The influence of printed circuit board design on TEM cell measurements

The IEC 61967-2 integrated circuit radiated emissions test standard describes the use of the TEM cell to measure near-field emissions from an IC. This test requires a printed circuit board (PCB) to mount to IC. The IEC guidelines allow for flexibility in the design of this test PCB which may cause variations in the measured emissions. This thesis studies the impact of typical variations in the PCB design on the measured emissions --Abstract, page iii

The Influence of Test Parameters on TEM Cell Measurements of ICs

The IEC 61967-2 TEM cell standard allows for variations in test parameters which may cause variations in the measured emissions from integrated circuits (ICs). To test the impact of these parameters, two printed circuit boards were designed within the IEC standard using poor PCB design strategies and using good design strategies. Emissions from three pin-for-pin compatible 8051 microcontrollers were tested. Emissions were measured using both PCBs, changing the PCB configuration, and changing test parameters like the program running on the IC, the rise time of the input clock, and I/O switching. Emissions from the poor PCB were about 3-8 dB higher than emissions from the good PCB. A change in the program run by the IC, the clock rise-time, and I/O caused a 4-15 dB change in emissions. Emissions differed considerably among the ICs. Possible causes for variations in emissions with the test parameters are discussed

Pattern of Noise Induced Hearing Loss and its Relation with Duration of Exposure in Traffic Police Personnel

Background: Occupational noise exposure is a major and preventable cause of hearing loss. Traffic policemen are constantly exposed to noise pollution. Noise induced hearing loss (NIHL) denotes a selective 4000 Hz hearing loss (unilateral or bilateral). Objective: To assess the prevalence pattern of NIHL and its relation with duration of exposure to noise in traffic policemen. Material and methods: Otoscopy, tuning fork tests and Pure Tone Audiometry (PTA) were performed in 150 apparently healthy police personnel. Results: Rinne’s and Weber’s test were normal in all the subjects. Schwabach’s test showed normal bone conduction in normal subjects as well as those with NIHL. PTA revealed that 33 (22% of sample) subjects were suffering from NIHL; 8 (5.3%) had sensorineural hearing loss whereas 109 (72.7%) performed normally in the test. None of the subjects with sensorineural hearing loss showed the characteristic notch at 4 kHz. Majority of the subjects (69.7%) with NIHL had mild to moderate grades of hearing loss in both ears. No subject had profound hearing loss. Significant association was observed between NIHL and duration of exposure. Steps need to be taken at the level of employers as well as individuals to counter occupational noise threat

Efficacy and safety of avelumab treatment in patients with metastatic Merkel cell carcinoma: experience from a global expanded access program

BackgroundAvelumab, a human anti–programmed death-ligand 1 immunoglobulin G1 monoclonal antibody, showed favorable efficacy and safety in patients with metastatic Merkel cell carcinoma (mMCC) in the phase II JAVELIN Merkel 200 trial, leading to approval in multiple countries. We describe real-world experience with avelumab in patients with mMCC from an expanded access program.MethodsEligible patients had mMCC and progressive disease during or after chemotherapy or were ineligible for chemotherapy or clinical trial participation. Patients received an initial 3-month supply of avelumab (administered as 10 mg/kg intravenously every 2 weeks until progressive disease or unacceptable toxicity); resupply was allowed following complete response, partial response, stable disease, or clinical benefit per physician assessment.ResultsBetween December 15, 2015, and March 4, 2019, 558 of 620 requests from 38 countries were medically approved, and 494 patients received avelumab. Among 240 evaluable patients, the objective response rate was 46.7% (complete response in 22.9%, including 3 of 16 potentially immunocompromised patients), and the disease control rate was 71.2%. The median duration of treatment in evaluable patients with response was 7.9 months (range, 1.0–41.7) overall and 5.2 months (range, 3.0–13.9) in immunocompromised patients. No new safety signals were identified. The expanded access program closed for new requests on December 31, 2018, as required after regulatory approval; benefitting patients continued to receive avelumab.ConclusionsThe avelumab expanded access program for patients with mMCC demonstrated efficacy and safety in a real-world setting, consistent with the results from JAVELIN Merkel 200, and provided a treatment for patients with limited options

Avelumab in patients with previously treated metastatic melanoma: phase 1b results from the JAVELIN Solid Tumor trial

Background We report phase 1b data from patients enrolled in the JAVELIN Solid Tumor clinical trial (NCT01772004) with unresectable stage IIIC or IV melanoma that had progressed after ≥1 line of therapy for metastatic disease. Patients and methods Patients received avelumab (10 mg/kg)—a human anti–PD-L1 antibody. Assessments included objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and safety. Results As of December 31, 2016, 51 patients were treated and followed for a median of 24.2 months (range, 16.1–31.5). Most patients had cutaneous (n = 28 [54.9%]) or ocular (n = 16 [31.4%]) melanoma and had received a median of 2 prior lines of therapy (range, 0–4), including ipilimumab (n = 26 [51.0%]). The confirmed ORR was 21.6% (95% CI, 11.3–35.3; complete response, 7.8%; partial response, 13.7%). The median duration of response was not estimable (95% CI, 2.6 months-not estimable). Median PFS and OS were 3.1 months (95% CI, 1.4–6.3) and 17.2 months (95% CI, 6.6-not estimable), respectively. Subgroup analyses suggested meaningful clinical activity (ORR [95% CI]) in patients with non-ocular melanoma (31.4% [16.9–49.3]), PD-L1–positive tumors (42.1% [20.3–66.5]), or prior ipilimumab therapy (30.8% [14.3–51.8]). Thirty-nine patients (76.5%) had a treatment-related adverse event (TRAE), most commonly infusion-related reaction (29.4%), fatigue (17.6%), and chills (11.8%); 4 patients (7.8%) had a grade 3 TRAE. Five patients (9.8%) had an immune-related TRAE (all were grade 1/2). No grade 4 TRAEs or treatment-related deaths were reported. Conclusion Avelumab showed durable responses, promising survival outcomes, and an acceptable safety profile in patients with previously treated metastatic melanoma. Trial registration ClinicalTrials.gov identifier: NCT01772004This trial was sponsored by Merck KGaA, Darmstadt, Germany, and is part of an alliance between Merck KGaA and Pfizer, Inc., New York, NY, USA. Medical writing support was provided by ClinicalThinking, Inc., Hamilton, NJ, USA, and funded by Merck KGaA, and Pfizer, Inc

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Pattern of Noise Induced Hearing Loss and its Relation with Duration of Exposure in Traffic Police Personnel

Background: Occupational noise exposure is a major and preventable cause of hearing loss. Traffic policemen are constantly exposed to noise pollution. Noise induced hearing loss (NIHL) denotes a selective 4000 Hz hearing loss (unilateral or bilateral). Objective: To assess the prevalence pattern of NIHL and its relation with duration of exposure to noise in traffic policemen. Material and methods: Otoscopy, tuning fork tests and Pure Tone Audiometry (PTA) were performed in 150 apparently healthy police personnel. Results: Rinne’s and Weber’s test were normal in all the subjects. Schwabach’s test showed normal bone conduction in normal subjects as well as those with NIHL. PTA revealed that 33 (22% of sample) subjects were suffering from NIHL; 8 (5.3%) had sensorineural hearing loss whereas 109 (72.7%) performed normally in the test. None of the subjects with sensorineural hearing loss showed the characteristic notch at 4 kHz. Majority of the subjects (69.7%) with NIHL had mild to moderate grades of hearing loss in both ears. No subject had profound hearing loss. Significant association was observed between NIHL and duration of exposure. Steps need to be taken at the level of employers as well as individuals to counter occupational noise threat

Crystal and molecular structure of 8a-bromo-1,2,3,5,6,7,8,8a-octahydro-1,3-dioxoisoquinoline-4-carbonitrile

The crystal structure of the title compound has been determined by the heavy-atom method from 1 113 observed three-dimensional photographic data. Crystals are monoclinic with a=17.05, b=7.11, c=17.10 Å(all ±0.02 Å), β=89.0 (0.2)° , space group C2/c, with Z= 8. The structure was refined by block-diagonal least-squares to R 0.098. There is an intermolecular hydrogen bond of the N-H … O type. The cyclohexane portion of the molecule adopts a slightly distorted chair conformation