110 research outputs found

    Disparity in outcomes of melanoma adjuvant immunotherapy by demographic profile

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    Background: Randomized comparisons have demonstrated survival benefit of adjuvant immunotherapy in node-positivemelanoma patients but have limited power to determine if this benefit persists across various demographic factors. Materials & methods: We assessed the impact of demographic factors on the survival benefit of adjuvant immunotherapy in a database of 38,189 node-positive melanoma patients using the Kaplan–Meier method and Cox proportional hazards models. Results: All assessed demographic factors other than race significantly impacted survival of node-positive melanoma patients in univariate analysis. In multivariable analysis, only the age group interacted with immunotherapy. Conclusion: Analysis of this large database of unselected node-positive melanoma patients demonstrated a positive survival benefit of immunotherapy across all demographic factors assessed and the impact was greater for patients 65 years of age and older

    Influence of participant and reviewer characteristics in application scores for a hematology research training program

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    The American Society of Hematology Clinical Research Training Institute (CRTI) is a clinical research training program with a competitive application process. The objectives were to compare application scores based on applicant and reviewer sex and underrepresented minority (URM) status. We included applications to CRTI from 2003 to 2019. The application scores were transformed into a scale from 0 to 100 (100 was the strongest). The factors considered were applicant and reviewer sex and URM status. We evaluated whether there was an interaction between the characteristics and time related to application scores. In total, 713 applicants and 2106 reviews were included. There was no significant difference in scores according to applicant sex. URM applicants had significantly worse scores than non-URM applicants (mean [standard error] 67.9 [1.56] vs 71.4 [0.63]; P = .0355). There were significant interactions between reviewer sex and time (P = .0030) and reviewer URM status and time (P = .0424); thus, results were stratified by time. For the 2 earlier time periods, male reviewers gave significantly worse scores than did female reviewers; this difference did not persist for the most recent time period. The URM reviewers did not give significantly different scores across time periods. URM applicants received significantly lower scores than non-URM applicants. The impact of reviewer sex and URM status changed over time. Although male reviewers gave lower scores in the early periods, this effect did not persist in the late period. Efforts are required to mitigate the impact of applicant URM status on application scores

    Frequency and Significance of HIV Infection among Patients Diagnosed with Thrombotic Thrombocytopenic Purpura

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    Background. Case series of patients with a diagnosis of thrombotic thrombocytopenic purpura (TTP) have reported different frequencies of human immunodeficiency virus (HIV) infection; some series suggest that HIV infection may cause TTP. Methods. We systematically reviewed all reports of HIV infection in case series of patients with TTP. We analyzed data from the Oklahoma TTP-HUS (hemolytic uremic syndrome) Registry, an inception cohort of 362 consecutive patients, for 1989-2007. Results. Nineteen case series reported the occurrence of HIV infection at the time of diagnosis of TTP in 0%-83% of patients; individual patient data were rarely described. The Oklahoma TTP-HUS Registry determined the HIV status at the time of diagnosis of TTP in 351 (97%) of 362 patients. HIV infection was documented in 6 (1.84%; 95% CI, 0.68%-4.01%) of 326 adult patients (age, 26-51 years); follow-up data were complete for all 6 patients. The period prevalence of HIV infection among all adults in the Oklahoma TTP-HUS Registry region for 1989-2007 was 0.30%. One patient had typical features of TTP with 5 relapses. Five patients had single episodes; in 4, the clinical features that had initially suggested the diagnosis of TTP were subsequently attributed to malignant hypertension (in 3 patients) and disseminated Kaposi sarcoma (in 1 patient). Conclusions. HIV infection, similar to other inflammatory conditions, may trigger acute episodes of TTP in susceptible patients. More commonly, acquired immunodeficiency syndrome-related disorders may mimic the clinical features of TTP. If the diagnosis of TTP is suggested in a patient with HIV infection, there should be careful evaluation for alternative diagnoses and cautious consideration of plasma exchange, the required treatment for TT

    Youth Assets and Sexual Activity Among Hispanic Youth

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    Hispanic females, ages 15-19, experienced the highest birth rates and smallest decline in birth rates over the past decade compared to youth of other racial/ethnic groups. This study’s purpose was to investigate relationships among a series of protective factors, or youth assets, and sexual activity in the Hispanic/Latino youth population. Data were collected from Hispanic youth and their parents (N=232 youth/parent pairs) in randomly selected households using in-person, in-home interview methods. Independent variables were nine youth assets; “never had sexual intercourse” was the dependent variable. Data were analyzed using logistic regression analysis. Three assets were found to be significantly associated with whether or not Hispanic/Latino youth ever had sexual intercourse. Odds of never having had sexual intercourse were at least three times higher for youth with the Peer Role Models, Use of Time (religion), or Responsible Choices assets, compared to youth without these assets. Further Hispanic youth asset/risk behavior research is merited

    Youth Assets and Sexual Activity Among Hispanic Youth

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    Hispanic females, ages 15-19, experienced the highest birth rates and smallest decline in birth rates over the past decade compared to youth of other racial/ethnic groups. This study’s purpose was to investigate relationships among a series of protective factors, or youth assets, and sexual activity in the Hispanic/Latino youth population. Data were collected from Hispanic youth and their parents (N=232 youth/parent pairs) in randomly selected households using in-person, in-home interview methods. Independent variables were nine youth assets; “never had sexual intercourse” was the dependent variable. Data were analyzed using logistic regression analysis. Three assets were found to be significantly associated with whether or not Hispanic/Latino youth ever had sexual intercourse. Odds of never having had sexual intercourse were at least three times higher for youth with the Peer Role Models, Use of Time (religion), or Responsible Choices assets, compared to youth without these assets. Further Hispanic youth asset/risk behavior research is merited

    Potential Protective Effect of the Community Involvement Asset on Adolescent Risk Behaviors

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    The potential of Community Involvement as a protective factor (youth asset) for eight adolescent risk behaviors was examined in this study. Cross-sectional data were collected from a randomly-selected population using in-home, in-person interviews in racially diverse inner-city neighborhoods of two Midwestern cities. Research participants were teenagers (n=1,278) and parents of the teenagers (n=1,278). Data included demographic variables; eight adolescent risk behaviors, including sexual activity, violence and the use of tobacco, alcohol and drugs. This study found youth with the Community Involvement asset were significantly (

    Potential Protective Effect of the Community Involvement Asset on Adolescent Risk Behaviors

    Get PDF
    The potential of Community Involvement as a protective factor (youth asset) for eight adolescent risk behaviors was examined in this study. Cross-sectional data were collected from a randomly-selected population using in-home, in-person interviews in racially diverse inner-city neighborhoods of two Midwestern cities. Research participants were teenagers (n=1,278) and parents of the teenagers (n=1,278). Data included demographic variables; eight adolescent risk behaviors, including sexual activity, violence and the use of tobacco, alcohol and drugs. This study found youth with the Community Involvement asset were significantly (

    Evaluating the impact of a year-long external mentorship pilot program in classical hematology

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    Effective mentorship is a pivotal factor in shaping the career trajectory of trainees interested in classical hematology (CH), which is of critical importance due to the anticipated decline in the CH workforce. However, there is a lack of mentorship opportunities within CH compared with medical oncology. To address this need, a year-long external mentorship program was implemented through the American Society of Hematology Medical Educators Institute. Thirty-five hematology/oncology fellows interested in CH and 34 academically productive faculty mentors from different institutions across North America were paired in a meticulous process that considered individual interests, experiences, and background. Pairs were expected to meet virtually once a month. Participation in a scholarly project was optional. A mixed-methods sequential explanatory design was used to evaluate the program using mentee and mentor surveys, a mentee interview, and a mentee focus group. Thirty-three mentee-mentor pairs (94.2%) completed the program. Sixty-three percent of mentee respondents worked on a scholarly project with their mentor; several mentees earned publications, grants, and awards. Mentee perception that their assigned mentor was a good match was associated with a perceived positive impact on confidence (P = .0423), career development (P = .0423), and professional identity (P = .0302). Furthermore, 23 mentees (66%) accepted CH faculty positions after fellowship. All mentor respondents believed that this program would increase retention in CH. This mentorship program demonstrates a productive, beneficial way of connecting mentees and mentors from different institutions to improve the careers of CH trainees, with the ultimate goal of increasing retention in CH
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