Lessons Learned from 15 Years of KIMS and 5 Years of ACROSTUDY.

Background: Pharmacoepidemiological surveys provide a valuable contribution to the continued monitoring of drug-related effects in patients with rare disorders. One of the earliest examples of this type of survey is KIGS (Pfizer International Growth Study Database), which has monitored the safety and effectiveness of growth hormone (GH) therapy in GH-deficient children since its inception in 1987. Following closely in the footsteps of KIGS is KIMS (Pfizer International Metabolic Database). As of 2009, KIMS has been collecting data on the long-term safety and clinical outcomes of GH replacement in GH-deficient adults for 15 years. Approximately 5 years ago, the ACROSTUDY database was established to monitor the long-term safety and effectiveness of pegvisomant in patients with acromegaly. Conclusions: By collecting data on the treatment of relatively rare conditions in routine clinical practice, pharmacoepidemiological surveys such as KIMS and ACROSTUDY provide valuable information on the safety and effectiveness of treatment with GH replacement and pegvisomant in the real world.

Lack of original antigenic sin in recall CD8(+) T cell responses.

In the real world, mice and men are not immunologically naive, having been exposed to numerous antigenic challenges. Prior infections sometimes negatively impact the response to a subsequent infection. This can occur in serial infections with pathogens sharing cross-reactive Ags. At the T cell level it has been proposed that preformed memory T cells, which cross-react with low avidity to epitopes presented in subsequent infections, dampen the response of high-avidity T cells. We investigated this with a series of related MHC class-I restricted Ags expressed by bacterial and viral pathogens. In all cases, we find that high-avidity CD8(+) T cell precursors, either naive or memory, massively expand in secondary cross-reactive infections to dominate the response over low-avidity memory T cells. This holds true even when >10% of the CD8(+) T cell compartment consists of memory T cells that cross-react weakly with the rechallenge ligand. Occasionally, memory cells generated by low-avidity stimulation in a primary infection recognize a cross-reactive epitope with high avidity and contribute positively to the response to a second infection. Taken together, our data show that the phenomenon of original antigenic sin does not occur in all heterologous infections.

Effectiveness of Parallel Noise Barriers - An Iowa Study, HR-540, 1987

Traffic noise monitoring using FHWA's Demonstration Projects Division Mobile Noise Laboratory at free field, single wall and parallel barrier site on I-380 in Evansdale, Iowa is described. Access to I-380 prior to its being open to traffic afforded a controlled pass-by monitoring phase involving different vehicle types. A subsequent second phase entailed identical measurement methodology to monitor "real world" I-380 traffic noise. Phase I data indicated increases in noise were significant under the parallel barrier conditions for light duty vehicles operating in the far lane. Phase II results showed that the actual I-380 traffic mix largely offset the earlier observed effect, but minor increases in traffic noise under the parallel system were noted. These differences in noise barrier system effectiveness are judged to be insignificant at this particular study location.

Evaluation of a multicomponent worksite health promotion program for cardiovascular risk factors-correcting for the regression towards the mean effect.

BACKGROUND: We assessed the impact of a multicomponent worksite health promotion program for0 reducing cardiovascular risk factors (CVRF) with short intervention, adjusting for regression towards the mean (RTM) affecting such nonexperimental study without control group. METHODS: A cohort of 4,198 workers (aged 42 +/- 10 years, range 16-76 years, 27% women) were analyzed at 3.7-year interval and stratified by each CVRF risk category (low/medium/high blood pressure [BP], total cholesterol [TC], body mass index [BMI], and smoking) with RTM and secular trend adjustments. Intervention consisted of 15 min CVRF screening and individualized counseling by health professionals to medium- and high-risk individuals, with eventual physician referral. RESULTS: High-risk groups participants improved diastolic BP (-3.4 mm Hg [95%CI: -5.1, -1.7]) in 190 hypertensive patients, TC (-0.58 mmol/l [-0.71, -0.44]) in 693 hypercholesterolemic patients, and smoking (-3.1 cig/day [-3.9, -2.3]) in 808 smokers, while systolic BP changes reflected RTM. Low-risk individuals without counseling deteriorated TC and BMI. Body weight increased uniformly in all risk groups (+0.35 kg/year). CONCLUSIONS: In real-world conditions, short intervention program participants in high-risk groups for diastolic BP, TC, and smoking improved their CVRF, whereas low-risk TC and BMI groups deteriorated. Future programs may include specific advises to low-risk groups to maintain a favorable CVRF profile.

The EU-ADR Web Platform: delivering advanced pharmacovigilance tools

PURPOSE: Pharmacovigilance methods have advanced greatly during the last decades, making post-market drug assessment an essential drug evaluation component. These methods mainly rely on the use of spontaneous reporting systems and health information databases to collect expertise from huge amounts of real-world reports. The EU-ADR Web Platform was built to further facilitate accessing, monitoring and exploring these data, enabling an in-depth analysis of adverse drug reactions risks.METHODS: The EU-ADR Web Platform exploits the wealth of data collected within a large-scale European initiative, the EU-ADR project. Millions of electronic health records, provided by national health agencies, are mined for specific drug events, which are correlated with literature, protein and pathway data, resulting in a rich drug-event dataset. Next, advanced distributed computing methods are tailored to coordinate the execution of data-mining and statistical analysis tasks. This permits obtaining a ranked drug-event list, removing spurious entries and highlighting relationships with high risk potential.RESULTS: The EU-ADR Web Platform is an open workspace for the integrated analysis of pharmacovigilance datasets. Using this software, researchers can access a variety of tools provided by distinct partners in a single centralized environment. Besides performing standalone drug-event assessments, they can also control the pipeline for an improved batch analysis of custom datasets. Drug-event pairs can be substantiated and statistically analysed within the platform's innovative working environment.CONCLUSIONS: A pioneering workspace that helps in explaining the biological path of adverse drug reactions was developed within the EU-ADR project consortium. This tool, targeted at the pharmacovigilance community, is available online at https://bioinformatics.ua.pt/euadr/. Copyright © 2012 John Wiley & Sons, Ltd.

Modeling Merging Behavior at Lane Drops, InTrans Projects 13-466 and 06-277, 2015

In work-zone configurations where lane drops are present, merging of traffic at the taper presents an operational concern. In addition, as flow through the work zone is reduced, the relative traffic safety of the work zone is also reduced. Improving work-zone flow-through merge points depends on the behavior of individual drivers. By better understanding driver behavior, traffic control plans, work zone policies, and countermeasures can be better targeted to reinforce desirable lane closure merging behavior, leading to both improved safety and work-zone capacity. The researchers collected data for two work-zone scenarios that included lane drops with one scenario on the Interstate and the other on an urban arterial roadway. The researchers then modeled and calibrated these scenarios in VISSIM using real-world speeds, travel times, queue lengths, and merging behaviors (percentage of vehicles merging upstream and near the merge point). Once built and calibrated, the researchers modeled strategies for various countermeasures in the two work zones. The models were then used to test and evaluate how various merging strategies affect safety and operations at the merge areas in these two work zones.

Brief alcohol intervention as pragmatic intervention: Who is voluntarily taking an offered intervention?

Brief alcohol interventions (BAI) have shown the potential to decrease problematic alcohol use among adolescents and young adults. Most of the BAI studies have been efficacy trials designed to achieve high internal validity but have raised questions regarding the feasibility of large-scale implementation. Providing interventions for those voluntarily wanting them might offer an alternative, and studies using this design would be more similar to effectiveness studies. The present research compares randomly selected 20-year-old men who took part in a scientific trial (efficacy) with those who voluntarily sought an intervention (effectiveness). Sampling took place during army recruitment procedures that are mandatory for all males in Switzerland. At-risk drinking (20+ drinks per week, or more than one risky drinking occasion of 6+ drinks per month) was determined a posteriori; there was no screening. There were a higher percentage of at-risk drinkers in the volunteer arm at baseline, but at-risk drinkers did not differ from those in the trial arm on any of the assessed alcohol measures. This suggests that offering BAI on a large-scale, voluntary basis may reach at-risk drinkers as effectively as do more scientifically oriented trials, without needing to adhere to screening and stringent research procedures. Nevertheless, BAI was more effective for at-risk drinkers who were invited for trial participation versus those who volunteered. This could be due to behavior that is already consolidated and is difficult to change. Lacking further modifications, real-world implementations of BAI for young men may be less effective than randomized controlled trials designed to test the efficacy of BAI.

CIRAS News Annual Report 2000, January 3, 2001

CIRAS professionals, the equipment they use to do their jobs, and the latest in technical support equipment. With these investments, CIRAS continues to meet the needs of Iowa manufacturers, whether in doing routine problem solving, long-range planning, or transferring newer technologies. In all of its services, but most notably in product development projects, one of the strengths of CIRAS lies in bringing ISU students into the picture, both to help reach project goals and as real-job learning experiences for the students.

CIRAS News Annual Report 2001, January 3, 2001

CIRAS professionals, the equipment they use to do their jobs, and the latest in technical support equipment. With these investments, CIRAS continues to meet the needs of Iowa manufacturers, whether in doing routine problem solving, long-range planning, or transferring newer technologies. In all of its services, but most notably in product development projects, one of the strengths of CIRAS lies in bringing ISU students into the picture, both to help reach project goals and as real-job learning experiences for the students.

CIRAS News Annual Report 2002, January 3, 2001

CIRAS professionals, the equipment they use to do their jobs, and the latest in technical support equipment. With these investments, CIRAS continues to meet the needs of Iowa manufacturers, whether in doing routine problem solving, long-range planning, or transferring newer technologies. In all of its services, but most notably in product development projects, one of the strengths of CIRAS lies in bringing ISU students into the picture, both to help reach project goals and as real-job learning experiences for the students.

CIRAS News Annual Report 2003, January 5, 2004

CIRAS professionals, the equipment they use to do their jobs, and the latest in technical support equipment. With these investments, CIRAS continues to meet the needs of Iowa manufacturers, whether in doing routine problem solving, long-range planning, or transferring newer technologies. In all of its services, but most notably in product development projects, one of the strengths of CIRAS lies in bringing ISU students into the picture, both to help reach project goals and as real-job learning experiences for the students.

CIRAS News Annual Report 2004, November 29, 2004

CIRAS professionals, the equipment they use to do their jobs, and the latest in technical support equipment. With these investments, CIRAS continues to meet the needs of Iowa manufacturers, whether in doing routine problem solving, long-range planning, or transferring newer technologies. In all of its services, but most notably in product development projects, one of the strengths of CIRAS lies in bringing ISU students into the picture, both to help reach project goals and as real-job learning experiences for the students.

CIRAS News Annual Report 2005, October 21, 2005

CIRAS professionals, the equipment they use to do their jobs, and the latest in technical support equipment. With these investments, CIRAS continues to meet the needs of Iowa manufacturers, whether in doing routine problem solving, long-range planning, or transferring newer technologies. In all of its services, but most notably in product development projects, one of the strengths of CIRAS lies in bringing ISU students into the picture, both to help reach project goals and as real-job learning experiences for the students.

CIRAS News Annual Report 2006, September 4, 2007

CIRAS professionals, the equipment they use to do their jobs, and the latest in technical support equipment. With these investments, CIRAS continues to meet the needs of Iowa manufacturers, whether in doing routine problem solving, long-range planning, or transferring newer technologies. In all of its services, but most notably in product development projects, one of the strengths of CIRAS lies in bringing ISU students into the picture, both to help reach project goals and as real-job learning experiences for the students.

Market Index Biases and Minimum Risk Indices

Markets, in the real world, are not efficient zero-sum games where hypotheses of the CAPM are fulfilled. Then, it is easy to conclude the market portfolio is not located on Markowitz"s efficient frontier, and passive investments (and indexing) are not optimal but biased. In this paper, we define and analyze biases suffered by passive investors: the sample, construction, efficiency and active biases and tracking error are presented. We propose Minimum Risk Indices (MRI) as an alternative to deal with to market index biases, and to provide investors with portfolios closer to the efficient frontier, that is, more optimal investment possibilities. MRI (using a Parametric Value-at-Risk Minimization approach) are calculated for three stock markets achieving interesting results. Our indices are less risky and more profitable than current Market Indices in the Argentinean and Spanish markets, facing that way the Efficient Market Hypothesis. Two innovations must be outlined: an error dimension has been included in the backtesting and the Sharpe"s Ratio has been used to select the"best" MRI