Short Schedule Research Articles

Palliative thoracic radiotherapy near the end of life in lung cancer: A population-based analysis

ObjectivesPalliative thoracic radiotherapy (RT) can improve quality of life for patients with advanced lung cancer, but treatment can be associated with acute toxicity and symptomatic relief may take several weeks. The optimal fractionation schedule is not known. Delivery of RT near the end of life (EOL) is an emerging indicator of poor quality care. The aim of this study was to determine utilization of palliative thoracic RT in the last 4 weeks of life, and factors associated with its use, in patients with incurable lung cancer in a population-based healthcare system. Materials and methodsAll patients with lung cancer in British Columbia treated with palliative thoracic RT in 2014 and 2015 were identified. Associations between starting a course of palliative thoracic RT within 4 weeks of death and patient/treatment characteristics were assessed using univariate and multivariate logistic regression analysis. Results1676 courses of palliative thoracic RT were delivered to 1584 lung cancer patients. Median survival was 20 weeks. 12% of palliative thoracic RT courses were delivered in the last 4 weeks of life, with short fractionation schedules and simple RT planning techniques used more frequently near EOL. Of RT courses delivered in the last 4 weeks of life 89% were courses of 1 – 5 fractions, 75% were completed as prescribed and 94% involved simple 1–2 field RT techniques. Receipt of RT in the last 4 weeks of life was associated with male gender, younger age, poor performance status, metastatic disease, small cell carcinoma histology and no prior chemotherapy. ConclusionFurther study and standardization of quality indicators for palliative RT utilization near EOL is required. Whilst clarification occurs, physicians should consider the prognosis of patients with incurable lung cancer and the realistic expectation of benefit from palliative thoracic RT when considering treatment indications and fractionation schedules.

Quality of life after ultra-hypofractionated radiotherapy for prostate cancer: the challenge of RTOG 0938 trial

In the Red Journal , Lukka and colleagues reported optimal quality of life (QoL) outcomes of the NRG Oncology RTOG 0938 trial (1). This trial randomly compared two short radiation schedules of 5 and 12 fractions of 7.25 and 4.3 Gy each, respectively, for the treatment of localized, low risk prostate cancer. The primary endpoint was the proportion of patients with a change in bowel and urinary EPIC-50 score at 1-year.

A Personal History of the IBM Personal Computer

The development of the IBM Personal Computer was an exciting time -- a brand-new design, a short design schedule and lots of things to go wrong. An insider recalls the things that happened, the problems solved, and the interesting adventures along the way.

Buku Cerita Si Kancil dan Perilaku Meniru Siswa Taman Kanak-kanak

The purpose of this paper is to find out whether the storybook or the Kancil fairy tale influences the imitating behavior of the Sunggal 41 ABA 41 Kindergarten students and sees how storytellers are very influential in conveying the message content of a story. This research method uses descriptive, which is taking a problem or focusing on actual problems as they were at the time the research was conducted. The description in this study was to see the imitating behavior of the Sunggal 41 ABA Kindergarten students. The results of the study found that fairy tales or stories of the Kancil can enrich knowledge by recognizing various types of animals that are used as characters in a story or fairy tale or in increasing children's understanding of good and bad things. Children who tend to not be able to focus on one thing / object in a certain period of time are challenges and homework that the teacher must overcome when telling stories / storytelling. Short time and schedule of storytelling / storytelling activities obtained at school are not enough to-create-imitating-behaviors-of-children.

Updated Results from the Phase 2 Centaurus Study of Daratumumab (DARA) Monotherapy in Patients with Intermediate-Risk or High-Risk Smoldering Multiple Myeloma (SMM)

Updated Results from the Phase 2 Centaurus Study of Daratumumab (DARA) Monotherapy in Patients with Intermediate-Risk or High-Risk Smoldering Multiple Myeloma (SMM)

Immunogenicity of the CYD tetravalent dengue vaccine using an accelerated schedule: randomised phase II study in US adults

BackgroundThe live attenuated tetravalent dengue vaccine (CYD-TDV) is licensed using a 0-, 6- and 12-month schedule in dengue-endemic areas. An effective shorter schedule may provide more rapid, optimal protection of targeted populations during vaccine campaigns in dengue-endemic countries. We compared immune responses to two schedules of CYD-TDV in a non-endemic population. We also evaluated the impact of yellow fever (YF) co-administration.MethodsThis phase II, open-label, multicentre study enrolled 390 healthy 18–45-year-olds in the USA with no prior exposure to dengue. Participants were randomised (4:4:4:1) to four treatment groups stratified by prior YF vaccine status: Group 1, CYD-TDV standard 0–6–12 months schedule; Group 2, CYD-TDV accelerated 0–2–6 months schedule; Group 3, CYD-TDV accelerated schedule with YF co-administered (dose 1); Group 4, YF vaccination only. Neutralising antibody geometric mean titres (GMTs) and percentages of seropositive participants (antibody titres ≥10 [1/dil]) were measured against each dengue serotype using a 50% plaque reduction neutralisation test.ResultsOn D28 post-CYD-TDV dose 3, there were no marked differences in seropositivity rates and GMTs between Groups 1 and 2. In Groups 1 and 2 respectively, 73.4 and 82.4% were dengue seropositive for ≥3 serotypes, with 50.0 and 42.6% seropositive against all four serotypes. Flavivirus status (FV+ or FV−) at baseline did not markedly affect GMTs and seropositivity rates with either schedule. In Groups 1 and 2, GMTs measured 6 months after the third dose decreased against all serotypes, except for a small increase in GMT for serotype 4 in Group 1. In addition, dengue seropositivity remained above 70% for serotypes 2, 3 and 4 in Groups 1 and 2. Co-administration with YF did not affect antibody responses against dengue and YF or impact vaccine safety following completion of the compressed schedule, compared to dengue or YF vaccination alone.ConclusionsThe live attenuated CYD-TDV vaccine given in a compressed schedule in a non-endemic setting can elicit similar antibody responses to the licensed CYD-TDV schedule.Trial registrationThis trial was registered on cinicaltrials.gov, NCT01488890 (December 8, 2011).

Multi-Criteria Decision-Making for Heterogeneous Multiprocessor Scheduling

This paper proposes a new tri-objective scheduling algorithm called Heterogeneous Reliability-Driven Energy-Efficient Duplication-based (HRDEED) algorithm for heterogeneous multiprocessors. The goal of the algorithm is to minimize the makespan (schedule length) and energy consumption, while maximizing the reliability of the generated schedule. Duplication has been employed in order to minimize the makespan. There is a strong interest among researchers to obtain high-performance schedules that consume less energy. To address this issue, the proposed algorithm incorporates energy consumption as an objective. Moreover, in order to deal with processor and link failures, a system reliability model is proposed. The three objectives, i.e., minimizing the makespan and energy, while maximizing the reliability, have been met by employing a method called Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS). TOPSIS is a popular Multi-Criteria Decision-Making (MCDM) technique that has been employed to rank the generated Pareto optimal schedules. Simulation results demonstrate the capability of the proposed algorithm in generating short, energy-efficient and reliable schedules. Based on simulation results, we observe that HRDEED algorithm demonstrates an improvement in both the energy consumption and reliability, with a reduced makespan. Specifically, it has been shown that the energy consumption can be reduced by 5–47%, and reliability can be improved by 1–5% with a 1–3% increase in makespan.

Short Hypofractionated Radiation Therapy in Palliation of Pediatric Malignancies: Outcomes and Toxicities

Treatment strategies in palliation of pediatric cancer remain a significant challenge. In this study, we aimed to assess the efficacy and safety of a short course of hypofractionated radiation therapy (RT) for metastatic or recurrent childhood tumors. A total of 104 lesions in 62 pediatric patients with metastatic or recurrent cancer were treated with a short hypofractionation schedule (>1 but ≤5 fractions; ≥3Gy per fraction) between 2007 and 2017 in our institution. The primary endpoint was local control (LC). Other endpoints included treatment response, overall survival, progression-free survival, and toxicity. Toxicities were assessed using the Common Terminology Criteria for Adverse Events v.4.0. The most common histologies were neuroblastoma, comprising 50 of the 104 lesions (48.1%); osteosarcoma, 17 lesions (16.4%); and Ewing sarcoma, 13 lesions (12.5%). A median total dose of 24Gy was delivered in a median of 5 fractions. Of 104 lesions, 26 (25.0%) were treated with stereotactic body radiation therapy, 24 (23.1%) with intensity modulated RT, and 48 (46.2%) with 2-dimensional RT or 3-dimensional conformal RT. A complete or partial response was observed in 63 (60.6%) of lesions, and stable disease was observed in 34 (32.7%). At a median follow-up of 8.7months, 21 local failures occurred (20.2%). The 1- and 2-year LC rateswere 74% and 68%, respectively. LC was better for tumors without previous irradiation (83% vs 57% with previous RT; P=.004). LC rates did not differ between RTtechniques or total biologically effective dose with α/β ratio of 10 (BED10) (≤30 vs>30Gy). At the time of analysis, 38 deaths in the cohort of 62 patients (61.3%) wererecorded. The 1-year progression-free survival and overall survival rates were 31% and 44%, respectively. Incidence of any grade ≥3 toxicity was 6.7% (7 of 104). No grade 5 events occurred. A short hypofractionation scheme yields effective disease control and treatment response with a favorable side effect profile. Select pediatric patients with symptomatic metastases or recurrent disease can be considered for a short course of palliative RT.

Loss-to-Follow Up and Other Outcomes among HIV-Infected Women in Buenos Aires, Argentina, Previously Enrolled in NISDI Perinatal Cohort Studies

Background: No data are available on factors associated with loss-to-follow-up (LTFU) in the long-term postpartum period in HIV + women previously enrolled in perinatal cohort studies. We explored the role of two different postpartum visit schedules (short or long) and the probability of LTFU in HIV + mothers after participation in perinatal studies (NISDI Studies): Perinatal and LILAC. Methods & Materials: We used data from Perinatal (2002-2007) and LILAC (2008-2011) studies, with 2 different postpartum follow-up schedules: 6 or ≥ 24 months. We conducted a retrospective cohort study to analyze LTFU. We also measured sociodemographic and clinical characteristics. To assess differences in the probability of LTFU between short or long postpartum visit schedules, we performed a survival analysis with Kaplan-Meier estimator. Results: One hundred and fifty HIV + pregnant women were enrolled into NISDI studies at our site (Perinatal n = 112; LILAC n = 38). For this analysis, 141 patients met inclusion criteria. Median age at delivery was 30.7 (interquartile range (IQR) 27-33.6). 64.5% (91) had ≤ 7 years of education, and 35.5% (50) had completed 8th grade or more. At NISDI baseline: median CD4 cell count was 368 cell/ml; 85.8% (121) women were asymptomatic (class A of CDC classification), and 46.1% (65) had been prescribed antiretroviral treatment (ART). 10. 6% (15) reported a history of intravenous drug use; and 56% (79) of substance misuse (alcohol, cocaine, marijuana). In the survival analysis we found no association between LTFU and postpartum visit schedule (short or long) in a five-year period (Log-rank p = 0.70). In our analysis, the total mortality rate was 8.66/1000 person-years of follow-up (PY). Finally, incidence rates of AIDS and non-AIDS events were 31.2 and 2.84/1000 PY, respectively. Conclusion: Our findings showed that in the long term period (5 years), HIV + women are LTFU in the same proportion after participation in perinatal studies, regardless the type of postpartum type of follow-up (short or long). The results of mortality and AIDS rates in a cohort of previously asymptomatic HIV + women highlight the need to review the strategies to achieve better outcomes in this population.

Abscopal Effects With Hypofractionated Schedules Extending Into the Effector Phase of the Tumor-Specific T-Cell Response

Hypofractionated radiation therapy (hRT) combined with immune checkpoint blockade can induce T-cell-mediated local and abscopal antitumor effects. We had previously observed peak levels of tumor-infiltrating lymphocytes (TILs) between days 5 and 8 after hRT. Because TILs are regarded as radiosensitive, hRT schedules extending into this period might be less immunogenic, prompting us tocompare clinically relevant, short and extended schedules with equivalent biologically effective doses combined with anti-programmed cell death 1 (PD1) antibody treatment. In mice bearing 2 B16-CD133 melanoma tumors, the primary tumor was irradiated with 3×9.18Gy in 3 or 5days or with 5×6.43Gy in 10days; an anti-PD1 antibody was given weekly. The mice were monitored for tumor growth and survival. T-cell responses were determined on days 8 and 15 of treatment. The role of regional lymph nodes was studied by administering FTY720, which blocks lymph node egress of activated T cells. Tumor growth measurements after combination treatment using short or extended hRT and control treatment were also performed in the wild-type B16 melanoma and 4T1 breast carcinoma models. In the B16-CD133 model, growth inhibition of irradiated primary andnonirradiated secondary tumors and overall survival were similar with all 3hRT/anti-PD1 combinations, superior to hRT and anti-PD1 monotherapy, and was strongly dependent on CD8+ T cells. TIL infiltration and local and systemic tumor-specific CD8+ T-cell responses were also similar, regardless of whether short or extended hRT was used. Administration of FTY720 accelerated growth of both primary and secondary tumors, strongly reduced their TIL infiltration, and increased tumor-specific CD8+ T cells in the lymph nodes draining the irradiated tumor. In the 4T1 model, local and abscopal tumor control was also similar, regardless of whether short or extended hRT was used, although the synergy between hRT and anti-PD1 was weaker. No synergies were found in the B16 wild-type model lacking an exogenous antigen. Our data suggest that combination therapy with hRT schedules extending into the period during which treatment-induced T cells infiltrate the irradiated tumor can provoke local and systemic antitumor effects similar to those with therapy using shorter schedules, if the regional lymph nodes supply sufficient tumor-specific T cells. This has implications for planning clinical RT/immune checkpoint blockade trials.

Long-term Lactobacillus rhamnosus BMX 54 application to restore a balanced vaginal ecosystem: a promising solution against HPV-infection

BackgroundOver recent years, a growing interest has developed in microbiota and in the concept of maintaining a special balance between Lactobacillus and other bacteria species in order to promote women’s well-being. The aim of our study was to confirm that vaginal Lactobacilli long-lasting implementation in women with HPV-infections and concomitant bacterial vaginosis or vaginitis might be able to help in solving the viral infection, by re-establishing the original eubiosis.MethodsA total of 117 women affected by bacterial vaginosis or vaginitis with concomitant HPV-infections were enrolled at Department of Gynecological Obstetrics and Urological Sciences, La Sapienza University, Rome, Italy between February 2015 and March 2016. Women were randomized in two groups, standard treatment (metronidazole 500 mg twice a day for 7 days or fluconazole 150 mg orally once a day for 2 consecutive days) plus short-term (3 months) vaginal Lactobacillus implementation (group 1, short probiotics treatment protocol group, n = 60) versus the same standard treatment plus long-lasting (6 months) vaginal Lactobacillus rhamnosus BMX 54 administration (group 2, treatment group, n = 57).ResultsAfter a median follow up of 14 months (range 9–30 months) the chance to solve HPV-related cytological anomalies was twice higher in probiotic long-term users (group 2) versus short probiotics implementation group (group 1) (79.4% vs 37.5%, p = 0.041). Moreover, a total HPV-clearance was shown in 11.6% of short schedule probiotics implementation patients compared to a percentage of 31.2% in vaginal Lactobacilli long term users (p = 0.044), assessed as negative HPV-DNA test documented at the end of the study period.ConclusionsThe consistent percentage of clearance of PAP-smear abnormalities and HPV-clearance obtained in long-term treatment group has been interestingly high and encouraging. Obviously, larger and randomized studies are warranted to confirm these encouraging results, but we believe that eubiosis re-establishment is the key to tackle effectively even HPV-infection.Trial registrationRetrospectively registered on PRS NCT03372395 (12/12/2017).

Increasing Aggregation Convergecast Data Collection Frequency through Pipelining

We consider the problem of increasing the data collection frequency of aggregation convergecast. Previous studies attempt to increase the data collection frequency by shortening the completion of a single data collection cycle. We aim at increasing the frequency at which data collection updates are collected by the use of pipelining and, consequently, increasing the overall data collection frequency and throughput. To achieve this, we overlap the propagation schedule of multiple data snapshots within the same overall schedule cycle, thus increasing parallelism through pipelining. Consequently, the effective data collection time of an individual snapshot may span over multiple, successive, schedule cycles. To this end, we modify the aggregation convergecast model, decoupling schedule length, and data collection delay, by relaxing its precedence constraints. Our solution for this new problem involves the unconventional approach of constructing the schedule before finalizing the exact form of the data aggregation tree, which, in turn, requires that the schedule construction phase guarantees that every node can reach the sink. We compare our results using snapshot pipelining against a previously proposed algorithm that also uses a form of pipelining, as well as against an algorithm that though lacking pipelining, exhibits the ability to produce very short schedules. The results confirm the potential to achieve a substantial throughput increase, at the cost of some increase in latency.

Assessing the Benefits of the Integrated Project Delivery Method: A Survey of Expert Opinions

As a way to reduce the conflictual relationships between the parties involved in construction projects, the Integrated Project Delivery (IPD) has been emerging as a promising method to avoid some of the traditional inefficiencies of traditional contracting systems and maximize construction project success. However, IPD is struggling to spread in the industry and there is still the need to understand the value that it can unlock. To this end, a survey is proposed to explore the main benefits and open issues that practitioners face when using the IPD to deliver construction projects. The study reveals that initial high cost, contractual hardships, and complexity of implementation of IPD are the main reasons behind not adopting IPD, while shorter schedules, cost savings, better quality, and increased productivity are some of the main benefits derived from IPD adoption.

Exploring the Feasibility of a New Low Cost Intra-Dermal Pre & Post Exposure Rabies Prophylaxis Protocol in Domestic Bovine in Jawali Veterinary Hospital, District Kangra, Himachal Pradesh, India

Cattle are the backbone of household economy in rural areas of India and many of them die after bites by potentially rabid dogs, despite being given currently recommended five shots of intramuscular (IM) rabies vaccination as Post Exposure Prophylaxis (PEP). In 2016, seven of 21 bovine bitten by rabid dogs given IM rabies vaccination died due to rabies in Shimla Municipality. This scenario prompted the authors to look for a suitable protocol, based on human studies, to save animals. We tested various schedules of IDRV in bovine and found that a schedule of 0.2 ml given in middle 1/3rd of neck on day 0, 3, 7, 14 and 28 along with local wound infiltration of eRIG is sufficiently immunogenic and life saving in all of them, even if bitten by lab confirmed rabid dogs/mongoose as tested by CRI. Rabivac Vet, a Cell Culture Rabies Vaccine, available as 1 ml per vial was used off level for IDRV. While injecting the vaccine, a raised papule of ≥1 cm will appear slowly causing a peau d’orange appearance. All 60 bovine serum samples tested by RFFIT after IDRV, had titers more than 0.5 IU/ml on day 14. Thereafter, a total of 150 animals were given five doses of IDRV as PEP, with or without RIG, after their exposure to clinically or lab confirmed rabid dogs/mongoose and all survived for more than a year. Serum samples from 15 animals bitten by lab confirmed rabid dogs/mongoose were collected on day 14 and tested for RVNA by RFFIT from NIMHANS Bangalore and all had desired antibody titers above 0.5 IU/ml, without any immunosuppression. The RFFIT titers in 55% bovine in all groups were more than adequate after one year and 100% of them had anamnestic response to a single 0.2 ml booster given at one year. Few of the bovine and even one equine (Horse. Figure 4) brought for PEP at some of nearby vet hospitals were given IM rabies vaccine with local eRIG infiltration also survived. Local eRIG infiltration appeared to have covered the lacuna of longer window period required for indigenous antibodies production through IM route in bovine that are not sufficiently produced by day 14. While five times less vaccine was used in this low cost protocol and the survival was 100% compared to traditional IM protocol where survival was 66%. Pre-exposure prophylaxis was found to be effective as 0.2 ml dose of IDRV on day 0, 3, 7 and all bovine had titers higher than the desired by day seven after single 0.2 ml vaccine booster at one year. Our study points towards a possibility of having short schedules of three shots IDRV vaccination in bovine with or without local RIG (depending on presence or absence of wound/s) as PEP and single shot IDRV as PrEP, but further studies are required on a large number of animals. Our study also points out for allowing intra-dermal use in animals as well and labeling vaccines for the same as this is low cost more immunogenic and less painful compare to IM administration.

Comparative Study of Precancerous Lesions of the Uterine Cervix Among Users and Non-Users of Combined Oral Contraceptive Pills in Jos, Nigeria

Combined oral contraceptive pills (COCP) use, is link to the development of precancerous cervical lesions. There are variations in reports across studied populations. Our study was a comparative, cross-sectional study. SPSS version 20 (IBM, Armonk, NY, USA) was used for data analysis and P-Value < 0.05 was considered statistically significant. The Prevalence of precancerous cervical lesions in the Exposed and Control groups were 16.4% (9/55) and 14.5% (8/55) respectively (P = of 0.79). In the exposed group, four out of the nine women that had abnormal cervical cytology results had high grade squamous intra-epithelial lesions (HGSIL) while only one out of 8 women that had abnormal cytology results in the control group had HGSIL. We found no significant difference in the prevalence of pre-cancerous cervical lesions between users and non-users of COCP. However, women who used COCP had higher cases of HGSIL when compared with the control group. Therefore, we suggest relatively short schedule of cervical cytology screening for this group of women relative to the general population.

The effect of nurse-led pain education of patients with painful bone metastases on pain and quality of life: A multicenter randomized trial.

203 Background: Radiotherapy (RT) is an effective treatment for painful bone metastases, although pain is not always sufficiently controlled. Pain management education may improve patient empowerment and, consequently, reduce pain intensity. The effect of nurse-led education (NLE) in patients undergoing RT for painful bone metastases was investigated as compared to care as usual (CAU). Primary endpoint was pain intensity at 12 weeks, secondary outcome was quality of life (QoL). Methods: In this multicentre, randomised phase 3 study, patients referred for short schedule RT, with uncontrolled pain (a score of ≥5 on a 0-10 numeric rating scale (NRS)), were randomised between NLE or CAU before start of RT. The NLE consisted of a structured interview including assessment of pain knowledge, verbal and written education on all aspects of pain and follow-up phone calls at 1, 4, 8 &amp; 12 weeks to address pain-related questions. Patients in CAU received leaflets on RT, cancer pain and opioid use. Patient characteristics were assessed at baseline. Pain intensity and QoL were evaluated with the Brief Pain Inventory, EORTC QLQ-C15-PAL and EORTC QLQ-BM22 at baseline, and week 1, 4, 8 &amp; 12. Power calculation showed that there were 89 patients per arm needed to detect a 10% difference in number of patients with a NRS &lt; 5 at 12 weeks(1-sided α = 0.05; β 0.8). Results: Between May 2011-April 2016, 354 patients were randomised (176 NLE, 178 CAU), 38 were excluded (30 NRS &lt; 5 at baseline, 7 no short schedule RT, 1 missing informed consent). At twelve weeks, 185 (NLE 95) had completed follow-up (72 stopped filling out questionnaires, 59 died prematurely). Baseline characteristics were similar in both groups; mean age 65 years, 56% men. At week 12, more patients in NLE than in CAU had controlled pain (NRS &lt; 5; respectively 66% and 52%, p = 0.036). Moreover, patients in NLE reached faster a pain score &lt; 5 than patients in CAU (31 versus 54 days respectively, p = 0.026). On all time points, no significant differences in QoL were found between both groups. Conclusions: Controlled pain, i.e. a pain intensity &lt; 5, was reached faster and by more patients with painful bone metastases undergoing RT by the addition of nurse-led pain education. Clinical trial information: NCT01358539.

Determination of Prevalence and Antimicrobial Resistance Profiles of Mycobacterium tuberculosis Complex Isolates from HIV Positive Patients in Kisumu County, Kenya

The purpose of this study was to determine the prevalence and antimicrobial resistance profiles of Mycobacterium tuberculosis complex isolates from HIV positive patients in Kisumu County. This is because the spread of Multidrug-Resistant Tuberculosis (MDR-TB) strains has become a challenge to the global TB control and prevention program. Moreover, researchers from neighboring countries like Ethiopia have reported that despite the existence of MDR-TB strains, very limited information on the strains exist especially among the rural people. A cross-sectional study was conducted between December 2013 and June 2014. The study engaged, 379 HIV positive patients suspected of TB infection who gave sputum samples. The sputum samples were then decontaminated, concentrated, liquefied and neutralized before being cultured in liquid media using Mycobacteria Growth Indicator (MGIT) 960 tubes. The culture positive MGIT tubes were sub cultured in Brain Heart Infusion Agar (BHIA) before microscopic examination of the culture using Ziehl-Neelsen (ZN) smear for Acid Fast Bacilli (AFB), and identified using Genotype MTBC. MGIT 960 tubes positively identified to have Mycobacterium tuberculosis were then subjected to drug sensitivity test using BACTEC 960 susceptibility. This was on the four first line drugs collectively referred to as SIRE (Streptomycin, Isoniazid, Rifampicin and Ethambutol). In the study, 130 (34.3 %) of the 379 suspected TB patients were diagnosed positive for pulmonary TB by MGIT culture. This study also reveals a higher prevalence rate of MDR- TB (18.46 %) among HIV/ TB patients in Kisumu. Further, the study revealed that, the overall resistance to the first line drugs was 6.9% while the individual TB drugs had the following resistance rates; 6.2 % Streptomycin, 10 % Isoniazid, 9.2 % Rifampicin and 3.8 % Ethambutol. Based on the results, the study concludes the following: that Rifampicin and Isoniazid had the high resistance rates 9.2 % and 10 % respectively; the study also reveals a high prevalence rate of MDR-TB (18.46 %) among HIV/TB patients in Kisumu County. Therefore, there is urgent need for the public health sector to incorporate drug susceptibility testing in the management and control of TB so as to detect antimicrobial early and then treated by enhancing capacities of the medical Laboratories in the county. Also, there in need to develop shorter TB drug schedules to enhance adherence to treatment.

The RapidScat Ocean Winds Scatterometer: A Radar System Engineering Perspective

The NASA International Space Station (ISS)-RapidScat scatterometer operated on board the ISS from October 2014 into August 2016. It was developed using a combination of new subsystems and spare SeaWinds scatterometer engineering model subsystems to interface with the ISS. Using commercial (nonflight-qualified) parts in the new assemblies, developing RapidScat required a relatively small budget and short time schedule (just over two years). This article describes RapidScat's development from the perspective of radar system engineering, particularly in relation to performance requirements and testing.

Adherence and feasibility of 2 treatment schedules of S-1 as adjuvant chemotherapy for patients with completely resected advanced lung cancer: a multicenter randomized controlled trial

BackgroundWe conducted a multicenter randomized study of adjuvant S-1 administration schedules for surgically treated pathological stage IB-IIIA non-small cell lung cancer patients.MethodsPatients receiving curative surgical resection were centrally randomized to arm A (4 weeks of oral S-1 and a 2-week rest over 12 months) or arm B (2 weeks of S-1 and a 1-week rest over 12 months). The primary endpoints were completion of the scheduled adjuvant chemotherapy over 12 months, and the secondary endpoints were relative total administration dose, toxicity, and 3-year disease-free survival.ResultsFrom April 2005 to January 2012, 80 patients were enrolled, of whom 78 patients were eligible and assessable. The planned S-1 administration over 12 months was accomplished to 28 patients in 38 arm A patients (73.7%) and to 18 patients in 40 arm B patients (45.0%, p = 0.01). The average relative dose intensity was 77.2% for arm A and 58.4% for arm B (p = 0.01). Drug-related grade 3 adverse events were recorded for 11% of arm A and 5% of arm B (p = 0.43). Grade 1–3 elevation of bilirubin, alkaline phosphatase, aspartate aminotransferase, and alanine transaminase were more frequently recorded in arm A than in arm B. The 3-year disease-free survival rate was 79.0% for arm A and 79.3% for arm B (p = 0.94).ConclusionsThe superiority of feasibility of the shorter schedule was not recognized in the present study. The conventional schedule showed higher completion rates over 12 months (p = 0.01) and relative dose intensity of S-1 (p = 0.01). Toxicity showed no significant difference among the shorter schedule and the conventional schedule, except for grade 1–3 elevation of bilirubin.Trial registrationThis randomized multicenter study was retrospectively registered with the UMIN-CTR (UMIN000016086, registration date December 30, 2014).

Assessment of Needs: Differences between male and female patients with schizophrenia needs in psychiatric hospitals in Baghdad city.

Gender differences are one of the most important and crucial subjects in evaluating the nursing care as well as mental health care system for psychiatric patients especially patients with schizophrenia. We aimed to identify differences in needs of male and female patients with schizophrenia in psychiatric hospitals in Baghdad city and its relationship with some variables. A descriptive, analytical design that was carried out by using Camberwell needs assessment, short appraisal schedule, self-report version (CANSAS-P) after translating to Arabic. Results indicated that there were a lot of unmet needs of male and female patients with schizophrenia, according to the entire CANSAS-P domains especially psychological symptoms. Differences were found in types of needs as the majority of men have more social needs while females was found to be more occupied with their fears and need safety. there were differences in types of need between male and female patients with schizophrenia; needs were affected by some variables such as educational level, first 10 days of admission and family visiting.