Improvement of cardiovascular risk prediction: time to review current knowledge, debates, and fundamentals on how to assess test characteristics.

Cardiovascular risk assessment might be improved with the addition of emerging, new tests derived from atherosclerosis imaging, laboratory tests or functional tests. This article reviews relative risk, odds ratios, receiver-operating curves, posttest risk calculations based on likelihood ratios, the net reclassification improvement and integrated discrimination. This serves to determine whether a new test has an added clinical value on top of conventional risk testing and how this can be verified statistically. Two clinically meaningful examples serve to illustrate novel approaches. This work serves as a review and basic work for the development of new guidelines on cardiovascular risk prediction, taking into account emerging tests, to be proposed by members of the 'Taskforce on Vascular Risk Prediction' under the auspices of the Working Group 'Swiss Atherosclerosis' of the Swiss Society of Cardiology in the future.

Refinement of Rapid PCC Coarse Aggregate Testing Program, HR-1071, 1999

The characterization and categorization of coarse aggregates for use in portland cement concrete (PCC) pavements is a highly refined process at the Iowa Department of Transportation. Over the past 10 to 15 years, much effort has been directed at pursuing direct testing schemes to supplement or replace existing physical testing schemes. Direct testing refers to the process of directly measuring the chemical and mineralogical properties of an aggregate and then attempting to correlate those measured properties to historical performance information (i.e., field service record). This is in contrast to indirect measurement techniques, which generally attempt to extrapolate the performance of laboratory test specimens to expected field performance. The purpose of this research project was to investigate and refine the use of direct testing methods, such as X-ray analysis techniques and thermal analysis techniques, to categorize carbonate aggregates for use in portland cement concrete. The results of this study indicated that the general testing methods that are currently used to obtain data for estimating service life tend to be very reliable and have good to excellent repeatability. Several changes in the current techniques were recommended to enhance the long-term reliability of the carbonate database. These changes can be summarized as follows: (a) Limits that are more stringent need to be set on the maximum particle size in the samples subjected to testing. This should help to improve the reliability of all three of the test methods studied during this project. (b) X-ray diffraction testing needs to be refined to incorporate the use of an internal standard. This will help to minimize the influence of sample positioning errors and it will also allow for the calculation of the concentration of the various minerals present in the samples. (c) Thermal analysis data needs to be corrected for moisture content and clay content prior to calculating the carbonate content of the sample.

Current state of vaccine therapies in non-small-cell lung cancer.

A large variety of cancer vaccines have undergone extensive testing in early-phase clinical trials. A limited number have also been tested in randomized phase II clinical trials. Encouraging trends toward increased survival in the vaccine arms have been recently observed for 2 vaccine candidates in patients with non-small-cell lung cancer. These have provided the impetus for the initiation of phase III trials in large groups of patients with lung cancer. These vaccines target 2 antigens widely expressed in lung carcinomas: melanoma-associated antigen 3, a cancer testis antigen; and mucin 1, an antigen overexpressed in a largely deglycosylated form in advanced tumors. Therapeutic cancer vaccines aim at inducing strong CD8 and CD4 T-cell responses. The majority of vaccines recently tested in phase I clinical trials show efficacy in terms of induction of specific tumor antigen immunity. However, clinical efficacy remains to be determined but appears limited. Efforts are thus aimed at understanding the basis for this apparent lack of effect on tumors. Two major factors are involved. On one hand, current vaccines are suboptimal. Strong adjuvant agents and appropriate tumor antigens are needed. Moreover, dose, route, and schedule also need optimization. On the other hand, it is now clear that large tumors often present a tolerogenic microenvironment that hampers effective antitumor immunity. The partial understanding of the molecular pathways leading to functional inactivation of T cells at tumor sites has provided new targets for intervention. In this regard, blockade of cytotoxic T-lymphocyte antigen-4 and programmed death-1 with humanized monoclonal antibodies has reached the clinical testing stage. In the future, more potent cancer vaccines will benefit from intense research in antigen discovery and adjuvant agents. Furthermore, it is likely that vaccines need to be combined with compounds that reverse major tolerogenic pathways that are constitutively active at the tumor site. Developing these combined approaches to vaccination in cancer promises new, exciting findings and, at the same time, poses important challenges to academic research institutions and the pharmaceutical industry.

Field Instrumentation, Testing, and Long-Term Monitoring of High-Mast Lighting Towers in the State of Iowa, TR-518, 2006

As a result of the collapse of a 140 foot high-mast lighting tower in Sioux City, Iowa in November of 2003, a thorough investigation into the behavior and design of these tall, yet relatively flexible structures was undertaken. Extensive work regarding the root cause of this failure was carried out by Robert Dexter of The University of Minnesota. Furthermore, a statewide inspection of all the high-mast towers in Iowa revealed fatigue cracks and loose anchor bolts on other existing structures. The current study was proposed to examine the static and dynamic behavior of a variety of towers in the State of Iowa utilizing field testing, specifically long-term monitoring and load testing. This report presents the results and conclusions from this project. The field work for this project was divided into two phases. Phase 1 of the project was conducted in October 2004 and focused on the dynamic properties of ten different towers in Clear Lake, Ames, and Des Moines, Iowa. Of those ten, two were also instrumented to obtain stress distributions at various details and were included in a 12 month long-term monitoring study. Phase 2 of this investigation was conducted in May of 2005, in Sioux City, Iowa, and focused on determining the static and dynamic behavior of a tower similar to the one that collapsed in November 2003. Identical tests were performed on a similar tower which was retrofitted with a more substantial replacement bottom section in order to assess the effect of the retrofit. A third tower with different details was dynamically load tested to determine its dynamic characteristics, similar to the Phase 1 testing. Based on the dynamic load tests, the modal frequencies of the towers fall within the same range. Also, the damping ratios are significantly lower in the higher modes than the values suggested in the AASHTO and CAN/CSA specifications. The comparatively higher damping ratios in the first mode may be due to aerodynamic damping. These low damping ratios in combination with poor fatigue details contribute to the accumulation of a large number of damage-causing cycles. As predicted, the stresses in the original Sioux City tower are much greater than the stresses in the retrofitted towers at Sioux City. Additionally, it was found that poor installation practices which often lead to loose anchor bolts and out-of-level leveling nuts can cause high localized stresses in the towers, which can accelerate fatigue damage.

Field Instrumentation, Testing, and Long-Term Monitoring of High-Mast Lighting Tower No. 1 at the I-35/US 18 Interchange Near Clear Lake in the State of Iowa Phase 3, TR-562, 2009

The current study was initiated to quantify the stresses induced in critical details on the reinforcing jacket and the tower itself through the use of field instrumentation, load testing, and long-term monitoring. Strain gages were installed on the both the tower and the reinforcing jacket. Additional strain gages were installed on two anchor rods. Tests were conducted with and without the reinforcing jacket installed. Data were collected from all strain gages during static load testing and were used to study the stress distribution of the tower caused by known loads, both with and without the reinforcing jacket. The tower was tested dynamically by first applying a static load, and then quickly releasing the load causing the tower to vibrate freely. Furthermore, the tower was monitored over a period of over 1 year to obtain stress range histograms at the critical details to be used for a fatigue evaluation. Also during the long-term monitoring, triggered time-history data were recorded to study the wind loading phenomena that excite the tower.

MGMT testing-the challenges for biomarker-based glioma treatment.

Many patients with malignant gliomas do not respond to alkylating agent chemotherapy. Alkylator resistance of glioma cells is mainly mediated by the DNA repair enzyme O(6)-methylguanine-DNA methyltransferase (MGMT). Epigenetic silencing of the MGMT gene by promoter methylation in glioma cells compromises this DNA repair mechanism and increases chemosensitivity. MGMT promoter methylation is, therefore, a strong prognostic biomarker in paediatric and adult patients with glioblastoma treated with temozolomide. Notably, elderly patients (>65-70 years) with glioblastoma whose tumours lack MGMT promoter methylation derive minimal benefit from such chemotherapy. Thus, MGMT promoter methylation status has become a frequently requested laboratory test in neuro-oncology. This Review presents current data on the prognostic and predictive relevance of MGMT testing, discusses clinical trials that have used MGMT status to select participants, evaluates known issues concerning the molecular testing procedure, and addresses the necessity for molecular-context-dependent interpretation of MGMT test results. Whether MGMT promoter methylation testing should be offered to all individuals with glioblastoma, or only to elderly patients and those in clinical trials, is also discussed. Justifications for withholding alkylating agent chemotherapy in patients with MGMT-unmethylated glioblastomas outside clinical trials, and the potential role for MGMT testing in other gliomas, are also discussed.

Cardiologie. Tests de réactivité plaquettaire: mise à jour pour le praticien [Cardiology. Platelet function testing for clinicians].

Platelet P2YI2 receptor inhibition with clopidogrel, prasugrel or ticagrelor plays a key role to prevent recurrent ischaemic events after percutaneous coronary intervention in acute coronary syndromes or elective settings. The degree of platelet inhibition depends on the antiplatelet medication used and is influenced by clinical and genetic factors. A concept of therapeutic window exists. On one side, efficient anti-aggregation is required in order to reduce cardio-vascular events. On the other side, an excessive platelet inhibition represents a risk of bleeding complications. This article describes the current knowledge about some platelet function tests and genetic tests and summarises their role in the clinical practice.

Genetic analysis of sudden cardiac death victims: a survey of current forensic autopsy practices.

Autopsy-negative sudden cardiac deaths (SCD) seen in forensic practice are most often thought to be the result of sudden arrhythmic death syndrome. Postmortem genetic analysis is recommended in such cases, but is currently performed in only a few academic centers. In order to determine actual current practice, an on-line questionnaire was sent by e-mail to members of various forensic medical associations. The questions addressed routine procedures employed in cases of sudden cardiac death (autopsy ordering, macroscopic and microscopic cardiac examination, conduction tissue examination, immunohistochemistry and electron microscopy, biochemical markers, sampling and storage of material for genetic analyses, toxicological analyses, and molecular autopsy). Some questions concerned the legal and ethical aspects of genetic analyses in postmortem examinations, as well as any existing multidisciplinary collaborations in SCD cases. There were 97 respondents, mostly from European countries. Genetic testing in cases of sudden cardiac death is rarely practiced in routine forensic investigation. Approximately 60% of respondents reported not having the means to perform genetic postmortem testing and 40% do not collect adequate material to perform these investigations at a later date, despite working at university hospitals. The survey demonstrated that many of the problems involved in the adequate investigation of SCD cases are often financial in origin, due to the fact that activities in forensic medicine are often paid by and dependent on the judicial authorities. Problems also exist concerning the contact with family members and/or the family doctor, as well as the often-nonexistent collaboration with others clinicians with special expertise beneficial in the investigation of SCD cases, such as cardiologists and geneticists. This study highlights the importance in establishing guidelines for molecular autopsies in forensic medicine.

Predictive models for nanotoxicology: current challenges and future opportunities.

Characterizing the risks posed by nanomaterials is extraordinarily complex because these materials can have a wide range of sizes, shapes, chemical compositions and surface modifications, all of which may affect toxicity. There is an urgent need for a testing strategy that can rapidly and efficiently provide a screening approach for evaluating the potential hazard of nanomaterials and inform the prioritization of additional toxicological testing where necessary. Predictive toxicity models could form an integral component of such an approach by predicting which nanomaterials, as a result of their physico-chemical characteristics, have potentially hazardous properties. Strategies for directing research towards predictive models and the ancillary benefits of such research are presented here.

Testing a new multigroup inference approach to reconstructing past environmental conditions

A new, quantitative, inference model for environmental reconstruction (transfer function), based for the first time on the simultaneous analysis of multigroup species, has been developed. Quantitative reconstructions based on palaeoecological transfer functions provide a powerful tool for addressing questions of environmental change in a wide range of environments, from oceans to mountain lakes, and over a range of timescales, from decades to millions of years. Much progress has been made in the development of inferences based on multiple proxies but usually these have been considered separately, and the different numeric reconstructions compared and reconciled post-hoc. This paper presents a new method to combine information from multiple biological groups at the reconstruction stage. The aim of the multigroup work was to test the potential of the new approach to making improved inferences of past environmental change by improving upon current reconstruction methodologies. The taxonomic groups analysed include diatoms, chironomids and chrysophyte cysts. We test the new methodology using two cold-environment training-sets, namely mountain lakes from the Pyrenees and the Alps. The use of multiple groups, as opposed to single groupings, was only found to increase the reconstruction skill slightly, as measured by the root mean square error of prediction (leave-one-out cross-validation), in the case of alkalinity, dissolved inorganic carbon and altitude (a surrogate for air-temperature), but not for pH or dissolved CO2. Reasons why the improvement was less than might have been anticipated are discussed. These can include the different life-forms, environmental responses and reaction times of the groups under study.

Load and Performance Testing of Web Applications on Service Based Environments

Suorituskyky- ja kuormitustestien tekeminen sovelluksille on erittäin tärkeä osa tuotantoprosessia nykypäivänä. Myös Web-sovelluksia testataan yhä enemmän. Tarve suorituskyky- ja kuormitustestien tekemiselle on selvä. Testattavan ympäristön tämänhetkinen, mutta myös tulevaisuuden toimivuus taataan oikein tehdyillä testeillä ja niitä seuraavilla korjaustoimenpiteillä. Suurten käyttäjämäärien testaaminen manuaalisesti on kuitenkin hyvin vaikeaa. Sirpaleisen ympäristön, kuten palveluihin perustuvien Web-sovellusympäristöjen testaaminen on haaste. Tämän työn aiheena on arvioida työkaluja ja menetelmiä, joilla raskaita teollisia Web-sovelluksia voidaan testata. Tavoitteena on löytää testausmenetelmiä, joilla voidaan luotettavasti simuloida suuria käyttäjämääriä. Tavoitteena on myös arvioida erilaisten yhteyksien ja protokollien vaikutusta Web-sovelluksen suorituskykyyn.

Testing and Monitoring Mill Connection Messages

Tarve tälle työlle on noussut sanomapalvelinsoveluksissa (servers) esiintyvistä ongelmista. Sanomapalvelinsovelluksia käytetään lähettämään ja vastaanottamaan sanomia paperiteollisuuden myynnin ja jakelun järjestelmässä maantieteellisesti erillään olevista paperiteollisuuden tehtaista. Sanomapalvelinsovelusten kunnollinen toimivuus on tärkeää koko järjestelmän toimivuuden kannalta, koska nämä palvelimet käsittelevät päivittäin tuhansia sanomia, jotka sisältävät merkityksellistä järjestelmätietoa. Tässä työssä on tutkittu mahdollisia toteutustekniikoita ja näihin tutkimuksiin pohjautuen toteutettu työkalut sanomapalvelinsovellusten testaukseen ja valvontaan. Sovellus-arkkituuritekniikoita tutkittaessa tutkimus rajattiin 3-tasoarkkitehtuuritekniikkaan, erityisesti TUXEDOTM -järjestelmätekniikkaan, koska toteutettavaa sovellusta käytetään hajautetussa sovellusympäristössä. Sovellusasiakkaan (client) toteutusta varten tutkittiin ja vertailtiin XML-tekniikkaa ja Microsoft Visual C++ -tekniikkaa käytettynä Tieto-Enatorin Phobos Interaktiivisen C++ -luokkakirjaston kanssa. XML-tekniikoita sekä Visual C++ ja Phobos-luokkakirjasto –tekniikkaa tutkittiin niiltä osin, mitä tarvittiin sanomamerkkijonojen katseluun. XML-tietokantatekniikoita tutkittiin mahdollisena vaihtoehtona tietokanta ja sovelluspalvelintekniikalle. Työn ensimmäisenä tavoitteena oli toteuttaa työkalu sanomapalvelinsovellusten testaamiseen. Toisena tavoitteena oli toteuttaa työkalu sanomien sisällön oikeellisuuden valvontaan. Kolmantena tavoitteena oli analysoida olemassaolevaa sanomavirheiden valvontasovellusta ja kehittää sitä eteenpäin. Diplomityön tuloksena toteutettiin sovellus sanomapalvelinsovellusten testaamiseen ja valvontaan. Tutkituista asiakassovelustekniikoista valittiin toteutus-tekniikaksi MS Visual C++ käytettynä Phobos Interaktiivisen C++ luokkakirjaston kanssa tekniikan tunnettavuuden vuoksi. 3-taso TUXEDOTM-tekniikka valittiin sovelluksen arkkitehtuuriksi. Lisäksi löydettiin parannuksia olemassa oleviin sanoma-virheiden valvontatoimintoihin. Tutkitut toteutustekniikat ovat yleisiä ja niitä voidaan käyttää, kun toteutetaan samanlaisia sovelluksia samanlaisiin sovellusympäristöihin.

Current and future trens in the quality control of pharmaceuticals and biopharmaticals : impacts on Cost of Goods Sold (COGS)

[Summary] 2. Roles of quality control in the pharmaceutical and biopharmaceutical industries. - 2.1. Pharmaceutical industry. - 2.2. Biopharmaceutical industry. - 2.3. Policy and regulatory. - 2.3.1. The US Food and Drug Administration (FDA). - 2.3.2. The European Medicine Agency (EMEA). - 2.3.3. The Japanese Ministry of Work, Labor and Welfare (MHLW). - 2.3.4. The Swiss Agency for Therapeutic Products (Swissmedic). - 2.3.5. The International Conference on Harmonization (ICH). - - 3. Types of testing. - 3.1. Microbiological purity tests. - 3.2. Physiochemical tests. - 3.3. Critical to quality steps. - 3.3.1. API starting materials and excipients. - 3.3.2. Intermediates. - 3.3.3. APIs (drug substances) and final drug product. - 3.3.4. Primary and secondary packaging materials fro drug products. - - 4. Manufacturing cost and quality control. - 4.1.1. Pharmaceutical manufacturing cost breakdown. - 4.1.2. Biopharmaceutical manufacturing cost breakdown. - 4.2. Batch failure / rejection / rework / recalls. - - 5. Future trends in the quality control of pharmaceuticals and biopharmaceuticals. - 5.1. Rapid and real time testing. - 5.1.1. Physio-chemicals testing. - 5.1.2. Rapid microbiology methods

A Survey and Classification of Software Testing Tools

Software testing is one of the essential parts in software engineering process. The objective of the study was to describe software testing tools and the corresponding use. The thesis contains examples of software testing tools usage. The study was conducted as a literature study, with focus on current software testing practices and quality assurance standards. In the paper a tool classifier was employed, and testing tools presented in study were classified according to it. We found that it is difficult to distinguish current available tools by certain testing activities as many of them contain functionality that exceeds scopes of a single testing type.