The Ebola Experience: Media Lessons For Nurse Leaders

Background: In October, 2014 the nursing profession gained unprecedented media attention when two nurses became infected with the Ebola virus, and another nurse who cared for Ebola patients defied two gubernatorial quarantine orders. Nurses have traditionally received little media attention, and the nursing profession was largely unprepared for the intense media scrutiny which occurred during the Ebola crisis. Purpose: For decades nursing scholars have called for a new media image for the nursing profession, yet most of the nursing literature has focused on the profession’s poor media image rather than effective media communication techniques. The purpose of this paper is to review evidence of effective media communication strategies using the Ebola news story as context. Method: An extensive literature search was conducted including evidence of effective public relations strategies as well as identification of media needs during public health crises. The literature was cited in the context of the Ebola news story, in which various developments were compared with evidence of effective crisis communication strategies. Discussion: Various communication missteps as well as contradictory press statements fueled media mistrust and intensified news coverage during the Ebola controversy. As central figures in the Ebola news story, nurses were largely unprepared to effectively respond to the media during the crisis. Conclusion: Nurses could greatly benefit from media training which focuses on effective public health crisis communication techniques as well as identification of media needs during public health crises

Strait Talk: United States Containment of Communism in the Taiwan Strait

Since the conclusion of the Chinese Civil War, the Republic of China (ROC) and the People’s Republic of China (PRC) have maintained a complex relationship in which the PRC claims that the ROC is a PRC province, even though the ROC has its own two-party democratic system. The political separation of the ROC and the PRC is an exigent concern for the PRC, one that the PRC has threatened using military force to resolve. This thesis examines the military and political aspects of US involvement in the Asia Pacific during the Cold War, and how the United States used its security relationship with the ROC to establish a hegemonic presence and deter PRC aggressions against the ROC

Counterfeiting: A Challenge to Forensic Science, the Criminal Justice System, and Its Impact on Pharmaceutical Innovation

Counterfeit drugs threaten public health and present unique and complex challenges to the criminal justice system and the field of forensic science. Theft of intellectual property in the pharmaceutical industry has caused sickness and death, and it is necessary that the perpetrators of these crimes are brought to justice. In some cases, threats to health and safety are short term; in others they are long term. This research describes these threats in detail. The problem is complex, and there are many important factors that need to be considered to successfully address the problem. Public-health challenges, drug-development challenges, legal challenges, issues of public policy, and financial considerations are all important aspects of the problem that need to be understood. This research describes these details so that appropriate solutions can be proposed. The field of forensic science struggles to establish analytical methods to identity composition and establish provenance of counterfeit goods. No method has been shown to be universally applied to achieve this goal. The use of field-portable instruments to detect and identify counterfeits in the field is important emerging technology. These instruments must work quickly and accurately. This research defines the challenges faced by the field of forensic science and proposes methods that may be used to address these challenges. This will enable forensic scientists to provide support to law enforcement and other members of the criminal justice and legal systems to successfully investigate and adjudicate these crimes

The effects of fluid milk in attenuating postprandial hyperglycemia and hypertriglyceridemia

The increased risk of cardiovascular disease (CVD) and vascular dysfunction that is associated with postprandial hyperglycemia and hypertriglyceridemia may be reduced with consumption of non-fat dairy products. Due to the insulinotropic effect of milk-derived proteins, postprandial hyperglycemia has been shown to be reduced with the addition of dairy products. The purpose of Study 1 was to determine if one serving of non-fat milk added to an oral glucose tolerance test (OGTT) could attenuate postprandial hyperglycemia in individuals with elevated android adiposity independent of the effects of the milk’s protein content and whether these improvements would be associated with metabolic and/or peripheral hemodynamic effects. In this placebo controlled, randomized, crossover experimental study, twenty-nine overweight/obese adults consumed an OGTT combined with either non-fat milk or a placebo control. In the whole sample, blood glucose and insulin concentrations increased over time in both trials with no differences between trials. When the subjects were divided into tertiles of android body fat, the highest tertile displayed attenuated hyperglycemic responses as well as improvements in flow-mediated dilation during the milk intervention. Repeated exposure to elevated postprandial triglycerides, as seen with typical Western diets, contributes to atherosclerosis and vascular disease. The purpose of Study 2 was to determine if a single serving of non-fat milk added to a high fat meal could attenuate postprandial hypertriglyceridemia in individuals who consume a high fat diet. In this placebo controlled, randomized, crossover experimental study, thirty overweight/obese adults consumed a high fat meal combined with either non-fat milk, carbohydrate control, or caloric control. In the whole sample, plasma triglycerides increased over time with no differences between interventions. When participants were ranked and divided based on habitual dietary fat intake, the high fat diet group exhibited reduced triglycerides when supplemented with non-fat milk. No differences in hemodynamic measures (brachial flow-mediated dilation and femoral vascular conductance) were observed between the milk and caloric control trials for either the low fat or high fat diet groups. Taken together, the results indicate that a single serving of non-fat milk may attenuate acute hyperglycemia and hypertriglyceridemia in individuals that present with specific risk factors for CVD.Kinesiology and Health Educatio

APRICOT: A Dataset of Physical Adversarial Attacks on Object Detection

Physical adversarial attacks threaten to fool object detection systems, but reproducible research on the real-world effectiveness of physical patches and how to defend against them requires a publicly available benchmark dataset. We present APRICOT, a collection of over 1,000 annotated photographs of printed adversarial patches in public locations. The patches target several object categories for three COCO-trained detection models, and the photos represent natural variation in position, distance, lighting conditions, and viewing angle. Our analysis suggests that maintaining adversarial robustness in uncontrolled settings is highly challenging, but it is still possible to produce targeted detections under white-box and sometimes black-box settings. We establish baselines for defending against adversarial patches through several methods, including a detector supervised with synthetic data and unsupervised methods such as kernel density estimation, Bayesian uncertainty, and reconstruction error. Our results suggest that adversarial patches can be effectively flagged, both in a high-knowledge, attack-specific scenario, and in an unsupervised setting where patches are detected as anomalies in natural images. This dataset and the described experiments provide a benchmark for future research on the effectiveness of and defenses against physical adversarial objects in the wild.Comment: 23 pages, 14 figures, 3 tables. Updated version as accepted to ECCV 202

Antitumor activity and safety of the PARP inhibitor rucaparib in patients with high grade ovarian carcinoma and a germline or somatic BRCA1 or BRCA2 mutation: integrated analysis of data from Study 10 and ARIEL2

Objective: An integrated analysis was undertaken to characterize the antitumor activity and safety profile of the oral poly(ADP-ribose) polymerase inhibitor rucaparib in patients with relapsed high-grade ovarian carcinoma (HGOC). Methods: Eligible patients from Study 10 (NCT01482715) and ARIEL2 (NCT01891344) who received a starting dose of oral rucaparib 600 mg twice daily (BID) with or without food were included in these analyses. The integrated efficacy population included patients with HGOC and a deleterious germline or somatic BRCA1 or BRCA2 (BRCA1/2) mutation who received at least two prior chemotherapies and were sensitive, resistant, or refractory to platinum-based chemotherapy. The primary endpoint was investigator-assessed confirmed objective response rate (ORR). Secondary endpoints included duration of response (DOR) and progression-free survival (PFS). The integrated safety population included patients with HGOC who received at least one dose of rucaparib 600 mg BID, irrespective of BRCA1/2 mutation status and prior treatments. Results: In the efficacy population (n = 106), ORR was 53.8% (95% confidence interval [CI], 43.8–63.5); 8.5% and 45.3% of patients achieved complete and partial responses, respectively. Median DOR was 9.2 months (95% CI, 6.6–11.6). In the safety population (n = 377), the most frequent treatment-emergent adverse events (AEs) were nausea, asthenia/fatigue, vomiting, and anemia/hemoglobin decreased. The most common grade ≥ 3 treatment-emergent AE was anemia/hemoglobin decreased. Treatment-emergent AEs led to treatment interruption, dose reduction, and treatment discontinuation in 58.6%, 45.9%, and 9.8% of patients, respectively. No treatment-related deaths occurred. Conclusions: Rucaparib has antitumor activity in advanced BRCA1/2-mutated HGOC and a manageable safety profile

Human Very Small Embryonic-Like Cells Generate Skeletal Structures, In Vivo

Human very small embryonic-like (hVSEL) cells are a resident population of multipotent stem cells in the bone marrow involved in the turnover and regeneration of tissues. The levels of VSEL cells in blood are greatly increased in response to injury, and they have been shown to repair injured tissues. Adult hVSEL cells, SSEA-4+/CD133+/CXCR4+/Lin?/CD45?, express the pluripotency markers (Oct-4 and Nanog) and may be able to differentiate into cells from all 3 germ lineages. hVSEL cells isolated from blood by apheresis following granulocyte?colony-stimulating factor mobilization were fractionated and enriched by elutriation and fluorescence activated cell sorting. Collagen sponge scaffolds containing 2,000?30,000 hVSEL cells were implanted into cranial defects generated in SCID mice. Analysis by microcomputed tomography showed that a cell population containing VSEL cells produced mineralized tissue within the cranial defects compared with controls at 3 months. Histologic studies showed significant bone formation and cellular organization within the defects compared with cellular or scaffold controls alone. Antibodies to human leukocyte antigens demonstrated that the newly generated tissues were of human origin. Moreover, human osteocalcin was identified circulating in the peripheral blood. There was evidence that some level of hVSEL cells migrated away from the defect site, using quantitative real-time polymerase chain reaction to detect for human-specific Alu sequences. This study demonstrates that hVSEL cells are able to generate human bone tissue in a mouse model of skeletal repair. These studies lay the foundation for future cell-based regenerative therapies for osseous and connective tissue disorders, including trauma and degenerative conditions, such as osteoporosis, fracture repair, and neoplastic repair.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140198/1/scd.2012.0327.pd

Tolerability of maintenance olaparib in newly diagnosed patients with advanced ovarian cancer and a BRCA mutation in the randomized phase III SOLO1 trial

OBJECTIVES. In the phase III SOLO1 trial (NCT01844986), maintenance olaparib provided a substantial progression-free survival benefit in patients with newly diagnosed, advanced ovarian cancer and a BRCA mutation who were in response after platinum-based chemotherapy. We analyzed the timing, duration and grade of the most common hematologic and non-hematologic adverse events in SOLO1. METHODS. Eligible patients were randomized to olaparib tablets 300 mg twice daily (N = 260)or placebo (N = 131), with a 2-year treatment cap in most patients. Safety outcomes were analyzed in detail in randomized patients who received at least one dose of study drug (olaparib, n = 260; placebo, n = 130). RESULTS. Median time to first onset of the most common hematologic (anemia, neutropenia, thrombocytopenia) and non-hematologic (nausea, fatigue/asthenia, vomiting) adverse events was <3 months in olaparibtreated patients. The first event of anemia, neutropenia, thrombocytopenia, nausea and vomiting lasted a median of <2 months and the first event of fatigue/asthenia lasted a median of 3.48 months in the olaparib group. These adverse events were manageable with supportive treatment and/or olaparib dose modification in most patients, with few patients requiring discontinuation of olaparib. Of 162 patients still receiving olaparib at month 24, 64.2% were receiving the recommended starting dose of olaparib 300 mg twice daily. CONCLUSIONS. Maintenance olaparib had a predictable and manageable adverse event profile in the newly diagnosed setting with no new safety signals identified. Adverse events usually occurred early, were largely manageable and led to discontinuation in a minority of patients