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1
Blanchard, Walter. "The Genesis of the Decca Navigator System." Journal of Navigation 68, no. 2 (October 7, 2014): 219–37. http://dx.doi.org/10.1017/s0373463314000666.
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The Decca Navigator System was very unusual among radio-navigation systems in that the entire system was championed and marketed by a commercial company. How it came about was also unusual – it was neither the product of market research nor a military specification. It was a solution to one of the major problems of the 1930s facing those who attempted to use radio methods for the location of vehicles, that of measuring extremely small time intervals. The problem was eventually solved by pulse methods (radar), which were kept very secret at the time, but Decca offered an alternative particularly suited to marine navigation because of its use of low frequencies. No matter how good a technical solution, many systems fail if they are not actively supported by proper marketing and in this Decca Navigator was fortunate to have the backing of a major British company, the Decca Record Company. This paper describes the inception, wartime trials and eventual acceptance into general marine use of Decca Navigator. Some previously unpublished historical material from the company archives is included.
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Collins, I. P. C. "Mad Songs. (1993) Catherine Bott, Soprano. London: Editions L'Oiseau Lyre (433 187–2). The Decca Record Company." Psychiatric Bulletin 19, no. 12 (December 1995): 799. http://dx.doi.org/10.1192/pb.19.12.799.
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Johnson, Veronica. "Seeking traces of women in early Irish filmmaking." Alphaville: Journal of Film and Screen Media, no. 20 (January 27, 2021): 28–37. http://dx.doi.org/10.33178/alpha.20.03.
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Recent research by Díóg O’Connell and Donna Casella has brought to light the work of Ellen O’Mara Sullivan with the Film Company of Ireland (1916–20). These scholars trace the personal archive of Ellen O’Mara Sullivan’s descendants and use this data to create a trajectory of her role within this first significant Irish film company. While the official record of the Film Company of Ireland is considered limited, there are traces of the company in trade papers, archives and newspapers. In comparison, information about the role of women in this company is difficult to discover as women often slip from the official archive in this period. In the case of Ellen O’Mara Sullivan, she is frequently hidden behind her husband’s record as owner and director of the Film Company of Ireland, or behind her more famous father and brothers, well-connected Republicans, Mayors of Limerick, and successful businessmen. This paper will examine the role of Ellen O’Mara Sullivan and her sister Mary Rynne in the development of the Film Company of Ireland by examining the archival records available and exploring how to find information about these women when they elude the official record. Working in particular on documents found in the Rynne family archive, Special Collections, NUIG, this paper will attempt to trace the financial contribution of Mary Rynne to this film company and to bring to light the role these two sisters played in the development of the early Irish film industry.
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Dubblish, Puneet, and Shikha Bhatia. "Bright Soluble Private Limited: a case study on accounting process." Emerald Emerging Markets Case Studies 10, no. 2 (May 15, 2020): 1–21. http://dx.doi.org/10.1108/eemcs-05-2019-0087.
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Learning outcomes Learning outcomes of this paper are to analyse, record and classify financial transactions; prepare unadjusted trial balance; record the adjustment and closing entries and prepare post-closing trial balance; and prepare financial statements. Case overview/synopsis The case aims to induce users to draw up financial statements from the details provided. The complete accounting process is covered through solving the case. The case follows a start-up company from its first set of financial transactions to preparing the first set of financial statements. The case will help in application of accounting concepts, principles and the processes for recording transactions and preparation of financial statements. Complexity academic level The case is best suited for senior undergraduate- and graduate-level students of management/business schools in the courses of introductory financial accounting, intermediate accounting and financial reporting. Supplementary materials Teaching notes are available for educators only. Subject code CSS 1: accounting and finance.
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Agnes, Oyeniyi Aderonke, Akanbi Bosede Akanbi Bosede, and Babatunde Bayode Olusanya. "SALESMANSHIP BEHAVIOURAL PHYSIOGNOMIES AND BUSINESS PERFORMANCE OF BOVAS COMPANY LIMITED SOUTHWEST NIGERIA." Business Excellence and Management 10, no. 3 (September 15, 2020): 24–35. http://dx.doi.org/10.24818/beman/2020.10.3-02.
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The paper objective is to investigate salesmanship behavioral physiognomies and performance of Bovas Company. The instrument used to collect data is a structured questionnaire, and the sample size for the study was 120. The research methodology adopted a descriptive research design to examine the impact of salesmanship behavioral characteristics and business performance. A purposive is appropriate since the population is not significant. Purposive sampling technique was employed to select and sample the opinion of the 120 respondents in the different Bovas filling stations selected for the study. Data were obtained from the field survey and was later analyzed using SPSS 20.0 (Statistical Package for Social Sciences). The results revealed a significant relationship between salesmanship skills and SMEs business performance [r (117) =6.54**, p<.01]. The hypothesis revealed a significant positive relationship between financial record keeping and business performance [r(198)= 08, p>0.5]. Hypothesis three was supported by the result of the study. The study, therefore, concluded that salesman’s characteristics such as integrity, trust and confidence are significant to business performance.
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Macdonald, Ross. "Manufacturing MSCs for commercial application: an interview with Ross Macdonald." Regenerative Medicine 14, no. 11 (November 2019): 997–1000. http://dx.doi.org/10.2217/rme-2019-0122.
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Ross Macdonald is the CEO and Managing Director of Cynata Therapeutics Limited (Australia). He has over 30 years of experience and a track record of success in pharmaceuticals and biotechnology businesses. His career history includes positions as Vice President of Business Development for Sinclair Pharmaceuticals Ltd (now Sinclair IS Pharma), a UK-based specialty pharmaceuticals company, and Vice President of Corporate Development for Stiefel Laboratories, Inc., then the largest independent dermatology company in the world and acquired by GlaxoSmithKline in 2009 for £2.25 billion. He has also served as the CEO of Living Cell Technologies Ltd, Vice President of Business Development of Connetics Corporation and Vice President of Research and Development of F H Faulding & Co Ltd.
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Putra, Pandu Pratama, and Andi Supriadi Chan. "Pengembangan Aplikasi Perhitungan Prediksi Stock Motor Menggunakan Algoritma C 4.5 Sebagai Bagian dari Sistem Pengambilan Keputusan (Studi Kasus di Saudara Motor)." INOVTEK Polbeng - Seri Informatika 3, no. 1 (June 3, 2018): 24. http://dx.doi.org/10.35314/isi.v3i1.296.
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Limited company resources must be managed effectively and efficiently in order to guarantee corporate tax information technology information that will assist management within the company for every necessary process and reliable information. C 4.5 can be used to predict motor stock at Brothers Motor. the learning process that existed in the algorithm C 4.5 is preparing the data traning, calculate the root of the tree, and the partition process of the decision. The decision process will stop when all the records are in the N node that gets the same class, there are no attributes in the record that are partitioned again, there is no record in the empty network. The result of the average calculation algorithm algorithm C 4. Then the results of the calculation can be used for data processing. Data Mining uses the C4.5 algorithm then obtains a decision tree. Produce data obtained 12 rules (rules) in determining the prediction of preparation of motor stocks at Brothers Motor dealers.Key word: dss, algortm c 5.4,motorbike, dealer
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Chen, Xue Yu, Jin Zang, Miao Yang, Wei Ping Wang, and Yin Hu. "Design and Development of Self-Help Emergency Device Based on the Android Intelligence Platform." Applied Mechanics and Materials 687-691 (November 2014): 2591–94. http://dx.doi.org/10.4028/www.scientific.net/amm.687-691.2591.
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LD3320 is a high-performance speech recognition module which is made in ICR company. It can achieve non-specific voice recognition feature of a limited vocabulary. The chip does not require the user for record training, with a identify dynamically editable key words list, we just need to put the key words in the chip, which can take effect immediately in the next recognition. The design on the basis of Android platform, combined with non-specific speech recognition module, Bluetooth technology enables voice control hardware, design of a set of older self-aid devices.
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Fujimoto, Hiro. "Circulation of Medical Knowledge and Techniques through Film in Japan, 1929–1941." East Asian Science, Technology and Society 14, no. 3 (July 21, 2020): 439–58. http://dx.doi.org/10.1215/18752160-8697737.
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Abstract Several historians have analyzed the various uses of medical films and have examined how cinematography changed the epistemology of medical doctors, or how governments and private companies utilized moving pictures for promoting ideas of hygiene among the general public. But historians have paid little attention to those medical films that were circulated in Japan. Some Japanese surgeons recorded their operations and screened surgical films in academic meetings to convey their techniques effectively. Others used moving pictures to educate medical students, who had limited opportunities to observe professors’ skills in schools. In 1929, this type of medical film began to circulate in Japan: a pharmaceutical company imported German medical films while one film company collaborated with a medical professor to record the first surgical film in the country. The 1930s witnessed the wide dissemination of medical films that followed the introduction of small-gauge film to Japan, and a flourishing medical film production continued until the outbreak of the Pacific War in 1941. This article examines why and how these medical films were domestically circulated in Japan and internationally screened outside Japan by looking at not only how medical practitioners used films but also how they successfully cooperated with a pharmaceutical company, filmmakers, technicians, and government.
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Cameron, P. J., and J. G. Baird. "MARKET STRATIGRAPHY—THE 25-YEAR ODYSSEY OF THE AUSTRALIAN PUBLICLY-LISTED OIL AND GAS SECTOR (IS THE SMALLER E&P COMPANY THREATENED WITH EXTINCTION?)." APPEA Journal 41, no. 1 (2001): 803. http://dx.doi.org/10.1071/aj00050.
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A market view of the population of publicly listed oil and gas companies during the past 25 years provides insights to the survival of the smaller exploration and production company. Mapping the life span of companies, and company population against parameters such as oil price and market activity, demonstrates that oil price is not the crucial driver for the industry as one would expect. The number of exploration companies existing at any one time is independent of oil price and discovery levels, but is more closely related to market sentiment and external influences. The benefits of success are apparent, but the vulnerability of smaller companies to that success is also apparent. While the ASX Energy Index has significantly out-performed the market, and the resources sector in general over this period, it is still considered a high-risk investment area, which fails to attract substantial investment funds.At a time of an apparently sustainable higher oil price, and record market levels, why is the level of new corporate activity so limited? In stratigraphic terms, is the survival of this species threatened? Was Darwin right—will the strong get stronger and will the small E&P company be driven to extinction?
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Bell, Jill A., Aaron Galaznik, Eileen Farrelly, Marlo Blazer, Brian Seal, Huai-Che Shih, Augustina Ogbonnaya, Michael Eaddy, and Bruce J. Dezube. "Treatment Patterns and Outcomes Among Patients with Higher-Risk Myelodysplastic Syndromes Treated in a Real-World Setting: Electronic Medical Record-Based Data." Blood 128, no. 22 (December 2, 2016): 5540. http://dx.doi.org/10.1182/blood.v128.22.5540.5540.
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Abstract Introduction: Myelodysplastic syndromes (MDS) are a heterogeneous group of disorders resulting in ineffective hematopoiesis primarily affecting older adults; median age of diagnosis is >70 years. Treatment decisions in MDS are largely based on a prognostic scoring system that has been incorporated into some drug labeling (NCCN 2016). The use of hypomethylating agents (HMAs) in patients with higher-risk (HR) MDS is supported by consensus guidelines, thus the purpose of this study was to examine factors influencing prescribing patterns in this subset of patients. Methods: This was a retrospective cohort study using a large United States electronic medical record database. Newly diagnosed HR MDS patients initiating first-line therapy (1LT) between 1/2008 and 7/2015 were followed for 1 year prior to and ≥ 60 days after diagnosis. Included patients were ≥18 years old with evidence of HR MDS identified as follows: 1) ≥1 inpatient claim with an HR MDS diagnosis code (ICD-9 code: 238.73; ICD-10 codes: D46.20, D46.21, D46.22), or 2) ≥2 outpatient claims with an MDS diagnosis code, with the first one coded for HR MDS ≥60 days but <1 year apart during the identification period. The date of the first HR MDS claim served as the index diagnosis date. 1LT was defined as an MDS-specific systemic agent initiated on or after the index diagnosis date and included all agents received within 30 days following the first infusion or fill date. Subsequent lines of therapy (LOT) were defined as an addition of a new MDS-specific agent >30 days after the initial chemotherapy agent(s) or a switch to another drug combination. Stem cell transplantation (SCT) was considered part of the LOT in which it occurred. All patients were followed until death or progression to acute myeloid leukemia (AML), loss to follow-up, or the end of study period (9/30/2015). Results: 345 patients newly diagnosed with HR MDS met the study criteria; 218 (63%) were treated with supportive care (including transfusions, hydroxyurea, colony-stimulating factors [CSFs], azole antifungals, erythropoiesis-stimulating agents [ESAs], or pain medications) or observation only and 127 (37%) were treated with MDS-directed therapy (HMAs, immunosuppressive therapy, induction-type therapy, SCT, or lenalidomide) ± supportive care (Table 1). Compared to untreated patients, a greater proportion of treated patients were male, had severe cytopenias (specifically, neutrophils <0.8 K/L and/or platelets <50 K/L), and had received a transfusion of either red blood cells or platelets during the baseline period (Table 1). In the treated population, most patients received only 1LT (n=111, 87%); 16 patients (13%) went on to second-line therapy, and 3 (2.3%) to third-line therapy. HMAs were the most utilized agents in 1LT, with 84 (66%) and 29 (23%) patients receiving azacitidine and decitabine, respectively. Lenalidomide was used in 6.3% of patients (n=8), and induction-type chemotherapy in 3.2% (n=4); no patients received immunosuppressive therapy only (cyclosporine or anti-thymocyte globulin). At median follow-up of 9 months (interquartile range [IQR]: 4, 16) for the treated population, 46 (36%) had died and 36 (28%) had progressed to AML. Within the population that received an HMA (n=113), age ≥75 years was approximately 50% for each agent; however, a greater proportion of patients who received azacitidine had a known marrow blast count of >5%, hemoglobin <10 gm/dL, and platelets <50 K/L at baseline (Table 2). At end of follow-up, 27% (n=23) and 36% (n=30) of azacitidine-treated patients had progressed to AML or died whereas 28% (n=8) and 41% (n=12) of decitabine-treated patients progressed to AML or died, respectively. Conclusions: Despite the existence of treatment guidelines for HR MDS patients and given the limitations of a retrospective study, the majority of patients in a real-world setting are not treated with MDS-specific agents. Younger age (<75 years) and more severe cytopenias may be factors considered in the decision of whether or not to treat HR MDS. If treated, HMAs are the most utilized therapy in these patients, with azacitidine predominating. Cytopenias at baseline may also influence the choice between azacitidine and decitabine, although survival and progression to AML appear similar between groups. References: National Comprehensive Cancer Network (NCCN) Guidelines in Oncology for MDS v.1.2016. Disclosures Bell: Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment, Equity Ownership. Galaznik:Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment, Equity Ownership. Farrelly:Takeda: Research Funding. Blazer:Takeda: Research Funding. Seal:Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment, Equity Ownership. Shih:Takeda: Research Funding. Ogbonnaya:Takeda: Research Funding. Dezube:Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment, Equity Ownership.
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Yousef, Helena. "Studying the components status of the competitive advantage variable in the importer companies of the network products (HP Company) and its relation with demographic variables." Environment Conservation Journal 16, SE (December 5, 2015): 79–87. http://dx.doi.org/10.36953/ecj.2015.se1608.
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The purpose of this article is to study the components status of the competitive advantage variable in the importer companies of the network products (HP Company) and its relation with demographic variables. Current research in terms of purpose is applicable and it was done with descriptive-survey method. The statistical population of this research includes all customers of HP network products in AfzarPardazBatis Company in Tehran and they are 120 persons. Due to the limited number of the statistical population, census method was used in order to determine the sample size. In order to collect the data, standard questionnaire of Hill & Jones (2010) was used. The face and content validity of the questionnaire was confirmed by using of some professors,opinions. Cronbach’s alpha coefficient of the questionnaire was obtained higher than 0.7 which indicates the internal coordination of the items and acceptable reliability of the questionnaire. In order to study the research hypotheses, single sample t-test, independent t-test and ANOVA with application of spss software were used. According to the results, the amount of t-statistic was more than critical amount of 1.96; and it was in the critical area of the test and in other words, the average difference from figure 3 was meaningful. Therefore the assessment averageof the components status of competitive advantage variable was higher than the assumed average (3) and this indicates that accountability to the customers, services quality, innovation in presenting the services and superior efficiency as the competitive advantage components from the perspective of the intended customers had proper status. The other results of the research indicated that women, men and customers with different education and ages assess the competitive advantage of the company equally, but according to the results obtained, whatever the customers purchase record from this company is more, their perspective will be improved about the importer company of HP products and their assessment of competitive advantage will be higher.
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Chen, Wei‐Shing. "Analysis of a customer satisfaction survey using Rough Sets theory." Asia Pacific Journal of Marketing and Logistics 21, no. 1 (January 9, 2009): 93–105. http://dx.doi.org/10.1108/13555850910926263.
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PurposeThis paper seeks to present the use of Rough Sets (RS) theory as a processing method to improve the results in customer satisfaction survey applications.Design/methodology/approachThe research methodology is to apply an innovative tool to discover knowledge on customer behavior patterns instead of using conventional statistical methods. The RS theory was applied to discover the voice of customers in market research. The collected data contained 422 records. Each record included 20 condition attributes as well as two decision attributes. The important attributes that ensured high quality of classification were generated first. Then decision rules for classifying high and low overall satisfaction and loyalty categories were derived.FindingsThree important facts were found: the important product and service attributes that lead to overall satisfaction and loyalty; the percentage of latently dissatisfied customers; and customer decision rules.Research limitations/implicationsThe study is limited by the case company and its experience. These rules were presented to the company's sales and marketing managers who believed that they provided them with valuable information for creating strategies to increase customer satisfaction and retention.Originality/valueRS theory provides a mathematical tool to discover patterns hidden in survey data. The paper describes a new attempt of applying a RS‐based method to analyze overall customer satisfaction and loyalty behavior through regular satisfaction questionnaire surveys.
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Bani Bili, Asnat C., R. E. H. Riwumanu, and Ari Data. "ANALISIS DAN PERANCANGAN SISTEM AKUNTANSI PERSEDIAAN PADA UD LI JAYA KUPANG." Journal of Management : Small and Medium Enterprises (SMEs) 13, no. 3 (December 5, 2020): 355–66. http://dx.doi.org/10.35508/jom.v13i3.3313.
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Inventory is a large asset owned by the company. Large investments invested in the form of inventory willcause problems related to the cost of organizing where the cost will increase the warehouse costs. Inventoryis very vulnerable to damage, theft, and misappropriation. The inventory accounting system plays animportant role in the arrangement of avoiding the repatriation of the company's wealth, especiallyinventory. Proper and correct accounting treatment of inventory is absolutely necessary. This is becausethe inventory post has a considerable influence in the financial statements, which is in the balance sheetand in determining the price of inventory in the income statement. The problem in the research is how todesign good documents, records, and procedures related to the inventory accounting system ofmerchandise at Usaha Dagang Li Jaya Kupang and how the internal control system prevent the multipositions, mis-recording, and possible misappropriation of inventory of at Usaha Dagang Li JayaKupang. The results showed that the inventory accounting information system at UD. Li Jaya hasweaknesses in terms of inventory recording undone because of the limited educational background of theexisting workforce and in terms of its internal controls that have not been effective. The obstacles faced byUD. Li Jaya Kupang is the absence of computerized administration in the recording system, so that isno recording at all in the warehouse section. The inventory accounting information system at UD LiJaya Kupang must have its own recording administration, so that employees do not record bythemshelves.
Keywords : Inventory, Intenal Control, Inventory Accounting Information System
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Hamamura, Toshitaka, Shinichiro Suganuma, Mami Ueda, Jack Mearns, and Haruhiko Shimoyama. "Standalone Effects of a Cognitive Behavioral Intervention Using a Mobile Phone App on Psychological Distress and Alcohol Consumption Among Japanese Workers: Pilot Nonrandomized Controlled Trial." JMIR Mental Health 5, no. 1 (March 22, 2018): e24. http://dx.doi.org/10.2196/mental.8984.
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Background Research that investigates standalone effects of a mobile phone-based cognitive behavioral therapy without any human contact for reducing both psychological distress and risky drinking has been advancing; however, the number of studies is still limited. A mobile phone app called Self Record that facilitates cognitive restructuring through self-monitoring of daily thoughts and activities was developed in Japan. Objective This study conducted a nonrandomized controlled pilot trial of the Self Record app to investigate standalone effects of the intervention on psychological distress and alcohol consumption among Japanese workers. Additionally, we examined moderating effects of negative mood regulation expectancies, which are beliefs about one’s ability to control one’s negative mood. Methods A quasi-experimental design with a 1-month follow-up was conducted online in Japan from February 2016 to March 2016. A research marketing company recruited participants. The selection criteria were being a Japanese full-time worker (age 20-59 years), experiencing mild to moderate psychological distress, and having some interest in self-record apps. Assignment to group was based on participants’ willingness to use the app in the study. All participants completed outcome measures of negative mood regulation expectancies, positive well-being, general distress, depression, anxiety, and typical/most weekly alcohol consumption. Results From the recruitment, 15.65% (1083/6921) of participants met the inclusion criteria. Of these, 51.43% (557/1083) enrolled in the study: 54.9% (306/557) in the intervention group and 45.1% (251/557) in the control group. At the 1-month follow-up, 15.3% (85/557) of participants had dropped out. Intention-to-treat analyses revealed that participants in the intervention group reported increased typical drinking (η2=.009) and heavy drinking (η2=.001). Adherence to using the app was low; 64.8% (199/306) of participants in the intervention group discontinued using the app on the first day. Additionally, 65.7% (366/557) of the total sample did not correctly answer the validity checks in the outcome measures (eg, “Please select ‘mildly agree’ for this item”). Therefore, per-protocol analyses were conducted after removing these participants. Results showed that continuing app users (42/127) in the intervention group reported increases in anxiety (η2=.006), typical drinking (η2=.005), and heavy drinking (η2=.007) compared to those in the control group (85/127). Negative mood regulation expectancies moderated the effects of the intervention for general distress (beta=.39). Conclusions Results were contrary to our hypotheses. Self-recording methods of standalone mobile phone interventions may heighten individuals’ awareness of their pathological thought and drinking behavior, but may be insufficient to decrease them unless combined with a more intense or face-to-face intervention. Limitations include high attrition in this study; measures to improve the response rate are discussed.
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Sisodia, Sonal, and Nimit Chowdhary. "ABIL's dilemma: to brand or not to brand in India." Emerald Emerging Markets Case Studies 1, no. 1 (January 1, 2011): 1–11. http://dx.doi.org/10.1108/20450621111128583.
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Subject area Marketing strategy, product positioning, brand building, and economies of scope. Study level/applicability MBA groups, marketing consultants and business management students of undergraduate and postgraduate level. Case overview Abhishek Industries Limited (ABIL) is an entrepreneurial venture of Mr Abhishek Batra that came into being in 1993. ABIL is the leading supplier of Terry Towels to some of world's leading retailers including Wal-Mart, JC Penney and Sears. In spite of some business fluctuations, ABIL has an impressive performance record that is reflected in its financial data. The concern, however, is that of product commoditisation, since established foreign importers and distributors prefer to sell the products under their own brand name. Consequently, even though the export margins may be lucrative; the lack of a brand presence is what bothers the senior management of the company. Given an optimistic domestic business scenario, the senior management is once again evaluating the odds to enter the domestic market using its own brand name. While some of the younger managers are optimistic and want ABIL to emerge as a brand, some senior colleagues are unsure. Expected learning outcomes The student's skills will be sharpened in working through a problem; it will help the students take an active role of a thinker, analyser, evaluator, decider and implementer; it will assist the students in learning to reason with the given quantitative as well as qualitative data; it will help the students think critically and reason effectively; it will make the students realize that the emphasis is not on solution. Rather, the process of arriving at a solution is more important. Supplementary materials Teaching note.
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Fleischer, Rasmus. "If the Song has No Price, is it Still a Commodity? : Rethinking the Commodification of Digital Music." Culture Unbound 9, no. 2 (October 31, 2017): 146–62. http://dx.doi.org/10.3384/cu.2000.1525.1792146.
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In music streaming services like Spotify, discrete pieces of music no longer has a price, as has traditionally been the case in music retailing, both analog and digital. This article discusses the theoretical and practical implications of this shift towards subscriptions, starting from a critical review of recent literature dealing with the commodification of music. The findings have a relevance that is not limited to music or digital media, but also apply more broadly on the study of commodification. At the theoretical level, the article compares two ways of defining the commodity, one structural (Marx), one situational (Appadurai, Kopytoff), arguing for the necessity of a theory that can distinguish commodities from all that which is not (yet) commodified. This is demonstrated by taking Spotify as a case, arguing that it does not sell millions of different commodities to its users, but only one: the subscription itself. This has broad economic and cultural implications, of which four are highlighted: (1) The user of Spotify has no economic incentive to limit music listening, because the price of a subscription is the same regardless of the quantity of music consumed. (2) For the same reason, Spotify as a company cannot raise its revenues by making existing customers consume more of the product, but only by raising the number of subscribers, or by raising the price of a subscription. (3) Within platforms like Spotify, it is not possible to use differential pricing of musical recordings, as has traditionally been the case in music retail. Accordingly, record companies or independent artists hence can no longer compete for listeners by offering their music at a discount. (4) Within the circuit of capital. Spotify may actually be better understood as a commodity producer than as a distributor, implying a less symbiotic relationship to the recorded music industry.
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Passamonti, Francesco, Florian H. Heidel, Rohan C. Parikh, Derek Tang, Betsy J. Lahue, Jose Alberto Nadal, Keith L. Davis, Mayank Ajmera, Arianna Kee, and Pranav Abraham. "Real-World Clinical Outcomes of Patients with Myelofibrosis Treated with Ruxolitinib: Evidence from a Multinational Medical Record Review." Blood 136, Supplement 1 (November 5, 2020): 23. http://dx.doi.org/10.1182/blood-2020-136673.
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Introduction: Myelofibrosis (MF) is a myeloproliferative neoplasm characterized by cytopenia, splenomegaly, and debilitating constitutional symptoms, such as fatigue, night sweats, weight loss, bone pain, and pruritus. Prior to the approval of the selective Janus kinase-2 (JAK2) inhibitor fedratinib for adults with Intermediate (Int)-2 or High-risk MF in 2019, ruxolitinib (RUX) was the only FDA-approved JAK inhibitor and considered standard of care; treatment (tx) options after RUX were limited. Furthermore, although about 60% of pts carry JAK2 mutations, not all patients respond to RUX. The aim of this study was to describe real-world tx patterns and determine unmet need in pts with MF treated with RUX. Methods: We report interim data collected from the UK and USA as part of a global retrospective medical chart review of adult pts with Int-1, Int-2, or High-risk MF who started RUX tx between Jan 2012 and Dec 2016 in the USA, UK, Germany, Spain, Canada, and France, Pts were required to have discontinued RUX prior to data abstraction (Apr-May 2020). Prior tx was allowed, except for allogeneic hematopoietic cell transplantation or JAK2 inhibitor trial participation. Study measures included pt and tx characteristics at RUX initiation, tx patterns, dose modifications (DMs), and clinical outcomes. The rate of DMs (decrease or increase) during the first 6 months of tx was assessed. Recommended dose (REC) as per US FDA label of RUX was determined via baseline platelet count; atypical dose (ATY) was defined as non-REC RUX. The Kaplan-Meier method was used to estimate median overall survival (OS) from start of RUX tx. Descriptive statistics are used in this report. Results: A total of 183 pts (USA: 105, UK: 78) were included in the analysis. Mean age at diagnosis was 63 years, 69% were male, and 82% were White. Most pts had primary MF (84%), Int-2-risk disease (51%), and JAK2 V617F driver mutation (67%). RUX was first-line MF tx in 100 pts (55%). Of 140 pts with baseline platelet counts, 46% started on REC RUX, and 54% started ATY RUX. Of pts who initiated ATY RUX, those with platelet count below 200 ×109/L were more likely to receive a higher dose; those with a platelet count above 200 ×109/L, were more likely to receive a lower dose. The median time from diagnosis to RUX initiation overall was 1.3 months (mos); this was shorter in pts initiated on REC RUX and longer in pts initiated on ATY RUX (Table). The median duration of tx (DoT) was higher for pts who initiated ATY RUX vs REC RUX (Table). Among pts who had a dose change (n = 61), change in platelet/neutrophil count (43%), and inadequate response (33%) were the main reasons for the first dose change; dose changes due to toxicity were more common with ATY RUX (33%) vs REC RUX (5%). Eighty-six pts (47%) had clinician-defined inadequate response or progressed on RUX. Pts starting ATY RUX (63% vs 39% for REC RUX) or having a DM within 6 mos of initiation (59% vs 49% for no DM) had a higher proportion of progressive disease (PD). Of those with inadequate response/PD, 69% discontinued RUX and 22% continued RUX due to lack of other effective tx. Twenty-eight percent of pts that started REC RUX discontinued RUX due to experiencing no additional clinical benefit after initial improvement; for pts who started ATY RUX, progression due to anemia (33%) was the main reason for discontinuation. In pts who did not discontinue RUX immediately after inadequate response/PD, median time to RUX discontinuation from inadequate response/PD was higher in pts who received ATY RUX vs REC RUX (6.1 vs 1.9 mos). Of 164 evaluable pts, 32 (20%) received post-RUX tx, most commonly hydroxyurea (28%) or lenalidomide (27%, USA only). Median OS since RUX initiation was 44.2 mos. OS was shorter in pts who started ATY vs REC RUX (40.9 vs 43.1 mos) and those who had a DM vs no DM within 6 mos (38.6 vs 43.0). The most common causes of death were PD (34%) and progression to AML (19%) - pts who received DMs within the first 6 mos were more likely to die from progression to AML (27%) vs those with no DMs (19%). Conclusions: In this population of adults with MF, we provide observational data that indicates DMs, including starting ATY RUX at higher or lower than REC doses, may be associated with poorer survival outcomes and higher rates of discontinuation due to PD. Relatively few pts received subsequent tx after discontinuing RUX, underscoring a significant unmet need for newer and more effective tx for MF. Disclosures Passamonti: Novartis: Speakers Bureau; Roche: Other: Support of parent study and funding of editorial support; BMS: Speakers Bureau. Heidel:Novartis: Consultancy, Honoraria, Research Funding. Parikh:RTI Health Solutions: Other: I am a full-time employee of RTI Health Solutions, which received research funding from BMS to perform this study. RTI Health Solutions is a unit of Research Triangle Institute, an independent, nonprofit, research organization that does work for govern. Tang:BMS: Current Employment, Current equity holder in publicly-traded company. Lahue:BMS: Consultancy; Alkemi LLC: Current Employment. Nadal:BMS: Current Employment. Davis:RTI Health Solutions: Other: I am a full-time employee of RTI Health Solutions, which received research funding from BMS to perform this study. RTI Health Solutions is a unit of Research Triangle Institute, an independent, nonprofit, research organization that does work for govern; BMS, Astra Zeneca, Vertex, Novartis, Esai, United Therapeutics, Pfizer: Research Funding. Ajmera:RTI Health Solutions: Current Employment. Kee:Bristol Myers Squibb: Current Employment. Abraham:BMS: Current Employment, Current equity holder in publicly-traded company.
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Sharman, Jeff, Shaum Kabadi, Jamyia Clark, E. Susan Amirian, and David J. Andorsky. "Treatment Patterns and Outcomes of 159 Ibrutinib-Treated MCL Patients in the United States: A Retrospective Electronic Medical Record Database and Chart Review Study." Blood 132, Supplement 1 (November 29, 2018): 4163. http://dx.doi.org/10.1182/blood-2018-99-118848.
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Abstract Introduction Ibrutinib, a Bruton's tyrosine kinase inhibitor, was approved in the U.S. for the treatment of relapsed or refractory mantle cell lymphoma (MCL) in November of 2013. However, real-world data on ibrutinib use for the treatment of MCL is limited. The purpose of this study was to examine ibrutinib use, dosages, and reasons for treatment discontinuation among MCL patients treated in a community oncology practice setting. Methods The study population consisted of adult (≥18 year old) MCL patients treated with ibrutinib between November 1, 2013 and October 31, 2016, who were not enrolled in a clinical trial and had at least 2 visits to a US Oncology Network (USON) clinic. Patients with other primary cancers were excluded. Patient data were sourced from the USON's electronic health records system, iKnowMed (iKM)™. The structured iKM database provided information on demographics and clinical and treatment characteristics. Manual chart review was used to confirm ibrutinib treatment patterns. Duration of ibrutinib therapy (DOT), overall survival (OS), and progression-free survival (PFS) from systemic treatment initiation were estimated using Kaplan-Meier methods. Events were defined as death in the OS analysis, and progression or death in the PFS analysis. Patients were censored if their treatment was ongoing for DOT. Censors for OS and PFS were patients lost to follow up or those who did not experience a failure event within the study period. Results 159 eligible MCL patients were identified through iKM. The majority of patients were Caucasian (n=141, 88.7%), male (n=121, 76.1%), and diagnosed with Stage IV disease (n=117, 73.6%). Median follow-up for the population was 16.1 months. Approximately 7.5% (n=12) of patients received ibrutinib as first-line therapy (1L), compared to 54.1% (n=86) in 2L and 38.4% (n=61) in 3L or beyond. Median ibrutinib dose at initiation was 560mg (range: 140-700). During ibrutinib treatment, 16.4% (n=26) of patients experienced a dose reduction. Dose holds occurred in 30.2% (n=48), 66.7% (n=32) due toxicities. The overall discontinuation rate was 83.6% The primary reason for discontinuation was disease progression (n=46, 34.6%) followed by toxicities (n=34, 25.6%). Median DOT was higher for patients initiating treatment in 3L+ (14.9: 95% CI 8.8-17.1) compared to other lines. Median PFS was 19.6 (95% CI: 16.5-24.3) for the overall population and median OS was 25.8 months (95% CI: 19.9-not reached). Conclusions Our real-world findings on survival are consistent with those from clinical trials on ibrutinib in relapsed/refractory MCL, although our observed discontinuation rate (~84%) was higher than that of the trial (~58%), which had a similar median follow-up time (16.1 months vs. 15.3 months, respectively). Our findings provide additional data on MCL treatment patterns and patient outcomes in clinical practice. Disclosures Sharman: Acerta: Consultancy, Research Funding; Pharmacyclics, an AbbVie Company: Consultancy, Research Funding. Kabadi:AstraZeneca: Employment. Clark:McKesson Specialty Health: Employment, Equity Ownership. Amirian:McKesson Specialty Health: Employment. Andorsky:Celgene: Research Funding; CTI BioPharma: Consultancy, Research Funding; AstraZeneca: Consultancy; Genentech: Consultancy.
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Donnellan, William, Tao Xu, Esprit Ma, Huan Jin, Melissa Montez, Michelle Choi, Grace Ku, Raj Anand Rajeswaran, Giridharan Ramsingh, and Evelyn M. Flahavan. "Use of Venetoclax (VEN) and Hypomethylating Agents (HMA) in Newly Diagnosed Acute Myeloid Leukemia (AML) in the United States (US) - Real World (RW) Response, Treatment Duration, Dose and Schedule Modifications." Blood 136, Supplement 1 (November 5, 2020): 11–12. http://dx.doi.org/10.1182/blood-2020-134820.
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Introduction: VEN is approved conditionally in the US in combination with HMA (azacitidine or decitabine) or low-dose cytarabine in newly-diagnosed AML patients (pts) ineligible for intensive chemotherapy due to age (≥75 years) or comorbidities. The Phase Ib clinical trial NCT02203773 (DiNardo et al. Blood 2019) and Phase III VIALE-A trial (NCT02993523; DiNardo et al. EHA 2020), demonstrated the clinical benefit of VEN+HMA, but frequent VEN dose modifications were observed due to the occurrence of cytopenias. This study aims to evaluate RW VEN+HMA response, treatment (Tx) duration, dose and schedule modifications in newly-diagnosed pts with AML treated predominantly in the community setting. Methods: This is a retrospective cohort study using the Flatiron Health electronic health record (EHR)-derived de-identified database; a nationwide database comprising patient-level structured (demographics, labs, visits and Tx administered in-network) and unstructured data (pathology reports, hospital discharges and physician notes, out-of-network and oral Tx), curated via technology-enabled abstraction (Flahavan et al. EHA 2020). Pts newly diagnosed with AML, age ≥18 years, and who initiated VEN+HMA within 30 days of diagnosis from June 1, 2018 to November 30, 2019 were evaluated. Additional variables related to VEN Tx were abstracted manually from EHR unstructured data: including Tx start/end dates, dose holds, schedule changes, dose changes (in mg) or discontinuation (d/c), and the reasons for these interruptions. Response to Tx was a measured "blast clearance" ≤5% from bone-marrow (BM) biopsy (unstructured) or peripheral blood (PB) (structured) data. RW complete response (CR)/CR with partial hematologic recovery (rwCR/CRh) was derived as ≤5% BM+PB blasts with partial hematologic count recovery within 14 days. Kaplan-Meier analyses were conducted to examine Tx duration of VEN+HMA Tx, with follow-up (f/u) to date of Tx d/c on VEN or censoring at the last EHR activity before data cut-off (February 29, 2020). VEN treatment cycles, derived based on the HMA dosing (28 days per cycle), were evaluated in a subset of pts with complete structured data on HMA administrations. Dosing intensity was calculated as dosed days as a percentage of total days from start to end of therapy or end of f/u. Results: Overall 145 VEN+HMA pts (n=89, 61.4% received azacitidine combination) were included, median age at diagnosis was 77 years; 6% had Eastern Cooperative Oncology Group (ECOG) performance status ≥3; 9% had therapy-related AML (t-AML) and 40% had AML secondary to antecedent hematologic disorder (s-AML). Of the 95 pts with evaluable response data during the f/u period, 67 (71%) had BM blast clearance, and 47 (49%) had rwCR/CRh. At a median f/u of 4.3 months (range 0.6-17.7), 65 pts (45%) had not d/c VEN Tx at data cut-off. Data were not mature for overall survival analyses. The subset of 45 pts with complete structured HMA data that were examined for VEN Tx scheduling was similar to the overall cohort; however, median f/u was slightly lower at 3.0 months (range 0.6-16.7). VEN initiation was not always concurrent with HMA initiation; 50% started within 2 days and 75% within 9 days of HMA initiation. Twenty-six pts (58%) had not d/c VEN at end of f/u; a median of 3 cycles was observed for all-comers in this time (range 1-15). Dose and schedule modifications (not mutually exclusive) occurring in cycles 1-3 included VEN dose changes (67%), d/c (36%), in-cycle dose interruption (24%) and cycle delay (22%). The most commonly cited reason for dose and schedule modifications was toxicity. Mean VEN dosing intensity overall was 77%; 86% prior to dose and schedule modification and 90% prior to dose change. Conclusions: This study is the largest RW data analysis of pts with AML treated with VEN+HMA to date. This RW cohort treated predominantly in the community setting differed from the VEN+HMA clinical trial: pts were older, had worse ECOG performance status and a higher proportion had s-AML. Despite this, in the evaluable RW VEN+HMA pts, high response was observed. The RW Tx duration analyses were limited by short f/u and RW VEN initiation was not always concurrent with HMA. Dose modifications were common early in Tx course. Further characterization of this cohort will have additional f/u and analyses on the timing of VEN dose modifications in relation to cytopenia management and drug-drug interactions. Disclosures Donnellan: PTC Therapeutics: Consultancy, Research Funding; Ryvu Therapeutics: Research Funding; Seattle Genetics: Consultancy, Research Funding; Takeda: Research Funding; TCR2 Therapeutics: Research Funding; AstraZeneca: Research Funding; Astex Pharmaceuticals: Research Funding; Amgen: Consultancy; Abbvie: Consultancy, Research Funding; Bellicum Pharmaceuticals: Research Funding; Bristol-Myers Squibb: Research Funding; Celgene: Research Funding; Celularity: Research Funding; CTI Biopharma: Research Funding; Daiichi Sankyo: Research Funding; Forma Therapeutics: Research Funding; Forty Seven: Research Funding; Genentech: Research Funding; H3 Biomedicine: Research Funding; Incyte: Research Funding; Janssen: Research Funding; Karyopharm Therapeutics: Research Funding; Kite Pharma/Gilead: Research Funding; MedImmune: Research Funding; Pfizer: Research Funding. Xu:F. Hoffmann-La Roche Ltd: Current Employment, Other: All authors received support for third party writing assistance, furnished by Scott Battle, PhD, provided by F. Hoffmann-La Roche, Basel, Switzerland.. Ma:Genentech, Inc.: Current Employment, Current equity holder in publicly-traded company. Jin:Genentech, Inc.: Current Employment, Current equity holder in publicly-traded company. Montez:F. Hoffmann-La Roche: Current equity holder in publicly-traded company; Genentech, Inc.: Current Employment. Choi:AbbVie: Current Employment, Current equity holder in publicly-traded company. Ku:Genentech, Inc.: Current Employment; F. Hoffmann-La Roche: Current Employment, Current equity holder in publicly-traded company. Rajeswaran:F. Hoffmann-La Roche: Current Employment, Current equity holder in publicly-traded company, Divested equity in a private or publicly-traded company in the past 24 months. Ramsingh:NEKTAR: Current equity holder in publicly-traded company; F. Hoffmann-La Roche: Current equity holder in publicly-traded company; Exelixis: Current equity holder in publicly-traded company, Divested equity in a private or publicly-traded company in the past 24 months, Ended employment in the past 24 months; Genentech, Inc.: Current Employment. Flahavan:Roche Products Ltd.: Current Employment; F. Hoffmann-La Roche: Current equity holder in publicly-traded company.
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Yoon, Jenny Sumin, Ross Alistair Henderson, Merit Hanna, Eileen Merriman, Anna Elinder, Gilly Selman, Leone Kennedy, and Henry Chan. "Conservative Management of Hemochromatosis without Long-Term Maintenance Venesections in Patients with Moderate Iron Burden." Blood 136, Supplement 1 (November 5, 2020): 44–45. http://dx.doi.org/10.1182/blood-2020-136534.
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Introduction Hereditary hemochromatosis with serum ferritin (SF) greater than 1000µg/L at diagnosis has been associated with symptoms and end-organ damage from iron overload. However, clinical manifestation of iron overload is much less frequently observed when only a moderate iron overload of SF 1000µg/L or less is present at diagnosis. Data to guide optimal management with venesection of patients with moderate overload is currently limited and many clinical guidelines do not distinguish the degree of iron overload at presentation in their management recommendations. Since 2013, patients with hemochromatosis who present to our center with a SF of less than 1000µg/L without end organ dysfunction have been venesected to a target of <100µg/L before discharge without maintenance venesections. Patients and their primary care clinicians are advised to re-refer if iron reaccumulates to SF ≥500µg/L or if end-organ damage occurs. Here we present our experience in this practical approach in managing patients with moderate iron overload. Method Patients referred to our center for management of HFE mutated haemochromatosis between 1 January 2013 and 31 December 2017 were included (recent cohort). These patients were discharged after initial iron reduction. A second cohort of patients managed between 1 December 2001 to 31 December 2003 was also included for comparison (historic cohort). This historic cohort initially received maintenance venesections before being discharged in 2013, following a change in our policy. Patients were identified using the departmental electronic database and data was extracted from the patient electronic record. Time to re-referral was measured from the date of last venesection prior to discharge to the date of re-commencing venesection or referral to other services for iron related complications. Patients who had not been re-referred for resuming venesection or to other services for iron-overload complications were censored on 1 July 2020. Result A total of 109 patients were included for analysis (historic cohort: 54; recent cohort: 55). The median age was 45 (range: 45 - 81), and 74 (67.9%) patients were male. Homozygote C282Y mutation was the most common genotype (74.3%), followed by compound heterozygotes (C282Y/H65D or C282Y/S63C, 23.9%). The median SF prior to venesection was 539µg/L (range: 146 - 968), and a median of 8 venesections were required initially to achieve a SF of <100µg/L (range: 1-27). There was no significant difference between the two cohorts in baseline patient characteristics apart from gender, where the proportion of male patients was lower in the historic cohort (56% vs 80%, p = 0.006). The median time to re-referral was 151.5 months and there was no difference between the two cohorts (p = 0.507). The estimated rate of re-referral at 5 and 10 year was 36% and 44%, respectively. Compound heterozygotes had a lower rate of re-referral compared to homozygotes C282Y, albeit not statistically significant (p = 0.069). Age, gender, presenting SF (<500µg/L vs >500µg/L), and number of initial venesections needed for de-ironing (quartiles) were not predictive of re-referral. Conclusion Hereditary hemochromatosis patients who present with only a moderate iron overload at the time of diagnosis could be discharged to primary care following initial iron reduction. A significant proportion of patients do not accumulate significant levels of iron following cessation of venesection. The rate and pattern of iron re-accumulation was similar irrespective of whether patients received a period of maintenance venesection prior to discharge. Figure 1 Disclosures Chan: Amgen: Other: TRAVEL, ACCOMODATIONS, EXPENSES (paid by any for-profit health care company); Celgene: Other: TRAVEL, ACCOMODATIONS, EXPENSES (paid by any for-profit health care company); Roche: Other: TRAVEL, ACCOMODATIONS, EXPENSES (paid by any for-profit health care company); AbbVie: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees, Other: TRAVEL, ACCOMODATIONS, EXPENSES (paid by any for-profit health care company), Research Funding, Speakers Bureau.
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Zagadailov, Erin, Audra Boscoe, Viviana Garcia-Horton, Sherry Shi, Shuqian Liu, Lizheng Shi, and Dendy Macaulay. "Mortality Among Veterans with a Diagnosis of Pyruvate Kinase (PK) Deficiency: A Real-World Study Using US Veterans Health Administration Data." Blood 136, Supplement 1 (November 5, 2020): 24–25. http://dx.doi.org/10.1182/blood-2020-136693.
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Background: Pyruvate kinase (PK) deficiency is a rare, inherited disorder caused by autosomal recessive mutations in the PKLR gene, whereby a glycolytic defect causes reduced adenosine triphosphate levels and leads to hemolytic anemia. Patients with PK deficiency can experience serious complications associated with the disease and its treatment, including osteoporosis, pulmonary hypertension, sepsis, iron overload, and liver cirrhosis. The current standard of care for PK deficiency is supportive, including blood transfusions, splenectomy, iron chelation therapy and/or interventions for other disease-related morbidity. There is no approved therapy for this condition. Identifying PK deficiency in real-world data is challenging due to a lack of diagnosis codes and treatments that are specific to PK deficiency. As a result, population-based studies of PK deficiency using claims or electronic health record databases are limited. In addition, data on mortality in this patient population are lacking and limited to a few individual case reports. This study aimed to identify patients with a PK deficiency diagnosis as documented by physicians and to compare their mortality to an age- and gender-matched cohort of individuals without PK deficiency. Methods: Patients with ≥ 1 diagnosis code related to PK deficiency (i.e., anemia due to disorders of glycolytic enzymes [International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) D55.2], other hemolytic anemias due to enzyme deficiency [ICD-9-CM 282.3], or unspecified hereditary hemolytic anemia [ICD-9-CM 282.9, ICD-10-CM D58.9]) between January 1995 and July 2019 were selected from the US Veterans Health Administration (VHA) database. To be considered for inclusion, physicians' notes were required to contain the words "pyruvate", "kinase", and "deficiency." A manual review of these physicians' notes was performed to identify patients with a physician-documented diagnosis of PK deficiency (PK deficiency cohort). The index date for the PK deficiency cohort was defined as the date of the first medical record with a diagnosis code related to PK deficiency. Each patient in the PK deficiency cohort was matched 1:5 by age at index, sex, and index year (± 1 year) to patients from the general VHA population with no diagnosis codes related to PK deficiency (non-PK deficiency cohort). The index date for the non-PK deficiency cohort was defined as a random visit date during their match's index year. Survival time from the index date was compared between the PK deficiency cohort and their non-PK deficiency cohort matches using a univariate Cox proportional hazards model with robust standard error estimation. Results: A total of 18 patients met inclusion criteria for the PK deficiency cohort and were matched to 90 individuals in the non-PK deficiency cohort. Baseline characteristics for both cohorts are shown in the Table. For both cohorts, the mean age at index was 57 years and 94% of patients were male; 83-85% were white and the mean Charlson Comorbidity Index score was 0.4-0.5 (no significant differences between cohorts). Imbalances remained between the two cohorts with regard to region and body mass index. The median follow-up was 6.0 years for the PK deficiency cohort and 8.0 years for the non-PK deficiency cohort. Over the follow-up period, there were 9 (50%) observed deaths in the PK deficiency cohort and 28 (31%) observed deaths in the non-PK deficiency cohort. The median time until death was 10.9 years for the PK deficiency cohort and 17.1 years for the non-PK deficiency cohort; the Kaplan-Meier curves for both cohorts are shown in the Figure. Patients in the non-PK deficiency cohort had a significantly longer time to death than the PK deficiency cohort (hazard ratio: 2.3; p = 0.0306); 10 years after index, 42% of patients in the PK deficiency cohort had died compared with 28% of those in the non-PK deficiency cohort. Conclusions: The results of this study suggest that patients with PK deficiency may be at an increased risk of mortality. Further research to understand cause of death in this population is warranted, as is the replication of this study using larger sample sizes and other real-world data sources that better represent females and the pediatric and adolescent PK deficiency age groups. Disclosures Zagadailov: Agios Pharmaceuticals: Current Employment, Current equity holder in publicly-traded company. Boscoe:Agios Pharmaceuticals: Current Employment, Current equity holder in private company. Garcia-Horton:Agios Pharmaceuticals: Consultancy; Analysis Group, Inc.: Current Employment. Shi:Agios Pharmaceuticals: Consultancy; Analysis Group, Inc.: Current Employment. Liu:Analysis Group, Inc.: Consultancy. Shi:Analysis Group, Inc.: Consultancy. Macaulay:Agios Pharmaceuticals: Consultancy; Analysis Group, Inc.: Current Employment.
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Asaolu, T. O., O. Oyesanmi, P. O. Oladele, and A. M. Oladoyin. "Privatisation and commercialisation in Nigeria: Implications and prospects for good governance." South African Journal of Business Management 36, no. 3 (September 30, 2005): 65–74. http://dx.doi.org/10.4102/sajbm.v36i3.636.
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The privatisation and commercialisation Decree No. 25 of 1988 (amended 1999) which provided the legal backing for the Technical Committee of Privatisation and Commercialisation (TCPC), began the major paradigm shift in the conceptualisation of public enterprises in Nigeria. The paper primarily examined the privatisation exercise in Nigeria since 1988. It also attempted to provide measures that will simplify the complex process of privatisation with the hope of lessening the probability of crisis. The paper considered the impact of privatisation on performance of privatised companies, changes in employment and the increase in the prices of commodities of the enterprises vis-à-vis their gross income towards the overall good governance of the Nigerian society.The data for the paper were mainly secondary; and were drawn from the financial statements of companies in the stock Exchange and other stock Exchange reports, Central Bank Bulletins, publications and published reports of the Bureau of Public Enterprises. Newspapers and publication of the Federal Office of Statistics are other sources. The data were analysed by trend analysis using absolute figures, percentages and ratios based on the past record on privatisation in Nigeria.However, the study discovered that only a few successful enterprises, Flour Mills, African Petroleum, National oil and Chemical Marketing Company Limited (NOLCHEM) were partially privatised. The commercialisation of enterprises such as National Electric Power Authority (NEPA), Nigeria Telecommunications (NITEL) and Nigerian National Petroleum Corporation (NNPC), hardly showed any significant improvement in their operational and economic performance.The papers showed that employment levels were affected by privatisation. Between 1989 and 1993, the public sector accounted for more job losses than privatised companies. When privatised firms employment rose, public and private sectors still had lower employment levels. The sharp increase in prices between 1992 and 1994 did not create a sufficient increase in gross earnings for 1994. The results revealed that a reduction in public control would have an effect (at least in the short term) on prices. Profits increase but the extent to which this increase can attributed to reduction of government controls is not clear. Three banks witnessed sharp increase in investments and profitability immediately after privatisation, and there was a slight decrease before another increase. Results showed that privatisation has improved company performance, especially in the efficiency of resources utilisation. Higher profit to capital employed ratios has been witnessed since privatisation. Debt/Total Asset ratios have not been affected in any adverse way. Results from the study also revealed that price increases in excess of 200% occurred immediately after privatisation. This perhaps has an effect on the profits of the companies (especially those that still maintained monopoly status for a while.However, one fact is clear: the heydays of public enterprises in Nigeria are gone for good. It was on this note that the study concluded that privatisation is the appropriate economic recipe to achieve the much desired human development and good governance.
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Wilson, Amanda, Florence Joly, Gandarvaka Miles, Kammy Kuang, and Huy P. Pham. "Longitudinal Analysis of Anemia Severity, Treatment and Healthcare Resource Utilization Among Patients with Primary Cold Agglutinin Disease in a Large US Database." Blood 136, Supplement 1 (November 5, 2020): 48–49. http://dx.doi.org/10.1182/blood-2020-139637.
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Introduction Cold agglutinin disease (CAD) is a serious and rare autoimmune hemolytic anemia driven by cold agglutinin autoantibodies, which bind to red blood cells and activate the classical complement system to initiate hemolysis and anemia (Berentsen S. Hematology Am Soc Hematol Educ Program 2016). There is limited evidence on the individual and societal impact of CAD. A retrospective study of 27 patients in a US healthcare institute demonstrated fluctuations in severity of anemia over the course of the disease, and significant utilization of healthcare resources (Mullins M et al. Blood Adv 2017). The objective of this study was to understand the long-term characteristics and disease burden in patients with primary CAD from a large US Electronic Health Record (EHR) database. Methods This retrospective observational cohort study included adult patients from the Optum© EHR database between January 1, 2007 and September 30, 2019 who had ≥1 medical encounter with an autoimmune hemolytic anemia-related diagnosis code, ≥3 documentations (on different dates) of CAD and ≥1 hemoglobin (Hb) value <12 g/dL. The index date was defined as the first mention of CAD; all patients were required to have a 12-month baseline period prior to this. To limit the study to patients with primary CAD, patients were excluded if they had ≥1 medical encounter with mycoplasma, cytomegalovirus and Epstein-Barr at the index date, or ≥1 medical encounter with lymphoma, MALT lymphoma, chronic lymphoid leukemia, Waldenstrom macroglobulinemia or myeloma during the baseline period. Anemia severity (defined as the lowest Hb value in each study period), utilization of CAD-related therapies, blood transfusions and all-cause healthcare resource utilization (HCRU) were analyzed at baseline and at 6-month follow-up intervals. Although no treatment is approved in CAD, corticosteroids, immunoglobulin, rituximab, immunosuppressants, antineoplastic and biologics were considered as CAD-related therapies to reflect usual practice. Results were stratified by anemia severity category (severe [Hb <8 g/dL], moderate [Hb 8.0-10 g/dL], mild [Hb 10.1-<12 g/dL] or no anemia [Hb ≥12 g/dL]) during each follow-up interval. Severe hemolysis was defined as elevated LDH and/or elevated bilirubin. Results A total of 610 adults with primary CAD were included in the study (mean [SD] age 67.9 [14.5] years, 65.4% female). The mean (SD) duration of follow-up was 48.1 (30.6) months; 90% of patients had ≥12 months of follow-up. At baseline (0-6 months prior to first mention of CAD), 47.6% of patients had elevated bilirubin levels and 63.1% had elevated lactate dehydrogenase (LDH) levels. A high proportion of patients with CAD experienced severe or moderate anemia at baseline and in the 6 months post-baseline; this proportion tended to be lower, but still substantial, throughout the follow-up period (Table). Frequency of moderate/severe anemia or severe hemolysis events per patient year was also higher in the first 6 months: 5.70 (95% CI: 5.00, 6.49), compared with 2.92 (2.30, 3.71) and 2.43 (1.89, 3.11) events at months 19-24 and months 31-36, respectively. The median number of CAD-related treatments per patient was high in all CAD patients at 6 months and remained high during the follow-up period (Table). The most common therapies used (excluding blood transfusion) were corticosteroids, antineoplastics and biologics. The mean number of blood transfusions per patient was higher in the severe anemia category at all follow-up intervals. The number of hospitalizations and emergency room visits were generally higher in patients with increased anemia severity; outpatient visits were high in all CAD patients and remained so over the study period (Table). Conclusion This observational cohort study followed a large sample of primary CAD patients with a 4-year mean follow-up. The results highlight the long-term substantial burden of CAD on patients and healthcare systems, which generally increased with higher severity of anemia. Three years after diagnosis, the number of moderate to severe anemia or hemolysis events remained high in CAD patients, despite off-label CAD management. The need for blood transfusions was still substantial in the severe anemic population 3 years after diagnosis. This longitudinal analysis illustrates the unmet medical needs in primary CAD. Disclosures Wilson: Sanofi: Current Employment, Current equity holder in publicly-traded company. Joly:Sanofi: Current Employment, Current equity holder in publicly-traded company. Miles:Aetion Inc.: Current Employment, Other: Employee of software company that received funding from Sanofi for the current study. Kuang:Aetion Inc.: Current Employment, Other: Employee of software company that received funding from Sanofi for the current study. Pham:Sanofi: Consultancy; Alexion: Other: Speaker.
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Lin, Huamao Mark, Keith L. Davis, James A. Kaye, Katarina Luptakova, Lu Gao, Saurabh Nagar, Brian Seal, and Mohamad Mohty. "Real-World Treatment Patterns and Health Care Resource Utilization in Relapsed or Refractory Multiple Myeloma: Evidence from a Cohort Review in France." Blood 128, no. 22 (December 2, 2016): 5945. http://dx.doi.org/10.1182/blood.v128.22.5945.5945.
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Abstract INTRODUCTION: Despite the introduction of numerous novel agents and treatment strategies leading to improved response rates and overall survival, virtually all patients with multiple myeloma (MM) eventually relapse. While relapsed and/or refractory multiple myeloma (RRMM) remains an area of unmet need, little data have been generated describing typical treatment patterns and resource utilization in these patients. To help address this information gap, we analyzed data from a cohort of RRMM patients in France. METHODS: A retrospective medical record review was conducted in 200 patients with RRMM in France. Patients were selected (based on randomly generated first letter of last name) from the caseloads of 40 hematology/oncology providers across France practicing mainly in academic hospitals. Inclusion criteria were: ≥18 years of age at initial MM diagnosis; first determined to have RRMM between January 1, 2009 and December 31, 2011, where RRMM was defined by (1) first-line (induction) regimen of chemotherapy with or without stem cell transplant (SCT) and with or without other post-induction/SCT therapy and (2) disease progression while on or at any time after completion of first-line therapy. Baseline cytogenetic risk was defined as follows: high-risk: cytogenetic abnormalities del(17p), t(4:14), or t(14;16); unknown/unassessed risk: patients for whom cytogenetics were unavailable or unassessed; or standard-risk: all patients with known cytogenetics not classified as high-risk. Patients were retrospectively assessed on second- and third-line treatment regimens received, treatment duration and reasons for discontinuation, and subsequent health care utilization from date of first relapse (study index date). All analyses were descriptive. RESULTS: Demographic and clinical characteristics are presented in Table 1. Altogether 55 high-risk and 113 standard-risk patients were selected; risk category was unknown for 32 patients. Among the 200 patients studied, 192 (96%) received ≥1 additional line of systemic chemotherapy after first relapse; 114 patients (57%) received ≥2 additional lines of systemic therapy (i.e., at least second- and third-line therapy). The most common second-line regimen was lenalidomide + dexamethasone (54%), followed by bortezomib + dexamethasone with or without a third agent (23%). Median duration of second-line treatment was 9 cycles over 9.4 months. Most patients (92%) discontinued second-line treatment, most commonly due to disease progression (37%), to reaching complete clinical response with no additional benefit expected (33%), to lack/loss of response (13%), or to toxicities/adverse events (8%). Among the 114 patients receiving a third-line treatment, regimens were more varied; bortezomib + dexamethasone with or without other third agents was the most common third-line regimen (27%). Median third-line duration (across all regimens) was 6 cycles over 5.9 months. The leading reason for third-line treatment discontinuation was disease progression (42%), followed by attainment of complete response with no addition benefit expected (21%). During the follow-up period from RRMM diagnosis until death or last medical record, 35% of patients had ≥1 hospitalization, with high-risk patients having a higher hospitalization incidence than standard-risk patients (34 vs. 15 admissions per 100 person-years; p<0.05); a similar disparity was observed for emergency department utilization (25 vs. 15 visits per 100 person-years; p<0.05). Leading clinical burdens included bone pain (58%), fatigue/weakness (75%), impairment of daily activities (59%), anemia (55%), thrombocytopenia (44%), and neutropenia (40%). CONCLUSIONS: Lenalidomide + dexamethasone was the most commonly observed second-line regimen in this medical record review. Second-line treatment duration was generally less than a year, which indicates an unmet need in these patients, particularly in light of the primary reasons cited for unplanned discontinuation (disease progression, loss of response, no perceived additional benefit, and toxicities). Hospitalizations and emergency department visits were common among these patients after first relapse, indicating a potentially high cost burden of disease, particularly for patients with high-risk cytogenetic abnormalities in whom health care utilization was generally higher than for patients with standard-risk disease. Disclosures Lin: Takeda: Employment. Davis:Takeda: Research Funding. Kaye:Takeda: Research Funding. Luptakova:Takeda Oncology: Employment. Gao:Takeda: Employment. Nagar:Takeda: Research Funding. Seal:Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment, Equity Ownership.
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Shapiro, Amy, Ateefa Chaudhury, Nisha Jain, Elisa Tsao, Chris Barnowski, Jing Feng, and Doris Quon. "Real-World Data on the Use of rFIXFc in Subjects With Hemophilia B for Up to 3.7 Years Demonstrates Improved Bleed Control and Adherence With Reduced Treatment Burden." Blood 132, Supplement 1 (November 29, 2018): 2493. http://dx.doi.org/10.1182/blood-2018-99-116909.
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Abstract Introduction: Recombinant factor IX Fc fusion protein (rFIXFc) was the first extended half-life FIX product approved in the United States to treat children and adults with hemophilia B. Long-term data from clinical trials have demonstrated the safety and efficacy of rFIXFc as well as an extended dosing interval (once weekly or every 10‒14 days based on individual needs); however, real-world data are limited (Wang et al. Haemophilia, 2018; Buckley et al. AMCP NEXUS, 2015). We therefore performed a retrospective chart review to further understand the clinical experience and outcomes associated with real-world treatment of hemophilia B with rFIXFc. Methods: This retrospective chart review is being conducted at 6 sites across different regions of the United States and aims to include 70 patient charts. Data entry for 43 patient charts has been completed to date (cutoff: June 29, 2018). Data collection is ongoing. Inclusion criteria were diagnosis of hemophilia B and receipt of rFIXFc for ≥6 months. Subjects with other coagulation disorders or any record of positive FIX inhibitor titers were excluded. De-identified subject-level data were transcribed onto anonymous electronic case report forms. Endpoints included changes in FIX therapy dosing interval, factor consumption, bleed control, and patient adherence before and after rFIXFc initiation. Descriptive statistics were used to summarize the results. Results: For the 43 charts available for analysis, the duration of follow-up receiving rFIXFc ranged from 0.5 to 3.7 years. Of these, 58% of subjects (25/43) were >18 years of age, 77% (33/43) were of white race, and 51% (22/43) had severe hemophilia B (Table 1). The most common genotype was missense, occurring in 63% of subjects (27/43). Among subjects with comorbidity, 37% reported hemophilic arthropathy (16/43) and 28% had hepatitis C (12/43). All 22 subjects with severe hemophilia B were treated with rFIXFc prophylactically compared with 9/15 moderate and 3/6 mild cases. From the data collected thus far, 94% of prophylaxis subjects were on a dosing interval of weekly or longer (every 7 days, n=20; every 10 days, n=3; and every 14 days, n=9). The total weekly dose before and after switching to rFIXFc prophylaxis were available for 20 subjects. Of the 12 adults (9 severe, 2 moderate, and 1 mild), the median weekly factor consumption decreased from 111 IU/kg to 52.5 IU/kg. A similar pattern was observed for subjects who were 12-18 years of age (n=4). For subjects <12 years of age (n=4), 2 had reduced weekly consumption after switching to rFIXFc, whereas 2 (on plasma-derived product pre-rFIXFc) had an increase in weekly consumption. The annualized bleeding rates (ABRs), annualized spontaneous bleeding rates (AsBRs), and annualized joint bleeding rates (AjBRs) were available for 17 subjects treated with prophylaxis regimens pre- and post-rFIXFc (Table 2). Of these subjects, 11 had severe, 5 had moderate, and 1 had mild hemophilia B. Among 11 subjects with severe hemophilia B, median (interquartile range) ABRs decreased from 8.2 (4.4‒11.5) to 2.3 (0.6‒10.2), AsBR from 1.2 (0‒9.7) to 0.3 (0‒8.7), and AjBR from 2.3 (1.4‒8.2) to 0.7 (0‒6.9) before and after rFIXFc treatment. Subjects with moderate disease had a similar pattern (Table 2). The most common reason for switching to rFIXFc was to reduce the burden associated with therapy (21/43, 49%). No rationale for switching was documented in 40% (17/43) of subjects, and 7% (3/43) switched due to lack of efficacy with previous treatment. The other reasons, including difficult venous access, lack of adherence, and failure to reach desired trough were mentioned by <5% of subjects. No subject reported adherence issues while on rFIXFc. Conclusions: This real-world study of rFIXFc demonstrates improved bleed control, reduced overall consumption, and reduced frequency of injection for subjects with moderate and severe hemophilia B. The data also show that rFIXFc provides an opportunity to tailor dosing and improve adherence. These results echo the findings of the pivotal trials and add to the pool of evidence supporting rFIXFc in the treatment of hemophilia B. These data also reflect the use of rFIXFc for mild hemophilia patients in the real-world setting. Disclosures Shapiro: Kedrion Biopharma: Consultancy, Research Funding; Novo Nordisk: Membership on an entity's Board of Directors or advisory committees, Research Funding; Bioverativ, a Sanofi Company: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Prometic Life Sciences: Consultancy, Research Funding; Shire: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Genetech: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Bayer Healthcare: Other: International Network of Pediatric Hemophilia; BioMarin: Research Funding; Bio Products Laboratory: Consultancy; Octapharma: Research Funding; OPKO: Research Funding; Sangamo Biosciences: Consultancy; Daiichi Sankyo: Research Funding. Chaudhury:Bioverativ, a Sanofi Company: Consultancy, Research Funding; Bayer: Membership on an entity's Board of Directors or advisory committees. Jain:Bioverativ: Employment. Tsao:Bioverativ: Employment. Barnowski:Bioverativ, a Sanofi Company: Employment. Feng:Bioverativ: Employment. Quon:Shire: Speakers Bureau; Genetech: Consultancy, Speakers Bureau; NovoNordisk: Consultancy, Speakers Bureau; Bayer: Consultancy; Octapharma: Consultancy; Bioverativ, a Sanofi Company: Speakers Bureau.
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Сhubаiеvskуi, Vitаliу, Svitlаnа Rzаiеvа, and Dmуtrо Rzаiеv. "MОDЕLLING OF INFОRMАTIОN АND АNАLУTIСАL АССОUNTING SУSTЕM ОF ЕMPLОУЕЕS’ WОRKING TIME." Technical Sciences and Technologies, no. 2(16) (2019): 79–85. http://dx.doi.org/10.25140/2411-5363-2019-2(16)-79-85.
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Urgency of the research. This article describes the technology development and modeling of the information-analytical accounting system of employees’ working time. The system makes it possible to generate reports on all necessary parameters: the period, the user remainder of the time, the group name and more tasks. It enterprises employees to have the opportunity to keep time tracking, view how much time was spent per month, week, year, etc. for each task. Target setting. The problem of working time acccounting is to determine the amount of wages correctly and adequately. It is necessary to keep records of the completed work and actually spent time on each task. For each worker to be easy to understand it is necessary to design such system, which would allow to easily record the data about the amount of work completed and time spent. Actual scientific researches and issues analysis. Recently, a lot of literature has been published which is related to the consideration of the theoretical foundations of building information technology in the management of labor motivation, a description of the compilation and maintenance of a working time accounting table. However, the literature, which would cover the development and modeling of the information and analytical accounting system of employees'working time is absent. Uninvestigated parts of general matters defining. The information-analytical accounting system of the employees’ working time allows to solve such problems as: automatic registration of the arrival time (the beginning of task completion) and leaving time (termination of task completion), the possibility of forming a report about each employee; formation of reports on different parameters; fair payroll; simplified accounting and planning of labour complexity. The purpose of the article is to analyze the peculiarities of the modeling of the information-analytical system of accounting of working time of the enterprise employees. The presentation of the main material. The general definition of the working time accounting system has been given. The basic requirements have been formulated and the definition of the modes of operation of the information-analytical system of accounting of the working hours of the employees of the enterprise has been given. The stages of the development have been analyzed and the information-analytical system has been modeled. The web application of this system has been developed. Conclusions and suggestions. This information-analytical system of accounting of working time of employees of the enterprise was introduced into the activity of a limited liability company located in Kyiv (in view of the confidentiality, the authors do not disclose the name of the enterprise). Employees of the enterprise have an opportunity to get information about the time spent working conveniently and quickly.
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Shang, Aijing, Imi Faghmous, Dan Drozd, and Pablo Katz. "COMMODORE Cohort: A Novel, Real-World, Noninterventional Cohort Study Using a Patient-Centered Approach to Evaluate the Safety and Effectiveness of C5 Inhibitors in Patients with Paroxysmal Nocturnal Hemoglobinuria." Blood 136, Supplement 1 (November 5, 2020): 31–32. http://dx.doi.org/10.1182/blood-2020-137454.
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Background Paroxysmal nocturnal hemoglobinuria (PNH) is a life-threatening disease of dysregulated complement activation characterized by hemolysis and thrombosis and is associated with bone marrow failure. PNH can also impair patient quality of life and negatively impact the ability to work. PNH is a rare disease with an estimated incidence of 1 to 1.5 cases per million people globally. Inhibition of complement component 5 (C5) has been shown to reduce intravascular hemolysis, stabilize hemoglobin, reduce the need for blood transfusion, and improve quality of life for patients with PNH. C5 inhibitors eculizumab and ravulizumab are approved in the United States and other countries for treatment of PNH, yet there are limited data on the real-world use of these agents, especially in populations not eligible to participate in registrational clinical trials. Here we describe the COMMODORE Cohort study, which will use a novel patient-centered study design to collect both retrospective and prospective patient data on the real-world use, safety, and effectiveness of eculizumab and ravulizumab, as well as disease burden and outcomes, in patients with PNH in the United States. Study Design and Methods This noninterventional cohort study will collect data using the PicnicHealth digital personal health record platform. This platform uses a novel human-in-the-loop machine learning system to integrate, harmonize, and structure patient data, including clinical notes, medications, laboratory results, and diagnostic reports contained in medical records collected from any healthcare facility in the United States. This study was designed in collaboration with patient advocacy groups to ensure that data generated will answer questions important to the patient community. In contrast to many studies, patients will be directly recruited to participate through multiple avenues, including working with patient advocacy groups and societies as well as outreach through social media and other communication tools. All patients must complete an informed consent form to participate. Patient data is anonymized, and the study complies with the Health Insurance Portability and Accountability Act data security standards. The study will be submitted to IntegReview for institutional review board approval. Patients who report a diagnosis of PNH within the past 5 years and have subsequently been treated with eculizumab or ravulizumab can be included in this study (Figure). Data extracted by the platform will confirm that the patient meets study criteria. The study has 3 arms: arm A is comprised of patients who initiated therapy with eculizumab, arm B is patients who initiated therapy with ravulizumab, and arm C is patients who initiated therapy with eculizumab and later switched to ravulizumab. Exclusion criteria for patients in arms A and B includes treatment with a complement inhibitor prior to PNH diagnosis and treatment with eculizumab or ravulizumab for > 25 weeks. Exclusion criteria for all patients include platelet count < 30,000/μL, absolute neutrophil count < 500/μL, and history of bone marrow transplant. The primary objective is to describe the proportion of patients who do not receive packed red blood cell transfusion. Secondary objectives are to determine the proportions of patients with breakthrough hemolysis, stabilized hemoglobin, and a thromboembolic event and the change in normalized lactate dehydrogenase. Safety objectives are to determine the rates and proportions of selected adverse events. Primary, secondary, and safety objectives will be evaluated from week 5 to 25 of treatment. The effectiveness and safety analyses will be conducted in all patients who fulfill entry criteria and have a minimum of 25 weeks of accrued person-time from treatment initiation. Exploratory analyses assessing long-term experiences and outcomes and will be conducted in all patients who fulfill entry criteria with no minimum treatment duration requirement. Descriptive statistics will be provided. Summary The COMMODORE Cohort study will use a novel, patient-centered approach to data generation including collaborating with patient groups to ensure that the study answers questions important to the PNH community. This approach may serve as a model for future studies evaluating other rare diseases with limited real-world data. Disclosures Shang: F. Hoffmann-La Roche Ltd: Current Employment, Current equity holder in publicly-traded company, Other: All authors received support for third party writing assistance, furnished by Scott Battle, PhD, provided by F. Hoffmann-La Roche, Basel, Switzerland.. Faghmous:Kite Pharma: Current Employment; F. Hoffmann-La Roche Ltd: Ended employment in the past 24 months, Other: All authors received medical writing support for this abstract, furnished by Scott Battle, funded by F. Hoffmann-La Roche Ltd, Basel, Switzerland. . Drozd:PicnicHealth: Current Employment, Current equity holder in private company; F. Hoffmann-La Roche Ltd: Other: All authors received support for third party writing assistance, furnished by Scott Battle, PhD, provided by F. Hoffmann-La Roche, Basel, Switzerland.. Katz:F. Hoffmann-La Roche Ltd: Current Employment, Other: All authors received support for third party writing assistance, furnished by Scott Battle, PhD, provided by F. Hoffmann-La Roche, Basel, Switzerland..
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Lin, Huamao Mark, Keith L. Davis, James A. Kaye, Katarina Luptakova, Saurabh Nagar, and Brian Seal. "Real-World Treatment Patterns in Relapsed or Refractory Multiple Myeloma: Evidence from a Cohort Review in the United Kingdom." Blood 128, no. 22 (December 2, 2016): 5947. http://dx.doi.org/10.1182/blood.v128.22.5947.5947.
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Abstract INTRODUCTION: Despite advancements in induction and maintenance therapies leading to improved response rates and overall survival (OS), virtually all patients with multiple myeloma (MM) eventually relapse. Improvement in outcomes in relapsed and/or refractory multiple myeloma (RRMM) remains an area of unmet need, yet there is a shortage of data describing typical treatment patterns in these patients in real-world practice settings. Such data may help inform future health technology assessments and other regulatory evaluations of current and new therapies in RRMM. To help address this information gap, we analyzed retrospective data from a cohort of RRMM patients in the United Kingdom (UK). METHODS: A retrospective medical record review was conducted in a cohort (n = 216) of patients with RRMM in the UK. Patients were selected (based on randomly generated first letter of last name) from the caseloads of 41 hematology/oncology providers across the UK. Specific inclusion criteria were: ≥18 years of age at initial MM diagnosis; first determined to have RRMM between January 1, 2009 and December 31, 2011, where RRMM was defined by (1) receipt of a first-line (induction) treatment regimen of chemotherapy with or without stem cell transplant (SCT) and with or without post-induction/SCT maintenance therapy and (2) disease progression while on or at any time after completion of first-line therapy. Patients were retrospectively assessed on second- and third-line treatment regimens received, treatment duration, and reasons for treatment discontinuation from date of first relapse or progression (study index date). All analyses were descriptive and exploratory in nature. RESULTS: Demographic and clinical characteristics of the study sample are presented in Table 1. Mean (SD) age at study index (first relapse, or RRMM diagnosis) was 65.6 (8.7) years, with approximately half of patients (53%) having advanced age (≥65 years). The study sample was 62.5% male and more than two-thirds of patients (69%) were still alive at the time of the medical record review. Among the 216 patients studied, 208 (97%) received ≥1 additional line of systemic chemotherapy after first relapse (Table 2); 94 patients (43%) received ≥2 additional lines of therapy (i.e., at least second- and third-line therapy) during the observation period. The most common second-line regimen was bortezomib + dexamethasone with or without other agents (66% of second-line initiators), followed by lenalidomide + dexamethasone with or without other agents (20%). Median duration of second-line treatment was 6 cycles over a median of 5.4 months. Among the 98% of patients who discontinued second-line treatment, a majority (62%) stopped therapy due to reaching complete response with no additional benefit expected; 33 patients (16%) discontinued second-line treatment due to disease progression and 8% discontinued due to toxicities. Lenalidomide + dexamethasone with or without other agents was the predominant third-line regimen (67% of third-line initiators); bortezomib + dexamethasone with or without other agents was the next most common third-line regimen (14%). Among the 94 patients receiving third-line treatment, median duration was 6 cycles over a median of 5.7 months. The leading reason for third-line discontinuation was disease progression (48%); 30% of patients discontinued because they reached complete response with no anticipated additional benefit, and 20% discontinued because of loss or lack of response to therapy. CONCLUSIONS: In the RRMM cohort reviewed here, bortezomib-containing regimens were the predominant second-line therapy and lenalidomide + dexamethasone was the most common third-line regimen. The most common reasons for discontinuation of RRMM treatments were disease progression and physician-judged achievement of complete response with no additional benefit expected. While the most common reason for therapy discontinuation in second-line treatment was reaching complete response with no additional benefit expected, in third-line therapy it was disease progression. With growing evidence in the RRMM literature that treatment to progression may be superior to a fixed duration of therapy, as well as evidence of premature discontinuation being associated with inferior outcomes, the relatively short second-line duration reported here (<6 months) further highlights a potential unmet need in this disease area. Disclosures Lin: Takeda: Employment. Davis:Takeda: Research Funding. Kaye:Takeda: Research Funding. Luptakova:Takeda Oncology: Employment. Nagar:Takeda: Research Funding. Seal:Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment, Equity Ownership.
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Anderson, Margot. "Dance Overview of the Australian Performing Arts Collection." Dance Research 38, no. 2 (November 2020): 149–67. http://dx.doi.org/10.3366/drs.2020.0305.
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The Dance Collection at Arts Centre Melbourne traces the history of dance in Australia from the late nineteenth century to today. The collection encompasses the work of many of Australia's major dance companies and individual performers whilst spanning a range of genres, from contemporary dance and ballet, to theatrical, modern, folk and social dance styles. The Dance Collection is part of the broader Australian Performing Arts Collection, which covers the five key areas of circus, dance, opera, music and theatre. In my overview of Arts Centre Melbourne's (ACM) Dance Collection, I will outline how the collection has grown and highlight the strengths and weaknesses associated with different methods of collecting. I will also identify major gaps in the archive and how we aim to fill these gaps and create a well-balanced and dynamic view of Australian dance history. Material relating to international touring artists and companies including Lola Montez, Adeline Genée, Anna Pavlova and the Ballet Russes de Monte Carlo provide an understanding of how early trends in dance performance have influenced our own traditions. Scrapbooks, photographs and items of costume provide glimpses into performances of some of the world's most famous dance performers and productions. As many of these scrapbooks were compiled by enthusiastic and appreciative audience members, they also record the emerging audience for dance, which placed Australia firmly on the touring schedule of many international performers in the early decades of the 20th century. The personal stories and early ambitions that led to the formation of our national companies are captured in collections relating to the history of the Borovansky Ballet, Ballet Guild, Bodenwieser Ballet, and the National Theatre Ballet. Costume and design are a predominant strength of these collections. Through them, we discover and appreciate the colour, texture and creative industry behind pivotal works that were among the first to explore Australian narratives through dance. These collections also tell stories of migration and reveal the diverse cultural roots that have helped shape the training of Australian dancers, choreographers and designers in both classical and contemporary dance styles. The development of an Australian repertoire and the role this has played in the growth of our dance culture is particularly well documented in collections assembled collaboratively with companies such as The Australian Ballet, Sydney Dance Company, and Chunky Move. These companies are at the forefront of dance in Australia and as they evolve and mature under respective artistic directors, we work closely with them to capture each era and the body of work that best illustrates their output through costumes, designs, photographs, programmes, posters and flyers. The stories that link these large, professional companies to a thriving local, contemporary dance community of small to medium professional artists here in Melbourne will also be told. In order to develop a well-balanced and dynamic view of Australian dance history, we are building the archive through meaningful collecting relationships with contemporary choreographers, dancers, designers, costume makers and audiences. I will conclude my overview with a discussion of the challenges of active collecting with limited physical storage and digital space and the difficulties we face when making this archive accessible through exhibitions and online in a dynamic, immersive and theatrical way.
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Aureli, Selena. "Performance of unlisted Italian companies acquired by multinationals from emerging markets." Journal of Organizational Change Management 28, no. 5 (August 10, 2015): 895–924. http://dx.doi.org/10.1108/jocm-12-2014-0233.
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Purpose – The purpose of this paper is to shed lights on both economic and social impacts associated to the increasing amount of western companies acquired by multinationals from emerging countries. Focussing on the Italian context, its main intent is to analyze changes in targets’ performance and capability to contribute to stakeholders’ wealth to assess the business and social viability of this type of deal. Design/methodology/approach – Operations of mergers and acquisitions (M & As) were identified through Zephyr (Bureau VanDijk’s database). Only acquisitions of a controlling interest were considered for a total of eight case studies. Financial Statements and Management Reports over a eight-year period have been analyzed to understand the rationale of the deal and to assess financial performance and company social impact before and after the merger. Findings – Results suggest that foreign investors mainly search for know-how and technical expertise and their arrival does not lead to better financial performance. Only one target records profits. Four companies are still controlled by Indian investors while the other four have been dismissed. Nevertheless Indian investors are not destroying profitable organizations as these were recording negative results already before the merger. With reference to value added distribution, acquisitions do not reduce local stakeholders’ wealth for the benefits of shareholders. Jobs are preserved and valued added is mainly distributed to employees. Great difficulties in achieving the expected value resulting from synergies emerge. Research limitations/implications – Observations emerging from this explorative study are limited to the case studies analyzed while it could be important to enlarge the number of companies to investigate, including targets acquired by Russian, Chinese and Brazilian investors. Moreover, additional information could be obtained from interviews with top managers to reveal how they interpret the merger’s success or failure. Also interviews with local stakeholders like suppliers, clients, representatives of employees and local institutions could be of great importance as they can help identify their specific point of view about the social and economic impact of foreign investors’ arrival. Practical implications – With reference to the public debate on the increasing number of European companies sold to foreign investors, research findings indicate that FDI from emerging economies do not necessarily lead to job losses or target’s closure. Indian investors are interested in brand, knowledge and other intangible assets (like Chinese ones). However they do not relocate production or expertise abroad. Some target companies record higher investments financed by the new shareholder, indicating that the arrival of new investors owing a large amount of money to invest in financial distressed Italian companies, can be beneficial to the local economy. Originality/value – Most literature studies M & As from the buyer’s perspective to assess if shareholders’ value is created (Tuch and O’Sullivan, 2007; Meglio, 2009; Dauber, 2012). On the contrary this research adopts the target’s and stakeholders’ perspective, in order to measure the value created and distributed to the territory. Moreover it focuses on unlisted companies, while most studies deal with publicly traded companies (Meglio and Risberg, 2010; Meglio and Risberg, 2012b). Lastly it enriches M & A mainstream literature, which usually adopts a positivistic mindset and rely on statistical analysis, by adopting a qualitative approach based on case study analysis.
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Noga, Stephen J., Robert M. Rifkin, Sudhir Manda, Ruemu Ejedafeta Birhiray, Roger M. Lyons, Presley Whidden, Robert L. Schlossman, Bingxia Wang, and Ralph V. Boccia. "Real-World (RW) Treatment Patterns and Patient-Related Factors Including Quality of Life (QoL), Medication Adherence, and Actigraphy in Community Patients (pts) with Newly Diagnosed Multiple Myeloma (NDMM) Transitioning from Bortezomib (btz) to Ixazomib: The US MM-6 Community-Based Study." Blood 134, Supplement_1 (November 13, 2019): 3168. http://dx.doi.org/10.1182/blood-2019-124784.
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Background US MM-6 is a US community-based study that investigates the transition from a parenteral (btz) to an oral (ixazomib) proteasome inhibitor (PI) in NDMM to increase PI-based treatment duration and adherence, maintain QoL, and improve outcomes. Here, we report on the novel, RW aspects of the study including the use of digital devices/wearables to evaluate QoL, medication adherence, and actigraphy (average steps and sleep time/ day) in a community oncology setting, for the first 55 enrolled pts. Methods NDMM pts who are transplant-ineligible or transplant-delayed >24 mos and have ≥stable disease after 3 cycles of btz-based induction are being enrolled at 23 community sites. Pts receive IRd (ixazomib 4 mg, d 1, 8, 15; lenalidomide 25 mg, d 1-21; dexamethasone 40 mg [20 mg for pts aged >75 yrs], d 1, 8, 15, 22; each 28-d cycle) for up to 26 x 28-d cycles or until progression/toxicity. The primary endpoint is progression-free survival. Novel secondary and exploratory endpoints are included to capture pts' experience in the RW community setting. Electronic pt-reported outcomes (ePROs) are used to assess medication adherence and QoL, as measured by the European Organization for Research and Treatment of Cancer (EORTC) Core QoL Questionnaire (QLQ-C30), EORTC QoL Questionnaire-Multiple Myeloma Module (QLQ-MY20) for peripheral neuropathy (PN), and the Treatment Satisfaction Questionnaire for Medication (TSQM-9). Pts use wearable digital devices/smartphones to complete a monthly medication adherence survey and record actigraphy. Results At the data cutoff of April 1 2019, 55 pts had been enrolled at 16 sites in the US; 40 were still undergoing treatment. Females comprised 53% of pts, 13% were of Hispanic/Latino ethnicity, and 13% were black/African American. Pt/disease characteristics revealed a comorbid, difficult-to-treat RW population: median age was 72 yrs (35% 65-75 yrs; 42% ≥75 yrs); 40% had International Staging System stage III disease, and 42% had lytic bone disease. Most common comorbidities at study start were hypertension (51%), anemia (44%), fatigue (42%), renal and urinary disorders (36%), gastroesophageal reflux disease (31%), and cardiac disorders (27%). Prior to IRd treatment, the 3-cycle btz-based induction required adjusting in 11 (20%) pts: 38 (69%) pts started induction with btz-lenalidomide-dexamethasone (VRd) (1 had only 1 cycle documented, 1 de-escalated to Vd), 7 (13%) started on btz-cyclophosphomide-dexamethasone (VCd) (2 had only 1 cycle documented), 4 (7%) started on Vd (3 escalated to VRd), and 2 (4%) started on VCRd but de-escalated to VCd/VRd after 1 cycle; 3 (5%) pts received VR only (Figure). Average compliance with completing issued ePRO questionnaires during IRd treatment was 96%, and ≥87% in all cycles (61 pts; data cutoff July 8, 2019), revealing the feasibility of ePRO collection in community pts, most of whom were elderly. During IRd treatment, there was a trend toward improved treatment satisfaction and QoL, with no increase in PN symptoms (Figure). Mean change (95% CI) from baseline on EORTC QLQ-C30 score was 5.12 (-13.79-24.02) by cycle 5 (n=13), 15.47 (-16.45-47.39) by cycle 8 (n=7), and -4.18 (-21.29-12.94) by cycle 12 (n=5). Mean change (95% CI) from baseline on TSQM-9, subscale 'effectiveness', was 7.54 (-1.84-16.91) by cycle 5 (n=14), and 11.13 (-12.82-35.08) by cycle 12 (n=3), with similar patterns for subscales 'convenience' and 'global satisfaction' (Figure). Mean change from baseline on EORTC QLQ-MY20, PN component, was between 0.0-2.0 throughout all cycles. Patients recorded their monthly medication adherence for the previous 4 weeks; 81% of evaluable pts (n=32) in cycle 1, 81% in cycle 2 (n=27), 77% in cycle 3 (n=22), 96% in cycle 4 (n=24), and 94% in cycle 5 (n=18) (n<11 [20% of pts] beyond cycle 5) reported 'excellent'/'very good' adherence. Analysis of actigraphy data for 24 pts (2086 compliant days [≥12h of data]) (Figure) revealed normal levels of activity (Tudor-Locke 2011) and sleep durations (Coleman 2011). Updated actigraphy data will be presented. Conclusions Preliminary ePRO and actigraphy data from this RW community study suggest that long-term treatment with all-oral IRd has no impact on health-related QoL or on pts' lifestyle. High ePRO compliance indicates that RW studies using wearable electronic data collection devices are feasible in this mostly elderly, comorbid population, and may have a positive impact on medication adherence. Disclosures Noga: Takeda: Employment. Rifkin:Amgen: Membership on an entity's Board of Directors or advisory committees; Takeda: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees. Birhiray:Alexion: Consultancy; Bayer: Honoraria; Helsin: Honoraria; Sanofi Oncology: Speakers Bureau; Puma: Consultancy, Research Funding, Speakers Bureau; Novartis: Consultancy, Honoraria, Speakers Bureau; Incyte: Research Funding, Speakers Bureau; Pharmacyclics: Consultancy, Speakers Bureau; Pfizer: Speakers Bureau; Amgen: Honoraria, Speakers Bureau; BMS: Speakers Bureau; Tessaro: Speakers Bureau; Exelexis: Speakers Bureau; Kite Pharma: Honoraria; Clovis Oncology: Speakers Bureau; Lilly: Speakers Bureau; AstraZeneca: Speakers Bureau; Celgene: Honoraria; Takeda: Research Funding, Speakers Bureau; Genomic Health: Speakers Bureau; Jansen Bioncology: Consultancy, Speakers Bureau; Seattle Genetics: Honoraria; Abbvie: Consultancy, Honoraria; Coheris: Honoraria. Lyons:Texas Oncology: Equity Ownership; Amgen: Consultancy; McKesson: Other: Leadership. Whidden:Takeda: Employment. Schlossman:Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment. Wang:Millennium Pharmaceuticals, Inc., Cambridge, MA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment. Boccia:Celgene: Speakers Bureau; Genentech: Speakers Bureau; Amgen: Speakers Bureau; AstraZeneca: Speakers Bureau; AMAG: Consultancy; DSI: Speakers Bureau.
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Bailey, Neil, John M. Pagel, William Bensinger, Livia Hegerova, Raya Mawad, Michael Milder, Jennie Szeto, et al. "A Single Center Retrospective Study of Real World Relapsed/Refractory DLBCL Patients Eligible for CAR T-Cell Therapy: Patient Characteristics and Outcomes." Blood 132, Supplement 1 (November 29, 2018): 1715. http://dx.doi.org/10.1182/blood-2018-99-117780.
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Abstract Introduction: Patients with Diffuse large B-cell lymphoma (DLBCL) may experience excellent long-term outcomes after initial anthracycline containing therapy. However, patients with relapsed or refractory (R/R) DLBCL often have poor outcomes. Select R/R DLBCL patients may be treated with additional chemoimmunotherapy (CIT) followed by hematopoietic stem cell transplant (HSCT). However, as many as 50% of R/R DLBCL patients are unable to undergo HSCT due to lack of response to CIT or comorbidities (Gisselbrecht C, et al JCO 2010). Recent data reported in the SCHOLAR-1 study suggest a median overall survival (OS) of 6.3 months for these patients, with only 20% of patients alive at 2 years (Crump M, et al Blood 2017). Chimeric antigen receptor T-cell (CAR-T) therapy, a novel form of immunotherapy, offers improved outcomes for such patients with complete response rates of approximately 40% and 50% OS at 12 months or greater (Neelapu SS et al. NEJM 2017; Borchmann P et al, EHA 2018). Delivery of CAR-T therapy is specialized and remains limited to a small number of centers at present. The broad applicability of CAR-T therapy in a real world population of R/R DLBCL patients remains unknown. This retrospective study aimed to identify the characteristics and outcomes of a cohort of R/R DLBCL patients who would have been eligible for CAR-T cell therapy if available over a 4 year period at Swedish Cancer Institute (SCI). The SCI is a specialty cancer research center, based in a non-profit, non-university affiliated medical center. Methods: All patients with recorded diagnosis of DLBCL (ICD9/10) seen for an outpatient encounter in a SCI facility between the dates of 01/01/2014 and 01/01/2018 were identified from an electronic medical record database. Patients who had received anthracycline-based chemotherapy only at SCI as initial therapy and then subsequently received 2nd line or beyond therapy at SCI between January 2014 and January 2018 were included. This population was defined as the study cohort of R/R DLBCL patients and was then evaluated for would-be eligibility for CAR-T therapy by application of the defined Kite Zuma-1 clinical trial Inclusion/Exclusion (I/E) criteria. Patient characteristics for the CAR-T eligible population were obtained by retrospective medical record review. Overall survival of the potential CAR-T eligible population was assessed including stratification by receipt of HSCT at any time during the study period. Results: 486 patients with a diagnosis of DLBCL were seen during outpatient SCI encounters between Jan 2014 and Jan 2018. Of these, 60 patients received prior 1st line anthracycline therapy exclusively at SCI and then received 2nd line or beyond therapy at SCI between 2014 and 2018 for R/R DLBCL. The majority of patients, 82% (n=49), met all Zuma-1 I/E criteria for CAR-T therapy. Characteristics of these patients are identified in Table 1. Among all CAR-T eligible patients, OS was 37.1% at 24 months (Figure 1). Patients received a variety of 2nd line or beyond therapies, including 47% (n=23) who received HSCT. OS at 24 months for CAR-T eligible patients was significantly better for those receiving HSCT in 2nd line or beyond versus those who did not receive HSCT (61.6% vs 12.0%, respectively; p<0.001; Figure 2). Conclusion: In a retrospective cohort of real-world R/R DLBCL patients treated between 2014 and 2018 at SCI, a non-university based specialty cancer research center, 49 of 60 patients (82%) would have been eligible for CAR-T therapy based on Zuma 1 I/E criteria. This suggests that the majority of the patients with R/R DLBCL in the real-world may have an opportunity to receive CAR-T. Moreover, while those who underwent a successful HSCT as part of 2nd line or beyond therapy had greatly improved outcomes, those patients who did not undergo HSCT had poor outcomes. For such patients not receiving HSCT, the availability of CAR -T may lead to significantly improved outcomes. Disclosures Pagel: Pharmacyclics, an AbbVie Company: Consultancy; Gilead: Consultancy. Bensinger:Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; amgen: Speakers Bureau; Takeda: Speakers Bureau; celgene: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Mawad:Swedish Cancer Institute: Employment. Patel:Pharmacyclics/Janssen: Speakers Bureau; Sunesis Pharmaceuticals: Consultancy; AstraZeneca: Consultancy, Research Funding, Speakers Bureau; Genentech: Consultancy, Speakers Bureau; Celgene: Consultancy; Juno Therapeutics: Consultancy.
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Wegrzyn, L., K. Winthrop, S. Kim, Y. Ye, C. Huisingh, W. Krueger, A. Maniccia, and R. Kilpatrick. "POS1207 REAL WORLD POPULATION-BASED ASSESSMENT OF COVID-19 OUTCOMES AMONG RHEUMATOID ARTHRITIS PATIENTS USING BIOLOGIC OR SYNTHETIC DMARDs." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 886. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2206.
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Background:While some risk factors for severe COVID have been identified for patients with rheumatic diseases,1 few studies have investigated whether outcomes differ based on the type of rheumatoid arthritis (RA) treatment. Most existing reports have been limited to individual centers or voluntary reporting registries.2,3Objectives:To compare the occurrence of hospitalizations following COVID-19 diagnosis among patients with RA treated with various classes of DMARDs.Methods:A cohort of patients with confirmed COVID-19 (ICD10 diagnosis code or positive PCR or antigen test result) were identified within a large US electronic health record (EHR) dataset (Optum, Inc.) during the time period Feb 1, 2020 through Oct 14, 2020. From these, we identified RA patients (ICD10 RA diagnosis code) with treatment (most recent of JAK inhibitor [JAKi], biologic [bDMARD] or conventional synthetic [csDMARD] only) within the 12 months prior to COVID-19 diagnosis (i.e., index). The primary outcome was any hospitalization on or within 30 days after COVID-19 diagnosis. Multivariable logistic regression models compared users of JAKi’s to non-TNFi bDMARDs and csDMARDs (separately), as well as users of TNFi’s to non-TNFi bDMARDS and csDMARDs (separately), and were adjusted for age, gender, index month and baseline corticosteroid use. Sensitivity analyses included restriction of prevalent treatment use to within 180 days prior to COVID-19 diagnosis and restriction of csDMARDs to a group without hydroxychloroquine or chloroquine.Results:The study included 910 RA patients on DMARD treatment who were diagnosed with COVID-19 (mean age ± SD: 61±15, 80% female, 62% white. Of those, 26% (n=240) were hospitalized on or within 30 days after COVID-19 diagnosis. The proportion of patients hospitalized was highest in non-TNFi bDMARD users (37/87; 43%), followed by csDMARDs users (161/581; 28%) and lowest in JAKi (13/68; 19%) and TNFi users (29/174; 17%). In multivariable-adjusted models, no differences in risk of hospitalization were found comparing JAKi users to csDMARD users (aOR=0.71; 95% CI 0.37-1.36) or TNFi users to csDMARD users (aOR=0.67; 95%CI 0.43-1.06). Compared to non-TNFi bDMARD users, JAKi use and TNFi use was associated with reduced risk of hospitalization (JAKi aOR=0.32; 95%CI 0.14-0.71; TNFi aOR=0.34; 95%CI 0.18-0.62). Age and corticosteroid use were positively associated with 30-day hospitalization in all models. Results of sensitivity analyses were consistent with the main findings.Conclusion:In this study, roughly a quarter of RA patients with recent DMARD treatment were hospitalized within 30 days after COVID diagnosis. Patients treated with JAKi and TNFi therapies experienced the lowest risk of hospitalization, with risk of hospitalization significantly lower than non-TNFi bDMARDs. However, recent therapy recorded in the EHR may not reflect exposure at time of COVID-19 diagnosis and small sample size per treatment may limit interpretation.References:[1]Hyrich KL, Machado PM. Nat Rev Rheumatol 2020;1-2. doi:10.1038/s41584-020-00562-2[2]Gianfrancesco MA, et al. Lancet Rheumatol 2020;2(5):e250-e253. doi:10.1016/S2665-9913(20)30095-3[3]Veenstra J, et al. J Am Acad Dermatol 2020;83(6):1696-1703.Acknowledgements:Jonathan Johnson of Optum, Inc. provided dataset guidance and conducted data analyses. AbbVie funded this study, contributed to its design, participated in data collection, analysis, and interpretation of the data, and in the writing, review, and approval of the abstract. No honoraria or payments were made for authorship.Disclosure of Interests:Lani Wegrzyn Shareholder of: AbbVie, Employee of: AbbVie, Kevin Winthrop Consultant of: Pfizer, AbbVie, UCB, Eli Lilly & Company, Galapagos, GSK, Roche, Gilead, BMS, Regeneron, Sanofi, AstraZeneca, Novartis, Grant/research support from: BMS, Pfizer, Seoyoung Kim Grant/research support from: institutional research grants from Pfizer, AbbVie, Roche, BMS for unrelated studies, Yizhou Ye Shareholder of: AbbVie, Employee of: AbbVie, Carrie Huisingh Shareholder of: AbbVie, Employee of: AbbVie, Whitney Krueger Shareholder of: AbbVie, Employee of: AbbVie, anna maniccia Shareholder of: AbbVie, Employee of: AbbVie, Ryan Kilpatrick Shareholder of: AbbVie, Employee of: AbbVie.
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Huang, Qunying, and Xinyi Liu. "Semantic trajectory inference from geo-tagged tweets." Abstracts of the ICA 1 (July 15, 2019): 1–2. http://dx.doi.org/10.5194/ica-abs-1-129-2019.
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<p><strong>Abstract.</strong> Individual travel trajectories denote a series of places people visit along the time. These places (e.g., home, workspace, and park) reflect people’s corresponding activities (e.g., dwelling, work, and entertainment), which are discussed as semantic knowledge and could be implicit under raw data (Yan et al. 2013, Cai et al. 2016). Traditional survey data directly describe people’ activities at certain places, while costing tremendous labors and resources (Huang and Wong 2016). GPS data such as taxi logs record exact origin-destination pairs as well as people’s stay time along the way, from which semantics can be easily inferred combining with geographical context data (Yan et al. 2013). Research has been done to understand the activity sequences indicated by either individual or collective spatiotemporal (ST) travel trajectories using those dense data. Different models are proposed for trajectory mining and activity inference, including location categorization, frequent region detection, and so on (Njoo et al. 2015). A typical method for matching a location or region with a known activity type is to detect stay points and stay intervals of trajectories and to find geographical context of these stay occurrences (Furtado et al. 2013, Njoo et al. 2015, Beber et al. 2016, Beber et al. 2017).</p><p>However, limited progress has been made to mine semantics of trajectory data collected from social media platforms. Specifically, detection of stay points and their intervals could be inaccurate using online trajectories because of data sparsity. Huang et al. (2014) define the notion of activity zone to detect activity types from digital footprints. In this method, individual travel trajectories first are aggregated using spatial clustering method such as density-based spatial clustering of applications with noise (DBSCAN). Then produced clusters are classified based on a regional land use map and Google Places application programming interface (API). Such land use data are only published at specific places, such as the state cartography office’s website at University of Wisconsin-Madison. Researchers need to search for those data based on their study area. Moreover, while major land use maps can be searched for large areas such as the whole United States, detailed land use data for statewide or citywide areas are made in diverse standards, which adds extra work to classify activity zones consistently. Besides, Google Places API is a service that Google opened for developers and will return information about a place, given the place location (e.g., address or GPS coordinates), in the search request. However, API keys need to be generated before we can use these interfaces and each user can only make a limited number of free-charged requests every day (i.e., 1,000 requests per 24 hours period). In sum, previous methods to detect activity zone types using social media data are not sufficient and can hardly achieve effective data fusion. Comparing to the high cost of using officially published dataset, emerging Volunteered Geographic Information (VGI) data offer an alternative to infer the types of an individual’s activities performed in each zone (i.e., cluster).</p><p>Using geo-tagged tweets as an example, this research proposes a framework for mining social media data, detecting individual semantic travel trajectories, and individual representative daily travel trajectory paths by fusing with VGI data, specifically OpenStreetMap (OSM) datasets. First, inactive users and abnormal users (e.g., users representing a company with account being shared by many employees) are removed through data pre-processing (Step 1 in Figure 1). Next, a multi-scale spatial clustering method is developed to aggregate online trajectories captured through geo-tagged tweets of a group of users into collective spatial hot-spots (i.e., activity zones; Step 2). By integrating multiple OSM datasets the activity type (e.g., dwelling, service, transportation and work) of each collective zone then can be identified (Step 3). Each geo-tagged tweet of an individual, represented as a ST point, is then attached with a collective activity zone that either includes or overlaps a buffer zone of the ST point. Herein, the buffer zone is generated by using the point as the centroid and a predefined threshold as the radius. Given an individual’s ST points with semantics (i.e., activity type information) derived from the attached collective activity zone, a semantic activity clustering method is then developed to detect daily representative activity clusters of the individual (Step 4). Finally, individual representative daily semantic travel trajectory paths (i.e., semantic travel trajectory, defined as chronological travel activity sequences) are constructed between every two subsequent activity clusters (Step 5). Experiments with the historic geo-tagged tweets collected within Madison, Wisconsin reveal that: 1) The proposed method can detect most significant activity zones with accurate zone types identified (Figure 2); and 2) The semantic activity clustering method based on the derived activity zones can aggregate individual travel trajectories into activity clusters more efficiently comparing to DBSCAN and varying DBSCAN (VDBSCAN).</p>
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Lin, Huamao Mark, Keith L. Davis, James A. Kaye, Katarina Luptakova, Lu Gao, Saurabh Nagar, Brian Seal, and Mohamad Mohty. "Real-World Clinical Outcomes By Cytogenetic Risk Category in Relapsed or Refractory Multiple Myeloma: Evidence from a Cohort Review in France." Blood 128, no. 22 (December 2, 2016): 4784. http://dx.doi.org/10.1182/blood.v128.22.4784.4784.
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Abstract INTRODUCTION: Multiple Myeloma (MM) is an incurable hematologic cancer characterized by multiple recurrences. With each recurrence, patients have a lower probability of response and duration of response is shorter. Therefore, there is an unmet need to improve outcomes in relapsed/refractory multiple myeloma (RRMM). There is a shortage of data describing clinical features and outcomes in these patients in real-world practice, particularly with regard to differences in outcomes by baseline cytogenetic risk. To help address this information gap, this study analyzed data from a cohort of RRMM patients in France. METHODS: A retrospective observational review of medical records was conducted in a cohort of 200 patients with RRMM in France. Patients were selected (based on randomly generated first letter of last name) from the caseloads of 40 hematology/oncology providers across France practicing mainly in academic hospitals. Inclusion criteria were: ≥18 years of age at initial MM diagnosis; first determined to have RRMM between January 1, 2009 and December 31, 2011, where RRMM was defined by (1) first-line (induction) regimen of chemotherapy with or without stem cell transplant (SCT) and with or without other post-induction/SCT therapy and (2) disease progression while on or at any time after completion of first-line therapy. Patients could be alive or deceased at the time of record abstraction. Baseline cytogenetic risk was defined as follows: high-risk: cytogenetic abnormalities del(17p), t(4:14), or t(14;16); unknown/unassessed risk: patients for whom cytogenetics were unavailable; or standard-risk: all patients with known cytogenetics not classified as high-risk. Patients were assessed for treatment response, overall survival (OS) and progression-free survival (PFS) from date of first relapse (study index date). All analyses were descriptive. Survival was assessed using the Kaplan-Meier (K-M) method. RESULTS: Demographic and clinical characteristics of the study sample are presented in Table 1. A total of 55 high-risk and 113 standard-risk patients were identified; risk category was unknown or unassessed for 32 patients. Among all patients, mean (SD) age at RRMM diagnosis was 66.3 (8.9) years and 62% of the sample was male. Lenalidomide + dexamethasone was the most common second-line systemic regimen initiated (50% of high-risk patients, 59.5% of standard-risk patients receiving second-line treatment). A total of 114 patients (57%) initiated a third-line treatment. Despite clinical response in second-line treatment occurring sooner in high-risk patients (median: 106 days) than in standard-risk patients (median: 237 days), physician-assessed overall response rate (ORR) was lower in high-risk patients (63%: 17% complete response, 46% partial response) than standard-risk patients (91%: 26% complete response, 65% partial response) across all second-line treatments combined (Table 2).. For third-line treatment, ORR was lower in high-risk patients (54%: 12% complete response, 42% partial response) than standard-risk patients (74%: 9% complete response, 65% partial response). Among patients who initiated a second-line treatment (n = 192), 47.4% were deceased at the time of data collection. From second-line initiation, K-M estimates of 1- to 5-year OS and PFS were substantially lower for high-risk patients versus standard-risk. Specifically, the proportions of patients still alive 1, 3, and 5 years after second-line treatment initiation were 73%, 51%, and 36%, respectively, for high-risk patients and 94%, 73%, and 61% for standard-risk patients. The proportions of patients without disease progression at 1, 3, and 5 years after second-line initiation were 48%, 13.5%, and 5% for high-risk patients and 82%, 42%, and 14% for standard-risk patients. CONCLUSIONS: The importance of cytogenetic risk classification as a prognostic factor in RRMM was apparent in this retrospective review, in which patients with high-risk cytogenetics had less favorable outcomes in terms of ORR, OS, and PFS than standard-risk patients. Decreased response rate and lower PFS and OS was documented among patients with high-risk cytogenetics, which is in contrast to shorter time needed to achieve best clinical response in this subgroup. Results from this real-world study provide further confirmation of the unmet medical need presented by RRMM, especially for patients with high-risk cytogenetics. Disclosures Lin: Takeda: Employment. Davis:Takeda: Research Funding. Kaye:Takeda: Research Funding. Luptakova:Takeda Oncology: Employment. Gao:Takeda: Employment. Nagar:Takeda: Research Funding. Seal:Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment, Equity Ownership.
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Pitoyo, Chandra Singgih, Yuristian Yuristian, Cahyo Andrianto, and Riza Angelia. "PENINGKATAN KOMPETENSI KARYAWAN DAN SAFETY CULTURE MELALUI LEARNING MANAGEMENT SYSTEM “SINTESIS+” SEBAGAI KONTROL OPERASIONAL." Prosiding Temu Profesi Tahunan PERHAPI 1, no. 1 (March 29, 2020): 687–96. http://dx.doi.org/10.36986/ptptp.v1i1.110.
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ABSTRAK Dengan luas konsesi sebesar 118.400 hektar dan memperkerjakan hingga lebih dari 21.694 karyawan dan mitra kerja, pengelolaan operasional dan keselamatan, kesehatan kerja, dan lingkungan (K3L) adalah hal yang harus diperhatikan. Tantangan yang harus dihadapi PT Berau Coal adalah lokasi yang tersebar di 4 (empat) wilayah operasional terpisah: Lati, Binungan, Sambarata, dan Marine. Selain itu, karyawan juga tidak memiliki banyak waktu untuk mengakses informasi, karena sebagian besar waktunya dihabiskan untuk bekerja dengan minimal waktu kerja 8 (delapan) jam perhari. Dengan latar belakang berbagai tingkat pendidikan, mulai dari SD hingga perguruan tinggi, juga menjadi tantangan tersendiri. Disamping itu, berdasarkan data, mayoritas karyawan PT Berau Coal dan mitra kerja berada pada rentang umur 24-40 tahun yang dapat dikategorikan sebagai generasi melek teknologi. PT Berau Coal telah membangun sebuah platform pembelajaran bernama SINTESIS+ (Sistem Informasi Pelatihan dan Edukasi yang Sinergis) dan SID (Single Identity System). SINTESIS+ dan SID memiliki tujuan, antara lain (1) sebagai platform pembelajaran dan informasi terkait dengan operasional dan K3L, (2) meningkatkan kapasitas dan membangun kompetensi karyawan terkait operasional dan K3L, terutama peran pengawas sebagai posisi kunci dalam program pengawasan keselamatan, (3) meningkatkan kontrol operasional terhadap kompetensi karyawan yang terkait dengan ijin masuk, ijin kerja, lisensi, serta spesialisasi, serta (4) mengintervensi perilaku untuk mewujudkan safety culture di karyawan internal dan mitra kerja. Fitur dan konten yang dimiliki SINTESIS+ saat ini adalah online learning dengan konten pembelajaran multimedia, online testing dengan hasil yang real time, sertifikat yang otomatis muncul setelah pengguna lulus dalam online testing, webinar, berita insiden dan operasional pertambangan, repositori untuk portofolio kerja, sistem registrasi event dan pelatihan, terintegrasi dengan SID terkait perekaman data dan kontrol kompetensi karyawan dari segi operasional, baik itu ijin kerja, ijin masuk, lisensi, dan spesialisasi, serta proses yang dapat meningkatkan awareness terhadap K3L secara kontinyu. Sejak peluncurannya, SINTESIS+ telah diakses oleh lebih dari 7867 karyawan, menguji pengetahuan untuk lebih dari 1024 ujian, menyelenggarakan webinar yang diikuti oleh 330 karyawan, serta menjalankan proses yang lebih efektif dan efisien, mulai dari pendaftaran hingga evaluasi. Dampak dari segi operasional atas integrasinya dengan sistem SID adalah meningkatnya compliance level terhadap pemenuhan kompetensi karyawan menjadi sebesar 98% dan proses pemantauan menjadi lebih efisien. Dengan peningkatan tersebut, selain kompetensi karyawan yang meningkat, kontrol terhadap operasional juga menjadi semakin baik, kesadaran terhadap K3L meningkat, dan dengan harapan tingkat insiden dapat menurun. Kedepannya, untuk meningkatkan akses dan safety culture, PT Berau Coal sedang membangun platform mobile apps untuk SINTESIS+. Kata kunci: keselamatan, operasional, pelatihan, platform, teknologi, kompetensi, kontrol ABSTRACT With 118.400 hectare of concession area and employed people for more than 21.694 employees within company and from business partners, Berau Coal needs to put more concern in managing operational and health, safety and environment (SHE). The challenges that need to be faced are location that scattered into 4 operational areas, limited time for employees to access information because most of time exploited for working, various educational background, and technology literacy. Berau Coal has been developed a learning platform, named SINTESIS+ and SID. The aims in development of those platforms are; (1) as a operational and HSE-themed learning platform, (2) to increase capacity and to build HSE and operational competencies, (3) to increase operational control for competencies related to entry permit, work permit, license, and specialization, and (4) to intervene employees’ behaviour to build safety culture. Features and contents that has been embedded in SINTESIS+ are online learning with multimedia materials, online testing with real time result, webinar, incident and mining operational news, repositories for employees’ portfolio, event and training registration, integrated with SID to record employees’ historical competency-related data, and sustainable process to increase HSE awareness. Since its launching, SINTESIS+ has been accessed by 7867 employees, tested for 1024 exams, conducted webinar that participated by 330 employees, and run more effective and efficient processes. Impacts from integration process with SID are the increase of compliance level for competencies to 98% and the increase of process control efficiency. With those increments, beside the employees’ competency and HSE awareness is increased, hoped to lower incident rate. In the future, to improve access to the platform, Berau Coal is willing to develop mobile apps for SINTESIS+. Keywords: safety, operational, training, platform, technology, competency, control
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Merz, Lauren E., Kavita Mistry, Revital Freedman, Katherine L. Jolley, Hae Soo Park, David M. Dorfman, Donna S. Neuberg, and Maureen Achebe. "Impact of Sickle Cell Trait on Morbidity and Mortality from Sars-Cov-2 Infection." Blood 136, Supplement 1 (November 5, 2020): 31–32. http://dx.doi.org/10.1182/blood-2020-142835.
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Introduction: The high morbidity and mortality of SARS-CoV-2 in Blacks or African American in the United States is well established. Individuals with sickle cell trait (SCT), who are mostly Black or African American, have adverse health outcomes in situations of increased physiologic stress. The novel corona virus SARS-CoV-2 causes a severe multi-systemic viral infection that induces intense inflammation and metabolic derangements that can exacerbate RBC sickling and organ damage. The purpose of this study is to evaluate the impact of SCT status on the outcome of patients hospitalized for SARS-CoV-2. Methods: We conducted a multi-center, IRB-approved, retrospective analysis of Black/African American patients who were admitted for management of SARS-CoV-2 infection from March 24, 2020 to June 2, 2020. Patients were identified using an electronic medical record (EMR) report that selected for race as "Black or African American" and a positive SARS-CoV-2 PCR test during that admission. We excluded patients admitted for reasons other than SARS-CoV-2 infection and reviewed only the in-hospital experience. Patient demographics, co-morbidities, admission laboratory values, complications of SARS-CoV-2 infection, and status on discharge were abstracted by manual chart review. High performance liquid chromatography (HPLC) was performed on discarded blood of patients to test for sickle cell trait. The primary objective was to evaluate the impact of SCT status on morbidity outcomes of Blacks/African Americans hospitalized with SARS-CoV-2 infection. Categorical data were tested using the Fisher exact test, and quantitative data were tested using the Wilcoxon rank sum test. Testing was done at the nominal 0.05 two-sided significance level. Results: One hundred and sixty-six Black or African American patients admitted for SARS-CoV-2 infection are included in the analysis. Twenty patients had SCT, 143 had normal hemoglobin (AA) and 3 had hemoglobin C trait (AC). The 146 patients with AA and AC hemoglobin were pooled together. Patient demographics, comorbidities, and lab values on admission by SCT status are shown in Table 1. Complications of SARS-CoV-2 by SCT status is shown in Table 2. Among Black or African American patients admitted for SARS-CoV-2 in this study, SCT represented 12.0% of the total. At the time of admission, individuals with SCT had significantly higher creatinine (p=0.004) but were less likely to present with a history of chronic lung disease (p=0.004). However, a history of chronic lung disease was not in itself associated with death in hospital, p=0.056, and creatinine at admission was not associated with death, p=0.483. Correspondingly, a total of 19 of the 146 patients without SCT died in the hospital (13%), compared to 3 of 20 SCT patients (15%), Fisher exact test p-value = 0.732, despite the difference in the groups at admission. Discussion: The higher morbidity and mortality from SARS-CoV-2 infection in Black or African Americans is well-documented. This study showed equivalent outcomes in patients admitted for SARS-CoV-2 infection whether, or not they had SCT. There was a lower rate of chronic lung disease in patients with SCT, but no difference in respiratory outcome from SARS-CoV-2 between the groups. Patients with SCT also had worse creatinine at presentation but there was no difference in hospital death or end organ complications at discharge. Notably, individuals with SCT made up 12% of Black patients admitted for SARS-CoV-2 in this study which is higher than the reported prevalence of SCT of 7.31% in the African American population (p=0.025), but this is of unclear significance. Our study is limited by the restriction to one metropolitan area and by being retrospective in nature, but the initial data suggests that those with SCT may be more frequently admitted to hospital when infected by SARS-CoV-2 than individuals without SCT. A larger prospective study across multiple regions of the United States should be considered to further assess the prevalence of SARS-CoV-2 in the African American community and the apparent increased rate of hospitalizations for SARS-CoV-2 infection in individuals with SCT. Disclosures Neuberg: Madrigak Pharmaceuticals: Current equity holder in publicly-traded company; Celgene: Research Funding; Pharmacyclics: Research Funding. Achebe:Global Blood Therapeutics: Other: Advisory Board; Fulcrum Pharmaceuticals: Consultancy; Pharmacosmos: Other: Advisory Board.
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Ammann, Eric M., Annette Lam, Wenze Tang, Tobias Kampfenkel, Mohit Sharma, Charlene Lee, Shuchita Kaila, Alex Z. Fu, Kathleen Gray, and Jianming He. "Real-World Use of Maintenance Therapy and Associated Outcomes Following Autologous Stem Cell Transplant in US Patients with Newly Diagnosed Multiple Myeloma." Blood 136, Supplement 1 (November 5, 2020): 25–26. http://dx.doi.org/10.1182/blood-2020-139882.
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Background: In patients with newly-diagnosed multiple myeloma (NDMM) who receive frontline autologous stem cell transplantation (ASCT), maintenance therapy (MT) following ASCT has been shown to delay disease progression and death. Current National Comprehensive Cancer Network (NCCN) guidelines also recommend MT for patients with MM, including the use of lenalidomide, bortezomib-based regimens, or ixazomib. However, there is limited evidence on the use and outcomes associated with MT in contemporary real-world patients. The present study assessed MT treatment patterns and clinical outcomes in a real-world US cohort of patients with NDMM following ASCT. Methods: This retrospective, observational cohort study included NDMM patients initially diagnosed from 2011-2018 who received frontline ASCT. Patients were selected from the US Flatiron Health (FH) deidentified electronic health record (EHR)-derived database, which includes longitudinal patient-level data from over 265 community-based and academic cancer clinics across the US. To ensure capture of post-ASCT consolidation and MT, the study sample was restricted to patients who resumed contact within the FH network within 60 days following ASCT. Patients were excluded if they received treatment within the context of a clinical trial or had a second transplant within 180 days of their initial ASCT. Patients were classified as receiving MT if (during the 180-day post-transplant period) they initiated treatment with an NCCN-recommended MT regimen or continued to receive a subset of the antimyeloma agents used as induction regimen following ASCT and consolidation (if any). Key measures included baseline demographic and clinical characteristics, antimyeloma treatments (frontline induction, consolidation, and MT, if any), and clinical outcomes (time to next myeloma treatment [TTNT] and overall survival [OS]). Treatment duration and clinical outcomes were analyzed using Kaplan-Meier estimators and Cox regression to account for right-censoring. For TTNT and OS, follow-up began on the earlier of the ASCT date + 90 days or start of MT and continued through the dataset cut-off date (May 30, 2020) or loss to follow-up; TTNT and OS were estimated for patients receiving lenalidomide maintenance [R-MT], bortezomib maintenance [V-MT], or no MT, but was not estimated for other MT regimens due to sample size considerations. Results: 528 NDMM patients (median age 61 years, interquartile range [IQR]: 55, 68; 45.3% female) underwent ASCT and met study inclusion criteria. The most common induction regimens were bortezomib-lenalidomide-dexamethasone (VRd; 60.0%), lenalidomide-dexamethasone (Rd; 16.3%), and cyclophosphamide-bortezomib-dexamethasone (CyBorD; 10.2%). Following ASCT, 7.2% of patients received consolidation therapy and 74.2% received MT (lenalidomide monotherapy [R-MT]: 58.7%; bortezomib monotherapy [V-MT]: 7.6%; other MT: 7.8%). Median duration of MT was 18.0 months (IQR: 8.7, 29.1), and was similar for R-MT and V-MT (median 18.9 and 18.6 months, respectively). MT use increased from 69.3% to 79.0% from 2011-2013 to 2017-2018 (P=0.04); in addition, patients were more likely to have received VRd as induction across different MT (Table 1). R-MT and V-MT were both associated with longer TTNT relative to no MT (unadjusted hazard ratios [HRs]: 0.29 [95% CI: 0.22, 0.38] and 0.39 [95% CI: 0.25, 0.61], respectively) (Figure 1A). Improvements in OS were marginally significant with R-MT (HR: 0.58 [95% CI: 0.33, 1.00]) and nonsignificant with V-MT (HR: 0.86 [95% CI: 0.35, 2.11]) relative to no MT (Figure 1B); however, the OS estimates are characterized by low precision due to the relatively small number of events observed. Limitations included lack of documentation of reasons for treatment in the FH database, and use of consolidation and MT were inferred from observed treatment patterns; therefore, misclassification of MT was possible. Conclusions: This analysis demonstrates that MT use following ASCT has increased in routine clinical practice in the US since 2011-2013, with R-MT being the most common regimen followed by V-MT. However, a substantial proportion of patients did not receive MT. MT use in real-world settings was associated with longer TTNT and a trend toward longer OS. Exploration of additional maintenance regimens to improve clinical outcomes is warranted in this patient population. Disclosures Ammann: Janssen Scientific Affairs: Current Employment, Current equity holder in publicly-traded company. Lam:Janssen: Current Employment. Tang:Janssen: Current Employment. Kampfenkel:Janssen: Current Employment. Sharma:Mu Sigma: Current Employment; Janssen: Other: Contractor. Lee:Janssen: Current Employment. Kaila:Janssen Scientific Affairs: Current Employment. Fu:Janssen: Current Employment. Gray:Janssen: Current Employment. He:Janssen: Current Employment.
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Lin, Richard J., Laure Michaud, Stephanie M. Lobaugh, Reiko Nakajima, Theresa A. Elko, Josel D. Ruiz, Craig S. Sauter, et al. "The Geriatric Syndrome of Sarcopenia Impacts Allogeneic Hematopoietic Cell Transplantation Outcomes in Combination with Multi-Morbidity and Functional Impairment." Blood 134, Supplement_1 (November 13, 2019): 4508. http://dx.doi.org/10.1182/blood-2019-125141.
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Older patients with advanced hematologic malignancies are increasingly considered for allogeneic hematopoietic cell transplantation (allo-HCT). However, survival outcomes, especially non-relapse mortality (NRM) in these patients remain suboptimal due to multi-morbidity and geriatric vulnerabilities. We and others have shown previously that pre-transplant multi-morbidity, and functional limitation and post-HCT geriatric syndromes of delirium and fall significantly impact allo-HCT outcomes. Sarcopenia, an accelerated loss of muscle mass and function, has been increasingly recognized to affect HCT outcomes. However, it remains unknown whether sarcopenia is a simple surrogate of multi-morbidity or functional impairment and whether post-transplant sarcopenia also impacts outcomes. From our institutional database and the electronic medical record, we identified 146 lymphoma patients 50 years or older who were transplanted at our institution from 2008 to 2018 using reduced-intensity/nonmyeloablative conditioning and a matched related or unrelated, mismatched unrelated, or haploidentical donor, and who had either a PETCT or CT within 60 days of HCT. Two adjacent axial images within the same series at the third lumbar vertebra were selected for the analysis of total muscle cross-sectional area (cm2) and of total fat (subcutaneous and visceral adipose tissues) cross-sectional area (cm2) using MIM software. Skeletal muscle cross-sectional area was normalized for stature and reported as skeletal muscle index in cm2/m2. Sarcopenia was defined as a skeletal muscle index <41 in women, <43 in men with BMI <25, and <53 in men with BMI ≥25. Baseline characteristics, HCT outcomes, and geriatric assessment domains were obtained as previously described. Before allo-HCT, 80 (55%) patients were sarcopenic. Baseline demographic, transplant, and geriatric characteristics were well matched among the two groups except for slightly more females in the sarcopenic group (38% versus 21%, p=0.046). In multivariable analysis (Table 1), pre-HCT sarcopenia was significantly associated with overall survival (OS) with hazard ratio (HR) of 2.12 (95% CI 1.18 - 3.80, p=0.01); progression-free survival (HR 1.78, 95% CI 1.07 - 2.98, p=0.03); and NRM (HR 2.06, 95% CI 1.02 - 4.19, p=0.044). Multi-morbidity (HCT-CI ≥3) was independently associated with OS, PFS, and NRM, while functional impairment as measured by prior fall was significantly associated with PFS (Table 1). One hundred twenty-eight patients had CT images within 3-6 months post-HCT. Comparing to pre-transplant values, there were median decrease in total lean body mass of -2.86 kg (range -16.68 -9.87, p<0.001), and median decrease in total body fat mass of -2.23 kg (range -14.2 -5.67, p<0.001). Seventy percent of patients were sarcopenic post-transplant. We performed 6-month landmark analysis of OS, PFS, and NRM (Table 2). Post-HCT sarcopenia was significantly associated with OS (HR 3.12, 95% CI 1.10 - 8.89, p=0.03) and PFS (HR 4.2, 95% CI 1.27 - 13.94, p=0.02), but not NRM. Multi-morbidity (HCT-CI ≥3) was again independently associated with OS, PFS, and NRM in the landmark analyses, while grade 2-4 acute GVHD was significantly associated with PFS only in univariate analysis (Table 2). While limited by the retrospective design, single diagnosis of lymphoma, and inability to establish causal relationships among GVHD, steroid use, and post-HCT sarcopenia, our findings nevertheless illustrated the high prevalence of sarcopenia in older allo-HCT recipients. Importantly, we demonstrated significant negative impact of both pre- and post-HCT sarcopenia on survival which were independent of geriatric multi-morbidity, functional impairment, and acute GVHD. While requiring prospective confirmation, the temporal pattern and adverse survival impact of sarcopenia warrants preemptive, targeted, longitudinal, and multidisciplinary interventions to improve HCT outcomes for older patients. Disclosures Sauter: Spectrum Pharmaceuticals: Consultancy; Novartis: Consultancy; GSK: Consultancy; Genmab: Consultancy; Precision Biosciences: Consultancy; Kite/Gilead: Consultancy; Celgene: Consultancy; Sanofi-Genzyme: Consultancy, Research Funding; Juno Therapeutics: Consultancy, Research Funding. Perales:Abbvie: Honoraria, Membership on an entity's Board of Directors or advisory committees; NexImmune: Membership on an entity's Board of Directors or advisory committees; Medigene: Membership on an entity's Board of Directors or advisory committees; Merck: Consultancy, Honoraria; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Omeros: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bellicum: Honoraria, Membership on an entity's Board of Directors or advisory committees; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees; Nektar Therapeutics: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol-Meyers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; Incyte: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; MolMed: Membership on an entity's Board of Directors or advisory committees; Servier: Membership on an entity's Board of Directors or advisory committees; Kyte/Gilead: Research Funding; Miltenyi: Research Funding. Scordo:Angiocrine Bioscience, Inc.: Consultancy; McKinsey & Company: Consultancy. Giralt:Spectrum Pharmaceuticals: Consultancy; Novartis: Consultancy; Actinium: Consultancy, Research Funding; Johnson & Johnson: Consultancy, Research Funding; Celgene: Consultancy, Research Funding; Kite: Consultancy; Jazz Pharmaceuticals: Consultancy; Amgen: Consultancy, Research Funding; Miltenyi: Research Funding; Takeda: Consultancy, Research Funding.
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McKenna, Marshall, Rena Feinman, Jaeil Ahn, Shuqi Wang, Elli Gourna Paleoudis, David H. Vesole, Stuart L. Goldberg, et al. "Severe Infections and Antibiotic Use Negatively Impact Progression Free and Overall Survival of Multiple Myeloma Patients Undergoing Autologous Stem Cell Transplantation." Blood 134, Supplement_1 (November 13, 2019): 5510. http://dx.doi.org/10.1182/blood-2019-132134.
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Background: The discovery that gut microbial dysbiosis correlated with prognosis, immune reconstitution and development of graft-versus-host disease (GVHD) in patients undergoing allogeneic stem cell transplantation (allo-SCT) highlights the clinical relevance of the gut microbiome in shaping anti-tumor immune responses. Treatment of allo-SCT patients with antibiotics has recently been associated with increased GVHD mortality (Routy et al. 2017). Based on these studies and the association of distinct gut bacteria with increased efficacy to PD-1 blockade in patients with solid tumors (Derosa et al. 2018), we performed a retrospective analysis to determine if infection treated with antibiotics affected the outcomes of multiple myeloma (MM) patients after autologous SCT (ASCT). Methods: A list of all MM patients treated at our institution between January 2012 through December 2015 was obtained and 1095 patients were identified. A comprehensive review of the electronic medical record (EMR) of the first 142 who received ASCT was performed. Information was collected from diagnosis to the date of last contact. Baseline characteristics, treatment history, transplant course, antibiotic treatment, and infection severity using common terminology criteria for adverse event (CTCAE) version 4 were reviewed. Prophylactic antibiotics were excluded. Response was measured and defined using the International Myeloma Working Group Criteria. Progression free survival (PFS) and overall survival (OS) were estimated using log rank tests. Cox hazard stepwise regression model examined for multiple factors affecting PFS and OS using the Akaike information criterion. Results: Of the 142 patients, 93 (65%) were Durie Salmon (DS) III, 20 (14%) were Revised International Staging System (R-ISS) III, 44 (31%) had high-risk cytogenetics, and 76 (54%) were male. The median age at diagnosis was 60. Although there was a similar frequency of DS III (67% vs 61%) and high-risk cytogenetics (35% vs 25%) among patients in the antibiotic and non-antibiotic treated groups, there was an over-representation of R-ISS 3 (19% v 4%) patients in the antibiotic-treated group. Treatment with antibiotics was associated with decreased median PFS (2.38 vs 6.58 years (yrs), p =0.00003) (Figure 1a) and decreased median OS (7.43 vs 17.39 yrs, p = <0.0001). Fluoroquinolone use compared to no fluoroquinolone use was associated with decreased PFS (1.91 vs 4.09 yrs, p = 0.0001) (Figure 1b) as well as a trend toward decreased OS (7.01 vs 14.23 yrs, p = 0.1). Beta-lactam use compared to no beta-lactam use was associated with decreased PFS (1.74 vs 4.34 yrs, p = <0.0001) (Figure 1c) as well as decreased OS (7.01 vs 17.39 yrs, p = 0.0004). Maximal CTCAE grade of infection throughout the treatment course was a further predictor of decreased PFS-no infection vs CTCAE grade 1/2 vs CTCAE 3/4 (7.49 vs 3.77 vs 1.92 yrs, p = <0.0001) (Figure 2) and OS-no infection vs CTCAE 3/4 (17.39 vs 6.58 yrs, p = <0.0001). (Figure 2). Multivariate analysis demonstrated progression risk associated with beta-lactam use (HR-2.25, 95% CI, 1.31 - 3.85, p = 0.003), and DSS III (HR-2.28, 95% CI, 1.23 - 4.21, p = 0.009). Multivariate analysis demonstrated increased mortality associated with antibiotic treatment (HR-5.70, 95% CI, 1.34 - 34.29, p = 0.019) and decreased mortality risk with age younger than 65 (HR-0.24, 95% CI, 0.07 - 0.81, p = 0.022). For both PFS and OS, there was no statistical significance demonstrated in multivariate analysis for gender, fluoroquinolone treatment, high risk cytogenetics, R-ISS 3, or CTCAE grade. Conclusion: In this preliminary study, antibiotic use and infection severity predicted for decreased PFS and OS compared to patients who did not receive antibiotics in MM patients undergoing ASCT. Treatment with at least 2 classes of antibiotics-fluoroquinolones and beta-lactams, predicted for decreased PFS and OS. Multivariate analysis showed increased progression risk with beta lactams and DSS III as well as increased mortality risk with antibiotic treatment and advanced age. The study was limited by its relatively small sample size, retrospective nature, and the high correlation among infection and antibiotic groups that affected the multivariate analysis. Work is underway at our institution to further elucidate the impact of antibiotics on microbial diversity and patient survival. Disclosures Goldberg: COTA: Equity Ownership; Bristol-Myers Squibb: Consultancy; Cancer Outcomes Tracking and Analysis (COTA) Inc.: Equity Ownership. Rowley:Allergan: Equity Ownership; Fate Therapeutics: Consultancy. Siegel:Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Bristol-Myers Squibb Company: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau. Biran:Merck: Research Funding; Janssen: Consultancy, Honoraria, Research Funding; Amgen: Consultancy, Honoraria, Research Funding; Celgene: Consultancy, Honoraria; Takeda: Consultancy, Honoraria; Bristol Meyers Squibb: Research Funding.
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Yang, Xiaoqin, Kaushal D. Desai, Adrienne M. Gilligan, Monika Raut, and Akash Nahar. "Healthcare Resource Utilization and Cost in Patients with Relapsed/Refractory Classical Hodgkin's Lymphoma Who Received Autologous Stem Cell Transplantation in the US." Blood 136, Supplement 1 (November 5, 2020): 36–37. http://dx.doi.org/10.1182/blood-2020-136328.
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Introduction: Limited real-world studies exist on the management of relapsed/refractory (R/R) classical Hodgkin's lymphoma (cHL) patients (pts) who failed autologous stem transplant (auto-SCT) and their subsequent healthcare resource utilization (HRU) and cost. Current treatment options include chemotherapy, a second auto-SCT, allogenic (allo-) SCT, palliative care, or newer therapies like brentuximab vedotin (BV) or programmed death-1 (PD-1) blocking antibodies. Pts eligible for treatment post auto-SCT failure may consume significant resources and using real-world data may inform the place of therapy of newly approved agents. Therefore, the objectives of this study were to compare HRU and cost among R/R cHL pts who received auto-SCT by transplant success and failure. Methods: This retrospective cohort study used electronic medical record (EMR) data of US pts from a network of oncology practices, including practices affiliated with CancerLinQ, maintained in the Definitive Oncology Dataset. Eligible adult (≥18 years) pts who had a confirmed diagnosis of cHL and ≥1 R/R event that occurred between 2000 to 2019 were included. Treatment patterns included any systemic anti-cancer therapy received post auto-SCT failure. Descriptive analyses examined differences by auto-SCT success vs failure. Auto-SCT failure was defined as having a R/R event or disease progression after receipt of auto-SCT. HRU included hospitalization rates, emergency department (ED) visits, and infused supportive care drugs. Costs (inflated for 2020$) were based on matched Health Care Utilization Project coded events. HRU and costs were reported per patient per month (PPPM) from initial cHL diagnosis (first-line [1L] therapy) through the second R/R event (third-line [3L] therapy) and for 3L among a subset of pts who failed auto-SCT in second line (2L). PPPM was calculated by dividing the total HRU or cost during the observation period by the number of months of the observation period and then averaged across all pts (regardless of being flagged for a specific service). Results: A total of 157 pts (54.9%) received auto-SCT among the R/R cHL cohort (n=286). Most pts were Caucasian (77.7%) with a median age of 31 years (range: 19-73) at the first R/R event. Median length of follow-up was 11 months from the first R/R event. Nearly all pts (91.7%) received auto-SCT after the start of 2L (68.2%, n=107) and 3L (23.6%, n=37). Approximately 9.6% (n=15) also received allo-SCT in later lines. Among auto-SCT pts, 62.4% (n=98) had a transplant success vs 37.6% (n=59) with a transplant failure. Across these 59 pts, 46 (78.0%) received treatment post auto-SCT failure. Treatment post auto-SCT failure consisted of 21 different anti-cancer regimens (monotherapy or in combination) and included BV (alone or in combination) (37.3%, n=22), chemotherapy (30.5%, n=18), PD-1 therapy (alone or in combination) (6.8%, n=4), other (5.1%, n=3), and allo-SCT (1.7%, n=1). The 59 pts with auto-SCT failure primarily failed in 2L (66.1%, n=39) and 3L (27.1%, n=16). HRU and costs for the 39 pts who failed auto-SCT in 2L were substantial in 3L. Approximately 92.3% of pts had a hospitalization, 30.8% had an ED visit, and 51.3% received infused supportive care treatment in 3L. Monthly costs in 3L were high: hospitalization $3,903, ED visit $130, infused supportive care $279, anti-cancer therapy $64,572, and $69,186 total. From the start of 1L through the end of 3L, the proportion of pts with a hospitalization was significantly higher for pts who failed auto-SCT (Table). Subsequently, costs were also higher and average length of stay longer. While HRU did not differ, infused supportive care costs were higher for auto-SCT pts. No significant differences in HRU and cost were observed across the two groups for ED visits and oncology setting outpatient visits. Anti-cancer therapy costs were significantly higher for pts who failed auto-SCT. Total monthly costs were higher for pts who failed auto-SCT. Conclusion: In the real-world setting, almost 40% of R/R cHL pts failed auto-SCT. There appears to be no clear standard of care post auto-SCT failure and using real-world data may inform the place in therapy of newer therapies. The HRU and cost of managing post auto-SCT failure was substantial and highlights the significant unmet need in this population. These findings add to the scarce real-world data on treatment patterns, utilization, and cost among R/R cHL pts who receive auto-SCT. Disclosures Yang: Merck & Co, Inc.: Current Employment. Desai:Merck & Co., Inc: Current Employment, Current equity holder in publicly-traded company. Gilligan:ConcertAI: Current Employment; Merck & Co., Inc.: Research Funding. Raut:Merck & Co., Inc.: Current Employment. Nahar:Merck Sharp & Dohme, Corp., a subsididary of Merck & Co., Inc., Kenlworth, NJ, USA: Current Employment.
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Rifkin, Robert M., Eileen Fonseca, Yaozhu J. Chen, Patricia S. Fox, James E. Browning, and Ze Cong. "Carfilzomib Dosing Patterns and Survival in Patients with Relapsed and Refractory Multiple Myeloma: An Analysis from US Community Oncology Practices." Blood 126, no. 23 (December 3, 2015): 2084. http://dx.doi.org/10.1182/blood.v126.23.2084.2084.
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Abstract Introduction While novel agents have improved survival over the last decade, multiple myeloma (MM) remains incurable. Carfilzomib (CFZ), a second-generation proteasome inhibitor, was approved in July 2012 by the US Food and Drug Administration and had a label change in July 2015. During this study's data period, the label recommended Cycle 1 dose at 20 mg/m2/day and if tolerated increase Cycle 2 dose and subsequent cycles doses to 27 mg/m2/day. The purpose of this study is to assess baseline characteristics, CFZ dosing patterns and survival among MM patients in a US community oncology setting. Methods A retrospective study of MM patients from US Oncology Network practices that fully implemented McKesson Specialty Health's iKnowMed (iKM) oncology-specific electronic health records database was conducted on patients whose first treatment of CFZ (index) occurred between Jul-2012 and Nov-2014. Patients were eligible if they had a documented initial MM diagnosis date and had their first CFZ cycle documented in the database. Additionally, patients were required, before Dec-2014, to have either another visit to the practice post-index or a record of death and not have participated in interventional clinical trials during the previous 6 years. Data on eligible patients were collected up to March 2015. The death event was defined by the Social Security Death Index, supplemented by iKM; patients without the event were censored at the date of last observed visit. To adjust for clinical practice variations, a 10% variability was allowed for the recommended daily dose levels of 20 mg/m2 and 27 mg/m2. A subgroup was defined for patients with a 2nd cycle: "escalators" if they received 20 mg/m2/day doses throughout Cycle 1 and increased to 27 mg/m2/day on the first dose of Cycle 2; "non-escalators" if they received only 20 mg/m2 doses throughout Cycle 1 and did not increase to 27 mg/m2 on the first dose of Cycle 2; receiving any dose not equal to 20 or 27 mg/m2 were classified into "other". Survival after index was estimated using the Kaplan-Meier method with 95% confidence intervals (CI). A multivariable Cox proportional hazards (PH) model was conducted to evaluate the impact of escalation on survival accounting for selected baseline demographic and clinical characteristics. Results The cohort of 718 CFZ patients were identified with a median (interquartile range [IQR]) age of 68 (61-75) years at index, 57% (n=409) were male, and 12% (n=87) were Black and 77% (n=551) were Caucasian. At initial MM diagnosis, 19%, 27% and 42% were ISS Stage I, II, and III, respectively. Median (IQR) time from MM diagnosis to index was 3.6 (1.9-5.8) years. At index, 66% of patients had an ECOG performance status of 0-1, 21% of 2, and 2% of 3+; 54% (n=369) had moderate to severe renal impairment (eGFR<60 mL/min per 1.73 m2). Ninety percent (n=644) of patients started CFZ at 20 mg/m2, 4% (n=27) at 27 mg/m2 and 4% (n=25) at 15 mg/m2. Patients had a median (IQR) of 4 (2-7) cycles of CFZ and 45% (n=321) escalated to ≥27 mg/m2. Among these 321 patients, median (IQR) time to first escalation was 30 (28-56) days with 60% escalating in Cycle 2. The subgroup defined in "Methods" included 605 patients: 148 (24%) escalators, 342 (57%) non-escalators, and 115 (19%) other. Median (95% CI) duration from index to death was 21 (17.5-23.2) months. Unadjusted overall survival (OS) was significantly lower among non-escalators compared to escalators (log-rank p=0.024) [Figure 1]. Survival rates (95% CI) for non-escalators and escalators were 68% (62-74%) and 75% (66-82%) at year 1 and 42% (33-50%) and 61% (49-71%) at year 2, respectively. Within the multivariable Cox model, escalators showed a 33% significantly lower risk of death compared to non-escalators (HR=0.67, p=0.03) while also accounting for race, sex, age group, renal function per EGFR, and MM chain type. Other significant variables in this model were: EGFR < 15 and 15-29 vs 30-59 ml/min per 1.73m2 (HR=2.79, p<0.01; HR=1.64, p=0.04, respectively) and lambda vs kappa light chain (HR=1.55, p=0.03). Conclusions These results indicate escalation of CFZ at first dose of Cycle 2 is associated with better survival than dosing at 20 mg/m2 in Cycle 1 but not escalating at the start of Cycle 2. More research is needed to assess factors that impact physician decision-making on dose escalation to better inform physicians to improve the quality of multiple myeloma care. Disclosures Rifkin: Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Consultancy, Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees; Onyx Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees. Fonseca:McKesson Specialty Health, which received funding to conduct this research: Employment, Equity Ownership. Chen:Onyx Pharmaceuticals: Employment. Fox:McKesson Specialty Health, which received funding to conduct this research: Employment. Browning:Onyx Pharmaceuticals, An Amgen Subsidiary: Employment. Cong:Onyx Pharmaceuticals: Employment, Equity Ownership.
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Pacífico, Marsiel, and Luiz Roberto Gomes. "Suicídio.com: o último ato do espetáculo (Suicide.com: the last act of spectacle)." Revista Eletrônica de Educação 14 (July 27, 2020): 3873103. http://dx.doi.org/10.14244/198271993873.
Full textAbstract:
Dialoguing with the theoretical intersection between central references of the Critical Theory of Society and the philosopher Guy Debord, through literature review and case studies, this article sought to discuss the theme of suicide.com. Although the term has been coined, it was done, generically, for suicide cases in which the author uses some digital resource to the act. Therefore, suicide.com shows its characteristics and forms of manifestation that differs between cases in which the suicides are encouraged and directed by websites and/or internet users where, in general, such practices are restricted to the forums. accompanied by the chats, having as a visual record eventual images of the process; creation of suicide groups where people meet in forums to talk about the subject and they create a collective death pact; or cases where the suicide makes the practice public in video and live, from the access of Internet users to the webcam. However, the proposed approach embraced a new understanding of the concept, which could be based on the following premises: a) the suicide, as a social phenomenon, is limited to the historical context and cultural factors of its time and space, therefore, the media is an inherent component of contemporary suicide practices; b) suicide.com, however, is not just the virtualized replication of traditional suicide; It is the result of the processes of public spectacularization of private life in virtual environments.ResumoDialogando com a intersecção teórica entre referências centrais da Teoria Crítica da Sociedade e o filósofo Guy Debord, por meio de revisão bibliográfica e de estudos de caso, o presente artigo buscou discutir a temática do suicídio.com. Apesar de o termo já ter sido cunhado, o mesmo foi feito, genericamente, para casos de suicídio em que o autor utiliza algum meio digital para o ato. Assim sendo, o suicídio.com apresentou suas próprias características e formas de manifestação, que se diferem entre casos nos quais os suicidas são incentivados e orientados por sites e/ou usuários da internet onde, em geral, tais práticas ficam restritas aos fóruns, sendo acompanhadas pelos chats, tendo como forma de registro visual eventuais fotos do processo; criação de grupos suicidas onde as pessoas se encontram em fóruns sobre o assunto e criam um pacto de morte coletiva; ou casos em que o suicida torna a prática pública em vídeo e ao vivo, a partir do acesso dos internautas à webcam. Todavia, a propositura levantada abarcou uma nova compreensão do conceito, que pôde ser alicerçado nas seguintes premissas: a) o suicídio, enquanto fenômeno social, está circunscrito ao contexto histórico e aos fatores culturais de seu tempo e espaço, portanto, a mídia é um componente inerente às práticas contemporâneas de suicídio; b) o suicídio.com, porém, não é somente a replicação virtualizada do suicídio tradicional; é consequente dos processos de espetacularização pública da vida privada em ambientes virtuais.Palavras-chave: Suicídio.com, Sociedade do espetáculo, Cibercultura, Suicídio.Keywords: Suicide.com, Society of the spetacle, Cyberculture, Suicide.ReferencesADORNO, Theodor Wiesegrund; HORKHEIMER, Max. Dialética do esclarecimento: fragmentos filosóficos. Trad. Guido Antonio de Almeida. Rio de Janeiro: Jorge Zahar, 1985.ALMEIDA, Ana Filipa. Efeito de Werther. In: Análise psicológica, Lisboa, v. 18, n. 1, p. 37-51, 2000.ANES, Eugenia Maria Garcia; SILVA, N.; SILVA, S. Suicídio: um problema de saúde pública. Jornadas de enfermagem da escola superior de saúde do IPB: livro de atas. Bragança: Escola Superior de Saúde. p. 524-532, 2013.BATEY, Mark. O significado da marca: como as marcas ganham vida na mente dos consumidores. Tradução Gabriel Zide Neto. Rio de Janeiro: Best Business, 2010.BESTGORE. Man cuts his femoral artery and bleeds live on ooVoo webcam. 2012. Disponível em: <http://www.bestgore.com/suicide/man-cuts-his-femoral-artery-bleeds-live-oovoo-webcam/>. Acesso em: 29 out. 2018.BLINDERMAN, Ilia. See The First “Selfie” In History Taken by Robert Cornelius, a Philadelphia Chemist, in 1839. Openculture. 2013. Disponível em: < http://www.openculture.com/2013/11/the-first-selfie-in-history-1839.html>. Acesso em: 20 jan. 2019.BRUM, Eliane; AZEVEDO, Solange. Suicídio.com. Revista Época. São Paulo, v. 2, n. 2, p. 27-30, fev. 2008.CAMUS, Albert. O mito de Sísifo. 5.ed. Rio de Janeiro: Record, 2008.CHRISTANTE, Luciana. Com sem saída. Revista Unespciência. 13. ed., p. 30-35, out. 2010.COSTA, Ana Luisa. A relação entre o suicídio e a internet: o fenômeno do ‘suicídio.com’. CONGRESSO DE CIÊNCIAS DA COMUNICAÇÃO NA REGIÃO SUDESTE, 19., Vila Velha/ES, 2014. Anais... Vila Velha: Intercom – Sociedade Brasileira de Estudos Interdisciplinares da Comunicação, 2014.CRUVINEL, Monica Vasconcelos. Rastros virtuais de uma morte (a)enunciada: uma análise dos discursos do suicídio pelas páginas “brasileiras” do Orkut”. 2008. 198 f. Dissertação (Mestrado em Linguística) - Instituto de Estudos de Linguagem, Unicamp, Campinas, 2008.CRUZ, Dulce Márcia; KRÜGER, Fernando. L. As estratégias de marketing dos jogos eletrônicos de simulação da vida. 2009. Disponível em: <http://www.prodemge.gov.br/images/revistafonte/revista_9.pdf#page=65>. Acesso em: 10 jan. 2019.DAYLY MAIL. 'Took all my pills, bye bye': Woman commits suicide on Facebook... and none of her 1,082 online friends help. Daily Mail Reporter. News. 06 Jan. 2011. Disponível em: <https://www.dailymail.co.uk/news/article-1344281/Facebook-suicide-None-Simone-Backs-1-082-online-friends-helped-her.html>. Acesso em: 02 Fev. 2019.DEBORD, Guy. A sociedade do espetáculo. Tradução Estela dos Santos Abreu. Rio de Janeiro: Contraponto, 1997.DURKHEIM, Émile. O suicídio. Estudo sociológico. Tradução Monica Stahel. 1. ed. São Paulo: Martins Fontes, 2000. (Coleção Tópicos).FIERRO, Mariana. Suicidios que se transmitieron en vivo por redes sociales. Azteca. 2018. Disponível em: <https://www.aztecaamerica.com/galerias/noticias/13206/suicidios-que-se-transmitieron-en-vivo-por-redes-sociales/7>. Acesso em: 19 maio 2019.GOETHE, Johann Wolfgang. Os sofrimentos do jovem Werther, trad. de Erlon José Paschoal, São Paulo, Estação Liberdade, 1999.GOMES, J. O. et al. Suicídio e internet: análise de resultados em ferramentas de busca. In: Psicologia e Sociedade, v. 26, n. 1, p. 63-73, 2014.HISTÓRIA DIGITAL. 35 fotos post mortem. História Digital. Curiosidades. 2014. Disponível em: <https://historiadigital.org/curiosidades/35-fotos-post-mortem-feitas-apos-a-morte/>. Acesso em: 02 Fev. 2019.LOUREIRO, Paulo Roberto Amorim; MOREIRA, Tito Belchior; SACHSIDA, Adolfo. Os efeitos da mídia sobre o suicídio: uma análise empírica para os estados brasileiros. IPEA. Texto para Discussão 1851. Rio de Janeiro, 2013.MENEGHEL, Stela Nazareth et al. Características epidemiológicas do suicídio no Rio Grande do Sul. Revista Saúde Pública, v. 8, p. 804-810, 2004.MORENO, Ana Carolina; DANTAS, Carolina; OLIVEIRA, Monique. Suicídios de adolescentes: como entender os motivos e lidar com o fato que preocupa pais e educadores. Globo. Ciência e Saúde, 2018. Disponível em: < https://g1.globo.com/ciencia-e-saude/noticia/suicidios-de-adolescentes-como-entender-os-motivos-e-lidar-com-o-fato-que-preocupa-pais-e-educadores.ghtml >. Aceso em: 08 mar. 2019.NAÇÕES UNIDAS. OMS: quase 800 mil pessoas se suicidam por ano. Nações Unidas Brasil, 2018. Disponível em: <https://nacoesunidas.org/oms-quase-800-mil-pessoas-se-suicidam-por-ano/>. Acesso em: 04 mar. 2019.O GLOBO. Mãe encontra vídeo no Youtube Kids que ensina crianças como cometer suicídio. OGlobo. Sociedade. 2019. Disponível em: <https://oglobo.globo.com/sociedade/mae-encontra-video-no-youtube-kids-que-ensina-criancas-como-cometer-suicidio-23482770>. Acesso em: 19 maio 2019.OOVOO. Fast facts & figures. OOVOO. Company Fact Sheet 2014. Disponível em: <http://www.oovoo.com/fact-sheet/ooVoo_FactSheet_0807V5.pdf>. Acesso em: 10 jan. 2018.OWEN, Jonathan. Teens die after logging into 'suicide chat rooms'. Independent. This Britain. 2006. Disponível em: <https://www.independent.co.uk/news/uk/this-britain/teens-die-after-logging-into-suicide-chat-rooms-415386.html>. Acesso em 06 mar. 2019.PACÍFICO, Marsiel; GOMES, Luiz Roberto. O espetáculo de si: uma proposição sobre a atualidade da sociedade do espetáculo. Comunicações. Piracicaba, v. 26, n. 1, p. 165-179, 2019.R7. Por desilusão amorosa! Garota anuncia suicídio em rede social e posta última foto antes de se matar. R7. Hora7. 2014. Disponível em: <https://noticias.r7.com/hora-7/fotos/por-desilusao-amorosa-garota-anuncia-suicidio-em-rede-social-e-posta-ultima-foto-antes-de-se-matar-16062018#!/foto/8>. Acesso em: 18 dez. 2018.SILVA, Manuely Costa. A influência dos grupos Emo, Gótico e Punk no desenvolvimento dos adolescentes. Monografia (Especialização em Educação e Psicopedagogia) – Pontifícia Universidade Católica. Campinas, p. 33, 2006.SOUSA, Ana Cristina. Eugenia Cooney, a ‘rainha-esqueleto’, é demasiado magra para o Youtube?. Público. Sociedade, 2016. Disponível em: <https://www.publico.pt/2016/10/25/sociedade/noticia/anorexia-ou-magreza-natural-1748753>. Acesso em: 10 nov. 2018.STELTER, Brian. Web Suicide Viewed Live and Reaction Spur a Debate. NYTimes. 2008. Disponível em: <https://www.nytimes.com/2008/11/25/us/25suicides.html>. Acesso em: 18 maio 2019.STOKES, Paul. Chatroom users 'goaded man in web suicide'. The Telegraph. UKNews. 2007. Disponível em: <https://www.telegraph.co.uk/news/uknews/1563053/Chatroom-users-goaded-man-in-web-suicide.html>. Acesso em: 18 maio 2019.TÜRCKE. Christoph. Sociedade Excitada: filosofia da sensação. Tradução Antonio A. S. Zuin e outros. Campinas: Editora da Unicamp, 2010.VEJA. A cada 40 segundos ocorre um suicídio no mundo. Veja. Saúde, 2018. Disponível em <https://veja.abril.com.br/saude/a-cada-40-segundos-ocorre-um-suicidio-no-mundo/>. Acesso em: 12 maio 2019.VIANA, Bruno Mariante. Teasers: imagens que provocam a utilização do teaser de cartaz da saga Star Wars frente ao imaginário do público pós-moderno. Monografia (Bacharelado em Comunicação Social, Habilitação em Publicidade e Propaganda) – Faculdade de Biblioteconomia e Comunicação, Universidade Federal do Rio Grande do Sul, Porto Alegre, p. 92, 2010.YOUTUBE. Eugenia Cooney. Disponível em: <https://www.youtube.com/user/eugeniacooney/about>. Acesso em: 10 jan. 2019.e3873103
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Bathini, Dharma Raju, Neharika Vohra, and Manoj Jaiswal. "Wendt India Limited." Indian Institute of Management Ahmedabad, March 19, 2016, 1–14. http://dx.doi.org/10.1108/case.iima.2020.000122.
Full textAbstract:
Consistent growth and profitability had been the bedrock of Wendt India Limited (WIL) over the past ten years, in spite of facing huge financial mismanagement in the initial years and three ownership changes at group level. The strategic intent of WIL, “Wendt India sought to become a significant global player in offering customized functionally superior products/services for grinding and machining hard-to-process material,” kept the leaders of the company focused on exceptional performance. Despite a remarkable track record, WIL posted a lower growth 3.1% (CAGR) during 2007–2010, against an impressive 18% (CAGR) during 2000–2007 (See Exhibit 1). Rajesh Khanna, Chief Executive Officer of WIL, knew that the company's growth was tied to the perceptible slowdown in the economy post 2007. Industry analysts speculated that over the next few years, the abrasive industry itself was expected to grow at 7.2% per annum, mirroring the GDP growth rate. Goaded by the group chairperson's expectation that each business within the Murugappa group had to grow at three times the country's GDP growth rate, and personal belief that slowing down was not an option, Rajesh had set aggressive targets. He knew he would have to provide direction on how to reach the set expectations. He needed a coherent and strategic action plan to meet the aggressive targets.
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Khanh, Nguyen Cong, and Do Thi Huong. "The Education Assessment Capacity Structure of Primary Teachers in Vietnam." VNU Journal of Science: Education Research 34, no. 4 (November 7, 2018). http://dx.doi.org/10.25073/2588-1159/vnuer.4175.
Full textAbstract:
Education assessment capacity is considered to be indispensable for teachers at all levels. However, there are currently many difficulties in assessing this capacity, especially for primary teachers when there is a change in assessing students. In this report, we would like to suggest a education capacity assessment structure for primary teachers and to demonstrate such structure through a survey of primary teachers' assessment capacity in Vietnam. Survey results show that the education assessment capacity structure consists of 6 component competencies which suitable for primary teachers in Vietnam. And, the report also points out that Vietnamese primary teachers' education assessment capacity in Vietnam is currently evaluated at a fairly good level.
Keywords
Education assessment capacity structure, primary teachers
References
1. American Federation of Teachers & National Council on Measurement in Education (1990), Standards for Teacher Competence in Educational Assessment of Students, Washington DC.2. Dinh Quang Bao (2017), Fostering teachers to meet professional standards in the context of general education renovation, The summary record of a scientific conference: Rationale and practice of the professional capacity of teachers and educational administrators in the Northwest, Page 75-84.3. Ministry of Education and Training (2007), Professional standards for primary teachers, issued together with Decision No. 14/2007/QD-BGD dated 04 May 2007.4. Ministry of Education and Training (2010), Charter of primary schools, issued together with Circular No. 41/2010/TT-BGDDT dated 30 December 2010.5. Ministry of Education and Training (2016), Amending and supplementing some articles of the Regulations on the assessment of primary students, issued with Circular No. 22/2016/TT-BGDDT, dated 22 September 2016. 6. Canada Education Assosciation Joint Advisory Committee (1993), Principles for Fair Student Assessment Practices for Education in Canada, Edmonton, Alberta: Emonton.7. Nguyen Duc Chinh (2017), How do principals do to successfully lead teachers to develop student competencies, The summary record of a scientific conference: Rationale and practice of the professional capacity of teachers and educational administrators in the Northwest, Page 20-28.8. Nguyen Huu Chau (2008), Educational quality- Theoretical and practical issues, Vietnam Education Publishing House Limited Company.9. Bui Van Hue (1997), Primary psychology textbook, Vietnam Education Publishing House Limited Company, 1997, Page 33-91.10. Tran Thi Huong, Cao Xuan Hung (2017), Student assessment capacity building activities for primary teachers in District 3, Ho Chi Minh City, Ho Chi Minh City University of Education, Journal of Science , Volume 14, No. 10 (2017), Page 63-71.11. Nguyen Cong Khanh (2015), Student assessment based on the capacity-based approach. The summary record of an international conference: “Psychology and Pedagogy in the development of human beings in Vietnam”. University of Education Publishing House, Page 688-695.12. Nguyen Cong Khanh, Nguyen Vu Bich Hien (2013), Proposing the education assessment capacity framework for high school teachers, The summary record of READ conference, Hanoi.13. Nguyen Thi My Loc (2003), 21st century teachers: Being creative and effective, Journal of Teaching and Learning Today (7), Hanoi.14. Duong Thu Mai (2012), Studying and suggesting of a common capacity framework for the education assessment, The summary record of READ conference, Hanoi.15. Duong Thu Mai (2016), Forms of assessing modern education and methods of assessing the learning capacity of high school students in Vietnam, VNU Journal of Science: Educational research, Volume 32, No. 1 (2016) Page 51-61.16. Pham Duc Quang (2012), Some core components in the general education programs are built based on the competency building orientations, The summary record of a conference: The general core competency system of students for general education programs in Vietnam, Hanoi, Page 36- 49.17. Pham Hong Quang (2013), Development of teacher training programs, theoretical and practical issues, Thai Nguyen Publishing House.18. Nguyen Kim Son, Le Ngoc Hung, Nguyen Quy Thanh, Ta Thi Thu Hien, Pham Van Thuan, Duong Thi Hoang Yen (2018), Education Renovation in Vietnam: From the perspective of teachers, The summary record of an international conference: New trends in education, Page 42-57.19. Stronge, J. H. (2004), Qualities Of Effective Teacher, Le Van Canh translate, Vietnam Education Publishing House.20. Hoang Thi Tuyet (2004), Training of the education assessment capacity: A practical perspective, The summary record of a conference: The role of inspection and assessment activities in the renovation of education in Vietnam, Page 96-103.
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Mohd Rohani, Jafri, Mohamed Fitri Johari, Wan Harun Wan Hamid, and Hood Atan. "DEMOGRAPHIC ANALYSIS OF OCCUPATIONAL ACCIDENT OCCURRENCE IN MANUFACTURING INDUSTRY." Jurnal Teknologi 77, no. 1 (October 20, 2015). http://dx.doi.org/10.11113/jt.v77.4072.
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The objective of this paper is to analyze the demography aspect of occupational accident occurrence in Malaysia for manufacturing industry. High accident rate would give an adverse effect not only to the victims and their family but also to the organization as well. This study analyses various type of occupational accidents which limited to temporary disability with more than one day sick leave and cases recorded range between 2008 and 2013. The data is gathered from six different sectors within manufacturing industry by using local specific approach. Information related to each accident is obtained by checking past occupational accident record and interviewing site safety officer in charge, human resource representative, site supervisor and fellow workers. There are 342 cases in total have been gathered during data collection process before data analysis phase took place. This study provides a better perspective regarding to occupational accident occurrence to interested stakeholder such as enforcement body, occupational health and safety practitioner and company management itself. The findings from this study can be used to draft necessary preventive measures in order to provide safe working environment which can give significant impact through reduction of occupational accidents in the future.
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Medbøe, Haftor, and José Dias. "Improvisation in the digital age: New narratives in jazz promotion and dissemination." First Monday, October 5, 2014. http://dx.doi.org/10.5210/fm.v19i10.5553.
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Those that create, promote and disseminate jazz are experiencing a period of radical change. The dwindling interest from the major labels in releasing jazz has led to a mushrooming of both traditionally imagined and virtual independent jazz labels, often musician-led by individuals or collectives. Despite the ‘democratised’ potentials of digital dissemination made possible through third party vendors and streaming services such as iTunes and Spotify, modest or non-existent advertising budgets and lack of coherent marketing strategies often result in independent releases being drowned in the noise of an overcrowded marketplace. Financial returns from limited sales are also modest. The commercial underpinning that in previous times afforded the jazz musician both potential apprenticeship and métier has become fractured through increasing scarcity of record company and private/public funding. Against this black backdrop, musicians have engaged in new ways of disseminating their work. DIY strategies, such as free download netlabels or interactive app-albums, have become increasingly commonplace. Fresh approaches — the need for which are highlighted in this article with reference to the European jazz scene — indicate how musicians are networking informally, often with little or no institutional support. This paper highlights to what extent market realignments have prompted individual and collective creative responses to current difficulties associated with the promotion of jazz music.
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Dam, Gregers, Henrik Nøhr-Hansen, Flemming G. Christiansen, Jørgen A. Bojesen-Koefoed, and Troels Laier. "The oldest marine Cretaceous sediments in West Greenland (Umiivik-1 borehole) – record of the Cenomanian–Turonian Anoxic Event?" GEUS Bulletin, December 31, 1998, 128–37. http://dx.doi.org/10.34194/ggub.v180.5096.
Full textAbstract:
NOTE: This article was published in a former series of GEUS Bulletin. Please use the original series name when citing this article, for example:
Dam, G., Nøhr-Hansen, H., Christiansen, F. G., Bojesen-Koefoed, J. A., & Laier, T. (1998). The oldest marine Cretaceous sediments in West Greenland (Umiivik-1 borehole) – record of the Cenomanian–Turonian Anoxic Event?. Geology of Greenland Survey Bulletin, 180, 128-137. https://doi.org/10.34194/ggub.v180.5096
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The stratigraphic borehole Umiivik-1 on Svartenhuk Halvø was drilled in August–September 1995 as part of a joint programme between the Government of Greenland, Minerals Office (now Bureau of Minerals and Petroleum) and the Danish State (Mineral Resources Administration for Greenland). The joint programme was based on a political decision from November 1994 made in order to attract the oil and mineral industry to Greenland. The drilling of Umiivik-1 is one of several petroleum geological projects in West Greenland that were initiated early in 1995. Analyses on the core include detailed sedimentological, palynological and organic geochemical studies. The other petroleum geological projects comprise: description and interpretation of the three exploration boreholes on Nuussuaq, GANT#1, GANE#1 and GANK#1 that the Canadian oil company grønArctic Energy Inc. drilled in the summer of 1995 (e.g. Christiansen et al. 1996a, c; Dam 1996a–c; NøhrHansen 1997a); seismic surveys in the fjords around Disko, Nuussuaq and Svartenhuk Halvø (FjordSeis 95); seismic surveys in the offshore area between 68° and 71°N (DiskoSeis 95); and seismic surveys in the offshore area south of 68°N (IkerSeis 95, KangaSeis 95 and ExtraSeis 95; Chalmers et al. 1998, this volume; Skaarup & Chalmers 1998, this volume). The prime objective of Umiivik-1 was to document oil-prone source rocks in mid-Cretaceous strata. Although several types of crude oil have been found in seeps and slim-hole cores in West Greenland since 1992, there was only limited knowledge on actual source rocks when the project was initiated. Detailed organic geochemistry, especially the distribution of biomarkers in seeping oils, provides important information on the type of organic material, the depositional environment and the thermal history of the source rocks that generated these oils (Christiansen et al. 1996b, 1997b; Bojesen-Koefoed et al. in press). However, there are only limited data on thickness, areal distribution, generative potential, and stratigraphic age of the actual source rocks. Considering the exploration possibilities in West Greenland, the presence of source rocks seems to be one of the main risk elements, if not the most critical factor. It was therefore generally accepted in 1994 that the level of exploration interest in West Greenland would strongly benefit from the actual demonstration of the existence, age and depositional environment of oil-prone source rocks and by quantifying their generation potential. The most likely candidate in this context was a possible mid-Cretaceous marine source rock (Cenomanian–Turonian) that was first suggested in West Greenland by Chalmers et al. (1993) on the basis of world-wide analogies, but later supported by direct data from Ellesmere Island in Arctic Canada (Núñez-Betelu 1994). The Svartenhuk Halvø area is one of the few areas where Upper Cretaceous and Lower Tertiary marine sediments are exposed onshore West Greenland (Fig. 1), and the mudstones outcropping on Svartenhuk Halvø are the oldest known, fully marine deposits from West Greenland (Birkelund 1965; Nøhr-Hansen 1996). These mudstones have recently been studied during field work by the Geological Survey of Greenland in 1991 and 1992, a programme which also included five shallow boreholes between 66 and 86 m deep (Fig. 1; Christiansen 1993; Christiansen et al. 1994). Based on analytical work from these cores and samples from nearby outcrops, thermally immature mudstones of Coniacian to Early Santonian age have been documented (Nøhr-Hansen 1996), thereby giving hope that immature or early mature sediments of Cenomanian– Turonian age could be reached by drilling to relatively shallow depths along the southern shoreline of Umiiviup Kangerlua (Fig. 1).
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Hamann, Philip D. H., Nicola Minaur, Jon H. Tobias, and Emma M. Clark. "P104 Longitudinal patient reported outcome data collected from a smartphone app can map group level trajectories of disease activity over time." Rheumatology 59, Supplement_2 (April 1, 2020). http://dx.doi.org/10.1093/rheumatology/keaa111.102.
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Abstract Background Patient-reported outcome measures are a cornerstone of the current early inflammatory arthritis audit and part of the best practice tariff. However, outcome data are collected infrequently meaning longitudinal changes in disease activity cannot be accurately examined. We report results of a twelve-month clinical pilot of a cloud-enabled commercial smartphone app to record patient self-reported disease activity outcome measures to evaluate trends of disease activity in a routine rheumatology setting. Methods Patients with a clinical diagnosis of inflammatory arthritis attending routine rheumatology clinic were offered the opportunity to use a smartphone app to record their disease activity between hospital appointments using the RAPID3. Data from the first twelve months (July 2018 - July 2019) was extracted and latent class modelling using aggregate data was undertaken to explore the trends of disease activity experienced by our patients at a group level. Standard analysis recommendations were followed. Results Over the course of twelve-months, 58 patients used the app to record their disease activity using the RAPID3. These patients had a mean age of 53 and were 76% female. 35 patients had rheumatoid arthritis, 15 patients had psoriatic arthritis and 8 had another inflammatory arthritis. The median number of RAPID3 scores completed per patient was 8 (interquartile range 14), and a total of 706 RAPID3 scores were submitted over the 12 months. Three different trajectories of disease activity were identified among our cohort of patients. The first trajectory showed a low stable plateau of disease activity for six months before further improvement (27 patients:47%) over six months. The second trajectory (23 patients; 40%) showed an initial moderate disease activity which gradually declined over six months before improving markedly in the last three months, returning to moderate disease activity. The final trajectory (8 patients; 14%) identified patients with the highest disease activity which showed a gradual but slow improvement of disease activity over twelve months. These different trajectories show the changing burden of inflammatory arthritis over time. Conclusion Regular longitudinal data collection of patient-reported outcomes via a smartphone app can be used to show distinct group level trajectories of disease activity and could be used to examine changes in outcomes of patients over time. Data such as these could be used at a departmental level to examine the burden of inflammatory arthritis experienced by patients, assist planning future service requirements, and help anticipate the timings of future appointments more accurately for patients. Disclosures P.D.H. Hamann Consultancies; Living With Ltd. Royalties; PH has provided consultancy for and has an options and limited royalty agreement with, Living With Ltd. software company for the development of the smartphone application described in this abstract. N. Minaur None. J.H. Tobias None. E.M. Clark None.