Cancer immunotherapy has emerged as an effective, personalized treatment for certain patients, particularly for those with hematological malignancies. However, its efficacy in breast cancer has been marginal-perhaps due to cold, immune-excluded, or immune-desert tumors. Natural killer T (NKT) cells play a critical role in cancer immune surveillance and are reduced in cancer patients.
View Article and Find Full Text PDFVarious approaches have been proposed for bridge structural health monitoring. One of the earliest approaches proposed was tracking a bridge's natural frequency over time to look for abnormal shifts in frequency that might indicate a change in stiffness. However, bridge frequencies change naturally as the structure's temperature changes.
View Article and Find Full Text PDFThe consensus recommendations by Salter and colleagues (2023) regarding pediatric decision-making intentionally omitted adolescents due to the additional complexity their evolving autonomy presented. Using two case studies, one focused on truth-telling and disclosure and one focused on treatment refusal, this article examines medical decision-making with and for adolescents in the context of the six consensus recommendations. It concludes that the consensus recommendations could reasonably apply to older children.
View Article and Find Full Text PDFThis article describes the process engaged by 17 expert scholars in the development of a set of six consensus recommendations about the normative foundations of pediatric decision-making. The process began with a robust pre-reading assignment, followed by three days of in-person symposium discussions that resulted in a publication in Pediatrics entitled "Pediatric Decision-Making: Consensus Recommendations" (Salter et al. 2023).
View Article and Find Full Text PDFThis study proposes the new condition monitoring concept of using features in the measured rotation, or 'pitch' signal, of a crossing vehicle as an indicator of the presence of foundation scour in a bridge. The concept is explored through two-dimensional vehicle-bridge interaction modelling, with a reduction in stiffness under a pier used to represent the effects of scour. A train consisting of three 10-degree-of-freedom carriages cross the model on a profiled train track, each train varying slightly in terms of mass and velocity.
View Article and Find Full Text PDFResearch involving pediatric populations has important ethical and regulatory considerations. As children generally cannot consent to research, there are special protections put in place to ensure that the decisional vulnerability is protected, including parental permission and often the child's assent. Assent is an ethically important part of the research because it allows the child to participate in the process of agreeing to research, develop their autonomy, and express their values.
View Article and Find Full Text PDFDespite apparent disagreement in the scholarly literature on standards of pediatric decision making, a recognition that similar norms underpin many of the dominant frameworks motivated a June 2022 symposium "Best Interests and Beyond: Standards of Decision Making in Pediatrics" in St Louis, MO. Over the course of this 3-day symposium, 17 expert scholars (see author list) deliberated on the question "In the context of US pediatric care, what moral precepts ought to guide parents and clinicians in medical decision making for children?" The symposium and subsequent discussion generated 6 consensus recommendations for pediatric decision making, constructed with the primary goals of accessibility, teachability, and feasibility for practicing clinicians, parents, and legal guardians. In this article, we summarize these recommendations, including their justification, limitations, and remaining concerns.
View Article and Find Full Text PDFStructural Health Monitoring (SHM) is a technique that involves gathering information to ensure that a structure is safe and behaving as expected. Within SHM, vibration-based monitoring is generally seen as one of the more cost-effective types of monitoring. However, vibration-based monitoring has mostly been undertaken on long-span bridges using data collected with a dense network of sensors.
View Article and Find Full Text PDFStructural Health Monitoring (SHM) is critical in the observation and analysis of our national infrastructure of bridges. Due to the ease of measuring bridge rotation, bridge SHM using rotation measurements is becoming more popular, as even a single DC accelerometer placed at each end of span can accurately capture bridge deformations. Event detection methods for SHM typically entail additional instrumentation, such as strain gauges or continuously recording video cameras, and thus the additional cost limits their utility in resource-constrained environments and for wider deployment.
View Article and Find Full Text PDFWe modified and applied the surrogate decision-making framework of Buchanan and Brock for pediatrics, and present an integrated framework of pediatric health care decision-making, specifying authority and intervention principles, 2 guidance principles, and an additional category of relational principles, governing stakeholder interactions.
View Article and Find Full Text PDFOrganizational and systems leadership, a competency for doctor of nursing practice students, encompasses the evaluation of care delivery systems, accountable care of populations, and resolution of ethical dilemmas. Faculty created an online simulation in which students developed a management proposal for an impending pandemic. All students agreed or strongly agreed that the simulation increased their skills in systems-based thinking, increased their knowledge of others' roles and responsibilities in addressing health care crises, and enabled them to balance ethical considerations and societal interests.
View Article and Find Full Text PDFNKT cells are primed lymphocytes that rapidly secrete cytokines and can directly kill cancerous cells. Given the critical role NKT cells play in cancer immune surveillance, we sought to investigate the effect of mutations in Brca1, specifically a conditional deletion of exon 11, on type I invariant NKT cell development. We observed a significant reduction in invariant NKT cells in both primary lymphoid and peripheral organs in Brca1 mutant mice compared with wild-type C57BL/6.
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