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"Dini, Paul"
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Defibrotide for prophylaxis of hepatic veno-occlusive disease in paediatric haemopoietic stem-cell transplantation: an open-label, phase 3, randomised controlled trial
Hepatic veno-occlusive disease is a leading cause of morbidity and mortality after haemopoietic stem-cell transplantation (HSCT). We aimed to assess whether defibrotide can reduce the incidence of veno-occlusive disease in this setting.
In our phase 3 open-label, randomised controlled trial, we enrolled patients at 28 European university hospitals or academic medical centres. Eligible patients were younger than 18 years, had undergone myeloablative conditioning before allogeneic or autologous HSCT, and had one or more risk factor for veno-occlusive disease based on modified Seattle criteria. We centrally assigned eligible participants on the basis of a computer-generated randomisation sequence (1:1), stratified by centre and presence of osteopetrosis, to receive intravenous defibrotide prophylaxis (treatment group) or not (control group). The primary endpoint was incidence of veno-occlusive disease by 30 days after HSCT, adjudicated by a masked, independent review committee, in eligible patients who consented to randomisation (intention-to-treat population), and was assessed with a competing risk approach. Patients in either group who developed veno-occlusive disease received defibrotide for treatment. We assessed adverse events to 180 days after HSCT in all patients who received allocated prophylaxis. This trial is registered with ClinicalTrials.gov, number NCT00272948.
Between Jan 25, 2006, and Jan 29, 2009, we enrolled 356 eligible patients to the intention-to-treat population. 22 (12%) of 180 patients randomly allocated to the defibrotide group had veno-occlusive disease by 30 days after HSCT compared with 35 (20%) of 176 controls (risk difference −7·7%, 95% CI −15·3 to −0·1; Z test for competing risk analysis p=0·0488; log-rank test p=0·0507). 154 (87%) of 177 patients in the defibrotide group had adverse events by day 180 compared with 155 (88%) of 176 controls.
Defibrotide prophylaxis seems to reduce incidence of veno-occlusive disease and is well tolerated. Thus, such prophylaxis could present a useful clinical option for this serious complication of HSCT.
Gentium SpA, European Group for Blood and Marrow Transplantation.
Journal Article
Batman : Harley Quinn
\"Head over heels in her devotion to the Joker, Arkham psychiatrist Harleen Quinzel gave up her career (and her sanity) to transform herself into the ultimate companion for crime's clown prince-- the mad moll Harley Quinn. Of course, Harley's romance with the Joker hasn't been easy. The two are at each other's throats as often as in each other's arms, and that buzzkill Batman is always sticking his nose in just when things are starting to get fun. But what great love story is without the occasional incarceration and life-threating peril?\"--Provided by publisher.
Book
Group-Based Patterns of Life Satisfaction and Functional Independence over the 10 Years after Traumatic Brain Injury in Older Adults: A Model Systems Study
Background: Older adults who sustain a traumatic brain injury (TBI) have been shown to have reduced functional independence and life satisfaction relative to younger individuals with TBI. The purpose of this study was to examine the covarying patterns of functional independence and life satisfaction over the 10 years after TBI in adults who were 60 years of age or older upon injury. Method: Participants were 1841 individuals aged 60 or older at the time of TBI, were enrolled in the longitudinal TBI Model Systems database, and had Functional Independence Measure and Satisfaction with Life Scale scores during at least one time point at 1, 2, 5, and 10 years after TBI. Results: A k-means cluster analysis identified four distinct group-based longitudinal patterns of these two variables. Three cluster groups suggested that functional independence and life satisfaction generally traveled together over time, with one group showing relatively high functional independence and life satisfaction over time (Cluster 2), one group showing relatively moderate functional independence and life satisfaction (Cluster 4), and one group showing relatively low functional independence and life satisfaction (Cluster 1). Cluster 3 had relatively high functional independence over time but, nonetheless, relatively low life satisfaction; they were also the youngest group upon injury. Participants in Cluster 2 generally had the highest number of weeks of paid competitive employment but lower percentages of underrepresented racial/ethnic minority participants, particularly Black and Hispanic individuals. Women were more likely to be in the cluster with the lowest life satisfaction and functional independence (Cluster 1). Conclusion: Functional independence and life satisfaction generally accompany one another over time in older adults, although this does not always occur, as life satisfaction can still be low in a subgroup of older individuals after TBI with higher functioning. These findings contribute to a better understanding of post-TBI recovery patterns in older adults over time that may inform treatment considerations to improve age-related discrepancies in rehabilitation outcomes.
Journal Article
Justice League, the world's greatest superheroes by Alex Ross & Paul Dini
\"DC Comics proudly presents the acclaimed run on Justice League from the Eisner Award-winning team of artist Alex Ross and writer Paul Dini! Between 1998 and 2003, Dini, the Emmy Award-winning producer of Batman Beyond and The New Batman/Superman Adventures, joined forces with the incomparable Ross to create six oversize tabloid editions of stories featuring the World's Greatest Super Heroes. These classic works for all ages feature the iconic DC characters in a unique storytelling format that combines aspects of both comics and picture books. Also included are several pages of promotional art, preliminary art and thumbnails, art done for DC Direct product, model-to-finished-painting comparisons, reflections by the book's creators and much more! This landmark volume also features an introduction by award-winning book designer and author Chip Kidd, and an eight-page foldout featuring an image of every JLA member by Ross.-- Provided by publisher.
Book
Microbial Enzymatic Activities and Community-Level Physiological Profiles (CLPP) in Subsoil Layers Are Altered by Harvest Residue Management Practices in a Tropical Eucalyptus grandis Plantation
Harvest residue management is a key issue for the sustainability of Eucalyptus plantations established on poor soils. Soil microbial communities contribute to soil fertility by the decomposition of the organic matter (OM), but little is known about the effect of whole-tree harvesting (WTH) in comparison to stem only harvesting (SOH) on soil microbial functional diversity in Eucalyptus plantations. We studied the effects of harvest residue management (branches, leaves, bark) of Eucalyptus grandis trees on soil enzymatic activities and community-level physiological profiles in a Brazilian plantation. We measured soil microbial enzymatic activities involved in OM decomposition and we compared the community level physiological profiles (CLPP) of the soil microbes in WTH and SOH plots. WTH decreased enzyme activities and catabolic potential of the soil microbial community. Furthermore, these negative effects on soil functional diversity were mainly observed below the 0–5 cm layer (5–10 and 10–20 cm), suggesting that WTH can be harmful to the soil health in these plantations.
Journal Article
Men of steel
Angered over Superman's destruction of his Lex Skel 5000 battle suit, Lex Luthor creates a Superman android programmed to make the real Man of Steel look bad.
Book
Barriers and facilitators to physicians’ telemedicine uptake during the beginning of the COVID-19 pandemic
Despite decades of low utilization, telemedicine adoption expanded at an unprecedented rate during the COVID-19 pandemic. This study examined quantitative and qualitative data provided by a national online sample of 228 practicing physicians (64% were women, and 75% were White) to identify facilitators and barriers to the adoption of telemedicine in the United States (U.S.) at the beginning of the COVID-19 pandemic. Logistic regressions were used to predict the most frequently endorsed (20% or more) barriers and facilitators based on participant demographics and practice characteristics. The top five reported barriers were: lack of patient access to technology (77.6%), insufficient insurance reimbursement (53.5%), diminished doctor-patient relationship (46.9%), inadequate video/audio technology (46.1%), and diminished quality of delivered care (42.1%). The top five reported facilitators were: better access to care (75.4%), increased safety (70.6%), efficient use of time (60.5%), lower cost for patients (43%), and effectiveness (28.9%). Physicians’ demographic and practice setting characteristics significantly predicted their endorsement of telemedicine barriers and facilitators. Older physicians were less likely to endorse inefficient use of time ( p < 0.001) and potential for medical errors ( p = 0.034) as barriers to telemedicine use compared to younger physicians. Physicians working in a medical center were more likely to endorse inadequate video/audio technology ( p = 0.037) and lack of patient access to technology ( p = 0.035) as a barrier and more likely to endorse lower cost for patients as a facilitator ( p = 0.041) than providers working in other settings. Male physicians were more likely to endorse inefficient use of time as a barrier ( p = 0.007) than female physicians, and White physicians were less likely to endorse lower costs for patients as a facilitator ( p = 0.012) than physicians of color. These findings provide important context for future implementation strategies for healthcare systems attempting to increase telemedicine utilization.
Journal Article
Scooby-Doo! Team-up. Volume 2
\"Is Titans Tower haunted?! Robin calls in some experts--but when will Scooby, Shaggy, Cyborg, and Beast Boy stop chowing down on pizza and start looking for clues?\"-- Provided by publisher.
Book
How deep can ectomycorrhizas go? A case study on Pisolithus down to 4 meters in a Brazilian eucalypt plantation
Despite the strong ecological importance of ectomycorrhizal (ECM) fungi, their vertical distribution remains poorly understood. To our knowledge, ECM structures associated with trees have never been reported in depths below 2 meters. In this study, fine roots and ECM root tips were sampled down to 4-m depth during the digging of two independent pits differing by their water availability. A meta-barcoding approach based on Illumina sequencing of internal transcribed spacers (ITS1 and ITS2) was carried out on DNA extracted from root samples (fine roots and ECM root tips separately). ECM fungi dominated the root-associated fungal community, with more than 90% of sequences assigned to the genus Pisolithus. The morphological and barcoding results demonstrated, for the first time, the presence of ECM symbiosis down to 4-m. The molecular diversity of Pisolithus spp. was strongly dependent on depth, with soil pH and soil water content as primary drivers of the Pisolithus spp. structure. Altogether, our results highlight the importance to consider the ECM symbiosis in deep soil layers to improve our understanding of fine roots functioning in tropical soils.
Journal Article