An Analysis of ISO 9000\u27s Applicability to Worldwide Warehouse Quality Assurance

This study examines the applicability of ISO 9000, a world-wide quality standard, to the quality assurance procedures being built into a new Foreign Military Sales FMS program. This new program, the Worldwide Warehouse, is an Air Force Security Assistance Center AFSAC attempt to assist FMS customers in reducing excess materiel inventories. Areas of investigation include ISO 9000s international acceptance, its ability to ensure quality products, and a case study of SHARE, a NATO initiative which employs ISO 9000 in quality assurance and is dramatically similar to the Worldwide Warehouse. The researchers conduct an exploratory study using a literature review and personal interviews with individuals possessing special insight in the subject areas. It is concluded that achieving ISO 9000 certification is very difficult, maybe even impossible for some Worldwide Warehouse customers. This difficulty often results in years of effort. Going further, the fact that the benefits to be gained by the Worldwide Warehouse are minimal even if successful implementation were achieved, leads to the conclusion that the value added does not justify ISO 9000 as the standard for Worldwide Warehouse quality assurance

Natural history of ‘second’ biochemical failure after salvage radiation therapy for prostate cancer: a multi‐institution study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142463/1/bju13926.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142463/2/bju13926_am.pd

Development and validation of a unifying pre-treatment decision tool for intracranial and extracranial metastasis-directed radiotherapy

BackgroundThough metastasis-directed therapy (MDT) has the potential to improve overall survival (OS), appropriate patient selection remains challenging. We aimed to develop a model predictive of OS to refine patient selection for clinical trials and MDT.Patients and methodsWe assembled a multi-institutional cohort of patients treated with MDT (stereotactic body radiation therapy, radiosurgery, and whole brain radiation therapy). Candidate variables for recursive partitioning analysis were selected per prior studies: ECOG performance status, time from primary diagnosis, number of additional non-target organ systems involved (NOS), and intracranial metastases.ResultsA database of 1,362 patients was assembled with 424 intracranial, 352 lung, and 607 spinal treatments (n=1,383). Treatments were split into training (TC) (70%, n=968) and internal validation (IVC) (30%, n=415) cohorts. The TC had median ECOG of 0 (interquartile range [IQR]: 0-1), NOS of 1 (IQR: 0-1), and OS of 18 months (IQR: 7-35). The resulting model components and weights were: ECOG = 0, 1, and > 1 (0, 1, and 2); 0, 1, and > 1 NOS (0, 1, and 2); and intracranial target (2), with lower scores indicating more favorable OS. The model demonstrated high concordance in the TC (0.72) and IVC (0.72). The score also demonstrated high concordance for each target site (spine, brain, and lung).ConclusionThis pre-treatment decision tool represents a unifying model for both intracranial and extracranial disease and identifies patients with the longest survival after MDT who may benefit most from aggressive local therapy. Carefully selected patients may benefit from MDT even in the presence of intracranial disease, and this model may help guide patient selection for MDT

Consolidative radiotherapy for residual fluorodeoxyglucose activity on day +30 post CAR T-cell therapy in non-Hodgkin lymphoma

Majority of non-Hodgkin lymphoma (NHL) patients who achieve partial response (PR) or stable disease (SD) to CAR T-cell therapy (CAR T) on day +30 progress and only 30% achieve spontaneous complete response (CR). This study is the first to evaluate the role of consolidative radiotherapy (cRT) for residual fluorodeoxyglucose (FDG) activity on day +30 post- CAR T in NHL. We retrospectively reviewed 61 patients with NHL who received CAR T and achieved PR or SD on day +30. Progression-free survival (PFS), overall survival (OS), and local relapse-free survival (LRFS) were assessed from CAR T infusion. cRT was defined as comprehensive - treated all FDG-avid sites - or focal. Following day +30 positron emission tomography scan, 45 patients were observed and 16 received cRT. Fifteen (33%) observed patients achieved spontaneous CR, and 27 (60%) progressed with all relapses involving initial sites of residual FDG activity. Ten (63%) cRT patients achieved CR, and four (25%) progressed with no relapses in the irradiated sites. The 2-year LRFS was 100% in the cRT sites and 31% in the observed sites (P<0.001). The 2-year PFS was 73% and 37% (P=0.025) and the 2-year OS was 78% and 43% (P=0.12) in the cRT and observation groups, respectively. Patients receiving comprehensive cRT (n=13) had superior 2- year PFS (83% vs. 37%; P=0.008) and 2-year OS (86% vs. 43%; P=0.047) compared to observed or focal cRT patients (n=48). NHL patients with residual FDG activity following CAR T are at high risk of local progression. cRT for residual FDG activity on day +30 post-CAR T appears to alter the pattern of relapse and improve LRFS and PFS

Toxin-Based Therapeutic Approaches

Protein toxins confer a defense against predation/grazing or a superior pathogenic competence upon the producing organism. Such toxins have been perfected through evolution in poisonous animals/plants and pathogenic bacteria. Over the past five decades, a lot of effort has been invested in studying their mechanism of action, the way they contribute to pathogenicity and in the development of antidotes that neutralize their action. In parallel, many research groups turned to explore the pharmaceutical potential of such toxins when they are used to efficiently impair essential cellular processes and/or damage the integrity of their target cells. The following review summarizes major advances in the field of toxin based therapeutics and offers a comprehensive description of the mode of action of each applied toxin

Acceptable Activists, Absence, and Antifeminists : A Feminist Historical Critique of National Statuary Hall

vii + 135 pages, color photographs, and references (pages 122-135).In recent years, debates surrounding monuments and the messages they transmit through public space have exploded. A public, cultural conversation has emerged about monuments, collective memory, systemic racism, and societal values, not just in the United States, but globally. While academic conversations about monuments and their meanings have been present in the fields of history and art history since the 1990s, specific analysis about gender representation in the monumental landscape has only just begun. This thesis will examine National Statuary Hall and the monuments within it at the United States Capitol Building in Washington, D.C., the capital city that serves as both the political and commemorative core of the nation. By analyzing government legislation, lobbying records, Congressional reports, and other primary sources, I argue that Statuary Hall is a site of State-constructed monumental antifeminism. The existing monuments of women in Statuary Hall when it reached its capacity of 100 represented a constructed image of patriotic femininity reflecting specific images of an idealized American woman in the national narrative. Through primary source analysis, I examine how lobbyists and legislators at the state and federal level utilized constrictive ideas of gender norms to shape the legacies and histories of specific women to construct a core narrative of patriotism, loyalty to the State, and an ‘acceptable’ female activist within the Hall. I also examine the silences in Statuary Hall, particularly of feminist historical figures, to underscore my argument that the monuments within this national commemorative space have worked to present a specific narrative of the ‘ideal’ US-American woman, intended to serve as examples of virtue, patriotism, and acceptable feminine identity. I focus on three primary case studies of monuments in Statuary Hall: Frances E. Willard of Illinois, Maria Sanford of Minnesota, and Sacajawea of North Dakota. My analysis includes an examination of the legislative decisions behind the creation of each monument, the iconography in the statues themselves, and the power of place in their location in the Capitol Building. In addition, I discuss the overall gender inequity of the Hall and critique the inclusion of monuments honoring documented antifeminists. Overall, I argue that by manipulating the legacies of activist women to fit a nationalist ideal, ignoring gender inequity at the site, and commemorating men who have promoted antifeminist ideals, legislators with the power to influence representation at Statuary Hall have contributed to the creation of a powerful commemorative space that diminishes women’s roles in the national narrative, constructs an image of an ideal American woman centered on strict gender norms and notions of patriotism, and creates a falsified and damaging legacy for women and their activism in the nineteenth and twentieth centuries

Carvedilol offers significant advantages over Metoprolol for control of hypertension in patients with Type II Diabetes Mellitus.

The information provided in this handout does not necessarily reflect the views of the University of Minnesota Medical School physicians and faculty. These materials are provided for informational purposes only and are in no way intended to take the place of the advice and recommendations of your personal health care provider. You use the information provided in these handouts at your own risk.When using beta-blocker for blood pressure in patients with Type II diabetes mellitus, the metabolic effects of Carvedilol are superior to those of Metoprolol. While both drugs appear to have equivalent ability to lower blood pressure, patients taking Carvedilol better HgbA1c levels, improved insulin sensitivity, and lower levels of microalbuminuria.Stish, Brad. (2010). Carvedilol offers significant advantages over Metoprolol for control of hypertension in patients with Type II Diabetes Mellitus.. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/92202

A New Drug Delivery Method of Bispecific Ligand-Directed Toxins, Which Reduces Toxicity and Promotes Efficacy in a Model of Orthotopic Pancreatic Cancer

OBJECTIVE: Biologicals targeting EGFR and IL-13R react with over-expressed markers on cancer cells, but also react with receptor on normal cells. Since we developed novel bispecific ligand directed toxins (BLT) synthesized by cloning EGF and IL-13 on the same molecule with toxin, our objective was to determine whether we could block normal receptors while still targeting receptors over-expressed on cancer cells thereby decreasing toxicity while maintaining efficacy. METHODS: A method, ToxBloc, was developed in which a bolus IP dose of recombinant EGF13 (without toxin) was given to mice about 15-20 minutes prior to DTEGF13. Experiments were then performed to determine if the MTD was reduced and whether we still were able to eliminate progression of aggressive human, metastatic, systemic pancreatic cancer induced by orthotopic injection in nude mice. RESULTS: ToxBloc permitted us to safely exceed the DTEGF13 MTD by 15-fold. This approach permitted repetitive high dosing with the BLT resulting in tumor regression (p<0.01). Tumor affects were documented using a tumor imaging model in which tumor growth was monitored noninvasively in real time. ToxBloc was selective since other bispecific peptides did not block. CONCLUSIONS: ToxBloc represents a new method of drug delivery and a potential solution to the toxicity problem