Potential Impact of Amantadine on Aggression in Chronic Traumatic Brain Injury

Objective: To assess the effects of amantadine on anger and aggression among individuals with a chronic traumatic brain injury (TBI). Methods: A cohort of 118 persons with chronic TBI (>6 months postinjury) and moderate-severe aggression selected from a larger cohort of 168 participants enrolled in a parallel-group, randomized, double-blind, placebo-controlled trial of amantadine 100 mg twice daily (n = 82) versus placebo (n = 86) for treatment of irritability were studied. Anger and aggression were measured at treatment days 0, 28, and 60 using observer-rated and participant-rated State-Trait Anger Expression Inventory-2 (STAXI-2) and Neuropsychiatric Inventory-Agitation/Aggression domain (NPI-A) Most Problematic and Distress scores. Results: Participant-rated day 60 NPI-A Most Problematic (adjusted P = .0118) and NPI-A Distress (adjusted P = .0118) were statistically significant between the 2 groups, but STAXI-2 differences were not significant after adjustment for multiple comparisons. Substantial improvements were noted in both amantadine and placebo groups (70% vs 56% improving at least 3 points on day 60 Observer NPI-A; P = .11). Conclusion: Amantadine 100 mg twice daily in this population with chronic TBI appears to be beneficial in decreasing aggression from the perspective of the individual with TBI. No beneficial impact on anger was found

Vancomycin Dosing Practices among Critical Care Pharmacists: A Survey of Society of Critical Care Medicine Pharmacists

Introduction: Critically ill patients and their pharmacokinetics present complexities often not considered by consensus guidelines from the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Prior surveys have suggested discordance between certain guideline recommendations and reported infectious disease pharmacist practice. Vancomycin dosing practices, including institutional considerations, have not previously been well described in the critically ill patient population. Objectives: To evaluate critical care pharmacists\u27 self-reported vancomycin practices in comparison to the 2009 guideline recommendations and other best practices identified by the study investigators. Methods: An online survey developed by the Research and Scholarship Committee of the Clinical Pharmacy and Pharmacology (CPP) Section of the Society of Critical Care Medicine (SCCM) was sent to pharmacist members of the SCCM CPP Section practicing in adult intensive care units in the spring of 2017. This survey queried pharmacists\u27 self-reported practices regarding vancomycin dosing and monitoring in critically ill adults. Results: Three-hundred and sixty-four responses were received for an estimated response rate of 26%. Critical care pharmacists self-reported largely following the 2009 vancomycin dosing and monitoring guidelines. The largest deviations in guideline recommendation compliance involve consistent use of a loading dose, dosing weight in obese patients, and quality improvement efforts related to systematically monitoring vancomycin-associated nephrotoxicity. Variation exists regarding pharmacist protocols and other practices of vancomycin use in critically ill patients. Conclusion: Among critical care pharmacists, reported vancomycin practices are largely consistent with the 2009 guideline recommendations. Variations in vancomycin dosing and monitoring protocols are identified, and rationale for guideline non-adherence with loading doses elucidated

Envelope Determinants of Equine Lentiviral Vaccine Protection

Lentiviral envelope (Env) antigenic variation and associated immune evasion present major obstacles to vaccine development. The concept that Env is a critical determinant for vaccine efficacy is well accepted, however defined correlates of protection associated with Env variation have yet to be determined. We reported an attenuated equine infectious anemia virus (EIAV) vaccine study that directly examined the effect of lentiviral Env sequence variation on vaccine efficacy. The study identified a significant, inverse, linear correlation between vaccine efficacy and increasing divergence of the challenge virus Env gp90 protein compared to the vaccine virus gp90. The report demonstrated approximately 100% protection of immunized ponies from disease after challenge by virus with a homologous gp90 (EV0), and roughly 40% protection against challenge by virus (EV13) with a gp90 13% divergent from the vaccine strain. In the current study we examine whether the protection observed when challenging with the EV0 strain could be conferred to animals via chimeric challenge viruses between the EV0 and EV13 strains, allowing for mapping of protection to specific Env sequences. Viruses containing the EV13 proviral backbone and selected domains of the EV0 gp90 were constructed and in vitro and in vivo infectivity examined. Vaccine efficacy studies indicated that homology between the vaccine strain gp90 and the N-terminus of the challenge strain gp90 was capable of inducing immunity that resulted in significantly lower levels of post-challenge virus and significantly delayed the onset of disease. However, a homologous N-terminal region alone inserted in the EV13 backbone could not impart the 100% protection observed with the EV0 strain. Data presented here denote the complicated and potentially contradictory relationship between in vitro virulence and in vivo pathogenicity. The study highlights the importance of structural conformation for immunogens and emphasizes the need for antibody binding, not neutralizing, assays that correlate with vaccine protection. © 2013 Craigo et al

Modeling the impact of melt on seismic properties during mountain building

Initiation of partial melting in the mid/lower crust causes a decrease in P-wave and S-wave velocities; recent studies imply that the relationship between these velocities and melt is not simple. We have developed a modelling approach to assess the combined impact of various melt and solid phase properties on seismic velocities and anisotropy. The modelling is based on crystallographic preferred orientation (CPO) data measured from migmatite samples, allowing quantification of the variation of seismic velocities with varying melt volumes, shapes, orientations, and matrix anisotropy. The results show non-linear behaviour of seismic properties as a result of the interaction of all of these physical properties, which in turn depend on lithology, stress regime, strain rate, pre-existing rock fabrics, and pressure-temperature conditions. This non-linear behaviour is evident when applied to a suite of samples from a traverse across a migmatitic shear zone in the Seiland Igneous Province, Northern Norway. Critically, changes in solid phase composition and CPO, and melt shape and orientation with respect to the wave propagation direction can result in huge variations in the same seismic property even if the melt fraction remains the same. A comparison with surface wave interpretations from tectonically active regions highlights the issues in current models used to predict melt percentages or partially molten regions. Interpretation of seismic data to infer melt percentages or extent of melting should, therefore, always be underpinned by robust modelling of the underlying geological parameters combined with examination of multiple seismic properties in order to reduce uncertainty of the interpretation

A Case Study Demonstrating the Use of Appreciative Inquiry in a Financial Coaching Program

This article presents a case study of Appreciative Inquiry applied to client work within the context of a solution-focused, financial coaching model. Appreciative Inquiry (AI) is a process –a generative process—wherein a client envisions, describes, and constructs a new meaning or reality through structured questions and answers, and then designs a way to get there (to their destiny). The origins, tenants, and applications of AI approach are described, followed by a real case study involving the utilization of this approach to facilitate a client’s overcoming of a specific, maladaptive money script. The article provides implications for financial practitioners and a foundation for future experimental research on the effectiveness of the AI approach in financial coaching

Food security outcomes in agricultural systems models: Current status and recommended improvements

Improvement of food security is a common objective for many agricultural systems analyses, but how food security has been conceptualized and evaluated within agricultural systems has not been systematically evaluated. We reviewed the literature on agricultural systems analyses of food security at the household- and regionallevels, finding that the primary focus is on only one dimension of food security-agricultural output as a proxy for food availability. Given that food security comprises availability, access, utilization and stability dimensions, improved practice would involve more effort to incorporate food access and stability indicators into agricultural systems models. The empirical evidence base for including food access indicators and their determinants within agricultural systems models requires further development through appropriate short and longterm investments in data collection and analysis. Assessment of the stability dimension of food security (through time) is also particularly under-represented in previous work and requires the development and application of appropriate dynamic models of agricultural systems that include food security indicators, coupled with more formalized treatment of robustness and adaptability at both the regional and household levels. We find that agricultural systems models often conflate analysis of food security covariates that have the potential to improve food security (like agricultural yields) with an assessment of food security itself. Agricultural systems modelers should exercise greater caution in referring to analyses of agricultural output and food availability as representing food security more generally

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead