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Simple Summary: Undifferentiated pleomorphic sarcomas (UPSs) represent 10–20% of all soft tissue sarcomas (STSs) and have quickly emerged as one of the more immune-sensitive types. There are few real-world data on the use of immune checkpoint blockade (ICB) in UPS patients and those with other high-grade pleomorphic STSs. This is a retrospective, observational study of all patients with metastatic high-grade pleomorphic sarcomas treated with FDA-approved ICB at MD Anderson Cancer Center intended to describe the efficacy and toxicity of ICB in this particular group of patients. We find that our outcomes are comparable to those in the published literature and pose a question regarding the need to further evaluate the optimal sequencing of radiotherapy and prior lines of systemic therapy. Background: Undifferentiated pleomorphic sarcomas (UPSs) are amongst the most common subtypes of soft-tissue sarcomas. Few real-world data on the use of immune checkpoint blockade (ICB) in UPS patients and other high-grade pleomorphic STS patients are available. Purpose: The purpose of our study is to describe the efficacy and toxicity of ICB in patients with advanced UPSs and other high-grade pleomorphic sarcomas treated at our institution. Methods: This is a retrospective, observational study of all patients with metastatic high-grade pleomorphic sarcomas treated with FDA-approved ICB at MD Anderson Cancer Center between 1 January 2015 and 1 January 2023. Patients included in trials for which results are not yet published were excluded. Results: Thirty-six patients with advanced/metastatic pleomorphic sarcomas were included. The median age was 52 years. A total of 26 patients (72%) had UPSs and 10 patients (28%) had other high-grade pleomorphic sarcomas. The median follow-up time was 8.8 months. The median PFS was 2.9 months. The 3-month PFS and 6-month PFS were 46% and 32%, respectively. The median OS was 12.9 months. The 12-month OS and 24-month OS were 53% and 29%, respectively. The best response, previous RT, and type of ICB treatment were significantly and independently associated with shorter PFS (p = 0.0012, p = 0.0019 and p = 0.036, respectively). No new safety signal was identified, and the toxicity was overall manageable with no toxic deaths and only four patients (11%) stopping treatment due to toxicity. Conclusions: Real-world retrospective data are consistent with the published literature, with a promising 6-month PFS of 32%. Partial or stable responders to ICB treatment have significantly improved PFS compared to progressors. [ABSTRACT FROM AUTHOR]

Background: The COVID- 19 situation in Brazil is complex due to large differences in the shape and size of regional epidemics. Understanding these patterns is crucial to understand future outbreaks of SARS- CoV- 2 or other respiratory pathogens in the country. Methods: We tested 97,950 blood donation samples for IgG antibodies from March 2020 to March 2021 in 8 of Brazil's most populous cities. Residential postal codes were used to obtain representative samples. Weekly age- and sex- specific seroprevalence were estimated by correcting the crude seroprevalence by test sensitivity, specificity, and antibody waning. Results: The inferred attack rate of SARS- CoV- 2 in December 2020, before the Gamma variant of concern (VOC) was dominant, ranged from 19.3% (95% credible interval [CrI] 17.5--21.2%) in Curitiba to 75.0% (95% CrI 70.8--80.3%) in Manaus. Seroprevalence was consistently smaller in women and donors older than 55 years. The age- specific infection fatality rate (IFR) differed between cities and consistently increased with age. The infection hospitalisation rate increased significantly during the Gamma- dominated second wave in Manaus, suggesting increased morbidity of the Gamma VOC compared to previous variants circulating in Manaus. The higher disease penetrance associated with the health system's collapse increased the overall IFR by a minimum factor of 2.91 (95% CrI 2.43--3.53). Conclusions: These results highlight the utility of blood donor serosurveillance to track epidemic maturity and demonstrate demographic and spatial heterogeneity in SARS- CoV- 2 spread. Funding: This work was supported by Itaú Unibanco 'Todos pela Saude' program; FAPESP (grants 18/14389- 0, 2019/21585- 0); Wellcome Trust and Royal Society Sir Henry Dale Fellowship 204311/Z/16/Z; the Gates Foundation (INV- 034540 and INV- 034652); REDS- IV- P (grant HHSN268201100007I); the UK Medical Research Council (MR/S0195/1, MR/V038109/1); CAPES; CNPq (304714/2018- 6); Fundação Faculdade de Medicina; Programa Inova Fiocruz- CE/Funcap - Edital 01/2020 Number: FIO- 0167- 00065.01.00/20 SPU N°06531047/2020; JBS -- Fazer o bem faz bem. [ABSTRACT FROM AUTHOR]

Objectives: STM-001, a retargeted glycopeptide, is active against MDR E. coli expressing ESBLs including carbapenemases. Herein, we assessed its capability to combat E. coli complicated urinary tract infections (cUTI) in mice driven by clinically important serine (CTX-M-15) and metallo-β-lactamases (NDM-1).Methods: Plasma and urine pharmacokinetics following IV administration of STM-001 (1-50 mg/kg) were determined in mice via LC-MS/MS. The effects on bacterial burden (kidney, bladder and urine) were determined in a 7 day mouse cUTI model whereby STM-001 was administered q12h or q24h at 2-100 mg/kg/day from Day 4. Efficacy was assessed by the change in log10 cfu/g or log10 cfu/mL from vehicle-treated infected mice.Results: MICs of STM-001 for CTX-M-15 and NDM-1 E. coli were 8 and 16 mg/L, respectively. Blood pharmacokinetic profile was linear and dose-dependent with low clearance of 9.49 ± 0.31 mL/min/kg, V = 0.63 ± 0.02 L/kg and t½ = 1.16 ± 0.03 h. High STM-001 concentrations were recovered in urine 0-8 h post-administration, reaching up to 120-fold above its MIC. In cUTI efficacy studies, STM-001 (1-50 mg/kg, q12h) reduced CTX-M-15 burden by log10 4.31 (kidney), 3.95 (bladder) and 4.82 (urine) compared with vehicle-treated animals (P < 0.0001). STM-001 also reduced NDM-1 burden by log10 3.89 (kidney), 3.76 (bladder) and 3.08 (urine) (P < 0.0001), with similar inhibitory effects following q24h dosing.Conclusions: STM-001 was highly effective in reducing E. coli burden in kidney, bladder and urine in mouse cUTI models. The observed efficacy with either dosing regimen indicates potential low humanized doses of 1-5 mg/kg. These data support further development of STM-001 as an innovative, carbapenem-sparing antibiotic to combat human cUTIs. [ABSTRACT FROM AUTHOR]

Background: The city of Manaus, north Brazil, was stricken by a second epidemic wave of SARS-CoV-2 despite high seroprevalence estimates, coinciding with the emergence of the Gamma (P.1) variant. Reinfections were postulated as a partial explanation for the second surge. However, accurate calculation of reinfection rates is difficult when stringent criteria as two time-separated RT-PCR tests and/or genome sequencing are required. To estimate the proportion of reinfections caused by Gamma during the second wave in Manaus and the protection conferred by previous infection, we identified anti-SARS-CoV-2 antibody boosting in repeat blood donors as a mean to infer reinfection.Methods: We tested serial blood samples from unvaccinated repeat blood donors in Manaus for the presence of anti-SARS-CoV-2 IgG antibodies using two assays that display waning in early convalescence, enabling the detection of reinfection-induced boosting. Donors were required to have three or more donations, being at least one during each epidemic wave. We propose a strict serological definition of reinfection (reactivity boosting following waning like a V-shaped curve in both assays or three spaced boostings), probable (two separate boosting events) and possible (reinfection detected by only one assay) reinfections. The serial samples were used to divide donors into six groups defined based on the inferred sequence of infection and reinfection with non-Gamma and Gamma variants.Results: From 3655 repeat blood donors, 238 met all inclusion criteria, and 223 had enough residual sample volume to perform both serological assays. We found 13.6% (95% CI 7.0-24.5%) of all presumed Gamma infections that were observed in 2021 were reinfections. If we also include cases of probable or possible reinfections, these percentages increase respectively to 22.7% (95% CI 14.3-34.2%) and 39.3% (95% CI 29.5-50.0%). Previous infection conferred a protection against reinfection of 85.3% (95% CI 71.3-92.7%), decreasing to respectively 72.5% (95% CI 54.7-83.6%) and 39.5% (95% CI 14.1-57.8%) if probable and possible reinfections are included.Conclusions: Reinfection by Gamma is common and may play a significant role in epidemics where Gamma is prevalent, highlighting the continued threat variants of concern pose even to settings previously hit by substantial epidemics. [ABSTRACT FROM AUTHOR]

Background: There are few contemporary cohorts of Trypanosoma cruzi-seropositive individuals, and the basic clinical epidemiology of Chagas disease is poorly understood. Herein, we report the incidence of cardiomyopathy and death associated with T. cruzi seropositivity.Methods: Participants were selected in blood banks at 2 Brazilian centers. Cases were defined as T. cruzi-seropositive blood donors. T. cruzi-seronegative controls were matched for age, sex, and period of donation. Patients with established Chagas cardiomyopathy were recruited from a tertiary outpatient service. Participants underwent medical examination, blood collection, ECG, and echocardiogram at enrollment (2008-2010) and at follow-up (2018-2019). The primary outcomes were all-cause mortality and development of cardiomyopathy, defined as the presence of a left ventricular ejection fraction <50% or QRS complex duration ≥120 ms, or both. To handle loss to follow-up, a sensitivity analysis was performed using inverse probability weights for selection.Results: We enrolled 499 T. cruzi-seropositive donors (age 48±10 years, 52% male), 488 T. cruzi-seronegative donors (age 49±10 years, 49% male), and 101 patients with established Chagas cardiomyopathy (age 48±8 years, 59% male). The mortality in patients with established cardiomyopathy was 80.9 deaths/1000 person-years (py) (54/101, 53%) and 15.1 deaths/1000 py (17/114, 15%) in T. cruzi-seropositive donors with cardiomyopathy at baseline. Among T. cruzi-seropositive donors without cardiomyopathy at baseline, mortality was 3.7 events/1000 py (15/385, 4%), which was no different from T. cruzi-seronegative donors with 3.6 deaths/1000 py (17/488, 3%). The incidence of cardiomyopathy in T. cruzi-seropositive donors was 13.8 (95% CI, 9.5-19.6) events/1000 py (32/262, 12%) compared with 4.6 (95% CI, 2.3-8.3) events/1000 py (11/277, 4%) in seronegative controls, with an absolute incidence difference associated with T. cruzi seropositivity of 9.2 (95% CI, 3.6-15.0) events/1000 py. T. cruzi antibody level at baseline was associated with development of cardiomyopathy (adjusted odds ratio, 1.4 [95% CI, 1.1-1.8]).Conclusions: We present a comprehensive description of the natural history of T. cruzi seropositivity in a contemporary patient population. The results highlight the central importance of anti-T. cruzi antibody titer as a marker of Chagas disease activity and risk of progression. [ABSTRACT FROM AUTHOR]

Summary: Intermittent inflammation of the vulval pilosebaceous units is common and usually self‐limiting, but some patients experience recurrent and more troublesome symptoms. There is a scarcity of information on this problem. We describe the clinical and histological features in these patients and the response to treatment. A retrospective, observational study of 16 patients with this phenomenon of recurrent, protracted folliculocentric inflammation of the vulval pilosebaceous unit was performed. Details on the clinical features, histology and response to treatment were collected. Mean age at presentation was 32 years (range 21–45). All patients reported recurrent painful papules and pustules on the labia majora and labia minora. Nine patients reported a cyclical pattern to the development of lesions, with premenstrual exacerbation being most common. Histological examination of these lesions showed a folliculocentric microabscess formation surrounded by an acute and chronic inflammatory cell infiltrate, with a focal foreign‐body granulomatous reaction. All our patients responded well to tetracycline, antiandrogenic or retinoid therapy. We propose the term 'vulval acne' for this condition and propose a stepwise approach to its management. We hope to highlight this as a common but underreported entity. [ABSTRACT FROM AUTHOR]

After initially containing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many European and Asian countries had a resurgence of COVID-19 consistent with a large proportion of the population remaining susceptible to the virus after the first epidemic wave.[1] By contrast, in Manaus, Brazil, a study of blood donors indicated that 76% (95% CI 67-98) of the population had been infected with SARS-CoV-2 by October, 2020.[2] High attack rates of SARS-CoV-2 were also estimated in population-based samples from other locations in the Amazon Basin - eg, Iquitos, Peru 70% (67-73).[3] The estimated SARS-CoV-2 attack rate in Manaus would be above the theoretical herd immunity threshold (67%), given a basic case reproduction number (R SB 0 sb ) of 3.[4] In this context, the abrupt increase in the number of COVID-19 hospital admissions in Manaus during January, 2021 (3431 in Jan 1-19, 2021, vs 552 in Dec 1-19, 2020) is unexpected and of concern (figure).[[5]] After a large epidemic that peaked in late April, 2020, COVID-19 hospitalisations in Manaus remained stable and fairly low for 7 months from May to November, despite the relaxation of COVID-19 control measures during that period (figure). However, most of the SARS-CoV-2 infections in Manaus occurred 7-8 months before the resurgence in January, 2021; this is longer than the period covered by the UK study,[13] but nonetheless suggests that waning immunity alone is unlikely to fully explain the recent resurgence. Graph: Figure COVID-19 hospitalisations, excess deaths, and Rt in Manaus, Brazil, 2020-21(A) Dark lines are the 7-day rolling averages and lighter lines are the daily time series of COVID-19 hospitalisations and excess deaths. [Extracted from the article]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly in Manaus, the capital of Amazonas state in northern Brazil. The attack rate there is an estimate of the final size of the largely unmitigated epidemic that occurred in Manaus. We use a convenience sample of blood donors to show that by June 2020, 1 month after the epidemic peak in Manaus, 44% of the population had detectable immunoglobulin G (IgG) antibodies. Correcting for cases without a detectable antibody response and for antibody waning, we estimate a 66% attack rate in June, rising to 76% in October. This is higher than in S‹o Paulo, in southeastern Brazil, where the estimated attack rate in October was 29%. These results confirm that when poorly controlled, COVID-19 can infect a large proportion of the population, causing high mortality. [ABSTRACT FROM AUTHOR]

Objective: To investigate factors associated with colposcopy attendance in HPV‐positive women in São Paulo, Brazil. Methods: We analyzed data from a prospective cohort of women positive for high‐risk HPV (hr‐HPV) undergoing cervical cancer screening in primary care services in São Paulo, Brazil. Non‐pregnant women attending routine screening between December 2014 and March 2016 were offered an hr‐HPV test, and those testing positive and aged 25 years or older were invited for colposcopy. Sociodemographic information was recorded at study enrollment. We compared variables between women who did and did not attend colposcopy within a logistic regression framework. Results: Of 1537 hr‐HPV‐positive women, 1235 (80.4%) attended for colposcopy, with a median time from primary test to colposcopy of 132 days. Younger age (P<0.001) and concurrent negative cytology results (P=0.025) were associated with lower attendance. Women registered at units providing both the primary test and colposcopy were more likely to attend than those at units making external referrals (788/862 [91.4%] versus 447/675 [66.2%], P<0.001). Conclusion: Non‐attendance for colposcopy may limit the success of future screening programs based on hr‐HPV testing in Brazil. Transfer of colposcopy services to primary care is a simple and effective facilitator of attendance. Colposcopy attendance was limited in a feasibility study of high‐risk HPV‐based cervical cancer screening in Sao Paulo, Brazil. Primary care‐based colposcopy facilitated access. [ABSTRACT FROM AUTHOR]

Background: Although infection with Trypanosoma cruzi is thought to be lifelong, less than half of those infected develop cardiomyopathy, suggesting greater parasite control or even clearance. Antibody levels appear to correlate with T. cruzi (antigen) load. We test the association between a downwards antibody trajectory, PCR positivity and ECG alterations in untreated individuals with Chagas disease. Methodology/Principal findings: This is a retrospective cohort of T. cruzi seropositive blood donors. Paired blood samples (index donation and follow-up) were tested using the VITROS Immunodiagnostic Products Anti-T.cruzi (Chagas) assay (Ortho Clinical Diagnostics, Raritan NJ) and PCR performed on the follow-up sample. A 12-lead resting ECG was performed. Significant antibody decline was defined as a reduction of > 1 signal-to-cutoff (S/CO) unit on the VITROS assay. Follow-up S/CO of < 4 was defined as borderline/low. 276 untreated seropositive blood donors were included. The median (IQR) follow-up was 12.7 years (8.5–16.9). 56 (22.1%) subjects had a significant antibody decline and 35 (12.7%) had a low/borderline follow-up result. PCR positivity was lower in the falling (26.8% vs 52.8%, p = 0.001) and low/borderline (17.1% vs 51.9%, p < 0.001) antibody groups, as was the rate of ECG abnormalities. Falling and low/borderline antibody groups were predominantly composed of individuals with negative PCR and normal ECG findings: 64% and 71%, respectively. Conclusions/Significance: Low and falling antibody levels define a phenotype of possible spontaneous parasite clearance. Author summary: Infection with the single-celled parasite Trypanosoma cruzi (Chagas disease) is thought to be lifelong. However, only a third of infected people develop Chagas cardiomyopathy–the main disease manifestation. This may reflect the different extent to which individuals control the parasite, with some potentially clearing it entirely. In chronically infected immunocompetent patients, a marker of parasite burden is the quantity of antibody against T. cruzi in the blood: more parasite, more immune stimulation, more antibody. In this study we show how antibody levels change over many years in a cohort of untreated patients with Chagas disease. We find that among individuals with falling or low/borderline antibody levels there was a lower rate of parasite detection in the blood and a lower rate of cardiomyopathy. 60% of subjects with falling antibody levels had no evidence of active disease, twice as many as among patients with other antibody trajectories (stable or rising). Our findings support an account of the natural history of Chagas disease in which a proportion of those infected achieve a greater control of the parasite, with some individuals potentially clearing it completely. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the efficacy of a postoperative steroid regimen in maintaining vulvovaginal architecture and vaginal patency following surgical adhesiolysis in severe erosive lichen planus (ELP) and genital graft versus host disease (GVHD). Sixteen women applied potent topical steroids to the vulva and vagina from 48 hours after surgery. Sexual and urinary function and vulvovaginal anatomy were assessed at 6 weeks, 6, 12 and 24 months. All of the patients had failed sexual function due to vaginal stenosis. Eleven patients were unable to have cervical smears and three had associated haematocolpos. Vaginal adhesiolysis achieving complete patency occurred in all patients with stenosis. Fifteen (93.7%) patients were compliant with the regimen. After two years, 12 (75%) patients had maintained complete vaginal patency. Four patients (25%) developed vaginal restenosis. This study demonstrates that the potent topical steroids used post-operatively are very effective in maintaining vaginal patency and function. Impact statement What is already known on this subject? Potent topical steroids are the first line treatment for ELP and GVHD and have been reported to be helpful after surgery to release adhesions. What do the results of this study add? Topical steroids used immediately after surgical adhesiolysis in patients with vulvo-vaginal lichen planus and graft-versus-host disease improves the outcomes and maintains function, which can give a prolonged benefit. What are the implications of these findings for clinical practice and/or further research? The use of potent topical steroids should be considered as routine practice after surgery in erosive inflammatory disease to control inflammation and improve the long term outcomes for these patients. [ABSTRACT FROM AUTHOR]

The article offers information on the 2018 guidelines for the management of lichen sclerosus published by the British Association of Dermatologists (BAD). The guidelines are prepared for the BAD Clinical Standards Unit and aims to provide up-to-date, evidence-based recommendations for the management of lichen sclerosus.

Highlights: [•] We evaluated test characteristics for the detection of bovine cysticercosis. [•] ELISA based on excretory/secretory antigen showed high sensitivity and specificity. [•] An estimate of the standard European Union meat inspection procedure is provided. [•] Results indicate a high contact rate of dairy cows with Taenia saginata. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The objective is to develop a low-risk, cost-effective method to teach procedures that require learning by feel and high-volume pattern recognition, starting with the midurethral sling. Methods: This video describes the creation of a virtual reality model utilizing de-identified patient data, artificial intelligence algorithms and haptics; and demonstrates the use of the training system for trocar passage of the retropubic midurethral sling procedure. Results: This innovative system overcomes the lack of visualization and "blind" nature of sling surgery. Novel artificial intelligence provides high accuracy of anatomical landmarks and a realistic 3D environment. The trainee benefits from haptic and visual alerts for real-time feedback on the trocar insertion pathway and scoring to develop competency. Conclusion: This is one of the first noncadaveric, nonstatic models available in the field. It allows for multiple low-risk exercises and provides more surgeons with training outside the operating room, at their own institution, and avoids the need for patient subjects. Training can be disseminated at a significantly lower cost and greater convenience than remote cadaver laboratories or intraoperative observation and has a higher fidelity than available static models, particularly after multiple passes. This has implications not only for retropubic midurethral slings but also for urogynecological and "blind" surgery as a whole. [ABSTRACT FROM AUTHOR]

Abstract: A rapid ELISA employing intact Pseudomonas aeruginosa (PA) is described that allows discrimination between strains harboring flagellin type a or b. All 52 PA strains known to harbor flagellin type b were positive in this ELISA when screened with a fully human monoclonal antibody (LST-007) targeting flagellin type b. Completion of this assay in only 6 h, from picking a single bacterial colony to a colorimetric product, could easily be adapted to a clinical laboratory setting and permit the appropriate choice of therapeutic monoclonal antibody versus its homologous flagellin target in PA-infected patients. [Copyright &y& Elsevier]

Approximate dynamic programming (ADP) is a class of reinforcement learning methods that have shown their importance in a variety of applications, including feedback control of dynamical systems. ADP generally requires full information about the system internal states, which is usually not available in practical situations. In this paper, we show how to implement ADP methods using only measured input/output data from the system. Linear dynamical systems with deterministic behavior are considered herein, which are systems of great interest in the control system community. In control system theory, these types of methods are referred to as output feedback (OPFB). The stochastic equivalent of the systems dealt with in this paper is a class of partially observable Markov decision processes. We develop both policy iteration and value iteration algorithms that converge to an optimal controller that requires only OPFB. It is shown that, similar to Q -learning, the new methods have the important advantage that knowledge of the system dynamics is not needed for the implementation of these learning algorithms or for the OPFB control. Only the order of the system, as well as an upper bound on its “observability index,” must be known. The learned OPFB controller is in the form of a polynomial autoregressive moving-average controller that has equivalent performance with the optimal state variable feedback gain. [ABSTRACT FROM AUTHOR]

Using a representative sample of Scottish sheep comprising 125 flocks, the sensitivity and specificity of PCR for Jaagsiekte sheep retrovirus (JSRV) was estimated. By combining and adapting existing methods, the characteristics of the diagnostic test were estimated (in the absence of a gold standard reference) using repeated laboratory replicates. As the results of replicates within the same animal cannot be considered to be independent, the performance of the PCR was calculated at individual replicate level. The median diagnostic specificity of the PCR when applied to individual animals drawn from the Scottish flock was estimated to be 0.997 (95% confidence interval [CI] 0.996-0.999), whereas the median sensitivity was 0.107 (95% CI 0.077-0.152). Considering the diagnostic test as three replicates where a positive result on any one or more replicates results in a positive test, the median sensitivity increased to 0.279. Reasons for the low observed sensitivity were explored by comparing the performance of the test as a function of the concentration of target DNA using spiked positive controls with known concentrations of target DNA. The median sensitivity of the test when used with positive samples with a mean concentration of 1.0 target DNA sequence per 25 µL was estimated to be 0.160, which suggests that the PCR had a high true (analytical) sensitivity and that the low observed (diagnostic) sensitivity in individual samples was due to low concentrations of target DNA in the blood of clinically healthy animals. [ABSTRACT FROM AUTHOR]

Bovine viral diarrhoea (BVD) is an endemic disease of cattle that causes substantial losses to both beef and dairy production worldwide. The goal of this study was to estimate the prevalence of active BVD virus (BVDV) infection in beef suckler herds in Scotland. Information was collected from 301 herds using a stratified random sampling design based on agricultural census data. Herds were classified as with and without active infection based on the within-herd BVDV seroprevalence in young stock using Bayesian finite mixture modelling. This method accounted for within- and between-herd variability and allowed for classification error by the diagnostic tests. The observed sample data enabled the discrimination of three distinct seroprevalence cohorts. The results provided evidence of active BVDV infection in 16% of herds and no evidence of recent exposure in approximately two thirds of herds. The epidemiological significance of the further 16% of herds containing young stock with a median BVDV seroprevalence of 26.3-38.5% remains unclear. The fact that a large percentage of herds did not show evidence of recent infection is encouraging from an animal health and welfare perspective and the study provides a model for the further exploration of strategies aimed at BVD control at national level. [ABSTRACT FROM AUTHOR]

The article presents the 2010 guideline from the British Association of Dermatologists (BAD), which aims to guide dermatologists on the management of lichen sclerosus skin disease among adults and children. It says that the content of the guideline was based from the 2002 edition and is supported by published randomized controlled trials. Furthermore, it adds that the guideline was written by dermatologists and can be revised if necessary changes in practice are required.

Three years of optical monitoring of the low-mass X-ray binary (LMXB) 4U 1957+11 is presented. The source was observed in V, R and i bands using the Faulkes Telescopes North and South. The light curve is dominated by long-term variations which are correlated (at the level) with the soft X-ray flux from the All Sky Monitor on board the Rossi X-ray Timing Explorer. The variations span 1 mag in all three filters. We find no evidence for periodicities in our light curves, contrary to a previous short-time-scale optical study in which the flux varied on a 9.3-h sinusoidal period by a smaller amplitude. The optical spectral energy distribution is blue and typical of LMXBs in outburst, as is the power-law index of the correlation , where . The discrete cross-correlation function reveals a peak at an X-ray lag of 2–14 days, which could be the viscous time-scale. However, adopting the least-squares method we find the strongest correlation at a lag of d, consistent with X-ray reprocessing on the surface of the disc. We therefore constrain the optical lag behind X-ray to be between −14 and +4 d. In addition, we use the optical–X-ray luminosity diagram for LMXBs as a diagnostic tool to constrain the nature of the compact object in 4U 1957+11, since black hole and neutron star sources reside in different regions of this diagram. It is found that if the system contains a black hole (as is the currently favoured hypothesis), its distance must exceed ∼20 kpc for the optical and X-ray luminosities to be consistent with other soft-state black hole systems. For distances <20 kpc, the data lie in a region of the diagram populated only by neutron star sources (black hole systems are 10 times optically brighter for this X-ray luminosity). 4U 1957+11 is unique: it is either the only black hole LMXB to exist in an apparent persistent soft state or a neutron star LMXB which behaves like a black hole. [ABSTRACT FROM AUTHOR]

This paper provides a novel method for job and resource dispatching for condition-based maintenance using free-choice Petri nets (PNs) and Dempster-Shafer (DS) evidence theory. In free-choice PNs (also called free-choice multi re-entrant flow-lines - FMRF), a choice exists for the tasks to be performed. Hence decisions have to be made in real time. In case of unreliable sensors in the system, there is uncertainty in decision making. This uncertainty is modelled in this paper using the DS theory of combination, which is used to decide which path to take in the event of choice decisions in the Petri net. The computations required in DS theory are difficult to perform because of the many required summations over set inclusions and intersections. Therefore, a new matrix formulation is given herein for efficiently combining evidence and finding belief, plausibility and other quantities in DS theory. This, coupled with a previously developed matrix formulation for PNs, makes it straightforward to implement the decision framework as a discrete event controller using computer software. Examples are given showing how to apply the matrix formulation for decision making in intelligent diagnostics. [ABSTRACT FROM AUTHOR]

This paper presents an approach for designing compensators of specified structure for shaping the closed-loop step response that uses H-Infinity output-feedback design techniques. This approach results in controllers that take advantage of the wealth of experience in aircraft control design. Simplified conditions are presented, which only require the solution of two coupled matrix design equations. A new numerically efficient algorithm to solve the H-Infinity disturbance attenuation is given. An F-16 normal acceleration design example is solved to illustrate the power of the proposed approach. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the functional outcomes of two groups of patients with traumatic brain injury (TBI) with attention to the impact of reduced length of stay (LOS) in the trauma center (TC) and rehabilitation hospital (RH). From 1991 to 1994, 55 patients. Group 1, with serious TBI (Abbreviated Injury Scale score ≥3) were admitted to a level 1 TC and subsequently transferred to a comprehensive inpatient RH. These results have been previously published. From 1996 to 2002,64 similarly injured patients. Group 2, received inpatient care at the same TC and RH. These patients had a marked decrease in length of stay. Functional Independence Measures (FIM) were obtained at admission (Adm), discharge (D/C), and at 1 year follow-up for both groups. The average length of stay at the TC dropped from 36 days in Group 1 to 26 days in Group 2. In addition, the average length of stay at the RH dropped from 46 days (Group 1) to 25 days (Group 2); overall, an average reduction of 31 days of inpatient care. Group 2 had significantly lower FIM scores at the time of RH discharge for self-care, locomotion, and mobility compared to Group 1. At the 1 year follow-up, however, there were no significant differences between Groups 1 and 2 in these FIM scores. FIM scores at 1 year were higher in Group 2 for communication (90% vs 71%) and social cognition (77% vs 49%) compared to Group 1. Over one-fourth of each group returned to work by the 1 year follow-up. Socially disruptive behavior occurred at least weekly in 28 per cent (Group 1) and 23 per cent (Group 2) of patients. The outcome for serious TBI is better than generally perceived. Reduction of inpatient LOS did not adversely affect the ultimate functional outcome. The decreased LOS placed a greater demand on outpatient rehabilitative services as well as a greater burden on the family of the brain-injured patient [ABSTRACT FROM AUTHOR]

Analyzes a new recurrent neural-network predictive feedback control structure for a class of uncertain nonlinear dynamic time-delay systems in canonical form, as of March 2003. Causes of time-delay systems; Function of a recurrent neural networks; Steps in designing neural-network control systems.

Focuses on a study which reviewed and presented insights into the important considerations for the design of active piezoelectric polymer ultrasound transducers. Selection of piezoelectric polymer materials; Thickness and area of an active resonator; Electroding of transducers.

The effects of Schistosoma japonicum infection on the concentrations of zinc in serum, liver, spleen and muscle and on the concentrations of retinol in serum and liver were studied in 48 pigs. Twenty-four of the pigs were each infected by intramuscular inoculation with 2000 cercariae of S. japonicum in medium and the rest were similarly inoculated with parasite-free medium, as controls. On each of weeks 4, 11, 17 and 24 post-inoculation (PI), 12 pigs (six of which were infected) were killed. Tissue samples were collected at necropsy. Blood samples were taken prior to infection and at necropsy from all pigs, and bi-weekly from the pigs killed 24 weeks post-infection. In an analysis of variance in which serum retinol was the dependent variable, the interaction infection X time was found to be significant (P=0.009). The main reason for this significance was that the concentration of retinol in the sera collected from infected pigs at necropsy at 11 weeks PI was significantly lower than in the control pigs killed at the same time (P=0.02). Although, overall, infection led to higher zinc concentrations in the liver (P=0.04) and spleen tissue (P=0.01), it had no apparent effect on liver retinol, muscle zinc or serum zinc. However, among the pigs which were tested bi-weekly, serum zinc was consistently lower in the infected pigs than in the controls (P=0.01). The transient declines seen in the concentrations of retinol and zinc in sera from the infected pigs were not accompanied by similar changes in the tissue concentrations, and may reflect an acute-phase response to infection. Schistosoma japonicum infection in pigs is considered a useful model of S. japonicum infection (and probably also of S. mansoni infection) in humans. Similar effects, if they occur in the human infections, may lead to misclassification of vitamin-A and zinc status in endemic populations if this status is based on serum retinol and serum zinc. [ABSTRACT FROM AUTHOR]

Assumptions persisting over two decades suggest that black Americans are less concerned about environmental problems than white Americans. However, research since 1980 and analyses of NORC data (1973-90) strongly suggest that black Americans display strong "environmental concern," at least equal to an sometimes exceeding that shown by white Americans. Black Americans also display greater concern than white Americans for other pressing problems, but the authors caution that these priorities do not indicate black disregard for environmental quality. [ABSTRACT FROM AUTHOR]

Focuses on myths and misconceptions in the U.S. Supreme Court. Explanation behind the carpentry work on a conference room table; Analysis of an issue regarding the vacation of justices; Concern regarding the workload of judges.

This paper is a non-hostile outsider narrative describing the Rajneesh movement with special attention to their attempt to establish a spiritual center in Eastern Oregon. Analysis was complicated by the dispersed and mobile following exhibiting wide variation in commitment, linked communal groups, multiple corporate identities, and the movement's rejection of constraint to ideological consistency. Researchers of new religious movements may find the strategies employed useful when faced with these problems in other settings The research experience reinforces cautions about the importance of the researcher's social location and relationship to the group being studied. The identity and demeanor of the observer influences what is available to he seen as well as how that may be interpreted.
The United States has a long history of settlement by religious groups which are locally unconventional. Drawn by a religious pluralism and some separation of church-state affairs which would seem to provide an environment open to innovation, most exotic religions have encountered hostility and suspicion from their neighbors. Resistance to small communal groups (e.g. Amana, Oneida, Shaker) has been somewhat localized, but extensive conflict has attended settlement of larger groups (Calverton, 1941). Eventual accommodation with the larger society seems to be enhanced if the group is either fairly conventional in social terms (e.g. Seventh Day Adventists) or physically isolated to the extent of being more or less invisible to outsiders, as with the Mormon migration and contemporary rural communal settlements (Calverton, 1941; Bouvard, 1975, Kanter, 1972). [ABSTRACT FROM AUTHOR]

Discusses the problems associated with capital punishment and the justice system being practiced in the U.S. Impact of the delay between sentencing and execution; Background on the capital punishment practice in the country; Deterrence and reform of capital punishment.

Presents several articles that profiles retired Justice Potter Stewart of the U.S. Supreme Court. Discussion on the written opinions on various cases; Background on his career as justice and lawyer; His views on the role as justice.

Profiles U.S. Supreme Court Justice Byron R. White. Family background; Educational attainment; His achievements in sports; Career background.

Pays tribute to constitutional artist and critic Paul Freund, who died in 1992. Educational background; Views on constitutional law; Legacy.

Investigates the ferroelectric nylon materials for feasibility in ultrasonic transducer applications. Structure and properties of the nylons; Nylon sample preparations; Dielectric and electromechanical properties; Ultrasound transducer performance of the nylon; Conclusions.

Details the construction of disposable ultrasonic contact transducers with inexpensive polyvinylidene fluoride (PVDF) films for nondestructive testing (NDT) applications. Assessment of the temperature-dependent ultrasonic performance of commercial PVDF films and PVDF sensors; Center frequencies; Ultrasonic immersion transducer performance.

Describes new genera and species of terrestrial isopods (Crustacea: Oniscidea) from Australia. Genera Monitus and Cuckoldillo; Species of each of Scyphax, Rhycotus, Filippinodillo, Merulana, Myrmecodillo; Three new species of Acanthodillo; Synonomy of Merulana and Pyrgoniscus; Unavailability of the name Pseudodiploexochus; Confusion concerning the diagnoses of the genera Merulana Budde-Lund and Cubaris Brandt.

Presents a review of the book `The Blithedale Romance,' in which Nathaniel Hawthorne explores Coverdale's experience of at least three different kinds of theatricality. Ranges of dramatic gestures; Attention focused on Zenobia's death; Coverdale's apprehension of Zenobia's death; Hawthorne's portrayal of Zenobia's Ophelia-death; More.

Focuses on the sequence of areal occupance in a section of Saint Louis, Missouri. Factories in the Cheltenham District; Reputation for the manufacture of various types of clay products; Geographic landscape.

The article presents a study that determines methods for the proper management of vulval melanoma. It cites the case of a 75-year-old woman who was presented with the condition. It also provides discussion of the result which indicates the potential value of using confocal reflectance microscopy to select the most appropriate biopsy sites and identify the positive margins for proper treatment and intervention.

Swift J1357.2-0933 is a black hole transient that is of particular interest due to the optical recurrent dips found during its first two outbursts (in 2011 and 2017), which lack an obvious X-ray equivalent. We present a study based on fast optical photometry during its two most recent outbursts, in 2019 and 2021. Our observations reveal that the optical dips were present in every observed outburst of the source, although they were shallower and showed longer recurrence periods in the two most recent and fainter events. We performed a global study of the dips properties in the four outbursts and found that they do not follow a common temporal evolution. In addition, we discovered a correlation with the X-ray and optical fluxes, with the dips being more profound and showing shorter recurrence periods for brighter stages. This trend seems to extend even to the faintest, quiescent states of the source. We discuss these results in the context of the possible connection between optical dips and outflows found in previous works. [ABSTRACT FROM AUTHOR]

The article describes cases of laboratory-acquired vaccinia virus (VACV) in the U.S. from 2005 to 2007. A laboratory worker experienced a needlestick to a finger while injecting a mice with recombinant VACV. Infection with an orthopoxvirus was confirmed by testing in the Laboratory Response Network laboratory. Another laboratory worker experienced an injury and infection was confirmed by polymerase chain reaction and viral culture. Exposure to VACV can lead to infections and can be associated with a high inoculum.

Reflects on the passages in Hebrews 4:14-5:10 of the New Testament. Exposition of Jesus Christ as the great high priest; Significance of the priestly work of Jesus; Continuity and discontinuity between the role of Jesus and that of the high priests of the Old Testament.