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Checkpoint inhibitors have invigorated cancer immunotherapy research, including cancer vaccination. Classic early phase trial design and endpoints used in developing chemotherapy are not suited for evaluating all forms of cancer treatment. Peripheral T cell response dynamics have demonstrated inconsistency in assessing the efficacy of cancer vaccination. Tumor infiltrating lymphocytes (TILs), reflect the local tumor microenvironment and may prove a superior endpoint in cancer vaccination trials. Cancer vaccines may also promote success in combination immunotherapy treatment of weakly immunogenic tumors. This review explores the impact of TILs as an endpoint for cancer vaccination in multiple malignancies, summarizes the current literature regarding TILs analysis, and discusses the challenges of providing validity and a standardized implementation of this approach.

Background: Acyanotic and cyanotic congenital heart disease (CHD) patients are known to have distinct operative risk profiles. However, little is known about whether pulsatile and non-pulsatile cardiopulmonary bypass (CPB) have differential effects on cerebral hemodynamics or outcomes in these two patient groups. Methods: 159 pediatric (age Results: Regional-cerebral-oxygen-saturation, gaseous microemboli counts, and mean arterial pressure were similar between groups. PELOD-2 scores decreased over time, with similar scores between perfusion modalities in either group. Analysis of additional postoperative outcomes revealed no significant differences between non-pulsatile and pulsatile perfusion in either acyanotic or cyanotic groups. Conclusions: Despite patients undergoing pulsatile CBP demonstrating a more physiologic pulsatility index in both acyanotic and cyanotic groups, no clinically significant differences in cerebral hemodynamics or clinical outcomes were appreciated. Trial Registration Number and Registration Date: NCT00862407 (16/03/2009) (first registration date)

The American Concrete Institute has published ACI 440.11-22, Building Code Requirements for Structural Concrete Reinforced with Glass Fiber-Reinforced Polymer (GFRP) Bars—Code and Commentary. This new code was developed by an American National Standards Institute–approved consensus process and addresses structural systems, members, and connections, including cast-in-place, precast, nonprestressed, and composite concrete construction. ACI 440.11-22 is the first comprehensive building code covering the use of nonmetallic, GFRP reinforcing bars in structural concrete applications. This article provides background on this new code and discusses potential uses for precast concrete components and structures.

Pembakaran residu industri penyamakan kulit di area penyamakan kulit Magetan menghasilkan polutan berupa gas NO 2 dan SO 2 yang dapat membahayakan kesehatan pekerja. Tujuan dari penelitian ini adalah untuk menganalisis sejauh mana risiko NO2 dan SO2emisi gas buang terhadap kesehatan pekerja di area penyamakan kulit Magetan. Penelitian ini merupakan penelitian deskriptif kuantitatif dengan desain cross sectional dan pendekatan ARKL (Environmental Health Risk Analysis). Teknik pengambilan sampel yang digunakan adalah teknik non-random sampling, yaitu sampel lengkap yang mencakup seluruh populasi. Pengambilan sampel udara dilakukan di area pembakaran sisa penyamakan kulit. Metode analisis data menggunakan analisis risiko untuk mengetahui karakterisasi risiko pekerja yang dianggap 'aman' bila nilai RQ bernilai 1 dan tingkat risiko disebut 'tidak aman' bila nilai RQ > 1. Hasil penelitian menunjukkan bahwa konsentrasi NO 2 gas adalah 0,000555 g/m3 dan SO 2gas adalah 0,0006948 g/m3. Hasil pengukuran tidak melebihi NAB berdasarkan PP RI No. 22 Tahun 2021. Nilai intake tertinggi untuk gas NO 2 adalah 0,00001003 mg/kg/hari dan untuk SO2 0,00001255 mg/kg/hari. Risiko tertinggi ditemukan 0,0011721 (RQ

Given the lack of systemic venous return to the heart, palliated single ventricle patients frequently require epicardial pacemaker implantation for management of dysrhythmias including sinus node dysfunction, atrial arrhythmias, and heart block. Repeated device hardware replacement, frequently required due to high lead thresholds or other device failure, is a challenging and significant problem for this population. 3-dimensional imaging can assist in delineating the cardiac anatomy allowing for novel approaches to intervention. We review a patient with extracardiac Fontan circulation who underwent placement of an endocardial atrial pacemaker lead via a transmural approach with a 3D-printed model used for procedural guidance.

PurposeThis study examines whether online asynchronous discussion forums support student’s meaning-making about citizenship in a globalizing world. Citizenship is an increasingly contested identity for young people, yet they have few opportunities in traditional civic education to consider their own citizenship. Although online discussions are considered effective spaces for increasing dialogue and critical thinking between diverse students, there has been little research to understand how effective they are for helping students to construct new understandings of citizenship.Design/methodology/approachA content analysis approach was used to analyze and code 89 discussion board posts. The Interaction Analysis Model (IAM) coding scheme was used to describe and analyze the quality of knowledge construction that occurred across the posts focusing on different aspects of global citizenship.FindingsThe findings demonstrate that the discussion boards produced substantive talks about the meaning of citizenship that in some instances reached the level of new knowledge construction. The students considered different meanings for global citizenship and negotiated positions on key issues. However, the highest levels of knowledge construction were rarely reached.Practical implicationsA major implication is the need to organize and cue discussion boards to support knowledge construction in addition to fostering dialogue.Originality/valueThis study contributes to the role that technology can play in supporting students’ knowledge construction about global citizenship that go beyond the scripted meanings conveyed in civics classes.

Environmental exposures have been linked to childhood problems with overactivity, attention, and impulse control, and an increased risk of attention deficit hyperactivity disorder (ADHD) diagnosis. Two approaches to identify these types of exposure-related neurobehavioral problems include the use of computerized tests, such as the Behavioral Assessment and Research System (BARS), as well as the use of behavior rating scales. To assess comparability of these two types of measures, we analyzed data from 281 children aged 6 to 14 years enrolled in a 5-year research study investigating coal ash exposure and neurobehavioral health. All children lived in proximity of coal ash storage sites. We administered six computer tests from the BARS and obtained behavior measures from the parent-completed Child Behavior Checklist (CBCL) ADHD DSM oriented scale. BARS test performance was associated with age indicating that the tests could be used to evaluate neurodevelopmental changes over time or across a wide age range. Tests within the BARS including Continuous Performance (CPT) false alarm (standardized estimate 1.57, 95% confidence interval (CI) (0.67, 2.48), adjusted p = 0.006), Selective Attention (SAT) wrong count (standardized estimate 2.8, 95% CI (1.17, 4.44), adjusted p = 0.006), and SAT proportion correct (standardized estimate -2.45, 95% CI (-4.01, -0.88), adjusted p = 0.01) were associated with attention and impulse control problems on the CBCL after adjustment for multiple comparisons. Findings support that the BARS can contribute to research on environmental exposures by assessing subclinical behaviors related to ADHD such as sustained attention, impulse control, response inhibition, associative learning, and short-term memory. Future research can examine relationships of these BARS measures with biomarkers of neurotoxic exposures related to living near coal ash storage sites to better identify the potential risk for ADHD-related behaviors among children living near coal ash storage sites.

This article addresses the demand for global content knowledge that the process of internationalization has placed on the preparation of social studies teachers. Drawing on scholarship about global perspectives in teacher education, this study examined what one cohort of preservice teachers learned about globalization during participation in a three-week, web-based, international relations simulation. The unit was part of a methods course designed to prepare preservice teachers to teach global issues and internationalize the curriculum. International simulations have long been touted as a means for learning challenging knowledge about global issues yet are rarely studied in teacher education. This qualitative study drew on concept maps and written responses completed before and after the simulation to document the preservice teachers’ learning. The analysis generated two findings: (1) preservice teachers acquired a shared, conceptual vocabulary for globalization that included the events and actors represented in the simulation; and (2) they also demonstrated a more systematic and critical understanding of the ways that power and conflict shaped the events and actors. The study contributes to the question of what teachers need to know to teach with global perspectives and how efforts to internationalize teacher education programs can foster such knowledge.

In order to study the compression behavior of rectangular steel reinforced concrete columns with built-in steel tubes under different eccentric loads, three 1/10 scale specimens were designed and monotonic loading tests were carried out on them. The dimensions, steel bars and steel tube of the three specimens were the same except for the location of the loading point. The eccentricity ratios of the three specimens were 0, 0.25 and 0.5, respectively. The failure modes, load-bearing capacity and displacement characteristics of the test specimens were analyzed. According to the Chinese code, the load-bearing capacity calculation principles and methods of steel reinforced concrete columns with built-in steel tube were investigated for the comparison. The study shows that the peak vertical loads of specimens decrease and the corresponding vertical and horizontal peak displacement increase as the eccentricity increases. The load-bearing capacity calculation results from Chinese code are slightly smaller than the test result because of the unconsidered sleeve effect of the internal steel tube. The errors between them are small, and the calculation methods are beneficial to ensure the structural safety.

Purpose AE37 and GP2 are HER2 derived peptide vaccines. AE37 primarily elicits a CD4+ response while GP2 elicits a CD8+ response against the HER2 antigen. These peptides were tested in a large randomized trial to assess their ability to prevent recurrence in HER2 expressing breast cancer patients. The primary analyses found no difference in 5-year overall disease-free survival (DFS) but possible benefit in subgroups. Here, we present the final landmark analysis. Methods In this 4-arm, prospective, randomized, single-blinded, multi-center phase II trial, disease-free node positive and high-risk node negative breast cancer patients enrolled after standard of care therapy. Six monthly inoculations of vaccine (VG) vs. control (CG) were given as the primary vaccine series with 4 boosters at 6-month intervals. Demographic, safety, immunologic, and DFS data were evaluated. Results 456 patients were enrolled; 154 patients in the VG and 147 in CG for AE37, 89 patients in the VG and 91 in CG for GP2. The AE37 arm had no difference in DFS as compared to CG, but pre-specified exploratory subgroup analyses showed a trend towards benefit in advanced stage (p = 0.132, HR 0.573 CI 0.275–1.193), HER2 under-expression (p = 0.181, HR 0.756 CI 0.499–1.145), and triple-negative breast cancer (p = 0.266, HR 0.443 CI 0.114–1.717). In patients with both HER2 under-expression and advanced stage, there was significant benefit in the VG (p = 0.039, HR 0.375 CI 0.142–0.988) as compared to CG. The GP2 arm had no significant difference in DFS as compared to CG, but on subgroup analysis, HER2 positive patients had no recurrences with a trend toward improved DFS (p = 0.052) in VG as compared to CG. Conclusions This phase II trial reveals that AE37 and GP2 are safe and possibly associated with improved clinical outcomes of DFS in certain subgroups of breast cancer patients. With these findings, further evaluations are warranted of AE37 and GP2 vaccines given in combination and/or separately for specific subsets of breast cancer patients based on their disease biology.