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Takatori, Hiroaki, Yuka Kanno, Wendy T. Watford, Cristina M. Tato, Greta Weiss, Ivaylo I. Ivanov, Dan R. Littman, and John J. O'Shea. "Lymphoid tissue inducer–like cells are an innate source of IL-17 and IL-22." Journal of Experimental Medicine 206, no. 1 (December 29, 2008): 35–41. http://dx.doi.org/10.1084/jem.20072713.
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The interleukin (IL) 17 family of cytokines has emerged to be critical for host defense as well as the pathogenesis of autoimmune and autoinflammatory disorders, and serves to link adaptive and innate responses. Recent studies have identified a new subset of T cells that selectively produce IL-17 (Th17 cells; Bettelli, E., T. Korn, and V.K. Kuchroo. 2007. Curr. Opin. Immunol. 19:652–657; Kolls, J.K., and A. Linden. 2004. Immunity. 21:467–476), but the regulation of IL-17 production by innate immune cells is less well understood. We report that in vitro stimulation with IL-23 induced IL-17 production by recombination activating gene (Rag) 2−/− splenocytes but not Rag2−/− common γ chain−/− splenocytes. We found that a major source of IL-17 was CD4+CD3−NK1.1−CD11b−Gr1−CD11c−B220− cells, a phenotype that corresponds to lymphoid tissue inducer–like cells (LTi-like cells), which constitutively expressed the IL-23 receptor, aryl hydrocarbon receptor, and CCR6. In vivo challenge with the yeast cell wall product zymosan rapidly induced IL-17 production in these cells. Genetic deletion of signal transducer and activator of transcription 3 reduced but did not abrogate IL-17 production in LTi-like cells. Thus, it appears that splenic LTi-like cells are a rapid source of IL-17 and IL-22, which might contribute to dynamic organization of secondary lymphoid organ structure or host defense.
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Vanvi, Ariane, and Apollinaire Tsopmo. "Pepsin Digested Oat Bran Proteins: Separation, Antioxidant Activity, and Identification of New Peptides." Journal of Chemistry 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/8216378.
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The aim of this study was to determine pepsin hydrolysis conditions to produce digested oat bran proteins with higher radical scavenging activities and separate and identify peptides. Isolated proteins were then digested with different concentrations of pepsin and incubation times. Hydrolysates produced with 1 : 30 enzyme substrate (E/S) ratio and 2 h possessed the highest peroxyl radical scavenging activity, 608 ± 17 µM TE/g (compared to 456–474 µM TE/g for other digests), and was therefore subsequently fractionated into eight fractions (F1–F8) by high performance liquid chromatography (HPLC). F1 and F2 had little activity because of their low protein contents. Activities of F3–F8 were 447–874 µM TE/g, 20–36%, and 10–14% in the peroxyl, superoxide anion, and hydroxyl radical tests, respectively. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to identify a total of fifty peptides that may have contributed to the activity of F3, a fraction that better scavenged radicals.
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Spingola, Cristiana, and Anna Barnacka. "Constraining VLBI−optical offsets in high redshift galaxies using strong gravitational lensing." Monthly Notices of the Royal Astronomical Society 494, no. 2 (April 7, 2020): 2312–26. http://dx.doi.org/10.1093/mnras/staa870.
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ABSTRACT We present a multiwavelength analysis of two highly magnified strong gravitationally lensed galaxies, CLASS B0712+472 and CLASS B1608+656, at redshifts 1.34 and 1.394, respectively, using new VLBI (very long baseline interferometry) and archival Hubble Space Telescope observations. We reconstruct the positions of the radio and optical emissions with their uncertainties using Monte Carlo sampling. We find that in CLASS B0712+472 the optical and radio emissions are co-spatial within 2 ± 5 mas (17 ± 42 pc at redshift of 1.34). But, in CLASS B1608+656, we reconstruct an optical–radio offset of 25 ± 16 mas (214 ± 137 pc at redshift of 1.394), among the smallest offsets measured for an AGN (active galactic nucleus) at such high redshift. The spectral features indicate that CLASS B1608+656 is a post-merger galaxy, which, in combination with the optical–VLBI offset reported here, makes CLASS B1608+656 a promising candidate for a high- z offset–AGN. Furthermore, the milliarcsecond angular resolution of the VLBI observations combined with the precise lens models allow us to spatially locate the radio emission at 0.05 mas precision (0.4 pc) in CLASS B0712+472, and 0.009 mas precision (0.08 pc) in CLASS B1608+656. The search for optical–radio offsets in high redshift galaxies will be eased by the upcoming synoptic all-sky surveys, including Extremely Large Telescope and Square Kilometre Array, which are expected to find ∼105 strongly lensed galaxies, opening an era of large strong lensing samples observed at high angular resolution.
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Mikhailov, E. N., N. Z. Gasymova, S. А. Bayramova, V. E. Kharats, O. N. Kachalkova, A. Yu Dmitriev, R. E. Batalov, et al. "CLINICAL CHRACTERISTICS OF PATIENTS AND RESULTS OF CATHETER ABLATION IN ATRIAL FIBRILLATION IN RUSSIA: SUBANALYSIS OF THE EUROPEAN REGISTRY 2012-2016." Russian Journal of Cardiology, no. 7 (August 14, 2018): 7–15. http://dx.doi.org/10.15829/1560-4071-2018-7-7-15.
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Aim. The results presented, of subanalysis of the catheter ablation (CA) registry in atrial fibrillation (AF) with the patients properties, specifics of CA and treatment results, in Russia comparing to European countries.Material and methods. During 2012 to 2015, totally 3742 patients included to the registry, of those 477 in Russia. In 467 Russian patients (males 56,5%; mean age 58,5 y. o.) CA AF was done. During one year 392 patients were followed up. Minimum requirements to follow-up: routine ECG registration and non less than one contact after 12 months passed.Results. In Russian patients there were more common obesity (46,1% and 29,2%, p<0,001), hypertension heart disease (40,2% and 22,8%, p<0,0001), coronary heart disease (31,7% and 16,2%, p<0,0001), chronic heart failure (67,3% and 13,0%, p<0,0001). In Russia the patients more commonly underwent primary CA (83,5% in Russia and 77,6% in European countries, p<0,05), more rare in Russia the cryoballoon ablation was done (3% and 18%, p<0,05). Generally adverse events were reported more rare in Russia (10,5% and 16,6%, p=0,0007), including cardiovascular adverse events (2,6% and 5,2%, p<0,05). Tachiarrhythmias recurs were diagnosed more rare in Russia, including by the subsutaneous ECG monitors (17% and 1,6% in other countries, р<0,001). Within the year of follow-up, full absence of tachiarrhythmias recurs in Russia was found in 65,8% of patients, in other countries — in 74,7% (р=0,0003).Conclusion. In real clinical setting, high efficacy of CA AF was shown, resistant to antiarrhythmic therapy. In most of Russian patients there were cardiovascular comorbidities. There was lower rate of reported adverse events in Russian centers of interventional treatments.
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Tukhbatullin, M. G., and K. V. Yanakova. "Ultrasound elastography capabilities in studying uterine cerviх state in pregnant women of high-risk group in the first trimester of pregnancy." Kazan medical journal 97, no. 4 (August 15, 2016): 656–61. http://dx.doi.org/10.17750/kmj2015-656.
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Aim. To study capabilities of quantitative elastographic study to assess the elasticity of the uterine cervix in women with a fetal chromosomal abnormality in the first trimester of pregnancy.Methods. 230 pregnant women of high-risk group at 11-13.6 weeks of pregnancy (parietal-coccygeal length 45-84 mm) were included in this study. The first group consisted of 213 women without fetal pathology. The second group included 17 women, in whose fetuses different chromosomal abnormalities were detected. In ultrasound examination of pregnant women in the I trimester of pregnancy, in addition to standard methods of examination, quantitative cervical elastography was performed.Results. According to results of quantitative elastography in 14 (82.35%) out of 17 pregnant women (second group) one or another degree of the cervical tissue softening was found, and 3 (17.64%) pregnant women with fetal chromosomal pathology had stiff cervix (all 3 cases with Down syndrome). In the control group in 10 (4.7%) of 213 pregnant women relatively soft cervix was identified, and in 203 (95.3%) women cervical density was higher than the myometrial density. A statistically significant difference between the indices of SWE-Ratio in groups was revealed. Quantitative elastography, as a diagnostic test predicting the risk of miscarriage due to chromosomal abnormalities, has a high sensitivity (84.38%) and even higher specificity (95.26%) of negative predictive value 97.57%.Conclusion. Quantitative elastography reveals a significant decrease in the cervical elasticity (softening) in pregnant women with fetal chromosomal abnormality in the I trimester of pregnancy, which allows us to recommend this method of ultrasound examination as an additional marker for early diagnosis of miscarriage due to fetal chromosomal abnormality.
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NG, HEOK HEE, LALRAMLIANA LALRAMLIANA, and SAMUEL LALRONUNGA. "Pterocryptis subrisa, a new silurid catfish (Teleostei: Siluridae) from northeastern India." Zootaxa 4500, no. 1 (October 15, 2018): 126. http://dx.doi.org/10.11646/zootaxa.4500.1.8.
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Pterocryptis subrisa, a new species of silurid catfish from the Kaladan River drainage in northeastern India, is described in this study. It can be distinguished from congeners by the unique combination of the following characters: supralabial fold extending posteriorly beyond vertical through posterior orbital margin; nearly circular eye; head length 17.6–19.6% SL; head depth 10.6–11.9% SL; dorsal-fin height 2.6–4.7% SL; 2 dorsal-fin rays; pectoral-fin length 11.8–14.0% SL; body depth at anus 14.4–16.7% SL; caudal peduncle depth 6.8–8.5% SL; 66–75 anal-fin rays; confluent anal and caudal fins separated by deep notch; 17 principal caudal-fin rays; and 57 vertebrae. The generic status of Pterocryptis taytayensis is discussed, with this species being reassigned to Ompok.
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Rouhani, Behzad Djafari, and Mohsen Rahimi Piranfar. "Nonhomogeneous nonlinear oscillator with damping: asymptotic analysis in continuous and discrete time." Demonstratio Mathematica 52, no. 1 (September 13, 2019): 274–82. http://dx.doi.org/10.1515/dema-2019-0028.
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AbstractWe consider the following second order evolution equation modelling a nonlinear oscillator with damping$$\ddot{u} (t) + \gamma \dot u(t) + Au\left( t \right) = f\left( t \right),\,\,\,\,\,\,\,\,\,\,\,\,\,\left( {{\rm{SEE}}} \right)$$where A is a maximal monotone and α-inverse strongly monotone operator in a real Hilbert space H. With suitable assumptions on γ and f(t) we show that A−1(0) ≠ ∅, if and only if (SEE) has a bounded solution and in this case we provide approximation results for elements of A−1(0) by proving weak and strong convergence theorems for solutions to (SEE) showing that the limit belongs to A−1(0). As a discrete version of (SEE), we consider the following second order difference equation$${u_{n + 1}} - {u_n} - {\alpha _n}\left( {{u_n} - {u_{n - 1}}} \right) + {\lambda _n}A{u_{n + 1}\ni} f\left( t \right),$$where A is assumed to be only maximal monotone (possibly multivalued). By using the results in [Djafari Rouhani B., Khatibzadeh H., On the proximal point algorithm, J. Optim. Theory Appl., 2008, 137, 411–417], we prove ergodic, weak and strong convergence theorems for the sequence un, and show that the limit is the asymptotic center of un and belongs to A−1(0). This again shows that A−1(0) ≠ ∅ if and only if un is bounded. Also these results solve an open problem raised in [Alvarez F., Attouch H., An inertial proximal method for maximal monotone operators via dicretization of a nonlinear oscillator with damping, Set Valued Anal., 2001, 9, 3–11], namely the study of the convergence results for the inexact inertial proximal algorithm. Our paper is motivated by the previous results in [Djafari Rouhani B., Asymptotic behaviour of quasi-autonomous dissipative systems in Hilbert spaces, J. Math. Anal. Appl., 1990, 147, 465–476; Djafari Rouhani B., Asymptotic behaviour of almost nonexpansive sequences in a Hilbert space, J. Math. Anal. Appl., 1990, 151, 226–235; Djafari Rouhani B., Khatibzadeh H., Asymptotic behavior of bounded solutions to some second order evolution systems, Rocky Mountain J. Math., 2010, 40, 1289–1311; Djafari Rouhani B., Khatibzadeh H., A strong convergence theorem for solutions to a nonhomogeneous second order evolution equation, J. Math. Anal. Appl., 2010, 363, 648–654; Djafari Rouhani B., Khatibzadeh H., Asymptotic behavior of bounded solutions to a class of second order nonhomogeneous evolution equations, Nonlinear Anal., 2009, 70, 4369–4376; Djafari Rouhani B., Khatibzadeh H., On the proximal point algorithm, J. Optim. Theory Appl., 2008, 137, 411–417] and significantly improves upon the results of [Attouch H., Maingé P. E., Asymptotic behavior of second-order dissipative evolution equations combining potential with non-potential effects, ESAIM Control Optim. Calc. Var., 2011, 17(3), 836–857], and [Alvarez F., Attouch H., An inertial proximal method for maximal monotone operators via dicretization of a nonlinear oscillator with damping, Set Valued Anal., 2001, 9, 3–11].
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Bode, Kerstin, Peter Whittaker, Johannes Lucas, Andreas Müssigbrodt, Gerhard Hindricks, Sergio Richter, and Michael Doering. "Deep sedation for transvenous lead extraction: a large single-centre experience." EP Europace 21, no. 8 (May 18, 2019): 1246–53. http://dx.doi.org/10.1093/europace/euz131.
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Abstract Aims Transvenous lead extraction for cardiac implantable electronic devices (CIED) is of growing importance. Nevertheless, the optimal anaesthetic approach, general anaesthesia vs. deep sedation (DS), remains unresolved. We describe our tertiary centre experience of the feasibility and safety of DS. Methods and results Extraction procedures were performed in the electrophysiology (EP) laboratory by two experienced electrophysiologists. We used intravenous Fentanyl, Midazolam, and Propofol for DS. A stepwise approach with locking stylets, dilator sheaths, and mechanical sheaths via subclavian, femoral, or internal jugular venous access was utilized. Patient characteristics and procedural data were collected. Logistic regression models were used to identify parameters associated with sedation-related complications. Extraction of 476 leads (dwelling time/patient 88 ± 49 months, 30% ICD leads) was performed in 220 patients (64 ± 17 years, 80% male). Deep sedation was initiated with bolus administration of Fentanyl, Midazolam, and Propofol; mean doses 0.34 ± 0.12 μg/kg, 24.3 ± 6.8 μg/kg, and 0.26 ± 0.13 mg/kg, respectively. Deep sedation was maintained with continuous Propofol infusion (initial dose 3.7 ± 1.1 mg/kg/h; subsequently increased to 4.7 ± 1.2 mg/kg/h with 3.9 ± 2.6 adjustments) and boluses of Midazolam and Fentanyl as indicated. Sedation-related episodes of hypotension, requiring vasopressors, and hypoxia, requiring additional airway management, occurred in 25 (11.4%) and 5 (2.3%) patients, respectively. These were managed without adverse consequences. Five patients (2.3%) experienced major intraprocedural complications; there were no procedure-related deaths. All of our logistic regression models indicated intraprocedural support was associated with administration higher Fentanyl doses. Conclusion Transvenous lead extraction under DS in the EP laboratory is a safe procedure with high success rates when performed by experienced staff.
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Casalone, Elisabetta, Ioanna Tachmazidou, Eleni Zengini, Konstantinos Hatzikotoulas, Sophie Hackinger, Daniel Suveges, Julia Steinberg, et al. "A novel variant in GLIS3 is associated with osteoarthritis." Annals of the Rheumatic Diseases 77, no. 4 (February 7, 2018): 620–23. http://dx.doi.org/10.1136/annrheumdis-2017-211848.
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ObjectivesOsteoarthritis (OA) is a complex disease, but its genetic aetiology remains poorly characterised. To identify novel susceptibility loci for OA, we carried out a genome-wide association study (GWAS) in individuals from the largest UK-based OA collections to date.MethodsWe carried out a discovery GWAS in 5414 OA individuals with knee and/or hip total joint replacement (TJR) and 9939 population-based controls. We followed-up prioritised variants in OA subjects from the interim release of the UK Biobank resource (up to 12 658 cases and 50 898 controls) and our lead finding in operated OA subjects from the full release of UK Biobank (17 894 cases and 89 470 controls). We investigated its functional implications in methylation, gene expression and proteomics data in primary chondrocytes from 12 pairs of intact and degraded cartilage samples from patients undergoing TJR.ResultsWe detect a genome-wide significant association at rs10116772 with TJR (P=3.7×10−8; for allele A: OR (95% CI) 0.97 (0.96 to 0.98)), an intronic variant in GLIS3, which is expressed in cartilage. Variants in strong correlation with rs10116772 have been associated with elevated plasma glucose levels and diabetes.ConclusionsWe identify a novel susceptibility locus for OA that has been previously implicated in diabetes and glycaemic traits.
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Solmaz, D., U. Kalyoncu, I. Tinazzi, O. Bayindir, E. Dalkiliç, A. Dogru, C. Özişler, et al. "SAT0440 METHOTREXATE SURVIVAL RATE IN PATIENTS WITH PSORIATIC ARTHRITIS FROM PSORIATIC ARTHRITIS –INTERNATIONAL DATABASE (PsArt-ID) COHORT." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1176.2–1177. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2710.
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Background:Methotrexate (MTX) is the most common first-line disease-modified anti-rheumatic drugs in psoriatic arthritis (PsA), despite the controversies.Objectives:In this study, we aimed to determine the rate of withdrawal rate of MTX in PsA and reasons for discontinuing.Objectives:In this study, we aimed to determine the rate of withdrawal rate of MTX in PsA and reasons for discontinuing.Methods:A large prospective international multicenter PsA registry was used for this study. Data were collected either at enrolment, based on history, or prospectively if there was a follow up. We analyzed the frequency of MTX usage, discontinuation and the reason for discontinuation. The time on MTX was compared according to the reason of discontinuation (inefficacy vs side effects) using Kaplan-Meier and Cox regression analyses to identify risk factors for discontinuation.Results:At the time of analyses, 1670 patients had been recruited to the registry and 1359 PsA patients had used MTX during the course of the disease (81.3%). Within these, 942 (69.3%) were still on MTX at the time of analysis, and 417 (30.7%) patients have discontinued (Table). The most common reasons for withdrawal were side effects (219/417, 52.5%) and ineffectiveness (88/417, 21.1%). Other reasons included pregnancy, remission, self-decision (11.9% for all). For 60 patients (14.3%), the reason could not be identified. In patients who were still on MTX, the median duration of MTX therapy was 31 months (IQR=59) compared to 17 months (IQR=43) in the withdrawal group. The most common side effects were gastrointestinal symptoms (47%) and abnormal liver function tests (25%). There was a significant difference in survival plots (Log-rank p=0.026) with discontinuing due to side effects occurring earlier than inefficacy (Figure 1). In cox regression model, longer disease duration was found as an independent predictor of MTX discontinuation due to all reasons [Hazard Ratio (HR)=1.01, 95% Confidence interval (CI)=1.0-1.02; p=0.003].Conclusion:MTX is frequently used on PsA treatment, despite the controversies in the literature. One third of patients with PsA discontinue MTX, most commonly due to side effects or inefficacy. Patients discontinue MTX earlier in case of having side effects. Longer disease duration is linked to MTX discontinuation.Table.Demographics and disease characteristics of study groupsAll patientsn=1359Still on MTXn=942Withdrawal MTX any reasonn=417pAge, mean (SD)46.4 (13.4)46.1 (13.4)47.7 (14.0)0.038Male gender, n (%)523 (38.5)360 (38.2)163 (39.1)0.761Ever smoking, n (%)569/1258 (46.2)390/861 (45.3)179/397 (45.1)0.966Psoriasis duration (years), mean (SD)14.2 (11.7)14.0 (11.2)16.4 (12.7)0.003Polyarthritis, n (%)657/1343 (48.9)471/931 (50.6)186/412 (45.1)0.066Axial disease, n (%)388/1343 (28.9)267/931 (28.7)121/412 (29.4)0.797Nail involvement (ever), n (%)644 (47.8)435 (46.6)209 (50.5)0.191Swollen Joint Count, mean (SD)1.5 (2.6)1.4 (2.6)2.0 (3.2)<0.001Tender Joint Count, mean (SD)3.0 (4.4)3.5 (5.0)4.2 (5.4)<0.001HAQ, mean (SD)0.6 (0.6)0.7 (0.7)0.8 (0.7)0.035BASDAI,mean (SD)37 (22)39 (23)46 (25)0.001Disclosure of Interests:Dilek Solmaz: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB, Ilaria Tinazzi: None declared, Ozun Bayindir: None declared, Ediz Dalkiliç: None declared, Atalay Dogru: None declared, Cem Özişler: None declared, Gezmiş Kimyon: None declared, Gozde Yildirim Cetin Speakers bureau: AbbVie, Novartis, Pfizer, Roche, UCB, MSD, Ahmet Omma: None declared, Emine Figen Tarhan: None declared, Levent Kiliç: None declared, Servet Akar: None declared, Sema Yilmaz: None declared, Meryem Can: None declared, Sule Yavuz: None declared, Orhan Küçükşahin: None declared, Sibel Bakirci: None declared, Sibel Aydin: None declared
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Hamieh, Lana, Amin Nassar, Kathryn Lasseter, Barbara Ogorek, Rana R. McKay, Aaron Thorner, Anwesha Nag, et al. "Cell-free DNA analysis in renal cell carcinoma: Comparison with tumor sequencing and correlation with response to therapy." Journal of Clinical Oncology 37, no. 7_suppl (March 1, 2019): 655. http://dx.doi.org/10.1200/jco.2019.37.7_suppl.655.
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655 Background: Massively parallel sequencing (MPS) of circulating-free DNA (cfDNA) is seeing increasing use in multiple cancer types. There is little data on its use in metastatic renal cell carcinoma (mRCC) as a tool for prognostication and disease monitoring. Methods: cfDNA was extracted from 63 blood samples of 40 metastatic RCC patients (pts). Serial samples were obtained in 12 of 40 (30%) pts (median = 1, range = 1-7). cfDNA was used for targeted MPS using a custom bait-set of 27 genes commonly mutated in RCC. Variants observed in at least 3 reads, in both read directions, and at an allele frequency (AF) of ≥0.5% for single nucleotide variants (SNV), or in 2 reads and AF of ≥0.2% for small indels, were candidate variants validated by Sanger sequencing or amplicon MPS (aMPS). All mutations identified in cfDNA were also assessed in matched patient WBC DNA using aMPS and Sanger sequencing. Tumor specimens from 23 pts were also sequenced in parallel using our institutional OncoPanel assay that assesses 275-447 cancer-associated genes and results were compared with those seen in the cfDNA. Results: Thirty-one of 38 (82%) candidate variants were validated in 17 of 40 pts. Ten of those (32%) from 10 pts were also detected in WBC DNA, 3 of which were germline and 7 were at low mosaic frequency and likely reflected clonal hematopoiesis (CH). The remaining 21 variants validated in cfDNA were in TP53 (6), PBRM1 (3), SETD2 (3), VHL (2), ATM (2), NF2 (2), PTEN (1), PIK3CA (1), and MTOR (1). Two of 17 (12%) pts without tumor mutation analysis had 4 validated variants seen in cfDNA only. 10 of 23 (43%) pts with tumor mutation analysis had one or more variants seen in both tumor DNA and cfDNA. Three of the 23 had mutations seen only in cfDNA. Pts with any mutation in cfDNA (n = 14) had a significantly shorter overall survival in comparison to those without a finding (p < 0.001). Among 12 pts with serial samples, 5 had cfDNA variants identified. Response to therapy correlated with variant prevalence in all 5, including 2 with significant partial responses. Conclusions: This study suggests that paired tumor–cfDNA analysis has value in the assessment of response to therapy in RCC. Further analysis is proceeding.
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Pitz, Vanessa, Naveed Malek, Katherine A. Grosset, and Donald G. Grosset. "THUR 117 The L-DOPA response in pathologically confirmed parkinson’s disease." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 10 (September 13, 2018): A12.4—A13. http://dx.doi.org/10.1136/jnnp-2018-abn.46.
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Backgroundl-dopa is the standard treatment for Parkinson’s disease, but the response is variable.AimSystematic review of papers reporting the l-dopa response (motor response and/or complications) in pathologically confirmed Parkinson’s disease.Results467 cases of pathologically confirmed Parkinson’s were identified: 60.2% male, age at disease onset 63.3 years (SD 10.3), age at death 76.7 years (SD 7.8). Data on a graded l-dopa response were available in 411 cases (88.0% of 467). The motor response was excellent in 148/411 cases (36.0%), good in 179/411 (43.6%), moderate in 51/411 (12.4%) and poor/absent in 33/411 (8.0%). Data about motor complications were available for 161 patients: 71/161 (44.1%) had motor fluctuations and 89/161 (55.3%) had dyskinesia. Comorbid brain pathology was evaluated in 251/411 cases (61.1%), and was present in 148/251 (59.0%): cerebrovascular in 65/148 (43.9%), Alzheimer’s in 55/148 (37.2%), amyloid angiopathy in 18/148 (12.2%), and diffuse Lewy body disease in 10/148 (6.8%). Data linking the graded l-dopa response to comorbid pathologies were available in only 17 cases, of whom 8/17 (47.1%) had a good/excellent response.ConclusionThere is variation in the l-dopa response in pathologically confirmed Parkinson’s disease. The limited available information suggests a possible association of motor response to comorbid brain pathology.
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Rankin, Alisha. "Gabriele Wacker. Arznei und Confect: Medikale Kultur am Wolfenbütteler Hof im 16. und 17. Jahrhundert. Wolfenbütteler Forschungen 134. Wiesbaden: Harrassowitz Verlag, 2013. 608 pp. €98. ISBN: 978-3-447-06801-7." Renaissance Quarterly 67, no. 4 (2014): 1342–43. http://dx.doi.org/10.1086/679811.
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Meliani, Saliha, H. S. Sebaa, and N. Chebhouni. "Study on variation in morpho-anatomical attributes and germination features of five varieties of Capsicum annuum L. grown in Algeria." South Asian Journal of Experimental Biology 12, no. 2 (April 19, 2022): 192–202. http://dx.doi.org/10.38150/sajeb.12(2).p192-202.
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The introduction of seeds of new varieties in Algeria will make it possible to increase the capacities of adaptation of the plants of Capsicum annuum L. to the variable conditions of their environment having a great influence on the flowering, the self-fertilization and the fructification. The study of seed germination was carried out on five varieties: (Ciliegia Piccante Pepper; Hungaria yellow max hot; Cayenne Pepper; Grueso de Plaza and Largo de Reus), which begins with the imbibition until obtaining percentages of accumulated water in the following seed albumens: 91.33; 91.05; 91.09; 91.35 and 91.28. The recorded lag time is variable: 7, 10, 14, 15 to 17 days, by the mass of albumen and by the tegumentary dormancy due to the presence of polyphenols in the tegumentary cell walls. The percentage, speed, vigor and germination index of Capsicum seeds increase with their density and weight. They are of the order of [(63, 4.5, 2.9); (77, 5, 3.9); (83, 4.7, 4); (90, 5.7, 5.5); (100, 6, 6.8)] % and (0.86, 1.18, 1.21, 1.13, 2.03) germinated seeds/day. The average germination time decreases with their density, they are at (22, 20, 21, 17, 17) days. A morphological description of the plant has been made. This is followed by an anatomical analysis of the radicle at the level of the root hair region and the cotyledonary leaves presenting a structure less developed than that of the true leaves later formed. They provide the metabolites necessary for the first growth stage of the seedling by photosynthesis.
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Wang, X. X., and Z. N. Wu. "Lift force reduction due to body image of vortex for a hovering flight model." Journal of Fluid Mechanics 709 (August 20, 2012): 648–58. http://dx.doi.org/10.1017/jfm.2012.368.
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AbstractThe effect of the body on the lift force in hovering flight is studied here by including the effect of image vortex rings (IVRs) in the inviscid vortex ring model proposed by Rayner (J. Fluid Mech., vol. 91, 1979, pp. 697–730) and used by Wang & Wu (J. Fluid Mech., vol. 654, 2010, pp. 453–472) to study lift force due to wakes. The body is treated simply as an equivalent sphere following the data of Ellington (Phil. Trans. R. Soc. Lond. B, vol. 305, 1984a, pp. 17–40). It is shown that the body image reduces the lift by inducing a further downwash near the wing tip and an additional contraction to the real vortex rings (RVRs). The amount of force reduction due to body image is found to grow cubically with relative body size, defined by the equivalent radius relative to the wing span, and approximately linearly with the feathering parameter. For Apis and Bombus with large relative body size and large feathering parameter, the body images reduce lift by an amount near 8 % according to the present simplified analysis.
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Reynard, Jean-Sébastien, Justine Brodard, Nathalie Dubuis, Vivian Zufferey, Olivier Schumpp, Santiago Schaerer, and Paul Gugerli. "Grapevine red blotch virus: Absence in Swiss Vineyards and Analysis of Potential Detrimental Effect on Viticultural Performance." Plant Disease 102, no. 3 (March 2018): 651–55. http://dx.doi.org/10.1094/pdis-07-17-1069-re.
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Grapevine red blotch virus (GRBV) is a recently described virus that infects grapevine. Little information is available on the possible occurrence and distribution outside North America. Therefore, we surveyed commercial vineyards from the three major grape-growing regions in Switzerland to determine the presence or absence of GRBV. In total, 3,062 vines were analyzed by polymerase chain reaction. None of the vines tested positive for GRBV, suggesting the absence of GRBV from Swiss vineyards. We also investigated whether GRBV was present in 653 grapevine accessions in the Agroscope grapevine virus collection at Nyon, including dominantly Swiss (457) but also international accessions. Only six referential accessions were infected by GRBV, all originating from the United States, whereas all others from 10 European and 8 non-European origins tested negative. High-throughput sequencing analysis of Zinfandel A2V13, in the collection since 1985, confirmed close similarity of GRBV isolate Z_A2V13 to American isolates according to genomes deposited in GenBank. Because the Zinfandel A2V13 reference was also maintained grafted on the leafroll virus indicator Vitis vinifera ‘Gamay’, we evaluated the effect of GRBV on viticultural performance over a 3-year period. Our results showed clear detrimental effects of GRBV on grapevine physiology (vine vigor, leaf chlorophyll content, and gas exchange) and fruit quality. These findings underscore the importance of implementation of GRBV testing worldwide in certification and quarantine programs to prevent the dissemination of this virus.
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Simeakis, George Konstantinou, Ioanna Patinioti, Elli Anagnostou, Evangelia Zapanti, Vasiliki Vasileiou, Antonis Polymeris, Katerina Saltiki, Eleni Anastasiou, Maria Alevizaki, and Marina Mitropoulou. "Association of serum calcitonin levels with multinodular thyroid disease: 10-year single center experience." Problems of Endocrinology 62, no. 5 (September 22, 2016): 54. http://dx.doi.org/10.14341/probl201662554.
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Background. From 2005 to 2015 routine calcitonin (CT) screening was performed in our department in all patients with multinodular goiter (MNG) using the same assay.Aim. We investigated possible associations between unstimulated serum CT levels and the presence of either thyroid autoimmunity (AITD) or thyroid neoplasia.Methods. This is a retrospective study of 648 patients (559 female [F] 86.3%, 89 male [M] 13.7%, age range 18-89, median 58 years,). CT≤4.6 pg/ml [F] and ≤11.5 pg/ml [M] was defined as normal. Patients were stratified into 4 groups according to CT. Group1: CT<0.05 (undetectable), Group2: CT [F&M] within normal range, Group3: CT:4.7-10 [F] & 11.6-20 [M], Group4: CT>10 [F] & >20 [M]. Furthermore patients were subcategorized in those with Autoimmune Thyroid Disease (AITD) and those without (non-AITD).Results. The distribution of patients was: Group1: n=186 (28.7%), Group2: n=422 (65.1%), Group3: n=29 (4.5%), Group4: n=11 (1.7%). Of the patients with AITD history 23.4% belonged to Group1, 68.6% to Group2, 6.4% to Group3 and 1.6% to Group4 (x2, p=0.037). Forty seven patients (7.3%) underwent total thyroidectomy. Histopathological examination revealed: Medullary Thyroid Carcinoma (MTC) n=3 (3/3 Group4), C-Cell Hyperplasia (CCH) n=5 (3/5 Group3, 2/5 Group4), Papillary Thyroid Carcinoma (PTC) n=17 (7/17 Group1, 10/17 Group2), MNG n=22 (8/22 Group1, 10/22 Group2, 2/22 Group3, 2/22 Group4). 2/5 patients with CCH had PTC. 1/17 PTC patient had mixed PTC-MTC. Patients with MTC had remarkably higher CT levels (253-1222 pg/ml) compared to those with CCH (5.8-16.1 pg/ml).Conclusions. This study reaffirms the positive correlation between CT levels and the presence of MTC or CCH, clearly and conspicuously distinguished by the range of CT levels, albeit in a small number of patients with these diagnoses. Patients with AITD have more frequently detectable or slightly increased CT levels.
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Shiryaev, V., V. Karandashov, F. Shvetskij, and V. Potievskaya. "ПОТЕНЦИРОВАНИЕ МУЛЬТИМОДАЛЬНОЙ АНЕСТЕЗИИ КВАНТОВЫМ ИЗЛУЧЕНИЕМ ПРИ ПОМОЩИ ОПТОЭЛЕКТРОННЫХ УСТРОЙСТВ." EurasianUnionScientists 2, no. 11(80) (December 14, 2020): 71–78. http://dx.doi.org/10.31618/esu.2413-9335.2020.2.80.1098.
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The purpose of the work: to develop method of potentiation of multimodal anesthesia with led radiation in
650±20 nm and blue 470±10nm range using Autonomous optoelectronic devices.
Abstract . Material and methods. Conducting contact led exposure was carried out portable semiconductor led device AFS K-630/670 in the red range with a wavelength of 470±10 nm. Multimodal anesthesia was perfomed on the patients abdominal profile (n=124) (78 women and 46 men) with concomitant diseases aged 52 to 93 years/ The weight of patients ranged from 64 to 131 kg/ All patients had 3 degree of anesthetic risk according to the classification of MEAR. The patients were divided into 2 groups: the main group and the control group. In the main group (n=68) 42 patients underwent planned laparoscopic cholecystectomy, 26 patients herniation with alloplasty by laparoscopic method. In the control group (n=56) 39 patients underwent laparoscopic cholecystectomy and laparoscopic alloplasty in 17 patiemts.
Results. It is established that the potential multimodal anesthesia portable semiconductor led apparatus ASFto -630/670 in the red range with a wavelength of 650±20 nm and in the blue range ( the control group patients consumption of fentanil made up 4,92±0,34 mg/kg/h in the main 1,23±012 mg/kg/h. The indicator of Central hemodynamics si in main group increased at the end of surgery from 2,28±0,43 l/min/m2 to 3,29 l/min/m2. (OPSS) DIN C. sm-5 with the initial values from 1604,2±367,3 to 1196,7±385,1 DIN. C. sm-5. In the control group si increased at the end of surgery from 2,28±0,43 to 3,29±0,51 l/min/m2. (OPSS) DIN C. sm-5 increased at 1598,7,±426,5 tо 1610,7±429,1 DIN C. sm-5.
Conclusion. The potentiation of multimodal anesthesia by contact light emitting diodes during abdominal surgeries in the main group allowed, on average, to reduce the dosage of narcotic drugs by 4 times fentanyl analgesics, stabilize hemodynamic parameters, increase the heart index and reduce the total peripheral vascular resistance more than in the control group during the anesthetic treatment.
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Wang, Ming, Weiming Yan, Weipeng Qi, Di Wu, Lin Zhu, Weina Li, Xiaojing Wang, et al. "Clinical characteristics and risk factors of liver injury in COVID-19: a retrospective cohort study from Wuhan, China." Hepatology International 14, no. 5 (September 2020): 723–32. http://dx.doi.org/10.1007/s12072-020-10075-5.
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Abstract Background Coronavirus disease 2019 (COVID-19) has rapidly become a major international public health concern. This study was designed to evaluate the clinical characteristics and risk factors of COVID-19-associated liver injury. Methods A fraction of 657 COVID-19 patients were retrospectively analyzed. Clinical and laboratory data were derived from electronic medical records and compared between patients with or without liver injury. Multivariate logistic regression method was used to analyze the risk factors for liver injury. Results Among 657 patients, 303 (46.1%) patients had liver injury with higher rate in severe/critically ill patients [148/257 (57.6%)] than those in moderate cases [155/400 (38.8%)]. The incidence of liver injury was much higher in male [192/303 (63.4%)] than female [111/303 (36.6%)], and in severe/critical patients [148/303 (48.8%)] with percutaneous oxygen saturation ≤ 93% [89/279 (31.9%)] or peak body temperature ≥ 38.5 °C [185/301 (61.5%)] on admission. Liver injury-related inflammations included increased white blood cells, neutrophils and decreased lymphocytes. More patients with liver injury than without had increased serum IL-2R, TNFα, ferritin, hsCRP, PCT, ESR, γ-GT, and LDH. Multivariate regression analysis revealed that increasing odds of liver injury were related to male, higher serum hsCRP (≥ 10 mg/L), and neutrophil-to-lymphocyte ratio (NLR) (≥ 5). Moreover, more deceased patients (14/82 (17%)) had significantly elevated serum TBIL than discharged patients [25/532 (4.7%)]. Conclusion Liver injury is a common complication in COVID-19 patients. The potential risk factors of liver injury include male, hsCRP and NLR score. A close monitor of liver function should be warned in COVID-19 patients, especially in severe/critical individuals.
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Buller, Harry R. "Initial Outpatient Treatment of Venous Thromboembolism with Fondaparinux (Arixtra®): The Matisse Trials." Blood 104, no. 11 (November 16, 2004): 705. http://dx.doi.org/10.1182/blood.v104.11.705.705.
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Abstract Background: The MATISSE trials showed that a single dose regimen of fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the treatment of venous thromboembolism (VTE). In these trials, outpatient treatment of fondaparinux was encouraged but left at the investigator’s discretion. We analyzed the data in patients who received fondaparinux on an outpatient basis. Methods: Fondaparinux was administered at a once-daily subcutaneous dose of 7.5 mg (5.0 mg and 10.0 mg in patients <50 kg and >100 kg, respectively). In the MATISSE-DVT trial, fondaparinux was compared with twice-daily subcutaneous enoxaparin (1 mg/kg) in patients with deep-vein thrombosis (DVT). In the MATISSE-PE trial, it was compared with adjusted-dose intravenous unfractionated heparin (UFH) in patients with pulmonary embolism (PE). Outpatient treatment of DVT with enoxaparin was possible whereas outpatient treatment of PE with UFH was not feasible. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. The primary efficacy and safety outcomes were recurrent VTE during 3 months’ follow-up and major bleeding (MB) and death during the initial treatment period. Results: In MATISSE-DVT, 31.4% and 33.8% of the fondaparinux- and enoxaparin-treated patients, respectively, received therapy on an outpatient basis. In MATISSE-PE, 14.3% of the patients received fondaparinux on an outpatient basis, compared with none in the UFH group. In both MATISSE-DVT and -PE, efficacy and safety data from the patients who received fondaparinux on an outpatient basis were similar to those from the total population (Tables). The rates of recurrent VTE and MB in fondaparinux outpatients were similar to those in enoxaparin outpatients or UFH inpatients. Conclusion: Outpatient initial treatment of both DVT and PE with once-daily fondaparinux is feasible, effective and safe. MATISSE DVT Enoxaparin Fondaparinux All patients Outpatients All patients Outpatients *As treated patients n 1107 374 (33.8%) 1098 345 (31.4%) Age, yr (mean±SD) 61±17 60±16 61±17 58±17 Male/female 578/529 201/173 581/517 197/148 Hospital discharge, days (mean±SD) 7.0±6.2 1.8±1.9 7.6±7.7 1.6±1.7 ≥2 VTE risk factors, n (%) 283 (25.6) 122 (32.6) 293 (26.7) 97 (28.1) VTE, n (%) 45 (4.1) 16 (4.3) 43 (3.9) 7 (2.0) MB*, n (%) 13 (1.2) 3 (0.8) 12 (1.1) 5 (1.5) MATISSE-PE UFH Fondaparinux All patients Outpatients *As treated patients n 1110 1103 158 (14.3%) Age, yr (mean±SD) 62±17 63±16 57±16 Male/female 477/633 501/601 82/76 Hospital discharge, days (mean±SD) 10.2±6.8 9.7±7.7 4.4±2.2 ≥2 VTE risk factors, n (%) 260 (23.4) 241 (21.8) 35 (22.2) VTE, n (%) 56 (5.0) 42 (3.8) 5 (3.2) MB*, n (%) 12 (1.1) 14 (1.3) 0 (0)
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Patel, Meera, Jonathan M. Loree, Melissa W. Taggart, Anais Malpica, Aurelio Matamoros, Scott Kopetz, Gauri R. Varadhachary, Keith F. Fournier, Richard Eldon Royal, and Kanwal Pratap Singh Raghav. "Malignant peritoneal mesothelioma: Clinicopathological features, prognostic factors, and survival outcomes." Journal of Clinical Oncology 36, no. 4_suppl (February 1, 2018): 650. http://dx.doi.org/10.1200/jco.2018.36.4_suppl.650.
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650 Background: Peritoneal mesothelioma (PeM) is an orphan disease with approximately 300-400 cases diagnosed in the United States each year. Due to its rarity, data on its presentation and prognostic factors is limited. The purpose of this study was to investigate the clinicopathological profile and outcome of Malignant PeM (MPeM). Methods: We retrospectively reviewed 128 PeM patients (pts) seen at UTMDACC (2011 - 2017) comprised of 111 MPeM and 17 variants (VPeM) [9 well-differentiated papillary and 8 multicystic]. Kaplan-Meier method was used to estimate median overall survival (mOS) and compared with log-rank tests. Results: Median age at diagnosis was 57 yrs. with a higher proportion of women (61%). The mOS for MPeM was significantly shorter than VPeM (HR 3.7, 95% CI: 1.6 – 8.4, P = 0.002). Among pts with MPeM, median age at diagnosis was 56 yrs. and 58% were women. Only 22% had prior exposure to asbestos. Epithelioid subtype was seen in 94 (85%) pts. Calretinin and WT-1 IHC were positive in 98% and 96% of cases. BerEP4 and MOC-31 IHC were negative in 90% and 84% of cases. After median follow-up of 31 months (m), the mOS for MPeM cohort was 78 m. In univariate analysis, age, prior asbestos exposure, ECOG PS, histologic subtype, CA125, neutrophil-lymphocyte ratio (NLR) and cytoreductive surgery (CRS) were found to be associated with OS. In multivariate analyses, age ≥ 65 years (HR 4.5, 95% CI: 1.3 - 15.2, P = 0.02), prior asbestos exposure (HR 4.1, 95% CI: 1.1 – 15.6, P = 0.04), poor PS (ECOG 2/3) (HR 8.9, 95% CI: 1.7 – 47.7, P = 0.01), elevated CA125 ( > 3X upper limit of normal) (HR 4.5, 95% CI: 1.3 – 15.5, P = 0.02), and high NLR (HR 3.8, 95% CI: 1.1 – 12.6, P = 0.03) were found to be independently associated with poor OS. A total of 50 (45%) pts underwent CRS and among these the completion of cytoreduction score (CCS) was strongly associated with OS (mOS: 201 m, 53 m and 36 m for CCS 0, 1, 2/3, respectively, P = 0.005). Conclusions: MPeM is associated with poor survival outcomes. Prognostic factors include age, history of asbestos exposure, CA-125 level, NLR, and PS. CRS with CCS 0 results in favorable survival. Further understanding of molecular genetics is warranted to improve prognostication and outcomes.
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Cheloni, Daniele, and Aybige Akinci. "Source modelling and strong ground motion simulations for the 24 January 2020, Mw 6.8 Elazığ earthquake, Turkey." Geophysical Journal International 223, no. 2 (July 21, 2020): 1054–68. http://dx.doi.org/10.1093/gji/ggaa350.
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SUMMARY On 24 January 2020 an Mw 6.8 earthquake occurred at 20:55 local time (17:55 UTC) in eastern Turkey, close to the town of Sivrice in the Elazığ province, causing widespread considerable seismic damage in buildings. In this study, we analyse the main features of the rupture process and the seismic ground shaking during the Elazığ earthquake. We first use Interferometric Synthetic Aperture Radar (InSAR) interferograms (Sentinel-1 satellites) to constrain the fault geometry and the coseismic slip distribution of the causative fault segment. Then, we utilize this information to analyse the ground motion characteristics of the main shock in terms of peak ground acceleration (PGA), peak ground velocity (PGV) and spectral accelerations. The absence of seismic registrations in near-field for this earthquake imposes major constraints on the computation of seismic ground motion estimations in the study area. To do this, we have used a stochastic finite-fault simulation method to generate high-frequency ground motions synthetics for the Mw 6.8 Elazığ 2020 earthquake. Finally, we evaluate the potential state of stress of the unruptured portions of the causative fault segment as well as of adjacent segments, using the Coulomb stress failure function variations. Modelling of geodetic data shows that the 2020 Elazığ earthquake ruptured two major slip patches (for a total length of about 40 km) located along the Pütürge segment of the well-known left-lateral strike-slip East Anatolian Fault Zone (EAFZ), with up to 2.3 m of slip and an estimated geodetic moment of 1.70 $\,\, \times $ 1019 Nm (equivalent to a Mw 6.8). The position of the hypocentre supports the evidence of marked WSW rupture directivity during the main shock. In terms of ground motion characteristics, we observe that the high-frequency stochastic ground motion simulations have a good capability to reproduce the source complexity and capture the ground motion attenuation decay as a function of distance, up to the 200 km. We also demonstrate that the design spectra corresponding to 475 yr return period, provided by the new Turkish building code is not exceeded by the simulated seismograms in the epicentral area where there are no strong motion stations and no recordings available. Finally, based on the Coulomb stress distribution computation, we find that the Elazığ main shock increased the stress level of the westernmost part of the Pütürge fault and of the adjacent Palu segment and as a result of an off-fault lobe.
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Pervez, Asim, Abdul Razzaq, Muhammad Shoaib Farooq, Abdul Basit, and Muhammad Saleem Akhtar. "Role of boric acid on economic seed production of alfalfa under climatic conditions of Sargodha." World Journal of Biology and Biotechnology 5, no. 1 (April 15, 2020): 37. http://dx.doi.org/10.33865/wjb.005.01.0293.
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Alfalfa is one of the most important forage crops worldwide because of its wide range of adaptability and good forage quality. Seed yield is generally considered to be of secondary importance and is characterized by often poor seed yield and seed quality. A field experiment was conducted to determine the impact of boric acid foliar applications along with a basal dose during anthesis to enhance the alfalfa seed yield in agro-ecological conditions of Sargodha. In foliar boric acid fertilization 0, 2, 4, 6, 8, 10 boric acid along with basal dose 23-80-50 (NPK kg ha-1) was used. Phosphorous and potash were applied at the time of sowing while nitrogen will be applied in two split doses; half at sowing time and half of 1st irrigation. Two foliar applications, 1st at intensive plant growth stage and the 2ndat the beginning of the blossoming of the crop. The concentration of boric acid solutions used were 2 ,4 , 6 ,8 and 10 glit-1 which produces a seed yield of 161.7, 167.9,171.3, 175.0,186.7 and 176.1 kg ha-1 in year 2015-16 while next year in 2016-17 produces a seed yield of 286.5, 299.2,304.6, 308.3, 312.1 and 310.1kg ha-1 respectively which is higher than year 2015-16. Foliar fertilization with boron influenced forming of slightly higher number of seeds in the pod. Boron influenced the average increase of yield, with a slightly greater difference compared to control. Number of seeds per pod in boric acid dose of 0, 2, 4, 6, 8 and 10 remained 6.1, 6.3, 6.4, 6.6, 6.8 and 6.7respectively in year 2016-17 which were higher than 4.3,4.4,4.5, 4.5,4.9 and 4.7 in year 2015-16. Overall 8 g liter-1 boric acid foliar fertilization produces 8.9 % higher seed yield, 11.4 % higher no of seeds per pod compared to control in the year 2016-17 while produces 15.4% higher seed yield and 13.9 % higher no of seeds per pod as compared to control in the year 2015-16.
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McCreary, Erin K., Lloyd Clarke, Rachel V. Marini, Minh-Hong Nguyen, Cornelius J. Clancy, and Ryan K. Shields. "656. Prioritizing Gram-Negative Bacteremia (GNB) Cases for Rapid Detection by β-Lactam Resistance (BLR) and Patient Outcomes." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S301—S302. http://dx.doi.org/10.1093/ofid/ofz360.724.
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Abstract Background GNB is associated with significant morbidity and mortality. The availability of rapid diagnostic tests (RDTs) provides an opportunity to improve outcomes. Our goal was to review GNB and its empiric treatment at our center in order to devise rational approaches to diagnostic stewardship and use of RDTs. Methods All patients with GNB from 2010 to 2018 were evaluated. BLR was defined by 2019 CLSI breakpoints; phenotypes are shown in Table 1. Results A total of 2795 GNB cases were included (Table 2); 57% occurred within the first 24 hours of hospitalization and 29.3% in the ICU. The median length of stay (LOS) was 12 days; 17.2% of patients were re-admitted within 30 days. Fourteen- and 30-day mortality rates were 13.7% and 19.5%, respectively. Rates of death were higher (30 days; 26.3% vs. 17.1%; P < 0.001) and median LOS longer (17 vs. 11 days; P < 0.001) among patients with BLR compared with susceptible GNB. Thirty-day mortality rates were highest for CRE (30.1%) and BLR P. aeruginosa (BLR-Pa; 32.8%, Figure 1). 47.7% of BLR GNB were non-CRE/ESBL, which demonstrated higher mortality rates than CRE/ESBL (30 days; 27.6% vs. 21.2%; P = 0.048). Most common empiric regimens prescribed were piperacillin–tazobactam (TZP; 50.3%), cefepime (FEP; 24.2%), carbapenem (9.3%), or other agents (16.2%). 21.6% of GNB patients received inactive empiric treatment (IET). Empiric TZP (21.9%) was more likely to be inactive than FEP (17.5%; P = 0.05), but not a carbapenem (20.7%; P = NS). 57.6% of patients with inhibitor-resistant Enterobacteriaceae (IRE) received TZP empirically. Receipt of IET was associated with higher rates of death (30 days; 22.5% vs. 16.7, P = 0.03) and longer LOS (14 vs. 11 days; P < 0.001) than receipt of active ET. Rates of IET varied by pathogen (Figure 1). Conclusion IET is common against BLR GNB and associated with poor pt outcomes, highlighting the potential for RDTs and diagnostic stewardship teams (DSTs) to improve care. Genotypic RDTs detect most CRE/ESBL, but may miss nearly 50% of BLR GNB cases at our center. BLR-Pa and IRE are pathogens associated with prolonged LOS, and high rates of IET and death. These pathogens could be detected earlier by phenotypic RDTs and prioritized by DSTs to optimize early treatment regimens. Disclosures All authors: No reported disclosures.
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Suharyati, Suharyati. "Cost Effectiveness Upaya Penanggulangan Gizi Metode Positif Deviance dan Pemberian Makanan Tambahan di Puskesmas Gekbrong Kabupaten Cianjur 2006." Kesmas: National Public Health Journal 1, no. 6 (June 1, 2007): 282. http://dx.doi.org/10.21109/kesmas.v1i6.289.
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Provinsi Jawa Barat masih menghadapi masalah rawan gizi serius, terlihat pada 18.094 balita rawan pangan yang terhimpun di tiga kantong utama, Kabu- paten Cirebon (4.005), Bandung (2.991) dan Cianjur (2.670). Di Kabupaten Cianjur, balita gizi buruk dan gizi kurang ditemukan 2.670 (1,3%) dan 24.447 (11,7%) dari 208.572 balita yang ada. Tujuan penelitian ini membandingkan cost effectiveness upaya perbaikan gizi pemberian Makanan Tambahan (PMT) yang bersifat top down dan Positive Deviance (PD) yang besifat bottom up. Data ditinjau dari sisi provider dan perhitungan biaya peraktifitas menggunakan metoda Activity Based Costing (ABC Methode). Komponen biaya penanggulangan gizi terbesar berturut-turut adalah biaya operasional, investasi dan pemeliharaan (85%, 14,5% dan 0,3%). Metoda PD memerlukan waktu 54 hari dan metoda PMT 102 hari. Rata-rata kenaikan berat badan (BB) selama tiga bu- lan pada metoda PD (920 gram) adalah lebih besar daripada metoda PMT (650 gram). Rata-rata kenaikan BB pada bulan I. II dan II, pada metoda PD (470, 220 dan 230 gram) adalah lebih tinggi daripada metoda PMT (300, 170 dan 180 gram). Kenaikan BB balita dalam 3 bulan berdasar pita warna KMS, BB sa- ngat kurang dan kurang pada PD (54%, 17%) lebih rendah daripada PMT (78%, 22%). Nilai CER metoda PD (Rp 446.828,- /balita) terlihat lebih kecil daripada metoda PMT (Rp 768.887,-/balita). Disimpulkan bahwa metoda PD lebih cost effective daripada metoda PMT.Kata kunci: efektifitas biaya, BB, CEA, PD, PMTAbstactThe Province of West Java still faces serious malnutrition problem that can be seen in 18094 cases of under 5 years old children who suffer from malnutrition particularly in districts of Cirebon (4005), Bandung (2991) and Cianjur (2670). In Cianjur it was found that 2670 (1.3%) cases of severe under-nutrition and 24447 (11.7%) cases of under-nutrition out of 208572 children. The objective of this study is to compare the cost effectiveness between positive deviance (PD) and food supplementation (PMT) methods. The data were observed from the provider side using Activity Based Costing (ABC) method. The study shows that the biggest cost component is the operational cost (85%), investment cost (14.5%) and maintenance cost (0.3%). The time frame for PD method (54 days) is shorter than that of PMT method (102 days). The average body weight gain in three months, the PD method (920 grams) is smaller than that of PMT method (650 grams). The monthly average gain in the first, second and third for the PD method (470, 220 and 230 grams) is higher than that of the PMT method (300, 170 and 180 grams). From growth chart (KMS) in three months, below red line (BGM) and under-weight in the PD method (54%, and 17%) is lower than the PMT (78% and 22%). The CER value for PD method is Rp 446,828,-/child, lower than that of the PMT method ( Rp 768,887,-/child). It was concluded that PD method is more cost effective than PMT method.Key words: Cost-effectiveness, under-weight, Positive Deviance, food supplementation
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Kazantsev, A. N., R. A. Vinogradov, M. A. Chernyavsky, V. N. Kravchuk, D. V. Shmatov, A. A. Sorokin, A. A. Erofeyev, et al. "Multicenter Study of Resistant Arterial Hypertension Course After Classic and Eversion Carotid Endarterectomy." Russian Sklifosovsky Journal "Emergency Medical Care" 10, no. 4 (January 17, 2022): 649–58. http://dx.doi.org/10.23934/2223-9022-2021-10-4-649-658.
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Aim of study. Analysis of the dynamics of resistant arterial hypertension (RAH) and the spectrum of adverse cardiovascular events in patients after classical carotid endarterectomy (CEE) with preservation of carotid body (CB) and eversion CEE with CB transection.Material and methods. This cohort, comparative, retrospective, open-label study from January 2014 to December 2020 included 761 patients with hemodynamically significant stenosis of the internal carotid arteries (ICA) and RH lasting more than 3 years. Depending on the implemented revascularization strategy, 2 groups were formed: Group 1: 38.0% (n=289) — classical CEE with plasty of the reconstruction zone with a patch (made of diepoxy-treated xenopericardium or synthetic); Group 2: 62% (n=472) — eversion CEE with CB transection. To study the dynamics of systolic blood pressure (SBP) in the preoperative period for 4 days, and in the postoperative period, blood pressure was measured for 10 days (during the period when the patient was in intensive care - according to daily monitoring of blood pressure; in the department - 10 times per day, daily). The average SBP figures for all patients were taken into account when constructing a graph of BP fluctuations.Results. In the postoperative period, the groups were comparable in the frequency of the following events: death (group 1: 0.34% (n=1), group 2: 0.63% (n=3); p=0.98; OR 0.54; 95% CI 0.05–5.21), myocardial infarction (group 1: 0.34% (n=1), group 2: 0.84% (n=4); p=0.71; OR 0, 40; 95% CI 0.04–3.65), ischemic stroke (group 1: 0.34% (n=1), group 2: 1.27% (n=6); p=0.36; OR 0.26; 95% CI 0.03–2.25), hemorrhagic transformation (group 1: 0%, group 2: 0.84% (n=4); p=0.29; OR 0.17; 95% CI 0.009–3.35). However, in terms of the number of all complications (death + myocardial infarction + ischemic stroke + hemorrhagic transformation) presented as a combined endpoint, patients after eversion CEE with CB transection were three times superior to classical surgery (group 1: 1.03% (n=3 ), group 2: 3.60% (n=17); p=0.05; OR 0.28; 95% CI 0.08–0.9).Conclusion. The choice of a revascularization strategy in patients with hemodynamically significant ICA stenosis should be personalized and based on the conclusion of a multidisciplinary consultation, and not only on the preferences of the operating surgeon. In patients with RH, it is more expedient to use classical CEE with plasty of the reconstruction zone with a patch in view of the preservation of the CB during this operation. The intersection of the latter with eversion CEE provokes labile hypertension, progression of RAH and a statistically significant increase in the number of all unfavorable cardiovascular events. Thus, the use of carotid body preserving CEE in patients with RAH confirms the therapeutic mechanism of this manipulation in achieving the target SBP level.
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Midgley, Claire, Brian Rha, Joana Y. Lively, Angela P. Campbell, Julie A. Boom, Parvin H. Azimi, Geoffrey A. Weinberg, et al. "2639. Respiratory Virus Detections in Asthma-Related Pediatric Hospitalizations: New Vaccine Surveillance Network, United States." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S922—S923. http://dx.doi.org/10.1093/ofid/ofz360.2317.
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Abstract Background Respiratory viruses are associated with most asthma exacerbations (AEx) in children; however, the role of different viruses in AEx is unclear. We describe respiratory virus detections among pediatric inpatients with AEx (AEx-inpatients). Methods Through active, prospective surveillance at 7 US medical centers, we enrolled inpatients (<18 years) with acute respiratory illness (ARI) during November 1, 2015–June 30, 2016. We defined an AEx-inpatient as an inpatient with a principal admission or discharge diagnosis of asthma (ICD-10-CM, J45.xx). Mid-turbinate nasal and/or throat swabs were tested by molecular assays for influenza A or B, respiratory syncytial virus (RSV), parainfluenza virus 1–3, rhinovirus or enterovirus (RV/EV), human metapneumovirus and adenovirus. We assessed virus detections among AEx-inpatients throughout the surveillance period or by season (winter: December–February; spring: March–May), and by patient age and history of asthma/reactive airway disease (asthma/RAD). Results We tested 3,897 inpatients with ARI; of whom, 954 were AEx-inpatients. Most AEx-inpatients (741/954 [78%]) reported an asthma/RAD history. Viruses were more frequently detected among AEx-inpatients <5 years (350/458 [76%]) than 5–17 years (305/496 [61%], P < 0.001). Most (615/655 [94%]) detections were of single viruses. The most frequent single virus detections were RV/EV (474/954 [50%]) and RSV (76/954 [8%]) but the frequency of each virus varied by season and age group (figure). Single RV/EVs were the most common virus detections in both seasons and all groups. Single RSV detections were prominent among <5 year olds in winter (40/185 [22%]). Among those with single RV/EV or RSV detections, 285/474 (60%) and 49/76 (64%) required supplemental oxygen, respectively (P = 0.676); median length of stay was 1 day (range: 0–45; IQR: 1–2) and 2 days (range: 0–6; IQR: 1–2.5), respectively (P < 0.001). Conclusion AEx-inpatients <5 years were more likely to have respiratory virus detections than those 5–17 years. Single RV/EVs formed the majority of virus detections throughout the surveillance period, regardless of age. RSV played a notable role in winter among patients <5 years. These findings could inform prevention or treatment strategies for virus-associated AEx. Disclosures All authors: No reported disclosures.
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Gong, Jiansen, Jinqiu Zhang, Ming Xu, Chunhong Zhu, Yan Yu, Xuexian Liu, Patrick Kelly, Bu Xu, and Chengming Wang. "Prevalence and Fimbrial Genotype Distribution of Poultry Salmonella Isolates in China (2006 to 2012)." Applied and Environmental Microbiology 80, no. 2 (November 15, 2013): 687–93. http://dx.doi.org/10.1128/aem.03223-13.
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ABSTRACTIn this study, a total of 323Salmonella entericastrains were isolated from 3,566 rectal swab samples of 51 poultry farms in seven regions of 12 provinces of China between 2006 and 2012. The prevalences ofSalmonellasp. carriage were 12.4% in geese (66 positive/533 samples), 10.4% in turkeys (32/309), 9.8% in chickens (167/1,706), 6.8% in ducks (41/601), and 4.1% in pigeons (17/417), respectively. These isolates belonged to 20 serovars, in which the most frequent serovars wereS. entericaserovar Gallinarum biovar Pullorum (herein,S. Pullorum) (55 isolates, 17.0%),S. entericaserovar Typhimurium (50 isolates, 15.5%), andS. entericaserovar Enteritidis (39 isolates, 12.1%). Overall,S. Typhimurium was the most commonly detected serovar; among the individual species,S. Pullorum was most commonly isolated from chickens,S. Enteritidis was most common in ducks,S. Typhimurium was most common in geese and pigeons, andS. entericaserovar Saintpaul was most common in turkeys. PCR determination of 20 fimbrial genes demonstrated the presence ofbcfD,csgA,fimA,stdB, andsthEgenes and the absence ofstaAandstgAgenes in these isolates, and other loci were variably distributed, with frequency values ranging from 11.8 to 99.1%. These 323Salmonellaisolates were subdivided into 41 different fimbrial genotypes, and of these isolate, 285 strains (88.2%) had 12 to 14 fimbrial genes. Our findings indicated that theSalmonellaisolates from different poultry species were phenotypically and genetically diverse and that some fimbrial genes are more frequently associated with serovars or serogroups.
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Pereira, Juliano Alves, Adriana Fogagnolo Mauricio, Maria Julia Marques, and Humberto Santo Neto. "Dual Therapy Deflazacort/Doxycyclyne Is Better Than Deflazacort Monotherapy to Alleviate Cardiomyopathy in Dystrophin-Deficient mdx Mice." Journal of Cardiovascular Pharmacology and Therapeutics 22, no. 5 (December 28, 2016): 458–66. http://dx.doi.org/10.1177/1074248416686189.
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Cardiomyopathy related to the absence of dystrophin is an important feature in Duchenne muscular dystrophy (DMD) and in the mdx mouse. Doxycycline (DOX) could be a potential therapy for mdx skeletal muscles dystrophy. We investigated whether the corticoid deflazacort (DFZ) plus DOX could improve cardiac mdx dystrophy better than DFZ alone, later (17 months) in dystrophy. Mdx mice (8 months old) received DFZ/DOX or DFZ for 9 months. The combined therapy was greater than DFZ in reducing fibrosis (60% decrease with DFZ/DOX and 40% with DFZ alone) in the right ventricle and transforming growth factor β levels (6.8 ± 3.2 in untreated mdx mice, 2.8 ± 1.4 in combined therapy, and 4.6 ± 1.7 in DFZ; P < .05). Combined therapy more effectively ameliorated cardiac dysfunction (electrocardiogram [ECG]) than DFZ. Improvements were seen in the cardiomyopathy index (0.8 ± 0.1 in combined therapy and 1.0 ± 0.2 in DFZ), heart rate (418 ± 46 bpm in combined therapy and 457 ± 29 bpm in DFZ), QRS interval (11.3 ± 2 in combined therapy and 13.6 ± 1 in DFZ), and Q wave amplitude (−40.7 ± 21 in combined therapy and −90.9 ± 36 in DFZ). Both therapies decreased markers of inflammation (tumor necrosis factor α, nuclear factor κB, and metalloproteinase 9). DFZ/DOX improved mdx cardiomyopathy at this stage of the disease, supporting further clinical investigations.
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Reis, Zilma Silveira Nogueira, Juliano De Souza Gaspar, Gabriela Luiza Nogueira Vitral, Vitor Barbosa Abrantes, Ingrid Michelle Fonseca de-Souza, Maria Tereza Silveira Moreira, and Regina Amélia Lopes Pessoa Aguiar. "Quality of Pregnancy Dating and Obstetric Interventions During Labor: Retrospective Database Analysis." JMIR Pediatrics and Parenting 3, no. 1 (April 15, 2020): e14109. http://dx.doi.org/10.2196/14109.
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Background The correct dating of pregnancy is critical to support timely decisions and provide obstetric care during birth. The early obstetric ultrasound assessment before 14 weeks is considered the best reference to assist in determining gestational age (GA), with an accuracy of ±5 to 7 days. However, this information is limited in many settings worldwide. Objective The aim of this study is to analyze the association between the obstetric interventions during childbirth and the quality of GA determination, according to the first antenatal ultrasound assessment, which assisted the calculation. Methods This is a hospital-based cohort study using medical record data of 2113 births at a perinatal referral center. The database was separated into groups and subgroups of analyses based on the reference used by obstetricians to obtain GA at birth. Maternal and neonatal characteristics, mode of delivery, oxytocin augmentation, and forceps delivery were compared between groups of pregnancies with GA determination at different reference points: obstetric ultrasound assessment 14 weeks, 20 weeks, and ≥20 weeks or without antenatal ultrasound (suboptimal dating). Ultrasound-based GA information was associated with outcomes between the interest groups using chi-square tests, odds ratios (OR) with 95% CI, or the Mann-Whitney statistical analysis. Results The chance of nonspontaneous delivery was higher in pregnancies with 14 weeks ultrasound-based GA (OR 1.64, 95% CI 1.35-1.98) and 20 weeks ultrasound-based GA (OR 1.58, 95% CI 1.31-1.90) when compared to the pregnancies with ≥20 weeks ultrasound-based GA or without any antenatal ultrasound. The use of oxytocin for labor augmentation was higher for 14 weeks and 20 weeks ultrasound-based GA, OR 1.41 (95% CI 1.09-1.82) and OR 1.34 (95% CI 1.04-1.72), respectively, when compared to those suboptimally dated. Moreover, maternal blood transfusion after birth was more frequent in births with suboptimal ultrasound-based GA determination (20/657, 3.04%) than in the other groups (14 weeks ultrasound-based GA: 17/1163, 1.46%, P=.02; 20 weeks ultrasound-based GA: 25/1456, 1.71%, P=.048). Cesarean section rates between the suboptimal dating group (244/657, 37.13%) and the other groups (14 weeks: 475/1163, 40.84%, P=.12; 20 weeks: 584/1456, 40.10%, P=.20) were similar. In addition, forceps delivery rates between the suboptimal dating group (17/657, 2.6%) and the other groups (14 weeks: 42/1163, 3.61%, P=.24; 20 weeks: 46/1456, 3.16%, P=.47) were similar. Neonatal intensive care unit admission was more frequent in newborns with suboptimal dating (103/570, 18.07%) when compared with the other groups (14 weeks: 133/1004, 13.25%, P=.01; 20 weeks: 168/1263, 13.30%, P=.01), excluding stillbirths and major fetal malformations. Conclusions The present analysis highlighted relevant points of health care to improve obstetric assistance, confirming the importance of early access to technologies for pregnancy dating as an essential component of quality antenatal care.
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Lilley, Rebbecca, Bronwen McNoe, Gabrielle Davie, Brandon de Graaf, Simon Horsburgh, Brett Maclennan, and Tim Driscoll. "O7A.3 Creating safer workplaces: learning from work-related fatal injury in new zealand." Occupational and Environmental Medicine 76, Suppl 1 (April 2019): A61.3—A62. http://dx.doi.org/10.1136/oem-2019-epi.165.
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BackgroundNZ’s workplace fatality record is high compared to similar countries, with a rate twice that of Australia and four times that of the UK. The reasons for NZ’s substandard performance are highly debated, and in-depth analysis to inform this debate is limited by a dearth of detailed fatality data. This study aims to inform work-related injury prevention efforts for NZ by: i) enumerating the fatal injury burden; and ii) identifying high risk groups and circumstances to prioritise and target preventive action.MethodsA dataset spanning forty-years of Coronial records was created by collecting data for the period 1995–2014 and appending this to existing data for 1975–1994. Data collection involved: 1) identifying possible cases aged 0–84 years from mortality records using injury external cause codes, 2) linking these to Coronial records 3) retrieving and reviewing records for work-relatedness, and 4) coding work-related cases. Work-related cases were classified as workers, bystanders, commuters or students. Work-related injury frequencies and rates per 1 00 000 workers for the most recent 20 year period were calculated by age, sex, employment status, occupation and industry.ResultsOf 17 658 injury fatalities reviewed for the period 1995–2014, 3766 (23%) were work-related, of which 1762 were workers. This corresponds to an overall rate of fatal injury of 4.7 (95% CI 4.5, 5.0) per 1 00 000 workers. Rates of fatal injury were highest for older workers aged 70–84 years (18.1, 95% CI 14.8, 21.8) and males (8.1, 95% CI 7.7, 8.5). The two industry groups with the highest burden of fatal injury were the Agricultural, Forestry and Fisheries and Transport, Postal and Warehouse.ConclusionsThis research demonstrates an innovative use of coronial data, and provides a rare example of the establishment of a continuous and comprehensive long-term coronial dataset. It will be used to generate knowledge for informing workplace preventive strategies in NZ.
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Chang, Yunhua, Congrui Deng, Fang Cao, Chang Cao, Zhong Zou, Shoudong Liu, Xuhui Lee, Jun Li, Gan Zhang, and Yanlin Zhang. "Assessment of carbonaceous aerosols in Shanghai, China – Part 1: long-term evolution, seasonal variations, and meteorological effects." Atmospheric Chemistry and Physics 17, no. 16 (August 25, 2017): 9945–64. http://dx.doi.org/10.5194/acp-17-9945-2017.
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Abstract. Carbonaceous aerosols are major chemical components of fine particulate matter (PM2. 5) with major impacts on air quality, climate change, and human health. Gateway to fast-rising China and home of over twenty million people, Shanghai throbs as the nation's largest mega city and the biggest industrial hub. From July 2010 to December 2014, hourly mass concentrations of ambient organic carbon (OC) and elemental carbon (EC) in the PM2. 5 fraction were quasi-continuously measured in Shanghai's urban center. The annual OC and EC concentrations (mean ±1σ) in 2013 (8.9 ± 6.2 and 2.6 ± 2.1 µg m−3, n = 5547) and 2014 (7.8 ± 4.6 and 2.1 ± 1.6 µg m−3, n = 6914) were higher than those of 2011 (6.3 ± 4.2 and 2.4 ± 1.8 µg m−3, n = 8039) and 2012 (5.7 ± 3.8 and 2.0 ± 1.6 µg m−3, n = 4459). We integrated the results from historical field measurements (1999–2012) and satellite observations (2003–2013), concluding that carbonaceous aerosol pollution in Shanghai has gradually reduced since 2006. In terms of monthly variations, average OC and EC concentrations ranged from 4.0 to 15.5 and from 1.4 to 4.7 µg m−3, accounting for 13.2–24.6 and 3.9–6.6 % of the seasonal PM2. 5 mass (38.8–94.1 µg m−3), respectively. The concentrations of EC (2.4, 2.0, 2.2, and 3.0 µg m−3 in spring, summer, fall, and winter, respectively) showed little seasonal variation (except in winter) and weekend–weekday dependence, indicating EC is a relatively stable constituent of PM2. 5 in the Shanghai urban atmosphere. In contrast to OC (7.3, 6.8, 6.7, and 8.1 µg m−3 in spring, summer, fall, and winter, respectively), EC showed marked diurnal cycles and correlated strongly with CO across all seasons, confirming vehicular emissions as the dominant source of EC at the targeted site. Our data also reveal that both OC and EC showed concentration gradients as a function of wind direction (WD) and wind speed (WS), generally with higher values associated with winds from the southwest, west, and northwest. This was consistent with their higher potential as source areas, as determined by the potential source contribution function (PSCF) analysis. A common high-potential source area, located along the middle and lower reaches of the Yangtze River instead of northern China, was pinpointed during all seasons. These results demonstrate that the measured carbonaceous aerosols were driven by the interplay of local emissions and regional transport.
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Hardenbergh, Patricia H. "Improving cancer care by linking community cancer center physicians to disease site-specific experts." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 287. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.287.
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287 Background: The goal of this project is to improve quality of cancer care across the United States by connecting community cancer center radiation oncologists with highly specialized, disease site-specific radiation oncologists through the use of online technology. Methods: We have developed a website named chartrounds.com which allows community radiation oncologists to interact online with disease specialists and their peers on a scheduled basis in order to present and review radiation oncology treatment plans and cases in real time. Disease sites currently include breast, head and neck, gastrointestinal, gynecologic, prostate, central nervous systems, pediatric, lymphoma and lung cancers. At the conclusion of each session, participants are asked to complete a feedback questionnaire requesting feedback on quality and relevance of the session and the manner in which it might result in practice changes. Results: 650 community radiation oncology physician members from 49 states and 19 countries have enrolled online. In the initial 18-month period (12/2010-6/2012), 23 disease specialists have lead 188 chart rounds sessions with an average attendance ratio of 10 community physician members to 1 disease specialist. On a 5 point Likert scale with 5 representing the greatest impact possible, the mean response to feedback questions is as follows: session quality: 4.7, time used effectively: 4.6, discussions relevant to daily practice: 4.7, session is likely to result in a change in practice: 4.0.More specifically, members reported that they would make the following changes in their practice: change in clinical management of the radiation patient: 35%, change in the selection of patients for radiation: 17%, change in radiation fields: 15%, change in radiation prescription dose: 9%. Conclusions: Chartrounds.com appears to be impacting radiation oncology practice resulting in changes in management and treatment of patients in community cancer centers. Future directions of this project are aimed at demonstrating how these changes could result in significant improvements in cancer care across the United States. This work is funded by the Improving Cancer Care Grant of the ASCO Conquer Cancer Foundation.
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Evers, Patrick D., Neal Jorgensen, Borah Hong, Erin Albers, Mariska Kemna, Josh Friedland-Little, Robert J. Boucek, and Yuk Law. "Outcomes of low-intensity biopsy surveillance for rejection in paediatric cardiac transplantation." Cardiology in the Young 29, no. 7 (June 17, 2019): 910–16. http://dx.doi.org/10.1017/s1047951119001112.
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AbstractBackground:Significant inter-centre variability in the intensity of endomyocardial biopsy surveillance for rejection following paediatric cardiac transplantation has been reported. Our aim was to determine if low-intensity biopsy surveillance with two scheduled biopsies in the first year would produce outcomes similar to published registry outcomes.Methods:A retrospective study of paediatric recipients transplanted between 2008 and 2014 using a low-intensity biopsy protocol consisting of two surveillance biopsies at 3 and 12–13 months in the first post-transplant year, then annually thereafter. Additional biopsies were performed based on echocardiographic and clinical surveillance. Excluded were recipients that were re-transplanted or multi-organ transplanted or were followed at another institution.Results:A total of 81 recipients in the first 13 months after transplant underwent an average of 2 (SD ± 1.3) biopsies, 24 ± 6.8 echocardiograms, and 17 ± 4.4 clinic visits per recipient. During the 13-month period, 19 recipients had 24 treated rejection episodes, with the first at an average of 2.8 months post-transplant. The 3-, 12-, 36-, and 60-month conditional on discharge graft survival were 100%, 98.8%, 98.8%, and 90.4%, respectively, comparable to reported figures in major paediatric registries. At a mean follow-up of 4.7 ± 2.1 years, four patients (4.9%) developed cardiac allograft vasculopathy, three (3.7%) developed a malignancy, and seven (8.6%) suffered graft loss.Conclusion:Rejection surveillance with a low-intensity biopsy protocol demonstrated similar intermediate-term outcomes and safety measures as international registries up to 5 years post-transplant.
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Kam, Michael, Shaher El-Meccawi, Arieh Brosh, and A. Allan Degen. "Resting and field metabolic rates of Awassi sheep and Baladi goats raised by Negev bedouin." Journal of Agricultural Science 158, no. 5 (July 2020): 431–37. http://dx.doi.org/10.1017/s0021859620000726.
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AbstractSheep are grazers and goats are intermediate feeders. By employing O2 consumption and heart rate measurements, resting metabolic rate (RMR) and field metabolic rate (FMR) were determined in four male fat-tailed Awassi sheep (44.0 ± 3.94) and four male Baladi goats (35.5 ± 5.42 kg) that were co-grazing natural pasture in the Negev Desert. There were 67.7 ± 3.75 g DM/m2 of herbaceous vegetation biomass, which was rapidly becoming senescent and more fibrous. We hypothesized that FMR of these desert-adapted ruminants would be relatively low when compared to other sheep and goat breeds, as animals in arid areas tend to have low metabolic rates. Both sheep (n = 6) and goats (n = 6) foraged 71% of the allotted 11 h free-pasture period; however, sheep grazed more than goats (P < 0.001); whereas goats browsed more than sheep (P < 0.001). RMR was higher (P = 0.007) in sheep than in goats (529 ± 23.5 v. 474 ± 25.4 kJ/kg0.75 BW/d), but FMR did not differ between species (618 ± 55.7 v. 613 ± 115.2 kJ/kg0.75 BW/d). In addition, the cost of activities, as a proportion of FMR, did not differ between sheep and goats; FMR increased by 89 kJ/kg0.75 BW/d or 17% in sheep and by 138 kJ/kg0.75 BW/d or 29% in goats. In comparing FMRs of sheep and goats in this study with these species in other studies, differences were inconsistent and, therefore, our hypothesis was not supported.
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Plaut, I. "Effects of fin size on swimming performance, swimming behaviour and routine activity of zebrafish Danio rerio." Journal of Experimental Biology 203, no. 4 (February 15, 2000): 813–20. http://dx.doi.org/10.1242/jeb.203.4.813.
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The zebrafish Danio rerio exhibits substantial morphological variability in the sizes and shapes of the body and the caudal fin. The present study describes swimming performance, swimming behaviour and routine locomotor activity patterns in three of the major morphotypes: wild-type, long-finned and no-tail. Wild-type and long-finned differ in total length (TL), fork length (FL), caudal fin length (CFL) and caudal fin height (CFH). No-tail has no caudal fin and is significantly smaller in standard length (SL) than the other types. Critical swimming speeds (U(crit)) were measured at 28 degrees C in a modified Brett-type water tunnel. U(crit) of wild-type fish was 56.0+/−4.8 cm s(−1) or 15.5 SL s(−)(1) (mean +/− s.d., N=21), significantly faster than the U(crit) of long-finned fish (43.7+/−6.8 cm s(−1) or 12.5 SL s(−1), N=17); both were significantly faster than the U(crit) of no-tail fish (19. 8+/−4.7 cm s(−1) or 6.9 SL s(−1), N=15). When forced to swim in the water tunnel, zebrafish tended to turn and swim downstream for short periods at slow water velocities. Turning frequencies (turns per minute, f(T)) at the slowest velocity (4 cm s(−1)) were 10. 1+/−6.5 min(−)(1) (N=63) and 8.6+/−4.7 min(−1) (N=51) for wild-type and long-finned, respectively, significantly different from that of the no-tail fish, 4.7+/−2.8 min(−1) (N=45). These frequencies decreased below 1 min(−1) at 56%, 64% and 61% of U(crit) in wild-type, long-finned and no-tail fish, respectively. Activity levels of wild-type fish were generally significantly higher than those of long-finned fish, and the levels of both were significantly higher than those of no-tail fish. The pattern of differences in relative activity levels between types was similar to that for U(crit). The results show that the wild-type fish, on a size-scaled basis, is one of the fastest-swimming fishes ever measured, reaching the maximum predicted theoretical sustained swimming speed. U(crit) of long-finned fish was 22% lower than that of wild-type fish, and U(crit) of no-tail fish was 65% lower. Similar differences were found in turning frequencies and routine activity level.
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Tsygankova, O. V., O. V. Timoshchenko, and L. D. Latyntseva. "Possibilities of combined hypolipidemic therapy in different categories of high and very high cardiovascular risk patients (a pilot study)." Ateroscleroz 17, no. 4 (January 13, 2022): 66–73. http://dx.doi.org/10.52727/2078-256x-2021-17-4-66-73.
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Aim of the study was to evaluate the efficacy and safety of the combined use of statins with ezetimibe in patients of various nosological groups of high and very high cardiovascular risk. Material and methods. A prospective interventional non-randomized study included 40 people, mean age 60.7±9.5 years, high and very high cardiovascular risk, who did not receive statin therapy or took statins without reaching the target low density lipoprotein (LDL) cholesterol values. Patients were recommended to receive high-intensity statin therapy in combination with ezetimibe for 3 months. Biochemical parameters were determined by standard enzymatic methods and the beginning of combined lipid-correcting therapy and after 3 months. Results. In patients with high cardiovascular risk, the level of total cholesterol decreased by 39.7 % 3 months after treatment (6.8 ± 2.5 and 4.7 ± 2.5 mmol/L; p = 0.0001), the level of LDL cholesterol by 52.2 % (4.6 ± 2.4 and 2.8 ± 2.2 mmol/L; p = 0.0001), the TG level by 26 % (2.7 ± 1.1 and 2.0 ± 1.0 mmol/L; p = 0.008). In the group of patients with very high cardiovascular risk, we also noted a decrease in the total cholesterol level by 39.1 % (6.4 ± 1.4 and 4.4 ± 1.2 mmol/L; p = 0.0001), the level of LDL cholesterol by 45.5 % (4.4 ± 1.4 and 2.5 ± 0.9 mmol/L; p = 0.0001). We did not find statistically significant changes in the remaining lipid parameters. LDL cholesterol targets were achieved in 64 % of patients with high and 52 % of very high cardiovascular risk. There were no significant changes in activity of alanine and aspartate amino transferases, content creatine phosphokinase, glucose and glycated hemoglobin, glomerular filtration rate. Conclusions. Initial combination therapy with statin and ezetimibe is well tolerated and can reduce LDL cholesterol levels by 2 times within 3 months in various categories of patients with high and very high cardiovascular risk.
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Shahi, M. K., and K. P. Gairhe. "Prevalence of Helminths in Wild Asian Elephant and Indian Rhinoceros in Chitwan and Bardia National Park, Nepal." Nepalese Veterinary Journal 36 (December 1, 2019): 60–74. http://dx.doi.org/10.3126/nvj.v36i0.27755.
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The Nepalese elephant (Elephas maximus maximus) and rhinoceros (Rhinoceros unicornis), are an important part of Nepal’s heritage, culture and wildlife conservation. Despite its importance, not much is known about the helminth parasites that affect elephant and rhinoceros. This study investigates the prevalence of helminth parasites in wild Asian Elephant and wild Indian Rhinoceros.A study was conducted from November 2011 to April 2012 to screen helminth parasites of wild asian elephant and wild Indian Rhinoceros at Chitwan and Bardia National Park of Nepal. Total of 80 samples, 40 each taken from the Wild Asian Elephants and Indian Rhinoceros. The study showed 88.75% overall prevalence of helminthes. The prevalence in Wild Asian Elephant and Indian Rhinoceros was 95% and 82.5% respectively. 97.37% and 72.73% infection were mixed infections in elephant and rhinoceros respectively.Among 38 positive samples of the elephant of CNP and BNP, 9 different types of helminth eggs were found. 15 (39.47%) were positive for Fasciola Spp. With 450 EPG count, 11 (28.95%) for Paramphistomum spp. with 600 EPG, 27 (71.05%) for Schistosoma spp. with 500 EPG, 3 (7.89%) for Dicrocoelium spp. with 900 EPG, 12 (30.16%) for Moniezia spp. with 433.3 EPG, 17 (44.74%) for Oesophagostomum spp. with 1025 EPG, 10 (26.31%) for Chabartia spp. with 1141.65 EPG, 17 (44.74) for Strongyloides spp. with 15558.335 EPG and 23 (60.53%) for Strongylus spp. with 1700 EPG.Similarly out of the 33 positive samples of Rhinoceros of CNP and BNP, 8 different types of helminth eggs were found. 11 (33.33%) were positive for Fasciola Spp. With 558.34 EPG, 10 (30.30%) for Paramphistomum spp. with 525 EPG, 7 (21.21%) for Schistosoma spp. with 475 EPG, 4 (12.12%) for Moniezia spp. with 650 EPG, 6 (18.18%) for Strongyloides spp. with 1466.67 EPG, 4 (12.12%) for Strongylus spp. with 1625 EPG, 9 (27.27%) for Toxocara spp. with 699.98 EPG and 20 (60.61%) for Trychostrongylus spp. with 1149.98 were found to be positive.
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Souley, Mahaman Hamissou Illo, Karim Saley, Issa Chaibou, Boubacar M. Moussa, Ali Mahamane, and Mahamane Saadou. "Diversité Inter Décennale De La Végétation De La Vallée De Goulbi N’Kaba." European Scientific Journal, ESJ 14, no. 9 (March 31, 2018): 161. http://dx.doi.org/10.19044/esj.2018.v14n9p161.
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The present study is conducted in the Sylvo-Pastoral Zone (ZSP) of the Goulbi N'Kaba Valley and the agricultural zone (fields on adjacent terraces), in the southern center of Niger. The objective of the study is to evaluate the inter-decennial plant biodiversity (2004-2014). Thus, the phytosociological surveys (Daget and Poissonet, 1971) were carried out in plots of 2500 m², along the 6.5 km transects following stratified sampling. An ascending hierarchical classification, followed by an ordination by Nonmetric Multi-dimensional Scaling (NMS) allowed to identify the plant groups. The diversity of each group was evaluated. The results show that the families of Poaceae and Fabaceae are the most abundant in 2004 (15.58% and 11.69%) and in 2014 (18.75% and 7.29%). However, compared to the genera, Indigofera (10.53%), Cassia (6.58%), Acacia (5.26%), Aristida (5.26%) are the most abundant in 2004, while Aristida (4 , 17%), Cassia (4.17%), Spermacoce (3.13%), in 2014. Three groups (mixed, fields, ZSP) have been identified. The 2004 and 2014 index, of Margalef (18,38 and 11,28), Menhinick (2,55 and 1,52), Shannon-Weaver (4,77 and 4,14), the fairness of Pielou (0, 66 and 0.63), the Simpson index (0.89 and 0.91) and Hill (0.95 and 0.93) are high in all the groups, mixed, fields and ZSP (respectively for G1, G2 and G3). But the beta diversity (Whittaker (24), Jaccard (0.52), Sorensen (0.69) index) for each of these groupings remains low. There was no significant change in inter-decennial diversity at the Guidan Tawayé and Korin Habdjia sites from 2004 to 2014.
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Moscarelli, Marco, Rafik Margaryan, Alfredo Cerillo, Enkel Kallushi, Pierandrea Farneti, and Marco Solinas. "Minimally Invasive Mitral Valve Surgery in Truly High-Risk Patients: Are We Pushing the Boundaries? An Observational Study." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 10, no. 5 (September 2015): 328–33. http://dx.doi.org/10.1097/imi.0000000000000197.
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Objective This study aimed to assess in a retrospective series of truly high-risk patients who underwent minimally invasive mitral valve surgery: (1) postoperative and long-term results and (2) logistic EuroSCORE and EuroSCORE II discrimination power. Methods Between 2003 and 2013, we reviewed in our institution patients who underwent minimally invasive mitral valve surgery with or without tricuspid valve repair via right minithoracotomy with logistic EuroSCORE of 20 or higher. Results Among a total number of 1604, 88 patients were identified. Median logistic and EuroSCORE II was 27.29 (interquartile range, 15.3) and 12.7% (11.3%), respectively. Mean (SD) age was 71.9 (8.4) years; 42 were female (47.7%); 60 patients (68.1%) underwent previous sternotomy. Mitral valve was replaced in 59 (67%) and repaired in 29 (32.9%) patients; tricuspid valve repair was performed in 23 patients (26.1%). Median cardiopulmonary bypass and cross-clamp times were 157 minutes (interquartile range, 131–187 minutes) and 83 minutes (81–116 minutes), respectively; conversion to sternotomy and reopening for bleeding was necessary in 4 (4.5%) and 3 (3.4%) patients; permanent and transient neurological injuries were reported in 6 (6.8%) and 3 (3.4%) patients; acute kidney injury was reported in 13 patients (14.7%); 15 patients (17%) had pulmonary complications. Ten patients died while in the hospital (11.2%). Survival at 6 years was 78% (95% confidence interval, 69–88). Conclusions In this series of truly high-risk patients, minimally invasive mitral surgery was associated with acceptable early mortality and morbidity as well as long-term outcomes; both logistic and EuroSCORE II showed suboptimal discrimination power.
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Onishi, Tomohiro, Yusuke Nakano, Ken-ichi Hirano, Yasuyuki Nagasawa, Toru Niwa, Atomu Tajima, Hideki Ishii, et al. "Prevalence and clinical outcomes of triglyceride deposit cardiomyovasculopathy among haemodialysis patients." Heart 107, no. 2 (September 30, 2020): 127–34. http://dx.doi.org/10.1136/heartjnl-2020-317672.
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ObjectiveTo evaluate the effect of triglyceride deposit cardiomyovasculopathy (TGCV) on the cardiovascular outcomes in haemodialysis (HD) patients with suspected coronary artery disease (CAD).MethodsThis retrospective single-centre observational study included data from the cardiac catheter database of Narita Memorial Hospital between April 2011 and March 2017. Among 654 consecutive patients on HD, the data for 83 patients with suspected CAD who underwent both [123I]-β-methyl-iodophenyl-pentadecanoic acid scintigraphy and coronary angiography were analysed. Patients were divided into three groups: definite TGCV (17 patients), probable TGCV (22 patients) and non-TGCV control group (44 patients). The primary endpoint was a composite of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke assessed for up to 5 years of follow-up.ResultsThe prevalence of definite TGCV was approximately 20% and 2.6% among consecutive HD patients with suspected CAD and among all HD patients, respectively. At the end of the median follow-up period of 4.7 years, the primary endpoint was achieved in 52.9% of the definite TGCV patients (HR, 7.45; 95% CI: 2.28 to 24.3; p<0.001) and 27.3% of the probable TGCV patients (HR, 3.28; 95% CI: 0.93 to 11.6; p=0.066), compared with that in 9.1% of the non-TGCV control patients. Definite TGCV was significantly and independently associated with cardiovascular mortality and outcomes among HD patients in all multivariate models.ConclusionsTGCV is not uncommon in HD patients and is associated with an increased risk of cardiovascular events including cardiovascular death. Thus, TGCV might be a potential therapeutic target.
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Vihavainen, Elina, Hanna-Saara Lundstr�m, Tuija Susiluoto, Joanna Koort, Lars Paulin, Petri Auvinen, and K. Johanna Bj�rkroth. "Role of Broiler Carcasses and Processing Plant Air in Contamination of Modified-Atmosphere-Packaged Broiler Products with Psychrotrophic Lactic Acid Bacteria." Applied and Environmental Microbiology 73, no. 4 (December 1, 2006): 1136–45. http://dx.doi.org/10.1128/aem.01644-06.
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ABSTRACT Some psychrotrophic lactic acid bacteria (LAB) are specific meat spoilage organisms in modified-atmosphere-packaged (MAP), cold-stored meat products. To determine if incoming broilers or the production plant environment is a source of spoilage LAB, a total of 86, 122, and 447 LAB isolates from broiler carcasses, production plant air, and MAP broiler products, respectively, were characterized using a library of HindIII restriction fragment length polymorphism (RFLP) patterns of the 16 and 23S rRNA genes as operational taxonomic units in numerical analyses. Six hundred thirteen LAB isolates from the total of 655 clustered in 29 groups considered to be species specific. Sixty-four percent of product isolates clustered either with Carnobacterium divergens or with Carnobacterium maltaromaticum type strains. The third major product-associated cluster (17% of isolates) was formed by unknown LAB. Representative strains from these three clusters were analyzed for the phylogeny of their 16S rRNA genes. This analysis verified that the two largest RFLP clusters consisted of carnobacteria and showed that the unknown LAB group consisted of Lactococcus spp. No product-associated LAB were detected in broiler carcasses sampled at the beginning of slaughter, whereas carnobacteria and lactococci, along with some other specific meat spoilage LAB, were recovered from processing plant air at many sites. This study reveals that incoming broiler chickens are not major sources of psychrotrophic spoilage LAB, whereas the detection of these organisms from the air of the processing environment highlights the role of processing facilities as sources of LAB contamination.
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Yui, Jennifer, Mythri Mudireddy, Mrinal M. Patnaik, Naseema Gangat, Aref Al-Kali, Michelle Elliott, William J. Hogan, et al. "Myeloid Sarcoma: The Mayo Clinic Experience of Ninety Six Case Series." Blood 128, no. 22 (December 2, 2016): 2798. http://dx.doi.org/10.1182/blood.v128.22.2798.2798.
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Abstract Background: Myeloid sarcoma is a tumor mass consisting of myeloid blasts occurring at anatomical site other than the bone marrow (Arber et al. Blood 2016;127(20):2391-2405). It is a subgroup of acute myeloid leukemia, which can be localized or disseminated and may involve multiple organs. It can present with or without a positive bone marrow. It may precede or follow bone marrow involvement. It may be identified at diagnosis or relapse, and is not uncommon after stem cell transplantation (Koc et al. Cancer 1999;85(3):608-615; Yoshihara et al. Biol. Blood Marrow Transplant 2012;18(12):1800-1807). Objective: To describe the clinical characteristics, cytogenetics, prognosis and outcome of patients with myeloid sarcoma with or without bone marrow involvement. Methods: The Mayo Clinic database was interrogated using the ICD-9 codes 205.0, 205.2, 205.3, as well as terms "myeloid sarcoma," "chloroma," and "extramedullary sarcoma" in clinical notes and pathology reports. Patients' follow up information was collected until July 2016. Results: Ninety six patients with a diagnosis myeloid sarcoma were identified. The diagnosis was based on biopsy results and in some cases imaging studies in addition to bone marrow biopsy. The median age was 53 (range 17-83) years, and 64 (67%) patients were males. Myeloid sarcoma with de novo (primary) and secondary acute myeloid leukemia (with antecedent hematologic malignancy and therapy related) accounted for 64% (61) and 36% of the cases respectively. The sites involved based on their frequency of occurrence included integumentary system (skin and soft tissues) in 37 (38%), lymphatic system in 17 (18%), the gastrointestinal and genitourinary system in 14 (15%), the nervous system in 9 (9%), the breast in 3 (3%) and multiple and other single sites in 16 (17 %). Bone marrow cytogenetics findings were documented in 74 (77%) patients; favorable, intermediate, and poor cytogenetic abnormalities account for 7 (9%), 45 (61%), and 22 (30%) cases respectively. After a median follow up of 135 weeks, 57 (59%) patients died. The median survival of primary and secondary acute myeloid leukemia with myeloid sarcoma was 52 and 11.5 months (P<0.0001); and that of favorable, intermediate and unfavorable cytogenetics abnormalities was 169, 52 and 17.5 months (P=0.04) respectively. Twenty six (27%) patients had no bone marrow involvement; and 18 (69%) of them were primary myeloid sarcoma (without antecedent malignancy or therapy). The median (range) age of those with and without bone marrow involvement was 53 (17-83) and 56 (17-81) years (P=0.6). At diagnosis patients with and without bone marrow involvement have a median (range) hemoglobin (gm/dL) (10.3 (6.2-15.4) vs 13.1 (9.9-15.2) P=0.0002), white blood cell count (X109/L) (21.4 (1.1-182.5) vs 5.8 (2.4-23.2) P<0.0001), and platelet count (X109/L) (71 (8-437) vs 250 (17-561) respectively. Aggressive chemotherapy therapy was given to 58 (83%) and 20 (77%) of patients with and without bone marrow involvement (P=0.6). The median survival was 17 and 20 months with and without bone marrow involvement (P=0.4). Of those with bone marrow involvement, 49 (70%) achieved complete remission, and 26 (53%) of those individuals subsequently relapsed. Conclusion: The treatment outcome of patients with myeloid sarcoma with or without bone marrow involvement seems the same. The conventional risk factors, antecedent hematological neoplasms and cytogenetic findings, have significant impact on survival. Disclosures Al-Kali: Celgene: Research Funding; Onconova Therapeutics, Inc.: Research Funding.
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Strati, Paolo, Kari Chaffee, Sara Achenbach, Susan M. Schwager, Timothy G. Call, Neil E. Kay, James Cerhan, Susan L. Slager, and Tait D. Shanafelt. "Disease Progression and Complications Are the Main Cause of Death in Patients with Chronic Lymphocytic Leukemia (CLL) Independent of Age and Comorbidities at Diagnosis." Blood 126, no. 23 (December 3, 2015): 5265. http://dx.doi.org/10.1182/blood.v126.23.5265.5265.
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Abstract Introduction. CLL primarily affects elderly individuals who frequently have comorbid health conditions. It is typically assumed non-CLL-related etiologies will be the ultimate cause of death for most CLL patients, particularly those with comorbid conditions at diagnosis. Methods. Between 9/2002 and 11/2014, 1174 patients with newly diagnosed CLL were enrolled in a prospective cohort study evaluating the natural history of CLL. Comorbidities were prospectively recorded at the time of diagnosis. Comorbidities arising during the course of disease were not considered for this analysis. Standardized longitudinal follow-up was performed in all patients every 6 months for the first 3 years after diagnosis and annually thereafter through 04/2015. Internal and external medical records, death certificates, and information from next of kin were centrally reviewed to determine cause of death, using a standardized protocol. Categorical and continuous variables were evaluated using the c2 or Fisher exact tests and the Mann-Whitney test, as appropriate. Results. Baseline characteristics at time of CLL diagnosis are shown in the Table. Over 80% of patients had 2 or more comorbidities at diagnosis (median 3, range 0-11). After a median follow up of 5 years, 224 (19%) patients have died. The cause of death could be accurately determined in 183 (82%) of these patients. The cause of death was due to CLL in 135 (74%), including 84 (46%) CLL progressions, 14 (8%) infections, and 37 (20%) other cancers. Death was due to non-CLL-related causes (such as congestive heart failure, stroke or chronic obstructive pulmonary disease) in the remaining 48 (26%) patients. On univariable analysis, age and number of comorbid health conditions were not related to whether or not the cause of death was related/unrelated to CLL. The only specific co-morbid condition at diagnosis that predicted for non-CLL related death was stroke (8% vs 1%, p=0.04). Unmutated IGHV was the only prognostic factor thatpredicted greater likelihood of CLL-related death (70% vs 50%, p=0.03). Conclusions. The majority of patients with CLL have multiple comorbidities at time of diagnosis. Despite this fact, CLL progression and/or CLL-related complications are the primary cause of death. The number and type of comorbidities at diagnosis have minimal relationship to whether or not the ultimate cause of death was CLL-related. In contrast, the CLL-specific characteristic IGHV status (but interestingly not FISH defects) correlates with cause of death. Collectively, these findings illustrate the need for more effective CLL therapy, particularly treatments that can be tolerated by patients with comorbid health conditions. It is hoped the signaling inhibitors may help address this unmet need. Table. Number (%), median [range] N=1174 Age (years) 63 [23-89] Males Females 791 (67) 383 (33) Creatinine-Clearance > (mL/min) 86 [10-252] B2M (mg/dL) 2.3 [1.1-13.2] Rai stage 0 I-II III-IV 604 (52) 512 (38) 54 (10) CD49d positive negative 277 (30) 638 (70) CD38 positive negative 332 (30) 780 (70) ZAP70 positive negative 380 (37) 650 (63) IGHV unmutated mutated 394 (44) 506 (56) FISH del13q negative +12 del11q del17p 395 (40) 175 (18) 276 (28) 90 (9) 50 (5) Comorbid health conditions Other cancers 237 (20) Stroke 38 (3) Cardiac disease 326 (28) Hypertension 472 (40) Respiratory 210 (18) Endocrinologic 165 (14) Diabetes 118 (10) Hyperlipidemia 485 (41) Rheumatologic 489 (42) Gastrointestinal 384 (33) Genitourinary 412 (35) Psychiatric 197 (17) DVT/PE 33 (3) Substance abuse 58 (5) Sexually transmitted disease 35 (3) Obesity 376 (32) # of Comorbidities 0 1 2 3 4 > 4 66 (6) 148 (13) 203 (17) 220 (19) 206 (17) 331 (28) Disclosures Kay: Hospira: Research Funding; Genentech: Research Funding; Celgene Corporation: Membership on an entity's Board of Directors or advisory committees, Research Funding; Gilead: Membership on an entity's Board of Directors or advisory committees, Research Funding; Pharmacyclics: Research Funding; Tolero Pharma: Research Funding. Cerhan:Kite Pharma: Research Funding.
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Barbulescu, A., J. Askling, K. Chatzidionysiou, H. Forsblad-D’elia, A. Kastbom, U. Lindström, C. Turesson, and T. Frisell. "OP0122 COMPARATIVE EFFECTIVENESS OF JAKI VERSUS BDMARDS; A NATIONWIDE STUDY IN RA." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 68.2–68. http://dx.doi.org/10.1136/annrheumdis-2021-eular.774.
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Background:The Janus kinase inhibitors (JAKi) have been increasingly used for the treatment of rheumatoid arthritis (RA) in Sweden, with baricitinib representing ~80% of prescriptions. Evidence regarding the comparative effectiveness of JAKis versus biologics (bDMARDs), and in particular non- tumour-necrosis-factor inhibitor (TNFi) bDMARDs, in real-life is limited.Objectives:To compare RA patients treated with bDMARDs and JAKi in Sweden, in terms of: (1) patient characteristics at treatment start; (2) proportions of patients remaining on therapy, and response rates, at 12 months.Methods:RA patients starting treatment in 2017 and 2018 with either a TNFi, rituximab, abatacept, interleukin 6 inhibitors (IL6i) or a JAKi as different lines of treatment were identified in the Swedish Rheumatology Quality Register. One patient could contribute with more than one treatment episode.Treatment response at 12 months was measured as EULAR good response, HAQ improvement >0.2 units, DAS28 and CDAI remission, and as 0 tender and swollen joint counts (28JC). Patients were classified as non-responders if they stopped treatment before evaluation due to safety or inefficacy. Responses for patients who stopped treatment due to pregnancy or death and patients on treatment but with missing response were imputed using multiple imputation.Proportions of responders and differences in proportions between treatment groups, adjusted using inverse probability of treatment weighting, were estimated using linear regression with robust standard errors.Results:JAKi were often used after bDMARDs, and less frequently prescribed in combination with methotrexate. Measured comorbidities were less frequent among JAKi initiators than among non-TNFi biologic initiators, but RA activity was similar (Table).Table 1.Patient characteristics at treatment initiationCharacteristicMedian (IQR) or N (%)AbataceptIL6iRituximabTNFiJAKiTreatment Starts6945346923497905Age63 (53-71)59 (48-70)65 (54-73)59 (47-68)60 (51-70)Female543 (78)441 (83)519 (75)2739 (78)759 (84)RA duration (years)13 (5-21)10 (5-18)12 (6-22)9 (3-17)13 (7-22)Rheum. factor535 (79)385 (73)588 (87)2405 (70)686 (77)DAS284.8 (3.9-5.6)4.9 (4.0-5.7)4.7 (3.8-5.5)4.4 (3.4-5.3)4.7 (3.9-5.7)HAQ1.3 (0.8-1.6)1.3 (0.8-1.8)1.3 (0.8-1.8)1.0 (0.5-1.4)1.3 (0.8-1.8)Tender joints5 (2-9)6 (3-10)5 (2-9)4 (2-8)6 (2-10)Swollen joints4 (2-6)4 (2-7)4 (2-7)3 (1-6)4 (2-7)ts/bDMARD line3 (2-4)3 (2-4)2 (1-4)1 (1-2)4 (2-6)At least one prev. TNFi539 (78)442 (83)457 (66)1448 (41)770 (85)At least one prev. non-TNFi271 (39)220 (41)243 (35)441 (13)584 (65)Methotrexate co-treatment264 (50)172 (40)286 (53)1708 (62)296 (40)Glucocorticoids co-treatment247 (47)186 (43)275 (51)1126 (41)389 (53)Cancer*90 (2.8)64 (2.3)363 (7.7)410 (1.8)20 (2.2)Cardio-vascular dis.*245 (7.5)123 (4.4)322 (6.8)749 (3.4)41 (4.4)Chronic respiratory dis.*303 (9.3)140 (5.0)473 (10.0)721 (3.2)50 (5.4)Diabetes*324 (9.9)216 (7.7)456 (9.7)1479 (6.7)69 (7.5)* any diagnosis within 5 years before start Adjusted differences in proportion with each response outcomeIn a crude comparison, 65% (61%-68%) of JAKi, 62% (59%-66%) of abatacept, 58% (53%-62%) of IL6i, 80% (77%-83%) of rituximab and 68% (67%-70%) of TNFi initiators remained on treatment at 12 months after start. Also, JAKi showed lower overall responder proportions than TNFi, rituximab and IL6i.After adjustment for demographic and socio-economic factors, RA disease activity, previous use of ts/bDMARDs, co-medication with glucocorticoids and methotrexate and comorbidities at baseline, no significant differences in responder proportions between JAKi and bDMARDs remained (Figure). Furthermore, the adjusted proportions of patients on treatment were higher for JAKi and rituximab than for the other bDMARDs.Conclusion:This preliminary analysis of patients treated in clinical practice found no statistically significant difference in effectiveness between JAKi and bDMARDs.Disclosure of Interests:Andrei Barbulescu: None declared, Johan Askling Grant/research support from: Abbvie, Astra-Zeneca, BMS, Eli Lilly, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi, and UCB. These entities have entered into agreements with Karolinska Institutet with JA as principal investigator, mainly in the context of safety monitoring of biologics via the ARTIS national safety monitoring system, Katerina Chatzidionysiou Speakers bureau: Eli Lilly, Abbvie and Pfizer, Consultant of: Eli Lilly, Abbvie and Pfizer, Helena Forsblad-d’Elia: None declared, Alf Kastbom Employee of: Sanofi, Ulf Lindström: None declared, Carl Turesson Speakers bureau: Abbvie, Bristol-Myers Squibb, Medac, Pfizer, Roche, Consultant of: Roche, Grant/research support from: Bristol-Myers Squibb, Thomas Frisell: None declared
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Cunningham, Morven, Marco Iafolla, Yada Kanjanapan, Orlando Cerocchi, Marcus Butler, Lillian L. Siu, Philippe L. Bedard, et al. "Evaluation of liver enzyme elevations and hepatotoxicity in patients treated with checkpoint inhibitor immunotherapy." PLOS ONE 16, no. 6 (June 11, 2021): e0253070. http://dx.doi.org/10.1371/journal.pone.0253070.
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Background and aims Immune checkpoint inhibitors (ICI) are increasingly used in cancer therapy. Elevated liver enzymes frequently occur in patients treated with ICI but evaluation is poorly described. We sought to better understand causes of liver enzyme elevation, investigation and management. Methods Patients treated with anti-PD-1, PDL-1 or CTLA-4 therapy in Phase I/II clinical trials between August 2012 and December 2018 were included. Clinical records of patients with significant liver enzyme elevations were retrospectively reviewed. Results Of 470 ICI-treated patients, liver enzyme elevation occurred in 102 (21.6%), attributed to disease progression (56; 54.9%), other drugs/toxins (7; 6.9%), other causes (22; 21.6%) and ICI immunotoxicity (17; 16.7%; 3.6% of total cohort). Immunotoxicity was associated with higher peak ALT than other causes of enzyme elevation (N = 17; M = 217, 95% CI 145–324 for immunotoxicity, N = 103; M = 74, 95% CI 59–92 for other causes; ratio of means 0.34, 95% CI 0.19–0.60, p = <0.001) and higher ALT:AST ratio (M = 1.27, 95% CI 0.78–2.06 for immunotoxicity, M = 0.69, 95% CI 0.59–0.80 for other causes, ratio of means 0.54, 95% CI 0.36–0.82, p = 0.004). Immunotoxicity was more often seen in patients with prior CPI exposure (41.2% of immunotoxicity vs 15.9% of patients without, p = 0.01), anti-CTLA-4 –containing ICI treatments (29.4% of immunotoxicity vs 6.8% of patients without, p = <0.001) and other organ immunotoxicity (76.5% of immunotoxicity vs 19.2% of patients without, p = <0.001). Cause for enzyme elevation was established in most patients after non-invasive investigation. Liver biopsy was reserved for four patients with atypical treatment response. Conclusions Liver enzyme elevation is common in patients receiving ICI, but often has a cause other than immunotoxicity. A biochemical signature with higher ALT and ALT/AST ratio, a history of prior ICI exposure and other organ immunotoxicities may help to identify patients at a higher likelihood of immunotoxicity. Liver biopsy can be safely deferred in most patients. We propose an approach to diagnostic evaluation in patients with liver enzyme elevations following ICI exposure.
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Corash, Laurence, Fabrice Cognasse, Jean-Claude Osselaer, Natalie Messe, and Olivier Garraud. "Release of Immune Modulation Factors from Platelet Concentrates during Storage after Photochemical Pathogen Inactivation." Blood 108, no. 11 (November 16, 2006): 941. http://dx.doi.org/10.1182/blood.v108.11.941.941.
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Abstract Background. Platelets (plt) prepared for transfusion contain multiple molecules that modulate immune function, mediate acute transfusion reactions, induce immune responses, and affect hemostasis. These cytokines/chemokines are secreted differentially from plt during storage (Transfusion2006;46:1184), and may be affected by processing, including pathogen inactivation. Aims. The INTERCEPT Blood System (IBS) for platelets utilizes amotosalen-HCl (S-59) with ultraviolet A (UVA) light to inactivate a broad spectrum of pathogens and leukocytes. This study was designed to evaluate the effects of photochemical treatment on in vitro release of immune modulation molecules after processing during 7 days (d) of storage. Methods. Platelet concentrates (n = 10) collected by aphaeresis (CPA) with process leuko-reduction (< 106) containing 8.15x1011 ± 0.8 platelets were suspended in 35% donor plasma and 65% platelet additive solution (Intersol, Baxter, France) and divided into two equal components. One served as an untreated control (C) and the other was prepared with 150 uM amotosalen and a 3 J/cm2 UVA photochemical treatment (PCT) and stored at 22°C with shaking for 7 days. Platelet concentration (106/uL), pH and levels of immune modulation factors were measured: CD62p(ng/mL), PDGF-AB(ng/mL), IL8(pg/mL), sCD40L(pg/mL), IL1β(pg/mL) and TNFα(pg/mL). The concentration of each factor was determined by specific enzyme linked immunosorbent assays in plt and supernatant (s) fractions isolated from stored PCT and C plt components. Mean values ± SD were calculated and compared by paired t-test. Results. Platelet content, pH and cytokine/chemokine content and release from CPA prepared with photochemical treatment were not statistically different (p > 0.05) from C during 7 d of storage (Table). From d1 to d7, the pH of PCT and C units decreased similarly, but remained within acceptable ranges. No detectable IL1β and TNFα were observed in PCT or C CPA. During platelet storage CD62p, PDGF-AB, IL8, and sCD40L increased similarly in supernatants of PCT and C units. The increase in supernatant levels correlated with a decrease of these cytokines in plt. Platelets in PCT and C retained measurable levels of CD62, IL8, sCD40L and PDGF-AB though 7 d. Levels of sCD40L demonstrated marked variation. Conclusions. Cytokines increased moderately in the supernatants of CPA and decreased in platelets during storage. After 7 d C and PCT platelets in CPA retained detectable levels of cytokines. PCT had no differential influence on release of immune modulation molecules in vitro over 7 d of storage. Day O O 5 5 7 7 Product C PCT C PCT C PCT pH 7.1 ±.1 7.1 ±.1 6.9 ±.1 6.8 ±.1 6.9 ±.1 6.8 ±.1 Plt ct 1.29 ±.3 1.30 ±.2 1.30 ±.3 1.19 ±.2 1.27 ±.2 1.18 ±.2 CD62p-s 89 ± 21 87 ± 17 110 ± 23 115 ± 27 117 ± 22 119 ± 25 CD62p-plt 149 ± 33 151 ± 33 141 ± 23 141 ± 25 139 ± 25 139 ± 26 PDGF-s 14.5 ± 3.5 13.6 ± 3.5 17.7 ± 2.4 15.8 ± 1.5 18.0 ± 2.1 17.5 ± 1.8 PDGF-plt 28.3 ± 3.5 30.3 ± 3.1 25.2 ± 3.6 24.9 ± 2.5 23.2 ± 4.0 23.3 ± 3.3 IL8-s 107 ± 17 108 ± 14 136 ± 42 116 ± 9 123 ± 20 120 ± 22 IL8-plt 135 ± 29 134 ± 28 110 ± 11 117 ± 12 103 ± 17 119 ± 32 CD40L-s 51 ± 86 66 ± 94 172 ± 157 237 ± 214 188 ± 198 201 ± 167 CD40L-plt 990 ± 805 1098 ± 747 485 ± 373 474 ± 331 346 ± 293 314 ± 282
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Samatha, Yalamanchili, Avula Jogendra Sai Sankar, KS Ganapathy, Kandula Srinivas, Dasari Ankineedu, and Alluri Leela Subhashini Choudary. "Clinicopathologic Evaluation of Lesions associated with Tobacco Usage." Journal of Contemporary Dental Practice 15, no. 4 (2014): 466–72. http://dx.doi.org/10.5005/jp-journals-10024-1564.
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ABSTRACT Introduction Tobacco usage in different forms is the single most common etiological factor responsible for oral cancers. The aim of the present study was to record various mucosal lesions associated with tobacco usage and to ascertain the prevalence of dysplasia in them by histopathological evaluation and to compare the extent of dysplastic features seen among patients associated with a habit of smoked and smokeless form of tobacco. Materials and methods Seventy-six patients with the clinical diagnosis of tobacco related lesions (Leukoplakia, Erythroplakia, Nicotina stomatitis, Tobacco pouch keratosis) were selected. A detailed description of the clinical presentation of the lesion was noted and the patients were subjected to incisional biopsy followed by a histopathological evaluation. Results Showed dysplastic changes in 50 cases (65.8%) ranging from mild dysplasia in 27 cases (35.5%), moderate dysplasia in 17 cases (22.4%) and 6 cases (7.9%) showed severe dysplasia. Moderate to severe dysplasia was 1.83 times more likely to occur with smokeless tobacco usage when compared to smoked form. Data obtained from this study reveals that patients with a duration of tobacco usage more than 10 years were 2.17 times more likely to have moderate to severe dysplasia (p = 0.154). Conclusion Thus, the study highlights the role of oral physicians in detecting oral mucosal lesions and screening high-risk patients on a regular basis and also reaffirms the importance of public education, stressing the risk factors for oral cancers. How to cite this article Samatha Y, Sankar AJS, Ganapathy KS, Srinivas K, Ankineedu D, Choudary ALS. Clinicopathologic Evaluation of Lesions associated with Tobacco Usage. J Contemp Dent Pract 2014;15(4):466-472.
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Twist, Craig, Jamie Highton, Matthew Daniels, Nathan Mill, and Graeme Close. "Player Responses to Match and Training Demands During an Intensified Fixture Schedule in Professional Rugby League: A Case Study." International Journal of Sports Physiology and Performance 12, no. 8 (September 2017): 1093–99. http://dx.doi.org/10.1123/ijspp.2016-0390.
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Player loads and fatigue responses are reported in 15 professional rugby league players (24.3 ± 3.8 y) during a period of intensified fixtures. Repeated measures of internal and external loads, perceived well-being, and jump flight time were recorded across 22 d, comprising 9 training sessions and matches on days 5, 12, 15, and 21 (player exposure: 3.6 ± 0.6 matches). Mean training loads (session rating of perceived exertion × duration) between matches were 1177, 1083, 103, and 650 AU. Relative distance in match 1 (82 m/min) and match 4 (79 m/min) was very likely lower in match 2 (76 m/min) and likely higher in match 3 (86 m/min). High-intensity running (≥5.5 m/s) was likely to very likely lower than match 1 (5 m/min) in matches 2–4 (2, 4, and 3 m/min, respectively). Low-intensity activity was likely to very likely lower than match 1 (78 m/min) in match 2 (74 m/min) and match 4 (73 m/min) but likely higher in match 3 (81 m/min). Accumulated accelerometer loads for matches 1–4 were 384, 473, 373, and 391 AU, respectively. Perceived well-being returned to baseline values (~21 AU) before all matches but was very likely to most likely lower the day after each match (~17 AU). Prematch jump flight times were likely to most likely lower across the period, with mean values of 0.66, 0.65, 0.62, and 0.64 s before matches 1–4, respectively. Across a 22-d cycle with fixture congestion, professional rugby league players experience cumulative neuromuscular fatigue and impaired match running performance.
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Picard, Fabien, Francois Depret, Sergio Zanotti-Cavazzoni, and Steven Hollenberg. "Effect of anesthesia level on murine cardiac function." F1000Research 3 (July 22, 2014): 165. http://dx.doi.org/10.12688/f1000research.3873.1.
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Background: Echocardiography allows for sensitive and non-invasive assessment of cardiac function in mice, but requires sedation and immobility, which influences cardiac performance. Minimizing the hemodynamic effects of anesthesia is extremely important for improving the applicability of animal models to the clinical setting. We sought to evaluate the effects of isoflurane dose on myocardial function in a murine model.Methods: Twelve healthy C57BL/6 mice were studied with three different isoflurane anesthesia regimens: deep anesthesia with an objective of heart rate (HR) between 350 and 400 beats per minute (bpm), light anesthesia with an objective of HR between 475 and 525 bpm and just before the mice woke up (>575 bpm). Using a high-resolution ultrasound system, stroke volume, cardiac output, left ventricle dimension and fractional shortening were recorded.Results: Fractional shortening was not statistically different in the awake group and the light anesthesia group (49±5% in awake mice vs. 48±5%; p=0.62), whereas it was different compared to the deep anesthesia group (31±5%, p<0.0001 compared to both groups). Similar results were found for stroke volume (41.4±5.8 ml vs. 41.6±6.9 ml; p=0.81 and 35±8.3 ml; p<0.05 compared to both groups). Cardiac output was slightly lower in the light anesthesia group compared to the awake group (21.9±3.6 ml/min vs. 25.6±3.3; p=0.02) due to HR significant difference (522±17 bpm vs. 608±23 bpm; p<0.0001).Conclusions: Doppler echocardiography can be performed under very light anesthesia using small doses of isoflurane without influencing cardiac inotropic function. This technique allows for accurate and reproducible assessment of cardiac function while minimizing hemodynamic perturbations.