1,875 research outputs found

    Efficacy of adalimumab as second-line therapy in a pediatric cohort of crohn’s disease patients who failed infliximab therapy: The Italian society of pediatric gastroenterology, hepatology, and nutrition experience

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    Background: Adalimumab (Ada) treatment is an available option for pediatric Crohn’s disease (CD) and the published experience as rescue therapy is limited. Objectives: We investigated Ada efficacy in a retrospective, pediatric CD cohort who had failed previous infliximab treatment, with a minimum follow-up of 6 months. Methods: In this multicenter study, data on demographics, clinical activity, growth, laboratory values (CRP) and adverse events were collected from CD patients during follow-up. Clinical remission (CR) and response were defined with Pediatric CD Activity Index (PCDAI) score ≤10 and a decrease in PCDAI score of ≥12.5 from baseline, respectively. Results: A total of 44 patients were consecutively recruited (mean age 14.8 years): 34 of 44 (77%) had active disease (mean PCDAI score 24.5) at the time of Ada administration, with a mean disease duration of 3.4 (range 0.3–11.2) years. At 6, 12, and 18 months, out of the total of the enrolled population, CR rates were 55%, 78%, and 52%, respectively, with a significant decrease in PCDAI scores (P<0.01) and mean CRP values (mean CRP 5.7 and 2.4 mL/dL, respectively; P<0.01) at the end of follow-up. Steroid-free remission rates, considered as the total number of patients in CR who were not using steroids at the end of this study, were 93%, 95%, and 96% in 44 patients at 6, 12, and 18 months, respectively. No significant differences in growth parameters were detected. In univariate analysis of variables related to Ada efficacy, we found that only a disease duration >2 years was negatively correlated with final PCDAI score (P<0.01). Two serious adverse events were recorded: 1 meningitis and 1 medulloblastoma. Conclusion: Our data confirm Ada efficacy in pediatric patients as second-line biological therapy after infliximab failure. Longer-term prospective data are warranted to define general effectiveness and safety in pediatric CD patients

    Restorative Justice-Informed Moral Acquaintance: Resolving the Dual Role Problem in Correctional and Forensic Practice

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    The issue of dual roles within forensic and correctional fields has typically been conceptualized as dissonance—experienced by practitioners— when attempting to adhere to the conflicting ethical requirements associated with client well-being and community protection. In this paper, we argue that the dual role problem should be conceptualized more broadly; to incorporate the relationship between the offender and their victim. We also propose that Restorative Justice (RJ) is able to provide a preliminary ethical framework to deal with this common ethical oversight. Furthermore, we unite the RJ framework with that of Ward’s (2013) moral acquaintance model to provide a more powerful approach—RJ informed moral acquaintance—aimed at addressing the ethical challenges faced by practitioners within forensic and correctional roles

    Tapping Environmental History to Recreate America’s Colonial Hydrology

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    To properly remediate, improve, or predict how hydrological systems behave, it is vital to establish their histories. However, modern-style records, assembled from instrumental data and remote sensing platforms, hardly exist back more than a few decades. As centuries of data is preferable given multidecadal fluxes of both meteorology/climatology and demographics, building such a history requires resources traditionally considered only useful in the social sciences and humanities. In this Feature, Pastore et al. discuss how they have undertaken the synthesis of historical records and modern techniques to understand the hydrology of the Northeastern U.S. from Colonial times to modern day. Such approaches could aid studies in other regions that may require heavier reliance on qualitative narratives. Further, a better insight as to how historical changes unfolded could provide a “past is prologue” methodology to increase the accuracy of predictive environmental models

    The influence of winter water on phytoplankton blooms in the Chukchi Sea

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    Author Posting. © The Author(s), 2015. This is the author's version of the work. It is posted here by permission of Elsevier for personal use, not for redistribution. The definitive version was published in Deep Sea Research Part II: Topical Studies in Oceanography 118 (2015): 53-72, doi:10.1016/j.dsr2.2015.06.006.The flow of nutrient-rich winter water (WW) through the Chukchi Sea plays an important and previously uncharacterized role in sustaining summer phytoplankton blooms. Using hydrographic and biogeochemical data collected as part of the ICESCAPE program (June-July 2010-11), we examined phytoplankton bloom dynamics in relation to the distribution and circulation of WW (defined as water with potential temperature ≤ -1.6°C) across the Chukchi shelf. Characterized by high concentrations of nitrate (mean: 12.3 ± 5.13 μmol L-1) that typically limits primary production in this region, WW was correlated with extremely high phytoplankton biomass, with mean chlorophyll a concentrations that were three-fold higher in WW (8.64 ± 9.75 μg L-1) than in adjacent warmer water (2.79 ± 5.58 μg L-1). Maximum chlorophyll a concentrations (~30 μg L-1) were typically positioned at the interface between nutrient-rich WW and shallower, warmer water with more light availability. Comparing satellite-based calculations of open water duration to phytoplankton biomass, nutrient concentrations, and oxygen saturation revealed widespread evidence of under-ice blooms prior to our sampling, with biogeochemical properties indicating that blooms had already terminated in many places where WW was no longer present. Our results suggest that summer phytoplankton blooms are sustained for a longer duration along the pathways of nutrient-rich WW and that biological hotspots in this region (e.g. the mouth of Barrow Canyon) are largely driven by the flow and confluence of these extremely productive pathways of WW that flow across the Chukchi shelf.This material is based upon work supported by the National Aeronautic and Space Administration (NASA) under Grant No. NNX10AF42G and the National Science Foundation Graduate Research Fellowship under Grant No. DGE-0645962 to K.E. Lowry

    New conditional symmetries and exact solutions of nonlinear reaction-diffusion-convection equations. II

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    In the first part of this paper math-ph/0612078, a complete description of Q-conditional symmetries for two classes of reaction-diffusion-convection equations with power diffusivities is derived. It was shown that all the known results for reaction-diffusion equations with power diffusivities follow as particular cases from those obtained in math-ph/0612078 but not vise versa. In the second part the symmetries obtained in are successfully applied for constructing exact solutions of the relevant equations. In the particular case, new exact solutions of nonlinear reaction-diffusion-convection (RDC) equations arising in application and their natural generalizations are found

    Enhanced Group Analysis and Exact Solutions of Variable Coefficient Semilinear Diffusion Equations with a Power Source

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    A new approach to group classification problems and more general investigations on transformational properties of classes of differential equations is proposed. It is based on mappings between classes of differential equations, generated by families of point transformations. A class of variable coefficient (1+1)-dimensional semilinear reaction-diffusion equations of the general form f(x)ut=(g(x)ux)x+h(x)umf(x)u_t=(g(x)u_x)_x+h(x)u^m (m0,1m\ne0,1) is studied from the symmetry point of view in the framework of the approach proposed. The singular subclass of the equations with m=2m=2 is singled out. The group classifications of the entire class, the singular subclass and their images are performed with respect to both the corresponding (generalized extended) equivalence groups and all point transformations. The set of admissible transformations of the imaged class is exhaustively described in the general case m2m\ne2. The procedure of classification of nonclassical symmetries, which involves mappings between classes of differential equations, is discussed. Wide families of new exact solutions are also constructed for equations from the classes under consideration by the classical method of Lie reductions and by generation of new solutions from known ones for other equations with point transformations of different kinds (such as additional equivalence transformations and mappings between classes of equations).Comment: 40 pages, this is version published in Acta Applicanda Mathematica

    The Amundsen Sea Polynya International Research Expedition (ASPIRE)

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    In search of an explanation for some of the greenest waters ever seen in coastal Antarctica and their possible link to some of the fastest melting glaciers and declining summer sea ice, the Amundsen Sea Polynya International Research Expedition (ASPIRE) challenged the capabilities of the US Antarctic Program and RVIB Nathaniel B. Palmer during Austral summer 2010–2011. We were well rewarded by both an extraordinary research platform and a truly remarkable oceanic setting. Here we provide further insights into the key questions that motivated our sampling approach during ASPIRE and present some preliminary findings, while highlighting the value of the Palmer for accomplishing complex, multifaceted oceanographic research in such a challenging environment
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