Academic literature on the topic '621.397: 778.53'

Maddox Dairy, located in Riverdale, CA, USA, is a Holstein herd that milks 3500 cows with a 305-day mature-equivalent milk production of 12 800 kg, and they have been producing high genetic animals by embryo transfer (ET) since the early 1980s. Invivo-derived embryos from Holstein donors were transferred fresh (grade 1 or 2) or frozen (grade 1), at morula (4), early blastocyst (5), or blastocyst (6) stage, to virgin heifers (VH, natural oestrus, 13-15 months old) or lactating cows (LC, Presynch-Ovsynch, 86 days in milk, first or second lactation) 6 to 9 days after oestrus. Pregnancy diagnosis was done by transrectal ultrasonography at 32-46 days in VH and by the IDEXX PAG test at 30 days in LC. June, July, August, September, and October were called critical months (first service AI conception rate drops below 44%) and compared with the other months. The data from 32 503 ETs between January 2008 and December 2018 are summarised on Table 1. Pregnancy rates (PR) are lower for LC recipients than for VH. Embryo transfers performed 7 or 8 days after oestrus had higher PR in both types of recipients and embryos, but Day 6 and 9 oestrus are also used with fair results. The season does not seem to affect PR. There is not enough difference in the combination of stage and days from oestrus for invivo-derived embryos. These numbers do not belong to a planned experiment. Several management changes during the years were made, which make it very difficult to apply statistical methods to analyse the data correctly. They are used as a tool to make decisions in an attempt to improve future results. Table 1.Pregnancy rate (PR) of virgin heifers (top) and lactating cows (bottom)-fresh (SH) and frozen (OZ) invivo-derived embryo transfer1 Heat-months SH-ST4 SH-ST5 SH-ST6 SH-All OZ-ST4 OZ-ST5 OZ-ST6 OZ-All PR% n PR% n PR% n PR% n PR% n PR% n PR% n PR% n Heifers 6 d-CM 62 934 66 243 68 69 63 1246 56 473 58 219 62 42 57 734 6 d-OM 62 1623 67 489 69 211 64 2323 56 600 55 296 48 137 55 1033 6 d-T 62 2557 67 732 69 280 63 3569 56 1073 57 515 51 179 56 1767 7 d-CM 64 1506 68 495 67 221 65 2222 60 822 62 340 63 156 61 1318 7 d-OM 66 2723 68 1021 69 510 67 4254 57 1120 59 581 57 231 58 1932 7 d-T 66 4229 68 1516 69 731 67 6476 58 1942 60 921 60 387 59 3250 8 d-CM 65 1348 64 518 67 322 65 2188 59 595 64 258 63 108 61 961 8 d-OM 66 2166 68 886 70 510 67 3562 61 770 60 364 51 130 60 1264 8 d-T 66 3514 67 1404 69 832 66 5750 60 1365 62 622 56 238 60 2225 9 d-CM 60 109 56 43 70 20 60 172 60 5 33 6 50 4 47 15 9 d-OM 58 129 63 57 60 40 60 226 63 16 50 18 75 4 58 38 9 d-T 59 238 60 100 63 60 60 398 62 21 46 24 63 8 55 53 All-CM 64 3897 66 1299 67 632 65 5828 58 1895 61 823 63 310 60 3028 All-OM 65 6641 67 2453 69 1271 66 10 365 58 2506 58 1259 53 502 58 4267 All-T 65 10 538 67 3752 69 1903 66 16 193 58 4401 60 2082 57 812 59 7295 Lactating cows 6 d-CM 54 265 48 86 50 12 53 363 38 141 31 77 50 10 36 228 6 d-OM 49 463 52 203 45 56 50 723 46 101 48 54 59 27 48 182 6 d-T 51 728 51 289 46 68 51 1086 41 242 38 131 57 37 42 410 7 d-CM 54 755 59 274 56 103 55 1137 43 928 48 450 43 192 45 1570 7 d-OM 55 914 66 367 54 109 58 1393 46 1052 45 564 47 353 46 1969 7 d-T 55 1669 63 641 55 212 57 2530 45 1980 46 1014 46 545 45 3539 8 d-CM 63 252 68 82 76 33 65 368 48 219 56 80 42 33 50 332 8 d-OM 61 257 64 161 53 47 61 466 50 191 53 77 56 16 51 284 8 d-T 62 509 65 243 63 80 63 834 49 410 55 157 47 49 50 616 All-CM 56 1272 58 442 60 148 57 1868 44 1288 47 607 43 235 45 2130 All-OM 55 1634 62 731 51 212 56 2582 47 1344 46 695 48 396 47 2435 All-T 55 2906 60 1173 55 360 57 4450 45 2632 47 1302 46 631 46 4565 1ST=stage; CM=critical months (June, July, August, September, and October); OM=other months.

626 Background: Systemic chemotherapy is still mainstay of treatment of metastatic colorectal cancer (mCRC), while the role of palliative resection is not convincing. We intended to find out the role of palliative resection in mCRC. Methods: A total of 1,015 patients were diagnosed with mCRC at Seoul National University Hospital between 2000 and 2009. Except 169 patients who received curative metastectomy of liver and/or lung, 847 patients were retrospectively analyzed. Results: Out of 847 patients, 556 (65.6%) had metastasis at the time of diagnosis and 291 (34.4%) had recurrence after surgery. The median age was 61 (range, 16-88) and 491 (58.0%) were male. The median number of metastatic site was 1 (range, 1-6) and 738 (87.1%) had limited metastasis (number of metastatic site ≤2). The liver was most frequently involved site (451, 53.2%). Surgery was done in 527 (62.2%). One hundred three patients received resection of both primary and metastatic sites (group 1), while 347 and 78 received resection of primary (group 2) and metastatic sties (group 3), respectively. R0 resection was done in 95 patients (G1: 53, G3: 42), while R1/2 was done 431 in patients (G1: 56, G2: 336, G3:39). Of 95 patients with R0 resection, 93 (97.8%) had limited metastasis (number of metastatic organ ≤2) in the peritoneum, lymph nodes, liver, or lung. The median overall survival (OS) was 19.0 months (95% CI, 17.8-20.1) and resected patients had prolonged median OS compared with patients never resected (21.3 vs 14.1 months, p < 0.001). In multivariate analysis, R0 resection was associated with superior OS compared to R2 resection (51.3 vs 18.7 months; HR, 3.0; 95% CI, 1.86 to 4.85, P<0.001), and no resection (51.3 vs 14.1 months; HR, 2.93; 95% CI, 1.73 to 4.96, P<0.001). Palliative chemotherapy was administered in 746 (88.1%), while chemotherapy was not performed in 101 (11.9%) due to patient’s refusal and poor performance status. In multivariate analysis, chemotherapy was also independent prognostic factor for OS (20.4 vs 5.4 months, HR, 3.47; 95% CI, 2.25 to 5.35, P<0.001). Conclusions: Palliative resection with curative intent and chemotherapy confer long-term survival on subsets of mCRC with limited metastasis.

BackgroundWith the development of evidence-based interventions for treatment of priority mental health conditions in humanitarian settings, it is important to establish the cost-effectiveness of such interventions to enable their scale-up.AimsTo evaluate the cost-effectiveness of the Problem Management Plus (PM+) intervention compared with enhanced usual care (EUC) for common mental disorders in primary healthcare in Peshawar, Pakistan. Trial registration ACTRN12614001235695 (anzctr.org.au).MethodWe randomly allocated 346 participants to either PM+ (n = 172) or EUC (n = 174). Effectiveness was measured using the Hospital Anxiety and Depression Scale (HADS) at 3 months post-intervention. Cost-effectiveness analysis was performed as incremental costs (measured in Pakistani rupees, PKR) per unit change in anxiety, depression and functioning scores.ResultsThe total cost of delivering PM+ per participant was estimated at PKR 16 967 (US$163.14) using an international trainer and supervisor, and PKR 3645 (US$35.04) employing a local trainer. The mean cost per unit score improvement in anxiety and depression symptoms on the HADS was PKR 2957 (95% CI 2262–4029) (US$28) with an international trainer/supervisor and PKR 588 (95% CI 434–820) (US$6) with a local trainer/supervisor. The mean incremental cost-effectiveness ratio (ICER) to successfully treat a case of depression (PHQ-9 ≥ 10) using an international supervisor was PKR 53 770 (95% CI 39 394–77 399) (US$517), compared with PKR 10 705 (95% CI 7731–15 627) (US$102.93) using a local supervisor.ConclusionsThe PM+ intervention was more effective but also more costly than EUC in reducing symptoms of anxiety, depression and improving functioning in adults impaired by psychological distress in a post-conflict setting of Pakistan.

Background:Behcet’s disease (BD) is a systemic vasculitis affecting all types and sizes of blood vessels. Heart rate variability (HRV) reflects sympathetic -parasympathetic imbalance in the autonomic NS regulation. Low HRV values are known as independent risk factor of death and non-fatal cardiovascular events in both - survivors of a myocardial infarction and in asymptomatic population.Objectives:The aim of this study is to evaluate HRV in BD pts vs healthy controls.Methods:The study group included 74 BD pts (53males/21females) with disease duration of 9,0 (5,0;15,0)/9,0 (7;20) years, and the control group - 32/15 age-matched healthy m/f. The following HRV parameters from 24h ECG ambulatory recording were assessed: MeanNN and time-domain variables, adjusted by MeanNN (SDNNn%, SDNNin%, RMSSDn%). Additionally, all traditional cardiovascular risk factors such as systolic blood pressure (SPB), smoking status, BMI values, dyslipidemia profile, ultrasonographic values of carotid intima-media thickness (IMT), and levels high sensitive CRP (hsCRP) as a marker of inflammation were evaluated.Results:In BD patients HRV values (RMSSDn%) were significantly lower compared to healthy controls (table 1).Table 1.HRV parameters in BD patients and control groupParametersMalesFemalesBD (n=53)Control (n=32)BD (n=21)Control (n=15)Age, years30 (24; 36)30 (26; 35)32 (26; 37)28 (24; 31)MeanNN, ms810 (732; 849)782 (732; 835)776 (708; 830)764 (694; 832)SDNN n (%)16,9 (13,6; 19,4)17,2 (16,3; 21,1)13,1 (11,3; 5,3)12,2 (10,7; 14,6)SDNNi n (%)6,8 (5,1; 8,1)6,8 (5,0; 8,3)7,1 (6,1; 7,7)5,2 (4,9; 5,7)RMSSD n (%)2,1 (1,5; 2,3)**4,1 (2,7; 5,2)**1,7 (1,4; 3,7)*2,8 (2,2; 3,9)*Data are presented in median values and interquartile range, *p<0,05, **p<0,005 vs controls.There was a significant negative correlation in BD patients between HRV (SDNNin%) and age (r= -0,4; p=0,00), disease duration (r= -0,3; p=0,00), BMI (r= -0,2; p<0,01), cholesterol levels (r= -0,3; p=0,00), LDLP (r= -0,3; p=0,00) and increased IMT (r= -0,2; p=0,04), and also between HRV (RMSSD%) and age (r= -0,2; p=0,04), disease duration (r= -0,2; p=0,01), cholesterol levels (r= -0,3; p=0,00), HDLP (r= -0,2; p=0,04); a positive correlation was established between HRV (SNNN%) and smoking (r= -0,2; p=0,04). The control group showed positive correlation between HRV (SNNN%) and increased IMT (r= 0,4; p=0,01).Conclusion:HRV reduction reflects impaired sympathetic -parasympathetic regulation in BD pts, associated with pts’ age, disease duration and presence of traditional cardiovascular risk factors: BMI, increased cholesterol levels, LDLP, and such asymptomatic manifestation of atherosclerosis as increased IMT.Disclosure of Interests:None declared

An investigation was undertaken to determine the general clinical prevalence of diseases and disorders in cattle and goats at the Upazilla Veterinary Hospital, Mohammadpur, Magura during the period from January to December 2010. A total of 536 clinical cases (327 cattle and 209 goats) were recorded and analyzed. Diagnosis of each of the clinical cases was made on general examination, physical examination, clinical examination, microscopic examination and using common laboratory techniques. The clinical cases were divided into three groups on the basis of treatment required viz. (1) Medicinal, (2) Gynaeco-obstetrical and (3) Surgical cases. Among the three types of ruminant cases, medicinal cases constituted highest percentage (cattle 86.5% and goats 90.4%) in comparison to gynaeco-obstetrical (cattle 6.1% and goats 0.9%) and surgical (cattle 7.3% and goats 8.6%) cases. Among the medicinal cases, gastrointestinal nematodiasis (cattle 37.8% and goats 19.6%), diarrhoea (cattle 13.4% and goats 19.6%), fascioliasis (cattle 12.4% and goats 1.6%), paramphistomiasis (cattle 8.8% and goats 2.6%), fever (cattle 7.8% and goats 12.7%) were recorded major disease problems in cattle and goats. Among the gynaeco-obstetrical cases, retained placenta (cattle 30% and goats 50%) and repeat breeding (cattle 70% and goats 50%) were recorded as major gynaeco-obstetrical problems in cattle and goats. Abscess (cattle 45.8% and goats 5.6%), myiasis (cattle 20.8% and goats 20.8%), navel ill (cattle 12.5), urolithiasis (cattle 20.8% and goats 44.4%) and overgrown hoof (goats 33.3%) and gid disease (goats 5.6%) were recognized as the main disorders which required surgical interventions. It may conclude that a number of diseases have been occurring in the Mohammadpur upazila and this report may help to develop control strategies against major diseases reported in this study.DOI: http://dx.doi.org/10.3329/bjvm.v12i1.20463 Bangl. J. Vet. Med. (2014). 12 (1): 47-53

8048 Background: Organ response (OR) in AL is often delayed and difficult to predict early. Methods: We retrospectively analyzed 1308 patients (pts) with newly diagnosed AL from 2006 – 2015 to determine factors which could predict for OR. Results: Median age was 64 years (yr) and Mayo Stage was: 1 (22%); 2 (23%); 3 (25%); 4 (31%). Organ involvement was: cardiac (74%, n=932); renal (59%, n=738), liver (16%, n=205); gut (24%, n=310) and autonomic (12%, n=152). 59% (n=765) had > 1 organ involved, including 43% (n=567) with > 1 critical organ (heart, kidney, liver) involved. Treatment was: ASCT based (28%, n=330, N=1186), bortezomib based (24%, n=281), alkylator based (33%, n=392), others (5%, n=54) and none (10%). In evaluable pts, VGPR or better rates were: 53% at 6 months (m) (N=625), 72% at 12 m (N=465) and 57% overall (N=688). Table 1 lists OR at various time points. Complete OR in all involved critical organs was seen in: 51% (n=308, N=600), partial response (at least 1 OR when >1 organ involved) in 12% (n=73) and none in 37% (n=219). Complete OR was associated with better overall survival (OS) than partial or no OR (median OS: not reached vs 42 m vs 29 m; P <0.0001). In multivariate model the following variables at baseline or 1 yr mark were predictive of complete OR: lower Mayo Stage (p=0.01), fewer critical organs involved (p=0.007), higher baseline GFR (p=0.03), female sex (Complete OR 60% vs 47%; p=0.04) and VGPR at 1 yr (Complete OR 70% vs. 36%; p <0.0001). Other factors included in the model were age (p=0.9), bilirubin (p=0.1) and transplant (p=0.2). All aforementioned factors were significant in univariate analysis. Conclusions: Achievement of response in all involved critical organs is associated with better survival in AL pts than partial or no OR. Various baseline factors and VGPR at 1 yr can predict for achieving complete OR, with 70% pts who achieve VGPR at 1 yr having a complete OR. [Table: see text]

Background The effects of inspiratory muscle training on plasma cytokines, C-reactive protein and the soluble apoptosis mediators Fas and Fas ligand in chronic heart failure are unknown. Design and methods Thirty-eight patients with chronic heart failure, age 57 ± 2 years, New York Heart Association classification II-III, were assigned to either a high intensity training group ( n = 15, age 53±2 years) exercised at 60% of sustained maximal inspiratory pressure, or a low intensity training group ( n = 23, age 59 ± 2 years), exercised at 15% of sustained maximal inspiratory pressure, three times per week for 10 weeks. Patients in the high intensity training group and low intensity training group were matched for age, sex and New York Heart Association functional class. Plasma levels of tumor necrosis factor (TNF)-α, soluble TNF receptor I, interleukin-6, C-reactive protein, soluble apoptosis mediators Fas and Fas ligand were measured at baseline and at post-inspiratory muscle training. Pulmonary function was assessed by spirometry, exercise capacity by a cardiopulmonary exercise test and the 6 min walk test, whereas dyspnea by the Borg scale after the 6 min walk test. Results High intensity training group improved inspiratory muscle strength (105.1 ± 4.9 vs. 79.8 ± 4.7 cmH2O, P < 0.001), sustained maximal inspiratory pressure (504.5 ± 39.7 vs. 312.5 ± 26.5cmH2O/s/103, P<0.001), forced vital capacity (98.9 ± 3.9 vs. 96 ± 3.3%, P<0.05), peak Vo2 (19.4 ± 1.2 vs. 17.3 ± 0.9 ml/kg per min, P<0.01), 6 min walk test distance (404.3 ± 11.9 vs. 378.2 ± 10.4 m, P<0.01) and dyspnea (8.0 ± 0.4 vs. 9.2 ± 0.4, P<0.01). Circulating TNF-α, soluble TNF receptor I, interleukin-6, C-reactive protein, soluble apoptosis mediators Fas and Fas ligand were not significantly altered. Low intensity training group increased only the inspiratory muscle strength (90.3 ± 5.9 vs. 80.2 ± 5cmH2O, P<0.01). Comparison between groups was significant for soluble TNF receptor I change (high intensity training group, 5.8 ± 0.49 vs. 6.1 ± 0.42; low intensity training group, 8.4 ± 0.6 vs. 7.8 ± 0.6, P<0.01). Conclusion A high intensity inspiratory muscle training program resulted in improvement in functional status of chronic heart failure patients compared with low intensity inspiratory muscle training. Improvement in exercise capacity was not associated with an anti-inflammatory effect, although a beneficial influence on soluble TNF receptor I was recorded. Possible reasons include inadequate level of muscle mass exercise and the low pretraining New York Heart Association class. Eur J Cardiovasc Prev Rehabil14:679-685 © 2007 The European Society of Cardiology

Background:Elderly rheumatoid arthritis (RA) patients are generally at increased risk of serious infections (SI). At the same time, treatment with bDMARDs has been associated with a higher SI risk than treatment with csDMARDs (1). However, long-term use of bDMARDs did not increase the risk of SI in a small group of elderly patients over 65 (2). The extent to which elderly patients are exposed to a higher SI risk when treated with JAK inhibitors (JAKi) is an open question.Objectives:To assess the effects of bDMARDs and specifically JAKi on the risk of SI in elderly patients with RA.Methods:The German register RABBIT is a prospective, longitudinally followed cohort of RA patients enrolled with a new start of a DMARD after at least one csDMARD failure. This analysis comprises patients over 70 years of age who were enrolled between 01/2007 and 04/2020 and had at least one follow-up.Results:Of 13,491 patients followed-up in RABBIT, 2274 with an age > 70 years were included in the analysis. 626 SI were observed in 425 of these patients. Baseline characteristics at start of the respective DMARD are shown in Table 1. In most characteristics, patients on JAKi were more comparable to patients under bDMARDs than to those on csDMARDs. JAKi patients received glucocorticoids (GC) less frequently than patients on other treatments. The HR for SI was lower than 1 in patients receiving bDMARDs or JAKi compared to csDMARDs, but without statistical significance (Figure 1). GC use (HR 1.6, 95% CI: 1.2 – 2.2 for ≤ 10 mg/d), higher DAS28-ESR values (HR 1.1, 95% CI: 1.0 – 1.2 per 1 point increase), COPD or pulmonary fibrosis (HR 1. 8, 95% CI: 1.3 – 2.4), chronic kidney disease (HR 1.5, 95% CI: 1.2 – 1.9) and diabetes mellitus (HR 1.3, 95% CI: 1.0 – 1.7) were associated with an increased risk of SI. Better physical capacity was associated with a decreased risk of SI (HR 0.9, 95% CI: 0.88 – 0.98 for a 10 point increase).Table 1.Patient characteristics by treatment at baselineParametercsDMARDsTNFiRTXABAIL-6iJAKiN=758N=840N=209N=147N=212N=108Age (years)75.9 (3.9)75.5 (3.6)74.8 (3.6)76.1 (3.9)75.9 (3.7)76.7 (3.7)Male sex184 (24.3)220 (26.2)50 (23.9)36 (24.5)46 (21.7)28 (25.9)Ever smoker249 (32.8)287 (34.2)77 (36.8)50 (34)73 (34.4)39 (36.1)Disease duration (years)7.9 (8.8)12.3 (11.4)17 (11.1)12.8 (10)13.8 (11.7)11.9 (10.9)Seropositivity487 (64.3)671 (79.9)201 (96.2)126 (85.4)182 (85.8)79 (73.5)Number of previous DMARDs1.4 (0.7)2.5 (1.3)4.2 (1.8)3.6 (1.9)3.3 (1.8)2.6 (1.5)DAS28-ESR4.6 (1.2)5.1 (1.2)5.4 (1.3)5.3 (1.3)5.3 (1.3)5 (1.2)Proportion of full physical function64.8 (23.1)57.1 (23.6)50.4 (23.7)52.9 (23.5)55.3 (24.1)55.2 (23.7)Number of comorbidities3.1 (2.5)3.8 (2.6)4.2 (2.6)4.6 (2.9)3.6 (2.4)3.8 (2.2)No comorbidity52 (6.9)29 (3.5)4 (1.9)4 (2.7)9 (4.2)5 (4.6)Three and more comorbidities385 (50.8)528 (62.9)147 (70.3)107 (72.8)131 (61.8)76 (70.4)COPD or pulmonary fibrosis69 (9.1)89 (10.6)29 (13.9)26 (17.7)12 (5.7)11 (10.2)Chronic kidney disease94 (12.4)151 (18)28 (13.4)21 (14.3)39 (18.4)22 (20.4)Diabetes mellitus151 (19.9)172 (20.5)31 (14.8)23 (15.6)42 (19.8)25 (23.1)GCs (last 6 months)347 (45.8)526 (62.6)143 (68.8)82 (56.2)127 (59.9)44 (40.7)GCs (<5mg)447 (58.9)384 (45.7)101 (48.2)88 (60)118 (55.8)72 (66.7)GCs (5-9mg)252 (33.3)375 (44.6)81 (38.7)43 (29)72 (34.2)27 (25.1)GCs (>=10mg)59 (7.8)82 (9.8)274 (13.1)16 (11)21 (10)9 (8.2)Results are presented as mean ± SD for continuous variables and number (percentage) for discrete variables.Figure 1.Hazard ratios for serious infections with 95% confidence intervalsConclusion:Treatment with JAKi as well as treatment with bDMARDs was not associated with an increased risk of SI in elderly patients above 70 years of age. Key comorbidities such as diabetes mellitus, chronic pulmonary and kidney diseases were associated with increased risk, as was concomitant GC use and higher disease activity.References:[1] Listing J et al., Rheumatology 2013; 52 (1): 53-61.[2] Kawashima H. et al., Rheum. Intern. 2017; 37: 369-376.Acknowledgements:RABBIT is supported by a joint, unconditional grant from AbbVie, Amgen, BMS, Celltrion, Fresenius-Kabi, Gilead, Hexal, Lilly, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi-Aventis, UCB, and Viatris.Disclosure of Interests:None declared

Abstract Introduction: While R-CHOP has improved survival for DLBCL, outcome in patients (pts) with relapsed/refractory disease remains dismal and may have worsened since the introduction of immunochemotherapy. High-dose chemotherapy and stem cell transplantation (SCT) offers the best chance of secondary cure, but the majority of patients are ineligible due to age, co-morbidities or disease refractory to salvage chemotherapy. Novel agents will address this unmet medical need; however, their impact is difficult to assess without a reliable historical comparator. Herein, we evaluate the outcome in an unselected population with relapsed/refractory DLBCL following R-CHOP in whom SCT is not feasible. Methods: The BC Cancer Agency Lymphoid Cancer Database was used to identify all pts diagnosed with de novo DLBCL between Dec 2000 to Jan 2013 who were treated with curative intent R-CHOP and subsequently progressed or relapsed. Patients were excluded if they were HIV positive, had CNS involvement at diagnosis, PMBCL, composite/discordant histology or transformed lymphoma. Clinical information at baseline and at relapse/progression was compiled. Overall survival (OS) from relapse was calculated from the date of 1st relapse/progression to death or last follow-up. Progression-free survival (PFS) from relapse was defined as interval from 1st relapse/progression to the date of 2nd relapse, initiation of next line of therapy, death or last follow-up. Results: 379 pts with relapsed/refractory DLBCL were identified. 53 underwent SCT and were excluded from analysis. The remaining 326 (274 SCT-ineligible and 52 SCT-eligible pts who did not receive SCT due to toxicity or chemo-refractoriness) were analyzed. Response to primary treatment was: 44% CR; 20% PR; 2% SD; 34% PD. 174 (53%) were primary refractory (progression during or within 3 mos of primary R-CHOP). Median time from diagnosis to first recurrence was 7.8 mos (range 0 – 116). Patient characteristics at relapse: median age 70 y (range 21-93); 55% male; 59% elevated LDH; 58% ECOG PS >1; 55% stage III/IV; 18% >1 extra-nodal site; 53% IPI score at relapse > or = 3. 14 (4%) relapsed with an indolent histology only and 74 (23%) exhibited CNS involvement at relapse (54 isolated, 20 concurrent systemic). Treatment at initial relapse: 78 supportive care; 77 radiotherapy (RT) alone; 2 single agent rituximab (for indolent relapse); 168 (R)-chemo +/- RT (79 single agent, 89 multi-agent). (R)-GDP was the most commonly used multi-agent regimen (75%). 1 pt had missing information. Median follow-up for living pts from the time of first relapse was 3 y. Median OS and PFS from relapse for the entire cohort were 3.9 and 2.1 mos, respectively. Outcome was worse for pts with primary refractory disease (median OS 2.5 mos, median PFS 1.7 mos). On multivariate analysis elevated LDH, ECOG PS >1, Stage III/IV and primary refractory status were independent predictors of OS and PFS from relapse. Pts who relapsed > 2 y from diagnosis had a better median OS and PFS from relapse (11 mos and 5.7 mos, respectively). Excluding pts with CNS involvement, pts who received chemo +/- RT (median OS 6.1, median PFS 3.1 mos) or RT alone (median OS 5.7, median PFS 3.3 mos) had a marginally better outcome. Disease control was similar between pts who received multi-agent vs single agent chemotherapy (median PFS 3.3 vs 2.9 mos). Median OS and PFS from relapse for the 74 pts with CNS involvement were 3.3 mos and 2.2 mos, respectively; this was similar compared to the entire cohort. Outcome was also similar between those with isolated CNS recurrence and concurrent systemic disease but 10 pts with isolated CNS relapse survived > 2 yrs. The 14 pts with indolent histology-only relapse had a significantly better outcome (median OS 36 mos, median PFS 12 mos). Conclusion: The outcome in pts who relapse or progress following R-CHOP is exceedingly poor with standard therapy, with median OS less than 4 mos. Pts who receive treatment at initial relapse fare slightly better, but this may reflect more favorable pt characteristics. Disease control was equivalent for multi-agent vs single agent treatment. While CNS relapse is a rare event in DLBCL, a high proportion of relapsed/refractory pts have CNS disease. The presence of CNS disease did not negatively impact outcome, as outcome was dismal in the entire cohort. Novel treatments are greatly needed and these survival estimates may serve as a comparator to assess their benefit. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures Savage: F Hoffmann-La Roche: Research funding to support BCCA Lymphoid Cancer Database Other. Villa:F Hoffmann-La Roche: Other. Shenkier:F Hoffmann-La Roche: Research funding to support BCCA Lymphoid Cancer Database Other. Gerrie:F Hoffmann-La Roche: Other. Klasa:F Hoffmann-La Roche: Other. Connors:F Hoffmann-La Roche: Other. Sehn:F Hoffmann-La Roche: Research funding to support BCCA Lymphoid Cancer Database Other.

Abstract Background: To describe the clinical characteristics (CC) and survival predictors in NHL pts at a VA medical center. Methods: We performed a retrospective chart review of all pts diagnosed with Non Hodgkin’s lymphoma at the VANJHCS from January 1, 1997 through December 31, 2006. Records were reviewed for demographic, clinical, pathological data and survival. Statistical analyses were performed using STATA. The study was approved by the IRB. Results: 1. Clinical characteristics. There were 92 pts, with 57 deaths(62%). The median (M) age was 62 years (range 27–89). The race distribution was Caucasian 66(72.5%), African American 19(21%), other (6, 6.5%). The overall M survival (MS) was 698 days(13–3825). The M Hemoglobin(Hgb) was 12.3 g/dl (7.3–17.4) The M LDH was 203 IU/L(88–1905). The M Albumin was 3.6 g/dl (1.2–5.4). Beta 2 microglobulin (B2M) and HIV status were not available on all patients. The M Zubrod Performance Status (PS) was 1(0–4). The PS for 46 pts (50%) was 1(0–4). By Ann Arbor Stage, 44 pts(49%) were in stage I–II, and 46 pts(51%) had stages III–IV. MS for pts in stage I–II were 887.5(range 13–3713) days and 552(range 22–3825) days in stages III–IV. 2. Survival by histology is summarized in the accompanying table. Histological categories were low grade (CLL, follicular, MALT, marginal zone), diffuse large cell lymphoma, mantle cell lymphoma (MCL) and other(2 pts). The most common class of pts was low grade 49(53%), followed by intermediate 34(36.9%) and mantle cell lymphoma 9(9.7%). 3. Clinical Prognostic indicators: Charlson Comorbidity Index (CMI), the International Prognostic Index (IPI) and the Follicular Lymphoma International Prognostic Index (FLIPI) scores were tabulated. For pts with intermediate lymphoma, the M IPI score was 3 (range 0–5), and for low grade lymphoma M IPI score 2 (0–5). The 47 pts with low grade lymphomas had median FLIPI score of 1 (0–4). The M CMI was 6(1–12). 4. For all pts, univariate predictors of survival were lymphoma class, hemoglobin, PS, LDH, albumin. The IPI was a significant predictor on univariate analysis. In multivariate analysis, the PS(p<0.02), Albumin (p<0.02), CMI (p<0.05), LDH (p<0.06) and lymphoma class (p<0.02) were significant predictors. For low grade lymphoma pts, univariate predictors were LDH, albumin, IPI, and PS, but not the FLIPI. On multivariate analysis, the predictors were PS (p<0.02), and albumin (p<0.018). For intermediate grade lymphoma pts, univariate predictors were albumin, but not the IPI. On multivariate analysis, the PS (p<.006), albumin (p<0.03), and CMI (p<.02) were significant predictors. Conclusions: In this sample, prognostic factors differed for low grade and intermediate grade lymphomas. IPI did not predict survival in intermediate lymphoma pts. Comorbidity emerged as a potential prognostic factor for pts with intermediate grade lymphomas. The VA provides care for a large veteran population characterized by low socioeconomic status and higher comorbidity. These findings should be confirmed in larger VA and general populations. Survival by Histology Lymphoma type Number of pts Median survival(days) Range(days) Diffuse large 32(37%) 466 17–3402 CLL 14(15%) 1711 25–3541 Follicular 19(20%) 943 13–3825 Mantle cell 9(10%) 748 62–1231 Marginal zone 8(9%) 627 197–2686 MALT 8(9%) 1311 393–3194

The purpose of this document is to provide readers with the coding protocol that authors used to code 22 meta-analyses focused on mathematics interventions for students with or at-risk of disabilities. The purpose of the systematic review was to evaluate reporting quality in meta-analyses focused on mathematics interventions for students with or at risk of disabilities. To identify meta-analyses for inclusion, we considered peer-reviewed literature published between 2000 and 2020; we searched five education-focused electronic databases, scanned the table of contents of six special education journals, reviewed the curriculum vitae of researchers who frequently publish meta-analyses in mathematics and special education, and scanned the reference lists of meta-analyses that met inclusion criteria. To be included in this systematic review, meta-analyses must have reported on the effectiveness of mathematics-focused interventions, provided a summary effect for a mathematics outcome variable, and included school-aged participants with or at risk of having a disability. We identified 22 meta-analyses for inclusion. We coded each meta-analysis for 53 quality indicators (QIs) across eight categories based on recommendations from Talbott et al. (2018). Overall, the meta-analyses met 61% of QIs and results indicated that meta-analyses most frequently met QIs related to providing a clear purpose (95%) and data analysis plan (77%), whereas meta-analyses typically met fewer QIs related to describing participants (39%) and explaining the abstract screening process (48%). We discuss the variation in QI scores within and across the quality categories and provide recommendations for future researchers so that reporting in meta-analyses may be enhanced. Limitations of the current study are that grey literature was not considered for inclusion and that only meta-analyses were included; this limits the generalizability of the results to other research syntheses (e.g., narrative reviews, systematic reviews) and publication types (e.g., dissertations).

The purpose of this document is to provide readers with the coding protocol that authors used to code 22 meta-analyses focused on mathematics interventions for students with or at-risk of disabilities. The purpose of the systematic review was to evaluate reporting quality in meta-analyses focused on mathematics interventions for students with or at risk of disabilities. To identify meta-analyses for inclusion, we considered peer-reviewed literature published between 2000 and 2020; we searched five education-focused electronic databases, scanned the table of contents of six special education journals, reviewed the curriculum vitae of researchers who frequently publish meta-analyses in mathematics and special education, and scanned the reference lists of meta-analyses that met inclusion criteria. To be included in this systematic review, meta-analyses must have reported on the effectiveness of mathematics-focused interventions, provided a summary effect for a mathematics outcome variable, and included school-aged participants with or at risk of having a disability. We identified 22 meta-analyses for inclusion. We coded each meta-analysis for 53 quality indicators (QIs) across eight categories based on recommendations from Talbott et al. (2018). Overall, the meta-analyses met 61% of QIs and results indicated that meta-analyses most frequently met QIs related to providing a clear purpose (95%) and data analysis plan (77%), whereas meta-analyses typically met fewer QIs related to describing participants (39%) and explaining the abstract screening process (48%). We discuss the variation in QI scores within and across the quality categories and provide recommendations for future researchers so that reporting in meta-analyses may be enhanced. Limitations of the current study are that grey literature was not considered for inclusion and that only meta-analyses were included; this limits the generalizability of the results to other research syntheses (e.g., narrative reviews, systematic reviews) and publication types (e.g., dissertations).