Count Criteria Research Articles

X-RAY ABSORPTION OF HIGH-REDSHIFT QUASARS

Soft X-ray photoelectric absorption of high-z quasars has been known for two decades, but has no unambiguous astro-physical context. We construct the largest sample to date of 58 high redshift quasars (z > 0.45) selected from the XMM-Newton archive based on a high photon count criterion (> 1800). We measure the optical depth tau at 0.5 keV, and find that 43% of the quasars show significant absorption. We aim to find which physical parameters of the quasars drive their observed absorption, e.g., redshift, radio luminosity, radio loudness, or the X-ray luminosity. We compare the absorption behavior with redshift with the pattern expected if the diffuse intergalactic medium (IGM) is responsible for the observed absorption, and with a comparison sample of gamma ray burst (GRB) X-ray afterglows. Although the z > 2 quasar opacity is consistent with diffuse IGM absorption, many intermediate z (0.45 < z < 2) quasars are not sufficiently absorbed for this scenario, and are appreciably less absorbed than GRBs. Only 10/37 quasars at z < 2 are absorbed, and only 5/30 radio quiet quasars are absorbed. We find a weak correlation between tau and z, and even a weaker correlation between tau and radio luminosity, which leads to the conclusion that although a diffuse IGM origin for the quasar absorption is unlikely, optical depth does seem to increase with redshift, roughly as (1+z)^{2.2+-0.6}, tending at high-z to tau ~ 0.4, similar to the high-z GRB values. This result can be explained by an ionized and clumpy IGM at z < 2, and a cold, diffuse IGM at higher redshift. If, conversely, ascribed to local absorption at the quasar, and owing to the steep L_x ~ (1+z)^{7.1+-0.5} correlation in the present sample, the host column density scales as N_H ~ L_x^{0.7+-0.1}.

Radioguided parathyroidectomy effective in pediatric patients

BackgroundRadioguided parathyroidectomy (RGP) has been shown to be effective in adult patients with hyperparathyroidism (HPT), but the utility of RGP in pediatric patients has not been systematically examined. It is not known if adult criteria for radioactive counts can accurately detect hyperfunctioning parathyroid glands in pediatric patients. The purpose of our study was to determine the utility of RGP in children with primary HPT. Materials and methodsA retrospective review of our prospectively maintained single-institution database for patients who underwent a RGP for primary HPT identified 1694 adult and 19 pediatric patients aged 19 y or younger. From the adult population, we selected a control group matched three to one for gland weight and gender and compared pre- and postoperative laboratory values, surgical findings, pathology, and radioguidance values between the control and the pediatric groups. ResultsExcised glands from pediatric patients were smaller than those in the total adult population (437 ± 60 mg versus 718 ± 31 mg, P = 0.0004). When controlled for gland weight, ex vivo counts as a percentage of background were lower in the pediatric group (51% ± 5% versus 91% ± 11%, P = 0.04). However, ex vivo radionuclide counts >20% of the background were found in 100% of pediatric patients and 95% of the adult-matched control group. ConclusionsAll pediatric patients met the adult detection criteria for parathyroid tissue removal when a RGP was performed, and 100% cure was achieved. We conclude that RGP is a useful treatment option for pediatric patients with primary HPT.

FRI0127 Using epidemiological registry data to provide background rate context for adverse events in a rheumatoid arthritis drug development program - a coordinated approach

BackgroundObservational studies may provide context for adverse events observed in clinical trial programs, particularly for infrequent events or potential long-term risks. For such purposes, however, published observational data often have...

Agreement Among Categorical, Dimensional, and Impairment Criteria for ADHD and Common Comorbidities

To compare the results of categorically based versus dimensionally based scoring algorithms for a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV)-referenced teacher rating scale for assessing ADHD and commonly co-occurring conditions and to determine their relative agreement with ratings of symptom-induced impairment. Teachers completed Child and Adolescent Symptom Inventory-4R (CASI-4R) ratings for 1,092 youth (ages 6-18 years) referred to a child and adolescent psychiatry outpatient service. Caseness was determined according to DSM-IV symptom count (categorical model) and T-score (dimensional model) criteria. Agreement between symptom count and T-score cutoffs was generally good (kappa ≥ 0.61) for ADHD-Inattentive, ADHD-Hyperactive-Impulsive, ADHD-Combined (except adolescent females), Oppositional Defiant Disorder, and Conduct Disorder, but this was not the case for anxiety and depressive disorders where only 15% of kappas were good. Agreement of impairment cutoff with T-score and symptom count cutoffs ranged from poor to good. In general, although in many cases CASI-4R categorical and dimensional scoring algorithms generated similar results, there was considerable variability across disorders, age groups, scoring method, and in some cases, gender. Moreover, symptom counts and T-scores are not a proxy for assessing impairment suggesting that each scoring strategy likely provides unique information for clinical decision-making.

Extended Target tracking using projection curves analysis and matching Pixel count

A novel algorithm for detecting and tracing extended target using projection curves analysis and correlation tracking based on the maximum matching pixel count (MPC) criterion is presented. First, the projection curves of the difference image of two consecutive frames are analyzed to find the approximate areas of moving target on the entire scenes. Then correlation tracking based on the improved MPC criterion is used for target tracking against the cluttered background. Experimental results show, as compared to the conventional approaches, the proposed algorithm is more robust, has higher precision, and has simplified computational complexity for tracking an extended target against a cluttered background.

State-of-the-science assessment of non-asbestos amphibole exposure: Is there a cancer risk?

The distinction between amphibole asbestos fibers and non-asbestos amphibole particles has important implications for assessing potential cancer risks associated with exposure to amphibole asbestos or amphibole-containing products. Exposure to amphibole asbestos fibers can pose a cancer risk due to its ability to reside for long periods of time in the deep lung (i.e., biopersistence). In contrast, non-asbestos amphibole particles are usually cleared rapidly from the lung and do not pose similar respiratory risks even at high doses. Most regulatory and public health agencies, as well as scientific bodies, agree that non-asbestos amphiboles possess reduced biological (e.g., carcinogenic) activity. Although non-asbestos amphibole minerals have been excluded historically from Federal regulations, non-asbestos structures may be counted as asbestos fibers on the basis of dimensional criteria specified in analytical protocols. Given the potential to mischaracterize a non-asbestos structure as a "true" asbestos fiber, our objective was to assess whether exposure to non-asbestos amphiboles that may meet the dimensional criteria for counting as a fiber pose a cancer risk similar to amphibole asbestos. We reviewed analytical methods as well as the mineralogical, epidemiological, and toxicological literature for non-asbestos amphiboles. No evidence of demonstrable cancer effects from exposure to non-asbestos amphiboles that may be counted as fibers, under certain assessment protocols, was found. Data gaps (industrial hygiene data for amphibole-exposed cohorts), inconsistencies (analytical laboratory methods/protocols used to count fibers), and sources of potential bias from misclassification of exposure were identified.

Convex hull of n planar Brownian paths: an exact formula for the average number of edges

We establish an exact formula for the average number of edges appearing on the boundary of the global convex hull of n independent Brownian paths in the plane. This requires the introduction of a counting criterion which amounts to ‘cutting off’ edges that are, in a specific sense, small. The main argument consists in a mapping between planar Brownian convex hulls and configurations of constrained, independent linear Brownian motions. This new formula is confirmed by retrieving an existing exact result on the average perimeter of the boundary of Brownian convex hulls in the plane.

Probability of Eventual CR After Course 1 of Induction Therapy for Newly-Diagnosed AML As a Function of Platelet and Neutrophil Recovery.

AbstractAbstract 2598 Background:After initial induction chemotherapy for acute myeloid leukemia (AML), it is commonplace that reinduction or intensified therapy is not indicated if the bone marrow has <5% blasts, even despite persistently low neutrophil (ANC) and/or platelet counts. This practice suggests that complete remission (CR), i.e. ANC >1000/μl and platelet count >100,000/μl per standard criteria (Cheson BD, et al. J Clin Oncol. 1990;8(5):813-9), might still occur and that the lack of blood count recovery may not bear prognostic significance. However, the time to CR after the first induction has been shown to be inversely related to subsequent duration of disease-free survival (DFS) and survival (OS), independent of age, treatment, and cytogenetics (Estey EH, et al. Blood. 2000;95(1):72-7). Additionally, the level of ANC and platelet recovery at time of CR is prognostic, with significantly better DFS among patients with higher counts (Yanada M, et al. Leuk Res. 2008;32(10):1505-9). Newly-diagnosed AML patients often present with below normal neutrophil and platelet counts, suggesting that persistence of such cytopenias after induction may be a clinical indicator of minimal residual disease (MRD) in the marrow. We therefore examined whether blood count recovery affected the probability of subsequent CR in patients with <5% bone marrow blasts. Methods:We included 85 patients who, by day 21 or thereafter of induction therapy for newly-diagnosed AML, had not met blood count criteria for CR despite a bone marrow in the prior week with <5% blasts by morphology. Patients were classified by type of induction therapy based on cytarabine dosing. G-CSF was not systematically administered. Marrows were planned for day 21 after chemotherapy and/or weekly thereafter to assess for disease status and evidence of marrow recovery. Because patients were often managed as outpatients, counts and marrows were not uniformly available and thus “day 28” included days 21–28, “day 35” included days 29–35, etc. If a patient had more than one marrow evaluation after day 21, we included only the first one. Results:Overall cohort CR rate was 64%. Eventual CR rate was significantly affected by platelet count, with 44% eventual CR for patients with platelets <30,000, 66% CR for platelets 30,000–100,000, and 95% CR for platelets >100,000. The effect of ANC recovery on eventual CR was less dramatic, with an OR 0.4 (0.2–1.0, p=0.049), for ANC <0.1 vs. >0.1 in the univariate analysis. By day 28, patients with either ANC or platelet recovery were significantly more likely to obtain CR than patients with neither count recovery (89% vs. 51%), OR 8.05 (2.2–30, p=0.002). In the multivariate analysis, (a) lack of platelet recovery to >30,000 was associated with significantly lower incidence of CR, OR 0.26 (0.1–0.8, p=0.02), and was independent of cytogenetic risk, antecedent hematologic disorder, and induction regimen, and (b) there was a suggested association between earlier count recovery and CR (>28 days vs. day 21–28), OR 0.31 (0.1–1.0, p=0.051). Conclusion:Persistence of low peripheral blood counts, despite the presence of <5% bone marrow blasts, is predictive of low eventual CR rates after induction chemotherapy. These results suggest that initiation of further and possibly different therapy, rather than continued observation, should be investigated in this setting.DemographicNo.No. CR, %Patients, No.8554 (64%)Median age, years54 (range 20-81)CytogeneticsInv16 or t(8;21)87 (88%)Intermediate4425 (57%)Monosomal karyotype1710 (59%)Other unfavorable1612 (75%)Type of AMLDe novo AML4431 (70%)Secondary AML4123 (56%)Induction RegimenLow-dose cytarabine40Standard-dose cytarabine5637 (66%)High-dose cytarabine1813 (72%)Treatment without cytarabine74 (57%)Day of marrow <5% blastsPlatelets <30, CR(%)Platelets 30-100, CR(%)Platelets >100, CR(%)ANC <0.1, CR(%)ANC 0.1-0.5, CR(%)ANC 0.5-1.0, CR(%)ANC >1.0, CR(%)Total Patients, CR(%)21-2815,7 (47%)12,9 (75%)15,15 (100%)18,10 (56%)14,13 (93%)3,2 (67%)7,6 (86%)42,31 (74%)29-3514,6 (43%)12,5 (42%)4,3 (75%)17,8 (47%)8,3 (38%)1,0 (0%)4,3 (75%)30,14 (47%)36-424,1 (25%)5,5 (100%)03,2 (67%)3,3 (100%)03,1 (33%)9,6 (67%)>423,2 (67%)01,1 (100%)2,1 (50%)1,1 (100%)1,1 (100%)04,3 (75%)Totals36,16 (44%)29,19 (66%)20,19 (95%)40,21 (53%)26,20 (77%)5,3 (60%)14,10 (71%)85,54 (64%) Disclosures:Becker:Sanofi: Research Funding.

Risk Factors for Thrombocytopenia in Adult Chinese Patients Receiving Linezolid Therapy

BackgroundLinezolid (LZD), an oxazolidinone antibiotic agent, has excellent activity and bioavailability against most methicillin-sensitive and methicillin-resistant gram-positive bacteria. Although LZD is generally well tolerated, several studies have found adverse hematologic effects, of which thrombocytopenia is of most concern. ObjectiveTo investigate the risk factors for thrombocytopenia in patients who received oral or parenteral LZD therapy between February 1 and November 30, 2010. MethodsData were extracted retrospectively from the electronic medical records in our hospital information system. Thrombocytopenia was defined as either a final platelet count of <100 × 109/L (criterion 1) or a 25% reduction from the baseline platelet count (criterion 2). Risk factors were determined using logistic regression analysis, and clinical features were predicted using receiver operating characteristic curves. ResultsThe study included 254 patients, with mean (SD) age of 59 (17.66) years. The duration of LZD therapy was 9.43 (5.63) days. Thrombocytopenia developed in 69 patients (27.2%), as defined by criterion 1, and in 127 patients (50%), as defined by criterion 2. At univariate analysis, age, weight, creatinine clearance, serum albumin concentration, baseline platelet count, daily dosage, and concomitant use of caspofungin, levofloxacin, and meropenem were significant risk factors for thrombocytopenia. At multivariate analysis and using ROC curves, daily dose ≥18.75 mg/kg, baseline platelet count ≤181 × 109/L, duration of LZD therapy ≥10 days, and concomitant use of caspofungin and levofloxacin were independent risk factors for thrombocytopenia as defined by criterion 1, whereas creatinine clearance ≤88.39 mL/min/1.73 m2, serum albumin concentration ≤33.5 g/L, daily dose ≥18.46 mg/kg, and caspofungin were independent risk factors for thrombocytopenia as defined by criterion 2. ConclusionsThe incidence of LZD-related thrombocytopenia in the Chinese population is much higher than that suggested by the drug instructions. Low pretreatment platelet count, low body weight, low serum albumin concentration, long-term drug administration, advanced age, renal insufficiency, and concomitant use of caspofungin, levofloxacin, and meropenem have been identified as risk factors. Although predictors have been proposed for use in clinical practice to screen for patients at high risk who require intensified monitoring, further research on the dosage-based pharmacokinetics and pharmacodynamics of LZD are urgently needed.

Active foot synovitis in patients with rheumatoid arthritis: Applying clinical criteria for disease activity and remission may result in underestimation of foot joint involvement

To determine whether application of criteria for remission in rheumatoid arthritis (RA) may result in underestimation of foot joint involvement among patients in a clinic setting. RA patients (n = 123) were assessed at baseline and 6 months after commencement of a response-driven combination disease-modifying antirheumatic drug (DMARD) protocol. Remission was assessed using disease activity measures (the 28-joint Disease Activity Score using the erythrocyte sedimentation rate [DAS28-ESR], Simplified Disease Activity Index [SDAI], and Clinical Disease Activity Index [CDAI]) as well as Boolean-based criteria for remission (the 1981 American College of Rheumatology [ACR] preliminary criteria and the 2011 ACR/European League Against Rheumatism [EULAR] provisional criteria). The prevalence of foot synovitis and the mean swollen/tender foot joint count in RA patients meeting any of these remission criteria were estimated by hurdle (mixed distribution) regression. In patients who received 6 months of combination DMARD treatment, application of the 1981 ACR criteria and the newly proposed 2011 ACR/EULAR criteria, each utilizing full joint counts (which includes assessment of the feet), classified the least number of patients as being in remission (8-10%), and evidence of foot synovitis was minimal among these patients. In contrast, ongoing foot synovitis was present in a substantial proportion of patients (>20%) meeting the 28-joint count criteria for remission, including the DAS28-ESR, SDAI, CDAI, and 2011 ACR/EULAR criteria (clinical practice setting or clinical trials). Furthermore, applying the 2011 ACR/EULAR composite remission criterion of a SDAI score ≤3.3 to define remission did not adequately capture the resolution of foot synovitis (i.e., residual foot involvement was still detected in a substantial proportion of patients classified as being in remission by this definition). Although the DAS28-ESR, CDAI, and SDAI have been validated for assessment of remission in RA, this study shows that the performance of these 3 disease activity measures, which do not provide a direct assessment of the foot, in detecting foot synovitis is poor, in contrast to that of the 1981 ACR and 2011 ACR/EULAR remission criteria utilizing full joint counts. Thus, patients may be at risk of ongoing damage if treatment decisions are made solely on the basis of criteria that omit foot joint assessment.

An Inter-Laboratory Study to Determine the Effectiveness of Procedures for Discriminating Amphibole Asbestos Fibers from Amphibole Cleavage Fragments in Fiber Counting by Phase-Contrast Microscopy

The US Occupational Safety and Health Administration (OSHA) and Mine Safety and Health Administration do not regulate cleavage fragments of amphibole and serpentine minerals as asbestos, even when particles meet the dimensional criteria for counting under standard phase-contrast microscopy methods. The OSHA ID-160 method cautions that discriminatory counting is difficult and should not be attempted unless necessary and no procedure is provided for differentiation. A standard published by the American Society for Testing and Materials (ASTM International D7200-06) includes an attempt to codify a procedure but recognizes that the procedure should be validated in an inter-laboratory study. The US National Institute for Occupational Safety and Health has carried out such a study with multiple laboratories using slides made from riebeckite and crocidolite, grunerite and amosite, tremolite and tremolite asbestos, and actinolite and actinolite asbestos using two different measurement aids (graticules). The asbestos fibers had dimensions consistent with those reported for air samples from actual amphibole asbestos operations, and the cleavage fragments were also dimensionally consistent with those found in non-asbestos mining and milling operations. The procedure for discriminating asbestos fibers from other mineral particles in the ASTM Standard calls for the recognition of characteristics supposedly common to asbestos. For the asbestos fibers created in this study, these characteristics were found not to be common and generally a function of length. More importantly, different laboratories did not recognize these features consistently. Laboratories were much more consistent in measuring dimensions, but excessive overlap in the lengths of asbestos fibers and cleavage fragments rendered length a poor criterion for discrimination. The ASTM discrimination procedure as written could not be supported on the basis of this study. Width was a much more consistent parameter for distinguishing the asbestos and non-asbestos fibers in this study and inclusion of aspect ratio, while considered important by some researchers, did not refine the discrimination further. The ability of the majority of microscopists in this study to discriminate fibers and cleavage fragments through measurement of particle widths was determined and found to be within limits of uncertainty typical for air sampling measurements. A width criterion might be a very simple and useful aid where discrimination between asbestos and non-asbestos fibers in fiber counting by phase-contrast microscopy is required for further investigation. Recognition of asbestos features can also be retained as excessive recognition by some laboratories will lead to a conservative decision for additional investigation.

KELAYAKAN FINANSIAL REPLANTING TANAMAN KARET DI DESA BATUMARTA 1 KECAMATAN LUBUK RAJA KABUPATEN OGAN KOMERING ULU PROVINSI SUMATERA SELATAN

This research aim to: 1) to analyze the amount of financial worthiness of rubber plantation as long as economic age in Batumarta 1 Lubuk Raja Ogan Komering Ulu regency. 2) To know the level of sensitivity in replanting rubber to several dominant factors related to finance and advantage in Batumarta 1 Lubuk Raja Ogan Komering Ulu regency. 77 respondents are chosen, about 30 % from 258 population which have represented population, because the population in Batumarta1 homogeneously relative in rubber plantation system, that is rejuveration system. The sample was chosen by using Simple Random Sampling Method. The research methodology is Survey. While the data is analyzed by worthiness count criteria which consist of Net B/C ratio, Gross B/C ratio, Provitability ratio, Net Present value (NPV), Internal Return Rate(IRR), this valuation done to know the worthiness off rubber replanting. Otherwise, also done the counting of sensitivity experimental. The result shows that rubber replanting in Batumarta 1 can be properly applied and the most sensitive factor is the decresing of selling price, increasing of production cost (fertilizer and total cost before tax) Keywords: Finansial feasibility Rubber Replanting

Comparison Korean National Health Insurance Reimbursement and Other Guidelines for TNF-α Blocker in Rheumatoid Arthritis

Objective. The aim of this study was to examine how many Korean rheumatoid arthritis (RA) patients fulfilling the 2008 American College of Rheumatology (ACR) recommendation, 2007 British Society for Rheumatology (BSR) guideline and 2010 Japan College of Rheumatology (JCR) guideline for TNF-α blocker, meet the Korean National Health Insurance reimbursement criteria and to evaluate the reasons for failing the Korean National Health Insurance reimbursement criteria. Methods. Data were obtained from a registry of RA patients who visited rheumatology clinics of Hallym university affiliated hospitals. Patients who were previously prescribed with methotrexate or leflunomide for more than 3 months and had at least one DAS28 examination were included in the present study. Results. Of 642 patients included, 118 episodes meeting ACR guideline for using TNF-α blocker were identified in 88 patients (13.7%). In addition, 19 episodes meeting BSR guideline in 17 patients (2.6%) and 21 episodes meeting JCR guideline in 21 patients (6.2%) were identified. Four episodes (4.8%) meeting ACR recommendation, 0 episodes meeting BSR criteria and 5 episodes (12%) meeting JCR criteria, respectively, were eligible for TNF-α blocker according to the Korean National Health Insurance reimbursement guideline. The most common reason for failing the Korean National Health Insurance reimbursement criteria was the number of active joint counts (92.6%). Conclusion. Our results show that the majority of RA patients satisfying the ACR guideline, BSR and JCR guideline for use of the TNF-α blocker did not meet the Korean National Health Insurance reimbursement criteria. Patients most often failed due to active joint count criteria.

Barriers to antiretroviral initiation in HIV-1-discordant couples.

In Kenya and much of sub-Saharan Africa, nearly half of all couples affected by HIV are discordant. Antiretroviral therapy (ART) slows disease progression in HIV-1-infected individuals and reduces transmission to uninfected partners. We examined time to ART initiation and factors associated with delayed initiation in HIV-1-discordant couples in Nairobi. HIV-1-discordant couples were enrolled and followed quarterly for up to 2 years. Clinical staff administered questionnaires and conducted viral loads and CD4 counts. Participants with a CD4 count meeting ART criteria were referred to a nearby US President's Emergency Plan for AIDS Relief-funded treatment center. Barriers to ART initiation among participants with a CD4 count eligible for ART were assessed by Cox regression. Of 439 HIV-1-infected participants (63.6% females and 36.4% males), 146 met CD4 count criteria for ART during follow-up. Median time from meeting CD4 criteria until ART initiation was 8.9 months, with 42.0% of eligible participants on ART by 6 months and 63.4% on ART by 1 year. The CD4 count at the time of eligibility was inversely associated with time to ART initiation (hazard ratio = 0.49, P < 0.001). Compared with homeowners, those paying higher rents started ART 48% more slowly (P = 0.062) and those paying lower rents started 71% more slowly (P = 0.002). Despite access to regular health care, referrals to treatment centers, and free access to ART, over one-third of participants with an eligible CD4 count had not started ART within 1 year. Factors of lower socioeconomic status may slow ART initiation, and targeted approaches are needed to avoid delays in treatment initiation.

Total lymphocyte count is a good marker for HIV-related mortality and can be used as a tool for starting HIV treatment in a resource-limited setting

Total lymphocyte counts (TLC) may be used as an alternative for CD4 cell counts to monitor HIV infection in resource-limited settings, where CD4 cell counts are too expensive or not available. We used prospectively collected patient data from an urban HIV clinic in Indonesia. Predictors of mortality were identified via Cox regression, and the relation between TLC and CD4 cell counts was calculated by linear regression. Receiver operating characteristics (ROC) curves were used to choose the cut-off values of TLC corresponding with CD4 cell counts <200 and ≤350 cells/μl. Based on these analyses, we designed TLC-based treatment algorithms. Of 889 antiretroviral treatment (ART)-naïve subjects included, 66% had CD4 cell counts <200 and 81% had 350 ≤ cells/μl at baseline. TLC and CD4 cell count were equally strong predictors of mortality in our population, where ART was started based on CD4 cell count criteria. The correlation coefficient (R) between TLC and √CD4 was 0.70. Optimal cut-off values for TLC to identify patients with CD4 cell counts <200 and ≤350 cells/μl were 1500 and 1700 cells/μl, respectively. Treatment algorithms based on a combination of TLC, gender, oral thrush, anaemia and body mass index performed better in terms of predictive value than WHO staging or TLC alone. In our cohort, such an algorithm would on average have saved $14.05 per patient. Total lymphocyte counts is a good marker for HIV-associated mortality. Simple algorithms including TLC can prioritize patients for HIV treatment in a resource-limited setting, until affordable CD4 cell counts will be universally available.

Determination of ranges for reporting pollen aeroallergen levels in the Washington, DC, metropolitan area

Local aeroallergen monitoring provides useful information for the atopic patient and medical community. Currently, National Allergy Bureau (NAB) ranges are used for reporting pollen count levels in the Washington, DC, area. To determine standard range criteria (low, moderate, high, and very high) for the reporting of specific tree, grass, and weed aeroallergens representative of the Washington, DC, metropolitan region. Atmospheric sampling for pollen aeroallergens was performed using a volumetric rotating-arm impaction sampler (model 40 Rotorod, SDI Company, Plymouth Meeting, PA). The cumulative pollen count, over a 12-year period (1998-2009), was determined for specific pollen aeroallergens. Local ranges were developed using methodology previously employed to determine NAB ranges. A comparison was made between NAB and Washington, DC, area ranges. The local median count, and low and moderate range criteria, are markedly lower than NAB range counts for tree, grass, and weed pollen. The NAB 99th percentile (high) count is significantly higher for grass and weed pollen but lower for tree pollen. Using new local range criteria, an increase was seen in the number of high days recorded for weed pollen (1,300%), grass pollen (258.6%), and tree pollen (11.8%). Previously, using NAB range criteria, no very high days were reported for grass and weed pollen over the 12-year period. Washington, DC, ranges establish more relevant reporting standards for our local patient population and will allow for comparison with reporting levels developed for sampling locations nationwide as well as with other regional sites.

Zero tolerance cue angle analysis and its effect on successive sink rate of a low cost billiard reposition control tutoring system

Selecting the best sequence of shots for a given cue position is not an easy task in a game of billiards. The repositioning of the cue after its collision with an object ball determines its success on successive shots. A previous paper by the author was able to assist users in order to perfect a shot based on a selection criterion of maximum angle tolerance. This paper further extends the aiming capability to include a calculation of the ideal speed for the repositioning of the cue ball. The system makes use of a vision system for cue and object balls, and cue stick tracking. Users are able to adjust the cue stick in terms of both the aiming direction and hitting velocity according to the guidance information analyzed by a gaming strategy of this work. A new strategy is proposed to apply the maximum tolerance angle search sequentially twice. One on the pre-collision shot and the second on the post collision path. Additional to the maximum tolerance angle criterion, this paper also proposes a new visible object ball count criterion to assist cue ball repositioning strategy for both direct and indirect shots. This criterion was developed based on an analysis of the zero tolerance zone angle. It has been specifically tested to verify its relation with the successive sink rate using proposed guidance system. The experimental results of the maximum tolerance angle repositioning strategy of our training facility as tested by users with different skill levels all out performed the results without the advice for the same set of users. In addition, the distribution pattern of maximum tolerance test showed the highest degree of similarity with that of accessibility count as user skill level increases. This not only proves the reliability of our training system, but also proves the effectiveness of our algorithm for optimal repositioning.

P53gene therapy in combination with transcatheter arterial chemoembolization for HCC: One-year follow-up

To evaluate the efficacy and safety of combination therapy with recombinant adenovirus p53 injection (rAdp53) and transcatheter hepatic arterial chemoembolization (TACE) for advanced hepatocellular carcinoma (HCC). A total of 82 patients with advanced HCC treated only with TACE served as control group. Another 68 patients with HCC treated with TACE in combination with recombinant adenovirus-p53 injection served as p53 treatment group. Patients were followed up for 12 mo. Safety and therapeutic effects were evaluated according to the improvement in clinical symptoms, leukocyte count, Karnofsky and RECIST criteria. Survival rate was calculated with Kaplan-Meier method. The total effective rate was 58.3% for p53 treatment group, and 26.5% for control group (P < 0.05). The incidence of gastrointestinal symptoms was lower in p53 treatment group than in control group (P < 0.05). The 3-, 6- and 12-mo survival rates were significantly higher for p53 treatment group than for control group (P < 0.01). The combination treatment was well tolerated with such adverse events as fever (51.5%, P = 0.006) and pain of muscles and joints (13.2%, P = 0.003), which were significantly higher than the chemotherapy. Except for these minor adverse effects, no severe vector-related complications were identified. With respect to the efficacy, patients in p53 treatment group had less gastrointerestinal symptoms (P = 0.062), better improvement in tumor-related pain (P = 0.003), less downgrade of leukocyte counts (P = 0.003) and more upgrade of Karnofsky performance score (P = 0.029) than those in control group. The total effective rate (CR + PR) for p53 treatment group and control group was 58.3% and 26.5%, respectively, with distributions of different effect in two groups (P = 0.042). The survival rates were 89.71%, 76.13%, and 43.30% for p53 treatment group, and 68.15%, 36.98%, and 24.02% for control group, respectively, 3, 6 and 12 mo after treatment, suggesting that the survival rates are significantly higher for p53 treatment group than for control group (P = 0.0002). The rAd-p53 gene therapy in combination with TACE is a safe and effective treatment modality for advanced HCC.

Letter to the Editor: Treatment as Prevention: Are HIV Clinic Patients Interested in Starting Antiretroviral Therapy to Decrease HIV Transmission?

Letter to the Editor: Treatment as Prevention: Are HIV Clinic Patients Interested in Starting Antiretroviral Therapy to Decrease HIV Transmission?

Assessment of Safety and Efficacy of a New Intravenous Immunoglobulin (IGIV3I 10% Grifols) In Subjects with Chronic Immune Thrombocytopenia

AbstractAbstract 4669Two similarly designed prospective, uncontrolled, open-label clinical trials were planned to assess the safety and efficacy of a new intravenous immunoglobulin (IVIG), IGIV3I 10% Grifols, in subjects with chronic immune thrombocytopenia (ITP) in the USA, Canada and Europe (Spain, Russia and the United Kingdom). Subjects were candidates to be enrolled if they had a diagnosis of chronic ITP and a baseline platelet count ≤ 20 × 109/l. Eligible subjects received treatment with IGIV3I 10% Grifols 1g/kg for 2 consecutive days or 0.4 g/kg for 5 consecutive days. The primary efficacy endpoint was the response rate, defined as the proportion of subjects reaching or exceeding the threshold value of 50 × 109/l on or before day 8 (American study) or on day 30 (European study) where day 1 is the day of the first infusion. Secondary efficacy endpoints were the time to response, defined as the number of days elapsed from day 1 to achievement of the threshold value; duration of response, defined as the number of consecutive days with a platelet count known to be ≥50 × 109/l; the maximum (peak) platelet count and regression of haemorrhagic diathesis for those subjects presenting with bleeding signs at baseline. Safety endpoints included adverse events (AEs), physical examinations, vital signs and clinical laboratory parameters monitoring. A total of 27 subjects (18 adults and 9 pediatrics) have been enrolled, i.e. administered with at least one infusion of the product at any dose, in the study. Twenty-four (24) subjects (89%) were considered responders. This proportion was higher in pediatric subjects (9/9, 100%) than in adult subjects (15/18, 83%). The mean time to response was 1.6 days (Standard Deviation (SD) 0.9); the mean duration of response was 14.0 days (SD 12.1) and the mean maximum platelet count was 263 × 109/l (SD 195.6). Twenty-three (23) subjects (all the pediatric subjects 9/9 and 14/18 adults) presented with some sign of bleeding at baseline. All subjects (23/23, 100%) experienced an improvement in the haemorrhagic diathesis, regardless of some of them being considered non-responders according to the platelet count criterion. A total of 92 AEs potentially related to study drug were reported. The most common of these were headache (25 events), nausea (8 events), pyrexia (7 events) and chills (6 events). Only 1 AE was reported as definitely related to study drug, an event of palmar erythema. Two serious AEs (SAE) potentially related to the study drug were reported in 2 subjects. One of them was an unexpected laboratory alteration which consisted in leukopenia and decreased hemoglobin and advised to maintain the subject hospitalized for further observation during the weekend. The reaction was transient, without complications or other clinical symptoms and total recovery of the normal laboratory values. The second SAE was an event of thrombosis in the right humeral vein, in a patient with a number of predisposing medical conditions. At the time of discharge the patient's overall condition was satisfactory. Analysis of AEs, clinical laboratory values, physical assessments and vital signs did not indicate any safety concerns for subjects receiving the study drug and are in line with those expected for the ITP population treated with IVIG. Both primary and secondary efficacy endpoints show a good response to the product in terms of rapid elevation of platelet counts to an hemostatic level in line with what is expected for an IVIG product. Moreover, the improvement of the baseline bleeding diathesis even in patients considered as non-responders according to the platelet count criterion is highly suggestive of the clinical efficacy of the product. Overall, these results indicate that treatment with the new IGIV3I 10% Grifols is safe and efficacious for rapidly increasing platelet counts in chronic ITP subjects and improving their bleeding diathesis. Disclosures:Khojasteh:Grifols S.A.: Research Funding. Kato:Grifols S.A.: Research Funding. Parikh:Grifols S.A.: Research Funding. Singleton:Grifols S.A.: Research Funding. Tebbi:Grifols S.A.: Research Funding. Cromwell:Grifols S.A.: Research Funding. Fu:Grifols S.A.: Research Funding. Kessler:Grifols S.A.: Research Funding. Letzer:Grifols S.A.: Research Funding. Ritchie:Grifols S.A.: Research Funding. Sexauer:Grifols S.A.: Research Funding. Saxena:Grifols S.A.: Research Funding. Sirpal:Grifols S.A.: Research Funding. Torres:Grifols S.A.: Research Funding. Loriya:Grifols S.A.: Research Funding. Kovaleva:Grifols S.A.: Research Funding. Sandoval:Grifols S.A.: Research Funding. Sanz:Grifols S.A.: Research Funding. Julià:Grifols S.A.: Research Funding. Montañés:Grifols S.A.: Employment. Navarro:Grifols S.A.: Employment.