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  • Rasmussen Lin posted an update 1 week, 6 days ago

    With increasing therapeutic alternatives available, there is growing interest in tools that accurately identify patients most suitable for intensive acute myeloid leukemia (AML) chemotherapy. Nowadays, conceptual criteria proposed by an Italian panel of experts are widely used for this purpose. How accurately these Ferrara criteria predict fitness for intensive chemotherapy is unknown.

    We assessed the fitness of adults undergoing intensive AML therapy based on Ferrara criteria and determined the accuracy of this assessment for early mortality and survival prediction.

    Among 655 adults who received curative-intent induction or reinduction chemotherapy with 7 days of standard-dose cytarabine and 3 days of an anthracycline (“7+3”) CLAG-M (cladribine, high-dose cytarabine, granulocyte colony-stimulating factor, and mitoxantrone), or reduced-dose CLAG-M, 197 (30%) met at least one of the criteria defining unfitness for intensive chemotherapy (F-unfit). Compared with F-fit patients, the overall survival of F-u outcomes with intensive chemotherapy in F-fit and F-unfit patients.

    Ferrara unfitness criteria provide a good prediction tool for shorter-term mortality after intensive AML chemotherapy. Our data may serve as a benchmark for expected outcomes with intensive chemotherapy in F-fit and F-unfit patients.Women are normally self-employed in businesses involving buying and selling of goods. Such businesses were severely affected by the COVID-19 pandemic lock-down. The researchers explored the impact the of COVID-19 lockdown on self-employed women. The researchers used a qualitative approach. Interviews were used to collect data. Forty participants took part in the study. The data was thematically analyzed. The researchers found that participants were affected by Inadequate food supplies, Hopelessness to revive business, Poor access to health services, Psychological trauma, Defaulting medications, and Challenges of keeping children indoors. There is need to provide social and economic support to self-employed women.Rapid dissemination of mobile technology provides substantial opportunity for overcoming challenges reaching rural and marginalized populations. We assessed feasibility and acceptability of longitudinal mobile data capture among women undergoing fistula surgery in Uganda (n = 60) in 2014-2015. Participants were followed for 12 months following surgery, with data captured quarterly, followed by interviews at 12 months. Participant retention was high (97%). Most respondents reported no difficulty with mobile data capture (range 93%-100%), and preferred mobile interview (88%-100%). Mobile data capture saved 1000 person-hours of transit and organizational time. Phone-based mobile data collection provided social support. Our results support this method for longitudinal studies among geographically and socially marginalized populations.

    Cytology findings of atypical squamous cells of unknown significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) are common among women under 30, but evidence on best management strategy is insufficient. We therefore investigated how different management strategies used in Denmark influenced biopsy rates and detection of cervical intraepithelial neoplasia (CIN).

    Register-based cohort study including Danish women aged less than 30 years and born 1980-95, with ASCUS/LSIL as their first abnormal cervical cytology in 2008-16. Rates and relative risks (RR) of biopsy and detection of CIN3+, CIN2 and < CIN2 during two years follow-up were compared between women referred directly to colposcopy after ASCUS/LSIL or undergoing additional testing, including mRNA or DNA test for high risk HPV or repeat cytology.

    19,946 women with ASCUS and 19,825 with LSIL were included in the study of whom 92% had adequate information about follow-up. Among women referred directly to biopsy, CIN3+ was detected among 21%, CIN2 in 17%, while 62% had < CIN2. Repeating cytology after 6 months reduced the biopsy rate to 44% of which 53% had < CIN2. Biopsy rates with HPV test were 67% for DNA test, 77% with 14-type mRNA test and 58% with 5-type mRNA test. The detection of CIN3+ was somewhat higher, between 13% and 14% for the three HPV tests vs. 11% with repeat cytology. However, the detection of < CIN2 (not indicating treatment) also increased with RR 2.11 (95% CI 2.01-2.21) for 14-type mRNA test, 1.35 (95% CI 1.29-1.41) for 5-type mRNA test, and 1.86 (95% CI 1.76-1.97) with HPV DNA test.

    The choice of management strategy influences both the detection rate for severe lesions (CIN3+) and the proportion of women followed up for potentially insignificant findings.

    The choice of management strategy influences both the detection rate for severe lesions (CIN3+) and the proportion of women followed up for potentially insignificant findings.

    Human epididymis protein 4 (HE4) is a validated, complementary biomarker to cancer antigen 125 (CA125) for high grade serous ovarian carcinoma (HGSC). Currently, there are insufficient data on the utility of longitudinal HE4 measurement during HGSC treatment and follow up. We set to provide a comprehensive analysis on the kinetics and prognostic performance of HE4 with serial measurements during HGSC treatment and follow up.

    This prospective study included 143 patients with advanced HGSC (ClinicalTrials.gov identifier NCT01276574). Serum CA125 and HE4 were measured at baseline, before each cycle of chemotherapy and during follow up until first progression. Baseline biomarker values were compared to the tumor load assessed during surgery and to residual disease. GPCR agonist Biomarker nadir values and concentrations at progression were correlated to survival.

    The baseline HE4 concentration distinguished patients with a high tumor load from patients with a low tumor load assessed during surgery (

    <.0001). The baseur knowledge the first time this finding has been reported.

    Digital technology is closely intertwined with and influences people’s everyday lives. Within occupational science and occupational therapy, research is therefore warranted into situationally oriented analysis of the use of digital technology for engagement in occupation.

    To contribute with an analytic framework facilitating a situationally oriented analysis of the use of digital technology for engagement in occupation.

    An operationalisation of Dewey’s theory of transaction and inquiry in conjunction with an occupational science approach served as the analytical framework for exploring how underprivileged adults use digital technology for engaging in health-related occupation.

    The analytical framework proved useful for a situationally oriented analysis of digital technology use for engagement in occupation by fostering identification and registration of digital technology artefacts used for engagement in occupation, by making transparent the complexity that the situation creates for the participant, by identifying problems with and needs for inquiries in relation to engagement in occupation and, finally, by facilitating a situation-oriented analytical language.

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