The combination of 5-fluorouracil/leucovorin (5-FU/LV) plus oxaliplatin (FOLFOX) is widely acknowledged as the standard regimen for second-line treatment in patients with advanced biliary tract ...cancer. Nanoliposomal irinotecan (nal-IRI) has demonstrated its activity in patients with advanced pancreatic cancer. Recent studies have investigated the activity of nal-IRI in combination with 5-FU/LV for biliary tract cancer. However, the results have been contradictory. We conducted a meta-analysis to assess survival outcomes and response rates in randomised trials investigating the activity of nal-IRI in previously treated biliary tract cancer patients.
We systematically collected potentially relevant findings from PubMed/Medline, the Cochrane library and EMBASE. Abstracts presented at major international oncological meetings were also reviewed. We extracted hazard ratios and 95% confidence intervals for progression-free survival and overall survival, as well as odds ratios and 95% confidence intervals for objective response rate. The outcomes of the accessible randomised studies evaluating the activity of nal-IRI plus 5-FU/LV were analysed.
The combination therapy exhibited a statistically significant decrease in the risk of progression (hazard ratio 0.70; 95% confidence interval 0.50-0.97) when compared with 5-FU/LV alone. Additionally, the dual regimen yielded longer overall survival and a higher objective response rate.
Our meta-analysis showed that nal-IRI plus 5-FU/LV had a superior activity in comparison with 5-FU/LV. Further investigations are required to elucidate the role of nal-IRI in this setting and to identify subgroups of patients who could derive the greatest benefit from its administration.
A virtual version of the reorientation task was employed to test new behavioral measures of navigation strategies and spatial confidence within a gender-fair assessment approach. The results ...demonstrated that, from a behavioral point of view, women had lower level of spatial confidence than men regardless of level of accuracy. Moreover, the way men and women selected spatial strategies depended on the arrangement of spatial cues within the environment. In other terms women relied on landmarks under specific conditions compatible with an adaptive combination/associative model of spatial orientation. Finally, the present study emphasized the importance to assess gender differences taking into account specific affective variables and information selection processing, beyond accuracy.
► Men and women can reach with equal probability the maximum level of proficiency in the reorientation task. Consequently, it is suitable to assess gender differences according to gender fairness criteria. ► Gender differences in reorientation accuracy are slight. ► If geometry is the only available – ambiguous - spatial cue, men are more (behaviorally measured) confident than women, regardless the accuracy. ► Women recur to a (behaviorally measured) landmark-based strategy if the cue is salient/stable, i.e., landmark is far away from the viewer and/or near to the target. ► In navigation and reorientation women showed to be less tolerant to uncertainty about spatial cue and more constrained by the arrangement of the spatial cues than men.
•AT programs were used to promote adaptive behavior in three children cerebral palsy.•A new set-up fostering constructive engagement, choice behaviors and mood was assessed.•Increase in correct ...requests of preferred stimuli and positive mood was observed.•Performance and mood were maintained during post intervention check phase.•The technology system was suitable and affordable for children with cerebral palsy.
A technology-based program to promote independent choice behaviors by three children with cerebral palsy and multiple disabilities was assessed. The program was based on learning principles and assistive technology (i.e., customized input devices/sensors, personal computers, screening of preferred stimuli according to a binomial criterion). The first purpose of the present study was to provide the participants with a new set-up of assistive technology and to allow them to choose among three categories (i.e., food, beverage and leisure), and to request a specific item out of four in each category, adopting a procedure that minimized (according to a conditional probability criterion) unintentional choices. The second aim of the study was to carry out the effects of the program on detectable mood signs (i.e., happiness index). The study was conducted according to an ABAB sequence with a subsequent post intervention check for each participant. The results showed an increase of engagement and of the happiness index during intervention phases. Psychological as well as educational implications were discussed.
Objectives: To extend the use of assistive technology for promoting adaptive skills of children with cerebral palsy. To assess its effects on positive participation of ten participants involved. To ...carry out a social validation recruiting parents, physiotherapists and support teachers as external raters.
Method: A multiple probe design was implemented for Studies I and II. Study I involved five participants exposed to a combined program aimed at enhancing choice process of preferred items and locomotion fluency. Study II involved five further children for a combined intervention finalized at ensuring them with literacy access and ambulation responses. Study III recruited 60 external raters for a social validation assessment.
Results: All participants improved their performance, although differences among children occurred. Indices of positive participation increased as well. Social raters favorably scored the use of both technology and programs.
Conclusion: Assistive technology-based programs were effective for promoting independence of children with cerebral palsy.
Implications for Rehabilitation
A basic form of assistive technology such as a microswitch-based program may be useful and helpful for supporting adaptive skills of children with cerebral palsy and different levels of functioning.
The same program may improve the participants' indices of positive participation and constructive engagement with beneficial effects on their quality of life.
The positive social rating provided by external experts sensitive to the matter may recommend a favorable acceptance and implementation of the program in daily settings.
Background: In the field of spatial cognition, the study of individual differences represents a typical research topic. Gender and age have been prominently investigated. A promising statistical ...technique used to identify the different responses to items in relation to different group memberships is the Differential Item Functioning Analysis (DIF). The aim of the present study was to investigate the DIF of the Landmark positioning on a Map (LPM) task, across age groups (young and elderly) and gender, in a sample of 400 healthy human participants. Methods: LPM is a hometown map completion test based on well-known and familiar landmarks used to assess allocentric mental representations. DIF was assessed on LPM items two times: on categorical (i.e., positions) and coordinate (i.e., distances) scores, separately. Results: When positions and distances were difficult to assess with respect to the intended reference point, the probability to endorse the items seemed to get worse for the elderly compared to the younger participants. Instead other features of landmarks (high pleasantness, restorativeness) seemed to improve the elderly performance. A gender-related improvement of probability to endorse distance estimation of some landmarks, favoring women, emerged, probably associated with their repeated experiences with those landmarks. Overall, the complexity of the task seemed to have a differential impact on young and elderly people while gender-oriented activities and places seemed to have a differential impact on men and women. Conclusions: For the first time DIF was applied to a spatial mental representation task, based on the schematic sketch maps of the participants. The application of DIF to the study of individual differences in spatial cognition should become a systematic routine to early detect differential items, improving knowledge, as well as experimental control, on individual differences.
Background
Inconsistent results are reported so far in the literature on the relationship between subjective memory complaints (SMC) and objective memory performance. Mixed findings triggered the ...need to investigate whether other potential mediating variables, such as mood and non-memory domains, affect the relationship between SMC and memory performance.
Aims
The present study aimed to contribute in clarifying the relation between subjective and objective memory considering the potential role of mood and visuospatial/executive functions.
Methods
Six hundred and sixty Italian community-dwelling adults (52–91 years old) were enrolled. Italian version of Montreal Cognitive Assessment Test (MoCA), Geriatric Depression Scale and Subjective Memory Complaints Questionnaire (SMCQ) were administered. Four subsamples were composed according to the following criteria: (a) participants with high visuospatial/executive function (VSE) score at MoCA and high mood; (b) participants with high VSE score and low mood; (c) participants with low VSE score and high mood and; (d) participants with low VSE score and low mood.
Results
Preliminarily, two confirmatory factor analysis have set the one-factor structure of SMCQ as the best fitting model. Diagnostic accuracy of the SMCQ in discriminating high and low memory score was assessed. ROC analyses confirmed that a low score in executive tasks was associated with poor reliability of the SMCQ. On the contrary, well-preserved executive functions and high mood levels ensured a good reliability of SMCQ in detecting memory problems.
Discussion and conclusions
Although mood is a key mediator in the relationship between subjective and objective memory, preserving executive functions is essential for ensuring the accuracy of memory self-appraisal in adulthood and elderly.
We further extended the use of a microswitch-cluster technology to promote object manipulation and to reduce tongue protrusion in seven children with Angelman syndrome. Study I included seven ...participants with severe to profound developmental disabilities. An ABB
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AB
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experimental sequence was implemented. During the baselines (i.e., A phases) the technology was available but inactive. During the intervention (i.e., B phase) the adaptive responding was positively reinforced irrespective of the challenging behavior. During the cluster (i.e., B
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phases) the adaptive responding was contingently reinforced only if it occurred free of the challenging behavior. A long-term follow-up (i.e., 24 months) was conducted. Intervals with indices of positive participation as an outcome measure of the participants’ constructive engagement and favorable occupation were additionally recorded. Study II recruited 56 external raters (i.e., equally divided in 4 groups among caregivers, physiotherapists, psychologists, and teachers) in a social validation procedure. Results evidenced the effectiveness and the suitability of the technology to pursue the dual goal (i.e., increasing the adaptive responding and simultaneously decreasing the challenging behavior). All the participants consolidated their learning process and positively participated along the intervention phases. Social raters favorably scored the use of the technology. Educational, clinical, psychological, and rehabilitative implications of the findings were critically discussed. Some useful insights for future research and practice were emphasized.
Several strategies have been investigated to improve the 4% survival advantage of adjuvant chemotherapy in early-stage non-small-cell lung cancer (NSCLC). In this investigator-initiated study we ...aimed to evaluate the predictive utility of the messenger RNA (mRNA) expression levels of excision repair cross complementation group 1 (ERCC1) and thymidylate synthase (TS) as assessed in resected tumor.
Seven hundred and seventy-three completely resected stage II-III NSCLC patients were enrolled and randomly assigned in each of the four genomic subgroups to investigator’s choice of platinum-based chemotherapy (C, n = 389) or tailored chemotherapy (T, n = 384). All anticancer drugs were administered according to standard doses and schedules. Stratification factors included stage and smoking status. The primary endpoint of the study was overall survival (OS).
Six hundred and ninety patients were included in the primary analysis. At a median follow-up of 45.9 months, 85 (24.6%) and 70 (20.3%) patients died in arms C and T, respectively. Five-year survival for patients in arms C and T was of 65.4% (95% CI (confidence interval): 58.5% to 71.4%) and 72.9% (95% CI: 66.5% to 78.3%), respectively. The estimated hazard ratio (HR) was 0.77 (95% CI: 0.56-1.06, P value: 0.109) for arm T versus arm C. HR for recurrence-free survival was 0.89 (95% CI: 0.69-1.14, P value: 0.341) for arm T versus arm C. Grade 3-5 toxicities were more frequently reported in arm C than in arm T.
In completely resected stage II-III NSCLC tailoring adjuvant chemotherapy conferred a non-statistically significant trend for OS favoring the T arm. In terms of safety, the T arm was associated with better efficacy/toxicity ratio related to the different therapeutic choices in the experimental arm.
•Adjuvant platinum-based chemotherapy is accepted as standard of care in stage II and III (NSCLC) patients.•Several studies addressed the question of whether molecular tumor markers may serve as predictive biomarkers.•ITACA was planned to evaluate the predictive utility of ERCC1 and TS mRNA expression levels in completely resected NSCLC.•ITACA results indicate that adjuvant chemotherapy customization based on ERCC1 and TS mRNA levels did not improve efficacy.•In terms of safety, the pharmacogenomic-driven arm was associated with better efficacy/toxicity ratio.
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