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1.
Tim Holland 《The Hastings Center report》2023,53(1):50-51
This letter responds to the article “On the Authority of Advance Euthanasia Directives for People with Severe Dementia: Reflections on a Dutch Case,” by Henri Wijsbek and Thomas Nys, in the September-October 2022 issue of the Hastings Center Report. 相似文献
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Rajiv V. Dave Baek Kim Alona Courtney Rachel OConnell Tim Rattay Vicky P. Taxiarchi Jamie J. Kirkham Elizabeth M. Camacho Patricia Fairbrother Nisha Sharma Christopher W. J. Cartlidge Kieran Horgan Stuart A. McIntosh Daniel R. Leff Raghavan Vidya Shelley Potter Chris Holcombe Ellen Copson Charlotte E. Coles Ramsey I. Cutress Ashu Gandhi Cliona C. Kirwan 《British journal of cancer》2021,124(11):1785
Background The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions.Methods This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting.Findings Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey.Conclusions The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown.Subject terms: Breast cancer, Surgical oncology, Health care economics, Quality of life, Health policy 相似文献
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Mursheda Begum Grant Lewison Xiang Wang Philip D. Dunne Tim Maughan Richard Sullivan Mark Lawler 《International journal of cancer. Journal international du cancer》2023,152(3):470-479
The purpose of this study was to provide an evidence base for colorectal cancer research activity that might influence policy, mainly at the national level. Improvements in healthcare delivery have lengthened life expectancy, but within a situation of increased cancer incidence. The disease burden of CRC has risen significantly, particularly in Africa, Asia and Latin America. Research is key to its control and reduction, but few studies have delineated the volume and funding of global research on CRC. We identified research papers in the Web of Science (WoS) from 2007 to 2021, and determined the contributions of the leading countries, the research domains studied, and their sources of funding. We identified 62 716 papers, representing 5.7% of all cancer papers. This percentage was somewhat disproportionate to the disease burden (7.7% in 2015), especially in Eastern Europe. International collaboration increased over the time period in almost all countries except in China. Genetics, surgery and prognosis were the leading research domains. However, research on palliative care and quality-of-life in CRC was lacking. In Western Europe, the main funding source was the charity sector, particularly in the UK, but in most other countries government played the leading role, especially in China and the USA. There was little support from industry. Several Asian countries provided minimal contestable funding, which may have reduced the impact of their CRC research. Certain countries must perform more CRC research overall, especially in domains such as screening, palliative care and quality-of-life. The private-non-profit sector should be an alternative source of support. 相似文献
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Karyopherin Alpha 2 Is an Adverse Prognostic Factor in Clear-Cell and Papillary Renal-Cell Carcinoma
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Robert Baird Dave R. Lal Robert L. Ricca Karen A. Diefenbach Cynthia D. Downard Julia Shelton Stig Sømme Julia Grabowski Tolulope A Oyetunji Regan F. Williams Tim Jancelewicz Roshni Dasgupta L. Grier Arthur Akemi L. Kawaguchi Yigit S. Guner Ankush Gosain Robert L. Gates Juan E. Sola Adam Goldin 《Journal of pediatric surgery》2019,54(4):675-687
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Thomas Asendorf Robin Henderson Heinz Schmidli Tim Friede 《Statistics in medicine》2019,38(9):1503-1528
In some diseases, such as multiple sclerosis, lesion counts obtained from magnetic resonance imaging (MRI) are used as markers of disease progression. This leads to longitudinal, and typically overdispersed, count data outcomes in clinical trials. Models for such data invariably include a number of nuisance parameters, which can be difficult to specify at the planning stage, leading to considerable uncertainty in sample size specification. Consequently, blinded sample size re-estimation procedures are used, allowing for an adjustment of the sample size within an ongoing trial by estimating relevant nuisance parameters at an interim point, without compromising trial integrity. To date, the methods available for re-estimation have required an assumption that the mean count is time-constant within patients. We propose a new modeling approach that maintains the advantages of established procedures but allows for general underlying and treatment-specific time trends in the mean response. A simulation study is conducted to assess the effectiveness of blinded sample size re-estimation methods over fixed designs. Sample sizes attained through blinded sample size re-estimation procedures are shown to maintain the desired study power without inflating the Type I error rate and the procedure is demonstrated on MRI data from a recent study in multiple sclerosis. 相似文献
10.
Sharma Kirti Kumari Hales Tim G. Rao Vaidya Jayathirtha NicDaeid Niamh McKenzie Craig 《Forensic Toxicology》2019,37(1):1-16
Forensic Toxicology - A detailed review on the chemistry and pharmacology of non-fentanil novel synthetic opioid receptor agonists, particularly N-substituted benzamides and acetamides (known... 相似文献