Objective This study aims to test the acceptance, feasibility, and usefulness of the Arabic version of the revised Edmonton Symptom AssesSment System （ESAS-r） among Egyptian patients with advanced cancer and to comp...Objective This study aims to test the acceptance, feasibility, and usefulness of the Arabic version of the revised Edmonton Symptom AssesSment System （ESAS-r） among Egyptian patients with advanced cancer and to compare the rates of symptoms documented by patients and physicians. Methods Between August 2014 and February 2015, a total of 140 patients at Ain Shams University Hospitals in Cairo, Egypt received the Arabic version of the ESAS-r. For each patient, the ESAS-r was completed twice, first by the treating physician （as part of the basic assessment） and a second time by the patient, with a maximum of 2 hours between the two assessments. An additional survey was included to assess patients＇ acceptance of the survey and their preferences. Results Out of 140 enrolled patients in the study, 11 patients refused to complete the questionnaire, and 10 patients were excluded due to incomplete records in their medical records. Complete data was retrieved for 119 patients who were included for further analyses. The 78 （65%） patients declared that the test was clear and easy to complete. They were able to answer the test without help. Collectively, tiredness and sense of well-being were the most commonly encountered symptoms in ratings obtained by both patients and physicians. Tiredness was the only symptom showing a significant difference between the two rating methods, patient-rated scores being higher （P = 0.032）. Cronbach＇s alpha showed that both tests com- pleted by the physician and the patients were internally consistent： the physician-rated test had a coefficient of 0.877, and the patient-rated test had a coefficient of 0.863. All ESAS scores had good internal consis- tency, with a Cmnbach＇s alpha coefficient of 0.88. The internal consistency remained high after removal of individual symptom scores, with Cronbach＇s alpha coefficients ranging from 0.823 to 0.902, indicating that no individual question had undue influence on the total ESAS score. Conclusion The ESAS-r was easily understood by and applicable to patients. There was no significant discrepancy in the rates of symptoms reported by the patients and physicians, apart from tiredness. Based on this, the test could be applied on a larger scale with in-home patients. This test can be cost-effective and can decrease the number of hospital visits among advanced cancer patients in need of supportive treat- ment rather than active cancer therapy.展开更多
An attempt has been made to systematically revise the Late Cretaceous （Turonian） bivalves of the Bagh Beds, central India. Altogether, fifteen species have been described here. The two species Nicaniella （N） trigo...An attempt has been made to systematically revise the Late Cretaceous （Turonian） bivalves of the Bagh Beds, central India. Altogether, fifteen species have been described here. The two species Nicaniella （N） trigonoides ＆ Protocardia （P） laticostata, which are earlier known from Late Cretaceous of Tiruchirapalli subbasin, southern India, have been recorded for the first time from Narmada Basin. The other species recorded are： Modiolus typicus, Neithea morrisi, Plicatula batnensis, P. numidica, P. instabilis, Lucina （L.） cf. fallax, Astarte similis, Opis corniformis, Protocardia hillana, P. madagascariense, Cytherea （Callista） lancianata, Trigonocallista spathi and Pholadomya sp.. During course of systematic revision, it has been found that many species described by earlier workers from the Late Cretaceous of Bagh Beds have been found conspecific to already known species from the Cretaceous of different parts of the globe and hence, they have been recorded here as junior synonyms. These species have immense implication in the palaeobiogeography of the region.展开更多
The successes achieved by chimeric antigen receptor-modified T （CAR-T） cells in hematological malignancies raised the pos- sibility of their use in non-small lung cancer （NSCLC）. In this phase I clinical study （N...The successes achieved by chimeric antigen receptor-modified T （CAR-T） cells in hematological malignancies raised the pos- sibility of their use in non-small lung cancer （NSCLC）. In this phase I clinical study （NCT01869166）, patients with epidermal growth factor receptor （EGFR）-positive （〉50% expression）, relapsed/refractory NSCLC received escalating doses of EGFR-targeted CAR-T cell infusions. The EGFR-targeted CAR-T cells were generated from peripheral blood after a 10 to 13-day in vitro expansion. Serum cytokines in peripheral blood and copy numbers of CAR-EGFR transgene in peripheral blood and in tissue biopsy were monitored periodically. Clinical responses were evaluated with RECISTI.1 and im- mune-related response criteria, and adverse events were graded with CTCAE 4.0. The EGFR-targeted CAR-T cell infusions were well-tolerated without severe toxicity. Of 11 evaluable patients, two patients obtained partial response and five had stable disease for two to eight months. The median dose of transfused CAR＋ T cells was 0.97x 10^7 cells kg J （interquar- tile range （IQR）, 0.45 to 1.09x 10^7 cells kg 1）. Pathological eradication of EGFR positive tumor cells after EGFR-targeted CAR-T cell treatment can be observed in tumor biopsies, along with the CAR-EGFR gene detected in tumor-infiltrating T cells in all four biopsied patients. The EGFR-targeted CAR-T cell therapy is safe and feasible for EGFR-positive advanced re- lapsed/refractory NSCLC.展开更多
文摘Objective This study aims to test the acceptance, feasibility, and usefulness of the Arabic version of the revised Edmonton Symptom AssesSment System （ESAS-r） among Egyptian patients with advanced cancer and to compare the rates of symptoms documented by patients and physicians. Methods Between August 2014 and February 2015, a total of 140 patients at Ain Shams University Hospitals in Cairo, Egypt received the Arabic version of the ESAS-r. For each patient, the ESAS-r was completed twice, first by the treating physician （as part of the basic assessment） and a second time by the patient, with a maximum of 2 hours between the two assessments. An additional survey was included to assess patients＇ acceptance of the survey and their preferences. Results Out of 140 enrolled patients in the study, 11 patients refused to complete the questionnaire, and 10 patients were excluded due to incomplete records in their medical records. Complete data was retrieved for 119 patients who were included for further analyses. The 78 （65%） patients declared that the test was clear and easy to complete. They were able to answer the test without help. Collectively, tiredness and sense of well-being were the most commonly encountered symptoms in ratings obtained by both patients and physicians. Tiredness was the only symptom showing a significant difference between the two rating methods, patient-rated scores being higher （P = 0.032）. Cronbach＇s alpha showed that both tests com- pleted by the physician and the patients were internally consistent： the physician-rated test had a coefficient of 0.877, and the patient-rated test had a coefficient of 0.863. All ESAS scores had good internal consis- tency, with a Cmnbach＇s alpha coefficient of 0.88. The internal consistency remained high after removal of individual symptom scores, with Cronbach＇s alpha coefficients ranging from 0.823 to 0.902, indicating that no individual question had undue influence on the total ESAS score. Conclusion The ESAS-r was easily understood by and applicable to patients. There was no significant discrepancy in the rates of symptoms reported by the patients and physicians, apart from tiredness. Based on this, the test could be applied on a larger scale with in-home patients. This test can be cost-effective and can decrease the number of hospital visits among advanced cancer patients in need of supportive treat- ment rather than active cancer therapy.
文摘An attempt has been made to systematically revise the Late Cretaceous （Turonian） bivalves of the Bagh Beds, central India. Altogether, fifteen species have been described here. The two species Nicaniella （N） trigonoides ＆ Protocardia （P） laticostata, which are earlier known from Late Cretaceous of Tiruchirapalli subbasin, southern India, have been recorded for the first time from Narmada Basin. The other species recorded are： Modiolus typicus, Neithea morrisi, Plicatula batnensis, P. numidica, P. instabilis, Lucina （L.） cf. fallax, Astarte similis, Opis corniformis, Protocardia hillana, P. madagascariense, Cytherea （Callista） lancianata, Trigonocallista spathi and Pholadomya sp.. During course of systematic revision, it has been found that many species described by earlier workers from the Late Cretaceous of Bagh Beds have been found conspecific to already known species from the Cretaceous of different parts of the globe and hence, they have been recorded here as junior synonyms. These species have immense implication in the palaeobiogeography of the region.
基金supported by the Science and Technology Planning Project of Beijing City (Z151100003915076)the National Natural Science Foundation of China (31270820, 81230061, 81472612, 81402566)+1 种基金the National Basic Science and Development Programme of China (2013BAI01B04)the Nursery Innovation Fund (15KMM50)
文摘The successes achieved by chimeric antigen receptor-modified T （CAR-T） cells in hematological malignancies raised the pos- sibility of their use in non-small lung cancer （NSCLC）. In this phase I clinical study （NCT01869166）, patients with epidermal growth factor receptor （EGFR）-positive （〉50% expression）, relapsed/refractory NSCLC received escalating doses of EGFR-targeted CAR-T cell infusions. The EGFR-targeted CAR-T cells were generated from peripheral blood after a 10 to 13-day in vitro expansion. Serum cytokines in peripheral blood and copy numbers of CAR-EGFR transgene in peripheral blood and in tissue biopsy were monitored periodically. Clinical responses were evaluated with RECISTI.1 and im- mune-related response criteria, and adverse events were graded with CTCAE 4.0. The EGFR-targeted CAR-T cell infusions were well-tolerated without severe toxicity. Of 11 evaluable patients, two patients obtained partial response and five had stable disease for two to eight months. The median dose of transfused CAR＋ T cells was 0.97x 10^7 cells kg J （interquar- tile range （IQR）, 0.45 to 1.09x 10^7 cells kg 1）. Pathological eradication of EGFR positive tumor cells after EGFR-targeted CAR-T cell treatment can be observed in tumor biopsies, along with the CAR-EGFR gene detected in tumor-infiltrating T cells in all four biopsied patients. The EGFR-targeted CAR-T cell therapy is safe and feasible for EGFR-positive advanced re- lapsed/refractory NSCLC.
