Research Organizations Research Articles

Prognostic Factors of Oligometastasis After Stereotactic Body Radiotherapy: The Real-World Utility of the European Society for Radiotherapy and Oncology/European Organisation for Research and Treatment of Cancer Classification

Prognostic Factors of Oligometastasis After Stereotactic Body Radiotherapy: The Real-World Utility of the European Society for Radiotherapy and Oncology/European Organisation for Research and Treatment of Cancer Classification

Challenges of implementing a climate-smart agriculture-based curriculum in agricultural vocational schools: evidence from Iran

The research aimed to identify the challenges of developing and implementing a climate-smart agriculture (CSA)-based curriculum in Iran’s agricultural vocational schools. It was exploratory descriptive-analytical in nature and applied in goal, in which data were collected with the library and deep interview method. The research methodology was based on grounded theory. The statistical population was composed of 16 researchers, authors, managers, and experts of the Office of Textbook Compilation of the Organization for Educational Research and Planning and the Research Center of Educational Studies. The participants were selected by the homogenous purposive sampling method. The interview with the target population continued until it reached theoretical saturation. Data were analyzed using the content analysis method. The data collected in the interviews were subjected to open, axial, and selective coding, which resulted in deriving 119 concepts and 28 categories. The results revealed a seven-dimension structure composed of the challenges related to determining educational goals, trainees, trainers’ professional process, teaching methods, curriculum content selection and organization, curriculum implementation, and curriculum appraisal. The results can help the experts in the Office of Textbook Compilation experts adopt smarter policies and solutions to solve the challenges of developing and implementing a CSA-based curriculum in agricultural vocational schools in Iran.

Health-related quality of life with sacituzumab govitecan in HR+/HER2- metastatic breast cancer in the phase III TROPiCS-02 trial.

The TROPiCS-02 study (NCT03901339) demonstrated that sacituzumab govitecan (SG) has superior clinical outcomes over treatment of physician's choice (TPC) chemotherapy in patients with hormone receptor-positive, human epidermal growth factor 2 receptor-negative (HR+/HER2-) metastatic breast cancer (mBC). Here, we present health-related quality of life (HRQoL) patient-reported outcome (PRO) findings from this study. Eligible adults with HR+/HER2- mBC who previously received a taxane, endocrine-based therapy, a CDK4/6 inhibitor, and 2-4 lines of chemotherapy were randomized 1:1 to receive SG or TPC until progression or unacceptable toxicity. PROs were assessed at baseline and on day 1 of each cycle, using the European Organization for Research and Treatment of Cancer Quality-of-Life Core 30 (EORTC QLQ-C30), EQ-5D-5L, and PRO Common Terminology Criteria for Adverse Events (PRO-CTCAE). Compared to TPC, overall least square mean change from baseline was significantly better for SG for physical functioning and dyspnea, but worse for diarrhea. Time to first clinically meaningful worsening or death was significantly longer for SG in global health status/quality of life, physical functioning, fatigue, emotional functioning, dyspnea, insomnia, and financial difficulties of the EORTC QLQ-C30 and the EQ-VAS, but longer for TPC in diarrhea. Few patients in both arms reported experiencing any worsening to level 3 or 4 treatment-related symptomatic events during treatment, as assessed by 16 PRO-CTCAE items, except for diarrhea frequency and amount of hair loss, which favored TPC. SG was associated with an HRQoL benefit in most symptoms and functioning, compared with TPC. This supports the favorable profile of SG as a treatment option for patients with pretreated HR+/HER2- mBC.

Is transanal irrigation the best treatment possibility for low anterior resection syndrome? A multicenter, randomized clinical trial: study protocol

BackgroundUp to 50% of patients who undergo rectal resection suffer from various and partly severe functional problems, despite the preservation of the anal sphincter. These complaints are defined as low anterior resection syndrome (LARS). So far, there are no randomized clinical trials regarding the most effective treatment for LARS. Our aim is to evaluate whether transanal irrigation improves bowel function and quality of life in patients following low anterior resection compared to best supportive care.MethodsPatients who have undergone low anterior resection will be approached for this study. On patient's visit, complaints regarding the defecation as well as any deterioration in their overall quality of life will be assessed using questionnaires such as the Low Anterior Resection Syndromes score, Wexner score, European Organization for Research and Treatment of Cancer (EORTC) Quality of Life (QOL) CR-29, and Measure Yourself Medical Outcome Profile tool. Few additional target questions will be also asked, such as “Would you recommend the treatment to anybody; did you expect the improvement following the treatment; etc.” Questionnaires and scales will be filled on follow-up visits every 3 months for 1 year.DiscussionThis multicenter, randomized controlled trial will lead to a better understanding of LARS treatment. Moreover, it will be a hypothesis-generating study and will inform areas needing future prospective studies. Clinical Trial RegistrationClinicalTrials.gov, identifier (NCT05920681).

Realising the human development promise in dual VET

ABSTRACT Despite growing consensus around the need for a more holistic vision of development, realising the human development potential of educational interventions has proven a challenging task. This Forum grapples with how these tensions manifest in the international transfer of dual models of Vocational Education and Training (dVET) to low- and middle-income countries. While dVET has gained global currency, its developmental potential has been primarily framed in economic terms. Conversely, its alignment with human development remains an abstract possibility and is often not reflected in the policy design of dVET transfer attempts. Each contribution to this Forum probes a different facet of these tensions, exploring how dVET can be calibrated in different contexts to realise its human development potential. Taking a practice-led approach and featuring representatives from cooperation agencies, consultancy groups, and research organisations, this piece contributes to ongoing debates about the possibility of effectively integrating human development thinking into education policy.

Analysis of Stakeholders' Trust Level in the Nuclear Energy Domain in Japan

Abstract In discussions on the nuclear restart policy in Japan, trust among stakeholders in nuclear power is often raised as an issue. However, the discussion has progressed without analyzing the trust demanded by the Japanese public. A questionnaire survey was conducted to analyze the level of trust that 4,700 Japanese citizens (100 from each of the 47 prefectures) have in nuclear stakeholders by breaking trust down into three elements: “Perceived Competence,” “Perceived Motivation,” and “Salient Value Similarity” (SVS), which have been reported in the literature. In the survey, nine stakeholders were targeted: the Nuclear Regulation Authority; the Ministry of Economy, Trade and Industry; the courts; the Diet; host municipalities; nuclear power operators and manufacturers; experts; research and international organizations; and the mass media. The analysis showed that the Japanese public is particularly interested in SVS with “nuclear power operators and manufacturers” among the various nuclear stakeholders. The SVS of “nuclear power operators and manufacturers” was highly correlated with that of organizations promoting nuclear power, suggesting that the public tends to perceive these organizations as sharing similar values. These results offer suggestions for actions that should be taken by each nuclear stakeholder to restore and improve trust.

The influence of delayed gastric emptying on quality of life after partial duodenopancreatectomy.

Quality of life (QoL) is temporarily compromised after pancreatic surgery, but no evidence for a negative impact of postoperative complications on QoL has been provided thus far. Delayed gastric emptying (DGE) is one of the most common complications after pancreatic surgery and is associated with a high level of distress. Therefore, the aim of this study was to analyse the influence of DGE on QoL. This single-centre retrospective study analysed QoL after partial duodenopancreatectomy (PD) via the European Organization for Research and Treatment of Cancer core questionnaire (QLQ-C30). The QoL of patients with and without postoperative DGE was compared. Between 2010 and 2022, 251 patients were included, 85 of whom developed DGE (34%). Within the first postoperative year, compared to patients without DGE, those with DGE had a significantly reduced QoL, by 9.0 points (95% CI: -13.0 to -5.1, p < 0.001). Specifically, physical and psychosocial functioning (p = 0.020) decreased significantly, and patients with DGE suffered significantly more from fatigue (p = 0.010) and appetite loss (p = 0.017) than patients without DGE. After the first postoperative year, there were no significant differences in QoL or symptom scores between patients with DGE and those without DGE. Patients who developed DGE reported a significantly reduced QoL and reduced physical and psychosocial functioning within the first year after partial pancreatoduodenectomy compared to patients without DGE.

Establishment and evaluation of the impact of a supervisory group for chemotherapy safety management in an oncology department.

The nursing model of establishing a chemotherapy safety management supervisory group has guaranteed the safety and effectiveness of intravenous chemotherapy while reducing the adverse effects of chemotherapy and improving patient satisfaction and quality of life. To explore the impact of establishing a nursing supervision group on improving the safety management of patients receiving chemotherapy in the oncology department. We selected a total of 60 patients who underwent chemotherapy at the oncology department between January and June 2021 and assigned them to the control group. They received conventional chemotherapy safety management nursing care. We selected another 60 patients undergoing chemotherapy in the oncology department between July and December 2021 and assigned them to the observation group. They received a nursing intervention model facilitated by the chemotherapy safety supervision team. We compared the intervention effects in the two groups. Patient satisfaction was significantly higher in the observation group than in the control group (P< 0.05); the incidence of post-chemotherapy nausea and vomiting was significantly lower in the observation group than in the control group (P< 0.05); and the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) scores of patients in the observation group were reduced (P< 0.05) and significantly lower than in the control group (P< 0.05). We used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-core 30 (EORTC-QLQ-C30) and found a statistically significant difference in the quality of life of patients before the nursing intervention and on the day of discharge (P< 0.05). The establishment of a chemotherapy safety management supervisory group was effective in reducing the incidence of post-chemotherapy nausea and vomiting as well as the patient's psychological burden; it could also improve the quality of life of patients and their satisfaction with nursing care.

Re-use of research data in the social sciences. Use and users of digital data archive.

The aim of this paper is to investigate the re-use of research data deposited in digital data archive in the social sciences. The study examines the quantity, type, and purpose of data downloads by analyzing enriched user log data collected from Swiss data archive. The findings show that quantitative datasets are downloaded increasingly from the digital archive and that downloads focus heavily on a small share of the datasets. The most frequently downloaded datasets are survey datasets collected by research organizations offering possibilities for longitudinal studies. Users typically download only one dataset, but a group of heavy downloaders form a remarkable share of all downloads. The main user group downloading data from the archive are students who use the data in their studies. Furthermore, datasets downloaded for research purposes often, but not always, serve to be used in scholarly publications. Enriched log data from data archives offer an interesting macro level perspective on the use and users of the services and help understanding the increasing role of repositories in the social sciences. The study provides insights into the potential of collecting and using log data for studying and evaluating data archive use.

Defining high bleeding risk in patients undergoing transcatheter aortic valve implantation: a VARC-HBR consensus document.

<span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">The identification and management of patients at high bleeding risk (HBR) undergoing transcatheter aortic valve implantation (TAVI) are of major importance, but the lack of standardised definitions is challenging for trial design, data interpretation, and clinical decision-making. The Valve Academic Research Consortium for High Bleeding Risk (VARC-HBR) is a collaboration among leading research organisations, regulatory authorities, and physician-scientists from Europe, the USA, and Asia, with a major focus on TAVI-related bleeding. VARC-HBR is an initiative of the CERC (Cardiovascular European Research Center), aiming to develop a consensus definition of TAVI patients at HBR, based on a systematic review of the available evidence, to provide consistency for future clinical trials, clinical decision-making, and regulatory review. This document represents the first pragmatic approach to a consistent definition of HBR evaluating the safety and effectiveness of procedures, devices and drug regimens for patients undergoing TAVI.</span></span>.

The Role of the Public Sphere of Science in Fostering Public Trust in Science in Ukraine

Introduction. The war in Ukraine has created a challenging environment for scholarly research, as many researchers and institutions have found themselves in constrained conditions and resources. Furthermore, there has been a decline in public trust in institutions in Ukraine, including the scholarly community.Problem Statement. In Ukraine, public trust in science has been consistently low in recent years. This may have negative consequences for the development of science and technology in the country, as well as for public policy decisions that rely on scientifi c evidence. Therefore, there is a need to foster public trust in the science of Ukraine.Purpose. The purpose of this research is to identify the key tools and technologies of the public sphere of science, which can contribute to building trust in science among the Ukrainian public.Material and Methods. There have been used the methods of analysis, synthesis, comparison, structural, functional, system analysis, and integration.Results. The importance of the role of the public sphere of science in shaping public trust in scholarly research in Ukraine has been established. The main tools and technologies in the public sphere of science that can be used to engage the public and to enhance trust in science in Ukraine have been analyzed. The role of social media platforms, scientifi c webinars, scientifi c platforms, and scientifi c festivals in this process and their potential for engaging the public in scientifi c knowledge and research have been discussed.Conclusions. The importance of involving the public in scientifi c decision-making processes and engagement through organizing public discussions and debates has been concluded. Another crucial step is ensuring open access to scientifi c information and promoting greater transparency. Collaboration among research organizations, the public, the government, and other stakeholders is also vital to the development of eff ective scientifi c policies. The use of innovation technologies and digital tools facilitates interaction between science and the public. Ensuring access to scientifi c knowledge and scientifi c education contributes to increasing trust in science.

Applications of nanomaterials in medicine against cancer

Nowadays, all walks of life are developing with innovation at their core, and the subject of materials is no exception, while nanomaterials occupy an important position in the emerging field due to their unique properties and wide coverage. In addition, the incidence of cancer, a difficult disease with a very high mortality rate, is increasing day by day. Therefore, research on cancer has received extensive attention from society. Therefore, this paper explores how cancer can be treated by means of nanomaterials through the organization of current research and papers in the field. Research at this stage suggests that nanomaterials play a major auxiliary role in anti-cancer technology, as follows: enhancing the ability of other substances to disrupt cell membranes, assisting in the delivery of anti-tumor drugs, improving imaging capabilities, and enhancing the ability of some substances to inhibit tumor growth through specific mechanisms. In future research, the focus will be on minimizing the side effects of the treatment and improving its safety.

Forage yield, seed, and forage qualitative traits evaluation by determining the optimal forage harvesting stage in dual-purpose cultivation in safflower varieties (Carthamus tinctorius L.)

Abstract Safflower (Carthamus tinctorius L.), adapted to arid and semiarid regions, is grown for seed and petal production, but the present study aimed to evaluate the possibility of simultaneous forage and seed production in the autumn and middle types of safflower varieties in dual-purpose cultivation in semiarid areas in the shortfall forage period. An experiment was done based on a randomized complete block design with nine treatments and three replications at the Seed and Plant Improvement Institute, Agriculture Research, Education and Extension Organization, Karaj, Iran. The treatments included the cultivation of Parnian, Goldasht, and Golmehr varieties with the purpose of seed harvesting as control treatments; the same varieties (Parnian, Goldasht, and Golmehr), once with the aim of forage harvesting at 50% stem elongation stage and seed harvesting; and again with the aim of forage harvesting at 50% branching stage and seed harvesting. The results showed that forage harvesting at the 50% branching stage significantly increased the dry and fresh forage yield compared to the 50% stem elongation stage. The highest fresh and dry forage yields (DFY) (42,229 and 11,266 kg/ha) were related to the Golmehr variety at the 50% branching stage. Forage harvesting at the stem elongation stage decreased the crude protein, protein content, and digestibility compared to the branching stage in three safflower varieties. Parnian variety had the maximum seed yield (2,226 kg/ha) without forage harvesting. The highest seed yield in the second year (2018–2019) of the experiment belonged to the Golmehr variety (1,310 kg/ha) to harvest forage at 50% stem elongation (rapid stem growth) and seed harvest treatment, which compared to the first year (2017–2018), showed an increase of 25%. Finally, the forage harvested amount of all three varieties studied was higher in the branching stage than in the stem elongation stage. These results implied that the Golmehr variety (11,266 kg/ha DFY and 520 kg/ha seed yield) is for dual-purpose cultivation, and the Parnian variety (2,226 kg/ha seed yield) is suitable for only seed production for the semiarid region of Karaj in Iran and similar areas in terms of climate.

Application of Patient-Reported Outcome Measurements in Adult Tumor Clinical Trials in China: Cross-Sectional Study.

International health policies and researchers have emphasized the value of evaluating patient-reported outcomes (PROs) in clinical studies. However, the characteristics of PROs in adult tumor clinical trials in China remain insufficiently elucidated. This study aims to assess the application and characteristics of PRO instruments as primary or secondary outcomes in adult randomized clinical trials related to tumors in China. This cross-sectional study identified tumor-focused randomized clinical trials conducted in China between January 1, 2010, and June 30, 2022. The ClinicalTrials.gov database and the Chinese Clinical Trial Registry were selected as the databases. Trials were classified into four groups based on the use of PRO instruments: (1) trials listing PRO instruments as primary outcomes, (2) trials listing PRO instruments as secondary outcomes, (3) trials listing PRO instruments as coprimary outcomes, and (4) trials without any mention of PRO instruments. Pertinent data, including study phase, settings, geographic regions, centers, participant demographics (age and sex), funding sources, intervention types, target diseases, and the names of PRO instruments, were extracted from these trials. The target diseases involved in the trials were grouped according to the American Joint Committee on Cancer Staging Manual, 8th Edition. Among the 6445 trials examined, 2390 (37.08%) incorporated PRO instruments as part of their outcomes. Within this subset, 26.82% (641/2390) listed PRO instruments as primary outcomes, 52.72% (1260/2390) as secondary outcomes, and 20.46% (489/2390) as coprimary outcomes. Among the 2,155,306 participants included in these trials, PRO instruments were used to collect data from 613,648 (28.47%) patients as primary or secondary outcomes and from 74,287 (3.45%) patients as coprimary outcomes. The most common conditions explicitly using specified PRO instruments included thorax tumors (217/1280, 16.95%), breast tumors (176/1280, 13.75%), and lower gastrointestinal tract tumors (173/1280, 13.52%). Frequently used PRO instruments included the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire-30, the visual analog scale, the numeric rating scale, the Traditional Chinese Medicine Symptom Scale, and the Pittsburgh Sleep Quality Index. Over recent years, the incorporation of PROs has demonstrated an upward trajectory in adult randomized clinical trials on tumors in China. Nonetheless, the infrequent measurement of the patient's voice remains noteworthy. Disease-specific PRO instruments should be more effectively incorporated into various tumor disease categories in clinical trials, and there is room for improvement in the inclusion of PRO instruments as clinical trial end points.

Fostering Open Data Practices in Research-Performing Organizations

Open data provide the scientific community and other stakeholders with unrestricted access to data. Open data serve as a foundation for reproducing research findings, while also facilitating collaboration and enabling novel discoveries. However, open data practices are still not commonly applied. To contribute to the implementation of open data strategy in academia in Austria and beyond, a collection of local strategies from regional universities and higher education institutions in the Austrian provinces of Styria and Carinthia was compiled through workshop-based discussions between participants from research support service units at research-performing organizations. The collection was further organized into categories based on application time scenarios, target groups, and involved parties, as well as corresponding thematic focus. A strategic guide consisting of various measures has been developed to encourage the adoption of open data practices from an organizational standpoint. Designed for adaptability, it aims to be applicable and modifiable by all interested research and higher education institutions, regardless of their priorities and resources. Our guideline aids research organizations in crafting a tailored strategy to enhance their data dissemination practices, thereby increasing their research visibility and impact.

Innovative Coastal Structure Solutions And The Role Of Physical Modelling In The Design Process (Dawlish Mog2 Casino)

With the increase in storminess due to climate change induced sea level rise, coastal protection solutions need to be able to contend with larger storms, resulting in larger incident waves, on a more regular basis. Many traditional coastal protection systems like vertical seawalls are proving to be expensive to design for the increased overtopping associated with this change in coastal conditions. As such, engineers are developing more bespoke and innovative design solutions, such as the use of bullnoses and the use of multiple seawalls located one behind the other. Examples of the former can be found in the new Dawlish seawall (see Figure 1) built to replace the old seawall that was damaged during a storm surge in February 2012. For the later, recent examples include the Middelkerke CASINO stilling basin (see Figure 2) and the new energy island being developed by Elia in Belgium (MOG2). The latter consists of two vertical seawalls (see Figure 3), each with a bullnose to reduce overtopping rates. CASINO and MOG2 have in common the novel approach of allowing significant overtopping of the first seawall but instead using the second wall as the safety line, to ensure safe overtopping limits are achieved at this location, thus reducing the required height of the front wall. Moving towards alternative design solutions is associated with its own set of design challenges. The primary challenge is the lack of consistent design guidelines within the field of coastal structures. In Europe, EurOtop is commonly used for overtopping estimates in design (van der Meer et al., 2018). In the US, the Coastal Engineering Manual is used instead (USACE, 2002). Both of these guidelines rely on empirical equations and the variations between the two are primarily a question of preference. However, the empirical equations can have large variations in their solutions (a factor of 3 for the overtopping rate is commonly accepted), the value of which can be heavily dependant on the geometric configuration being used for the seawall, toe protection and bathymetry, limiting their applicability to novel solutions. There is limited research currently available investigating novel geometries such as bullnoses (Dong et al., 2021, Castellino et al., 2018) and stilling basins, and much of the existing literature is limited in scope, thus limiting its wider applicability. In the case of MOG2 and CASINO, the use of the two seawall configuration, combined with drainage solutions, means that there is no suitable guidance in neither of the aforementioned design guides. As a result, coastal designers often turn to physical modelling in order to identify the specific design loads and overtopping values of their proposed design. Physical modelling performed in collaboration with research organisations allows design engineers to benefit from the expertise of researchers working with state-of-the-art techniques informed by the most recent research. However, the physical modelling phase is often not fully integrated into the design process meaning that is it not fully utilised. Integrating physical modelling fully into the design cycle can help to optimise the design as well as identifying the structural loading and verifying the overtopping performance.

Enhancing biomethanation performance through co-digestion of diverse organic wastes: a comprehensive study on substrate optimization, inoculum selection, and microbial community analysis.

A blend of organic municipal solid waste, slaughterhouse waste, fecal sludge, and landfill leachate was selected in different mixing ratios to formulate the best substrate mixture for biomethanation. Individual substrates were characterized, and the mixing ratio was optimized with the help of a response surface methodology tool to a value of 1:1:1:1 (with a C/N ratio of 28±0.769 and total volatile fatty acid (VFA) concentration of 2500±10.53 mg/L) to improve the overall biomethanation. The optimized blend (C/N ratio: 28.6, VFA: 2538 mg/L) was characterized for physicochemical, biological, and microbial properties and subjected to anaerobic digestion in lab-scale reactors of 1000 mL capacity with and without the addition of inoculum. The biogas yield of individual substrates and blends was ascertained separately. The observed cumulative biogas yield over 21 days from the non-inoculated substrates varied between 142±1.95 mL (24.6±0.3 ml/gVS) and 1974.5±21.72 mL (270.4±3.1 ml/gVS). In comparison, the addition of external inoculation at a 5% rate (w/w) of the substrate uplifted the minimum and maximum cumulative gas yield values to 203±9.9 mL (35.0±1.6 mL/gVS) and 3394±13.4 mL (315.3±1.2 mL/gVS), respectively. The inoculum procured from the Defence Research and Development Organisation (DRDO) was screened in advance, considering factors such as maximizing VFA production and consumption rate, biogas yield, and digestate quality. A similar outcome regarding biogas yield and digestate quality was observed for the equivalent blend. The cumulative gas yield increased from 2673±14.5 mL (373.7±2.2 mL/gVS) to 4284±111.02 mL (391.47±20.02 mL/gVS) over 21 days post-application of a similar dosage of DRDO inoculum. The 16S rRNA genomic analysis revealed that the predominant bacterial population belonged to the phylum Firmicutes, with the majority falling within the orders Clostridiales and Lactobacillales. Ultimately, the study advocates the potential of the blend mentioned above for biomethanation and concomitant enrichment of both biogas yield and digestate quality.

Performance of the EORTC and CUETO Models to Predict Recurrence and Progression in High-risk Non-muscle-invasive Bladder Cancer Patients.

To evaluate the performance of the European Organization for Research and Treatment of Cancer (EORTC) and the Spanish Urological Club for Oncological Treatment (CUETO) risk scoring models in non-muscle-invasive bladder cancer (NMIBC) patients defined as high risk according to European Association of Urology guidelines and managed based on current recommendations. Data from 187 high-risk NMIBC patients treated at a tertiary center between July 2010 and November 2021 were analyzed retrospectively. One- and five-year recurrence- and progression-free survival were assessed for each patient using the EORTC and CUETO risk scores. The patients were divided into four risk groups according to their risk scores as low, medium-low, medium-high and high risk, as indicated in the models. Discriminative ability was evaluated with the Harrell's concordance index (c-index). Both risk scoring models overestimated the risk of recurrence and progression at one and five years. Only the prediction of recurrence at five years in the high risk group according to the CUETO model was compatible with our cohort. CUETO (c-indices for recurrence and progression were 0.802 and 0.834, respectively) exhibited better discrimination than EORTC (0.722 for recurrence and 0.752 for progression) in the prediction of disease recurrence and progression. The CUETO model was superior to the EORTC model in predicting recurrence and progression and stratifying patients with different prognoses in our high-risk NMIBC patient population treated according to current guideline recommendations. However, both models overestimated the probability of disease recurrence and progression. Only the probability of recurrence at five years in the high-risk group of the CUETO model was compatible with our cohort.

Physical function as a predictor of chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer

BackgroundA growing body of research indicates that poor functional status before chemotherapy may be correlated with the severity of chemotherapy-induced peripheral neuropathy (CIPN) after the neurotoxic treatment. However, little is known about the associations between pre-chemotherapy physical function and CIPN in patients with pancreatic cancer.PurposeTo identify the predictors of CIPN in relation to pre-chemotherapy physical function in patients with pancreatic cancer.MethodsThis secondary analysis included data from patients with pancreatic cancer who participated in a longitudinal research study at National Cheng Kung University Hospital, Tainan, Taiwan. Four physical function tests (i.e., grip strength, Timed Up and Go (TUG), 2-minute step test (2MST), and Romberg test) and two questionnaires (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 [EORTC QLQ-C30] and Chemotherapy-Induced Peripheral Neuropathy Module [CIPN20]) were assessed at baseline (i.e., before first chemotherapy session) and 2-, 3-, 4-, and 6-month follow-up. Multiple linear regression with adjustment for confounding factors was used to assess the associations between the four functional tests at baseline and the CIPN20 total score and individual subscale scores (sensory, motor, and autonomic) at 6-month follow-up.ResultsData from a total of 209 pancreatic cancer patients (mean age: 64.4 years, 54.5% male) were analyzed. The findings showed that the severity of CIPN at 6-month follow-up was significantly associated with the baseline TUG completion time (β = 0.684, p = 0.003). The TUG completion time was also positively correlated with the 6-month CIPN sensory and autonomic subscales. In addition, a baseline positive Romberg test (β = 0.525, p = 0.009) was a significant predictor of the severity of motor neuropathy at 6-month follow-up.ConclusionThe TUG completion time and positive Romberg test before chemotherapy may be predictive factors of the CIPN severity 6 months after the commencement of chemotherapy. Accordingly, the incorporation of TUG and Romberg tests into the clinical assessment protocol emerges as imperative for individuals diagnosed with pancreatic carcinoma undergoing chemotherapy regimens.

Quality-of-lifeoutcomes in metastatic spinal cord compression: findings from the SCORAD trial.

This article reports detailed quality-of-life data including preferred and actual place of care from SCORAD, the only large prospective randomized trial in metastatic spinal cord compression (MSCC). SCORAD compared 2 doses of radiotherapy in patients with MSCC: 8 Gy single fraction and 20 Gy in 5 fractions. In total, 686 patients were randomized, of whom 590 had Health-Related Quality of Life (HRQoL) data collected at baseline and at least 1 later time point. HRQoL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 supplemented with the QLU-C10D and data on place of care at weeks 1, 4, 8, and 12 postrandomization. Quality-of-Life Adjusted Survival was computed by multiplying Kaplan-Meier survival probabilities with the UK utility weights obtained from the QLU-C10D. Patients with a baseline physical functioning score of above 50 demonstrated a 28% reduction in the risk of death (hazard ratio [HR] = 0.72, 99% confidence interval [CI] = 0.54 to 0.95; P = .003). An increased risk of death was associated with fatigue (HR = 1.35, 99% CI = 1.03 to 1.76; P = .0040), dyspnea (HR = 1.61, 99% CI = 1.24 to 2.08; P < .001), and appetite loss (HR = 1.25, 99% CI = 0.99 to 1.59; P = .014). The preferred place of care for the majority was at home or with relatives (61%-74% across the 12 weeks) but achieved by only 53% at 8 weeks. Prolonged survival in patients with MSCC was associated with better HRQoL. More than 60% of patients preferred to be cared for at home or with relatives, but only half were able to achieve this. There was no difference in HRQoL between the multifraction and single-fraction groups. ISRCTN97555949 and ISRCTN97108008.