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Margetts, John, Manfred Durzak, and Hartmut Steinecke. "F. C. Delius: Studien uber sein literarisches Werk." Modern Language Review 95, no. 4 (October 2000): 1141. http://dx.doi.org/10.2307/3736697.
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Gess, Nicola. "nr="110"Ein Schreiben des Selbst am Leitfaden der Musik. : F. C. Delius’ ,,Zukunft der Schönheit“." Zeitschrift für Germanistik 31, no. 2 (January 1, 2021): 110–24. http://dx.doi.org/10.3726/92169_110.
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Abstract Musik ist in der Lage, Vergessenes wieder in Erinnerung zu rufen – der Artikel macht sich auf die Suche nach dem literarischen Ursprung dieser Annahme, die gegenwärtig in Psychologie und Populärwissenschaft Konjunktur hat. Nach Ausführungen zur literarischen Romantik und zur Intermedialitätstheorie konzentriert er sich auf Friedrich Christian Delius’ autobiographischen Roman Die Zukunft der Schönheit (2018), um an ihm das Schreiben des Selbst am Leitfaden der Musik zu untersuchen – einer erinnerten/erzählten Musik, die Erinnerungen wachruft, die ihrerseits erzählt werden wollen.Music is able to evoke memories long forgotten – this article takes a closer look at the literary dimensions of this assumption that is currently receiving a great deal of attention in psychology and popular science. After reflecting on literary romanticism and theories of intermediality, it focuses on Friedrich Christian Delius’ novel Die Zukunft der Schönheit (2018). Based on this book, the connection of music, memory, and literature is examined systematically, by reading it, on the one hand, as a multi-layered structure of evocations and in the tradition of literary inspiration myths, and, on the other, by examining how the literary text speaks about music and itself becomes ,musicalized‘.
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McNally, Michael J. "The Search for Thomas F. Ward, Teacher of Frederick Delius by Don C. Gillespie." Catholic Historical Review 83, no. 3 (1997): 519–20. http://dx.doi.org/10.1353/cat.1997.0057.
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Hamm, E. "Knowledge From Underground: Leibniz Mines the Enlightenment." Earth Sciences History 16, no. 2 (January 1, 1997): 77–99. http://dx.doi.org/10.17704/eshi.16.2.5204u8j628w3027l.
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The history of geology has focused largely on the foundations of geology in the late eighteenth and early nineteenth centuries. Considerable attention has also been given to grand theories of the earth, or cosmogonies, of the seventeenth century. This approach has left out most of eighteenth-century mineralogy; it has also left out mining. The argument here is that Leibniz's Protogaea is best understood in the context of the Harz mines, where Leibniz spent considerable energy doing administrative work and inventing new mining machinery. By looking to the mines we not only make sense of Protogaea, but of most of German mineralogy in the eighteenth century. J. G. Lehmann, J. F. W. Charpentier, C. G. Delius and many other practitioners working in and around mines were deeply concerned with mapping the subterranean structure of the earth's crust and they contrasted their work with the "fantastic" world of theorists. The Freiberg Mining Academy, other institutions, and the way vocabularies of mining changed will also be considered. Finally there are some concluding thoughts on why mining has almost disappeared from the history of geology.
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Leibrandt, Isabella. "Reading comprehension of literary texts using a multimodal language–image approach." International Journal of New Trends in Social Sciences 6, no. 2 (November 4, 2022): 97–111. http://dx.doi.org/10.18844/ijss.v6i2.8223.
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The importance of multimodal reading comprehension from multiple perspectives is particularly reflected in the theoretical work that has been published in recent times. Expanding the perspectives students use to make sense of these multimodal texts is an important part of comprehension instruction. The study focuses on the textual linking of language and image with the aim of promoting the textual productive and receptive use of images, assigning a relevant meaning to the image in the literary context of use, complementing the literary text with the visual message, integrating language and contextualised images and including them in the process of overall comprehension. The project presented here in the form of an experience report shows the results of and provides suggestions for the procedural application of a multimodal text–image approach to reading comprehension of a literary text. It is based on the reading of F. C. Delius' novel The Walk from Rostock to Syracuse. This text lends itself to being explored in a multimodal way, as it pre-supposes implicit knowledge that includes certain historical and cultural contextual references.
Keywords: Images, intertextuality, literacy, multimodality, reading comprehension
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Li, Yongxiang. "Positive Periodic Solutions of Second-Order Differential Equations with Delays." Abstract and Applied Analysis 2012 (2012): 1–13. http://dx.doi.org/10.1155/2012/829783.
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The existence results of positiveω-periodic solutions are obtained for the second-order differential equation with delays−u″+a(t)=f(t,u(t−τ1),...,u(t−τn)), wherea∈C(ℝ,(0,∞))is aω-periodic function,f:ℝ×[0,∞)n→[0,∞)is a continuous function, which isω-periodic int, andτ1,τ2,...,τnare positive constants. Our discussion is based on the fixed point index theory in cones.
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Zatz, M., G. D. Lange, and M. D. Rollag. "What does changing the temperature do to the melatonin rhythm in cultured chick pineal cells?" American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 266, no. 1 (January 1, 1994): R50—R58. http://dx.doi.org/10.1152/ajpregu.1994.266.1.r50.
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Chick pineal cells in static culture display a persistent, photosensitive circadian rhythm of melatonin production and release. We previously described the effects of light, the major physiological regulator of circadian rhythms, on the amplitude, period, and phase of the melatonin rhythm. Here we describe the effects of temperature, another physiological regulator of circadian rhythms, on the amplitude, period, and phase of this rhythm. Maintaining cells at 40.0-43.3 degrees C (104-110 degrees F) instead of 36.7 degrees C (98 degrees F) doubled the amplitude of the melatonin rhythm. In contrast, amplitude was reduced by about half at 33.3 degrees C (92 degrees F), and at 46.7 degrees C (116 degrees F) melatonin production was stopped within a few hours. Although temperatures of 40.0-43.3 degrees C raised melatonin output (unlike light, which suppresses it), they lengthened the period of the rhythm (as does constant light). Exposure of cells to 8-h pulses of these temperatures (40.0-43.3 degrees C) induced both phase delays and phase advances of the rhythm in subsequent cycles, with a phase dependence similar to that for the phase shifts induced by light pulses. Pulses of 40.0-43.3 degrees C were, however, weaker in their phase-shifting effects than light pulses. Pulses at still higher temperatures (46.7 degrees C) markedly inhibited melatonin output and delayed or disrupted the rhythm. The relationships (physiological and mechanistic) between the effects of temperature and light on the melatonin rhythm remain to be determined.
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Li, Yongxiang, and Qiang Li. "Positive Periodic Solutions of Third-Order Ordinary Differential Equations with Delays." Abstract and Applied Analysis 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/547683.
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The existence results of positiveω-periodic solutions are obtained for the third-order ordinary differential equation with delaysu′′′(t)+a(t)u(t)=f(t,u(t-τ0),u′(t-τ1),u′′(t-τ2)),t∈ℝ,wherea∈C(ℝ,(0,∞))isω-periodic function andf:ℝ×[0,∞)×ℝ2→[0,∞)is a continuous function which isω-periodic int,and τ0,τ1,τ2are positive constants. The discussion is based on the fixed-point index theory in cones.
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Migda, Małgorzata, Ewa Schmeidel, and Małgorzata Zdanowicz. "Existence of nonoscillatory solutions for system of neutral difference equations." Applicable Analysis and Discrete Mathematics 9, no. 2 (2015): 271–84. http://dx.doi.org/10.2298/aadm150811016m.
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The system of neutral type difference equations with delays {?(x(n) + p(n) x(n - ?))= a(n) f(y(n - l)) ?y(n) = b(n) g(z(n - m)) ?z(n) = c(n) h(x(n - k)) is considered. The aim of this paper is to present sufficient conditions for the existence of nonoscillatory bounded positive solutions of the considered system with various (p(n)).
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Li, Qiang, and Yongxiang Li. "On the Existence of Positive Periodic Solutions for Second-Order Functional Differential Equations with Multiple Delays." Abstract and Applied Analysis 2012 (2012): 1–13. http://dx.doi.org/10.1155/2012/929870.
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The existence results of positiveω-periodic solutions are obtained for the second-order functional differential equation with multiple delaysu″(t)+a(t)u(t)=f(t,u(t),u(t−τ1(t)),…,u(t−τn(t))), wherea(t)∈C(ℝ)is a positiveω-periodic function,f:ℝ×[0,+∞)n+1→[0,+∞)is a continuous function which isω-periodic int, andτ1(t),…,τn(t)∈C(ℝ,[0,+∞))areω-periodic functions. The existence conditions concern the first eigenvalue of the associated linear periodic boundary problem. Our discussion is based on the fixed-point index theory in cones.
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Oliveira, Ágda Malany Forte de, Railene Hérica Carlos Rocha de Araújo, Kalinny Araújo Alves, Francisco de Assis de Sousa, Albert Einstein Mathias Medeiros Teodosio, Elny Alves Onias, Ana Paula Nunes Ferreira, et al. "Active packaging using Scenedesmus sp. and agar delays maturity and maintains post-harvest quality of 'Paluma' guavas." MAY 2021, no. 15(05):2021 (May 10, 2021): 703–7. http://dx.doi.org/10.21475/ajcs.21.15.05.p3011.
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The use of new technologies is important for the preservation of guava, especially in reaching long-distance markets, being indispensable to associate storage techniques to increase the durability of fresh fruit. We evaluated the efficiency of edible coatings based on agar and Scenedemus sp. on the quality and post-harvest conservation of 'Paluma' guava. The experiment consisted of a randomized design with four replicates. The treatments (T) were composed of mixing concentrations between agar and Scenedesmus sp.: A: (0% + 0%); B: (0% + 0.5%); C: (0% + 1%); D: (0% + 2%); E: (3% + 0%); F: (3% + 0.5%); G: (4% + 0%) and H: (4% + 0.5%) applied by immersion. At the end of 11 days of storage at 10 °C ± 2ºC and 65% ± 5% RH, the fruit was analyzed. There was a significant effect (P < 0.05) of the coating based on Scenedesmus sp. on the brightness (L*) of the peel and pulp of guava, hue (°h) and chromaticity (C*) of the peel, loss of fresh mass, firmness of the pulp, ascorbic acid, titratable acidity, pH, SS/AT ratio, and total sugars. We observed a lower maturation and maintenance of the post-harvest quality of 'Paluma' guava with the active packages corresponding to treatments F and H. This included the maintenance of the indexes L*, C* and h of peel color, retention in the loss of fresh mass, in the firmness and maintenance of organic acids
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Nunes, M. C. N., A. M. M. B. Morais, J. K. Brecht, S. A. Sargent, and J. A. Bartz. "Prompt Cooling Reduces Incidence and Severity of Decay Caused by Botrytis cinerea and Rhizopus stolonifer in Strawberry." HortTechnology 15, no. 1 (January 2005): 153–56. http://dx.doi.org/10.21273/horttech.15.1.0153.
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Delays in initiating the cooling of freshly harvested `Chandler' strawberries (Fragaria ×ananassa) were compared with prompt cooling to determine how such handling affected development of postharvest decays during subsequent storage and marketing. Strawberries at the three-quarter to full red ripeness stages were harvested four times between mid-June and late July, inoculated with Botrytis cinerea or Rhizopus stolonifer and then handled to simulate prompt or delayed precooling prior to storage. This was done by incubating fruit at 35 °C (95.0 °F) and 70% to 80% relative humidity (RH) for 1 or 6 hours. The fruit were then forced-air cooled to 5 °C (41.0 °F) in 1 hour and stored for 7 days at 2 °C (35.6 °F) and 85% to 95% RH, plus displayed in a simulated market at 20 °C (68.0 °F) and 85% RH for 1 day. Decay incidence increased as the season progressed. For non-inoculated fruit, prompt cooling reduced the incidence of decay by an average of 25% and the decay severity by ∼24%. With inoculated fruit, prompt cooling resulted in 15% and 29% decreases in the incidence and severity, respectively, of rhizopus rot compared to delayed cooling, and 5% and 22% decreases in the incidence and severity, respectively, of botrytis rot. Overall, the incidence of botrytis and rhizopus fruit rot averaged 60% and 85% in the prompt and delayed cooling treatments, respectively. Although prompt cooling is important for minimizing postharvest decay of strawberries, temperature management alone may not sufficiently control postharvest decay when decay pressure is high.
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Yang, Huan, Wei Yu, Wen Gao Chang, Zeng Qiang Man, and Yun Fei Cao. "Accelerated Transformation of Hot Deformed Austenite in SCM435 Steel." Materials Science Forum 993 (May 2020): 541–49. http://dx.doi.org/10.4028/www.scientific.net/msf.993.541.
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The element chromium and molybdenum delays the γ→α phase transition, while the deformation energy storage and high temperature diffusion can promote the γ→α phase transition process. The phase change of alloy structural steel SCM435 under different deformation temperature and cooling path after heating and holding at 1050°C was measured by a thermal simulator. The microstructure and hardness of the steel under various rolling processes were studied by using SEM and micro-hardness tests. The low deformation temperature (800~720°C) and the slow post-rolling cooling speed (1~0.3°C/s) were favorable for the γ→α phase change, where the phase microstructure showed the low hardness. As the isothermal temperature decreases, the microstructure changes from Pearlite (P)+ Ferrite (F) to P+ F + Martensite(M). The lower the isothermal temperature, the higher the martensite content in the structure, and the higher the hardness was. Both the low temperature deformation and 660°C isothermal treatment could quickly accelerate the γ→α transformation of SCM435. The fastest transformation temperature in this case for pearlite of SCM435 was 660°C, and the phase transition ended within 300s, which significantly shortened the time compared with the isothermal time in the low temperature zone.
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Kalantari, S., G. Samson, J. Makhlouf, and J. Arul. "378 Does Exposure to Hormic Dose of UV-C Light Affect the Ripening of Tomato Pericarp Disc?" HortScience 34, no. 3 (June 1999): 509B—509. http://dx.doi.org/10.21273/hortsci.34.3.509b.
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The application of ultraviolet light on fruit and vegetables is a promising new method to control storage diseases and to delay the onset of senescence. In this investigation, we studied the effects of hormic dose (1,4 Merg•cm-2) of UV-radiation on the ripening of tomato pericarp discs by measuring different characteristics of ripening and senescence during storage. We observed that UV-treatment induced significant delays of the red color development, chlorophyll degradation, and lycopene production compared to control discs. UV-treatment also retarded the decline of the chlorophyll-a fluorescence ratios Fv: Fm and *F : Fm′, two characteristics related, respectively, to the maximum and operational quantum yield of photosystem II electron transport. Furthermore, the climacteric ethylene peak was delayed in the treated discs. However, UV-treatment did not alter textural changes, and the respiratory climacteric peaks were observed concomitantly for both treated and untreated tomato discs. However, the respiratory rate was consistently higher in treated discs. These results indicate that UV irradiation of tomato pericarp discs delays some processes of ripening associated with chloroplast to chromoplast transition whereas other ripening processes seem unaffected.
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Pavlovic, Natasa, Milenko Pikula, and Biljana Vojvodic. "First regularized trace of the limit assignment of Sturm-Liouville type with two constant delays." Filomat 29, no. 1 (2015): 51–62. http://dx.doi.org/10.2298/fil1501051p.
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We observe spectral assignment D2y = ?y defined by -y''(x) + q1(x)y(x - ?1) + q2(x)y(x - ?2) = ?y(x), ? = z2 (1) q1(x), q2(x) ? L1[0,?], ?1, ?2 ? (0,?) y(x -?1)? 0, x ? (0, ?1], ?1 = k0?2 (2), y(?) = 0 (3) In this paper, we construct a solution y(x, z) which satisfies (1) and (2), and then (3) is used to construct the characteristic function F(z), z ? C. Then the asymptotics of eigenvalues of the operator D2 is constructed. Finally, the first regularized trace is calculated.
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Diblík, Josef, and Blanka Morávková. "Representation of the Solutions of Linear Discrete Systems with Constant Coefficients and Two Delays." Abstract and Applied Analysis 2014 (2014): 1–19. http://dx.doi.org/10.1155/2014/320476.
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The purpose of this paper is to develop a method for the construction of solutions to initial problems of linear discrete systems with constant coefficients and with two delaysΔx(k)=Bx(k-m)+Cx(k-n)+f(k),wherem,n∈ℕ,m≠n,are fixed,k=0,…,∞,B=(bij),C=(cij)are constantr×rmatrices,fis a givenr×1vector, andxis anr×1unknown vector. Solutions are expressed with the aid of a special function called the discrete matrix delayed exponential for two delays. Such approach results in a possibility to express an initial Cauchy problem in a closed form. Examples are shown illustrating the results obtained.
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Lehar, Sophie M., and Michael J. Bevan. "T Cells Develop Normally in the Absence of both Deltex1 and Deltex2." Molecular and Cellular Biology 26, no. 20 (August 21, 2006): 7358–71. http://dx.doi.org/10.1128/mcb.00149-06.
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ABSTRACT Deltex1, Deltex2, and Deltex4 form a family of related proteins that are the mammalian homologues of Drosophila Deltex, a known regulator of Notch signals. Deltex1 is highly induced by Notch signaling in thymocytes, and overexpression of Deltex1 in T-cell progenitors can block Notch signals, suggesting that Deltex1 may play an important role in regulating Notch signals during T-cell development. A recent report found that T cells develop normally in mice carrying a targeted deletion in the Deltex1 gene (S. Storck, F. Delbos, N. Stadler, C. Thirion-Delalande, F. Bernex, C. Verthuy, P. Ferrier, J. C. Weill, and C. A. Reynaud, Mol. Cell. Biol. 25: 1437-1445, 2005), suggesting that other Deltex homologues may compensate in Deltex1-deficient T cells. We generated mice that lack expression of both Deltex1 and Deltex2 by gene targeting and further reduced expression of Deltex4 in Deltex1/Deltex2 double-deficient T-cell progenitors using RNA interference. Using a sensitive in vitro assay, we found that Notch signaling is more potent in cells expressing lower levels of Deltex proteins. Nevertheless, we were unable to detect any significant defects in thymocyte maturation in Deltex1/Deltex2 double-knockout mice. Together these data suggest that Deltex can act as a negative regulator of Notch signals in T cells but that endogenous levels of Deltex1 and Deltex2 are not important for regulating Notch signals during thymocyte development.
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Altamirano, G., I. Mejía, A. Hernández-Expósito, and J. M. Cabrera. "Effect of boron on the continuous cooling transformation kinetics in a low carbon advanced ultra-high strength steel (A-UHSS)." MRS Proceedings 1485 (2012): 83–88. http://dx.doi.org/10.1557/opl.2013.253.
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ABSTRACTThe aim of the present research work is to investigate the influence of B addition on the phase transformation kinetics under continuous cooling conditions. In order to perform this study, the behavior of two low carbon advanced ultra-high strength steels (A-UHSS) is analyzed during dilatometry tests over the cooling rate range of 0.1-200°C/s. The start and finish points of the austenite transformation are identified from the dilatation curves and then the continuous cooling transformation (CCT) diagrams are constructed. These diagrams are verified by microstructural characterization and Vickers micro-hardness. In general, results revealed that for slower cooling rates (0.1-0.5 °C/s) the present phases are mainly ferritic-pearlitic (F+P) structures. By contrast, a mixture of bainitic-martensitic structures predominates at higher cooling rates (50-200°C/s). On the other hand, CCT diagrams show that B addition delays the decomposition kinetics of austenite to ferrite, thereby promoting the formation of bainitic-martensitic structures. In the case of B microalloyed steel, the CCT curve is displaced to the right, increasing the hardenability. These results are associated with the ability of B atoms to segregate towards austenitic grain boundaries, which reduce the preferential sites for nucleation and development of F+P structures.
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Abuasbeh, Kinda, Ramsha Shafqat, Azmat Ullah Khan Niazi, and Muath Awadalla. "Local and Global Existence and Uniqueness of Solution for Class of Fuzzy Fractional Functional Evolution Equation." Journal of Function Spaces 2022 (September 5, 2022): 1–14. http://dx.doi.org/10.1155/2022/7512754.
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For fuzzy fractional functional evolution equations, the concept of global and local existence and uniqueness will be presented in this work. We employ the contraction principle and successive approximations for global and local existence and uniqueness, respectively, as given 0 c D q H x I = f I , x I + ∫ 0 I g I , s , x s ds , I ≥ I 0 , I ∈ 0 , T , x I = ψ I − I 0 = ψ 0 ∈ C σ , I 0 ≥ I ≥ I 0 − σ , x ′ I = ψ ′ I = ψ 1 , where C σ denotes the set of fuzzy continuous mapping defined on I 0 − σ , T and σ > 1 . We also use this method to solve fuzzy fractional functional evolution equations with fuzzy population models and distributed delays using fuzzy fractional functional evolution equations. To explain these results, some theorems are given. Finally, certain fuzzy fractional functional evolution equations are illustrated.
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Haywood, H. Carl. "Clinical Applications of Cognitive Education." Journal of Cognitive Education and Psychology 2, no. 1 (January 2001): 22–36. http://dx.doi.org/10.1891/1945-8959.2.1.22.
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Applications of cognitive education have taken place primarily in schools, but applications outside the classroom can be equally rewarding. “Clinical” applications have so far included: (a) cognitive and motivational redevelopment of individuals with mental retardation; (b) psychological treatment of individuals with severe psychiatric disorders; (c) clinical treatment of persons with delays in language development; (d) treatment of children with learning disabilities, including ADD and ADHD; (e) cognitive and social redevelopment of persons with psychological and character disorders; (f) cognitive, motivational, and social redevelopment of persons who have sustained traumatic brain injuries. The last two of these applications, in psychotherapy and in neuropsychology, are especially promising and are examined in some detail.
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Liao, Yongzhi, Tianwei Zhang, and Yongkun Li. "Antiperiodic Solutions for a Generalized High-Order(p,q)-Laplacian Neutral Differential System with Delays in the Critical Case." Abstract and Applied Analysis 2013 (2013): 1–12. http://dx.doi.org/10.1155/2013/454619.
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By applying the method of coincidence degree, some criteria are established for the existence of antiperiodic solutions for a generalized high-order(p,q)-Laplacian neutral differential system with delays(φp((x(t)-cx(t-τ))(k)))(m-k)=F(t,xθ0(t),xθ1(t)′,…,xθk(t)(k),yϑ0(t),yϑ1(t)′,…,yϑl(t)(l)),(φq((y(t)-dy(t-σ))(l)))(n-l)=G(t,yμ0(t),yμ1(t)′,…,yμl(t)(l),xν0(t),xν1(t)′,…,xνk(t)(k))in the critical case|c|=|d|=1. The results of this paper are completely new. Finally, an example is employed to illustrate our results.
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Encalada, Sandra E., John Willis, Rebecca Lyczak, and Bruce Bowerman. "A Spindle Checkpoint Functions during Mitosis in the Early Caenorhabditis elegans Embryo." Molecular Biology of the Cell 16, no. 3 (March 2005): 1056–70. http://dx.doi.org/10.1091/mbc.e04-08-0712.
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During mitosis, chromosome segregation is regulated by a spindle checkpoint mechanism. This checkpoint delays anaphase until all kinetochores are captured by microtubules from both spindle poles, chromosomes congress to the metaphase plate, and the tension between kinetochores and their attached microtubules is properly sensed. Although the spindle checkpoint can be activated in many different cell types, the role of this regulatory mechanism in rapidly dividing embryonic animal cells has remained controversial. Here, using time-lapse imaging of live embryonic cells, we show that chemical or mutational disruption of the mitotic spindle in early Caenorhabditis elegans embryos delays progression through mitosis. By reducing the function of conserved checkpoint genes in mutant embryos with defective mitotic spindles, we show that these delays require the spindle checkpoint. In the absence of a functional checkpoint, more severe defects in chromosome segregation are observed in mutants with abnormal mitotic spindles. We also show that the conserved kinesin CeMCAK, the CENP-F-related proteins HCP-1 and HCP-2, and the core kinetochore protein CeCENP-C all are required for this checkpoint. Our analysis indicates that spindle checkpoint mechanisms are functional in the rapidly dividing cells of an early animal embryo and that this checkpoint can prevent chromosome segregation defects during mitosis.
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Kun, Sheila, Gregory Placencia, Sally Davidson Ward, and Thomas Keens. "A System Analysis of Delay in Outpatient Respiratory Equipment Delivery." Care Management Journals 17, no. 4 (December 2016): 161–69. http://dx.doi.org/10.1891/1521-0987.17.4.161.
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Objectives: To systematically assess barriers delaying home respiratory equipment requisition and to evaluate for temporal correlation between delays and emergency room or hospitalization episodes.Background: Initiation of home respiratory treatments is delayed because of delays in delivery of durable medical equipment (DME). This study assesses root causes of such delays from a system perspective. We also describe clinical consequences by measuring emergency room visits and hospitalization days for temporal correlations.Methods: We conducted a retrospective review of DME ordering records from April 2011 to March of 2012.Settings: Outpatient DME records in Pediatric Pulmonary Division.Results: Of 164 available orders studied, deliveries were made as followed: 31 (19%) within 24 hr: 18 (59%) oxygen orders and 10 (32%) nebulizer orders 50 (30%) within 1 week: 25 (50%) nebulizer orders and 10 (20%) oxygen orders Delays: 45 (27%) delivered > 1 month: Bilevel positive airway pressure (BPAP) = 16 (36%) Oxygen = 12 (26%) Cough assist device = 7 (16%) Nebulizer = 5 (11%) Miscellaneous devices = 5 (11%) Analysis of barriers includes (a) type of insurance, (b) human error, (c) communication barrier, (d) deficit in training or knowledge, (e) no clear policy, (f) differences in clinical policy/ standard, (g) no DME benefit, (h) no clinical justification, and (i) error in communication/record keeping. Six patients with 7 emergency department (ED) visits and 4 inpatient admissions, totaling 24 hospital days, were temporally associated with delays in delivery of equipment over 30 days.Conclusion: One half of commonly used DMEs were delivered within the first week. One quarter of more expensive required more steps for approval. Twenty-nine ED/hospital days with respiratory morbidities were temporally associated with delays.
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Summerfield, R. J., R. J. Lawn, A. QI, R. H. Ellis, E. H. Roberts, P. M. Chay, J. B. Brouwer, et al. "Towards the Reliable Prediction of Time to Flowering in Six Annual Crops. II. Soyabean (Glycine Max)." Experimental Agriculture 29, no. 3 (July 1993): 253–89. http://dx.doi.org/10.1017/s0014479700020858.
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SUMMARYEleven genotypes of soyabean (Glycine max) of tropical, sub-tropical and temperate origin and one accession of G. soja were grown in six locations in Australia during 1986–88, and at one location in Australia and two in Taiwan during 1989–91. Dates of sowing were varied within and among locations so as to expose plants to as many as 32 environments of widely different diurnal temperature and daylength. Times from sowing to flowering (f) were recorded, from which rates of progress towards flowering (1/f) were calculated. These derived data were then related to mean pre-flowering values of temperature (T¯) and photoperiod (P) using a three-plane linear model developed from controlled environment data. Among genotypes, mean values of f varied between 24–49 d and between 139–291 d in the most- and least-inductive environments, respectively. These differences were associated with variations in P from about 11 to 16 h d-1, in daily mean maximum temperatures from about 17° to 36°C, in daily mean minimum temperatures from about 5° to 25°C, and in T¯ from about 11° to 30°C, that is, a very wide range of photothermal regimes. The relations of 1/f to T¯ and P can be described in photoperiod-insensitive genotypes by a thermal plane defined by two constants, a and b, and additionally by a photothermal plane defined by three constants, a′, b′ and c′, in the more numerous photoperiod-sensitive genotypes. If photoperiod-sensitive genotypes are grown in sufficiently long days then a third photoperiod and temperature-insensitive plane is exposed, defined by a constant, d′; this plane indicates the maximum delay in flowering of which the genotype is capable. The constants a′, b′, c′ and d′ define the delay in flowering caused by photoperiod-sensitivity genes. The two intercepts between the three planes define, respectively, the critical photoperiod, Pc, above which increase in daylength delays flowering, and the ceiling photoperiod, Pcc, above which there is no further delay. The values of the six constants for any genotype can be estimated from observations of fin several natural environments. Comparisons between years in Australia and between Australia and Taiwan show that these genotypic constants can predict 1/f, and so the time taken to flower, given data on latitude, sowing date and daily values of maximum and minimum air temperatures. This model is more accurate than an alternative logistic model; we also believe that all six constants in the three-plane rate model described here have biological meaning. They indicate separate genetic control of flowering responses to P and T¯ and could form a rational basis for the genetic characterization and analysis of these responses in the soyabean germplasm.Pronóstico del momento de floración II
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Korista, K. T., and M. R. Goad. "Quantifying the impact of variable BLR diffuse continuum contributions on measured continuum interband delays." Monthly Notices of the Royal Astronomical Society 489, no. 4 (August 23, 2019): 5284–300. http://dx.doi.org/10.1093/mnras/stz2330.
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ABSTRACT We investigate the contribution of reprocessed continuum emission (1000–10 000 Å) originating in broad-line region (BLR) gas, the diffuse continuum (DC), to the wavelength-dependent continuum delays measured in AGN disc reverberation mapping experiments. Assuming a spherical BLR geometry, we adopt a Local Optimally emitting Cloud (LOC) model for the BLR that approximately reproduces the broad emission-line strengths of the strongest UV lines (Ly α and C iv) in NGC 5548. Within this LOC framework, we explore how assumptions about the gas hydrogen density and column density distributions influence flux and delay spectra of the DC. We find that: (i) models which match well measured emission-line luminosities and time delays also produce a significant DC component, (ii) increased $\rm {\mathit{ n}_H}$ and/or $\rm {\mathit{ N}_H}$, particularly at smaller BLR radii, result in larger DC luminosities and reduced DC delays, (iii) in a given continuum band the relative importance of the DC component to the measured interband delays is proportional (though not 1:1) to its fractional contribution to the total light in that band, (iv) the measured DC delays and DC variability amplitude depend also on the variability amplitude and characteristic variability time-scale of the driving continuum, (v) the DC radial surface emissivity distributions F(r) approximate power laws in radius with indices close to −2 (≈1:1 response to variations in the driving continuum flux), thus their physics is relatively simple and less sensitive to the unknown geometry and uncertainties in radiative transfer. Finally, we provide a simple recipe for estimating the DC contribution in disc reverberation mapping experiments.
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Ellenbogen, Jeffrey M., Peter T. Hu, Jessica D. Payne, Debra Titone, and Matthew P. Walker. "Human relational memory requires time and sleep." Proceedings of the National Academy of Sciences 104, no. 18 (April 20, 2007): 7723–28. http://dx.doi.org/10.1073/pnas.0700094104.
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Relational memory, the flexible ability to generalize across existing stores of information, is a fundamental property of human cognition. Little is known, however, about how and when this inferential knowledge emerges. Here, we test the hypothesis that human relational memory develops during offline time periods. Fifty-six participants initially learned five “premise pairs” (A>B, B>C, C>D, D>E, and E>F). Unknown to subjects, the pairs contained an embedded hierarchy (A>B>C>D>E>F). Following an offline delay of either 20 min, 12 hr (wake or sleep), or 24 hr, knowledge of the hierarchy was tested by examining inferential judgments for novel “inference pairs” (B>D, C>E, and B>E). Despite all groups achieving near-identical premise pair retention after the offline delay (all groups, >85%; the building blocks of the hierarchy), a striking dissociation was evident in the ability to make relational inference judgments: the 20-min group showed no evidence of inferential ability (52%), whereas the 12- and 24-hr groups displayed highly significant relational memory developments (inference ability of both groups, >75%; P < 0.001). Moreover, if the 12-hr period contained sleep, an additional boost to relational memory was seen for the most distant inferential judgment (the B>E pair; sleep = 93%, wake = 69%, P = 0.03). Interestingly, despite this increase in performance, the sleep benefit was not associated with an increase in subjective confidence for these judgments. Together, these findings demonstrate that human relational memory develops during offline time delays. Furthermore, sleep appears to preferentially facilitate this process by enhancing hierarchical memory binding, thereby allowing superior performance for the more distant inferential judgments, a benefit that may operate below the level of conscious awareness.
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Engevik, Melinda A., Heather A. Danhof, Alexandra L. Chang-Graham, Jennifer K. Spinler, Kristen A. Engevik, Beatrice Herrmann, Bradley T. Endres, et al. "Human intestinal enteroids as a model of Clostridioides difficile-induced enteritis." American Journal of Physiology-Gastrointestinal and Liver Physiology 318, no. 5 (May 1, 2020): G870—G888. http://dx.doi.org/10.1152/ajpgi.00045.2020.
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Clostridioides difficile is an important nosocomial pathogen that produces toxins to cause life-threatening diarrhea and colitis. Toxins bind to epithelial receptors and promote the collapse of the actin cytoskeleton. C. difficile toxin activity is commonly studied in cancer-derived and immortalized cell lines. However, the biological relevance of these models is limited. Moreover, no model is available for examining C. difficile-induced enteritis, an understudied health problem. We hypothesized that human intestinal enteroids (HIEs) express toxin receptors and provide a new model to dissect C. difficile cytotoxicity in the small intestine. We generated biopsy-derived jejunal HIE and Vero cells, which stably express LifeAct-Ruby, a fluorescent label of F-actin, to monitor actin cytoskeleton rearrangement by live-cell microscopy. Imaging analysis revealed that toxins from pathogenic C. difficile strains elicited cell rounding in a strain-dependent manner, and HIEs were tenfold more sensitive to toxin A (TcdA) than toxin B (TcdB). By quantitative PCR, we paradoxically found that HIEs expressed greater quantities of toxin receptor mRNA and yet exhibited decreased sensitivity to toxins when compared with traditionally used cell lines. We reasoned that these differences may be explained by components, such as mucins, that are present in HIEs cultures, that are absent in immortalized cell lines. Addition of human-derived mucin 2 (MUC2) to Vero cells delayed cell rounding, indicating that mucus serves as a barrier to toxin-receptor binding. This work highlights that investigation of C. difficile infection in that HIEs can provide important insights into the intricate interactions between toxins and the human intestinal epithelium. NEW & NOTEWORTHY In this article, we developed a novel model of Clostridioides difficile-induced enteritis using jejunal-derived human intestinal enteroids (HIEs) transduced with fluorescently tagged F-actin. Using live-imaging, we identified that jejunal HIEs express high levels of TcdA and CDT receptors, are more sensitive to TcdA than TcdB, and secrete mucus, which delays toxin-epithelial interactions. This work also optimizes optically clear C. difficile-conditioned media suitable for live-cell imaging.
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Zhen, Tao, Erika Mijin Kwon, R. Katherine Hyde, Ling Zhao, Guadalupe Lopez, Lemlem Alemu, and Paul P. Liu. "Title: Runx1 Is Indispensable for Leukemia Development Induced By Cbfb-MYH11." Blood 132, Supplement 1 (November 29, 2018): 1337. http://dx.doi.org/10.1182/blood-2018-99-116930.
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Abstract Inversion of chromosome 16 is a consistent finding in patients with acute myeloid leukemia subtype M4 with eosinophilia (AML M4Eo), which generates a CBFB-MYH11 fusion gene. It is generally considered that CBFβ-SMMHC, the fusion protein encoded by CBFB-MYH11, is a dominant negative repressor of RUNX1, a transcription factor that physically interacts with CBFβ and CBFβ-SMMHC. While loss-of-function mutations in RUNX1 are common in human AML, they have not been found in inv(16) AML. Moreover, we have demonstrated that CBFβ-SMMHC has RUNX1-repression independent functions (Hyde et al., Blood 115:1433, 2010), and Runx1 insufficiency (Runx1+/lz) delays Cbfb-MYH11-induced leukemia in a mouse model (Hyde et al., Leukemia 29:1771, 2015). These findings challenge the RUNX1-repression model for CBFβ-SMMHC mediated leukemogenesis. However, our previous findings are not conclusive since the Runx1+/lz mice used in the previous study have one wild-type Runx1 allele, and still retain some Runx1 function. To definitively address this question, we generated mice with both Cre-based conditional Runx1 knockout and Cbfb-MYH11 knockin (Runx1f/f, Mx1-Cre,Cbfb+/56M), which express Cbfb-MYH11 but no Runx1 after pIpC (poly I:C) treatment to induce Cre expression. Runx1f/f, Mx1-Cre,Cbfb+/56Mmice had higher numbers of Lin-/Sca1-/c-Kit+ (LK) and Lin-/Sca1+/c-Kit+ cells in the bone marrow when comapred with Mx1-Cre, Cbfb+/56M mice at 3 weeks after pIpC. However, none of the Runx1f/f, Mx1-Cre, Cbfb+/56M mice developed leukemia up to one year after pIpC treatment. As reported previously, all Mx1-Cre,Cbfb+/56M mice developed leukemia with an median survival time of 4 months. Moreoever, none of the recipients transplanted with bone marrow cells from Runx1f/f, Mx1-Cre,Cbfb+/56M mice and then treated with pIpC developed leukemia, while all of the recipients of the Mx1-Cre,Cbfb+/56M bone marrow cells did, suggesting that the loss of leukemogenesis is cell autonomous. All together, these results indicate that Runx1 is indispensable for Cbfb-MYH11 induced leukemogenesis. Even though at 3 weeks after pIpC the Runx1f/f, Mx1-Cre,Cbfb+/56M mice had more c-Kit+ cells, and more significantly the abnormal myeloid progenitors (AMPs) (LK/CD34-/Fc□RII/III+) from which the leukemia cells arise, these cells started to decrease and disappear 4 weeks after pIpC, suggesting that this is a critical stage for the failure of leukemogenesis in the Runx1f/f, Mx1-Cre,Cbfb+/56M mice. We therefore performed RNA-seq on the AMP population isolated from Mx1-Cre,Cbfb+/56M and Runx1f/f, Mx1-Cre,Cbfb+/56M mice three weeks after pIpC treatment, to explore the global gene expression changes between them. Our preliminary data analysis showed that many genes (1635) were differential expressed (DEGs; Padj ≤0.05, absolute fold change ≥ 2) between Runx1f/f, Mx1-Cre, Cbfb+/56M and Mx1-Cre, Cbfb+/56M mice. Many of these DEGs (37.6%) are RUNX1 target genes (Mandoli et al., Leukemia. 28:770, 2014). Among the significantly enriched gene sets by gene set enrichment analysis of the DEGs, the "GAL_LEUKEMIC_STEM_CELL_DN" gene set, which contains genes down-regulated in leukemic stem cells, is positively correlated with DEGs upregulated in Runx1f/f, Mx1-Cre,Cbfb+/56M cells, suggesting that the AMP population from Runx1f/f, Mx1-Cre,Cbfb+/56M mice lost the leukemia initiating ability. We are preforming ChIP-seq on the AMP population to determine how loss of RUNX1 disrupts binding of CBFβ-SMMHC to target genes. The above results suggest that RUNX1 is required for the regulation of critical genes for leukemogenesis by CBFβ-SMMHC. Disclosures No relevant conflicts of interest to declare.
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Naghawi, Hana, Alaa AlSoud, and Taqwa AlHadidi. "The Possibility for Implementing the Superstreet Unconventional Intersection Design in Jordan." Periodica Polytechnica Transportation Engineering 46, no. 3 (February 26, 2018): 122–28. http://dx.doi.org/10.3311/pptr.11635.
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This paper provides policy makers with an objective assessment on the possibility for implementing an unconventional arterial intersection design, the Superstreet, for improving safety and operational characteristics for an existing signalized intersection. The signalized intersection selected for analysis was Tabarbour, located in Amman, Jordan. Tabarbour intersection is considered one of the most significant signalized intersections in Amman. The intersection currently suffers from the following problems: long queues, delays and excessive emissions. SYNCHRO microscopic simulation software was used for signal optimization of the current conventional intersection. VISSIM microscopic simulation software was used to analyze and compare the Superstreet design to the conventional design. It was found that the proposed Superstreet reduced the average delay per vehicle by up to 87% and reduced the maximum queue length by almost 97%. This resulted in improving the level of service from F to C. Finally, five year future traffic demand analysis was performed; it was found that the Superstreet design didn’t perform as expected under heavy traffic volume.
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Mainwaring, P. N., and C. Shannon. "A phase II study of dose-dense chemotherapy (doxorubicin (A), cyclophosphamide (C), paclitaxel (T), gemcitabine (G)) supported by pegfilgrastim (P) and darbepoetin-alfa (D) for patients with high-risk early stage breast cancer (ICANDO)." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 11068. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.11068.
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11068 Background: The primary objective of this study was to estimate the proportion of chemotherapy dose delays in a dose- dense regimen consisting of A (60mg/m2), C (600 mg/m2) x 4 cycles q2 weeks followed by T (175 mg/m2) G (1g/m2) x 4 cycles q2w with pegfilgrastim (6 mg/m2 sc d2) and darbepoetin-alfa (2.25 microg/kg if Hb < 110g/L) as treatment for patients with high-risk early stage breast cancer. Dose delay was defined by the proportion of subjects experiencing delay = 7 days in any cycle. Entry criteria path stage IIA-IIIA breast adenocarcinoma; node positive patients > 6 axillary lymph nodes removed or sentinel LN biopsy positive for metastasis. Treatment commenced within 8 weeks. Secondary endpoints included proportion of delays by cycle, causes of delay by cycle, causes of dose reduction by cycle, as well as time to haematological engraftment. Patients underwent weekly FBC, electrolytes, LFTs, with a normal baseline echo assessment. Herceptin therapy was approved in Australia 1st October 2006 and was added to TG therapy for FISH/CISH/IHC 3+ positive patients. All patients completed FACT-F QOL forms. The half-width confidence interval to predict for delay based on the AC-T data is 0.17 for n = 20 patients. Results: Twenty (20) women; median age 50 (41–66) met the criteria for treatment. No patients had treatment delays ≥ 2 days for any reason. One (5%) patient underwent a blood transfusion for a rapid decline in haemoglobin (Hb) prior to darbepoetin therapy. One (5%) patient was admitted for uncontrolled vomiting. Seven (35%) patients received darbepoetin therapy without secondary Hb rise above 130 g/L. One (5%) patient had a 20% dose reduction in A dose due to mucositis. For nausea >G1 aprepitant therapy was added. There have been no dose modifications due to hepatic toxicity. Final cycle, QOL and pharmacogenomic data will be presented at the meeting. [Table: see text] No significant financial relationships to disclose.
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Roberts, Megan York, Tara Hensle, and Michael K. Brooks. "More Than “Try This at Home”—Including Parents in Early Intervention." Perspectives of the ASHA Special Interest Groups 1, no. 1 (March 31, 2016): 130–43. http://dx.doi.org/10.1044/persp1.sig1.130.
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Current state and federal recommendations encourage the delivery of early intervention services in a child's natural environment with typical communication partners (Individuals With Disabilities Education Act [IDEA], 2004). As such, speech-language pathologists (SLPs) often provide intervention services in homes and work closely with parents. However, only 30% of SLPs have early intervention expertise (ASHA, 2014) and 68% of SLPs report low-levels of competence in working with infants and toddlers (Campbell, Chiarello, Wilcox, & Milbourne, 2009). This may be due to the fact that the majority of graduate programs (60%) provide little or no training in early intervention (Bruder & Dunst, 2005). Working in early intervention is a challenging albeit rewarding task for even the most seasoned therapist. Given that the largest percentage of children served under part C of IDEA are children with language delays (Hebbeler et al., 2007), it is essential that SLPs working in early intervention implement effective strategies for both parents and children. The purpose of this paper is to: (a) explain why including parents in intervention is important; (b) discuss ways of including parents in early intervention; (c) examine strategies used to teach parents; (d) describe a method for teaching parents; (e) compare methods of measuring parent progress; and (f) propose future directions for research.
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Pakpahan, Mangaramot Justisiano, and Budi Hartanto Susilo. "STUDI WAKTU PERJALANAN DAN TUNDAAN DENGAN APLIKASI VISSIM PADA RUAS JALAN A.H. NASUTION." Jurnal Teknik Sipil 17, no. 2 (October 1, 2021): 125–44. http://dx.doi.org/10.28932/jts.v17i2.2880.
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A.H Nasution Street is one of the primary arterial roads that connect between Cileunyi to East Bandung. East Bandung region is one of the areas that chosen by people at Bandung to settle. Therefore during rush hour there is congestion at A.H Nasution Street.
The goal of this research is to identify vehicle travel time on A.H Nasution Street, and evaluate each intersection that is one of the major delays on A.H Nasution Street and provide alternative solutions using PTV Vissim. The road sections that reviewed ini this research started from the A.H nasution – Ahmad Yani Intersection until Ditbintekjatan, (Direktorat Bina Teknik Jalan dan Jembatan) with data collection time on Monday, 9th Mar 2020 at 06.00 am – 07.00 am.
The existing analysis on A.H Nasution street from West to East has LoS F with vehicle travel time taken for
22 minutes 10 seconds with a delay of 410 seconds, while from East to West has LoS F with vehicle travel time taken for 23 minutes 47 seconds with a delay of 345 seconds. If repairs are made by widening the lane at Sta (0+000) – Sta (0+500) and the the prohibition of turning right at each unsignalized intersection on the section that reviewed, the A.H Nasution street from West to East has a LoS C with vehicle travel time faster with a shorter delay, while from East to West has a LoS D with vehicle travel time faster with a shorter delay.
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Pakpahan, Mangaramot Justisiano, and Budi Hartanto Susilo. "STUDI WAKTU PERJALANAN DAN TUNDAAN DENGAN APLIKASI VISSIM PADA RUAS JALAN A.H. NASUTION." Jurnal Teknik Sipil 17, no. 2 (October 1, 2021): 125–44. http://dx.doi.org/10.28932/jts.v17i2.2880.
Full textAbstract:
A.H Nasution Street is one of the primary arterial roads that connect between Cileunyi to East Bandung. East Bandung region is one of the areas that chosen by people at Bandung to settle. Therefore during rush hour there is congestion at A.H Nasution Street.
The goal of this research is to identify vehicle travel time on A.H Nasution Street, and evaluate each intersection that is one of the major delays on A.H Nasution Street and provide alternative solutions using PTV Vissim. The road sections that reviewed ini this research started from the A.H nasution – Ahmad Yani Intersection until Ditbintekjatan, (Direktorat Bina Teknik Jalan dan Jembatan) with data collection time on Monday, 9th Mar 2020 at 06.00 am – 07.00 am.
The existing analysis on A.H Nasution street from West to East has LoS F with vehicle travel time taken for
22 minutes 10 seconds with a delay of 410 seconds, while from East to West has LoS F with vehicle travel time taken for 23 minutes 47 seconds with a delay of 345 seconds. If repairs are made by widening the lane at Sta (0+000) – Sta (0+500) and the the prohibition of turning right at each unsignalized intersection on the section that reviewed, the A.H Nasution street from West to East has a LoS C with vehicle travel time faster with a shorter delay, while from East to West has a LoS D with vehicle travel time faster with a shorter delay.
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Vaira, Rizky, Yanti Yanti, and Asri Hidayat. "A qualitative study of partnership between woman and midwife within midwife-led care clinic." Journal of Health Technology Assessment in Midwifery 3, no. 1 (May 20, 2020): 29–45. http://dx.doi.org/10.31101/jhtam.1368.
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One indirect causes of maternal mortality in Indonesia is "Three Delays", delays in: (1) deciding to seek appropriate medical help for an obstetric emergency; (2) reaching an appropriate obstetric facility; and (3) receiving adequate care when a facility is reached, which has relation with the lack of women's ability in empowering herself to actively participate and to make suitable decisions about midwifery care they need. The research aims to explore the partnership between woman and midwife in midwifery care. A descriptive qualitative study was conducted using a convenience sample of six low-risk women after they had given birth and six midwives from six geographically distinct midwife-led care clinic in Bantul Regency. Data were collected through semi‑structured in‑depth interviews. The interview was conducted two to three times and recorded by audio record. Interviews were transcribed and analyzed by the thematic analysis according to Cresswell approach. Seven major themes were identified: (a) midwives ability to partner with women, (b) equality and reciprocity, (c) negotiation, (d) empowerment, (e) trust and time, (f) sharing power and responsibility, and (g) professional friendship. Most of the women are not capable to empower themselves such as less participating in decision making, less considerate in choosing a birthing position, and worsen by the limitations of midwives availability during the delivery process. Midwives need to reflect more the philosophy meaning inside the midwifery care and strengthen the midwifery professionals curriculum in order to persuade women as a partner who capable to empower themselves and to participate actively.
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Permana, Gusti Komang, Dedi Sofyan, and Kasmaini Kasmaini. "An Analysis of Communication Strategies Applied by English Study Program Students in Speaking for Presentation." Journal of English Education and Teaching 3, no. 4 (December 6, 2019): 494–505. http://dx.doi.org/10.33369/jeet.3.4.494-505.
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Abstract This Study was a mix method research which used the combination of both qualitative and quantitative data. This study was aimed to find out the types and the dominant communication strategies used by the fourth semester students of English Study Program in University of Bengkulu. The instruments used in this research were observation checklist adapted from Dornyei (1995) and video recorder to collect data. The data were analyzed by Dornyei’s Theory of Communication Strategies. The population of this study was fourth semester students of class A of English Study Program. The samples of this study were selected with purposive sampling technique. The findings of this research were: (1) the students used all types of communication strategies, namely: a) message replacement, b) topic avoidance, c) message abandonment, d) circumlocution, e) approximation, f) word coinage, g) non-verbal signal, h) literal translation, i) foreignizing, j) code switching, k) time gaining strategy, and l) appeal for help, and 2) the dominant type of communication strategies used by the students is time gaining strategy with 47.87%. The students mostly used time gaining strategy because they already have good proficiency but they still needed times or delays to produce the utterances.
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Xu, Qi-Yu, Quan-Bing Zhang, Yun Zhou, A.-Ying Liu, and Feng Wang. "Preventive effect and possible mechanisms of ultrashort wave diathermy on myogenic contracture in a rabbit model." Science Progress 104, no. 4 (October 2021): 003685042110549. http://dx.doi.org/10.1177/00368504211054992.
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The purpose of this study was to determine the preventive effect of ultrashort wave diathermy on immobilization-induced myogenic contracture and to explore its underlying mechanisms. Forty-two rabbits were randomly assigned into control (Group C), immobilization (Group I, which was further divided into one week, Group I-1; two weeks, Group I-2; and four weeks, Group I-4, subgroups by the length of immobilization) and ultrashort wave prevention (Group U, which was further divided into one week, Group U-1; two weeks, Group U-2; and four weeks, Group U-4, by time of treatment) groups. Intervention effects were assessed by evaluating rectus femoris cross-sectional area (CSA), knee range of motion, and the protein levels for myogenic differentiation (MyoD) and muscle atrophy F-box (MAFbx-1) in the rectus femoris. Compared with those of Group C, in Groups I and U, total contracture, myogenic contracture, MyoD and MAFbx-1 levels were significantly elevated, and CSA was significantly smaller ( p < 0.05). Compared with those of Group I at each time point, MyoD levels were significantly elevated, MAFbx-1 levels were significantly lower, CSA was significantly larger, and myogenic contracture was significantly alleviated in Group U ( p < 0.05). In the early stages of contracture, ultrashort wave diathermy reduces muscle atrophy and delays the process of myogenic contracture during joint immobilization; the mechanism of this may be explained as increased expression of MyoD triggered by suppression of the MAFbx-1-mediated ubiquitin-proteasome pathway.
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Delbos, Frédéric, Said Aoufouchi, Ahmad Faili, Jean-Claude Weill, and Claude-Agnès Reynaud. "DNA polymerase η is the sole contributor of A/T modifications during immunoglobulin gene hypermutation in the mouse." Journal of Experimental Medicine 204, no. 1 (December 26, 2006): 17–23. http://dx.doi.org/10.1084/jem.20062131.
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Mutations at A/T bases within immunoglobulin genes have been shown to be generated by a repair pathway involving the DNA-binding moiety of the mismatch repair complex constituted by the MSH2–MSH6 proteins, together with DNA polymerase η (pol η). However, residual A/T mutagenesis is still observed upon inactivation in the mouse of each of these factors, suggesting that the panel of activities involved might be more complex. We reported previously (Delbos, F., A. De Smet, A. Faili, S. Aoufouchi, J.-C. Weill, and C.-A. Reynaud. 2005. J. Exp. Med. 201:1191–1196) that residual A/T mutagenesis in pol η–deficient mice was likely contributed by another enzyme not normally involved in hypermutation, DNA polymerase κ, which is mobilized in the absence of the normal polymerase partner. We report the complete absence of A/T mutations in MSH2–pol η double-deficient mice, thus indicating that the residual A/T mutagenesis in MSH2-deficient mice is contributed by pol η, now recruited by uracil N-glycosylase, the second DNA repair pathway involved in hypermutation. We propose that this particular recruitment of pol η corresponds to a profound modification of the function of uracil glycosylase in the absence of the mismatch repair complex, suggesting that MSH2–MSH6 actively prevent uracil glycosylase from error-free repair during hypermutation. pol η thus appears to be the sole contributor of A/T mutations in the normal physiological context.
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DU, HONGYUE. "ADAPTIVE OPEN-PLUS-CLOSED-LOOP CONTROL METHOD OF MODIFIED FUNCTION PROJECTIVE SYNCHRONIZATION IN COMPLEX NETWORKS." International Journal of Modern Physics C 22, no. 12 (December 2011): 1393–407. http://dx.doi.org/10.1142/s0129183111016956.
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This paper investigates the modified function projective synchronization (MFPS) in drive-response dynamical networks (DRDNs) with different nodes, which means that systems in nodes are strictly different. An adaptive open-plus-closed-loop (AOPCL) control method is proposed, which is a practically realizable method and can overcome the model mismatched to achieve synchronization. It is well known that each of the close-loop and open-loop control method possesses some advantages and disadvantages. By combining their advantages, the open-plus-closed-loop (OPCL) control method was proposed by Jackson and Grosu. For arbitrary nonlinear dynamic systems, dx/dt = F(x,t), Jackson and Grosu proved that there exists solutions, x(t), in the neighborhood of any arbitrary goal dynamics g(t) that are entrained to g(t), through the use of an additive controlling action, K(g,x,t) = H(dg/dt,g) + C(g,t)(g(t) - x), which is the sum of the open-loop action, H(dg/dt,g), and a suitable linear closed-loop (feedback) action C(g,t). This method is a practically realizable method and robust to limited accuracy of data and effects of noise. The AOPCL control method preserve the merits of OPCL control method and its closed loop control part can be automatically adapted to suitable constants. Considering time-delays are always unavoidably in the practical situations, MFPS in DRDNs with time-varying coupling delayed is further investigated by the proposed method. Corresponding numerical simulations are performed to verify and illustrate the analytical results.
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Sage, S. O., R. Reast, and T. J. Rink. "ADP evokes biphasic Ca2+ influx in fura-2-loaded human platelets. Evidence for Ca2+ entry regulated by the intracellular Ca2+ store." Biochemical Journal 265, no. 3 (February 1, 1990): 675–80. http://dx.doi.org/10.1042/bj2650675.
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Stopped-flow fluorimetric studies at 37 degrees C have shown that ADP, at optimal concentrations, can evoke Ca2+ or Mn2+ influx in fura-2-loaded human platelets without measurable delay. In contrast, the release of Ca2+ from intracellular stores is delayed in onset by about 200 ms. By working at a lower temperature, 17 degrees C, we have now shown that the rise in cytosolic calcium concentration ([Ca2+]i) evoked by ADP in the presence of external Ca2+ is biphasic. The use of Mn2+ as a tracer for bivalent-cation entry indicates that both phases of the ADP-evoked response are associated with influx. The fast phase of the ADP-evoked rise in [Ca2+]i, which occurs without measurable delay at both 17 degrees C and 37 degrees C, is consistent with Ca2+ entry mediated by receptor-operated channels in the plasma membrane. The delayed phase, indicated by Mn2+ quench, is coincident with the discharge of the intracellular Ca2+ stores. Forskolin did not inhibit the fast phases of ADP-evoked rise in [Ca2+]i or Mn2+ quench, but completely abolished ADP-evoked discharge of the intracellular stores, the delayed phase of the rise in [Ca2+]i observed in the presence of external Ca2+ and the second phase of Mn2+ quench. The timing of the delayed event appears to be modulated by [Ca2+]i: the delayed phase of Mn2+ quench coincides with discharge of the intracellular stores in the absence of added Ca2+, but with the second phase of the ADP-evoked rise in [Ca2+]i in the presence of extracellular Ca2+. Similarly, blockade of the early phase of Ca2+ entry by SK&F 96365 further delays the second phase. It is suggested that a pathway for Ca2+ entry which is regulated by the intracellular Ca2+ store exists in platelets. This pathway operates alongside, and appears to be modulated by the activity of other routes for Ca2+ entry into the cytosol.
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Mc-Cutchan, R., S. Maier, V. Winkler, B. Gruber, and M. Schirmer. "AB1303-HPR TIME UNTIL DIAGNOSIS IN RHEUMATOLOGICAL PRACTICE: RESULTS FROM A CROSS-SECTIONAL MIDDLE-EUROPEAN COHORT COMPARED TO DATA FROM A SYSTEMATIC LITERATURE REVIEW." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1942.1–1942. http://dx.doi.org/10.1136/annrheumdis-2020-eular.3724.
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Background:The time from first symptom to diagnosis (= diagnostic delay) is considered as key factor for better outcome in many chronic inflammatory rheumatic diseases, especially for rheumatoid arthritis (RA) and vasculitides like giant cell arteritis (GCA). A longer diagnostic delay may cause pain, reduced functionality, reduced life-quality and increased morbidity, as well as structural damages of the organs linked with higher mortality. This retrospective study assessed the diagnostic delay in consecutive Middle-European outpatients and compared results with those of a systematic literature review (SLR).Objectives:To compare disease-specific diagnostic delays of consecutive rheumatic patients with international data from a systematic literature review.Methods:Charts of a single-centre cohort with consecutively recruited patients were retrospectively reviewed for patients’ and diseases’ characteristics at a Middle-European university outpatient clinic for rheumatology. A SLR was performed according to PRISMA guidelines.Results:The average mean ± SD time from first symptom to established diagnosis was 7.9 ± 11.7 (0.02-56.7) years. Spondyloarthritis patients showed the longest diagnostic delay with 13.1 ± 14.2 (0.1-56.7) years, whereas polymyalgia rheumatica-patients had the shortest diagnostic delay with 1.5 ± 0.4 (0.3-18.0) months. In the SLR, most data for diagnostic delays are comparable to the Innsbruck cohort, but the diagnostic delay for psoriatic arthritis in Innsbruck is longer than in the Danish DANBIO registry (p<0.001). Independent risk factors for prolonged diagnostic delays could not be identified.Conclusion:For this Middle-European area, initiatives are justified especially to shorten diagnostic delays of SpA and PsA.References:[1]O’Dell JR. Treating rheumatoid arthritis early: A window of opportunity? Arthritis Rheum. 2002;46:283–5.[2]Seo MR, Baek HL, Yoon HH, Ryu HJ, Choi HJ, Baek HJ, et al. Delayed diagnosis is linked to worse outcomes and unfavourable treatment responses in patients with axial spondyloarthritis. Clin Rheumatol. 2015;34:1397–405.[3]Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis. Ann Rheum Dis. 2015;74:1045–50.[4]Dejaco C, Brouwer E, Mason JC, Buttgereit F, Matteson EL, Dasgupta B. Giant cell arteritis and polymyalgia rheumatica: current challenges and opportunities. Nat Rev Rheumatol. Nature Publishing Group; 2017;13:578–92.Acknowledgments:We acknowledge and thank all patients who could be recruited to the SolutionX project. Ethical vote was obtained by the local ethics committee of the Medical University of Innsbruck (AN2017-0041 370/4.18).Disclosure of Interests:Rick Mc-Cutchan: None declared, Sarah Maier: None declared, Valentin Winkler: None declared, Bernhard Gruber: None declared, Michael Schirmer Grant/research support from: total <3000.- €, Speakers bureau: total <3000.- €
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Bararia, Deepak, Michael Heide, Robert S. Welner, Tatiana Romashova, Alessandro Pastore, Radhika Mathur, Randy D. Gascoyne, et al. "Disruptive ARID1A Mutations in Follicular Lymphoma Impair DNA Repair Efficiency and Are Associated with Favorable Outcome in Patients Receiving First-Line Immunochemotherapy." Blood 126, no. 23 (December 3, 2015): 571. http://dx.doi.org/10.1182/blood.v126.23.571.571.
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Abstract Follicular lymphoma (FL) is among the most common lymphomas worldwide and considered incurable for the majority of patients who present with advanced disease. FL is a clinically and molecularly heterogeneous disease. We have recently established a clinicogenetic risk model (m7-FLIPI) that integrates the mutation status of 7 genes, including ARID1A, into a predictive algorithm for improved risk stratification for failure-free survival in patients receiving first-line immunochemotherapy (Pastore et al., Lancet Oncology 2015). When adjusted for FLIPI and ECOG performance status, the presence of ARID1A mutations correlated with longer failure-free survival (HR 2.85, 95% confidence interval (CI) 1.12-7.27; p=0.049) in patients receiving first-line R-CHOP. The underlying molecular mechanism for better treatment outcome of patients with ARID1A mutated FL is unclear. ARID1A is a member of SWI/SNF nucleosome remodeling complex. Evolving evidence indicates that the SWI/SNF complex functions as a tumor suppressor and is implicated in DNA damage repair. ARID1Ais the most commonly mutated SWI/SNF complex member in FL: in our series, we identified 44 ARID1A mutations in 304 FL cases (14%). These mutations were primarily heterozygous and disruptive (66%), another 6 cases harbored splice site mutations. Primary patient samples and lymphoma cell lines that harbored ARID1A mutations (e.g., SU-DHL5, WSU-FSCCL, Namalwa) were had lower ARID1A protein expression as compared to ARID1A wild type (wt) t(14;18)-positive lymphoma cell lines (OCI-Ly1, -Ly8, DB). Non-homologous end joining (NHEJ) has been reported to be the predominant pathway of DNA double strand break (DSB) repair in FL (Koues et al., Immunity 2015) and is indispensible for successful VDJ rearrangement during early B-cell maturation.To analyze the impact of Arid1a disruption on B-cell maturation in vivo, we used a conditional Arid1a knock-out mouse model (Arid1af/f; Gao, PNAS 2008). 8-10 week old Mx1-Cre+Arid1af/f mice and control (Mx1-Cre-Arid1af/f) mice were treated with poly(IC). Bone marrow (BM) were harvested from these animals 14 days later. Conditionally deletion of Arid1a (n=3) resulted in severely impaired B-cell maturation in BM cells affecting Hardy fractions B/C though F. E.g., flow cytometric analysis showed that the frequency of fraction C (B220+ CD43+ HSA+ BP-1+) was greatly reduced in BM from Mx1-Cre+Arid1af/f vs in the control group (0.1 % vs 1.2 %, n=3), consistent with the inability to successfully complete VDJ recombination. As a proof-of-principle experiment we assayed the impact of Arid1a loss on DSB repair efficiency using mouse embryo fibroblasts (MEFs) from either wt or conditional Arid1a knock-out mice. MEFs were irradiated with 2 Gy 36 hrs after retroviral transduction with Cre and stained for γH2A.X and 53BP1 to assay for NHEJ. In three independent and blinded experiments, evaluation of >100 cells per condition demonstrated significantly more double-positive cells (>6 foci/cell) in Arid1a-/- MEFs (43+/-14%) compared to both Arid1af/f MEFs (9+/-1%) and Cre-exposed wt MEFs (15+/-5%) at 16 hrs post irradiation, whereas there was no significant difference for Arid1af/f or wt MEFs with or without Cre at baseline (all <10%), and 1 hr post irradiation (all >50%). ARID1A haplodeficient lymphoma cell lines (SU-DHL5, WSU-FSCCL, Namalwa) were 10-100 fold more sensitive to the DSB inducing doxorubicin treatment compared to ARID1A wt lymphoma cell lines (OCI-Ly1, -Ly8, DB). Tet-induced shRNA knock-down (via pTRIPZ vectors) of endogenous ARID1A in two t(14;18)-positive lymphoma cell lines with wt ARID1A (OCI-Ly1 and OCI-Ly8) doubled the number of NHEJ foci by 53-BP1 staining in two independent experiments. Furthermore, shRNA knock-down of ARID1A resulted in increased sensitivity to doxorubicine (IC50 <10 nM) in OCI-Ly8 cell lines as compared to 25 nM for scrambled shRNA. We conclude that ARID1A is recurrently and significantly mutated in FL. Most mutations are disruptive and result in functionally relevant ARID1A protein loss. ARID1A disruption slows the repair kinetics of NHEJ and delays the clearance of DSB both in a genetically clean MEF model and in t(14;18)-positive lymphoma cell lines. As a result, ARID1A loss might underlie the genomic instability of FL, but -at the same time- sensitize tumors to DNA damaging agents and irradiation. Disclosures No relevant conflicts of interest to declare.
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Sacchi, Stefano, Samantha Pozzi, Raffaella Marcheselli, Stefano Luminari, Massimo Federico, Alessandra Tucci, Francesco Merli, et al. "Rituximab (R) in Combination with Fludarabine (F) and Cyclophosphamide (C) in Relapsed Follicular Lymphoma (FL) Patients (pts).Final Results of FC + R Phase II Trial by the GISL." Blood 108, no. 11 (November 16, 2006): 2763. http://dx.doi.org/10.1182/blood.v108.11.2763.2763.
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Abstract Fifty-four Pts entered this trial between January 2000 and December 2002. Eligible Pts had histologic documentation of CD 20+ relapsed FL, according to the revised European/American Lymphoma classification, that required treatment, measurable lesion, and an ECOG performance status of 0 or 1. Pts were further required to be aged 18–70 years, and to have undergone < 3 previous lines of chemotherapy. Pts received FC + R chemoimmunotherapy consisting of F 25 mg/m2 and C 300 mg/m2/day for 3 consecutive days every 3 weeks for 4 cycles. R 375 mg/m2 I.V. infusion was administered starting 2 weeks following the first FC course and then on day 1 of each cycle thereafter. Clinical response were defined according to the International Working Group recommendations. BCL 2 analysis was performed by PCR assay. DR, TTP and OS were analyzed by Kaplan-Meier method. Cox analysis was used to analyse the association of baseline prognostic factors with response to treatment, DR,TTP and OS. The overall response rate for all 54 Pts by ITT analysis was 90%; forty Pts (74%), obtained complete responses. Progression occurred in 3 Pts ( 6% ) and 2 Pts dropped out of the trial: 1 for toxicity and 1 refused to start with therapy. A univariate analysis of baseline prognostic factors demonstrated that none of these factors predicted for response to treatment. There were 29 Pts out of 45 tested, positive for BCL 2 before therapy. Among these, 22 Pts were evaluated after treatment and 19 ( 86%) converted to BCL negativity. At last follow up (FU), 40 Pts were alive, 31 with ongoing response and 9 with progressive disease. The median DR, TTP and OS have not been reached after a median FU time of 45 months ( range, 1 to 74 months ). The median DR in the 49 Pts who have reached CR or PR was 35 months ( range, 6 to 70 months). None of the baseline prognostic characteristics was significantly related to DR. The median TTP in all 54 Pts, was 36 months ( range, 1 to 74 months ).BCL2 positivity and < 2 previous treatments were related with better TTP (p<0.05 ) OS rate at 4 years was 75%. Toxicity was evaluable in 52 Pts. The most common severe side effects were hematologic, and included 21 cases of neutropenia, 3 cases of thrombocytopenia and 2 cases of anemia. Infectious complications manifested in 3 Pts and 1 died for pneumonitis. Treatment delays of 1–3 weeks was necessary in 12 patients. The results of our trial have demonstrated that FC+R chemoimmunotherapy is active and relatively well tolerated. The OR rate of 90%, associated with an excellent molecular remission rate, and the mean DR of 35 months compares favourably with the results obtained in other trials in similar subset of patients and supports the use of an FC+R arm in future controlled trials.
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Mehta, Aneesh K., Maricar Malinis, Gabriel Vece, Lara Danziger-Isakov, Diana F. Florescu, Marian Michaels, Cameron R. Wolfe, Lynne Strasfeld, and Susan Tlusty. "1733. 10 Years of DTAC Experience With Donor-Derived Cryptococcus Transmission in Solid-Organ Transplantation in the United States." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S59. http://dx.doi.org/10.1093/ofid/ofy209.139.
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Abstract Background Cryptococcosis is an important fungal complication of solid organ transplantation (SOT); cases occurring within 6 months posttransplant are often severe and sometimes donor derived. Morbidity can be related to delayed recognition of clinical symptoms or lack of communications among the SOT recipient centers. To better understand transmission of Cryptococcus (Crypto) and to identify opportunities for improved identification and communication, all potential donor-derived transmission events (PDDTE) of Crypto reported to OPTN/UNOS ad hoc Disease Transmission Advisory Committee (DTAC) over 10 years were analyzed. Methods All Crypto cases reported to DTAC between January 2008 and December 2017 were reviewed retrospectively as potential donor-derived transmission events (PDDTE). Likelihood of donor-derivation was adjudicated based on recipient and donor data. Results Fourty-six cases of Crypto were reported to DTAC during this period, involving 145 SOT recipients. Of the Proven or Probable donor-derived Crypto cases (n = 9), transmission occurred in 15 recipients; 2 donors each transmitted Crypto to 3 different recipients. Of the Possible cases, 9 recipients were affected. Six recipients with PDDTE Crypto died. Eight recipients received antifungal medications that would prevent transmission of Crypto (classified as intervention without disease transmission). UNOS Region 7 had the highest number donors with 10, with 6 and 7 from Regions 2 and 3, respectively. No cases C. gattii were reported; however, most of the reports to DTAC did not discriminate between C. neoformans and C. gattii. Conclusion This DTAC case series highlights both donor and recipient-derived cryptococcal infections and their potential to have devastating clinical impact. These data also highlight important delays in recognizing Crypto in SOT and in communicating these results to other centers when a PDDTE is possible. Transplant teams should have a high level of suspicion for Crypto in SOT, particularly in those with fever of unknown etiology, pulmonary infiltrates, headaches, and mental status changes. In the future, it may be helpful for transplant center to perform specific testing to discriminate between Cryptococcus species to understand their differential impact in SOT. Disclosures D. F. Florescu, Astellas: Grant Investigator, Grant recipient. C. R. Wolfe, Merck: Scientific Advisor, Consulting fee.
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SCHAFFNER, DONALD W., LAURA GREEN BROWN, DANNY RIPLEY, DAVE REIMANN, NICOLE KOKTAVY, HENRY BLADE, and DAVID NICHOLAS. "Quantitative Data Analysis To Determine Best Food Cooling Practices in U.S. Restaurants†." Journal of Food Protection 78, no. 4 (April 1, 2015): 778–83. http://dx.doi.org/10.4315/0362-028x.jfp-14-252.
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Data collected by the Centers for Disease Control and Prevention (CDC) show that improper cooling practices contributed to more than 500 foodborne illness outbreaks associated with restaurants or delis in the United States between 1998 and 2008. CDC's Environmental Health Specialists Network (EHS-Net) personnel collected data in approximately 50 randomly selected restaurants in nine EHS-Net sites in 2009 to 2010 and measured the temperatures of cooling food at the beginning and the end of the observation period. Those beginning and ending points were used to estimate cooling rates. The most common cooling method was refrigeration, used in 48% of cooling steps. Other cooling methods included ice baths (19%), room-temperature cooling (17%), ice-wand cooling (7%), and adding ice or frozen food to the cooling food as an ingredient (2%). Sixty-five percent of cooling observations had an estimated cooling rate that was compliant with the 2009 Food and Drug Administration Food Code guideline (cooling to 41°F [5°C] in 6 h). Large cuts of meat and stews had the slowest overall estimated cooling rate, approximately equal to that specified in the Food Code guideline. Pasta and noodles were the fastest cooling foods, with a cooling time of just over 2 h. Foods not being actively monitored by food workers were more than twice as likely to cool more slowly than recommended in the Food Code guideline. Food stored at a depth greater than 7.6 cm (3 in.) was twice as likely to cool more slowly than specified in the Food Code guideline. Unventilated cooling foods were almost twice as likely to cool more slowly than specified in the Food Code guideline. Our data suggest that several best cooling practices can contribute to a proper cooling process. Inspectors unable to assess the full cooling process should consider assessing specific cooling practices as an alternative. Future research could validate our estimation method and study the effect of specific practices on the full cooling process.
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Abromowitch, Minnie, Richard Sposto, Sherrie Perkins, Jonathan Finlay, and Mitchell S. Cairo. "Results of CCG-5941: Intensified Multiagent Chemotherapy and Non-Cross Resistant Maintenance Therapy for Advanced Lymphoblastic Lymphoma in Children and Adolescents." Blood 108, no. 11 (November 16, 2006): 533. http://dx.doi.org/10.1182/blood.v108.11.533.533.
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Abstract The treatment of advanced (Stage III/IV) pediatric lymphoblastic lymphoma (LL) has recently utilized treatment strategies similar to childhood acute lymphoblastic leukemia (ALL) with prolonged maintenance chemotherapy for up to two years (Burkhardt et al JCO, 2006) compared to older treatment strategies of less intense lymphoma type therapy (Anderson et al NEJM, 1983). The CCG previously piloted a “NY regimen” for “lymphomatous” ALL with a new intensive induction/intensive conditioning and alternating non-cross resistant combination maintenance therapy (Steinherz et al JCO, 1986). We modified the NY regimen for lymphomatous ALL in children with advanced (Stage III/IV) lymphoblastic lymphoma with ≤25% BM lymphoblasts. Between July 1994 and June 1997, 85 eligible LL patients with advanced disease (Stage III/IV) were enrolled in a pilot study CCG-5941 to estimate toxicity, feasibility and efficacy of a short (12 month) aggressive multiagent chemotherapy regimen. Patients were staged according to the St. Jude staging system. Induction (3wks) consisted of VCR, Pred, Daunomycin, Cyclophosphamide, L-ASP and IT MTX/ARA-C. Consolidation (3wks) consisted of VCR, ARA-C, VP-16, HD MTX and IT MTX. There were six maintenance courses each consisting of 4 pulses: A (Cylcophosphamide, 6TG), B (VCR, Pred, Dauno), C (VCR, HD MTX, L-ASP) and D (ARA-C, VP-16). CNS positive pts received 1800 cGy-cranial and 600 cGy spinal at completion of chemotherapy (approximately 1 yr). Central pathology review (84%) and immunophenotyping were preformed with CD3, CD5, CD45RO, TDT, CD 79 and CD20. Neupogen (G-CSF) was given after each cycle to maintain dose intensity. Median age 10 yrs (1–18 yrs), 64% male, median f/u 7.2 yrs, 91% T-cell, 7% B-cell, 2% mixed lineage, 27% LDH ≥2nL, 12 % M2 BM, 5% CNS positive. Among the 85 patients there were four deaths unrelated to disease progression (4.7%), three due to infectious complications and one due to venoclusive disease of the liver. Two second malignant neoplasms (AML) have occurred. Hematopoietic (grade III/IV) toxicity occurred in approximately 80% of patients, resulting in delays in chemotherapy. The 5yr event free survival (EFS) is 78±4.5% and 3 yr overall survival (OS) is 85±3.9%. Analysis of EFS by age, sex, induction responses, marrow status at diagnosis (M2 vs M1), presence of CNS disease, LDH ≥2nL and presence of mediastinal mass was not significant. The prognosis in patients with progressive/relapsed disease was dismal with a 2 yr OS of 33±14%. These pilot results suggest that this experimental approach in children and adolescents with advanced LL is safe and feasible and results in similar long term efficacy as compared to more prolonged maintenance ALL type chemotherapy regimens.
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El Aoufy, K., M. R. Melis, M. Balzani, S. Guiducci, S. Bellando Randone, S. Bambi, L. Rasero, and M. Matucci-Cerinic. "POS1530-HPR RHEUMATIC MUSCULOSKELETAL DISEASES (RMDs) DURING THE FIRST WAVE OF THE COVID19 PANDEMIC: PATIENTS’ POINT OF VIEW ON THE ROLE OF TELEMEDICINE." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1109.2–1110. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2643.
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BackgroundThe COVID19 pandemic has caused health problems in people’s daily lives with a significant psychological impact. In fact, patients with RMDs have experienced diseases’ flare and also psychological problems. The lockdown and the “social quality changes” have impacted the life and the well-being of RMDs patients, influencing directly the implementation of telemedicine during daily practice.ObjectivesA descriptive observational study was designed to analyse the short-term effect of the first wave on RMDs patients on social quality changes and the usefulness of telemedicine.MethodsThe survey was carried out by administering a questionnaire consisting of 30 questions, developed ad hoc using Likert scales. Items such as family and work environment, access to healthcare facilities, healthcare provided to the patient, disease activity and the mental health status of individuals (anxiety / depressive symptoms) were investigated. Preliminary data on the first wave were collected between September and November 2021 through patient associations and social networks.Results40 RMDs patients (Rheumatoid Arthritis 57.5%, Psoriatic Arthritis 35%, Fibromyalgia and others 7.5%) prevalently women (97.5%) were included in the survey. During the pandemic, 72% of respondents reported cancellation or delays in scheduled appointments and 50% did not have alternative contacts (telephone consultations, e-mail prescriptions, telematics training) with the hospital. 40.5% of patients reported difficulty in finding DMARDs and material for the treatment of ulcers, 28.2% reported difficulties in accessing the health facilities. In particular, 34.2% reported the total closure of the hospital facilities.Moreover, our data show a worsening of health status due to an increased anxiety concerning the management of their RMDs, an increased stress within the family, a reduced access to care facilities due to their closure or travel restrictions. In 57% of patients, a worsening of health status was reported, while in 90% stress and a feeling of abandonment was developed since the beginning of the pandemic. In this context, telemedicine was considered useful by 97.5% of patients, although patients felt that an improvement was necessary with an integration with the regular follow up.ConclusionPatients with RMDs reported that the significant delays or cancellation of the outpatient visits provoked an increase of stress, worry and anxiety for their health. The majority was very concerned about the overall management of their RMDs. The worsening of symptoms in more than half of the patients was the most worrisome observation. Almost all patients agreed that Telemedicine might help the clinical evaluation of their RMDs, also providing a significant support to their psychological condition because of the direct contact with the caring physician and health professionals.References[1]Morales-Torres J, Aceves-Ávila FJ (20210) Rheumatologists in the COVID-19 era: will there be a new role for the rheumatologist in the care of rheumatic patients? Clin Rheumatol 39(11):3177-3183. doi: 10.1007/s10067-020-05380-1[2]Webster P. (2020) Virtual health care in the era of COVID-19. Lancet 395(10231):1180–1181. doi:10.1016/S0140-6736(20)30818-7[3]Matsumoto RA, Barton JL (2021) Telerheumatology: before, during, and after a global pandemic. Curr Opin Rheumatol 33(3):262-269. doi: 10.1097/BOR.0000000000000790.[4]El Aoufy K, Melis MR, Bellando Randone S, Blagojevic J, Bartoli F, Fiori G, Nacci F, Conforti ML, Cometi L, Bruni C, Orlandi M, Moggi-Pignone A, Rasero L, Guiducci S, Matucci-Cerinic M. The positive side of the coin: Sars-Cov-2 pandemic has taught us how much Telemedicine is useful as standard of care procedure in real life. Clin Rheumatol. 2022 Feb;41(2):573-579. doi: 10.1007/s10067-021-05975-2. Epub 2021 Nov 5. PMID: 34739619; PMCID: PMC8569841.Disclosure of InterestsNone declared
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Li, Kevin, Kajal Mehta, Ada Wright, Joohee Lee, Tam N. Pham, Kiran K. Nakarmi, and Barclay T. Stewart. "75 Geographic Location-Allocation Modeling to Optimize National Burn Care Delivery and Disaster Planning." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S52—S53. http://dx.doi.org/10.1093/jbcr/irab032.079.
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Abstract Introduction The study country has a disproportionally high burn incidence rate compared to other low- and middle-income countries. Preventable death and disability are common due to poor population-level spatial access to organized burn care, including no organized system of ground or aeromedical transport. Currently, severe burns are referred to a single facility nationwide, often with suboptimal stabilization and/or significant care delay. Therefore, we aimed to identify existing candidate hospitals that would optimize population-level access to acute burn care if burn stabilization capabilities were strengthened in each hospital. Methods The 175 general hospitals that referred patients to the single national burn referral center between 2016–2020 were designated as candidate hospitals. Demand points for location-allocation modelling were derived from a 2020 estimated population density grid for the country (total population 30,184,338). Road network and national speed limit data were extracted from publicly available geodata to inform travel distance and time. Six models were developed (Models A-F) using cost-distance and network analyses to identify the 3 vs 5 candidate hospitals that would optimize population-level spatial access if their initial burn stabilization capabilities were strengthened. Three travel time thresholds (≤2, 6, and 12 hours) were used for both sets of models. Results Currently, 6,151,298 people (20.3% of the national population) have access to organized burn care within 2 hours of travel, 11,240,957 (37.2%) within 6 hours and 21,925,928 (72.6%) within 12 hours [Table 1]. If acute burn stabilization capabilities were strengthened, Models A-C of 3 chosen hospitals would increase population-level burn care access to 45.2%, 89.4%, and 99.8% of the national population at ≤2, 6, and 12 travel-hours, respectively. Models D-F demonstrated that 5 chosen hospitals would increase population-level burn care access to 53.4%, 95.0%, and 99.9% of national the population at ≤2, 6, and 12 travel-hours, respectively. Conclusions This exercise demonstrates two sets of models for increasing population-level access to acute burn stabilization in the study country. If acute burn stabilization capabilities were strengthened in the identified hospitals, approximately 90% of the national population would have access to burn care within 6 travel-hours in both the 3 and 5 hospital scenarios. Although the models with 5 strengthened hospitals reduce mean travel time, the percent of population with improved travel time access is only marginally higher. Strategic, organized efforts to increase burn stabilization capabilities might reduce the rates of preventable burn-related death and disability country-wide by reducing delays.
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Agabani, Ayat, Lenny Cornwall, Sumeet Gupta, Helen Oatway, and Hayli Ingram. "Adult ADHD Patients in Community Mental Health Teams – an Unmet Need." BJPsych Open 8, S1 (June 2022): S127—S128. http://dx.doi.org/10.1192/bjo.2022.376.
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AimsThis Service Survey is a part of a Quality improvement project which aims to :1- To assess the extent of the problem regarding accessing Adult ADHD assessment and treatment by getting the views of clinicians.2- Evaluate negative impact on care coordinators of the delay in accessing timely and effective diagnosis and treatment of ADHD; This will: a-Increase understanding of the care needed by this patient group. b-Clarify current practice and any difficulties staff face in condition management when diagnosis not confirmed i.e. outline training needs. c-Determine if waiting time for diagnosis results in iatrogenic harm (deterioration driven by ‘unmet need’). 3-Inform the development of an alternative pathway of care; thus: a-Reduce inequality of healthcare access for those with this neurodevelopmental condition. b-Reduce stigma. c-Improve service user health and well-being. d-Support families and carers. e-Reduce social costs to individual and community. f-Support community staff and increase knowledge and effectiveness.MethodsMethods of the service survey part: 1.Service survey: Sent to 21 consultants who are working in Adult CMHT.2.Service Satisfaction survey for all of the Redcar & Cleveland Affective disorder team's clinical staff members (18).Results: Consultants Service Survey11 consultants responded out of 21 (52%)Approximate number of the diagnosed ADHD patients / team varied between 7–80 patients.Wait time for an ADHD assessment varied between 12 -30 months.Number of patients/ team waiting for assessments by the specialist team 2- 27 patients.50% of the consultants reported significant delays between referral to the services and initiation of treatment 6–36 months.All consultants reported commencing treatment of ADHD, if a patient already had the diagnosis.9/11 (82%) consultants reported making the initial diagnosis and treating ADHD patients in CMHTs. However, all consultant reported the need for further training in assessment and management of ADHD patients.6/11 (55%) consultants stated that ADHD patients should be managed in CMHTs provided they are care coordinated by another clinician.Clinical Staff Satisfaction SurveyAll 3 staffs responded out of 18 staff, reported un satisfaction with the current service provision.Conclusion1.The current service model is not able to meet the increasing demand for the services and leading to significant delay in accessing appropriate treatment.2.There is a need to improve competencies of community mental health teams to manage these patients.3.This survey will be used to model a new care pathway.
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Cattaneo, Chiara, Erika Borlenghi, Francesca Bracchi, Liana Signorini, Alessandro Re, Elisa Cerqui, Liliana Baushi, Roberto Stellini, and Giuseppe Rossi. "Analysis of Infections In Acute Leukemia According to the Different Phases of Treatment Reveals Marked Differences Potentially Useful for Tailored Prophylactic and Empiric Antimicrobial Treatments." Blood 116, no. 21 (November 19, 2010): 2773. http://dx.doi.org/10.1182/blood.v116.21.2773.2773.
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Abstract Abstract 2773 Introduction. Infections during chemotherapy-induced aplasia are still a problem in the management of acute leukemia (AL) patients (pts), causing potentially life-threatening consequences and treatment delays. Adequate empiric antibiotic therapy is crucial for a favourable clinical evolution. In order to better define the best antimicrobial management for AL pts during different phases of treatment, we analyzed all infectious events occurring to consecutively treated AL pts at our Institute during a period of six years. Patients and Methods. Since June 2004 a program of active epidemiological surveillance is ongoing at our Institute. Data concerning infections occurring during chemotherapy-induced cytopenia in AL pts were analysed. All pts showing fever or signs/symptoms of infection underwent thorax X-ray and culture of any other fluid/drainage obtained from a suspected infection site. CT scan of thorax was performed when fever persisted >48h. An infection was considered clinically documented (CDI) when pertinent symptoms, objective signs, or diagnostic radiological findings were present and microbiologically documented (MDI) when microorganisms were isolated. Results. From June 2004 to May 2010, 210 cases of AL (154 acute myeloid leukemia [AML], 53 acute lymphoblastic leukemia [ALL], and 3 blastic plasmacytoid dendritic cell leukemia), were diagnosed and treated with at least one induction cycle followed by consolidation and with reinduction cycles in relapsing/refractory pts. Overall, 1014 chemotherapy cycles were delivered, subdivided as induction (I) (210), consolidation (C) (708) and salvage (S) (96) treatment. Overall 309 clinically documented infections (CDI) were observed (30.5%). Incidence of CDI was higher during S therapy in comparison with I or C (77.1% vs 41.9% and 20.7%, p<0.0001). Incidence of pneumonia was similar in S and I phase (18.7% vs 17.6%) and significantly higher than in C (1.8%, p<0.0001). Incidence of bloodstream infections (BSI) was similar during I and C phase (20% and 15%, p=0.09) and significantly lower than in S (54.2%, p<0.0001). MDI were diagnosed in 270/1014 cycles (26.6%). Isolates were Gram negative (G-) in 54.8%, Gram-positive (G+) in 32.6% and fungi (F, moulds only) in 2,6% of cases; in 27 cases (10%) a mixed infection was documented. Frequency of fungal infections was higher during I therapy (6.9%) than in C+S (1%, p=0.016). Epidemiological distribution of G+ and G- infections during different phases was similar, with the exception of a lower frequency of G- during I (41.7%) vs C+S (59.6%, p=0.012). Mixed infections were more frequent during I (16.7%) than C+S (7.6%, p=0.038). Overall, 297 pathogens were isolated. S. aureus (9/270, 3.3%) and coagulase-negative staphylococci (43/270, 15.9%) were more frequent during I than C+S (respectively: 6.9% vs 2%, p=0.059 and 25% vs 12.6%, p=0.02); E. coli infections (92/270, 34.1%) were predominant during C (52.5%) in comparison with I+S (25.7%, p=0.004). Enterococci (30/270, 11.1%) and P. aeruginosa infections (52/270, 19.6%) were uniformly distributed during different phases. Death occurred in 19 cases (6 and 13 during I and S, respectively). At univariate analysis, S phase (p<0.0001), P. aeruginosa and S. aureus, alone or in association with other pathogens, emerged as poor prognostic factors (p=0.002 and 0.016, respectively). Two of the 7 cases of probable aspergillosis died during I. Conclusions. The S phase has the highest infectious risk, particularly for BSI. Both prophylactic and empiric antibiotic therapy guided by epidemiological data seem warranted. In the I phase pneumonia, particularly of mycotic origin, is relatively more frequent, confirming the appropriateness of an effective antifungal prophylaxis. The C phase carries a very limited risk of life-threatening infections and a relatively high incidence of E. coli. Therefore, the need for antimicrobial and antifungal prophylaxis during C may be reconsidered. Overall the frequency of bacterial infections largely outweighs that of fungal infections and is responsible for 84% of infectious deaths. Among bacteria, P. aeruginosa ranks as the second more frequent microorganism after E. coli and carries the highest risk of death. Given its intrinsic ability of developing antibiotic resistance, it should be presently considered as the most threatening infectious agent in AL against which empiric antibiotic therapy should be tailored. Disclosures: No relevant conflicts of interest to declare.
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Marin-Niebla, Ana, Eduardo Rios-Herranz, Juan M. Rodriguez, Ramiro Nunez, Ascension Herrera, Ricardo Parody, and Ildefonso Espigado. "Efficacy and Safety of Fludarabine/Cyclophosphamide (FC) as Front-Line Treatment of CLL. Final Results of a Phase II Clinical Trial in a Single Center." Blood 104, no. 11 (November 16, 2004): 4826. http://dx.doi.org/10.1182/blood.v104.11.4826.4826.
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Abstract BACKGROUND: Fludarabine (F), already demonstrated to be a highly active drug in the management of relapsing or refractory CLL, presents improved clinical and molecular responses when it is associated to alkylating agents such as Cyclophosphamide (C). This combination (FC) appears as a promising option as front-line treatment in CLL patients with good performance status and no previous treatments, in whom a much better outcome, and perhaps curation, is expectable. Objectives: 1) Evaluation of the clinical and molecular response to FC as front-line treatment of CLL. 2) Assessment of toxicity and complications associated to this combination. Patients and method : Since June 2001 to August 2004, 26 B-CLL untreated patients (pts) (19M/7F; M age: 60 years (43–74); ECOG:0 (0–1); Binet AII 4 pts, BI 4 pt, BII 14 pt, CIII 4 pt) were included in the trial to receive treatment with FC combination (F:25 mg iv/m2/d x3 d; C: 300 mg/m2/d x3d). Initially, 6 courses at 28-day intervals were programmed, but the scheme was reduced to 4 courses in accordance with the Local Ethics Committee due to the toxicity observed in the first patients. Anti-infectious prophylaxis: Trimetoprim-sulfametoxazol and fluconazol. Hemogram at inclusion: (Median (R) values) WBC: 70.7x109/L (7.93–242), lymphocytes: 64,7x109/L (6,2–179), Hb: 138 g/L (71–162), platelets: 151x109/L (62–324). Renal and hepatic parameters within normal range limits. Cytogenetics by FISH: No alterations (9), +12 (8), p53 (4), 13q (17), ATM (6). Response to treatment was first assessed at course 3 and then at course 6 in pts receiving 6 courses, and after the 4th course in those receiving 4 courses. The assessment was made according to the revised NCI criteria as well as by PCR amplification of the VDJ segment of IgH with FR3 and JH regions primers. Results: 6/26 pts did not complete 4 courses yet, so they are not evaluable. Among the 20 evaluable: 6 pts completed 6 full courses, 5 courses: 1pt, 4 courses: 9 pts, 3 courses: 1 pt (due to renal toxicity), 2 courses: 2 pts (exitus before 3rd course). Responses: CR: 15 pts (75%); PR: 3 pts (15%); No response: 2 pts (10%). Only 1 pt, with initial PR, progressed after 21 months follow-up. Median follow-up: 11,5 months (2–30). Up to 147 toxicity events were recorded (84 FC total), assessed according to WHO criteria, but only 50 were grade III-IV : 72% hematological (neutropenia most frequently), 18% liver toxicity, 10% renal. Toxicity occurred mainly after the first 3 courses, with increasing severity and extension, but regressing when the treatment was withdrawn, being hematological toxicity the most severe and prolongued. After reducing the number of courses from 6 to 4, hematological toxicity decreased, while other types of toxicity did not significantly improve. Complications: 40 episodes of infection (associated neutropenia 12/40, requiring hospitalization 21/40), 2 cases of bleeding and 3 cases of thrombosis. Six patients died: 3 died of infectious complications due to prolongued hematologic toxicity: TRM: 3/20 (15%) and 3 pts due to disease progression. Conclusions : 1) FC combination as front-line treatment is effective in B-CLL (90% overall response rate and 75% CR -clinical and molecular-). 2) Hematological toxicity is the most severe observed, causing treatment delays and leading to infections. 3) Reducing the number of FC courses from 6 to 4 caused a decrease in haematological toxicity, so 4 FC appears as an effective scheme in terms of efficacy and safety.