Newborn screening for cystic fibrosis

Since the late 1970s when the potential of the immunoreactive trypsinogen assay for early identification of infants with cystic fibrosis was first recognised, the performance of newborn blood spot screening (NBS) has been continually assessed and its use has gradually expanded. NBS for cystic fibrosis is a cost-effective strategy and, if standards of care are fully implemented and robust management pathways are in place, has a positive effect on clinical outcomes. In the past decade, NBS has undergone rapid expansion and an unprecedented number of infants with cystic fibrosis have access to early diagnosis and care. Cystic fibrosis NBS has now moved on from the development phase and is entering an era of consolidation. In the future, research should focus on the rationalisation and optimisation of existing programmes, with particular attention to bioethical implications such as unwanted detection of carriers and inconclusive diagnoses

Information Requirements for MCM and ISR Missions : PUMA Phase II

This document contains display requirements for Littoral Combat Ship (LCS) control station displays to be used by unmanned vehicle units in support of heterogeneous unmanned vehicle missions (such as Special Operations Force (SOF) insertion). The method used for generating the requirements was that of a Hybrid Cognitive Task Analysis (CTA)1 which entails describing a scenario overview of a representative mission, generating event flow diagrams, and depicting decision ladders for the key decisions identified in the event flow diagrams. These steps are then used together to generate an informational requirements summary which includes the situational awareness requirements that are derived from the event flow and display requirements of the decision ladders. This method was developed in Phase I of the PUMA (Plan Understanding for Mixed-initiative control of Autonomous systems) project2. In PUMA I, the mission scenario primarily consisted of Intelligence, Surveillance and Reconnaissance (ISR) tasks. For PUMA II, the scenario has been expanded to include Mine Counter Measures (MCM), Harbor Bottom Image-Mapping (HBI), and Anti- Terrorism / Force Protection (AT/FP) mission types. There is a specific emphasis on the MCM and ISR missions to highlight the informational requirement differences between the two task types. This document incorporates the expanded vehicle and mission type heterogeneities that are present in PUMA II in order to develop a cohesive set of informational requirements necessary for such a complex mission.Prepared for Charles River Analytic

Thermal emission spectroscopy of the middle atmosphere

The general objective of this research is to obtain, via remote sensing, simultaneous measurements of the vertical distributions of stratospheric temperature, ozone, and trace constituents that participate in the catalytic destruction of ozone (NO(sub y): NO, NO2, NO3, HNO3, ClONO2, N2O5, HNO4; Cl(sub x): HOCl), and the source gases for the catalytic cycles (H2O, CH4, N2O, CF2Cl2, CFCl3, CCl4, CH3Cl, CHF2Cl, etc.). Data are collected during a complete diurnal cycle in order to test our present understanding of ozone chemistry and its associate catalytic cycles. The instrumentation employed is an emission-mode, balloon-borne, liquid-nitrogen-cooled Michelson interferometer-spectrometer (SIRIS), covering the mid-infrared range with a spectral resolution of 0.020 cm(exp -1). Cryogenic cooling combined with the use of extrinsic silicon photoconductor detectors allows the detection of weak emission features of stratospheric gaseous species. Vertical distributions of these species are inferred from scans of the thermal emission of the limb in a sequence of elevation angles. The fourth SIRIS balloon flight was carried out from Palestine, Texas on September 15-16, 1986 with 9 hours of nighttime data (40 km). High quality data with spectral resolution 0.022 cm(exp -1), were obtained for numerous limb sequences. Fifteen stratospheric species have been identified to date from this flight: five species from the NO(sub y) family (HNO3, NO2, NO, ClONO2, N2O5), plus CO2, O3, H2O, N2O, CH4, CCl3F, CCl2F2, CHF2Cl, CF4, and CCl4. The nighttime values of N2O5, ClONO2, and total odd nitrogen have been measured for the first time, and compared to model results. Analysis of the diurnal variation of N2O5 within the 1984 and 1986 data sets, and of the 1984 ClONO2 measurements, were presented in the literature. The demonstrated ability of SIRIS to measure all the major NO(sub y) species, and therefore to determine the partitioning of the nitrogen family over a continuous diurnal cycle, is a powerful tool in the verification and improvement of photochemical modeling

One Work Analysis, Two Domains: A Display Information Requirements Case Study

Work domain analyses can be time consuming, requiring extensive interviews, documentation review, and observations, among other techniques. Given the time and resources required, we examine how to generalize a work domain analysis technique, namely the hybrid Cognitive Task Analysis (hCTA) method across two domains in order to generate a common set of display information requirements. The two domains of interest are field workers troubleshooting low voltage distribution networks and telecommunication problems. Results show that there is a high degree of similarity between the two domains due to their service call nature, particularly in tasking and decision-making. While the primary differences were due to communication protocols and equipment requirements, the basic overall mission goals, functions, phases of operation, decision processes, and situation requirements were very similar. A final design for both domains is proposed based on the joint requirements

Rolofylline, an adenosine A1−receptor antagonist, in acute heart failure

Background: Worsening renal function, which is associated with adverse outcomes, often develops in patients with acute heart failure. Experimental and clinical studies suggest that counterregulatory responses mediated by adenosine may be involved. We tested the hypothesis that the use of rolofylline, an adenosine A1−receptor antagonist, would improve dyspnea, reduce the risk of worsening renal function, and lead to a more favorable clinical course in patients with acute heart failure. Methods: We conducted a multicenter, double-blind, placebo-controlled trial involving patients hospitalized for acute heart failure with impaired renal function. Within 24 hours after presentation, 2033 patients were randomly assigned, in a 2:1 ratio, to receive daily intravenous rolofylline (30 mg) or placebo for up to 3 days. The primary end point was treatment success, treatment failure, or no change in the patient’s clinical condition; this end point was defined according to survival, heart-failure status, and changes in renal function. Secondary end points were the post-treatment development of persistent renal impairment and the 60-day rate of death or readmission for cardiovascular or renal causes. Results: Rolofylline, as compared with placebo, did not provide a benefit with respect to the primary end point (odds ratio, 0.92; 95% confidence interval, 0.78 to 1.09; P=0.35). Persistent renal impairment developed in 15.0% of patients in the rolofylline group and in 13.7% of patients in the placebo group (P=0.44). By 60 days, death or readmission for cardiovascular or renal causes had occurred in similar proportions of patients assigned to rolofylline and placebo (30.7% and 31.9%, respectively; P=0.86). Adverse-event rates were similar overall; however, only patients in the rolofylline group had seizures, a known potential adverse effect of A1-receptor antagonists. Conclusions: Rolofylline did not have a favorable effect with respect to the primary clinical composite end point, nor did it improve renal function or 60-day outcomes. It does not show promise in the treatment of acute heart failure with renal dysfunction. (Funded by NovaCardia, a subsidiary of Merck; ClinicalTrials.gov numbers, NCT00328692 and NCT00354458.

Identifikasi Desain Jaringan Manajemen Rantai Pasok Kopra di Kota Manado (Studi di Kelurahan Bengkol dan Kelurahan Tongkaina)

Kopra merupakan komoditi perdagangan yang bernilai ekonomis. Tetapi rendahnya harga dan lamanya waktu dalam mengolah kopra membuat para petani beralih profesi bahkan mengalihfungsikan lahan menjadi pemukiman. Manajemen rantai pasokan merupakan suatu aktivitas pengembangan produk, pengadaan bahan, produksi dan pendistribusian. Sebuah desain jaringan bisa menentukan apakah suatu manajemen rantai pasokan akan bisa efesien. Tujuan penelitian ini untuk mengidentifikasi desain jaringan manajemen rantai pasokan kopra pada Kelurahan Bengkol dan Tongkaina di Kota Manado dalam rangka mendesain rantai pasokan yang memberi nilai tambah sehingga menguntungkan petani dan industri. Metode analisis yang digunakan adalah analisis deskriptif kualitatif. Teknik pengumpulan data dengan cara melakukan observasi, wawancara dan dokumentasi. Hasil penelitian menunjukan pola desain jaringan rantai pasok kopra pada Kelurahan Bengkol dan Tongkaina meliputi para petani, pedagang pengumpul, kemudian industri bekerjasama dengan distributor menyalurkan kopra kepada para konsumen. Para petani sebaiknya membentuk kelompok tani dan menyalurkan secara langsung kopra hasil usahanya kepada industri. Kata kunci: manajemen rantai pasokan, desain jaringan, kopr

Incidence and drug treatment of emotional distress after cancer diagnosis : a matched primary care case-control study

Notes This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License.Peer reviewedPublisher PD

Relationship between psychological and biological factors and physical activity and exercise behaviour in Filipino students

The aim of the present study was threefold. Firstly, it investigated whether a general measure or specific measure of motivational orientation was better in describing the relationship between motivation and exercise behaviour. Secondly, it examined the relationship between the four most popular indirect methods of body composition assessment and physical activity and exercise patterns. Thirdly, the interaction between motivation and body composition on physical activity and exercise behaviour was explored in a sample of 275 Filipino male and female students. Males were found to have higher levels of exercise whereas females had higher levels of physical activity. Furthermore, general self-motivation together with body weight and percentage body fat were found to be the best predictor of exercise behaviour whereas the tension/pressure subscale of the ‘Intrinsic Motivation Inventory’ (IMI) was the best predictor of levels of physical activity. However, significant gender differences were observed. That is, for the males only self-motivation and for the females only body weight and BMI predicted exercise behaviour. Also, tension/pressure predicted physical activity levels for the females but not the males. No inverse relationship was found between the four body composition measures and exercise and physical activity behaviour. The results support the notion that the psychobiological approach might be particularly relevant for high intensity exercise situations but also highlights some important gender differences. Finally, the results of this study emphasise the need for more cross-cultural research

Absence of system xc⁻ on immune cells invading the central nervous system alleviates experimental autoimmune encephalitis

Background: Multiple sclerosis (MS) is an autoimmune demyelinating disease that affects the central nervous system (CNS), leading to neurodegeneration and chronic disability. Accumulating evidence points to a key role for neuroinflammation, oxidative stress, and excitotoxicity in this degenerative process. System x(c)- or the cystine/glutamate antiporter could tie these pathological mechanisms together: its activity is enhanced by reactive oxygen species and inflammatory stimuli, and its enhancement might lead to the release of toxic amounts of glutamate, thereby triggering excitotoxicity and neurodegeneration. Methods: Semi-quantitative Western blotting served to study protein expression of xCT, the specific subunit of system x(c)-, as well as of regulators of xCT transcription, in the normal appearing white matter (NAWM) of MS patients and in the CNS and spleen of mice exposed to experimental autoimmune encephalomyelitis (EAE), an accepted mouse model of MS. We next compared the clinical course of the EAE disease, the extent of demyelination, the infiltration of immune cells and microglial activation in xCT-knockout (xCT(-/-)) mice and irradiated mice reconstituted in xCT(-/-) bone marrow (BM), to their proper wild type (xCT(+/+)) controls. Results: xCT protein expression levels were upregulated in the NAWM of MS patients and in the brain, spinal cord, and spleen of EAE mice. The pathways involved in this upregulation in NAWM of MS patients remain unresolved. Compared to xCT(+/+) mice, xCT(-/-) mice were equally susceptible to EAE, whereas mice transplanted with xCT(-/-) BM, and as such only exhibiting loss of xCT in their immune cells, were less susceptible to EAE. In none of the above-described conditions, demyelination, microglial activation, or infiltration of immune cells were affected. Conclusions: Our findings demonstrate enhancement of xCT protein expression in MS pathology and suggest that system x(c)- on immune cells invading the CNS participates to EAE. Since a total loss of system x(c)- had no net beneficial effects, these results have important implications for targeting system x(c)- for treatment of MS