Building more usable APIs

Traditional software usability methods can help us design more understandable and more useful application program interfaces (APIs). They also give us information we need to write good API reference documentation-before we invest in either programmers or writers and before evolving a large body of code or content     

The impact of various rehydration volumes for firefighters wearing protective clothing in warm environments

This study examined different fluid replacement quantities during intermittent work while wearing firefighting protective clothing and self-contained breathing apparatus in the heat (35 degrees C, 50% relative humidity). Twelve firefighters walked at 4.5 km per h with 0% elevation on an intermittent work (50 min) and rest (30 min) schedule until they reached a rectal temperature of 39.5 degrees C during work periods and 40.0 degrees C during rest, heart rates of 95% of maximum and/or exhaustion. During the heat-stress trials subjects received one of four fluid replacement quantities, high (H), moderate (M), low (L), and no hydration (NH), where H, M and L represented 78%, 63% and 37% of fluid loss, respectively. The total tolerance time (work + rest) was significantly greater during H (111.8 +/- 3.5), M (112.9 +/- 5.2) and L (104.2 +/- 5.8) compared to NH (95.3 +/- 3.8). In addition, work time (min), which excluded rest periods, was significantly greater in H (82.6 +/- 3.5), and M (82.9 +/- 5.2) compared to NH (65.3 +/- 3.8). It is concluded that incorporating even partial fluid replacement strategies while wearing firefighting protective clothing and self-contained breathing apparatus in the heat improves tolerance time.     

Infertility update: use of assisted reproductive technology

OBJECTIVE: To describe assisted reproductive technology (ART) and use of medications during these procedures. DATA SOURCES: Recent clinical literature. STUDY SELECTION: Not applicable. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: ARTs are procedures used in treatment of infertility that involve removal of oocytes and their manipulation outside the woman's uterus. The simplest form of ART, in vitro fertilization, involves aspirating eggs from the ovaries, fertilizing them outside the body, and transferring the embryos into the uterus at the four- to eight-cell stage. Experimental regimens for in vitro fertilization include use of various medications (gonadotropin-releasing hormone agonists, human menotropins, follicle-stimulating hormone, growth hormone) at varying points in the menstrual cycle and after introduction of the embryo into the uterus. Human chorionic gonadotropin has been used to increase implantation of embryos during the woman's luteal phase. Gamete intrafallopian transfer (GIFT) involves transfer of oocytes and sperm into the fallopian tubes, where fertilization takes place. This technique has the advantage of causing the zygote to enter the uterus at the time it would during natural conception. Zygote intrafallopian transfer is similar to GIFT, except that fertilization occurs in vitro, with embryos placed in the fallopian tubes at the two-cell stage. Various micromanipulation techniques and innovative sperm aspiration procedures are currently under development. CONCLUSION: Many advancements have been made in ART, and pharmacists who understand these procedures can serve patients by providing medication information in an empathetic and supportive manner.     

IFN-alpha 2B enhances Th1 cytokine responses in bladder cancer patients receiving Mycobacterium bovis bacillus Calmette-Guérin immunotherapy

Combination therapy with intravesical bacillus Calmette-Guérin (BCG) plus IFN-alpha for superficial bladder cancer has been demonstrated to be more effective than either single agent alone in animal studies and of suggested greater efficacy in clinical studies. However, the mechanism by which IFN-alpha enhances BCG-mediated antitumor activity is poorly understood. Using PBMCs from bladder cancer patients, IFN-alpha was found to substantially enhance the efficacy of BCG to induce IFN-gamma production. Among 34 patients tested, 80% showed >4-fold increase. This effect of IFN-alpha was observed in both initial and memory responses to BCG. In addition, IFN-alpha up-regulated BCG-induced IL-12 and TNF-alpha and down-regulated BCG-induced IL-10. Neutralizing endogenous IL-10 or adding exogenous IL-12 provided further synergy for IFN-gamma production. In clinical practice, intravesical IFN-alpha 2B (50 million units (MU)/dose) was observed to accelerate urinary IFN-gamma production to low-dose BCG (one-tenth or one-third of a full dose) in patients treated with combination therapy compared with BCG alone. These results suggest that IFN-alpha is a potent BCG enhancer that polarizes the BCG-induced immune response toward the cellular immune pathway by promoting Th1 cytokine expression and reducing Th2 cytokine expression. This study provides an immunological basis for future rational use of IFN-alpha in conjunction with intravesical BCG for bladder cancer immunotherapy.