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Tsimberidou, A. M., C. Tam, W. Wierda, S. O' Brien, S. Lerner e M. J. Keating. "Beta-2 microglobulin (B2M) is an independent prognostic factor for clinical outcomes in patients with CLL treated with frontline fludarabine, cyclophosphamide, and rituximab (FCR) regardless of age, creatinine clearance (CrCl)". Journal of Clinical Oncology 25, n.º 18_suppl (20 de junho de 2007): 7034. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.7034.
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7034 Introduction: High β2M levels are a risk factor in CLL. PCR therapy has been reported to be better tolerated than FCR in older or with decrease renal function pts (Shanafelt, Blood 108:15a). We assessed the association between age, CrCl, PS, β2M and outcomes in pts treated with FCR. Methods: From 7/99 to 1/04, 300 pts received rituximab 375 mg/m2 D1; fludarabine 25 mg/m2/d D2–3; and cyclophosphamide 250 mg/m2/d D2–3. Serum β2M levels were measured by radioimmunoassay. CrCl was calculated (Cockcroft-Gault equation). Results: The median age was 57 yrs (≥70, 14%). Age ≥70 was associated with fewer FCR courses (p<.0001); lower rates of CR (p=.001), overall response (OR; p=.04), survival (OS; p<.0001), and FFS (p=.008); and higher rates of G3–4 thrombopenia (p<.0001) or anemia (p=.002) compared with age<70. The median CrCl was 90 mL/min (CrCl <70, 27%). Pts with CrCl <70 had higher rates of G3–4 thrombopenia (p=.006) or anemia (p=.01) than others. There were no differences between the 2 groups in the other outcomes. PS was 0 in 40%, 1 in 57%, and 2 in 3% of pts. Better PS was associated with higher rates of CR (p=.007) and FFS (p=.02) but did not affect OR or OS. The median β2M level was 3.7 mg/L (β2M ≥ 4, 43%). The rates of CR, survival, and FFS were lower in pts with β2M ≥ 4 compared with others (p<.0001 each). High β2M levels were associated with older age, lower CrCl levels, poorer PS (p<.0001 each), higher rates of G3–4 neutropenia (p=.005), thrombocytopenia (p=.01), and infections (p=.03), and fewer FCR courses (p=.004). The median follow-up was 5 yrs. The rates of CR, 3-yr OS and 3-yr FFS were 72%, 87% and 76%, respectively. Independent factors predicting response were lower β2M (p=.0004) and lower WBC counts (p=.02). Independent factors predicting longer OS were younger age (p=.001), lower β2M (p=.003) and lower WBC (p=.03). Independent factors predicting longer FFS were lower β2M levels (p=.0006), and lower WBC counts (p=.005). Conclusion: Age ≥70 yrs and poor PS, but not CrCl level were associated with poor clinical outcomes. High β2M levels are an independent adverse prognostic factor for CR, OS, and FFS in the context of other prognostic factors. No significant financial relationships to disclose.
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Yuan, Ying, Hong Qiu, Lei Song, Xiaoying Hu, Tong Luo, Xueyan Zhao, Jun Zhang et al. "A New Risk Factor Profile for Contrast-Induced Acute Kidney Injury in Patients Who Underwent an Emergency Percutaneous Coronary Intervention". Angiology 69, n.º 6 (29 de outubro de 2017): 523–31. http://dx.doi.org/10.1177/0003319717736157.
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We developed a new risk factor profile for contrast-induced acute kidney injury (CI-AKI) under a new definition in patients who underwent an emergency percutaneous coronary intervention (PCI). Consecutive patients (n = 1061) who underwent an emergency PCI were divided into a derivation group (n = 761) and a validation group (n = 300). The rates of CI-AKI were 23.5% (definition 1: serum creatinine [SCr] increase ≥25% in 72 hours), 4.3% (definition 2: SCr increase ≥44.2 μmol/L in 72 hours), and 7.0% (definition 3: SCr increase ≥44.2 μmol/L in 7 days). Due to the high sensitivity of definition 1 and the high rate of missed cases for late diagnosis of CI-AKI under definition 2, definition 3 was used in the study. The risk factor profile included body surface area <1.6 m2 ( P = .030), transient ischemic attack/stroke history ( P = .001), white blood cell count >15.00 × 109/L ( P = .047), estimated glomerular filtration rate <60 mL/min/1.73 m2 ( P = .002) or baseline SCr >133 μmol/L ( P = .007), intra-aortic balloon pump application ( P = .006), and diuretics administration ( P < .001), showing a significant predictive power in the derivation group and validation group. The new risk factor profile of CI-AKI under a new CI-AKI definition in emergency PCI patients is easily applicable with a useful predictive value.
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Daneshfar, Amin, Carl J. Petersen, Majid S. Koozehchian e Daniel E. Gahreman. "Caffeinated Chewing Gum Improves Bicycle Motocross Time-Trial Performance". International Journal of Sport Nutrition and Exercise Metabolism 30, n.º 6 (1 de novembro de 2020): 427–34. http://dx.doi.org/10.1123/ijsnem.2020-0126.
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This study aimed to identify the acute effects of caffeinated chewing gum (CAF) on bicycle motocross (BMX) time-trial (TT) performance. In a randomized, placebo-controlled, double-blind cross-over design, 14 male BMX riders (age = 20.0 ± 3.3 years; height = 1.78 ± 0.04 m; body mass = 72 ± 4 kg), consumed either (300 mg; 4.2 ± 0.2 mg/kg) caffeinated (300 mg caffeine, 6 g sugars) or a placebo (0 mg caffeine, 0 g sugars) gum, and undertook three BMX TTs. Repeated-measure analysis revealed that CAF has a large ergogenic effect on TT time, F(1, 14) = 33.570, p = .001, ; −1.5% ± 0.4 compared with the placebo. Peak power and maximal power to weight ratio also increased significantly compared with the placebo condition, F(1, 14) = 54.666, p = .001, ; +3.5% ± 0.6, and F(1, 14) = 57.399, p = .001, ; +3% ± 0.3, respectively. Rating of perceived exertion was significantly lower F(1, 14) = 25.020, p = .001, in CAF (6.6 ± 1.3) compared with the placebo (7.2 ± 1.7). Administering a moderate dose (300 mg) of CAF could improve TT time by enhancing power and reducing the perception of exertion. BMX coaches and riders may consider consuming CAF before a BMX race to improve performance and reduce rating of perceived exertion.
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Fishman, Loren M. "Isometric Yoga-Like Maneuvers Improve Adolescent Idiopathic Scoliosis—A Nonrandomized Control Trial". Global Advances in Health and Medicine 10 (janeiro de 2021): 216495612098825. http://dx.doi.org/10.1177/2164956120988259.
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Objective Assess therapeutic value of specific yoga poses for thoracic and lumbar adolescent idiopathic scoliosis (AIS) taught in office or Internet. Study Design Nonrandomized control trial: Fifty-six adolescents (mean age 14.0 years; mean Risser 3.0) were recruited from our clinic; 41 did the side-plank, the half-moon and elevated side plank poses as appropriate (treatment group) and 15 did not (controls). Thirty curves were treated in office, 30 via Internet. Curve change was evaluated by blinded serial Cobb angles, and analyzed using Mann-Whitney U, paired t-tests and χ2. Results Mean lumbar and thoracolumbar Cobb angle change was −9.2 (95% CI = −11.8, −6.6) in the treatment group and 5.4 (95% CI = 1.7, 9.0) in controls. Both treatment group improvement and deterioration in controls were significant (treatment group: paired t-test t = −7.1, df = 40, p = .000; controls: t = 3.2, df = 12, p = .008). Mean thoracic Cobb angle change was −7.1 (95% CI = −13.1, −1.2) in the treatment group and 9.3 (95% CI = 4.5, 14.6) in controls. Both changes were significant (paired t-test t = −3.3, df = 21, p = .022 for treatment group; t = 4.5, df = 5, p = .006 for controls). Nine Internet patients were non-compliant vs. 6 office patients. Office patients improved 1.6 degrees/month or 5.5%/month; Internet patients improved .72 degrees/month or 3.3%/month. Conclusion These yoga poses show promise for reversing adolescent idiopathic scoliosis. Telemedicine had greater non-compliance and lower efficacy but still produced patient improvement.
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Hofheimer, Julie A., Monica McGrath, Rashelle Musci, Guojing Wu, Sarah Polk, Courtney K. Blackwell, Annemarie Stroustrup et al. "Assessment of Psychosocial and Neonatal Risk Factors for Trajectories of Behavioral Dysregulation Among Young Children From 18 to 72 Months of Age". JAMA Network Open 6, n.º 4 (26 de abril de 2023): e2310059. http://dx.doi.org/10.1001/jamanetworkopen.2023.10059.
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ImportanceEmotional and behavioral dysregulation during early childhood are associated with severe psychiatric, behavioral, and cognitive disorders through adulthood. Identifying the earliest antecedents of persisting emotional and behavioral dysregulation can inform risk detection practices and targeted interventions to promote adaptive developmental trajectories among at-risk children.ObjectiveTo characterize children’s emotional and behavioral regulation trajectories and examine risk factors associated with persisting dysregulation across early childhood.Design, Setting, and ParticipantsThis cohort study examined data from 20 United States cohorts participating in Environmental influences on Child Health Outcomes, which included 3934 mother-child pairs (singleton births) from 1990 to 2019. Statistical analysis was performed from January to August 2022.ExposuresStandardized self-reports and medical data ascertained maternal, child, and environmental characteristics, including prenatal substance exposures, preterm birth, and multiple psychosocial adversities.Main Outcomes and MeasuresChild Behavior Checklist caregiver reports at 18 to 72 months of age, with Dysregulation Profile (CBCL-DP = sum of anxiety/depression, attention, and aggression).ResultsThe sample included 3934 mother-child pairs studied at 18 to 72 months. Among the mothers, 718 (18.7%) were Hispanic, 275 (7.2%) were non-Hispanic Asian, 1220 (31.8%) were non-Hispanic Black, 1412 (36.9%) were non-Hispanic White; 3501 (89.7%) were at least 21 years of age at delivery. Among the children, 2093 (53.2%) were male, 1178 of 2143 with Psychosocial Adversity Index [PAI] data (55.0%) experienced multiple psychosocial adversities, 1148 (29.2%) were exposed prenatally to at least 1 psychoactive substance, and 3066 (80.2%) were term-born (≥37 weeks’ gestation). Growth mixture modeling characterized a 3-class CBCL-DP trajectory model: high and increasing (2.3% [n = 89]), borderline and stable (12.3% [n = 479]), and low and decreasing (85.6% [n = 3366]). Children in high and borderline dysregulation trajectories had more prevalent maternal psychological challenges (29.4%-50.0%). Multinomial logistic regression analyses indicated that children born preterm were more likely to be in the high dysregulation trajectory (adjusted odds ratio [aOR], 2.76; 95% CI, 2.08-3.65; P &lt; .001) or borderline dysregulation trajectory (aOR, 1.36; 95% CI, 1.06-1.76; P = .02) vs low dysregulation trajectory. High vs low dysregulation trajectories were less prevalent for girls compared with boys (aOR, 0.60; 95% CI, 0.36-1.01; P = .05) and children with lower PAI (aOR, 1.94; 95% CI, 1.51-2.49; P &lt; .001). Combined increases in PAI and prenatal substance exposures were associated with increased odds of high vs borderline dysregulation (aOR, 1.28; 95% CI, 1.08-1.53; P = .006) and decreased odds of low vs high dysregulation (aOR, 0.77; 95% CI, 0.64-0.92; P = .005).Conclusions and RelevanceIn this cohort study of behavioral dysregulation trajectories, associations were found with early risk factors. These findings may inform screening and diagnostic practices for addressing observed precursors of persisting dysregulation as they emerge among at-risk children.
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Reddy, Akhila Sunkepally, Maxine Grace Jaucian De La Cruz, Eden Mae Rodriguez, Jessica Thames, Jimin Wu, Gary B. Chisholm, Diane Liu et al. "Storage, disposal, and utilization of opioids among cancer outpatients." Journal of Clinical Oncology 31, n.º 31_suppl (1 de novembro de 2013): 222. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.222.
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222 Background: Prescription opioid abuse is an epidemic in the US. Of the abusers, 75% obtain the opioid from a friend or relative, which may be related to improper opioid storage and disposal practices. Our aim was to determine patients’ practices of opioid use, storage, and disposal. Methods: We surveyed 300 cancer outpatients presenting to our Supportive Care Center who were receiving opioids for at least 1 month and collected information regarding opioid use, storage, and disposal along with patient characteristics and scores on Cut-down, Annoyed, Guilty, Eye-opener (CAGE) questionnaire for alcoholism. Sharing or losing their opioids was defined as an unsafe use. Results: The median age of the patients was 57 years; 53% were female, 72% were white, and 63% were married. Most (89%) had advanced cancer, and lung cancer was the most common (22%). CAGE was positive in 19%, 9% had history of illicit drug use, and 36% lived with adult/young adult children. Of the 300 respondents, 19% stored opioids in the open, 69% kept opioids hidden but unlocked, and 9% locked their opioids. Patients with history of CAGE positivity (P=.007), illicit drug use (.0002), smoking (P=.03), and those living with adult children (P=.004) were more likely to keep their opioids locked. 66% were unaware of proper opioid disposal methods. 46% had unused opioids at home. 53% did not routinely dispose opioids, of whom 44% saved them for future use. 26% indulged in unsafe use by sharing (9%) or losing (17%) their opioids, and 44% informed their family and friends that they were on pain medications. 39% were unaware that their opioid could be fatal when taken by others. Compared with married patients, those who were never married [OR=2.92; 95% CI 1.48-5.77], separated [OR=11.38; 1.52-112.5], or divorced [OR=1.27; 0.55-2.91] had higher odds of unsafe use (P=.006). CAGE positivity (40% vs. 21%, P=.003) and illicit drug use (42% vs. 23%, P=.031) were also significant predictors of unsafe use. Conclusions: An alarming proportion of patients improperly and unsafely use, store, and dispose of opioids. Patient education by physicians/pharmacists and creation of more drug take back programs may reduce availability of prescription opioids for potential abuse. More research is needed in this area.
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LIU, Q., C. WANG, G. GUO, W. Z. YANG, K. H. DONG, Y. X. HUANG, X. M. YANG e D. C. HE. "Effects of calcium propionate on rumen fermentation, urinary excretion of purine derivatives and feed digestibility in steers". Journal of Agricultural Science 147, n.º 2 (23 de janeiro de 2009): 201–9. http://dx.doi.org/10.1017/s0021859609008429.
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SUMMARYThe objective of the current study was to evaluate the effects of calcium propionate supplementation on rumen fermentation, urinary excretion of purine derivatives (PD) and feed digestibility in the total gastrointestinal tract of steers. Eight ruminally cannulated Simmental steers (462±14 kg) were used in a replicated 4×4 Latin square arrangement of treatments with experimental periods of 21 days. The treatments were: control (without calcium propionate), LCaP (calcium propionate – low), MCaP (calcium propionate – medium) and HCaP (calcium propionate – high) with 100, 200 and 300 g calcium propionate per steer per day. Diet consisted of 0·60 maize stover and 0·40 concentrate (dry matter (DM) basis). DM intake (average 9 kg/day) was restricted to a maximum of 0·90 ofad libitumintake. Ruminal pH (range of 6·7–6·5) linearly (P<0·003) and quadratically (P<0·005) decreased, and total volatile fatty acid (VFA) concentration (range of 64·4–67·1 mm) tended (P<0·087) to increase linearly with rising calcium propionate supplementation. Ratio of acetate to propionate fell linearly (P<0·006) and quadratically (P<0·008) from 3·5 to 2·6 as calcium propionate supplementation increased due to the additional propionate supplementation.In situruminal neutral detergent fibre (NDF) degradation of maize stover and crude protein (CP) degradability of concentrate mix were improved with increasing concentration of calcium propionate. Urinary excretion of PD was linearly (P<0·032) and quadratically (P<0·048) increased with greater calcium propionate supplementation (72, 74, 77 and 76 mmol/day for control, LCaP, MCaP and HCaP, respectively). Similarly, digestibilities of organic matter (OM), NDF and CP in the total tract were also linearly and quadratically improved with increasing calcium propionate. The results indicate that the calcium propionate supplementation potentially improves rumen fermentation and feed digestion in beef cattle. It is speculated that calcium propionate stimulates the digestive microorganisms or enzymes in a dose-dependent manner. In the experimental conditions of the current trial, the optimum calcium propionate dose was about 200 g calcium propionate per steer per day.
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Siegel, David S., Jesus G. Berdeja, Jeffrey R. Infante, Jonathan L. Kaufman, Michael (Luhua) Wang, Thomas G. Martin, Ruben Niesvizky et al. "Updated Results from a Phase 2 Extension Study of Patients with Multiple Myeloma or Solid Tumors Previously Enrolled in Carfilzomib Company-Sponsored Phase 1 and 2 Clinical Trials (PX-171-010)". Blood 124, n.º 21 (6 de dezembro de 2014): 2134. http://dx.doi.org/10.1182/blood.v124.21.2134.2134.
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Abstract Introduction: PX-171-010 (010; NCT00884312) is an extension study of patients who completed a phase 1 or 2 carfilzomib study that aims to provide insights into the long-term tolerability, safety, and clinical benefit of carfilzomib. Methods: Patients who completed a carfilzomib study were eligible to enroll and continue receiving carfilzomib at the same dosing level, with dose adjustments permitted per protocol. Addition of other approved anticancer agents at the time of progression was allowed. The primary end point was safety; efficacy was also evaluated. Results: Between 2009 and 2012, patients with multiple myeloma (MM; n=91) or solid tumors (ST; n=9) were enrolled in this extension study. Patients were enrolled from the PX-171-002, PX-171-003-A0, PX-171-003-A1, PX-171-004, PX-171-005, PX-171-006, PX-171-007, and PX-171-008 studies (Table 1). Among patients with MM, 57.1% had prior bortezomib exposure and 95.6% had prior immunomodulatory agent (IMiD) exposure; 37.4% were refractory to bortezomib, 61.5% were refractory to an IMiD, and 31.9% were refractory to both bortezomib and an IMiD. In the initial studies, patients received 15–70 mg/m2 carfilzomib. In 010, patients received a median dose of 27 mg/m2 carfilzomib (range, 13–52 mg/m2). Median duration of carfilzomib treatment (initial study+010) was 88.9 weeks (range, 4.4–273.4 weeks). Median number of carfilzomib treatment cycles was 22.5 (range, 2–67); 60.0% of patients received carfilzomib for ≥19 cycles and 27.0% for ≥37 cycles. Treatment-emergent grade ≥3 adverse events (AEs) and serious AEs are presented in Table 2. Twenty-three patients (23.0%) had treatment-emergent AEs that led to discontinuation of study treatment, including 18 patients with MM (19.8%). Eight patients (8.0%) died on the 010 study or within 30 days of last dose of study drug, including 7 patients with MM (4 deaths due to AEs, 3 due to disease progression). One patient with ST died due to disease progression. The 4 AE deaths were due to myocardial infarction (MI; n=2), pneumonia (n=1), and pneumonia with MI (n=1). The 3 patients with MI had pre-existing cardiac disease and died after 9–47 cycles on study. None of the 8 deaths were assessed as carfilzomib-related. Overall, 74 patients (74.0%) had ≥1 regimen change. Among patients with MM, 72 patients (79.1%) had ≥1 regimen change; 22 (30.6%) of these patients continued receiving single-agent carfilzomib at a different dose/schedule, and 50 (69.4%) received additional combination therapy, including 48 patients (66.7%) who received dexamethasone, 26 (36.1%) who received lenalidomide, and 25 (34.7%) who received cyclophosphamide. Notably, responses were observed among patients with MM after regimen change due to disease progression: the overall response rate was 20.0% after first progression, 35.0% after second progression, and 30.8% after third progression. Conclusion: The types and rates of AEs in 010 were similar to those previously reported with single-agent carfilzomib. Patients were able to receive carfilzomib for an average of 89 weeks (up to 273 weeks; median of 22.5 treatment cycles) and continued receiving clinical benefit, with no new significant safety signals noted from additional cumulative exposure. Table 1 Patient Enrollment in PX-171-010 by Initial Study Table 1. Patient Enrollment in PX-171-010 by Initial Study Table 2 Treatment-Emergent Grade ≥3 or Serious AEs Occurring in ≥5% of Patients in PX-171-010 Table 2. Treatment-Emergent Grade ≥3 or Serious AEs Occurring in ≥5% of Patients in PX-171-010 Disclosures Off Label Use: Carfilzomib as treatment in multiple myeloma and solid tumors. Kaufman:Millennium: Consultancy, Honoraria; Celgene: Consultancy, Honoraria, Research Funding; Novartis: Consultancy, Honoraria, Research Funding; Onyx: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria; Spectrum: Consultancy, Honoraria; Merck: Research Funding. Wang:Onyx: Honoraria, Research Funding. Martin:Sanofi: Research Funding; Novartis: Speakers Bureau. Niesvizky:Celgene: Consultancy, Research Funding, Speakers Bureau; Millennium: Consultancy, Research Funding, Speakers Bureau; Onyx: Consultancy, Research Funding, Speakers Bureau. Reu:Onyx: Consultancy, Speakers Bureau. Jagannath:Millennium: Honoraria; Celgene: Honoraria; Onyx: Honoraria; Merck: Honoraria; Ortho Biotech: Membership on an entity's Board of Directors or advisory committees; Imedex: Membership on an entity's Board of Directors or advisory committees; Medicom Worldwide: Membership on an entity's Board of Directors or advisory committees; Optum Health Worldwide: Membership on an entity's Board of Directors or advisory committees; PER group: Membership on an entity's Board of Directors or advisory committees. Rajangam:Onyx Pharmaceuticals, an Amgen subsidiary: Employment, Equity Ownership. Huang:Onyx Pharmaceuticals: Employment. Vij:Celgene: Honoraria, Research Funding; Onyx: Honoraria, Research Funding; Sanofi: Honoraria; Jannsen: Honoraria; Novartis: Honoraria; Millennium: Honoraria; Array: Honoraria.
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Briantio, Alfred, Sobron Yamin Lubis e Steven Darmawan. "ANALISIS PENINGKATAN TERJADINYA KEAUSAN MATA PAHAT KERAMIK PADA PROSES PEMOTONGAN BAJA AISI 4340". Jurnal Serina Sains, Teknik dan Kedokteran 2, n.º 1 (1 de março de 2024): 15–26. http://dx.doi.org/10.24912/jsstk.v2i1.31648.
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Proses pemotongan logam tidak dapat dipisahkan dengan penggunaan mata pahat potong. Sifat-sifat mata pahat potong memberi spesifikasi tersendiri terhadap parameter pemotongan. Pertimbangan utama yang dilakukan dalam pemilihan mata pahat potong bergantung pada jenis benda kerja yang digunakan dan proses pemotongan yang dilaksanakan. Berkembangnya bahan benda kerja terutama dalam menghasilkan sifat sifat yang memiliki ketahanan tinggi terhadap kekerasan dan juga suhu pemotongan hal tersebut memicu perkembangan jenis bahan mata pahat potong tersebut. Salah satu jenis mata pahat yang memiliki kekerasan dan ketahanan terhadap temperatur tinggi adalah keramik. Namun demikian, jika digunakan secara kontinu mata pahat akan mengalami keausan. Penelitian ini dilaksanakan bertujuan untuk mengetahui peningkatan terjadinya keausan pada mata pahat keramik ketika melakukan pemotongan baja paduan yang keras seperti AISI 4340. Percobaan dilakukan dengan menggunakan mesin bubut konvensional. jenis mata pahat digunakan dalam penelitian ini yaitu mata pahat keramik type TNGA 160404T02025. Parameter pemotonagan terdiri Kecepatan pemotongan : 140 m/min, 220 m/min, 350 m/min, Putaran spindel : 350 r/min, 710, r/min, 1120 r/min, Kedalaman pemotongan : 0.06 mm, 0.08 mm, 1.00 mm, Hantaran pemotongan : 0.2 mm. Proses pembubutan dilakukan dengan rentang waktu 3menit, maka setiap rentang waktu tersebut pembubutan dihentikan dan dilakukan pengamatan dan pengukuran keausan pada mata pahat. Mata pahat dianggap aus jika telah mencapai nilai 0.3 mm. Dari hasil penelitian diperoleh bahwa kecepatan potong (Vc) berpengaruh terhadap waktu penggunaan mata pahat sisipan. Semakin tinggi kecepatan potong (Vc) maka semakin rendah nilai waktu penggunaan mata pahat sisipan. Nilai keausan mata pahat tercepat yaitu pada menit ke-9 dengan kecepatan potong 350 m/min serta kedalaman potong 0,1 mm dan nilai keausan mata pahat terlama pada menit ke-72 pada kecepatan potong 140 m/menit dan kedalaman potong 0,06 mm.
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Garifullin, Andrey, Sergei Voloshin, Sergey Linnikov, Irina Martynkevich, Alexey Kuvshinov, Anastasiya Kuzyaeva, Zhanna Chubukina et al. "The Prognostic Significance of Minimal Residual Disease in Multiple Myeloma in the Molecular Genetic Groups Msmart 3.0". Blood 136, Supplement 1 (5 de novembro de 2020): 42. http://dx.doi.org/10.1182/blood-2020-139239.
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Assessment of the role of genetic abnormalities and minimal residual disease (MRD) is an active developing area in hematology. The use of genetic methods makes it possible to predict the course of the disease and apply an individualized approach to antimyeloma therapy. At the same time, the identification of MRD after therapy determines possibility of relapse. Aim. To identify the prognostic potential of MRD in patients in the standard and high molecular risk groups. Materials and methods. We analyzed 72 patients with MM (median age was 59 years (range 37-80), male/female - 1.3:1). All patients received initial therapy with proteasome inhibitors and / or immunomodulators. High dose therapy (MEL200) and autologous stem cell transplantation (ASCT) was carried out 50 (69%) patients. Standard cytogenetic and FISH methods were used to stratify patients in risk groups of mSMART 3.0. The standard risk (SR) was established in 52 (72%) patients, the high risk (HR) - in 20 (28%) patients. The MFC MRD status of bone marrow was evaluated after 4-6 cycles of induction therapy or after ASCT with use of 5-colors flow cytometry. MRD-negative status (MRD-) was based on level of clonal plasma cells <10-4 in bone marrow sample. Results. The MRD- was reached in 36% (26/72) patients. The median of OS in MRD+ group was 104 months, in MRD- was 146 months (p=.01). The median of PFS in MRD+ group was 26 months, in MRD- was 70 months (p=.00021). 2-years PFS in MRD+ group was 56%, in MRD- group was 100% (p=.00021). We divided patients into the following groups for evaluation the effect of MRD on survival in risk groups: SR МRD+ 34/72 (47%), SR МRD- 18/72 (25%), HR МRD+ 12/72 (17%) and HR MFC МRD- 8/72 (11%). The median of OS in HR MRD+ group was 72 months, in SR MRD+ - 104 months, in HR MRD- - 146 months, in SR MRD- was not achieved (p=.02). The median of PFS in HR MRD+ group was 24 months, in SR MRD+ - 26 months, in HR MRD- - 68 months, in SR MRD- - 70 months (p=.003). The 2-years PFS in HR MRD+ group was 44%, in SR MRD+ group was 50% and in SR MRD- and HR MRD- groups were 100% (p=.003). Conclusion. The absence of MRD is the most important prognostic factor. The leveling of negative effect of genetic abnormalities become possible when the MRD-negative response status is achieved. Presumably, this is due to the elimination of clonal plasma cells owing to the use of optimal antimyeloma therapy which is based on the risk stratification. Disclosures Martynkevich: Pfizer: Honoraria, Speakers Bureau; BMS: Honoraria, Speakers Bureau; Novartis: Honoraria, Speakers Bureau. Shuvaev:Novartis: Honoraria, Speakers Bureau; BMS: Honoraria, Speakers Bureau; Pfizer: Honoraria, Speakers Bureau.
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Lawal, Folake B., e Omotayo F. Fagbule. "Knowledge of School-Going Adolescents About the Oral Effects of Tobacco Usage in Ibadan, Southwest Nigeria". International Quarterly of Community Health Education 40, n.º 4 (22 de dezembro de 2019): 337–43. http://dx.doi.org/10.1177/0272684x19896730.
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Background The individual knowledge of the effects of tobacco usage on health plays an important role in its uptake. Tobacco consumption usually starts during adolescence, and lack of knowledge about the oral problems of tobacco usage probably plays a role in it. Aim To determine the knowledge of adolescents about the effect of tobacco usage on oral health. Methods A cross-sectional study was conducted among 1,465 adolescents aged 12 to 20 years who attended senior secondary schools in a major city in Nigeria. Data were obtained through a semistructured questionnaire. Data obtained were analyzed with SPSS. Results The mean age of respondents was 15.2 (±1.4) years. Only 40 (2.7%) of them used tobacco at the time of study and 992 (67.7%) said that tobacco usage has effect(s) on oral health. The main effects mentioned were mouth odor: 338 (34.1%); teeth discoloration: 297 (29.9%); tooth decay: 138 (13.9%); damage to teeth: 72 (7.3%); lip discoloration: 39 (3.9%); and oral cancer: 11 (1.1%). It was found that female respondents (72.1%, odds ratio = 1.4, confidence interval = 1.1–1.7, p = .005); those aged 12 to 15 years (73.6%, odds ratio = 2.0, confidence interval = 1.6–2.5, p < .001); and children of skilled workers (73.4%, odds ratio = 1.9, confidence interval = 1.2–3.0, p = .008) were more likely to mention that tobacco has adverse effect(s) on oral health. Conclusion Although two thirds of the students knew that tobacco usage has effects on oral health, there were gross inadequacies in the knowledge and misconceptions about those effects.
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Smith, Brian J., Stephen M. Kirschner e Lon V. Kendall. "Pharmacokinetics of Sustained-release, Oral, and Subcutaneous Meloxicam over 72 Hours in Male Beagle Dogs". Journal of the American Association for Laboratory Animal Science 59, n.º 6 (1 de novembro de 2020): 737–41. http://dx.doi.org/10.30802/aalas-jaalas-19-000155.
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In cynomolgus macaques, plasma levels of sustained-release formulations of meloxicam meet or exceed efficacious concentrations for 48 to 72 h, thereby allowing less animal handling and providing more consistent efficacy than standard formulations of meloxicam. The goal of this study was to compare the pharmacokinetics of a single subcutaneous dose of a sustained-release formulation of meloxicam (Melox-SR) with those of oral (Melox-PO) and standard subcutaneous (Melox-SC) formulations dosed every 24 h for 3 consecutive days. Dogs (5 or 6 adult male Beagles) each received the following 3 treat- ments: first, Melox-SR (10 mg/mL, 0.6 mg/kg SC once), next Melox-SC (0.2 mg/kg SC once, followed by 0.1 mg/kg SC every 24 h), and finally Melox-PO (same dosage as Melox-SC), with a washout period of at least 2 wk between formulations. Blood was collected at 0 (baseline), 1, 4, 8, 12, 24, 48, and 72 h after the initial administration of each formulation for comparison of meloxicam plasma concentrations. Blood was also collected before administration and at 48 h after Melox-SR injection for CBC and chemistry analysis. Plasma concentrations (mean ± 1 SD) of Melox-SR peaked at the 1-h time point (2180 ± 359 ng/ mL), whereas those of Melox-PO (295 ± 55 ng/mL) and Melox-SC (551 ± 112 ng/mL) peaked at the 4-h time point. Melox-SR yielded significantly higher plasma concentrations than Melox-PO and Melox-SC until the 48 and 72-h time points, respec- tively. Melox-SC plasma concentrations were significantly higher than those of Melox-PO at 4, 8, 12, 24, 48 and 72 h. No lesions were noted at the Melox-SR injection sites, and Melox-SR administration was not associated with changes in the CBC and serum chemistry panels. A single 0.6-mg/kg dose of Melox-SR can yield plasma concentrations that exceed 350 ng/mL for at least 72 h in adult male dogs.
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Tewari, Nitesh, Vijay Prakash Mathur, Rigzin Tamchos e Morankar Rahul. "Oral manifestations of lamellar ichthyosis in association with rickets". BMJ Case Reports 13, n.º 7 (julho de 2020): e235008. http://dx.doi.org/10.1136/bcr-2020-235008.
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Lamellar ichthyosis (LI) is a rare genetic condition that affects the skin, with an incidence of less than 1:300 000 in different parts of the world. This report describes a case of a 5-year-old girl with LI and rickets presenting with premature loss of 51, 52, 61, 62 and 71, grade II mobility in 72, 73, 81, 82 and 83 along with loss of supporting bone with 53, 63, 72, 73, 82 and 83. This is the first report describing oral manifestations of this combination of LI and rickets.
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Snydman, David R., Maureen Donnelly-Reidy, Linda K. Perry e William J. Martin. "Intravenous Tubing Containing Burettes Can Be Safely Changed at 72 Hour Intervals". Infection Control 8, n.º 3 (março de 1987): 113–16. http://dx.doi.org/10.1017/s019594170006728x.
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AbstractNo studies testing the safety of changing intravenous systems containing in-line burettes at 72 hours in an intensive care setting have been performed. Patients entering a medical or surgical intensive care unit were alternatively assigned to have any line with an in-line burette changed at either 48 hour (105 patients) or 72 hour (65 patients) intervals. Daily quantitative cultures with a 2 ml aliquot of burette fluid were obtained. Contaminated burette fluid was detected in 60 of 1181 (5.0%, 95% confidence interval, 3.7% to 6.3%) samples from the burettes changed at 48 hour intervals, and in 40 of 901 (4.4%, 95% confidence interval, 3.0% to 5.8%) samples from 72 hour interval burettes. Significant bacterial contamination of burette fluid, defined as ten or more colonies per milliliter, occurred in only seven (0.6%) cultures from patients in the 48 hour interval group compared with only three (0.3%) cultures in the 72 hour group. None of the contaminated burette fluids was associated with a primary bacteremia. Change of inline burettes in patients in intensive care at 72-hour intervals is safe and should result in substantial cost savings to hospitals.
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Gonzalez-Angulo, Ana M., Jennifer K. Litton, Kristine R. Broglio, Funda Meric-Bernstam, Ronjay Rakkhit, Fatima Cardoso, Florentia Peintinger et al. "High Risk of Recurrence for Patients With Breast Cancer Who Have Human Epidermal Growth Factor Receptor 2–Positive, Node-Negative Tumors 1 cm or Smaller". Journal of Clinical Oncology 27, n.º 34 (1 de dezembro de 2009): 5700–5706. http://dx.doi.org/10.1200/jco.2009.23.2025.
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Purpose To evaluate the risk of recurrence in women diagnosed with T1a and T1b, node-negative, human epidermal growth factor receptor 2 (HER2) –positive breast cancer. Methods We reviewed 965 T1a,bN0M0 breast cancers diagnosed at our institution between 1990 and 2002. Dedicated breast pathologists confirmed HER2 positivity if 3+ by immunohistochemistry or if it had a ratio of 2.0 or greater by fluorescence in situ hybridization (FISH). Patients who received adjuvant chemotherapy or trastuzumab were excluded. Kaplan-Meier product was used to calculate recurrence-free survival (RFS) and distant recurrence–free survival (DRFS). Cox proportional hazard models were fit to determine associations between HER2 status and survival after adjustment for patient and disease characteristics. Additionally, 350 breast cancers from two other institutions were used for validation. Results Ten percent of patients had HER2-positive tumors. At a median follow-up of 74 months, there were 72 recurrences. The 5-year RFS rates were 77.1% and 93.7% in patients with HER2-positive and HER2-negative tumors, respectively (P < .001). The 5-year DRFS rates were 86.4% and 97.2% in patients with HER2-positive and HER2-negative tumors, respectively (P < .001). In multivariate analysis, patients with HER2-positive tumors had higher risks of recurrence (hazard ratio [HR], 2.68; 95% CI, 1.44 to 5.0; P = .002) and distant recurrence (HR, 5.3; 95% CI, 2.23 to 12.62; P < .001) than those with HER2-negative tumors. Patients with HER2-positive tumors had 5.09 times (95% CI, 2.56 to 10.14; P < .0001) the rate of recurrences and 7.81 times (95% CI, 3.17 to 19.22; P < .0001) the rate of distant recurrences at 5 years compared with patients who had hormone receptor–positive tumors. Conclusion Patients with HER2-positive T1abN0M0 tumors have a significant risk of relapse and should be considered for systemic, anti-HER2, adjuvant therapy.
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Gopal, Ajay K., Oliver W. Press, Jonathan R. Fromm, Shani Wilbur e John M. Pagel. "I-131-Anti-CD45 Radioimmunotherapy Effectively Targets and Treats T-Cell Non-Hodgkin’s Lymphoma". Blood 112, n.º 11 (16 de novembro de 2008): 880. http://dx.doi.org/10.1182/blood.v112.11.880.880.
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Abstract T-cell non-Hodgkin lymphoma (T-NHL) exhibits inferior remission durations and survival rates compared to B-cell NHL. This may be at least partially due to the paucity of targeted therapies and the absence of approved radioimmunoconjugates available for T-NHL. The CD45 antigen is expressed on ~90% of T-NHL and is not readily internalized or shed, making it an appealing target for radioimmunotherapy (RIT). In order to test this hypothesis, we first demonstrated that CD45 was expressed in high copy numbers on the surface of human T-NHL samples and T-NHL cell lines with a median of 3.4×105 CD45 molecules/cell on T-NHL lines (CCRF-CEM, Karpas 299) and 2.25×105 CD45 molecules/cell on patient derived T-NHL specimens (T-LBL, CTCL, NK/T-NHL). We employed an athymic murine xenograft model with the above human T-NHL lines to show that targeting human CD45 could deliver more radioactivity to tumor nodules than to normal tissues. Mice with palpable human T-NHL xenografts were injected with 131I-labeled BC8 (a murine anti-human CD45 antibody [Ab]) and an 125I-labeled murine isotype matched nonbonding control Ab (BHV1). CCRF-CEM xenografts targeted with 131I-BC8 demonstrated 86% (p=.003) and 106% (p=.001) more radioiodine retention at 24h and 48h, respectively, compared to xenografts targeted with the control BHV1 Ab. More importantly, tumor sites exhibited 1.6 (p=.045), 2.4 (p=.008), and 2.7 (p=.007)-fold 131I retention compared to the lungs, liver, and kidneys, respectively (CCRF-CEM, 24h). Similar results were observed at later time points and with other T-NHL lines. We next hypothesized that this preferential tumor targeting would translate into improved tumor control and survival using therapeutic doses of 131I-BC8. Mice with palpable T-NHL xenografts (CCRF-CEM) were randomly assigned to receive 200μg of BC8 labeled with either 300 or 400μCi of 131I, 200μg of BHV-1 (control) labeled with 300μCi 131I, or no treatment. Tumor dimensions and survival were tracked. By day 9, complete remissions (CR) were attained in 90% of mice treated with 400 μCi of 131I-BC8 and 67% of mice that received 300 μCi of 131I-BC8 (Figure). In contrast, none of the untreated control mice or mice that received 300 μCi of 131I-BHV-1 achieved CR (p<0.0001). All 20 mice in the 2 control groups required euthanasia due to tumor growth, whereas only 4 of 20 of the mice in experimental arms needed to be sacrificed due to disease progression and unmaintained remissions persisted for over 72 days following therapy. Since CD45 is also expressed on most normal hematopoietic tissues, we evaluated the ability of anti-CD45 RIT to preferentially localize to tumor and hematolymphoid sites in a syngeneic model targeting murine CD45. Mice with palpable EL-4 (murine T-NHL) xenografts were treated with 200 μg of 131I-30F11 (anti-murine CD45) followed by harvest of tumor sites and normal organs. In this syngeneic model, the ratios of retained radioactivity in tumor sites to critical non-target sites were: lung 5.3 (p<.001), liver 5.4 (p<.001), and kidney 8.7 (p<.001). Comparable ratios were seen when other target sites (marrow, spleen) were compared to normal non-target organs. These data indicate that CD45 is highly expressed on T-NHL, allows reliable antibody targeting of tumor sites in both xenogeneic and syngeneic models, and translates into significantly improved control of T-NHL xenografts. These results support the hypothesis that CD45-targed RIT transplant conditioning regimens may improve outcomes for patients with relapsed/refractory T-NHL. Figure: Tumor volumes of T-NHL xenografts after treatment with 131I-BC8 (anti-CD45), 131I-BHV1 (control), or no-treatment. Figure:. Tumor volumes of T-NHL xenografts after treatment with 131I-BC8 (anti-CD45), 131I-BHV1 (control), or no-treatment.
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Lenart, Sylvia, e Nayak L. Polissar. "Comparison of 2 Methods for Postpyloric Placement of Enteral Feeding Tubes". American Journal of Critical Care 12, n.º 4 (1 de julho de 2003): 357–60. http://dx.doi.org/10.4037/ajcc2003.12.4.357.
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• Background Multiple techniques are available for postpyloric placement of feeding tubes. Administration of metoclopramide and air insufflation are easily accomplished at the bedside. Variable success rates have been reported for both procedures. • Objectives To determine which method, administration of 10 mg of metoclopramide or gastric insufflation of 350 mL of air, is superior for successful postpyloric placement of feeding tubes at the bedside. • Methods A prospective trial consisting of 60 adult patients randomized to have a feeding tube placed by 1 of 2 methods, either after intravenous administration of 10 mg of metoclopramide or via gastric insufflation of 350 mL of air. Placement results were confirmed by radiography. • Results Among patients receiving narcotics, the 72% successful placement rate with insufflation was significantly better than the 11% success rate achieved with metoclopramide (P < .001). Among the narcotic-free patients, the 83% success rate with metoclopramide was not significantly better than the 58% success rate with insufflation (P = .37). The difference in treatment effect between narcotic and narcotic-free groups was significant (P < .001). • Conclusion Patients receiving narcotics should have feeding tubes placed via the air insufflation technique. The use of continuous or regularly scheduled administration of narcotics significantly decreases the effectiveness of metoclopramide in successful placement of feeding tubes.
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Qiu, Chong-Rong, Qiang Fu, Jian Sui, Qian Zhang, Peng Wei, Yan Wu, Ke Zhu, Yi Lu e Peng Wan. "Analysis of Serum Endothelial Cell-Specific Molecule 1 (Endocan) Level in Type 2 Diabetes Mellitus With Acute ST-Segment Elevation Myocardial Infarction and its Correlation". Angiology 68, n.º 1 (29 de setembro de 2016): 74–78. http://dx.doi.org/10.1177/0003319716634581.
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Endothelial cell-specific molecule 1 (ESM-1; endocan) is expressed by endothelial cells, and it can be overexpressed in diabetic patients. However, little is known concerning diabetic patients with acute ST-segment elevation myocardial infarction (STEMI). Therefore, we assessed serum ESM-1 level in patients having type 2 diabetes mellitus (T2DM) STEMI; 72 patients with DM (38 with and 34 without vascular disease) and 33 individuals as a control group were included. There was a significant difference in serum ESM-1 level between the T2DM group and the control group ( P = .03). There was also a significant difference in serum ESM-1 level between the T2DM with STEMI group and newly diagnosed T2DM group without vascular disease ( P = .01). In patients with T2DM, serum ESM-1 levels correlated positively with high-sensitivity C-reactive protein levels and the neutrophil to lymphocyte ratio ( r = .321, P = .006 and r = .320, P = .006). Our findings suggest that serum ESM-1 level may be a novel endothelial dysfunction biomarker and it may be related to vascular disease in T2DM.
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Louvel, J. P., E. Primard, J. Henry, C. Houlette, A. Weinstein e A. Janvresse. "Effects of the Low-Osmolality Contrast Medium Ioversol (Optiray) on Renal Function in a Geriatric Population". Acta Radiologica 37, n.º 3P2 (maio de 1996): 950–53. http://dx.doi.org/10.1177/02841851960373p2101.
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Purpose: To assess the incidence of nephrotoxicity following i.v. injection of the iodinated low-osmolality contrast medium ioversol 300 (Optiray) in a geriatric population compared with a control group aged under 60 years, neither group presenting any associated risk factors. Material and Methods: CT with i.v. bolus injection of ioversol 300 mg I/ml was performed at a mean dose of 1.36±0.06 ml/kg (range 1–2 ml/kg b.w.) in 47 patients aged over 69 years. Serum creatinine level was measured and creatinine clearance was calculated at 24, 48 and 72 h after the examination, and compared to a reference serum creatinine value taken before CT. The findings were compared with a control group of 44 patients aged under 60 years. Results: No significant increase in serum creatinine (+0.6 mmol/l) or in creatinine clearance (+0.7 ml/min) was found during the course of 3 days after the injection. Only one patient (aged 82) presented an increase of 25% in serum creatinine (109 mmol/l). Conclusion: The trial did not demonstrate any significant difference between the 2 groups, although the elderly patients had a subclinical renal impairment revealed by the decrease of the initial creatinine clearance. The use of low-osmolality ioversol makes it possible to perform examination with an iodinated contrast agent without increasing the incidence of nephrotoxicity in elderly subjects.
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Tok Cekmecelioglu, Busra, Peter Legeza, Kavya Sinha, Pooja Tekula, Alan Lumsden e Zsolt Garami. "Preliminary Experience With Transcranial Doppler Monitoring in Patients Undergoing Carotid Artery Revascularization: Initial Observations on Cerebral Embolization Patterns". Journal for Vascular Ultrasound 45, n.º 3 (21 de julho de 2021): 104–10. http://dx.doi.org/10.1177/15443167211032371.
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Intraoperative transcranial Doppler (TCD) monitoring allows us to see intracranial blood flow changes related to endovascular and surgical manipulation in real time. This study evaluates the results of TCD monitoring during transcarotid artery revascularization (TCAR) with flow reversal, carotid endarterectomy (CEA) without shunt, with a shunt (shCEA), and transfemoral carotid artery stenting (tfCAS) with distal filter protection. Patients who underwent carotid artery revascularization with TCD monitoring were included. Patient demographics and medical history were recorded based on medical documentation. Intraoperative TCD, hemodynamics, fluoroscopy images, and surgical manipulation were recorded simultaneously with a 4-channel video recording system, and based on the recordings, the number of high-intensity signals (HITS) and middle cerebral artery (MCA) flow changes were registered. HITS during contrast injections were not included in the analysis due to the high number of artifacts. HITS were compared between the four groups, and HITS during lesion crossing/predilation/stent deployment/postdilation were compared between the tfCAS and TCAR groups. Thirty six patients were involved (mean age 69.5 ± 10.59 years; 24 male) (9 CEA; 11 shCEA; 4 tfCAS; 12 TCAR). Hypertension, diabetes mellitus, coronary artery disease, and smoking were frequent in all groups. Median number of HITS for CEA, shCEA, tfCAS, and TCAR were 5 (range: 0-90), 10 (range: 3-72), 197.5 (range: 153-340), and 29 (range: 2-74), respectively. The number of HITS during TCAR was not significantly different compared to CEA or shCEA but significantly lower than in patients receiving tfCAS ( P < .01). Procedural phases of lesion crossing, predilation, stent deployment, and postdilation were associated with significantly higher HITS during tfCAS than TCAR ( P = .002, P = .006, P = .04, P = .006, respectively). The number of embolic events during TCAR is comparable with CEA with and without a shunt and associated with a significantly lower HITS rate than tfCAS with distal filter protection. According to our results, TCAR appears to be a safer alternative to tfCAS.
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Keating, Michael J., Susan O’Brien, Maher Albitar, Susan Lerner, William Wierda e Hagop Kantarjian. "Extended Follow-Up of a Chemo-Immunotherapy Regimen FCR (Fludarabine, F; Cyclophosphamide, C; and Rituximab, R) as Initial Therapy for Chronic Lymphocytic Leukemia (CLL)." Blood 106, n.º 11 (16 de novembro de 2005): 2118. http://dx.doi.org/10.1182/blood.v106.11.2118.2118.
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Abstract Combination regimens are increasingly being used in CLL. The addition of R to F±C has increased the complete response (CR) rate in previously untreated patients (pts) with CLL. FCR was given to 300 previously untreated pts with CLL; 70.3% male, 33% Rai stage III-IV, with median value and ranges for age − 57 years (17–86), hemoglobin − 12.5G% (6.1–18.7), white cell count − 76 x 103/μl (2.1–620), platelets − 154 x 103/μl (8–406). 51% had splenomegaly. All pts fulfilled the NCIWG indications for therapy. 72% achieved CR, 10% nodular partial remission (NPR), and 12% PR. The pretreatment characteristic most strongly associated with CR was the beta-2-microglobulin level (P<.001) with significant differences between those with a value less than twice normal versus higher values. Advanced age (≥ 70 yrs), advanced stage, low hemoglobin (<11G%), low albumin (<3.6G%), and elevated BUN (>23mg%) were all significantly associated with a lower CR rate (P<.01). CD38 was not associated with CR. Mutation status, ZAP70, and FISH cytogenetics were not routinely measured. Median follow-up was 43 months (18–73). Several characteristics were associated with remission duration (R Dur). Multivariate analysis showed that (1) PCR for IgVH, (2) NCIWG response, and (3) flow responses were all independently associated with R Dur. PCR negativity for IgVH was most strongly correlated with R Dur. Seven of 79 PCR negative pts have relapsed at 31, 39, 43, 44, 62, 64, and 67 months. Response Patients 4-Yr. R Dur Θ 4-Year Surv. Flow CR† PCR Neg.$ *P<.01;𝛉Projected;†Marrow CD5+CD19<1%;$PCR IgVH CR 217 83%* 84%* 165/208 (79%) 69/160 (43%) NPR 31 64% 84% 10/27 (37%) 7/19 (37%) PR 37 38% 50% 10/26 (38%) 3/13 (23%) Overall 300 77% (CR+PR) 83% 185/261 (71%) NA There was no significant difference in survival between CR and NPR pts despite a significantly shorter R Dur (P<.01) for NPR pts. Survival was similar for progressive Rai 0-II and III-IV pts with projected four-year survival of >80%. The median survival for the 300 patients and various prognostic subgroups has not been reached. Second cancers occurred in 53 cases (20 with non-melanomatous skin cancers). Three cases of AML and 3 additional cases of myelodysplastic syndrome occurred. Autoimmune hemolytic anemia (AIHA) or red cell aplasia (RCA) occurred in 25 and 6 cases respectively. These complications remain a significant clinical problem in CLL. There was no significant difference in the IgA or IgM levels over time but a lower mean initial IgG (837±567mg%) versus 690±338mg% six months after FCR was completed (P<.005) was noted. 56/72 (78%) who failed or relapsed have been started on salvage therapy. The salvage response rate on retreatment with FCR+alemtuzumab was 9/17 (53%). More pts failing after initial CR or NPR claimed a second response (17/29, 59%) compared with the PR or refractory pts (3/20, 16%; P=.002). Multivariate analysis of characteristics associated with CR rate and survival for FCR and preceding non-R protocols demonstrated a significant advantage for FCR (P<.001). Conclusion When compared with other completed chemotherapy protocols without R, FCR significantly improved CR rate, time-to-progression and treatment failure, and overall survival establishing FCR as the most successful protocol which we have conducted to date.
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Evangelista, Lorraine S., Erin Sackett e Kathleen Dracup. "Pain and Heart Failure: Unrecognized and Untreated". European Journal of Cardiovascular Nursing 8, n.º 3 (agosto de 2009): 169–73. http://dx.doi.org/10.1016/j.ejcnurse.2008.11.003.
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Background: Although evidence exists to support the presence of pain in advanced stages of heart failure (HF), the pain experience in the early phases of this progressive disease is poorly documented, and therefore, poorly understood. The current study was conducted to: 1) examine the prevalence of pain in cohort of patients with chronic HF (New York Heart Association class I–IV); and 2) determine the relationship between pain and QOL. Methods and results: Data were obtained from 300 patients (mean age 54.2 ± 12.7 years; 72% male; 65% Caucasians; time since HF diagnosis 4.6 ± 4.8 years). Two-thirds of the patients (67%) reported some degree of pain; the prevalence of pain increased as functional class worsened ( p < .009). Differences in QOL outcomes for patients experiencing pain vs. no pain were statistically significant for physical and overall QOL. Pain accounted for 20% of the variance in QOL ( p < .001) even after adjusting for age, gender, and functional class. Conclusions: Our findings suggest pain is present in a majority of patients with HF. Given the potential deleterious effects of untreated pain on QOL in patients with HF, it is important that healthcare providers assess patients for this often-unrecognized symptom.
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Thompson, Louisa I., Jennifer R. Strenger, Sheina Emrani, Alyssa De Vito, Karra Harrington, Nelson Roque, Stephen Salloway, Martin Sliwinski e Stephen Correia. "91 Remote Smartphone-Based Assessment Predicts Standard Neuropsychological Test Performance and Cerebral Amyloid Status in Cognitively Normal Older Adults". Journal of the International Neuropsychological Society 29, s1 (novembro de 2023): 493–94. http://dx.doi.org/10.1017/s1355617723006392.
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Objective:Routine cognitive screening in the elderly may facilitate earlier diagnosis of neurodegenerative diseases and access to care and resources for patients and families. However, despite growing rates of Alzheimer's and related disorders (ADRD), the availability and implementation of cognitive screening for older adults in the US remains quite limited. Remote cognitive assessment via smartphone app may reduce several barriers to more widespread screening. We examined the validity of a remote app-based cognitive screening protocol in healthy older adults by examining remote task convergence with standard-person assessments and cerebral amyloid (Aß) status as an AD biomarker.Participants and Methods:Participants (N =117) were cognitively unimpaired adults aged 60-80 years (67.5% female, 88% White, 75% education > 16 years). A portion had Aß PET imaging results available from prior research participation [(Aß positive (Aß+) n =26, and Aß negative (Aß-) n = 44]. A modified Telephone Interview for Cognitive Status (TICSm) cutoff score of >34 was used to establish unimpaired cognition. Participants completed 8 consecutive assessment days using Mobile Monitoring of Cognitive Change (M2C2), a smartphone app-based testing platform developed as part of the National Institute of Aging's Mobile Toolbox initiative. Brief (i.e., 3-4 minute) M2C2 sessions were assigned daily within morning, afternoon, and evening time windows. Tasks included measures of visual working memory (WM), processing speed (PS), and episodic memory (EM) (see Thompson et al., 2022). Participants then completed a battery of standard neuropsychological assessments in-person at a follow-up visit.Results:Participants completed 22.6 (SD = 2.6) out of 24 assigned sessions (3 sessions x 8 days) on average. Performance on all M2C2 tasks decreased significantly with age. Women performed significantly better on WM and EM tasks relative to men. There were no detectable significant differences in performance by race or education. Shorter mean reaction time on M2C2 PS trials predicted faster Trails A and B completion (ß = .26, p < .01, 95% CI [3.8, 23.3] and ß = .20, p < .05, 95% CI [.23, 6.8], respectively). Greater mean M2C2 WM accuracy predicted longer maximum backward digital span (ß = .24, p = .01, 95% CI [.02, .16]). Greater mean M2C2 EM accuracy predicted stronger Logical Memory delayed recall (ß = .33, p < .001, 95% CI [.004, .012]) and total immediate recall on the Free and Cued Selective Reminding Test (ß = .19, p < .05, 95% CI [.000, .006]). Moreover, EM significantly distinguished Aß- and Aß+ individuals (t (68) = 3.0, p < .01) with fair accuracy (AUC = .72).Conclusions:Mean performance across 8-days on each M2C2 task predicted same-domain cognitive task performance on a standard assessment battery, with medium effect sizes. Performance on the EM task was also sensitive to cerebral Aß status, consistent with subtle memory changes implicated in the preclinical stage of AD. These findings support the validity of this remote testing protocol in healthy older adults, with implications for future efforts to facilitate accessible and sensitive cognitive screening for early detection of ADRD. Limitations include the restricted generalizability of this primarily white and college educated sample.
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Teo, Alvin Kuo Jing, Kiesha Prem, Mark I. C. Chen, Adrian Roellin, Mee Lian Wong, Hanh Hao La e Alex R. Cook. "Estimating the size of key populations for HIV in Singapore using the network scale-up method". Sexually Transmitted Infections 95, n.º 8 (9 de maio de 2019): 602–7. http://dx.doi.org/10.1136/sextrans-2018-053747.
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ObjectivesTo develop a localised instrument and Bayesian statistical method to generate size estimates—adjusted for transmission error and barrier effects—of at-risk populations in Singapore.MethodsWe conducted indepth interviews and focus group to guide the development of the survey questionnaire. The questionnaire was administered between July and August 2017 in Singapore. Using the network scale-up method (NSUM), we developed a Bayesian hierarchical model to estimate the number of individuals in four hidden populations at risk of HIV. The method accounted for both transmission error and barrier effects using social acceptance measures and demographics.ResultsThe adjusted size estimate of the population of male clients of female sex workers was 72 000 (95% CI 51 000 to 100 000), of female sex workers 4200 (95% CI 1600 to 10 000), of men who have sex with men 210 000 (95% CI 140 000 to 300 000) and of intravenous drug users 11 000 (95% CI 6500 to 17 000).ConclusionsThe NSUM with adjustment for attitudes and demographics allows national-level estimates of multiple priority populations to be determined from simple surveys of the general population, even in relatively conservative societies.
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Werk, Jessica, Kirill Tchernyshyov, Hannah Bish, Yong Zheng, Mary Putman, Joshua Peek e David Schiminovich. "The Plane Quasar Survey: First Data Release". Astrophysical Journal Supplement Series 273, n.º 2 (24 de julho de 2024): 21. http://dx.doi.org/10.3847/1538-4365/ad58df.
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Abstract We present a sample of 305 QSO candidates having ∣b∣ < 30°, the majority with GALEX magnitudes near-UV < 18.75. To generate this sample, we apply UV–IR color selection criteria to photometric data from the Ultraviolet Galactic Plane Survey as part of GALEX-CAUSE, the Million Quasars Catalog, Gaia DR2, and Pan-STARRS DR1. 165 of these 305 candidate UV-bright active galactic nuclei (AGN; 54%) have published spectroscopic redshifts from 45 different surveys, confirming them as AGN. We further obtained low-dispersion, optical, long-slit spectra with the Apache Point Observatory 3.5 m, MDM 2.4 m, and MDM 1.3 m telescopes for 84 of the candidates, and confirm 86% (N = 72) as AGN, generally with z < 0.6. Of these 72 confirmed AGN, 25 are newly discovered low-latitude QSOs without any previous spectroscopy. These sources fill a gap in the Galactic latitude coverage of the available samples of known UV-bright QSO background probes. Along with a description of the confirmed QSO properties, we provide the fully reduced, flux- and wavelength-calibrated spectra of 72 low-latitude QSOs through the Mikulski Archive for Space Telescopes. Future Hubble Space Telescope/Cosmic Origins Spectrograph spectroscopy of these low-Galactic-latitude QSOs has the potential to transform our view of the Milky Way and Local Group circumgalactic medium.
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Du, Chun-Xia, Xiao-Yan Liu, Hong-Gang Zhang e Ai-Ping Zhou. "Docetaxel plus FOLFOX4 compared with FOLFOX4 as adjuvant chemotherapy for gastric cancer." Journal of Clinical Oncology 33, n.º 3_suppl (20 de janeiro de 2015): 181. http://dx.doi.org/10.1200/jco.2015.33.3_suppl.181.
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181 Background: To compare the efficacy of docetaxel plus FOLFOX4 to FOLFOX4 as adjuvant chemotherapy for gastric cancer patients. Methods: 320 patients with stage IB-IV (M0) gastric cancer were enrolled into the retrospective study. All patients received a total or subtotal gastrectomy with at least D1 lymph nodes dissection. 193 patients received FOLFOX4 as adjuvant chemotherapy. 127 patients received biweekly docetaxel plus FOLFOX4 (DOF regimen) as adjuvant chemotherapy. Docetaxel was administered at 40 mg/m2 on day 1, followed by FOLFOX4 regimen. Both of the regimens were repeated every 2 weeks for a maximum of 12 cycles. Results: In comparison with patients in FOLFOX4 group, patients in DOF group were relatively younger (p=.001), with more advanced disease in pN stage (p=.035) and pTNM stage (p=.031), received more cycles of adjuvant chemotherapy (p=.004), and had a higher percentage of adjuvant radiation (p =.002). After adjustment of unbalanced variables as mentioned above, no statistical difference was observed between DOF group and FOLFOX4 group in terms of 3-year disease-free survival (54% vs 69%, p = 0.100, HR 1.362, 95% CI (0.943-1.967)) and 3-year overall survival(70% vs 72%, p = 0.810, HR 1.049, 95% CI (0.711-1.548)). Stratified analysis according to clinicopathologic characters showed that there were almost no statistical differences of 3-year overall survival rates between two groups, except the primary site (middle 1/3) (p =.025) and pTNM stage (IIb stage) (p =.035) in favor of FOLFOX4 group. The incidences of grade 3/4 adverse events were obviously higher in DOF group than in FOLFOX4 group,including decreased appetite (18.1% V 10.4%, P = 0.046), diarrhea (4.7% V 0%, p=0.004 ), hypersensitivity reactions to oxaliplatin (3.1% V 0%, p=0.024) and neutropenia (47.3% V 31.6%, p=0.004). Conclusions: Compared to FOLFOX4 regimen, adjuvant docetaxel plus FOLFOX4 did not show significant survival advantages in gastric cancer patients. However, a more serious toxicity profile was observed in docetaxel plus FOLFOX4 arm. Further studies are needed to decide whether triplet regimen is appropriate as adjuvant chemotherapy of gastric cancer.
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Horwich, A., D. T. Sleijfer, S. D. Fosså, S. B. Kaye, R. T. Oliver, M. H. Cullen, G. M. Mead et al. "Randomized trial of bleomycin, etoposide, and cisplatin compared with bleomycin, etoposide, and carboplatin in good-prognosis metastatic nonseminomatous germ cell cancer: a Multiinstitutional Medical Research Council/European Organization for Research and Treatment of Cancer Trial." Journal of Clinical Oncology 15, n.º 5 (maio de 1997): 1844–52. http://dx.doi.org/10.1200/jco.1997.15.5.1844.
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PURPOSE This prospective randomized multicenter trial was designed to evaluate the efficacy of carboplatin plus etoposide and bleomycin (CEB) versus cisplatin plus etoposide and bleomycin (BEP) in first-line chemotherapy of patients with good-risk nonseminomatous germ cell tumors. PATIENTS AND METHODS Between September 1989 and May 1993, a total of 598 patients with good-risk nonseminomatous germ cell tumors were randomized to receive four cycles of either BEP or CEB. In each cycle, the etoposide dose was 120 mg/m2 on days 1, 2, and 3, and the bleomycin dose was 30 U on day 2. BEP patients received cisplatin at 20 mg/m2/d on days 1 to 5 or 50 mg/m2 on days 1 and 2. For CEB patients, the carboplatin dose was calculated from the glomerular filtration rate to achieve a serum concentration x time of 5 mg/mL x minutes. Chemotherapy was recycled at 21-day intervals to a total of four cycles. RESULTS Of patients assessable for response, 253 of 268 (94.4%) of those allocated to receive BEP achieved a complete response, compared with 227 of 260 (87.3%) allocated to receive CEB (P = .009). There were 30 treatment failures in the 300 patients allocated to BEP and 79 in the 298 allocated to CEB (log-rank chi 2 = 26.9; P < .001), which led to failure-free rates at 1 year of 91% (95% confidence interval [CI], 88% to 94%) and 77% (95% CI, 72% to 82%), respectively. There were 10 deaths in patients allocated to BEP and 27 in patients allocated to CEB (log-rank chi 2 = 8.77; P = .003), which led to 3-year survival rates of 97% (95% CI, 95% to 99%) and 90% (95% CI, 86% to 94%), respectively. CONCLUSION With these drug doses and schedules, combination chemotherapy based on carboplatin was inferior to that based on cisplatin. This BEP regimen that contains moderate doses of etoposide and bleomycin is effective in the treatment of patients with good-prognosis metastatic nonseminoma.
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Latham, Robert, Ava D. Lancaster, Janet F. Covington, John S. Pirolo e Clarence S. Thomas. "The Association of Diabetes and Glucose Control With Surgical-Site Infections Among Cardiothoracic Surgery Patients". Infection Control & Hospital Epidemiology 22, n.º 10 (outubro de 2001): 607–12. http://dx.doi.org/10.1086/501830.
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AbstractObjective:To assess the importance of diabetes, diabetes control, hyperglycemia, and previously undiagnosed diabetes in the development of surgical-site infections (SSIs) among cardiothoracic surgery patients.Setting:A 540-bed tertiary-care university-affiliated hospital.Design:Prospective cohort and case-control studies.Patients:All patients having cardiothoracic surgery between November 1998 and September 1999 were eligible for participation. One thousand patients had preoperative hemoglobin Ale determinations. Seventy-four patients with SSIs were identified.Results:Diabetes (odd ratio [OR], 2.76; P<.001) and postoperative hyperglycemia (OR, 2.02; P=.007) were independently associated with development of SSIs. Among known diabetics, elevated hemoglobin Ale values were not associated with a statistically significantly increased risk of infection; the mean Ale value was 8.44% among those with infections compared with 7.80% for those without (P=.09). Forty-two (6%) of 700 patients without prior diabetes history had evidence of undiagnosed diabetes; their infection rate was comparable to that of known diabetics (3/42 [796] vs 17/300 [6%]; P=.72). An additional 30% of nondiabetics had elevated hemoglobin Ale determinations or perioperative hyperglycemia.Conclusions:Postoperative hyperglycemia and previously undiagnosed diabetes are associated with development of SSIs among cardiothoracic surgery patients. Screening for diabetes and hyperglycemia among patients having cardiothoracic surgery may be warranted to prevent postoperative and chronic complications of this metabolic abnormality.
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Ashbrook, Matthew, Maggie McGing, Vincent Cheng, Morgan Schellenberg, Matthew Martin, Kenji Inaba e Kazuhide Matsushima. "Outcomes Following Surgical and Nonsurgical Treatment for Uncomplicated Appendicitis in Older Adults". JAMA Network Open 7, n.º 8 (26 de agosto de 2024): e2429820. http://dx.doi.org/10.1001/jamanetworkopen.2024.29820.
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ImportanceThe optimal treatment of acute uncomplicated appendicitis in older adults with frailty is not defined.ObjectiveTo examine outcomes associated with treatment strategies for acute uncomplicated appendicitis in older adults with or without frailty.Design, Setting, and ParticipantsThis retrospective cohort study used National Inpatient Sample data from adults 65 years or older with a diagnosis of uncomplicated appendicitis from January 1, 2016, to December 31, 2018. Data were analyzed from July to November 2023. The National Inpatient Sample database approximates a 20% stratified sample of all inpatient hospital discharges in the US.ExposuresStudy patients were categorized into 3 groups: nonoperative management, immediate operation, and delayed operation.Main Outcomes and MeasuresClinical outcomes, including hospital complications and in-hospital mortality, were assessed among older adults with and without frailty, identified using an adapted claims-based frailty index.ResultsA total of 24 320 patients were identified (median [IQR] age, 72 [68-79] years; 50.9% female). Of those, 7290 (30.0%) were categorized as having frailty. Overall, in-hospital mortality was 1.4%, and the incidence of complications was 37.3%. In patients with frailty, multivariable analysis showed both nonoperative management (odds ratio [OR], 2.89; 95% CI, 1.40-5.98; P &lt; .001) and delayed appendectomy (OR, 3.80; 95% CI, 1.72-8.43; P &lt; .001) were associated with increased in-hospital mortality compared with immediate appendectomy. In patients without frailty, immediate appendectomy was associated with increased hospital complications compared with nonoperative management (OR, 0.77; 95% CI, 0.64-0.94; P = .009) and lower hospital complications compared with delayed appendectomy (OR, 2.05; 95% CI, 1.41-3.00; P &lt; .001).Conclusions and RelevanceIn this cohort study of older adults with uncomplicated appendicitis, outcomes differed among management strategies based on frailty status. Routine frailty assessments incorporated in the care of older adult patients may help guide discussions for shared decision-making.
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Travassos, Kaline Dantas, Hans Raj Gheyi, Helder Morais Mendes Barros, Frederico Antônio Loureiro Soares, Claudio Augusto Uyeda, Marcelo Gurgel Tavares, Nildo Da Silva Dias e René Chipana-Rivera. "Water consumption of the sunflower crop irrigatedwith saline water". DYNA 86, n.º 208 (1 de janeiro de 2019): 221–26. http://dx.doi.org/10.15446/dyna.v86n208.73203.
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The objective was to evaluate the water consumption of sunflower cultivars irrigated with saline waters. The experimental design utilized was in randomized blocks of a 2 x 4 factorial arrangement. This was composed of two levels of electrical conductivity (ECw) of irrigation water (N1 - 0.6 and N2 - 3.0 dS m-1 at 25 ºC) and four cultivars of sunflower (C1 - Helio 863, C2 - Embrapa 122-V2000, C3 - Catissol 01 and C4 - Multissol), with three replications, each of them with three plants totaling 72 experimental units. There was a reduction in water consumption of sunflower cultivars irrigated with saline water (N2 - 3.0 dS m-1). The irrigation with saline water resulted in a greater volume of drained water in all sunflower cultivars.
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Nonka, T. G., E. V. Lebedeva e A. N. Repin. "The effect of depressive disorder on the clinical presentation of coronary artery disease and five-year survival of patients after myocardial infarction". Bulletin of Siberian Medicine 21, n.º 3 (14 de outubro de 2022): 81–86. http://dx.doi.org/10.20538/1682-0363-2022-3-81-86.
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Aim. To assess the effect of depressive disorder (DD) on the clinical presentation of coronary artery disease (CAD) and five-year survival rate of patients with chronic CAD.Materials and methods. The study included 79 patients with functional class II–III exertional angina who experienced myocardial infarction more than 6 months before. The patients were divided into two groups: group 1 (n = 45) consisted of patients with CAD and depression and group 2 (n = 34) encompassed patients with CAD without depression. The clinical presentation of CAD was assessed by the results of filling out the angina pectoris self-control diary and exertion tests. The presence and severity of DD were determined using psychometric scales, such as Hospital Anxiety and Depression Scale (HADS) and Beck Depression Inventory (BDI), and verified by the psychiatrist. Information about five-year survival was obtained via telephone interviews with the patients and their relatives.Results. Patients with CAD and DD were characterized by more frequent episodes of angina pectoris during a week (10 [8; 14] vs 6 [4; 7], p = 0.000004), an increased demand for nitroglycerin (4 [0; 10] tablets vs 0 [0; 4] tablets, p = 0.001), and lower exercise tolerance (50 [25; 75] W vs 75 [50; 75] W (p = 0.06), 350 [250; 400] meters vs 435 [350; 500] meters (p = 0.01) than CAD patients without DD. The five-year survival rate was significantly lower in group 1 than in group 2 (69 [62; 72] vs 71 [68; 72] months (p = 0.04)), 35 (77.8%) vs 32 (94.1%) patients survived. In group 1, a greater number of deaths from cardiovascular accidents (10 (22.2%) vs 2 (5.9%)) was noted (log-rank test, p = 0.03).Conclusion. In patients with CAD, associated depression results in aggravation of the clinical course of CAD and poor disease prognosis, which requires timely diagnosis and treatment of DD.
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Stuart, Ivor G., John D. Koehn, Tim A. O'Brien, John A. McKenzie e Gerry P. Quinn. "Too close for comfort: a fishway exit and a hydro-power station inlet". Marine and Freshwater Research 61, n.º 1 (2010): 23. http://dx.doi.org/10.1071/mf08340.
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A major environmental issue for hydro-electric power generation is passage of fish through turbines, or entrainment onto trash racks. At Yarrawonga Weir, on the upper Murray River in south-eastern Australia, the positioning of a fish lock resulted in the potential for upstream migrating fish to be swept back into the adjacent power station by cross flows. In 2004, a 4.5-m long steel extension flume was attached to the exit to alleviate this problem. To determine the fate of native fish after exiting the extension flume, 72 individuals (305–1015 mm long) were implanted with radio-transmitters and released into the fish lock exit channel. In 2004 (power station inflows 10 300 ML day–1), the majority of fish exited successfully (44 of 45) and only a single fish (2%) was entrained into the power station. In 2005 (power station inflows 12 000 ML day–1), fish again exited successfully (26 of 27) but with a higher proportion entrained (5 of 27; 18%). This reduced success appeared to be related to strong transverse flows with high water velocities adjacent to the fish lock exit. The efficiency of fish passage at this site might be improved by altering water management strategies, integrating engineering and fish biology, and through field-testing of proposed solutions.
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Kamaraju, Sailaja, Blaise Bayer, Mingjin Chang, William Williams, Charles Wiseman e Giuseppe Del Priore. "Abstract CT204: Efficacy of Bria-IMT regimen in inducing CNS metastasis regression". Cancer Research 84, n.º 7_Supplement (5 de abril de 2024): CT204. http://dx.doi.org/10.1158/1538-7445.am2024-ct204.
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Abstract Objectives: Breast cancer metastasis to the central nervous system (CNS) often leads to severe morbidity and mortality, and while systemic treatments manage primary tumors, their impact on CNS metastases is limited. This retrospective analysis evaluates the efficacy of Bria-IMT as a monotherapy or in combination with an immune checkpoint inhibitor (ICI) on CNS tumor regression. Methods: Post-hoc analysis of a subset of advanced MBC patients with CNS metastases from previous phase 1 and 2, and ongoing randomized phase 2 trials involving SV-BR-1-GM. SV-BR-1-GM is a GM-CSF secreting, antigen-presenting immortalized breast cancer cell line. Bria-IMT (SV-BR-1-GM ~20x106 cells, intradermally 48-72 hours after cyclophosphamide 300 mg/m2, followed by interferon-alpha at the inoculation sites 2 days later) was administered q3wks. In the combination setting, an ICI was administered with each cycle. Patients A002 and 02-003 received Bria-IMT as monotherapy. Patients 06-005 and 06-007 received Bria-IMT in combination with an ICI. Results: Median pt age of 65 (range 58-70). All pts had ≥1 HLA match with SV-BR-1-GM. Significant CNS tumor regression was observed in all pts. Pt A002 (ER+/PR+, HER2-) received 6 cycles, achieving an 83% reduction in breast lesions. ~3 months after the last cycle, imaging revealed the onset of multiple brain metastases and recurrence of right breast lesions. Following 3 additional cycles, marked measurable regression in both brain metastases and breast lesions was noted. Pt 02-003 (ER-/PR-, HER2 1+ (IHC)) received 5 cycles and observed a 60% reduction (5mm ->2mm) in a left parietal periventricular lesion, and complete resolution (CR) of a left parietal lobe lesion. Pt 06-005 (ER+/PR-, HER2 1+(IHC)) demonstrated a 56% (9mm -> 4mm) reduction in the thickness of a dural lesion overlying the left anterior temporal lobe after 6 cycles of SV-BR-1-GM + ICI (pembrolizumab). After 2 additional cycles of SV-BR-1-GM + ICI (retifanlimab) and 1 cycle of SV-BR-1-GM (ICI was skipped on final cycle due to grade 2 AE), patient achieved CR of a left orbital mass observed at baseline (24mm -> 0m). Circulating cancer-associated macrophage-like cells (CAMLs) varied throughout the treatment, with levels ranged from a baseline of 90 to 24 by Cycle 13. Pt 06-007 (ER-/PR-, HER2 1+ (IHC)) demonstrated significant reductions in CNS lesions after 3 cycles of SV-BR-1-GM + ICI (pembrolizumab): a 67% reduction in a right frontal lobe lesion, 29% in the right parietal, 30% in the right thalamus, and 67% in the right precentral gyrus lesions. CAML levels remained low throughout treatment. Conclusions: This review consolidates evidence for the efficacy of the Bria-IMT regimen in CNS metastasis regression, both alone and with ICIs. The consistent regression seen across all breast cancer subtypes among heavily pretreated patients highlights the potential of SV-BR-1-GM in managing CNS metastasis. Ongoing trials will determine the full extent. Citation Format: Sailaja Kamaraju, Blaise Bayer, Mingjin Chang, William Williams, Charles Wiseman, Giuseppe Del Priore. Efficacy of Bria-IMT regimen in inducing CNS metastasis regression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr CT204.
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Cheng, Yi-Ting, Hsien-Wen Wan, Tun-Wen Pi, Jueinai Kwo e Minghwei Hong. "Microscopic Views of Ge Segregation and Scavenging Ge on Thin Si on Epi-Ge(001)". ECS Meeting Abstracts MA2022-01, n.º 19 (7 de julho de 2022): 1053. http://dx.doi.org/10.1149/ma2022-01191053mtgabs.
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Si capping layer is the most notable approach used in Ge metal-oxide-semiconductor (MOS);1-2 however, the Ge segregation and diffusion occurred during the growth of Si.3-4 The formation of undesirable GeOx is detrimental to the Ge nMOS reliability.5 This work focuses on using the scavenging process to reduce the segregated Ge atoms and to completely remove GeOx in the high-k/epi-Si/epi-Ge(001). We used high-resolution synchrotron radiation photoelectron spectroscopy (SRPES) to show the detailed development of Ge segregation and scavenging Ge using in-situ film growth, oxidation, and annealing. The Si films in 8Å thickness were grown on the epi-Ge(001) in a semiconductor molecular beam epitaxy (MBE) chamber.2 These samples were in-situ transferred to National Synchrotron Radiation Research Center in Taiwan for electronic structure studies using photoemission. Molecular oxygen was exposed to the epi-Si/epi-Ge(001) surfaces at 300°C in the photoemission chamber. The samples were then in-situ annealed at 500°C for 5 min under an ultra-high vacuum (UHV). The topmost surface of epi-Ge(001) is terminated with Ge-Ge buckled dimers.6 In the case of room-temperature grown amorphous Si (a-Si) film, the intensity of the Ge down-dimer component from the underlying epi-Ge remains as it is. The Ge up-dimer atoms were partly diffused into the a-Si film, and some of them were segregated to the top of the a-Si surface. The epi-Si grown at 260 - 280°C causes the rest of the Ge down-dimer atoms to move to the epi-Si surface to become both segregated Ge (segGe) and diffused Ge (diff-Ge). The growth of Si merely affects the topmost surface, and the Ge atoms in the second layer of the epi-Ge remain intact. A comparison of the amount of GeOx for HfO2/epi-Si/epi-Ge(001) and HfO2/epi-Ge(001) shows that the epi-Si has greatly reduced the amount of GeOx. However, the GeOx, segGe and diff-Ge components are still observed in the HfO2/epi-Si/Ge(001) samples. We have previously reported that three-time scavenging cycles have greatly reduced the amount of segGe and diff-Ge atoms in high-κ/epi-Si/n-Ge(001), thus decreasing electron traps.7 Each scavenging cycle includes room-temperature oxidation followed by thermal annealing. In this study, the oxidation of the as-grown epi-Si/epi-Ge(001) samples was performed at 300°C. It is worth noting that there is no GeOx formation on the surface after the thermal oxidation, which is different from the room-temperature oxidation of the epi-Si/epi-Ge(001) surfaces. In addition, the oxidation at 300°C affects part of the diff-Ge atoms to evaporate from the surface, which is also different from our previous work, where the diff-Ge component shows no change in intensity since the oxidation occurred at room temperature. The subsequent in-situ annealing at 500°C moved the residual Ge-boned Si (diff-Ge) inside the epi-Si to the surface to become part of the segGe atoms. In conclusion, we have used the aforementioned process to further reduce the segregated Ge, and thus the GeOx, on top of the epi-Si/epi-Ge(001). To whom the correspondence is addressed: mhong@phys.ntu.edu.tw (M. Hong), raynien@phys.nthu.edu.tw (J. Kwo), and pi@nsrrc.org.tw (T. W. Pi) Acknowledgments This work is supported by MOST 110-2112-M-002-036-, 110-2622-8-002-014-, 110-2923-M-002-001-, and 110-2112-M-213-012- of the Ministry of Science and Technology in Taiwan. Reference 1 H. Arimura, E. Capogreco, A. Vohra, C. Porret, R. Loo, E. Rosseel, A. Hikavyy, D. Cott, G. Boccardi, L. Witters, G. Eneman, J. Mitard, N. Collaert, and N. Horiguchi, IEEE Int. Electron Devices Meet., 2.1.1−2.1.4 (2020). 2 H. W. Wan, Y. J. Hong, Y. T. Cheng, C. K. Cheng, C. H. Hsu, C. T. Wu, T. W. Pi, J. Kwo, and M. Hong, M., ACS Appl. Electron. Mater. 3, 2164−2169 (2021). 3 R. Loo, H. Arimura, D. Cott, L. Witters, G. Pourtois, A. Schulze, B. Douhard, W. Vanherle, G. Eneman, O. Richard, P. Favia, J. Mitard, D. Mocuta, R. Langer, N. Collaert, ECS J. Solid State Sci. Technol. 7, 66−72 (2018). 4 Y. T. Cheng, H. W. Wan, C. K. Cheng, C. P. Cheng, J. Kwo, M. Hong, T. W. Pi, Appl. Phys. Express 13, 085504 (2020). 5 J. Franco, B. Kaczer, P. J. Roussel, J. Mitard, S. Sioncke, L. Witters, H. Mertens, T. Grasser, G. Groeseneken, IEEE Int. Electron Devices Meet., 15.2.1−15.2.4 (2013). 6 Y. T. Cheng, Y. H. Lin, W. S. Chen, K. Y. Lin, H. W. Wan, C. P. Cheng, H. H. Cheng, J. Kwo, M. Hong, T. W. Pi, Appl. Phys. Express 10, 075701 (2017). 7 Y. T. Cheng, H. W. Wan, T. Y. Chu, T. W. Pi, J. Kwo, M. Hong, ACS Appl. Electron. Mater. 3, 4484-4489 (2021).
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Comba, Atakan, Emre Demir e Nadiye Barış Eren. "Nutritional status and related factors of schoolchildren in Çorum, Turkey". Public Health Nutrition 22, n.º 1 (8 de novembro de 2018): 122–31. http://dx.doi.org/10.1017/s1368980018002938.
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AbstractObjectiveWe aimed to determine nutritional status and related factors among schoolchildren in Çorum, Central Anatolia, Turkey.DesignSchoolchildren’s height and weight were measured to calculate BMI and BMI Z-scores. Height, weight and BMI Z-scores were analysed and nutritional status classified according to the WHO.SettingCentral Anatolia, Turkey.ParticipantsSchoolchildren aged 5–17 years (n 1684) participated in study.ResultsOf children, 4·2% were stunted, 6·9% thin, 13·8% overweight and 6·6% were obese. Proportions of stunting, thinness and overweight/obesity were significantly higher in children aged >10 years (78·6, 75·0 and 64·9%, respectively) than in those aged ≤10 years (21·4, 25·0 and 35·1%, respectively; all P <0·001). Median (range) birth weight and breast-feeding duration in children with stunting (2750 (1400–3600)g; 10 (0–36) months) were significantly lower and shorter, respectively, than those of normal height (3200 (750–5500)g; 15 (0–72) months) and tall children (3500 (2500–4900)g; 18 (0–36) months; P <0·001, <0·001, 0·011 and 0·016, respectively). The same relationship was observed in thin children (3000 (1000–4500)g; 12 (0–36) months) compared with normal-weight (3200 (750–5500)g; 15 (0–72) months) and overweight/obese children (3300 (1200–5500)g; 16 (0–48) months; P=0·026, <0·001, 0·045 and 0·011, respectively).ConclusionsOverweight and obesity are health problems that must be addressed in schoolchildren. Adolescents also have a risk of double malnutrition. Promoting normal birth weight and encouraging long duration of breast-feeding are important to support normal growth in children.
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Portuguese, Andrew J., Aya Albittar, Emily C. Liang, Jennifer J. Huang, Alexandre V. Hirayama, Erik L. Kimble, Lorenzo Iovino et al. "Lisocabtagene Maraleucel Versus Axicabtagene Ciloleucel: Efficacy and Toxicity in a Real-World Setting". Blood 142, Supplement 1 (28 de novembro de 2023): 2131. http://dx.doi.org/10.1182/blood-2023-172978.
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CD19 CAR-T therapy has revolutionized the management of high-risk and relapsed/refractory (R/R) large B-cell lymphoma (LBCL) but remains limited by significant toxicities leading to morbidity/mortality and high resource utilization. Single-arm studies have suggested differences in efficacy and toxicity across FDA-approved CD19 CAR-T products. A matching-adjusted indirect treatment comparison showed comparable efficacy and more favorable safety with lisocabtagene maraleucel (liso-cel) compared to axicabtagene ciloleucel (axi-cel), but was limited to clinical trial patients (pts) and suffered from an absence of patient-level data (Maloney, J Hematol Oncol, 2021). In the absence of randomized clinical trial data, adjusted comparative analyses using pt-level data are critically needed to guide product choice. Therefore, we retrospectively evaluated the impact of CAR-T product type on the outcomes of 129 LBCL pts receiving liso-cel or axi-cel per standard of care. All LBCL pts treated at our center with liso-cel or axi-cel outside of a clinical trial between 1/2018 and 5/2023 were included. Best response was determined within 3 months of CAR-T infusion by PET-CT imaging per Lugano 2014 criteria. Cytokine release syndrome (CRS) and immune-effector cell-associated neurotoxicity syndrome (ICANS) were graded using ASTCT criteria. Of 129 total pts, 37% (n=48) and 63% (n=81) received liso-cel and axi-cel, respectively. Seven pts received out-of-specification liso-cel on an expanded access protocol. Pts who received liso-cel were older (median 67 vs 62 years, p=.003). Other baseline characteristics, including male sex (liso-cel vs axi-cel: 63% vs 69%, p=.4), HCT-CI score (1.0 vs 1.0, p=.6), pre-lymphodepletion (LD) LDH (178 vs 214 U/L, p=.14) and ALC (0.65 vs 0.60 x 10³/µL, p=.3), largest lesion diameter (3.1 vs 3.0 cm, p=.4), and extranodal disease (56% vs 56%, p>.9) were similar. The vein-to-vein time (time from leukapheresis to CAR-T infusion) was longer for liso-cel: median, 35 vs 27 days (p<.001). After liso-cel, the total inpt duration was shorter (median, 5 vs 14 days, p<.001) and fewer pts had ≥2 admissions (8.3% vs 22%, p=0.043). In pts with measurable disease prior to LD (n=113), we observed comparable efficacy with liso-cel vs axi-cel: ORR, 82% vs 77% (p=.5); CR, 56% vs 51% (p=.8). After a median follow-up of 17.7 months, we observed comparable 1-year outcomes with liso-cel vs axi-cel: duration of response (DOR), 56% vs 61% (p=.7); progression-free survival (PFS), 47% vs 47% (p=.99; Figure); and overall survival (OS), 69% vs 60% (p=.39). In pts evaluable for toxicity assessment (n=129), liso-cel was associated with lower rates of CRS and ICANS compared to axi-cel: any grade CRS, 62% vs 88% (p=.001); ICANS any grade, 32% vs 56% (p=.010); days with fever, median 2 vs 5 days (p<.001). Grade 3-4 CRS, 2.1% vs 9.9% (p=.2) or grade 3-4 ICANS, 23% vs 19% (p=0.5) were similar. We measured lower peak serum inflammatory markers after liso-cel: CRP, 58 vs 114 mg/L (p<.001); ferritin, 622 vs 1,315 ng/mL (p=0.007); IL-6, 55 vs 204 pg/mL (p=.010); and D-dimer, 1.4 vs 2.4 mg/L (p=.017). The incidence of infectious complications after liso-cel vs axi-cel was as follows: bacteremia: 6% vs 9% (p=.7); CMV viremia: 13% vs 6.2% (p=.3). Post-infusion median nadir cytopenias were less severe after liso-cel: ANC, 0.32 vs 0.04 x 10³/µL (p<.001); Plt, 69 vs 35 x 10³/µL (p=.003); and Hgb, 8.9 vs 8.2 g/dL (p<.001). Fewer pts developed severe neutropenia after liso-cel: 72% vs 93% (p=0.002). In multivariable analysis including pre-LD LDH and ALC, largest lesion diameter, age and HCT-CI score, we could not confirm an independent impact of the product type on CR, PFS, or OS ( Table). However, axi-cel remained independently associated with a higher odds of any grade CRS (adjusted OR [aOR] 4.56, 95% CI 1.65-13.5, p=.004) and any grade ICANS (aOR 3.44, 95% CI 1.42-8.85, p=.008). Our analysis of CD19 CAR-T therapy for R/R LBCL in the non-trial setting showed similar rates of durable responses following liso-cel and axi-cel. Pts who received liso-cel were older, with otherwise comparable baseline characteristics. Although liso-cel was associated with less toxicity, its vein-to-vein time was longer. In multivariable analyses, pre-LD LDH and largest lesion diameter were the only factors independently associated with response outcomes. We conclude that liso-cel is a robust alternative to other CD19 CAR-T products in older and frailer LBCL pts.
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Li, Yiran, Yan Guo, Y. Alicia Hong, Yu Zeng, Aliza Monroe-Wise, Chengbo Zeng, Mengting Zhu et al. "Dose–Response Effects of Patient Engagement on Health Outcomes in an mHealth Intervention: Secondary Analysis of a Randomized Controlled Trial". JMIR mHealth and uHealth 10, n.º 1 (4 de janeiro de 2022): e25586. http://dx.doi.org/10.2196/25586.
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Background The dose–response relationship between patient engagement and long-term intervention effects in mobile health (mHealth) interventions are understudied. Studies exploring long-term and potentially changing relationships between patient engagement and health outcomes in mHealth interventions are needed. Objective This study aims to examine dose–response relationships between patient engagement and 3 psychosocial outcomes in an mHealth intervention, Run4Love, using repeated measurements of outcomes at baseline and 3, 6, and 9 months. Methods This study is a secondary analysis using longitudinal data from the Run4Love trial, a randomized controlled trial with 300 people living with HIV and elevated depressive symptoms to examine the effects of a 3-month mHealth intervention on reducing depressive symptoms and improving quality of life (QOL). We examined the relationships between patient engagement and depressive symptoms, QOL, and perceived stress in the intervention group (N=150) using 4–time-point outcome measurements. Patient engagement was assessed using the completion rate of course assignments and frequency of items completed. Cluster analysis was used to categorize patients into high- and low-engagement groups. Generalized linear mixed effects models were conducted to investigate the dose–response relationships between patient engagement and outcomes. Results The cluster analysis identified 2 clusters that were distinctively different from each other. The first cluster comprised 72 participants with good compliance to the intervention, completing an average of 74% (53/72) of intervention items (IQR 0.22). The second cluster comprised 78 participants with low compliance to the intervention, completing an average of 15% (11/72) of intervention items (IQR 0.23). Results of the generalized linear mixed effects models showed that, compared with the low-engagement group, the high-engagement group had a significant reduction in more depressive symptoms (β=−1.93; P=.008) and perceived stress (β=−1.72; P<.001) and an improved QOL (β=2.41; P=.01) over 9 months. From baseline to 3, 6, and 9 months, the differences in depressive symptoms between the 2 engagement groups were 0.8, 1.6, 2.3, and 3.7 points, respectively, indicating widening between-group differences over time. Similarly, between-group differences in QOL and perceived stress increased over time (group differences in QOL: 0.9, 1.9, 4.7, and 5.1 points, respectively; group differences in the Perceived Stress Scale: 0.9, 1.4, 2.3, and 3.0 points, respectively). Conclusions This study revealed a positive long-term dose–response relationship between patient engagement and 3 psychosocial outcomes among people living with HIV and elevated depressive symptoms in an mHealth intervention over 9 months using 4 time-point repeat measurement data. The high- and low-engagement groups showed significant and widening differences in depressive symptoms, QOL, and perceived stress at the 3-, 6-, and 9-month follow-ups. Future mHealth interventions should improve patient engagement to achieve long-term and sustained intervention effects. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019
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Jacobsen, S., O. Johansen e L. Garby. "A 24-m3 direct heat-sink calorimeter with on-line data acquisition, processing, and control". American Journal of Physiology-Endocrinology and Metabolism 249, n.º 4 (1 de outubro de 1985): E416—E432. http://dx.doi.org/10.1152/ajpendo.1985.249.4.e416.
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The construction and performance of a 24-m3 direct heat-sink calorimeter for continuous measurement of evaporative and sensible heat loss in human subjects are described. Extensive use of real-time processing for compensation of physical time constants and delays made it possible to solve response-time and stability problems associated with the large volume. The performance characteristics of the calorimeter are 1) a linear response between 0 and 320 W (471 g . h-1) for evaporative heat with a precision of 4.0-0.6% in the range 25-100 W, 2) a linear response between 0 and 280 W for sensible heat with a precision of 1.4-0.2% in the range 50-200 W, 3) a stability corresponding to a drift of less than 0.6 W (24 and 72 h) on both evaporative and sensible heat outputs and 24- and 72-h standard deviations (values every 2 min) of 0.3 and 0.4 W for evaporative heat and 0.6 and 0.7 W for sensible heat, 4) response times (95%) of 15 min for both evaporative and sensible heat, 5) independency on the position of the calibration source within the chamber, 6) no measurable "cross talk" between evaporative and sensible heat inputs, 7) negligible dependency of the external air humidity between 14 and 70%, and 8) operating temperature range from 18 to 30 degrees C. More than 40 experiments of 25-h duration with human subjects have been carried out. In no case was any discomfort recorded. An example of the 25-h continuous evaporative and sensible heat output tracing of one experiment is given.
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E Silva, Thâmara Machado, Osvaldo Gomes Pinto, Lucas Leonardo Da Silva, Raissa Kelly Correa De Paiva, Leonardo Luiz Borges e Samantha Salomão Caramori. "Gum of Terminalia argentea Mart. Et. Zucc. (Combretaceae) as a Resource in Biotechnology Processes: Chemistry and Toxicity". Fronteiras: Journal of Social, Technological and Environmental Science 8, n.º 2 (1 de maio de 2019): 52–72. http://dx.doi.org/10.21664/2238-8869.2019v8i2.p52-72.
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Biodegradable polymers are in areas such as pharmaceutical, food and bioremediation processes. Isolation, characterization (SEM, FTIR, TGA, Monosaccharide Composition, Zeta Potential), antimicrobial activity and toxicity to Artemia salina and Allium cepa L. from the in natura gummy exudate of Terminalia argentea (GTa) are presented herein. The data show irregular morphology and depressions, bands in 1770, 2112, 1354 cm-1, indicating groups of polysaccharides, amphiphilic character, thermo-degradation above 300 ° C and low water activity (0.6). The assays were negative for S. aureus and E. coli, nontoxic against the bioindicators tested. GTa presented low cost, extracted and isolated in a sustainable way, with possibility of commercial exploitation by communities, since these biopolymers present possibilities of applications as agents in the support of immobilization of enzymes, as sensors in diagnostics, encapsulating material in processes of microencapsulation of drugs and additives in food industries.
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Bass, James W. "A Review of the Rationale and Advantages of Various Mixtures of Benzathine Penicillin G". Pediatrics 97, n.º 6 (1 de junho de 1996): 960–63. http://dx.doi.org/10.1542/peds.97.6.960.
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Intramuscular benzathine (BZ) penicillin G has been accepted as the gold standard for treatment of patients with streptococcal pharyngitis since it was first introduced in 1952. Unfortunately, it has been associated with pain and tenderness at the site of injection. Efforts to lessen this by combining it with varied quantities of procaine (PC) penicillin G have been successful, decreasing the incidence of significant local reactions to 5% to 10%, little more than that seen with PC penicillin alone. A preparation containing 600 000 U BZ penicillin G and 600 000 U PC penicillin in 2 mL has been marketed since the mid-1950s as CR Bicillin 600/600 but the content of BZ penicillin G has been considered adequate only for children who weigh <60 pounds. This prompted the evaluation of a preparation containing 900 000 U BZ penicillin G plus 300 000 U PC penicillin G in a 2-mL injection. Of 400 children with streptococcal pharyngitis 100 each received this preparation, 600 000 U BZ penicillin G alone in 1 mL, 1.2 million U BZ penicillin G alone in 2 mL or 600 000 U BZ penicillin G plus 600 000 U PC penicillin G in 2 mL Clinical response was equal in all four groups; all patients were well in 36 to 48 hours. The two preparations containing PC penicillin G had significantly less severe local reactions and throat cultures were negative in all by 48 hours; it remained positive in some patients who received BZ penicillin G alone after 72 hours. The cure rate in patients receiving the 900 000/300 000 combination of BZ and PC penicillin G was equal to that in patients who received 1.2 million U BZ penicillin G with these added advantages. This combination offers optimal parenteral treatment for streptococcal pharyngitis in all children who weigh <140 pounds and it has been marketed for this purpose since 1976.
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Balcells, J., M. Fondevila, J. A. Guada, C. Castrillo e J. C. E. Surra. "Urinary excretions of purine derivatives and nitrogen in sheep given straw supplemented with different sources of carbohydrates". Animal Science 57, n.º 2 (outubro de 1993): 287–92. http://dx.doi.org/10.1017/s0003356100006905.
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AbstractEstimations of purine derivatives excretion and urinary-nitrogen loss were used to test the response of rumen fermentation to supplementation of straw with different sources of carbohydrate. Two groups of Rasa Aragonesa ewes (44 (s.e. 0·75) kg live weight were given ad libitum basal diets of either ammonia-treated (ATS) or urea-supplemented (USS) barley straw, with 12 animals per basal diet group. Three supplements, barley grain, sugar-beet pulp or grass hay, respectively, were given to each basal diet group, giving a total of six dietary treatments with four animals per treatment group. Four levels of supplementation were studied (150, 300, 450 and 600 g air dry matter per day), one in each of four experimental periods. Each 45-day experimental period comprised 38 days of adjustment followed by a 7-day measurement period. Digestible organic matter (DOM) intake was higher in animals receiving ATS than in animals receiving USS (504 v. 474 (s.e. 21·1) g/day, P < 0·005) and higher in animals receiving barley grain and sugar-beet pulp than in those receiving grass hay (512 and 496 v. 370 (s.e. 25·9) g/day, P < 0·005). DOM intake also increased with the level of supplementation and this increase was greater with barley grain (504 to 634 and 314 to 554 g/day for ATS and USS) and sugar-beet pulp (440 to 582 and 315 to 522 g/day) than with grass hay (430 to 407 and 267 to 370 for ATS and USS). Urinary excretions of hypoxanthine, xanthine and uric acid were not affected by the experimental treatment whereas allantoin excretion (y, mmol) increased in response to DOM intake (x, kg) (y = 13·72 × − 0·26; r = 0·79; P < 0·001; no. = 96). The response in allantoin excretion was mainly explained by the increase in DOM intake. However when data were expressed per unit of DOM intake significant differences were still evident. Allantoin/DOM intake (mmol·kg) ratio and calculated microbial nitrogen (g·kg DOM intake) supply were lower with USS diets and sugar-beet pulp supplemented diets (P< 0·05) and increased significantly with level of supplementation (P < 0·001).
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Moschonis, George, Sofia Tanagra, Anastasia Vandorou, Aikaterini E. Kyriakou, Vasiliki Dede, Paraskevi E. Siatitsa, Alexandra Koumpitski et al. "Social, economic and demographic correlates of overweight and obesity in primary-school children: preliminary data from the Healthy Growth Study". Public Health Nutrition 13, n.º 10A (outubro de 2010): 1693–700. http://dx.doi.org/10.1017/s1368980010002247.
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AbstractObjectiveTo record the prevalence of overweight and obesity in urban primary-school children in relation to several socio-economic and demographic factors.DesignCross-sectional.Setting/subjectsA representative sample of 729 schoolchildren (379 male and 350 female), aged 9–13 years, stratified by parental educational level, was examined in the urban region of Athens. Weight and height were measured using standard procedures. The International Obesity Task Force thresholds were used for the definition of overweight and obesity. Several socio-economic and demographic data and the child’s ‘popularity’ score were also recorded with specifically designed standardized questionnaires.ResultsThe prevalence of overweight and obesity was 29·6 % and 11·1 %, respectively. Annual family income of €12 000–20 000 (OR = 1·58), residence ownership (OR = 1·63) and the grandmother as the child’s primary caregiver (OR = 1·38) were significantly associated with higher odds of childhood overweight and obesity. Non-Greek parental nationality (OR = 0·72) and higher ‘popularity’ scores of children (OR = 0·42) were significantly associated with lower odds of overweight and obesity. The grandmother as the child’s primary caregiver and an annual family income of €12 000–20 000 remained significantly associated with childhood overweight and obesity after adding all significant correlates of childhood overweight and obesity observed at the bivariate level in a multivariate regression model (OR = 1·51 and 1·61, respectively).ConclusionsAmong family income, residence ownership, child’s primary caregiver, parental nationality and popularity scores that were identified as significant correlates of childhood overweight and obesity at the bivariate level, lower family income and grandmother as the child’s primary caregiver were the only factors that remained significantly associated with childhood overweight and obesity at a multivariate level.
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Hughes, Heather Y., Robin T. Odom, Angela V. Michelin, Evan S. Snitkin, Ninet Sinaii, Aaron M. Milstone, David K. Henderson e Tara N. Palmore. "A retrospective cohort study of antibiotic exposure and vancomycin-resistant Enterococcus recolonization". Infection Control & Hospital Epidemiology 40, n.º 4 (7 de fevereiro de 2019): 414–19. http://dx.doi.org/10.1017/ice.2019.15.
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AbstractObjective:In the National Institutes of Health (NIH) Clinical Center, patients colonized or infected with vancomycin-resistant Enterococcus (VRE) are placed in contact isolation until they are deemed “decolonized,” defined as having 3 consecutive perirectal swabs negative for VRE. Some decolonized patients later develop recurrent growth of VRE from surveillance or clinical cultures (ie, “recolonized”), although that finding may represent recrudescence or new acquisition of VRE. We describe the dynamics of VRE colonization and infection and their relationship to receipt of antibiotics.Methods:In this retrospective cohort study of patients at the National Institutes of Health Clinical Center, baseline characteristics were collected via chart review. Antibiotic exposure and hospital days were calculated as proportions of VRE decolonized days. Using survival analysis, we assessed the relationship between antibiotic exposure and time to VRE recolonization in a subcohort analysis of 72 decolonized patients.Results:In total, 350 patients were either colonized or infected with VRE. Among polymerase chain reaction (PCR)-positive, culture (Cx)-negative (PCR+/Cx−) patients, PCR had a 39% positive predictive value for colonization. Colonization with VRE was significantly associated with VRE infection. Among 72 patients who met decolonization criteria, 21 (29%) subsequently became recolonized. VRE recolonization was 4.3 (P = .001) and 2.0 (P = .22) times higher in patients with proportions of antibiotic days and antianaerobic antibiotic days above the median, respectively.Conclusion:Colonization is associated with clinical VRE infection and increased mortality. Despite negative perirectal cultures, re-exposure to antibiotics increases the risk of VRE recolonization.
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Dieguez, C., V. Jordan, P. Harris, S. Foord, M. D. Rodriguez-Arnao, A. Gomez-Pan, R. Hall e M. F. Scanlon. "Growth hormone responses to growth hormone-releasing factor (1–29) in euthyroid, hypothyroid and hyperthyroid rats". Journal of Endocrinology 109, n.º 1 (abril de 1986): 53–56. http://dx.doi.org/10.1677/joe.0.1090053.
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ABSTRACT In order to investigate whether the impaired GH secretion associated with hypothyroidism and hyperthyroidism is due to a hypothalamic or a pituitary disorder, we have studied plasma GH responses to GH-releasing factor (1–29) (GRF) in euthyroid, hypothyroid and hyperthyroid rats. Hypothyroid rats showed a significant (P< 0·001) reduction in GH responses to GRF (5 μg/kg) at 5 min (350 ± 35 vs 1950 ±260 μg/l), 10 min (366±66 vs 2320 ± 270 μg/l) and 15 min after GRF injection (395 ± 72 vs 1420 ± 183 μg/l; means ± s.e.m.) compared with euthyroid rats. Hyperthyroid rats showed a significant (P<0·05) decrease in GH responses to 5 μg GRF/kg after 30 min (200±14 vs 325 ± 35 μg/l) but not at other time-points, or after the administration of 1 μg GRF/kg. These data indicate that in hypothyroidism and perhaps hyperthyroidism there is an alteration in the responsiveness of the somatotroph to GRF administration. J. Endocr (1986) 109, 53–56
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Malikov, Z. M., e M. E. Madaliev. "NUMERICAL STUDY OF A SWIRLING TURBULENT FLOW THROUGH A CHANNEL WITH AN ABRUBT EXPANSION". Vestnik Tomskogo gosudarstvennogo universiteta. Matematika i mekhanika, n.º 72 (2021): 93–101. http://dx.doi.org/10.17223/19988621/72/8.
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A strongly swirling turbulent flow through an abrupt expansion is studied using the highly resolved DNS, LES, and SAS to shed more light on a stagnation region and spiral vortex destruction, though these methods require high computational expenses. The vortex fracture induced by a sudden expansion resembles the so-called vortex rope that occurs in hydropower draft tubes. It is known that large-scale spiral vortex structures can be captured by regular RANS turbulence models. In this paper, a numerical study of a strongly swirling flow, which abruptly expands, is carried out using the Reynolds stress models SSG / LRR-RSM and EARSM with experimental measurements implemented by Dellenback et al. (1988). Calculations are carried out using the finite volume method. The flow dynamics is studied at the Reynolds number of 3.0 × 104 at almost constant large swirl numbers of 0.6. The time-averaged velocity and pressure fields, as well as the root-mean-square values of the velocity fluctuations are recorded and studied qualitatively. The obtained results are compared with known experimental data. The aim of this work is to test the ability of the models to describe anisotropic turbulence. It is shown that the SSG / LRRRSM model is more appropriate for studying such flows.
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Meurette, G. "Étude randomisée prospective en double insu évaluant l’effet du métronidazole sur la douleur après hémorroïdectomie ambulatoire Carapeti EA, Kamm MA, McDonald PJ, Phillips RK (1998) Lancet 351:169–72". Côlon & Rectum 13, n.º 1 (fevereiro de 2019): 44–45. http://dx.doi.org/10.3166/cer-2019-0067.
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Kenyon, P. R., S. T. Morris, K. J. Stafford e D. M. West. "Effect of ewe body condition and nutrition in late pregnancy on the performance of triplet-bearing ewes and their progeny". Animal Production Science 51, n.º 6 (2011): 557. http://dx.doi.org/10.1071/an10192.
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The aim of the present study was to determine the production response of triplet-bearing ewes and their lambs to two differing feeding treatments in mid to late pregnancy and to determine the effect of ewe body condition. Ninety-two days after the start of their breeding period (P92) triplet-bearing ewes, were allocated to either a Medium (n = 72) or ad libitum (‘Adlib’, n = 72) feeding treatment until P113, followed by both groups being merged and offered ad libitum feeding conditions until lambing. The Medium feeding treatment was designed to ensure pre- and postgrazing herbage masses were below 1200 and 1000 kg DM/ha, respectively. Each feeding treatment included ewes from the following body condition score groups: 2.0 or less (CS ≤2.0), 2.5 (CS2.5) or 3.0 or greater (CS ≥3.0). At P113, Medium ewes were lighter (P < 0.05) and had lower (P < 0.05) body condition scores than Adlib ewes (72.4 ± 0.80 vs 75.2 ± 0.85 kg and 2.8 ± 0.06 vs 3.3 ± 0.06, respectively). However, at P141 liveweight no longer differed (P > 0.05, 86.2 ± 0.94 vs 86.6 ± 0.99 kg, respectively), although a small difference in condition score remained (P < 0.05, 3.0 ± 0.07 vs 3.3 ± 0.08, respectively). Ewe feeding treatment had no effect (P > 0.05) on lamb liveweight or survival or ewe liveweight and body condition during lactation. Ewe body condition score group had no effect (P > 0.05) on lamb birthweight. Lambs born to CS2.5 group ewes were heavier 70 days after the midpoint of lambing (L70) than those born to CS ≤2.0 group ewes (20.9 ± 0.41 vs 19.6 ± 0.36 kg, respectively), although they displayed lower survival to L70 (56.0 vs 69.5%). Liveweight at L70 and survival of lambs born to CS ≥3.0 group ewes (20.0 ± 0.39 kg and 61.7%) did not differ (P > 0.05) from those born to either CS ≤2.0 or CS2.5 group ewes. In conclusion, these results suggest triplet-bearing ewes can be maintained under restricted feeding conditions until at least Day 113 of pregnancy without negatively affecting ewe or lamb performance when they are subsequently offered unrestricted feeding for the remainder of pregnancy and during lactation. Under these grazing conditions the body condition of triplet-bearing ewes had little to no effect on their subsequent performance or that of their lambs.
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Broggi, Francesca, Jessica Ponti, Guido Giudetti, Fabio Franchini, Vicki Stone, César Pascual García e François Rossi. "Silver nanoparticles induce cytotoxicity, but not cell transformation or genotoxicity on Balb3T3 mouse fibroblasts". BioNanoMaterials 14, n.º 1-2 (1 de setembro de 2013): 49–60. http://dx.doi.org/10.1515/bnm-2013-0006.
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AbstractSilver nanoparticles (Ag NPs) are one of the most common nanomaterials present in nanotechnology-based products. Here, the physical chemical properties of Ag NPs suspensions of 44 nm, 84 nm and 100 nm sizes synthesized in our laboratory were characterized. The NM-300 material (average size of 17 nm), supplied by the Joint Research Centre Nanomaterials Repository was also included in the present study. The Ag NPs potential cytotoxicity was tested on the Balb3T3 cell line by the Colony Forming Efficiency assay, while their potential morphological neoplastic transformation and genotoxicity were tested by the Cell Transformation Assay and the micronucleus test, respectively. After 24 h of exposure, NM-300 showed cytotoxicity with an IC50 of 8 µM (corresponding to 0.88 µg/mL) while for the other nanomaterials tested, values of IC50 were higher than 10 µM (1.10 µg/mL). After 72 h of exposure, Ag NPs showed size-dependent cytotoxic effect with IC50 values of 1.5 µM (1.16 µg/mL) for NM-300, 1.7 µM (1.19 µg/mL) for Ag 44 nm, 1.9 µM (0.21 µg/mL) for Ag 84 nm and 3.2 µM (0.35 µg/mL) for Ag 100 nm. None of the Ag NPs tested was able to induce either morphological neoplastic transformation or micronuclei formation.
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Dombret, Hervé, Alexandra Coelho, Laurène Fenwarth, Jean-Baptiste Micol, Lionel Ades, Thomas Cluzeau, Emmanuel Raffoux et al. "Treatments and Outcomes of Adult Patients with AML in the Real-Life - First Report of the French Observational ALFA-PPP Study". Blood 144, Supplement 1 (5 de novembro de 2024): 2424. https://doi.org/10.1182/blood-2024-207226.
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Introduction. AML treatment options have been recently enriched. New agents like gemtuzumab ozogamicin (GO), FLT3 or IDH inhibitors, or CPX-351 have been approved for some patient subsets. Less-intensive options, like the AZA-VEN combination, are used in older/unfit patients. However, while treatments and indications are standardized, their choice is not, depending on often-subjective factors. This makes observational studies so important to describe the real-life management and outcomes of AML patients. Methods. In 2022, the ALFA group initiated a 2-cohort (newly diagnosed, relapsed/refractory) prospective observational study (ALFA-PPP, NCT04777916) aiming to collect clinical data and bio-samples in all AML patients aged ≥18y referred to 27 ALFA centers. Data/sample collection was structured by approved therapies including best supportive care (BSC). Patients treated on a compassionate basis or included in a clinical trial are also registered. Treatment decision-making criteria are prospectively collected. All patients should have a centralized genomic diagnosis (50-gene NGS panel) and molecular/flow MRD follow-up. We report here the initial observations made in the first 648 patients included between April 2022 and September 2023 in the newly diagnosed cohort. The current patient recruitment rate is around 650 new patients per year. Results. There were 340 males and 308 females (median age, 65y [range, 18-100]; ECOG-PS 0/1/2/3/4/NA, 195/295/97/33/8/19; HCT-CI comorbidity index 0/1/2/3+/NA, 54/269/106/216/3; median WBC, 6.9 G/L [IQR, 2.4-26]; median marrow blast percentage, 53% [IQR, 29-79]). The numbers of patients with de novo, post-MDS, post-MPN and therapy-related AML (tAML) were 467 (72%), 54 (8%), 58 (9%) and 69 (11%), respectively. ELN-2022 risk was favorable in 136 (21%), intermediate in 129 (20%), adverse in 340 (52.5%), and not available in 43 (6.5%) patients. In the 595 patients tested, incidences of NPM1, FLT3-ITD, IDH1/2, TP53 and secondary AML (sAML)-like gene mutations were 27%, 19%, 22%, 12% and 48%, respectively. A minority of 172 (26.5%) patients were included into a clinical trial frontline (investigator/company-sponsored trial, 140/32 patients; intensive/less intensive/two-option trial, 142/20/10 patients). They were significantly younger than the 476 (73.5%) patients treated outside any clinical trial (median age, 55 vs 69y, p<.001). In these 476 patients, treatment decision was intensive in 266 (median age, 62y [18-79]; 210 7+3 ± GO or midostaurin, 54 CPX-351, 2 others), less intensive in 185 (median age, 76y [36-100]; 149 AZA-VEN, 18 AZA or low-dose cytarabine alone, 13 AZA-ivosidenib, 5 others), and BSC in 21 patients, while the 4 remaining patients early died before any treatment decision. By investigator declaration, the main reason for selecting a less intensive treatment was advanced age (n=138), AML characteristics/risk (n=19), concomitant diseases (n=16), patient's choice (n=1), or other (n=11), with good statistical correlations with objective data. The objective factors independently associated with the choice of a less intensive option were age ≥65y (p<.001), higher ECOG-PS (p<.001) or comorbidity index (p=.001), but also post-MDS (p=.001) or post-MPN (p<.001) AML, lower WBC (p=.022), poor cytogenetics (p=0.046), and TP53 (p=.003) or IDH1/2 (p=.003) mutation. A total of 89/476 (18.5%) patients received an allogeneic SCT during the first 6 months of follow-up, including 81 intensively and only 8 less-intensively treated patients. In the 185 less-intensively treated patients with a median follow-up of 15 months, median overall survival (OS) was 10.3 months (95% CI, 7.2-12.9) with a 12-month estimate at 45.3% (95% CI, 37.7-52.5). In these patients, multivariate stepwise Cox model evidenced higher ECOG-PS (p=.038), concomitant diseases (p=.003), tAML (p=.046), higher marrow blast percentage (p=.024), sAML-like (p=.048) and TP53 (p<.001) mutation as bad-prognosis factors for OS, while IDH1/2 mutations (p=.001) were associated with longer OS. Conclusions. Awaiting the ELN-2024 recommendations for less-intensive AML therapies, this prospective real-life study confirms their rising place in a European context. Rather than age by itself, survival after less-intensive treatment is governed by multiple independent clinical and genomic factors. Future reports will update these observations on an annual basis.
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Yamanaka, Ryo, Hayato Ohnuma, Ryosuke Ando, Fumiya Tanji, Toshiyuki Ohya, Masahiro Hagiwara e Yasuhiro Suzuki. "Sprinting Ability as an Important Indicator of Performance in Elite Long-Distance Runners". International Journal of Sports Physiology and Performance 15, n.º 1 (1 de janeiro de 2020): 141–45. http://dx.doi.org/10.1123/ijspp.2019-0118.
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Purpose: Increases in maximal oxygen uptake () and running economy improve performance in long-distance runners. Nevertheless, long-distance runners require sprinting ability to win, especially in the final phase of competitions. The authors determined the relationships between performance and sprinting ability, as well as other abilities in elite long-distance runners. Methods: The subjects were 12 elite long-distance runners. Mean official seasonal best times in 5000-m (5000 m-SB) and 10,000-m (10,000 m-SB) races within 1 year before or after the examination were 13:58.5 (0:18.7) and 28:37.9 (0:25.2) (mean [SD]), respectively. The authors measured 100-m and 400-m sprint times as the index of sprinting ability. They also measured and running economy ( at 300 m·min−1 of running velocity). They used a single correlation analysis to assess relationships between 5000 m-SB or 10,000 m-SB and other elements. Results: There were significant correlations between 5000 m-SB was significantly correlated with 100-m sprint time (13.3 [0.7] s; r = .68, P = .014), 400-m sprint time (56.6 [2.7] s; r = .69, P = .013), and running economy (55.5 [3.9] mL·kg−1·min−1; r = .59, P = .045). There were significant correlations between 10,000 m-SB and 100-m sprint time (r = .72, P = .009) and 400-m sprint time (r = .85, P < .001). However, there was no significant correlation between 5000 m-SB or 10,000 m-SB and (72.0 [3.8] mL·kg−1·min−1). Conclusions: The authors' data suggest that sprinting ability is an important indicator of performance in elite long-distance runners.