bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Value of HER2 to CEP17 Ratio on Fluorescence In Situ Hybridization Ratio in Patients with Nonmetastatic HER2-Positive Inflammatory and Noninflammatory Breast Cancer Treated with Neoadjuvant Chemotherapy with or without Trastuzumab
Authors: Kogawa Takahiro , Fujii Takeo , Wu Jimin , Harano Kenichi , Fouad Tamer M. , Liu Diane D. , Shen Yu , Masuda Hiroko , Krishnamurthy Savitri , Chavez-MacGregor Mariana , Lim Bora , Murthy Rashmi K. , Valero Vicente , Tripathy Debu , Ueno Naoto T.
Published: February 2020

Background

We previously reported that in patients with HER2-positive (HER2+) locally advanced breast cancer treated with neoadjuvant trastuzumab-containing regimens, high HER2 to centromere enumerator probe 17 ratio on fluorescence in situ hybridization (HER2 FISH ratio) was an independent predictor of high pathologic complete response (pCR) rate, which translated into improved recurrence-free survival (RFS). We sought to determine whether high HER2 FISH ratio is a predictor of pCR and prognosis in patients with HER2+ nonmetastatic inflammatory breast cancer (IBC) and non-IBC treated with neoadjuvant chemotherapy with or without trastuzumab.

Materials and Methods

This study included all patients with histologically proven stage III, HER2+ primary IBC, and non-IBC treated with neoadjuvant chemotherapy with or without trastuzumab and definitive surgery during 1999–2012. Univariate and multivariate logistic regression models were applied to assess the effect of covariates on pCR. Kaplan-Meier estimates with log-rank test were employed for survival analysis. Univariate and multivariate Cox proportional hazards models were used to assess the effect of covariates on RFS and overall survival (OS).

Results

The study included 555 patients with stage III, HER+ breast cancer, 181 patients with IBC, and 374 with non-IBC. In the IBC cohort, HER2 FISH ratio was not significantly associated with pCR, RFS, or OS. In the non-IBC cohort, higher HER2 FISH ratio was significantly associated with higher pCR rate and longer OS.

Conclusion

HER2 FISH ratio showed prognostic value among patients with HER2+ non-IBC but not HER2+ IBC treated with neoadjuvant chemotherapy. This disparity may be due to the underlying aggressive nature of IBC.

Implications for Practice

The findings of this study indicate that the HER2 to fluorescence in situ hybridization ratio as a continuous variable has promise as a predictor of pathologic complete response to neoadjuvant chemotherapy in patients with HER2-positive (HER2+) noninflammatory breast cancer (non-IBC) regardless of the results on HER2 immunohistochemical testing. In the future, some patients with HER2+ non-IBC and a high HER2 FISH ratio might even be offered personalized treatment options, such as nonsurgical treatment.
Second Primary Malignancies in Patients with Colorectal Cancer: A Population-Based Analysis
Authors: Jia Huixun , Li Qingguo , Yuan Jing , Sun Xiaodong , Wu Zhenyu
Published: February 2020

Purpose

This study aimed to profile the characteristics of patients with colorectal cancer (CRC) with a second primary malignancy (SPM) and to identify patients with CRC at high risk of developing SPMs.

Methods

We retrospectively reviewed data on patients with CRC aged 20–79 years from the Surveillance, Epidemiology, and End Results (SEER) database. Eligible patients were categorized into only one primary malignancy and SPM cohorts. A competing-risk model was used to quantify associations between SPM occurrence and the multiple traits of patients. Finally, a decision curve analysis (DCA) was used to evaluate the clinical usefulness of the model by calculating net benefit.

Results

A total of 179,884 patients were identified, 18,285 (10.2%) of whom developed SPMs during a maximum follow-up of approximately 18 years. The median survival time after the second diagnosis was less than 4 years. The 3-year, 5-year, and 10-year cumulative risks of developing an SPM were 3.9%, 5.9%, and 10.0%, respectively. According to the multivariable competing-risk model, male colon cancer survivors, older in age, with a well-differentiated tumor and localized disease, who were treated with surgery were susceptible to SPMs. The DCA yielded a wide range of risk thresholds at which the net benefits would be obtained from our proposed model.

Conclusion

CRC survivors remain at high risk of developing SPMs. Patients with a second diagnosis of cancer showed not only significantly worse survival but also higher cancer-specific mortality. A web-based individualized predictive tool was also provided to assist clinicians in identifying patients at high risk of developing SPMs and planning their future care management.
Impact of Onset of Psychiatric Disorders and Psychiatric Treatment on Mortality Among Patients with Cancer
Authors: Lee Sang Ah , Nam Chung Mo , Kim Young Hoon , Kim Tae Hyun , Jang Sung-In , Park Eun-Cheol
Published: February 2020

Background

Psychiatric disorders are common in patients with cancer. The impact of both psychiatric disorders and psychiatric treatment on mortality in patients with cancer needs to be established.

Materials and Methods

Nationwide claims data were analyzed. To investigate the association between psychiatric disorders and mortality, 6,292 male and 4,455 female patients with cancer who did not have a record of psychiatric disorders before cancer onset were included. To examine the association between psychiatric treatment and mortality, 1,467 male and 1,364 female patients with cancer were included. Incident psychiatric disorder and receipt of psychiatric treatment within 30 days from the onset of a psychiatric disorder were the main independent variables. Dependent variables were all-cause and cancer-related mortality. Cox proportional hazards regression with time-dependent covariates was used.

Results

The onset of psychiatric disorders was associated with a significantly increased risk of mortality in both male (all-cause hazard ratio [HR]: 1.55; cancer-related HR: 1.47) and female patients with cancer (all-cause HR: 1.50; cancer-related HR: 1.44) compared with patients with cancer without psychiatric disorders. Both male and female patients who received psychiatric treatment within 30 days of diagnosis of a psychiatric disorder had a lower risk of cancer-related mortality (males, HR: 0.73; females, HR: 0.71) compared with patients with cancer with psychiatric disorders who did not receive psychiatric treatment.

Conclusion

Patients with cancer with newly diagnosed psychiatric disorders had a higher mortality rate. Among these, those who received psychiatric treatment showed lower rates of mortality. Thus, early detection and early treatment of psychiatric disorders in patients with cancer is needed.
A Randomized Trial of Real-Time Geriatric Assessment Reporting in Nonelectively Hospitalized Older Adults with Cancer
Authors: Jolly Trevor A. , Deal Allison M. , Mariano Caroline , Markowski Nicole , Kirk Sharanda , Perlmutt Max S. , Jones Franklin , Choi Seul Ki , Nyrop Kirsten A. , Busby-Whitehead Jan , Muss Hyman
Published: February 2020

Background

Hospitalized older adults have significant geriatric deficits that may lead to poor outcomes. We conducted a randomized trial to investigate the effectiveness of providing clinicians with a real-time geriatric assessment (GA) report in nonelectively hospitalized older patients with cancer.

Subjects, Materials, and Methods

We developed a web-based software platform for administering a modified GA (Cancer 2005;104:1998–2005) to older (>70 years) nonelectively hospitalized patients with pathologically confirmed malignancy. Patients were randomized to have their GA report provided to their treating clinicians (Intervention arm) or not provided (Control arm).

Results

Our study included 135 patients, median age 76 years, 52% female, 75% white, 21% black, 79% greater than high school education, 59% married, and 17% living alone. All patients had at least one GA-identified deficit, including physical function deficits (90%), cognitive impairment (22%), >5 comorbidities (28%), polypharmacy (>9 medications; 38%), weight loss ≥10% in the past 6 months (40%), anxiety (32%), or depression (30%). There was no difference between the Intervention (6%) and Control arms (9%) in the proportion of patients who were referred by their clinical team for an intervention to address a deficit (p = .53).

Conclusion

Many older nonelectively hospitalized patients with cancer have geriatric deficits that are amenable to evidence-based interventions. Real-time GA reports provided to the care team prior to discharge did not influence provider referral for such interventions. There is a need for systems-level interventions to address deficits in this vulnerable patient population.

Implications for Practice

Geriatric deficits are common in hospitalized older adults with cancer and lead to poor outcomes. Addressing modifiable deficits represents an appealing way to improve outcomes. Widespread geriatrician consultation is impractical owing to resource and personnel constraints. This work tested whether prompt delivery of a mostly self-administered, web-based geriatric assessment report to clinicians improved referral rates for evidence-informed interventions. It confirmed frequent geriatric deficits and high readmission rates in this population but found that real-time geriatric assessment reporting did not influence provider referral for evidence-informed interventions on geriatric assessment identified deficits. These findings highlight the need for systems-level intervention to improve outcomes in this vulnerable patient population.
Clinicopathological Features Predict Outcomes in Patients with Radioiodine-Refractory Differentiated Thyroid Cancer Treated with Sorafenib: A Real-World Study
Authors: Cheng Lin , Fu Hao , Jin Yuchen , Sa Ri , Chen Libo
Published: February 2020

Background

Because beneficial response and progression-free survival (PFS) were achieved by well-designed clinical trials with tyrosine kinase inhibitors (TKIs) in patients with progressive radioiodine-refractory differentiated thyroid cancer (RR-DTC), the overall survival (OS) and improvement of therapeutic outcomes in the real world have been anticipated.

Subjects, Materials, and Methods

This prospective, single-center, real-world study assessed the predictive significance of clinicopathological features on disease control rate (DCR), objective response rate (ORR), PFS, and OS in a cohort of 72 patients with progressive RR-DTC treated with sorafenib at an initial dose of 200 mg twice daily.

Results

Disease control, objective response, and biochemical effectiveness were achieved in 73.3%, 21.7%, and 77.9% of patients, respectively. The median PFS and OS were 17.6 and 28.9 months, respectively. Multivariate analyses showed that hand-foot syndrome (HFS) was an independent predictor for better DCR and ORR, and 131I-avidity for higher ORR. In univariate analyses, longer PFS and OS were observed in patients with Eastern Cooperative Oncology Group performance status (ECOG PS) ≤2, pathologically well DTC, lung-only metastasis, absence of bone metastasis, biochemically nonineffective response, HFS, or radiological disease control. In multivariate analyses, only well DTC and ECOG PS ≤2 remained as independent prognostic factors for more favorable PFS and OS, respectively, whereas the absence of bone metastasis and biochemically nonineffective response independently predicted superior PFS and OS.

Conclusion

This study demonstrated that clinicopathological features might play a vital role in predicting therapeutic outcomes in patients with progressive RR-DTC treated with sorafenib, warranting further optimization of candidates for TKIs.
Trimodality Therapy in the Treatment of Stage III N2-Positive Non-Small Cell Lung Cancer: A National Cancer Database Analysis
Authors: Behera Madhusmita , Steuer Conor E. , Liu Yuan , Fernandez Felix , Fu Chao , Higgins Kristin A. , Gillespie Theresa W. , Pakkala Suchita , Pillai Rathi N. , Force Seth , Belani Chandra P. , Khuri Fadlo R. , Curran Walter J. , Ramalingam Suresh S.
Published: February 2020

Background

Significant controversy remains regarding the care of patients with clinical stage III (N2-positive) NSCLC. Although multimodality therapy is effective, the roles of surgery, chemotherapy, and radiotherapy are not fully defined and the optimal treatment approach is not firmly established. We analyzed outcomes and predictors associated with trimodality therapy (TT) in the National Cancer Database.

Materials and Methods

The NCDB was queried from 2004 to 2014 for patients with NSCLC diagnosed with stage III (N2) disease and treated with chemotherapy and radiation (CRT). Three cohorts of patients were studied: CRT only/no surgery (NS), CRT plus lobectomy (LT), and CRT plus pneumonectomy (PT). The univariate and multivariable analyses (MVA) were conducted using Cox proportional hazards model and log-rank tests.

Results

A total of 29,754 patients were included in this analysis: NS 90.1%, LT 8.4%, and PT 1.5%. Patient characteristics: median age 66 years; male 56% and white 85%. Patients treated at academic centers were more likely to receive TT compared with those treated at community centers (odds ratio: 1.85 [1.53–2.23]; p < .001). On MVA, patients that received TT were associated with better survival than those that received only CRT (hazard ratio: 0.59 [0.55–0.62]; p < .001). The LT group was associated with significantly better survival than the PT and NS groups (median survival: 62.8 months vs. 51.8 months vs. 34.2 months, respectively). In patients with more than two nodes involved, PT was associated with worse survival than LT and NS (median survival: 51.4 months in LT and 39 months in NS vs. 37 months in PT). The 30-day and 90-day mortality rates were found to be significantly higher in PT patients than in LT.

Conclusion

TT was used in less than 10% of patients with stage III N2 disease, suggesting high degree of patient selection. In this selected group, TT was associated with favorable outcomes relative to CRT alone.

Implications for Practice

This analysis demonstrates that trimodality therapy could benefit a selected subset of patients with stage III (N2) disease. This plan should be considered as a treatment option following patient evaluation in a multidisciplinary setting in experienced medical centers with the needed expertise.
Predictive Impact of Mucinous Tumors on the Clinical Outcome in Patients with Poorly Differentiated, Stage II Colon Cancer: A TOSCA Subgroup Analysis
Authors: Rosati Gerardo , Galli Fabio , Cantore Maurizio , Bergamo Francesca , Banzi Maria , Zampino Maria Giulia , Mattioli Rodolfo , Cardellino Giovanni Gerardo , Ronzoni Monica , Di Bartolomeo Maria , Tamberi Stefano , Marchetti Paolo , Rimassa Lorenza , Corsi Domenico , Bochicchio Anna Maria , Artioli Fabrizio , Labianca Roberto , Galli Francesca , Rulli Eliana , Bilancia Domenico , Bregni Giacomo ,   on behalf of TOSCA (Three or Six Colon Adjuvant) Investigators
Published: February 2020

Background

Although American Society of Clinical Oncology and European Society for Medical Oncology guidelines have identified the negative prognostic factors that clinicians have to consider when treating their patients with stage II colon cancer (CC), the role of histological subtype is controversial.

Subjects, Materials, and Methods

The randomized, multicenter, phase III TOSCA trial compared 3 versus 6 months of fluoropyrimidine-oxaliplatin adjuvant chemotherapy in 3,759 patients with high-risk stage II or stage III CC. The objective of this substudy was to evaluate the influence of histological subtypes on the impact of the treatment duration of adjuvant chemotherapy in terms of relapse-free survival (RFS) and overall survival (OS) in 85 mucinous adenocarcinoma (MUC) and 389 nonmucinous adenocarcinoma (NMUC) patients with high-risk stage II, grade 3 CC.

Results

A significant interaction between treatment duration and histology was observed in both RFS (p = .027) and OS (p = .017). In the subgroup of patients with MUC, worse RFS (adjusted hazard ratio [HR], 3.95; 95% confidence interval [CI], 1.03–15.17; p = .045) and OS (HR, 9.56; 95% CI, 1.14–79.98; p = .037) were detected for patients treated in the 3-month arm. No statistically significant differences were found in the subgroup of patients with NMUC.

Conclusion

Patients with MUC, grade 3, stage II CC require special attention and may need 6 months of oxaliplatin-based chemotherapy. Larger studies are required to assess the combined use of histology and other prognostic/predictive factors to define the administration of chemotherapy in patients with stage II CC and to improve their prognosis.

Implications for Practice

Although ASCO and ESMO guidelines define the prognostic factors for patients with stage II colon cancer to establish the use of adjuvant chemotherapy, the influence of histological subtypes is controversial in this population. This study underscores that patients with grade 3 mucinous adenocarcinomas may need adjuvant chemotherapy with oxaliplatin and fluoropyrimidines for a duration of 6 months rather than 3 months.
The EORTC QLQ-C30 Summary Score as a Prognostic Factor for Survival of Patients with Cancer: A Commentary
Authors: Kasper Bernd
Published: February 2020

Patients can provide a unique perspective on their disease, symptoms, and health-related quality of life. This commentary provides context for the recently reported results of the PROFILES study of patient-reported outcomes using the 30-item quality of life questionnaire developed by the European Organisation for Research and Treatment of Cancer.
A Staff Dialogue on Aggressive Palliative Treatment Demanded by a Terminally Ill Patient: Psychosocial Issues Faced by Patients, Their Families, and Caregivers
Authors: Lintz Kathleen C. , Penson Richard T. , Cassem Ned , Harmon David C. , Chabner Bruce A. , Lynch Thomas J.
Published: February 2020

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery which provides hope to the patient, support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum during which caregivers discuss a specific cancer patient, reflect on the important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from their fellow staff members.

In this article, the case presentation and verbatim dialogue from the rounds are discussed with an emphasis on staff psychosocial issues. The case presented was of a 32-year-old man, who developed small cell osteosarcoma and was treated at MGH. He died after undergoing multiple courses of relatively ineffective chemotherapy. The case is made all the more poignant because of the pleasures, hopes and stresses of having a child late in the course of his illness. Staff identified closely, both with him and his family, and their concern for him brought joy and meaning to their work, yet this complicated their ability to deal with his impending death. They felt that his unwillingness to admit defeat prevented them from saying goodbye to someone whom they loved and admired. Despite this, staff recognized that, ultimately, the patient's emotional needs and wishes had to be respected as a first priority and that constructive closure can be worked toward, if not achieved. In such situations, it is vital to have a colleague support system and a forum for discussion of such issues in order to defuse distress and reassure staff that they are doing all that can be done as professionals and caregivers.
A Staff Dialogue on Caring for a Cancer Patient Who Commits Suicide: Psychosocial Issues Faced by Patients, Their Families, and Caregivers
Authors: O'Shea Elizabeth M. , Lintz Kathleen C. , Penson Richard T. , Seiden Michael V. , Chabner Bruce A. , Lynch Thomas J.
Published: February 2020

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery which provides hope to the patient, support to caregivers, and encourages the healing process. The Center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum during which caregivers discuss a specific cancer patient, reflect on the important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from their fellow staff members.

The case presented was of a 31-year-old man who developed adenocarcinoma of the lung with painful bone metastases. His tumor was unresponsive to treatment and he subsequently committed suicide by shooting himself. The verbatim and subsequent discussion raised a number of issues. Staff were devastated by the violent way that he ended his life. They questioned whether more could have been done to prevent this outcome, yet acknowledged that it mirrored the way he had lived, and were able to discuss the values by which we live and die. Some, but not all, felt that the patient had the right to choose how and when to end his life.
Surgical Management of Superior Sulcus Tumors
Authors: Dartevelle Philippe , Macchiarini Paolo
Published: February 2020

Superior sulcus tumor refers to any primary lung cancer presenting with constant pain in the nerve distribution of the eighth cervical, first and second thoracic nerve roots and Horner's syndrome caused by invasion of the stellate ganglion. The pain is steady, severe, and unrelenting, involving the shoulder, the vertebral margin of the scapula and ulnar distribution of the arm to the elbow and finally to the ulnar surface of the forearm, and the small and ring fingers of the hand (Pancoast-Tobias syndrome). Weakness and atrophy of the hand muscles can also occur as the lesions spreads to involve the first and second ribs and vertebrae. Radiologically, there is a small shadow at the extreme apex of the lung with rib and possible vertebral body invasion. Pulmonary symptoms are less frequent because of the peripheral location of the lesions. Since Shaw and Paulson approached superior sulcus tumors in 1961 by using preoperative radiationtherapy (30 to 45 Gy in four weeks including the primary tumor, mediastinum and supraclavicular region) followed by surgical resection, this radiosurgical approach shortly became the standard treatment yielding better disease control and survival than that offered by other treatment modalities. It has now become evident that en bloc resection of the chest wall, involved adjacent structures as well as lobectomy must be considered the standard surgical approach for superior sulcus tumors combined with external radiation (preoperative, postoperative, or both). The goal of the operation is the complete and en bloc resection of the upper lobe in continuity with the invaded ribs, transverse processes, subclavian vessels, T1 nerve root, upper dorsal sympathetic chain and prevertebral muscles.
A Staff Dialogue on a Socially Distanced Patient: Psychosocial Issues Faced by Patients, Their Families, and Caregivers
Authors: Goodman Annekathryn , Penson Richard T. , Blatman Robert , McIntyre James , Gioiella Marie Elena , Chabner Bruce A. , Lynch Thomas J.
Published: February 2020

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members.

The following case of an HIV-positive woman who was diagnosed with cervical cancer during a twin pregnancy was discussed at the May, 1999 Schwartz Center Rounds. The patient was in drug rehabilitation having been dependant on crack cocaine, with a past history of syphilis and gonorrhea. She was single and her other children were in foster care. Initially she was suspicious and non-compliant. A plan was negotiated to biopsy the cervical lesion after cesarean section and with confirmation of malignancy she underwent radical surgery and subsequently radiotherapy. Despite the almost insurmountable social and educational distance between her and her caregivers, they managed to bond and facilitate care. Although there were compromises with which staff were uncomfortable, the relationship was maintained and continues.
Cancer, Coagulation, and Anticoagulation
Authors: Letai Anthony , Kuter David J.
Published: February 2020

Thromboembolic disease affects about 15% of cancer patients and presents a challenge to the oncologist for both prophylaxis and treatment. Although long known to be associated with malignancy, the underlying biochemical mechanisms are poorly understood. Both low-dose warfarin and low molecular weight heparin are effective strategies for prophylaxis of venous thromboembolism, including those involving venous access devices. Current treatment options for venous thromboembolism include heparin (unfractionated and low molecular weight), warfarin, and internal vena cava filters. The appropriate use of these therapeutic options in cancer patients is reviewed herein. There is suggestive evidence that heparin may be superior to warfarin in the long-term treatment of venous thromboembolism. Whether anticoagulants might also improve cancer survival rates independent of their effect on thromboembolism deserves further investigation.
Palliative Chemotherapy: No Longer a Contradiction in Terms
Authors: Archer V.R. , Billingham L.J. , Cullen M.H.
Published: February 2020

Palliative chemotherapy is defined as treatment in circumstances where the impact of intervention is insufficient to result in major survival advantage, but does affect improvement in terms of tumor-related symptoms, and where the palliation/toxicity trade-off from treatment clearly favors symptom relief.

The role of chemotherapy in circumstances where little or no survival benefit is anticipated remains controversial. This is despite the mounting body of evidence in favor of its use for symptom palliation. The notion persists that outcomes other than significant survival benefit are not valid, because of firmly held perceptions of toxicity.

Studies of chemotherapeutic palliation using valid measures of quality of life, show that patients may be willing to accept some side effects of treatment, as long as they gain relief from tumor-related symptoms.

The aims of this review are to present the case for palliative chemotherapy, to highlight the areas of progress which have made this feasible, and to provide guidance with regard to its appropriate use.
Reality Testing in Cancer Treatment: The Phase I Trial of Endostatin
Authors: Ryan David P. , Penson Richard T. , Ahmed Sabrina , Chabner Bruce A. , Lynch Thomas J.
Published: February 2020

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery which provides hope to the patient, support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members.

The September 1999 Schwartz Center Rounds addressed the growing attention around the phase I trial of Endostatin™. Endostatin represents a new treatment paradigm. It is an anti-angiogenic protein, an endogenous fragment of collagen XVIII. In an attempt to ensure a fair allocation of a very limited number of treatment slots in this classical phase I trial, a lottery was established. More than 1,400 patients enrolled within two days of the lottery, all vying for three places in the first cohort. Two contrasting cases are presented, each a potentially eligible patient. The discussion focuses on the dilemma presented by patients desperate for an unproven treatment and the responsibility of staff to explain and support without compounding the hype or suffocating the hope.
Do Minorities Pay More for Mortgages?
Authors: Bhutta Neil , Hizmo Aurel
Published: February 2020

We test for racial discrimination in the prices charged by mortgage lenders. We construct a unique dataset where we observe all three dimensions of a mortgage's price: the interest rate, discount points, and fees. While we find statistically significant gaps by race and ethnicity in interest rates, these gaps are offset by differences in discount points. We trace out point-rate schedules and show that minorities and whites face identical schedules, but sort to different locations on the schedule. Such sorting may reflect systematic differences in liquidity or preferences. Finally, we find no differences in total fees by race or ethnicity.
Endometrium dissociation with trypsin v1
Authors: Hoo Regina , Vento-Tormo Roser
Published: February 2020

This protocol is for enrichment of epithelial glands on endometrium; following the step from "Endometrium dissociation with collagenase".
Hematologic alterations and early mortality in a cohort of HIV positive African patients v1
Authors: Ciccacci Fausto , Lucaroni Francesca , Latagliata Roberto , Morciano Laura , Mondlane Elisa , Balama Moises , Tembo Dyna , Gondwe Jane , Orlando Stefano , Palombi Leonardo , Cristina Marazzi Maria
Published: February 2020

Infection with Human Immunodeficiency Virus (HIV) is highly prevalent worldwide, especially in Sub-Saharan Africa, where anaemia is also widespread. HIV infection is known to be associated with anaemia and various other haematologic alterations, but little data on correlation with immunological and virologic conditions in treatment-naïve patients is available. To investigate these associations, we conducted a retrospective analysis of baseline data (general details, nutritional status, full blood count and HIV infection progress data) and 12 months follow-up status for HIV+ adult patients in 22 health facilities in Malawi and Mozambique. Among the 22.657 patients included, we found associations of sex, nutritional status, CD4 count, and VL with anaemia, leukopenia, and thrombocytopenia. Also, any cytopenia was present in 1/3 of patients with normal nutritional status and less advanced HIV infection, and it wouldn’t be diagnosed in a basic HIV care setting. Moreover anaemia, lower Red blood cells and platelets counts correlated with mortality in the first year of care, independently by BMI, Hb, CD4 count and VL. Our results emphasize the need for including a full blood count in the routine HIV care services in Sub-Saharan Africa.
Monitoring cell-surface expression of GPCR by ELISA v1
Authors: Besserer-Offroy Elie , L Brouillette Rebecca , Longpré Jean-Michel , Sarret Philippe
Published: February 2020

Quantifying cell surface expression of G Protein-Coupled Receptors (GPCRs) can be exteremly important for the expression of mutant receptors. Herein we report a useful Enzyme-Linked Immunosorbent Assay (ELISA) for the cell-surface detection of a HA-tagged version of a GPCR.
Gestão Democrática: função administrativa pedagógica e a atuação financeira dos gestores nas escolas de Sinop/MT-Brasil.
Authors: Da Costa Rosalia Vicente
Published: February 2020

Este artigo buscou-se verificar a atuação quanto à função administrativa pedagógica e financeira dos gestores nas escolas de Sinop de Mato Grosso-Brasil. Por tanto, esta pesquisa verifica se a gestão escolar dos gestores em quanto às distintas funções administrativas, pedagógicas e financeiras, estão pautadas no princípio da gestão democrática. Efetivamente, buscamos compreender através das leituras bibliográficas, observações do campo empírico, documentos como Regimento Escolar, Projeto Político Pedagógico e Prestações de Contas específicas de cada escola. Como objetivo geral buscamos analisar se a gestão escolar dos gestores em quanto às distintas funções administrativas, pedagógica e financeira, estão pautadas no princípio da Gestão democrática. Também, investigamos se a prática da gestão administrativa dos gestores está pautada na gestão democrática. Esta pesquisa qualitativa tem carácter descritivo com desenho não experimental. Desenvolvemos esta pesquisa em duas escolas públicas estaduais, e contamos com uma amostra não probabilística intencional porque realizamos a pesquisa com 48 pessoas que integram à comunidade escolar sendo os gestores, coordenadores pedagógicos, professores, funcionários e alunos. Analisamos os dados coletados através dos questionários e documentação mantida nas escolas. Neste contexto, consideramos os aspectos particulares da gestão, e também, a gestão democrática e sua relação com a comunidade educativa.
Emotional education in people with functional diversity.
Authors: Moreno Molina David , Villalba Delgado Yaiza Adaya
Published: February 2020

The objective of this text is to explore and make visible the relevance of emotionaleducation in students, as well as its repercussions. This importance is related to theobjective of achieving a comprehensive education of students in all its facets, so thatthey can cope with emotionally complex situations that arise in their lives. In addition,emotional education becomes more important in relation to people with functionaldiversity, because they have to face emotionally complex situations, which they haveto overcome, and where emotional education provides them with a series of tools thatmake possible different techniques to be able to face such situations in an adequateway. The results provided derive from an analysis of different research on emotionaleducation, where it is appreciated that the techniques on which emotional educationshould be based are aimed at achieving emotional balance, improving the level ofhealth, motivation of students, etc.
Maná del cielo: ¿fantasía religiosa para los mayores, o resiliencia en las dificultades de la vida?
Authors: De Medeiros Gomes Maria Suênia , Alencar Libório Luiz
Published: February 2020

El nuevo paradigma de ancianos en Brasil nos hace reflexionar sobre la búsqueda por proyectos de vida, el compromiso con la salida y con la dimensión espiritual. Delante de este nuevo escenario, se objetivó investigar si la religión puede ser un recurso de resiliencia para los que buscan un envejecimiento saludable. Se realizó un abordaje exploratorio, fundamentado en la teoría de Viktor Frankl (2008), ícono de la resiliencia por la superación en el período en el cual fue prisionero en Auschwitz y consecuentemente responder al sufrimiento con dignidad. También se abarcará a Jung, por sus pesquisas con experiencias religiosas, además de otros autores que contribuyeron para el enriquecimiento de la temática presentada. El fenómeno de la muerte encontrado en Kübler-Ross (2017), la exposición sobre los escenarios de las iglesias en Brasil impregnados de muertes, asaltos y el uso abusivo del móvil, cuyo hábito se define como nomofobia, fueron analizados. Ante todo, lo expuesto, uno cree que cuanto más viejo, más resiliente la persona se vuelve, y el “maná” estimula a llegar a la tierra prometida.
To the question of the relevance of modern comparative research
Authors:   Taras Shevchenko National University of Kyiv, Kyiv, Ukraine, Podolian G. P.
Published: February 2020

The article analyzes the relevance of comparative research in the modern conditions of the global world. The forms of communication that are immanent for any culture, the development of another's experience of cultural being, intercultural interactions are determined. The significance of philosophy is deter- mined as one of the foundations contributing to the processes of forming dialogism as a cultural characteristic of ancient, and then Western culture. The culture-creating nature of the communicative, dialogical nature of Western culture is interpreted as an important basis for the emergence of a comparative historical method of studying cultural diversity. Attention is focused on the productive experience of cultural interaction that emerged in ancient Greece and developed by further followers in the Western world. The history of the development of the comparative tradition is traced through the delineation of the main factors, which, in their entirety, have become a favorable basis for the emergence of systemic research using the comparative method. Indicates the main trends of modern comparative searches and unsolved problems. The directions of the heuristic development of the future prospects of this method of cultural analysis are indicated. These include: a high level of dialogicity of ancient, and then Western culture; geographical discoveries of the New time; educational and cultural activities of representatives of the Enlightenment; the development of scientific knowledge in the direction of the penetration of ideas about the natural movement of social development from the natural sciences into the social sciences; the appeals and popularization of O. Conte of studying the "main laws" of social phenomena, including the comparative historical method; authoritative recognition of history and linguistics as a science in the nineteenth century; the idea of progressive progress of human culture; scientific activities of representatives of cultural schools of evolutionary anthropology, diffusionism, social anthropology.
Visual art as an instrument of reorganization of post-catastrophic memory
Authors:   National University ", Geraschenko O. O. ,   Kyiv Mohyla Academy"
Published: February 2020

This article provides analysis of the Art approach towards transformation of longstanding traumatic experience in different countries, suggests possible consequences for the society in case if the catastrophic memory remains un-reorganized and grounds conclusion as for need to review approaches towards the later problem in Ukraine. During last three decades of statehood one can observe dynamic movement of Ukraine toward cultural assertion. One of its important elements is the comprehension of public traumatic experience. The latter bares immense importance for the success of Ukraine as a state due to the fact that for generations Ukrainians have been accumulating memory of mournful events that took place in the lives of their ancestors without the possibility to carry out the proper work of sorrow. Topicality of the mentioned problem has a special meaning nowadays considering that the state of Ukraine apt for new bouleversements. In the circumstances of internal and external turbulence conclusion of a new social contract is crucial, at the same time the negative experience of generations which was not proper transformed, does not allow to address current social problems rationally and to consolidate society. Much is already said as for the role of memory in recreation of the past for the sake of the future, but the place of artistic practices in this process remains complex and uncomprehended. How do artistic practices objectivate social life and assist heeling? Visual art resonates with private or collective memory allowing new means of acceptation as well as perceptional rectification and conceptualization of experience associated with sorrow. This article suggests the theoretical and methodological analysis of the “work of sorrow” through the prism of artistic expressions, characterizes their influence of re-organization of traumatic memory and demonstrates the role of visual art as an instrument to operate with reminiscence.
Motivational Function of Emotions: Theoretical Approach to Study
Authors: Pyrev E.A.
Published: February 2020

The article reveals the problems of human emotional motivation. The definition of this phenomenon is given. The theoretical aspect of emotional motivation is represented by an analysis of domestic and foreign literature on emotions and motivation. Also, the theoretical part of the study is devoted to the nature of emotions and the content of their motivational potential. The origins of this phenomenon are seen in the subjectivity of emotions, manifested in the relationship of a person with various aspects of his life. Emotion as an unconscious motive induces unintentional actions towards the subject of communication. There is emotion at several levels of human functioning: neural, physiological, psychological and behavioral. The first two levels provide the appearance of emotion, which is then realized in motor reactions and detailed behavior towards the subject of communication. The implementation of the motor program over time leads to awareness of emotions and a decrease in their motivational potential.
University’s “Center for the Development of Giftedness” as a Coordinator of Innovative Activities to Support Gifted Children
Authors: Parfenova G.L. , Kholodkova O.G.
Published: February 2020

The article is devoted to the actual problem of psychological and pedagogical support of gifted children in the educational space. The existing system of work on the development of personality giftedness is discussed. The importance of innovation in the development of gifted children in the region is emphasized. Emphasis is placed on significant differences in economic, educational, socio*cultural resources and the activities of municipalities on the development of gifted children in different regions of the country, including the Altai Territory. The structure of the Center for the Development of Giftedness created at the Pedagogical University is revealed; directions and content of its activities and cooperation with other departments of the university; trajectories of network interaction with various institutions and organizations of the region for work with gifted children. Particular attention is paid to describing the capabilities of the center in working with parents of gifted children, including from rural areas. The presented model can be adapted into a system for managing work with gifted children in a specific region of Russia.
Anti-Corruption Legislation of Russia: A Retrospective Analysis of the Formation of the Mechanism of Legal Effect
Authors: Avdeeva O. A. , Avdeev V. A.
Published: February 2020

The paper investigates methodological, organizational and practical aspects of the legal effect on corruption during the period of formation and development of the national statehood. The novelty of the subject under consideration lies in the issue associated with: 1) the disclosure of the causes and conditions of corruption as a socially negative phenomenon at certain stages of the state and legal development; 2) identification of key directions of the legal policy in the field of anti-corruption predetermined by socio-economic and political transformations. In the course of achieving the goal of the study, the author has applied special legal methods of cognition contributing to the retrospective analysis of the legal regulation of legal liability for corruption-related offenses. As the result of the study, the paper shows the legal nature of corruption, its essential specificities and features as a socially negative phenomenon. The authors have identified peculiarities of anti-corruption measures undertaken during the period of the Russian statehood under review. Also, they have determined the tendencies in the legal regulation of corruption-related crimes and defined the features of the mechanism of the legal regulation of legal responsibility for corruption. The authors have expressed their opinion about the absence of categorical and legal assessment of the concept of corruption in the domestic legislation of the period under review that would predetermine recognition of measures having effect under criminal law as a strategic resource of counteracting corruption-related offenses. The paper draws conclusions about the factors inspiring the legislative regulation of corruption-related crimes and about the specifics of the implementation of punishment and other measures under criminal law.
STRATEGI KOMUNIKASI TIM SUKSES PADA KAMPANYE POLITIK UNTUK MEMENANGKAN CALON LEGISLATIF MAKASSAR
Authors: Nur Emilsyah
Published: February 2020

Komunikasi dalam kondisi saat ini sangat diperlukan untuk menyampaikan visi dan misi setiap calon legislatif peserta Pemilu. Karena komunikasi yang baik akan memberikan dampak terhadap elektabilitas setiap Caleg dalam rangkan memperoleh suara dalam calon legislatif serentak yang akan digulir pada  tanggal 17 April 2019. Untuk mengetahui sejauhmana peran komunikasi yang dilakukan oleh Caleg dan Tim sukses dalam melakukan komunikasi dengan masyarakat, maka dalam peneltian ini, menggunakan penelitian kualitatif untuk mendeskripsikan hasil penelitian. Hasil penelitian Pengalaman strategi komunikasi Caleg dan Tim Sukses pada kampanye politik dalam memenangkan calon legislatif Makassar melalui Strategi komunikasi yang dapat diterima oleh semua kalangan adalah langkah komprehensif dengan pendekatan nilai-nilai lokal (local wisdom). Strategi Komunikasi Caleg dan Tim Sukses dalam memenangkan calon legislatif Makassar terdiri dari tiga langkah penting yakni perencanaan, pelaksanaan dan evaluasi.