Background Interstitial lung disease (ILD) is a recognized complication of RA. Prior studies have suggested stabilization or improvement of ILD in patients with RA (RA-ILD) treated with abatacept. [1,2] Few studies ha...
Background Interstitial lung disease (ILD) is a recognized complication of RA. Prior studies have suggested stabilization or improvement of ILD in patients with RA (RA-ILD) treated with abatacept. [1,2] Few studies have evaluated the background incidence rate of RA-ILD. Objectives To determine the incidence rate of clinically significant ILD in a cohort of patients with RA receiving abatacept + MTX versus placebo + MTX from multiple clinical trials. Methods This retrospective analysis examined pooled safety data from ten phase 3 clinical trials of patients with RA treated with background MTX in combination with abatacept or placebo. The term ‘interstitial lung’ was used to identify incidences of ILD reported as AEs in the safety data. The exposure period for each patient was censored at first incidence of clinically significant ILD, 56 days after last study drug administration, or 1 day prior to commencement of another study drug, whichever occurred first. Poisson regression models were used to estimate crude incidence rates per 100 person-years for baseline risk factors within treatment groups, and to estimate incidence rate ratios for the placebo + MTX versus abatacept + MTX treatment groups. Disease activity parameters, DAS28 (CRP) and HAQ-DI, were estimated from baseline to the time of ILD diagnosis (as reported by AEs). Results In total, 3,708 patients (10,521 person-years) treated with abatacept + MTX and 999 patients (938 person-years) treated with placebo + MTX were included. Patients treated with placebo + MTX had a higher incidence rate of ILD per 100 person-years (95% CI) versus those treated with abatacept + MTX (0.43 [0.16–1.14] vs 0.10 [0.05–0.18], respectively; Figure 1). The incidence rate ratio of placebo + MTX versus abatacept + MTX treatment groups for the total population was 4.49 (95% CI, 1.23–13.42). For all subpopulations stratified by baseline risk factors (where ≥ 1 patient in each treatment group had an ILD event), incidence rate ratios wer
Little is known about the health of sexual minority women caregivers, or vulnerable subgroups in this population. We compared self-rated health of caregivers to adults with cancer versus other conditions among 266 sex...
Little is known about the health of sexual minority women caregivers, or vulnerable subgroups in this population. We compared self-rated health of caregivers to adults with cancer versus other conditions among 266 sexual/gender minority women who completed an internet survey during January 2018. Women were recruited via the National LGBT Cancer Network Facebook site. Eligibility included identifying as lesbian, gay, bisexual or transgender (LGBT), and providing care to an adult for > 2 hours/week. Respondents’ mean age was 38.0 (+ 8.4) years; 76% were white; 45% cared for a relative or friend with cancer, which were mainly breast (24%) and lung (26%) cancers, followed by lymphoma, colorectal, and prostate cancer. Other respondents cared for persons with dementia (29%), heart disease, aging-related disorders, mental illness, and AIDS (12%-23%). Cancer caregivers were significantly (p<0.05) more likely than other caregivers to be non-white, care for a spouse, live with the care recipient, and perform caregiving tasks >5 hours/day. They were more likely to rate their own health as fair/poor (43% vs. 12%), particularly if they helped a spouse with cancer (45%). In confounder-adjusted multinomial logistic regression analyses, cancer caregivers had higher odds than other caregivers of rating their health as fair/poor (adjusted odds ratio, aOR = 8.20, 95% confidence interval, CI= 3.26–20.61) or good (aOR = 1.97, CI = 0.89–4.34) versus excellent/very good (22% vs. 49%). In conclusion, LGBT women caregivers for persons with cancer had worse self-rated health and may be at risk of adverse health outcomes; these results merit further study.
During the last 6 years Central statistical Office of Poland (CSO) made great progress in the field of geographic information systems. Up to 2008 all geographic data was kept and maintained solely on paper maps. Today...
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Background: Amnestic mild cognitive impairment (aMCI) and mild-to-moderate Alzheimer’s disease (AD) are clinically distinct but impact cognitive and functional ability similarly. Comprehensive assessment of cognitive...
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Background: Amnestic mild cognitive impairment (aMCI) and mild-to-moderate Alzheimer’s disease (AD) are clinically distinct but impact cognitive and functional ability similarly. Comprehensive assessment of cognitive and functional deficits may prove useful in informing differential diagnosis in early stages of dementia and in informing endpoint selection in therapeutic AD trials. Objective: The objective of this study was to characterize patterns of cognitive and functional impairment in aMCI and mild-to-moderate AD subjects compared to cognitively intact healthy elderly (HE). Methods: Thirty-one healthy elderly, 20 aMCI and 19 AD participants were administered a cognitive test battery that included the ADAS-Cog and functional assessments. Z-scores were calculated for all endpoints based on the HE reference group. Results: Cognitive deficits were observed in AD and aMCI participants relative to the referent group. On average, aMCI participants performed 1 - 2 standard deviations below HE on cognitive tests, and AD participants performed 2 - 3 standard deviations below HE. Domain-specific functional deficits among AD participants (z- score -0.4 to -6.4) were consistently greater than those of aMCI participants (z-score 0 to -1.7). Conclusion: This study provides further support for comprehensive assessment and monitoring of cognitive and functional domain scores in the diagnosis and treatment of aMCI and mild AD. Domain-specific cognitive scores may be more useful than composite scores in characterizing impairment and decline. Measuring domains such as attention, processing speed and executive function may increase the sensitivity of detecting disease progression and therapeutic effects, particularly in mild-moderate AD where memory decline may be too slow to detect drug effects during a typical clinical trial.
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NANCY MERRITTTERRY FAINSUSAN TURNERExtensive experience conducting justice system policy studies at the state and local level. As a Policy Analyst with the RAND Corporation and government agencies
she designed and directed studies focused on the development implementation and evaluation of sentencing policy as well as juvenile and adult correctional programs. Her current work focuses on the implementation and impact of mandatory sentencing laws cross-jurisdictional variations in their application and the effects of prosecutorial discretion. Additional areas of interest include the development implementation and evaluation of juvenile justice programming. Ms. Merritt received her M.S. from the Pennsylvania State University University Park and is a Ph.D. candidate with the Rutgers University School of Criminal Justice. M.A.
M.S. is a Senior project associate in the Behavioral Sciences Department at RAND Corporation. He has extensive research experience in criminal justice and substance abuse. He is expert in computer statistical techniques as well as in managing large datasets. He has conducted analysis for many RAND projects and is author or co-author of numerous publications both from RAND and in peer-reviewed journals. His research interests include alternatives to incarceration substance abuse and treatment racial disparities in prison admissions and research collaborations with state and local justice agencies. Professor in the Department of Criminology
Law and Society at the University of California's Irvine campus. She received her Ph.D. in Social Psychology from the University of North Carolina at Chapel Hill. She has led a variety of research projects including studies on racial disparity field experiments of private sector alternatives for serious juvenile offenders work release day fines and a 14–site evaluation of intensive supervision probation. Dr. Turner's areas of expertise include the design and implementation of randomized field experiments and research collaborations with state and local justice agencies. He
Research Summary: Oregon's Measure 11, a mandatory minimum sentencing policy passed in 1994, had fewer negative system impacts than had been anticipated by many state and local criminal justice administrators, due...
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Research Summary: Oregon's Measure 11, a mandatory minimum sentencing policy passed in 1994, had fewer negative system impacts than had been anticipated by many state and local criminal justice administrators, due largely to the fact that prosecutors exercised the discretion provided them under the law to selectively prosecute cases. Consequently, fewer Measure 11-eligible cases were sentenced under the relevant statues than before passage of the measure, and more were sentenced to lesser related offenses. At the same time, incarceration rates and sentence lengths increased for both Measure 11 and lesser related offenses. Trial rates increased for two years after Measure 11 took effect before reverting to previous levels. Policy Implications: The “unintended consequences” that Measure 11 produced should not have been unexpected. Our research indicates that the entire system will quickly adapt to mitigate the more draconian outcomes predicted by those who assume a simplistic implementation, which underscores the importance of understanding system dynamics and inter-relationships before implementing reform, as well as the pitfalls of designing legislation for either symbolic appeal or formal logic rather than for actual effect.
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