Search

This study analyzes the comparative economic outcomes of the U.S. Department of Defense (DoD) Small Business Innovation Research and Small Business Technology Transfer (SBIR/ STTR) programs, conducting an analysis to determine if high-award states or low-award states are more effective at commercializing technology as a direct result of the DoD SBIR/STTR programs. Three common definitions of underserved states are used for this analysis — states that receive fewer awards (underserved), states that receive relatively fewer awards when adjusted for population, and states participating in the National Science Foundation's Established Program to Stimulate Competitive Research. The data used in these analyses represent the economic outcomes of the entire survey population of DoD SBIR Phase II awards on which information was obtained (a total of 96 percent of the 16,959 awards in the study). The findings indicate that commercialization success of DoD SBIR Phase II projects in underserved states was superior to those in high-award states. Sixty different measures were used to compare the relative success of these different states and awardees. Analysis showed that underserved states consistently outperformed high-award states in commercializing the outcomes of their DoD SBIR Phase II projects. For 47 of the 60 different measures — 30 of which were statistically significant for low-award states — the low-award states outperformed the high-award states. On only 10 of the 60 measures did the high-award states show superior results. These results support the argument that SBIR program efforts to assist firms in low-award states are a sound investment. However, the findings call for additional research as to why states with fewer awards, fewer awards per capita, and other disadvantages have more commercial success with their awards than select counterparts.

To assess efficacy, safety, pharmacokinetics, and immunogenicity of pegloticase plus methotrexate (MTX) versus pegloticase plus placebo cotreatment for uncontrolled gout in a randomized, placebo-controlled, double-blind trial.This study included adults with uncontrolled gout, defined as serum urate ≥7 mg/dl, oral urate-lowering therapy failure or intolerance, and presence of ongoing gout symptoms including ≥1 tophus, ≥2 flares in the past 12 months, or gouty arthritis. Key exclusion criteria included MTX contraindication, current immunosuppressant use, G6PDH deficiency, and estimated glomerular filtration rate40 ml/minute/1.73 mA total of 152 patients were randomized, 100 to receive pegloticase plus MTX, 52 to receive pegloticase plus placebo. Significantly higher treatment response occurred during month 6 in the MTX group versus the placebo group (71.0% [71 of 100 patients] versus 38.5% [20 of 52 patients], respectively; between-group difference 32.3% [95% confidence interval 16.3%, 48.3%]) (P 0.0001 for between-group difference). During the first 6 months of pegloticase plus MTX or pegloticase plus placebo treatment, 78 (81.3%) of 96 MTX patients versus 47 (95.9%) of 49 placebo patients experienced ≥1 adverse event (AE), most commonly gout flare (64 [66.7%] of 96 MTX patients and 34 [69.4%] of 49 placebo patients). Reports of AEs and serious AEs were comparable between groups, but the infusion reaction rate was considerably lower with MTX cotherapy (4.2% [4 of 96 MTX patients, including 1 patient who had anaphylaxis]) than with placebo cotherapy (30.6% [15 of 49 placebo patients, 0 who had anaphylaxis]) (P 0.001). Antidrug antibody positivity was also lower in the MTX group.MTX cotherapy markedly increased pegloticase response rate over placebo (71.0% versus 38.5%) during month 6 with no new safety signals. These findings verify higher treatment response rate, lower infusion reaction incidence, and lower immunogenicity when pegloticase is coadministered with MTX.

This study's goal was to determine if appropriately designed, completely virtual formats of language courses are able to engender in students speaking ability progress comparable to that fostered within traditional face-to-face (F2F) classrooms. The study further sought to clarify language learners' perceptions of online Japanese courses. The speaking ability of all participants was assessed at the beginning and end of their Japanese language course. A mixed-design analysis of variance was conducted to analyze the effect of course type on speaking ability. Results showed that participant speaking ability improved significantly over time regardless of course type (online or F2F). This study also revealed that the majority of participants were able to use online tools with ease and found the online format to be an effective method of learning Japanese. Two principal reasons for studying Japanese online are reported. Implications and suggestions are discussed.

Focused Clinical Question: What are the immediate effects of instrumented-assisted soft tissue mobilization (IASTM) application on measures of lower extremity range of motion, muscular power, and strength in physically active adults not currently suffering from a musculoskeletal injury? Clinical Bottom Line: Grade 1 evidence supports immediate improvements in lower extremity range of motion in physically active adults after IASTM application. However, the evidence is lacking to support IASTM to improve muscular power and strength. Therefore, additional research is warranted to determine the acute effects of IASTM use on muscular power and strength in healthy, physically active adults.

Background/Objective Pegloticase is used for treatment of refractory gout, which has failed maximal medical management, but only 42% of patients respond completely to treatment because of the presumed development of antidrug antibodies, which rapidly clear the pegloticase molecule. Immunomodulatory medications temper antidrug antibody development in other diseases. The aim of this case series was to investigate the utility of adding methotrexate to a pegloticase regimen to increase the response durability in a real-world practice setting. Methods In this multicenter, proof-of-concept, observational case series, refractory tophaceous gouty arthropathy patients being started on pegloticase 8 mg every 2 weeks were identified. The patients began oral methotrexate 15 mg/wk and folic acid 1 mg/d, 1 month prior to the initial pegloticase administration, and continued throughout pegloticase treatment. Responders were defined by demonstrating ≥80% of preinfusion serum uric acid (sUA) levels

Purpose of Review Gout is a systemic disease from which some patients develop numerous painful tophi that adversely affect quality of life and functionality. Some patients treated with oral urate-lowering therapy are unable to maintain serum urate levels below 6 mg/dL, and these patients, thus classified as having refractory or uncontrolled gout, often require therapy with pegloticase to reduce symptoms and tophaceous burden. The objective of this expert opinion review is to summarize the available evidence supporting the use of concomitant immunomodulators with pegloticase to prevent development of anti-drug antibodies (ADAs) when treating patients with uncontrolled gout. Recent Findings Emerging evidence suggests that adding an immunomodulator to pegloticase therapy can substantially increase response rates to double those observed in phase 3 randomized controlled trials. Summary The combination of immunomodulation with pegloticase should be considered in routine clinical practice to improve durability of response, efficacy, and safety among patients with uncontrolled gout who otherwise have limited therapeutic options.

Background: Publications suggest immunomodulation co-therapy improves responder rates in uncontrolled/refractory gout patients undergoing pegloticase treatment. The MIRROR open-label trial showed a 6-month pegloticase+methotrexate co-therapy responder rate of 79%, compared to an established 42% pegloticase monotherapy responder rate. Longer-term efficacy/safety data are presented here.Methods: Uncontrolled gout patients (serum urate [SU]≥6 mg/dL and SU≥6 mg/dL despite urate-lowering therapy [ULT], ULT intolerance, or functionally-limiting tophi) were included. Patients with immunocompromised status, G6PD deficiency, severe kidney disease, or methotrexate contraindication were excluded. Oral methotrexate (15 mg/week) and folic acid (1 mg/day) were administered 4-weeks before and during pegloticase therapy. Twelve-month responder rate (SUResults: Fourteen patients were included (all male, 49.3 ± 8.7 years, 13.8 ± 7.4 year gout history, pre-therapy SU: 9.2 ± 2.5 mg/dL). Three patients were non-responders and discontinued study treatment before 24-weeks, one patient exited the study per-protocol at 24-weeks (enrolled prior to treatment extension amendment), and 10 remained in study through Week 52. Of the 10, 8 completed 52-weeks of pegloticase+methotrexate and were 12-month responders. The remaining two discontinued pegloticase+methotrexate at Week 24 (met treatment goals) and stayed in study under observation (allopurinol prescribed at physicians’ discretion); one remained a responder at 12-months. At 52-weeks, change from baseline in SU was -8.2 ± 4.1 mg/dL (SU: 1.1 ± 2.4 mg/dL, n=10). Gout flares were common early in treatment but progressively decreased while on therapy (Weeks 1-12: 13/14 [92.9%], Weeks 36-52: 2/8 [25.0%]). One patient recovered from sepsis (serious AE). Two non-responders developed high ADA titres; fewer patients had trough concentrations (Cmin) below quantitation limit (BQL) and median Cmin was higher (1.03 mg/mL vs. BQL) than in pegloticase monotherapy trials.Conclusions: Methotrexate+pegloticase co-therapy was well-tolerated over 12-months, with sustained SU lowering, progressive gout flare reduction, and no new safety concerns. Antibody/PK findings suggest methotrexate attenuates ADA formation, coincident with higher treatment response rates.Trial registration: ClinicalTrials.gov: NCT03635957, registered 17 August 2018, https://clinicaltrials.gov/ct2/show/NCT03635957

Although previous studies have indicated that supervisory status positively impacts job satisfaction, studies comparing supervisors with non-supervisors in different work contexts are limited. The current global comparative study examines the balance between work and home life, motivational rewards, and worker interactions to determine their impact on job satisfaction based on supervisory status. The study analyzes job satisfaction factors across 37 nations using International Social Survey Program data. The current research was based on a job satisfaction model based on evidence from theory and research. A range of descriptive analytics and regression analyses based on the model were conducted. Findings confirm a statistically significant difference in reported levels of job satisfaction for supervisors versus non-supervisors. Additionally, job autonomy, a job useful to society, and scheduling flexibility were not statistically significant for supervisors but non-supervisors. The overall model fit was slightly better for supervisors than non-supervisors. Given that supervisors have greater job satisfaction than non-supervisors, the former may overestimate job satisfaction among their workers. This could be an issue if supervisors assume that their employees are as satisfied as they are. Awareness of differences in job satisfaction based on supervisory status, then, is critical for help managers support their workers. In terms of the question of whether supervisors and non-supervisory differ in their satisfaction levels and the determinants of their satisfaction, this study supports that conclusion. This suggests that the benefits of taking on a supervisory role outweigh the additional demands. And while we did find variables that affect non-supervisors that don’t affect supervisors, most variables were important to both. This suggests that things that contribute to job satisfaction will impact employees regardless of whether they are in a supervisory position.

ObjectiveTo examine the efficacy and safety of pegloticase in combination with methotrexate (MTX) in patients with uncontrolled gout in an exploratory, open-label clinical trial (ClinicalTrials.gov: NCT03635957) prior to a randomized, controlled trial.MethodsA multicenter, open-label efficacy and safety study of pegloticase with MTX co-treatment was conducted in patients with uncontrolled gout. Patients were administered oral MTX (15 mg/week) and folic acid (1 mg/day) 4 weeks prior to and throughout pegloticase treatment. The primary study outcome was the proportion of responders, defined as serum uric acid (sUA) < 6 mg/dL for ≥ 80% of the time during Month 6 (Weeks 20, 22, and 24). All analyses were performed on a modified intent-to-treat population, defined as patients who received ≥ 1 pegloticase infusion.ResultsSeventeen patients were screened and 14 patients (all men, average age 49.3 ± 8.7 years) were enrolled. On Day 1, mean sUA was 9.2 ± 2.5 mg/dL, and 12 of the 14 patients had visible tophi. At the 6-month timepoint, 11/14 (78.6%, 95% CI 49.2–95.3%) met the responder definition, with 3 patients discontinuing after meeting protocol-defined treatment discontinuation rules (preinfusion sUA values > 6 mg/dL at 2 consecutive scheduled visits). All patients tolerated MTX. No new safety concerns were identified.ConclusionIn this study, an increased proportion of patients maintained therapeutic response at 6 months when treated concomitantly with MTX and pegloticase as compared to the previously reported 42% using pegloticase alone. These results support the need for a randomized study of MTX or placebo with pegloticase to validate these open-label findings.

Background Pegloticase is a recombinant DNA-produced porcine-like uricase enzyme, which metabolizes relatively insoluble urate to highly soluble allantoin. It is used in the treatment of refractory gout which has failed maximal medical management, typically with xanthine oxidase inhibitors (XOI). Studies have shown a complete responder rate of 42% when defined as repeat serum uric acid (sUA) levels 80% of the time during months 3 and 6 of treatment. Patients that do not maintain a low uric acid while on pegloticase therapy are presumed to have developed anti-drug antibodies (ADA) which rapidly clear the pegloticase molecule. As is routinely utilized in the treatment of other rheumatologic diseases, coadministration of immunomodulatory medications, such as methotrexate, could potentially temper the development of these ADAs (as defined by maintenance of sUA response) in patients treated with pegloticase for refractory gouty arthropathy. Objectives The aim of the current case series was to identify and clinically evaluate patients in a real-world practice setting in order to investigate the utility of adding methotrexate to a pegloticase regimen to increase the durability of response. Methods In this prospective, proof-of-concept, observational case series, 10 sequential patients with refractory tophaceous gouty arthropathy being started on treatment with pegloticase 8 mg every two weeks (as per the label) were identified from 3 separate infusion centers. No inclusion/exclusion criteria were implemented or prescreening performed. Methotrexate (MTX) 15 mg orally once weekly and folic acid 1 mg orally once daily was started one month prior to the initial administration of pegloticase and continued throughout pegloticase treatment. Any infusion pre-medications, which were consistent with standard practices, were administered per the individual physician’s discretion as well as management of any gout flares which occurred during the treatment course. As per standard of care, sUA was measured every two weeks, prior to each subsequent infusion. At the completion of pegloticase treatment for all patients, the number and percentage of patients able to maintain an sUA at goal Results Ten patients ranging in age from 35-80 were identified, from 3 separate infusion centers. There were 143 total pegloticase infusions performed within the observation period. All 10 patients received at least 10 infusions (5 months), 9 patients at least 12 infusions (6 months), 5 patients at least 16 infusions (8 months), 2 patients at least 18 infusions (9 months), and 1 patient received 19 infusions. All 10 patients completed a full course of pegloticase treatment. All patients stayed on MTX 15 mg/week. There were no dose adjustments. 100% of patients were responders as defined by >80% of sUA levels being maintained at goal Conclusion In this proof-of-concept case series of 10 sequential patients, pretreatment and co-administration of methotrexate 15 mg orally once weekly and folic acid 1 mg orally once daily with pegloticase resulted in a 100% maintenance of pegloticase sUA response with no infusion reactions. Although additional studies would be needed to corroborate these results, these data support a potential paradigm shift in treatment of refractory gout with pegloticase. Reference [1] Sundy JS, et al. JAMA. 2011;306:711 Acknowledgement Research sponsored by the Alaska Rheumatology Alliance. Disclosure of Interests John Botson Shareholder of: Publicly traded stock: Horizon, Johnson and Johnson, Pfizer, Rigel, Consultant for: Celgene, Eli Lilly, Genentech, Horizon, Mallinckrodt, Novartis, Pfizer, Speakers bureau: Celgene, Eli Lilly, Horizon, Mallinckrodt, Novartis, Pfizer, Jeff Peterson Consultant for: Celgene, Genentech, Horizon, Lilly, Novartis, Regeneron (2017-2018), Speakers bureau: Abbvie, Horizon, Lilly, Novartis (2017-2018)

Background:Gout development follows persistent serum uric acid (sUA) elevation. Patients who are refractory to or cannot tolerate oral urate lowering therapies (ULTs) have limited treatment options. Pegloticase is effective in treating refractory gout, but many patients develop anti-drug antibodies (ADAs), which are associated with loss of urate-lowering efficacy1-3 and infusion reactions (IRs).1,2 In phase 3 trials, the pooled pegloticase responder rate during Months 3 and 6 combined was 42% (8 mg infusion every 2 weeks), with high-titer ADA positive patients losing efficacy prior to 6 months.1 The 6-month results from the MIRROR open-label trial (79% response rate [11/14], 95%CI 49-95%)4 suggest that methotrexate (MTX) administered in conjunction with pegloticase increases treatment responder rate.Objectives:To examine longer-term (12-month) exploratory endpoints from the MIRROR open-label trial, including joint, overall health, and gout global assessments. Serial dual-energy computed tomography (DECT) images were also examined when available.Methods:Adult patients with uncontrolled gout (sUA ≥6 mg/dL with ≥1 of the following: sUA ≥6 mg/dL despite ULT use, intolerance to ULT, or functionally limiting tophaceous deposits) were included. Patients with immunocompromised status, G6PD deficiency, severe renal impairment, or MTX contraindication were excluded. Patients were administered oral MTX (15 mg/week) and folic acid (1 mg/day) 4 weeks prior to and throughout pegloticase therapy (8 mg biweekly infusion for up to 52 weeks). Exploratory outcomes included mean change from baseline (CFB) in number of affected joints (tophi, swollen, tender), Health Assessment Questionnaire (HAQ) scores (Disability Index [DI; score 0−3], Pain [score 0−100], Health [score 0−100]), and Gout Global Assessments (Patient, Physician; score 0−10). A decrease in these measures reflects clinical/patient-reported health improvement. Change in urate deposition volume, as measured on DECT imaging, was also examined as available. Analyses were performed on the modified intent-to-treat (mITT) population (≥1 pegloticase infusion received).Results:14 patients (all male, mean±SD age: 49.3±8.7 years) made up the mITT population. Mean±SD sUA prior to pegloticase treatment was 9.2±2.5 mg/dL and 13 patients had visible tophi. 3 patients discontinued due to 2 consecutive sUA levels >6 mg/dL and 1 patient completed the study at week 24 (pre-protocol amendment extending treatment from 24 to 52 weeks). 10 patients completed the 52-week study. Of these, 8 patients received 26 infusions and 2 patients received 12 infusions, discontinued pegloticase after meeting their treatment goal at 24 weeks, and started allopurinol while remaining in study under observation. At week 52 (n=10, sUA=1.1±2.5 mg/dL), the number of affected joints improved, along with HAQ measures (Figure 1). Global Assessments of Gout also improved (Physician: CFB=-5.7±2.6, Patient CFB=-4.6±2.1) and majority of subjects had a score of 0 or 1 (0=“excellent health”) at week 52 (Physician: 0.3±0.5, Patient: 1.1±1.3). Two patients had available DECT imaging. One received pegloticase/methotrexate co-therapy thru week 52 and had a marked reduction in total urate volume (baseline: 128.76 cm3, week 52: 1.33 cm3). The other received only 5 pegloticase infusions, but also showed total urate volume reduction (baseline: 59.20 cm3, week 10: 25.07 cm3). Both patients displayed improvement in bone erosion healing.Conclusion:These 12-month exploratory endpoints of the MIRROR open-label trial suggest that MTX/pegloticase co-therapy results in meaningful changes in clinical evaluations (tophaceous, tender, and swollen joint counts), and patient-reported outcomes (pain, disability) in patients with uncontrolled gout.References:[1]Sundy JS et al. JAMA 2011;306:711-20[2]Baraf HS et al. J Clin Rheumatol 2014;20:427-32[3]Lipsky PE et al. Arthritis Res Ther 2014, 16:R60[4]Botson JK et al. J Rheum 2020 [Epub ahead of print]Disclosure of Interests:John Botson Speakers bureau: Horizon Therapeutics, Celgene, Novartis, and AbbVie, Consultant of: Horizon Therapeutics, Celgene, Novartis, and AbbVie, Grant/research support from: Horizon Therapeutics and Radius Health, Paul M. Peloso Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Katie Obermeyer Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Brian LaMoreaux Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Lin Zhao Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Michael E. Weinblatt Shareholder of: Lycera, Can-Fite BioPharma, Scipher Medicine, Inmedix, and Vorso, Consultant of: Bristol Myers Squibb, Corona, Lilly, AbbVie, Amgen, Arena, GlaxoSmithKline, Gilead Sciences, Horizon Therapeutics, Lycera, Novartis, Pfizer, Roche, Samsung, Scipher Medicine, and Set Point, Grant/research support from: Amgen, Bristol-Myers Squibb, Crescendo Bioscience, Lilly and Sanofi, Jeff Peterson Speakers bureau: Horizon Therapeutics plc, Grant/research support from: Horizon Therapeutics plc.

Background:Gout is a painful inflammatory arthritis caused by persistently elevated serum uric acid (sUA) levels. Pegloticase, an infused recombinant PEGylated uricase, rapidly lowers sUA levels by converting uric acid to allantoin, a water-soluble molecule that is readily excreted by the kidneys. In the phase 3 clinical trials, 42% of patients1dosed with pegloticase every two weeks maintained sUA levels below 6.0 mg/dL during months 3 and 6 of pegloticase treatment. The loss of pegloticase efficacy has been attributed to the development of anti-drug antibodies (ADAs)1-3and these ADAs have been associated with infusion reactions (IRs).1,2Case reports4and prospective case series5, 6indicate that methotrexate (MTX) may allow patients to attain more complete therapeutic benefits, presumably through attenuation of pegloticase immunogenicity. The current study prospectively examines the efficacy and safety of MTX-pegloticase co-therapy in patients with uncontrolled gout.Objectives:To assess efficacy and safety of concomitant pegloticase and MTX therapy in patients with uncontrolled gout.Methods:Adult patients with uncontrolled gout who were beginning pegloticase therapy were considered for enrollment in this ongoing multicenter, open-label, efficacy and safety study of pegloticase with MTX co-treatment (NCT03635957). Patients were administered oral MTX (15 mg/week) and folate (1 mg/day) 4 weeks prior to the first pegloticase infusion (Day 1) and throughout the pegloticase treatment period. Blood was drawn prior to each infusion to measure sUA level, monitor clinical parameters, and examine for ADA development. All patients followed typical IR prophylaxis protocols (fexofenadine one day before and the morning of each infusion and acetaminophen and IV corticosteroid the morning of each infusion). Patients also received gout flare prophylaxis with either NSAIDs, colchicine or prednisone initiated at least 1 week prior to Day 1. The primary study outcome was the proportion of responders, defined as sUA Results:A total of 17 patients were screened and 14 patients (all men, average age: 49.3 ± 8.7 years) were enrolled. On Day 1, mean sUA was 9.2 ± 2.5 mg/dL and 12 of the 14 patients had visible tophi. At the 6 months timepoint, 11/14 (78.6%, 95%CI 49.2-95.3%) met the responder definition, with 3 patients discontinuing after meeting stopping rules (pre-infusion sUA values greater than 6 mg/dL at 2 consecutive scheduled visits). All patients tolerated MTX. One serious AE of bacterial sepsis occurred (resolved). AEs that occurred in >1 patient during the co-treatment period were: diarrhea and upper respiratory tract infection in 3 patients each, sinusitis, muscle strain, and hypertension in 2 patients each. Gout flares occurred in 12/14 (85.7%) patients. No new safety concerns were identified.Conclusion:An increased proportion of patients maintained therapeutic response at 6 months when treated concomitantly with MTX and pegloticase (78.6%) when compared to the previously reported 42% using pegloticase alone.1These results support and reflect the improved response rates demonstrated in two prior case series.5,6A definitive randomized double-blinded trial evaluating pegloticase with MTX vs. pegloticase with placebo is ongoing.References:[1]Sundy JS et al.JAMA2011;306:711-20.[2]Baraf HS et al.J Clin Rheumatol2014;20:427-32.[3]Lipsky PE et al.Arthritis Res Ther2014;16:R60.[4]Bessen SY et al.Semin Arthritis Rheum2019;49:56-61.[5]Botson J, Peterson J.Ann Rheum Dis2019;78:A1289.[6]Albert JA et al.Arthritis & Rheumatology2019;71(S10):A1236.Disclosure of Interests: :John Botson Grant/research support from: Horizon Therapeutics (PI and study site), Radius Health (study site), Consultant of: Horizon Therapeutics, Speakers bureau: Celgene, Eli Lilly, Horizon Therapeutics, Mallinckrodt, Novartis, Pfizer, Paul M. Peloso Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Katie Obermeyer Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Michael E. Weinblatt Grant/research support from: BMS, Amgen, Lilly, Crescendo and Sonofi-Regeneron, Consultant of: Horizon Therapeutics, Bristol-Myers Squibb, Amgen, Abbvie, Crescendo, Lilly, Pfizer, Roche, Gilead, Jeff Peterson Grant/research support from: Abbvie, UCB, Smith Klein, Horizon Therapeutics, Consultant of: Lilly, Norvartis, Horizon Therapeutics, Speakers bureau: Lilly, Novartis, Horizon Therapeutics, Abbvie, Genentech

Recent research has demonstrated that learners of Japanese struggle producing correct Japanese pitch accent. The goal of the present study was to investigate the effect learners’ first language (L1) may have on accent acquisition following the introduction and use of a digital Japanese Pitch Accent Learning and Practice (PALP) program in two Japanese courses. The PALP program visually and aurally presents learners with pitch patterns and requires learners to select the correct pitch accent pattern for new vocabulary. Participants’ pitch accent abilities were assessed at the beginning and end of their courses. A mixed design ANOVA was conducted to analyze the effect of learners’ L1 on pitch accent acquisition. Results evince a significant interaction effect between participant group (treatment/control) and L1 (Chinese/English), F(1, 24) = 10.09, p < .01 (η2 = .30). Specifically, English L1 participants in the treatment group considerably outperformed the control group English L1 participants. However, the Chinese L1 participants in both groups performed at approximately equal levels. These results suggest the existence of an L1 influence on pitch accent acquisition.

This article will review the use of temporary hospitals to augment the healthcare system as one solution for dealing with a surge of patients related to war, pandemic disease outbreaks, or natural disaster. The experiences highlighted in this article are those of North Carolina (NC) over the past 150 years, with a special focus on the need following the September 11, 2001 (9/11) attacks. It will also discuss the development of a temporary hospital system from concept to deployment, highlight recent developments, emphasize the need to learn from past experiences, and offer potential solutions for assuring program sustainability. Historically, when a particular situation called for a temporary hospital, one was created, but it was usually specific for the event and then dismantled. As with the case with many historical events, the details of the 9/11 attacks will fade into memory, and there is a concern that the impetus which created the current temporary hospital program may fade, as well. By developing a broader and more comprehensive approach to disaster responses through all-hazards preparedness, it is reasonable to learn from these past experiences, improve the understanding of current threats, and develop a long-term strategy to sustain these resources for future disaster medical needs.

Objectives The objective of this study was to identify Latina youths' perceptions of local assets and concerns related to children's environmental health (EH) in an agricultural community. Design and Sample Four photovoice sessions were used to elicit 6 promotores' and 5 middle school students' perspectives on problems and strengths related to “children; environment; and health.” Measures Data collection was diverse and included a demographic and evaluation questionnaire, photographs, audio recordings of group photo-sharing sessions, and field notes. Results Participants identified three themes that reflected group discussion during two photo-sharing sessions: a lack of structured youth activities; poverty and stress; and benefits and detriments of agricultural work. Community assets related to creating a healthy environment for youth were identified and included the clinic, churches, and youth programs. Conclusions Findings from this study reinforce that social background and position affect how EH issues are defined and may be addressed. Participant perspectives are valuable to nurses because they offer a lens through which to see the complexities of EH from the viewpoint of those most directly affected. Leadership training and opportunities to serve on coalitions and neighborhood councils are recommended approaches to meaningfully involving youth in environmental justice initiatives.

Much of the early literature on branding takes a primarily cognitive approach to brand management. Recently though, emotional research has been incorporated into branding studies. Fusing these two streams of thought, contemporary inquiry suggests that effective branding results from the creation of both a cognitive and an emotive bond (that is, a dual-process approach) between the brand and the consumer. As such, we investigate, across three studies, the relationship between cognitively driven perceived needs and affective responses on brand attitude and purchase intentions. Specifically, for Study 1, we explore the effects of need for achievement and positive affect on iPhone brand attitude and purchase intent. Study 2 tests a similar model in a computer operating system context. Study 3 extends this model by incorporating need for cognition as an antecedent of brand attitude and purchase intent for Android-based phones. The data support the posited models, while revealing that for both Studies 2 and 3, brand attitude serves as a mediator between need for achievement and purchase intent. Implications for brand management and directions for future research are offered.

What if an aircraft part could tell you when it needs to be repaired or replaced? With continuous data collection, monitoring and application of advanced analytics, it can. Predictive maintenance in aviation offers the promise of increased reliability along with bolstered operational and supply chain efficiencies. The integration of Cloud-based analytics with industrial machinery has driven the advent of a new “Industrial Internet”—and with it, opportunities for huge productivity gains. Industrial machines equipped with a growing number of electronic sensors can see, hear and feel a lot more than ever before—and deliver enormous amounts of data to be analyzed. Sophisticated algorithms then provide insights that allow us to operate machines—fleets of engines, airplanes, and network entire systems like airlines and airports—in entirely new, more efficient ways. To realize the value in predictive maintenance and achieve business outcomes that matter, machines, data, insights and people need to be brought together.

Summary This paper describes the application of a genetic algorithm to the development of a solvent-additive SAGD process. A review of related field projects and key simulation studies is provided, together with a discussion of the pros and cons of potential alkane solvents. Economics and the impact of dynamic and ultimate retention are discussed. A general conclusion drawn from literature is that optimal solvent application to SAGD will likely involve time variations in both rate and composition of the solvent. This results in an optimization problem that has a large number of dimensions, and is nonlinear. We have found genetic algorithms, which mimic biological evolution, have been found to be extremely effective in addressing such problems. The general methodology of application to solvent additives by Laricina Energy Ltd. is described. A key product of this effort, optimized for a simple clastic reservoir, is presented. The genetic algorithm produced an operable process, which could be described as a new combination of preexisting concepts. The process offers material improvements in thermal bitumen supply costs, as well as recovery factor. Major reductions in the physical steam/oil ratio (SOR), (and therefore) capital intensity and carbon emissions, are indicated.

Summary The majority of steam assisted gravity drainage (SAGD) development to date has been concentrated in the McMurray formation in the Eastern Athabasca fairway. More recently operators have identified projects with considerable resources located in shoreface sands of the Grand Rapids formation in the Wabasca area. Laricina Energy's Germain thermal project in Grand Rapids has associated basal water underlying much of the reservoir. In this paper the authors show that SAGD can be configured to maximize bitumen recovery for such reservoirs, based on laboratory and new simulation studies. The result is a SAGD configuration where the producers are placed at the base of porosity, within the basal water zone.

The current article presents a systematic approach to theory pruning (defined here as hypothesis specification and study design intended to bound and reduce theory). First, we argue that research that limits theory is underrepresented in the organizational sciences, erring overwhelmingly on the side of confirmatory null hypothesis testing. Second, we propose criteria for determining comparability, deciding when it is appropriate to test theories or parts of theories against one another. Third, we suggest hypotheses or questions for testing competing theories. Finally, we revisit the spirit of ‘‘strong inference.’’ We present reductionist strategies appropriate for the organizational sciences, which extend beyond traditional approaches of ‘‘critical’’ comparisons between whole theories. We conclude with a discussion of strong inference in organizational science and how theory pruning can help in that pursuit.

Spurred by the acquisition of rival Pillsbury, the General Mills promotion marketing department developed a promotion competency model, a consistent identity that reflects the value of having an in-house promotional function aligned with the company's success factors. The most important of the model's nine competencies—and the trickiest to develop—is creativity. One of several development initiatives, the department's Good Idea program is built around service learning: Department members exercise their creative muscles by addressing the promotional and branding problems of nonprofit organizations. In this emerging form of corporate philanthropy, everybody is winning. © 2004 Wiley Periodicals, Inc.

The purpose of this work was to examine the creation and evolution of the North Carolina state medical response system (SMRS). During the past 30 years, states and local communities have developed a somewhat incongruent patchwork of medical disaster response systems. Several local or regional programs participated in the National Disaster Medical System; however, aside from the Disaster Medical Assistance Teams, most of these local resources lacked national standards and national direction. The September 11, 2001 terrorist attacks in Washington, DC and New York, and the anthrax-laced letters mailed to prominent individuals in the US media and others (bioterrorism) in the months that followed were tragic, but they served as both a tipping point and a unifying factor to drive preparedness activities on a national level. Each state responded to the September 11, 2001 attacks by escalating planning and preparedness efforts for a medical disaster response. The North Carolina SMRS was created based on the overall national direction and was tailored to meet local needs such as hurricane response. This article reviews the accomplishments to date and examines future aims. From regional medical response teams to specialty programs such as ambulance strike teams, burn surge planning, electronic inventory and tracking systems, and mobile pharmacy resources, the North Carolina SMRS has emerged as a national leader. Each regional coalition, working with state leadership, has developed resources and has used those resources while responding to disasters in North Carolina. The program is an example of how national leadership can work with state and local agencies to develop a comprehensive and effective medical disaster response system.

The Upper Devonian Grosmont Formation, located in the West Athabasca Oil Sands Deposit, contains an estimated 406 billion barrels of bitumen. The reservoir is a heavily karsted and fractured, bitumen-saturated carbonate. Initial thermal horizontal well development is currently underway in this resource. These horizontal wells have similar logistics, well construction and materials challenges to those in the McMurray Formation. Laricina has been actively developing the Grosmont Formation. Production from the pilot began in 2011 and many lessons have been learned. The next phase of development is a 10,700 bbl/day commercial project scheduled for first steam in 2014. The Grosmont, despite many drilling challenges such as severe lost circulation, also provides many opportunities not typically achievable in clastic oil sands developments. Carbonate rock is typically a good candidate for open-hole completions due to its geomechanical properties. This paper will discuss the geomechanical investigation evaluating borehole stability during drilling and completion, steam injection and production operations.

You've heard the direction, you've seen the papers, and you've read the publications. The Government of Canada's March 2008 "Turning The Corner - Taking Action to Fight Climate Change" report has set the foundation for CO2 regulations which "start tough and get tougher". The "Toughest" requirements are set for new oil sands plants and coal-fired power plants that come into operation in 2012, or later. The public and legal arena is also impacted by how oil sands carbon emissions are addressed. The Report on Business, March 6, 2008, reported; "a federal court judge … found the approval of Imperial Oil Ltd's $8 billion oil sands mine insufficient on climate change and green house gas emissions." The Conference Board of Canada Carbon Disclosure Project Report 2007 has also stated that "Alberta's GHG reduction legislation will add approximately $0.18/bbl in additional operating costs for a typical integrated oil-sands mining project, and $0.22/bbl for a steam-assisted gravity drainage project." These and other factors have changed the landscape for oil sands development. A review of the political, social, and regulatory pressures and obligations for the in situ oil sands industry to reduce its oil sands carbon foot print will be provided. This paper will discuss Laricina's insights and views on the carbon challenge, describe initiatives Laricina is taking to manage these imperatives and outline the challenges the overall industry is facing. The objective of this paper is to spur dialogue and collaboration by the oil sands industry in an effort to evolve and advance the knowledge and understanding of the impacts this important issue has on our business. This paper will also attempt to describe the dimensions of the carbon problem, point out the experience base our industry has to contribute to a solution, review the parameters to demonstrate CO2 or GHG's containment and storage, touch on the state of regulatory and policy issues, and try to scope out a progression to technical and economic success.

not Available.

not Available.

not Available.

not Available.