Counterparts In USA Research Articles

Incorporation of Machine Learning Tools to Predict Global Outcomes for Patients with Relapsed and Refractory Peripheral T and NK/T-Cell Lymphomas in the Contemporary Era

There has been a progressive increase in therapies for patients with relapsed and refractory (R/R) peripheral T-cell lymphomas (PTCLs) in the last decade, including antibody-drug conjugates, epigenetic modifiers, small molecule inhibitors, and monoclonal antibodies (novel single agents, SA). Their comparative efficacy to conventional chemotherapy (CC) globally remains unknown. Here, we present preliminary results of an international collaborative study spanning multiple centers across 6 continents with diverse histological epidemiology, demographics, treatment patterns, and drug access. We analyzed data from 324 patients with R/R PTCL enrolled between Jan 2010 and Dec 2020 [Brazil (n=120), Australia (AUS, n=69), COMPLETE registry USA (n=61), South Korea (SK, n=37), South Africa (SAF, n=24), and Saudi Arabia (SAU, n=13)], with ongoing participation from investigators in Italy, Chile, India, and Japan. Of 321 patients, 197 (61%) were refractory to 1st line therapy and 39% had relapsed. As expected, there was demographic heterogeneity globally. Median age at diagnosis was 54, with patients from AUS being significantly older (63). Majority were males except in SK (60% vs 25%). Overall, the most common histological subtypes were PTCL-NOS (40%), ALK- ALCL (16%), AITL (14%) and ENKTCL (12%). Exceptions included ENKTCL as the dominant subtype in SK (46%), ALCL in SAU (46%), and ATLL as the second most common subtype in Brazil (21%). Majority of patients had Ann Arbor stage III-IV disease (75%) and intermediate risk IPI (67%) and PIT scores (72%). SK and SAF had higher proportions of patients with early-stage disease and low risk IPI. Overall, only 17% of patients underwent autoSCT consolidation in first remission with higher rates in SAU (50%) and SK (41%). Patients received either SA (25%) or CC (73%) for first retreatment. Brazilian patients received significantly less SA relative to CC (6% vs. 92%) in contrast with USA (49% vs. 51%), AUS (35% vs. 64%), SK (30% vs. 68%), SAF (29% vs. 71%) and SAU (15% vs. 85%). Globally, 38% and 22% achieved a second complete (CR) and partial remission respectively upon first retreatment. 25% of patients proceeded to alloSCT, with a significantly higher number in USA (71%) and SAF (43%). Second retreatment with SA vs. CC was received by 71% vs. 26% patients in AUS and 58% vs. 42% in USA as opposed to 35% vs. 65% in SK and 33% vs. 67% in SAF. Of interest, up to 48% of patients achieved a third CR to second retreatment. No patients in Brazil received second retreatment or further salvage therapy. At median follow-up of 1.4 years (0.79-3.09), 32% of patients were alive, 61% had died, and 7% were lost to follow up. The median overall survival (OS) for patients with refractory disease (1.25 y) was inferior to those with relapsed disease (3.24 y; p<0.0001). When stratifying OS in each histological subtype by country, no statistically significant difference was found among patients with PTCL-NOS and ALCL entities. However, within the AITL subset, patients in Brazil exhibited a shorter survival compared to their counterparts in USA (p=0.045) and SK (p=0.045). In contrast, amid ENKTCL, patients in SK and Brazil had superior OS in comparison with USA (p=0.02 and 0.036) despite comparable age, stage, and IPI score. No statistically significant difference in OS was identified with respect to first retreatment with SA or CC overall and within individual histologies (Figure. 1). When stratified by calendar period of diagnosis (2010-2015 vs. 2016-2020), patients with ENKTCL (p=0.028) and ALCL (p=0.049) demonstrated an improved OS. In separate models, overall risk of death was associated with histological subtype, PIT score, and lack of CR to 1st line treatment (Table 1). We then derived a final model by comparing AICs and concordance index across several models with combinations of these three measures. We verified the risk prediction of our final model with a second machine learning strategy using random survival forest. In conclusion, this global study represents the first analysis of this type in R/R PTCL contrasting SA to CC and demonstrates that both strategies are comparable. Results confirm dismal prognosis for patients with primary refractory disease but also highlight improvements in OS in ALCL and ENKTCL in the last 5 years. We continue to enroll patients in our study and build better prediction models using state of the art synthetic intervention approaches to inform future clinical trials. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Big Tech Influence on China Financial Sector

Purpose: The objective of the paper is to present Chinese Big Tech companies and present their increasing activity on domestic financial sector. Design/Methodology/Approach: For the purpose of the paper, the following methods have been applied, critical analysis of literature and research papers as well as descriptive method and comparative analysis of presented data. Findings: Based on the above-mentioned methodology methods, Big Tech can be determined that Chinese Big Tech companies have significant potential to impact not only Chinese domestic financial sector, but also the global financial sector. What is more, COVID-19 fastened several trends undergoing on the banking sector (such as digital transformation) that Chinese financial sector is relying upon. Practical Implications: During COVID-19, Chinese Big Tech companies outperformed key players in Chinese domestic financial sector in key financial metrics such as market capitalization, revenue increase, net income. Originality/value: Chinese Big Tech companies have stronger foothold on the domestic financial markets rather than their counterparts in USA (Amazon, Apple, Google).

Cross cultural comparison of constipation profiles at tertiary care centers between India and USA.

Despite potential differences in patient perception of chronic constipation (CC) in geographically and culturally distinct regions, head-to-head studies comparing the clinical profile, constipation severity, impact on quality of life (QOL) and economic impact are lacking. We conducted a cross-sectional cohort study of patients presenting with CC to tertiary care centers in the USA and India. Standardized instruments were used to assess constipation subtype, disease severity, disease-specific QOL, somatization, and psychiatric comorbidities. We used multivariable linear regression to determine the predictors of QOL and number of healthcare visits. Sixty-six and 98 patients with CC were enrolled in the USA and India, respectively. Indian patients with CC had significantly more frequent bowel movements/week compared to their USA counterparts (Median 5 vs 3, P<.0001). The proportion of patients with Bristol stool form scale type 1 and 2 was significantly higher in the USA compared to India (65.5% vs 48%, P=.04). Higher depression score (P=.001), more severe constipation symptoms (P=.001) and site of the study being USA (P=.008) independently predicted worse QOL. Indian patients (P<.001) and worse QOL (P=.02) were independent predictors of number of healthcare visits in the last 12months. Indian patients with CC have more frequent and softer bowel movements compared to those in the USA suggesting significant differences in perception of CC in different geographic and cultural settings. QOL and economic impact related to constipation varies with geographic/cultural setting irrespective of other clinical and psychosomatic features.

Participatory organic research in the USA and Italy: Across a continuum of farmer–researcher partnerships

AbstractOrganic agriculture continues to expand in the USA and in the European Union (EU), particularly in Italy, which had 48,650 organic farms in 2014 compared with 19,474 in the USA. Additionally, EU support for organic research is nearly double than that of the USA. Along with increased support for organic research, the EU organic community has achieved recognition at the European Commission policy level for a dedicated innovation platform, advocating the practice of farmer-first models for participatory research. The US land-grant universities have a long history of on-farm research, primarily through the Extension Service, but the need exists for more inclusive, second-loop, co-research with organic farmers. A survey was conducted of organic farmers and researchers in Italy and in the USA to ascertain the extent of participatory organic research activities and experiences, and explore the vision each group had for the future of co-innovation between organic farmers and researchers. Results indicated that, despite the higher level of organic research support in the EU, the percentage of researchers involved in on-farm/participatory organic research was equivalent in Italy and the USA, presumably due to the more recent emphasis in Italian/EU agricultural research agendas on the importance of farmer knowledge and participation in organic research. Overall, 60% of surveyed organic researchers in both countries cited involvement in on-farm/participatory organic research, with ‘farming systems’ and ‘nutrient/pest management’ the main research focus in the USA, compared with ‘farming systems’ and ‘equipment’ in Italy. Both countries’ researchers expressed their vision of participatory research as helping to improve communication between researchers and farmers, to enable work on relevant research, and to allow farmers to adapt technologies to their own conditions. Organic farmers in Italy completed survey questionnaires as part of a field day activity, leading to more Italian farmers responding to the survey, compared with USA counterparts who were queried via e-mail. Organic farmers in Italy identified ‘knowledge-sharing’ as a critical value of participatory research, and were conducting on-farm research with less compensation than US farmers. The ‘lack of time’ was cited as the most important constraint limiting participatory research by Italian and US farmers, although the ‘lack of common language’ also was rated as potentially impairing full participation. Lessons shared between EU and US organic researchers as a result of this project included methods to institute policies aimed at increasing support for organic research and co-innovations with organic farming communities, and connecting experienced on-farm researchers in the US with Italian colleagues to enhance collaborative activities with organic farmers.

Will the science and technology gap between China and USA becomes narrower, wider, or stay in the same in 50 years' time?

It is acknowledged that currently USA overall takes a wide lead in science and technology ahead of China. Will the science and technology gap between China and USA becomes narrower, wider, or stay in the same in 50 years’ time? This question recently occurred to me when a few reports in media claimed that China has become the ‘globally second player’ in research and development (1-3). Unfortunately, the data presented in these media were quite quantitative, mostly concerning the number of papers published, the number of graduate students trained, the amount of funds spent on R&D. The qualitative aspects of R&D in China have not been well studied. Back in 2011 Wadhwa noted that the engineer graduates in China were less skilled compared their USA counterparts (4). Wadhwa commented that ‘ our (U.S.) engineers can think outside the box… U.S.-educated engineers learn a broad variety of skills…The graduates of U.S. engineering programs are productive from the day they graduate… Our engineering education system… gives us a big advantage in productivity, innovation and entrepreneurship ’. Wadhwa argues that there was no shortage of engineers in USA overall. In a free economy such as USA, supply responds to demand. Using salaries as the indicator, in most engineering professions salaries have not increased more than inflation over the past two decades, and graduating more of the wrong types of engineers is likely to increase unemployment rather than create jobs (4).

Profile of Physiotherapist Educators in Anglophone West African Countries: A Cross-Sectional Study

Background: In the last two decades, physiotherapy profession in many countries has transitioned their entry-level education to a Master’s or doctoral degree levels. Given these changes, there is a new need to discern the profile of physiotherapist educators in different countries. Objectives: This cross-sectional study was designed to investigate the profile of the physiotherapist lecturers from Anglophone West African countries and to compare the data with their USA counterparts. Methods: The Head of Department of all the physiotherapy programs in West African universities (N = 14) completed a questionnaire that sought information on the University’s debut date and ownership, faculty gender, educational qualification and academic rank. Results: The vast majority (93%) of the physiotherapy programs surveyed are located in public universities. There were 126 lecturers employed in the programs surveyed (average of 9 lecturers per program). In Nigeria, 72% of the lecturers were men, but in Ghana there was an equal (50:50) split between men and women. Fifty-nine percent (59%) of the lecturers in Nigeria had a Ph.D. and 32% were with MS degree. Thirty-four percent (34%) were a Senior lecturer, 19% Lecturer I, 10% Associate Professor/Reader and 10% Professor. More Nigerian lecturers attained higher (p

Icelandic and United States families of adolescents with asthma: predictors of health‐related quality of life from the parents’ perspective

To evaluate cultural differences in sociodemographic factors, illness severity and parents' perception of their adolescent's quality of life for Icelandic and USA families of adolescents with asthma; and to determine predictors of parent-rated quality of life. Asthma is known to have an impact on the quality of life of affected adolescents and their families, but few studies have addressed parents' perception of their adolescent's health-related quality of life. Cross-sectional exploratory study. The study involved families of adolescents with asthma included 15 from Iceland and 15 from USA, recruited from paediatric practices. Parent and adolescent participants completed questionnaires; this study is based on the parent responses. Data were collected from January-May 2006. While parents from Iceland and USA were similar in demographic characteristics, parents from Iceland rated their children's health-related quality of life (PedsQL(TM) 3.0, Varni 1998) more positively than did USA parents, even though Icelandic parents were more likely than their USA counterparts to report that their adolescent's asthma is severe. Significant predictors of parent-rated quality of life included location (higher scores for Icelandic parents), gender (higher scores for parents of boys), exposure to second hand smoke in the home (higher scores for those not exposed) and frequency of troublesome wheezing (higher scores for lower frequency). Quality of life has been acknowledged as an essential health outcome measure. Even though gender difference was not found in asthma severity, parents of boys perceived their adolescent's quality of life as more positive compared with parents of girls. It might be helpful for Icelandic and USA families to integrate into care delivery models, cultural differences in parent-rated quality of life. Asthma management interventions may improve quality of life for adolescents with asthma by reducing symptoms. Interventions promoting smoke-free homes and enhanced self-monitoring to prevent exacerbations may improve quality of life.

Information Systems Research and Academic Societies in Japan: an Overview

Japanese information systems (IS) research and the activities and foci of Japanese IS academic societies remain relatively unknown outside of Japan. A number of obstacles including structural and linguistic factors inhibit the smooth transfer and exchange of knowledge between Japanese IS researchers and international colleagues. There is also a lack of research exploring these factors and their consequences. This paper seeks to contribute to addressing both these issues. It commences with an empirical comparative analysis of the research foci of IS researchers in Japan and in the USA, and highlights a marked structural difference with Japanese IS researchers engaged in a more diverse range of activities than their USA counterparts. Using interviews these results are discussed with leading Japanese IS researchers and insights generated in relation IS academic societies and the characteristics and factors influencing Japanese IS research and its under-representation in the international IS community.

Cross‐cultural comparison of interactivity and advertising appeals on antismoking web sites in the United States and South Korea

PurposeThis study aims to examine the content of health promotional web sites in two culturally distinct countries, the USA and South Korea, by investigating the level of interactivity and types of advertising appeals presented on antismoking web sites.Design/methodology/approachAntismoking web sites in the two countries were collected through the three major search engines (msn, Yahoo and Google) using relevant keywords. The final sample contained a total of 89 web sites (USA=67, South Korea=22) that met the condition of promoting antismoking behavior rather than just selling antismoking products. Three bilingual coders were hired for the analysis.FindingsThe South Korean antismoking web sites presented significantly higher levels of interactivity than their USA counterparts. By contrast, there is hardly any differentiation between the two countries in the amount of advertising appeals used on the health web sites.Research limitations/implicationsEven though antismoking is certainly an important global issue, the findings related to antismoking web sites may not be generalizable to various other health‐related topics. Future research should replicate our findings on interactivity and advertising appeals in the context of various health issues.Practical implicationsTo cross‐cultural researchers, the results provide more theoretical and practical rationales for cross‐cultural differences beyond such well‐known typologies as Hofstede's Individualism/Collectivism and Hall's high‐low context.Originality/valueThis study provided at least two useful findings for practitioners and researchers: better definition of the roles of cultural differences in the level of interactivity and the types of advertising appeals in promoting health information online and a broadening of the scope of cross‐cultural advertising research to health promotional contexts online.

Nurse practitioners, learning from the USA experience: a review of the literature

This paper reviews the nurse practitioner (NP) literature to address a number of topical issues. It considers whether USA NP experiences translate to the UK, and what needs NPs might meet. The author contends that a ‘care gap’ exists, which can be linked to factors such as inner-city deprivation, technical knowledge deficits and iatrogenesis, chronic illness, failure of prevention and screening, and rising health expectations on the part of the public. NP roles might be developed to fill the care vacuum in these areas. However, progress to date has been hampered by opposition from the nursing profession itself, as well as from doctors. The paper reviews the empirical evidence on the implementation of NP roles, and considers the implications for nurse education. The NP role is highly demanding, and includes prescriptive authority in many instances. To date, the evidence from the USA studies of NPs’ safety and performance is almost unequivocally positive. To educate NPs in the UK to the high standard of their USA counterparts poses a challenge for nurse educators, particularly in pharmacology and pathophysiology. If nurse educators do not fill the ‘education gap’ in the technical areas, such as pharmacology, it is possible that the pharmaceutical industry will become involved as has happened in medicine.

South Asians and Cardiovascular Risk

Case presentation: A 36-year-old nonsmoking, normotensive South Asian man presented to the emergency department of a community hospital with retrosternal chest pain of &60 minutes’ duration. His 12-lead ECG demonstrated 10 mm of ST-segment elevation in leads V2 through V6, and he received fibrinolytic therapy within 90 minutes of symptom onset. His pain resolved, but his ST segments only partially normalized; he had a peak creatine kinase of 4564 IU/L, and he showed signs of early heart failure. LDL cholesterol was 135 mg/dL, HDL 32 mg/dL, triglycerides 20 mg/dL, and total cholesterol 206 mg/dL; his body mass index (BMI) was 24 kg/m2. Cardiac catheterization demonstrated severe and diffuse triple-vessel disease, including occlusion of the proximal left anterior descending artery, as well as moderate left ventricular dysfunction. While in the hospital, he was diagnosed with new-onset type 2 diabetes mellitus and subsequently underwent uncomplicated coronary bypass surgery. South Asians are individuals whose ethnic roots originate from the Indian subcontinent, a large geographic area that includes India, Pakistan, Sri Lanka, Nepal, and Bangladesh. Collectively, South Asians represent one fifth of the global population. In North America, more than 2 million South Asians reside in the United States and almost 1 million in Canada. It is important to recognize that the term “South Asian” refers to a heterogeneous population, with important differences in diet, culture, and lifestyle among different South Asian populations and religions. Multiple studies of migrant South Asian populations have, however, confirmed a 3- to 5-fold increase in the risk for myocardial infarction and cardiovascular death as compared with other ethnic groups.1–3 In an analysis of age-standardized coronary heart disease (CHD) mortality in Canada over a 15-year period, South Asians had the highest CHD mortality compared with individuals of Chinese and European descent.4 In …

Evaluation of Lp[a] and other independent risk factors for CHD in Asian Indians and their USA counterparts

Conventional risk factors for coronary heart disease (CHD) do not completely account for the observed increase in premature CHD in people from the Indian subcontinent or for Asian Indians who have immigrated to the USA. The objective of this study was to determine the effect of immigration to the USA on plasma levels of lipoprotein [a] (Lp[a]) and other independent risk factors for CHD in Asian Indians. Three subject groups were studied: group 1, 57 subjects living in India and diagnosed with CHD (CHD patients); group 2, 46 subjects living in India and showing no symptoms of CHD (control subjects); group 3, 206 Asian Indians living in the USA. Fasting blood samples were drawn to determine plasma levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein [LDL cholesterol (LDL-Chol)], high density lipoprotein [HDL cholesterol (HDL-Chol)], apolipoprotein B-100 (apoB-100), and Lp[a]. Apolipoprotein [a] (apo[a]) size polymorphism was determined by immunoblotting. Plasma TG, apoB-100, and Lp[a] concentrations were higher in CHD patients than in control and USA groups. CHD patients had higher levels of TC and LDL-Chol and lower HDL-Chol than control subjects. However, the USA population had higher levels of TC, LDL-Chol, and apoB-100 and lower HDL-Chol than control subjects. Plasma Lp[a] levels were inversely correlated with the relative molecular weight of the more abundant of each subject's two apo[a] isoforms (MAI), and CHD patients showed higher frequencies of lower relative molecular weights among MAI. Our observed changes in lipid profiles suggest that immigrating to the USA may place Asian Indians at increased risk for CHD. This study suggests that elevated plasma Lp[a] confers genetic predisposition to CHD in Asian Indians, and nutritional and environmental factors further increase the risk of CHD. This is the first report implicating MAI size as a predictor for development of premature CHD in Asian Indians. Including plasma Lp[a] concentration and apo[a] phenotype in screening procedures may permit early detection and preventive treatment of CHD in this population.

MAP progress for Europe

Since March, 1985 when the first conference on MAP in Europe took place, there has been rapid progress to balance the effort between USA and Europe to speed up the development of International Standards for MAP. There are now over 200 firms in the European MAP User Group (EMUG) and three working groups with EMUG sharing work with their USA counterparts. The coordination of European National Standard Bodies via EMUG, CEN/CENELEC, CNMA and SPAG must be enhanced to speed up formulation of International Standards for MAP. Towards this objective countries have or are forming, National Chapters to advance MAP progress with each country whilst supporting EMUG as the centre of Technical Development for MAP.