131 research outputs found

    Romer v. Evans: Judicial Judgment or Emotive Utterance?

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    Investigating Evacuation Behaviour in Retirement Facilities: Case Studies from New Zealand

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    Caul Read and Publish agreement 2022.Publishe

    Effects of ruxolitinib cream on pruritus and quality of life in atopic dermatitis: Results from a phase 2, randomized, dose-ranging, vehicle- and active-controlled study

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    BACKGROUND: Atopic dermatitis (AD), a chronic, highly pruritic skin disorder, impairs quality of life (QoL). Janus kinase inhibitors suppress inflammatory and pruritus-associated cytokine signaling in AD. OBJECTIVE: To report the effects of ruxolitinib (RUX) cream on itch and QoL in AD. METHODS: A total of 307 adult patients with an Investigator\u27s Global Assessment (score of 2 or 3) and 3% to 20% affected body surface area were randomly assigned for 8 weeks to receive double-blind treatment with RUX (1.5% twice daily, 1.5% once daily, 0.5% once daily, or 0.15% once daily), vehicle twice daily, or triamcinolone cream (0.1% twice daily for 4 weeks then vehicle for 4 weeks). Itch was measured by using the numerical rating scale, and patient QoL was assessed with Skindex-16. RESULTS: Improvements in itch numerical rating scale and Skindex-16 were observed with RUX cream. Overall, 42.5% of patients who applied 1.5% RUX twice daily experienced minimal clinically important difference in itch within 36 hours of treatment (vehicle, 13.6%; P \u3c .01); near-maximal improvement was observed by week 4. Itch reduction was associated with improved QoL burden (Pearson correlation, 0.67; P \u3c .001). Significant improvements in Skindex-16 overall scores were noted at week 2. LIMITATIONS: Facial AD lesions were not treated. CONCLUSION: RUX cream provides a clinically meaningful reduction in itch and QoL burden

    Treatment of atopic dermatitis with ruxolitinib cream (JAK1/JAK2 inhibitor) or triamcinolone cream

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    BACKGROUND: Atopic dermatitis (AD) is a highly pruritic chronic inflammatory skin disorder. Ruxolitinib, a selective inhibitor of Janus kinase 1 and Janus kinase 2, potently suppresses cytokine signaling involved in AD pathogenesis. OBJECTIVE: We sought to evaluate the efficacy and safety of ruxolitinib (RUX) cream in adults with AD. METHODS: In this phase 2 study (NCT03011892), 307 adult patients with AD, an Investigator\u27s Global Assessment score of 2 or 3 (mild or moderate), and 3% to 20% affected body surface area were equally randomized for 8 weeks of double-blind treatment to RUX (1.5% twice daily [BID], 1.5% once daily [QD], 0.5% QD, 0.15% QD), vehicle, or triamcinolone cream (0.1% BID for 4 weeks, then vehicle for 4 weeks). Subsequently, patients could apply 1.5% RUX BID for 4 additional weeks of open-label treatment. The primary end point was the comparison between 1.5% RUX cream BID and vehicle in mean percentage change from baseline in Eczema Area and Severity Index at week 4. RESULTS: All RUX regimens demonstrated therapeutic benefit at week 4; 1.5% BID provided the greatest improvement in Eczema Area and Severity Index (71.6% vs 15.5%; P \u3c .0001) and Investigator\u27s Global Assessment responses (38.0% vs 7.7%; P \u3c .001) versus vehicle. Rapid reductions in the itch numerical rating scale score occurred within 36 hours (1.5% BID vs vehicle, ‒1.8 vs ‒0.2; P \u3c .0001) and were sustained through 12 weeks. Patients who transitioned to 1.5% RUX BID improved in all measures. RUX was not associated with clinically significant application-site reactions. CONCLUSIONS: RUX cream provided rapid and sustained improvements in AD symptoms and was well tolerated

    The impact of a change on the size of the smoke compartment in the evacuation of health care facilities

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    Evacuation in health-care facilities is complex due to the physical impairment of the patients. This kind of evacuation usually requires the assistance of the workforce members. A proposed change of NFPA 101, Life Safety Code, would increase the maximum allowable size of a smoke compartment (a space within the building enclosed by smoke barriers on all sides that restricts the movement of smoke) in health-care occupancies from 2090 m2 to 3700 m2, almost double the size. This study aims to analyse the impact of this change in the required time for evacuating patients during a fire in order to understand the consequences of that potential change. This paper is focused on the area where the patient?s rooms are located. The evacuation scenario is a floor plan comprised of four smoke compartments. To analyse the proposed change, the smoke barriers between two adjacent compartments were removed in a floor plan and three ratios of number of patients per one staff member were considered (4:1, 3:1 and 2:1). A computational methodology was conducted to calibrate the model STEPS for simulating assisted evacuation processes. In addition, Fire Dynamic Simulator (FDS) was used to simulate the fire and smoke spread in a table and a PC to compare fire and evacuation results The evacuation results show that the change of the smoke compartment size increases the mean evacuation time by 23%; however, the fire results show that the available safe egress time is 16 min for both smaller and large smoke compartment. The ratio of the number of patients per staff member is also a strong factor that increases the evacuation up to 82% when comparing the ratios of 2 patients per staff member and 4 patients per staff member

    The simulation of wildland-urban interface fire evacuation: The WUI-NITY platform

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    Wildfires are a significant safety risk to populations adjacent to wildland areas, known as the wildland-urban interface (WUI). This paper introduces a modelling platform called WUI-NITY. The platform is built on the Unity3D game engine and simulates and visualises human behaviour and wildfire spread during an evacuation of WUI communities. The purpose of this platform is to enhance the situational awareness of responders and residents during evacuation scenarios by providing information on the dynamic evolution of the emergency. WUI-NITY represents current and predicted conditions by coupling the three key modelling layers of wildfire evacuation, namely the fire, pedestrian, and traffic movement. This allows predictions of evacuation behaviour over time. The current version of WUI-NITY demonstrates the feasibility and advantages of coupling the modelling layers. Its wildfire modelling layer is based on FARSITE, the pedestrian layer implements a dedicated pedestrian response and movement model, and the traffic layer includes a traffic evacuation model based on the Lighthill-Whitham-Richards model. The platform also includes a sub-model called PERIL that designs the spatial location of trigger buffers. The main contribution of this work is in the development of a modular and model-agnostic (i.e., not linked to a specific model) platform with consistent levels of granularity (allowing a comparable modelling resolution in the representation of each layer) in all three modelling layers. WUI-NITY is a powerful tool to protect against wildfires; it can enable education and training of communities, forensic studies of past evacuations and dynamic vulnerability assessment of ongoing emergencies

    Assessment of oxidative damage to proteins and DNA in urine of newborn infants by a validated UPLC-MS/MS approach

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    The assessment of oxidative stress is highly relevant in clinical Perinatology as it is associated to adverse outcomes in newborn infants. This study summarizes results from the validation of an Ultra Performance Liquid Chromatography-tandem Mass Spectrometry (UPLC-MS/MS) method for the simultaneous quantification of the urinary concentrations of a set of endogenous biomarkers, capable to provide a valid snapshot of the oxidative stress status applicable in human clinical trials, especially in the field of Perinatology. The set of analytes included are phenylalanine (Phe), para-tyrosine (p-Tyr), ortho-tyrosine (o-Tyr), meta-tyrosine (m-Tyr), 3-NO2-tyrosine (3NO 2-Tyr), 3-Cl-tyrosine (3Cl-Tyr), 2′-deoxyguanosine (2dG) and 8-hydroxy-2′-deoxyguanosine (8OHdG). Following the FDA-based guidelines, appropriate levels of accuracy and precision, as well as adequate levels of sensitivity with limits of detection (LODs) in the low nanomolar (nmol/L) range were confirmed after method validation. The validity of the proposed UPLC-MS/MS method was assessed by analysing urine samples from a clinical trial in extremely low birth weight (ELBW) infants randomized to be resuscitated with two different initial inspiratory fractions of oxygen

    Mutual Information for the Detection of Crush

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    Fatal crush conditions occur in crowds with tragic frequency. Event organizers and architects are often criticised for failing to consider the causes and implications of crush, but the reality is that both the prediction and prevention of such conditions offer a significant technical challenge. Full treatment of physical force within crowd simulations is precise but often computationally expensive; the more common method of human interpretation of results is computationally “cheap” but subjective and time-consuming. This paper describes an alternative method for the analysis of crowd behaviour, which uses information theory to measure crowd disorder. We show how this technique may be easily incorporated into an existing simulation framework, and validate it against an historical event. Our results show that this method offers an effective and efficient route towards automatic detection of the onset of crush
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