61 research outputs found
Evaluation of seroepidemiological toxoplasmosis in HIV/AIDS patients in the south of Brazil
- Author
- Alves JM
- Antinori A
- Beatris Gonzalez Cademartori
- Bhaskar R
- Cademartori BG
- Camara VD
- Contini C
- Cook AJ
- del Rio-Chiriboga C
- Dias RAF
- Diniz EMA
- do Carmo EL
- Dubey JP
- Dunlop O
- Gomides MDA
- Graciela Augusto Xavier
- Holland GN
- Kawasaki ML
- Loges LA
- Lopes FMR
- Matos KTF
- Mohraz M
- Nara Amélia da Rosa Farias
- Nilton Azevedo da Cunha Filho
- Nissapatorn V
- Nunes CLX
- Sitoe SPBL
- Sotolongo PC
- Spalding SM
- Teixeira MG
- Varella IS
- Wallace GR
- Weiss LM
- Zajdenweber M
- Publication venue
- 'FapUNIFESP (SciELO)'
- Publication date
- Field of study
New iodine derivatives of flavonol and isoflavone
- Author
- Publication venue
- 'FapUNIFESP (SciELO)'
- Publication date
- Field of study
Recommended from our members
Toward an improved representation of middle atmospheric dynamics thanks to the ARISE project
- Author
- A Camara de la
- A Camara de la
- A Charlton
- A Hauchecorne
- A Hauchecorne
- A Hertzog
- A Hertzog
- A Pichon Le
- A Pichon Le
- A Pichon Le
- A Pichon Le
- A Pichon Le
- A Pichon Le
- A Pichon Le
- A Pichon Le
- A. Charlton-Perez
- A. Hauchecorne
- A. Le Pichon
- AJ Charlton-Perez
- AJ Charlton-Perez
- AJ Prata
- AK Smith
- AL Dabrowa
- B Bilitza
- C Bonadonna
- C Caudron
- C Claud
- C Millet
- C Pilger
- C Pilger
- C. F. Lee
- C. Millet
- C. Pilger
- CJ Wright
- CL Silva Da
- D Drob
- D Fee
- D Rind
- D Rind
- D Rind
- D Tailpied
- DC Fritts
- DC Fritts
- DD Sentman
- DJ Cecil
- DL Wu
- DN Green
- DP Drob
- DP Drob
- DWJ Thompson
- E Blanc
- E Blanc
- E Blanc
- E Blanc
- E Manzini
- E Marchetti
- E Marchetti
- E Marchetti
- E. Blanc
- E. Marchetti
- EP Gerber
- F Ardhuin
- F Ardhuin
- F Lefeuvre
- F Lott
- G Angot
- G Heinemann
- G Noer
- G Occhipinti
- G Ulivieri
- GJ Fishman
- HC Stenbaek-Nielsen
- HJ Christian
- IP Chunchuzov
- IP Chunchuzov
- J Artru
- J Artru
- J Chum
- J Chum
- J Lastovicka
- J Marty
- J Marty
- J Yue
- J. Chum
- J. D. Assink
- J. Kero
- J. Lastovicka
- JA Screen
- JB Orbaek
- JD Assink
- JD Assink
- JE Stopa
- JL Baray
- JM Lalande
- JR Holton
- JR Holton
- KW Hoppel
- L Costantino
- L Costantino
- L Goncharenko
- L Hoffmann
- L. Ceranna
- L. Eliasson
- L. G. Evers
- LG Evers
- LG Evers
- LJ Gallin
- LJ Liszka
- M Bertin
- M Diamantakis
- M Ern
- M Ern
- M FĂŒllekrug
- M Garcés
- M Garcés
- M Landes
- M Ripepe
- M Rojo
- M Sigmond
- M. Ripepe
- MAH Hedlin
- MJ Alexander
- MJ Alexander
- MJ Alexander
- ML Chanin
- MP Baldwin
- MP Baldwin
- MP Hickey
- N Butchart
- N Mze
- N. B. Crosby
- N. Brachet
- N. KĂ€mpfer
- N. Mze
- P Keckhut
- P Keckhut
- P. Blanc-Benon
- P. Heinrich
- P. J. Espy
- P. Keckhut
- P. S. M. Smets
- PSM Smets
- PSM Smets
- R Arechiga
- R Plougonven
- R RĂŒfenacht
- R. E. Hibbins
- R. RĂŒfenacht
- RA Vincent
- RD Ray
- RJ Wit de
- RJ Wit de
- RS Lindzen
- RS Matoza
- RS Matoza
- S Khaykin
- S Larquier de
- S. J. Gibbons
- S. Khaykin
- S. P. NĂ€sholm
- SH Francis
- SJ Gibbons
- SM Khaykin
- SN Kulichkov
- T Dunkerton
- T Farges
- T Farges
- T Farges
- T Neubert
- T Neubert
- T Sindelarova
- T. Farges
- T. Kvaerna
- T. Sindelarova
- TA Shaw
- TA Shaw
- V Ramaswamy
- W Randel
- WK Hocking
- WL Donn
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2018
- Field of study
This paper reviews recent progress toward understanding the dynamics of the middle atmosphere in the framework of the Atmospheric Dynamics Research InfraStructure in Europe (ARISE) initiative. The middle atmosphere, integrating the stratosphere and mesosphere, is a crucial region which influences tropospheric weather and climate. Enhancing the understanding of middle atmosphere dynamics requires improved measurement of the propagation and breaking of planetary and gravity waves originating in the lowest levels of the atmosphere. Inter-comparison studies have shown large discrepancies between observations and models, especially during unresolved disturbances such as sudden stratospheric warmings for which model accuracy is poorer due to a lack of observational constraints. Correctly predicting the variability of the middle atmosphere can lead to improvements in tropospheric weather forecasts on timescales of weeks to season. The ARISE project integrates different station networks providing observations from ground to the lower thermosphere, including the infrasound system developed for the Comprehensive Nuclear-Test-Ban Treaty verification, the Lidar Network for the Detection of Atmospheric Composition Change, complementary meteor radars, wind radiometers, ionospheric sounders and satellites. This paper presents several examples which show how multi-instrument observations can provide a better description of the vertical dynamics structure of the middle atmosphere, especially during large disturbances such as gravity waves activity and stratospheric warming events. The paper then demonstrates the interest of ARISE data in data assimilation for weather forecasting and re-analyzes the determination of dynamics evolution with climate change and the monitoring of atmospheric extreme events which have an atmospheric signature, such as thunderstorms or volcanic eruptions
Assessment of functional status in the ICU: instruments used in Brazilian settings
- Author
- Ambrosino N
- Azevedo LCP
- Batt J
- Bienvenu JO
- Cabral CR
- Camara FM
- Christakou A
- Curzel J
- De Jonghe B
- Fan E
- Farias N
- França EET
- Ganong LH
- Garcia NG
- Graf C
- Granger CV
- Griffiths J
- GuimarĂŁes RB
- Haas JS
- Hayes J
- Herridge MS
- Hodgson DL
- Jennett B
- Karnofsky DA
- Lawton MP
- Mahoney FI
- Murakami MF
- Needham DM
- Oken MM
- Parry SM
- Reis HSC
- Ribeiro M
- Soares M
- Stiller K
- Tansey CM
- Teixeira C
- van Der Schaaf M
- van Der Schaaf M
- Vesz PS
- Ydemann M
- Publication venue
- 'FapUNIFESP (SciELO)'
- Publication date
- Field of study
Lawson criterion for ignition exceeded in an inertial fusion experiment
- Author
- Abu-Shawareb H
- Acree R
- Adams J
- Adams P
- Addis B
- Aden R
- Adrian P
- Afeyan BB
- Aggleton M
- Aghaian L
- Aguirre A
- Aikens D
- Akre J
- Albert F
- Albrecht M
- Albright BJ
- Albritton J
- Alcala J
- Alday C
- Alessi DA
- Alexander N
- Alfonso J
- Alfonso N
- Alger E
- Ali SJ
- Ali ZA
- Alley WE
- Amala P
- Amendt PA
- Amick P
- Ammula S
- Amorin C
- Ampleford DJ
- Anderson RW
- Anklam T
- Antipa N
- Appelbe B
- Aracne-Ruddle C
- Araya E
- Arend M
- Arnold P
- Arnold T
- Asay J
- Atherton LJ
- Atkinson D
- Atkinson R
- Auerbach JM
- Austin B
- Auyang L
- Awwal AS
- Ayers J
- Ayers S
- Ayers T
- Azevedo S
- Bachmann B
- Back CA
- Bae J
- Bailey DS
- Bailey J
- Baisden T
- Baker KL
- Baldis H
- Barber D
- Barberis M
- Barker D
- Barnes A
- Barnes CW
- Barrios MA
- Barty C
- Bass I
- Batha SH
- Baxamusa SH
- Bazan G
- Beagle JK
- Beale R
- Beck BR
- Beck JB
- Bedzyk M
- Beeler RG
- Beeler RG
- Behrendt W
- Belk L
- Bell P
- Belyaev M
- Benage JF
- Benedetti LR
- Benedict LX
- Bennett G
- Berger R
- Bernat T
- Bernstein LA
- Berry B
- Bertolini L
- Berzak Hopkins L
- Besenbruch G
- Betcher J
- Bettenhausen R
- Betti R
- Bezzerides B
- Bhandarkar SD
- Bickel R
- Biener J
- Biesiada T
- Bigelow K
- Bigelow-Granillo J
- Bigman V
- Bionta RM
- Birge NW
- Bitter M
- Black AC
- Bleile R
- Bleuel DL
- Bliss E
- Bliss E
- Blue B
- Boehly T
- Boehm K
- Boley CD
- Bonanno R
- Bond EJ
- Bond T
- Bonino MJ
- Borden M
- Bourgade J-L
- Bousquet J
- Bowers J
- Bowers M
- Boyd R
- Bozek A
- Bradley DK
- Bradley KS
- Bradley L
- Bradley PA
- Brannon L
- Brantley PS
- Braun D
- Braun T
- Brienza-Larsen K
- Briggs TM
- Britten J
- Brooks ED
- Browning D
- Bruhn MW
- Brunner TA
- Bruns H
- Brunton G
- Bryant B
- Buczek T
- Bude J
- Buitano L
- Burkhart S
- Burmark J
- Burnham A
- Burr R
- Busby LE
- Butlin B
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- Cabot WH
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- Caggiano J
- Cahayag R
- Caldwell SE
- Calkins S
- Callahan DA
- Calleja-Aguirre J
- Camara L
- Camp D
- Campbell EM
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- Carey B
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- Carlisle K
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- Carman L
- Carmichael J
- Carpenter A
- Carr C
- Carrera JA
- Casavant D
- Casey A
- Casey DT
- Castillo A
- Castillo E
- Castor JI
- Castro C
- Caughey W
- Cavitt R
- Celeste J
- Celliers PM
- Cerjan C
- Chandler G
- Chang B
- Chang C
- Chang J
- Chang L
- Chapman R
- Chapman T
- Chase L
- Chen H
- Chen H
- Chen K
- Chen L-Y
- Cheng B
- Chittenden J
- Choate C
- Chou J
- Chrien RE
- Chrisp M
- Christensen K
- Christensen M
- Christopherson AR
- Chung M
- Church JA
- Clark A
- Clark DS
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- Claus L
- Cline B
- Cline JA
- Cobble JA
- Cochrane K
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- Collins G
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- Collins TJB
- Conder A
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- Cook AW
- Cook D
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- Cooley JC
- Cooper G
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- Coppari F
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- Czechowicz D
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- Desjardin R
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- Di Nicola J-MG
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- Publication venue
- 'American Physical Society (APS)'
- Publication date
- 06/07/2022
- Field of study
For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37Â MJ of fusion for 1.92Â MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion
The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study
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- Publication venue
- 'Royal College of Obstetricians & Gynaecologists (RCOG)'
- Publication date
- 01/06/2022
- Field of study
AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4âweeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4âweeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, PÂ =Â 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, Pâ<â0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, PÂ =Â 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, PÂ =Â 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease
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- Abdel-Aziz AK
- Abdelfatah S
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- Zuryn S
- Zwerschke W
- Ălvarez ĂMC
- Ăvalos Y
- Ănal G
- ĂstĂŒn S
- ÄoliÄ M
- ÄokiÄ J
- Ćœerovnik E
- Publication venue
- 'Informa UK Limited'
- Publication date
- 01/01/2021
- Field of study
In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field
Is evolvability evolvable?
- Author
- A Ariew
- A Bergman
- A Minelli
- A Tanay
- A Wagner
- AC Love
- AG Jones
- AJR Carter
- AM Leroi
- AP Quayle
- AS Wilkins
- C Adami
- C Darwin
- C Queitsch
- CD Rollo
- CD Schlichting
- CD Schlichting
- CJ Breuker
- CK Griswold
- CR Landry
- D Houle
- D Misevic
- DA Roff
- DJ Earl
- E Jablonka
- E Mayr
- E Mayr
- E Sober
- E Sober
- EP Martins
- F Harrison
- G Bell
- GB Muller
- GC Williams
- GC Williams
- GE Budd
- GP Wagner
- GP Wagner
- GP Wagner
- GR Price
- HF Nijhout
- HL True
- I Lozada-Chavez
- J Hey
- J Kaplan
- J Masel
- J Maynard-Smith
- J Maynard-Smith
- JA Coyne
- JAGM de Visser
- JAGM de Visser
- JD Bloom
- JFY Brookfield
- JL Hendrikse
- JS Robert
- KC Kleene
- L Ancel Meyers
- L Keller
- L Partridge
- M Camara
- M Conrad
- M Eigen
- M Kirschner
- M Lynch
- M Pigliucci
- M Pigliucci
- M-L Dichtel-Danjoy
- Massimo Pigliucci
- MJ Wade
- MJ West-Eberhard
- MJ West-Eberhard
- N Eldredge
- NA Johnson
- O Rieppel
- P Alberch
- PD Sniegowski
- PD Sniegowski
- PD Sniegowski
- PM Brakefield
- R Dawkins
- R Montville
- RA Fisher
- RC Lewontin
- RL Carroll
- RP Freckleton
- S Ciliberti
- S Gavrilets
- S Okasha
- S Okasha
- S Wright
- SE Schoustra
- SJ Gould
- SJ Gould
- SJ Gould
- SL Rutherford
- SM Stanley
- T Flatt
- TF Hansen
- TF Hansen
- V Sollars
- Publication venue
- Publication date
- 01/01/2008
- Field of study
In recent years, biologists have increasingly been asking whether the ability to evolve â the evolvability â of biological systems, itself evolves, and whether this phenomenon is the result of natural selection or a by-product of other evolutionary processes. The concept of evolvability, and the increasing theoretical and empirical literature that refers to it, may constitute one of several pillars on which an extended evolutionary synthesis will take shape during the next few years, although much work remains to be done on how evolvability comes about
Is evolvability evolvable?
- Author
- A Ariew
- A Bergman
- A Minelli
- A Tanay
- A Wagner
- AC Love
- AG Jones
- AJR Carter
- AM Leroi
- AP Quayle
- AS Wilkins
- C Adami
- C Darwin
- C Queitsch
- CD Rollo
- CD Schlichting
- CD Schlichting
- CJ Breuker
- CK Griswold
- CR Landry
- D Houle
- D Misevic
- DA Roff
- DJ Earl
- E Jablonka
- E Mayr
- E Mayr
- E Sober
- E Sober
- EP Martins
- F Harrison
- G Bell
- GB Muller
- GC Williams
- GC Williams
- GE Budd
- GP Wagner
- GP Wagner
- GP Wagner
- GR Price
- HF Nijhout
- HL True
- I Lozada-Chavez
- J Hey
- J Kaplan
- J Masel
- J Maynard-Smith
- J Maynard-Smith
- JA Coyne
- JAGM de Visser
- JAGM de Visser
- JD Bloom
- JFY Brookfield
- JL Hendrikse
- JS Robert
- KC Kleene
- L Ancel Meyers
- L Keller
- L Partridge
- M Camara
- M Conrad
- M Eigen
- M Kirschner
- M Lynch
- M Pigliucci
- M Pigliucci
- M-L Dichtel-Danjoy
- Massimo Pigliucci
- MJ Wade
- MJ West-Eberhard
- MJ West-Eberhard
- N Eldredge
- NA Johnson
- O Rieppel
- P Alberch
- PD Sniegowski
- PD Sniegowski
- PD Sniegowski
- PM Brakefield
- R Dawkins
- R Montville
- RA Fisher
- RC Lewontin
- RL Carroll
- RP Freckleton
- S Ciliberti
- S Gavrilets
- S Okasha
- S Okasha
- S Wright
- SE Schoustra
- SJ Gould
- SJ Gould
- SJ Gould
- SL Rutherford
- SM Stanley
- T Flatt
- TF Hansen
- TF Hansen
- V Sollars
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Optimisation of Perioperative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial: study protocol for a multicentre international trial of cardiac output-guided fluid therapy with low-dose inotrope infusion compared with usual care in patients undergoing major elective gastrointestinal surgery.
- Author
- Abad-Gurumeta A
- Abad-Motos A
- Abbott T
- Abdel-Nabi H
- Abu Khudair H
- Abu Kwiak S
- Abukhudair H
- Agarwal N
- Ahmad N
- Al Masri M
- Alarcon MM
- Aldecoa C
- Aldecoa C
- Alfonso SM
- Allcock C
- Amaral VDS
- Anumakonda V
- Ayach N
- Azi LMTDA
- Balasinorwala T
- Barberis L
- Bastos FA
- Baulch S
- Beattie S
- Bekele S
- Ben MRT
- Benedetti RH
- Berdunov V
- Blanco RP
- Blunt M
- Bolger C
- Brage SM
- Brandt S
- Buckley A
- Burnish R
- Buron FD
- Caldera-Alvarez MV
- Camara L
- Campbell D
- Campbell R
- Carlon VA
- Carroll J
- Cashman J
- Castro AMG
- Chowdary R
- Clark P
- Clark S
- Clarke H
- Claxton G
- Codere-Maruyama T
- Cole A
- Collings N
- Conde MJP
- Corcoran P
- Craven D
- Da Prat IC
- da Silva RJC
- Davila AS
- Dawson H
- de Almeida JP
- de Godoy EP
- de Nadal M
- de Pablo EL
- Dias P
- Diers A
- Diez AF
- dos Santos WF
- Duncan D
- Dunkley S
- Duran MV
- Edinger F
- Edwards M
- Edwards MR
- Ehrentraut H
- Ertmer M
- Evered L
- Evered L
- Falcao LF
- Farhoud E
- Feijoo JR
- Fernandes CR
- Fernandez M
- Fernandez-Francos S
- Fidler K
- Filipe H
- Fingerhut M-L
- Fitzgerald E
- Fleischer A
- Forbes G
- Fortier LP
- Fowler A
- Fowler S
- Funk D
- Galan P
- Galas FRBG
- Gardner W
- Gata A
- Ghidan A
- Gidda R
- Gillies MA
- Girling L
- Gleeson Y
- Gobert Q
- Godin N
- Gomes MDA
- Gonzalez AP
- Gracia E
- Gray K
- Griffiths B
- Grigoras I
- Grigoras I
- Grocott MPW
- Grote T
- Guerra Y
- Guha A
- Guimaraes GN
- Gunter U
- Gutierrez A
- Guttenthaler V
- Habig L
- Haines R
- Hajjar LA
- Hajjar LA
- Harris S
- Hatzakorzian R
- Heringlake M
- Herrero A
- Hodgson A
- Hodgson R
- Hodkinson G
- Hofer C
- Hofer CK
- Horan A
- Hudson C
- Ivermee C
- Jaeger M
- Januszewska M
- Jerath A
- Jitaru I
- Joaquim EHG
- Jonas M
- Jones T
- Kahan BC
- Kanapeckaite L
- Kelleher M
- Klintworth S
- Koch C
- Kowalski S
- Ladha K
- Lang A
- Lattermann R
- Lineburger E
- Lipka A
- MacDonald N
- MacDonald N
- Malbouisson LMS
- Manole M
- Manou V
- Marcolino I
- Mariotti S
- Markmann M
- Martin T
- Martinez-Hurtado E
- May S
- Mayo G
- McCluskey S
- McCluskey SA
- McGrane T
- McGregor A
- McQuaide S
- McSkeane A
- Meineri M
- Mihaylova B
- Mohamed M
- Monterola M
- Moore A
- Mugarra A
- Murat L
- Mythen MG
- Nannen L
- Navarro L
- Neumann C
- Niebrzegowska E
- Nozal-Mateo B
- Oliveira M
- Olsson S
- Ortola CF
- Pabel S
- Pakats M-L
- Pakou G
- Parada PD
- Pardal CB
- Parotto M
- Pates K
- Pawa N
- Pazmino-Canizares J
- Pearse RM
- Peral C
- Peral EC
- Perez A
- Perz LV
- Peyton P
- Phan TD
- Poonawala H
- Pozo N
- Prado RG
- Prentice S
- Price T
- Raj A
- Ratnam V
- Rea N
- Reay M
- Richebe P
- Ripolles-Melchor J
- Ripolles-Melchor J
- Ristescu I
- Rivas MC
- Romero E
- Rosbergen M
- Ruhrmann S
- Rusu D
- Salgado M
- Salles LC
- Salvachua-Fernandez R
- Sanchez CGM
- Sancho JM
- Sander M
- Sander M
- Sato H
- Sato T
- Saunders Z
- Sayan A
- Schemke S
- Schmidt C
- Schneck E
- Schricker T
- Schulte D
- Sellers D
- Shelley J
- Shore DD
- Sidiropolous S
- Simoes C
- Singer R
- Smee E
- Smith T
- Soares SD
- Soro M
- Stefani LC
- Stephens T
- Suarez SG
- Svensson M-L
- Szakmany T
- Szczeklik W
- Thankachen M
- Thompson R
- Thomson A
- Tilley A
- Tindall M
- Torres MB
- Trauzeddel R-F
- Treskatsch S
- Tuong P
- Turnbo T
- Una-Orejon R
- van Vlymen J
- Verdonck O
- Villafane AP
- Visauta EC
- Walker S
- Wasowicz M
- Watts A
- Weinstein M
- Weyland A
- Whalley J
- Wijeysundera D
- Wijeysundera DN
- Wilson T
- Winkler A
- Winter A
- Wittenberg M
- Wittmann M
- Yang G
- Publication venue
- 'BMJ'
- Publication date
- 01/01/2019
- Field of study
INTRODUCTION: Postoperative morbidity and mortality in older patients with comorbidities undergoing gastrointestinal surgery are a major burden on healthcare systems. Infections after surgery are common in such patients, prolonging hospitalisation and reducing postoperative short-term and long-term survival. Optimal management of perioperative intravenous fluids and inotropic drugs may reduce infection rates and improve outcomes from surgery. Previous small trials of cardiac-output-guided haemodynamic therapy algorithms suggested a modest reduction in postoperative morbidity. A large definitive trial is needed to confirm or refute this and inform widespread clinical practice. METHODS: The Optimisation of Perioperative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial is a multicentre, international, parallel group, open, randomised controlled trial. 2502 high-risk patients undergoing major elective gastrointestinal surgery will be randomly allocated in a 1:1 ratio using minimisation to minimally invasive cardiac output monitoring to guide protocolised administration of intravenous fluid combined with low-dose inotrope infusion, or usual care. The trial intervention will be carried out during and for 4âhours after surgery. The primary outcome is postoperative infection of Clavien-Dindo grade II or higher within 30 days of randomisation. Participants and those delivering the intervention will not be blinded to treatment allocation; however, outcome assessors will be blinded when feasible. Participant recruitment started in January 2017 and is scheduled to last 3âyears, within 50 hospitals worldwide. ETHICS/DISSEMINATION: The OPTIMISE II trial has been approved by the UK National Research Ethics Service and has been approved by responsible ethics committees in all participating countries. The findings will be disseminated through publication in a widely accessible peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: ISRCTN39653756.The OPTIMISE II trial is supported by Edwards Lifesciences (Irvine, CA) and the UK National Institute for Health Research through RMPâs NIHR Professorship
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