Predicting adverse events in children with fever and chemotherapy-induced neutropenia: the prospective multicenter SPOG 2003 FN study.

PURPOSE To develop a score predicting the risk of adverse events (AEs) in pediatric patients with cancer who experience fever and neutropenia (FN) and to evaluate its performance. PATIENTS AND METHODS Pediatric patients with cancer presenting with FN induced by nonmyeloablative chemotherapy were observed in a prospective multicenter study. A score predicting the risk of future AEs (ie, serious medical complication, microbiologically defined infection, radiologically confirmed pneumonia) was developed from a multivariate mixed logistic regression model. Its cross-validated predictive performance was compared with that of published risk prediction rules. Results An AE was reported in 122 (29%) of 423 FN episodes. In 57 episodes (13%), the first AE was known only after reassessment after 8 to 24 hours of inpatient management. Predicting AE at reassessment was better than prediction at presentation with FN. A differential leukocyte count did not increase the predictive performance. The score predicting future AE in 358 episodes without known AE at reassessment used the following four variables: preceding chemotherapy more intensive than acute lymphoblastic leukemia maintenance (weight = 4), hemoglobin > or = 90 g/L (weight = 5), leukocyte count less than 0.3 G/L (weight = 3), and platelet count less than 50 G/L (weight = 3). A score (sum of weights) > or = 9 predicted future AEs. The cross-validated performance of this score exceeded the performance of published risk prediction rules. At an overall sensitivity of 92%, 35% of the episodes were classified as low risk, with a specificity of 45% and a negative predictive value of 93%. CONCLUSION This score, based on four routinely accessible characteristics, accurately identifies pediatric patients with cancer with FN at risk for AEs after reassessment.

Pediatric drug-related problems: a multicenter study in four French-speaking countries.

BACKGROUND: Pediatric intensive care patients represent a population at high risk for drug-related problems. There are few studies that compare the activity of clinical pharmacists between countries. OBJECTIVE: To describe the drug-related problems identified and interventions by four pharmacists in a pediatric cardiac and intensive care unit. SETTING: Four pediatric centers in France, Quebec, Switzerland and Belgium. METHOD: This was a six-month multicenter, descriptive and prospective study conducted from August 1, 2009 to January 31, 2010. Drug-related problems and clinical interventions were compiled from four pediatric centers in France, Quebec, Switzerland and Belgium. Data on patients, drugs, intervention, documentation, approval and estimated impact were compiled. MAIN OUTCOME MEASURE: Number and type of drug-related problems encountered in a large pediatric inpatient population. RESULTS: A total of 996 interventions were recorded: 238 (24 %) in France, 278 (28 %) in Quebec, 351 (35 %) in Switzerland and 129 (13 %) in Belgium. These interventions targeted 270 patients (median 21 months old, 53 % male): 88 (33 %) in France, 56 (21 %) in Quebec, 57 (21 %) in Switzerland and 69 (26 %) in Belgium. The main drug-related problems were inappropriate administration technique (29 %), untreated indication (25 %) and supra-therapeutic dose (11 %). The pharmacists' interventions were mostly optimizing the mode of administration (22 %), dose adjustment (20 %) and therapeutic monitoring (16 %). The two major drug classes that led to interventions were anti-infectives for systemic use (23 %) and digestive system and metabolism drugs (22 %). Interventions mainly involved residents and all clinical staff (21 %). Among the 878 (88 %) proposed interventions requiring physician approval, 860 (98 %) were accepted. CONCLUSION: This descriptive study illustrates drug-related problems and the ability of clinical pharmacists to identify and resolve them in pediatric intensive care units in four French-speaking countries.

Studies on the fracture behaviour of polymer blends with special reference to PP/HDPE and PS/HIPS blends

Investigations on the fracture behaviour of polymer blends is the topic of this thesis. The blends selected are PP/HDPE and PS/HIPS. PP/HDPE blend is chosen due to its commercial importance and PS/HIPS blend is selected to study the transition from brittle fracture to ductile fracture.PP/HDPE blends were prepared at different compositions by melt blending at 180°C and fracture failure process was investigated by conducting notch sensitivity test and tensile test at different strain rates. The effects of two types of modifiers (particulate and elastomer) on the fracture behaviour and notch sensitivity of PP/HDPE blends were studied. The modifiers used are calcium carbonate, a hard particulate filler commonly used in plastics and Ethylene Propylene Diene Monomer (EPDM). They were added in 2%, 4% and 6% by weight of the blends.The study shows that the mechanical properties of PP/HDPE blends can be optimized by selecting proper blend compositions. The selected modifiers are found to alter and improve the fracture behaviour and notch sensitivity of the blends. Particulate fillers like calcium carbonate can be used for making the mechanical behaviour more stable at the various blend compositions. The resistance to notch sensitivity of the blends is found to be marginally lower in the presence of calcium carbonate. The elastomeric modifier EPDM produces a better stability of the mechanical behaviour. A low concentration of EPDM is sufficient to effect such a change. EPDM significantly improves the resistance to notch sensitivity of the blends. The study shows that judicious selection of modifiers can improve the fracture behaviour and notch sensitivity of PP/HDPE blends and help these materials to be used for critical applications.For investigating the transition in fracture behaviour and failure modes, PS/HIPS blends were selected. The blends were prepared by melt mixing followed by injection moulding to prepare the specimens for conducting tensile, impact and flexure tests. These tests were used to simulate the various conditions which promote failure.The tensile behaviour of unnotched and notched PS/HIPS blend samples were evaluated at slow speeds. Tensile strengths and moduli were found to increase at the higher testing speed for all the blend combinations whereas maximum strain at break was found to decrease. For a particular speed of testing, the tensile strength and modulus show only a very slight decrease as HIPS content is increased up to about 40%. However, there is a drastic decrease on increasing the HIPS content thereafter.The maximum strain at break shows only a very slight change up to about 40% HIPS content and thereafter shows a remarkable increase. The notched specimens also follow a comparable trend even though the notch sensitivity is seen high for PS rich blends containing up to 40% HIPS. The notch sensitivity marginally decreases with increase in HIPS content. At the same time, it is found to increase with the increase in strain rate. It is observed that blends containing more than 40% HIPS fail in ductile mode.The impact characteristics of PSIHIPS blends studied were impact strength, the energy absorbed by the test specimen and impact toughness. Remarkable increase in impact strength is observed as HIPS content in the blend exceeds 40%. The energy absorbed by the test specimens and the impact toughness also show a comparable trend.Flexural testing which helps to characterize the load bearing capacity was conducted on PS/HIPS blend samples at the two different testing speeds of 5mmlmin and 10 mm/min. The flexural strength increases with increase in testing speed for all the blend compositions. At both the speeds, remarkable reduction in flexural strength is observed as HIPS content in the blend exceeds 40%. The flexural strain and flexural energy absorbed by the specimens are found to increase with increase in HIPS content. At both the testing speeds, brittle fracture is observed for PS rich blends whereas HIPS rich blends show ductile mode of failure.Photoelastic investigations were conducted on PS/HIPS blend samples to analyze their failure modes. A plane polariscope with a broad source of light was utilized for the study. The coloured isochromatic fringes formed indicate the presence of residual stress concentration in the blend samples. The coverage made by the fringes on the test specimens varies with the blend composition and it shows a reducing trend with the increase in HIPS content. This indicates that the presence of residual stress is a contributing factor leading to brittle fracture in PS rich blends and this tendency gradually falls with increase in HIPS content and leads to their ductile mode of failure.

Studies on Some Aspects of Landings,Utilization and Export of Commercially Important Cephalopods

In the present study two aspects of cephalopod fishery such as (i) landings and (ii) utilization including export of cephalopods from Indian are dealt with. Under the topic landings, craft, both traditional and mechanized and fishing techniques employed for capturing cephalopods are discussed. General trend in cephalopod landing in India and particularly south west coast, species composition, description and geographic distribution of important species of cuttle fishes, squids and octopus and the distribution and abundance of cephalopods along the continental shelf of the south west coast are also discussed. Some biological aspects like population parameters, maturation and spawning, food and feeding of the two representive species of cuttle fishes and squid viz, Sepia pharaonis and Loligo duvauceli are studied.Under utilization, general handling and processing of various frozen cephalopods products for exports and commercial operation in a typical plant are studied. The export of cephalopod products since its commencement is studied in detail and market strategy for enhancing the export are suggested.

Studies on Riverine Fishing Gears of Central Kerala

The overall focus of the thesis involves Studies on the riverine fishing geara of central kerala.Rivers and reservoirs of India harbour a rich and varied spectrum of fishes exceeding 400 species, which include commercially important fishes.The fish and fisheries play a crucial role in kerala's economy,employment generation ,food security and well being of its people.In the present study ,results of investigations conducted during 2001-2002 on riverine fishing gears of central kerala are presented along with detailed description of fishing gears,their distribution and operation covering aspects of selectivity and operational economics.Chapter I gives an introduction to the topiC of the study highlighting the relevance of the study and reviews of the existing literature on fishing gears and practices in riverine sector and sets out objectives of the study.The chapter 11 deals with the Materials and Methods used for the conduct of the investigations. In this chapter the area and the rivers selected for the study. reasons for the selection process and methodologies used for survey of riverine fishing gaear and investigations on design, structure and operation of different gear systems are presented.The chapter III discusses gillnet and its operation. Gill netting is one of the simplest and oldest methods of fishing. They are the most widely operated fishing gear in the rivers of Central Kerala. Gill netting being a low cost fishing method is of special interest for artisanal fisheries. Twenty different types of gillnets are operated in this sector.Chapter IV deals with cast nets. The origin and evolution of cast net has been briefly described in the introductory part.The chapter V deals with fishing lines, traps and other miscellaneous gears.This findings will be useful for riverine fishermen for deployment of appropriate gear systems during different seasons to ensure profitability of fishing operations.

Studies on the macrobenthic community of Cochin backwaters with special reference to culture of Eriopisa chilkensis (Gammaridae-Amphipoda)

This thesis Entitled studies on the macrobenthic community of cochin backwaters with special reference to culture of eriopisa chilkensis (Gammaridae- amphipoda).Benthic organisms are usually studied for environmental impact assessment, pollution control and resource conservation. The benthic monitoring component has three major objectives: 1) characterize the benthic communities to assess the estuarine health, 2) determine seasonal and spatial variability in benthic communities, and 3) detect changes in the estuarine community through examination of changes in abundances of specific indicator taxa and other standard benthic indices.Cochin backwaters situated at the tip of the northern Vembanad lake is a tropical positive estuarine system. The backwaters of Kerala support as much biological productivity and diversity as tropical rain forest and are responsible for the rich fishery potential of Kerala. Backwaters also act as nursery grounds for commercially important prawns and fishes.The thesis has been subdivided into seven chapters. The first chapter gives a general introduction about the topic and also highlights the scope and purpose of the study. The second chapter covers the methodology adopted for the collection and analysis of water quality parameters, sediment and the macrobenthic fauna.Chapter 3 deals with hydrographic features, sediment characteristics and the spatial variation and abundance of macrobenthic fauna in the Cochin estuary.Chapter 4 explains the impact of organic enrichment on macrobenthic popUlation in the Cochin estuary and includes the comparison of the present data with the earlier work in this region.Chapter 5 deals with seasonal variability in abundance of macrobenthic species in the estuary. The study was conducted from 9 stations during three seasons (pre-monsoon, monsoon and post-monsoon) in 2003.Chapter 6 deals with Life history and Population Dynamics of Eriopisa chilkensis Chilton (Gammaridae-Amphipoda). The life cycle of the gammarid amphipod Eriopisa chilkensis from the Cochin estuary, south west coast of India was studied for the first time under laboratory conditions.

Studies on the digestive enzymes of the cultivable grey mullet liza parsia (hamilton buchanan, 1822)

Culturing of fish in captivity demands a detailed knowledge on well balanced diet and adequate feeding. Formulation and production of nutritionally balanced diets for fish require research, quality control and biological evaluation. It is often assuemed that what is ingested is also digested, but this is not always be the case. Digestion depends upon both the physical state of the food and the kind and quantity of enzymes in the digestive tract. The ability of fish to digest a particular component of diet can be ascertained by investigating the complement of digestive enzymes present along the digestive tract. Investigations on the basic digestive physiology will not only enhance our present knowledge on nutrition and feed development, but will also contribute in understanding the digestive functions of lower vertebrates. It is against this background that the present topic of investigation "Studies on the digestive enzymes of the cultivable grey mullet Liza parsia Hamilton Buchanan, l822" has been selected. The thesis is arranged and presented in eight chapters.

”Studies on Selected conducting polymers for Microwave and Electrical Applications

The electrical properties of polymers make up an inherently interdisciplinary topic, being closely associated, on the one hand, with the mechanical properties of polymers polarization and relaxation) and, on the other hand, with the semi conductive properties (conduction and break down). In addition, unlike conventional technologies, which use these properties in its various applications like antistatic coatings, rechargeable batteries, sensors, electrochromic devices, electrochemical devices etc, microwave technology extract the microwave absorbing ability of electrically conducting polymers. The conducting polymers are widely used in its potential applications like electro magnetic interference shielding, satellite communication links, beam steering radars, frequency selective surfaces etc. Considering the relevance of microwave applications of conducting polymers, the study of microwave properties of conducting polymers stands poised to become a compelling choice for synthetic chemists and condensed - matter physicists, physical chemists and material scientists, electrochemists and polymer scientists. The main aim of the present work is to study the microwave and low frequency properties of various conducting polymers, conducting semi-interpenetrating networks, conducting copolymers and to characterise it. Also this thesis collated the microwave properties of these conducting systems and exposes the various technologically important applications in the industrial, scientific, communication and defence applications.

Studies on The Ecology And Production of Algae in Prawn Culture Systems

Existing method of culture were largely based on empirical knowledge. Lacking a scientific basis as such methods did, they were often wasteful and suffered severe limitation. Modern methods of fish and prawn culture based on scientific research, have revolutioned the industry in recent years and not only extended its scope to cover the whole country but led to increased fish and prawn production. An understanding of the biological capability of the water in the perennial and seasonal culture ponds, and the nature and extent of the influence of the abiotic factors on the production of organisms in the primary level of food chain would contribute to effectively implement management measures in the stocking strategies and in the evaluation of economics of production of prawns. It is against this background that the present topic of investigation "Studies on the ecology and production of algae in prawn culture systems” was selected.

Establishing a sexual identity: case studies of learners with autism and learning difficulties

The physical and emotional changes that occur in adolescence are part of the process of sexual maturity. These changes occur irrespective of ability and are often aligned with psychological and social factors. When the nature of a disability has an inherent limitation in social awareness, as is the case for individuals with autism, the achievement of personal sexual identity can become much more complex. Challenges in supporting individuals in this respect can be caused by the sensitive aspects of inappropriate behaviour, the abstract nature of teaching the topic, and the general reluctance on the part of parents and staff to discuss sexuality in individuals with disabilities. This article explores how a residential school addressed this gap. It provides details of how this need was met for seven students and the process undertaken to involve staff, parents and other stakeholders to establish ongoing support.

Linking energy and maintenance management for sustainability through three American case studies

Purpose – The purpose of this paper is to present the findings and lessons learned from three case studies conducted for facilities located in California, North America. The findings aim to focus on energy and maintenance management practices and the interdependent link between energy and maintenance. Design/methodology/approach – The research is based on a positivist epistemological philosophical approach informed by action research. The research cycle was completed for each case study. A case study report was provided to each facility management team to foster collaboration with the researcher and to document case study process and results. Findings – Composite findings of the case studies include: there is an interdependent link between energy and maintenance management; reactive maintenance and energy management methods are commonly used; and more proactively operated and managed buildings require the interdependent link between energy maintenance management to be better understood. Research limitations/implications – The three case studies were located in California. Although the case study results can be generalized, determination of how to generalize and apply the results to commercial buildings outside of the USA is beyond the scope of this paper. Practical implications – Detailed discussion of the needs of the three facility management teams are discussed by identifying a current challenge, developing a solution and documenting lessons learned using the research cycle. Originality/value – The paper seeks to demonstrate the interdependencies of energy and maintenance management, two topics which are often researched interdependently. Additionally, the paper provides insight about maintenance management, a topic often cited as being under researched.

Multicenter Analysis of Glucocerebrosidase Mutations in Parkinson`s Disease

Background Recent studies indicate an increased frequency of mutations in the gene encoding glucocerebrosidase (GBA), a deficiency of which causes Gaucher`s disease, among patients with Parkinson`s disease. We aimed to ascertain the frequency of GBA mutations in an ethnically diverse group of patients with Parkinson`s disease. Methods Sixteen centers participated in our international, collaborative study: five from the Americas, six from Europe, two from Israel, and three from Asia. Each center genotyped a standard DNA panel to permit comparison of the genotyping results across centers. Genotypes and phenotypic data from a total of 5691 patients with Parkinson`s disease (780 Ashkenazi Jews) and 4898 controls (387 Ashkenazi Jews) were analyzed, with multivariate logistic-regression models and the Mantel-Haenszel procedure used to estimate odds ratios across centers. Results All 16 centers could detect two GBA mutations, L444P and N370S. Among Ashkenazi Jewish subjects, either mutation was found in 15% of patients and 3% of controls, and among non-Ashkenazi Jewish subjects, either mutation was found in 3% of patients and less than 1% of controls. GBA was fully sequenced for 1883 non-Ashkenazi Jewish patients, and mutations were identified in 7%, showing that limited mutation screening can miss half the mutant alleles. The odds ratio for any GBA mutation in patients versus controls was 5.43 across centers. As compared with patients who did not carry a GBA mutation, those with a GBA mutation presented earlier with the disease, were more likely to have affected relatives, and were more likely to have atypical clinical manifestations. Conclusions Data collected from 16 centers demonstrate that there is a strong association between GBA mutations and Parkinson`s disease.

Topic- and mode-sensitive interaction strategies : Functions of ellipsis in oral communication

In this article, we discuss ellipsis as an interactive strategy by analysing the author’s textchat corpus and the VOICE corpus of English as a Lingua Franca. It is found that there were fewer repetitions in the textchat data, and this is explained as a consequence of the textchat mode. Textchat contributions are preserved as long as the chat is active or has been saved, and therefore users can scroll through and review the discussion, compared to the more fleeting nature of oral conversation. As a result, repetition is less necessary. The frequency of other functions identified could be attributed to the topic of discourse. Discussions involve much ellipsis used to develop discourse, although some were self-presentations with repetition used to confirm details. Back-channel support and comments were often low because speakers instead used forms like yeah as supportive utterances.

Clinical features of obsessive-compulsive disorder with hoarding symptoms: A multicenter study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Physical exercise modulates peripheral levels of brain-derived neurotrophic factor (BDNF): A systematic review of experimental studies in the elderly

The objective of this study was to conduct a systematic review of studies that analyzed the effect of physical exercise on the peripheral levels of BDNF in elderly individuals. Method: We conducted a search in PsycINFO, Biological Abstracts, Pubmed, Web of Science, and Science Direct from 1990 to 2011, using the following keywords: physical exercise , physical activity , physical therapy , training , BDNF , neuroplasticity , neurotrophins , neuroplasticity proteins , aged , older , elderly The articles were considered for inclusion in the review if they were studies with elderly, assessed peripheral (serum and/or plasma) BDNF and evaluated an acute exercise or chronic exercise (training). Results: Five randomized controlled trial and one randomized non-controlled trial studies were analyzed. Five out of six studies reported a significantly higher BDNF response to aerobic acute exercise and to aerobic or strength training program in healthy elderly and elderly with different pathologies. Conclusion: It was not possible to establish a recommendation protocol for the type and intensity of physical exercise required to produce an increase in levels BDNF. However, physical exercise, particularly, moderate-intensity exercises seem to be more effective to promote increase the peripheral levels of BDNF in the elderly. © 2012 Elsevier B.V.