563 research outputs found

    Epidemiology and natural history of central venous access device use and infusion pump function in the NO16966 trial

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    Background: Central venous access devices in fluoropyrimidine therapy are associated with complications; however, reliable data are lacking regarding their natural history, associated complications and infusion pump performance in patients with metastatic colorectal cancer.<p></p> Methods: We assessed device placement, use during treatment, associated clinical outcomes and infusion pump perfomance in the NO16966 trial.<p></p> Results: Device replacement was more common with FOLFOX-4 (5-fluorouracil (5-FU)+oxaliplatin) than XELOX (capecitabine+oxaliplatin) (14.1% vs 5.1%). Baseline device-associated events and post-baseline removal-/placement-related events occurred more frequently with FOLFOX-4 than XELOX (11.5% vs 2.4% and 8.5% vs 2.1%). Pump malfunctions, primarily infusion accelerations in 16% of patients, occurred within 1.6–4.3% of cycles. Fluoropyrimidine-associated grade 3/4 toxicity was increased in FOLFOX-4-treated patients experiencing a malfunction compared with those who did not (97 out of 155 vs 452 out of 825 patients), predominantly with increased grade 3/4 neutropenia (53.5% vs 39.8%). Febrile neutropenia rates were comparable between patient cohorts±malfunction. Efficacy outcomes were similar in patient cohorts±malfunction.<p></p> Conclusions: Central venous access device removal or replacement was common and more frequent in patients receiving FOLFOX-4. Pump malfunctions were also common and were associated with increased rates of grade 3/4 haematological adverse events. Oral fluoropyrimidine-based regimens may be preferable to infusional 5-FU based on these findings

    Opt-out as an acceptable method of obtaining consent in medical research: a short report

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    <p>Abstract</p> <p>Background</p> <p>A prospective cohort study was set up to investigate a possible association between antibiotic prescribing and antibiotic resistance of <it>E. coli </it>urinary tract infection in the community. Participation of patients with urinary tract infection was obtained through an opt-out methodology. This short paper reports on the acceptability of the opt-out recruitment approach.</p> <p>Methods</p> <p>Participating practices (22) were requested to send a urine sample from all patients presenting with symptoms of urinary tract infection. Upon receipt of the sample in the laboratory, a letter explaining the study, an opt-out form and a freepost envelope were sent to all adult patients. A website with additional information and including an 'opt-out' button was set up for the study.</p> <p>Results</p> <p>A total of 1362 urine samples were submitted by the 22 participating practices representing 1178 adult patients of whom 193 actively responded to the letter: 142 opted out by letter, 15 through the website, 2 by phone and 12 sent the letter back without indication, making a total of 171 patients or 14.5% opt-out; the remaining 22 patients (1.9%) explicitly opted in. The total group consisted of 80% women and the mean age was 50.9 years (sd 20.8). No significant differences were found between patients who participated and those who opted out in terms of age, gender or whether the urine sample was positive or not.</p> <p>Conclusions</p> <p>Overall the opt-out method was well received and participation in the study reached 85.5%. The low number of complaints (2) indicates that this is a generally acceptable method of patient recruitment. The 14.5% opt-out shows that it effectively empowers patients to decline participation. The similarity between patients opting out and the rest of the patients is reassuring for extrapolation of the results of the study.</p

    Blueberry Progress Reports

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    The 1978 edition of the Blueberry Progress Reports was prepared for the Maine Blueberry Commission and the University of Maine Blueberry Advisory Committee by researchers with the Maine Life Sciences and Agriculture Experiment Station and Maine Cooperative Extension Service at the University of Maine, Orono. Projects in this report include: 1. Weed Control in Blueberry Fields 2. Pruning of Blueberries 3. Integrated Management of Blueberry Fields 4. Factors Regulating Rhizome Initiation and Development in the Lowbush Blueberry 5. Effect of Plant-Water Stress on Lowbush Blueberry Growth Yield and Quality 6. Blossom Blight of Blueberries 7. Botrytis Blossom Blight of Lowbush Blueberries 8. Insects Affecting the Blueberry 9. Treatment of Blueberries with Potassium Sorbate to Reduce Spoilage During Temporary Storage 10. Cooperative Extension Activitie

    On the Spiral Structure of the Milky Way Galaxy

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    We consider the possible pattern of the overall spiral structure of the Galaxy, using data on the distribution of neutral (atomic), molecular, and ionized hydrogen, on the base of the hypothesis of the spiral structure being symmetric, i.e. the assumption that spiral arms are translated into each other for a rotation around the galactic center by 180{\deg} (a two-arm pattern) or by 90{\deg} (a four-arm pattern). We demonstrate that, for the inner region, the observations are best represented with a four-arm scheme of the spiral pattern, associated with all-Galaxy spiral density waves. The basic position is that of the Carina arm, reliably determined from distances to HII regions and from HI and H2 radial velocities. This pattern is continued in the quadrants III and IV with weak outer HI arms; from their morphology, the Galaxy should be considered an asymmetric multi-arm spiral. The kneed shape of the outer arms that consist of straight segments can indicate that these arms are transient formations that appeared due to a gravitational instability in the gas disk. The distances between HI superclouds in the two arms that are the brightest in neutral hydrogen, the Carina arm and the Cygnus (Outer) arm, concentrate to two values, permitting to assume the presence of a regular magnetic field in these arms.Comment: 21 pages, 14 fugures; accepted for publication in Astronomichesky Journal (Astron. Rep.

    The academy for future science faculty:randomized controlled trial of theory-driven coaching to shape development and diversity of early-career scientists

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    Background: Approaches to training biomedical scientists have created a talented research community. However, they have failed to create a professional workforce that includes many racial and ethnic minorities and women in proportion to their representation in the population or in PhD training. This is particularly true at the faculty level. Explanations for the absence of diversity in faculty ranks can be found in social science theories that reveal processes by which individuals develop identities, experiences, and skills required to be seen as legitimate within the profession. Methods/Design: Using the social science theories of Communities of Practice, Social Cognitive Career Theory, identity formation, and cultural capital, we have developed and are testing a novel coaching-based model to address some of the limitations of previous diversity approaches. This coaching intervention (The Academy for Future Science Faculty) includes annual in-person meetings of students and trained faculty Career Coaches, along with ongoing virtual coaching, group meetings and communication. The model is being tested as a randomized controlled trial with two cohorts of biomedical PhD students from across the U.S., one recruited at the start of their PhDs and one nearing completion. Stratification into the experimental and control groups, and to coaching groups within the experimental arms, achieved equal numbers of students by race, ethnicity and gender to the extent possible. A fundamental design element of the Academy is to teach and make visible the social science principles which highly influence scientific advancement, as well as acknowledging the extra challenges faced by underrepresented groups working to be seen as legitimate within the scientific communities. Discussion: The strategy being tested is based upon a novel application of the well-established principles of deploying highly skilled coaches, selected and trained for their ability to develop talents of others. This coaching model is intended to be a complement, rather than a substitute, for traditional mentoring in biomedical research training, and is being tested as such

    Avaliação do Ensino de Empreendedorismo entre Estudantes Universitários por meio do Perfil Empreendedor

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    Entrepreneurship is a socioeconomic phenomenon that has been valued for its influence on the growth and development of regional and national economies. The main promoter of this phenomenon are entrepreneurs, subjects endowed with multiple features that make up their profiles. They are dynamic and results oriented, benefitting from the fruits of their own personal efforts. Entrepreneurial education is highlighted as one of the most efficient ways to promote an entrepreneurial culture and train new entrepreneurs. However, some difficulty has been observed in assessing the effectiveness of teaching and learning this subject. The objective of this study was to analyze, by means of multivariate techniques, an instrument whose function is to measure the learning of Entrepreneurship, verifying the change in entrepreneur profiles of 407 college students participating or not in an entrepreneurial training process. The results showed that students who participated in Entrepreneurship educational training activities showed significant changes in their entrepreneurial profiles. The main contributions showed growth in the Self-realization, Planner, Innovative and Risks Assumed dimensions

    Echocardiographic evaluation of mitral geometry in functional mitral regurgitation

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    <p>Abstract</p> <p>Objectives</p> <p>We sought to evaluate the geometric changes of the mitral leaflets, local and global LV remodeling in patients with left ventricular dysfunction and varying degrees of Functional mitral regurgitation (FMR).</p> <p>Background</p> <p>Functional mitral regurgitation (FMR) occurs as a consequence of systolic left ventricular (LV) dysfunction caused by ischemic or nonischemic cardiomyopathy. Mitral valve repair in ischemic MR is one of the most controversial topic in surgery and proper repairing requires an understanding of its mechanisms, as the exact mechanism of FMR are not well defined.</p> <p>Methods</p> <p>136 consecutive patients mean age of 55 with systolic LV dysfunction and FMR underwent complete echocardiography and after assessing MR severity, LV volumes, Ejection Fraction, LV sphericity index, C-Septal distance, Mitral valve annulus, Interpapillary distance, Tenting distance and Tenting area were obtained.</p> <p>Results</p> <p>There was significant association between MR severity and echocardiogarphic indices (all p values < 0.001). Severe MR occurred more frequently in dilated cardiomyopathy (DCM) patients compared to ischemic patients, (p < 0.001). Based on the model, only Mitral valve tenting distance (TnD) (OR = 22.11, CI 95%: 14.18 – 36.86, p < 0.001) and Interpapillary muscle distance (IPMD), (OR = 6.53, CI 95%: 2.10 – 10.23, p = 0.001) had significant associations with MR severity.</p> <p>Mitral annular dimensions and area, C-septal distance and sphericity index, although greater in patients with severe regurgitation, did not significantly contribute to FMR severity.</p> <p>Conclusion</p> <p>Degree of LV enlargement and dysfunction were not primary determinants of FMR severity, therefore local LV remodeling and mitral valve apparatus deformation are the strongest predictors of functional MR severity.</p

    Measurement of the Masses and Widths of the Sigma_c^++ and Sigma_c^0 Charmed Baryons

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    Using data recorded by the CLEO II and CLEO II.V detector configurations at CESR, we report new measurements of the masses of the Sigma_c^{++} and Sigma_c^0 charmed baryons, and the first measurements of their intrinsic widths. We find M(Sigma_c^{++}) - M(Lambda_c^+) = 167.4 +- 0.1 +- 0.2 MeV, Gamma(Sigma_c^{++}) = 2.3 +- 0.2 +- 0.3 MeV, and M(Sigma_c^0) - M(Lambda_c^+) = 167.2 +- 0.1 +- 0.2 MeV, Gamma(Sigma_c^0) = 2.5 +- 0.2 +- 0.3 MeV, where the uncertainties are statistical and systematic, respectively.Comment: 9 pages postscript, also available through http://w4.lns.cornell.edu/public/CLNS, submitted to PRD, Rapid Communications. Reference [13] correcte
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