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Recent studies have suggested that speech perception outcomes after cochlear implantation (CI) in prelingually deafened adults have improved with advances in CI technology and speech processing strategies. However, the outcomes vary from case to case. Communication mode has been reported in many studies as the factor that related to the post CI outcomes. This study aimed at investigating the post CI outcomes and the progress during 2 years for each communication mode.The subjects were 17 prelingually deafened adults undergoing CI at our hospital between April 2013 and March 2019. We investigated preoperative factors affecting post CI outcomes. Also we analyzed post CI outcomes for each communication mode and compared preoperative factors for each communication mode.Communication mode and preoperative discrimination score were the factor affecting on postoperative discrimination score. The speech perception score after CI improved significantly in the oral and lip-reading group and total communication group. The speech perception scores in postlingually deafened adults improved significantly during the first six months and became to plateau after CI. On the other hand, the scores of prelingually deafened adults tended to improve gradually after six months postoperatively. Furthermore, the degree of improvement and progress differed by each communication mode.The communication mode is important factors in predicting outcomes in prelingually deafened adults after CI. Long-term auditory training is important for prelingually deafened adults who use visual information as their preoperative method of communication.

Purpose The purpose of this study was to investigate the impact of social isolation and loneliness on the overall survival and death at home in patients with lung cancer. Methods This prospective cohort study was conducted in a Japanese tertiary hospital. The enrollment period was from April 2018 to March 2020. Patients with pathologically diagnosed advanced lung cancer were included in this study. The primary outcome was overall survival, whereas the secondary outcome was death at home. The exposures were social isolation and loneliness. Results A total of 211 patients were enrolled and divided into two groups and further into quartiles according to their social isolation and loneliness level, respectively. The hazard ratios of social isolation were 1.65 (95% confidence interval; 1.12 to 2.44) and 1.87 (95% confidence interval; 1.15 to 3.03) in the univariate analysis, while 1.40 (95% confidence interval; 0.92 to 2.13) in the multivariate analysis with complete case and multiple imputation. The odds ratio of death at home with social isolation was 3.47 (95% confidence interval; 1.08 to 11.1) in the multivariate analysis with multiple imputation. Loneliness was not associated with overall survival or death at home. Conclusions Our study suggests that social isolation may be related to overall survival and death at home among patients with advanced lung cancer. More attention should be given to such patients at the time of diagnosis.

Background Social determinants of health (SDHs) are social factors that affect human health; loneliness and social isolation are core SDH factors. There is a possibility that SDHs are related to passive decisionmaking. However, few studies have evaluated SDHs, especially social isolation and loneliness, among lung cancer patients. This study aims to investigate the effects of social isolation and loneliness on the diagnosis and treatment of Japanese lung cancer patients. Methods This is a prospective cohort study that was conducted in a tertiary referral hospital in Japan (University Hospital Medical Information Network registration: UMIN000031810). The enrollment period was between April 2018 and March 2020. Patients with clinical and/or pathological diagnosis of lung cancer were enrolled in this study. Exposures were social isolation and loneliness, and main outcomes were diagnosis methods and whether the initial treatment involved active therapy or best supportive care (BSC). The confounding factors were defined as sex, age, smoking status, respiratory symptoms, weight loss, presentation with any symptoms, Eastern Cooperative Oncology Group (ECOG) performance status, tumor nodes metastasis (TNM) classification, driver gene mutations [i.e., epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK)], and programmed death-ligand 1 (PD-L1) tumor proportion score. Results The study enrolled 264 patients who were divided into quartiles according to their loneliness scores and into two groups according to the social isolation level. Univariate analysis, complete case analysis, and multivariate analysis with multiple imputation failed to detect significant differences in diagnostic method or initial treatment strategy according to loneliness or social isolation level. Conclusions Physicians may not need to consider a patient's loneliness and/or social isolation when diagnosing lung cancer and selecting treatment under universal health insurance coverage. Further studies are needed to understand the influences of loneliness and social isolation on the prognosis of lung cancer patients.

Background/aim Previous reviews of Social determinants of health in lung cancer patients have not examined essential factors such as social isolation and loneliness. This study aimed to explore the factors affecting social isolation and loneliness among lung cancer patients. Patients and methods A cross-sectional study was conducted. Social isolation, loneliness, and the presence of dementia were measured using Japanese adaptations of the Lubben Social Network Scale, UCLA Loneliness Scale, and Life Function Evaluation for Care Provision, respectively. Results From March 2019 to March 2020, 264 patients were included. Social isolation was significantly higher for patients receiving welfare (adjusted OR=5.28, 95% CI=2.24-12.4). Loneliness was significantly higher for patients receiving welfare (beta coefficient=0.52, 95% Cl=0.13-0.90) with symptoms of dementia (beta coefficient=0.28, 95% Cl=0.03-0.54). Conclusion Results showed that receiving welfare was associated with experiencing social isolation. Receiving welfare and symptoms of dementia were associated with experiencing loneliness.

Hintergrund: Osimertinib, ein epidermaler Wachstumsfaktorrezeptor-Tyrosinkinasehemmer (Epidermal Growth Factor Receptor-Tyrosine-kinase Inhibitor, EGFR-TKI) der 3. Generation, ist mittlerweile die Standardtherapie in Fällen, in denen die Rebiopsie nach der Erstlinienbehandlung mit EGFR-TKI eine T790M-Mutation ergibt. Die Prognose der Patienten nach Rebiopsie, dem wichtigsten Outcome bei Krebspatienten, wurde bislang jedoch nicht ausreichend beschrieben. Die vorliegende systematische Übersichtsarbeit sollte klären, ob die Rebiopsie bei Patienten, die gegenüber den EGFR-TKI der 1. und 2. Generation refraktär sind, zu einer verbesserten Prognose beiträgt. Methoden: Mithilfe freier Wort- und Kontrollbegriffe im Zusammenhang mit «nicht kleinzelligem Bronchialkarzinom» und «Rebiopsie» suchten wir Studien aus dem Medical Literature Analysis and Retrieval System Online über PubMed, Embase, Cochrane Central Register of Controlled Trials und die World Health Organization International Clinical Trials Registry Platform. Eingeschlossen wurden Kohortenstudien und Fallberichte in englischer Sprache und es erfolgte eine Beurteilung, ob die jeweilige Studie unsere wissenschaftliche Fragestellung beantwortete. Ergebnisse: Von den 144 eingeschlossenen Studien enthielt nur eine Studie Angaben zur Prognose von Patienten mit/ohne Rebiopsie und zeigte, dass bei EGFR-TKI-refraktären Patienten mit nicht kleinzelligem Bronchialkarzinom das Überleben nach Krankheitsprogression (post-progression survival, PPS) bei Patienten, die eine Rebiopsie sowie eine Behandlung entsprechend dem Resistenzmechanismus erhalten hatten, signifikant länger war (medianes PPS: 24,2 Monate) als bei Patienten die eine Rebiopsie und Salvage-Therapie erhalten hatten (medianes PPS: 15,2 Monate, p = 0,002) und solchen ohne Rebiopsie (medianes PPS: 9,7 Monate, p < 0,001). Die meisten anderen Studien berichteten über die Nachweisrate von T790M-Mutationen oder das Rebiopsieverfahren. Schlussfolgerungen: Nur wenige der bisher durchgeführten Studien untersuchten die Wirksamkeit der Rebiopsie. Daher sind weitere Untersuchungen erforderlich, um die Prognose oder Nebenwirkungen der Rebiopsie zu ermitteln.

This article was migrated. The article was marked as recommended. Background: Writing letters to the editor based on critical appraisal can serve as the first step in scholarly activity. The workshop in this study focused on educating physicians about the best ways to write letters to the editor. Methods: We conducted a 90-minute workshop as a part of scientific conference. Participants were physicians and medical students who chose to join this workshop. We developed the following learning outcomes for participants: 1) to be able to explain falsificationism; 2) to be able to explain how to check author instructions; 3) to be able to explain how to write a letter to the editor. Results: Twenty-eight participants, including three medical students, attended the workshop. Participants' satisfaction with the workshop had a mean of 4.5 points out of 5 (standard deviation: 0.5). Nearly 80% of participants achieved the learning outcomes. Four participants' groups submitted letters within a month after the workshop, and all four were published. These four groups encompassed a total of 13 authors. In addition, none of the first author of each letter had previously written a clinical research paper. Findings and Discussion: This workshop improved not only the participants' knowledge but it also led to the concrete result of four published letters. Japanese physicians would be able to use this framework to write letters to the editor.

IntroductionSocioeconomic factors with an influence on human health are known as social determinants of health (SDH). There are some SDH studies in patients with lung cancer, but important exposures such as social isolation and loneliness have not been adequately investigated. This study will assess the influence of SDH, particularly social isolation and loneliness, on patients with advanced lung cancer in Japan.Methods and analysisThe inclusion criteria for this prospective cohort study will be as follows: a diagnosis of advanced lung cancer; unsuitability for curative surgery; and willingness to participate. The primary outcome will be the initial choice of treatment and the secondary outcomes will be overall survival, changes in disease staging or performance status, route to diagnosis and place of death. The exposures will be social isolation, loneliness, employment, insurance type, education and dementia. The study enrolment period will be 1 year and the follow-up duration will be 2 years. The log-rank test will be used to compare overall survival between patients when grouped according to the study exposures and multivariate analysis will be performed using Cox proportional hazards regression. The Χ2test will be used to compare the initial treatment, changes in disease stage and place of death, and logistic regression will be used for multivariate analysis of these factors. A p value Ethics and disseminationThis study has been approved by the Institutional Review Board at Hyogo Prefectural Amagasaki General Medical Center (No 29-164). A manuscript summarising the outcome of this study will be submitted to a peer-reviewed journal and the data will be presented at conferences.Trial registration numberUMIN000031810.

The title compounds are synthesized by regioselective one-pot synthesis in three steps: cycloaddition, dehydration, and deprotection.

The title compounds are synthesized by regioselective one-pot synthesis in three steps: cycloaddition, dehydration, and deprotection.