infectious disease (20%), and addiction medicine (15%). Physicians identified physician, patient, and logistical factors that would either facilitate or serve as a barrier to their integration of BMT into clinical practice. Physician facilitators included promoting continuity of patient care, positive perceptions of BMT, and viewing BMT as a positive alternative to methadone maintenance. Physician barriers included competing activities, lack of interest, and lack of expertise in addiction treatment. Physicians’ perceptions of patient-related barriers included concerns about confidentiality and cost, and low motivation for treatment. Perceived logistical barriers included lack of remuneration for BMT, limited ancillary support for physicians, not enough time, and a perceived low prevalence of opioid dependence in physicians’ practices. CONCLUSIONS Addressing physicians’ perceptions of facilitators and barriers to BMT is crucial to supporting the further expansion of BMT into primary care and office-based practices. PMID:19089500

  5. Development of a Microsimulation Model to Predict Stroke and Long-Term Mortality in Adherent and Nonadherent Medically Managed and Surgically Treated Octogenarians with Asymptomatic Significant Carotid Artery Stenosis.

    PubMed

    Luebke, Thomas; Brunkwall, Jan

    2016-08-01

    The primary study objective was to develop a microsimulation model to predict preventable first-ever and recurrent strokes and mortality for a population of medically or surgically managed octogenarians with substantial (>60%) asymptomatic carotid artery stenosis and comparing an adherent with a real-world nonadherent best medical treatment (BMT) regimen subjected to sex. A Monte Carlo microsimulation model was constructed with a 14-year time horizon and with 10,000 patients. Probabilities and values for clinical outcomes were obtained from the current literature. The stratification of the microsimulation estimates by treatment strategy within the female group of octogenarians showed a statistically significant lower stroke rate during follow-up for carotid endarterectomy (CEA) compared with nonadherent BMT (P < 0.0001) as well as compared with adherent BMT (P < 0.0001). In male octogenarians, the CEA strategy was also associated with statistically significant lower stroke rates compared with adherent and nonadherent BMT (P < 0.0001 and P < 0.0001, respectively). For each treatment strategy, female octogenarians had a statistically significant longer overall long-term survival compared with male octogenarians (P < 0.0001, respectively). In terms of stratification by sex, in octogenarian men and women, long-term survival was significantly better for adherent BMT compared with nonadherent BMT, and CEA was associated with a significant better long-term survival compared with nonadherent BMT. In the present microsimulation, in real-world drug adherence, it was likely that a strategy of early endarterectomy was beneficial in octogenarians with significant asymptomatic carotid artery disease compared with BMT alone. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Bilateral primary motor cortex circuitry is modulated due to theta burst stimulation to left dorsal premotor cortex and bimanual training.

    PubMed

    Neva, Jason L; Vesia, Michael; Singh, Amaya M; Staines, W Richard

    2015-08-27

    Motor preparatory and execution activity is enhanced after a single session of bimanual visuomotor training (BMT). Recently, we have shown that increased primary motor cortex (M1) excitability occurs when BMT involves simultaneous activation of homologous muscles and these effects are enhanced when BMT is preceded by intermittent theta burst stimulation (iTBS) to the left dorsal premotor cortex (lPMd). The neural mechanisms underlying these modulations are unclear, but may include interhemispheric interactions between homologous M1s and connectivity with premotor regions. The purpose of this study was to investigate the possible intracortical and interhemispheric modulations of the extensor carpi radials (ECR) representation in M1 bilaterally due to: (1) BMT, (2) iTBS to lPMd, and (3) iTBS to lPMd followed by BMT. This study tests three related hypotheses: (1) BMT will enhance excitability within and between M1 bilaterally, (2) iTBS to lPMd will primarily enhance left M1 (lM1) excitability, and (3) the combination of these interventions will cause a greater enhancement of bilateral M1 excitability. We used single and paired-pulse transcranial magnetic stimulation (TMS) to quantify M1 circuitry bilaterally. The results demonstrate the neural mechanisms underlying the early markers of rapid functional plasticity associated with BMT and iTBS to lPMd primarily relate to modulations of long-interval inhibitory (i.e. GABAB-mediated) circuitry within and between M1s. This work provides novel insight into the underlying neural mechanisms involved in M1 excitability changes associated with BMT and iTBS to lPMd. Critically, this work may inform rehabilitation training and stimulation techniques that modulate cortical plasticity after brain injury. Copyright © 2015. Published by Elsevier B.V.

  7. Role of transplanted bone marrow cells in development of rotator cuff muscle fatty degeneration in mice.

    PubMed

    Klomps, Lawrence V; Zomorodi, Naseem; Kim, H Mike

    2017-12-01

    Rotator cuff muscle fatty degeneration after a chronic tendon tear is an irreversible pathologic change associated with poor clinical outcomes of tendon repair, and its exact pathogenesis remains unknown. We sought to investigate the role of transplanted bone marrow cells in the development of fatty degeneration, specifically in adipocyte accumulation, using a mouse model. Fourteen mice were divided into 2 bone marrow chimeric animal groups: bone marrow transplantation (BMT) group and reverse BMT group. For the BMT group, C57BL/6J wild-type mice underwent whole body irradiation followed by BMT into the retro-orbital sinus from green fluorescent protein (GFP)-transgenic donor mice. For the reverse BMT group, GFP-transgenic mice received BMT from C57BL/6J wild-type donor mice after irradiation. The supraspinatus tendon, infraspinatus tendon, and suprascapular nerve were surgically transected 3 weeks after transplantation. The rotator cuff muscles were harvested 13 weeks after transplantation for histologic analysis and GFP immunohistochemistry. On histologic examination, both groups showed substantial fatty degeneration, fibrosis, and atrophy of the cuff muscles. The BMT group showed no noticeable GFP immunostaining, whereas the reverse BMT group showed significantly stronger GFP staining in most adipocytes (P < .001). However, both groups also showed that a small number of adipocytes originated from transplanted bone marrow cells. A small number of myocytes showed a large cytoplasmic lipid vacuole resembling adipocytes. This study's findings suggest that most adipocytes in fatty degeneration of the rotator cuff muscles originate from sources other than bone marrow-derived stem cells, and there may be more than 1 source for the adipocytes. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  8. [The blood coagulation system and microcirculatory disorders in ixodid tick-borne borreliosis caused by Borrelia miyamotoi].

    PubMed

    Platonov, A E; Sarksyan, D S; Karan, L S; Shipulin, G A; Gordygina, E V; Malinin, O V; Maleev, V V

    2015-01-01

    To study blood coagulation and microcirculatory disorders as a possible cause of transient dysfunctions of organs (the kidney, liver, heart, lung, etc.) in patients with ixodid tick-borne borreliosis caused by Borrelia miyamotoi (Bmt). SUBJECTS AND METHODS; Twenty-four patients with Lyme disease (LD) and 28 Bmt patients treated at Izhevsk City Hospital (Udmurtia) were examined in the study. Platelet counts and the presence of D-dimers were determined; activated partial thromboplastin time, prothrombin time, thrombin time, fibrinogen and antithrombin III levels, and Factor XIIa-dependent fibrin clot lysis time were measured. Slit lamp microscopy of the conjunctiva was. also carried out. Results. Platelet counts'were less than 150,000 per pL of blood in 43% of the Bmt patients. All the Bmt patients had at least one abnormal coagulation parameter of the eight ones that were tested; 64% of them had marked coagulation disorders with three or more abnormal laboratory findings. In contrast, all the eight parameters were normal in 71% of the LD patients. The other seven LD patients had only one or two abnormal coagulation parameters (p < 0.001 in comparison with Bmt patients). Microscopic examination of eye capillary blood flow revealed pathological findings that included aggregates of erythrocytes and obstructed and/or sinuous capillaries in 22 (79%) of the Bmt patients, but none of the LD patients. A total of 14 Bmt patients had both coagulation and microcirculatory abnormalities. Eleven of them also had transient signs of organ dysfunction. As far as Borrelia secrete no known toxins, we hypothesized that uncovered disorders of blood coagulation and microcirculation in Bmt patients may contribute to organ dysfunction.

  9. Relativistic ponderomotive Hamiltonian of a Dirac particle in a vacuum laser field

    DOE PAGES

    Ruiz, D. E.; Ellison, C. L.; Dodin, I. Y.

    2015-12-16

    Here, we report a point-particle ponderomotive model of a Dirac electron oscillating in a high-frequency field. Starting from the Dirac Lagrangian density, we derive a reduced phase-space Lagrangian that describes the relativistic time-averaged dynamics of such a particle in a geometrical-optics laser pulse propagating in vacuum. The pulse is allowed to have an arbitrarily large amplitude provided that radiation damping and pair production are negligible. The model captures the Bargmann-Michel-Telegdi (BMT) spin dynamics, the Stern-Gerlach spin-orbital coupling, the conventional ponderomotive forces, and the interaction with large-scale background fields (if any). Agreement with the BMT spin precession equation is shown numerically.more » The commonly known theory in which ponderomotive effects are incorporated in the particle effective mass is reproduced as a special case when the spin-orbital coupling is negligible. This model could be useful for studying laser-plasma interactions in relativistic spin-1/2 plasmas.« less

  10. Improvement in temperature dependence and dielectric tunability properties of PbZr0.52Ti0.48O3 thin films using Ba(Mg1/3Ta2/3)O3 buffer layer

    NASA Astrophysics Data System (ADS)

    Wu, Zhi; Zhou, Jing; Chen, Wen; Shen, Jie; Yang, Huimin; Zhang, Shisai; Liu, Yueli

    2016-12-01

    In this paper, Pb(Zr0.52Ti0.48)O3 (PZT) thin films were prepared via sol-gel method. The effects of Ba(Mg1/3Ta2/3)O3 (BMT) buffer layer on the temperature dependence and dielectric tunability properties of PZT thin films were studied. As the thickness of BMT buffer layer increases, the tan δ and tunability of PZT thin films decrease while tunability still maintains above 10%. This result shows that BMT buffer layer can improve the dielectric tunability properties of PZT thin films. Furthermore, the temperature coefficient of the dielectric constant decreases from 2333.4 to 906.9 ppm/°C with the thickness of BMT buffer layer increasing in the range from 25 to 205 °C, indicating that BMT buffer layer can improve the temperature stability of PZT thin films. Therefore, BMT buffer layer plays a critical role in improving temperature dependence and dielectric tunability properties of PbZr0.52Ti0.48O3 thin films.

  11. Chagas disease in bone marrow transplantation: an approach to preemptive therapy.

    PubMed

    Altclas, J; Sinagra, A; Dictar, M; Luna, C; Verón, M T; De Rissio, A M; García, M M; Salgueira, C; Riarte, A

    2005-07-01

    The efficacy of preemptive therapy was evaluated in bone marrow transplantation (BMT) recipients associated with Chagas disease (CD). The criterion to include patients in the protocol was the serological reactivity for CD in recipients and/or donors before transplant. After BMT, the monitoring was performed using the direct Strout method (SM), which detects clinical levels of Trypanosome cruzi parasitemia, and CD conventional serological tests. Monitoring took place during 60 days in ABMT and throughout the immunosuppressive period in allogeneic BMT. Reactivation of CD was diagnosed by detecting T. cruzi parasites in blood or tissues. In primary T. cruzi infection, an additional diagnostic criterion was the serological conversion. A total of 25 CD-BMT patients were included. Two ABMT and four allogeneic BMT recipients showed CD recurrences diagnosed by SM. One patient also showed skin lesions with T. cruzi amastigotes. Benznidazole treatment (Roche Lab), an antiparasitic drug, was prescribed at a dose of 5 mg/kg/day during 4-8 weeks with recovery of patients. Primary T. cruzi infection was not observed. This report proves the relevance of monitoring CD in BMT patients and demonstrates that preemptive therapy was able to abrogate the development of clinical and systemic disease.

  12. Transfusional iron burden and liver toxicity after bone marrow transplantation for acute myelogenous leukemia and hemoglobinopathies.

    PubMed

    Jastaniah, Wasil; Harmatz, Paul; Pakbaz, Zahra; Fischer, Roland; Vichinsky, Elliott; Walters, Mark C

    2008-02-01

    While it is appropriate to treat transfusional iron overload to limit end-organ injury after bone marrow transplantation (BMT) for beta-thalassemia major (TM), this approach after BMT for sickle cell disease (SCD) and hematological malignancies has not been studied. Fifteen children with SCD (n = 4), TM (n = 6), or acute myelogenous leukemia (AML, n = 5) underwent HLA-identical sibling BMT between 2000 and 2003. Prospective evaluations of iron biomarkers were performed and the three groups were compared. The pre-BMT duration and volume of RBC transfusions varied among the three groups, but baseline ferritin and liver iron concentration (LIC) were similar. In contrast, liver histology differed. Liver inflammation was present in four TM patients and portal fibrosis was observed in five TM and one SCD patient. Hepatic veno-occlusive disease (VOD) developed in 5 of 15 patients. VOD was not associated with age, ferritin, ALT, or transfusions, but an association with liver inflammation and elevated LIC was suggested. Phlebotomy was performed in five patients after BMT. Changes in LIC were minimal in non-phlebotomized patients (P = 0.02). Iron biomarkers demonstrated significant iron overload before BMT in patients with malignant and non-malignant disorders. However, iron overload was associated with liver inflammation and VOD primarily in TM patients. The clinical significance of iron overload in patients after BMT remains uncertain, but this is the first study to suggest that VOD may be associated with transfusional iron burden. (c) 2007 Wiley-Liss, Inc.

  13. Physical therapy for patients after bone marrow transplantation.

    PubMed

    James, M C

    1987-06-01

    The purpose of this article is to provide an overview of bone marrow transplantation (BMT) as it relates to the practice of physical therapy based on experiences at a cancer research center. This overview includes information on the diseases treated with BMT, patient treatment regimens during hospitalization, and complications commonly encountered. Physical therapy guidelines are suggested for the evaluation of and therapeutic intervention for patients after BMT.

  14. VLT spectroscopic observations of highly magnified Galactic Disk microlensing event Gaia18bmt

    NASA Astrophysics Data System (ADS)

    Wyrzykowski, L.; Gromadzki, M.; Kruszynska, K.; Rybicki, K. A.; Zielinski, P.

    2018-06-01

    Gaia18bmt (Ra, Dec = 14:16:03.55, -56:54:48.24) was found by Gaia Science Alerts programme on 2018-06-11 (http://gsaweb.ast.cam.ac.uk/alerts/alert/Gaia18bmt/) as a significant brigthening by more than 2 mag on a 15.5 mag star in the Galactic Disk (l,b = 314.32362, 4.07498).

  15. Navigating Survival: Quality of Life Following Bone Marrow Transplantation.

    DTIC Science & Technology

    1991-01-01

    This study explored the quality of life of adult Bone Marrow Transplantation (BMT) survivors and processes involved in maintaining or enhancing life...quality were identified. Ground theory methodology was used to explore quality of life from the survivor’s perspective. Five adults, 87 to 578 days...processes employed by BMT survivors to manage quality of life disruptions. BMT survivors identified disruptions in quality of life during the rapid

  16. Donor cell-derived leukemia after cord blood transplantation and a review of the literature: differences between cord blood and BM as the transplant source.

    PubMed

    Shiozaki, H; Yoshinaga, K; Kondo, T; Imai, Y; Shiseki, M; Mori, N; Teramura, M; Motoji, T

    2014-01-01

    Donor cell-derived leukemia (DCL) is a rare complication of SCT. Here, we present a case of DCL following cord blood transplantation (CBT) and review the clinical features of previously reported DCL. To our knowledge, this is the first report comparing clinical characteristics of DCL from the standpoint of the transplant source, with umbilical cord blood and BM. AML and myelodysplastic syndrome (MDS) were recognized more frequently in DCL after CBT, whereas the incidence of AML and ALL was similar after BMT. The median duration between the occurrence of DCL following CBT and BMT was 14.5 and 36 months, respectively. DCL occurred in a significantly shorter period after CBT than after BMT. Abnormal karyotypes involving chromosome 7 were observed in 52.4% of CBT recipients and 17.3% of BMT recipients; this was a statistically significant difference. Particularly, the frequency of monosomy 7 was significantly higher in DCL after CBT than after BMT. The types of abnormal karyotypes in DCL following BMT were similar to those characteristically observed in adult de novo AML and MDS. DCL patients generally have a poor prognosis in both groups. SCT is the best treatment for curing DCL. DCL appears to have different clinical features according to the transplant source.

  17. Monitoring of polyomavirus BK viruria in bone marrow transplantation patients by DNA hybridization assay and by polymerase chain reaction: an approach to assess the relationship between BK viruria and hemorrhagic cystitis.

    PubMed

    Azzi, A; Fanci, R; Bosi, A; Ciappi, S; Zakrzewska, K; de Santis, R; Laszlo, D; Guidi, S; Saccardi, R; Vannucchi, A M

    1994-08-01

    An association between long-lasting hemorrhagic cystitis (HC) in bone marrow transplantation (BMT) patients and viral infections, mostly with reactivation of the human polyomavirus BK (BKV), is suggested by several previous reports. We have carried out a prospective study in 55 (30 allogeneic, 24 autologous, 1 syngeneic) BMT recipients with the aim of evaluating the role of BKV in this frequent complication after BMT. To overcome the well known difficulties in BK virus isolation in cell cultures, a DNA hybridization assay and the polymerase chain reaction (PCR) were used for the detection and monitoring of viral urinary shedding, respectively. The presence of human polyomavirus JC and adenovirus DNA was also sought in urine specimens. BK viruria was demonstrated in 52.7% of patients (in 53.3% allogeneic and in 54.1% autologous BMT), whereas JCV and adenovirus were seldom present. Seven cases of HC (20% in allogeneic and 4% in autologous BMT) occurred and in all cases the clinical event was associated with BKV urinary shedding. This study suggests that BKV infection alone does not invariably lead to HC in BMT patients; for HC to occur the presence of other, at present unidentified, factors seems to be necessary.

  18. BKV infection and hemorrhagic cystitis after allogeneic bone marrow transplant.

    PubMed

    Fioriti, D; Degener, A M; Mischitelli, M; Videtta, M; Arancio, A; Sica, S; Sora, F; Pietropaolo, V

    2005-01-01

    Hemorrhagic cystitis (HC) is a well-known complication after allogeneic bone marrow transplant (BMT) and can be related to adenovirus or human polyomavirus BK (BKV) infections. In this study a group of 20 patients after allogeneic BMT has been examined. BMT urine samples were analysed for the presence of Adenovirus and BKV DNAby means of polymerase chain reaction (PCR). 5/20 BMT patients developed HC after BMT. The presence of BKV DNA in urine samples was evident in 3/15 patients without HC and in 5/5 patients with HC. In 2/5 HC-patients the BKV DNA was not found after therapy with Cidofovir and Ribavirin. The search for adenovirus DNA in all samples was negative. The analysis of BKV non-coding control region (NCCR) isolated from urine samples revealed a structure very similar to the archetype in all samples. The RFLP (Restriction Fragment Length Polymorphism assay) showed the presence of BKV subtypes I and IV, with the prevalence of subtype I (4/5). This study supports the hypothesis that HC is mainly related to BKV rather than to adenovirus infection in BMT patients. Moreover, since BKV subtype I was predominant, it is reasonable to hypothesize that a specific BKV subtype could be associated with the development of HC.

  19. Domain wall and interphase boundary motion in (1-x)Bi(Mg 0.5 Ti 0.5 )O 3 –xPbTiO 3 near the morphotropic phase boundary

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

    Tutuncu, Goknur; Chen, Jun; Fan, Longlong

    Electric field-induced changes in the domain wall motion of (1-x)Bi(Mg 0.5Ti 0.5)O 3–xPbTiO 3 (BMT-xPT) near the morphotropic phase boundary (MPB) where x = 0.37 (BMT-37PT) and x =0.38 (BMT-38PT), are studied by means of synchrotron x-ray diffraction. Through Rietveld analysis and profile fitting, a mixture of coexisting monoclinic (Cm) and tetragonal (P4mm) phases is identified at room temperature. Extrinsic contributions to the property coefficients are evident from electric-field-induced domain wall motion in both the tetragonal and monoclinic phases, as well as through the interphase boundary motion between the two phases. Domain wall motion in the tetragonal and monoclinic phasesmore » for BMT-37PT is larger than that of BMT-38PT, possibly due to this composition's closer proximity to the MPB. Increased interphase boundary motion was also observed in BMT-37PT. Lattice strain, which is a function of both intrinsic piezoelectric strain and elastic interactions of the grains (the latter originating from domain wall and interphase boundary motion), is similar for the respective tetragonal and monoclinic phases.« less

  20. Hematopoietic stem cell transplantation for acquired aplastic anemia

    PubMed Central

    Georges, George E.; Storb, Rainer

    2016-01-01

    Purpose of review There has been steady improvement in outcomes with allogeneic bone marrow transplantation (BMT) for severe aplastic anemia (SAA), due to progress in optimization of the conditioning regimens, donor hematopoietic cell source and supportive care. Here we review recently published data that highlight the improvements and current issues in the treatment of SAA. Recent findings Approximately one-third of AA patients treated with immune suppression therapy (IST) have acquired mutations in myeloid cancer candidate genes. Because of the greater probability for eventual failure of IST, human leukocyte antigen (HLA)-matched sibling donor BMT is the first-line of treatment for SAA. HLA-matched unrelated donor (URD) BMT is generally recommended for patients who have failed IST. However, in younger patients for whom a 10/10-HLA-allele matched URD can be rapidly identified, there is a strong rationale to proceed with URD BMT as first-line therapy. HLA-haploidentical BMT using post-transplant cyclophosphamide (PT-CY) conditioning regimens, is now a reasonable second-line treatment for patients who failed IST. Summary Improved outcomes have led to an increased first-line role of BMT for treatment of SAA. The optimal cell source from an HLA-matched donor is bone marrow. Additional studies are needed to determine the optimal conditioning regimen for HLA-haploidentical donors. PMID:27607445

  1. Bone marrow transplantation alters lung antigen presenting cells to promote TH17 response and the development of pneumonitis and fibrosis following gammaherpesvirus infection

    PubMed Central

    Zhou, Xiaofeng; Loomis-King, Hillary; Gurczynski, Stephen J.; Wilke, Carol A.; Konopka, Kristine E.; Ptaschinski, Catherine; Coomes, Stephanie M; Iwakura, Yoichiro; van Dyk, Linda F.; Lukacs, Nicholas W.; Moore, Bethany B.

    2015-01-01

    Hematopoietic stem cell transplantation (HSCT) efficacy is limited by numerous pulmonary complications. We developed a model of syngeneic bone marrow transplant (BMT) followed by infection with murine gamma herpesvirus (γHV-68) that results in pneumonitis and fibrosis and mimics human “non-infectious” HSCT complications. BMT mice experience increased early lytic replication, but establish viral latency by 21 days post infection (dpi). CD4 T cells in BMT mice are skewed towards IL-17A rather than IFN-γ production. Transplantation of bone marrow from Il-17a−/− donors or treatment with anti-IL-17A neutralization antibodies at late stages attenuates pneumonitis and fibrosis in infected BMT mice, suggesting that hematopoietic-derived IL-17A is essential for development of pathology. IL-17A directly influences activation and extracellular matrix production by lung mesenchymal cells. Lung CD11c+ cells of BMT mice secrete more TGF-β1, and pro-TH17 mRNAs for IL-23 and IL-6, and less TH1-promoting cytokine mRNA for IFN-γ but slightly more IL-12 mRNA in response to viral infection. Adoptive transfer of non-BMT lung CD11c-enriched cells restores robust TH1 response and suppresses aberrant TH17 response in BMT mice to improve lung pathology. Our data suggest “non-infectious” HSCT lung complications may reflect preceding viral infections and demonstrate that IL-17A neutralization may offer therapeutic advantage even after disease onset. PMID:26376362

  2. Angioinvasive pulmonary aspergillosis after allogeneic bone marrow transplantation: clinical and high-resolution computed tomography findings in 12 cases.

    PubMed

    Gasparetto, Emerson L; Souza, Carolina A; Tazoniero, Priscilla; Davaus, Taisa; Escuissato, Dante L; Marchiori, Edson

    2007-02-01

    The aim of this study was to present the clinical and high-resolution CT scan findings of angioinvasive pulmonary aspergillosis (APA) in 12 patients who underwent allogeneic bone marrow transplantation (BMT). The CT scans were reviewed by three chest radiologists who assessed the pattern and distribution of findings by consent. There were 7 (58%) female and 5 (42%) male patients, with aging between 5 and 50 years (average of 26 years). All patients were submitted to BMT for the treatment of hematological conditions. The diagnosis of APA was defined between 5 and 373 days after BMT, with average of 111 days. Three cases (25%) were diagnosed in the neutropenic phase after the BMT, five (42%) in the early phase and four patients in the late phase post-BMT. Regarding high-resolution CT (HRCT) scan findings, nodules were found in 75% of the cases (9/12), most of the cases with more than 10 lesions (7/9) and of centrilobular localization (6/9). Consolidations were identified in seven patients (58%), being single in six, and commonly presenting ill defined borders (n=3) and subsegmental localization (n=5). Ground glass attenuation was found in six patients (50%). The halo sign was observed in nine cases (75%). Cavitations were seen in two air-space consolidations and one large nodule (2.5 cm). Patients submitted to BMT presenting respiratory symptoms and nodules or consolidations with halo sign at HRCT scan need to have the diagnosis of angioinvasive pulmonary aspergillosis included in all the post BMT phases.

  3. Living with the unknown: Posttraumatic stress disorder in pediatric bone marrow transplantation survivors and their mothers.

    PubMed

    Taskıran, Gülseren; Sürer Adanır, Aslı; Özatalay, Esin

    2016-04-01

    Bone marrow transplantation (BMT) is used to treat children with various hematologic, oncologic, and metabolic diseases. Although the treatment can be lifesaving, it is also physically and psychologically demanding for both the child and caregivers. In previous studies, BMT is found to be related with anxiety, posttraumatic stress disorder (PTSD), depression, and psychosocial problems both in children and parents. The aim of this study was to investigate PTSD in pediatric BMT survivors and their mothers compared with the healthy controls. Twenty-seven BMT survivors and their mothers and 28 healthy peers and their mothers were recruited as the study group and as the comparison group, respectively. All children were interviewed using Child Posttraumatic Stress Disorder-Reaction Index (CPTSD-RI) for assessing posttraumatic stress responses. As for mothers, Clinician-Administered PTSD Scale (CAPS) was used. In healthy children and mothers, instead of BMT, the most important traumatic event reported by them was included. All data were analyzed by a neutral statistician from the Department of Biostatistics of the university. The BMT group, both children and mothers, obtained significantly higher PTSD rates than the control group (66.5% and 17.8%, respectively, in children; 57.6% and 7%, respectively, in mothers). However, there was a weak correlation between survivors' and mothers' posttraumatic stress responses. These findings suggest that BMT is a significant stressor for both children and mothers. Clinicians should be aware of psychiatric symptoms of children who underwent such a life-threatening condition. Combination of medical treatment with psychosocial support is imperative.

  4. Translation and validation of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) version 4 quality of life instrument into Arabic language.

    PubMed

    Soudy, Hussein; Maghfoor, Irfan; Elhassan, Tusneem Ahmed M; Abdullah, Eman; Rauf, Shahzad M; Al Zahrani, Ahmed; Akhtar, Saad

    2018-03-12

    Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) has been translated from English into several languages. Currently, there is no validated translation of FACT-BMT in Arabic. Here, we are reporting the first Arabic translation and validation of the FACT-BMT. The study was approved by the Institutional Research Advisory Council. The Arabic translation followed the standard Functional Assessment of Chronic Illness Therapy (FACIT.org) translation methodology (with permission). Arabic FACT-BMT (50- items) was statistically validated. Cronbach's alpha for internal consistency, Spearman's rank correlation coefficients method for Inter-scale correlations and Principal Component Analysis for factorial construct validity was used. One hundred and eight consecutive relapsed /refractory lymphoma patients who underwent high dose chemotherapy and autologous stem cell transplant were enrolled. There were 68 males (63%) and 40 females (37%) with a median age of 29 years (range 14-62). After Arabic questionnaire pre-testing (Cronbach's alpha 0.744), the study included 108 patients. Cronbach's alpha for the entire FACT-BMT indicated an excellent internal consistency (0.90); range (0.67 to 0.91). Cronbach's alpha for sub-groups of social (0.78), emotional (0.67) and functional wellbeing was (0.88). Cronbach's alpha for bone marrow transplant (0.81), FACT-General (0.89), and FACT- Trial Outcome Index (TOI); (0.91) also revealed excellent internal consistency. Patients had high scores in all domains of quality of life, indicating that most patients were leading a normal life. This translation of FACT-BMT in Arabic was reviewed and approved for submission by the FACIT.org. Our data reports the first translated, validated and approved Arabic version of FACT-BMT. This will help large numbers of Arabic speaking patients undergoing stem cell/bone marrow transplantation, across the globe.

  5. Physical Performance and Attrition Among U.S. Air Force Trainees Participating in the Basic Military Training Fueling Initiative.

    PubMed

    Bartlett, Carrissa G; Stankorb, Susan

    2017-01-01

    Dietary intake of military initial entry trainees is often inadequate because of the structured food environment, lack of snacking, and limited time for meals. Inadequate intake during training increases risk for injury, poor performance, and attrition from training. A performance nutrition initiative was implemented at Joint Base San Antonio Lackland to mitigate this inadequacy in Air Force trainees and better reflect recommendations for active populations and mitigate nutritional inadequacy. Trainees (N = 867) in two squadrons either received a nutrition bar before bed (snack squadron n = 423) or did not (standard squadron n = 444). This study retrospectively compared trainees' attrition and fitness measures as recorded in the Basic Military Training (BMT) Surveillance database. Both groups had similar rates of attrition and graduation at the end of 8 weeks (p = 0.23). At the start of training, only one out of four trainees in either Squadron passed the Physical Fitness Assessment (PFA). Although both squadrons' fitness measures improved as a result of the effects of training, the snack squadron had a significantly greater percent improvement in all PFA categories (p < 0.001), as represented by improved muscular fitness measures (p < 0.001), decreased median run time (p = 0.001), and greater improvement in scaled run scores (p = 0.013) as compared to the standard squadron. Those who received the snack were 1.62 (confidence interval: 1.2-2.2) times more likely to pass the PFA at 4 weeks than those who did not receive the snack. This study shows that military trainees' fitness improves with a modest nutritional supplement and suggests that optimizing overall nutrition benefits trainees. Attrition from BMT costs the U.S. Air Force up to $22,000 per trainee lost. In contrast, a trainee could receive one nutrition bar per day during BMT for $34. As the nutrition bar initiative improves fitness as well as costs less than recruiting and medically treating trainees whom ultimately attrite from training, the snack intervention was beneficial. Future studies of strategic nutrition interventions in military training populations can help trainees to better meet their macronutrient and micronutrient needs and further optimize training performance. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  6. Clinical management of aplastic anemia

    PubMed Central

    DeZern, Amy E; Brodsky, Robert A

    2011-01-01

    Acquired aplastic anemia is a potentially fatal bone marrow failure disorder that is characterized by pancytopenia and a hypocellular bone marrow. Hematopoietic stem-cell transplantation or bone marrow transplantation (BMT) is the treatment of choice for young patients who have a matched sibling donor. Immunosuppression with either anti-thymocyte globulin and cyclosporine or high-dose cyclophosphamide is an effective therapy for patients who are not suitable BMT candidates owing to age or lack of a suitable donor. Results of BMT from unrelated and mismatched donors are improving, but presently this treatment option is best reserved for those patients who do not respond, relapse or develop secondary clonal disorders following immunosuppressive therapy. Efforts are currently underway to both improve immunosuppressive regimens and to expand the application of BMT. PMID:21495931

  7. Anabolic Adaptations Occur in Conscripts During Basic Military Training Despite High Prevalence of Vitamin D Deficiency and Decrease in Iron Status.

    PubMed

    Ööpik, Vahur; Timpmann, Saima; Rips, Leho; Olveti, Indrek; Kõiv, Kersti; Mooses, Martin; Mölder, Hanno; Varblane, Ahti; Lille, Hele-Reet; Gapeyeva, Helena

    2017-03-01

    In Estonian Defense Forces that are drawn up on the basis of the conscription model considerable numbers of young men are prematurely discharged from military service for medical reasons, but causes leading to premature dropout of conscripts have not been systematically studied. However, one of the factors involved could be relatively demanding physical training that starts at the beginning of military service in the form of basic military training (BMT). Cumulative training and nontraining stresses experienced by conscripts during BMT may exceed their physiological adaptability and increase the probability of becoming prematurely discharged. Therefore, the primary purpose of this study was to assess physiological responses to 10-week BMT in Estonian conscripts. The protocol of the study confirmed to the standards set by the Declaration of Helsinki and it was approved by the Research Ethics Committee of the University of Tartu. Mean ± SD age and body mass index of 94 conscripts studied was 20.9 ± 1.7 years and 24.2 ± 3.0 kg · m -2 , respectively. Fasting venous blood analysis was performed four times during BMT (October to December) and once 15 weeks after the end of BMT (in March). One-factor (time) repeated measures analysis of variance was used to evaluate the differences within the variables. Statistical significance was set at p < 0.05. Where a significant main effect was observed, Tukey's honesty significant difference post-hoc analysis was used to locate differences between the means. A Pearson product moment coefficient of correlation (r) with α level set at 0.05 was applied to determine the relationship between variables. Significant increases in serum testosterone concentration (60.6%), testosterone to cortisol ratio (61.1%), blood erythrocyte count (4.3%), hemoglobin concentration (3.8%) and hematocrit (2.2%), and decrease in serum ferritin concentration (39.3%) occurred between weeks 1 and 10 during BMT (in all cases p < 0.0001). Fifteen weeks later, these parameters were still at increased or decreased levels, respectively, compared to week 1. The prevalence of vitamin D deficiency (serum 25(OH) D concentration <50 nmol · L -1 ) increased from 42.6% in week 1 to 80.8% in week 10 and to 91.5% 15 weeks later. Serum 25(OH)D levels did not correlate with testosterone concentrations (r = 0.062, p = 0.552 in Wk-1 and r = -0.079, p = 0.448 in Wk-25). These findings suggest that BMT induces anabolic physiological adaptations in conscripts despite vitamin D deficiency and decrease in iron status. However, high prevalence of vitamin D deficiency and decline in iron status may limit physiological adaptations and improvement in physical work capacity to a suboptimal level. Furthermore, as vitamin D influences a variety of functions important for health, deficiency in conscripts should be considered a major concern that needs treatment. An acknowledged limitation of the study is the lack of a control group of conscripts possessing normal vitamin D status and stable serum ferritin levels throughout the study period. Nevertheless, the research design employed enabled to determine two factors that potentially limit physiological adaptability of conscripts to military training loads in ecologically authentic environment. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  8. Mental state and its psychophysical conditions in patients with acute leukaemia treated with bone marrow transplantation.

    PubMed

    Warchala, Anna; Wojtyna, Ewa; Krysta, Krzysztof

    2015-09-01

    Acute leukaemia and bone marrow transplantation (BMT) as a method of its treatment are great psychological stressors, which are responsible for anxiety and depression in the group of patients. The aim of the study was to assess the patients' mental state and its psychophysical predictors before and after BMT. The study was of a longitudinal and self-descriptive character. The questionnaires: LOT-R, AIS, Mini-Mac, CECS, RSCL and HADS were filled by 60 patients with acute leukaemia before and after BMT. There were no essential statistical differences between the severity of anxiety and depression before and after BMT but the pattern and the power of various mental state predictors changed in the course of the hospitalization. Anxiety before transplantation was greater when the psychological stress and the strategy of "anxious preoccupation" were stronger and the strategy of "fighting spirit" and the level of generalized optimism were weaker. The factors explained 51% variations of anxiety before transplantation. After BMT 77% variations of anxiety were explained, which were associated with a high level of distress at the end of the hospitalization, higher level of anxiety before transplantation, weaker strategy of "fighting spirit" before transplantation and stronger strategy of "anxious preoccupation" after BMT. Before transplantation 36% variations of depression were explained and estimated as weaker "fighting spirit" and worse "global life quality". The essential predictors of depressive symptoms after transplantation, explained by 81% variations of depression, were weaker "fighting spirit" before transplantation, stronger "anxious preoccupation" after transplantation, worse "global life quality" after transplantation and higher level of anxious and depressive symptoms on admission to hospital. The psychological and pharmacological interventions, which reduce anxiety, depression and "anxious preoccupation" as well as enhance "fighting spirit", should be introduced before BMT to improve the patients' mental state.

  9. What They Want: Inclusion of Blood and Marrow Transplantation Survivor Preference in the Development of Models of Care for Long-Term Health in Sydney, Australia.

    PubMed

    Dyer, Gemma; Gilroy, Nicole; Brown, Louisa; Hogg, Megan; Brice, Lisa; Kabir, Masura; Greenwood, Matt; Larsen, Stephen R; Moore, John; Hertzberg, Mark; Kwan, John; Huang, Gillian; Tan, Jeff; Ward, Christopher; Kerridge, Ian

    2016-04-01

    Four hundred forty-one adult allogeneic blood and marrow transplantation (BMT) survivors participated in a cross-sectional survey to assess long-term follow-up (LTFU) model of care preference. Survey instruments included the Sydney Post BMT Survey, Functional Assessment of Cancer Therapy-BMT, Depression Anxiety Stress Scales 21, the Chronic GVHD Activity Assessment-Patient Self Report (Form B), the Lee Chronic GVHD Symptom Scale and the Post-Traumatic Growth Inventory. We found most BMT survivors (74%) would prefer LTFU with their transplantation physicians alone or in combination with transplantation center-linked services (satellite clinics or telemedicine) Over one-quarter indicated a preference for receiving comprehensive post-transplantation care in a "satellite" clinic staffed by their BMT team situated closer to their place of residence, with higher income, higher educational level, and sexual morbidity being significant social factors influencing this preference. Regular exercise was reported less often in those who preferred telemedicine, which may reflect reduced mobility. The factor most strongly associated with a preference for transplantation center follow-up was the severity of chronic graft-versus-host disease. Full- and part-time work were negatively associated with transplantation center follow-up, possibly implying decreased dependency on the center and some return to normalcy. This study is the first to explore the preferences of BMT survivors for long-term post-transplantation care. These data provides the basis for LTFU model of care development and health service reform consistent with the preferences of BMT survivors. Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  10. Masks for prevention of respiratory viruses on the BMT unit: results of a quality initiative.

    PubMed

    Sokol, Kelsey A; De la Vega-Diaz, Imelda; Edmondson-Martin, Kathleen; Kim, Sara; Tindle, Sharon; Wallach, Fran; Steinberg, Amir

    2016-12-01

    Respiratory viral infections (RVI) cause significant morbidity and mortality in hospitalized oncology patients. These viruses are easily spread from asymptomatic and/or symptomatic healthcare workers and visitors to immunocompromised patients, and literature review of facemasks for prevention of infection revealed mixed results. The Bone Marrow Transplant (BMT) Quality Assurance (QA) Committee at Mount Sinai began a surgical mask initiative on the BMT unit. The purpose of our initiative was to assess the impact of surgical mask implementation for healthcare workers and visitors on nosocomial RVI in all patients hospitalized on the BMT unit. We hypothesized that implementing surgical masks would reduce the number of hospital-acquired RVI. We performed a retrospective study involving all patients with malignancy hospitalized on the BMT unit for 4 years. During the latter 2 years, all healthcare workers and visitors were required to wear a surgical mask in every patient room on the BMT unit. Primary endpoint was incidence of RVI after implementation of surgical masks. The 2-year incidence of RVI in the pre-mask period was 14 out of a total of 15 001 patient days on the unit vs 2 out of 15 608 patient days after mask implementation. The difference in incidence of RVI within the two time intervals was noted to be statistically significant (P<.05, 2-proportion z-test). Our quality initiative demonstrated that surgical masks are an infection control modality that may provide benefit to oncology/BMT units by decreasing the risk for hospital-acquired RVI. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. HLA matching in unrelated donor bone marrow transplantation.

    PubMed

    Charron, D J

    1996-11-01

    The availability of an HLA-matched sibling donor in only 30% to 35% of patients requiring allogeneic bone marrow transplantation (BMT) has led to the proposal of unrelated donors as an alternative source of bone marrow. The greater HLA incompatibility, which, although present, was undetected until recently in many unrelated donor BMT cases, has resulted in a higher rate of posttransplant complications and impaired acturial survival when compared with HLA-matched sibling BMT. Molecular HLA typing enables us to evaluate the impact of incompatibility at each locus in the outcome of unrelated donor BMT. The overall retrospective data would recommend that HLA-A, -B and -C allelic molecular matching should be implemented in addition to HLA-DR allelic matching. Further retrospective analysis is needed in order to assess which incompatibility or combinations are better tolerated than others. Only the definitive knowledge at the sequence level of the donor and the recipient HLA allelic diversity involved in controlling the allogeneic immune response will allow us to understand the precise biologic rationale of the graft-versus-host disease. Knowledge and control of the HLA incompatibilities should allow us to offset the detrimental effects of histoincompatibility while developing strategies to take advantage of the beneficial graft-versus-leukemia effect. Also the role of minor histocompatibility antigens remains largely unknown and will require careful evaluation before minor antigens can be used as a selection criterion in BMT. Carefully designed prospective studies will enable us to test the impact of each HLA locus. HLA typing and BMT represent a successful example of productive cooperation between basic and clinical sciences that should be pursued for the improvement of the clinical outcome of unrelated donor BMT.

  12. Screening for Asymptomatic Clostridium difficile Among Bone Marrow Transplant Patients: A Mixed-Methods Study of Intervention Effectiveness and Feasibility.

    PubMed

    Barker, Anna K; Krasity, Benjamin; Musuuza, Jackson; Safdar, Nasia

    2018-02-01

    OBJECTIVE To identify facilitators and barriers to implementation of a Clostridium difficile screening intervention among bone marrow transplant (BMT) patients and to evaluate the clinical effectiveness of the intervention on the rate of hospital-onset C. difficile infection (HO-CDI). DESIGN Before-and-after trial SETTING A 505-bed tertiary-care medical center PARTICIPANTS All 5,357 patients admitted to the BMT and general medicine wards from January 2014 to February 2017 were included in the study. Interview participants included 3 physicians, 4 nurses, and 4 administrators. INTERVENTION All BMT patients were screened within 48 hours of admission. Colonized patients, as defined by a C. difficile-positive polymerase chain reaction (PCR) stool result, were placed under contact precautions for the duration of their hospital stay. METHODS Interview responses were coded according to the Systems Engineering Initiative for Patient Safety conceptual framework. We compared pre- and postintervention HO-CDI rates on BMT and general internal medicine units using time-series analysis. RESULTS Stakeholder engagement, at both the person and organizational level, facilitates standardization and optimization of intervention protocols. While the screening intervention was generally well received, tools and technology were sources of concern. The mean incidence of HO-CDI decreased on the BMT service postintervention (P<.0001). However, the effect of the change in the trend postintervention was not significantly different on BMT compared to the control wards (P=.93). CONCLUSIONS We report the first mixed-methods study to evaluate a C. difficile screening intervention among the BMT population. The positive nature by which the intervention was received by front-line clinical staff, laboratory staff, and administrators is promising for future implementation studies. Infect Control Hosp Epidemiol 2018;39:177-185.

  13. Replication and validation of genetic polymorphisms associated with survival after allogeneic blood or marrow transplant

    PubMed Central

    Karaesmen, Ezgi; Rizvi, Abbas A.; Preus, Leah M.; McCarthy, Philip L.; Pasquini, Marcelo C.; Onel, Kenan; Zhu, Xiaochun; Spellman, Stephen; Haiman, Christopher A.; Stram, Daniel O.; Pooler, Loreall; Sheng, Xin; Zhu, Qianqian; Yan, Li; Liu, Qian; Hu, Qiang; Webb, Amy; Brock, Guy; Clay-Gilmour, Alyssa I.; Battaglia, Sebastiano; Tritchler, David; Liu, Song; Hahn, Theresa

    2017-01-01

    Multiple candidate gene-association studies of non-HLA single-nucleotide polymorphisms (SNPs) and outcomes after blood or marrow transplant (BMT) have been conducted. We identified 70 publications reporting 45 SNPs in 36 genes significantly associated with disease-related mortality, progression-free survival, transplant-related mortality, and/or overall survival after BMT. Replication and validation of these SNP associations were performed using DISCOVeRY-BMT (Determining the Influence of Susceptibility COnveying Variants Related to one-Year mortality after BMT), a well-powered genome-wide association study consisting of 2 cohorts, totaling 2888 BMT recipients with acute myeloid leukemia, acute lymphoblastic leukemia, or myelodysplastic syndrome, and their HLA-matched unrelated donors, reported to the Center for International Blood and Marrow Transplant Research. Gene-based tests were used to assess the aggregate effect of SNPs on outcome. None of the previously reported significant SNPs replicated at P < .05 in DISCOVeRY-BMT. Validation analyses showed association with one previously reported donor SNP at P < .05 and survival; more associations would be anticipated by chance alone. No gene-based tests were significant at P < .05. Functional annotation with publicly available data shows these candidate SNPs most likely do not have biochemical function; only 13% of candidate SNPs correlate with gene expression or are predicted to impact transcription factor binding. Of these, half do not impact the candidate gene of interest; the other half correlate with expression of multiple genes. These findings emphasize the peril of pursing candidate approaches and the importance of adequately powered tests of unbiased genome-wide associations with BMT clinical outcomes given the ultimate goal of improving patient outcomes. PMID:28811306

  14. Population Based Analysis of Hematologic Malignancy Referrals to a Comprehensive Cancer Center, Referrals for Blood and Marrow Transplantation, and Participation in Clinical Trials, Survey and Biospecimen Research by Race

    PubMed Central

    Clay, Alyssa; Peoples, Brittany; Zhang, Yali; Moysich, Kirsten; Ross, Levi; McCarthy, Philip; Hahn, Theresa

    2017-01-01

    Racial and ethnic disparities have been reported in clinical trial/research participation, utilization of autologous and allogeneic BMT and availability of allogeneic donors. We performed a population-based cohort study to investigate adult hematologic malignancy referrals to a U.S tertiary cancer center, utilization of BMT and participation in clinical trials, survey and biospecimen research, by race. U.S. Census Data and the New York State Public Access Cancer Epidemiology Database identified the racial distribution of the general population and new hematologic malignancy cases in the primary catchment area. From 2005–2011, 1,106 patients aged 18–75 years were referred for BMT consultation; while the rate of BMT among hematologic malignancy referrals did not differ by race, the reasons for not receiving a BMT did. Participation in biospecimen research did not vary by race, however African-Americans and other minorities were significantly less likely to participate in survey research than European-Americans. While rates of hematologic malignancy referrals and use of BMT for minorities appear low (<10%), they closely reflect the race distribution of all hematologic malignancy cases and the Western New York population. African-Americans are equally likely as other races to participate in biospecimen banking, but further study is needed to understand reasons for lower participation in survey research. PMID:25899454

  15. Domain wall and interphase boundary motion in (1−x)Bi(Mg{sub 0.5}Ti{sub 0.5})O{sub 3}–xPbTiO{sub 3} near the morphotropic phase boundary

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

    Tutuncu, Goknur; Chen, Jun; Fan, Longlong

    Electric field-induced changes in the domain wall motion of (1−x)Bi(Mg{sub 0.5}Ti{sub 0.5})O{sub 3}–xPbTiO{sub 3} (BMT-xPT) near the morphotropic phase boundary (MPB) where x = 0.37 (BMT-37PT) and x = 0.38 (BMT-38PT), are studied by means of synchrotron x-ray diffraction. Through Rietveld analysis and profile fitting, a mixture of coexisting monoclinic (Cm) and tetragonal (P4mm) phases is identified at room temperature. Extrinsic contributions to the property coefficients are evident from electric-field-induced domain wall motion in both the tetragonal and monoclinic phases, as well as through the interphase boundary motion between the two phases. Domain wall motion in the tetragonal and monoclinic phases for BMT-37PT ismore » larger than that of BMT-38PT, possibly due to this composition's closer proximity to the MPB. Increased interphase boundary motion was also observed in BMT-37PT. Lattice strain, which is a function of both intrinsic piezoelectric strain and elastic interactions of the grains (the latter originating from domain wall and interphase boundary motion), is similar for the respective tetragonal and monoclinic phases.« less

  16. Successful pregnancy following very high-dose total body irradiation (1575 cGy) and bone marrow transplantation in a woman with acute myeloid leukemia.

    PubMed

    Wang, W S; Tzeng, C H; Hsieh, R K; Chiou, T J; Liu, J H; Yen, C C; Chen, P M

    1998-02-01

    A 22-year-old woman had a normal full-term delivery 6 years after a successful allogeneic bone marrow transplantation (BMT) for acute myeloid leukemia (AML). Conditioning therapy consisted of cyclophosphamide (120 mg/kg) and total body irradiation (TBI) to a total of 1575 cGy in seven fractions (225 cGy x 7, at a dose rate of 3.5 cGy/min). Graft-versus-host disease prophylaxis was with methotrexate and cyclosporin A. Grade I acute GVHD developed after BMT but there was no chronic GVHD. She became amenorrhoeic after BMT and serial gonadal testing indicated hypergonadotrophic hypogonadism. She became pregnant and delivered a full-term, healthy baby 6 years after BMT. Successful pregnancy after TBI of more than 1200 cGy is extremely rare. This case, to the best of our knowledge, is the second patient who received a higher dose of TBI (1575 cGy) to have a successful pregnancy. This and previous reports indicate that normal pregnancy is possible after BMT with TBI in excess of 1200 cGy.

  17. Enhanced anandamide signaling reduces flight behavior elicited by an approaching robo-beetle.

    PubMed

    Heinz, Daniel E; Genewsky, Andreas; Wotjak, Carsten T

    2017-11-01

    Our current knowledge of the implications of endocannabinoids in fear and anxiety is largely based on fear conditioning paradigms and approach-avoidance conflicts. Here we establish the ethobehavioral beetle mania task (BMT), which confronts mice with an erratically moving robo-beetle. With the help of this task we demonstrate decreased tolerance yet increased avoidance responses to an approaching beetle in high-anxiety behavior (HAB) and BALBc mice compared to C57BL/6N, CD1 and normal-anxiety behavior (NAB) mice. Also DBA/2N mice showed decreased passive and increased active behavior, but followed the robo-beetle more often than HAB and BALBc mice. Treatment with diazepam (1 mg/kg) increased tolerance without affecting avoidance behavior in HAB mice. Treatment with the MAGL inhibitor JZL184 (8 mg/kg) increased flight behavior, but did not affect tolerance. The FAAH inhibitor URB597 (0.3 mg/kg), however, reduced flight behavior and enhanced tolerance to the robo-beetle. The latter effects were blocked by co-treatment with the CB1 receptor antagonist SR141716A (3 mg/kg), which failed to affect the behavior by itself. Taken together, we validate the BMT as a novel test for studying endocannabinoids beyond traditional paradigms and for assessing active fear responses in mice. Furthermore, we demonstrate panicolytic consequences of pharmacological enhancement of anandamide, but not 2-AG signaling. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Increased non-relapse mortality due to high-dose cytarabine plus CY/TBI in BMT/PBSCT for acute lymphoblastic leukaemia in adults.

    PubMed

    Arai, Yasuyuki; Kondo, Tadakazu; Shigematsu, Akio; Tanaka, Junji; Ohashi, Kazuteru; Fukuda, Takahiro; Kawakita, Toshiro; Mori, Takehiko; Hoshino, Takumi; Onizuka, Makoto; Ozawa, Yukiyasu; Yoshida, Shuro; Ueda, Yasunori; Mizuno, Ishikazu; Atsuta, Yoshiko; Mizuta, Shuichi

    2017-07-01

    The efficacy of high-dose cytarabine (HDCA) plus cyclophosphamide/total-body irradiation (CY/TBI) has been proved in cord blood transplantation (CBT) for acute lymphoblastic leukaemia (ALL), but not in bone marrow or peripheral blood stem cell transplantation (BMT/PBSCT). In this cohort study, we compared the prognosis of CY/TBI (N = 1244) and HDCA/CY/TBI (N = 316) regimens in BMT/PBSCT for ALL. The addition of HDCA decreased post-transplant relapse, while significantly increasing non-relapse mortality (risk ratio, 1·33), and overall survival was not improved. The positive effects of HDCA reported in CBT cannot be extrapolated to BMT/PBSCT, and HDCA may not be recommended in these procedures. © 2017 John Wiley & Sons Ltd.

  19. Isolated extra-medullary relapse of acute leukemia following allogeneic bone marrow transplantation.

    PubMed

    Firas, Al Sabty; Demeckova, E; Bojtarova, E; Czako, B; Hrubisko, M; Mistrik, M

    2008-01-01

    Isolated extramedullary relapse (IEMR) of acute leukemia (AL) after allogeneic bone marrow transplantation (BMT) is a rare occurrence. It is seen more commonly after BMT than after conventional chemotherapy (CHT) alone. We describe the natural history and response to treatment in four patients with IEMR following allogeneic BMT. The results indicate a stronger graft-versus-leukemia (GVL) effect in the marrow than in the peripheral tissues (Fig. 4, Ref. 13). Full Text (Free, PDF) www.bmj.sk.

  20. Recent incarceration and buprenorphine maintenance treatment outcomes among human immunodeficiency virus-positive patients.

    PubMed

    Riggins, Daniel P; Cunningham, Chinazo O; Ning, Yuming; Fox, Aaron D

    2017-01-01

    Opioid use disorder is a common cause of morbidity and mortality among people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Buprenorphine maintenance treatment (BMT) is an effective means of therapy, but patients with recent criminal justice involvement may need more support during BMT than other patients. The authors hypothesized that recently incarcerated BMT patients who initiated treatment in primary care would have poorer treatment outcomes than those who were not recently incarcerated. Investigators analyzed data from a multisite cohort study of BMT integrated into HIV care. Patients were stratified by self-reported incarceration in the 30 days before initiation of BMT. The outcomes of interest were 6- and 12-month treatment retention and self-reported opioid use. Investigators used multivariable logistic regression and hierarchical linear model, respectively, to evaluate the association between recent incarceration and these outcomes while adjusting for potential confounding variables. Among 305 BMT patients living with HIV/AIDS, 39 (13%) reported recent incarceration. Patients with recent incarceration (vs. without) were more likely to be homeless, unemployed, and previously diagnosed with mental illness. Recent incarceration was not significantly associated with differences in 6-month (odds ratio [OR] = 0.95; 95% confidence interval [CI] = 0.46-1.98) and 12-month (OR = 0.57; 95% CI = 0.27-1.18) treatment retention or in self-reported opioid use (OR = 0.99; 95% CI = 0.51-1.92) after adjustment for potential confounding variables. Those with incarceration in the 30 days prior to BMT initiation were more likely to be homeless, unemployed, and previously diagnosed with mental illness than those without recent incarceration. However, no significant difference in self-reported opioid use or 6-month or 12-month retention in treatment was detected between those with and without recent incarceration. Future studies should confirm these findings with larger sample sizes. Encouraging formerly incarcerated individuals with opioid use disorder to initiate evidence-based treatments, including BMT, should be part of efforts to confront the opioid addiction epidemic in the United States.

  1. Allogeneic bone marrow transplantation for children with acute lymphoblastic leukemia in second remission or relapse.

    PubMed

    Lin, K H; Jou, S T; Chen, R L; Lin, D T; Lui, L T; Lin, K S

    1994-01-01

    Most children with acute lymphoblastic leukemia (ALL) are successfully treated by chemotherapy. For those patients, who relapse on therapy, bone marrow transplantation (BMT) is considered most appropriate after a subsequent remission is achieved. Three boys with ALL aged from 9 to 13 years met these criteria and received BMT from their HLA-compatible sisters after marrow ablation with total body irradiation 12 Gy plus high dose cytosine arabinoside 3 gm/m2/12h x 12 doses and graft-versus-host disease (GVHD) prophylaxis with cyclosporine plus short course methotrexate from March 10, 1989 to May 23, 1992. Filgrastim (rhG-CSF) was used to hasten the recovery of granulocyte in one patient. All three patients got full engraftment and two had grade 1 acute GVHD. None of them developed chronic GVHD. Two patients have disease-free survival over 51 and 12 months respectively post BMT without further chemotherapy. One patient died of recurrent refractory leukemia 5 months after BMT. The toxicity of this conditioning regimen included photophobia, conjunctivitis and erythematous skin rashes. One patient who received filgrastim from day 1 to 21 developed severe bone pain. However, this patient had faster recovery of granulocyte count than the other two patients. The preliminary results of this work favors BMT for children with recurrent ALL whose ultimate survival is usually poor when treated with chemotherapy. Further efforts are necessary to investigate new methods for reducing leukemic relapse in ALL patients undergoing BMT.

  2. Population-Based Analysis of Hematologic Malignancy Referrals to a Comprehensive Cancer Center, Referrals for Blood and Marrow Transplantation, and Participation in Clinical Trial, Survey, and Biospecimen Research by Race.

    PubMed

    Clay, Alyssa; Peoples, Brittany; Zhang, Yali; Moysich, Kirsten; Ross, Levi; McCarthy, Philip; Hahn, Theresa

    2015-08-01

    Racial and ethnic disparities have been reported in clinical trial/research participation, utilization of autologous and allogeneic blood and marrow transplantation (BMT), and availability of allogeneic donors. We performed a population-based cohort study to investigate adult hematologic malignancy referrals to a US tertiary cancer center, utilization of BMT, and participation in clinical trial, survey, and biospecimen research by race. US Census Data and the New York State Public Access Cancer Epidemiology Database identified the racial distribution of the general population and new hematologic malignancy cases in the primary catchment area. From 2005 to 2011, 1106 patients aged 18 to 75 years were referred for BMT consultation; although the rate of BMT among hematologic malignancy referrals did not differ by race, the reasons for not receiving a BMT did. Participation in biospecimen research did not vary by race; however, African Americans and other minorities were significantly less likely to participate in survey research than European Americans. Although rates of hematologic malignancy referrals and use of BMT for minorities appear to be low (<10%), they closely reflect the race distribution of all hematologic malignancy cases and the western New York population. African Americans are equally likely as other races to participate in biospecimen banking, but further study is needed to understand reasons for lower participation in survey research. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  3. Normalized levels of red blood cells expressing phosphatidylserine, their microparticles, and activated platelets in young patients with β-thalassemia following bone marrow transplantation.

    PubMed

    Klaihmon, Phatchanat; Vimonpatranon, Sinmanus; Noulsri, Egarit; Lertthammakiat, Surapong; Anurathapan, Usanarat; Sirachainan, Nongnuch; Hongeng, Suradej; Pattanapanyasat, Kovit

    2017-10-01

    Bone marrow transplantation (BMT) serves as the only curative treatment for patients with β-thalassemia major; however, hemostatic changes have been observed in these BMT patients. Aggregability of thalassemic red blood cells (RBCs) and increased red blood cell-derived microparticles (RMPs) expressing phosphatidylserine (PS) are thought to participate in thromboembolic events by initially triggering platelet activation. To our knowledge, there has been no report providing quantitation of these circulating PS-expressing RBCs and RMPs in young β-thalassemia patients after BMT. Whole blood from each subject was fluorescently labeled to detect RBC markers (CD235a) and annexin-V together with the known number TruCount™ beads. PS-expressing RBCs, RMPs, and activated platelets were identified by flow cytometry. In our randomized study, we found the decreased levels of three aforementioned factors compared to levels in patients receiving regular blood transfusion (RT). This study showed that BMT in β-thalassemia patients decreases the levels of circulating PS-expressing RBCs, their MPs, and procoagulant platelets when compared to patients who received RT. Normalized levels of these coagulation markers may provide the supportive evidence of the effectiveness of BMT for curing thalassemia.

  4. Fine-needle aspiration biopsy of the salivary gland: problem cases.

    PubMed

    MacLeod, C B; Frable, W J

    1993-01-01

    Among 582 fine-needle aspiration (FNA) biopsies of major and minor salivary glands performed between 1974 and 1990, lack of cytological histologic correlation was noted in 21 cases. Of these, the cause in 10 FNAs was inadequate cytological sampling of the lesion. [One case of malignant hemangiopericytoma was tentatively diagnosed as a monomorphic adenoma on FNA, a polymorphic T-cell lymphoma was diagnosed as granulomatous inflammation on aspiration biopsy, a benign lymphoepithelial lesion was diagnosed as a reactive lymph node, a branchial cleft cyst was called benign mixed tumor (BMT), one case of chronic sialoadenitis was called BMT by FNA, two cases of benign lymphoepithelial lesion (BLEL) were diagnosed as cystic Warthin's tumor, two low-grade mucoepidermoid carcinomas were called BMT, and a BMT was cytologically diagnosed as a Warthin's tumor with squamous metaplasia versus low-grade mucoepidermoid carcinoma. One case of low-grade mucoepidermoid carcinoma was diagnosed only as a "cyst."] Review of these cases identifies constant features that permit differentiation between Warthin's tumor and BLEL, and among BMT, mucoepidermoid carcinoma, and chronic sialoadenitis. Despite a few problem cases, FNA of the salivary gland is accurate in the preoperative diagnosis and classification of salivary gland neoplasms.

  5. 9. Detail of "BMT lines" tile sign, and decorative tiles ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. Detail of "BMT lines" tile sign, and decorative tiles between center and east castellations of south facade. Looking north. - Stillwell Avenue Station, Intersection of Stillwell & Surf Avenues, Brooklyn, Kings County, NY

  6. PBSCT is associated with poorer survival and increased chronic GvHD than BMT in Japanese paediatric patients with acute leukaemia and an HLA-matched sibling donor.

    PubMed

    Shinzato, Aki; Tabuchi, Ken; Atsuta, Yoshiko; Inoue, Masami; Inagaki, Jiro; Yabe, Hiromasa; Koh, Katsuyoshi; Kato, Koji; Ohta, Hideaki; Kigasawa, Hisato; Kitoh, Toshiyuki; Ogawa, Atsushi; Takahashi, Yoshiyuki; Sasahara, Yoji; Kato, Shun-Ichi; Adachi, Souichi

    2013-09-01

    Peripheral blood stem cells (PBSC) may be used as an alternative to bone marrow (BM) for allogeneic transplantation. Since peripheral blood stem cell bank from unrelated volunteer donor has been started in Japan, use of PBSC allografts may be increased. Therefore we surveyed the outcomes of Japanese leukemia children after PBSC and BM transplantation. This retrospective study compared the outcomes of 661 children (0-18 years) with acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia (AML) who received their first allogeneic peripheral blood stem cell transplantation (PBSCT; n = 90) or bone marrow transplantation (BMT; n = 571) from HLA-matched siblings between January 1996 and December 2007. Neutrophil recovery was faster after PBSCT than after BMT (ALL: P < 0.0001; AML: P = 0.0002), as was platelet recovery (ALL: P = 0.0008; AML: P = 0.0848). However, the cumulative incidence of chronic graft-versus-host disease (GvHD) was higher after PBSCT than after BMT (ALL: 26.0% vs. 9.9%, P = 0.0066; AML: 41.6% vs. 11.1%, P < 0.0001). The 5-year disease-free survival (DFS) was lower after PBSCT than after BMT for ALL (40.6% vs. 57.1%, P = 0.0257). The 5-year overall survival (OS) was lower after PBSCT than after BMT for ALL (42.4% vs. 63.7%, P = 0.0032) and AML (49.8% vs. 71.8%, P = 0.0163). Multivariate analysis revealed the use of PBSC was a significant risk factor for DFS and OS. PBSCT and BMT did not differ in relapse rate, acute GvHD for ALL and AML, or in DFS for AML. PBSC allografts in Japanese children engraft faster but are associated with poorer survival and increased chronic GvHD. Copyright © 2013 Wiley Periodicals, Inc.

  7. Acute bleeding after bone marrow transplantation (BMT)- incidence and effect on survival. A quantitative analysis in 1,402 patients.

    PubMed

    Nevo, S; Swan, V; Enger, C; Wojno, K J; Bitton, R; Shabooti, M; Fuller, A K; Jones, R J; Braine, H G; Vogelsang, G B

    1998-02-15

    Acute bleeding after bone marrow transplantation (BMT) was investigated in 1,402 patients receiving transplants at Johns Hopkins Hospital between January 1, 1986 and June 30, 1995. Bleeding categorization was based on daily scores of intensity used by the blood transfusion service. Moderate and severe episodes were analyzed for bleeding sites. Analysis of the cause of death and the interval of the bleeding episode to outcome endpoints was recorded. Survival estimates were computed for 1,353 BMT patients. The overall incidence was 34%. Minor bleeding was seen in 10.6%, moderate bleeding was seen in 11.3%, and severe bleeding was seen in 12% of all patients. Fourteen percent of patients had moderate or severe gastrointestinal hemorrhage, 6.4% had moderate or severe hemorrhagic cystitis, 2.8% had pulmonary hemorrhage, and 2% had intracranial hemorrhage. Sixty-one percent had 1 bleeding site and 34.4% had more than 1 site. Moderate and severe bleeding was more prevalent in allogeneic (31%) and unrelated patients (62.5%) compared with autologous patients (18.5%). Significant distribution of incidence was found among the different diagnoses, but not by disease status in acute myeloid leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, Hodgkin's disease, and non-Hodgkin's lymphoma. Bleeding was associated with significantly reduced survival in allogeneic, autologous, and unrelated BMT and in each disease category except multiple myeloma. Survival was correlated with the bleeding intensity, bleeding site, and the number of sites. Although close temporal association was evident to mortality, bleeding was recorded as the cause of death in only the minority of cases compared with other toxicities after BMT (graft-versus-host disease, infections, and preparative regimen toxicity). Acute bleeding is a common complication after BMT that is profoundly associated with morbidity and mortality. Although bleeding was not a direct cause of death in the majority of cases, it has a potential prognostic implication as a predictor of poor outcome in clinical assessment of patients after BMT.

  8. [Treatment of asymptomatic carotid artery stenosis: improvement of evidence with new SPACE-2 design necessary].

    PubMed

    Reiff, T; Amiri, H; Ringleb, P A; Jansen, O; Hacke, W; Eckstein, H H; Fraedrich, G; Mudra, H; Mansmann, U

    2013-12-01

    Asymptomatic carotid artery stenosis may be treated with carotid endarterectomy (CEA), carotid artery stenting (CAS) or with best medical treatment (BMT) only. Definitive and evidence-based treatment recommendations for one of these options are currently not possible. Studies showing an advantage of CEA over BMT alone do not meet current standards from a pharmacological point of view. On the other hand, more recent data point to a further stroke risk reduction using BMT according to current standards. Studies on carotid artery stenting as a third alternative treatment are partially insufficient, especially when comparing CAS with BMT. Initiated in 2009, the randomized, controlled, multicenter SPACE-2 trial is intended to answer the question about the best treatment option of asymptomatic carotid artery stenosis; however, to increase recruitment rates as a condition for the successful completion of this important study, the trial design had to be modified.

  9. Microvascular Outcomes after Metabolic Surgery (MOMS) in patients with type 2 diabetes mellitus and class I obesity: rationale and design for a randomised controlled trial

    PubMed Central

    Cohen, Ricardo Vitor; Pereira, Tiago Veiga; Aboud, Cristina Mamédio; Caravatto, Pedro Paulo de Paris; Petry, Tarissa Beatrice Zanata; Correa, José Luis Lopes; Schiavon, Carlos Aurélio; Correa, Mariangela; Pompílio, Carlos Eduardo; Pechy, Fernando Nogueira Quirino; le Roux, Carel

    2017-01-01

    Introduction There are several randomised controlled trials (RCTs) that have already shown that metabolic/bariatric surgery achieves short-term and long-term glycaemic control while there are no level 1A of evidence data regarding the effects of surgery on the microvascular complications of type 2 diabetes mellitus (T2DM). Purpose The aim of this trial is to investigate the long-term efficacy and safety of the Roux-en-Y gastric bypass (RYGB) plus the best medical treatment (BMT) versus the BMT alone to improve microvascular outcomes in patients with T2DM with a body mass index (BMI) of 30–34.9 kg/m2. Methods and analysis This study design includes a unicentric randomised unblinded controlled trial. 100 patients (BMI from 30 to 34.9 kg/m2) will be randomly allocated to receive either RYGB plus BMT or BMT alone. The primary outcome is the change in the urine albumin-to-creatinine ratio (uACR) captured as the proportion of patients who achieved nephropathy remission (uACR<30 mg/g of albumin/mg of creatinine) in an isolated urine sample over 12, 24 and 60 months. Ethics and dissemination The study was approved by the local Institutional Review Board. This study represents the first RCT comparing RYGB plus BMT versus BMT alone for patients with T2DM with a BMI below 35 kg/m2. Trial registration number NCT01821508; Pre-results. PMID:28077412

  10. Neonatal bone marrow transplantation prevents bone pathology in a mouse model of mucopolysaccharidosis type I.

    PubMed

    Pievani, Alice; Azario, Isabella; Antolini, Laura; Shimada, Tsutomu; Patel, Pravin; Remoli, Cristina; Rambaldi, Benedetta; Valsecchi, Maria Grazia; Riminucci, Mara; Biondi, Andrea; Tomatsu, Shunji; Serafini, Marta

    2015-03-05

    Neonatal bone marrow transplantation (BMT) could offer a novel therapeutic opportunity for genetic disorders by providing sustainable levels of the missing protein at birth, thus preventing tissue damage. We tested this concept in mucopolysaccharidosis type I (MPS IH; Hurler syndrome), a lysosomal storage disorder caused by deficiency of α-l-iduronidase. MPS IH is characterized by a broad spectrum of clinical manifestations, including severe progressive skeletal abnormalities. Although BMT increases the life span of patients with MPS IH, musculoskeletal manifestations are only minimally responsive if the timing of BMT delays, suggesting already irreversible bone damage. In this study, we tested the hypothesis that transplanting normal BM into newborn MPS I mice soon after birth can prevent skeletal dysplasia. We observed that neonatal BMT was effective at restoring α-l-iduronidase activity and clearing elevated glycosaminoglycans in blood and multiple organs. At 37 weeks of age, we observed an almost complete normalization of all bone tissue parameters, using radiographic, microcomputed tomography, biochemical, and histological analyses. Overall, the magnitude of improvements correlated with the extent of hematopoietic engraftment. We conclude that BMT at a very early stage in life markedly reduces signs and symptoms of MPS I before they appear. © 2015 by The American Society of Hematology.

  11. Microvascular Outcomes after Metabolic Surgery (MOMS) in patients with type 2 diabetes mellitus and class I obesity: rationale and design for a randomised controlled trial.

    PubMed

    Cohen, Ricardo Vitor; Pereira, Tiago Veiga; Aboud, Cristina Mamédio; Caravatto, Pedro Paulo de Paris; Petry, Tarissa Beatrice Zanata; Correa, José Luis Lopes; Schiavon, Carlos Aurélio; Correa, Mariangela; Pompílio, Carlos Eduardo; Pechy, Fernando Nogueira Quirino; le Roux, Carel W

    2017-01-11

    There are several randomised controlled trials (RCTs) that have already shown that metabolic/bariatric surgery achieves short-term and long-term glycaemic control while there are no level 1A of evidence data regarding the effects of surgery on the microvascular complications of type 2 diabetes mellitus (T2DM). The aim of this trial is to investigate the long-term efficacy and safety of the Roux-en-Y gastric bypass (RYGB) plus the best medical treatment (BMT) versus the BMT alone to improve microvascular outcomes in patients with T2DM with a body mass index (BMI) of 30-34.9 kg/m 2 . This study design includes a unicentric randomised unblinded controlled trial. 100 patients (BMI from 30 to 34.9 kg/m 2 ) will be randomly allocated to receive either RYGB plus BMT or BMT alone. The primary outcome is the change in the urine albumin-to-creatinine ratio (uACR) captured as the proportion of patients who achieved nephropathy remission (uACR<30 mg/g of albumin/mg of creatinine) in an isolated urine sample over 12, 24 and 60 months. The study was approved by the local Institutional Review Board. This study represents the first RCT comparing RYGB plus BMT versus BMT alone for patients with T2DM with a BMI below 35 kg/m 2 . NCT01821508; 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/.

  12. Suppression of graft-versus-host disease and retention of graft-versus-tumour reaction by murine genetically engineered dendritic cells following bone marrow transplantation.

    PubMed

    Huang, Yihong; Feng, Saran; Xu, Yujie; Chen, Wanru; Wang, Shuhua; Li, Depeng; Li, Zhenyu; Lu, Qunxian; Pan, Xiuying; Xu, Kailin

    2015-05-01

    The effect of infusion of lentiviral vector‑mediated, genetically engineered dendritic cells (DCs) following allogeneic bone marrow transplantation (allo‑BMT) on graft‑versus‑host disease (GVHD) and graft‑versus‑leukemia (GVL) was investigated in a mouse model. Lentivirus‑mediated expression of soluble tumor necrosis factor receptor 1 (sTNFR1) converted immature DCs (imDCs) from BABL/c mice into engineered DCs in vitro. An EL4 leukemia allo‑BMT model of BABL/c to C57BL/6 mice was established. Engineered DCs with donor bone marrow cells and splenocytes were subsequently transplanted into myeloablatively irradiated recipients. The average survival duration in the sTNFR1‑ and pXZ9‑imDC groups was significantly prolonged compared with that of the allo‑BMT group (P<0.05). Mild histological changes in GVHD or leukemia were observed in the recipients in the sTNFR1‑imDC group and clinical GVHD scores in this group were significantly decreased compared with those of the transplantation and pXZ9‑imDC groups. Serum interferon‑γ levels were decreased in the pXZ9‑imDC and sTNFR1‑imDC groups compared with those in the allo‑BMT group (P<0.05), with the reduction being more significant in the sTNFR1‑imDC group (P<0.05). Serum interleukin‑4 expression levels were decreased in the allo‑BMT group, but gradually increased in the pXZ9‑imDC and sTNFR1‑imDC groups (P<0.05). Co‑injection of donor genetically‑engineered imDCs was able to efficiently protect recipient mice from lethal GVHD while preserving GVL effects during allo‑BMT.

  13. Health related quality of life patterns in patients treated with interstitial prostate brachytherapy for localized prostate cancer--data from CaPSURE.

    PubMed

    Downs, Tracy M; Sadetsky, Natalia; Pasta, David J; Grossfeld, Gary D; Kane, Christopher J; Mehta, Shilpa S; Carroll, Peter R; Lubeck, Deborah P

    2003-11-01

    We measured the impact brachytherapy monotherapy (BMT) has on general and disease specific health related quality of life (HRQOL) compared to patients treated with radical prostatectomy (RP). We studied 419 men with newly diagnosed prostate cancer who enrolled in CaPSURE (Cancer of the Prostate Strategic Urological Research Endeavor) data base whose primary treatment was brachytherapy monotherapy (92) or radical prostatectomy (327). The validated RAND 36-Item Health Survey and the UCLA Prostate Cancer Index were used to measure HRQOL before treatment and at 6-month intervals during the first 2 years after treatment. Patients treated with BMT or RP did not differ greatly in general HRQOL after treatment. Both treatment groups showed early functional impairment in most general domains with scores returning to or approaching baseline in most domains 18 to 24 months after treatment. Patients treated with BMT had significantly higher urinary function scores at 0 to 6 months after treatment (84.5, SD 18.7) than patients treated with RP (63.3, SD 26.6). Urinary bother scores at 0 to 6 months after treatment were not significantly different between patients treated with BMT (67.7, SD 31.2) and those treated with RP (67.4, SD 29.1). Both treatment groups had decreases in sexual function that did not return to pretreatment levels. Overall BMT and RP are well tolerated procedures that cause mild changes in general HRQOL. Disease specific HRQOL patterns are different in patients treated with BMT or RP. Baseline and serial HRQOL measurements after treatment can provide valuable information regarding expected quality of life outcome after treatment for localized prostate cancer.

  14. Comparison of culture and PCR methods in the diagnosis of bacterial meningitis.

    PubMed

    Başpınar, Emel Ödemiş; Dayan, Saim; Bekçibaşı, Muhammed; Tekin, Recep; Ayaz, Celal; Deveci, Özcan; Hoşoğlu, Salih

    Our aim in this study is to compare the standard culture method with the multiplex PCR and the Speed-Oligo ® Bacterial Meningitis Test (SO-BMT) - a hybridization-based molecular test method - during the CSF examination of the patients with the pre-diagnosis of acute bacterial meningitis. For the purposes of this study, patients with acute bacterial meningitis treated at the Dicle University Medical Faculty Hospital, Infectious Diseases and Clinical Microbiology Clinic between December 2009 and April 2012 were retrospectively evaluated. The diagnosis of bacterial meningitis was made based on the clinical findings, laboratory test anomalies, CSF analysis results, and the radiological images. Growth was observed in the CSF cultures of 10 out of the 57 patients included in the study (17.5%) and Streptococcus pneumoniae was isolated in all of them. The CSF samples of 34 patients (59.6%) were positive according to the SO-BMT and S. pneumoniae was detected in 33 of the samples (97.05%), while Neisseria meningitidis was found in 1 sample (2.95%). In a total of 10 patients, S. pneumoniae was both isolated in the CSF culture and detected in the SO-BMT. The culture and the SO-BMT were negative in 23 of the CSF samples. There was no sample in which the CSF culture was positive although the SO-BMT was negative. While SO-BMT seems to be a more efficient method than bacterial culturing to determine the pathogens that most commonly cause bacterial meningitis in adults, further studies conducted on larger populations are needed in order to assess its efficiency and uses. Copyright © 2016 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

  15. Marital Therapy as a Treatment for Depression.

    ERIC Educational Resources Information Center

    Jacobson, Neil S.; And Others

    1991-01-01

    Compared cognitive-behavioral therapy (CT), behavioral marital therapy (BMT), and combination of two therapies in alleviation of wives' depression and enhancement of marital satisfaction. Found BMT less effective than CT for depression in maritally nondistressed couples. For maritally distressed couples, two treatments were equally effective.…

  16. Suppression of the motor deficit in a mucolipidosis type IV mouse model by bone marrow transplantation

    PubMed Central

    Walker, Marquis T.; Montell, Craig

    2016-01-01

    Mucolipidosis IV (MLIV) is a severe lysosomal storage disorder, which results from loss of the TRPML1 channel. MLIV causes multiple impairments in young children, including severe motor deficits. Currently, there is no effective treatment. Using a Drosophila MLIV model, we showed previously that introduction of trpml+ in phagocytic glia rescued the locomotor deficit by removing early dying neurons, thereby preventing amplification of neuronal death from cytotoxicity. Because microglia, which are phagocytic cells in the mammalian brain, are bone marrow derived, and cross the blood–brain barrier, we used a mouse MLIV model to test the efficacy of bone marrow transplantation (BMT). We found that BMT suppressed the reduced myelination and the increased caspase-3 activity due to loss of TRPML1. Using a rotarod test, we demonstrated that early BMT greatly delayed the motor impairment in the mutant mice. These data offer the possibility that BMT might provide the first therapy for MLIV. PMID:27270598

  17. Lung transplantation after allogeneic marrow transplantation in pediatric patients: the Memorial Sloan-Kettering experience.

    PubMed

    Heath, J A; Kurland, G; Spray, T L; Kernan, N A; Small, T N; Brochstein, J A; Gillio, A P; Boklan, J; O'Reilly, R J; Boulad, F

    2001-12-27

    Chronic lung disease and pulmonary failure are complications that can occur after bone marrow transplantation (BMT) and are associated with severe morbidity and mortality. We report on four patients who developed chronic, progressive, and irreversible lung disease 1 to 3 years after allogeneic BMT in childhood. These patients had chronic graft-versus-host disease (n=3) or radiation-related pulmonary fibrosis (n=1). Three patients underwent double lung transplants and one patient underwent a single lung transplant 2 to 14 years after BMT. All four patients tolerated the lung transplantation procedure well and showed significant clinical improvement with normalization of pulmonary function tests by 1 year posttransplant. One patient died from infectious complications 3 years after lung transplantation, and one patient died after chronic rejection of the transplanted lungs 6 years posttransplant. Two patients remain alive without significant respiratory impairment 2 and 7 years after lung transplantation. We conclude that lung transplantation offers a viable therapeutic option for patients who develop respiratory failure secondary to BMT.

  18. Monoclonal antibody-purged bone marrow transplantation therapy for multiple myeloma.

    PubMed

    Anderson, K C; Andersen, J; Soiffer, R; Freedman, A S; Rabinowe, S N; Robertson, M J; Spector, N; Blake, K; Murray, C; Freeman, A

    1993-10-15

    Forty patients with plasma cell dyscrasias underwent high-dose chemoradiotherapy and either anti-B-cell monoclonal antibody (MoAb)-treated autologous, anti-T-cell MoAb-treated HLA-matched sibling allogeneic or syngeneic bone marrow transplantation (BMT). The majority of patients had advanced Durie-Salmon stage myeloma at diagnosis, all were pretreated with chemotherapy, and 17 had received prior radiotherapy. At the time of BMT, all patients demonstrated good performance status with Karnofsky score of 80% or greater and had less than 10% marrow tumor cells; 34 patients had residual monoclonal marrow plasma cells and 38 patients had paraprotein. Following high-dose chemoradiotherapy, there were 18 complete responses (CR), 18 partial responses, one non-responder, and three toxic deaths. Granulocytes greater than 500/microL and untransfused platelets greater than 20,000/microL were noted at a median of 23 (range, 12 to 46) and 25 (range, 10 to 175) days posttransplant (PT), respectively, in 24 of the 26 patients who underwent autografting. In the 14 patients who received allogeneic or syngeneic grafts, granulocytes greater than 500/microL and untransfused platelets greater than 20,000/microL were noted at a median of 19 (range, 12 to 24) and 16 (range, 5 to 32) days PT, respectively. With 24 months median follow-up for survival after autologous BMT, 16 of 26 patients are alive free from progression at 2+ to 55+ months PT; of these, 5 patients remain in CR at 6+ to 55+ months PT. With 24 months median follow-up for survival after allogeneic and syngeneic BMT, 8 of 14 patients are alive free from progression at 8+ to 34+ months PT; of these, 5 patients remain in CR at 8+ to 34+ months PT. This therapy has achieved high response rates and prolonged progression-free survival in some patients and proven to have acceptable toxicity. However, relapses post-BMT, coupled with slow engraftment post-BMT in heavily pretreated patients, suggest that such treatment strategies should be used earlier in the disease course. To define the role of BMT in the treatment of myeloma, its efficacy should be compared with that of conventional chemotherapy in a randomized trial.

  19. Non-myeloablative allogeneic stem cell transplantation focusing on immunotherapy of life-threatening malignant and non-malignant diseases.

    PubMed

    Slavin, S; Nagler, A; Shapira, M; Panigrahi, S; Samuel, S; Or, A

    2001-01-01

    Allogeneic bone marrow transplantation (BMT) represents an important therapeutic tool for treatment of otherwise incurable malignant and non-malignant diseases. Until recently, myeloablative regimens were considered mandatory for eradication of all undesirable host-derived hematopoietic elements. Our preclinical and ongoing clinical studies indicated that much more effective eradication of host immunohematopoietic system cells could be achieved by adoptive allogeneic cell therapy with donor lymphocyte infusion (DLI) following BMT. Thus, eradication of blood cancer cells, especially in patients with CML can be frequently accomplished despite complete resistance of such tumor cells to maximally tolerated doses of chemoradiotherapy. Our cumulative experience suggested that graft versus leukemia (GVL) effects might be a useful tool for eradication of otherwise resistant tumor cells of host origin. The latter working hypothesis suggested that effective BMT procedures may be accomplished without lethal conditioning of the host, using new well tolerated non-myeloablative regimen, thus possibly minimizing immediate and late side effects related to myeloablative procedures considered until recently mandatory for conditioning of BMT recipients. Recent clinical data that will be presented suggests that safe non-myeloablative stem cell transplantation (NST), with no major toxicity can replace the conventional BMT. Thus, NST may provide an option for cure for a large spectrum of clinical indications in children and elderly individuals without lower or upper age limit, while minimizing procedure-related toxicity and mortality.

  20. Mucositis and salivary antioxidants in patients undergoing bone marrow transplantation (BMT)

    PubMed Central

    Mazzeo, Marcelo A.; López, María M.; Linares, Jorge A.; Jarchum, Gustavo; Wietz, Fernando M.; Finkelberg, Ana B.

    2014-01-01

    Objectives: High doses of chemotherapy generate DNA damage in patients undergoing bone marrow transplantation (BMT), due to the production of reactive oxygen species (ROS). In order to evaluate the local defensive effectiveness of the patient undergoing BMT, the concentrations of the antioxidants superoxide dismutase (SOD) and uric acid (UA) were measured in saliva. Study Design: Basal saliva samples were collected from 20 patients undergoing BMT at the Oncology Department, Sanatorio Allende (Córdoba), in the stages: initial, prior to conditioning therapy (I); middle: 7 to 10 days after BMT (M) and final stage, 30 days after discharge from isolation (F). SOD levels were determined using a RANDOX kit (RANSOD superoxide dismutase manual), and for uric acid enzymatic UOD / PAP spectrophotometric method, ( Trinder Color Kit , Wiener Lab) was used. Results: 85% of the patients developed oral mucositis. SOD concentration in the M stage was significantly higher (p<0.01) compared with stage I, and it reversed in stage F. UA concentration was significantly lower (p<0.001) in stage M compared with stage I, and in stage F it recovered the initial values. Conclusions: SOD increase in stage M coincided with the appearance of mucositis, which could be interpreted as a defensive mechanism of saliva against oxidative stress produced by chemotherapy. UA decrease in stage M would favour the development of higher degrees of mucositis. Key words:Bone marrow transplantation, mucositis, superoxide dismutase, uric acid. PMID:24608218

  1. Successful Single-Lung Transplant for Severe Lung Graft-Versus-Host Disease Two Years After Sibling Allograft for Acute Lymphoblastic Leukemia: A Case Report.

    PubMed

    Irhimeh, M R; Musk, M; Cooney, J P

    2016-11-01

    Bone marrow transplantation (BMT) has been performed as a successful life-saving treatment for hematological and neoplastic diseases. Despite the predictable long-term survival rates in BMT, pulmonary complications reduce the survival rates significantly mainly because of chronic graft-versus-host disease (GVHD). This report briefly discusses a successful lung transplantation case for severe lung GVHD after allograft for acute lymphoblastic leukemia. This case report supports the scarce evidence in the literature for the importance of lung transplantation as a therapeutic option for patients who develop respiratory failure secondary to BMT. Copyright © 2016. Published by Elsevier Inc.

  2. Recurrence of chronic active Epstein-Barr virus infection from donor cells after achieving complete response through allogeneic bone marrow transplantation.

    PubMed

    Arai, Ayako; Imadome, Ken-ichi; Wang, Ludan; Wu, Nan; Kurosu, Tetsuya; Wake, Atsushi; Yamamoto, Hisashi; Ota, Yasunori; Harigai, Masayoshi; Fujiwara, Shigeyoshi; Miura, Osamu

    2012-01-01

    We report the case of a 35-year-old woman with chronic active Epstein-Barr virus (EBV) infection (CAEBV). She underwent allogeneic bone marrow transplantation (BMT) from an unrelated male donor and achieved a complete response. However, her CAEBV relapsed one year after BMT. EBV-infected cells proliferated clonally and revealed a 46XY karyotype. In addition, the infecting EBV strain differed from that detected before BMT. These findings indicated that her disease had developed from donor cells. This is the first report of donor cell-derived CAEBV that recurred after transplantation, suggesting that host factors may be responsible for the development of this disease.

  3. Boeing Extrication Team training on Boeing Mock-Up Trainer (BMT)

    NASA Image and Video Library

    2018-05-25

    The Boeing extrication team train on the Boeing Mock-up Trainer from May 25 through May 28, 2018, at NASA's Johnson Space Center in Houston. The extrication team is comprised of firefighters from various U.S. Boeing sites. Each member of the team brings an expertise in Aerospace Confined Space Rescue, are Emergency Medical Technicians and have years of rescue experience. The team is highly motivated to getting the crew out quickly, safely and efficiently. The training at Johnson included suit training, side hatch egress, and Intravehicular Activity (IVA) rigging and egress. The week included a run for record on IVA egress for a testing requirement. Participants also included NASA Medical, the 45th Operations Group's Detachment 3, based at Patrick Air Force Base, and U.S. Air Force pararescue representation.

  4. Prevalence of cutaneous viral infections in incident cutaneous squamous cell carcinoma detected among chronic lymphocytic leukemia and hematopoietic stem cell transplant patients.

    PubMed

    Hampras, Shalaka S; Locke, Frederick L; Chavez, Julio C; Patel, Nishit S; Giuliano, Anna R; Miller, Kyle; Gheit, Tarik; Tommasino, Massimo; Rollison, Dana E

    2018-04-01

    The role of cutaneous viral infections in the development of non-melanoma skin cancer (NMSC), including cutaneous squamous cell carcinoma (SCC), among chronic lymphocytic leukemia (CLL) and blood and marrow transplant (BMT) patients is not established. CLL (n = 977) and BMT (n = 3587) patients treated at the Moffitt Cancer Center were included in a retrospective cohort study. Human papillomavirus (HPV) and human polyomavirus (HPyV) DNA were examined in a subset of incident SCC tumors. Five-year cumulative incidence of NMSC was 1.42% in both BMT (n = 31 NMSCs) and CLL (n = 18 NMSCs) cohorts. Of the nine SCC tumors examined from each cohort, 22.2% and 33.3% were positive for viral DNA in the transplant (HPV 65, MCV) and CLL (HPV 38, HPV 15, HPyV6) cohort, respectively. Enhanced skin cancer screening of BMT/CLL patients should be conducted to better capture incident NMSCs and examine the role of viral infections in these tumors.

  5. Administration of RANKL boosts thymic regeneration upon bone marrow transplantation.

    PubMed

    Lopes, Noella; Vachon, Hortense; Marie, Julien; Irla, Magali

    2017-06-01

    Cytoablative treatments lead to severe damages on thymic epithelial cells (TECs), which result in delayed de novo thymopoiesis and a prolonged period of T-cell immunodeficiency. Understanding the mechanisms that govern thymic regeneration is of paramount interest for the recovery of a functional immune system notably after bone marrow transplantation (BMT). Here, we show that RANK ligand (RANKL) is upregulated in CD4 + thymocytes and lymphoid tissue inducer (LTi) cells during the early phase of thymic regeneration. Importantly, whereas RANKL neutralization alters TEC recovery after irradiation, ex vivo RANKL administration during BMT boosts the regeneration of TEC subsets including thymic epithelial progenitor-enriched cells, thymus homing of lymphoid progenitors, and de novo thymopoiesis. RANKL increases specifically in LTi cells, lymphotoxin α, which is critical for thymic regeneration. RANKL treatment, dependent on lymphotoxin α, is beneficial upon BMT in young and aged individuals. This study thus indicates that RANKL may be clinically useful to improve T-cell function recovery after BMT by controlling multiple facets of thymic regeneration. © 2017 The Authors. Published under the terms of the CC BY 4.0 license.

  6. DNA profiling in peripheral blood, buccal swabs, hair follicles and semen from a patient following allogeneic hematopoietic stem cells transplantation

    PubMed Central

    LI, YA-TING; XIE, MING-KUN; WU, JIN

    2014-01-01

    Allogeneic peripheral blood stem cells transplantation (allo-PBSCT) or allogeneic bone marrow transplantation (allo-BMT) have been widely used to treat patients exhibiting certain severe illnesses. However, previous studies have shown that the biological materials of allo-PBSCT or allo-BMT recipients may not constitute credible materials for personal identification. In the present study, four types of commonly used samples were collected from a male individual following gender-matched allo-BMT. Autosomal short tandem repeat (STR) and Y-STR markers analysis, based on polymerase chain reaction, were used to evaluate the chimerism status. The results showed that the blood sample were all donor type, the buccal swab sample were mixed chimerism, and the sperm and hair follicle samples maintained a recipient origin of 100%. In conclusion, identical results were obtained by the two methods and it was confirmed that DNA extracted from hair follicles and sperm can be used as a reference for the pre-transplant genotype DNA profile of the recipient in the gender-match allo-BMT or -PBSCT. PMID:25279149

  7. Comparison of Donor Sources in Hematopoietic Stem Cell Transplantation for Childhood Acute Leukemia: A Nationwide Retrospective Study.

    PubMed

    Sakaguchi, Hirotoshi; Watanabe, Nobuhiro; Matsumoto, Kimikazu; Yabe, Hiromasa; Kato, Shunichi; Ogawa, Atsushi; Inagaki, Jiro; Goto, Hiroaki; Koh, Katsuyoshi; Yoshida, Nao; Kato, Keisuke; Cho, Yuko; Kosaka, Yoshiyuki; Takahashi, Yoshiyuki; Inoue, Masami; Kato, Koji; Atsuta, Yoshiko; Miyamura, Koichi

    2016-12-01

    Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the best therapeutic option for childhood high-risk acute leukemia. However, which donor source is optimal for children lacking an identical sibling remains unclear. To evaluate the clinical impact of donor source on allo-HSCT in childhood acute leukemia, we analyzed data from 577 children who underwent allo-HSCT after a myeloablative regimen during first or second complete remission from 2005 to 2012, using registry data of the Japan Society for Hematopoietic Cell Transplantation, and we compared outcomes of 7/8 to 8/8 HLA allelic-matched unrelated bone marrow transplantation (UR-BMT, n = 218) and 4/6 to 6/6 HLA allelic-matched unrelated cord blood transplantation (UR-CBT, n = 200) to those of HLA-identical related bone marrow transplantation (ID-BMT, n = 159). The median follow-up of survivors was 40.0 months. Three-year overall survival (OS) and leukemia-free survival (LFS) rates for ID-BMT, UR-BMT, and UR-CBT were 74.8% and 69.0%, 75.0% and 69.6%, and 71.8% and 63.8%, respectively. The multivariate analysis demonstrated that OS and LFS for the 3 groups are comparable, although UR-CBT carries a greater risk of nonrelapse mortality (hazard ratio, 2.20; P = .03, compared to ID-BMT) in the myeloablative setting for childhood high-risk acute leukemia. Copyright © 2016 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  8. Allogeneic bone marrow transplantation in multiple myeloma.

    PubMed

    Tura, S; Cavo, M

    1992-04-01

    The use of high-dose chemoradiotherapy with allogeneic hemopoietic stem cell support for the treatment of MM began about a decade ago. Because this procedure has been performed increasingly and because larger numbers of patients are being followed for longer periods of time, the proper role of allogeneic BMT in this setting is becoming clearer. Data available thus far indicate that such an approach results in a complete remission rate of at least 50% to 60%, and even higher if applied as consolidation treatment in the remission phase, a transplant-related mortality reported as 40% to 50% and a long-term survival plateau at around 40%. The 40% 5-year probability of relapse-free survival is considerably higher than that observed following autologous BMT and may result from an allogeneic graft-versus-tumor effect (graft versus myeloma) similar to the well-recognized graft-versus-leukemia effect. Although follow-up is still too short to clearly identify the likelihood of cure for MM allotransplant recipients, a certain number of them are currently long-term, disease-free survivors and--we hope--cured. These promising results and the incurability of MM with conventional chemotherapy should, therefore, encourage further application of allogeneic BMT to selected patients with unfavorable prognostic features. Continued efforts to reduce the morbidity and mortality related to the procedure, as well as to design effective pretransplant regimens with lower extramedullary toxicity and to identify those patients most likely to benefit from BMT, will improve the value of allogeneic BMT in MM.

  9. Molecular Epidemiological Study of Aspergillus fumigatus in a Bone Marrow Transplantation Unit by PCR Amplification of Ribosomal Intergenic Spacer Sequences

    PubMed Central

    Radford, Sarah A.; Johnson, Elizabeth M.; Leeming, John P.; Millar, Michael R.; Cornish, Jacqueline M.; Foot, Annabel B. M.; Warnock, David W.

    1998-01-01

    We have developed a PCR-based method for the subspecific discrimination of Aspergillus fumigatus types by using two primers designed to amplify the intergenic spacer regions between ribosomal DNA transcription units. The method permitted the reproducible discrimination of 11 distinct DNA types among a total of 119 isolates of A. fumigatus collected from patients and from the environment of a bone marrow transplantation (BMT) unit over a three-year period. Ten DNA types of A. fumigatus were isolated from patients in the BMT unit; eight of these types were also found in the hospital environment, and six of these were present in the unit itself. Thirteen BMT patients developed infection with one of three DNA types some months after these had first been found in the environment of the unit. In other instances, the same DNA types of A. fumigatus were isolated from BMT patients that were later recovered from the environment of the unit. Several DNA types of A. fumigatus were found in the hospital environment over an 18-month period. Molecular typing of multiple isolates of A. fumigatus, obtained from postmortem tissue samples, showed that one patient was infected with a single DNA type, but two others had up to three different DNA types. Our findings suggest that A. fumigatus infection in BMT recipients may be nosocomial in origin and underline the need for careful environmental monitoring of units in which high-risk patients are housed. PMID:9574694

  10. Present status of bone marrow transplantation in Japan.

    PubMed

    Masaoka, T; Shibata, H; Nakamura, H; Inoue, T

    1985-06-01

    One hundred and seventy three bone marrow transplantations (BMT) including 133 allogeneic, 17 syngeneic and 23 autologous BMT were recorded in Japan during the period between September, 1975 and March, 1984. The number of cases of BMT increased rapidly over the years, i.e., 16 cases in 1980, 27 in 1981, 39 in 1982 and 57 in 1983. All cases were treated in clean rooms, many of them receiving intensive gut decontamination containing vancomycin. In 110 cases with acute leukemia, the main causes of death were interstitial pneumonitis, relapse of leukemia, infection and GvHD. Favorable factors determined from 180-day survival were remission, no infection, low dose rate and fractionated total body irradiation (TBI), ABO minor mismatch and positive graft versus host reaction. Long-term survival of patients who received BMT during remission and were without infection amounted to 70% of acute lymphocytic leukemia (ALL) and 40% of acute myelogenous leukemia (AML) patients. Cyclosporin A (Cy-A) administered in 21 cases was compared with methotrexate (MTX) given in 20 cases. A statistically significant decrease of stomatitis was observed, while no difference in GvHD or survival was seen. There were seven cases giving a more than good response out of 11 cases treated with cyclosporin because methotrexate or immuran was ineffective or could not be administered due to toxicity. Such data suggest that allogeneic BMT is acceptable as a very promising form of treatment for acute leukemia in Japan.

  11. Interrelations between Glycine Betaine Catabolism and Methionine Biosynthesis in Sinorhizobium meliloti Strain 102F34

    PubMed Central

    Barra, Lise; Fontenelle, Catherine; Ermel, Gwennola; Trautwetter, Annie; Walker, Graham C.; Blanco, Carlos

    2006-01-01

    Methionine is produced by methylation of homocysteine. Sinorhizobium meliloti 102F34 possesses only one methionine synthase, which catalyzes the transfer of a methyl group from methyl tetrahydrofolate to homocysteine. This vitamin B12-dependent enzyme is encoded by the metH gene. Glycine betaine can also serve as an alternative methyl donor for homocysteine. This reaction is catalyzed by betaine-homocysteine methyl transferase (BHMT), an enzyme that has been characterized in humans and rats. An S. meliloti gene whose product is related to the human BHMT enzyme has been identified and named bmt. This enzyme is closely related to mammalian BHMTs but has no homology with previously described bacterial betaine methyl transferases. Glycine betaine inhibits the growth of an S. meliloti bmt mutant in low- and high-osmotic strength media, an effect that correlates with a decrease in the catabolism of glycine betaine. This inhibition was not observed with other betaines, like homobetaine, dimethylsulfoniopropionate, and trigonelline. The addition of methionine to the growth medium allowed a bmt mutant to recover growth despite the presence of glycine betaine. Methionine also stimulated glycine betaine catabolism in a bmt strain, suggesting the existence of another catabolic pathway. Inactivation of metH or bmt did not affect the nodulation efficiency of the mutants in the 102F34 strain background. Nevertheless, a metH strain was severely defective in competing with the wild-type strain in a coinoculation experiment. PMID:17015658

  12. Intensive therapy before or during the conditioning regimen of allogeneic marrow transplantation in adult acute lymphoblastic leukemia patients: we must choose to reduce Toxicity--a Groupe Ouest-Est d'Etude des Leucemies et Autres Maladies du Sang study.

    PubMed

    Deconinck, Eric; Hunault, Mathilde; Milpied, Noël; Bernard, Marc; Renaud, Marc; Desablens, Bernard; Delain, Martine; Witz, Francis; Lioure, Bruno; Pignon, Bernard; Guyotat, Denis; Berthou, Christian; Jouet, Jean-Pierre; Casassus, Phillipe; Ifrah, Norbert; Boiron, Jean-Michel

    2005-06-01

    To improve the results in the treatment of adult acute lymphoblastic leukemia patients, different strategies have been proposed. The intensification could concern the induction and early consolidation phases, the conditioning regimen before allogeneic bone marrow transplantation (alloBMT), or both. We analyzed 2 consecutive trials for adult patients in first remission and with the same prognostic features. The Leucemie Aigue Lymphoblastique Paris-Ouest-France (LALPOF) protocol proposed alloBMT with standard conditioning after a classic induction and intensified consolidation scheme; the Groupe Ouest Est des Leucemies Aigues Lymphoblastiques (GOLEAL1) protocol tested an intensified induction and consolidation course before alloBMT with a reinforced conditioning regimen. The 4-year survival rates after alloBMT for LALPOF and GOELAL1 were, respectively, 71% +/- 12% and 36% +/- 13% ( P = .009). The 4-year disease-free survival reached 75% +/- 11% in the LALPOF study and 69% +/- 13% in the GOELAL1 study ( P = .30). The toxic death rate was significantly lower in the LALPOF (2/18) than in the GOELAL1 (6/15) group. Event-free survival at 4 years was significantly higher in LALPOF than in GOELAL1: 66% +/- 11% and 35% +/- 11%, respectively ( P = .02). For adult acute lymphoblastic leukemia patients in first remission, the intensification of chemotherapy before a reinforced conditioning regimen before alloBMT may lead to an increased toxic death rate.

  13. Dentists' and Parents' Attitude Toward Nitrous Oxide Use in Kuwait

    PubMed Central

    Alkandari, Sarah A.; Almousa, Fatemah; Abdulwahab, Mohammad; Boynes, Sean G.

    2016-01-01

    The aim of this study was to investigate the attitude of dentists in Kuwait toward the use of nitrous oxide sedation as a behavior management technique (BMT) for pediatric patients and assess their training in nitrous oxide sedation. In addition, we assessed parents' knowledge of and attitude toward the use of nitrous oxide as a BMT for their children. The objective was to determine if nitrous oxide sedation is being provided and utilized as a means to enhance dental care for pediatric patients. A cross-sectional survey was randomly distributed to both groups of interest: parents accompanying their children to the dentist and licensed dentists in Kuwait. Participants had to meet certain inclusion criteria to be included in the survey and had to complete the entire questionnaire to be part of the analysis. A total of 381 parents completed the questionnaires. The majority of parents responded that they were unaware of nitrous oxide sedation and were not aware of it as a BMT (79%). Two thirds of the parent would accept nitrous oxide sedation if recommended by a dentist treating their children. Two hundred and one dentists completed the survey and met the inclusion criteria. The majority (74.5%) of dentists were willing to use nitrous oxide as a BMT. However, only 6% were utilizing nitrous oxide sedation and providing it to their child patient if indicated. The main reasons for this huge gap are lack of facilities/equipment and lack of training as indicated by the dentists. This study showed that parents are accepting nitrous oxide sedation as a BMT for their children. It also showed the willingness of the dentists to provide such BMT to their patients. The lack of training and lack of equipment are the main barriers to providing such service to the patients. More training courses and more facilities should be provided to eliminate such barriers. PMID:26866406

  14. Nutritional issues and body weight in long-term survivors of allogeneic blood and marrow transplant (BMT) in NSW Australia.

    PubMed

    Smith, Jennifer; Poon, Christine; Gilroy, Nicole; Kabir, Masura; Brice, Lisa; Dyer, Gemma; Hogg, Megan; Greenwood, Matthew; Moore, John; Hertzberg, Mark; Brown, Louisa; Tan, Jeff; Huang, Gillian; Kwan, John; Larsen, Stephen; Ward, Christopher; Kerridge, Ian

    2017-01-01

    The aims of this study were to describe the long-term nutrition, body weight and body image issues facing survivors of Allogeneic Blood and Marrow Transplant (BMT) and their impact on quality of life. It also describes survivors' perception of enteral feeding during BMT. Four hundred and forty-one survivors who had undergone a BMT in NSW, Australia between 2000 and 2012 (n = 441/583) completed the Sydney Post BMT Study Survey (SPBS). Forty-five percent of survivors less than 2-year post-transplant reported a dry mouth, 36 % reported mouth ulcers and 19 % had diarrhoea. This was consistent across all survivor groups, regardless of time since transplant. Patients with one or more gastrointestinal (GI) symptoms had significantly lower quality of life scores. There was a significant difference in quality of life scores when comparing those with no GI symptoms to those with one or more symptoms (P = <0.0001). Quality of life was significantly higher in those who once again enjoyed mealtimes (P < 0.0001). Males were more likely to be satisfied with their body weight compared to females (P = 0.009). The median body mass index (BMI) for all patients reporting body weight satisfaction was significantly lower (BMI 23.5) than those reporting dissatisfaction (BMI 27.5) (P = <0.0001). Survivors who had a normal BMI had significantly higher rates of body weight satisfaction compared to underweight, overweight and obese survivors (P = <0.0001). Those survivors who were overweight or obese were significantly more likely to be diabetic (P = 0.008). This study revealed an important relationship between gastrointestinal symptoms, body weight and body image and survivor's quality of life. It provides further support for the importance of nutrition therapy post-BMT.

  15. Improvement of thrombocytopenia following bone marrow transplantation by pegylated recombinant human megakaryocyte growth and development factor in mice.

    PubMed

    Kabaya, K; Shibuya, K; Torii, Y; Nitta, Y; Ida, M; Akahori, H; Kato, T; Kusaka, M; Miyazaki, H

    1996-12-01

    We examined whether pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF) is capable of improving thrombocytopenia and promoting thrombopoietic reconstitution following lethal irradiation and bone marrow transplantation (BMT) in mice. Immediately after receiving 10 Gy whole body irradiation (day 0), male C3H/HeN mice were inoculated with 10(6) bone marrow cells obtained from syngeneic mice. Circulating platelet counts decreased to below 4% of the normal counts with a nadir on day 10, and then returned to the normal level on day 28 in the control mice undergoing BMT. Subcutaneous consecutive treatment with PEG-rHuMGDF at doses from 10 to 300 micrograms/kg/day from day 1 for 13 days significantly improved the platelet nadir and promoted platelet recovery. The white blood cell counts and hemoglobin concentration following BMT were not influenced by the PEG-rHuMGDF. PEG-rHuMGDF-injection starting from day 5 did not improve the platelet nadir following BMT. Furthermore, administration with PEG-rHuMGDF on alternate days at 55.7 micrograms/kg/day for 7 days or at an interval of 3 days at 78 micrograms/kg/day for 4 days (twice a week for 2 weeks) had a significant efficacy, but these administration regimens had less efficacy than consecutive administration at 30 micrograms/kg/day for 13 days. The numbers of megakaryocytes and megakaryocyte progenitor cells decreased to 5 and 0.2% of normal level, respectively, in the control mice. Consecutive administration of PEG-rHuMGDF enhanced the recovery of the mean number of these cells compared to those in vehicle-treated mice, although such effects were not statistically significant except for the number of megakaryocyte progenitors on day 12. These results suggest that consecutive treatment with PEG-rHuMGDF beginning from the day after BMT may be effective in improving thrombocytopenia following BMT.

  16. Dentists' and Parents' Attitude Toward Nitrous Oxide Use in Kuwait.

    PubMed

    Alkandari, Sarah A; Almousa, Fatemah; Abdulwahab, Mohammad; Boynes, Sean G

    2016-01-01

    The aim of this study was to investigate the attitude of dentists in Kuwait toward the use of nitrous oxide sedation as a behavior management technique (BMT) for pediatric patients and assess their training in nitrous oxide sedation. In addition, we assessed parents' knowledge of and attitude toward the use of nitrous oxide as a BMT for their children. The objective was to determine if nitrous oxide sedation is being provided and utilized as a means to enhance dental care for pediatric patients. A cross-sectional survey was randomly distributed to both groups of interest: parents accompanying their children to the dentist and licensed dentists in Kuwait. Participants had to meet certain inclusion criteria to be included in the survey and had to complete the entire questionnaire to be part of the analysis. A total of 381 parents completed the questionnaires. The majority of parents responded that they were unaware of nitrous oxide sedation and were not aware of it as a BMT (79%). Two thirds of the parent would accept nitrous oxide sedation if recommended by a dentist treating their children. Two hundred and one dentists completed the survey and met the inclusion criteria. The majority (74.5%) of dentists were willing to use nitrous oxide as a BMT. However, only 6% were utilizing nitrous oxide sedation and providing it to their child patient if indicated. The main reasons for this huge gap are lack of facilities/equipment and lack of training as indicated by the dentists. This study showed that parents are accepting nitrous oxide sedation as a BMT for their children. It also showed the willingness of the dentists to provide such BMT to their patients. The lack of training and lack of equipment are the main barriers to providing such service to the patients. More training courses and more facilities should be provided to eliminate such barriers.

  17. The effect of glass additives on the microwave dielectric properties of Ba(Mg{sub 1/3}Ta{sub 2/3})O{sub 3} ceramics

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

    Surendran, K.P.; Mohanan, P.; Sebastian, M.T.

    2004-11-01

    The effect of glass additives on the densification, phase evolution, microstructure and microwave dielectric properties of Ba(Mg{sub 1/3}Ta{sub 2/3})O{sub 3} (BMT) was investigated. Different weight percentages of quenched glass such as B{sub 2}O{sub 3}, SiO{sub 2}, B{sub 2}O{sub 3}-SiO{sub 2}, ZnO-B{sub 2}O{sub 3}, 5ZnO-2B{sub 2}O{sub 3}, Al{sub 2}O{sub 3}-SiO{sub 2}, Na{sub 2}O-2B{sub 2}O{sub 3}.10H{sub 2}O, BaO-B{sub 2}O{sub 3}-SiO{sub 2}, MgO-B{sub 2}O{sub 3}-SiO{sub 2}, PbO-B{sub 2}O{sub 3}-SiO{sub 2}, ZnO-B{sub 2}O{sub 3}-SiO{sub 2} and 2MgO-Al{sub 2}O{sub 3}-5SiO{sub 2} were added to calcined BMT precursor. The sintering temperature of the glass-added BMT samples were lowered down to 1300 deg. C compared to solid-statemore » sintering where the temperature was 1650{sup o}C. The formation of high temperature satellite phases such as Ba{sub 5}Ta{sub 4}O{sub 15} and Ba{sub 7}Ta{sub 6}O{sub 22} were found to be suppressed by the glass addition. Addition of glass systems such as B{sub 2}O{sub 3}, ZnO-B{sub 2}O{sub 3}, 5ZnO-2B{sub 2}O{sub 3} and ZnO-B{sub 2}O{sub 3}-SiO{sub 2} improved the densification and microwave dielectric properties. Other glasses were found to react with BMT to form low-Q phases which prevented densification. The microwave dielectric properties of undoped BMT with a densification of 93.1% of the theoretical density were {epsilon}r=24.8, {tau}f=8ppm/{sup o}C and Q{sub u}xf=80,000GHz. The BMT doped with 1.0wt% of B{sub 2}O{sub 3} has Q{sub u}xf=124,700GHz, {epsilon}r=24.2, and {tau}f=-1.3ppm/ deg/ C. The unloaded Q factor of 0.2wt% ZnO-B{sub 2}O{sub 3}-doped BMT was 136,500GHz while that of 1.0wt% of 5ZnO-2B{sub 2}O{sub 3} added ceramic was Q{sub u}xf=141,800GHz. The best microwave quality factor was observed for ZnO-B{sub 2}O{sub 3}-SiO{sub 2} (ZBS) glass-added ceramics which can act as a perfect liquid-phase medium for the sintering of BMT. The microwave dielectric properties of 0.2wt% ZBS-added BMT dielectric was Q{sub u}xf=152,800GHz, {epsilon}r=25.5, and {tau}f=-1.5ppm/ deg. C.« less

  18. The Human Figure Drawing with Donor and Nondonor Siblings of Pediatric Bone Marrow Transplant Patients.

    ERIC Educational Resources Information Center

    Packman, Wendy L.; Beck, Vanessa L.; VanZutphen, Kelly H.; Long, Janet K.; Spengler, Gisele

    2003-01-01

    There is little research on the psychological impact of bone marrow transplantation (BMT) on family members. This study uses the Human Figure Drawing (HFD) to measure siblings' emotional distress toward BMT. Among the siblings, feelings of isolation, anger, depression, anxiety, and low self-esteem emerged as major themes. Findings indicate the…

  19. Nursing challenges caring for bone marrow transplantation patients with graft versus host disease.

    PubMed

    Neumann, Joyce

    2017-12-01

    Nursing care of blood and marrow transplantation (BMT) patients is complicated. Nursing considerations of BMT patients with GVHD require an additional set of skills and knowledge that include side effects, both expected and less common, assessment skills, treatment administration, both standard and novel, and acute or intensive care. Nursing care of BMT patients with skin GVHD will be determined by the degree of skin alteration with distinct decisions made about hygiene, both topical and systemic treatment, infection prevention, relief of discomfort, functional ability (ADL) and body image alteration. The nurse needs to have knowledge about assessment criteria for acute and chronic (NIH) assessment with special attention to skin (presence of rash, texture, mobility), joint mobility, mouth care, dressings, and skin care products. Nursing consideration of gastrointestinal GVHD includes importance of accurate intake and output, obtaining culture, fluid and electrolyte imbalance, nutrition, treatment, and skin care. Complication of GVHD treatment, namely effects of steroids require experts from many disciplines to provide comprehensive care. Caring and advocating for GVHD patients may include preparing for outcomes that are undesirable and impact the patient's quality of life and mortality. BMT survivorship programs are a major source of patient education about chronic GVHD for patients after treatment. Caring for BMT patients, especially those experiencing GVHD, takes a knowledgeable, committed, and caring team of healthcare providers. Workshops like this are vital in providing information and networking to keep providers around the region and globe engaged in this critical work. Copyright © 2017. Published by Elsevier B.V.

  20. Simultaneous bone marrow and composite tissue transplantation in rats treated with nonmyeloablative conditioning promotes tolerance1

    PubMed Central

    Xu, Hong; Ramsey, Deborah M.; Wu, Shengli; Bozulic, Larry D.; Ildstad, Suzanne T.

    2012-01-01

    Background Approaches to safely induce tolerance in vascularized composite allotransplantation (VCA) with chimerism through bone marrow transplantation (BMT) are currently being pursued. However, the VCA were historically performed sequentially after donor chimerism was established. Delayed VCA is not clinically applicable due to the time constraints associated with procurement from deceased donors. A more clinically relevant approach to perform both the BMT and VCA simultaneously was evaluated. Methods WF (RT1Au) rats were treated with a short course of immunosuppressive therapy (anti-αβ-TCR mAb, FK-506, and anti-lymphocyte serum). One day prior to BMT, rats were treated with varying doses of total body irradiation (TBI) followed by transplantation of heterotopic osteomyocutaneous flaps from hind limbs of ACI (RT1Aabl) rats. Results 80% of rats conditioned with 300 cGy TBI and 40% of rats receiving 400 cGy TBI accepted the VCA. Mixed chimerism was detected in peripheral blood at one month post-VCA, but chimerism was lost in all transplant recipients by 4 months. The majority of peripheral donor cells originated from the BMT and not the VCA. Acceptors of VCA were tolerant of a donor skin graft challenge and no anti-donor antibodies were detectable, suggesting a central deletional mechanism for tolerance. Regulatory T cells (Treg) from spleens of acceptors more potently suppressed lymphocyte proliferation than Treg from rejectors in the presence of donor stimulator cells. Conclusions These studies suggest that simultaneous BMT and VCA may establish indefinite allograft survival in rats through Treg-mediated suppression and thymic deletion of alloreactive T cells. PMID:23250336

  1. Quality of life and its socio-demographic and psychological determinants after bone marrow transplantation.

    PubMed

    Janicsák, Henriett; Masszi, Tamás; Reményi, Péter; Ungvari, Gabor S; Gazdag, Gábor

    2013-08-01

    A host of medical, socio-demographic, and psychological factors that affect bone marrow transplantation (BMT) patients' quality of life (QOL) have been identified, but due to the methodological diversity of the studies, the findings have been contradictory. The aim of this study was to examine the influence of somatic status, social characteristics, and psychological symptoms on QOL in BMT patients. The study had a cross-sectional design. QOL was evaluated using the Hungarian version of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) scale. Anxiety and depression were assessed using Spielberger's State and Trait Anxiety Inventory (SSTAI) and the Beck Depression Inventory (BDI). A questionnaire designed for the study was used to record socio-demographic variables. One hundred and twenty-one patients formed the study sample. Patients' QOL was better in our sample than in another study with similar mean time after BMT. BDI scores indicated mild depression; SSTAI scores corresponded with healthy population levels. QOL was strongly influenced by psychological symptoms (depression P < 0.001; anxiety P = 0.001; psychiatric comorbidity P = 0.001), employment status (P = 0.042), and gender (P = 0.05). The somatic factors influenced only separate aspects of QOL; somatic comorbidity only affected cancer-associated QOL (P = 0.004). This is the first study on a Hungarian BMT sample that included economic factors in the assessment of QOL. Psychological variables were the strongest determinants of QOL in this study. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Quantification of polyoma BK viruria in hemorrhagic cystitis complicating bone marrow transplantation.

    PubMed

    Leung, A Y; Suen, C K; Lie, A K; Liang, R H; Yuen, K Y; Kwong, Y L

    2001-09-15

    Polyoma BK virus (BKV) is frequently identified in the urine of bone marrow transplantation (BMT) patients with hemorrhagic cystitis (HC). However, viruria is common even in asymptomatic patients, making a direct causative role of BKV difficult to establish. This study prospectively quantified BK viruria and viremia in 50 BMT patients to define the quantitative relationship of BKV reactivation with HC. Adenovirus (ADV) was similarly quantified as a control. More than 800 patient samples were quantified for BKV VP1 gene with a real-time quantitative polymerase chain reaction. Twenty patients (40%) developed HC, 6 with gross hematuria (HC grade 2 or higher) and 14 with microscopic hematuria (HC grade 1). When compared with asymptomatic patients, patients with HC had significantly higher peak BK viruria (6 x 10(12) versus 5.7 x 10(7) genome copies/d, P <.001) and larger total amounts of BKV excreted during BMT (4.9 x 10(13) versus 7.7 x 10(8) genome copies, P <.001). There was no detectable increase in BK viremia. Binary logistic regression analysis showed that BK viruria was the only risk factor, with HC not related to age, conditioning regimen, type of BMT, and graft-versus-host disease. Furthermore, the levels of ADV viruria in patients with or without HC were similar and comparable with those of BK viruria in patients without HC, suggesting that the significant increase in BK viruria in HC patients was not due to background viral reactivation or damage to the urothelium. BK viruria was quantitatively related to the occurrence of HC after BMT.

  3. Bone Marrow Cell Transfer into Fetal Circulation Can Ameliorate Genetic Skin Diseases by Providing Fibroblasts to the Skin and Inducing Immune Tolerance

    PubMed Central

    Chino, Takenao; Tamai, Katsuto; Yamazaki, Takehiko; Otsuru, Satoru; Kikuchi, Yasushi; Nimura, Keisuke; Endo, Masayuki; Nagai, Miki; Uitto, Jouni; Kitajima, Yasuo; Kaneda, Yasufumi

    2008-01-01

    Recent studies have shown that skin injury recruits bone marrow-derived fibroblasts (BMDFs) to the site of injury to accelerate tissue repair. However, whether uninjured skin can recruit BMDFs to maintain skin homeostasis remains uncertain. Here, we investigated the appearance of BMDFs in normal mouse skin after embryonic bone marrow cell transplantation (E-BMT) with green fluorescent protein-transgenic bone marrow cells (GFP-BMCs) via the vitelline vein, which traverses the uterine wall and is connected to the fetal circulation. At 12 weeks of age, mice treated with E-BMT were observed to have successful engraftment of GFP-BMCs in hematopoietic tissues accompanied by induction of immune tolerance against GFP. We then investigated BMDFs in the skin of the same mice without prior injury and found that a significant number of BMDFs, which generate matrix proteins both in vitro and in vivo, were recruited and maintained after birth. Next, we performed E-BMT in a dystrophic epidermolysis bullosa mouse model (col7a1−/−) lacking type VII collagen in the cutaneous basement membrane zone. E-BMT significantly ameliorated the severity of the dystrophic epidermolysis bullosa phenotype in neonatal mice. Type VII collagen was deposited primarily in the follicular basement membrane zone in the vicinity of the BMDFs. Thus, gene therapy using E-BMT into the fetal circulation may offer a potential treatment option to ameliorate genetic skin diseases that are characterized by fibroblast dysfunction through the introduction of immune-tolerated BMDFs. PMID:18688022

  4. Review of attrition and adherence in exercise studies following hematopoietic stem cell transplantation.

    PubMed

    Hacker, Eileen Danaher; Mjukian, Maral

    2014-04-01

    Implementing exercise programs in people receiving high-dose chemotherapy followed by bone marrow (BMT) or hematopoietic stem cell transplantation (SCT) presents unique challenges. This review examines subject attrition rates and reasons for attrition as well as adherence to exercise interventions following BMT/SCT. Studies published between January 1985 and December 2012 that prospectively tested an exercise intervention following BMT or SCT were included in the review. Evaluation criteria included: (1) exercise modality; (2) the amount of supervision required to implement the intervention; (3) timing of the intervention; (4) subject attrition rates and reasons for attrition; and (5) exercise adherence rates. Of the 20 studies reviewed, most tested an aerobic exercise intervention or a combination of aerobic and strength training. Supervised exercise sessions were more commonly used than unsupervised sessions. The overall attrition rate was 18% for the 998 subjects enrolled in the studies. Major reasons for attrition included death, change in health status, protocol issues, personal issues with subjects, and lost to follow-up/no reason provided. Authors of supervised exercise programs rarely published exercise adherence information. Unsupervised exercise programs relied mainly on self-report to document adherence. Exercise research following BMT/SCT is becoming more sophisticated as researchers build upon the expanding literature base. Questions regarding subject attrition and adherence to exercise interventions must be addressed to identify interventions that are likely to be successful when translated into clinical practice. Subject attrition from exercise studies following BMT/SCT is relatively low. Adherence information for exercise interventions needs to be regularly addressed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Marital Violence in the Year before and after Spouse-Involved Alcoholism Treatment.

    ERIC Educational Resources Information Center

    O'Farrell, Timothy J.; Choquette, Keith A.

    The Conflict Tactics Scale questionnaire on marital violence was administered to 29 alcoholics and their wives at entry to, and 1 year after, completing a behavioral marital therapy (BMT) treatment program. In the year prior to BMT, prevalence rates of any violent act, of minor to moderate violent acts, and of severe violent acts were five to six…

  6. Perceptions of stress, burnout, and support systems in pediatric bone marrow transplantation nursing.

    PubMed

    Gallagher, Regan; Gormley, Denise K

    2009-12-01

    Bone marrow transplantation (BMT) is used to treat various conditions, ranging from immune disorders to many types of cancer. The critical complexity of patients and the environment in which BMT nurses work can lead to stress, burnout, and, ultimately, poor retention. This study aimed to investigate nurses' perceptions of work-related stress and burnout as well as current support systems for nurses. The study included 30 BMT staff nurses from a large pediatric medical center in the midwestern United States. Critical illness or acuity of patients was reported as the most stressful factor; long work hours was the least stressful factor. Most nurses perceived moderate to high levels of emotional exhaustion, and 33% reported moderate levels of depersonalization. Fifty percent perceived high levels of personal accomplishment, despite the critical illness or acuity of their patients, demanding patient families, rotating shifts, short staffing, and caring for dying patients. Most nurses felt that support systems were in place and that staff was accessible, but most respondents were undecided about the helpfulness of the support systems. Results suggest that support systems may significantly affect work satisfaction and feelings of accomplishment for BMT nurses.

  7. Proton magnetic resonance spectroscopy in adult cancer patients with delirium

    PubMed Central

    Yager, Jeffrey R.; Magnotta, Vincent A.; Mills, James A.; Vik, Stacie M.; Weckmann, Michelle T.; Capizzano, Aristides A.; Gingrich, Roger; Beglinger, Leigh J.

    2010-01-01

    Background Delirium is associated with a host of negative outcomes, including increased risk of mortality, longer hospital stay, and poor long-term cognitive function. The pathophysiology of delirium is not well understood. Cancer patients undergoing a bone marrow transplant (BMT) are at high risk for developing delirium and Proton Magnetic Resonance Spectroscopy (1H-MRS) could lead to better understanding of the delirium process. Methods Fourteen BMT patients and 10 controls completed 1H-MRS, positioned above the corpus callosum, shortly after delirium onset or at study end if no delirium occurred. Results In the BMT-delirium group, statistically significantly elevated tCho/tCr was found in contrast to the BMT-no delirium group (p<0.05). The BMT–delirium group also showed statistically significantly lesser NAA/tCho compared to both controls (p=0.01) and the BMT–no delirium group (p=0.04). Conclusions Elevated choline and reduced NAA indicate inflammatory processes and white matter damage as well as neuronal metabolic impairment. Further research is needed to separate the choline peaks, as well as more detailed collection of medication regimens to determine whether a higher choline concentration is a function of the delirium process or cancer treatment effects. PMID:21227658

  8. Successful pregnancy after total body irradiation and bone marrow transplantation for acute leukaemia.

    PubMed

    Giri, N; Vowels, M R; Barr, A L; Mameghan, H

    1992-07-01

    We report successful pregnancies in two young women (aged 24 and 20 years) following allogeneic bone marrow transplantation (BMT) for acute non-lymphoblastic leukaemia. Conditioning therapy consisted of cyclophosphamide (120 mg/kg) and total body irradiation (TBI, 12 Gy) in 2 Gy fractions once daily for 6 days or twice daily for 3 days. Graft-versus-host disease prophylaxis was with methotrexate alone. Both women were amenorrhoeic after BMT and gonadal testing indicated hypergonadotrophic hypogonadism. Both women had normal pregnancies (2 years and 5 years after BMT) resulting in normal healthy infants. Previously successful pregnancy has been reported after TBI in three women in whom the TBI dose was less than 8 Gy. Our cases illustrate that normal outcome of pregnancy is possible at even higher doses of TBI.

  9. Behavioral Marital Therapy (BMT) for Alcoholics and Wives: Review of Literature and a Proposed Research Program.

    ERIC Educational Resources Information Center

    O'Farrell, Timothy J.; Cutter, Henry S. G.

    After describing a social learning formulation of the male alcoholic's marriage, this paper reviews the few studies of behavioral marital therapy (BMT) for alcoholics and their wives. Although none of these studies are as rigorous as one might wish and many of them are merely case studies, a review of the literature shows that behavioral marital…

  10. Endocrine and metabolic disorders in young adult survivors of childhood acute lymphoblastic leukaemia (ALL) or non-Hodgkin lymphoma (NHL).

    PubMed

    Steffens, M; Beauloye, V; Brichard, B; Robert, A; Alexopoulou, O; Vermylen, Ch; Maiter, D

    2008-11-01

    Treatments of acute lymphoblastic leukaemia (ALL) and non-Hodgkin lymphoma (NHL), involving various combinations of chemotherapy (chemo), cranial irradiation (CI) and/or bone marrow transplantation after total body irradiation (BMT/TBI), are often successful but may have several long-term harmful effects. To evaluate late endocrine and metabolic complications in adult survivors of childhood ALL and NHL, in relation with the different therapeutic schemes received. Endocrine and metabolic parameters were determined in 94 patients (48 men, mean age: 24 +/- 5 years) with a former childhood ALL (n = 78) or NHL (n = 16) and subgrouped according to their previous treatment: chemo only (group I; n = 44), chemo + CI (group II; n = 32) and chemo + BMT/TBI (group III; n = 18). Severe GH deficiency (peak < 3.0 ng/ml after glucagon) was observed in 22% and 50% of patients of groups II and III, respectively, while hypothyroidism was mainly observed in group III (56%). Moreover, 83% of men developed hypogonadism after BMT/TBI, compared to 17% and 8% in groups I and II, respectively (P < 0.05), and all grafted women had ovarian failure, in contrast with other female patients in whom menarche had occurred spontaneously. Patients with BMT/TBI had also an adverse metabolic profile, with insulin resistance in 83% and dyslipidaemia in 61%. This study reveals a high prevalence of endocrine and metabolic disorders in young adult survivors of childhood ALL or NHL, this frequency mainly depending on the treatment received. Treatment with BMT/TBI is the most detrimental and many of these patients will develop GHD, hypothyroidism, hypogonadism, insulin resistance and dyslipidaemia.

  11. Estimations of BCR-ABL/ABL transcripts by quantitative PCR in chronic myeloid leukaemia after allogeneic bone marrow transplantation and donor lymphocyte infusion.

    PubMed

    Otazú, Ivone B; Tavares, Rita de Cassia B; Hassan, Rocío; Zalcberg, Ilana; Tabak, Daniel G; Seuánez, Héctor N

    2002-02-01

    Serial assays of qualitative (multiplex and nested) and quantitative PCR were carried out for detecting and estimating the level of BCR-ABL transcripts in 39 CML patients following bone marrow transplantation. Seven of these patients, who received donor lymphocyte infusions (DLIs) following to relapse, were also monitored. Quantitative estimates of BCR-ABL transcripts were obtained by co-amplification with a competitor sequence. Estimates of ABL transcripts were used, an internal control and the ratio BCR-ABL/ABL was thus estimated for evaluating the kinetics of residual clones. Twenty four patients were followed shortly after BMT; two of these patients were in cytogenetic relapse coexisting with very high BCR-ABL levels while other 22 were in clinical, haematologic and cytogenetic remission 2-42 months after BMT. In this latter group, seven patients showed a favourable clinical-haematological progression in association with molecular remission while in 14 patients quantitative PCR assays indicated molecular relapse that was not associated with an early cytogenetic-haematologic relapse. BCR-ABL/ABL levels could not be correlated with presence of GVHD in 24 patients after BMT. In all seven patients treated with DLI, high levels of transcripts were detected at least 4 months before the appearance of clinical haematological relapse. Following DLI, five of these patients showed decreasing transcript levels from 2 to 5 logs between 4 and 12 months. In eight other patients studied long after BMT, five showed molecular relapse up to 117 months post-BMT and only one showed cytogenetic relapse. Our findings indicated that quantitative estimates of BCR-ABL transcripts were valuable for monitoring minimal residual disease in each patient.

  12. Rapid reduction of central line infections in hospitalized pediatric oncology patients through simple quality improvement methods.

    PubMed

    Choi, Sung W; Chang, Lawrence; Hanauer, David A; Shaffer-Hartman, Jacqueline; Teitelbaum, Daniel; Lewis, Ian; Blackwood, Alex; Akcasu, Nur; Steel, Janell; Christensen, Joy; Niedner, Matthew F

    2013-02-01

    Pediatric hematology-oncology (PHO) patients are at significant risk for developing central line-associated bloodstream infections (CLA-BSIs) due to their prolonged dependence on such catheters. Effective strategies to eliminate these preventable infections are urgently needed. In this study, we investigated the implementation of bundled central line maintenance practices and their effect on hospital-acquired CLA-BSIs. CLA-BSI rates were analyzed within a single-institution's PHO unit between January 2005 and June 2011. In May 2008, a multidisciplinary quality improvement team developed techniques to improve the PHO unit's safety culture and implemented the use of catheter maintenance practices tailored to PHO patients. Data analysis was performed using time-series methods to evaluate the pre- and post-intervention effect of the practice changes. The pre-intervention CLA-BSI incidence was 2.92 per 1,000-patient days (PD) and coagulase-negative Staphylococcus was the most prevalent pathogen (29%). In the post-intervention period, the CLA-BSI rate decreased substantially (45%) to 1.61 per 1,000-PD (P < 0.004). Early on, blood and marrow transplant (BMT) patients had a threefold higher CLA-BSI rate compared to non-BMT patients (P < 0.033). With additional infection control countermeasures added to the bundled practices, BMT patients experienced a larger CLA-BSI rate reduction such that BMT and non-BMT CLA-BSI rates were not significantly different post-intervention. By adopting and effectively implementing uniform maintenance catheter care practices, learning multidisciplinary teamwork, and promoting a culture of patient safety, the CLA-BSI incidence in our study population was significantly reduced and maintained. Copyright © 2012 Wiley Periodicals, Inc.

  13. Intestinal helminths regulate lethal acute graft-versus-host disease and preserve the graft-versus-tumor effect in mice.

    PubMed

    Li, Yue; Chen, Hung-Lin; Bannick, Nadine; Henry, Michael; Holm, Adrian N; Metwali, Ahmed; Urban, Joseph F; Rothman, Paul B; Weiner, George J; Blazar, Bruce R; Elliott, David E; Ince, M Nedim

    2015-02-01

    Donor T lymphocyte transfer with hematopoietic stem cells suppresses residual tumor growth (graft-versus-tumor [GVT]) in cancer patients undergoing bone marrow transplantation (BMT). However, donor T cell reactivity to host organs causes severe and potentially lethal inflammation called graft-versus-host disease (GVHD). High-dose steroids or other immunosuppressive drugs are used to treat GVHD that have limited ability to control the inflammation while incurring long-term toxicity. Novel strategies are needed to modulate GVHD, preserve GVT, and improve the outcome of BMT. Regulatory T cells (Tregs) control alloantigen-sensitized inflammation of GVHD, sustain GVT, and prevent mortality in BMT. Helminths colonizing the alimentary tract dramatically increase the Treg activity, thereby modulating intestinal or systemic inflammatory responses. These observations led us to hypothesize that helminths can regulate GVHD and maintain GVT in mice. Acute GVHD was induced in helminth (Heligmosomoides polygyrus)-infected or uninfected BALB/c recipients of C57BL/6 donor grafts. Helminth infection suppressed donor T cell inflammatory cytokine generation and reduced GVHD-related mortality, but maintained GVT. H. polygyrus colonization promoted the survival of TGF-β-generating recipient Tregs after a conditioning regimen with total body irradiation and led to a TGF-β-dependent in vivo expansion/maturation of donor Tregs after BMT. Helminths did not control GVHD when T cells unresponsive to TGF-β-mediated immune regulation were used as donor T lymphocytes. These results suggest that helminths suppress acute GVHD using Tregs and TGF-β-dependent pathways in mice. Helminthic regulation of GVHD and GVT through intestinal immune conditioning may improve the outcome of BMT. Copyright © 2015 by The American Association of Immunologists, Inc.

  14. A synthetic eicosanoid LX-mimetic unravels host-donor interactions in allogeneic BMT-induced GvHD to reveal an early protective role for host neutrophils.

    PubMed

    Devchand, Pallavi R; Schmidt, Birgitta A; Primo, Valeria C; Zhang, Qing-yin; Arnaout, M Amin; Serhan, Charles N; Nikolic, Boris

    2005-02-01

    Lipoxin A(4) (LXA(4)) and aspirin-triggered 15-epi-LXA(4) are potent endogenous lipid mediators thought to define the inflammatory set-point. We used single prophylactic administrations of a synthetic aspirin-triggered lipoxin A(4) signal mimetic, ATLa, to probe dynamics of early host-donor interactions in a mouse model for the inflammation-associated multifactorial disease of allogeneic bone marrow transplant (BMT) -induced graft-vs.-host disease (GvHD). We first demonstrated that both host and donor are responsive to the ATLa signals. The simple and restricted regimen of a single prophylactic administration of ATLa [100 ng/mL to donor cells or 1 microg (approximately 50 microg/kg) i.v. to host] was sufficient to delay death. Clinical indicators of weight, skin lesions, diarrhea and eye inflammation were monitored. Histological analyses on day 45 post-BMT showed that the degree of cellular trafficking, particularly neutrophil infiltrate, and protection of end-organ target pathology are different, depending on whether the host or donor was treated with ATLa. Taken together, these results chart some ATLa protective effects on GvHD cellular dynamics over time and identify a previously unrecognized effect of host neutrophils in the early phase post-BMT as important determinants in the dynamics of GvHD onset and progression.-Devchand, P. R., Schmidt, B. A., Primo, V. C., Zhang, Q.-y., Arnaout, M. A., Serhan, C. N., Nikolic, B. A synthetic eicosanoid LX-mimetic unravels host-donor interactions in allogeneic BMT-induced GvHD to reveal an early protective role for host neutrophils.

  15. Platelet transfusion refractoriness attributable to HLA antibodies produced by donor-derived cells after allogeneic bone marrow transplantation from one HLA-antigen-mismatched mother.

    PubMed

    Hatakeyama, Naoki; Hori, Tsukasa; Yamamoto, Masaki; Inazawa, Natsuko; Iesato, Kotoe; Miyazaki, Toru; Ikeda, Hisami; Tsutsumi, Hiroyuki; Suzuki, Nobuhiro

    2011-12-01

    PTR is a serious problem in patients being treated for hematologic disorders. Two patients with acute leukemia developed PTR after allogeneic BMT from one HLA-antigen-mismatched mother attributable to HLA antibodies, which could not be detected in their serum before BMT. HLA antibodies, whose specificity resembled that of each patient, were detected in each donor's serum. Each donor had probably been immunized during pregnancy by their partner's HLA antigens expressed by the fetus, consequently, transplanted donor-derived cells provoked HLA antibodies in each recipient early after BMT, and those HLA antibodies induced PTR. If the mothers are selected as donors for their children, they should be tested for the presence of HLA antibodies. © 2010 John Wiley & Sons A/S.

  16. Application of the Biosonar Measurement Tool (BMT) and Instrumented Mine Simulators (IMS) to Exploration of Dolphin Echolocation During Free-Swimming, Bottom-Object Searches

    DTIC Science & Technology

    2003-09-01

    0-933957-31-9 311 Application of the Biosonar Measurement Tool (BMT) and Instrumented...dolphin biosonar (echolocation). Research work conducted by the Navy has addressed the characteristics of echolocation clicks, mechanisms of...information on dolphin echolocation that can be data mined for biosonar search strategies under real-world conditions. Results can be applied to the

  17. [Bone marrow transplantation].

    PubMed

    Masaoka, T

    1984-10-01

    One hundred seventy-one of cases bone marrow transplantation (BMT), including 132 allogeneic, 16 syngeneic and 23 autologous, were recorded in Japan during the period from September 1975 through March 1984. The number of BMT cases increase showed a rapid chronological i.e., 16 cases in 1980, 27 in 1981, 39 in 1982 and 57 in 1983. All cases were treated in clean rooms, and many of them received intensive gut decontamination using Vancomycin.

  18. HLA-matched sibling bone marrow transplantation for β-thalassemia major

    PubMed Central

    Sabloff, Mitchell; Chandy, Mammen; Wang, Zhiwei; Logan, Brent R.; Ghavamzadeh, Ardeshir; Li, Chi-Kong; Irfan, Syed Mohammad; Bredeson, Christopher N.; Cowan, Morton J.; Gale, Robert Peter; Hale, Gregory A.; Horan, John; Hongeng, Suradej; Eapen, Mary

    2011-01-01

    We describe outcomes after human leukocyte antigen-matched sibling bone marrow transplantation (BMT) for 179 patients with β-thalassemia major. The median age at transplantation was 7 years and the median follow-up was 6 years. The distribution of Pesaro risk class I, II, and III categories was 2%, 42%, and 36%, respectively. The day 30 cumulative incidence of neutrophil recovery and day 100 platelet recovery were 90% and 86%, respectively. Seventeen patients had graft failure, which was fatal in 11. Six of 9 patients with graft failure are alive after a second transplantation. The day 100 probability of acute graft-versus-host disease and 5-year probability of chronic graft-versus-host disease was 38% and 13%, respectively. The 5-year probabilities of overall- and disease-free survival were 91% and 88%, respectively, for patients with Pesaro risk class II, and 64% and 62%, respectively, for Pesaro risk class III. In multivariate analysis, mortality risks were higher in patients 7 years of age and older and those with hepatomegaly before BMT. The leading causes of death were interstitial pneumonitis (n = 7), hemorrhage (n = 8), and veno-occlusive disease (n = 6). Proceeding to BMT in children younger than 7 years before development of end-organ damage, particularly in the liver, should improve results after BMT for β-thalassemia major. PMID:21119108

  19. An exploratory study investigating children's perceptions of dental behavioural management techniques.

    PubMed

    Davies, E Bethan; Buchanan, Heather

    2013-07-01

    Behaviour management techniques (BMTs) are utilised by dentists to aid children's dental anxiety (DA). Children's perceptions of these have been underexplored, and their feedback could help inform paediatric dentistry. To explore children's acceptability and perceptions of dental communication and BMTs and to compare these by age, gender, and DA. A total of sixty-two 9- to 11-year-old school children participated in the study. Children's acceptability of BMTs was quantified using a newly developed Likert scale, alongside exploration of children's experiences and perceptions through interviews. anova and t-tests explored BMT acceptability ratings by age, gender, and DA. Thematic analysis was used to analyse interviews. Statistical analyses showed no effect of age, gender, or DA upon BMT acceptability. Children generally perceived the BMTs as acceptable or neutral; stop signals were the most acceptable, and voice control the least acceptable BMT. Beneficial experiences of distraction and positive reinforcement were common. Children described the positive nature of their dentist's communication and BMT utilisation. Dental anxiety did not affect children's perceptions of BMTs. Children were generally positive about dentist's communication and established BMTs. Children's coping styles may impact perceptions and effectiveness of BMTs and should be explored in future investigations. © 2012 John Wiley & Sons Ltd, BSPD and IAPD.

  20. Graft-versus-Host Disease-Associated Vulvovaginal Symptoms after Bone Marrow Transplantation.

    PubMed

    Chung, Christopher P; Sargent, Rachel E; Chung, Nadia T; Lacey, James V; Wakabayashi, Mark T

    2016-02-01

    We conducted a retrospective review to assess the prevalence of graft-versus-host disease (GVHD)-associated gynecologic conditions among bone marrow transplantation (BMT) patients at City of Hope Medical Center. We calculated the associations among the estimated risks of various gynecologic complications, including vaginal stenosis, by performing chi-square tests and t-test statistics. Between 2010 and 2014, 180 patients were referred to the gynecologic clinic after their BMT. One hundred twenty-four patients (69%) had GVHD; among these patients, 51 (41%) experienced dyspareunia and 43 (35%) had vaginal stenosis. GVHD patients were significantly more likely to have vaginal stenosis (P < .0001), more likely to have used a vaginal dilator (P = .0008), and less likely to have urinary incontinence (UI) than those without GVHD (P < .001). There was no difference in developing pelvic organ prolapse (POP) in patients with or without GVHD (P = .4373). GVHD was a common complication after allogenic BMT. Patients with BMT were more likely to have vulvovaginal symptoms, such as dyspareunia and pelvic pain. Patients with GVHD are at high risk for vaginal stenosis requiring the use of a vaginal dilator. However, they are at low risk for developing UI and POP. Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  1. A quality of life study in 20 adult long-term survivors of unrelated donor bone marrow transplantation.

    PubMed

    Marks, D I; Gale, D J; Vedhara, K; Bird, J M

    1999-07-01

    There are few specific data available concerning quality of life (QOL) of survivors of unrelated donor bone marrow transplantation (UD-BMT). The procedure is expensive, difficult and is being employed increasingly yet we have little information concerning the QOL of survivors to justify this intervention. In this study, 20 long-term (>1 year post-BMT) survivors were studied with four self report questionnaires designed to assess quality of life, satisfaction with life, social support and employment status. Overall, satisfaction with life measures was above average but there was dissatisfaction with physical strength and appearance. The post-transplant employment data indicates that 60% of long-term survivors returned to full-time work and 15% to part-time work. Failure to return to work was not correlated with graft-versus-host disease (GVHD), relapse, age at or time since transplant. In general, there was a good correlation between the clinician's and patient's view of their health but the clinician's assessment of the patients mental health and energy was higher than the patients reported. Further research is required in the area of QOL post-UD-BMT. This will enable transplant physicians to counsel patients better pre-BMT and to evaluate fully the results achieved by different centres performing the procedure.

  2. Successful bone marrow transplantation in a boy with X-linked lymphoproliferative syndrome and acute severe infectious mononucleosis.

    PubMed

    Pracher, E; Panzer-Grümayer, E R; Zoubek, A; Peters, C; Gadner, H

    1994-05-01

    We report a 5.9-year-old boy with X-linked lymphoproliferative syndrome (XLP) who presented with acute severe infectious mononucleosis. Clinical symptoms rapidly improved after chemotherapy with etoposide. Allogeneic bone marrow transplantation (BMT) was performed after conditioning with etoposide, busulfan and cyclophosphamide. After successful hematopoietic recovery we were able to demonstrate seroconversion from an impaired antibody response to Epstein-Barr virus (EBV) to a normal antibody-producing state in an immunocompetent child. The only post-transplant complication was mild acute graft-versus-host disease (GVHD). Three years after BMT, the boy is healthy and shows no signs of immunodeficiency. This is the first report on successful allogeneic BMT in the severe course of acute infectious mononucleosis in a patient with XLP. We speculate that the application of etoposide contributed to the positive outcome in this patient.

  3. Psychosocial predictors of immune response following bone marrow transplantation.

    PubMed

    Pulgar, Ángeles; Garrido, Sergio; Alcalá, Antonio; Reyes del Paso, Gustavo A

    2012-01-01

    This study analyzed the relationship between some psychosocial variables (depression, anxiety, stress, coping strategies, social support, optimism, rationality, and need for harmony) and clinical parameters indicative of immunological response after bone marrow transplantation (BMT; day of engraftment, number of infections and hemoglobin level) while controlling for demographic variables (age, educative level, civil state, and time from cancer diagnosis). Thirty-one post BMT hematological cancer patients were evaluated. Results show that higher educative levels are associated to lower number of infections, while age is associated with a delay in the time of engraftment; coping strategies, specially redefinition of the situation, relaxation, stoicism and passivity, are positively associated with the three clinical indices; depression is positively associated to number of infections during the hospitalization period; and rationality is associated with lower hemoglobin levels. These results suggest that psychosocial variables, especially coping strategies, play an important role in determining the immunological response after BMT.

  4. Successful treatment of natural killer (NK) cell leukemia following a long-standing chronic active Epstein-Barr virus (CAEBV) infection with allogeneic bone marrow transplantation.

    PubMed

    Ebihara, Y; Manabe, A; Tanaka, R; Yoshimasu, T; Ishikawa, K; Iseki, T; Hayakawa, J; Maeda, M; Asano, S; Tsuji, K

    2003-06-01

    The optimal treatment for natural killer (NK) cell leukemia after chronic active Epstein-Barr virus (CAEBV) infection has not been determined. A 15-year-old boy presented with NK cell leukemia following CAEBV infection for 5 years. The peripheral blood and BM had an increased number of CD3(-)CD56(+) large granular lymphocytes and a monoclonal integration of the EBV genome was detected. Chemotherapy was not sufficiently effective to control the disease. Allogeneic BMT from an HLA-identical sister was performed using a conditioning regimen consisting of total body irradiation, cyclophosphamide and thiotepa. The patient is disease-free with a perfect performance status 24 months after BMT. This is the first report to show that allogeneic BMT is potentially able to cure NK cell leukemia after CAEBV infection.

  5. Evaluation of CMV/human herpes virus-6 positivity in bronchoalveolar lavage fluids as early detection of acute GVHD following BMT: evidence of a significant relationship.

    PubMed

    Takemoto, Y; Takatsuka, H; Wada, H; Mori, A; Saheki, K; Okada, M; Tamura, S; Fujimori, Y; Okamoto, T; Kakishita, E; Kanamaru, A

    2000-07-01

    We evaluated the relationship between CMV and human herpes virus-6 (HHV-6) reactivation and the incidence of grades 2 to 4 acute GVHD post BMT. Bronchoalveolar lavage fluid (BALF) samples extracted from 54 BMT recipients on post-BMT day 35 were analyzed by PCR for detection of CMV DNA, HHV-6 DNA and CMV plus HHV-6 DNA. CMV DNA was detected in 26 patients and 13 (50%) developed grades 2 to 4 acute GVHD. Of the 28 who were CMV negative, only six (21.4%) developed grades 2 to 4 acute GVHD. HHV-6 was detected in 18 patients, and 11 (61.1%) developed grades 2 to 4 acute GVHD. Of the 36 who were HHV-6 negative, only eight (22.2%) developed grades 2 to 4 acute GVHD. CMV and HHV-6 were detected in 13 patients, and eight (61.5%) developed grades 2 to 4 acute GVHD. Of the 23 who were negative for both CMV and HHV-6, only three (13%) developed grades 2 to 4 acute GVHD. In all experiments, the difference between the groups was significant (P<0.05, P<0.05 and P<0.01, respectively). We conclude that herpes virus infection, in particular CMV concurrent with HHV-6 reactivation, is predictive of moderate to severe acute GVHD.

  6. Enzyme replacement therapy improves joint motion and outcome of the 12-min walk test in a mucopolysaccharidosis type VI patient previously treated with bone marrow transplantation.

    PubMed

    Sohn, Young Bae; Park, Sung Won; Kim, Se-Hwa; Cho, Sung-Yoon; Ji, Sun-Tae; Kwon, Eun Kyung; Han, Sun Ju; Oh, Se Jung; Park, Yong Jae; Ko, Ah-Ra; Paik, Kyung-Hoon; Lee, Jeehun; Lee, Dong Hwan; Jin, Dong-Kyu

    2012-05-01

    Mucopolysaccharidosis type VI (MPS VI; Maroteaux-Lamy syndrome, OMIM #253200) is a rare disorder involving multiple organs and manifested particularly by severe skeletal abnormalities. Bone marrow transplantation (BMT) improves cardiopulmonary function and facial features, but has limited success in ameliorating skeletal abnormalities and short stature. Here, we report the outcome of enzyme replacement therapy (ERT) with recombinant human arylsulfatase-B (ASB, Naglazyme, BioMarin, Novato, CA) in an MPS VI patient who received BMT 10 years prior to ERT induction. Administration of weekly Naglazyme for 18 months was effective in improving range of motion in several joints [shoulders (improvement of flexion (Right/Left): 40°/55°; improvement of extension 30°/40°; improvement of abduction 10°/10°), elbows (improvement of flexion 25°/25°; improvement of extension 10°/15°), hips (improvement of flexion 25°/10°), and knees (improvement of flexion 45°/40°; improvement of extension 50°/60°)]. Improvement in the outcome of the 12-min walk test (70% increase) and 3-min stair-climbing test (29% increase) was also noted after ERT. Because ERT improved clinical features in an MPS VI patient who had undergone prior BMT, the role of ERT post successful BMT in MPS VI needs further investigation. Copyright © 2012 Wiley Periodicals, Inc.

  7. Adenovirus is a key pathogen in hemorrhagic cystitis associated with bone marrow transplantation.

    PubMed

    Akiyama, H; Kurosu, T; Sakashita, C; Inoue, T; Mori Si; Ohashi, K; Tanikawa, S; Sakamaki, H; Onozawa, Y; Chen, Q; Zheng, H; Kitamura, T

    2001-05-01

    Late-onset hemorrhagic cystitis (HC) is a well-known complication of bone marrow transplantation (BMT) that is mainly attributed to infection with BK virus (BKV) and adenovirus (AdV). From 1986 through 1998, 282 patients underwent BMT, and 45 of them developed HC. Urine samples tested positive for AdV in 26 patients, of which 22 showed virus type 11. Among patients who underwent allogeneic BMT, logistic regression analysis revealed acute graft-versus-host disease (grade, > or = 2) to be the most significant predictive factor for HC (P < .0001). In addition, a total of 193 urine samples regularly obtained from 26 consecutive patients who underwent allogeneic BMT were examined for BKV, JC virus (JCV), and AdV by means of polymerase chain reaction. Of patients without HC, approximately 30% of the specimens tested positive for BKV (58 samples) and JCV (55 samples), whereas 5 (3%) tested positive for AdV. Of the 3 samples obtained from patients with HC, the numbers of positive results for BKV, JCV, and AdV were 3, 1, and 1, respectively; the numbers of positive results increased to 14 of 17, 9 of 17, and 10 of 17, respectively, when we added another 14 samples obtained from 14 patients with HC (P < .0001, P = .026, and P < .0001, respectively). In conclusion, there was significant correlation between AdV and HC in the patients we studied.

  8. Addressing parenting concerns of bone marrow transplant patients: opening (and closing) Pandora's box.

    PubMed

    Moore, C W; Rauch, P K

    2006-12-01

    Although a significant number of adults undergoing stem cell transplant (SCT) or bone marrow transplantation (BMT) care for dependent children, and these treatments pose significant challenges for families, research has virtually ignored the impact of parenting on patients' quality of life during BMT/SCT and children's responses to having a parent undergo these treatments. Physicians rarely inquire about parenting concerns related to the extended hospitalizations necessitated by these treatments, yet clinical experience suggests that addressing patient concerns about children's reactions to cancer and BMT/SCT can improve the experience of the patient and the patient's family, and help the medical team respond effectively to sources of patients' distress. Parents frequently want to know what reactions to expect from children, thus general developmental information is reviewed, and recommendations given for when professional help for children is warranted. A key way for parents to support their children is with open, honest communication; however, parents often find it extremely difficult to talk about cancer and BMT/SCT with their children. The medical team can assist patients' efforts to communicate with and support their children by asking about a patient's children, providing some targeted information, and discussing the potential impact of treatments on parenting capacity. Inquiring about and addressing parenting concerns may initially seem difficult, but can ultimately facilitate stronger doctor-patient alliances, and more compassionate care.

  9. Growth in children following irradiation for bone marrow transplantation

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

    Bushhouse, S.; Ramsay, N.K.; Pescovitz, O.H.

    Longitudinal height data from 46 pediatric bone marrow transplant (BMT) patients, including 18 with aplastic anemia (AA), 19 with acute nonlymphoblastic leukemia (ANLL), and 9 with acute lymphoblastic leukemia (ALL), were analyzed to assess growth posttransplantation. Patients were prepared for BMT with high-dose cyclophosphamide followed by 7.5 Gy single-dose irradiation; AA patients received total lymphoid irradiation (TLI), and leukemia patients received total body irradiation (TBI). AA patients demonstrated reduced height posttransplant as reflected in a negative mean standard deviation score. The observed reduction was statistically significant only at 3 years following transplant. In contrast, leukemia patients showed a significant lossmore » in relative height that was first visible at 1 year post-BMT and continued until at least 4 years post-BMT. Mean growth velocities in the leukemia patients were significantly below median for the 3 years following transplant. With a median follow-up of 4 years, antithymocyte globulin plus steroids in combination with methotrexate as graft vs. host prophylaxis was associated with less severe growth suppression than methotrexate alone, while there were no significant associations between growth during the first 2 years following transplant and prepubertal status at transplant (as defined by age), graft vs. host disease, thyroid or gonadal function, or previous therapies received by the leukemia patients. Children undergoing marrow transplantation, particularly those receiving TBI, are at significant risk of subsequent growth suppression.« less

  10. Pubertal development and final height after autologous bone marrow transplantation for acute lymphoblastic leukemia.

    PubMed

    Frisk, P; Arvidson, J; Gustafsson, J; Lönnerholm, G

    2004-01-01

    We describe pubertal development and growth in 17 children who underwent bone marrow transplantation (BMT), including total body irradiation (TBI) for ALL. Seven children also received cranial irradiation (CI) and five boys testicular irradiation. All underwent transplantation before (n=15) or at the beginning of (n=2) puberty and reached a final height (FH). Puberty started spontaneously in all boys not given testicular irradiation. All boys who received testicular irradiation developed hypergonadotrophic hypogonadism. Puberty started spontaneously in two girls and was induced with increasing doses of ethinylestradiol in two girls. In two girls, a low dose of ethinylestradiol was given until menarche. In one girl with early onset of puberty and short stature, puberty was blocked with a GnRH analogue. The standard deviation score for height decreased significantly from BMT to FH, both in the children who received TBI only (-1.1, P=0.005) as well as in those given additional CI (-1.7, P=0.027). Most of the loss occurred during puberty. In all, 10 children received growth hormone (GH) treatment. CI, young age at BMT, and short duration of GH treatment were predictors of height loss after BMT. Although limited by the small and heterogeneous sample, our study supports the use of early GH treatment in children with decelerating growth rate and low GH levels.

  11. Oral cryotherapy reduces mucositis and opioid use after myeloablative therapy--a randomized controlled trial.

    PubMed

    Svanberg, Anncarin; Birgegård, Gunnar; Ohrn, Kerstin

    2007-10-01

    Mucositis is a major complication in myeloablative therapy, which often necessitates advanced pharmacological pain treatment, including i.v. opioids. Attempts to prevent oral mucositis have included oral cryotherapy, which has been shown to reduce mucositis, but there is a lack of knowledge concerning the effect of oral cryotherapy on opioid use by reducing the mucositis for patients treated with myeloablative therapy before bone marrow transplantation (BMT). The aim of the present study was to evaluate if oral cryotherapy could delay or alleviate the development of mucositis and thereby reduce the number of days with i.v. opioids among patients who receive myeloablative therapy before BMT. Eighty patients 18 years and older, scheduled for BMT, were included consecutively and randomised to oral cryotherapy or standard oral care. A stratified randomisation was used with regard to type of transplantation. Intensity of pain, severity of mucositis and use of opioids were recorded using pain visual analogue scale (VAS) scores, mucositis index scores and medical and nursing charts. This study showed that patients receiving oral cryotherapy had less pronounced mucositis and significantly fewer days with i.v. opioids than the control group. In the autologous setting, cryotherapy patients also needed significantly lower total dose of opioids. Oral cryotherapy is an effective and well-tolerated therapy to alleviate mucositis and consequently reduce the number of days with i.v. opioids among patients treated with myeloablative therapy before BMT.

  12. Use of opioid substitution therapies in the treatment of opioid use disorder: results of a UK cost-effectiveness modelling study.

    PubMed

    Kenworthy, James; Yi, Yunni; Wright, Antony; Brown, Jim; Maria Madrigal, Ana; Dunlop, William C N

    2017-07-01

    This study investigated the cost-effectiveness of buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT) vs no opioid substitution therapy (OST) for the treatment of opioid use disorder, from the UK National Health Service (NHS)/personal social services (PSS) and societal perspectives over 1 year. Cost-effectiveness of OST vs no OST was evaluated by first replicating and then expanding an existing UK health technology assessment model. The expanded model included the impact of OST on infection rates of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection. Versus no OST, incremental cost-effectiveness ratios (ICERs) for BMT and MMT were £13,923 and £14,206 per quality-adjusted life year (QALY), respectively, from a NHS/PSS perspective. When total costs (NHS/PSS and societal) are considered, there are substantial savings associated with adopting OST; these savings are in excess of £14,032 for BMT vs no OST and £17,174 for MMT vs no OST over 1 year. This is primarily driven by a reduction in victim costs. OST treatment also impacted other aspects of criminality and healthcare resource use. The model's 1-year timeframe means long-term costs and benefits, and the influence of changes over time are not captured. OST can be considered cost-effective vs no OST from the UK NHS/PSS perspective, with a cost per QALY well below the UK's willingness-to-pay threshold. There were only small differences between BMT and MMT. The availability of two or more cost-effective options is beneficial to retaining patients in OST programs. From a societal perspective, OST is estimated to save over £14,032 and £17,174 per year for BMT and MMT vs no OST, respectively, due to savings in victim costs. Further work is required to fully quantify the clinical and health economic impacts of different OST formulations and their societal impact over the long-term.

  13. Mechanical Thrombectomy for Minor and Mild Stroke Patients Harboring Large Vessel Occlusion in the Anterior Circulation: A Multicenter Cohort Study.

    PubMed

    Dargazanli, Cyril; Arquizan, Caroline; Gory, Benjamin; Consoli, Arturo; Labreuche, Julien; Redjem, Hocine; Eker, Omer; Decroix, Jean-Pierre; Corlobé, Astrid; Mourand, Isabelle; Gaillard, Nicolas; Ayrignac, Xavier; Charif, Mahmoud; Duhamel, Alain; Labeyrie, Paul-Emile; Riquelme, Carlos; Ciccio, Gabriele; Smajda, Stanislas; Desilles, Jean-Philippe; Gascou, Grégory; Lefèvre, Pierre-Henri; Mantilla-García, Daniel; Cagnazzo, Federico; Coskun, Oguzhan; Mazighi, Mikael; Riva, Roberto; Bourdain, Frédéric; Labauge, Pierre; Rodesch, Georges; Obadia, Michael; Bonafé, Alain; Turjman, Francis; Costalat, Vincent; Piotin, Michel; Blanc, Raphaël; Lapergue, Bertrand

    2017-12-01

    Proximal large vessel occlusion (LVO) is present in up to 30% of minor strokes. The effectiveness of mechanical thrombectomy (MT) in the subgroup of minor stroke with LVO in the anterior circulation is still open to debate. Data about MT in this subgroup of patients are sparse, and their optimal management has not yet been defined. The purpose of this multicenter cohort study was to evaluate the effectiveness of MT in patients experiencing acute ischemic stroke (AIS) because of LVO in the anterior circulation, presenting with minor-to-mild stroke symptoms (National Institutes of Health Stroke Scale score of <8). Multicenter cohort study involving 4 comprehensive stroke centers having 2 therapeutic approaches (urgent thrombectomy associated with best medical treatment [BMT] versus BMT first and MT if worsening occurs) about management of patients with minor and mild acute ischemic stroke harboring LVO in the anterior circulation. An intention-to-treat analysis was conducted. The primary end point was the rate of excellent outcome defined as the achievement of a modified Rankin Scale score of 0 to 1 at 3 months. Three hundred one patients were included, 170 with urgent MT associated with BMT, and 131 with BMT alone as first-line treatment. Patients treated with MT were younger, more often received intravenous thrombolysis, and had shorter time to imaging. Twenty-four patients (18.0%) in the medical group had rescue MT because of neurological worsening. Overall, excellent outcome was achieved in 64.5% of patients, with no difference between the 2 groups. Stratified analysis according to key subgroups did not find heterogeneity in the treatment effect size. Minor-to-mild stroke patients with LVO achieved excellent and favorable functional outcomes at 3 months in similar proportions between urgent MT versus delayed MT associated with BMT. There is thus an urgent need for randomized trials to define the effectiveness of MT in this patient subgroup. © 2017 American Heart Association, Inc.

  14. Acute and chronic graft-versus-host disease after allogeneic peripheral-blood stem-cell and bone marrow transplantation: a meta-analysis.

    PubMed

    Cutler, C; Giri, S; Jeyapalan, S; Paniagua, D; Viswanathan, A; Antin, J H

    2001-08-15

    Controversy exists as to whether the incidence of graft-versus-host disease (GVHD) is increased after peripheral-blood stem-cell transplantation (PBSCT) when compared with bone marrow transplantation (BMT). We performed a meta-analysis of all trials comparing the incidence of acute and chronic GVHD after PBSCT and BMT reported as of June, 2000. Secondary analyses examined relapse rates after the two procedures. An extensive MEDLINE search of the literature was undertaken. Primary authors were contacted for clarification and completion of missing information. A review of cited references was also undertaken. Sixteen studies (five randomized controlled trials and 11 cohort studies) were included in this analysis. Data was extracted by two pairs of reviewers and analyzed for the outcomes of interest. Meta-analyses, regression analyses, and assessments of publication bias were performed. Using a random effects model, the pooled relative risk (RR) for acute GVHD after PBSCT was 1.16 (95% confidence interval [CI], 1.04 to 1.28; P=.006) when compared with traditional BMT. The pooled RR for chronic GVHD after PBSCT was 1.53 (95% CI, 1.25 to 1.88; P <.001) when compared with BMT. The RR of developing clinically extensive chronic GVHD was 1.66 (95% CI, 1.35 to 2.05; P <.001). The excess risk of chronic GVHD was explained by differences in the T-cell dose delivered with the graft in a meta-regression model that did not reach statistical significance. There was a trend towards a decrease in the rate of relapse after PBSCT (RR = 0.81; 95% CI, 0.62 to 1.05). Both acute and chronic GVHD are more common after PBSCT than BMT, and this may be associated with lower rates of malignant relapse. The magnitude of the transfused T-cell load may explain the differences in chronic GVHD risk.

  15. Nosocomial outbreak of Legionella pneumophila serogroup 3 pneumonia in a new bone marrow transplant unit: evaluation, treatment and control.

    PubMed

    Oren, I; Zuckerman, T; Avivi, I; Finkelstein, R; Yigla, M; Rowe, J M

    2002-08-01

    A nosocomial outbreak of pneumonia caused by Legionella pneumophila serogroup 3 occurred in four patients following hematopoietic stem cell transplantation (HSCT) in a new bone marrow transplantation (BMT) unit during a 2 week period. The causative organism was recovered from the water supply system to the same unit just before the outbreak. Nineteen other BMT patients were hospitalized in the same unit at the same time, giving a frequency of proven infection of 4/23 = 17%. Immediately after recognition of the outbreak, use of tap water was forbidden, humidifiers were disconnected, and ciprofloxacin prophylaxis was started for all patients in the unit, until decontamination of the water was achieved. No other cases were detected. In conclusion, contamination of the hospital water supply system with legionella carries a high risk for legionella pneumonia among BMT patients. Early recognition of the outbreak, immediate restrictions of water use, antibiotic prophylaxis for all non-infected patients, and water decontamination, successfully terminated the outbreak.

  16. Giant negative electrocaloric effect in PbZrO3/0.88BaTiO3-0.12Bi(Mg1/2,Ti1/2)O3 multilayered composite ferroelectric thin film for solid-state refrigeration

    NASA Astrophysics Data System (ADS)

    Huang, D.; Wang, J. B.; Zhong, X. L.; Li, B.; Zhang, Y.; Jin, C.; Zheng, D. F.; Meng, X. J.

    2017-11-01

    A giant negative electrocaloric (EC) effect in a PbZrO3/(0.88BaTiO3-0.12 Bi(Mg1/2,Ti1/2)O3) (PZ/(BT-BMT)) multilayered composite ferroelectric (MCFE) thin film which is grown on Pt(111)/Ti/SiO2/Si(100) substrates by the sol-gel method is investigated in this work. The negative EC effect in the PZ/(BMT-BT) MCFE thin film is greatly higher than that in the PZ AFE thin film with an adiabatic temperature change (ATC) ΔT = 1.5 K. The ATC ΔT of the PZ/(BMT-BT) MCFE thin film is -32 K under the applied electric field change ΔE = 1151 kV/cm. The result is conducive to enhance the EC refrigeration efficiency greatly.

  17. Support of the transplant team.

    PubMed

    Kiss, A

    1994-01-01

    Both patients and staff in a bone marrow transplantation (BMT) unit have to cope with the effects of an aggressive treatment that helps many patients but also kills some. This has led to the regular involvement of support services in most American BMT units. This article describes the experience in 4 years of continuous psychosomatic liaison activity at the BMT unit at the University Hospital in Basel. The specific stressors a transplant team is subject to are described, such as high morbidity and mortality of patients and the close relationship between patients and staff members. Support for the transplant team consists in the following activities: a psychosocial interview with each patient at the beginning of his or her hospital stay; weekly psychosocial round-ups with the whole team; regular participation in ward rounds; organization of workshops to prevent burnout. Although an empirical evaluation of this approach is lacking, the clinical evidence suggests that constant and reliable team support helps to stabilize the team, adding to its inner security. This ultimately improves patient care.

  18. A case of a long-time survivor with chronic active Epstein-Barr virus infection.

    PubMed

    Takeoka, Yasunobu; Nakao, Yoshitaka; Ueda, Misako; Koh, Ki-Ryang; Aoyama, Yasutaka; Nakamae, Hirohisa; Yamamura, Ryousuke; Ohta, Kensuke; Takubo, Takayuki; Yamane, Takahisa; Hino, Masayuki; Tokura, Yoshiki; Ishihara, Shigehiko; Oshima, Koichi; Kimura, Hiroshi; Imashuku, Shinsaku

    2004-01-01

    Epstein-Barr virus (EBV) is associated with hypersensitivity to mosquito bites (HMB) and fatal EBV-associated hemophagocytic syndrome (HPS). The prognosis of patients with chronic active EBV infection (CAEBV) is very poor. We report a rare case of an adult woman patient with a 28-yr history of HMB, who developed EBV-HPS. EBV genome was detected in the serum and peripheral blood lymphocytes. Clonal proliferation of EBV was demonstrated by Southern blot analysis using an EBV genome terminal-repeat probe. This is a very rare case of a long-term survivor with CAEBV. The patient was initially treated with immunochemotherapy and achieved complete remission. However, the patient immediately relapsed and underwent allogeneic bone marrow transplantation (BMT) from her HLA-matched brother. Peripheral blood cell recovered well, and EBV genome disappeared from the peripheral blood. Allogeneic BMT may be effective in eradicating EBV-HPS. Unfortunately, the patient died of graft vs. host disease on the 92nd day after BMT.

  19. [Chronic active Epstein-Barr virus infection treated with reduced intensity stem cell transplantation].

    PubMed

    Sakata, Naoki; Sato, Emiko; Sawada, Akihisa; Yasui, Masahiro; Inoue, Masami; Kawa, Keisei

    2004-05-01

    A 31-year-old woman had been suffering from fever and a sore throat since January 1999, and had a left neck lymphadenopathy in December 1999. Pathological findings of the biopsied lymphnode suggested malignant lymphoma. She was finally diagnosed as having a chronic active Epstein-Barr virus(EBV) infection because of abnormal antibody titers against EBV antigens and an increased EBV load in her peripheral blood. After receiving chemotherapy consisting of CHOP and high dose cytarabine, the amount of the EBV genome decreased below the detection limit before BMT. Therefore, instead of a conventional myeloablative transplant, we performed BMT using reduced-intensity conditioning regimens consisting of fludarabine and melphalan from an HLA-identical sibling donor. After 14 months, the patient remained in complete remission. Menstruation occurred on day 83 following BMT, and the serum level of LH and FSH on day 316 were within normal range. Under these circumstances, RIST seems to be one of the curative treatments for the patients with CAEBV with minimal late side effects.

  20. Patient perceptions of a 1-h art-making experience during blood and marrow transplant treatment.

    PubMed

    Mische Lawson, L; Cline, J; French, A; Ismael, N

    2017-09-01

    Patients with various forms of cancer receiving blood and marrow transplant (BMT) treatment at an outpatient clinic develop chemotherapy-related symptoms and an increased desire to use complementary and alternative medicine in order to address these symptoms. Art-making offers an inexpensive way to pass time and relieve symptoms during long hours in treatment. Twenty-one BMT patients painted a tile and participated in research. Researchers used semi-structured interviews to understand patients' experiences with art-making. Interviews were recorded, transcribed and coded independently by researchers who met to agree on themes. Ten themes emerged from the data including, meaningful activity (32.2%), expression (18.7%), passing time (13.2%), BMT process (12.1%), social outlet (8.1%), therapy-related symptoms (7.3%), negative aspects of painting (5.9%) and encouragement to paint (2.6%). The results of this study revealed that art-making experience can provide patients a meaningful activity during treatment and an outlet to express their feelings. © 2016 John Wiley & Sons Ltd.

  1. Notch-dependent T-lineage commitment occurs at extrathymic sites following bone marrow transplantation

    PubMed Central

    Maillard, Ivan; Schwarz, Benjamin A.; Sambandam, Arivazhagan; Fang, Terry; Shestova, Olga; Xu, Lanwei; Bhandoola, Avinash; Pear, Warren S.

    2006-01-01

    Early T-lineage progenitors (ETPs) arise after colonization of the thymus by multipotent bone marrow progenitors. ETPs likely serve as physiologic progenitors of T-cell development in adult mice, although alternative T-cell differentiation pathways may exist. While we were investigating mechanisms of T-cell reconstitution after bone marrow transplantation (BMT), we found that efficient donor-derived thymopoiesis occurred before the pool of ETPs had been replenished. Simultaneously, T lineage–restricted progenitors were generated at extrathymic sites, both in the spleen and in peripheral lymph nodes, but not in the bone marrow or liver. The generation of these T lineage–committed cells occurred through a Notch-dependent differentiation process. Multipotent bone marrow progenitors efficiently gave rise to extrathymic T lineage–committed cells, whereas common lymphoid progenitors did not. Our data show plasticity of T-lineage commitment sites in the post-BMT environment and indicate that Notch-driven extrathymic Tlineage commitment from multipotent progenitors may contribute to early T-lineage reconstitution after BMT. PMID:16397133

  2. Methotrexate vs Cyclosporin A as a single agent for graft-versus-host disease prophylaxis in pediatric patients with hematological malignancies undergoing allogeneic bone marrow transplantation from HLA-identical siblings: a single-center analysis in Japan.

    PubMed

    Koga, Y; Nagatoshi, Y; Kawano, Y; Okamura, J

    2003-07-01

    The efficacy of methotrexate (MTX) as a single graft-versus-host disease (GVHD) prophylaxis agent was compared to that of cyclosporin A (CSA) in 62 pediatric patients (median age: 8 years) with hematological malignancies who had undergone bone marrow transplantation (BMT) from HLA-identical sibling donors at National Kyushu Cancer Center since 1977. In all, 30 patients received MTX by intravenous bolus injection, with a dose of 15 mg/m(2) on day +1, followed by 10 mg/m(2) on days +3, +6, and +11, and then once a week until day +100. A total of 32 patients were treated with CSA, which was given intravenously in the early stages and orally thereafter until day +100, and then gradually tapered and stopped 6 months after BMT. There were no differences between the groups in terms of rates of hematopoietic recovery after BMT. The probabilities of acute GVHD (grades II-IV) and chronic GVHD were 29.6 vs 40.6% (P=0.294) and 19 vs 20% (MTX vs CSA), respectively. Relapse rates and event-free survival were identical. These results suggest that MTX and CSA were equally effective when given after BMT in Japanese pediatric patients with hematological malignancies. Since MTX was given over a shorter time than CSA, it might be more practical in the management of such patients.

  3. Long-term complications following bone marrow transplantation in children.

    PubMed

    Giri, N; Davis, E A; Vowels, M R

    1993-06-01

    Seventeen children who underwent bone marrow transplantation (BMT) between 1975 and 1985 and survived for more than 2 years were evaluated for growth and development. The patients had a follow up of 2.1-13.1 years. Prior to transplant, children with malignancy had received multi-agent chemotherapy and nine had also received central nervous system irradiation. Transplant preparation for malignancy (group 1; n = 13) included high-dose cyclophosphamide (CPA) 120-200 mg/kg and total body irradiation (TBI) 10-13.2 Gy, whereas conditioning for non-malignant disorders (group 2; n = 4) included high-dose CPA 200 mg/kg with or without busulphan. Patients in group 1 showed a steady decline in height velocity following initial chemotherapy and cranial irradiation and the decline was even greater following BMT. Growth hormone (GH) deficiency developed in eight of nine children tested, hypergonadotrophic hypogonadism developed in 11 who reached puberty, thyroid hormone abnormalities were encountered in four out of 10 tested and 11 of 13 developed cataracts. Patients in group 2 did not show decline in linear growth rate, thyroid hormone abnormalities or cataracts after BMT. The only child tested had normal GH levels and the two patients who reached puberty showed delayed but complete gonadal recovery. Our data demonstrate that TBI leads to significant late effects on growth and gonadal function. Contrary to previous reports, a high incidence of cataract formation is observed after fractionated TBI. Conditioning regimens TBI should be considered in children undergoing BMT.

  4. [Buccal mucosa transplant the concept of ideal graft in surgical management of peyronies disease].

    PubMed

    Kotov, S V; Yusufov, A G; Semenov, M K

    2017-09-01

    Surgical techniques in managing Peyronies disease include plication corporoplasty, plaque incision, grafting and penile prosthesis implantation. The question of an ideal transplant for corporoplasty remains open. To evaluate the effectiveness of the substitution corporoplasty using buccal mucosa transplant (BMT) in treating Peyronies disease. From January 2011 to February 2016, 28 patients with stable stage Peyronies disease underwent substitution coroproplasty using BMT (incision and grafting). The mean age of patients was 54.8+/-6.2 years. All patients completed an IIEF-5 questionnaire and underwent a standard preoperative examination: anamnesis, physical examination, penile duplex pharmaco-ultrasonography and penile fixation photography to assess the type and angle of curvature. The average angle of penile curvature was 82.8 (45-120). All patients underwent incision and grafting using BMT; in 5 patients additionally the plication of the penile tunica albuginea was performed. Follow-up examinations were concluded at 3, 6 and 12 months and more after surgery. Median follow-up was 30 months. Postoperative penile straightening was achieved in 93% of patients. The duplex peak systolic velocity of the right and left cavernosal arteries improved from 42.59 to 45.64 cm/s and from 34.55 to 43.48 cm/s, respectively (p less or equal 0.05). Penile corproroplasty using BMT is a safe and effective method of treating patients with Peyronies disease. Follow-up clinical and instrumental examination showed no impairment of the erectile function or penile hemodynamics.

  5. The management of menstrual suppression and uterine bleeding: a survey of current practices in the Pediatric Blood and Marrow Transplant Consortium.

    PubMed

    Adegite, Enitan A; Goyal, Rakesh K; Murray, Pamela J; Marshal, Mike; Sucato, Gina S

    2012-09-01

    Current guidelines recommend the use of combined hormonal contraceptive pills for menstrual suppression in pediatric blood and marrow transplant (BMT) recipients but recent research reveals that provider practice varies. This study was designed to describe the current practice for managing menstrual issues, that is, menstrual suppression and uterine bleeding, in pediatric BMT patients and to better understand health care providers' practices in the use of gonadotropin-releasing hormone agonists (GnRHa). A cross sectional survey consisting of 53 questions was distributed via email to principal investigators in the Pediatric Blood and Marrow Transplant Consortium (PBMTC). Responses were collected using www.surveymonkey.com. Menstrual suppression and uterine bleeding in pediatric BMT patients are primarily managed by pediatric oncologists (97%). The most frequently reported hormonal method used for induction of therapeutic amenorrhea was GnRHa (41%). The top three reasons for choosing a method were greater likelihood of amenorrhea, concerns about side effects, and possible gonadal protection. Continuous combined hormonal contraceptive pills were the most commonly used method for the management of clinically significant uterine bleeding regardless of primary method used for menstrual suppression. Despite the 2002 PBMTC guidelines, wide variation in menstrual suppression management practices still exists. Our data show that use of GnRHa is more common than previously reported. Additional research is needed to develop evidence-based practice guidelines in pediatric BMT patients. Copyright © 2012 Wiley Periodicals, Inc.

  6. Better Movers and Thinkers (BMT): An Exploratory Study of an Innovative Approach to Physical Education

    PubMed Central

    Dalziell, Andrew; Boyle, James; Mutrie, Nanette

    2015-01-01

    Recent research has confirmed a positive relationship between levels of physical activity and academic achievement. Some of these studies have been informed by neurological models of Executive Functioning (EF). There is a general consensus within the literature that the three core EF skills are; working memory, inhibitory control and cognitive flexibility. The development of these core EF skills has been linked with learning and academic achievement and is an essential component in the delivery of PE using a new and innovative approach called ‘Better Movers and Thinkers (BMT).’ A mixed methods design was used to investigate the effectiveness and feasibility of a 16-week intervention programme using BMT where 46 children were tested on two separate occasions for coordination and balance control, academic skills, working memory and non-verbal reasoning skills. One school acted as the control condition (21 students, aged 9 – 10 years) and another school acted as the intervention condition (25 students, aged 9 – 10 years). Quantitative data revealed an effect between pre and post-test conditions in the areas of phonological skills (p = .042), segmentation skills (p = .014) and working memory (p = .040) in favour of the intervention condition. Further analysis identified a gender-interaction with male students in the intervention condition making significant gains in phonological skills (p = .005) segmentation skills (p = .014) and spelling (p = .007) compared to boys in the control condition. Analysis of qualitative data from a sample of students from the intervention condition and their class teacher indicated good acceptability of BMT as an alternative approach to PE. PMID:27247688

  7. Umbilical cord blood as an alternative source of reduced-intensity hematopoietic stem cell transplantation for chronic Epstein-Barr virus-associated T or natural killer cell lymphoproliferative diseases.

    PubMed

    Sawada, Akihisa; Inoue, Masami; Koyama-Sato, Maho; Kondo, Osamu; Yamada, Kayo; Shimizu, Mariko; Isaka, Kanako; Kimoto, Tomiko; Kikuchi, Hiroaki; Tokimasa, Sadao; Yasui, Masahiro; Kawa, Keisei

    2014-02-01

    Chronic Epstein-Barr virus-associated T/natural killer cell lymphoproliferative diseases represented by chronic active Epstein-Barr virus infection are lethal but are curable with several courses of chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT). Recently, we reported that reduced-intensity conditioning (RIC) provided better outcomes than myeloablative conditioning because RIC was less toxic. However, it was unclear whether cord blood transplantation (CBT) works in the context of RIC. We retrospectively analyzed 17 patients who underwent RIC followed by bone marrow transplantation (RIC-BMT) and 15 patients who underwent RIC followed by CBT (RIC-CBT). The representative regimen was fludarabine and melphalan based. The overall survival rates with RIC-BMT and RIC-CBT were 92.9% ± 6.9% and 93.3% ± 6.4%, respectively (P = .87). One patient died of lung graft-versus-host disease after RIC-BMT, and 1 patient died of multiple viral infections after RIC-CBT. Although cytotoxic chemotherapy was also immunosuppressive and might contribute to better donor cell engraftment after RIC-HSCT, the rate of engraftment failure after RIC-CBT was still higher than that after RIC-BMT (not significant); however, patients who had experienced graft failure were successfully rescued with a second HSCT. Unrelated cord blood can be an alternative source for RIC-HSCT if a patient has no family donor. Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  8. Do decision-analytic models identify cost-effective treatments? A retrospective look at helicobacter pylori eradication.

    PubMed

    Fairman, Kathleen A; Motheral, Brenda R

    2003-01-01

    Pharmacoeconomic models of Helicobacter (H) pylori eradication have been frequently cited but never validated. Examine retrospectively whether H pylori pharmacoeconomic models direct decision makers to cost-effective therapeutic choices. We first replicated and then validated 2 models, replacing model assumptions with empirical data from a multipayer claims database. Database subjects were 435 commercially insured U.S. patients treated with bismuthmetronidazole- tetracycline (BMT), proton pump inhibitor (PPI)-clarithromycin, or PPI-amoxicillin. Patients met >1 clinical requirement (ulcer disease, gastritis/duodenitis, stomach function disorder, abdominal pain, H pylori infection, endoscopy, or H pylori assay). Sensitivity analyses included only patients with ulcer diagnosis or gastrointestinal specialist care. Outcome measures were: (1) rates of eradication retreatment; (2) use of office visits, hospitalizations, endoscopies, and antisecretory medication; and (3) cost per effectively treated (nonretreated) patient. Model results overstated the cost-effectiveness of PPI-clarithromycin and underestimated the cost-effectiveness of BMT. Prior to empirical adjustment, costs per effectively treated patient were 1,001 US dollars, 980 US dollars, and 1,730 US dollars for BMT, PPIclarithromycin, and PPI-amoxicillin, respectively. Estimates after adjustment were US dollars for BMT, 1,118 US dollars for PPI-clarithromycin, and 1,131 US dollars for PPI-amoxicillin. Key model assumptions that proved retrospectively incorrect were largely unsupported by either empirical evidence or systematic assessment of expert opinion. Organizations with access to medical and pharmacy claims databases should test key assumptions of influential models to determine their validity. Journal peer-review processes should pay particular attention to the basis of model assumptions.

  9. Bremelanotide for Female Sexual Dysfunctions in Premenopausal Women: A Randomized, Placebo-Controlled Dose-Finding Trial

    PubMed Central

    Clayton, Anita H; Althof, Stanley E; Kingsberg, Sheryl; DeRogatis, Leonard R; Kroll, Robin; Goldstein, Irwin; Kaminetsky, Jed; Spana, Carl; Lucas, Johna; Jordan, Robert; Portman, David J

    2016-01-01

    Aim: Evaluate efficacy/safety of bremelanotide (BMT), a melanocortin-receptor-4 agonist, to treat female sexual dysfunctions in premenopausal women. Methods: Patients randomized to receive placebo or BMT 0.75, 1.25 or 1.75 mg self-administered subcutaneously, as desired, over 12 weeks. Primary end point was change in satisfying sexual events/month. Secondary end points included total score changes on female sexual function index and female sexual distress scale-desire/arousal/orgasm. Results: Efficacy data, n = 327. For 1.25/1.75-mg pooled versus placebo, mean changes from baseline to study end were +0.7 versus +0.2 satisfying sexual events/month (p = 0.0180), +3.6 versus +1.9 female sexual function index total score (p = 0.0017), −11.1 versus −6.8 female sexual distress scale-desire/arousal/orgasm total score (p = 0.0014). Adverse events: nausea, flushing, headache. Conclusion: In premenopausal women with female sexual dysfunctions, self-administered, as desired, subcutaneous BMT was safe, effective, and well tolerated (NCT01382719). PMID:27181790

  10. Pre-transplant Exercise and Hematopoietic Cell Transplant Survival: a secondary analysis of Blood and Marrow Transplant Clinical Trials Network (BMT CTN 0902)

    PubMed Central

    Wingard, John R.; Wood, William A.; Martens, Michael; Le-Rademacher, Jennifer; Logan, Brent; Knight, Jennifer M.; Jacobsen, Paul B.; Jim, Heather; Majhail, Navneet S.; Syrjala, Karen; Rizzo, J. Douglas; Lee, Stephanie J.

    2016-01-01

    Blood and Marrow Transplant Clinical Trials Network (BMT CTN) Protocol 0902 evaluated whether exercise and stress management training prior to hematopoietic cell transplantation (HCT) improved physical and mental functioning after HCT. Neither overall survival nor other patient-reported transplant outcomes were improved by the training intervention. In some animal studies of HCT, moderate intensity exercise for 8 weeks before HCT has been associated with positive effects on hematopoietic progenitors resulting in improved donor engraftment and improved survival. Accordingly, we performed a secondary analysis of data from BMT CTN 0902 to determine whether exercise engagement prior to HCT was associated with engraftment and survival. There were no significant associations between self-reported pre-HCT exercise levels and engraftment or survival. There was also no effect of pre-transplant exercise on either neutrophil or platelet engraftment. These findings do not support the observations in animal models but are limited by several shortcomings that do not refute the hypothesis that exercise before HCT may be beneficial. PMID:27742574

  11. Negative Allosteric Modulators Selective for The NR2B Subtype of The NMDA Receptor Impair Cognition in Multiple Domains

    PubMed Central

    Weed, Michael R; Bookbinder, Mark; Polino, Joseph; Keavy, Deborah; Cardinal, Rudolf N; Simmermacher-Mayer, Jean; Cometa, Fu-ni L; King, Dalton; Thangathirupathy, Srinivasan; Macor, John E; Bristow, Linda J

    2016-01-01

    Antidepressant activity of N-methyl-D-aspartate (NMDA) receptor antagonists and negative allosteric modulators (NAMs) has led to increased investigation of their behavioral pharmacology. NMDA antagonists, such as ketamine, impair cognition in multiple species and in multiple cognitive domains. However, studies with NR2B subtype-selective NAMs have reported mixed results in rodents including increased impulsivity, no effect on cognition, impairment or even improvement of some cognitive tasks. To date, the effects of NR2B-selective NAMs on cognitive tests have not been reported in nonhuman primates. The current study evaluated two selective NR2B NAMs, CP101,606 and BMT-108908, along with the nonselective NMDA antagonists, ketamine and AZD6765, in the nonhuman primate Cambridge Neuropsychological Test Automated Battery (CANTAB) list-based delayed match to sample (list-DMS) task. Ketamine and the two NMDA NR2B NAMs produced selective impairments in memory in the list-DMS task. AZD6765 impaired performance in a non-specific manner. In a separate cohort, CP101,606 impaired performance of the nonhuman primate CANTAB visuo-spatial Paired Associates Learning (vsPAL) task with a selective impairment at more difficult conditions. The results of these studies clearly show that systemic administration of a selective NR2B NAM can cause transient cognitive impairment in multiple cognitive domains. PMID:26105137

  12. Mouse Models in Bone Marrow Transplantation and Adoptive Cellular Therapy

    PubMed Central

    Arber, Caroline; Brenner, Malcolm K.; Reddy, Pavan

    2014-01-01

    Mouse models of transplantation have been indispensable to the development of bone marrow transplantation (BMT). Their role in the generation of basic science knowledge is invaluable and is subject to discussion below. However, this article focuses on the direct role and relevance of mouse models towards the clinical development and advances in BMT and adoptive T-cell therapy for human diseases. The authors aim to present a thoughtful perspective on the pros and cons of mouse models while noting that despite imperfections these models are obligatory for the development of science-based medicine. PMID:24216170

  13. Mixed donor chimerism in non-malignant haematological diseases after allogeneic bone marrow transplantation.

    PubMed

    Shamshad, Ghassan Umair; Ahmed, Suhaib; Bhatti, Farhat Abbas; Ali, Nadir

    2012-12-01

    To determine the frequency of mixed donor chimerism in patients of non-malignant haematological diseases after allogeneic bone marrow transplant. A cross-sectional, observational study. Department of Haematology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, from July 2010 to June 2011. Donor chimerism was assessed in patients of aplastic anaemia and beta-thalassaemia major who underwent allogeneic bone marrow transplantation (BMT). Peripheral blood samples were used to assess chimerism status by analysis of short tandem repeats (STR). In patients where pre-transplant blood sample was not available, swab of buccal mucosa was used for pre-transplant STR profile. A standard set of primers for STR markers were used and the amplified DNA was resolved by gel electrophoresis and stained with silver nitrate. The percentage of donor origin DNA was estimated by densitometer. Out of 84 patients, 52 (62%) were males, while 32 (38%) were females. In patients of beta-thalassaemia major, 31 (62%) developed mixed donor chimerism (MC), 13 (26%) developed complete donor chimerism (CC) and 6 (12%) had graft failure. In aplastic anaemia, 17 patients (50%) achieved MC, 13 (38.2%) had CC and 4 (11.8%) developed graft failure. The combined frequency of mixed donor chimerism for both the diseases was 58.3%. D3S1358 was the most informative STR marker in these patients. Majority of the studied patients developed mixed donor chimerism following bone marrow transplantation, whereas only a minor percentage of the patients had graft failure. Analysis of D3S1358 was the most informative in assessing donor chimerism in patients who underwent BMT.

  14. Trading or coercion? Variation in male mating strategies between two communities of East African chimpanzees.

    PubMed

    Kaburu, Stefano S K; Newton-Fisher, Nicholas E

    2015-06-01

    Across taxa, males employ a variety of mating strategies, including sexual coercion and the provision, or trading, of resources. Biological market theory (BMT) predicts that trading of commodities for mating opportunities should exist only when males cannot monopolize access to females and/or obtain mating by force, in situations where power differentials between males are low; both coercion and trading have been reported for chimpanzees ( Pan troglodytes ). Here, we investigate whether the choice of strategy depends on the variation in male power differentials, using data from two wild communities of East African chimpanzees ( Pan troglodytes schweinfurthii ): the structurally despotic Sonso community (Budongo, Uganda) and the structurally egalitarian M-group (Mahale, Tanzania). We found evidence of sexual coercion by male Sonso chimpanzees, and of trading-of grooming for mating-by M-group males; females traded sex for neither meat nor protection from male aggression. Our results suggest that the despotism-egalitarian axis influences strategy choice: male chimpanzees appear to pursue sexual coercion when power differentials are large and trading when power differentials are small and coercion consequently ineffective. Our findings demonstrate that trading and coercive strategies are not restricted to particular chimpanzee subspecies; instead, their occurrence is consistent with BMT predictions. Our study raises interesting, and as yet unanswered, questions regarding female chimpanzees' willingness to trade sex for grooming, if doing so represents a compromise to their fundamentally promiscuous mating strategy. It highlights the importance of within-species cross-group comparisons and the need for further study of the relationship between mating strategy and dominance steepness.

  15. Intestinal Helminths Regulate Lethal Acute Graft Versus Host Disease and Preserve Graft Versus Tumor Effect in Mice

    PubMed Central

    Li, Yue; Chen, Hung-lin; Bannick, Nadine; Henry, Michael; Holm, Adrian N.; Metwali, Ahmed; Urban, Joseph F.; Rothman, Paul B.; Weiner, George J.; Blazar, Bruce R.; Elliott, David E.; Ince, M. Nedim

    2014-01-01

    Donor T lymphocyte transfer with hematopoietic stem cells suppresses residual tumor growth (graft-versus-tumor; GVT) in cancer patients undergoing bone marrow transplantation (BMT). However, donor T cell reactivity to host organs causes severe and potentially lethal inflammation, called graft-versus-host disease (GVHD). High dose steroids or other immune suppressives are used to treat GVHD that have limited ability to control the inflammation while incurring long-term toxicity. Novel strategies are needed to modulate GVHD, preserve GVT and improve the outcome of BMT. Regulatory T cells (Tregs) control alloantigen-sensitized inflammation of GVHD, sustain GVT and prevent mortality in bone marrow transplantation. Helminths colonizing the alimentary tract dramatically increase the Treg activity, thereby modulating intestinal or systemic inflammatory responses. These observations led us to hypothesize that helminths can regulate GVHD and maintain GVT in mice. Acute GVHD was induced in helminth (Heligmosomoides polygyrus)-infected or uninfected Balb/C recipients of C57BL/6 donor grafts. Helminth infection suppressed donor T cell inflammatory cytokine generation along with reduction in GVHD lethality and maintenance of GVT. H. polygyrus colonization promoted the survival of TGFβ generating recipient Tregs after a conditioning regimen with total body irradiation and led to a TGFβ-dependent in vivo expansion/maturation of donor Tregs after BMT. Helminths did not control GVHD, when T cells unresponsive to TGFβ-mediated immune regulation were used as donor T lymphocytes. These results suggest that helminths suppress acute GVHD, employing regulatory T cells and TGFβ-dependent pathways in mice. Helminthic regulation of GVHD and GVT through intestinal immune conditioning may improve the outcome of BMT. PMID:25527786

  16. Constipation and other common symptoms reported by women and men in methadone and buprenorphine maintenance treatment.

    PubMed

    Haber, Paul S; Elsayed, Mahmoud; Espinoza, David; Lintzeris, Nicholas; Veillard, Anne-Sophie; Hallinan, Richard

    2017-12-01

    Opioid substitution treatment (OST) is often continued long-term and, therefore, opioid-associated symptoms are of interest. Symptoms associated with methadone maintenance treatment (MMT) in men are well described, but there are fewer reports concerning symptoms associated with buprenorphine maintenance treatment (BMT) and very few reports among women. Recipients of BMT (n=113) and MMT (n=184), non-opioid users (n=105) and opioid users not receiving OST (n=87) completed the Patient Assessment of Constipation (PAC-SYM) and a general symptom checklist. Multivariate analysis included other potential moderators of opioid-associated symptoms. Opioid users reported a higher frequency and severity of symptoms than non-opioid users. Constipation, dry mouth, decreased appetite, sweating and fatigue were highly prevalent in the previous 30days (51-80%). Nausea, itchy skin, trouble urinating, menstrual problems, lightheadedness, blurred vision, heart racing were also common (30-50%). Non-OST opioid users had significantly higher frequency and severity than OST recipients of nausea, vomiting, diarrhoea, decreased appetite, sweating and itchy skin. Sweating was significantly more common in MMT than BMT. Constipation scores were higher in women, otherwise most sex differences were small. Higher PAC-SYM scores were associated with vomiting (OR=1.04) and sweating (OR=1.06). Cannabis use was associated with vomiting (OR=2.19). Constipation (OR=1.07), insomnia (OR=2.5) and depression (OR=2.82) were associated with fatigue. Men and women receiving OST report similarly high rates of somatic symptoms, though less than opioid users not receiving OST. There were few differences between BMT and MMT. Buprenorphine might be preferred where sweating is problematic. Several modifiable factors were identified. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Administration of herpes simplex-thymidine kinase-expressing donor T cells with a T-cell-depleted allogeneic marrow graft.

    PubMed

    Tiberghien, P; Ferrand, C; Lioure, B; Milpied, N; Angonin, R; Deconinck, E; Certoux, J M; Robinet, E; Saas, P; Petracca, B; Juttner, C; Reynolds, C W; Longo, D L; Hervé, P; Cahn, J Y

    2001-01-01

    Administration of donor T cells expressing the herpes simplex-thymidine kinase (HS-tk) with a hematopoietic stem cell (HSC) transplantation could allow, if graft-versus-host disease (GVHD) was to occur, a selective in vivo depletion of these T cells by the use of ganciclovir (GCV). The study evaluates the feasibility of such an approach. Escalating numbers of donor HS-tk-expressing CD3(+) gene-modified cells (GMCs) are infused with a T-cell-depleted bone marrow transplantation (BMT). Twelve patients with hematological malignancies received 2 x 10(5) (n = 5), 6 x 10(5) (n = 5), or 20 x 10(5) (n = 2) donor CD3(+) GMCs/kg with a BMT from a human leukocyte antigen (HLA)-identical sibling. No acute toxicity was associated with GMC administration. An early increase of circulating GMCs followed by a progressive decrease and long-lasting circulation of GMCs was documented. GCV treatment resulted in significant rapid decrease in circulating GMCs. Three patients developed acute GVHD, with a grade of at least II, while one patient developed chronic GVHD. Treatment with GCV alone was associated with a complete remission (CR) in 2 patients with acute GVHD, while the addition of glucocorticoids was necessary to achieve a CR in the last case. Long-lasting CR occurred with GCV treatment in the patient with chronic GVHD. Unfortunately, Epstein-Barr virus-lymphoproliferative disease occurred in 3 patients. Overall, the administration of low numbers of HS-tk-expressing T cells early following an HLA-identical BMT is associated with no acute toxicity, persistent circulation of the GMCs, and GCV-sensitive GVHD. Such findings open the way to the infusion of higher numbers of gene-modified donor T cells to enhance post-BMT immune competence while preserving GCV-sensitive alloreactivity.

  18. Urologic Outcomes of Children With Hemorrhagic Cystitis After Bone Marrow Transplant at a Single Institution.

    PubMed

    Au, Jason K; Graziano, Christopher; Elizondo, Rodolfo A; Ryan, Sheila; Roth, David R; Koh, Chester J; Gonzales, Edmond T; Tu, Duong T; Janzen, Nicolette; Naik, Swati; Seth, Abhishek

    2017-03-01

    To analyze clinical outcomes and the risk factors associated with genitourinary (GU) morbidity and mortality in children who present with hemorrhagic cystitis (HC) after bone marrow transplant (BMT). A retrospective chart review of patients with HC who had undergone BMT at a single pediatric hospital from 2008 to 2015 was conducted. Demographic data, severity of hematuria, HC management, and mortality were analyzed. Bivariate analysis and binary logistic regression were performed to identify risk factors. Out of 43 patients who met inclusion criteria, 67.4% were male with a median age at BMT of 10.2 years (interquartile range 5.8-14.6). Percutaneous nephrostomy catheters were inserted in 5 patients for urinary diversion. All-cause mortality was 32.6% (N = 14). Intravesical retroviral therapy (P <.001), HC grade (P <.001), total Foley time (P <.001), total gross hematuria time (P <.001), total days hospitalized (P = .012), and days to most improved hematuria (P = .032) were associated with significant GU morbidity on bivariate analysis. On multivariable analysis, days to most improved hematuria was associated with significant GU morbidity odds ratio of 1.177 (1.006-1.376) (P = .042). Status of percutaneous nephrostomy was not associated with increased mortality (P = .472); however, in the multivariate model, BK viremia (P = .023), need for renal dialysis (P = .003), and presence of Foley catheter (P = .005) were associated with increased mortality. Children with HC after BMT fall in a very high-risk category with high mortality and significant GU morbidity. The presence of a Foley catheter, need for dialysis, and BK viremia are associated with increased mortality. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Hand digit control in children: motor overflow in multi-finger pressing force vector space during maximum voluntary force production.

    PubMed

    Shim, Jae Kun; Karol, Sohit; Hsu, Jeffrey; de Oliveira, Marcio Alves

    2008-04-01

    The aim of this study was to investigate the contralateral motor overflow in children during single-finger and multi-finger maximum force production tasks. Forty-five right handed children, 5-11 years of age produced maximum isometric pressing force in flexion or extension with single fingers or all four fingers of their right hand. The forces produced by individual fingers of the right and left hands were recorded and analyzed in four-dimensional finger force vector space. The results showed that increases in task (right) hand finger forces were linearly associated with non-task (left) hand finger forces. The ratio of the non-task hand finger force magnitude to the corresponding task hand finger force magnitude, termed motor overflow magnitude (MOM), was greater in extension than flexion. The index finger flexion task showed the smallest MOM values. The similarity between the directions of task hand and non-task hand finger force vectors in four-dimensional finger force vector space, termed motor overflow direction (MOD), was the greatest for index and smallest for little finger tasks. MOM of a four-finger task was greater than the sum of MOMs of single-finger tasks, and this phenomenon was termed motor overflow surplus. Contrary to previous studies, no single-finger or four-finger tasks showed significant changes of MOM or MOD with the age of children. We conclude that the contralateral motor overflow in children during finger maximum force production tasks is dependent upon the task fingers and the magnitude and direction of task finger forces.

  20. 75 FR 45606 - Interagency Ocean Policy Task Force-Final Recommendations of the Interagency Ocean Policy Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ... COUNCIL ON ENVIRONMENTAL QUALITY Interagency Ocean Policy Task Force--Final Recommendations of the Interagency Ocean Policy Task Force AGENCY: Council on Environmental Quality. ACTION: Notice of Availability, Interagency Ocean Policy Task Force's [[Page 45607

  1. Two-Photon Probes for Lysosomes and Mitochondria: Simultaneous Detection of Lysosomes and Mitochondria in Live Tissues by Dual-Color Two-Photon Microscopy Imaging.

    PubMed

    Lim, Chang Su; Hong, Seung Taek; Ryu, Seong Shick; Kang, Dong Eun; Cho, Bong Rae

    2015-10-01

    Novel two-photon (TP) probes were developed for lysosomes (PLT-yellow) and mitochondria (BMT-blue and PMT-yellow). These probes emitted strong TP-excited fluorescence in cells at widely separated wavelength regions and displayed high organelle selectivity, good cell permeability, low cytotoxicity, and pH insensitivity. The BMT-blue and PLT-yellow probes could be utilized to detect lysosomes and mitochondria simultaneously in live tissues by using dual-color two-photon microscopy, with minimum interference from each other. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. The Role of Dectin-2 for Host Defense Against Disseminated Candidiasis.

    PubMed

    Ifrim, Daniela C; Quintin, Jessica; Courjol, Flavie; Verschueren, Ineke; van Krieken, J Han; Koentgen, Frank; Fradin, Chantal; Gow, Neil A R; Joosten, Leo A B; van der Meer, Jos W M; van de Veerdonk, Frank; Netea, Mihai G

    2016-04-01

    Despite the fact that Candida albicans is an important human fungal pathogen and Dectin-2 is a major pattern recognition receptor for fungi, our knowledge regarding the role of Dectin-2 for the host defense against disseminated candidiasis is limited. Dectin-2 deficient (Dectin-2(-/-)) mice were more susceptible to systemic candidiasis, and the susceptibility was mirrored by an elevated fungal load in the kidneys that correlated with the presence of large inflammatory foci. Phagocytosis of Candida by the macrophages lacking the Dectin-2 receptor was moderately decreased, while production of most of the macrophage-derived cytokines from Dectin-2(-/-) mice with systemic candidiasis was decreased. No striking differences among several Candida mutants defective in mannans could be detected between naïve wild-type and Dectin-2(-/-) mice, apart from the β-mannan-deficient bmt1Δ/bmt2Δ/bmt5Δ triple mutant, suggesting that β-mannan may partially mask α-mannan detection, which is the major fungal structure recognized by Dectin-2. Deciphering the mechanisms responsible for host defense against the majority of C. albicans strains represents an important step in understanding the pathophysiology of systemic candidiasis, which might lead to the development of novel immunotherapeutic strategies.

  3. Polymorphisms of the bovine DKK2 and their associations with body measurement traits and meat quality traits in Qinchuan cattle.

    PubMed

    Zhan, Xiaoli; Gao, Jianbin; Huangfu, Yifan; Fu, Changzhen; Zan, Linsen

    2013-12-01

    The objective of this research were to detect bovine Dickkopf 2 (DKK2) gene polymorphism and analyze their associations with body measurement traits (BMT) and meat quality traits (MQT) of animals. Blood samples were taken from a total of 541 Qinchuan cattle aged from 18 to 24 months. Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was employed to find out DKK2 single-polymorphism nucleotide (SNPs) and to explore their possible association with BMT and MQT. Sequence analysis of DKK2 gene revealed 2 SNPs (C29 T and A169C) in 5' untranslated region (5'UTR) of exon 1.C29T and A164T SNPs are both synonymous mutation, which showed 2 genotypes namely (CC, CT) and (AA and AC), respectively. Association analysis of polymorphism with body measurement and meat quality traits at the two locus showed that there were significant effects on CT, BL, RL, PBW, BFT, LMA, and IFC. These results suggest that the DKK2 gene might have potential effects on BMT and MQT in Qinchuan cattle population and could be used for marker-assisted selection.

  4. JACIE accreditation for blood and marrow transplantation: past, present and future directions of an international model for healthcare quality improvement

    PubMed Central

    Snowden, J A; McGrath, E; Duarte, R F; Saccardi, R; Orchard, K; Worel, N; Kuball, J; Chabannon, C; Mohty, M

    2017-01-01

    Blood and marrow transplantation (BMT) is a complex and evolving medical speciality that makes substantial demands on healthcare resources. To meet a professional responsibility to both patients and public health services, the European Society for Blood and Marrow Transplantation (EBMT) initiated and developed the Joint Accreditation Committee of the International Society for Cellular Therapy and EBMT—better known by the acronym, JACIE. Since its inception, JACIE has performed over 530 voluntary accreditation inspections (62% first time; 38% reaccreditation) in 25 countries, representing 40% of transplant centres in Europe. As well as widespread professional acceptance, JACIE has become incorporated into the regulatory framework for delivery of BMT and other haematopoietic cellular therapies in several countries. In recent years, JACIE has been validated using the EBMT registry as an effective means of quality improvement with a substantial positive impact on survival outcomes. Future directions include development of Europe-wide risk-adjusted outcome benchmarking through the EBMT registry and further extension beyond Europe, including goals to faciliate access for BMT programmes in in low- and middle-income economies (LMIEs) via a ‘first-step’ process. PMID:28346416

  5. GVHD prevents NK-cell-dependent leukemia and virus-specific innate immunity.

    PubMed

    Bunting, Mark D; Varelias, Antiopi; Souza-Fonseca-Guimaraes, Fernando; Schuster, Iona S; Lineburg, Katie E; Kuns, Rachel D; Fleming, Peter; Locke, Kelly R; Huntington, Nicholas D; Blazar, Bruce R; Lane, Steven W; Tey, Siok-Keen; MacDonald, Kelli P A; Smyth, Mark J; Degli-Esposti, Mariapia A; Hill, Geoffrey R

    2017-02-02

    Allogeneic bone marrow transplantation (allo-BMT) is a curative therapy for hematological malignancies, but is associated with significant complications, principally graft-versus-host disease (GVHD) and opportunistic infections. Natural killer (NK) cells mediate important innate immunity that provides a temporal bridge until the reconstruction of adaptive immunity. Here, we show that the development of GVHD after allo-BMT prevented NK-cell reconstitution, particularly within the maturing M1 and M2 NK-cell subsets in association with exaggerated activation, apoptosis, and autophagy. Donor T cells were critical in this process by limiting the availability of interleukin 15 (IL-15), and administration of IL-15/IL-15Rα or immune suppression with rapamycin could restore NK-cell reconstitution. Importantly, the NK-cell defect induced by GVHD resulted in the failure of NK-cell-dependent in vivo cytotoxicity and graft-versus-leukemia effects. Control of cytomegalovirus infection after allo-BMT was also impaired during GVHD. Thus, during GVHD, donor T cells compete with NK cells for IL-15 thereby inducing profound defects in NK-cell reconstitution that compromise both leukemia and pathogen-specific immunity. © 2017 by The American Society of Hematology.

  6. Corruption of dendritic cell antigen presentation during acute GVHD leads to regulatory T-cell failure and chronic GVHD

    PubMed Central

    Leveque-El mouttie, Lucie; Koyama, Motoko; Le Texier, Laetitia; Markey, Kate A.; Cheong, Melody; Kuns, Rachel D.; Lineburg, Katie E.; Teal, Bianca E.; Alexander, Kylie A.; Clouston, Andrew D.; Blazar, Bruce R.; Hill, Geoffrey R.

    2016-01-01

    Chronic graft-versus-host disease (cGVHD) is a major cause of late mortality following allogeneic bone marrow transplantation (BMT) and is characterized by tissue fibrosis manifesting as scleroderma and bronchiolitis obliterans. The development of acute GVHD (aGVHD) is a powerful clinical predictor of subsequent cGVHD, suggesting that aGVHD may invoke the immunologic pathways responsible for cGVHD. In preclinical models in which sclerodermatous cGVHD develops after a preceding period of mild aGVHD, we show that antigen presentation within major histocompatibility complex (MHC) class II of donor dendritic cells (DCs) is markedly impaired early after BMT. This is associated with a failure of regulatory T-cell (Treg) homeostasis and cGVHD. Donor DC-restricted deletion of MHC class II phenocopied this Treg deficiency and cGVHD. Moreover, specific depletion of donor Tregs after BMT also induced cGVHD, whereas adoptive transfer of Tregs ameliorated it. These data demonstrate that the defect in Treg homeostasis seen in cGVHD is a causative lesion and is downstream of defective antigen presentation within MHC class II that is induced by aGVHD. PMID:27338097

  7. Influence of allogeneic bone marrow transplantation on the endocrine system in children.

    PubMed

    Dopfer, R; Ranke, M B; Einsele, H; Ehninger, G; Blum, W F; Niethammer, D

    1989-01-01

    With increasing survival rates of children grafted for different malignancies concerns about the longterm side effects of this treatment are growing. Therefore, investigations on the function of endocrine systems were conducted in a total 28 patients grafted for various reasons: ALL (N = 18), AML (N = 1), SAA (N = 3), CML(N = 4), neuroblastoma (N = 2). The results can be summarized as follows: 1. The extent of hormonal derangements is primarily dependent on the extent of irradiation prior to BMT. Integrity of hormonal systems was found in cases without irradiation (SAA) or if TBI did not exceed 3 Gy. 2. Primary hypogonadism was present in 18 patients. 3. Primary hypothyroidism was present in 2 patients. 4. Growth impairment was observed in 8 patients. In four of these cases growth hormone deficiency was the cause. In four other cases with graft-versus-host-disease and hepatic involvement SmC/IGF I levels were severely diminished. The data suggest that in most cases BMT itself has relatively few negative effects on the endocrine regulatory system. However, more detailed investigations before and after BMT will be needed to further validate these observations.

  8. Chronic active Epstein-Barr virus infection with mosquito allergy successfully treated with reduced-intensity unrelated allogeneic bone marrow transplantation in a boy.

    PubMed

    Matsunaga, Takayuki; Kurosawa, Hidemitsu; Okuya, Mayuko; Nakajima, Daisuke; Hagisawa, Susumu; Sato, Yuya; Fukushima, Keitaro; Sugita, Kenichi; Arisaka, Osamu

    2009-03-01

    EBV-infected T-/NK cells play an important role in the pathogenesis of mosquito allergy, and the prognosis of most patients with mosquito allergy is poor without proper treatment. We describe a 13-yr-old boy who had CAEBV with mosquito allergy and was successfully treated with BMT from an unrelated donor after reduced-intensity preconditioning. Because combination chemotherapy failed to achieve CR, we performed unrelated BMT to reconstitute normal immunity and eradicate any residual EBV-infected cells. To reduce complications after BMT, we selected a reduced-intensity preconditioning regimen consisting of fludarabine, l-phenylalanine mustard, and antithymocyte Ig instead of a conventional myeloablative preconditioning. Although grade II acute GVHD developed, it was successfully controlled with immunosuppressive therapy. After 27 months, the patient has been well without any signs of CAEBV, and the EBV DNA has been undetectable with real-time PCR analysis. We conclude that RIST from the bone marrow of an unrelated donor is indicated for some patients who have CAEBV that is refractory to chemotherapy and who have no HLA-matched related donors or cord blood as a source of stem cells.

  9. Decision-making in adult thalassemia patients undergoing unrelated bone marrow transplantation: quality of life, communication and ethical issues.

    PubMed

    Caocci, G; Pisu, S; Argiolu, F; Giardini, C; Locatelli, F; Vacca, A; Orofino, M G; Piras, E; De Stefano, P; Addari, M C; Ledda, A; La Nasa, G

    2006-01-01

    Bone marrow transplantation (BMT) represents a potentially curative treatment of thalassemia. For patients without an HLA-identical sibling donor, recourse to an unrelated donor is a practicable option but the candidates and their families are faced with a difficult decision. They can either choose to continue the supportive therapy, with no chance of definitive cure, or they accept the mortality risk of BMT in the hope of obtaining a definitive resolution of the disease. We investigated the communication strategies and the post transplantation quality of life (QoL) in 19 adult thalassemia patients surviving after an unrelated donor BMT. The patients were given two questionnaires: a questionnaire to evaluate pre-transplantation communication factors and the EORTC QLQ-C30 questionnaire to assess global QoL. All patients were satisfied with the communication modalities employed by the physicians. The global post transplantation QoL in our patient cohort was found to be good. The approach used in this study may offer a contribution to understanding the decision-making process leading to the choice of a treatment with a high mortality risk for a chronic, non-malignant disease. Finally, some ethical issues of this therapeutic approach are briefly addressed.

  10. Rapid and automated processing of bone marrow grafts without Ficoll density gradient for transplantation of cryopreserved autologous or ABO-incompatible allogeneic bone marrow.

    PubMed

    Schanz, U; Gmür, J

    1992-12-01

    The growing number of BMTs has increased interest in safe and standardized in vitro bone marrow processing techniques. We describe our experience with a rapid automated method for the isolation of mononuclear cells (MNC) from large volumes of bone marrow using a Fenwal CS-3000 cell separator without employing density gradient materials. Forty bone marrow harvests with a mean volume of 1650 +/- 307 ml were processed. A mean of 75 +/- 34% (50 percentile range 54-94%) of the original MNCs were recovered in a volume of 200 ml with only 4 +/- 2% of the starting red blood cells (RBC). Removal of granulocytes, immature myeloid precursors and platelets proved to be sufficient to permit safe cryopreservation and successful autologous BMT (n = 25). Allogeneic BMT (n = 14, including three major ABO-incompatible) could be performed without additional manipulation. In both groups of patients timely and stable engraftment comparable to historical controls receiving Ficoll gradient processed autologous (n = 17) or unprocessed allogeneic BMT (n = 54) was observed. Moreover, 70 +/- 14% of the RBC could be recovered from the grafts. They were used for autologous RBC support of donors, rendering unnecessary autologous blood pre-donations.

  11. Wild-type bone marrow transplant partially reverses neuroinflammation in progranulin-deficient mice.

    PubMed

    Yang, Yue; Aloi, Macarena S; Cudaback, Eiron; Josephsen, Samuel R; Rice, Samantha J; Jorstad, Nikolas L; Keene, C Dirk; Montine, Thomas J

    2014-11-01

    Frontotemporal dementia (FTD) is a neurodegenerative disease with devastating changes in behavioral performance and social function. Mutations in the progranulin gene (GRN) are one of the most common causes of inherited FTD due to reduced progranulin expression or activity, including in brain where it is expressed primarily by neurons and microglia. Thus, efforts aimed at enhancing progranulin levels might be a promising therapeutic strategy. Bone marrow (BM)-derived cells are able to engraft in the brain and adopt a microglial phenotype under myeloablative irradiation conditioning. This ability makes BM-derived cells a potential cellular vehicle for transferring therapeutic molecules to the central nervous system. Here, we utilized BM cells from Grn(+/+) (wild type or wt) mice labeled with green fluorescence protein for delivery of progranulin to progranulin-deficient (Grn(-/-)) mice. Our results showed that wt bone marrow transplantation (BMT) partially reconstituted progranulin in the periphery and in cerebral cortex of Grn(-/-) mice. We demonstrated a pro-inflammatory effect in vivo and in ex vivo preparations of cerebral cortex of Grn(-/-) mice that was partially to fully reversed 5 months after BMT. Our findings suggest that BMT can be administered as a stem cell-based approach to prevent or to treat neurodegenerative diseases.

  12. Corruption of dendritic cell antigen presentation during acute GVHD leads to regulatory T-cell failure and chronic GVHD.

    PubMed

    Leveque-El Mouttie, Lucie; Koyama, Motoko; Le Texier, Laetitia; Markey, Kate A; Cheong, Melody; Kuns, Rachel D; Lineburg, Katie E; Teal, Bianca E; Alexander, Kylie A; Clouston, Andrew D; Blazar, Bruce R; Hill, Geoffrey R; MacDonald, Kelli P A

    2016-08-11

    Chronic graft-versus-host disease (cGVHD) is a major cause of late mortality following allogeneic bone marrow transplantation (BMT) and is characterized by tissue fibrosis manifesting as scleroderma and bronchiolitis obliterans. The development of acute GVHD (aGVHD) is a powerful clinical predictor of subsequent cGVHD, suggesting that aGVHD may invoke the immunologic pathways responsible for cGVHD. In preclinical models in which sclerodermatous cGVHD develops after a preceding period of mild aGVHD, we show that antigen presentation within major histocompatibility complex (MHC) class II of donor dendritic cells (DCs) is markedly impaired early after BMT. This is associated with a failure of regulatory T-cell (Treg) homeostasis and cGVHD. Donor DC-restricted deletion of MHC class II phenocopied this Treg deficiency and cGVHD. Moreover, specific depletion of donor Tregs after BMT also induced cGVHD, whereas adoptive transfer of Tregs ameliorated it. These data demonstrate that the defect in Treg homeostasis seen in cGVHD is a causative lesion and is downstream of defective antigen presentation within MHC class II that is induced by aGVHD. © 2016 by The American Society of Hematology.

  13. Prognostic significance of cytogenetic abnormalities in patients with chronic myelogenous leukemia.

    PubMed

    Przepiorka, D; Thomas, E D

    1988-03-01

    The cytogenetic data for 126 patients with Ph-positive chronic myelogenous leukemia (CML) in accelerated phase or blast crisis were analysed for clonal chromosomal abnormalities in addition to the standard Ph prior to allogeneic or syngeneic bone marrow transplantation (BMT). Additional clonal abnormalities were found in 84%, and 14% had a variant Ph (VPh). In decreasing order of frequency, the most common clonal abnormalities were a second Ph, +8, i(17q), -Y and +19. A second Ph, VPh or +8 occurred more frequently in patients who relapsed following BMT than in those who survived disease-free for at least 1 1/2 years. The presence of an i(17q) alone did not correlate with relapse. The patients with a second Ph, VPh or +8 had a median time to relapse of 19 months, and the risk of relapse at 3 years was 73%. Those with other or no additional clonal abnormalities had not reached a median time to relapse and had a 3-year risk of relapse of 31% (p = 0.002). This analysis suggests that specific cytogenetic abnormalities may be useful indicators of resistance to therapy for CML and should be included in proportional hazard models to predict outcome after BMT.

  14. A Trial-Based Economic Evaluation Comparing Spinal Cord Stimulation With Best Medical Treatment in Painful Diabetic Peripheral Neuropathy.

    PubMed

    Slangen, Rachel; Faber, Catharina G; Schaper, Nicolaas C; Joosten, Elbert A; van Dongen, Robert T; Kessels, Alfons G; van Kleef, Maarten; Dirksen, Carmen D

    2017-04-01

    The objective was to perform an economic evaluation comparing spinal cord stimulation (SCS) in combination with best medical treatment (BMT) with BMT in painful diabetic peripheral neuropathy patients. Alongside a prospective 2-center randomized controlled trial, involving 36 painful diabetic peripheral neuropathy patients with severe lower limb pain not responding to conventional therapy, an economic evaluation was performed. Incremental cost-effectiveness ratios were based on: 1) societal costs and quality-adjusted life years (QALYs), and 2) direct health care costs and the number of successfully treated patients, respectively, both with a time horizon of 12 months. Bootstrap and secondary analyses were performed to address uncertainty. Total societal cost amounted to €26,539.18 versus €5,313.45 per patient in the SCS and BMT group, respectively. QALYs were .58 versus .36 and the number of successfully treated patients was 55% versus 7% for the SCS and BMT group, respectively. This resulted in incremental cost-effectiveness ratios of €94,159.56 per QALY and €34,518.85 per successfully treated patient, respectively. Bootstrap analyses showed that the probability of SCS being cost-effective ranges from 0 to 46% with willingness to pay threshold values ranging between €20,000 and €80,000 for a QALY. Secondary analyses showed that cost-effectiveness of SCS became more favorable after correcting for baseline cost imbalance between the 2 groups, extending the depreciation period of SCS material to 4 years, and extrapolation of the data up to 4 years. Although SCS was considerably more effective compared with BMT, the substantial initial investment that is required resulted in SCS not being cost-effective in the short term. Cost-effectiveness results were sensitive to baseline cost imbalances between the groups and the depreciation period of the SCS material. Painful diabetic peripheral neuropathy is a common complication of diabetes mellitus and the humanistic and economic burden is high. This article presents the cost-effectiveness of SCS in patients suffering from painful diabetic peripheral neuropathy from a societal and health care perspective with a time horizon of 12 months. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  15. Strategies for the Identification of T Cell–Recognized Tumor Antigens in Hematological Malignancies for Improved Graft-versus-Tumor Responses after Allogeneic Blood and Marrow Transplantation

    PubMed Central

    Zilberberg, Jenny; Feinman, Rena; Korngold, Robert

    2015-01-01

    Allogeneic blood and marrow transplantation (allo-BMT) is an effective immunotherapeutic treatment that can provide partial or complete remission for patients with hematological malignancies. Mature donor T cells in the donor inoculum play a central role in mediating graft-versus-tumor (GVT) responses by destroying residual tumor cells that persist after conditioning regimens. Alloreactivity towards minor histocompatibility antigens (miHA), which are varied tissue-related self-peptides presented in the context of major histocompatibility complex (MHC) molecules on recipient cells, some of which may be shared on tumor cells, is a dominant factor for the development of GVT. Potentially, GVT can also be directed to tumor-associated antigens or tumor-specific antigens that are more specific to the tumor cells themselves. The full exploitation of allo-BMT, however, is greatly limited by the development of graft-versus-host disease (GVHD), which is mediated by the donor T cell response against the miHA expressed in the recipient’s cells of the intestine, skin, and liver. Because of the significance of GVT and GVHD responses in determining the clinical outcome of patients, miHA and tumor antigens have been intensively studied, and one active immunotherapeutic approach to separate these two responses has been cancer vaccination after allo-BMT. The combination of these two strategies has an advantage over vaccination of the patient without allo-BMT because his or her immune system has already been exposed and rendered unresponsive to the tumor antigens. The conditioning for allo-BMT eliminates the patient’s existing immune system, including regulatory elements, and provides a more permissive environment for the newly developing donor immune compartment to selectively target the malignant cells. Utilizing recent technological advances, the identities of many human miHA and tumor antigenic peptides have been defined and are currently being evaluated in clinical and basic immunological studies for their ability to produce effective T cell responses. The first step towards this goal is the identification of targetable tumor antigens. In this review, we will highlight some of the technologies currently used to identify tumor antigens and anti-tumor T cell clones in hematological malignancies. PMID:25459643

  16. Strategies for the identification of T cell-recognized tumor antigens in hematological malignancies for improved graft-versus-tumor responses after allogeneic blood and marrow transplantation.

    PubMed

    Zilberberg, Jenny; Feinman, Rena; Korngold, Robert

    2015-06-01

    Allogeneic blood and marrow transplantation (allo-BMT) is an effective immunotherapeutic treatment that can provide partial or complete remission for patients with hematological malignancies. Mature donor T cells in the donor inoculum play a central role in mediating graft-versus-tumor (GVT) responses by destroying residual tumor cells that persist after conditioning regimens. Alloreactivity towards minor histocompatibility antigens (miHA), which are varied tissue-related self-peptides presented in the context of major histocompatibility complex (MHC) molecules on recipient cells, some of which may be shared on tumor cells, is a dominant factor for the development of GVT. Potentially, GVT can also be directed to tumor-associated antigens or tumor-specific antigens that are more specific to the tumor cells themselves. The full exploitation of allo-BMT, however, is greatly limited by the development of graft-versus-host disease (GVHD), which is mediated by the donor T cell response against the miHA expressed in the recipient's cells of the intestine, skin, and liver. Because of the significance of GVT and GVHD responses in determining the clinical outcome of patients, miHA and tumor antigens have been intensively studied, and one active immunotherapeutic approach to separate these two responses has been cancer vaccination after allo-BMT. The combination of these two strategies has an advantage over vaccination of the patient without allo-BMT because his or her immune system has already been exposed and rendered unresponsive to the tumor antigens. The conditioning for allo-BMT eliminates the patient's existing immune system, including regulatory elements, and provides a more permissive environment for the newly developing donor immune compartment to selectively target the malignant cells. Utilizing recent technological advances, the identities of many human miHA and tumor antigenic peptides have been defined and are currently being evaluated in clinical and basic immunological studies for their ability to produce effective T cell responses. The first step towards this goal is the identification of targetable tumor antigens. In this review, we will highlight some of the technologies currently used to identify tumor antigens and anti-tumor T cell clones in hematological malignancies. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  17. 76 FR 60863 - Aquatic Nuisance Species Task Force Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ...] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: This notice announces a meeting of the Aquatic Nuisance Species Task Force (ANS Task Force). The ANS Task Force's purpose is to develop and implement a program for U.S. waters to prevent...

  18. 78 FR 29378 - Aquatic Nuisance Species Task Force; Public Teleconference/Webinar

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-20

    ...-FF09F14000-134] Aquatic Nuisance Species Task Force; Public Teleconference/ Webinar AGENCY: Fish and Wildlife... teleconference/webinar of the Aquatic Nuisance Species Task Force (ANS Task Force). The ANS Task Force's purpose... aquatic nuisance species; to monitor, control, and study such species; and to disseminate related...

  19. Keepin' On: Five Years Down the Road to Better Schools. Reports of the Task Force on Improving Kentucky's Schools and the Task Force on Restructuring Time and Learning.

    ERIC Educational Resources Information Center

    Prichard Committee for Academic Excellence, Lexington, KY.

    This report contains the findings of two task forces established during 1994 by the Prichard Committee for Academic Excellence: (1) the Task Force on Improving Kentucky Schools; and (2) the Task Force on Restructuring Time and Learning. The task forces, comprised of parents and business members of the Prichard Committee, examined key elements of…

  20. Reduced-intensity conditioning for the treatment of malignant and life-threatening non-malignant disorders.

    PubMed

    Slavin, Shimon; Aker, Mehmet; Shapira, Michael Y; Resnick, Igor; Bitan, Menachem; Or, Reuven

    2003-01-01

    Allogeneic bone marrow or blood stem cell transplantation (BMT) represents an important therapeutic tool for the treatment of an otherwise incurable broad spectrum of malignant and non-malignant diseases. Until recently, BMT was used primarily to replace a malignant, genetically abnormal or deficient immunohematopoietic compartment and therefore, highly toxic myeloablative regimens were considered mandatory for more effective eradication of all undesirable host-derived hematopoietic cells, including stem cells and their progeny. Our preclinical and ongoing clinical studies indicated that much more effective eradication of host immunohematopoietic system cells can be mediated by donor lymphocytes in the process of adoptive allogeneic cell therapy following BMT. Thus, eradication of all malignant cells, especially in patients with CML and, to a lesser extent, in patients with other hematologic malignancies can be accomplished despite complete resistance of puch tumor cells to maximally tolerated doses of chemoradiotherapy. Our cumulative experience suggested that graft-versus-malignancy effects might be used as a tool for eradication of otherwise resistant tumor cells of host origin. We speculated that the therapeutic benefit of BMT may be improved by using safer conditioning for engraftment of donor stem cells induce host-versus-graft unresponsiveness to enable engraftment of donor lymphocytes for subsequent induction of graft-versus-malignancy effects, or even graft-versus-autoimmunity and graft-versus-genetically abnormal cells. In other words, focusing on more selective and smarter rather than stronger modalities. Effective BMT procedures may be accomplished without lethal conditioning of the host, using a new, well-tolerated and user-friendly non-myeloablative regimen, thus eliminating or minimizing immediate and late procedure-related toxicity and mortality. It appears that initial induction of graft tolerance, mediated by engraftment of donor stem cells, leads to durable engraftment of immunocompetent donor lymphocytes, which may be necessary for induction of effective biologic warfare against host-type immunohematopoietic cells. Consequently, stem-cell therapy following induction of transplantation tolerance by selective elimination of alloreactive donor lymphocytes may represent the treatment of choice for a wide range of otherwise incurable diseases, including cancer (hematologic malignancies and certain metastatic solid tumors), genetic disorders (hemoglobinopathies and enzyme deficiency disorders), diseases caused by self-reactive lymphocytes (autoimmune diseases such as multiple sclerosis, rheumatoid arthritis) to mention just a few. Using reduced intensity conditioning, non-myeloablative stem cell transplantation (NST) can be accomplished with no major procedure-related toxicity or mortality. Thus, NST offers the feasibility of safe stem cell transplantation and cell-mediated procedures for a large and constantly growing spectrum of clinical indications for all patients in need without lower or upper age limit. Future strategies currently under investigation include developing new approaches for control of alloreactivity of host-versus-graft and graft-versus host reactivity reactions and developing better approaches for maximizing the capacity of donor lymphocytes to eliminate cancer cells more selectively, while avoiding or minimizing GVHD for safer and more effective treatment of patients in need of BMT.

  1. Safety of live vaccinations on immunosuppressive therapy in patients with immune-mediated inflammatory diseases, solid organ transplantation or after bone-marrow transplantation - A systematic review of randomized trials, observational studies and case reports.

    PubMed

    Croce, Evelina; Hatz, Christoph; Jonker, Emile F; Visser, L G; Jaeger, Veronika K; Bühler, Silja

    2017-03-01

    Live vaccines are generally contraindicated on immunosuppressive therapy due to safety concerns. However, data are limited to corroborate this practice. To estimate the safety of live vaccinations in patients with immune-mediated inflammatory diseases (IMID) or solid organ transplantation (SOT) on immunosuppressive treatment and in patients after bone-marrow transplantation (BMT). A search was conducted in electronic databases (Cochrane, Pubmed, Embase) and additional literature was identified by targeted searches. Randomized trials, observational studies and case reports. Patients with IMID or SOT on immunosuppressive treatment and BMT patients <2years after transplantation. Live vaccinations: mumps, measles, rubella (MMR), yellow fever (YF), varicella vaccine (VV), herpes zoster (HZ), oral typhoid, oral polio, rotavirus, Bacillus Calmette-Guérin (BCG), smallpox. One author performed the data extraction using predefined data fields. It was cross-checked by two other authors. 7305 articles were identified and 64 articles were included: 40 on IMID, 16 on SOT and 8 on BMT patients. In most studies, the administration of live vaccines was safe. However, some serious vaccine-related adverse events occurred. 32 participants developed an infection with the vaccine strain; in most cases the infection was mild. However, in two patients fatal infections were reported: a patient with RA/SLE overlap who started MTX/dexamethasone treatment four days after the YFV developed a yellow fever vaccine-associated viscerotropic disease (YEL-AVD) and died. The particular vaccine lot was found to be associated with a more than 20 times risk of YEL-AVD. One infant whose mother was under infliximab treatment during pregnancy received the BCG vaccine at the age of three months and developed disseminated BCG infection and died. An immunogenicity assessment was performed in 43 studies. In most cases the patients developed satisfactory seroprotection rates. In the IMID group, YFV and VV demonstrated high seroconversion rates. MTX and tumor necrosis factor inhibitory therapy appeared to reduce immune responses to VV and HZ vaccine, but not to MMR and YF-revaccination. Seroconversion in SOT and BMT patients showed mostly higher rates for rubella than for measles, mumps and varicella. Risk of bias was high in the majority of studies since 39 of them were observational and 17 were case series/case reports. Only eight studies were randomized trials. BMT patient numbers included in this review were low. Although live vaccinations were safe and sufficiently immunogenic in most studies, some serious reactions and vaccine-related infections were reported in immunosuppressed IMID and SOT patients. Apart from mild vaccine-related infections MMR and VV vaccines were safe when administered less than two years after BMT. Until further data are available, live vaccinations under most immunosuppressive treatments should only be administered after a careful risk benefit assessment of medications and dosages. None. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Grip force and force sharing in two different manipulation tasks with bottles.

    PubMed

    Cepriá-Bernal, Javier; Pérez-González, Antonio; Mora, Marta C; Sancho-Bru, Joaquín L

    2017-07-01

    Grip force and force sharing during two activities of daily living were analysed experimentally in 10 right-handed subjects. Four different bottles, filled to two different levels, were manipulated for two tasks: transporting and pouring. Each test subject's hand was instrumented with eight thin wearable force sensors. The grip force and force sharing were significantly different for each bottle model. Increasing the filling level resulted in an increase in grip force, but the ratio of grip force to load force was higher for lighter loads. The task influenced the force sharing but not the mean grip force. The contributions of the thumb and ring finger were higher in the pouring task, whereas the contributions of the palm and the index finger were higher in the transport task. Mean force sharing among fingers was 30% for index, 29% for middle, 22% for ring and 19% for little finger. Practitioner Summary: We analysed grip force and force sharing in two manipulation tasks with bottles: transporting and pouring. The objective was to understand the effects of the bottle features, filling level and task on the contribution of different areas of the hand to the grip force. Force sharing was different for each task and the bottles features affected to both grip force and force sharing.

  3. PRN 94-9: Announcing the Formation of Two Industry-Wide Task Forces: Agricultural Reentry Task Force and Outdoor Residential Exposure Task Force

    EPA Pesticide Factsheets

    This Notice announces two industry-wide Task Forces being formed in response to generic exposure data requirements. It contains EPA's policy on a registrant's options for, and responsibilities when joining Task Force as a way to satisfy data requirements.

  4. 78 FR 60306 - Aquatic Nuisance Species Task Force Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-01

    ...-FF09F14000-134] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and Wildlife Service, Interior... the Aquatic Nuisance Species (ANS) Task Force. The ANS Task Force's purpose is to develop and... Task Force will meet from 8 a.m. to 4:30 p.m. on Wednesday, November 6, through Thursday, November 7...

  5. 77 FR 61019 - Aquatic Nuisance Species Task Force Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ..., Cost Center: FF09F14000, Fund: 134] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and... Aquatic Nuisance Species (ANS) Task Force. The ANS Task Force's purpose is to develop and implement a.... DATES: The ANS Task Force will meet from 8:30 a.m. to 5:00 p.m. Wednesday November 14, and from 8:30 a.m...

  6. Task specific grip force control in writer's cramp.

    PubMed

    Schneider, A S; Fürholzer, W; Marquardt, C; Hermsdörfer, J

    2014-04-01

    Writer's cramp is defined as a task specific focal dystonia generating hypertonic muscle co-contractions during handwriting resulting in impaired writing performance and exaggerated finger force. However, little is known about the generalisation of grip force across tasks others than writing. The aim of the study was to directly compare regulation of grip forces during handwriting with force regulation in other fine-motor tasks in patients and control subjects. Handwriting, lifting and cyclic movements of a grasped object were investigated in 21 patients and 14 controls. The applied forces were registered in all three tasks and compared between groups and tasks. In addition, task-specific measures of fine-motor skill were assessed. As expected, patients generated exaggerated forces during handwriting compared to control subjects. However there were no statistically significant group differences during lifting and cyclic movements. The control group revealed a generalisation of grip forces across manual tasks whereas in patients there was no such correlation. We conclude that increased finger forces during handwriting are a task-specific phenomenon that does not necessarily generalise to other fine-motor tasks. Force control of patients with writer's cramp in handwriting and other fine-motor tasks is characterised by individualised control strategies. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  7. 76 FR 22685 - Interagency Management Task Force Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-22

    ... Force Public Meeting AGENCY: Office of Energy Efficiency and Renewable Energy, Department of Energy (DOE... meetings of the Interagency Energy Management Task Force (Task Force) in 2011. FEMP intends to hold recurring public meetings of the Task Force. Interested parties can check http://www.femp.energy.gov/news...

  8. Economic and environmental review of Waste-to-Energy systems for municipal solid waste management in medium and small municipalities.

    PubMed

    Fernández-González, J M; Grindlay, A L; Serrano-Bernardo, F; Rodríguez-Rojas, M I; Zamorano, M

    2017-09-01

    The application of Directive 2008/98/CE on Municipal Solid Waste (MSW) implies the need to introduce technologies to generate energy from waste. Incineration, the most widely used method, is difficult to implement in low populated areas because it requires a large amount of waste to be viable (100,000 tons per year). This paper analyses the economic and environmental costs of different MSW-to-Energy technologies (WtE) in an area comprising of 13 municipalities in southern Spain. We analyse anaerobic digestion (Biomethanization), the production of solid recovered fuel (SRF) and gasification, and compare these approaches to the present Biological Mechanical Treatment (BMT) with elimination of the reject in landfill, and incineration with energy recovery. From an economic standpoint the implementation of WtE systems reduces the cost of running present BMT systems and incineration; gasification presents the lowest value. From the environmental standpoint, Life Cycle Assessment shows that any WtE alternatives, including incineration, present important advantages for the environment when compared to BMT. Finally, in order to select the best alternative, a multi-criteria method is applied, showing that anaerobic digestion is the optimal solution for the area studied. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. A qualitative study of blood and marrow transplant patient experiences participating in art making and music listening.

    PubMed

    Mische Lawson, Lisa; Wedan, Lindsay; Stock, Morgan; Glennon, Cathy

    2016-06-01

    To explore patient experiences of engaging in art making or music listening while receiving treatment in a blood and marrow transplant clinic. Researchers recruited 25 individuals receiving blood and marrow transplant (BMT) treatment, 12 men and 13 women aged 22 to 74, from a Midwestern outpatient BMT clinic. Participants engaged in a painting activity or listened to music on an iPad using an internet music application for one hour. Researchers interviewed participants after the one-hour activity to gain insight into participants' perceptions of the art making or music listening experience. Interviews were recorded, transcribed verbatim, and independently coded by members of the research team. Researchers met on several occasions to analyse codes and agree on emerging themes. Nine themes emerged from the data including, Engaging in Activity, Art and Music in Daily Life, Expression, Engaging with Equipment, Novelty, BMT Process, Activity Process, Social Support, and Living Situation. Participants enjoyed art making and music listening and found the activities beneficial during treatment. Participants benefited from art making and music listening because these activities increased the variety of options available during treatment, allowed for self-expression, and could be done alone or with caregivers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Easy-to-Read Informed Consent Forms for Hematopoietic Cell Transplantation Clinical Trials

    PubMed Central

    Denzen, Ellen M; Santibáñez, Martha E Burton; Moore, Heather; Foley, Amy; Gersten, Iris D; Gurgol, Cathy; Majhail, Navneet S; Spellecy, Ryan; Horowitz, Mary M; Murphy, Elizabeth A

    2011-01-01

    Informed consent is essential to ethical research and is requisite to participation in clinical research. Yet most hematopoietic cell transplantation (HCT) informed consent forms (ICFs) are written at reading levels that are above the ability of the average person in the US. The recent development of ICF templates by the National Cancer Institute, National Institutes of Health and the National Heart Blood and Lung Instituthas not resulted in increased patient comprehension of information. Barriers to creating Easy-to-Read ICFs that meet US federal requirements and pass Institutional Review Board (IRB) review are the result of multiple interconnected factors. The Blood and Marrow Transplant Clinical Trials Network (BMT CTN) formed an ad hoc review team to address concerns regarding the overall readability and length of ICFs used for BMT CTN trials. This paper summarizes recommendations of the review team for the development and formatting of Easy-to-Read ICFs for HCT multicenter clinical trials, the most novel of which is the use of a two-column layout. These recommendations intend to guide the ICF writing process, simplify local IRB review of the ICF, enhance patient comprehension and improve patient satisfaction. The BMT CTN plans to evaluate the impact of the Easy-to-Read format compared to the traditional format on the informed consent process. PMID:21806948

  11. Wild Type Bone Marrow Transplant Partially Reverses Neuroinflammation in Progranulin-Deficient Mice

    PubMed Central

    Yang, Yue; Aloi, Macarena S.; Cudaback, Eiron; Josephsen, Samuel R.; Rice, Samantha J.; Jorstad, Nikolas L.; Keene, C. Dirk; Montine, Thomas J.

    2014-01-01

    Frontotemporal dementia (FTD) is a neurodegenerative disease with devastating changes in behavioral performance and social function. Mutations in the progranulin gene (GRN) are one of the most common causes of inherited FTD due to reduced progranulin expression or activity, including in brain where it is expressed primarily by neurons and microglia. Thus, efforts aimed at enhancing progranulin levels might be a promising therapeutic strategy. Bone marrow-derived cells are able to engraft in the brain and adopt a microglial phenotype under myeloablative irradiation conditioning. This ability makes bone marrow (BM)-derived cells a potential cellular vehicle for transferring therapeutic molecules to the central nervous system. Here, we utilized BM cells from Grn+/+ (wild type or wt) mice labeled with green fluorescence protein for delivery of progranulin to progranulin deficient (Grn−/−) mice. Our results showed that wt bone marrow transplantation (BMT) partially reconstituted progranulin in the periphery and in cerebral cortex of Grn−/− mice. We demonstrated a pro-inflammatory effect in vivo and in ex vivo preparations of cerebral cortex of Grn−/− mice that was partially to fully reversed five months after BMT. Our findings suggest that BMT can be administered as a stem cell-based approach to prevent or to treat neurodegenerative diseases. PMID:25199051

  12. The Hospital at Home program: no place like home.

    PubMed

    Lippert, M; Semmens, S; Tacey, L; Rent, T; Defoe, K; Bucsis, M; Shykula, T; Crysdale, J; Lewis, V; Strother, D; Lafay-Cousin, L

    2017-02-01

    The treatment of children with cancer is associated with significant burden for the entire family. Frequent clinic visits and extended hospital stays can negatively affect quality of life for children and their families. Here, we describe the development of a Hospital at Home program (H@H) that delivers therapy to pediatric hematology, oncology, and blood and marrow transplant (bmt) patients in their homes. The services provided include short infusions of chemotherapy, supportive-care interventions, antibiotics, post-chemotherapy hydration, and teaching. From 2013 to 2015, the H@H program served 136 patients, making 1701 home visits, for patients mainly between the ages of 1 and 4 years. Referrals came from oncology in 82% of cases, from hematology in 11%, and from bmt in 7%. Since inception of the program, no adverse events have been reported. Family surveys suggested less disruption in daily routines and appreciation of specialized care by hematology and oncology nurses. Staff surveys highlighted a perceived benefit of H@H in contributing to early discharge of patients by supporting out-of-hospital monitoring and teaching. The development of a H@H program dedicated to the pediatric hematology, oncology, or bmt patient appears feasible. Our pilot program offers a potential contribution to improvement in patient quality of life and in cost-benefit for parents and the health care system.

  13. 75 FR 20578 - Federal Advisory Committee; Defense Health Board (DHB); Department of Defense Task Force on the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-20

    ... (DHB); Department of Defense Task Force on the Prevention of Suicide by Members of the Armed Forces... announces a meeting of the Department of Defense Task Force on the Prevention of Suicide by Members of the... Secretary, Department of Defense Task Force on the Prevention of Suicide by Members of the Armed Forces, One...

  14. 75 FR 21603 - Renewal of Department of Defense Federal Advisory Committee; Missouri River (North Dakota) Task...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-26

    ...-6128. SUPPLEMENTARY INFORMATION: The Task Force is a non-discretionary Federal advisory committee and... Committee; Missouri River (North Dakota) Task Force AGENCY: Department of Defense (DoD). ACTION: Renewal of... Missouri River (North Dakota) Task Force (hereafter referred to as the Task Force). FOR FURTHER INFORMATION...

  15. Force fluctuations while pressing and moving against high- and low-friction touch screen surfaces.

    PubMed

    Joshi, Mukta N; Keenan, Kevin G

    2016-07-01

    The purpose of this study was to identify the influence of a high- and low-friction surface on the ability to maintain a steady downward force during an index finger pressing and moving task. Fifteen right-handed subjects (24-48 years) performed a static force pressing task and a hybrid pressing and moving task on the surface of an iPad mini while holding a steady 2-N force on high- and low-friction surfaces. Variability of force was quantified as the standard deviation (SD) of normal force (F z) and shear force (F xy) across friction conditions and tasks. The SD of F z was 227 % greater during the hybrid task as compared to the static task (p < .001) and was 19 % greater for the high- versus low-friction condition (p = .033). There were positive correlations between SD of F z and F xy during the hybrid force/motion tasks on the high- and low-friction conditions (r (2) = 0.5 and 0.86, respectively), suggesting significant associations between normal and shear forces for this hybrid task. The correlation between the SD of F z for static and hybrid tasks was r (2) = 0.44, indicating that the common practice of examining the control of static tasks may not sufficiently explain performance during hybrid tasks, at least for the young subjects tested in the current study. As activities of daily living frequently require hybrid force/motion tasks (e.g., writing, doing the dishes, and cleaning counters), the results of this study emphasize the need to study motor performance during hybrid tasks in addition to static force tasks.

  16. Pilot study of high-intensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients wait-listed for liver transplantation.

    PubMed

    Chok, Kenneth S H; Cheung, Tan To; Lo, Regina C L; Chu, Ferdinand S K; Tsang, Simon H Y; Chan, Albert C Y; Sharr, William W; Fung, James Y Y; Dai, Wing Chiu; Chan, See Ching; Fan, Sheung Tat; Lo, Chung Mau

    2014-08-01

    The objective of this study was to investigate the outcomes of high-intensity focused ultrasound (HIFU) ablation as a bridging therapy for patients with hepatocellular carcinoma (HCC) who had been wait-listed for deceased donor liver transplantation (DDLT). Adult patients with unresectable and unablatable HCCs within the University of California San Francisco criteria who had been wait-listed for DDLT were screened for their suitability for HIFU ablation as a bridging therapy if they were not suitable for transarterial chemoembolization (TACE). Treatment outcomes for patients receiving HIFU ablation, TACE, and best medical treatment (BMT) were compared. Fifty-one patients were included in the analysis. Before the introduction of HIFU ablation, only 39.2% of the patients had received bridging therapy (TACE only, n = 20). With HIFU ablation in use, the rate increased dramatically to 80.4% (TACE + HIFU, n = 41). The overall dropout rate was 51% (n = 26). Patients in the BMT group had a significantly higher dropout rate (P = 0.03) and significantly poorer liver function as reflected by higher Model for End-Stage Liver Disease scores and higher Child-Pugh grading. Clinically relevant ascites was found in 5 patients in the HIFU group and 2 patients in the BMT group, but none was found in the TACE group (P = 0.01 and P = 0.03, respectively). The TACE and HIFU groups had comparable percentages of tumor necrosis in excised livers (P = 0.35), and both were significantly higher than that in the BMT group (P = 0.01 and P = 0.02, respectively). In conclusion, HIFU ablation was safe even for HCC patients with Child-Pugh C disease. Its adoption increased the percentage of patients receiving bridging therapy from 39.2% to 80.4%. A randomized controlled trial for further validation of its efficacy is warranted. © 2014 American Association for the Study of Liver Diseases.

  17. Flow Cytometric Panel-Reactive Antibody Results and the Ability to Find Transfusion-Compatible Platelets after Antibody-Desensitization for Allogeneic Bone Marrow Transplant.

    PubMed

    Rosenbaum, Eric R; Pandey, Soumya; Harville, Terry O; Drobena, Gina A; Cottler-Fox, Michele

    2016-12-01

    Panel reactive antibody (PRA) reduction protocols are used to decrease anti-HLA antibodies with concomitant PRA monitoring as a measure of successful treatment prior to organ and haploidentical blood and marrow transplant (BMT). We hypothesized that the more sensitive flow cytometry (FC) based assays for PRA [FlowPRA ® and Luminex ® based Single Antigen Bead (SAB)] would also correlate with the ability to find compatible platelets for allosensitized recipients. A female patient with myelodysplastic syndrome and a high HLA class I PRA [>90% PRA and cPRA by complement-dependent cytotoxicity (CDC) assay and Flow PRA] required allogeneic BMT. Baseline HLA Class I and class II antigen typing was performed and a matched sibling donor was identified. Although baseline anti-HLA class I and class II antibodies measured by FC and CDC revealed no donor specific antibodies (DSA), the decision was made to attempt antibody desensitization to facilitate platelet transfusion during BMT. FC and CDC assays were performed to determine anti-HLA class I antibodies and cPRA/%PRA prior to starting desensitization and at the end of desensitization. Over the course of desensitization and BMT, a total of 194 apheresis platelet units underwent cross-match (XM) using Capture-P ® . We compared temporally-related PRA results with platelet XM results. High PRA by FC or CDC assays correlates with a high % of XM-positive (incompatible) platelet units. When the CDC PRA fell to 2% after desensitization, platelet XM incompatibility fell from 100% to 63% positive (incompatible). When the FC PRA fell to 5% the positive platelet XM fell to 5%. Antibody desensitization facilitated platelet transfusion. PRA determination by FC appeared better correlated than determination by CDC with the ability to find XM-compatible platelets. © 2016 by the Association of Clinical Scientists, Inc.

  18. U.S. Northern Command > Newsroom > Fact Sheets

    Science.gov Websites

    Operations Command, North U.S. Marine Forces Northern Command U.S. Fleet Forces Command Air Forces Northern U.S. Army North Joint Task Force North Joint Task Force Civil Support Joint Task Force Alaska Joint

  19. Major Histocompatibility Mismatch and Donor Choice for Second Allogeneic Bone Marrow Transplantation.

    PubMed

    Imus, Philip H; Blackford, Amanda L; Bettinotti, Maria; Iglehart, Brian; Dietrich, August; Tucker, Noah; Symons, Heather; Cooke, Kenneth R; Luznik, Leo; Fuchs, Ephraim J; Brodsky, Robert A; Matsui, William H; Huff, Carol Ann; Gladstone, Douglas; Ambinder, Richard F; Borrello, Ivan M; Swinnen, Lode J; Jones, Richard J; Bolaños-Meade, Javier

    2017-11-01

    Large alternative donor pools provide the potential for selecting a different donor for a second allogeneic (allo) bone or marrow transplant (BMT). As HLA disparity may contribute to the graft-versus-tumor effect, utilizing new mismatched haplotype donors may potentially improve the antitumor activity for relapsed hematologic malignancies despite a previous alloBMT. Data from patients who received a second alloBMT for relapsed hematologic malignancies at Johns Hopkins were analyzed. Outcomes were compared between patients who received a second allograft with the same MHC composition and those who received an allograft with a new mismatched haplotype. Loss of heterozygosity analysis was performed for patients with acute myeloid leukemia (AML) whose first allograft was haploidentical. Between 2005 and 2015, 40 patients received a second BMT for a relapsed hematologic malignancy. The median follow-up is 750 (range, 26 to 2950) days. The median overall survival (OS) in the cohort is 928 days (95% confidence interval [CI], 602 to not reached [NR]); median event-free survival (EFS) for the cohort is 500 days (95% CI, 355 to NR). The 4-year OS is 40% (95% CI, 25% to 64%), and the 4-year EFS is 36% (95% CI, 24% to 55%). The cumulative incidence of nonrelapsed mortality by 2 years was 27% (95% CI, 13% to 42%). The cumulative incidence of grade 3 to 4 acute graft-versus-host disease (GVHD) at 100 days was 15% (95% CI, 4% to 26%); the cumulative incidence of extensive chronic GVHD at 2 years was 22% (95% CI, 9% to 36%). The median survival was 552 days (95% CI, 376 to 2950+) in the group who underwent transplantation with a second allograft that did not harbor a new mismatched haplotype, while it was not reached in the group whose allograft contained a new mismatched haplotype (hazard ratio [HR], .36; 95% CI, .14 to .9; P = .02). EFS was also longer in the group who received an allograft containing a new mismatched haplotype, (NR versus 401 days; HR, .50; 95% CI, .22 to 1.14; P = .09). Although the allograft for this patient's second BMT contained a new mismatched haplotype, AML nevertheless relapsed a second time. Second BMTs are feasible and provide a reasonable chance of long-term survival. An allograft with a new mismatched haplotype may improve outcomes after second BMTs for relapsed hematologic malignancies. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  20. Proximal arm kinematics affect grip force-load force coordination

    PubMed Central

    Vermillion, Billy C.; Lum, Peter S.

    2015-01-01

    During object manipulation, grip force is coordinated with load force, which is primarily determined by object kinematics. Proximal arm kinematics may affect grip force control, as proximal segment motion could affect control of distal hand muscles via biomechanical and/or neural pathways. The aim of this study was to investigate the impact of proximal kinematics on grip force modulation during object manipulation. Fifteen subjects performed three vertical lifting tasks that involved distinct proximal kinematics (elbow/shoulder), but resulted in similar end-point (hand) trajectories. While temporal coordination of grip and load forces remained similar across the tasks, proximal kinematics significantly affected the grip force-to-load force ratio (P = 0.042), intrinsic finger muscle activation (P = 0.045), and flexor-extensor ratio (P < 0.001). Biomechanical coupling between extrinsic hand muscles and the elbow joint cannot fully explain the observed changes, as task-related changes in intrinsic hand muscle activation were greater than in extrinsic hand muscles. Rather, between-task variation in grip force (highest during task 3) appears to contrast to that in shoulder joint velocity/acceleration (lowest during task 3). These results suggest that complex neural coupling between the distal and proximal upper extremity musculature may affect grip force control during movements, also indicated by task-related changes in intermuscular coherence of muscle pairs, including intrinsic finger muscles. Furthermore, examination of the fingertip force showed that the human motor system may attempt to reduce variability in task-relevant motor output (grip force-to-load force ratio), while allowing larger fluctuations in output less relevant to task goal (shear force-to-grip force ratio). PMID:26289460

  1. 78 FR 23970 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force Meeting. SUMMARY: This document corrects the SBA's Interagency Task Force on Veterans Small Business Developments...

  2. 32 CFR 700.1053 - Commander of a task force.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Commander of a task force. 700.1053 Section 700... Command Detail to Duty § 700.1053 Commander of a task force. (a) A geographic fleet commander, and any other naval commander, may detail in command of a task force, or other task command, any eligible...

  3. 75 FR 76422 - Meeting of the Department of Defense Task Force on the Care, Management, and Transition of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ... DEPARTMENT OF DEFENSE Office of the Secretary Meeting of the Department of Defense Task Force on... Forces (Subsequently Referred to as the Task Force) AGENCY: Department of Defense. ACTION: Notice... forthcoming meeting of the Department of Defense Task Force on the Care, Management, and Transition of...

  4. 75 FR 62611 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be...

  5. 75 FR 76744 - National Disaster Housing Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-09

    ...] National Disaster Housing Task Force AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice of Meeting. SUMMARY: The National Disaster Housing Task Force (NDHTF) will meet by teleconference on December...: Mitchell Wyllins, National Disaster Housing Task Force, 500 C Street, SW., (Room 428), Washington, DC 20472...

  6. 77 FR 41472 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-13

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be...

  7. 76 FR 8393 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-14

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be...

  8. 75 FR 62438 - Interagency Task Force on Veterans Small Business Development Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-08

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development Meeting AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force... first public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting...

  9. Face and Construct Validity of a Novel Virtual Reality-Based Bimanual Laparoscopic Force-Skills Trainer With Haptics Feedback.

    PubMed

    Prasad, Raghu; Muniyandi, Manivannan; Manoharan, Govindan; Chandramohan, Servarayan M

    2018-05-01

    The purpose of this study was to examine the face and construct validity of a custom-developed bimanual laparoscopic force-skills trainer with haptics feedback. The study also examined the effect of handedness on fundamental and complex tasks. Residents (n = 25) and surgeons (n = 25) performed virtual reality-based bimanual fundamental and complex tasks. Tool-tissue reaction forces were summed, recorded, and analysed. Seven different force-based measures and a 1-time measure were used as metrics. Subsequently, participants filled out face validity and demographic questionnaires. Residents and surgeons were positive on the design, workspace, and usefulness of the simulator. Construct validity results showed significant differences between residents and experts during the execution of fundamental and complex tasks. In both tasks, residents applied large forces with higher coefficient of variation and force jerks (P < .001). Experts, with their dominant hand, applied lower forces in complex tasks and higher forces in fundamental tasks (P < .001). The coefficients of force variation (CoV) of residents and experts were higher in complex tasks (P < .001). Strong correlations were observed between CoV and task time for fundamental (r = 0.70) and complex tasks (r = 0.85). Range of smoothness of force was higher for the non-dominant hand in both fundamental and complex tasks. The simulator was able to differentiate the force-skills of residents and surgeons, and objectively evaluate the effects of handedness on laparoscopic force-skills. Competency-based laparoscopic skills assessment curriculum should be updated to meet the requirements of bimanual force-based training.

  10. Childhood Obesity Task Forces Established by State Legislatures, 2001-2010

    PubMed Central

    Kim, Sonia A.; Sherry, Bettylou; Blanck, Heidi M.

    2013-01-01

    Introduction States and communities are considering policy and environmental strategies, including enacting legislation, to reduce and prevent childhood obesity. One legislative approach has been to create task forces to understand key issues and develop a course of action. The goal of this study was to describe state-level, childhood obesity task forces in the United States created by legislation from 2001 through 2010. Methods We used the Center for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity database to identify state-level childhood obesity task forces created through legislation from 2001 through 2010. Results We identified 21 states that had enacted legislation creating childhood obesity task forces of which 6 had created more than one task force. Most task forces were charged with both gathering and reviewing information and making recommendations for obesity-prevention actions in the state. Most legislation required that task forces include representation from the state legislature, state agencies, community organizations, and community members. Conclusion Evaluation of the effectiveness of obesity-prevention task forces and the primary components that contribute to their success may help to determine the advantages of the use of such strategies in obesity prevention. PMID:23987250

  11. The role of autologous blood stem cells in support of high-dose therapy for multiple myeloma.

    PubMed

    Fermand, J P; Chevret, S; Levy, Y; Miclea, J M; Tsapis, A; Gerota, J; Benbunan, M; Brouet, J C

    1992-04-01

    During the last few years, high-dose therapy with hemopoietic stem cell support has become a well-admitted therapeutic option for young patients with MM. The role of allogeneic or autologous graft and of blood rather than bone marrow as the source of hemopoietic stem cells must be further investigated. Autologous PBSC transplantation has, however, both practical and theoretic advantages over allogeneic and autologous BMT: (1) It can be applied to most patients, especially if blood stem cells are collected early in the course of therapy. (2) It usually induces relatively rapid hematologic reconstitution. (3) In comparison with autologous BMT, it appears to minimize the hazard of the reinfusion of malignant cells.

  12. BK virus-associated fatal renal failure following late-onset hemorrhagic cystitis in an unrelated bone marrow transplantation.

    PubMed

    Iwamoto, Shotaro; Azuma, Eiichi; Hori, Hiroki; Hirayama, Masahiro; Kobayashi, Michihiro; Komada, Yoshihiro; Nishimori, Hisashi; Miyahara, Masazumi

    2002-06-01

    The human polyomavirus BK (BKV)-associated hemorrhagic cystitis (HC) has been a frequent and, seldom life-threatening complication after bone marrow transplantation (BMT). The authors report a male with melodysplastic syndrome, who developed BKV-associated late-onset HC 12 days after HLA-matched unrelated BMT. His urine contained epithelial cells with intranuclear inclusion bodies suggestive of BKV infection and was positive for BKV in polymerase chain reaction. He did not respond to any treatment for HC. In addition, he developed BKV-associated acute renal failure on day 26, followed by hepatic veno-occlusive disease on day 42. This is the first case in which BKV may be associated with fatal progressive renal failure.

  13. Hypogonadotrophism fails to prevent severe testicular damage induced by total body irradiation in a patient with beta-thalassaemia major and acute lymphoblastic leukaemia.

    PubMed

    Chatterjee, R; Kottaridis, P D; McGarrigle, H H; Papatryphonos, A; Goldstone, A H

    2001-11-01

    Radiation and chemotherapeutic drugs for cancer produce prolonged and often irreversible gonadal damage. To determine whether total body irradiation (TBI)-induced gonadal damage can be prevented by suppression of pituitary gonadotrophin levels, we studied a patient with transfusion dependent homozygous beta-thalassaemia and acute lymphoblastic leukaemia (ALL) who underwent one-antigen mismatched related bone marrow transplantation (BMT). Our data showed that despite having hypogonadotrophic hypogonadism (HH) prior to BMT, the patient developed primary testicular failure following the procedure, indicating that hypogonadotrophism failed to offer protection against TBI-induced testicular damage in this patient. Although this is an interesting case report, no firm conclusions can be drawn from a single patient.

  14. Pleuroparenchymal fibroelastosis as a series of airway complications associated with chronic graft-versus-host disease following allogeneic bone marrow transplantation.

    PubMed

    Fujikura, Yuji; Kanoh, Soichiro; Kouzaki, Yuji; Hara, Yu; Matsubara, Osamu; Kawana, Akihiko

    2014-01-01

    We herein report the case of a 31-year-old woman who presented with bilateral upper lobe volume loss and pleural irregularities with hilar retraction. She had undergone allogeneic bone marrow transplantation (BMT) for the treatment of acute lymphoblastic leukemia nine years earlier. A surgical lung biopsy showed pleural thickening and subpleural alveolar collapse and fibrosis, consistent with a diagnosis of pleuroparenchymal fibroelastosis (PPFE). Antecedent sicca syndrome and the absence of other causes of fibroelastosis suggested that these abnormalities were associated with chronic graft-versus-host disease (cGVHD). PPFE as a late, noninfectious complication is rare; however, the present case suggests a new class of BMT-related pulmonary complications associated with cGVHD.

  15. 2015 International PV Quality Assurance Task Force (PVQAT) Workshop |

    Science.gov Websites

    Photovoltaic Research | NREL International PV Quality Assurance Task Force (PVQAT) Workshop 2015 International PV Quality Assurance Task Force (PVQAT) Workshop Wednesday, February 25, 2015 Chairs : Tony Sample and Masaaki Yamamichi The 2015 International PV Quality Assurance Task Force (PVQAT

  16. 78 FR 27969 - Meeting of the Community Preventive Services Task Force (Task Force)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-13

    ... discussed: Matters to be discussed: cancer prevention and control, cardiovascular disease prevention and... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the Community Preventive Services Task Force (Task Force) AGENCY: Centers for Disease Control and Prevention...

  17. 77 FR 56845 - Meeting of the Community Preventive Services Task Force (Task Force)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-14

    ...: Matters to be discussed: Tobacco, oral health and cardiovascular disease. Meeting Accessibility: This... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the Community Preventive Services Task Force (Task Force) AGENCY: Centers for Disease Control and Prevention...

  18. 78 FR 59939 - Meeting of the Community Preventive Services Task Force (Task Force)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-30

    .... Matters to be discussed: Cancer prevention and control, cardiovascular disease prevention and control... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the Community Preventive Services Task Force (Task Force) AGENCY: Centers for Disease Control and Prevention...

  19. 78 FR 7849 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force Meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

  20. 76 FR 54258 - Request for Comments-Fiscal Oversight Task Force Report and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-31

    ... LEGAL SERVICES CORPORATION Request for Comments--Fiscal Oversight Task Force Report and... Fiscal Oversight Task Force, which reviewed and made recommendations regarding how LSC conducts fiscal... territories. By Resolution adopted on July 21, 2010, the Board established the Fiscal Oversight Task Force...

  1. 78 FR 70087 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-22

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

  2. 78 FR 45996 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-30

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

  3. 78 FR 21492 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force Meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

  4. 77 FR 41165 - Notice of Meeting of the Agricultural Air Quality Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-12

    ... Agricultural Air Quality Task Force AGENCY: Natural Resources Conservation Service, USDA. ACTION: Notice of meeting. SUMMARY: The Department of Agriculture (USDA), Agricultural Air Quality Task Force (AAQTF) will.../Concerns Discussion Continued discussion of goals for Task Force Anaerobic Digester Technologies Odor...

  5. Community hoarding task forces: a comparative case study of five task forces in the United States.

    PubMed

    Bratiotis, Christiana

    2013-05-01

    During the past decade, many community task forces have formed to address hoarding problems that come to public attention. Such task forces provide a societal-level intervention to assist people with the most severe cases of hoarding, who do not voluntarily seek or want help for their hoarding behaviour. This qualitative study of five U.S. hoarding task forces included sites selected for their diversity of purpose, approaches to hoarding intervention and community geography, composition and resources. Data were collected during the period of September 2007-March 2008. The case study methodology used multiple forms of data, including semi-structured interviews, analysis of documents, small group interviews and investigator observation. This study captured the perspectives of public and private sector service providers such as mental health, housing, social service, public health agencies and community enforcement organisations (fire, police, legal, animal control) to examine how task forces organise and operate and the emerging practice and policy changes. Study findings suggest that structural factors (e.g. leadership, purpose, funding and membership) impact hoarding task force viability, that participation on a task force influences practice and policy decisions about hoarding, and that social work can expand its role in task force leadership. Task forces may be a mechanism for improving community policies about hoarding and mechanisms for addressing other social problems across multiple sectors. © 2012 Blackwell Publishing Ltd.

  6. 75 FR 32186 - Task Force on Community Preventive Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-07

    ... by space available. Purpose: The mission of the Task Force is to develop and publish the Guide to... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Task Force on Community Preventive Services Name: Task Force on Community Preventive Services meeting. Times and Dates: 8...

  7. 78 FR 2996 - Meeting of the Community Preventive Services Task Force (Task Force)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-15

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the Community Preventive Services Task Force (Task Force) AGENCY: Centers for Disease Control and Prevention... for Disease Control and Prevention (CDC) announces the next meeting of the Community Preventive...

  8. 77 FR 16256 - Aquatic Nuisance Species Task Force Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-20

    ...] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: This notice announces a meeting of the Aquatic Nuisance Species (ANS) Task Force. The ANS Task Force's purpose is to develop and implement a program for U.S. waters to prevent introduction...

  9. 75 FR 57987 - Evaluation of the Groundwater Task Force Report: Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-23

    ... NUCLEAR REGULATORY COMMISSION [NRC-2010-0302] Evaluation of the Groundwater Task Force Report... Task Force (GTF) in March 2010 to determine whether past, current, and planned actions should be... recommendations made in the Liquid Radioactive Release Lessons Learned Task Force Final Report dated September 1...

  10. 75 FR 70764 - Small Business Information Security Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-18

    ... SMALL BUSINESS ADMINISTRATION Small Business Information Security Task Force AGENCY: U.S. Small... publish meeting minutes for the Small Business Information Security Task Force Meeting. DATES: 1 p.m... Task Force. Chairman, Rusty Pickens, called the meeting to order on October 13, 2010 at 1 p.m. Roll...

  11. 7 CFR 1900.6 - Chair, Loan Resolution Task Force.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Chair, Loan Resolution Task Force. 1900.6 Section... AGRICULTURE PROGRAM REGULATIONS GENERAL Delegations of Authority § 1900.6 Chair, Loan Resolution Task Force. The Chair, Loan Resolution Task Force is delegated the following authorities, to be exercised until...

  12. 76 FR 5232 - Small Business Information Security Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-28

    ... SMALL BUSINESS ADMINISTRATION Small Business Information Security Task Force AGENCY: U.S. Small... publish meeting minutes for the Small Business Information Security Task Force Meeting. DATES: 1 p.m... Task Force. Chairman, Rusty Pickens, called the meeting to order on December 8, 2010 at 1 p.m. Roll...

  13. 76 FR 11307 - Small Business Information Security Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-01

    ... SMALL BUSINESS ADMINISTRATION Small Business Information Security Task Force AGENCY: U.S. Small... publish meeting minutes for the Small Business Information Security Task Force Meeting. DATES: 1 p.m... Task Force. Chairman, Mr. Rusty Pickens, called the meeting to order on January 12, 2011 at 1 p.m. Roll...

  14. Gulf Coast Ecosystem Restoration Task Force Meeting and Public Listening

    Science.gov Websites

    Data Media & News Publications Press Releases Story Archive Home Gulf Coast Ecosystem Restoration Task Force Meeting and Public Listening Session Gulf Coast Ecosystem Restoration Task Force Meeting and Title: Gulf Coast Ecosystem Restoration Task Force Meeting and Public Listening SessionDescription: The

  15. Task Force II: Energy and Its Socioeconomic Impacts

    ERIC Educational Resources Information Center

    Appalachia, 1977

    1977-01-01

    Summarizing the Task Force Issues Paper presented at the Appalachian Conference on Balanced Growth and Economic Development (1977), this article presents selected comments by Task Force participants, and Task Force recommendations re: a national severence tax on extraction of nonrenewable energy resources; socioeconomic costs of nuclear energy; a…

  16. Unintentional force changes in cyclical tasks performed by an abundant system: Empirical observations and a dynamical model.

    PubMed

    Reschechtko, Sasha; Hasanbarani, Fariba; Akulin, Vladimir M; Latash, Mark L

    2017-05-14

    The study explored unintentional force changes elicited by removing visual feedback during cyclical, two-finger isometric force production tasks. Subjects performed two types of tasks at 1Hz, paced by an auditory metronome. One - Force task - required cyclical changes in total force while maintaining the sharing, defined as relative contribution of a finger to total force. The other task - Share task - required cyclical changes in sharing while keeping total force unchanged. Each trial started under full visual feedback on both force and sharing; subsequently, feedback on the variable that was instructed to stay constant was frozen, and finally feedback on the other variable was also removed. In both tasks, turning off visual feedback on total force elicited a drop in the mid-point of the force cycle and an increase in the peak-to-peak force amplitude. Turning off visual feedback on sharing led to a drift of mean share toward 50:50 across both tasks. Without visual feedback there was consistent deviation of the two force time series from the in-phase pattern (typical of the Force task) and from the out-of-phase pattern (typical of the Share task). This finding is in contrast to most earlier studies that demonstrated only two stable patterns, in-phase and out-of-phase. We interpret the results as consequences of drifts of parameters in a dynamical system leading in particular to drifts in the referent finger coordinates toward their actual coordinates. The relative phase desynchronization is caused by the right-left differences in the hypothesized drift processes, consistent with the dynamic dominance hypothesis. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

  17. Unintentional force changes in cyclical tasks performed by an abundant system: Empirical observations and a dynamical model

    PubMed Central

    Reschechtko, Sasha; Hasanbarani, Fariba; Akulin, Vladimir M.; Latash, Mark L.

    2017-01-01

    The study explored unintentional force changes elicited by removing visual feedback during cyclical, two-finger isometric force production tasks. Subjects performed two types of tasks at 1 Hz, paced by an auditory metronome. One – Force task – required cyclical changes in total force while maintaining the sharing, defined as relative contribution of a finger to total force. The other task – Share task – required cyclical changes in sharing while keeping total force unchanged. Each trial started under full visual feedback on both force and sharing; subsequently, feedback on the variable that was instructed to stay constant was frozen, and finally feedback on the other variable was also removed. In both tasks, turning off visual feedback on total force elicited a drop in the mid-point of the force cycle and an increase in the peak-to-peak force amplitude. Turning off visual feedback on sharing led to a drift of mean share toward 50:50 across both tasks. Without visual feedback there was consistent deviation of the two force time series from the in-phase pattern (typical of the Force task) and from the out-of-phase pattern (typical of the Share task). This finding is in contrast to most earlier studies that demonstrated only two stable patterns, in-phase and out-of-phase. We interpret the results as consequences of drifts of parameters in a dynamical system leading in particular to drifts in the referent finger coordinates toward their actual coordinates. The relative phase desynchronization is caused by the right-left differences in the hypothesized drift processes, consistent with the dynamic dominance hypothesis. PMID:28344070

  18. 77 FR 4584 - Sunshine Act Meetings; National Science Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-30

    ... of a National Academy of Sciences/National Research Council study CPP Task Force on Unsolicited Mid... and December 13 meeting minutes Discussion of the MS Task Force draft report CSB Task Force on Data... Task Force Closing Remarks From the Chairman Committee on Audit and Oversight (A&O) Open Session: 4-4...

  19. Academic Standards Task Force Report.

    ERIC Educational Resources Information Center

    Burnham, Peter F.

    The product of a year-long research process undertaken by a Task Force on Academic Standards at Tompkins Cortland Community College (TCCC) in 1980-81, this report provides background to the deliberations of the Task Force and a presentation of their position on academic standards at TCCC. The report establishes the Task Force's commitments to…

  20. 75 FR 61175 - Aquatic Nuisance Species Task Force Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-04

    ...] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: This notice announces a meeting of the Aquatic Nuisance Species (ANS) Task Force. The.... DATES: The ANS Task Force will meet from 8 a.m. to 5 p.m. on Wednesday, November 3 through Thursday...

  1. 18 CFR 701.58 - Task forces.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Task forces. 701.58... Headquarters Organization § 701.58 Task forces. The Director with Council concurrence or the Council may establish task forces from time to time to aid in the preparation of issues for presentation to the Council...

  2. 3 CFR - White House Task Force on Middle-Class Working Families

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false White House Task Force on Middle-Class Working... Task Force on Middle-Class Working Families Memorandum for the Heads of Executive Departments and... times. To these ends, I hereby direct the following: Section 1. White House Task Force on Middle-Class...

  3. 77 FR 441 - Measurement and Control of Combustible Gas Generation and Dispersal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-05

    ... Task Force Review of Insights from the Fukushima Dai-ichi Accident'' (Fukushima Task Force Report... Fukushima Task Force Report: ``[t]he task force recommends, as part of the longer term review, that the NRC... additional information is revealed through further study of the Fukushima Dai-ichi accident.'' The Commission...

  4. 76 FR 58165 - Petitions for Rulemaking Submitted by the Natural Resources Defense Council, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-20

    ...-Term Task Force Review of Insights from the Fukushima Dai-ichi Accident'' (Fukushima Task Force Report... the Fukushima Task Force Report for the purpose of providing the Commission with fully-informed... recommendations from the Fukushima Task Force Report, and is not providing a separate opportunity for public...

  5. 76 FR 76189 - Notice of Public Hearing-Fiscal Oversight Task Force Report & Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-06

    ... period; and (3) reactions to those comments submitted by Task Force members. DATES: Monday, December 12... Report, the public comments previously submitted, and reactions to those comments from several Task Force members. The public comments and a summary of Task Force members' reactions may be viewed online at http...

  6. Solar Energy Task Force Report: Technical Training Guidelines.

    ERIC Educational Resources Information Center

    O'Connor, Kevin

    This task force report offers guidelines and information for the development of vocational education programs oriented to the commercial application of solar energy in water and space heating. After Section I introduces the Solar Energy Task Force and its activities, Section II outlines the task force's objectives and raises several issues and…

  7. The effect of bracing availability on one-hand isometric force exertion capability.

    PubMed

    Jones, Monica L H; Reed, Matthew P; Chaffin, Don B

    2013-01-01

    Environmental obstructions that workers encounter can kinematically limit the postures that they can achieve. However, such obstructions can also provide an opportunity for additional support by bracing with the hand, thigh or other body part. The reaction forces on bracing surfaces, which are in addition to those acting at the feet and task hand, are hypothesised to improve force exertion capability, and become required inputs to biomechanical analysis of tasks with bracing. The effects of kinematic constraints and associated bracing opportunities on isometric hand force were quantified in a laboratory study of 22 men and women. Analyses of one-hand maximal push, pull and lift tasks demonstrated that bracing surfaces available at the thighs and non-task hand enabled participants to exert an average of 43% more force at the task hand. Task hand force direction deviated significantly from the nominal direction for exertions performed with bracing at both medium and low task hand locations. This study quantifies the effect of bracing on kinematically constrained force exertions. Knowledge that appropriate bracing surfaces can substantially increase hand force is critical to the evaluation of task-oriented strength capability. Force estimates may also involve large off-axis components, which have clear implications for ergonomic analyses of manual tasks.

  8. Performance drifts in two-finger cyclical force production tasks performed by one and two actors.

    PubMed

    Hasanbarani, Fariba; Reschechtko, Sasha; Latash, Mark L

    2018-03-01

    We explored changes in the cyclical two-finger force performance task caused by turning visual feedback off performed either by the index and middle fingers of the dominant hand or by two index fingers of two persons. Based on an earlier study, we expected drifts in finger force amplitude and midpoint without a drift in relative phase. The subjects performed two rhythmical tasks at 1 Hz while paced by an auditory metronome. One of the tasks required cyclical changes in total force magnitude without changes in the sharing of the force between the two fingers. The other task required cyclical changes in the force sharing without changing total force magnitude. Subjects were provided with visual feedback, which showed total force magnitude and force sharing via cursor motion along the vertical and horizontal axes, respectively. Further, visual feedback was turned off, first on the variable that was not required to change and then on both variables. Turning visual feedback off led to a mean force drift toward lower magnitudes while force amplitude increased. There was a consistent drift in the relative phase in the one-hand task with the index finger leading the middle finger. No consistent relative phase drift was seen in the two-person tasks. The shape of the force cycle changed without visual feedback reflected in the lower similarity to a perfect cosine shape and in the higher time spent at lower force magnitudes. The data confirm findings of earlier studies regarding force amplitude and midpoint changes, but falsify predictions of an earlier proposed model with respect to the relative phase changes. We discuss factors that could contribute to the observed relative phase drift in the one-hand tasks including the leader-follower pattern generalized for two-effector tasks performed by one person.

  9. Hemorrhagic cystitis in children undergoing bone marrow transplantation: a putative role for simian virus 40.

    PubMed

    Comar, Manola; D'Agaro, Pierlanfranco; Andolina, Marino; Maximova, Natasha; Martini, Fernanda; Tognon, Mauro; Campello, Cesare

    2004-08-27

    Late-onset hemorrhagic cystitis (HC) is a well-known severe complication of bone marrow transplantation (BMT), both in adults and in children. Protracted postengraftment HC is associated with graft-versus-host disease and viral infections, mainly caused by BK virus (BKV) or adenovirus (AV). This study investigated whether simian virus 40 (SV40) DNA sequences can be detected in specimens from pediatric patients affected by severe postengraftment HC. The clinical diagnosis of HC was made in 7 of 28 BMT children. DNA from peripheral blood mononuclear cells (PBMC) and urine sediment cells and supernatants was analyzed by polymerase chain reaction (PCR) for human cytomegalovirus (HCMV), AV, BKV, JC virus (JCV), and SV40. DNA filter hybridization and sequencing was carried out in SV40-positive samples. SV40 footprints were detected in two of seven cases of HC. Specific SV40 DNA sequences were detected by PCR and by filter hybridization both in urine and in PBMC samples at the HC onset and during the follow-up. The DNA sequencing proved that the amplicons belonged to the SV40 wild-type. Urine samples of the two HC cases tested negative by cell cultures, PCR, or both for HCMV, BKV, JCV, and AV. The detection of SV40 DNA sequences suggest that this simian polyomavirus could be involved, at least in some cases, in the HC occurring in children after BMT.

  10. Combined effects of interleukin-7 and stem cell factor administration on lymphopoiesis after murine bone marrow transplantation.

    PubMed

    Chung, Brile; Min, Dullei; Joo, Lukas W; Krampf, Mark R; Huang, Jing; Yang, Yujun; Shashidhar, Sumana; Brown, Janice; Dudl, Eric P; Weinberg, Kenneth I

    2011-01-01

    The decreased ability of the thymus to generate T cells after bone marrow transplantation (BMT) is a clinically significant problem. Interleukin (IL)-7 and stem cell factor (SCF) induce proliferation, differentiation, and survival of thymocytes. Although previous studies have shown that administration of recombinant human IL-7 (rhIL-7) after murine and human BMT improves thymopoiesis and immune function, whether administration of SCF exerts similar effects is unclear. To evaluate independent or combinatorial effects of IL-7 and SCF in post-BMT thymopoiesis, bone marrow (BM)-derived mesenchymal stem cells transduced ex vivo with the rhIL-7 or murine SCF (mSCF) genes were cotransplanted with T cell-depleted BM cells into lethally irradiated mice. Although rhIL-7 and mSCF each improved immune reconstitution, the combination treatment had a significantly greater effect than either cytokine alone. Moreover, the combination treatment significantly increased donor-derived common lymphoid progenitors (CLPs) in BM, suggesting that transplanted CLPs expand more rapidly in response to IL-7 and SCF and may promote immune reconstitution. Our findings demonstrate that IL-7 and SCF might be therapeutically useful for enhancing de novo T cell development. Furthermore, combination therapy may allow the administration of lower doses of IL-7, thereby decreasing the likelihood of IL-7-mediated expansion of mature T cells. 2011. Published by Elsevier Inc.

  11. Differential susceptibility of C57BL/6NCr and B6.Cg-Ptprca mice to commensal bacteria after whole body irradiation in translational bone marrow transplant studies

    PubMed Central

    Duran-Struuck, Raimon; Hartigan, Adam; Clouthier, Shawn G; Dyson, Melissa C; Lowler, Kathi; Gatza, Erin; Tawara, Isao; Toubai, Tomomi; Weisiger, Elisabeth; Hugunin, Kelly; Reddy, Pavan; Wilkinson, John E

    2008-01-01

    Background The mouse is an important and widely utilized animal model for bone marrow transplant (BMT) translational studies. Here, we document the course of an unexpected increase in mortality of congenic mice that underwent BMT. Methods Thirty five BMTs were analyzed for survival differences utilizing the Log Rank test. Affected animals were evaluated by physical examination, necropsy, histopathology, serology for antibodies to infectious disease, and bacterial cultures. Results Severe bacteremia was identified as the main cause of death. Gastrointestinal (GI) damage was observed in histopathology. The bacteremia was most likely caused by the translocation of bacteria from the GI tract and immunosuppression caused by the myeloablative irradiation. Variability in groups of animals affected was caused by increased levels of gamma and X-ray radiation and the differing sensitivity of the two nearly genetically identical mouse strains used in the studies. Conclusion Our retrospective analysis of thirty five murine BMTs performed in three different laboratories, identified C57BL/6NCr (Ly5.1) as being more radiation sensitive than B6.Cg-Ptprca/NCr (Ly5.2). This is the first report documenting a measurable difference in radiation sensitivity and its effects between an inbred strain of mice and its congenic counterpart eventually succumbing to sepsis after BMT. PMID:18307812

  12. Physical fitness level affects perception of chronic stress in military trainees.

    PubMed

    Tuch, Carolin; Teubel, Thomas; La Marca, Roberto; Roos, Lilian; Annen, Hubert; Wyss, Thomas

    2017-12-01

    This study investigated whether physical fitness affects the perception of chronic stress in military trainees while controlling for established factors influencing stress perception. The sample consisted of 273 men (20.23 ± 1.12 years, 73.56 ± 10.52 kg, 1.78 ± 0.06 m). Physical fitness was measured by progressive endurance run (maximum oxygen uptake; VO 2 max), standing long jump, seated shot put, trunk muscle strength, and one leg standing test. Perceived stress was measured using the Perceived Stress Questionnaire in Weeks 1 and 11 of basic military training (BMT). VO 2 max and four influencing variables (perceived stress in Week 1, neuroticism, transformational leadership style, and education level) explained 44.44% of the variance of the increase in perceived stress during 10 weeks of BMT (R 2  = 0.444, F = 23.334, p < .001). The explained variance of VO 2 max was 4.14% (R 2  = 0.041), with a Cohen's f 2 effect size of 0.045 (assigned as a small effect by Cohen, ). The results indicate a moderating influence of good aerobic fitness on the varied level of perceived stress. We conclude that it is advisable to provide conscripts with a specific endurance training program prior to BMT for stress prevention reasons. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Low immunosuppressive burden after HLA-matched related or unrelated BMT using posttransplantation cyclophosphamide.

    PubMed

    Kanakry, Christopher G; Bolaños-Meade, Javier; Kasamon, Yvette L; Zahurak, Marianna; Durakovic, Nadira; Furlong, Terry; Mielcarek, Marco; Medeot, Marta; Gojo, Ivana; Smith, B Douglas; Kanakry, Jennifer A; Borrello, Ivan M; Brodsky, Robert A; Gladstone, Douglas E; Huff, Carol Ann; Matsui, William H; Swinnen, Lode J; Cooke, Kenneth R; Ambinder, Richard F; Fuchs, Ephraim J; de Lima, Marcos J; Andersson, Borje S; Varadhan, Ravi; O'Donnell, Paul V; Jones, Richard J; Luznik, Leo

    2017-03-09

    The intensive and prolonged immunosuppressive therapy required to prevent or treat graft-versus-host disease (GVHD) after allogeneic blood or marrow transplantation (alloBMT) puts patients at substantial risk for life-threatening infections, organ toxicity, and disease relapse. Posttransplantation cyclophosphamide (PTCy) can function as single-agent GVHD prophylaxis after myeloablative, HLA-matched related (MRD), or HLA-matched unrelated (MUD) donor T-cell-replete bone marrow allografting, obviating the need for additional prophylactic immunosuppression. However, patients who develop GVHD require supplemental treatment. We assessed the longitudinal requirement for immunosuppressive therapy in 339 patients treated with this transplantation platform: 247 receiving busulfan/cyclophosphamide (BuCy) conditioning (data collected retrospectively) and 92 receiving busulfan/fludarabine (BuFlu) conditioning (data collected prospectively). Approximately 50% of MRD patients and 30% of MUD patients never required immunosuppression beyond PTCy. In patients requiring further immunosuppression, typically only 1 to 2 agents were required, and the median durations of systemic pharmacologic immunosuppression for the BuCy MRD, BuFlu MRD, BuCy MUD, and BuFlu MUD groups all were 4.5 to 5 months. For these 4 groups, 1-year probabilities of being alive and off all systemic immunosuppression were 61%, 53%, 53%, and 51% and 3-year probabilities were 53%, 48%, 49%, and 56%, respectively. These data suggest that PTCy minimizes the global immunosuppressive burden experienced by patients undergoing HLA-matched alloBMT.

  14. 76 FR 52318 - U.S. Coral Reef Task Force Public Meeting and Public Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-22

    ... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration U.S. Coral Reef Task Force... of the U.S. Coral Reef Task Force. The meeting will be held in Ft. Lauderdale, Florida. This meeting, the 26th bi-annual meeting of the U.S. Coral Reef Task Force, provides a forum for coordinated...

  15. 76 FR 7579 - U.S. Coral Reef Task Force Public Meeting and Public Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-10

    .... Coral Reef Task Force Public Meeting and Public Comment AGENCY: Fish and Wildlife Service, Interior... Service (Service), announce a public business meeting of the U.S. Coral Reef Task Force (USCRTF) [email protected] ); or Liza Johnson, U.S. Coral Reef Task Force Department of the Interior Liaison, U.S...

  16. 76 FR 15334 - Aquatic Nuisance Species Task Force Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-21

    ...] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: This notice announces a meeting of the Aquatic Nuisance Species (ANS) Task Force. The.... DATES: The ANS Task Force will meet from 8 a.m. to 5 p.m. on Wednesday, May 4; and Thursday May 5; and...

  17. Drinking and driving and riding with an alcohol impaired driver among United States Air Force recruits.

    PubMed

    DeBon, Margaret; Vander Weg, Mark W; Sherrill-Mittleman, Deborah; Klesges, Robert C; Talcott, Gerald W

    2011-04-01

    To identify the prevalence and correlates of binge drinking, driving after drinking, and riding in a vehicle with a driver who had consumed alcohol in US Air Force active duty recruits. A military cohort (N = 31,108; 25.1% female) was analyzed to identify variables associated with binge drinking, drinking and driving, and riding with a driver who had consumed alcohol. Results indicated that 53 percent (including 45% of those under the legal drinking age) reported alcohol use in the month prior to entering basic military training (BMT). Thirty-eight percent of all active duty recruits reported binge drinking (ie, consuming 5 or more drinks on a single occasion) at least one time in the past 30 days. Nearly 1 in 4 (23%) reported 1 to 3 episodes of binge drinking. Three percent of reported alcohol users drove after consuming five or more drinks, and 9 percent rode as a passenger in a vehicle with a driver who had been drinking heavily. Several demographic, behavioral, and attitudinal correlates of risky drinking patterns were identified. Prevention efforts are needed to address the implications of these findings because they influence the health, safety, and military readiness of active duty personnel.

  18. Force Control Characteristics for Generation and Relaxation in the Lower Limb.

    PubMed

    Ohtaka, Chiaki; Fujiwara, Motoko

    2018-05-29

    We investigated the characteristics for force generation and relaxation using graded isometric contractions of the knee extensors. Participants performed the following tasks as quickly and accurately as possible. For the force generation task, force was increased from 0% to 20%, 40% and 60% of the maximal voluntary force (MVF). For the force relaxation task, force was decreased from 60% to 40%, 20% and 0%. The following parameters of the recorded force were calculated: error, time, and rate of force development. The error was consistently greater for force relaxation than generation. Reaction and adjustment times were independent of the tasks. The control strategy was markedly different for force relaxation and generation, this tendency was particularly evident for the lower limb compared to the upper limb.

  19. Consolidated fuel reprossing program: The implications of force reflection for teleoperation in space

    NASA Technical Reports Server (NTRS)

    Draper, John V.; Herndon, Joseph N.; Moore, Wendy E.

    1987-01-01

    Previous research on teleoperator force feedback is reviewed and results of a testing program which assessed the impact of force reflection on teleoperator task performance are reported. Force relection is a type of force feedback in which the forces acting on the remote portion of the teleoperator are displayed to the operator by back-driving the master controller. The testing program compared three force reflection levels: 4 to 1 (four units of force on the slave produce one unit of force at the master controller), 1 to 1, and infinity to 1 (no force reflection). Time required to complete tasks, rate of occurrence of errors, the maximum force applied to tasks components, and variability in forces applied to components during completion of representative remote handling tasks were used as dependent variables. Operators exhibited lower error rates, lower peak forces, and more consistent application of forces using force relection than they did without it. These data support the hypothesis that force reflection provides useful information for teleoperator users. The earlier literature and the results of the experiment are discussed in terms of their implications for space based teleoperator systems. The discussion described the impact of force reflection on task completion performance and task strategies, as suggested by the literature. It is important to understand the trade-offs involved in using telerobotic systems with and without force reflection.

  20. Immune-mediated neuropathy with Epstein-Barr virus-positive T-cell lymphoproliferative disease.

    PubMed

    Hattori, Takaaki; Arai, Ayako; Yokota, Takanori; Imadome, Ken-Ichi; Tomimitsu, Hiroyuki; Miura, Osamu; Mizusawa, Hidehiro

    2015-01-01

    A 47-year-old man with Epstein-Barr virus (EBV)-positive T/NK- cell lymphoproliferative disease (EBV-T/NK-LPD) developed acute-onset weakness. A nerve conduction study showed a conduction block in both the proximal and most distal segments. Although the patient's neuropathy transiently responded to intravenous immunoglobulin, it was progressive for at least 25 days until the start of prednisolone (PSL) administration, after which it remarkably improved. The neuropathy further improved after allogeneic bone marrow transplantation (BMT). The present patient's clinical course is not consistent with that of typical Guillain-Barré syndrome. This case suggests that EBV-T/NK-LPD can cause progressive immune-mediated neuropathy as a result of chronic EBV antigen presentation and can be treated with PSL and BMT.

  1. Lethal graft-versus-host disease in congenital neutropenia caused by p14 deficiency after allogeneic bone marrow transplantation from an HLA-identical sibling.

    PubMed

    Bohn, Georg; Hardtke-Wolenski, Matthias; Zeidler, Cornelia; Maecker, Britta; Sauer, Martin; Sykora, Karl-Walter; Grigull, Lorenz; Welte, Karl; Klein, Christoph

    2008-09-01

    The molecular heterogeneity of severe congenital neutropenia (SCN) is increasingly recognized and may influence the risk-benefit assessment of therapeutic strategies. We report on a patient with p14 deficiency who succumbed to severe grade IV graft-versus-host disease (GvHD) after a human leukocyte antigen-identical bone marrow transplantion (BMT) from a sibling donor. Before BMT, in vitro generated p14-deficient dendritic cells showed a markedly elevated tumor necrosis factor (TNF-) alpha production upon toll-like receptor stimulation. We hypothesize that p14 deficiency predisposes to GvHD through increased TNF-alpha production. Adequate genetic testing is needed to prospectively assess potential risk factors for GvHD in defined SCN subgroups. (c) 2008 Wiley-Liss, Inc.

  2. Resolution of hematocolpos in adolescents affected with Graft Versus Host Disease.

    PubMed

    Michala, Lina; Vlachopapadopoulou, Elpis; Tsimaris, Pandelis; Papaioannou, Georgia; Paisiou, Anna; Peristeri, Ioulia; Michalacos, Stephanos; Kitra, Vassiliki

    2018-05-29

    Bone Marrow Transplant (BMT) is a lifesaving procedure for a range of serious benign or malignant hematological conditions. A proportion of patients however will develop Graft Versus Host Disease (GVHD), acute or chronic, with serious long term sequalae. We present two cases of hematocolpos that developed in adolescence because of vaginal synechiae due to GVHD. The condition was initially asymptomatic, resolved spontaneously at first and recurred. In one girl blunt lysis of the adhesions was performed under general anesthetic, followed thereafter by local hydrocortisone and estriol treatment. Genital symptoms may not be readily reported by adolescents post BMT. Physicians should be aware of possible late effects of GVHD on genitalia, inquire about symptoms and be acquainted with addressing complications, such as vaginal obstruction. Copyright © 2018. Published by Elsevier Inc.

  3. Dynamical signatures of isometric force control as a function of age, expertise, and task constraints.

    PubMed

    Vieluf, Solveig; Sleimen-Malkoun, Rita; Voelcker-Rehage, Claudia; Jirsa, Viktor; Reuter, Eva-Maria; Godde, Ben; Temprado, Jean-Jacques; Huys, Raoul

    2017-07-01

    From the conceptual and methodological framework of the dynamical systems approach, force control results from complex interactions of various subsystems yielding observable behavioral fluctuations, which comprise both deterministic (predictable) and stochastic (noise-like) dynamical components. Here, we investigated these components contributing to the observed variability in force control in groups of participants differing in age and expertise level. To this aim, young (18-25 yr) as well as late middle-aged (55-65 yr) novices and experts (precision mechanics) performed a force maintenance and a force modulation task. Results showed that whereas the amplitude of force variability did not differ across groups in the maintenance tasks, in the modulation task it was higher for late middle-aged novices than for experts and higher for both these groups than for young participants. Within both tasks and for all groups, stochastic fluctuations were lowest where the deterministic influence was smallest. However, although all groups showed similar dynamics underlying force control in the maintenance task, a group effect was found for deterministic and stochastic fluctuations in the modulation task. The latter findings imply that both components were involved in the observed group differences in the variability of force fluctuations in the modulation task. These findings suggest that between groups the general characteristics of the dynamics do not differ in either task and that force control is more affected by age than by expertise. However, expertise seems to counteract some of the age effects. NEW & NOTEWORTHY Stochastic and deterministic dynamical components contribute to force production. Dynamical signatures differ between force maintenance and cyclic force modulation tasks but hardly between age and expertise groups. Differences in both stochastic and deterministic components are associated with group differences in behavioral variability, and observed behavioral variability is more strongly task dependent than person dependent. Copyright © 2017 the American Physiological Society.

  4. Crafting a Balanced System of Assessment in Wisconsin. Recommendations of the Next Generation Assessment Task Force

    ERIC Educational Resources Information Center

    Wisconsin Department of Public Instruction, 2009

    2009-01-01

    The Next Generation Assessment Task Force was convened to formulate Wisconsin's path forward. Task force members listened to leaders from business and technology sectors as well as leaders from PK-12 and higher education. This summary shares the process, definitions, assumptions, and recommendations of the task force. This paper aims to use these…

  5. 75 FR 47624 - U.S. Coral Reef Task Force Public Meeting and Public Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service U.S. Coral Reef Task Force Public Meeting and... (Service), announce a public meeting of the U.S. Coral Reef Task Force (USCRTF) and a request for written.... Coral Reef Task Force Department of the Interior Liaison, U.S. Department of the Interior, MS-3530-MIB...

  6. 75 FR 15457 - Aquatic Nuisance Species Task Force Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-29

    ...] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: This notice announces a meeting of the Aquatic Nuisance Species (ANS) Task Force. The.... DATES: The ANS Task Force will meet from 8 a.m. to 5 p.m. on Wednesday, May 5, and from 8 a.m. to 5 p.m...

  7. 77 FR 23667 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-20

    ... CONTACT: Mail Delivery service through Recovering Warrior Task Force, Hoffman Building II, 200 Stovall St... Review of Non- Medical Case Management. 9:30-9:45 a.m. Break. 9:45-10:45 a.m. Task Force Recommendation... Task Force through the contact information in FOR FURTHER INFORMATION CONTACT, and this individual will...

  8. Forest biomass as an energy source

    Treesearch

    P.E. Laks; R.W. Hemingway; A. Conner

    1979-01-01

    The Task Force on Forest Biomass as an Energy Source was chartered by the Society of American Foresters on September 26, 1977, and took its present form following an amendment to the charter on October 5, 1977. It built upon the findings of two previous task forces, the Task Force on Energy and Forest Resources and the Task Force for Evaluation of the CORRIM Report (...

  9. Control of force during rapid visuomotor force-matching tasks can be described by discrete time PID control algorithms.

    PubMed

    Dideriksen, Jakob Lund; Feeney, Daniel F; Almuklass, Awad M; Enoka, Roger M

    2017-08-01

    Force trajectories during isometric force-matching tasks involving isometric contractions vary substantially across individuals. In this study, we investigated if this variability can be explained by discrete time proportional, integral, derivative (PID) control algorithms with varying model parameters. To this end, we analyzed the pinch force trajectories of 24 subjects performing two rapid force-matching tasks with visual feedback. Both tasks involved isometric contractions to a target force of 10% maximal voluntary contraction. One task involved a single action (pinch) and the other required a double action (concurrent pinch and wrist extension). 50,000 force trajectories were simulated with a computational neuromuscular model whose input was determined by a PID controller with different PID gains and frequencies at which the controller adjusted muscle commands. The goal was to find the best match between each experimental force trajectory and all simulated trajectories. It was possible to identify one realization of the PID controller that matched the experimental force produced during each task for most subjects (average index of similarity: 0.87 ± 0.12; 1 = perfect similarity). The similarities for both tasks were significantly greater than that would be expected by chance (single action: p = 0.01; double action: p = 0.04). Furthermore, the identified control frequencies in the simulated PID controller with the greatest similarities decreased as task difficulty increased (single action: 4.0 ± 1.8 Hz; double action: 3.1 ± 1.3 Hz). Overall, the results indicate that discrete time PID controllers are realistic models for the neural control of force in rapid force-matching tasks involving isometric contractions.

  10. Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease.

    PubMed

    Huang, Cheng-Ya; Chen, Yu-An; Hwang, Ing-Shiou; Wu, Ruey-Meei

    2018-03-31

    To examine the task prioritization effects on postural-suprapostural dual-task performance in patients with early-stage Parkinson disease (PD) without clinically observed postural symptoms. Cross-sectional study. Participants performed a force-matching task while standing on a mobile platform, and were instructed to focus their attention on either the postural task (posture-first strategy) or the force-matching task (posture-second strategy). University research laboratory. Individuals (N=16) with early-stage PD who had no clinically observed postural symptoms. Not applicable. Dual-task change (DTC; percent change between single-task and dual-task performance) of posture error, posture approximate entropy (ApEn), force error, and reaction time (RT). Positive DTC values indicate higher postural error, posture ApEn, force error, and force RT during dual-task conditions compared with single-task conditions. Compared with the posture-first strategy, the posture-second strategy was associated with smaller DTC of posture error and force error, and greater DTC of posture ApEn. In contrast, greater DTC of force RT was observed under the posture-second strategy. Contrary to typical recommendations, our results suggest that the posture-second strategy may be an effective dual-task strategy in patients with early-stage PD who have no clinically observed postural symptoms in order to reduce the negative effect of dual tasking on performance and facilitate postural automaticity. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. Interagency Task Forces: The Right Tools for the Job

    DTIC Science & Technology

    2011-01-01

    shortcomings. This analysis discusses four organizational reform models and recommends the interagency task force ( IATF ) as the preferred structure...model.64 Still others recommend creating and deploying ad hoc IATFs for crisis operations. These interagency task forces would be task- organized to...forces assigned for planning, exercises, and mission execution.65 A 2005 article in Policy Review recommended developing IATFs as needed for specific

  12. Vocational Evaluation and Work Adjustment Bulletin; Vol. 8, Special Edition: Vocational Evaluation Project Final Report Part 2.

    ERIC Educational Resources Information Center

    Vocational Evaluation and Work Adjustment Association, Washington, DC.

    Part 2 of the three-part Vocational Evaluation Project final report contains brief summaries of the seven task force report which comprise the final report and two such task force reports. The report of task force 5, Standards for Vocational Evaluation, describes the task force's effort to study the standards for accreditation presently used by…

  13. Comparing the Values Hierarchy of the Kentucky Department of Education's Character/Values Task Force. Comparing a Character/Values Task Force to a National Sample.

    ERIC Educational Resources Information Center

    Butler, Fonda P.

    In March 1989, the Kentucky Department of Education assembled a task force to make recommendations regarding the issue of teaching values and character in public schools in Kentucky. The 23-member task force represented educators, parents, the legislature, state and local school boards, law enforcement agencies, higher education, Catholic…

  14. Task Force on Defense Strategies for Ensuring the Resilience of National Space Capabilities. Executive Summary

    DTIC Science & Technology

    2017-03-21

    March 2017 Task Force on Defense Strategies for Ensuring the Resilience of National Space Capabilities OFFICE OF THE UNDER SECRETARY OF...the Department of Defense. The DSB Task Force on Defense Strategies for Ensuring the Resilience of National Space Capabilities completed its formal...Ensuring the Resilience of National Space Capabilities | i DSB Task Force on Defense Strategies for Ensuring the

  15. Communicating with New and Existing Markets. A Task Force of Howard Community College's 1998-1999 Commission on the Future.

    ERIC Educational Resources Information Center

    Howard Community Coll., Columbia, MD.

    This is a report from a task force formed by Howard Community College (Maryland) to examine existing and future markets. The task force also explored ways to use marketing strategies to attract potential customers to the college. The task force recommends that the college use its strengths to attract customers, such as its commitment to open…

  16. Differential role of gp130-dependent STAT and Ras signalling for haematopoiesis following bone-marrow transplantation.

    PubMed

    Kroy, Daniela C; Hebing, Lisa; Sander, Leif E; Gassler, Nikolaus; Erschfeld, Stephanie; Sackett, Sara; Galm, Oliver; Trautwein, Christian; Streetz, Konrad L

    2012-01-01

    Bone marrow transplantation (BMT) is a complex process regulated by different cytokines and growth factors. The pleiotropic cytokine IL-6 (Interleukin-6) and related cytokines of the same family acting on the common signal transducer gp130 are known to play a key role in bone marrow (BM) engraftment. In contrast, the exact signalling events that control IL-6/gp130-driven haematopoietic stem cell development during BMT remain unresolved. Conditional gp130 knockout and knockin mice were used to delete gp130 expression (gp130(ΔMx)), or to selectively disrupt gp130-dependent Ras (gp130(ΔMxRas)) or STAT signalling (gp130(ΔMxSTAT)) in BM cells. BM derived from the respective strains was transplanted into irradiated wildtype hosts and repopulation of various haematopoietic lineages was monitored by flow cytometry. BM derived from gp130 deficient donor mice (gp130(ΔMx)) displayed a delayed engraftment, as evidenced by reduced total white blood cells (WBC), marked thrombocytopenia and anaemia in the early phase after BMT. Lineage analysis unravelled a restricted development of CD4(+) and CD8(+) T-cells, CD19(+) B-cells and CD11b(+) myeloid cells after transplantation of gp130-deficient BM grafts. To further delineate the two major gp130-induced signalling cascades, Ras-MAPK and STAT1/3-signalling respectively, we used gp130(ΔMxRas) and gp130(ΔMxSTAT) donor BM. BMT of gp130(ΔMxSTAT) cells significantly impaired engraftment of CD4(+), CD8(+), CD19(+) and CD11b(+) cells, whereas gp130(ΔMxRas) BM displayed a selective impairment in early thrombopoiesis. Importantly, gp130-STAT1/3 signalling deficiency in BM grafts severely impaired survival of transplanted mice, thus demonstrating a pivotal role for this pathway in BM graft survival and function. Our data unravel a vital function of IL-6/gp130-STAT1/3 signals for BM engraftment and haematopoiesis, as well as for host survival after transplantation. STAT1/3 and ras-dependent pathways thereby exert distinct functions on individual bone-marrow-lineages.

  17. Complete surgical resection combined with aggressive adjuvant chemotherapy and bone marrow transplantation prolongs survival in children with advanced neuroblastoma.

    PubMed

    Chamberlain, R S; Quinones, R; Dinndorf, P; Movassaghi, N; Goodstein, M; Newman, K

    1995-03-01

    A multi-modality approach combining surgery with aggressive chemotherapy and radiation is used to treat advanced neuroblastoma. Despite this treatment, children with advanced disease have a 20% 2-year survival rate. Controversy has developed regarding the efficacy of combining aggressive chemotherapy with repeated surgical intervention aimed at providing a complete surgical resection (CSR) of the primary tumor and metastatic sites. Several prospective and retrospective studies have provided conflicting reports regarding the benefit of this approach on overall survival. Therefore, we evaluated the efficacy of CSR versus partial surgical resection (PSR) using a strategy combining surgery with aggressive chemotherapy, radiation, and bone marrow transplantation (BMT) for stage IV neuroblastoma. A retrospective study was performed with review of the medical records of 52 consecutive children with neuroblastoma treated between 1985 and 1993. Twenty-eight of these 52 children presented with advanced disease, 24 of which had sufficient data to allow for analysis. All children were managed with protocols designed by the Children's Cancer Group (CCG). Statistical analysis was performed using Student's t test, chi 2 test, and Kaplan-Meier survival curves. Mean survival (35.1 months) and progression-free survival (29.1 months) for the CSR children was statistically superior to that of the PSR children (20.36 and 16.5 months, p = 0.04 and 0.04, respectively). Similar significance was demonstrated using life table analysis of mean and progression-free survival of these two groups (p = 0.05 and < 0.01, respectively). One-, 2-, and 3-year survival rates for the CSR versus the PSR group were 100%, 80%, and 40% versus 77%, 38%, and 15%, respectively. An analysis of the BMT group compared with those children treated with aggressive conventional therapy showed improvement in mean and progression-free survival. Aggressive surgical resection aimed at removing all gross disease is warranted for stage IV neuroblastoma. CSR is associated with prolonged mean and progression-free survival. BMT prolongs mean and progression-free survival in children with stage IV disease. These results suggest that CSR and BMT offer increased potential for long-term remission in children with advanced neuroblastoma.

  18. Report of the Defense Science Board Task Force on Quality of Life.

    DTIC Science & Technology

    1995-10-15

    The Quality of Life Task Force is deeply grateful to those distinguished Americans who served as Counselors to the Task Force. Although they did not... Quality of Life issues to the readiness and well being of our Armed Forces. Their willingness to offer suggestions and advice on topics within their...respective expertise was most helpful The recommendations of the Report are those of the Quality of Life Task Force; and Counselors may, or may not, concur in whole or in part with them.

  19. Screening for Hepatitis C Infections in Adults

    MedlinePlus

    Understanding Task Force Recommendations Screening for Hepatitis C Virus Infection in Adults The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Hepatitis C ...

  20. U.S. Preventive Services Task Force

    MedlinePlus

    ... USPSTF Our Members Conflict of Interest Disclosures Task Force Resources Our Partners Reports to Congress Contact Us ... effort to make the U.S. Preventive Services Task Force (USPSTF) recommendations clearer and its processes more transparent, ...

  1. Novel Approaches for Graft-versus-Host Disease Prevention Compared to Contemporary Controls (BMT CTN 1203)

    ClinicalTrials.gov

    2018-04-05

    Acute Leukemia; Chronic Myelogenous Leukemia; Myelodysplasia; Chronic Lymphocytic Leukemia; Small Lymphocytic Lymphoma; Lymphoma, B-Cell; Lymphoma, Follicular; Lymphoma, Large B-Cell, Diffuse; Hodgkin's Lymphoma

  2. 78 FR 10127 - Request for Nominations to the Agricultural Air Quality Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-13

    ... Conservation Service Request for Nominations to the Agricultural Air Quality Task Force AGENCY: Natural... Nominations to the Agricultural Air Quality Task Force. SUMMARY: The Secretary of Agriculture invites... Force (AAQTF) which was established by the Federal Agriculture Improvement and Reform Act of 1996 to...

  3. Science and Sandy: Lessons Learned

    NASA Astrophysics Data System (ADS)

    Werner, K.

    2013-12-01

    Following Hurricane Sandy's impact on the mid-Atlantic region, President Obama established a Task Force to '...ensure that the Federal Government continues to provide appropriate resources to support affected State, local, and tribal communities to improve the region's resilience, health, and prosperity by building for the future.' The author was detailed from NOAA to the Task Force between January and June 2013. As the Task Force and others began to take stock of the region's needs and develop plans to address them, many diverse approaches emerged from different areas of expertise including: infrastructure, management and construction, housing, public health, and others. Decision making in this environment was complex with many interests and variables to consider and balance. Although often relevant, science and technical expertise was not always at the forefront of this process. This talk describes the author's experience with the Sandy Task Force focusing on organizing scientific expertise to support the work of the Task Force. This includes a description of federal activity supporting Sandy recovery efforts, the role of the Task Force, and lessons learned from developing a science support function within the Task Force.

  4. Preceding immunosuppressive therapy with antithymocyte globulin and ciclosporin increases the incidence of graft rejection in children with aplastic anaemia who underwent allogeneic bone marrow transplantation from HLA-identical siblings.

    PubMed

    Kobayashi, Ryoji; Yabe, Hiromasa; Hara, Junichi; Morimoto, Akira; Tsuchida, Masahiro; Mugishima, Hideo; Ohara, Akira; Tsukimoto, Ichiro; Kato, Koji; Kigasawa, Hisato; Tabuchi, Ken; Nakahata, Tatsutoshi; Ohga, Shoichi; Kojima, Seiji

    2006-12-01

    The incidence of graft rejection was determined in 66 children with acquired aplastic anaemia (AA) following bone marrow transplantation (BMT) from a related donor. Eleven of 65 evaluable patients experienced either early or late rejection. Multivariate analysis identified previous immunosuppressive therapy with antithymocyte-globulin (ATG) and ciclosporin (CsA) as a risk factor for graft rejection (relative risk: 16.6, P = 0.001). Patients who received ATG and CsA had a significantly lower probability of failure-free survival than those who did not (69.7 +/- 6.2% vs. 87.9 +/- 8.0%, P = 0.044). These results suggest that BMT should be instituted immediately in children with severe AA who have human leucocyte antigen-identical siblings.

  5. BK virus induced nephritis in a boy with acute myeloid leukaemia undergoing bone marrow transplantation

    PubMed Central

    Hoefele, Julia; Rüssmann, Despina; Klein, Barbara; Weber, Lutz T.; Führer, Monika

    2008-01-01

    BK virus (BKV) is a human polyomavirus. The primary infection occurs typically without specific signs or symptoms. Almost 80% of adults are seropositive. Clinically relevant infections are usually limited to individuals who are immunosuppressed. After primary infection, BKV remains latent in the kidneys and can be reactivated in the setting of immunosuppression. BKV is associated with tubulointerstitial nephritis and ureteric stenosis in renal transplant recipients. Furthermore, BKV-induced haemorrhagic cystitis (HC) is a severe complication of bone marrow transplantation (BMT) in children and adults. A combination of HC and tubulointerstitial nephritis in a patient has not been reported so far. We report on an 11-year-old boy with acute myeloid leukaemia undergoing BMT. BKV infection was reactivated during post-transplant immunosuppressive therapy causing HC associated with tubulointerstitial nephritis. PMID:25983928

  6. Structural control sensors for the CASES GTF

    NASA Technical Reports Server (NTRS)

    Davis, Hugh W.; Bukley, Angelia P.

    1993-01-01

    CASES (Controls, Astrophysics and Structures Experiment in Space) is a proposed space experiment to collect x-ray images of the galactic center and solar disk with unprecedented resolution. This requires precision pointing and suppression of vibrations in the long flexible structure that comprises the 32-m x-ray telescope optical bench. Two separate electro-optical sensor systems are provided for the ground test facility (GTF). The Boom Motion Tracker (BMT) measures eigenvector data for post-mission use in system identification. The Tip Displacement Sensor (TDS) measures boom tip position and is used as feedback for the closed-loop control system that stabilizes the boom. Both the BMT and the TDS have met acceptance specifications and were delivered to MSFC in February 1992. This paper describes the sensor concept, the sensor configuration as implemented in the GTF, and the results of characterization and performance testing.

  7. Analysis of sepsis in allogeneic bone marrow transplant recipients: a single-center study.

    PubMed

    Mitsui, Hideki; Karasuno, Takahiro; Santo, Taisuke; Fukushima, Kentaro; Matsunaga, Hitomi; Nakamura, Hiroyuki; Hiraoka, Akira

    2003-09-01

    We reviewed the records of 235 consecutive recipients of allogeneic bone marrow transplantation (allo-BMT) at our center between February 1983 and October 2000. Sepsis occurred in 25 patients (10.6%) at a median of 10 days (range, 1-280 days) after BMT. Five of the 25 patients (20%) died of sepsis. Pathogens isolated from blood culture were gram-positive cocci in 19 patients, gram-negative rods in 7, fungi in 2, and others in 1 patient. Two pathogens were detected concomitantly in 4 patients. Univariate analysis revealed that risk factors for sepsis were selective gut decontamination using lomefloxacin hydrochloride and nystatin, an unrelated donor, HLA mismatched BMT, and stomatitis. Multivariate logistic regression analysis revealed that an unrelated donor was the only significant independent risk factor, with a relative risk of 5.432. In 12 of 25 patients with sepsis, the pathogens of sepsis were sensitive to antibiotics used for gut decontamination. Selective gut decontamination significantly increased the incidence of sepsis, especially that with gram-positive cocci, but not the mortality rate of sepsis, compared with total gut decontamination using vancomycin. We also found a significant relationship between pathogens isolated from blood culture and those isolated from surveillance cultures of stool, urine, and gargled water in the period before sepsis occurred. The present study revealed an independent risk factor for sepsis (unrelated donor), the feasibility of selective gut decontamination, and the importance of surveillance culture.

  8. β-1,2-Mannosyltransferases 1 and 3 Participate in Yeast and Hyphae O- and N-Linked Mannosylation and Alter Candida albicans Fitness During Infection.

    PubMed

    Courjol, Flavie; Jouault, Thierry; Mille, Céline; Hall, Rebecca; Maes, Emmanuel; Sendid, Boualem; Mallet, Jean Maurice; Guerardel, Yann; Gow, Neil A R; Poulain, Daniel; Fradin, Chantal

    2015-09-01

    β-1,2-mannosylation of Candida albicans glycoconjugates has been investigated through the identification of enzymes involved in the addition of β-1,2-oligomannosides (β-Mans) to phosphopeptidomannan and phospholipomannan. β-1,2-oligomannosides are supposed to have virulence properties that they confer to these glycoconjugates. In a previous study, we showed that cell wall mannoproteins (CWMPs) harbor β-Mans in their O-mannosides; therefore, we analyzed their biosynthesis and impact on virulence. In this study, we demonstrate that O-mannans are heterogeneous and that α-mannosylated O-mannosides, which are biosynthesized by Mnt1 and Mnt2 α-1,2-mannosyltransferases, can be modified with β-Mans but only at the nonreducing end of α-1,2-mannotriose. β-1,2-mannosylation of this O-mannotriose depends on growth conditions, and it involves 2 β-1,2-mannosyltransferases, Bmt1 and Bmt3. These Bmts are essential for β-1,2-mannosylation of CWMPs and expression of β-Mans on germ tubes. A bmt1Δ mutant and a mutant expressing no β-Mans unexpectedly disseminated more in BALB/c mice, whereas they had neither attenuated nor enhanced virulence in C57BL/6 mice. In galectin (Gal)3 knockout mice, the reference strain was more virulent than in C57BL/6 mice, suggesting that the β-Mans innate receptor Gal3 is involved in C. albicans fitness during infection.

  9. Antibody responses to tetanus toxoid and Haemophilus influenzae type b conjugate vaccines following autologous peripheral blood stem cell transplantation (PBSCT).

    PubMed

    Chan, C Y; Molrine, D C; Antin, J H; Wheeler, C; Guinan, E C; Weinstein, H J; Phillips, N R; McGarigle, C; Harvey, S; Schnipper, C; Ambrosino, D M

    1997-07-01

    Accelerated granulocyte and platelet recovery following peripheral blood stem cell transplantation (PBSCT) are well documented. We hypothesize that functional immunity may also be enhanced in PBSCT and performed a phase II trial of immunizations in patients with lymphoma undergoing autologous transplantation with peripheral blood stem cells or bone marrow. Seventeen BMT and 10 PBSCT recipients were immunized at 3, 6, 12, and 24-months post-transplantation with Haemophilus influenzae type b (HIB)-conjugate and tetanus toxoid (TT) vaccines. IgG anti-HIB and anti-TT antibody concentrations were measured and compared between the two groups. Geometric mean IgG anti-HIB antibody concentrations were significantly higher for PBSCT recipients compared to BMT recipients at 24 months post-transplantation (11.3 micrograms/ml vs 0.93 microgram/ml, P = 0.051) and following the 24 month immunization (66.2 micrograms/ml vs 1.30 micrograms/ml, P = 0.006). Similar results were noted for IgG anti-TT antibody with significantly higher geometric mean antibody concentrations in the PBSCT group at 24 months post-transplantation (182 micrograms/ml vs 21.6 micrograms/ml, P = 0.039). Protective levels of total anti-HIB antibody were achieved earlier in PBSCT recipients compared with those of BMT recipients. PBSCT recipients had higher antigen-specific antibody concentrations following HIB and TT immunizations. These results suggest enhanced recovery of humoral immunity in PBSCT recipients and earlier protection against HIB with immunization.

  10. Gynaecomastia with hypergonadotrophic hypogonadism and Leydig cell insufficiency in recipients of high-dose chemotherapy or chemo-radiotherapy.

    PubMed

    Harris, E; Mahendra, P; McGarrigle, H H; Linch, D C; Chatterjee, R

    2001-12-01

    Late side-effects of stem cell transplantation include hypogonadism with infertility and sexual dysfunction, but gynaecomastia is less well recognised. We report five cases of gynaecomastia with features of hypergonadotrophic hypogonadism (primary testicular failure), who received either a TBI/cyclophosphamide conditioned allograft (n = 3) or a BEAM autograft (n = 2). Patients receiving an allograft had gynaecomastia, Leydig cell insufficiency (LCI) diminished libido and erectile dysfunction. Surgery was required in one case, while in two cases the gynaecomastia resolved spontaneously after 6 months. Two patients also had gynaecomastia and sexual dysfunction, severe hypogonadism, very low testosterone levels and marked hyperprolactinaemia following autoBMT. Both responded well to testosterone replacement therapy (TRT). As a group, all patients had primary testicular failure and all except one, had LCI (compensated or frank). However, there was no correlation between the severity of gynaecomastia and the degree of endocrine dysfunction. This preliminary study is the first to suggest that gynaecomastia, due to primary hypogonadism and LCI, may be a significant complication of myeloablative conditioning therapy. Therefore gynaecomastia in BMT recipients must always be treated as a pathological entity as it may be the external manifestation of a complex endocrine pathology. It is a potentially treatable condition. Although spontaneously reversible, some patients may require TRT or even surgery. We recommend comprehensive endocrine testing in conjunction with a reproductive endocrinologist and prompt intervention to alleviate embarrassment and anxiety in afflicted BMT recipients.

  11. Pulmonary complications in patients with haematological malignancies treated at a respiratory ICU.

    PubMed

    Ewig, S; Torres, A; Riquelme, R; El-Ebiary, M; Rovira, M; Carreras, E; Raño, A; Xaubet, A

    1998-07-01

    Patients with haematological malignancies developing severe pulmonary complications have a poor outcome, especially after bone-marrow transplantation (BMT). We studied the aetiology, the yield of different diagnostic tools, as well as the outcome and prognostic factors in the corresponding population admitted to our respiratory intensive care unit (RICU). Overall, 89 patients with haematological malignancies and pulmonary complications treated within a 10 yr period were included. The underlying malignancies were predominantly acute leukaemia and chronic myeloid leukaemia (66/89, 74%). Fifty-two of 89 (58%) patients were bone marrow recipients. An aetiological diagnosis could be obtained in 61/89 (69%) of cases. The aetiology was infectious in 37/89 (42%) and noninfectious in 24/89 (27%). Blood cultures and cytological examinations of bronchoalveolar lavage fluid were the diagnostic tools with the highest yield (13/43 (30%) and 13/45 (29%) positive results, respectively). Necropsy results were coincident with results obtained during the lifetime in 43% of cases with infectious and 60% with noninfectious aetiologies. Overall mortality was 70/89 (79%), and 47/52 (90%) in transplant recipients. The requirement of mechanical ventilation, BMT, and an interval <90 days of BMT prior to ICU admission were independent adverse prognostic factors. The outcome in this patient population was uniformly poor. It was worst in bone marrow recipients developing pulmonary complications <90 days after transplantation and requiring mechanical ventilation. Decisions about intensive care unit admission and mech-anical ventilation should seriously consider the dismal prognosis of these patients.

  12. Bovine GDF10 gene polymorphism analysis and its association with body measurement traits in Chinese indigenous cattle.

    PubMed

    Adoligbe, C; Zan, Linsen; Farougou, S; Wang, Hongbao; Ujjan, J A

    2012-04-01

    The objective of this research was to detect bovine GDF10 gene polymorphism and analyze its association with body measurement traits (BMT) of animals sampled from 6 different Chinese indigenous cattle populations. The populations included Xuelong (Xl), Luxi (Lx), Qinchuan (Qc), Jiaxian red (Jx), Xianang (Xn) and Nanyang (Ny). Blood samples were taken from a total of 417 female animals stratified into age categories of 12-36 months. Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was employed to find out GDF10 single polymorphism nucleotide (SNPs) and explore their possible association with BMT. Sequence analysis of GDF10 gene revealed 3 SNPs in total: 1 in exon1 (G142A) and 2 in exon3 (A11471G, and T12495C). G142A and T12495C SNPs are both synonymous mutation. They showed 2 genotypes namely respectively (GG, GA) and (PP and PB). A11471G SNP is a missense mutation leading to the change of Alanine to Threonine amino acid. It showed three genotypes namely AA, BB and AB. Analysis of association of polymorphism with body measurement traits at the three locus showed that there were significant effects on BMT in Qc, Jx and Ny cattle population. These results suggest that the GDF10 gene might have potential effects on body measurement traits in the above mentioned cattle populations and could be used for marker-assisted selection.

  13. Force related hemodynamic responses during execution and imagery of a hand grip task: A functional near infrared spectroscopy study.

    PubMed

    Wriessnegger, Selina C; Kirchmeyr, Daniela; Bauernfeind, Günther; Müller-Putz, Gernot R

    2017-10-01

    We examined force related hemodynamic changes during the performance of a motor execution (ME) and motor imagery (MI) task by means of multichannel functional near infrared spectroscopy (fNIRS). The hemodynamic responses of fourteen healthy participants were measured while they performed a hand grip execution or imagery task with low and high grip forces. We found an overall higher increase of [oxy-Hb] concentration changes during ME for both grip forces but with a delayed peak maximum for the lower grip force. During the MI task with lower grip force, the [oxy-Hb] level increases are stronger compared to the MI with higher grip force. The facilitation in performing MI with higher grip strength might thus indicate less inhibition of the actual motor act which could also explain the later increase onset of [oxy-Hb] in the ME task with the lower grip force. Our results suggest that execution and imagery of a hand grip task with high and low grip forces, leads to different cortical activation patterns. Since impaired control of grip forces during object manipulation in particular is one aspect of fine motor control deficits after stroke, our study will contribute to future rehabilitation programs enhancing patient's grip force control. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. 78 FR 28580 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces AGENCY: Office... Defense announces the following Federal Advisory Committee meeting of the Department of Defense Task Force...

  15. 77 FR 68744 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-16

    ... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces; Federal... Committee meeting of the Department of Defense Task Force on the Care, Management, and Transition of...

  16. 75 FR 59698 - Federal Advisory Committee; Department of Defense Task Force on the Care, Management, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-28

    .... SUPPLEMENTARY INFORMATION: The Task Force is a non-discretionary Federal advisory committee established to (a... for wounded, ill, and injured members of the Armed Forces; ii. Medical case management; iii. Non... Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Member of...

  17. PRN 2009-1: Establishment of Antimicrobial Exposure Assessment Task Force II

    EPA Pesticide Factsheets

    This PR notice announces the establishment of the Antimicrobial Exposure Assessment Task Force II, an industry-wide task force to develop mixer, loader, applicator and post-application exposure data for antimicrobial pesticides used in various settings.

  18. Practice and Age-Related Loss of Adaptability in Sensorimotor Performance

    PubMed Central

    Sosnoff, Jacob J.; Voudrie, Stefani J.

    2009-01-01

    The purpose of the present investigation was to examine whether the ability to adapt to task constraints is influenced by short-term practice in older adults. Young (18–29 years old) and old (65–75 years old) adults produced force output to a constant force target and a 1-Hz sinusoidal force target by way of the index finger flexion. Participants completed each task 5 times per session for 5 concurrent sessions. The amount and structure of force variability was calculated using linear and nonlinear analyses. As expected, there was a decrease in the magnitude of variability (coefficient of variation) in both tasks and task-related change in the structure of force variability (approximate entropy) with training across groups. The authors found older adults to have a greater amount of variability than their younger counterparts in both tasks. Older adults also demonstrated an increase in the structure of force output in the constant task but a decrease in structure in the sinusoidal task. Age differences in the adaptability to task constraints persisted throughout practice. The authors propose that older adults' ability to adapt sensorimotor output to task demands is not a result of lack of familiarity with the task but that it is, instead, characteristic of the aging process. PMID:19201684

  19. Tibiofemoral contact forces during walking, running and sidestepping.

    PubMed

    Saxby, David J; Modenese, Luca; Bryant, Adam L; Gerus, Pauline; Killen, Bryce; Fortin, Karine; Wrigley, Tim V; Bennell, Kim L; Cicuttini, Flavia M; Lloyd, David G

    2016-09-01

    We explored the tibiofemoral contact forces and the relative contributions of muscles and external loads to those contact forces during various gait tasks. Second, we assessed the relationships between external gait measures and contact forces. A calibrated electromyography-driven neuromusculoskeletal model estimated the tibiofemoral contact forces during walking (1.44±0.22ms(-1)), running (4.38±0.42ms(-1)) and sidestepping (3.58±0.50ms(-1)) in healthy adults (n=60, 27.3±5.4years, 1.75±0.11m, and 69.8±14.0kg). Contact forces increased from walking (∼1-2.8 BW) to running (∼3-8 BW), sidestepping had largest maximum total (8.47±1.57 BW) and lateral contact forces (4.3±1.05 BW), while running had largest maximum medial contact forces (5.1±0.95 BW). Relative muscle contributions increased across gait tasks (up to 80-90% of medial contact forces), and peaked during running for lateral contact forces (∼90%). Knee adduction moment (KAM) had weak relationships with tibiofemoral contact forces (all R(2)<0.36) and the relationships were gait task-specific. Step-wise regression of multiple external gait measures strengthened relationships (0.20

  20. Fitts' Law in the Control of Isometric Grip Force With Naturalistic Targets.

    PubMed

    Thumser, Zachary C; Slifkin, Andrew B; Beckler, Dylan T; Marasco, Paul D

    2018-01-01

    Fitts' law models the relationship between amplitude, precision, and speed of rapid movements. It is widely used to quantify performance in pointing tasks, study human-computer interaction, and generally to understand perceptual-motor information processes, including research to model performance in isometric force production tasks. Applying Fitts' law to an isometric grip force task would allow for quantifying grasp performance in rehabilitative medicine and may aid research on prosthetic control and design. We examined whether Fitts' law would hold when participants attempted to accurately produce their intended force output while grasping a manipulandum when presented with images of various everyday objects (we termed this the implicit task). Although our main interest was the implicit task, to benchmark it and establish validity, we examined performance against a more standard visual feedback condition via a digital force-feedback meter on a video monitor (explicit task). Next, we progressed from visual force feedback with force meter targets to the same targets without visual force feedback (operating largely on feedforward control with tactile feedback). This provided an opportunity to see if Fitts' law would hold without vision, and allowed us to progress toward the more naturalistic implicit task (which does not include visual feedback). Finally, we changed the nature of the targets from requiring explicit force values presented as arrows on a force-feedback meter (explicit targets) to the more naturalistic and intuitive target forces implied by images of objects (implicit targets). With visual force feedback the relation between task difficulty and the time to produce the target grip force was predicted by Fitts' law (average r 2 = 0.82). Without vision, average grip force scaled accurately although force variability was insensitive to the target presented. In contrast, images of everyday objects generated more reliable grip forces without the visualized force meter. In sum, population means were well-described by Fitts' law for explicit targets with vision ( r 2 = 0.96) and implicit targets ( r 2 = 0.89), but not as well-described for explicit targets without vision ( r 2 = 0.54). Implicit targets should provide a realistic see-object-squeeze-object test using Fitts' law to quantify the relative speed-accuracy relationship of any given grasper.

  1. A guide for statewide impaired-driving task forces.

    DOT National Transportation Integrated Search

    2009-09-01

    The purpose of the guide is to assist State officials and other stakeholders who are interested in establishing an : Impaired-Driving Statewide Task Force or who are exploring ways to improve their current Task Force. The guide : addresses issues suc...

  2. PRN 2007-3: The Agricultural Handlers Exposure Task Force, L.L.C

    EPA Pesticide Factsheets

    This PR Notice discusses the Agricultural Handlers Exposure Task Force, an industry-wide task force formed to develop mixer, loader, and applicator exposure data for pesticides used in agricultural settings. It includes contacts for more information.

  3. 78 FR 7415 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-01

    ... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces; Notice of... Committee meeting of the Department of Defense Task Force on the Care, Management, and Transition of...

  4. 78 FR 66902 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-07

    ... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces; Notice of... Federal Advisory Committee meeting of the Department of Defense Task Force on the Care, Management, and...

  5. 77 FR 31337 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-25

    ... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces; Notice of... Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and...

  6. 76 FR 38118 - Meeting of the Department of Defense Task Force on the Care, Management, and Transition of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

    ... DEPARTMENT OF DEFENSE Office of the Secretary Meeting of the Department of Defense Task Force on... Forces AGENCY: Department of Defense. ACTION: Meeting notice. SUMMARY: Under the provisions of the... that the following Federal Advisory Committee meeting of the Department of Defense Task Force on the...

  7. 78 FR 38015 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    ... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces; Notice of... of the Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

  8. Load type influences motor unit recruitment in biceps brachii during a sustained contraction.

    PubMed

    Baudry, Stéphane; Rudroff, Thorsten; Pierpoint, Lauren A; Enoka, Roger M

    2009-09-01

    Twenty subjects participated in four experiments designed to compare time to task failure and motor-unit recruitment threshold during contractions sustained at 15% of maximum as the elbow flexor muscles either supported an inertial load (position task) or exerted an equivalent constant torque against a rigid restraint (force task). Subcutaneous branched bipolar electrodes were used to record single motor unit activity from the biceps brachii muscle during ramp contractions performed before and at 50 and 90% of the time to failure for the position task during both fatiguing contractions. The time to task failure was briefer for the position task than for the force task (P=0.0002). Thirty and 29 motor units were isolated during the force and position tasks, respectively. The recruitment threshold declined by 48 and 30% (P=0.0001) during the position task for motor units with an initial recruitment threshold below and above the target force, respectively, whereas no significant change in recruitment threshold was observed during the force task. Changes in recruitment threshold were associated with a decrease in the mean discharge rate (-16%), an increase in discharge rate variability (+40%), and a prolongation of the first two interspike intervals (+29 and +13%). These data indicate that there were faster changes in motor unit recruitment and rate coding during the position task than the force task despite a similar net muscle torque during both tasks. Moreover, the results suggest that the differential synaptic input observed during the position task influences most of the motor unit pool.

  9. Task- and time-dependent modulation of Ia presynaptic inhibition during fatiguing contractions performed by humans

    PubMed Central

    Maerz, Adam H.; Gould, Jeffrey R.; Enoka, Roger M.

    2011-01-01

    Presynaptic modulation of Ia afferents converging onto the motor neuron pool of the extensor carpi radialis (ECR) was compared during contractions (20% of maximal force) sustained to failure as subjects controlled either the angular position of the wrist while supporting an inertial load (position task) or exerted an equivalent force against a rigid restraint (force task). Test Hoffmann (H) reflexes were evoked in the ECR by stimulating the radial nerve above the elbow. Conditioned H reflexes were obtained by stimulating either the median nerve above the elbow or at the wrist (palmar branch) to assess presynaptic inhibition of homonymous (D1 inhibition) and heteronymous Ia afferents (heteronymous Ia facilitation), respectively. The position task was briefer than the force task (P = 0.001), although the maximal voluntary force and electromyograph for ECR declined similarly at failure for both tasks. Changes in the amplitude of the conditioned H reflex were positively correlated between the two conditioning methods (P = 0.02) and differed between the two tasks (P < 0.05). The amplitude of the conditioned H reflex during the position task first increased (129 ± 20.5% of the initial value, P < 0.001) before returning to its initial value (P = 0.22), whereas it increased progressively during the force task to reach 122 ± 17.4% of the initial value at failure (P < 0.001). Moreover, changes in conditioned H reflexes were associated with the time to task failure and force fluctuations. The results suggest a task- and time-dependent modulation of presynaptic inhibition of Ia afferents during fatiguing contractions. PMID:21543747

  10. 77 FR 6786 - U.S. Coral Reef Task Force Public Meeting and Public Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-09

    ... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration U.S. Coral Reef Task Force... of the U.S. Coral Reef Task Force. The meeting will be held in Washington, DC This meeting, the 27th [[Page 6787

  11. First Responder Refresher: National Standard Curriculum (Instructor Course Guide)

    DOT National Transportation Integrated Search

    1997-07-08

    This white paper provides a brief overview of the report titled "ITS Focus Task Force on System Architecture Report", dated May 1997. The report was prepared by a special task force of the United Kingdoms ITS Focus organization. This task force wa...

  12. Repairing the Breach. Key Ways To Support Family Life, Reclaim Our Streets, and Rebuild Civil Society in America's Communities. Report of the National Task Force on African-American Men and Boys.

    ERIC Educational Resources Information Center

    Austin, Bobby William, Ed.

    This report of the National Task Force on African-American Men and Boys is the beginning of an approach to repair society's breaches and restore the streets to safety. The Task Force, headed by Andrew J. Young and established in 1994, conceived its mission as one of reclamation. The Task Force made 61 specific recommendations, and three general…

  13. [Treating patients with acute myeloid leukemias (AML) according to the protocol of the AML-01.10 Russian multicenter randomized trial: the coordinating center's results].

    PubMed

    Parovichnikova, E N; Troitskaia, V V; Kliasova, G A; Kuz'mina, L A; Sokolov, A N; Paramonova, E V; Galstian, G M; Kessel'man, S A; Drokov, M Iu; Vasil'eva, V A; Obukhova, T N; Kulikov, S M; Savchenko, V G

    2014-01-01

    To make a randomized comparison of 2 consolidation treatment options (two patient groups): 2 cycles of cytarabine in average (Ig/m2 in Group 2) and standard (100 mg/mi2 in Group 1) doses in combination with idarubicin (8-12 mg/m2) and mitoxantrone (10 mg/m2), after two 7+3 induction cycles of daunorubicin (60 mg/mi2) and subsequent 6 cycles of maintenance therapy. In January 2010 to October 2013, a Russian multicenter trial was conducted to treat patients with acute myeloid leukemias (AML) in accordance with the AML-01.10 protocol (ClinicalTrials.gov Identifier: NCT01587430). The trial enrolled 243 AML patients from 21 centers, including 71 patients (median age 38 years) from the State Hematology Center, Ministry of Health of the Russian Federation; 35 and 36 patients were randomized to Groups 1 and 2, respectively. The randomized groups were balanced by basic clinical and laboratory parameters. Favorable, intermediate, and high cytogenetic prognoses were in 14 (21.9%), 40 (62.5%), and 10 (15.6%) patients, respectively. Prior to treatment, 2 patients died; one patient refused treatment. Fifty-eight (85.3%) of the 68 patients achieved complete remission (CR); early deaths was in 2 (2.9%) and resistance in 8 (11.8%). Four (6.9%) patients died during CR. Protocol deviations (doses, intervals, and the number of cycles) were recorded in 12 (20.7%) of the 58 patients. Other 8 (11.8%) patients were switched to low-dose cytarabine because of complications, withdrawn from the protocol and not included into the analysis of randomized comparison. Twenty allogeneic bone marrow transplantations (allo-BMT) (7 related, 12 unrelated, and 1 haploidentical) were performed; of them 15 allo-BMTs were done during first CR. In the 68 patients, 3-year overall survival (OS) was 45.6%; relapse-free survival (RFS) was 41.5%. OS was 64.6% in Group 1 and 58.3% in Group 2; RFS was 62 and 38.8% in Groups 1 and 2, respectively (p>0.5). In the favorable, intermediate, and high prognosis groups, OS was 79.5, 60, and 31.1% and RFS was 81.8, 41.3, and 33.3%, respectively (p=0.1). The consolidation treatment option unchanged survival rates in the above risk groups. Unachieved CR after the first cycle considerably decreased RFS (33.9% versus 60%) and served as an indication for allo-BMT during first CP (RFS without BMT was 0; that with BMT was 78%). No differences were found between both consolidation options according to long-term results. Protocol deviations were recorded in one-third of the patients. While implementing the protocol, the efficiency of treatment was high. Allo-BMT during first CR substantially increased RFS if CP was not achieved after the first cycle.

  14. Bidirectional transfer between joint and individual actions in a task of discrete force production.

    PubMed

    Masumoto, Junya; Inui, Nobuyuki

    2017-07-01

    The present study examined bidirectional learning transfer between joint and individual actions involving discrete isometric force production with the right index finger. To examine the effects of practice of joint action on performance of the individual action, participants performed a pre-test (individual condition), practice blocks (joint condition), and a post-test (individual condition) (IJI task). To examine the effects of practice of the individual action on performance during the joint action, the participants performed a pre-test (joint condition), practice blocks (individual condition), and a post-test (joint condition) (JIJ task). Whereas one participant made pressing movements with a target peak force of 10% maximum voluntary contraction (MVC) in the individual condition, two participants produced the target force of the sum of 10% MVC produced by each of them in the joint condition. In both the IJI and JIJ tasks, absolute errors and standard deviations of peak force were smaller post-test than pre-test, indicating bidirectional transfer between individual and joint conditions for force accuracy and variability. Although the negative correlation between forces produced by two participants (complementary force production) became stronger with practice blocks in the IJI task, there was no difference between the pre- and post-tests for the negative correlation in the JIJ task. In the JIJ task, the decrease in force accuracy and variability during the individual action did not facilitate complementary force production during the joint action. This indicates that practice performed by two people is essential for complementary force production in joint action.

  15. 77 FR 55218 - Homeland Security Advisory Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-07

    ... childhood arrivals program. The HSAC will also receive a report from the Sustainability and Efficiency Task Force, review and discuss the task forces' report, and formulate recommendations for the Department. The.... HSAC conference call details and the Sustainability and Efficiency Task Force report will be provided...

  16. Task force on deterrence of air piracy : final report.

    DOT National Transportation Integrated Search

    1978-11-01

    In February 1969, as the frequency of hijacking of U.S. air carrier aircraft was rising to an all-time high, the Federal Aviation Administration established a multi-disciplinary Task Force on Deterrence of Air Piracy. The work of the Task Force in de...

  17. 75 FR 16577 - Gulf War Veterans' Illnesses Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION: Notice with request for comments. SUMMARY: The Secretary Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to...

  18. 77 FR 18307 - Gulf War Veterans' Illnesses Task Force Report

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force Report AGENCY: Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Secretary Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive...

  19. 78 FR 28292 - Gulf War Veterans' Illnesses Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-14

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION: Notice with request for comments. SUMMARY: The Secretary, Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to...

  20. 76 FR 65321 - Gulf War Veterans' Illnesses Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION: Notice with request for comments. SUMMARY: The Secretary, Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to...

  1. 78 FR 63208 - UPDATE-Meeting of the Community Preventive Services Task Force (Task Force)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ..., and issues recommendations. These recommendations provide evidence-based options from which decision makers in communities, companies, health departments, health plans and healthcare systems, non..., available resources, and constraints of their constituents. The Task Force's recommendations, along with the...

  2. An introductory handbook for state task forces to combat drunk driving.

    DOT National Transportation Integrated Search

    1983-01-01

    In June 1982 Governor Robb created a task force to identify and assess efforts under way in Virginia to address the problem of drunken driving and to make recommendations. This booklet was prepared to assist the task force in its deliberations.

  3. Forced Aerobic Exercise Preceding Task Practice Improves Motor Recovery Poststroke.

    PubMed

    Linder, Susan M; Rosenfeldt, Anson B; Dey, Tanujit; Alberts, Jay L

    To understand how two types of aerobic exercise affect upper-extremity motor recovery post-stroke. Our aims were to (1) evaluate the feasibility of having people who had a stroke complete an aerobic exercise intervention and (2) determine whether forced or voluntary exercise differentially facilitates upper-extremity recovery when paired with task practice. Seventeen participants with chronic stroke completed twenty-four 90-min sessions over 8 wk. Aerobic exercise was immediately followed by task practice. Participants were randomized to forced or voluntary aerobic exercise groups or to task practice only. Improvement on the Fugl-Meyer Assessment exceeded the minimal clinically important difference: 12.3, 4.8, and 4.4 for the forced exercise, voluntary exercise, and repetitive task practice-only groups, respectively. Only the forced exercise group exhibited a statistically significant improvement. People with chronic stroke can safely complete intensive aerobic exercise. Forced aerobic exercise may be optimal in facilitating motor recovery associated with task practice. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  4. BMT Abatacept for Non-Malignant Diseases

    ClinicalTrials.gov

    2018-05-16

    Hurler Syndrome; Fanconi Anemia; Glanzmann Thrombasthenia; Wiskott-Aldrich Syndrome; Chronic Granulomatous Disease; Severe Congenital Neutropenia; Leukocyte Adhesion Deficiency; Shwachman-Diamond Syndrome; Diamond-Blackfan Anemia; Dyskeratosis-congenita; Chediak-Higashi Syndrome; Severe Aplastic Anemia; Thalassemia Major; Hemophagocytic Lymphohistiocytosis; Sickle Cell Disease

  5. [Growing up with bone marrow transplantation: repercussions for the quality of life of children and adolescents].

    PubMed

    Anders, Jane Cristina; Lima, Regina Aparecida Garcia de

    2004-01-01

    Nowadays, various knowledge areas take an increasing interest in the discussion about the quality of life of people submitted to bone marrow transplantation-BMT. This study aims to describe the experiences of children and adolescents who survived this kind of transplantation and to discover how this therapy mode influenced their quality of life. Study participants were 14 children/adolescents who survived BMT. In this qualitative research, data were collected by means of interviews, which were held at the participants' homes or when they returned to hospital. We identified their life as permeated by insecurity, changed body image, physical and emotional problems. These data indicate the importance of understanding the experience of children/adolescents living with bone marrow transplantation, seeking to identify aspects for the intervention and planning of nursing care, so as to contribute to their reinsertion and a better quality of life.

  6. Alloreactive Regulatory T Cells Allow the Generation of Mixed Chimerism and Transplant Tolerance.

    PubMed

    Ruiz, Paulina; Maldonado, Paula; Hidalgo, Yessia; Sauma, Daniela; Rosemblatt, Mario; Bono, Maria Rosa

    2015-01-01

    The induction of donor-specific transplant tolerance is one of the main goals of modern immunology. Establishment of a mixed chimerism state in the transplant recipient has proven to be a suitable strategy for the induction of long-term allograft tolerance; however, current experimental recipient preconditioning protocols have many side effects, and are not feasible for use in future therapies. In order to improve the current mixed chimerism induction protocols, we developed a non-myeloablative bone-marrow transplant (NM-BMT) protocol using retinoic acid (RA)-induced alloantigen-specific Tregs, clinically available immunosuppressive drugs, and lower doses of irradiation. We demonstrate that RA-induced alloantigen-specific Tregs in addition to a NM-BMT protocol generates stable mixed chimerism and induces tolerance to allogeneic secondary skin allografts in mice. Therefore, the establishment of mixed chimerism through the use of donor-specific Tregs rather than non-specific immunosuppression could have a potential use in organ transplantation.

  7. Three-Dimensional Dose Calculation for Total Body Irradiation

    NASA Astrophysics Data System (ADS)

    Ito, Akira

    Bone Marrow Transplant (BMT) therapy has been a big success in the treatment of leukemia and other haematopoietic diseases 1 . Prior to BMT, total body irradiation (TBI) is given to the patient for the purpose of (1) killing leukemia cells in bone marrow, as well as in the whole body, and (2) producing immuno-suppressive status in the patient so that the donor's marrow cells will be transplanted without rejection. TBI employs a very large field photon beam to irradiate the whole body of the patient. A uniform dose distribution over the entire body is the treatment goal. To prevent the occurrence of a serious side effect (interstitial pneumonia), the lung dose should not exceed a certain level. This novel technique poses various new radiological physics problems. The accurate assessment of dose and dose distribution in the patient is essential. Physical and dosimetric problems associated with TBI are reviewed elsewhere 2,3 .

  8. Green Synthesis of Ag-Cu Nanoalloys Using Opuntia ficus- indica

    NASA Astrophysics Data System (ADS)

    Rocha-Rocha, O.; Cortez-Valadez, M.; Hernández-Martínez, A. R.; Gámez-Corrales, R.; Alvarez, Ramón A. B.; Britto-Hurtado, R.; Delgado-Beleño, Y.; Martinez-Nuñez, C. E.; Pérez-Rodríguez, A.; Arizpe-Chávez, H.; Flores-Acosta, M.

    2017-02-01

    Bimetallic Ag/Cu nanoparticles have been obtained by green synthesis using Opuntia ficus- indica plant extract. Two synthesis methods were applied to obtain nanoparticles with core-shell and Janus morphologies by reversing the order of precursors. Transmission electronic microscopy revealed size of 10 nm and 20 nm for the core-shell and Janus nanoparticles, respectively. Other small particles with size of up to 2 nm were also observed. Absorption bands attributed to surface plasmon resonance were detected at 440 nm and 500 nm for the core-shell and Janus nanoparticles, respectively. Density functional theory predicted a breathing mode type (BMT) located at low wavenumber due to small, low-energy clusters of (AgCu) n with n = 2 to 9, showing a certain correlation with the experimental one (at 220 cm-1). The dependence of the BMT on the number of atoms constituting the cluster is also studied.

  9. Lichenoid exanthema mimicking graft-versus-host disease associated with obstructive lung disease in a non-transplanted patient.

    PubMed

    Eberle, Franziska Carola; Holland, Angelique; Hörster, Stefan; Vogelmeier, Claus; Hertl, Michael

    2010-01-01

    Lichenoid graft-versus-host disease (GVHD) is commonly observed in patients who have received donor lymphocyte infusions or allogeneic bone marrow transplantation (BMT). Here we report a striking case of lichenoid GVH-like exanthema in a young woman without any history of blood transfusions or BMT. A polymorphous, multiforme-like exanthema was observed after systemic antibiotic therapy of bronchitis and was initially diagnosed as drug eruption. Later on, disseminated lichenoid papules were noticed on the trunk and extremities with all histologic and clinical characteristics of lichenoid GVHD. Cutaneous GVH-like disease developed, as did obstructive lung disease. Pulmonary as well as skin disease were both refractory to various immunosuppressive therapies. The immune pathogenesis that caused the skin and lung disease in this patient remains unclear. Multiple pregnancies with two abortions with the potential induction of microchimerism may play a role in the disease pathogenesis.

  10. Response to Vogelstein: How the 2012 AAP Task Force on circumcision went wrong.

    PubMed

    Van Howe, Robert S

    2018-01-01

    Vogelstein cautions medical organizations against jumping into the fray of controversial issues, yet proffers the 2012 American Academy of Pediatrics' Task Force policy position on infant male circumcision as 'an appropriate use of position-statements.' Only a scratch below the surface of this policy statement uncovers the Task Force's failure to consider Vogelstein's many caveats. The Task Force supported the cultural practice by putting undeserved emphasis on questionable scientific data, while ignoring or underplaying the importance of valid contrary scientific data. Without any effort to quantitatively assess the risk/benefit balance, the Task Force concluded the benefits of circumcision outweighed the risks, while acknowledging that the incidence of risks was unknown. This Task Force differed from other Academy policy-forming panels by ignoring the Academy's standard quality measures and by not appointing members with extensive research experience, extensive publications, or recognized expertise directly related to this topic. Despite nearly 100 publications available at the time addressing the substantial ethical issues associated with infant male circumcision, the Task Force chose to ignore the ethical controversy. They merely stated, with minimal justification, the opinion of one of the Task Force members that the practice of infant male circumcision is morally permissible. The release of the report has fostered an explosion of academic discussion on the ethics of infant male circumcision with a number of national medical organizations now decrying the practice as a human rights violation. © 2017 John Wiley & Sons Ltd.

  11. Task analysis of Air Force pharmacy practice.

    PubMed

    Bartholomew, A; Sawyer, W T; Coats, L

    1995-01-15

    The frequency with which United States Air Force pharmacists perform specific professional tasks and the pharmacists' views as to the importance of those tasks were studied. A questionnaire was prepared that asked recipients to rate each of 36 tasks selected as representing the spectrum of practice activities. There were four categories of tasks: managerial tasks, dispensing tasks, drug information tasks, and patient care tasks. Recipients rated the tasks with respect to frequency of performance and importance on separate 6-point scales. The questionnaire was mailed in May 1991 to the 225 pharmacists then serving in the Air Force worldwide. Of the 225 questionnaires, 150 usable questionnaires were returned (response rate, 67%). All the tasks in the survey were performed by at least one Air Force pharmacy officer, although the frequency of task performance varied. In particular, the frequency of many patient care tasks was low. All the tasks were perceived to have some importance, but drug information tasks were rated as being significantly more important than tasks in the other categories; patient care tasks were rated lowest in importance. The results varied with the respondents' demographic characteristics. Pharmacy officers with more years of service, more senior positions, higher rank, or an advanced degree in a field other than pharmacy tended to give responses that diverged from those of the population. A 1991 survey showed an awareness among Air Force pharmacists of the need to orient practice around patient care; however, they were not spending substantial time on patient care and tended to view it as less important than more traditional pharmacy tasks.

  12. Grip force control in individuals with multiple sclerosis.

    PubMed

    Iyengar, Veena; Santos, Marcio J; Ko, Michael; Aruin, Alexander S

    2009-10-01

    Appropriate regulation of grip force is essential in performance of various activities of daily living such as drinking, eating, buttoning a shirt, and so on. The extent to which individuals with multiple sclerosis (MS) are able to regulate grip forces while performing elements of the activities of daily living is largely unknown. . To investigate how individuals with MS control grip force during performance of functional tasks. . This study evaluated the grip force control in selected individuals with MS (n = 9) and healthy control subjects (n = 9) while they performed the task of lifting and placing an instrumented object on a shelf and the task of lifting the object and bringing it close to the mouth to mimic drinking. The grip forces, object acceleration, force ratio, and time lag were recorded and analyzed. . The individuals with MS used significantly larger peak grip force and force ratio than control subjects while performing both tasks and for both hands. In addition, the time lag between the peaks of grip and load forces was significantly longer in individuals with MS. . The application of excessive grip force could predispose individuals with MS to additional fatigue and musculoskeletal overuse trauma. Rehabilitation protocols for the MS population may need to account for increased levels of grip force applied during the performance of functional tasks.

  13. 76 FR 52932 - Notice of Meeting of the Agricultural Air Quality Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-24

    ... DEPARTMENT OF AGRICULTURE Natural Resources Conservation Service Notice of Meeting of the Agricultural Air Quality Task Force AGENCY: Natural Resources Conservation Service (NRCS). ACTION: Notice of meeting. SUMMARY: The Agricultural Air Quality Task Force (AAQTF) will meet to continue discussions on...

  14. Using grasping tasks to evaluate hand force coordination in children with hemiplegic cerebral palsy.

    PubMed

    Mackenzie, Samuel J; Getchell, Nancy; Modlesky, Christopher M; Miller, Freeman; Jaric, Slobodan

    2009-08-01

    Mackenzie SJ, Getchell N, Modlesky CM, Miller F, Jaric S. Using grasping tasks to evaluate hand force coordination in children with hemiplegic cerebral palsy. To assess force coordination in children with hemiplegic cerebral palsy (CP) using a device that allows for testing both unimanual and bimanual manipulation tasks performed under static and dynamic conditions. Nonequivalent groups design. University research laboratory for motor control. Six children with hemiplegic CP (age, mean +/- SD, 11.6+/-1.8 y) and 6 typically developing controls (11.6+/-1.6 y). Not applicable. Children performed simple lifting and force-matching static ramp tasks by way of both unimanual and bimanual pulling using a device that measures grip force (force acting perpendicularly at the digits-device contact area) and load force (tangential force). Main outcome measures were grip/load force ratios (grip force scaling) and correlation coefficients (force coupling). CP subjects showed significantly higher grip/load force ratios (P<.05) and slightly lower correlation coefficients than the control group, with more pronounced differences for most tasks when using their involved hand. For subjects with CP, switching from unimanual to bimanual conditions did not bring changes in scaling or coupling for the involved hand (P>.05). Compared with healthy children, the impaired hand function in the hemiplegic CP pediatric population could be reflected in excessive grip force that is also decoupled from ongoing changes in load force. Therefore, the bimanual grip load device used in this study could provide a sensitive measure of grip force coordination in CP, although nonmotor deficits should be taken into account when asking children to perform more complex tasks.

  15. 77 FR 3241 - Intent To Hold North Dakota Task Force Meeting as Established by the Missouri River Protection...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-23

    ... duties of the Task Force are to prepare and approve a plan for the use of the funds made available under... of the Task Force are to prepare and approve a plan for the use of the funds made available under... Force Meeting as Established by the Missouri River Protection and Improvement Act of 2000 (Title VII...

  16. Cost-Effectiveness of Deep Brain Stimulation for Advanced Parkinson's Disease in the United States.

    PubMed

    Pietzsch, Jan B; Garner, Abigail M; Marks, William J

    2016-10-01

    Deep brain stimulation (DBS), which uses an implantable device to modulate brain activity, is clinically superior to medical therapy for treating advanced Parkinson's disease (PD). We studied the cost-effectiveness of DBS in conjunction with medical therapy compared to best medical therapy (BMT) alone, using the latest clinical and cost data for the U.S. healthcare system. We used a decision-analytic state-transition (Markov) model to project PD progression and associated costs for the two treatment strategies. We estimated the discounted incremental cost-effectiveness ratio (ICER) in U.S. dollars per quality-adjusted life-year (QALY) from the Medicare payer perspective, considering a ten-year horizon, and evaluated the robustness of our projections through extensive deterministic sensitivity analyses. Over ten years, DBS treatment led to discounted total costs of $130,510 compared to $91,026 for BMT and added 1.69 QALYs more than BMT, resulting in an ICER of $23,404 per QALY. This ICER was relatively insensitive to variations in input parameters, with neurostimulator replacement, costs for DBS implantation, and costs for treatment of disease-related falls having the greatest effects. Across all investigated scenarios, including a five-year horizon, ICERs remained under $50,000 per QALY. Longer follow-up periods and younger treatment age were associated with greater cost-effectiveness. DBS is a cost-effective treatment strategy for advanced PD in the U.S. healthcare system across a wide range of assumptions. DBS yields substantial improvements in health-related quality of life at a value profile that compares favorably to other well-accepted therapies. © 2016 International Neuromodulation Society.

  17. Higher CD3(+) and CD34(+) cell doses in the graft increase the incidence of acute GVHD in children receiving BMT for thalassemia.

    PubMed

    Gaziev, J; Isgrò, A; Marziali, M; Daniele, N; Gallucci, C; Sodani, P; Simone, M D; Adorno, G; Paciaroni, K; Andreani, M; Lanti, A; Del Proposto, G; Testi, M; De Angelis, G; Roveda, A; Alfieri, C; Saltarelli, F; Lucarelli, G

    2012-01-01

    We evaluated the incidence of GVHD, risk factors and the impact of graft composition on acute GVHD (aGVHD) in 92 children who underwent BMT for thalassemia following busulfan/cyclophosphamide (BUCY)-based conditioning regimens and GVHD prophylaxis with CSA/short-MTX and methylprednisolone. The incidence of grade 2-4 and 3-4 aGVHD was 35% (95% confidence interval (CI) 25-44) and 9% (95% CI 4-16), respectively. We found that CD3(+) and CD34(+) cell doses above the median were associated with high incidence of grade 2-4 aGVHD (49 vs 20%, P=0.005 and 46 vs 23%, P=0.021, respectively). In multivariate analysis, high CD3(+) (hazard ratio (HR) 4.6; 95% CI 1.4-14.7; P=0.010) and CD34(+) (HR 4.3; 95% CI 1.4-12.7; P=0.011) cell doses were associated with grade 2-4 aGVHD. We further examined the effect of CD3(+) and CD34(+) cell doses on aGVHD using quartile cutoff points and found a minimum threshold for CD3(+) (38 × 10(6)/kg) and CD34(+) (4 × 10(6)/kg) cells above which the incidence of grade 2-4 aGVHD is significantly increased. This study shows for the first time a positive correlation between the number of CD3(+) and CD34(+) cells and aGVHD in children receiving sibling BMT, and indicates that using tailored and more intensive post transplant immunosuppression may permit to better control aGVHD.

  18. Variation in caries treatment proposals among dentists in Norway: the best interest of the child.

    PubMed

    Rønneberg, A; Skaare, A B; Hofmann, B; Espelid, I

    2017-10-01

    To explore variation in treatment-related-decisions for severe caries in children among dentists in the Public Dental Service (PDS) in Norway. It was also to evaluate the treatment choices in relation to the best interest of children and a child's rights to enjoy the highest standard of health care. A pre-coded questionnaire was sent electronically to all general dental practitioners (GDPs) working in the PDS in eight counties in Norway (n = 611). The questionnaire included two case scenarios to reflect common dental conditions related to severe caries among 5-year-old children. Paediatric dentists and paediatric students were invited to validate the different treatment options. Frequency distributions and statistical analyses were carried out using Chi square statistics. The response rate was 65% (n = 391) among the GDPs. A majority of the GDPs preferred a new appointment with behaviour management techniques (BMT) to a child presenting pulpitis and pain. Dentists educated outside the Nordic region would use restraint more often as a treatment alternative when the child was in pain than Nordic-educated dentists (p\\0.05). Dentists with less than 10 years of experience preferred BMT and sedation more often when the child was in pain than their older colleagues, who, however, preferred a waiting approach and no immediate treatment if the child was not in pain(p\\0.05) [corrected]. Use of BMT and sedation is related to region of education and years of experience. Awareness of ethical principles with the child´s best interest in mind, should receive increased attention.

  19. 75 FR 33838 - NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (10-065)] NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration announces a meeting of the Ad-Hoc Task Force on...

  20. 75 FR 15742 - NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-30

    ... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice: (10-035)] NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration announces a meeting of the Ad-Hoc Task Force on...

  1. Honeywell's Working Parents Task Force. Final Report and Recommendations.

    ERIC Educational Resources Information Center

    Honeywell, Inc., Minneapolis, Minn.

    This publication provides a summary of the Honeywell Working Parent Task Force's recommendations on how to solve problems experienced by working parents. The Task Force consisted of three committees: the Employment Practices Committee (EPC); the Parent Education Committee (PEC); and the Child Care Facilities Committee (CCFC). After examining a…

  2. 77 FR 71471 - Interagency Task Force on Veterans Small Business Development; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-30

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development; Notice of Meeting AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency... agenda for its public meeting of the Interagency Task Force on Veterans Small Business Development. The...

  3. 75 FR 34439 - Defense Science Board Task Force on Nuclear Treaty Monitoring and Verification

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ... DEPARTMENT OF DEFENSE Office of the Secretary Defense Science Board Task Force on Nuclear Treaty... meetings. SUMMARY: The Defense Science Board Task Force on Nuclear Treaty Monitoring and Verification will... Applications International Corporation, 4001 North Fairfax Drive, Suite 300, Arlington, VA. FOR FURTHER...

  4. 76 FR 70913 - Retrospective Review Under Executive Order 13579

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... Fukushima Task Force Report. DATES: November 16, 2011. ADDRESSES: You can access publicly available... Enhancing Reactor Safety in the 21st Century: The Near-Term Task Force Review of Insights from the Fukushima Dai-ichi Accident'' (Fukushima Task Force Report, ML111861807), was issued. The Commission has...

  5. 76 FR 55394 - Meeting of the Task Force on Community Preventive Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the...), Department of Health and Human Services (HHS). ACTION: Notice of meeting. SUMMARY: The Centers for Disease... (Task Force). The Task Force--an independent, nonfederal body of nationally known leaders in public...

  6. 76 FR 4115 - Meeting of the Task Force on Community Preventive Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the...), Department of Health and Human Services (HHS). ACTION: Notice of meeting. SUMMARY: The Centers for Disease... (Task Force). The Task Force--an independent, nonfederal body of nationally known leaders in public...

  7. 75 FR 63846 - Meeting of the Task Force on Community Preventive Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the...), Department of Health and Human Services (HHS). ACTION: Notice of meeting. SUMMARY: The Centers for Disease... (Task Force). The Task Force is an independent, nonfederal body of nationally known leaders in public...

  8. 75 FR 48929 - Notice of Meeting of the Agricultural Air Quality Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-12

    ... Agricultural Air Quality Task Force AGENCY: Natural Resources Conservation Service (NRCS), United States... Triangle Park, North Carolina 27711; (919) 541-5400. The Agricultural Air Quality Task Force (AAQTF) will meet to continue discussions on air quality issues relating to agriculture. Additionally, the Livestock...

  9. NASA replanning efforts continue

    NASA Astrophysics Data System (ADS)

    Katzoff, Judith A.

    A task force of the National Aeronautics and Space Administration (NASA) is producing new launch schedules for NASA's three remaining space shuttle orbiters, possibly supplemented by expendable launch vehicles. In the wake of the explosion of the space shuttle Challenger on January 28, 1986, the task force is assuming a delay of 12-18 months before resumption of shuttle flights.NASA's Headquarters Replanning Task Force, which meets daily, is separate from the agency's Data and Design Analysis Task Force, which collects and analyzes information about the accident for the use of the investigative commission appointed by President Ronald Reagan.

  10. Report of NASA Lunar Energy Enterprise Case Study Task Force

    NASA Technical Reports Server (NTRS)

    Kearney, John J.

    1989-01-01

    The Lunar Energy Enterprise Case Study Task Force was asked to determine the economic viability and commercial potential of mining and extracting He-3 from the lunar soil, and transporting the material to Earth for use in a power-generating fusion reactor. Two other space energy projects, the Space Power Station (SPS) and the Lunar Power Station (LPS), were also reviewed because of several interrelated aspects of these projects. The specific findings of the Task Force are presented. Appendices contain related papers generated by individual Task Force Members.

  11. 14th International Congress on Antiphospholipid Antibodies Task Force Report on Catastrophic Antiphospholipid Syndrome.

    PubMed

    Cervera, Ricard; Rodríguez-Pintó, Ignasi; Colafrancesco, Serena; Conti, Fabrizio; Valesini, Guido; Rosário, Cristina; Agmon-Levin, Nancy; Shoenfeld, Yehuda; Ferrão, Claudia; Faria, Raquel; Vasconcelos, Carlos; Signorelli, Flavio; Espinosa, Gerard

    2014-07-01

    The 'Task Force on Catastrophic Antiphospholipid Syndrome (CAPS)' was developed on the occasion of the 14th International Congress on Antiphospholipid Antibodies. The objectives of this Task Force were to assess the current knowledge on pathogenesis, clinical and laboratory features, diagnosis and classification, precipitating factors and treatment of this condition in order to address recommendations for future research. This article summarizes the studies analyzed by the Task Force, its recommendations and the future research agenda. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Fitts’ Law in the Control of Isometric Grip Force With Naturalistic Targets

    PubMed Central

    Thumser, Zachary C.; Slifkin, Andrew B.; Beckler, Dylan T.; Marasco, Paul D.

    2018-01-01

    Fitts’ law models the relationship between amplitude, precision, and speed of rapid movements. It is widely used to quantify performance in pointing tasks, study human-computer interaction, and generally to understand perceptual-motor information processes, including research to model performance in isometric force production tasks. Applying Fitts’ law to an isometric grip force task would allow for quantifying grasp performance in rehabilitative medicine and may aid research on prosthetic control and design. We examined whether Fitts’ law would hold when participants attempted to accurately produce their intended force output while grasping a manipulandum when presented with images of various everyday objects (we termed this the implicit task). Although our main interest was the implicit task, to benchmark it and establish validity, we examined performance against a more standard visual feedback condition via a digital force-feedback meter on a video monitor (explicit task). Next, we progressed from visual force feedback with force meter targets to the same targets without visual force feedback (operating largely on feedforward control with tactile feedback). This provided an opportunity to see if Fitts’ law would hold without vision, and allowed us to progress toward the more naturalistic implicit task (which does not include visual feedback). Finally, we changed the nature of the targets from requiring explicit force values presented as arrows on a force-feedback meter (explicit targets) to the more naturalistic and intuitive target forces implied by images of objects (implicit targets). With visual force feedback the relation between task difficulty and the time to produce the target grip force was predicted by Fitts’ law (average r2 = 0.82). Without vision, average grip force scaled accurately although force variability was insensitive to the target presented. In contrast, images of everyday objects generated more reliable grip forces without the visualized force meter. In sum, population means were well-described by Fitts’ law for explicit targets with vision (r2 = 0.96) and implicit targets (r2 = 0.89), but not as well-described for explicit targets without vision (r2 = 0.54). Implicit targets should provide a realistic see-object-squeeze-object test using Fitts’ law to quantify the relative speed-accuracy relationship of any given grasper. PMID:29773999

  13. Neuropsychological changes following deep brain stimulation surgery for Parkinson's disease: comparisons of treatment at pallidal and subthalamic targets versus best medical therapy.

    PubMed

    Rothlind, Johannes C; York, Michele K; Carlson, Kim; Luo, Ping; Marks, William J; Weaver, Frances M; Stern, Matthew; Follett, Kenneth; Reda, Domenic

    2015-06-01

    Deep brain stimulation (DBS) improves motor symptoms in Parkinson's disease (PD), but questions remain regarding neuropsychological decrements sometimes associated with this treatment, including rates of statistically and clinically meaningful change, and whether there are differences in outcome related to surgical target. Neuropsychological functioning was assessed in patients with Parkinson's disease (PD) at baseline and after 6 months in a prospective, randomised, controlled study comparing best medical therapy (BMT, n=116) and bilateral deep brain stimulation (DBS, n=164) at either the subthalamic nucleus (STN, n=84) or globus pallidus interna (GPi, n=80), using standardised neuropsychological tests. Measures of functional outcomes were also administered. Comparison of the two DBS targets revealed few significant group differences. STN DBS was associated with greater mean reductions on some measures of processing speed, only one of which was statistically significant in comparison with stimulation of GPi. GPi DBS was associated with lower mean performance on one measure of learning and memory that requires mental control and cognitive flexibility. Compared to the group receiving BMT, the combined DBS group had significantly greater mean reductions at 6-month follow-up in performance on multiple measures of processing speed and working memory. After calculating thresholds for statistically reliable change from data obtained from the BMT group, the combined DBS group also displayed higher rates of decline in neuropsychological test performance. Among study completers, 18 (11%) study participants receiving DBS displayed reliable decline by multiple indicators in two or more cognitive domains, a significantly higher rate than in the BMT group (3%). This multi-domain cognitive decline was associated with less beneficial change in subjective ratings of everyday functioning and quality of life (QOL). The multi-domain cognitive decline group continued to function at a lower level at 24-month follow-up. In those with PD, the likelihood of significant decline in neuropsychological functioning increases with DBS, affecting a small minority of patients who also appear to respond less optimally to DBS by other indicators of QOL. NCT00056563 and NCT01076452. 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.

  14. Influence of recombinant human granulocyte colony-stimulating factor (filgrastim) on hematopoietic recovery and outcome following allogeneic bone marrow transplantation (BMT) from volunteer unrelated donors.

    PubMed

    Berger, C; Bertz, H; Schmoor, C; Behringer, D; Potthoff, K; Mertelsmann, R; Finke, J

    1999-05-01

    Effects of recombinant human granulocyte colony-stimulating factor (rhG-CSF, filgrastim) on hematopoietic recovery and clinical outcome in patients undergoing allogeneic bone marrow transplantation (BMT) from volunteer unrelated donors (VUD) were analyzed retrospectively. Additionally, the influence of baseline patient and transplant characteristics on hematopoietic recovery was evaluated. From January 1994 to March 1996, 47 consecutive adult patients received VUD-BMT. GVHD prophylaxis was cyclosporin A/short course methotrexate/prednisolone, and in four patients additional ATG. Post-transplantation, cohorts of patients received rhG-CSF (5 microg/kg/day) (n = 22) or no rhG-CSF (n = 25) in a non-randomized manner. The patient groups with and without rhG-CSF were rather comparable with respect to baseline patient and transplant characteristics. Median time to neutrophil counts (ANC) >500/microl was 14 days with rhG-CSF vs 16 days without rhG-CSF (P = 0.048), to ANC >1000/microl was 15 vs 18 days (P = 0.084). Neutrophil recovery was accelerated in patients receiving more than the median MNC dose of 2.54 x 10(8)/kg with a median time to ANC >1000/microl of 13 days vs 19 days (P = 0.017). RhG-CSF did not influence platelet recovery and incidence of infectious complications. Incidence of acute GVHD II-IV was 50% with rhG-CSF and 28% without rhG-CSF (P = 0.144), but death before acute GVHD II-IV occurred in 9% of patients with and 20% of patients without rhG-CSF. The median follow-up time was 38 and 36 months in patients with and without rhG-CSF, respectively. Survival at 2 years post-transplant was 39% (95% confidence interval (18%, 60%)) in patients with rhG-CSF and 24% (95% confidence interval (7%, 41%)) in patients without rhG-CSF. Administration of rhG-CSF after VUD-BMT may lead to more rapid neutrophil recovery, but did not influence the incidence of infectious complications. Patients receiving rhG-CSF showed a slightly higher incidence of acute GVHD II-IV. Higher numbers of MNC in the marrow graft accelerated hematopoietic engraftment.

  15. Covert face recognition in congenital prosopagnosia: a group study.

    PubMed

    Rivolta, Davide; Palermo, Romina; Schmalzl, Laura; Coltheart, Max

    2012-03-01

    Even though people with congenital prosopagnosia (CP) never develop a normal ability to "overtly" recognize faces, some individuals show indices of "covert" (or implicit) face recognition. The aim of this study was to demonstrate covert face recognition in CP when participants could not overtly recognize the faces. Eleven people with CP completed three tasks assessing their overt face recognition ability, and three tasks assessing their "covert" face recognition: a Forced choice familiarity task, a Forced choice cued task, and a Priming task. Evidence of covert recognition was observed with the Forced choice familiarity task, but not the Priming task. In addition, we propose that the Forced choice cued task does not measure covert processing as such, but instead "provoked-overt" recognition. Our study clearly shows that people with CP demonstrate covert recognition for faces that they cannot overtly recognize, and that behavioural tasks vary in their sensitivity to detect covert recognition in CP. Copyright © 2011 Elsevier Srl. All rights reserved.

  16. Report of the Fermilab ILC Citizens' Task Force

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

    None

    Fermi National Accelerator Laboratory convened the ILC Citizens' Task Force to provide guidance and advice to the laboratory to ensure that community concerns and ideas are included in all public aspects of planning and design for a proposed future accelerator, the International Linear Collider. In this report, the members of the Task Force describe the process they used to gather and analyze information on all aspects of the proposed accelerator and its potential location at Fermilab in northern Illinois. They present the conclusions and recommendations they reached as a result of the learning process and their subsequent discussions and deliberations.more » While the Task Force was charged to provide guidance on the ILC, it became clear during the process that the high cost of the proposed accelerator made a near-term start for the project at Fermilab unlikely. Nevertheless, based on a year of extensive learning and dialogue, the Task Force developed a series of recommendations for Fermilab to consider as the laboratory develops all successor projects to the Tevatron. The Task Force recognizes that bringing a next-generation particle physics project to Fermilab will require both a large international effort and the support of the local community. While the Task Force developed its recommendations in response to the parameters of a future ILC, the principles they set forth apply directly to any large project that may be conceived at Fermilab, or at other laboratories, in the future. With this report, the Task Force fulfills its task of guiding Fermilab from the perspective of the local community on how to move forward with a large-scale project while building positive relationships with surrounding communities. The report summarizes the benefits, concerns and potential impacts of bringing a large-scale scientific project to northern Illinois.« less

  17. Status Report on Activities of the Systems Assessment Task Force, OECD-NEA Expert Group on Accident Tolerant Fuels for LWRs

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

    Bragg-Sitton, Shannon Michelle

    The Organization for Economic Cooperation and Development /Nuclear Energy Agency (OECD/NEA) Nuclear Science Committee approved the formation of an Expert Group on Accident Tolerant Fuel (ATF) for LWRs (EGATFL) in 2014. Chaired by Kemal Pasamehmetoglu, INL Associate Laboratory Director for Nuclear Science and Technology, the mandate for the EGATFL defines work under three task forces: (1) Systems Assessment, (2) Cladding and Core Materials, and (3) Fuel Concepts. Scope for the Systems Assessment task force includes definition of evaluation metrics for ATF, technology readiness level definition, definition of illustrative scenarios for ATF evaluation, parametric studies, and selection of system codes. Themore » Cladding and Core Materials and Fuel Concepts task forces will identify gaps and needs for modeling and experimental demonstration; define key properties of interest; identify the data necessary to perform concept evaluation under normal conditions and illustrative scenarios; identify available infrastructure (internationally) to support experimental needs; and make recommendations on priorities. Where possible, considering proprietary and other export restrictions (e.g., International Traffic in Arms Regulations), the Expert Group will facilitate the sharing of data and lessons learned across the international group membership. The Systems Assessment Task Force is chaired by Shannon Bragg-Sitton (INL), while the Cladding Task Force will be chaired by a representative from France (Marie Moatti, Electricite de France [EdF]) and the Fuels Task Force will be chaired by a representative from Japan (Masaki Kurata, Japan Atomic Energy Agency [JAEA]). This report provides an overview of the Systems Assessment Task Force charter and status of work accomplishment.« less

  18. Increased reaction times and reduced response preparation already starts at middle age

    PubMed Central

    Wolkorte, Ria; Kamphuis, Janine; Zijdewind, Inge

    2014-01-01

    Generalized slowing characterizes aging and there is some evidence to suggest that this slowing already starts at midlife. This study aims to assess reaction time changes while performing a concurrent low-force and high-force motor task in young and middle-aged subjects. The high-force motor task is designed to induce muscle fatigue and thereby progressively increase the attentional demands. Twenty-five young (20–30 years, 12 males) and 16 middle-aged (35–55 years, 9 males) adults performed an auditory two-choice reaction time task (CRT) with and without a concurrent low- or high-force motor task. The CRT required subjects to respond to two different stimuli that occurred with a probability of 70 or 30%. The motor task consisted of index finger abduction, at either 10% (10%-dual-task) or 30% (30%-dual-task) of maximal voluntary force. Cognitive task performance was measured as percentage of correct responses and reaction times. Middle-aged subjects responded slower on the frequent but more accurately on the infrequent stimuli of CRT than young subjects. Both young and middle-aged subjects showed increased errors and reaction times while performing under dual-task conditions and both outcome measures increased further under fatiguing conditions. Only under 30%-dual-task demands, an age-effect on dual-task performance was present. Both single- and dual-task conditions showed that already at mid-life response preparation is seriously declined and that subjects implement different strategies to perform a CRT task. PMID:24808862

  19. TASK FORCE REPORT ON ASSESSMENT AND EVALUATION.

    ERIC Educational Resources Information Center

    MORRIS, ROBERT

    THE TASK FORCE ON ASSESSMENT AND EVALUATION HAS BEEN CHARGED TO RECOMMEND THE MOST EFFECTIVE MEANS FOR ASSESSING AND EVALUATING THE SHORT-TERM ACTIVITIES AND THE LONG-TERM ACHIEVEMENTS OF ACTION FOR BOSTON COMMUNITY DEVELOPMENT. THE GENERAL OBJECTIVES OF THE TASK FORCE ARE--THE ANALYSIS OF DATA RELEVANT FOR EVALUATING DAY-BY-DAY DECISION-MAKING,…

  20. Inter-Association Task Force Report on Image.

    ERIC Educational Resources Information Center

    Special Libraries Association, Washington, DC.

    In 1988, the Board of Directors of the Special Libraries Association provided funding to a task force to gather data which would determine how certain segments of society perceive librarians, how librarians view themselves and their colleagues, and to provide recommendations for addressing the issue of image. The task force project consisted of…

  1. Report of the Social Studies Task Force.

    ERIC Educational Resources Information Center

    Gathman, John; And Others

    In 1982 the Colorado Board of Education directed the State Board of Education to organize task forces to address a variety of state educational needs. This report, presented by the Social Studies Task Force, explains the group's purposes and concerns, provides a social studies definition, and outlines the Colorado grades K-12 social studies…

  2. Human Health Effects, Task Force Assessment, Preliminary Report.

    ERIC Educational Resources Information Center

    Aronow, Wilbert S.; And Others

    Presented in this preliminary report is one of seven assessments conducted by a special task force of Project Clean Air, the Human Health Effects Task Force. The reports summarize assessments of the state of knowledge on various air pollution problems, particularly in California, and make tentative recommendations as to what the University of…

  3. Report of the Task Force on School Health.

    ERIC Educational Resources Information Center

    Maryland State Dept. of Health and Mental Hygiene, Baltimore.

    The 1990 Report of the Task Force on School Health examines the current status of Maryland's school health programs and proposes 16 recommendations designed to implement a comprehensive school health (CSH) program to meet the needs of all students. The report describes the Task Force, which was appointed in 1989. After presenting a background on…

  4. A Status Report from the Task Force on Marketing Research.

    ERIC Educational Resources Information Center

    Keim, William A.; And Others

    Concerned with changes in enrollment and credit hour patterns, the chancellor of the Kansas City Metropolitan Community Colleges (MCC) created a special Task Force to consider recommendations for marketing strategies for the 1978-79 academic year. The Task Force reviewed regional and district demography, area population trends and density, age and…

  5. Task Force on Education Funding Equity, Accountability, and Partnerships. Final Report.

    ERIC Educational Resources Information Center

    Maryland State Dept. of Legislative Services, Annapolis.

    In 1997, Maryland formed the Task Force on Education Funding Equity, Accountability, and Partnerships. The group made a comprehensive review of education funding and programs in grades K-12 to ensure that students throughout Maryland have an equal opportunity for academic success. The task force's final report features the membership roster, the…

  6. 75 FR 43943 - Defense Science Board; Task Force on Nuclear Treaty Monitoring and Verification

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-27

    ... DEPARTMENT OF DEFENSE Office of the Secretary Defense Science Board; Task Force on Nuclear Treaty... meetings. SUMMARY: The Defense Science Board Task Force on Nuclear Treaty Monitoring and Verification will... held September 13-14, and 25-26, 2010. ADDRESSES: The meetings will be held at Science Applications...

  7. 76 FR 69296 - Proposed Models for Plant-Specific Adoption of Technical Specifications Task Force Traveler TSTF...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-08

    ... Adoption of Technical Specifications Task Force Traveler TSTF-500, Revision 2, ``DC Electrical Rewrite... Technical Specifications Task Force (TSTF) Traveler TSTF-500, Revision 2, ``DC Electrical Rewrite--Update to... Reactor Systems Engineer, Technical Specifications Branch, Mail Stop: O-7 C2A, Division of Inspection and...

  8. 28 CFR 16.105 - Exemption of Foreign Terrorist Tracking Task Force System.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Exemption of Foreign Terrorist Tracking Task Force System. 16.105 Section 16.105 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR... of Foreign Terrorist Tracking Task Force System. (a) The following system of records is exempt from 5...

  9. 26 CFR 54.9815-2713T - Coverage of preventive health services (temporary).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... the current recommendations of the United States Preventive Services Task Force with respect to the... States Preventive Services Task Force with respect to the individual. The provider bills the plan for an... A or B in the current recommendations of the United States Preventive Services Task Force with...

  10. National Task Force on Student Aid Problems. Final Report.

    ERIC Educational Resources Information Center

    1975

    This document presents a full discussion of the activities, findings, and recommendations of the National Task Force on Student Aid Problems. The task force was a voluntary association of concerned and interested agencies and organizations. Its only standing came from the support of those directly concerned with student aid problems. By design and…

  11. Task Force on Education Funding Equity, Accountability, and Partnerships. Preliminary Report.

    ERIC Educational Resources Information Center

    Maryland State Dept. of Legislative Services, Annapolis.

    In 1997, Maryland formed the Task Force on Education Funding Equity, Accountability, and Partnerships to ensure that students throughout Maryland have an equal opportunity for academic success. The Task Force's preliminary report features a comprehensive review of education funding and programs in grades K-12. The report presents membership and…

  12. 78 FR 44034 - Petition for Rulemaking Submitted by the Natural Resources Defense Council, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-23

    ... the Fukushima Dai-ichi Accident,'' (Fukushima Task Force Report, ADAMS Accession No. ML111861807..., pages 43-46, of the Fukushima Task Force Report, which discusses the enhancement of spent fuel pool... Commission was still in the process of reviewing the Fukushima Task Force Report, and the NRC did not...

  13. Initial Report of the Task Force on Cultural Competence Education in the Health Sciences

    ERIC Educational Resources Information Center

    New Mexico Higher Education Department, 2007

    2007-01-01

    This report summarizes the findings and recommendations of the Task Force on Cultural Competence Education and represents the distillation of the Task Force's efforts to fulfill its legislative charge. The report is intended to facilitate a statewide conversation about the health services provided to New Mexico's multicultural citizenry. It…

  14. 75 FR 30002 - Federal Advisory Committee; Defense Task Force on Sexual Assault in the Military Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... DEPARTMENT OF DEFENSE Office of the Secretary Federal Advisory Committee; Defense Task Force on Sexual Assault in the Military Services AGENCY: Department of Defense (DoD). ACTION: Termination of... Department of Defense gives notice that it is terminating the Defense Task Force on Sexual Assault in the...

  15. Convergence, Competition, Cooperation: The Report of the Governor's Blue Ribbon Telecommunications Infrastructure Task Force. Volume One.

    ERIC Educational Resources Information Center

    Wisconsin Governor's Office, Madison.

    This report by the Blue Ribbon Task Force on Wisconsin's Telecommunications Infrastructure considers infrastructure to be the common network that connects individual residences, businesses, and agencies, rather than the individual systems and equipment themselves. The task force recognizes that advances in telecommunications technologies and…

  16. The Washington State Task Force on Student Transportation Safety. Final Report.

    ERIC Educational Resources Information Center

    Washington State Legislature, Olympia.

    Findings of a study conducted by the Washington State Task Force on Student Transportation Safety are presented in this report. The data-collection process involved four phases: meetings with experts in student transportation and pedestrian safety; public meetings, informational work sessions, and tours of problems areas; task force meetings; and…

  17. Youth Employment. Final Recommendations of the State Superintendent's Task Force.

    ERIC Educational Resources Information Center

    Wisconsin State Dept. of Public Instruction, Madison.

    This report contains the final recommendations of the task force on youth employment for the state of Wisconsin. The task force was specifically charged with studying issues related to working teenagers, reviewing existing laws and regulations on child labor, and developing recommendations to ensure that when teenagers work, their jobs do not…

  18. 78 FR 10636 - Task Force on Research on Violence Against American Indian and Alaska Native Women; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... DEPARTMENT OF JUSTICE Task Force on Research on Violence Against American Indian and Alaska Native Women; Meeting AGENCY: Office on Violence Against Women, United States Department of Justice. ACTION... public meeting of the Task Force on Research on Violence Against American Indian and Alaska Native Women...

  19. 32 CFR 700.1053 - Commander of a task force.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Commander of a task force. 700.1053 Section 700.1053 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY... Command Detail to Duty § 700.1053 Commander of a task force. (a) A geographic fleet commander, and any...

  20. 32 CFR 700.1053 - Commander of a task force.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Commander of a task force. 700.1053 Section 700.1053 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY... Command Detail to Duty § 700.1053 Commander of a task force. (a) A geographic fleet commander, and any...

  1. 32 CFR 700.1053 - Commander of a task force.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Commander of a task force. 700.1053 Section 700.1053 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY... Command Detail to Duty § 700.1053 Commander of a task force. (a) A geographic fleet commander, and any...

  2. 77 FR 59627 - Homeland Security Advisory Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-28

    ... purpose of reviewing and deliberating on recommendations by the HSAC's Cyber Skills Task Force. DATES: The.... The HSAC will meet to review and deliberate on the Cyber Skills Task Force report of findings and... details and the Cyber Skills Task Force report will be provided to interested members of the public at the...

  3. Report of the Task Force on Declining Enrollment. Third Revision.

    ERIC Educational Resources Information Center

    Highline Public Schools, Seattle, WA.

    The purpose of this task force was to study the program, facilities, and alternatives of the Highline School District as they relate to enrollment decline. Specifically, the task force was to establish criteria for identifying facilities where changes should be considered; identify and prioritize alternatives for use of excess classroom space; and…

  4. 77 FR 1913 - Notice of Meeting of the Agricultural Air Quality Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-12

    ... Conservation Service Notice of Meeting of the Agricultural Air Quality Task Force AGENCY: Natural Resources...), Agricultural Air Quality Task Force (AAQTF) will meet to continue discussions on critical air quality issues... relationship between agricultural production and air quality. The meeting is open to the public, and a draft...

  5. Status Report on Activities of the Systems Assessment Task Force, OECD-NEA Expert Group on Accident Tolerant Fuels for LWRs

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

    Bragg-Sitton, Shannon Michelle

    The Organization for Economic Cooperation and Development /Nuclear Energy Agency (OECD/NEA) Nuclear Science Committee approved the formation of an Expert Group on Accident Tolerant Fuel (ATF) for LWRs (EGATFL) in 2014. Chaired by Kemal Pasamehmetoglu, INL Associate Laboratory Director for Nuclear Science and Technology, the mandate for the EGATFL defines work under three task forces: (1) Systems Assessment, (2) Cladding and Core Materials, and (3) Fuel Concepts. Scope for the Systems Assessment task force (TF1) includes definition of evaluation metrics for ATF, technology readiness level definition, definition of illustrative scenarios for ATF evaluation, and identification of fuel performance and systemmore » codes applicable to ATF evaluation. The Cladding and Core Materials (TF2) and Fuel Concepts (TF3) task forces will identify gaps and needs for modeling and experimental demonstration; define key properties of interest; identify the data necessary to perform concept evaluation under normal conditions and illustrative scenarios; identify available infrastructure (internationally) to support experimental needs; and make recommendations on priorities. Where possible, considering proprietary and other export restrictions (e.g., International Traffic in Arms Regulations), the Expert Group will facilitate the sharing of data and lessons learned across the international group membership. The Systems Assessment task force is chaired by Shannon Bragg-Sitton (Idaho National Laboratory [INL], U.S.), the Cladding Task Force is chaired by Marie Moatti (Electricite de France [EdF], France), and the Fuels Task Force is chaired by a Masaki Kurata (Japan Atomic Energy Agency [JAEA], Japan). The original Expert Group mandate was established for June 2014 to June 2016. In April 2016 the Expert Group voted to extend the mandate one additional year to June 2017 in order to complete the task force deliverables; this request was subsequently approved by the Nuclear Science Committee. This report provides an update on the status Systems Assessment Task Force activities.« less

  6. Methods for estimating bicycling and walking in Washington state.

    DOT National Transportation Integrated Search

    2014-05-01

    This report presents the work performed in the first and second phases in the process of creating a method to : calculate Bicycle and Pedestrian Miles Traveled (BMT/PMT) for the state of Washington. First, we recommend : improvements to the existing ...

  7. NIH Blood and Marrow Transplant Late Effects Consensus Conference

    Cancer.gov

    This day and a half symposium will bring together experts in blood and marrow transplantation, late effects, and health care delivery to discuss current evidence and knowledge gaps, develop consensus guidelines, and inform future research in the BMT survivor population.

  8. Fifth Report of the NASA Advisory Council Task Force on the Shuttle-Mir Rendezvous and Docking Missions

    NASA Technical Reports Server (NTRS)

    1995-01-01

    The NASA Advisory Council Task Force on the Shuttle-Mir rendezvous and docking missions examine a number of specific issues related to the Shuttle-Mir program. Three teams composed of Task Force members and technical advisors were formed to address the follow issues: preliminary results from STS-71 and the status of preparations for STS-74; NASA's presence in Russia; and NASA's automated data processing and telecommunications (ADP/T) infrastructure in Russia. The three review team reports have been included in the fifth report of the Task Force.

  9. Enhanced Training by a Systemic Governance of Force Capabilities, Tasks, and Processes

    DTIC Science & Technology

    2013-06-01

    18th ICCRTS “C2 in Underdeveloped, Degraded and Denied Operational Environments” Enhanced Training by a Systemic Governance of Force Capabilities...TITLE AND SUBTITLE Enhanced Training by a Systemic Governance of Force Capabilities, Tasks, and Processes 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...assess, evaluate and accredit the Swedish forces. This paper presents a Systemic Governance of Capabilities, Tasks, and Processes applied to the

  10. Evaluation of pliers' grip spans in the maximum gripping task and sub-maximum cutting task.

    PubMed

    Kim, Dae-Min; Kong, Yong-Ku

    2016-12-01

    A total of 25 males participated to investigate the effects of the grip spans of pliers on the total grip force, individual finger forces and muscle activities in the maximum gripping task and wire-cutting tasks. In the maximum gripping task, results showed that the 50-mm grip span had significantly higher total grip strength than the other grip spans. In the cutting task, the 50-mm grip span also showed significantly higher grip strength than the 65-mm and 80-mm grip spans, whereas the muscle activities showed a higher value at 80-mm grip span. The ratios of cutting force to maximum grip strength were also investigated. Ratios of 30.3%, 31.3% and 41.3% were obtained by grip spans of 50-mm, 65-mm, and 80-mm, respectively. Thus, the 50-mm grip span for pliers might be recommended to provide maximum exertion in gripping tasks, as well as lower maximum-cutting force ratios in the cutting tasks.

  11. U.S. Preventive Services Task Force recommendations and cancer screening among female Medicare beneficiaries.

    PubMed

    Salloum, Ramzi G; Kohler, Racquel E; Jensen, Gail A; Sheridan, Stacey L; Carpenter, William R; Biddle, Andrea K

    2014-03-01

    Medicare covers several cancer screening tests not currently recommended by the U.S. Preventive Services Task Force (Task Force). In September 2002, the Task Force relaxed the upper age limit of 70 years for breast cancer screening recommendations, and in March 2003 an upper age limit of 65 years was introduced for cervical cancer screening recommendations. We assessed whether mammogram and Pap test utilization among women with Medicare coverage is influenced by changes in the Task Force's recommendations for screening. We identified female Medicare beneficiaries aged 66-80 years and used bivariate probit regression to examine the receipt of breast (mammogram) and cervical (Pap test) cancer screening reflecting changes in the Task Force recommendations. We analyzed 9,760 Medicare Current Beneficiary Survey responses from 2001 to 2007. More than two-thirds reported receiving a mammogram and more than one-third a Pap test in the previous 2 years. Lack of recommendation was given as a reason for not getting screened among the majority (51% for mammogram and 75% for Pap). After controlling for beneficiary-level socioeconomic characteristics and access to care factors, we did not observe a significant change in breast and cervical cancer screening patterns following the changes in Task Force recommendations. Although there is evidence that many Medicare beneficiaries adhere to screening guidelines, some women may be receiving non-recommended screening services covered by Medicare.

  12. Deficits in inhibitory force control in young adults with ADHD.

    PubMed

    Neely, Kristina A; Wang, Peiyuan; Chennavasin, Amanda P; Samimy, Shaadee; Tucker, Jacqueline; Merida, Andrea; Perez-Edgar, Koraly; Huang-Pollock, Cynthia

    2017-05-01

    Poor inhibitory control is a well-established cognitive correlate of adults with ADHD. However, the simple reaction time (RT) task used in a majority of studies records performance errors only via the presence or absence of a single key press. This all-or-nothing response makes it impossible to capture subtle differences in underlying processes that shape performance. Subsequently, all-or-nothing tasks may underestimate the prevalence of executive function deficits in ADHD. The current study measured inhibitory control using a standard Go/No-Go RT task and a more sensitive continuous grip force task among adults with (N=51, 22 female) and without (N=51, 29 female) ADHD. Compared to adults without ADHD, adults with ADHD made more failed inhibits in the classic Go/No-Go paradigm and produced greater and more variable force during motor inhibition. The amount of force produced on failed inhibits was a stronger predictor of ADHD-related symptoms than the number of commissions in the standard RT task. Adults with ADHD did not differ from those without ADHD on the mean force and variability of force produced in Go trials. These findings suggest that the use of a precise and continuous motor task, such as the force task used here, provides additional information about the nature of inhibitory motor control in adults with ADHD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Estimation of lumbar spinal loading and trunk muscle forces during asymmetric lifting tasks: application of whole-body musculoskeletal modelling in OpenSim.

    PubMed

    Kim, Hyun-Kyung; Zhang, Yanxin

    2017-04-01

    Large spinal compressive force combined with axial torsional shear force during asymmetric lifting tasks is highly associated with lower back injury (LBI). The aim of this study was to estimate lumbar spinal loading and muscle forces during symmetric lifting (SL) and asymmetric lifting (AL) tasks using a whole-body musculoskeletal modelling approach. Thirteen healthy males lifted loads of 7 and 12 kg under two lifting conditions (SL and AL). Kinematic data and ground reaction force data were collected and then processed by a whole-body musculoskeletal model. The results show AL produced a significantly higher peak lateral shear force as well as greater peak force of psoas major, quadratus lumborum, multifidus, iliocostalis lumborum pars lumborum, longissimus thoracis pars lumborum and external oblique than SL. The greater lateral shear forces combined with higher muscle force and asymmetrical muscle contractions may have the biomechanical mechanism responsible for the increased risk of LBI during AL. Practitioner Summary: Estimating lumbar spinal loading and muscle forces during free-dynamic asymmetric lifting tasks with a whole-body musculoskeletal modelling in OpenSim is the core value of this research. The results show that certain muscle groups are fundamentally responsible for asymmetric movement, thereby producing high lumbar spinal loading and muscle forces, which may increase risks of LBI during asymmetric lifting tasks.

  14. Finger Interdependence: Linking the Kinetic and Kinematic Variables

    PubMed Central

    Kim, Sun Wook; Shim, Jae Kun; Zatsiorsky, Vladimir M.; Latash, Mark L.

    2008-01-01

    We studied the dependence between voluntary motion of a finger and pressing forces produced by the tips of other fingers of the hand. Subjects moved one of the fingers (task finger) of the right hand trying to follow a cyclic, ramp-like flexion-extension template at different frequencies. The other fingers (slave fingers) were restricted from moving; their flexion forces were recorded and analyzed. Index finger motion caused the smallest force production by the slave fingers. Larger forces were produced by the neighbors of the task finger; these forces showed strong modulation over the range of motion of the task finger. The enslaved forces were higher during the flexion phase of the movement cycle as compared to the extension phase. The index of enslaving expressed in N/rad was higher when the task finger moved through the more flexed postures. The dependence of enslaving on both range and direction of task finger motion poses problems for methods of analysis of finger coordination based on an assumption of universal matrices of finger inter-dependence. PMID:18255182

  15. Report of the MLA Task Force on Evaluating Scholarship for Tenure and Promotion

    ERIC Educational Resources Information Center

    Modern Language Association, 2007

    2007-01-01

    In 2004 the Executive Council of the Modern Language Association of America (MLA) created a task force to examine current standards and emerging trends in publication requirements for tenure and promotion in English and foreign language departments in the United States. To fulfill its charge, the task force reviewed numerous studies, reports, and…

  16. Short-Circuiting the Bureaucracy: Policy Origins in Education.

    ERIC Educational Resources Information Center

    Graham, Hugh Davis

    The Great Society's secret task forces created by Lyndon Johnson, particularly in the case-study area of federal education policy, show the use and misuse of the task force device. Modern use of it began with John F. Kennedy. Although he used the task force device effectively sometimes, he did not use it effectively in his educational programs in…

  17. 77 FR 39724 - U.S. Coral Reef Task Force Public Meeting and Public Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    ...-DS61200000] U.S. Coral Reef Task Force Public Meeting and Public Comment AGENCY: Fish and Wildlife Service... Wildlife Service (Service), announce a public meeting of the U.S. Coral Reef Task Force (USCRTF) and a... strengthen U.S. government actions to better preserve and protect coral reef ecosystems. The Departments of...

  18. Idaho Rural Education Task Force. Public School Information. Legislative Report, 2008

    ERIC Educational Resources Information Center

    Idaho State Department of Education, 2008

    2008-01-01

    The Idaho Rural Education Task Force was formed in July 2007 with the goal of proposing and examining solutions to challenges facing rural schools. The task force's work this year has focused on three areas: recruitment and retention of highly qualified teachers, funding shortages related to insurance costs and staff allowances, and the technology…

  19. Lifelong Learning NCES Task Force: Final Report, Volume I. Working Paper Series.

    ERIC Educational Resources Information Center

    Binkley, Marilyn; Hudson, Lisa; Knepper, Paula; Kolstad, Andy; Stowe, Peter; Wirt, John

    In September 1998, the National Center for Education Statistics (NCES) established a 1-year task force to review the NCES's role concerning lifelong learning. The eight-member task force established a working definition of lifelong learning ("a process or system through which individuals are able and willing to learn at all stages of life,…

  20. Million Hearts 2022: Understanding the Links between Environmental Pollutant Exposure and Cardiovascular and Cerebrovascular Events - Justus-Warren Heart Disease and Stroke Prevention Task Force

    EPA Science Inventory

    The webinar was requested by the Justus-Warren Heart Disease and Stroke Prevention Task Force. From their website, “The task force was established in 1995 in North Carolina to provide statewide leadership for the prevention and management of cardiovascular disease. Meetings are...

  1. History and background of the California Oak Mortality Task Force (COMTF)

    Treesearch

    Mark R. Stanley

    2006-01-01

    The California Oak Mortality Task Force was formed in August 2000 as a consensus group to address the impacts caused by Phytophthora ramorum. It is over 1000 strong with over 80 agencies, universities, public, and private groups currently involved. The Task Force has been a tremendous success and may serve as model for other similar efforts.

  2. 77 FR 17534 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing of Proposed Rule...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-26

    ... Association (``SIFMA'') formed the MMI Blue-Sky Task Force (``Task Force'') to address systemic and unique... processing. The Task Force, along other money market industry members,\\8\\ determined that DTC's current MMI... amount or proceeds after the 3 p.m. E.T. deadline for RTP instructions.\\9\\ Accordingly, DTC is proposing...

  3. "Rekindle and Recapture the Love": Establishing System-Wide Indicators of Progress in Community Engagement and Economic Development

    ERIC Educational Resources Information Center

    Janke, Emily M.

    2014-01-01

    In May 2012, University of North Carolina (UNC) President Tom Ross simultaneously commissioned two task forces to develop indicators that all UNC campuses could use to measure "progress in community engagement and economic development." The charge to the Community Engagement Task Force and the Economic Development Task Force was to…

  4. 77 FR 16483 - Petition for Rulemaking Submitted by the Natural Resources Defense Council, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ... Enhancing Reactor Safety in the 21st Century: The Near-Term Task Force Review of Insights from the Fukushima Dai-ichi Accident'' (Fukushima Task Force Report, ADAMS Accession No. ML111861807), dated July 12..., of the Fukushima Task Force Report, regarding the enhancement of the ability of nuclear power plants...

  5. San Juan College Task Force on Innovation 1995 Report.

    ERIC Educational Resources Information Center

    Moore, Nelle

    In fall 1994, San Juan College, in New Mexico, established the Task Force on Innovation to examine changes in the paradigm of education and how those changes might affect the college. The Task Force determined that the primary driver of change in education was technology, and specifically the increasing number of means and ease of access to…

  6. Report of the Task Force on Continuing Education and Non-Credit Instruction.

    ERIC Educational Resources Information Center

    Ernest, Richard J.; And Others

    The Task Force on Continuing Education and Non-Credit Instruction was appointed to develop specific strategies for expanding lifelong learning and non-credit instruction in the Virginia community colleges. The task force reviewed a report on the state funding of non-credit instruction; wrote to the community college coordinating offices in 17…

  7. ACHP | News

    Science.gov Websites

    Search skip specific nav links Home arrow News arrow June 27, 2012 ACHP Rightsizing Task Force to Meet in Cleveland The ACHP's Rightsizing Task Force will be making a visit to Cleveland, Ohio, June 25-26 for a tour and a listening session and open meeting. The task force will host a public meeting on June 26 at

  8. Responding to Violence and Abuse: Educating Minnesota Professionals for the Future. A Report of the Statewide Task Forces.

    ERIC Educational Resources Information Center

    Minnesota Higher Education Center against Violence and Abuse, St. Paul.

    In response to a 1993 Minnesota crime bill, four task forces reviewed violence education in professional higher education programs and made recommendations for legislation and law enforcement. The four task forces--in Law, Health Services, Human Services, and Education--made several critical recommendations that applied across professions:…

  9. National Library of Education Advisory Task Force. Briefing Book.

    ERIC Educational Resources Information Center

    National Library of Education (ED/OERI), Washington, DC.

    This briefing book with appendices was prepared for the initial meetings of the National Library of Education Advisory Task Force (NLE/ATF), in March 1996. An agenda for this meeting is included in the briefing book. The first section, "Governing Authorities for NLE and the Advisory Task Force," contains a copy of Public Law 103-227,…

  10. Attainment and retention of force moderation following laparoscopic resection training with visual force feedback.

    PubMed

    Hernandez, Rafael; Onar-Thomas, Arzu; Travascio, Francesco; Asfour, Shihab

    2017-11-01

    Laparoscopic training with visual force feedback can lead to immediate improvements in force moderation. However, the long-term retention of this kind of learning and its potential decay are yet unclear. A laparoscopic resection task and force sensing apparatus were designed to assess the benefits of visual force feedback training. Twenty-two male university students with no previous experience in laparoscopy underwent relevant FLS proficiency training. Participants were randomly assigned to either a control or treatment group. Both groups trained on the task for 2 weeks as follows: initial baseline, sixteen training trials, and post-test immediately after. The treatment group had visual force feedback during training, whereas the control group did not. Participants then performed four weekly test trials to assess long-term retention of training. Outcomes recorded were maximum pulling and pushing forces, completion time, and rated task difficulty. Extreme maximum pulling force values were tapered throughout both the training and retention periods. Average maximum pushing forces were significantly lowered towards the end of training and during retention period. No significant decay of applied force learning was found during the 4-week retention period. Completion time and rated task difficulty were higher during training, but results indicate that the difference eventually fades during the retention period. Significant differences in aptitude across participants were found. Visual force feedback training improves on certain aspects of force moderation in a laparoscopic resection task. Results suggest that with enough training there is no significant decay of learning within the first month of the retention period. It is essential to account for differences in aptitude between individuals in this type of longitudinal research. This study shows how an inexpensive force measuring system can be used with an FLS Trainer System after some retrofitting. Surgical instructors can develop their own tasks and adjust force feedback levels accordingly.

  11. A teleoperation training simulator with visual and kinesthetic force virtual reality

    NASA Technical Reports Server (NTRS)

    Kim, Won S.; Schenker, Paul

    1992-01-01

    A force-reflecting teleoperation training simulator with a high-fidelity real-time graphics display has been developed for operator training. A novel feature of this simulator is that it enables the operator to feel contact forces and torques through a force-reflecting controller during the execution of the simulated peg-in-hole task, providing the operator with the feel of visual and kinesthetic force virtual reality. A peg-in-hole task is used in our simulated teleoperation trainer as a generic teleoperation task. A quasi-static analysis of a two-dimensional peg-in-hole task model has been extended to a three-dimensional model analysis to compute contact forces and torques for a virtual realization of kinesthetic force feedback. The simulator allows the user to specify force reflection gains and stiffness (compliance) values of the manipulator hand for both the three translational and the three rotational axes in Cartesian space. Three viewing modes are provided for graphics display: single view, two split views, and stereoscopic view.

  12. Improving child and adolescent psychiatry education for medical students: an inter-organizational collaborative action plan.

    PubMed

    Fox, Geraldine S; Stock, Saundra; Briscoe, Gregory W; Beck, Gary L; Horton, Rita; Hunt, Jeffrey I; Liu, Howard Y; Partner Rutter, Ashley; Sexson, Sandra; Schlozman, Steven C; Stubbe, Dorothy E; Stuber, Margaret L

    2012-11-01

    A new Child and Adolescent Psychiatry in Medical Education (CAPME) Task Force, sponsored by the Association for Directors of Medical Student Education in Psychiatry (ADMSEP), has created an inter-organizational partnership between child and adolescent psychiatry (CAP) educators and medical student educators in psychiatry. This paper outlines the task force design and strategic plan to address the long-standing dearth of CAP training for medical students. The CAPME ADMSEP Task Force, formed in 2010, identified common challenges to teaching CAP among ADMSEP's CAPME Task Force members, utilizing focus-group discussions and a needs-assessment survey. The Task Force was organized into five major sections, with inter-organizational action plans to address identified areas of need, such as portable modules and development of benchmark CAP competencies. The authors predict that all new physicians, regardless of specialty, will be better trained in CAP. Increased exposure may also improve recruitment into this underserved area.

  13. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma.

    PubMed

    Wells, Samuel A; Asa, Sylvia L; Dralle, Henning; Elisei, Rossella; Evans, Douglas B; Gagel, Robert F; Lee, Nancy; Machens, Andreas; Moley, Jeffrey F; Pacini, Furio; Raue, Friedhelm; Frank-Raue, Karin; Robinson, Bruce; Rosenthal, M Sara; Santoro, Massimo; Schlumberger, Martin; Shah, Manisha; Waguespack, Steven G

    2015-06-01

    The American Thyroid Association appointed a Task Force of experts to revise the original Medullary Thyroid Carcinoma: Management Guidelines of the American Thyroid Association. The Task Force identified relevant articles using a systematic PubMed search, supplemented with additional published materials, and then created evidence-based recommendations, which were set in categories using criteria adapted from the United States Preventive Services Task Force Agency for Healthcare Research and Quality. The original guidelines provided abundant source material and an excellent organizational structure that served as the basis for the current revised document. The revised guidelines are focused primarily on the diagnosis and treatment of patients with sporadic medullary thyroid carcinoma (MTC) and hereditary MTC. The Task Force developed 67 evidence-based recommendations to assist clinicians in the care of patients with MTC. The Task Force considers the recommendations to represent current, rational, and optimal medical practice.

  14. Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma

    PubMed Central

    Asa, Sylvia L.; Dralle, Henning; Elisei, Rossella; Evans, Douglas B.; Gagel, Robert F.; Lee, Nancy; Machens, Andreas; Moley, Jeffrey F.; Pacini, Furio; Raue, Friedhelm; Frank-Raue, Karin; Robinson, Bruce; Rosenthal, M. Sara; Santoro, Massimo; Schlumberger, Martin; Shah, Manisha; Waguespack, Steven G.

    2015-01-01

    Introduction: The American Thyroid Association appointed a Task Force of experts to revise the original Medullary Thyroid Carcinoma: Management Guidelines of the American Thyroid Association. Methods: The Task Force identified relevant articles using a systematic PubMed search, supplemented with additional published materials, and then created evidence-based recommendations, which were set in categories using criteria adapted from the United States Preventive Services Task Force Agency for Healthcare Research and Quality. The original guidelines provided abundant source material and an excellent organizational structure that served as the basis for the current revised document. Results: The revised guidelines are focused primarily on the diagnosis and treatment of patients with sporadic medullary thyroid carcinoma (MTC) and hereditary MTC. Conclusions: The Task Force developed 67 evidence-based recommendations to assist clinicians in the care of patients with MTC. The Task Force considers the recommendations to represent current, rational, and optimal medical practice. PMID:25810047

  15. International confederation for cleft lip and palate and related craniofacial anomalies task force report: holistic outcomes.

    PubMed

    Broder, Hillary L

    2014-11-01

    Objective : This paper describes the process and outcomes of the 2013 American Cleft Palate-Craniofacial Association task force on Holistic Outcomes. The goals and membership of the task force are presented. Methods : Using internet communication, the group introduced themselves, shared ideas and information related to holistic assessment and implementation of using a validated holistic measure, the Child Oral Health Impact Profile (COHIP) at participating international sites. Results : Data from the sites were analyzed using descriptive statistics. Administration of the COHIP was successful. It varied from self-completion as well as verbal presentation due to language differences and a function of the short time period to complete collection. Additionally qualitative comments were reported by the task force site directors. Conclusions : Future directions for holistic assessment and communication among task force members and sites were discussed at the Congress and are presented in this report.

  16. NASA's Big Data Task Force

    NASA Astrophysics Data System (ADS)

    Holmes, C. P.; Kinter, J. L.; Beebe, R. F.; Feigelson, E.; Hurlburt, N. E.; Mentzel, C.; Smith, G.; Tino, C.; Walker, R. J.

    2017-12-01

    Two years ago NASA established the Ad Hoc Big Data Task Force (BDTF - https://science.nasa.gov/science-committee/subcommittees/big-data-task-force), an advisory working group with the NASA Advisory Council system. The scope of the Task Force included all NASA Big Data programs, projects, missions, and activities. The Task Force focused on such topics as exploring the existing and planned evolution of NASA's science data cyber-infrastructure that supports broad access to data repositories for NASA Science Mission Directorate missions; best practices within NASA, other Federal agencies, private industry and research institutions; and Federal initiatives related to big data and data access. The BDTF has completed its two-year term and produced several recommendations plus four white papers for NASA's Science Mission Directorate. This presentation will discuss the activities and results of the TF including summaries of key points from its focused study topics. The paper serves as an introduction to the papers following in this ESSI session.

  17. A Model for Steering with Haptic-Force Guidance

    NASA Astrophysics Data System (ADS)

    Yang, Xing-Dong; Irani, Pourang; Boulanger, Pierre; Bischof, Walter F.

    Trajectory-based tasks are common in many applications and have been widely studied. Recently, researchers have shown that even very simple tasks, such as selecting items from cascading menus, can benefit from haptic-force guidance. Haptic guidance is also of significant value in many applications such as medical training, handwriting learning, and in applications requiring precise manipulations. There are, however, only very few guiding principles for selecting parameters that are best suited for proper force guiding. In this paper, we present a model, derived from the steering law that relates movement time to the essential components of a tunneling task in the presence of haptic-force guidance. Results of an experiment show that our model is highly accurate for predicting performance times in force-enhanced tunneling tasks.

  18. Results of telerobotic hand controller study using force information and rate control

    NASA Technical Reports Server (NTRS)

    Willshire, Kelli F.; Harrison, F. W.; Hogge, Edward F.; Williams, Robert L.; Soloway, Donald

    1992-01-01

    To increase quantified information about the effectiveness and subjective workload of force information relayed through manipulator input control devices, a space related task was performed by eight subjects with kinesthetic force feedback and/or local force accommodation through three different input control devices (i.e., hand controllers) operating in rate control mode. Task completion time, manipulator work, and subjective responses were measured. Results indicated a difference among the hand controllers. For the Honeywell six degree-of-freedom hand controller, the overall task completion times were shortest, the amount of work exerted was the least, and was the most preferred by test subjects. Neither force accommodation with or without reflection resulted in shorter task completion times or reduced work although those conditions were better than no force information for some aspects. Comparisons of results from previous studies are discussed.

  19. Problems and research issues associated with the hybrid control of force and displacement

    NASA Technical Reports Server (NTRS)

    Paul, R. P.

    1987-01-01

    The hybrid control of force and position is basic to the science of robotics but is only poorly understood. Before much progress can be made in robotics, this problem needs to be solved in a robust manner. However, the use of hybrid control implies the existence of a model of the environment, not an exact model (as the function of hybrid control is to accommodate these errors), but a model appropriate for planning and reasoning. The monitored forces in position control are interpreted in terms of a model of the task as are the monitored displacements in force control. The reaction forces of the task of writing are far different from those of hammering. The programming of actions in such a modeled world becomes more complicated and systems of task level programming need to be developed. Sensor based robotics, of which force sensing is the most basic, implies an entirely new level of technology. Indeed, robot force sensors, no matter how compliant they may be, must be protected from accidental collisions. This implies other sensors to monitor task execution and again the use of a world model. This new level of technology is the task level, in which task actions are specified, not the actions of individual sensors and manipulators.

  20. Quarterly Performance/Technical Report of the National Marrow Donor Program

    DTIC Science & Technology

    2011-01-28

    emergency notification system, the NMDP public announcement system, Government Emergency Telecommunications Service calling cards (GETS cards ), and the...Contract Audit Agency RCC Renal Cell Carcinoma DIY Do it yourself RCI BMT Resource for Clinical Investigations in Blood and Marrow Transplantation

  1. Identification of Occupational Areas for Indiana's Future. Final Report of the Technology Forecasting Task Force.

    ERIC Educational Resources Information Center

    Indiana State Commission on Vocational and Technical Education, Indianapolis.

    A task force representing the Indiana private sector was convened for two purposes: to (1) identify the impact of technology on required worker skills, the labor market, and the vocational education, training, and employment system; and (2) identify occupational areas that should be future growth areas for the state. Task force members reviewed…

  2. Task Force for Expanding Credit and Noncredit Courses for Students with Intellectual and Development Disabilities. Final Report

    ERIC Educational Resources Information Center

    Maryland Higher Education Commission, 2016

    2016-01-01

    The Task Force to Study the Impact of Expanding Credit and Noncredit Courses for Students with Intellectual and Developmental Disabilities was formed in July 2013. Chapter 392, Acts of 2013, (House Bill 813) established the Task Force to Study the Impact of Expanding Credit and Noncredit Courses for Students with Intellectual and Developmental…

  3. Arizona Community Colleges: Report of the Task Force on Community College Enrollment Growth Planning.

    ERIC Educational Resources Information Center

    Arizona State Board of Directors for Community Colleges, Phoenix.

    The Task Force on Enrollment Growth Planning (TFEGP), authorized in 1992 by the State Board of Directors for Community Colleges (SBDCC) of Arizona, includes representatives from each community college as well as staff from SBDCC office. The Task Force was created to prepare enrollment growth estimates for community colleges through the year 2010;…

  4. The Educational, Fiscal, and Access Implications of the Fall Academic Calendar. The Report of the Academic Calendar Task Force.

    ERIC Educational Resources Information Center

    Armstrong, William B.

    In 1991, California's San Diego Community College District (SDCCD) formed a task force to investigate the effects of adopting academic calendars that end either before or after the winter holidays. To gather information, the task force performed a grade distribution analysis among district college students to determine the impact of fall semester…

  5. Report of the Task Force to Explore Feasibility of a Three-Year Baccalaureate Program. Established March 1, 1972.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee.

    Presented in this document are the results of a Task Force study in Florida that explored the feasibility of a baccalaureate degree program that can be completed in 3 academic years. The Task Force addressed itself to the issues surrounding time-shortened degrees: acceleration; locksteps; relevancy of educational objectives to individual and…

  6. Report of the Task Force on the Status of Women at the University of California, Davis.

    ERIC Educational Resources Information Center

    Fisher, Kathleen M.

    The charge given to the Task Force on the Status of Women at the University of California, Davis, was to determine the employment opportunities for women on the Davis campus. The Task Force addressed itself primarily to 4 major employment categories: non-academic staff, academic staff, faculty, and administration, with lesser consideration given…

  7. A Report by the Governor's Task Force on Vocational and Technical Education.

    ERIC Educational Resources Information Center

    Governor's Task Force on Vocational and Technical Education, Columbus, OH.

    On July 19, 1968, a Task Force on Vocational and Technical Education was created by the governor of Ohio to develop proposals for organization, financing, and legislation. Some major problems to which the Task Force gave attention were: (1) the serious gap between the need for and the availability of vocational and technical education, (2) the…

  8. 76 FR 70067 - Taxpayers and Ratepayers United, et al.; Environmental Impacts of Severe Reactor and Spent Fuel...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-10

    ... environmental issues raised in the Fukushima Task Force Report. The NRC is not instituting a public comment... Reactor Safety in the 21st Century: The Near-Term Task Force Review of Insights from the Fukushima Dai-ichi Accident'' (Fukushima Task Force Report, ADAMS Accession No. ML111861807), dated July 12, 2011, as...

  9. 77 FR 30560 - Proposed Generic Communication; Generic Letter on Seismic Risk Evaluations for Operating Reactors

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-23

    ... the Fukushima Near-Term Task Force Recommendations 2.1 and 2.3. The request for information letters... addressing the Fukushima Near-Term Task Force Recommendations 2.1 and 2.3. The memorandum is available... Fukushima Near-Term Task Force Recommendations 2.1 and 2.3 (ADAMS Accession Number ML12056A046), as...

  10. The APA Task Force on Statistical Inference (TFSI) Report as a Framework for Teaching and Evaluating Students' Understandings of Study Validity.

    ERIC Educational Resources Information Center

    Thompson, Bruce

    Web-based statistical instruction, like all statistical instruction, ought to focus on teaching the essence of the research endeavor: the exercise of reflective judgment. Using the framework of the recent report of the American Psychological Association (APA) Task Force on Statistical Inference (Wilkinson and the APA Task Force on Statistical…

  11. Building Bridges to the Information Superhighway: Annual Report of the Disabilities Issues Task Force, Federal Communications Commission (March 1995--April 1996).

    ERIC Educational Resources Information Center

    Federal Communications Commission, Washington, DC.

    This report describes activities and accomplishments of the Federal Communications Commission's Disabilities Issues Task Force on disabilities issues from March 1995 through April 1996, its first year. Introductory material includes a message from the chairman of the Commission and a statement of the Task Force's purpose, which is to address…

  12. U. S. Atlantic Fleet, Task Force 85. Operation Plan Number 3-44

    DTIC Science & Technology

    1944-07-27

    Potential Targets in Sectors of Responsibility Gril /8thPhib/Al6-3 Serial: 0031(P) DEAN/14- Potential Targets in Se_otors t of Respon- sibility...tags accompany the remains, ANNEX QUEEN MEDICAL PLAN - Page 6 of 8 GrIl /8thPhib/Al6-3 WESTERN NAVAL TASK FORCE, Serial: 0037(P) TASK FORCE EIGHTY-FIVE

  13. Credentialing Educational Accomplishment. Report and Recommendations of the Task Force on Educational Credit and Credentials.

    ERIC Educational Resources Information Center

    Miller, Jerry W., Ed.; Mills, Olive, Ed.

    The Task Force on Educational Credit and Credentials of the American Council on Education undertook a two-year study to determine how postsecondary education's system for awarding credit and credentials can be changed or its adequacy improved to meet today's educational and social needs. This book sets forth the Task Force's report and…

  14. Tomorrow. The Report of the Task Force for the Study of Chemistry Education in the United States.

    ERIC Educational Resources Information Center

    American Chemical Society, Washington, DC.

    An American Chemical Society (ACS) task force was charged to examine the state of chemistry education in the United States and to make recommendations in light of its findings. This document presents the task force's report and 39 major (and also secondary) recommendations. These recommendations, with accompanying discussions, focus on: (1)…

  15. User-Centered Design Groups to Engage Patients and Caregivers with a Personalized Health Information Technology Tool.

    PubMed

    Maher, Molly; Kaziunas, Elizabeth; Ackerman, Mark; Derry, Holly; Forringer, Rachel; Miller, Kristen; O'Reilly, Dennis; An, Larry C; Tewari, Muneesh; Hanauer, David A; Choi, Sung Won

    2016-02-01

    Health information technology (IT) has opened exciting avenues for capturing, delivering and sharing data, and offers the potential to develop cost-effective, patient-focused applications. In recent years, there has been a proliferation of health IT applications such as outpatient portals. Rigorous evaluation is fundamental to ensure effectiveness and sustainability, as resistance to more widespread adoption of outpatient portals may be due to lack of user friendliness. Health IT applications that integrate with the existing electronic health record and present information in a condensed, user-friendly format could improve coordination of care and communication. Importantly, these applications should be developed systematically with appropriate methodological design and testing to ensure usefulness, adoption, and sustainability. Based on our prior work that identified numerous information needs and challenges of HCT, we developed an experimental prototype of a health IT tool, the BMT Roadmap. Our goal was to develop a tool that could be used in the real-world, daily practice of HCT patients and caregivers (users) in the inpatient setting. Herein, we examined the views, needs, and wants of users in the design and development process of the BMT Roadmap through user-centered Design Groups. Three important themes emerged: 1) perception of core features as beneficial (views), 2) alerting the design team to potential issues with the user interface (needs); and 3) providing a deeper understanding of the user experience in terms of wider psychosocial requirements (wants). These findings resulted in changes that led to an improved, functional BMT Roadmap product, which will be tested as an intervention in the pediatric HCT population in the fall of 2015 (ClinicalTrials.govNCT02409121). Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  16. Immune transfer studies in canine allogeneic marrow graft donor-recipient pairs

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

    Grosse-Wilde, H.; Krumbacher, K.; Schuening, F.D.

    1986-07-01

    Transfer of immunity occurring with bone marrow grafting was studied using the dog as a preclinical model. Allogeneic bone marrow transplantation (BMT) was performed between DLA-identical beagle litter-mates. The donors were immunized with tetanus toxoid (TT) or sheep red blood cells (SRBC), and their humoral response was monitored by hemagglutination. The recipients of bone marrow from TT-immunized donors showed a marked increase of antibody titer one week posttransplantation, while in the recipients of marrow from SRBC immunized donors the antibody titers were considerably lower. Within the following 60 days the antibody titers in both groups diminished gradually to pregrafting levels.more » Control experiments in which cell-free plasma from donors immunized with TT and SRBC respectively was transfused indicated that the initial rise of specific antibody titers after marrow grafting is likely to be due to a passive transfer of humoral immunity. A single challenge of these marrow graft recipients with the respective antigen 15-18 weeks posttransplantation led to a secondary type of humoral immune response. It could be demonstrated that transfer of memory against TT or SRBC was independent from the actual antibody titer and the time of vaccination of the donor. One dog was immunized with TT after serving as marrow donor. When the donor had shown an antibody response, a peripheral blood leukocytes (PBL) transfusion was given to his chimera. Subsequent challenge of the latter resulted in a secondary type of specific antibody response. This indicates that specific cellular-bound immunological memory can be transferred after BMT from the donor to his allogeneic bone marrow chimera by transfusion of peripheral blood leukocytes. The data may be of importance in clinical BMT to protect patients during the phase of reduced immune reactivity by transfer of memory cells.« less

  17. Optimal Outcomes in Young Class 3 Patients With Thalassemia Undergoing HLA-Identical Sibling Bone Marrow Transplantation.

    PubMed

    Gaziev, Javid; Isgrò, Antonella; Sodani, Pietro; Marziali, Marco; Paciaroni, Katia; Gallucci, Cristiano; De Angelis, Gioia; Andreani, Marco; Testi, Manuela; Alfieri, Cecilia; Ribersani, Michela; Galluccio, Tiziana; Battarra, Maria Rosa; Morrone, Aldo; Lucarelli, Guido

    2016-04-01

    Bone marrow transplantation (BMT) for class 3 patients with thalassemia is challenging due to high rates of graft rejection and transplant-related mortality. Since the first studies of BMT in the late 1980s, a number of conditioning regimens have been designed to improve outcomes, but with suboptimal results. Here we report the outcome of transplantation in class 3 patients using a modified protocol. Sixty-three patients between 5 and 16.7 years of age with class 3 thalassemia received HLA-matched sibling BMT following either the original protocol (26 patients) or the modified protocol (37 patients). Both regimens comprised preconditioning cytoreduction with hydroxyurea and azathioprine starting at -45 days pretransplant, and fludarabine from days -16 to -12. Conditioning was performed with busulfan and cyclophosphamide (original protocol) or with busulfan, thiotepa, and cyclophosphamide (modified protocol). The 2 groups showed similar patient demographics. At day 0, the degree of cytoreduction (lymphopenia, neuthropenia, and thrombocytopenia) achieved by the modified protocol was greater than the original protocol. The incidence of graft failure/rejection was significantly higher in the original group (15%; 95% confidence interval [95% CI], 5-32%) compared with the modified group (0%) (P = 0.014). The respective 5-year thalassemia-free survival rates were 73% (95% CI, 51-86%) and 92% (95% CI, 77-97%) (P = 0.047). Both groups showed similar incidences of grades II to IV acute graft-versus host disease. Modified protocol did not increase nonhematological toxicity or infectious complications. The modified treatment protocol effectively and safely prevented graft failure/rejection and significantly increased thalassemia-free survival of class 3 patients with thalassemia.

  18. Polarized type 2 alloreactive CD4+ and CD8+ donor T cells fail to induce experimental acute graft-versus-host disease.

    PubMed

    Krenger, W; Snyder, K M; Byon, J C; Falzarano, G; Ferrara, J L

    1995-07-15

    Acute graft-vs-host disease (GVHD) is thought to be mediated by alloreactive T cells with a type 1 cytokine phenotype. To prevent the development of acute GVHD, we have successfully polarized mature donor T cells toward a type 2 cytokine phenotype ex-vivo by incubating them with murine rIL-4 in a primary MLC. Polarized type 2 T cells were then transplanted with T cell-depleted bone marrow cells into irradiated recipients across either MHC class II (bm12-->C57BL/6) or class I (bm1-->C57BL/6) barriers, and the intensity of GVHD was measured by assessment of several in vitro and in vivo parameters. The injection of polarized type 2 T cells abrogated the mitogen-induced production of IFN-gamma by splenocytes from transplanted hosts on day 13 after bone marrow transplantation (BMT). Injection of polarized type 2 T cells failed to induce secretion of the effector phase cytokine TNF-alpha by splenocytes stimulated with LPS both in vitro and in vivo, and survival of transplanted mice after i.v. injection with LPS was significantly improved. Furthermore, cell-mixing experiments revealed that polarized type 2 T cells were able to inhibit type 1 cytokine responses induced by naive T cells after BMT. These data demonstrate that both polarized CD4+ and CD8+ type 2 alloreactive donor T cells can be generated in vitro from mature T cell populations. These cells function in vivo to inhibit type 1 T cell responses, and such inhibition attenuates the systemic morbidity of GVHD after BMT across both MHC class II or class I barriers in mice.

  19. Effect of art making on cancer-related symptoms of blood and marrow transplantation recipients.

    PubMed

    Lawson, Lisa Mische; Williams, Phoebe; Glennon, Cathy; Carithers, Kendall; Schnabel, Erin; Andrejack, Amy; Wright, Nicole

    2012-07-01

    To examine whether a one-hour art-making session during blood and marrow transplantation (BMT) treatment significantly affects therapy-related symptoms, state anxiety, and stress. A pre- and post-test crossover design. An urban outpatient cancer center in the midwestern United States. A convenience sample of 20 patients, aged 20-68 years (X = 38.5), receiving treatment at a BMT clinic. Participants completed a demographic questionnaire, the Therapy-Related Symptom Checklist, and the Spielberger State-Trait Anxiety Index, and provided salivary cortisol samples. After pretesting, individuals were assigned to either a wait list or intervention. Individuals in the wait-list group received the usual treatment before completing the post-test measures. Individuals in the intervention group participated in a one-hour art-making session, after which they completed post-test measures. Participants then crossed over to the other group. Art making, stress, state anxiety, and therapy-related symptoms. Therapy-related symptom concerns for the intervention group at post-test were significantly lower than at pretest; no change ocurred in the control group. The salivary cortisol levels were significantly lower at post-test in the intervention and control groups. No change occurred in the anxiety levels of participants in the intervention and control groups. The study hypothesis was partially supported. Art making decreased therapy-related symptoms (e.g., feeling sluggish, difficulty concentrating). Use of more physiologic indices to measure stress and replication on a larger sample are suggested. Individuals receiving BMT may benefit from participation in art-making interventions. Art making is easy to implement in a clinic setting and allows for positive interactions between nurses and patients.

  20. Variations in water temperature and implications for trout populations in the Upper Schoharie Creek and West Kill, New York, USA

    USGS Publications Warehouse

    George, Scott D.; Baldigo, Barry P.; Smith, Martyn J.; Mckeown, Donald M; Faulringer, Jason

    2016-01-01

    Water temperature is a key component of aquatic ecosystems because it plays a pivotal role in determining the suitability of stream and river habitat to most freshwater fish species. Continuous temperature loggers and airborne thermal infrared (TIR) remote sensing were used to assess temporal and spatial temperature patterns on the Upper Schoharie Creek and West Kill in the Catskill Mountains, New York, USA. Specific objectives were to characterize (1) contemporary thermal conditions, (2) temporal and spatial variations in stressful water temperatures, and (3) the availability of thermal refuges. In-stream loggers collected data from October 2010 to October 2012 and showed summer water temperatures exceeded the 1-day and 7-day thermal tolerance limits for trout survival at five of the seven study sites during both summers. Results of the 7 August 2012 TIR indicated there was little thermal refuge at the time of the flight. About 690,170 m2 of water surface area were mapped on the Upper Schoharie, yet only 0.009% (59 m2) was more than 1.0 °C below the median water surface temperature (BMT) at the thalweg and no areas were more than 2.0 °C BMT. On the West Kill, 79,098 m2 were mapped and 0.085% (67 m2) and 0.018% (14 m2) were BMT by 1 and 2 °C, respectively. These results indicate that summer temperatures in the majority of the study area are stressful for trout and may adversely affect growth and survival. Validation studies are needed to confirm the expectation that resident trout are in poor condition or absent from the downstream portion of the study area during warm-water periods.

  1. Blockade of p38 Mitogen-Activated Protein Kinase Inhibits Murine Sclerodermatous Chronic Graft-versus-Host Disease.

    PubMed

    Matsushita, Takashi; Date, Mutsumi; Kano, Miyu; Mizumaki, Kie; Tennichi, Momoko; Kobayashi, Tadahiro; Hamaguchi, Yasuhito; Hasegawa, Minoru; Fujimoto, Manabu; Takehara, Kazuhiko

    2017-04-01

    Bone marrow transplantation (BMT) of B10.D2 mice into sublethally irradiated BALB/c mice across minor histocompatibility loci is a well-established animal model for human sclerodermatous chronic graft-versus-host disease (Scl-cGVHD) and systemic sclerosis (SSc). The p38 mitogen-activated protein kinase (MAPK) pathway is a key regulator of inflammation and cytokine production. Furthermore, the activation of p38 MAPK plays an important role in collagen production in SSc. We investigated the effects of p38 MAPK inhibitor, VX-702, on Scl-cGVHD mice. VX-702 was orally administered to Scl-cGVHD mice from day 7 to 35 after BMT. We compared skin fibrosis of Scl-cGVHD mice between the VX-702-treated group and control group. Allogeneic BMT increased the phosphorylation of p38 MAPK in the skin. The administration of VX-702 attenuated the skin fibrosis of Scl-cGVHD compared to the control mice. Immunohistochemical staining showed that VX-702 suppressed the infiltration of CD4 + T cells, CD8 + T cells, and CD11b + cells into the dermis of Scl-cGVHD mice compared to the control mice. VX-702 attenuated the mRNA expression of extracellular matrix and fibrogenic cytokines, such as IL-6 and IL-13, in the skin of Scl-cGVHD mice. In addition, VX-702 directly inhibited collagen production from fibroblasts in vitro. VX-702 was shown to be a promising candidate for use in treating patients with Scl-cGVHD and SSc. Copyright © 2017 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  2. Zn(1-x)Cu(x)O (0.02 ≤ x ≤ 0.1) Nanomaterials Prepared by Ball Milling, Citrate Sol Gel, and Molten Salt Flux Methods.

    PubMed

    Balamurugan, S; Melba, K

    2015-06-01

    The Cu doped ZnO, (Zn(1-x)Cu(x))O (x = 0.02, 0.04, 0.06, 0.08, and 0.1) nanomaterials were prepared by ball milling technique (BMT), citrate sol gel (CSG), and molten salt flux (MSF) methods. The various as-prepared (Zn(1-x)Cu(x))O materials were analyzed by powder X-ray diffraction (pXRD), FT-IR, and SEM-EDX measurements in order to check the phase formation, purity, surface morphology and elements present in the annealed materials. Due to the preparation methods as well as doping of 'x' slight variations in cell parameters are seen. The average crystalline size of CSG method shows smaller size (25-35 nm) than BMT and MSF approaches. The materials obtained by MSF technique reveal the average crystalline size in the range of 32-72 nm whereas the BMT materials exhibit 36-50 nm for the composition, 0.02 ≤ x ≤ 0.1. The presence of functional groups and the chemical bonding in (Zn(1-x)Cu(x))O system is confirmed through FT-IR measurements. It is evident from the FT-IR data that bands seen at 400-500 cm(-1) are characteristics of M-O (M = metal ion) bonding in the studied materials. The micro images observed by SEM exhibiting polycrystalline character as compared with the crystallite size obtained from XRD. Among the three approaches employed in the present investigations, in terms of average particle size the CSG method may be concluded as an efficient method for the preparation of Zn(1-x)Cu(x)O nanomaterials.

  3. Comparison of Characteristics and Outcomes of Trial Participants and Nonparticipants: Example of Blood and Marrow Transplant Clinical Trials Network 0201 Trial.

    PubMed

    Khera, Nandita; Majhail, Navneet S; Brazauskas, Ruta; Wang, Zhiwei; He, Naya; Aljurf, Mahmoud D; Akpek, Görgün; Atsuta, Yoshiko; Beattie, Sara; Bredeson, Christopher N; Burns, Linda J; Dalal, Jignesh D; Freytes, César O; Gupta, Vikas; Inamoto, Yoshihiro; Lazarus, Hillard M; LeMaistre, Charles F; Steinberg, Amir; Szwajcer, David; Wingard, John R; Wirk, Baldeep; Wood, William A; Joffe, Steven; Hahn, Theresa E; Loberiza, Fausto R; Anasetti, Claudio; Horowitz, Mary M; Lee, Stephanie J

    2015-10-01

    Controversy surrounds the question of whether clinical trial participants have better outcomes than comparable patients who are not treated on a trial. We explored this question using a recent large, randomized, multicenter study comparing peripheral blood (PB) with bone marrow transplantation from unrelated donors, conducted by the Blood and Marrow Transplant Clinical Trials Network (BMT CTN). We compared characteristics and outcomes of study participants (n = 494) and nonparticipants (n = 1384) who appeared eligible and received similar treatment without enrolling on the BMT CTN trial at participating centers during the study time period. Data were obtained from the Center for International Blood and Marrow Transplant Research. Outcomes were compared between the 2 groups using Cox proportional hazards regression models. No significant differences in age, sex, disease distribution, race/ethnicity, HLA matching, comorbidities, and interval from diagnosis to hematopoietic cell transplantation were seen between the participants and nonparticipants. Nonparticipants were more likely to have lower performance status, lower risk disease, and older donors, and to receive myeloablative conditioning and antithymocyte globulin. Nonparticipants were also more likely to receive PB grafts, the intervention tested in the trial (66% versus 50%, P < .001). Overall survival, transplantation-related mortality, and incidences of acute or chronic graft-versus-host disease were comparable between the 2 groups though relapse was higher (hazard ratio, 1.22; 95% confidence interval, 1.02 to 1.46; P = .028) in nonparticipants. Despite differences in certain baseline characteristics, survival was comparable between study participants and nonparticipants. The results of the BMT CTN trial appear generalizable to the population of trial-eligible patients. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  4. Dentists' use of behavioural management techniques and their attitudes towards treating paediatric patients with dental anxiety.

    PubMed

    Strøm, Kjetil; Rønneberg, Anne; Skaare, Anne B; Espelid, Ivar; Willumsen, Tiril

    2015-08-01

    The purpose of this study was to explore the relationship between dentists' education in treatment of dental anxiety (DA), dentists' attitudes towards patients with DA and dentists' use of BMT. An anonymous questionnaire was sent electronically to 611 dentists in the Public Dental Service in Norway. Statistical evaluation was done using cross tabulation with Chi square and logistic regression analyses. The response rate was 65 % (n = 391). About half of the respondents (53 %, n = 208) had followed postgraduate courses in treating patients with DA. The following were the most common attitudes towards treating young patients with DA: it feels like making a contribution (72 %, n = 286), it is difficult or tiresome (54 %, n = 215) and it is a positive challenge (51 %, n = 203). Dentists who had taken postgraduate courses in DA more often reported anxious patients as a positive challenge (60 vs. 42 %, p < 0.001) and were less reluctant to treat these patients (5 vs. 15 %, p = 0.002). The most frequently used BMT was tell-show-do (87 %, n = 340), followed by relaxation (35 %, n = 132), distraction (25 %, n = 94), systematic cognitive behaviour therapy (22 %, n = 84) and conscious sedation (18 %, n = 69). Dentists without postgraduate courses in DA used fewer techniques when treating these patients (OR 2.1, 95 % CI 1.3-3.3, p = 0.001) compared with dentists who had taken these courses. Country of graduation and postgraduate courses in DA had a strong relationship with dentists' use of BMT and dentists' attitudes towards young patients with DA.

  5. Enslaving in a serial chain: interactions between grip force and hand force in isometric tasks.

    PubMed

    Paclet, Florent; Ambike, Satyajit; Zatsiorsky, Vladimir M; Latash, Mark L

    2014-03-01

    This study was motivated by the double action of extrinsic hand muscles that produce grip force and also contribute to wrist torque. We explored interactions between grip force and wrist torque in isometric force production tasks. In particular, we tested a hypothesis that an intentional change in one of the two kinetic variables would produce an unintentional change in the other (enslaving). When young healthy subjects produced accurate changes in the grip force, only minor effects on the force produced by the hand (by wrist flexion/extension action) were observed. In contrast, a change in the hand force produced consistent changes in grip force in the same direction. The magnitude of such unintentional grip force change was stronger for intentional hand force decrease as compared to hand force increase. These effects increased with the magnitude of the initial grip force. When the subjects were asked to produce accurate total force computed as the sum of the hand and grip forces, strong negative covariation between the two forces was seen across trials interpreted as a synergy stabilizing the total force. An index of this synergy was higher in the space of "modes," hypothetical signals to the two effectors that could be changed by the controller one at a time. We interpret the complex enslaving effects (positive force covariation) as conditioned by typical everyday tasks. The presence of synergic effects (negative, task-specific force covariation) can be naturally interpreted within the referent configuration hypothesis.

  6. Enslaving in a serial chain: Interactions between grip force and hand force in isometric tasks

    PubMed Central

    Paclet, Florent; Ambike, Satyajit; Zatsiorsky, Vladimir M.; Latash, Mark L.

    2014-01-01

    This study was motivated by the double action of extrinsic hand muscles that produce grip force and also contribute to wrist torque. We explored interactions between grip force and wrist torque in isometric force production tasks. In particular, we tested a hypothesis that an intentional change in one of the two kinetic variables would produce an unintentional change in the other (enslaving). When young healthy subjects produced accurate changes in the grip force, only minor effects on the force produced by the hand (by wrist flexion/extension action) were observed. In contrast, a change in the hand force produced consistent changes in grip force in the same direction. The magnitude of such unintentional grip force change was stronger for intentional hand force decrease as compared to hand force increase. These effects increased with the magnitude of the initial grip force. When the subjects were asked to produce accurate total force computed as the sum of the hand and grip forces, strong negative co-variation between the two forces was seen across trials interpreted as a synergy stabilizing the total force. An index of this synergy was higher in the space of “modes”, hypothetical signals to the two effectors that could be changed by the controller one at a time. We interpret the complex enslaving effects (positive force co-variation) as conditioned by typical everyday tasks. The presence of synergic effects (negative, task-specific force co-variation) can be naturally interpreted within the referent configuration hypothesis. PMID:24309747

  7. The interaction of force and repetition on musculoskeletal and neural tissue responses and sensorimotor behavior in a rat model of work-related musculoskeletal disorders

    PubMed Central

    2013-01-01

    Background We examined the relationship of musculoskeletal risk factors underlying force and repetition on tissue responses in an operant rat model of repetitive reaching and pulling, and if force x repetition interactions were present, indicative of a fatigue failure process. We examined exposure-dependent changes in biochemical, morphological and sensorimotor responses occurring with repeated performance of a handle-pulling task for 12 weeks at one of four repetition and force levels: 1) low repetition with low force, 2) high repetition with low force, 3) low repetition with high force, and 4) high repetition with high force (HRHF). Methods Rats underwent initial training for 4–6 weeks, and then performed one of the tasks for 12 weeks, 2 hours/day, 3 days/week. Reflexive grip strength and sensitivity to touch were assayed as functional outcomes. Flexor digitorum muscles and tendons, forelimb bones, and serum were assayed using ELISA for indicators of inflammation, tissue stress and repair, and bone turnover. Histomorphometry was used to assay macrophage infiltration of tissues, spinal cord substance P changes, and tissue adaptative or degradative changes. MicroCT was used to assay bones for changes in bone quality. Results Several force x repetition interactions were observed for: muscle IL-1alpha and bone IL-1beta; serum TNFalpha, IL-1alpha, and IL-1beta; muscle HSP72, a tissue stress and repair protein; histomorphological evidence of tendon and cartilage degradation; serum biomarkers of bone degradation (CTXI) and bone formation (osteocalcin); and morphological evidence of bone adaptation versus resorption. In most cases, performance of the HRHF task induced the greatest tissue degenerative changes, while performance of moderate level tasks induced bone adaptation and a suggestion of muscle adaptation. Both high force tasks induced median nerve macrophage infiltration, spinal cord sensitization (increased substance P), grip strength declines and forepaw mechanical allodynia by task week 12. Conclusions Although not consistent in all tissues, we found several significant interactions between the critical musculoskeletal risk factors of force and repetition, consistent with a fatigue failure process in musculoskeletal tissues. Prolonged performance of HRHF tasks exhibited significantly increased risk for musculoskeletal disorders, while performance of moderate level tasks exhibited adaptation to task demands. PMID:24156755

  8. The interaction of force and repetition on musculoskeletal and neural tissue responses and sensorimotor behavior in a rat model of work-related musculoskeletal disorders.

    PubMed

    Barbe, Mary F; Gallagher, Sean; Massicotte, Vicky S; Tytell, Michael; Popoff, Steven N; Barr-Gillespie, Ann E

    2013-10-25

    We examined the relationship of musculoskeletal risk factors underlying force and repetition on tissue responses in an operant rat model of repetitive reaching and pulling, and if force x repetition interactions were present, indicative of a fatigue failure process. We examined exposure-dependent changes in biochemical, morphological and sensorimotor responses occurring with repeated performance of a handle-pulling task for 12 weeks at one of four repetition and force levels: 1) low repetition with low force, 2) high repetition with low force, 3) low repetition with high force, and 4) high repetition with high force (HRHF). Rats underwent initial training for 4-6 weeks, and then performed one of the tasks for 12 weeks, 2 hours/day, 3 days/week. Reflexive grip strength and sensitivity to touch were assayed as functional outcomes. Flexor digitorum muscles and tendons, forelimb bones, and serum were assayed using ELISA for indicators of inflammation, tissue stress and repair, and bone turnover. Histomorphometry was used to assay macrophage infiltration of tissues, spinal cord substance P changes, and tissue adaptative or degradative changes. MicroCT was used to assay bones for changes in bone quality. Several force x repetition interactions were observed for: muscle IL-1alpha and bone IL-1beta; serum TNFalpha, IL-1alpha, and IL-1beta; muscle HSP72, a tissue stress and repair protein; histomorphological evidence of tendon and cartilage degradation; serum biomarkers of bone degradation (CTXI) and bone formation (osteocalcin); and morphological evidence of bone adaptation versus resorption. In most cases, performance of the HRHF task induced the greatest tissue degenerative changes, while performance of moderate level tasks induced bone adaptation and a suggestion of muscle adaptation. Both high force tasks induced median nerve macrophage infiltration, spinal cord sensitization (increased substance P), grip strength declines and forepaw mechanical allodynia by task week 12. Although not consistent in all tissues, we found several significant interactions between the critical musculoskeletal risk factors of force and repetition, consistent with a fatigue failure process in musculoskeletal tissues. Prolonged performance of HRHF tasks exhibited significantly increased risk for musculoskeletal disorders, while performance of moderate level tasks exhibited adaptation to task demands.

  9. [Autobiographical memory of depressed patients].

    PubMed

    Yao, Shuqiao; Liu, Xianhua; Zhao, Weifeng; Yang, Wenhui; Tan, Furong

    2010-07-01

    To explore the autobiographical memory characteristics in depressed patients and their influence factors. Autobiographical memory, emotion and cognitive executive function of 60 depressed patients and 60 healthy controls were assessed with autobiographical memory test (AMT), Hamilton depression scale (HAMD), Beck depression inventory (BDI), Beck anxiety inventory (BAI), hospital anxiety and depression scale (HAD), arrow-task stroop test (ATST), Wisconsin card sorting test (WCST), Backward masking test (BMT) and continuous performance test (CPT). The specific memory of the depressed group was significantly less than that of the control group, and was negatively related with the negative emotion score, the time of anterograde and retrograde reading of ATST, and the time difference of ATST. The overgeneral memory increased and the latency to response of ATST was significantly longer than that of the control group. The two factors were positively related with the negative emotion score, the time of anterograde and retrograde reading of ATST, and the time difference of ATST. The autobiographical memory of the depressed patients is overgeneralized and retarded. These characteristics are related with negative emotion and impairment of cognitive executive function.

  10. Learning to combine high variability with high precision: lack of transfer to a different task.

    PubMed

    Wu, Yen-Hsun; Truglio, Thomas S; Zatsiorsky, Vladimir M; Latash, Mark L

    2015-01-01

    The authors studied effects of practicing a 4-finger accurate force production task on multifinger coordination quantified within the uncontrolled manifold hypothesis. During practice, task instability was modified by changing visual feedback gain based on accuracy of performance. The authors also explored the retention of these effects, and their transfer to a prehensile task. Subjects practiced the force production task for 2 days. After the practice, total force variability decreased and performance became more accurate. In contrast, variance of finger forces showed a tendency to increase during the first practice session while in the space of finger modes (hypothetical commands to fingers) the increase was under the significance level. These effects were retained for 2 weeks. No transfer of these effects to the prehensile task was seen, suggesting high specificity of coordination changes. The retention of practice effects without transfer to a different task suggests that further studies on a more practical method of improving coordination are needed.

  11. Finding the Balance Between Schoolhouse and On-the-Job Training

    DTIC Science & Technology

    2007-01-01

    military training [BMT] to 3-level award1 for mission-ready airmen). Specifically, we examined seven specialties: Airborne Crypto - logic Linguist (Air...sup- port and interfaces with other units. Performs and assists in mission planning. Maintains publications and currency items. Maintains and

  12. Lead-free Bi(Mg0.5Ti0.5)O3-modified 0.875Bi0.5Na0.5TiO3-0.125BaTiO3 ferroelectric ceramics with tetragonal structure and large field-induced strains

    NASA Astrophysics Data System (ADS)

    Li, Ling; Zhu, Mankang; Ren, Xiaowei; Wei, Qiumei; Zheng, Mupeng; Hou, Yudong

    2017-12-01

    A electrostrictive ceramics were designed by introducing Bi(Mg0.5Ti0.5)O3 into 0.875Bi0.5Na0.5TiO3-0.125BaTiO3 with tetragonal structure. All the specimens prepared by a conventional solid sintering technique exhibit the excellent sintering ability with a high relative density over 97%. It is found that, as BMT added, the specimens undergo a structure crossover from ferroelectric P4mm to ergodic P4bm, and the coexistence of both tetragonal structures takes bridge between them. A large field-induced strain of 0.30% and field-independent strain coefficient of 0.0254 m4/C2 occur at 4 mol.% BMT added. This material with excellent sinterability is suitable for the application in actuators and microposition controllers.

  13. Evidence for Management of Carotid Artery Stenosis

    PubMed Central

    YOSHIDA, Kazumichi; MIYAMOTO, Susumu

    2015-01-01

    In this review, we presented the evidence concerning carotid artery stenosis treatment in symptomatic stenosis and asymptomatic stenosis separately, and discussed the future challenges. The validity of carotid endarterectomy (CEA) to treat moderate or greater degree of symptomatic carotid artery stenosis appears to be established. Due to the additional option of carotid artery stenting (CAS), it is necessary to comprehensively determine whether CEA or CAS is more appropriate for each individual patient. Moreover, since there are rapid advancements in devices for CAS and improvements in treatment outcomes, continual learning of the latest treatment method is essential. For asymptomatic stenosis, due to improvements in the outcomes with best medical treatment (BMT), it is essential to re-evaluate the use of invasive CEA/CAS. Continual verification of the latest randomized clinical trial that compares CEA, CAS, and BMT, and establishment of a diagnostic method that can accurately extract the group of patients who have the highest future risk of developing ischemia, are desired. PMID:25739437

  14. Task Analysis in Optical & Contact Lens Dispensing. Dispensing Opticians.

    ERIC Educational Resources Information Center

    Hrushowy, Eugene; Stanley, Dale

    A task force of opticians and educators in British Columbia was assembled to determine the knowledge and skills required of dispensing opticians and contact lens specialists. The ideas generated by the task force were analyzed and distilled into the standardized tasks listed in this document, using Krathwohl's taxonomy. The document contains 36…

  15. Maximal force and tremor changes across the menstrual cycle.

    PubMed

    Tenan, Matthew S; Hackney, Anthony C; Griffin, Lisa

    2016-01-01

    Sex hormones have profound effects on the nervous system in vitro and in vivo. The present study examines the effect of the menstrual cycle on maximal isometric force (MVC) and tremor during an endurance task. Nine eumenorrheic females participated in five study visits across their menstrual cycle. In each menstrual phase, an MVC and an endurance task to failure were performed. Tremor across the endurance task was quantified as the coefficient of variation in force and was assessed in absolute time and relative percent time to task failure. MVC decreases 23% from ovulation to the mid luteal phase of the menstrual cycle. In absolute time, the mid luteal phase has the highest initial tremor, though the early follicular phase has substantially higher tremor than other phases after 150 s of task performance. In relative time, the mid luteal phase has the highest level of tremor throughout the endurance task. Both MVC and tremor during an endurance task are modified by the menstrual cycle. Performance of tasks and sports which require high force and steadiness to exhaustion may be decreased in the mid luteal phase compared to other menstrual phases.

  16. 75 FR 4051 - Defense Health Board; DoD Task Force on the Prevention of Suicide by Members of the Armed Forces...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... Prevention of Suicide by Members of the Armed Forces; Meeting AGENCY: Department of Defense (DoD). ACTION... of Suicide by Members of the Armed Forces (hereafter, Task Force) will meet on February 11, 2010, to gather information pertaining to suicide and suicide prevention programs for members of the Armed...

  17. Neural Correlates of Task Cost for Stance Control with an Additional Motor Task: Phase-Locked Electroencephalogram Responses

    PubMed Central

    Hwang, Ing-Shiou; Huang, Cheng-Ya

    2016-01-01

    With appropriate reallocation of central resources, the ability to maintain an erect posture is not necessarily degraded by a concurrent motor task. This study investigated the neural control of a particular postural-suprapostural procedure involving brain mechanisms to solve crosstalk between posture and motor subtasks. Participants completed a single posture task and a dual-task while concurrently conducting force-matching and maintaining a tilted stabilometer stance at a target angle. Stabilometer movements and event-related potentials (ERPs) were recorded. The added force-matching task increased the irregularity of postural response rather than the size of postural response prior to force-matching. In addition, the added force-matching task during stabilometer stance led to marked topographic ERP modulation, with greater P2 positivity in the frontal and sensorimotor-parietal areas of the N1-P2 transitional phase and in the sensorimotor-parietal area of the late P2 phase. The time-frequency distribution of the ERP primary principal component revealed that the dual-task condition manifested more pronounced delta (1–4 Hz) and beta (13–35 Hz) synchronizations but suppressed theta activity (4–8 Hz) before force-matching. The dual-task condition also manifested coherent fronto-parietal delta activity in the P2 period. In addition to a decrease in postural regularity, this study reveals spatio-temporal and temporal-spectral reorganizations of ERPs in the fronto-sensorimotor-parietal network due to the added suprapostural motor task. For a particular set of postural-suprapostural task, the behavior and neural data suggest a facilitatory role of autonomous postural response and central resource expansion with increasing interregional interactions for task-shift and planning the motor-suprapostural task. PMID:27010634

  18. Task Force on the Role of General Education in Associate Science Degree Programs. Final Report and Recommendations.

    ERIC Educational Resources Information Center

    Weyers, Lori; Langerman, Philip

    In 1989-90, the General Education Task Force of the Wisconsin Technical College System (WTCS) was convened to determine the role of the general education curriculum in the attainment of skills that enhance the likelihood of success among technical college graduates in their careers, homes and communities. The Task Force consisted of at least one…

  19. Guidelines for Cognitive Behavioral Training within Doctoral Psychology Programs in the United States: Report of the Inter-Organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education

    ERIC Educational Resources Information Center

    Klepac, Robert K.; Ronan, George F.; Andrasik, Frank; Arnold, Kevin D.; Belar, Cynthia D.; Berry, Sharon L.; Christofff, Karen A.; Craighead, Linda W.; Dougher, Michael J.; Dowd, E. Thomas; Herbert, James D.; McFarr, Lynn M.; Rizvi, Shireen L.; Sauer, Eric M.; Strauman, Timothy J.

    2012-01-01

    The Association for Behavioral and Cognitive Therapies initiated an interorganizational task force to develop guidelines for integrated education and training in cognitive and behavioral psychology at the doctoral level in the United States. Fifteen task force members representing 16 professional associations participated in a yearlong series of…

  20. Homelessness: The New Hampshire Response. The Final Report and Recommendations of the New Hampshire Task Force on Homelessness.

    ERIC Educational Resources Information Center

    New Hampshire State Div. of Mental Health and Developmental Services, Concord.

    This report presents results and recommendations of a two-year study and information-gathering effort by the New Hampshire Task Force on Homelessness, in compliance with the charge of the State legislature. The report is comprised of five sections. Section 1, "Introduction," presents an overview of the Task Force and a report on the…

  1. Funds for the Future. Report of the Twentieth Century Fund Task Force on College and University Endowment Policy.

    ERIC Educational Resources Information Center

    Williamson, J. Peter

    The Task Force on College and University Endowment Policy examines endowment policy in a broad context. They feel that it is important to preserve private colleges and universities and develop a sense of mission about how best to pursue this objective. The Task Force reviews policy issues faced by managers of endowment funds for institutions of…

  2. Conference-EC-US Task Force Joint US-EU Workshop on Metabolomics and Environmental Biotechnology

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

    PI: Lily Y. Young

    2009-06-04

    Since 1990, the EC-US Task Force on Biotechnology Research has been coordinating transatlantic efforts to guide and exploit the ongoing revolution in biotechnology and the life sciences. The Task Force was established in June 1990 by the European Commission and the White House Office of Science and Technology Policy. The Task Force has acted as an effective forum for discussion, coordination, and development of new ideas for the last 18 years. Task Force members are European Commission and US Government science and technology administrators who meet annually to enhance communication across the Atlantic, and to encourage collaborative research. Through sponsoringmore » workshops, and other activities, the Task Force also brings together scientific leaders and early career researchers from both sides of the Atlantic to forecast research challenges and opportunities and to promote better links between researchers. Over the years, by keeping a focus on the future of science, the Task Force has played a key role in establishing a diverse range of emerging scientific fields, including biodiversity research, neuroinformatics, genomics, nanobiotechnology, neonatal immunology, transkingdom molecular biology, biologically-based fuels, and environmental biotechnology. The EC-US Task Force has sponsored a number of Working Groups on topics of mutual transatlantic interest. The idea to create a Working Group on Environmental Biotechnology research was discussed in the Task Force meeting of October 1993. The EC-US Working Group on Environmental Biotechnology set as its mission 'To train the next generation of leaders in environmental biotechnology in the United States and the European Union to work collaboratively across the Atlantic.' Since 1995, the Working Group supported three kinds of activities, all of which focus one early career scientists: (1) Workshops on the use of molecular methods and genomics in environmental biotechnology; (2) Short courses with theoretical, laboratory and field elements; and (3) Short term exchange fellowships. The short term exchange fellowships were created to enable young scientists to develop collaborations with colleagues across the Atlantic and to learn a new skill or expertise in the area of environmental biotechnology.« less

  3. The synergic control of multi-finger force production: Stability of explicit and implicit task components

    PubMed Central

    Reschechtko, Sasha; Zatsiorsky, Vladimir M.; Latash, Mark L.

    2016-01-01

    Manipulating objects with the hands requires the accurate production of resultant forces including shear forces; effective control of these shear forces also requires the production of internal forces normal to the surface of the object(s) being manipulated. In the present study, we investigated multi-finger synergies stabilizing shear and normal components of force, as well as drifts in both components of force, during isometric pressing tasks requiring a specific magnitude of shear force production. We hypothesized that shear and normal forces would evolve similarly in time, and also show similar stability properties as assessed by the decomposition of inter-trial variance within the uncontrolled manifold hypothesis. Healthy subjects were required to accurately produce total shear and total normal forces with four fingers of the hand during a steady-state force task (with and without visual feedback) and a self-paced force pulse task. The two force components showed similar time profiles during both shear force pulse production and unintentional drift induced by turning the visual feedback off. Only the explicitly instructed components of force, however, were stabilized with multi-finger synergies. No force-stabilizing synergies and no anticipatory synergy adjustments were seen for the normal force in shear force production trials. These unexpected qualitative differences in the control of the two force components – which are produced by some of the same muscles and show high degree of temporal coupling – are interpreted within the theory of control with referent coordinates for salient variables. These observations suggest the existence of two classes of neural variables: one that translates into shifts of referent coordinates and defines changes in magnitude of salient variables, and the other controlling gains in back-coupling loops that define stability of the salient variables. Only the former are shared between the explicit and implicit task components. PMID:27601252

  4. Force-stabilizing synergies in motor tasks involving two actors

    PubMed Central

    Solnik, Stanislaw; Reschechtko, Sasha; Wu, Yen-Hsun; Zatsiorsky, Vladimir M.; Latash, Mark L.

    2015-01-01

    We investigated the ability of two persons to produce force-stabilizing synergies in accurate multi-finger force production tasks under visual feedback on the total force only. The subjects produced a time profile of total force (the sum of two hand forces in one-person tasks and the sum of two subject forces in two-person tasks) consisting of a ramp-up, steady-state, and ramp-down segments; the steady-state segment was interrupted in the middle by a quick force pulse. Analyses of the structure of inter-trial finger force variance, motor equivalence, anticipatory synergy adjustments (ASAs), and the unintentional drift of the sharing pattern were performed. The two-person performance was characterized by a dramatically higher amount of inter-trial variance that did not affect total force, higher finger force deviations that did not affect total force (motor equivalent deviations), shorter ASAs, and larger drift of the sharing pattern. The rate of sharing pattern drift correlated with the initial disparity between the forces produced by the two persons (or two hands). The drift accelerated following the quick force pulse. Our observations show that sensory information on the task-specific performance variable is sufficient for the organization of performance-stabilizing synergies. They suggest, however, that two actors are less likely to follow a single optimization criterion as compared to a single performer. The presence of ASAs in the two-person condition might reflect fidgeting by one or both of the subjects. We discuss the characteristics of the drift in the sharing pattern as reflections of different characteristic times of motion within the sub-spaces that affect and do not affect salient performance variables. PMID:26105756

  5. Force-stabilizing synergies in motor tasks involving two actors.

    PubMed

    Solnik, Stanislaw; Reschechtko, Sasha; Wu, Yen-Hsun; Zatsiorsky, Vladimir M; Latash, Mark L

    2015-10-01

    We investigated the ability of two persons to produce force-stabilizing synergies in accurate multi-finger force production tasks under visual feedback on the total force only. The subjects produced a time profile of total force (the sum of two hand forces in one-person tasks and the sum of two subject forces in two-person tasks) consisting of a ramp-up, steady-state, and ramp-down segments; the steady-state segment was interrupted in the middle by a quick force pulse. Analyses of the structure of inter-trial finger force variance, motor equivalence, anticipatory synergy adjustments (ASAs), and the unintentional drift of the sharing pattern were performed. The two-person performance was characterized by a dramatically higher amount of inter-trial variance that did not affect total force, higher finger force deviations that did not affect total force (motor equivalent deviations), shorter ASAs, and larger drift of the sharing pattern. The rate of sharing pattern drift correlated with the initial disparity between the forces produced by the two persons (or two hands). The drift accelerated following the quick force pulse. Our observations show that sensory information on the task-specific performance variable is sufficient for the organization of performance-stabilizing synergies. They suggest, however, that two actors are less likely to follow a single optimization criterion as compared to a single performer. The presence of ASAs in the two-person condition might reflect fidgeting by one or both of the subjects. We discuss the characteristics of the drift in the sharing pattern as reflections of different characteristic times of motion within the subspaces that affect and do not affect salient performance variables.

  6. The Role of Direct and Visual Force Feedback in Suturing Using a 7-DOF Dual-Arm Teleoperated System.

    PubMed

    Talasaz, Ali; Trejos, Ana Luisa; Patel, Rajni V

    2017-01-01

    The lack of haptic feedback in robotics-assisted surgery can result in tissue damage or accidental tool-tissue hits. This paper focuses on exploring the effect of haptic feedback via direct force reflection and visual presentation of force magnitudes on performance during suturing in robotics-assisted minimally invasive surgery (RAMIS). For this purpose, a haptics-enabled dual-arm master-slave teleoperation system capable of measuring tool-tissue interaction forces in all seven Degrees-of-Freedom (DOFs) was used. Two suturing tasks, tissue puncturing and knot-tightening, were chosen to assess user skills when suturing on phantom tissue. Sixteen subjects participated in the trials and their performance was evaluated from various points of view: force consistency, number of accidental hits with tissue, amount of tissue damage, quality of the suture knot, and the time required to accomplish the task. According to the results, visual force feedback was not very useful during the tissue puncturing task as different users needed different amounts of force depending on the penetration of the needle into the tissue. Direct force feedback, however, was more useful for this task to apply less force and to minimize the amount of damage to the tissue. Statistical results also reveal that both visual and direct force feedback were required for effective knot tightening: direct force feedback could reduce the number of accidental hits with the tissue and also the amount of tissue damage, while visual force feedback could help to securely tighten the suture knots and maintain force consistency among different trials/users. These results provide evidence of the importance of 7-DOF force reflection when performing complex tasks in a RAMIS setting.

  7. Age-related differences in postural adjustments in connection with different tasks involving weight transfer while standing.

    PubMed

    Jonsson, Erika; Henriksson, Marketta; Hirschfeld, Helga

    2007-10-01

    Weight transfer designed to change the area of the supportive base during the performance of three different motor tasks (one-leg stance, tandem stance and gait initiation) was examined both in healthy, physically active elderly people and younger adults. The former two tasks are balance tests used clinically. Our hypothesis was that the elderly subjects would demonstrate age-related changes in their postural adjustments that could be detected by analysis of the ground reaction forces. While 24 healthy elderly adults (65-77 years of age) and 26 younger adults (24-40 years of age) performed these three tasks, the ground reaction forces were recorded from two force plates. Prior to the onset of all three tasks, the elderly placed significantly more weight on the leg that was to provide support (the stance leg), than did the younger individuals. The analyses revealed two distinct phases of weight transfer, i.e., an initial thrust and a subsequent unloading phase. The elderly individuals exhibited a significantly longer unloading phase, as well as a higher frequency of peaks of vertical and lateral forces during this phase. Moreover, the maximal force rate during this phase was achieved at an earlier time point by the elderly. However, both groups generated forces of similar magnitudes and force rates. In conclusion, our findings indicate the presence of age-related differences in the temporal phasing of the ground reaction forces in all three of these tasks involving weight transfer, whereas the magnitude and rates of change of these forces are independent of age.

  8. Haptic force-feedback devices for the office computer: performance and musculoskeletal loading issues.

    PubMed

    Dennerlein, J T; Yang, M C

    2001-01-01

    Pointing devices, essential input tools for the graphical user interface (GUI) of desktop computers, require precise motor control and dexterity to use. Haptic force-feedback devices provide the human operator with tactile cues, adding the sense of touch to existing visual and auditory interfaces. However, the performance enhancements, comfort, and possible musculoskeletal loading of using a force-feedback device in an office environment are unknown. Hypothesizing that the time to perform a task and the self-reported pain and discomfort of the task improve with the addition of force feedback, 26 people ranging in age from 22 to 44 years performed a point-and-click task 540 times with and without an attractive force field surrounding the desired target. The point-and-click movements were approximately 25% faster with the addition of force feedback (paired t-tests, p < 0.001). Perceived user discomfort and pain, as measured through a questionnaire, were also smaller with the addition of force feedback (p < 0.001). However, this difference decreased as additional distracting force fields were added to the task environment, simulating a more realistic work situation. These results suggest that for a given task, use of a force-feedback device improves performance, and potentially reduces musculoskeletal loading during mouse use. Actual or potential applications of this research include human-computer interface design, specifically that of the pointing device extensively used for the graphical user interface.

  9. Performance evaluation of a six-axis generalized force-reflecting teleoperator

    NASA Technical Reports Server (NTRS)

    Hannaford, B.; Wood, L.; Guggisberg, B.; Mcaffee, D.; Zak, H.

    1989-01-01

    Work in real-time distributed computation and control has culminated in a prototype force-reflecting telemanipulation system having a dissimilar master (cable-driven, force-reflecting hand controller) and a slave (PUMA 560 robot with custom controller), an extremely high sampling rate (1000 Hz), and a low loop computation delay (5 msec). In a series of experiments with this system and five trained test operators covering over 100 hours of teleoperation, performance was measured in a series of generic and application-driven tasks with and without force feedback, and with control shared between teleoperation and local sensor referenced control. Measurements defining task performance included 100-Hz recording of six-axis force/torque information from the slave manipulator wrist, task completion time, and visual observation of predefined task errors. The task consisted of high precision peg-in-hole insertion, electrical connectors, velcro attach-de-attach, and a twist-lock multi-pin connector. Each task was repeated three times under several operating conditions: normal bilateral telemanipulation, forward position control without force feedback, and shared control. In shared control, orientation was locally servo controlled to comply with applied torques, while translation was under operator control. All performance measures improved as capability was added along a spectrum of capabilities ranging from pure position control through force-reflecting teleoperation and shared control. Performance was optimal for the bare-handed operator.

  10. Altered visual strategies and attention are related to increased force fluctuations during a pinch grip task in older adults.

    PubMed

    Keenan, Kevin G; Huddleston, Wendy E; Ernest, Bradley E

    2017-11-01

    The purpose of the study was to determine the visual strategies used by older adults during a pinch grip task and to assess the relations between visual strategy, deficits in attention, and increased force fluctuations in older adults. Eye movements of 23 older adults (>65 yr) were monitored during a low-force pinch grip task while subjects viewed three common visual feedback displays. Performance on the Grooved Pegboard test and an attention task (which required no concurrent hand movements) was also measured. Visual strategies varied across subjects and depended on the type of visual feedback provided to the subjects. First, while viewing a high-gain compensatory feedback display (horizontal bar moving up and down with force), 9 of 23 older subjects adopted a strategy of performing saccades during the task, which resulted in 2.5 times greater force fluctuations in those that exhibited saccades compared with those who maintained fixation near the target line. Second, during pursuit feedback displays (force trace moving left to right across screen and up and down with force), all subjects exhibited multiple saccades, and increased force fluctuations were associated ( r s = 0.6; P = 0.002) with fewer saccades during the pursuit task. Also, decreased low-frequency (<4 Hz) force fluctuations and Grooved Pegboard times were significantly related ( P = 0.033 and P = 0.005, respectively) with higher (i.e., better) attention z scores. Comparison of these results with our previously published results in young subjects indicates that saccadic eye movements and attention are related to force control in older adults. NEW & NOTEWORTHY The significant contributions of the study are the addition of eye movement data and an attention task to explain differences in hand motor control across different visual displays in older adults. Older participants used different visual strategies across varying feedback displays, and saccadic eye movements were related with motor performance. In addition, those older individuals with deficits in attention had impaired motor performance on two different hand motor control tasks, including the Grooved Pegboard test. Copyright © 2017 the American Physiological Society.

  11. The Oklahoma Attorney General's Task Force report on the State of End-of-Life Health Care, 2005.

    PubMed

    Edmondson, W A Drew

    2005-05-01

    This article includes the recommendations submitted by the 15 members of the Oklahoma Attorney General's Task Force in their Report on the State of End-of-Life Health Care. The task force was created on April 21, 2004, and their report was accepted by Attorney General W.A. Drew Edmondson at a press conference April 11, 2005. It has been forwarded to members of the Oklahoma Legislature, relevant state agencies and organizations with an invitation to join with members of the task force to continue efforts to improve end-of-life care for Oklahomans. Copies of the report are available upon request to the Office of Attorney General.

  12. Impaired Inhibitory Force Feedback in Fixed Dystonia.

    PubMed

    Mugge, Winfred; Schouten, Alfred C; van Hilten, Jacobus J; van der Helm, Frans C T

    2016-04-01

    Complex regional pain syndrome (CRPS) is a multifactorial disorder associated with an aberrant host response to tissue injury. About 25% of CRPS patients suffer poorly understood involuntary sustained muscle contractions associated with dysfunctional reflexes that result in abnormal postures (fixed dystonia). A recent modeling study simulated fixed dystonia (FD) caused by aberrant force feedback. The current study aims to validate this hypothesis by experimentally recording the modulation of reflexive force feedback in patients with FD. CRPS patients with and without FD, patients with FD but without CRPS, as well as healthy controls participated in the experiment. Three task instructions and three perturbation characteristics were used to evoke a wide range of responses to force perturbations. During position tasks ("maintain posture"), healthy subjects as well as patients resisted the perturbations, becoming more stiff than when being relaxed (i.e., the relax task). Healthy subjects and CRPS patients without FD were both more compliant during force tasks ("maintain force") than during relax tasks, meaning they actively gave way to the imposed forces. Remarkably, the patients with FD failed to do so. A neuromuscular model was fitted to the experimental data to separate the distinct contributions of position, velocity and force feedback, as well as co-contraction to the motor behavior. The neuromuscular modeling indicated that inhibitory force feedback is deregulated in patients with FD, for both CRPS and non-CRPS patients. From previously published simulation results and the present experimental study, it is concluded that aberrant force feedback plays a role in fixed dystonia.

  13. Effect of loudness on reaction time and response force in different motor tasks.

    PubMed

    Jaśkowski, Piotr; Włodarczyk, Dariusz

    2005-12-01

    Van der Molen and Keuss, in 1979 and 1981, showed that paradoxically long reaction times occur with extremely strong auditory stimuli when the task is difficult, e.g., choice-by-location or Simon paradigm. It was argued that this paradoxical behavior of RT is due to active inhibition of an arousal-dependent bypassing mechanism to prevent false responses. As the peak force, i.e., maximal force exerted by participants on a response key, is considered to be related to immediate arousal, we predicted that for extremely loud stimuli and for difficult tasks, lengthening of RT should be associated with reduction of peak force. Moreover, these effects should be enhanced when emphasis is on accuracy rather than speed. Although the relation between RT and intensity depended on task difficulty, no increase in RT was found for the loudest tones. Moreover, peak force increased monotonically with loudness, showing no tendency to be suppressed for loudest tones and difficult tasks.

  14. Corporate funding and conflicts of interest: a primer for psychologists.

    PubMed

    Pachter, Wendy S; Fox, Ronald E; Zimbardo, Philip; Antonuccio, David O

    2007-12-01

    A presidential task force on external funding was established by the American Psychological Association (APA) in 2003 to review APA policies, procedures, and practices regarding the acceptance of funding and support from private corporations for educational and training programs; continuing education offerings; research projects; publications; advertising; scientific and professional meetings and conferences; and consulting, practice, and advocacy relationships. This article, based on the Executive Summary of the APA Task Force on External Funding Final Report, presents the findings and unanimous recommendations of the task force in the areas of association income, annual convention, research and journals, continuing education, education, practice, and conflicts of interest and ethics. The task force concluded that it is important for both APA and individual psychologists to become familiar with the challenges that corporate funding can pose to their integrity. The nature and extent of those challenges led the task force to recommend that APA develop explicit policies, educational materials, and continuing education programs to preserve the independence of psychological science, practice, and education. (Copyright) 2007 APA.

  15. Early childhood: breastfeeding, "solving the problem of childhood obesity within a generation," an excerpt from the White House Task Force on Childhood Obesity: report to the President, May 2010.

    PubMed

    2010-10-01

    On February 9, 2010, the same day the First Lady launched the Let's Move! campaign, President Obama created a new interagency White House Task Force on Childhood Obesity, charged with creating and implementing a comprehensive action plan to end the childhood obesity epidemic. The resulting action plan was developed by experts from across the federal government, with substantial public input, and released on May 11. The first chapter of the task force report discusses strategies for getting children a healthy start on life, including supporting breastfeeding. Here is an excerpt from the discussion of breastfeeding that appears in the report. The full text of the task force report can be found at www.letsmove.gov . —Martha Coven, JD Special Assistant to the President for Mobility and Opportunity White House Domestic Policy Council Lead Staff, White House Task Force on Childhood Obesity.

  16. Improving the Agility of the NATO Response Force (NRF)

    DTIC Science & Technology

    2010-04-01

    the MCCE and the MIH helicopter task force. As 168 Hauser and Kernic eds., 140-141. 169 NATO...agility through unified efforts. Initiatives such as the MIH helicopter task force and the Movement Coordination Centre Europe (MCCE) are positive

  17. Toward a State of Esteem. The Final Report of the California Task Force to Promote Self-esteem and Personal and Social Responsibility.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    This document contains the final report of a California Task Force created to promote self-esteem and personal responsibility. It begins with an executive summary listing key principles of the task force and providing recommendations and discussions in each of six major areas upon which the report focuses. The next section presents the task…

  18. 7 CFR Exhibit D to Subpart B of... - Fact Sheet-The Federal Interagency Task Force on Food and Shelter for the Homeless

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Fact Sheet-The Federal Interagency Task Force on Food... (CONTINUED) PROPERTY MANAGEMENT Management of Property Exhibit D to Subpart B of Part 1955—Fact Sheet—The Federal Interagency Task Force on Food and Shelter for the Homeless Editorial Note: Exhibit D is not...

  19. Proceedings: The Conference of the University/Urban Schools National Task Force: What Works in Urban Schools (3rd, San Francisco, CA, July 9-10, 1982).

    ERIC Educational Resources Information Center

    Bossone, Richard M., Ed.

    Proceedings of the University/Urban Schools Task Force conference on what works in urban schools are summarized in this report. The future direction of the Task Force, articulated by conference participants, is described as a move toward the conceptualization and design of programs to teach thinking skills versus programs that mainly teach subject…

  20. Report and Recommendations of the British Columbia Teacher's Federation's (BCTF) Task Force on First Nations Education to the Annual General Meeting (January 1999). (Revised Annotated Version).

    ERIC Educational Resources Information Center

    British Columbia Teachers' Federation, Vancouver.

    In 1998, the British Columbia Teachers' Federation (BCTF) appointed an eight-member task force to investigate the effectiveness of the education system for First Nations students. The task force report and recommendations are intended to serve several groups of Aboriginal students: First Nations students, with or without status under Canada's…

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