Alternate Weeks Research Articles

Water Absorption and Release Characteristics of a Polymer and its Effect on Available Water Content, Tomato (Lycopersicon esculentum) Productivity and Water Use Efficiency in a Semi-arid Sandy Loam Soil

The problem of inefficient use of rain and irrigation water by crops is most important on light textured soils of semi-arid and arid regions. Application of super absorbent polymers into the soil could be one of the effective ways to increase water use efficiency in crops. Therefore, laboratory and field investigations have been conducted to study water retention and release characteristics of a cross linked polymer of polyacrylamide and potassium acrylate (PAM) and to evaluate its effect on yield and water productivity in tomato grown on sandy loam soil under field conditions. In laboratory studies, irrespective of source of water, polymer showed rapid initial hydration followed by no more water absorption towards the point of equilibrium. Overall, the amount of water absorbed by one gram of polymer ranged from 247–369 g in distilled water, 141–175 g in 50% Hoagland solution, 120–155 g in irrigation water, 116–141 g in 100% Hoagland solution, 96–115 g in 0.01 M CaCl2 and 86–111 g in 200% Hoagland solution over 5–240 min saturation period. The amount of water absorbed by polymer decreased from 360 to 110 g g−1 with increasing electrical conductivity (EC) of the source of water from 0.03 to 2.23 dS m−1. Application of polymer at graded rates (0.25–1.0% of soil, w/w) to sandy loam and sandy clay loam soils increased the available water content by 101–192 per cent as compared to untreated soils. In field experiment, at every week irrigation, application of polymer @ 25 or 50 kg ha−1 had no significant effect on tomato plant height and fruit yield. Similarly, application of polymer had no significant effect on plant height and fruit yield when tomato was irrigated every third week. But application of polymer at 25 kg ha−1 with alternate week irrigation not only produced the higher tomato yield but also increased the water productivity to 290.6 kg ha-mm−1 and thereby saved 180 ha-mm irrigation waters during a crop growth season.

Comparative treatment approach for Sarcoptes and Psoroptes mite infestation in a Boer cross

This case was carried out to compare the healing process and time for the treatment of mange in goats using a combination of Ivermectin with dexamethasone to the earlier Ivermectin with antihistaminics approach. A 3 ½ years old female Boer cross goat was presented with a complaint of crusty lesions on different parts of the body during a routine farm visit in Selangor, Malaysia. Microscopic examinations of the skin scrapes taken revealed Sarcoptes and Psoroptes sp. of mites, while hematological analysis showed slight leucocytosis, neutrophilia with left shift, monocytosis, hyperproteinemia and hyperglobulinemia. Ivermectin injection at 0.2 mg/kg subcutaneously was administered once every 2 weeks in 4 divided doses, while Dexamethasone injection at 1 mg/10 kg and multivitamin at 10 mg/kg IM for 5 days repeated at alternate weeks. Significant improvement was recorded 6 weeks after commencement of treatment and full recovery at 10 weeks. The current drug regimen proved more effective when compared with previous cases that were treated with a combination of ivermectin and antihistaminics.

Efficacy of resisted exercise in straightened cervical lordosis: A case report: ABAB design

The purpose of this study was to evaluate the efficacy of resisted exercise in a patient with a painful straightened cervical lordosis. A 35-year-old male patient was referred by an orthopedist with a complaint of neck ache; he had difficulty in bending backward to see the roof and forward (chin poke) since one and half months. He experienced pain severity of 9 on a visual analog scale (VAS). Neck's active range of motions in all six directions were measured using a universal goniometer; flexion was 20΀, extension 10΀, left and right lateral flexion were 20΀ each side, and rotation was 35΀ each side. The patient was given mild resisted exercise in phoenix position twice a day for two alternative weeks along with initial short wave diathermy for one week for pain relief. At the end of the fifth week, pain was nearly normal on the numeric scale. Hence, an attempt was made to explore the efficacy of resisted exercise in straightened cervical lordosis to correct and prevent painful living and irreversible cervical lordotic deformity.

Understanding usage of a hybrid website and smartphone app for weight management: a mixed-methods study.

BackgroundAdvancements in mobile phone technology offer huge potential for enhancing the timely delivery of health behavior change interventions. The development of smartphone-based health interventions (apps) is a rapidly growing field of research, yet there have been few longitudinal examinations of how people experience and use these apps within their day-to-day routines, particularly within the context of a hybrid Web- and app-based intervention.ObjectiveThis study used an in-depth mixed-methods design to examine individual variation in (1) impact on self-reported goal engagement (ie, motivation, self-efficacy, awareness, effort, achievement) of access to a weight management app (POWeR Tracker) when provided alongside a Web-based weight management intervention (POWeR) and (2) usage and views of POWeR Tracker.MethodsThirteen adults were provided access to POWeR and were monitored over a 4-week period. Access to POWeR Tracker was provided in 2 alternate weeks (ie, weeks 1 and 3 or weeks 2 and 4). Participants’ goal engagement was measured daily via self-report. Mixed effects models were used to examine change in goal engagement between the weeks when POWeR Tracker was and was not available and whether the extent of change in goal engagement varied between individual participants. Usage of POWeR and POWeR Tracker was automatically recorded for each participant. Telephone interviews were conducted and analyzed using inductive thematic analysis to further explore participants’ experiences using POWeR and POWeR Tracker.ResultsAccess to POWeR Tracker was associated with a significant increase in participants’ awareness of their eating (β1=0.31, P=.04) and physical activity goals (β1=0.28, P=.03). The level of increase varied between individual participants. Usage data showed that participants used the POWeR website for similar amounts of time during the weeks when POWeR Tracker was (mean 29 minutes, SD 31 minutes) and was not available (mean 27 minutes, SD 33 minutes). POWeR Tracker was mostly accessed in short bursts (mean 3 minutes, SD 2 minutes) during convenient moments or moments when participants deemed the intervention content most relevant. The qualitative data indicated that nearly all participants agreed that it was more convenient to access information on-the-go via their mobiles compared to a computer. However, participants varied in their views and usage of the Web- versus app-based components and the informational versus tracking tools provided by POWeR Tracker.ConclusionsThis study provides evidence that smartphones have the potential to improve individuals’ engagement with their health-related goals when used as a supplement to an existing online intervention. The perceived convenience of mobile access to information does not appear to deter use of Web-based interventions or strengthen the impact of app access on goal engagement. A mixed-methods design enabled exploration of individual variation in daily usage of the app-based tools.

Comparison of Enteral versus Intravenous Potassium Supplementation in hypokalaemia in postcardiac surgery paediatric cardiac intensive care patients: prospective open label randomised control trial (EIPS)

BackgroundHypokalaemia is frequently encountered in the daily clinical practices of a paediatric cardiac intensive care unit (PCICU). It is a strong independent predictor of mortality in patients with heart failure....

Elimination of Progressive Mammary Cancer by Repeated Administrations of Chimeric Antigen Receptor-Modified T Cells

Continuous oncogenic processes that generate cancer require an on-going treatment approach to eliminate the transformed cells, and prevent their further development. Here, we studied the ability of T cells expressing a chimeric antibody-based receptor (CAR) to offer a therapeutic benefit for breast cancer induced by erbB-2. We tested CAR-modified T cells (T-bodies) specific to erbB-2 for their antitumor potential in a mouse model overexpressing a human erbB-2 transgene that develops mammary tumors. Comparing the antitumor reactivity of CAR-modified T cells under various therapeutic settings, either prophylactic, prior to tumor development, or therapeutically. We found that repeated administration of CAR-modified T cells is required to eliminate spontaneously developing mammary cancer. Systemic, as well as intratumoral administered CAR-modified T cells accumulated at tumor sites and eventually eliminated the malignant cells. Interestingly, within a few weeks after a single CAR T cells' administration, and rejection of primary lesion, tumors usually relapsed both in treated mammary gland and at remote sites; however, repeated injections of CAR-modified T cells were able to control the secondary tumors. Since spontaneous tumors can arise repeatedly, especially in the case of syndromes characterized by specific susceptibility to cancer, multiple administrations of CAR-modified T cells can serve to control relapsing disease.

Evaluation of the effect of spinal manipulation in upper limb spasticity post a stroke.

Introduction: Cerebral Vascular Accident is the third leading cause of death and the leading cause of neurological disability in adults with hemiplegic and spasticity is the most prevalent motor dysfunction, with consequent impairment of muscle strength and joint range of motion. Objective: To evaluate the immediate effect techniques of spinal manipulation in upper limb spasticity after cerebral vascular accident. Method: Participants were six patients included in both groups: group A, submitted to the application of the techniques of spinal manipulation and group B, control. The order of participation of patients was randomized and performed on alternate weeks. In both groups, participants were evaluated for spasticity by Modified Ashworth Scale, immediately before and after a given intervention. Results: The results did not permit an inference about the acute effects of spinal manipulation on spasticity , however, can be observed in the study group was reduced in 50% of cases with increased tone, while in the control group, 30 % cases had increased tone reduction , and if increased. There was increased tone in two cases which were previously normal. Conclusion: The immediate evaluation of the effect of spinal manipulation in patients with spasticity got reduced muscle tone, however, on the number of participants and changes in reducing and also from increased tone in the control group , it is not possible assignment of the obtained effects only the techniques applied , thus being further studies with larger samples and other methods of assessment needed.

Phase I/II trial of vorinostat (SAHA) and erlotinib for non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations after erlotinib progression

ObjectivesVorinostat or suberoylanilide hydroxamic acid (SAHA) is a novel histone deacetylase inhibitor with demonstrated antiproliferative effects due to drug-induced accumulation of acetylated proteins, including the heat shock protein 90. We prospectively studied the activity of vorinostat plus erlotinib in EGFR-mutated NSCLC patients with progression to tyrosine kinase inhibitors. Patients and methodsWe conducted this prospective, non-randomized, multicenter, phase I/II trial to evaluate the maximum tolerated dose, toxicity profile and efficacy of erlotinib and vorinostat. Patients with advanced NSCLC harboring EGFR mutations and progressive disease after a minimum of 12 weeks on erlotinib were included. The maximum tolerated dose of vorinostat plus erlotinib was used as recommended dose for the phase II (RDP2) to assess the efficacy of the combination. The primary end point was progression-free-survival rate at 12 weeks (PFSR12w). Pre-treatment plasma samples were required to assess T790M resistant mutation. ResultsA total of 33 patients were enrolled in the phase I–II trial. The maximum tolerated dose was erlotinib 150mg p.o., QD, and 400mg p.o., QD, on days 1–7 and 15–21 in a 28-day cycle. Among the 25 patients treated at the RDP2, the most common toxicities included anemia, fatigue and diarrhea. No responses were observed. PFSR12w was 28% (IC95%: 18.0–37.2); median progression-free survival (PFS) was 8 weeks (IC 95%: 7.43–8.45) and overall survival (OS) 10.3 months (95% CI: 2.4–18.1). ConclusionFull dose of continuous erlotinib with vorinostat 400mg p.o., QD on alternative weeks can be safely administered. Still, the combination has no meaningful activity in EGFR-mutated NSCLC patients after TKI progression.

Platelet-rich plasma (PRP) in chronic epicondylitis: study protocol for a randomized controlled trial

BackgroundTendinopathy is a difficult problem to manage and can result in significant patient morbidity. Currently, the clinical use of platelet-rich plasma (PRP) in painful tendons is widespread but its efficacy remains controversial.Methods/DesignThis study is a single-center, randomized double-blind controlled trial. Eighty patients will be allocated to have ultrasound (US)-guided needling combined with a leukocyte-depleted (that is, pure) PRP or lidocaine each alternate week for a total of two interventions. Outcome data will be collected before intervention, and at 6 weeks, 3, 6, and 12 months after intervention. Main outcome measure: Changes in pain and activity levels, as assessed by Disabilities of the Arm, Shoulder and Hand (DASH-E, Spanish version) score, at 6 months. We will compare the percentage of patients in each group that achieve a successful treatment defined as a reduction of at least 25% in the DASH-E score. Secondary outcome measures include changes in DASH-E at 3 and 12 months, changes in pain as assessed by the visual analogue scale (VAS) at the 6-week, 3-, 6-, and 12-month follow-up, changes in sonographic features and neovascularity, and percentage of patients in each group with adverse reactions at 3, 6, and 12 months.DiscussionThe results of this study will provide insights into the effect of pure PRP in tendon and may contribute to identifying the best protocol for PRP application in tendinopathies.Trial registrationClinicalTrials.gov: NCT01945528.

Randomised controlled trial of whether erotic material is required for semen collection: impact of informed consent on outcome

Semen is collected to evaluate male fertility or cryostore sperm preferentially in laboratories but such collection facilities have no standard fit-out. It is widely believed but untested whether providing erotic material (EM) is required to collect semen by masturbation in the unfamiliar environment. To test this assumption, 1520 men (1046 undergoing fertility evaluation, 474 sperm cryostorage, providing 1932 semen collection episodes) consecutively attending the semen laboratory of a major metropolitan teaching hospital for semen analysis were eligible for randomization to be provided or not with printed erotic material EM (X-rated, soft-core magazines) during semen collection. Randomization was performed by providing magazines in the collection rooms (as a variation on non-standard fit-out) on alternate weeks using a schedule concealed from participants. In the pilot study, men were randomized without seeking consent. In the second part of the study, which continued on from the first without interruption, an approved informed consent procedure was added. The primary outcome, the time to collect semen defined as the time from receiving to returning the sample receptacle, was significantly longer (by ~6%, 14.9±0.3 [mean±standard error of mean] vs. 14.0±0.2 minutes, p=0.02) among men provided with EM than those randomized to not being provided. There was no significant increase in the failure to collect semen samples (2.6% overall) nor any difference in age, semen volume or sperm concentration, output or motility according to whether EM was provided or not. The significantly longer time to collect was evident in the pilot study and the study overall, but not in the main study where the informed consent procedure was used. This study provides evidence that refutes the assumption that EM needs to be provided for semen collection in a laboratory. It also provides an example of a usually unobservable participation bias influencing study outcome of a randomized controlled trials.

Weight loss in children with asthma improves asthma control and quality of life

Weight loss in children with asthma improves asthma control and quality of life

Effect of dexamethasone (DEX) dose modification on osteonecrosis (ON) risk associated with intensified therapies for standard risk acute lymphoblastic leukemia (SR-ALL): A report from the Children’s Oncology Group (COG) study AALL0331.

10002 Background: ON is a known toxicity of childhood ALL therapy, particularly in patients (pts) >9 years (y). Intensified use of DEX, methotrexate (MTX), and asparaginase (ASNase) may increase the risk of developing ON among B-precursor NCI SR-ALL pts despite their younger age. Methods: Newly diagnosed SR-ALL pts 1-9y enrolled on AALL0331 between 4/05 and 5/10 were prospectively monitored for symptomatic ON within three treatment cohorts risk-stratified by clinical, cytogenetic, and early response criteria. ON sites were confirmed by imaging. SR-Low (SRL) pts were randomized to standard therapy +/- 4 additional doses of PEG-ASNase. SR-Average (SRA) pts were randomized (2x2) to standard therapy +/- an intensive consolidation (IC) +/- an augmented interim maintenance/delayed intensification (AIM/ADI). SR-High (SRH) pts all received IC and two AIM/ADI phases. After 6/08, alternate week DEX (AWD, days 1-7/15-21) replaced continuous DEX (days 1-21) during DI, and escalating-dose MTX replaced oral MTX during IM. All pts received DEX days 1-28 during induction and 5-day pulses every 4 weeks during maintenance. Results: Overall ON cumulative incidence (CI) at 5y was 2.7% (133/5261), correlating with sex (F 3.7%, M 1.9%, p<0.0001), age (1-2y 0.8%, 3-4y 2.0%, 5-6y 3.3%, 7-9y 7.8%, p<0.0001), and risk group (SRL 2.6%, SRA 2.9%, SRH 5.7%, p=0.0009). Before 6/08, ON CI was higher for SRA pts given intensive vs standard consolidation (5.8% vs 1.9%, p=0.002), and trended higher for SRL pts given additional PEG-ASNase (4.0 vs 2.3%, p=0.09). Use of AWD significantly reduced ON CI at 3y among SRH pts (7.4% vs 1.5%, p=0.003) and further reduced ON events in SRL/SRA pts. Conclusions: Young children receiving intensified therapy for SR-ALL therapy are at risk for ON. Extended exposure to PEG-ASNase is a likely contributing factor, possibly by potentiating DEX exposure during DI. ON risk can be significantly reduced by using AWD during DI, which is now COG standard of care. Clinical trial information: NCT00103285.

Rainbow Beneath the Sky: Mental Health Help for Chinese Americans

<i>Rainbow Beneath the Sky</i>: Mental Health Help for Chinese Americans

Treatment reduction for children and young adults with low-risk acute lymphoblastic leukaemia defined by minimal residual disease (UKALL 2003): a randomised controlled trial

Minimal residual disease (MRD) is the most sensitive and specific predictor of relapse risk in children with acute lymphoblastic leukaemia (ALL) during remission. We assessed whether treatment intensity could be adjusted for children and young adults according to MRD risk stratification. Between Oct 1, 2003 and June 30, 2011, consecutive children and young adults (aged 1-25 years) with ALL from the UK and Ireland were recruited. Eligible patients were categorised into clinical standard, intermediate, and high risk groups on the basis of a combination of National Cancer Institute (NCI) criteria, cytogenetics, and early response to induction therapy, which was assessed by bone marrow blast counts taken at days 8 (NCI high-risk patients) and 15 (NCI standard-risk patients) after induction began. Clinical standard-risk and intermediate-risk patients were assessed for MRD. Those classified as MRD low risk (undetectable MRD at the end of induction [day 29] or detectable MRD at day 29 that became undetectable by week 11) were randomly assigned to receive one or two delayed intensification courses. Patients had received induction, consolidation, and interim maintenance therapy before they began delayed intensification. Delayed intensification consisted of pegylated asparaginase on day 4; vincristine, dexamethasone (alternate weeks), and doxorubicin for 3 weeks; and 4 weeks of cyclophosphamide and cytarabine. Computer randomisation was done with stratification by MRD result and balancing for sex, age, and white blood cell count at diagnosis by method of minimisation. Patients, clinicians, and data analysts were not masked to treatment allocation. The primary outcome was event-free survival (EFS), which was defined as time to relapse, secondary tumour, or death. Our aim was to rule out a 7% reduction in EFS in the group given one delayed intensification course relative to that given two delayed intensification courses. Analyses were by intention to treat. This trial is registered, number ISRCTN07355119. Of 3207 patients registered in the trial overall, 521 MRD low-risk patients were randomly assigned to receive one (n=260) or two (n=261) delayed intensification courses. Median follow-up of these patients was 57 months (IQR 42-72). We recorded no significant difference in EFS between the group given one delayed intensification (94·4% at 5 years, 95% CI 91·1-97·7) and that given two delayed intensifications (95·5%, 92·8-98·2; unadjusted odds ratio 1·00, 95% CI 0·43-2·31; two-sided p=0·99). The difference in 5-year EFS between the two groups was 1·1% (95% CI -5·6 to 2·5). 11 patients (actuarial relapse at 5 years 5·6%, 95% CI 2·3-8·9) given one delayed intensification and six (2·4%, 0·2-4·6) given two delayed intensifications relapsed (p=0·23). Three patients (1·2%, 0-2·6) given two delayed intensifications died of treatment-related causes compared with none in the group given one delayed intensification (p=0·08). We recorded no significant difference between groups for serious adverse events and grade 3 or 4 toxic effects; however, the second delayed intensification course was associated with one (<1%) treatment-related death, and 74 episodes of grade 3 or 4 toxic effects in 45 patients (17%). Treatment reduction is feasible for children and young adults with ALL who are predicted to have a low risk of relapse on the basis of rapid clearance of MRD by the end of induction therapy. Medical Research Council and Leukaemia and Lymphoma Research.

Modulation of cytochrome P450 enzymes in response to continuous or intermittent high-fat diet in pigs

1. To date, no information has been available on the modulation of cytochrome P450 enzymes (CYPs) following the administration of a hyperlipidemic diet in pigs.2. We investigated the potential modulation of xenobiotic-metabolizing CYPs in liver, heart and duodenum of pigs subjected to a high-fat/high-cholesterol diet for 2 months continuously (C-HFD) or on alternate weeks (A-HFD).3. The administration of the high-fat diet resulted in considerably increased plasma cholesterol levels although the animals were still able to manage the lipid overload efficiently, and no sign of effective tissue inflammation occurred in livers. Plasma lipid profile and liver histology indicated a better adaptive response of the A-HFD pigs compared to the C-HFD group. We showed a post-transcriptional induction of hepatic CYP2E1 activity in C-HFD pigs and a transcriptional induction of hepatic CYP3As – especially in the A-HFD group. No further CYP modulation was observed in either liver or extra-hepatic tissues.4. In conclusion, the administration of a high-fat diet in pigs resulted in limited effects on the drug metabolism system. The better adaptive response of A-HFD pigs compared to C-HFD pigs is a very interesting observation since the intermittent administration of the diet reflects the mode of human behavior more closely.

Safety, pharmacokinetics and pharmacodynamics of the anti-A33 fully-human monoclonal antibody, KRN330, in patients with advanced colorectal cancer

PurposeThe objective of this first-in-human trial included the safety, maximum tolerated dose (MTD), pharmacokinetics, immunogenicity and antitumour effects of KRN330, a novel fully-human monoclonal antibody directed against A33, a membrane bound glycoprotein uniformly expressed in 95% of colorectal cancers. MethodsPatients with advanced or metastatic colorectal cancer (CRC) refractory to standard therapy were eligible. Twenty-nine patients received weekly intravenous KRN330 (0.1–10mg/kg) for a minimum of 4 weeks in a standard 3+3 design, and nine patients received q2week doses at 3mg/kg with pre- and post-biopsies to evaluate tumour binding and safety on this schedule. ResultsThe most common KRN330 related adverse events (all grades) were nausea (66%), diarrhoea (61%) and vomiting (47%). The MTD was 3mg/kg weekly, with dose-limiting grade 3 gastrointestinal toxicities at 10mg/kg and the intermediate dose level of 6mg/kg. Pharmacokinetics of KRN330 was linear. Stable disease was reported in 12/38 patients (32%), with a median duration of 155 days. There was no evidence of human anti-human antibodies, and immunohistochemistry on biopsy samples demonstrated that KRN330 remained bound to tumour 2 weeks after dosing. ConclusionsKRN330 is safe and tolerable at the MTD of 3mg/kg once weekly in patients with advanced CRC. Dosing on alternate weeks is supported by tumour binding. The long treatment durations and lack of immunogenicity warrant further investigation of KRN330 in combination.

Efficacy of in-feed medication with chlortetracycline in a farrow-to-finish herd against a clinical outbreak of respiratory disease in fattening pigs

The efficacy of chlortetracycline (CTC) in-feed medication to treat pigs with clinical respiratory disease was investigated in a farrow-to-finish pig herd infected with Mycoplasma hyopneumoniae, and with clinical respiratory disease...

EXPANDINGtheRepertoireofTeachingandLearning StrategiesforFuture Nurse Educators:Introducing Interpretive Pedagogies in an Online Graduate Nurse Education Course

SINCE INTERPRETIVE PEDAGOGY WAS INTRODUCED TO OUR FACULTY DURING A WORKSHOP WITH NANCY DIEKELMANN, LEAVING SAFE HARBORS: re-forming education and the new Pedagogies, faculty have struggled with this teaching-learning method, finding it foreign and difficult to incorporate into a teaching repertoire entrenched with behaviorist traditions. one curriculum change that resulted from the workshop was the development of a nurse educator course, nursing education Pedagogies, which introduces interpretive pedagogies to new teachers. the inefficiency of conventional pedagogy for all current health care education is acknowledged in many different disciplines and supported by the proponents of constructivist theory (Packer & Goicoechea, 2000). Constructivists assert that knowledge and truth are based on beliefs and experience in situations (Cobb & Bowers, 1999), a product of individual cognition (simpson, 2002) and situated in contexts (Bredo, 2006). First described in 1988, interpretive pedagogy has been implemented with feminist studies, interactive learning environments, and midwifery programs, family health promotion, socially challenged children, special education classrooms, sports education, teacher education, and geriatric courses to name a few. since the interpretive pedagogies and conventional pedagogies co-occur, nurse educators should have an understanding of their differences in terms of theory, knowledge, experience, language, and social significance (diekelmann, 2001). exposure to interpretive pedagogy introduces new nurse educators to environments where conversations among participants promote emerging possibilities in practice (dahlberg, ekebergh, & ironside, 2003; ironside, 2001). the uniqueness of interpretive pedagogy encourages teachers and students to adjust to socially situated cognition, which is important for a practice discipline such as nursing. Classroom and simulated environments play a significant role in student learning, but learning in the authentic environment, and using stories about that environment, call for a different approach. interpretive pedagogies encourage students to process the multiple perspectives that exist in nursing, such as dieklemann's (2001) concernful practices of schooling learning teaching. the model used for this course is to compare and contrast traditional learning theories and interpretive pedagogies, to show how they diverge and support each other for teaching and learning. Course Design the online course is scheduled over 15 weeks; live, synchronous classes meet for seven sessions on alternate weeks. sessions are archived for students who miss class or want to review the discussion. Content is organized into learning modules, each with unique readings and assignments to achieve the goal of understanding the co-occurrence and symbiotic relationship between interpretive pedagogy and contemporary learning theory. the specific learning goals are to: a) evaluate the historical perspective of conventional pedagogy and compare it with interpretive pedagogy; b) critique specific narrative pedagogies by general themes, teacher/student relationships, and strengths and limitations; c) analyze contemporary higher education theory as it supports interpretive pedagogies; d) analyze the impact of contemporary and future practice on curriculum design and use of interpretive pedagogies; and e) create new pedagogical activities in the context of clinical experiences, classroom sessions, and teacher evaluation. assignments encourage immersion into the literature and critiquing exemplars of interpretive pedagogy from various disciplines. the textbooks used include schunk (2012) and diekelmann (2003). students are required to read textbook chapters and write three summaries: one to synthesize the major principles and theories; one to reflect on the synthesis and how it relates to a specific narrative pedagogy; and one to discuss how each principle and theory could be used for a strategy to teach nursing. …

A Novel Long-Acting Human Growth Hormone Fusion Protein (VRS-317): Enhanced In Vivo Potency and Half-Life

A novel recombinant human growth hormone (rhGH) fusion protein (VRS-317) was designed to minimize receptor-mediated clearance through a reduction in receptor binding without mutations to rhGH by genetically fusing with XTEN amino acid sequences to the N-terminus and the C-terminus of the native hGH sequence. Although in vitro potency of VRS-317 was reduced approximately 12-fold compared with rhGH, in vivo potency was increased because of the greatly prolonged exposure to the target tissues and organs. VRS-317 was threefold more potent than daily rhGH in hypophysectomized rats and fivefold more potent than daily rhGH in juvenile monkeys. In juvenile monkeys, a monthly dose of 1.4 mg/kg VRS-317 (equivalent to 0.26 mg/kg rhGH) caused a sustained pharmacodynamic response for 1 month equivalent to 0.05 mg/kg/day rhGH (1.4 mg/kg rhGH total over 28 days). In monkeys, VRS-317, having a terminal elimination half-life of approximately 110 h, was rapidly and near-completely absorbed, and was well tolerated with no observed adverse effects after every alternate week subcutaneous dosing for 14 weeks. VRS-317 also did not cause lipoatrophy in pig and monkey studies. VRS-317 is currently being studied in GH-deficient patients to confirm the observations in these animal studies. © 2012 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 101:2744–2754, 2012

A randomised efficacy and discontinuation study of etanercept versus adalimumab (RED SEA) for rheumatoid arthritis: a pragmatic, unblinded, non-inferiority study of first TNF inhibitor use: outcomes over 2 years

ObjectiveTo compare adalimumab versus etanercept in patients with active rheumatoid arthritis (RA) to test the hypothesis that adalimumab was not inferior to etanercept in terms of drug continuation by a...