A clinical insight into therapeutic sequence in advanced melanoma.

2018 ◽  
Vol 36 (5_suppl) ◽  
pp. 186-186 ◽  
Author(s):  
Jesus Vera Aguilera ◽  
Jonas Paludo ◽  
Marcella Tschautscher ◽  
Cecilia Yu ◽  
Narjust Duma ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Salvage Chemotherapy ◽  
Wilcoxon Test ◽  
Test Results ◽  
Time To Event ◽  
Duration Of Treatment ◽  
Optimal Sequence ◽  
Kaplan Meier ◽  
Therapeutic Sequence ◽  
Melanoma Patients

186 Background: The optimal sequence strategy of BRAF/MEK inhibitors, anti-PD- 1/PDL-1 and anti-CTLA-4 in metastatic BRAF-mutated melanoma patients (pts) is unknown and no treatment guidelines exist. Therefore, we report a single-institution experience of different treatment approaches using targeted therapy (TT) and immunotherapy and its impact on outcomes. Methods: BRAF-mutated metastatic melanoma pts treated with TT and immunotherapy from 2012 to2017 were analyzed. Six groups were identified based on treatment strategy. All time-to-event analyses were calculated using the Kaplan-Meier method and Wilcoxon test. Results: Forty-four pts were identified. The median age at diagnosis was 49 years (range 21-73), 54% pts were females and 43% developed brain metastases during disease course. The most common approach strategy was immunotherapy followed by TT, the median duration of treatment was 11 and 19 weeks, respectively. Time-to-next therapy (TTNT) following 1st line treatment was similar in pts treated with TT (median 23 weeks [95% CI: 15-31]) or immunotherapy (median 26 weeks [95% CI: 10-33], p = 0.94). A trend towards better overall survival (OS) was seen in pts who received immunotherapy followed by TT (p = 0.09); patients who received salvage chemotherapy (carboplatin/paclitaxel) had significantly longer OS (median 7 years [95% CI: 3.2-7.08]) ( p = 0.03). Conclusions: No differences in TTNT were seen with immunotherapy, TT or combined (triple therapy) when used as 1st or 2nd line. The significant longer OS benefit with 1st line immunotherapy was only seen in patients who received chemotherapy later in their treatment course. [Table: see text]

scholarly journals Comparison of natural durability of wood by stake tests followed by survival analysis

2021 ◽  
Vol 67 (1) ◽  
Author(s):  
Ikuo Momohara ◽  
Haruko Sakai ◽  
Hiroshi Kurisaki ◽  
Wakako Ohmura ◽  
Toshikazu Kakutani ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Japanese Cedar ◽  
Scientific Basis ◽  
Wilcoxon Test ◽  
Test Results ◽  
Japanese Cypress ◽  
Conventional Procedure ◽  
Kaplan Meier ◽  
The Mean ◽  
The Relationship

AbstractThe conventional stake test is widely used to evaluate wood durability. The test monitors the deterioration level observed on stakes partially inserted into the ground. The test results are conventionally expressed as the relationship between the mean deterioration level and exposure periods. Durability is compared between the stake groups based on the test results; however, there is no scientific basis for the comparison. To include a scientific basis to the conventional stake test, we applied survival analysis to it. Four stake groups were subjected to deterioration at three sites for 7 years. The deterioration levels were monitored according to the conventional procedure, and survival analysis was applied to the monitored data. The Kaplan–Meier curves plotting the survival probabilities against the exposure periods indicated that the durability of the test stakes of Japanese cedar heartwood is higher than those of Japanese cedar sapwood. However, it was also demonstrated that the durability ratio between Japanese cedar heartwood and sapwood was strongly dependent on the test sites. It was also revealed that the durability of the heartwood portion did not differ significantly among Japanese cedar, Japanese cypress, and Japanese larch. These results were verified using the modified Gehan–Wilcoxon test.

scholarly journals Review of Outcomes after Diagnosis of Malignancy in Kidney Transplant Patients: UNOS Database

2021 ◽  
Vol 2 (3) ◽  
pp. 253-263
Author(s):  
Het Patel ◽  
Nikhil Agrawal ◽  
Voravech Nissaisorakarn ◽  
Ridhi Gupta ◽  
Francesca Cardarelli
Keyword(s):  
Kidney Transplant ◽  
Graft Failure ◽  
Event Analysis ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Time To Event ◽  
Transplant Patients ◽  
Kaplan Meier ◽  
Lung Malignancy ◽  
Kidney Transplant Patients

Malignancy is the third major cause of death among transplant recipients. Patient and kidney transplant outcomes after the diagnosis of malignancy are not well described. We reviewed incidences and outcomes of colorectal, lung, PTLD, and renal malignancy after transplant among patients who received a transplant from January 2000 to December 2018 using the UNOS/OPTN database. Incidence of each malignancy was measured at 5 years and 10 years of transplant. The Kaplan–Meier curve was used for time-to-event analysis (graft and patient outcomes). Additionally, we sought to identify the causes of graft failure among these recipients. We found that 12,764 (5.5%) patients suffered malignancy, excluding squamous and basal cell skin carcinoma after transplant. During the first 5 years of transplant, incidence of colorectal, lung, PTLD, and renal malignancies was 2.99, 9.21, 15.61, and 8.55 per 10,000 person-years, respectively. Rates of graft failure were 10.3%, 7.6%, 19.9%, and 18.8%, respectively, among these patients at 5 years. Mortality rate was highest among patients who suffered lung malignancy (84%), followed by colorectal (61.5%), PTLD (49.1%), and renal (35.5%) at 5 years after diagnosis of malignancy. In conclusion, kidney transplant recipients diagnosed with lung malignancy have the lowest graft survival, compared to PTLD, colorectal, and renal malignancy. PTLD has the highest incidence rate in the first 5 years of transplant.

RECQL5 mutations as a potential efficacious predictor of immunotherapy in melanoma patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21547-e21547
Author(s):  
Yun Zhao ◽  
Dandan Fan ◽  
Xiaochun Huang ◽  
Mengli Huang ◽  
Yaoxu Chen ◽  
...  
Keyword(s):  
Dna Damage ◽  
T Cells ◽  
Immune Cells ◽  
Statistical Significance ◽  
Dna Damage Repair ◽  
Objective Response ◽  
Wilcoxon Test ◽  
Durable Response ◽  
Damage Repair ◽  
Melanoma Patients

e21547 Background: Gene mutations in DNA damage repair (DDR) pathway were reported to affect the clinical response to immune checkpoint inhibitors (ICIs) by driving mutagenicity. Previous studies showed that RECQL5 is involved in RAD51-mediated strand invasion for homologous recombination DNA damage repair (HR-DDR). RECQL5 encoding RecQ protein-like 5 (RECQL5) is a member of RecQ helicase family and was discovered to play a tumor-suppressive or oncogenic role in various cancers. However, the association between RECQL5 mutation and ICI efficacy has not been revealed. Methods: Data of nine publicly independent cohorts of NSCLC, melanoma, and pan-cancer were retrieved (Rizvi, MSKCC, OAK/POPLAR, Van Allen, Hugo, Synder, Miao and Samstein cohorts) to investigate the correlation between RECQL5 mutations and clinical events including overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and clinical benefit rate (CBR). Wilcoxon test was used for comparing tumor mutational burden (TMB) between RECQL5-mutated patients and their wild-type counterparts. In addition, the correlation between infiltration of immune cells and RECQL5 mutation status was also analyzed by QUANTISEO using data of SKCM cohort (n=466) from TCGA database. Statistical significance was set at P = 0.05. Results: RECQL5 mutations were most commonly seen in melanoma patients and the detection rate was 4%-8% in melanoma patients from cohort Van Allen, Hugo, Synder, and Miao. RECQL5 mutation was not detected in other cancers except for one lung cancer case. In the three melanoma cohorts (Van Allen, Synder, Miao) with OS data available, the OS of the RECQL5-mutated patients was 2 to 3 times longer than that of the RECQL5-wt patients. In Synder cohort, the difference in OS between these two subsets was statistically significant (53.9 months vs 25.0 months, P = 0.045). In addition, the occurrence of RECQL5 mutations was correlated with higher CBR both in Miao ( P = 0.017) and Synder cohorts ( P = 0.011). No difference was observed in the PFS or ORR between these two subsets. Notably, RECQL5 mutations were associated with higher TMB levels both in Miao (32.6 mut/Mb vs 7.9 mut/Mb, P = 0.016) and Synder cohorts (1124 mut/Mb vs 358 mut/Mb, P = 0.033). Moreover, RECQL5 mutations were found to be correlated with increased infiltration of CD4+ T cells (no-regulatory) ( P = 0.037), B cells ( P = 0.13) and decreased infiltration of regulatory CD4+ T cells ( P = 0.02) in RECQL5-mutated tumors over RECQL5-wt tumors. Conclusions: RECQL5 mutations can serve as a potential predictor for a durable response to ICIs in melanoma. Moreover, the occurrence of RECQL5 mutations was correlated with higher TMB level as well as infiltration of immune cells, indicating the underlying mechanism of its predictive effect.

Moving to e-bidding

2019 ◽  
Vol 24 (1) ◽  
pp. 2-18 ◽  
Author(s):  
Djoen San Santoso ◽  
Nuttapon Bourpanus
Keyword(s):  
Wilcoxon Test ◽  
Test Results ◽  
Public Infrastructure ◽  
Senior Managers ◽  
Content Type ◽  
Thai Government ◽  
Infrastructure Project ◽  
The Difference ◽  
Public Money ◽  
Mean Differences

Purpose This study aims to examine the influences of shifting the bidding system of Thai public infrastructure projects from e-auction to e-bidding. Design/methodology/approach A questionnaire survey was conducted with owners or senior managers with direct responsibility in deciding the mark-up of 72 small and medium-sized contractor firms. Five senior professionals were interviewed to provide insights into and to strengthen the discussion of the findings. The Wilcoxon test was applied to analyze the difference in the importance of the factors between e-auction and e-bidding. Findings The results revealed a shift in the importance of the factors, from those related to the financial aspects in the e-auction to the situational aspects in the e-bidding. The comparison test results also suggested that the majority of factors become significantly less important in the e-bidding system, with “identity of competitors” and “general expense of the bidding process” having the most apparent mean differences. The interview results supported by data on winning prices and estimations strongly indicated that bid collusions likely exist in the e-auction. By shifting to e-bidding, the data also show that the Thai Government can save public money in its infrastructure project development. Originality/value The study provides an analysis from the perspectives of contractor firms on how e-auction and e-bidding options influence bid mark-up decisions. Many studies have focused on the issues and advantages provided by the e-procurement mainly from the owner (government)’s perspective but how the change influences the contractor’s attitude has been less explored.

scholarly journals Pelatihan Upaya Kesehatan Kerja Bagi Masyarakat Cipayung Kota Depok

2020 ◽  
Vol 4 (4) ◽  
pp. 605-610
Author(s):  
Azizah Musliha Fitri ◽  
Fajaria Nurcandra ◽  
Terry Yuliana Rahadian Pristya
Keyword(s):  
Test Scores ◽  
Residential Location ◽  
Wilcoxon Test ◽  
P Value ◽  
Test Results ◽  
Average Value ◽  
Post Test ◽  
Level Of Knowledge ◽  
Initial Survey ◽  
The Village

An initial survey that had been done  found that the location of the settlement where residents of cipayung lived was very close to the location of the Cipayung Landfill. The unhealthy environment tended to cause disease and any other health problems, so that efforts needed to be made to overcome this, one effort that could be done is training on health . This counseling activity was attended by 21 residents living in the village of West Bulak which is the closest residential location to the Cipayung landfill site. Wilcoxon test results on the pre-test and post-test scores of participants showed a P- value of 0.001 which means that there were differences in the level of knowledge of the participants after attending counseling. The average value of pre-test and post-test had a difference of 34.5 shows that counseling that has been carried out is able to increase knowledge.

scholarly journals Medicine treatment of glaucoma in Australia 2012–2019: prevalence, incidence and persistence

2021 ◽  
Vol 6 (1) ◽  
pp. e000921
Author(s):  
Benjamin Daniels ◽  
Paul Healey ◽  
Claudia Bruno ◽  
Iain Kaan ◽  
Helga Zoega
Keyword(s):  
Medical Therapy ◽  
Median Duration ◽  
Duration Of Treatment ◽  
Treatment Persistence ◽  
Prostaglandin Analogues ◽  
The Past ◽  
Kaplan Meier ◽  
Glaucoma Treatment ◽  
Persistence To Treatment

ObjectiveMedical therapy can halt or significantly slow the progression of glaucoma if medicines are used in accordance with the guidelines. We used dispensing claims for a 10% sample of all Australians dispensed publicly subsidised glaucoma medicines to determine the prevalence and incidence of glaucoma medicine treatment and to examine treatment persistence between July 2012 and June 2019.MethodsWe estimated incidence and prevalence per 10 000 population for Australian financial years (1 July to 30 June). We defined prevalence as at least one dispensing of any glaucoma medicine and incidence as a dispensing of any glaucoma medicine with no previous dispensing during the preceding 12 months. We estimated duration of treatment for a cohort initiating glaucoma medicines and used Kaplan-Meier methods to estimate the proportion of people persisting on treatment at 6, 12, 18 and 36 months after initiation. We stratified analyses by the number of repeats prescribed at initiation, age, sex and medicine class.ResultsPrevalence remained stable over the study period at around 180/10 000 people/year; incidence was also stable around 36/10 000/year. Among 34 900 people initiating glaucoma medicines, 37.0% remained on treatment at 6 months from initiation, 29.8% at 12 months and 19.2% at 36 months. Median duration of treatment was 13.2 months (IQR: 2.5—not reached) for people initiating prostaglandin analogues and less than 3 months for those initiating other medicine classes.ConclusionPrevalence and incidence of glaucoma treatment have not changed in Australia over the past decade. Persistence to treatment increased with age but remained poor throughout the study period.

scholarly journals Penyembuhan Pranic Healing terhadap Kesehatan Tubuh Fisik Primigravida Trimester III

2019 ◽  
Vol 2 (2) ◽  
pp. 134-145
Author(s):  
Cahyaning Puji Astuti ◽  
Melyana Nurul Widyawati
Keyword(s):  
Pregnant Women ◽  
Controlled Trial ◽  
Test Group ◽  
Health Condition ◽  
Wilcoxon Test ◽  
P Value ◽  
Test Results ◽  
Third Trimester ◽  
Physical Energy ◽  
Post Test

This study aims to improve the physical health condition of third trimester primigravida pregnant women. The method in this study uses a randomized controlled trial design. This type of research uses pre-test & post-test group design. The results of this study indicate that the results of organ energy as an indicator of physical body health have increased the frequency of pre and post test. The repeated ANOVA test showed a decrease in both groups. While the Wilcoxon test results showed that there were differences in the post test 2 energy organs p = 0.013 (<0.05), post test 3 p value 0.001 (<0.05). Conclusion, pranic healing therapy can increase the physical energy of pregnant women.   Keywords: Organ Energy, Trimester III Pregnancy, Pranic Healing, Primigravida

scholarly journals PELATIHAN KOMUNIKASI INTERPERSONAL UNTUK MENINGKATKAN KOMITMEN ORGANISASI KARYAWAN

2019 ◽  
Vol 9 (2) ◽  
pp. 151-159
Author(s):  
Nira Gusfika
Keyword(s):  
Organizational Commitment ◽  
Interpersonal Communication ◽  
Communication Training ◽  
Wilcoxon Test ◽  
Control Group ◽  
Test Results ◽  
Whitney Test ◽  
Mann Whitney Test ◽  
Before And After ◽  
Experimental Group

This study aims to determine the improvement of organizational commitment through interpersonal communication training. The hypothesis of this research is that there is a difference of organizational commitment to employees between before and after being given interpersonal communication training on experimental group, where the level of commitment of employee organization after being given interpersonal communication training is higher than the level of organizational commitment of the employees before being given interpersonal communication training. Second hypothesis, there is difference of posttest organizational commitment level between experiment group and control group, where posttest of organizational commitment in experiment group is higher than control group.The subject of this research is 17 employees at STAI YAPPTI Balaiselasa. Characteristics of the subjects of this study are employees who have levels of organizational commitment and interpersonal communication in the category very low, low and medium. The design used was Pretest-Posttest Control Group, while the data was collected using organizational commitment scale then analyzed using Mann Whitney test to see the difference of score between the experimental group who were given interpersonal communication training with the control group who were not given interpersonal communication training. Furthermore, Wilcoxon test was done for see experimental group scores between before and after interpersonal communication training.Based on Mann Whitney test results found Z = -3.447 (p <0.01), meaning there is a difference in scores between experimental groups who were trained with control groups who were not trained. Based on Wilcoxon test results found there was a difference between organizational commitment score in the experimental group between before and after being given interpersonal communication training with Z = -2,668 (p<0,01).

Physician adherence to acute rhinosinusitis antibiotic treatment guidelines

2021 ◽  
pp. jim-2021-001934
Author(s):  
Esther Levi ◽  
Ohad Ronen
Keyword(s):  
Antibiotic Treatment ◽  
Medical Records ◽  
Treatment Guidelines ◽  
Medical Center ◽  
Duration Of Treatment ◽  
Acute Rhinosinusitis ◽  
Financial Expenditure ◽  
Proper Diagnosis ◽  
Recommended Guidelines ◽  
Physician Adherence

Antibiotic treatment guidelines promote proper diagnosis and treatment and optimize antibiotic treatment, minimizing both antimicrobial resistance to antibiotics and financial expenditure. This study aimed to investigate whether community physicians and emergency department (ED) physicians diagnose and treat acute rhinosinusitis according to accepted guidelines. This was a retrospective study of medical records and referrer letters of patients admitted to the medical center between 2014 and 2015. Physician adherence to antibiotic guidelines regarding indication, type and duration of treatment was assessed. Overall, the study included 84 patients diagnosed with acute rhinosinusitis and admitted to the ED. Fewer than 20% of doctors treating patients with rhinosinusitis at our institution followed the current recommended guidelines. In most cases, the type of treatment administered by ED physicians and by community physicians complied with the guidelines (90% and 96%, respectively, p=0.564). The duration of treatment prescribed by the ED physicians aligned with the guidelines in 37.7% of the cases. There was insufficient compliance with acute rhinosinusitis treatment guidelines among all treating physicians in this study, which was characterized by excessive antibiotic treatment. Therefore, ways to increase understanding and adherence to clinical guidelines, and to provide optimal settings in the clinics to carry out the guidelines should be investigated.

Comparing the clinical efficacies of anti-PD-1 antibody monotherapy and anti-PD-1 and anti-CTLA-4 combination therapy as first-line immunotherapy in Japanese advanced acral melanoma: A retrospective, multicenter study (JAMP-neo study).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 9542-9542
Author(s):  
Yasuhiro Nakamura ◽  
Yukiko Kiniwa ◽  
Hiroshi Kato ◽  
Osamu Yamasaki ◽  
Takeo Maekawa ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Clinical Efficacy ◽  
Objective Response ◽  
Evaluation Criteria ◽  
Progression Free Survival ◽  
First Line ◽  
Acral Melanoma ◽  
Kaplan Meier ◽  
Melanoma Patients ◽  
Clinical Records

9542 Background: Anti-PD-1 antibody monotherapy (PD1) has been commonly used for patients with advanced acral melanoma (AM). However, recent studies have demonstrated the limited clinical efficacy of PD1 in AM compared to non-acral cutaneous melanoma, particularly in nail apparatus melanoma. Although advanced AM patients are strong candidates for first-line anti-PD-1 and anti-CTLA-4 combination therapy (PD1+CTLA4), data on the clinical efficacy of PD1+CTLA4 in AM are lacking. Thus, we aimed to compare the clinical efficacies of PD1+CTLA4 and PD1 in Japanese advanced AM patients. Methods: We retrospectively reviewed the clinical records of advanced AM patients treated with PD1+CTLA4 or PD1 as first-line immunotherapy at 23 Japanese institutions. Clinical response was assessed using the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Survival was estimated using Kaplan-Meier analysis. Toxicity was assessed according to CTCAE 4.0. Results: A total of 192 patients (median age, 72 years) with advanced AM (palm and sole melanoma, 135; nail apparatus melanoma, 57) were included in the study. PD1+CTLA4 and PD1 were used as first-line immunotherapy in 39 and 153 patients, respectively. The baseline demographics and characteristics were similar between the PD1+CTLA4 and PD1 groups, except for age (median age 67.3 vs. 73.2; P = 0.005). The objective response rate (ORR) in PD1+CTLA4 was significantly higher than that of the PD1 group (38.5% vs. 16.3%; P = 0.047). The median progression-free survival (PFS) and overall survival (OS) in the PD1+CTLA4 group tended to be longer than those of the PD1 group, but the differences were not significant (median PFS 7.3 months vs. 4.5 months; P = 0.19, median OS 43.6 months vs. 18.2 months; P = 0.19). In the subgroup analysis of the palm and sole melanoma cohorts, no significant differences in ORR, PFS, and OS were observed between the PD1+CTLA4 and PD1 groups (ORR 31% vs. 20.8%; P = 0.67, median PFS 5.3 months vs. 5.9 months; P = 0.87, median OS not reached vs. 22.3 months; P = 0.66). Meanwhile, the nail apparatus melanoma cohort in the PD1+CTLA4 group exhibited significantly higher ORR, and longer PFS and OS than the PD1 group (ORR 60% vs 6.1%; P < 0.001; median PFS 19.6 months vs 3.8 months; P = 0.008, median OS 43.6 months vs 13.5 months; P = 0.049). Due to immune-related adverse events in all cohorts, the treatment cessation rate was higher in the PD1+CTLA4 group than the PD1 group (59% vs. 11.8%). Conclusions: PD1+CTLA4 was clinically more efficacious than PD 1 in advanced AM patients. Notably, advanced nail apparatus melanoma patients were strong candidates for first-line PD1+CTLA4.

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