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Lal, Punita, Vipul Nautiyal, Tamojit Chaudhuri, Mranalini Verma, Koilpillai Joseph Maria Das, and Shaleen Kumar. "Is aspiration as detected on pretreatment video fluorography, a harbinger of poor quality of life and early mortality in cancers of the upper aerodigestive tract treated with radiotherapy?" South Asian Journal of Cancer 03, no. 04 (October 2014): 209–12. http://dx.doi.org/10.4103/2278-330x.142968.
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Abstract Background: Patients with cancers of the upper aerodigestive tract (head and neck cancer (HNC)) tend to aspirate, either due to disease or treatment. The association of aspiration (documented on video fluorography (VFG)) with quality of life (QOL) and unexpected mortality was studied prospectively in patients treated with simultaneous integrated boost technique of intensity-modulated radiotherapy (SIB-IMRT). Materials and Methods: Moderately advanced (stage III/IV) HNC were treated by SIB-IMRT delivering 66 Gy/30 fr, 60 Gy/30 fr, and 54 Gy/30 fr to high, intermediate, and low risk volumes, respectively. They underwent serial VFG and QOL assessments (Quality of Life Questionnaire-Core 30 ( QLQ-C30) and head and neck-35 (HN35) European Organisation for Research and Treatment of Cancer (EORTC) tools) at 0, 3, and 6 months. Pharyngeal musculature (PM) was additionally delineated on planning computed tomography (CT) scans as potential organs at risk (OARs). Results: Between November 2009 and May 2011, 20 HNC were treated as per protocol. All patients were fit (Karnofsky performance status (KPS) ≥ 80). Based on VFG findings, seven patients (4/9 oropharynx and 3/11 laryngopharynx) were grouped as aspirators (A) and remaining 13 as non-aspirators (NA). The QOL study showed that pretreatment coughing and swallowing difficulties were greater in group A versus NA and remained persistently higher. In group A, deaths attributable to aspiration were seen in 3/7 patients, while none occurred in the NA group (Fisher′s exact P = 0.03). The mean PM dose was 60 Gy in both the groups and mean V60 was similar at 69 and 67% in A and NA groups, respectively. Conclusions: VFG helps identify patients who aspirate and are at risk of premature death due to its complications, alerting caregivers to direct attention appropriately.
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Chandrakash, Saravanan, and Kenneth R. Davey. "Advancing the Fr 13 risk framework to an integrated three-step microbiological failure synthesis of pasteurization of raw milk containing Mycobacterium avium subsp. Paratuberculosis (MAP)." Chemical Engineering Science 171 (November 2017): 1–18. http://dx.doi.org/10.1016/j.ces.2017.05.020.
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Pérez de la Puente, Constanza, Federico Losco, Carolina Chacon, Juan Pablo Sade, Gonzalo H. Giornelli, Matias Chacon, and Reinaldo D. Chacon. "Intermediate-risk prostate cancer treated with external beam radiotherapy (EBRT): A risk group with heterogeneous behavior." Journal of Clinical Oncology 34, no. 2_suppl (January 10, 2016): 145. http://dx.doi.org/10.1200/jco.2016.34.2_suppl.145.
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145 Background: In men with intermediate-risk prostate cancer (IR-PC) treated with low dose EBRT, the addition of androgen deprivation therapy (ADT) prolongs overall survival. Zumsteg proposes a subdivision for de IR-PC group: favorable or unfavorable. Purpose: retrospective evaluation of EBRT efficacy according to IR-PC subgroups (favorable or unfavorable). Methods: From the institutional radiotherapy department database, from 2000 to 2011, 95 men with IR-PC were identified and subdivided as follows: Favorable Risk (FR) – Gleason 3+4 or less and positive prostate biopsies (ppb) not exceeding 50% and only one intermediate-risk factor excluding 4+3; Unfavorable risk (UR) – Gleason 4+3 or at least 2 intermediate-risk factors or at least one intermediate risk factor and ppb >50%. Results: 95 patients were included in the analysis, mean FUP 6.2 years. 32.6% (31) had >50% ppb, 14.7% (14) had Gleason 4+3, 38.9% (37) had 2 intermediate-risk factors. 42.1% (40) were FR and 57.9% (55) were UR. Median EBRT dose: 79.8Gy. Only 25% of FR patients received some hormonal therapy treatment. There were no differences in time to Prostatic Specific Androgen (PSA) nadir (FR 12 vs UR 13 months; p= .50), biochemical relapse free survival (RFS) (FR 60 vs US 58 months; p= .80), or doubling time PSA (FR 12 vs UR 11 months; p= .19). Biochemical relapse (BR) and local relapse (LR) rates were lower for FR (BR: FR 27.5 vs UR 38.2%, p= .17; LR: FR 5 vs UR 14.5%, p= .40). Local RFS (FR 13.6 vs UR 9.6 years; p= .11) and distant RFS (FR 13.1 vs UR 12.4 years; p= .65) were longer for FR patients. Conclusions: Short course ADT is the standard treatment in IR-PC patients when EBRT is indicated, especially if they have UR features. In our study IR-PC group had heterogeneous outcomes and, in spite the study limitations, FR patients had a trend for better prognosis even with a very low use of ADT. If Favorable IR-PC patients may avoid ADT morbidity should be answered by a randomized trial.
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Maksimov, D. A., and V. S. Markina. "FEATURES OF ASSESSMENT AND ACCOUNTING MARKET ACTIVITIES RISK OF ENTERPRISES OF A VERTICALLY INTEGRATED HOLDING." Фундаментальные исследования (Fundamental research), no. 4 2019 (2019): 71–77. http://dx.doi.org/10.17513/fr.42441.
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Cante, Domenico, Cristina Piva, Edoardo T. F. Petrucci, Piera Sciacero, Silvia Ferrario, Massimo Pasquino, Valeria Casanova Borca, Maria R. La Porta, and Pierfrancesco Franco. "Moderately Hypofractionated Radiotherapy with Simultaneous Integrated Boost in Prostate Cancer: A Comparative Study with Conventionally Fractionated Radiation." Journal of Oncology 2020 (November 28, 2020): 1–6. http://dx.doi.org/10.1155/2020/3170396.
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Background. To report 5-year clinical outcomes and toxicity in organ-confined prostate cancer (PCa) for low- and intermediate-risk patients treated with a moderately hypofractionated schedule of radiotherapy (RT) delivered with simultaneous integrated boost (SIB) compared to a conventionally fractionated RT regimen. Methods. Data of 384 patients with PCa treated between August 2006 and June 2017 were retrospectively reviewed. The treatment schedule consisted of hypofractionated RT (HYPO FR) with SIB up to 70 Gy to the prostate gland and 63 Gy to seminal vesicles delivered in 28 fractions or in conventionally fractionated RT (CONV FR) up to a total dose of 80 Gy in 40 fractions. Patient allocation to treatment was based on the time period considered. For intermediate-risk patients, androgen deprivation was given for a median duration of 6 months. The 5-year biochemical relapse-free survival (bRFS), cancer-specific survival (CSS), and overall survival (OS) were assessed. Furthermore, we evaluated gastrointestinal (GI) and genitourinary (GU) toxicities. Uni- and multivariate Cox regression analyses were used to test the impact of clinical variables on both outcome and toxicity. Results. A total of 198 patients was treated with hypofractionated RT and 186 with the conventional schedule. At a median follow-up of 5 years, no significant differences were observed in terms of GI toxicity and outcome between the two groups. Early GU toxicity was significantly increased in HYPO FR, while late GU toxicity was significantly higher in CONV FR. In HYPO FR, a biochemical relapse occurred in 12 patients (6.1%), and 9 patients (4.5%) reported a clinical relapse (4 local, 2 locoregional, and 3 systemic recurrence). In CONV FR, 15 patients (8.1%) experienced a biochemical relapse and 11 patients (5.9%) showed a clinical relapse (5 local, 4 locoregional, and 3 systemic recurrences). Early grades 1-2 GU and GI toxicities were observed in 60 (30.3%) and 37 (18.7%) patients, respectively, in the hypofractionated group and in 33 (17.7%) and 27 (14.5%) patients, respectively, in the conventionally fractionated RT group. Late GU and GI toxicities occurred in 1 (0.51%) and 8 (4.1%) patients, respectively, in HYPO FR. In CONV FR, 5 (2.7%) and 6 (3.2%) patients experienced late GU and GI toxicities, respectively. The 5-year OS, bRFS, and CSS were 98.9%, 94.1%, and 99.5%, respectively, in HYPO FR, and 94.5%, 92.1%, and 99.0%, respectively, in CONV FR. Conclusions. Results obtained in this study showed that moderately hypofractionated RT employing SIB can be an effective approach providing valuable clinical outcomes with an acceptable toxicity profile.
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Alonzo, Todd A., Phoenix A. Ho, Robert B. Gerbing, Alan S. Gamis, Susana C. Raimondi, Betsy A. Hirsch, Todd Cooper, et al. "Conventional Cytogenetics, Molecular Profiling, and Flow Cytometric Response Data Allow the Creation of a Two-Tiered Risk-Group System for Risk-Based Therapy Allocation In Childhood AML- a Report From the Children's Oncology Group." Blood 116, no. 21 (November 19, 2010): 761. http://dx.doi.org/10.1182/blood.v116.21.761.761.
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Abstract Abstract 761 Conventional cytogenetics and morphologic response to induction chemotherapy have historically provided the tools for predicting outcome in patients with acute myeloid leukemia (AML). Several mutations are predictive of clinical outcome and have provided additional tools to help predict outcome in patients with AML without other risk features. Despite these recent advances, our ability to identify specific risk groups has been limited to a subset of patients, and nearly half of the patients with AML are regarded as having standard-risk (SR) disease. We inquired whether adding response by multidimensional flow cytometry (MDF) to data from conventional cytogenetics analysis and presence/absence of genomic alterations of FLT3 (FLT3-ITD), CEBPA, and NPM would provide a more robust risk-stratification system for risk-based therapy allocation. COG AML protocol AAML03P1 collected comprehensive cytogenetics characteristics, mutation profile (FLT3/ITD, CEBPA, and NPM mutation status), and MDF data on most of the 340 eligible patients enrolled on the study. Molecular and cytogenetic data were available for 275 of the 293 (94%) patients with responsive disease at the end of induction I. Disease-free survival (DFS) from the end of induction I was determined based on a combined molecular and cytogenetic risk profile. Risk status was defined based on the presence of t(8;21), inv(16), NPMc, and CEBPA mutations (favorable risk, FR) or the presence of monosomy 7, monosomy 5/del5q, and high allelic ratio FLT3-ITD (high risk, HR). On the basis of this allocation, 88 (32%) patients had FR AML, and 26 (10%) had HR AML. The remaining 161 (59%) patients without specific risk features were considered to have SR AML. DFS at 2 years from the end of induction I was 70%±12% for the FR cohort, 55% ±9% for the SR cohort, and 17%±20% for the HR cohort (p<0.001). The prevalence and prognostic significance of minimal residual disease (MRD) were assessed in the 103 patients with SR disease; 31 (30%) had evidence of MRD by MDF. DFS at 3 years from the end of induction I was significantly worse for those with MRD than for those without it (26%±21% vs. 67%±13%, p=0.01). Corresponding relapse risk in patients with or without MRD was 69%±21% and 30%±13%, respectively (p=0.011). We assessed the clinical impact of MRD in patients with HR or FR disease. Of the 18 patients with HR AML who had MRD data, 8 (44%) had MRD. DFS at 2 years for patients with HR disease with or without MRD was not significantly different (13%±23% vs. 36%±40%; p=0.127). Of the 73 patients with FR AML, MRD was detected in 12 (16%); MRD did not significantly influence DFS at 3 years from the end of induction I in those patients (45%±33% vs. 72%±17%, p=0.138). Thus, although the presence of MRD was significantly associated with worse outcome in patients with SR AML, similar significance could not be demonstrated in the FR or HR cohorts. Clinical outcomes of risk groups were reassessed after combining the MRD data with specific cytogenetic and molecular risk groups, i.e., patients with SR AML and MRD were added to the HR cohort, and those without MRD were added to the FR cohort. In the new risk-stratification system, 57 of 217 (26%) patients were in the HR cohort, and the remaining 160 (74%) patients were in the FR cohort. DFS at 3 years from induction I was 68%±9% for the FR cohort and 20%±16% (p<0.001) for the HR cohort. Cumulative incidence of relapse at 3 years from the end of induction I for those with FR or HR disease was 27%±9% and 71%±17%, respectively (p<0.001). Cytogenetics, molecular genotyping, and post-induction MDF analysis provide a robust means of stratifying all pediatric patients with AML into 2 risk groups with significantly different outcomes. This novel risk-allocation schema will be implemented in the upcoming COG Phase III AML trial. Disclosures: No relevant conflicts of interest to declare.
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Arabameri, Pradhan, Rezaei, and Lee. "Assessment of Landslide Susceptibility Using Statistical- and Artificial Intelligence-based FR–RF Integrated Model and Multiresolution DEMs." Remote Sensing 11, no. 9 (April 26, 2019): 999. http://dx.doi.org/10.3390/rs11090999.
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Landslide is one of the most important geomorphological hazards that cause significant ecological and economic losses and results in billions of dollars in financial losses and thousands of casualties per year. The occurrence of landslide in northern Iran (Alborz Mountain Belt) is often due to the geological and climatic conditions and tectonic and human activities. To reduce or control the damage caused by landslides, landslide susceptibility mapping (LSM) and landslide risk assessment are necessary. In this study, the efficiency and integration of frequency ratio (FR) and random forest (RF) in statistical- and artificial intelligence-based models and different digital elevation models (DEMs) with various spatial resolutions were assessed in the field of LSM. The experiment was performed in Sangtarashan watershed, Mazandran Province, Iran. The study area, which extends to 1,072.28 km2, is severely affected by landslides, which cause severe economic and ecological losses. An inventory of 129 landslides that occurred in the study area was prepared using various resources, such as historical landslide records, the interpretation of aerial photos and Google Earth images, and extensive field surveys. The inventory was split into training and test sets, which include 70 and 30% of the landslide locations, respectively. Subsequently, 15 topographic, hydrologic, geologic, and environmental landslide conditioning factors were selected as predictor variables of landslide occurrence on the basis of literature review, field works and multicollinearity analysis. Phased array type L-band synthetic aperture radar (PALSAR), ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer), and SRTM (Shuttle Radar Topography Mission) DEMs were used to extract topographic and hydrologic attributes. The RF model showed that land use/land cover (16.95), normalised difference vegetation index (16.44), distance to road (15.32) and elevation (13.6) were the most important controlling variables. Assessment of model performance by calculating the area under the receiving operating characteristic curve parameter showed that FR–RF integrated model (0.917) achieved higher predictive accuracy than the individual FR (0.865) and RF (0.840) models. Comparison of PALSAR, ASTER, and SRTM DEMs with 12.5, 30 and 90 m spatial resolution, respectively, with the FR–RF integrated model showed that the prediction accuracy of FR–RF–PALSAR (0.917) was higher than FR–RF–ASTER (0.865) and FR–RF–SRTM (0.863). The results of this study could be used by local planners and decision makers for planning development projects and landslide hazard mitigation measures.
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Rabby, Yasin Wahid, and Yingkui Li. "Landslide Susceptibility Mapping Using Integrated Methods: A Case Study in the Chittagong Hilly Areas, Bangladesh." Geosciences 10, no. 12 (November 29, 2020): 483. http://dx.doi.org/10.3390/geosciences10120483.
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Landslide susceptibility mapping is of critical importance to identify landslide-prone areas to reduce future landslides, causalities, and infrastructural damages. This paper presents landslide susceptibility maps at a regional scale for the Chittagong Hilly Areas (CHA), Bangladesh. The frequency ratio (FR) was integrated with the analytical hierarchy process (AHP) (FR_AHP) and logistic regression (LR) (FR_LR). A landslide inventory of 730 landslide locations and 13 landslide predisposing factors including elevation, slope, aspect, plan curvature, profile curvature, topographic wetness index (TWI), stream power index (SPI), land use/land cover, rainfall, distance from drainage network, distance from fault lines, lithology, and normalized difference vegetation index (NDVI) were used. Landslide locations were randomly split into training (80%) and validation (20%) sites to support the susceptibility analysis. A safe zone was determined based on a slope threshold for logistic regression using the exploratory data analysis. The same number of non-landslide locations were randomly selected from the safe zone to train the model (FR_LR). Success and prediction rate curves and statistical indices, including overall accuracy, were used to assess model performance. The success rate curves show that FR_LR showed the highest area under the curve (AUC) (79.46%), followed by the FR_AHP (77.15%). Statistical indices also showed that the FR_LR model gave the best performance as the overall accuracy was 0.86 for training and 0.82 for validation datasets. The prediction rate curve shows similar results. The correlation analysis shows that the landslide susceptibility maps produced by FR and FR_AHP are highly correlated (0.95). In contrast, the correlation between the maps produced by FR and FR_LR was relatively lower (0.85). It indicates that the three models are highly convergent with each other. This study’s integrated methods would be helpful for regional-scale landslide susceptibility mapping, and the landslide susceptibility maps produced would be useful for regional planning and disaster management of the CHA, Bangladesh.
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Fernandes, B. M., S. Garcia, S. Ganhão, M. Rato, F. Pinheiro, M. Bernardes, and L. Costa. "SAT0449 SPONDYLOARTHRITIS AND FRACTURE RISK: DOES DXA REALLY HAVE AN IMPACT IN THE RISK OF FRACTURE ESTIMATED BY FRAX?" Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1181.1–1182. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1570.
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Background:Low bone mineral density (BMD) is common in ankylosing spondylitis (AS). The fracture risk (FR) is increased and its reduction with pharmacologic therapy is not clearly defined in this population. However, early screening and bisphosphonates as first-line treatment are recommended.Objectives:To investigate the influence of dual-energy X-ray absorptiometry (DXA) in the ten-year risk of fracture assessed by FR Assessment Tool (FRAX) and to determine possible demographic or clinical factors associated with an increased FR in a spondyloarthritis (SpA) population.Methods:Retrospective study including all the over 40 years-old SpA patients (ASAS classification criteria) followed at our Rheumatology Department and registered in the national database. Demographic, clinical and laboratorial data were collected at the time of the last follow-up visit. Data from the last DXA (until 3 years prior to the last visit) were collected. Indication for pharmacological treatment by FRAX was assessed according to the national recommendations.Results:A total of 231 SpA patients were included: 126 males (54.5%), 53 (22.9%) smokers; 171 (74%) had AS, 23 (10%) had Inflammatory Bowel Disease Associated SpA and 37 (16%) had Undifferentiated SpA. At the last follow-up visit, the mean age was 52.9 years (±9.6) and the median disease duration was 21.9 years [1.0-55.5]. The mean ASDAS-CRP was 2.5 (±0.9) and the majority of patients had moderate (25.5%) or high (48.5%) disease activity (according to ASDAS). One hundred and thirty patients (56.3%) were taking NSAIDs, 45 (19.5%) were taking glucocorticoids, 85 (36.8%) were under csDMARDs and 170 (73.6%) under bDMARDs [157 (68%) under TNFi, 11 (4.8%) under secukinumab and 2 (0.9%) under ustekinumab].Eleven patients (4.8%) had previous fragility fractures, 118 (51.1%) had DXA in the last 3 years and 167 (72.3%) were taking calcium and/or vitamin D supplements.Sixteen patients (6.9%) had indication for treatment by FRAX without DXA and 9 of these (56.3%) were already under treatment. Similarly, 16 (6.9%) had indication for treatment by FRAX with DXA and 13 of these (81.3%) were already under treatment. Ten patients (4.3%) were reclassified in FRAX with DXA: 7 (3%) had no indication for treatment by FRAX without DXA but obtained it by FRAX with DXA and 3 (1.3%) had indication for treatment by FRAX without DXA but they lost it by FRAX with DXA. We found a moderate level of agreement in the indication for treatment between FRAX with and without DXA (kappa=0.595; p<0.001). The use of DXA in FRAX estimated a significant higher median FR, both for major osteoporotic fracture (2.4% [0.8-31.0] vs 1.8% [0.6-20.0]; p<0.001) and for hip fracture (0.5% [0.0-23.0] vs 0.2% [0.0-14.0]; p<0.001).We found significant correlations between FR and some disease-related variables (table 1).Table 1.Correlations between the risk of fracture estimated by FRAX and disease-related variables.Disease durationBASDAIASDAS-CRPBASMIBASFIEstimated fracture risk by FRAX:without DXAmajor osteoporotic fracturer=0.352p<0.001r=0.204p=0.002r=0.214p=0.001r=0.301p<0.001r=0.317p<0.001hip fracturer=0.389p<0.001r=0.142p=0.034r=0.170p=0.011r=0.305p<0.001r=0.275p<0.001with DXAmajor osteoporotic fracturer=0.227p=0.014r=0.314p=0.001r=0.356p<0.001r=0.293p=0.002r=0.379p<0.001hip fracturen.s.r=0.197p=0.036r=0.269p=0.004r=0.271p=0.004r=0.258p=0.006Conclusion:Our results showed that a similar number of patients had indication for pharmacological treatment by FRAX both with and without DXA. Although the inclusion of DXA resulted in a higher estimated FR by FRAX, the observed moderate level of agreement between FRAX with and without DXA suggests that the FR estimation by FRAX, even without DXA, may be a reasonable approach in SpA patients. In line with literature, we found significant associations between the estimated risk fracture by FRAX and some disease activity and function measures.Disclosure of Interests:Bruno Miguel Fernandes: None declared, Salomé Garcia: None declared, Sara Ganhão: None declared, Maria Rato: None declared, Filipe Pinheiro: None declared, Miguel Bernardes Speakers bureau: Abbvie, Amgen, Biogen, Eli-Lilly, Glaxo-Smith-Kline, Pfizer, Janssen, Novartis, Lúcia Costa: None declared
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Lai, Yung-Cheng, Athaphon Kawprasert, Chen-Yu Lin, M. Rapik Saat, Chun-Hao Liang, and Christopher P. L. Barkan. "Integrated Optimization Model to Manage Risk of Transporting Hazardous Materials on Railroad Networks." Transportation Research Record: Journal of the Transportation Research Board 2261, no. 1 (January 2011): 115–23. http://dx.doi.org/10.3141/2261-13.
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Sevilya, Ziv, Yael Leitner-Dagan, Mila Pinchev, Ran Kremer, Dalia Elinger, Hedy S. Rennert, Edna Schechtman, et al. "Low Integrated DNA Repair Score and Lung Cancer Risk." Cancer Prevention Research 7, no. 4 (December 19, 2013): 398–406. http://dx.doi.org/10.1158/1940-6207.capr-13-0318.
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Honda, Yohsuke, Shinsuke Mori, Tomoya Fukagawa, Toshihiko Kishida, Takahide Nakano, Shigemitsu Shirai, Masafumi Mizusawa, et al. "ULSOSEAL Technique: A Unique Technique to Achieve Hemostasis Using ExoSeal in High-Risk Patients after Common Femoral Artery Puncture." Journal of Interventional Cardiology 2021 (August 28, 2021): 1–7. http://dx.doi.org/10.1155/2021/2470333.
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This study aimed to assess the safety and feasibility of the ULtrasound-guided uSe Of exoSEAL technique (ULSOSEAL technique) in patients at a high risk of complications following the use of ExoSeal. ExoSeal is a novel, completely extravascular hemostatic device that can treat punctures of the common femoral artery; however, it is not preferable for use in cases that require hemostasis of complex puncture sites. From November 2019 to August 2020, the ULSOSEAL technique was performed in 35 patients with implanted stents (6 patients, 17%), severe calcification (32 patients, 91%), and plaque (7 patients, 20%) around the puncture site; the presence of these conditions is usually undesirable when using ExoSeal. The antegrade approach was used in 22 patients (71%). The size of the ExoSeal used was 5 Fr (13 patients, 37%), 6 Fr (21 patients, 60%), and 7 Fr (1 patient, 2%). Technical success was achieved in 34 patients (97%), while ExoSeal malfunction occurred in 1 patient. There was no incidence of vessel occlusion, pseudoaneurysm, arteriovenous fistula, infection, and secondary bleeding. One patient developed a hematoma (>5 cm in size); however, it occurred before the use of ExoSeal due to side leakage from the inserted sheath. The ULSOSEAL technique was safe and feasible for hemostasis in patients who were considered unsuitable for the ExoSeal device.
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Nosari, Annamaria, Guido Nador, Andrea de Gasperi, Nichelatti Michele, Anghilieri Michela, Cozzi Paola, Mancini Valentina, et al. "Complications of Central Venous Catheters in Patients with Hematologic Malignancy: Analysis of Risk Factors." Blood 104, no. 11 (November 16, 2004): 4520. http://dx.doi.org/10.1182/blood.v104.11.4520.4520.
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Abstract CVC-related complications were retrospectively analysed for 373 CVCs inserted in 261 hematologic pts consecutively admitted to our Hematology Department between January 2002 and March 2004. Pts diagnosis comprised AML (96 pts, 36.8%), ALL (19 pts, 7.3%), lymphoproliferative disorders (74 pts, 28.3%), MM (51 pts, 19.5%), CML (13 pts, 5%), others (8 pts, 3.1%). The CVCs were polyurethane Plastimed three lumen 7 Fr (193 cases) for chemotherapy and polyurethane Arrow three lumen 12 Fr (173 cases) for chemotherapy and peripheral blood stem cell (PBSC) apheresis. CVCs were inserted, according to physician’s judgement, either at bedside (369 cases) or in the operating room (4 cases) and were used for drug infusion in 309 cases (82.8%), for total parenteral nutrition in 19 cases (5.1%), for blood transfusions in 226 cases (60.6%), for PBSC apheresis in 152 cases (40.7%). Fifty five CVCs were inserted in neutropenic pts ( N < 1 x 109/L); severe thrombocytopenia (Plts < 30 x 109/L) was present in 33/373 cases. Antithrombotic prophylaxis with low molecular weight heparin because of previous thrombosis was instituted in 33 cases (8.8%). At univariate and multivariate analysis the following risk factors for catheter-related bloodstream infections were considered: pt age, number of days/catheter, haematological disease, catheter lumen, administration of chemotherapy (standard- vs high-dose), presence of neutropenia. The median duration of CVCs after placement was 22.7 days (range 2–70) for the 7 Fr lumen, and 9 (range 1–39) for the 12 Fr. Major hemorrhagic complications related to the insertion procedure were observed in 4 cases of whom 2 were severely thrombocytopenic. CVC occlusion were observed in 24 cases (6.4%). Thrombotic complications developed in 7 cases (1.87% of inserted CVCs) and in 2/7 were complicated by pulmonary embolism; thrombophilia tests were negative in all 7 pts who developed thrombosis. Among febrile pts the frequency of bacteriemias was 19.6% (73/373 cases) of which 52/373 were CVC-related (13.9%). Approximately 6% of cases (23/373 CVCs) had CVC exit point infection with or without associated bacteriemia. Gram positive bacteria were isolated in 49 cases (67.1%), 38 of which were CVC-related (19 S. epidermidis, 4 S. pneumoniae, 3 S. aureus, 3 Enterococci species, 9 others). Gram negative bacteria were isolated in 23 cases, of which 13 were CVC-related (5 E.coli, 4 E. cloacae, 2 P. aeruginosa, 2 K pneumoniae). Candida was isolated in one case. Overall mortality in our patient population was 4.2% (11/261 pts); one patient only died of infection (P. aeruginosa sepsis) not CVC-related. At univariate and multivariate analysis significant risk factors for infection (p<0.0001) were only the number of days/catheters and duration of neutropenia. Among severely thrombocytopenic pts, haemorrhagic complications at CVC insertion were infrequent (6%). Although pts in our study population frequently displayed prolonged and severe neutropenia, frequency of CVC-related bacteremias was low (13.9%) compared to a general population reported frequency of 5–25%. Moreover, none of the pts died of CVC-related infection.
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Mamelak, Adam, Vivien Bonert, Ning-Ai Liu, Anat BenShlomo, Artak Labadzhyan, Risha Malik, Albert Shamouelian, and Odelia Cooper. "PMON47 Fluid restriction reduces hyponatremia and hospital readmission rates following pituitary surgery." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A553—A554. http://dx.doi.org/10.1210/jendso/bvac150.1150.
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Abstract Rationale: Hyponatremia occurs in approximately 20% of patients after transsphenoidal pituitary surgery (TSS). Symptomatic delayed hyponatremia from SIADH is a major cause of morbidity and hospital readmission. Prophylactic fluid restriction (FR) protocols starting 2-5 days after surgery may potentially reduce rates of symptomatic hyponatremia and readmissions. Methods Patients who underwent TSS for sellar and parasellar masses at a tertiary referral center were discharged with a one-liter fluid restriction protocol. Serum sodium levels were measured on post-operative day (POD) 7 with telephone follow-up care. Rates of hyponatremia and readmissions were compared to a cohort of 316 post-operative patients treated prior to the protocol. Numerical variables were summarized as mean ± SD and significance testing calculated by Chi-square and t-test. Results 105 patients were enrolled on the FR protocol upon discharge. Twelve patients were excluded as they had diabetes insipidus or prolonged hospitalization beyond POD 7. Ninety-three patients were included in the analysis, of whom 74.3% had pituitary adenomas, 5.4% Rathke's Cleft cysts, 8.6% meningiomas, 5.4% apoplexy, 2.2% craniopharyngiomas, and 4.3% other masses. Hyponatremia occurred in 13/93 (14%) patients. Mean POD 7 sodium was 137.9 mmol/L across the entire cohort. Two patients (2.1%) were readmitted for hyponatremia, while 3 were re-admitted for other causes. 88/93 (94.6%) of patients complied with the FR protocol. Of the 5 non-compliant patients, 2 developed hyponatremias (40%) compared to 3/88 (3.4%) in those who complied (p=0.008). Mean POD7 sodium was 138 (+/-4.5) mmol/L in those that complied and 135 (+/- 4.7) mmol/L in those who did not. Overall readmission rate for those with postoperative hyponatremia was 23% compared to 2.5% for those with normal sodium levels (p=0.0023). 15.4% of patients with hyponatremia were re-admitted for hyponatremia treatment, compared to 0/80 (0%) of those who did not develop post-operative hyponatremia (p=0.0004). Age and BMI did not impact hyponatremia rates. In 316 patients treated in 2012-2018 prior to the FR protocol, 78 (24.7%) developed delayed hyponatremia with 6% readmitted for hyponatremia. Thirty nine percent of patients with delayed hyponatremia were re-admitted, compared to 7.6% for those without hyponatremia. Compared to patients not on FR, patients on the FR protocol had 50% reduced risk of hyponatremia (OR=0.49 (95% CI 0.26-0.94, p=0.03), and a 3-fold reduced risk of overall readmissions (OR=0.31; 95% CI 0.12-0.81, p=0.0157) and readmission for hyponatremia (OR= 0.34;95% CI 0.08-1.5, p=0.16). A post-operative CSF leak or use of a lumbar drain were associated with an increased readmission rate in the historical cohort. Conclusion Instituting a one-liter daily FR protocol in patients after TSS results in significantly reduced rates of hyponatremia, overall readmissions, and readmission for symptomatic hyponatremia. A FR protocol should become routine practice in the post-operative care of patients undergoing pituitary surgery. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.
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Zou, Wei, and Kenneth R. Davey. "An integrated two-step Fr 13 synthesis - demonstrated with membrane fouling in combined ultrafiltration-osmotic distillation (UF-OD) for concentrated juice." Chemical Engineering Science 152 (October 2016): 213–26. http://dx.doi.org/10.1016/j.ces.2016.06.020.
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Naulin, Marie, Andreas Kortenhaus, and Hocine Oumeraci. "FAILURE PROBABILITY OF FLOOD DEFENCE STRUCTURES/ SYSTEMS IN RISK ANALYSIS FOR EXTREME STORM SURGES." Coastal Engineering Proceedings 1, no. 32 (February 2, 2011): 13. http://dx.doi.org/10.9753/icce.v32.management.13.
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Extreme storm surges can cause failures of flood defences resulting in severe flooding of the hinterland and catastrophic damages. In order to quantify the risk of flooding an integrated risk analysis is being performed wherein one task is the determination of failure probabilities of flood defences. In this paper the failure probability calculations of flood defence structures and systems under the loading of extreme storm surges are reported. Moreover, the analysis of the breach and breach development is briefly introduced. Preliminary results of the failure probabilities and the breach modelling are presented using the example of the estuarine urban area of Hamburg, Germany. These results are put in context of an integrated risk analysis approach for extreme storm surges which is applied within an ongoing German joint research project.
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Saeed, Sahrai, Anastasia Vamvakidou, Spyridon Zidros, George Papasozomenos, Vegard Lysne, Rajdeep S. Khattar, and Roxy Senior. "Sex differences in transaortic flow rate and association with all-cause mortality in patients with severe aortic stenosis." European Heart Journal - Cardiovascular Imaging 22, no. 9 (March 18, 2021): 977–82. http://dx.doi.org/10.1093/ehjci/jeab045.
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Abstract Aims It is not known whether transaortic flow rate (FR) in aortic stenosis (AS) differs between men and women, and whether the commonly used cut-off of 200 mL/s is prognostic in females. We aimed to explore sex differences in the determinants of FR, and determine the best sex-specific cut-offs for prediction of all-cause mortality. Methods and results Between 2010 and 2017, a total of 1564 symptomatic patients (mean age 76 ± 13 years, 51% men) with severe AS were prospectively included. Mean follow-up was 35 ± 22 months. The prevalence of cardiovascular disease was significantly higher in men than women (63% vs. 42%, P < 0.001). Men had higher left ventricular mass and lower left ventricular ejection fraction compared to women (both P < 0.001). Men were more likely to undergo an aortic valve intervention (AVI) (54% vs. 45%, P = 0.001), while the death rates were similar (42.0% in men and 40.6% in women, P = 0.580). A total of 779 (49.8%) patients underwent an AVI in which 145 (18.6%) died. In a multivariate Cox regression analysis, each 10 mL/s decrease in FR was associated with a 7% increase in hazard ratio (HR) for all-cause mortality (HR 1.07; 95% CI 1.03–1.11, P < 0.001). The best cut-off value of FR for prediction of all-cause mortality was 179 mL/s in women and 209 mL/s in men. Conclusion Transaortic FR was lower in women than men. In the group undergoing AVI, lower FR was associated with increased risk of all-cause mortality, and the optimal cut-off for prediction of all-cause mortality was lower in women than men.
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Kruse, S., and I. Seidl. "Social capacities for drought risk management in Switzerland." Natural Hazards and Earth System Sciences 13, no. 12 (December 23, 2013): 3429–41. http://dx.doi.org/10.5194/nhess-13-3429-2013.
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Abstract. This paper analyses the social capacities for drought risk management from the perspective of national and regional water users and policy- and decision-makers in Switzerland. The analysis follows five dimensions of social capacities as prerequisites for drought risk management. Regarding information and knowledge (1), basic data is available, however not assembled for an integrated drought information system. As for technology and infrastructure (2), limited proactive capacities are available with the exception of a few of the drought-prone regions; in emergency response to drought however, provisional capacities are put together. Regarding organisation and management (3) most regions have enough personnel and effective cooperation in the case of acute and sporadic drought; long-term strategies though are largely missing. Economic resources (4) are sufficient if droughts remain rare. Finally, institutions and policies (5) are not sufficient for proactive drought risk management, but have been suitable in the drought of 2003. Starting points for building social capacities are first, to draw on the extensive experiences with the management of other natural hazards, second to build an integrated drought information system, including social and economic impacts, and third to improve the institutional framework through consistent regulations and coordination for proactive drought risk management.
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Li, Bo. "GCT-24. RELAPSE PATTERN AND QUALITY OF LIFE IN PATIENTS WITH LOCALIZED GERMINOMA ORIGINATING FROM BASAL GANGLIA REGION." Neuro-Oncology 22, Supplement_3 (December 1, 2020): iii332—iii333. http://dx.doi.org/10.1093/neuonc/noaa222.244.
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Abstract BACKGROUND The optimal radiation field in localized basal ganglia (BG) germinoma was not well defined, mostly due to unknown relapse patterns. In our institute, both focal radiotherapy (FR) and craniospinal irradiation (CSI) plus boost were considered in this population until whole-brain radiotherapy (WBRT) plus boost became an option in 2008. Thus, a retrospective study was conducted to address the issue. Furthermore, the health-related quality of life (HRQOL) was also evaluated. METHODS Patients who were diagnosed as localized BG germinoma between 2000 and 2017 were studied. HRQOL was evaluated by PedsQL 4.0 (≤15 years) and SF-36 (>15 years) questionnaires based on the age at last follow-up. RESULTS Among 161 patients included, 35 patients received FR, 109 patients received WBRT plus boost, and 17 patients received CSI plus boost. After a median follow-up of 83 months (range, 13 to 214 months), 15 patients relapsed in FR group, 4 in WBRT group and 0 in CSI group. The 5-year DFS was 74.3%, 97.2%, and 100%, respectively (p<0.001). Among 15 patients who relapsed after FR, 14 had positive radiological findings, in which 6 (42.8%) had lesions documented at the periventricular area, and 7 (50.0%) in the frontal lobe. HRQOL data were available in 69 patients, which generally scored low. In 38 patients evaluated by SF-36, those receiving CSI had significantly lower mental component scores than those receiving WBRT (p=0.027) or FR (p=0.011). CONCLUSIONS Patients with localized BG germinoma present a unique relapse pattern. WBRT, which covers at-risk areas, showed both better disease control and HRQOL.
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Waqas, Hassan, Linlin Lu, Aqil Tariq, Qingting Li, Muhammad Fahad Baqa, Jici Xing, and Asif Sajjad. "Flash Flood Susceptibility Assessment and Zonation Using an Integrating Analytic Hierarchy Process and Frequency Ratio Model for the Chitral District, Khyber Pakhtunkhwa, Pakistan." Water 13, no. 12 (June 12, 2021): 1650. http://dx.doi.org/10.3390/w13121650.
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Pakistan is a flood-prone country and almost every year, it is hit by floods of varying magnitudes. This study was conducted to generate a flash flood map using analytical hierarchy process (AHP) and frequency ratio (FR) models in the ArcGIS 10.6 environment. Eight flash-flood-causing physical parameters were considered for this study. Five parameters were based on the digital elevation model (DEM), Advanced Land Observation Satellite (ALOS), and Sentinel-2 satellite, including distance from the river and drainage density slope, elevation, and land cover, respectively. Two other parameters were geology and soil, consisting of different rock and soil formations, respectively, where both layers were classified based on their resistance against water percolation. One parameter was rainfall. Rainfall observation data obtained from five meteorological stations exist close to the Chitral District, Pakistan. According to its significant importance in the occurrence of a flash flood, each criterion was allotted an estimated weight with the help of AHP and FR. In the end, all the parameters were integrated using weighted overlay analysis in which the influence value of the drainage density was given the highest value. This gave the output in terms of five flood risk zones: very high risk, high risk, moderate risk, low risk, and very low risk. According to the results, 1168 km2, that is, 8% of the total area, showed a very high risk of flood occurrence. Reshun, Mastuj, Booni, Colony, and some other villages were identified as high-risk zones of the study area, which have been drastically damaged many times by flash floods. This study is pioneering in its field and provides policy guidelines for risk managers, emergency and disaster response services, urban and infrastructure planners, hydrologists, and climate scientists.
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Fujita, Toshihiro, Shinichi Hashimoto, Shiroh Tanoue, Kengo Tsuneyoshi, Yoshitaka Nakamura, Makoto Hinokuchi, Hiromichi Iwaya, et al. "Factors Associated with the Technical Success of Bilateral Endoscopic Metallic Stenting with Partial Stent-In-Stent Placement in Patients with Malignant Hilar Biliary Obstruction." Gastroenterology Research and Practice 2019 (September 16, 2019): 1–7. http://dx.doi.org/10.1155/2019/5928040.
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Background. Bilateral biliary drainage decreases the risk of cholangitis, but bilateral endoscopic metallic stenting is technically challenging. Aim. We retrospectively evaluated the factors associated with successful bilateral self-expanding metal stent (SEMS) placement using the partial stent-in-stent (PSIS) method for malignant hilar biliary obstruction and also assessed the safety and efficacy of this technique. Methods. From April 2010 to February 2016, 47 consecutive patients (mean age, 73.0±8.6 years; 32 males and 15 females) underwent PSIS placement for malignant hilar biliary obstruction in our hospital. The technical success of PSIS, clinical response, and complications were investigated. Factors associated with the technical success of PSIS were assessed. Using a propensity score-matched analysis, we compared the procedure time, clinical response, complications, stent patency, and survival time in 17 matched patients treated with bilateral SEMS placement using a SEMS delivery system of <6.0 or ≥6.0 Fr. Results. The technical success rate was 77%. The clinical response rate was 91%, and the complication rate was 26%. Regarding complications, pancreatitis occurred in 5 patients (11%), cholangitis in 6 (13%), and cholecystitis in 1 (2%). A multiple logistic regression analysis identified the use of a SEMS with a delivery system<6.0 Fr as a factor associated with technical success (P=0.033; odds ratio, 10.769; 95% confidence interval, 1.205-96.212). In the 17 matched patients assigned according to the SEMS delivery system size, the procedure time was significantly shorter in those with a delivery system size<6.0 Fr than in those with ≥6.0 Fr (P<0.01). There were no significant differences in the clinical response, complication rate, stent patency, or survival time between the two groups. Conclusion. Using a delivery system<6.0 Fr in size helped improve the technical success and reduced the procedure time for the placement of a SEMS by the PSIS method.
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Mosalygin, V. O. "An integrated approach to the study of the risks." Entrepreneur’s Guide 13, no. 1 (February 21, 2020): 38–44. http://dx.doi.org/10.24182/2073-9885-2020-13-1-38-44.
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This article is devoted to the problem faced by all companies entering a new market and wishing to make a profit under uncertain conditions of the market economy. Risk is the favorable or unfavorable deviation of an event from the intended result. Since adverse deviations can cause significant damage to the business, at present, the risk is given the greatest attention. Companies are actively creating special departments that are dedicated to the analysis and forecasting of market risks, which helps to prevent adverse consequences. Moreover, there are different approaches to risk management. However, it is important to understand that a systematic approach is important in risk analysis, therefore, all methods should be used together, not separately, this significantly increases the effectiveness of making the right strategic decisions.
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Vogiatzi, Maria, Eric Macklin, Robert Schneider, Joseph Lane, Irina Chaikodinov, Nancy Olivieri, Melanie Kirby, et al. "Vertebral Abnormalities by Spine Morphometry in Thalassemia." Blood 108, no. 11 (November 16, 2006): 3829. http://dx.doi.org/10.1182/blood.v108.11.3829.3829.
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Abstract Background: The Thalassemia Clinical Research Network previously reported a high prevalence of low bone mass in thalassemia (thal) despite current treatment practices. Currently we report the association of vertebral compression fractures (frs) and vertebral (vert) growth disturbances with bone pain, bone mass, bone turnover and therapies in thal. Methods: Vert frs (T10-L4) were assessed by morphometry. Vert compression frs by quantitative assessment (Fr-qt) were defined as anterior or mid-vert hts at least 25% shorter than posterior hts or average vert ht at least 25% shorter than hts of adjacent vert. Frs by qualitative assessment (Fr-ql) and growth plate (GP) abnormalities were determined. Bone mineral density by DXA and bone turnover markers were measured. Results: 353 thal pts were studied 64% beta-thal major (beta-TM) 12% beta-thal Intermedia 11% E/beta-thal 11% HbH 1% alpha thal 1% stem cell transplant pts, mean age 23 (SD 12 yrs, range 6 – 75 yrs). General bone pain and back pain were self-reported for the 30 days prior to morphometry by 34% and 26% pts, respectively. Fr-qt occurred in 41 (12%) and Fr-ql in 9 (2.5%), while only 7 pts (2%) had a history of vertebral fr and prevalence did not differ by type of thal or gender. Fr-qt and Fr-ql prevalence increased with age (Fr-qt p < 0.1; Fr-ql p < 0.001). After controlling for age, lumbar DXA Z or T scores were negatively associated with frs (odds ratio for 1-SD increase: Fr-qt 0.670, 95% CI 0.488 to 0.921, p = 0.01; Fr-ql 0.303, 95% CI 0.125 to 0.730, p < 0.01). Hypertransfusion, yrs or onset of chelation, serum transferrin receptor or ferritin did not correlate with frs after controlling for age. Decreased ht Z score (p < 0.01) and growth hormone deficiency (GHD) (p = 0.01) were associated with higher risk for Fr-qt after correcting for age. Hypogonadism was also associated with Fr-qt but not after correction for age (odds ratio 1.916, 95% CI 0.927 to 3.959 p = 0.08). Presence of Fr-ql but not Fr-qt was correlated with generalized bone and back pain specifically (Fr-ql vs. back pain odds ratio 11.05, 95% CI 2.035 to 110.2, p = 0.001). GP abnormalities were present in 30 pts (9%), including 7 (2%) who also had Fr-qt. Prevalence of GP did not differ by gender but was more common in beta-TM pts (13%), E-beta thal (5%) and among all others (0%) (p=0.04). In beta-TM pts, lumbar DXA Z or T scores (p < 0.01), ht Z scores (p < 0.001) and age that chelation was started (p < 0.01) were all negatively associated with GP abnormalities after controlling for age. Hypogonadism (p = 0.001) and GHD (p = 0.04) were positively associated with GP abnormalities after controlling for age. Presence of GP was not correlated with either general bone pain or back pain specifically. Conclusions: Morphometry identified vert abnormalities in 18% of thal pts. These included moderate to severe vert wedging or GP disturbances. A subgroup of pts (2.5%) also had vert compression frs by radiologic assessment. Morphometry vert lesions were associated with low bone mass. Back pain was strongly correlated with radiologic frs but not with other lesions seen by morphometry.
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Lee, G., K. S. Jun, and E. S. Chung. "Integrated multi-criteria flood vulnerability approach using fuzzy TOPSIS and Delphi technique." Natural Hazards and Earth System Sciences 13, no. 5 (May 22, 2013): 1293–312. http://dx.doi.org/10.5194/nhess-13-1293-2013.
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Abstract. This study aims to develop a new procedure that combines multi-criteria spatial vulnerability analysis with the traditional linear probabilistic risk approach. This approach is named integrated fuzzy flood vulnerability assessment because it combines the watershed-based vulnerability framework with stream-based risk analysis. The Delphi technique and pressure-state-impact-response framework are introduced to objectively select evaluation criteria, and the fuzzy TOPSIS technique is proposed to address the uncertainty of weights to all criteria and crisp input data of all spatial units. ArcGIS is used to represent the spatial results to all criteria. This framework is applied to the south Han River basin in South Korea. As a result, the flood vulnerability ranking was derived and vulnerability characteristics of all spatial units were compared. This framework can be used to conduct a prefeasibility study for flood mitigation projects when various stakeholders should be included.
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Santoro, Giulio A. "BEYOND IMAGINATION: INTEGRATED IMAGING APPROACH TO PELVIC FLOOR DISORDERS." Koloproktologia 19, no. 1 (March 16, 2020): 8–20. http://dx.doi.org/10.33878/2073-7556-2020-19-1-8-20.
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Pelvic floor disorders (PFD) represents a significant social and economic problem involving about 25% of women older than 60 years with a 13% lifetime risk of undergoing surgery for PFD. Optimal management is impossible without comprehensive assessment of pelvic floor and multimodal approach. A combination of ultrasonic methods has several advantages (low cost, wide accessibility and availability, office procedure performed by clinicians, intraoperative technique, relatively time consuming, good compliance) and should be performed as first-line assessment in PFD.
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Cheng, Jing, Lihong Yin, Shiping Zhou, Min Tang, Yunxian Li, and Fazhong Yang. "The Inhibitory Effect of Powdery Mildew-Induced Volatiles from Rose on Host Selection Behavior of Beet Armyworm Moths (Lepidoptera: Noctuidae)." Journal of Entomological Science 57, no. 1 (December 17, 2021): 96–113. http://dx.doi.org/10.18474/jes21-13.
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Abstract Plant-mediated indirect interactions (PMIIs) between phytopathogenic fungi and herbivorous insects on shared host plants occur in nature. Knowledge of PMIIs is critical in plant molecular breeding and integrated pest management. We studied the response and chemical mechanism of beet armyworm, Spodoptera exigua (Hübner), adults to rose plants, Rosa chinensis Jacquin, infected with rose powdery mildew, Podosphaera pannosa (Wallr.: Fr.) de Bary. Using gas chromatography-electroantennographic detection (GC-EAD) coupled with electroantennogram (EAG), we found that beet armyworm antennae responded to 8, 11, and 3 volatile organic compounds (VOCs) from noninfected roses, mildew-infected roses, and mildew alone, respectively. The EAG analyses showed 11 chemicals (e.g., limonene [1], 2-ethyl-1-hexanol [2], linalool [3], nonanal [4], (E)-β-caryophyllene [5], 1-dodecanol [7], nhexadecane [9], 1-hexadecanol [11], methyl palmitate [12], 1-octadecanol [14], and n-butyl hexadecanoate [15]) elicited electrophysiological responses of beet armyworm antennae with significant dose-response relationships (P < 0.05). The EAG responses to the three chemicals (3, 11, and 15) were greater than that to the reference chemical [i.e., (E)-2-hexenal] at 0.5, 5.0, and 50.0 mg/ml. Olfactory and ovipositional behavior assays indicated that three chemicals (2, 3, and 5) significantly attracted beet armyworm females and four chemicals (7, 11, 14, and 15) strongly repelled females. Chemicals 2, 3, and 5 from healthy roses appear to be responsible for the attraction of beet armyworm moths to healthy roses, whereas chemicals 7, 11, 14, and 15 from mildew-infected roses play key roles in inhibiting attraction of moths. VOCs from mildew alone did not attract or repel beet armyworm moths.
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Nguyen, Tan-Hoang, Alexander Charney, Xin He, Kenneth Kendler, Patrick Sullivan, Silviu Bacanu, Brien Riley, and Eli Stahl. "13 INTEGRATED ANALYSIS OF RARE VARIANTS AND SINGLE-CELL EXPRESSION DATA PROVIDES INSIGHTS INTO SCHIZOPHRENIA RISK." European Neuropsychopharmacology 29 (October 2019): S65—S66. http://dx.doi.org/10.1016/j.euroneuro.2019.07.154.
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Ciabatti, Elena, Maria Immacolata Ferreri, Angelo Valetto, Alice Guazzelli, Veronica Bertini, Susanna Grassi, Francesca Guerrini, et al. "Myelodysplastic Syndromes: A Multidisciplinary Integrated Diagnostic Work-up for Patients' Risk Stratification." Blood 124, no. 21 (December 6, 2014): 5579. http://dx.doi.org/10.1182/blood.v124.21.5579.5579.
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Abstract Conventional cytogenetics continues to have a fundamental role in the classification and risk scoring of myelodysplastic syndromes (MDS). Nevertheless, non-informative karyotypes represent up to 20% of cases. Some different molecular methods, not included in the routinary diagnostic workup, such as aCGH or mutational analysis, could be able to detect new abnormalities and improve the subtyping of MDS. The aim of this study was to propose a new diagnostic workup to determine the eventual adjunctive value offered by FISH, aCGH, and somatic mutation assays in respect of the the conventional cytogenetics only. In this study, we analyzed 50 patients: 29% female and 71% male, median age 71 (range 30-88 years), 66% at low/int1 IPSS risk, 54% at very-low/low R-IPSS risk, 33% with RCMD, 15% with RA, 14% with RARS, 14% with RAEB, 8% 5q-, and 16% with MMCL. We assessed these new MDS cases by different techniques: i) conventional cytogenetics; ii) FISH for chromosome 5, 7, PDGFRa, and PDGFRb; iii) aCGH, and iiii) specific RT-PCR for ASXL1, EZH2, TP53, and TET2 mutations. Conventional cytogenetics showed 42% of patients with at least one chromosomal aberration, including +8, del(11), del(7), del(5), -Y, +6, del(13), +14, del(20), and complex karyotypes (6% of cases). After FISH analysis, we were able to correctly classify as affected by the 5q- syndrome 2 cases who then received lenalidomide. The aGCH allowed to detect quantitative chromosomal aberrations in 44% of cases (del(13), -7, del(12), del(16), del(17), del(11), del(8), dupl(14), 5q-), including 10 cases (20%) showing a normal karyotype. After the RT-PCR, 32% of patients resulted mutated, with highest frequency for TP53 (22%). Four of these TP53-mutated patients showed normal karyotype, and resulted unmutated also by FISH and aCGH; in a case TP53 mutated we added treatment with steroid. Other 3 patients TP53-mutated did not respond to azacitidine Four low-risk patients (8%) showed ASXL1 gene mutation, three of them not earlier detected by cytogenetics or aCGH. One of these patients died after progression into acute leukemia. The identification of TP53 or ASXL1 mutations after RT-PCR and of dupl(14) by the aCGH prompted us to strictly follow patients at high risk of transformation. Only one case showed TET2 mutation; although TET2 mutations have been related to a better survival in patients receiving 5-azacitidine, this patient resulted not-responsive after 9 cycles. In conclusion, these results sustain the necessity of an integrated work-up for the diagnosis and the correct risk scoring of MDS patients. Disclosures No relevant conflicts of interest to declare.
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Ke, Temin, Artitaya Lophatananon, Kenneth Muir, and Xinzhu Yu. "Abstract 2236: A novel integrated predictive model for pancreatic cancer." Cancer Research 82, no. 12_Supplement (June 15, 2022): 2236. http://dx.doi.org/10.1158/1538-7445.am2022-2236.
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Abstract Background: Pancreatic cancer is the 7th leading cause of cancer-related mortality and the 12 th most common cancer globally. Many studies have identified risk factors for pancreatic cancer, nevertheless, there have been few combined risk factor models developed for the UK specific population. Due to the high incidence with a poor survival rate together with the potential high preventable rate, it is important to establish an accessible predictive risk factor model for identifying potential high-risk populations. Study aim: To establish a pancreatic cancer risk prediction model by integrating the current risk factors together with established genomic biomarkers. Method:Using data from the UK biobank we have investigated the role of established and suggested risk factors for pancreatic cancer. The established risk factors include age, BMI, smoking, alcohol consumption, diabetes and pancreatitis. We also calculate the added prediction from the current polygenic risk score (PRS) to evaluate the risk for genetic predisposition. Last, we utilise the multivariate logistic regression models to establish a novel risk model by integrating the well-known risk factors such as cigarette smoking, heavy alcohol consumption, increased BMI, chronic pancreatitis, diabetics, some germline mutation, and our new evaluated PRS and biological clocks. Results: We will present the performance of the novel integrated model which will be useful for use in primary care to identify the at-risk population. This will assist in the promotion of prevention recommendations and for future health check follow-up. Citation Format: Temin Ke, Artitaya Lophatananon, Kenneth Muir, Xinzhu Yu. A novel integrated predictive model for pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2236.
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Xue, Yarong, Dazhao Song, Zhenlei Li, Jianqiang Chen, Xueqiu He, Shengquan He, and Donghui Li. "GA-Based Early Warning Method for Rock Burst with Microseismic and Acoustic Emission in Steeply Inclined Coal Seam." Shock and Vibration 2020 (September 3, 2020): 1–16. http://dx.doi.org/10.1155/2020/8865654.
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Aiming at problem of low efficacy of early warning of rock burst in coal mine, a multisystem and multiparameter integrated early warning method based on genetic algorithm (GA) is proposed. In this method, firstly, the temporal-spatial-intensity information of energy incubation process of rock burst is deeply mined, and the multidimensional precursory characteristic parameter system of rock burst is constructed. Secondly, the genetic algorithm is used to train the historical monitoring data to obtain the optimal critical value and fitness value of each precursory characteristic parameter, and then the early warning index WC of each monitoring system is calculated. Finally, the integrated rock burst early warning index IC is obtained by synthesizing the early warning index WC of each system. The value of IC corresponds to the specific rock burst risk level of the mine. This method is applied to Wudong coal mine in Xinjiang, China. Based on the actual situation of the mine, a multidimensional precursory characteristic parameter system of rock burst is constructed, which includes energy deviation (DE), frequency ratio (Fr), frequency deviation (DF), degree of dispersion (DS), and total high value of energy deviation (DH). After analyzing the rock burst danger status and risk level in the monitoring area, the early warning capability of this method is found to reach 0.896. Combining with the specific prevention and control measures corresponding to different rock burst risk levels, it can provide effective guidance for the field work.
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Tariq, Aqil, Jianguo Yan, Bushra Ghaffar, Shujing Qin, B. G. Mousa, Alireza Sharifi, Md Enamul Huq, and Muhammad Aslam. "Flash Flood Susceptibility Assessment and Zonation by Integrating Analytic Hierarchy Process and Frequency Ratio Model with Diverse Spatial Data." Water 14, no. 19 (September 29, 2022): 3069. http://dx.doi.org/10.3390/w14193069.
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Flash floods are the most dangerous kinds of floods because they combine the destructive power of a flood with incredible speed. They occur when heavy rainfall exceeds the ability of the ground to absorb it. The main aim of this study is to generate flash flood maps using Analytical Hierarchy Process (AHP) and Frequency Ratio (FR) models in the river’s floodplain between the Jhelum River and Chenab rivers. A total of eight flash flood-causative physical parameters are considered for this study. Six parameters are based on remote sensing images of the Advanced Land Observation Satellite (ALOS), Digital Elevation Model (DEM), and Sentinel-2 Satellite, which include slope, elevation, distance from the stream, drainage density, flow accumulation, and land use/land cover (LULC), respectively. The other two parameters are soil and geology, which consist of different rock and soil formations, respectively. In the case of AHP, each of the criteria is allotted an estimated weight according to its significant importance in the occurrence of flash floods. In the end, all the parameters were integrated using weighted overlay analysis in which the influence value of drainage density was given the highest weight. The analysis shows that a distance of 2500 m from the river has values of FR ranging from 0.54, 0.56, 1.21, 1.26, and 0.48, respectively. The output zones were categorized into very low, low, moderate, high, and very high risk, covering 7354, 5147, 3665, 2592, and 1343 km2, respectively. Finally, the results show that the very high flood areas cover 1343 km2, or 6.68% of the total area. The Mangla, Marala, and Trimmu valleys were identified as high-risk zones of the study area, which have been damaged drastically many times by flash floods. It provides policy guidelines for risk managers, emergency and disaster response services, urban and infrastructure planners, hydrologists, and climate scientists.
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Bestwick, Jonathan P., and Nicholas J. Wald. "Antenatal reflex DNA screening for trisomy 18 and trisomy 13 in addition to Down’s syndrome." Journal of Medical Screening 23, no. 4 (July 8, 2016): 171–74. http://dx.doi.org/10.1177/0969141315617982.
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Objective Antenatal reflex DNA screening for Down’s syndrome has a high screening performance. We aimed to determine the performance of trisomy 18 and trisomy 13 reflex DNA screening when added to Down’s syndrome screening. Methods In our modelled screening protocol, women provide two samples: a serum sample for a Combined test and a plasma sample for a possible DNA test. Women with Down’s syndrome, trisomy 18, or trisomy 13 Combined test risks above a single cut-off have a reflex DNA test using the plasma sample, without the need to recall them to collect another sample and provide counselling. Women with a failed DNA test (after a second attempt using a fresh plasma sample) have an Integrated test, and are classified as positive if any of the Down’s syndrome, trisomy 18, or trisomy 13 Integrated test risks are greater than 1 in 25. Results At 1 in 800 term risk cut-offs for Down’s syndrome, trisomy 18, and trisomy 13, an estimated 10% of women are reflexed to DNA screening, yielding a 91% Down’s syndrome detection rate, an 89% trisomy 18 detection rate, and a 79% trisomy 13 detection rate for a 0.05% false-positive rate. At a 1 in 1900 term risk cut-off for Down’s syndrome, trisomy 18, or trisomy 13, an estimated 20% of women are reflexed to DNA screening, and this yields a 94% Down’s syndrome detection rate, a 92% trisomy 18 detection rate, and an 84% trisomy 13 detection rate for a 0.10% false-positive rate. Conclusion Reflex DNA screening for trisomies 18 and 13 can be usefully added to reflex DNA screening for Down’s syndrome.
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Wey, Tina W., Émy Roberge, Véronique Legault, Joseph W. Kemnitz, Luigi Ferrucci, and Alan A. Cohen. "An Emergent Integrated Aging Process Conserved Across Primates." Journals of Gerontology: Series A 74, no. 11 (May 2, 2019): 1689–98. http://dx.doi.org/10.1093/gerona/glz110.
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Abstract Aging is a complex process emerging from integrated physiological networks. Recent work using principal component analysis (PCA) of multisystem biomarkers proposed a novel fundamental physiological process, “integrated albunemia,” which was consistent across human populations and more strongly associated with age and mortality risk than individual biomarkers. Here we tested for integrated albunemia and associations with age and mortality across six diverse nonhuman primate species and humans. PCA of 13 physiological biomarkers recovered in all species a primary axis of variation (PC1) resembling integrated albunemia, which increased with age in all but one species but was less predictive of mortality risk. Within species, PC1 scores were often reliably recovered with a minimal biomarker subset and usually stable between sexes. Even among species, correlations in PC1 structure were often strong, but the effect of phylogeny was inconclusive. Thus, integrated albunemia likely reflects an evolutionarily conserved process across primates and appears to be generally associated with aging but not necessarily with negative impacts on survival. Integrated albunemia is unlikely to be the only conserved emergent physiological process; our findings hence have implications both for the evolution of the aging process and of physiological networks more generally.
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Liu, Junyang, Motoki Kaidu, Ryuta Sasamoto, Fumio Ayukawa, Nobuko Yamana, Hiraku Sato, Kensuke Tanaka, et al. "Two-fraction high-dose-rate brachytherapy within a single day combined with external beam radiotherapy for prostate cancer: single institution experience and outcomes." Journal of Radiation Research 57, no. 3 (June 1, 2016): 280–87. http://dx.doi.org/10.1093/jrr/rrw003.
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Abstract We investigated the outcomes of treatment for patients with localized prostate cancer (PCa) treated with 3D conformal radiation therapy (3D-CRT) followed by two-fraction high-dose-rate brachytherapy within a single day (2-fr.-HDR-BT/day) at a single institution. A total of 156 consecutive Asian males (median age, 67 years) were enrolled. To compare our findings with those of other studies, we analyzed our results using the D'Amico classification, assigning the patients to low- ( n = 5; 3.2%), intermediate- ( n = 36; 23.1%) and high-risk ( n = 115; 73.7%) groups (Stage T3 PCa patients were classified as high-risk). One patient in the D'Amico low-risk group (20%), 13 intermediate-risk patients (36.1%) and 99 high-risk patients (86.1%) underwent androgen deprivation therapy. We administered a prescription dose of 39 Gy in 13 fractions of 3D-CRT combined with 18 Gy of HDR-BT in two 9-Gy fractions delivered within a single day. We did not distinguish between risk groups in determining the prescription dose. The median follow-up period was 38 months. Of the 156 patients, one died from primary disease and five died from other diseases. The 3-year overall survival (OS) rates were 100%, 100% and 93.7%, and the 3-year ‘biochemical no evidence of disease (bNED)’ rates were 100%, 100% and 96.9% for the D'Amico low-, intermediate- and high-risk groups, respectively. No patient developed ≥ Grade 3 early toxicity. The Grade 3 late genitourinary toxicity rate was 2.6%, and no ≥ Grade 3 late gastrointestinal toxicity occurred. The efficacy and safety of this study were satisfactory, and longer-term follow-up is necessary.
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Nichols, Hazel B., Til Stürmer, Valerie S. Lee, Chelsea Anderson, Jean S. Lee, Janise M. Roh, Kala Visvanathan, Hyman Muss, and Lawrence H. Kushi. "Breast Cancer Chemoprevention in an Integrated Health Care Setting." JCO Clinical Cancer Informatics, no. 1 (November 2017): 1–12. http://dx.doi.org/10.1200/cci.16.00059.
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Purpose National guidelines encourage counseling high-risk women about pharmacologic breast cancer risk reduction. We evaluated the use of integrated health care data to identify and characterize breast cancer chemoprevention use. Chemoprevention included US Food and Drug Administration–approved use of tamoxifen and raloxifene and off-label use of aromatase inhibitors (AIs). Patients and Methods Using electronic medical and pharmacy records (EMRs) in the Kaiser Permanente Northern California health care system, we sampled cancer-free women age 35 to 69 years who used tamoxifen, raloxifene, exemestane, anastrozole, or letrozole from 2005 to 2013. Risk-benefit profiles were calculated for tamoxifen and raloxifene using published indices. The proportion of days covered was calculated from pharmacy records to assess adherence. Results Among 90 chemoprevention users (confirmed with EMR review from a sample of 371 women), 74% used tamoxifen, 11% used raloxifene, and 13% used an AI. For tamoxifen and raloxifene users, the risk-benefit index indicated 23% of women had insufficient evidence that benefits would outweigh risks. For all agents, adherence decreased from an average proportion of days covered of 75% at 1 year to 67% at 5 years. Automated EMR searches identified breast cancer chemoprevention users with 60% positive predictive value overall and 75% for tamoxifen after post hoc modifications. Conclusion Our study contributes to an emerging picture of breast cancer chemoprevention use in real-world settings, where evidence of net benefit is not uniform and nonadherence is common. Among breast cancer chemoprevention agents, our automated selection best performed for tamoxifen use. We also identified off-label use of AIs for chemoprevention, suggesting that expansion of risk-benefit indices to include AIs is warranted.
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Mazzaschi, Giulia, Alessandro Olivari, Antonio Pavarani, Costanza Anna Maria Lagrasta, Caterina Frati, Denise Madeddu, Bruno Lorusso, et al. "Integrated MRI–Immune–Genomic Features Enclose a Risk Stratification Model in Patients Affected by Glioblastoma." Cancers 14, no. 13 (July 1, 2022): 3249. http://dx.doi.org/10.3390/cancers14133249.
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Background: The aim of the present study was to dissect the clinical outcome of GB patients through the integration of molecular, immunophenotypic and MR imaging features. Methods: We enrolled 57 histologically proven and molecularly tested GB patients (5.3% IDH-1 mutant). Two-Dimensional Free ROI on the Biggest Enhancing Tumoral Diameter (TDFRBETD) acquired by MRI sequences were used to perform a manual evaluation of multiple quantitative variables, among which we selected: SD Fluid Attenuated Inversion Recovery (FLAIR), SD and mean Apparent Diffusion Coefficient (ADC). Characterization of the Tumor Immune Microenvironment (TIME) involved the immunohistochemical analysis of PD-L1, and number and distribution of CD3+, CD4+, CD8+ Tumor Infiltrating Lymphocytes (TILs) and CD163+ Tumor Associated Macrophages (TAMs), focusing on immune-vascular localization. Genetic, MR imaging and TIME descriptors were correlated with overall survival (OS). Results: MGMT methylation was associated with a significantly prolonged OS (median OS = 20 months), while no impact of p53 and EGFR status was apparent. GB cases with high mean ADC at MRI, indicative of low cellularity and soft consistency, exhibited increased OS (median OS = 24 months). PD-L1 and the overall number of TILs and CD163+TAMs had a marginal impact on patient outcome. Conversely, the density of vascular-associated (V) CD4+ lymphocytes emerged as the most significant prognostic factor (median OS = 23 months in V-CD4high vs. 13 months in V-CD4low, p = 0.015). High V-CD4+TILs also characterized TIME of MGMTmeth GB, while p53mut appeared to condition a desert immune background. When individual genetic (MGMTunmeth), MR imaging (mean ADClow) and TIME (V-CD4+TILslow) negative predictors were combined, median OS was 21 months (95% CI, 0–47.37) in patients displaying 0–1 risk factor and 13 months (95% CI 7.22–19.22) in the presence of 2–3 risk factors (p = 0.010, HR = 3.39, 95% CI 1.26–9.09). Conclusion: Interlacing MRI–immune–genetic features may provide highly significant risk-stratification models in GB patients.
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Sarwoningrum, R. T., C. Nissa, R. Purwanti, and O. Setiarso. "Factors influencing the implementation of ‘Four Pillars of Balanced Nutrition’ in a Retired Health Cadre Program for the elderly in BTPN Salatiga." Food Research 4, S3 (May 30, 2020): 147–54. http://dx.doi.org/10.26656/fr.2017.4(s3).s18.
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Elderly people are at risk in overnutrition or undernutrition, and thus leading to cause multiple diseases. Responding to this, ‘Four Pillars of Balanced Nutrition’ is recommended to promote health status, particularly in Integrated Service Post for Retired People (Posyandu lansia). However, there is limited evidence regarding factors influencing the implementation of ‘Four Pillars of Balanced Nutrition’. Retired Health Cadre is a BTPN bank-funded program which provides similar facilities to regular Integrated Service Post with several adjustments including time, services and the usage of peer counseling. Therefore, this cross sectional study was aimed to investigate the correlation of the frequency of participant attendance, gender, education level and income of elderly people in Retired Health Cadre Program to implement ‘Four Pillars of Balanced Nutrition’. This research was conducted in BTPN Salatiga branch offices with forty-four participants aged 60-74 years, enrolled by consecutive sampling method. Data collected include general characteristics, single 24-hour recall, level of physical activity and questionnaire of implementation clean and healthy lifestyle. The participants' weight and height were measured to calculate BMI. Statistical analysis included univariate analysis, bivariate analysis using chi-square and multivariate analysis using logistic regression. Bivariate analysis showed no correlation between the program attendance frequency with Dietary Diversity Score (DDS) (p=0.1000), physical activity (p=0.383), clean and healthy lifestyle implementation (p=0.357) and nutrition status (p=0.068). However, the multivariate analysis showed that the level of education affects food diversity more than the frequency of attendance (p=0.019) and frequency of attendance is the factor that affects nutritional status most (p=0.037) compared to others. In conclusion, there was no correlation between participant attendance frequency toward dietary diversity, physical activity, clean and healthy lifestyle implementation and nutrition status among elderly participants of Retired Health Cadre Program in BTPN Salatiga. However, dietary diversity was affected by education level while the nutrition status was affected by the frequency of attending.
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Kushwaha, Dinesh Kumar, Dilbagh Panchal, and Anish Sachdeva. "Risk analysis of cutting system under intuitionistic fuzzy environment." Reports in Mechanical Engineering 1, no. 1 (December 3, 2020): 162–73. http://dx.doi.org/10.31181/rme200101162k.
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Failure Mode Effect Analysis (FMEA) is popular and versatile approach applicable to risk assessment and safety improvement of a repairable engineering system. This method encompasses various fields such as manufacturing, healthcare, paper mill, thermal power industry, software industry, services, security etc. in terms of its application. In general, FMEA is based on Risk Priority Number (RPN) score which is found by product of probability of Occurrence (O), Severity of failure (S) and Failure Detection (D). As human judgement is approximate in nature, the accuracy of data obtained from FMEA members depend on degree of subjectivity. The subjective knowledge of members not only contains uncertainty but hesitation too which in turn, affect the results. Fuzzy FMEA considers uncertainty and vagueness of the data/ information obtained from experts. In order to take into account, the hesitation of experts and vague concept, in the present work we propose integrated framework based on Intuitionistic Fuzzy- Failure Mode Effect Analysis (IF-FMEA) and IF-Technique for Order Preference by Similarity to Ideal Solution (IF-TOPSIS) techniques to rank the listed failure causes. Failure cause Fibrizer (FR) was found to be the most critical failure cause with RPN score 0.500. IF-TOPSIS has been implemented within IF-FMEA to compare and verify ranking results obtained by both the IF based approaches. The proposed method was presented with its application for examining the risk assessment of cutting system in sugar mill industry situated in western Uttar Pradesh province of India. The result would be useful for the plant maintenance manager to fix the best maintenance schedule for improving availability of cutting system.
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Doyen, Jerome, Eric Francois, Anne-Claire Frin, Karen Benezery, Fuxiang Zhou, Pascale Romestaing, Olivier Chapet, Nicolas N. Barbet, and Jean-Pierre Gerard. "Contact x-ray brachytherapy 50 kV (CXB) for organ preservation in T2 T3a-b rectal cancer: Lyon-Nice experience in 120 patients." Journal of Clinical Oncology 33, no. 3_suppl (January 20, 2015): 676. http://dx.doi.org/10.1200/jco.2015.33.3_suppl.676.
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676 Background: Organ preservation (avoiding TME surgery) for T2 T3 a-b rectal cancer is a field of active clinical research. Contact X Ray CXB combined with external beam radiotherapy (EBRT) ± concurrent chemotherapy (CRT) is an attractive method to achieve clinical complete response (cCR) and consequently rectal preservation. We report an overview of 120 patients treated with CXB+EBRT over a 25 year period in Lyon since 1986 and then in Nice until 2012. Methods: Between 1986 and 2012, 120 patients presenting rectal adenocarcinoma T2 T3a-b (distal rectum: 87; middle rectum: 33) were treated with CXB +EBRT with conservative intent. In Lyon (1986-2001), 80 patients median age: 73y; T2:52; T3:28) risk were treated using CXB (80-110 Gy/3-4 fr/4-6 weeks) followed by EBRT (39 Gy/13 fr/18 days) and 192 Iridium implant boost (20 Gy). When cCR was achieved, close surveillance was proposed. In Nice (2002-2012), 40 patients (median age 81y; T2:22; T3:18) received CXB same regimen as in Lyon (using new Papillon 50 machine since 2009) + EBRT (45-50 Gy/5weeks) with concurrent chemotherapy (5-FU or Capecitabine). When cCR was achieved close surveillance was proposed or local excision (13 pts). Results: Median follow-up time 58 months in both groups. Local relapse occurred mainly in the 2 first years. Isolated lymph node recurrence <5%. Bowel function good or excellent when rectum preserved. Main clinical outcomes in table (some improved results in Nice possibly due to better treatment approach and patient selection). Conclusions: CXB with EBRT and concurrent capecitabine achieve safely high rate of cCR with organ preservation. The OPERA randomized trial will reproduce Lyon R 96 trial (Gerard JP, JCO 2004;22:2404) and test the superiority of CXB boost for organ preservation. [Table: see text]
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Iguchi, Masato, Haruhisa Nakamichi, Hiroshi Tanaka, Yusaku Ohta, Atsushi Shimizu, and Daisuke Miki. "Integrated Monitoring of Volcanic Ash and Forecasting at Sakurajima Volcano, Japan." Journal of Disaster Research 14, no. 5 (August 1, 2019): 798–809. http://dx.doi.org/10.20965/jdr.2019.p0798.
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The Sakurajima volcano is characterized by frequent vulcanian eruptions at the Minamidake or Showa crater in the summit area. We installed an integrated monitoring system for the detection of volcanic ash (composed of remote sensing sensors XMP radars, lidar, and GNSS with different wave lengths) and 13 optical disdrometers on the ground covering all directions from the crater to measure drop size distribution and falling velocity. Campaign sampling of volcanic ash supports the conversion of particle counts measured by the disdrometer to the weight of volcanic ash. Seismometers and tilt/strain sensors were used to estimate the discharge rate of volcanic ash from the vents. XMP radar can detect volcanic ash clouds even under visual difficulty because of weather such as fog or clouds. A vulcanian eruption on November 13 was the largest event at the Sakurajima volcano in 2017; however, the volcanic plume was not visible due to clouds covering the summit. Radar revealed that the volcanic plume reached an elevation of 4.2–6.2 km. Post-fit phase residuals (PPR) from the GNSS analysis increased suddenly after the eruption, and large-PPR paths from the satellites to the ground-based receivers intersected each other at an elevation of 4.2 km. The height of the volcanic plume was also estimated from the discharge rate of volcanic ash to be 4.5 km, which is empirically related to seismic energy and the deflation volume obtained via ground deformation monitoring. Using the PUFF model, the weight of the ash-fall deposit was accurately forecast in the main direction of transport of the volcanic ash, which was verified by disdrometers. For further advances in forecasting of the ash-fall deposit, we must consider high-resolution wind field, shape of volcanic plume as the initial value, and the particle number distribution along the volcanic plume.
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Bouariu, Alexandra, Anca Maria Panaitescu, and Kypros H. Nicolaides. "First Trimester Prediction of Adverse Pregnancy Outcomes—Identifying Pregnancies at Risk from as Early as 11–13 Weeks." Medicina 58, no. 3 (February 22, 2022): 332. http://dx.doi.org/10.3390/medicina58030332.
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There is consistent evidence that many of the pregnancy complications that occur late in the second and third trimester can be predicted from an integrated 11–13 weeks visit, where a maternal and fetal assessment are comprehensively performed. The traditional aims of the 11–13 weeks visit have been: establishing fetal viability, chorionicity and dating of the pregnancy, and performing the combined screening test for common chromosomal abnormalities. Recent studies have shown that the first trimester provides important information that may help to predict pregnancy complications, such as preeclampsia and fetal growth restriction, stillbirth, preterm birth, gestational diabetes mellitus and placenta accreta spectrum disorder. The aim of this manuscript is to review the methods available to identify pregnancies at risk for adverse outcomes after screening at 11–13 weeks. Effective screening in the first trimester improves pregnancy outcomes by allowing specific interventions such as administering aspirin and directing patients to specialist clinics for regular monitoring.
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Novera, R., W. P. Rahayu, H. D. Kusumaningrum, N. Indrotristanto, and E. Nikastri. "Prevalence of Salmonella contamination in processing chain of selected chicken based side dishes." Food Research 4, no. 3 (January 17, 2020): 690–96. http://dx.doi.org/10.26656/fr.2017.4(3).338.
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This study was aimed to determine the prevalence, the level and the main contributing factors to contamination of Salmonella spp. in four selected chicken-based side dishes prepared for the school canteens. One hundred and seven samples were collected from four different food processing chains, i.e. fried chicken with precooking, fried chicken without precooking, breaded fried chicken, and sauced chicken. Salmonella contamination was determined by the most probable number (MPN) and confirmed with polymerase chain reaction. Salmonella spp. were detected in 8 of 21 chicken cuts samples (360-920 MPN/g) and in 4 of 30 end products samples (0.61-3 MPN/g). The fact that Salmonella was still found at the end product indicated that cross-contamination and/or inadequate heating process likely occurred. Besides the chicken cuts, the contributing factors to the Salmonella contamination were water (4 of 17 samples) and seasonings (8 of 13 samples). To ensure the safety of chicken-based side dishes prepared for the school canteen, adequate cooking process must be performed by all food handlers. The results of this study might contribute to analysing the risk of salmonellosis in Indonesia.
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Nyman, Mark A., Thulasee Jose, Ivana T. Croghan, Mark A. Parkulo, Charles D. Burger, Darrell R. Schroeder, Ryan T. Hurt, and John C. O’Horo. "Utilization of an Electronic Health Record Integrated Risk Score to Predict Hospitalization Among COVID-19 Patients." Journal of Primary Care & Community Health 13 (January 2022): 215013192110697. http://dx.doi.org/10.1177/21501319211069748.
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Objective: To evaluate the performance of an Electronic Health Record (EHR) integrated risk score for COVID-19 positive outpatients to predict 30-day risk of hospitalization. Patients and Methods: A retrospective observational study of 67 470 patients with COVID-19 confirmed by polymerase chain reaction (PCR) test between March 12, 2020 and February 8, 2021. Risk scores were calculated based on data in the chart at the time of the incident infection. Results: The Mayo Clinic COVID-19 risk score consisted of 13 components included age, sex, chronic lung disease, congenital heart disease, congestive heart failure, coronary artery disease, diabetes mellitus, end stage liver disease, end stage renal disease, hypertension, immune compromised, nursing home resident, and pregnant. Univariate analysis showed all components, except pregnancy, have significant ( P < .001) association with admission. The Mayo Clinic COVID-19 risk score showed a Receiver Operating Characteristic Area Under Curve (AUC) of 0.837 for the prediction of admission for this large cohort of COVID-19 positive patients. Conclusion: The Mayo Clinic COVID-19 risk score is a simple score that is easily integrated into the EHR with excellent predictive performance for severe COVID-19. It can be leveraged to stratify risk for severe COVID-19 at initial contact, when considering therapeutics or in the allocation of vaccine supply.
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Shkola, V. Y., O. V. Prokopenko, and V. A. Omelianenko. "Transformation of the Emergency Risk Management Methodology Based on the Conception of Sustainable Innovation Proactivity: The Global and Local Dimensions." Business Inform 9, no. 524 (2021): 13–21. http://dx.doi.org/10.32983/2222-4459-2021-9-13-21.
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The article is aimed at improving fundamental methodological approaches to the system of emergency risk management on the basis of the conception of sustainable innovation proactivity, which will allow to prevent and respond in a timely manner to various kinds of destructive phenomena, will contribute to ensuring/increasing the stability and security of economic systems in the face of modern global challenges and threats (both actual and potential). As result of the research, the essence of the main categories of risk management theory is deepened; the influence of various types of global risks in dynamics is analyzed (in the short, medium and long term); the extant approaches to risk management are generalized and systematized; the authors’ own structure of the risk management process is proposed. The methodology for determining the status of economic system, a methodical approach to comprehensive risk assessment based on the theory of sustainability and the theory of complex systems are improved; the principle of integrated risk assessment based on an integrated approach to the assessment of challenges and threats through the synergy of economic, diplomatic, human, international, legal, political, and cultural dimensions of security is determined. Prospect for further research is the development of a theoretical-methodical approach to the choice of strategies and instruments to counter the challenges and threats in Ukraine under unstable socio-economic conditions, taking into account changes in the security environment and in the potential of national economies.
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Garzia, Fabio, and Roberto Cusani. "The integrated safety/security/communication system of the gran sasso mountain in italy." International Journal of Safety and Security Engineering 2, no. 1 (March 30, 2012): 13–39. http://dx.doi.org/10.2495/safe-v2-n1-13-39.
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M. Soliman, Alaa, Adam Mukhtar, and Moade F. Shubita. "The long-term relationship between enterprise risk management and bank performance: the missing link in Nigeria." Banks and Bank Systems 13, no. 1 (April 5, 2018): 128–38. http://dx.doi.org/10.21511/bbs.13(1).2018.12.
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This study investigates the relationship between Enterprise Risk Management adoption and implementation, and the performance of banks using a sample of four out of the seven Strategically Important Banks (SIB) listed on the Nigerian Stock Exchange covering the period from 2005 q1 to 2015 q2. In this study, we determined a measure for Enterprise Risk Management (ERM) adoption or implementation (ERM index) using an integrated Enterprise Risk Management measurement model for the banking sector suggested by Soliman and Mukhtar (2017). A time series Johansen’s cointegration test was used to obtain evidence of the long-term association between ERM and performance, while Vector Error Correction Model (VECM) analysis was performed to gather evidence of causality relationship between ERM and performance. Finally, Generalized Impulse Response Function was used to obtain evidence of how performance responds to the introduction of a shock on Enterprise Risk Management. This study makes significant contributions to the existing body of knowledge, as it yields the first Enterprise Risk Management-performance-based empirical results that indicate a long-term relationship, causation effects, in addition to responding to performance ERM.
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Hathurusingha, Priyantha I., and Kenneth R. Davey. "Chemical taste taint accumulation in RAS farmed fish – A Fr 13 risk assessment demonstrated with geosmin (GSM) and 2-methylisoborneol (MIB) in barramundi ( Lates calcarifer )." Food Control 60 (February 2016): 309–19. http://dx.doi.org/10.1016/j.foodcont.2015.08.014.
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Vanderveer, Elysha, Steven J. T. Huang, Helene Bruyere, Tanya Gillan, Charles H. Li, Khaled Ramadan, Diego Villa, et al. "Oral Fludarabine and Intravenous Rituximab (FR) for Chronic Lymphocytic Leukemia (CLL): Long Term Outcomes and Secondary Malignancies in 673 Patients Treated in British Columbia (BC)." Blood 134, Supplement_1 (November 13, 2019): 4300. http://dx.doi.org/10.1182/blood-2019-125189.
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Background: Oral fludarabine and intravenous rituximab (FR) was the standard first-line therapy for CLL or small lymphocytic lymphoma (SLL) patients (pts) in BC from 2003-2015. Ibrutinib for relapsed/refractory (R/R) CLL was introduced and publicly funded in 2015. Our aim was to review long term outcomes of all CLL/SLL pts treated with FR in BC, including the impact of 2nd line therapy with ibrutinib versus chemoimmunotherapy and to report the risk of secondary malignancies in this population based cohort. Methods: The BC Provincial CLL Database was used to identify all CLL/SLL pts who received first-line FR from 2003-2017. The BC Cancer Registry was used to identify secondary malignancies occurring after FR. Primary outcomes were overall survival (OS) and treatment free survival (TFS), defined as start of FR to next-line therapy or death/last follow-up. Variables examined for impact on OS/TFS included age at FR, gender, primary diagnosis (CLL vs SLL), B symptoms, advanced stage (Rai stage 3-4 CLL, Ann Arbor 1-2 SLL), baseline hemoglobin, lymphocyte count, platelets, LDH and FISH abnormalities. All variables significant on univariate analyses (P<.1) were included in multivariate Cox proportional hazard regression models to identify significant predictors of OS/TFS. Results: 673 pts were identified as receiving FR as first-line therapy for CLL (86%) or SLL (14%). Median time from CLL/SLL diagnosis to FR was 2.5 years (y) (range 0.1-27.3). Median age at FR was 67 y (range 26-91) with 73% ≥ 60 y and 39% ≥ 70 y. Most pts were male (66.1%), had early stage disease (84.2%) with no B symptoms (89.7%) and normal LDH (81.1%). Of 411 pts with pre-treatment FISH testing, prevalence of FISH abnormalities were: 48.5% del13q, 25.7% trisomy 12, 12.9% del11q, 8.0% del17p. Median number of FR cycles was 6 (range 1-10). Median follow-up of living pts from FR was 6.4 y (range 0.2-12.7). 2 y and 5 y OS were 89.4% (95% CI: 86.8-91.6) and 73% (95% CI: 69.0-76.6) respectively; median OS 11.6 y (95% CI: 4.6-13.7 y). 2 y and 5 y TFS were 72% (95% CI: 68-75%) and 37% (95% CI: 33 - 41) respectively, median TFS 3.8 y (95% CI: 1.78-7.09). Those with del17p had significantly worse OS and TFS compared to those without (median OS 5.7 vs 13.7 y, P<.001; median TFS 1.4 vs 3.9 y, P<.001), Fig. 1. Multivariate analysis identified only del17p (HR 4.35, 95%CI: 2.10-9.01, P<.001) and age at FR (HR 1.04, 95% CI: 1.01-1.07, P=.007) as significant predictors of OS, and del17p (HR 4.3, 95% CI: 2.5-7.5, P<.001) as a significant predictor of TFS. During the follow up period, 351 pts (52%) went on to 2nd-line therapy: ibrutinib 87 (including 2 with BR and 1+R), cyclophosphamide-based (CVP/CHOP) +/- R 102, repeat FR 71, FCR 6, F alone 21, bendamustine +/-R 13, chlorambucil+/-R 38, steroids 3, R alone 3, alemtuzumab 2, other chemotherapy 3 and allotransplant 2. Median follow-up after 2nd-line therapy was 2.8 y (range 0.1-10.8). Median OS and TFS from 2nd-line treatment (TFS2) for ibrutinib (n=87) vs. for other treatments (n=264) was: OS not reached vs 5.3 y, P<.001; TFS2 not reached vs 1.2 y, P<.001. These significant differences persisted when analyses were restricted to those who received ibrutinib vs. chemoimmunotherapy (n=169): median OS not reached vs. 6.3 y (P=.002); median TFS not reached vs. 1.7 y (P<.001), Fig. 2. 2 y OS and TFS2 after ibrutinib were 91% (95% CI: 80-96%) and 78% (95% CI: 65-87%), respectively. A total of 202 malignancies were recorded after initiation of FR in 166 pts (24.7%), Table 1. The median time from FR to 2nd malignancy was 2.3 y (range 0.1-13.5). Richter's transformation (RT) occurred in 36 pts (5.3%) at median 1.9 y (range 0.1-13.2) from FR. Most frequent 2nd malignancies were: non-melanoma skin cancer (11.7%), lung (2.5%), colon (2.1%), other heme (1.9%), and prostate (1.8%). There were 4 cases of acute myeloid leukemia (AML), 2 of which received alkylator therapy after FR prior to AML diagnosis. Conclusions: In this large, homogeneous cohort of CLL/SLL pts treated with first-line FR, including nearly 40% of pts ≥ age 70, we demonstrate a short median TFS of 3.8 y; however, a long OS of 11.6 y. Rates of 2nd malignancies are low after this non-alkylator based chemoimmunotherapy regimen. Ibrutinib for R/R CLL/SLL after FR resulted in significantly improved survival over alternate therapy, with excellent 2 yr OS 91% and TFS 78%. These data demonstrate the efficacy of FR and the benefit of ibrutinib over chemoimmunotherapy as second-line therapy for CLL/SLL in the real-world. Disclosures Bruyere: Jenssen: Other: Travel Grant; Celgene: Honoraria. Villa:Roche, Abbvie, Celgene, Seattle Genetics, Lundbeck, AstraZeneca, Nanostring, Janssen, Gilead: Consultancy, Honoraria. Scott:Celgene: Consultancy; Roche/Genentech: Research Funding; Janssen: Consultancy, Research Funding; NanoString: Patents & Royalties: Named inventor on a patent licensed to NanoSting [Institution], Research Funding. Savage:BMS, Merck, Novartis, Verastem, Abbvie, Servier, and Seattle Genetics: Consultancy, Honoraria; Seattle Genetics, Inc.: Consultancy, Honoraria, Research Funding. Connors:Takeda Pharmaceuticals: Honoraria; Seattle Genetics: Honoraria, Research Funding; Bristol-Myers Squibb: Consultancy. Sehn:TEVA Pharmaceuticals Industries: Consultancy, Honoraria; Acerta: Consultancy, Honoraria; Morphosys: Consultancy, Honoraria; F. Hoffmann-La Roche/Genentech: Consultancy, Honoraria, Research Funding; Seattle Genetics: Consultancy, Honoraria; Seattle Genetics: Consultancy, Honoraria; Astra Zeneca: Consultancy, Honoraria; F. Hoffmann-La Roche/Genentech: Consultancy, Honoraria, Research Funding; Kite Pharma: Consultancy, Honoraria; Kite Pharma: Consultancy, Honoraria; Morphosys: Consultancy, Honoraria; Abbvie: Consultancy, Honoraria; Amgen: Consultancy, Honoraria; TEVA Pharmaceuticals Industries: Consultancy, Honoraria; Amgen: Consultancy, Honoraria; Acerta: Consultancy, Honoraria; Abbvie: Consultancy, Honoraria; Astra Zeneca: Consultancy, Honoraria. Gerrie:Lundbeck, Seattle Genetics: Consultancy, Honoraria.
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Garner, Daniel, Lindsay Lunt, Wing Leung, Jennifer Llewellyn, Matthew Kahn, David Jay Wright, and Archana Rao. "Use of CIED Generated Heart Failure Risk Score (HFRS) Alerts in an Integrated, Multi-Disciplinary Approach to HF Management—A Prospective Cohort Study." Sensors 22, no. 5 (February 25, 2022): 1825. http://dx.doi.org/10.3390/s22051825.
Full textAbstract:
Aim: To evaluate use of CIED-generated Heart Failure Risk Score (HFRS) alerts in an integrated, multi-disciplinary approach to HF management. Methods: We undertook a prospective, single centre outcome study of patients implanted with an HFRS-enabled Medtronic CIED, generating a “high risk” alert between November 2018 and November 2020. All patients generating a “high risk” HFRS alert were managed within an integrated HF pathway. Alerts were shared with local HF teams, prompting patient contact and appropriate intervention. Outcome data on health care utilisation (HCU) and mortality were collected. A validated questionnaire was completed by the HF teams to obtain feedback. Results: 367 “High risk” alerts were noted in 188 patients. The mean patient age was 70 and 49% had a Charlson Comorbidity Score of >6. Mean number of alerts per patients was 1.95 and 44 (23%) of patients had >3 “high risk” alerts in the follow up period. Overall, 75 (39%) patients were hospitalised in the 4–6-week period of the alert; 53 (28%) were unplanned of which 24 (13%) were for decompensated HF. A total of 33 (18%) patients died in the study period. Having three or more alerts significantly increased the risk of hospitalisation for heart failure (HR 2.5, CI 1.1–5.6 p = 0.03). The feedback on the pathway was positive. Conclusions: Patients with “high risk” alerts are co-morbid and have significant HCU. An integrated approach can facilitate timely risk stratification and intervention. Intervention in these patients is not limited to HF alone and provides the opportunity for holistic management of this complex cohort.
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Liu, Yimo, Wanchang Zhang, Zhijie Zhang, Qiang Xu, and Weile Li. "Risk Factor Detection and Landslide Susceptibility Mapping Using Geo-Detector and Random Forest Models: The 2018 Hokkaido Eastern Iburi Earthquake." Remote Sensing 13, no. 6 (March 18, 2021): 1157. http://dx.doi.org/10.3390/rs13061157.
Full textAbstract:
Landslide susceptibility mapping is an effective approach for landslide risk prevention and assessments. The occurrence of slope instability is highly correlated with intrinsic variables that contribute to the occurrence of landslides, such as geology, geomorphology, climate, hydrology, etc. However, feature selection of those conditioning factors to constitute datasets with optimal predictive capability effectively and accurately is still an open question. The present study aims to examine further the integration of the selected landslide conditioning factors with Q-statistic in Geo-detector for determining stratification and selection of landslide conditioning factors in landslide risk analysis as to ultimately optimize landslide susceptibility model prediction. The location chosen for the study was Atsuma Town, which suffered from landslides following the Eastern Iburi Earthquake in 2018 in Hokkaido, Japan. A total of 13 conditioning factors were obtained from different sources belonging to six categories: geology, geomorphology, seismology, hydrology, land cover/use and human activity; these were selected to generate the datasets for landslide susceptibility mapping. The original datasets of landslide conditioning factors were analyzed with Q-statistic in Geo-detector to examine their explanatory powers regarding the occurrence of landslides. A Random Forest (RF) model was adopted for landslide susceptibility mapping. Subsequently, four subsets, including the Manually delineated landslide Points with 9 features Dataset (MPD9), the Randomly delineated landslide Points with 9 features Dataset (RPD9), the Manually delineated landslide Points with 13 features Dataset (MPD13), and the Randomly delineated landslide Points with 13 features Dataset (RPD13), were selected by an analysis of Q-statistic for training and validating the Geo-detector-RF- integrated model. Overall, using dataset MPD9, the Geo-detector-RF-integrated model yielded the highest prediction accuracy (89.90%), followed by using dataset MPD13 (89.53%), dataset RPD13 (88.63%) and dataset RPD9 (87.07%), which implied that optimized conditioning factors can effectively improve the prediction accuracy of landslide susceptibility mapping.