135 research outputs found
Association of Day-100 Oral GVHD with subsequent Chronic GVHD Diagnosed by NIH 2005 Consensus Criteria and Treated with Systemic Immunosuppression
No full textThesis (Master's)--University of Washington, 2017-03University of Washington Abstract Association of Day-100 Oral GVHD with subsequent Chronic GVHD Diagnosed by NIH 2005 Consensus Criteria and Treated with Systemic Immunosuppression Niveditha Venkatesh Chair of Supervisory Committee: Mark M. Schubert DDS, MSD Department of Oral Medicine Background: Graft-versus-host disease (GVHD) is a significant cause of morbidity and mortality post hematopoietic transplantation (HCT). The oral cavity is a common site of chronic GVHD and can be one of the first sites of involvement. Clinical and laboratory investigations have been utilized within the allogeneic transplant population to identify or predict chronic GVHD development near the time of departure from the transplant service (approximately Day +70-120 post-HCT). Such investigations routinely include oral examinations to assess for GVHD-related findings; however, there are currently no published studies in the literature that have exclusively examined the specific association between oral GVHD, based solely on clinical findings at departure and the development of future systemic chronic GVHD. Aim: To examine the association between oral mucosal GVHD at the time of departure evaluation (day+ 70-120) in patients without prior evidence of other chronic GVHD activity and the development of subsequent chronic GVHD requiring treatment with systemic immunosuppression. Methods: The electronic medical records (EMRs) of 642 consecutive adult patients (≥ 21 years of age) who received their first allogeneic HCT at Seattle Cancer Care Alliance (SCCA; Seattle, WA, USA) between January 1st 2010- June 30th 2014 were reviewed for inclusion in the study. Oral mucosal GVHD disease status was determined based on review of oral medicine “departure” examination records (departure exams were completed between day +70-120 post-HCT). Demographic data, transplant protocols, and event timeline information were obtained from the Fred Hutchison Cancer Center (FHCRC) optical web library and the Gateway database. In cases where an official oral GVHD diagnosis was not made or when oral examination findings were non-specific, clinical descriptors were independently reviewed by three oral medicine providers and, a discussion was held until a consensus on oral mucosal GVHD status was reached. The diagnosis of oral mucosal GVHD was based on the NIH diagnostic criteria. The FHCRC optical web library gateway database was reviewed to determine the primary outcome variable “future chronic GVHD treated with systemic immunosuppression”. All cases of chronic GVHD were diagnosed based on the 2005 NIH consensus criteria. Univariate and multivariable logistic regression were used to examine the association between a diagnosis of oral mucosal GVHD at and the development of chronic GVHD. All analyses were performed using SAS (Statistical Analysis Software) v9.4. Results: Five hundred and thirty-eight patients met the criteria for inclusion in the study. In both the univariate and multivariable analyses, clinical oral mucosal GVHD at departure without other chronic GVHD activity prior or at departure was associated with an increased risk for subsequent development of chronic GVHD requiring treatment with systemic immunosuppression. In the univariate analysis, those with oral mucosal GVHD at departure were 1.5 times as likely to develop chronic GVHD compared to those without chronic systemic GVHD at departure (odds ratio (OR)=1.5, 95% CI 1.1-2.2, p=0.02). After adjusting for risk factors related to the development of chronic GVHD (specifically recipient age, patient/donor gender, donor relationship, graft source, acute GVHD grades 2-4, conditioning regimen and prednisone treatment at time of departure), the association was similar (OR=1.6, 95% CI 1.2-2.4, p=0.01). Conclusion: A clinical diagnosis of oral mucosal GVHD at the time of departure was found to be associated with increased risk for subsequent development of systemic chronic GVHD. This study highlights the potential value of examining patients 70-120 days’ post HCT to determine the presence of oral GVHD-related changes. With future studies supporting such an association, it would reaffirm the value of diagnosing oral GVHD accurately and in a timely manner to improve not only oral health and patient comfort but perhaps even overall survival. Patients with an oral GVHD diagnosis at departure should be advised of the increased risk of chronic GVHD development and receive appropriate education to allow for early recognition and reporting of chronic GVHD signs and symptoms to their medical team
An experimental investigation of interaction of crossflow instability with forward facing steps
No full textExperimental measurements are performed on a 45 degree swept flat plate model at the low speed laboratory (LSL) at the Delft University of Technology, in a low turbulence environment to stimulate the development of stationary crossflow. The swept flat plate model is equipped with two linear manual stages to create forward and backward facing steps. Preliminary measurements characterize the pressure gradient over the swept flat plate model under study. In the preliminary study , hot-wire anemometry (HWA) measurements characterize the flow over the swept plate without steps over a large chordwise domain with and without forcing by discrete roughness elements (DREs). The DREs are spaced at a spanwise wavelength corresponding to the overall maximum N factors from LST. The mean velocity contours and N factor trends presented in these measurements reinforced the need for DREs to control flow. Spectral content is monitored and the frequency bands associated with probe vibration and travelling crossflow interaction were delineated. Infrared thermography was employed to observe the movement of transition front with varying step heights and initial crossflow amplitudes. When the DRE height increases, the transition front moves upstream consistently for all step heights. Furthermore, when the DRE height is kept a constant , but the array is moved upstream and downstream of the neutral point, the transition front moves upstream for all step heights. In order to observe the flow in the vicinity of the step, HWA was once again used to quantify the interaction of crossflow with FFS. The clean, short FFS and supercritical step height configurations identified from the IR study, are studied for two initial amplitudes. For the supercritical step configuration, bandpass filtered fluctuations are found to align with a high wall normal and spanwise shear region which has been identified in previous work. It is postulated to be associated with a vortex shedding mechanism, for which frequency bands are delineated. Estimates of the range of recirculation bubble length were made and a flapping frequency range was also demarcated. In this study, a vortex shedding scenario is used to explain the presence of these near wall fluctuations. To conclude the report, recommendations are made for extending the present study for future work.Aerospace Engineering | Aerodynamic
Isolation of Proteins from Aged Garlic Extract (AGE) and their Effect on Lymphocytes and Macrophages
No full textThis Dissertation / Report is the outcome of investigation carried out by the creator(s) / author(s) at the department/division of Central Food Technological Research Institute (CFTRI), Mysore mentioned below in this page
Nutraceutical Properties of Wellness Rice Flour.
No full textThis Dissertation / Report is the outcome of investigation carried out by the creator(s) / author(s) at the department/division of Central Food Technological Research Institute (CFTRI), Mysore mentioned below in this page
Multiscale Modeling of Buoyant Fires
No full textPresentationThe use of computational fluid dynamics (CFD) for understanding the fire hazard potential, can be an alternative to experimental studies for the process safety industry. Detailed experimental measurements are available for some lab-scale and medium-scale fires, however, large-scale fire experiments are significantly more difficult and expensive to conduct and availability of detailed experimental data is scarcer. Furthermore, applicability of available test data to industrial applications is sometimes difficult due to differences (geometry, flow conditions etc.) between the scenario under investigation and that considered during the experiments. Therefore, availability of a reliable technique that can overcome the above shortcomings (cost of experiments, and uncertainties about applicability) could bring benefits to the process safety industry. The performance of the CFD models in predicting the characteristics of buoyant fires depends on how adequately the fluid dynamics, chemical kinetics, and heat transfer mechanisms in these systems are modeled. In this study, the commercial software package STAR-CCM+ is used for modeling fires of differentsizes. The CFD models used in this study are first validated by comparing numerical results against the available experimental data for these fires. The validated models are then used to demonstrate a large- scale fire scenario. First, axial distribution of temperature and velocity from the Lab-scale experiments of purely buoyant diffusion flames of different heat release rates are compared between CFD simulations and experiments. The CFD model is able to capture the three regimes seen in these flames: (a) a continuous flame region, (b) an intermittent regime, and (c) the plume region. Next, a medium-scale 1m diameter pool fire is modeled, where the mean species concentrations, temperature, and velocity fields are compared with experimental measurements. Finally, a large-scale pool fire scenario is demonstrated using the same modeling approach. Detailed temporal and spatial information of the fire characteristics such as temperature and species concentration distribution, and radiative fluxes from this fire can be easily extracted from the CFD model, which would otherwise be difficult to obtain from field data. CFD simulations can thus be considered as a valuable tool for understanding the fire dynamics under various scenarios and be used to help devise appropriate safety strategies
Isolation and Characterisation of Carotenogenic Bacteria from Marine Environment
No full textThis Dissertation / Report is the outcome of investigation carried out by the creator(s) / author(s) at the department/division of Central Food Technological Research Institute (CFTRI), Mysore mentioned below in this page
Beyond the 3 R’s ‘Reduce, Reuse, Recycle’: a matterphorical eco-pedagogy project with a picturebook author, illustrator, teacher educator and a London primary school
No full textThis article describes a picturebook arts-based happening that came about spontaneously through an academic meeting the author of the picturebook Ammu’s Bottle Boat and the classteacher eco-lead of a Primary school linked with her university, and finding both to be inspiring champions of eco-pedagogy. Classteacher Andromachi, picturebook author Niveditha, illustrator Aindri and teacher educator Victoria then all met on zoom and planned sessions with the group of children who represent environmental matters for their class as school eco-ambassadors, reading and discussing the book, then making artwork in response to it. Bringing these perspectives together is not only highly unusual but significant in terms of a shared happening where a picturebook enacts this ecocritical nature, or nature-culture. Following Donna Haraway’s inseparability of nature-culture into ‘Natureculture’ (where collective eco-relationships are recognised as both biophysically and socially formed and thus closely associated) the author, illustrator, teacher, teacher-educator and children co-create in response to a picturebook’s ecocritical value. For Haraway, language and matter are also intertwined in ‘matterphorical’ ways, connecting physical, material and language elements together. For Gandorfer and Ayub, matterphorical practice is ‘an aesth-ethics of thought’ which ‘calls for an ethics of both sense-making and sensing in the making’. In this context, the art of the picturebook ‘shapes’ the associated practices of authorship, illustration, environmental education and teaching with ecopedagogies; combining sense-making and sensory learning as they interplay. The article will first set the context for eco-conscious education and various ways in which environmental research and ‘zero carbon’ schools have come together, introduce and explore the picturebook that features here by both its author and illustrator, and conclude with a teacher’s perspective of Green school practice using this picturebook in her primary school
Role of Antenatal Magnesium Sulphate as a Fetal Neuroprotection in Preterm Babies
No full textBACKGROUND:
The prevalence of preterm labour is increasing , while survival of infants born preterm has improved, their neurological outcome remains a major concern, as
preterm birth is associated with neurodevelopemental impairements such as neuromotor deficits, cognitive deficits, learning disabilities, behavioral and
psychiatric disturbances and neurosensory deficiencies. The risk of cerebral palsy increases with decreasing gestational age. 25% of all cases of cerebral palsy are in infants born less than 34 weeks of gestation.
Strategies to reduce cerebral palsy in these infants should be considered and implemented If shown to be effective in order to reduce the effects of this disabling condition on individuals, families, health care and society.
AIM OF THE STUDY:
1. To understand the risk of neurological disability in preterm babies.
2. To understand the role of MgSO4for neuroprotection in preterm deliveries and its effect in preventing neurological outcomes.
3. To evaluate the feasibility of its application in all mothers with preterm labour in future.
MATERIALS AND METHODOLOGY:
All preterm women who attended the labour ward in the Department of Obstetrics and Gynaecology in Coimbatore Medical College Hospital based on inclusion and
exclusion criteria will be enrolled in this study. We selected 100 antenatal mothers and all of them given magnesium sulphate and the outcome of the neonate
regarding neurological abnormalities were studied.
RESULTS:
Among 100 patients with preterm labour who was given magnesium sulphate, only 14% shows features of cerebral palsy and 20% babies shows neurological abnormalities at 6 months compared to groups who has not given magnesium
sulphate where > 30% of babies at 6 months shows neurological abnormalities.
Finally neuroprotection was better in mothers without PPROM, those who got magnesium sulphate infusion > 6 hours and in babies whose weight > 1.5 kg.
CONCLUSION:
Antenatal magnesium sulphate given prior to preterm birth for fetal neuroprotection prevents CP and reduces the combined risk of fetal/infant death or CP. Benefit is seen regardless of the reason for preterm birth, with similar effects across a range of preterm gestational ages and different treatment regimens.
Widespread adoption worldwide of this relatively inexpensive, easy-to-administer treatment would lead to important global health benefits for infants born preterm
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