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

Targeting the antigen processing and presentation pathway to overcome resistance to immune checkpoint therapy

Despite the significant clinical advances with the use of immune checkpoint inhibitors (ICIs) in a wide range of cancer patients, response rates to the therapy are variable and do not always result in long-term tumor regression. The development of ICI-resistant disease is one of the pressing issue in clinical oncology, and the identification of new targets and combination therapies is a crucial point to improve response rates and duration. Antigen processing and presentation (APP) pathway is a key element for an efficient response to ICI therapy. Indeed, malignancies that do not express tumor antigens are typically poor infiltrated by T cells and unresponsive to ICIs. Therefore, improving tumor immunogenicity potentially increases the success rate of ICI therapy. In this review, we provide an overview of the key elements of the APP machinery that can be exploited to enhance tumor immunogenicity and increase the efficacy of ICI-based immunotherapy

Prolonged hospitalisation for immigrants and high risk patients with positive smear pulmonary tuberculosis.

Background and objective. Tuberculosis (TB) occurring in immigrants and resistance to drugs are major problems for TB control in Western countries. Directly observed therapy (DOT) reduces disease transmission, but this approach may have poor results among illegal immigrants. Our aim was to evaluate a prolonged hospitalisation programme to improve early outcome of TB treatment in high risk patients. Methods. All the consecutive adult patients with sputum smear-positive pulmonary TB admitted to 2 Italian referral TB Centres were evaluated. Hospital-based DOT was provided to high risk patients up-to smear conversion. Demographic, microbiological and clinical conditions, as potential factors associated with confirmed smear conversion at 60 and 90 days of anti-tuberculous therapy were evaluated. Results. 122 patients were studied, 45.9% of them were immigrants (20% illegal) from high-prevalence TB countries. HIV testing was negative in all cases. Twelve patients had M. tuberculosis resistant to ≥ 1 first-line anti-tuberculous agents. The rate of defaulting from TB treatment was 7.3%. Sputum smear became negative in 84.4% cases after 60 days and 93.3% cases after 90 days. At such time, smear conversion rates were similar among different high risk subgroups such as illegal immigrants (95.9%), legal foreign-born (92.5%) and Italian persons (94.8%). Persistent sputum smear positivity was independently correlated with the extent of pulmonary lesions at 60 (p&lt;0.0001) and 90 days (p=0.038) of hospital-based DOT. Conclusions. These findings suggest that prolonged hospitalisation for illegal immigrants and high risk TB patients, may positively influence the early outcome of TB treatment despite of drug resistance and legal status