27th June Research Articles

Argx-110 for Treatment of CD70-Positive Advanced Cutaneous T-Cell Lymphoma in a Phase 1/2 Clinical Trial

Argx-110 for Treatment of CD70-Positive Advanced Cutaneous T-Cell Lymphoma in a Phase 1/2 Clinical Trial

Põhjamaade kudumissümpoosion 2018 „Balti eri“ Viljandis / Nordic Knitting Symposium 2018: Baltic Special in Viljandi

The department of Estonian Native Crafts of the University of Tartu Viljandi Culture Academy hosted the 19th Nordic Knitting Symposium in Viljandi between the 24th of June and the 1st of July. This was the second time the symposium has taken place in Estonia. The gathering hosted a total of 104 participants from 12 different countries, as well as 19 knitting instructors and lecturers. The sub-title ‘Baltic Special’ means that the focus of the symposium was on the traditional knitting of the Baltics and neighbouring regions of Russia, and the instructors and lecturers all came from these countries. There was a tightly-packed programme of workshops, lectures, field trips, exhibitions, a crafts fair and other activities over the six days of the symposium, that had taken a year in planning.
 Knitting workshops were held on four of the days of the symposium. Two three-hour and two six-hour sessions were planned for each participant. These had to be chosen by participants during their pre-registration in January on the symposium’s website www.sisu.ut.ee/knitting2018. There was a range of workshops which chiefly featured topics directly or indirectly related to traditional Estonian knitting. There were also workshops on topics proposed by the two Latvian, one Lithuanian and two Russian knitting instructors.
 Four evenings also featured presentations on the history of traditional knitting, the knitted item collections of several museums, and the current revival of heritage knitting. Subjects related to Estonia were covered on two of the evenings. Anu Pink from Saara Publishing House presented a detailed account of archaeological Estonian knitted items from the perspective of a native crafts specialist. Siiri Reimann talked about the hundred-year history of the Haapsalu shawl and how the tradition of knitting Haapsalu shawls is still successfully kept alive. Riina Tomberg gave an overview of the historical knitted items of Estonian Swedes – Pakri, Noarootsi, Vormsi and Ruhnu Coastal Swedes – based on the collections of Estonian and some foreign museums. Kristi Jõeste analysed the factors that have breathed new life into traditional Estonian knitting.
 The Latvian lecture night on the 27th of June featured researcher Irita Žeiere from the Latvian National History Museum who talked about archaeological finds of knitted items from the 15th to 18th centuries. A total of 50 items have been found in Latvia, which is more than have been found in Estonia. Irita Heinola, curator of textile exhibitions at the same museum, provided participants with an in-depth photographic overview of ethnographic Latvian mittens, stockings and socks found in the museum’s collections.
 At the Russian lecture night on the 28th of June, Dr. Lyudmila Korolkova gave an overview of the Russian Ethnographical Museum’s collection of FinnoUgric knitting and Olga Konkova presented the ambitious project of the Villaväki Finno-Ugric society from the Leningrad Oblast seeking to revive the knitting of the traditional patterns of the region, drawing upon the collections of various museums. The photographer and knitting enthusiast Albina Lebedeva discussed the present situation of Western Russian knitting: the folk tradition is not in a good state at present, but it could be improved by well-planned promotional and pedagogical activities.
 On the one day with no workshops, the participants were taken to the Estonian National Museum, where they were able to visit four exhibitions: the permanent exhibition on Estonia, as well as ‘Echo of the Urals’, ‘Regarded as a Norm, Perennially Worn’, and ‘Landscapes of My Fatherland’. The latter exhibition featured the tapestries of Anu Raud. Several exhibitions of knitted items were also displayed in Viljandi in connection to the symposium.
 Friday’s programme gave the participants the opportunity to have some fun, as after the morning workshops, they were taken to the Heimtali Museum near Viljandi. Knitters from Tõstamaa and Kihnu demonstrated traditional knitted items and knitting, the participants paid a visit to Anu Raud at her farm and viewed unfinished tapestries in her workshop. Anu Raud also gave the participants an in-depth tour of the Heimtali Museum’s textiles collection. Later in the evening, the legendary open-air knitting competition ‘Walk and Knit’ took place for the seventh time. A total of 15 teams (each featuring 4 people) took part. First place went to the Finnish team, second to the joint Norwegian-Finnish team, and third to the joint team of Latvian and Lithuanian teachers.
 On the 30th of June, the last day of the symposium, tours of the Vilma lecture building of Viljandi Culture Academy and the small wool factory located inside the building took place. In the evening, the symposium concluded with a small exhibition and a gala dinner with thank-you announcements. The location of the next year’s symposium was also announced: the 20th anniversary of the event will be celebrated in Denmark, home of the Gavstrik federation, the founders of the symposium.

W opozycji do mitu i micie opozycji. Analiza polaryzacji stanowisk i ocen dotyczących Poznańskiego Czerwca '56, czyli rzecz o strajku na tle ekonomiczno-socjalnym i zamieszkach zbojnych o charakterze politycznym oraz o antykomunistycznym powstaniu i ofiarach totalitarnego systemu.

The article focuses on the question of Poznań 1956 protests. It presents three different types of showing this event and compares them. The article presents how the way of describing this historical event has been changing. Firstly, the author characterizes the statement of the communist authority in 1956, then the elaborations from 1980s (written during the “Carnival of Solidarity”) and finally, two different ways of contemporary analysis of what happened on the 28th of June, 1956. To sum up, the article emphasizes characteristic features of these elaborations which

Assessment of Some Risk Factors among Patients with Coronary Heart Disease

Background: Coronary heart disease is the most common type of heart diseases. This condition could results from a buildup of plaque inside the arteries, which decrease blood flow to the heart and raises the risk of a heart attack. The World Health Organization estimates that coronary heart disease prominent cause of death worldwide, and a number of well-characterized factors, including advanced age, genders, hypertension, diabetes mellitus, smoking and others contribute to Coronary heart disease risk development. Objective: To assess of some risk factors of patients with coronary heart disease. Patients and Methods: Hospitals based case-control study was conducted at Iraqi center for heart diseases in Ghazi Al-Hariri hospital / Medical City, Ibn-AL-Bitar cardiac surgery hospital and Ibn-AL-Nafees hospital during the periods from the 1st of November 2016 to the 30th of June 2017. A convenient sample was taken from each hospital. Typical questionnaire was used to interview 300 individuals, 100 (cases) and 200 (controls). The data collection included demographic characteristics and some risk factors of coronary heart disease. The participants were diagnosed by qualified physician and confirmed by specific laboratory and clinical tests including electrocardiogram (ECG) with the healthy controls that matched the age groups and genders. Results: This study offered that the percentage of age group is higher among (60-69) years were (12.0 %) in the cases, the number of males and females were (50, 16.7%), for each of them, according to marital status most of cases were married and educational levels the majority of cases were among institutes, colleges and above, while the occupation status were (11.3%) among house wife finally, the residence was high as (21.0%) in the urban areas, most of the risk factors were significantly associated with coronary heart diseases (P<0.05). Conclusion: Our outcomes indicated there were a significant association of modifiable risk factors (smoking, family history, diabetes mellitus, hypertension, taken meals contained high quantity fat and physical activity) for heart disease among patients with coronary heart disease.

Detection of the dispersion and residence of volcanic SO2 and sulfate aerosol from Nabro in 2011

Continuous detection of dispersion and residence of volcanic plumes in troposphere and lower stratosphere is vitally important for improving the understanding on the role of volcano eruptions in climate change. We report a 3-month continuous detection of dispersion and residence of volcanic plumes in the troposphere and stratosphere generated from the volcanic SO2 erupted by Nabro in Eritrea on June 12th, 2011 observed by the OMI sensor. The background SO2 concentration of 3 different height layers in troposphere and lower stratosphere were estimated by the 3-year-average daily concentration of monthly SO2 in 2005, 2007 and 2013, when there were no large explosive volcanic eruptions occurring. We also traced the diffusion path and the concentration of volcanic SO2 for the first 3 months after Nabro's eruption, and detected the appearance and dissipation of sulfate aerosols, which is a product converted from volcanic SO2. The results show that after Nabro erupted on June 12th, the volcanic plumes spread to middle latitudes (30°N-60°N) of Northern Hemisphere and loading by westerly jet. The volcanic SO2 in middle troposphere layer (TRM) and lower troposphere layer (TRL) stopped eastward spreading, and dissipated over the western Pacific Ocean on June 23rd. On June 26th, the volcanic SO2 in upper troposphere and lower stratosphere (STL) reached Mexico in Central America, and almost encircled the low latitudes and parts of middle latitudes. On June 28th, the volcanic SO2 plume showed an even distribution in STL. 37 days after the eruption, the volcanic SO2 in STL encircled the Northern Hemisphere evenly, sulfate aerosols in STL largely covered the low and middle latitudes and the daily concentration of SO2 was still higher than the background value. One month after the eruption, the global mean daily concentration of SO2 dropped to the normal value, but the daily concentration of SO2 and sulfate aerosols in low latitudes remained high, and dissipated not earlier than 3 months after the eruption of Nabro.

The prevalence of hepatitis B and C among blood donors at the National Blood Transfusion Center (CNTS) in Burundi.

Introductionin Burundi, blood safety is one of the concerns of the Ministry of Public Health and Fight against AIDS. To this end, all donor blood bags must be screened for hepatitis B and C, that is the reason why the National Blood Transfusion Center (CNTS) has an Enzyme-Linked Immunosorbent Assay (ELISA); better chain to perform these tests properly. This study aimed to highlight the prevalence of hepatitis B and C among blood donors at the National Blood Transfusion Center of Burundi for a period from the January the 1st to the 30th of June 2016.Methodsthis retrospective study was conducted among blood donors (both sexes) aged between 18 years and 50 years. The objective was to collect from the registration registers and the monthly activity reports, the results of the ELISA test obtained after the diagnosis of hepatitis B and C of the blood donors from 1stJanuary to 30th June 2016.Resultsin our series of 8,993 samples tested, the prevalence of HBV was 1.04% and HCV was 1.12%. No association VHB- HCV was recorded.Conclusionthis study showed a low prevalence rate which shows a clear improvement in preventative measures for donor selection and screening tests.

AUTOPSY

Background: One of the most frustrating challenges faced by the medicolegal doctors/ forensic pathologists is the inability to determine the cause of death in casesof sudden / unexpected deaths of medicolegal nature even after detailed autopsy as well asHistopathological / Toxicological analysis. Objective: The study was aimed to find out thepercentage of negative autopsy against the total cases of medicolegal autopsies conductedduring the study period in Lakki Marwat KPK. Material and methods: The study was carried outin DHQ Lakki Marwat based upon five years autopsy data from 1st January 2013 to 31st December2017. All the medico legal autopsies were included in the study whereas; the cases of allegedcustodial deaths / police encounters were excluded. The cases where gross examination atinitial autopsy, histopathalogical examination &amp; toxicological analysis failed to detect the causeof death were labeled as negative autopsies. Study design: Descriptive, Retrospective Study.Setting: The study was conducted at DHQ hospital Lakki Marwat. Period: 1st January 2013to 25th June 2017. Results: Out of the total 200 autopsies, there were 39 negative autopsiescomprising of 26 (60.46%) males and 17(39.53%) females. Conclusion: The cases of negativeautopsy are higher at lakki marwat as compared to international perspectives.the negativeautopsies are higher because of the inadequate training of doctors or limited resources likeavailability of histo-pathological labs, analytical services and radiological facilities. Postmortemunits and toxicology laboratories are not equipped according to the modern standards in thelight of recent advances in the field of medico legal death investigation.

Ann Sutherland: An Unforgettable Map Curator

9th November 1934 to 25th June 2018Ann Sutherland, who died on 25th June 2018, was best known in the cartographic community for her long-term leadership of the Map Curators’ Group (MCG). Her influe...

PCN254 - TRENDS IN BRCA TESTING OVER TIME AND SOCIOECONOMIC DEPRIVATION

BRCA1&2 (BRCA) testing received much publicity following Angelina Jolie’s editorial ‘My Medical Choice’ in the New York Times on the 14th May 2013. In addition, in the UK, guidelines were updated by NICE (clinical guidance CG164) on the 25th June 2013. We analysed the effects of these two events on uptake of BRCA1 and BRCA2 testing in the area covered by Cheshire and Merseyside Regional Genetic Service, and whether this was affected by socioeconomic deprivation. A database was collated using routinely collected hospital data for patients who received hereditary breast and ovarian cancer (HBOC) BRCA testing. A total of 1393 patients received BRCA testing. A natural experimental approach was undertaken using segmented linear regression to estimate changes in the level and trend of BRCA testing following the publication of both the Jolie’s editorial and NICE CG164. Regression coefficients were used to calculate average change in rates, adjusted for prior level and trend. The Index of Multiple Deprivation (IMD) of patients from areas who received BRCA testing to those of the catchment population were compared. The month following the publication of Jolie’s editorial and NICE CG164, BRCA testing increased by approximately 84% (P=0.006). Between April 2010 and March 2017, testing rates increased 11-fold from 0.14 to 1.52 tests/100,000 per month. The odds of receiving BRCA testing were higher for patients from socioeconomically advantaged areas pre-publication (OR 1.21 95% CI 0.99-1.48, P=0.06) although this was not significant. After publication the odds were significantly higher for patients from advantaged areas compared with disadvantaged areas (OR 1.18 95% CI 1.08-1.29, P=0.0002). Our study found that BRCA testing uptake increased following the publication of Jolie’s editorial and NICE CG164. However, uptake was lower in more deprived areas. This inequity should be further investigated, and consideration given to targeted care within areas of greater socioeconomic deprivation.

MTE06.02 How to Register Toxicity and Guide Patients

There are 125 million people exposed to asbestos in the workplace and it causes over 100,000 deaths annually (IOSH 2018). The UK has the highest incidence of Malignant Mesothelioma in the world with 2697 cases in 2015 (CRUK 2018). Approved treatment in the UK has not changed for over a decade with Pemetrexed and Cisplatin being the only standard treatment widely available. However the last 2 years has seen an increase in clinical trial opportunities using both targeted and immunotherapy drugs. To help promote equitable access, Mesothelioma UK publishes a regular clinical trials update listing all trials that are open to recruitment (Mesothelioma UK 2018). These new treatment options have brought with them new challenges in terms of patient expectation, accessing treatment and side effects. McCambridge et al (2018) describe 2017 as a year characterised by several important advances in the field although only a minority are considered practice changing. This results in patients feeling anxious about the ongoing limited treatment options and frustrated by difficulties experienced in trying to access new treatment modalities. This presentation will briefly review current treatment options in the UK and how patients and health care professionals are kept informed about treatment and trial opportunities. Approaches to managing treatment expectation are explored and finally how health care professionals and patients are educated about side effects from new treatment modalities in and out of clinical trials. IOSH 2018 (Institute of Occupational Safety and Health) No Time to Lose Campaign https://www.iosh.co.uk/VP/Home/Toolkit/IOSH-No-Time-to-Lose-Campaign.aspx (Last viewed June 18th 2018) CRUK 2018 (Cancer Research UK) Mesothelioma Incidence Statistics https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/mesothelioma/incidence (Last viewed June 28th 2018) Mesothelioma UK 2018 Clinical Trials http://www.mesothelioma.uk.com/information-support/information/clinical-trials/ (Last viewed July 4th 2018) McCambridge AJ, Napolitano A, Mansfield AS, Fennell DA, Sekido Y, Nowak AK, Reungwetwattana T, Mao W, Pass HI, Carbone M, Yang H, Peikert T, 2018. Progress in the Management of Malignant Pleural Mesothelioma in 2017. Journal of Thoracic Oncology Vol 13 No 5 606-623. Mesothelioma - accessing treatment

The role of district heating in coupling of the future renewable energy sectors

For the last decades energy efficiency initiatives have avoided enormous amounts of energy consumption, to the favor of the environment and consumer expenditures. Although there is still a big potential for further energy efficiency improvements it is time to move further and start preparing the whole energy system for the challenge of oversupply from intermittent renewable energy sources, particularly in the power sector. In 2015 the maximum one-hour power oversupply from wind turbines alone in Denmark happened the 26th of June, peaking at around 900 MW and the oversupply over a 15-hour period was 10 GWh. Known solutions to make use of oversupply in the power sector are power export, energy storage and halting the power generation. The power export needs to rely on sufficient capacity at local interconnectors, power demand in the importing country and there is an economic gain in the export. Energy storages can range from storing of power in batteries, pumped hydro, synthetic fuels to fuel displacing at other energy sectors. The last option is stopping the turbines, which should be avoided. The optimum energy storage would have large capacity, fast charging, high recovery efficiency and low cost. Scoring high on all criteria’s can be difficult when focusing on a single energy sector. By widening the perspective and start taking advantages of synergies between the energy sectors there is a possibility to score high on all three criteria’s. In this paper the potential of utilizing synergies between the power and heat sectors will be explored by considering the projections for the Danish energy system in 2025. The result of the analysis shows the optimum energy storage of renewable power is achieved through fuel displacement in the heating sector in combination with utility sized heat pumps, electric boilers and large thermal storages.

Non-medical university students are not more knowledgeable than general population concerning serious diseases

Background: The aim of this study was to know the level of awareness of non-medical university students of risk factors and symptoms of colorectal cancer.Methods: This is a cross-sectional study conducted at Al Baha University among non-medical students between 1st of May and 30th of June 2017.Results: The study comprised (n=463) students. Smoking and sedentary life as risk factors to CRC was known by (55.3%) and (51.0%) respectively. less than half (42%) knew that alcohol is a risk factor. The vast majority of our students (68.7%) had known that fruits and vegetables can decrease the incidence of CRC. The symptoms of CRC that more recognized by participants were abdominal pain (43.2%) and bleeding per rectum(45.5%).Conclusions: We concluded that the overall knowledge of non-medical University students concerning the awareness of risk factors and symptomatology of colorectal cancer is poor and nearly similar to general population knowledge concerning this problem.

Effect of Certain Weather Factors and Some Natural Enemies on The Population Densities of Four Piercing-Sucking Insects on The Cotton Crop at Kafr El-Sheikh Governorate

The effect of prevailing weather factors (mean daily of temperature, relative humidity and wind speed) and some natural enemies (six insect predators were recorded; Coccinella undecimpunctata, L.; Scymnus interruptus Goez.; Paederus alfierii Koch, Syrphus spp., Orius spp. and Chrysoperlla carnea (Steph.) on the population densities of the cotton aphid (Aphis gossypii Glover), whitefly (Bemisia tabaci (Genn.), Jassids (Empoasca spp.) and green stink bug (Nezara viridula (L.)), during 2016 to 2017 cotton growing seasons was studied at the Farm of Sakha Agricultural Research Station, Kafr El-Sheikh Governorate. Results revealed that: 1. The initial infestation cotton aphid on cotton plants appeared in the second week of July of 2016 and 2017 seasons (12th and 11th of July of the two seasons, respectively) and had three peaks of population activity of both seasons of the long period of 12th of July till the 20th of September of the first season, and 11th of July till the 26th of September of the second season. The aphid population density was affected positive significantly (0.498*) in the first season and unsignificantly (0.310) in the second season by the temperature. Whereas, the relative humidity was affected positive unsignificantly in both seasons (0.375 and 0.320), respectively, but the effect by the wind speed was negative and highly significant in the two seasons 2016 and 2017 (-0.582** and 0.710**), respectively. The effect by the insect predators on the population density of A. gossypii were positive and highly significant correlations recorded in both seasons were (0.587** and 0.620**), respectively. 2. The cotton whitefly began to appear on cotton leaves at 28th of June of both seasons and had four peaks of population activity of both seasons, of the long period of 28th of June till the 4th of October in the first season and 28th of June till the end of the second season (24th of October). The whitefly population density was affected positive highly significant (0.727**) in the first season, and unsignificantly (0.383) in the second season by the temperature. Whereas, the relative humidity was affected positive unsignificantly (0.378) in the first season and significant (0.490*) in the second season, but the affected by the wind speed was unsignificantly positive and negative (0.090 and -0.280) in the 2016 and 2017 seasons, respectively. The effect by the insect predators on the population density of B. tabaci were positive and significant correlations recorded in both seasons were (0.505* and 0.470*), respectively. 3. The cotton jassids began to appear on cotton leaves at 30th of May and 6th of June in the two seasons, respectively, and had five peaks of population activity in 2016 season of the long period of 30th of May till the 27th of September and six peaks in 2017 season of the long period of 6th of June till the end of the season (24th of October). The relationship between the temperature and the population density of this insect was positive and highly significant (0.713**) in the first season, and unsignificant (0.420) in the second season. So, the effect by the relative humidity on the population density of jassids was positive and unsignificant (0.221 and 0.400) in both seasons, respectively. While, the wind speed was positively insignificantly and negatively significantly (0.298 and -0.490*) with insect numbers in 2016 and 2017 seasons, respectively. While the effect by the insect predators on the population density of Empoasca spp. were positive and significant correlations recorded in both seasons were (0.485* and 0.510*), respectively. 4. The green stink bug began to appear on cotton leaves at 14th and 13th of June in the 2016 and 2017 seasons, respectively, and had three peaks of both seasons of the long period of 14th of June till 18th of October in the first season and 13th of June till 17th of October of the second season. The population density of this insect on cotton plants was affected negatively and unsignificantly (-0.086 and 0.180) in both seasons by the temperature, respectively. But, the relative humidity had unsignificantly positive and negative (0.021 and -0.060) in both seasons, respectively. While, the effect of the wind speed was negative and unsignificantly (-0.237 and -0.080) in both seasons, respectively. The population density of N. viridula on cotton plants was affected by the insect predators were positive and significant correlations recorded in both seasons were (0.515* and 0.499*), respectively. Study the effect of abiotic and naturally occurring biotic factors on seasonal population fluctuations of insect pests, this factors to played the main factor in the evolution and distribution of this insect pest.

Ureamic Syndrome in Theileria Equi-Infected Argentine Polo Pony: A Case Report.

On June 26th, 2016, an 8-year old Argentine Polo Pony in the Fifth Chukker Polo and Country Resort, Maraban Jos, Igabi Local Government Area of Kaduna State, Nigeria was reported with the chief complaint of anorexia, depression, recurrent recumbency, colic and pyrexia. Physical examination revealed the following signs; pyrexia, tachypnoea and rapid pulse rates, bilateral epiphora as well as icteric ocular, gingival and vaginal mucous membranes, 5% dehydration, trembling, sweating, colic, body condition score of 3/5, reddish brown urine and tick infestation (identified as Rhipicephalus spp). Blood was collected via jugular venipuncture into vacutainer containing ethylenediamine tetraacetic acid (EDTA) for microscopic and haematological analyses while a second aliquot was transferred into plain vacutainer for biochemical analysis. Giemsa stained thin blood smear revealed the presence of Theileria equi haemogram revealed normocytic hypochromic anaemia with thrombocytopaenia. The biochemical analysis showed decreased serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) levels, hyperproteinaemia, hyperglobulinaemia, ureamia, hyperkalaemia, hyponatraemia, hypochloraemia and decreased bicarbonate concentration. Based on the presenting clinical signs, presence of ticks and laboratory findings, equine piroplasmosis accompanied by ureamic syndromewas diagnosed..

Umbilical Cord Blood Banking: Consensus Statement of the Indian Academy of Pediatrics

Practitioners and people need information about the therapeutic potential of umbilical cord blood stem cells and pros and cons of storing cord blood in public versus private banks. Indian Academy of Pediatrics conducted a consultative meeting on umbilical cord blood banking on 25th June 2016 in Pune, attended by experts in the field of hematopoietic stem cell transplantation working across India. Review of scientific literature was also performed. All expert committee members reviewed the final manuscript. To bring out consensus guidelines for umbilical cord banking in India. Umbilical cord blood stem cell transplantation has been used to cure many malignant disorders, hematological conditions, immune deficiency disorders and inherited metabolic disorders, even when it's partially HLA mismatched. Collection procedure is safe for mother and baby in an otherwise uncomplicated delivery. Public cord blood banking should be promoted over private banking. Private cord blood banking is highly recommended when an existing family member (sibling or biological parent) is suffering from diseases approved to be cured by allogenic stem cell transplantation. Otherwise, private cord blood banking is not a 'biological insurance', and should be discouraged. At present, autologous cord stem cells cannot be used for treating diseases of genetic origin, metabolic disorders and hematological cancers. Advertisements for private banking are often misleading. Legislative measures are required to regularize the marketing strategies of cord blood banking.

Evaluation of Microphysics and Cumulus Schemes of WRF for Forecasting of Heavy Monsoon Rainfall over the Southeastern Hilly Region of Bangladesh

Accurate forecasting of heavy rainfall is crucial for the improvement of flood warning to prevent loss of life and property damage due to flash-flood-related landslides in the hilly region of Bangladesh. Forecasting heavy rainfall events is challenging where microphysics and cumulus parameterization schemes of Weather Research and Forecast (WRF) model play an important role. In this study, a comparison was made between observed and simulated rainfall using 19 different combinations of microphysics and cumulus schemes available in WRF over Bangladesh. Two severe rainfall events during 11th June 2007 and 24–27th June 2012, over the eastern hilly region of Bangladesh, were selected for performance evaluation using a number of indicators. A combination of the Stony Brook University microphysics scheme with Tiedtke cumulus scheme is found as the most suitable scheme for reproducing those events. Another combination of the single-moment 6-class microphysics scheme with New Grell 3D cumulus schemes also showed reasonable performance in forecasting heavy rainfall over this region. The sensitivity analysis confirms that cumulus schemes play a greater role than microphysics schemes for reproducing the heavy rainfall events using WRF.

Brexit and Correlations of Equity Returns in France, Germany, Italy, Spain and the U.K.

This paper investigates whether the UK's referendum decision to leave the European Union (Brexit) had a positive impact on portfolio risk diversification. We estimate weekly dynamic conditional correlations between 1973 and 2018, and then optimal sectoral portfolio allocations over the same period. Our results show that correlations of equity returns increased as a consequence of economic integration among European countries from the mid-1980s until the late 2000s, and decreased in the UK after Black Wednesday and the Brexit referendum. We tested the existence of a correlation change-point on 27th June 2016 by applying Wied, Kraemer, and Dehling (2012)'s correlation structural break test, which we modified to account for dynamic conditional correlations. Application of this test confirms that the referendum date was a break-point in a third of UK manufacturing industries. The failure of Lehman Brothers and the 1987 stock market crash were also identified as structural breaks in equity correlations. Moreover, our findings suggest that the Brexit vote may constitute a long-term trend reversal of the convergence of equity return correlations in European markets, akin to Black Wednesday, rather than a shock like the 1987 and 2008 financial crises, which merely intensified the historical upward trend in correlations of European equity returns.

KECEMASAN ORANG TUA PADA ANAK DENGAN THALASEMIA DI POLI ANAK RUMAH SAKIT UMUM DAERAH H. ABDUL MANAP KOTA JAMBI TAHUN 2015

Children with thalassemia must undergo blood transfusions to sustain life and routinely done in periods of continuous lama.Pengobatan will have an impact on psychosocial problems in the family, especially in the elderly. Parents will face a backlash in any care and treatment such as guilt, anxiety, fear, sadness, economic problems and worry about not getting the proper care and treatment.This research is a quantitative descriptive research that aims to describe the level of anxiety of parents of children with thalassemia in Poly Children's Hospital. H. Abdul Manap Jambi City in 2015. The population in this study were all parents whose children suffer from thalassemia as many as 56 people with a total sample of 33 people. This research was conducted on the 26th of June to July 26, 2015 with interview techniques and questionnaires. Results showed that of the 33 respondents, it is as much as 26 respondents (78.8%) had moderate anxiety level, as many as six respondents (18.2%) had mild anxiety level and 1 respondent (3%) had severe anxiety level. It is expected that nurses need to pay attention to and involve parents in performing nursing care in children with thalassemia, and improve the provision of information about the treatment of children to parents, so as to reduce anxiety.Keywords: Anxiety, Parents, Thalassemia

Abstract TP239: Initial Results From a Community Emergency Medical System Based Bypass Protocol Using Rapid Arterial Occlusion Scale to Screen for Emergent Large Vessel Occlusion

Introduction: Although mechanical thrombectomy (MT) is the standard of care for patients with acute ischemic stroke due to emergent large vessel occlusion (ELVO), few patients remain eligible for MT due to pre-hospital delays and presentation to non-MT capable hospitals. Emergence of in field screening tools have allowed EMS to reliably identify patients with likely ELVO, thus facilitating their direct triage to MT capable hospitals for prompt thrombectomy. Methods: In collaboration with the Peninsulas EMS Council (PEMS), we implemented a community based pilot program in the Hampton Roads region of Southeastern Virginia to identify patients with ELVO by utilizing the Rapid Arterial oCclusion Evaluation (RACE) scale, a validated in field screening tool. Under this protocol, since March 1 st , 2017, patients with a RACE score of ≥ 5, presenting within 6 hours of last known well would be transported directly to a Comprehensive Stroke Center (CSC) rather than a Primary Stroke Center (PSC), provided the bypass does not prolong the trip by more than 15 minutes. We present the initial results of this study including iv tPA and MT treatment rates, time metrics, and patient outcomes, in comparison to the pre-RACE protocol data. Results: Between March 1 st and June 30 th , 2017, of the 75 brain attacks received in our CSC, 45 patients were screened using the RACE scale by the EMS. 30 patients scored ≥ 5 on the RACE scale (RACE +) and 21 of those bypassed PSCs on their way. RACE + patients had a higher median NIHSS (16 vs. 6, p &lt; .0 5 ), and ischemic strokes (70% vs. 58%), compared to the non-RACE + patients in the preceding 4 months. Improved time metrics (median) were observed for symptom onset to arrival (54 min vs. 81 min), arrival to CT (8.5 min vs. 12 min, p &lt; .05), DTN (36 min vs. 47 min), DTG (94 min vs. 105 min), and arrival to recanalization with MT (142 min vs. 185 min). IV tPA (27% vs. 11%) and MT treatments rates (33% vs. 11%) with TICI ≥ 2b (90% vs. 77%) were higher in the RACE + patients compared to the non-RACE + cohort. Conslusion: Our pilot program employing RACE as an in field screening tool for ELVO and using it to bypass PSCs in favor of CSCs is feasible in the community setting, and demonstrates improved metrics in key domains known to be associated with better outcomes for these patients.

Adjuvant treatment of resectable biliary tract cancer with cisplatin plus gemcitabine: A prospective single center phase II study

BackgroundBiliary tract cancer (BTC) is a dismal disease, even after curative intent surgery. We conducted this prospective, non-randomized phase II study to evaluate the feasibility and efficacy of cisplatin and gemcitabine as adjuvant treatment in patients with resected BTC.MethodsPatients initially received gemcitabine 1000 mg/m2 alone on days 1, 8 and 15 every 28-days for a total of six cycles (single agent cohort), and after protocol amendment a combination therapy with gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on days 1 and 8 was administered every 21 days for a total of eight cycles (combined regimen cohort). Treatment was planned to start within eight weeks after curative intent resection. Adverse events, disease-free survival and overall survival were assessed.ResultsOverall 30 patients were enrolled in the study from August 2008 and last patient was enrolled at 2nd December 2014. The follow-up of the patients ended at 31st December 2016. The first 9 patients received single-agent gemcitabine. The interim analysis met the predefined feasibility criteria and, from September 2010 on, the second group of 21 patients received the combination of cisplatin plus gemcitabine. In the single-agent cohort with gemcitabine the median relative dose intensity (RDI) was 100% (IQR 88.3–100). Patients treated with the combination cisplatin-gemcitabine received an overall median RDI of 100% (IQR 50–100) for cisplatin and 100% (IQR 75–100) for gemcitabine respectively. The most significant non-hematological adverse events (grade 3 or 4) were fatigue (20%), infections during neutropenia (10%), and two cases of biliary sepsis (7%). Abnormal liver function was seen in 10% of the patients. One patient died due to infectious complications during treatment with cisplatin and gemcitabine. The median disease-free survival (DFS) was 14.9 months (95% CI 0–33.8) with a corresponding 3-year DFS of 43.1 ± 9.1%. The median overall survival (OS) was 40.6 months (95% CI 18.8–62.3) with a 3-year OS of 55.7 ± 9.2%. No statistically significant differences in survival were seen between the two treatment cohorts.ConclusionAdjuvant chemotherapy with gemcitabine with or without cisplatin was well tolerated and resulted in promising survival of the patients.Trial registrationThe study was retrospectively registered on 25th June 2009 at clinicaltrials.gov (NCT01073839).