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Background Bronchoscopy is commonly used to evaluate suspicious lung lesions. The yield is likely dependent on patient, radiographic, and bronchoscopic factors. Few studies have assessed these factors simultaneously while also including the preprocedure physician-assessed probability of cancer (pCA) when assessing yield. Methods This study is a secondary data analysis from a prospective multicenter trial. Diagnostic yield of standard bronchoscopy with biopsy ± fluoroscopy, endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA), electromagnetic navigation, and combination bronchoscopies was assessed. Definitions for diagnostic and nondiagnostic bronchoscopies were rigorously predefined. The association of diagnostic yield with individual variables was examined by using univariate and multivariate logistic regression analyses where appropriate. Results A total of 687 patients were included from 28 sites. Overall diagnostic yield was 69%; 80% for EBUS, 55% for bronchoscopy with biopsy ± fluoroscopy, 57% for electromagnetic navigation, and 74% for combination procedures (P 60% yielded a positive result in 77% (P Conclusions This study is the first to assess the yield of bronchoscopy according to physician-assessed pCA in a large, prospective multicenter trial. The yield of bronchoscopy varied greatly according to physician suspicion that cancer is present, the patients’ clinical/radiographic features, and the type of procedure performed. Of the procedures performed, EBUS-TBNA was the most likely to provide a diagnosis.

Background Studies have suggested that a fasciculoventricular pathway (FVP) may be the cause of preexcitation in patients with Danon disease, a rare X-linked dominant genetic disorder of hypertrophic cardiomyopathy. Objective The purpose of this study was to describe the prevalence of ventricular preexcitation on resting 12-lead electrocardiogram (ECG) in patients with Danon disease and the electrophysiological study (EPS) results of those with preexcitation. Methods Patients with confirmed Danon disease diagnosed with preexcitation (PR ≤120 ms, delta wave, QRS >110 ms) on ECG were included from a multicenter registry. The incidence of arrhythmias, implantable cardioverter-defibrillator (ICD) procedures, ICD shocks, and EPS results were collected. Results Thirteen of 40 patients (32.5%) with Danon disease were found to have preexcitation (mean age 17.3 years; 38% women). EPS performed in 9 of 13 patients (69%) demonstrated FVP only in 2 (22.2%), extranodal pathway without exclusion of FVP in 2 (22.2%), and both FVP and extranodal pathway in 5 (55.6%). Two patients had malignant accessory pathway (AP) properties. Over median follow-up of 842 days (interquartile range 138–1678), 11 patients (85%) had ICD placement, and 6 (46.1%) underwent heart transplantation. No patients required therapy for ventricular tachycardia, and 2 patients (15%) had paroxysmal atrial fibrillation. Conclusion In a large multicenter cohort of patients with Danon disease, there was a high prevalence of FVP and extranodal pathways diagnosed on EPS in those with preexcitation. These findings suggest patients with preexcitation and Danon disease should undergo EPS to assess for FVP and potentially malignant extranodal AP.

Background and objective. Increasing physical activity (PA) is safe and beneficial in lung cancer (LC) patients. Advanced-stage LC patients are under-studied and have worse symptoms and quality of life (QoL). We evaluated the feasibility of monitoring step count in advanced LC as well as potential correlations between PA and QoL. Methods. This is a prospective, observational study of 39 consecutive patients with advanced-stage LC. Daily step count over 1 week (via Fitbit Zip), QoL, dyspnea, and depression scores were collected. Spearman rank testing was used to assess correlations. Correlation coefficients (ρ) >0.3 or

Danon Disease is a rare X-linked myopathy associated with hypertrophic cardiomyopathy and Wolff-Parkinson-White (WPW) syndrome. The prevalence of WPW in Danon Disease is unclear. This study examined the prevalence of WPW and associated outcomes in a cohort of Danon Disease patients. EKGs of 28

DNA- and modified virus Ankara (MVA)-vectored candidate vaccines expressing human immunodeficiency virus type 1 (HIV-1) clade A-derived p24/p17 gag fused to a string of HLA class I epitopes, called HIVA, were tested in phase I trials in healthy, HIV-1/2-uninfected adults in Oxford, United Kingdom. Eighteen volunteers were vaccinated with pTHr.HIVA DNA (IAVI-001) alone, 8 volunteers received MVA.HIVA (IAVI-003) alone and 9 volunteers from study IAVI-001 were boosted with MVA.HIVA 9-14 months after DNA priming (IAVI-005). Immunogenicity results observed in these trials was published previously [Mwau M, Cebere I, Sutton J, Chikoti P, Winstone N, Wee EG-T, et al. An HIV-1 clade A vaccine in clinical trials: stimulation of HIV-specific T cell responses by DNA and recombinant modified vaccinia virus Ankara (MVA) vaccines in humans. J Gen Virol 2004;85:911-9]. Here, we report on the safety of the two vaccines and the vaccine regimes. Overall, both candidate vaccines were safe and well tolerated. There were no reported vaccine-related adverse events over the 6-month period of the study and up to 2 years after the last vaccination. There were no moderate or severe local symptoms recorded after the pTHr.HIVA DNA intramuscular administration. Almost all participants experienced local reactogenicity events such as redness and induration after MVA.HIVA intradermal injection. Thus, the results from these initial small phase I trials administering the pTHr.HIVA DNA and MVA.HIVA vaccines either alone or in a prime-boost regime to healthy HIV-1/2-negative adults indicated that the vaccines were safe and warranted further testing of this approach in larger phase I/II studies.

During a multi-district study on part-time teaching employment, part-time teachers, school administrators, and teachers’ association officials spoke about a range of micropolitical activities related to part-time teaching arrangements as a component of flexible workforces and as an element of flexible workplaces. The study was conducted in one Canadian province during a period of rapidly imposed changes, including funding cuts, typical of the globalized school restructuring movement. We describe administrators’ strategic efforts to mobilize their biases related to part-time teaching employment by organizing their micropolitical resources either to support that preference or to minimize such arrangements. We discuss the strategies that part-time teachers used in order to survive as flexible workers, and sometimes to flourish in rather fragile versions of flexible workplaces. We conclude by noting micropolitical themes that have application beyond the little-studied subculture of part-time teaching. These themes offer insights about power, perceptions, values, and gender that apply more widely to the micropolitics of school organizations.

This was a 3-year retrospective cohort study of traumatic injuries in a midwestern pork meatpacking plant. Based on n = 5410 workers, this was a diverse workforce: Caucasian (56.6%), Hispanic (38.9%), African American (2.7%), Asian (1.1%) and Native American (0.8%). There were n = 1655 employees with traumatic injuries during this period. At 6 months of employment, the probability of injury was 33% in the harvest workers who were responsible for slaughter operations. The overall incidence injury rate was 22.76 per 100 full-time employees per year. Women experienced a higher incidence for injury than men. The risk ratio (RR) for traumatic injury was significantly lower in Hispanic workers compared to Caucasians (RR = 0.54, 95% CI = 0.49-0.60) and nonsignificantly higher in African American and Native American workers after adjusting for age, gender, work section assignment, and experience (RR = 1.33, 95% CI = 1.21-1.47). These findings suggest that either Hispanics are very safe employees or they underreport injuries. We make the case for the latter in the discussion.

Marketing literature has long concerned itself with the purchasing behaviour of organisations and provides suitable models for the evaluation of such decision‐making processes. Analysts evaluating international shipping, on the other hand, have been preoccupied with industry structure — its efficiency and its competitiveness — often viewing shippers as being homogeneous (price‐oriented). This article proposes to assess the purchase of international transport services, specifically container shipping services, from a marketer's viewpoint in order to determine the factors which limit the inclusion of a carrier in a shipper's choice set.

In a recent study of the Bureau of Labor Statisticsoperated national industrial safety statistics program conducted by the authors,1 it was found that current data collected underestimates the extent of industrial accidents nationally and provides no reliable insight into the incidence rates below the federal level. Various alternative methods for estimating work injuries deserve consideration. This paper will focus attention on the use of accident rate tables for derivation of state level estimates of work injuries and fatalities. In addition, some attention will be directed towards assessing the value of work injury rate tables in developing measures of work injury incidence and relative improvement over the working lifetime of individuals. The concept of accident rate tables is not a new development. It has been used extensively in the insurance industry as a basis of developing work injury experience rates of different industries and occupations. Further, some researchers in the field of Workmen's Compensation and statistical program evaluation, notably Jaffe and Pearce,2'3 have conducted experiments in the generation and application of work injury rate tables to estimates and actual counts of the labor force by age, sex and industry to develop synthetic work injury measures. However, in both instances, the experiments were tied to the necessity of having available information on the age, sex, industry and occupational affiliation of the labor force. Information of this fine degree of demographic detail is generally unavailable at any time except for decennial Censuses. Annual estimates of the labor force by age and sex at both the national and state levels have, until recently, been virtually lacking. Data on the age and sex of both industrial fatalities and disabilities can be obtained from tallies of individual reports of accidents filed with State Accident or Workmen's Compensation systems. Therefore, the further refinement of the estimating technique has been stymied by both the lack of good demographic detail of national and state labor forces on an annual basis and untabulated data on the demographic characteristics of accident data in most states. A notable exception is the State of California, Work Injury Reporting System. For over a decade, the State of California Department of Industrial Relations, Division of Research and Statistics, has compiled and published tabulations of the age, sex distributions of both fatalities and disabling injuries. The Division has also developed, to a lesser-known extent, estimates and projections of the State Labor Force by Age and Sex. The information is generally available on a five-year bench-mark basis.4 Thus, in light of this data availability, it was decided to conduct several tests with the combined data sources in California as an' experiment in the refined application of the accident rate table concept of work injury estimation.