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The purpose of this phase III clinical trial was to compare two different extracellular contrast agents, 1.0 M gadobutrol and 0.5 M gadopentate dimeglumine, for magnetic resonance imaging (MRI) in patients with known or suspected focal renal lesions. Using a multicenter, single-blind, interindividual, randomized study design, both contrast agents were compared in a total of 471 patients regarding their diagnostic accuracy, sensitivity, and specificity to correctly classify focal lesions of the kidney. To test for noninferiority the diagnostic accuracy rates for both contrast agents were compared with CT results based on a blinded reading. The average diagnostic accuracy across the three blinded readers (‘average reader’) was 83.7% for gadobutrol and 87.3% for gadopentate dimeglumine. The increase in accuracy from precontrast to combined precontrast and postcontrast MRI was 8.0% for gadobutrol and 6.9% for gadopentate dimeglumine. Sensitivity of the average reader was 85.2% for gadobutrol and 88.7% for gadopentate dimeglumine. Specificity of the average reader was 82.1% for gadobutrol and 86.1% for gadopentate dimeglumine. In conclusion, this study documents evidence for the noninferiority of a single i.v. bolus injection of 1.0 M gadobutrol compared with 0.5 M gadopentate dimeglumine in the diagnostic assessment of renal lesions with CE-MRI.
In 2010, the Conference of the Parties of the Convention on Biological Diversity agreedon the Strategic Plan for Biodiversity 2011–2020 in Aichi Prefecture, Japan. As this planapproaches its end, we discussed whether marine biodiversity and prediction studieswere nearing the Aichi Targets during the 4th World Conference on Marine Biodiversityheld in Montreal, Canada in June 2018. This article summarises the outcome of a five-day group discussion on how global marine biodiversity studies should be focusedfurther to better understand the patterns of biodiversity. We discussed and reviewedseven fundamental biodiversity priorities related to nine Aichi Targets focusing onglobal biodiversity discovery and predictions to improve and enhance biodiversitydata standards (quantity and quality), tools and techniques, spatial and temporal scaleframing, and stewardship and dissemination. We discuss how identifying biodiversityknowledge gaps and promoting efforts have and will reduce such gaps, including via theuse of new databases, tools and technology, and how these resources could be improvedin the future. The group recognised significant progress toward Target 19 in relationto scientific knowledge, but negligible progress with regard to Targets 6 to 13 whichaimed to safeguard and reduce human impacts on biodiversity.
Restructuration des répertoires langagiers de migrant·e·s de la République du Congo en Lorraine
(2023)
Cette thèse étudie la complexité du plurilinguisme des migrant·e·s d’origine de la République du Congo en Lorraine à travers le prisme de la restructuration des répertoires langagiers. En affûtant la conceptualisation de la restructuration des répertoires langagiers par l’étude du plurilinguisme des migrant·e·s d’origine congolaise, cette recherche ouvre de nouvelles perspectives pour les recherches portant sur le plurilinguisme, notamment concernant les mobilités transgénérationnelles et la diversité des processus de restructuration façonnant les répertoires langagiers. En se focalisant sur les biographies langagières et migratoires de 15 individus migrants, sur leurs réseaux sociaux et sur leurs ressources langagières, cette étude révèle la diversité des processus et des facteurs au cœur des restructurations des répertoires langagiers à travers une étude ethnographique multi-située en Lorraine et au Congo. La compréhension de la diversité des dynamiques restructurant les connaissances langagières des enquêté·e·s passe par l’étude des situations de socialisation langagière au Congo dans leur historicité, des itinéraires de migration et des restructurations des réseaux sociaux ainsi que des répertoires langagiers dans l’installation en Lorraine. Les participations à la société lorraine et ses groupes sociaux imprègnent les identifications, les orientations sociales et les positionnements dans les réseaux sociaux et vice-versa.
Les répertoires langagiers apparaissent comme des enregistrements de la mobilité des individus et de celle des générations antérieures ainsi que de leur entourage. Les restructurations concernent entre autres les ressources associées au français, aux langues congolaises et à d’autres langues appropriées par la migration. Les ressources du français sont restructurées par les migrant·e·s en s’appropriant les ressources courantes dans différentes situations sociales en Lorraine, en marquant et/ou en dissimulant les ressources appropriées ailleurs et inappropriées dans ces situations. En même temps, un savoir de différenciation des ressources, dont font aussi partie les schémas de catégorisation et les stratégies communicatives, est développé et une (in)sécurité langagière se manifeste. Les ressources associées aux langues congolaises, leurs fonctions sociales et leurs représentations sont restructurées dans des processus d’attrition, d’actualisation, de transformation et d’élaboration langagière. Les ressources associées à d’autres langues européennes appropriées par la migration sont reléguées au second plan et se perdent lentement par manque d’usage. Enfin, les connaissances liées à la gestion du plurilinguisme, de la diversité culturelle et de l’altérité, appropriées dans les mêmes situations de diversité, aident au traitement interne des expériences des mobilités spatiales et sociales ainsi que des restructurations des répertoires langagiers.
Background: Despite novel therapeutic agents, most multiple myeloma (MM) patients eventually relapse. Two large phase III trials have shown significantly improved response rates (RR) of lenalidomide/dexamethasone compared with placebo/dexamethasone in relapsed MM (RMM) patients. These results have led to the approval of lenalidomide for RMM patients and lenalidomide/dexamethasone has since become a widely accepted second-line treatment. Furthermore, in RMM patients consolidation with high-dose chemotherapy plus autologous stem cell transplantation has been shown to significantly increase progression free survival (PFS) as compared to cyclophosphamide in a phase III trial. The randomized prospective ReLApsE trial is designed to evaluate PFS after lenalidomide/dexamethasone induction, high-dose chemotherapy consolidation plus autologous stem cell transplantation and lenalidomide maintenance compared with the well-established lenalidomide/dexamethasone regimen in RMM patients.
Methods/Design: ReLApsE is a randomized, open, multicenter phase III trial in a planned study population of 282 RMM patients. All patients receive three lenalidomide/dexamethasone cycles and - in absence of available stem cells from earlier harvesting - undergo peripheral blood stem cell mobilization and harvesting. Subsequently, patients in arm A continue on consecutive lenalidomide/dexamethasone cycles, patients in arm B undergo high dose chemotherapy plus autologous stem cell transplantation followed by lenalidomide maintenance until discontinuation criteria are met. Therapeutic response is evaluated after the 3rd (arm A + B) and the 5th lenalidomide/dexamethasone cycle (arm A) or 2 months after autologous stem cell transplantation (arm B) and every 3 months thereafter (arm A + B). After finishing the study treatment, patients are followed up for survival and subsequent myeloma therapies. The expected trial duration is 6.25 years from first patient in to last patient out. The primary endpoint is PFS, secondary endpoints include overall survival (OS), RR, time to best response and the influence of early versus late salvage high dose chemotherapy plus autologous stem cell transplantation on OS.
Discussion: This phase III trial is designed to evaluate whether high dose chemotherapy plus autologous stem cell transplantation and lenalidomide maintenance after lenalidomide/dexamethasone induction improves PFS compared with the well-established continued lenalidomide/dexamethasone regimen in RMM patients. Trial registration: ISRCTN16345835 (date of registration 2010-08-24).