Second-line status epilepticus treatment: comparison of phenytoin, valproate, and levetiracetam.

Purpose:  Phenytoin (PHT), valproic acid (VPA), or levetiracetam (LEV) are commonly used as second-line treatment of status epilepticus (SE), but comparative studies are not available. Methods:  Among 279 adult SE episodes identified prospectively in our tertiary care hospital over 4 years, we retrospectively identified 187 episodes in which PHT, VPA, or LEV were given after benzodiazepines. Patients with postanoxic SE were not included. Demographics, clinical SE features, failure of second-line treatment to control SE, new handicap, and mortality at hospital discharge were assessed. Uni- and multivariable statistical analyses were applied to compare the three agents. Key Findings:  Each compound was used in about one third of SE episodes. VPA failed to control SE in 25.4%, PHT in 41.4%, and LEV in 48.3% of episodes in which these were prescribed. A deadly etiology was more frequent in the VPA group, whereas SE episodes tended to be more severe in the PHT group. After adjustment for these known SE outcome predictors, LEV failed more often than VPA [odds ratio (OR) 2.69; 95% confidence interval (CI) 1.19-6.08]; 16.8% (95% CI: 6.0-31.4%) of second-line treatment failures could be attributed to LEV. PHT was not statistically different from the other two compounds. Second-line treatment did not seem to influence new handicap and mortality, whereas etiology and the SE Severity Score (STESS) were robust independent predictors. Significance:  Even without significant differences on outcome at discharge, LEV seems less efficient than VPA to control SE after benzodiazepines. A prospective comparative trial is needed to address this potentially concerning finding.

Indicadores fisiológicos da interação entre deficit hídrico e acidez do solo em cana-de-açúcar

O objetivo deste trabalho foi avaliar os indicadores fisiológicos da interação entre deficit hídrico e acidez do solo em plantas jovens de cana-de-açúcar. As plantas foram submetidas a três tratamentos de disponibilidade hídrica, medidos em percentagem de capacidade de campo (CC) - sem estresse (70% CC), estresse moderado (55% CC) e estresse severo (40% CC); e três tratamentos de acidez no solo, medidos em termos de saturação por bases (V) - baixa acidez (V = 55%), média acidez (V = 33%) e alta acidez (V = 23%). O experimento foi realizado em casa de vegetação a 29,7±4,3ºC e 75±10% UR. O delineamento experimental utilizado foi o de blocos ao acaso, em esquema fatorial 3x3, com quatro repetições. Após 60 dias, foram determinados os teores de solutos compatíveis - trealose, glicina betaína e prolina - na folha diagnóstico e o crescimento inicial da parte aérea. Os solutos compatíveis trealose, glicina betaína e prolina são indicadores do efeito da interação dos estresses hídrico e ácido no solo. O acúmulo dos solutos compatíveis nos tecidos foliares das plantas não é capaz de impedir a redução na produção de matéria seca da cana-de-açúcar, resultante do agravamento nas condições de disponibilidade hídrica e de acidez no solo.

Status of the Iowa Workforce and Economy, December 2015

Iowa Workforce Development's newsletter.

Road Use Tax Fund Efficiency Report savings status, December 31, 2015

Senate File 2355, 85th General Assembly, states the Iowa Department of Transportation shall submit annual reports regarding the implementation of efficiency measures identified in the “Road Use Tax Fund Efficiency Report,” January 2012. This report shall provide details of activities undertaken in the previous year relating to one-time and long-term program efficiencies and partnership efficiencies. Issues to be covered in the reports shall include but are not limited to savings realized from the implementation of particular efficiency measures; updates concerning measures that have not been implemented; efforts involving cities, counties, other jurisdictions, or stakeholder interest groups; any new efficiency measures identified or undertaken; and identification of any legislative action that may be required to achieve efficiencies.

Respostas biométricas e fisiológicas ao deficit hídrico em cana-de-açúcar em diferentes fases fenológicas

O objetivo deste trabalho foi avaliar as respostas biométricas e fisiológicas de cana-de-açúcar (Saccharum spp.) ao deficit hídrico (DH), em diferentes fases fenológicas. Os genótipos IACSP 94-2094 e IACSP 96-2042 foram submetidos a DH nas fases de crescimento inicial, crescimento máximo e de acúmulo de sacarose no colmo. O delineamento experimental foi inteiramente casualizado. A suscetibilidade ao DH foi determinada pela redução de matéria seca do colmo e do conteúdo de sólidos solúveis no caldo. O deficit hídrico causou redução nas trocas gasosas, nas três fases fenológicas, em ambos os genótipos. Foi observada menor altura das plantas, menor acúmulo de matéria seca do colmo e de sólidos solúveis, e redução no número e comprimento de entrenós, apenas na fase de crescimento inicial, no clone IACSP 96-2042. Na fase de crescimento inicial, observou-se tolerância ao DH no genótipo IACSP 94-2094, com evidências de aclimatação fisiológica, e redução na produção de fitomassa e de sólidos solúveis no genótipo IACSP 96-2042, como resposta à menor condutância estomática e à menor eficiência aparente de carboxilação da fotossíntese. Independentemente da fase fenológica, o genótipo IACSP 94-2094 foi tolerante ao deficit hídrico, pois manteve a produção de fitomassa mesmo com redução das trocas gasosas.

Infrastructure Annual Status Report 2016

This is the Iowa Department of Transportation's summary of project status for infrastructure projects that have been appropriated revenue from various funds including Rebuild Iowa Infrastructure, Health Restricted Capitals, Revenue Bonds Capitals and Revenue Bonds Capitals II.

Status of the Iowa Workforce and Economy, January 2016

Iowa Workforce Development's newsletter.

Midwest Regional Rail Passenger Initiative and Passenger Rail Service in Iowa status report

This report provides the status of the Passenger Rail Service Revolving Fund and the development and operation of the Midwest regional rail system and the state’s passenger rail service.

Predictive value of the MGMT promoter methylation status in metastatic melanoma patients receiving first-line temozolomide plus bevacizumab in the trial SAKK 50/07.

The O6-methylguanine-DNA-methyltransferase (MGMT) promoter methylation status is a predictive parameter for the response of malignant gliomas to alkylating agents such as temozolomide. First clinical trials with temozolomide plus bevacizumab therapy in metastatic melanoma patients are ongoing, although the predictive value of the MGMT promoter methylation status in this setting remains unclear. We assessed MGMT promoter methylation in formalin-fixed, primary tumor tissue of metastatic melanoma patients treated with first-line temozolomide and bevacizumab from the trial SAKK 50/07 by methylation-specific polymerase chain reaction. In addition, the MGMT expression levels were also analyzed by MGMT immunohistochemistry. Eleven of 42 primary melanomas (26%) revealed a methylated MGMT promoter. Promoter methylation was significantly associated with response rates CR + PR versus SD + PD according to RECIST (response evaluation criteria in solid tumors) (p<0.05) with a trend to prolonged median progression-free survival (8.1 versus 3.4 months, p>0.05). Immunohistochemically different protein expression patterns with heterogeneous and homogeneous nuclear MGMT expression were identified. Negative MGMT expression levels were associated with overall disease stabilization CR + PR + SD versus PD (p=0.05). There was only a poor correlation between MGMT methylation and lack of MGMT expression. A significant proportion of melanomas have a methylated MGMT promoter. The MGMT promoter methylation status may be a promising predictive marker for temozolomide therapy in metastatic melanoma patients. Larger sample sizes may help to validate significant differences in survival type endpoints.

Deficit hídrico e secamento parcial do sistema radicular em pomar de lima ácida

O objetivo deste trabalho foi avaliar o efeito do deficit hídrico associado ao secamento parcial do sistema radicular ("partial rootzone drying", PRD) na produção e eficiência de uso de água, em pomar de lima ácida 'Tahiti', na Região do Semiárido baiano. Utilizou-se o delineamento de blocos ao acaso, com seis tratamentos e seis repetições. Os tratamentos com PRD foram realizados pela alternância periódica (7, 14 ou 21 dias) dos lados em que o microaspersor localizava-se em relação às plantas. Esses tratamentos foram conduzidos com lâmina d'água equivalente a 50% da evapotranspiração da cultura (ETc) e comparados ao tratamento com deficit hídrico de 50% da ETc com microaspersor fixo em um dos lados das plantas, e ao tratamento 100% da ETc, com aspersores de ambos os lados das plantas. Avaliou-se também o PRD (21 dias) com diminuição da irrigação em 25% da ETc. O PRD com 50% da ETc não difere do tratamento com esse mesmo deficit e sem alternância de lados da irrigação, em termos de produtividade, eficiência do uso da água, e diâmetro e peso dos frutos, independentemente do período de alternância dos lados de irrigação. O PRD com diminuição da irrigação em 25% da ETc não causa perdas em relação à condição sem deficit e sem localização da irrigação.

Status of Females in the Juvenile Justice System Iowa, 2016

Young women in the juvenile justice system present with characteristics and experiences that differentiate them from their male counterparts. As such, the juvenile justice system in Iowa must consider these factors if it is to effectively and efficiently impact recidivism, rehabilitation and public safety.

Status of the Iowa Workforce and Economy January 2016, March 14, 2016

Iowa Workforce Development's newsletter.

Falls efficacy predicts functional status on month after discharge in elderly patients undergoing post-accute rehabilitation

Objective: To investigate the relationship between falls efficacy at admission and functional status reported one month after discharge from post-acute rehabilitation in a cohort of elderly patients. Methods: Participants were elderly patients admitted to postacute rehabilitation in an academic geriatric facility. Data on demographics and affective status were collected upon admission; functional status and gait speed were measured at admission and at discharge; self-reported functional status and history of falls since discharge were collected one month after discharge (follow-up). Falls efficacy was measured using the Fall Efficacy Scale, that assesses confidence in performing 12 activities of daily living without falling (range 0 to 100, higher score indicating higher confidence). Patients were classified using the median FES score at baseline (95) as cut-off to divide the population into "confident" and "fearful" groups. Results: Participants' (N=180, mean age 81.3±7.1 years, 75.6% women) mean FES score was 92.3±8.7 at baseline (range 60-100). Basic ADL score averaged 3.5±1.6 at baseline, 4.7±1.3 at discharge, and 5.5±0.7 at follow-up (self-reported). Baseline FES score was positively correlated with basic ADL at follow-up (rho=0.35, p<.001). At follow-up, 58.7% of the patients were fully independent in basic ADL, this proportion being significantly higher in confident than fearful patients (70.7% vs 42.4%, p<.001). Compared to confident patients, those fearful had significantly lower odds (OR 0.3, 95%CI 0.2-0.6, p<.001) to report full independence at follow-up. This relationship remained (adjOR = 0.4, 95%CI 0.2-0.8, p=.01) after controlling for demographics, baseline gait speed, depressive symptoms, functional status at discharge, and history of falls since discharge. Conclusion: In this cohort of older rehab patients, poor falls efficacy at admission was associated with lower function reported one month after discharge even after controlling for initial mobility performance and functional status at discharge. Further studies should determine whether interventions aiming at falls efficacy improvement will also result in improved function in fearful subjects undergoing rehabilitation.

Produção da toxina Cry1Ac e preferência para alimentação e oviposição de Alabama argillacea em algodão Bt sob estresse hídrico

O objetivo deste trabalho foi avaliar a produção da toxina Cry1Ac de Bacillus thuringiensis (Bt) em plantas de algodão geneticamente modificado (algodão Bt), e a preferência para alimentação e oviposição de Alabama argillacea confinada em algodão Bt e não Bt sob estresse hídrico. As variedades de algodão Bt - Acala 90B e NuOpal - e não Bt - Acala 90 e DeltaOpal - foram cultivadas em microparcelas, com e sem estresse hídrico. A produção de toxina foi avaliada em folhas e partes reprodutivas das variedades de algodão Bt. Para o teste de escolha para oviposição, mariposas de A. argillacea foram liberadas em telado que continha as quatro variedades do algodão. Após 72 horas, o número de ovos foi quantificado. Para a preferência de alimentação, foram avaliadas lagartas com três e 10 dias de idade. A produção da toxina Cry1Ac foi superior nas folhas da parte apical das plantas, das duas variedades sob estresse hídrico, e similar nas brácteas e cascas de maçãs. Lagartas e mariposas de A. argillacea não diferenciam algodão Bt e não Bt na escolha quanto à alimentação e à oviposição, respectivamente. Entretanto, as mariposas preferem ovipositar em plantas sem estresse hídrico.

Status of the Iowa Workforce and Economy February 2016, March 2016

Iowa Workforce Development's newsletter.