A Mediterranean undercurrent seeding experiment (AMUSE) : part II: RAFOS float data report, May 1993-March 1995

This is the final data report of all acoustically tracked RAFOS data collected in 1993-1995 during A Mediterranean Undercurrent Seeding Experiment (AMUSE). The overall objective of the program was to observe directly the spreading pathways by which Mediterranean Water enters the North Atlantic. This includes the direct observation of Mediterranean eddies (meddies), which is one mechanism that transports Mediterranean Water to the North Atlantic. The experiment was comprised of a repeated high-resolution expendable bathythermograph (XBT) section and RAFOS float deployments across the Mediterranean Undercurrent south of Portugal near 8.5°W. A total of 49 floats were deployed at a rate of about two floats per week on 23 cruises on the chartered Portuguese-based vessel, Kialoa II, and one cruise on the R/V Endeavor. The floats were ballasted for 1100 or 1200 decibars (db) to seed the lower salinity core of the Mediterranean Undercurrent. The objectives of the Lagrangian float study were (1) to identify where meddies form, (2) to make the first direct estimate of meddy formation frequency, (3) to estimate the fraction of time meddies are being formed, and (4) to determine the pathways by which Mediterranean Water which is not trapped in meddies enters the North Atlantic.Funding was provided by the National Science Foundation through Grant No. OCE-91-01033 to the Woods Hole Oceanographic Institution and Grant No. OCE-91-00724 to Scripps Institution of Oceanography, and by the Luso-American Foundation for Development through Grant No. 54/93 to the University of Lisbon

Transition-edge superconducting antenna-coupled bolometer

We report test results for a single pixel antenna-coupled bolometric detector. Our device consists of a dual slot microstrip antenna coupled to an Al/Ti/Au voltage-biased transition edge superconducting bolometer (TES). The coupling architecture involves propagating the signal along superconducting microstrip lines and terminating the lines at a normal metal resistor colocated with a TES on a thermally isolated island. The device, which is inherently polarization sensitive, is optimized for 140 GHz band measurements. In the thermal bandwidth of the TES, we measure a noise equivalent power of 2.0 × 10^(-17) W/√Hz in dark tests that agrees with calculated NEP including only contributions from thermal, Johnson and amplifier noise. We do not measure any excess noise at frequencies between 1 and 200 Hz. We measure a thermal conductance G ~5.5 × 10^(-11) W/K. We measure a thermal time constant as low as 437μs at 3μV bias when stimulating the TES directly using an LED

Veterans health administration hepatitis B testing and treatment with anti-CD20 antibody administration

AIM: To evaluate pretreatment hepatitis B virus (HBV) testing, vaccination, and antiviral treatment rates in Veterans Affairs patients receiving anti-CD20 Ab for quality improvement. METHODS: We performed a retrospective cohort study using a national repository of Veterans Health Administration (VHA) electronic health record data. We identified all patients receiving anti-CD20 Ab treatment (2002-2014). We ascertained patient demographics, laboratory results, HBV vaccination status (from vaccination records), pharmacy data, and vital status. The high risk period for HBV reactivation is during anti-CD20 Ab treatment and 12 mo follow up. Therefore, we analyzed those who were followed to death or for at least 12 mo after completing anti-CD20 Ab. Pretreatment serologic tests were used to categorize chronic HBV (hepatitis B surface antigen positive or HBsAg+), past HBV (HBsAg-, hepatitis B core antibody positive or HBcAb+), resolved HBV (HBsAg-, HBcAb+, hepatitis B surface antibody positive or HBsAb+), likely prior vaccination (isolated HBsAb+), HBV negative (HBsAg-, HBcAb-), or unknown. Acute hepatitis B was defined by the appearance of HBsAg+ in the high risk period in patients who were pretreatment HBV negative. We assessed HBV antiviral treatment and the incidence of hepatitis, liver failure, and death during the high risk period. Cumulative hepatitis, liver failure, and death after anti-CD20 Ab initiation were compared by HBV disease categories and differences compared using the χ2 test. Mean time to hepatitis peak alanine aminotransferase, liver failure, and death relative to anti-CD20 Ab administration and follow-up were also compared by HBV disease group. RESULTS: Among 19304 VHA patients who received anti-CD20 Ab, 10224 (53%) had pretreatment HBsAg testing during the study period, with 49% and 43% tested for HBsAg and HBcAb, respectively within 6 mo pretreatment in 2014. Of those tested, 2% (167/10224) had chronic HBV, 4% (326/7903) past HBV, 5% (427/8110) resolved HBV, 8% (628/8110) likely prior HBV vaccination, and 76% (6022/7903) were HBV negative. In those with chronic HBV infection, ≤ 37% received HBV antiviral treatment during the high risk period while 21% to 23% of those with past or resolved HBV, respectively, received HBV antiviral treatment. During and 12 mo after anti-CD20 Ab, the rate of hepatitis was significantly greater in those HBV positive vs negative (P = 0.001). The mortality rate was 35%-40% in chronic or past hepatitis B and 26%-31% in hepatitis B negative. In those pretreatment HBV negative, 16 (0.3%) developed acute hepatitis B of 4947 tested during anti-CD20Ab treatment and follow-up. CONCLUSION: While HBV testing of Veterans has increased prior to anti-CD20 Ab, few HBV+ patients received HBV antivirals, suggesting electronic health record algorithms may enhance health outcomes

Stakeholder perspectives of a pilot multicomponent delirium prevention intervention for adult patients with advanced cancer in palliative care units: A behaviour change theory-based qualitative study

Background: Theory-based and qualitative evaluations in pilot trials of complex clinical interventions help to understand quantitative results, as well as inform the feasibility and design of subsequent effectiveness and implementation trials. Aim: To explore patient, family, clinician and volunteer (‘stakeholder’) perspectives of the feasibility and acceptability of a multicomponent non-pharmacological delirium prevention intervention for adult patients with advanced cancer in four Australian palliative care units that participated in a phase II trial, the ‘PRESERVE pilot study’. Design: A trial-embedded qualitative study via semi-structured interviews and directed content analysis using Michie’s Behaviour Change Wheel and the Theoretical Domains Framework. Setting/participants: Thirty-nine people involved in the trial: nurses (n = 17), physicians (n = 6), patients (n = 6), family caregivers (n = 4), physiotherapists (n = 3), a social worker, a pastoral care worker and a volunteer. Results: Participants’ perspectives aligned with the ‘capability’, ‘opportunity’ and ‘motivation’ domains of the applied frameworks. Of seven themes, three were around the alignment of the delirium prevention intervention with palliative care (intervention was considered routine care; intervention aligned with the compassionate and collaborative culture of palliative care; and differing views of palliative care priorities influenced perspectives of the intervention) and four were about study processes more directly related to adherence to the intervention (shared knowledge increased engagement with the intervention; impact of the intervention checklist on attention, delivery and documentation of the delirium prevention strategies; clinical roles and responsibilities; and addressing environmental barriers to delirium prevention). Conclusion: This theory-informed qualitative study identified multiple influences on the delivery and documentation of a pilot multicomponent non-pharmacological delirium prevention intervention in four palliative care units. Findings inform future definitive studies of delirium prevention in palliative care

ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction) Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine

"The ACC/AHA Task Force on Practice Guidelines was formed to make recommendations regarding the diagnosis and treatment of patients with known or suspected cardiovascular disease (CVD). Coronary artery disease (CAD) is the leading cause of death in the United States. Unstable angina (UA) and the closely related condition of non–ST-segment elevation myocardial infarction (NSTEMI) are very common manifestations of this disease. The committee members reviewed and compiled published reports through a series of computerized literature searches of the English-language literature since 2002 and a final manual search of selected articles. Details of the specific searches conducted for particular sections are provided when appropriate. Detailed evidence tables were developed whenever necessary with the specific criteria outlined in the individual sections. The recommendations made were based primarily on these published data. The weight of the evidence was ranked highest (A) to lowest (C). The final recommendations for indications for a diagnostic procedure, a particular therapy, or an intervention in patients with UA/NSTEMI summarize both clinical evidence and expert opinion.

The Suppressor of AAC2 Lethality SAL1 Modulates Sensitivity of Heterologously Expressed Artemia ADP/ATP Carrier to Bongkrekate in Yeast

The ADP/ATP carrier protein (AAC) expressed in Artemia franciscana is refractory to bongkrekate. We generated two strains of Saccharomyces cerevisiae where AAC1 and AAC3 were inactivated and the AAC2 isoform was replaced with Artemia AAC containing a hemagglutinin tag (ArAAC-HA). In one of the strains the suppressor of ΔAAC2 lethality, SAL1, was also inactivated but a plasmid coding for yeast AAC2 was included, because the ArAACΔsal1Δ strain was lethal. In both strains ArAAC-HA was expressed and correctly localized to the mitochondria. Peptide sequencing of ArAAC expressed in Artemia and that expressed in the modified yeasts revealed identical amino acid sequences. The isolated mitochondria from both modified strains developed 85% of the membrane potential attained by mitochondria of control strains, and addition of ADP yielded bongkrekate-sensitive depolarizations implying acquired sensitivity of ArAAC-mediated adenine nucleotide exchange to this poison, independent from SAL1. However, growth of ArAAC-expressing yeasts in glycerol-containing media was arrested by bongkrekate only in the presence of SAL1. We conclude that the mitochondrial environment of yeasts relying on respiratory growth conferred sensitivity of ArAAC to bongkrekate in a SAL1-dependent manner. © 2013 Wysocka-Kapcinska et al

First Tests of Prototype SCUBA-2 Superconducting Bolometer Array

We present results of the first tests on a 1280 pixel superconducting bolometer array, a prototype for SCUBA‐2, a sub‐mm camera being built for the James Clerk Maxwell Telescope in Hawaii. The bolometers are TES (transition edge sensor) detectors; these take advantage of the large variation of resistance with temperature through the superconducting transition. To keep the number of wires reasonable, a multiplexed read‐out is used. Each pixel is read out through an individual DC SQUID; room temperature electronics switch between rows in the array by biasing the appropriate SQUIDs in turn. Arrays of 100 SQUIDs in series for each column then amplify the output. Unlike previous TES arrays, the multiplexing elements are located beneath each pixel, making large arrays possible, but construction more challenging. The detectors are constructed from Mo/Cu bi‐layers; this technique enables the transition temperature to be tuned using the proximity effect by choosing the thickness of the normal and superconducting materials. To achieve the required performance, the detectors are operated at a temperature of approximately 120 mK. We describe the results of a basic characterisation of the array, demonstrating that it is fully operational, and give the results of signal to noise measurements