| 421. |
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| 422. |
- Khaleva, E, et al.
(författare)
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Definitions of non-response and response to biological therapy for severe asthma: a systematic review
- 2023
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Ingår i: ERJ open research. - : European Respiratory Society (ERS). - 2312-0541. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Biologics have proven efficacy for patients with severe asthma but there is lack of consensus on defining response. We systematically reviewed and appraised methodologically developed, defined, and evaluated definitions of non-response and response to biologics for severe asthma.MethodsWe searched four bibliographic databases from inception to 15th March 2021 (PROSPERO: CRD42021211249).Two reviewers screened references, extracted data, assessed methodological quality of development, measurement properties of outcome measures and definitions of response based on COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN). Modified GRADE approach and narrative synthesis were undertaken.ResultsThirteen studies reported three composite outcome measures, three measures of asthma symptoms, one asthma control and one quality of life. Only four were developed with patient input; none were composite measures. Studies utilised 17 definitions of response: 10/17 (58.8%) were based on Minimal Clinically Important Difference (MCID) or Minimal Important Difference (MID) and 16/17 (94.1%) had high quality evidence. Results were limited by poor methodology for development process and incomplete reporting of psychometric properties. Most measures rated “very low” to “low” for quality of measurement properties and none met all quality standards.ConclusionThis is the first review to synthesize evidence about definitions of response to biologics for severe asthma. While high quality definitions are available, most are MCIDs or MIDs which may be insufficient to justify continuation of biologics in terms of cost-effectiveness. There remains an unmet need for universally accepted, patient-centred, composite definitions to aid clinical decision making and comparability of responses to biologics.
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| 423. |
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| 424. |
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| 425. |
- Khoury, J. D., et al.
(författare)
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The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms
- 2022
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Ingår i: Leukemia. - : Springer Science and Business Media LLC. - 0887-6924 .- 1476-5551. ; 36
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Tidskriftsartikel (refereegranskat)abstract
- The upcoming 5th edition of the World Health Organization (WHO) Classification of Haematolymphoid Tumours is part of an effort to hierarchically catalogue human cancers arising in various organ systems within a single relational database. This paper summarizes the new WHO classification scheme for myeloid and histiocytic/dendritic neoplasms and provides an overview of the principles and rationale underpinning changes from the prior edition. The definition and diagnosis of disease types continues to be based on multiple clinicopathologic parameters, but with refinement of diagnostic criteria and emphasis on therapeutically and/or prognostically actionable biomarkers. While a genetic basis for defining diseases is sought where possible, the classification strives to keep practical worldwide applicability in perspective. The result is an enhanced, contemporary, evidence-based classification of myeloid and histiocytic/dendritic neoplasms, rooted in molecular biology and an organizational structure that permits future scalability as new discoveries continue to inexorably inform future editions.
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| 426. |
- Kind, R., et al.
(författare)
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Scandinavia : A former Tibet?
- 2013
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Ingår i: Geochemistry Geophysics Geosystems. - : American Geophysical Union (AGU). - 1525-2027. ; 14:10, s. 4479-4487
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Tidskriftsartikel (refereegranskat)abstract
- The Himalaya and the Tibetan Plateau are uplifted by the ongoing northward underthrusting of the Indian continental lithosphere below Tibet resulting in lithospheric stacking. The layered structure of the Tibetan upper mantle is imaged by seismic methods, most detailed with the receiver function method. Tibet is considered as a place where the development of a future craton is currently under way. Here we study the upper mantle from Germany to northern Sweden with seismic S receiver functions and compare the structure below Scandinavia with that below Tibet. Below Proterozoic Scandinavia, we found two low-velocity zones on top of each other, separated by a high-velocity zone. The top of the upper low-velocity zone at about 100 km depth extends from Germany to Archaean northern Sweden. It agrees with the lithosphere-asthenosphere boundary (LAB) below Germany and Denmark. Below Sweden it is known as the 8 degrees discontinuity, or as a mid-lithospheric discontinuity (MLD), similar to observations in North America. Seismic tomography places the LAB near 200 km in Scandinavia, which is close to the top of our deeper low-velocity zone. We also observed the bottom of the asthenosphere (the Lehmann discontinuity) deepening from 180 km in Germany to 260 km below Sweden. Remnants of old subduction in the upper about 100 km below Scandinavia and Finland are known from controlled source seismic experiments and local earthquake studies. Recent tomographic studies indicate delamination of the lithosphere below southern Scandinavia and northern Germany. We are suggesting that the large-scale layered structure in the Scandinavian upper mantle may be caused by processes similar to the ongoing lithospheric stacking in Tibet.
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| 427. |
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| 428. |
- Kislev, T., et al.
(författare)
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On the nature of opaque cylindrical regions formed at fibre break sites in a fragmentation test
- 2002
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Ingår i: Advanced Composites Letters. - : SAGE Publications. - 0963-6935 .- 2633-366X. ; 11:1, s. 7-13
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Tidskriftsartikel (refereegranskat)abstract
- When a single-fibre composite test is performed to obtain information about the interfacial adhesion in a composite, a gradual strain increase often causes an opaque (black) cylinder to nucleate at, and grow from, the fibre failure sites. The nature of the opaque cylinder is difficult to ascertain using optical microscopy. This is the subject of the present note. To study the inside of the opaque cylinder we use several experimental methods based on imaging the failed region: optical microscopy, laser Raman spectroscopy and scanning electron microscopy. Mechanical models, including FEM analysis and analytic equations based on the shear-lag, approach, are used to discuss the experimental work. The nature and growth mechanism of the opaque cylinder are of importance in defining the parameters and/or contributions that appear in both the force balance and the. energy balance schemes.
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| 429. |
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| 430. |
- Kjaer, Susanne K., et al.
(författare)
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A Pooled Analysis of Continued Prophylactic Efficacy of Quadrivalent Human Papillomavirus (Types 6/11/16/18) Vaccine against High-grade Cervical and External Genital Lesions
- 2009
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Ingår i: Cancer Prevention Research. - 1940-6207. ; 2:10, s. 868-878
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Tidskriftsartikel (refereegranskat)abstract
- Quadrivalent human papillomavirus (HPV) vaccine has been shown to provide protection from HPV 6/11/16/18-related cervical, vaginal, and vulvar disease through 3 years. We provide an update on the efficacy of the quadrivalent HPV vaccine against high-grade cervical, vaginal, and vulvar lesions based on end-of-study data from three clinical trials. Additionally, we stratify vaccine efficacy by several baseline characteristics, including age, smoking status, and Papanicolaou (Pap) test results. A total of 18,174 females ages 16 to 26 years were randomized and allocated into one of three clinical trials (protocols 007, 013, and 015). Vaccine or placebo was given at baseline, month 2, and month 6. Pap testing was conducted at regular intervals. Cervical and anogenital swabs were collected for HPV DNA testing. Examination for the presence of vulvar and vaginal lesions was also done. Endpoints included high-grade cervical, vulvar, or vaginal lesions (CIN 2/3, VIN 2/3, or VaIN 2/3). Mean follow-up time was 42 months post dose 1. Vaccine efficacy against HPV 6/11/16/18-related high-grade cervical lesions in the per-protocol and intention-to-treat populations was 98.2% [95% confidence interval (95% CI), 93.3-99.8] and 51.5% (95% CI, 40.6-60.6), respectively. Vaccine efficacy against HPV 6/11/16/18-related high-grade vulvar and vaginal lesions in the per-protocol and intention-to-treat populations was 100.0% (95% CI, 82.6-100.0) and 79.0% (95% CI, 56.4-91.0), respectively. Efficacy in the intention-to-treat population tended to be lower in older women, women with more partners, and women with abnormal Pap test results. The efficacy of quadrivalent HPV vaccine against high-grade cervical and external anogenital neoplasia remains high through 42 months post vaccination.
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