A movement from traditional malarial chemoprophylaxis to the use of intermittent preventive treatment as a method of protection for children diagnosed with sickle-cell disease: A proposal for consideration based on a systematic review of the literature

Approximately 200,000 African children are born with sickle-cell anemia each year. Research has shown that individuals with hemoglobin disorders, particularly sickle-cell anemia, have increased susceptibility to contracting malaria. Currently it is recommended that patients diagnosed with sickle-cell anemia undergo malaria chemoprophylaxis in order to decrease their chances of malarial infection. However, studies have shown that routine administration of these drugs increases the risk of drug resistance and could possibly impair the development of naturally acquired immunity. Clinical trials have shown intermittent preventive treatment (IPT) to be an effective method of protection against malaria. The objective of this report was to review previously conducted clinical trials that study the effects of intermittent preventive treatment on malaria and anemia in infants and children. Based on the review, implications for its appropriateness as a protective measure against malaria for infants and children diagnosed with sickle-cell disease were provided.^ The 18 studies reviewed were randomized controlled trials that focused on IPT’s effect on malaria (7 studies), anemia (1 study), or both (8 studies). In addition to these 16, one study looks at IPT’s effect on molecular resistance to malaria, and another study is a follow-up to a study in order to review IPT’s potential to cause a rebound effect. The 18 th study in this review specifically looks at IPT’s protective efficacy in children with SCA. The studies in this report were restricted to randomized controlled trials that have been performed from 2000 to 2010. Reports on anemia were included to illustrate possible added benefits of the use of IPT specific to burdens associated with SCA other than malaria susceptibility. The outcomes of these studies address several issues of concern involving the administration of IPT: protective efficacy (in reference to age, seasonal versus perennial malaria regions, and overall effectiveness against malaria and anemia), drug resistance, drug rebound effect, drug side-effects, and long-term effects. Overall, these showed that IPT has a significant level of protective efficacy against malaria and/or anemia in children. More specifically, the IPT study evaluating children diagnosed with sickle-cell anemia proved IPT to be a more effective method of protection than traditional chemoprophylaxis. ^

Differential Activity of the KRAS Oncogene by Method of Activation: Implications for Signaling and Therapeutic Intervention

Despite having been identified over thirty years ago and definitively established as having a critical role in driving tumor growth and predicting for resistance to therapy, the KRAS oncogene remains a target in cancer for which there is no effective treatment. KRas is activated b y mutations at a few sites, primarily amino acid substitutions at codon 12 which promote a constitutively active state. I have found that different amino acid substitutions at codon 12 can activate different KRas downstream signaling pathways, determine clonogenic growth potential and determine patient response to molecularly targeted therapies. Computer modeling of the KRas structure shows that different amino acids substituted at the codon 12 position influences how KRas interacts with its effecters. In the absence of a direct inhibitor of mutant KRas several agents have recently entered clinical trials alone and in combination directly targeting two of the common downstream effecter pathways of KRas, namely the Mapk pathway and the Akt pathway. These inhibitors were evaluated for efficacy against different KRAS activating mutations. An isogenic panel of colorectal cells with wild type KRas replaced with KRas G12C, G12D, or G12V at the endogenous loci differed in sensitivity to Mek and Akt inhibition. In contrast, screening was performed in a broad panel of lung cell lines alone and no correlation was seen between types of activating KRAS mutation due to concurrent oncogenic lesions. To find a new method to inhibit KRAS driven tumors, siRNA screens were performed in isogenic lines with and without active KRas. The knockdown of CNKSR1 (CNK1) showed selective growth inhibition in cells with an oncogenic KRAS. The deletion of CNK1 reduces expression of mitotic cell cycle proteins and arrests cells with active KRas in the G1 phase of the cell cycle similar to the deletion of an activated KRas regardless of activating substitution. CNK1 has a PH domain responsible for localizing it to membrane lipids making KRas potentially amenable to inhibition with small molecules. The work has identified a series of small molecules capable of binding to this PH domain and inhibiting CNK1 facilitated KRas signaling.

Method of threshing grain

This invention relates generally to grain threshing apparatus and in particular to an improved method of an apparatus for threshing grain wherein an impeller is rotatable within a concave or tubular screen. An object of this invention is to provide an improved method and apparatus for threshing grain.

An interactive method of fuzzy probability elicitation in risk analysis

Expert knowledge is used to assign probabilities to events in many risk analysis models. However, experts sometimes find it hard to provide specific values for these probabilities, preferring to express vague or imprecise terms that are mapped using a previously defined fuzzy number scale. The rigidity of these scales generates bias in the probability elicitation process and does not allow experts to adequately express their probabilistic judgments. We present an interactive method for extracting a fuzzy number from experts that represents their probabilistic judgments for a given event, along with a quality measure of the probabilistic judgments, useful in a final information filtering and analysis sensitivity process.

Teaching based on the case method of building collective protection

One of the fundamental aspects in the adaptation of the teaching to the European higher education is changing based models of teacher education to models based on student learning. In this work we present an educational experience developed with the teaching method based on the case method, with a clearly multidisciplinary. The experience has been developed in the teaching of analysis and verification of safety rails. This is a multidisciplinary field that presents great difficulties during their teaching. The use of the case method has given good results in the competences achieved by students

Development of a method of assessment of the problem-solving competence at the technical University of Madrid.

The competence evaluation promoted by the European High Education Area entails a very important methodological change that requires guiding support to help lecturers carry out this new and complex task. In this regard, the Technical University of Madrid (UPM, by its Spanish acronym) has financed a series of coordinated projects with the objective of developing a model for teaching and evaluating core competences and providing support to lecturers. This paper deals with the problem-solving competence. The first step has been to elaborate a guide for teachers to provide a homogeneous way to asses this competence. This guide considers several levels of acquisition of the competence and provides the rubrics to be applied for each one. The guide has been subsequently validated with several pilot experiences. In this paper we will explain the problem-solving assessment guide for teachers and will show the pilot experiences that has been carried out. We will finally justify the validity of the method to assess the problem-solving competence.

Development of a method of assessment of the problem-solving competency at the Technical University of Madrid

The competence evaluation promoted by the European High Education Area entails a very important methodological change that requires guiding support to help lecturers carry out this new and complex task. In this regard, the Technical University of Madrid (UPM, by its Spanish acronym) has financed a series of coordinated projects with the objective of developing a model for teaching and evaluating core competences and providing support to lecturers. This paper deals with the problem solving competence. The first step has been to elaborate a guide for teachers to provide an homogeneous way to asses this competence. This guide considers several levels of acquisition of the competence and provided the rubrics to be applied for each one. The guide has been subsequently validated with several pilot experiences. In this paper we will explain the problem-solving assessment guide for teachers and will show the pilot experiences that has been carried out. We will finally justify the validity of the method to assess the problem solving competence.

Initial design with L2 Monge-Kantorovich theory for the Monge–Ampère equation method of freeform optics

The Monge–Ampère (MA) equation arising in illumination design is highly nonlinear so that the convergence of the MA method is strongly determined by the initial design. We address the initial design of the MA method in this paper with the L2 Monge-Kantorovich (LMK) theory, and introduce an efficient approach for finding the optimal mapping of the LMK problem. Three examples, including the beam shaping of collimated beam and point light source, are given to illustrate the potential benefits of the LMK theory in the initial design. The results show the MA method converges more stably and faster with the application of the LMK theory in the initial design.

A bankable method of assessing the performance of a CPV plant

Concentrating Photovoltaics (CPV) is an alternative to flat-plate module photovoltaic (PV) technology. The bankability of CPV projects is an important issue to pave the way toward a swift and sustained growth in this technology. The bankability of a PV plant is generally addressed through the modeling of its energy yield under a baseline loss scenario, followed by an on-site measurement campaign aimed at verifying its energy performance. This paper proposes a procedure for assessing the performance of a CPV project, articulated around four main successive steps: Solar Resource Assessment, Yield Assessment, Certificate of Provisional Acceptance, and Certificate of Final Acceptance. This methodology allows the long-term energy production of a CPV project to be estimated with an associated uncertainty of ≈5%. To our knowledge, no such method has been proposed to the CPV industry yet, and this critical situation has hindered or made impossible the completion of several important CPV projects undertaken in the world. The main motive for this proposed method is to bring a practical solution to this urgent problem. This procedure can be operated under a wide range of climatic conditions, and makes it possible to assess the bankability of a CPV plant whose design uses any of the technologies currently available on the market. The method is also compliant with both international standards and local regulations. In consequence, its applicability is both general and international.

Effect of type of fiber, site of fermentation, and method of analysis on digestibility of soluble and insoluble fiber in rabbits

The effect of type of fiber, site of fermetation, method for quantifying insoluble and soluble dietary fiber, and their correction for intestinal mucin on fiber digestibility were examined in rabbits. Three diets differing in soluble fiber were formulated (8.5% soluble fiber, on DM basis, in the low soluble fiber [LSF] diet; 10.2% in the medium soluble fiber [MSF] diet; and 14.5% in the high soluble fiber [HSF] diet). They were obtained by replacing half of the dehydrated alfalfa in the MSF diet with a mixture of beet and apple pulp (HSF diet) or with a mix of oat hulls and soybean protein (LSF diet). Thirty rabbits with ileal T-cannulas were used to determine ileal and fecal digestibility. Cecal digestibility was determined by difference between fecal and ileal digestibility. Insoluble fiber was measured as NDF, insoluble dietary fiber (IDF), and in vitro insoluble fiber, whereas soluble fiber was calculated as the difference between total dietary fiber (TDF) and NDF (TDF_NDF), IDF (TDF-IDF), and in vitro insoluble fiber (TDF-in vitro insoluble fiber). The intestinal mucin content was used to correct the TDF and soluble fiber digestibility. Ileal and fecal concentration of mucin increased from the LSF to the HSF diet group (P < 0.01). Once corrected for intestinal mucin, ileal and fecal digestibility of TDF and soluble fiber increased whereas cecal digestibility decreased (P < 0.01). Ileal digestibility of TDF increased from the LSF to the HSF diet group (12.0 vs. 28.1%; P < 0.01), with no difference in the cecum (26.4%), resulting in a higher fecal digestibility from the LSF to the HSF diet group (P < 0.01). Ileal digestibility of insoluble fiber increased from the LSF to the HSF diet group (11.3 vs. 21.0%; P < 0.01), with no difference in the cecum (13.9%) and no effect of fiber method, resulting in a higher fecal digestibility for rabbits fed the HSF diet compared with the MSF and LSF diets groups (P < 0.01).Fecal digestibility of NDF was higher compared with IDF or in vitro insoluble fiber (P < 0.01). Ileal soluble fiber digestibility was higher for the HSF than for the LSF diet group (43.6 vs. 14.5%; P < 0.01) and fiber method did not affect it. Cecal soluble fiber digestibility decreased from the LSF to the HSF diet group (72.1 vs. 49.2%; P < 0.05). The lowest cecal and fecal soluble fiber digestibility was measured using TDF-NDF (P < 0.01). In conclusion, a correction for intestinal mucin is necessary for ileal TDF and soluble fiber digestibility whereas the selection of the fiber method has a minor relevance. The inclusion of sugar beet and apple pulp increased the amount of TDF fermented in the small intestine.

A consistent method of analysis of RC shell structures

In this paper some topics related to the design of reinforced concrete (RC) shells are addressed. The influence of the reinforcement layout on the service and ultimate behavior of the shell structure is commented. The well established methodology for dimensioning and verifying RC sections of beam structures is extended. In this way it is possible to treat within a unified procedure the design and verification of RC two dimensional structures, in particular membrane and shell structures. Realistic design situations as multiple steel farnilies and non orthogonal reinforcement layout can be handled. Finally, some examples and applications of the proposed methodology are presented.

Efficiency of the u,v method of estimation

Given a pool of motorists, how do we estimate the total intensity of those who had a prespecified number of traffic accidents in the past year? We previously have proposed the u,v method as a solution to estimation problems of this type. In this paper, we prove that the u,v method provides asymptotically efficient estimators in an important special case.

Randomised controlled trial of the READER method of critical appraisal in general practice

Objective: To evaluate the READER model for critical reading by comparing it with a free appraisal, and to explore what factors influence different components of the model.

3D numerical modelling of acoustic horns using the method of fundamental solutions

In the present work, a three-dimensional (3D) formulation based on the method of fundamental solutions (MFS) is applied to the study of acoustic horns. The implemented model follows and extends previous works that only considered two-dimensional and axisymmetric horn configurations. The more realistic case of 3D acoustic horns with symmetry regarding two orthogonal planes is addressed. The use of the domain decomposition technique with two interconnected sub-regions along a continuity boundary is proposed, allowing for the computation of the sound pressure generated by an acoustic horn installed on a rigid screen. In order to reduce the model discretization requirements for these cases, Green’s functions derived with the image source methodology are adopted, automatically accounting for the presence of symmetry conditions. A strategy for the calculation of an optimal position of the virtual sources used by the MFS to define the solution is also used, leading to improved reliability and flexibility of the proposed method. The responses obtained by the developed model are compared to reference solutions, computed by well-established models based on the boundary element method. Additionally, numerically calculated acoustic parameters, such as directivity and beamwidth, are compared with those evaluated experimentally.