31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Developing and Testing the Effectiveness of a Novel Health Qigong for Frail Elders in Hong Kong: A Preliminary Study

Eight-Section Brocades and Yijin Jing consist of some routine movements that are too difficult for frail elders. A novel health qigong protocol was developed and its effectiveness for frail elders was examined using a randomized clinical trial (RCT). An expert panel performed functional anatomy analysis and safety field test prior to the RCT. The experimental group (n=61, 83±6 yr) was given a 12-week qigong exercise program, while the comparison group (n=55, 84±6 yr) participated in a newspaper reading program with the same duration and frequency. Pre-, mid-, post-, and follow-up assessments were conducted. At 12 weeks, the qigong group had significant improvements in thinking operations (F=4.05, P=.02) and significant reduction of resting heart rate (F=3.14, P=.045) as compared to the newspaper reading group. A trend of improvements in grip strength and a decreasing trend of depression levels were observed among the qigong group. Significant perceived improvements in physical health (F=13.01, P=.001), activities of daily living (F=5.32, P=.03), and overall health status (F=15.26, P=.0001) were found. There are improvements in some aspects of psychosocial, cognitive, physical, and physiological domains. Clinical applications and possibilities for further research are discussed

Examining Factor Structure of the Chinese Version of the PIRLS 2011 Home Questionnaire

The home questionnaire of the Progress in International Reading Literacy Study (PIRLS-HQ 2011) was designed to gather information from parents or primary caregivers of fourth-grade pupils on their reading literacy development related to aspects of pupils’ home lives across countries/districts. The questionnaire was translated into different languages for international comparison and research purposes. This study aims to assess the psychometric properties of the Chinese version of the PIRLS 2011 home questionnaire (PIRLS-HQCV 2011) and identify the underlying factor structure using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) among Chinese fourth-grade pupils in Hong Kong. A 7-factor structure model has been identified by EFA and confirmed to resemble much to the original PIRLS structure by CFA. Additional conceptually important domains have been identified which add further insights into the inconclusive results in the literature regarding the relationship between home factors and reading achievement. Implications for further studies are discussed

An International Reading Literacy Study: Factor Structure of the Chinese Version of the Student Questionnaire (PIRLS-SQCV 2011)

The student questionnaire (PIRLS-SQ 2011) of the Progress in International Reading Literacy Study (PIRLS) was designed to gather information from pupils on reading literacy development as to aspects of pupils’ self-lives, home, and school lives across countries/districts. In order to serve the purposes of research and international comparison, the questionnaire was translated into various languages. Using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), the current study investigates the psychometric properties of the Chinese version of the student questionnaire (PIRLS-SQCV 2011) and identifies its underlying factor structure among Chinese fourth-grade pupils in Hong Kong. A 10-factor structure model was identified and much resemblance could be drawn to the original PIRLS structure. While the similarity allows international comparisons of studies in different places following the PIRLS strategy, the findings of this study add to extant literature on the relationship between student factors and reading achievement

Self-competence in death work among health and social care workers: a region-wide survey in Hong Kong

Abstract Background According to the Quality of Death Index, Hong Kong is lagging behind many other Western and Asian countries in the category of palliative and healthcare. To ensure the provision of high-quality palliative care, it is important to explore the self-competence of health and social care workers in coping with death work including palliative care. This region-wide study aims to assess the level of self-competence with a validated Self-Competence in Death Work Scale (SC-DWS) and examine its correlates. Methods The SC-DWS was administered to a cross-sectional convenience sample of health and social care workers across eight healthcare institutions between January and October 2016. Total scores for the 16-item SC-DWS and its Existential and Emotional subscales were calculated. We then examined sociodemographic variables (e.g., age, profession, place of employment) in relation to the total and subscale scores using multiple linear regression. Coding was conducted on responses to a final open-ended question asking about the personal views of the workers towards their self-competence in death work. Result We collected data from 885 health and social care workers. Mean score of the SC-DWS was 60.16 (range: 16 – 80), while its Existential and Emotional subscales scored 37.90 (range: 10 – 50) and 14.46 (range: 4 – 20) respectively. Four categories of personal view towards self-competence in death work including (1) personal resources; (2) existential challenges and coping; (3) emotional challenges and coping; and (4) personal recommendations on improving self-competence were identified. In multivariate analyses, workers aged 50 or above, divorced, working in Hospice A, Rehabilitation Hospital B (where a quality improvement initiative in end-of-life care was implemented) and Acute Hospital B (a Christian institution with strong caring culture) and with personal bereavement experience had significantly higher scores, whereas nurses scored significantly lower than less-educated personal care assistants. Conclusion There is still room for improvement in self-competence in death work among health and social care workers, particularly the young, nurses and those working in acute hospitals. Future initiatives should involve identifying barriers in individual healthcare institutions. Training of the provision of palliative care is necessary