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1
Payes, Lucas F., Oscar G. Lombardero und Víctor J. Toranzos. „Diseño de un transmisor de datos con modulación FSK en banda HF para un sistema de telemetría“. Extensionismo, Innovación y Transferencia Tecnológica 6 (17.06.2020): 240. http://dx.doi.org/10.30972/eitt.604397.
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<p>La necesidad de contar con un sistema de registro de parámetros físicos en forma remota en lugares donde no existe cobertura de los sistemas de comunicación convencionales como ser WiFi, Bluetooth, GPRS, LTE, en otros, motivó el desarrollo del presente trabajo, como proyecto final de graduación de la carrera de Ingeniería en Electrónica de la FACENA UNNE, que consistió en el diseño y construcción de un Transmisor de Datos con modulación FSK en banda HF. El sistema consiste de tres etapas que son: a) Toma de datos y codificación, b) Transmisión y c) Recepción. El procesamiento de señales se realizó mediante un sistema embebido con un microcontrolador Atmega328p, que toma los datos de origen y genera la codificación en protocolo RTTY. El sistema de transmisión se diseñó teniendo en cuenta la flexibilidad en cuanto a las frecuencias de trabajo, que sea económico, robusto para la aplicación, y con una potencia de salida de unos pocos vatios. Para la verificación de la recepción de los datos, se utilizó un transceptor comercial marca Yaesu modelo FT-80C. Para decodificación y control se utilizó una computadora personal con el programa RTTY Decover de uso libre.</p><p> </p>
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Patterson, Davis G., David Schmitz und Randall L. Longenecker. „Family Medicine Rural Training Track Residencies: Risks and Resilience“. Family Medicine 51, Nr. 8 (06.09.2019): 649–56. http://dx.doi.org/10.22454/fammed.2019.769343.
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Background and Objectives: Family medicine rural training track (RTT) residency programs produce a higher proportion of graduates who choose rural practice than other programs, yet RTTs face continuing threats to their existence. This study sought to understand threats to RTT sustainability and resilience factors that enable RTTs to thrive. Methods: In 2014 and 2015, the authors conducted semistructured interviews of 21 RTT leaders representing two closed programs and 22 functioning programs. Interview topics included program strengths providing resilience and sustainability, risk factors for closure or vulnerabilities threatening sustainability, and advice for other RTTs. The authors performed a content analysis, coding pertinent themes in all interview data. Results: From the top three assets, risks, and advice that respondents offered, the following nine themes emerged, in order from most to least mentioned: leadership, faculty and teaching resources, program support, finances, resident recruitment, program attributes, program mission, political and environmental context, and patient-related clinical experiences. Interviewees frequently reported multifactorial causes for RTT sustainability or closure. Conclusions: Numerous factors identified, such as distance, can operate as positive or negative influences for program resilience, depending on place and context. Resilience depends on multiple forms of social capital, including robust networks among individuals and various communities: the local population and patients, local health care providers, residency faculty, and RTTs in general. The small size and remoteness of RTTs make them vulnerable to multiple challenges in finances, regulations, and accreditation, requiring program adaptability and suggesting the need for flexibility in the policies that govern them.
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Lee, Bum-Soo, Conrad P. Lichtenstein, Brenda Faiola, Lori A. Rinckel, William Wysock, M. Joan Curcio und David J. Garfinkel. „Posttranslational Inhibition of Ty1 Retrotransposition by Nucleotide Excision Repair/Transcription Factor TFIIH Subunits Ssl2p and Rad3p“. Genetics 148, Nr. 4 (01.04.1998): 1743–61. http://dx.doi.org/10.1093/genetics/148.4.1743.
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Abstract rtt4-1 (regulator of Ty transposition) is a cellular mutation that permits a high level of spontaneous Ty1 retrotransposition in Saccharomyces cerevisiae. The RTT4 gene is allelic with SSL2 (RAD25), which encodes a DNA helicase present in basal transcription (TFIIH) and nucleotide excision repair (NER) complexes. The ssl2-rtt (rtt4-1) mutation stimulates Ty1 retrotransposition, but does not alter Ty1 target site preferences, or increase cDNA or mitotic recombination. In addition to ssl2-rtt, the ssl2-dead and SSL2-1 mutations stimulate Ty1 transposition without altering the level of Ty1 RNA or proteins. However, the level of Ty1 cDNA markedly increases in the ssl2 mutants. Like SSL2, certain mutations in another NER/TFIIH DNA helicase encoded by RAD3 stimulate Ty1 transposition. Although Ssl2p and Rad3p are required for NER, inhibition of Ty1 transposition is independent of Ssl2p and Rad3p NER functions. Our work suggests that NER/TFIIH subunits antagonize Ty1 transposition posttranslationally by inhibiting reverse transcription or destabilizing Ty1 cDNA.
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Hales, R., J. Rodgers, L. Whiteside, G. Budgell, J. Berresford, A. Choudhury und C. Eccles. „OC-0683: RTTs at the helm: moving towards RTT-led MR-guided radiotherapy“. Radiotherapy and Oncology 152 (November 2020): S380—S381. http://dx.doi.org/10.1016/s0167-8140(21)00705-2.
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Pan, Wansu, Haibo Tan, Xiru Li und Xiaofeng Li. „Improved RTT Fairness of BBR Congestion Control Algorithm Based on Adaptive Congestion Window“. Electronics 10, Nr. 5 (06.03.2021): 615. http://dx.doi.org/10.3390/electronics10050615.
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To alleviate the lower performance of Transmission Control Protocol (TCP) congestion control over complex network, especially the high latency and packet loss scenario, Google proposed the Bottleneck Bandwidth and Round-trip propagation time (BBR) congestion control algorithm. In contrast with other TCP congestion control algorithms, BBR adjusted transfer data by maximizing delivery rate and minimizing delay. However, some evaluation experiments have shown that the persistent queues formation and retransmissions in the bottleneck can lead to serious fairness issues between BBR flows with different round-trip times (RTTs). They pointed out that small RTT differences cause unfairness in the throughput of BBR flows and flows with longer RTT can obtain higher bandwidth when competing with the shorter RTT flows. In order to solve this fairness problem, an adaptive congestion window of BBR is proposed, which adjusts the congestion window gain of each BBR flow in network load. The proposed algorithms alleviate the RTT fairness issue by controlling the upper limit of congestion window according to the delivery rate and queue status. In the Network Simulator 3 (NS3) simulation experiment, it shows that the adaptive congestion window of BBR (BBR-ACW) congestion control algorithm improves the fairness by more than 50% and reduces the queuing delay by 54%, compared with that of the original BBR in different buffer sizes.
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Engel-Hills, P. C. „Professional expertise for radiation therapists in Africa“. Journal of Radiotherapy in Practice 6, Nr. 03 (September 2007): 125–31. http://dx.doi.org/10.1017/s1460396907006127.
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AbstractThe radiation therapist (RTT) is a practitioner who must learn to take responsibility as an autonomous professional within a collaborative multi-professional team. A case study of international students on fellowship studies to a South African Higher Education Institution was used as the lens to explore the development of professional expertise in RTTs. Documents and semi-structured interviews generated textual data that was semantically analysed. The findings are presented as a discussion of the themes that emerged from the text data; (1) autonomy in a team, (2) collaboration facilitates learning, (3) the need for professional competence, (4) reflective practice and (5) participatory learning. The paper offers the interpretation of professional competence as a practitioner who has applicable knowledge, clinical and generic competence as well as appropriate behaviour and attitudes. It is proposed that a collaborative, integrated curriculum meets the need for the education of RTTs on the African continent. In such an environment optimised learning is facilitated by access to good clinical role models, the development of skills toward reflective practice and student participation in the learning environment.
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Pashtan, Itai Max, Tara Kosak, Kevin Beaudette, Amy Buckman, Abigail Clark, Jill Connolly, Lynne Hicks et al. „Addressing alert fatigue by reducing radiation oncology software alert volume.“ Journal of Clinical Oncology 39, Nr. 28_suppl (01.10.2021): 261. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.261.
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261 Background: Radiation therapists (RTTs) administer radiation treatments to patients with cancer. Treatments are delivered using linear accelerators (LINACs), operated by vendor specific software. Prior to delivering treatment, RTTs perform a time-out, and read aloud critical electronic communications (alerts) entered by members of the radiation oncology care team. Alerts are effective at communicating critical information, including treatment setup and imaging instructions, but can become a source of error due to alert fatigue when placed indiscriminately. Methods: A multicenter retrospective review of alert use per patient was conducted in 4 radiation oncology centers with a total of 6 LINACs. Alert usage was reviewed pre-intervention for 40 randomly selected patients using manual chart review. Each alert was reviewed for frequency and utilization. In attempt of improving communication and reducing alert fatigue, a multidisciplinary process improvement working group (with Radiation Oncologists, RTTs, nursing, physicists, and administration) was formed to review the utilization of alerts in our department and propose interventions. Three months after intervention, an additional 40 chart review was performed. Our aim was to reduce the volume of alerts by 20% within 3 months. A 2-tail t-test was used for statistical analysis. Results: Process improvements were implemented to reduce the volume of alerts per patient. Interventions included 1) defining an alert for all departmental staff, 2) creating guidelines for appropriate utilization of alerts, 3) routing communications not critical to RTTs at the time of radiation treatment administration through other channels, and 4) training staff as to the above. The pre-intervention review yielded 239 alerts. Post-intervention, there were 173 alerts, a reduction of 27% (p =.008). Conclusions: This practice change reduced average alert volume by 27%. As a result, alerts which are critical to safe treatment delivery by RTTs (i.e. daily setup alerts), became more heavily represented. Other alerts, which could be communicated effectively in other ways (i.e. OTVs [weekly on treatment visit with Radiation Oncologist]), were eliminated. By decreasing alert volume, the risk of RTT alert fatigue is reduced, communication improved, and treatment safety enhanced.[Table: see text]
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Guo, Yanjun, und Yihui Ding. „Long-Term Free-Atmosphere Temperature Trends in China Derived from Homogenized In Situ Radiosonde Temperature Series“. Journal of Climate 22, Nr. 4 (15.02.2009): 1037–51. http://dx.doi.org/10.1175/2008jcli2480.1.
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Abstract In this paper, radiosonde temperature time series (RTT) from 1958 to 2005 collected by the 116-station Chinese radiosonde network are examined. Quality control and homogenization are used to obtain a reliable RTT. The homogenization results revealed significant discontinuities in the RTT. Analysis suggested that 70% data availability is the minimum data requirement (MDR) for these RTTs. A new dataset is built by meeting this MDR, which reduced the number of potential stations from 116 to 92. Analysis on this dataset reveals that warming trends in the troposphere and cooling trends in the stratosphere were weakened by reducing the stations. Averaged RTT trends for China were generally consistent with those of global scale, but with some discrepancies. During 1958–2005, averaged temperatures in China tended to decrease in the lower stratosphere and upper troposphere, in contrast to warming trends in the mid- and lower troposphere. The trends varied with two different subperiods. For 1958–78, cooling trends in the entire atmosphere were similar to trends at the global scale. For 1979–2005, warming occurred in the lower troposphere, with the amplitude of the warming tending to weaken with increases in altitude and shifting to a cooling trend above 400 hPa. Seasonal trend structures suggest that warming in the lower troposphere is attributable to temperature increases in December–February (DJF); cooling in the upper troposphere and stratosphere was found mainly in June–August (JJA). Unlike with results of a larger spatial scale, a robust cooling layer was found around 300 hPa.
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Engel-Hills, Penelope C. „Radiation therapist research in Africa: overcoming the barriers to reap the rewards“. Journal of Radiotherapy in Practice 8, Nr. 2 (Juni 2009): 93–98. http://dx.doi.org/10.1017/s1460396908006547.
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AbstractRadiation therapy is recognised throughout the world as an essential modality in the treatment of many malignant diseases. A quality treatment process requires highly competent health care professionals and high-technology equipment. In the majority of countries in Africa there is a desperate need for equipment and skilled therapists and in many countries there is no access to radiation therapy to relieve the suffering of cancer patients. As a region, Africa can therefore be considered as ‘under resourced’ in terms of radiation oncology services. In this context both service and research are challenged by a lack of equipment, poor maintenance, inadequate funding, inconsistent consumable supplies, a scarcity of competent professionals to ensure optimal use of what is available and excessive workload. Africa therefore has many examples of the situation, where low-income countries generally have a poor research infrastructure. Radiation therapist (RTT) research in Africa has to develop where the barriers to research can in most instances be traced back to a lack of resources and any initiatives to overcome these barriers are frequently blocked by the limitations of a resource-poor environment. To locate the discussion on the research environment of RTTs in Africa, barriers to and benefits of research are integrated with brief information under the following headings: the macro environment, the RTT environment and the RTT research environment. The latter includes insights from interviews and discussions covering the following topics: research now, research priorities, research opportunities and strategies for future research.
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Rindasari, Niken Mareta, Julehah Julehah und Neneng Masitoh. „EVALUASI TATA KELOLA DAN KINERJA KELEMBAGAAN KOMISI IRIGASI (KOMIR) KABUPATEN PANDEGLANG“. Jurnal Ilmiah Mahasiswa Agroinfo Galuh 7, Nr. 3 (25.09.2020): 534. http://dx.doi.org/10.25157/jimag.v7i3.3562.
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Penelitian ini bertujuan untuk (i) mengidentifikasi berbagai pencapaian dan realisasi program kerja komisi irigasi, (ii) menilai kinerja kelembagaan komisi irigasi dan (ii) merekomendasikan perbaikan kelembagaan komisi irigasi di Kabupaten Pandeglang. Metode pengumpulan data yang digunakan dalam penelitian ini berbagai strategi, diantaranya adalah gabungan antara metode dokumentasi dan survei yang dilengkapi dengan metode observasi. Untuk penilaian kinerja komisi irigasi dengan metode penilaian cepat secara partisipatif terhadap 3 variabel meliputi pembentukan, sekretariat dan pendanaan yang di uraikan kedalam 10 variabel dengan 25 indikator penilaian kinerja komisi irigasi. Komisi irigasi telah melakukan 3 (tiga) sidang komisi irigasi dengan melakukan pengesahan tata tertib sidang dan menyusun Penyusunan dan Penetapan RTTG dan RTTD masa Tanam 2019 – 2020. Hasil penilaian kinerja komisi irigasi mendapatkan nilai skor 70 dengan kategori berkinerja cukup. Penilaian tersebut menjelaskan dalam pengelolaan kelembagaan komisi irigasi terdapat beberapa kendala yang perlu untuk di tingkatkan meliputi ketersediaan tenaga ahli dan narasumber dalam berbagai pelaksanaan kegiatan komisi irigasi, masih rendahnya dukungan pendanaan untuk kegiatan operasional komisi irigasi, dan sekretariat komisi irigasi yang masih bersifat sementara (sewa).
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Čurić, Ilija. „Case Report: The impact of the ESTRO-IAEA Best Practice in Radiation Oncology train the RTT trainers project for Serbian RTTs“. Technical Innovations & Patient Support in Radiation Oncology 8 (Dezember 2018): 17–18. http://dx.doi.org/10.1016/j.tipsro.2018.09.007.
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Morimoto, Mitsuru, und Raphael Kopan. „rtTA toxicity limits the usefulness of the SP-C-rtTA transgenic mouse“. Developmental Biology 325, Nr. 1 (Januar 2009): 171–78. http://dx.doi.org/10.1016/j.ydbio.2008.10.013.
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Chou, En-Ju, und Tang K. Tang. „Human Microcephaly Protein RTTN Is Required for Proper Mitotic Progression and Correct Spindle Position“. Cells 10, Nr. 6 (09.06.2021): 1441. http://dx.doi.org/10.3390/cells10061441.
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Autosomal recessive primary microcephaly (MCPH) is a complex neurodevelopmental disorder characterized by a small brain size with mild to moderate intellectual disability. We previously demonstrated that human microcephaly RTTN played an important role in regulating centriole duplication during interphase, but the role of RTTN in mitosis is not fully understood. Here, we show that RTTN is required for normal mitotic progression and correct spindle position. The depletion of RTTN induces the dispersion of the pericentriolar protein γ-tubulin and multiple mitotic abnormalities, including monopolar, abnormal bipolar, and multipolar spindles. Importantly, the loss of RTTN altered NuMA/p150Glued congression to the spindle poles, perturbed NuMA cortical localization, and reduced the number and the length of astral microtubules. Together, our results provide a new insight into how RTTN functions in mitosis.
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Kron, Miriam, Jasper L. Zimmermann, Mathias Dutschmann, Frank Funke und Michael Müller. „Altered responses of MeCP2-deficient mouse brain stem to severe hypoxia“. Journal of Neurophysiology 105, Nr. 6 (Juni 2011): 3067–79. http://dx.doi.org/10.1152/jn.00822.2010.
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Rett syndrome (RTT) patients suffer from respiratory arrhythmias with frequent apneas causing intermittent hypoxia. In a RTT mouse model (methyl-CpG-binding protein 2-deficient mice; Mecp2−/ y) we recently discovered an enhanced hippocampal susceptibility to hypoxia and hypoxia-induced spreading depression (HSD). In the present study we investigated whether this also applies to infant Mecp2−/ y brain stem, which could become life-threatening due to failure of cardiorespiratory control. HSD most reliably occurred in the nucleus of the solitary tract (NTS) and the spinal trigeminal nucleus (Sp5). HSD susceptibility of the Mecp2−/ y NTS and Sp5 was increased on 8 mM K+-mediated conditioning. 5-HT1A receptor stimulation with 8-hydroxy-2-(di-propylamino)tetralin (8-OH-DPAT) postponed HSD by up to 40%, mediating genotype-independent protection. The deleterious impact of HSD on in vitro respiration became obvious in rhythmically active slices, where HSD propagation into the pre-Bötzinger complex (pre-BötC) immediately arrested the respiratory rhythm. Compared with wild-type, the Mecp2−/ y pre-BötC was invaded less frequently by HSD, but if so, HSD occurred earlier. On reoxygenation, in vitro rhythms reappeared with increased frequency, which was less pronounced in Mecp2−/ y slices. 8-OH-DPAT increased respiratory frequency but failed to postpone HSD in the pre-BötC. Repetitive hypoxia facilitated posthypoxic recovery only if HSD occurred. In 57% of Mecp2−/ y slices, however, HSD spared the pre-BötC. Although this occasionally promoted residual hypoxic respiratory activity (“gasping”), it also prolonged the posthypoxic recovery, and thus the absence of central inspiratory drive, which in vivo would lengthen respiratory arrest. In view of the breathing disorders in RTTs, the increased hypoxia susceptibility of MeCP2-deficient brain stem potentially contributes to life-threatening disturbances of cardiorespiratory control.
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Legrand, Nicolas, Gisela J. van der Velden, Raphaël Ho Tsong Fang, Marc Douaisi, Kees Weijer, Atze T. Das, Bianca Blom, Christel H. Uittenbogaart, Ben Berkhout und Mireille Centlivre. „A doxycycline-dependent human immunodeficiency virus type 1 replicates in vivo without inducing CD4+ T-cell depletion“. Journal of General Virology 93, Nr. 9 (01.09.2012): 2017–27. http://dx.doi.org/10.1099/vir.0.042796-0.
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A novel genetic approach for the control of virus replication was used for the design of a conditionally replicating human immunodeficiency virus (HIV) variant, HIV-rtTA. HIV-rtTA gene expression and virus replication are strictly dependent on the presence of a non-toxic effector molecule, doxycycline (dox), and thus can be turned on and off at will in a graded and reversible manner. The in vivo replication capacity, pathogenicity and genetic stability of this HIV-rtTA variant were evaluated in a humanized mouse model of haematopoiesis that harbours lymphoid and myeloid components of the human immune system (HIS). Infection of dox-fed BALB Rag/γc HIS (BRG-HIS) mice with HIV-rtTA led to the establishment of a productive infection without CD4+ T-cell depletion. The virus did not show any sign of escape from dox control for up to 10 weeks after the onset of infection. No reversion towards a functional Tat–transactivating responsive (TAR) RNA element axis was observed, confirming the genetic stability of the HIV-rtTA variant in vivo. These results demonstrate the proof of concept that HIV-rtTA replicates efficiently in vivo. HIV-rtTA is a promising tool for fundamental research to study virus–host interactions in vivo in a controlled fashion.
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Mohan, S., P. Mazumder, R. K. Mains, J. P. Sun und G. I. Haddad. „Ultrafast pipelined adders using RTTs“. Electronics Letters 27, Nr. 10 (09.05.1991): 830–31. http://dx.doi.org/10.1049/el:19910520.
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Cheng, Yulong, Yutong Su, Aijing Shan, Xiuli Jiang, Qinyun Ma, Weiqing Wang, Guang Ning und Yanan Cao. „Generation and Characterization of Transgenic Mice Expressing Mouse Ins1 Promoter for Pancreatic β-Cell-Specific Gene Overexpression and Knockout“. Endocrinology 2016, Nr. 1 (01.01.2016): 85–92. http://dx.doi.org/10.1210/en.2015-1104.
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Abstract The technologies for pancreatic β-cell-specific gene overexpression or knockout are fundamental for investigations of functional genes in vivo. Here we generated the Ins1-Cre-Dsred and Ins1-rtTA mouse models, which expressed the Cre recombinase or reverse tetracycline regulatable transactivator (rtTA) without hGH minigene under the control of mouse Ins1 promoter. Our data showed that the Cre-mediated recombination and rtTA-mediated activation could be efficiently detected at embryonic day 13.5 when these models were crossed with the reporter mice (ROSAmT/mG or tetO-HIST1H2BJ/GFP). The Cre and rtTA expression was restricted to β-cells without leakage in the brain and other tissues. Moreover, both the transgenic lines showed normal glucose tolerance and insulin secretion. These results suggested that the Ins1-Cre-Dsred and Ins1-rtTA mice could be used to knock out or overexpress target genes in embryos and adults to facilitate β-cell researches. (Endocrinology 156: 2724–2731, 2015)
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Kavidha, V., und V. Sadasivam. „Fuzzy Logic-Based Round Trip Time Scaling and Scheduling in High Speed TCP Stacks“. International Journal of Fuzzy System Applications 3, Nr. 2 (April 2013): 71–86. http://dx.doi.org/10.4018/ijfsa.2013040105.
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Network management and control is a complex problem that requires intelligent, control methodologies to obtain satisfactory performance. Round trip time (RTT) scaling mechanism has been introduced for changing congestion window and to perform congestion control satisfactorily in all circumstances. This paper presents a fuzzy RTT scaling (FRTTS) scheme that performs RTT scaling and RTT scheduling for different high speed transmission control protocol (TCP) networks. In this scheme, RTT samples are allocated requesting application by using RTT scheduling factor and RTT samples are scaled for an application by using RTT scaling factor. A RTT scaler placed at the end node performs the RTT scheduling as well as RTT scaling. We also apply a FRTTS scheme on different high speed TCP’s namely high-TCP (H-TCP) and scalable-TCP(S-TCP) and demonstrates that it provides better performance than non fuzzy scheme. The scheme has been extensively simulated to test the performance in terms of flow rate, RTT flows, packet size and congestion window size. The results show that FRTTS scheme provides better performance than non fuzzy scheme which employs dynamic RTT scheduling and RTT scaling.
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Hjoberg, Josephine, Stephanie Shore, Lester Kobzik, Shoji Okinaga, Arlene Hallock, Joseph Vallone, Venkat Subramaniam et al. „Expression of nitric oxide synthase-2 in the lungs decreases airway resistance and responsiveness“. Journal of Applied Physiology 97, Nr. 1 (Juli 2004): 249–59. http://dx.doi.org/10.1152/japplphysiol.01389.2003.
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Individuals with asthma have increased levels of nitric oxide in their exhaled air. To explore its role, we have developed a regulatable transgenic mouse capable of overexpressing inducible nitric oxide synthase in a lung-specific fashion. The CC10-rtTA-NOS-2 mouse contains two transgenes, a reverse tetracycline transactivator under the control of the Clara cell protein promoter and the mouse nitric oxide synthase-2 (NOS-2) coding region under control of a tetracycline operator. Addition of doxycycline to the drinking water of CC10-rtTA-NOS-2 mice causes an increase in nitric oxide synthase-2 that is largely confined to the airway epithelium. The fraction of expired nitric oxide increases over the first 24 h from ∼10 parts per billion to a plateau of ∼20 parts per billion. There were no obvious differences between CC10-rtTA-NOS-2 mice, with or without doxycycline, and wild-type mice in lung histology, bronchoalveolar protein, total cell count, or count differentials. However, airway resistance was lower in CC10-rtTA-NOS-2 mice with doxycycline than in CC10-rtTA-NOS-2 mice without doxycycline or wild-type mice with doxycycline. Moreover, doxycycline-treated CC10-rtTA-NOS-2 mice were hyporesponsive to methacholine compared with other groups. These data suggest that increased nitric oxide in the airways has no proinflammatory effects per se and may have beneficial effects on pulmonary function.
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Chetia, Kamala, Bhargab Sarma, GAUTAM SARMA, Shashi Bhushan Sharma und Papu Das. „Preparedness, Precaution and Practice of Radiotherapy during COVID-19 Pandemic- Radiotherapy Technologists Perspective“. Asian Pacific Journal of Cancer Care 5, S1 (14.08.2020): 183–85. http://dx.doi.org/10.31557/apjcc.2020.5.s1.183-185.
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COVID-19 is a highly contagious virus and is transmitted from human to human respiratory droplets or coming in contact with a virus contaminated surface. Cancer patients are more vulnerable than general population to get infected with COVID-19 due to their immunosuppressed condition. Radiotherapy Technologists (RTTs) are among frontline healthcare providers who are at high risks of being exposed to COVID-19. RTTs are directly involved with treatment of cancer patients daily and also provide supporting roles in radiation safety, quality assurance education and training, administration research and service development. To cope with this present pandemic, RTTs would require prior preparation, precaution, judicious use of resources, clear communications and strong leadership. This article will help the RTTs to prepare themselves to tackle the present crisis and to carry out the radiotherapy practices in their respective hospitals.
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Fuss, Martin, Sean X. Cavanaugh, Cristina Fuss, Dennis A. Cheek und Bill J. Salter. „Daily Stereotactic Ultrasound Prostate Targeting: Inter-user Variability“. Technology in Cancer Research & Treatment 2, Nr. 2 (April 2003): 161–69. http://dx.doi.org/10.1177/153303460300200213.
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We analyzed the inter-user variability of patient setup for prostate radiotherapy using a stereotactic ultrasound-targeting device. Setup variations in 20 prostate cancer patients were analyzed. Users were a radiation oncologist, a medical physicist, four radiation technologists (RTT) and a radiologist. The radiation oncologist, radiologist, physicist and two RTTs were experienced users of the system (>18 months of experience); two RTTs were users new to the system. Gold standard for this analysis was a control CT acquired immediately following ultrasound targeting. For inter-user variability assessments, the radiation oncologist provided a set of axial and sagittal freeze-frames (standard freeze-frames) for virtual targeting by all users. Additionally each user acquired individual freeze-frames for target alignments. We analyzed the range of virtual setups in each patient along the principal room axes based on standard and individual freeze-frames. The magnitude of residual setup error and percentage of setup change for each user was assessed by control CT/planning CT comparison with individual virtual shifts. A total of 184 alignments were analyzed. The range of virtual shifts between users was 2.7±1.4, 3.6±1.1, and 4.4±1.4 mm (mean±SD) in x, y and z-direction for setups based on standard freeze-frames and 3.9±2.6, 6.0±4.7, and 5.4±2.7 mm for setups based on individual freeze-frames. When only virtual shifts of experienced users were analyzed, the mean ranges were reduced by up to 2.4 mm. Average magnitude of initial setup error before ultrasound targeting was 14.3 mm. Average improvement of prostate setup was 63.1±23.4% in experienced and 35.14±37.7% in inexperienced users, respectively (p<0.0001). Only 5 of 184 (2.7%) virtual alignments would have introduced new larger setup errors (mean 3.2 mm, range 0.2 to 9.5 mm) than the magnitude of the initial setup error. We conclude that ultrasound guided treatment setup for patients treated for prostate cancer can be performed with high inter-user consistency and does lead to improved treatment setup in more than 97% of attempted setups. Experienced use is correlated with a reduced range of setups between users and higher degree of setup improvement when compared with users new to the system.
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Coffey, M. „16 Educating RTTS – a European adventure“. European Journal of Cancer Supplements 7, Nr. 2 (September 2009): 7. http://dx.doi.org/10.1016/s1359-6349(09)70023-0.
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Pollaris, Gwen, Stéphanie Note, Didier Desruelles und Marc Sabbe. „Novel IT Application for Reverse Triage Selection: A Pilot Study“. Disaster Medicine and Public Health Preparedness 12, Nr. 5 (10.11.2017): 599–605. http://dx.doi.org/10.1017/dmp.2017.115.
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ABSTRACTObjectiveThe objective of this study was to develop and evaluate an evidence-based information technology (IT) application that guides clinical decision-making during the reverse-triage selection process in mass casualty incidents.MethodsBased upon 28 validated critical interventions (CI) relevant for determining whether a patient qualifies for early discharge, we developed the Reverse Triage Tool of Leuven (RTTL). The RTTL is compatible with the health electronic record (HER) of UZ Leuven, a tertiary hospital in Belgium. During a 3-week period in March 2015, we registered data from 2 groups of patients: a random group (no RTTL usage) and a filtered group (RTTL usage).ResultsWhen applying the original 28 CIs, we were able to select almost twice as many patients in the filtered group who qualified for early discharge compared with patients in the random group. The predictive validity was highly satisfactory.ConclusionsThe RTTL saves time in 2 ways. First, it reduces the patient population that needs to be evaluated for potential early discharge to one-third. Second, it doubles the probability of selecting an actual dischargeable patient. Each selected patient, however, still must undergo multidisciplinary reassessment in order to qualify for early discharge. Thus, further research is required to optimize the IT application.(Disaster Med Public Health Preparedness. 2018;12:599–605)
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Coffey, Mary, Michelle Leech, Harald Hentschel, Ingrid Kristensen, Annette Boejen und Philipp Scherer. „Guest Editorial: RTT Workshops-Preparing the RTT profession for the future“. Technical Innovations & Patient Support in Radiation Oncology 10 (Juni 2019): 13–15. http://dx.doi.org/10.1016/j.tipsro.2019.06.002.
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Pan, Wansu, Xiaofeng Li, Haibo Tan, Jinlin Xu und Xiru Li. „Improvement of RTT Fairness Problem in BBR Congestion Control Algorithm by Gamma Correction“. Sensors 21, Nr. 12 (16.06.2021): 4128. http://dx.doi.org/10.3390/s21124128.
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Google proposed the bottleneck bandwidth and round-trip propagation time (BBR), which is a new congestion control algorithm. BBR creates a network path model by measuring the available bottleneck bandwidth and the minimum round-trip time (RTT) to maximize delivery rate and minimize latency. However, some studies have shown that there are serious RTT fairness problems in the BBR algorithm. The flow with longer RTT will consume more bandwidth and the flows with shorter RTT will be severely squeezed or even starved to death. Moreover, these studies pointed out that even small RTT differences will lead to the throughput of BBR flows being unfair. In order to solve the problem of RTT fairness, an improved algorithm BBR-gamma correction (BBR-GC) is proposed. BBR-GC algorithm takes RTT as feedback information, and then uses the gamma correction function to fit the adaptive pacing gain. This approach can make different RTT flows compete for bandwidth more fairly, thus alleviating the RTT fairness issue. The simulation results of Network Simulator 3 (NS3) show that that BBR-GC algorithm cannot only ensure the channel utilization, but also alleviate the RTT fairness problem of BBR flow in different periods. Through the BBR-GC algorithm, RTT fairness is improved by 50% and the retransmission rate is reduced by more than 26%, compared with that of the original BBR in different buffer sizes.
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Gillan, Caitlin, Emily Milne, Nicole Harnett, Thomas G. Purdie, David A. Jaffray und Brian Hodges. „Professional implications of introducing artificial intelligence in healthcare: an evaluation using radiation medicine as a testing ground“. Journal of Radiotherapy in Practice 18, Nr. 1 (03.10.2018): 5–9. http://dx.doi.org/10.1017/s1460396918000468.
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AbstractAimThis study will evaluate radiation medicine professionals’ perceptions of clinical and professional risks and benefits, and the evolving roles and responsibilities with artificial intelligence (AI).MethodsRadiation oncologists (ROs), medical physicists (MPs), treatment planners (TP-RTTs) and treatment delivery radiation therapists (TD-RTTs) at a cancer centre in preliminary stages of implementing an AI-enabled treatment planning system were invited to participate in uniprofessional focus groups. Semi-structured scripts addressed the perceptions of AI, including thoughts regarding changing roles and competencies. Sessions were audiorecorded, transcribed and coded thematically through consensus-building.ResultsA total of 24 participants (four ROs, five MPs, seven TP-RTTs and eight TD-RTTs) were engaged in four focus groups of 58 minutes average duration (range 54–61 minutes). Emergent themes addressed AI’s impact on quality of care, changing professional tasks and changing competency requirements. Time-consuming repetitive tasks such as delineating targets, generating treatment plans and quality assurance were thought conducive to offloading to AI. Outcomes data and adaptive planning would be incorporated into clinical decision-making. Changing workload would necessitate changing skills, prioritising plan evaluation over generation and increasing interprofessional communication. All groups discussed AI reducing the need for TP-RTTs, though displacement was thought more likely than replacement.ConclusionsIt is important to consider how professionals perceive AI to be proactive in informing change, as gains in quality and efficiency will require new workflows, skills and education.
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Iwama, Kazuhiro, Takeshi Mizuguchi, Eri Takeshita, Eiji Nakagawa, Tetsuya Okazaki, Yoshiko Nomura, Yoshitaka Iijima et al. „Genetic landscape of Rett syndrome-like phenotypes revealed by whole exome sequencing“. Journal of Medical Genetics 56, Nr. 6 (06.03.2019): 396–407. http://dx.doi.org/10.1136/jmedgenet-2018-105775.
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BackgroundRett syndrome (RTT) is a characteristic neurological disease presenting with regressive loss of neurodevelopmental milestones. Typical RTT is generally caused by abnormality of methyl-CpG binding protein 2 (MECP2). Our objective to investigate the genetic landscape of MECP2-negative typical/atypical RTT and RTT-like phenotypes using whole exome sequencing (WES).MethodsWe performed WES on 77 MECP2-negative patients either with typical RTT (n=11), atypical RTT (n=22) or RTT-like phenotypes (n=44) incompatible with the RTT criteria.ResultsPathogenic or likely pathogenic single-nucleotide variants in 28 known genes were found in 39 of 77 (50.6%) patients. WES-based CNV analysis revealed pathogenic deletions involving six known genes (including MECP2) in 8 of 77 (10.4%) patients. Overall, diagnostic yield was 47 of 77 (61.0 %). Furthermore, strong candidate variants were found in four novel genes: a de novo variant in each of ATPase H+ transporting V0 subunit A1 (ATP6V0A1), ubiquitin-specific peptidase 8 (USP8) and microtubule-associated serine/threonine kinase 3 (MAST3), as well as biallelic variants in nuclear receptor corepressor 2 (NCOR2).ConclusionsOur study provides a new landscape including additional genetic variants contributing to RTT-like phenotypes, highlighting the importance of comprehensive genetic analysis.
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Verdoni, Angela M., Christopher B. Cole, Shamika Ketkar-Kulkarni, Tamara Lamprecht, Nichole Havey, David H. Spencer und Timothy J. Ley. „DNMT3A R882H Overexpression Acts in a Dominant Negative Manner to Cause DNA Hypomethylation and Increased Susceptibility to Hematopoietic Malignancies in Transgenic Mice“. Blood 124, Nr. 21 (06.12.2014): 609. http://dx.doi.org/10.1182/blood.v124.21.609.609.
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Abstract Somatic mutations in the DNA methyltransferase, DNMT3A, have been identified in >30% of de novo AML cases with a normal karyotype, and in >10% of patients with MDS and T-ALL. To understand whether mutations in DNMT3A alter hematopoietic development, we generated a transgenic mouse model capable of overexpressing either wild type human DNMT3A or the most common DNMT3A mutation found in AML cases (R882H, a hypomorphic variant that acts as a potent dominant negative inhibitor of WT DNMT3A, D. Germain et al., Cancer Cell 2014). Full-length human cDNAs encoding WT or R882H DNMT3A were cloned into a mammalian expression vector directly downstream from a tetracycline responsive element. This allows for the inducible expression of DNMT3A upon the expression of the rtTA coactivator, and the presence of Doxycycline (Dox). A single founder line for the WT DNMT3A allele, and two founder lines for the R882H DNMT3A allele, were established in the C57Bl6/J background. The WT DNMT3A transgene overexpressed 3.5x more human DNMT3A than endogenous murine DNMT3A in bone marrow cells; R882H DNMT3A transgenic line 1 expressed at a 4.5 fold excess, and R882H line 2 at a 16 fold excess. To determine whether overexpression of the R882H allele was associated with focal DNA hypomethylation in the bone marrow cells of mice (similar to that observed in human AML samples), we used a novel CpG capture approach with bisulfite sequencing to assess 200,000 genomic regions containing ~3 million CpGs in the bone marrow cells of 3 WT C57Bl6/J mice, 3 Dnmt3a null mice, and healthy transgenic mice noted above that had been on Dox chow for either 6 months or 1 year (transgenic mice do not develop hematopoietic malignancies even after one year of transgene induction). We were able to assess 1.6 million CpGs with 10X or greater coverage in all 14 samples. The Dnmt3a null marrow samples contained 188,367 differentially methylated CpGs (average of >25% difference compared to WT bone marrow, q value=<0.01). Of these, 187,093 were hypomethylated (>99%); the hypomethylated CpGs were nearly identical in all three samples. Marrow cells from the two mice overexpressing the WT DNMT3A gene had only 338 differentially methylated CpGs compared to two matched rtTA control mice; of these, 337 were hypermethylated (>99%). For the two mice overexpressing the R882H allele in line 2 (16x overexpression), bone marrow cells had 2,356 differentially methylated CpGs, of which 2,316 were hypomethylated (98%). Of these CpGs, 1,745 (73%) overlapped with hypomethylated CpGs in the Dnmt3a null marrow samples, indicating that R882H overexpression causes hypomethylation in a subset of CpGs whose methylation in bone marrow cells is Dnmt3a dependent. Because none of our mice developed hematologic malignancies even after one year, but had shown significant hypomethylation in the bone marrow, we hypothesized that cooperating mutations were necessary to produce malignancy. We transduced whole bone marrow cells from four transgenic mice: WT DNMT3A Tg x rtTA; R882H-1 Tg x rtTA; R882H-2 Tg x rtTA; and rtTA only (the same samples analyzed for methylation changes in the previous paragraph) with an MSCV-derived virus containing a human FLT3-ITD cDNA, and transplanted the transduced cells into 8-10 lethally irradiated recipients. Mice of all genotypes succumbed to myeloproliferative disease, T-cell lymphoma, T-lymphoma/ALL, or T-ALL. Overall median latencies were: rtTA=155 days, WT DNMT3A Tg x rtTA=164 days, R882H Tg-1 x rtTA=108.5 days, R882H-2 Tg x rtTA=135.5 days. The average latency for T cell malignancies demonstrated even greater differences among the four genotypes: rtTA n=4, 160.8 +/- 12.49 days (SEM), WT DNMT3A Tg x rtTA n=5, 167.3 +/- 4.854, R882H Tg-1 x rtTA n=3, 124.7 +/- 17.7, R882H-2 Tg x rtTA n=4 124.5 days +/- 22.14. T malignancies derived from R882H expressing cells were especially homogeneous compared to other groups; these tumors were CD4/CD8 double positive in all hematopoietic compartments. Despite the small sample size, these results demonstrate a trend towards a decreased latency for T malignancies in R882H expressing marrow cells, using a FLT3-ITD viral transduction model. We are confirming these data with additional mice. Taken together, our results demonstrate a clear focal hypomethyation phenotype in the bone marrow cells of DNMT3A R882H overexpressing mice, which may lead to increased susceptibility to neoplastic transformation. Disclosures No relevant conflicts of interest to declare.
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Cogliati, Francesca, Valentina Giorgini, Maura Masciadri, Maria Teresa Bonati, Margherita Marchi, Irene Cracco, Davide Gentilini et al. „Pathogenic Variants in STXBP1 and in Genes for GABAa Receptor Subunities Cause Atypical Rett/Rett-like Phenotypes“. International Journal of Molecular Sciences 20, Nr. 15 (24.07.2019): 3621. http://dx.doi.org/10.3390/ijms20153621.
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Rett syndrome (RTT) is a neurodevelopmental disorder, affecting 1 in 10,000 girls. Intellectual disability, loss of speech and hand skills with stereotypies, seizures and ataxia are recurrent features. Stringent diagnostic criteria distinguish classical Rett, caused by a MECP2 pathogenic variant in 95% of cases, from atypical girls, 40–73% carrying MECP2 variants, and rarely CDKL5 and FOXG1 alterations. A large fraction of atypical and RTT-like patients remain without genetic cause. Next Generation Sequencing (NGS) targeted to multigene panels/Whole Exome Sequencing (WES) in 137 girls suspected for RTT led to the identification of a de novo variant in STXBP1 gene in four atypical RTT and two RTT-like girls. De novo pathogenic variants—one in GABRB2 and, for first time, one in GABRG2—were disclosed in classic and atypical RTT patients. Interestingly, the GABRG2 variant occurred at low rate percentage in blood and buccal swabs, reinforcing the relevance of mosaicism in neurological disorders. We confirm the role of STXBP1 in atypical RTT/RTT-like patients if early psychomotor delay and epilepsy before 2 years of age are observed, indicating its inclusion in the RTT diagnostic panel. Lastly, we report pathogenic variants in Gamma-aminobutyric acid-A (GABAa) receptors as a cause of atypical/classic RTT phenotype, in accordance with the deregulation of GABAergic pathway observed in MECP2 defective in vitro and in vivo models.
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Ružickij, Robert, Tomas Astrauskas, Sarma Valtere und Raimondas Grubliauskas. „Sound Absorption Properties Evaluation and Analysis of Recycled Tyre Textile Fibre Waste“. Environmental and Climate Technologies 24, Nr. 3 (01.11.2020): 318–28. http://dx.doi.org/10.2478/rtuect-2020-0106.
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AbstractModern world is exposed to various environmental concerns which are closely related to human health condition. Since the automatization, world became vulnerable to the noise and the waste amounts generated. World Health Organization report states, due to noise, Western Europe each year loses approximately 1 million of healthy life years. However, noise is not the only concern. Tyres, since they were banned from the landfills, became enormous problem in a modern society. Approximately 2.6 million tonnes of tyres are generated each year in Europe, out of which 320 000 tonnes of Recycled Tyre Textile Fibre (RTTF) waste. Practically, rubber granules and metals extracted from tyre can be reused, however reusing RTTF is a challenge. The main focus is on the possibility of reuse of RTTF in buildings for acoustical comfort improvement. The determination of sound absorption is implemented by experimental research, based on ISO 10534 standard, involving five types of sound absorbing materials. It was concluded that RTTF has a great potential in use for sound absorption structures and can be an alternative substitute to non-renewable and non-recyclable materials.
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Symon, P., und R. M. Walker. „A Consumer Perspective on Performance Indicators: The Local Housing Authority Reports to Tenants Regimes in England and Wales“. Environment and Planning C: Government and Policy 13, Nr. 2 (Juni 1995): 195–216. http://dx.doi.org/10.1068/c130195.
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Performance indicators were formally introduced into local authority housing management in England and Wales by Section 167(1) of the 1989 Local Government and Housing Act, which required local housing authorities to circulate annual Reports to Tenants (RTTs) containing information on performance indicators. In this paper, the background to the new regime is discussed, noting the absence of a consumer perspective on performance indicators in much of the research literature. There is an examination of the appropriateness of the concepts of client, customer, consumer, and citizen as descriptions of tenants. The reaction of tenants in England and Wales to the first year of RTTs is then discussed. The impact on tenants was minimal, and consumers did not use the information in the reports in the way central government might have hoped. The value to tenants of the growing number of RTTs regimes is questioned. The paper concludes with a criticism of the concept of tenants as consumers in the context of RTTs regimes, and points to the inherent conflicts within these regimes.
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Luque Paz, David, Betsega Bayeh, Pierre Chauvin, Florence Poizeau, Mathieu Lederlin, Mallorie Kerjouan, Charles Lefevre et al. „Intrapleural use of urokinase and DNase in pleural infections managed with repeated thoracentesis: A comparative cohort study“. PLOS ONE 16, Nr. 9 (21.09.2021): e0257339. http://dx.doi.org/10.1371/journal.pone.0257339.
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Introduction Evacuation of infected fluid in pleural infections is essential. To date, the use of an intrapleural fibrinolytic agent such as urokinase and DNase has not yet been assessed in infections managed by repeated therapeutic thoracentesis (RTT). Methods We performed a retrospective comparative study of two successive cohorts of consecutive patients with pleural infections from 2001 to 2018. Between 2001 and 2010, patients had RTT with intrapleural urokinase (RTT-U). After 2011, patients received intrapleural urokinase and DNase with RTT (RTT-UD). Data were collected through a standardized questionnaire. Results One hundred and thirty-three patients were included: 93 were men and the mean age was 59 years (standard deviation 17.2). Eighty-one patients were treated with a combination of intrapleural urokinase and DNase, and 52 were treated with intrapleural urokinase only. In the RTT-UD, RTT failure occurred in 14 patients (17%) compared to 10 (19%) in the RTT-U group (P = 0.82). There was no difference between the two groups in intensive care unit admission, surgical referrals or in-hospital mortality. RTT-UD was associated with faster time to apyrexia (aOR = 0.51, 95%CI [0.37–0.72]), a reduced length of hospital stay (aOR = 0.61, 95%CI [0.52–0.73]) and a higher volume of total pleural fluid retrieved (aOR = 1.38, 95%CI [1.02–1.88]). Complications were rare with only one hemothorax in the RTT-UD group and no pneumothorax requiring drainage in either group. Conclusion Compared to urokinase only, intrapleural use of urokinase and DNase in RTT was associated with quicker defervescence, shorter hospital stay and increased volumes of pleural fluid drained. Randomized controlled trials evaluating urokinase and DNase with RTT technique would be required to confirm these results.
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King, Joseph J., und Dennis P. Stimart. „787 PB 439 A MUTATION ALTERING AUXIN HOMEOSTASIS AND PLANT MORPHOLOGY IN ARABIDOPSIS THALIANA L. HEYNH“. HortScience 29, Nr. 5 (Mai 1994): 545f—545. http://dx.doi.org/10.21273/hortsci.29.5.545f.
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In an attempt to analyze genetically the interaction of endogenous auxin concentration and adventitious root formation, an EMS mutagenized M2 population of Arabidopsis thaliana was screened for mutants with altered abilities to form adventitious roots. A selected recessive nuclear mutant, rooty (rty), is characterized by extreme proliferation of roots, inhibition of shoot development and other morphological alterations suggestive of auxin or ethylene effects. The rty phenotype occurs in wild type seedlings grown on auxin containing medium and relatively normal growth is stimulated in rty seedlings growing on cytokinin containing medium. Analysis by GC-MS found that endogenous IAA concentrations in rty are 2 to 17 times higher than in wild type depending on tissue type and IAA form. Dose response experiments with IAA and NAA indicated that rty does not express increased sensitivity to auxin. These data suggest that the rty phenotype is due to elevated endogenous auxin. A genetic map location for rty and possible roles for the wild type RTY gene product in regulating auxin concentration will be presented.
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Bottino, Dean, Axel Gomez, Jackson Burton, Katherine Williams, Douglas White und Arijit Chakravarty. „Paradoxical behavior of time to RECIST progression as a metric for treatment effect.“ Journal of Clinical Oncology 35, Nr. 15_suppl (20.05.2017): e14022-e14022. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e14022.
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e14022 Background: RECIST time to progression (RTTP) is the cornerstone of widely used surrogates for patient benefit such as RECIST progression-free survival (RPFS), which in turn is used either for accelerated regulatory approval or to study the effects of factors such as drug exposure and drug target expression levels on RPFS. While one might expect increased antitumor effect to result in longer RTTP and RPFS, we will show that this is often not the case due to a fundamental mathematical property of the RECIST definition of disease progression. Methods:We use a simple mathematical model that treats patient tumor burden dynamics as an evolutionary process consisting of a decreasing drug-sensitive subpopulation of tumor cells and an independently growing drug-resistant subpopulation. This model has successfully described tumor dynamics in NSCLC, melanoma (CPT Pharmacometrics Syst. Pharmacol. (2017) 6, 29–39), and ovarian cancer (internal data). In the presence of drug, we represent the net fitness of the sensitive cells in terms of an exponential decay or “kill” rate k > 0, and the net fitness of the resistant cells as an exponential growth rate g > 0, and the initial fraction of drug-resistant cells by 0 ≤ f ≤ 1. For a given virtual patient (parameter set), we simulate RTTP as the time after start of treatment at which tumor burden V(t) is 20% higher than its lowest value (per RECIST criteria). We then vary the kill rate k and check whether RTTP increases or decreases with increasing k. Results: There is a large set of parameter values for which RTTP is predicted to vary inversely with increasing kill rate k. These parameter values are attained clinically in ovarian cancer patients taking alisertib and paclitaxel (internal data). Conclusions: While RECIST progression criteria may be useful for patient care to identify when a patient is losing her response, care must be taken in interpreting RTTP as a metric of treatment effect due to the real possibility that a stronger treatment effect results in shorter RTTP. We recommend that alternative metrics for patient benefit, such as a generalization of Days Gained (Neal et al PLoS ONE 8(1)e51951), be evaluated. We will present results of these evaluations currently in progress.
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Leoncini, Silvia, Claudio De Felice, Cinzia Signorini, Gloria Zollo, Alessio Cortelazzo, Thierry Durand, Jean-Marie Galano et al. „Cytokine Dysregulation inMECP2- andCDKL5-Related Rett Syndrome: Relationships with Aberrant Redox Homeostasis, Inflammation, andω-3 PUFAs“. Oxidative Medicine and Cellular Longevity 2015 (2015): 1–18. http://dx.doi.org/10.1155/2015/421624.
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An involvement of the immune system has been suggested in Rett syndrome (RTT), a devastating neurodevelopmental disorder related to oxidative stress, and caused by a mutation in the methyl-CpG binding protein 2 gene (MECP2) or, more rarely, cyclin-dependent kinase-like 5 (CDKL5). To date, it is unclear whether both mutations may have an impact on the circulating cytokine patterns. In the present study, cytokines involved in the Th1-, Th2-, and T regulatory (T-reg) response, as well as chemokines, were investigated inMECP2- (MECP2-RTT) (n=16) andCDKL5-Rett syndrome (CDKL5-RTT) (n=8), before and afterω-3 polyunsaturated fatty acids (PUFAs) supplementation. A major cytokine dysregulation was evidenced in untreated RTT patients. InMECP2-RTT, a Th2-shifted balance was evidenced, whereas inCDKL5-RTT both Th1- and Th2-related cytokines (except for IL-4) were upregulated. InMECP2-RTT, decreased levels of IL-22 were observed, whereas increased IL-22 and T-reg cytokine levels were evidenced inCDKL5-RTT. Chemokines were unchanged. The cytokine dysregulation was proportional to clinical severity, inflammatory status, and redox imbalance. Omega-3 PUFAs partially counterbalanced cytokine changes, as well as aberrant redox homeostasis and the inflammatory status. RTT is associated with a subclinical immune dysregulation as the likely consequence of a defective inflammation regulatory signaling system.
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Wennervirta, Jenni, und Torbjörn Wigren. „RTT Positioning Field Performance“. IEEE Transactions on Vehicular Technology 59, Nr. 7 (September 2010): 3656–61. http://dx.doi.org/10.1109/tvt.2010.2054843.
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Koch, D., M. Bass, M. Haessig und R. Inauen. „Tibial tuberosity conformation as a risk factor for cranial cruciate ligament rupture in the dog“. Veterinary and Comparative Orthopaedics and Traumatology 22, Nr. 01 (2009): 16–20. http://dx.doi.org/10.3415/vcot-07-08-0078.
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SummaryThe influence of the tibial tuberosity conformation on cranial cruciate ligament (CrCl) rupture was evaluated and the size of the tibial tuberosity of healthy dogs (group H) was compared with dogs with CrCl rupture (group R) and dogs treated by tibial tuberosity advancement (TTA) (group T). The medio-lateral radio-graphs of 219 stifle joints were evaluated. Relative tibial tuberosity width (rTTW), proximal tibial tuberosity angle (PTTA), tibial plateau angle (TPA), tibial width (TW) and tibial plateau length (TPL) were measured on each radiograph. Body weight (BW) was measured and relative body weight (rBW) was calculated. The data from group H was compared with that of group R and group T. Group H had significantly larger rTTW, lower BW, lower rBW and smaller PTTA than group R. A comparison of groups H and T showed that dogs from group H were significantly younger, had a lower BW, a lower rBW, a greater PTTA and a smaller rTTW. In each of the comparisons, the TPA and the TW/TPL were not significantly different. The conformation of the canine tibial tuberosity has a significant influence on CrCl rupture. We hypothesized that the smaller the tibial tuberosity width, the larger the cranial tibial thrust, which results in more rapid CrCL degeneration, thus leading to rupture in a younger population of dogs. The rTTW could be a helpful measurement for breeding selection. Only dogs with a rTTW of more than 0.90 should be used for breeding.
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Seegmiller, Adam C., und Ravindra Sarode. „Increased Sensitivity of Prothrombin Time Using Recombinant Tissue Thromboplastin Reagents: Implications for Plasma Transfusion.“ Blood 106, Nr. 11 (16.11.2005): 4058. http://dx.doi.org/10.1182/blood.v106.11.4058.4058.
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Abstract Acquired coagulopathies are often treated with fresh frozen plasma (FFP) transfusion. Standards for the tranfusion of FFP vary, but are often based on coagulation tests, especially prothrombin time (PT). Previously, the PT test was performed using tissue thromboplastin (TT) reagents derived from human or animal tissue homogenates (hTT). These preparations were fairly crude and varied between manufacturers and lots. Recently, these have been replaced with recombinant TT (rTT) reagents that are more consistent. However, anecdotal reports suggest that rTT is more sensitive to mildly decreased clotting factor levels, leading to longer PTs and increases in FFP transfusion. The purpose of this study is to test the hypothesis that rTT reagents are more sensitive and to determine if thresholds for FFP transfusion should be increased. Fifty plasma samples from patients with prolonged PTs (range 13.0–27.6 seconds; normal 9.2–12.8 seconds) were randomly selected. PTs for each sample were re-measured using rTT (Innovin, Dade-Behring, Liederbach, Germany; ISI=0.91) and hTT (Thromboplastin Reagent, Helena Laboratories, Beaumont, Texas; ISI=2.07) on the same instrument (Start 4 benchtop coagulation analyzer, Diagnostica Stago, Parsippany, New Jersey). These measured PTs are compared in Fig. 1. At the lower end of the PT range (beginning at ~13 seconds), the rTT PTs are shorter, on average, than the hTT PTs. However, the average rTT PT increases at a 1.4 times greater rate than the hTT PT, such that the average PT of the two reagents is equivalent at 16.4 seconds and longer for rTT thereafter. This suggests that the rTT reagent is indeed more sensitive. A similar pattern is seen when factor II and VII levels for each sample are plotted against the corresponding PT (Fig. 2). At high factor levels, the rTT PT is lower, on average, than the hTT PT. However, as factor levels decrease, the rTT PT rises about twice as fast as the hTT PT. The PTs for the two reagents are equivalent at 66% factor II (PT=15.7) and 46% factor VII (PT=17.7). The important thresholds for risk of surgical bleeding are 40% factor II and 25% factor VII. The equivalent PTs in this study are 20.5 (rTT) and 18.1 (hTT) for 40% factor II and 22.3 (rTT) and 19.6 (hTT) for 25% factor VII. These differences are not corrected by converting PTs to the international normalized ratio (INR). Instead, INRs are higher for hTT than rTT, and the degree of difference between the two reagents is greater. The equivalent INRs are 1.90 (rTT) and 2.54 (hTT) for 40% factor II activity, and 2.05 (rTT) and 2.98 (hTT) for 25% factor VII activity. The results of this study confirm that PTs measured using rTT are more sensitive to changes in clotting factor levels than those measured using hTT, especially at clinically significant factor levels. This suggests that thresholds for the transfusion of FFP should be raised at those institutions using rTT. Fig. 1: Comparison of PTs measured Using rTT and hTT Reagents Fig. 1:. Comparison of PTs measured Using rTT and hTT Reagents Fig. 2: Correlation of Prothrombin Time and Factor Levels Fig. 2:. Correlation of Prothrombin Time and Factor Levels
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Byiers, Breanne J., Ameante Payen, Timothy Feyma, Angela Panoskaltsis-Mortari, Michael J. Ehrhardt und Frank J. Symons. „Associations Among Diurnal Salivary Cortisol Patterns, Medication Use, and Behavioral Phenotype Features in a Community Sample of Rett Syndrome“. American Journal on Intellectual and Developmental Disabilities 125, Nr. 5 (01.09.2020): 353–68. http://dx.doi.org/10.1352/1944-7558-125.5.353.
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Abstract Rett syndrome (RTT) is a severe neurodevelopmental disorder resulting from mutations of the MECP2 gene. Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis and abnormal stress responses have been observed in animal models of RTT, but little is known about HPA axis function among individuals with RTT. Diurnal salivary cortisol patterns from 30 females with RTT were examined in relation to mutation type, medication use, and features of the RTT behavioral phenotype. Cortisol patterns were significantly related to mutation severity, anticonvulsant medication status, and bruxism (tooth grinding). This study provides preliminary support for the hypothesis that RTT may be at risk for outcomes associated with aberrant HPA axis function, and that this risk may be mediated by mutation type.
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Lim, Min-Ki, und Dong-Hoi Kim. „The Congestion Estimation based TCP Congestion Control Scheme using the Weighted Average Value of the RTT“. Journal of Digital Contents Society 16, Nr. 3 (30.06.2015): 381–88. http://dx.doi.org/10.9728/dcs.2015.16.3.381.
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Smirnov, Kirill, Tatiana Stroganova, Sophie Molholm und Olga Sysoeva. „Reviewing Evidence for the Relationship of EEG Abnormalities and RTT Phenotype Paralleled by Insights from Animal Studies“. International Journal of Molecular Sciences 22, Nr. 10 (18.05.2021): 5308. http://dx.doi.org/10.3390/ijms22105308.
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Rett syndrome (RTT) is a rare neurodevelopmental disorder that is usually caused by mutations of the MECP2 gene. Patients with RTT suffer from severe deficits in motor, perceptual and cognitive domains. Electroencephalogram (EEG) has provided useful information to clinicians and scientists, from the very first descriptions of RTT, and yet no reliable neurophysiological biomarkers related to the pathophysiology of the disorder or symptom severity have been identified to date. To identify consistently observed and potentially informative EEG characteristics of RTT pathophysiology, and ascertain areas most worthy of further systematic investigation, here we review the literature for EEG abnormalities reported in patients with RTT and in its disease models. While pointing to some promising potential EEG biomarkers of RTT, our review identify areas of need to realize the potential of EEG including (1) quantitative investigation of promising clinical-EEG observations in RTT, e.g., shift of mu rhythm frequency and EEG during sleep; (2) closer alignment of approaches between patients with RTT and its animal models to strengthen the translational significance of the work (e.g., EEG measurements and behavioral states); (3) establishment of large-scale consortium research, to provide adequate Ns to investigate age and genotype effects.
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Stallworth, Jennifer L., Marisela E. Dy, Caroline B. Buchanan, Chin-Fu Chen, Alexandra E. Scott, Daniel G. Glaze, Jane B. Lane et al. „Hand stereotypies“. Neurology 92, Nr. 22 (03.05.2019): e2594-e2603. http://dx.doi.org/10.1212/wnl.0000000000007560.
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ObjectiveTo characterize hand stereotypies (HS) in a large cohort of participants with Rett syndrome (RTT).MethodsData from 1,123 girls and women enrolled in the RTT Natural History Study were gathered. Standard tests for continuous and categorical variables were used at baseline. For longitudinal data, we used repeated-measures linear and logistic regression models and nonparametric tests.ResultsHS were reported in 922 participants with classic RTT (100%), 73 with atypical severe RTT (97.3%), 74 with atypical mild RTT (96.1%), and 17 females with MECP2 mutations without RTT (34.7%). Individuals with RTT who had classic presentation or severe MECP2 mutations had higher frequency and earlier onset of HS. Heterogeneity of HS types was confirmed, but variety decreased over time. At baseline, almost half of the participants with RTT had hand mouthing, which like clapping/tapping, decreased over time. These 2 HS types were more frequently reported than wringing/washing. Increased HS severity (prevalence and frequency) was associated with worsened measures of hand function. Number and type of HS were not related to hand function. Overall clinical severity was worse with decreased hand function but only weakly related to any HS characteristic. While hand function decreased over time, prevalence and frequency of HS remained relatively unchanged and high.ConclusionsNearly all individuals with RTT have severe and multiple types of HS, with mouthing and clapping/tapping decreasing over time. Interaction between HS frequency and hand function is complex. Understanding the natural history of HS in RTT could assist in clinical care and evaluation of new interventions.
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Finch, Maida A. „Tennessee to the Top: One State’s Pursuit to Win Race to the Top“. Educational Policy 31, Nr. 4 (18.09.2015): 481–517. http://dx.doi.org/10.1177/0895904815604216.
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In 2009, a seldom-used policy lever emerged in the form of a competitive grant program, Race to the Top (RTTT), and sparked a flurry of state-led initiatives as states vied for federal dollars. The current study examines the policymaking context that surrounded these events and propelled Tennessee to the top of the race among the states. Through interviews with legislators and bureaucrats, I analyze the state-level processes instigated by a federal program in which all but four states participated, but fewer than half were winners. My examination details the parallels between the RTTT guidelines, Tennessee’s efforts, including the Special Session in the General Assembly, and the state’s plan for improving education in the state as outlined in their RTTT application.
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Qiu, Sugan, Xiaonan Ren, Yinyin Ben, Yanqin Ren, Jing Wang, Xiaoyan Zhang, Yanmin Wan und Jianqing Xu. „Fusion-Expressed CTB Improves Both Systemic and Mucosal T-Cell Responses Elicited by an Intranasal DNA Priming/Intramuscular Recombinant Vaccinia Boosting Regimen“. Journal of Immunology Research 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/308732.
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Previous study showed that CTB (Cholera toxin subunit B) can be used as a genetic adjuvant to enhance the systemic immune responses. To further investigate whether it can also be used as a genetic adjuvant to improve mucosal immune responses, we constructed DNA and recombinant Tiantan vaccinia (rTTV) vaccines expressing OVA-CTB fusion antigen. Female C57BL/6 mice were immunized with an intranasal DNA priming/intramuscular rTTV boosting regimen. OVA specific T-cell responses were measured by IFN-γELISPOT and specific antibody responses were determined by ELISA. Compared to the nonadjuvant group (pSV-OVA intranasal priming/rTTV-OVA intramuscular boosting), pSV-OVA-CTB intranasal priming/rTTV-OVA-CTB intramuscular boosting group significantly improved the magnitudes of T-cell responses at spleen (1562±567SFCs/106splenocytes versus330±182SFCs/106splenocytes,P<0.01), mesenteric LN (96±83SFCs/106lymphocytes versus1±2SFCs/106lymphocytes,P<0.05), draining LNs of respiratory tract (109±60SFCs/106lymphocytes versus2±2SFCs/106lymphocytes,P<0.01) and female genital tract (89±48SFCs/106lymphocytes versus23±21SFCs/106lymphocytes,P<0.01). These results collectively demonstrated that fusion-expressed CTB could act as a potent adjuvant to improve both systemic and mucosal T-cell responses.
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Juul, Rasmus Vestergaard, Sten Rasmussen, Mads Kreilgaard, Lona Louring Christrup, Ulrika S. H. Simonsson und Trine Meldgaard Lund. „Repeated Time-to-event Analysis of Consecutive Analgesic Events in Postoperative Pain“. Anesthesiology 123, Nr. 6 (01.12.2015): 1411–19. http://dx.doi.org/10.1097/aln.0000000000000917.
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Abstract Background Reduction in consumption of opioid rescue medication is often used as an endpoint when investigating analgesic efficacy of drugs by adjunct treatment, but appropriate methods are needed to analyze analgesic consumption in time. Repeated time-to-event (RTTE) modeling is proposed as a way to describe analgesic consumption by analyzing the timing of consecutive analgesic events. Methods Retrospective data were obtained from 63 patients receiving standard analgesic treatment including morphine on request after surgery following hip fracture. Times of analgesic events up to 96 h after surgery were extracted from hospital medical records. Parametric RTTE analysis was performed with exponential, Weibull, or Gompertz distribution of analgesic events using NONMEM®, version 7.2 (ICON Development Solutions, USA). The potential influences of night versus day, sex, and age were investigated on the probability. Results A Gompertz distribution RTTE model described the data well. The probability of having one or more analgesic events within 24 h was 80% for the first event, 55% for the second event, 31% for the third event, and 18% for fourth or more events for a typical woman of age 80 yr. The probability of analgesic events decreased in time, was reduced to 50% after 3.3 days after surgery, and was significantly lower (32%) during night compared with day. Conclusions RTTE modeling described analgesic consumption data well and could account for time-dependent changes in probability of analgesic events. Thus, RTTE modeling of analgesic events is proposed as a valuable tool when investigating new approaches to pain management such as opioid-sparing analgesia.
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Pini, Giorgio, Maria Flora Scusa, Laura Congiu, Alberto Benincasa, Paolina Morescalchi, Ilaria Bottiglioni, Pietro Di Marco et al. „IGF1 as a Potential Treatment for Rett Syndrome: Safety Assessment in Six Rett Patients“. Autism Research and Treatment 2012 (2012): 1–14. http://dx.doi.org/10.1155/2012/679801.
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Rett syndrome (RTT) is a devastating neurodevelopmental disorder that affects one in ten thousand girls and has no cure. The majority of RTT patients display mutations in the gene that codes for the methyl-CpG-binding protein 2 (MeCP2). Clinical observations and neurobiological analysis of mouse models suggest that defects in the expression of MeCP2 protein compromise the development of the central nervous system, especially synaptic and circuit maturation. Thus, agents that promote brain development and synaptic function, such as insulin-like growth factor 1 (IGF1), are good candidates for ameliorating the symptoms of RTT. IGF1 and its active peptide, (1–3) IGF1, cross the blood brain barrier, and (1–3) IGF1 ameliorates the symptoms of RTT in a mouse model of the disease; therefore they are ideal treatments for neurodevelopmental disorders, including RTT. We performed a pilot study to establish whether there are major risks associated with IGF1 administration in RTT patients. Six young girls with classic RTT received IGF1 subcutaneous injections twice a day for six months, and they were regularly monitored by their primary care physicians and by the unit for RTT in Versilia Hospital (Italy). This study shows that there are no risks associated with IGF1 administration.
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Sarajlija, Adrijan, Darija Kisic-Tepavcevic, Zorana Nikolic, Dusanka Savic Pavicevic, Slobodan Obradovic, Milena Djuric und Tatjana Pekmezovic. „Epidemiology of Rett Syndrome in Serbia: Prevalence, Incidence and Survival“. Neuroepidemiology 44, Nr. 1 (2015): 1–5. http://dx.doi.org/10.1159/000369494.
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Background: Rett syndrome (RTT) is a severe neurodevelopmental disorder that represents the second most common cause of mental retardation in females. However, incidence and prevalence of RTT are scarcely reported. Methods: A retrospective study included all patients with RTT diagnosed between 1981 and 2012 in Serbia. Estimation of incidence and prevalence was calculated on the basis of vital statistics reported by Statistical Office of Republic of Serbia. Results: From 1981 to 2012, RTT has been diagnosed in 102 girls in Serbia. Incidence of RTT in Serbia is estimated at 0.586:10,000 female live births. We estimated the prevalence of RTT in population of females younger than 19 years at 1:8,439. Death occurred in 19 patients (18.63%), with pneumonia as the most common cause. The lethal outcome by the age of 12 years could be expected for 11% of patients. The mean age at diagnosis was 3.5 years and we have confirmed a significant trend towards earlier dianosis during studied period. Conclusions: Rett syndrome incidence in Serbia is in accordance with reports from other countries. Serbian RTT patients have increased risk for early death when compared to patients in more developed countries, most commonly due to pneumonia. There was significant trend towards early diagnosis of RTT in Serbia over recent decades.
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Pecorelli, Alessandra, Guido Leoni, Franco Cervellati, Raffaella Canali, Cinzia Signorini, Silvia Leoncini, Alessio Cortelazzo et al. „Genes Related to Mitochondrial Functions, Protein Degradation, and Chromatin Folding Are Differentially Expressed in Lymphomonocytes of Rett Syndrome Patients“. Mediators of Inflammation 2013 (2013): 1–18. http://dx.doi.org/10.1155/2013/137629.
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Rett syndrome (RTT) is mainly caused by mutations in the X-linked methyl-CpG binding protein (MeCP2) gene. By binding to methylated promoters on CpG islands, MeCP2 protein is able to modulate several genes and important cellular pathways. Therefore, mutations inMeCP2can seriously affect the cellular phenotype. Today, the pathways thatMeCP2mutations are able to affect in RTT are not clear yet. The aim of our study was to investigate the gene expression profiles in peripheral blood lymphomonocytes (PBMC) isolated from RTT patients to try to evidence new genes and new pathways that are involved in RTT pathophysiology. LIMMA (Linear Models for MicroArray) and SAM (Significance Analysis of Microarrays) analyses on microarray data from 12 RTT patients and 7 control subjects identified 482 genes modulated in RTT, of which 430 were upregulated and 52 were downregulated. Functional clustering of a total of 146 genes in RTT identified key biological pathways related to mitochondrial function and organization, cellular ubiquitination and proteosome degradation, RNA processing, and chromatin folding. Our microarray data reveal an overexpression of genes involved in ATP synthesis suggesting altered energy requirement that parallels with increased activities of protein degradation. In conclusion, these findings suggest that mitochondrial-ATP-proteasome functions are likely to be involved in RTT clinical features.
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Pini, Giorgio, Laura Congiu, Alberto Benincasa, Pietro DiMarco, Stefania Bigoni, Adam H. Dyer, Niall Mortimer et al. „Illness Severity, Social and Cognitive Ability, and EEG Analysis of Ten Patients with Rett Syndrome Treated with Mecasermin (Recombinant Human IGF-1)“. Autism Research and Treatment 2016 (2016): 1–9. http://dx.doi.org/10.1155/2016/5073078.
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Rett Syndrome (RTT) is a severe neurodevelopmental disorder characterized by an apparently normal development followed by an arrest and subsequent regression of cognitive and psychomotor abilities. At present, RTT has no definitive cure and the treatment of RTT represents a largely unmet clinical need. Following partial elucidation of the underlying neurobiology of RTT, a new treatment has been proposed, Mecasermin (recombinant human Insulin-Like Growth Factor 1), which, in addition to impressive evidence from preclinical murine models of RTT, has demonstrated safety in human studies of patients with RTT. The present clinical study examines the disease severity as assessed by clinicians (International Scoring System: ISS), social and cognitive ability assessed by two blinded, independent observers (RSS: Rett Severity Score), and changes in brain activity (EEG) parameters of ten patients with classic RTT and ten untreated patients matched for age and clinical severity. Significant improvement in both the ISS (p=0.0106) and RSS (p=0.0274) was found in patients treated with IGF1 in comparison to untreated patients. Analysis of the novel RSS also suggests that patients treated with IGF1 have a greater endurance to social and cognitive testing. The present clinical study adds significant preliminary evidence for the use of IGF-1 in the treatment of RTT and other disorders of the autism spectrum.
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Papini, Anna Maria, Francesca Nuti, Feliciana Real-Fernandez, Giada Rossi, Caterina Tiberi, Giuseppina Sabatino, Shashank Pandey et al. „Immune Dysfunction in Rett Syndrome Patients Revealed by High Levels of Serum Anti-N(Glc) IgM Antibody Fraction“. Journal of Immunology Research 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/260973.
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Rett syndrome (RTT), a neurodevelopmental disorder affecting exclusively (99%) female infants, is associated with loss-of-function mutations in the gene encoding methyl-CpG binding protein 2 (MECP2) and, more rarely, cyclin-dependent kinase-like 5 (CDKL5) and forkhead box protein G1 (FOXG1). In this study, we aimed to evaluate the function of the immune system by measuring serum immunoglobulins (IgG and IgM) in RTT patients (n=53) and, by comparison, in age-matched children affected by non-RTT pervasive developmental disorders (non-RTT PDD) (n=82) and healthy age-matched controls (n=29). To determine immunoglobulins we used both a conventional agglutination assay and a novel ELISA based on antibody recognition by a surrogate antigen probe, CSF114(Glc), a syntheticN-glucosylated peptide. Both assays provided evidence for an increase in IgM titer, but not in IgG, in RTT patients relative to both healthy controls and non-RTT PDD patients. The significant difference in IgM titers between RTT patients and healthy subjects in the CSF114(Glc) assay (P=0.001) suggests that this procedure specifically detects a fraction of IgM antibodies likely to be relevant for the RTT disease. These findings offer a new insight into the mechanism underlying the Rett disease as they unveil the possible involvement of the immune system in this pathology.