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Development of a Functional Assessment of Chronic Illness Therapy item library and primary symptom list for the assessment of patient-reported adverse events associated with immune checkpoint modulators

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Journal of Cancer Metastasis and Treatment 2020年第1期6卷 74-87页

作者： Kimberly A.Webster Mary L.o’Connor Aaron R.Hansen Sheetal Kircher Heather S.L.Jim Adam P.Dicker Monika Janda Kari Ala-leppilampi clifton o.bingham III Josephine Feliciano Norah Lynn Henry Laurie E.Steffen McLouth David Cella Department of Medical Social Sciences Northwestern University Feinberg School of MedicineChicagoIL 60611USA Princess Margaret Cancer Center University Health NetworkToronto M5G 1Z5Canada Robert H Lurie Comprehensive Cancer Center Northwestern UniversityChicagoIL 60611USA Department of Health outcomes and Behavior Moffitt Cancer CenterTampaFL 33612USA Department of Radiation oncology Sidney Kimmel Medical College and Cancer Center at Thomas Jefferson UniversityPhiladelphiaPA 19107USA Centre for Health Services Research The University of QueenslandQLD 4102Australia Applied Health Research Centre Li Ka Shing Knowledge InstituteSt Michael’s HospitalToronto M5B 1W8Canada Divisions of Rheumatology and Allergy and Clinical Immunology Johns Hopkins UniversityBaltimoreMD 21224USA Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center BaltimoreMD 21231USA University of Michigan Rogel Cancer Center Ann ArborMI 48109USA Department of Behavioral Science Center for Health Equity Transformation and Markey Cancer CenterUniversity of Kentucky College of MedicineLexingtonKY 40536USA

Aim:To develop a comprehensive item library of patient-reported,immunotherapy-related adverse events(irAEs)that draws from and expands on the Functional Assessment of Chronic Illness Therapy(FACIT)Measurement ***:Literature review and iterative expert *** on a literature review of irAEs,we developed a framework of immunotherapy classes and their associated *** experts then reviewed iterations of symptom summaries and item maps linked to the immunotherapy *** provided content review and feedback was shared across experts until consensus was *** iterative process facilitated creation of a Primary Symptom List associated with immune checkpoint modulators(ICMs),drawn from the larger set of *** FACIT items were mapped to the symptom list,and new items were written as needed to create the item ***:The full item library of irAEs is comprised of 239 items,covering 142 unique symptoms across 75 inflammatory reactions/immune conditions.A subset of 66 items comprises a Primary Symptom List considered most common/relevant to ICM *** includes gastrointestinal,skin,pulmonary,neurologic,musculoskeletal,and multiple miscellaneous and constitutional ***:The FACIT Immunotherapy Item Library is a compilation of 239 self-report items that capture the wide range of AEs experienced by people receiving immune treatments.A subset of 66 items comprises a Primary Symptom List meant for ICM *** of items selected from this library is encouraged in clinical research and clinical practice evaluation.

关键词： Immunotherapy immune checkpoint modulators quality of life immune-related adverse events patient reported outcomes cancer oncology

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2010年类风湿关节炎分类标准——美国风湿病学会和欧洲抗风湿病联盟的联合倡议

2010年类风湿关节炎分类标准——美国风湿病学会和欧洲抗风湿病联...

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贵州省医学会风湿病学分会第四届学术年会

作者： Daniel Aletaha Tuhina Neogi Alan J Silman Julia Funovits David T Felson clifton o bingham ⅲ Neal S Birnbaum Gerd R Burmester Vivian P Bykerk Marc D Cohen Bernard Combe Karen H Costenbader Maxime Dougados Paul Emery Gianfranco Ferraccioli Johanna MW Hazes Kathryn Hobbs Tom WJ Huizinga Arthur Kavanaugh Jonathan Kay Tore K Kvien Timothy Laing Philip Mease Henri A Menard Larry W Moreland Raymond L Naden Theodore Pincus Josef S Smolen Ewa Stanislawska-Biernat Deborah Symmons Paul P Tak Katherine S Upchurch Jiri Vencovsky Frederick Wolfe Gillian Hawker 季兰岚邓雪蓉赵明田真张卓莉 Medical University of Vienna ViennaAustria Boston University School of Medicine BostonMassachusettsUSA

目的 :在早期类风湿关节炎(rheumatoid arthritis,RA)的诊断中,1987年美国风湿病学会(AmericanCollege of Rheumatology,ACR;旧称AmericanRheumatism Association,ARA)的诊断标准因为缺乏敏感度而受到质疑。本研究的目的是建立新的RA分类标准。方法 :由ACR和欧洲抗风湿病联盟(EuropeanLeague Against Rheumatism,EULAR)共同组成的工作小组,分三个阶段建立RA新的分类标准。研究的目标人群是初发的未分化关节炎患者,主要研究目的是寻找能够预测这些病人发展为RA的危险因素,并将RA疾病特点定义为持续性和/或侵蚀性关节炎。结果 :在新的分类标准中,确诊RA至少需要一个关节有明确的滑膜炎表现,除外其他可能导致滑膜炎症的疾病,同时以下四项评分的总分≥6分(最高10分):受累关节的数量和部位(0-5分)、血清学自身抗体异常(0-3分)、急性期反应物升高(0-1分)和症状持续时间(共分两级;0-1分)。结论 :既往诊断RA比较依赖骨破坏这一RA晚期表现,而新的分类标准着重于疾病早期表现而不是晚期特点,将疾病特点重新定义为持续性和/或侵蚀性滑膜炎。这一新标准的推出将再次强调了RA早期诊断的必要性以及早期有效治疗对于预防或减少不良后遗症的发生具有重要意义。

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Awareness and adoption of land,soil and water conservation practices in the Chinyanja Triangle,Southern Africa

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International Soil and Water Conservation Research 2017年第2期5卷 122-129页

作者： Nelson Mango clifton Makate Lulseged Tamene Powell Mponela Gift Ndengu International Centre for Tropical Agriculture(CIAT) c/o Kawanda Research StationP.O.Box 6247KampalaUganda International Centre for Tropical Agriculture(CIAT) P.O.MP 228HarareZimbabwe International Centre for Tropical Agriculture(CIAT) c/o Chitedze Agricultural Research StationP.O.Box 158LilongweMalawi

The promotion of land,soil and water conservation measures has been a widespread development in sub-Saharan Africa in a bid to tackle degradation and improve *** a result,several gov-ernments have launched various campaigns on soil,land and water conservation *** aim of this study is to determine some of the factors that influence farmers'awareness(knowledge)and adoption of land,soil and water conservation *** for this study was collected from 312 households using a questionnaire survey in the Chinyanja Triangle of Southern *** study *** sampled from Tete province of Mozambique,central and southern regions of Malawi and eastern Province of *** used t-tests to classify adopters and non-adopters of soil,land and water con-servation measures and binomial logit models to identify the factors that infuence farmers'knowledge of conservation measures and adoption of land productivity *** results show that the household head's age,education,agricultural advice reception and farmer group membership are critical in raising *** the household head's age,education,agricultural advice reception,farmer group membership,pieces of land owned or used in production and land-to-man ratio influenced adoption *** study,therefore,concludes that in order to improve land productivity in the Chinyanja Triangle,there is a need to consider farmers'heterogeneity in terms of household head's age,level of education,extension services outreach,and socio-economic char *** suggests that governments'policies in the region should be aimed at improving farmers'level of education,extension delivery that will target the elderly and the youth,land ownership,credit access,and social capital such as group formation.

关键词： Conservation Agriculture Awareness Adoption Chinyanja Triangle

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乳化七氟烷静脉输注复合芬太尼，氯胺酮，静松灵麻前给药对矮马的影响及麻醉效果研究

乳化七氟烷静脉输注复合芬太尼，氯胺酮，静松灵麻前给药对矮马的...

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作者： Alancia carol clifton 东北农业大学

学位级别：硕士

随着马业的健康发展,国内马俱乐部逐渐增多,同时动物园作为观赏的马属动物也不断增长如矮马、斑马及野驴等在动物园中占比非常大。作为观赏动物及马术俱乐部的马属动物,其商业价值远远超过传统农业中的使役家畜。马属动物寿命很长,一生... 详细信息

随着马业的健康发展,国内马俱乐部逐渐增多,同时动物园作为观赏的马属动物也不断增长如矮马、斑马及野驴等在动物园中占比非常大。作为观赏动物及马术俱乐部的马属动物,其商业价值远远超过传统农业中的使役家畜。马属动物寿命很长,一生中也会患各种各样的疾病。在兽医临床上兽医师经常需要给马做各种各样的手术包括去势,外伤处理消化道结症及其他外科手术。马属动物感觉敏锐,对疼痛比较敏感,一般的局部麻醉不适合马属动物手术,因此马的手术一般都要采取全身麻醉。吸入麻醉是最常见最安全的可靠的一种的麻醉方法,但是,对大动物如马属动物的使用受限,因为他需要配备手术室及麻醉机,特别是在医院外做手术吸入麻醉的使用很不方便。现在人医及兽医临床应用的吸入麻醉剂以氟烷类为主,如安氟烷、异氟烷、七氟烷及地氟烷等。氟烷类麻醉剂具有麻醉效果好、安全、对人及动物体生理机能特别是心肺功能影响轻微等特点,因此作为吸入麻醉剂被广泛应用。对于动物医学来讲,因受麻醉设备限制,有时无法进行呼吸道给药进行吸入麻醉。但将吸入麻醉剂经血管给药,麻醉药物直接进入血液循环,以匀速的滴注速度达到一个麻醉平衡状态,是一种非常理想的麻醉方法。其优点是既能调节麻醉深度,又能维持麻醉所需时间要求,是一种优于单纯肌肉麻醉的有一种麻醉方法。将吸入麻醉剂乳化后静脉输注不但随时可以控制麻醉深度,还可以控制麻醉时间,且有很好的安全性,其麻醉效果等同于吸入麻醉。本实验研究目的是选择适宜的麻前给药使矮马安静下来,人能接近后进行乳化的七氟烷静脉维持麻醉,选出一种较为安全、麻醉效果更好的麻醉方法,这不仅可以用于兽医在矮马的麻醉进行参考,也可以用于其他马属动物如斑马野驴等的麻醉。实验选用5匹矮马,按以下剂量芬太尼0.2μg/kg,氯胺酮5mg/kg,静松灵34μg/kg混合后肌肉注射,待矮马站立不稳后倒地保定,颈静脉以滴注乳化七氟烷,麻醉维持1.5 h。实验结果表明:本麻醉方案以芬太尼0.2μg/kg、氯胺酮5mg/kg及静松灵34μg/kg混合后肌肉注射,矮马的倒地时间为2.70±0.84 min,倒地后直接以乳化七氟烷按2.1 m L/kg/h静脉输注,其麻醉效果良好,镇静、镇痛确实。麻醉后通过对矮马心肺及血氧饱和度、血气、肝肾生理指标的监测。呼吸频率(RR)从19.40±0.89降为13.40±1.67次/min,心率(HR)从56.20±3.03降为35.60±16次/min有,收缩压从136.20±6.65降为119.00±12.06 mm Hg,舒张压从93.20±3.70降为72.80±7.12 mm Hg平均动脉压显著地从107.20±1.79降到88.20±8.5(po)从98.80±0.84降为90.60±0.55%,体温(T)从38.66±0.59降为37.56±0.30。C。麻醉对矮马的心电图结果没太大影响,P,QRS与T波都出来,麻前给药后P波出现一次倒置但是以后快恢复正常,在维持麻醉时间段T波出现双峰。矮马麻醉后肝肾生理指标(BUN,AST,ALT,ALT,CREA)没有出现明显变化。血气检测指标(p H,PCo,HCo-,Na+,K+,Cl-)的改变都在矮马接受的范围内。血清ACTH,与CGRP在90 min时间出现最高浓度,PGE浓度在60 min时间最高。结论:矮马选用芬太尼、氯胺酮及静松灵诱导,以乳化七氟烷静脉连续滴注可产生良好的镇痛、镇静及肌松效果,能够达到外科麻醉期可以完成较大的复杂手术,麻醉时间及麻醉深度随时可以调节。所有临测指标的改变都在可接受的生理范围。

关键词：马麻醉乳化七氟烷心电图

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Hypoxia Imaging of Rodent Xenografts with <sup>18</sup>F-Fluoromisonidazole: Comparison of Dynamic and Static PET Imaging

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International Journal of Medical Physics, Clinical Engineering and Radiation oncology 2012年第3期1卷 95-104页

作者： Kelin Wang Jens-Christoph Georgi Pat Zanzonico Manoj Narayanan Timo Paulus Matthien Bal Wenli Wang Shangde Cai Joseph o’Donoghue C. clifton Ling John L. Humm Department of Medical Physics Memorial Sloan-Kettering Cancer Center New York USA Department of Radiation oncology University of Miami Coral Gables USA Department of Radiology Memorial Sloan-Kettering Cancer Center New York USA Philips Research North America Briarcliff Manor New York USA Philips Technologie GmbH Forschungslaboratorien Aachen Germany Toshiba Medical Research Institute Vernon Hill USA Varian Medical Systems Inc. Palo Alto USA

Purpose: To generate parametric images of tumor hypoxia in a tumor-bearing rat model using voxel-based compartmental analysis of dynamic fluorine-18 labeled misonidazole (18F-FMISo) microPET? images, and to compare the parametric images thus derived with static “late” 18F-FMISo microPET? images for the detection of tumor hypoxia. Materials and Methods: Nude rats bearing HT-29 colorectal carcinoma xenografts (≈1.5 - 2 cm in diameter) in the right hind limb were positioned in a custom-fabricated, animal-specific foam mold. Animals were injected via the tail vein with ≈55.5 MBq 18F-FMISo and continuously imaged for either 60 or 120 minutes, with additional late static images up to 3 hour post-injection. The raw list-mode data was reconstructed into 37 - 64 frames with earlier frames of shorter time durations (12 - 15 seconds) and later frames of longer durations (up to 300 seconds). Time activity curves (TACs) were generated over regions encompassing the tumor as well as an artery, the latter for use as an input function. A beta version of a compartmental modeling package (BioGuide?, Philips Healthcare) was used to generate parametric images of k3 and Ki, rate constants of entrapment and flux of 18F-FMISo, respectively. Results: Data for 7 HT-29 tumor xenografts were presented, 6 of which yielded clear areas of tumor hypoxia as defined by Ki/k3 maps. Importantly, intratumoral foci with high 18F-FMISo uptakes on the late images did not always exhibit high Ki/k3 values and may there- fore represent false-positives for radiobiologically significant hypoxia. Conclusions: This study attempts to quantify tumor hypoxia using compartmental analysis of dynamic 18F-FMISo PET images in rodent xenograft tumor models. The results demonstrate feasibility of the approach in small-animal imaging studies, and provide evidence for the possible unreliability of late-time static imaging of 18F-FMISo PET in identifying tumor hypoxia.

关键词： Tumor Hypoxia Dynamic image Compartmental Modeling 18F-FMISo PET

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一项关于产时HIV-1快速检测的多中心研究

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世界核心医学期刊文摘（妇产科学分册） 2005年第1期1卷 3-4页

作者： Bulterys M. Jamieson D.J. o’Sullivan M.J 石磊 Div. HIV/AIDS Prev. Survlnc./E. Natl.Center for HIV STD/TB Prev. Ctr. for Dis. Control and Prevention 1600 Clifton Rd Atlanta GA 30333United States Dr

Context: Timely testing of women in labor with undocumented human immunodeficiency virus (HIV) status could enable immediate provision of antiretroviral ***: To determine the feasibility and acceptance of rapid HIV testing among women in labor and to assess rapid HIV assay performance. Design, Setting, and Patients: The Mother Infant Rapid Intervention At Delivery(MIRIAD) study implemented 24-hour counseling and voluntary rapid HIV testing for women in labor at 16 US hospitals from November 16, 2001, through November 15, 2003. A rapid HIV-1 antibody test for whole blood was used. Main outcome Measures: Acceptance of HIV testing; sensitivity, specificity, and predictive value of the rapid test; time from blood collection to patient notification of results. Results: There were 91 707 visits to thelabor and delivery units in the study, 7381 of which were by eligible women without documentation of HIV *** these, 5744 (78%) women were approached for rapid HIV testing and 4849 (84%) consented. HIV-1 test results were positive for 34 women (prevalence=7/1000). Sensitivity and specificity of the rapid test were 100%and 99.9%, respectively; positive predictive value was 90%compared with 76%for enzyme immunoassay (EIA). Factors independently associated with higher test acceptance included younger age, being black or Hispanic,gestational age less than 32 weeks, and having had no prenatal care. Lower acceptance was associated with being admitted between 4 PM and midnight, particularly on Friday nights, but this may be explained in part by fewer available personnel. Median time from blood collection to patient notification of result was 66 minutes(interquartile range, 45-120 minutes), compared with 28 hours for EIA (P onclusions: Rapid HIV testingis feasible and delivers accurate and timely test results for women in labor. It provides HIV positive women prompt access to intrapartum and neonatal antiretroviral prophylaxis,proven to reduce perin

关键词：产时抗逆转录病毒围生期产前检查酶联免疫法快速检测法高危人群预测价值阳性预测值时母

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体外受精错误分类对“叶酸与双胎关系研究”的影响:基于瑞典人口记录的人群调查

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世界核心医学期刊文摘（妇产科学分册） 2005年第9期1卷 1-1页

作者： Berry R.J. Kihlberg R. Devine o. 王佳楣 Natl. Ctr. Birth Defects/Devmtl. D. Centers for Dis. Contr. and Prev. Dept. of Health and Human Services 1600 Clifton Road Atlanta GA 30333 United States

objective: To determine whether failure to adequately adjust for a reported 40 %misclassification of use of in vitro fertilisation (IVF) as reported in a Swed ish study could have led to a false finding that folic acid increases dizygotic twinning. Design: Modelling with population based data. Setting: Swedish vital r ecords for 1995-9. Main outcome measures: Rates of twinning calculated accordin g to whether women used IVF to become pregnant. Estimated unadjusted and adjuste d odds ratios of the association between use of folic acid and twinning by use o f IVF. Results: In 1995-9, Swedish women who used IVF had almost 20 times the c hance of having twins than women who did not use IVF (rate ratio 19.7, 95%confi dence interval 18.7 to 20.6). In the absence of a true effect of folic acid, the use of a 40%misclassified surrogate variable to adjust for use of IVF would ha ve resulted in a false finding that folic acid was associated with a more than t wo fold increase in twinning. Conclusion: Use of IVF is a strong confounder beca use it is associated with both use of folic acid and twinning. Even when misclas sification of IVF was reduced to 5%, this bias persisted in the adjusted model. Using a 40%misclassified surrogate to adjust for IVF, as reported in the Swedi sh study, probably led to a false finding that folic acid increased dizygotic tw inning.

关键词：体外受精人群调查错误分类分类错误替代变量校正模型数据模型混杂因素

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