Beach litter sources around Nuuk, Greenland: An analysis by UArctic summer school graduate course students

Modeling studies illustrate the potential for long-range transport of plastics into the Arctic, although the degree to which this occurs remains relatively undocumented. We utilised a teaching exercise at a UArctic summer school graduate course in Nuuk, Greenland to conduct a preliminary in-depth analysis of beach litter sources in the Nuup Kangerlua fjord. Students and instructors collected and analysed 1800 litter items weighing 200 kg from one location in the fjord and another at its mouth. The results suggest a predominance of local sources to macrolitter, rather than long-range transport from Europe. Fisheries-related items and rope were common. Packaging which could be identified was largely suspected to be products distributed in Greenland, and soft plastics, which rarely disperse far from its source, were also common. The results suggest local measures to reduce mismanaged waste and emissions from fisheries are important for reducing marine litter in West Greenland.publishedVersio

Treatment of Patients with Advanced Biliary Tract Cancer with Either Oxaliplatin, Gemcitabine, and Capecitabine or Cisplatin and Gemcitabine—A Randomized Phase II Trial

This study is an investigator-initiated randomized phase II trial focusing on the treatment of advanced biliary tract cancer with either oxaliplatin 50 mg/m2 and gemcitabine 1000 mg/m2 on day 1 in a two-week cycle with capecitabine 650 mg/m2 twice-daily continuously or cisplatin 25 mg/m2 and gemcitabine 1000 mg/m2 on day 1 and day 8 in a three-week cycle. One-hundred patients were included. Forty-seven patients received oxaliplatin, gemcitabine, and capecitabine with a median progression-free survival (mPFS) of 5.7 months (95% CI 3.0–7.8) and a median overall survival (mOS) of 8.7 months (95% CI 6.5–11.2). Forty-nine patients received cisplatin and gemcitabine with a mPFS of 7.3 months (95% CI 6.0–8.7) and a mOS of 12.0 months (95% CI 8.3–16.7). This trial confirms a mOS of 12 months with cisplatin and gemcitabine, as found in earlier trials. With a superior tumor control rate of 79% vs. 60% (p = 0.045), a difference in the mPFS of 1.6 months (HR = 0.721, p = 0.1), and a difference in the mOS of 3.3 months (HR = 0.731, p = 0.1), cisplatin and gemcitabine should still be considered the standard first-line treatment for advanced biliary tract cancer

The HAIR-QoL measure Part 2 : Validation of an instrument to measure of the severity and impact of chemotherapy-induced alopecia (CIA)

Objetivo La alopecia inducida por quimioterapia (CIA) es uno de los efectos secundarios más comunes y angustiantes relacionados con el tratamiento del cáncer . Se han desarrollado pocas medidas de resultados informados por los pacientes (PROM) específicamente para medir la experiencia del paciente con la caída del cabello durante el tratamiento de quimioterapia. En la parte I de esta investigación, se desarrolló un conjunto de ítems de cuestionario provisionales para una nueva herramienta. Este artículo se centra en la validación y pruebas psicométricas de los ítems de puntuación específicos de la CIA en la medida provisional HAIR-QoL. Métodos El cuestionario provisional HAIR-QoL, compuesto por 43 ítems específicos de la CIA, se administró a una gran muestra de pacientes (n = 228) de 8 centros internacionales, que estaban recibiendo quimioterapia. Las pruebas psicométricas utilizaron una combinación de métodos de la teoría clásica de las pruebas (CTT) y la teoría de la respuesta al ítem; Análisis de Componentes Principales (PCA) y Análisis Rasch , respectivamente. Resultados Del conjunto inicial de 43 ítems, 28 ítems cumplieron los criterios para su inclusión en cuatro componentes. Las cuatro subescalas identificadas fueron las siguientes: 1) Preocupación por el cambio de apariencia, 2) Imagen de uno mismo, 3) Preparación para la caída del cabello y 4) Impacto de la caída del cabello en usted y en los demás. Los resultados de los análisis cuantitativos, PCA y análisis de Rasch sugirieron una modificación modesta en el número de elementos de la medida provisional HAIR-QoL . Se informó que las propiedades psicométricas eran muy buenas/excelentes para las cuatro subescalas y se encontró que eran sensibles para detectar diferencias grupales. Conclusión Se descubrió que los ítems refinados que componen la medida final HAIR-QoL aprovechan varios dominios psicosociales importantes que preocupan a los pacientes que experimentaron CIA. Las puntuaciones de la subescala tienen el potencial de informar la toma de decisiones futuras sobre las necesidades no satisfechas de información y apoyo de los pacientes y allanar el camino para una atención psicológica personalizada y una investigación más sólida sobre la eficacia del enfriamiento del cuero cabelludo .Objective: Chemotherapy-induced alopecia (CIA) is one of the most common and distressing side effects related to cancer treatment. Few patient-reported outcome measures (PROMs) have been developed specifically to measure the patient-experience of hair loss during chemotherapy treatment. In part I of this research, a set of provisional questionnaire items were developed for a new tool. This article focusses on the validation and psychometric testing of the CIA-specific scoring items in the provisional HAIR-QoL measure. Methods: The provisional HAIR-QoL questionnaire, comprised of 43 CIA-specific items, was administered to a large sample of patients (n = 228) from 8 international centres, who were undergoing chemotherapy. Psychometric testing used a combination of Classical Test Theory (CTT) and Item Response Theory methods; Principal Components Analysis (PCA) and Rasch Analysis, respectively. Results: From the initial item pool of 43 items, 28 items satisfied the criteria for inclusion into four components. The four subscales identified were as follows, 1) Concern about change in appearance, 2) Image of self, 3) Preparedness for hair loss and 4) Impact of hair loss on you and others. The results of the quantitative analyses, PCA and Rasch analysis, suggested modest amendment to the number of items to the provisional HAIR-QoL measure. Psychometric properties were reported to be very good/excellent for all four subscales and were found to be sensitive to detecting group differences. Conclusion: The refined items which comprise the final HAIR-QoL measure were found to tap into several important psycho-social domains of concern for patients who experienced CIA. The subscale scores have the potential to inform future decision-making on patients’ unmet information and support needs and pave the way for personalised psychological care and more robust research on efficacy of scalp coolingRevista Internacional - No indexadaS

Protein Signatures and Individual Circulating Proteins, including IL-6 and IL-15, Associated with Prognosis in Patients with Biliary Tract Cancer

Biliary tract cancer (BTC) is a rare gastrointestinal cancer with a dismal prognosis. Biomarkers with clinical utility are needed. In this study, we investigated the association between survival and 89 immuno-oncology-related proteins, with the aim of identifying prognostic biomarkers for BTC. The study included patients with BTC (n = 394) treated at three Danish hospitals. Patients were divided into four cohorts: the first-line discovery cohort (n = 202), first-line validation cohort (n = 118), second-line cohort (n = 56), and surgery cohort (n = 41). Plasma protein levels were measured using a proximity extension assay (Olink Proteomics). Twenty-seven proteins were associated with overall survival (OS) in a multivariate analysis in the discovery cohort. In the first-line validation cohort, high levels of interleukin (IL)-6, IL-15, mucin 16, hepatocyte growth factor, programmed cell death ligand 1, and placental growth factor were significantly associated with poor OS in univariate Cox regression analyses. When adjusting for performance status, location, and stage, the association was significant only for IL-6 (hazard ratio (HR) = 1.25, 95% confidence interval (CI) 1.08–1.46) and IL-15 (HR = 2.23, 95% CI 1.48–3.35). Receiver operating characteristic analyses confirmed IL-6 and IL-15 as the strongest predictors of survival. Combining several proteins into signatures further improved the ability to distinguish between patients with short (18 months). The study identified several circulating proteins as prognostic biomarkers in patients, with BTC, IL-6, and IL-15 being the most promising markers. Combining proteins in a prognostic signature improved prognostic performance, but future studies are needed to determine the optimal combination and thresholds