Vitamin B12 Deficiency due to Chlorofluorocarbon: A Case Report

Background. Vitamin B12 is vital for optimal functioning of various organ systems but more importantly the central nervous system and the hematological system. Deficiency of vitamin B12 clinically manifests as excessive daytime fatigue, memory difficulties, encephalopathy, myelopathy, peripheral neuropathy, and optic neuropathy. In occupational medicine, vitamin B12 deficiency has been reported with exposure to nitrous oxide in health care workers. However, not much is known about exposure to Freons in other industries and vitamin B12 deficiency. Aim. We are reporting a case of vitamin B12 deficiency in the setting of exposure to chlorofluorocarbon (CFC) gases. Case Report. A 55-year-old male refrigerator mechanic experienced recurrent visual symptoms, which included diplopia and blurring. A complete workup was done and was significant of vitamin B12 deficiency. However, his B12 levels were refractory to supplementation. Appropriate precautions at workplace improved patient's symptoms and were associated with significant improvement in B12 levels. Conclusion. To the best of our knowledge, this is the first reported case of vitamin B12 deficiency (that remains refractory to supplementation) in the setting of exposure to Freon gases

A Novel Approach to PID Controller Design for Improvement of Transient Stability and Voltage Regulation of Nonlinear Power System

In this paper, a novel design method for determining the optimal PID controller parameters for non-linear power system using the particle swarm optimization (PSO) algorithm is presented. The direct feedback linearization (DFL) technique is used to linearize the nonlinear system for computing the PID (DFL-PID) controller parameters. By taking an example of single machine infinite bus (SMIB) power system it has been shown that PSO based PID controller stabilizes the system and restores the pre-fault system performance after fault is cleared and line is restored. The performance of this controlled system is compared with the performance of DFL-state feedback controlled power system. It has been shown that the performance of DFL-PID controlled system is superior compared to DFL-state feedback controlled system. For simulation MATLAB 7 software is used.

Giant magnetoelectric coupling interaction in BaTiO3/BiFeO3/BaTiO3 trilayer multiferroic heterostructures

Multiferroic trilayer thin films of BaTiO3/BiFeO3/BaTiO3 were prepared by RF-magnetron sputtering technique at different thicknesses of BiFeO3 layer. A pure phase polycrystalline growth of thin films was confirmed from X-ray diffraction results. The film showed maximum remnant electric polarization (2P(r)) of 13.5 mu C/cm(2) and saturation magnetization (M-s) of 61 emu/cc at room temperature. Thermally activated charge transport dominated via oxygen vacancies as calculated by their activation energy, which was consistent with current-voltage characteristics. Magnetic field induced large change in resistance and capacitance of grain, and grain boundary was modeled by combined impedance and modulus spectroscopy in the presence of varied magnetic fields. Presence of large intrinsic magnetoelectric coupling was established by a maximum 20% increase in grain capacitance (C-g) with applied magnetic field (2 kG) on trilayer having 20 nm BiFeO3 layer. Substantially higher magnetoelectric coupling in thinner films has been observed due to bonding between Fe and Ti atoms at interface via oxygen atoms. Room temperature magnetoelectric coupling was confirmed by dynamic magnetoelectric coupling, and maximum longitudinal magnetoelectric coupling of 515 mV/cm-Oe was observed at 20 nm thickness of BiFeO3. The observed magnetoelectric properties are potentially useful for novel room temperature magnetoelectric and spintronic device applications for obtaining higher voltage at lower applied magnetic field

First Results on Survival from a Large Phase 3 Clinical Trial of an Autologous Dendritic Cell Vaccine in Newly Diagnosed Glioblastoma

Background: Standard therapy for glioblastoma includes surgery, radiotherapy, and temozolomide. This Phase 3 trial evaluates the addition of an autologous tumor lysate-pulsed dendritic cell vaccine (DCVax®-L) to standard therapy for newly diagnosed glioblastoma. Methods: After surgery and chemoradiotherapy, patients were randomized (2:1) to receive temozolomide plus DCVax-L (n = 232) or temozolomide and placebo (n = 99). Following recurrence, all patients were allowed to receive DCVax-L, without unblinding. The primary endpoint was progression free survival (PFS); the secondary endpoint was overall survival (OS). Results: For the intent-to-treat (ITT) population (n = 331), median OS (mOS) was 23.1 months from surgery. Because of the cross-over trial design, nearly 90% of the ITT population received DCVax-L. For patients with methylated MGMT (n = 131), mOS was 34.7 months from surgery, with a 3-year survival of 46.4%. As of this analysis, 223 patients are ≥ 30 months past their surgery date; 67 of these (30.0%) have lived ≥ 30 months and have a Kaplan-Meier (KM)-derived mOS of 46.5 months. 182 patients are ≥ 36 months past surgery; 44 of these (24.2%) have lived ≥ 36 months and have a KM-derived mOS of 88.2 months. A population of extended survivors (n = 100) with mOS of 40.5 months, not explained by known prognostic factors, will be analyzed further. Only 2.1% of ITT patients (n = 7) had a grade 3 or 4 adverse event that was deemed at least possibly related to the vaccine. Overall adverse events with DCVax were comparable to standard therapy alone. Conclusions: Addition of DCVax-L to standard therapy is feasible and safe in glioblastoma patients, and may extend survival

NRG/RTOG 0837: Randomized, Phase II, Double-Blind, Placebo-Controlled Trial of Chemoradiation With or Without Cediranib in Newly Diagnosed Glioblastoma

BACKGROUND: A randomized, phase II, placebo-controlled, and blinded clinical trial (NCT01062425) was conducted to determine the efficacy of cediranib, an oral pan-vascular endothelial growth factor receptor tyrosine kinase inhibitor, versus placebo in combination with radiation and temozolomide in newly diagnosed glioblastoma. METHODS: Patients with newly diagnosed glioblastoma were randomly assigned 2:1 to receive (1) cediranib (20 mg) in combination with radiation and temozolomide; (2) placebo in combination with radiation and temozolomide. The primary endpoint was 6-month progression-free survival (PFS) based on blinded, independent radiographic assessment of postcontrast T1-weighted and noncontrast T2-weighted MRI brain scans and was tested using a 1-sided RESULTS: One hundred and fifty-eight patients were randomized, out of which 9 were ineligible and 12 were not evaluable for the primary endpoint, leaving 137 eligible and evaluable. 6-month PFS was 46.6% in the cediranib arm versus 24.5% in the placebo arm ( CONCLUSIONS: This study met its primary endpoint of prolongation of 6-month PFS with cediranib in combination with radiation and temozolomide versus placebo in combination with radiation and temozolomide. There was no difference in overall survival between the 2 arms

Cancer Stem Cell Assay-Guided Chemotherapy Improves Survival of Patients With Recurrent Glioblastoma in a Randomized Trial

Therapy-resistant cancer stem cells (CSCs) contribute to the poor clinical outcomes of patients with recurrent glioblastoma (rGBM) who fail standard of care (SOC) therapy. ChemoID is a clinically validated assay for identifying CSC-targeted cytotoxic therapies in solid tumors. In a randomized clinical trial (NCT03632135), the ChemoID assay, a personalized approach for selecting the most effective treatment from FDA-approved chemotherapies, improves the survival of patients with rGBM (2016 WHO classification) over physician-chosen chemotherapy. In the ChemoID assay-guided group, median survival is 12.5 months (95% confidence interval [CI], 10.2-14.7) compared with 9 months (95% CI, 4.2-13.8) in the physician-choice group (p = 0.010) as per interim efficacy analysis. The ChemoID assay-guided group has a significantly lower risk of death (hazard ratio [HR] = 0.44; 95% CI, 0.24-0.81; p = 0.008). Results of this study offer a promising way to provide more affordable treatment for patients with rGBM in lower socioeconomic groups in the US and around the world

Correction to: First results on survival from a large Phase 3 clinical trial of an autologous dendritic cell vaccine in newly diagnosed glioblastoma

Following publication of the original article [1], the authors reported an error in the spelling of one of the author names. In this Correction the incorrect and correct author names are indicated and the author name has been updated in the original publication. The authors also reported an error in the Methods section of the original article. In this Correction the incorrect and correct versions of the affected sentence are indicated. The original article has not been updated with regards to the error in the Methods section.https://deepblue.lib.umich.edu/bitstream/2027.42/144529/1/12967_2018_Article_1552.pd

Performance comparison of two solar cooking storage pots combined with wonderbag slow cookers for off-sunshine cooking

Two similar storage cooking pots are experimentally evaluated and compared during solar cooking and storage off-sunshine cooking periods. One storage pot has sunflower oil as the sensible heat storage material, while the other has erythritol as the phase change material (PCM). To test their thermal performance during off-sunshine periods, the two pots are placed in insulated wonderbag slow cookers. Water and sunflower oil are used as the cooking fluids in the experimental tests. The sunflower oil cooking pot shows better performance during the solar cooking periods since it shows shorter cooking times (1.8–5.6 h) compared to the erythritol PCM pot (3.8–6.6 h). The sunflower oil pot also attains higher maximum storage temperatures (124–145 °C) compared to the erythritol PCM pot (118–140 °C). Storage efficiencies for the sunflower oil pot (3.0–7.1%) are also greater than those of the PCM pot (2.5–3.7%). During the storage cooking periods, the erythritol based phase change material cooking pot shows better performance as evidenced by the lower temperature drops (0.1–9.7 °C) from the maximum cooking temperatures compared to 8.3 to 34 °C for the sunflower oil pot. The heat utilisation efficiencies for the erythritol pot (4.8–14.3%) are also greater compared to the sunflower oil pot (3.7–6%)

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe