scholarly journals Blood Supply Management Amidst COVID -19 Pandemic

2022 ◽  
Author(s):  
KIRTI DEVGAN ◽  
Subrat Gupta ◽  
VIJAY SHARMA
Keyword(s):  
Phase I ◽  
Blood Supply ◽  
Phase Ii ◽  
Whole Blood ◽  
Blood Donation ◽  
Supply Management ◽  
Phase Iii ◽  
Mass Gatherings ◽  
Second Wave ◽  
Phase Iv

Abstract AIMS AND OBJECTIVES: The mandatory lockdown restrictions and curtailment strategies towards mass gatherings imposed by the government amid the COVID-19 outbreak, the organization of the voluntary blood donation camps were suspended and in house donations were limited leading to scarcity of blood With this we intend to assess the effect of this mass lockdown on our blood supply management in four phases [phase-I prior to the outbreak] ,phase-II[during the outbreak], Phase-III: The declining phase [Oct20-Feb21] and Phase IV: The second wave [March21-may21] MATERIALS AND METHOD : This is a retrospective study of twenty months of a blood bank supplying to a 1200 bedded multi-specialty Tertiary Care Academic Hospital in Lucknow. The study was divided into four phases namely: • Phase-I: Pre-pandemic phase [Oct’19 to Feb’20] • Phase-II: The full-blown pandemic phase [Mar 20-Sep 20] • Phase-III: The declining phase [Oct20-Feb21] • Phase IV: The second wave [March21-may21] Details of the blood units collected both in-house as well as in the VBDC’s were used for the study. The date of collection, expiry and date of issue for each packed red blood cell [PRBC] units were noted. The components prepared from the whole blood was also noted. The average In-house donations were tabulated. The various components issued month wise was also noted. The supply of Convalescent plasma in all the three phases was tabulate RESULT: The average whole blood collection pre pandemic was 1103 units (55%), 768units (51%) in pandemic phase, 1219units (61%) in declining phase and only 692units (21%) in second wave of the pandemic. In Phase I 27 VBDC collected 1153 units (58%) and in Phase III 8 VBDC collected 236units(12%) Due to restrictions in mass gatherings and lockdown enforced, the whole blood collections from Phase II and Phase IV was 93units (6.5%) and 76units (2.2%) only. In Phase I, the average In House Donation was 33.6%, In Phase II it was12%, In Phase III was 5.75% and lastly in Phase IV was 5.4% The PRBC issued on an average in the four phases was 59%, 48%, 55% and 26% respectively. Similarly the FFP issued in Phase I , II, III and IV was 62%,34%,58% and 20%. Lastly the RDP issued was 15%, 13%, 19% and 4.5% in all the various phases. CONCLUSION: Our study concluded that COVID 19 pandemic had a negative impact on total number of In-house donations, voluntary blood donation camps, blood stock inventory and transfusion recipients along with taking a major toll on health and safety of our blood bank staff as well. With little insight of the disease and everyday learning, by motivating more voluntary donors and health care workers the efficient chain of blood supply and demand can be maintained as the virus is to stay with us for a long time.

scholarly journals Hemispheric Brain Dominance and Mathematics Performance of Western Visayas College of Science and Technology Students – Phase IV

2015 ◽  
Vol 2 ◽  
pp. 111-119 ◽  
Author(s):  
Belinda M. Go ◽  
Doly Joy C. Celindro
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Mathematics Performance ◽  
Phase Iii ◽  
Brain Dominance ◽  
Brain Hemisphere ◽  
Bachelor Of Science ◽  
Left Brain ◽  
Right Brain ◽  
Phase Iv

This is the last phase of a four-year study which aimed to determine the significance of the difference in the mathematics (math) performance of the participants when grouped according to their hemispheric dominance (HD). The study was anchored in the Split-Brain or Lateralization Theory of Roger Wolcott Sperry which states that the brain is divided into two hemispheres, the left, and the right hemisphere. The participants were eighty-eight (88) fourth-year college students from the courses of Bachelor of Science in Mathematics (BSM), Bachelor of Science in Education major in Mathematics (BSEd), Bachelor of Science in Electrical Engineering (BSEE), Bachelor of Science in Electronics and Communication Engineering (BSECE), and Bachelor of Science in Mechanical Engineering major in Automotive Engineering (BSMEAE) at Western Visayas College of Science and Technology SY 2014-2015. The participants’ HD was determined by the use of a researcher-made 46-item Hemispheric Brain Dominance Test while their mathematics performance was based on their Math classes average final grades. The statistical tools used were the mean, standard deviation, Mann-Whitney, Kruskal-Wallis, and Post hoc tests. The hypothesis was set at the 0.05 alpha level. As an entire group, the left brain was the dominant brain hemisphere among the participants from phase I to phase IV. When the participants were grouped according to program in phase I, the BSM, BSEd, and BSMEAE was left-brain dominant while the BSEE participants were right-brain dominant. The BSECE had an equal number of left-brained and right-brained participants. In phase II, the dominant brain hemisphere was the left brain. Only the BSEE participants were right-brain dominant. In phase III, the dominant brain hemisphere was the left brain, except for the BSMEAE where there was an equal number of left-brained and right-brained participants. In phase IV, all participants from the different programs were left-brained. Only the BSEE participants were right-brain dominant. As an entire group, phase I and II participants had “fair” mathematics performance; phase III had “good” mathematics performance, and phase IV had “very good” mathematics performance. When the participants who were right-brained were grouped according to mathematics performance, phase I had “conditional” mathematics performance; phase II and III had “fair” mathematics performance; and phase IV had “good” mathematics performance. Those who were left-brain dominant had “fair” mathematics performance in phase I, “good” mathematics performance in phase II and III, and “very good” mathematics performance in phase IV. In all phases of the study, significant differences existed in the level of mathematics performance when the participants were grouped according to their hemispheric brain dominance. The “left-brained” performed better in mathematics than the “right-brained”. There was a significant decrease in the enrolment of participants who were right-brain dominant because they shifted to other courses or they transferred to other schools. In phases, I, II and III, significant differences existed in the level of mathematics performance when the participants were grouped according to their program. There is no significant difference in the hemispheric brain dominance of the participants when grouped according to the phase of the study. This implies that the slight changes in the hemispheric brain dominance of the participants were not significant in the last four years.

scholarly journals The four phases of esophageal bolus transit defined by high-resolution impedance manometry and fluoroscopy

2014 ◽  
Vol 307 (4) ◽  
pp. G437-G444 ◽  
Author(s):  
Zhiyue Lin ◽  
Brandon Yim ◽  
Andrew Gawron ◽  
Hala Imam ◽  
Peter J. Kahrilas ◽  
...  
Keyword(s):  
High Resolution ◽  
Phase I ◽  
Phase Ii ◽  
Intrathoracic Pressure ◽  
Phase Iii ◽  
Esophageal Disease ◽  
Esophageal Wall ◽  
Slow Increase ◽  
Bolus Transit ◽  
Phase Iv

We aimed to model esophageal bolus transit based on esophageal pressure topography (EPT) landmarks, concurrent intrabolus pressure (IBP), and esophageal diameter as defined with fluoroscopy. Ten healthy subjects were studied with high-resolution impedance manometry and videofluoroscopy. Data from four 5-ml barium swallows (2 upright, 2 supine) in each subject were analyzed. EPT landmarks were utilized to divide bolus transit into four phases: phase I, upper esophageal sphincter (UES) opening; phase II, UES closure to the transition zone (TZ); phase III, TZ to contractile deceleration point (CDP); and phase IV, CDP to completion of bolus emptying. IBP and esophageal diameter were analyzed to define functional differences among phases. IBP exhibited distinct changes during the four phases of bolus transit. Phase I was associated with filling via passive dilatation of the esophagus and IBP reflective of intrathoracic pressure. Phase II was associated with auxotonic relaxation and compartmentalization of the bolus distal to the TZ. During phase III, IBP exhibited a slow increase with loss of volume related to peristalsis (auxotonic contraction) and passive dilatation in the distal esophagus. Phase IV was associated with the highest IBP and exhibited isometric contraction during periods of nonemptying and auxotonic contraction during emptying. IBP may be used as a marker of esophageal wall state during the four phases of esophageal bolus transit. Thus abnormalities in IBP may identify subtypes of esophageal disease attributable to abnormal distensibility or neuromuscular dysfunction.

Praxisempfehlungen für psychologische Interventionen in der neurologischen Rehabilitation: Multiple Sklerose, Idiopathisches Parkinson-Syndrom und Schlaganfall

2019 ◽  
Vol 30 (1) ◽  
pp. 45-47 ◽  
Author(s):  
Hanna Kampling ◽  
Jutta Küst ◽  
Niels Allert ◽  
Christian Dettmers ◽  
Oskar Mittag
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Multiple Sklerose ◽  
Phase Iii ◽  
Interdisziplinäre Behandlung ◽  
Neurologische Rehabilitation ◽  
Psychologische Interventionen ◽  
Diagnostik Und Therapie ◽  
Diagnostik Therapie ◽  
Phase Iv

Zusammenfassung. Hintergrund: Patienten mit neurologischen Erkrankungen sehen sich mit einer Vielzahl motorischer und nicht-motorischer Problemlagen konfrontiert, die eine umfassende interdisziplinäre Behandlung erfordern. Hier greift die neurologische Rehabilitation. Psychologisch fundierte Interventionen bilden dabei einen wesentlichen Baustein der multimodalen und interdisziplinären Behandlung. In der klinischen Praxis fällt es jedoch oft schwer, aus der Vielzahl von Leitlinien zu ganz bestimmten Störungsaspekten konkrete Informationen für die Behandlung zu gewinnen und auf den Einzelfall anzuwenden. Vor diesem Hintergrund wurden im Rahmen zweier Projekte evidenzbasierte Praxisempfehlungen für psychologische Interventionen in der neurologischen Rehabilitation entwickelt, die das gesamte interdisziplinäre Team darin unterstützen sollen, auf den Patienten individuell zugeschnittene Einzelfallentscheidungen treffen zu können. Methode: In Phase I des Entwicklungsprozesses wurde zunächst eine systematische Literaturrecherche (Schritt 1) und parallel eine bundesweite Befragung aller neurologischen Rehabilitationseinrichtungen hinsichtlich ihrer strukturellen und prozeduralen Gegebenheiten (Schritt 2) durchgeführt. In Phase II diskutierte und konsentierte ein interdisziplinäres Expertengremium die in Phase I erarbeitete erste Version der Praxisempfehlungen (Schritt 3). Ziel von Phase III war der Einbezug von Klinikern und Patienten, daher wurde die erste Version als Konsultationsfassung deutschlandweit an die leitenden Psychologinnen/Psychologen und Ärztinnen/Ärzte aller neurologischen Rehabilitationseinrichtungen versandt (Schritt 4) und in indikationsspezifischen Fokusgruppen mit Patienten diskutiert (Schritt 5). Rückmeldungen und Anmerkungen wurden abschließend in Phase IV mit dem Expertengremium abgestimmt und die Praxisempfehlungen final konsentiert (Schritt 6). Nachdem zunächst die Praxisempfehlungen für Patienten nach Schlaganfall entwickelt wurden, konnten in einem Folgeprojekt die Indikationsbereiche Multiple Sklerose und Idiopathisches Parkinson-Syndrom nach analogem Vorgehen in die Praxisempfehlungen Schlaganfall integriert werden. Ergebnisse: Inhaltlich unterscheiden die Praxisempfehlungen für die drei Indikationsbereiche zwei Hauptkomplexe: 1) Die Allgemeinen Vorbemerkungen einschließlich der strukturellen Rahmenbedingungen und Prozessanforderungen sowie 2) Empfehlungen zu Diagnostik und Therapie. Letztere unterteilen sich weiter in die Teile A bis E, welche 34 für die neurologische Rehabilitation relevante Aspekte abdecken und z. T. weiter unterteilt sind in Empfehlungen zu Diagnostik, Therapie, Nachsorge sowie Anmerkungen, sodass insgesamt 191 verschiedene Empfehlungsbereiche vorliegen. Adressiert werden in den Teilen A bis E die Problemlagen in den Bereichen „Partizipation – Übergeordnete Ziele der Rehabilitation“ (Teil A), „Kognition“ (Teil B), „Affektivität und Verhalten“ (Teil C), „Risikofaktoren“ (Teil D) sowie „Spezifische Aspekte und Spezielle Problemlagen“ (Teil E). Mit einer durchschnittlichen Zustimmung von jeweils 97 % (Range Schlaganfall: 88–100 %; Range Multiple Sklerose/Idiopathisches Parkinson-Syndrom: 91–100 %) wurden die Praxisempfehlungen von leitenden Psychologen und Ärzten (= Schritt 4) weit akzeptiert. Diskussion: Damit umfassen die „Praxisempfehlungen für psychologische Interventionen in der neurologischen Rehabilitation: Multiple Sklerose, Idiopathisches Parkinson-Syndrom und Schlaganfall“ detaillierte, evidenzbasierte und gleichzeitig breit konsentierte Empfehlungen, die individualisierte Einzelfallentscheidungen im gesamten interdisziplinären Team unterstützen können.

Demonstration of a correlation between young leaves, apex and young bunches specific to a young grapevine cutting in the first period of its development

OENO One ◽  
2001 ◽  
Vol 35 (3) ◽  
pp. 117
Author(s):  
Jean-Claude Fournioux
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Inhibitory Effect ◽  
Phase Iii ◽  
Apical Bud ◽  
Terminal Bud ◽  
Young Leaves ◽  
Hardwood Cutting ◽  
In The Beginning ◽  
Phase Iv

<p style="text-align: justify;">The development of hardwood cutting of grapevine comprise 4 succesive phases. Phase I: first period of shoot extension. Phase II: characterized by a slow growth due to a very low activity of the terminal bud. Phase III: reactivation of the growth consecutive to a resumption of the apical activity. Phase IV: when the growth becomes maximal.</p><p style="text-align: justify;">The objective of this work has been to identify the cause of the slowdown of the activity of apical bud during the phase II.</p><p style="text-align: justify;">In a first experiment, we have compared the effects of three modes of defoliation applied from the beginning of the phase II on the apical activity: total defoliation, defoliation to have two adult leaves at the base of the shoot and defoliation to have two young leaves near the apex. The results of this experiment showed that only treatments depriving the shoot of young leaves induced an activation of the plastochronic activity. So, it appeared that young leaves exercises an inhibitory effect on the apex. The same experiment has been carried out during the phase IV of cuttings development, when the apical activity was maximal. In this condition, no treatments modified the apical activity. This suggests that the inhibition of the apex by young leaves is specifie to the phase II of the develop¬ ment of a grapevine cutting. In a third experiment, we have demonstrated that the foliar inhibition persisted during the all period of the laminart growth. Cytokinins are probably implied in this competition because exogenous applications of these growth regulators during the phase II produced a stimulation of the activity of apical bud. Results of a last experiment showed that, in cuttings prerooted before budburst, the apical activity was not decreased after the phase I. In other words, in this condition, the growth of the shoot was regular without phase II. We explain this resuit as follows. The roots preformed on the cuttings produced cytokinins in sufficient quantity for provide for needs of both foliar growth and apical activity.</p><p style="text-align: justify;">In previous studies, MULLINS showed that abortion of the young bunches on cuttings of grapevine was due to an inhibition by deficiency in cytokinins exercised by young leaves.The present work reveales the existence of an exactly similar correlation between the young leaves and the apex. So, in the beginning of the development of a grapevine cutting, young leaves, apical bud and young bunches are implied in a common correlative process which results on the one hand from a small availability of cytokinins due to the lack of roots and, on the other hand from a more efficient sink effect towards the cytokinins for the young leaves than for the apex and young bunches.</p>

Trends of Obesity in 10-Years of Follow-up among Tehranian Children and Adolescents: Tehran Lipid and Glucose Study (TLGS)

2020 ◽  
Author(s):  
Farhad HOSSEINPANAH ◽  
Sara SERAHATI ◽  
Maryam BARZIN ◽  
Shayan ARYANNEZHAD ◽  
Maryam REZAIE ◽  
...  
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Parental Education ◽  
Estimating Equation ◽  
Phase Iii ◽  
Total Prevalence ◽  
Equation Analysis ◽  
Using Data ◽  
Phase Iv

Background: We aimed to investigate the trend of childhood obesity in Tehranian population during a median follow-up of 10 years. Methods: Within a prospective cohort study, using data collected from Tehran Lipid and Glucose Study (TLGS), 1406 participants, aged 3-11 yr were selected and monitored in 4 phases: phase I (1999-2001), phase II (2002–2005), phase III (2006–2008) and phase IV (2009–2011). Results: Total prevalence of obesity in children increased from 5.5% to 9.4% from phase I to IV. Performing GEE (Generalized Estimating Equation) analysis, relative risk of obesity was calculated, comparing each phase to its previous phase: phase II in reference to phase I (RR=1.06, CI=1.04-1.08), phase III in reference to phase II (RR=1.01, CI=1.00-1.03) and phase IV in reference to phase III (RR=0.96, CI=0.94-0.98). Between group difference was significant in all subgroups (age, gender, parental obesity) except parental education. Test of interaction for effect of time was insignificant in all subgroups except for the age group. For children younger than 7 yr old at phase I, trend of obesity throughout the study was higher compared to those with 7 yr of age and older at phase I. Conclusion: During a decade of follow-up, trend of obesity was rising in this Tehranian children in both genders, especially in younger children. Any preventive interventions for stopping this trend should focus on early stages of childhood.

Structure–property correlation over five phases and four transitions in Pb5Al3F19

2003 ◽  
Vol 59 (5) ◽  
pp. 557-574 ◽  
Author(s):  
S. C. Abrahams ◽  
J. Ravez ◽  
H. Ritter ◽  
J. Ihringer
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Thermal Hysteresis ◽  
Ambient Pressure ◽  
Entropy Change ◽  
Phase Iii ◽  
Mode Analysis ◽  
First Order ◽  
Five Phases ◽  
Phase Iv

The calorimetric and dielectric properties of Pb5Al3F19 in the five phases stable under ambient pressure are correlated with structure for fuller characterization of each phase. The first-order transition between ferroelectric phase V and antiferroelectric phase IV at T V,IV = 260 (5) K exhibits a thermal hysteresis of 135 (5) K on heating, with a maximum atomic displacement Δ(xyz)max = 1.21 (6) Å; the transition from phase IV to ferroelastic phase III at 315 (5) K is also first order but with a thermal hysteresis of 10 (5) K and Δ(xyz)max = 0.92 (7)  Å; that from phase III to paraelastic phase II at 360 (5) K is second order without hysteresis and has Δ(xyz)max = 0.69 (4) Å; and the transition from phase II to paraelectric phase I at 670 (5) K is second or higher order, with Δ(xyz)max = 0.7 (4) Å. The measured entropy change ΔS at T V,IV agrees well with ΔS as derived from the increased configurational energy by Stirling's approximation. For all other phase transitions, 0.5 ≥ ΔS > 0 J mol−1 K−1 is consistent with an entropy change caused primarily by the changes in the vibrational energy. The structure of phase III is determined both by group theoretical/normal mode analysis and by consideration of the structures of phases II, IV and V reported previously; refinement is by simultaneous Rietveld analysis of the X-ray and neutron diffraction powder profiles. The structure of prototypic phase I is predicted on the basis of the atomic arrangement in phases II, III, IV and V. The introduction of 3d electrons into the Pb5Al3F19 lattice disturbs the structural equilibrium, the addition of 0.04% Cr3+ causing significant changes in atomic positions and increasing T IV,III by ∼15 K. Substitution of Al3+ by 20% or more Cr3+ eliminates the potential minima that otherwise stabilize phases IV, III and II.

Bewegungstherapie und körperliche Aktivität bei Patienten mit Herzinsuffizienz

Praxis ◽  
2018 ◽  
Vol 107 (17-18) ◽  
pp. 951-958 ◽  
Author(s):  
Matthias Wilhelm
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Körperliche Aktivität ◽  
Phase Iii

Zusammenfassung. Herzinsuffizienz ist ein klinisches Syndrom mit unterschiedlichen Ätiologien und Phänotypen. Die überwachte Bewegungstherapie und individuelle körperliche Aktivität ist bei allen Formen eine Klasse-IA-Empfehlung in aktuellen Leitlinien. Eine Bewegungstherapie kann unmittelbar nach Stabilisierung einer akuten Herzinsuffizienz im Spital begonnen werden (Phase I). Sie kann nach Entlassung in einem stationären oder ambulanten Präventions- und Rehabilitationsprogramm fortgesetzt werden (Phase II). Typische Elemente sind Ausdauer-, Kraft- und Atemtraining. Die Kosten werden von der Krankenversicherung für drei bis sechs Monate übernommen. In erfahrenen Zentren können auch Patienten mit implantierten Defibrillatoren oder linksventrikulären Unterstützungssystemen trainieren. Wichtiges Ziel der Phase II ist neben muskulärer Rekonditionierung auch die Steigerung der Gesundheitskompetenz, um die Langzeit-Adhärenz bezüglich körperlicher Aktivität zu verbessern. In Phase III bieten Herzgruppen Unterstützung.

scholarly journals AB0332 IMMUNOSUPPRESSIVE AND IMMONOMODULATING AGENTS IN RHEUMATOID ARTHRITIS: A SYSTEMATIC REVIEW OF CLINICAL TRIALS AND THEIR CURRENT DEVELOPMENT STAGE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1464.1-1465
Author(s):  
J. Blaess ◽  
J. Walther ◽  
J. E. Gottenberg ◽  
J. Sibilia ◽  
L. Arnaud ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
B Cells ◽  
Phase I ◽  
Phase Ii ◽  
Clinical Development ◽  
Phase Iii ◽  
Jak Inhibitors ◽  
Exclusion Criteria ◽  
Immunomodulating Drugs

Background:Rheumatoid arthritis (RA) is the most frequent chronic inflammatory diseases with an incidence of 0.5% to 1%. Therapeutic arsenal of RA has continuously expanded in recent years with the recent therapeutic progress with the arrival of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), biological (bDMARDs) and targeted synthetic (tsDMARDs), JAK inhibitors. However, there are still some unmet needs for patients who do not achieve remission and who continue to worsen despite treatments. Of note, only approximately 40% of patients are ACR70 responders, in most randomized controlled trials. For these patients, finding new therapeutic avenues is challenging.Objectives:The objective of our study was to analyze the whole pipeline of immunosuppressive and immunomodulating drugs evaluated in RA and describe their mechanisms of action and stage of clinical development.Methods:We conducted a systematic review of all drug therapies in clinical development in RA in 17 databases of international clinical trials. Inclusion criterion: study from one of the databases using the keywords “Rheumatoid arthritis” (search date: June 1, 2019). Exclusion criteria: non-drug trials, trials not related to RA or duplicates. We also excluded dietary regimen or supplementations, cellular therapies, NSAIDs, glucorticoids or their derivatives and non-immunosuppressive or non-immunomodulating drugs. For each csDMARD, bDMARD and tsDMARD, we considered the study at the most advanced stage. For bDMARDs, we did not take into account biosimilars.Results:The research identified 4652 trials, of which 242 for 243 molecules met the inclusion and exclusion criteria. The developed molecules belong to csDMARDs (n=21), bDMARDs (n=117), tsDMARDs (n=105).Among the 21 csDMARDs molecules: 8 (38%) has been withdrawn, 4 (19%) are already labelled in RA (hydroxychloroquine, leflunomide, methotrexate and sulfasalazine) and 9 (43%) are in development: 1 (11%) is in phase I/II, 5 (56%) in phase II, 3 (33%) in phase IV.Among the 117 bDMARDs molecules: 69 (59%) has been withdrawn, 9 (8%) are labeled in RA (abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, sarilumab, tocilizumab) and 39 (33%) are in development: 9 (23%) in phase I, 3 (8%) in phase I/II, 21 (54%) in phase II, 5 (12%) are in phase III, 1 (3%) in phase IV. bDMARDs currently under development target B cells (n=4), T cells (n=2), T/B cells costimulation (n=2),TNF alpha (n=2), Interleukine 1 or his receptor (n=3), Interleukine 6 or his receptor (n=7), Interleukine 17 (n=4), Interleukine 23 (n=1), GM-CSF (n=1), other cytokines or chemokines (n=5), integrins or adhesion proteins (n=3), interferon receptor (n=1) and various other targets (n=4).Among the 105 tsDMARDs molecules: 64 (61%) has been withdrawn, 6 (6%) JAK inhibitors, have just been or will probably soon be labelled (baricitinib, filgotinib, peficitinib, tofacitinib and upadacitinib), 35 (33%) are in development: 8 (24%) in phase I, 26 (74%) in phase II, 1 (3%) in phase III and. tsDMARDs currently under development target tyrosine kinase (n=12), janus kinase (JAK) (n=3), sphingosine phostate (n=3), PI3K pathway (n=1), phosphodiesterase-4 (n=3) B cells signaling pathways (n=3) and various other targets (n=10).Conclusion:A total of 242 therapeutic trials involving 243 molecules have been or are being evaluated in RA. This development does not always lead to new treatments since 141 (58%) have already been withdrawn. Hopefully, some of the currently evaluated drugs will contribute to improve the therapeutic management of RA patients, requiring a greater personalization of therapeutic strategies, both in the choice of molecules and their place in therapeutic sequences.Disclosure of Interests:Julien Blaess: None declared, Julia Walther: None declared, Jacques-Eric Gottenberg Grant/research support from: BMS, Pfizer, Consultant of: BMS, Sanofi-Genzyme, UCB, Speakers bureau: Abbvie, Eli Lilly and Co., Roche, Sanofi-Genzyme, UCB, Jean Sibilia: None declared, Laurent Arnaud: None declared, Renaud FELTEN: None declared

scholarly journals Unconventional Anticancer Agents: A Systematic Review of Clinical Trials

2006 ◽  
Vol 24 (1) ◽  
pp. 136-140 ◽  
Author(s):  
Andrew J. Vickers ◽  
Joyce Kuo ◽  
Barrie R. Cassileth
Keyword(s):  
Clinical Trials ◽  
Phase I ◽  
Cancer Patients ◽  
Phase Ii ◽  
Dose Finding ◽  
Phase Iii ◽  
High Dose ◽  
Free Text ◽  
Phase Ii Trials ◽  
Off Label

Purpose A substantial number of cancer patients turn to treatments other than those recommended by mainstream oncologists in an effort to sustain tumor remission or halt the spread of cancer. These unconventional approaches include botanicals, high-dose nutritional supplementation, off-label pharmaceuticals, and animal products. The objective of this study was to review systematically the methodologies applied in clinical trials of unconventional treatments specifically for cancer. Methods MEDLINE 1966 to 2005 was searched using approximately 200 different medical subject heading terms (eg, alternative medicine) and free text words (eg, laetrile). We sought prospective clinical trials of unconventional treatments in cancer patients, excluding studies with only symptom control or nonclinical (eg, immune) end points. Trial data were extracted by two reviewers using a standardized protocol. Results We identified 14,735 articles, of which 214, describing 198 different clinical trials, were included. Twenty trials were phase I, three were phase I and II, 70 were phase II, and 105 were phase III. Approximately half of the trials investigated fungal products, 20% investigated other botanicals, 10% investigated vitamins and supplements, and 10% investigated off-label pharmaceuticals. Only eight of the phase I trials were dose-finding trials, and a mere 20% of phase II trials reported a statistical design. Of the 27 different agents tested in phase III, only one agent had a prior dose-finding trial, and only for three agents was the definitive study initiated after the publication of phase II data. Conclusion Unconventional cancer treatments have not been subject to appropriate early-phase trial development. Future research on unconventional therapies should involve dose-finding and phase II studies to determine the suitability of definitive trials.

Hydrogeological Characterization Based on Long Term Groundwater Pressure Monitoring

2010 ◽  
Author(s):  
Shuji Daimaru ◽  
Ryuji Takeuchi ◽  
Masaki Takeda ◽  
Masayuki Ishibashi
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Large Scale ◽  
Pumping Test ◽  
Phase Iii ◽  
Pressure Monitoring ◽  
Energy Agency ◽  
Hydrogeological Characteristics ◽  
Under Construction

The Mizunami Underground Research Laboratory (MIU) is now under construction by the Japan Atomic Energy Agency in the Tono area of central Japan. The MIU project is being implemented in three overlapping Phases: Surface-based Investigation (Phase I), Construction (Phase II) and Operation (Phase III). The changes of groundwater pressure due to shaft excavation can be considered analogous to a large-scale pumping test. Therefore, there is the possibility that the site scale groundwater field (several km square) can be approximated by the long-term groundwater pressure monitoring data from Phase II. Based on the monitoring observations, hydrogeological characteristics were estimated using the s-log(t/r2) plot based on the Cooper-Jacob straight line method. Results of the s-log(t/r2) plots are as follows. The groundwater flow field around the MIU construction site is separated into domains by an impermeable fault. In other words, the fault is a hydraulic barrier. Hydraulic conductivity calculated from s-log(t/r2) plots are in the order of 1.0E−7(m/s). The above results from the long term monitoring during Phase II are a verification of the hydrogeological characteristics determined in the Phase I investigations.

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