Three-month life expectancy as inclusion criterion for clinical trials in advanced pancreatic cancer: is it really a valid tool for patient selection?

PURPOSE: To analyze the 3-month life expectancy rate in pancreatic cancer (PC) patients treated within prospective trials from the German AIO study group. PATIENTS AND METHODS: A pooled analysis was conducted for patients with advanced PC that were treated within five phase II/III studies conducted between 1997 and 2017 (Gem/Cis, Ro96, RC57, ACCEPT, RASH). The primary goal for the current report was to identify the actual 3-month survival rate, a standard inclusion criterion in oncology trials. RESULTS: Overall, 912 patients were included, 83% had metastatic and 17% locally advanced PC; the estimated median overall survival (OS) was 7.1 months. Twenty-one percent of the participants survived < 3 months, with a range from 26% in RC57 to 15% in RASH. Significant predictors for not reaching 3-month OS were > 1 previous treatment line (p < 0.001) and performance status (p < 0.001). CONCLUSIONS: Despite the definition of a life expectancy of > 3 months as a standard inclusion criterion in clinical trials for advanced PC, a significant proportion of study patients does not survive > 3 months. TRIAL REGISTRATION NUMBERS: NCT00440167 (AIO-PK0104), NCT01729481 (RASH), NCT01728818 (ACCEPT).

Purchase behavior in COVID-19: A cross study in Mexico, Colombia, and Ecuador.

This article explores the critical factors of consumption in Mexico, Ecuador, and Colombia, due to confinement and social distancing. Besides, which are the factors that influence the purchase decision. In the proposed model, we tested from quantitative research with a sample of 2,065 online consumers. We analyzed the following statistics: CFA, structural equations, invariance of measurement instruments, and multi-group analysis with the Smart Pls 3 and EQS 6.3 software. The study reveals that time, space, and place in the consumption process is more visible in the purchasing behavior with social distancing, healthy distance, and the commercial restriction caused by the health contingency. In addition to being a health and humanitarian crisis, the pandemic has severe economic consequences worldwide as 1) the increase in unemployment rates, 2) collapsed health systems, 3) education models overwhelmed by technology, 4) supply chains interrupted by the closure of borders, 5) international and domestic tourism suspended due to a lack of sanitary protocols,6) social coexistence curtailed by significantly increased infections and 7) a decreasing demand by consumers for the closure of companies. Despite being Latin American countries, cultural differences were not the priority of consumption in the crisis period due to Covid-19. They significantly change purchasing behaviors, and all have adapted to online and home delivery purchases by the social factor, local consumption, and consumers' attitude. The article presents several considerations on the main factors of consumption in Covid-19 in collectivist countries (North American and South America) such as Mexico, Colombia, and Ecuador and finds no substantial differences with consumers. There are practical implications for companies to adopt online channels and to create sales strategies in the face of the endemic pandemic.

Are young university millennials compulsive in their purchase? / ¿Los jóvenes millenials universitarios son compulsivos en su compra? / Serão os jovens universitários compulsivos nas suas compras? / Les jeunes milléniaux universitaires sont-ils des acheteurs compulsifs?

Abstract Objective: To analyze the purchasing behaviors in university students of the Mexican Republic and determine if there are differences between sexes that show the behavior provided is considered compulsive, following the model of Valence, d'Astous and Fortier. Materials and methods: We carried out a quantitative, descriptive, correlational and explanatory study, because it confirms the structure of the Valence d'Astous and Fortier compulsive buying scale, in the following factors: tendency to spend, reactive aspect and post-purchase guilt. The study involved 1,687 students of the millennials generation of 27 states of the Mexican Republic, composed of a 60 per cent of women and 40% men; the data collection was made via online with the software SurveyMonkey using a questionnaire of 16 items, in Likert scale. The statistical treatment used was the Pearson's Chi-square test, by the SPSS version 24. Results: The findings show that the purchasing behavior of the sample under study cannot be considered as compulsive disorder under the model of Valence, d'Astous And Fortier, although women in relation to men, had a tendency toward compulsive buying, this got on the results shown in the construct "tendency to spend". Conclusions: The results obtained by this research must be of great importance for companies; it is important to note that the subject of the compulsive buying should be a concern and the subject of further research for universities, authorities and practitioners of marketing. Today, thanks to studies on the subject, responsibles for developing the marketing strategies are becoming more aware of how they affect the decisions of consumers, we must not lose sight of the fact that the members of the millennial generation are the future of the country and the world, and they should have the opportunity to make more responsible consumption, of benefit to the current world and future generations.

Resumen Objetivo: Analizar los comportamientos de compra de los estudiantes universitarios de la República Mexicana y determinar si existen diferencias por sexo que muestren que el comportamiento presentado se considera compulsivo, siguiendo el modelo de Valence, dAstous y Fortier. Materiales y métodos: Se realizó un estudio de tipo cuantitativo, descriptivo, correlacional y explicativa, porque confirma la estructura de la escala de las compras compulsivas de Valence, d'Astous y Fortier en los factores: tendencia a gastar, urgencia de comprar y sentimientos de culpabilidad. El estudio involucró a 1.687 estudiantes de la generación millenials de 27 estados de la República Mexicana, compuesta por un 60% de mujeres y 40% varones; el levantamiento de la información fue online con el software survey monkey mediante cuestionario de 16 ítems, en escala de Likert. El tratamiento estadístico utilizado fue la Prueba Chi cuadrada Pearson, usando el paquete SPSS versión 24. Resultados: Los hallazgos muestran que el comportamiento de compra de la muestra bajo estudio no puede ser considerado como compulsivo bajo el modelo de Valence, d'Astous y Fortier, aunque las mujeres, en relación con los hombres, presentan tendencia hacia la compra compulsiva por los resultados mostrados en el constructo "tendencia a gastar". Conclusiones: Los resultados obtenidos por la investigación deben ser de gran importancia para las empresas; es importante destacar que el tema de la compra compulsiva no debe dejar de ser una preocupación y tema de investigación permanente para universidades, autoridades y practicantes de la mercadotecnia. Hoy en día, gracias a los estudios realizados sobre el tema, los encargados de elaborar las estrategias mercadológicas están tomando más conciencia de la forma como afectan en las decisiones de los consumidores, no hay que perder de vista que los integrantes de la generación millennial son el futuro del país y del mundo, y ellos deben tener la oportunidad de realizar consumos más responsables, de beneficio para el mundo actual y las generaciones futuras.

Resumo Objetivo: Analisar os comportamentos de compras dos estudantes universitários da República Mexicana e determinar se há diferenças por sexo que mostram que o comportamento seja considerado compulsivo, seguindo o modelo de Valence, d'Astous e Fortier. Materiais e métodos: Realizou-se um estudo quantitativo, descritivo, correlacional e explicativo, confirmando a estrutura da escala de compras compulsivas de Valence, d'Astous e Fortier nos fatores: tendencia para gastar, o desejo de comprar e os sentimentos de culpa. O estudo envolveu 1.687 estudantes da "geração do milénio" dos 27 estados da República Mexicana, composto por 60% de mulheres e 40% de homens; o levantamento das informa9oes foi efetuado via on-line através do software survey monkey, com aplica9áo de um questionário com 16 itens, sob forma de escala Likert. O tratamento estatístico baseou-se na analise do Qui-quadrado, utilizando-se o programa SPSS versão 24. Resultados: Os dados mostram que o comportamento da amostra em estudo não pode ser considerada como tendo comortamentos compulsivos de compra com base no modelo de Valence, d'Astous e Fortier. Porém, as mulheres comparadas com os homens tem uma tendência para as compras compulsivas porque os resultados demonstram uma "tendência para o gasto". Conclusões: Os resultados obtidos são de importancia capital para as empresas; é importante destacar que o tema das compras compulsivas deve continuar a ser uma preocupação e objecto de estudo para as universidades, as autoridades e os profissionais de marketing. Hoje, graçãs aos estudos realizados sobre o tema, os decisores de politicas de marketing estão mais conscientes de como afetam as decisoes dos consumidores, e náo se pode de ter em atenção o fato de que os membros da "Geração do milénio" são o futuro do país e do mundo, devendo ter a oportunidade de realizar um consumo mais responsável, com benefícios para o mundo atual e futuras gerações.

Résumé Objectif: Analyser les comportements d'achat des étudiants universitaires mexicains selon le sexe et déterminer s'il existe un comportement considéré compulsif, d'après le modele de Valence, d'Astous et Fortier. Matériaux et méthode: L'étude réalisée est quantitative, descriptive, corrélationnelle et explicative, car elle confirme la structure de l'Échelle de mesure de l'achat compulsif de Valence, d'Astous et Fortier pour les facteurs suivants: tendance à dépenser, envie d'acheter et sentiment de culpabilité. L'échantillon a inclus 1.687 étudiants de la génération millénaire, de 27 États du Mexique, 60% de sexe féminin et 40% de sexe masculin. L'information a été recueillie en ligne avec le logiciel Survey Monkey grâce à un questionnaire de 16 items, de type échelle de Likert. Le traitement statistique a été réalisé au moyen du test du Chi-carré, avec le logiciel SPSS versión 24. Resultados: Les résultats montrent que le comportement d'achat de l'échantillon étudié ne peut être considéré compulsif d'après le modèle de Valence, d'Astous et Fortier; cependant, selon la section "tendance a dépenser", les femmes ont tendance à acheter plus compulsivement que les hommes. Conclusions: Les résultats obtenus dans cette recherche sont d'une grande importance pour les entreprises; il est important de souligner que la question de l'achat compulsif ne devrait pas cesser d'être une préoccupation et un thème de recherche permanent pour les universités, les autorités et les praticiens du marketing Aujourd'hui, grâce aux études sur ce sujet, les responsables du développement de stratégies de marketing sont de plus en plus conscients de leur impact sur les décisions des consommateurs. Nous ne devons pas perdre de vue que les membres de la génération millénaire sont l'avenir du pays et du monde; ils doivent avoir l'opportunité de consommer de façon plus responsable, pour bénéficier au monde actuel et aux générations futures.

Childhood malnutrition and maltreatment are linked with personality disorder symptoms in adulthood: Results from a Barbados lifespan cohort.

Both childhood malnutrition and maltreatment are associated with mental health problems that can persist into adulthood. Previously we reported that in Barbados, those with a history of infant malnutrition were more likely to report having experienced childhood maltreatment. Few studies, however, address the long-term outcomes of those who have been exposed to both. We assessed the unique and combined associations of a history of early malnutrition and childhood maltreatment with personality pathology in mid-adulthood in participants of the 47-year longitudinal Barbados Nutrition Study. We used the Structured Clinical Interview for DSM-IV-TR Axis II Personality Disorders Personality Questionnaire (SCID-II-PQ) and NEO Personality Inventory-Revised derived Five-Factor Model (NEO PI-R FFM) personality disorder (PD) scores to assess personality pathology, the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to assess childhood maltreatment, and clinical documentation of malnutrition in infancy. We tested the associations of malnutrition and maltreatment with PD scores using linear regression models, unadjusted and adjusted for other childhood adversities. We found increased scores for paranoid, schizoid, avoidant, and dependent PDs among those who had been malnourished and increased scores for paranoid, schizoid, schizotypal, and avoidant PDs among those with higher childhood maltreatment scores. Overall, those exposed to both adversities had even greater PD scores.

Parental history of moderate to severe infantile malnutrition is associated with cognitive deficits in their adult offspring.

OBJECTIVES: We compared the IQ and academic achievement of the young adult offspring of parents malnourished in infancy and those of a healthy control group in order to test the hypothesis that the offspring of previously malnourished individuals would show IQ and academic deficits that could be related to reduced parental socioeconomic status. METHODS: We conducted a group comparison study based on a community sample in Barbados (Barbados Nutrition Study). Participants were adult children ≥16 years of age whose parents had been malnourished during the first year of life (n = 64; Mean age 19.3 years; 42% male) or whose parents were healthy community controls (n = 50; Mean age 19.7 years; 48% male). The primary outcome was estimated IQ (Wechsler Abbreviated Scale of Intelligence); a secondary outcome was academic achievement (Wide Range Achievement Test - Third Edition). Data were analyzed using PROC MIXED with and without adjusting for parental socioeconomic status (Hollingshead Index of Social Position). RESULTS: IQ was reduced in the offspring of previously malnourished parents relative to the offspring of controls (9.8 point deficit; P < 0.01), but this difference was not explained by parental socioeconomic status or parental IQ. The magnitude of the group difference was smaller for basic academic skills and did not meet criteria for statistical significance. DISCUSSION: The deleterious impact of infant malnutrition on cognitive function may be transmitted to the next generation; however, this intergenerational effect does not appear to be explained by the reduced socioeconomic status or IQ of the parent generation.

DNA Methylation Signatures of Early Childhood Malnutrition Associated With Impairments in Attention and Cognition.

BACKGROUND: Early childhood malnutrition affects 113 million children worldwide, impacting health and increasing vulnerability for cognitive and behavioral disorders later in life. Molecular signatures after childhood malnutrition, including the potential for intergenerational transmission, remain unexplored. METHODS: We surveyed blood DNA methylomes (~483,000 individual CpG sites) in 168 subjects across two generations, including 50 generation 1 individuals hospitalized during the first year of life for moderate to severe protein-energy malnutrition, then followed up to 48 years in the Barbados Nutrition Study. Attention deficits and cognitive performance were evaluated with the Connors Adult Attention Rating Scale and Wechsler Abbreviated Scale of Intelligence. Expression of nutrition-sensitive genes was explored by quantitative reverse transcriptase polymerase chain reaction in rat prefrontal cortex. RESULTS: We identified 134 nutrition-sensitive, differentially methylated genomic regions, with most (87%) specific for generation 1. Multiple neuropsychiatric risk genes, including COMT, IFNG, MIR200B, SYNGAP1, and VIPR2 showed associations of specific methyl-CpGs with attention and IQ. IFNG expression was decreased in prefrontal cortex of rats showing attention deficits after developmental malnutrition. CONCLUSIONS: Early childhood malnutrition entails long-lasting epigenetic signatures associated with liability for attention and cognition, and limited potential for intergenerational transmission.

[Use of dental services by preschool children in Canela, Rio Grande do Sul State, Brazil]. / Utilização de serviços odontológicos por crianças de 0 a 5 anos de idade no Município de Canela, Rio Grande do Sul, Brasil.

The aim of this study was to assess the use of dental services and age at first dental visit in preschool children in Canela, Rio Grande do Sul State, Brazil. A representative sample of under-five children was surveyed on National Children's Vaccination Day. Children's parents completed questionnaires containing socio-demographic data and age at first dental visit. Data were analyzed using multiple logistic regression. 192 children were examined. 13.3% of the sample had already visited the dentist at least once, but only 4.3% had their first dental visit by one year of age. The number of children who had already visited a dentist increased with age. Girls showed higher odds of having visited a dentist (OR = 1.46; 95%CI: 1.01-2.1). Public health strategies are needed to determine the effectiveness of health promotion and improve the use of dental services by preschool children.

Utilização de serviços odontológicos por crianças de 0 a 5 anos de idade no Município de Canela, Rio Grande do Sul, Brasil / Use of dental services by preschool children in Canela, Rio Grande do Sul State, Brazil

O objetivo deste estudo foi verificar a utilização de serviços odontológicos e idade da primeira visita odontológica em pré-escolares do Município de Canela, Rio Grande do Sul, Brasil. Um levantamento epidemiológico em crianças menores de cinco anos de idade foi realizado durante a Campanha Nacional de Multivacinação Infantil no município. Um questionário contendo informações a respeito da idade da primeira consulta odontológica e características demográficas da criança foi respondido pelos responsáveis. Os dados foram analisados utilizando-se modelo de regressão logística. Um total de 1.092 crianças foram examinadas. Do total da amostra, 13,3 por cento já haviam consultado o cirurgião-dentista, e somente 4,3 por cento realizaram algum tipo de consulta odontológica até o primeiro ano de vida. O número de crianças que já haviam recebido atendimento odontológico aumentou com a idade. Crianças do sexo feminino apresentaram maior chance de ter recebido atendimento odontológico do que as do sexo masculino (OR = 1,46; IC95 por cento: 1,01-2,1). Conclui-se que é necessário o estabelecimento de políticas públicas de promoção de saúde e reorientação de serviços que facilitem a utilização dos serviços odontológicos e possibilitem o atendimento às crianças de pouca idade.

The aim of this study was to assess the use of dental services and age at first dental visit in preschool children in Canela, Rio Grande do Sul State, Brazil. A representative sample of under-five children was surveyed on National Children's Vaccination Day. Children's parents completed questionnaires containing socio-demographic data and age at first dental visit. Data were analyzed using multiple logistic regression. 192 children were examined. 13.3 percent of the sample had already visited the dentist at least once, but only 4.3 percent had their first dental visit by one year of age. The number of children who had already visited a dentist increased with age. Girls showed higher odds of having visited a dentist (OR = 1.46; 95 percentCI: 1.01-2.1). Public health strategies are needed to determine the effectiveness of health promotion and improve the use of dental services by preschool children.