CAR T-Cell Therapy: A New Road to Treat Cancer

Accounts of cancer have been around for many centuries. The ‘War on Cancer’ has officially been going on since 1971 with the passing of the National Cancer Act. The aim of this was to understand more about the behavior and biology of cancer in addition to the development of efficacious drug therapies. Although such therapies have been discovered and developed, the precision of ‘traditional chemotherapeutics’ have shown not to be as precise as desired. For example, these drugs aim to kill cancer cells that are dividing at a higher rate than normal relative noncancerous cells. However, noncancerous cells that require to divide rapidly (gut, epidermis, keratinocytes of the scalp) are prone to these traditional chemotherapies and as such patients experience undesirable side effects. The aim of this paper is to address the development of a novel cellular-based cancer therapy called CAR T-cell therapy. The structure of such a therapy enables greater precision than traditional chemotherapies and potentially greater efficacy than standard cancer immunotherapy drugs. The structure, function, and cytotoxic mechanisms of CAR T-cells will be addressed along with landmark clinical trials that have lead to the US FDA approval of two CAR T-cell therapies. In addition to successes, consequences of this therapy will be discussed involving toxicities, economic costs, and hardships against solid tumors

How banks can self-monitor their lending to comply with the equal credit opportunity act

The authors provide a step-by-step discussion of how an individual lender in the United States can self-monitor its loan process for compliance with the Equal Credit Opportunity Act and provide an empirical example for illustration. Along the way, they discuss the problems faced by individual lenders who attempt to self-monitor their lending process and conclude with a discussion of the continuing, constructive role for bank examiners and regulators in this endeavor.Regulation B: Equal Credit Opportunity

Aerodynamic shape optimization of a low drag fairing for small livestock trailers

Small livestock trailers are commonly used to transport animals from farms to market within the United Kingdom. Due to the bluff nature of these vehicles there is great potential for reducing drag with a simple add-on fairing. This paper explores the feasibility of combining high-fidelity aerodynamic analysis, accurate metamodeling, and efficient optimization techniques to find an optimum fairing geometry which reduces drag, without significantly impairing internal ventilation. Airflow simulations were carried out using Computational Fluid Dynamics (CFD) to assess the performance of each fairing based on three design variables. A Moving Least Squares (MLS) metamodel was built on a fifty-point Optimal Latin Hypercube (OLH) Design of Experiments (DoE), where each point represented a different geometry configuration. Traditional optimization techniques were employed on the metamodel until an optimum geometrical configuration was found. This optimum design was tested using CFD and it matched closely to the metamodel prediction. Further, the drag reduction was measured at 14.4% on the trailer and 6.6% for the combined truck and trailer

A Computational Study of UV disinfection performance within a naturally ventilated hospital ward

The airborne transmission of pathogens including tuberculosis and influenza pose a significant threat to human health. This is especially the case in healthcare settings such as hospital wards which inevitably contain a high concentration of viruses and bacteria. These have the potential to infect both patients with weakened immune systems and healthcare workers. In order to reduce the infection risk, improvements in hospital ward design and the application of disinfection systems can offer significant benefits. One such strategy, upper-room Ultraviolet Germicidal Irradiation (UVGI), relies on a collimated irradiance field which works in conjunction with ventilation patterns to disinfect the air. The focus of this study is to predict the UVGI system performance within a naturally ventilated hospital ward, for a range of ambient conditions using Computational Fluid Dynamics (CFD). A computer model of an open-plan six-bed Nightingale-style hospital ward was generated based on the dimensions of a former hospital building situated in Bradford, UK. With a total volume of 200 m3, natural ventilation is supplied through three casement windows and a further three openings on the leeward side ensure steady cross-ventilation. Boundary conditions are based on experimental measurements of the ventilation rate which were determined using a tracer technique. An experimentally-determined irradiance field is included in the model and stored as a fixed-value scalar field. A total of fifty steady-state CFD simulations show that disinfection performance depends on the ventilation rate, the degree of mixing present and the position of the UVGI fixture within the ward. The results underline the potential performance gains from UVGI installations and how they could be integrated within existing healthcare facilities as an infection control measure

Mechanisms of tissue injury in lupus nephritis

Systemic lupus erythematosus is a prototypic autoimmune disease characterized by autoantibody production and immune complex formation/deposition in target organs such as the kidney. Resultant local inflammation then leads to organ damage. Nephritis, a major cause of morbidity and mortality in patients with lupus, occurs in approximately 50% of lupus patients. In the present review, we provide an overview of the current research and knowledge concerning mechanisms of renal injury in both lupus-prone mouse models and human lupus patients

Ultrastructural Variation in Enamel of Australian Marsupials

This paper initiates a survey of the enamel of fossil and extant Australian marsupials by scanning electron microscopy. Enamel was examined from 17 extant and 11 extinct marsupials. Assessment was made of prism packing pattern, prism course, tubule presence, tubule size and distribution. Values calculated were: prism diameter; prism axis ratio; cross-sectional prism area; cross-sectional ameloblast area; and numerical prism density. Three different prism packing arrangements were found for extant and fossil marsupials within the classical Pattern 2. The Pattern 1 arrangement found in three extant species was relatively unexpected given the general acceptance of Marsupialia as having Pattern 2 enamel. Attention is drawn to the variable loss of prism demarcation towards the outer enamel surface. The majority of both extant and fossil marsupials exhibited a simple radial prism course. Prism diameters were small ranging from 1.4 μm to 3.9 μm and prism densities were high, compared to those for human and multituberculate enamel. A significant inter-species variation was noted in the presence and size of enamel tubules. The absence of enamel tubules in the incisors of D. optatum, N. tedfordi and T. rostratus and the molar of W. wakefieldi was confirmed. Large bulbous spaces were found either along or at the termination of enamel tubules in some teeth of five fossil species: these spaces may represent the resting place of an ameloblast. We have found: a greater variation in prism packing patterns; a greater difference in characteristics studied between incisor and molar teeth; and a greater variety of tubule morphology than anticipated. There are signs that useful enamel ultrastructural characters are emerging to help ultimately with taxonomic investigations of Australian marsupials

Functional recovery of a resilient hospital type

Four adaptation options for ‘Nightingale’-type hospital ward buildings devised with practising clinicians are presented and evaluated. The adaptations recover functionality in an archaic ward configuration by delivering care to current UK National Health Service (NHS) models whilst preserving resilience to summer overheating. The investigation builds on recent work that demonstrates the significant resilience to heatwaves enjoyed by such traditionally constructed communal dormitories, the dominant UK hospital type between the late 1850s and 1939. Nightingale wards are potentially well-ventilated naturally, with good dilution of airborne pathogens. Although condemned as outdated by health ministers in recent years, many remain in use. As financial retrenchment suggests economical, creative refurbishment of hospitals will be required rather than new-build and replacement, the authors argue for health estates’ strategies that place value on resilience in a changing climate. Proposed adaptation options are investigated to assess resulting internal airflows and patient exposure to airborne pathogens. Options are costed and payback periods calculated to the standard public sector methodology. The proposed adaptations save time and cost over new-build equivalents. Selection of the most appropriate option is dependent on the characteristics of the patient cohort and care required.Four adaptation options for ‘Nightingale’-type hospital ward buildings devised with practising clinicians are presented and evaluated. The adaptations recover functionality in an archaic ward configuration by delivering care to current UK National Health Service (NHS) models whilst preserving resilience to summer overheating. The investigation builds on recent work that demonstrates the significant resilience to heatwaves enjoyed by such traditionally constructed communal dormitories, the dominant UK hospital type between the late 1850s and 1939. Nightingale wards are potentially well-ventilated naturally, with good dilution of airborne pathogens. Although condemned as outdated by health ministers in recent years, many remain in use. As financial retrenchment suggests economical, creative refurbishment of hospitals will be required rather than new-build and replacement, the authors argue for health estates’ strategies that place value on resilience in a changing climate. Proposed adaptation options are investigated to assess resulting internal airflows and patient exposure to airborne pathogens. Options are costed and payback periods calculated to the standard public sector methodology. The proposed adaptations save time and cost over new-build equivalents. Selection of the most appropriate option is dependent on the characteristics of the patient cohort and care required.This is the final published version distributed under a Creative Commons Attribution License 2.0, which can also be viewed on the publisher's website at: http://www.tandfonline.com/doi/full/10.1080/09613218.2014.926605#.U8ZFv_ldXH