Validation of the HULL Score clinical prediction rule (CPR) for unsuspected pulmonary embolism in ambulatory cancer patients

Background Clinical prediction rules (CPRs) developed to predict adverse outcomes of suspected pulmonary embolism (PE) and facilitate outpatient management have limitations in discriminating outcomes for ambulatory cancer patients with unsuspected PE (UPE). The HULL Score CPR uses a 5‑point scoring system incorporating performance status and self-reported new or recently evolving symptoms at UPE diagnosis. It stratifies patients into low, intermediate and high risk for proximate mortality. This study aimed to validate the HULL Score CPR in ambulatory cancer patients with UPE. Patients and methods 282 consecutive patients managed under the UPE-acute oncology service in Hull University Teaching Hospitals NHS Trust were included from January 2015 to March 2020. The primary end-point was all-cause mortality, and outcome measures were proximate mortality for the three risk categories of the HULL Score CPR. Results 30-day, 90-day and 180-day mortality rates for the whole cohort were 3.4% (n=7), 21.1% (n=43) and 39.2% (n=80), respectively. The HULL Score CPR stratified patients into low-risk (n=100, 35.5%), intermediate-risk (n=95, 33.7%) and high-risk (n=81, 28.7%) categories. Correlation of the risk categories with 30-day mortality (area under the curve (AUC) 0.717, 95% CI 0.522–0.912), 90-day mortality (AUC 0.772, 95% CI 0.707–0.838), 180-day mortality (AUC 0.751, 95% CI 0.692–0.809) and overall survival (AUC 0.749, 95% CI 0.686–0.811) was consistent with the derivation cohort. Conclusion This study validates the capacity of the HULL Score CPR to stratify proximate mortality risk in ambulatory cancer patients with UPE. The score uses immediately available clinical parameters and is easy to integrate into an acute outpatient oncology setting

Four cycles of paclitaxel and carboplatin as adjuvant treatment in early-stage ovarian cancer: a six-year experience of the Hellenic Cooperative Oncology Group

BACKGROUND: Surgery can cure a significant percentage of ovarian carcinoma confined to the pelvis. Nevertheless, there is still a 10–50% recurrence rate. We administered paclitaxel/carboplatin as adjuvant treatment in early-stage ovarian carcinoma. METHODS: Patients with stages Ia or Ib, Grade 2 or 3 and Ic to IIb (any grade) were included. Patients were treated with 4 cycles of Paclitaxel 175 mg/m(2 )and Carboplatin [area under the curve (AUC) 6 (Calvert Formula)] every 3 weeks. RESULTS: Sixty-nine patients with no residual disease following cytoreductive surgery and minimal or modified surgical staging were included in this analysis. Grade 3 or 4 neutropenia occured in 29.9% of patients, while neutropenic fever was reported in 4.5%. Neurotoxicity (all Grade 1 or 2) was reported in 50% of cases. Median follow-up was 62 months. 5-year overall survival (OS) and relapse-free survival (RFS) were: 87% (95% confidence intervals [CI]: 78–96) and 79% (95% CI: 69–89), respectively. Significantly fewer patients with stages Ic-IIb and tumor grade 2 or 3 achieved a 5-year RFS than patients with only one of these two factors (73% vs 92%, p = 0.03). CONCLUSION: Paclitaxel/Carboplatin chemotherapy is a safe and effective adjuvant treatment in early-stage ovarian carcinoma. Patients with stages Ic-IIb and tumor grade 2 or 3 may benefit from more extensive treatment

SOCIAL MEDIA SENSING FOR FOREST WILDFIRES - A CASE STUDY FROM GREECE

<p>Climate change intensifies wildfire risk and impact, leading to more frequent and extreme events that profoundly affect the environment, society, economy, and vital ecosystem services. Wildfires have both consequences, such as loss of life, pollution, and damage, and beneficial effects, including organic material clearance, improved soil fertility, and eradication of invasive species. Technological advancements and mobile devices have proven invaluable for disaster readiness, prevention, and response, with successful real-life applications of social media and sensing tools in emergency management. In this paper, a social media sensing tool is presented that consists of a Social Media Analysis Toolkit, that includes fire event detection and visual analytics, enabling the collection, analysis, and visualization of fire-related tweets. The effectiveness and usability of the tool were tested for the pilot area of Evia in Greece. The social media sensing tool collected fire-related tweets the summer of 2021, analyzed them and filtered them in order to provide an enhanced situational awareness tool the massive wildfire incident that occurred in August 2021. The results illustrate a significant increase in Twitter activity during the wildfire period, demonstrating the tool's effectiveness in monitoring and analyzing social media data for wildfire detection.</p&gt