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Journal articles on the topic "+519.816] (043.3)"
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Cairo, Mitchell S., Erin Cooney, Mark Krailo, Richard Belanger, Sherrie L. Perkins, Rashid Fawwaz, Anne Angiolillo, and Peter Adamson. "A Phase I Study of 90Y-Ibritumomab-Tiuxetan (90Y-It) in Children with Recurrent/Refractory CD20 Positive Lymphoma: A Cog Phase I Consortium Study." Blood 106, no. 11 (November 16, 2005): 2448. http://dx.doi.org/10.1182/blood.v106.11.2448.2448.
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Abstract More than 98% of newly diagnosed childhood B-NHL expresses CD20 (Perkins/Cairo, Clin Adv Hem/Onc 2003). The prognosis for children and adolescents with recurrent CD20 positive NHL, particularly DLBCL and BL, is dismal (Cairo et al, Am J Hem, 2003, Cairo et al, Br J Hem, 2003). A radiolabeled anti-CD20 antibody, 90Y-IT, has recently received FDA approval for adults with recurrent indolent CD20+ B-NHL. The dose limiting toxicity in adults has been myelosuppression (Witzig et al, JCO, 2003). Through the COG Phase I Consortium, we evaluated the safety of 90Y-IT in Pts with refractory childhood and adolescent CD20+ lymphoma: DLBCL (n=3) 1st relapse (n=1), 2nd relapse (n=2); refractory BL (n=1); refractory PTLD (DLBCL) (n=1); M:F ratio 4:1, median age 12 yrs (5–18). Pts (n=5) had a minimum of 2 x 106 CD34/kg cryopreserved PBSC. Pts (n=5) received Rituximab 250 mg/m2 IV on Days 0 and 7 and Indium 5 mCi IV on Day 0. Gamma imaging scans and peripheral blood dosimetry studies were performed on Days 0, 1, 3, and 6. Immediately following Rituximab on Day 7 (n=4) or approximately 24 hrs post Rituximab on Day 8 (n=1), Pts received 90Y-IT if dosimetry studies demonstrated ≤2000 cGy exposure to all solid organs and ≤300 cGy to red marrow based on a dose escalation schema stratified by marrow reserve and Plt; 0.4 mCi/kg (dose level 1) (n=3), 0.1 mCi/kg (dose level 1) (post BMT) (n=2). One Pt progressed prior to DLT evaluation. No evaluable pts (n=4) experienced non-hematologic DLT defined as any Grade III or IV non-hematologic toxicity attributable to the investigational agent or hematologic DLT defined as Grade IV ANC or Grade IV thrombocytopenia of > 7 days duration, and an ANC that did not reach ≥500 mm3 and/or platelet count that did not recover to ≥20,000/mm3 by Day 35. The incidence of HAMA/HACA was 0% (n=0). Toxicities related to the 90Y-IT included Grade I muscle pain/abdominal cramping (n=2), Grade III Plts (n=1), Hgb (n=1), infection (n=1), and Grade IV ANC (n=2), Plts (n=1). One Pt experienced Grade II infusion related chills associated with Rituximab. Mean organ radiation exposure (cGy) was as follows: kidneys 341 (112–515), liver 345 (83–714), lungs 309 (155–519), red marrow 46 (20–78), spleen 565 (161–816), and total body 3.7 (2.1 – 4.8). Mean serum quantitative immunoglobulins (mg/dl) at Day 35 were as follows: IgA 65, IgG 394, and IgM 32. 5/5 Pts experienced progressive disease and went on to receive further therapy. In conclusion, 90Y-IT appears to be well tolerated in children and adolescents with recurrent/refractory CD20+ lymphoma and associated with low exposure of radiation to solid organs and marrow. Based on these findings, an investigator-initiated limited institutional Phase II study is planned to further evaluate the safety, tolerability, and response rate with dose stratification based on marrow reserve and Plt: 0.4 mCi/kg (no prior BMT and Plt ≥ 150k), 0.3 mCi/kg (no prior BMT and Plt 100-149 k), 0.2 mCi/kg (prior BMT and Plt ≥ 100k).
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Houška, L. "The relationship between culling rate, herd structure and production efficiency in a pig nucleus herd." Czech Journal of Animal Science 54, No. 8 (August 18, 2009): 365–75. http://dx.doi.org/10.17221/1660-cjas.
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Computer simulation of sow culling was run in a nucleus herd. The specified constant culling rate from 15 to 21% was simulated for all parities. The resultant different age structure of a herd was studied from the aspect of piglet production and other production indicators. With increasing culling rate the percentage of mated gilts was increased in order to maintain the constant size of the sow herd. With 15% simulated culling, which required 17.09% of mated gilts, the percentage of sows at parity 1 and 2 and the percentage of sows at parities 3–5 were balanced (31.62% and 31.77%, respectively). Annual herd replacement was 37.62%. After five parities only a little more than a half (55.63%) of the total number of sows in the herd was removed. Similar results were obtained with 16% culling, which also made it possible to maintain the recommended herd structure. With higher culling rate parities 1 and 2 became dominant in the herd. With 21% culling and 19.84% of mated gilts the percentage of sows at parities 1 and 2 was 35.52% while it was only 29.90% at parities 3–5. Annual herd replacement amounted to 43.67%, and almost 70% of sows were removed after five parities in this case. With increasing culling rate the average age of sows removed from a herd decreased (1 158.1–1 021.2 days), the number of barren days in a herd per year increased (6 174–6 680 days) and the number of piglets weaned per sow per year decreased (19.54–18.92 piglets). At the same time, there was a decrease in total costs (64 789–63 519 Kč), returns (79 816–77 327 Kč) and profit (15 026–13 808 Kč) in the herd, as recalculated per sow per year, and profitability also decreased.
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Li, Xuanping, and Lin Pan. "Precise Point Positioning with Almost Fully Deployed BDS-3, BDS-2, GPS, GLONASS, Galileo and QZSS Using Precise Products from Different Analysis Centers." Remote Sensing 13, no. 19 (September 29, 2021): 3905. http://dx.doi.org/10.3390/rs13193905.
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The space segment of all the five satellite systems capable of providing precise position services, namely BeiDou Navigation Satellite System (BDS) (including BDS-3 and BDS-2), Global Positioning System (GPS), GLObal NAvigation Satellite System (GLONASS), Galileo and Quasi-Zenith Satellite System (QZSS), has almost been fully deployed at present, and the number of available satellites is approximately 136. Currently, the precise satellite orbit and clock products from the analysis centers European Space Agency (ESA), GeoForschungsZentrum Potsdam (GFZ) and Wuhan University (WHU) can support all five satellite systems. Thus, it is necessary to investigate the positioning performance of a five-system integrated precise point positioning (PPP) (i.e., GRECJ-PPP) using the precise products from different analysis centers under the current constellation status. It should be noted that this study only focuses on the long-term performance of PPP based on daily observations. The static GRECJ-PPP can provide a convergence time of 5.9–6.9/2.6–3.1/6.3–7.1 min and a positioning accuracy of 0.2–0.3/0.2–0.3/1.0–1.1 cm in east/north/up directions, respectively, while the corresponding kinematic statistics are 6.8–8.6/3.3–4.0/7.8–8.1 min and 1.0–1.1/0.8/2.5–2.6 cm in three directions, respectively. For completeness, although the real-time precise products from the analysis center Centre National d’Etudes Spatiales (CNES) do not incorporate QZSS satellites, the performance of real-time PPP with the other four satellite systems (i.e., GREC-PPP) is also analyzed. The real-time GREC-PPP can achieve a static convergence time of 8.7/5.2/11.2 min, a static positioning accuracy of 0.6/0.8/1.3 cm, a kinematic convergence time of 11.5/6.9/13.0 min, and a kinematic positioning accuracy of 1.7/1.6/3.6 cm in the three directions, respectively. For comparison, the results of single-system and dual-system PPP are also provided. In addition, the consistency of the precise products from different analysis centers is characterized.
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Thompson, John A., D. Gary Gilliland, Josef T. Prchal, John M. Bennett, Kay Larholt, Richard A. Nelson, Esther H. Rose, and Margaret H. Dugan. "Effect of recombinant human erythropoietin combined with granulocyte/ macrophage colony-stimulating factor in the treatment of patients with myelodysplastic syndrome." Blood 95, no. 4 (February 15, 2000): 1175–79. http://dx.doi.org/10.1182/blood.v95.4.1175.004k51_1175_1179.
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This randomized, placebo-controlled trial was designed to assess the efficacy and safety of therapy with granulocyte-macrophage colony-stimulating factor (GM-CSF) and erythropoietin (epoetin alfa) in anemic, neutropenic patients with myelodysplastic syndrome. Sixty-six patients were enrolled according to the following French–American–British classification: refractory anemia (20), refractory anemia with excess blasts (35), refractory anemia with ringed sideroblasts (9), and refractory anemia with excess blasts in transformation (2). Patients were stratified by their serum erythropoietin levels (less than or equal to 500 mU/mL, n = 37; greater than 500 mU/mL, n = 29) and randomized, in a 2:1 ratio, to either GM-CSF (0.3-5.0 μg/kg·d) + epoetin alfa (150 IU/kg 3 times/wk) or GM-CSF (0.3-5.0 μg/kg·d) + placebo (3 times/wk). The mean neutrophil count rose from 948 to 3831 during treatment with GM-CSF ± epoetin alfa. Hemoglobin response (increase greater than or equal to 2 g/dL, unrelated to transfusion) occurred in 4 of 45 (9%) patients in the GM-CSF + epoetin alfa group compared with 1 of 21 (5%) patients with GM-CSF + placebo group (P = NS). Percentages of patients in the epoetin alfa and the placebo groups requiring transfusions of red blood cells were 60% and 92%, respectively, for the low-endogenous erythropoietin patients and 95% and 89% for the high-endogenous erythropoietin patients (P = NS). Similarly, the average numbers of units of red blood cells transfused during the 12-week study in the epoetin alfa and the placebo groups were 5.9 and 9.5, respectively, in the low-endogenous erythropoietin patients and 9.7 and 8.6 in the high-endogenous erythropoietin patients (P = NS). GM-CSF ± epoetin alfa had no effect on mean platelet count. Treatment was well tolerated in most patients, though 10 withdrew from the study for reasons related predominantly to GM-CSF toxicity.
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Schwenk, W. F., and J. C. Kahl. "Acetaminophen glucuronidation accurately reflects gluconeogenesis in fasted dogs." American Journal of Physiology-Endocrinology and Metabolism 271, no. 3 (September 1, 1996): E529—E534. http://dx.doi.org/10.1152/ajpendo.1996.271.3.e529.
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To assess whether acetaminophen glucuronide accurately reflects uridyl diphosphate-glucose (UDP-glucose) derived from gluconeogenesis during fasting, three mongrel dogs received infusions of [U-14C]lactate, [1-13C]galactose, and [6-3H]glucose (after fasting overnight or for 2.5 days). After initiation of the isotopes (3 h), acetaminophen was given, and the urinary acetaminophen glucuronide was isolated. The mean plasma [14C]glucose specific activity (SA) was similar to the mean urinary acetaminophen glucuronide SA both after fasting overnight [299 +/- 19 vs. 296 +/- 14 disintegrations.min-1 (dpm).mumol-1, respectively] and after 2.5 days of fasting (511 +/- 8 vs. 562 +/- 32 dpm/mumol, respectively). Mean plasma glucose flux calculated using [6-3H]glucose decreased (P < 0.05) with two additional days of fasting (18.7 +/- 1.2 vs. 13.6 +/- 0.6 mumol.kg-1.min-1), as did intrahepatic (P < 0.05) UDP-glucose flux measured using [1-13C]galactose (8.6 +/- 0.7 vs. 5.5 +/- 0.3 mumol.kg-1.min-1). We conclude that, in fasted dogs, plasma glucose and UDP-glucose, as sampled by acetaminophen, equally reflect gluconeogenesis and appear to come from the same pool of glucose 6-phosphate. In addition, cycling of glucose moieties through UDP-glucose and glycogen decreases with an increased period of fasting.
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Paxinos, Odysseas, Petros Savourdos, Vasilis Alexelis, Anastasios Anastasopoulos, Eleni Karantoni, Panagiotis Grigoropoulos, and Xenofon Konstantinou. "In-Flight Medical Events and Cabin Crew First Aid Response." Aerospace Medicine and Human Performance 92, no. 1 (January 1, 2021): 32–38. http://dx.doi.org/10.3357/amhp.5715.2021.
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INTRODUCTION: In-flight medical events (IMEs), although rare, are challenging due to the limited onboard resources and the time needed to reach an airport. Cabin crewmembers (CCMs) are trained to provide first aid, but their effectiveness has not been appropriately studied.METHODS: IMEs occurring in the biggest airline of Greece were prospectively recorded during a 5-yr period (20142018) and categorized according to a symptom-based taxonomy.RESULTS: During the study period 990 IMEs were recorded corresponding to 16 IMEs for each million passengers or 1.8 IMEs for every thousand flights. The most frequent events were loss of consciousness (38.4%) followed by injuries (8.6%), gastrointestinal problems (8.3%), respiratory symptoms (7.3%), anxiety (5.7%), and burns (5.9%). Diversion was decided in 3% of the cases while death on board was rare (0.3% of events). CCMs responded in 33.5% of IMEs without assistance by a volunteer health professional, achieving a 97% success rate.DISCUSSION: IMEs are rare events and the majority can be treated with simple first aid measures. CCMs acting according to a simplified algorithm were very efficient in providing first aid. A standardized symptom-based IME form will assist in creating a reliable registry for further studies.Paxinos O, Savourdos P, Alexelis V, Anastasopoulos A, Karantoni E, Grigoropoulos P, Konstantinou X. In-flight medical events and cabin crew first aid response. Aerosp Med Hum Perform. 2021; 92(1):3238.
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Meerveld-Eggink, Aafke, Niels Graafland, Sofie Wilgenhof, Johannes V. Van Thienen, Michael Grant, Bernadett Szabados, Yasmin Abu-Ghanem, et al. "Real-world safety and efficacy data of patients with synchronous metastatic renal cell carcinoma (mRCC) treated with nivolumab and ipilimumab (N+I) and the primary tumour (PT) in place." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e17083-e17083. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e17083.
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e17083 Background: Following CARMENA and SURTIME, upfront cytoreductive nephrectomy (CN) is no longer standard of care. Intermediate and poor risk patients (pts) receive systemic therapy with the PT in place with the option to perform deferred CN in responding pts. This practice has been adopted after the recent shift to immune checkpoint inhibitor combination in frontline for mRCC. We assessed the safety and efficacy of this approach in a real-world population. Methods: A retrospective analysis of a clinical audit from 3 institutional datasets of pts treated with first-line N+I and the PT in place. Pts and tumour characteristics, International Metastatic RCC Database Consortium (IMDC) risk, overall response rate (ORR) in the PT and metastatic sites, time to response (TTR) of the PT, PT- and immune related- (ir) adverse events (AE), deferred CN rate, progression free- (PFS) and overall survival (OS) were assessed. Results: Of 41 pts treated with N+I and the PT in place, 46.3% were IMDC poor risk and 51.2% had > 3 metastatic sites. After a median follow-up of 5.9 (2-10.3) months, 29 had at least 1 CT scan from baseline. Of those, 7 (24.3% [95% confidence interval [CI] 0.10-0.43]) had a partial response (PR) of the PT with a median TTR of 5.3 (2.5-8.6) months. Mean and median PT reduction were 16.9% (+7.6 to -70.3%) and 10% from a baseline mean tumour size of 9.5 (3.8-16.1) cm. Pts with a PT reduction > median (n = 14) had a PR at metastatic sites in 86% (CI 0.57-0.98) and no progressive disease (PD). Pts with PT reduction < median (n = 14) had PR in only 21% and PD at metastatic sites in 57% (CI 0.28-0.82). None of the PT progressed. There was no complete response (CR) at metastatic sites . No CN was performed; 5 pts (12%) developed hematuria grade 1-3, requiring embolisation in 2 (4.9%). Grade 3-4 irAE were observed in 22% of pts. Median PFS and OS are 8.6 months and not reached. Conclusions: N+I with the PT in place is safe and PT reduction is associated with response at metastatic sites. Most PT responded by 6 months. No CR at metastatic sites were observed (compared to a 9% CR rate in the pivotal trial) in this real-world population with a relatively high percentage of poor-risk pts. Furthermore, no deferred CN has been performed, neither for near-CR at metastatic sites nor for PT symptoms.
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Fomin, I. V., and N. G. Vinogradova. "Rationale of specialized medical care for patients with chronic heart failure in the Russian Federation." South Russian Journal of Therapeutic Practice 1, no. 3 (December 20, 2020): 44–53. http://dx.doi.org/10.21886/2712-8156-2020-1-3-44-53.
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Objectives: to determine the causes of ineffective observation and poor prognosis in patients undergoing ADHF, in real clinical practice and to consider the basics of the formation of specialized medical care for patients with heart failure (HF).Materials and methods: the study was conducted based on the City Center for the treatment of heart failure (center HF), N. Novgorod. The study consistently included 942 patients with heart failure (HF) at the age of 18 years and older who underwent ADHF and received inpatient treatment in center HF between March 4, 2016 and March 3, 2017. Based on the decisions of patients to continue outpatient monitoring in center HF, two groups of patients were distinguished: patients who continued to be monitored in center HF (group I, n = 510) and patients who continued to be monitored in outpatient clinics at the place of residence (group II, n = 432). The assessment of adherence to treatment, overall mortality, survival and re-admission to a depth of two years of observation was carried out. Statistical data processing was performed using Statistica 7.0 for Windows and the software package R.Results: all patients in the study groups had high comorbidity. Group 2 patients turned out to be statistically significantly older, more often had III functional class (FC) HF, lower the baseline test score of 6-minute walk, and higher the baseline clinical assessment scale. After 2 years of follow-up in group II, there was a significant deterioration in adherence to basic therapy of HF compared with group I. According to the results of multifactorial proportional risk Cox models, it was shown that observation of patients in the group 1 is an independent factor increasing the risk of overall mortality by 2.8 times by the end of the second year of observation. Survival after two years of follow-up was: in group I — 89.8 %, and in group II — 70.1 % of patients (OR = 0.3, 95 % CI 0.2 – 0.4; p1/2 < 0.001). After two years of follow-up, the proportion of re-hospitalized patients in group II was greater (78.0 % of patients) versus group 1 (50.6 % of patients, OR = 3.5, 95 % CI 2.6 – 4.6; p1/2 <0.001). The independent risk of re-hospitalization according to multinominal logit regression was 3.4 times higher in group II and 2.4 times for III – IV FC HF. Conclusions: the inclusion of patients with HF in the system of specialized medical care improves adherence to treatment, prognosis of life and reduces the risk of repeated hospitalizations. Patients of an older age and with an initially greater clinical severity refused specialized supervision in center HF.
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Czimmer, József, Mulugeta Million, and Yvette Taché. "Urocortin 2 acts centrally to delay gastric emptying through sympathetic pathways while CRF and urocortin 1 inhibitory actions are vagal dependent in rats." American Journal of Physiology-Gastrointestinal and Liver Physiology 290, no. 3 (March 2006): G511—G518. http://dx.doi.org/10.1152/ajpgi.00289.2005.
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We characterized the influence of the selective corticotropin-releasing factor 2 (CRF2) receptor agonist human urocortin 2 (Ucn 2), injected intracisternally, on gastric emptying and its mechanism of action compared with intracisternal CRF or urocortin (Ucn 1) in conscious rats. The methylcellulose phenol red solution was gavaged 20 min after peptide injection, and gastric emptying was measured 20 min later. The intracisternal injection of Ucn 2 (0.1 and 1 μg) and Ucn 1 (1 μg) decreased gastric emptying to 37.8 ± 6.9%, 23.1 ± 8.6%, and 21.6 ± 5.9%, respectively, compared with 58.4 ± 3.8% after intracisternal vehicle. At lower doses, Ucn 2 (0.03 μg) and Ucn 1 (0.1 μg) had no effect. The CRF2 antagonist astressin2-B (3 μg ic) antagonized intracisternal Ucn 2 (0.1 μg) and CRF (0.3 μg)-induced inhibition of gastric emptying. Vagotomy enhanced intracisternal Ucn 2 (0.1 or 1 μg)-induced inhibition of gastric emptying compared with sham-operated group, whereas it blocked intracisternal CRF (1 μg) inhibitory action (45.5 ± 8.4% vs. 9.7 ± 9.7%). Sympathetic blockade by bretylium prevented intracisternal and intracerebroventricular Ucn 2-induced delayed gastric emptying, whereas it did not influence intravenous Ucn 2-, intracisternal CRF-, and intracisternal Ucn 1-induced inhibition of gastric emptying. Prazosin abolished the intracisternal Ucn 2 inhibitory effect, whereas yohimbine and propranolol did not. None of the pretreatments modified basal gastric emptying. These data indicate that intracisternal Ucn 2 induced a central CRF2-mediated inhibition of gastric emptying involving sympathetic α1-adrenergic mechanisms independent from the vagus contrasting with the vagal-dependent inhibitory actions of CRF and Ucn 1.
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Khare, Reeti, Tarush Kothari, Joseph Castagnaro, Bryan Hemmings, May Tso, and Stefan Juretschko. "Active Monitoring and Feedback to Improve Blood Culture Fill Volumes and Positivity Across a Large Integrated Health System." Clinical Infectious Diseases 70, no. 2 (April 9, 2019): 262–68. http://dx.doi.org/10.1093/cid/ciz198.
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AbstractBackgroundThe sensitivity of blood cultures increases with the volume of blood collected. However, hospitals face challenges in collecting adequate volume, and underfilled blood bottles are ubiquitous.MethodsBlood bottle fill volumes were measured using an automated monitoring system across multiples sites (10 hospitals, 3 laboratories) within a large suburban/urban health system. Baseline fill volumes were measured for 4 months. A quality improvement program was then implemented over 36 months. Strategies to improve fill volumes included education, standardized data collection, novel and unblinded information cascades, targeted communication, and bottle markings for blood collectors.ResultsA total of 516 201 blood cultures were evaluated over 40 months. In the preimplementation period (January–April 2015), no hospitals collected the recommended 8–10 mL/bottle, and the average system fill volume was 2.3 mL. In the final postimplementation period (January–April 2018), 7 of 10 hospitals achieved ≥8 mL per bottle and the system average increased to 8.6 mL (P < .0001). The positivity rate increased 20%, from 7.39% to 8.85% (P < .001), whereas the contamination rate did not change and remained low. Compared to the preimplementation period, the odds of positive cultures containing potential pathogens increased to 1.18 (95% confidence interval, 1.05–1.32; P = .003).ConclusionsHere we show that underfilled blood cultures are extremely common but that operational and educational strategies can result in sustained improvements across a complex network of hospitals and laboratories. This leads to increased detection of pathogens, which can have tremendous impact on the management of bloodstream infections and sepsis.