Petrogenesis of archaean grey gneisses from the amphibolite-granulite transition zone of southern Karnataka, India

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Effectiveness of a Surgery Admission Unit for patients undergoing major elective surgery in a tertiary university hospital

<p>Abstract</p> <p>Background</p> <p>The increasing demand on hospitalisation, either due to elective activity from the waiting lists or due to emergency admissions coming from the Emergency Department (ED), requires looking for strategies that lead to effective bed management. The aim of this study was to evaluate the effectiveness of a surgery admission unit for major elective surgery patients who were admitted for same-day surgery.</p> <p>Methods</p> <p>We included all patients admitted for elective surgery in a university tertiary hospital between the 1st of September and the 31st of December 2006, as well as those admitted during the same period of 2008, after the introduction of the Surgery Admission Unit. The main outcome parameters were global length of stay, pre-surgery length of stay, proportion of patients admitted the same day of the surgery and number of cancellations. Differences between the two periods were evaluated by the T-test and Chi-square test. Significance at P < 0.05 was assumed throughout.</p> <p>Results</p> <p>We included 6,053 patients, 3,003 during 2006 and 3,050 patients during 2008. Global length of stay was 6.2 days (IC 95%:6.4-6) in 2006 and 5.5 days (IC 95%:5.8-5.2) in 2008 (p < 0.005). Pre-surgery length of stay was reduced from 0.46 days (IC 95%:0.44-0.48) in 2006 to 0.29 days (IC 95%:0.27-0.31) in 2008 (p < 0.005). The proportion of patients admitted for same-day surgery was 67% (IC 95%:69%-65%) in 2006 and 76% (IC 95%:78%-74%) in 2008 (p < 0.005). The number of cancelled interventions due to insufficient preparation was 31 patients in 2006 and 7 patients in 2008.</p> <p>Conclusions</p> <p>The implementation of a Surgery Admission Unit for patients undergoing major elective surgery has proved to be an effective strategy for improving bed management. It has enabled an improvement in the proportion of patients admitted on the same day as surgery and a shorter length of stay.</p

Improving Operational Short- to Medium-Range (SR2MR) Streamflow Forecasts in the Upper Zambezi Basin and Its Sub-Basins Using Variational Ensemble Forecasting

The combination of Hydrological Models and high-resolution Satellite Precipitation Products (SPPs) or regional Climatological Models (RCMs), has provided the means to establish baselines for the quantification, propagation, and reduction in hydrological uncertainty when generating streamflow forecasts. This study aimed to improve operational real-time streamflow forecasts for the Upper Zambezi River Basin (UZRB), in Africa, utilizing the novel Variational Ensemble Forecasting (VEF) approach. In this regard, we describe and discuss the main steps required to implement, calibrate, and validate an operational hydrologic forecasting system (HFS) using VEF and Hydrologic Processing Strategies (HPS). The operational HFS was constructed to monitor daily streamflow and forecast them up to eight days in the future. The forecasting process called short- to medium-range (SR2MR) streamflow forecasting was implemented using real-time rainfall data from three Satellite Precipitation Products or SPPs (The real-time TRMM Multisatellite Precipitation Analysis TMPA-RT, the NOAA CPC Morphing Technique CMORPH, and the Precipitation Estimation from Remotely Sensed data using Artificial Neural Networks, PERSIANN) and rainfall forecasts from the Global Forecasting System (GFS). The hydrologic preprocessing (HPR) strategy considered using all raw and bias corrected rainfall estimates to calibrate three distributed hydrological models (HYMOD_DS, HBV_DS, and VIC 4.2.b). The hydrologic processing (HP) strategy considered using all optimal parameter sets estimated during the calibration process to increase the number of ensembles available for operational forecasting. Finally, inference-based approaches were evaluated during the application of a hydrological postprocessing (HPP) strategy. The final evaluation and reduction in uncertainty from multiple sources, i.e., multiple precipitation products, hydrologic models, and optimal parameter sets, was significantly achieved through a fully operational implementation of VEF combined with several HPS. Finally, the main challenges and opportunities associated with operational SR2MR streamflow forecasting using VEF are evaluated and discussed

Efficacy and safety of high-dose lanreotide autogel in patients with progressive pancreatic or midgut neuroendocrine tumours: CLARINET FORTE phase 2 study results

Lanreotide; Progression-free survival; SomatostatinLanreótido; Supervivencia libre de progresión; SomatostatinaLanreòtid; Supervivència lliure de progressió; SomatostatinaIntroduction This prospective, single-arm, phase 2 study assessed the efficacy and safety of lanreotide autogel (LAN) administered at a reduced dosing interval in patients with progressive neuroendocrine tumours (NETs) after LAN standard regimen. Methods Patients had metastatic or locally advanced, grade 1 or 2 midgut NETs or pancreatic NETs (panNETs) and centrally assessed disease progression on LAN 120 mg every 28 days. They were treated with LAN 120 mg every 14 days for up to 96 weeks (midgut cohort) or 48 weeks (panNET cohort). The primary end-point was centrally assessed progression-free survival (PFS). PFS by Ki-67 categories was analysed post hoc. Secondary end-points included quality of life (QoL) and safety. Results Ninety-nine patients were enrolled (midgut, N = 51; panNET, N = 48). Median (95% CI) PFS was 8.3 (5.6–11.1) and 5.6 (5.5–8.3) months, respectively. In patients with Ki-67 ≤ 10%, median (95% CI) PFS was 8.6 (5.6–13.8) and 8.0 (5.6–8.3) months in the midgut and panNET cohorts, respectively. Patients’ QoL did not deteriorate during the study. There were no treatment-related serious adverse events and only two withdrawals for treatment-related adverse events (both in the panNET cohort). Conclusions In patients with progressive NETs following standard-regimen LAN, reducing the dosing interval to every 14 days provided encouraging PFS, particularly in patients with a Ki-67 ≤ 10% (post hoc); no safety concerns and no deterioration in QoL were observed. Increasing LAN dosing frequency could therefore be considered before escalation to less well-tolerated therapies.This study was sponsored by Ipsen

Cabozantinib for the treatment of solid tumors: a systematic review

Cabozantinib; Hepatocellular carcinoma; Solid tumorCabozantinib; Carcinoma hepatocel·lular; Tumor sòlidCabozantinib; Carcinoma hepatocelular; Tumor sólidoBackground: Cabozantinib is approved, in various settings, for the treatment of renal cell carcinoma, medullary thyroid cancer, and hepatocellular carcinoma, and it has been investigated for the treatment of other cancers. With the available evidence and the real-world performance of cabozantinib compared with clinical trial data, we performed a systematic review of cabozantinib monotherapy as treatment for solid tumors in adults. Methods: This study was designed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and registered with PROSPERO (CRD42020144680). We searched for clinical and observational studies of cabozantinib monotherapy for solid tumors using Embase, MEDLINE, and Cochrane databases (October 2020), and screened relevant congress abstracts. Eligible studies reported clinical or safety outcomes, or biomarker data. Small studies (n < 25) and studies of cabozantinib combination therapies were excluded. Quality was assessed using National Institute for Health and Care Excellence methodology, and study characteristics were described qualitatively. Results: Of 2888 citations, 114 were included (52 randomized studies, 29 observational studies, 32 nonrandomized phase I or II studies or pilot trials, and 1 analysis of data from a randomized study and a nonrandomized study). Beyond approved indications, other tumors studied were castration-resistant prostate cancer, urothelial carcinoma, Ewing sarcoma, osteosarcoma, uveal melanoma, non-small-cell lung cancer, Merkel cell carcinoma, glioblastoma, pheochromocytomas and paragangliomas, cholangiocarcinoma, gastrointestinal stromal tumor, colorectal cancer, salivary gland cancer, carcinoid and pancreatic neuroendocrine tumors, and breast, endometrial and ovarian cancers. The most common adverse events were hypertension, diarrhea, and fatigue. Conclusion: The identified evidence demonstrates the positive efficacy/effectiveness of cabozantinib monotherapy in various solid tumor types, with safety findings being consistent with those observed with other VEGFR-targeting tyrosine kinase inhibitors. When available, real-world findings were consistent with the data reported from clinical trials. A limitation of this review is the high proportion of abstracts; however, this allowed us to capture the most up-to-date findings.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by Ipsen