Anti-tumour necrosis factor discontinuation in inflammatory bowel disease patients in remission: study protocol of a prospective, multicentre, randomized clinical trial

Background: Patients with inflammatory bowel disease who achieve remission with anti-tumour necrosis factor (anti-TNF) drugs may have treatment withdrawn due to safety concerns and cost considerations, but there is a lack of prospective, controlled data investigating this strategy. The primary study aim is to compare the rates of clinical remission at 1?year in patients who discontinue anti-TNF treatment versus those who continue treatment. Methods: This is an ongoing, prospective, double-blind, multicentre, randomized, placebo-controlled study in patients with Crohn?s disease or ulcerative colitis who have achieved clinical remission for ?6?months with an anti-TNF treatment and an immunosuppressant. Patients are being randomized 1:1 to discontinue anti-TNF therapy or continue therapy. Randomization stratifies patients by the type of inflammatory bowel disease and drug (infliximab versus adalimumab) at study inclusion. The primary endpoint of the study is sustained clinical remission at 1?year. Other endpoints include endoscopic and radiological activity, patient-reported outcomes (quality of life, work productivity), safety and predictive factors for relapse. The required sample size is 194 patients. In addition to the main analysis (discontinuation versus continuation), subanalyses will include stratification by type of inflammatory bowel disease, phenotype and previous treatment. Biological samples will be obtained to identify factors predictive of relapse after treatment withdrawal. Results: Enrolment began in 2016, and the study is expected to end in 2020. Conclusions: This study will contribute prospective, controlled data on outcomes and predictors of relapse in patients with inflammatory bowel disease after withdrawal of anti-TNF agents following achievement of clinical remission. Clinical trial reference number: EudraCT 2015-001410-1

Estudios culturales, territorios encontrados

601, [2] p. : im?genes en color, cuadros, gr?ficas. Incluye bibliograf?asLa variedad y profundidad de los art?culos... abordan diversos acontecimientos y perspectivas culturales ... brindan al lector la posibilidad de analizar y cuestionar sus propias pr?cticas. La reflexi?n, sustentada en metodolog?as cient?ficas y evidencias emp?ricas, permite ampliar el horizonte cultural y el conocimiento de los fen?menos de actualidad. Sin embargo, la materia prima del an?lisis la proporciona la cultura humana y, como mencionamos ya, es un fen?meno que construimos en conjunto, a lo largo del tiempo, que nos afecta a todos, propiciando cambios en nuestro modo de vida y, en el mejor de los casos, la evoluci?n y desarrollo de nuestra especie. Llegar a ser hombres m?s conscientes del entorno y ciudadanos mejor preparados para afrontar los desaf?os de la civilizaci?n actual es, en suma, el objetivo del estudio de la cultura humana que nos distingue como especie del mundo natural

Gu?a r?pidas de consultor?a telef?nica m?dica y de enfermer?a

Gu?a de consulta para o persoal m?dico e de enfermar?a que desenvolve o seu traballo en centros de coordinaci?n telef?nica para a atenci?n ?s urxencias e ?s emerxencias sanitarias. Est? estruturada en 12 cap?tulos nos que describen os principais protocolos de actuaci?n para a asistencia ?s patolox?as m?is com?ns atendidas no ?mbito de urxencias extra hospitalarias.Gu?a de consulta para el personal m?dico y de enfermer?a que desarrolla su trabajo en centros de coordinaci?n telef?nica para la atenci?n a las urgencias y a las emergencias sanitarias. Est? estructurada en 12 cap?tulos en los que describen los principales protocolos de actuaci?n para la asistencia a las patolog?as m?s comunes atendidas en el ?mbito de urgencias extra hospitalarias

Measurement of charged particle spectra in minimum-bias events from proton-proton collisions at root s =13 TeV

Pseudorapidity, transverse momentum, and multiplicity distributions are measured in the pseudorapidity range vertical bar eta vertical bar 0.5 GeV in proton-proton collisions at a center-of-mass energy of root s = 13 TeV. Measurements are presented in three different event categories. The most inclusive of the categories corresponds to an inelastic pp data set, while the other two categories are exclusive subsets of the inelastic sample that are either enhanced or depleted in single diffractive dissociation events. The measurements are compared to predictions from Monte Carlo event generators used to describe high-energy hadronic interactions in collider and cosmic-ray physics.Peer reviewe

Measurement of the CP-violating phase phi_s in the Bs0→^0_\mathrm{s}\to J/ψ ϕ/\psi\, \phi(1020) →μ+μ−\to \mu^+\mu^-K+^+K−^- channel in proton-proton collisions at s=\sqrt{s} = 13 TeV

The CP-violating weak phase ?s and the decay width difference ??s between the light and heavy B0s mass eigenstates are measured with the CMS detector at the LHC in a sample of 48 500 reconstructed B0s? J/I) d (1020) ?11+11? K+K? events. The measurement is based on a data sample corresponding to an integrated luminosity of 96.4 fb?1, collected in proton-proton collisions at ?s = 13 TeV in 2017?2018. To extract the values of ?s and ??s, a time-dependent and flavor-tagged angular analysis of the 11+11?K+K? final state is performed. The analysis employs a dedicated tagging trigger and a novel opposite-side muon flavor tagger based on machine learning techniques. The measurement yields ?s = ?11 ?50 (stat) ? 10 (syst) mrad and ??s = 0.114 ? 0.014 (stat)? 0.007 (syst) ps?1, in agreement with the standard model predictions. When combined with the previous CMS measurement at ?s = 8 TeV, the following values are obtained: ?s = ?21 ? 44 (stat) ? 10 (syst) mrad, ??s = 0.1032 ? 0.0095 (stat) ? 0.0048 (syst) ps?1, a significant improvement over the 8 TeV result. ? 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY licens

Measurement of the C P-violating phase φs in the B0 s → J/ψφ(1020) → μ+μ− K+K− channel in proton-proton collisions at √s = 13 TeV

The C P-violating weak phase φs and the decay width difference s between the light and heavy B0 s mass eigenstates are measured with the CMS detector at the LHC in a sample of 48 500 reconstructed B0 s → J/ψ φ(1020) → μ+μ− K+K− events. The measurement is based on a data sample corresponding to an integrated luminosity of 96.4 fb−1, collected in proton-proton collisions at √s = 13 TeV in 2017–2018. To extract the values of φs and s, a time-dependent and flavor-tagged angular analysis of the μ+μ−K+K− final state is performed. The analysis employs a dedicated tagging trigger and a novel opposite-side muon flavor tagger based on machine learning techniques. The measurement yields φs = −11±50 (stat)±10 (syst) mrad and s = 0.114±0.014 (stat)±0.007 (syst) ps−1, in agreement with the standard model predictions. When combined with the previous CMS measurement at √s = 8 TeV, the following values are obtained: φs = −21 ± 44 (stat) ± 10 (syst) mrad, s = 0.1032 ± 0.0095 (stat) ± 0.0048 (syst) ps−1, a significant improvement over the 8 TeV result