Identification of Critical Events by Lifeguards, Instructors, and Non-Lifeguards

Lifeguards are instructed to respond both to dangerous behavior and to distress/drowning events. Variability in lifeguard effectiveness may result from variability in how individual lifeguards define what events are important to monitor (“critical events”). The variability in defining critical events was examined in the current study by presenting videos of normal aquatic activity to lifeguards (N=17), lifeguard instructors (N=10), non-lifeguards (N=20), and students enrolled in a lifeguarding course (N=12). Participants were asked to identify the events that they thought were important for a lifeguard to monitor and provide an explanation as to why they were critical. All participant groups (instructors included) had very few events that were consistently reported, and many of the events that the instructors or lifeguards reported were also well-reported by non-lifeguards. These results suggest that there is a lack of agreement in the identification of critical events

An examination of the severity of aquatic incidents

Lanagan-Leitzel (2012) found that lifeguards do not consistently report incidents when free-viewing aquatic scenes and miss some incidents that should be considered critical. This could have been because they did not know what incidents were critical to monitor or because they were busy monitoring other incidents. In the current study, lifeguards and non-lifeguards were presented with video clips of isolated incidents and rated the severity of each on a scale of 0 – 7. The lifeguards reported greater mean and maximum incident severity than non-lifeguards. Further analyses of lifeguard responses revealed that severity ratings were only moderately correlated to the report rate in Lanagan-Leitzel (2012). Some of the incidents, though under-reported in Lanagan-Leitzel (2012), were given high severity ratings when isolated in the current study. It is proposed that lack of report in Lanagan-Leitzel (2012) may have occurred due to attention being diverted to other critical incidents. Future research should utilize eye-tracking to assess the relationship between severity and monitoring

Do Lifeguards Monitor the Events They Should?

Lifeguard training texts suggest that a lifeguard should continually scan their zone of coverage, carefully examining patrons whose behavior is consistent with drowning or distress. The current study examined whether lifeguard performance is consistent with these specifications, and whether these behaviors have enough visual interest to attract the gaze of non-lifeguards looking for drowning behaviors (“trained”) or those who were given no specified target (“naïve”). Participants viewed video clips of natural swimming taken from three aquatic locations while an eye-tracker recorded their eye position. Lifeguard performance was to some extent consistent with the specifications above, although on many measures it was not statistically better than briefly-trained participants. Implications for future research and training are considered

Investing in antibiotics to alleviate future catastrophic outcomes : what is the value of having an effective antibiotic to mitigate pandemic influenza?

Over 95% of post-mortem samples from the 1918 pandemic, which caused 50 to 100 million deaths, showed bacterial infection complications. The introduction of antibiotics in the 1940s has since reduced the risk of bacterial infections, but growing resistance to antibiotics could increase the toll from future influenza pandemics if secondary bacterial infections are as serious as in 1918, or even if they are less severe. We develop a valuation model of the option to withhold wide use of an antibiotic until significant outbreaks such as pandemic influenza or foodborne diseases are identified. Using real options theory, we derive conditions under which withholding wide use is beneficial, and calculate the option value for influenza pandemic scenarios that lead to secondary infections with a resistant Staphylococcus aureus strain. We find that the value of withholding an effective novel oral antibiotic can be positive and significant unless the pandemic is mild and causes few secondary infections with the resistant strain or if most patients can be treated intravenously. Although the option value is sensitive to parameter uncertainty, our results suggest that further analysis on a case-by-case basis could guide investment in novel agents as well as strategies on how to use them

Overexpression of c-erbB2 is an independent marker of resistance to endocrine therapy in advanced breast cancer

The present study investigated the interaction between c-erbB2 overexpression and the response to first-line endocrine therapy in patients with advanced breast cancer. The primary tumours of 241 patients who were treated at first relapse with endocrine therapy were assessed for overexpression of c-erbB2 by immunohistochemistry. c-erbB2 was overexpressed in 76 (32%) of primary breast cancers and did not correlate with any other prognostic factor. The overall response to treatment and time to progression were significantly lower in patients with c-erbB2-positive tumours compared to those that were c-erbB2-negative (38% vs 56%, P = 0.02; and 4.1 months vs 8.7 months, P < 0.001, respectively). In multivariate analysis, c-erbB2 status was the most significant predictive factor for a short time to progression (P = 0.0009). In patients with ER-positive primary tumours treated at relapse with tamoxifen (n = 170), overexpression of c-erbB2 was associated with a significantly shorter time to progression (5.5 months vs 11.2 months, P < 0.001). In conclusion, overexpression of c-erbB2 in the primary tumour is an independent marker of relative resistance to first-line endocrine therapy in patients with advanced breast cancer. In patients with ER-positive primary tumours, the overexpression of c-erbB2 defines a subgroup less likely to respond to endocrine therapy. © 1999 Cancer Research Campaig

Cell-surface sensors for real-time probing of cellular environments

Author Manuscript 2012 August 1.The ability to explore cell signalling and cell-to-cell communication is essential for understanding cell biology and developing effective therapeutics. However, it is not yet possible to monitor the interaction of cells with their environments in real time. Here, we show that a fluorescent sensor attached to a cell membrane can detect signalling molecules in the cellular environment. The sensor is an aptamer (a short length of single-stranded DNA) that binds to platelet-derived growth factor (PDGF) and contains a pair of fluorescent dyes. When bound to PDGF, the aptamer changes conformation and the dyes come closer to each other, producing a signal. The sensor, which is covalently attached to the membranes of mesenchymal stem cells, can quantitatively detect with high spatial and temporal resolution PDGF that is added in cell culture medium or secreted by neighbouring cells. The engineered stem cells retain their ability to find their way to the bone marrow and can be monitored in vivo at the single-cell level using intravital microscopy.National Institutes of Health (U.S.) (Grant HL097172)National Institutes of Health (U.S.) (Grant HL095722)National Institutes of Health (U.S.) (Grant DE019191)National Institutes of Health (U.S.) (Grant NIAID 5RC1AI086152)Charles A. Dana FoundationAmerican Heart Association (Grant 0970178N)National Science Foundation (U.S.) (Graduate Fellowship

Comparison of HER-2 overexpression in primary breast cancer and metastatic sites and its effect on biological targeting therapy of metastatic disease

HER-2 overexpression, a predictive marker of tumour aggressiveness and responsiveness to therapy, occurs in 20–30% of breast cancer. Although breast cancer is a heterogeneous disease, HER-2 measurement is carried out in primary tumour. This study aims to evaluate HER-2 overexpression in primary and metastases and its effect on treatment decisions. Biopsies from primary breast cancer and corresponding metastases from 58 patients were studied. HER-2 overexpression was evaluated immunohistochemically in all primary and metastatic sites. Positive overexpression in primary and/or metastases was confirmed by fluorescence in situ hybridisation (FISH). Discordance in HER-2 overexpression between primary and metastatic sites was 14% (eight of 58 patients). Concordance was found in 50 (86%) of patients (95% CI: 77–95). In one patient (2%), HER-2 was negative in metastasis but positive in primary. In seven (12%) patients, HER-2 was positive in metastases and negative in primary (95% CI: 3.7–20), and three of them responded to trastuzumab. Gene amplification by FISH was found in all cases with HER-2 positive (+2 and +3) by immunohistochemistry. Our data suggest that a possible discordance of HER-2 overexpression between primary and metastases should be considered when making treatment decisions in patients with primary HER-2-negative tumours