40 research outputs found
Blood Pressure Measurement Validation Off the Cuff? Comment on A New Cuffless Device for Measuring Blood Pressure: A Real-Life Validation Study .
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199952.pdf (publisher's version ) (Open Access
Case Studies on the Implementation of Balanced Mix Design and Performance Tests for Asphalt Mixtures: California Department of Transportation (Caltrans)
The primary objective of this overall effort was to identify and put forth positive practices used by SHAs when implementing BMD and performance testing of asphalt mixtures. To accomplish this objective, information was collected through site visits and other means with seven key agencies. California Department of Transportation (Caltrans) graciously agreed to host a virtual site visit
Case Studies on the Implementation of Balanced Mix Design and Performance Tests for Asphalt Mixtures: Illinois Department of Transportation (IDOT)
The primary objective of this overall effort was to identify and put forth positive practices used by SHAs when implementing BMD and performance testing of asphalt mixtures. To accomplish this objective, information was collected through site visits and other means with seven key agencies. Illinois Department of Transportation (IDOT) graciously agreed to host a virtual site visit
Positive Practices, Lessons Learned, and Challenges When Implementing Balanced Design of Asphalt Mixtures: Site Visits
Virtual site visits and interviews of seven key State Departments of Transportation (DOTs), along with material producers, consultants and paving contractors that serviced the agencies were conducted to learn more regarding the details of Balanced Mix Design (BMD) and performance tests implementation efforts. Successful practices documented from these virtual site visits were collected and synthesized into an overall process of implementing BMD as part of mix design approval and quality assurance (QA). This process comprises eight major tasks that are meant to present and summarize the activities that a State DOT may need to undertake to implement a BMD program depending on its organizational structure, staffing level, workspace, annual asphalt tonnage, as well as industry experiences and practices. Examples of positive practices, lessons learned, and challenges from States for the various tasks are presented. A list of research and deployment topics identified during the virtual site visits are also summarized
Case Studies on the Implementation of Balanced Mix Design and Performance Tests for Asphalt Mixtures: Maine Department of Transportation (MaineDOT)
The primary objective of this overall effort was to identify and put forth positive practices used by SHAs when implementing BMD and performance testing of asphalt mixtures. To accomplish this objective, information was collected through site visits and other means with seven key agencies. Maine Department of Transportation (MaineDOT) graciously agreed to host a virtual site visit
Case Studies on the Implementation of Balanced Mix Design and Performance Tests for Asphalt Mixtures: Texas Department of Transportation (TxDOT)
The primary objective of this overall effort was to identify and put forth positive practices used by SHAs when implementing BMD and performance testing of asphalt mixtures. To accomplish this objective, information was collected through site visits and other means with seven key agencies. Texas Department of Transportation (TxDOT) graciously agreed to host a virtual site visit
Case Studies on the Implementation of Balanced Mix Design and Performance Tests for Asphalt Mixtures: Virginia Department of Transportation (VDOT)
The primary objective of this overall effort was to identify and put forth positive practices used by SHAs when implementing BMD and performance testing of asphalt mixtures. To accomplish this objective, information was collected through site visits and other means with seven key agencies. Virginia Department of Transportation (VDOT) graciously agreed to host a virtual site visit
Assessing the Effect of Cold Weather on Rural Cardiovascular Disease Deaths in Vermont
Objective: To study Vermont mortality and temperature data to determine if there is an increased incidence of cardiovascular disease related death on categorically cold streak days among rural residents.
Methods: A retrospective study was conducted using a cohort of Vermont CVD deaths between 2009-2017 subset with corresponding daily temperature data. CVD deaths that occurred on a categorical cold streak day were then identified and analyzed using a Poisson Regression to assess the relationship between ambient temperature changes, CVD mortality, and rurality.
Results: As compared to non-cold streak days, risk of CVD mortality was 4% higher on cold streak days (P (P\u3c0.001). However, when controlling for cold streak days, rurality, and tobacco use, the excess risk of CVD deaths was 4.5% lower for each successive year of age.
Conclusion: Our findings highlight an increased risk of CVD death among rural residents on cold-streak days. However, further research is needed to understand why CVD death on cold-streak days was less likely with every year increase in age among our sample
Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): overall survival results of a phase 3 randomised trial
Background:
The ICON7 trial previously reported improved progression-free survival in women with ovarian cancer with the addition of bevacizumab to standard chemotherapy, with the greatest effect in patients at high risk of disease progression. We report the final overall survival results of the trial.
Methods:
ICON7 was an international, phase 3, open-label, randomised trial undertaken at 263 centres in 11 countries across Europe, Canada, Australia and New Zealand. Eligible adult women with newly diagnosed ovarian cancer that was either high-risk early-stage disease (International Federation of Gynecology and Obstetrics [FIGO] stage I–IIa, grade 3 or clear cell histology) or more advanced disease (FIGO stage IIb–IV), with an Eastern Cooperative Oncology Group performance status of 0–2, were enrolled and randomly assigned in a 1:1 ratio to standard chemotherapy (six 3-weekly cycles of intravenous carboplatin [AUC 5 or 6] and paclitaxel 175 mg/m2 of body surface area) or the same chemotherapy regimen plus bevacizumab 7·5 mg per kg bodyweight intravenously every 3 weeks, given concurrently and continued with up to 12 further 3-weekly cycles of maintenance therapy. Randomisation was done by a minimisation algorithm stratified by FIGO stage, residual disease, interval between surgery and chemotherapy, and Gynecologic Cancer InterGroup group. The primary endpoint was progression-free survival; the study was also powered to detect a difference in overall survival. Analysis was by intention to treat. This trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN91273375.
Findings:
Between Dec 18, 2006, and Feb 16, 2009, 1528 women were enrolled and randomly assigned to receive chemotherapy (n=764) or chemotherapy plus bevacizumab (n=764). Median follow-up at the end of the trial on March 31, 2013, was 48·9 months (IQR 26·6–56·2), at which point 714 patients had died (352 in the chemotherapy group and 362 in the bevacizumab group). Our results showed evidence of non-proportional hazards, so we used the difference in restricted mean survival time as the primary estimate of effect. No overall survival benefit of bevacizumab was recorded (restricted mean survival time 44·6 months [95% CI 43·2–45·9] in the standard chemotherapy group vs 45·5 months [44·2–46·7] in the bevacizumab group; log-rank p=0·85). In an exploratory analysis of a predefined subgroup of 502 patients with poor prognosis disease, 332 (66%) died (174 in the standard chemotherapy group and 158 in the bevacizumab group), and a significant difference in overall survival was noted between women who received bevacizumab plus chemotherapy and those who received chemotherapy alone (restricted mean survival time 34·5 months [95% CI 32·0–37·0] with standard chemotherapy vs 39·3 months [37·0–41·7] with bevacizumab; log-rank p=0·03). However, in non-high-risk patients, the restricted mean survival time did not differ significantly between the two treatment groups (49·7 months [95% CI 48·3–51·1]) in the standard chemotherapy group vs 48·4 months [47·0–49·9] in the bevacizumab group; p=0·20). An updated analysis of progression-free survival showed no difference between treatment groups. During extended follow-up, one further treatment-related grade 3 event (gastrointestinal fistula in a bevacizumab-treated patient), three grade 2 treatment-related events (cardiac failure, sarcoidosis, and foot fracture, all in bevacizumab-treated patients), and one grade 1 treatment-related event (vaginal haemorrhage, in a patient treated with standard chemotherapy) were reported.
Interpretation:
Bevacizumab, added to platinum-based chemotherapy, did not increase overall survival in the study population as a whole. However, an overall survival benefit was recorded in poor-prognosis patients, which is concordant with the progression-free survival results from ICON7 and GOG-218, and provides further evidence towards the optimum use of bevacizumab in the treatment of ovarian cancer.
Funding:
The National Institute for Health Research through the UK National Cancer Research Network, the Medical Research Council, and Roche
Identification of six new susceptibility loci for invasive epithelial ovarian cancer.
Genome-wide association studies (GWAS) have identified 12 epithelial ovarian cancer (EOC) susceptibility alleles. The pattern of association at these loci is consistent in BRCA1 and BRCA2 mutation carriers who are at high risk of EOC. After imputation to 1000 Genomes Project data, we assessed associations of 11 million genetic variants with EOC risk from 15,437 cases unselected for family history and 30,845 controls and from 15,252 BRCA1 mutation carriers and 8,211 BRCA2 mutation carriers (3,096 with ovarian cancer), and we combined the results in a meta-analysis. This new study design yielded increased statistical power, leading to the discovery of six new EOC susceptibility loci. Variants at 1p36 (nearest gene, WNT4), 4q26 (SYNPO2), 9q34.2 (ABO) and 17q11.2 (ATAD5) were associated with EOC risk, and at 1p34.3 (RSPO1) and 6p22.1 (GPX6) variants were specifically associated with the serous EOC subtype, all with P < 5 Ă— 10(-8). Incorporating these variants into risk assessment tools will improve clinical risk predictions for BRCA1 and BRCA2 mutation carriers.COGS project is funded through a European Commission's Seventh Framework Programme grant (agreement number 223175 ] HEALTH ]F2 ]2009 ]223175). The CIMBA data management and data
analysis were supported by Cancer Research.UK grants 12292/A11174 and C1287/A10118. The Ovarian Cancer Association Consortium is supported by a grant from the Ovarian Cancer Research
Fund thanks to donations by the family and friends of Kathryn Sladek Smith (PPD/RPCI.07). The scientific development and funding for this project were in part supported by the US National Cancer Institute GAME ]ON Post ]GWAS Initiative (U19 ]CA148112). This study made use of data generated by the Wellcome Trust Case Control consortium. Funding for the project was provided by the Wellcome Trust under award 076113. The results published here are in part based upon data
generated by The Cancer Genome Atlas Pilot Project established by the National Cancer Institute and National Human Genome Research Institute (dbGap accession number phs000178.v8.p7). The cBio portal is developed and maintained by the Computational Biology Center at Memorial Sloan ] Kettering Cancer Center. SH is supported by an NHMRC Program Grant to GCT. Details of the funding of individual investigators and studies are provided in the Supplementary Note. This study made use of data generated by the Wellcome Trust Case Control consortium, funding for which was provided by the Wellcome Trust under award 076113. The results published here are, in part, based upon data generated by The Cancer Genome Atlas Pilot Project established by the National Cancerhttp://dx.doi.org/10.1038/ng.3185This is the Author Accepted Manuscript of 'Identification of six new susceptibility loci for invasive epithelial ovarian cancer' which was published in Nature Genetics 47, 164–171 (2015) © Nature Publishing Group - content may only be used for academic research