The mere effort account of task performance posits that task evaluation apprehension leads to performance concerns, motivating task-takers to do well and thus potentiating a dominant response. When ...applied to stereotype threat (ST), mere effort posits that ST motivates test-takers to disprove a stereotype, facilitating a prepotent solve response, augmenting solve type question (e.g., equations) performance, but decreasing comparison type question (e.g., estimations) performance. We tested the mere effort account of ST. In Experiment 1, undergraduates (women) engaged in a practice statistics exam. ST did not facilitate performance on solve questions, but it debilitated performance on comparison questions. In Experiment 2, middle and high school students (girls and boys) engaged in a math practice exam. ST augmented girls' performance on solve questions and debilitated performance on comparison questions. The manipulation that produced stereotype threat in girls lifted boys' performance. This research documents mere effort ST effects in educational settings.
We describe the 5-year oncological and functional outcomes of transoral laser microsurgery, neck dissection (TLM + ND) and adjuvant radiotherapy (PORT) used to treat patients with oropharyngeal ...carcinoma. The effectiveness of external carotid artery (ECA) ligation in reducing post-operative bleeding, and fibrin glue following ND in reducing wound drainage and length of hospital stay is reported.
This retrospective case review of consecutive patients undergoing TLM between 2006 and 2017 used the Kaplan-Meier Estimator and Log-Rank Test for univariate, time-to-event analyses, and Cox-Proportionate Hazard modelling for multivariate analysis.
264 consecutive patients were included. Mean follow-up was 49.4 months. 219 (82.9%) patients received PORT. Five-year overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) rates were 74.9%, 73.7%, and 86.2%, respectively. Five-year locoregional control was 89.4%. 65.5% of cases were Human papillomavirus associated (HPV+), for whom OS, DFS and DSS was 85.6%, 84.7% and 92.7%, respectively, and demonstrated significantly higher OS (hazard ratio (HR) 0.28, CI 0.16–0.49, p < 0.0001), DFS (HR 0.28, CI 0.17–0.47, p < 0.0001) and DSS (HR 0.2, CI 0.09–0.44, <0.001). Post-operative oropharyngeal bleeding occurred in 23 patients (8.7%), of which 5 were major/severe, in patients without ECA ligation. Fibrin glue significantly reduced neck drain output (p < 0.001), and length of hospital stay (p < 0.001). One-year gastrostomy dependence rate was 2.3%.
TLM + ND + PORT results in favourable 5-year survival and locoregional control rates, and low feeding tube dependency rates. ECA ligation and fibrin glue appear to reduce major post-operative haemorrhage, wound drainage and length of hospital stay.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Prior studies have identified variable effects of healthy aging on neurovascular coupling (NVC). Carbon dioxide (CO 2 ) affects both cerebral blood velocity (CBv) and NVC, but the effects of age on ...NVC under different CO 2 conditions are unknown. Therefore, we investigated the effects of aging on NVC in different CO 2 states in healthy controls during cognitive paradigms. 78 healthy participants (18-78 years) underwent continuous recordings of CBv by bilateral insonation of middle (MCA) and posterior (PCA) cerebral arteries (transcranial Doppler), blood pressure, end-tidal CO 2 , and heart rate during poikilocapnia, hypercapnia (5% CO 2 inhalation) and hypocapnia (paced hyperventilation). Neuroactivation via visuospatial (VS) and attention tasks (AT) augmented CBv. Peak percentage change in MCAv/PCAv, were compared between CO 2 conditions and age groups (< 30, 31-60, and >60 years). For the VS task, in normocapnia, younger adults had a lower NVC response compared to older adults (mean difference (MD): -7.92% (standard deviation (SD): 2.37), p=0.004), but comparable between younger and middle-aged groups. In hypercapnia, both younger (MD: -4.75% (SD: 1.56), p=0.009) and middle (MD: -4.58% (SD: 1.69), p=0.023) age groups had lower NVC responses compared to older adults. Finally, in hypocapnia, both older (MD: 5.92% (SD: 2.21), p=0.025) and middle (MD: 5.44% (SD: 2.27), p=0.049) age groups had greater NVC responses, compared to younger adults. In conclusion, the middle-aged adults demonstrated a variable NVC response, comparable to younger adults under hypercapnia, and older adults under hypocapnia. This may owe to a more cognitively favourable profile while under hypercapnic conditions, compared to hypocapnia.
Prior studies have identified variable effects of healthy aging on neurovascular coupling (NVC). Carbon dioxide (CO2) affects both cerebral blood velocity (CBv) and NVC, but the effects of age on NVC ...under different CO2 conditions are unknown. Therefore, we investigated the effects of aging on NVC in different CO2 states in healthy controls during cognitive paradigms. 78 healthy participants (18-78 years) underwent continuous recordings of CBv by bilateral insonation of middle (MCA) and posterior (PCA) cerebral arteries (transcranial Doppler), blood pressure, end-tidal CO2, and heart rate during poikilocapnia, hypercapnia (5% CO2 inhalation) and hypocapnia (paced hyperventilation). Neuroactivation via visuospatial (VS) and attention tasks (AT) augmented CBv. Peak percentage change in MCAv/PCAv, were compared between CO2 conditions and age groups (< 30, 31-60, and >60 years). For the VS task, in normocapnia, younger adults had a lower NVC response compared to older adults (mean difference (MD): -7.92% (standard deviation (SD): 2.37), p=0.004), but comparable between younger and middle-aged groups. In hypercapnia, both younger (MD: -4.75% (SD: 1.56), p=0.009) and middle (MD: -4.58% (SD: 1.69), p=0.023) age groups had lower NVC responses compared to older adults. Finally, in hypocapnia, both older (MD: 5.92% (SD: 2.21), p=0.025) and middle (MD: 5.44% (SD: 2.27), p=0.049) age groups had greater NVC responses, compared to younger adults. In conclusion, the middle-aged adults demonstrated a variable NVC response, comparable to younger adults under hypercapnia, and older adults under hypocapnia. This may owe to a more cognitively favourable profile while under hypercapnic conditions, compared to hypocapnia.Prior studies have identified variable effects of healthy aging on neurovascular coupling (NVC). Carbon dioxide (CO2) affects both cerebral blood velocity (CBv) and NVC, but the effects of age on NVC under different CO2 conditions are unknown. Therefore, we investigated the effects of aging on NVC in different CO2 states in healthy controls during cognitive paradigms. 78 healthy participants (18-78 years) underwent continuous recordings of CBv by bilateral insonation of middle (MCA) and posterior (PCA) cerebral arteries (transcranial Doppler), blood pressure, end-tidal CO2, and heart rate during poikilocapnia, hypercapnia (5% CO2 inhalation) and hypocapnia (paced hyperventilation). Neuroactivation via visuospatial (VS) and attention tasks (AT) augmented CBv. Peak percentage change in MCAv/PCAv, were compared between CO2 conditions and age groups (< 30, 31-60, and >60 years). For the VS task, in normocapnia, younger adults had a lower NVC response compared to older adults (mean difference (MD): -7.92% (standard deviation (SD): 2.37), p=0.004), but comparable between younger and middle-aged groups. In hypercapnia, both younger (MD: -4.75% (SD: 1.56), p=0.009) and middle (MD: -4.58% (SD: 1.69), p=0.023) age groups had lower NVC responses compared to older adults. Finally, in hypocapnia, both older (MD: 5.92% (SD: 2.21), p=0.025) and middle (MD: 5.44% (SD: 2.27), p=0.049) age groups had greater NVC responses, compared to younger adults. In conclusion, the middle-aged adults demonstrated a variable NVC response, comparable to younger adults under hypercapnia, and older adults under hypocapnia. This may owe to a more cognitively favourable profile while under hypercapnic conditions, compared to hypocapnia.
Abstract Background: TNBCs in patients (pts) who are germline BRCA wild type (gBRCAwt) may show homologous recombination deficiency and genomic instability, resulting in a BRCA-like phenotype. The ...PARTNER Trial tested olaparib in combination with neoadjuvant carboplatin and paclitaxel in pts with TNBC (gBRCAwt). Methods: Pts with TNBC diagnosed locally were confirmed centrally with immunohistochemistry for ER, PR, HER2 and EGFR, CK5/6 and AR to define basal-like TNBC, before entry to the PARTNER trial. Pts were gBRCAwt. Tumours were assessed for tumour infiltrating lymphocytes (TILs). Pts were randomised 1:1 to research (R) and control arms (C). Pts received neoadjuvant carboplatin AUC 5, day(d) 1, with paclitaxel 80mg/m2 d1, 8, 15, every (q) 3 weeks (w), x 4 cycles(cy), +/- olaparib 150mg bd, po, d3-14 q 3w. Then all pts had 3cy of anthracycline chemotherapy before surgery. Primary endpoint was pathological complete response (pCR), and secondary endpoints included event-free survival (EFS), and overall survival (OS). A total of 454 patients were needed to attest 90% power with 5% significance assuming pCR rate of 50% in C and 65% in R. Results: From Sept 2016 to Dec 2021, 559 pts with TNBC (gBRCAwt) were randomised at 29 UK centres. Data cut-off was 30/11/23 with median (med) follow-up of 38 months (m). There were 276 R and 264 C pts in the intention-to-treat population. Pt and tumour characteristics were balanced between the arms: med pt age 49 years; 95% ECOG 0; 36% previous oophorectomy or post-menopausal; 95% tumour size ≤50mm; TILS score ≥60% in 22%. In R, 88% received at least 80% of the planned olaparib dose. More than 90% of patients in both R and C received at least 80% of the planned carboplatin (R 96% and C 94%) and paclitaxel (R 100% and C 99%) doses.Of 543 pts, 141 (51.1%) in R and 140 (52.4%) in C had a pCR with a difference of -1.3% (95% CI -9.7% to 7.0%, p-value=0.753). Percentage of pts with pCR increased with increasing TILs; pCR rate was 32% with TILs 0-10%, increasing to 67% with TILs 90-100%. Estimated EFS at 36 months (m) was 80% in R and 79% in C (log-rank p>0.9); estimated OS at 36m was 90% in R and 87.2% in C (log-rank p=0.8). Estimated 36m EFS rate was 90.4% (95% CI, 86.4 to 94.5) in pts with pCR and 70% (95% CI, 64.2 to 76.2) in pts with non-pCR (HR=0.3, 95% CI 0.2 to 0.4; p < 0.001). Estimated 36m OS was 95.7% (95% CI, 93.0 to 98.5) in pts with pCR, and 83% (95% CI, 78 to 88.2) in pts with non-pCR (HR=0.2, 95% CI 0.1 to 0.3; p < 0.001). More events and deaths were observed in non-pCR pts compared to pCR pts regardless of the treatment received. Conclusions: Neo-adjuvant olaparib in the dose and schedule tested, in addition to carboplatin/taxol and anthracycline chemotherapy in basal-like TNBC in gBRCAwt patients, did not improve pCR rates, EFS or OS. Pts who achieved a pCR had significantly better EFS and OS than those with non-pCR. These results are in marked contrast to the significant benefit of olaparib in those with gBRCA mutations reported in parallel. Citation Format: Jean E. Abraham, Karen Pinilla, Louise Grybowicz, Alimu Dayimu, Nikolaos Demiris, Caron Harvey, Lynsey M. Drewett, Rebecca Lucey, Alexander Fulton, Anne N. Roberts, Joanna R. Worley, Anita Chhabra, Wendi Qian, Richard M. Hardy, Stephen Chan, Tamas Hickish, Devashish Tripathi, Ramachandran Venkitaraman, Mojca Persic, Shahzeena Aslam, Daniel Glassman, Sanjay Raj, Annabel Borley, Jeremy P. Braybrooke, Stephanie Sutherland, Emma Staples, Lucy C. Scott, Mark Davies, Cheryl A. Palmer, Margaret Moody, Mark J. Churn, Jacqueline C. Newby, Mukesh B. Mukesh, Amitabha Chakrabarti, Rebecca R. Roylance, Philip C. Schouten, Nicola Levitt, Karen McAdam, Anne C. Armstrong, Ellen R. Copson, Emma McMurtry, Marc Tischkowitz, Elena Provenzano, Helena Earl, PARTNER Trial Group. PARTNER Trial: Neoadjuvant olaparib in triple negative breast cancer (TNBC) abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr CT012.
Janda et al investigate whether total laparoscopic hysterectomy (TLH) is equivalent to total abdominal hysterectomy (TAH) in women with treatment-naive endometrial cancer. At 4.5 years of follow-up, ...disease-free survival was 81.3% in the TAH group and 81.6% in the TLH group. The disease-free survival rate difference was 0.3% (favoring TLH; 95% CI, -5.5% to 61%; P = .007), meeting criteria for equivalence. There was no statistically significant between-group difference in recurrence of endometrial cancer (28/353 in TAH group 7.9% vs 33/407 in TLH group 81%; risk difference, 0.2% 95% CI, -3.7% to 4.0%; P = .93) or in overall survival (24/353 in TAH group 6.8% vs 30/407 in TLH group 7.4%; risk difference, 0.6% 95% CI, -3.0% to 4.2%; P = .76).
Abstract Objectives This article is an evaluation of the current trial processes within a national proton beam therapy (PBT) clinical trial service in the United Kingdom. The work within the article ...identifies priority challenges associated with the implementation of PBT trials with a view to improving patient trial processes. Methods The nominal group technique (NGT) was used. Five Clinical Trials Radiographers were asked the target question “what are the major challenges when implementing PBT clinical trials and facilitating PBT trial-related activities?” Participants individually and silently listed their challenges to the target question. Following this, group discussion clarified and refined responses. Participants then individually selected five challenges that they deemed most pertinent to the target question, giving a weighted score (out of 10). Individual scores were combined to provide a ranked, weighted order of challenges. Further group discussion identified improvement strategies to the highest scored challenges. Results After combining lists generated by participants, 59 challenges were identified. Group discussion eliminated 27 responses. Eighteen were merged, resulting in 14 challenges. The two challenges that ranked highest were: (i) lack of initial understanding of the responsibilities of teams and who the relevant stakeholders were, and (ii) that a national PBT service requires the provision of shared care across multi-disciplinary teams and sites. Improvement areas include the development of shared protocols, clarifying stakeholder responsibilities and improving communication between centres to streamline PBT trial processes. Conclusions This work has identified priority areas requiring development to improve the conduct of a national PBT clinical trials programme. Advances in knowledge This is the first publication to evaluate current clinical trial processes for the United Kingdom’s PBT service.
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