The report is in four parts: (1) Contingency Prepardness: Collect information from transplant centers, build awareness of the Transplant Center Contingency Planning Committee and educate the transplant community about the critical importance of establishing a nationwide contingency response plan; (2) Rapid Identification of Matched Donors : Increase operational efficiencies that accelerate the search process and increase patient access are key to preparedness in a contingency event; (3) Immunogenetic Studies: Increase understanding of the immunologic factors important in HSC transplantation; (4) Clinical Research in Transplantation: Create a platform that facilitates multicenter collaboration and data management.

关键词：骨髓；临床医学；捐助者（医学）；造血干细胞

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On March 8, 2013, a 60-year-old volunteer Fire Captain failed to respond to the scene of an emergency call at 1054 hours. Several hours later (1530 hours) he was found laying in his driveway wearing a jacket with his fire department logo; his personal vehicle was running and the windshield was partially cleared of snow. Emergency medical service (EMS) personnel reported that the Captain was unresponsive with significant rigor mortis and no signs of life. Based on the local EMS protocols, the Captain was pronounced dead at the scene. Neighbors witnessed the Captain walking in his front yard less than a half hour before the call (1030 hours). Therefore, the Captain was assumed to be responding to the emergency call when he suffered a sudden cardiac event. The autopsy report, completed by the County's Medical Examiner's office, listed the cause of death as 'atherosclerotic and hypertensive cardiovascular disease.' The autopsy revealed severe coronary atherosclerosis with a remote (old) myocardial infarction, cardiomegaly, and left ventricular hypertrophy. NIOSH offers the following recommendations to reduce the risk of heart attacks and sudden cardiac arrest among fire fighters at this and other fire departments across the country.

关键词：事故分析；心脏骤停；心血管系统疾病

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This contract represents the continuation of support from USAMRAA for medical science and research programs on behalf of the U.S. Army Medical Research and Materiel Command (USAMRMC) and its subordinate laboratory, the Walter Reed Army institute of Research (WRAIR) and its Special Foreign Activity (SFA) the U.S. Army Medical Research Unit Kenya (USAMRU-K). Previous support was provided under contract DAMD17-02-2-0022 for the period 01 March 2002 to 31 December 2006. USAMRU-K's mission is focused on developing and testing improved means for predicting, detecting, preventing and treating worldwide infectious disease threats to deployed US military personnel. The unit is also involved in global surveillance, training, research, and response to emerging infectious disease threats. Several diseases that are currently endemic to Kenya have historically impacted military operations. Malaria is hyper-endemic in the coastal lowlands and lake regions of Kenya, leishmaniasis focally distributed in Baringo district and the arid northeastern portion of the country while HIV/AIDS and enterics are present throughout the country with a higher prevalence in urban slum areas.

关键词：干旱的土地；陆军研究；临床试验；沿海地区

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In September 2012, the National Institute for Occupational Safety and Health (NIOSH) received a confidential health hazard evaluation request from employees at a specialty chemicals plant. They were concerned about skin and respiratory exposures to chemicals used at the plant. They felt that workers were at risk for lung disease, rashes, and cancer, among other illnesses. In February 2013, NIOSH visited the plant. During the visit, we confidentially interviewed a variety of employees, talked to company officials (local and corporate), met with the union president, and toured the plant. We also reviewed documents provided by the company, including a list of some chemicals used at the plant, results of recent industrial hygiene sampling, injury and illness logs, and information about how unsafe conditions are reported. We found that the plant uses and produces many chemicals with respiratory toxicity, and two employees have sought medical attention for respiratory illnesses. One employee's physician diagnosed him/her with bronchiolitis obliterans, which is an irreversible lung disease that the physician attributed to chemical exposures at the plant. Another employee was diagnosed with occupational asthma and reactive airways dysfunction syndrome. In conversations with employees, we found that many had concerns about the effect of work-related exposures on their health, though most did not have symptoms they specifically attributed to the plant. Workers expressed concern about mechanisms for reporting of safety concerns, feeling that filing a complaint led to a 'black mark' on their record, instead of being recognized as a proactive safety initiative. Some workers reported concerns about accidents as well, saying people who were involved in accidents were eventually fired or disciplined, and stated that they would hesitate to report an accident. The plant does not allow retaliation for accidents, but notes that workers can be disciplined for failing to follow safety procedures. During the tour we noticed that the plant had a variety of chemical odors in different areas, and although workers were careful about required personal protective equipment and local ventilation, bystanders in similar areas were not required to adhere to the same protection standards. The industrial hygiene sampling plan focused on measuring task-based exposure and workers with the highest exposure potential. Sampling was not performed on bystanders; neither did the plan account for simultaneous exposures to multiple chemicals during an eight-hour shift or the extended shifts worked by many employees. We made several recommendations in an interim letter in May 2013. Since that time, the company has begun to implement some changes. These include adding spirometry to annual medical exams and planning for changes in the industrial hygiene monitoring protocol for 2014. Given the potential exposure to recognized respiratory toxins, the occurrence of respiratory illness in the workforce, and employees' concerns about exposure and health, we recommend that the company use an improved comprehensive exposure assessment strategy and medical monitoring to guide preventive interventions.

关键词：对健康的危害；职业安全与健康；环境暴露

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The common perception that men and women walk differently has been supported by studies in psychology and human perception; however, in modern empirical kinematic studies, sex differences are surprisingly limited, contradictory, or equivocal. Interest in sex differences spans many fields, from psychology to medicine to surveillance. In this review, we assemble and analyze what is known about spatiotemporal and kinematic variables of female and male gait. Historical perspectives, which indicate that sex is identifiable from point-light walkers, are briefly canvassed to help guide identification of structural and kinematic differences. Both spatiotemporal and kinematic data from the past three decades are then presented and discussed. We further analyze the published data in order to identify how height-normalization may affect noted spatiotemporal differences between the sexes. Subsequently, gaps in published data, and the implication of such missing information on gait analysis, are identified. From the analysis performed herein, we suggest that the pooled literature indicates that gait speed decreases with age, and, furthermore, decreases more for women than men. The meta-analysis of spatiotemporal variables normalized to height implies that step length is height-dependent, and, when height-matched, women may walk at a slightly faster preferred speed than men. The compilation of kinematic data suggests that coronal plane pelvis and hip range of motion may be different between the sexes. However, further investigation is needed on nearly every body segment, with special attention to the torso and upper extremities, to explain and quantify or refute gait differences as identified through perception and psychology literature.

关键词：四肢；步态；人体；运动学；知觉（心理学）

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This study is collecting survey data and rich qualitative information on student veterans mental health, help-seeking behavior, and attitudes regarding mental health treatment. Ultimately, this survey and qualitative data will inform the development of a new screening and linkage to care intervention that is feasible in the community college setting and acceptable to this student veteran population and their families. The survey portion of the study is completed and we are conducting proposed analyses. Qualitative interviews and focus groups are ongoing. Analyses from the survey indicate that psychiatric distress is prevalent in the sample of veterans: 32% depression, 23% generalized anxiety, 26% PTSD, 44% with any MH disorder, and 36% binge drinking. Compared to a civilian sample from the same schools, the veterans have significantly higher prevalence of MH disorders in all categories except generalized anxiety. The rates being reported for positive screens are high, thereby demonstrated a need to for increased recognition and intervention in the population. The Veterans in the in-depth interviews are recommending linkage and or services interventions that are acceptable to them, many of which are consistent with current interventions in VA, while some are completely novel. In the next year we will be exploring these intervention ideas further, creating intervention plans in partnership with student Veterans and college representatives, and writing grant applications to allow us to develop and pilot test them.

关键词：心理健康；退伍军人（军事人员）；酗酒;焦虑

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The Health Hazard Evaluation Program received a request from a poultry processing plant in South Carolina. The United States Department of Agriculture/Food Safety and Inspection Service required the plant to request a NIOSH evaluation in order to obtain an evisceration line speed waiver under the Salmonella Initiative Program. The plant asked NIOSH to identify the potential for increase in musculoskeletal and upper extremities trauma due to the planned evisceration line speed increase. In response to this request, NIOSH investigators evaluated ergonomic hazards, nerve damage in employees' hands and wrists (known as carpal tunnel syndrome), and traumatic injuries during three visits. We assessed repetition and force in 67 job tasks, and collected medical and personnel records, and logs of work-related injuries and illnesses to evaluate musculoskeletal disorders and traumatic injuries. In an August 2012 baseline evaluation, we gave a questionnaire and tested nerve function for Fresh Plant production line employees and live hang contractors. After our baseline evaluation, two evisceration lines were combined into one resulting in a similar number of birds processed by most employees daily. In a June 2013 follow-up evaluation, we interviewed Fresh Plant production line employees and live hang contractors who had participated in August 2012. We noted changes the plant had made after increasing the evisceration line speed and assessed the effect of these plant changes on musculoskeletal disorders and traumatic injuries among employees. The results of our baseline evaluation indicated that 41% of participants were performing jobs above the ACGIH TLV for hand activity and force and 42% had evidence of carpal tunnel syndrome. The prevalence of hand or wrist symptoms (pain, burning, numbness, or tingling) was similar at baseline and follow-up. Fifty-seven percent of participants reported at least one musculoskeletal symptom (not including hand or wrist symptoms) at both baseline and follow-up evaluations. The Fresh Plant's rate of OSHA recordable injuries and illnesses was higher than the poultry processing industry average for 2009-2012. The most common work-related injuries by cause, for all years, were 'cut/puncture/scrape,' 'repetitive motion,' 'fall/slip/trip,' 'cumulative,' and 'caught in/under/between.'

关键词：对健康的危害；食品加工工人；家禽饲养业；肌肉骨骼系统疾病

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Incorporating clinical laboratory test results into certified electronic health record (EHR) technology as structured data is a core requirement for eligible hospitals and professionals under Stage 2 of the Medicare and Medicaid EHR Incentive Programs. Currently, there is limited information concerning the readiness of clinical laboratories to deliver structured test results. To address this gap in knowledge, the Office of the National Coordinator for Health IT (ONC) sponsored a national survey of independent and hospital laboratories. This brief describes the capability and extent to which these laboratories send test results as structured data to ordering practitioners EHR systems.

关键词：医疗信息交换；临床医学；实验室；测试结果

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During the human genome project, a set of ancient retrovirus named Human endogenous retrovirus (HERVs) was discovered to be stably integrated into the human genome forming 8.5% of the total human genome1. Among the HERVs, HERV- K was found as an oncogenic allelic variant involved in melanoma, breast cancer, ovarian cancer, tretatocarcinoma and prostate cancer along with various autoimmune diseases like multiple sclerosis and rheumatoid arthritis. The oncogenic potential of HERV-K is contributed by the envelope (env) and GAG protein (Rec). Recent studies have shown that the expression of the HERV-K env protein exclusively on tumor cell surface and not on normal skin cells. The expression of HERVK env protein was found to increase with more aggressive and metastatic type III and type IV melanoma than less aggressive and localized type I melanoma. This selective expression of HERV-K env protein on melanoma cells can be harnessed as a treatment strategy for patients with refractory or metastatic melanoma. Patients with metastatic melanoma have a poor prognosis due to resistance to conventional therapies such as chemotherapy, radiation and surgery. Thus, new targeted treatment strategies are required to improve therapeutic outcome.

关键词：乳腺癌细胞（生物学）；嵌合抗原受体基因组；医药

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Athletes in contact sports who have sustained multiple concussive traumatic brain injuries are at high risk for delayed, progressive neurological and psychiatric deterioration 1-9. This syndrome is termed chronic traumatic encephalopathy (CTE) 1, 7, 10, and is also known as dementia pugilistica 3, 11 or punch drunk syndrome 9, 12. US military personnel 13, 14 and others who have sustained multiple concussive traumatic brain injuries 15-17 may also be at risk for this condition. Currently, there are no methods to identify progressive tau pathology in living humans. Hypothesis: Aggregated forms of hyperphosphorylated tau protein formed acutely in the setting of traumatic brain injury can seed further aggregation of intracellular tau in nearby cells, leading to delayed propagation of tau pathology and neurodegeneration. Objective: To develop standardized, high-throughput blood and cerebrospinal fluid assays for aggregated forms of tau responsible for propagation of tau pathology after traumatic brain injury. Progress to date: The major year 1 goal for the Brody lab was to determine which mouse model of experimental TBI and which human tau transgenic mouse line would be most useful for these experiments. We have determined that controlled cortical impact in 3xTg-AD mice will be optimal. The major year 1 goal for the Diamond lab was to refine and standardize the tau propagation assay. We have increased the sensitivity of the assay by nearly 1000 fold using a flow-cytometry based assay and established quantitative standard curves.

关键词：细胞（生物学）；脑脊液；脑炎；神经学

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