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1
Heynicke, Ralf, Dmytro Krush, Christoph Cammin, et al. "IO-Link Wireless enhanced factory automation communication for Industry 4.0 applications." Journal of Sensors and Sensor Systems 7, no. 1 (2018): 131–42. http://dx.doi.org/10.5194/jsss-7-131-2018.
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Abstract. In the context of the Industry 4.0 initiative, Cyber-Physical Production Systems (CPPS) or Cyber Manufacturing Systems (CMS) can be characterized as advanced networked mechatronic production systems gaining their added value by interaction with the ambient Industrial Internet of Things (IIoT). In this context appropriate communication technologies and standards play a vital role to realize the manifold potential improvements in the production process. One of these standards is IO-Link. In 2016 more than 5 million IO-Link nodes have been produced and delivered, still gaining increasing acceptance for the communication between sensors, actuators and the control level. The steadily increasing demand for more flexibility in automation solutions can be fulfilled using wireless technologies. With the wireless extension for the IO-Link standard, which will be presented in this article, maximum cycle times of 5 ms can be achieved with a probability that this limit will be exceeded to be at maximum one part per billion. Also roaming capabilities, wireless coexistence mechanisms and the possibility to include battery-powered or energy-harvesting sensors with very limited energy resources in the realtime network were defined. For system planning, setup, operation and maintenance, the standard engineering tools of IO-Link can be employed so that the backward compatibility with wired IO-Link solutions can be guaranteed. Interoperability between manufacturers is a key requirement for any communication standard, thus a procedure for IO-Link Wireless testing is also suggested.
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Umaru, Kalyankolo, Munguleni Marlon, Yudaya Nansukusa, Salaama Asikuru, Nafuna Ritah, and Kalyankolo Zaina. "PLC Based Speed Control in a Color Sorting System: A Design and Simulation Perspective." Journal of Engineering, Technology, and Applied Science (JETAS) 7, no. 1 (2025): 37–51. https://doi.org/10.36079/lamintang.jetas-0701.828.
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For simulation purposes in Factory IO and TIA Portal, the research is tailored to emulate industrial sorting operations. In numerous industrial scenarios, sorting operations play a crucial role, with objects segregated based on various criteria such as dimensions, colors, weight, and material composition. For instance, within Thermal Power Stations, electromagnetic sorting techniques are employed to separate ferromagnetic materials from coal. This research specifically focuses on sorting goods based on color, with adjustable speed parameters to match production rates. The system is equipped with a digital display screen, providing real-time feedback on the count of sorted objects, and receives an analog speed signal from the PLC for precise control. This research is divided into two primary components, i.e. Software and Simulation in Factory IO. The software aspect involves the implementation of ladder logic programming in TIA Portal, enabling systematic control of the entire research process based on the input data sequence, while the simulation in Factory IO is encompasses the virtual representation of conveyors for object transportation and RGB color vision sensors for color detection. The entry conveyor features two branches to load objects onto the respective conveyors, directed by the sorting logic implemented in TIA Portal.
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Munđar, Goran, Miha Kovačič, and Uroš Župerl. "Development and Control of Virtual Industrial Process using Factory IO and MATLAB." Tehnički glasnik 18, no. 3 (2024): 497–501. http://dx.doi.org/10.31803/tg-20240423112303.
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In today's rapidly evolving business landscape, the strategic adoption of virtual manufacturing methods has emerged as a key driver for companies seeking to streamline operations and expedite product launches in a cost-effective manner. This progressive approach involves the creation of a synthetic and interconnected environment, empowered by advanced software tools and systems, including Virtual Reality and Simulation technologies, tailored to optimize industrial processes. Our methodology employs a unique combination of two simulation software tools: Factory I/O for process development and MATLAB for control program implementation. Furthermore, we explore the use of the Modbus TCP/IP communication protocol as the framework for seamless interaction between these software tools during simulation. This research presents practical insights into the transformative potential of virtual manufacturing, showcasing its real-world application in enhancing operational efficiency and agility within industrial settings.
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Monika, Rybczak. "Approach to Sorting Line Control using PLC and Factory I/O." International Journal of Innovative Technology and Exploring Engineering (IJITEE) 13, no. 10 (2024): 1–6. https://doi.org/10.35940/ijitee.I9941.13100924.
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<strong>Abstract:</strong> The article presents the possibility of using a 3D environment to simulate the operation of a manufacturing process and control a virtual object with a PLC. A sample application of the Factory I/O environment compatible with TIA Portal software and the real S7-1214 DC/DC/DC controller is presented. Visualization and program code written in LAD language correlated with the 3D environment were presented. The results showed the importance of a dynamic programming environment that reflects the program code designed to sort virtual production line components. The research showed that working with the code and the virtual object experiences students and is closer to industrial solutions than just laboratory ones.
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Sabbag, Ornar Jorge. "Construction of UHE 'Três Innãos' (hidroelectric factory) and impacts about the mining." Revista OMNIA Interdisciplinar 8 (May 9, 2024): 80–87. http://dx.doi.org/10.69719/roi.v8i1.721.
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Aimplantação de usinas hidrelétricas ocasionam uma série de impactos ambientais, inclusive na atividade de mineração, e por conseqüência, no desenvolvimento econômico regional. Isto se evidenciou principalmente, em décadas anteriores, pela não obrigatoriedade do licenciamento ambiental para os empreendimentos. O presente trabalho tem como objetivo realizar um levantamento dos impactos causados com a construção da Usina Hidrelétrica de "Três Irmãos" em especial à atividade de mineração, na cidade de Pereira Barreto - SP, com o intuito de se estudar um planejamento ambiental adequado às situações semelhantes, e confrontá-Io com as recomendações da legislação ambiental pertinente, para implantação de novas usinas.
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Monika, Rybczak, Wenta Natalia, and Trzciński Dawid. "Visualization of Control Processes and Code Validation." International Journal of Innovative Technology and Exploring Engineering (IJITEE) 11, no. 1 (2021): 59–63. https://doi.org/10.35940/ijitee.A9590.1111121.
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The article contains an overview of articles related to the description of control process visualization. It provides short information on how to visualize the production line based on two programming environments: Factory IO and Inventor together with Matlab/Simulink. The analysis of these two environments concerns control of a virtual 3D object from a real PLC. Both virtual production line projects are based on control from the S7-1214 DC/DC/DC controller. Currently, there is a need to validate the program code or control process which has been done using several commercially available programs.
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Shyr, Wen-Jye, Hou-Chueh Juan, Chih-Yu Tsai, and Yu-Jia Chang. "Application of Cyber-Physical System Technology on Material Color Discrimination." Electronics 11, no. 6 (2022): 920. http://dx.doi.org/10.3390/electronics11060920.
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With the innovative advance in science and technology, manufacturing production methods have made considerable progress. However, before the production process is actually implemented, it is important to examine whether the design can meet the actual need. By applying cyber-physical system technology to test the production process, the development problems of the actual construction can be avoided. Based on the existing components, this study incorporated the cyber-physical system via innovative integration. In addition to the human–machine interface, this was employed as the operating spindle to integrate the material color identification system of the physical organization. This study also adopted the automated virtual factory constructed by the simulation software of Factory IO with an aim to achieve the technical application.
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Rybczak, Monika, Dawid Trzcińśki, and Natalia Wenta. "Visualization of Control Processes a nd Code Validation." International Journal of Innovative Technology and Exploring Engineering 11, no. 1 (2021): 59–63. http://dx.doi.org/10.35940/ijitee.a9590.1111121.
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The article contains an overview of articles related to the description of control process visualization. It provides short information on how to visualize the production line based on two programming environments: Factory IO and Inventor together with Matlab/Simulink. The analysis of these two environments concerns control of a virtual 3D object from a real PLC. Both virtual production line projects are based on control from the S7-1214 DC/DC/DC controller. Currently, there is a need to validate the program code or control process which has been done using several commercially available programs.
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PRIETO OLIVARES, JOSUE ANTONIO, Elvia Ruiz Beltrán, CARLOS-RENATO VAZQUEZ TOPETE, and JORGE LUIS OROZCO MORA. "ACTIVE FAULT DIAGNOSIS IN AUTOMATED MANUFACTURING SYSTEMS: MODELED USING INTERPRETED PETRI NETS." DYNA 100, no. 3 (2025): 260–66. https://doi.org/10.52152/d11367.
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This paper deals with active diagnosis in Discrete Event System represented as Interpreted Petri Nets, which have been used to model an automated manufacturing system (AMS). In addition, a fault diagnosis scheme is implemented through residuals in an AMS controlled by a Mitsubishi PLC, which is monitored by an embedded system capable of measuring the current in the controllers in order to share information to the diagnoser, through the Modbus communication protocol with the purpose of increasing its reliability in the pronouncement. Key Words: Interpreted Petri Nets, active diagnosis, Factory IO, diagnosability, fault diagnosis.
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Salah, Bashir, Ali M. Alsamhan, Waqas Saleem, Razaullah Khan, and Ahmed Tawhid Ahmed Soliman. "3D Simulation of a Yogurt Filling Machine Using Grafcet Studio and Factory IO: Realization of Industry 4.0." Transactions of FAMENA 47, no. 3 (2023): 15–30. http://dx.doi.org/10.21278/tof.473049922.
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Maria, Fernanda Moraes da Silva, Mark Lobo de Oliveira Jean, and de Souza Costa Alexandre. "AUTOMATIZAÇÃO AVANÇADA: MONITORAMENTO EM TEMPO REAL NA LINHA DE PRODUÇÃO INDUSTRIAL DE RECICLAGEM COM CLP E FACTORY IO." REVISTA FT 28, no. 128 (2023): 54. https://doi.org/10.5281/zenodo.10198354.
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Neste trabalho de conclusão de curso, exploramos a integração avançada de Controladores Lógicos Programáveis (PLCs) e um simulador de fabrica 3D (FACTORY IO), em uma fabrica de reciclagem, como exemplo uma esteira separadora de peças de metal, destacando sua importância na busca por eficiência, precisão e qualidade na produção industrial. A combinação dessas tecnologias permite o monitoramento em tempo real e o controle da qualidade na linha de produção, possibilitando a coleta e análise instantânea de dados cruciais. Por meio de um estudo de caso detalhado em uma esteira separadora de metais, demonstramos como essa integração resulta em uma produção mais eficiente, redução de custos operacionais e melhoria significativa na qualidade do produto. Foi discutido desafios éticos, como o impacto na força de trabalho, a segurança e a confiança do resultado final, enfatizando a necessidade de uma abordagem responsável para garantir uma integração bem- sucedida e sustentável dessa tecnologia na indústria.
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Asmara, Dody Yuli, and Endryansyah Endryansyah. "Perancangan Sistem Transfer Station Barang Pada Sistem Penyortiran Otomatis Menggunakan Teknologi Elektro-Pneumatik." JURNAL TEKNIK ELEKTRO 13, no. 2 (2024): 174–81. https://doi.org/10.26740/jte.v13n2.p174-181.
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Kebutuhan sistem penyortiran otomatis meningkat karena pertumbuhan bisnis dan volume barang. Sistem ini dapat meningkatkan efisiensi, mengurangi kesalahan, dan mempercepat pengiriman. Penelitian ini merancang sistem transfer station barang pada sistem penyortiran otomatis menggunakan teknologi elektro-pneumatik. Tujuannya untuk meningkatkan efisiensi dan akurasi penyortiran. Metode penelitian eksperimental digunakan. Rancangan sistem dibuat dengan software Automation Studio dan pengujian 3D dengan software factory IO. Sistem terdiri dari konveyor, silinder pneumatik, solenoid valve, dan sensor proximity. Hasil pengujian menunjukkan sistem bekerja dengan baik. Sistem dapat memindahkan barang secara otomatis dan diintegrasikan dengan sistem penyortiran otomatis dan teknologi elektro-pneumatik. Sistem ini meningkatkan efisiensi dan akurasi penyortiran barang dan dapat digunakan di berbagai industri. Kata Kunci: Sistem Transfer Station, Sistem Penyortiran Otomatis, Teknologi Elektro-Pneumatik, Konveyor, Silinder Pneumatik, Solenoid Valve, Sensor Proximity.
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Iandoli, Gerardo. "Una macabra invenzione." Italies 28 (2024): 283–98. https://doi.org/10.4000/139xt.
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L’article analyse les romans décrivant l’assassinat de Silvio Berlusconi, publiés entre 2003 et 2005, période de consolidation maximale du berlusconisme dans l’histoire de l’Italie. Voici les textes, classés par ordre chronologique : L’omicidio Berlusconi (2003) d’Andrea Salieri, Sono stato io (2004) d’Oliviero Beha, 2005 Dopo Cristo (2005) de Babette Factory, Chi ha ucciso Silvio Berlusconi (2005) de Giuseppe Caruso et Kill? Romanzo di fantapolitica (2005) de Roberto Vacca. Dans la première partie de l’article, nous examinerons les structures de focalisation, afin de comprendre de quel point de vue la figure de Berlusconi est observée et à quel type d’imaginaire elle se réfère. Dans la deuxième partie, nous analyserons les scènes des attentats pour montrer comment ces textes interagissent avec l’imaginaire qui a émergé dans la première partie et, enfin, nous déterminerons le type de pensée critique qui est développé par les textes, en vue de réfléchir sur la culture politique italienne au début des années 2000.
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Maila-Andrango, Edison. "Tecnologías de industria 4.0 aplicables para el desarrollo de PYMES." CienciAmérica 9, no. 4 (2020): 83. http://dx.doi.org/10.33210/ca.v9i4.348.
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INTRODUCCIÓN. La industria 4.0 abarca distintas tecnologías, por lo que, se ha desarrollado un sistema que utiliza parte de estas técnicas, con el fin de emplearlas para el progreso y desarrollo de Pymes. OBJETIVO. Simular un sistema para el control y monitoreo de procesos, que permita planificar la producción en Pymes. MÉTODO. El sistema de control y adquisición de datos se realizó con el software Ignition SCADA de Inductive Automation, la base de datos utilizada fue MYSQL, para el control del PLC se utilizó el software TIA PORTAL de Siemens y la simulación de la planta se realizó con el software Factory IO. RESULTADOS. El sistema desarrollado permite adquirir las señales del controlador lógico programable y enviarlas al servidor OPC-UA de Ignition de manera que se comunica con el SCADA, a su vez los datos del sensor de altura y los identificadores de los productos son enviados a la base de datos de MySQL. DISCUSIÓN Y CONCLUSIONES. El desarrollo del sistema con tecnologías aplicables en la industria 4.0, ha permitido tener una mejor toma de decisiones, una trazabilidad, una gestión de stock y datos de almacenamiento para el desarrollo de pequeñas y medianas empresas.
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Moreno Ramos, Victor Joel, Martin Alonso Narváez Grijalba, Paul Oscar Ramirez Zamudio, Juan Diego Sánchez Agreda, Josmell Henry Alva Alcántara, and Edgar André Manzano Ramos. "ANÁLISIS Y COMPARACIÓN DE LA SINTONIZACIÓN DE UN CONTROLADOR PID DE NIVEL EN UN TANQUE USANDO ALGORITMOS DE OPTIMIZACIÓN." Revista de Investigaciones 10, no. 4 (2021): 348–59. http://dx.doi.org/10.26788/riepg.v10i4.3499.
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Actualmente en las industrias, la búsqueda de optimizar controladores de nivel en depósitos o tanques es uno de los requisitos más buscados. Gran parte de los procesos industriales cuentan con estos sistemas, bien para el bombeo de líquidos o su almacenamiento en tanques, un claro ejemplo es en sistemas de prevención como el almacenamiento de agua para incendios o para fines reutilizables como el tratamiento de aguas residuales. Teniendo en cuenta lo mencionado se tomará como objeto de estudio el control de nivel de agua en un tanque en el entorno Factory IO. La planta tendrá dos válvulas para el control de caudal, una de flujo constante y la otra de flujo variable. Primero se planteó el objetivo de control, establecer la estructura de control, identificación y descripción de elementos, obtener el modelo de la planta y diseñar el controlador. Para el control PID se usó la sintonización Ziegler Nichols. También se planteó la optimización de los parámetros PID por medio de algoritmos genéticos (AG), algoritmo de colonia de abejas (ABC), algoritmo de enjambre de partículas (PSO) y algoritmo de evolución diferencial. Esto algoritmos nos permitió comparar y analizar las diferentes respuestas del controlador en tiempos de establecimiento y sobreelongación para obtener los mejores resultados. Finalmente, los valores obtenidos para los algoritmos en tiempos de establecimiento: AG: 2.17seg, PSO: 8.04seg, ABC: 6.87seg, ED:7.69seg. Además, en términos de sobreelongación se obtuvo AG:1.24 %, PSO: 1.01, ABC: 6.87seg, ED:7.69seg.
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Alfathsyah, Arrasyid, Nunung Nurhasanah, Siti Wardah Zakaria, and Wawan Tripiawan. "Model Konseptual Perancangan Fasilitas Industri Konveksi Pakaian dengan Soft System Methodology." JURNAL Al-AZHAR INDONESIA SERI SAINS DAN TEKNOLOGI 9, no. 2 (2024): 215. http://dx.doi.org/10.36722/sst.v9i2.2879.
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<p><strong>Facility design refers to the method of organizing factory facilities to support the efficiency of the production process and the effectiveness of production results. This improvement is done by updating the design of previous facilities or designing a complete facility that has not yet been built. In designing this facility design system, Soft System Methodology (SSM) was used. SSM is a structured approach to information system development that is used to understand the problem thoroughly, design conceptual models, assess the feasibility and desired changes, and then implement them into reality. In this research, SSM proved to be a highly effective framework for designing facility design systems in the context of the clothing convection industry. SSM includes abstract problem mapping, needs analysis of <em>stakeholder</em>s involved in the system, CATWOE analysis, depiction of desired and undesired inputs and outputs through IO Diagram, expression description through Rich Picture, and grouping of core activities with Conceptual Modeling. The result of this research is a description that is traceable to the problem situation that exists in the facility design system so that it can know and master the involvement of actors in the system and the relationship between actors and activities that take place</strong>.</p><p><strong><em>Keywords</em></strong> <em>– Clothing Convection Industry, Facility Design, Soft System Methodology(SSM),</em><strong> </strong><em>System Approach</em><em>.</em></p>
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Huan-Niemi, Ellen, and Marja Knuuttila. "The multiplier effects of the Finnish sugar sector." Suomen Maataloustieteellisen Seuran Tiedote, no. 30 (January 31, 2014): 1–7. http://dx.doi.org/10.33354/smst.75418.
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Background information on the economic role of industries is crucial to policy and decision makers due to the involvement of public financing. At the provincial and municipal level, the economic role of industries is crucial for employment and tax revenues that sustain the livelihood of the provinces and municipalities in Finland. This study employed an input-output model (IO model) to answer the question on the linkages between the sugar sector with the different industries in the economy and how much production, value-added and employment would be lost if the sugar sector in Finland would disappear totally. The IO-model would produce the direct, indirect and induced economic effects usually referred to as the multiplier effects of the sugar sector. The gross output of sugar beet production is approximated at about € 33million, and the value-added sugar beet production is estimated at € 17.2 million. The output of the sugar factories is approximated to be € 165.7 million, and the value-added is estimated at € 39.6 million. Even though the effects of primary sugar beet production and sugar factory production including multiplier effects seem rather small compared to the total effects at the regional level, the actual effects are felt at the municipalities level in the form of decreasing tax revenues and unemployment if the sugar sector in Finland disappears and is not substituted for by other forms of production and industry. The output effects of the sugar chain production including sugar beet production, sugar factories and sugar utilizing industries totals € 14 371.0 million when indirect multiplier effects € 8 258.3 million in addition to direct effects € 6 112.7 million are taken into account. The value-added effects of the sugar chain production totals € 4 451.5 million when indirect value-added effects € 2 857.7 million in addition to direct value-added effects € 1 593.8 are taken into account. The employment effects of the sugar chain production totals 58 733 persons as the indirect employment effects 37 979 persons in addition to direct effects 20 754 persons are taken into account. As far as employment effects are concerned, the number of employees does not refer to full-time employees, but included also all those who are involved at any stages of the sugar chain production. The indirect effects include multiplier effects due to both household spending and intermediate input purchases. Hence, if the sugar utilizing industries are included in the production chain, the multiplier effects are considerable. There is data to prove that without domestic production, the sugar price is higher for Ireland compared to the other EU member states due to imperfections in the EU sugar market after the reform of the EU sugar regime in 2006. The sugar price for consumers in Ireland is the highest compared to the United Kingdom (UK), Finland and Germany. The UK and Finland are not self-sufficient in producing sugar for the domestic market, but Germany has been always producing over its self-sufficiency limit. Therefore, the consumers in Germany enjoy the lowest price for sugar compared to Ireland, Finland and the UK. Due to the existing domestic sugar production in Finland and the UK, the price of sugar is lower in these countries compared to Ireland.
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Kottke, Janet L., Elizabeth L. Shoenfelt, and Nancy J. Stone. "Undergraduates Learn About Industrial–Organizational Psychology and Human Factors From an Informational Brochure." Teaching of Psychology 44, no. 1 (2016): 68–73. http://dx.doi.org/10.1177/0098628316679970.
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An informational brochure was created to assist students and faculty unfamiliar with the industrial–organizational (IO) and human factors (HF) disciplines. The brochure highlights the content of these two professions, presents advice for undergraduates to prepare for admission to IO and HF graduate programs, provides sources of IO and HF information, and suggests employability options in IO and HF. To determine if this brochure effectively informed students about these professions, students read either the IO and HF brochure or information about school psychology. Knowledge about IO and HF programs increased significantly after reading the IO and HF brochure. Suggestions for its distribution are offered.
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Sapta, Sapta, and Sari Farlianti. "TINGKAT KINERJA STRUKTUR BAJA BANGUNAN PENJEMURAN KARET PT. MARDEC SIGER WAYKANAN DENGAN PERKUATAN BRESING KONSENTRIK AKIBAT BEBAN GEMPA." TEKNIKA: Jurnal Teknik 3, no. 1 (2017): 21. http://dx.doi.org/10.35449/teknika.v3i1.37.
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Bangunan penjemuran karet adalah bangunan bertingkat, yang digunakan pada pabrik Karet (Crumb Rubber Factory), dimana bangunan ini digunakan untuk penjemuran lembaran karet (rubber sheet) yang digantung pada masing-masing lantai dengan menggunakan penggantung kayu dalam jumlah tertentu, pada perinsipnya bangunan ini digunakan untuk mengeringkan karet dalam bentuk lembaran sehingga bentuk dan posisi bangunan ditentukan berdasarkan arah angin. Pada penelitian ini struktur bangunan penjemuran karet pada PT. Mardec Siger Waykanan terbuat dari struktur Baja Profile Wide Flange (WF) yang merupakan portal terbuka tanpa ada sekat dinding pada setiap lantainya. Dilihat dari letak geografis berdasarkan peta hazard gempa Indonesia 2010, lokasi bangunan tersebut terletak daerah rawan gempa, sedangkan bila dilihat dari histories bangunan tersebut dibangun pada tahun 2008, yang mana peraturan perencanaan bangunan tahan gempa masih mengacu pada SNI 03-1726-2002 yang mengacu pada UBC97, sedangkan pada saat ini perencanaan bangunan tahan gempa mengacu pada SNI 03-1726-2012 yang mengacu pada ASCE-10. Dari hasil analisa dengan mengacu pada SNI 03-1726-2012, didapatkan kondisi struktur bangunan mengalami kelebihan tegangan pada penampang (section overstressed) pada kolom dengan Strength Ratio 2,231 > 1 dengan kapasitas nominal beban gempa dasar rencana kurang dari 519,25kN dan drift antar lantai maksimum arah x sebesar 540,08mm > drift izin sebesar 90mm dan arah y sebesar 118,76mm > drift izin sebesar 90mm, sehingga perlu diadakan perkuatan pada rangka struktur dengan menambahkan Bresing Konsentrik pada Rangka Struktur pada arah melintang (arah y) dan memanjang (arah x). Dengan adanya perkuatan pada Rangka Struktur Strength Ratio menjadi 0,942 < 1 dengan kapasitas nominal beban gempa dasar rencana sebesar 991,760kN dan drift antar lantai maksimum arah x 9,98mm < Drift izin 90mm dan arah y sebesar 21,94mm. Dari hasil analisa non-linier tingkat kinerja struktur bangunan eksisiting pada perfomance point adalah Collapse (C) dengan kapasitas diambang keruntuhan Vpp= 656,322kN dan Dpp= 394,76kN pada rangka arah-x, untuk bangunan dengan perkuatan tingkat kinerjanya pada perfomance point adalah Damage Control (IO-LS) dengan kapasitas keruntuhan pada bresing konsentrik sebesar Vpp=2788,563kN dan Dpp= 58,37mm pada rangka arah-y, artinya penggunaan bresing konsentrik sebagai perkuatan pada bangunan eksisting telah memenuhi persyaratan.
 Kata kunci: kapasitas, tingkat kinerja, bresing konsentrik, drift, gempa kuat.
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Mariam, Tesfamichael G., Addisu Taye Abate, and Mehammed Adem Getnet. "Surgical Management Outcome of Intestinal Obstruction and Its Associated Factors at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2018." Surgery Research and Practice 2019 (July 28, 2019): 1–8. http://dx.doi.org/10.1155/2019/6417240.
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Background. Intestinal obstruction (IO) is one of the most common acute abdominal disorders that often requires emergency surgical management in the hospital setting. However, the surgical management sometimes ends with unfavorable outcomes characterized by fatal and nonfatal postoperative complications. Aim. The aim of this study was to analyze the surgical management outcome of IO and its associated factors among surgically treated patients for intestinal obstruction at the University of Gondar Comprehensive Specialized Hospital (UGCSH), Ethiopia, 2018. Methods. An institution-based cross-sectional study was conducted among patients who were surgically treated for IO during the last 3 years at the UGCSH. The patient participants were selected using a systematic random sampling technique. A structured research tool was used to collect all the necessary data from the patients’ medical records. The data were analyzed by using SPSS version 21. Frequencies with percentages were used to describe the surgical management outcome of IO. The binary logistic regression model was used to explore the determinant factors associated with the surgical management outcome of IO. Factors at P<0.05 were declared statically significant. Results. 227 patient participants were included and finally analyzed in this study. From these, 83.3% patients have favorable surgical management outcomes of IO, whereas the rest 16.7% patients have unfavorable outcomes. Of 38 patients with unfavorable outcome, the most common postoperative complication occurred was surgical site infection (36.8%), followed by pneumonia (23.6%) and septic shock (21.0%) among other complications. A total of 10 postoperative deaths were also documented as unfavorable surgical management outcomes of IO. Of the determinant factors analyzed in this study, only three factors, duration of illness before surgery, length of hospital stay after surgery, and comorbidity, were independently significantly associated with the surgical management outcome of IO. Conclusions. In this study, the majority of patients had favorable surgical management outcomes of IO, and the proportion of patients with unfavorable outcomes was however considerable. Thus, designing a strategy addressing the significantly associated determining factors could be helpful to further increase the likelihood of favorable surgical management outcomes of IO.
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Geynisman, Daniel M., Jonathan Kish, Angelica Falkenstein, et al. "US physician perceptions of treatment decision making for advanced renal cell carcinoma." Journal of Clinical Oncology 40, no. 6_suppl (2022): 311. http://dx.doi.org/10.1200/jco.2022.40.6_suppl.311.
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311 Background: The immuno-oncology (IO) therapy combination nivolumab + ipilimumab, and the IO-tyrosine kinase inhibitor (TKI) combination pembrolizumab + axitinib, received US FDA approvals in 2018 and 2019, respectively, as first-line (1L) therapy for advanced renal cell carcinoma (aRCC). We examined physician perceptions of concerns about and barriers to 1L treatment by class of regimen (IO-IO, IO-TKI, and single-agent TKI [SA-TKI]) in the United States. Methods: US-based oncologists treating ≥ 5 aRCC patients in the prior 12 months were identified from the Cardinal Health network, a community of > 800 oncologists. Physicians were surveyed about concerns in prescribing and barriers to treating by class (scale of 1–5; 1 = no concern/not a barrier, 5 = most concerning/major barrier); mean scores are reported. Adverse events (AEs) of concern were selected from a prespecified list and respondents rank-ordered from most to least concerning by class. Physicians were also asked to gauge affordability and to rank-order 13 characteristics to identify key factors in prescribing preference. The impact of COVID-19 on aRCC care in practice was also assessed. Results: A total of 49 providers (84% community, 16% academic) treating a median of 20 (IQR 14–30) aRCC patients from across the United States participated. For IO-IO, the top 3 concerns in prescribing were AEs (4.3), patient out-of-pocket costs (OOP; 3.7), and unexpected late AEs (3.6), whereas patient OOP (4.3), AEs (4.1), and patient adherence (3.9) were of most concern for IO-TKI. For SA-TKIs, the top 3 concerns were patient adherence (3.9), patient OOP (3.9), and AEs (3.6). High patient OOP and impact on quality of life were the top 2 barriers in using IO-TKI therapy. The most concerning AEs were colitis, pneumonitis, and hypertension for IO-IO or IO-TKI, and diarrhea, fatigue, hand-foot syndrome, and hypertension for SA-TKI. Overall survival (OS), progression-free survival (PFS), and complete response (CR) were ranked 1st, 2nd, and 3rd factors in prescribing preferences while patient compliance, patient preference, and practice reimbursement ranked 11th, 12th, and 13th. Patient OOP and drug acquisition costs (DAC) were the most important factors when considering the affordability of treatment, with the perception that IO-IO was the most expensive among the classes of therapy. The overall impact of COVID-19 on caring for aRCC patients was very limited, with a moderate increased use of telemedicine and a slight impact on the timing and number of routine care visits. Conclusions: OS, PFS, and CR ranked highest among the most important factors influencing selection of 1L treatment for aRCC. Factors of concern and barriers varied by class of treatment, with patient adherence and OOP affecting use of TKI or IO-TKI therapies, and AEs affecting the use of IO-based therapy. This study revealed perceptions of high patient OOP and DAC of IO-IO therapy, in contrast to our expectations.
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Yang, Chaokun, Mengyao Pan, and Xin Zhao. "Factors Influencing Recognition Capability of Inverse Opal Structured Photonic Crystal Sensors." Crystals 12, no. 6 (2022): 859. http://dx.doi.org/10.3390/cryst12060859.
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Nowadays, many kinds of colloidal photonic crystal (PC) sensors with inverse opal (IO) structures have been developed. However, there are few systematic studies on the factors influencing their recognition capability and responsiveness capability. In this paper, the relationships between recognition capability of IO structured PC sensors and all the parameters in Bragg–Snell’s law have been explored. In addition, research on the recognition ability of PC sensors typically focuses only on the refractive index difference between the identified substances. Herein, we define two concepts, namely the absolute refractive index difference and the relative refractive index difference, and prove that the recognition ability not only relies on the absolute refractive index between the identified substances, but also on the relative refractive index. Bragg–Snell’s law analysis confirms that the responsiveness capability is directly proportional to the void size of the IO structure, which is also confirmed by the finite difference time domain (FDTD) method. It is believed that these systematic studies have important guiding significance for creating advanced IO structured PC sensors.
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Garitaonaindia, Yago, Mariola Blanco, Fernando Franco, et al. "Risk factors for cardiovascular events in patients treated with immunotherapy." Journal of Clinical Oncology 40, no. 16_suppl (2022): e18736-e18736. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e18736.
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e18736 Background: Immunotherapy (IO) is increasingly widespread in current clinical practice; however, little is known about its cardiovascular safety profile. The aim of this study is to identify clinical factors that are associated with increased risk of having a cardiac event (CE). Methods: we conducted a retrospective study in a single institution including patients treated with IO from 2014 to 2020. We analyzed their clinical characteristics and the CE developed during IO treatment and compared those who had a registered CE with those who had not. Results: 378 patients were analyzed. After a mean-follow up 15.9 months, we registered the following CE: ECG abnormalities 12.2%, congestive heart failure 3.4%, pulmonary embolism 1.9%, coronary syndrome 0.8%, myocarditis 0.5% and pericarditis 0.5%. The specific cardiac mortality was 0.8%. Results are shown in Table. Conclusions: In our study, elder age, history of ischemic heart disease or arrythmia, and reporting other immune-related adverse events (irAE), appear to be risk factors for developing a CE during IO treatment. Although most are well-known cardiovascular risk factors, the relationship between other irAEs and CE should be highlighted, and prospective studies are needed to delve into this hypothesis.[Table: see text]
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Garitaonaindia, Yago, Mariola Blanco, Fernando Franco, et al. "Risk factors for cardiovascular events in patients treated with immunotherapy." Journal of Clinical Oncology 40, no. 16_suppl (2022): e18736-e18736. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e18736.
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e18736 Background: Immunotherapy (IO) is increasingly widespread in current clinical practice; however, little is known about its cardiovascular safety profile. The aim of this study is to identify clinical factors that are associated with increased risk of having a cardiac event (CE). Methods: we conducted a retrospective study in a single institution including patients treated with IO from 2014 to 2020. We analyzed their clinical characteristics and the CE developed during IO treatment and compared those who had a registered CE with those who had not. Results: 378 patients were analyzed. After a mean-follow up 15.9 months, we registered the following CE: ECG abnormalities 12.2%, congestive heart failure 3.4%, pulmonary embolism 1.9%, coronary syndrome 0.8%, myocarditis 0.5% and pericarditis 0.5%. The specific cardiac mortality was 0.8%. Results are shown in Table. Conclusions: In our study, elder age, history of ischemic heart disease or arrythmia, and reporting other immune-related adverse events (irAE), appear to be risk factors for developing a CE during IO treatment. Although most are well-known cardiovascular risk factors, the relationship between other irAEs and CE should be highlighted, and prospective studies are needed to delve into this hypothesis.[Table: see text]
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Hall, Rebecca, Leanna Keeble, Sandra-Ilona Sünram-Lea, and Michelle To. "A review of risk factors associated with insulin omission for weight loss in type 1 diabetes." Clinical Child Psychology and Psychiatry 26, no. 3 (2021): 606–16. http://dx.doi.org/10.1177/13591045211026142.
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Research suggests that as many as 60% of people with type 1 diabetes (T1D) admit to misusing insulin. Insulin omission (IO) for the purpose of weight loss, often referred to as diabulimia, is a behaviour becoming increasingly recognised, not least since prolonged engagement can lead to serious vascular complications and mortality. Several risk factors appear to be relevant to the development of IO, most notably gender, anxiety and depression and increased weight concerns and body dissatisfaction. Evidence suggests that women, especially young girls, are more likely to omit insulin as a method of weight loss compared to men. Mental health conditions such as anxiety and depression are increasingly prevalent in people with T1D compared to their peers, and appear to contribute to the risk of IO. Increased weight concerns and body dissatisfaction are further prominent risk factors, especially given increases in weight which often occur following diagnosis and the monitoring of weight by diabetes teams. This review presents evidence examining these risk factors which increase the likelihood of a person with T1D engaging in IO and highlights the complications associated with prolongment of the behaviour. Further research looking at the comorbidities of these risk factors, alongside other factors, would provide greater insight into understanding IO in people with T1D.
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Lee, Matthew, Jianyou Liu, Emily Miao, et al. "Clinical efficacy of frontline immunotherapy (IO) in ethnic-minority patients (pts) with metastatic NSCLC." Journal of Clinical Oncology 41, no. 16_suppl (2023): e21063-e21063. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.e21063.
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e21063 Background: Since minority pts have been historically underrepresented in key IO trials, knowledge on the clinical use of IO in ethnic-minority pts with non-small cell lung cancer (NSCLC) remains limited. This study aims to evaluate race/ethnicity and other demographic, socioeconomic and clinical factors of pts with metastatic NSCLC treated with first-line IO. Methods: A retrospective cohort study of 5920 pts diagnosed with lung cancer within the Montefiore Health system from 1/1/2013 to 6/1/2022 was conducted. Pts with metastatic NSCLC without EGFR or ALK alterations and underwent first-line IO use were identified. The primary endpoint was overall survival (OS) with secondary endpoints of progression-free survival (PFS) and time to discontinuation (TTD) from the start of IO. Results: In total, 248 pts were identified with median follow-up time of 10.7 months (mons), median age of 66 years and 39.1% as Non-Hispanic Black (NHB), 30.2% as Hispanic and 30.7% as non-Hispanic White (NHW). OS (p = 0.39), PFS (p = 0.29) and TTD (p = 0.98) were similar among races/ethnic groups. ECOG < 2 at the start of IO was associated with longer OS summarized in Table 1. Significantly higher PFS and TTD were noted respectively in pts with Medicare insurance and PD-L1 status (TPS>1), while lower PFS and TTD with lower BMI. These results were remained after adjusting for biological sex, smoking status, histology, and IO regimen. Conclusions: Our study demonstrates that race/ethnicity does not impact the benefits of IO. However, factors such as ECOG status impact OS, and BMI, insurance and PD-L1 significantly impact PFS and TTD. These findings help identify potential factors that can be addressed to optimize outcomes and supportive care while undergoing IO.[Table: see text]
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Bolan, Patrick, Gavin Hui, Yen Low, et al. "Real world evidence comparison of first-line (1L) immune-oncology(IO)/tyrosine kinase inhibitor (TKI) vs. IO/IO combination therapy in renal cell carcinoma (RCC)." Journal of Clinical Oncology 42, no. 4_suppl (2024): 402. http://dx.doi.org/10.1200/jco.2024.42.4_suppl.402.
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402 Background: IO/IO and IO/TKI are the preferred first-line combinations for treatment of RCC. While these combinations have been superior to sunitinib, no head-to-head clinical trials have been completed, which leaves uncertainty about the preferred combination. Here, we have leveraged ASCO Cancerlinq data to compare overall survival for RCC patients (pts) receiving first line IO/IO vs. IO/TKI combinations. We hypothesized that IO/IO and IO/TKI would have similar survival. Methods: We performed a retrospective cohort study comparing IO/IO vs IO/TKI therapy for pts with metastatic RCC. We used the Atropos health platform, which is a commercial platform and queried ASCO CancerLinq data for this study. We identified pts with kidney cancer who received IO/IO or IO/TKI combinations between 2019 and 2023. For our primary analysis, we included only pts with ICD10 code consistent with clear cell [cc]RCC, but also did a secondary analysis including all pts with kidney cancer. The IO/TKI pts received either avelumab/axitinib, pembrolizumab/axitinib, nivolumab/cabozantinib, pembrolizumab/lenvatinib, or atezolizumab/cabozantinib within two weeks of each other. The IO/IO pts were identified as pts receiving ipilimumab and nivolumab within 2 weeks of each other without interceding TKI. We conducted a survival analysis of time to death using Cox proportional hazards regression to compare the two groups. The analysis was performed under three different confounder adjustment scenarios: without adjustment, with basic matching on sex and age, and with high dimensional propensity score (hdPS) using inverse probability of treatment weighting. Results: A total of 584 pts (286 IO/IO and 296 IO/TKI) with kidney cancer and 146 with ccRCC (75 IO/IO and 71 IO/TKI) were included. Mean age was 63-65 years and 30-35% female sex across groups. Table shows the restricted mean survival time (RMST) and HR for the Cox models. In the ccRCC cohort, 20 pts with IO/IO and 7 with IO/TKI died with RMST of 947 and 1071 days, respectively (hdPS HR 0.35, p=0.03). In the RCC cohort, 76 pts with IO/IO vs 49 with IO/TKI died with RMST 1126 vs 1017 (hdPS HR 0.61, p=0.04). Conclusions: In this exploratory, hypothesis-generating analysis of CancerLinq data, pts treated with IO/TKI had longer OS vs those treated with IO/IO. Limitations include the retrospective nature of the study, low power, lack of randomization, and potential unmeasured confounding factors (e.g., confounding by indication). Further investigation and prospective validation are needed to confirm these findings. [Table: see text]
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Raphael, Jacques, Lucie Richard, Melody Lam, et al. "Uptake of immunotherapy in patients with advanced cancer: A population-based study using health administrative data from Ontario, Canada." Journal of Clinical Oncology 39, no. 15_suppl (2021): 6529. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.6529.
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6529 Background: The introduction of immunotherapy (IO) in the treatment of patients with cancer has significantly improved clinical outcomes. Herein we report on IO uptake in Ontario, Canada, a publicly funded healthcare system. Methods: We conducted a retrospective cohort study using provincial health administrative data to: 1) assess IO uptake in adult patients with advanced melanoma, bladder, lung, head and neck (HN) and kidney cancers; and 2) identify predictors of IO usage between 2011 (pre-IO funding) and 2019. The datasets were linked using unique encoded identifiers and analyzed at ICES. IO uptake was captured between cancer diagnosis and last follow up and reported as a proportion of the entire cohort and by tumor site and drug type. A competing risk Fine and Gray regression model with death as competing risk was used to identify factors associated with IO use. Results: Among 59,510 patients with one of the five advanced cancers of interest, 7,660 (12.9%) received IO. Details of IO uptake are summarized in Table. IO uptake increased yearly from 2011 (2.7%) to 2019 (34.0%). Uptake was highest in melanoma (48.2%) and lowest in HN cancer (5.8%). The most commonly used drugs used were pembrolizumab (41.1%) and nivolumab (40.5%). In adjusted analysis, predictors of lower IO uptake included older age (hazard ratio (HR) 0.953, 95%CI 0.934-0.972 with every additional 10 years), female sex (HR 0.859, 95%CI 0.819-0.9), lower income quintile (HR 0.893, 95%CI 0.83-0.96), history of hospital admission (HR 0.768, 95%CI 0.734-0.805), female oncologist (HR 0.942, 95%CI 0.892-0.995), and de novo stage 4 cancer (HR 0.918, 95%CI 0.873-0.966). Predictors of higher IO uptake were low Charlson score (HR 1.118, 95%CI 1.01-1.236) and previous radiation therapy (HR 1.438, 95%CI 1.367-1.512). IO uptake was heterogeneous across cancer centres levels (1 to 4) and regions. Conclusions: While the use of IO for advanced cancer has steadily increased over time, uptake is associated with patient and physician characteristics, as well as system level factors. This variation suggests potential inequity in access to these potentially life-prolonging drugs and should be further investigated and addressed.[Table: see text]
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Torres-Torrillas, Marta, Elena Damiá, José J. Cerón, et al. "Treating Full Depth Cartilage Defects with Intraosseous Infiltration of Plasma Rich in Growth Factors: An Experimental Study in Rabbits." CARTILAGE 13, no. 2_suppl (2021): 766S—773S. http://dx.doi.org/10.1177/19476035211057246.
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Objective Intraarticular (IA) administration of platelet-rich plasma (PRP) has been proposed as a new strategy to halt osteoarthritis (OA) progression. In patients with severe OA, its potential is limited because it is unable to reach the subchondral bone, so a new strategy is needed, and intraosseous (IO) infiltration has been suggested. The purpose is to assess the impact of IA together with IO infiltration of plasma rich in growth factors (PRGF) in serum hyaluronic acid (HA) and type II collagen cleavage neoepitope (C2C) levels. Design A total of 32 rabbits were included in the study and randomly divided into 2 groups: control and treatment. A 4-mm chondral defect was created in the medial femoral condyle and IA followed by IO infiltration were performed. Serum C2C and HA levels were measured using enzyme-linked immunosorbent assay (ELISA) tests before infiltration and 28, 56, and 84 days post-infiltration. Results Significant lower C2C serum levels were obtained in treatment group (IA + IO infiltration of PRGF) at 84 days post-infiltration than in control group (IA infiltration of PRGF + IO infiltration of saline solution), while no significant differences between groups were reported at any other study times. Regarding HA, at 56 days post-infiltration, greater significant levels were seen in the treatment group. However, at 84 days post-infiltration, no significant differences were obtained, although lower levels were reported in the treatment group. Conclusions Despite inconclusive, the results suggest that the combination of IA and IO infiltration with PRGF may enhance cartilage and subchondral bone regeneration, but further studies are needed.
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Huang, Yu-Te, Jamie Jiin-Yi Chen, Ming-Yen Wu, et al. "The Effects of Modified Graded Recession, Anteriorization and Myectomy of Inferior Oblique Muscles on Superior Oblique Muscle Palsy." Journal of Clinical Medicine 10, no. 19 (2021): 4433. http://dx.doi.org/10.3390/jcm10194433.
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Background: The aim was to investigate the effect of inferior oblique (IO) operation (IO myectomy or graded recession and anteriorization) for unilateral and bilateral superior oblique muscle palsy (SOP); Methods: A total of 167 eyes undergoing IO surgery by a single surgeon between 2008 and 2015 were retrospectively reviewed. The method for treating symmetric bilateral SOP was bilateral IO myectomy (n = 102) and the method for treating unilateral SOP or non-symmetric bilateral SOP was IO-graded recession and anteriorization (n = 65). Associated clinical results and other factors were analyzed; Results: Head tilt, vertical deviation, IO overaction, SO underaction degree and ocular torsion angle were all clearly changed, but there was no statistically significance between these two procedures. Mean preoperative torsional angle was 15.3 ± 6.4 degree, which decreased to 5.3 ± 2.7 degree after surgery. Preoperative torsional angle, IOOA and SOUA degree were all significantly affected in postoperative torsional angle (p = 0.025, 0.003 and 0.038). Horizontal rectus muscle and IO muscle operation did not interfere with each other’s results (p = 0.98); Conclusions: Symmetric bilateral SOP could be treated with bilateral IO myectomy and IO-graded recession and anteriorization should be reserved for unilateral SOP or non-symmetric bilateral SOP.
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Itoh, Tsubasa, Miki Takeuchi, Marina Sakagami, et al. "Gsx2 is required for specification of neurons in the inferior olivary nuclei from Ptf1a-expressing neural progenitors in zebrafish." Development 147, no. 19 (2020): dev190603. http://dx.doi.org/10.1242/dev.190603.
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ABSTRACTNeurons in the inferior olivary nuclei (IO neurons) send climbing fibers to Purkinje cells to elicit functions of the cerebellum. IO neurons and Purkinje cells are derived from neural progenitors expressing the proneural gene ptf1a. In this study, we found that the homeobox gene gsx2 was co-expressed with ptf1a in IO progenitors in zebrafish. Both gsx2 and ptf1a zebrafish mutants showed a strong reduction or loss of IO neurons. The expression of ptf1a was not affected in gsx2 mutants, and vice versa. In IO progenitors, the ptf1a mutation increased apoptosis whereas the gsx2 mutation did not, suggesting that ptf1a and gsx2 are regulated independently of each other and have distinct roles. The fibroblast growth factors (Fgf) 3 and 8a, and retinoic acid signals negatively and positively, respectively, regulated gsx2 expression and thereby the development of IO neurons. mafba and Hox genes are at least partly involved in the Fgf- and retinoic acid-dependent regulation of IO neuronal development. Our results indicate that gsx2 mediates the rostro-caudal positional signals to specify the identity of IO neurons from ptf1a-expressing neural progenitors.
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Aharony, Noa, and Tali Gazit. "Factors affecting students’ information literacy self-efficacy." Library Hi Tech 37, no. 2 (2019): 183–96. http://dx.doi.org/10.1108/lht-10-2018-0154.
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PurposeThe purpose of this paper is to explore how computer self-efficacy (CSE), perceived information overload (IO) and the digital native perspective predict students’ information literacy (IL) self-efficacy.Design/methodology/approachThe research was conducted in Israel and comprised 117 students from the Information Science Department at Bar-Ilan University. Researchers used five questionnaires to gather personal details: a demographic questionnaire, the IL self-efficacy questionnaire, the CSE questionnaire, technology usage (TU) questionnaire and the perceived IO questionnaire.FindingsThe findings confirm that these variables significantly predict students’ IL self-efficacy.Originality/valueInstructors and librarians should be familiar with the issue of individual differences, as well with the issue of students’ age. These factors may help them choose the most appropriate way when instructing IL skills to their students.
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Tan, Tira Jing Ying, David W. Cescon, Lisa Wang, et al. "Hyperprogressive disease in advanced triple-negative breast cancer (aTNBC) treated with immunotherapy (IO)." Journal of Clinical Oncology 37, no. 15_suppl (2019): 1086. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.1086.
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1086 Background: Hyperprogression of disease (HPD), a rapid acceleration of tumor growth rate (TGR) has been reported with IO in other tumor types. Here, we explore HPD in aTNBC. Methods: A retrospective chart review identified aTNBC patients who consented for IO clinical trials at Princess Margaret Cancer Centre between June 2013 and June 2018. Demographic data, medical history, details of trial enrolment and RECIST 1.1 response to study treatment were recorded. Patients with RECIST 1.1 measurable disease on CT scans or physical examination before trial entry, at trial baseline and at protocol-defined interval following IO start were evaluable for TGR as defined by Champiat et al. Clin Cancer Res 2017. HPD defined as a ≥2-fold increase in TGR between baseline and on-trial restaging assessment. Univariable logistic regression used to identify variables [age, co-morbidity index, prognostic index, performance status, distant disease free interval (dDFI), lactate dehydrogenase, no. of metastatic sites, visceral disease and no. of prior treatment lines] associated with HPD. Overall survival (OS) curves were estimated with the Kaplan-Meier method and compared by the log-rank test. Results: 99 patients with aTNBC consented for 15 IO clinical trials, 60% IO monotherapy, 22% chemotherapy+/-IO and 18% IO combinations. Median age 52 (range 25-78), median no. of lines of prior systemic therapy for advanced disease 1 (range 0-8). 15% had de-novo metastatic disease, 58% recurred after a dDFI of < 3 years and 25% after a dDFI of > 3 years. 61% had < 3 metastatic disease sites, and 71% had metastases involving the viscera. 66 received IO treatment, 40 patients (20 monotherapy, 7 IO combination, 13 chemotherapy+/-IO) were evaluable for TGR. Median TGR pre-IO was 74.3 (range -17 – 1680) and post-IO was 2.5 (-71.4 – 223). 4 patients (10%) met criteria for HPD. All 4 treated with monotherapy PD1 inhibitor and received at least 2 further lines of therapy post-trial; 1 patient treated with IO as first-line therapy, 3 in the second or later lines. There was no significant difference in the overall OS of patients with HPD and patients who did not meet definition for HPD HR 0.89, (95% CI: 0.26-3.01; p = 0.41). Univariable analysis did not identify factors associated with HPD. Conclusions: HPD was observed in 10% of aTNBC treated on IO clinical trials. HPD was not associated with worse survival outcomes or known prognostic factors in our analysis.
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Gardeazabal, Itziar, Ignacio Matos, Cinta Hierro, et al. "Patient survival with immune checkpoint inhibitors and targeted agents in phase 1 trials: A propensity score weighted analysis." Journal of Clinical Oncology 37, no. 15_suppl (2019): 2580. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.2580.
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2580 Background: There have been important changes in early drug development units with an unprecedented increase of immune-oncology (IO) trials. Currently at the Vall d’Hebron Institute Oncology (VHIO) close to 50% of our Phase 1 trials (Ph1t) portfolio includes IO drugs, while from 2011 to 2015 more than 80% of our trials assessed targeted agents (TA). We wanted to investigate whether this swift had a positive impact on patient (pts) outcome. Methods: We performed a retrospective analysis of the pts treated with IO and TA at VHIO Ph1t Unit from Jun’11 to May’18. Only patients treated with IO in ≥ 2nd line were included (and without an approved IO therapy as per standard-of-care) and those with TA classified as tiers II-III-IV by the ESMO scale for clinical actionability of molecular targets ESCAT (which also represents unapproved indications). The aim of this study was to compare overall survival (OS) for the two cohorts. Given the non-randomized nature of the study a propensity score weighting (PSW) was used to control for selection bias in treatment effect estimation. Results: Out of 545 eligible pts, 281 (51.5%) received TA and 264 (48.5%) IO, with unadjusted median OS (mOS) of 7.7 months (m) and 9.2m, respectively. In univariate analysis, OS was associated with tumor type, number of previous treatment lines, regimen (monotherapy vs combination), and clinical-laboratory prognostic factors (Vioscore: albumin < 3.5 g/dl; LDH > upper limit of normal; neutrophil/[leukocytes minus neutrophils] ratio (dNLR) > 3; more than 2 sites of metastasis; and presence of liver metastasis) (p < 0.05). After adjusting for these factors in a PSW model, the IO group showed statistically significant longer OS with HR = 0.75 (CI95% 0.65 – 0.86, p < 0.0001). The In a stratified analysis by tumor type we found no significant heterogeneity in the relative benefit of IO over TA. Conclusions: In real world data from our Ph1t population, treatment with IO was associated with longer OS than treatment with TA, even after adjusting for known prognostic factors and treatment selection biases. These results suggest that the likelihood of patient benefit with IO therapies in Ph1t is increasing.
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Labaki, Chris, Ziad Bakouny, Audreylie Lemelin, et al. "Efficacy of first-line (1L) immunotherapy (IO)-based regimens in patients with sarcomatoid and/or rhabdoid (S/R) metastatic non-clear cell renal cell carcinoma (nccRCC): Results from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC)." Journal of Clinical Oncology 41, no. 16_suppl (2023): 4519. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.4519.
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4519 Background: Patients with advanced RCC with S/R components exhibit poor clinical outcomes. IO-based combination therapies demonstrated substantial efficacy among patients with metastatic S/R ccRCC, compared to VEGF targeted therapy (VEGF-TT). Recent trials showed promising activity of IO-based regimens in patients with advanced nccRCC. We sought to assess the efficacy of IO regimens among patients with S/R nccRCC. Methods: Patients with advanced nccRCC treated with 1L IO regimens (IO/IO or IO/VEGF-TT) or 1L VEGF-TT monotherapy (sunitinib or pazopanib) were included. Cases were categorized as S/R or non-S/R. The primary outcomes were overall survival (OS) and time to treatment failure (TTF) in patients with S/R nccRCC receiving 1L IO or VEGF-TT. Overall response rate (ORR) was a secondary outcome. OS and TTF were compared between groups (IO vs. VEGF-TT) using Cox regression models adjusted for age, IMDC risk groups, and nccRCC subtype. ORR was compared between groups (IO vs. VEGF-TT) using a logistic regression adjusted for the same confounders. Results: Overall, 103 patients with S/R nccRCC were included, of whom 33 (32%) received 1L IO regimens. Median follow-up was 31 months. After adjustment for confounding factors, patients with S/R nccRCC treated with IO regimens presented with significantly improved survival outcomes as compared to those receiving VEGF-TT (median OS [mOS]: NR vs. 7.1 and mTTF: 9.4 vs. 2.9 mos for IO regimens and VEGF-TT, respectively). Similarly, a higher ORR was seen in patients with S/R nccRCC receiving IO regimens versus VEGF-TT (34.1 vs. 10.9%, respectively). Among 430 patients with non-S/R nccRCC (IO regimens: n=44), no significant differences in survival outcomes between regimen classes were seen (mOS: 24.4 vs. 14.8 and mTTF: 4.2 vs. 5.0 mos for IO regimens and VEGF-TT, respectively). Conclusions: To our knowledge, this represents the largest effort to characterize the outcomes of patients with S/R nccRCC treated with IO regimens. Patients with S/R nccRCC appear to derive a substantial and selective benefit from IO regimens (vs. VEGF-TT). These data support the use of IO-based regimens in patients with S/R nccRCC. [Table: see text]
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Youssef, Alicia, Siguo Li, and Alexander Melamed. "An NCDB study examining disparities in the administration of immunotherapy among advanced cervical cancer patients." Journal of Clinical Oncology 43, no. 16_suppl (2025): 5524. https://doi.org/10.1200/jco.2025.43.16_suppl.5524.
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5524 Background: The addition of immunotherapy (IO) to standard therapy has demonstrated substantial survival benefits in the upfront treatment of advanced cervical cancer. Our primary objective was to investigate the role of race on the administration of IO among patients with stage IV cervical cancer, following the publication of KEYNOTE-826 in 2021. Secondarily, we aimed to describe additional factors that may be associated with disproportionate administration. Methods: This was a retrospective cohort study utilizing the National Cancer Database (NCDB). We included all patients diagnosed in 2022 with stage IV adenocarcinoma, adenosquamous carcinoma, and squamous cell carcinoma of the cervix. Proportions were used to estimate the administration of IO. Multivariable models adjusted for age, insurance, education, Charlson-Deyo comorbidity scores, geography, distance to treatment center, as well as treatment facility type, location, and volume. Results: There were 937 cases identified, of which 368 (39.3%) received IO and 569 (60.7%) did not. A higher proportion of patients received IO at age < 65 compared to > 65 (74.5% vs 25.5%). Patients with Medicaid received IO at similar rates compared to privately-insured patients, at 33.4% verses 34.5%, respectively. When controlling for all other variables, higher education was associated with a greater likelihood of receiving IO (RR 1.46, CI 1.10 – 1.95, p=0.01). Patients with comorbidity scores > 2 were less likely to receive IO than those with lower scores (RR 0.71, CI 0.52 – 0.98, p=0.038). Proportions of patients receiving IO in urban verses rural communities was also similar, at 33.3% and 39.4%, respectively. There were no significant differences in administration of IO associated with treatment center type (RR 1.05, CI 0.89 – 1.23, p=0.55) or volume (RR 0.95, CI 0.79 – 1.13, p=0.55). Mean distances to treatment centers were similar between patients who did and did not receive IO (29.31 vs 30.0 miles). Hispanic patients received IO at higher rates than non-Hispanic White, non-Hispanic Black, and Asian patients at a rate of 47.2% compared to 37.6%, 38.5%, and 38.1%, respectively. Even after adjusting for demographic and tumor factors, the increased receipt of IO among Hispanic patients could not be explained. Conclusions: Not only were there no racial disparities observed in the administration of IO among racial groups, but there were no disparities recognized among traditionally marginalized groups. Interestingly, the overall administration IO was lower than expected. The population included in KEYNOTE-826 had a PD-L1 combined positivity score of >1 among approximately 88% of participants. This difference in overall IO administration may be explained by PD-L1 positivity, however our study was limited by the lack of this data. Further investigation is warranted to understand trends in IO administration.
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Elkrief, Arielle, Joao M. Victor Alessi, Biagio Ricciuti, et al. "Efficacy of PD-(L)1 blockade monotherapy compared with PD-(L)1 blockade plus chemotherapy in first-line PD-L1-positive advanced lung adenocarcinomas: a cohort study." Journal for ImmunoTherapy of Cancer 11, no. 7 (2023): e006994. http://dx.doi.org/10.1136/jitc-2023-006994.
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BackgroundSingle-agent PD-(L)1 blockade (IO) alone or in combination with chemotherapy (Chemotherapy-IO) is approved first-line therapies in patients with advanced lung adenocarcinomas (LUADs) with PD-L1 expression ≥1%. These regimens have not been compared prospectively. The primary objective was to compare first-line efficacies of single-agent IO to Chemotherapy-IO in patients with advanced LUADs. Secondary objectives were to explore if clinical, pathological, and genomic features were associated with differential response to Chemotherapy-IO versus IO.MethodsThis was a multicenter retrospective cohort study. Inclusion criteria were patients with advanced LUADs with tumor PD-L1 ≥1% treated with first-line Chemotherapy-IO or IO. To compare the first-line efficacies of single-agent IO to Chemotherapy-IO, we conducted inverse probability weighted Cox proportional hazards models using estimated propensity scores.ResultsThe cohort analyzed included 866 patients. Relative to IO, Chemotherapy-IO was associated with improved objective response rate (ORR) (44% vs 35%, p=0.007) and progression-free survival (PFS) in patients with tumor PD-L1≥1% (HR 0.84, 95% CI 0.72 to 0.97, p=0.021) or PD-L1≥50% (ORR 55% vs 38%, p<0.001; PFS HR 0.68, 95% CI 0.53 to 0.87, p=0.002). Using propensity-adjusted analyses, only never-smokers in the PD-L1≥50% subgroup derived a differential survival benefit from Chemotherapy-IO vs IO (p=0.013). Among patients with very high tumor PD-L1 expression (≥90%), there were no differences in outcome between treatment groups. No genomic factors conferred differential survival benefit to Chemotherapy-IO versus IO.ConclusionsWhile the addition of chemotherapy to PD-(L)1 blockade increases the probability of initial response, never-smokers with tumor PD-L1≥50% comprise the only population identified that derived an apparent survival benefit with treatment intensification.
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Sussman, Tamara A., Wei Wei, Pauline Funchain, and Brian Gastman. "Outcomes of stage IV melanoma in the era of immunotherapy (IO): A National Cancer Database (NCDB) analysis." Journal of Clinical Oncology 39, no. 15_suppl (2021): e21520-e21520. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e21520.
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e21520 Background: The majority of data for IO in melanoma stems from trials that have specific inclusion criteria and often exclude important populations. In this analysis, we present the first real-world evidence of outcomes for stage IV patients (pts) with cutaneous melanoma receiving IO from 2015–2017 (addition of anti-PD-1 therapies) and factors associated with receipt of IO, and compare these outcomes with pts receiving IO (likely interferon and interleukin-2) from 2004–2010, and IO (addition of ipilimumab) from 2011–2014. Methods: The NCDB was analyzed to identify pts with stage IV melanoma from 2004–2017. Pts were categorized into receipt of IO or not during time periods 2004–2010, 2011–2014, and 2015–2017. Overall survival (OS) was analyzed by Kaplan-Meier, log-rank, and Cox proportional hazard models; IO status was analyzed using logistic regression. Results: 24,544 pts were analyzed from 2004–2017. Overall, 5,238 pts (21.3%) that received IO had improved median OS compared to those that did not (20.2 vs. 7.4 mos; p<0.0001). 4.1% received IO from 2004-2010, 7.8% from 2011-2014, and 9.4% from 2015-2017. Three-year OS significantly improved in pts treated with IO across treatment years; p<0.0001 (Table). Similarly, median time to IO initiation improved over time: 62 days in 2011-2014 vs. 49 days in 2015-2017 (p<0.0001). In the overall cohort, age<65 years, female gender, private insurance, no comorbidities, residence in metropolitan area, and treatment at academic centers were associated with better OS (p<0.0001 for all). Race was not associated with differences in OS (p=0.07). Multivariate analysis for 2015-2017 demonstrated that lack of treatment with IO [HR 1.98, 95%CI 1.81-2.17], radiation therapy [HR 1.20, 95%CI 1.09-1.32], presence of liver metastases [HR 1.87, 95%CI 1.63-2.13], and lack of surgery [HR 1.68, 95%CI 1.45-1.93] were independently associated with worse OS (p<0.0001 for all). In multivariate analysis, receipt of IO from 2015-2017, was associated with age<65 years [OR 1.27, 95%CI 1.08-1.50], African American race [OR 5.88, 95%CI 1.60-28.58], lack of comorbidities [OR 1.43, 95%CI 1.23-1.66], and treatment at academic centers [OR 1.44, 95%CI 1.26-1.65] (p<0.05 for all). Conclusions: OS was improved in stage IV melanoma pts receiving IO, with the highest OS rate in 2015-2017. Our findings that represent a real-world population are consistent with recent trials, like KEYNOTE 006 and CheckMate 067 where 3-year OS for anti-PD-1 therapy was 50% and 52%, respectively. In our study, African Americans demonstrate a 5-fold increase in likelihood of receiving IO, a population underrepresented in clinical trials. Significant socioeconomic factors may impact receipt of IO and survival.[Table: see text]
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Mathur, Anisha, and Rakesh Kumar. "Effect of Organic and Inorganic Nitrogen Management and Planting Technique on Nutrient Uptake by Maize Crop." International Journal of Plant & Soil Science 35, no. 18 (2023): 670–74. http://dx.doi.org/10.9734/ijpss/2023/v35i183332.
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Maize production is affected by many factors including climate and soil parameters. Soil parameters may include nutrient availability and management. Maize crop production may also be highly affected by the planting techniques involved in its cultivation. These may in the long run have an impact on the yield realised from a particular enterprise. The research was conducted in 2019-20, at Chhapang Experimental Farm, Dr. KSG Akal Faculty of Agriculture, Eternal University, Baru Sahib, to analyze the effects of organic and inorganic nitrogen management and planting strategies on the nutrition of crops. Experiments were conducted in a split-plot design for 3 replications with 2 main applications (i.e. flatbed and raised bed) and 5 minor treatments (i.e. 100% IO, 100% FYM, 50% IO + 50% FYM, 75% IO + 25% FYM, 100% IO + 25% FYM) and observed at 25, 50 and 75 days after sowing. The results showed that T3 treatment (50% IO + 50% FYM) showed the highest yield from corn and straw. Therefore, the integration of T3 (50% IO + 50% FYM) with organic and inorganic in the raised bed resulted in the best maize. A litter mix of 50% IO + 50% FYM is recommended for maize growth and quality management.
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David, Rachel Julie, Andrea Baran, and Ronald John Maggiore. "Immunotherapy use, outcomes, and toxicities in gastrointestinal malignancies." Journal of Clinical Oncology 36, no. 5_suppl (2018): 100. http://dx.doi.org/10.1200/jco.2018.36.5_suppl.100.
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100 Background: Use of checkpoint inhibitors has expanded over recent years, and the gastrointestinal (GI) oncologic indications for immunotherapy (IO) continue to evolve. IO use in GI malignancies is still in its infancy, and we sought to describe our clinical experience thus far. Methods: We retrospectively identified all patients (pts) with GI malignancies treated with IO at the Wilmot Cancer Institute from December, 2015 through July, 2017. We examined patient and tumor-related clinicopathologic features. Our main outcomes of interest were best response on IO, and frequency/severity of IO toxicity. Fisher’s exact test was used to compare categorical factors between groups of interest. Results: 21 pts received IO for a GI malignancy, all of whom had metastases (mets). 76% of pts were male, and the median age was 62 years (range, 25 – 87). Common diagnoses were colorectal (CRC) (n = 10), gastroesophageal (GE) (n = 5), and hepatocellular cancers (HCC) (n = 4). 76% of pts received pembrolizumab, and 24% of pts received nivolumab. 67% received IO as ≥ 3rd-line therapy. The median time from diagnosis of metastatic disease to initiation of IO was 17.8 mos (range, 3 – 140). The median time on therapy was 2.62 months (95% CI 1.48, 6.52 mos) (range, 0.5 – 11 mos), with 3 pts still responding at the time of the analysis. Pts with HCC had the longest time on IO (8.95 mos), compared to 2.62 mos for GE, 2.39 mos for CRC, and 1.26 mos for all other (p = 0.10). Pts who received IO as 3rd or greater line of therapy had a significantly increased likelihood of non-response or progressive disease/death compared to pts who received IO as 2nd-line (p = 0.02). There was a trend towards non-response to IO in pts with liver mets vs. extrahepatic mets (p = 0.09). 57% experienced grade 3/4 toxicities: the most common were anemia (24%), hyponatremia (14%), and fatigue (14%). No IO-specific grade 3/4 immune-related toxicities were observed. Conclusions: The majority of our pts received IO as 3rd line therapy or beyond, and were significantly less likely to respond to treatment compared to those who received IO earlier on. The presence of liver mets is potentially associated with non-response to IO, and needs further exploration. No unexpected or severe IO-related toxicities were observed.
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Ahmed, Jibran, Rony Dev, Evan Kwiatkowski, et al. "Fatigue in patients with cancer treated on immunotherapy-based early phase clinical trials." JCO Oncology Practice 19, no. 11_suppl (2023): 294. http://dx.doi.org/10.1200/op.2023.19.11_suppl.294.
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294 Background: Immunotherapy (IO)-related fatigue is a common yet underrecognized adverse event (AE). The objective of this study was to determine the frequency of IO-related fatigue and non-IO-related fatigue, contributing factors, and the association between fatigue and treatment outcome in patients with advanced tumors, who received different types of IO-based treatments. Methods: We performed a retrospective chart review of patients treated on IO-based early phase clinical trials between September 2016 and May 2021. We collected data on baseline patient characteristics, AEs, fatigue at baseline and on-treatment, response to treatment, progression free survival (PFS), and overall survival (OS). AEs attribution to treatment were determined by the investigator. We determined IO-related based on the timing of the highest-grade fatigue with respect to treatment start date. Cox proportional hazards were used to assess association between fatigue and survival endpoints. Results: A total of 511 patients with 45 different cancer types were included in this analysis. The most common tumor types were colon (n=50), pancreatic, ovarian, sarcoma (n=35 each), cervical (n=29), and melanoma (n=26). The median age was 62 years, and 98% of patients were ECOG 1. Of the 136 patients (26.6 %) who reported fatigue, 21 (4.1%) had baseline fatigue and 115 (22.5%) developed fatigue after treatment initiation. A total of 69 (13.5%) patients had IO-related and 67 (13.1%) had non-IO related fatigue. The majority of the patients (87.8%) were treated on immune checkpoint-inhibitor-based regimens. Among 69 patients with IO-related fatigue, 58% of the patients reported fatigue only after treatment initiation and 29% had worsening grades of fatigue. In univariate analysis, patients with IO-related fatigue had a higher frequency of baseline depression than those with non-IO-related (14.5% vs. 3%, p=0.0391). Among the 81 patients with fatigue who were evaluated for response by irRECIST, objective response rate was 11.1% (5/45) in patients with IO-related versus 8.3% (3/36) in those with non-IO related fatigue. The median PFS was 4.08 mo in patients with IO related versus 3.68 in non-IO-related fatigue (p=0.27). The median OS was 15 mo in patients with IO related vs 10.6 mo (p=0.8) in non-IO related fatigue. The median OS for all the patients on the study was 14.7 mo in patients with IO-related vs 9.4 mo in non-IO related fatigue (p=0.32). Conclusions: In half of the patients reporting fatigue on IO-based clinical trials, fatigue was related to treatment. Patients with IO-related fatigue had higher response rates, improved PFS and OS, although not significant. Ongoing analysis with patient-reported outcome may provide more insight into prevalence of fatigue in this patient population. Further understanding of underlying biology may help to develop treatment strategies.
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Gao, He, Jinying Yang, Wenfei Pan, and Min Yang. "Iron Overload and the Risk of Diabetes in the General Population: Results of the Chinese Health and Nutrition Survey Cohort Study." Diabetes & Metabolism Journal 46, no. 2 (2022): 307–18. http://dx.doi.org/10.4093/dmj.2020.0287.
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Background: Recent studies have found that there are significant associations between body iron status and the development of diabetes. In the present study, we aimed to analyze the association among iron overload (IO), insulin resistance (IR), and diabetes in Chinese adults, and to explore the sex difference.Methods: Men and women (age >19 years) who participated in the Chinese Health and Nutrition Survey and did not have diabetes at baseline were followed between 2009 and 2015 (n=5,779). Over a mean of 6 years, 75 participants were diagnosed with incident diabetes. Logistic regression was used to assess the risk factors associated with IO. Cox proportional hazard regression was used to estimate the risk of incident diabetes and to determine whether the risk differed among subgroups. Causal mediation analysis (CMA) was used to explore the mechanism linking IO and diabetes.Results: According to sex-stratified multivariable-adjusted Cox proportional hazards regression, IO increased the risk of incident diabetes. Women with IO had a higher risk of diabetes than men. Subgroup analysis with respect to age showed that the association between IO and diabetes was stronger in older women and younger men (P<0.001). CMA showed that liver injury (alanine transaminase) and lipid metabolism abnormalities (triglyceride, apolipoprotein B) contributed to the association between IO and diabetes.Conclusion: IO is associated with diabetes and this association is sex-specific. IO may indirectly induce IR via liver injury and lipid metabolism abnormalities, resulting in diabetes.
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Ueda, Kosuke, Keiichiro Uemura, Naoki Ito, et al. "Soluble Immune Checkpoint Molecules as Predictors of Efficacy in Immuno-Oncology Combination Therapy in Advanced Renal Cell Carcinoma." Current Oncology 31, no. 4 (2024): 1701–12. http://dx.doi.org/10.3390/curroncol31040129.
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Immuno-oncology (IO) combination therapy is the first-line treatment for advanced renal cell carcinoma (RCC). However, biomarkers for predicting the response to IO combination therapy are lacking. Here, we investigated the association between the expression of soluble immune checkpoint molecules and the therapeutic efficacy of IO combination therapy in advanced RCC. The expression of soluble programmed cell death-1 (sPD-1), soluble programmed cell death ligand-1 (sPD-L1), soluble PD-L2 (sPD-L2), and lymphocyte activation gene-3 (sLAG-3) was assessed in plasma samples from 42 patients with advanced RCC who received first-line IO combination therapy. All IMDC risk classifications were represented among the patients, including 14.3, 57.1, and 28.6% with favorable, intermediate, and poor risk, respectively. Univariate analysis revealed that prior nephrectomy, sPD-L2 levels, and sLAG-3 levels were significant factors affecting progression-free survival (PFS), whereas multivariate analyses suggested that sPD-L2 and sLAG-3 levels were independent prognostic factors for PFS. In a univariate analysis of the overall survival, prior nephrectomy and sPD-L2 levels were significant factors; no significant differences were observed in the multivariate analysis. No significant correlation was observed between the sPD-L2 and sLAG-3 levels and PD-L2 and LAG-3 expression via immunohistochemistry. In conclusion, sPD-L2 and sLAG-3 expression may serve as a potential biomarker for predicting IO combination therapy efficacy.
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Raghav Bhat, K., Richard P. Curley, and Robert S. Gutzwiller. "Researching Influence Operation (IO) Mitigation: An HFE Step Forward." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 66, no. 1 (2022): 626–30. http://dx.doi.org/10.1177/1071181322661171.
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Influence operations (IO) are coordinated efforts by an actor, individual or group, to interfere in the process of meaning-making for manipulation or corruption of public debate (e.g., Bergh, 2020), often involving dis-or misinformation spread. IOs are often employed through social media and based around political, social and/or ‘hotbutton’ issues and narratives. There is increasing study of misinformation spread and correction, but less research examines IO mitigation using human participants and controlled tests (rather than post-facto metrics). We conducted a lightly scoped literature review of IO research using social media, revealing emergent difficulties and challenges to designing and studying IO, and paths toward improving experimentation based on human factors research.
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F, Garibay-González, Navarrete-Arellano M, Moreno-Delgado F, Salinas-Hernández EL, Rodríguez-Ayala E, and Cleva-Villanueva G. "Incidence of intestinal obstruction due to post-surgical adhesions in the Central Military Hospital. Associated risk factors." Revista de Sanidad Militar 71, no. 6 (2017): 534–44. http://dx.doi.org/10.56443/rsm.v71i6.137.
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Introduction: Intestinal obstruction (IO) due to postoperative adhesions is an important cause of hospital admissions worldwide, with signifi cant morbidity and mortality that represent great costs for health systems worldwide. Objective: To estimate the incidence of intestinal obstruction due to postoperative adhesions and to identify risk factors in patients admitted to the General Surgery Service of the Central Military Hospital (CMH). Material and methods: The database of admitted patients to the CMH was revised from January 2009 to December 2013. Of the 14,769 surgeries performed, 393 patients presented intestinal obstruction. The demographic characteristics, type and number of previous surgeries and other risk factors for adhesions were identifi ed. Each patient was classified as IO by adhesions (IOA) or as IO associated with another pathology (IOP). Results: The overall incidence of post-surgical IO was 2.7%; 236 cases (1.6%) were secondary to surgical adhesions and the rest (1.1%) were associated with other pathology. Morbidity occurred in 8.5% of the IOA patients versus 13.5% of the IOP group (p = 0.118). Mortality was 6.4 versus 12.1%, respectively (p < 0.05). Laparotomy (34%), cholecystectomy (22%) and appendectomy (19%) were the surgeries most frequently associated with obstruction. Surgical treatment was done in 20% of the patients of the IOA group, versus 43% in the IOP group (p = 0.001). Risk factors associated to IOA were: female patients, number of previous abdominal surgeries and past admissions for intestinal obstruction. Conclusions: Intestinal obstruction syndrome due to post-surgical adhesions was the most common cause of IO from 2009 to 2013 in the Central Military Hospital. The incidence of this post-surgical adhesion syndrome is similar to that reported in world literature. Therapeutic decision oriented toward an initial conservative treatment should be correct. There were fewer hospitalization days and less mortality in the adhesion group treated without surgery.
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Long, S. T., P. V. Gioi, and N. T. Suong. "Some Factors Associated with Ovarian Disorders of Dairy Cattle in Northern Vietnam." Tropical Animal Science Journal 44, no. 2 (2021): 240–47. http://dx.doi.org/10.5398/tasj.2021.44.2.240.
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This research’s objectives were to assess the risk factors associated with ovarian disorders in dairy cattle in Hanoi Capital, Ha Nam Province, Vinh Phuc Province, and Moc Chau District in Son La Province. The ovarian diseases were evaluated by rectal palpation combined with information collected based on the questionnaire and surveys. Records of feeding management and ovarian disorders were comprising of persistent corpus luteum (PCL), cystic ovarian disease (COD), inactive ovary (IO) from 818 females, including heifers and cows from the first to the eighth parities. A multinomial logistic regression procedure in SAS9.0 was applied for data analysis. The results have shown that the changes of region, age classes, housing condition, and body condition scores were associated with the odds of suffering from dairy cattle’s ovarian disorder categories. The cows got the odds of suffering from PCL in the old age or fatter condition, and IO at the younger or angular cows. When cattle were confined in simple houses or laid on rubber bedding, they suffered from IO, but they tended to get the odds of suffering from PCL when the cattle were raised in modern houses or laid on concrete bedding. In conclusion, region, parity, body condition score, housing type, and bedding material affect ovarian disorders in dairy cattle in northern Vietnam.
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Rizwan, Saleha, Khaled Alhamad, Stephen Abel, et al. "Comparison of survival outcomes with the use of combination chemoimmunotherapy versus immunotherapy alone in NSCLC with high PD-L1 expression." Journal of Clinical Oncology 39, no. 15_suppl (2021): e21217-e21217. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e21217.
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e21217 Background: Constituting up to 85% of all lung cancer, non-small cell lung cancer (NSCLC) is unfortunately often discovered in the metastatic setting. Profiling tumors for driver mutations and assessing PD-L1 expression have become essential in tailoring treatment. National guidelines recommend that patients with PD-L1 expression ≥ 50% may receive immunotherapy (IO) alone or chemotherapy in conjunction with immunotherapy (ChT/IO). At present, there is no strong data suggesting that the addition of chemotherapy to IO is superior to IO alone in this patient subgroup, and treatment decision is entirely physician dependent. This decision is often based on factors such as age, performance status, co-morbidities and disease burden with elderly/frail patients receiving IO alone compared to the younger population with higher disease burden receiving the combination. The aim of our study was to evaluate whether there is a difference in survival outcomes for patients with high PD-L1 expression receiving combination ChT/IO versus IO alone. Methods: We performed a retrospective analysis on stage IV NSCLC patients treated with either ChT plus pembrolizumab or pembrolizumab monotherapy in the first line setting from December 2016 to December 2019. PD-L1 status was evaluated for all patients and only patients with PD-L1 expression ≥ 50% were included in the analysis. Univariable and multivariable analyses identified characteristics predictive of overall survival (OS) and progression-free survival (PFS). OS was calculated using Kaplan Meier curves to present the cumulative probability of survival, and log-rank statistics were used to assess statistical significance between groups. Results: 195 patients were evaluated out of which 82 (42%) patients were identified as having PD-L1 expression ≥ 50%. 13 (13.4%) out of 82 patients received chemotherapy alone and were therefore excluded from the analysis. 49 (71%) patients received IO alone compared to 20 (29%) who received combination ChT/IO. Median PFS was 8.1 months (IO alone group) vs 9.9 months (ChT/IO group) with a hazard ratio (HR) of 0.95 (95% confidence interval [CI] 0.54-1.7, p = 0.87). Median OS was 13.7 months (IO alone group) vs 19 months (ChT/IO group) with a HR of 0.76 (95% [CI] 0.41-1.4, p = 0.42). Our results did not show a statistically significant difference between patients treated with IO alone vs combination ChT/IO. Conclusions: Our retrospective analysis revealed that although there was no statistically significant difference between high PD-L1 NSCLC patients receiving ChT/IO vs IO alone with respect to survival, there was a trend towards improved PFS and particularly OS in favor of the group receiving chemotherapy in combination with immunotherapy. Given our small sample size, further studies are needed to determine the benefit of adding chemotherapy to IO for NSCLC patients with high PD-L1 expression.
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Akinboro, Oladimeji, Jonathon Joseph Vallejo, Erica C. Nakajima, et al. "Outcomes of anti–PD-(L)1 therapy with or without chemotherapy (chemo) for first-line (1L) treatment of advanced non–small cell lung cancer (NSCLC) with PD-L1 score ≥ 50%: FDA pooled analysis." Journal of Clinical Oncology 40, no. 16_suppl (2022): 9000. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.9000.
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9000 Background: FDA-approved 1L treatment options for patients with PD-L1-high advanced NSCLC (PD-L1 score ≥50%) include IO ± chemo (± anti-angiogenics) but it is unclear if chemo substantially improves efficacy outcomes when added to IO in this patient population. Methods: Data was pooled from 12 randomized controlled trials that investigated anti-PD-(L)1 regimens ± chemo for the 1L treatment of patients with advanced NSCLC. PD-L1 score was defined as the proportion of tumor cells stained by the assay and analysis was conducted for patients with tumor PD-L1 score ≥50%. OS, PFS, and ORR were compared between chemo-IO and IO alone via a pooled analysis. Median survival times were estimated using Kaplan-Meier methods. Hazard ratios were estimated using Cox proportional hazards models stratified by trial; odds ratios were estimated using a logistic regression model with trial as a covariate. All analyses were adjusted for age, sex, race, ECOG, histology and smoking status. Results: A total of 3,189 patients with NSCLC and PD-L1 score ≥50% were identified for this analysis. Baseline characteristics were: 38% ages 65-74 years and 11% ages ≥75 years; 69% male; 80% White; 66% ECOG ≥1; and 89% former/current smokers. Median OS in the pooled chemo-IO ( N=455) and IO-only ( N=1,298) arms was 25.0 vs 20.9 months (HR 0.82; 95% CI: 0.62, 1.08); median PFS was 9.6 vs 7.1 months, respectively (HR 0.69; 95% CI: 0.55, 0.87). ORR was higher with chemo-IO than with IO alone (61% vs 43%; Odds ratio 1.2, 95% CI: 1.1, 1.3). Conclusions: This exploratory, hypothesis-generating pooled analysis suggests that most subgroups of patients with advanced NSCLC with PD-L1 score ≥50% receiving FDA-approved chemo-IO regimens may have OS and PFS outcomes that are comparable with or better than IO-only regimens. Patients ≥75 years of age receiving chemo-IO may not have improved outcomes over IO. These results support shared decision-making that balances potential benefits and risks of adding chemo to IO regimens based on patient factors that may impact tolerability. [Table: see text]
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Cabrera, Leopoldo, Gustavo A. Marrero, Juan Gabriel Rodríguez, and Pedro Salas-Rojo. "Inequality of Opportunity in Spain: New Insights from New Data." Revista Hacienda Pública Española 237, no. 2 (2021): 153–85. http://dx.doi.org/10.7866/hpe-rpe.21.2.6.
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Modern theories of social justice consider Inequality of Opportunity (IO), the part of overall inequality explained by individual circumstances (factors beyond the individual control, like socioeconomic background), as the truly concept of unfair inequality. In addition, recent empirical studies have found that IO harms growth. Then, given the big increase in income inequality in Spain during the last decade (now one of the highest levels in the EU), how large is IO in Spain? By using a novel database from the Centro de Investigaciones Sociológicas (CIS) questionnaire on ‘Social inequality and social mobility in Spain’, we observe that the share of IO is 44% of overall inequality (Gini index). By circumstances, we find that about 90% of IO is due to parental education and occupation, the type of school attended, the gender of the household’s head and the size of the household. In addition, it is found that a large share of IO is channeled through the occupation and, especially, the level of education of the individual. These findings are consistent with the low levels of relative mobility in education and occupation observed in the database for Spain (2017).
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Garrington, Catherine, Peter Chamberlain, Debra Rickwood, and Douglas P. Boer. "Risk assessment of online child abuse material (CAM) offenders: a review of existing tools." Journal of Criminal Psychology 8, no. 2 (2018): 150–61. http://dx.doi.org/10.1108/jcp-05-2017-0022.
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Purpose The purpose of this paper is to summarise the available risk and assessment tools for child abuse material (CAM) offenders. Noting the rise of internet-based offences surrounding CAM, it has been proposed that there may be substantial differences between internet only (IO) offenders, contact only and mixed profile sexual offenders. Design/methodology/approach Through online searches, risk assessment tools for sexual offenders were identified. Scoring manuals were consulted for applicability to IO offenders. Findings Nine risk assessment tools for sexual offenders were included. Risk assessment tools for sexual offenders use cautionary language regarding the application of sexual offence risk assessment tools to IO offenders. An additional five tools were identified specifically addressing IO offenders. Three of these tools address risk assessment and two assess cognitions and behaviours. Research limitations/implications Limitations include the identification of static and dynamic risk factors and the application of structured professional judgement. Practical implications By drawing together existing tools and recommendations for use with the IO offender population, a gap is identified for CAM specific risk assessment tools. Originality/value Appropriate risk assessment, case planning and treatment will contribute to the appropriate management and treatment of the IO offender population.