Amelioration of Acute Sequelae of Blast Induced Mild Traumatic Brain Injury by N-Acetyl Cysteine: A Double-Blind, Placebo Controlled Study

Background: Mild traumatic brain injury (mTBI) secondary to blast exposure is the most common battlefield injury in Southwest Asia. There has been little prospective work in the combat setting to test the efficacy of new countermeasures. The goal of this study was to compare the efficacy of N-acetyl cysteine (NAC) versus placebo on the symptoms associated with blast exposure mTBI in a combat setting. Methods: This study was a randomized double blind, placebo-controlled study that was conducted on active duty service members at a forward deployed field hospital in Iraq. All symptomatic U.S. service members who were exposed to significant ordnance blast and who met the criteria for mTBI were offered participation in the study and 81 individuals agreed to participate. Individuals underwent a baseline evaluation and then were randomly assigned to receive either N-acetyl cysteine (NAC) or placebo for seven days. Each subject was re-evaluated at 3 and 7 days. Outcome measures were the presence of the following sequelae of mTBI: dizziness, hearing loss, headache, memory loss, sleep disturbances, and neurocognitive dysfunction. The resolution of these symptoms seven days after the blast exposure was the main outcome measure in this study. Logistic regression on the outcome of 'no day 7 symptoms' indicated that NAC treatment was significantly better than placebo (OR = 3.6, p = 0.006). Secondary analysis revealed subjects receiving NAC within 24 hours of blast had an 86% chance of symptom resolution with no reported side effects versus 42% for those seen early who received placebo. Conclusion: This study, conducted in an active theatre of war, demonstrates that NAC, a safe pharmaceutical countermeasure, has beneficial effects on the severity and resolution of sequelae of blast induced mTBI. This is the first demonstration of an effective short term countermeasure for mTBI. Further work on long term outcomes and the potential use of NAC in civilian mTBI is warranted. Trial Registration: ClinicalTrials.gov NCT00822263

School Poverty Concentration and Kindergarten Students' Numerical Skills

Schools that enroll disproportionately high percentages of pupils from low-income families are widely believed to have negative consequences for student performance. Prior research has investigated the relationship of school poverty and outcomes in numerous ways, but the basic proposition is that school composition affects student learning, such that otherwise similar students realize different levels of achievement in schools with different proportions of low-income. This paper updates and extends the research on compositional effects in several respects. First, we extend the research to the early elementary level of schooling. Second, the data needed to assess the relative importance of individual and school factors have not been available and the mechanisms that mediate the school-level effect independent of student background factors are thus not clear. This paper draws upon nationally representative data on kindergarten pupils and the schools they attend to estimate both the overall impact of school poverty on mathematics achievement and its impact on a variety of other school and schooling-experience variables that may in turn affect student learning. Finally, this paper analyzes the effects of high poverty schools on several schooling variables hypothesized to affect student achievement.

Radioimmunologic Methods for Diagnosis of Malignant Diseases

The recent availability of the carcinoembryonic antigen (CEA) assay has stimulated great clinical interest in tumor antigens. Carcinoembryonic antigen is not the only specific or tumor-associated antigen currently identified. There are a number of other tumor antigens which have been isolated, some of which are related to CEA and some of which are totally different. There is, for example, a nonspecific cross-reacting antigen (NCA) which has been discovered in certain preparations which were considered originally to be CEA. Nonspecific cross-reacting antigen is a beta globulin (25% carbohydrate) which cross-reacts with antibodies to CEA and may be the nonspecific background element that causes the CEA titer to be elevated in certain nonmalignant diseases. There is also a membrane-associated, low molecular weight tissular autoantigen (MTA) which has been recently identified. However, this material is not antigenetically related to CEA or NCA

Microscopic calculations of collective flow probing the short-range nature of the nuclear force

Collisions between two nuclei have been modeled by numerical solution of classical approximations to the equations of motion of the constituent nucleons. For the reaction Nb(400 MeV/u)+Nb, a correlated sidewards emission of nucleons is observed. This is attributed to the repulsive short-range component of the nucleon-nucleon potential. A strong dependence of the flow angle on the impact parameter is observed, in accord with recent experimental results

Use of Bone Scanning and Skeletal Radiography in the Diagnosis of Bone Metastasis

The radionuclide bone scan is becoming increasingly useful for evaluating a wide variety of bone and joint disorders. However, the commonest application is still the detection of skeletal metastases in the patient with known or suspected neoplastic disease. The role of this examination relative to other well established methods of evaluating these patients, especially the radiographic skeletal survey, is not clear to all physicians. We hope in this communication to define the role of the radionuclide bone scan and to place in perspective the integral relationship between the scan and the survey, the two radiologic modalities which today are the principal methods of evaluating the skeletal system for metastatic disease

Applications of active microwave imagery

The following topics were discussed in reference to active microwave applications: (1) Use of imaging radar to improve the data collection/analysis process; (2) Data collection tasks for radar that other systems will not perform; (3) Data reduction concepts; and (4) System and vehicle parameters: aircraft and spacecraft

Rs12979860 and rs8099917 single nucleotide polymorphisms of interleukin-28B gene: simultaneous genotyping in Caucasian patients infected with hepatitis C virus

Introduction. Recent studies have demonstrated the role of the interleukin 28B (IL28B) polymorphisms in predicting treatment induced and spontaneous clearance from Hepatitis C virus (HCV) infection, suggesting the possibility of tailored therapy in HCV infected patients. Genome-wide association studies have shown that single nucleotide polymorphisms (SNPs) near IL 28B gene on chromosome 19 are strong predictors of sustained virologic response (SVR) to pegylated interferon and ribavirin. This study was aimed at analyzing the co-prevalence of two common and clinically significant SNPs in a cohort of Ligurian patients. Methods. Two SNPs (rs12979860, rs8099917) were genotyped in the IL28B locus from 175 DNA samples collected from HCV- infected consecutive patients in a Laboratory of Liguria Region, northern Italy. A real-time polymerase chain reaction in a Cor- bett Research Termocycler (Rotor Gene 3000A) by fluorescent probes (Fast Set IL 28B©, Arrow Diagnostics) was used for the detection, according to the manufacturer?s instructions. Results. Carriers of rs12979860CT genotype predominated (87/175, 50%), homozygotes for allele C were 68/175 (39%) and the remaining were homozygotes for IFN-resistant allele T (11%). As for the rs8099917 SNP, genotypes were thus distributed: 96/175 (55%) carried the rs8099917 TT genotype, whereas 70/175 (40%) and 9/175 (5%), were heterozygotes or homozygotes for the G allele. The variants rs12979860CC and rs8099917TT were found in 39% and 54% of overall patients with HCV genotype 1, respec- tively. The combined assessment of examined SNPs resulted in three most prevalent genotypes (rs12979860CC/rs8099917TT, rs12979860CT/rs8099917TG and rs12979860CT/rs8099917TT) with a frequency of 35%, 31% and 18%, respectively. Discussion. Recent findings demonstrated that in carriers of rs12979860CT the determination of additional genotype of rs8099917 SNP could significantly improve the prediction of SVR. In our study cohort carriers of rs12979860CT represented 50% of all patients, who could take advantage with respect to SVR prediction by further determination of the rs8099917 SNP. The simultaneous genotyping of two IL28B SNPs should thus be recommended in HCV infected patients prior to treatment initiation