Pembrolizumab-combination therapy for NSCLC- effectiveness and predictive factors in real-world practice.

Introduction: Pembrolizumab combined with chemotherapy has become the standard of care for patients with non-small-cell lung cancer (NSCLC) and the expression of programmed death ligand 1 (PD-L1) in <50% of tumour cells (TC). Methods: We evaluated the efficacy of the treatment in real-world practice, paying attention to the predictive factors, with a special focus on low level of PD-L1 expression. This study is a multicenter retrospective analysis of patients with stage IV NSCLC. Results: A group of 339 consecutive patients was analysed, among them 51% patients with low PD-L1 expression. In the overall population, the ORR was 40.6%, median PFS and OS were 13 months (95% CI 11.4-15) and 16.8 months (95% CI 13.3-20.3), respectively. In multivariate analysis for the entire study population, performance status - ECOG 1 vs. 0 (HR 2.2, 95%CI 1.1-4.6; p=0.02), neutrophil to lymphocyte ratio (NLR)>3 (HR 2.3, 95%CI 1.3-4.2; p=0.04), presence of liver (HR 2.0, 95%CI 1-3.7; p=0. 03) and bone metastases (HR 1.3, 95%CI 1-3; p=0.04), weight loss (HR 1.8, 95%CI 1.1-2.8; p=0.01) and sum of measurable lesions diameters >110 mm (HR 1.7, 95%CI 1-2.9, p=0.049) had a negative impact on OS. Conclusions: In the real world, patients can clinically benefit from immunochemotherapy, regardless of the expression of PD-L1 and the histological type. Other clinicopathological factors such as performance status, extent, and location of secondary lesions have prognostic significance.

Bio-Polyurethane Foams Modified with a Mixture of Bio-Polyols of Different Chemical Structures.

We report on rigid polyurethane (PUR) foams prepared using different contents of a mixture of two bio-polyols (20-40 php). The bio-polyols were obtained through epoxidation and a ring opening reaction. Different chemical structures of the bio-polyols resulted from the use of 1-hexanol and 1,6-hexanediol as opening agents. The bio-polyols were characterized by hydroxyl values of 104 and 250 mgKOH/g and viscosities of 643 and 5128 mPa·s, respectively. Next, the influence of the bio-polyols on the foaming process of PUR systems as well as the foam properties was evaluated. The bio-foams modified with different contents of the bio-polyols were next compared with a reference foam obtained using a polyether petrochemical polyol. The effect of the apparent density reduction as a result of replacing the petrochemical polyol was minimized by decreasing the water content in the formulation. It was found that the modification of the recipe by changing the content of water, acting as a chemical foaming agent, did not affect the foaming process. However, the introduction of the bio-polyols mixture limited the reactivity of the systems by reducing the maximum temperature of the foaming process. The bio-materials with comparable apparent densities to that of the reference material were characterized by similar values of the thermal conductivity coefficient and a decrease in their mechanical strengths. A deterioration of mechanical properties was caused by the plasticization of the polyurethane matrices with the bio-polyols containing dangling chains. However, all materials were dimensionally stable at room temperature.

The correlation of patients' anxiety after a liver or kidney transplantation with functional and self-reported work ability.

Organ transplantation has become the treatment of choice for end-stage organ failure, including renal and liver failure. The benefits of patient employment after transplantation are numerous, but factors determining the ability to work among these patients are not clearly defined. The growing interest in these factors has strong practical implications for organizations creating vocational rehabilitation programs. Given the interconnection between psychological and physical functioning in patients after transplantation, the present study examined the impact of anxiety on vocational rehabilitation and its relationship with functional tests. A total of 100 patients after liver or kidney transplantation underwent functional tests, including the 6-minute walking test and 30-second chair stand test (30"CST), and psychological tests, specifically the Inventory of Physical Activity Objectives, Work Ability Index, and State-Train Anxiety Inventory. Working ability was affected by psychological factors. State and trait anxiety exhibited inverse relationships with subjective readiness to occupational activity (P < .001, r = -.59 and P < .001, r = -.56, respectively). The level of anxiety was negatively related to the results of the 30"CST. State-Train Anxiety Inventory, State Anxiety subscale and State-Train Anxiety Inventory, State-Trait Anxiety subscale vs 30"CST: P < .001, r = -.43 P < .001, r = -.44). Thus, state and trait anxiety influence perceived work ability and partially functional status. These observations may indicate the potential benefits of including psychologists in interdisciplinary teams for physical and especially vocational rehabilitation of patients after liver or kidney transplantation.

Multivariate analysis of biopsychosocial determinants of professional activity among patients after kidney or liver transplantation in Poland.

OBJECTIVE: The aim of the present study was to assess the employment rate among kidney and liver transplant recipients in Poland and identify the predictors of employment. SETTINGS: The study was based on a self-prepared questionnaire containing five parts: demographic data and professional, medical, physical and psychological factors. This is a multicentre study involving four hospitals in Poland. PARTICIPANTS: The investigated group consisted of 285 individuals (92 women and 185 men; 8 no sex given) aged between 18 and 45 years who underwent kidney or liver transplantation 1-5 years prior. Because of missing data, 279 questionnaires were considered regarding employment status after transplantation and 277 when sex differences were considered. RESULTS: A total of 120 patients (43%) worked full-time, 42 (15%) part-time and 117 (42%) remained unemployed, with a higher employment rate post-transplantation among men than women (60% vs 55%, p=0.04). More women performed white collar work (74% vs 41%, p=0.0003) and had to modify their working position than men (22% vs 7%, p=0.0118). Factors determining employment after transplantation included higher level of education (OR=27.08; p=0.0096), employment 1 year prior to transplantation (OR=11.05; p<0.001) and good psychological adaptation (OR=4.23; p<0.001). Men working the year before transplantation had higher education (OR=9.66; p=0.0356). Among men, more kidney recipients worked compared with liver recipients (OR=3.567; p=0.0417). Among women, age determined employment status (OR=0.89; p=0.0234). CONCLUSION: Higher education is the most important predictor of employment after transplantation. Therefore, rehabilitation programmes including vocational activity should be directed to increase the level of education, both pretransplantation and post-transplantation if possible.

The Effect of Specific Sling Exercises on the Functional Movement Screen Score in Adolescent Volleyball Players: A Preliminary Study.

The existing data indicate that the result of the Functional Movement Screen (FMS) test influences the likelihood of subsequent injury in professional athletes. Therefore, exercises increasing test scores of the FMS may be useful at various stages of sports activity. This study evaluated the effects of the NEURAC sling exercises method on the FMS test score in teenage volleyball players. The study was conducted on 15 volleyball players aged 14 years. The FMS test was performed three times interspersed with a two-month interval. Between the first and the second assessment, neither additional treatment nor training was applied, while between the second and the third assessment, the participants performed stabilisation exercises based on the NEURAC method. Training was carried out twice a week, for eight weeks. The analysis showed that between the first and the second measurement, no significant differences occurred. The use of specific sling exercises caused a significant improvement in FMS results (p ≤ 0.01) between the first and the third, as well as the second and the third measurement. The applied stabilisation exercises based on the NEURAC method positively influenced the FMS test result in male subjects practicing volleyball. Performance of such exercises also resulted in more than 90% of the subjects having a total FMS test score ≥ 17, which may be important in the prevention of injuries. The preliminary results indicate that this type of exercise should be included in a teenage volleyball training routine.