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Fulltext AVERT2 (a very early rehabilitation trial, a very effective reproductive trigger): retrospective observational analysis of the number of babies born to trial staff

Bernhardt J, Lindley RI, Lalor E, Ellery F, Chamberlain J, Van Holsteyn J, et al.

BMJ, 2015 Dec 11;351:h6432.
PMID: 26658193 DOI: 10.1136/bmj.h6432

OBJECTIVE: To report the number of participants needed to recruit per baby born to trial staff during AVERT, a large international trial on acute stroke, and to describe trial management consequences.
DESIGN: Retrospective observational analysis.
SETTING: 56 acute stroke hospitals in eight countries.
PARTICIPANTS: 1074 trial physiotherapists, nurses, and other clinicians.
OUTCOME MEASURES: Number of babies born during trial recruitment per trial participant recruited.
RESULTS: With 198 site recruitment years and 2104 patients recruited during AVERT, 120 babies were born to trial staff. Births led to an estimated 10% loss in time to achieve recruitment. Parental leave was linked to six trial site closures. The number of participants needed to recruit per baby born was 17.5 (95% confidence interval 14.7 to 21.0); additional trial costs associated with each birth were estimated at 5736 Australian dollars on average.
CONCLUSION: The staff absences registered in AVERT owing to parental leave led to delayed trial recruitment and increased costs, and should be considered by trial investigators when planning research and estimating budgets. However, the celebration of new life became a highlight of the annual AVERT collaborators' meetings and helped maintain a cohesive collaborative group.
TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry no 12606000185561.
DISCLAIMER: Participation in a rehabilitation trial does not guarantee successful reproductive activity.

Matched MeSH terms: Patient Selection
Fulltext Exploring threats to generalisability in a large international rehabilitation trial (AVERT)

Bernhardt J, Raffelt A, Churilov L, Lindley RI, Speare S, Ancliffe J, et al.

BMJ Open, 2015 Aug 17;5(8):e008378.
PMID: 26283667 DOI: 10.1136/bmjopen-2015-008378

OBJECTIVE: The purpose of this paper is to examine potential threats to generalisability of the results of a multicentre randomised controlled trial using data from A Very Early Rehabilitation Trial (AVERT).
DESIGN: AVERT is a prospective, parallel group, assessor-blinded randomised clinical trial. This paper presents data assessing the generalisability of AVERT.
SETTING: Acute stroke units at 44 hospitals in 8 countries.
PARTICIPANTS: The first 20,000 patients screened for AVERT, of whom 1158 were recruited and randomised.
MODEL: We use the Proximal Similarity Model, which considers the person, place, and setting and practice, as a framework for considering generalisability. As well as comparing the recruited patients with the target population, we also performed an exploratory analysis of the demographic, clinical, site and process factors associated with recruitment.
RESULTS: The demographics and stroke characteristics of the included patients in the trial were broadly similar to population-based norms, with the exception that AVERT had a greater proportion of men. The most common reason for non-recruitment was late arrival to hospital (ie, >24 h). Overall, being older and female reduced the odds of recruitment to the trial. More women than men were excluded for most of the reasons, including refusal. The odds of exclusion due to early deterioration were particularly high for those with severe stroke (OR=10.4, p<0.001, 95% CI 9.27 to 11.65).
CONCLUSIONS: A model which explores person, place, and setting and practice factors can provide important information about the external validity of a trial, and could be applied to other clinical trials.
TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12606000185561) and Clinicaltrials.gov (NCT01846247).

Matched MeSH terms: Patient Selection*
Fulltext Doppler echocardiography guided cardiac resynchronization therapy in heart failure

Oemar, Hamed, Abdulgani, Hafil Budianto

Medical Health Reviews, 2008;2008(1):17-28.
MyJurnal

Heart failure (HF) is a major burden in almost all countries. The prevalence of symptomatic HF is still high. Despite our best understanding of its pathophysiologic mechanisms and the recent advances in pharmacologic therapy, it remains a highmortality and morbidity disease. About 30-50% of patients with HF have concurrent electrical delay in the electrocardiogram (ECG), mainly in the form of LBBB.1 This kind of conduction delay commonly occurs in patients with idiopathic dilated cardiomyopathy and ischemic cardiomyopathy as well. The abnormality of left ventricle (LV) conduction will lead to a change in LV contraction pattern resulting dyssynchronized with right ventricle) contraction. Thus, a dyssynchronous LV contractile pattern usually manifested by late activation of the LV lateral wall which in turn impairs LV systolic function, reduces cardiac output, raises filling pressure and worsens mitral regurgitation2. Cardiac resynchronization therapy (CRT) improves cardiac function and exercise capacity leading to an improved survival in patients with advanced heart failure and ventricular conduction delay.3 The underlying mechanisms of these beneficial effects are not fully understood, but they appear to be related to a restored coordination of the left (LV) and right ventricular (RV) contraction and relaxation.4 These effects may directly lead to augmented contractility and reduction of LV filling pressures.5 Echocardiography has been widely used to identify patients who are candidates for CRT and to monitor the response in LV function at follow-up after device implantation. This review addresses the applications of CRT in patients with moderate– severe heart failure and the role of echocardiography in optimizing CRT including patient selection, risk and benefit of CRT and appropriate measures.

Matched MeSH terms: Patient Selection
The use of magnetic resonance phase-contrast cine in Chiari malformation with syringomyelia

Goh CH, Hamzah MR, Kandasamy R, Ghani ARI, Wong SH, Idris Z, et al.

Med J Malaysia, 2020 11;75(6):666-671.
PMID: 33219175

INTRODUCTION: Chiari malformation (CM) is a disorder of mesodermal origin and is commonly associated with syringomyelia. Foramen magnum decompression is the first-line of standard treatment in symptomatic patients with a confirmed radiographic diagnosis. Magnetic resonance (MR) cine allows accurate evaluation of cerebrospinal fluid (CSF) physiology at the craniovertebral junction but often this is under-utilised in Malaysia.
METHODS: In this series, we looked into nine cases of CM with syringomyelia from clinical and radiological perspective before and after surgery. The radiological parameters were herniated tonsillar length, syrinx: cord ratio, syrinx length and diameter. Flow velocity and morphologic changes in Chiari were illustrated.
RESULTS: Seven patients showed either reduction in syrinx length, syrinx: cord ratio or both postoperatively. Clinical recovery somewhat varied in motor and sensory symptoms. Four patients gained better functional grade in modified Rankin scale (MRS) while the rest remained similar. The study highlighted the advantage of CSF flow dynamics information over MR anatomical radiographic improvement in addressing the neurologic and functional recovery. We also discussed the practicality of cine sequence in preoperative patient selection, syrinx analysis and postoperative flow evaluation in anticipation of clinical outcome.
CONCLUSION: Phase-contrast cine MRI is a useful tool dictated by resource availability. We recommend its routine use in preoperative analysis and subsequent observational follow-up after surgery.

Matched MeSH terms: Patient Selection
A reappraisal of thyroid surgery under local anaesthesia: back to the future?

Hisham AN, Aina EN

ANZ J Surg, 2002 Apr;72(4):287-9.
PMID: 11982518 DOI: 10.1046/j.1445-2197.2002.02372.x

BACKGROUND: Thyroid surgery is usually performed under general anaesthesia. However, for a selected group of patients, local anaesthesia may be preferable. The aim of this study was to review the authors' experiences with local anaesthesia with regard to the safety and outcome of this approach.
METHODS: A total of 65 consecutive patients who underwent primary thyroid surgery were accrued prospectively into this study from May to December 1999. A field block with 0.5% bupivacaine and adrenaline in 1:200 000 dilutions was given in all cases. In addition, light sedative and narcotics were given as necessary to achieve patient comfort and cooperation. The pain experienced during surgery was recorded using a visual analogue scoring system on a scale of 1-10.
RESULTS: Unilateral thyroid resection was performed in 58 patients, isthmectomy in four patients and bilateral thyroid resection in three patients, two of which were in their second trimester of pregnancy diagnosed with papillary thyroid cancer. There were 55 women and 10 men with an average age of 38.2 years (range: 18-67 years). No conversion to general anaesthetic was needed, and the mean operating time was 80 min. The postoperative recovery was quick with this technique and, of interest, 22 (33.9%) patients were discharged within 6 h following the surgery. Overall 62 (95.4%) patients were discharged in the first 24 h and three (4.6%) patients after 24 h. There were no significant postoperative complications encountered except for wound infection in two (3.1%) patients.
CONCLUSIONS: Thyroid surgery under local anaesthesia can be performed safely in a selected group of patients. It offers an effective alternative approach to general anaesthesia and is associated with low morbidity and high levels of patient satisfaction.

Matched MeSH terms: Patient Selection
Fulltext Efficient model selection of collector efficiency in solar dryer using hybrid of LASSO and robust regression

Javaid, Anam, Mohd. Tahir Ismail, Ali, Majid Khan Majahar

Pertanika Journal of Science & Technology, 2020;28(1):193-210.
MyJurnal

There are many variables involved in the real life problem so it is difficult to choose an efficient model out of all possible models relating to analytical factors. Interaction terms affecting the model also need to be addressed because of its vital role in the actual dataset. The current study focused on efficient model selection for collector efficiency of solar dryer. For this purpose, collector efficiency of solar dryer was used as a dependent variable with time, inlet temperature, collector average temperature and solar radiation as independent variables. Hybrid of the least absolute shrinkage and selection operator (LASSO) and robust regression were proposed for the identification of efficient model selection. The comparison was made with the ordinary least square (OLS) after performing a multicollinearity and coefficient test and with a ridge regression analysis. The final selected model was obtained using eight selection criteria (8SC). To forecast the efficient model, the mean absolute percentage error (MAPE) was used. As compared to other methods, the proposed method provides a more efficient model with minimum MAPE.

Matched MeSH terms: Patient Selection
The effectiveness of combined tonsillectomy and anterior palatoplasty in the treatment of snoring and obstructive sleep apnoea (OSA)

Adzreil B, Wong EHC, Saraiza AB, Raman R, Amin J

Eur Arch Otorhinolaryngol, 2017 Apr;274(4):2005-2011.
PMID: 27838741 DOI: 10.1007/s00405-016-4382-x

The prevalence of obstructive sleep apnoea (OSA) is increasing due to a rising rate of obesity. Multiple surgical techniques used to address obstruction at the palatal level have been associated with significant morbidities. Few studies have reported good outcomes of anterior palatoplasty (AP) in mild-to-moderate OSA. The aim of this study is to investigate the effectiveness of combining tonsillectomy and anterior palatoplasty in the treatment of snoring and OSA. All patients with snoring and OSA treated with tonsillectomy and anterior palatoplasty were analyzed. The primary outcome was reduction of the apnoea hypopnoea index (AHI) with surgical success criteria; reduction of AHI by ≥50% and AHI ≤10. The secondary outcomes measured were patients' Epworth Sleepiness Scale (ESS) and snoring visual analogue scale (VAS) scores. Thirty one patients completed the study, where 19% had mild, 42% moderate, and 39% had severe OSA. The mean surgical success rate was 45% at 3 months and 32% at 1-year post-operatively. There was a significant reduction of ESS and VAS at 3 months and 1-year post-operatively (p patients (mild-to-moderate OSA with mainly retropalatal obstruction). The surgical success was found to reduce with time, and BMI optimization should be emphasized as part of post-operative care.

Matched MeSH terms: Patient Selection
Best practices on immunomodulators and biologic agents for ulcerative colitis and Crohn's disease in Asia

Ooi CJ, Hilmi I, Banerjee R, Chuah SW, Ng SC, Wei SC, et al.

J Gastroenterol Hepatol, 2019 Aug;34(8):1296-1315.
PMID: 30848854 DOI: 10.1111/jgh.14648

The Asia-Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, under the auspices of the Asia-Pacific Association of Gastroenterology with the goal of improving inflammatory bowel disease care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in conjunction with conventional treatments for ulcerative colitis and Crohn's disease in Asia. These statements also address how pharmacogenetics influences the treatments of ulcerative colitis and Crohn's disease and provides guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of inflammatory bowel disease workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing, and future revisions are likely as new data continue to emerge.

Matched MeSH terms: Patient Selection
SIRveNIB: Selective Internal Radiation Therapy Versus Sorafenib in Asia-Pacific Patients With Hepatocellular Carcinoma

Chow PKH, Gandhi M, Tan SB, Khin MW, Khasbazar A, Ong J, et al.

J Clin Oncol, 2018 07 01;36(19):1913-1921.
PMID: 29498924 DOI: 10.1200/JCO.2017.76.0892

Purpose Selective internal radiation therapy or radioembolization (RE) shows efficacy in unresectable hepatocellular carcinoma (HCC) limited to the liver. This study compared the safety and efficacy of RE and sorafenib in patients with locally advanced HCC. Patients and Methods SIRveNIB (selective internal radiation therapy v sorafenib), an open-label, investigator-initiated, phase III trial, compared yttrium-90 (90Y) resin microspheres RE with sorafenib 800 mg/d in patients with locally advanced HCC in a two-tailed study designed for superiority/detriment. Patients were randomly assigned 1:1 and stratified by center and presence of portal vein thrombosis. Primary end point was overall survival (OS). Efficacy analyses were performed in the intention-to-treat population and safety analyses in the treated population. Results A total of 360 patients were randomly assigned (RE, 182; sorafenib, 178) from 11 countries in the Asia-Pacific region. In the RE and sorafenib groups, 28.6% and 9.0%, respectively, failed to receive assigned therapy without significant cross-over to either group. Median OS was 8.8 and 10.0 months with RE and sorafenib, respectively (hazard ratio, 1.1; 95% CI, 0.9 to 1.4; P = .36). A total of 1,468 treatment-emergent adverse events (AEs) were reported (RE, 437; sorafenib, 1,031). Significantly fewer patients in the RE than sorafenib group had grade ≥ 3 AEs (36 of 130 [27.7%]) v 82 of 162 [50.6%]; P < .001). The most common grade ≥ 3 AEs were ascites (five of 130 [3.8%] v four of 162 [2.5%] patients), abdominal pain (three [2.3%] v two [1.2%] patients), anemia (zero v four [2.5%] patients), and radiation hepatitis (two [1.5%] v zero [0%] patients). Fewer patients in the RE group (27 of 130 [20.8%]) than in the sorafenib group (57 of 162 [35.2%]) had serious AEs. Conclusion In patients with locally advanced HCC, OS did not differ significantly between RE and sorafenib. The improved toxicity profile of RE may inform treatment choice in selected patients.

Matched MeSH terms: Patient Selection
Fulltext Effect of curcumin dose, treatment duration and intervention type on tumor inhibition in animal models: a systematic literature review using meta-analysis techniques

Arina Nasruddin, Azura Amid

Biological and Natural Resources Engineering Journal, 2019;2(2):1-12.
MyJurnal

Curcuma longa L. uses widely as a traditional medicine especially in India and China for the treatment of diabetic wounds, inflammatory, hepatic, and digestive disorders. These effects lead to the research of this plant for the treatment of chronic diseases. To assess the tumour inhibition effect of curcumin in animal models by integrating various studies into a systematic literature review (SLR) and meta-analysis. Studies of curcumin treatment in tumor-induced animal models were searched in electronic databases. The assessment of the quality of the studies included and the tumor inhibition effect used SYRCLE’s Risk of Bias tool and Review Manager (The Cochrane Collaboration) software. From the 732 articles identified, only 11 studies met the selection criteria and included in the analysis. Curcumin significantly inhibited the tumor volume in the animal models in overall, and the subgroup analyses revealed that high dose, long-duration curcumin treatment, and intervention by injection have a more significant effect compared to the opposite group. Curcumin was effective in inhibiting tumor volume in animal models. The study quality and heterogeneity of the meta-analysis can probably be improved if a larger-scale bases of animal models and a well-designed study were available

Matched MeSH terms: Patient Selection
Fulltext Contemporary surgical management of advanced end stage emphysema: an evidence based review

Sachithanandan A, Badmanaban B

Med J Malaysia, 2012 Jun;67(3):253-8.
PMID: 23082412 MyJurnal

Emphysema is a progressive unrelenting component of chronic obstructive pulmonary disease and a major source of mortality and morbidity globally. The prevalence of moderate to severe emphysema is approximately 5% in Malaysia and likely to increase in the future. Hence advanced emphysema will emerge as a leading cause of hospital admission and a major consumer of healthcare resources in this country in the future. Patients with advanced disease have a poor quality of life and reduced survival. Medical therapy has been largely ineffective for many patients however certain subgroups have disease amenable to surgical palliation. Effective surgical therapies include lung volume reduction surgery, lung transplantation and bullectomy. This article is a comprehensive evidence based review of the literature evaluating the rationale, efficacy, safety and limitations of surgery for advanced emphysema highlighting the importance of meticulous patient selection and local factors relevant to Malaysia.

Matched MeSH terms: Patient Selection
Fulltext Post pneumonectomy bronchopleural fistula: is it the closure technique or the operative side that really matters?

Sachithanandan A, Badmanaban B

Interact Cardiovasc Thorac Surg, 2011 Apr;12(4):562.
PMID: 21429878 DOI: 10.1510/icvts.2010.251157B
Matched MeSH terms: Patient Selection
Fulltext eComment: Two- or three-dimensional echocardiography: an important diagnostic and prognostic tool in patients with large central pulmonary embolism

Sachithanandan A, Badmanaban B

Interact Cardiovasc Thorac Surg, 2011 May;12(5):841-2.
PMID: 21555445 DOI: 10.1510/icvts.2010.257188A
Matched MeSH terms: Patient Selection
Fulltext eComment: Debridement for empyema: an alternative to decortication but in whom and when?

Sachithanandan A, Badmanaban B

Interact Cardiovasc Thorac Surg, 2011 May;12(5):727.
PMID: 21555437 DOI: 10.1510/icvts.2010.247619A
Matched MeSH terms: Patient Selection
Current status in decision making to treat acute type A dissection: limited versus extended repair

Velayudhan BV, Idhrees M, Matalanis G, Park KH, Tang D, Sfeir PM, et al.

J Cardiovasc Surg (Torino), 2020 Jun;61(3):285-291.
PMID: 32337940 DOI: 10.23736/S0021-9509.20.11397-1

Acute type A aortic dissection remains one of the most challenging conditions in aortic surgery. Despite the advancements in the field, the mortality rate still remains high. Though there is a general consensus that the ascending aorta should be replaced, the distal extension of the surgery still remains a controversy. Few surgeons argue for a conservative approach to reduce operative and postoperative morbidity while others considering the problems associated with "downstream problems" support an aggressive approach including a frozen elephant trunk. The cohort in the Indian subcontinent and APAC is far different from the western world. Many factors determine the decision for surgery apart from the pathology of the disease. Economy, availability of the suitable prosthesis, the experience of the surgeon, ease of access to the medical facility all contribute to the decision making to treat acute type A dissection.

Matched MeSH terms: Patient Selection
Fulltext Diabetic Foot Management: How Could a Procedural Pathway Improve the Surgical Outcome?

Belgaid V, Courtin C, Desmarchelier R, Fessy M, Besse JL

Malays Orthop J, 2020 Nov;14(3):82-89.
PMID: 33403066 DOI: 10.5704/MOJ.2011.013

Introduction: Diabetic foot ulcer is the main aetiology for non-traumatic amputation, which is a major public health care concern. A multidisciplinary approach in the management of this pathology has been shown to improve the surgical outcome. However, there are little data available on the tools we can use to pursue this multidisciplinary approach. The main goal of this cross-sectional study was to find out whether the implementation of a specific management pathway could improve the treatment outcome in the treatment of diabetic foot.
Materials and Methods: From 2012 to 2014, we consecutively recruited patients with diabetic foot referred to Orthopaedic surgery department of our university for surgical opinion. A specific diabetic foot pathway was introduced in 2013. One group of patients who were treated with previous method were evaluated retrospectively. Another group of patients who were treated after implementation of the pathway were evaluated prospectively. We compared treatment outcome between the two groups.
Results: We included 51 patients. Amputation rate was similar both the groups: 74% in the retrospective group not using the new pathway versus 73% in a prospective group that used the new pathway. Revision surgery was 39% in the retrospective group and 14% in the prospective group (p=0.05).
Conclusion: We recommend the use of this simple and cost-effective pathway to guide the interdisciplinary management of diabetic foot. A prospective study with more subjects would provide a better overview of this management pathway.

Matched MeSH terms: Patient Selection
Fulltext A cost-effectiveness comparison of the NICE 2015 and WHO 2013 diagnostic criteria for women with gestational diabetes with and without risk factors

Jacklin PB, Maresh MJ, Patterson CC, Stanley KP, Dornhorst A, Burman-Roy S, et al.

BMJ Open, 2017 Aug 11;7(8):e016621.
PMID: 28801424 DOI: 10.1136/bmjopen-2017-016621

OBJECTIVES: To compare the cost-effectiveness (CE) of the National Institute for Health and Care Excellence (NICE) 2015 and the WHO 2013 diagnostic thresholds for gestational diabetes mellitus (GDM).
SETTING: The analysis was from the perspective of the National Health Service in England and Wales.
PARTICIPANTS: 6221 patients from four of the Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study centres (two UK, two Australian), 6308 patients from the Atlantic Diabetes in Pregnancy study and 12 755 patients from UK clinical practice.
PRIMARY AND SECONDARY OUTCOME MEASURES PLANNED: The incremental cost per quality-adjusted life year (QALY), net monetary benefit (NMB) and the probability of being cost-effective at CE thresholds of £20 000 and £30 000 per QALY.
RESULTS: In a population of pregnant women from the four HAPO study centres and using NICE-defined risk factors for GDM, diagnosing GDM using NICE 2015 criteria had an NMB of £239 902 (relative to no treatment) at a CE threshold of £30 000 per QALY compared with WHO 2013 criteria, which had an NMB of £186 675. NICE 2015 criteria had a 51.5% probability of being cost-effective compared with the WHO 2013 diagnostic criteria, which had a 27.6% probability of being cost-effective (no treatment had a 21.0% probability of being cost-effective). For women without NICE risk factors in this population, the NMBs for NICE 2015 and WHO 2013 criteria were both negative relative to no treatment and no treatment had a 78.1% probability of being cost-effective.
CONCLUSION: The NICE 2015 diagnostic criteria for GDM can be considered cost-effective relative to the WHO 2013 alternative at a CE threshold of £30 000 per QALY. Universal screening for GDM was not found to be cost-effective relative to screening based on NICE risk factors.

Matched MeSH terms: Patient Selection*
Liver transplantation in children

Boey CC

Med J Malaysia, 2005 Jul;60 Suppl B:90-3.
PMID: 16108184
Matched MeSH terms: Patient Selection
Eight weeks of ledipasvir/sofosbuvir is effective for selected patients with genotype 1 hepatitis C virus infection

Kowdley KV, Sundaram V, Jeon CY, Qureshi K, Latt NL, Sahota A, et al.

Hepatology, 2017 04;65(4):1094-1103.
PMID: 28027579 DOI: 10.1002/hep.29005

Eight weeks duration of ledipasvir/sofosbuvir (LDV/SOF) can be considered in genotype 1 hepatitis C virus-infected patients who are treatment-naive, do not have cirrhosis, and have a pretreatment viral load <6,000,000 IU/mL. The effectiveness of this regimen, however, has not been fully confirmed by real-world experience. Using data from real-world cohorts, we aimed to determine the effectiveness of 8 weeks of LDV/SOF treatment, examine variables associated with relapse after treatment with this regimen, and compare the effectiveness of 8 weeks and 12 weeks of LDV/SOF treatment. To evaluate the effectiveness of 8 weeks of therapy and characteristics associated with relapse, we used individual patient data from the IFI (Institut für Interdisziplinäre Medizin), Burman's Pharmacy, and Kaiser Permanente Southern California. All patients had fibrosis staging assessed with biopsy, transient elastography, or serum biomarkers. We also performed a systematic review and meta-analysis of six additional real-world cohorts, to compare effectiveness of 8 weeks to 12 weeks duration. In our pooled data analysis, 634 patients were treated for 8 weeks with LDV/SOF, of whom all had outcomes of cure or relapse without loss to follow-up. Per protocol rates of sustained virologic response at 12 weeks were 98.1% (622/634) in the full cohort and 97.9% (571/583) among treatment-eligible patients. Exact logistic regression revealed no specific patient characteristics associated with relapse. Our meta-analysis of six additional real-world cohorts, comprised of 5,637 patients, demonstrated similar risk for relapse between 8 weeks and 12 weeks of LDV/SOF (relative risk = 0.99, 95% confidence interval 0.98-1.00).
CONCLUSION: An 8-week duration of treatment with LDV/SOF is highly effective in properly selected patients; greater use of this regimen is recommended. (Hepatology 2017;65:1094-1103).

Matched MeSH terms: Patient Selection
Search for Evidence of the Type-III Seesaw Mechanism in Multilepton Final States in Proton-Proton Collisions at sqrt[s]=13 TeV

Sirunyan AM, Tumasyan A, Adam W, Ambrogi F, Asilar E, Bergauer T, et al.

Phys Rev Lett, 2017 Dec 01;119(22):221802.
PMID: 29286783 DOI: 10.1103/PhysRevLett.119.221802

A search for a signal consistent with the type-III seesaw mechanism in events with three or more electrons or muons is presented. The data sample consists of proton-proton collisions at sqrt[s]=13 TeV collected by the CMS experiment at the LHC in 2016 and corresponds to an integrated luminosity of 35.9 fb^{-1}. Selection criteria based on the number of leptons and the invariant mass of oppositely charged lepton pairs are used to distinguish the signal from the standard model background. The observations are consistent with the expectations from standard model processes. The results are used to place limits on the production of heavy fermions of the type-III seesaw model as a function of the branching ratio to each lepton flavor. In the scenario of equal branching fractions to each lepton flavor, heavy fermions with masses below 840 GeV are excluded. This is the most sensitive probe to date of the type-III seesaw mechanism.

Matched MeSH terms: Patient Selection

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