Lack of utility of chimerism studies obtained 2-3 months after myeloablative hematopoietic cell transplantation for ALL.

Lineage-specific chimerism studies are commonly obtained at several time points after nonmyeloablative hematopoietic cell transplantation to assess the tempo and degree of engraftment, and to monitor graft rejection. For patients who receive myeloablative transplants, the value of frequent chimerism analyses using sensitive molecular techniques is less certain. In this study, a retrospective analysis was performed to assess the transplant outcome of 89 adult patients with ALL who had chimerism studies of unfractionated BM cells or peripheral blood subsets performed approximately 80 days after transplantation. These patients received unmanipulated, myeloablative transplants using either HLA-identical or HLA-mismatched, related or unrelated donor stem cells. Incomplete donor engraftment was present only in the CD3+ peripheral blood T cells in a small percentage of patients. There was no correlation of mixed chimerism with transplant outcome. Routine 'day 80' chimerism studies in this group of patients who receive intensive, myeloablative conditioning regimens are not recommended

Experiences of Inpatient Bone Marrow Transplantation Nurses and Providers Using Electronic Symptom Reporting

Purpose To investigate the use of electronic patient-reported outcomes (PROs) to assess symptoms and how they can provide opportunities to clinicians to address symptoms in a timely manner to improve clinical care. As part of a larger study to evaluate whether providing standardized symptom reports to the medical team would decrease the time to treatment of reported symptoms in hematopoietic stem-cell transplant recipients, we assessed nurses’ and providers’ perceptions of electronic symptom reporting. Methods Semistructured interviews of RNs, MDs, NPs and PAs were conducted at an academic cancer center in the southeastern United States. Nurses’ and providers’ perceptions of electronic symptom reporting were explored. Interviews were audio-recorded, transcribed, and coded by two investigators to identify major themes. Results Fourteen RNs and seven providers (MDs, PAs, and NPs) participated in the interviews. Three main themes emerged from the interviews: electronic symptom reporting may improve assessment and care, integrating symptom reporting into nurse workflow presents difficulties, and there are barriers for completion of surveys. Conclusion The majority of nurses and providers believed that the inclusion of electronic symptom reporting in bone marrow transplantation inpatient units has the potential to improve care but that barriers to implementation remain

Picosecond polarised fluorescence studies of oxazine 4 motion and order in nematic and isotropic phases of 5-, 6- and 7-cyanobiphenyl

Picosecond fluorescence anisotropy and lifetime measurements are used to investigate the orientational dynamics and steady state order of the fluorescent probe oxazine 4 in the nematic and isotropic phases of 5, 6 and 7 cyanobiphenyl. Variation of the excitation polarisation angle beta with respect to the nematic director allows the preparation of both cylindrically symmetric and asymmetrically aligned probe distributions whose relaxation dynamics are sensitive to both theta and phi motions yielding two characteristic relaxation times: tau(20) (pure theta-diffusion) and tau(22) (predominantly phi-diffusion). Analysis of the fluorescence intensity decays for excitation polarisation angles of beta=0degrees and beta=54.7degrees allows a determination of the effect of local field and differential reflection losses without the measurement of sample refractive indices. A striking feature of oxazine 4 dynamics in the approach to the nematic-isotropic phase transition temperature (T-NI) is that whilst theta diffusion shows a characteristic Arrhenius temperature dependence, the rate of diffusion in the phi coordinate is reduced as the system becomes less ordered. In the isotropic phase over a 50degreesC temperature range above T-NI the fluorescence anisotropy is characterised by two correlation times consistent with restricted rotational diffusion (intra-domain relaxation tau(f)) within a slowly relaxing (pseudo-domain) structure (tau(s)). The temperature dependence of tau(f) and tau(s) was in good agreement with recent theoretical models for intra- and inter-domain relaxation

Hip disability and osteoarthritis outcome score (HOOS) – validity and responsiveness in total hip replacement

BACKGROUND: The aim of the study was to evaluate if physical functions usually associated with a younger population were of importance for an older population, and to construct an outcome measure for hip osteoarthritis with improved responsiveness compared to the Western Ontario McMaster osteoarthritis score (WOMAC LK 3.0). METHODS: A 40 item questionnaire (hip disability and osteoarthritis outcome score, HOOS) was constructed to assess patient-relevant outcomes in five separate subscales (pain, symptoms, activity of daily living, sport and recreation function and hip related quality of life). The HOOS contains all WOMAC LK 3.0 questions in unchanged form. The HOOS was distributed to 90 patients with primary hip osteoarthritis (mean age 71.5, range 49–85, 41 females) assigned for total hip replacement for osteoarthritis preoperatively and at six months follow-up. RESULTS: The HOOS met set criteria of validity and responsiveness. It was more responsive than WOMAC regarding the subscales pain (SRM 2.11 vs. 1.83) and other symptoms (SRM 1.83 vs. 1.28). The responsiveness (SRM) for the two added subscales sport and recreation and quality of life were 1.29 and 1.65, respectively. Patients ≤ 66 years of age (range 49–66) reported higher responsiveness in all five subscales than patients >66 years of age (range 67–85) (Pain SRM 2.60 vs. 1.97, other symptoms SRM 3.0 vs. 1.60, activity of daily living SRM 2.51 vs. 1.52, sport and recreation function SRM 1.53 vs. 1.21 and hip related quality of life SRM 1.95 vs. 1.57). CONCLUSION: The HOOS 2.0 appears to be useful for the evaluation of patient-relevant outcome after THR and is more responsive than the WOMAC LK 3.0. The added subscales sport and recreation function and hip related quality of life were highly responsive for this group of patients, with the responsiveness being highest for those younger than 66

Future needs and requirements for AMS C-14 standards and reference materials

C-14 measurement uses a number of standards and reference materials with different properties. Historically the absolute calibration of C-14 measurement was tied to 1890 wood, through the 'primary' standard of NBS-OxI (produced by the National Bureau of Standards, now NIST - National Institute of Standards and technology) subsequently replaced by NBS-OxII. These are both internationally calibrated and certified materials, whose C-14 activities are known absolutely. A second tier of materials, often called secondary standards or reference materials, and including internationally recognised materials such as ANU-sucrose (now also IAEA-C6), Chinese - sucrose and the IAEA C1-C6 series, augmented by additional oxalic acid samples are also used routinely. The activity of these materials has been estimated from large numbers of measurements made by many laboratories. Recently, further natural materials from the Third and Fourth International Radiocarbon Inter- comparisons (TIRI and FIRI) have been added to this list. The activities of these standards and reference materials span both the applied C-14 age range and the chemical composition range of typical samples, but this is not achieved uniformly and there is a continuing need for reference materials for laboratory quality control and measurement-traceability purposes. In this paper, we review the development of C-14 Standards and reference materials and consider the future requirements for such materials within the C-14 AMS community

NuRV: A nuXmv Extension for Runtime Verification

We present NuRV, an extension of the nuXmv model checker for assumption-based LTL runtime verification with partial observability and resets. The tool provides some new commands for online/offline monitoring and code generations into standalone monitor code. Using the online/offline monitor, LTL properties can be verified incrementally on finite traces from the system under scrutiny. The code generation currently supports C, C++, Common Lisp and Java, and is extensible. Furthermore, from the same internal monitor automaton, the monitor can be generated into SMV modules, whose characteristics can be verified by Model Checking using nuXmv. We show the architecture, functionalities and some use scenarios of NuRV, and we compare the performance of generated monitor code (in Java) with those generated by a similar tool, RV-Monitor. We show that, using a benchmark from Dwyer's LTL patterns, besides the capacity of generating monitors for long LTL formulae, our Java-based monitors are about 200x faster than RV-Monitor at generation-time and 2–5x faster at runtime

Component-wise incremental LTL model checking

Efficient symbolic and explicit-state model checking approaches have been developed for the verification of linear time temporal logic (LTL) properties. Several attempts have been made to combine the advantages of the various algorithms. Model checking LTL properties usually poses two challenges: one must compute the synchronous product of the state space and the automaton model of the desired property, then look for counterexamples that is reduced to finding strongly connected components (SCCs) in the state space of the product. In case of concurrent systems, where the phenomenon of state space explosion often prevents the successful verification, the so-called saturation algorithm has proved its efficiency in state space exploration. This paper proposes a new approach that leverages the saturation algorithm both as an iteration strategy constructing the product directly, as well as in a new fixed-point computation algorithm to find strongly connected components on-the-fly by incrementally processing the components of the model. Complementing the search for SCCs, explicit techniques and component-wise abstractions are used to prove the absence of counterexamples. The resulting on-the-fly, incremental LTL model checking algorithm proved to scale well with the size of models, as the evaluation on models of the Model Checking Contest suggests

Investment in online self-evaluation tests: A theoretical approach

BACKGROUND: Large-scale traumatic events may burden any affected public health system with consequential charges. One major post-disaster, expense factor emerges form early psychological interventions and subsequent, posttraumatic mental health care. Due to the constant increase in mental health care costs, also post-disaster public mental health requires best possible, cost-effective care systems. Screening and monitoring the affected population might be one such area to optimize the charges. METHODS: This paper analyzes the potential cost-effectiveness of monitoring a psychologically traumatized population and to motivate individuals at risk to seek early treatment. As basis for our model served Grossman's health production function, which was modified according to fundamental concepts of cost-benefit analyzes, to match the basic conditions of online monitoring strategies. We then introduce some fundamental concepts of cost-benefit analysis. RESULTS: When performing cost-benefit analyses, policy makers have to consider both direct costs (caused by treatment) and indirect costs (due to non-productivity). Considering both costs sources we find that the use of Internet-based psychometric screening instruments may reduce the duration of future treatment, psychological burden and treatment costs. CONCLUSION: The identification of individuals at risk for PTSD following a disaster may help organizations prevent both the human and the economic costs of this disease. Consequently future research on mental health issues should put more emphasis on the importance of monitoring to detect early PTSD and focus the most effective resources within early treatment and morbidity prevention

The HAPPY (Healthy and Active Parenting Programmme for early Years) feasibility randomised control trial: acceptability and feasibility of an intervention to reduce infant obesity.

The prevalence of infant obesity is increasing, but there is a lack of evidence-based approaches to prevent obesity at this age. This study tested the acceptability and feasibility of evaluating a theory-based intervention aimed at reducing risk of obesity in infants of overweight/obese women during and after pregnancy: the Healthy and Active Parenting Programme for Early Years (HAPPY).A feasibility randomised controlled trial was conducted in Bradford, England. One hundred twenty overweight/obese pregnant women (Body Mass Index [BMI] ≥25 kg/m(2)) were recruited between 10-26 weeks gestation. Consenting women were randomly allocated to HAPPY (6 antenatal, 6 postnatal sessions: N = 59) or usual care (N = 61). Appropriate outcome measures for a full trial were explored, including: infant's length and weight, woman's BMI, physical activity and dietary intake of the women and infants. Health economic data were collected. Measurement occurred before randomisation and when the infant was aged 6 months and 12 months. Feasibility outcomes were: recruitment/attrition rates, and acceptability of: randomisation, measurement, and intervention. Intra-class correlations for infant weight were calculated. Fidelity was assessed through observations and facilitator feedback. Focus groups and semi-structured interviews explored acceptability of methods, implementation, and intervention content.Recruitment targets were met (~20 women/month) with a recruitment rate of 30 % of eligible women (120/396). There was 30 % attrition at 12 months; 66 % of recruited women failed to attend intervention sessions, but those who attended the first session were likely to continue to attend (mean 9.4/12 sessions, range 1-12). Reaction to intervention content was positive, and fidelity was high. Group clustering was minimal; an adjusted effect size of -0.25 standard deviation scores for infant weight at 12 months (95 % CI: -0.16-0.65) favouring the intervention was observed using intention to treat analyses. No adverse events were reported.The HAPPY intervention appeared feasible and acceptable to participants who attended and those delivering it, however attendance was low; adaptations to increase initial attendance are recommended. Whilst the study was not powered to detect a definitive effect, our results suggest a potential to reduce risk of infant obesity. The evidence reported provides valuable lessons to inform progression to a definitive trial.Current Controlled Trials ISRCTN56735429

Intrinsic gain modulation and adaptive neural coding

In many cases, the computation of a neural system can be reduced to a receptive field, or a set of linear filters, and a thresholding function, or gain curve, which determines the firing probability; this is known as a linear/nonlinear model. In some forms of sensory adaptation, these linear filters and gain curve adjust very rapidly to changes in the variance of a randomly varying driving input. An apparently similar but previously unrelated issue is the observation of gain control by background noise in cortical neurons: the slope of the firing rate vs current (f-I) curve changes with the variance of background random input. Here, we show a direct correspondence between these two observations by relating variance-dependent changes in the gain of f-I curves to characteristics of the changing empirical linear/nonlinear model obtained by sampling. In the case that the underlying system is fixed, we derive relationships relating the change of the gain with respect to both mean and variance with the receptive fields derived from reverse correlation on a white noise stimulus. Using two conductance-based model neurons that display distinct gain modulation properties through a simple change in parameters, we show that coding properties of both these models quantitatively satisfy the predicted relationships. Our results describe how both variance-dependent gain modulation and adaptive neural computation result from intrinsic nonlinearity.Comment: 24 pages, 4 figures, 1 supporting informatio