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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

The immunogenicities of candidate DNA- and modified vaccinia virus Ankara (MVA)-vectored human immunodeficiency virus (HIV) vaccines were evaluated on their own and in a prime–boost regimen in phase I clinical trials in healthy uninfected individuals in the United Kingdom. Given the current lack of approaches capable of inducing broad HIV-neutralizing antibodies, the pTHr.HIVA DNA and MVA.HIVA vaccines focus solely on the induction of cell-mediated immunity. The vaccines expressed a common immunogen, HIVA, which consists of consensus HIV-1 clade A Gag p24/p17 proteins fused to a string of clade A-derived epitopes recognized by cytotoxic T lymphocytes (CTLs). Volunteers' fresh peripheral blood mononuclear cells were tested for HIV-specific responses in a validated gamma interferon enzyme-linked immunospot (ELISPOT) assay using four overlapping peptide pools across the Gag domain and three pools of known CTL epitopes present in all of the HIVA protein. Both the DNA and the MVA vaccines alone and in a DNA prime–MVA boost combination were safe and induced HIV-specific responses in 14 out of 18, seven out of eight and eight out of nine volunteers, respectively. These results are very encouraging and justify further vaccine development.

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.

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.

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.