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"Moser, Barry"
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Voices of ancient Egypt
Individual craftsmen, artists, and laborers describe the work that they do in Egypt during the time of the Old Kingdom, and the historical note places them in context.
Book
Post-Transplantation B Cell Function in Different Molecular Types of SCID
Purpose
Severe combined immunodeficiency (SCID) is a syndrome of diverse genetic cause characterized by profound deficiencies of T, B and sometimes NK cell function. Non-ablative HLA-identical or rigorously T cell-depleted haploidentical parental bone marrow transplantation (BMT) results in thymus-dependent genetically donor T cell development in the recipients, leading to a high rate of long-term survival. However, the development of B cell function has been more problematic. We report here results of analyses of B cell function in 125 SCID recipients prior to and long-term after non-ablative BMT, according to their molecular type.
Methods
Studies included blood immunoglobulin measurements; antibody titers to standard vaccines, blood group antigens and bacteriophage Φ X 174; flow cytometry to examine for markers of immaturity, memory, switched memory B cells and BAFF receptor expression; B cell chimerism; B cell spectratyping; and B cell proliferation.
Results
The results showed that B cell chimerism was not required for normal B cell function in IL7Rα-Def, ADA-Def and CD3-Def SCIDs. In X-linked-SCID, Jak3-Def SCID and those with V-D-J recombination defects, donor B cell chimerism was necessary for B cell function to develop.
Conclusion
The most important factor determining whether B cell function develops in SCID T cell chimeras is the underlying molecular defect. In some types, host B cells function normally. In those molecular types where host B cell function did not develop, donor B cell chimerism was necessary to achieve B cell function. 236 words
Journal Article
Lousy rotten stinkin' grapes
Retells the fable of a frustrated fox that, after many tries to reach a high bunch of grapes, decides they must be sour anyway.
Book
Hemorrhagic Complications of Thoracentesis and Small-Bore Chest Tube Placement in Patients Taking Clopidogrel
Clopidogrel is a commonly used antiplatelet medication. The risk of local hemorrhage associated with use of this drug during routine thoracentesis or small-bore chest tube placement is not well established.
We conducted a prospective cohort study to assess the risk of hemothorax in patients taking clopidogrel while undergoing either pleural procedure.
Twenty-five consecutive adult patients who were taking clopidogrel at the time they were offered thoracentesis or small-bore (14 Fr) chest tube placement consented to continue taking the drug through their procedure. A control group consisted of 50 patients undergoing these pleural procedures who were not taking clopidogrel at the time they consented to undergo either procedure. All of the pleural procedures were performed under ultrasound guidance by an interventional pulmonologist or a fellow under direct faculty supervision. Hospitalized patients were screened for hemothorax by observing for a post-procedure drop in blood hemoglobin content of 2 g/dl or reaccumulation of their pleural effusion within 24 hours of the procedure. Outpatients were called within 2 weeks after their procedure to determine whether they had any symptoms suggestive of hemothorax.
There was one case of hemothorax after thoracentesis in the clopidogrel group versus none in the control group. The one patient with hemothorax required transfusion with 2 units of packed red blood cells and small-bore chest tube placement, and clopidogrel was withheld. There were no other clinically apparent complications of either procedure.
Considered in combination with other small previously published studies, this single-center, nonrandomized, controlled prospective cohort study suggests that the rate of clinically consequential hemorrhage after ultrasound-guided thoracentesis or chest tube placement in patients taking clopidogrel is sufficiently low to warrant a large, randomized clinical trial designed to determine the safety of performing these procedures without interrupting clopidogrel therapy.
Journal Article
And still the turtle watched
A turtle carved in rock on a bluff over the Hudson River by Indians long ago watches with sadness the changes man brings over the years.
Book
Gaps in a gappy forest: plant resources, longleaf pine regeneration, understory response to tree removal in longleaf pine savannas
Resource availability and planted longleaf pine (Pinus palustris Mill.) seedling and understory vegetation response within and among three sizes of experimentally created canopy gaps (0.11, 0.41, 1.63 ha) in a mature longleaf pine savanna were investigated for 2 years. Longleaf pine seedlings and understory vegetation showed increased growth in gaps created by tree removal. Longleaf pine seedling growth within gaps was maximized approximately 18 m from the uncut savanna. Increased longleaf pine seedling survival under the uncut savanna canopy observed after the first year suggests that the overstory may facilitate establishment of longleaf pine seedlings rather than reduce survival through competition. Despite the relative openness of the uncut longleaf pine forest, light quantity was increased by tree removal. Light was also the resource most strongly correlated with seedling and understory vegetation growth. Although net N mineralization was correlated to seedling response, the amount of variation explained was low relative to light. Belowground (root) gaps were not strong, in part because of non-pine understory roots increasing in biomass following tree removal. These results suggest that regeneration of longleaf pine may be maximized within gap sizes as small as approximately 0.10 ha, due largely to increases in light availability.
Journal Article
I am the dog, I am the cat
A dog and a cat take turns explaining what is wonderful about being who they are.
Book
Reformulating the hazard ratio to enhance communication with clinical investigators
Background: Clinical trials with time to event outcomes are often designed utilizing the Cox [1] proportional hazard model with a hazard ratio parameter Δ.
Purpose: The purpose of this article is to demonstrate that a Cox proportional hazard model with a hazard ratio parameter is equivalent to a Cox proportional hazard model with a parameter equal to the probability that a patient given one treatment will have an event earlier than if the same patient were given a different treatment. This probability will subsequently be referred to as θ. Clinically interesting differences between the treatment arms are easier for researchers to quantify in terms of θ in situations where they have a difficult time with the hazard ratio, allowing better communication between the statistician and the researcher.
Methods: The problem and its solution are demonstrated mathematically. The utility of the Cox proportional hazard model in terms of θ is illustrated through a Lymphoma clinical trial example.
Results: The Cox proportional hazard model with parameter θ is shown to be equivalent to the Cox proportional hazard model with a hazard ratio parameter Δ. A table of typical hazard ratios Δ is presented with their equivalent θ values. In the appendix the mathematical derivations are developed and an unbiased estimate of θ is provided using Gehan's [2] generalization of the Wilcoxon statistic.
Limitations: The equivalence of the Cox proportional hazard model in terms of the probability θ and the hazard ratio Δ is established only for continuous failure times with a single binary covariate. Conditions under which approximate equivalence holds with multiple covariates are discussed in the Appendix.
Conclusions: The probability θ provides a natural parameterization for the Cox proportional hazard model, affords a tool to conceptualize treatment differences, and provides a method to improve communication between statisticians and researchers. Clinical Trials 2008; 5: 248—252. http://ctj.sagepub.com
Journal Article
