Buprenorphine is an effective medication for the treatment of opioid dependence. Its use has increased in the United States as a result of the Drug Addiction Treatment Act of 2000, which allowed physicians to prescribe certain medications as part of office-based treatment for opioid addiction. In France, widespread use of medication-assisted therapy, primarily buprenorphine treatment, was associated with an 80decrease in overdose deaths from heroin or cocaine from 465 in 1996 to 89 in 2003 (1). With the expanded use of buprenorphine, an increase in exposures among children and adults has been reported in the United States. These exposures (including unintentional and intentional, therapeutic and nontherapeutic) have resulted in adverse effects and, in a small number of cases, death. To assess statewide increases in buprenorphine use and the number of reported exposures, the Utah Department of Health analyzed data from the Utah Controlled Substance Database (CSD) and the Utah Poison Control Center (PCC). The results of that analysis indicated a statewide increase in the annual number of patients prescribed buprenorphine from 22 in 2002 to 9,793 in 2011, and a concurrent increase in the annual number of prescribers writing buprenorphine prescriptions from 16 to 1,088. Over the same period, the number of exposures to buprenorphine reported annually to the PCC increased from six to 81. However, comparison of the ratios of buprenorphine exposures to patients and prescribers in 2002 with data for 2011 indicated substantial decreases from 6/22 for patients and 6/16 for prescribers in 2002 to 81/9,793 for patients and 81/1,088 for prescribers in 2011. Three of the total 462 buprenorphine exposures reported during 20022011 in Utah, in a teen and two adults, were associated with fatal outcomes. Increased buprenorphine prescribing in Utah during 20022011 likely represents expanded access to critically needed opioid addiction treatment; however, safeguards should be in place to prevent adverse effects. Prescribers and pharmacists are encouraged to counsel patients carefully regarding the safe use, storage, and disposal of buprenorphine.

关键词：处方药;药物治疗;接触;成年人;儿童;死亡;药物滥用,毒品

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Metastatic melanoma (common skin cancer) develops from malignant transformation of the melanocyte, a cell that produces the pigment melanin. Melanomas spread superficially or systemically by nodular invasion. Metastases spread to regional lymph nodes and then distally to the lungs, liver, bone, and brain, where they grow into large tumor masses. Melanoma, a cell type that is highly radiation-resistant, is treated by wide surgical excision of primary tumors. However, distal symptomatic metastases can only be treated by chemotherapy (dicarbazine, temozolomide, paclitaxel, or cisplatin), which produce low response rates to therapy (15), serious side-effects, and no improvement in overall survival. Current medical treatments are rarely successful, and the prognosis for patients diagnosed with metastatic melanoma is poor (Claveau et al., 2009). The need for improved and more effective therapies against metastatic melanoma is well-confirmed by recent clinical studies. Radiation biologists recognize that alpha particles are effective in killing melanoma cancer cells. High-linear-energy alpha particles can be effective in treating radiation-resistant disease that responds poorly to traditional low-linear-energy beta/gamma emitters (Sgouros et al., 2010). Because of the short range of alpha particles (40 to 70 micrometers in soft tissue), and to be effective in cell killing, the alpha-emitters need to be delivered directly to cancer cells using cell-targeted radioimmunotherapy.

关键词：黑素瘤;肽;肿瘤;细胞培养;化疗;诊断(医学)

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Ovarian cancer is the eighth most common cancer in women and is the fifth leading cause of cancer death, with an age-adjusted rate of 8.2 deaths per 100,000 women. Given current age-specific incidence and demographic projections, the number of cases of ovarian cancer will almost double over the next 35 years as women born between 1946 and 1964 (the baby boom generation) reach the age of highest incidence (60 years and older). While advances in surgery, chemotherapy, and radiation therapy over the past 20 years have led to improved outcomes, overall 5-year survival is only 42 percent for ovarian cancer compared with 88 percent for breast cancer and 63 percent for colorectal cancer. The high mortality rate in women with ovarian cancer is largely attributed to the later stage at presentation compared with other common cancers. This has led to intense research efforts to identify effective screening strategies for ovarian cancer, but results have been disappointing, particularly with regard to decreases in mortality. The objective of this report was to estimate the overall balance of harms and benefits from the potential use of oral contraceptives (OCs) for the primary prevention of ovarian cancer.

关键词：卵巢癌;口服避孕药;预防;风险;福利;死亡率

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National HIV Testing Day, June 27, promotes the importance of testing in detecting, treating, and preventing human immunodeficiency virus (HIV) infection. HIV testing is the essential entry point to a continuum of prevention, health-care, and social services that improve the quality of life and the length of survival for persons with HIV (1). Persons with HIV who receive appropriate treatment, monitoring, and health care also reduce their chances of transmitting HIV to others. CDC recommends that all persons aged 1364 years be screened for HIV in health-care settings located in areas where the prevalence of undiagnosed HIV infection is >0.1, and that persons with increased risk for HIV be retested at least annually (2). In April 2013, the U.S. Preventive Services Task Force updated its 2005 guidelines on HIV screening, to recommend that clinicians screen all persons aged 1565 years for HIV infection at least once, regardless of their risk; that younger adolescents and older adults with increased risk also be screened; and that persons with increased risk be screened more frequently (3). These updated recommendations are based on increasing evidence of the benefits of early antiretroviral therapy for HIV-infected persons and its effectiveness in preventing HIV transmission.

关键词：获得性免疫缺陷综合征;艾滋病;艾滋病;传染病;人类;检测;评估

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There are two signaling pathways: HIF-1alpha and Stat3 are important targets for prostate cancer (PC) therapy. HIF-1alpha is the key gene that controls the amount of the transcription of hypoxia-inducible genes. Overexpression of HIF-1alpha not only strongly enhances the rate of tumor growth and metastatic potential, but also contributes to resistance to radiotherapy and chemotherapy, leading to treatment failure and increased patient mortality. Stat3 participates in oncogenesis through the upregulation of genes encoding apoptosis inhibitors, cell-cycle regulators, and inducers of angiogenesis in many human cancers, including prostate cancer. Also, Stat3 suppresses anti-tumor immune responses and mediates the cancer-promoting properties. Previously, we demonstrated that treatment of PC in preclinical models with a combination of a Stat3 inhibitor and a HIF-1alpha inhibitor greatly enhanced drug efficacy and dramatically increased apoptosis in human tumors compared with the use of either agent alone, showing that targeting both Stat3 and HIF-1alpha together can improve tumor response. In this research period, we have developed TEL03, a dual inhibitor from nature products, for cancer therapy. TEL03 targets both HIF-1alpha and Stat3, blocks the expression of their down-regulated oncogenes and significantly suppresses tumor growth in vivo. TEL03 also demonstrated a greater-than-expected in vivo potency, perhaps because of synergy arising from the ability of this agent to simultaneously target two critical oncogenic pathways.

关键词：前列腺癌;凋亡;基因;抑制剂;肿瘤

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In 2011, Medicare paid about $5.7 billion to provide outpatient therapy services for 48 million beneficiaries.

关键词：手册;医疗保险;医疗费用;门诊服务;物理治疗

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Ovarian cancer is the eighth most common cancer in women and is the fifth leading cause of cancer death, with an age-adjusted rate of 8.2 deaths per 100,000 women. Given current age-specific incidence and demographic projections, the number of cases of ovarian cancer will almost double over the next 35 years as women born between 1946 and 1964 (the baby boom generation) reach the age of highest incidence (60 years and older). While advances in surgery, chemotherapy, and radiation therapy over the past 20 years have led to improved outcomes, overall 5-year survival is only 42 percent for ovarian cancer compared with 88 percent for breast cancer and 63 percent for colorectal cancer. The high mortality rate in women with ovarian cancer is largely attributed to the later stage at presentation compared with other common cancers. This has led to intense research efforts to identify effective screening strategies for ovarian cancer, but results have been disappointing, particularly with regard to decreases in mortality. The objective of this report was to estimate the overall balance of harms and benefits from the potential use of oral contraceptives (OCs) for the primary prevention of ovarian cancer.

关键词：卵巢癌;口服避孕药;预防;风险;福利

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The Energy Efficient Buildings Hub (EEBHub) uses Sankey diagrams to visually analyze energy use in the building of its headquarters, Building 101 (B101). This report describes B101 energy consumption and passive energy exchanges with the surrounding environment and through the building. For this initial Sankey diagram exercise, completed on January 31, 2013, the data/model integration was primarily performed by calibrating the EnergyPlus model to measured energy consumption data. The annual model is used as a starting point, while iterations of the EnergyPlus simulation provide results for January and July to demonstrate how energy use changes throughout the year. Annually, the Sankey diagram shows energy consumption from electricity and natural gas, as well as the end uses. The heating, cooling, and air handling are the largest sources of energy usage. Interior lighting and equipment are also considerable consumers of electricity. Seasonally, the trends of energy consumption are visually demonstrated by comparing January and June Sankey diagrams. As expected, winter requires heating via the boiler as the largest energy consumer, while much of the building heat is lost is to the exterior. The summer months have several sources of heat, both exterior and interior, to the building. Cooling is the largest consumer of electricity in July, followed by interior lighting and equipment, and the air handling. From these seasonal diagrams, it is easy to recognize the buildings interactions with its environment, and the strain that induces on its energy consumption. These visualizations help identify where equipment modifications (with better efficiencies) can reduce energy consumption. This report demonstrates the integration of multiple sources of data to output a broad picture of engineered and environmental fluxes of energy through the EEBHub. The outcomes of this project are to provide a building energy analysis on B101 that helps identify large sources of energy consumption, gaps in data, and provide opportunities to deploy energy saving technologies.

关键词：能源分析；能源效益；节能；能源消耗

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The 2011 Mars Science Laboratory was the first Mars guided entry which safely delivered the rover to a landing within a touchdown ellipse of 19.1 km x 6.9 km. The Entry Terminal Point Controller guidance algorithm is derived from the final phase Apollo Command Module guidance and, like Apollo, modulates the bank angle to control the range flown. The guided entry performed as designed without any significant exceptions. The Curiosity rover was delivered about 2.2 km from the expected touchdown. This miss distance is attributed to little time to correct the downrange drift from the final bank reversal and a suspected tailwind during heading alignment. The successful guided entry for the Mars Science Laboratory lays the foundation for future Mars missions to improve upon.

关键词：行后分析;大气进入;入学指导（STS）;下降;航天器着陆

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This report describes the activities of the NOAA Chesapeake Bay Office for fiscal year (FY) 2011 and 2012 under the NOAA Authorization Act, 15 U.S.C. 1511d. This report fulfills the Congressional requirement in Sec. 307 (b)(7) for a biennial report on the activities of the Office and on the progress made in protecting and restoring the living resources and habitat of the Chesapeake Bay.

关键词：水产资源;栖息地;保护;报告的要求;水资源

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