1,720,982 research outputs found
EVEROLIMUS-BASED IMMUNOSUPPRESSION IS ASSOCIATED WITH A REDUCED RISK OF NEW- ONSET MALIGNANCIES AFTER LIVER TRANSPLANTATION
No full textBackground and Aim: The inhibitor of the mammalian target of rapamycin (mTOR) everolimus (EVR) has shown anti-proliferative effects in experimental and clinical models. We investigated whether liver transplant (LT) recipients on EVR-based immunosuppression had comparable outcome in terms of the incidence of new-onset post-transplant malignancies (NOPTM ) versus patients receiving calcine urin inhibitors(CNI).
Materials and methods: This was a retrospective analysis of as ingle-center, prospectively collected database. Between January 1996 and December 2013, 1,510 LT procedures were performed on 1437 patients. A total of 243 patients received EVR for reasons other than denovo or recurrent malignancies and were compared against 1182 patients on CNI-based immunosuppression (total dataset = 1425 patients). Data were censored until occurrence of NOPTM, death, lost to follow-up or as of November 2014.
Results: At a median follow-up of 1740 days (range 1–6510), a total of 43 NOPTM was observed (3.01%). Two (0.8%) NOPTM were observed in the EVR group (median follow-up 1050 days; range 7– 2880) (1 skin cancer, 1 post- transplant lymphoproliferative disease (PTLD)) versus 41 (3.4%) in patients on CNI (median follow-up 3121 days (range 1–6510) (11 skin cancers; 7 PTLD; 23 solidorgan) (p = 0.031). Being older at transplantation, higher CNI exposure, Epstein-Barr virus negative status at transplantation, and no exposure to EVR were independent risk factors for NOPTM.
Conclusions: EVR utilization was associated with a reduced risk for NOPTM after LT. To the best of our knowledge, this is the first evidence to be reported for EVR-based immunosuppressive regimens
Predicting adverse events in liver transplant patients on everolimus-based immunosuppression
No full textBackground: Scanty information is available on correlation between exposure to everolimus (EVR) and adverse events (AEs) for liver transplant (LT) recipients on immunosuppression regimens incorporating EVR.
Materials and methods: This was a retrospective analysis of adult, LT recipients receiving EVR-based immunosuppression at a single center. Patients were included into current analysis if adult (318 years) and with at least one EVR trough whole blood level. The primary study endpoints were incidence of AEs and correlation between exposure to EVR and AEs. AEs were imputed as either categorical or continuous variables, as appropriate. All AEs observed while on treatment with EVR or within 30 days after last EVR oral dose were considered treatment-related.
Results: A total of 302 adult, LT recipients (mean [SD] age 51.2 [6.4] years; male 76.5%; mean [SD] time since transplantation 49.7 [11.6] months) who received EVR were included. At a median [range] follow-up of 41 [0-110] months after EVR introduction, 218 (72.2%) patients reported at least one AE. The most frequent AEs were: hypercholesterolemia in 63 patients (20.8%); infectious events in 31 (10.3%); oral ulcers in 24 (7.9%); leukopenia in 28 (9.3%); thrombocytopenia in 26 (8.6%), edema in 24 (7.9%), and wound complications in 16 (5.3%). Proteinuria 32g/day was observed in 9 (3%) patients. A total of 65 (21.5%) patients discontinued EVR due to AEs. Complications associated with higher EVR exposure were hypercholesterolemia (r=0.65; p<0.0001), thrombocytopenia (r=-0.78; p<0.0001), and oral ulcers (r=0.63; p<0.0001). Infectious events (r=0.04; p=0.71), leukopenia (r=0.05; p=0.64), edema (r=0.04; p=0.67), wound complications (r=-0.05; p=0.68), and proteinuria (r=0.15; p=0.21) were not statistically correlated with higher EVR exposure.
Conclusions: In patients on EVR-based immunosuppression, incidence of AEs is not always correlated with higher drug exposure. A linear exposure-effect correlation was observed only for hypercholesterolemia, thrombocytopenia, and oral sores
The impact of everolimus on renal function in maintenance liver transplantation
No full textWe retrospectively investigated the impact on renal function (RF) of conversion from calcineurin inhibitors (CNI) to everolimus (EVL) monotherapy in orthotopic liver transplant (OLT) recipients. Between January 2006 and July 2007, 70 deceased donor OLT recipients including 51 men and 19 women of overall mean age of 55.9 +/- 11 years were enrolled into a program of conversion to EVL monotherapy at a mean interval of 45 +/- 35.9 months from transplantation (range, 7-192 months). The indication for conversion was deteriorating RF in 64 (91.4%). Efficacy failure was defined as the persistence of CNI, EVL discontinuation, death, graft loss, loss to follow-up, or need for dialysis at 12 months. Twelve months after switching, 53 patients (75.7%) were on EVL monotherapy. Their mean change in creatinine clearance (CrCl) from baseline (day 1 before EVL introduction) to endpoint (12 months) was 5.8 +/- 13.1 mL/min. On univariate and multivariate analyses, the clinical variable correlated with the greatest probability of improvement was the baseline CrCl (P < .0001). Conversion from CNI to EVL monotherapy was successful in 75.7% of cases with improvement in RF correlated with baseline CrCl. These data supported preemptive minimization of CNI in the posttransplant course, seeking to delay the decline in RFWe retrospectively investigated the impact on renal function (RF) of conversion from calcineurin inhibitors (CNI) to everolimus (EVL) monotherapy in orthotopic liver transplant (OLT) recipients. Between January 2006 and July 2007, 70 deceased donor OLT recipients including 51 men and 19 women of overall mean age of 55.9 +/- 11 years were enrolled into a program of conversion to EVL monotherapy at a mean interval of 45 +/- 35.9 months from transplantation (range, 7-192 months). The indication for conversion was deteriorating RF in 64 (91.4%). Efficacy failure was defined as the persistence of CNI, EVL discontinuation, death, graft loss, loss to follow-up, or need for dialysis at 12 months. Twelve months after switching, 53 patients (75.7%) were on EVL monotherapy. Their mean change in creatinine clearance (CrCl) from baseline (day 1 before EVL introduction) to endpoint (12 months) was 5.8 +/- 13.1 mL/min. On univariate and multivariate analyses, the clinical variable correlated with the greatest probability of improvement was the baseline CrCl (P < .0001). Conversion from CNI to EVL monotherapy was successful in 75.7% of cases with improvement in RF correlated with baseline CrCl. These data supported preemptive minimization of CNI in the posttransplant course, seeking to delay the decline in RF
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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