48 research outputs found

    Book Reviews

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    Creating a Local History Archive at Your Public Library. Faye Phillips. Paper Cadavers: The Archives of Dictatorship in Guatemala. Kirsten Weld. The Silence of the Archives. David Thomas, Simon Fowler, and Valerie Johnson. The Bad-Ass Librarians of Timbuktu and Their Race to Save the World\u27s Most Precious Manuscripts. Joshua Hammer. The International Business Archives Handbook: Understanding and Managing the Historical Records of Business. Edited by Alison Turton. Putting Descriptive Standards to Work. Edited by Kris Kiesling and Christopher J. Prom. Moving Image and Sound Collections for Archivists. Anthony Cocciolo

    Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

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    OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

    Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

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    The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

    Determinants of anti-PD-1 response and resistance in clear cell renal cell carcinoma

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    Efficacy and safety of baricitinib or ravulizumab in adult patients with severe COVID-19 (TACTIC-R): a randomised, parallel-arm, open-label, phase 4 trial

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    Background From early in the COVID-19 pandemic, evidence suggested a role for cytokine dysregulation and complement activation in severe disease. In the TACTIC-R trial, we evaluated the efficacy and safety of baricitinib, an inhibitor of Janus kinase 1 (JAK1) and JAK2, and ravulizumab, a monoclonal inhibitor of complement C5 activation, as an adjunct to standard of care for the treatment of adult patients hospitalised with COVID-19. Methods TACTIC-R was a phase 4, randomised, parallel-arm, open-label platform trial that was undertaken in the UK with urgent public health designation to assess the potential of repurposing immunosuppressants for the treatment of severe COVID-19, stratified by a risk score. Adult participants (aged ≥18 years) were enrolled from 22 hospitals across the UK. Patients with a risk score indicating a 40% risk of admission to an intensive care unit or death were randomly assigned 1:1:1 to standard of care alone, standard of care with baricitinib, or standard of care with ravulizumab. The composite primary outcome was the time from randomisation to incidence (up to and including day 14) of the first event of death, invasive mechanical ventilation, extracorporeal membrane oxygenation, cardiovascular organ support, or renal failure. The primary interim analysis was triggered when 125 patient datasets were available up to day 14 in each study group and we included in the analysis all participants who were randomly assigned. The trial was registered on ClinicalTrials.gov (NCT04390464). Findings Between May 8, 2020, and May 7, 2021, 417 participants were recruited and randomly assigned to standard of care alone (145 patients), baricitinib (137 patients), or ravulizumab (135 patients). Only 54 (39%) of 137 patients in the baricitinib group received the maximum 14-day course, whereas 132 (98%) of 135 patients in the ravulizumab group received the intended dose. The trial was stopped after the primary interim analysis on grounds of futility. The estimated hazard ratio (HR) for reaching the composite primary endpoint was 1·11 (95% CI 0·62–1·99) for patients on baricitinib compared with standard of care alone, and 1·53 (0·88–2·67) for ravulizumab compared with standard of care alone. 45 serious adverse events (21 deaths) were reported in the standard-of-care group, 57 (24 deaths) in the baricitinib group, and 60 (18 deaths) in the ravulizumab group. Interpretation Neither baricitinib nor ravulizumab, as administered in this study, was effective in reducing disease severity in patients selected for severe COVID-19. Safety was similar between treatments and standard of care. The short period of dosing with baricitinib might explain the discrepancy between our findings and those of other trials. The therapeutic potential of targeting complement C5 activation product C5a, rather than the cleavage of C5, warrants further evaluation

    Michael Polanyi and his generation: origins of the social construction of science

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    In Michael Polanyi and His Generation, Mary Jo Nye investigates the role that Michael Polanyi and several of his contemporaries played in the emergence of the social turn in the philosophy of science. This turn involved seeing science as a socially based enterprise that does not rely on empiricism and reason alone but on social communities, behavioral norms, and personal commitments. Nye argues that the roots of the social turn are to be found in the scientific culture and political events of Europe in the 1930s, when scientific intellectuals struggled to defend the universal status of scientific knowledge and to justify public support for science in an era of economic catastrophe, Stalinism and Fascism, and increased demands for applications of science to industry and social welfare. At the center of this struggle was Polanyi, who Nye contends was one of the first advocates of this new conception of science. Nye reconstructs Polanyi’s scientific and political milieus in Budapest, Berlin, and Manchester from the 1910s to the 1950s and explains how he and other natural scientists and social scientists of his generation—including J. D. Bernal, Ludwik Fleck, Karl Mannheim, and Robert K. Merton—and the next, such as Thomas Kuhn, forged a politically charged philosophy of science, one that newly emphasized the social construction of science

    University of California Press eScholarship editions

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    How did chemistry and physics acquire their separate identities, and are they on their way to losing them again? Mary Jo Nye has written a graceful account of the historical demarcation of chemistry from physics and subsequent reconvergences of the two, from Lavoisier and Dalton in the late eighteenth century to Robinson, Ingold, and Pauling in the mid-twentieth century.Using the notion of a disciplinary "identity" analogous to ethnic or national identity, Nye develops a theory of the nature of disciplinary structure and change. She discusses the distinctive character of chemical language and theories and the role of national styles and traditions in building a scientific discipline. Anyone interested in the history of scientific thought will enjoy pondering with her the question of whether chemists of the mid-twentieth century suspected chemical explanation had been reduced to physical laws, just as Newtonian mechanical philosophers had envisioned in the eighteenth century
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