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1.
Front Psychol ; 15: 1336474, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39220398

RESUMO

Introduction: Sensory-processing sensitivity (SPS) refers to interindividual differences in sensitivity to positive and negative environmental stimuli and reflects the concept of differential susceptibility. The Highly Sensitive Person Scale (HSPS) has been utilized to capture the multifaceted experiences of highly sensitive individuals. The scale's total score (i.e., the sum of the subfactors) is an indicator of high sensitivity. However, it cannot differentiate between the contributions of the specific subfactors. Consequently, interpreting the total score cannot help resolve the current theoretical debate about how individuals integrate the positive and negative aspects of sensitivity, whereas a multidimensional profile should be able to offer a more comprehensive understanding. Intriguingly, in variable-centered research, the subfactors' differential associations with external constructs in negative or positive trait spaces have suggested heterogeneity (i.e., interindividual differences) among highly sensitive individuals. Thus, person-centered approaches should be better suited to address this heterogeneity. Methods: To explore heterogeneity within the highly sensitive population, we conducted a three-step Latent Profile Analysis in two independent German-speaking samples (N = 1,102; N = 526). Subsequently, we employed the Five-Factor Model of personality to provide a detailed description of the latent sensitivity groups. Results: Beyond the frequently identified quantitative three-class differentiation of sensitivity groups, we obtained a four-class model that included two qualitatively different high-sensitivity groups, each displaying distinct HSPS subfactor and personality patterns that corresponded to prototypical personality profiles. Within these high sensitivity groups, (i) the Confident Sensitivity Group exhibited average Neuroticism, significantly above-average Openness, and slightly above-average Extraversion. By contrast, (ii) the Vulnerable Sensitivity Group displayed the typical personality pattern of significantly above-average Neuroticism, below-average Extraversion, and slightly above-average Openness. Personality analyses revealed that features such as passiveness, internalizing tendencies, giftedness, and aesthetics, often commonly ascribed to all highly sensitive individuals, are features that differ across distinct sensitivity groups. Discussion: To avoid over- or underestimating sensitivity effects, future research should consider these interindividual differences in highly sensitive individuals. For instance, studies could focus on the different associations of sensitivity groups with abilities, health aspects, emotion regulation and intervention outcomes, taking into account the different environmental factors that shape the type of sensitivity.

2.
Cureus ; 16(8): e65947, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39221304

RESUMO

A 41-year-old woman, never-smoker, accessed the emergency room for an episode of hemoptysis in September 2019. CT scan showed a defect of opacification in the left pulmonary artery and a solid mass of 12 cm in the left annex. PET confirmed high metabolic activity in the ovarian mass and, surprisingly, in the left hilar lung. The patient underwent a left annessiectomy and the histological examination showed a metastasis of small-cell lung cancer (SCLC) that mimicked a primary ovarian cancer. Fibrobronchoscopy and echo-guided biopsy confirmed the diagnosis of pulmonary SCLC. From January 2020, we started systemic therapy with carboplatin, etoposide, and atezolizumab. After six cycles of induction therapy with a complete response, thoracic and prophylactic cranial radiotherapy was done and maintenance therapy with atezolizumab was administered. After 53 months, the patient is still under treatment with a complete radiological response. This case report describes a rare instance of ovarian metastasis from SCLC that responded exceptionally well to immunotherapy. By reviewing literature from 1950 to the present, we identified other cases of ovarian metastases from SCLC, highlighting shared clinical and pathological traits and distinguishing them from primary ovarian tumors. We also examined the potential mechanisms behind the prolonged immunotherapy response observed in this case. As research on SCLC and immunotherapy evolves, this case may offer valuable insights into prognostic and predictive factors for this typically fatal cancer.

3.
Toxicol In Vitro ; 101: 105932, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39226997

RESUMO

INTRODUCTION: In vitro methods have been widely used to assess adverse effects. Reconstructed Human Epidermis (RHE) poses as a fascinating test system employed to assess the dermal irritation hazard potential of chemicals. Although several RHE models are reported in the OECD Test Guideline No. 439, the OECD Document No. 220 encourages the scientific community to develop and validate new RHE test systems due to its relevance for socio-economic advancement. METHODS: Following the criteria documented in the OECD No. 220, a blind study for skin irritation (OECD 439) was conducted employing the Minimum List of Reference Chemicals for Determination of Reproducibility and Predictive Capacity using ES®-RHE. Structural and functional characteristics were assessed alongside the prediction model. RESULTS: The model has shown reproducibility of optical density and barrier function, similarly to internationally validated methods. Furthermore, it shows the cell layers' development and differentiation ability due to Cytokeratin14, Cytokeratin10, and filaggrin expression. The prediction model resulted in sensitivity, specificity and accuracy rates of 100, 70, and 77 %, respectively. CONCLUSIONS: The ES®-RHE demonstrated reliability and relevance, with similar structural and functional characteristics comparable to internationally validated models, in addition to the accepted predictive capacity according to OECD required minimum criteria, thus confirming the suitability of the national ES®-RHE in the hazard prediction of dermal irritation based on OECD Test Guideline No. 439.

5.
EClinicalMedicine ; 75: 102795, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39252865

RESUMO

Background: This phase II prospective trial aimed to investigate the efficacy and safety of adebrelimab (PD-L1 antibody) plus first-line chemotherapy followed by sequential thoracic radiotherapy (TRT) combined with adebrelimab in extensive-stage small-cell lung cancer (ES-SCLC). Biomarkers associated with potential therapeutic effects were also explored. Methods: Patients with previously untreated ES-SCLC were enrolled at Shandong Cancer Hospital and Institute (Jinan, China). Patients received 4-6 cycles of adebrelimab (20 mg/kg, D1, Q3W) combined with EP/EC (etoposide, 100 mg/m2, D1-3, Q3W and cisplatin, 75 mg/m2, D1, Q3W or carboplatin, AUC = 5, D1, Q3W). Then patients with response sequentially underwent consolidative TRT (≥30 Gy in 10 fractions or ≥50 Gy in 25 fractions, involved-field irradiation), and maintenance adebrelimab until disease progression or intolerable adverse events (AEs). The primary endpoint was overall survival (OS). Genomic and circulating tumour DNA (ctDNA) profiling were also analyzed with tumour tissues and peripheral blood. This trial was registered with ClinicalTrials.gov, NCT04562337. Findings: From October 2020 to April 2023, 67 patients diagnosed with ES-SCLC were enrolled and received at least one dose of study treatment. All patients were included in the efficacy and safety analyses. 45 patients received sequential TRT as planned. The median OS and progression-free survival (PFS) was 21.4 months (95% CI: 17.2-not reached months) and 10.1 months (95% CI: 6.9-15.5 months), respectively. The confirmed objective response rate was 71.6% (48/67, 95% CI: 59.3-82.0%) and disease control rate was 89.6% (60/67, 95% CI: 79.7-95.7%). There were no treatment-related deaths. The most common grade 3 or higher treatment-related adverse events (TRAEs) were hematological toxicities. The incidence of any grade and G3+ pneumonitis was 25% (17/67) and 6% (4/67), respectively. No unexpected adverse events were observed. Patients without co-mutations of TP53/RB1 in both tissue and peripheral blood displayed longer PFS (tissue, P = 0.071; ctDNA, P = 0.060) and OS (tissue, P = 0.032; ctDNA, P = 0.031). Interpretation: Adebrelimab plus chemotherapy and sequential TRT as first-line therapy for ES-SCLC showed promising efficacy and acceptable safety. Funding: This study was funded by the National Natural Science Foundation of China (82172865), Jiangsu Hengrui Pharmaceuticals Co., Ltd. and Amoy Diagnostics Co., Ltd.

6.
Elife ; 122024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39255192

RESUMO

Proteotoxic stress impairs cellular homeostasis and underlies the pathogenesis of many neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS). The proteasomal and autophagic degradation of proteins are two major pathways for protein quality control in the cell. Here, we report a genome-wide CRISPR screen uncovering a major regulator of cytotoxicity resulting from the inhibition of the proteasome. Dihydrolipoamide branched chain transacylase E2 (DBT) was found to be a robust suppressor, the loss of which protects against proteasome inhibition-associated cell death through promoting clearance of ubiquitinated proteins. Loss of DBT altered the metabolic and energetic status of the cell and resulted in activation of autophagy in an AMP-activated protein kinase (AMPK)-dependent mechanism in the presence of proteasomal inhibition. Loss of DBT protected against proteotoxicity induced by ALS-linked mutant TDP-43 in Drosophila and mammalian neurons. DBT is upregulated in the tissues of ALS patients. These results demonstrate that DBT is a master switch in the metabolic control of protein quality control with implications in neurodegenerative diseases.


Assuntos
Complexo de Endopeptidases do Proteassoma , Proteostase , Animais , Complexo de Endopeptidases do Proteassoma/metabolismo , Humanos , Drosophila/metabolismo , Autofagia , Esclerose Lateral Amiotrófica/metabolismo , Esclerose Lateral Amiotrófica/genética , Neurônios/metabolismo , Drosophila melanogaster/metabolismo , Drosophila melanogaster/genética
7.
Transl Cancer Res ; 13(8): 4146-4158, 2024 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-39262463

RESUMO

Background: Currently, immune checkpoint inhibitors (ICIs) combined with platinum-etoposide (EP) are gradually becoming the first-line standard treatment for extensive-stage small cell lung cancer (ES-SCLC). This meta-analysis aims to compare the efficacy and safety of ICIs combined with EP vs. EP alone in the first-line treatment of ES-SCLC. Methods: We searched PubMed, Embase, and Cochrane Library databases for phase II/III randomized controlled trials (RCTs) that met inclusion criteria from January 2016 to November 2023. Outcome measures included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), treatment-related adverse events (TRAEs), treatment-related serious adverse events (TRSAEs), and immune-related adverse events (IRAEs). The effect analysis statistics of the outcome indicators were expressed with hazard ratio (HR) and odds ratio (OR) and their 95% confidence interval (CI). Results: This study included nine RCTs with a total of 4,711 patients. Compared to EP, ICIs plus EP improved patients' PFS (HR =0.71; 95% CI: 0.64-0.79; P<0.001), OS (HR =0.79; 95% CI: 0.74-0.84; P<0.001), and ORR (OR =1.27; 95% CI: 1.12-1.44; P=0.001), but increased the incidence of adverse events (AEs): TRAEs (OR =1.45; 95% CI: 1.20-1.76; P<0.001), IRAEs (OR =3.97; 95% CI: 2.49-6.32; P<0.001), and grade 3-4 IRAEs (OR =6.17; 95% CI: 2.36-16.15; P<0.001). However, there was no significant difference in the incidence of grade 3-4 TRAEs (OR =1.05; P=0.54), TRSAEs (OR =1.40; P=0.13), and grade 3-4 TRSAEs (OR =1.17; P=0.72). Subgroup analysis found that patients with brain metastasis did not benefit from ICIs combined with EP therapy, and patients with programmed cell death ligand 1 (PD-L1) expression ≥1% had poorer survival benefits compared to patients with PD-L1 expression <1%. Conclusions: In the first-line treatment of ES-SCLC, compared to EP chemotherapy, ICIs with EP can benefit patients in terms of PFS, OS, and ORR, but it will increase the occurrence of AEs.

8.
Int J Mol Sci ; 25(18)2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39337378

RESUMO

Vascular aging is associated with the development of cardiovascular complications, in which endothelial cell senescence (ES) may play a critical role. Nitric oxide (NO) prevents human ES through inhibition of oxidative stress, and inflammatory signaling by mechanisms yet to be elucidated. Endothelial cells undergo an irreversible growth arrest and alter their functional state after a finite number of divisions, a phenomenon called replicative senescence. We assessed the contribution of NO during replicative senescence of human aortic (HAEC) and coronary (CAEC) endothelial cells, in which accumulation of the senescence marker SA-ß-Gal was quantified by ß-galactosidase staining on cultured cells. We found a negative correlation in passaged cell cultures from P0 to P12, between a reduction in NO production with increased ES and the formation of reactive oxygen (ROS) and nitrogen (ONOO-) species, indicative of oxidative and nitrosative stress. The effect of ES was evidenced by reduced expression of endothelial Nitric Oxide Synthase (eNOS), Interleukin Linked Kinase (ILK), and Heat shock protein 90 (Hsp90), alongside a significant increase in the BH2/BH4 ratio, inducing the uncoupling of eNOS, favoring the production of superoxide and peroxynitrite species, and fostering an inflammatory environment, as confirmed by the levels of Cyclophilin A (CypA) and its receptor Extracellular Matrix Metalloprotease Inducer (EMMPRIN). NO prevents ES by preventing the uncoupling of eNOS, in which oxidation of BH4, which plays a key role in eNOS producing NO, may play a critical role in launching the release of free radical species, triggering an aging-related inflammatory response.


Assuntos
Senescência Celular , Células Endoteliais , Óxido Nítrico Sintase Tipo III , Óxido Nítrico , Estresse Oxidativo , Humanos , Óxido Nítrico Sintase Tipo III/metabolismo , Células Endoteliais/metabolismo , Óxido Nítrico/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Células Cultivadas , Aorta/metabolismo , Aorta/citologia
9.
Chin Clin Oncol ; 13(Suppl 1): AB076, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39295394

RESUMO

BACKGROUND: Eighty percent of the global epilepsy burden is borne by developing countries, and 30% of these patients have drug-resistant epilepsy (DRE). Epilepsy surgery (ES) can significantly improve the cognition and quality of life in DRE. A comprehensive epilepsy center was established in Pakistan in 2010, the only facility for ES in a country of 231 million people. Hundreds of epilepsy patients are medically managed at the center each year. We aimed to study seizure control in all ES cases performed at the only comprehensive epilepsy center in the country during last 10 years. METHODS: It was a retrospective cohort study. Medical records of all cases of ES performed at our center from 2012 to 2021 were retrieved, through the Hospital's Information Management System. Patients were also contacted via phone calls where needed, to collect information about their seizure control as per Engel Classification. Data was analyzed using SPSSv21. RESULTS: Thirty-three surgeries including 10 temporal lobectomies with amygdalohippocampectomy, 11 selective amygdalohippocampectomies, 9 corpus callosotomies, 1 callosotomy with lesionectomy, 1 lesionectomy and 1 temporal lobectomy were performed. The median age of patients was 23: [18-31] years. Complex partial seizures were most common (14; 42.4%), followed by generalized seizures (10; 30.3%). The median duration of AEDs before surgery was 6 (IQR: 3.25-13.75) years. Eighteen (54.5%) patients had complete freedom from disabling seizures (Engel Class IA) at a median follow-up of 3.25 (IQR: 1.12-6) years. All patients continued to receive antiepileptic drugs after surgery, and all procedures had nearly 50% optimum seizure control outcomes. CONCLUSIONS: The clinical outcomes of ES performed at our center are consistent with evidence. However, the small volume highlights the underutilization of this extremely important service. More studies are needed to identify the factors responsible for this disparity, so that all DRE patients have access to ES.


Assuntos
Epilepsia , Humanos , Masculino , Feminino , Adulto , Estudos Retrospectivos , Paquistão , Epilepsia/cirurgia , Adolescente , Adulto Jovem
10.
Updates Surg ; 2024 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-39320569

RESUMO

There is still disagreement on the best treatment option for cholecystocholedocholithiasis. Although there are some benefits to the single-step procedure, the "laparoendoscopic rendezvous" (LERV) technique that include a lower risk of post-ERCP pancreatitis and a shorter hospital stay, the standard technique is still the two-step approach for clearing the common bile duct (CBD) using ERCP and then performing a laparoscopic cholecystectomy. The purpose of this study was to assess the effectiveness and safety of the LERV technique vs. the standard two-step approach. Four hundred thirty-six patients with symptomatized concomitant stones at both the gall bladder (GB) and the (CBD), at two gastroenterology centers in Zagazig city, Egypt, from January 2010 till April 2022, were analyzed. Patients were randomly divided into two equally groups. The overall length of hospital stay was the primary outcome, and the success of CBD clearance and morbidity, particularly post-ERCP pancreatitis, were the secondary endpoints. The LERV group experienced a significantly shorter hospital stay (median 2(2-8) days compared to 4.5 (4-11) days for the two-stage approach (p < 0.001)). The two groups did not differ in terms of CBD clearing success. Also, there was no significant difference in the number of patients with post-ERCP pancreatitis between the LERV group [14 patients (6.4%)] and the two-stage approach [26 patients (11.9%)] with p value = 0.703. For patients with cholecystocholedocholithiasis, the optimal treatment must be determined by the knowledge and resources that are accessible locally. Our data further supported the idea that treating patients with cholecystocholedocholithiasis in one stage is a safe and successful strategy.

11.
Glob Health Action ; 17(1): 2403972, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-39314117

RESUMO

BACKGROUND: Rights-based Respectful Maternity Care (RMC) is crucial for quality of care and improved birth outcomes, yet RMC measurements are rarely included in facility improvement initiatives. We aimed to (i) co-create a routine RMC measurement tool (RMC-T) for congested maternity units in Dar es Salaam, Tanzania, and (ii) assess the RMC-T's acceptability among women and healthcare stakeholders. METHOD: We employed a participatory approach utilizing multiple mixed methods. This included a scoping review, stakeholder engagement involving postnatal women, healthcare providers, health leadership, and global researchers through interviews, focus groups, and two surveys involving 201 and 838 postnatal women. Cronbach's alpha and factor analysis were conducted for validation using Stata 15. Theories of social practice and Thematic Framework of Acceptability guided the assessment of stakeholder priorities and tool acceptability. RESULTS: The multi-phased iterative co-creation process produced the 25-question RMC-T that measures satisfaction, communication, mistreatment (including physical, verbal, and sexual abuse; neglect; discrimination; lack of privacy; unconsented care; post-birth clean-up; informal payments; and denial of care), supportive care (such as food intake and mobility), birth companionship, post-procedure pain relief, bed-sharing, and newborn respect. The pragmatic validation process prioritized stakeholder feedback over strict statistics, lowering Cronbach's alpha from 0.70 in version 1 to 0.57 for the RMC-T. Women valued the opportunity to share their experiences. CONCLUSIONS: The RMC-T is contextualized, validated, and acceptable for measuring women's experiences of RMC. Routine use in facility-based quality improvement initiatives, along with targeted actions to address gaps, will advance rights-based RMC. Further validation and community-based studies are needed.


• Main findings: This study describes the participatory approach involving postnatal women, healthcare providers, health leadership, and global researchers to co-create and validate a tool for measuring women's experiences of respectful maternity care in Dar es Salaam's urban health facilities.• Added knowledge: The iterative process produced a concise, 25-item Respectful Maternity Care Measurement tool that is user-friendly, administered in 15­20 minutes and addresses all mistreatment domains. The tool reflects women's priorities and is well accepted by postnatal women and health leaders.• Global health impact for policy and action: Regular use of the tool can enhance awareness of childbirth rights and drive actions to improve and normalize respectful maternity care in low-resource urban settings.


Assuntos
Serviços de Saúde Materna , Respeito , Humanos , Tanzânia , Feminino , Serviços de Saúde Materna/normas , Serviços de Saúde Materna/organização & administração , Gravidez , Adulto , Grupos Focais , Qualidade da Assistência à Saúde/organização & administração , Satisfação do Paciente , Inquéritos e Questionários
14.
Can J Occup Ther ; : 84174241255472, 2024 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-39285696

RESUMO

Background. Limited knowledge is available regarding the impact of oculopharyngeal muscular dystrophy (OPMD) impairments on participation in daily and social activities, which currently hinders occupational therapy practice in this population. Purpose. To describe social participation and explore influencing factors in individuals with OPMD. Methods. Thirty-four individuals were assessed with outcome measures of social participation restrictions, mobility, dysphagia, and fatigue. Spearman correlations and stepwise multiple regression analyses were used. Findings. Results show a negative impact of OPMD on the social participation level, which was more important in participants aged over 60 years. Walking speed was found to be the main factor influencing participation levels for daily and social activities, with faster walking associated with higher participation. Conclusions. This study emphasizes the impact of OPMD impairments and limitations on social participation level. While dysphagia is obviously an important impairment to consider, interventions for mobility limitations should also be considered during clinical follow-up.

15.
ACS Appl Mater Interfaces ; 16(34): 44409-44427, 2024 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-39162197

RESUMO

Cancer presents a significant health threat, necessitating the development of more precise, efficient, and less damaging treatment approaches. To address this challenge, we employed the 1-ethyl-(3-dimethyl aminopropyl) carbodiimide/N-hydroxy succinimide (EDC/NHS) catalytic system and utilized quaternized chitosan oligosaccharide (HTCOSC) as a drug carrier to construct a nanoparticle delivery system termed HTCOSC-cRGD-ES2-MTX (CREM). This system specifically targets integrin αvß3 on tumor cell surfaces and enables simultaneous loading of the antiangiogenic agent ES2 (IVRRADRAAVP) and the chemotherapy drug methotrexate (MTX). Due to its amphiphilic properties, CREM self-assembles into nanoparticles in aqueous solution, exhibiting an average diameter of 179.47 nm. Comparative studies demonstrated that CREM, in contrast to free ES2 and MTX-free nanoparticles (CRE), significantly suppressed the proliferation of EAhy926 endothelial cells and B16 melanoma cells in vitro, resulting in inhibition rates of 71.18 and 82.25%, respectively. Furthermore, CREM exhibited a hemolysis rate below 2%, indicating excellent in vitro antiangiogenic and antitumor activity as well as favorable blood compatibility. Additionally, both CRE and CREM demonstrated favorable tumor targeting capabilities through the specific binding action of cyclic RGD (cRGD) to integrin αvß3. Further in vivo investigations revealed that CREM induced apoptosis in tumor cells via the mitochondrial apoptotic pathway and reduced the expression of angiogenic factors such as vascular endothelial growth factor (VEGF), thereby inhibiting tumor angiogenesis. This potent antitumor effect was evident through a tumor suppression rate of 80.19%. Importantly, histopathological staining (HE staining) demonstrated the absence of significant toxic side effects of CREM on various organs compared to MTX. In conclusion, the CREM nano drug delivery system synergistically enhances the therapeutic efficacy of antiangiogenic drugs and chemotherapeutic agents, thus offering a novel targeted approach for cancer treatment.


Assuntos
Quitosana , Metotrexato , Oligossacarídeos , Metotrexato/química , Metotrexato/farmacologia , Metotrexato/uso terapêutico , Quitosana/química , Animais , Humanos , Camundongos , Oligossacarídeos/química , Oligossacarídeos/farmacologia , Portadores de Fármacos/química , Linhagem Celular Tumoral , Nanopartículas/química , Proliferação de Células/efeitos dos fármacos , Inibidores da Angiogênese/química , Inibidores da Angiogênese/farmacologia , Antineoplásicos/química , Antineoplásicos/farmacologia , Integrina alfaVbeta3/metabolismo , Oligopeptídeos/química , Oligopeptídeos/farmacologia
17.
Support Care Cancer ; 32(9): 622, 2024 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-39215800

RESUMO

BACKGROUND: Trilaciclib, in comparison to placebo plus carboplatin, etoposide, ± atezolizumab (PEA), has shown significant reductions in incidence of severe neutropenia (SN) among patients with extensive-stage small cell lung cancer (ES-SCLC). Despite these findings, real-world utility remains limited. METHODS: A single-center quasi-experimental study compared trilaciclib + PEA (PEAT) versus PEA in ES-SCLC patients. The study period ranged from April 1, 2021 to July 31, 2022, for the PEAT recipients and February 1, 2020, to February 28, 2021, for PEA recipients. The primary endpoint evaluated was incidence of SN after cycle 1 and during the treatment period. Secondary endpoints included measures related to myelopreservation and patient outcomes. RESULTS: Among 34 PEAT and 44 PEA patients, baseline characteristics were similar, except for a higher median age (69 vs 64 years) and more males (64.7% vs 38.6%) in the PEAT cohort. The PEAT cohort exhibited a lower SN rate (3%) versus the PEA cohort (18%), with statistical significance demonstrated on multivariate analysis (p = 0.015). Additionally, the PEAT cohort also demonstrated significant reductions in red blood cell transfusion requirements (3% vs 23%; p = 0.02), grade 3-4 anemia (6% vs 25%; p = 0.03), and grade 3-4 thrombocytopenia (0% vs 11%, p = 0.045). CONCLUSION: Trilaciclib, in combination with PEA, demonstrated an improvement in the safety profile without compromising survival outcomes in ES-SCLC patients. These findings underscore the potential benefits of incorporating trilaciclib in real-world clinical settings for enhanced patient care.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias Pulmonares , Carcinoma de Pequenas Células do Pulmão , Humanos , Masculino , Feminino , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Carcinoma de Pequenas Células do Pulmão/patologia , Pessoa de Meia-Idade , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Triazóis/administração & dosagem , Triazóis/uso terapêutico , Neutropenia/induzido quimicamente , Neutropenia/epidemiologia , Estadiamento de Neoplasias , Pirimidinas , Pirróis
18.
Cureus ; 16(7): e63910, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39105030

RESUMO

Ewing sarcoma (ES) is an uncommon and highly aggressive bone malignancy that predominantly occurs in children and young adults. Extraosseous Ewing sarcoma (EES), an even rarer variant, can present in the soft tissues instead of bone. In this case report, we detail a previously healthy 28-year-old male presenting with an isolated enlarged left inguinal lymph node, subsequently diagnosed as EES. The patient presented with a three-month history of a non-tender, gradually enlarging lump in the left groin. Fine needle aspiration revealed a small round blue cell tumor with a high Ki-67 score, and subsequent excisional biopsy identified a rare genetic fusion mutation. Postoperative positron emission tomography (PET)/computed tomography (CT) scan did not show any fludeoxyglucose F18 (FDG) uptake lesions to suggest residual malignancy. The patient is currently awaiting chemotherapy. Throughout the discussion of this case, we highlight the importance of considering EES in the differential diagnosis of isolated lymph node enlargement, the role of genetic testing in diagnosis, and the treatment modalities offered.

19.
Evol Comput ; : 1-27, 2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-39101902

RESUMO

Modular algorithm frameworks not only allow for combinations never tested in manually selected algorithm portfolios, but they also provide a structured approach to assess which algorithmic ideas are crucial for the observed performance of algorithms. In this study, we propose a methodology for analyzing the impact of the different modules on the overall performance. We consider modular frameworks for two widely used families of derivative-free black-box optimization algorithms, the Covariance Matrix Adaptation Evolution Strategy (CMA-ES) and differential evolution (DE). More specifically, we use performance data of 324 modCMA-ES and 576 modDE algorithm variants (with each variant corresponding to a specific configuration of modules) obtained on the 24 BBOB problems for 6 different runtime budgets in 2 dimensions. Our analysis of these data reveals that the impact of individual modules on overall algorithm performance varies significantly. Notably, among the examined modules, the elitism module in CMA-ES and the linear population size reduction module in DE exhibit the most significant impact on performance. Furthermore, our exploratory data analysis of problem landscape data suggests that the most relevant landscape features remain consistent regardless of the configuration of individual modules, but the influence that these features have on regression accuracy varies. In addition, we apply classifiers that exploit feature importance with respect to the trained models for performance prediction and performance data, to predict the modular configurations of CMA-ES and DE algorithm variants. The results show that the predicted configurations do not exhibit a statistically significant difference in performance compared to the true configurations, with the percentage varying depending on the setup (from 49.1% to 95.5% for mod-CMA and 21.7% to 77.1% for DE).

20.
Annu Rev Sociol ; 50: 41-59, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39149714

RESUMO

Experience sampling (ES) - also referred to as ecological momentary assessment (EMA) - is a data collection method that involves asking study participants to report on their thoughts, feelings, behaviors, activities, and environments in (or near) real time. ES/EMA is typically administered using an intensive longitudinal design (repeated assessments within and across days). Although use of ES/EMA is widespread in psychology and health sciences, uptake of the method among sociologists has been limited. We argue that ES/EMA offers key advantages for the investigation of sociologically relevant phenomena, particularly in light of recent disciplinary emphasis on investigating the everyday mechanisms through which social structures and micro (individual and relational) processes are mutually constitutive. We describe extant and potential research applications illustrating advantages of ES/EMA regarding enhanced validity, disentangling short-term dynamics, and the potential for linkage with spatially and temporally referenced data sources. We also consider methodological challenges facing sociological research using ES/EMA.

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