Development of type 1 diabetes in a patient treated with anti-TNF-α therapy for active rheumatoid arthritis

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Variation in nomenclature of somatic variants for selection of oncological therapies:Can we reach a consensus soon?

A standardized nomenclature for reporting oncology biomarker variants is key to avoid misinterpretation of results and unambiguous registration in clinical databases. External quality assessment (EQA) schemes have revealed a need for more consistent nomenclature use in clinical genetics. We evaluated the propensity of EQA for improvement of compliance with Human Genome Variation Society (HGVS) recommendations for reporting of predictive somatic variants in lung and colorectal cancer. Variant entries between 2012 and 2018 were collected from written reports and electronic results sheets. In total, 4,053 variants were assessed, of which 12.1% complied with HGVS recommendations. Compliance improved over time from 2.1% (2012) to 22.3% (2018), especially when laboratories participated in multiple EQA schemes. Compliance was better for next-generation sequencing (20.9%) compared with targeted techniques (9.8%). In the 1792 reports, HGVS recommendations for reference sequences were met for 31.9% of reports, for 36.0% of noncommercial, and 26.5% of commercial test methods. Compliance improved from 16.7% (2012) to 33.1% (2018), and after repeated EQA participation. EQA participation improves compliance with HGVS recommendations. The residual percentage of errors in the most recent schemes suggests that laboratories, companies, and EQA providers need to collaborate for additional improvement of harmonization in clinical test reporting

Delayed gastric emptying and reduced postprandial small bowel water content of equicaloric whole meal bread versus rice meals in healthy subjects: novel MRI insights

BACKGROUND/OBJECTIVES: Postprandial bloating is a common symptom in patients with functional gastrointestinal (GI) diseases. Whole meal bread (WMB) often aggravates such symptoms though the mechanisms are unclear. We used magnetic resonance imaging (MRI) to monitor the intragastric fate of a WMB meal (11% bran) compared to a rice pudding (RP) meal. SUBJECTS/METHODS: 12 healthy volunteers completed this randomised crossover study. They fasted overnight and after an initial MRI scan consumed a glass of orange juice with a 2267 kJ WMB or an equicaloric RP meal. Subjects underwent serial MRI scans every 45 min up to 270 min to assess gastric volumes and small bowel water content and completed a GI symptom questionnaire. RESULTS: The MRI intragastric appearance of the two meals was markedly different. The WMB meal formed a homogeneous dark bolus with brighter liquid signal surrounding it. The RP meal separated into an upper, liquid layer and a lower particulate layer allowing more rapid emptying of the liquid compared to solid phase (sieving). The WMB meal had longer gastric half emptying times (132±8 min) compared to the RP meal (104±7 min), P<0.008. The WMB meal was associated with markedly reduced MRI-visible small bowel free mobile water content compared to the RP meal, P<0.0001. CONCLUSIONS: WMB bread forms a homogeneous bolus in the stomach which inhibits gastric sieving and hence empties slower than the equicaloric rice meal. These properties may explain why wheat causes postprandial bloating and could be exploited to design foods which prolong satiation

Lack of Relationship Between Chronic Upper Abdominal Symptoms and Gastric Function in Functional Dyspepsia

To determine the relationship between gastric function and upper abdominal sensations we studied sixty FD patients (43 female). All patients underwent three gastric function tests: 13C octanoic gastric emptying test, three-dimensional ultrasonography (proximal and distal gastric volume), and the nutrient drink test. Upper abdominal sensations experienced in daily life were scored using questionnaires. Impaired proximal gastric relaxation (23%) and a delayed gastric emptying (33%) are highly prevalent in FD patients; however, only a small overlap exists between the two pathophysiologic disorders (5%). No relationship was found between chronic upper abdominal symptoms and gastric function (proximal gastric relaxation, gastric emptying rate, or drinking capacity) (all P > 0.01). Proximal gastric relaxation or gastric emptying rate had no effect on maximum drinking capacity (P > 0.01). The lack of relationship between chronic upper abdominal sensations and gastric function questions the role of these pathophysiologic mechanisms in the generation of symptoms

HYTHIRM Radiance Modeling and Image Analyses in Support of STS-119, STS-125 and STS-128 Space Shuttle Hypersonic Re-entries

We provide the first geometrically accurate (i.e., 3-D) temperature maps of the entire windward surface of the Space Shuttle during hypersonic reentry. To accomplish this task we began with estimated surface temperatures derived from CFD models at integral high Mach numbers and used them, the Shuttle's surface properties and reasonable estimates of the sensor-to-target geometry to predict the emitted spectral radiance from the surface (in units of W sr-1 m-2 nm-1). These data were converted to sensor counts using properties of the sensor (e.g. aperture, spectral band, and various efficiencies), the expected background, and the atmosphere transmission to inform the optimal settings for the near-infrared and midwave IR cameras on the Cast Glance aircraft. Once these data were collected, calibrated, edited, registered and co-added we formed both 2-D maps of the scene in the above units and 3-D maps of the bottom surface in temperature that could be compared with not only the initial inputs but also thermocouple data from the Shuttle itself. The 3-D temperature mapping process was based on the initial radiance modeling process. Here temperatures were guessed for each node in a well-resolved 3-D framework, a radiance model was produced and compared to the processed imagery, and corrections to the temperature were estimated until the iterative process converged. This process did very well in characterizing the temperature structure of the large asymmetric boundary layer transition the covered much of the starboard bottom surface of STS-119 Discovery. Both internally estimated accuracies and differences with CFD models and thermocouple measurements are at most a few percent. The technique did less well characterizing the temperature structure of the turbulent wedge behind the trip due to limitations in understanding the true sensor resolution. (Note: Those less inclined to read the entire paper are encouraged to read an Executive Summary provided at the end.

A Vision of Quantitative Imaging Technology for Validation of Advanced Flight Technologies

Flight-testing is traditionally an expensive but critical element in the development and ultimate validation and certification of technologies destined for future operational capabilities. Measurements obtained in relevant flight environments also provide unique opportunities to observe flow phenomenon that are often beyond the capabilities of ground testing facilities and computational tools to simulate or duplicate. However, the challenges of minimizing vehicle weight and internal complexity as well as instrumentation bandwidth limitations often restrict the ability to make high-density, in-situ measurements with discrete sensors. Remote imaging offers a potential opportunity to noninvasively obtain such flight data in a complementary fashion. The NASA Hypersonic Thermodynamic Infrared Measurements Project has demonstrated such a capability to obtain calibrated thermal imagery on a hypersonic vehicle in flight. Through the application of existing and accessible technologies, the acreage surface temperature of the Shuttle lower surface was measured during reentry. Future hypersonic cruise vehicles, launcher configurations and reentry vehicles will, however, challenge current remote imaging capability. As NASA embarks on the design and deployment of a new Space Launch System architecture for access beyond earth orbit (and the commercial sector focused on low earth orbit), an opportunity exists to implement an imagery system and its supporting infrastructure that provides sufficient flexibility to incorporate changing technology to address the future needs of the flight test community. A long term vision is offered that supports the application of advanced multi-waveband sensing technology to aid in the development of future aerospace systems and critical technologies to enable highly responsive vehicle operations across the aerospace continuum, spanning launch, reusable space access and global reach. Motivations for development of an Agency level imagery-based measurement capability to support cross cutting applications that span the Agency mission directorates as well as meeting potential needs of the commercial sector and national interests of the Intelligence, Surveillance and Reconnaissance community are explored. A recommendation is made for an assessment study to baseline current imaging technology including the identification of future mission requirements. Development of requirements fostered by the applications suggested in this paper would be used to identify technology gaps and direct roadmapping for implementation of an affordable and sustainable next generation sensor/platform system

Models for linking hunter retention and recruitment to regulations and game populations

IntroductionDeclining hunter populations across North America present wildlife management agencies with the prospect of declining revenues for wildlife conservation and management and the need for new tools to evaluate management strategies and predict future status of game species and hunters.MethodsHere we present a modeling framework and potential decision support tool for managers to link future hunter population dynamics to regulatory restrictiveness, prey abundance, and harvest success. Our hunter model is parameterized based on the authors’ judgment and can be used for demonstration purposes. We simulated three scenarios of restricted harvest, moderate harvest and liberal harvest.ResultsOur simulations show that even though liberal harvest predicts higher cumulative license sales revenue, it corresponds with a slight decline in buck abundance over 10 years. In contrast, highly restrictive harvest corresponds with deer population growth, but a near collapse of hunter populations. Our model demonstrates that managers might face tradeoffs between managing for deer population abundance and hunting revenue and clarifies how these factors might affect decision making.DiscussionThe utility of our tool would be dependent on accessing data on hunter retention and recruitment, however, the strength of our paper is in highlighting a new way of thinking about and potentially addressing these potential tradeoffs. Further, these simulations demonstrate that these tools could be used to evaluate management strategies but also highlight uncertainties, establish research priorities, and potentially design an adaptive management framework