Academic literature on the topic '373.21 (73) + 373.21 (71)'

373 Background: Initial results of the NEOSCOPE trial comparing pre-operative CarPac vs OxCap based chemoradiotherapy (CRT) in patients with adenocarcinoma of the oesophagus or oesophagogastric junction showed comparable toxicity and improvement in pathological complete response (pCR) in favour of the CarPacRT. Here we report survival after a median follow-up of 40.7 months (95% CI: 45.1-53.6). Methods: NEOSCOPE was an open, randomised, ‘pick a winner’ phase II trial. Patients with resectable oesophageal adenocarcinoma ≥ cT3 and/or ≥ cN1 were randomised to OxCapRT (oxaliplatin 85 mg/m2 day 1, 15, 29; capecitabine 625 mg/m2 bd on days of RT) or CarPacRT (carboplatin AUC2; paclitaxel 50 mg/m2 day 1, 8, 15, 22, 29). RT dose was 45 Gy/25 fractions/5 weeks. Induction OxCap (2 cycles) was given prior to CRT. Surgery was performed 6–8 weeks after CRT.The primary endpoint was pCR, secondary endpoints were toxicity, PFS and OS. Results: Between Oct 2013 and Feb 2015, 85 patients were recruited from 17 UK centres. Median OS was not reached in the CarPacRT group and was 41.72 months (95% CI 19.58-.)in the OxCap group (HR 0.56[95% CI 0.29-1.07]; p=0.079). 3-year and 5-year OS rates were 74% (95% CI 58%-85%) and 54% (95% CI 34%-71%) (CarPacRT), and 52% (95% CI 35%-67%) and 39% (95% CI 21%-56%) (OxCapRT). Median PFS (not reached vs 35.3 months, HR=0.61 [95% CI 0.33-1.12]; p=0.111) and metastatic PFS (not reached vs 39.0 months, HR=0.61 [95% CI 0.32-1.14], p=0.118) both favoured the CarPacRT arm. Local recurrence rate was low (OxCapRT= 10%; CarPacRT= 7%). The OS benefit for CarPacRT was consistent across subgroups but not statistically significant. Conclusions: In this longer term analysis there was some evidence that induction OxCap followed by switch to CarPacRT was superior to continuing OxCapRT, with efficacy similar to that seen in other published studies such as ‘CROSS’ and ‘FLOT’. Taken together with the previously published pCR results CarPacRT rather than OxCapRT warrants inclusion in future trials. Funding: Cancer Research UK (C44694/A14614). Clinical trial information: NCT01843829.

ABSTRACT Patients with typhoid fever due to Salmonella enterica serotype Typhi strains for which fluoroquinolones MICs are elevated yet that are classified as susceptible by the current interpretive criteria of the Clinical and Laboratory Standards Institute may not respond adequately to fluoroquinolone therapy. Patients from seven U.S. states with invasive Salmonella serotype Typhi infection between 1999 and 2002 were enrolled in a multicenter retrospective cohort study. Patients infected with Salmonella serotype Typhi isolates with ciprofloxacin MICs of 0.12 to 1 μg/ml (decreased ciprofloxacin susceptibility but not resistant to ciprofloxacin [DCS]) were compared with patients infected with isolates with ciprofloxacin MICs <0.12 μg/ml for fever clearance time and treatment failure. Of 71 patients, 30 (43%) were female and 24 (34%) were infected with Salmonella serotype Typhi with DCS; the median age was 14 years (range, 1 to 51 years). Twenty-one (88%) of 24 isolates with DCS were resistant to nalidixic acid. The median antimicrobial-related fever clearance times in the DCS and non-DCS groups were 92 h (range, 21 to 373 h) and 72 h (range, 19 to 264 h) (P = 0.010), respectively, and the fluoroquinolone-related fever clearance times in the DCS and non-DCS groups were 90 h (range, 9 to 373 h) and 64 h (range, 34 to 204 h) (P = 0.153), respectively. Four (17%) of 24 patients in the DCS group and 2 (4%) of 46 patients in the non-DCS group (relative risk, 2.5; 95% confidence interval, 1.2 to 5.1) experienced treatment failure. Associations persisted after adjustment for potential confounders. We demonstrate that patients infected with Salmonella serotype Typhi isolates with DCS show evidence of a longer time to fever clearance and more frequent treatment failure. Nalidixic acid screening does not detect all isolates with DCS.

Object. This is a retrospective analysis of 353 surgically treated sciatic nerve lesions in which injury mechanisms, location, time to surgical repair, surgical techniques, and functional outcomes are reported. Results are presented to provide guidelines for management of these injuries. Methods. One hundred seventy-five patients with buttock-level and 178 with thigh-level sciatic nerve injury were surgically treated at the Louisiana State University Health Sciences Center between 1968 and 1999. Buttock-level injury mechanisms included injection in 64 patients, hip fracture/dislocation in 26, contusion in 22, compression in 19, gunshot wound (GSW) in 17, hip arthroplasty in 15, and laceration in 12; at the thigh level, GSW was the cause in 62 patients, femoral fracture in 34, laceration in 32, contusion in 28, compression in 12, and iatrogenic injury in 10. Patients with sciatic nerve divisions in which positive intraoperative nerve action potentials (NAPs) were found underwent neurolysis and attained at least Grade 3 functional outcomes in 108 (87%) of 124 and in 91 (96%) of 95 buttock- and thigh-level tibial divisions, respectively, compared with 84 (71%) of 119 and 75 (79%) of 95, respectively, in the peroneal divisions. For suture repair, recovery to at least Grade 3 occurred in eight (73%) of 11 buttock-level and in 27 (93%) of 29 thigh-level tibial division injuries, and in three (30%) of 10 buttock-level and 20 (69%) of 29 thigh-level peroneal division lesions. For graft repair, good recovery occurred in 21 (62%) of 34 and in 43 (80%) of 54 buttock- and thigh-level tibial divisions, respectively, even in proximal repairs requiring long grafts, and in only nine (24%) of 37 and 22 (45%) of 49 buttock- and thigh-level peroneal division lesions, respectively. Conclusions. Surgical exploration and neurolysis after positive NAP readings, or repair with sutures or grafts after negative NAP results are worthwhile in selected cases.

Player loads and fatigue responses are reported in 15 professional rugby league players (24.3 ± 3.8 y) during a period of intensified fixtures. Repeated measures of internal and external loads, perceived well-being, and jump flight time were recorded across 22 d, comprising 9 training sessions and matches on days 5, 12, 15, and 21 (player exposure: 3.6 ± 0.6 matches). Mean training loads (session rating of perceived exertion × duration) between matches were 1177, 1083, 103, and 650 AU. Relative distance in match 1 (82 m/min) and match 4 (79 m/min) was very likely lower in match 2 (76 m/min) and likely higher in match 3 (86 m/min). High-intensity running (≥5.5 m/s) was likely to very likely lower than match 1 (5 m/min) in matches 2–4 (2, 4, and 3 m/min, respectively). Low-intensity activity was likely to very likely lower than match 1 (78 m/min) in match 2 (74 m/min) and match 4 (73 m/min) but likely higher in match 3 (81 m/min). Accumulated accelerometer loads for matches 1–4 were 384, 473, 373, and 391 AU, respectively. Perceived well-being returned to baseline values (~21 AU) before all matches but was very likely to most likely lower the day after each match (~17 AU). Prematch jump flight times were likely to most likely lower across the period, with mean values of 0.66, 0.65, 0.62, and 0.64 s before matches 1–4, respectively. Across a 22-d cycle with fixture congestion, professional rugby league players experience cumulative neuromuscular fatigue and impaired match running performance.

Caso N.º 1. Ententes: Dec.Com. 7 abril 2004, Société Air France/Alitalia Linee Aeree Italiane SpA, DO L 362 de 9 diciembre 2004 Caso N.º 2. Ententes: STJCE 29 abril 2004, C-359/01 P, British Sugar plc/Comisión Caso N.º 3. Ententes: STPI de 29 de abril de 2004, Tokai carbón Co. Ltd y otros/Comisión de las Comunidades Europeas As. T-236/01, T-239/01, T-244/01, T-245/01, T-246/01, T-251/01 y T-252/01 Caso N.º 4. Ententes: Sentencia del Tribunal de Primera Instancia 15 junio 2005, Graphites spéciaux, As. T-71/03, T-74/03, T-87/03 y T-91/03 Caso N.º 5. Ententes: STPI 8 julio 2004, Mannesmannröhren-Werke/ Comisión, T-44/00; STPI 8 julio 2004, Corus/Comisión, T-48/00; STPI 8 julio 2004, Dalmine/Comisión, T-50/00; STPI 8 julio 2004, asuntos acumulados JFE Engineering/Comisión, T-67/00, Nippon Steel/Comisión, T-68/00, JFE Steel/Comisión, T-71/00, y Sumitomo Metal Industries/ Comisión, T-78/00 Caso N.º 6. Ententes: Dec.Com. 9 diciembre 2004, Cloruro de colina, DO L 190 de 22 julio 2005. Caso N.º 7. Ententes: STJCE 28 junio 2005, Dansk Rørindustri A/S (C-189/02 P), Isoplus Fernwärmetechnik Vertriebsgesellschaft mbH y otros (C-202/02 P), KE KELIT Kunststoffwerk GmbH (C-205/02 P), LR af 1998 A/S (C-206/02 P), Brugg Rohrsysteme GmbH (C-207/02 P), LR af 1998 (Deutschland) GmbH (C-208/02 P) y ABB Asea Brown Boveri Ltd (C-213/02 P)/Comisión, Tubos de calefacción urbana (tubos preaislados), Asuntos acumulados C-189/02 P, C-202/02 P, C-205/02 P a C-208/02 P y C-213/02 P Caso N.º 8. Ententes: STPI 18 julio 2005, Scandinavian Airlines System AB/Comisión, T-241/01 Caso N.º 9. Ententes: STPI (Sala Segunda) de 27 de julio de 2005, Asuntos acumulados T-49/02 a T-51/02, Brasserie nationale SA (anteriormente Brasseries Funck-Bricher y Bofferding), Brasserie Jules Simon et Cie SCS y Brasserie Batín SNC v. Comisión de las Comunidades Europeas Caso N.º 10. Ententes: Comunicación publicada de conformidad con el artículo 27, apartado 4, del Reglamento (CE) n.º 1/2003 del Consejo, en los asuntos COMP/C2/3912-BUMA y COMP/C2/39151-SABAM (Acuerdo de Santiago-COMP/C2/38126, DO C 200 de 17 agosto 2005, pp. 11-12) Caso N.º 11. Ententes: STPI 15 septiembre 2005, DaimlerChrysler AG/ Comisión, T-325/01 Caso N.º 12. Abuso de posición dominante: Dec.Com. 24 marzo 2004, Microsoft Europe, COMP/C-3/37.792: Noción de abuso de posición dominante (la tensión entre el Derecho de la competencia y el Derecho de la propiedad intelectual) Caso N.º 13. Abuso de posición dominante: Dec. Com. 20 octubre 2004, Deutsche Post AG y RFA, COMP/38.745: Abuso de posición dominante cometido por el operador postal histórico de Alemania, por el hecho de una disposición legislativa que deberá ser modificada Caso N.º 14. Abuso de posición dominante: STPI 26 enero 2005, Piau/ Féderation Internationale de Football Association (FIFA), T-193/02, Rec., p. I-1113: Posición dominante colectiva Caso N.º 15. Abuso de posición dominante: Dec.Com. 22 junio 2005, Coca-Cola, COMP/A.39.116/B2, DO L 253 de 29 septiembre 2005: Decisión compromiso (Coca-Cola se compromete a no abusar de su posición dominante y se libra de toda sanción) Caso N.º 16. Concentraciones: Decisión de la Comisión 19 julio 2004, SONY/BMG, M. 3333 Caso N.º 17. Concentraciones: Dec.Com. 15 julio 2005, Procter &amp; Gamble/ Gillette, M. 3732 Caso N.º 18. Concentraciones: Dec.Com. 29 julio 2005, Maersk/Ponl, M. 3829 Caso N.º 19. Concentraciones: STJCE 15 febrero 2005, Tetra Laval, C-12/03P, Rec., p. I-1113. Caso N.º 20. Concentraciones: STPI 21 septiembre 2005, EDP/Comisión, T-87/05

The study involves strengthening timber beams by known jute fibers with various forms of strengthening and comparison the bending test results with the control beams and beams strengthened by steel plates. Twenty-two timber specimens with dimensions (70×100×1000) mm are divided into eight groups and loaded under a one-point load. The work is carried out to study the flexural and shear strengthening effects on behavior of the tested beams. Four specimens wrapped in U technique in single and double layers, along the whole length of the beam in full and strips wrapping technique, seven beams bonded in full and spiral configuration, seven timber specimens wrapped in flexural strengthening technique with single and multiple layers, and two samples strengthened by steel plates. The results show that jute fibers strengthening are improved the ultimate loads of timber beams by between (30%-101%) compared with the control beams for different types of strengthening and by about (80%, 85%) using steel plates strengthening. On the other hand, the mid-span deflection are decreased by between (28%-45%) at the same load. Furthermore, it is found that the highest ultimate load deflection is when the beam wrapped in full strengthening technique. The ductility, stiffness, toughness at yield load and toughness at ultimate load are increased by between (21%-51%), (10%- 73%), (45%-373%), and (57%-401%), respectively. The jute fibers strengthening have high elasticity performance and prove that the jute fibers materials have a large potential to act as a structural strengthening material.

Background:Diagnostic delay is a major challenge in axial spondyloarthritis (axSpA) with an extended interval of 8-10 years in Europe and 14 years in the United States between symptom onset and disease diagnosis (1, 2).Objectives:To assess the delay in the diagnosis of axSpA over time in a real world axSpA cohort diagnosed in the last 3 decades and to evaluate factors associated with this delay.Methods:A cohort of axSpA patients was recruited from a national multicenter registry of inflammatory arthritis. This cohorts’ demographic, clinical and diagnostic variables were studied. The diagnostic delay was defined as the time interval between the year of first symptom and year of diagnosis. The mean and median diagnostic delay were calculated. A survival analysis was performed evaluating the association between the demographic, clinical and diagnostic variables on the diagnostic delay.Results:Of the 373 axSpA patients in the registry, 198 (47%) are men. Ankylosing spondylitis fulfilling New York criteria was diagnosed in 73% of the patients. HLA-B*27 positivity was found in 64% of patients. The majority of the patients (63%) reported symptom onset between the age of 21-45, 21% before the age of 21 and 16% after the age of 45. Nine percent were diagnosed before the age of 21, 28% between 21-30, 23% between 31-40, 21% between 41-50 and 18% after the age of 50. One hundred and ten patients were diagnosed before 2000, 133 between 2001-2009 and 130 between 2010-2020. The mean and median delay in diagnosis was 9.1, 6 (±8.4) years when diagnosed before 2000, 5, 4 (±4.1) years when diagnosed 2001-2009, and 2, 1 (±1.5) years when diagnosed 2010-2020, respectively (graph 1). The only variable which was found to be associated with a shorter delay was the interval between symptom onset and first rheumatology consult: HR of 5.86 (4.3-8, p<0.001) if the rheumatology visit was within the first year of symptoms, HR 3.5 (2.4-5, p<0.001) if assessed 2-3 years after symptom onset. Additionally, age <21 at symptom onset was associated with a shorter delay (p=0.005). Sex, type of axSpA (radiographic vs. non radiographic axSpA), level of education, and HLA-B*27 positivity were not associated with a delay in diagnosis.Conclusion:Delay in axSpA diagnosis has significantly improved in this real-world cohort during the last decade. The most significant factor associated with a faster diagnosis was the time of the first rheumatology consult relative to symptom onset. Increasing the awareness of disease manifestations and early referral to a rheumatology service can improve the diagnosis delay of axSpA.References:[1]Sorensen J, Hetland ML, all departments of rheumatology in D. Diagnostic delay in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis: results from the Danish nationwide DANBIO registry. Ann Rheum Dis. 2015;74(3):e12.[2]Deodhar A, Mittal M, Reilly P, Bao Y, Manthena S, Anderson J, et al. Ankylosing spondylitis diagnosis in US patients with back pain: identifying providers involved and factors associated with rheumatology referral delay. Clin Rheumatol. 2016;35(7):1769-76.Graph 1.The improvement in the delay in diagnosis of axial spondyloarthropathy over the last 3 decadesDisclosure of Interests:None declared.

The oxygen concentration (FiO2) and arterial oxygen tension (PaO2) delivered in patients undergoing major surgery is poorly understood. We aimed to assess current practice with regard to the delivered FiO2 and the resulting PaO2 in patients undergoing major surgery. We performed a retrospective cohort study in a tertiary hospital. Data were collected prospectively as part of a larger randomised controlled trial but were analysed retrospectively. Patients were included if receiving controlled mandatory ventilation and arterial line monitoring. Anaesthetists determined the FiO2 and the oxygenation saturation (SpO2) targets. An arterial blood gas (ABG) was obtained 15–20 minutes after induction of anaesthesia, immediately before the emergence phase of anaesthesia and 15 minutes after arrival in the post-anaesthesia care unit (PACU). We defined hyperoxaemia as a PaO2 of >150 mmHg and included a further threshold of PaO2 >200 mmHg. We studied 373 patients. The median (interquartile range (IQR)) lowest intraoperative FiO2 and SpO2 values were 0.45 (IQR 0.4–0.5) and 97% (IQR 96–98%), respectively, with a median PaO2 on the first and second ABG of 237 mmHg (IQR 171–291 mmHg) and 189 mmHg (IQR 145–239 mmHg), respectively. In the PACU, the median lowest oxygen flow rate was 6 L/min (IQR 3–6 L/min), and the PaO2 was 158 mmHg (IQR 120–192 mmHg). Hyperoxaemia occurred in 82%, 73% and 54% of participants on the first and second intraoperative and postoperative ABGs respectively. A PaO2 of >200 mmHg occurred in 64%, 41% and 21% of these blood gases, respectively. In an Australian tertiary hospital, a liberal approach to FiO2 and PaO2 was most common and resulted in a high incidence of perioperative hyperoxaemia.

Abstract Objectives To assess changes in working patterns and education experienced by radiology residents in Northwest Italy during the COVID-19 pandemic. Methods An online questionnaire was sent to residents of 9 postgraduate schools in Lombardy and Piedmont, investigating demographics, changes in radiological workload, involvement in COVID-19-related activities, research, distance learning, COVID-19 contacts and infection, changes in training profile, and impact on psychological wellbeing. Descriptive and χ2 statistics were used. Results Among 373 residents invited, 300 (80%) participated. Between March and April 2020, 44% (133/300) of respondents dedicated their full time to radiology; 41% (124/300) engaged in COVID-19-related activities, 73% (90/124) of whom working in COVID-19 wards; 40% (121/300) dedicated > 25% of time to distance learning; and 66% (199/300) were more involved in research activities than before the pandemic. Over half of residents (57%, 171/300) had contacts with COVID-19-positive subjects, 5% (14/300) were infected, and 8% (23/300) lost a loved one due to COVID-19. Only 1% (3/300) of residents stated that, given the implications of this pandemic scenario, they would not have chosen radiology as their specialty, whereas 7% (22/300) would change their subspecialty. The most common concerns were spreading the infection to their loved ones (30%, 91/300), and becoming sick (7%, 21/300). Positive changes were also noted, such as being more willing to cooperate with other colleagues (36%, 109/300). Conclusions The COVID-19 pandemic changed radiology residents’ training programmes, with distance learning, engaging in COVID-19-related activities, and a greater involvement in research becoming part of their everyday practice. Key Points • Of 300 participants, 44% were fully dedicated to radiological activity and 41% devoted time to COVID-19-related activities, 73% of whom to COVID-19 wards. • Distance learning was substantial for 40% of residents, and 66% were involved in research activities more than before the COVID-19 pandemic. • Over half of residents were exposed to COVID-19 contacts and less than one in twenty was infected.

Abstract Lactose is a critical nutrient in post weaning diets to help pigs transition from sows’ milk to dry feed. The objective of this study was to evaluate the effects of increasing dietary lactose level on nursery pig performance. For this trial 1,080 weaned pigs (PIC 359 x 1050; BW = 6.24 kg; 21 d) were fed 5 lactose programs using a feed budget. Program A = 24, 18, 7%; B = 20, 14, 5%; C =16, 10, 3%; D = 12, 6, 1%; and E = 8, 2, 0% lactose for Phase 1, 2, and 3; respectively. The feed budget for Phase 1 (d 0–7), 2 (d 7–14), and 3 (d 14–20) was 0.91, 3.4, and 4.5 kg/pig; respectively. A common Phase 4 (d 20–48) diet (0% lactose) was fed ad libitum. There was a quadratic response to lactose level in treatments A through E for Phase 1 ADFI (89, 71, 73, 73, 89 g/d; respectively, P = 0.034) and G:F (1.09, 1.33, 1.14, 1.15, 0.91; respectively, P = 0.042). Treatment A through E Phase 1 ADG was 100, 95, 91, 82, and 82 g/d, and Phase 2 ADG (Linear, P = 0.023) was 322, 313, 318, 304, and 295 g/d; respectively. The result was a linear trend for increased BW at the end of Phase 2 (P = 0.10) for treatments A through E (9.21, 9.10, 9.16, 9.00, 8.86 kg; respectively). Although feed cost/pig increased as lactose level increased (Linear, P = 0.041), there was no significant response in margin over feed cost/pig during the overall nursery period for treatments A through E ($15.31, $16.41, $16.22, $15.87, $16.04; respectively). In conclusion, pig performance improved during Phase 1 and 2 with increasing level of dietary lactose. These results confirm previous research showing the importance of dietary lactose in weaned pig diets.

Platelet-PA-Inhibitors can be released by thrombin, Col laaen( Col) and others.If they are physiologically important,inhibition of their release might facilitate thrombolysis.Intrinsic PA were tested in euclobulins (eug)of PPP and PPP+Washed platelets(WP) ,with and without aspirinf ASA) .treated with UK,SK and Col(20 atfd l2uo/ml) Results(mm2)were:euaPPP:232+78;+3×106WP/ul:217+71;+10%7ul:188+/5 +2×106MP/ul: 157+69:With UK:eugPPP:283+76;+3×l0517P/ul :234+69;+106 WP/ul :172+55;+2×l(PWP/ul :154+48; With SK:euoPPP:303+99;+3×l05WP/ul 252+65;+1067P/ul:203+68;+2×106UP/ul: 174+85;Wi th Col (20ug/ml) :eur PPP:234+97;+3×105WP/ul:160+63;+106WP/ul:141+73;+2×l06WP/ul:129+81; +2×106WP/ul+ASA: 105+31;Wi th Col uc/ml) :euaPPP:230+56;+3×l05NP/ul: 160+52;+106WP/ul:139+44;+2×106wp/ul:126+21;+2×106WP/ul+ASA:118+28. EugPPP+l/P showed lower lysis area.Col induced more decrease of lysis area in euc with WP.ASA did not modify this effect.UK and SK produced higher lysis area only in euoPPP.No difference was observed between high and low doses of Col-effect upon WP.Combined treatment of eucPPP+WP+Col, with UK and SK showed:(mm2):UK-treated eugPPP+2×106WP/ul+Col(29ug/ml):134+25;+ASA and Col(20ug/ml):115+65;+Col(2uc/ml):157+50;+ASA and Col(2uo/ml):133+49; SK-treated eupPPP+2×106WP/ul:+Col(20uo/ml):144+49;+ASA and Col(20ug/ml):128+ 60;+Co1(2ug/ml):173+66;+ASA and Col(2ug/ml):142+36.Col (20ug/ml) produced slight lower lysis area of UK and SK-treated eugPPP+WP. (p:ns). ASA did not modify this effect.Col (2uc/ml) did not produce changes in lysis area of UK and SK-treated eupPPP +WP. ASA produced slight lower lysis area(p:ns).Conclusion: high dosis of Col could release anti UK,anti SK and intrinsic PA-inhibitors from platelets;low dosis of Col could only release fntrinsic PA-inhibi tors. It suggests that anti UK and anti SK release might be triggered by stronger stimuli than intrinsic PA inhibitors.ASA could not inhibit any inhibitors release.We must consider that PA-inhibi tors could be released by different metabolic pathways other than cyclooxygenase pathway.