Fault tree analysis for system modeling in case of intentional EMI

The complexity of modern systems on the one hand and the rising threat of intentional electromagnetic interference (IEMI) on the other hand increase the necessity for systematical risk analysis. Most of the problems can not be treated deterministically since slight changes in the configuration (source, position, polarization, ...) can dramatically change the outcome of an event. For that purpose, methods known from probabilistic risk analysis can be applied. One of the most common approaches is the fault tree analysis (FTA). The FTA is used to determine the system failure probability and also the main contributors to its failure. In this paper the fault tree analysis is introduced and a possible application of that method is shown using a small computer network as an example. The constraints of this methods are explained and conclusions for further research are drawn

A strategy for tissue self-organization that is robust to cellular heterogeneity and plasticity

Developing tissues contain motile populations of cells that can self-organize into spatially ordered tissues based on differences in their interfacial surface energies. However, it is unclear how self-organization by this mechanism remains robust when interfacial energies become heterogeneous in either time or space. The ducts and acini of the human mammary gland are prototypical heterogeneous and dynamic tissues comprising two concentrically arranged cell types. To investigate the consequences of cellular heterogeneity and plasticity on cell positioning in the mammary gland, we reconstituted its self-organization from aggregates of primary cells in vitro. We find that self-organization is dominated by the interfacial energy of the tissue–ECM boundary, rather than by differential homo- and heterotypic energies of cell–cell interaction. Surprisingly, interactions with the tissue–ECM boundary are binary, in that only one cell type interacts appreciably with the boundary. Using mathematical modeling and cell-type-specific knockdown of key regulators of cell–cell cohesion, we show that this strategy of self-organization is robust to severe perturbations affecting cell–cell contact formation. We also find that this mechanism of self-organization is conserved in the human prostate. Therefore, a binary interfacial interaction with the tissue boundary provides a flexible and generalizable strategy for forming and maintaining the structure of two-component tissues that exhibit abundant heterogeneity and plasticity. Our model also predicts that mutations affecting binary cell–ECM interactions are catastrophic and could contribute to loss of tissue architecture in diseases such as breast cancer

Temozolomide plus pegylated interferon alfa-2b as first-line treatment for stage IV melanoma: a multicenter phase II trial of the Dermatologic Cooperative Oncology Group (DeCOG)

Background: Combination of temozolomide (TMZ) with nonpegylated interferon alfa is associated with increased efficacy in terms of response rates compared with monotherapy. A multicenter phase II study was carried out to assess the activity and toxicity of TMZ plus pegylated interferon alfa-2b (peg-IFNα-2b), hypothesizing improved efficacy due to modified pharmacokinetic properties of the novel interferon (IFN) formulation. Patients and methods: In all, 124 patients with stage IV melanoma without prior chemotherapy and no cerebral metastases were treated with 100 μg peg-IFNα-2b s.c. per week and oral TMZ 200 mg/m2 (days 1-5, every 28 days). Primary study end point was objective response, and secondary end points were overall and progression-free survival (PFS) and safety. Results: In all, 116 patients were assessable for response: 2 (1.7%) had a complete response and 19 (16.4%) a partial response (overall response rate 18.1%). Of total, 25.0% achieved disease stabilization and 56.9% progressed. Overall survival was 9.4 months; PFS was 2.8 months. Grade 3/4 thrombocytopenia occurred in 20.7% and grade 3/4 leukopenia in 23.3%. Conclusions: The efficacy of TMZ plus peg-IFNα-2b in this large phase II study is moderate and comparable to published results of the combination of TMZ with non-peg-IFN. Likewise, the safety profile of peg-IFNα-2b seems to be similar to non-peg-IFN when combined with TM

The Contribution of National Spontaneous Reporting Systems to Detect Signals of Torsadogenicity: Issues Emerging from the ARITMO Project

Introduction: Spontaneous reporting systems (SRSs) are pivotal for signal detection, especially for rare events with a high drug-attributable component, such as torsade de pointes (TdP). Use of different national SRSs is rarely attempted because of inherent difficulties, but should be considered on the assumption that rare events are diluted in international databases. Objective: The aim was to describe TdP-related events associated with antipsychotics, H1-antihistamines and anti-infectives in three national SRSs (in Italy, Germany and France) and highlight potential signals of torsadogenicity through a combined literature evaluation. Methods: A common search strategy was applied to extract TdP-related events: (1) TdP, (2) QT interval abnormalities, (3) ventricular fibrillation/tachycardia, and (4) sudden cardiac death. Signals of disproportionate reporting (SDRs) were calculated for TdP + QT interval abnormalities and defined by a lower limit of the 95 % confidence interval of the reporting odds ratio (ROR) >1. Among SDRs with at least three cases without concomitant pro-arrhythmic drugs, we defined potential new signal of torsadogenicity as drugs with no published evidence from (a) the crediblemeds® website (http://www.crediblemeds.com, as of November 1st, 2014); (b) studies on the FDA Adverse Event Reporting System (FAERS); and (c) safety trials or pharmaco-epidemiological studies (as of December 16th, 2014). Results: Overall, 3505 cases were retrieved (1372, 1468, and 801 for France, Germany and Italy, respectively). Antipsychotics were mainly recorded in Germany (792 cases), whereas antibiotics peaked at 515 and 491 (France and Italy, respectively). Forty-one drugs met criteria for SDRs in at least one single source, of which 31 were detected only from one single SRS: 18, ten and three (French, German and Italian SRS, respectively). By contrast, only five SDRs were detected in all national data sources (amisulpride, aripiprazole, haloperidol, olanzapine, risperidone). Overall, five potential new signals of torsadogenicity were identified: flupentixol, ganciclovir, levocetirizine, oxatomide and tiapride. Conclusions: We found differences across and within national SRSs in the reporting of drug-induced TdP, which finally resulted in five potential new signals of torsadogenicity. These findings warrant targeted pharmacovigilance studies to formally assess the existence of actual drug–event associations

New Insights into the mineralogy of the Atlantis II deep metalliferous sediments, Red Sea

The Atlantis II Deep of the Red Sea hosts the largest known hydrothermal ore deposit on the ocean floor and the only modern analog of brine pool-type metal deposition. The deposit consists mainly of chemical-clastic sediments with input from basin-scale hydrothermal and detrital sources. A characteristic feature is the millimeter-scale layering of the sediments, which bears a strong resemblance to banded iron formation (BIF). Quantitative assessment of the mineralogy based on relogging of archived cores, detailed petrography, and sequential leaching experiments shows that Fe-(oxy)hydroxides, hydrothermal carbonates, sulfides, and authigenic clays are the main “ore” minerals. Mn-oxides were mainly deposited when the brine pool was more oxidized than it is today, but detailed logging shows that Fe-deposition and Mn-deposition also alternated at the scale of individual laminae, reflecting short-term fluctuations in the Lower Brine. Previous studies underestimated the importance of nonsulfide metal-bearing components, which formed by metal adsorption onto poorly crystalline Si-Fe-OOH particles. During diagenesis, the crystallinity of all phases increased, and the fine layering of the sediment was enhanced. Within a few meters of burial (corresponding to a few thousand years of deposition), biogenic (Ca)-carbonate was dissolved, manganosiderite formed, and metals originally in poorly crystalline phases or in pore water were incorporated into diagenetic sulfides, clays, and Fe-oxides. Permeable layers with abundant radiolarian tests were the focus for late-stage hydrothermal alteration and replacement, including deposition of amorphous silica and enrichment in elements such as Ba and Au

Analysis of BRAF and NRAS Mutation Status in Advanced Melanoma Patients Treated with Anti-CTLA-4 Antibodies: Association with Overall Survival?

Ipilimumab and tremelimumab are human monoclonal antibodies (Abs) against cytotoxic T-lymphocyte antigen-4 (CTLA-4). Ipilimumab was the first agent to show a statistically significant benefit in overall survival in advanced melanoma patients. Currently, there is no proven association between the BRAFV600 mutation and the disease control rate in response to ipilimumab. This analysis was carried out to assess if BRAFV600 and NRAS mutation status affects the clinical outcome of anti-CTLA-4-treated melanoma patients. This is a retrospective multi-center analysis of 101 patients, with confirmed BRAF and NRAS mutation status, treated with anti-CTLA-4 antibodies from December 2006 until August 2012. The median overall survival, defined from the treatment start date with the anti-CTLA-4. Abs-treatment to death or till last follow up, of BRAFV600 or NRAS mutant patients (n = 62) was 10.12 months (95% CI 6.78-13.2) compared to 8.26 months (95% CI 6.02-19.9) in BRAFV600/NRASwt subpopulation (n = 39) (p = 0.67). The median OS of NRAS mutated patients (n = 24) was 12.1 months and although was prolonged compared to the median OS of BRAF mutated patients (n = 38, mOS = 8.03 months) or BRAFV600/NRASwt patients (n = 39, mOS = 8.26 months) the difference didn't reach statistical significance (p = 0.56). 69 patients were able to complete 4 cycles of anti-CTLA-4 treatment. Of the 24 patients treated with selected BRAF- or MEK-inhibitors, 16 patients received anti-CTLA 4 Abs following either a BRAF or MEK inhibitor with only 8 of them being able to finish 4 cycles of treatment. Based on our results, there is no difference in the median OS in patients treated with anti-CTLA-4 Abs implying that the BRAF/NRAS mutation status alone is not sufficient to predict the outcome of patients treated with anti-CTLA-4 Abs

Recent variability of the global ocean carbon sink

We present a new observation-based estimate of the global oceanic carbon dioxide (CO2) sink and its temporal variation on a monthly basis from 1998 through 2011 and at a spatial resolution of 1×1. This sink estimate rests upon a neural network-based mapping of global surface ocean observations of the partial pressure of CO2 (pCO2) from the Surface Ocean CO2 Atlas database. The resulting pCO2 has small biases when evaluated against independent observations in the different ocean basins, but larger randomly distributed differences exist particularly in high latitudes. The seasonal climatology of our neural network-based product agrees overall well with the Takahashi et al. (2009) climatology, although our product produces a stronger seasonal cycle at high latitudes. From our global pCO2 product, we compute a mean net global ocean (excluding the Arctic Ocean and coastal regions) CO2 uptake flux of −1.42 ± 0.53 Pg C yr−1, which is in good agreement with ocean inversion-based estimates. Our data indicate a moderate level of interannual variability in the ocean carbon sink (±0.12 Pg C yr−1, 1𝜎) from 1998 through 2011, mostly originating from the equatorial Pacific Ocean, and associated with the El Nino–Southern Oscillation. Accounting for steady state riverine and Arctic Ocean carbon fluxes our estimate further implies a mean anthropogenic CO2 uptake of −1.99 ± 0.59 Pg C yr−1 over the analysis period. From this estimate plus the most recent estimates for fossil fuel emissions and atmospheric CO2 accumulation, we infer a mean global land sink of −2.82 ± 0.85 Pg C yr−1 over the 1998 through 2011 period with strong interannual variation

Methylphenidate and the risk of psychotic disorders and hallucinations in children and adolescents in a large health system

Previous studies have suggested that risk of psychotic events may be increased in children exposed to methylphenidate (MPH). However, this risk has not been fully examined and the possibility of confounding factors has not been excluded. Patients aged 6-19 years who received at least one MPH prescription were identified using Hong Kong population-based electronic medical records on the Clinical Data Analysis & Reporting System (2001-2014). Using the self-controlled case series design, relative incidence of psychotic events was calculated comparing periods when patients were exposed to MPH with non-exposed periods. Of 20 586 patients prescribed MPH, 103 had an incident psychotic event; 72 (69.9%) were male and 31 (30.1%) female. The mean age at commencement of observation was 6.95 years and the mean follow-up per participant was 10.16 years. On average, each participant was exposed to MPH for 2.17 years. The overall incidence of psychotic events during the MPH exposure period was 6.14 per 10 000 patient-years. No increased risk was found during MPH exposed compared to non-exposed periods (incidence rate ratio (IRR) 1.02 (0.53-1.97)). However, an increased risk was found during the pre-exposure period (IRR 4.64 (2.17-9.92)). Results were consistent across all sensitivity analyses. This study does not support the hypothesis that MPH increases risk of incident psychotic events. It does indicate an increased risk of psychotic events prior to the first prescription of MPH, which may be due to an association between psychotic events and the behavioural and attentional symptoms that led to psychiatric assessment and initiation of MPH treatment