We previously reported preliminary findings that post induction imatinib mesylate (340 mg/m(2)/day), in combination with intensive chemotherapy, resulted in outcomes similar to blood and marrow ...transplant (BMT) for pediatric patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). We now report 5-year outcomes of imatinib plus intensive chemotherapy in 91 children (1-21 years) with and without allogeneic BMT (N=91). We explore the impacts of additional chromosomal abnormalities and minimal residual disease (MRD) by flow cytometry on outcomes. The 5-year disease-free survival was similar for Cohort 5 patients, treated with chemotherapy plus imatinib (70%±12%, n=28), sibling donor BMT patients (65%±11%, n=21) and unrelated donor BMT patients (59±15%; P=0.60, n=13). Patients with additional cytogenetic abnormalities had worse outcomes (P=0.05). End induction (pre-imatinib) MRD was not prognostic for Cohort 5 or allogeneic BMT patients, although limited by small numbers. The re-induction rate following relapse was similar to other higher-risk ALL groups. Longer-term follow-up confirms our initial observation of substantially good outcomes for children and adolescents with Ph+ ALL treated with imatinib plus intensive chemotherapy with no advantage for allogeneic BMT.
The "can do, do do" concept aims at identifying subgroups among persons with chronic obstructive pulmonary disease (COPD). Following a two-dimensional categorization, individuals are binarily ...classified with respect to their levels of physical capacity ("can't do" or "can do") and physical activity ("don't do" or "do do"), resulting in four disjunct quadrants. The approach has been debated recently and the latest articles have concluded that the quadrants should be specifically examined in terms of psychological aspects of physical activity. Therefore, the goal of the present study was to explore the role of psychological variables in physical activity in the context of the "can do, do do" quadrant concept.
Within the scope of secondary data analyses of the "Stay Active After Rehabilitation" (STAR) randomized controlled trial, a total of 298 COPD rehabilitants of an inpatient pulmonary rehabilitation program were grouped into the suggested quadrants. We set fixed cut-offs at 70% of relative 6-min walking test performances for healthy individuals (physical capacity dimension) and 5.000 steps per day (physical activity dimension). Univariate and multivariate logistic regression analyses served to analyze whether depression scores, fear avoidance behaviors, disease-specific anxiety, self-concordance for physical activity, and five indicators of physical activity-related health competence (PAHCO) effectively discriminated between the "don't do" and "do do" groups.
Among persons with lower relative physical capacity, depression scores, fear avoidance behaviors, and disease-specific anxiety (univariate case) significantly differentiated between the more and the less active. Among persons with higher relative physical capacity, fear avoidance behaviors, disease-specific anxiety, as well as three PAHCO indicators (physical activity-specific self-efficacy, self-control, and affect regulation) significantly separated the more and the less active. In multivariate analyses, only fear avoidance behaviors and affect regulation discriminated among individuals with better relative physical capacity.
The findings identified important psychological and competence-oriented variables that explain discrepancies in the quadrant concept. Based on this, we discuss implications for physical activity promotion in individuals with COPD. Respiratory research can benefit from future studies complementing the quadrant concept through further behavioral analyses. Trial registration Clinicaltrials.gov, ID: NCT02966561. Registered 17 November, 2016, https://clinicaltrials.gov/ct2/show/NCT02966561 .
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The impacts of introduced or overabundant large herbivores are a concern for the conservation of forest plant communities and the sustainability of ecosystem function. White-tailed deer (Odocoileus ...virginianus) are considered ecologically overabundant in much of North America. Previous work suggests that impacts of deer overabundance are broadly negative and are consequently degrading forests at multiple ecological and taxonomic levels. However, no quantitative synthesis currently exists to verify the generality or magnitude of these impacts. Here, we report the results of a meta-analysis quantifying the effects of deer exclusion on the diversity, cover and abundance of woody, herbaceous and whole community components of forest understories in North America. In addition, we explore the relationships of environmental and experimental factors on the direction and magnitude of plant community outcomes using meta-regression. Using 119 calculated effect sizes sourced from 25 peer-reviewed articles, we constructed 10 community-specific data sets and found strongly positive diversity, cover and abundance responses of the woody community to deer exclusion, but no significant effects for the herbaceous or whole community components of forest understories. Local deer density and time since exclusion were significant moderators of both whole community and woody community richness. Local deer density also moderated the effects of deer exclusion on whole community cover. Plot area, in contrast, showed no relationship to any of the community response outcomes. We suggest that the use of inadequate diversity indices, non-native species replacement or legacy effects of chronic deer overabundance might explain why the herbaceous and whole community components of forest understories showed no diversity or cover responses to deer exclusion. We also suggest some strategies to increase opportunities for future quantitative syntheses of deer impacts on forests, including providing better access to existing and future data. Ultimately, we show that white-tailed deer have strongly negative impacts on forest understorey plant communities in North America, but these impacts are not ubiquitous for all components of the plant community.
Behavioral operations: The state of the field Croson, R.; Schultz, K.; Siemsen, E. ...
Journal of operations management,
January 2013, 2013-01-00, 20130101, Letnik:
31, Številka:
1-2
Journal Article
Recenzirano
The field of behavioral operations has matured into an established area within the discipline of operations management. The field fills an essential void by laying the micro-foundations for the ...broader discipline of operations management. As such, the field examines a variety of topics and is methodologically diverse.
Phase-sensitive detection is an important experimental technique that allows signals to be extracted from noisy data. Commercial lock-in amplifiers, often used for phase-sensitive detection, are ...expensive and host a bewildering array of controls that may intimidate a novice user. Low-cost microcontrollers such as the Arduino family of devices might seem like a good match for learning about such devices, but making a self-contained device that includes a reference signal, a voltage input, a signal mixer, a filter, and a display is difficult. Here, we present the construction of a phase-sensitive detector (PSD) using an Arduino.
Electron energy distributions of singly and doubly ionized helium in an intense 390 nm laser field have been measured at two intensities (0.8 PW/cm2 and 1.1 PW/cm2, where PW is defined as 10(15) ...W/cm2). Numerical solutions of the full-dimensional time-dependent helium Schrödinger equation show excellent agreement with the experimental measurements. The high-energy portion of the two-electron energy distributions reveals an unexpected 5U(p) cutoff for the double ionization (DI) process and leads to a proposed model for DI below the quasiclassical threshold.
Three articles in this issue detail the process and results of reliability tests for proposed DSM-5 diagnoses and cross-diagnosis symptom domains. The editorial highlights the good reliability of ...borderline personality disorder and relates the questionable reliability of major depressive disorder to its heterogeneity. The editorial is also available in Spanish, Traditional Chinese, and Simplified Chinese.
Objectives: To see whether the percentage of older adults entering substance abuse treatment for their first time was increasing and whether there were changes in the use patterns leading to the ...treatment episode, particularly an increase in illicit drugs. Setting: The Treatment Episode Data Sets publicly available from the Substance Abuse Mental Health Services Administration from 1998 to 2008. Participants: Young adults age 30–54 years as a comparison group (N = 3,547,733) and those age 55 years or older (N = 258,542) with a first-time admission for a publicly funded substance abuse treatment. Measurements: Demographic and substance use history variables at admission. Result: The proportion of older adults going for substance abuse treatment for the first time is increasing relative to younger adults. The pattern of drug use is also changing, with an increasing illicit drug involvement (cocaine and heroin) in older adult admissions. Conclusions: We know little of these long-time users, their current medical state, cognitive abilities, and psychiatric symptoms after such a long exposure time. Previous studies on heroin and cocaine exposure focused on individuals identified much earlier in life, and the aging long-term users might represent a relatively large but unknown population.
Background
Recent randomized trials demonstrated that laparoscopic lavage compared with resection for Hinchey III perforated diverticulitis was associated with similar mortality, less stoma formation ...but a higher rate of early reintervention. The aim of this study was to compare 1‐year outcomes in patients who participated in the randomized Scandinavian Diverticulitis (SCANDIV) trial.
Methods
Between February 2010 and June 2014, patients from 21 hospitals in Norway and Sweden presenting with suspected perforated diverticulitis were enrolled in a multicentre RCT comparing laparoscopic lavage and sigmoid resection. All patients with perforated diverticulitis confirmed during surgery were included in a modified intention‐to‐treat analysis of 1‐year results.
Results
Of 199 enrolled patients, 101 were assigned randomly to laparoscopic lavage and 98 to colonic resection. Perforated diverticulitis was confirmed at the time of surgery in 89 and 83 patients respectively. Within 1 year after surgery, neither severe complications (34 versus 27 per cent; P = 0·323) nor disease‐related mortality (12 versus 11 per cent) differed significantly between the lavage and surgery groups. Among the 144 patients with purulent peritonitis, the rate of severe complications (27 per cent (20 of 74) versus 21 per cent (15 of 70) respectively; P = 0·445) and disease‐related mortality (8 versus 9 per cent) were similar. Laparoscopic lavage was associated with more deep surgical‐site infections (32 versus 13 per cent; P = 0·006) but fewer superficial surgical‐site infections (1 versus 17 per cent; P = 0·001). More patients in the lavage group underwent unplanned reoperations (27 versus 10 per cent; P = 0·010). Including stoma reversals, a similar proportion of patients required a secondary operation (28 versus 29 per cent). The stoma rate at 1 year was lower in the lavage group (14 versus 42 per cent in the resection group; P < 0·001); however, the Cleveland Global Quality of Life score did not differ between groups.
Conclusion
The advantages of laparoscopic lavage should be weighed against the risk of secondary intervention (if sepsis is unresolved). Assessment to exclude malignancy (although uncommon) is advised. Registration number: NCT01047462 (
http://www.clinicaltrials.gov).
Fewer stomas with lavage
Taylor et al present their perspectives on the management of vascular depression. They reflect on the case of an 80-year-old married man who was presented for his first psychiatric evaluation. The ...patient denies any previous mental heath problems, history of psychotropic medication use, or history of therapy. A radiographic marker was considered for the evaluation of the patient's vascular depression.
PDF
