Computed tomography–based body composition in patients with ovarian cancer: association with chemotoxicity and prognosis

PurposeTo assess the association between computed tomography (CT)-derived quantitative measures of body composition profiling and chemotherapy-related complications, in terms of dose reduction, premature discontinuation of chemotherapy, and cycle delays in patients with ovarian cancer. Secondary purposes were to evaluate associations between sarcopenia and survival, and to evaluate differences in body composition profiling at baseline and after neoadjuvant chemotherapy. Materials and MethodsThe study population was retrospectively selected from a database of patients with newly diagnosed ovarian cancer (any stage) referred to our Institution between Feb 2011 and Mar 2020. Clinical data were recorded, and CT images at the level of the 3(rd) lumbar vertebra were stored. By using specific software, skeletal muscle area (SMA), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle density (SMD) were extracted. Skeletal muscle index (SMI) was then calculated. Statistical analysis was performed by logistic regression models to identify body composition features predictive of dose reduction, premature end of chemotherapy, and cycle delays. Kaplan-Meier analyses were performed to assess overall survival (OS) and progression-free survival (PFS). The log-rank test was used to determine differences in OS and PFS between sarcopenic and non-sarcopenic patients. Wilcoxon test was performed to compare body composition features before and after neoadjuvant chemotherapy (NACT). ResultsSixty-nine patients were included. A significant association was found between VAT and cycle delays (OR = 1.01, z = 2.01, 95% CI: 1.00-1.02, p < 0.05), between SMA and early discontinuation of chemotherapy (OR = 1.03, z = 2.10, 95% CI: 1.00-1.05, p < 0.05), and between mean SMD and cycle delays (OR = 0.92, z = -2.70, 95%CI: 0.87-0.98, p < 0.01). No significant difference emerged for OS in sarcopenic and non-sarcopenic patients, nor in CT body composition features before and after NACT. ConclusionsIn ovarian cancer patients, CT-derived body composition profiling might predict the risk of chemotoxicity. In particular, VAT and SMD are associated with chemotherapy cycle delays, and SMA with early discontinuation of chemotherapy

Body composition as a predictor of chemotherapy-related toxicity in ovarian cancer patients: a systematic review

Objectives:The main objective of this systematic review was to examine the literature evaluating association of image-based body composition with chemotherapy-related toxicity in ovarian cancer patients. A secondary objective was to evaluate the different definitions of sarcopenia across studies. Methods:This systematic review was conducted according to the PRISMA-DTA statement and the protocol was registered on Prospero. A comprehensive literature search of 3 electronic databases was performed by two authors. For each eligible article, information was collected concerning the clinical setting; basic study data; population characteristics; technical aspects; body composition features; chemotherapy drugs administered; association of body composition values and toxicities. The overall quality of the included studies was critically evaluated. Results:After the initial retrieval of 812 articles, the systematic review included 6 articles (5/6 studies were retrospective; one was prospective). The number of patients ranged between 69 and 239; mean/median age ranged between 55 and 65 years; the percentage of sarcopenic patients ranged between 25% and 54%. The cut-off values to define sarcopenia and the vertebral levels for evaluation of body composition were different. Five studies included chemotherapy based on carboplatin and paclitaxel, 1 included chemotherapy based on pegylated liposomal doxorubicin. Among the studies including carboplatin and paclitaxel, 3/5 demonstrated an association with toxicity, whereas 2/5 did not. Altogether, 4/6 papers demonstrated an association between the body composition values and the development of chemotherapy-related toxicities. Conclusions:There is a wide variability of results about the association of body composition and chemotherapy-related toxicity in ovarian cancer patients. Therefore further studies, possibly including a comprehensive assessment of body compartments and where the definition of body composition cut-offs is constant, are warranted to better understand this association

Whole-body composition features by computed tomography in ovarian cancer: pilot data on survival correlations

Background: The primary objective of this study was to assess the associations of computed tomography (CT)-based whole-body composition values with overall survival (OS) and progression-free survival (PFS) in epithelial ovarian cancer (EOC) patients. The secondary objective was the association of body composition with chemotherapy-related toxicity. Methods: Thirty-four patients (median age 64.9 years; interquartile range 55.4–75.4) with EOC and thorax and abdomen CT scans were included. Clinical data recorded: age; weight; height; stage; chemotherapy-related toxicity; and date of last contact, progression and death. Automatic extraction of body composition values was performed by dedicated software. Sarcopenia was defined according to predefined cutoffs. Statistical analysis included univariate tests to investigate associations of sarcopenia and body composition with chemotoxicity. Association of body composition parameters and OS/PFS was evaluated by log-rank test and Cox proportional hazard model. Multivariate models were adjusted for FIGO stage and/or age at diagnosis. Results: We found significant associations of skeletal muscle volume with OS (p = 0.04) and PFS (p = 0.04); intramuscular fat volume with PFS (p = 0.03); and visceral adipose tissue, epicardial and paracardial fat with PFS (p = 0.04, 0.01 and 0.02, respectively). We found no significant associations between body composition parameters and chemotherapy-related toxicity. Conclusions: In this exploratory study, we found significant associations of whole-body composition parameters with OS and PFS. These results open a window to the possibility to perform body composition profiling without approximate estimations

Delving into the Determinants of Default Risk in Savings Groups: Empirical Evidence from Ecuador.

Financial inclusion has been broadly recognized as critical in alleviating poverty and achieving inclusive economic growth. The capability of borrowers to repay their microcredit loans is a critical concern and is the first risk of Microfinance institutions sustainability. Exploring the determinants of credit risk is an issue of substantial importance in microfinance. The purpose of this research was to identify the savings group members’ characteristics that have impact on default risk. We have used a multivariate regression model to identify the factors that affect default behaviour among microcredit borrowers from savings groups. We have analysed a sample of more than different 400 Savings Groups and 7251 active users of the “Saving and Learning” program in Ecuador. Empirical results demonstrated that factors such as seniority, accumulated savings and the number of members in the savings groups are determinant variables of default risk. The significant positive sign on variable “Gender” is consistent with the previous authors that indicate that the probability of having problems in loan repayment is higher for males than for females. The generalizability of our findings should, of course, be interpreted with caution, as they may be idiosyncratic of the sample, period or region. To contrast and contextualize these results, we had in-depth discussions with the Savinco managers and their field agent in Ecuador. There are many contributions. For practitioners, relevant factors that can affect savings groups default rates have been identified. For academics, the rich information provided by the Savinco mobile App could be a starting point for further quantitative research.post-print881 K

Challenge of coordenation and its impacts on the competitiveness between chains and agribusiness systems

Este artigo pretende apresentar alguns dos conceitos de coordenação de sistemas agroindustriais (SAGs) e de competitividade entre cadeias, mais especificamente as cadeias de carnes (bovinos, suínos e aves). Em seguida, são analisados alguns exemplos recentes de diferentes formas de coordenação de SAGs e como elas afetam a competitividade entre as cadeias.This paper intends to present some of the concepts of coordination of agribusiness systems (AGSs) and of competitiveness between chains, specifically meat chains (beef, pork and chicken meat). Then, some recent examples of different forms of coordination of AGSs are analysed and also how they affect competitiveness between the chains

Search for Deeply Bound Kaonic Nuclear States with AMADEUS

We briefly report on the search for Deeply Bound Kaonic Nuclear States with AMADEUS in the Sigma0 p channel following K- absorption on 12C and outline future perspectives for this work

Thermoremanence anomaly in Fe-Zr(B,Cu) Invar metallic glasses: Volume expansion induced ferromagnetism

We report the existence of a thermally induced sharp increase of thermoremanence around the Curie temperature of Invar-like Fe-Zr(B,Cu) soft magnetic glasses. Neutron-diffraction measurements indicate that a true enhancement of the average local magnetic moment, rather than only a change in the domain structure, occurs. Such enhancement has been tentatively attributed to the increasing volume expansion that takes place beyond the Curie temperature and reinforces ferromagnetism in some low-density clusters

Direct measurements of the correlation between reentrant ferromagnetism and lattice expansion in FeCuZr alloys

Amorphous metastable alloy of nominal composition [Fe_(0.5)Cu_(0.5)]_(87)Zr_(13) has been synthesized by high-energy ball milling. The alloy exhibit a ferromagnetic behavior with a Curie Temperature of T_(C)=255 K, as determined from low-field measurements whereas no transition to a paramagnetic state is observed under high- enough applied magnetic fields. The evolution of hysteresis loops with temperature as well as thermoremanence measurements indicate an anomalous magnetic behavior characterized by a spontaneous increase in the magnetization values as well as by a magnetic hardening when the temperature is increased above T_(C). These effects are strongly correlated with a dilation of the Fe-Fe nearest-neighbor distances, as determined from extended x-ray absorption fine structure (EXAFS) studies. EXAFS results indicate an almost negligible thermal expansion at temperatures below T_(C) while normal thermal expansion takes place at higher temperatures. Such expansion seems to promote a reinforcement of the ferromagnetic interactions among Fe-Fe atoms that would account for the observed spontaneous increase in the magnetization as well as for the evolution of the coercive field

Magnetic properties of ZnO nanoparticles

We experimentally show that it is possible to induce room-temperature ferromagnetic-like behavior in ZnO nanoparticles without doping with magnetic impurities but simply inducing an alteration of their electronic configuration. Capping ZnO nanoparticles (similar to 10 nm size) with different organic molecules produces an alteration of their electronic configuration that depends on the particular molecule, as evidenced by photoluminescence and X-ray absorption spectroscopies and altering their magnetic properties that varies from diamagnetic to ferromagnetic-like behavior