90 research outputs found

    Oncology in FMUSP and the boundaries between clinical and experimental science

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    A mora em Direito Tributário

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    Uso da inteligência artificial em Oncologia: Doctor in silico?

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    Estabilidade de fenitrotion e esfenvalerato durante o processamento de amostras de milho e trigo

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    A presença de resíduos de inseticida em amostras de cereais representa um risco ao consumidor, pois estas substâncias são empregadas em larga escala na preservação de grãos armazenados. Neste sentido, o efeito de três métodos de processamento de amostras de milho e trigo na estabilidade de inseticidas protetores de grãos armazenados foram avaliados. O fenitrotion e o esfenvalerato foram aplicados de modo a produzir concentração teórica de 10 e 0,5 mg kg-1, respectivamente. Duas horas após o tratamento, os grãos foram processados e os depósitos analisados mediante cromatografia gasosa. A espécie de grão não teve influência na estabilidade dos inseticidas, sendo que essa estabilidade apenas dependeu do método de processamento e do inseticida. Os grãos processados junto com gelo seco proporcionaram a maior porcentagem de recuperação de ambos os inseticidas. Independente do método de processamento utilizado, conseguiu-se recuperar mais esfenvalerado do que fenitrotion, demonstrando-se assim, a maior estabilidade do piretróide durante esta operação.The presence of insecticide residues in cereals represents a risk for the consumer, because these substances are used in large scale to protect stored grains from the attack of pests. The effects of three processing methods for corn and wheat samples on the stability of stored-grain protective insecticides were here evaluated. Fenitrothion and esfenvalerate were applied so as to produce theoretical concentrations of 10 and 0.5 mg kg-1, respectively. Two hours after treatment, the grains were processed and deposition was analyzed by gas chromatography. Grain species did not influence insecticide stability. This stability was only dependent upon the processing method and insecticide type. Grains processed together with dry ice provided the greatest percentage of recovery for both insecticides. Regardless of the processing method, more esfenvalerate than fenitrothion was recovered, thus demonstrating the greater stability of the pyrethroid during this operation

    Pembrolizumab alone or with chemotherapy for recurrent or metastatic head and neck squamous cell carcinoma: Health-related quality-of-life results from KEYNOTE-048

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    Immunotherapy; Pembrolizumab; Quality of lifeInmunoterapia; Pembrolizumab; Calidad de vidaImmunoteràpia; Pembrolizumab; Qualitat de vidaObjectives To assess health-related quality of life (HRQoL) with first-line pembrolizumab, pembrolizumab-chemotherapy, or cetuximab-chemotherapy in recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) in the phase 3 KEYNOTE-048 trial (NCT02358031). Materials and Methods HRQoL was measured using the European Organisation for Research and Treatment of Cancer 30-question quality-of-life (EORTC QLQ-C30), the EORTC 35-question quality-of-life head and neck cancer–specific module (EORTC QLQ-H&N35), and the EuroQol 5-dimension 3-level instruments (EQ-5D-3L). Secondary endpoints included mean change from baseline in EORTC QLQ-C30 global health status/quality of life (GHS/QoL) at week 15 and time to deterioration (TTD) in EORTC QLQ-C30 GHS/QoL and EORTC QLQ-H&N35 pain and swallowing. Results Of 882 enrolled participants, 844 received ≥ 1 dose of study treatment and completed ≥ 1 HRQoL assessment; adherence was ≥ 79% at week 15 across treatment groups. At week 15, EORTC QLQ-C30 GHS/QoL scores remained stable; no clinically meaningful between-group differences were observed (least squares mean difference, pembrolizumab vs cetuximab-chemotherapy, 0.24; 95% CI, −3.34 to 3.82; pembrolizumab-chemotherapy vs cetuximab-chemotherapy, 0.40; 95% CI, −3.46 to 4.26). Median TTD in EORTC QLQ-C30 GHS/QoL and EORTC QLQ-H&N35 pain and swallowing scores was not reached over 51 weeks across groups, showing stable HRQoL. TTD was similar between groups for EORTC QLQ-C30 GHS/QoL (pembrolizumab vs cetuximab-chemotherapy: HR, 1.38; 95% CI, 0.95–2.00; pembrolizumab-chemotherapy vs cetuximab-chemotherapy: HR, 1.37; 95% CI, 0.94–2.00), as was TTD in EORTC QLQ-H&N35 pain and swallowing scores. Conclusions Pembrolizumab monotherapy and pembrolizumab-chemotherapy extended OS while maintaining HRQoL, further supporting first-line use for R/M HNSCC.Funding for this research was provided by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA

    UMA APLICAÇÃO DA TÉCNICA DELPHI NO MAPEAMENTO DAS DIMENSÕES DAS QUALIFICAÇÕES DOCENTES NA ÁREA CONTÁBIL

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    The assessment of teaching qualifications has been a recurring theme in the literature without controversies. This study aims to discover and analyze how a group of accounting experts perceive the dimensions of the teaching qualifications that are considered essential in contemporary higher accounting education by means of the Delphi technique. Therefore, a commission of 21 Brazilian and international experts was constituted, with a heterogeneous educational background, representative of the teaching qualifications that were to be analyzed. Three rounds were needed to reach a consensus. The results indicated that the academic qualification included factors related to degree, research and publication; professional qualification involved factors related to professional experience and credentials; and the pedagogical qualification comprises factors related to institutional support, teaching experience and permanent education. In addition, the complete commission valued the academic education most highly, reaching 46.7% of the investigated experts.La evaluación de las calificaciones docentes ha sido un tema recurrente en la literatura y no sin controversias. Este estudio se propone conocer y analizar las percepciones de un grupo de especialistas del área contable sobre las dimensiones de las calificaciones docentes consideradas esenciales en la educación superior contable en la contemporaneidad, utilizando la técnica Delphi. Para ello, fue formada una comisión de 21 especialistas nacionales y extranjeros, con formación heterogénea, representativa de las dimensiones de la calificación docente que se pretendía analizar. Fueron necesarias tres rondas para que se alcanzase el consenso. Los resultados indicaron que la calificación académica resultó compuesta por factores relativos a la titulación, pesquisa y publicación; la calificación profesional por factores relativos a la experiencia profesional y credenciales; y la calificación pedagógica por factores relacionados al apoyo institucional, experiencia en la enseñanza y formación continuada. También puede ser verificado que la formación académica es la formación más valorizada por la comisión completa, alcanzando al 46,7% de los especialistas pesquisados.A avaliação das qualificações docentes tem sido um tema recorrente na literatura e não sem controvérsias. Este estudo se propõe a conhecer e analisar as percepções de um grupo de especialistas da área contábil sobre as dimensões das qualificações docentes consideradas essenciais na educação superior contábil na contemporaneidade, utilizando-se da técnica Delphi. Para tanto, foi formada uma comissão de 21 especialistas nacionais e estrangeiros, com formação heterogênea, representativa das dimensões da qualificação docente que se pretendia analisar. Foram necessárias três rodadas para que se atingisse o consenso. Os resultados indicaram que a qualificação acadêmica ficou composta por fatores relativos à titulação, pesquisa e publicação; a qualificação profissional por fatores relativos à experiência profissional e credenciais; e a qualificação pedagógica por fatores relacionados ao apoio institucional, experiência no ensino e formação continuada. Também pode ser verificado que a formação acadêmica é a formação mais valorizada pela comissão completa, alcançando 46,7% dos especialistas pesquisados

    Pembrolizumab Alone or With Chemotherapy for Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma in KEYNOTE-048: Subgroup Analysis by Programmed Death Ligand-1 Combined Positive Score

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    Quimioteràpia; Carcinoma de cèl·lules escamoses de cap i collQuimioterapia; Carcinoma de células escamosas de cabeza y cuelloChemotherapy; Head and neck squamous cell carcinomaPURPOSE The phase III KEYNOTE-048 (ClinicalTrials.gov identifier: NCT02358031) trial of pembrolizumab in recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) included planned efficacy analyses in the total population and in participants with programmed death ligand-1 (PD-L1) combined positive score (CPS) ≥ 1 and CPS ≥ 20. To further characterize the predictive value of PD-L1 expression on outcome, we conducted efficacy analyses in the PD-L1 CPS < 1 and CPS 1-19 subgroups in KEYNOTE-048. METHODS Participants with R/M HNSCC and no prior systemic therapy for R/M disease were randomly assigned 1:1:1 to pembrolizumab, pembrolizumab-chemotherapy, or cetuximab-chemotherapy. Post hoc efficacy analyses of the PD-L1 CPS < 1 and CPS 1-19 subgroups were performed. RESULTS Of 882 participants enrolled, 128 had PD-L1 CPS < 1 and 373 had CPS 1-19. For pembrolizumab versus cetuximab-chemotherapy, the median overall survival was 7.9 versus 11.3 months in the PD-L1 CPS < 1 subgroup (hazard ratio [HR], 1.51 [95% CI, 0.96 to 2.37]) and 10.8 versus 10.1 months in the CPS 1-19 subgroup (HR, 0.86 [95% CI, 0.66 to 1.12]). For pembrolizumab-chemotherapy versus cetuximab-chemotherapy, the median overall survival was 11.3 versus 10.7 months in the PD-L1 CPS < 1 subgroup (HR, 1.21 [95% CI, 0.76 to 1.94]) and 12.7 versus 9.9 months in the CPS 1-19 subgroup (HR, 0.71 [95% CI, 0.54 to 0.94]). CONCLUSION Increased efficacy of pembrolizumab or pembrolizumab-chemotherapy was observed with increasing PD-L1 expression. PD-L1 CPS < 1 subgroup analysis was limited by small participant numbers. Results from the PD-L1 CPS 1-19 subgroup support previous findings of treatment benefit with pembrolizumab monotherapy and pembrolizumab-chemotherapy in patients with PD-L1 CPS ≥ 1 tumors. Although PD-L1 expression is informative, exploration of additional predictive biomarkers is needed for low PD-L1–expressing HNSCC.Funding for this research was provided by Merck Sharp & Dohme Corp, a subsidiary of Merck & Co Inc, Kenilworth, NJ

    Pembrolizumab With or Without Chemotherapy in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: Updated Results of the Phase III KEYNOTE-048 Study

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    Pembrolizumab; Carcinoma de células escamosas de cabeza y cuelloPembrolizumab; Head and neck squamous cell carcinomaPembrolizumab; Carcinoma de cèl·lules escamoses de cap i collPURPOSE Pembrolizumab and pembrolizumab-chemotherapy demonstrated efficacy in recurrent/metastatic head and neck squamous cell carcinoma in KEYNOTE-048. Post hoc analysis of long-term efficacy and progression-free survival on next-line therapy (PFS2) is presented. METHODS Patients were randomly assigned (1:1:1) to pembrolizumab, pembrolizumab-chemotherapy, or cetuximab-chemotherapy. Efficacy was evaluated in programmed death ligand 1 (PD-L1) combined positive score (CPS) ≥ 20, CPS ≥ 1, and total populations, with no multiplicity or alpha adjustment. RESULTS The median study follow-up was 45.0 months (interquartile range, 41.0-49.2; n = 882). At data cutoff (February 18, 2020), overall survival improved with pembrolizumab in the PD-L1 CPS ≥ 20 (hazard ratio [HR], 0.61; 95% CI, 0.46 to 0.81) and CPS ≥ 1 populations (HR, 0.74; 95% CI, 0.61 to 0.89) and was noninferior in the total population (HR, 0.81; 95% CI, 0.68 to 0.97). Overall survival improved with pembrolizumab-chemotherapy in the PD-L1 CPS ≥ 20 (HR, 0.62; 95% CI, 0.46 to 0.84), CPS ≥ 1 (HR, 0.64; 95% CI, 0.53 to 0.78), and total (HR, 0.71; 95% CI, 0.59 to 0.85) populations. The objective response rate on second-course pembrolizumab was 27.3% (3 of 11). PFS2 improved with pembrolizumab in the PD-L1 CPS ≥ 20 (HR, 0.64; 95% CI, 0.48 to 0.84) and CPS ≥ 1 (HR, 0.79; 95% CI, 0.66 to 0.95) populations and with pembrolizumab-chemotherapy in the PD-L1 CPS ≥ 20 (HR, 0.64; 95% CI, 0.48 to 0.86), CPS ≥ 1 (HR, 0.66; 95% CI, 0.55 to 0.81), and total (HR, 0.73; 95% CI, 0.61 to 0.88) populations. PFS2 was similar after pembrolizumab and longer after pembrolizumab-chemotherapy on next-line taxanes and shorter after pembrolizumab and similar after pembrolizumab-chemotherapy on next-line nontaxanes. CONCLUSION With a 4-year follow-up, first-line pembrolizumab and pembrolizumab-chemotherapy continued to demonstrate survival benefit versus cetuximab-chemotherapy in recurrent/metastatic head and neck squamous cell carcinoma. Patients responded well to subsequent treatment after pembrolizumab-based therapy
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