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Eatock, M. M., J. Szanto, N. C. Tebbutt, C. L. Bampton, A. H. Strickland, M. Valladares Ayerbes, N. Nanayakkara, Y. Sun, A. H. Adewoye, and G. Bodoky. "Randomized, double-blind, placebo-controlled phase II study of AMG 386 in combination with cisplatin and capecitabine (CX) in patients (pts) with metastatic gastroesophageal adenocarcinoma." Journal of Clinical Oncology 29, no. 4_suppl (February 1, 2011): 66. http://dx.doi.org/10.1200/jco.2011.29.4_suppl.66.
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66 Background: AMG 386, a first-in-class investigational peptide-Fc fusion protein (peptibody), blocks angiogenesis via inhibiting the interaction between angiopoietins-1 and -2 and the Tie2 receptor. We evaluated the efficacy and tolerability of AMG 386 or placebo plus CX in the first-line treatment of metastatic gastroesophageal adenocarcinoma. Methods: Pts with confirmed metastatic adenocarcinoma of the stomach, gastroesophageal junction or distal esophagus were randomized 1:1:1 to receive CX (cisplatin, 80 mg/m2 IV Q3W; capecitabine, 1,000 mg/m2 orally BID for 14 days Q3W) plus AMG 386 10 mg/kg (Arm A), 3 mg/kg (Arm B), or placebo (Arm C) IV QW. The primary endpoint was progression-free survival (PFS). Secondary endpoints included objective response rate (ORR; in pts with measurable disease), adverse events (AEs), and pharmacokinetics (PK). Results: 171 pts were randomized (Arm A/B/C, n = 56/59/56). Efficacy results are summarized in the table. The incidence of grade ≥ 3 AEs in Arms A/B/C was 80/84/75%. Serious AEs occurred in 73/60/47% and serious AEs grade ≥ 3 in 66/60/43% of pts. AEs in Arms A/B/C included abdominal pain (30/40/17%; grade ≥ 3, 18/3/4%), peripheral edema (13/29/6%; grade ≥ 3, 0/2/0%), venous thromboembolic events (20/22/19%; grade ≥ 3, 20/19/17%), and pulmonary embolism (9/3/15%; grade ≥ 3, 9/2/13%). Median AMG 386 Cmax and Cmin values at steady state after CX coadministration were dose-proportional. Coadministration with CX did not markedly affect AMG 386 exposure. Conclusions: In this study, AMG 386 plus CX did not significantly improve PFS or ORR over placebo plus CX in this patient population. The toxicity of the combination of AMG 386 plus CX, compared with placebo, was greater but manageable. No unexpected AEs occurred. [Table: see text] [Table: see text]
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Atkins, Michael B., Alain Ravaud, Gwenaelle Gravis, Kazimierz Drosik, Tomasz Demkow, Piotr Tomczak, Karolyn Kracht, Markus Puhlmann, and David Michael Weinreich. "Safety and efficacy of AMG 386 in combination with sunitinib in patients with metastatic renal cell carcinoma (mRCC) in an open-label multicenter phase II study." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 4606. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.4606.
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4606 Background: AMG 386, an investigational peptide-Fc fusion protein, inhibits angiogenesis by disrupting the angiopoietin/Tie2 axis. We evaluated the safety and efficacy of AMG 386 plus sunitinib in patients (pts) with mRCC. Methods: Adults with mRCC who were naïve to angiogenesis inhibitors were sequentially enrolled to 2 cohorts: sunitinib 50 mg PO QD (4 wks on, 2 wks off) plus AMG 386 at 10 mg/kg (A) or 15 mg/kg (B) IV QW. Primary endpoints: adverse events (AEs), dose interruptions/reductions due to AEs in the first 12 wks of treatment; secondary endpoints included: progression-free survival (PFS) and response rate (ORR). Results: 85 pts received ≥1 dose of study medication (A/B, n=43/42). In A/B, 88%/76% were male and 30%/36% were age ≥65; MSKCC risk scores were low (40%/36%) or intermediate (60%/62%). For A/B: median follow-up time was 19.6/12.0 mos; AMG 386 discontinuations due to AEs were 16%/29%; and grade ≥3 treatment-related AEs occurred in 72%/74% with virtually all attributed to sunitinib. Grade 3 AEs occurring with >5% frequency were hypertension, hand foot syndrome, asthenia, fatigue, elevated lipase, diarrhea, mucositis, vomiting, thrombocytopenia, and neutropenia, with no distinction between dose levels. The percentage of pts with sunitinib dose interruptions within the first 12 wks (A/B, 58%/57%) met the prespecified criteria. One pt in B had fatal acute pulmonary edema. No pt developed anti-AMG 386 antibodies. The Kaplan-Meier estimate (95% CI) of PFS was 13.9 (10.4, 19.2) mos in A; PFS in B is not yet mature with only 21% of pts having disease progression. ORR (95% CI) was 58% (42, 73) in A including 1 CR, and 59% (42, 74) in B. Conclusions: In pts with mRCC, AMG 386 at 10 and 15 mg/kg combined with sunitinib appeared to be tolerable. Reported sunitinib dose modifications for the observation period were within the prespecified range. Efficacy results suggest potential benefit for the addition of AMG 386 to sunitinib.
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Sly, L. I., M. A. Bronsdon, J. P. Bowman, A. Holmes, and E. Stackebrandt. "The Phylogenetic Position of Helicobacter nemestrinae." International Journal of Systematic Bacteriology 43, no. 2 (April 1, 1993): 386–87. http://dx.doi.org/10.1099/00207713-43-2-386.
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van Asselt, G. J., J. H. Sloos, R. P. Mouton, C. P. A. van Boven, and J. A. M. van de Klundert. "Susceptibility of Streptococcus pyogenes to azithromycin, clarithromycin, erythromycin and roxithromycin in vitro." Journal of Medical Microbiology 43, no. 5 (November 1, 1995): 386–91. http://dx.doi.org/10.1099/00222615-43-5-386.
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Reinhard, E., E. Nedivi, J. Wegner, J. H. Skene, and M. Westerfield. "Neural selective activation and temporal regulation of a mammalian GAP-43 promoter in zebrafish." Development 120, no. 7 (July 1, 1994): 1767–75. http://dx.doi.org/10.1242/dev.120.7.1767.
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Neurons throughout the vertebrate nervous system selectively activate the gene for a growth cone component, GAP-43, during embryonic development, and then decrease its expression abruptly as they form synapses. Distal interruption of mature axons in the central nervous system (CNS) of fish and amphibians, but not in the mammalian CNS reverses the developmental down-regulation of GAP-43 expression. To explore functional conservation and divergence of cis-acting elements that regulate expression of the GAP-43 gene, we studied activation, in transgenic zebrafish embryos, of mammalian GAP-43 genomic sequences fused to a marker gene. The DNA fragments containing the GAP-43 promoter, including a short fragment of 386 base pairs, were preferentially activated in the embryonic fish nervous system at times when extensive neuronal differentiation and neurite outgrowth take place. After 2 days of development, expression of the mammalian transgenes was specifically downregulated in the fish spinal cord but increased in more rostral regions of the CNS. This expression pattern was well correlated with the regulation of the endogenous fish GAP-43 gene revealed by in situ hybridization. Elements of the mammalian gene located a substantial distance upstream of the minimal promoter directed additional expression of the marker gene in a specific set of non-neural cells in zebrafish embryos. Our results indicate that cis-acting elements of the GAP-43 gene, and signaling pathways controlling these elements during embryonic development, have been functionally conserved in vertebrate evolution.
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McCall, W. Vaughn, Niki Boggs, and Alan Letton. "Erratum to “Changes in sleep and wake in response to different sleeping surfaces: A pilot study” [Appl. Ergon. (43/2) 386–391]." Applied Ergonomics 43, no. 3 (May 2012): 637. http://dx.doi.org/10.1016/j.apergo.2011.11.001.
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Mwaisaka, Davidson Mghanga, George K'Aol, and Caren Ouma. "Influence of directive and supportive leadership styles on employee job satisfaction in commercial banks in in Kenya." International Journal of Research in Business and Social Science (2147- 4478) 8, no. 6 (October 26, 2019): 168–74. http://dx.doi.org/10.20525/ijrbs.v8i6.468.
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The purpose of the study was to examine the influence of directive and supportive leadership style on employee job satisfaction in commercial banks in Kenya. The study adopted the positivism research philosophy and descriptive correlational research design. The target population of the study was 15,030 employees in all the 43 commercial banks licensed to operate in Kenya as of June 2018. Using a stratified sampling technique, the study drew a sample size of 386 employees reporting to middle-level managers. Data was collected by means of a questionnaire and analyzed using descriptive and inferential statistics. Statistical Package for Social Sciences (SPSS) version 20. The results of the study showed that a directive leadership style and supportive leadership styles positively and significantly predicted employee job satisfaction. The results of the regression analysis after moderation showed that environmental contingency factors significantly moderated the relationship between path-goal leadership style and employee job satisfaction.
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Mwaisaka, Davidson Mghanga, George K'Aol, and Caren Ouma. "Influence of participative and achievement oriented leadership styles on employee job satisfaction in commercial banks in Kenya." International Journal of Research in Business and Social Science (2147- 4478) 8, no. 5 (August 17, 2019): 42–53. http://dx.doi.org/10.20525/ijrbs.v8i5.465.
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The purpose of the study was to examine the influence of participative and achievement-oriented leadership styles on employee job satisfaction in commercial banks in Kenya. This study adopted the positivism research philosophy while building a descriptive correlational research design. The target population of the study was 15,030 employees in all the 43 commercial banks licensed to operate in Kenya as of June 2018. , the study drew a sample size of 386 employees reporting to middle-level managers, using a stratified sampling technique. Data were collected utilizing a questionnaire and analyzed using descriptive and inferential statistics — statistical Package for Social Sciences (SPSS) version 20. The results of the study showed that a participative leadership style and achievement-oriented leadership styles positively and significantly predicted employee job satisfaction. From the results of the regression analysis after moderation, it was revealed that environmental contingency factors significantly moderated the relationship between path-goal leadership style and employee job satisfaction.
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Nargis, Tahmina, Md Humayun Kabir Talukder, and Kazi Khairul Alam. "The hidden curriculum in under graduate medical education in Bangladesh: medical students' perception." Bangladesh Journal of Medical Education 4, no. 1 (April 14, 2017): 20–24. http://dx.doi.org/10.3329/bjme.v4i1.32192.
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This descriptive cross sectional study was conducted among 386 students of 3rd phase of selected 2 government and 2 non government medical colleges of Bangladesh in 2013. The objective of the study was to find out the perceptions of the students regarding hidden curriculum in undergraduate medical education. Sampling technique was convenient. A self administered structured questionnaire was used and it consisting of 43 items in relation to hidden curriculum in the likert scale. Perceptions of the respondents were positive about 27 items that is the issues on these item areas were satisfactory in their institutes. Mean scores of these items were more than 3 for each. On the contrary perceptions of the respondents were negative for 16 items that is the issues on these item areas were not satisfactory in their institutes. Mean scores of these items were less than 3 for each. The study result can be used to sensitize and aware the concerned teachers/ authorities for valuing the importance of hidden curriculum and address the issues accordingly.Bangladesh Journal of Medical Education Vol.4(1) 2013: 20-24
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Duan, Zelin, Qing Li, Xuejie Li, Lin He, and Qun Wang. "GSK3β is involved in the spermatogenesis of the Chinese mitten crab Eriocheir sinensis H. Milne Edwards, 1853." Crustaceana 89, no. 5 (2016): 559–81. http://dx.doi.org/10.1163/15685403-00003543.
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Glycogen synthase kinase3β (GSK3β) is a Serine/Threonine kinase involved in metabolic reactions, and the Wnt, Akt, Hedgehog and BMP/Smad1 signalling pathways. It regulates cell metabolism, the cell cycle and cell fate through the phosphorylation of a diverse array of substrates. Its disorders lead to testicular degeneration, testicular cord disruption and many other reproductive diseases that often lead to infertility. In mammals, GSK3β plays an important role in the regulation of spermatogenesis. To explore functions of GSK3β during spermatogenesis inEriocheir sinensiswe cloned the full-lengthGSK3β cDNA sequence from the testis ofE. sinensis(EsGSK3β). The 1161-nucleotide open reading frame encodes a 386-amino-acid protein with a predicted molecular mass of 43 kDa. Additionally, we examined the expression pattern of EsGSK3β in different tissues and testis developmental stages using real-time PCR and Western blotting. Localization analysis ofEsGSK3β RNA and protein by in situ hybridization and immunofluorescence, respectively, showed that molecules translocated from the cytoplasm and nucleus to the regions of the acrosomal tubule and apical cap during spermatogenesis. The results indicated that EsGSK3β might play an important role duringE. sinensisspermatogenesis.
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Farrah, J., and S. K. Shami. "Patterns of Incompetence in Patients with Recurrent Varicose Veins: A Duplex Ultrasound Study." Phlebology: The Journal of Venous Disease 16, no. 1 (March 2001): 34–37. http://dx.doi.org/10.1177/026835550101600109.
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Objectives: To identify the patterns of venous incompetence in patients with recurrent varicose veins using duplex ultrasound scanning. Setting: Oldchurch District General Hospital, Southeast England. Patients and methods: 836 patients (581 women, median age 51 years (range 22–86 years) and 255 men, median age 53 years (range 23–28 years) referred to the vascular laboratory for the assessment of recurrent varicose veins. Duplex ultrasonography was undertaken by an experienced operator to evaluate the venous system in the lower limbs. A total of 1254 limbs with recurrent varicose veins were studied. Results: Recurrent reflux was found at the sapheno-femoral (SFJ) or saphenopopliteal junction (SPJ) in 43% of cases. The source of recurrent varices was an unoperated SFJ or SPJ in 386 (31%) limbs. Thigh perforators accounted for varices in 16% of limbs. Conclusion: Nearly half of recurrences were attributable to inadequate surgical treatment at the initial operation or possible angiogenesis. Nearly a third of recurrences originated at previously unoperated sites, confirming a need for objective venous assessment before recurrent varicose vein surgery.
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SHEHU, L. M., and L. T. ZARIA. "SCREENING TEST FOR BOVINE TUBERCULOSIS AMONGST CATTLE POPULATION IN ZARIA AREA USING SINGLE CAUDAL-FOLD TECHNIQUE." Nigerian Journal of Animal Production 18 (January 12, 2021): 82–87. http://dx.doi.org/10.51791/njap.v18i.1980.
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Five hundred out of 732 heads of cattle in twenty selected birds in Zaria and its environs, were screened for tuberculosis using the single caudal fold (SCF) tuberculin test. Fifty nine (11.8%) beads of cattle were detected to be reactors, while 43 (8.6%) and 398 (79.6%) were suspects and non-reactors respectively. Only one herd had no reactors nor suspects. Amongst reactors, the incidence increased with age, with 6.9% reactors in 0-1 year age group; while those over 5 years old had 28 (20.9%) reactors. The difference was statistically significant (P<0.05;x2) Management system had an effect on the incidence of tuberculin test reactors with purely nomadic animals showing a greater number of reactors (72.88%) than intensively (0.0%) and semi-intensively (27.12%) managed farms, Sex had no effect on reactor rates as 13(11.4%) of 114 males and 46 (11.9%) of 386 females were reactors. The difference was not statistically significant(P<0.05;x2). It is therefore concluded that cattle in nomadic Fulani herds harbour Mycobacteria which serve as a potential source of tuberculosis to man and other animals.
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Asseng, S., I. R. P. Fillery, F. X. Dunin, B. A. Keating, and H. Meinke. "Potential deep drainage under wheat crops in a Mediterranean climate. I. Temporal and spatial variability." Australian Journal of Agricultural Research 52, no. 1 (2001): 45. http://dx.doi.org/10.1071/ar99186.
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High rates of deep drainage (water loss below the root-zone) in Western Australia are contributing to groundwater recharge and secondary salinity. However, quantifying potential drainage through measurements is hampered by the high degree of complexity of these systems as a result of diverse soil types, a range of crops, different rainfall regions, and in particular the inherent season-to-season variability. Simulation models can provide the appropriate means to extrapolate across time and space. The Agricultural Production Systems Simulator (APSIM) was used to analyse deep drainage under wheat crops in the Mediterranean climate of the central Western Australian wheatbelt. In addition to rigorous model testing elsewhere, comparisons between simulated and observed soil water loss, evapotranspiration, and deep drainage for different soil types and seasons confirmed the reasonable performance of the APSIM model. The APSIM model was run with historical weather records (70–90 years) across 2 transects from the coast (high rainfall zone) to the eastern edge of the wheatbelt (low rainfall zone). Soils were classified as 5 major types: deep sand, deep loamy sand, acid loamy sand, shallow duplex (waterlogging), and clay soil (non-waterlogging). Simulations were carried out on these soil types with historical weather records, assuming current crop management and cultivars. Soil water profiles were reset each year to the lower limit of plant-available water, assuming maximum water use in the previous crop. Results stressed the high degree of seasonal variability of deep drainage ranging from 0 to 386 mm at Moora in the high rainfall region (461 mm/year average rainfall), from 0 to 296 mm at Wongan Hills in the medium rainfall region (386 mm/year average rainfall), and from 0 to 234 mm at Merredin in the low rainfall region (310 mm/year average rainfall). The largest amounts of drainage occurred in soils with lowest extractable water-holding capacities. Estimates of annual drainage varied with soil type and location. For example, average (s.d.) annual drainage at Moora, Wongan Hills, and Merredin was 134 (73), 90 (61), and 36 (43) mm on a sand, and 57 (64), 26 (43), and 4 (18) mm on a clay soil, respectively. These values are an order of magnitude higher than drainage reported elsewhere under native vegetation. When not resetting the soil each year, carry-over of water left behind in the soil reduced the water storage capacity in the subsequent year, increasing long-term average deep drainage, depending on soil type and rainfall region. The analyses revealed the extent of the excess water problem that currently threatens the sustainability of the wheat-based farming systems in Western Australia.
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Fakan, Bernadett, Eszter Baranyi, Réka Horváth, Endre Kálmán, Janina Kulka, Katalin Tölgyesi, Miklós Török, Nóra Udvarhelyi, Tamás Zombori, and Gábor Cserni. "Emlőrák miatti szervmegtartó műtétek reszekciós széleinek vizsgálata. Multicentrikus retrospektív elemzés." Orvosi Hetilap 160, no. 26 (June 2019): 1036–44. http://dx.doi.org/10.1556/650.2019.31449.
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Abstract: Introduction: Breast conserving surgery for breast cancer requires the analysis of surgical margins. If the tumor is not removed completely, additional treatments (reoperation, boost irradiation) are generally recommended. Aim: To analyze the information content of histopathology reports on surgical margins in consecutive cases of breast conservation for invasive female breast cancer, to evaluate the frequency of incompletely removed tumors and to estimate the rate of further treatments after incomplete removal. Method: Analysis of margin related data of consecutive histopathology reports from 8 Hungarian pathology units with locoregional treatment related data in case of unsafe margins. Results: 386 reports were analyzed after exclusions. 200 and 32 cases were identified as having unsafe margins according to the previous (<5 mm) and the new (0 mm) definition of unclear margin, respectively. Unsafe margins were more common with lobular carcinomas. Specimens with clear margins weighed more. Reoperations for unsafe margins were performed in 43/180 and 12/22 cases according to the previous and the new definitions, respectively. Only 75/137 patients without reoperation received boost irradiation of the tumor bed; information on boost radiotherapy was often missing. Residual cancer was identified in 15/43 reoperated patients, of whom 9 had >0 mm margin distance. Conclusions: Some pathology reports lack information on surgical margins. Unsafe margin rates decreased with the new definition. Residual cancer may be left behind in case of clear margins with no ink on tumor. Neither reoperation, nor boost radiotherapy is given to some patients with unclear surgical margins. Orv Hetil. 2019; 160(26): 1036–1044.
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Samborski, Alexandra, Alexandra Michelle Blackman, Michael Craig Miller, Elizabeth Eklund, Geralyn Messerlian, and Richard G. Moore. "Biomarker lead time for predicting progression in women with ovarian cancer compared to imaging." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e18074-e18074. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e18074.
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e18074 Background: Both CA125 and HE4 are biomarkers used to monitor women diagnosed with epithelial ovarian cancer (EOC). When these biomarkers increase and suggest progression of disease, imaging is frequently obtained for further assessment and confirmation. This study aims to assess how far in advance these biomarkers begin to trend upwards in comparison to the radiographic evidence of disease progression. Methods: This was an IRB approved retrospective trial. Residual longitudinal serum samples drawn for serum CA125 levels during treatment and monitoring from women with EOC were obtained. The samples were drawn every 3-5-weeks for patients on chemotherapy and every 3 months while monitoring. Serum CA125 and HE4 levels in the residual sera were analyzed at each time point. Imaging data was collected for each patient. Patients were included if either HE4 or CA125 was a marker for their disease. For each patient, the date of time point when the biomarker started to trend upward was identified and the date of radiographic evidence of progression was determined. The lead time (in days) for elevation of both CA125 and HE4 prior to evidence of radiographic progression was determined for each patient. Results: A total of 48 patients undergoing 58 treatment and monitoring events were identified. Each had evidence of disease progression by CA125 levels, HE4 levels, and computed tomography (CT). CA125 was the first biomarker to trend upward for 9 events (15.5%), HE4 was the first biomarker for 10 events (17.2%), and both increased simultaneously for 39 events (67.2%). Mean lead time for CA125 elevation prior to progression on imaging was 60 days (95% CI: 43 - 78, median = 44, range = 0 - 386). For HE4, mean lead time was 66 days (95% CI: 48 – 83, median = 46, range = 0 - 386). There was no significant difference in the average lead times between the two biomarkers (p < 0.01). Conclusions: When used for EOC monitoring both CA125 and HE4 have similar average lead times (~2 months) prior to the detection of progressive or recurrent disease by CT imaging.
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Fahmi, NFN, and Rumondang Purwati. "Refleksi Diri untuk Memperbaiki Hasil Belajar berdasarkan Hasil TIMSS." Indonesian Journal of Educational Assesment 2, no. 1 (July 1, 2019): 1. http://dx.doi.org/10.26499/ijea.v2i1.13.
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The aim of this study is to obtain information about the mathematics competency of Indonesian students based on international benchmark in TIMSS 2011. This study is a quantitative descriptive study based on TIMSS 2011 data. The population of this study is all students in the junior high schools (SMP) in Indonesia. The subjects of the research are 5.795 Indonesian students from 154 schools. The methods of multistage stratified and random sampling are conducted as sample-determining technic. Data analysis was administered by International Association for the Evaluation of Educational Achievement (IEA) using IDB analyzer program.The average mathematics score acquired by Indonesian students is 386, below the international average score (500). Indonesian students is at rank 40 of 45. Based on international benchmark, there are 0% Indonesian students who can achieve advanced level, 2% reaching the high level, 15% achieving intermediate level, and 43% in the low level. For most of Indonesian students the mastery of Mathematics material is very low, especially in solving the problem at proficient level and high level. The research concludes that: (1) Indonesian students are less accustomed to work on items in applying and reasoning cognitive domain, especially in constructed-response items; (2) Indonesian students are less accustomed to work on items that need more than one process of solving the questions; (3) Misconception among Indonesian students about arithmetic operations (+, -, x, :), which one should be done first; and (4) Indonesians students have more difficulties in working on algebraic operations than number operations.Abstract. The aim of this study is to obtain information about the mathematics competency of Indonesian students based on international benchmark in TIMSS 2011. This study is a quantitative descriptive study based on TIMSS 2011 data. The population of this study is all students in the junior high schools (SMP) in Indonesia. The subjects of the research are 5.795 Indonesian students from 154 schools. The methods of multistage stratified and random sampling are conducted as sample-determining technic. Data analysis was administered by International Association for the Evaluation of Educational Achievement (IEA) using IDB analyzer program.The average mathematics score acquired by Indonesian students is 386, below the international average score (500). Indonesian students is at rank 40 of 45. Based on international benchmark, there are 0% Indonesian students who can achieve advanced level, 2% reaching the high level, 15% achieving intermediate level, and 43% in the low level. For most of Indonesian students the mastery of Mathematics material is very low, especially in solving the problem at proficient level and high level. The research concludes that: (1) Indonesian students are less accustomed to work on items in applying and reasoning cognitive domain, especially in constructed-response items; (2) Indonesian students are less accustomed to work on items that need more than one process of solving the questions; (3) Misconception among Indonesian students about arithmetic operations (+, -, x, :), which one should be done first; and (4) Indonesians students have more difficulties in working on algebraic operations than number operations.AbstrakTujuan penelitian ini adalah memperoleh informasi tentang kemampuan matematika siswa Indonesia berdasarkan benchmark Internasional dalam TIMSS 2011. Penelitian ini merupakan penelitian deskriptif kuantitatif berdasarkan data TIMSS tahun 2011. Populasi dari penelitian ini adalah seluruh siswa SMP/MTs dan sampel penelitian adalah siswa kelas VIII SMP/MTs. Jumlah siswa yang menjadi sampel sebanyak 5.795 siswa dari 154 sekolah. Penentuan sampel dilakukan dengan metode multistage stratified dan acak. Analisis data dilakukan oleh International Association for the Evaluation of Educational Achievement (IEA) menggunakan program IDB analyzer. Rerata skor matematika siswa Indonesia adalah 386, di bawah rerata skor Internasional (500). Indonesia berada pada peringkat 40 dari 45 negara peserta. Capaian siswa Indonesia untuk level mahir 0%, level tinggi 2%, level menengah 15%, dan level rendah 43%. Penguasaan materi matematika bagi sebagian besar siswa Indonesia masih sangat rendah terutama untuk menyelesaikan soal-soal pada level mahir dan level tinggi. Simpulan dari penelitian ini adalah: (1) siswa Indonesia masih menemui kesulitan untuk menyelesaikan soal aplikasi dan penalaran, terutama untuk soal uraian, (2) dalam konsep operasi hitung (+, - , x, : ) masih ditemukan siswa yang belum memahami urutan oprerasi hitung yang dikerjakan terlebih dahulu, dan (3) siswa Indonesia masih kesulitan menyelesaikan soal dalam bentuk variabel atau operasi aljabar.
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Gao, Liang, Limin Zhang, and Mengqian Lu. "Characterizing the spatial variations and correlations of large rainstorms for landslide study." Hydrology and Earth System Sciences 21, no. 9 (September 13, 2017): 4573–89. http://dx.doi.org/10.5194/hess-21-4573-2017.
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Abstract. Rainfall is the primary trigger of landslides in Hong Kong; hence, rainstorm spatial distribution is an important piece of information in landslide hazard analysis. The primary objective of this paper is to quantify spatial correlation characteristics of three landslide-triggering large storms in Hong Kong. The spatial maximum rolling rainfall is represented by a rotated ellipsoid trend surface and a random field of residuals. The maximum rolling 4, 12, 24, and 36 h rainfall amounts of these storms are assessed via surface trend fitting, and the spatial correlation of the detrended residuals is determined through studying the scales of fluctuation along eight directions. The principal directions of the surface trend are between 19 and 43°, and the major and minor axis lengths are 83–386 and 55–79 km, respectively. The scales of fluctuation of the residuals are found between 5 and 30 km. The spatial distribution parameters for the three large rainstorms are found to be similar to those for four ordinary rainfall events. The proposed rainfall spatial distribution model and parameters help define the impact area, rainfall intensity and local topographic effects for landslide hazard evaluation in the future.
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Almutairi, Wedad M. "Incidences of Atonic Postpartum Hemorrhage and Related Risk Factors at a Tertiary Hospital in Saudi Arabia." Nursing Reports 10, no. 2 (December 16, 2020): 164–71. http://dx.doi.org/10.3390/nursrep10020020.
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Background: In 2017, there were 295,000 maternal deaths worldwide from preventable causes related to birth. The leading cause of maternal mortality is obstetric hemorrhage. In Saudi Arabia, a paucity of evidence about incidences of atonic Postpartum Hemorrhage (PPH) and related risk factors exists. Therefore, aims were to (a) identify incidences of atonic PPH from 2015 to 2018 (b) determine risk factors of atonic PPH in vaginal birth. Methods: Retrospective chart review with purposive sampling conducted revealed 386 charts, 220 (57%) vaginal birth and 166 (43%) caesarian section (CS). Logistic regression analysis was used. Results: Incidences of atonic PPH were 2.5% from 2015 to 2017, with the rate increasing by 12% from 2017 to 2018. In vaginal birth, significant associations between the severity of blood loss with epidural (F = 6.314, df = 1, p = 0.013), episiotomy (F = 4.38, df = 1, p = 0.038), induction of labor (IOL) (F = 1.224, df = 1, p = 0.004), and Interaction between IOL, AUG, and epidural (F = 7.24, df = 1, p = 0.041) found. Discussion: Increasing rate of atonic PPH confirmed. Epidural, episiotomy, induction of labor, and induction with augmentation are factors associated with severe atonic PPH in vaginal birth.
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Nazahiyah, R., Z. Yusop, and I. Abustan. "Stormwater quality and pollution loading from an urban residential catchment in Johor, Malaysia." Water Science and Technology 56, no. 7 (October 1, 2007): 1–9. http://dx.doi.org/10.2166/wst.2007.692.
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Sampling of urban runoff was carried out in a small catchment, which represents a residential area (3.34 ha) in Skudai, Johor. One hundred and seventeen runoff samples from ten storm events were analysed. Runoff quality showed large variations in concentrations during storms, especially for SS, BOD5 and COD. Concentrations of NO3−N, NO2−N, NH3−N, and P were also high. Lead (Pb) was also detected but the levels were low (<0.001 mg/L). In general, the river quality is badly polluted and falls in Class V based on the Malaysian Interim National Water Quality Standards. Event mean concentrations for all parameters were found to vary greatly between storms. The values (mg/L) were BOD5 (72), COD (325), SS (386), NO3−N (2.5), NO2−N (0.58), NH3−N (6.8), P (3.4), respectively. First flush phenomena were observed for BOD, COD, SS, NO3−N, NH3−N and P. The first 20–30% of the runoff volume evacuated between 20–59% BOD, 15–69% COD, 15–78% SS, 14–49% NO3−N, 14–19% NO2−N, 23–53% NH3−N and 23–43% P.
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Shouzu, Akira, Seitaro Omoto, Takashi Hayakawa, Hideo Kagawa, Mitsushige Nishikawa, Mitsuo Inada, Yoshihiro Fujimura, Yasuo Ikeda, Shirou Fukuhara, and Shosaku Nomura. "Effect of Cilostazol on Soluble Adhesion Molecules and Platelet-derived Microparticles in Patients with Diabetes." Thrombosis and Haemostasis 80, no. 09 (1998): 388–92. http://dx.doi.org/10.1055/s-0037-1615217.
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SummaryWe evaluated the plasma concentrations of soluble adhesion molecules and platelet-derived microparticles (PMP) in patients with non-insulin dependent diabetes mellitus (NIDDM) and studied the effect of cilostazol on PMP generation. There were differences in the levels of soluble adhesion molecules between NIDDM patients (N = 43) and the control subjects (N = 30) (soluble thrombomodulin: 11.5 ± 5.3 vs. 7.0 ± 1.2 TU/ml, p<0.0001; soluble vascular cell adhesion molecule-1: 708 ± 203 vs. 492 ± 113 ng/dl, p<0.0001; soluble intercellular cell adhesion molecules-1: 274 ± 65 vs. 206 ± 48 ng/dl, p<0.0001; soluble P-selectin: 194 ± 85 vs. 125 ± 43 ng/dl, p<0.0001). There were also differences in the levels of PMP and platelet activation markers between NIDDM patients and the controls (PMP: 943 ± 504 vs. 488 ± 219/10 4 plt, p<0.0001; platelet CD62P: 9.2 ± 4.6 vs. 4.4 ± 4.3%, p<0.001; platelet CD63: 10.2 ± 4.5 vs. 4.5 ± 3.3%, p<0.0001; platelet annexin V: 9.1 ± 3.9 vs. 5.3 ± 3.8%, p<0.001). To study the release of PMP into plasma, a modified cone-and-plate viscometer was used. Increased release of PMP from platelets was observed in diabetic plasma compared to normal plasma under high shear stress conditions (2,672 ± 645 vs. 1,498 ± 386/104 plt, p<0.05). Therefore, one cause of PMP elevation in NIDDM may be high shear stress. The levels of PMP, activated platelets, and soluble adhesion molecules all decreased significantly after treatment with cilostazol. These results suggest that cilostazol may be useful for the inhibition of both PMP-dependent and -independent vascular damage in NIDDM.
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Guzman Valqui, Betty Karina, and Damaris Leiva Tafur. "Diatomeas como bioindicadores para la evaluación de la calidad del agua en la cuenca del río Utcubamba, Amazonas - Perú." Revista Científica UNTRM: Ciencias Naturales e Ingeniería 2, no. 1 (November 20, 2017): 16. http://dx.doi.org/10.25127/ucni.v2i1.220.
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<span class="fontstyle0">En la presente investigación se ha evaluado la calidad del agua de la cuenca del río Utcubamba utilizando diatomeas (Bacillariophyceae) como parámetro biológico</span><span class="fontstyle0">. </span><span class="fontstyle0">Para ello, se realizó dos muestreos, en época seca (octubre 2014) y húmeda (marzo 2015), en 43 estaciones ubicadas a lo largo de la cuenca del río, situadas entre 386 y 2 834 msnm. Se dividió la cuenca en alta, media y baja según el piso altitudinal. Se usó como herramienta principal el índice de diversidad de Shannon y Wienner (H') para diatomeas</span><span class="fontstyle0">. </span><span class="fontstyle0">En la época seca, se encontró niveles de contaminación moderada para el tramo alto de la cuenca y contaminación leve en los tramos medio y bajo, con valores entre 1 981 y 2 533 bits cel -1. Para la época húmeda se registraron los mismos datos interpretativos</span><span class="fontstyle0">, </span><span class="fontstyle0">pero con valores entre 1 890 y 2 004 bits cel -1 </span><span class="fontstyle0">.</span>
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Barber, P. Alan, Teddy Y. Wu, and Annemarei Ranta. "Stroke reperfusion therapy following dabigatran reversal with idarucizumab in a national cohort." Neurology 94, no. 19 (February 20, 2020): e1968-e1972. http://dx.doi.org/10.1212/wnl.0000000000009155.
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ObjectiveTo assess the frequency and utilization trends of dabigatran reversal with idarucizumab and compare associated complications, outcomes, and door-to-needle times to those of patients not exposed to idarucizumab in a nationwide cohort of thrombolyzed patients over a 24-month period.MethodsThis is an observational cohort study of all New Zealand patients with stroke treated with stroke reperfusion entered into a mandatory online national registry. Each hospital records data including patient demographics, treatment delays, complications, 7-day outcomes, and idarucizumab use.ResultsBetween 1 January 2017 and 31 December 2018, 1,336 patients received thrombolysis. Fifty-one patients received idarucizumab prior to thrombolysis (median [interquartile range] age 73 [57–83] years): 8 (1.3%) in 2017 and 43 (6%) in 2018 (p < 0.001). Over the same 24-month period, 386 patients had stroke clot retrieval, of whom 8 (2.1%) were first treated with idarucizumab. Idarucizumab-treated patients had slower door-to-needle times (83 [54–110] minutes vs 61 [43–85] minutes, p = 0.0006). Symptomatic intracerebral hemorrhage occurred in 2 (3.9%) of the idarucizumab-treated patients and 49 (3.8%) of the other thrombolyzed patients (p = 0.97). None of the idarucizumab-treated patients had significant thrombotic complications. At 7 days, 3 (5.9%) idarucizumab-treated and 101 (7.9%) of the other thrombolyzed patients had died (p = 0.61).ConclusionIdarucizumab was used in 6% of all thrombolyzed patients in a national cohort during 2018, up from 1.3% in 2017. Idarucizumab appeared to be safe with similar clinical outcomes to routinely managed patients, despite a 22-minute door-to-needle time delay. Idarucizumab can facilitate thrombolysis in patients with stroke taking dabigatran.Classification of evidenceThis study provides Class III evidence that idarucizumab use is associated with similar early post-thrombolysis outcomes compared with patients not exposed to this drug.
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Sacco, Rodolfo, Valeria Mismas, Antonio Romano, Barbara Ginanni, Sara Marceglia, Luca Giacomelli, Gianluca Masi, et al. "Overall survival in intermediate-stage hepatocellular carcinoma (HCC) patients after first transarterial chemoembolization (TACE): Proposal of a new scoring system." Journal of Clinical Oncology 33, no. 3_suppl (January 20, 2015): 386. http://dx.doi.org/10.1200/jco.2015.33.3_suppl.386.
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386 Background: TACE is the standard treatment for patients with intermediate-stage HCC (BCLC-B according to the Barcelona Clinic Liver Cancer [BCLC] classification). However, prognostic factors for survival after the first TACE cycle are unclear. We correlated pre-treatment characteristics and response to therapy with overall survival (OS) and time to tumor progression (TTP), in order to propose a scoring system aimed at facilitating clinical decision after the first TACE. Methods: We retrospectively analyzed 149 patients (125 males; mean age 65.1±9.2 years) with BCLC-B HCC who received ≥1 cycle of TACE (Lipidol TACE, n=106; drug-eluting beads TACE, n=43). Univariate and multivariate analysis were used to correlate pre-treatment characteristics and response to TACE with OS and TTP. Identified predictive factors were used to define a score for each patient. Results: Median OS was 23 (95% Confidence interval [CI] 11.5-27) months, and median TTP was 11 months (CI 7-11). Complete response (CR) was reported in 63 patients (42.3%) and partial response (PR) in 71 (47.7%). Age >65 years (Hazard Ratio [HR] 1.77; 95% CI: 1.18-2.67), ascites (HR 2.44; 95% CI 1.32-4.29), total diameter of nodules >61 mm (HR: 1.96; 95% CI 1.28-3.08) and response at 1 month (HR 1.70; 95% CI 1.30-2.20) were predictors of survival and were used to build the scoring system (Table). Three groups of patients with different OS and TTP were then identified. Patients with score 0-1 had a longer OS (57.8 months) and TTP (12.7 months) than those with score 2-3 (21.1 and 8.2 months) or score 4-6 (8.0 and 6.3 months) (p<0.001 for both comparisons). Conclusions: This scoring system may allow the identification of three groups of patients with different prognosis after a first cycle of TACE and may therefore be useful in guiding clinical decisions, in particular whether continuing TACE therapy after a first cycle or moving to different therapies. Validation of this scoring system on a larger population is ongoing. [Table: see text]
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Hishizawa, Masakatsu, Junya Kanda, Atae Utsunomiya, Shuichi Taniguchi, Tetsuya Eto, Yukiyoshi Moriuchi, Ryuji Tanosaki, et al. "Transplantation of allogeneic hematopoietic stem cells for adult T-cell leukemia: a nationwide retrospective study." Blood 116, no. 8 (August 26, 2010): 1369–76. http://dx.doi.org/10.1182/blood-2009-10-247510.
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Abstract Allogeneic hematopoietic stem cell transplantation (HSCT) is increasingly used as a curative option for adult T-cell leukemia (ATL), an intractable mature T-cell neoplasm causally linked with human T-cell leukemia virus type I (HTLV-I). We compared outcomes of 386 patients with ATL who underwent allogeneic HSCT using different graft sources: 154 received human leukocyte antigen (HLA)–matched related marrow or peripheral blood; 43 received HLA-mismatched related marrow or peripheral blood; 99 received unrelated marrow; 90 received single unit unrelated cord blood. After a median follow-up of 41 months (range, 1.5-102), 3-year overall survival for entire cohort was 33% (95% confidence interval, 28%-38%). Multivariable analysis revealed 4 recipient factors significantly associated with lower survival rates: older age (> 50 years), male sex, status other than complete remission, and use of unrelated cord blood compared with use of HLA-matched related grafts. Treatment-related mortality rate was higher among patients given cord blood transplants; disease-associated mortality was higher among male recipients or those given transplants not in remission. Among patients who received related transplants, donor HTLV-I seropositivity adversely affected disease-associated mortality. In conclusion, allogeneic HSCT using currently available graft source is an effective treatment in selected patients with ATL, although greater effort is warranted to reduce treatment-related mortality.
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Chapin, Brian Francis, Scott Edward Delacroix, Patrick Aloysius Kenney, Graciela M. Nogueras Gonzalez, Pheroze Tamboli, Eric Jonasch, Nizar M. Tannir, and Christopher G. Wood. "Nodal disease in the setting of metastatic renal cell carcionoma: Can a lymph node dissection alter outcomes?" Journal of Clinical Oncology 30, no. 5_suppl (February 10, 2012): 386. http://dx.doi.org/10.1200/jco.2012.30.5_suppl.386.
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386 Background: The impact of lymph node dissection (LND) in patients with metastatic renal cell carcinoma (mRCC) undergoing cytoreductive nephrectomy (CN) is unclear. The aims of this study were to determine the predictive ability of LN status for overall survival (OS) in patients treated with CN in the targeted therapy era and if LND increases the morbidity of CN. Methods: We performed a retrospective review of all patients with mRCC treated with CN at a single institution between 2004–2010. Patients participating in open or unpublished trials were excluded, leaving 173 patients for analysis. LNs >1cm by long axis diameter were considered clinically positive (cN+). OS was calculated using COX proportional hazard regression. Complications were classified using the modified Clavien system. Results: Sixty-five (37.6%) patients were clinically node positive (cN+). Median OS was significantly worse for the cN+ patients compared to cN0 patients [17.5 vs 29.1 mos;HR 1.8;(1.3-2.6)]. Clinical node status remained an independent predictor of OS on multivarible analysis (MV) [HR 1.7;CI 1.1-2.7]. LND was performed in 61/65 (93.4%) cN+ patients and in 56/108 (52%) of cN0 patients. Pathologic node positive disease (pN+) was more common in cN+ compared to cN0 patients (75% vs. 23%,p <0.001). pN+ patients had worse median OS than pN0 patients [16.0 v 35.5 mos;HR 2.3(1.5-3.6)]. Among pN+ patients (n=54), complete resection of all identifiable nodal disease was associated with an improved OS compared to patients with unresectable nodal disease (n=4) [16.0 v 5.6 mos;HR 2.9(1.0-8.3)]. On univariate analysis LND patients were more likely to have a post-operative complication (64% vs 43%,p=0.008) and more specifically chylous ascites (12 v 0,p=0.01). Despite this association, LND did not reach statistical significance when MV analysis was performed [OR 1.9;(0.9-3.8)]. Conclusions: Among patients undergoing CN, those with cN+ disease had worse OS. Likewise, pN+ patients have worse OS than pN0 patients. LND is associated with higher morbidity than CN alone. Further efforts are needed to determine removal of pathologic nodes alters the natural history of the disease, and if the benefit offsets the increased morbidity.
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Uspenskaya, O. A., N. V. Tiunova, A. D. Timoshenko, S. M. Alekseeva, and A. A. Shamro. "Experience in use of collagen-based drugs in complex treatment of recurrent aphthous stomatitis." Medical alphabet 2, no. 11 (November 23, 2019): 43–45. http://dx.doi.org/10.33667/2078-5631-2019-2-11(386)-43-45.
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Recurrent aphthous stomatitis is characterized by a recurrent course, torpidity to conventional therapy and painful ulcerations. Despite the continual improvement of the diagnostic methods and treatment of the disease, the incidence of RAS tends to increase. So, the search for new drugs and the treatment of this pathology is important and justified. The article presents the case of complex treatment of recurrent aphthous stomatitis, using collagen biodegradable drugs in the local treatment regimen, which showed the good clinical result.
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N., Srinivas, Ravi M. R., Prashantha B., and Prakash B. "Prevalence of overweight and obesity, body image perception and weight control practices among college going adolescent girls in Mysore District, Karnataka." International Journal Of Community Medicine And Public Health 4, no. 4 (March 28, 2017): 954. http://dx.doi.org/10.18203/2394-6040.ijcmph20170950.
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Background: The World Health Organization has described obesity as one of today’s most neglected public health problems. Body image is a psychosocial dimension of body size that encompasses both perceptual and attitudinal factors and has been associated with eating disorders. Adolescents are becoming over conscious of their body image. Body weight perception refers to the personal evaluation of one’s weight irrespective of actual BMI. The objectives of the study was to assess the prevalence of overweight and obesity, body image perception and weight control practices among college going adolescents girls and to determine differences between existing BMI and body image perception among college going adolescents girls. Methods: A cross-sectional study was conducted among college going adolescents girls in Mysore district, two colleges were randomly selected and 661 study participants were participated in the study. Data was collected through a self-administered pre tested structured questionnaire and height and weight were measured using standard tools to calculate body mass index. Results: Among the study percipients prevalence of overweight and obesity was found to be 36 (5.4%) and 43 (6.5%) respectively, whereas 70 (10.6) feel they are obese and 386 (59.2%) were ever practiced weight control methods. Body image perception and actual weight were found to statistically significant. Conclusions: Perception about body image as obese was higher among adolescents. Hence adolescents should be given education regarding body mass index and expected BMI for their age and about appropriate dietary practices.
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Ardah, Fauzah, Razia Begum Suroyo, Razia Begum Suroyo, Mangatas Silaen, and Lucia Lastiur. "Analysis of Antenatal Care by Maternal to Health Services Utilization in Working Area of Cot Girek Health Centre." Journal La Medihealtico 2, no. 3 (April 27, 2021): 17–29. http://dx.doi.org/10.37899/journallamedihealtico.v2i3.344.
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According to Minister of Health Regulation (Permenkes) No. 43 of 2016 every maternal must get antenatal services according to the standard which provided to pregnant women at least 4 times during pregnancy with a schedule of one first trimester, one second trimester and two-third trimesters. The purpose of this study was to determine and analyze the influence of knowledge, attitudes, education, parity, income, support of health workers, a distance of health services and maternal health to the utilization of health services in the working area of the Cot Girek health centre, a population of this study amounted 512 people and 83 respondents were taken as the sample of this study. The research was Quantitative research used Mixed Method. The results showed of knowledge p = 0.000, education p = 0.000, income p = 0.000, support of health workers p = 0.000 shows a relationship to the utilization of health services. While attitudes p = .609, parity p = .823, distance of health services p = .167, maternal health p = .386 showed no relationship to the utilization of health services. The conclusion in this study is the influence of knowledge, education, income and support of health workers on the utilization of health services found, while the attitudes, parity, distance of health services and maternal health have no found about relationship to the utilization of health services. This research can be used as information for health workers to be more active in promoting antenatal care programs.
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van de Putte, Dietje E., Kathelijn Fischer, Michael Makris, R. Tait, Peter W. Collins, Karina Meijer, Goris Roosendaal, Pratima Chowdary, Roger E. G. Schutgens, and Eveline P. Mauser-Bunschoten. "Increased prevalence of hypertension in haemophilia patients." Thrombosis and Haemostasis 108, no. 10 (2012): 750–55. http://dx.doi.org/10.1160/th12-05-0313.
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SummaryAn increased prevalence of hypertension is reported in haemophilia patients, but data from large, unbiased studies are lacking. The aim of our study was to cross-sectionally assess the prevalence of hypertension in a large cohort of 701 haemophilia patients. Blood pressure (BP) measurements performed in 386 Dutch and 315 UK haemophilia patients aged 30 years or older were analysed and compared with the general age-matched male population. Mean values of up to three BP measurements were used when available. Hypertension was defined as BP over 140/90 mmHg and/or the use of antihypertensive medication. A total of 49% of patients had severe haemophilia. Mean age was 49.8 years. The prevalence of hypertension was significantly higher in haemophilia patients (49%, 95% confidence interval [CI] 45–53) than in the general population (40%, 95% CI 37–43). The prevalence of hypertension was higher in patients with severe haemophilia than in those with non-severe disease, but similar across haemophilia types and in Dutch and UK patients. Multiple BP measurements were available for 70%.The prevalence of hypertension was similar in patients with multiple BP measurements and the complete cohort. Hypertension was not significantly associated with renal function, a history of renal bleeding or with infection with hepatitis C or HIV, but it was associated with overweight/obesity and age. In conclusion, the prevalence of hypertension is higher in haemophilia patients than in the general population. The cause of this increased prevalence is unknown. Blood pressure measurements should be part of standard care in haemophilia patients aged 30 years or older.
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Biewenga, Maaike, Monique K. van der Kooij, Michel W. J. M. Wouters, Maureen J. B. Aarts, Franchette W. P. J. van den Berkmortel, Jan Willem B. de Groot, Marye J. Boers-Sonderen, et al. "Checkpoint inhibitor induced hepatitis and the relation with liver metastasis and outcome in advanced melanoma patients." Hepatology International 15, no. 2 (February 25, 2021): 510–19. http://dx.doi.org/10.1007/s12072-021-10151-4.
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Abstract Background Checkpoint inhibitor-induced hepatitis is an immune-related adverse event of programmed cell death protein 1 (PD-1) inhibition, cytotoxic T-lymphocyte associated 4 (CTLA-4) inhibition or the combination of both. Aim of this study was to assess whether checkpoint inhibitor-induced hepatitis is related to liver metastasis and outcome in a real-world nationwide cohort. Methods Data from the prospective nationwide Dutch Melanoma Treatment Registry (DMTR) was used to analyze incidence, risk factors of checkpoint inhibitor-induced grade 3–4 hepatitis and outcome. Results 2561 advanced cutaneous melanoma patients received 3111 treatments with checkpoint inhibitors between May 2012 and January 2019. Severe hepatitis occurred in 30/1620 (1.8%) patients treated with PD-1 inhibitors, in 29/1105 (2.6%) patients treated with ipilimumab and in 80/386 (20.7%) patients treated with combination therapy. Patients with hepatitis had a similar prevalence of liver metastasis compared to patients without hepatitis (32% vs. 27%; p = 0.58 for PD-1 inhibitors; 42% vs. 29%; p = 0.16 for ipilimumab; 38% vs. 43%; p = 0.50 for combination therapy). There was no difference in median progression free and overall survival between patients with and without hepatitis (6.0 months vs. 5.4 months progression-free survival; p = 0.61; 17.0 vs. 16.2 months overall survival; p = 0.44). Conclusion Incidence of hepatitis in a real-world cohort is 1.8% for PD-1 inhibitor, 2.6% for ipilimumab and 20.7% for combination therapy. Checkpoint inhibitor-induced hepatitis had no relation with liver metastasis and had no negative effect on the outcome.
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ALLEN, D. GREY, DAVID P. GREEN, GREGORY E. BOLTON, LEE-ANN JAYKUS, and W. GREGORY COPE. "Detection and Identification of Histamine-Producing Bacteria Associated with Harvesting and Processing Mahimahi and Yellowfin Tuna†‡." Journal of Food Protection 68, no. 8 (August 1, 2005): 1676–82. http://dx.doi.org/10.4315/0362-028x-68.8.1676.
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Histamine poisoning is one of the most common chemically induced seafoodborne illnesses reported in the United States today. The causative agents are biogenic amines, commonly produced by gram-negative bacteria. The purpose of this study was to detect and identify histamine-producing bacteria associated with standard industry practices during the harvesting, receiving, and processing of mahimahi and yellowfin tuna in North Carolina. Twenty-nine composite samples were obtained from 18 mahimahi and 11 yellowfin tuna and analyzed for their histamine content. No sample analyzed exceeded 2 ppm histamine, the lower detection limit. Composite fish muscle and environmental samples were screened (n = 386) for the presence of histamine-producing bacteria. Twenty-six percent (145) of 549 isolates selected on the basis of their morphological characteristics tested positive on Niven's media. Sixty-three Niven-positive isolates were gram negative, and 58 were gram positive. Of the 43 isolates tested further, 5 were confirmed as histamine producers, and all 5 produced at low levels (<250 ppm in 48 h at >15°C). Three gram-negative and two gram-positive isolates were identified as Enterobacter cloacae and Staphylococcus kloosii, respectively. This study revealed that gram-negative bacteria might not be solely responsible for histamine production in at-risk fish. The confirmation of histamine-producing bacteria demonstrates the potential risk for histamine production. However, no detectable levels were found in the composite fish muscle samples analyzed even though 60% of the yellowfin tuna harvested did not meet the U.S. Food and Drug Administration's regulatory hazard analysis critical control point guidelines for temperature reduction. Therefore, no seafood safety risks were found under the standard industry practices observed in this study.
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Seo, Min-Goo, In-Ohk Ouh, Sang Kyu Lee, Jong-Seok Lee, Oh-Deog Kwon, and Dongmi Kwak. "Molecular Detection and Genetic Characteristics of Equine Herpesvirus in Korea." Pathogens 9, no. 2 (February 11, 2020): 110. http://dx.doi.org/10.3390/pathogens9020110.
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Respiratory diseases cause significant economic losses (especially in the horse racing industry). The present study describes the detection and genetic characteristics of equine herpesvirus (EHV) from a total of 1497 samples from clinically healthy horses in Korea, including 926 blood samples, 187 lung tissues, and 384 nasal swabs. EHV-2 and EHV-5 were detected in 386 (41.7%; 95% CI: 38.5–44.9) and 201 (21.7%; 95% CI: 19.1–24.4) blood samples, respectively, and in 25 (13.4%; 95% CI: 8.5–18.2) and 35 (18.7%; 95% CI: 13.1–24.3) lung tissues, respectively. EHV-1 and EHV-4 were not detected in either blood or lung tissues. EHV-1, EHV-2, and EHV-5 were detected in 46 (12.0%; 95% CI: 8.7–15.2), 21 (5.5%; 95% CI: 3.2–7.7), and 43 (11.2%; 95% CI: 8.0–14.4) nasal swabs, respectively. EHV-4 was not detected in nasal swabs. Co-infection with EHV-2 and EHV-5 was detected in 11.6% (107/926) of the blood samples and 6.4% (12/187) of lung tissues. In nasal swabs, co-infection with EHV-1, EHV-2, and EHV-5 was detected in 0.8% (3/384) of samples. Phylogenetic analysis of the glycoprotein B gene showed that EHV-1, EHV-2, and EHV-5 strains demonstrated significant genetic diversity in Korea, with a nucleotide sequence identity among them that ranged from 95.7% to 100% for EHV-1, 96.2–100% for EHV-2, and 93.8–99.3% for EHV-5. These results are the first phylogenetic analyses of EHV-1 in Korea in nasal swabs from a nationwide population of clinically healthy horses. Both EHV-2 and EHV-5 from blood, lung tissues, and nasal swabs were also detected.
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Rivera-Brown, Anita M., and José R. Quiñones-González. "Normative Data for Sweat Rate and Whole-Body Sodium Concentration in Athletes Indigenous to Tropical Climate." International Journal of Sport Nutrition and Exercise Metabolism 30, no. 4 (July 1, 2020): 264–71. http://dx.doi.org/10.1123/ijsnem.2019-0299.
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This study determined normative data for sweat rate (SR) and whole-body (WB) sweat sodium concentration [Na+] in athletes indigenous to a tropical climate, categorized by age, gender, and sport classification. We analyzed data from 556 athletes (386 adult and 170 young) in endurance (END), team/ball (TBA), and combat (COM) sports exercising in tropical environments (wet bulb globe temperature = 29.4 ± 2.1 °C). SR was calculated from change in body weight corrected for urine output and fluid/food intake. Sweat was collected using absorbent patches, and regional [Na+] was determined using an ion selective analyzer and normalized to WB sweat [Na+]. Data are expressed as mean ± SD. SR was higher in males compared with females in both young (24.2 ± 7.7 ml·kg−1·hr−1 vs. 16.7 ± 5.7 ml·kg−1·hr−1) and adult (22.8 ± 7.4 ml·kg−1·hr−1 vs. 18.6 ± 7.0 ml·kg−1·hr−1) athletes, in END sports in girls (END = 19.1 ± 6.0 ml·kg−1·hr−1; TBA = 14.6 ± 4.5 ml·kg−1·hr−1), and in adult males (END = 25.2 ± 6.3 ml·kg−1·hr−1; TBA = 19.1 ± 7.2 ml·kg−1·hr−1; COM = 18.4 ± 8.5 ml·kg−1·hr−1) and females (END = 23.5 ± 5.6 ml·kg−1·hr−1; TBA = 14.2 ± 5.2 ml·kg−1·hr−1; COM = 15.3 ± 5.2 ml·kg−1·hr−1); p < .05. WB sweat [Na+] was higher in adult athletes than in young athletes (43 ± 10 mmol/L vs. 40 ± 9 mmol/L, p < .05). These norms provide a reference range for low, low average, average high, and high SR and WB sweat [Na+], which serve as a guide for fluid replacement for athletes who live and train in the tropics.
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Crump, Michael, Stefan Gluck, Dongsheng Tu, Doug Stewart, Mark Levine, Peter Kirkbride, Janet Dancey, et al. "Randomized Trial of High-Dose Chemotherapy With Autologous Peripheral-Blood Stem-Cell Support Compared With Standard-Dose Chemotherapy in Women With Metastatic Breast Cancer: NCIC MA.16." Journal of Clinical Oncology 26, no. 1 (January 1, 2008): 37–43. http://dx.doi.org/10.1200/jco.2007.11.8851.
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Purpose We conducted a multicenter, randomized trial to compare progression-free survival (PFS), overall survival (OS), and quality of life in women with metastatic breast cancer (MBC) receiving high-dose chemotherapy plus autologous stem-cell transplantation (ASCT; HDCT) compared with standard-dose therapy. Patient and Methods Between April 1997 and December 2000, 386 women with MBC and no prior chemotherapy for metastatic disease were registered. After initial response to anthracycline- or taxane-based induction chemotherapy, 224 patients were randomly assigned: 112 to high-dose cyclophosphamide, mitoxantrone, and carboplatin chemotherapy and ASCT (HDCT), and 112 to standard therapy (ST). Median age was 47 years (range, 25 to 67 years). Thirty two percent of women randomly assigned had estrogen and progesterone receptor–negative breast cancer, 42% had visceral metastases, and 58% had bone metastases. Complete remission rates before random assignment were 11% for those receiving HDCT and 12% for those receiving ST. Results After a median follow-up of 48 months, 79 deaths were observed in the HDCT arm and 77 deaths were observed in the ST arm; seven patients (6%) in the HDCT arm died as a result of toxicity. The median OS was 24 months for the HDCT arm (95% CI, 21 to 35 months) and 28 months for ST (95% CI, 22 to 33 months; hazard ratio [HR], 0.9; 95% CI, 0.6 to 1.2; P = .43). PFS was 11 months for HDCT and 9 months for ST (HR, 0.6 in favor of HDCT; 95% CI, 0.5 to 0.9; P = .006). Conclusion HDCT did not improve OS in women with MBC when used as consolidation after response to induction chemotherapy.
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Shankaran, Veena, June M. McKoy, Neal Dandade, Narissa Nonzee, Cara A. Tigue, Charles L. Bennett, and Tom D. Denberg. "Costs and Cost-Effectiveness of a Low-Intensity Patient-Directed Intervention to Promote Colorectal Cancer Screening." Journal of Clinical Oncology 25, no. 33 (November 20, 2007): 5248–53. http://dx.doi.org/10.1200/jco.2007.13.4098.
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Purpose Colorectal cancer (CRC) screening is the most underused evidence-based cancer screening test in the United States. Few studies have reported the cost-effectiveness of CRC screening promotional efforts. In a recent randomized controlled trial, a patient-directed intervention for average-risk patients who had been referred for screening colonoscopy led to a 12% increase in CRC screening rates. The objective of this secondary analysis is to assess the cost-effectiveness of this intervention. Patients and Methods Patients in the intervention arm received a customized mailed brochure that included a reminder to schedule a screening colonoscopy and general information about CRC, the importance of CRC screening, and how to prepare for the procedure. The end point was completion of screening colonoscopy. The costs and incremental cost-effectiveness ratio of this patient-directed intervention were derived. Sensitivity analyses were based on varying the costs of labor and supplies. Results Rates of CRC screening for the intervention (n = 386 patients) versus control (n = 395) arms were 71% and 59%, respectively (P = .001). The total cost of the intervention was $1,927 and the incremental cost-effectiveness ratio was $43 per additional patient screened ($38 to $47 in a sensitivity analysis). Conclusion An intervention based on mailing a customized brochure to patients who were referred for a screening colonoscopy improved CRC screening rates at a university-based general medicine clinic. This intervention was comparable in effectiveness and cost-effectiveness to a similar recently reported low-intensity patient-directed CRC screening intervention, and markedly more affordable and cost-effective than a previously reported physician-directed CRC screening promotion intervention.
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Comer, M. B., D. L. Campbell, R. L. Rasmusson, D. R. Lamson, M. J. Morales, Y. Zhang, and H. C. Strauss. "Cloning and characterization of an Ito-like potassium channel from ferret ventricle." American Journal of Physiology-Heart and Circulatory Physiology 267, no. 4 (October 1, 1994): H1383—H1395. http://dx.doi.org/10.1152/ajpheart.1994.267.4.h1383.
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FK1, a ferret ventricular full-length cDNA clone, encodes a 654-amino acid protein with 98% identity to human K+ transient outward current (Ito)-like HK1 (Tamkun et al. FASEB J.5: 331-337, 1991). FK1 is detectable in ferret brain, atrium, left and right ventricle, and kidney but not in skeletal muscle, endothelial cells, aorta, and liver. In Xenopus oocytes, FK1 cRNA gives rise to a rapidly activating and inactivating Ito-like current, which is highly K+ selective (Na(+)-to-K+ permeability ratio = 0.003). Activation occurs over an approximately 50-mV range (-40 to +10 mV) and displays a sigmoid delay in onset with potential-dependent time constants that decrease with depolarization. Steady-state activation can be described with either a simple Boltzmann relationship [half-activation potential (V1/2) = -25 mV, slope (k) = 10 mV] or a Boltzmann relationship raised to either the third or fourth power (alpha 3: V1/2 = -43 mV, kappa = 13.1 mV; alpha 4: V1/2 = -48 mV, kappa = 13.6 mV, where alpha is the activation variable). Inactivation kinetics are biexponential, with the main fast time constant becoming independent of membrane potential depolarized to 0 mV. Steady-state inactivation can be described with a single Boltzmann relationship (V1/2 = -57 mV, kappa = 5.0 mV). Fast inactivation is removed by NH2-terminal deletions. Recovery from inactivation (-90 mV) is quite slow (half-time = 4.8 +/- 2.5 s). In 2 mM extracellular K+ concentration ([K+]o), FK1 tail currents display conventional deactivation behavior; however, in 98 mM [K+]o the tail currents display "reopening" behavior. These results suggest a molecular basis for the electrophysiological similarities between ferret and human ventricular Ito (Campbell et al. J. Gen. Physiol. 101: 571-601, 1993; Nabauer et al. Circ. Res. 73: 386-394, 1993).
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Kreckman, John, Waiz Wasey, Sharron Wise, Tammy Stevens, Lance Millburg, and Cassie Jaeger. "Improving medication reconciliation at hospital admission, discharge and ambulatory care through a transition of care team." BMJ Open Quality 7, no. 2 (April 2018): e000281. http://dx.doi.org/10.1136/bmjoq-2017-000281.
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Medication reconciliation is an important component to the care of hospitalised patients and their safe transition to the ambulatory setting. In our Family Medicine Hospitalist Service, patient care is frequently transferred between the various physicians, residents, nurses and eventually to a separate group of providers who provide ambulatory management. Due to frequent transitions of care, there was no clear ownership of the medication reconciliation process. To improve the medication reconciliation process, a Transition of Care Team composed of registered nurses was created to oversee the entire reconciliation process. The team engaged the patient and their family, when needed, contacted patients’ pharmacies and their providers, reconciled the patients’ hospital medication list with the ambulatory list at hospital admission and within 24 hours of discharge, and attended the hospital follow-up visit to verify medications and provide continuity of care. Implementation of the team allowed for additional investigative resources, redundancy in preventing errors and early recovery should an error occur. The percent of medications with error after implementation of the Transition of Care Team was reduced from 131/386 (33.9%) to 147/787 (18.7%) at hospital admission, 81/354 (22.9%) to 42/834 (5.0%) at discharge and 43/337 (12.8%) to 6/809 (0.7%) at follow-up visit (two proportion tests, p<0.001). In addition, the percent of charts without any errors improved at hospital discharge from 8/31 (25.8%) to 46/70 (65.7%) and at hospital follow-up visit from 16/31 (51.6%) to 64/70 (91.4%) (two-proportion test, p<0.001). Previously viewed as three separate reconciliations occurring at admission, discharge and hospital follow-up, the approach to medication reconciliation was reframed as a continuous process occurring throughout the hospitalisation and hospital follow-up resulting in improved reconciliation accuracy and safer transitions to the ambulatory setting.
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Saeed, Fahad, Paul R. Duberstein, Ronald M. Epstein, Valerie J. Lang, and Scott E. Liebman. "Frequency and Severity of Moral Distress in Nephrology Fellows: A National Survey." American Journal of Nephrology 52, no. 6 (2021): 487–95. http://dx.doi.org/10.1159/000516575.
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<b><i>Introduction:</i></b> Moral distress is a negative affective response to a situation in which one is compelled to act in a way that conflicts with one’s values. Little is known about the workplace scenarios that elicit moral distress in nephrology fellows. <b><i>Methods:</i></b> We sent a moral distress survey to 148 nephrology fellowship directors with a request to forward it to their fellows. Using a 5-point (0–4) scale, fellows rated both the frequency (never to very frequently) and severity (not at all disturbing to very disturbing) of commonly encountered workplace scenarios. Ratings of ≥3 were used to define “frequent” and “moderate-to-severe” moral distress. <b><i>Results:</i></b> The survey was forwarded by 64 fellowship directors to 386 fellows, 142 of whom (37%) responded. Their mean age was 33 ± 3.6 years and 43% were female. The scenarios that most commonly elicited moderate to severe moral distress were initiating dialysis in situations that the fellow considered futile (77%), continuing dialysis in a hopelessly ill patient (81%) and carrying a high patient census (75%), and observing other providers giving overly optimistic descriptions of the benefits of dialysis (64%). Approximately 27% had considered quitting fellowship during training, including 9% at the time of survey completion. <b><i>Conclusion:</i></b> A substantial majority of nephrology trainees experienced moral distress of moderate to severe intensity, mainly related to the futile treatment of hopelessly ill patients. Efforts to reduce moral distress in trainees are required.
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Vallabhajosyula, Saarwaani, Margaret Fuchs, Li-Tan Yang, Jose Medina Inojosa, Tanya H. Tajouri, Maurice Enriquez-Sarano, Sabrina D. Phillips, Rajiv Gulati, Kyle W. Klarich, and Hector Michelena. "Anomalous coronary artery origin from the opposite sinus in patients with bicuspid aortic valve: comparison with tricuspid aortic valve." Open Heart 8, no. 1 (June 2021): e001567. http://dx.doi.org/10.1136/openhrt-2020-001567.
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ObjectiveTo compare the prevalence and patterns of anomalous coronary artery origin from the opposite sinus (ACAOS) in patients with bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV).MethodsRetrospective review of consecutive patients with surgically excised BAV and TAV was performed from 1994 to 2015. Clinical notes, echocardiograms, coronary angiograms, CT angiographies, and pathology reports were reviewed. ACAOS included right coronary artery from the left cusp, left circumflex artery from the right cusp and left main or left anterior descending artery from the right cusp.Results2371 (years 1994–2015) and 1679 (years 2009–2015) consecutive patients with pathology-confirmed BAV and TAV, respectively, and defined preoperative coronary anatomy were identified. A left dominant coronary circulation was present in 386 (18%) patients with BAV and 179 (11%) patients with TAV (p<0.001). ACAOS was identified in 43 (1.8%) patients with BAV and 15 (0.9%) patients with TAV, p=0.02. Among patients with BAV and ACAOS, the most common phenotype was right-left fusion (n=34, 79%) with present raphe (n=36, 84%), with no association between BAV phenotype and ACAOS type. On multivariate analysis, BAV status and size of the mid-ascending aorta were independently associated with ACAOS (OR 3.29; CI 1.26 to 8.6; p=0.02; OR 0.93; CI 0.87 to 0.98; p=0.01; respectively). Only two patients with ACAOS, one with BAV and one with TAV, had a perioperative coronary ischaemic event.ConclusionsThe prevalence of the potentially malignant ACAOS is significantly higher (threefold higher odds) in patients with BAV as compared with TAV, yet remains uncommon in absolute terms. Most patients with BAV and ACAOS had right-left cusp fusion and present raphe. Perioperative coronary events are rare in patients with ACAOS.
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Hayat, Amjad, David O'Brien, Fiona Quinn, Fionnuala Keane, Imelda Parker, Johanna Kelly, Marzena Wieczorkowska, et al. "Minimal Residual Disease Stratification in Fludarabine Ccyclophosphamide Rituximab (FCR) Therapy in Chronic Lymphocytic Leukaemia (CLL." Blood 120, no. 21 (November 16, 2012): 1791. http://dx.doi.org/10.1182/blood.v120.21.1791.1791.
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Abstract Abstract 1791 Six courses of FCR is considered standard therapy for fit, non-(17p) deleted patients with Chronic Lymphocytic Leukaemia (CLL), however the optimal dose of Rituximab in combined chemotherapy for CLL or the number of FCR courses required has never been formally assessed. Minimal residual disease (MRD) eradication (assessed by 6 colour flow-cytometry(FC) is associated with an increased disease free interval and is a logical endpoint in determining length/efficacy of treatment. Serial MRD testing following therapy provides an objective test of disease re-emergence. A multi-centre prospective phase II study in treatment-naïve CLL patients with modified FCR (Rituximab 375mg/m2) using MRD to determine treatment length/efficacy and identify disease emergence recruited from 2009–2012. Standard pre-treatment assessment plus C-T scan, FISH and Ig somatic hypermutation (SHM) analyses were performed. Patient in radiological and MRD-ve remission after 4 courses of FCR stopped therapy and the remainder received 6 courses. All were followed by 6 monthly MRD assessment. Fifty-two patients were included (35M/17F), mean age 52 years (range 37–72), mean WCC 51 × 109/L (range 8–386), elevated LDH 23 of 45 (51%), lymphadenopathy 43 (83%) and hepatosplenomegaly in 37 (71%). Abnormal FISH results were, del(11q) in 15, +12 in 5, del(13q) in 18; SHM 15(29%) mutated and 37(71%) unmutated or with V3–21 gene usage. Post-treatment MRD is available in 43 patients; 36 (70%) were MRD –ve including 18 (42%) after 4 courses. Nine patients did not complete treatment (toxicity −7, progression-1, non-compliance-1). With a mean follow-up of 20.7 months (range 4.5–38), 6 patients have reverted to MRD +ve at a mean of 13 months (range 10–19) from therapy; only the patient with primary treatment failure has required further chemotherapy. Myelotoxoicty resulted in 23 NCI grade 3 episodes and 7 treatment delays of a mean duration of 25 days (range15–32). One further grade 3 toxicity of pneumonia was identified. Modified FCR was effective in this patient cohort with high risk features (38% unfavourable FISH, 71% unfavourable SHM), with 70% patients achieving MRD-ve status on completion of therapy. 42% of patients became MRD-ve after 4 courses of FCR, suggesting that some patients may not require 6 courses of therapy. Myelotoxicity remains an issue with 7 patients not completing therapy. Longer follow-up will clarify whether shortened therapy will have an impact on MRD+ve reversion, time to re-treatment and survival. Disclosures: No relevant conflicts of interest to declare.
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Iimura, Y., K. Saito, Y. Fujii, J. Ishioka, A. Iwai, N. Numao, Y. Okada, F. Koga, H. Masuda, and K. Kihara. "Use of C-reactive protein to predict perinephric or renal sinus fat invasion in patients with clinical T1N0M0 renal cell carcinoma." Journal of Clinical Oncology 29, no. 7_suppl (March 1, 2011): 385. http://dx.doi.org/10.1200/jco.2011.29.7_suppl.385.
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385 Background: Indication of nephron sparing surgery (NSS) for renal cell carcinoma (RCC) has been extending, as NSS can be considered for not only cT1a but also cT1b tumors. However, some cT1 diseases have pathological perinephric or renal sinus fat invasion. It is useful to know the probability of the presence of fat invasion before surgery, but diagnostic ability of imaging studies such as CT for predicting pT3a disease is limited. Therefore, estimation of the risk for pT3a disease in cT1 RCC patients could be helpful. C-reactive protein (CRP) has been shown to be a strong prognostic factor in RCC patients, reflecting tumor aggressiveness. We evaluated the predictive ability of preoperative CRP for pT3a disease in cT1N0M0 RCC patients. Methods: Of consecutive 386 patients treated with radical nephrectomy for cT1a-bN0M0 RCC, 82 were excluded due to hemodialysis, inflammatory disease, bilateral synchronous renal tumors, synchronous other malignant disease or loss of each data. The remaining 304 patients constituted the current study cohort. Cut off point of CRP was 3 mg/L. Associations were analyzed between pT3a and preoperative factors including age, sex, BMI, laterality, tumor size, CRP, hemoglobin, platelet, LDH, ALP, calcium and albumin. We developed a multivariate model for predicting pT3a disease in cT1 RCC. Results: Of the 304 patients, 28 (9%) had pT3a disease. Of 43 patients with elevated CRP level, 10 (23%) had pT3a disease. In contrast, of the remaining 261 patients with non-elevated CRP level, 18 (7%) had (p=0.002). Univariate and then multivariate analyses identified age (p=0.021), tumor size (p=0.007), and CRP (p=0.024) as independent and significant predictors for pT3a disease. Incorporating these three factors, we developed a predictive model for pT3a disease with predictive accuracy of area under the ROC curve of 0.772. Conclusions: Preoperative CRP is an independent predictor for pT3a disease in cT1 RCC along with age and tumor size. The model could be useful to estimate the risk of the probability of fat invasion before surgery, especially NSS. No significant financial relationships to disclose.
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Mohamed, I., T. Jordan, and M. Coman. "Breast cancer survivors’ motivation to perform preventive health behaviors: An application of the protection motivation theory." Journal of Clinical Oncology 29, no. 27_suppl (September 20, 2011): 251. http://dx.doi.org/10.1200/jco.2011.29.27_suppl.251.
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251 Background: Little is known about what motivates breast cancer survivors to engage in preventive health behaviors to prevent recurrence of breast cancer. The primary objective was to assess how survivors’ fear of recurrence, spirituality, and perceptions of risk and coping appraisal were associated with their motivation to perform healthy lifestyle and cancer screening behaviors. Methods: A reliable and valid questionnaire was developed. An a priori power analysis indicated that a minimum of 386 completed surveys were needed for adequate statistical power. Based on an estimated 50% return rate, the investigators randomly selected a state-wide sample of 800 survivors from Ohio. A 3-wave mailing was used to increase response rate. Results: 559 surveys were completed (72%). Respondents with higher perceived risks of recurrence were more motivated to perform healthy lifestyle behaviors than those with lower perceived risks (t=2.51, df=521, p=.039). Most (>70%) agreed that healthy lifestyle behaviors such as regular exercise reduce one’s risk of recurrence. Only 43% exercised regularly. Only 54% reported their doctor discussed how to reduce the risk of recurrence. Survivors who were satisfied with their physician’s communication exercised more regularly than those who were not satisfied (chi-square =13.09, p=.016, df=5). Cancer survivors with a high level of motivation and high level of behavioral intentions were more likely to be engaging in preventive health and cancer screening behaviors. Higher levels of spirituality were positively correlated with a higher level of motivation to engage in preventive health behaviors (r=.345, n=468, p<0.001). Conclusions: This study provides strong evidence that the Protection-Motivation Theory (PMT) helps to explain certain factors that impact survivors’ motivation and behavioral intentions to engage in healthy lifestyle behaviors and follow up screening tests. When developing programs for breast cancer survivors, health professionals should consider incorporating spirituality, fear of recurrence, and the constructs of the PMT.
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O’Connor, David, Anthony V. Moorman, Rachel Wade, Jeremy Hancock, Ronald M. R. Tan, Jack Bartram, John Moppett, et al. "Use of Minimal Residual Disease Assessment to Redefine Induction Failure in Pediatric Acute Lymphoblastic Leukemia." Journal of Clinical Oncology 35, no. 6 (February 20, 2017): 660–67. http://dx.doi.org/10.1200/jco.2016.69.6278.
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Purpose Our aim was to determine the role of end-of-induction (EOI) minimal residual disease (MRD) assessment in the identification and stratification of induction failure in patients with pediatric acute lymphoblastic leukemia (ALL) and to identify genetic abnormalities that drive disease in these patients. Patients and Methods Analysis included 3,113 patients who were treated in the Medical Research Council UKALL2003 multicenter randomized trial (NCT00222612) between 2003 and 2011. MRD was measured by using standardized real-time quantitative PCR. Median follow-up was 5 years 9 months. Results Fifty-nine patients (1.9%) had morphologic induction failure with 5-year event-free survival (EFS) of 50.7% (95% CI, 37.4 to 64.0) and 5-year overall survival of 57.7% (95% CI, 44.2 to 71.2). Of these, a small proportion of patients with M2 marrow (6 of 44) and a low EOI MRD level (< 0.01%) had 5-year EFS of 100%. Conversely, among patients with morphologic remission 2.3% (61 of 2,633) had high MRD (≥ 5%) and 5-year EFS of 47.0% (95% CI, 32.9 to 61.1), which was similar to those with morphologic induction failure. Redefining induction failure to include morphologic induction failure and/or MRD ≥ 5% identified 3.9% (120 of 3,133 patients) of the trial cohort with 5-year EFS of 48.0% (95% CI, 39.3 to 58.6). Induction failure (morphologic or MRD ≥ 5%) occurred most frequently in T-ALL (10.1%; 39 of 386 T-ALL cases) and B-other ALL, that is, lacking established chromosomal abnormalities (5.6%; 43 of 772 B-other cases). Genetic testing within the B-other group revealed the presence of PDGFRB gene fusions, particularly EBF1-PDGFRB, in almost one third of B-other ALL cases. Conclusion Integration of EOI MRD level with morphology identifies induction failure more precisely than morphology alone. Prevalence of EBF1-PDGFRB fusions in this group highlights the importance of genetic screening to identify abnormalities that may be targets for novel agents.
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Nelson, Christina, Shannon Fleck-Derderian, Katharine Cooley, Heidi Becksted, Dana Meaney-Delman, and Paul Mead. "1636. Antibiotic Treatment of Human Plague: A Systematic Literature Review of Worldwide Cases, 1937–2016." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S596—S597. http://dx.doi.org/10.1093/ofid/ofz360.1500.
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Abstract Background Yersinia pestis remains endemic in countries throughout Africa, Asia, and the Americas and is a tier 1 bioterrorism agent. Antibiotic treatment with aminoglycosides such as streptomycin or gentamicin is effective when initiated early in the course of illness but can have serious side effects. Alternatives such as fluoroquinolones, tetracyclines, and sulfonamides are potentially safer but currently lack robust human data on their efficacy. Methods We searched PubMed Central, Medline, Embase, CINAHL, and other databases for articles in any language with terms related to plague, Yersinia pestis, and antibiotics. Articles that contained case-level information on antibiotic treatment and patient outcome were included. We abstracted information related to patient demographics, clinical features of plague, treatment, and survival using a standardized form. Results Among 4,874 articles identified and screened, we found 723 published cases of treated plague reported between 1937 and 2016. Fifty-two percent of patients were male; median age was 22 years (range: 8 days-80 years). Cases were most commonly reported from the United States (21%), India (13%), China (11%), Vietnam (10%), and Madagascar (10%). Overall, the case fatality rate was 21%. The majority of patients had primary bubonic (64%), pneumonic (21%), or septicemic (4%) plague, of which survival was 83%, 71%, and 55%, respectively. Among those treated with an aminoglycoside (n = 386, 53%), survival was 86%. Among those treated with a tetracycline (n = 145, 20%), fluoroquinolone (n = 45, 6%), or sulfonamide (n = 311, 43%), survival was 90%, 84%, and 77%, respectively. Survival rates did not substantially differ between patients treated with one vs. two classes of antibiotics (table). Conclusion Published cases of treated plague offer an opportunity to evaluate the treatment efficacy of different antibiotic classes. In addition to aminoglycosides, tetracyclines, fluoroquinolones, and sulfonamides appear to be effective for plague treatment, although publication bias and low numbers in certain treatment groups may limit interpretation. Disclosures All authors: No reported disclosures.
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van Aert, Gijs J. J., Lijckle van der Laan, Leandra J. M. Boonman-de Winter, Cornelis A. S. Berende, Hans G. W. de Groot, Pieter Boele van Hensbroek, Philip M. J. Schormans, Michiel B. Winkes, and Dagmar I. Vos. "Effect of the COVID-19 pandemic during the first lockdown in the Netherlands on the number of trauma-related admissions, trauma severity and treatment: the results of a retrospective cohort study in a level 2 trauma centre." BMJ Open 11, no. 2 (February 2021): e045015. http://dx.doi.org/10.1136/bmjopen-2020-045015.
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ObjectivesTo determine the impact of the first lockdown in the Netherlands’ measures during the COVID-19 pandemic on the number and type of trauma-related injuries presenting to the emergency department (ED).DesignA single-centre retrospective cohort study.SettingA level 2 trauma centre in Breda, The Netherlands.ParticipantsAll patients with trauma seen at the ED between 11 March and 10 May 2020 (the first Dutch lockdown period) were included in this study. Comparable groups were generated for 2019 and 2018.Main outcome measuresPrimary outcomes were the total number of patients with trauma admitted to the ED and the trauma mechanism. Secondary outcomes were triage categories, time of ED visit, trauma severity (Injury Severity Score (ISS) >12), anatomical region of injury and treatment.ResultsA total of 4674 patients were included in this study. During the first months of the COVID-19 pandemic, there was a decrease of 32% in traumatic injuries at the ED (n=1182) compared with the previous years 2019 (n=1717) and 2018 (n=1775) (p<0.001). Sports-related injuries decreased most during the lockdown (n=164) compared with 2019 (n=386) and 2018 (n=367) (p<0.001). We observed more frequent injuries due to a fall from standing height (p<0.001) and work-related injuries (p<0.05). The mean age was significantly higher (mean 48 years vs 42 and 43 years). There was no difference in anatomical place of injury or ISS >12. The amount of patients admitted for emergency surgery was significantly higher (14.6% vs 9.4%; 8.6%, p<0.001). Seven patients (0.6%) tested positive for COVID-19.ConclusionsMeasures taken in the COVID-19 outbreak result in a predictable decrease in the total number of patients with trauma, especially sports-related trauma. Although the trauma burden on the emergency room appears to be lower, more people have been admitted for trauma surgery, possibly due to increased throughput in the operating theatres.
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Collins, Peter W., Francesco Baudo, Paul Knoebl, Herve Levesque, Laszlo Nemes, Fabio Pellegrini, Lilian Tengborn, and Angela Huth-Kuehne. "Inhibitor Eradication In Acquired Haemophilia A: Final Results of European Acquired Haemophilia Registry (EACH2)." Blood 116, no. 21 (November 19, 2010): 715. http://dx.doi.org/10.1182/blood.v116.21.715.715.
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Abstract Abstract 715 The optimal first line immunosuppression (IS) for eradicating factor (F)VIII inhibitors in acquired haemophilia A (AHA) is controversial. Steroids and cyclophosphamide are commonly used and there has been recent interest in the role of rituximab. Prospective randomised controlled trials (RCTs) would be challenging and in their absence registries may provide useful data to guide clinical practice. EACH2 collected data on 281 analysable patients who received first line IS. Complete remission (CR) was defined as inhibitor undetectable, FVIII>70IU/dL and IS stopped. Stable CR was defined as CR without relapse. A higher proportion of patients achieved CR with steroids and a cytotoxic (predominantly cyclophosphamide) (77%) than those treated with steroids alone (58%) (P<0.005) or a rituximab based regimen (61%) (P<0.02). The 12 patients treated with rituximab alone had the lowest proportion achieving CR (42%). Median time to normal FVIII and undetectable inhibitor was similar in the steroid alone and steroid and cytotoxic groups (about 5 weeks) but slower in those treated with a rituximab based regimens (about 9 weeks), although this was in part due to the slow response of patients treated with rituximab alone. Relapse was most common after initial treatment with steroids alone (19%). In this group relapse was diagnosed a median (range) 134 (13-695) days after stopping IS. In contrast, only 1 patient (4%) who achieved a CR with a rituximab based regimen relapsed. Stable CR after first line treatment was highest after steroids plus a cytotoxic (67%) and rituximab plus another IS (64%). Stable CR was lower in the steroids alone (48%) and rituximab alone groups (42%). Patients who achieved CR after first line IS had higher FVIII and lower inhibitor titres compared with those who did not, median (IQR) for FVIII 2 (1-7) compared to 1 (1-4)IU/dL (P<0.005) and inhibitor titre 13 (4-45) compared to 31 (7-75)BU/mL P<0.03. To minimise bias, propensity score matched analysis based on age, weight, gender, FVIII level, inhibitor titre and underlying aetiology was performed to compare oral prednisone plus oral cyclophosphamide with oral prednisone alone (n=70 in each arm). This showed an odds ratio (95% CI) of achieving a stable CR of 3.25 (1.51-6.99) (P<0.003) in favour of combined treatment despite the prednisone alone group being treated with a higher mean dose of prednisone/kg (P<0.005). There were insufficient patients to perform a propensity score matched analysis with the rituximab group. There was no statistically significant difference in survival between the groups and similarly a proportion of patients were alive and in CR at final follow up (FU), median (IQR) FU was 246 (66-665) days. In conclusion, stable CR after first line IS was more likely following combination therapy with oral prednisone and cyclophosphamide than oral prednisone alone. Although a lower proportion of patients achieved CR with rituximab based regimens than steroids plus cytotoxics the lower relapse rate resulted in a comparable proportion achieving stable CR. Stable CR after rituximab alone was low, although there were only 12 patients. These are the best data available to date relating to the response to first line IS in AHA and will be useful for informing treatment guidelines and designing future RCTs. Table. Outcome of first line immunosuppression (IS) for AHA. Regimen Age Years FVIII at diagnosis (IU/dL) Inhibitor titre at diagnosis (BU/mL) CR after 1st line IS N (%) Days from start of IS Relapse (%) Stable CR after 1st line IS % Alive and in CR at final FU % Inhibitor -ve FVIII >70 IU/dL IS stopped Steroids alone n=142 75 (63–81) 3 (1–6) 13 (5–43) 83 (58) 34 (17–76) 32 (15–51) 108 (55–208) 19 48 60 13–104 0–28 0.1–1020 5–321 3–551 11–1169 Steroids and cytotoxics n=88 76 (63–80) 1 (1–4) 22 (8–67) 68 (77) 32 (12–77) 40 (18–81) 74 (52–151) 14 67 60 16–101 0–34 0.4–2800 0–386 2–386 1–386 All rituximab regimen n=51 74 (5–78) 2 (0–7) 16 (6–62) 31 (61) 65 (29–144) 64 (28–206) 43 (22–96) 4 59 67 14–104 0–20 0.1–2176 10–436 10–569 17–257 Rituximab plus another IS n=39 75 (57–78) 2 (0–7) 16 (9–62) 26 (67) 47 (28–96) 38 (28–141) 55 (26–96) 4 64 61 14–104 0–20 0.1–2176 10–436 10–569 17–257 Rituximab alone n=12 69 (65–77) 1 (0–8) 16 (3–71) 5 (42) 53, 145, 209, 334* 145, 209, 252, 334* 21, 21, 21, 21, 22* 0 42 70 50–85 0–15 1–460 Data are median, interquartile range (IQR) and range, * actual days due to low number of patients. Disclosures: Collins: NovoNordisk: Consultancy, Honoraria, The EACH2 registry was funded by Novonordisk; Baxter Healthcare: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau. Off Label Use: The use of Rituximab for the treatment of acquired haemophilia. Baudo:NovoNordisk: Consultancy, Honoraria, NovoNordisk fund the EACH2 registry, Speakers Bureau; Bayer Healthcare: Honoraria, Speakers Bureau. Knoebl:NovoNordisk: Consultancy, Membership on an entity's Board of Directors or advisory committees, NovoNordisk fund the EACH2 registry, Research Funding; Baxter Healthcare: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding. Levesque:NovoNordisk: NovoNordisk fund the EACH2 registry. Nemes: NovoNordisk: Novonordisk fund the EACH2 registry. Pellegrini:Novonordisk: Consultancy, Honoraria, Speakers Bureau, The EACH2 registry is funded by Novonordisk. Tengborn:NovoNordisk: NovoNordisk fund the EACH2 registry. Huth-Kuehne:NovoNordisk: Consultancy, Membership on an entity's Board of Directors or advisory committees, NovoNordisk fund the EACH2 registry; Baxter Healthcare: Consultancy, Membership on an entity's Board of Directors or advisory committees.
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Merkley, Cari. "The Library of Congress, Dewey Decimal, and Universal Decimal Classification Systems are Incomplete and Unsystematic." Evidence Based Library and Information Practice 6, no. 4 (December 15, 2011): 134. http://dx.doi.org/10.18438/b8qk7s.
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Objective – To determine the extent to which knowledge is currently addressed by the Library of Congress (LCC), Dewey Decimal (DDC), and Universal Decimal (UDC) classification systems.
Design – Comparative analysis of the LCC, DDC, and UDC systems using Zin’s 10 Pillars of Knowledge.
Setting – The Faculty of Philosophy and Science at a Brazilian university.
Subjects – Forty one subject-related classes and 386 subclasses from the first two levels of the LCC, DDC, and UDC systems.
Methods – To evaluate the LCC, DDC, and UDC systems, the researchers employed the 10 Pillars of Knowledge, a “hierarchical knowledge tree” developed by the lead author of this study (p. 878). According to the authors, the 10 Pillars of Knowledge seek to illustrate relationships between fields of knowledge while capturing their breadth. The first level of the Pillars consists of the following categories: Knowledge, Supernatural, Matter and Energy, Space and Earth, Nonhuman Organizations, Body and Mind, Society, Thought and Art, Technology, and History. Each of the 10 Pillars is further subdivided, resulting in a four level hierarchical structure of 76 categories. Of the 76 categories, 55 are unique subject areas. A selection of subject-based classes and subclasses from the first two levels of the LCC, DDC, and UDC systems were then mapped to the relevant subclasses within the Pillars. Analysis was limited to the first two levels of LCC, DDC, and UDC, except for the LCC categories of BF and BL where further subclasses were analyzed. Classes or subclasses in LCC, DDC, or UDC that were not subject based (for example, those based on publication type) were excluded from the study. In total, 41 main classes and 386 subclasses from LLC, DDC, and UDC were categorized using the 10 Pillars.
Main Results – The LLC, DDC, and UDC systems were deemed to be complete and systematic in their coverage of only three of the 10 Pillars: Matter and Energy, Thought and Art, and History. This means that there was at least one class or subclass in each of the three systems that corresponded to the subclasses in these pillars. The remaining seven pillars were only partially covered by the three systems to varying degrees. For example, the coverage of religion in LCC and DDC show evidence of a bias towards Christianity and incomplete coverage of other faiths. In addition to the lack of completeness in terms of subject coverage, the researchers found inconsistencies and problems with how relationships between subjects were illustrated by the systems. For example, botany should be a subclass of biology, but the subjects occupy the same level in the LCC, DDC, and UDC systems. Researchers also noted cases where subclasses on the same level were not mutually exclusive e.g., the BR (Christianity) and BS (The Bible) subclasses in LCC. Overall, LLC performed slightly better than DDC or UDC, covering 47 of the 55 unique subject categories in the 10 Pillars. It was followed by UDC with 44 out of 55, and DDC with 43 out of 55. Some of the 55 unique subject categories in the 10 Pillars system were not represented by any of the systems: 3 subclasses under Society (Society at Large – Area Based, Social Groups – Age, and Social Groups – Ethnicity), 2 under Technology (Technologies – Materials and Technologies – Processes), and 1 under Foundations (Methodology).
Conclusion – The researchers conclude that none of the three major classification systems analyzed provides complete and systematic coverage of the world of knowledge, and call for the library community to move to new systems, such as the 10 Pillars of Knowledge.
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Mwaisaka, Davidson, George K'Aol, and Caren Ouma. "Influence of Supportive and Directive Leadership Styles on Employee Job Satisfaction in Commercial Banks in Kenya." IJHCM (International Journal of Human Capital Management) 3, no. 2 (October 3, 2019): 41–58. http://dx.doi.org/10.21009/ijhcm.03.02.05.
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Abstract
Purpose: The purpose of the study was to investigate the influence of supportive and directive leadership style on employee job satisfaction in commercial banks in Kenya.
Methodology: The study adopted positivism research philosophy to guide the study and limited itself to descriptive correlational research design to analyze and provide responses to the research questions. The research design was preferred because it allows description and comparison of characteristics of populations based on data collected from samples through questionnaires. The target population of the study was 15,030 employees in all the 43 commercial banks licensed to operate in Kenya as of June 2018. Using stratified sampling technique, the study drew a sample size of 386 employees reporting to middle level managers. Data was collected by means of a questionnaire and analyzed using descriptive and inferential statistics, which included factor analysis, correlational analysis, chi-square, one-way analysis of variance (ANOVA), and regression analysis using Statistical Package for Social Sciences (SPSS) version 20 and Windows’ Microsoft excel programs.
Results: From the findings of multiple linear regression analysis, it was established that directive leadership style had a positive and significant relationship with employee job satisfaction, R2 = .228, F(1, 362) = 53.396, p < .05; β = .454, p < .05. The results from multiple linear regression analysis also showed that supportive leadership style positively and significantly predicted employee job satisfaction, R2 = .603, F(1, 366) = 278.269, p < .05; β = .716, p < .05. In addition, the study tested the moderating influence of environmental contingency factors and was confirmed that environmental contingency factors significantly moderated the relationship between path-goal leadership style and employee job satisfaction, R2=0.090, F(5,364) = 35.04, p < .05; β= 0.229, p<.05.
Unique contribution to theory, practice and policy: The study makes a contribution to the literature of the influence of directive and supportive leadership styles from Kenyan commercial banks’ perspective and adds an impetus to employees, management and policymakers to address issues that are impeding employee job satisfaction. The future researchers should include all bank employees in their study to determine the influence of directive leadership style and supportive leadership style on employee job satisfaction.
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Imig, John D., Gabriel L. Navar, Li-Xian Zou, Katie C. O’Reilly, Patricia L. Allen, James H. Kaysen, Timothy G. Hammond, and L. Gabriel Navar. "Renal endosomes contain angiotensin peptides, converting enzyme, and AT1A receptors." American Journal of Physiology-Renal Physiology 277, no. 2 (August 1, 1999): F303—F311. http://dx.doi.org/10.1152/ajprenal.1999.277.2.f303.
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Kidney cortex and proximal tubular angiotensin II (ANG II) levels are greater than can be explained on the basis of circulating ANG II, suggesting intrarenal compartmentalization of these peptides. One possible site of intracellular accumulation is the endosomes. In the present study, we tested for endosomal ANG I, ANG II, angiotensin type 1A receptor (AT1A), and angiotensin converting enzyme (ACE) activity and determined whether these levels are regulated by salt intake. Male Sprague-Dawley rats were fed chow containing either high or low dietary sodium for 10–14 days. Blood and kidneys were harvested and processed for measurement of plasma, kidney, and renal intermicrovillar cleft and endosomal angiotensin levels. Kidney ANG I averaged 179 ± 20 fmol/g and ANG II averaged 258 ± 36 fmol/g in rats fed a high-sodium diet and were significantly higher, averaging 347 ± 58 fmol/g and 386 ± 55 fmol/g, respectively, in rats fed a low-salt diet. Renal intermicrovillar clefts and endosomes contained ANG I and ANG II. Intermicrovillar cleft ANG I and ANG II levels averaged 8.4 ± 2.6 and 74 ± 26 fmol/mg, respectively, in rats fed a high-salt diet and 7.6 ± 1.7 and 70 ± 25 fmol/mg in rats fed a low-salt diet. Endosomal ANG I and ANG II levels averaged 12.3 ± 4.4 and 43 ± 19 fmol/mg, respectively, in rats fed a high-salt diet, and these levels were similar to those observed in rats fed a low-salt diet. Renal endosomes from rats fed a low-salt diet demonstrated significantly more AT1A receptor binding compared with rats fed a high-salt diet. ACE activity was detectable in renal intermicrovillar clefts and was 2.5-fold higher than the levels observed in renal endosomes. Acute enalaprilat treatment decreased ACE activity in renal intermicrovillar clefts by 90% and in renal endosomes by 84%. Likewise, intermicrovillar cleft and endosomal ANG II levels decreased by 61% and 52%, respectively, in enalaprilat-treated animals. These data demonstrate the presence of intact angiotensin peptides and ACE activity in renal intermicrovillar clefts and endosomes, indicating that intact angiotensin peptides are formed and/or trafficked through intracellular endosomal compartments and are dependent on ACE activity.
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Zanenga, C. A., C. M. Martins, N. C. Rodovalho, F. Aidar, J. F. Hasler, I. C. C. Santos, and R. Valentim. "153 EFFECT OF DIFFERENT HOLDING AND TRANSPORT MEDIA ON CONCEPTION RATES FOLLOWING TRANSFER OF IN VIVO AND IN VITRO FERTILIZATION-DERIVED BOVINE EMBRYOS." Reproduction, Fertility and Development 23, no. 1 (2011): 180. http://dx.doi.org/10.1071/rdv23n1ab153.
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Two experiments were conducted to compare conception rates following embryo transfer (ET) of bovine embryos held and transported in Syngro® holding medium (Bioniche, Belleville, Ontario, Canada) with other 2 holding media: Emcare® (ICPbio, Auckland, New Zealand) for in vivo-derived embryos and HEPES-buffered synthetic oviduct fluid (H-SOF) for IVF-derived embryos. The first trial was performed in the period from October through December 2006 at the Curitiba farm in Poços de Caldas, Minas Gerais, Brazil. A total of 140 in vivo-derived embryos were produced from 20 Nelore donor cows and transferred fresh at the same farm. After each donor recovery, embryos were equally separated per stage (morula or blastocyst) and classification (grades 1, 2, and 3) into 2 Petri dishes, each containing either Syngro or Emcare. The embryos were held for an average of 3 h after recovery, loaded into 0.25-mL straws, and transferred fresh into recipients heifers, which were all previously synchronized with the same hormonal protocol treatment and presented a corpus luteum on the day of transference. Conception rate was checked at approximately 60 days of conception by rectal palpation. The chi-square test was used for statistical analysis. The conception rate of embryos maintained in Syngro was significantly higher than those in Emcare: 64.2% (43/67) v. 47.9% (35/73; P < 0.05). A second experiment was performed between September and December 2008 at Embriza Biotechnology Laboratory, Campo Grande, Mato Grosso do Sul, Brazil. A total of 1689 IVF-derived embryos (stage = 7, quality = 1), produced from Nelore donor cows, were randomly assigned to be held and transported in either Syngro (769) or H-SOF transport medium (920). Transportation time ranged from 1 to 9 h, and the recipient farms ranged from 100 to 1200 km in distance from the Embriza Laboratory. Crossbred recipient heifers (Bos taurus × Bos indicus) were synchronized with prostaglandin or vaginal progesterone device protocols. Pregnancy diagnosis was performed by ultrasonography approximately 60 days after ET. Statistical comparisons were performed using the chi-square test. Conception rates resulting from embryos transported in Syngro (45.1%, 347/769) and in H-SOF (42.0%, 386/920) were not different (P = 0.19). Financial support from Embriza Biotecnology, Tecnopec LTDA, and Bioniche Animal Health