Institution
University of Amsterdam
Education•Amsterdam, Noord-Holland, Netherlands•
About: University of Amsterdam is a education organization based out in Amsterdam, Noord-Holland, Netherlands. It is known for research contribution in the topics: Population & Randomized controlled trial. The organization has 59309 authors who have published 140894 publications receiving 5984137 citations. The organization is also known as: UvA & Universiteit van Amsterdam.
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University of Pittsburgh1, Utrecht University2, Imperial College Healthcare3, Université Paris-Saclay4, King Saud bin Abdulaziz University for Health Sciences5, University of Oxford6, St. Michael's Hospital7, University of Bristol8, Monash University9, University of Amsterdam10, NHS Blood and Transplant11, University of Antwerp12, Mahidol University13, Princess Alexandra Hospital14, Université de Sherbrooke15, University Health Network16, University of Western Australia17, University of Toronto18, Queen's University Belfast19, Health Research Council of New Zealand20, Auckland City Hospital21, University of British Columbia22, University of Auckland23, Radboud University Nijmegen24, The George Institute for Global Health25, University of Manitoba26, UCLA Medical Center27, University of California, Los Angeles28, St John of God Subiaco Hospital29
TL;DR: To determine whether hydrocortisone improves outcome for patients with severe COVID-19, an ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin was conducted.
Abstract: Importance Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures The primary end point was organ support–free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned –1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support–free days were 0 (IQR, –1 to 15), 0 (IQR, –1 to 13), and 0 (–1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support–free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support–free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration ClinicalTrials.gov Identifier:NCT02735707
630 citations
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University of Amsterdam1, Utrecht University2, University of Virginia3, Brown University4, Bond University5, University of Sydney6, University of Ottawa7, Ottawa Hospital Research Institute8, University of California, San Francisco9, VU University Amsterdam10, Harvard University11, Northwestern University12, University of Oxford13, Pierre-and-Marie-Curie University14
TL;DR: An updated list of 30 essential items that should be included in every report of a diagnostic accuracy study is presented, which incorporates recent evidence about sources of bias and variability in diagnostic accuracy and is intended to facilitate the use of STARD.
Abstract: Incomplete reporting has been identified as a major source of avoidable waste in biomedical research. Essential information is often not provided in study reports, impeding the identification, critical appraisal, and replication of studies. To improve the quality of reporting of diagnostic accuracy studies, the Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement was developed. Here we present STARD 2015, an updated list of 30 essential items that should be included in every report of a diagnostic accuracy study. This update incorporates recent evidence about sources of bias and variability in diagnostic accuracy and is intended to facilitate the use of STARD. As such, STARD 2015 may help to improve completeness and transparency in reporting of diagnostic accuracy studies.
630 citations
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630 citations
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TL;DR: TagRFP is reported, a monomeric red fluorescent protein, which is characterized by high brightness, complete chromophore maturation, prolonged fluorescence lifetime and high pH-stability, which makes it an excellent tag for protein localization studies and fluorescence resonance energy transfer (FRET) applications.
Abstract: Fluorescent proteins have become extremely popular tools for in vivo imaging and especially for the study of localization, motility and interaction of proteins in living cells. Here we report TagRFP, a monomeric red fluorescent protein, which is characterized by high brightness, complete chromophore maturation, prolonged fluorescence lifetime and high pH-stability. These properties make TagRFP an excellent tag for protein localization studies and fluorescence resonance energy transfer (FRET) applications.
628 citations
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TL;DR: The authors argue that the affordances an environment offers to an animal are dependent on the skills the animal possesses and that the landscape of affordances we inhabit as humans is very rich and resourceful.
Abstract: How broad is the class of affordances we can perceive? Affordances (Gibson, 1979/1986) are possibilities for action provided to an animal by the environment—by the substances, surfaces, objects, and other living creatures that surround it. A widespread assumption has been that affordances primarily relate to motor action—to locomotion and manual behaviors such as reaching and grasping. We propose an account of affordances according to which the concept of affordances has a much broader application than has hitherto been supposed. We argue that the affordances an environment offers to an animal are dependent on the skills the animal possesses. By virtue of our many abilities, the landscape of affordances we inhabit as humans is very rich and resourceful.
628 citations
Authors
Showing all 59759 results
Name | H-index | Papers | Citations |
---|---|---|---|
Richard A. Flavell | 231 | 1328 | 205119 |
Scott M. Grundy | 187 | 841 | 231821 |
Stuart H. Orkin | 186 | 715 | 112182 |
Kenneth C. Anderson | 178 | 1138 | 126072 |
David A. Weitz | 178 | 1038 | 114182 |
Dorret I. Boomsma | 176 | 1507 | 136353 |
Brenda W.J.H. Penninx | 170 | 1139 | 119082 |
Michael Kramer | 167 | 1713 | 127224 |
Nicholas J. White | 161 | 1352 | 104539 |
Lex M. Bouter | 158 | 767 | 103034 |
Wolfgang Wagner | 156 | 2342 | 123391 |
Jerome I. Rotter | 156 | 1071 | 116296 |
David Cella | 156 | 1258 | 106402 |
David Eisenberg | 156 | 697 | 112460 |
Naveed Sattar | 155 | 1326 | 116368 |