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Background: Previous studies have observed an increased incidence of Cetuximab-induced hypersensitivity infusion reactions (CI-IRs) in the southeastern states of the USA. Tick’s bites were suspected of generating cross-reactions between cetuximab and alpha-gal. This study aims was to describe the incidence and associated risk factors of CI-IRs, in the French areas chosen according to their Lyme disease incidence. Patients and methods: A retrospective chart review was conducted on patients that received cetuximab infusion from January 2010 to June 2019 in 4 French areas with different Lyme disease incidence rates. Results: Of 1392 patients, 117 (8.4%) experienced a CI-IR, including 68 severe (grade 3 or 4) reactions (4.9%). This CI-IR incidence was significantly higher in the Lyme disease high-risk area than in the other areas (13.2% versus 7.1%, 8.1% and 6.4%; P = 0.016). Sex (P = 0.53), premedication (P = 0.91), primary cancer location (P = 0.46) and chemotherapy regimen type (P = 0.78) had no impact on CI-IR incidence in the overall population. In the head and neck squamous cell carcinoma (HNSCC) patient subgroup, CI-IRs were significantly more frequent in the high-risk area (16.4% versus 6.7%, 7.1% and 7.0%; P = 0.0015). Conclusion: This study suggests that patients treated in the French area with the highest incidence of Lyme disease are at a higher risk of CI-IRs. Highlights In a large series of 1392 patients, the 266 patients treated in the French area with the highest incidence of Lyme disease were at a higher risk of cetuximab-induced hypersensitivity infusion reactions compared to those from other areas (16.4% versus 6.7%, 7.1% and 7.0% in medium-, low- and very-low-risk areas; P = 0.0015). The risk of cetuximab-induced hypersensitivity infusion reactions in head and neck squamous cell carcinoma patients was higher only in the area with the highest incidence of Lyme disease. Age, sex, premedication, primary cancer location and chemotherapy regimen type had no impact on the incidence of cetuximab-induced infusion reactions in the overall population.

The hypothesis was tested that hyperbaric oxygen therapy (HBO) reduced brain infarction by preventing apoptotic death in ischemic cortex in a rat model of focal cerebral ischemia. Male Sprague-Dawley rats were subjected to middle cerebral artery occlusion/reperfusion (MCAO/R) and subsequently were exposed to HBO (2.5 atmospheres absolute) for 2 h, at 6 h after reperfusion. Rats were killed and brain samples were collected at 24, 48, 72 h, and 7 days after reperfusion. Neurologic deficits, infarction area, and apoptotic changes were evaluated by clinical scores, 2,3,7-triphenyltetrazolium chloride staining, caspase-3 expression, DNA fragmentation assay, and terminal deoxynucleotidyl transferase-mediated 2′-deoxyuridine 5′-triphosphate-biotin nick end labeling (TUNEL)-hematoxylin and eosin (H&E) costaining. In MCAO/R without HBO treatment animals, DNA fragmentation was observed in injured cortex at 24, 48, and 72 h but not in samples at 7 days after reperfusion. Double labeling of brain slides with NeuN and caspase-3 demonstrated neurons in the injured cortex labeled with caspase-3. TUNEL+H&E costaining revealed morphologic apoptotic changes at 24, 48, and 72 h after reperfusion. Hyperbaric oxygen therapy abolished DNA fragmentation and reduced the number of TUNEL-positive cells. Hyperbaric oxygen therapy reduced infarct area and improved neurologic scores at 7 days after reperfusion. One of the molecular mechanisms of HBO-induced brain protection is to prevent apoptosis, and this effect of HBO might preserve more brain tissues and promote neurologic functional recovery.

Genital condylomata acuminata are nonmalignant human papillomavirus (HPV)-induced tumors in which HPV types 6 and 11 are most commonly found. Usual treatments for condylomata acuminata are nonspecific and are based on the destruction or removal of infected tissue. These procedures are often painful and are characterized by a high relapse rate. We report here what is to our knowledge the first double-blind, placebo-controlled study of the use of cidofovir, a nucleotide analogue, for the treatment of genital papillomavirus infections. Thirty patients were enrolled in the study; 19 received cidofovir, and 11 received placebo. The median number of warts and the median baseline wart area were comparable for both groups. Nine (47%) of 19 patients in the cidofovir group had a complete response (total healing), compared with 0 of the patients in the placebo group (P = .006). None of the patients in the cidofovir group experienced progression of the disease, compared with 5 (45%) of 11 patients in the placebo group. The side effects recorded for both groups were comparable.

Purpose The purpose of this paper is to explore the connections between employee engagement, positive organizational psychology and an individual’s ability to adapt to ongoing organizational change. Design/methodology/approach The literature on individual adaptability, positive organizational psychology and employee engagement is reviewed. A model that suggests that a positive work culture enhances employee engagement and in specific cases leads to increased adaptability is developed. Findings While organizational engagement will have a positive effect on the individual’s ability to adapt to changes, job engagement will have the opposite effect, uncovering potential obstacles to change management in organizations. Research limitations/implications Suggestions for future research are provided with the intent to further academic research in this area. This model can serve as a starting point for future research design and can be tested in organizations undergoing various changes. Practical implications A positive culture fosters both job and organizational engagement within an organization. Managers can understand how to cultivate a positive, engaged environment for employees while understanding how certain job changes might have both positive and negative effects on an individual’s ability to adapt. Originality/value A model for identifying relationships between positive organizational behaviors, two types of employee engagement (organizational engagement and job engagement) and an individual’s ability to adapt to change is helpful to researchers and practitioners alike.

This article summarizes a field-based experiment exploring an individual and small-group financial coaching intervention. Both types of coaching programs had the same goal: To develop clients' financial capability through a series of planned meetings focusing on client driven goals. Results indicated clients who were coached either individually or in groups demonstrated increases in financial knowledge, gains in confidence, reductions in stress, and positive changes in behavior. The findings provide support for coaching as an intervention for developing financial capability and suggests group coaching as an alternative for reaching more clients and spreading financial capability more widely in a cost-effective way.

Objective:To evaluate and identify the risk factors associated with the pathogenesis of congenital hydrocephalus in a large specific population.Methods:An International Classification of Diseases (ICD)-9 database search of patients with congenital hydrocephalus treated at the University of Mississippi Medical Center between 1998 and 2007 was performed. All recruited patients were interviewed, assessing maternal age, onset of prenatal care, geographic location of pregnancy, maternal diabetes and chronic hypertension, pregnancy induced hypertension, pre-eclampsia, eclampsia, single or multiparous gestation, maternal alcohol, tobacco and drug use, infection and trauma during gestation, trauma or sexually transmitted disease at parturition, and other family members with hydrocephalus.Results:In this 10 year retrospective study, several significant risk factors were identified among 596 well defined cases of congenital hydrocephalus. The identified risk factors included lack of prenatal care, multiparous gestation, maternal diabetes, maternal chronic hypertension, maternal hypertension during gestation and alcohol use during pregnancy. Of these patients with congenital hydrocephalus, 12.1% identified an additional family member also diagnosed with hydrocephalus. No differences in risk factors were identified between sporadic and familial congenital hydrocephalus cases except for an increased incidence of multiparous pregnancies and prenatal care in the first trimester in familial cases.Conclusions:A number of key risk factors have been identified to be strongly associated with the development of congenital hydrocephalus in an infant. The prevalence of familial patterns of inheritance for congenital hydrocephalus suggests a broader role for genetic factors in the pathogenesis of congenital hydrocephalus.

Despite notable progress in realizing the benefits of microgravity, the physical stability of therapeutics processed in space has not been sufficiently investigated. Environmental factors including vibration, acceleration, radiation, and temperature, if not addressed, could impact the feasibility of in-space drug processing. The presented work demonstrates the successful recovery of the metastable Form III of ritonavir generated in orbit. The samples processed in orbit, along with control samples of Form I, Form II, Form III, and amorphous ritonavir brought to space and back exhibited excellent physical and chemical stability when exposed to space environments. Stability was determined through comparison to reference samples processed and held on Earth. By providing a detailed experimental dataset centered on survivability, we address a key concern in pharmaceutical processing under microgravity with potential applications for both drug development on Earth and pharmaceutical needs for long-duration human exploration initiatives.

The origin of Galactic cosmic rays is a century-long puzzle. Indirect evidence points to their acceleration by supernova Shockwaves, but we know little of their escape from the shock and their evolution through the turbulent medium surrounding massive stars. Gamma rays can probe their spreading through the ambient gas and radiation fields. The Fermi Large Area Telescope (LAT) has observed the star-forming region of Cygnus X. The 1-to 100-gigaelectronvolt images reveal a 50-parsec-wide cocoon of freshly accelerated cosmic rays that flood the cavities carved by the stellar winds and ionization fronts from young stellar clusters. It provides an example to study the youth of cosmic rays in a superbubble environment before they merge into the older Galactic population.

Gamma-ray bursts (GRBs) are highly energetic explosions signaling the death of massive stars in distant galaxies. The Gamma-ray Burst Monitor and Large Area Telescope onboard the Fermi Observatory together record GRBs over a broad energy range spanning about 7 decades of gamma-ray energy. In September 2008, Fermi observed the exceptionally luminous GRB 080916C, with the largest apparent energy release yet measured. The high-energy gamma rays are observed to start later and persist longer than the lower energy photons. A simple spectral form fits the entire GRB spectrum, providing strong constraints on emission models. The known distance of the burst enables placing lower limits on the bulk Lorentz factor of the outflow and on the quantum gravity mass.

Vnous thromboembolism is frequent in cancer. Low molecular weight heparins (LMWH) are recommended for prevention/treatment of thrombosis in cancer Community pharmacists are very often faced with patients' questions (dosage, tolerance, treatment duration). The aim of this study was to assess the community pharmacists' knowledge regarding 'thrombosis in cancer'. A web-questionnaire (built by a multidisciplinary group) was open between October and November 2013 to community pharmacists in Champgne-Ardenne region. Collected data were 1) pharmacy's general organization for cancer patients' management, 2) management of ambulatory patients with 'thrombosis and cancer ' and 3) pharmacists' knowledge assessment through a simple case report: after an initial 10-days hospital prescription, what should a patient receive as anticoagulant treatment?' One hundred eighty (38 %) community pharmacists answered the questionnaire. Among those, in 65 %, the number of patients with cancer was 6-15/pharmacy In 70 % the number of patients with thrombosis and cancer was 1-10/pharmacy This regional questionnaire will be extended to all French regions. Continuous education sessions are being put in place. Another questionnaire will be launched at the end of 2014 to assess education sessions' efficacy.