44 research outputs found

    State of the art conference on weight management in VA: Policy and research recommendations for advancing behavioral interventions

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    This article summarizes outcomes of the behavioral interventions work group for the Veterans Health Administration (VHA) State of the Art Conference (SOTA) for Weight Management. Sixteen VHA and non-VHA subject matter experts, representing clinical care delivery, research, and policy arenas, participated. The work group reviewed current evidence of efficacy, effectiveness, and implementation of behavioral interventions for weight management, participated in phone- and online-based consensus processes, generated key questions to address gaps, and attended an in-person conference in March 2016. The work group agreed that there is strong evidence for efficacy and effectiveness of core behavioral intervention components and processes, but insufficient evidence to determine the comparative effectiveness of multiple clinician delivered weight management modalities, as well as technologies that may or may not supplement clinician delivered treatments. Effective strategies for implementation of weight management services in VHA were identified. The SOTA work group’s foremost policy recommendations are to establish a system-wide culture for weight management and to identify a population-level health metric to measure the impact of weight management interventions that can be tracked and clearly communicated throughout VHA. The work group’s top research recommendation is to determine how to deploy and scale the most effective behavioral weight management interventions for Veterans

    Is there a role for the quantification of RRM1 and ERCC1 expression in pancreatic ductal adenocarcinoma?

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    <p>Abstract</p> <p>Background</p> <p>RRM1 and ERCC1 overexpression has been extensively investigated as potential predictive markers of tumor sensitivity to conventional chemotherapy agents, most thoroughly in lung cancer. However, data in pancreatic cancer are scarce.</p> <p>Methods</p> <p>We investigated the mRNA and protein expression of ERCC1 and RRM1 by RT-PCR and immunohistochemistry (IHC) in formalin-fixed, paraffin-embedded pancreatic ductal carcinoma (PDA) tissues. The primary outcome investigated was the association between RRM1 and ERCC1 expression and overall survival (OS) or disease-free survival (DFS).</p> <p>Results</p> <p>A total of 94 patients with resected PDA were included in this study. Most of them (87%) received gemcitabine based chemotherapy. Data for OS analysis was available in all cases but only 68% had enough information to estimate DFS. IHC analysis revealed information for 99% (93/94) and 100% of the cases for RRM1 and ERCC1 expression respectively. However, PCR data interpretation was possible in only 49 (52%) and 79 (84%) cases respectively. There was no significant association between high or low expression of either RRM1 or ERCC1, detected by IHC and OS (14.4 vs. 19.9 months; <it>P </it>= 0.5 and 17.1 vs. 19.9; <it>P </it>= 0.83 respectively) or PCR and OS (48.0 vs. 24.1 months; <it>P </it>= 0.21 and 22.0 vs. 16.0 months; <it>P </it>= 0.39 respectively). Similar results were obtained for DFS.</p> <p>Conclusions</p> <p>RRM1 and ERCC1 expression does not seem to have a clear predictive or prognostic value in pancreatic cancer. Our data raise some questions regarding the real clinical and practical significance of analyzing these molecules as predictors of outcomes.</p

    Phase I Evaluation of Intravenous Ascorbic Acid in Combination with Gemcitabine and Erlotinib in Patients with Metastatic Pancreatic Cancer

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    Preclinical data support further investigation of ascorbic acid in pancreatic cancer. There are currently insufficient safety data in human subjects, particularly when ascorbic acid is combined with chemotherapy.14 subjects with metastatic stage IV pancreatic cancer were recruited to receive an eight week cycle of intravenous ascorbic acid (three infusions per week), using a dose escalation design, along with standard treatment of gemcitabine and erlotinib. Of 14 recruited subjects enrolled, nine completed the study (three in each dosage tier). There were fifteen non-serious adverse events and eight serious adverse events, all likely related to progression of disease or treatment with gemcitabine or erlotinib. Applying RECIST 1.0 criteria, seven of the nine subjects had stable disease while the other two had progressive disease.These initial safety data do not reveal increased toxicity with the addition of ascorbic acid to gemcitabine and erlotinib in pancreatic cancer patients. This, combined with the observed response to treatment, suggests the need for a phase II study of longer duration.Clinicaltrials.gov NCT00954525

    Automatic Cross-Language Information Retrieval using Latent Semantic Indexing

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    We descride a method for fully automated cross-language document retrieval in which no query translation is required. Queries in one language can retrieve documents in other languages (as well as the original language). This is accomplished by a method that automatically constructs a multi-lingual semantic space using Latent Semantic Indexing (LSI). We present strong preliminary test results for our cross-language LSI (CL-LSI) method for a French-English collection. We also provide some evidence that this automatic method performs comparably to a retrieval method based on machine translation (MT-LSI)

    Automatic Cross-Linguistic Information Retrieval using Latent Semantic Indexing

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    this document as a bag of freely intermingled French and English words. A set of training documents like this is analyzed using LSI, and the result is a reduced dimension semantic space in which related terms are near each other. Because the documents contained both French and English terms, the LSI space will contain terms from both languages; this is what makes it possible for the CL-LSI method to avoid query translation. Words that are consistently paired in translation (e.g., Libya and Libye) will be given identical representations in the LSI space, whereas words that are frequently associated with one another (e.g., not and pas) will be given similar representations. The next step in the CL-LSI method is to add (or &quot;fold in&quot;) documents in just French or English. As described above, this is done by locating a new document at the weighted vector sum of its constituent terms. The result of this process is that each document in the database has a language-independent representation in terms of numerical vectors. Users can now pose queries in either French or English and get back the most similar documents regardless of language. 3.2 Experimental Test

    Automatic 3-Language Cross-Language Information Retrieval with Latent Semantic Indexing

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    This paper describes cross-language informationretrieval experiments carried out for TREC-6. Our retrieval method, cross-language latent semantic indexing (CL-LSI), is completely automatic and we were able to use it to create a 3-way EnglishFrench -German IR system. This study extends our previous work in terms of the large size of training and testing corpora, the use of low-quality training data, the evaluation using relevance judgments, and the number of languages analyzed. Introduction Cross-language LSI (CL-LSI) is a fully automatic method for cross-language document retrieval in which no query translation is required. Queries in one language can retrieve documents in other languages (as well as the original language). This is accomplished by a method that automatically constructs a multi-lingual semantic space using latent semantic indexing (LSI); this semantic space is exploited in the form of a vector lexicon, which assigns each word in each language to a point in the high-dim..
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