Drug hypersensitivity: flare-up reactions, cross-reactivity and multiple drug hypersensitivity

In drug hypersensitivity, change of drug treatment and continuation with a new drug may result in reappearance of drug hypersensitivity symptoms. This is not uncommon in patients with chronic infections requiring continued and long-lasting antibiotic treatments. For the clinician, the question arises whether these symptoms are due to cross-reactivity, are due to a new sensitization or are a reflection of a multiple drug hypersensitivity syndrome. Based on the p-i concept (pharmacological interaction with immune receptors), we propose that the efficient stimulation of T cells by a drug is the sum of drug-T-cell receptor affinity and readiness of the T cell to react, and therefore not constant. It heavily depends on the state of underlying immune activation. Consequently, drug hypersensitivity diseases, which go along with massive immune stimulations and often high serum cytokine values, are themselves risk factors for further drug hypersensitivity. The immune stimulation during drug hypersensitivity may, similar to generalized virus infections, lower the threshold of T-cell reactivity to drugs and cause rapid appearance of drug hypersensitivity symptoms to the second drug. We call the second hypersensitivity reaction a "flare-up" reaction; this is clinically important, as in most cases the second drug may be tolerated again, if the cofactors are missing. Moreover, the second treatment is often too short to cause a relevant sensitization.

Leukocyte populations and mRNA expression of inflammatory factors in quarter milk fractions at different somatic cell score levels in dairy cows

The effect of somatic cell count (SCC) and milk fraction on milk composition, distribution of cell populations, and mRNA expression of various inflammatory parameters was studied. Therefore, quarter milk samples were defined as cisternal (C), first 400 g of alveolar (A1), and remaining alveolar milk (A2) during the course of milking. Quarters were assigned to 4 groups according to their total SCC: 1) <12 x 10(3)/mL, 2) 12 to 100 x 10(3)/mL, 3) 100 to 350 x 10(3)/mL, and 4) >350 x 10(3)/mL. Milk constituents of interest were SCC, fat, protein, lactose sodium, and chloride ions as well as electrical conductivity. Cell populations were classified into lymphocytes, macrophages, and neutrophils (PMN). The mRNA expression of the inflammatory factors tumor necrosis factor-alpha, interleukin-1beta, cyclooxygenase-2, lactoferrin, and lysozyme was measured via real-time, quantitative reverse transcription PCR. Somatic cell count decreased from highest levels in C to lowest levels in A1 and increased thereafter to A2 in all groups. Fat content increased from C to A2 and with increasing SCC level. Lactose decreased with increasing SCC level but remained unchanged during milking. Concentrations of sodium and chloride, and electrical conductivity increased with increasing SCC but were higher in C than in A1 and A2. Protein was not affected by milk fraction or SCC level. The distribution of leukocytes was dramatically influenced by milk fraction and SCC. Lymphocytes were the dominating cell population in group 1, but the proportion of lymphocytes was low in groups 2, 3, and 4. Macrophage proportion was highest in group 2 and decreased in groups 3 and 4, whereas that of PMN increased from group 2 to 4. The content of macrophages decreased during milking in all SCC groups whereas that of PMN increased. The proportion of lymphocytes was not affected by milk fraction. The mRNA expression of all inflammatory factors showed an increase with increasing SCC but minor changes occurred during milking. In conclusion, milk fraction and SCC level have a crucial influence on the distribution of leukocyte populations and several milk constituents. The surprisingly high content of lymphocytes and concomitantly low mRNA expression of inflammatory factors in quarters with SCC <12 x 10(3)/mL indicates a different and possibly reduced readiness of the immune system to respond to invading pathogens.

"From Dartboards to Dashboards: The Imperative of using Data to Improve Student Achievement"

Aimee Guidera, Director of the National Data Quality Campaign, delivered the second annual Lee Gurel '48 Lecture in Education, "From Dartboards to Dashboards: The Imperative of Using Data to Improve Student Outcomes." Aimee Rogstad Guidera is the Founding Executive Director of the Data Quality Campaign. She manages a growing partnership among national organizations collaborating to improve the quality, accessibility and use of education data to improve student achievement. Working with 10 Founding Partners, Aimee launched the DQC in 2005 with the goal of every state having a robust longitudinal data system in place by 2009. The Campaign is now in the midst of its second phase focusing on State Actions to ensure effective data use. Aimee joined the National Center for Educational Accountability as Director of the Washington, DC office in 2003. During her eight previous years in various roles at the National Alliance of Business, Aimee supported the corporate community's efforts to increase achievement at all levels of learning. As NAB Vice President of Programs, she managed the Business Coalition Network, comprised of over 1,000 business led coalitions focused on improving education in communities across the country. Prior to joining the Alliance, Aimee focused on school readiness, academic standards, education goals and accountability systems while in the Center for Best Practices at the National Governors Association. She taught for the Japanese Ministry of Education in five Hiroshima high schools where she interviewed educators and studied the Japanese education system immediately after receiving her AB from Princeton University’s Woodrow Wilson School of Public & International Affairs. Aimee also holds a Masters Degree in Public Policy from Harvard’s John F. Kennedy School of Government.

The Mediterranean climate: An overview of the main characteristics and issues

The Mediterranean Region has many morphologic, geographical, historical, and societal characteristics, which make its climate scientifically interesting. The concept of Mediterranean climate is characterized by mild wet winters and warm to hot, dry summers and occur on the west side of continents between about 30° and 40° latitude. However, the presence of a relatively large mass of water is unique to the actual Mediterranean region. The Mediterranean Sea is a marginal and semi-enclosed sea; it is located on the western side of a large continental area and is surrounded by Europe to the North, Africa to the South, and Asia to the East. The chapter discusses that the climate of the Mediterranean region is to a large extent forced by planetary scale patterns. The time and space behavior of the regional features associated with such large-scale forcing is complex. Orography and land–sea distribution play an important role establishing the climate at basin scale and its teleconnections with global patterns. Different levels of services of readiness to emergencies, technological, and economic resources are likely to result in very different adaptation capabilities to environmental changes and new problems. The different economic situations and demographic trends are likely to produce contrasts and conflicts in a condition of limited available resources and environmental stress.

Asymmetric sexual conflict over parental care in a biparental cichlid

Theoretical models predict that parents should adjust the amount of care both to their own and their partner's body condition. In most biparental species, parental duties are switched repeatedly allowing for repeated mutual adjustment of the amount of care. In the mouthbrooding cichlid Eretmodus cyanostictus, terms are switched only once with females taking the first share. The timing of the shift of the clutch between mates strongly determines both partners' brooding period and thereby their parental investment. Females signal their readiness to transfer the young several days before the male finally takes them, suggesting sexual conflict over the timing of the shift. In a lab experiment, we reduced the body condition of either the female or the male of a pair to test whether energy reserves affect the timing of the shift and whether female signalling behaviour depends on energetic state. Males with a lowered condition took the young later and incubated for a shorter period, which prolonged the incubation time of their female partners. When female condition was lowered, female and male incubation durations remained unchanged, although females signalled their readiness to shift more intensely. Our results suggest that males adjust their parental investment to own energy reserves but are unresponsive to their mate's condition. Females appear to carry the entire costs for the male's adjustment of care. We propose that intrinsic asymmetries in the scope for mutual adjustment of parental investment and the costs of negotiation crucially influence solutions of the conflict between sexes over care.

[Bisexuality and AIDS. Implications for heterosexual HIV infections in women]

One of the possible pathways into heterosexual population is the transfer of HIV-virus from bisexual men to their female partners. Therefore sexual behaviour of HIV-positive and -negative bisexual men (n = 31) before and after Aids-disease was analysed. Prior to the Aids-epidemic promiscuous behavior towards male partners (about one female partner per year versus 10 male partners per year). Relatively common contacts to woman occurred within steady relationships. After contact with HIV-test and personal counselling sexual practice became significantly different. The number of female and male contacts was markedly reduced, especially female chance acquaintances were avoided; safer sex was preferred and readiness to inform female partners about bisexuality was increased. This study suggests that reduction of risk for HIV-infection of female partners by homosexual men can be achieved by means of a HIV-test and personal counselling, a possibility that should be considered in preventive concepts.

Engineering design motivations : a qualitative and quantitative analysis of university students

What motivates students to perform and pursue engineering design tasks? This study examines this question by way of three Learning Through Service (LTS) programs: 1) an on-going longitudinal study examining the impacts of service on engineering students, 2) an on-going analysis of an international senior design capstone program, and 3) an on-going evaluation of an international graduate-level research program. The evaluation of these programs incorporates both qualitative and quantitative methods, utilizing surveys, questionnaires, and interviews, which help to provide insight on what motivates students to do engineering design work. The quantitative methods were utilized in analyzing various instruments including: a Readiness assessment inventory, Intercultural Development Inventory, Sustainable Engineering through Service Learning survey, the Impacts of Service on Engineering Students’ survey, Motivational narratives, as well as some analysis for interview text. The results of these instruments help to provide some much needed insight on how prepared students are to participate in engineering programs. Additional qualitative methods include: Word clouds, Motivational narratives, as well as interview analysis. This thesis focused on how these instruments help to determine what motivates engineering students to pursue engineering design tasks. These instruments aim to collect some more in-depth information than the quantitative instruments will allow. Preliminary results suggest that of the 120 interviews analyzed Interest/Enjoyment, Application of knowledge and skills, as well as gaining knowledge are key motivating factors regardless of gender or academic level. Together these findings begin to shed light on what motivates students to perform engineering design tasks, which can be applied for better recruitment and retention in university programs.

MITEP: REFLECTIVE JOURNEY

This research looks at the use of the Interactive Student Notebook (ISN) in the math classroom and the impact on student achievement as part of the MiTEP program. A reflective critical analysis of the MiTEP program discusses impact on teacher pedagogy, leadership, and connections to people and resources. The purpose of the study stemmed from the lack of student retention, poor organizational skills, and the students’ inability to demonstrate college readiness skills such as how to study, completing homework, and thinking independently. Motivation also stemmed from teacher frustration. The research was conducted at Linden Grove Middle School in Kalamazoo Michigan in a strategic math class. Twenty-two sixth graders, thirty-two seventh graders, and forty eighth graders were part of the study.Students were given the Strategic Math Inventory (SMI) test in week 1 of the class and again at the end of a 12 week marking period. Students participated in an attitude survey to record their feelings about the use of the ISN in the strategic math classroom. The data compared the control group (the previous year’s [2012-2013] growth data) to the experimental group, the current year’s (2013-2014) growth data. Both groups were statistically similar in that the mean average was about a 4th grade level equivalency and the groups had similar numbers of grade level students. The significant findings were in the amount of growth made using the ISN. The control group started with a mean average of 586.6 and ended with a mean average of 697.1, making about one year’s growth from a 4th to a 5th grade level equivalency. The experimental group started with a mean average of 585.2 and ended with a mean average of 744.2, making about two years growth from a 4th to a 6th grade level equivalency. This is double the growth of the control group. The Cohen’s test resulted in a score of 0.311 which describes that the teaching method, the use of the ISN in the math classroom had a medium impact on student growth.

Physics and Science Policy Implications of Reduction of the U.S. Nuclear Weapons Arsenal

Maintaining the readiness U.S. nuclear weapons stockpile is a fundamental pillar of American defense policy. The biggest issue facing the national laboratories that are charged with this mission is replenishing the highly skilled and specialized manpower that is necessary for this task. This lecture presents both physics and science policy questions that must be answered. It also presents employment opportunities for young scientists and engineers.

Are there risk factors in alpine skiing? A controlled multicentre survey of 1278 skiers

OBJECTIVE: To analyse risk factors in alpine skiing. DESIGN: A controlled multicentre survey of injured and non-injured alpine skiers. SETTING: One tertiary and two secondary trauma centres in Bern, Switzerland. PATIENTS AND METHODS: All injured skiers admitted from November 2007 to April 2008 were analysed using a completed questionnaire incorporating 15 parameters. The same questionnaire was distributed to non-injured controls. Multiple logistic regression was performed. Patterns of combined risk factors were calculated by inference trees. A total of 782 patients and 496 controls were interviewed. RESULTS: Parameters that were significant for the patients were: high readiness for risk (p = 0.0365, OR 1.84, 95% CI 1.04 to 3.27); low readiness for speed (p = 0.0008, OR 0.29, 95% CI 0.14 to 0.60); no aggressive behaviour on slopes (p<0.0001, OR 0.19, 95% CI 0.09 to 0.37); new skiing equipment (p = 0.0228, OR 59, 95% CI 0.37 to 0.93); warm-up performed (p = 0.0015, OR 1.79, 95% CI 1.25 to 2.57); old snow compared with fresh snow (p = 0.0155, OR 0.31, 95% CI 0.12 to 0.80); old snow compared with artificial snow (p = 0.0037, OR 0.21, 95% CI 0.07 to 0.60); powder snow compared with slushy snow (p = 0.0035, OR 0.25, 95% CI 0.10 to 0.63); drug consumption (p = 0.0044, OR 5.92, 95% CI 1.74 to 20.11); and alcohol abstinence (p<0.0001, OR 0.14, 95% CI 0.05 to 0.34). Three groups at risk were detected: (1) warm-up 3-12 min, visual analogue scale (VAS)(speed) >4 and bad weather/visibility; (2) VAS(speed) 4-7, icy slopes and not wearing a helmet; (3) warm-up >12 min and new skiing equipment. CONCLUSIONS: Low speed, high readiness for risk, new skiing equipment, old and powder snow, and drug consumption are significant risk factors when skiing. Future work should aim to identify more precisely specific groups at risk and develop recommendations--for example, a snow weather index at valley stations.

Blattmeier

Technische Produktionssysteme und Prozesse - welcher Technologie auch immer - müssen den Bedürfnissen der industriellen Bauteilherstellung für Endanwendungen im Automobilbau entsprechen. Es stellt sich zunächst die Frage, auf welchem technologischen Reifegrad sich die generativen Technologien für den Automobilbau derzeit befinden? Welche außerordentlichen Vorteile können generative Prozessketten gegenüber konventionellen Herstellungsverfahren bieten und welche Hürden müssen genommen werden? Im Vordergrund der Untersuchung steht die Betrachtung von Pre-, In- und Post-Prozessen generativer wie auch konventioneller Produktionsverfahren. Bei der Gegenüberstellung der Prozessketten werden Maßstäbe angesetzt, die derzeit bei der Bauteilherstellung im Automobilbau Gültigkeit haben und auf Kriterien wie Effizienz, Reproduzierbarkeit und Kontrollierbarkeit aufbauen. Schließlich findet eine Einschätzung aus der Perspektive der Technologieintegration in derzeitige Produktionssysteme und Lieferketten statt. Es werden Restriktionen und Handlungsfelder von generativen Prozessen deutlich, die für den Einsatz für Endkunden-Bauteile im Fahrzeugbau behandelt werden müssen.

Technologische Reife von generativen Herstellungsverfahren für Endanwendungen im Automobilbau

Technische Produktionssysteme und Prozesse - welcher Technologie auch immer - müssen den Bedürfnissen der industriellen Bauteilherstellung für Endanwendungen im Automobilbau entsprechen. Es stellt sich zunächst die Frage, auf welchem technologischen Reifegrad sich die generativen Technologien für den Automobilbau derzeit befinden? Welche außerordentlichen Vorteile können generative Prozessketten gegenüber konventionellen Herstellungsverfahren bieten und welche Hürden müssen genommen werden? Im Vordergrund der Untersuchung steht die Betrachtung von Pre-, In- und Post-Prozessen generativer wie auch konventioneller Produktionsverfahren. Bei der Gegenüberstellung der Prozessketten werden Maßstäbe angesetzt, die derzeit bei der Bauteilherstellung im Automobilbau Gültigkeit haben und auf Kriterien wie Effizienz, Reproduzierbarkeit und Kontrollierbarkeit aufbauen. Schließlich findet eine Einschätzung aus der Perspektive der Technologieintegration in derzeitige Produktionssysteme und Lieferketten statt. Es werden Restriktionen und Handlungsfelder von generativen Prozessen deutlich, die für den Einsatz für Endkunden-Bauteile im Fahrzeugbau behandelt werden müssen.

Encore® Implant Use in Feedlot Steers

A feedlot demonstration utilizing Encore®, a new longterm implant product, was completed at the Allee Demonstration Farm at Newell, Iowa in 1999. Seventyone steers (697 lbs.) were allotted by weight and hide color and assigned to one of three treatments: 1) Encore® (43.9 mg estradiol = E) on day 0; 2) Encore® plus Component® TS (140 mg trenbolone acetate = ETS0) on day 0; or 3) Encore® on day 0 followed by Component® TS (ETS100) on day 100. Due to wide standard deviation in the weight of steers at the beginning of the demonstration, cattle were harvested in two groups. Approximately half of each treatment group was sorted by visual appraisal as to market readiness. Statistical interactions existed within treatment group between first and second harvest dates, therefore data were split and analyzed accordingly. In the first harvest group, ETS0 steers had higher marbling scores than ETS100 steers, and lower average daily gain than E steers and ETS100 steers. In the second harvest group, ETS0 steers had more fat at the 12th/13 rib than ETS100 steers, but did not differ from E steers. Marbling scores were also higher for ETS0 steers than either ETS100 or E steers in the second harvest group. Pooled data reveal that ETS0 steers had higher marbling scores than ETS100 steers and tended to have higher marbling scores than E steers. First harvest E and ETS100 steers had greater average daily gain than ETS0 steers. In the second harvest group, ETS0 steers had heavier final ending weights than E steers but did not differ from ETS100 steers. Final ending weights, rib eye area, fat thickness at the 12th/13th rib, KPH fat, and calculated yield grades did not differ among treatment groups in the pooled data.

Intergenerational support: A comparison between Russian and German adult daughters

The aim of this study is a Russian-German cross-cultural comparison of the actual support and the readiness for support that adult daughters give to their parents as well as of the conditions for this support. Compared to Russia, Germany can be characterized by a more individualistic value system and a fully developed social-welfare system. Therefore, the extent of intergenerational support should be less in Germany than in Russia. Furthermore, the study attempts to test if the support-related differences between the two countries are mediated by differences in cultural values. The participants were German and Russian adult daughters who at the same time were mothers of adolescent children. The cross-cultural comparisons showed that compared to their German counterparts, Russian adult daughters reported more current support as well as a higher readiness for future support. These differences were mediated through a higher emotional interdependence (intimacy) of the Russian adult daughters, as well as through their considerably higher family values and norm-oriented motives for support. The results are discussed with regard to theoretical approaches regarding parent-child relations and the culture-specific meaning of intergenerational support in Russia and Germany.

Sexual Health Education from the Perspective of School Staff: Implications for Adoption and Implementation of Effective Programs in Middle School

Introduction: US teens are having sex early; however, the vast majority of schools do not implement evidence-based sexual health education (SHE) programs that could delay sexual behavior and/or reduce risky behavior. This study examines middle school staff’s knowledge, attitudes, barriers, self-efficacy, and perceived support (psychosocial factors known to influence SHE program adoption and implementation). Methods: Professional school staff from 33 southeast Texas middle schools completed an internet or paper-based survey. Prevalence estimates for psychosocial variables were computed for the total sample. Chi-square and t-test analyses examined variation by demographic factors. Results: Almost 70% of participants were female, 37% white, 42% black, 16% Hispanic; 20% administrators, 15% nurses/counselors, 31% non-physical education/non-health teachers, 28% physical education/health teachers; mean age = 42.78 years (SD = 10.9). Over 90% favored middle school SHE, and over 75% reported awareness of available SHE curricula or policies. More than 60% expressed confidence for discussing SHE. Staff perceived varying levels of administrator (28%-56%) support for SHE and varying levels of support for comprehensive sex education from outside stakeholders (e.g., parents, community leaders) (42%-85%). Overall, results were more favorable for physical education/health teachers, nurses/counselors, and administrators (when compared to non-physical education/non-health teachers) and individuals with experience teaching SHE. Few significant differences were observed by other demographic factors. Conclusions: Overall, study results were extremely positive, which may reflect a high level of readiness among school staff for adopting and implementing effective middle school SHE programs. Study results highlight the importance of several key action items for schools.