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In the CARD study (NCT02485691), cabazitaxel significantly improved median radiographic progression-free survival (rPFS) and overall survival (OS) versus abiraterone/enzalutamide in patients with metastatic castration-resistant prostate cancer (mCRPC) who had previously received docetaxel and progressed ≤12 mo on the alternative agent (abiraterone/enzalutamide).

To assess cabazitaxel versus abiraterone/enzalutamide in older (≥70yr) and younger (<70yr) patients in CARD.

Patients with mCRPC were randomized 11 to cabazitaxel (25mg/m

plus prednisone and granulocyte colony-stimulating factor) versus abiraterone (1000mg plus prednisone) or enzalutamide (160mg).

Analyses of rPFS (primary endpoint) and safety by age were prespecified; others were post hoc. Treatment groups were compared using stratified log-rank or Cochran-Mantel-Haenszel tests.

Of the 255 patients randomized, 135 were aged ≥70yr (median 76yr). Cabazitaxel, compared with abiraterone/enzalutamide, significantly improved median rPFS in of age. TEAEs were more frequent among older patients. The cabazitaxel safety profile was manageable across age groups.

Clinical trial data showed that cabazitaxel improved survival versus abiraterone/enzalutamide with manageable side effects in patients with metastatic castration-resistant prostate cancer who had previously received docetaxel and the alternative agent (abiraterone/enzalutamide), irrespective of age.

Clinical trial data showed that cabazitaxel improved survival versus abiraterone/enzalutamide with manageable side effects in patients with metastatic castration-resistant prostate cancer who had previously received docetaxel and the alternative agent (abiraterone/enzalutamide), irrespective of age.

To assess oncologic outcomes in endometrial cancer patients with low-volume metastasis (LVM) in the sentinel lymph nodes (SLNs).

Patients with endometrial cancer and SLN-LVM (≤2 mm) from December 3, 2009, to December 31, 2018, were retrospectively identified from 22 centers worldwide. Patients with International Federation of Gynecology and Obstetrics (FIGO) stage IV, adnexal involvement, or unknown adjuvant therapy (ATx) were excluded.

Of 247 patients included, 132 had isolated tumor cell (ITC) and 115 had micrometastasis (MM). Overall 4-year recurrence-free survival (RFS) was 77.6% (95% CI, 70.2%-85.9%); median follow-up for patients without recurrence was 29.6 (interquartile range, 19.2-41.5) months. At multivariate analysis, Non-endometrioid (NE) (HR, 5.00; 95% CI, 2.50-9.99; P < .001), lymphovascular space invasion (LVSI) (HR, 3.26; 95% CI, 1.45-7.31; P = .004), and uterine serosal invasion (USI) (HR, 3.70; 95% CI, 1.44-9.54; P = .007) were independent predictors of recurrence. Among 47 endometr subgroup.

Low socio-economic status of individuals has been reported to be associated with a higher incidence of stroke and influence the diagnosis after revascularization. However, whether it is associated with poorer acute stroke management is less clear. To determine whether social deprivation was associated with a poorer access to reperfusion therapy, either intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT) in a population-based cohort.

Over a 14-month period, all consecutive adult patients admitted to any emergency department or a comprehensive or primary stroke center (CSC/PSC) of the Rhône county with a confirmed ischemic stroke were included. The socioeconomic status of each patient was measured using the European Deprivation Index (EDI). The association between EDI and access to reperfusion therapy was assessed in univariate and multivariate logistic regression analyses.

Among the 1226 consecutive IS patients, 316 (25%) were admitted directly in a PSC or CSC, 241 (19.7%) received a reperfusion therapy; 155 IVT alone, 20 EVT alone, and 66 both therapies. selleck inhibitor Median age was 79 years, 1030 patients had an EDI level of 1 to 4, and 196 an EDI of 5 (the most deprived group). The most deprived patients (EDI level 5) did not have a poorer access to reperfusion therapy compared to all other patients in univariate (OR 1.22, 95%CI [0.85; 1.77]) nor in multivariate analyses (adjOR 0.97, 95%CI [0.57; 1.66]).

We did not find any significant association between socioeconomic deprivation and access to reperfusion therapy. This suggests that the implementation of EVT was not associated with increased access inequities.

We did not find any significant association between socioeconomic deprivation and access to reperfusion therapy. This suggests that the implementation of EVT was not associated with increased access inequities.

In the Canadian province of Quebec, placing children in foster care is an exceptional measure whose ultimate goal is family reunification. When child-protection workers decide that reunification is unlikely, they must design permanency plans that ensure continuity of care and stable relationships for the child. Most studies of this important decision-making process have focused on individual practitioners as if they acted alone. This process is collective, interactive, and influenced by various contextual elements.

The objective of this exploratory study was to examine the collective, interactive aspects of the decision-making process involved in permanency planning.

The participants were key players involved in child-protection decisions at an Integrated University Health and Social Services Centre (CIUSSS).

The theoretical approach of this study combines Giddens's structuration theory with ethnomethodology. Data were collected through interviews with 16 key players and nine months of observing advis practitioners accountable and penalizing them for mistakes, but rather on providing adequate conditions for practice to facilitate thoughtful collective deliberation and learning and ethical decision-making.

There are few studies on late-adopted adolescents' outcomes -e.g., emotional-behavioral problems, attachment and cognitive status- and their possible predictive factors, none from Italy.

This paper aimed to investigate emotional-behavioral problems, attachment representations, and verbal skills in late-adopted adolescents in Italy and to explore the predictive role of pre-adoption adversities and adoption variables for worse adoptees' outcomes.

The study included N=79 late-adopted (mean age at adoption=6years) adolescents, between 11 and 18years, placed via both intercountry and domestic adoption.

Parents provided information about pre-adoption and adoption history and filled the Children's Behavior Checklist 6-18 for measuring participants' emotional-behavioral problems. Attachment representations were assessed through the Friend and Family Interview administered directly to adolescents, like the verbal comprehension index of the Wechsler Intelligence Scale for Children (4th edition) for measuring participants' verbal IQ.

Maltreatment and its interaction with multiple placements were the main predictors of other problems-i.e., social, thought, and identity difficulties (respectively, p=.007 and p=.029)-while intercountry adoption was the unique predictor of both externalizing and total problems (respectively, p=.047 and p=.015). However, domestic adoption was the most important predictor both for higher insecurity and disorganized attachment representations and lower verbal skills (all p<.044); even stronger if domestic adoption interacted with pre-adoptive institutionalization.

Pre-adoption adversities as well as domestic vs. intercountry adoption, but not the age at placement, contributed to adolescent adoptees' developmental outcomes.

Pre-adoption adversities as well as domestic vs. intercountry adoption, but not the age at placement, contributed to adolescent adoptees' developmental outcomes.

To assess the value of using SARS-CoV-2 specific antibody testing to prioritize the vaccination of susceptible individuals as part of a COVID-19 vaccine distribution plan when vaccine supply is limited.

An extended susceptible-infected-recovered (SIR) compartmental model was used to simulate COVID-19 spread when considering diagnosis, isolation, and vaccination of a cohort of 1 million individuals. The scenarios modeled represented 4 pandemic severity scenarios and various times when the vaccine becomes available during the pandemic. Eligible individuals have a probability p of receiving antibody testing prior to vaccination (p=0, 0.25, 0.5, 0.75, and 1). The vaccine was modeled as a single dose vaccine with 90% and 70% efficacy. The value of serology testing was evaluated by comparing the infection attack rate, peak infections, peak day, and deaths.

The use of antibody testing to prioritize the allocation of limited vaccines reduces infection attack rates and deaths. The size of the reduction depends on when the vaccine becomes available relative to the infection peak day. link2 The largest percentage reduction in cases and deaths occurs when the vaccine is deployed before and close to the infection peak day. The reduction in the number of cases and deaths diminishes as vaccine deployment is delayed.

Antibody testing as part of the vaccination plan is an effective method to maximize the benefit of a COVID-19 vaccine. Decision-makers need to consider relative timing between the infection peak day and when the vaccine becomes available.

Antibody testing as part of the vaccination plan is an effective method to maximize the benefit of a COVID-19 vaccine. Decision-makers need to consider relative timing between the infection peak day and when the vaccine becomes available.

The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group aims to develop composite response criteria for ANCA-Associated Vasculitis (AAV).

The project follows the OMERACT approach for composite measures (i) choose relevant domains; (ii) define high-quality instruments; (iii) decide on a scoring system approach; (iv) put through the OMERACT Filter 2.1 for validation.

A systematic literature review of outcome measures used in clinical trials in AAV and an international Delphi exercise among patients with AAV and clinician-investigators with expertise in AAV have been completed to inform the candidate domains/instruments for the composite response criteria, which are the first two steps in the OMERACT approach for developing composite measures. Results of the systematic literature review and Delphi were presented at the OMERACT 2020 virtual workshop, and feedback was received on the next steps of the project, including the development of a scoring system approach.

The ultimate goal of this project is to develop validated composite response criteria for use in clinical trials of AAV.

The ultimate goal of this project is to develop validated composite response criteria for use in clinical trials of AAV.

Donation after circulatory death donors are becoming a common source of organs for transplant. Despite good long-term outcomes of grafts from donation after circulatory death, this group is affected by a higher occurrence of delayed graft function and primary nonfunction. Our hypothesis is based on the assumption that washing the kidney grafts in the donor's body using a simple mechanical perfusion pump will result in faster and better perfusion of the parenchyma and more efficient cooling compared with hydrostatic perfusion alone.

A total of 7 experimental animals (pigs) were used. The animals were divided into 2 groups group A (n=3) and group B (n=4). After a 30-minute ischemic period for the selected kidney (clamped renal vessels), intra-arterial perfusion was performed. In group A perfusion was performed using hydrostatic pressure; in group B mechanical controlled perfusion was performed. After perfusion, declamping of the renal vessels caused restoration of flow. link3 For graft quality evaluation, biopsy specimens were harvested, and the cooling speed was observed.