scholarly journals Prognostic implications of depression and inflammation in patients with metastatic lung cancer

2020 ◽  
Author(s):  
Daniel C McFarland ◽  
Rebecca M. Saracino ◽  
Andrew H. Miller ◽  
William Breitbart ◽  
Barry Rosenfeld ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Hazard Ratio ◽  
Proportional Hazard ◽  
Metastatic Lung Cancer ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Metastatic Lung ◽  
Cox Proportional Hazard Models ◽  
Prognostic Implications

Background: Lung cancer-related inflammation is associated with depression. Both elevated inflammation and depression are associated with worse survival. However, outcomes of patients with concomitant depression and elevated inflammation are not known. Materials & methods: Patients with metastatic lung cancer (n = 123) were evaluated for depression and inflammation. Kaplan–Meier plots and Cox proportional hazard models provided survival estimations. Results: Estimated survival was 515 days for the cohort and 323 days for patients with depression (hazard ratio: 1.12; 95% CI: 1.05–1.179), 356 days for patients with elevated inflammation (hazard ratio: 2.85, 95% CI: 1.856–4.388), and 307 days with both (χ2 = 12.546; p < 0.001]). Conclusion: Depression and inflammation are independently associated with inferior survival. Survival worsened by inflammation is mediated by depression-a treatable risk factor.

scholarly journals LAMB1 Is Related to the T Stage and Indicates Poor Prognosis in Gastric Cancer

2021 ◽  
Vol 20 ◽  
pp. 153303382110049
Author(s):  
Tao Ran ◽  
ZhiJi Chen ◽  
LiWen Zhao ◽  
Wei Ran ◽  
JinYu Fan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Poor Prognosis ◽  
Hazard Models ◽  
Proportional Hazard ◽  
Kegg Analysis ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models ◽  
Gastric Cancer Patients

Background and Objective: Gastric cancer (GC) is a common tumor malignancy with high incidence and poor prognosis. Laminin is an indispensable component of basement membrane and extracellular matrix, which is responsible for bridging the internal and external environment of cells and transmitting signals. This study mainly explored the association of the LAMB1 expression with clinicopathological characteristics and prognosis in gastric cancer. Methods: The expression data and clinical information of gastric cancer patients were downloaded from The Cancer Genome Atlas (TCGA) and Asian Cancer Research Group (ACRG). And we analyzed the relationship between LAMB1 expression and clinical characteristics through R. CIBERSORTx was used to calculate the absolute score of immune cells in gastric tumor tissues. Then COX proportional hazard models and Kaplan-Meier curves were performed to evaluate the role of LAMB1 and its influence on prognosis in gastric cancer patients. Finally, GO and KEGG analysis were applied for LAMB1-related genes in gastric cancer, and PPI network was constructed in Cytoscape software. Results: In the TCGA cohort, patients with gastric cancer frequently generated LAMB1 gene copy number variation, but had little effect on mRNA expression. Both in the TCGA and ACRG cohorts, the mRNA expression of LAMB1 in gastric cancer tissues was higher than it in normal tissues. All patients were divided into high expression group and low expression group according to the median expression level of LAMB1. The elevated expression group obviously had more advanced cases and higher infiltration levels of M2 macrophages. COX proportional hazard models and Kaplan-Meier curves revealed that patients with enhanced expression of LAMB1 have a worse prognosis. GO/KEGG analysis showed that LAMB1-related genes were enriched in PI3K-Akt signaling pathway, focal adhesion, ECM-receptor interaction, etc. Conclusions: The high expression of LAMB1 in gastric cancer is related to the poor prognosis of patients, and it may be related to microenvironmental changes in tumors.

scholarly journals Overexpression of fibulin-3 in tumor tissue predicts poor survival of malignant mesothelioma patients from hand-spinning asbestos exposed area in eastern China

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhaoqiang Jiang ◽  
Wei Shen ◽  
Shibo Ying ◽  
Zhibin Gao ◽  
Xianglei He ◽  
...  
Keyword(s):  
Survival Data ◽  
Median Overall Survival ◽  
Tumor Tissue ◽  
Eastern China ◽  
Proportional Hazard ◽  
Poor Survival ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models

AbstractFibulin-3 is an extracellular matrix glycoprotein widely expressed in various tissues. Tissue fibulin-3 expression have never been reported in association with prognosis of mesothelioma. Hence, we sought to determine the association between fibulin-3 expression and mesothelioma survival. We made a tissue microarray, which was comprised of cancer and normal tissue from mesothelioma patients (n = 82) during the period 1998–2017 in China. Fibulin-3 and HGMB1 expression were analyzed by immunohistochemistry method. Kaplan–Meier method and Cox proportional hazard models were used for analyzing survival data. Overall, 61 cases (74.4%) were female; 90.2% were of epithelioid type; the median overall survival time was 12.5 months. Fibulin-3 and HMGB1 were highly expressed in tumor tissue rather than adjacent tissue. The expression of fibulin-3 in tissue was correlated with that of HMGB1 (r = 0.32, P = 0.003). High expression of fibulin-3 in tumor tissue could predict poor survival in patients with mesothelioma (P = 0.02). This remained true in a multivariate model, with a significant hazard ratio of 1.91. We demonstrated that fibulin-3 in tumor tissue was a novel biomarker of poor survival of mesothelioma, suggesting it may be a relevant target for therapeutic intervention.

The effect of under and uninsured status on survival in lung cancer while adjusting for other mortality risk factors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21734-e21734
Author(s):  
Mohamed K. Mohamed ◽  
Dana Herndon ◽  
Monica Schmidt ◽  
Matthew A. Manning
Keyword(s):  
Lung Cancer ◽  
Health System ◽  
Hazard Models ◽  
Proportional Hazard ◽  
Risk Of Death ◽  
Proportional Hazard Models ◽  
Full Coverage ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
First Diagnosis

e21734 Background: Lung cancer is the leading cause of cancer death in the US. Significant improvements in survival have occurred with improved treatments. Payer status has been recognized as a barrier to treatment access across multiple cancer types including lung. This study aims to evaluate the impact of payer on 2-year survival rates for patients presenting in one health system with newly diagnosed lung or bronchus cancer. Methods: This is a retrospective survival analysis. There were 1,681 patients with lung cancer (small and non-small) under observation from time of first diagnosis. The first diagnosis date in the Cone health system defined study entry. Failure was defined as death during the 2-year observation period with right censoring after 2-years. Patients were categorized as underinsured if they had no insurance or Medicaid while those with commercial and Medicare were considered having full coverage. Cox proportional hazard models were used reporting hazard ratios. Results: Mortality rates per 10 patients diagnosed with lung or bronchus cancers were 3.5 for those with commercial insurance, 3.8 for Medicare, 3.3 for Medicaid and 5.4 for uninsured patients. Of those patients considered underinsured, 56.7% presented with stage IV cancer compared to those with full coverage (41.4%)*. 40.7% of those without insurance or underinsured were current tobacco product users compared to 25.1% of those with full coverage. Cox proportional hazard models revealed the risk of death is 1.34* times (95% CI 1.07-1.68) greater for underinsured patients compared to those with full coverage. The model adjusted for age, race, gender, marital status, language, Gini coefficient, Elixhauser comorbidity index, illicit drug use, cigarette smoker, smokeless tobacco user, alcohol use, PCP on record, and religion. However, when we add the AJCC stage to this model, the underinsured estimate is no longer statistically significant (1.23; 95% CI 0.92-1.65). Conclusions: Patients without insurance are diagnosed at later stages of disease. This late diagnosis is the primary driver of poor survival. Although being underinsured or uninsured is associated with a greater risk of death after diagnosis, adjusting for stage mitigates this effect. These findings support the need for equal access to early screening and diagnosis regardless of payer. *statistically significant at p < 0.05.

Abstract 16571: The Potential Impact of Expanding Cardiac Rehabilitation Coverage in Heart Failure: Insights From Get With the Guidelines Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jacob P Kelly ◽  
Brad G Hammill ◽  
Jacob A Doll ◽  
G. Michael Felker ◽  
Paul A Heidenreich ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Rehabilitation ◽  
Adverse Outcomes ◽  
P Value ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models ◽  
Expanded Criteria ◽  
Get With The Guidelines

Background: In February 2014, coverage for cardiac rehabilitation (CR) was expanded by Centers for Medicare & Medicaid to include patients with chronic symptomatic heart failure (HF) on optimal medical therapy with ejection fraction <35%. Thus, we sought to characterize the patient population newly eligible for CR based on the expanded criteria and their associated outcomes. Methods: We analyzed the Get With The Guidelines-HF registry linked to Medicare claims data from 2008-2012 to assess three groups of patients age 65 or older: previously eligible (due to prior MI, CABG, stable angina, heart valve surgery, or PCI in the previous 12 months), newly eligible, and ineligible for CR. Ineligible patients met neither criteria. Incidence rate was calculated with Kaplan-Meier estimates and Cox proportional hazard models were used to determine the association of events. Results: Among 51,665 HF patients discharged alive, 27.2% (n=14,053) were newly eligible and 14.5% were previously eligible for CR (n=7477). Newly eligible patients were more likely to be black, have atrial fibrillation and EF < 35%, while having fewer previous hospitalizations than patients previously eligible for CR. Newly eligible and ineligible patients had similar risk for 1-year mortality compared with those previously eligible (adjusted Hazard Ratio [HR] 0.95, 95% Confidence Interval [CI] 0.88-1.02, p-value=0.13 and [HR] 1.05, 95% [CI] 0.98-1.13, p-value=0.17, respectively). However, newly eligible and ineligible patients had lower risk for 1-year readmission compared with those previously eligible (adjusted [HR] 0.89, 95% [CI] 0.85-0.93, p-value<0.001 and [HR] 0.94, 95% [CI] 0.90- 0.98, p-value<0.001). Conclusions: The extension of coverage for cardiac rehabilitation has tripled the potentially eligible HF population. As these newly eligible patients are at high risk for adverse outcomes, cardiac rehabilitation should be considered.

scholarly journals Revolutions and the Military: Endgame Coups, Instability, and Prospects for Democracy

2019 ◽  
Vol 47 (1) ◽  
pp. 148-176 ◽  
Author(s):  
Kevin Koehler ◽  
Holger Albrecht
Keyword(s):  
Distinct Type ◽  
Proportional Hazard ◽  
Data Set ◽  
Systematic Analysis ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Original Medium ◽  
Cox Proportional Hazard Models ◽  
The Military ◽  
Nondemocratic Regimes

This article presents a systematic analysis of military coups following popular mass uprisings in nondemocratic regimes, conceptualized as endgame coups. Drawing on our original, medium- n data set of revolutionary situations, we find that such endgame coups form a distinct type of military intervention in politics. Compared to regular coups, episodes of popular mass contestation prompt conservative interventions in politics of the military’s leadership aimed at preserving the regime’s authoritarian infrastructure. A systematic test of factors characterizing postcoup political trajectories is based on Cox proportional hazard models and provides empirical evidence in contrast to the widely held notion of “democratic coups.” Our findings reveal that endgame coups are conservative rollback coups, executed by military leaderships, that result in continued political instability and illiberal politics.

scholarly journals Low rather than high mean corpuscular volume is associated with mortality in Japanese patients under hemodialysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hirokazu Honda ◽  
Miho Kimachi ◽  
Noriaki Kurita ◽  
Nobuhiko Joki ◽  
Masaomi Nangaku
Keyword(s):  
Mean Corpuscular Volume ◽  
Japanese Patients ◽  
Cubic Spline ◽  
Hazard Models ◽  
Proportional Hazard ◽  
Corpuscular Volume ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models

Abstract Recent studies have reported that high mean corpuscular volume (MCV) might be associated with mortality in patients with advanced chronic kidney disease (CKD). However, the question of whether a high MCV confers a risk for mortality in Japanese patients remains unclear. We conducted a longitudinal analysis of a cohort of 8571 patients using data derived from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS) phases 1 to 5. Associations of all-cause mortality, vascular events, and hospitalization due to infection with baseline MCV were examined via Cox proportional hazard models. Non-linear relationships between MCV and these outcomes were examined using restricted cubic spline analyses. Associations between time-varying MCV and these outcomes were also examined as sensitivity analyses. Cox proportional hazard models showed a significant association of low MCV (< 90 fL), but not for high MCV (102 < fL), with a higher incidence of all-cause mortality and hospitalization due to infection compared with 94 ≤ MCV < 98 fL (reference). Cubic spline analysis indicated a graphically U-shaped association between baseline MCV and all-cause mortality (p for non-linearity p < 0.001). In conclusion, a low rather than high MCV might be associated with increased risk for all-cause mortality and hospitalization due to infection among Japanese patients on hemodialysis.

Second-Hand Smoke As a Predictor of Smoking Cessation Among Lung Cancer Survivors

2014 ◽  
Vol 32 (6) ◽  
pp. 564-570 ◽  
Author(s):  
Lawson Eng ◽  
Jie Su ◽  
Xin Qiu ◽  
Prakruthi R. Palepu ◽  
Henrique Hon ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Survivors ◽  
Second Hand Smoke ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Peer Smoking ◽  
After Cancer

Purpose Second-hand smoke (SHS; ie, exposure to smoking of friends and spouses in the household) reduces the likelihood of smoking cessation in noncancer populations. We assessed whether SHS is associated with cessation rates in lung cancer survivors. Patients and Methods Patients with lung cancer were recruited from Princess Margaret Cancer Centre, Toronto, ON, Canada. Multivariable logistic regression and Cox proportional hazard models evaluated the association of sociodemographics, clinicopathologic variables, and SHS with either smoking cessation or time to quitting. Results In all, 721 patients completed baseline and follow-up questionnaires with a mean follow-up time of 54 months. Of the 242 current smokers at diagnosis, 136 (56%) had quit 1 year after diagnosis. Exposure to smoking at home (adjusted odds ratio [aOR], 6.18; 95% CI, 2.83 to 13.5; P < .001), spousal smoking (aOR, 6.01; 95% CI, 2.63 to 13.8; P < .001), and peer smoking (aOR, 2.49; 95% CI, 1.33 to 4.66; P = .0043) were each associated with decreased rates of cessation. Individuals exposed to smoking in all three settings had the lowest chances of quitting (aOR, 9.57; 95% CI, 2.50 to 36.64; P < .001). Results were similar in time-to-quitting analysis, in which 68% of patients who eventually quit did so within 6 months after cancer diagnosis. Subgroup analysis revealed similar associations across early- and late-stage patients and between sexes. Conclusion SHS is an important factor associated with smoking cessation in lung cancer survivors of all stages and should be a key consideration when developing smoking cessation programs for patients with lung cancer.

Incidence of dementia: evidence for an effect modification by gender. The ILSA Study

2013 ◽  
Vol 25 (11) ◽  
pp. 1867-1876 ◽  
Author(s):  
Marianna Noale ◽  
Federica Limongi ◽  
Sabina Zambon ◽  
Gaetano Crepaldi ◽  
Stefania Maggi
Keyword(s):  
Risk Factors ◽  
Competing Risks ◽  
Depressive Symptomatology ◽  
Significant Risk ◽  
Effect Modification ◽  
Proportional Hazard ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Incidence Of Dementia

ABSTRACTBackground:Gender differences for incidence of dementia among elderly people have been usually investigated considering gender as a predictor and not as a stratification variable.Methods:Analyses were based on data collected by the Italian Longitudinal Study on Aging (ILSA), which enrolled 5,632 participants aged 65–84 years between 1992 and 2000. During a median follow-up of 7.8 years, there were 194 cases of incident dementia in the participants with complete data. Cox proportional hazard models for competing risks, stratified by sex, were defined to determine risk factors in relation to developing dementia.Results:The incidence rate of dementia increased from 5.57/1,000 person-years at 65–69 years of age to 30.06/1,000 person-years at 80–84 years. Cox proportional hazard models for competing risks of incidence of dementia and death revealed that, among men, significant risk factors were heart failure, Parkinson's disease, family history of dementia, mild depressive symptomatology and age, while triglycerides were associated with a lower risk of developing dementia. Significant risk factors in women were age, both mild and severe depressive symptomatology, glycemia ≥109 mg/dL, and a BMI < 24.1 kg/m2. Even as little as three years of schooling was found to be a significant protective factor against the incidence of dementia only for women.Conclusions:Our results suggest that there is an effect modification by gender in our study population in relation to the association between low education level, lipid profile, BMI, and glycemia and dementia.

Learning at the museum

2017 ◽  
Vol 23 (2) ◽  
pp. 281-294 ◽  
Author(s):  
Juan Gabriel Brida ◽  
Chiara Dalle Nogare ◽  
Raffaele Scuderi
Keyword(s):  
Cultural Capital ◽  
Capital Accumulation ◽  
Cultural Consumption ◽  
Proportional Hazard ◽  
Actual Length ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Proportional Odds Assumption ◽  
Cox Proportional Hazard Models

Museum attendance is often seen as a chance for visitors to learn and thus increase their cultural capital. However, a share of the visitors may decide to attend museums for reasons other than cultural capital accumulation. This article investigates whether learning process takes place also in the case of tourists whose main motivation for the visit is recreational. Different attitudes towards cultural consumption may have a role in explaining visit length, seen as a proxy for learning. We present an empirical analysis of the determinants of both willingness to stay and actual length of stay at a museum. Evidence is based on a survey of tourists visiting the Italian museum of Vittoriale. Generalized ordered logit under partial proportional odds assumption and Cox proportional hazard models are used to assess the role of the covariates. A set of economic, socio-demographic, trip-related and psychographic controls is tested, with particular emphasis on motivation.

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