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Kearsley-Fleet, L., K. Hyrich, M. Schaefer, D. Huschek, A. Strangfeld, J. Zavada, M. Lagová, et al. "OP0105 FEASIBILITY AND USEFULNESS OF MAPPING BIOLOGIC REGISTRIES TO A COMMON DATA MODEL: ILLUSTRATION USING COMORBIDITIES." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 58.2–59. http://dx.doi.org/10.1136/annrheumdis-2021-eular.888.
Повний текст джерелаАнотація:
Background:The Observational and Medical Outcomes Partnerships (OMOP) common data model (CDM) provides a framework for standardising health data with a view towards federated analyses, thus maximising the use and power of combining disparate datasets.Objectives:To assess feasibility and usefulness of mapping biologic registry data from different European countries to the OMOP CDM and present initial descriptive data regarding comorbidities.Methods:Five biologic registries, as part of a funded FOREUM project, have been mapped to the OMOP CDM: 1) the Czech biologics register (ATTRA), 2) Registro Español de Acontecimientos Adversos de Terapias Biológicas en Enfermedades Reumáticas (BIOBADASER), 3) British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRBR-RA), 4) German biologics register ‘Rheumatoid arthritis observation of biologic therapy’ (RABBIT), and 5) Swiss register ‘Swiss Clinical Quality Management in Rheumatic Diseases’ (SCQM). The mapping includes socio-demographic, observation period within the studies, baseline comorbidities, and baseline medications. Only patients with RA were included. Using R, registers received identical scripts to run on their mapped databases to produce an initial description of patient characteristics without the need to share patient-level data.Results:A total of 54,458 individuals are included the five registries being mapped to the OMOP CDM, see table. Age and gender distribution was similar across registries. All registers reported on cardiovascular system comorbidities, diabetes mellitus, mental disorders, and respiratory system comorbidities. However, it was noted that results of comorbidity mapping relies on what each register collect on each patient at the point of registration.Whilst the Charlson comorbidity index could be calculated within each registry, due to lack of the specific coding needed, such as “uncomplicated diabetes mellitus” / “end-organ damage diabetes mellitus”, it was felt to be an inaccurate measure. The granularity of the comorbidities was insufficient, as many registers coded, for example, diabetes mellitus without any extra information.Table 1.OARSI scoresRegistryATTRABIOBADASERBSRBR-RARABBITSCQMCountryCzechiaSpainUnited KingdomGermanySwitzerlandNumber of Participants23343012251791365210281Gender FemaleMale1808 (77%)526 (23%)2372 (79%)640 (21%)18995 (75%)6184 (25%)10191 (75%)3461 (25%)7584 (74%)2697 (26%)Age at observation start date59 (52, 66)56 (47, 63)58 (49, 66)58 (50, 67)57 (47, 66)First observation start dateFeb-2002Oct-1999Oct-2001Aug-2006March-1995Number of comorbidities1 (1, 2)1 (0, 2)1 (0, 2)2 (1, 3)2 (1, 4)Disorder of cardiovascular system1609 (69%)208 (7%)2239 (9%)6330 (46%)3969 (39%)Diabetes mellitus331 (14%)273 (9%)1770 (7%)1591 (12%)792 (8%)Depressive Disorder165 (7%)04971 (20%)1023 (7%)1337 (13%)Disorder of respiratory system215 (9%)209 (7%)4125 (16%)1282 (9%)1630 (16%)Conclusion:This is the first analysis of data from the newly mapped OMOP CDM across five European registers. Through mapping the registers into a CDM, and using the same script, the ability to undertake collaborative analysis without sharing patient level data outside of the country can be realised. Due to differences in study design and data capture, there needs to be a focus on harmonising the coding and analysing of the comorbidities and drugs across registries.Disclosure of Interests:Lianne Kearsley-Fleet: None declared, Kimme Hyrich: None declared, Martin Schaefer: None declared, Doreen Huschek: None declared, Anja Strangfeld: None declared, Jakub Zavada Speakers bureau: Abbvie, Eli-Lilly, UCB, Sanofi., Consultant of: Abbvie, UCB, Sanofi, Gilead., Markéta Lagová: None declared, Delphine Courvoisier Speakers bureau: Medtalks Switzerland, Christoph Tellenbach: None declared, Kim Lauper Speakers bureau: Medtalks Switzerland, Carlos Sánchez-Piedra: None declared, Nuria Montero: None declared, Jesús-Tomás Sánchez-Costa: None declared, Daniel Prieto-Alhambra Consultant of: Amgen (speaker fees and advisory board membership fees paid to DPA’s department) and UCB (consultancy fees paid to DPA’s department), Grant/research support from: grants and other from AMGEN, grants, non-financial support and other from UCB Biopharma, grants from Les Laboratoires Servier, outside the submitted work., Edward Burn: None declared
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Burn, E., L. Kearsley-Fleet, K. Hyrich, M. Schaefer, D. Huschek, A. Strangfeld, J. Zavada, et al. "OP0285 TOWARDS IMPLEMENTING THE OMOP CDM ACROSS FIVE EUROPEAN BIOLOGIC REGISTRIES." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 177.2–178. http://dx.doi.org/10.1136/annrheumdis-2020-eular.3303.
Повний текст джерелаАнотація:
Background:The Observational and Medical Outcomes Partnerships (OMOP) common data model (CDM) provides a framework for standardising health data.Objectives:To map national biologic registry data collected from different European countries to the OMOP CDM.Methods:Five biologic registries are currently being mapped to the OMOP CDM: 1) the Czech biologics register (ATTRA), 2) Registro Español de Acontecimientos Adversos de Terapias Biológicas en Enfermedades Reumáticas (BIOBADASER), 3) British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRBR-RA), 4) German biologics register ‘Rheumatoid arthritis observation of biologic therapy’ (RABBIT), and 5) Swiss register ’Swiss Clinical Quality Management in Rheumatic Diseases’ (SCQM).Data collected at baseline are being mapped first. Details that uniquely identify individuals are mapped to the person table, with the observation_period table defining the time a person may have had clinical events recorded. Baseline comorbidities are mapped to the condition_occurrence CDM table, while baseline medications are mapped to the drug_exposure CDM table. This mapping is summarised in Figure 1.Figure 1.Overview of initial mappingResults:A total of 64,901 individuals are included in the 5 registries being mapped to the OMOP CDM, see table 1. The number of unique baseline conditions being mapped range from 17 in BSRBR-RA to 108 in RABBIT, while the number of baseline medications range from 26 in ATTRA to 802 in BSRBR-RA. Those registries which captured more comorbidities or medications generally allowed for these to be inputted as free text.Table 1.Summary of initial code mappingRegistryNumber of individualsNumber of mapped baseline conditionsNumber of mapped baseline medicationsATTRA5,3262626BIOBADASER6,4963051BSRBR-RA21,69517802RABBIT13,06210878SCQM18,3222633Conclusion:Due to differences in study design and data capture, the baseline information captured on comorbidities and drugs across registries varies greatly. However, these data have been mapped and mapping biologic registry data to the OMOP CDM is feasible. The adoption of the OMOP CDM will facilitate collaboration across registries and allow for multi-database studies which include data from both biologic registries and other sources of health data which have been mapped to the CDM.Disclosure of Interests:Edward Burn: None declared, Lianne Kearsley-Fleet: None declared, Kimme Hyrich Grant/research support from: Pfizer, UCB, BMS, Speakers bureau: Abbvie, Martin Schaefer: None declared, Doreen Huschek: None declared, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis, Jakub Zavada Speakers bureau: Abbvie, UCB, Sanofi, Elli-Lilly, Novartis, Zentiva, Accord, Markéta Lagová: None declared, Delphine Courvoisier: None declared, Christoph Tellenbach: None declared, Kim Lauper: None declared, Carlos Sánchez-Piedra: None declared, Nuria Montero: None declared, Jesús-Tomás Sanchez-Costa: None declared, Daniel Prieto-Alhambra Grant/research support from: Professor Prieto-Alhambra has received research Grants from AMGEN, UCB Biopharma and Les Laboratoires Servier, Consultant of: DPA’s department has received fees for consultancy services from UCB Biopharma, Speakers bureau: DPA’s department has received fees for speaker and advisory board membership services from Amgen
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Bardenheuer, Kristina, Alun Passey, Maria d'Errico, Barbara Millier, Carine Guinard-Azadian, Johan Aschan, and Michel van Speybroeck. "Honeur (Heamatology Outcomes Network in Europe): A Federated Model to Support Real World Data Research in Hematology." Blood 132, Supplement 1 (November 29, 2018): 4839. http://dx.doi.org/10.1182/blood-2018-99-111093.
Повний текст джерелаАнотація:
Abstract Introduction: The Haematology Outcomes Network in EURope (HONEUR) is an interdisciplinary initiative aimed at improving patient outcomes by analyzing real world data across hematological centers in Europe. Its overarching goal is to create a secure network which facilitates the development of a collaborative research community and allows access to big data tools for analysis of the data. The central paradigm in the HONEUR network is a federated model whereby the data stays at the respective sites and the analysis is executed at the local data sources. To allow for a uniform data analysis, the common data model 'OMOP' (Observational Medical Outcomes Partnership) was selected and extended to accommodate specific hematology data elements. Objective: To demonstrate feasibility of the OMOP common data model for the HONEUR network. Methods: In order to validate the architecture of the HONEUR network and the applicability of the OMOP common data model, data from the EMMOS registry (NCT01241396) have been used. This registry is a prospective, non-interventional study that was designed to capture real world data regarding treatments and outcomes for multiple myeloma at different stages of the disease. Data was collected between Oct 2010 and Nov 2014 on more than 2,400 patients across 266 sites in 22 countries. Data was mapped to the OMOP common data model version 5.3. Additional new concepts to the standard OMOP were provided to preserve the semantic mapping quality and reduce the potential loss of granularity. Following the mapping process, a quality analysis was performed to assess the completeness and accuracy of the mapping to the common data model. Specific critical concepts in multiple myeloma needed to be represented in OMOP. This applies in particular for concepts like treatment lines, cytogenetic observations, disease progression, risk scales (in particular ISS and R-ISS). To accommodate these concepts, existing OMOP structures were used with the definition of new concepts and concept-relationships. Results: Several elements of mapping data from the EMMOS registry to the OMOP common data model (CDM) were evaluated via integrity checks. Core entities from the OMOP CDM were reconciled against the source data. This was applied for the following entities: person (profile of year of birth and gender), drug exposure (profile of number of drug exposures per drug, at ATC code level), conditions (profile of number of occurrences of conditions per condition code, converted to SNOMED), measurement (profile of number of measurements and value distribution per (lab) measurement, converted to LOINC) and observation (profile of number of observations per observation concept). Figure 1 shows the histogram of year of birth distribution between the EMMOS registry and the OMOP CDM. No discernible differences exist, except for subjects which have not been included in the mapping to the OMOP CDM due to lacking confirmation of a diagnosis of multiple myeloma. As additional part of the architecture validation, the occurrence of the top 20 medications in the EMMOS registry and the OMOP CDM were compared, with a 100% concordance for the drug codes, which is shown in Figure 2. In addition to the reconciliation against the different OMOP entities, a comparison was also made against 'derived' data, in particular 'time to event' analysis. Overall survival was plotted from calculated variables in the analysis level data from the EMMOS registry and derived variables in the OMOP CDM. Probability of overall survival over time was virtually identical with only one day difference in median survival and 95% confidence intervals identically overlapping over the period of measurement (Figure 3). Conclusions: The concordance of year of birth, drug code mapping and overall survival between the EMMOS registry and the OMOP common data model indicates the reliability of mapping potential in HONEUR, especially where auxiliary methods have been developed to handle outcomes and treatment data in a way that can be harmonized across platform datasets. Disclosures No relevant conflicts of interest to declare.
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Carus, Jasmin, Sylvia Nürnberg, Frank Ückert, Catarina Schlüter, and Stefan Bartels. "Mapping Cancer Registry Data to the Episode Domain of the Observational Medical Outcomes Partnership Model (OMOP)." Applied Sciences 12, no. 8 (April 15, 2022): 4010. http://dx.doi.org/10.3390/app12084010.
Повний текст джерелаАнотація:
A great challenge in the use of standardized cancer registry data is deriving reliable, evidence-based results from large amounts of data. A solution could be its mapping to a common data model such as OMOP, which represents knowledge in a unified semantic base, enabling decentralized analysis. The recently released Episode Domain of the OMOP CDM allows episodic modelling of a patient’ disease and treatment phases. In this study, we mapped oncology registry data to the Episode Domain. A total of 184,718 Episodes could be implemented, with the Concept of Cancer Drug Treatment most frequently. Additionally, source data were mapped to new terminologies as part of the release. It was possible to map ≈ 73.8% of the source data to the respective OMOP standard. Best mapping was achieved in the Procedure Domain with 98.7%. To evaluate the implementation, the survival probabilities of the CDM and source system were calculated (n = 2756/2902, median OAS = 82.2/91.1 months, 95% Cl = 77.4–89.5/84.4–100.9). In conclusion, the new release of the CDM increased its applicability, especially in observational cancer research. Regarding the mapping, a higher score could be achieved if terminologies which are frequently used in Europe are included in the Standardized Vocabulary Metadata Repository.
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van Bragt, Job J. M. H., Susanne Hansen, Ratko Djukanovic, Elisabeth H. D. Bel, Anneke ten Brinke, Scott S. Wagers, Anke H. Maitland-van der Zee, and Celeste Porsbjerg. "SHARP: enabling generation of real-world evidence on a pan-European scale to improve the lives of individuals with severe asthma." ERJ Open Research 7, no. 2 (March 18, 2021): 00064–2021. http://dx.doi.org/10.1183/23120541.00064-2021.
Повний текст джерелаАнотація:
Real-world evidence is important to help unravel unanswered problems in severe asthma and is valuable to better understand the patient experience and common clinical practice.The Severe Heterogeneous Asthma Registry, Patient-centred (SHARP) Clinical Research Collaboration is created as a network of national registries and severe asthma centres that work together to perform registry based real-world research and clinical studies on a pan-European scale.Such collaboration requires a new, innovative design to overcome the many issues that arise with large-scale data collection across national borders. SHARP has developed a platform that offers a federated analysis approach where national registry data are transformed and integrated into a common data model (CDM). The CDM then allows a local analysis of de-identified patient data and subsequent aggregate (meta-)analysis. To facilitate an easily accessible way to set up new registries, SHARP enables new registries to take part in a central database, based on already proven technology. Next to being economical, this linkage ensures data from different SHARP central members to be comparable.Technological advancements lead to an ever-expanding rate of patient data that will be collected; with the collective effort of the pan-European severe asthma research community SHARP hopes to ensure that they are well equipped to enter a new era of medical research, with the ultimate goal to positively impact the lives of patients with severe asthma.
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Welberry, Heidi, Margo Linn Barr, Elizabeth J. Comino, Ben F. Harris-Roxas, Elizabeth Harris, and Mark Fort Harris. "Increasing use of general practice management and team care arrangements over time in New South Wales, Australia." Australian Journal of Primary Health 25, no. 2 (2019): 168. http://dx.doi.org/10.1071/py18113.
Повний текст джерелаАнотація:
The number of older people living with chronic health conditions is increasing in Australia. The Chronic Disease Management (CDM) items program was introduced to the Medicare Benefits Schedule (MBS) to encourage a more structured approach to managing patients with chronic conditions. Initial uptake was slow and recent research has suggested that uptake is decreasing. This paper examines: person MBS CDM claims in NSW between 2006 and 2014 — using baseline survey data (2006–09) from the Sax Institute’s 45 and Up Study linked to MBS and Death Registry data (2006–14) — and MBS CDM claims per 100000 population — using billing data sourced from the Medicare Australia Statistics website — to systematically examine any changes in uptake using a time-series analysis. After age adjustment, claims for initial plans increased from 11.3% in 2006 to 22.4% in 2014. Increases were also seen for allied health service claims (from 4.1% in 2006 to 20.8% in 2014) and for plan reviews (from 5.9% in 2006 to 16.0% in 2014). These increases were consistent with the MBS summary claims data. There is evidence that these plans are appropriately targeting those in most need; however, there is limited evidence of their effect. Claims for plan reviews, although increasing, are suboptimal and may indicate poor continuity of care.
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Glicksberg, Benjamin Scott, Shohei Burns, Rob Currie, Ann Griffin, Zhen Jane Wang, David Haussler, Theodore Goldstein, and Eric Collisson. "Blockchain-Authenticated Sharing of Genomic and Clinical Outcomes Data of Patients With Cancer: A Prospective Cohort Study." Journal of Medical Internet Research 22, no. 3 (March 20, 2020): e16810. http://dx.doi.org/10.2196/16810.
Повний текст джерелаАнотація:
Background Efficiently sharing health data produced during standard care could dramatically accelerate progress in cancer treatments, but various barriers make this difficult. Not sharing these data to ensure patient privacy is at the cost of little to no learning from real-world data produced during cancer care. Furthermore, recent research has demonstrated a willingness of patients with cancer to share their treatment experiences to fuel research, despite potential risks to privacy. Objective The objective of this study was to design, pilot, and release a decentralized, scalable, efficient, economical, and secure strategy for the dissemination of deidentified clinical and genomic data with a focus on late-stage cancer. Methods We created and piloted a blockchain-authenticated system to enable secure sharing of deidentified patient data derived from standard of care imaging, genomic testing, and electronic health records (EHRs), called the Cancer Gene Trust (CGT). We prospectively consented and collected data for a pilot cohort (N=18), which we uploaded to the CGT. EHR data were extracted from both a hospital cancer registry and a common data model (CDM) format to identify optimal data extraction and dissemination practices. Specifically, we scored and compared the level of completeness between two EHR data extraction formats against the gold standard source documentation for patients with available data (n=17). Results Although the total completeness scores were greater for the registry reports than those for the CDM, this difference was not statistically significant. We did find that some specific data fields, such as histology site, were better captured using the registry reports, which can be used to improve the continually adapting CDM. In terms of the overall pilot study, we found that CGT enables rapid integration of real-world data of patients with cancer in a more clinically useful time frame. We also developed an open-source Web application to allow users to seamlessly search, browse, explore, and download CGT data. Conclusions Our pilot demonstrates the willingness of patients with cancer to participate in data sharing and how blockchain-enabled structures can maintain relationships between individual data elements while preserving patient privacy, empowering findings by third-party researchers and clinicians. We demonstrate the feasibility of CGT as a framework to share health data trapped in silos to further cancer research. Further studies to optimize data representation, stream, and integrity are required.
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Cho, Sylvia, Margaret Sin, Demetra Tsapepas, Leigh-Anne Dale, Syed A. Husain, Sumit Mohan, and Karthik Natarajan. "Content Coverage Evaluation of the OMOP Vocabulary on the Transplant Domain Focusing on Concepts Relevant for Kidney Transplant Outcomes Analysis." Applied Clinical Informatics 11, no. 04 (August 2020): 650–58. http://dx.doi.org/10.1055/s-0040-1716528.
Повний текст джерелаАнотація:
Abstract Background Improving outcomes of transplant recipients within and across transplant centers is important with the increasing number of organ transplantations being performed. The current practice is to analyze the outcomes based on patient level data submitted to the United Network for Organ Sharing (UNOS). Augmenting the UNOS data with other sources such as the electronic health record will enrich the outcomes analysis, for which a common data model (CDM) can be a helpful tool for transforming heterogeneous source data into a uniform format. Objectives In this study, we evaluated the feasibility of representing concepts from the UNOS transplant registry forms with the Observational Medical Outcomes Partnership (OMOP) CDM vocabulary to understand the content coverage of OMOP vocabulary on transplant-specific concepts. Methods Two annotators manually mapped a total of 3,571 unique concepts extracted from the UNOS registry forms to concepts in the OMOP vocabulary. Concept mappings were evaluated by (1) examining the agreement among the initial two annotators and (2) investigating the number of UNOS concepts not mapped to a concept in the OMOP vocabulary and then classifying them. A subset of mappings was validated by clinicians. Results There was a substantial agreement between annotators with a kappa score of 0.71. We found that 55.5% of UNOS concepts could not be represented with OMOP standard concepts. The majority of unmapped UNOS concepts were categorized into transplant, measurement, condition, and procedure concepts. Conclusion We identified categories of unmapped concepts and found that some transplant-specific concepts do not exist in the OMOP vocabulary. We suggest that adding these missing concepts to OMOP would facilitate further research in the transplant domain.
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Morris, Joan K., Ester Garne, Maria Loane, Ingeborg Barisic, James Densem, Anna Latos-Bieleńska, Amanda Neville, et al. "EUROlinkCAT protocol for a European population-based data linkage study investigating the survival, morbidity and education of children with congenital anomalies." BMJ Open 11, no. 6 (June 2021): e047859. http://dx.doi.org/10.1136/bmjopen-2020-047859.
Повний текст джерелаАнотація:
IntroductionCongenital anomalies (CAs) are a major cause of infant mortality, childhood morbidity and long-term disability. Over 130 000 children born in Europe every year will have a CA. This paper describes the EUROlinkCAT study, which is investigating the health and educational outcomes of children with CAs for the first 10 years of their lives.Methods and analysisEUROCAT is a European network of population-based registries for the epidemiological surveillance of CAs. EUROlinkCAT is using the EUROCAT infrastructure to support 22 EUROCAT registries in 14 countries to link their data on births with CAs to mortality, hospital discharge, prescription and educational databases. Once linked, each registry transforms their case data into a common data model (CDM) format and they are then supplied with common STATA syntax scripts to analyse their data. The resulting aggregate tables and analysis results are submitted to a central results repository (CRR) and meta-analyses are performed to summarise the results across all registries. The CRR currently contains data on 155 594 children with a CA followed up to age 10 from a population of 6 million births from 1995 to 2014.EthicsThe CA registries have the required ethics permissions for routine surveillance and transmission of anonymised data to the EUROCAT central database. Each registry is responsible for applying for and obtaining additional ethics and other permissions required for their participation in EUROlinkCAT.DisseminationThe CDM and associated documentation, including linkage and standardisation procedures, will be available post-EUROlinkCAT thus facilitating future local, national and European-level analyses to improve healthcare. Recommendations to improve the accuracy of routinely collected data will be made.Findings will provide evidence to inform parents, health professionals, public health authorities and national treatment guidelines to optimise diagnosis, prevention and treatment for these children with a view to reducing health inequalities in Europe.
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Castellanos Ruiz, Mª José. "Comentarios a las resoluciones de la Dirección General de los Registros y del Notariado de 20 de diciembre de 2016, sobre la inscripción en el Registro de Bienes Muebles de Madrid de varios contratos de arrendamiento financiero sobre aeronaves = Comments to the “resoluciones” of the Dirección General de los Registros y del Notariado of december 20, 2016 on the access to the Chattels Registry in Madrid of several leasing contracts for aircrafts." CUADERNOS DE DERECHO TRANSNACIONAL 9, no. 2 (October 5, 2017): 650. http://dx.doi.org/10.20318/cdt.2017.3894.
Повний текст джерелаАнотація:
Resumen: Las Resoluciones de la DGRN de 20 diciembre 2016, abordan la cuestión del acceso de tres contratos de arrendamiento financiero de aeronaves al Registro de Bienes Muebles. La DGRN examina toda la normativa aplicable al Registro de Bienes Muebles, especialmente el Real Decreto384/2015, de 22 de mayo, por el que se aprueba el Reglamento de matriculación de aeronaves civiles, pues uno de sus objetivos es la coordinación entre el Registro de Bienes Muebles y el Registro de Matrícula de Aeronaves Civiles. Sin embargo, este Real Decreto no soluciona totalmente los problemas que ya existían, con respecto a la inscripción en el Registro de Bienes Muebles de los contratos de arrendamiento financiero sobre aeronaves, pues siguen siendo de aplicación Leyes obsoletas, como es el caso del art. 180 del Reglamento del Registro Mercantil de 1956.Palabras clave: contratos de arrendamiento financiero, aeronaves civiles, Registro de Bienes Muebles, Registro de Matrícula de Aeronaves Civiles, Real Decreto 384/2015, Reglamento del Registro Mercantil de 1956.Abstract: The “Resoluciones” of the Dirección General de los Registros y del Notariado of December 20, 2016 faces the question of the access to the Chattels Registry of three leasing contracts. The Spanish DGRN examines all the regulations applicable to the Chattels Registry, especially Spanish “Real Decreto 384/2015”, of 22 May, which approves the Regulation of registration of civil aircraft, as one of its objectives is coordination between the Chattels Registry y the Aircraft Registry. However, the “Real Decreto 384/2015” doesn´t completely solve the problems that already existed, with respect to the registration of leasing of aircraft in the Chattels Registry, since they remain applicable obsolete laws, as is the case of art. 180 of the Spanish Regulation of “Registro Mercantil” of 1956.Keywords: leasing contracts, civil aircrafts, Chattels Registry, Aircraft Registry, Real Decreto 384/2015, Regulation of “Registro Mercantil” of 1956.s
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Solari, Patricia Ximena. "Asma infantil: Efectos inmunomoduladores de los liofilizados bacterianos." Kompass Neumología 3, no. 2 (2021): 62–63. http://dx.doi.org/10.1159/000515757.
Повний текст джерелаАнотація:
<b>Background:</b> Polyvalent Mechanical Bacterial Lysate (PMBL®) contains antigens of bacteria responsible for respiratory infections. PMBL® has been proven to reduce the number of respiratory infections, and in its use, immunological benefits have been seen in allergic patients. PMBL® activates both innate and specific immune responses. The lysate induces dendritic cells, T and B lymphocytes and IgA secretion, as well as the production of antibodies directed against administered bacterial antigens. Moreover, it increases the response against other bacteria and viruses. The immunologic mechanism of lysate’s action is not yet clearly determined. The objective of this study was to assess the effect of PMBL® on T cells in children with allergic asthma. <b>Methods:</b> This study was a part of the EOLIA study. Herein, 49 children with allergic asthma and house dust mites allergy were included: 21 in PMBL® and 28 in the Placebo group, both, drug and placebo were administered sublingually. The tests were done at baseline and 12 weeks after the last tablet intake. The lymphocytes CD45+, lymphocytes T CD3+, CD3+CD25+, CD3+CD69+, Th CD3+CD4+, CD4+CD25+, CD4+CD25+ high, CD4+CD69+, Treg CD4+CD25+FOXP3, Tc CD3+CD8+, CD8+CD25+, CD8+CD69+, NK-like T CD3+CD16+CD56+ and NK cells CD3−CD16+CD56+ were described. <b>Results:</b> At baseline, no significant differences between groups relative to blood count cells were observed, except for eosinophils. After 12 weeks, we observed an increase of T lymphocytes count. In addition, CD4+CD25+FOXP3+, CD8+ and CD3−CD16+CD56+ and (insignificantly) Th count increased. However, CD69+ and CD25+ subset of CD3+ significantly decreased. <b>Conclusions:</b> The EOLIA study demonstrated that PMBL® administration 10 days per month for 3 months changed the panel of T lymphocytes. <b>Trial registration Clinical Trial Registration:</b> This study was a part of the EOLIA (Efficacy Of mechanical bacterial Lysate In Allergic children), a clinical study NCT02541331. Frederic Durmont, MD Lallemand Pharma International AG. Date of registration 09/08/2013. URL of trial registry record: https://clinicaltrials.gov/ct2/show/study/NCT02541331.
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Plumelle, Yves, Rishika Banydeen, jean-Come Meniane, Stephane Michel, Gerard Panelatti, and Delaunay Christine. "Epidemiology of Adult T-Cell Leukemia/Lymphoma in Martinique (1983-2013): Robustness of Classification of Lymphoma Study Group of Japa, Relevance of Cutaneous Lesions, Atypical Phenotype and Origin of the HTLV-1 Infected Cell." Blood 124, no. 21 (December 6, 2014): 5418. http://dx.doi.org/10.1182/blood.v124.21.5418.5418.
Повний текст джерелаАнотація:
Abstract We describe the epidemiological, clinical and biological features of the patients with ATL (Acute T-cell Leukaemia), extracted from the Hematological Cancer Registry of Martinique, between January 1st, 1983 and March 31st, 2013 and confront our experience with the acquired data.One hundred and seventy-five new cases of ATL were listed. All the patients with ATL were of mixed African-Caucasian descent. There were 88 men and 87 women. The median age was 56 years (from 16 to 95). One hundred and forty six patients (83,4 %) were more than 40 years old. According to the classification of the Lymphoma Study Group of Japan ( LSG) (Shimoyama M and al, Br J Haematol on 1991), the distribution of the 3 clinical types, acute, lymphoma and chronic, was respectively 62.9 % (N=110), 29.1 % (N=51) and 8 % (N=14). None smoldering type was identified. Three cases presented exclusive skin lesions. The median survival time was 5,43 months for all the cases, 3.09 months for the acute type, 8.13 for the lymphoma type and 45.16 for the chronic type (fig 1, p value of log-rank test < 0.001). The survival was significantly higher for the lymphoma type with skin lesions (fig 2, median: 13.96 versus 6.06 months, p value of log-rank test < 0.035) and for the acute type without hypercalcemia (4 versus 2.4 months, p< 0.01). The symptoms associated with hypercalcaemia present in 82 patients (47 %) and skin lesions present in 74 patients(42 %) were the most successful clinical signs for the diagnosis of ATL. Forty two percent were infected by Strongyloïdes stercoralis (Ss). Over the studied period, 154 patients (104 acute, 41 lymphoma, 9 chronic) died with a median overall survival of 4.68 months, 6.22 for the lymphoma type and 2.86 months for the acute type. The hypercalcemia was the first cause of death. No strict lymphoma type (atypical lymphoïd cells < 1%) progressed to a leukaemia form. In most of the cases, the ATL cell presented the activated post-thymic T cell phenotype CD2, CD3, CD4, CD25. Weak expression of CD3 and TCR was observed in every case analyzed. The absence of CD7 membrane expression was observed in 75 among 96 cases. This typical phenotype applied to 79,6 % of the leukaemia patients. Twenty three patients had a different phenotype: double negative ( DN) CD4(-) CD8(-)( 14 cases), double positive ( DP) CD4(+)CD8(+) (4 cases) and negative CD3(-) (4 cases) and CD8(-) (1 case). Five DN cells expressed CD7. The patients with an atypical phenotype had a significantly lower survival (median: 2.0 versus 5.76 months, p=0.013). In our series, the epidemiological and clinical characteristics of patients with ATL were comparable with those of the series of Japan and Jamaica. Scarcity of evolution from a type to another testified to the robustness of the LSG and suggested that the natural history of the tumoral cells of the various types of ATL was different. Hypercalcaemia was a discrimination factor for severity, particularly in the acute type, and the major cause of death. Skin lesions conferring a better prognosis, in particular in the lymphoma type, required early detection of these lesions in indolent disease and in HTLV-1 healthy carriers, especially among relatives of patients with ATL and/or infected by Ss, and suggested that their treatment could limit transformation to the aggressive forms of ATL. The atypical phenotypes, in particular DN cases, CD7 (- ) or CD7 (+), DP cases and CD3(-) cases, could be interpreted as thymic progenitors. Also, weak expression of the complex CD3 / TCR observed on ATL cells suggested that the target cell had acquired an intermediate differentiation level between immature cortical thymocytes and mature thymocytes. The scarcity of ATL in adolescents, associated with the strong majority of the patients being more than 40 years old, suggested the hypothesis of the necessity of the "involution" of the thymus for an accomplished ATL cell. Disclosures No relevant conflicts of interest to declare.
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Pertusa Rodríguez, Luis. "Dimensión consular de la gestación por sustitución en Derecho internacional privado = Consular aspects of surrogate gestation under International Private Law." CUADERNOS DE DERECHO TRANSNACIONAL 10, no. 2 (October 5, 2018): 597. http://dx.doi.org/10.20318/cdt.2018.4391.
Повний текст джерелаАнотація:
Resumen: El artículo 10.1 de la Ley 14/2006 establece la nulidad de los contratos de gestación por sustitución en España. La Instrucción de la DGRN de 5 de octubre de 2010 diseña un mecanismo para recibir resoluciones extranjeras que establezcan filiaciones mediante gestación por sustitución en un registro civil consular. La instrucción exige que la filiación venga determinada por una sentencia judicial. El encargado del registro civil consular tiene un amplio margen de maniobra a la hora de realizar la inscripción así como para exigir que la sentencia extranjera haya obtenido un exequatur o bien realizar un reconocimiento incidental de la misma.Palabras clave: gestación por sustitución, Instrucción de la DGRN, registro civil consular, sentencia judicial, reconocimiento incidental.Abstract: Article 10(1) of law 14/2006 establishes the nullity of contracts of surrogate gestation in Spain. DGRN Rule of October the 5th of 2010 devises a mechanism to receive in a consular civil registry foreign resolutions that establishes filiations through surrogate gestation. The Rule requires that the filiation will be determined by a court ruling. The person in charge of the consular civil registry has a wide discretion when registering this ruling as well as considering if an exequatur is needed or a direct recognition is adequate.Keywords: surrogate gestation, DGRN ruling, consular civil registry, court ruling, direct recognition.
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Giannis, Dimitrios, Steven L. Allen, Anne Davidson, Galina S. Marder, Sarah Flint, David Garrett, Richa Thakur, et al. "Thromboembolic Outcomes of Hospitalized COVID-19 Patients in the 90-Day Post-Discharge Period: Early Data from the Northwell CORE-19 Registry." Blood 136, Supplement 1 (November 5, 2020): 33–34. http://dx.doi.org/10.1182/blood-2020-141901.
Повний текст джерелаАнотація:
Introduction Thromboembolic outcomes have emerged as an important issue in sick hospitalized patients with COVID-19. Multiple pathogenetic mechanisms for thrombosis have been implicated, including endothelial dysfunction, increased von Willebrand factor (vWF), interleukin-6 release, and activation of/interaction between macrophages, monocytes, endothelial cells, platelets and lymphocytes. The actual rate of arterial and venous thromboembolic events (ATE and VTE) in hospitalized patients with COVID-19, especially in the immediate post-hospital discharge period, has not been fully elucidated, with most of the data derived from retrospective studies with small sample sizes. Methods Against this background, we have designed and implemented an ongoing prospective registry (CORE-19) consisting of 11,249 consecutive hospitalized patients with COVID-19 from March 1st 2020 through May 31st 2020 using data derived from the Northwell Health System and the COVID-19 Research Consortium to study through 90-days post-discharge the rate of VTE and ATE, major bleeding, all-cause mortality, and other complications. We are capturing data of interest including demographic characteristics, co-morbidities, relevant medications, hospital setting, in-hospital treatment, thromboprophylaxis usage, key laboratory parameters, and 90-day thromboembolic and other key outcomes. A unified data repository (datamart) of hospitalized COVID-19 patients across multiple datasets from electronic health records, health informatics exchange, a dedicated radiology database, and a standardized data collection tool in REDCap, that includes telephonic calls up to 90 days post-discharge, is being implemented. A common data model (CDM) is utilized to ensure semantic interoperability between data originating from disparate sources. Northwell Health protocols stipulate the use of post-discharge low-molecular weight heparin, direct oral anticoagulants, or baby aspirin in hospitalized COVID-19 patients with high thrombotic risk features. Results Our cohort as of August 7, 2020 consists of complete follow up in 4,100 patients with a mean age of 61.0 years (SD: 17.0) with 54.7% males (Table 1). Preliminary data show an all-cause mortality rate of 4.29%, an overall thromboembolic rate of 3.51% (2.41% VTE and 1.10% ATE), a major bleeding rate of 1.61%, and a rehospitalization rate of 12.85%. Of patients with either DVT or PE post-discharge, 13.43% (9/67) died. The full dataset, including risk factors, comorbidities, key in-hospital and post-discharge medications including anticoagulant and antiplatelet agents, will be available at the time of presentation to the ASH congress. Conclusion Our ongoing registry is a large prospective study evaluating the rate of overall thromboembolic complications and all-cause mortality in hospitalized COVID-19 patients through 90 days post discharge. Current rates of thromboembolic events signify the importance of post-discharge surveillance and, potentially, post-discharge extended thromboprophylaxis, in this acutely ill medical population. Disclosures Allen: Bristol Myers Squibb: Current equity holder in publicly-traded company. Spyropoulos:Janssen, Boehringer Ingelheim, Bayer, BMS, Portola, ATLAS Group: Consultancy; Janssen, Boehringer Ingelheim: Research Funding.
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Sánchez Cano, Mª Jesús. "La determinación de la filiación en situaciones transnacionales: cuestiones prácticas." CUADERNOS DE DERECHO TRANSNACIONAL 12, no. 2 (October 8, 2020): 1177. http://dx.doi.org/10.20318/cdt.2020.5666.
Повний текст джерелаАнотація:
Los problemas que suscita en la práctica el establecimiento de la filiación se acrecientan en supuestos transfronterizos, debido a los diferentes elementos internacionales que presentan este tipo de situaciones. La cuestión puede dar lugar a mayores dificultades cuando la filiación viene establecida por una autoridad extranjera y no ha accedido al Registro Civil español. Más aún, si existe contradicción entre la filiación establecida en virtud de inscripción registral extranjera y la que consta en el Registro Civil español. En estos casos cabe preguntarse cuál será la ley aplicable al establecimiento de la filiación y si es posible otorgar algún efecto a la documentación registral extranjera.
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Xia, Ying, Aqing Liu, Wentao Li, Yunhe Liu, Guan Zhang, Songshan Ye, Zhijieruo Zhao, et al. "Reference range of naïve T and T memory lymphocyte subsets in peripheral blood of healthy adult." Clinical and Experimental Immunology 207, no. 2 (December 29, 2021): 208–17. http://dx.doi.org/10.1093/cei/uxab038.
Повний текст джерелаАнотація:
Abstract Naïve T and T memory cell subsets are closely related to immune response and can provide important information for the diagnosis and treatment of immunological and hematological disorders. Lymphocyte compartment undergoes dramatic changes during adulthood; age-related reference values derived from healthy individuals are crucial. However, extensively detailed reference values of peripheral blood lymphocytes in the whole spectrum of adulthood detected by multi-color flow cytometry on a single platform are rare. Three hundred and nine healthy adult volunteers were recruited from Tianjin in China. The absolute counts and percentages of CD3+CD4+ T cells, CD3+CD8+ T cells, naïve T cells (Tn), T memory stem cells (Tscm), central memory T cells (Tcm), effector memory T cells (Tem), and terminal effector T cells (Tte) were detected by flow cytometry with single platform technologies. Reference range of absolute counts and percentage of T lymphocyte subsets were formulated by different age and gender. The results showed that Tn and Tscm cells, which had stem cell properties, decreased with aging; while, Tcm and Tem increased with aging, which increased from 18 to 64 years old but presented no significant change over the 65 years old. Gender had an influence on the fluctuation of lymphocyte subsets, the absolute count of CD3+CD8+, CD8+Tcm, CD8+Tem in males were higher than those in females. The reference values of percentages and absolute numbers of naïve T and T memory cell subsets can help doctors to understand the immune state of patients and evaluate conditions of prognosis then adjust the treatment for patients. (Chinese Clinic Trial Registry number: ChiCTR-IOR-17014139.)
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Kurian, Tony J., Vivian Irizarry Gatell, William Adams, Stephanie B. Tsai, Scott E. Smith, Patrick J. Stiff, and Patrick Hagen. "Impact of Graft Composition on Graft-Versus-Host Disease in Peripheral Blood HLA-Identical Sibling Transplants: Protective Role of CD8 Cell Dose." Blood 132, Supplement 1 (November 29, 2018): 5719. http://dx.doi.org/10.1182/blood-2018-99-115557.
Повний текст джерелаАнотація:
Abstract Introduction and Objective: Acute graft-versus-host disease (aGVHD) is a leading cause of transplant related mortality following allogeneic hematopoietic stem cell transplantation (HSCT). Data on the impact of graft composition, namely CD34 and T-cell subsets, and aGVHD is conflicting. We hypothesized an upper cell dose limit of CD34 would exist predictive of aGVHD without affecting engraftment and sought to explore T-cell subsets and their impact on aGVHD outcomes amongst peripheral blood progenitor cell (PBPC) HLA-identical sibling transplants (Allo-Sib). Methods: In an IRB approved protocol, consecutive Allo-Sib patients underwent HSCT for hematologic malignancy at our center from 1/2004 to 12/2012. Demographic and clinical data were prospectively collected and retrospectively confirmed. Patients received the entire D1 CD34 PBPC collection from their donors and from a second day of collection if necessary to achieve a dose of 4 x 106 CD34/kg cells. aGVHD prophylaxis was uniformly tacrolimus and mini-methotrexate. Tacrolimus was monitored to achieve a trough of 10-15 ng/ml. aGVHD was graded as per the International Bone Marrow Transplant Registry System. Exact binary logistic regression models were used to estimate the odds of aGVHD as a function of patient demographic and clinical data. For the association between cell counts and aGVHD, binary cut scores were determined by finding the point along the receiver operating characteristic curve that maximized sensitivity and specificity. Non-parametric Spearman correlation coefficients were used to estimate the association between CD34, CD3, CD4, and CD8 cell counts. Results: We analyzed 160 consecutive patients. In this mostly male (63%) population, median age was 51 and most patients underwent a myeloablative transplant (93%). Disease risk as per Armand et al 2012 was low 45%, intermediate 13.2%, and high 41.7%. Co-Morbidity Index by Sorror et al (HCT-CI) was 30.5% for 0, 33.8% for 1-2, and 35.8% for > 2. Sixteen patients (10%) developed grade II-IV aGVHD while 9 (6%) developed grade III-IV aGVHD. Median CD34 cell dose infused was 6.27 X 106/kg. Median CD3, CD4, and CD8 cell doses infused were 2.51 X 108/kg, 1.80 X 108/kg, and 0.66 X 108/kg, respectively. In univariate analysis, patients (n=67) receiving > 9.94 x 106 CD34/kg were 12 times more likely to develop grade III-IV aGVHD (odds ratio =12.308; p=0.01)(figure 1). Conversely, patients receiving > 0.50 x 108 CD8/kg were less likely to develop grade II-IV aGVHD (odds ratio = 0.30; p=0.049)(Figure 2), but not Grade III-IV aGVHD. The only other factor associated with aGVHD was a diagnosis of AML, which was protective (p=0.01). CD3 and CD4 cell counts did not correlate with aGVHD in our patient cohort. There was no correlation between engraftment and CD34, CD3, CD4, or CD8 cell dose. Finally, we found no direct correlation between CD34 cells counts and CD3, CD4, or CD8 cell counts. Conclusion: This study represents the largest evaluation examining the correlation between both infused CD34 cells and T-cell composition with aGVHD among patients undergoing strictly matched related donor HSCT. Importantly, the data demonstrates patients receiving > 10 x 106 CD34/kg have increased risk of developing clinically significant aGVHD, a dose that far exceeds adequate engraftment doses and serves now as a cap on CD34 cell dose in our program. Interestingly, our data suggests infusion of > 0.50 x 108 CD8/kg may protect from severe aGVHD whereas prior reports have demonstrated no association between CD8 cells and aGVHD. Further investigation is needed to better characterize the relationship between CD8 cells and aGVHD and better define the correlation between CD8 and CD34 cell doses in the development of aGVHD. Disclosures No relevant conflicts of interest to declare.
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Douglas, Raymond S., Thomas H. Brix, Catherine J. Hwang, Laszlo Hegedüs, and Terry J. Smith. "Divergent Frequencies of IGF-I Receptor-Expressing Blood Lymphocytes in Monozygotic Twin Pairs Discordant for Graves’ Disease: Evidence for a Phenotypic Signature Ascribable to Nongenetic Factors." Journal of Clinical Endocrinology & Metabolism 94, no. 5 (May 1, 2009): 1797–802. http://dx.doi.org/10.1210/jc.2008-2810.
Повний текст джерелаАнотація:
Abstract Context: Graves’ disease (GD) is an autoimmune process of the thyroid and orbital connective tissues. The fraction of T and B cells expressing IGF-I receptor (IGF-IR) is increased in GD. It is a potentially important autoantigen in GD. Susceptibility to GD arises from both genetic and acquired factors. Objective: The aim of the study was to determine whether the increased frequency of IGF-IR-expressing T and B cells in GD results from genetic or nongenetic factors. Design/Setting/Participants: Display of IGF-IR was assessed on blood lymphocytes from 18 pairs of monozygotic twins in the Danish Twin Registry, including seven discordant pairs, four pairs concordant for GD, and seven healthy pairs. Main Outcome Measures: Subjects underwent physical examination and laboratory analysis. Surface display of IGF-IR on T and B cells was analyzed by flow cytometry. Results: Twins with GD display increased IGF-IR-expressing CD3+ T cells and T cell subsets including total CD4+, CD4+ naive, CD4+ memory, and CD8+ cells (P < 0.0001, P = 0.0001, P = 0.0003, P = 0.01, and P = 0.02, respectively) compared to healthy twins. The frequency of IGF-IR-expressing B cells from affected twins was increased relative to healthy controls (P = 0.009). In pairs discordant for GD, affected twins exhibited increased frequency of IGF-IR+ CD3+, CD4+, and CD4+ naive T cells (P < 0.05, P = 0.03, and P = 0.03, respectively) compared to their healthy twin. Conclusion: Our findings suggest that more frequent IGF-IR+ T cells in GD cannot be attributed to genetic determinants. Rather, this skew appears to be acquired. These results underscore the potential role of nongenetic, acquired factors in genetically susceptible individuals.
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Egbert, Jesse, and Douglas Biber. "Do all roads lead to Rome?: Modeling register variation with factor analysis and discriminant analysis." Corpus Linguistics and Linguistic Theory 14, no. 2 (September 25, 2018): 233–73. http://dx.doi.org/10.1515/cllt-2016-0016.
Повний текст джерелаАнотація:
Abstract Previous theoretical and empirical research on register variation has argued that linguistic co-occurrence patterns have a highly systematic relationship to register differences, because they both share the same functional underpinnings. The goal of this study is to test this claim through a comparison of two statistical techniques that have been used to describe register variation: factor analysis (as used in Multi-Dimensional analysis, MDA) and canonical discriminant analysis (CDA). MDA and CDA have different statistical bases and thus give priority to different analytical considerations: linguistic co-occurrence in the case of MDA and the prediction of register differences in the case of CDA. Thus, there is no statistical reason to expect that the two techniques, if applied to the same corpus, will produce similar results. We hypothesize that although MDA and CDA approach register variation from opposite sides, they will produce similar results because both types of statistical patterns are motivated by underlying discourse functions. The present paper tests this claim through a case-study analysis of variation among web registers, applying MDA and CDA to analyze register variation in the same corpus of texts.
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Saad, Ayman, Tao Wang, Michael T. Hemmer, Stephen R. Spellman, Mukta Arora, Lawrence S. Lamb, and Shahrukh K. Hashmi. "Impact of T-Cell Dose on Gvhd Risk after Allogeneic HLA-Matched PBSC Transplantation." Blood 132, Supplement 1 (November 29, 2018): 3410. http://dx.doi.org/10.1182/blood-2018-99-113513.
Повний текст джерелаАнотація:
Abstract Background: Conflicting data exists on whether T-cell dose of allogeneic stem cell product influences transplant outcome. Methods: Using CIBMTR database, we identified 2,736 adult patients who underwent first allogeneic HCT for AML/ALL/MDS (between 2008-2014) with PBSC from an HLA-identical sibling donor (MSD) or 8/8-matched unrelated donor (MUD). This cohort excluded ex-vivo and in-vivo T-cell depletion transplants. Correlative analysis was done between CD3 cell dose and risk of GVHD, relapse, NRM, DFS and OS. Results: T-cell dose cutoff values were identified (using maximum likelihood estimation method) to identify differential risk of aGVHD (grade II-IV) in both MSD and MUD groups. A CD3 cell dose cutoff of 14 x107 cells/kg identified MSD/low CD3 (n=223) and MSD/high CD3 (n=1214) and a dose of 15 x107 cells/kg identified MUD/low CD3 (n=197) and MUD/high CD3 (n=1102). CD3 and CD34 cell doses did not correlate. Median CD3 cell dose were 11 and 29 in the MSD/Low and MSD/High groups, respectively, and 10 and 28 in the MUD/Low and MUD/High groups, respectively. In MSD/high CD3, cumulative incidence (CI) of D100-aGVHD (GII-IV) was higher (33% vs 25%) (P value =0.009) without influence on engraftment, severe aGVHD (GIII-IV), cGVHD, NRM, relapse, DFS, or OS. In MUD/high CD3, CI of D100-aGVHD (GII-IV) was higher (50% vs 40%) (p value=0.009) and so was the CI of 6-month-cGVHD (31% vs23%) (p value = 0.02) with no influence on engraftment, severe aGVHD, 2-year-GVHD, NRM, relapse, DFS, or OS. On multivariate analysis, both MSD (table 1) and MUD (table 2) groups failed to show a correlation between CD3 cell dose and aGVHD (GII-IV) (p value =0.1 and 0.07), cGVHD (p value=0.8 and 0.3) for both groups respectviely. Sub-analysis of CD4, CD8 and CD4/CD8 ratio failed to identify cutoff values predictive of transplant outcome. Using log-rank test, the sample size was, however, suboptimal to identify difference (with 80% power at 0.05% significant level) at these cutoff cell dose. Conclusion: In this relatively small registry study, the CD3 cell dose in the PBSCT product did not influence the risk of acute or chronic GVHD or other transplant outcome when using matched sibling or 8/8 unrelated donors. Disclosures Saad: Actinium: Consultancy. Lamb:Incysus Therapeutics Inc.: Consultancy, Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Research Funding.
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Martins, Faber Sérgio Bastos, and José Augusto Rodrigues Dos Santos. "Alterações agudas induzidas por uma prova de triathlon longo em diferentes biomarcadores enzimáticos e da função imune." Revista Brasileira de Fisiologia do Exercício 11, no. 1 (November 13, 2019): 7. http://dx.doi.org/10.33233/rbfe.v11i1.3373.
Повний текст джерелаАнотація:
Objectivo: Analisar as alterações hematológicas agudas induzidas por uma prova de triathlon longo. Avaliou-se o comportamento de diversos biomarcadores enzimáticos e da função imune em atletas portugueses masculinos de triathlon. Métodos: 10 atletas seniores masculinos (31,5 ± 1,2 anos; 69,3 ± 1,9 kg; 177,7 ± 1,4 cm; 22,0 ± 0,8 de IMC e 10,1 ± 2,2 % GC) divididos em grupos elite e não-elite. Foram recolhidas amostras de sangue venoso periférico antes e imediatamente após as provas. Utilizou-se estatística descritiva, testes não-paramétricos de Wilcoxon e Mann-Whitney e coeficiente de correlação de Spearman. Resultados: Verificou-se o aumento da actividade das enzimas CK e AST (p < 0,05) em ambos os grupos. O aumento da actividade da enzima GGT (p < 0,05) ocorreu somente no grupo elite. Foi constatado, em ambos os grupos, um aumento da contagem leucocitária, fundamentalmente expressa pelo aumento da contagem de neutrófilos (p < 0,05). Após a prova, registou-se a diminuição da relação CD4/CD8 e aumento das concentrações dos linfócitos T CD3+CD8+, T CD4+reg e T CD4+CD69+ nos atletas dos grupos não-elite. Conclusão: Os resultados encontrados sugerem que a intensidade e a duração da prova de triathlon condicionam as respostas dos diversos biomarcadores analisados em função do nível de treino dos atletas.Palavras-chave: triathlon, treino, actividade enzimática, sistema imune, linfócitos.
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Horvath, Alena Veronica, and Juan Pablo Pérez Velázquez. "Análisis comparado de los registros de la propiedad alemán y español: ¿sería posible un registro de la propiedad común europeo?" CUADERNOS DE DERECHO TRANSNACIONAL 13, no. 2 (September 10, 2021): 256–88. http://dx.doi.org/10.20318/cdt.2021.6267.
Повний текст джерелаАнотація:
Sobre la base de un análisis comparado de los Registros de la Propiedad alemán y español, el objetivo de este trabajo es abordar el estudio de la viabilidad de crear un Registro de la Propiedad Común Europeo, que elimine las incertidumbres que genera que un ciudadano comunitario adquiera un bien inmueble en otro país de la Unión Europea, otorgando seguridad jurídica en el tráfico inmobiliario. En definitiva, configurar un sistema registral transfronterizo comunitario, que agilice y otorgue seguridad jurídica a la transmisión de bienes inmuebles.
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Nelson, Lorene M., Barbara Topol, Wendy Kaye, Jaime Raymond, D. Kevin Horton, Paul Mehta, and Todd Wagner. "Evaluation of the Completeness of ALS Case Ascertainment in the US National ALS Registry: Application of the Capture-Recapture Method." Neuroepidemiology 56, no. 2 (December 20, 2021): 104–14. http://dx.doi.org/10.1159/000521591.
Повний текст джерелаАнотація:
<b><i>Introduction:</i></b> The Centers for Disease Control and Prevention (CDC) National Amyotrophic Lateral Sclerosis (ALS) Registry is the first national registry for a chronic neurologic disease in the USA and uses a combination of case-finding methods including administrative healthcare data and patient self-registration. <b><i>Methods:</i></b> We applied capture-recapture methodology to estimate the completeness of the Registry for ascertaining patients with ALS for the first full year and the fourth year of the Registry (2011, 2014). The Registry uses the combination of two national administrative claims databases (Medicare and Veterans Affairs) with a self-register option at the registry portal. We conducted descriptive analyses of the demographic and clinical characteristics of the ALS cases identified by each of the sources and estimated the completeness of case ascertainment for each of the three ALS Registry sources individually, pairwise, and in all combinations. <b><i>Results:</i></b> Case-finding completeness was 54% in 2011 and improved to 56% in 2014. A smaller proportion of ALS patients under age 65 were ascertained than those 65 or older, and ascertainment was also lower for nonwhite than white patients. The uncorrected ALS prevalence was 4.3/100,000 in 2011 (in 2014, 5.0/100,000), but after correction for underascertainment, annual prevalence in 2011 was 7.9/100,000 (95% CI: 7.6–8.2) (in 2014 was 8.9/100,000 [95% CI: 8.7–9.2]). <b><i>Discussion/Conclusion:</i></b> Our findings indicate that administrative healthcare databases are a very efficient method for identifying the majority of ALS prevalent cases in the National ALS Registry and that the inclusion of a web registry portal for patients to self-register is important to ensure a more representative population for estimating ALS prevalence. Nonetheless, more than 40% of ALS cases were not ascertained by the Registry, with individuals younger than age 65 and people of color underrepresented. Recommendations are provided for additional methods that can be considered to improve the completeness of case ascertainment.
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Chadwick, R., K. Elliott, R. Haworth, H. Kearney, and A. Laviolette. "P066: A quality improvement project to improve access to automated external defibrillators in the Niagara region community." CJEM 22, S1 (May 2020): S88. http://dx.doi.org/10.1017/cem.2020.272.
Повний текст джерелаАнотація:
Background: Over 35,000 Canadians lose their lives to cardiac arrest each year. CPR and automated external defibrillator (AED) use are modifiable factors. Survival rates drop by 7-10% each minute that defibrillation is delayed, and survival rates are less than 5% after 12 minutes of ventricular fibrillation which stresses the need for bystander AED use in out-of-hospital arrests. Niagara Region lacks a publicly accessible registry of AEDs. AED access is a major focus in King County, Washington which has higher survival rates and has all AEDs registered with Emergency Medical Services. Aim Statement: This project aims to log 100 or more AEDs within a year into a publicly accessible registry and to connect the registry information to medical trainees in the Niagara region and all employees of the Niagara Health System involved in patient care. Measures & Design: PulsePoint is an application used to register AEDs within the Niagara region. PulsePoint allows users to geotag AEDs while tracking data entries. Over 16 weeks, 4 PDSA cycles tested the effectiveness of logging methods for AEDs including opportunistic logging, daily emailed reminders, and contacting organizations with high likelihood of having an AED. Information about the project and registry was shared with residents and medical students in Niagara. A second phase of cycles involves relaying information to Niagara Health system employees and the medical community. A final cycle will target a broader group of local organizations with intermediate probability of having AEDs. Primary outcome measures include the numbers of regional AEDs logged and members reached by knowledge sharing cycles. Evaluation/Results: PulsePoint was found to be an effective, free, publicly accessible resource to log AEDs within the Niagara region. The initial round of 4 PDSA cycles added a total of 56 new AEDs within the region, which were logged into PulsePoint app and the Excel spreadsheet. Through the fourth PDSA cycle, 136 businesses were contacted and made aware of the project and the AED application. In addition,138 health-related colleagues and medical students were contacted to raise awareness. PDSA cycles five through eight are currently ongoing or in the planning stages. Discussion/Impact: Raising awareness among emergency services and sharing information about the registry to local CPR training providers will be paramount. Creating awareness of PulsePoint and installing AEDs in locations that currently lack such devices could ultimately improve cardiac arrest survival rates within Niagara Region.
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Carrasco, A., B. Beltran, J. Malaga, G. Ferrel, H. Rios, J. Castillo, J. Huamani, M. Rodriguez, D. Flores, and S. Falcon. "Immunophenotypic diversity and prognosis of adult T-cell leukemia/lymphoma." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 17565. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.17565.
Повний текст джерелаАнотація:
17565 Background: Adult T-cell leukaemia/lymphoma (ATLL) is an aggressive disease associated with human T-cell lymphotropic virus type-I (HTLV-I) with heterogeneous clinical presentation and outcomes, described in Southern Japan, Europe, Caribbean and previously on Pacific coast of South America including Peru (EHA 2001, abst. 304). Shimoyama’s ATLL classification (BHJ 1991:79), includes four types: acute, lymphomatous, chronic and smouldering; recently a new clinical cutaneous type had been described (BJD 2005:152). Methods: We described our experienced previously (ASH 2005, abst. 4797). Herein we analyzed immunophenotypically our ATLL patient population by flow cytometry looking for aberrant phenotypes and their correlation with overall survival. The statistical method was descriptive and survival was calculated using the Kaplan-Meier method. Results: From July 1997 to March 2005 our registry had 69 cases, 37 had flow pre-treatment: acute type (n = 31) and lymphomatous (n = 6). Over our 37 flow done we were able to analysis only 33. The incidence of the typical (CD4+/CD8-) phenotype, the double-negative (CD4-/CD8-), the double-positive (CD4+/CD8+), and the CD8 positive (CD4-/CD8+) phenotypes was 58%, 12%, 15%, and 12% respectively. The median overall survival (OS) for the 33 patients was 4.1 months (range: 0.5–46.1). The patients with typical phenotypes had a median OS of 4.1 months better than the patients with the double-negative phenotype whom median OS was 2.0 (range: 1.5–9.7) but not significant. Median OS in the double positive and the CD4-/CD8+ phenotype population were 15.2 and 4.8 months respectively with no significance Conclusions: ATLL has a diversity of immunophenotype, our data suggest that there is not any correlation with survival, major accrual will gave us a final conclusion. No significant financial relationships to disclose.
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Kenney, M. B., J. French, J. Fraser, B. Phelan, I. Watson, S. Benjamin, A. Chisholm, T. Pishe, J. Middleton, and P. R. Atkinson. "LO052: Sticks and stones may break your bones, but does having a car crash in a rural location affect your access to EMS care and surgical intervention? The initial analysis of a unique EMS and Trauma Dataset." CJEM 18, S1 (May 2016): S48. http://dx.doi.org/10.1017/cem.2016.89.
Повний текст джерелаАнотація:
Introduction: In Canada, major trauma is a healthcare priority and in 2014 was responsible for over 15866 deaths, with a total economic burden of 26.8 billion dollars. Numerous factors influence the likelihood of occurrence and outcome from major trauma, including incident factors, host, EMS response, emergency, surgical and critical care. Traditionally trauma registers contained information that mainly concerning hospital treatment and host factors. This collaborative analysis uses matched data from a Provincial Trauma Research Register and records from a Provincial Ambulance Service. Methods: A retrospective observational (registry) study comparing rural and urban adult and pediatric major trauma patients (Injury Severity Score >15) who were injured in a motor vehicle crash (ICD V20-V99) and presented to a level 1 or level 2 trauma centre by EMS by primary or secondary transfer, between April 2011 and March 2013 in a selected province in Canada. Comparisons of the process care times, and patient disposition, were made in an inclusive trauma system. Results: 108 cases meet the inclusion criteria with 78 considered rural and 30 urban using published definitions. The median response times were 16.2 minutes for rural (95% CI: 13.2 -19.8) and 7.8 minutes for urban (95% CI: 7.2 - 10.5) with 60% and 61% meeting response targets respectively. A greater proportion of urban patients are taken initially to level 3-5 centers and require secondary transfer (45% urban vs 24% rural p=<0.01). Median times intervals to surgical care were double for the urban patients (14 rural vs 32 hrs urban p=<0.01). Conclusion: The majority of serious road traffic collisions occur in rural areas. Although rural patients wait longer for an initial EMS response, more rural patients are taken directly to a level 1 or 2 trauma center. Unexpectedly then rural patients have much shorter times to surgical care. The benefits of an inclusive trauma system should be weighed against the benefits of bypass processes in urban environments where the nearest Emergency Department is not a Level 1 or 2 Trauma Center.
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Ruiz Sutil, Carmen. "Control por la DGRN de la certificación de nacimiento extranjera y la aplicación imperativa de la presunción de la paternidad del marido de la madre." CUADERNOS DE DERECHO TRANSNACIONAL 12, no. 2 (October 8, 2020): 758. http://dx.doi.org/10.20318/cdt.2020.5629.
Повний текст джерелаАнотація:
La mención del dato del padre recogido en un Registro extranjero y su acceso en la inscripción de nacimiento del Registro Civil español viene suscitando lo que hemos denominado como filiación contradictoria, problemática que trae causa en la presunción de paternidad del marido de la madre cuando los cónyuges ya se hallan separados de hecho en la época del nacimiento del hijo. El rechazo de la inscripción de la paternidad –cuando se incorpora en un título extranjero– origina una abundante doctrina de la DGRN, que afecta principalmente a las inscripciones de nacimiento de un importante sector de naturalizados españoles, además de entorpecer el derecho de opción y la atribución a la nacionalidad española del descendiente de sujeto español. Dicho resultado se debe a la aplicación como norma imperativa de la regla sustantiva de la presunción de paternidad matrimonial que lleva a cabo la autoridad registral española en el control de la filiación contenida en la certificación extranjera. Este estudio servirá, por un lado, para evidenciar la necesidad de mejorar la constatación de la paternidad del nacido de progenitor diferente al marido de la madre y, por otro lado, para ofrecer soluciones que atenúen las situaciones claudicantes de filiación que surgen a raíz de las circunstancias expuestas.
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Steindl, Ariane, Maximilian Mair, Angelika Martina Starzer, Karin Dieckmann, Georg Widhalm, Johannes A. Hainfellner, Manuela Schmidinger, Matthias Preusser, and Anna Sophie Berghoff. "Radiation-induced changes in the inflammatory microenvironment composition of lung cancer brain metastases." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 2528. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.2528.
Повний текст джерелаАнотація:
2528 Background: Radiotherapy was postulated to impact the inflammatory microenvironment composition in patients with lung cancer brain metastases (BM). Methods: Formalin fixed and paraffin embedded BM specimens from treatment naïve patients (group 1) and from patients treated with radiation therapy including whole brain radiotherapy and/or stereotactic radiosurgery (group 2) or prophylactic cranial irradiation (group 3) before BM resection were identified from the Vienna Brain Metastasis Registry. T cell subsets (CD3+,CD8+,CD45RO+,FOXP3+,PD-L1+) were investigated using the Ventana Benchmark Ultra system Definiens software. Results: Specimens from 41 patients (28/41;68.3% NSCLC, 13/41;31.7% SCLC) were included in the study. A significant difference in CD3+TIL density between group 1 (median: 964.5cells/mm2) and group 2 (median: 283.4cells/mm2; p-value=0.021; Mann-Whitney-U test), as well as group 3 (median: 168.8 cells/mm2; p-value= 0.028; Mann-Whitney-U test) were observed. Furthermore, CD8+ and FOXP3+TIL densities of group 2 (CD8+ median: 172.1cells/mm2; FOXP3+ median: 210.7cells/mm2) were numerically lower compared to group 1 (CD8+ median: 190.1 cells/mm2; FOXP3+ median: 221.2 cells/mm2). Of 10/41 (24.4%) patients further resected BM tissue specimens after initial resection were available. Here, the inflammatory microenvironment of BM treated with radiation therapy between the resections was significantly associated with lower densities of CD3+ (median: 105.1 cells/mm2) and CD8+ (median: 20.3cells/mm2) compared to radiation-naïve patients (CD3+ median: 825.4cells/mm2; CD8+median: 105.5cells/mm2; p=0.037; Mann-Whitney U-test). Conclusions: Radiation treatment was associated with lower densities of TIL subsets in our BM cohort. Although results have to be interpreted with caution due to the limited sample size, further studies investigating the sequencing of radiotherapy and immune modulating therapies might be of interest. [Table: see text]
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Vinall, M., and R. Henry. "An Update on the CCS CDI Registry." MD Conference Express 14, no. 24 (October 1, 2014): 15. http://dx.doi.org/10.1177/155989771424007.
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Martin, Claudio M., Fran Priestap, Harold Fisher, Robert A. Fowler, Daren K. Heyland, Sean P. Keenan, Christopher J. Longo, Teresa Morrison, Diane Bentley, and Neil Antman. "A prospective, observational registry of patients with severe sepsis: The Canadian Sepsis Treatment and Response Registry*." Critical Care Medicine 37, no. 1 (January 2009): 81–88. http://dx.doi.org/10.1097/ccm.0b013e31819285f0.
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Martins, Faber Sérgio Bastos, and José Augusto Rodrigues Dos Santos. "Modulação dos marcadores de ativação linfocitária induzida por três diferentes competições de triathlon." Revista Brasileira de Fisiologia do Exercício 13, no. 2 (April 10, 2014): 86. http://dx.doi.org/10.33233/rbfe.v13i2.3292.
Повний текст джерелаАнотація:
Introdução: A ativação do sistema nervoso simpático durante o exercício físico influencia a resposta imunológica através da produção e libertação de catecolaminas e glucocorticóides, responsáveis pela redistribuição dos linfócitos, exercendo uma ação imunossupressora sobre o organismo. Objectivo: Analisar os efeitos de três diferentes provas de triathlon na modulação dos marcadores de ativação linfocitária. Métodos: Foram estudados 10 atletas masculinos (31,5 ± 1,2 anos; 69,3 ± 1,9 kg; 177,7 ± 1,4 cm; 22,0 ± 0,8 de IMC e 10,1 ± 2,2 % GC) divididos em grupos elite e não-elite. Foram recolhidas amostras de sangue venoso periférico antes e imediatamente após as provas. Utilizou-se estatística descritiva, testes não-paramétricos de Wilcoxon e Mann-Whitney e coeficiente de correlação de Spearman. Resultados: Foram observados, após o TL, aumentos da contagem linfocitária do fenótipo TCD3+CD4+CD25+ (reguladoras) nos grupos elite (151,1%, p = 0,015) e não-elite (83,8%, p = 0,000). O biomarcador CD3+CD4+CD69 registou um comportamento conflitual após o TL, tendo aumentado 87,5% (p = 0,009) no grupo elite e diminuído 124,5% (p = 0,023) nos não-elite. O fenótipo citotóxico CD8+CD127 sofreu reduções em todas as provas, somente no grupo elite. Após o TO observou-se um incremento da contagem das células que expressam o marcador CD4+CD45RO+ em ambos os grupos (p < 0,05). Conclusão: Os resultados encontrados sugerem que a intensidade e a duração das provas de triathlon modulam o comportamento dos biomarcadores de ativação linfocitária em função do nível do treino dos triatletas.Palavras-chave: leucocitose, linfopenia, cortisol, catecolaminas, interleucinas.
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Vega, Marti Yareli Del Monte, Teresa Shamah-Levy, Abelardo Ávila Curiel, MarcoAntonio Avila Arcos, Ignacio Mendez-Gómez Humarán, and Carlos Galindo Gómez. "Overweight and Obesity Behavior in Mexican School-Age Children Attending to Public Elementary Schools During 2015 to 2018 Period." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 1394. http://dx.doi.org/10.1093/cdn/nzaa061_022.
Повний текст джерелаАнотація:
Abstract Objectives To document the behavior of overweight and obesity among school-age population, that attends to public elementary schools through four consecutive school years. Methods An epidemiological, descriptive study, that consisted on four transversal yearly and consecutive stages from August 2015 to December 2018. Applied a Generalized Ordinal Logistic Regression model and the relative risk (RR) calculation. Country region, rural or urban locality and marginalization index (MI) of the school were used as socio demographic variables. Overweight and obesity prevalences where adjusted through the marginal probabilities estimators. The databases used were the public versions of the results of the National Weight and Height Registry (Registro Nacional de Peso y Talla in Spanish) from the Mexico National Nutrition Institute. Results A total of 59,724 schools were evaluated from which 17’491,685 anthropometries were obtained for the four school years. Regarding RR evaluation, from the regression model we were able to identify statistically significant differences (P < 0.001) by sex, rural or urban locality, MI, and age in the two panels (Panel 1 Overweight development, Panel 2: Obesity development). Urban school-age population shown a RR greater by 22.2% for develop overweight and 25% for obesity when comparing with the rural. RR 74% and 104% greater were identified for develop overweight and obesity respectively for school children with very low MI in comparison with those with high MI. Men displayed a 20% greater RR of develop overweight when they previously had a normal nutritional status and a RR 46% greater of develop obesity when they came from a normal or overweight nutritional status when compared with women. Adjusted prevalences analysis allowed to observe how the Center Region (unlike North and south regions), shown a decreasing trend in the probability of develop overweight in the 2015–2018 period. Conclusions We identified an accelerated increase in a relatively short period of time in the South region, rural localities and high MI. The results from National Weight and Height Registry provide the evidence at local level allow us to have a closer overview of the actual situation, to the changes and challenges that the Mexican school-age. Funding Sources Nutrition Direction of National Nutrition Institute “Salvador Zubirán” provided the resources for this study.
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Nishisaki, Akira, David A. Turner, Calvin A. Brown, Ron M. Walls, and Vinay M. Nadkarni. "A National Emergency Airway Registry for Children." Critical Care Medicine 41, no. 3 (March 2013): 874–85. http://dx.doi.org/10.1097/ccm.0b013e3182746736.
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Montesinos, Pau, Guillermo Martin, Jesus Martinez, Mariluz Perez-Sirvent, Jaime Sanz, Ignacio Lorenzo, Ninotchka Mendoza, et al. "Incidence and Characteristics of Acute Promyelocytic Leukemia in Adult Patients. A Single Centre Registry Study." Blood 110, no. 11 (November 16, 2007): 4301. http://dx.doi.org/10.1182/blood.v110.11.4301.4301.
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Abstract Background: Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML) characterized by specific morphological and clinical features. However, its relative incidence among patients with AML is not yet established. Objectives: To define the relative incidence of APL in a large series of patients diagnosed with AML in a single institution and to identify the clinical-biological features characterizing the APL patients within the target population of AML. Methods: From 1976 to 2007, 1205 patients (median age 56 years, range 15–98) were consecutively diagnosed with AML in our institution. One hundred patients (8%) were considered AML secondary to solid neoplasia or chemotherapy, while 143 (12%) were secondary to myelodysplastic or myeloprolypherative syndromes (MDS/MPCS). The APL diagnosis was achieved through cytological studies supported by cytogenetics, and since 1995 by molecular techniques. Inmunophenotype analysis, using flow cytometry or inmunohistochemistry, was available in 808 (67%) patients. Positivity was defined as more than 20% blasts expressing a specific antigen. Results: Overall, 170 patients (14%) were diagnosed of APL. Of them, 43 (25%) were classified as M3 variant. The relative incidence of APL within AML secondary to solid neoplasia or chemotherapy and de novo AML was 13% y 16%, respectively (p=ns). In contrast, the relative incidence of APL within AML secondary to MDS/MPCS was 0.7% (p<0.0001) (only 1 case of APL secondary to MDS/MPCS was registered). The median age of APL patients was 44 years, and its relative incidence decreased with older age: 26% between 15 and 50 years, 12% between 51 and 60, 8% between 61 and 70, and 5% in older than 70 (p<0,0001). The percentage of APL patients receiving induction was higher compared with the rest of AML (93% vs 79%, p<0,0001). The complete remission rate was higher in APL (72% vs 53%), due to a lower resistance (3% vs 22%, p<0,0001), whereas the induction mortality was similar (25% vs 25%). The frequency of causes of death were different in APL compared with the rest of AML: hemorrhage (59% vs 22%), infection (27% vs 56%), hemorrhage and infection (8% vs 6%) and other (6% vs 16%). APL was associated with the following clinical-biological features: presence of Auer rods (80% vs 27%, p<0,0001), peroxidase positive blasts >75% (94% vs 27%, p<0,0001), bone marrow blasts >70% (92% vs 49%, p<0,0001), WBC <10x109/L (70% vs 48%, p<0,0001), LDH <600 U/L (68% vs 58%, p=0,003), uric acid <7,5 mg/dL (96% vs 87%, p=0,002), fibrinogen <170 mg/dL (53% vs 3%, p<0,0001), hemorrhagic syndrome at diagnosis (84% vs 32%, p<0,0001), lack of hepatosplenomegaly (12% vs 24%, p=0,001). APL was significantly associated with the following surface or cytoplasmatic antigens: CD34 negative (−), CD36(−), HLA-DR(−), CD14(−), CD4(−), CD56(−), TdT(−), CD11b(−), CD7(−), CD2 positive (+), CD9(+), CD33(+), CD71(+), CD117(+) and myeloperoxidase(+). Conclusion: In this large series of patients diagnosed with de novo or secondary AML, the relative incidence of APL was 14%, being exceptional the APL secondary to MDS/MPCS. To our knowledge, this is the larger hospital registry establishing the relative incidence of APL in a target AML population.
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Issa-El-Khoury, Karine, Christine McCusker, Bruce Mazer, Reza Alizadehfar, and Moshe Ben-Shoshan. "Children diagnosed with common variable immune deficiency show distinct T cell maturation phenotypes when compared with adults (P3333)." Journal of Immunology 190, no. 1_Supplement (May 1, 2013): 175.14. http://dx.doi.org/10.4049/jimmunol.190.supp.175.14.
Повний текст джерелаАнотація:
Abstract INTRODUCTION: Common variable immune deficiency (CVID) is considered primarily a B cell disorder characterized by low immunoglobulin levels, defective specific antibody production and susceptibility to sinopulmonary infections. Recent studies have implicated T cells in the pathogenesis of CVID. OBJECTIVES: To compare T cell maturation in children and adults with CVID. METHODS: Through PRIMES (Canadian Primary IMmunodeficiency Evaluation Study) registry, we recruited eight children and ten adults with CVID. T cell phenotype was assessed by flow cytometry. Patients were compared to healthy controls (thirteen children and ten adults). Wilcoxon Rank Sum test was used to assess differences in T cell subsets. RESULTS: Total lymphocyte count, CD3, CD4 and CD8 lymphocytes were decreased in children with CVID compared to controls (p=0.0006, p=0.0003, p=0.0003, p=0.03). Percentage and absolute numbers of naïve (p=0.012, p=0.002) and absolute numbers of memory cells (p=0.001) were decreased in children with CVID. However, there were no statistical differences between adults with CVID and healthy controls. DISCUSSION: Our data shows decreased T cell subsets in childhood CVID while levels in adults were normal. Studies assessing temporal trends in T cell subsets are required to determine if these differences in children are due to age-related compensatory mechanisms or if different mechanisms play a role in the pathogenesis of childhood versus adult onset CVID.
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Rodríguez Delgado, Juan Pablo. "Algunas observaciones sobre el proyecto de convenio de Uncitral sobre la venta judicial de buques." CUADERNOS DE DERECHO TRANSNACIONAL 13, no. 2 (September 10, 2021): 472–97. http://dx.doi.org/10.20318/cdt.2021.6268.
Повний текст джерелаАнотація:
La venta judicial de un buque representa el capítulo final de cualquier procedimiento judicial por la reclamación de deudas marítimas. La venta tiene que garantizar el mejor precio posible del buque, lo que permite que un número mayor de acreedores puedan ver satisfechos sus créditos. Este final se logrará solo si la venta confiere al comprador un “título de propiedad limpio”, extinguiendo todas las cargas, derechos y reclamaciones existentes sobre el buque. Este proceso asegurará al comprador poder cancelar la inscripción registral del buque y registrar su nueva propiedad bajo una nueva bandera a su conveniencia, pudiendo navegar alrededor del mundo sin temor a ser nuevamente embargado por créditos no satisfechos. Este artículo proporciona algunos apuntes sobre el Proyecto de Instrumento sobre venta judicial de buques que está actualmente en elaboración en el seno del GT VI de UNCITRAL
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Durán Ayago, Antonia. "Gestación por sustitución en España: a hard case needs law. De por qué la jurisprudencia no puede resolver este problema = Surrogacy in Spain: a hard case needs law. Why jurisprudence can not solve this problem." CUADERNOS DE DERECHO TRANSNACIONAL 11, no. 2 (October 1, 2019): 575. http://dx.doi.org/10.20318/cdt.2019.4977.
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Resumen: El presente trabajo constituye un balance de los diez años que han transcurrido desde la Resolución de la Dirección General de los Registros y del Notariado de 18 de febrero de 2009 que por primera vez autorizó la inscripción en el Registro Civil de los hijos de un matrimonio de varones españoles que habían nacido en Estados Unidos a través de gestación por sustitución. Aunque esta Resolución fue anulada, los hechos que se han ido sucediendo, con pronunciamientos judiciales en cierto modo encontrados, demandan una actuación del legislador para clarificar la situación y garantizar la seguridad jurídica de todos los implicados en un proceso de gestación por sustitución, particularmente de los niños nacidos a través de esta técnica.Palabras clave: gestación por sustitución, filiación intencional, reconocimiento de decisiones extranjeras, interés superior del menor.Abstract: This paper is a balance of the ten years since the Resolution of the General Directorate of Registries and Notaries of February 18, 2009 wich for the first time authorized the registration in the Civil Registry of the children of a marriage of Spanish males who were born in the United States through surrogacy. Although this resolution was annulled, the facts that have been happening, with judicial different pronouncements in a certain way, require action by the legislator to clarify the situation and ensure the legal certainty of all those involved in a process of surrogacy, particularly of children born through this technique.Keywords: surrogacy, intentional filiation, recognition of foreign decisions, best interest of the child.
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Boughan, Kirsten Marie, and Thomas P. Loughran. "The large granular lymphocytic leukemia registry: A detailed analysis of 79 patients with LGL leukemia and rheumatoid arthritis." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 6590. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.6590.
Повний текст джерелаАнотація:
6590 Background: The purpose of this study is to analyze patients enrolled in the LGL leukemia registry to distinguish the similarities between LGL leukemia and rheumatoid arthritis in order to access overlapping immune mechanisms that may be responsible for neutrophil mediated destruction. Methods: A retrospective chart review was performed on 79 patients enrolled in the LGL registry at Penn State Cancer Institute. All patients enrolled in the study had a diagnosis of both rheumatoid arthritis and potentially LGL leukemia. Data was collected for age, sex, RF factor positivity, family history, autoimmune disease, T-cell receptor gene rearrangement, and bone marrow invasion. Results: Of 79 patients the mean age of onset for LGL leukemia was 60 years old with no discrepancy noted between sexes, 37 M, 42 F. 49 patients were positive for rheumatoid factor. 27 patients had rheumatoid arthritis in a first degree relative with no discrimination between maternal or paternal inheritance. 22 patients were positive for any other autoimmune process. 60 patients were positive for T-cell receptor gene rearrangement. Of the remaining 19 patients that were negative for T-cell receptor rearrangement, 12 had evidence of bone marrow invasion (CD3/CD8+ infiltrate in >20% bone marrow) and two showed bone marrow invasion of NK cell LGL (CD3/CD8-, CD57+) (Table). Conclusions: Patients with T cell LGL leukemia and rheumatoid arthritis appear to be clinically similar with regard to age, duration of disease, and other autoimmune disorders as patients with rheumatoid arthritis alone. Our patient population showed those with TLGL and RA also tends to have a positive family history of RA in up to 20% as opposed to 5-10% in RA patients. Given that RA and TLGL have a significantly higher expression of the HLA-DR4 haplotype than healthy patients, it is conceivable that with shared genetic alterations, and gene environment interactions that may promote posttranslational modification, there may be a loss of tolerance resulting in T cell activation, and eventual transformation into a T cell clone. [Table: see text]
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Zhang, Huiqing, Geliang Yang, Wei Zhang, Wei Gu, Yonghua Su, and Changquan Ling. "Characteristic Analysis of Complementary and Alternative Medicine in Randomized Controlled Trials of Oncology: A Comparison of Published Studies." Integrative Cancer Therapies 17, no. 2 (March 15, 2017): 551–57. http://dx.doi.org/10.1177/1534735417696722.
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Background: Complementary and alternative medicine (CAM) has been widely used by cancer patients and oncologists in the past decades. The present study aimed to examine and compare the characteristics and registration status of published studies in a sample of recently published CAM randomized controlled trial (RCT) reports of oncology in leading journals of 3 categories: general and internal medicine (GIM), clinical oncology (CO), and CAM. Methods: Articles published in the top 5 journals of the 3 categories from 2006 to 2015 were searched in PubMed. Basic characteristics, registration information, impact factor, and citations were identified and extracted from the included RCTs. Data were summarized by frequency, mean, and median and compared using χ2 test and Kruskal-Wallis H test. Results: A total of 59 RCTs were included; among them, 34 (58%) could be identified with a registration number. GIM journals (15) enjoyed the highest average number of citations per article, followed by CO (12) and CAM (3) journals ( P < .0001). ClinicalTrials.gov was the most popular registry for these RCTs. Of the RCTs registered in ClinicalTrials.gov , 24% (4/17) of the published studies in CO journals put their results in the registry; however, no study in GIM and CAM journals put the result in the registry ( P = .372). Conclusion: The top GIM, CO, and CAM journals rarely published CAM RCTs of oncology from 2006 to 2015, and the CAM articles of oncology were less cited. However, there was a clear improvement in the trial registration rate over the past decades.
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Soelberg-Sorensen, Per, Fernando Dangond, Christine Hicking, and Gavin Giovannoni. "WED 182 Cladribine tablets effects on lymphocytes in ms patients." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 10 (September 13, 2018): A25.1—A25. http://dx.doi.org/10.1136/jnnp-2018-abn.87.
Повний текст джерелаАнотація:
BackgroundLymphopenia is expected from the mechanism of action of cladribine tablets 3.5 mg/kg (CT3.5)ObjectiveInvestigate absolute lymphocyte counts (ALC; 312 weeks) and subsets (240 weeks) in RRMS patients receiving 2 annual courses of CT3.5.MethodsPooled data from patients randomised to CT3.5 over 2 years in CLARITY/CLARITY-Extension inclusive of the PREMIERE registry (n=685).ResultsBaseline: median ALC=1.86 × 109/L. Year-1: ALC reached nadir at 9 weeks post-treatment with CT3.5 (1.00 × 109/L). Year-2: ALC reached nadir at Week-55 (0.81 × 109/L), then recovered to the normal range (≥1.00 × 109/L; Week-96). ALC was in normal range in 75% of patients by Week-144. Baseline median CD4+ were 851 cells/µL. Nadirs occurred at Week-16 (385 cells/µL) in Year-1 and at Week-60 (292 cells/µL) in Year-2; values increased after nadirs and regained threshold (350 cells/µL, ~Week-120). Baseline median CD8+ were 378 cells/µL. Nadirs occurred at Week-16 (239 cells/µL; Year 1) and Week-72 (232 cells/µL; Year 2). CD8+ recovered quickly after treatment and remained above 200 cells/µL at all times. Baseline median CD19+ were 205 cells/µL. Nadirs occurred at Week-9 (18 cells/µL; Year-1) and Week-52 (31 cells/µL; Year-2). CD19+ then reached threshold of 100 cells/µL by the end of Year-2.ConclusionLymphocyte recovery begins soon after CT3.5. ALC, CD19+ B and CD4+ T cells; reached threshold by 7.5, 12 and 18 months. CD8+ cells remained above threshold.Disclaimerhttp://medpub-poster.merckgroup.com/ABN2018DISC_LongLymph.pdf
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Yoo, J. H., J. Trojanowski, M. Laberge, D. Griesdale, and J. R. Brubacher. "P132: Development and implementation of an intubation registry within a Canadian tertiary-care hospital." CJEM 19, S1 (May 2017): S122—S123. http://dx.doi.org/10.1017/cem.2017.334.
Повний текст джерелаАнотація:
Introduction: Intubation is a high-risk procedure that is frequently performed within the ED. Few Canadian centres have a system in place to monitor intubation frequency, indications, methods used, operator characteristics, first-pass success, and adverse event rates. There are no published data on the frequency of success or complications of emergency airway management in Canada. An airway registry would be a valuable quality improvement (QI) tool for assessing the impact of practice changes such as pre-intubation checklists and for identifying patients with “difficult airways.” We describe the development and implementation of an airway registry in a Canadian tertiary-care centre. Methods: We created a collaborative working group with staff from EM, ICU, Respiratory Therapy (RT), and Privacy. An airway data form was created. Over a 3 month trial period, the form was completed by RTs following each non-OR intubation. At our centre, RTs are present at every intubation outside of the OR. If a patient was intubated outside of the hospital, forms were completed using verbal handover. RTs also provided constructive feedback and after 3 months the form was revised and finalized. Medical student volunteers entered data from the forms and from chart reviews into a secure online database created for this purpose. Results: We have enrolled 373 patients over the first 5 months with ongoing enrolment at the time of abstract submission. The airway form captures the seniority and discipline of the intubator, preparation, technique, and any airway manoeuvres that were used. The form also captures Cormack-Lehane airway grading, confirmation techniques, complications, and the option to identify the patient as a “Difficult Airway.” Privacy permission was granted to include patient identifiers in the airway registry so that additional information from chart reviews could be obtained at a later date. Preliminary results will be presented at the conference. Conclusion: Our airway registry tracks intubation performance and may identify factors associated with adverse patient outcomes, which could prompt system-wide changes. Comparison of intubation performance to other Canadian institutions may be possible if similar airway registries are implemented. The development and implementation of an airway registry requires multi-disciplinary collaboration, engagement, and user feedback.
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Marín Consarnau, Diana. "La “uniones registradas” en España como beneficiaria del derecho de la UE a propósito de la Directiva 2004/38/ce y del Reglamento (UE) 2016/1104 = Spanish “registered partnerships” as beneficiaries of EU law according to the Directive 2004/38 (ec) and the Regulation (EU) 2016/1104." CUADERNOS DE DERECHO TRANSNACIONAL 9, no. 2 (October 5, 2017): 419. http://dx.doi.org/10.20318/cdt.2017.3880.
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Resumen: El legislador europeo contempla las uniones registradas como modelos familiares beneficiarios del derecho a la libre circulación y residencia, cuyos obstáculos además precisan ser eliminados cuando se trata de resolver los problemas derivados en la administración o división de su patrimonio. Esta realidad impacta en el legislador interno a distintos niveles. Uno de ellos es la voluntad de plantearse si las parejas nacidas a la luz de la normativa interna pueden o no acogerse a las bondades que ofrecen los instrumentos europeos como son la Directiva 2004/38/CE, de 29 de abril de 2004 y el Reglamento (UE) 2016/1104, de 24 de junio de 2016. Cuestión a la que forzadamente se ha visto abocado el legislador catalán, cuyo intento de adaptación a la categoría de pareja registrada sigue presentando interrogantes tras el Decreto-ley 3/2015, de 6 de octubre, relativo a la creación del Registro de parejas estables.Palabras clave: unión registrada, libertad de circulación y residencia, derechos de residencia, efectos patrimoniales.Abstract: The aim of this report is to analyze the current situation of Spanish “registered partnerships “and the application of benefits included in the Directive 2004/38/EC of 29 April 2004 and in the Regulation (EU) 2016/1104 of 24 June 2016. The European instruments promote their freedom of movement and residence, the obstacles to which shall be eliminated, in particular regarding the difficulties experienced by couples in managing or dividing their property, although that impacts in the national Law in different levels. One of them implies to discussion concerning the application of both instruments according to the definition of registered partnership. In order to manage it, the Catalan Civil Code has been amended by the Decree-Law 3/2015 of October 6, relating to the creation of a Register of unmarried partners. However, the Catalan Register shows some characteristics that pose new questions to solve.Keywords: registered partnership, freedom of movement and residence, residence rights, property consequences.
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Sajjadi, Elham, Konstantinos Venetis, Marianna Noale, Hatem A. Azim, Concetta Blundo, Giuseppina Bonizzi, Eugenia Di Loreto, et al. "Breast Cancer during Pregnancy as a Special Type of Early-Onset Breast Cancer: Analysis of the Tumor Immune Microenvironment and Risk Profiles." Cells 11, no. 15 (July 24, 2022): 2286. http://dx.doi.org/10.3390/cells11152286.
Повний текст джерелаАнотація:
Breast cancer during pregnancy (PrBC) is a rare tumor with only a little information on its immune landscape. Here, we sought to characterize the cellular composition of the tumor microenvironment (TME) of PrBC and identify its differences from early-onset breast cancer (EOBC) in non-pregnant women. A total of 83 PrBC and 89 EOBC were selected from our Institutional registry and subjected to tumor-infiltrating lymphocytes (TILs) profiling and immunohistochemistry for CD4, CD8, forkhead box P3 (FOXP3), and programmed death-ligand 1 (PD-L1) (clone 22C3). A significantly lower frequency of hormone receptor (HR)-positive tumors was observed in PrBC. The prevalence of low/null PD-L1 and CD8+TILs was higher in PrBC than in the controls, specifically in HR+/HER2– breast cancers. PrBC had a significantly higher risk of relapse and disease-related death, compared to EOBC. The presence of TILs and each TIL subpopulation were significantly associated with disease relapse. Moreover, the death rate was higher in PrBC with CD8+ TILs. The TME of PrBC is characterized by specific patterns of TIL subpopulations with significant biological and prognostic roles. Routine assessment of TILs and TILs subtyping in these patients would be a valid addition to the pathology report that might help identify clinically relevant subsets of women with PrBC.
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Saugstad, Ola Didrik. "When increased mortality indicates improved care: CDH ECMO registry data." Journal of Pediatrics 190 (November 2017): 4–5. http://dx.doi.org/10.1016/j.jpeds.2017.09.037.
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Blasch, Lisa. "Indexing authenticity in visual political (social media) communication: a metapragmatics-based analysis of two visual registers of the authentic." Multimodal Communication 10, no. 1 (January 1, 2021): 37–53. http://dx.doi.org/10.1515/mc-2020-0019.
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Abstract In this paper, I apply a metapragmatics-based approach to visual communication, combined with adapted concepts of Social Semiotics (“visual modality”) and CDA-oriented visual analysis (“canons of use”), to reconstruct two visual registers of authenticity which are prevailing within a social media photo sample of recent Austrian chancellor Sebastian Kurz (Facebook, Instagram; total of 84 photos), posted during the parliamentary elections in 2017. Triangulated with the discourse analysis of the marketing manager’s metapragmatic reflections on this social media campaign, the study shows how the partly intertwined registers of (1) “professional sensorism” (as a blended register comprising emblems of sensory modality and balanced composition, thereby drawing on the conceptualization of authenticity as sensory and affective experience of “now”) and (2) “voyeuristic fictionalization” (comprising indexicals associated with fiction genre, and based on the notion of authenticity as arising via “unnoticed observing”) are conceptualized and implemented as a—superior—visual stylization, acting as a social positioning, in mediatized political communication.
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Yoo, J. H., J. Trojanowski, K. Dullemond, C. Liu, C. Renschler, D. Griesdale, and J. Brubacher. "P164: Development of the BC-Airway Registry for Emergencies (BCARE) network." CJEM 20, S1 (May 2018): S115. http://dx.doi.org/10.1017/cem.2018.362.
Повний текст джерелаАнотація:
Introduction: Intubation is one of the highest-risk procedures performed in the ED. Few Canadian centres monitor intubation frequency, indications, methods used, success, and/or complication rates. An airway registry that tracks patient outcomes and variation in practice would be a valuable quality improvement (QI) tool. We describe the development of the BC-Airway Registry for Emergencies (BCARE) network, an emergency intubation database at two tertiary-care and one community hospital. Methods: Respiratory Therapists (RTs) are present at every intubation outside of the OR and complete a standardized post-intubation form. The airway forms were developed collaboratively with input from RTs, emergency physicians, intensivists, and anesthetists. Completed forms are collected from participating sites and data is entered into a secure online database where patient outcomes are analyzed in real-time. Results: We collected data from 737 unique intubations over 19 months with ongoing enrolment at the time of abstract submission. Mean age was 59.4 (Range 17-95, SD 17.6), Male 66.2%, intubation locations were ED (396, 53.7%), ICU (221, 30.0%), Ward (120, 16.3%). The most common indications for ED intubation were ICH/stroke (14.6%), seizure (10.9%), and sepsis (9.5%). Intubations are done by attending physicians more frequently in the ED (48.0%) compared to in the ICU (11.8%), and ward (8.6%). ED intubations were more commonly performed using video laryngoscopy (57.7%) with a smaller proportion using direct laryngoscopy (39.0%). First-pass success was 81.8% in the ED, 79.2% in the ICU, and 77.5% on the wards. Of ED intubations, 56 (14.1%) had complications and 73 (18.4%) were considered to be a difficult airway. Conclusion: The BCARE network tracks intubation performance across hospitals and is a valuable QI tool. BCARE can be used to ensure that all centres are meeting a benchmark success rate, for assessing the impact of practice changes such as pre-intubation checklists, and for implementing systematic methods to identify patients who previously had a “difficult airway.”
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Erdogan, Mete, Nelofar Kureshi, Mark Asbridge, and Robert S. Green. "Trauma recidivism in a Canadian province: a 14-year registry review." CJEM 21, no. 4 (January 30, 2019): 473–76. http://dx.doi.org/10.1017/cem.2018.496.
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ABSTRACTObjectivesTo determine the rate of recurrent major trauma (i.e., trauma recidivism) using a provincial population-based trauma registry. We compared outcomes between recidivists and non-recidivists, and assessed factors associated with recidivism and mortality.MethodsReview of all adult (>17 years) major trauma patients in Nova Scotia (2001–2015) using data from the Nova Scotia Trauma Registry. Outcomes of interest were mortality, duration of hospital stay, and in-hospital complications. Multiple regression was used to assess factors associated with recidivism and mortality.ResultsOf 9,365 major trauma patients, 2% (150/9365) were recidivists. Mean age at initial injury was 52 ± 21.5 years; 73% were male. The mortality rate for both recidivists and non-recidivists was 31%. However, after adjusting for potential confounders the likelihood of mortality was over 3 times greater for recidivists compared to non-recidivists (OR 3.67, 95% CI 2.06–6.54). Other factors associated with mortality included age, male gender, penetrating injury, Injury Severity Score, trauma team activation (TTA) and admission to the intensive care unit. The only variables associated with recidivism were age (OR 0.98, 95% CI 0.97–1.00) and TTA (OR 0.59, 95% CI 0.34–0.96).ConclusionsThis is the first provincial investigation of major trauma recidivism in Canada. While recidivism was infrequent (2%), the adjusted odds of mortality were over three times greater for recidivists. Further research is warranted to determine the effectiveness of strategies for reducing rates of major trauma recidivism such as screening and brief intervention in cases of violence or substance abuse.
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Shu, Bofei, Hong Li, Xu Zhou, Zhaohui Ding, and Liling Wan. "Efficacy and Safety of Re Du Ning Injection for Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis." Evidence-Based Complementary and Alternative Medicine 2022 (March 21, 2022): 1–10. http://dx.doi.org/10.1155/2022/7479639.
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Background. Re Du Ning, a traditional Chinese medicine injection, has been widely used for the treatment of chronic obstructive pulmonary disease, although without established systematic review evidence. This systematic review aimed to assess the efficacy and safety of Re Du Ning in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Methods. We searched seven databases (PubMed, Embase, the Cochrane Library, SinoMed, CNKI, WanFang, and the Chinese Clinical Trial Registry) up to November 1, 2021, to identify randomized controlled trials of Re Du Ning for AECOPD. Two researchers independently carried out literature screening and data extraction. Effects were measured by risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs). The meta-analysis was completed by RevMan 5.4 software. Results. Twenty-six studies met the eligibility criteria, with a total of 2284 patients. The findings of the meta-analysis indicated that the response rate of the experimental group was higher than that of the control group: RR = 1.14% and 95% CI: (1.09, 1.19). Significantly greater improvements in pulmonary function: FEV1: MD = 0.28 L, 95% CI: (0.20, 0.36); FEV1/FVC: MD = 8.63%, 95% CI: (4.68, 12.59); T-lymphocyte counts: CD4: MD = 6%, 95% CI: (2.44, 9.56); CD3: MD = 10.42%, 95% CI: (8.6, 12.24); CD4/CD8: MD = 0.38%, 95% CI: (0.32, 0.43); acid/base imbalance: PH: MD = 0.05, 95% CI: (0.01, 0.10); PaO2: MD = 9.02 mmHg, 95% CI: (11.11, 0.10), p = 0.005 ; C-reactive protein: MD = −6.65 mg/L, 95% CI: (−10.97, −2.34); and PCT: MD = −0.28 μg/L, 95% (CI: −0.41, −0.15) were observed in patients receiving Re Du Ning compared with those receiving the control treatment. Re Du Ning did not significantly change the carbon dioxide partial pressure. All reported adverse reactions were mild. Conclusion. Re Du Ning injection, as a complementary therapy to routine treatment, has better efficacy than Western medicine alone in relieving clinical symptoms, delaying pulmonary function decline, and improving inflammation indicators for AECOPD, with good safety. The evidence was limited by a lack of high-quality RCTs.
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Hemphill, J. Claude. "The need for a registry renaissance in neurocritical care*." Critical Care Medicine 35, no. 9 (September 2007): 2208–9. http://dx.doi.org/10.1097/01.ccm.0000281458.24915.9c.
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Gluhaia, Diana. "Inscripción del matrimonio canónico celebrado en España entre un español y una lituana residentes en el extranjero. Reflexiones sobre la resolución (16ª) de la DGRN de 14 de noviembre de 2019." CUADERNOS DE DERECHO TRANSNACIONAL 13, no. 2 (September 14, 2021): 731–38. http://dx.doi.org/10.20318/cdt.2021.6288.
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La Resolución de la DGRN de 14 de noviembre se enfrenta con la cuestión del acceso al Registro Civil español del matrimonio canónico celebrado en España entre un español y una lituana, ambos con domicilio en Londres. La DGRN acepta la inscripción en el Registro civil amparándose fundamentalmente en el Acuerdo entre el Estado español y la Santa Sede sobre asuntos jurídicos.