12 research outputs found

    Casemix, management, and mortality of patients receiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study

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    Community assessment to advance computational prediction of cancer drug combinations in a pharmacogenomic screen

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    The effectiveness of most cancer targeted therapies is short-lived. Tumors often develop resistance that might be overcome with drug combinations. However, the number of possible combinations is vast, necessitating data-driven approaches to find optimal patient-specific treatments. Here we report AstraZeneca’s large drug combination dataset, consisting of 11,576 experiments from 910 combinations across 85 molecularly characterized cancer cell lines, and results of a DREAM Challenge to evaluate computational strategies for predicting synergistic drug pairs and biomarkers. 160 teams participated to provide a comprehensive methodological development and benchmarking. Winning methods incorporate prior knowledge of drug-target interactions. Synergy is predicted with an accuracy matching biological replicates for >60% of combinations. However, 20% of drug combinations are poorly predicted by all methods. Genomic rationale for synergy predictions are identified, including ADAM17 inhibitor antagonism when combined with PIK3CB/D inhibition contrasting to synergy when combined with other PI3K-pathway inhibitors in PIK3CA mutant cells.Peer reviewe

    The effect of spring frosts on the nectar production and the bee visitation of fruit trees

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    Fruit tree species suffered very strong spring frosts in 1997 in Hungary. This caused partial or total damages at buds and flowers depending on site and time of blooming. It was demonstrated at a number of experiments that frost and cold weather also strongly affected the nectar production of surviving flowers. No or very little amount of nectar was measured in flowers first of all of early blooming fruit tree species (apricot) but also of pear and apple in some places. In spite of this fact intensive honeybee visitation was detected in the flowers of fruit trees that suffered partial frost damage only at those sites where honeybee colonies were placed in or at the experimental plantations and the lack of sufficient amount of nectar did not affected bee behaviour seriously on fruit flowers. This means that bad nectar production failed to affect bee visitation of fruit trees definitely. The reason for this was the fact that not only fruit trees but another early bee plants (wild plants, too) suffered frost damage. Accordingly, in lack of forage bees intensively searched for food at blooming fruit trees with some living flowers. Consequently, there was an acceptable yield at those plantations where bud and flower damage was not complete. Accordingly, intensive bee visitation (that is moving additional bee colonies to overpopulate fruit orchards with honeybees) can be an effective tool to decrease or eliminate the detrimental effect of spring frost on the yield of fruit trees where bud or fruit damage is not too high. &nbsp

    The effect of spring frosts on the nectar production and the bee visitation of fruit trees

    No full text
    Fruit tree species suffered very strong spring frosts in 1997 in Hungary. This caused partial or total damages at buds and flowers depending on site and time of blooming. It was demonstrated at a number of experiments that frost and cold weather also strongly affected the nectar production of surviving flowers. No or very little amount of nectar was measured in flowers first of all of early blooming fruit tree species (apricot) but also of pear and apple in some places. In spite of this fact intensive honeybee visitation was detected in the flowers of fruit trees that suffered partial frost damage only at those sites where honeybee colonies were placed in or at the experimental plantations and the lack of sufficient amount of nectar did not affected bee behaviour seriously on fruit flowers. This means that bad nectar production failed to affect bee visitation of fruit trees definitely. The reason for this was the fact that not only fruit trees but another early bee plants (wild plants, too) suffered frost damage. Accordingly, in lack of forage bees intensively searched for food at blooming fruit trees with some living flowers. Consequently, there was an acceptable yield at those plantations where bud and flower damage was not complete. Accordingly, intensive bee visitation (that is moving additional bee colonies to overpopulate fruit orchards with honeybees) can be an effective tool to decrease or eliminate the detrimental effect of spring frost on the yield of fruit trees where bud or fruit damage is not too high. &nbsp

    The effect of the limitation of insect pollination period on the fruit set and yield of temperate-zone fruit tree species

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    The duration of effective bee pollination period was limited by caging flowering branches for shorter or longer time in blooming fruit trees in a number of experiments during the past decades. In the case of self-sterile fruit species and cultivars (apples, pears, quinces, some plums, some sour cherries) even partial limitation of the effective duration of bee pollination period significantly reduced the fruit set and the yield. In the case of self-fertile apricots the effect of the total and also the influence of partial limitation of bee pollination period was the same as in the case of the mentioned self-sterile fruits. On the other hand, in the case of another self-fertile fruits (some plums, some sour cherries), the effect of partial limitation of bee pollination period was usually small, but complete (or incomplete but strong) limitation of be pollination usually resulted in a strong reduction of yield. This means that not only self-sterile but also self-fertile fruits clearly depend on insect (bee) pollination. This is because pollen dehiscence of anthers and the receptive period of stigmas do not overlap in time within the individual flowers. Stigmas in self-fertile trees, therefore, need pollen carried by bees from another flowers of the same tree (or compatible pollen from another trees). Accordingly, additional bee pollination (moving bee colonies to the orchards in flower) is needed to all kinds of temperate-zone fruit tree species when bee visitation of plantations is not abundant enough for some reasons

    Children eat their school lunch too quickly: an exploratory study of the effect on food intake

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    <p>Abstract</p> <p>Background</p> <p>Speed of eating, an important aspect of eating behaviour, has recently been related to loss of control of food intake and obesity. Very little time is allocated for lunch at school and thus children may consume food more quickly and food intake may therefore be affected. Study 1 measured the time spent eating lunch in a large group of students eating together for school meals. Study 2 measured the speed of eating and the amount of food eaten in individual school children during normal school lunches and then examined the effect of experimentally increasing or decreasing the speed of eating on total food intake.</p> <p>Methods</p> <p>The time spent eating lunch was measured with a stop watch in 100 children in secondary school. A more detailed study of eating behaviour was then undertaken in 30 secondary school children (18 girls). The amount of food eaten at lunch was recorded by a hidden scale when the children ate amongst their peers and by a scale connected to a computer when they ate individually. When eating individually, feedback on how quickly to eat was visible on the computer screen. The speed of eating could therefore be increased or decreased experimentally using this visual feedback and the total amount of food eaten measured.</p> <p>Results</p> <p>In general, the children spent very little time eating their lunch. The 100 children in Study 1 spent on average (SD) just 7 (0.8) minutes eating lunch. The girls in Study 2 consumed their lunch in 5.6 (1.2) minutes and the boys ate theirs in only 6.8 (1.3) minutes. Eating with peers markedly distorted the amount of food eaten for lunch; only two girls and one boy maintained their food intake at the level observed when the children ate individually without external influences (258 (38) g in girls and 289 (73) g in boys). Nine girls ate on average 33% less food and seven girls ate 23% more food whilst the remaining boys ate 26% more food. The average speed of eating during school lunches amongst groups increased to 183 (53)% in the girls and to 166 (47)% in the boys compared to the speed of eating in the unrestricted condition. These apparent changes in food intake during school lunches could be replicated by experimentally increasing the speed of eating when the children were eating individually.</p> <p>Conclusions</p> <p>If insufficient time is allocated for consuming school lunches, compensatory increased speed of eating puts children at risk of losing control over food intake and in many cases over-eating. Public health initiatives to increase the time available for school meals might prove a relatively easy way to reduce excess food intake at school and enable children to eat more healthily.</p

    Intracranial pressure monitoring in patients with acute brain injury in the intensive care unit (SYNAPSE-ICU): an international, prospective observational cohort study

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    Background: The indications for intracranial pressure (ICP) monitoring in patients with acute brain injury and the effects of ICP on patients’ outcomes are uncertain. The aims of this study were to describe current ICP monitoring practises for patients with acute brain injury at centres around the world and to assess variations in indications for ICP monitoring and interventions, and their association with long-term patient outcomes. Methods: We did a prospective, observational cohort study at 146 intensive care units (ICUs) in 42 countries. We assessed for eligibility all patients aged 18 years or older who were admitted to the ICU with either acute brain injury due to primary haemorrhagic stroke (including intracranial haemorrhage or subarachnoid haemorrhage) or traumatic brain injury. We included patients with altered levels of consciousness at ICU admission or within the first 48 h after the brain injury, as defined by the Glasgow Coma Scale (GCS) eye response score of 1 (no eye opening) and a GCS motor response score of at least 5 (not obeying commands). Patients not admitted to the ICU or with other forms of acute brain injury were excluded from the study. Between-centre differences in use of ICP monitoring were quantified by using the median odds ratio (MOR). We used the therapy intensity level (TIL) to quantify practice variations in ICP interventions. Primary endpoints were 6 month mortality and 6 month Glasgow Outcome Scale Extended (GOSE) score. A propensity score method with inverse probability of treatment weighting was used to estimate the association between use of ICP monitoring and these 6 month outcomes, independently of measured baseline covariates. This study is registered with ClinicalTrial.gov, NCT03257904. Findings: Between March 15, 2018, and April 30, 2019, 4776 patients were assessed for eligibility and 2395 patients were included in the study, including 1287 (54%) with traumatic brain injury, 587 (25%) with intracranial haemorrhage, and 521 (22%) with subarachnoid haemorrhage. The median age of patients was 55 years (IQR 39–69) and 1567 (65%) patients were male. Considerable variability was recorded in the use of ICP monitoring across centres (MOR 4·5, 95% CI 3·8–4·9 between two randomly selected centres for patients with similar covariates). 6 month mortality was lower in patients who had ICP monitoring (441/1318 [34%]) than in those who were not monitored (517/1049 [49%]; p&lt;0·0001). ICP monitoring was associated with significantly lower 6 month mortality in patients with at least one unreactive pupil (hazard ratio [HR] 0·35, 95% CI 0·26–0·47; p&lt;0·0001), and better neurological outcome at 6 months (odds ratio 0·38, 95% CI 0·26–0·56; p=0·0025). Median TIL was higher in patients with ICP monitoring (9 [IQR 7–12]) than in those who were not monitored (5 [3–8]; p&lt;0·0001) and an increment of one point in TIL was associated with a reduction in mortality (HR 0·94, 95% CI 0·91–0·98; p=0·0011). Interpretation: The use of ICP monitoring and ICP management varies greatly across centres and countries. The use of ICP monitoring might be associated with a more intensive therapeutic approach and with lower 6-month mortality in more severe cases. Intracranial hypertension treatment guided by monitoring might be considered in severe cases due to the potential associated improvement in long-term clinical results. Funding: University of Milano-Bicocca and the European Society of Intensive Care Medicine

    Intracranial pressure monitoring in patients with acute brain injury in the intensive care unit (SYNAPSE-ICU): an international, prospective observational cohort study

    No full text
    Background: The indications for intracranial pressure (ICP) monitoring in patients with acute brain injury and the effects of ICP on patients’ outcomes are uncertain. The aims of this study were to describe current ICP monitoring practises for patients with acute brain injury at centres around the world and to assess variations in indications for ICP monitoring and interventions, and their association with long-term patient outcomes. Methods: We did a prospective, observational cohort study at 146 intensive care units (ICUs) in 42 countries. We assessed for eligibility all patients aged 18 years or older who were admitted to the ICU with either acute brain injury due to primary haemorrhagic stroke (including intracranial haemorrhage or subarachnoid haemorrhage) or traumatic brain injury. We included patients with altered levels of consciousness at ICU admission or within the first 48 h after the brain injury, as defined by the Glasgow Coma Scale (GCS) eye response score of 1 (no eye opening) and a GCS motor response score of at least 5 (not obeying commands). Patients not admitted to the ICU or with other forms of acute brain injury were excluded from the study. Between-centre differences in use of ICP monitoring were quantified by using the median odds ratio (MOR). We used the therapy intensity level (TIL) to quantify practice variations in ICP interventions. Primary endpoints were 6 month mortality and 6 month Glasgow Outcome Scale Extended (GOSE) score. A propensity score method with inverse probability of treatment weighting was used to estimate the association between use of ICP monitoring and these 6 month outcomes, independently of measured baseline covariates. This study is registered with ClinicalTrial.gov, NCT03257904. Findings: Between March 15, 2018, and April 30, 2019, 4776 patients were assessed for eligibility and 2395 patients were included in the study, including 1287 (54%) with traumatic brain injury, 587 (25%) with intracranial haemorrhage, and 521 (22%) with subarachnoid haemorrhage. The median age of patients was 55 years (IQR 39–69) and 1567 (65%) patients were male. Considerable variability was recorded in the use of ICP monitoring across centres (MOR 4·5, 95% CI 3·8–4·9 between two randomly selected centres for patients with similar covariates). 6 month mortality was lower in patients who had ICP monitoring (441/1318 [34%]) than in those who were not monitored (517/1049 [49%]; p&lt;0·0001). ICP monitoring was associated with significantly lower 6 month mortality in patients with at least one unreactive pupil (hazard ratio [HR] 0·35, 95% CI 0·26–0·47; p&lt;0·0001), and better neurological outcome at 6 months (odds ratio 0·38, 95% CI 0·26–0·56; p=0·0025). Median TIL was higher in patients with ICP monitoring (9 [IQR 7–12]) than in those who were not monitored (5 [3–8]; p&lt;0·0001) and an increment of one point in TIL was associated with a reduction in mortality (HR 0·94, 95% CI 0·91–0·98; p=0·0011). Interpretation: The use of ICP monitoring and ICP management varies greatly across centres and countries. The use of ICP monitoring might be associated with a more intensive therapeutic approach and with lower 6-month mortality in more severe cases. Intracranial hypertension treatment guided by monitoring might be considered in severe cases due to the potential associated improvement in long-term clinical results. Funding: University of Milano-Bicocca and the European Society of Intensive Care Medicine
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