Determinants of neoadjuvant chemotherapy use in muscle-invasive bladder cancer

Filipe LF. Carvalho,Alexander Zeymo,Jillian Egan,Colleen H. Kelly,Chaoyi Zheng,John H. Lynch,Jonathan Hwang,Lambros Stamatakis,Ross E. Krasnow,Keith J. Kowalczyk 대한비뇨의학회 2020 Investigative and Clinical Urology Vol.61 No.4

Purpose: Cisplatin-based neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) is standard of care for muscle-invasive bladder cancer (MIBC). However, NAC is used in less than 20% of patients with MIBC. Our goal is to investigate factors that contribute to underutilization NAC to facilitate more routine incorporation into clinical practice. Materials and Methods: We identified 5,915 patients diagnosed with cT2-T3N0M0 MIBC who underwent RC between 2004 and 2014 from the National Cancer Database. Univariate and multivariable models were created to identify variables associated with NAC utilization. Results: Only 18.8% of patients received NAC during the study period. On univariate analyses, NAC utilization was more likely at academic hospitals, US South and Midwest (p<0.05). Higher Charlson score was associated with decrease use of NAC (p<0.05). On multivariate analysis, treatment in academic hospitals (odds ratio [OR], 1.367; 95% confidence interval [CI], 1.186–1.576), in the Midwest (OR, 1.538; 95% CI, 1.268–1.977) and South (OR, 1.424; 95% CI, 1.139–1.781) were independently associated with NAC utilization. Older age (75 to 84 years old; OR, 0.532; 95% CI, 0.427–0.664) and higher Charlson score (OR, 0.607; 95% CI, 0.439–0.839) were associated with decreased NAC utilization. Sixty-eight percent of patients did not receive NAC because it was not planned and only 2.5% of patients had contraindications for NAC treatment. Conclusions: Our study demonstrates that NAC is underutilized. Decreased utilization of NAC was associated with older patients and higher Charlson score. This underutilization may be related to practice patterns as very few patients have true contraindications.

Comparison of The Thickness of Free Anterolateral Thigh Flap in Different Fascial Planes: Clinical Results of Subfascial and Superficial Fat Flap

Tuluy Yavuz,Bali Zülfükar Ulaş,Ünsal Merve Özkaya,Parspancı Aziz,Yoleri Levent,Çiçek Çağla,Filinte Gaye Taylan 대한성형외과학회 2023 Archives of Plastic Surgery Vol.50 No.6

Background The anterolateral thigh (ALT) flap is a preferred option in the reconstruction of a wide variety of defects, enabling multiple tissue components and thicknesses.Methods This study was conducted to investigate the correlation of the thickness of the traditional subfascial ALT flap and superficial fat flap with age, gender, and body mass index (BMI). A total of 42 patients (28 males and 14 females) were included in the study.Results Mean age was 50.2 (range, 16–75) years and mean BMI was 24.68 ± 4.02 (range, 16.5–34.7) kg/m2. The subfascial flap thickness was significantly thinner in male patients (16.07 ± 2.77 mm) than in female patients (24.07 ± 3.93 mm; p < 0.05), whereas no significant difference was found between male (4.28 ± 1.15 mm) and female patients (4.85 ± 1.09 mm) regarding superficial fat flap thickness (p = 0.13). The thickness of both flaps had a positive correlation with BMI, and the strongest correlation was found for subfascial ALT thickness in female patients (r = 0.81). Age had no effect on both flap thickness measurements. The anterior thigh is thicker in women than in men, although it varies according to BMI. This shows that flap elevation is important in the superthin plane, especially if a thin flap is desired in female patients in defect reconstruction with the ALT flap. Thus, a single-stage reconstruction is achieved without the need for a defatting procedure after subfascial dissection or a second defatting procedure 3 to 6 months later.Conclusion The appropriate ALT flap plane should be selected considering the gender and BMI of the patient.

MAKET EFFICIENCY IN A SMALL INDUSTRIALIZED COUNTRY: THE CASE OF DENMARK

David M. Reeb,Helle L. Lf}nroth,Chuck C. Y. Kwok 사람과세계경영학회 1998 Global Business and Finance Review Vol.3 No.2

This article examines the informational efficiency of the Copenhagen Stock Exchange (CSE) in Denmark. Following Famas(l970) three levels ofmarket efficiency, efficiency tests are applied to the CSE daily stock return datafrom January 1985 to March 1994. Besides the traditional random walk andfilter rule tests, a more recent methodology ofexpected utility test is applied to test the weakform efficiency. In testing semi-strongform efficiency, the focus is on how fast new information is incorporated in security prices. Finally, the strong form test investigates if security analysts in Denmark possess private information that may lead to excess profits. The results do not suggest that the CSE is any less efficient than the larger stock markets in the world.

Does HRCT Pattern Influence the Effect of Nintedanib in Patients with Progressive Fibrosing Interstitial Lung Diseases (ILDs)?

( Jin Woo Song ),( Kevin K Brown ),( Simon Lf Walsh ),( Anand Devaraj ),( Wim A Wuyts ),( Claudia Valenzuela ),( Rainer-georg Goeldner ),( Susanne Stowasser ),( Rozsa Schlenker-herceg ),( Athol U Well 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-

Background Several studies have suggested that the progression of fibrosing ILDs is more rapid in patients with a usual interstitial pneumonia (UIP) pattern on HRCT. In the INBUILD trial, nintedanib slowed the rate of decline in FVC in subjects with fibrosing ILDs and a progressive phenotype. We assessed the effect of nintedanib in subgroups by HRCT pattern at baseline. Methods In the INBUILD trial, subjects (n=663) with a progressive fibrosing ILD were randomized to receive nintedanib or placebo. Randomization was stratified by HRCT pattern (UIP-like fibrotic pattern or other fibrotic patterns) based on central review. In pre-specified analyses, we assessed the effects of nintedanib in subgroups of subjects with a UIP-like fibrotic pattern and other fibrotic patterns on HRCT at baseline. Results At baseline, 62.1% of total subjects had a UIP-like fibrotic pattern on HRCT. In subjects who received placebo, the adjusted mean annual rate (SE) of decline in FVC was -209.2 (19.1) mL/year in subjects with a UIP-like fibrotic pattern on HRCT and -155.4 (23.6) mL/year in subjects with other fibrotic patterns on HRCT. The difference between the nintedanib and placebo groups in the annual rate of decline in FVC was 127.8 (95% CI: 74.3, 181.2) mL/year in subjects with a UIP-like fibrotic pattern on HRCT and 75.4 (95% CI: 9.5, 141.4) mL/year in subjects with other fibrotic patterns on HRCT (treatment-by-subgroup-by-time interaction p=0.23) (Table). The effects of nintedanib vs placebo on change from baseline in K-BILD questionnaire total score at week 52, time to acute exacerbation of ILD or death over 52 weeks, and time to death over 52 weeks between the subgroups by HRCT pattern are shown in the Table. Conclusions In the INBUILD trial, the effect of nintedanib on slowing the rate of FVC decline was consistent regardless of fibrotic pattern on HRCT.

Synthesis and characterization of carbon doped TiO2 photocatalysts supported on stainless steel mesh by sol-gel method

JO. Tijani,OO. Fatoba,TC. Totito,WD. Roos,LF. Petrik 한국탄소학회 2017 Carbon Letters Vol.22 No.-

This study synthesized pure anatase carbon doped TiO2 photocatalysts supported on a stainless steel mesh using a sol-gel solution of 8% polyacrylonitrile (PAN)/dimethylformamide (DMF)/TiCl4. The influence of the pyrolysis temperature and holding time on the morphological characteristics, particle sizes and surface area of the prepared catalyst was investigated. The prepared catalysts were characterized by several analytical methods: high resolution scanning electron microscopy (HRSEM), energy dispersive spectroscopy (EDS), X-ray diffraction (XRD), Brunauer-Emmett-Teller (BET), and X-ray photoelectron spectroscopy (XPS). The XRD patterns showed that the supported TiO2 nanocrystals are typically anatase, polycrystalline and body-centered tetragonal in structure. The EDS and XPS results complemented one another and confirmed the presence of carbon species in or on the TiO2 layer, and the XPS data suggested the substitution of titanium in TiO2 by carbon. Instead of using calcination, PAN pyrolysis was used to control the carbon content, and the mesoporosity was tailored by the applied temperature. The supported TiO2 nanocrystals prepared by pyrolysis at 300, 350, and 400ºC for 3 h on a stainless steel mesh were actual supported carbon doped TiO2 nanocrystals. Thus, PAN/DMF/TiCl4 offers a facile, robust sol-gel related route for preparing supported carbon doped TiO2 nanocomposites.