In re Fund for Encouragement of Self Rel., 135 Nev. Adv. Op. 10 (Apr. 25, 2019)

NRS § 163.556 does not permit a court to disregard trustees\u27 objections and appoint half of a wholly charitable trust’s assets to a new trust when, pursuant to the trust instrument’s terms, all trustees must consent before distributing half of the trust’s assets

Gathrite v. Eighth Jud. Dist. Ct., 135 Nev. Adv. Op. 54 (Nov. 7, 2019)

For purposes of NRS 172.135(2), evidence that has been suppressed in justice court proceedings on a felony complaint is not “legal evidence,” and therefore, may not be presented to a grand jury. The Court will grant an exception to this rule if the suppression was reversed before the grand jury proceedings

Case study: adult learning and public health—a foundational training programme in field epidemiology with lessons and opportunities for collaboration

This article explores the first field epidemiology training programme(FETP) through a case study to understand its approach to learning andeducation. Field epidemiologists deploy to outbreaks to investigate, control,and prevent future epidemics and pandemics. Since the 1950s, theyhave learned their trade through FETP. FETP arose at a paradigmaticcrossroads, has endured for seventy years, and is now delivered in overninety countries. COVID-19 has highlighted the urgency for re-thinkinglearning in the health sector, hence the analysis of this case can informFETP, public health, and the adult education field. Inductive contentanalysis of this case using published accounts from the programmedesigner-leader and participants suggests the programme’s approach tolearning reflected Knowles’s andragogical assumptions, Kolb’s experientiallearning cycle, and Lave and Wenger’s legitimate peripheral participationin communities of practice. Alignment with such influentialcontributors to the field of adult learning clarifies the programme’s paradigmand explains its endurance. Now, given the lessons of COVID-19,critical learning approaches are needed to enable field epidemiologists toengage issues of culture and power as they investigate epidemics. Recentadult learning theories offer opportunities for adult educators to collaboratewith public health programmes. COVID-19 urges that we do nothesitate

A Rapid Culture Technique Produces Functional Dendritic-Like Cells from Human Acute Myeloid Leukemia Cell Lines

Most anti-cancer immunotherapeutic strategies involving dendritic cells (DC) as vaccines rely upon the adoptive transfer of DC loaded with exogenous tumour-peptides. This study utilized human acute myeloid leukemia (AML) cells as progenitors from which functional dendritic-like antigen presenting cells (DLC) were generated, that constitutively express tumour antigens for recognition by CD8+ T cells. DLC were generated from AML cell lines KG-1 and MUTZ-3 using rapid culture techniques and appropriate cytokines. DLC were evaluated for their cell-surface phenotype, antigen uptake and ability to stimulate allogeneic responder cell proliferation, and production of IFN-γ; compared with DC derived from normal human PBMC donors. KG-1 and MUTZ-3 DLC increased expression of CD80, CD83, CD86, and HLA-DR, and MUTZ-3 DLC downregulated CD14 and expressed CD1a. Importantly, both KG-1 and MUTZ-3-derived DLC promoted proliferation of allogeneic responder cells more efficiently than unmodified cells; neither cells incorporated FITC-labeled dextran, but both stimulated IFN-γ production from responding allogeneic CD8+ T cells. Control DC produced from PBMC using the FastDC culture also expressed high levels of critical cell surface ligands and demonstrated good APC function. This paper indicates that functional DLC can be cultured from the AML cell lines KG-1 and MUTZ-3, and FastDC culture generates functional KG-1 DLC

Exploring the lives of women smallholder farmers in Papua New Guinea through a collaborative mixed methods approach

This paper analyzes the design, implementation, and challenges associated with mixing methods within a baseline study involving the collaboration of rural women smallholders and their families in three regions of Papua New Guinea. We first describe the context of the research and how the baseline study was conceptualized as part of a participatory research and development project designed to provide a rich collaborative learning exchange between participants and researchers. We explain how three qualitative participatory techniques used alongside a small-scale quantitative livelihoods survey to gain an understanding of the social, economic, and agricultural factors impacting upon the lives women smallholders and their families. We follow this with a critical discussion of the challenges and benefits of utilizing mixed methods in an international development contex

Ten years after the first inspection of a candidate European centre, an EBMT registry analysis suggests that clinical is improved when hematopoietic SCT is performed in a Jacie accredited program

In 2010, JACIE, the Joint Accreditation Committee of ISCT (International Society for Cell Therapy) Europe and EBMT (European group for Blood and Marrow Transplantation) celebrated the tenth anniversary of the first inspection of a European hematopoietic SCT program. JACIE standards establish the criteria for a comprehensive quality management program that covers all three major domains of activity that are necessary for the delivery of HSCT: clinical, collection and processing, as well as their interactions with ancillary and supportive activities. Although more than 200 European programs have applied for JACIE accreditation, and more than 100 have been granted accreditation, a recent retrospective analysis of the large-size EBMT registry of autologous and allogenic hematopoietic HSCT demonstrates that one of the factors affecting the overall survival of recipients of allogenic transplantation is the status of the transplant program regarding JACIE accreditation. This provides one of the first demonstrations that introduction of a quality management system contributes to the overall survival of patients treated with a highly specific medical procedure, and represents a milestone in the implementation of JACIE

Marrow transplants from unrelated donors for patients with aplastic anemia: Minimum effective dose of total body irradiation

AbstractPatients with aplastic anemia who do not have suitably HLA-matched, related donors generally receive immunosuppressive treatment as first-line therapy and are considered for transplantation from an unrelated donor only if they fail to respond to immunosuppressive treatment. In this setting, rates of transplantation-related morbidity and mortality have been high. We conducted a prospective study to determine the minimal dose of total body irradiation (TBI) sufficient to achieve sustained engraftment when it is used in combination with 3 cycles of 30 mg/kg of antithymocyte globulin (ATG) and 4 cycles of 50 mg/kg of cyclophosphamide (CY). We also wanted to determine the tolerability and toxicity of the regimen. The starting dosage of TBI was 3 x 200 cGy given over 2 days following CY/ATG. The TBI dose was to be escalated in increments of 200 cGy if graft failure occurred in the absence of prohibitive toxicity, and de-escalated for toxicity in the absence of graft failure. Twenty-one female and 29 male patients aged 1.3 to 46.5 years (median age, 14.4 years) underwent transplantation at 14 medical centers. The time interval from diagnosis to transplantation was 2.8 to 264 months (median, 14.5 months). All patients had been transfused multiple times and all had received 1 to 11 courses (median, 4 courses) of immunosuppressive treatment and other modalities of treatment. In 38 cases, the donors were HLA-A, -B and -DR phenotypically matched with the patients, and, in 12 cases, the donor phenotype differed from that of the recipient by 1 HLA antigen. Recipients of mismatched transplants were considered separately for TBI dose modification, and this study is still ongoing. Seven patients did not tolerate ATG and were prepared with 6 x 200 cGy of TBI plus 120 mg/kg of CY. Of the HLA-matched recipients prepared with CY/ATG/TBI, all 20 who received 3 x 200 or 2 x 200 cGy of TBI achieved engraftment, and 10 are alive. Of the 13 patients who received 1 x 200 cGy of TBI, 1 failed to engraft, and 8 are alive. Each of 10 patients who received an HLA-nonidentical transplant achieved engraftment, and 3 of 6 who were given 3 x 200 cGy of TBI, and 4 of 4 who were given 2 x 200 cGy are alive. Pulmonary toxicity occurred in 8 of 30 patients who were given 3 x 200 or 2 x 200 cGy of TBI concurrently with ATG and CY at 200 mg/kg, and in 2 of 13 patients who received 1 x 200 cGy of TBI, a pattern that suggests a decrease in toxicity with TBI dose de-escalation. Overall, the highest probability of survival (73%) was observed among patients who underwent transplantation within 1 year of diagnosis, compared with patients who underwent transplantation after a longer period of disease. In addition, younger patients (aged < or = 20 years) were more likely to survive than older patients (aged > 20 years). Thus, for patients with an HLA-matched, unrelated donor, a TBI dose of 200 cGy (in combination with CY/ATG) was sufficient to allow for engraftment without inducing prohibitive toxicity. As in previous studies, patient age and pretransplantation disease duration remain important prognostic factors.Biol Blood Marrow Transplant 2001;7(4):208-15

Rapid treatment of moderate to severe hypertension using a novel protocol in a single-centre, before and after interventional study.

This is the author accepted manuscript. The final version is available from Springer Nature via the DOI in this record Rapid treatment to target in hypertension may have beneficial effects on long-term outcomes. This has led to a new recommendation in the 2018 European hypertension guidelines for patients with grade II/III hypertension to be treated to target within three months. However, whether it is feasible and safe to quickly manage treatment-naïve grade II/III hypertension to target was unclear. We examined this using a single-centre before and after interventional study, treating newly diagnosed, never-treated, grade II/III hypertensive patients with a daytime average systolic ABP ≥ 150 mmHg to target within 18 weeks. The proportion at office target BP at 18 weeks was determined, together with office and ambulatory BP change from baseline to after the intervention. The protocol was designed to maximise medication adherence, including a low threshold for treatment adaptation. Safety was evaluated through close monitoring of adverse events and protocol discontinuation. Fifty-five participants were enrolled with 54 completing the protocol. 69 ± 12.3% were at office target BP at their final visit, despite a high average starting BP of 175/103 mmHg, as a consequence of significant reductions in both office and ambulatory BP. Of those at office target BP, 51% were above target on ambulatory measurement. Adherence testing demonstrated that 92% of participants were adherent to treatment at their final visit. Therefore we conclude that the accelerated management of treatment-naïve grade II/III hypertension is feasible and safe to implement in routine practice and there is no evidence to suggest it causes harm. Further large-scale randomised studies of rapid, adaptive treatment, including a cost-effectiveness analysis, are required.Gawthorn Cardiac TrustNational Institute for Health Researc