Pretransplantation Exercise and Hematopoietic Cell Transplantation Survival: A Secondary Analysis of Blood and Marrow Transplant Clinical Trials Network (BMT CTN 0902)

Blood and Marrow Transplant Clinical Trials Network (BMT CTN) Protocol 0902 evaluated whether exercise and stress management training prior to hematopoietic cell transplantation (HCT) improved physical and mental functioning after HCT. Neither overall survival nor other patient-reported transplant outcomes were improved by the training intervention. In some animal studies of HCT, moderate intensity exercise for 8 weeks before HCT has been associated with positive effects on hematopoietic progenitors resulting in improved donor engraftment and improved survival. Accordingly, we performed a secondary analysis of data from BMT CTN 0902 to determine whether exercise engagement prior to HCT was associated with engraftment and survival. There were no significant associations between self-reported pre-HCT exercise levels and engraftment or survival. There was also no effect of pre-transplant exercise on either neutrophil or platelet engraftment. These findings do not support the observations in animal models but are limited by several shortcomings that do not refute the hypothesis that exercise before HCT may be beneficial

OOI Biogeochemical Sensor Data: Best Practices and User Guide. Version 1.0.0.

The OOI Biogeochemical Sensor Data Best Practices and User Guide is intended to provide current and prospective users of data generated by biogeochemical sensors deployed on the Ocean Observatories Initiative (OOI) arrays with the information and guidance needed for them to ensure that the data is science-ready. This guide is aimed at researchers with an interest or some experience in ocean biogeochemical processes. We expect that users of this guide will have some background in oceanography, however we do not assume any prior experience working with biogeochemical sensors or their data. While initially envisioned as a “cookbook” for end users seeking to work with OOI biogeochemical (BGC) sensor data, our Working Group and Beta Testers realized that the processing required to meet the specific needs of all end users across a wide range of potential scientific applications and combinations of OOI BGC data from different sensors and platforms couldn’t be synthesized into a single “recipe”. We therefore provide here the background information and principles needed for the end user to successfully identify and understand all the available “ingredients” (data), the types of “cooking” (end user processing) that are recommended to prepare them, and a few sample “recipes” (worked examples) to support end users in developing their own “recipes” consistent with the best practices presented here. This is not intended to be an exhaustive guide to each of these sensors, but rather a synthesis of the key information to support OOI BGC sensor data users in preparing science-ready data products. In instances when more in-depth information might be helpful, references and links have been provided both within each chapter and in the Appendix

Exercise and Stress Management Training Prior to Hematopoietic Cell Transplantation: Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 0902

Studies show that engaging patients in exercise and/or stress management techniques during hematopoietic cell transplantation (HCT) improves quality of life. The Blood and Marrow Transplant Clinical Trials Network tested the efficacy of training patients to engage in self-directed exercise and stress management during their HCTs. The study randomized 711 patients at 21 centers to receive one of four training interventions before HCT: a self-directed exercise program, a self-administered stress management program, both or neither. Participants completed self-reported assessments at enrollment and up to 180 days after transplant. Randomization was stratified by center and transplant type. There were no differences in the primary endpoints of the physical (PCS) and mental (MCS) component scales of the SF36 at day 100 among the groups based on an intention-to-treat analysis. There were no differences observed in overall survival, hospital days through day 100 post-HCT, or in other patient-reported outcomes, including treatment-related distress, sleep quality, pain, and nausea. Patient randomized to training in stress management reported more use of those techniques; patients randomized to training in exercise did not report more physical activity. Although other studies have reported efficacy of more intensive interventions, brief training in an easy-to-disseminate format for either self-directed exercise or stress management was not effective in our trial

Delineation of Stage Specific Expression of Plasmodium falciparum EBA-175 by Biologically Functional Region II Monoclonal Antibodies

EBA-175 binds its receptor sialic acids on glycophorin A when invading erythrocytes. The receptor-binding region (RII) contains two cysteine-rich domains with similar cysteine motifs (F1 and F2). Functional relationships between F1 and F2 domains and characterization of EBA-175 were studied using specific monoclonal antibodies (mAbs) against these domains..The role of the F1 and F2 domains in erythrocyte invasion and binding was elucidated with mAbs. These mAbs interfere with native EBA-175 binding to erythrocyte in a synergistic fashion. The stage specific expression of EBA-175 showed that the primary focus of activity was the merozoite stage. A recombinant RII protein vaccine consisting of both F1 and F2 domains that could induce synergistic activity should be optimal for induction of antibody responses that interfere with merozoite invasion of erythrocytes

Aerosolized Delivery of Antifungal Agents

Pulmonary infections caused by Aspergillus species are associated with significant morbidity and mortality in immunocompromised patients. Although the treatment of pulmonary fungal infections requires the use of systemic agents, aerosolized delivery is an attractive option in prevention because the drug can concentrate locally at the site of infection with minimal systemic exposure. Current clinical evidence for the use of aerosolized delivery in preventing fungal infections is limited to amphotericin B products, although itraconazole, voriconazole, and caspofungin are under investigation. Based on conflicting results from clinical trials that evaluated various amphotericin B formulations, the routine use of aerosolized delivery cannot be recommended. Further research with well-designed clinical trials is necessary to elucidate the therapeutic role and risks associated with aerosolized delivery of antifungal agents. This article provides an overview of aerosolized delivery systems, the intrapulmonary pharmacokinetic properties of aerosolized antifungal agents, and key findings from clinical studies

Better Regional Ocean Observing Through Cross-National Cooperation: A Case Study From the Northeast Pacific

The ocean knows no political borders. Ocean processes, like summertime wind-driven upwelling, stretch thousands of kilometers along the Northeast Pacific (NEP) coast. This upwelling drives marine ecosystem productivity and is modulated by weather systems and seasonal to interdecadal ocean-atmosphere variability. Major ocean currents in the NEP transport water properties such as heat, fresh water, nutrients, dissolved oxygen, pCO2, and pH close to the shore. The eastward North Pacific Current bifurcates offshore in the NEP, delivering open-ocean signals south into the California Current and north into the Gulf of Alaska. There is a large and growing number of NEP ocean observing elements operated by government agencies, Native American Tribes, First Nations groups, not-for-profit organizations, and private entities. Observing elements include moored and mobile platforms, shipboard repeat cruises, as well as land-based and estuarine stations. A wide range of multidisciplinary ocean sensors are deployed to track, for example, upwelling, downwelling, ocean productivity, harmful algal blooms, ocean acidification and hypoxia, seismic activity and tsunami wave propagation. Data delivery to shore and observatory controls are done through satellite and cell phone communication, and via seafloor cables. Remote sensing from satellites and land-based coastal radar provide broader spatial coverage, while numerical circulation and biogeochemical modeling complement ocean observing efforts. Models span from the deep ocean into the inland Salish Sea and estuaries. NEP ocean observing systems are used to understand regional processes and, together with numerical models, provide ocean forecasts. By sharing data, experiences and lessons learned, the regional ocean observatory is better than the sum of its parts

Patient-Reported Outcomes and Socioeconomic Status as Predictors of Clinical Outcomes after Hematopoietic Stem Cell Transplantation: A Study from the Blood and Marrow Transplant Clinical Trials Network 0902 Trial

This secondary analysis of a large, multi-center Blood and Marrow Transplant Clinical Trials Network (BMT CTN) randomized trial assessed whether patient-reported outcomes (PROs) and socioeconomic status (SES) before hematopoietic stem cell transplantation (HCT) are associated with each other and predictive of clinical outcomes including time to hematopoietic recovery, acute graft-versus-host disease, hospitalization days, and overall survival (OS) among 646 allogeneic and autologous HCT recipients. Pre-transplant Cancer and Treatment Distress (CTXD), Pittsburgh Sleep Quality Index (PSQI), and mental and physical component scores (MCS and PCS) of the SF-36 were correlated with each other and with SES variables. PROs and SES variables were further evaluated as predictors of clinical outcomes, with the PSQI and CTXD evaluated as OS predictors (p<.01 considered significant given multiple testing). Lower attained education was associated with increased distress (p=.002); lower income was related to worse physical functioning (p=.005) and increased distress (p=.008); lack of employment pre-transplant was associated with worse physical functioning (p<.01); unmarried status was associated with worse sleep (p=.003). In this large heterogeneous cohort of HCT recipients, while PROs and SES variables were correlated at baseline, they were not associated with any clinical outcomes. Future research should focus on HCT recipients at greater psychosocial disadvantage

Figuring others: Toward a transnational feminist rhetorical analytic

In this project, I attempt to look at various genres of texts - public policy documents, national, alternative, and locally circulated presses - as well as multiple time frames in which these texts circulate in order to show how figures ideologically traffic across temporal terrain. These rhetorical productions become nodes in the analysis, and thinking in terms of nodes or linkages allows for a discussion of connectivity and contiguity, rather than analogy or linearity. By tracing figures across seemingly different temporal and cultural discourses, I hope to show the ways in which ideologies traffic across these discourses in the name of power. By bringing seemingly naturalized (or normalized) rhetorics into proximity with seemingly unrelated rhetorics I can begin to expose the ways that these rhetorics work together to mystify power and hierarchical relationships produced by nation states and capital. I am interested in using a transnational feminist rhetorical analytic to show how the past, present, and future are not causally connected through notions of nostalgia and/or progress, but instead are scrambled and ever-present from one temporal location to the next. In order to define the figures analyzed in this dissertation, I compiled an archive of various media publications (mainstream, independent, and limited circulation or ethnic presses) over the last twenty years. Within this initial research, I discovered that particular figures - the bandit, contaminant, terrorist, and predator - dominated media discussions of immigration and LGBT rights to varying degrees. What varied was the frequency of the term across particular dates. From there, I discovered that the terms were used most often in conjunction with the development, discussion, and adoption or defeat of national legislation. And what became even more significant was how the figures present in the media could also be found within the legislation itself. These eruptions of the figures demonstrate how media and legislative discourse are linked, and from this basic discovery, I began to formulate a project that not only traced figures across history, but also demonstrated how these figures are palimpsestic in nature - carrying markings of previous utterances across time and space

Current Smoking and Type 2 Diabetes Among Patients in Selected Indian Health Service Clinics, 1998–2003

Objectives. In non-American Indian/Alaska Native groups, current smoking prevalence is similar for those with or without diabetes (26%) We analyzed current smoking prevalence in American Indian/Alaska Natives by diabetes status