Integration of different MBSE approaches within the design of a control maintenance system applied to the aircraft fuel system

The design of a control maintenance system (CMs) deeply deals with the mission, the on–board systems interfaces and the identification of their behaviour in operation. This paper describes how the Model Based Systems Engineering (MBSE) was applied to an industrial test case to perform the functional design of an innovative CMs to be integrated with the aircraft fuel system (Fs). The impact of different approaches applied when modelling the two systems through the SysML on their integration was investigated. As the IBM Rational Rhapsody® tool was used, the Harmony® methodology was applied to the CMs, while a MBSE customized approach was implemented for the Fs, even to cope with some differences in coupling an avionic system to a physical one

Impact Of A Steam Lab On Science Achievement And Attitudes For Girls

This research identifies a problem of practice with standardized science test scores declining over the last eight years. The Sea Turtle Elementary School for the Creative Arts (STESCA; pseudonym) schedule allowed 150 minutes per week for science instruction, compared with 450 minutes per week for mathematics instruction. Science instruction has been implemented primarily through direct instruction and the use of textbooks and videos. In addition to the limited instructional time for science and predominant use of direct instructional methods, there is a lack of racially diverse and female role models evident in the curriculum. With STESCA’s standardized science test scores declining over the last eight years, the staff has embraced the integration of STEAM (Science, Technology, Engineering, Arts, Math) into the curriculum. The identification of the problem led to the question: Will implementing a STEAM lab that promotes inquiry, cooperative learning, and hands-on activities have a positive impact on science achievement and attitudes towards science of elementary age girls? To answer the question, an action research study was utilized using the four stages: planning, acting, developing, and reflecting (Mertler, 2014). The approach of the action research is through the lens of feminist pedagogy. The action research study was comprised of a one-group pretest-posttest pre-experimental design

Impact of switching from an initial tumor necrosis factor inhibitor on health care resource utilization and costs among patients with rheumatoid arthritis

Onur Başer (MEF Author)Purpose: Despite improved clinical outcomes for the majority of patients, nearly 30% of patients with rheumatoid arthritis (RA) who initiate tumor necrosis factor antagonist (anti-TNF) biologic agents fail to respond to their first-line anti-TNF and switch to another anti-TNF or a non-TNF biologic. How this change affects health care costs and resource utilization is unknown. We therefore compared RA patients taking first-line anti-TNFs who switched to a second anti-TNF versus those patients who switched to an alternate biologic. Methods: Health care claims data were obtained from a large US database for eligible adults with confirmed RA diagnoses who initiated anti-TNF treatment and switched to another biologic. Health care costs and utilization during the first 12 months' postswitch were compared. Generalized linear models were used to adjust for differences in demographic and clinical characteristics before switching. Findings: Patients who switched to a second anti-TNF rather than a non-TNF biologic were generally younger (53.0 vs. 55.3 years; P < 0.0001) and less likely to be female (79.7% vs. 82.7%; P = 0.0490). Of the 3497 eligible patients who switched from first-line anti-TNFs, 2563 (73.3%) switched to another anti-TNF and 934 (26.7%) switched to a non-TNF. Adalimumab was the most frequently prescribed (43.4%) second-line anti-TNF, and abatacept was the most common non anti-TNF (71.4%). Patients who switched to a second anti-TNF remained on their first medication for a significantly shorter period (342.5 vs 420.6 days; P < 0.0001) and had lower comorbidity indices and higher disease severity at baseline than those who switched to a non anti-TNF. After adjusting for baseline differences, patients who switched to second anti-TNFs versus a non-TNF incurred lower RA-related costs ($20,938.9 vs$22,645.2; P = 0.0010) and total health care costs ($34,894.6 vs$38,437.2; P = 0.0010) 1 year postswitch. These differences were driven by increased physician office visit costs among the non-TNF group. Implications: Among the anti-TNF initiators who switched therapy, more patients switched to a second anti-TNF than to a non-TNF. Switching to a second anti-TNF treatment was associated with lower all-cause and RA-related health care costs and resource utilization than switching to a non-TNF. Because switching therapy may be unavoidable, finding a treatment algorithm mitigating this increase to any extent should be considered. These data are limited by their retrospective design. Additional confounding variables that could not be controlled for may affect results. (C) 2015 The Authors. Published by Elsevier HS journals, Inc.WOS:0003593921000082-s2.0-84937640448PMID: 25999184Science Citation Index ExpandedQ2ArticleUluslararası işbirliği ile yapılan - EVETTemmuz2015YÖK - 2014-1

Biologic TNF inhibiting agents for treatment of rheumatoid arthritis: persistence and dosing patterns in Germany

Objective: To obtain detailed real-world data on persistence and dosing patterns in the utilisation of the TNF inhibitors adalimumab, etanercept, and infliximab in rheumatoid arthritis (RA) patients treated in Germany. Methods: In this retrospective observational study claims data of a major German health insurance fund between 2005 and 2008 were analysed. Patients receiving at least one prescription of adalimumab, etanercept or infliximab were identified and categorised as "TNF inhibitor naive" or "TNF inhibitor continuing". For the calculation of TNF inhibitor persistence a survival analysis with the Kaplan-Meier estimator was used. A Cox regression was used to analyse, if any relevant factors were influencing persistence. Dosage increase rates were analysed for adalimumab, etanercept and infliximab. Sensitivity analyses based on variations in gap length were conducted. Results: A total of 2,201 RA patients were identified. 1,468 of these patients were TNF inhibitor naive patients and 733 were defined as TNF inhibitor continuing patients. There were no significant differences in the treatment persistence rates between adalimumab, etanercept and infliximab for TNF inhibitor naive and continuing patients. The persistence rate after three years was 22.47% for adalimumab, 24.27% for etanercept and 21.49% for infliximab naive patients. For continuing patients, the persistence rate after three years was 32.88% for adalimumab, 30.95% for etanercept, and 33.90% for infliximab, respectively. Gender, medication and Charlson Comorbidities Index did not influence the persistence significantly. Dosage increase occurred in 7.3% adalimumab, 1.4% etanercept, and 17.2% infliximab naive patients and 5.8%, 1.1% and 11.9% respectively in the continuing patients. Conclusions: In this study, there were no significant differences in persistence among adalimumab, etanercept and infliximab treated patients. Consistent with previous research, there was a higher dose escalation for infliximab than for the two subcutaneous treatments, adalimumab or etanercept

PMS31 Economic Evaluation of Adalimumab Versus Other Biologic Treatments for Moderate to Severe Psoriatic Arthritis in Italy

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Proline-Rich Tyrosine Kinase 2 and Rac Activation by Chemokine and Integrin Receptors Controls NK Cell Transendothelial Migration

Abstract Protein tyrosine kinase activation is an important requisite for leukocyte migration. Herein we demonstrate that NK cell binding to endothelium activates proline-rich tyrosine kinase 2 (Pyk-2) and the small GTP binding protein Rac that are coupled to integrin and chemokine receptors. Chemokine-mediated, but not integrin-mediated, Pyk-2 and Rac activation was sensitive to pretreatment of NK cells with pertussis toxin, a pharmacological inhibitor of Gi protein-coupled receptors. Both Pyk-2 and Rac are functionally involved in chemokine-induced NK cell migration through endothelium or ICAM-1 or VCAM-1 adhesive proteins, as shown by the use of recombinant vaccinia viruses encoding dominant negative mutants of Pyk-2 and Rac. Moreover, we found that Pyk-2 is associated with the Rac guanine nucleotide exchange factor Vav, which undergoes tyrosine phosphorylation upon integrin triggering. Finally, we provide direct evidence for the involvement of Pyk-2 in the control of both chemokine- and integrin-mediated Rac activation. Collectively, our results indicate that Pyk-2 acts as a receptor-proximal link between integrin and chemokine receptor signaling, and the Pyk-2/Rac pathway plays a pivotal role in the control of NK cell transendothelial migration