Quality of life gains in frail and intermediate-fit patients with multiple Myeloma:Findings from the prospective HOVON123 clinical trial

Background: Frailty in newly-diagnosed multiple myeloma (NDMM) patients is associated with treatment-related toxicity, which negatively affects health-related quality of life (HRQoL). Currently, data on changes in HRQoL of frail and intermediate-fit MM patients during active treatment and post-treatment follow-up are absent. Methods: The HOVON123 study (NTR4244) was a phase II trial in which NDMM patients ≥ 75 years were treated with nine dose-adjusted cycles of Melphalan-Prednisone-Bortezomib (MPV). Two HRQoL instruments (EORTC QLQ-C30 and -MY20) were obtained before start of treatment, after 3 and 9 months of treatment and 6 and 12 months after treatment for patients who did not yet start second-line treatment. HRQoL changes and/or differences in frail and intermediate-fit patients (IMWG frailty score) were reported only when both statistically significant (p &lt; 0.005) and clinically relevant (&gt;MID). Results: 137 frail and 71 intermediate-fit patients were included in the analysis. Compliance was high and comparable in both groups. At baseline, frail patients reported lower global health status, lower physical functioning scores and more fatigue and pain compared to intermediate-fit patients. Both groups improved in global health status and future perspective; polyneuropathy complaints worsened over time. Frail patients improved over time in physical functioning, fatigue and pain. Improvement in global health status occurred earlier than in intermediate-fit patients. Conclusion: HRQoL improved during anti-myeloma treatment in both intermediate-fit and frail MM patients. In frail patients, improvement occurred faster and, in more domains, which was retained during follow-up. This implies that physicians should not withhold safe and effective therapies from frail patients in fear of HRQoL deterioration.</p

Quality of life gains in frail and intermediate-fit patients with multiple Myeloma:Findings from the prospective HOVON123 clinical trial

Background: Frailty in newly-diagnosed multiple myeloma (NDMM) patients is associated with treatment-related toxicity, which negatively affects health-related quality of life (HRQoL). Currently, data on changes in HRQoL of frail and intermediate-fit MM patients during active treatment and post-treatment follow-up are absent. Methods: The HOVON123 study (NTR4244) was a phase II trial in which NDMM patients ≥ 75 years were treated with nine dose-adjusted cycles of Melphalan-Prednisone-Bortezomib (MPV). Two HRQoL instruments (EORTC QLQ-C30 and -MY20) were obtained before start of treatment, after 3 and 9 months of treatment and 6 and 12 months after treatment for patients who did not yet start second-line treatment. HRQoL changes and/or differences in frail and intermediate-fit patients (IMWG frailty score) were reported only when both statistically significant (p &lt; 0.005) and clinically relevant (&gt;MID). Results: 137 frail and 71 intermediate-fit patients were included in the analysis. Compliance was high and comparable in both groups. At baseline, frail patients reported lower global health status, lower physical functioning scores and more fatigue and pain compared to intermediate-fit patients. Both groups improved in global health status and future perspective; polyneuropathy complaints worsened over time. Frail patients improved over time in physical functioning, fatigue and pain. Improvement in global health status occurred earlier than in intermediate-fit patients. Conclusion: HRQoL improved during anti-myeloma treatment in both intermediate-fit and frail MM patients. In frail patients, improvement occurred faster and, in more domains, which was retained during follow-up. This implies that physicians should not withhold safe and effective therapies from frail patients in fear of HRQoL deterioration.</p

Remittances and the Dutch Disease

Using data for El Salvador and Bayesian techniques, we develop and estimate a two-sector dynamic stochastic general equilibrium model to analyze the effects of remittances in emerging market economies. We find that, whether altruistically motivated or otherwise, an increase in remittance flows leads to a decline in labor supply and an increase in consumption demand that is biased toward nontradables. The higher nontradable prices serve as incentive for an expansion of that sector, culminating in reallocation of labor away from the tradable sector; a phenomenon known as the Dutch disease. Quantitative results also indicate that remittances improve households'welfare as they smooth income flows and increase consumption and leisure levels. A Bayesian vector autoregression analysis provides results that are consistent with the dynamics of the model

The Role of US Monetary Policy in Banking Crises Across the World

We examine the role of US monetary policy in banking crises across the world by using a cross-country database spanning 69 countries over the 1870–2010 period. US monetary policy tightening increases the probability of a banking crisis for those countries with direct linkages to the USA, either in the form of trade links or significant share of USD-denominated liabilities. Conversely, if a country is integrated globally, rather than having a direct exposure, the effect is ambiguous. These findings suggest that the effect of US monetary policy in global banking crises is not uniform and is largely dependent on the nature of linkages with the USA

Measurement of M-shell X-ray production cross sections for the element 73 ≤ Z ≤ 83 using 5.96 keV photons

Total M-shell X-ray production cross sections (M XRF) of the some elements in the atomic number range 73 ≤ Z ≤ 83 were measured at 5.96 keV incident photon energy using a Si(Li) detector. The results are compared with the experimental and theoretical values in the literature

Thorax computed tomography findings and anti-SARS-CoV-2 immunoglobulin G levels in polymerase chain reaction-negative probable COVID-19 cases.

OBJECTIVE: This study aimed to evaluate the SARS-CoV-2 immunoglobulin G (IgG) levels after 6 months of polymerase chain reaction (PCR) negativebut assumed to be COVID-19 positive cases to investigate the relationship between IgG levels and thoracic computed tomography (CT) findings.METHODS: This was a single-center study that included patients whose PCR test results were negative at least three times using nasopharyngealswabs but had clinical findings of COVID-19 and thoracic CT findings compatible with viral pneumonia. Six months after discharge, the IgG antibodieswere analyzed. The cutoff value for negative and positive serology was defined as &lt;1.4 (index S/C) and ≥1.4 (index S/C), respectively. In addition, thepatients were categorized according to their thoracic CT findings as high (typical) and low (atypical). Also, the patients were grouped into classes as&lt;5% lung involvement versus ≥5% lung involvement.RESULTS: The patients’ mean age was 49.78±12.96 years. PCR was negative, but patients with COVID-19 symptoms who had SARS-CoV-2 IgGpositive were 81.9% (n=95). The antibody titer and lung involvement ≥5% were statistically significantly higher in SARS-CoV-2 IgG positive cases(p&lt;0.001 and p=0.021). Age and chest CT findings were the risk factors for lung involvement (OR=1.08, p&lt;0.001 and OR=2.19, p=0.010, respectively).CONCLUSION: This study is valuable because increasing severity (≥5%) of lung involvement appears to be associated with high and persistent IgGantibody titers. In probable cases of COVID-19, even if the PCR test is negative, high IgG titers 6 months after discharge can predict the rate of lungparenchymal involvement

Climate change and agriculture: an integrated approach to evaluate economy-wide effects for Turkey

Effects of climate change in Turkey, which is already a water stressed country, are expected to be significant. The aim of this paper is to quantify the effects of climate change on overall economy by using an integrated framework incorporating a computable general equilibrium model and a crop water requirement model for the period 2010-2099. Since agriculture is the most important sector that will be affected by climate change, analysis of climate change effects on the overall economy necessitate taking into account backward and forward linkages of agriculture. The CGE model used in this paper models the links between agriculture and other sectors and economic agents at 12 NUTS1 regions level. On the other hand, the crop model is used to translate the results of global climate models to estimate changes in yields and irrigation requirements for the period 2010-2099 at 81 NUTS3 level for 35 crops. The results of the crop model are then introduced to CGE model as climate shocks. The results suggest that the economic effects of climate change will not be significant until late 2030s; therefore Turkey has a chance to develop appropriate adaptation policies. However after 2030s, effects of climate change will be significant. Production patterns and relative prices will change drastically. The economic effects will differ among regions. The regions where irrigated agriculture is relatively low, the effects will be milder suggesting a need for putting more emphasis on the region-specific climate change policy design. Agriculture and food production will be the most affected sectors. Increasing irrigation requirements will cause farmers to reduce irrigated production. Combined with decline in yields, this will cause significant deterioration in agricultural production and prices will increase. The loss in household welfare will be significant. Some part of production decline will be compensated by imports, causing an increase in agrofood trade which will cause trade balance to worsen with declining manufacturing exports due to increasing cost of production