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1
Adam, J. D. "MSW devices for EW receiver applications." Circuits, Systems, and Signal Processing 4, no. 1-2 (March 1985): 301–16. http://dx.doi.org/10.1007/bf01600087.
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Park, So Ryoung, Ilku Nam, and Sanguk Noh. "Modeling and Simulation for the Investigation of Radar Responses to Electronic Attacks in Electronic Warfare Environments." Security and Communication Networks 2018 (2018): 1–13. http://dx.doi.org/10.1155/2018/3580536.
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An electronic warfare (EW) simulator is presented to investigate and evaluate the tracking performance of radar system under the electronic attack situations. The EW simulator has the input section in which the characteristic parameters of radar threat, radar warning receiver, jammer, electromagnetic wave propagation, and simulation scenario can be set up. During the process of simulation, the simulator displays the situations of simulation such as the received signal and its spectrum, radar scope, and angle tracking scope and also calculates the transient and root-mean-squared tracking errors of the range and angle tracking system of radar. Using the proposed EW simulator, we analyze the effect of concealment according to the noise and signal powers under the noise jamming and also analyze the effect of deception by calculating errors between the desired value and the estimated one under the deceptive jamming. Furthermore, the proposed EW simulator can be used to figure out the feature of radar threats based on the information collected from the EW receiver and also used to carry out the electronic attacks efficiently in electronic warfare.
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Hao, Yan Zhong, Fu Chun Zhang, Wang Hui, Shu Qiang Wang, and Yong Ji Lu. "Research on Warfare Simulation System of EW Aircraft Based on HLA." Advanced Materials Research 756-759 (September 2013): 4506–10. http://dx.doi.org/10.4028/www.scientific.net/amr.756-759.4506.
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The current simulation research on military tactics operation of EW Aircraft mainly takes meatures of function simulation based on radar equation and jam equation, model on scout receiver and jam transmitter, which not only can not reach the precious and resembility of signal simulation. but it also construct system-system Simulation system. Aiming at such problems, adopting signal simulation, considering current development of simulation technique and the request of air battle to EW, the battle simulation system of EW Aircraft is presented based on high level architecture. And the key techniques of composition and development process of federation are studied. Simulation is carried out whose result verifies the efficiency. The successful exploitation of the system will supply the analyses evaluation of the whole EW Aircraft warfare simulation system efficiency with performance and basis, which has active sense for the tactics use of EW Aircraft.
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Rao, M. Sreenivasa, Chandan C. Mishra, K. Krishna Naik, and K. Maheshwara Reddy. "Discrete Electronic Warfare Signal Processing using Compressed Sensing Based on Random Modulator Pre-Integrator." Defence Science Journal 65, no. 6 (November 10, 2015): 472. http://dx.doi.org/10.14429/dsj.65.8414.
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Electronic warfare receiver works in the wide electromagnetic spectrum in dense radar signal environment. Current trends in radar systems are ultra wideband and low probability of intercept radar technology. Detection of signals from various radar stations is a concern. Performance and probability of intercept are mainly dependent on high speed ADC technology. The sampling and reconstruction functions have to be optimized to capture incoming signals at the receiver to extract characteristics of the radar signal. The compressive sampling of the input signal with orthonormal base vectors, projecting the basis in the union of subspaces and recovery through convex optimisation techniques is the current traditional approach. Modern trends in signal processing suggest the random modulator pre-integrator (RMPI), which sample the input signal at information rate non-adaptively and recovery by the processing of discrete and finite vectors. Analysis of RMPI theory, application to EW receiver, simulation and recovery of EW receiver signals are discussed.
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Rao, M. Sreenivasa, K. Krishna Naik, and K. Maheshwara Reddy. "Radar Signal Recovery using Compressive Sampling Matching Pursuit Algorithm." Defence Science Journal 67, no. 1 (December 23, 2016): 94. http://dx.doi.org/10.14429/dsj.67.9906.
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In this study, we propose compressive sampling matching pursuit (CoSaMP) algorithm for sub-Nyquist based electronic warfare (EW) receiver system. In compressed sensing (CS) theory time-frequency plane localisation and discretisation into a N×N grid in union of subspaces is established. The train of radar signals are sparse in time and frequency can be under sampled with almost no information loss. The CS theory may be applied to EW digital receivers to reduce sampling rate of analog to digital converter; to improve radar parameter resolution and increase input bandwidth. Simulated an efficient approach for radar signal recovery by CoSaMP algorithm by using a set of various sample and different sparsity level with various radar signals. This approach allows a scalable and flexible recovery process. The method has been satisfied with data in a wide frequency range up to 40 GHz. The simulation shows the feasibility of our method.
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Esmaeilkhah, A. "An Inherent Limitative Parameter in Spoofing GNSS-Based Navigation Clients." Advanced Electromagnetics 8, no. 3 (June 10, 2019): 29–35. http://dx.doi.org/10.7716/aem.v8i3.1043.
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Deception of navigational subsystems of a client, ranging from a hunting GPS receiver to the military-class GNSS receiver onboard of a Cruise Missile, is one of the probable electronic attacks. One of the simplest and practical way too deceive these receivers is to re-broadcast the delayed navigational signals. The authors were studied the feasibility of this method in the “Best” attainable conditions while the generality of study retained. The results from introduced geometrical and mathematical models were used to define the minimum and maximum operational range of Repeater Deception System parametrically. Then the parameters were substituted by information of various GNSS constellations. Investigation of reliability of selected EW scenario concluded the article.
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Bartnikas, Lisa M., William J. Sheehan, Katherine L. Tuttle, Carter R. Petty, Lynda C. Schneider, and Wanda Phipatanakul. "Ovomucoid Specific Immunoglobulin E as a Predictor of Tolerance to Cooked Egg." Allergy & Rhinology 6, no. 3 (January 2015): ar.2015.6.0135. http://dx.doi.org/10.2500/ar.2015.6.0135.
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Background Ovomucoid is the dominant allergen in hen's egg. Although several studies evaluated the utility of ovomucoid specific immunoglobulin E (sIgE) levels in predicting baked (e.g., muffin or cupcake) or raw egg food challenge outcomes, studies that evaluated ovomucoid sIgE as a predictor of cooked egg (e.g., scrambled or hard boiled) challenge outcomes are limited. Objective To determine the relation of ovomucoid sIgE levels with cooked egg food challenge outcomes. Methods A retrospective review of 44 children who underwent cooked egg food challenge and who had the ovomucoid sIgE level measured. Results Thirty-six of 44 children (81.8%) passed cooked egg challenge. The ovomucoid sIgE level predicted cooked egg challenge outcome (passed median, <0.35 kU/L [range, <0.35–0.64 kU/L]; failed median, 0.40 kU/L [range, <0.35–3.13 kU/L]; p = 0.004). Ovomucoid sIgE levels correlated with egg white (EW) sIgE levels (Spearman correlation coefficient, 0.588; p = 0.001). Receiver operating characteristic curve analysis of ovomucoid and EW sIgE demonstrated areas under the curve of 0.711 and 0.766, respectively. No significant difference was observed among those immunologic parameters in their abilities to predict cooked egg challenge outcome (p = 0.559). Conclusion The ovomucoid sIgE level may be helpful in predicting cooked egg challenge outcomes. However, our study did not support a role for ovomucoid sIgE replacing EW sIgE testing in evaluating egg allergy.
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Marriage, D. E., M. Erlewyn-Lajeunesse, D. J. Unsworth, and A. J. Henderson. "Unscrambling Egg Allergy: The Diagnostic Value of Specific IgE Concentrations and Skin Prick Tests for Ovomucoid and Egg White in the Management of Children with Hen’s Egg Allergy." ISRN Allergy 2012 (February 9, 2012): 1–6. http://dx.doi.org/10.5402/2012/627545.
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Resolution of egg allergy occurs in the majority of egg allergic children. Positive specific IgE antibodies to ovomucoid (OVM) have been suggested to be of greater predictive value for persistent egg allergy than specific IgE to egg white. The performance of OVM-specific IgE antibody levels in a cohort of children referred for a routine egg challenge was compared with egg white specific IgE levels in predicting a positive egg challenge. 24/47 subjects had persistent egg allergy. Receiver operating characteristic analysis showed that OVM-specific IgE testing was the most useful test for the diagnosis of persistent egg allergy. The optimal decision points for the prediction of persistent egg allergy were >0.35 kUA/L for specific IgE levels to both EW and OVM, and ≥3 mm for SPT. Children with specific IgE levels suggestive of persistent egg allergy need not be subject to an egg provocation challenge, reducing both costs and risks to the child.
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Choy, Suelynn, Chuan-Sheng Wang, Ta-Kang Yeh, John Dawson, Minghai Jia, and Yuriy Kuleshov. "Precipitable Water Vapor Estimates in the Australian Region from Ground-Based GPS Observations." Advances in Meteorology 2015 (2015): 1–14. http://dx.doi.org/10.1155/2015/956481.
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We present a comparison of atmospheric precipitable water vapor (PWV) derived from ground-based global positioning system (GPS) receiver with traditional radiosonde measurement and very long baseline interferometry (VLBI) technique for a five-year period (2008–2012) using Australian GPS stations. These stations were selectively chosen to provide a representative regional distribution of sites while ensuring conventional meteorological observations were available. Good agreement of PWV estimates was found between GPS and VLBI comparison with a mean difference of less than 1 mm and standard deviation of 3.5 mm and a mean difference and standard deviation of 0.1 mm and 4.0 mm, respectively, between GPS and radiosonde measurements. Systematic errors have also been discovered during the course of this study, which highlights the benefit of using GPS as a supplementary atmospheric PWV sensor and calibration system. The selected eight GPS sites sample different climates across Australia covering an area of approximately 30° NS/EW. It has also shown that the magnitude and variation of PWV estimates depend on the amount of moisture in the atmosphere, which is a function of season, topography, and other regional climate conditions.
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Lopes Nobre, Jessica, Patricia Cristina Lisboa, Natália da Silva Lima, Juliana Gastão Franco, José Firmino Nogueira Neto, Egberto Gaspar de Moura, and Elaine de Oliveira. "Calcium supplementation prevents obesity, hyperleptinaemia and hyperglycaemia in adult rats programmed by early weaning." British Journal of Nutrition 107, no. 7 (November 9, 2011): 979–88. http://dx.doi.org/10.1017/s0007114511003928.
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It is known that Ca therapy may have anti-obesity effects. Since early weaning leads to obesity, hyperleptinaemia and insulin resistance, we studied the effect of dietary Ca supplementation in a rat model. Lactating rats were separated into two groups: early weaning (EW) – dams were wrapped with a bandage to interrupt lactation in the last 3 d of lactation and control (C) – dams whose pups had free access to milk during the entire lactation period (21 d). At 120 d, EW and C offspring were subdivided into four groups: (1) C, received standard diet; (2) CCa, received Ca supplementation (10 g of calcium carbonate/kg of rat chow); (3) EW, received standard diet; (4) EWCa, received Ca supplementation similar to CCa. The rats were killed at 180 d. The significance level was at P < 0·05. Adult EW offspring displayed hyperphagia (28 %), higher body weight (9 %) and adiposity (77 %), hyperleptinaemia (twofold increase), hypertriacylglycerolaemia (64 %), hyperglycaemia (16 %), higher insulin resistance index (38 %) and higher serum 25-hydroxyvitamin D3 (fourfold increase), but lower adiponectinaemia:adipose tissue ratio (44 %). In addition, they showed Janus tyrosine kinase 2 and phosphorylated signal transducer and activator of transcription 3 underexpression in hypothalamus (36 and 34 %, respectively), suggesting leptin resistance. Supplementation of Ca for 2 months normalised these disorders. The EW group had no change in serum insulin, thyroxine or triiodothyronine, and Ca treatment did not alter these hormones. In conclusion, we reinforced that early weaning leads to late development of some components of the metabolic syndrome and leptin resistance. Dietary Ca supplementation seems to protect against the development of endocrine and metabolic disorders in EW offspring, maybe through vitamin D inhibition.
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Reiner, Anton, Jonathan T. Erichsen, John B. Cabot, Craig Evinger, Malinda E. C. Fitzerald, and Harvey J. Karten. "Neurotransmitter organization of the nucleus of Edinger–Westphal and its projection to the avian ciliary ganglion." Visual Neuroscience 6, no. 5 (May 1991): 451–72. http://dx.doi.org/10.1017/s0952523800001310.
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AbstractTwo morphologically distinct types of preganglionic endings are observed in the avian ciliary ganglion: boutonal and cap-like. Boutonal endings synapse on ciliary ganglion neurons (called choroidal neurons) innervating choroidal blood vessels, while cap-like endings synapse on ciliary ganglion neurons (called ciliary neurons) controlling the lens and pupil. Some of both types of preganglionic endings contain the neuropeptides substance P (SP) and/or leucine-enkephalin (LENK). Although both types of preganglionic terminals are also known to be cholinergic, there has been no direct evidence that SP and LENK are found in cholinergic endings in the ciliary ganglion. The present studies in pigeons, which involved the use of single- and double-label immunohistochemical techniques, were undertaken to examine this issue, as well as to (1) determine the relative percentages of the boutonal and cap-like endings that contain SP, LENK, or both SP and LENK; and (2) determine if the two different types of terminals in the ciliary ganglion arise from different subdivisions of the nucleus of Edinger-Westphal (EW).Single- and double-label immunohistochemical studies revealed that all neurons of EW, regardless of whether they contained immunohistochemically detectible amounts of SP or LENK, are cholinergic. In the medial subdivision of EW (EWM), which was found to contain approximately 700 neurons, 20.2% of these neurons were observed to contain both SP and LENK, while 11.6% were observed to contain SP only and 10.7% were observed to contain LENK only. In contrast, in lateral EW (EWL), which was found to contain approximately 500 neurons, 16.2% of the neurons were observed to contain both SP and LENK, while 19.2% of the neurons were observed to contain SP only and 12.6% were observed to contain LENK only. Retrograde-labeling studies involving horseradish peroxidase injections into the ciliary ganglion revealed that EW was the sole source of input to the ciliary ganglion and all, or nearly all, neurons in EW innervate the ciliary ganglion.Immunohistochemical labeling of the ciliary ganglion neurons with an antiserum against choline acetyltransferase revealed that approximately 900 choroidal neurons and approximately 600 ciliary neurons are present in the ganglion, all of which receive cholinergic preganglionic endings. Of the choroidal neurons, 94% receive butonal terminals containing both SP and LENK, while only 2% receive SP+ only boutonal endings and 2% receive LENK+ only butonal endings. Of the ciliary neurons, 25% receive cap-like endings containing both SP and LENK, 30% receive cap-like endings containing only SP and 3% receive cap-like endings containing only LENK. Total unilateral lesions of EW resulted in the loss of all SP+ or LENK+ terminals in the ipsilateral ganglion. Subtotal EW lesions that spared either part of EWM or part of EWL revealed that boutonal endings arise from EWM neurons and cap-like endings from EWL neurons.The present results suggest that the choroidal neurons, which regulate choroidal blood flow, may be relatively uniform in their functional properties since they nearly all receive boutonal endings from EWM that co-contain SP, LENK, and acetylcholine. In contrast, the ciliary neurons, which receive their preganglionic input from EWL, may consist of at least three major functionally distinct subgroups: (1) those receiving SP/LENK/acetylcholine-containing cap-like endings; (2) those receiving SP/acetylcholine-containing cap-like endings; and (3) those receiving acetylcholine-containing cap-like endings. The functional diversity of ciliary neurons may in part be related to the fact that some ciliary neurons innervate the iris and others the ciliary body.
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Chen, He, Xiujie Qu, Yuedong Luo, and Chenwei Deng. "Implementing EW Receivers Based on Large Point Reconfigured FFT on FPGA Platforms." International Journal of Computational Intelligence Systems 4, no. 6 (2011): 1131. http://dx.doi.org/10.2991/ijcis.2011.4.6.3.
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Chen, He, Xiujie Qu, Yuedong Luo, and Chenwei Deng. "Implementing EW Receivers Based on Large Point Reconfigured FFT on FPGA Platforms." International Journal of Computational Intelligence Systems 4, no. 6 (December 2011): 1131–39. http://dx.doi.org/10.1080/18756891.2011.9727861.
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Li, Yihang, Karina Matos, Mrigendra Rajput, and Adam James Moeser. "191 Early weaning in pigs induces long-term alterations in intestinal nutrient transporter function and expression partially via beta adrenergic enteric neural receptors." Journal of Animal Science 97, Supplement_2 (July 2019): 112–13. http://dx.doi.org/10.1093/jas/skz122.199.
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Abstract Early weaning (EW) has negative impacts on performance and health that persist from wean-to-finish. The mechanisms linking EW and lifetime performance reductions are poorly understood. The objective of this study was to investigate whether EW influences the long-term development of intestinal epithelial nutrient transporter function and expression and the potential mechanisms. Yorkshire gilts were split-weaned from their sows at 15 d (EW) or 28 d of age (Late Weaning; LW) and transferred to an on-site nursery room. All pigs received the same diets in a standard phase feeding program and were euthanized at 75 d of age. Mid-jejunum and distal ileum were mounted on Ussing chambers to evaluate Na+-dependent glucose and amino acid (AA) transporter function, measured as nutrient-induced changes in short circuit current (Isc). EW gilts exhibited reduced capacity for electrogenic transport of glucose (by ~30%; P < 0.05) and glutamate, glutamine, and alanine by (~ 30–35%; P < 0.05), compared with LW pigs. In contrast, jejunal and ileal lysine transporter function was upregulated (by 110% and 25%, respectively; P < 0.05) in EW pigs. Epithelial expression for glucose transporter (SGLT1) was reduced (P < 0.05) while glucose/fructose transporter (GLUT2), fructose transporter (GLUT5) and lysine transporters (B0AT1, CAT1, and ATB0, +) were enhanced in the EW jejunum. No differences observed in villus morphology between EW and LW pigs. Pretreatment of ileal mucosa on Ussing chambers with the Na+ channel blocker (Tetrodotoxin) or the β-adrenergic receptor blocker (Propranolol) augmented glucose, lysine and alanine transporter function in EW but not LW pigs. Together, these data show that EW in gilts induces lasting and divergent alterations in intestinal nutrient transporter function and expression which is mediated in part by the enteric nervous system and β-adrenergic receptor pathways. These new findings may explain why EW pigs exhibit lasting deleterious impacts on performance. Further mechanism-based investigations could reveal new targets for optimizing performance in EW pigs throughout the production lifespan.
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Kondo, Tomohiro, Satoshi Yuki, Yasuyuki Kawamoto, Yasushi Tsuji, Ayumu Hosokawa, Michio Nakamura, Osamu Muto, et al. "Updated analysis of phase II trial of irinotecan/s-1/cetuximab (IRIS/Cet) as second-line treatment in patients with KRAS exon2 wild type metastatic colorectal cancer (mCRC): HGCSG0902—Comparison of administration interval in cetuximab treatment." Journal of Clinical Oncology 34, no. 4_suppl (February 1, 2016): 771. http://dx.doi.org/10.1200/jco.2016.34.4_suppl.771.
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771 Background: HGCSG0902 is the multicenter phase II study to investigate the safety and efficacy of irinotecan, S-1 (IRIS) plus cetuximab as second line treatment in patients with KRAS exon2 wild type mCRC. Response rate (RR) was 33.3% (95%CI 20.8-45.9%), therefore primary endpoint was met (Muto O, et al. ESMO 2014). Here we report an exploratory analysis of outcomes based on administration interval of cetuximab (every week [EW] vs bi-weekly [BW]). Methods: Eligibility includes histologically confirmed mCRC, previously received oxaliplatin-contained chemotherapy, PS: 0-1, EGFR positive and KRAS exon2 wild type. Patients received S-1 80-120 mg/day p.o. on days 1-14 and irinotecan 100mg/m2 on day 1 and 15 repeated every 28 days. Cetuximab was administrated 400mg/m2 as loading dose and continued 250mg/m2 every week or 500mg/m2 bi-weekly. The primary endpoint was RR and the secondary endpoints were disease control rate, PFS, OS and safety. To compare with EW and BW, Fisher’s exact test was used in terms of patient characteristics, AE, RR, and Log-rank test was used in terms of PFS and OS. Results: Between Mar 2010 and Sep 2013, 58 pts were enrolled. One patient was not administered (57 pts were safety analysis set), and 3 pts were ineligible (54 pts were efficacy analysis set). Based on each physician’s choice, 34 patients of EW and 23 of BW were included in the full safety analysis set. RR was 34.4% in the EW and 31.8% in the BW (p = 1.000). Median PFS was 4.2 months in the EW and 6.1 months in the BW (HR 0.752, p = 0.350). Median OS was 8.9 months in the EW and 10.7 months in the BW (HR 0.902, p = 0.737). The most common non-hematological adverse events of grade 3 or higher were diarrhea (23.5% in the EW vs 52.2% in the BW: p = 0.005) and stomatitis (2.9% in the EW vs 30.4% in the BW group: p = 0.046), these were significantly more common in the BW. Conclusions: IRIS/Cet appeared to be highly effective with RR, PFS and OS in the both treatment schedule. Diarrhea and stomatitis were significantly more common in the BW. Therefore, in case of treatment with IRIS/Cet should be administered in the EW. Clinical trial information: UMIN000004882.
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Schuh, Patrick, Hardy Sledzik, Rolf Reber, Kristina Widmer, Martin Oppermann, Markus Mußer, Matthias Seelmann-Eggebert, and Rudolf Kiefer. "GaN-based amplifiers for wideband applications." International Journal of Microwave and Wireless Technologies 2, no. 1 (February 2010): 135–41. http://dx.doi.org/10.1017/s1759078710000152.
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Different wideband amplifiers, hybrid designs at lower frequencies, and monolithically integrated circuits (MMIC) at higher frequencies were designed, fabricated, and measured. These amplifiers are all based on AlGaN/GaN HEMT technology. The future applications for these types of amplifiers are mainly electronic warfare (EW) applications. Novel communication jammers and especially active electronically scanned array EW systems have a high demand for wideband high power amplifiers. The second application also needs high robust low noise amplifiers for its receive path. Output power levels of 38 W for hybrid amplifiers at lower frequencies up to 6 GHz and 15 W for the MMIC power amplifiers at higher frequencies are measured. With these building blocks, novel EW system approaches can be investigated.
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Hunter, JJ Kobus, Luigi TARRICONE, Cornelis Volschenk, Christian Giacalone, Maria Susete Melo, and Roberto Zorer. "Grapevine physiological response to row orientation-induced spatial radiation and microclimate changes." OENO One 54, no. 2 (June 30, 2020): 411–33. http://dx.doi.org/10.20870/oeno-one.2020.54.2.3100.
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Terroir factors and vineyard practices largely determine canopy and root system functioning. In this study, changes in soil conditions, multi-level (vertical, horizontal) light interception (quantitative, photographic, schematic, 3D modelled), leaf water potential and photosynthetic activity were measured during the grape ripening period on NS, EW, NE-SW, and NW-SE orientated (Southern Hemisphere) vertically trellised Shiraz grapevine canopies. It was hypothesised that the spatial radiation interception angle and radiation distribution of differently orientated and vertically trained grapevine rows would affect soil conditions and vine physiological activity. Soil water content showed an increase and soil temperature a decreasing gradient with soil depth. In the afternoon, soil layers of EW orientated rows reached their highest temperature. This, along with measured photosynthetic active radiation received by canopies, complimented the diurnally-captured photographic, constructed and 3D modelled images (also schematically) of canopy and soil exposure patterns. The top, bottom and outside of NS canopies mainly received radiation from directly above, from the E and the W; during midday, high radiation was only received from above. The EW rows received the highest radiation component from above and from the N. The NE-SW rows received high levels of radiation from above, from the SE until 10:00, and from the NW from 13:00. A similar profile can be described for NW-SE rows, but with high radiation received from the NE up to 13:00 and from the SW from 16:00. Overall, lowest leaf water potential occurred for NE-SW canopies, followed by those orientated NW-SE, NS and EW. Photosynthetic activity reflected the positive radiation impact of the sun azimuth during the grape ripening period; best overall performance seemed to occur for E and N exposed canopy sides. This was largely driven by the responsiveness of the secondary leaves to radiation. Photosynthetic output decreased from apical to basal canopy zones with low, erratic values in the light-limited canopy centre. The NS and EW orientated canopies generally showed the highest average photosynthesis, while it was lower for the sides facing S, SE and SW. The results provide a better understanding of the physiological functioning of horizontal and vertical leaf layers in differently orientated grapevine canopies, as affected by climatic conditions. The study contributes to the longstanding challenges of capturing the complexity of parallel microclimatic and physiological output of grapevine canopies under open field conditions. The results can be directly applied to the selection of vineyard practices and seasonal management to ensure the attainment of yield, grape composition and wine quality objectives.
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Komatsu, Yoshito, Satoshi Yuki, Hiroshi Nakatsumi, Ayumu Hosokawa, Michio Nakamura, Osamu Muto, Takashi Meguro, et al. "Phase II trial of irinotecan plus s-1 (IRIS) with cetuximab (IRIS/Cet) as second-line treatment in patients with KRAS wild-type metastatic colorectal cancer (mCRC): HGCSG0902—Comparison of administration interval in cetuximab treatment." Journal of Clinical Oncology 33, no. 3_suppl (January 20, 2015): 746. http://dx.doi.org/10.1200/jco.2015.33.3_suppl.746.
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746 Background: HGCSG0902 is the multicenter phase II study to investigate the safety and efficacy of IRIS/Cet as second-line treatment in patients with KRAS wild type mCRC. RR was 33.3% (95% CI, 20.8%-45.9%), therefore primary endpoint was met (Muto et al. ESMO 2014 ). Here we report an exploratory analysis of outcomes based on administration interval of Cet (every week [EW] vs bi-weekly [BW]). Methods: Eligibility includes histologically confirmed colorectal cancer, previously received oxaliplatin-contained chemotherapy, PS: 0-1, EGFR positive and KRAS WT. Pts. received S-1 80-120 mg/day p.o. on days 1-14 and irinotecan 100 mg/m2 on days 1 and 15 repeated every 28 days. Cet was administrated 400 mg/m2 as loading dose and continued 250 mg/m2 every week or 500 mg/m2 bi-weekly. The primary endpoint was RR and the secondary endpoints were disease control rate, PFS, OS and safety. To compare with EW and BW, Fisher’s exact test was used in terms of patient characteristics, AE, RR, and Log-rank test was used in terms of PFS, OS, and TTF. Results: Between March 2010 and September 2013, 58 pts were enrolled. One patient was not administered (57 pts were safety analysis set), and 3 pts were ineligible (54 pts were efficacy analysis set). Based on each physician choice, 34 pts. of EW and 23 of BW were included in the full safety analysis set. RR was 34.4% in the EW group and 31.8% in the BW group (p=1.000). Median PFS was 4.2 months (95% CI 3.5−4.9) in the EW group and 6.1 months (4.1-8.1) in the BW group (HR 0.752, 95% CI 0.413−1.372, p=0.350). The most common non-hematological adverse events of grade 3 or higher were diarrhea (23.5% in the EW group vs. 52.2% in the BW group: p=0.005) and stomatitis (2.9% in the EW group vs. 30.4% in the BW group: p=0.046), these were significantly more common in the BW group. Conclusions: IRIS/Cet appeared to be highly effective with RR and PFS in the both treatment schedule, and also had met the primary endpoint. Diarrhea and stomatitis were significantly more common in the BW group. Therefore, in case of treatment with IRIS, cetuximab should be administered weekly. Clinical trial information: 000004882.
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Lonkar, V. D., GD Yenge, AS Ranade, AY Doiphode, VR Patodkar, and CS Mote. "Effect of Dietary Inclusion of Combination of Inulin and Saponin on Egg Qualities of Laying Hens." INDIAN JOURNAL OF VETERINARY SCIENCES AND BIOTECHNOLOGY 15, no. 03 (March 10, 2020): 74–76. http://dx.doi.org/10.21887/ijvsbt.15.3.20.
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Effect of supplementation of combination of two feed additives, inulin from Chicory root powder (Cichorium intybus L.) and saponin from Sapindaceae plant powder on egg qualities in laying hens of “BV300”strain was studied from 21-52 week of age (32 weeks period). Total 300 laying hens at 21 week of age were randomly assigned to three equal groups (A, B and C) of 100 hens each. Group A received control basal diet. Group B received basal diet with combination of 0.1g inulin and 0.005g of saponin /kg of feed Group C received basal diet with combination of 0.167 g inulin and 0.0083 g saponin/kg of feed. Egg quality parameters like Egg Weight (EW), Yolk Weight (YW), Albumen Weight (AW) and Shell Weight (SW), Shape Index (SI) and Shell Thickness (ST) were recorded at monthly interval from 21 to 52 week of age. Results of the study indicated that the EW, AW and SW were improved significantly (p less than 0.05) in group B compared to group C and group A without any adverse effect. However, there was no adverse effect of additives on these egg quality parameters at higher dose level in the diet.
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Bertasso, Iala Milene, Carla Bruna Pietrobon, Beatriz Souza da Silva, Rosiane Aparecida Miranda, Maria Lucia Bonfleur, Sandra Lucinei Balbo, Alex Christian Manhães, Elaine Oliveira, Egberto Gaspar de Moura, and Patricia Cristina Lisboa. "Hepatic lipid metabolism in adult rats using early weaning models: sex-related differences." Journal of Developmental Origins of Health and Disease 11, no. 5 (June 10, 2020): 499–508. http://dx.doi.org/10.1017/s2040174420000495.
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AbstractNon-pharmacological early weaning (NPEW) induces liver damage in male progeny at adulthood; however, pharmacological early weaning (PEW) does not cause this dysfunction. To elucidate this difference in liver dysfunction between these two models and determine the phenotype of female offspring, de novo lipogenesis, β-oxidation, very low-density lipoprotein (VLDL) export, and gluconeogenesis in both sexes were investigated in the adult Wistar rats that were weaned after a normal period of lactation (control group) or early weaned either by restriction of access to the dams’ teats (NPEW group) or by reduction of dams’ milk production with bromocriptine (PEW group). The offspring received standard diet from weaning to euthanasia (PN180). NPEW males had higher plasma triglycerides and TyG index, liver triglycerides, and cholesterol by de novo lipogenesis, which leads to intracellular lipids accumulation. As expected, hepatic morphology was preserved in PEW males, but they showed increased liver triglycerides. The only molecular difference between PEW and NPEW males was in acetyl-CoA carboxylase-1 (ACC-1) and stearoyl-CoA desaturase-1 (SCD-1), which were lower in PEW animals. Both early weaning (EW) females had no changes in liver cholesterol and triglyceride contents, and the hepatic cytoarchitecture was preserved. The expression of microsomal triglyceride transfer protein was increased in both the female EW groups, which could constitute a protective factor. The changes in hepatic lipid metabolism in EW offspring were less marked in females. EW impacted in the hepatic cytoarchitecture only in NPEW males, which showed higher ACC-1 and SCD-1 when compared to the PEW group. As these enzymes are lipogenic, it could explain a worsened liver function in NPEW males.
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Vollmer, Timothy L., Daniel R. Wynn, M. Shamsul Alam, and Joaquin Valdes. "A phase 2, 24-week, randomized, placebo-controlled, double-blind study examining the efficacy and safety of an anti-interleukin-12 and -23 monoclonal antibody in patients with relapsing–remitting or secondary progressive multiple sclerosis." Multiple Sclerosis Journal 17, no. 2 (December 6, 2010): 181–91. http://dx.doi.org/10.1177/1352458510384496.
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Background: Interleukins 12 and 23 (IL-12/23) have been implicated in multiple sclerosis (MS) pathogenesis. This study assessed the efficacy and safety of ABT-874, a monoclonal anti-IL-12/23 antibody, in active relapsing–remitting MS (RRMS) or secondary progressive MS (SPMS). Methods: In this 24-week study, patients with RRMS or SPMS received ABT-874 200 mg every other week (EOW), ABT-874 200 mg every week (EW), or placebo. The cumulative number of gadolinium-enhanced lesions, relapse rate, disability progression, and adverse events were measured. Results: 215 patients were randomized (ABT-874 200 mg EOW, N = 76; ABT-874 200 mg EW, N = 70; placebo, N = 69). At week 24, gadolinium-enhanced lesions were statistically significantly reduced with ABT-874 200 mg EOW vs. placebo (mean number [SD]: 5.4 [8.1] vs. 7.6 [14.4], p = 0.003), but not with ABT-874 200 mg EW (6.8 [11.3], p = 0.134). Mean relapse rate (relapses/y) was significantly lower for ABT-874 200 mg EW vs. placebo (0.1 [95% CI −0.0, 0.3] vs. 0.5 [0.2, 0.8], p = 0.007). Changes from baseline in disability scores and incidences of adverse events were not significantly different across treatment groups, although a numerically greater percentage of serious adverse events was reported for ABT-874 treatment groups. Conclusions: Although rates of adverse events were not significantly different between ABT-874 treatment groups and placebo, the magnitude of ABT-874 efficacy was less than that observed with other agents currently in development for MS treatment. Anti-IL-12/23 monotherapy does not appear to warrant further testing as monotherapy treatment for MS.
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Ryoo, Kunkul, Byeongdoo Kang, and Osao Sumita. "Electrolyzed Water as an Alternative for Environmentally Benign Semiconductor Cleaning." Journal of Materials Research 17, no. 6 (June 2002): 1298–304. http://dx.doi.org/10.1557/jmr.2002.0194.
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The present semiconductor cleaning technology is based upon RCA cleaning [W. Kern and D.A. Puotinen, Cleaning Solutions Based on Hydrogen Peroxide for use in Silicon Semiconductor Technology (RCA Rev., 1970) pp. 187–206], a high-temperature process that consumes vast amounts of chemicals and ultrapure water (UPW) [T. Futatsuki, T. Imaoka, Y. Yamashita, and K. Mitsumori, J. Electrochem. Soc., 142, 966 (1995)]. Therefore, this technology gives rise to many environmental issues, and some alternatives such as electrolyzed water (EW) are being studied. In this work, intentionally contaminated Si wafers were cleaned using electrolyzed water. The electrolyzed water was generated by an electrolysis system that consists of anode, cathode, and middle chambers. Oxidative water and reductive water were obtained in the anode and cathode chambers, respectively. When a NH4Cl electrolyte was supplied in the middle chamber, the oxidation–reduction potential and pH for anode water (AW) and cathode water (CW) were +1050 mV and 4.8, and −750 mV and 10.0, respectively. AW and CW deterioriated after electrolysis but maintained their characteristics for more than 40 min, which was sufficient for cleaning. Their deterioration was correlated with CO2 concentration changes dissolved from air. Contact angles of UPW, AW, and CW on DHF-treated Si wafer surfaces were 65.9°, 66.5°, and 56.8°, respectively, which characterizes clearly the electrolyzed water. To analyze the amount of metallic impurities on Si wafer surface, inductively coupled plasma, mass spectroscopy was introduced. AW was effective for Cu removal, while CW was more effective for Fe removal. To analyze the number of particles on Si wafer surfaces, we used the particle measurement Tencor 6220. The particle distributions after various particle removal processes maintained the same pattern. Overflow of EW during cleaning particles resulted in the same cleanness as that obtained with the RCA cleaning process. The roughness of patterned wafer surfaces after EW cleaning was similar to that of as-received wafers. Regardless of process sequence in this work, RCA consumed about 9 l of chemicals, while EW consumed only 400 ml HCl electrolyte or 600 ml NH4Cl electrolyte to clean 8-in. wafers. It was thus concluded that EW cleaning technology would be very effective for releasing environmental safety, and health issues in the next generation of semiconductor manufacturing.
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Luksch, Roberto, Giuseppe Maria Milano, Francesco Barretta, Alessandra Longhi, Emanuela Palmerini, Nadia Puma, Sebastian Dorin Asaftei, et al. "Efficacy of dose intensification in induction therapy for localized Ewing sarcoma: Italian Sarcoma Group (ISG) and Associazione Italiana Ematologia ed Oncologia Pediatrica (AIEOP) ISG/AIEOP EW-1 study." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): 11501. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.11501.
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11501 Background: The role of dose intensification of chemotherapy in Ewing sarcoma (ES) is under evaluation in prospective trials. This is a controlled, randomized phase III study evaluating the impact on event-free survival (EFS) of two arms at different intensity of induction therapy in localized ES at onset. Methods: Newly diagnosed localized ES patients aged 2-40 were eligible. They were randomized to receive 4-courses induction therapy - 1 every 21 days - either with a standard arm (arm A) as per ISG/SSGIII protocol (Ferrari S, et at, Ann Oncol. 2011;22(5):1221) or with an intense arm B, consisting of vincristine 1,5mg/sqm+ doxorubicin 80mg/sqm+ifosfamide 9g/sqm for each course. After induction, patients underwent surgery and/or radiotherapy,followed by an adaptive treatment. Good responders received standard courses chemotherapy: arm A pts received 9 courses, while arm B pts received 5 courses. Poor responders in both arms received 4 courses followed by high-dose busulfan/melphalan+autologous stem cell rescue. The primary outcome measure was EFS for the 2 arms in the intention-to-treat population. Kaplan-Meier curves compared with log-rank test and Cox model were performed to assess differences between study arms. A secondary outcome was toxicity differences, assessed by means of the Fisher’s exact test. Initial sample size was 230 pts, type I error rate 5%, power 80%. Results: Between 2009 and 2019, 234 patients were randomized (arm A-115; arm B-119). M:F ratio was 1.8; median age 14 years (range 2-40); tumour site extremity in 55%, axial/pelvis in 45%; tumour volume < 200ml in 31% and ≥200ml in 69%. A good response was obtained in 56% in arm A and 60% in arm B. Median follow-up was 68 months. EFS was not significantly different between arms; HR: 0.85; 95% CI: 0,51-1,41, 5-year EFS (95% CI) was 73% (64-82%) in arm A and 75% (67-83%) in arm B ( p = 0.526). Good responders in arm A and in arm B and poor responders in arm B had comparable results: 5-year EFS (95% CI) was 80% (71-91%), 77% (67-88%), and 72% (59-86%), respectively, while poor responders in arm A showed a worse, not statistically significant (p = 0.164) performance (63%; 50-78%). Subgroup analyses showed similar outcome for age, tumour site and volume in both arms. Hematological, gastrointestinal, and cardiovascular grade ≥3 toxicities were more pronounced in arm B (p < 0.05). Conclusions: Intense induction therapy with arm B did not improve 5-year EFS when compared with the standard arm A. The higher toxicity observed in arm B than in arm A was counterbalanced, in good responders, by a similar outcome with a shorter treatment plan. For poor responders, with almost 30 patients per arm event-free and with < 48-month FUP, better 5-year EFS in arm B than in arm A was observed but needs further observation. Clinical trial information: NCT02063022.
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McGee, Thomas. "Saving the Survivors: Yezidi Women, Islamic State and the German Admissions Program." Kurdish Studies 6, no. 1 (May 28, 2018): 85–109. http://dx.doi.org/10.33182/ks.v6i1.435.
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Brutality and sexual violence perpetrated by the Islamic State (IS) group against women and girls held in captivity have left traumatic effects on survivors and their communities. In this context, the German federal state of Baden-Württemberg launched a novel ‘Special Quota’ Humanitarian Admissions Programme to receive one thousand vulnerable women and children. They are predominantly from the Yezidi religious minority in Iraq and its autonomous Kurdistan Region. The programme serves as a noble precedent for new and expanded forms of international protection to those affected by conflict-related sexual violence and associated trauma. This article draws, however, on interviews with participants of the programme in order to consider critically the gendered assumptions embedded within its design, implementation and related discourse. Research findings indicate that explicit exclusion of all adult male family members from accompanying the vulnerable “womenandchildren” [1]to Germany is against the wishes and self-perceived best interests of some women survivors. Moreover, women’s inability to maintain family unity compounds their lack of agency to determine the conditions of their own recovery and future within the programme framework.[1] This article borrows the one-word compound term coined by feminist writer Cynthia Enloe to evoke the treatment of women within a conflated conceptual category of diminished personal agency and essentialised vulnerability.ABSTRACT IN KURMANJIXelaskirina yên saxmayî. Jinên êzidî, Dewleta Îslamî û bernameya Almanyayê ya qebûlê Wehşet û şideta cinsî ya ji hêla Dewleta Îslamî pêk hatî li hember jin û keçên dîl tesîrên trawmatîk li ser ên xelasbûyî û li ser cemaetên wan hiştiye. Di vê çarçoveyê de, eyaleta Alman a Baden-Württemberg bernameyeke nû “Kotaya Taybet” a Bernameya Însanî ya Qebûlkirinê da destpêkirin da ku hezar jin û zarokên di rewşa hesas de qebûl bike. Ew jî bi piranî ji kêmîneya olî ya êzidiyan pêk tên li Iraqê û li Herêma Otonom ya Kurdistanê. Bername wek pêşengeke hêja ye ji bo awayên nû û berfireh ên vehewandin û parastina navneteweyî ji wan kesan re ku ketine ber şideta seksî ya ji ber şer û trawmayên ji wê çêbûyî. Ev meqale xwe dispêre hevpeyvînên ligel beşdarên bernameyê ji bo ku bi awayekî rexneyî li wan pêşferzên cinsî yên di binyad û dîzayn û tetbîq û gotara wê de. Encamên lêkolîne nîşan didin ku bi eşkereyî rênedana hemû endamên mêr ên malbatê da ligel “jin û zarokên” di rewşa hesas de werin Almanyayê li dijî daxwaz û baştirîn feydeya (bi baweriya wan) hin ji wan jinên xelasbûyî ye. Herwiha, zehmetiya jinan ji bo parastina yekîtiya malbatên xwe kêmasiya bikeriya wan jî xurttir dike ku ew bi xwe karibin biryarê bigrin ji bo şert û mercên qencbûna xwe û dahatûya xwe di nav çarçoveya bernameyê de.ABSTRACT IN SORANIRizgarkrdinî zîndûmawan, jinanî êzdî, Dewlletî Îslamî û programî wergirtinî EllmanîEw weḧşiyet û tundûtîjîye sêksîyey û ke le layen grupî Dewlletî Îslamîyewe le dijî jinan û kiçanî be dîlgraw hatote encam dan, karîgerîy tirawmatîkî le ser zîndûmawan û komellgakanyan be cê hêştûwe. Lem kontêkste da wîlayetî fîdirrallîy Baden Wurtembêrgî Ellmanya programêkî be nawî pişkî taybet (Special Quota) dest pê kird ke brîtîye le prrogramêkî xêrxwazîy bo wergirtin, bo pêşwazîkirdin le yek hezar jin û mindallî brînbar. Zortirînyan ser be kemîney ayînî êzdîn le 'Êraq û herêmî Kurdistanin. Ew prrograme wek despêşxerîyekî nayab şwênî xoy kirdotewe bo brewdan be şêwazî nwêtir û berfrawantirî parastinî nêwneteweyî bo ewaney ke kewtûnete jêr karîgerîy tundûtîjîy sêksî û ew tirawmayey ke bew hoyewe tûşyan bûwe. Le ser binemay çawpêkewtingelî encamdraw legell beşdarbûwanî programeke da em meqaleye be şêweyekî rexnegirane ew grîmane cenderîyane şî dekatewe ke le naw nawerrok û şêwazî cêbecêkirdin û gutarî peywendîdar dan. Encamekanî lêkollînewe derî dexen ke xistinederî tewawî endame nêrînekanî xêzan ke hawşanî "jinan û mindallan"î brînbar birron bo Ellmanya le dijî wîst û pêdawîstîye kesîyekanî hendêk le jine zîndumawekane. Herweha nebûnî twanayîy ewey ke jinekan xêzanekanyan be yekgirtûwîy bihêllinewe, rêga le karabûnyan degirêt le pêkhênanî mercekanî çareserî û dahatûyan le çwarçêwey ew programe da.
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Oppermann, Martin, Felix Thurow, and Ralf Rieger. "RF Sensor Modules – Needs for Multifunctional Architectures." Additional Conferences (Device Packaging, HiTEC, HiTEN, and CICMT) 2016, CICMT (May 1, 2016): 000207–10. http://dx.doi.org/10.4071/2016cicmt-tha25.
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Abstract Next generation of RF sensor modules, mainly for airborne applications, will cover a variety of multifunction in terms of different operating modes, e.g. Radar, EW and Communications / Datalinks. The operating frequencies will cover a bandwidth of > 10 GHz and for realisation of modern Active Electronically Steered Antennas (AESA) the Transmit/Receive (T/R) modules have to match with challenging geometry demands, and RF requirements, like switching and filtering between different operational frequencies in transmit and receive mode. New GaN technology based MMICs, e.g. LNA, HPA are in development and multifunctional components (MFC MMICs) cover more than one RF function in one chip. Different front end demonstrators will be presented, based on multilayer ceramic (LTCC) and RF-PCB and associated assembly technologies, like chip&wire and SMD reflow soldering. These TRM front ends include a Low Noise Amplifier with an integrated Switch (LNA/SW) and for characterisation the measured Noise Figure (NF), a key characteristic for receive performance, will be compared. The need for high integration on module level is obvious and therefore specific demands for low loss ceramic and PCB based modules, packages and housings exist.
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HODOS, WILLIAM, RONALD F. MILLER, MIMI M. GHIM, MALINDA E. C. FITZGERALD, CLAUDIO TOLEDO, and ANTON REINER. "Visual acuity losses in pigeons with lesions of the nucleus of Edinger-Westphal that disrupt the adaptive regulation of choroidal blood flow." Visual Neuroscience 15, no. 2 (February 1998): 273–87. http://dx.doi.org/10.1017/s0952523898152070.
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Choroidal blood flow (ChBF) in birds is regulated by a neural circuit whose components are the retina, the suprachiasmatic nucleus, the medial division of the Edinger-Westphal nucleus (EWM), the ciliary ganglion, and the choriod. We have previously shown that lesions of EWM appear to result in pathological alterations in the retina. To determine whether EWM lesions also lead to altered visual functions, we have examined the effects of EWM lesions on visual acuity in pigeons. Bilateral lesions of EWM were made electrolytically, and visual acuity for high-contrast, square-wave gratings was determined behaviorally about 1 year later and compared to that of a group of pigeons that had received sham lesions of EW about 1 year prior to acuity testing. Because lesions targeting EWM invariably resulted in damage to the adjoining lateral part of the Edinger-Westphal nucleus (EWL), which controls pupillary constriction and accommodation, two additional control groups were studied. In one such control group, bilateral lesions in the area pretectalis (AP), which innervates the pupillary control part of EWL and thereby controls pupillary constriction, were made and the effects on visual acuity determined about 1 year later. In the second such control group, the effects of acute accommodative and pupillary dysfunction on acuity were studied in pigeons made cycloplegic. The accuracy of all lesions was later confirmed histologically. The mean acuities of birds with AP lesions (9.1 ± 1.4 cycles/deg) and sham lesions (7.1 ± 1.5 cycles/deg) were not significantly different from normal, based on published normative data on pigeons. In contrast, pigeons with lesions that completely destroyed EW bilaterally showed visual acuity (2.7 ± 0.1 cycles/deg) that was well below the acuity of the sham and AP-lesion control groups. The acuity of the cycloplegic pigeons (4.8 ± 0.3 cycles/deg) and one pigeon with a nearly complete bilateral EWL but a unilateral EWM lesion (6.4 cycles/deg) indicated that only about half of the loss with a bilateral EW lesion could be attributed to accommodative dysfunction. Thus, bilateral destruction of EWM appears to have led to a loss in visual acuity. This conclusion suggests that disruption of adaptive neural regulation of ChBF may impair visual function. Destruction of EWM was, however, associated with damage to the somatic components of the oculomotor and trochlear nuclei. The possibility cannot be excluded that such damage also contributed to the acuity loss.
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Asaftei, Sebastian Dorin, Nadia Puma, Anna Paioli, Marco Petraz, Carlo Morosi, Marta Podda, Angela Tamburini, et al. "Front-Line Window Therapy with Temozolomide and Irinotecan in Patients with Primary Disseminated Multifocal Ewing Sarcoma: Results of the ISG/AIEOP EW-2 Study." Cancers 13, no. 12 (June 18, 2021): 3046. http://dx.doi.org/10.3390/cancers13123046.
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Purpose: The main objective was to evaluate the activity and tolerability of TEMIRI as a front-line treatment in primary disseminated Ewing sarcoma (PDMES) using the RECIST 1.1 criteria. The secondary objectives included the assessment of toxicity and the performance status/symptom changes. Methods: Between 2012 and 2018, patients with PDMES received two courses of temozolomide 100 mg/sqm/day + irinotecan 50 mg/sqm/day for 5 days every 3 weeks as an amendment to the Italian Sarcoma Group/Associazione Italiana EmatoIogia ed Oncologia Pediatrica (ISG/AIEOP) EW-2 protocol (EUDRACT#2009-012353-37, Vers. 1.02). Results: Thirty-four patients were enrolled. The median age at diagnosis was 19 years (range 3–55). After TEMIRI, the RECIST response was as follows: a partial response in 20 (59%) patients, stable disease in 11 (32%), and disease progression in 3 (9%). The ECOG/Lansky score was improved in 25/34 (73.5%) cases, and a reduction or disappearance of pain was observed in 31/34 patients (91%). The incidence of grade 3–4 toxicity was 3%. The 3-year event-free survival (EFS) and overall survival (OS) were 21% (95% CI 6–35%) and 36% (95% CI: 18–54%), respectively. Conclusion: the smooth handling and encouraging activity demonstrated by up-front TEMIRI did not change the EFS in PDMES, so this result suggests the need for the further evaluation of the efficacy of TEMIRI in combination with conventional treatments in non-metastatic patients.
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Oppermann, Martin, and Ralf Rieger. "RF Modules (Tx–Rx) with Multifunctional MMICs." Additional Conferences (Device Packaging, HiTEC, HiTEN, and CICMT) 2017, NOR (July 1, 2017): 1–5. http://dx.doi.org/10.4071/2017-nor-oppermann.
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Abstract Next generation RF sensor modules for multifunction active electronically steered antenna (AESA) systems will need a combination of different operating modes, such as radar, electronic warfare (EW) functionalities and communications/datalinks within the same antenna frontend. They typically operate in C-Band, X-Band and Ku-Band and imply a bandwidth requirement of more than 10 GHz. For the realisation of modern active electronically steered antennas, the transmit/receive (T/R) modules have to match strict geometry demands. A major challenge for these future multifunction RF sensor modules is dictated by the half-wavelength antenna grid spacing, that limits the physical channel width to < 12 mm or even less, depending on the highest frequency of operation with accordant beam pointing requirements. A promising solution to overcome these geometry demands is the reduction of the total monolithic microwave integrated circuit (MMIC) chip area, achieved by integrating individual RF functionalities, which are commonly achieved through individual integrated circuits (ICs), into new multifunctional (MFC) MMICs. Various concepts, some of them already implemented, towards next generation RF sensor modules will be discussed and explained in this work.
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Behrakis, P. K., B. D. Higgs, D. R. Bevan, and J. Milic-Emili. "Partitioning of respiratory mechanics in halothane-anesthetized humans." Journal of Applied Physiology 58, no. 1 (January 1, 1985): 285–89. http://dx.doi.org/10.1152/jappl.1985.58.1.285.
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In five spontaneously breathing anesthetized subjects [halothane approximately 1 minimal alveolar concentration (MAC), 70% N2O, 30% O2], flow, changes in lung volume, and esophageal and airway opening pressure were measured in order to partition the elastance (Ers) and flow resistance (Rrs) of the total respiratory system into the lung and chest wall components. Ers averaged (+/- SD) 23.0 +/- 4.9 cmH2O X l-1, while the corresponding values of pulmonary (EL) and chest wall (EW) elastance were 14.3 +/- 3.2 and 8.7 +/- 3.0 cmH2O X l-1, respectively. Intrinsic Rrs (upper airways excluded) averaged 2.3 +/- 0.2 cmH2O X l-1 X s, the corresponding values for pulmonary (RL) and chest wall (RW) flow resistance amounting to 0.8 +/- 0.4 and 1.5 +/- 0.5 cmH2O X l-1 X s, respectively. Ers increased relative to normal values in awake state, mainly reflecting increased EL. Rw was higher than previous estimates on awake seated subjects (approximately 1.0 cmH2O X l-1 X s). RL was relatively low, reflecting the fact that the subjects had received atropine (0.3–0.6 mg) and were breathing N2O. This is the first study in which both respiratory elastic and flow-resistive properties have been partitioned into lung and chest wall components in anesthetized humans.
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Xing, Wang, Xu, Lin, Li, Jiao, Zhang, and Liu. "A Depth-Adaptive Waveform Decomposition Method for Airborne LiDAR Bathymetry." Sensors 19, no. 23 (November 20, 2019): 5065. http://dx.doi.org/10.3390/s19235065.
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Airborne LiDAR bathymetry (ALB) has shown great potential in shallow water and coastal mapping. However, due to the variability of the waveforms, it is hard to detect the signals from the received waveforms with a single algorithm. This study proposed a depth-adaptive waveform decomposition method to fit the waveforms of different depths with different models. In the proposed method, waveforms are divided into two categories based on the water depth, labeled as “shallow water (SW)” and “deep water (DW)”. An empirical waveform model (EW) based on the calibration waveform is constructed for SW waveform decomposition which is more suitable than classical models, and an exponential function with second-order polynomial model (EFSP) is proposed for DW waveform decomposition which performs better than the quadrilateral model. In solving the model’s parameters, a trust region algorithm is introduced to improve the probability of convergence. The proposed method is tested on two field datasets and two simulated datasets to assess the accuracy of the water surface detected in the shallow water and water bottom detected in the deep water. The experimental results show that, compared with the traditional methods, the proposed method performs best, with a high signal detection rate (99.11% in shallow water and 74.64% in deep water), low RMSE (0.09 m for water surface and 0.11 m for water bottom) and wide bathymetric range (0.22 m to 40.49 m).
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Liu, Tong, Mei Zhang, Yihan Wang, Lili Tang, Kefan Wang, and Fuchen Shi. "The Effect of Different Cleaning Methods on Needles for Assessing the Atmospheric Heavy Metal Retention Capacity of Three Coniferous Trees." Applied Sciences 11, no. 4 (February 12, 2021): 1668. http://dx.doi.org/10.3390/app11041668.
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Urban air pollution has received increasing attention in recent years. To investigate the interaction between several heavy metal elements and the degree of atmospheric pollution, the leaves of three evergreen tree species—Chinese juniper (Juniperus chinensis L.), dragon juniper (Juniperus chinensis L. ‘Kaizuca’), and cedar (Cedrus deodara (Roxb. ex D.Don) G.Don)—were collected from main road intersections in the urban area of Tianjin, China. Two different treatments—water washing (WW) and ethanol washing (EW)—were used, and the contents of Cu, Mn, Cd, and Zn were measured in both washed and unwashed (UW) leaves. It was found that the heavy metal contents within Chinese juniper and dragon juniper were ranked as Mn > Zn > Cu > Cd, and the metal accumulation index (MAI) value was higher for dragon juniper. For the three plants, water washed off 5.36% to 58.58% of the total heavy metals in the needles, while ethanol washed off 16.08% to 71.60% of the total. Both washes were more effective for Cu, Zn, and Cd, and especially for the element Cd. Ethanol could clean off 38.64% to 71.60% of the total Cd from the leaves. Ethanol had a better elution effect compared to water, and the trend of the Cd content in the leaves of the three plants showed a change after the use of different washing methods, which suggests that the water washing may have masked the real difference.
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Hohmann, Lisa G., Tong Yin, Helen Schweizer, Isabella J. Giambra, Sven König, and Armin M. Scholz. "Comparative Effects of Milk Containing A1 versus A2 β-Casein on Health, Growth and β-Casomorphin-7 Level in Plasma of Neonatal Dairy Calves." Animals 11, no. 1 (December 30, 2020): 55. http://dx.doi.org/10.3390/ani11010055.
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Research has shown that digestion of A1 β-casein (β-CN) affects gastrointestinal motility and opioid activity through the release of the peptide β-casomorphin-7 (β-CM7). In the case of the A2 variant, the cleavage of β-CM7 does not occur or occurs at a very low rate. Therefore, the aim of the study was to compare the effects of milk containing either homozygote A1 or A2 β-CN on health and growth parameters of dairy calves. Forty-seven neonatal calves (24 females, 23 males) of the breeds German Holstein (GH, n = 9), German Simmental (GS, n = 33) and their crossing (GH × GS, n = 5) were used in a 21-day feeding study. Fecal score (FS), respiratory frequency (RF), and rectal body temperature (BT) were recorded daily, whereas body weight was measured at birth and at day 21 to estimate the average daily weight gain (ADG). Additionally, blood was collected from calves three times during the experimental period and, for the first time, the respective plasma samples were analyzed for intact β-CM7. Consumption of A2-milk led to a lower daily milk intake (dMI) (p < 0.05). Furthermore, fecal consistency was softer for calves fed A2-milk (p < 0.05). Although 44% of A2-calves had diarrhea or revealed a tendency towards it (FS ≥ 3), A1-calves had a prevalence of 21%. Calves with a FS of 4 were offered an electrolyte solution and received a dietary food supplement for the stabilization of the fluid and electrolyte balance. Nevertheless, similar ADG and end weights (EW) of calves fed A1- or A2-milk (p > 0.05) indicate that A2-milk may compensate higher diarrhea rates and lower dMI due to the associated higher protein content. This is the first report of intact β-CM7 in plasma of calves fed milk of either A1 or A2 β-CN. Evidence from this study suggests that due to the change in the amino-acid sequence, A2-milk might be able to prevent or, at least, to minimize the cleavage of β-CM7 in calves.
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Li, Dapeng, Qin Tong, Zhengxiang Shi, Weichao Zheng, Yu Wang, Baoming Li, and Geqi Yan. "Effects of Cold Stress and Ammonia Concentration on Productive Performance and Egg Quality Traits of Laying Hens." Animals 10, no. 12 (November 30, 2020): 2252. http://dx.doi.org/10.3390/ani10122252.
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In a cold climate, ensuring indoor air quality and heat preservation simultaneously has always been a difficult problem in the poultry house. The current study was carried out in order to determine the effects of chronic low temperature and ammonia concentration on productive performance and egg quality of commercial laying hens. 576 18-week-old Hy-line Brown hens were used in this study. Birds were housed in cages and received for 20-week exposure to low temperature and ammonia in six artificial environmental chambers. Birds were randomly assigned into six treatments: treatment 1 (T1, 20 °C, ≤5 ppm, control group), treatment 2 (T2, 20 °C, 20 ppm), treatment 3 (T3, 20 °C, 45 ppm), treatment 4 (T4, 8 °C, ≤5 ppm), treatment 5 (T5, 8 °C, 20 ppm) and treatment 6 (T6, 8 °C, 45 ppm). Daily feed intake (DFI), feed efficiency (FE), egg production (EP) and body weight (BW) were recorded and calculated from 19 weeks of age. Egg samples were collected at 22, 26, 30, 34 and 38 weeks of age and egg weight (EW), shell breaking strength (SBS), albumen height (AH), yolk weight (YW), shell weight (SW), shell thickness (ST) and Haugh unit (HU) were measured. The results of the present study indicated that low temperature and excessive ammonia decreased the EP of hens compared with those of the T1 birds. Low temperature increased DFI of hens thereby FE showed significant differences among treatments. During the early period of the experiment, low temperature treatment increased the BW of laying hens, but this trend of increase was suppressed by the treatment of ammonia with the prolongation of the experimental period. Egg quality was also affected by low temperature and excessive ammonia. At different experimental periods, egg quality traits of hens exposed to the cold and ammonia stress presented significant differences compared to those of control birds. The present study indicated that the effect of ammonia was more pronounced on hens than that of low temperature at the early and peak laying period in terms of several main traits of productive performance and egg quality under long term hens breeding.
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Coates, L. C., W. Tillett, M. A. D’agostino, P. Rahman, F. Behrens, P. G. Conaghan, E. Mcdearmon-Blondell, et al. "OP0050 ADALIMUMAB INTRODUCTION VERSUS METHOTREXATE DOSE ESCALATION IN PATIENTS WITH INADEQUATELY CONTROLLED PSORIATIC ARTHRITIS: RESULTS FROM RANDOMIZED PHASE 4 CONTROL STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 33.2–33. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2393.
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Background:Methotrexate (MTX) is often used as first-line therapy for patients (pts) with psoriatic arthritis (PsA) despite limited efficacy and data on appropriate dosage. Minimal Disease Activity (MDA) is suggested as an optimal treat-to-target outcome. Biologic disease-modifying antirheumatic drugs (bDMARDs) have demonstrated improved outcomes (including MDA rates) over MTX. However, more data are needed to define the optimal timing of bDMARD initiation and characterize efficacy of MTX dose escalation, to achieve optimal outcomes.Objectives:To compare achievement of MDA between adding adalimumab (ADA) vs escalating MTX dose in PsA pts with inadequate disease control after initial MTX therapy.Methods:The open-label, 2-part CONTROL study enrolled bDMARD-naive adult pts with active PsA (not in MDA at screening and ≥3 tender and ≥3 swollen joints) despite MTX 15 mg every wk (ew) for ≥4 wks. Pts were randomized to ADA 40 mg every other wk + MTX 15 mg (ADA+MTX) or escalated MTX to 20–25 mg ew or highest tolerable dose during 16-wk part 1 (Fig 1). The primary endpoint was achievement of MDA, defined as fulfilling ≥5 of the 7 criteria: tender joint count 68 (TJC68) ≤1, swollen joint count 66 (SJC66) ≤1, Psoriasis Area Severity Index (PASI) ≤1 or body surface area (BSA) ≤3%, pt’s pain (visual analogue scale [VAS] 0–100) ≤15, Pt’s Global Assessment of disease activity (PtGA) VAS ≤20, Health Assessment Questionnaire Disability Index (HAQ-DI) ≤0.5 and tender entheseal points (0–8) ≤1. Key secondary efficacy endpoints were achievement of ACR20 and PASI75 and change from baseline in HAQ-DI and Leeds Enthesitis Index (LEI) at wk 16.Results:Overall, 246 pts were randomized; 245 received treatment (ADA+MTX, n=123; escalated MTX, n=122); 117 (95%) pts and 110 (90%) pts, respectively, completed part 1. Baseline characteristics were similar between groups (Table). During part 1, the average dose of MTX was 21.8 mg/wk (55% on oral MTX) in the escalated MTX group. Significantly higher proportion of pts in ADA+MTX (42%) vs escalated MTX (13%) group achieved MDA at wk 16 (non-responder imputation [NRI]; difference [95% CI] 28% [18%–39%];P<0.001;Fig 2). Observed case analysis confirmed the NRI analysis. Lower MDA rates at wk 16 were observed in the escalated MTX arm regardless of prior MTX duration (Fig 2). Significant improvements in key secondary endpoints were also observed with ADA+MTX vs escalated MTX (allP<0.05;Fig 2). In part 1, the proportion of patients with adverse events was similar between groups (ADA+MTX, 62% vs escalated MTX, 57%); no opportunistic infections, tuberculosis, malignancies, or deaths were reported during part 1.Conclusion:A significantly higher proportion of pts achieved MDA at wk 16 after introducing ADA compared with escalating MTX dose; higher rates were observed regardless of prior MTX duration. Significantly higher responses in musculoskeletal, skin, and quality of life measures were observed with ADA+MTX vs escalated MTX. No new safety signals with ADA were identified in this pt population.Table 1.Baseline DemographicsCharacteristics, mean (SD)ADA+MTXn=123Escalated MTXn=122Female, n (%)64 (52.0)59 (48.4)Age, y51.4 (12.2)48.8 (12.7)BSA >3%, n (%)74 (60.2)78 (63.9)Pt pain63.7 (19.5)62.3 (20.9)PtGA65.0 (19.9)62.9 (20.9)HAQ-DI1.2 (0.6)1.2 (0.7)LEI + plantar count3.5 (2.1)3.5 (2.1)Disclosure of Interests:Laura C Coates: None declared, William Tillett Grant/research support from: AbbVie, Celgene, Eli Lilly, Janssen, Novartis, Pfizer Inc, UCB, Consultant of: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, MSD, Pfizer Inc, UCB, Speakers bureau: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, Pfizer Inc, UCB, Maria Antonietta D’Agostino Consultant of: AbbVie, BMS, Novartis, and Roche, Speakers bureau: AbbVie, BMS, Novartis, and Roche, Proton Rahman Grant/research support from: Janssen and Novartis, Consultant of: Abbott, AbbVie, Amgen, BMS, Celgene, Lilly, Janssen, Novartis, and Pfizer., Speakers bureau: Abbott, AbbVie, Amgen, BMS, Celgene, Lilly, Janssen, Novartis, Pfizer, Frank Behrens Grant/research support from: Pfizer, Janssen, Chugai, Celgene, Lilly and Roche, Consultant of: Pfizer, AbbVie, Sanofi, Lilly, Novartis, Genzyme, Boehringer, Janssen, MSD, Celgene, Roche and Chugai, Philip G Conaghan Consultant of: AbbVie, BMS, Eli Lilly, EMD Serono, Flexion Therapeutics, Galapagos, GSK, Novartis, Pfizer, Speakers bureau: AbbVie, Eli Lilly, Novartis, Pfizer, Erin McDearmon-Blondell Shareholder of: AbbVie, Employee of: AbbVie, Xianwei Bu Shareholder of: AbbVie, Employee of: AbbVie, Liang Chen Shareholder of: AbbVie, Employee of: AbbVie, Mudra Kapoor Shareholder of: AbbVie, Employee of: AbbVie, Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau
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Kanter, Arlene S. "There's No Place Like Home: The Right to Live in the Community for People with Disabilities, Under International Law and the Domestic Laws of the United States and Israel." Israel Law Review 45, no. 2 (June 29, 2012): 181–233. http://dx.doi.org/10.1017/s0021223712000015.
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This article explores the developing ‘right to live in the community’ for people with disabilities under international law and the domestic laws of two countries: the United States and Israel. In 2006, the United Nations adopted the Convention on the Rights of People with Disabilities (CRPD). This Convention embraces a human rights approach to disability, based on the principles of equality, dignity, freedom and inclusion. Based on these principles, Article 19 of the CRPD includes a specific right of all people with disabilities ‘to live in the community, with choices equal to others’. The author argues that the mandate of community living in Article 19 supports an explicit legal right of all people with disabilities not only to live in the community, but to choose where to live and with whom, and with supports, as needed. This new international legal right to live in one's home in the community also advances the goals and principles of the domestic laws of the US and Israel.In the US, the Americans with Disabilities Act (ADA) protects the right of people with disabilities to receive services in ‘the most integrated’ setting. Relying on this ‘integration mandate’, the US Supreme Court, in 1999, upheld a limited right of people with disabilities to live in the community inOlmstead v LC and EW. In Israel, the Parliament (Knesset) enacted a law similar to the ADA in 1998. This law, the Equal Rights of Persons with Disabilities Law (‘Equal Rights Law’) includes a general right of people with disabilities to equality and non-discrimination. Although the current version of the Equal Rights Law does not include a specific article on the right to live in the community, the basis for such a right may be found in other articles of the law as well as other Israeli laws. In addition, in the recent case ofLior Levy et al., the Israeli High Court of Justice was asked to consider the right to live in the community under Israeli law. While the Court in this case recognised a limited right to live in the community, it failed to invalidate as discriminatory the Israeli government's policy of placing people with disabilities in large institution-like hostels rather than in homes in the community. The author concludes the article with a discussion of the scope and meaning of community living and the extent to which institutions, as well as community housing that functions just like institutions, should be prohibited under the CRPD as well as under US and Israeli law.
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Wierzbowska, Agnieszka, Ewa Wawrzyniak, Monika Siemieniuk-Rys, Aleksandra Kotkowska, Agnieszka Pluta, Tadeusz Robak, Anna Jaskowiec, et al. "Cladribine Added to Daunorubicin and Cytarabine Induction Regimen Prolongs Survival of Patients with Complex but Not Monosomal Karyotype Acute Myeloid Leukemia – Retrospective Analysis of Polish Adult Leukemia Group (PALG)." Blood 124, no. 21 (December 6, 2014): 2347. http://dx.doi.org/10.1182/blood.v124.21.2347.2347.
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Abstract Objectives:Cytogenetics is one of the most important prognostic factors in acute myeloid leukemia (AML). Two major, partially overlapping cytogenetic subsets of AML associated with an adverse prognosis, are AML with complex karyotype (CK) and AML with monosomal karyotype (MK). MK has been shown to constitute a cytogenetic feature that identifies AML patients (pts) with very poor outcomes when treated with currently available therapy. CK-AML pts are very heterogeneous cytogenetically, and treatment outcomes of these subsets are also influenced by TP53 alterations, complexity of the karyotype or presence of residual normal metaphases. However, impact of all these variables on outcome of CK-AML patients was so far analyzed separately. The aim of our study was to assess treatment outcome of CK-AML patients with or without MK regarding some cytogenetic and clinical features. Materials and methods: One hundred twenty five newly diagnosed AML patients with CK treated between January 2007 and January 2013 with PALG protocols (Holowiecki et al., JCO 2012) were included into the study. Cytogenetic analysis was performed on metaphases from bone marrow aspirates taken at diagnosis using standard banding techniques. Karyotypes were reported in accordance with the ISCN 2009. CK was defined as a presence of ≥ 3 unrelated abnormalities. MK was defined by the presence of an autosomal monosomy in conjunction with at least one other autosomal monosomy or structural abnormality in the absence of t(8;21), inv(16), t(15;17) (Breems et al., JCO 2008). FISH method was used to verify MK in all cases with monosomy as well as to assess 17p13 (TP53) deletion. Results:Clinical characteristics. The median age of all pts was 60 years (range 19-85 years). FISH verification proved the MK karyotype (MK+) in 75 out of 125 (60%) pts with CK-AML. Remaining pts had non-monosomal CK (MK-). Sixty six (55%) pts received intensive induction chemotherapy (IC) according to PALG protocols and 59 pts received non-intensive treatment with low-dose cytarabine (LDAC) or best supportive care (BSC). Baseline characteristics were generally balanced between MK+ and MK- groups in terms of age, WBC and PLT counts, hemoglobin level, percentage of bone marrow blasts at diagnosis and presence of residual normal metaphases in the karyotype. Higher proportions of MK+ pts had deletion of 17p13 (TP53) (47,9% vs. 20,4% of MK-; p=0.0017) as well as ≥5 cytogenetic aberrations (93,3% vs. 74%; p=0.004). Furthermore, there were no differences in the proportion of IC, LDAC and BSC strategies between both groups. Treatment Response and Outcome. With the median time of follow-up 7,7 months (mos), median OS in MK- pts was significantly longer compared to MK+ group (4,5 mos vs. 2,0 mos; p=0.0075). 66/125 CK-AML pts received standard IC according to PALG AML protocols (DA-36 pts; DAC-27 pts and DAF-3 pts). Only 7 pts underwent allogeneic stem cell transplantation (allo-SCT). In intensively treated pts the overall CR rate in MK- was about twice as high as in MK+ group (62,1% vs 32,4%; p=0.013). The median OS in MK- pts was longer compared to MK+ group (6,8 mos vs. 2,7 mos; p=0.016). Probability of 1-year OS in MK+ vs. MK- group was 14% vs. 30%. In multivariate analysis we have found that WBC >20 G/l, MK and ≥5 chromosomal abnormalities were independent prognostic factors associated with significantly shorter OS (Table 1). In contrast, allo-SCT was associated with survival benefit. Furthermore, we analyzed the impact of purine analogue containing induction regimens on treatment outcome. We found that addition of cladribine to the standard DA regimen improves OS in MK- but not in MK+ group (Figure 1). Conclusions: Monosomal karyotype, high WBC count and high complexity of the karyotype (≥5 aberrations) are associated with more aggressive clinical course and short survival in high-risk CK-AML. Cladribine added to standard DA induction regimen prolongs survival of pts with complex but not monosomal karyotype. *AW and EW equally contributed to the study. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures No relevant conflicts of interest to declare.
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Calvo Moya, M. I., I. Omella Usieto, I. El Hajra Martinez, E. Santos Perez, Y. Gonzalez Lama, B. Ruiz Antoran, B. Menchen Viso, et al. "P533 Adalimumab 80mg every other week in inflammatory bowel disease: Treatment intensification outcomes in real life clinical practice." Journal of Crohn's and Colitis 15, Supplement_1 (May 1, 2021): S507—S509. http://dx.doi.org/10.1093/ecco-jcc/jjab076.655.
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Abstract Background Adalimumab (ADA) intensification is recommended for inadequate or loss of response in inflammatory bowel disease (IBD) patients. A new presentation of ADA 80mg administered every other week (eow) has been approved as an alternative to ADA 40mg every week (ew). Data regarding impact of ADA 80mg eow in clinical practice is still scarce. The aim of this study was to assess long-term durability, safety and cost-effectiveness of treatment with ADA 80mg eow in patients with IBD. Methods A retrospective cohort study in a tertiary hospital that included all IBD patients under intensified maintenance therapy with ADA 80mg eow was performed. Durability was calculated considering the time from the first dose to treatment withdrawn or to the end of follow-up. Biological remission (BR) was defined as CR together with fecal calprotectin (FC) <250µg/g and C-reactive protein (CRP) <5mg/dl. Economic impact of ADA 80mg eow was estimated considering current price of both ADA 40mg and ADA 80mg pens at our centre. Results Sixty-three patients (52 CD and 11 CU) were included; median age 47 (IQR 39–59), 54% male; median duration of the disease before ADA of 11 years (IQR 6–20); 30% were active smokers. Among CD patients, 56% had ileal disease, 17% colonic and 27% ileocolonic. The inflammatory behavior was the most frequent (52%) and 31% had perianal disease. In UC, 55% had extensive colitis. 44 patients (70%) were bio-naïve and 36 (57%) received immunosuppressants at baseline. At the time of escalation, 48 patients (76%) were symptomatic. After intensification, 52 (83%) patients (CD 42 and UC 10) achieved CR and 46 (73%) BR. The changes in the levels of FC, CRP and ADA were significant (p <0.001) (Graphs 1–3). 22 patients (35%) discontinued treatment after a median of 6.5 (IQR 5–10) months due to: 11 no clinical response (50%), 4 loss of response (18%), 3 adverse events (14%) (psoriasis) and 4 endoscopic progression (18%). 44 patients (70%) remained under treatment and in CR (median follow-up 17 months, IQR 13–24) (Graph 4) and with a median ADA levels of 10.46 mg/l (IQR 7.34–15.25). Use of ADA 80 eow regimen saved 223500€ in patients who maintained treatment. In the multivariate analysis, being in CR when intensifying reduced the risk of treatment discontinuation by 87% (HR 0.13, 95%CI 0.02–0.99; p<0.001), having reached BR by 99.5% (HR 0.05, 95%CI 0.02–0.14; p <0.001) and having ADA levels ≥5 mg/l after intensification by 68% (HR 0.32, 95%CI 0.13–0.75; p = 0.02). Smoking habit was associated with treatment withdrawn (HR 1.74, 95%CI 1.02–2.96; p=0.04). Conclusion ADA intensification to 80mg eow in IBD patients is safe, effective and may reduce costs in real life clinical practice. Early intensification, even in CR, may enhance ADA treatment durability.
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Berinstein, Neil L., Nancy M. Pennell, Rashmi Weerasinghe, Matthew C. Cheung, Eugenia Piliotis, Kevin R. Imrie, Mary-Anne Cussen, et al. "Risk Adjusted Management of Newly Diagnosed High and Intermediate FLIPI Follicular Lymphoma Using (90)Y Ibritumomab Tiuxetan." Blood 128, no. 22 (December 2, 2016): 1794. http://dx.doi.org/10.1182/blood.v128.22.1794.1794.
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Abstract Background: Although the natural history of follicular lymphoma is indolent with a median overall survival of about 12-15 years, the disease is heterogeneous. The 5 and 10 year overall survival (OS) of low, intermediate and high risk FLIPI is 91%, 78% and 53% and 71%, 51% and 36% using standard rituximab-based treatment. 5-year progression-free survival (PFS) is 80%, 70% and 48% respectively. Methods: Based upon this we conducted an investigator-initiated single-centre Phase II trial of intensified therapy with CHOP-R followed by (90)Y ibritumomab tiuxetan consolidation and 24 months of rituximab maintenance as treatment for patients with intermediate and high-risk newly diagnosed symptomatic follicular lymphoma. 33 patients were enrolled. Results: The addition of (90)Y ibritumomab tiuxetan was well tolerated but resulted in asymptomatic grade 3 or 4 thrombocytopenia and neutropenia in11-36% and 10-24% of patients between weeks 2-8 post (90) Y. After 9 years of follow-up (median follow-up 61 months) the 0S for intermediate and high risk FLIPI was 95% and 78%. The 5 year PFS was 79% and 64% for intermediate and high risk FLIPI, respectively. Responses at three months post consolidation were as follows: 3/33 (9%) achieved CR, 25/33(76%), achieved CRU, 1/33(3%) had PR, and 1/33(3%) had PD. Three patients did not receive (90)Y ibritumomab tiuxetan due to disease progression 2/33(6%), or death 1/33(3%). Of 19 patients who had a molecular marker for their lymphoma, 18 (95%) achieved molecular remissions in peripheral blood with CHOP-R therapy. Nine (47%) of these patients have been recently assessed for MRD and remain in molecular remission. The therapy resulted in decreased levels of IgG, IgM and IgA below the lower normal level in 33%, 40% and 23% of patients respectively post therapy. These levels did not recover in most of these patients. B cells were depleted to undetectable levels during therapy including rituximab maintenance. In 18 evaluable patients only 11 recovered normal B cell counts post maintenance rituximab. There was no correlation between normal B-cell recovery and Ig levels. Many patients with low or no B cell counts had normal IgG levels, whereas some patients who regained normal B cell counts were still unable to reach normal Ig levels. No patient developed human anti-mouse antibody. Immunity to measles, mumps, or rubella was retained post therapy. Patients did not have significant infections or opportunistic infections (although 2 developed Grade 1 shingles post (90)Y ibritumomab tiuxetan) and none required IVIG. Conclusions: We conclude that this intensified regimen is highly active in cyto-reducing lymphoma in high and intermediate risk FLIPI follicular lymphoma patients. The toxicity is tolerable although a significant percentage of patients will end up with persistent asymptomatic reductions in B cells and serum Ig. Only randomized trials will determine whether this regimen enhances outcome over standard of care in this higher risk follicular lymphoma population. References: 1.Examination of the follicular lymphoma international prognostic index (FLIPI) in the National LymphoCare study (NLCS): a prospective US patient cohort treated predominantly in community practices. Nooka AK, Nabhan C, Zhou X, Taylor MD, Byrtek M, Miller TP, Friedberg JW, Zelenetz AD, Link BK, Cerhan JR, Dillon H, Sinha R, Shenoy PJ, Levy D, Dawson K, Hirata JH, Flowers CR. Ann Oncol. 2013 Feb;24(2):441-8. doi: 10.1093/annonc/mds429. Epub 2012 Oct 5 2.Validation, revision and extension of the Follicular Lymphoma International Prognostic Index (FLIPI) in a population-based setting. van de Schans SA, Steyerberg EW, Nijziel MR, Creemers GJ, Janssen-Heijnen ML, van Spronsen DJ. Ann Oncol. 2009 Oct;20(10):1697-702. doi: 10.1093/annonc/mdp053. Epub 2009 Jun 23. PMID: 19549712 Disclosures Buckstein: Novartis: Honoraria; Celgene: Honoraria, Research Funding.
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Thodberg, Christian. "Grundtvigs skovoplevelse i 1811 og prædikerne over Peters fiskedræt i tiden, der fulgte." Grundtvig-Studier 38, no. 1 (January 1, 1986): 11–55. http://dx.doi.org/10.7146/grs.v38i1.15970.
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Grundtvig’s Experience in a Wood in 1811 and his subsequent sermons on the miraculous draught of fishes.By Christian Thodberg.It is common knowledge that in connection with the revival of his Christianity Grundtvig suffered a breakdown in December 1810, after which he returned with his friend, F. C. Sibbern, to his home village and his parents in Udby, South Zealand. However, in May 1811, after a stay in Copenhagen, he was again on his way to Udby to become curate for his aging father when he had an equally important experience in the wood outside Udby which has hitherto passed apparently unheeded. He describes it in a contemporary poem to Sibbern himself.In an attack of despondency, brought on by the sight of Udby church and his childhood home and by the thought of his forthcoming ministry, he knelt down in the wood and read I Cor. 15: 55-58. Grundtvig had been ordained in Copenhagen on May 29th, but in the wood two days later he experienced a special call to the priesthood. The nature of this experience is clearly visible in his sermon for the 5th Sunday after Trinity on the miraculous draught of fishes (Luke 5: 1-11), given 22 years later on July 7th 1833. In the sermon Grundtvig relates the experience and adds that the Lord Himself had spoken to him on that occasion and had called him with the words used to Simon Peter: “Let down the net. From henceforth thou shalt catch men!”A closer analysis of Grundtvig’s sermons from 1811 until his death in 1872 shows that over the years it is on the 5th Sunday after Trinity that he reflects on the Lord’s special call to him, and thus on his life’s special destiny. He uses Peter’s catch as his starting-point, both because of Jesus’ words to Peter and because the frightened and kneeling Peter in the gospel story undoubtedly reminds Grundtvig of his situation and literal position in the wood on Friday May 31st 1811.In his sermon for the 5th Sunday after Trinity 1811 the call motif does not appear; on the other hand he does use the biblical themes of Ezek. 47: 8-10 and Amos 8: 11, which are repeated in the later sermons on the miraculous draught. The unfinished sermon of 1812 is of a quite different order, but the very long sermon in 1818 is such a penetrating analysis of the preacher’s situation that it reveals Grundtvig’s extremely personal relationship to the account of Peter’s call. The same tension can be felt in the three drafts for the sermon of 1821; the last draft is continued in the major prose-poem sermon of 1822. The theme is “listening to God’s Word”, and the sermon is divided into five images: the first depicts the days of the ancient covenant, when the Jews refused to listen and ended up under the curse of slavery; the second is John the Baptist’s sermon; the third is Jesus’ teachings and works, while the fourth is the Church’s enthusiastic reflection on this central vision. The fifth image is basically Grundtvig’s own prophecy for the near future and for himself; for it is he himself who through his coming activity in Copenhagen, Denmark’s Jerusalem, will be the crucial link in the renewal of the salvation story. So self-conscious a sermon could not but have its source in a personal revelation, that is, the experience om May 31st 1811. The first sermon in Copenhagen in 1823 already includes the biblical themes mentioned above and describes the coming Christian revival. In the highly-charged sermon of 1824 Grundtvig clearly recalls the beginning of his ministry in 1811 and confesses that he has never preached better! This particular sermon of 1824 affords grounds for an analysis of the two central poems from that year: The Land o f the Living and N ew Year’s Morn, which were most probably written in June and July 1824 respectively. The Land o f the Living contains three sequences: 1) the childhood dream, 2) the vain dream of the adult worldling, and 3) the childhood dream recovered. The same three themes are also to be found in the poem to Sibbern, and the experience in the wood in 1811 offers a plausible explanation of the break between stanzas 1-6 and 7-13, i.e. between the description of the vain dream of the adult worldling and the childhood dream recovered. In fact it is compelling to regard stanzas 7-8 as a retelling in poetic form of the experience in the wood. The same experience would also seem to have left a significant trace in N ew Year’s Morn, in stanza 54 where there are similarities as regards both content and language between the Sibbern poem of 1811 and the retelling of the experience in the wood in the sermon of 1824.Among the reworked sermons in The Sunday Book we find in Vol. II (1828) a memoir of 1811 in a sermon on the miraculous draught of fishes, but the personal experience is emphasised by the stress, under the inspiration of Irenaeus, on the human as a prerequisite for the Christian. The gospel of the day must be particularly comforting to people torn between fear and hope – like Grundtvig in 1811. Jesus’ calling of Peter is again recalled in 1832 as the basic premise for Grundtvig’s own ministry. The sermon of 1833 - the cornerstone of this survey - has already been mentioned. In 1834 Jesus’ words to Peter are underlined with a minor gloss: fisher of living men, from which Grundtvig argues for his new view of the Church: the capacious Church. People must not be forced into Christianity, and they must be allowed to choose the priest they wish to attach themselves to. In 1835 Grundtvig recalls his ordination in 1811. In 1836 the human aspect of the sermon is emphasised, as it is in The Sunday Book.In 1837 Grundtvig uses the call of Peter to consider the justification of lay preaching - presumably because he himself received a direct call in 1811. In 1838 the Irenaeus inspiration culminates. The dangerous life of a fisherman is a precise image of the rightness of Grundtvig’s well-known thesis: First a Man, then a Christian. In 1839 the experience in the wood is retold, this time in even more detail than in 1833; while in 1840 Grundtvig demonstratively sets his two great “revelations” up against one another: the experience in the wood in 1811 and the “unparalleled discovery” of baptism and the eucharist in 1825. From now on it is clear to him that the later “revelation’ is the greater, a belief he finally confirms in his sermon of 1842. Irenaeus continues to inspire him in the sermons of 1841 and 1844, underlining yet again Grundtvig’s personal relationship to the account of the miraculous draught. In the remainder of Grundtvig’s preaching life the, experience of 1811 is less strongly recalled on the 5th Sunday after Trinity, though it does happen both in 1856 and in 1861.The survey shows that the experience has been of central significance to the revival of Grundtvig’s faith, and that right into the 1840s it is an important starting-point for his understanding of himself as a Christian. The sermon on the 5th Sunday after Trinity on the miraculous draught of fishes thus becomes an interesting guideline to an appreciation of Grundtvig’s personal and theological development.
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Fuchs, Ephraim J., Shannon R. McCurdy, Scott R. Solomon, Tao Wang, Michelle Kuxhausen, Yvette L. Kasamon, MHD Monzr Al Malki, et al. "Improving Donor Selection for Haploidentical Stem Cell Transplantation with Post-Transplant Cyclophosphamide through Selective HLA-Mis/Matching." Blood 136, Supplement 1 (November 5, 2020): 24–26. http://dx.doi.org/10.1182/blood-2020-140433.
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Background HLA-haploidentical (haplo) blood or marrow transplantation (BMT) with post-transplantation cyclophosphamide (PTCy) is widely used, but few factors that inform donor selection have been identified. Based on prior observations for HLA-B leader (EW Petersdorf et al. Lancet Haematol 2020), HLA-DRB1 (YL Kasamon et al. BBMT 2010), and HLA-DPB1 (SR Solomon et al. BBMT 2018), we hypothesized that mismatching at individual HLA loci may influence BMT outcomes, but single and additive HLA gene effects have not been evaluated systematically in the context of haploBMT with PTCy. Methods The Center for International Blood and Marrow Transplant Research (CIBMTR) identified 1,434 patients who underwent T-cell-replete haploBMT with PTCy for acute leukemia or myelodysplastic syndrome (MDS) between 2008-2017. Multivariable models assessed transplant outcomes associated with 3 HLA-factors: (1) B-leader dimorphism (MM, MT, TT) matching; (2) HLA-DRB1 mismatching in the graft-versus-host (GVH) direction; and (3) nonpermissive HLA-DPB1 mismatching in the GVH direction using the T-cell epitope-3 model, which classifies HLA-DPB1 mismatches into permissive or non-permissive. All final models contained the HLA factors and adjusted for other significant clinical covariates at p<.05 in univariate analysis. P-values were not adjusted for multiple testing. Results Diagnoses were 58% AML, 23% ALL, 19% MDS. 22% of AML patients were in advanced disease stage (relevant analyses were stratified for disease stage for both acute leukemia and MDS). Median recipient age was 54 (range 1-78) years. Median follow up among survivors was 12 (range 2-119) months. Marrow was the graft source in 43% of recipients. Myeloablative conditioning was used in 45% of recipients. Fifty percent of recipients had hematopoietic cell transplantation-comorbidity index (HCT-CI) scores of ≥3. HLA-DP typing was missing in 52% of cases and thus all models had a "missing" category for HLA-DP. Mismatching in the GVH direction at HLA-A, HLA-C, or HLA-DQ was not associated with study outcomes [overall survival (OS), disease-free survival (DFS), relapse, nonrelapse mortality (NRM), or grade II-IV acute, grade III-IV acute, or chronic graft-versus-host disease (gr2-4a or cGVHD)]. When compared to leader-matched patients, HLA-B leader-mismatching was associated with worse OS and DFS (hazard ratio [HR] 1.25 [95% CI, 1.09 to 1.44]; P=.002, and HR 1.18 [95% CI, 1.03 to 1.34]; P=.01, respectively), and higher risk of NRM (HR 1.38 [95% CI, 1.10 to 1.74]; P=.005), but was not associated gr2-4a or cGVHD, or relapse. In contrast, when compared to matching at HLA-DRB1, the presence of any GVH direction mismatch at HLA-DRB1 was associated with improved DFS (HR 0.80 [95% CI, 0.68 to 0.94]; P=.007) and lower risk of relapse (HR 0.69 [95% CI, 0.56 to 0.86]; P=.0008), but with no effect on OS, gr2-4a or cGVHD, or NRM. Similarly, any nonpermissive GVH mismatching at HLA-DPB1 was also associated with improved DFS (HR 0.72 [95% CI, 0.55-0.94], p=.015) and OS (HR 0.59 [95% CI, 0.43-0.82], p=.002), with a tendency towards lower relapse (HR 0.75 [95% CI, 0.54-1.05], p=.09), but with no effect on gr2-4a or cGVHD, or NRM. When combining the effects of leader matching at HLA-B and mismatching at HLA-DRB1 there was an additive improvement in both DFS and OS (Figure 1 A and B) with significantly lower NRM (p=0.03) and relapse (p=0.008) when compared to other groups. Within this unselected large cohort, favorable haplo donors based on B-leader matching and HLA-DRB1 mismatching were used for 48.5% of recipients and had improved DFS (HR 0.68 [95% CI, 0.52 to 0.88], p=.004) when compared to B-leader mismatched and HLA-DRB1 matched pairs, suggesting that with intentional selection of donors based on these factors, even more could receive a favorable combination. Conclusion HLA-B leader mismatching is a risk factor for NRM and worse OS and DFS, whereas either HLA-DRB1 or nonpermissive HLA-DPB1 mismatch is associated with reduced relapse and improved DFS, after haploBMT with PTCy. PTCy dissociates the graft-versus-leukemia effect of HLA-DRB1 and nonpermissive HLA-DPB1 mismatching from GVHD. The best outcomes after haploBMT with PTCy are seen when a donor is HLA-B leader matched and HLA-DRB1 mismatched. When there is more than one potential haplo donor for an acute leukemia or MDS patient, selection based on HLA considerations may improve DFS and OS. Figure Disclosures Shaw: Orca Bio: Consultancy. Lee:Takeda: Research Funding; AstraZeneca: Research Funding; Novartis: Research Funding; Incyte: Consultancy, Research Funding; Syndax: Research Funding; Pfizer: Consultancy, Research Funding; Amgen: Research Funding; Kadmon: Research Funding.
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"Unknown Location Determination using TDOA Computation with Convergence Points." International Journal of Innovative Technology and Exploring Engineering 8, no. 11 (September 10, 2019): 2862–67. http://dx.doi.org/10.35940/ijitee.k2412.0981119.
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Real time location/unknown target position is important in Electronic Warfare (EW) system. To find the location the hyperbolic multilateration method is used. Many algorithms are available to solve nonlinear hyperbolic equations. The techniques which are mostly used for solving and determining non-linear measurements are the Taylor Series method and Ezzat’s approach. Taylor series approach computes the position fix in an iterative fashion where as Ezzat’s solution gives a direct solution. In this paper to solve the non-linear measurements which are in the hyperbolic form we used two types of techniques. These two techniques are implemented on different receiver/ sensors distributions ex. square, triangle etc. In this paper we explores the optimal value for different receiver combinations and also we compares the convergence issues, relative performance for all combinations and in three dimensions. Finally we determined the standard deviation for every case and compared it for better optimal solution
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Potter, E., Y. Liu, S. Teo, M. Inouye, and T. H. Marwick. "P3431Machine learning applied to energy waveform ECG for prediction of subclinical myocardial dysfunction." European Heart Journal 40, Supplement_1 (October 1, 2019). http://dx.doi.org/10.1093/eurheartj/ehz745.0305.
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Abstract Background Energy waveform (ew) ECG used continuous wavelet transforms (CWT) to create time-frequency energy characterisations. Although ewECG changes reflect myocardial disease, the optimal measures for prediction of subclinical left ventricular dysfunction (sLVD) are unclear. Aim Using machine learning, we investigated whether ewECG could predict sLVD in community subjects at risk of heart failure (HF). Methods Asymptomatic community subjects aged ≥65 yrs. with ≥1 non-ischaemic risk factor for HF underwent clinical evaluation, MyoVista (HeartSciences, Southlake, TX) ewECG and echocardiographic evaluation. sLVD was defined as systolic (global longitudinal strain, GLS≤16%) or diastolic (E/e' ≥15, E/e'>10 with left atrial enlargement, or impaired relaxation with other changes). A gradient boosting algorithm (supervised machine learning) with regularisation was implemented to predict sLVD using 362 ewECG features. The performance was assessed by precision, recall, F measure, precision-recall (PR) curve and receiver operating characteristic (ROC) curve. Feature importance was inspected by information gain node splitting. Results Of 97 subjects (age 71 (68–73) yrs., 53% female) 56 (58%) had sLVD. For prediction of sLVD, ewECG showed areas under PR and ROC curves of 0.86 and 0.8 respectively. The feature of greatest importance, with twice the importance of the second was a CWT frequency related to depolarisation. Baseline characteristics Hypertension (%) 83 (86) Diabetes Mellitus (%) 34 (36) Atrial Fibrillation (%) 8 (8) BMI (IQR) 31 (27–34) LVMi (SD) 73 (23) Ejection fraction (SD) 60 (6) GLS (SD) 18 (3) E/e' (IQR) 8 (7–10) LAVi (IQR) 33 (28–40) IQR, Interquartile range; BMI, body mass index; LVMi, left ventricular mass index; GLS, global longitudinal strain; LAVi, left atrial volume index. Prediction model performance Conclusion ewECG shows good predictive performance for sLVD in elderly subjects at risk of HF. HF prevention strategies incorporating ewECG to select individuals for echocardiographic evaluation should be considered. Acknowledgement/Funding Baker Heart and Diabetes Institute
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Jeevarajan, Jerome A., Alicia M. Zha, Liang Zhu, Christy M. Ankrom, Alyssa D. Trevino, Michele M. Joseph, Rene M. Malazarte, et al. "Abstract TP252: Extended Window TPA is Safe at Community Emergency Departments via Telestroke." Stroke 51, Suppl_1 (February 2020). http://dx.doi.org/10.1161/str.51.suppl_1.tp252.
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Introduction: Recent studies support tPA for acute ischemic stroke (AIS) patients presenting beyond 4.5 hours from last known well (LKW), if established infarct is not evident on advanced imaging. Many community hospitals, where AIS patients may be managed via telestroke (TS), lack advanced imaging capability and hesitate to administer off-label tPA. In our TS network, physicians adhere to an extended window tPA (EW) protocol also used in the hub emergency room; eligibility includes NIHSS≤25, <1/3 MCA territory hypodensity on CT brain, and off-label tPA consent. Here, we characterize patients receiving EW via TS and investigate safety. Methods: We identified 1,150 AIS patients who received tPA via TS (9/2015-12/2018). We compared baseline characteristics between patients who received EW (arrival >4.5 hrs) and those who received standard window tPA (SW, arrival ≤4.5 hrs). We explored clinical outcomes and describe incidence of adverse effects from tPA. Results: Forty patients received EW, with median ASPECTS of 9 (Q1-Q3: 9-10). Median LKW to arrival time was 491 mins with EW and 66 mins with SW (p<0.0001, Table 1). EW led to few tPA complications; symptomatic intracranial hemorrhage incidence was 2%. EW was given for more severe stroke than SW (median NIHSS 10 vs 7, p=0.011). Both groups had comparable baseline characteristics, except a higher rate of tobacco use with EW. EW patients had longer length of stay (median 5 vs 3, p=0.023) and were more likely to be discharged to rehab than home (OR: 2.05 (1.01 4.15), p=0.046), however a small number of EW patients precludes in-depth comparative outcomes analysis. Conclusions: Our data suggest that EW is safe via TS for select patients with favorable CT, in settings that may lack advanced imaging capability. A specified mismatch between NIHSS and acute ischemia on plain CT is not part of our EW protocol, however EW is more likely given for severe stroke in our TS network. Small sample size warrants further study on clinical outcomes.
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Ngim, Chin Fang, Paul Douglas Fullerton, Vanassa Ratnasingam, Valliammai Jayanthi Thirunavuk Arasoo, Nisha Angela Dominic, Cindy Pei Sze Niap, and Sivakumar Thurairajasingam. "Feedback after OSCE: A comparison of face to face versus an enhanced written feedback." BMC Medical Education 21, no. 1 (March 24, 2021). http://dx.doi.org/10.1186/s12909-021-02585-z.
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Abstract Background The Objective Structured Clinical Exam (OSCE) is a useful means of generating meaningful feedback. OSCE feedback may be in various forms (written, face to face and audio or video recordings). Studies on OSCE feedback are uncommon, especially involving Asian medical students. Methods We compared two methods of OSCE feedback delivered to fourth year medical students in Malaysia: (i) Face to face (FTF) immediate feedback (semester one) (ii) Individualised enhanced written (EW) feedback containing detailed scores in each domain, examiners’ free text comments and the marking rubric (semester two). Both methods were evaluated by students and staff examiners, and students’ responses were compared against their OSCE performance. Results Of the 116 students who sat for both formative OSCEs, 82.8% (n=96) and 86.2% (n=100) responded to the first and second survey respectively. Most students were comfortable to receive feedback (91.3% in FTF, 96% in EW) with EW feedback associated with higher comfort levels (p=0.022). Distress affected a small number with no differences between either method (13.5% in FTF, 10% in EW, p=0.316). Most students perceived both types of feedback improved their performance (89.6% in FTF, 95% in EW); this perception was significantly stronger for EW feedback (p=0.008). Students who preferred EW feedback had lower OSCE scores compared to those preferring FTF feedback (mean scores ± SD: 43.8 ± 5.3 in EW, 47.2 ± 6.5 in FTF, p=0.049). Students ranked the “marking rubric” to be the most valuable aspect of the EW feedback. Tutors felt both methods of feedback were equally beneficial. Few examiners felt they needed training (21.4% in FTF, 15% in EW) but students perceived this need for tutors’ training differently (53.1% in FTF, 46% in EW) Conclusion Whilst both methods of OSCE feedback were highly valued, students preferred to receive EW feedback and felt it was more beneficial. Learning cultures of Malaysian students may have influenced this view. Information provided in EW feedback should be tailored accordingly to provide meaningful feedback in OSCE exams.
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Procaccia, Rossella, Giulia Segre, Giancarlo Tamanza, and Gian Mauro Manzoni. "Benefits of Expressive Writing on Healthcare Workers’ Psychological Adjustment During the COVID-19 Pandemic." Frontiers in Psychology 12 (February 25, 2021). http://dx.doi.org/10.3389/fpsyg.2021.624176.
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COVID-19 outbroke in Wuhan, China, in December 2019 and promptly became a pandemic worldwide, endangering health and life but also causing mild-to-severe psychological distress to lots of people, including healthcare workers (HCWs). Several studies have already showed a high prevalence of depression, anxiety, and post-traumatic symptoms in HCWs but less is known about the efficacy of psychological interventions for relieving their mental distress. The aims of this study were: (1) to evaluate the psychological adjustment of Italian HCWs during the COVID-19 pandemic; (2) to investigate the efficacy of an expressive writing (EW) intervention, based on Pennebaker’s paradigmatic protocol, on their psychological adjustment; (3) to analyze if outcomes of EW vary in function of individual differences (age, gender, marital status, and baseline values of symptoms). Fifty-five HCWs were randomly assigned to one of two writing conditions: EW (n = 30) or neutral writing (NW; n = 25). Psychological adjustment (in terms of ptsd, depression and global psychopathology’s symptoms, perceived social support, and resilience) was assessed before and after three writing sessions. Participants who received the EW intervention showed higher improvements in ptsd, depression, and global psychopathology symptoms. Improvements in EW group varied in function of age, gender, marital status, and baseline values: young, men, married participants and those who had higher baseline scores showed a higher reduction of psychological distress symptoms while women, single and those who had lower baseline value showed increased social support, and resilience. In conclusion, the EW intervention had positive effects which varied in function of individual differences on HCWs’ psychological health.
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Omi, Naomi, Hideki Shiba, Eisaku Nishimura, Sakuka Tsukamoto, Hiroko Maruki-Uchida, Masaya Oda, and Minoru Morita. "Effects of enzymatically modified isoquercitrin in supplementary protein powder on athlete body composition: a randomized, placebo-controlled, double-blind trial." Journal of the International Society of Sports Nutrition 16, no. 1 (September 10, 2019). http://dx.doi.org/10.1186/s12970-019-0303-x.
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Abstract Background Enzymatically modified isoquercitrin (EMIQ), a water-soluble quercetin, has been shown to intensify muscle hypertrophy in mice. We investigated the effect of EMIQ in supplementary protein powder on athlete body composition. Methods Forty Japanese males who played American football (age: 19.8 ± 1.4 years; body height: 174.1 ± 6.0 cm; body mass: 75.5 ± 10.7 kg) were assigned to a randomized, placebo-controlled, double-blind trial of parallel group. Participants received either EMIQ in whey protein (EW, n = 19) or contrast whey protein (W, n = 20) 6 days per week over 4 months. Body composition was assessed using dual-energy X-ray absorptiometry. Markers of oxidative stress, derivatives of reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP), were assessed using a free radical analytical system. Data were analyzed using a univariate and repeated measures general model statistics. Results After 4 months, changes in lower limb fat-free mass and muscle mass were significantly greater in the EW group than in the W group (mean change ±95% CI; W: 324.1 ± 284.3, EW: 950.3 ± 473.2, p = 0.031, W: 255.7 ± 288.6, EW: 930.9 ± 471.5, p = 0.021, respectively). Moreover, the EW group exhibited a significantly higher BAP/d-ROMs ratio, antioxidation index, than the W group after 4 months (mean change ± SD; W: 8.8 ± 1.1, EW: 10.3 ± 2.8; p = 0.028). No significant differences in body mass, lean body mass, fat mass, or lower limb fat mass were observed between the groups. Conclusion Ingestion of EMIQ in supplementary protein powder for 4 months exerts antioxidant effects and increases muscle mass among American football players. Trial registration University Hospital Medical Information Network Clinical Trial Registry, UMIN000036036. Retrospectively registered in 2019.
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Pitigala Liyana Arachchi, Ishani Shehara, Chandana Siriwardana, Dilanthi Amaratunga, and Richard Haigh. "Evaluation of societal trust on multi-hazard early warning (MHEW) mechanism: Sri Lankan context." International Journal of Disaster Resilience in the Built Environment ahead-of-print, ahead-of-print (July 9, 2021). http://dx.doi.org/10.1108/ijdrbe-01-2021-0010.
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Purpose It is significant to assess the societal trust toward the new advancements in multi-hazard early warnings (MHEW) with the focus on disaster risk reduction (DRR). Based on this, the purpose of this paper is to examine the extent of societal trust behavior along with the parameters such as mode of communication and institutions of issuing early warnings (EWs). Design/methodology/approach A field questionnaire survey was conducted to identify the extent of societal trust. This was conducted in ten selected Grama Niladari divisions in Sri Lanka based on a developed hazard matrix. The fuzzy logic approach was applied to examine the trust level of collected 323 responses obtained through this. The analysis was done based on the responses on mobile-based platforms in EW and the credibility level of the warnings received through different institutions. Findings The analyzed survey responses indicated that society has a higher extent of trust toward the EWs disseminated through mobile-based platforms. Moreover, these represent a strong positive correlation among the societal trust level and the level of importance of EW dissemination through mobile-based platforms. Further, in terms of trusted stakeholders in issuing EW alerts, Disaster Management Center, Sri Lanka Police and Media ranked the highest in the Sri Lankan context. Overall, findings were visually mapped through the causal loop diagrams (CLDs). Practical implications In enhancing the effectiveness of the existing MHEW mechanism, the policy implications could be done, based on the results obtained from this research study. These could be altered with the implementation of DRR strategies with a community focus. Originality/value The fuzzy logic approach was used in the determination of the societal decision-making on the extent of trust level. Fuzzy triangulation is mainly applied in the interpretation of the results. Further, overall parameters that determine the community trust on MHEW are represented through CLDs through system dynamics application.
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Menendez Cepero, Silvia. "OZONE THERAPY: SCIENTIFIC UPDATES AND RESEARCHES IN RECENT YEARS." Journal of Ozone Therapy 2, no. 2 (March 4, 2018). http://dx.doi.org/10.7203/jo3t.2.2.2018.11126.
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Ozone medical applications gather strength, day by day. Ozone, in its oxidant status, administered in low doses and in a number of controlled treatments, is able to trigger the endogenous antioxidant systems achieving a redox balance. As such, it is able to control chronic oxidative stress associated with many diseases. Moreover, levels of nitric oxide and pro-inflammatory cytokines, like tumor necrosis factor (TNF- ?) and interleukin 1 and 6, were able to be modulated by ozone. Also, mitochondrial integrity and functionality was preserved, calcium homeostasis was achieved, adenosine A1 receptors were activated and activity of the superoxide dismutase enzyme was regulated. In this lecture, preclinical and clinical studies of recent researches developed in Cuba are presented. Two topics have been selected: Alcoholism and arthritis. In today's world, alcoholism is a serious health and social problem, affecting millions of people, without distinction of race, sex, culture or latitude. One diagnostic criterion of alcohol dependence is the appearance of a withdrawal syndrome when alcohol consumption ceases. Experimental studies have demonstrated that many consequences of withdrawal found in animals resemble those observed in humans. Such signs and symptoms of ethanol withdrawal (EW) include enhanced activity of the autonomic nervous system; body posture and motor abnormalities; hyperexcitability of the central nervous system (CNS), including sensory hyperreactivity, convulsion, anxiety, etc. Chronic ingestion of high levels of alcohol may bring about oxidative stress, associated with hepatic alterations, and of CNS, mainly due to the formation, through alcohol metabolism, of free radicals, acetaldehyde, lipid and protein oxidation and their reaction products. The protective effects of ozone on brain injury induced by oxidative stress and behavioral changes in rats, after 2 weeks of EW, were studied. Also, a clinical trial with 10 alcoholic patients (elapsed time after ethanol withdrawal: ? 3 weeks) treated with ozone by rectal insufflation (ozone concentration from 20 to 35 mg/L and volumes from 100 to 150 ml) was performed. In the preclinical study, 4 groups of rats (n=10 each one) were settled: I-Control, II-Ethanol, III- Ethanol + Ozone (20 mg/L, dose of 1 mg/kg, 10 sessions by rectal insufflation) and IV- Ethanol + Oxygen. At the end of EW, rats were subjected to behavioral tests followed by brain tissue collection to measure markers of oxidative damage. Ozone increased food consumption, maintained water intake at the same levels as the control group and reestablished cellular redox status. Anxiety, locomotor activity and memory/learning of the rats were improved. Ozone protected the brain against oxidative injury, improving important functions of the CNS. In the clinical study, the results demonstrated that ozone improved 70% of the signs from Clinical Institute Withdrawal Scale (CIWA-Ar), mainly those associated to CNS. Ozone efficacy was observed in patients that required pharmacological treatment. Reduction of CIWA-Ar scores and the oxidative stress (p<0.05) was demonstrated. In summary, ozone improved CNS functions and reduced oxidative stress in animals and patients during EW. These results suggest ozone´s regulator effects on important neurotransmitters of the CNS. With respect to arthritis, many pro-inflammatory mediators are increased in rheumatoid arthritis (RA), including Reactive Oxygen Species (ROS) such as nitric oxide NO, pro-inflammatory cytokines as tumor necrosis factor alpha (TNF-?), interleukin- 1 beta (IL-1?) and other molecules. Ozone treatment has regulatory effects on some pathological targets associated with RA. Thus, the aim of this study was to investigate the efficacy of ozone therapy on joint swelling, pro-inflammatory cytokines and oxidative stress in the experimental chronic polyarthritis induced by i.p. injection of bacterial cell wall peptidoglycanpolysaccharide (PG/PS) in vivo. Moreover, cytokines, nitric oxide and oxidative stress levels in spleen homogenates were evaluated. The protocol consisted of four experimental groups (n=20). Group 1 (n=5): Negative control, only received the needle stress into articular space, 3 times/week; Group 2 (n=5) rats received PG/PS; Group 3 (n=5), as group 2, but after 10 days of PG/PS administration, rats received 0.2 ml of ozone by intraarticular injection, 3 times/week (3.5 weeks). Hind paws were selected by the treatments. Group 4 (n=5), as Group 3 but ozone treatment was substituted by oxygen. In spleen homogenates ozone treatment decreased the levels of TNF-? and IL-1? transcripts and TNF-? concentration whereas NO concentration was reestablished after ozone treatment. Besides a reduction of oxidative stress and the reestablish of fructolysine (AGE precursor) levels were achieved. All these molecules are goals of different drugs and all of them are targets of ozone therapy. Also, a clinical trial in patients with knee osteoarthritis was performed. Osteoarthritis (OA) is defined as a degenerative joint disease that causes pain, stiffness, swelling and loss of motion in the joints which is aggravated by prolonged activity. It is a process of progressive deterioration. of articular cartilage (it breaks down and becomes thin) and formation of new bone (osteophyte) at the joint surface. OA is becoming increasingly prevalent worldwide because of the combination of an aging population and growing levels of obesity. An increase level of oxidative stress occur in OA, leading to cells unable to respond effectively to normal loading regimens and potentially contributes to disease onset. The aim of this study was to evaluate the action of ozone therapy in oxidative stress parameters in synovial fluid of patients suffering of knee osteoarthritis and their clinical evolution. In 42 patients, ozone was administered rectally (ozone concentrations between 25 and 40 mg/L and volumes of 100 to 200 mL, 20 sessions) and by intra-articular applications. Synovial fluid was extracted for the measurement of parameters associated with oxidative stress. Also, evaluation of the joint capacity, pain, and ultrasound imaging were performed. Combined ozone therapy produced an intra-articular redox balance and a significant reduction of pain, with a maintained satisfactory response in 80% of patients in 1-year follow-up. Reduction of oxidative stress by ozone not only decreased ROS concentrations, which are otherwise able to cause degeneration in joint cartilage, but also reduced metalloproteinase activities preventing their participation in a degeneration of the extracellular matrix. In both topics studied, alcoholism and arthritis, adenosine and redox status are therapeutic targets of medical ozone. Also, an increase in the quality of life of these patients treated with ozone therapy was observed, without the presence of side effects.
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Valbonesi, Cecilia. "Between Necessity and Legal Responsibility: The Development of EEWS in Italy and its International Framework." Frontiers in Earth Science 9 (August 16, 2021). http://dx.doi.org/10.3389/feart.2021.685153.
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Earthquake Early Warning Systems (EEWSs) represent a technical-scientific challenge aimed at improving the chance of the population exposed to the earthquake shaking of surviving or being less affected. The ability of an EEWS to affect the risk and, in particular, vulnerability and exposure, may determine serious legal responsibilities for people involved in the system, as scientists and experts. The main question concerns, in fact, the relationship between EEWSs and the predictability and avoidability of earthquake effects-i.e., the ground shaking affecting citizens and infrastructures - and the possibility for people to adopt self-protective behavior and/or for industrial infrastructures to be secured. In Italy, natural disasters, such as the 2009 L’Aquila earthquake, teach us that the relationship between science and law is really difficult. So, before EEW’s become operational in Italy, it is necessary to: 1) examine the legislative and technical solutions adopted by some of the international legal systems in countries where this service is offered to citizens; 2) reconstruct the international and European regulatory framework that promotes the introduction of EW systems as life-saving tools for the protection of the right to life and understand whether and how these regulatory texts can impose an obligation on the Italian legal system to develop EEWS; 3) understand what responsibilities could be ascribed to the scientists and technicians responsible for managing EEWS in Italy, analyzing the different impact of vulnerability and exposure on the predictability and avoidability of the harmful event; 4) reflect on the lessons that our legal system will have to learn from other Countries when implementing EEW systems. In order to find appropriate solutions, it is essential to reflect on the opportunity to provide shared and well-structured protocols and creating detailed disclaimers clearly defining the limits of the service. A central role must be recognized to education, because people should not only expect to receive a correct alarm but must be able to understand the uncertainties involved in rapid estimates, be prepared to face the risk, and react in the right way.
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Alim, Uzma, Duane Bates, Ashten Langevin, Denise Werry, Deonne Dersch-Mills, Robert J. Herman, Marcy Mintz, and Sunita Ghosh. "Thiamine Prescribing Practices for Adult Patients Admitted to an Internal Medicine Service." Canadian Journal of Hospital Pharmacy 70, no. 3 (June 30, 2017). http://dx.doi.org/10.4212/cjhp.v70i3.1657.
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<p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Thiamine (vitamin B1) is an essential cofactor responsible for the breakdown of glucose, and its deficiency is associated with Wernicke encephalopathy (WE). There is a lack of evidence from systematic studies on the optimal dosing of thiamine for WE.</p><p><strong>Objectives:</strong> The primary objective was to describe the prescribing patterns for IV thiamine in adult patients admitted to a large teaching hospital. The secondary objective was to evaluate the clinical resolution of WE symptoms (confusion, ataxia, and/or ocular motor abnormalities) in<br />relation to the dose of IV thiamine prescribed.</p><p><strong>Methods:</strong> A retrospective design was used to review data for adult patients admitted to an internal medicine service from June 1, 2014, to June 30, 2015. All patients included in the study received IV thiamine: low-dose therapy was defined as 100 mg IV daily and high-dose therapy was defined as dosage greater than 100 mg IV daily.</p><p><strong>Results:</strong> A total of 141 patients were included; low-dose thiamine was prescribed for 115 (81.6%) and high-dose thiamine for 26 (18.4%). Patients for whom high-dose thiamine was prescribed were more likely to be those in whom a diagnosis of WE was being considered (12/26<br />[46.2%] versus 5/115 [4.3%], p < 0.001). Of the total 219 IV thiamine doses ordered, 180 (82.2%) were for 100 mg, and 143 (65.3%) were prescribed for once-daily administration. There was no statistically significant difference in the time to resolution of WE symptoms for patients receiving high-dose versus low-dose thiamine.</p><p><strong>Conclusions:</strong> A wide variety of thiamine prescribing patterns were noted. This study did not show a difference in time to resolution of WE symptoms in relation to the dose of IV thiamine. Additional large-scale studies are required to determine the optimal dosing of thiamine for WE.</p><p><strong>RÉSUMÉ</strong></p><p><strong>Contexte :</strong> La thiamine (vitamine B1) est un cofacteur essentiel responsable du métabolisme du glucose. Une carence en thiamine est associée à l’encéphalopathie de Wernicke (EW). Or, on observe une absence de données probantes provenant d’analyses systématiques portant sur la<br />posologie optimale de thiamine dans le traitement de l’EW.</p><p><strong>Objectifs :</strong> L’objectif principal était de décrire les habitudes de prescription de thiamine à administrer par voie intraveineuse chez les patients adultes admis dans un important hôpital universitaire. L’objectif secondaire était d’évaluer la disparition clinique des symptômes de l’EW (confusion, ataxie ou troubles moteurs oculaires) en fonction de la dose prescrite de thiamine à administrer par voie intraveineuse.</p><p><strong>Méthodes :</strong> Un plan d’étude rétrospectif a été utilisé pour étudier les données concernant les patients adultes admis à un service de médecine interne entre le 1er juin 2014 et le 30 juin 2015. Tous les patients à l’étude ont reçu de la thiamine par voie intraveineuse : le traitement à faible dose était de 100 mg par jour et le traitement à dose élevée excédait 100 mg par jour.</p><p><strong>Résultats :</strong> Au total, 141 patients ont été admis à l’étude; l’on a prescrit une faible dose de thiamine à 115 (81,6 %) d’entre eux et une dose élevée aux 26 (18,4 %) autres. Les patients qui se sont vus prescrire une dose élevée de thiamine étaient vraisemblablement ceux pour qui l’on envisageait un diagnostic d’EW (12/26 [46,2 %] contre 5/115 [4,3 %], p < 0,001). Pour l’ensemble des 219 doses prescrites de thiamine à administrer par voie intraveineuse, 180 (82,2 %) étaient de 100 mg et 143 (65,3 %) devaient être injectées à une fréquence uniquotidienne. On n’a relevé aucune différence statistiquement significative quant au temps de disparition des symptômes de l’EW entre les patients ayant reçu une dose élevée de thiamine et ceux en ayant reçu une faible dose.</p><p><strong>Conclusions :</strong> On a noté une grande variété d’habitudes de prescription de la thiamine. La présente étude n’a pas montré que la dose de thiamine administrée par voie intraveineuse changeait le temps nécessaire à la disparition des symptômes de l’EW. Il est nécessaire de mener de plus amples études à grande échelle afin de déterminer quelle est la posologie optimale de thiamine dans le traitement de l’EW.</p>