Allergic and immunological aspects of therapy with cefotaxime and other cephalosporins

Immunogenicity and allergenicity studies in rodents show that cefotaxime and cefur-oxime are less immunogenic than benzylpenicillin or the semisynthetic penicillins. Cross-reactions of these antibiotics with benzylpenicilloyl-specific animal and human IgE antibodies appear minimal. Some cross-reactivity at the level of cell-mediated allergic reactions may, however, be expecte

Method for Rapid Interplanetary Trajectory Analysis using ΔV Maps with Flyby Options

This paper develops a convenient tool which is capable of calculating ballistic interplanetary trajectories with planetary flyby options to create exhaustive V contour plots for both direct trajectories without flybys and flyby trajectories in a single chart. The contours of V for a range of departure dates (x-axis) and times of flight (y-axis) serve as a “visual calendar” of launch windows, which are useful for the creation of a long-term transportation schedule for mission planning purposes. For planetary flybys, a simple powered flyby manoeuvre with a reasonably small velocity impulse at periapsis is allowed to expand the flyby mission windows. The procedure of creating a V contour plot for direct trajectories is a straightforward full- factorial computation with two input variables of departure and arrival dates solving Lambert's problem for each combination. For flyby trajectories, a “pseudo full-factorial” computation is conducted by decomposing the problem into two separate full- factorial computations. Mars missions including Venus flyby opportunities are used to illustrate the application of this model for the 2020-2040 time frame. The “competitiveness” of launch windows is defined and determined for each launch opportunity

Detailed site distribution of melanoma and sunlight exposure: aetiological patterns from a Swiss series

Background: The relation between detailed cutaneous distribution of melanoma and indicators of sun exposure patterns has scantily been explored in moderately sun-sensitive populations. Patients and methods: The precise site of 1658 primary malignant melanoma, registered from 1995 to 2002, in Switzerland were retrieved and clinically validated. Relative melanoma density (RMD) was computed by the ratio of observed to expected number of melanoma allowing for body site surface areas, and further adjusted for site-specific melanocyte density. Results: Sites of highest risks were the face, shoulder and upper arm for both sexes, the back for men, and leg for women. Major features of this series were: (i) an unexpectedly high RMD for the face in women (5.6 versus 3.7 in men), (ii) the absence of a male predominance for melanoma on the ears and (iii) for the upper limbs, a steady gradient of increasing melanoma density with increasing proximity to the trunk, regardless of sex. Age and sex patterns of RMD parallelled general indicators of sun exposure and behaviour, except for the hand (RMD = 0.2). Conclusion: RMD increased with (cumulative) site sun exposure, but a few notable exceptions support the impact of intermittent exposure in melanoma ris

A Generalized Multi-Commodity Network Flow Model for the Earth-Moon-Mars Logistics System

Simple logistics strategies such as "carry-along" and Earth-based "resupply" were sufficient for past human space programs. Next-generation space logistics paradigms are expected to be more complex, involving multiple exploration destinations and in-situ resource utilization (ISRU). Optional ISRU brings additional complexity to the interplanetary supply chain network design problem. This paper presents an interdependent network flow modeling method for determining optimal logistics strategies for space exploration and its application to the human exploration of Mars. It is found that a strategy utilizing lunar resources in the cislunar network may improve overall launch mass to low Earth orbit for recurring missions to Mars compared to NASA’s Mars Design Reference Architecture 5.0, even when including the mass of the ISRU infrastructures that need to be pre-deployed. Other findings suggest that chemical propulsion using LOX/LH[subscript 2], lunar ISRU water production, and the use of aerocapture significantly contribute to reducing launch mass from Earth. A sensitivity analysis of ISRU reveals that under the given assumptions, local lunar resources become attractive at productivity levels above 1.8 kg/year/kg in the context of future human exploration of Mars.Jet Propulsion Laboratory (U.S.). Strategic University Research Partnerships Progra

Strengthening Competence of Therapists-in-Training in the Treatment of Health Anxiety (Hypochondriasis): Validation of the Assessment of Core CBT Skills (ACCS)

Although the observation and assessment of psychotherapeutic competences is central to training, supervision, patient care, quality control, and life‐long practice, structured instruments are used only occasionally. In the current study, an observation‐based tool for the Assessment of Core CBT Skills (ACCS) was translated into German and adapted, and its psychometric properties were pilot evaluated. Competence of therapists‐in‐training was assessed in a random sample of n = 30 videos on cognitive‐behavioral therapy including patients diagnosed with hypochondriasis. Two of three raters independently assessed the competences demonstrated in the entire, active treatment sessions (n = 60). In our sample, internal consistency was excellent, and interrater reliability was good. Convergent validity (Cognitive Therapy Scale) and discriminant validity (Helping Alliance Questionnaire) were within the expected ranges. The ACCS total score did not significantly predict the reduction of symptoms of hypochondriasis, and a one‐factorial structure of the instrument was found. By providing multiple opportunities for feedback, self‐reflection and supervision, the ACCS may complement current tools for the assessment of psychotherapeutic competences and importantly, support competence‐based training and supervision

Recommendations for Clinical CYP2C19 Genotyping Allele Selection: A Report of the Association for Molecular Pathology

This document was developed by the Pharmacogenetics (PGx) Working Group of the Association for Molecular Pathology Clinical Practice Committee, whose aim is to recommend variants for inclusion in clinical pharmacogenetic testing panels. The goals of the Association for Molecular Pathology PGx Working Group are to define the key attributes of PGx alleles recommended for clinical testing and to define a minimum set of variants that should be included in clinical PGx genotyping assays. These recommendations include a minimum panel of variant alleles (tier 1) and an extended panel of variant alleles (tier 2) that will aid clinical laboratories when designing PGx assays. The Working Group considered variant allele frequencies in different populations and ethnicities, the availability of reference materials, and other technical considerations for PGx testing when developing these recommendations. These CYP2C19 genotyping recommendations are the first of a series of recommendations for PGx testing. These recommendations are not to be interpreted as restrictive, but they are meant to provide a helpful guide

Identification of Human Papillomavirus Infection in Cancer Tissue by Targeted Next-generation Sequencing

Human papillomaviruses (HPV) are oncogenic DNA viruses implicated in squamous cell carcinomas of several anatomic sites, as well as endocervical adenocarcinomas. Identification of HPV is an actionable finding in some carcinomas, potentially influencing tumor classification, prognosis, and management. We incorporated capture probes for oncogenic HPV strains 16 and 18 into a broader next-generation sequencing (NGS) panel designed to identify actionable mutations in solid malignancies. A total of 21 head and neck, genitourinary and gynecological squamous cell carcinomas and endocervical adenocarcinomas were sequenced as part of the UNCSeq project. Using p16 immunohistochemical results as the gold standard, we set a cutoff for proportion of aligned HPV reads that maximized performance of our NGS assay (92% sensitive, 100% specific for HPV). These results suggest that sequencing of oncogenic pathogens can be incorporated into targeted NGS panels, extending the clinical utility of genomic assays