Outcomes and risk score for distal pancreatectomy with celiac axis resection (DP-CAR) : an international multicenter analysis

Background: Distal pancreatectomy with celiac axis resection (DP-CAR) is a treatment option for selected patients with pancreatic cancer involving the celiac axis. A recent multicenter European study reported a 90-day mortality rate of 16%, highlighting the importance of patient selection. The authors constructed a risk score to predict 90-day mortality and assessed oncologic outcomes. Methods: This multicenter retrospective cohort study investigated patients undergoing DP-CAR at 20 European centers from 12 countries (model design 2000-2016) and three very-high-volume international centers in the United States and Japan (model validation 2004-2017). The area under receiver operator curve (AUC) and calibration plots were used for validation of the 90-day mortality risk model. Secondary outcomes included resection margin status, adjuvant therapy, and survival. Results: For 191 DP-CAR patients, the 90-day mortality rate was 5.5% (95 confidence interval [CI], 2.2-11%) at 5 high-volume (1 DP-CAR/year) and 18% (95 CI, 9-30%) at 18 low-volume DP-CAR centers (P=0.015). A risk score with age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) score, multivisceral resection, open versus minimally invasive surgery, and low- versus high-volume center performed well in both the design and validation cohorts (AUC, 0.79 vs 0.74; P=0.642). For 174 patients with pancreatic ductal adenocarcinoma, the R0 resection rate was 60%, neoadjuvant and adjuvant therapies were applied for respectively 69% and 67% of the patients, and the median overall survival period was 19months (95 CI, 15-25months). Conclusions: When performed for selected patients at high-volume centers, DP-CAR is associated with acceptable 90-day mortality and overall survival. The authors propose a 90-day mortality risk score to improve patient selection and outcomes, with DP-CAR volume as the dominant predictor

EU-wide methodology to map and assess ecosystem condition

The EU Biodiversity Strategy for 2030 calls for developing an EU-wide methodology to map, assess and achieve good condition of ecosystems, so they can deliver benefits to society through the provision of ecosystem services. The EU-wide methodology presented in this report addresses this methodological gap. The EU-wide methodology has adopted the System of Environmental Economic Accounting - Ecosystem Accounting (SEEA EA) as reference framework. The SEEA EA is an integrated framework for organizing biophysical information about ecosystems, adopted as a global statistical standard by the United Nations. The SEEA EA is also the reference framework under the proposal for the amendment of Regulation (EU) No 691/2011 on European environmental economic accounts. Building on previous work done within the MAES initiative, the EU-wide methodology presents useful insights to operationalise the SEEA EA at EU level by integrating different EU data streams in a consistent way with this global statistical standard to consistently map and assess ecosystem condition in the EU across all ecosystem types. The adoption of the SEEA EA framework offers the flexibility to integrate different data flows, leveraging the use of available EU data, such as data reported by MS under EU legislation and EU geospatial data. The EU-wide methodology. The implementation of the EU-wide methodology, making use of available data, will provide the scientific knowledge base to support a range of policies and legal instruments

Método específico para la evaluación medioambiental de los lagos de origen glaciar pirenaicos y su aplicación al lago de Sabocos

This study proposes a new method to asses the environmental state of the Pyrenean glacial lakes, based on the Water Framework Directive, the concept of ecological state and inspired by widely tested and used methodologies. Starting from a good ecological state as a reference term, a series of matrices are used to identify and characterize all anthropic impacts and pressures. Information regarding the most significant ones is then compared with the criteria of a panel of experts and finally the results are summarised in ICPA matrices of Impacts, Consequences, Proposals of Corrective Measures, and Applicability. This method has been tested in the glacial lake of Sabocos, finding that its ecological quality is lower than expected, based on the identification of some severe impacts. In order to subdue them, it has been proposed a plan of correcting measures and valued its applicability.En este trabajo se propone un nuevo método para la evaluación medioambiental de los lagos pirenaicos de origen glaciar a partir de la Directiva Marco del Agua, fundamentado en el concepto de estado ecológico e inspirado en metodologías ampliamente contrastadas. Partiendo de un estado ecológico de referencia se identifican y caracterizan todas las presiones e impactos antropogénicos mediante el empleo de una serie de matrices adaptadas. Los impactos más significativos son contrastados por un panel de expertos. Finalmente, los resultados se expresan mediante matrices ICPA de Impactos, Consecuencias, Propuestas de medidas correctoras y Aplicabilidad. Este método de evaluación medioambiental se ha aplicado al lago de Sabocos. Los resultados obtenidos muestran una calidad ecológica inferior a la esperada y que algunos de los impactos identificados son severos. Con el objetivo de mitigar tales afecciones, se han propuesto una serie de medidas correctoras y evaluado su aplicabilidad

Long-term follow-up of certolizumab pegol in uveitis due to immune-mediated inflammatory diseases: multicentre study of 80 patients

ObjectivesTo evaluate effectiveness and safety of certolizumab pegol (CZP) in uveitis due to immune-mediated inflammatory diseases (IMID).MethodsMulticentre study of CZP-treated patients with IMID uveitis refractory to conventional immunosuppressant. Effectiveness was assessed through the following ocular parameters: best-corrected visual acuity, anterior chamber cells, vitritis, macular thickness and retinal vasculitis. These variables were compared between the baseline, and first week, first, third, sixth months, first and second year.ResultsWe studied 80 (33 men/47 women) patients (111 affected eyes) with a mean age of 41.6 +/- 11.7 years. The IMID included were: spondyloarthritis (n=43), Behcet's disease (n=10), psoriatic arthritis (n=8), Crohn's disease (n=4), sarcoidosis (n=2), juvenile idiopathic arthritis (n=1), reactive arthritis (n=1), rheumatoid arthritis (n=1), relapsing polychondritis (n=1),ConclusionsCZP seems to be effective and safe in uveitis related to different IMID, even in patients refractory to previous biological drugs

Outcomes and Risk Score for Distal Pancreatectomy with Celiac Axis Resection (DP-CAR): An International Multicenter Analysis

Background: Distal pancreatectomy with celiac axis resection (DP-CAR) is a treatment option for selected patients with pancreatic cancer involving the celiac axis. A recent multicenter European study reported a 90-day mortality rate of 16%, highlighting the importance of patient selection. The authors constructed a risk score to predict 90-day mortality and assessed oncologic outcomes. Methods: This multicenter retrospective cohort study investigated patients undergoing DP-CAR at 20 European centers from 12 countries (model design 2000–2016) and three very-high-volume international centers in the United States and Japan (model validation 2004–2017). The area under receiver operator curve (AUC) and calibration plots were used for validation of the 90-day mortality risk model. Secondary outcomes included resection margin status, adjuvant therapy, and survival. Results: For 191 DP-CAR patients, the 90-day mortality rate was 5.5% (95 confidence interval [CI], 2.2–11%) at 5 high-volume (≥ 1 DP-CAR/year) and 18% (95 CI, 9–30%) at 18 low-volume DP-CAR centers (P = 0.015). A risk score with age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) score, multivisceral resection, open versus minimally invasive surgery, and low- versus high-volume center performed well in both the design and validation cohorts (AUC, 0.79 vs 0.74; P = 0.642). For 174 patients with pancreatic ductal adenocarcinoma, the R0 resection rate was 60%, neoadjuvant and adjuvant therapies were applied for respectively 69% and 67% of the patients, and the median overall survival period was 19 months (95 CI, 15–25 months). Conclusions: When performed for selected patients at high-volume centers, DP-CAR is associated with acceptable 90-day mortality and overall survival. The authors propose a 90-day mortality risk score to improve patient selection and outcomes, with DP-CAR volume as the dominant predictor

Rate and duration of hospitalisation for acute pulmonary embolism in the real-world clinical practice of different countries : Analysis from the RIETE registry

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Search for narrow resonances in dilepton mass spectra in proton-proton collisions at root s=13 TeV and combination with 8 TeV data

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Observation of Charge-Dependent Azimuthal Correlations in p-Pb Collisions and Its Implication for the Search for the Chiral Magnetic Effect

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Search for R-parity violating supersymmetry with displaced vertices in proton-proton collisions at root s=8 TeV

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Multiplicity and rapidity dependence of strange hadron production in pp, pPb, and PbPb collisions at the LHC

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