National Register Testing At Sites 41BP585, 41BP594, And 41BP595 Three Oaks Mine, Bastrop County, Texas

Between October 2012 and July 2013, Atkins conducted National Register of Historic Places (NRHP) eligibility testing at historic sites 41BP585 and 41BP594 and prehistoric site 41BP595, located within the Three Oaks Mine in Bastrop County, Texas, which is owned and operated by Luminant. Impacts to all three sites are anticipated as a result of planned mine development. This work was conducted under the direction of Principal Investigator David L. Sherman. This report of investigations was written at Atkins and is being finalized by Blanton & Associates, with David L. Sherman remaining as the Principal Investigator. This work demonstrated that significant archeological deposits that may contribute to the overall NRHP eligibility statuses of the two historic sites are absent at both sites. Standing architecture at 41BP594, however, has previously been determined to be eligible for listing on the NRHP (Martin 2001). Archival research conducted as part of the current investigation into the histories of the historic sites remains inconclusive with respect to the identity of their 1870s and earlier occupants. Testing at prehistoric site 41BP595 indicated it resulted from multiple occupational episodes during the period from the late Paleoindian to the Late Prehistoric. Shovel testing and mechanical trenching revealed the presence of an expansive buried anthrogenic A soil horizon, or midden, replete with preserved subsistence remains. Mechanical trenching also exposed a variety of burned rock cooking facilities partially surrounding the midden area. Radiocarbon assays of burned nut shells recovered from feature contexts, along with the assemblage of diagnostic lithic artifacts, suggest the site was most intensively occupied from the Late Archaic to the early Late Prehistoric. A suite of special studies was conducted on burned rock samples recovered from four of the better-preserved burned rock features. These studies, which include residue, starch, and phytolith analysis, suggest that the burned rock features were used in part to process tubers/roots and grass seeds for subsistence. Macrobotanical analysis of flotation samples recovered from feature contexts identified spent fuel remains including oak and hickory wood and subsistence remains including oak, hickory, black walnut, and acorn burned nut shells. A small amount of burned bulb, possibly representing wild onion, was also recovered through flotation. These findings suggest that significant archeological deposits important to understanding the Late Archaic to early Late Prehistoric period have been preserved at 41BP595

Functional Recovery After Open Versus Laparoscopic Colonic Resection: A Randomized, Blinded Study

BACKGROUND: Laparoscopic colonic surgery has been claimed to hasten recovery and reduce hospital stay compared with open operation. Recently, enforced multimodal rehabilitation (fast-track surgery) has improved recovery and reduced hospital stay in both laparoscopic and open colonic surgery. Since no comparative data between laparoscopic and open colonic resection with multimodal rehabilitation are available, the value of laparoscopy per se is unknown. METHODS: In a randomized, observer-and-patient, blinded trial, 60 patients (median age 75 years) underwent elective laparoscopic or open colonic resection with fast-track rehabilitation and planned discharge after 48 hours. Functional recovery was assessed in detail during the first postoperative month. RESULTS: Median postoperative hospital stay was 2 days in both groups, with early and similar recovery to normal activities as assessed by hours of mobilization per day, computerized monitoring of motor activity assessed, pulmonary function, cardiovascular response to treadmill exercise, pain, sleep quality, fatigue, and return to normal gastrointestinal function. There were no significant differences in postoperative morbidity, mortality, or readmissions, although 3 patients died in the open versus nil in the laparoscopic group. CONCLUSION: Functional recovery after colonic resection is rapid with a multimodal rehabilitation regimen and without differences between open and laparoscopic operation. Further large-scale studies are required on potential differences in serious morbidity and mortality

L'heure espagnole / M. Ravel, comp. ; Janine Linda, S (Concepcion) ; Jean Mollien, T (Torquemada) ; Jean Hoffmann, BAR (Ramiro) ; Lucien Mans, B (Don Inigo)... [et al.] ; Orchestre radio-symphonique de Paris ; René Leibowitz, dir.

Titre uniforme : Ravel, Maurice (1875-1937). Compositeur. [L'heure espagnole. O 52]BnF-Partenariats, Collection sonore - BelieveContient une table des matière

Postoperative Protein Sparing With Epidural Analgesia and Hypocaloric Dextrose

OBJECTIVE: We examined the hypothesis that epidural analgesia prevents the increase in amino acid oxidation after elective colorectal surgery in patients receiving hypocaloric infusion of dextrose. SUMMARY BACKGROUND DATA: Increased oxidative protein loss after surgery may adversely affect postoperative outcome. We have previously shown that effective segmental pain relief by epidural analgesia improves postoperative substrate utilization, resulting in less protein catabolism. METHODS: We randomly allocated 10 patients to receive general anesthesia combined with epidural analgesia using bupivacaine/fentanyl and 10 to receive general anesthesia followed by patient-controlled analgesia with intravenous morphine. All patients received a peripheral 72-hour infusion of dextrose 10% from the day before until the second day after surgery. The dextrose infusion rate was adjusted to provide 50% of the patients’ resting energy expenditure. The primary end point was whole-body leucine oxidation as determined by a stable isotope tracer technique (l-[1-(13)C]leucine). RESULTS: In the intravenous analgesia group, leucine oxidation increased from 19 ± 4 to 28 ± 6 μmol kg(−1) h(−1) after surgery. Epidural analgesia prevented this increase of leucine oxidation (preoperative 21 ± 6 μmol kg(−1) h(−1), postoperative 21 ± 5 μmol kg(−1) h(−1)). This difference was statistically significant (P = 0.01; analysis of variance for repeated measures). CONCLUSION: Perioperative epidural analgesia and hypocaloric dextrose infusion suppress the postoperative increase in amino acid oxidation, thereby saving more than 100 g of lean body mass per day

L'HEURE ESPAGNOLE / Poème de FRANC-NOHAIN - Musique de Maurice RAVEL ; Janine LINDA (Concepcion) - André DRAN (Gonsalvo) - Jean MOLLIEN (Torquemada) - Jean HOFFMANN (Ramiro) - Lucien MANS (Don INIGO) et l'Orchestre Radio-Symphonique de Paris dir. René LEIBOWITZ

Titre uniforme : [L'heure espagnole. O 52]BnF-Partenariats, Collection sonore - BelieveContient une table des matière

Phase 1/2 study of daratumumab, lenalidomide, and dexamethasone for relapsed multiple myeloma

Daratumumab, a human CD38 IgG1κ monoclonal antibody, has activity as monotherapy in multiple myeloma (MM). This phase 1/2 study investigated daratumumab plus lenalidomide/dexamethasone in refractory and relapsed/refractory MM. Part 1 (dose-escalation) evaluated 4 daratumumab doses plus lenalidomide (25 mg/day p.o. on Days 1 21 of each cycle) and dexamethasone (40 mg/week). Part 2 (dose-expansion) evaluated daratumumab at the recommended phase 2 dose (RP2D) plus lenalidomide/dexamethasone. Safety, efficacy, pharmacokinetics, immunogenicity and accelerated daratumumab infusions were studied. In Part 1 (13 patients), no dose-limiting toxicities were observed; 16 mg/kg was selected as the R2PD. In Part 2 (32 patients), median time since diagnosis was 3.2 years, with a median (range) of two (one-three) prior therapies, including proteasome inhibitors (91%), alkylating agents (91%), autologous stem cell transplant (78%), thalidomide (44%), and lenalidomide (34%); 22% were refractory to last line of therapy. Grade 3/4 adverse events (≥5%) included neutropenia, thrombocytopenia, and anemia. In Part 2, infusion-related reactions (IRRs) occurred in 18 patients (56%); most were grade ≤2 (grade 3, 6.3%). IRRs predominantly occurred during first infusions and were more common during accelerated infusions. In Part 2 (median follow-up of 15.6 months), overall response rate was 81% with 8 (25%) stringent complete responses, 3 (9%) complete responses, and 9 (28%) very good partial responses. Eighteen-month progression-free and overall survival rates were 72% (95% CI, 51.7-85.0) and 90% (95% CI, 73.1-96.8), respectively. Daratumumab plus lenalidomide/dexamethasone resulted in rapid, deep, durable responses. The combination was well-tolerated and consistent with the safety profiles observed with lenalidomide/dexamethasone or daratumumab monotherapy

Phase 1/2 study of daratumumab, lenalidomide, and dexamethasone for relapsed multiple myeloma

Daratumumab, a human CD38 IgG1κ monoclonal antibody, has activity as monotherapy in multiple myeloma (MM). This phase 1/2 study investigated daratumumab plus lenalidomide/dexamethasone in refractory and relapsed/refractory MM. Part 1 (dose-escalation) evaluated 4 daratumumab doses plus lenalidomide (25 mg/day p.o. on Days 1 21 of each cycle) and dexamethasone (40 mg/week). Part 2 (dose-expansion) evaluated daratumumab at the recommended phase 2 dose (RP2D) plus lenalidomide/dexamethasone. Safety, efficacy, pharmacokinetics, immunogenicity and accelerated daratumumab infusions were studied. In Part 1 (13 patients), no dose-limiting toxicities were observed; 16 mg/kg was selected as the R2PD. In Part 2 (32 patients), median time since diagnosis was 3.2 years, with a median (range) of two (one-three) prior therapies, including proteasome inhibitors (91%), alkylating agents (91%), autologous stem cell transplant (78%), thalidomide (44%), and lenalidomide (34%); 22% were refractory to last line of therapy. Grade 3/4 adverse events (≥5%) included neutropenia, thrombocytopenia, and anemia. In Part 2, infusion-related reactions (IRRs) occurred in 18 patients (56%); most were grade ≤2 (grade 3, 6.3%). IRRs predominantly occurred during first infusions and were more common during accelerated infusions. In Part 2 (median follow-up of 15.6 months), overall response rate was 81% with 8 (25%) stringent complete responses, 3 (9%) complete responses, and 9 (28%) very good partial responses. Eighteen-month progression-free and overall survival rates were 72% (95% CI, 51.7-85.0) and 90% (95% CI, 73.1-96.8), respectively. Daratumumab plus lenalidomide/dexamethasone resulted in rapid, deep, durable responses. The combination was well-tolerated and consistent with the safety profiles observed with lenalidomide/dexamethasone or daratumumab monotherapy

Targeting CD38 with daratumumab monotherapy in multiple myeloma

Background: Multiple myeloma cells uniformly overexpress CD38. We studied daratumumab, a CD38-targeting, human IgG1κ monoclonal antibody, in a phase 1-2 trial involving patients with relapsed myeloma or relapsed myeloma that was refractory to two or more prior lines of therapy. Methods: In part 1, the dose-escalation phase, we administered daratumumab at doses of 0.005 to 24 mg per kilogram of body weight. In part 2, the dose-expansion phase, 30 patients received 8 mg per kilogram of daratumumab and 42 received 16 mg per kilogram, administered once weekly (8 doses), twice monthly (8 doses), and monthly for up to 24 months. End points included safety, efficacy, and pharmacokinetics. Results: No maximum tolerated dose was identified in part 1. In part 2, the median time since diagnosis was 5.7 years. Patients had received a median of four prior treatments; 79% of the patients had disease that was refractory to the last therapy received (64% had disease refractory to proteasome inhibitors and immunomodulatory drugs and 64% had disease refractory to bortezomib and lenalidomide), and 76% had received autologous stem-cell transplants. Infusion-related reactions in part 2 were mild (71% of patients had an event of any grade, and 1% had an event of grade 3), with no dose-dependent adverse events. The most common adverse events of grade 3 or 4 (in ≥5% of patients) were pneumonia and thrombocytopenia. The overall response rate was 36% in the cohort that received 16 mg per kilogram (15 patients had a partial response or better, including 2 with a complete response and 2 with a very good partial response) and 10% in the cohort that received 8 mg per kilogram (3 had a partial response). In the cohort that received 16 mg per kilogram, the median progression-free survival was 5.6 months (95% confidence interval [CI], 4.2 to 8.1), and 65% (95% CI, 28 to 86) of the patients who had a response did not have progression at 12 months. Conclusions: Daratumumab monotherapy had a favorable safety profile and encouraging efficacy in patients with heavily pretreated and refractory myeloma