Higher CPR Research Articles

Neoadjuvant Immunotherapy in Resectable HNSCC: An Updated Systematic Review and Meta-analysis.

Immunotherapy is a recently recognised FDA-approved treatment for R/M HNSCC. Our goal is to explore the safety profile and the efficacy of immunotherapy in the neoadjuvant setting before surgery in mucosal head and neck cancer. Three electronic databases had been systematically searched through March 2024. Demographic and tumour characteristics were extracted. Primary outcomes obtained were disease-free survival (DFS), progression-free survival (PFS), overall survival (OS), complete pathological response (cPR), which was defined as no residual tumour, and major pathological response (MPR), which as defined as <10% residual viable tumour. Safety outcomes examined were grade 3 and above adverse event, median time to surgery, delays to surgery, and death related to neoadjuvant treatment. A total of 459 patients from 15 studies were included in the analysis. The pooled estimate of cPR for all the studies was 14.9% (95% confidence interval [CI] 8.0-26.2). Subgroup analysis showed chemoimmunotherapy had a higher cPR 30.1% (95% CI 22.8-38.62) compared with immunotherapy alone 1.4% (95% CI 0.3-5.2). There was no treatment-related death. Chemoimmunotherapy had a higher pooled estimate of adverse events 22.9% (95% CI 11.0-41.5) compared with immunotherapy alone 8.5% (95% CI 2.6-24.3). Subgroup analysis demonstrated that chemoimmunotherapy had a higher DFS compared with immunotherapy alone: 89.8% (95% CI 81.4-94.7) versus 80.44% (95% CI 73.9-85.7), respectively. Neoadjuvant immunoradiotherapy had conflicting results. Neoadjuvant immunotherapy was well tolerated. Neoadjuvant chemoimmunotherapy may be more effective in treating LAHNSCC over immunotherapy alone; however, TRAEs were higher.

Serum levels of anti-Müllerian hormone influence pregnancy outcomes associated with gonadotropin-releasing hormone antagonist treatment: a retrospective cohort study

As a specific predictor of ovarian reserve, serum anti-Müllerian hormone (AMH) has become an area of intense research interest in the field of assisted reproductive technology. We assessed the relationship between AMH levels and pregnancy outcomes in Chinese patients and investigate the influencing factors of cumulative live birth in patients with high AMH levels. A total of 1379 patients starting their IVF/ICSI cycle were divided into normal (Group A, 1.1–4.0 ng/ml, n = 639) and high (Group B, > 4.0 ng/ml, n = 740) groups by serum AMH levels. Live birth rate (LBR), cumulative live birth rate (CLBR) and cumulative clinical pregnancy rate (CCPR) were also investigated. Compared with Group A, Group B had a significantly higher CLBR (65.80% vs. 43.95%) and CCPR (76.77% vs. 57.14%), respectively. Binomial logistic regression analysis showed that age over 40 years, LH/FSH > 2.5, total Gn dose and Gn duration, and greater than 4000 ng/ml serum E2 levels on HCG day were significantly associated with CLBR in Group B. The AUC value of CLBR averaged 0.664 (ranging from 0.621 to 0.706) (p < 0.001). The patients with high AMH levels had higher CPR, higher LBR, and lower MR with no statistically significant differences, although there were significant improvements in CLBR. Advanced age (> 40 years) still impacted CLBR, even in women with good ovarian reserves. Consequently, it is still recommended that patients over 40 years old with high AMH levels actively receive IVF treatment if they seek to become pregnant. PCOS diagnoses did not influence the CLBR. In summary, this study showed that serum AMH levels could positively predict patient ovarian responses and further affect pregnancy outcomes.

The effect of follicular phase length on cycle outcomes and endometrial development in gonadotrophin ovarian stimulation/intrauterine insemination cycles.

Does a shorter follicular phase length (FPL) affect cycle outcomes and endometrial development among women undergoing gonadotrophin ovarian stimulation/intrauterine insemination (OS/IUI)? Retrospective cohort study of 4773 OS/IUI cycles among 2054 patients. FPL was analysed first continuously, then dichotomously using an arbitrary cut-off at the 15th percentile (8 days) to divide cycles into shorter and longer FPL groups. Receiver operating characteristic (ROC) curves were constructed to further analyse the impact of FPL on all outcomes. Primary outcomes included clinical pregnancy, spontaneous abortion, multiple pregnancy and non-viable (ectopic/biochemical) pregnancy rates (CPR, SABR, MPR and NVPR, respectively). Secondary outcomes included endometrial thickness. All analyses controlled for age, day 3 FSH and body mass index. When analysing FPL continuously, CPR increased by 6.0% (adjusted odds ratio [aOR] 1.06, 95% CI 1.03-1.09, P<0.001) with each additional follicular phase day. Similarly, in the dichotomous analysis, cycles with a longer FPL resulted in higher CPR with 45% higher odds of clinical pregnancy (aOR 1.45, 95% CI 1.07-1.97, P = 0.018). No effect of FPL was noted on NVPR, SABR or MPR. Endometrial thickness increased by 0.09mm (95% CI 0.06-0.12, P<0.001) with each additional FPL day and was increased in the longer compared with the shorter FPL group (adjusted mean difference 1.08mm, 95% CI 0.81-1.34, P<0.001). The data suggest that in gonadotrophin OS/IUI cycles, FPL might impact both chance of clinical pregnancy and endometrial thickness, independent of maternal age and ovarian reserve.

Twelve Year Outcomes of Oxinium Total Knee Arthroplasty Compared to the Same Cobalt Chrome Prosthesis

Introduction:Alternative bearings surfaces to Cobalt Chrome (Co-Cr), such as Oxidised have been introduced in an attempt to reduce polyethylene wear and hence decrease TKA loosening and lysis. While non-comparative reports have been described as promising, no short or long term clinical studies exists showing the superiority of Oxinium on a polyethylene bearing surfaces. In this study, we investigate the long-term outcomes of Oxinium and Co-Cr TKR in a “like for like” or matched cohort analysis of the Genesis II design (Smith & Nephew, Memphis, TN, USA). Using data from a large national joint replacement registry we selected cohorts that used only the cruciate retaining design, with the same method of fixation and polyethylene type, differing only in the femoral component bearing surfaces. Our primary hypothesis was that Oxinium TKA would have a lower cumulative percent revision than the same Co-Cr prosthesis at 12 years for all causes of revision. Our secondary hypothesis was that Oxinium TKA would have a lower loosening/ lysis rate and lower rate of non-infective revision than the same Co-Cr prosthesis at 12 years.Methods:Cumulative percent revision and revision diagnosis data were obtained from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) from 1 September 1999, until 31 December 2013.Results:At 12 years the cumulative percent revision of the Co-Cr Genesis II of 4.8 % (95%: CI 4.2, 5.4) for all causes was not statistically different to the Oxinium Genesis II CPR of 7.7 % (95%: CI 6.2, 9.5) (For the entire period, Hazard Ratio = 1.09 (95%: CI 0.92, 1.29), p = 0.329). The CPR for all causes was not different in the under 55 years old age group (Figure 3) (HR= 1.06 (0.68, 1.66) p=0.798).). Subgroup analysis of the CPR for loosening /lysis in both groups overall was not different (HR= 0.87 (95%: CI 0.61, 1.26), p = 0.461) Subgroup analysis of all causes of revisions excluding infection in both groups overall was not different (HR = 0.87 (95%: CI 0.71, 1.06), p = 0.155) . No difference in CPR was found between the Oxinium and Co-Cr groups for any age category for all causes of revision, loosening/lysis or non-infective causes, except for loosening/lysis in the >75 years old group (p=0.033). In these patients, Oxinium TKA had a higher CPR due to uncertain reasons.Conclusions:In this AOANJRR age stratified matched cohort study, Oxinium femoral components did not reduce revision rates due to all causes, loosening/lysis or when infection as a cause of revision was removed, compared to the same Co-Cr femoral component, across all age groups including patients who were under 55 years of age.

Sa1194 Consistently High C Reactive Protein Is Associated With Subsequent Development of Perianal Fistulae in Patients With Crohn's Disease

in the use of systemic steroids. Conclusions: At the moment of diagnosis of CD, smoking, abdominal pain, diarrhea, lower hemoglobin values and higher CPR, ESR or platelet values, as well as ileocolonic location of the disease, penetrating or stricturing disease, and perianal involvement are associated with a subsequent surgical outcome. The early recognition of these features in newly diagnosed patients should be seriously taken into account when deciding for more aggressive medical treatments, such as immunosuppressors or biological agents, in order to defer the more invasive surgical procedures.

The Effect of Integrating Family Planning with HIV and Aids Services on Contraceptives Uptake among HIV Positive Women

Background: Integrating Family Planning (FP) into HIV services provides opportunity to increase access to contraception among clients. However, data on the effectiveness of FP/HIV integration on FP uptake is limited. Objective: Determine the effect of FP/HIV services integration, focusing on FP integration with Antiretroviral Therapy (ART) Methods: A cross-sectional comparative design was conducted in facilities with and without FP/ART integration in four major regions of Ethiopia. The study population included HIV positive women attending ART clinics. Data were collected using structured questionnaire from 843 and 691 HIV positive women in intervention and comparison facilities respectively from April 23 to May 2, 2012. Data entry and analysis was done using SPSS version 17.0 and proportions and relevant associations were computed. Results: Most of the women (94.7%) received one or more HIV services. In both groups, 736 (48.2%) women used any type of FP method; the majority (97%) used modern FP and 54.6% used injectables. Over all CPR was 48%; with higher CPR in intervention than comparison group (52.6 %versus 42.9%) [AOR (95%CI) =1.23, (1.23, 1.92). A higher proportion of women in intervention than comparison group used dual methods [AOR (95%CI) =1.50 (1.01, 2.2)]. Total unmet need for FP in the study was 16.2 percent. There was no significant difference in unmet need for FP between intervention and comparison groups (15.7% vs. 16.9% respectively) [(OR 0.94 95% CI (0.63, 1.39)]. Conclusion and Recommendation: FP/HIV integration improved CPR and use of dual methods showing the benefit of FP/HIV integration. However, there was no difference in unmet need for FP between the two groups calling the need for more research.

Evaluation of metabolic syndrome and associations with inflammation and graft function in renal transplant recipients

Cardiovascular disease (CVD) is a major determinant of mortality in renal transplant recipients (RTR). Metabolic syndrome (MS) and chronic inflammation are currently considered non traditional risk factors for cardiovascular disease. This study evaluates the frequency of these conditions their associations with graft function. To evaluate the prevalence of metabolic syndrome (MS) and inflammation and their associations with graft function in renal transplant recipients. A cross-sectional study was carried out with 200 RTR. MS was defined by the NCEP-ATP III criteria. Inflammation was assessed by CRP levels. Renal function was assessed by GFR estimation using the MDRD equation. MS occurred in 71 patients (35.5%). Patients with MS had higher CPR and decreased GFR levels. Inflammation was present in 99 patients (49.5%). Mean waist perimeter, body mass index, triglycerides and serum total cholesterol were significantly higher in inflamed patients. An association between MS and inflammation was demonstrated, 48 (67.6%) patients with MS were inflamed and among those without MS the rate of inflamed patients was 39.5% (51 patients) (p < 0.001). A significantly higher percentage of patients with MS in the group of patients in chronic renal disease stages III and IV was observed. In RTR there is a significant association among MS and inflammation. MS is negatively associated with graft function. The clinical implications of these findings must be evaluated in longitudinal studies.

Alumni Mahaiswa Program Doktor Ilmu Ekonomi Pascasarjana Untag 1945 Surabaya

This research focus on TFR, CPR, Empowerment of family economic and Family welfare inWestNusatenggaraProvince. The question is could the Family Planning (TFR and CPR) increase efectivity of the Family economis and family welfare inWestNusaTenggaraProvince? Leibenstein (1958) in His fertility theory said factors which determine amount of birth which expected family are parents. According Becker (1960, 1963) with his demand theory strengthen by Ananta (1981) that fertility assumed as commodity (Consumer Durable) like threated commudity in economic. In demand theory one of variable which determine are income and in using simple preference theory, and can describe by two dimension graph with Indifference curve (Becker and Ananta 1960, 1981). Terance J. Hull (1976-1978) and Masri Singarimbun (1976), in their research connected with Fertility and social ekonomi strata. Birsall dan Sanding dalam Sri Murtiningsih (2005) talking about fertility, Increme percapita and welfare. Related with this desertation research that variable which research are CPR and TFR variable and its influences toward efectivity family economic and family welfare programme, which mean value of children and first time marriage in one family/TFR and join in Family Planning including Unmetneed/CPR, could have a positive influences toward efectivity family economic and family welfare programme which expected will find a model concept and find a variable which have a significant influence between every variable. This desertation constitute develop from becker (1960), Ronald Freedman (1975), J. Bongaart theory (1978), with proximate determinants of fertility, Leiberstain (1958), Birsall dan sanding dalam Sri Moertiningsih (2005) Terance J. Hall (1976-1978), and Becker strengthen by ananta which focuses in advantage value from additional child in one family relate with productivity from child birth according to parts of this theory push the power of increasing family welfare in one family are fertility and economic recovery which described in this research with TFR, CPR and family economical (UPPKS). Increasing of education level, quality of health with general caused by modernism process give motivation to women or eligible couple to limited the amount of their child, then their have knowledge which needed in using contraceptive as family Planning method. Related with this finding research that higher CPR then lower the child in one family which analogize with the decrease of TFR (Total Fertility Rate). This research population are all eligible couple in West Nusa Tenggara Province and research sample are 200 Family/eligible couple take by multistage purposive random sampling, with divide 4 district according its region and divide become 4 kwadran are: Kwadran I, II, III, IV, based BKKBN count. The data collect by spreading open questioner with continue scale. The questioner examined to 30 people to get good data, through validity test and reability by SPSS version 11.00, that data have fulfillment to analyze with SEM, with software AMOS 4.01 version. Theority test based on theory and first result research. The desertation found : Comprehensively from variables research in all hypothesis accepted and examined significantly, and new model that explain research model aboaut welfare. Based on analysis and structural model from this research, show that model which get by base emphiric data have fulfill the classification (Goodness of Fit). And this finding and from research model inspected relly that CPR, TFR and family economic/UPPKS strong enough and effective as determination in effort to increase family economic current user. What we get from this research basically with theories or results of othe research. If we inspect the variables of CPR, TFR and family economic/UPPKS, in partial or simultance, influence toward family economic are very significant. This influences have two reason: first, factor which determine good or bad of increase of family economic are the effort on CPR participants, TFR which have good control, that term give influences on strengthen better family economic/UPPKS. Second in the three variables (CPR, TFR, and UPPKS) UPPKS have lower influence than CPR and TFR factors participant can manage in good handle, in directly can give effect toward increase of family economic. Although the effort of UPPKS significantly need more concern to increase family economic. That all about influences TFR and CPR factor toward effectivity family economic related with increase family welfare on West Nusa Tenggara people. Otherwise the activities of influence toward family income as a factor of more attention in term of supporting increasing family welfare of family planning acceptors.

Gene expression of cytokines relevant to natural killer cell differentiation in mouse uterus during pregnancy

The effects of fetuses or placentas (with fetuses) removal on progesterone receptors (PR) in deciduomal tissues were investigated in unilateral pregnant (ULP) hamsters. Deciduomal reactions in response to artificial stimuli were induced on the tube-ligated uterine horns of ULP hamsters. Fetuses or placentas (with fetuses) were removed on day 8 of ULP, and the cytosolic and nuclear PR (cPR, and nPR, respectively) levels in deciduomal tissues at mesometrial (MS) and antimesometrial (AMS) sites were separately studied on day 10 and 12 of ULP. In the sham control group, cPR at the MS decreased with time, but at a slower rate than that at the AMS. The MS deciduoma contained higher cPR than the AMS deciduoma on day 12. Removal of fetuses did not cause any significant change of the decline rate, and the PR levels were similar to that of the control. The nPR at the MS and AMS also declined with time in all three groups. Removal of placentas induced drastic losses of cPR and nPR at the MS and AMS on day 10 and 12. Supplement of progesterone (P; 2 mg/animal/day) to the placenta-removed group restored the cPR somewhat at the MS site, but not back to the level of the control. The effect of P to restore nPR levels could be observed at the MS and AMS on day 10, but only at the MS on day 12. These data suggest that placental factor(s) other than P may play an important role on the maintenance of PR in deciduoma. Other cellular mechanisms may exist at the MS and AMS sites for the heterogeneous responses.

Changes of progesterone receptors in mesometrial and antimesometrial deciduoma after removal of fetus or placenta in unilateral pregnant hamster

The effects of fetuses or placentas (with fetuses) removal on progesterone receptors (PR) in deciduomal tissues were investigated in unilateral pregnant (ULP) hamsters. Deciduomal reactions in response to artificial stimuli were induced on the tube-ligated uterine horns of ULP hamsters. Fetuses or placentas (with fetuses) were removed on day 8 of ULP, and the cytosolic and nuclear PR (cPR, and nPR, respectively) levels in deciduomal tissues at mesometrial (MS) and antimesometrial (AMS) sites were separately studied on day 10 and 12 of ULP. In the sham control group, cPR at the MS decreased with time, but at a slower rate than that at the AMS. The MS deciduoma contained higher cPR than the AMS deciduoma on day 12. Removal of fetuses did not cause any significant change of the decline rate, and the PR levels were similar to that of the control. The nPR at the MS and AMS also declined with time in all three groups. Removal of placentas induced drastic losses of cPR and nPR at the MS and AMS on day 10 and 12. Supplement of progesterone (P; 2 mg/animal/day) to the placenta-removed group restored the cPR somewhat at the MS site, but not back to the level of the control. The effect of P to restore nPR levels could be observed at the MS and AMS on day 10, but only at the MS on day 12. These data suggest that placental factor(s) other than P may play an important role on the maintenance of PR in deciduoma. Other cellular mechanisms may exist at the MS and AMS sites for the heterogeneous responses.