91 research outputs found

    Futureproofing [18F]Fludeoxyglucose manufacture at an Academic Medical Center

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    Abstract Background We recently upgraded our [18F]fludeoxyglucose (FDG) production capabilities with the goal of futureproofing our FDG clinical supply, expanding the number of batches of FDG we can manufacture each day, and improving patient throughput in our nuclear medicine clinic. In this paper we report upgrade of the synthesis modules to the GE FASTLab 2 platform (Phase 1) and cyclotron updates (Phase 2) from both practical and regulatory perspectives. We summarize our experience manufacturing FDG on the FASTLab 2 module with a high-yielding self-shielded niobium (Nb) fluorine-18 target. Results Following installation of Nb targets for production of fluorine-18, a 55 ΌA beam for 22 min generated 1330 ± 153 mCi of [18F]fluoride. Using these cyclotron beam parameters in combination with the FASTLab 2, activity yields (AY) of FDG were 957 ± 102 mCi at EOS, corresponding to 72% non-corrected AY (n = 235). Our workflow, inventory management and regulatory compliance have been greatly simplified following the synthesis module and cyclotron upgrades, and patient wait times for FDG PET have been cut in half at our nuclear medicine clinic. Conclusions The combination of FASTlab 2 and self-shielded Nb fluorine-18 targets have improved our yield of FDG, and enabled reliable and repeatable manufacture of the radiotracer for clinical use.https://deepblue.lib.umich.edu/bitstream/2027.42/145727/1/41181_2018_Article_48.pd

    External influences and priority-setting for anti-cancer agents: a case study of media coverage in adjuvant trastuzumab for breast cancer

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    <p>Abstract</p> <p>Background</p> <p>Setting priorities for the funding of new anti-cancer agents is becoming increasingly complex. The funding of adjuvant trastuzumab for breast cancer has brought this dilemma to the fore. In this paper we review external factors that may influence decision-making bodies and present a case study of media response in Ontario, Canada to adjuvant trastuzumab for breast cancer.</p> <p>Methods</p> <p>A comprehensive search of the databases of Canadian national and local newspapers and television was performed. Articles pertaining to trastuzumab in adjuvant breast cancer as well as 17 other anti-cancer drugs and indications were retrieved. The search period was from the date when individual trial results were announced to the date funding was made available in Ontario.</p> <p>Results</p> <p>During the 2.6 months between the release of the trastuzumab results to funding approval in Ontario, we identified 51 episodes of media coverage. For the 17 other drugs/indications (7 breast and 10 non-breast), the median time to funding approval was 31 months (range 14–46). Other recent major advances in oncology such as adjuvant vinorelbine/cisplatin for resected NSCLC and docetaxel for advanced prostate cancer received considerably less media attention (17 media reports for each) than trastuzumab. The median number of media reports for breast cancer drugs was 4.5 compared to 2.5 for non-breast cancer drugs (p = 0.56).</p> <p>Conclusion</p> <p>Priority-setting for novel anti-cancer agents is a complex process that tries to ensure fair use of constrained resources to fund therapies with the best evidence of clinical benefit. However, this process is subject to external factors including the influence of media, patient advocates, politicians, and industry. The data in this case study serve to illustrate the significant involvement one (or all) of these external factors may play in the debate over priority-setting.</p

    Patterns of abundance across geographical ranges as a predictor for responses to climate change:Evidence from UK rocky shores

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    Aim: Understanding patterns in the abundance of species across thermal ranges can give useful insights into the potential impacts of climate change. The abundant-centre hypothesis suggests that species will reach peak abundance at the centre of their thermal range where conditions are optimal, but evidence in support of this hypothesis is mixed and limited in geographical and taxonomic scope. We tested the applicability of the abundant-centre hypothesis across a range of intertidal organisms using a large, citizen science-generated data set. Location: UK. Methods: Species' abundance records were matched with their location within their thermal range. Patterns in abundance distribution for individual species, and across aggregated species abundances, were analysed using Kruskal–Wallis tests and quantile general additive models. Results: Individually, invertebrate species showed increasing abundances in the cooler half of the thermal range and decreasing abundances in the warmer half of the thermal range. The overall shape for aggregated invertebrate species abundances reflected a broad peak, with a cool-skewed maximum abundance. Algal species showed little evidence for an abundant-centre distribution individually, but overall the aggregated species abundances suggested a hump-backed abundance distribution. Main Conclusions: Our study follows others in showing mixed support for the abundant-centre hypothesis at an individual species level, but demonstrates an increased predictability in species responses when an aggregated overall response is considered

    A Measurement of Coherent Neutral Pion Production in Neutrino Neutral Current Interactions in NOMAD

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    We present a study of exclusive neutral pion production in neutrino-nucleus Neutral Current interactions using data from the NOMAD experiment at the CERN SPS. The data correspond to 1.44×1061.44 \times 10^6 muon-neutrino Charged Current interactions in the energy range 2.5≀EΜ≀3002.5 \leq E_{\nu} \leq 300 GeV. Neutrino events with only one visible π0\pi^0 in the final state are expected to result from two Neutral Current processes: coherent π0\pi^0 production, {\boldmath Îœ+A→Μ+A+π0\nu + {\cal A} \to \nu + {\cal A} + \pi^0} and single π0\pi^0 production in neutrino-nucleon scattering. The signature of coherent π0\pi^0 production is an emergent π0\pi^0 almost collinear with the incident neutrino while π0\pi^0's produced in neutrino-nucleon deep inelastic scattering have larger transverse momenta. In this analysis all relevant backgrounds to the coherent π0\pi^0 production signal are measured using data themselves. Having determined the backgrounds, and using the Rein-Sehgal model for the coherent π0\pi^0 production to compute the detection efficiency, we obtain {\boldmath 4630±522(stat)±426(syst)4630 \pm 522 (stat) \pm 426 (syst)} corrected coherent-π0\pi^0 events with Eπ0≄0.5E_{\pi^0} \geq 0.5 GeV. We measure {\boldmath σ(ÎœA→ΜAπ0)=[72.6±8.1(stat)±6.9(syst)]×10−40cm2/nucleus\sigma (\nu {\cal A} \to \nu {\cal A} \pi^0) = [ 72.6 \pm 8.1(stat) \pm 6.9(syst) ] \times 10^{-40} cm^2/nucleus}. This is the most precise measurement of the coherent π0\pi^0 production to date.Comment: 23 pages, 9 figures, accepted for publication in Phys. Lett.

    Expected Performance of the ATLAS Experiment - Detector, Trigger and Physics

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    A detailed study is presented of the expected performance of the ATLAS detector. The reconstruction of tracks, leptons, photons, missing energy and jets is investigated, together with the performance of b-tagging and the trigger. The physics potential for a variety of interesting physics processes, within the Standard Model and beyond, is examined. The study comprises a series of notes based on simulations of the detector and physics processes, with particular emphasis given to the data expected from the first years of operation of the LHC at CERN

    A new data-driven map predicts substantial undocumented peatland areas in Amazonia

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    Tropical peatlands are among the most carbon-dense terrestrial ecosystems yet recorded. Collectively, they comprise a large but highly uncertain reservoir of the global carbon cycle, with wide-ranging estimates of their global area (441 025–1700 000 km2) and below-ground carbon storage (105–288 Pg C). Substantial gaps remain in our understanding of peatland distribution in some key regions, including most of tropical South America. Here we compile 2413 ground reference points in and around Amazonian peatlands and use them alongside a stack of remote sensing products in a random forest model to generate the first field-data-driven model of peatland distribution across the Amazon basin. Our model predicts a total Amazonian peatland extent of 251 015 km2^2 (95th percentile confidence interval: 128 671–373 359), greater than that of the Congo basin, but around 30% smaller than a recent model-derived estimate of peatland area across Amazonia. The model performs relatively well against point observations but spatial gaps in the ground reference dataset mean that model uncertainty remains high, particularly in parts of Brazil and Bolivia. For example, we predict significant peatland areas in northern Peru with relatively high confidence, while peatland areas in the Rio Negro basin and adjacent south-western Orinoco basin which have previously been predicted to hold Campinarana or white sand forests, are predicted with greater uncertainty. Similarly, we predict large areas of peatlands in Bolivia, surprisingly given the strong climatic seasonality found over most of the country. Very little field data exists with which to quantitatively assess the accuracy of our map in these regions. Data gaps such as these should be a high priority for new field sampling. This new map can facilitate future research into the vulnerability of peatlands to climate change and anthropogenic impacts, which is likely to vary spatially across the Amazon basin

    Predictors of packed red cell transfusion after isolated primary coronary artery bypass grafting – The experience of a single cardiac center: A prospective observational study

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    <p>Abstract</p> <p>Background</p> <p>Preoperative patients' characteristics can predict the need for perioperative blood component transfusion in cardiac surgical operations. The aim of this prospective observational study is to identify perioperative patient characteristics predicting the need for allogeneic packed red blood cell (PRBC) transfusion in isolated primary coronary artery bypass grafting (CABG) operations.</p> <p>Patients and Methods</p> <p>105 patients undergoing isolated, first-time CABG were reviewed for their preoperative variables and followed for intraoperative and postoperative data. Patients were 97 males and 8 females, with mean age 58.28 ± 10.97 years. Regression logistic analysis was used for identifying the strongest perioperative predictors of PRBC transfusion.</p> <p>Results</p> <p>PRBC transfusion was used in 71 patients (67.6%); 35 patients (33.3%) needed > 2 units and 14 (13.3%) of these needed > 4 units. Univariate analysis identified female gender, age > 65 years, body weight ≀ 70 Kg, BSA ≀ 1.75 m<sup>2</sup>, BMI ≀ 25, preoperative hemoglobin ≀ 13 gm/dL, preoperative hematocrit ≀ 40%, serum creatinine > 100 ÎŒmol/L, Euro SCORE (standard/logistic) > 2, use of CPB, radial artery use, higher number of distal anastomoses, and postoperative chest tube drainage > 1000 mL as significant predictors. The strongest predictors using multivariate analysis were CPB use, hematocrit, body weight, and serum creatinine.</p> <p>Conclusion</p> <p>The predictors of PRBC transfusion after primary isolated CABG are use of CPB, hematocrit ≀ 40%, weight ≀ 70 Kg, and serum creatinine > 100 ÎŒmol/L. This leads to better utilization of blood bank resources and cost-efficient targeted use of expensive blood conservation modalities.</p

    A Search for Single Photon Events in Neutrino Interactions

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    We present a search for neutrino-induced events containing a single, exclusive photon using data from the NOMAD experiment at the CERN SPS where the average energy of the neutrino flux is ≃25\simeq 25 GeV. The search is motivated by an excess of electron-like events in the 200--475 MeV energy region as reported by the MiniBOONE experiment. In NOMAD, photons are identified via their conversion to e+e−e^+e^- in an active target embedded in a magnetic field. The background to the single photon signal is dominated by the asymmetric decay of neutral pions produced either in a coherent neutrino-nucleus interaction, or in a neutrino-nucleon neutral current deep inelastic scattering, or in an interaction occurring outside the fiducial volume. All three backgrounds are determined {\it in situ} using control data samples prior to opening the `signal-box'. In the signal region, we observe {\bf 155} events with a predicted background of {\bf 129.2 ±\pm 8.5 ±\pm 3.3}. We interpret this as null evidence for excess of single photon events, and set a limit. Assuming that the hypothetical single photon has a momentum distribution similar to that of a photon from the coherent π0\pi^0 decay, the measurement yields an upper limit on single photon events, {\boldmath <4.0×10−4< 4.0 \times 10^{-4}} per \nm\ charged current event. Narrowing the search to events where the photon is approximately collinear with the incident neutrino, we observe {\bf 78} events with a predicted background of {\bf 76.6 ±\pm 4.9 ±\pm 1.9} yielding a more stringent upper limit, {\boldmath <1.6×10−4< 1.6 \times 10^{-4}} per \nm\ charged current event
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