14 results on '"Ren, Yi"'
Search Results
2. Stress, Depression, and Drug Use Among Aging Mexican American Men Living in the Barrio.
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Villarreal, Yolanda R., Torres, Luis R., Stotts, Angela, Ren, Yi, Sampson, McClain, and Bordnick, Patrick S.
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CHI-squared test ,CONFIDENCE intervals ,STATISTICAL correlation ,MENTAL depression ,PSYCHOLOGY of Hispanic Americans ,INTERVIEWING ,PROBABILITY theory ,PSYCHOLOGICAL tests ,QUESTIONNAIRES ,RESEARCH funding ,PSYCHOLOGICAL stress ,T-test (Statistics) ,LOGISTIC regression analysis ,SOCIOECONOMIC factors ,CROSS-sectional method ,PSYCHOLOGY of drug abusers ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Residing in Mexican Americanbarriosmight place individuals at heightened risk for chronic financial and acute stress, which are associated with adverse mental health outcomes. Stressors could be exacerbated for substance users. This research explores relations between chronic financial stress, acute stress, and depressive symptomatology among aging Mexican American heroin and other drug-using men. A prospective cohort study and field-intensive outreach methodology were used to recruit 227 men for in-depth interviews. Participants were categorized into depressed and nondepressed groups based on symptomatology measured by the Center for Epidemiological Studies Depression Scale. Chronic financial stress (i.e., poverty) and acute stress (i.e., Life Events Questionnaire) associated with depressive symptomatology were tested using logistic regression. Findings suggest scores of depressive symptoms among substance users are highly related to chronic financial stress. Community-level interventions targeting chronic stressors present in the barrio could be especially salient in improving the mental health of Latino drug users. [ABSTRACT FROM PUBLISHER]
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- 2017
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3. Examining children’s health equity under the Chinese basic medical insurance system: A comparison between the United States and Mainland China.
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Ren, Yi, Pritzker, Suzanne, and Leung, Patrick
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HEALTH services accessibility , *HEALTH insurance , *MEDICAID , *EVALUATION of medical care , *NATIONAL health services - Abstract
Public health insurance for China’s children is analyzed using an equity analysis framework and compared to US public health insurance for low-income children. Four dimensions of comparisons are addressed: fairness of financial support, equal treatment for equal need, equality of access to services, and equality of health outcomes. Secondary data from China and US government statistics were used for the comparisons. Recommendations to strengthen China’s health insurance for children include lower out-of-pocket expenses, standardized data collection and management, qualified nurse practitioners providing rural health care, and explicit coverage requirements. [ABSTRACT FROM AUTHOR]
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- 2016
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4. Historical Changes in Weight Classes and the Influence of NAFLD Prevalence: A Population Analysis of 34,486 Individuals.
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Nah BKY, Ng CH, Chan KE, Tan C, Aggarwal M, Zeng RW, Xiao J, Chin YH, Tan EXX, Ren YP, Chee D, Neo J, Chew NWS, Tseng M, Siddiqui MS, Sanyal AJ, Dan YY, and Muthiah M
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- Body Mass Index, Humans, Nutrition Surveys, Obesity epidemiology, Odds Ratio, Overweight epidemiology, Prevalence, United States, Non-alcoholic Fatty Liver Disease epidemiology
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Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease globally in tandem with the growing obesity epidemic. However, there is a lack of data on the relationship between historical weight changes 10 years ago and at present on NAFLD prevalence at the population level. Therefore, we sought to evaluate the relationship between weight classes and the prevalence of NAFLD. Methods: Data were used from the United States National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Univariate and multivariate general linear model analyses were used to obtain risk ratio (RR) estimations of NAFLD events. Results: In total, 34,486 individuals were analysed, with those who were lean at both time points as the control group. Overweight (RR: 14.73, 95%CI: 11.94 to 18.18, p < 0.01) or obese (RR: 31.51, 95%CI: 25.30 to 39.25, p < 0.01) individuals at both timepoints were more likely to develop NAFLD. Residual risk exists where previously obese individuals became overweight (RR: 14.72, 95%CI: 12.36 to 17.52, p < 0.01) or lean (RR: 2.46, 95%CI: 1.40 to 4.31, p = 0.02), and previously overweight individuals who became lean (RR 2.24, 95%CI 1.42 to 3.54, p = 0.01) had persistent elevated risk of developing NAFLD despite weight regression. Sensitivity analysis identified that a higher proportion of individuals with regression in weight class were diabetics and Mexican Americans, while fewer African Americans saw weight-class regression. Conclusions: Residual risk exists in patients who lost weight despite the smaller magnitude of effect, and targeted weight reductions should still be used to mitigate the risk of NAFLD at the population level.
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- 2022
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5. FDA Approval Summary: Ivosidenib for the Treatment of Patients with Advanced Unresectable or Metastatic, Chemotherapy Refractory Cholangiocarcinoma with an IDH1 Mutation.
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Casak SJ, Pradhan S, Fashoyin-Aje LA, Ren Y, Shen YL, Xu Y, Chow ECY, Xiong Y, Zirklelbach JF, Liu J, Charlab R, Pierce WF, Fesenko N, Beaver JA, Pazdur R, Kluetz PG, and Lemery SJ
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- Abdominal Pain, Adult, Asthenia, Bile Ducts, Intrahepatic, Disease Progression, Double-Blind Method, Drug Approval, Fatigue, Glycine analogs & derivatives, Humans, Isocitrate Dehydrogenase genetics, Mutation, Nausea, Pyridines, United States, United States Food and Drug Administration, Vomiting, Bile Duct Neoplasms drug therapy, Bile Duct Neoplasms genetics, Cholangiocarcinoma drug therapy, Cholangiocarcinoma genetics
- Abstract
On August 25, 2021, the FDA approved ivosidenib for the treatment of adult patients with unresectable locally advanced or metastatic hepatocellular isocitrate dehydrogenase 1 (IDH1) mutated cholangiocarcinoma (CCA) as detected by an FDA-approved test with disease progression after 1 to 2 prior lines of systemic therapy for advanced disease. The approval was based on data from Study AG120-C-005 (ClarIDHy), a double-blind placebo-controlled trial that randomly allocated (2:1) patients to receive either ivosidenib or placebo. Independently assessed progression-free survival (PFS) was the primary endpoint. With a median follow-up of 6.9 months, the HR for PFS was 0.37 [95% confidence interval (CI), 0.25-0.54; P < 0.0001). Overall survival (OS) was the key secondary endpoint. At the final analysis of OS, with 70.5% of patients in the placebo arm receiving ivosidenib post disease progression, a non-statistically significant improvement in the ivosidenib arm with an HR = 0.79 (95% CI, 0.56-1.12) and median OS of 10.3 months (95% CI, 7.8-12.4) and 7.5 months (95% CI, 4.8-11.1) in the ivosidenib and placebo arms, respectively, were reported. Adverse reactions occurring in >20% of patients receiving ivosidenib were fatigue/asthenia, nausea, diarrhea, abdominal pain, ascites, vomiting, cough, and decreased appetite. Adverse reactions occurring in >20% of patients receiving placebo were fatigue/asthenia, nausea, abdominal pain, and vomiting. This is the first approval for the subset of patients with CCA harboring an IDH1 mutation., (©2022 American Association for Cancer Research.)
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- 2022
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6. FDA Approval Summary: Pembrolizumab, Atezolizumab, and Cemiplimab-rwlc as Single Agents for First-Line Treatment of Advanced/Metastatic PD-L1-High NSCLC.
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Akinboro O, Larkins E, Pai-Scherf LH, Mathieu LN, Ren Y, Cheng J, Fiero MH, Fu W, Bi Y, Kalavar S, Jafri S, Mishra-Kalyani PS, Fourie Zirkelbach J, Li H, Zhao H, He K, Helms WS, Chuk MK, Wang M, Bulatao I, Herz J, Osborn BL, Xu Y, Liu J, Gong Y, Sickafuse S, Cohen R, Donoghue M, Pazdur R, Beaver JA, and Singh H
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- Antibodies, Monoclonal, Humanized, Antineoplastic Combined Chemotherapy Protocols adverse effects, B7-H1 Antigen, Humans, Platinum therapeutic use, United States, Carcinoma, Non-Small-Cell Lung pathology, Lung Neoplasms pathology
- Abstract
FDA's approval of cemiplimab-rwlc on February 22, 2021, follows prior approvals of pembrolizumab and atezolizumab for similar indications as first-line treatment for patients with programmed death ligand-1 (PD-L1)-high advanced non-small cell lung cancer (NSCLC). Approvals of these anti-PD-L1 agents were supported by statistically significant and clinically meaningful improvements in overall survival (OS) in international, multicenter, active-controlled randomized trials. In KEYNOTE-024, the OS HR was 0.60 [95% confidence interval (CI), 0.41-0.89; P = 0.005] favoring pembrolizumab over platinum-doublet chemotherapy. In IMpower110, the OS HR was 0.59 (95% CI, 0.40-0.89; P = 0.0106) favoring atezolizumab over platinum-doublet chemotherapy. In Study 1624, the OS HR was 0.68 (95% CI, 0.53-0.87; P = 0.0022) favoring cemiplimab-rwlc over platinum-doublet chemotherapy. The progression-free survival (PFS) effect sizes for these anti-PD-L1 antibodies were also comparable across their respective registrational trials, and their safety profiles were consistent with the anti-PD-L1 class adverse event profile. The consistent survival benefits and manageable toxicity profiles of these single-agent anti-PD-L1 antibodies have established them as important treatment options in the PD-L1-high NSCLC treatment landscape. FDA approvals of these anti-PD-L1 antibodies, based on their favorable benefit-risk profiles, present effective chemotherapy-free therapeutic options for patients with advanced PD-L1-high NSCLC in the United States., (©2022 American Association for Cancer Research.)
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- 2022
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7. Racial and Ethnic Disparities in Surgical Outcomes after Postmastectomy Breast Reconstruction.
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Sarver MM, Rames JD, Ren Y, Greenup RA, Shammas RL, Hwang ES, Hollenbeck ST, Hyslop T, Butler PD, and Fayanju OM
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- Ethnicity, Female, Healthcare Disparities, Humans, Mastectomy, Postoperative Complications epidemiology, Postoperative Complications surgery, Retrospective Studies, Treatment Outcome, United States, Breast Neoplasms surgery, Mammaplasty
- Abstract
Background: Women of color with breast cancer are less likely to undergo post-mastectomy reconstruction compared with White women, but it is unclear whether their perioperative outcomes are worse. The goal of this study was to investigate differences in preoperative comorbidities and postoperative complications by race/ethnicity among women with breast cancer undergoing postmastectomy reconstruction., Study Design: Data were collected from the National Inpatient Sample database of the Healthcare Cost and Utilization Project from 2012 to 2016. Patient demographics, types of reconstruction, comorbid conditions, Charlson-Deyo Combined Comorbidity (CDCC) scores, length of stay (LOS), and perioperative complications were abstracted. Multivariate linear and logistic regression were performed to model LOS and likelihood of postoperative complications, respectively., Results: Compared with White women (n = 19,730), Black women (n = 3,201) underwent autologous reconstruction more frequently (40.7% vs 28.3%), had more perioperative comorbidities (eg diabetes: 12.9% vs 5.8%), higher CDCC scores (% CDCC ≥ 4: 5.5% vs 2.7%), and longer LOS (median 3 vs 2 days, all p < 0.001). Being Black (vs White: +0.13 adjusted days, 95% CI 0.06 to 0.19) was also associated with longer LOS and an increased likelihood of surgical complications (vs White: odds ratio 1.24, 95% CI 1.09 to 1.42, both p < 0.01), but this association did not persist when outcomes were limited to microsurgical complications., Conclusion: Disparities in postmastectomy breast reconstruction between Black and White women extend beyond access to care and include perioperative factors and outcomes. These findings suggest an important opportunity to mitigate inequities in reconstruction through perioperative health optimization and improved access to and co-management with primary care., (Copyright © 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)
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- 2022
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8. Home-Based Hematopoietic Cell Transplantation in the United States.
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Sung AD, Giri VK, Tang H, Nichols KR, Lew MV, Bohannon L, Ren Y, Jung SH, Dalton T, Bush A, Van Opstal J, Artica A, Messina J, Shelby R, Frith J, Lassiter M, Burleson J, Leonard K, Potter AS, Choi T, Gasparetto CJ, Horwitz ME, Long GD, Lopez RD, Sarantopoulos S, and Chao NJ
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- Case-Control Studies, Humans, Recurrence, Transplantation, Autologous, United States, Hematopoietic Stem Cell Transplantation, Quality of Life
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Patients undergoing allogeneic (allo) and autologous (auto) hematopoietic cell transplantation (HCT) require extensive hospitalizations or daily clinic visits for the duration of their transplantation. Home HCT, wherein patients live at home and providers make daily trips to the patient's residence to perform assessments and deliver any necessary interventions, may enhance patient quality of life and improve outcomes. We conducted the first study of home HCT in the United States to evaluate this model in the US healthcare setting and to determine the effect on clinical outcomes and quality of life. This case-control study evaluated patients who received home HCT at Duke University in Durham, North Carolina, from November 2012 to March 2018. Each home HCT patient was matched with 2 controls from the same institution who had received standard treatment based on age, disease, and type of transplant for outcomes comparison. Clinical outcomes were abstracted from electronic health records, and quality of life was assessed via Functional Assessment of Cancer Therapy-Bone Marrow Transplant. Clinical outcomes were compared with Student's t-test or Fisher's exact test (continuous variables) or chi-square test (categorical variables). Quality of life scores were compared using the Student t-test. All analyses used a significance threshold of 0.05. Twenty-five patients received home HCT, including 8 allos and 17 autos. Clinical outcomes were not significantly different between the home HCT patients and their matched controls; home HCT patients had decreased incidence of relapse within 1 year of transplantation. Pre-HCT quality of life was well preserved for autologous home HCT patients. This Phase I study demonstrated that home HCT can be successfully implemented in the United States. There was no evidence that home HCT outcomes were inferior to standard-of-care treatment, and patients undergoing autologous home HCT were able to maintain their quality of life. A Phase II randomized trial of home versus standard HCT is currently underway to better compare outcomes and costs., (Copyright © 2022 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
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- 2022
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9. Characterizing participants in the North Carolina Breast and Cervical Cancer Control Program: A retrospective review of 90,000 women.
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Tait SD, Ren Y, Horton CC, Oshima SM, Thomas SM, Wright S, Caesar A, Plichta JK, Hwang ES, Greenup RA, Rosenberger LH, DiLalla GD, Menendez CS, Tolnitch L, Hyslop T, Nelson D, and Fayanju OM
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- Adult, Early Detection of Cancer, Ethnicity, Female, Healthcare Disparities, Humans, North Carolina epidemiology, Retrospective Studies, United States, Young Adult, Breast Neoplasms diagnosis, Breast Neoplasms epidemiology, Racial Groups
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Background: The North Carolina Breast and Cervical Cancer Control Program (NC BCCCP) provides breast cancer screening services to underserved women to mitigate disparities in access to care. The authors sought to characterize this understudied population., Methods: Women 21 years old or older who underwent their first breast cancer screen through NC BCCCP from 2008 to 2018 were included. Demographic factors associated with the timeline of care and odds of a breast cancer diagnosis were identified with negative binomial and logistic regression, respectively., Results: Of the 88,893 women identified, 45.5% were non-Hispanic (NH) White, 30.9% were NH Black, 19.6% were Hispanic, 1.7% were American Indian, and 1.1% were Asian. Breast cancer was diagnosed in 2.5% of the women (n = 2255). Hispanic women were the least likely to be diagnosed with breast cancer (odds ratio vs NH White women, 0.40; 95% confidence interval [CI], 0.34-0.47). Among patients with breast pathology, the median time to diagnosis was 19 days (interquartile range [IQR], 10-33 days), and the time to treatment was 33 days (IQR, 19-54 days). After adjustments, a longer time to diagnosis was significantly associated with age (incidence rate ratio [IRR], 1.01; 95% CI, 1.01-1.02) and being NH Black (vs NH White; IRR, 1.17; 95% CI, 1.06-1.29). A longer time to treatment was significantly associated with age (IRR, 1.01; 95% CI, 1.01-1.01), being NH Black (vs NH White; IRR, 1.20; 95% CI, 1.10-1.31), and being Hispanic (vs NH White; IRR, 1.22; 95% CI, 1.05-1.41)., Conclusions: NC BCCCP participants with breast cancer received treatment within approximately 1 month of presentation, and this finding aligns with quality care benchmarks. Nevertheless, racial/ethnic disparities in timeliness of care persist, and this suggests opportunities for improvement., Lay Summary: This review of approximately 90,000 participants in a breast cancer screening program for uninsured and underinsured women highlights the importance of safety net programs in providing timely care to underserved patients. The authors found that the North Carolina Breast and Cervical Cancer Control Program met timeliness benchmarks from the Centers for Disease Control and Prevention across all racial/ethnic groups. However, non-Hispanic Black women experienced relative delays in the time to diagnosis, and both non-Hispanic Black women and Hispanic women experienced relative delays in the time to treatment. These findings demonstrate how racial/ethnic disparities in the timeliness of care can persist even within a program intended to reduce barriers to access., (© 2021 American Cancer Society.)
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- 2021
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10. Surgical Management of the Axilla in Elderly Women With Node-Positive Breast Cancer.
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Marks CE, Ren Y, Rosenberger LH, Thomas SM, Greenup RA, Fayanju OM, McDuff S, Kimmick G, Shelley Hwang E, and Plichta JK
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- Aged, Aged, 80 and over, Breast Neoplasms mortality, Cohort Studies, Combined Modality Therapy, Female, Humans, United States epidemiology, Axilla surgery, Breast Neoplasms surgery, Lymph Node Excision
- Abstract
Background: Elderly women with clinically node-positive (cN+) breast cancer (BC) often have comorbidities that limit life expectancy and complicate treatment. We sought to determine whether the number of lymph nodes (LNs) retrieved among older women with node-positive BC was associated with overall survival (OS)., Methods: Using the National Cancer Database (2010-2015), women 70-90 y with cN + BC and ≥1 LNs removed were categorized by treatment sequence: upfront surgery or neoadjuvant chemotherapy (NAC). Multivariable Cox proportional hazards models with restricted cubic splines characterized the functional association of LN retrieval with OS; threshold values of LN retrieval were estimated. Cox proportional hazards models were used to estimate the association of LN retrieval groups with OS., Results: In the upfront surgery cohort, a nonlinear association was identified between LNs retrieved and OS. In the NAC cohort, no association was identified. For the upfront surgery cohort, the optimal threshold value of LN retrieval was 21 LNs (90% confidence interval 18-23). Based on this estimate, LN retrieval groups were created: <6, 6-11, 12-17, 18-23, and >23 LNs. After adjustment, retrieval of <12 LNs in the upfront surgery group was associated with a worse OS. No differences were observed in the NAC group., Conclusions: For elderly women receiving upfront surgery, there is no survival benefit to removing more than 12 LNs, and for those receiving NAC, there is no association between number of LNs removed and survival. In older women who present with cN + BC, aggressive surgery to remove more than 12 LNs may not be necessary., (Copyright © 2020 Elsevier Inc. All rights reserved.)
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- 2020
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11. Implications for Breast Cancer Restaging Based on the 8th Edition AJCC Staging Manual.
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Plichta JK, Ren Y, Thomas SM, Greenup RA, Fayanju OM, Rosenberger LH, Hyslop T, and Hwang ES
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- Aged, Female, Humans, Middle Aged, Predictive Value of Tests, Prognosis, Retrospective Studies, SEER Program, United States, Breast Neoplasms diagnosis, Neoplasm Staging methods
- Abstract
Objective: We assessed the changes that have resulted from the latest breast cancer staging guidelines and the potential impact on prognosis., Background: Contemporary data suggest that combining anatomic staging and tumor biology yields a predictive synergy for determining breast cancer prognosis. This forms the basis for the American Joint Committee on Cancer's (AJCC) Staging Manual, 8th edition. We assessed the changes that have resulted from the new staging guidelines and the potential impact on prognosis., Methods: Women with stages I to III breast cancer from 2010 to 2014 in the National Cancer Data Base were pathologically staged according to the 7th and 8th editions of the AJCC Staging Manual. Patient characteristics and restaging outcomes were summarized. Unadjusted overall survival (OS) was estimated, and differences were assessed. Cox proportional-hazards models were utilized to estimate the adjusted association of stage with OS., Results: After restaging the 493,854 women identified, 6.8% were upstaged and 29.7% were downstaged. The stage changes varied by tumor histology, receptor status, tumor grade, and Oncotype DX scores (all P < 0.0001). Applying the 8th edition criteria yielded an incremental reduction in survival for each increase in stage, which was not consistently seen in the 7th edition. In a subgroup analysis based on hormone receptor (HR) status, those with stages II and III, and HR- disease had a worse OS than those with HR+ disease., Conclusions: Applying the 8th edition staging criteria resulted in a stage change for >35% of patients diagnosed with invasive breast cancer and refined OS estimates. Overall, the transition to the 8th edition is expected to better drive clinical care, treatment recommendations, and future research.
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- 2020
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12. The Clinical Significance of Breast-only and Node-only Pathologic Complete Response (pCR) After Neoadjuvant Chemotherapy (NACT): A Review of 20,000 Breast Cancer Patients in the National Cancer Data Base (NCDB).
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Fayanju OM, Ren Y, Thomas SM, Greenup RA, Plichta JK, Rosenberger LH, Tamirisa N, Force J, Boughey JC, Hyslop T, and Hwang ES
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- Adult, Axilla, Breast Neoplasms surgery, Databases, Factual, Female, Humans, Lymph Node Excision, Middle Aged, Neoplasm Staging, Neoplasm, Residual pathology, Survival Analysis, Treatment Outcome, United States, Breast Neoplasms drug therapy, Breast Neoplasms pathology, Chemotherapy, Adjuvant, Lymphatic Metastasis pathology, Neoadjuvant Therapy
- Abstract
Objective: To determine whether the association between overall survival (OS) and response to neoadjuvant chemotherapy (NACT) in breast cancer patients varies with tumor subtype and anatomic extent of pathologic complete response (pCR)., Background: pCR after NACT predicts improved OS in breast cancer, but it is unclear whether pCR limited to the breast or axilla is also associated with OS., Methods: Women with cT1-3/cN0-1 breast cancer diagnosed in 2010 to 2014 who underwent surgery following NACT were identified in the NCDB and divided into 4 subtypes based on reported hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. Kaplan-Meier curves and Cox proportional hazards models were used to estimate OS. Multivariate logistic regression was used to identify factors associated with post-NACT response, defined as upstage (yp stage>clinical stage); no change (clinical stage = yp stage); overall (breast+axilla, ypT0N0), breast-only (ypT0N1/N1mic), or node-only (ypT1-3N0) pCR., Results: Of 33,162 identified patients, 20,265 experienced overall pCR (n = 6370, 19.2%), breast-only pCR (n = 494, 1.5%), node-only pCR (n = 1133, 3.4%), no stage change (n = 9641, 29.1%), or upstage (n = 2627, 7.9%). Compared with no stage change, breast-only pCR was associated with improved OS in triple-negative disease [hazard ratio = 0.58, 95% confidence interval (95% CI) = 0.37-0.89], and node-only pCR was associated with improved OS in both triple-negative (hazard ratio = 0.55,95% CI = 0.39-0.76) and HR+/HER2- disease (hazard ratio = 0.54, 95% CI = 0.33-0.89). For patients achieving overall (breast+axilla) pCR, unadjusted 5-year OS was 0.94 (95% CI = 0.93-0.95), with no difference between patients who were cN0 (hazard ratio = 0.95, 95% CI = 0.93-0.96) or cN1 (hazard ratio = 0.94, 95% CI = 0.92-0.96) at diagnosis., Conclusions: In node-positive patients, pCR limited to either the breast or axilla predicts survival for select receptor subtypes. In patients achieving pCR in both the breast and axilla, survival is driven by response to NACT rather than presenting cN stage.
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- 2018
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13. Estimating anatomically-correct reference model for craniomaxillofacial deformity via sparse representation.
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Ren Y, Wang L, Gaol Y, Tang Z, Chen KC, Li J, Shen SG, Jin Yan, Lee PK, Chow B, Xia JJ, and Shen D
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- Computer Simulation, Humans, Reference Values, Reproducibility of Results, Sensitivity and Specificity, United States, Craniofacial Abnormalities diagnostic imaging, Craniofacial Abnormalities pathology, Imaging, Three-Dimensional methods, Models, Anatomic, Radiographic Image Interpretation, Computer-Assisted methods, Subtraction Technique, Tomography, X-Ray Computed methods
- Abstract
The success of craniomaxillofacial (CMF) surgery depends not only on the surgical techniques, but also upon an accurate surgical planning. However, surgical planning for CMF surgery is challenging due to the absence of a patient-specific reference model. In this paper, we present a method to automatically estimate an anatomically correct reference shape of jaws for the patient requiring orthognathic surgery, a common type of CMF surgery. We employ the sparse representation technique to represent the normal regions of the patient with respect to the normal subjects. The estimated representation is then used to reconstruct a patient-specific reference model with "restored" normal anatomy of the jaws. We validate our method on both synthetic subjects and patients. Experimental results show that our method can effectively reconstruct the normal shape of jaw for patients. Also, a new quantitative measurement is introduced to quantify the CMF deformity and validate the method in a quantitative approach, which is rarely used before.
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- 2014
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14. Gray's time-varying coefficients model for posttransplant survival of pediatric liver transplant recipients with a diagnosis of cancer.
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Ren Y, Chang CC, Zenarosa GL, Tomko HE, Donnell DM, Kang HJ, Roberts MS, and Bryce CL
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- Child, Child, Preschool, Computational Biology, Female, Histocompatibility Testing, Humans, Infant, Kaplan-Meier Estimate, Male, Multivariate Analysis, Proportional Hazards Models, Tissue Donors, Tissue and Organ Procurement statistics & numerical data, United States epidemiology, End Stage Liver Disease mortality, End Stage Liver Disease surgery, Liver Neoplasms mortality, Liver Neoplasms surgery, Liver Transplantation mortality, Models, Statistical, Survival Analysis
- Abstract
Transplantation is often the only viable treatment for pediatric patients with end-stage liver disease. Making well-informed decisions on when to proceed with transplantation requires accurate predictors of transplant survival. The standard Cox proportional hazards (PH) model assumes that covariate effects are time-invariant on right-censored failure time; however, this assumption may not always hold. Gray's piecewise constant time-varying coefficients (PC-TVC) model offers greater flexibility to capture the temporal changes of covariate effects without losing the mathematical simplicity of Cox PH model. In the present work, we examined the Cox PH and Gray PC-TVC models on the posttransplant survival analysis of 288 pediatric liver transplant patients diagnosed with cancer. We obtained potential predictors through univariable (P < 0.15) and multivariable models with forward selection (P < 0.05) for the Cox PH and Gray PC-TVC models, which coincide. While the Cox PH model provided reasonable average results in estimating covariate effects on posttransplant survival, the Gray model using piecewise constant penalized splines showed more details of how those effects change over time.
- Published
- 2013
- Full Text
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