フランス業績予算改革のインプリメンテーション : 政府予算の裁量と統制

application/pdfArticledepartmental bulletin pape

The COMET Open-label Phase II Study of Neoadjuvant FOLFOX or XELOX Treatment Combined with Molecular Targeting Monoclonal Antibodies in Patients with Resectable Liver Metastasis of Colorectal Cancer

Background: Advantages of neoadjuvant chemotherapy combined with monoclonal antibodies for treating patients with resectable colorectal cancer liver metastasis (CLM) have not been established. The purpose of this study was to evaluate the efficacy and safety of oxaliplatin-based regimen (FOLFOX or XELOX) plus monoclonal antibodies (cetuximab or bevacizumab) treatment in patients with resectable CLM. Methods: A single-arm, open-label, multicenter, phase II trial was conducted for patients aged ≥ 20 years with resectable and untreated CLM. Patients received preoperative FOLFOX (6 cycles) or XELOX (4 cycles). Cetuximab or bevacizumab was administered to patients with wild-type or mutated KRAS codons 12 and 13, respectively. The primary endpoint was progression-free survival (PFS). Results: Between January 2010 and June 2012, 47 patients were enrolled from 12 institutions. Wild-type or mutant KRAS sequences were examined in 32 and 15 patients, respectively. Twenty-one (45 %) patients experienced Grades 3/4 adverse events, and 55 % of all patients responded to therapy. The sizes of tumors of patients in the wild-type KRAS group were significantly reduced compared with those of the mutant KRAS group. The overall rates of liver resection and postoperative morbidity were 83 and 14 %, respectively, and the median PFS was 15.6 months. The median PFS times of the KRAS wild-type and mutant groups were 22.5 months and 10.5 months, respectively. Conclusions: Neoadjuvant therapy using FOLFOX/XELOX combined with monoclonal antibodies did not improve PFS, although it was administered safely and had less adverse effects after liver resection.journal articl

Generation and Measurement of Picosecond Laser Pulses (III) -Oscillation and Amplification of a CPM G1ass Laser -

Ultra-short light pulses of several picoseconds are easily obtained from a conventional selιmode-locked Nd3+ glass laser. However, we tried to improve the pulse-width further by use of CPM (Colliding Pulse Mode-locking) method, as a new proposal, in which a saturable absorber cell of 1 mm thick was set in the centre of the laser cavity of 1 m length and a glass rod (LHG-8, 5φ,75ι) was between the cell and the coupling mirror. We used the dye NDL-112 as a saturable absorber of self-mode-locking. The pulse-width was measured by observation of TPF patterns in Rh-6G cell. By exact adjustment of the cell position, we was able to get a long train of about 100 pulses per shot,of which the pulse-width was less than 3 psec, just a half of the conventional.departmental bulletin pape

ICT を活用した教育支援システムの導入とファカルティ・ディベロップメント－岩手大学の事例から－

The University Education Center in Iwate University used Ministry of Education, Culture, Sports, Science and Technology funding (Special Education Research Funding) from 2005 to 2007 to carry out a project for systematic lesson improvement and the construction of an extramural study support system. One part of this project was the development of the ‘In Assistant’ education support system which functions to systematically improve lessons, and also support extra-mural study. The system has been implemented throughout the university. The salient feature of this project is that it is a university-wide education support system run by the University Education Center’s Education Evaluation and Reform section, who run the FD for the whole university. In Assistant has been structured in such a way as to visualize each individual teacher’s basic education reform activities, thus enabling improvements in the education on offer. In concrete terms, it has built a PDCA cycle into its system: PDCA refers to the actual giving of lessons, with P (planning the syllabus) → D (delivering the lessons) → C (making lesson records) → A (improvements in the lessons). Teachers need various kinds of support in order to understand the concept of this system, and to use it in practice, but this function has been built into the system for use by all teaching staff, and so it can be kept as a basis for carrying out educational reforms in future. From this example, it can be seen how important it is that a foundation system for dealing with education in universities be developed not just by the teaching staff, but also in co-operation with office staff and information officers. If an educational reform mechanism can be built into the foundation education system, then the university-wide education system can be reformed. This paper seeks to introduce an example of how the center and the center’s full-time teachers are involved in the development, introduction and management of a university-wide education support system. It also discusses the center’s role as one element in the education support system.departmental bulletin pape

Flow chart depicting algorithm for determining fibrosis status of AIH patient.

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Fig 2 -

A. Top ten most significant canonical pathways related to differential gene expression of AIH patients compared to healthy controls. B. kmer-based phylogenetic analysis performed with the IDSeq platform shows relationships between four assembled pegivirus genomes from the GRACE cohort and their closest related publicly available pegivirus NCBI reference genomes, with patient metadata annotated.</p

Fig 1 -

A. Schematic of sample processing for library preparation of whole blood for AIH cohort. B. Heat map displaying gene counts (variance stabilizing transformation, see DESeq2) of the top 1000 genes with highest variance amongst samples. Samples are clustered on the x-axis and protein coding genes are clustered on the y-axis using a Ward D2 method. Relevant metadata included patient status, steroid exposure, and fibrosis groups to classify samples. C. PCA plot of variance stabilizing transformed gene counts colored by sex of patient sample. D. Volcano plot of differential gene expression in DESeq2, showing genes with P 1 in red, and genes with only log fold change > 1 in blue, and genes with only P < 0.05 in grey.</p

DataSheet_1_DCD liver transplant in patients with a MELD over 35.pdf

IntroductionDonation after circulatory death (DCD) liver transplantation (LT) makes up well less than 1% of all LTs with a Model for End-Stage Liver Disease (MELD)≥35 in the United States. We hypothesized DCD-LT yields acceptable ischemia-reperfusion and reasonable outcomes for recipients with MELD≥35.MethodsWe analyzed recipients with lab-MELD≥35 at transplant within the UCSF (n=41) and the UNOS (n=375) cohorts using multivariate Cox regression and propensity score matching.ResultsIn the UCSF cohort, five-year patient survival was 85% for DCD-LTs and 86% for matched-Donation after Brain Death donors-(DBD) LTs (p=0.843). Multivariate analyses showed that younger donor/recipient age and more recent transplants (2011-2021 versus 1999-2010) were associated with better survival. DCD vs. DBD graft use did not significantly impact survival (HR: 1.2, 95%CI 0.6-2.7). The transaminase peak was approximately doubled, indicating suggesting an increased ischemia-reperfusion hit. DCD-LTs had a median post-LT length of stay of 11 days, and 34% (14/41) were on dialysis at discharge versus 12 days and 22% (9/41) for DBD-LTs. 27% (11/41) DCD-LTs versus 12% (5/41) DBD-LTs developed a biliary complication (p=0.095). UNOS cohort analysis confirmed patient survival predictors, but DCD graft emerged as a risk factor (HR: 1.5, 95%CI 1.3-1.9) with five-year patient survival of 65% versus 75% for DBD-LTs (p=0.016). This difference became non-significant in a sub-analysis focusing on MELD 35-36 recipients. Analysis of MELD≥35 DCD recipients showed that donor age of DiscussionIn highly selected recipient/donor pair, DCD transplantation is feasible and can achieve comparable survival to DBD transplantation. Biliary complications occurred at the expected rates. In the absence of selection, DCD-LTs outcomes remain worse than those of DBD-LTs.</p

Random forest results with increasing standard deviation multiplicative factor separating AIH patients and healthy controls.

Random forest results with increasing standard deviation multiplicative factor separating AIH patients and healthy controls.</p

A. Top 10 activated upstream regulators identified by pathway analysis for treatment-naïve patients compared to healthy controls.

B. Top 10 inhibited upstream regulators identified by pathway analysis for treatment-naïve patients compared to healthy volunteers.</p