To update the 1997 OMERACT-OARSI (Outcome Measures in Rheumatology-Osteoarthritis Research Society International) core domain set for clinical trials in hip and/or knee osteoarthritis (OA).
An ...initial review of the COMET database of core outcome sets (COS) was undertaken to identify all domains reported in previous COS including individuals with hip and/or knee OA. These were presented during 5 patient and health professionals/researcher meetings in 3 continents (Europe, Australasia, North America). A 3-round international Delphi survey was then undertaken among patients, healthcare professionals, researchers, and industry representatives to gain consensus on key domains to be included in a core domain set for hip and/or knee OA. Findings were presented and discussed in small groups at OMERACT 2018, where consensus was obtained in the final plenary.
Four previous COS were identified. Using these, and the patient and health professionals/researcher meetings, 50 potential domains formed the Delphi survey. There were 426 individuals from 25 different countries who contributed to the Delphi exercise. OMERACT 2018 delegates (n = 129) voted on candidate domains. Six domains gained agreement as mandatory to be measured and reported in all hip and/or knee OA clinical trials: pain, physical function, quality of life, and patient's global assessment of the target joint, in addition to the mandated core domain of adverse events including mortality. Joint structure was agreed as mandatory in specific circumstances, i.e., depending on the intervention.
The updated core domain set for hip and/or knee OA has been agreed upon. Work will commence to determine which outcome measurement instrument should be recommended to cover each core domain.
To assess the uptake of the OMERACT-OARSI (Outcome Measures in Rheumatology- Osteoarthritis Research Society International) core outcome set (COS) domains in hip and/or knee osteoarthritis (OA) ...trials.
There were 382 trials of hip and/or knee OA identified from the ClinicalTrial.gov registry from 1997 to 2017. Frequency of COS adoption was assessed by year and per 5-yearly phases.
COS adoption decreased from 61% between 1997 and 2001 to 38% between 2012 and 2016. Pain (95%) and physical function (86%) were most consistently adopted. Patient's global assessment (48%) was the principal missing domain.
Limited adoption of the COS domains indicates that further consideration to improve uptake is required.
Food and the mid-level farm Lyson, Thomas A; Stevenson, G. W; Welsh, Rick
2008, 2008-06-13, 20080101, Letnik:
1
eBook, Book
Practitioners and scholars from a range of disciplines discuss how midsize farms can better connect with consumers, organize collectively to develop markets for their products, and promote public ...policies that address agriculture-of-the-middle issues.
Earlier investigations have demonstrated that inactivation of the p53 tumor suppressor gene might play a role in the development and progression of bladder cancer. Complex formation with the MDM2 ...oncogene product is one mechanism inactivating the p53 protein. Therefore, the MDM2 and the p53 protein were investigated to study potential interactions in bladder cancer.
200 archival bladder tissue specimens from 92 patients were studied by immunohistochemistry using monoclonal antibodies DO-1 against p53 and IF2 against MDM2.
No staining was observed for p53 or MDM2 in normal urothelium. Alterations of both genes were rare in dysplasia. p53 accumulation was observed in 27-44% of the tumor stages examined. MDM2 overexpression increased from 18% in carcinoma in situ to 49% in T1 tumors, but was present in only 22% of the advanced tumors. Alterations of both genes were more frequent in high-grade lesions. To investigate the prognostic impact of these alterations 61 patients with superficial bladder tumors were followed for at least 2 years (mean 51 months). Multivariate analysis demonstrated that multifocal disease and p53 accumulation were significantly correlated with tumor progression (p = 0.0099 and 0.0135). MDM2 overexpression alone had no prognostic significance. Patients with alterations of both genes had a very high risk of tumor progression (p = 0.0064).
These results demonstrate a positive correlation between p53 accumulation and MDM2 overexpression in the progression of bladder cancer which may have prognostic value.
The twentieth century was one of profound transformation in
rural America. Demographic shifts and economic restructuring have
conspired to alter dramatically the lives of rural people and their
...communities. Challenges for Rural America in the Twenty-First
Century defines these changes and interprets their
implications for the future of rural America. The volume follows in
the tradition of "decennial volumes" co-edited by presidents of the
Rural Sociological Society and published in the Society's Rural
Studies Series. Essays have been specially commissioned to examine
key aspects of public policy relevant to rural America in the new
century.
Contributors include:Lionel Beaulieu, Alessandro Bonnano, David
Brown, Ralph Brown, Frederick Buttel, Ted Bradshaw, Douglas
Constance, Steve Daniels, Lynn England, William Falk, Cornelia
Flora, Jan Flora, Glenn Fuguitt, Nina Glasgow, Leland Glenna,
Angela Gonzales, Gary Green, Rosalind Harris, Tom Hirschl, Douglas
Jackson-Smith, Leif Jensen, Ken Johnson, Richard Krannich, Daniel
Lichter, Linda Lobao, Al Luloff, Tom Lyson, Kate MacTavish, David
McGranahan, Diane McLaughlin, Philip McMichael, Lois Wright Morton,
Domenico Parisi, Peggy Petrzelka, Kenneth Pigg, Rogelio Saenz,
Sonya Salamon, Jeff Sharp, Curtis Stofferahn, Louis Swanson, Ann
Tickameyer, Leanne Tigges, Cruz Torres, Mildred Warner, Ronald
Wimberley, Dreamal Worthen, and Julie Zimmerman.
The twentieth century was one of profound transformation in rural America. Demographic shifts and economic restructuring have conspired to alter dramatically the lives of rural people and their ...communities. Challenges for Rural America in the Twenty-First Century defines these changes and interprets their implications for the future of rural America. The volume follows in the tradition of "decennial volumes" co-edited by presidents of the Rural Sociological Society and published in the Society's Rural Studies Series. Essays have been specially commissioned to examine key aspects of public policy relevant to rural America in the new century.
Contributors include:Lionel Beaulieu, Alessandro Bonnano, David Brown, Ralph Brown, Frederick Buttel, Ted Bradshaw, Douglas Constance, Steve Daniels, Lynn England, William Falk, Cornelia Flora, Jan Flora, Glenn Fuguitt, Nina Glasgow, Leland Glenna, Angela Gonzales, Gary Green, Rosalind Harris, Tom Hirschl, Douglas Jackson-Smith, Leif Jensen, Ken Johnson, Richard Krannich, Daniel Lichter, Linda Lobao, Al Luloff, Tom Lyson, Kate MacTavish, David McGranahan, Diane McLaughlin, Philip McMichael, Lois Wright Morton, Domenico Parisi, Peggy Petrzelka, Kenneth Pigg, Rogelio Saenz, Sonya Salamon, Jeff Sharp, Curtis Stofferahn, Louis Swanson, Ann Tickameyer, Leanne Tigges, Cruz Torres, Mildred Warner, Ronald Wimberley, Dreamal Worthen, and Julie Zimmerman.
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