Opportunity: First 90 days on Mars

In this work, the effect of microfibrillated cellulose (MFC) and cellulose nanocrystals (CNCs) on the biodegradation, under composting conditions, of hierarchical PLA biocomposites (HBCs) was studied using a full 22 factorial experimental design. The HBCs were prepared by extrusion processing and were composted for 180 days. At certain time intervals, the specimens were removed from the compost for their chemical, thermal and morphological characterizations. An ANOVA analysis was carried out at different composting times to study MFC and CNCs’ effects on biodegradation. The specimen’s mass loss and molecular weight loss were selected as independent variables. The results show that the presence of MFC enhances the PLA biodegradation, while with CNCs it decreases. However, when both cellulosic fibers are present, a synergistic effect was evident—i.e., in the presence of the MFC, the inclusion of the CNCs accelerates the HBCs biodegradation. Analysis of the ANOVA results confirms the relevance of the synergistic role between both cellulosic fibers over the HBC biodegradation under composting conditions. The results also suggest that during the first 90 days of incubation, the hydrolytic PLA degradation prevails, whereas, beyond that, the enzymatic microbial biodegradation dominates. The SEM results show MFC’s presence enhances the surface biodeterioration to a greater extent than the CNCs and that their simultaneous presence enhances PLA biodegradation. The SEM results also indicate that the biodegradation process begins from hydrophilic cellulosic fibers and promotes PLA biodegradation.

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Driving Restrictions and Early Arrhythmias in Patients Receiving a Secondary Prevention Implantable Cardioverter-Defibrillator (DREAM-ICD-II study)

Circulation ◽

10.1161/circulationaha.121.056471 ◽

2021 ◽

Author(s):

Christian Steinberg ◽

Nicolas Dognin ◽

Amit Sodhi ◽

Catherine Champagne ◽

John A. Staples ◽

...

Keyword(s):

Secondary Prevention ◽

Incidence Rate ◽

Cardiac Event ◽

Tertiary Care ◽

Industrialized Countries ◽

Cardioverter Defibrillator ◽

Driving Restrictions ◽

Tertiary Care Centers ◽

First 90 Days ◽

Over Time

Background: Regulatory authorities of most industrialized countries recommend 6-months of private driving restriction after implantation of a secondary prevention ICD. These driving restrictions result in significant inconvenience and social implications. The purpose of this study was to assess the incidence rate of appropriate device therapies in contemporary recipients of a secondary prevention ICD. Methods: A retrospective study at three Canadian tertiary care centers enrolling consecutive patients with new secondary prevention ICD implants between 2016-2020. Results: 721 patients were followed for a median of 760 days (324, 1190). The risk of recurrent ventricular arrhythmia was highest during the first three months after device insertion (34.4%), and decreased over time (10.6% between 3−6 months, 11.7% between 6-12 months). The corresponding incidence rate per 100 patient-days was 0.48 (95% CI 0.35-0.64) at 90 days, 0.28 (95% CI 0.18−0.48) at 180 days and 0.20 (95% CI 0.13−0.31) between 181-365 days after ICD insertion (p<0.001). The cumulative incidence of arrhythmic syncope resulting in sudden cardiac incapacitation was 1.8% within the first 90 days and subsequently dropped to 0.4% between 91-180 days (p<0.001) after ICD insertion. Conclusions: The incidence rate of appropriate therapies resulting in sudden cardiac incapacitation in contemporary recipients of a secondary prevention ICD is much lower than previously reported, and significantly declines after the first three months. Lowering driving restrictions to three months after the index cardiac event seems safe and revision of existing guidelines recommending should be considered in countries still adhering to a 6-months period. Existing restrictions for private driving after implantation of a secondary prevention ICD should be reconsidered.

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Failure to Identify Human Immunodeficiency Virus-Seropositive Newborns: Epidemiology and Enrollment Patterns in a Predominantly White, Nonurban Setting

PEDIATRICS ◽

10.1542/peds.96.6.1083 ◽

1995 ◽

Vol 96 (6) ◽

pp. 1083-1089

Author(s):

James Coplan ◽

Timothy D. Dye ◽

Kathie A. Contello ◽

Coleen K. Cunningham ◽

Kim Kirkwood ◽

...

Keyword(s):

New York ◽

Human Immunodeficiency Virus ◽

Confidence Interval ◽

Predominantly White ◽

Pediatric Aids ◽

Immunodeficiency Virus ◽

Enrollment Rates ◽

First 90 Days ◽

Onondaga County ◽

Hiv Seropositive

Objective. To describe the epidemiology of newborn seroprevalence for human immunodeficiency virus (HIV) in a predominantly white, nonurban population, and to determine the factors associated with enrollment at a regional pediatric acquired immunodeficiency syndrome (AIDS) center serving that population. Design. Retrospective case series of children enrolled at a regional pediatric AIDS center during a 6-year period and comparison with universal blind newborn screening data collected by the state of New York during the same time interval. Setting. The Pediatric AIDS Center at State University of New York-Health Science Center at Syracuse, which serves as the only source of HIV-related pediatric care for children in a 16-county region of upstate New York totaling 1.8 million population. Results. One hundred thirty-nine HIV-seropositive infants were born in the region during the 6-year study period; complete blind screening data were available for 138. Sixty-five (47%) of these infants were white. Thirty-nine (28%) of 138 had been enrolled at the Pediatric AIDS Center within the first 90 days of life. An additional 22 (16%) were enrolled at older than 90 days of life. The remaining 77 (56%) have never been seen at the center and are presumed to be unidentified. County enrollment rates varied from 0% to 100% and correlated with percent nonwhite births (r = .58; 95% confidence interval, 0.04-0.86). Children in outlying counties were at greater risk for nonenrollment than children from Onondaga County (site of the Pediatric AIDS Center) (adjusted relative risk, 1.38; 95% confidence interval, 1.05-1.85). White infants residing outside of Onondaga County were at the greatest risk of nonenrollment; of 50 seropositive white infants residing outside of Onondaga County, only 7(14%) were enrolled at the center within the first 90 days of life. Conclusions. Local demographic factors can skew the racial distribution of HIV-seropositive infants dramatically compared with the national experience. White race and residence in counties away from the medical center each constituted risk factors for nonenrollment at the Pediatric AIDS Center. The epidemiology of HIV in this predominantly white, rural population, coupled with physician practices, probably contributed to low identification and enrollment rates. As the AIDS epidemic spreads into similar populations elsewhere, HIV infection in pregnant women or newborn infants is likely to become progressively harder to detect, unless universal screening is adopted.

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Real-world trends in biosimilar prescribing among oncology providers, 2019-2021.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18701 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18701-e18701

Author(s):

Kelly A. McGlynn ◽

Jacqueline McGarry ◽

Kashyap B. Patel ◽

Natasha Clinton

Keyword(s):

Real World ◽

Reference Product ◽

The United States ◽

Prescription Data ◽

Nccn Guidelines ◽

Prescribing Behavior ◽

Product Pricing ◽

Value Based Care ◽

Oncology Providers ◽

First 90 Days

e18701 Background: The number of approved biosimilars in the United States has increased exponentially in recent years. Within the oncology market, there are currently 14 approved biosimilars, with 11 launched since the start of 2019. The emergence of new oncology biosimilars provides a tool for success in value-based care, and has the potential to lower costs to patients and providers and expand access to care. Methods: Analysis of biosimilar prescribing behavior was performed using 2020 prescription data (Wolters Kluwer, n = 130,836), sales data (IQVIA), and dosage data for patients taking bevacizumab, trastuzumab, rituximab, or an FDA-approved biosimilar for these products (FDA Purple Book), between 2019-2021 (ION Solutions, n = 69,884). Drugs not directly interchangeable with the bevacizumab, trastuzumab or rituximab reference products according to NCCN guidelines were excluded. Results: Biosimilar products are currently available for bevacizumab (2 biosimilars), rituximab (3 biosimilars), and trastuzumab (5 biosimilars). We found that in 2020, 8.2% of new prescriptions for any of these three reference products were for a biosimilar. An analysis of real-world drug administration data revealed that in the 3 months following the 2019 launch of trastuzumab’s first biosimilar (trastuzumab-anns), 7.3% of initiating line 1 patients were prescribed the biosimilar over the reference product. During the same period in 2020, when a total of 5 trastuzumab biosimilars were available, 80.5% of initiating line 1 trastuzumab patients began treatment on a biosimilar, suggesting rapid uptake by providers. However, this differed by product, with the initial uptake for the first rituximab biosimilar (rituximab-pvvr), at only 2.3%. Uptake also occurred within treatment lines, with 11.1% of all patients (bevacizumab: 11.3%, trastuzumab: 14.1%, rituximab: 7.9%) switching from a reference product to a biosimilar during treatment. Uptake was particularly rapid for trastuzumab biosimilars: among patients on trastuzumab at the time of its first biosimilar launch, 18.2% switched to trastuzumab-anns in the first 90 days post-launch. Biosimilars launched at significantly lower prices than their reference products, with cost per prescription at -42.0%, -29.9% and -89.5% relative to the reference product for trastuzumab, rituximab and bevacizumab, respectively. However, biosimilar launches had little impact on reference product pricing, with 2019-2020 year-over-year (YOY) differences in price per prescription close to the YOY averages in previous years (2015-2019) for all three reference products. Conclusions: We conclude that uptake of biosimilars among oncology providers between 2019-2020 was rapid, although the extent of biosimilar prescribing varied among products. Biosimilars offered greatly reduced costs to providers, although reference product prices remained stable despite increased biosimilar competition.

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173: Incident Management of Hemodialysis Patients: Managing the First 90 Days

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2009.01.194 ◽

2009 ◽

Vol 53 (4) ◽

pp. B66

Keyword(s):

Hemodialysis Patients ◽

Incident Management ◽

First 90 Days

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Probability of pregnancy before ninety days postpartum in water buffaloes

Archivos Latinoamericanos de Producción Animal ◽

10.53588/alpa.300104 ◽

2021 ◽

Vol 30 (1) ◽

pp. 29-34

Author(s):

Hector Nava-Trujillo ◽

Robert Valeris-Chacin ◽

Adriana Morgado-Osorio ◽

Javier Hernández ◽

Janeth Caamaño ◽

...

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Water Buffalo ◽

Mixed Effects ◽

Short Photoperiod ◽

Water Buffaloes ◽

Negative Effect ◽

Log Odds ◽

First 90 Days ◽

Long Photoperiod

This study aimed to determine the effect of parity and season of calving on the probability of water buffalo cows becoming pregnant before 90 days postpartum. A retrospective analysis of reproductive records of 1,465 water buffaloes with 3,181 pregnancies was carried out. Buffaloes were grouped according to parity in one, two, or three and more calvings. Season of calving was created with the following values: long photoperiod (March-August) and short photoperiod (September-February) and predicted probabilities from the mixed-effects logistic regression model were calculated, and a generalized linear mixed model was fitted with random intercepts to calculate the log odds of becoming pregnant ≤90 days postpartum. The probability of pregnancy ≤90 days postpartum was 0.3645, and this was lower in primiparous (0.2717) in comparison with two-calved (0.3863) and three or more calving buffaloes (0.5166). Probability of pregnancy ≤90 days postpartum increased 1.77 odds by each increase in parity. The probability of becoming pregnant ≤90 days postpartum was higher in water buffaloes calving during the short photoperiod season (0.4239 vs. 0.2474, P>0.000), and water buffaloes calving during the long photoperiod season only had 0.2645 odds to become pregnant than those calving during the short photoperiod season. The negative effect of long photoperiod was observed indifferently of parity. In conclusion, primiparity and the long photoperiod affect water buffalo cow's reproductive performance, decreasing pregnancy probability during the first 90 days postpartum.

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Ninety days convert recruits into hosts at Edwardian Group London

Human Resource Management International Digest ◽

10.1108/hrmid-03-2014-0025 ◽

2014 ◽

Vol 22 (2) ◽

pp. 15-18

Keyword(s):

Crucial Role ◽

Design Methodology ◽

Training And Development ◽

Social Implications ◽

Content Type ◽

The Future ◽

First 90 Days ◽

Practical Implications

Purpose – Describes the various approaches taken to training and development at Edwardian Group London, a group of hotels. Design/methodology/approach – Examines the reasons for the training, the form it takes and the results it has achieved. Findings – Emphasizes the importance the company attaches to training in the first 90 days of an employee's tenure, when recruits receive general induction training plus training specific to their area of operation. Practical implications – Outlines how the company spots and develops its managers of the future. Social implications – Highlights the crucial role of training in ensuring that hotel guests have the best possible stay. Originality/value – Provides a thorough examination of the various forms of training at Edwardian Group London.

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First 90 Days

The Pragmatist's Guide to Corporate Lean Strategy ◽

10.1007/978-1-4842-3537-9_8 ◽

2018 ◽

pp. 73-92

Author(s):

Michael Nir

Keyword(s):

First 90 Days

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Abstract 17244: Atrial Fibrillation is Associated With Day 90 Mortality in Patients Undergoing Bone Marrow Transplant

Circulation ◽

10.1161/circ.138.suppl_1.17244 ◽

2018 ◽

Vol 138 (Suppl_1) ◽

Author(s):

Matthew Subramani ◽

Anita D’Souza ◽

Jason Rubenstein

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Bone Marrow ◽

Bone Marrow Transplant ◽

Antiarrhythmic Drug ◽

Anticoagulation Therapy ◽

Marrow Transplant ◽

Reduced Ejection Fraction ◽

All Cause Mortality ◽

First 90 Days

Introduction: Atrial fibrillation often occurs after bone marrow transplant (BMT) and has been shown to increase hospital stay and other morbidity. Treatment can be complicated due to contraindications to anticoagulation therapy. Our objective was to describe the incidence of atrial fibrillation in patients within the first 90 days after BMT and risk predictors for overall mortality. Methods: Patients with active malignancy undergoing BMT in 2016 at the Medical College of Wisconsin were included (n=259). Medical records were reviewed for baseline patient characteristics, atrial fibrillation risk factors, incidence of atrial fibrillation, and other complications. Patients were categorized based on survival at 90 days post-BMT. Baseline characteristics and risk factors were analyzed to determine if there was an association with the development of atrial fibrillation and all cause mortality at 90 days. Results: Overall, 10.4% developed atrial fibrillation within the first 90 days after BMT. Of those that died before 90 days, 33.3% developed atrial fibrillation compared to 9.6% in those who survived (OR 4.7, 1.11-20.13 p=0.04). Those that died before 90 days were also more likely to have heart failure with reduced ejection fraction, prior radiation therapy (XRT), undergo cardioversion, and to be started on an antiarrhythmic drug (Table 1). When all significant univariate variables were included in a multivariate regression, only XRT was independently predicative of mortality (OR 11.5, 2.4-54.9, p=0.002). The development of atrial fibrillation significantly predicted early mortality (Log Rank p=0.009). Conclusion: This analysis demonstrated that the development of atrial fibrillation was predictive of early post-transplant all cause mortality. XRT and antiarrhythmic drug use also significantly predicted mortality. Further studies are required to determine if there is a mortality benefit to the prevention of atrial fibrillation in patients after BMT.

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Management of communication disability in the first 90 days after stroke: a scoping review

Disability and Rehabilitation ◽

10.1080/09638288.2021.2012843 ◽

2021 ◽

pp. 1-15

Author(s):

Caroline Baker ◽

Abby M. Foster ◽

Sarah D’Souza ◽

Erin Godecke ◽

Ciara Shiggins ◽

...

Keyword(s):

Scoping Review ◽

First 90 Days ◽

Communication Disability

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