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Boulder, CO, United States

Alroqi F.J.,Room 214 | Chatila T.A.,Harvard University
Current allergy and asthma reports

Regulatory T (Treg) cells that express the transcription factor forkhead box protein P3 (FOXP3) play an essential role in enforcing immune tolerance to self tissues, regulating host-commensal flora interaction, and facilitating tissue repair. Their deficiency and/or dysfunction trigger unbridled autoimmunity and inflammation. A growing number of monogenic defects have been recognized that adversely impact Treg cell development, differentiation, and/or function, leading to heritable diseases of immune dysregulation and autoimmunity. In this article, we review recent insights into Treg cell biology and function, with particular attention to lessons learned from newly recognized clinical disorders of Treg cell deficiency. Source

To identify gender differences in correlates of anticipation and initiation of sexual activity in the baseline survey of 562 African-American 5th grade students prior to initiation of a school-based pregnancy prevention intervention curriculum. Students from 16 elementary schools were administered the baseline questionnaire during classroom periods. Using these data, binary and ordered logistic regression models were used to analyze the factors affecting virginity and anticipation of sexual activity separately by gender, and tests of interaction between each factor and gender were conducted on the combined sample. More boys than girls had already had sex (18% vs. 5%) and anticipated having sexual intercourse in the next 12 months (56% vs. 22%). Boys and girls also differed in the factors that affected these outcomes. The perception that their neighborhood was safe reduced the odds that boys anticipated sexual activity but was not associated with this outcome among girls. Pubertal knowledge increased the odds of anticipation, but only among boys. Attitudes favoring abstinence decreased anticipation of sex among both genders, but slightly more among girls than boys. Having more frequent parent-child communication about sex was associated with increased anticipation among girls but decreased anticipation among boys. Curriculum based approaches to adolescent pregnancy prevention are appropriate for 5th grade elementary students who may already be anticipating sexual activity in communities with disproportionate rates of teen pregnancy. The design of the interventions should consider the differences in motivating factors by gender. Source

Chahin R.,A+ Network | Gulamhusein H.,A+ Network | Breunis H.,A+ Network | Alibhai S.M.H.,A+ Network | And 2 more authors.
Supportive Care in Cancer

Objectives: This study aims to evaluate the quality of care (QOC) and use of validated risk algorithms provided in a specialized osteoporosis clinic to men with prostate cancer on androgen deprivation therapy (ADT) who are at risk of bone loss and fragility fractures. Patients and methods: Charts for 100 consecutive men (mean age 73.0 years) on ADT referred to a tertiary osteoporosis clinic in Toronto, Canada between 2010 and 2014 were reviewed. The following QOC issues were examined: (a) bone health services provided, i.e., screening, preventing, and treating osteoporosis; and (b) use of national guidelines and fracture risk assessment tools for targeting appropriate therapy. Results: The median (IQR) duration of ADT was 21.4 (26.9) months at the baseline visit. Nineteen patients had their first bone mineral density test before starting ADT and 34 during the first year of use. At initial consultation, 83 and 30 patients were taking inadequate amounts of calcium and vitamin D, respectively. A validated fracture risk assessment tool was used in all patients; 42 had a moderate 10-year fracture risk and 12 were high risk. Sixteen (72.7 %) of sedentary patients were advised to increase physical activity. Sixty-four (77.1 %) and 28 (93.3 %) of patients not taking appropriate amounts of calcium and vitamin D, respectively, were recommended to adjust their intake to guideline levels. All patients at high fracture risk were recommended a bisphosphonate. Conclusions: The majority of referred patients had moderate to high fracture risk. The osteoporosis clinic recommended guideline-based bone health care for the vast majority of men on ADT. © 2016 Springer-Verlag Berlin Heidelberg Source

Cross D.M.,Virginia Polytechnic Institute and State University | Canfield R.A.,Virginia Polytechnic Institute and State University | Canfield R.A.,Room 214
Structural and Multidisciplinary Optimization

Utilizing gradient-based optimization for large scale, multidisciplinary design problems requires accurate and efficient sensitivity or design derivative analysis. In general, numerical sensitivity methods, such as the finite difference method, are easy to implement but can be computationally expensive and inaccurate. In contrast, analytic sensitivity methods, such as the discrete and continuum methods, are highly accurate but can be very difficult, if not infeasible, to implement. A popular compromise is the semi-analytic method, but it too can be highly inaccurate when computing shape design derivatives. Presented here is an alternative method, which is easy to implement and can be as accurate as conventional analytic sensitivity methods. In this paper a general local continuum shape sensitivity method with spatial gradient reconstruction (SGR) is formulated. It is demonstrated that SGR, a numerical technique, can be used to solve the continuous sensitivity equations (CSEs) in a non-intrusive manner. The method is used to compute design derivatives for a variety of applications, including linear static beam bending, linear transient gust analysis of a 2-D beam structure, linear static bending of rectangular plates, and linear static bending of a beam-stiffened plate. Analysis is conducted with Nastran, and both displacement and stress design derivative solutions are presented. For each example the design derivatives are validated with either analytic or finite difference solutions. © 2014, Springer-Verlag Berlin Heidelberg. Source

Teuffel O.,Hospital for Sick Children | Cheng S.,Child Health Evaluative science | Ethier M.C.,Child Health Evaluative science | Diorio C.,Child Health Evaluative science | And 7 more authors.
Supportive Care in Cancer

Purpose To describe anticipated health-related quality of life (HRQL) for different hypothetical strategies of febrile neutropenia (FN) management in adult cancer patients. Methods Seventy-eight adult cancer patients were enrolled. Our study considered four different hypothetical treatment strategies for FN: (1) entire inpatient management with intravenous (IV) antibiotics; (2) oral treatment at home after an initial observation in hospital with IV antibiotics; (3) entire outpatient management with IV antibiotics; and (4) entire outpatient management with oral antibiotics. Initially, patients were asked to rank the different treatment strategies for FN based on their personal preference. Subsequently, HRQL was rated using visual analog scale (VAS), time trade-off (TTO), and willingness-to-pay (WTP). Results Seventy-five percent of all respondents preferred an outpatient strategy for FN (36% oral, 21% intravenous, 18% early discharge). Further, outpatient strategies were associated with higher mean VAS scores (possible range 0-10) (oral: 6.1 (standard deviation (SD) 3.1); intravenous: 6.2 (SD 2.2); early discharge: 5.7 (SD 2.1)) as compared to inpatient care (5.3 (SD 2.9)). On the aggregate level, patients were willing to give up between 9 and 10 weeks of their life (TTO; corresponding to <1% of remaining life expectancy) and to pay between $255 and $327 Canadian dollars (WTP) to avoid treatment in hospital. Conclusions Our study indicates that the majority of adult cancer patients would prefer an outpatient strategy for FN. However, patients' preferences vary substantially at the individual level. Implementation of outpatient strategies into routine clinical practice should consider this variability. © Springer-Verlag 2012. Source

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