322 research outputs found

    Prevention of cisplatin-induced hearing loss in children: Informing the design of future clinical trials.

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    Cisplatin is an essential chemotherapeutic agent in the treatment of many pediatric cancers. Unfortunately, cisplatin-induced hearing loss (CIHL) is a common, clinically significant side effect with life-long ramifications, particularly for young children. ACCL05C1 and ACCL0431 are two recently completed Childrens Oncology Group studies focused on the measurement and prevention of CIHL. The purpose of this paper was to gain insights from ACCL05C1 and ACCL0431, the first published cooperative group studies dedicated solely to CIHL, to inform the design of future pediatric otoprotection trials. Use of otoprotective agents is an attractive strategy for preventing CIHL, but their successful development must overcome a unique constellation of methodological challenges related to translating preclinical research into clinical trials that are feasible, evaluate practical interventions, and limit risk. Issues particularly important for children include use of appropriate methods for hearing assessment and CIHL severity grading, and use of trial designs that are well-informed by preclinical models and suitable for relatively small sample sizes. Increasing interest has made available new funding opportunities for expanding this urgently needed research

    Nonparametric inference for competing risks current status data with continuous, discrete or grouped observation times

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    New methods and theory have recently been developed to nonparametrically estimate cumulative incidence functions for competing risks survival data subject to current status censoring. In particular, the limiting distribution of the nonparametric maximum likelihood estimator and a simplified "naive estimator" have been established under certain smoothness conditions. In this paper, we establish the large-sample behavior of these estimators in two additional models, namely when the observation time distribution has discrete support and when the observation times are grouped. These asymptotic results are applied to the construction of confidence intervals in the three different models. The methods are illustrated on two data sets regarding the cumulative incidence of (i) different types of menopause from a cross-sectional sample of women in the United States and (ii) subtype-specific HIV infection from a sero-prevalence study in injecting drug users in Thailand.Comment: 16 pages, 3 figure

    Public Opinion About The Level Of The Population Security Of The Person And Work Of Interior Omsk Region

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    Based on of large-scale case study of public opinion conducted by the Foundation "Public Opinion" in 2012, in the article are analyzed the problems of the public opinion concerning the safety of the person and the Omsk region Interior agencies activity. Here are analyzed the factors permanently influencing the character of public valuation of the professional police activity

    On the Issue of Legal Regulations of Criminal Responsibility for Pedophilia

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    In this article the authors focus on the issues of criminal law regulation responsibility for crimes against sexual integrity of minors. Here are submitted for consideration the problematic crimes qualification issues and offered the ways of their solution by the enforcer before making the appropriate alterations in the criminal legislation, or official clarification of the Plenum of the RF Supreme Court

    Estimation Level by the Student Youth of the Ecological Special Features of Water Use.

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    Досліджено специфічні особливості води (“пам’ять води”) з використанням процесу бродіння рису у водному середовищі. Методом анкетування визначено оцінку студентами молодших курсів хімічного факуль-тету ВНУ імені Лесі Українки здатності води зберігати інформацію про можливий вплив людини на еколо-гічний стан води. Більшість респондентів вважає, що вода може “помститися” людству за погане відношення та забруднення. The specific special features of water (“the memory of water”) with the use of fermentation process of rice in the aqueous medium are investigated. Via questioning was determined estimation by the students of the low-order policies of the chemistry department VNU of the name of Lesya Ukrainka of the ability of water to preserve information about the possible influence of man on the ecological state of water. The majority of respondents considers that water can “take vengeance” upon humanity for the bad treatment and the pollution.Роботу виконано на кафедрі екології та охорони навколишнього середовища ВНУ ім. Лесі Українк

    Characterization of Pulmonary Metastases in Children With Hepatoblastoma Treated on Children\u27s Oncology Group Protocol AHEP0731 (The Treatment of Children With All Stages of Hepatoblastoma): A Report From the Children\u27s Oncology Group.

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    Purpose To determine whether the pattern of lung nodules in children with metastatic hepatoblastoma (HB) correlates with outcome. Methods Thirty-two patients with metastatic HB were enrolled on Children\u27s Oncology Group Protocol AHEP0731 and treated with vincristine and irinotecan (VI). Responders to VI received two additional cycles of VI intermixed with six cycles of cisplatin/fluorouracil/vincristine/doxorubicin (C5VD), and nonresponders received six cycles of C5VD alone. Patients were imaged after every two cycles and at the conclusion of therapy. All computed tomography scans and pathology reports were centrally reviewed, and information was collected regarding lung nodule number, size, laterality, timing of resolution, and pulmonary surgery. Results Among the 29 evaluable patients, only 31% met Response Evaluation Criteria in Solid Tumors (RECIST) for measurable metastatic disease. The presence of measurable disease by RECIST, the sum of nodule diameters greater than or equal to the cumulative cohort median size, bilateral disease, and ≥ 10 nodules were each associated with an increased risk for an event-free survival event ( P = .48, P = .08, P = .065, P = .03, respectively), with nodule number meeting statistical significance. Ten patients underwent pulmonary resection/metastasectomy at various time points, the benefit of which could not be determined because of small patient numbers. Conclusion Children with metastatic HB have a poor prognosis. Overall tumor burden may be an important prognostic factor for these patients. Lesions that fail to meet RECIST size criteria (ie, those \u3c 10 mm) at diagnosis may contain viable tumor, whereas residual lesions at the end of therapy may constitute eradicated tumor/scar tissue. Patients may benefit from risk stratification on the basis of the burden of lung metastatic disease at diagnosis

    Impact of central surgical review in a study of malignant germ cell tumors

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    BACKGROUND: Verification of surgical staging has received little attention in clinical oncology trials. Central surgical review was undertaken during a study of malignant pediatric germ cell tumors. METHODS: Children's Oncology Group study AGCT0132 included central surgical review during the study. Completeness of submitted data and confirmation of assigned stage were assessed. Review responses were: assigned status confirmed, assignment withheld pending review of additional information requested, or institutional assignment of stage disputed with explanation given. Changes in stage assignment were at the discretion of the enrolling institution. RESULTS: A total of 206 patients underwent central review. Failure to submit required data elements or need for clarification was noted in 40%. Disagreement with stage assignment occurred in 10% with 17/21 discordant patients reassigned to stage recommended by central review. Four ovarian tumor patients not meeting review criteria for Stage I remained in that stratum by institutional decision. Two-year event free survival in Stage I ovarian patients was 25% for discordant patients compared to 57% for those meeting Stage I criteria by central review. CONCLUSIONS: Central review of stage assignment improved complete data collection and assignment of correct tumor stage at study entry, and allowed for prompt initiation of chemotherapy in patients determined not to have Stage I disease
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