A Case of Extrapulmonary Tuberculosis Two-Ways

Tuberculosis (TB) is a widespread epidemic. The World HealthOrganization estimated 10.4 million cases of tuberculosis in 2016,with 490,000 new cases of multi-drug resistant (MDR) TB.1 Theprimary presentation of TB is pulmonary. However, in the UnitedStates in 2014, 21% of TB cases were extrapulmonary with the mostcommon sites in descending order of incidence being TB lymphadenitis(38.2%), pleural (16.3%), bone and/or joint (10.4%), peritoneal(5.7%), genitourinary (5%), meningeal (4.5%), and laryngeal (0.2%).

Glioblastoma and Increased Survival with Longer Chemotherapy Duration

Introduction The five-year survival rate for patients with glioblastoma (GBM) is low at approximately 4.7%. Radiotherapy plus concomitant and adjuvant temozolomide (TMZ) remains the standard of care. The optimal duration of therapy with TMZ is unknown. This study sought to evaluate the survival benefit of two years of treatment. Methods This was a retrospective chart review of all patients diagnosed with GBM and treated with TMZ for up to two years between January 1, 2002 and December 31, 2011. The Kaplan-Meier method with log-rank test was used to estimate the progression-free survival (PFS) and the overall survival (OS). The results were compared to historical controls and data from previous clinical trials of patients treated up to one year. Results Data from 56 patients with confirmed GBM were evaluated. The OS probability was 54% (SE = 0.068) at one year, 28.3% (SE = 0.064) at two years, 17.8% (SE = 0.059) at three years, and 4% (SE = 0.041) at five years. Seven patients (12.5%) were treated with TMZ for two years. Their median time-to-progression was 28 months (95% CI = 5.0 - 28.0), and they had an increased survival probability at three years compared to other patients (log-rank test χ2 (1, N = 56) = 19.2, p < 0.0001). Conclusions There may be an advantage for a longer duration of TMZ therapy among patients with GBM, but the sample size was too small for generalization. A multicenter prospective study is needed to dentify optimal duration of TMZ therapy

FORCE ASYMMETRY DURING ISOMETRIC CONTRACTIONS FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

The aim of this study was to compare isometric strength asymmetry in participants that have previously undergone anterior cruciate ligament (ACL) reconstruction and a healthy control group. Three-dimensional force data (1000 Hz) were collected from 21 ACL (3.2 ± 1.8 years post-surgery) and 21 control participants during maximal isometric contractions. Peak knee flexion force displayed significant asymmetry differences between groups, with ACL participants showing greater asymmetry (7.6 %) than the control group (0.1 %). No significant asymmetry differences were found between groups for peak extension, adduction and internal rotation force. Results suggest that following ACL reconstruction and rehabilitation, external force production during knee flexion is significantly less on the affected side than the uninjured side, which has implications on rehabilitation monitoring

Promoting a Consistent Food Safety and Quality Message to the Dairy Industry: An Updated Resource for Extension Faculty, Veterinarians, and Dairy Advisors

A team from seven western states developed educational resources providing a consistent meat safety and quality message to dairy producers, farm advisors, and veterinarians. The team produced a Web site and CD-ROM, DairyBeef: Maximizing Quality & Profits, consisting of videos, narrated slide sets, and on-farm tools. An additional project translated much of the curriculum into language appropriate for farm labor in both English and Spanish. DairyBeef: Maximizing Quality & Profits will help Extension faculty, veterinarians, and dairy advisors assist dairy producers and their employees in understanding market cattle food safety and quality issues and management practices to address them

Simulation in a dynamic prototyping environment: Petri nets or rules?

An evaluation of a prototyped user interface is best supported by a simulation of the system. A simulation allows for dynamic evaluation of the interface rather than just a static evaluation of the screen's appearance. This allows potential users to evaluate both the look (in terms of the screen layout, color, objects, etc.) and feel (in terms of operations and actions which need to be performed) of a system's interface. Because of the need to provide dynamic evaluation of an interface, there must be support for producing active simulations. The high-fidelity training simulators are delivered too late to be effectively used in prototyping the displays. Therefore, it is important to build a low fidelity simulator, so that the iterative cycle of refining the human computer interface based upon a user's interactions can proceed early in software development

Radiative and Collisional Jet Energy Loss in the Quark-Gluon Plasma at RHIC

We calculate and compare bremsstrahlung and collisional energy loss of hard partons traversing a quark-gluon plasma. Our treatment of both processes is complete at leading order in the coupling and accounts for the probabilistic nature of the jet energy loss. We find that the nuclear modification factor $R_{AA}$ for neutral $\pi^0$ production in heavy ion collisions is sensitive to the inclusion of collisional and radiative energy loss contributions while the averaged energy loss only slightly increases if collisional energy loss is included for parent parton energies $E\gg T$. These results are important for the understanding of jet quenching in Au+Au collisions at $200 {\rm AGeV}$ at RHIC. Comparison with data is performed applying the energy loss calculation to a relativistic ideal (3+1)-dimensional hydrodynamic description of the thermalized medium formed at RHIC.Comment: 4 pages, 3 figure

Trauma Patients Still Use Private Vehicle Transport Despite Improvement in EMS Response Times

Introduction: Recently, Detroit has seen a gradual improvement in Emergency Medical Service (EMS) response times. The historically long response times have been implicated in contributing to the high rates of private vehicle transportation (PVT) in Detroit, up to 3 times higher than the national average. This study tests the hypothesis that as EMS arrival times improve, the utilization of PVT in Detroit would decrease. Methods: This is a retrospective study at an academic, regional, Level 1 trauma center in Detroit over 28 months. Inclusion criteria were trauma patients that were admitted, transferred out of hospital, or died. Patients transferred from outside hospitals were excluded (N=2285). The data were obtained from hospital data registry and the city of Detroit’s performance dashboards. Correlation studies were then conducted between average EMS response time and percent PVT utilization and repeated for subgroup analysis by injury severity and trauma cause, and linear regression was conducted if correlation was significant.Results: Though correlation studies show a decline in EMS response time over 28 months with an R2 value of 0.817, there was a weak relationship between PVT usage and time (R2=0.017) and between PVT usage and EMS response time (R2=0.0058). Similar results were seen with subgroup analysis, with the largest R2 value being 0.273 in serious injuries. Conclusions: Despite continued improvement in EMS response times, we did not observe a corresponding decrease in PVT utilization. Potential explanations include a delay in this observation due to a long history of long EMS response time, the general public being unaware of this improvement, or the notion that factors other than historically high EMS arrival times play into this regional phenomenon which we explore through first-responder interviews and patient surveys.https://scholarlycommons.henryford.com/merf2019clinres/1061/thumbnail.jp

Process and System for Establishing a Moving Target Connection for Secure Communications in Client/Server Systems

A system and method performs a moving target blind rendezvous by exchanging data through a distributed hash table. The system allows users to securely send small pieces of information over a network while only requiring an exchange of public keys ahead of time. The system relies on the size and resilience of the BitTorrent Distributed Hash Table and the security properties of cryptographic constructions such as Elliptic Curve Diffie-Hellman key exchange and secure one-way hash functions.https://digitalcommons.usmalibrary.org/patents/1000/thumbnail.jp

Simulation in a dynamic prototyping environment: Petri nets or rules?

An evaluation of a prototyped user interface is best supported by a simulation of the system. A simulation allows for dynamic evaluation of the interface rather than just a static evaluation of the screen's appearance. This allows potential users to evaluate both the look (in terms of the screen layout, color, objects, etc.) and feel (in terms of operations and actions which need to be performed) of a system's interface. Because of the need to provide dynamic evaluation of an interface, there must be support for producing active simulations. The high-fidelity training simulators are normally delivered too late to be effectively used in prototyping the displays. Therefore, it is important to build a low fidelity simulator, so that the iterative cycle of refining the human computer interface based upon a user's interactions can proceed early in software development