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PURPOSE Since the development of the International Germ Cell Cancer Collaborative Group (IGCCCG) risk classification in a 1997 study, high-income countries have reported a significant increase in survival for poor prognosis patients. There are scant data on IGCCCG risk-stratified survival from low- and middle-income countries. We assessed the progression-free survival (PFS) and overall survival (OS) rates in a contemporary cohort of Belarusian patients with advanced germ cell cancer (GCC) stratified by the IGCCCG prognostic classification and analyzed prognostic factors for survival. MATERIALS AND METHODS The consecutive cohort of patients with clinical stage IIb-III testicular GCC or extragonadal germ cell tumors who received treatment or consultation in our two centers between 2010 and 2015 was included. All patients underwent primary chemotherapy. The patients were divided into seminoma and nonseminomatous germ cell carcinoma (NSGCC) subgroups. The Kaplan-Meier method was used to estimate 5-year PFS and OS. RESULTS This study included 111 patients with a median age of 32 years, 95% of whom were diagnosed with testicular cancer. Seminoma and NSGCC were identified in 32 (29%) and 79 (71%) patients, respectively. The median follow-up was 6.1 years. The 5-year PFS and OS rates for the entire cohort were 70% and 77%, respectively. In patients with good prognosis seminoma and good, intermediate, and poor prognosis NSGCC, the estimated PFS rates were 76%, 88%, 74%, and 39% and those for OS were 83%, 97%, 83%, and 38%, respectively. CONCLUSION In our cohort of Belarusian patients with advanced germ cell tumors, we failed to demonstrate an improvement in PFS and OS compared with the 1997 IGCCCG study. Moreover, survival in poor prognosis group is inferior to that in IGCCCG and all contemporary series from high-income countries.

Purpose The prognostic significance of lactate dehydrogenase (LDH) in patients with metastatic seminoma is not defined. We investigated the prognostic impact of LDH levels prior to first-line systemic treatment and other clinical characteristics in this subset of patients. Methods Files from two registry studies and one single-institution database were analyzed retrospectively. Uni- and multivariate analyses were conducted to identify patient characteristics associated with recurrence free survival (RFS), overall survival (OS), and complete response rate (CRR). Results The dataset included 351 metastatic seminoma patients with a median follow-up of 5.36 years. Five-year RFS, OS and CRR were 82%, 89% and 52%, respectively. Explorative analysis revealed a cut-off LDH level of n = 228) vs. ≥ 2.5 ULN (n = 123) to be associated with a significant difference concerning OS associated with 5-years OS rates of 93% vs. 83% (p = 0.001) which was confirmed in multivariate analysis (HR 2.87; p = 0.004). Furthermore, the cut-off LDH p = 0.012) and 32% vs. 59% (p ≤ 0.001), respectively. Conclusions LDH levels correlate with treatment response and survival in metastatic seminoma patients and should be considered for their prognostic stratification.

Background: Previous studies have shown that men with HIV and germ cell cancer (HIV-GCC) have inferior overall survival (OS) in comparison with their HIV-negative counterparts. However, little information is available on treatments and outcomes of HIV-GCC in the era of combination antiretroviral therapy (cART). Methods: This study examined men living with HIV who were 18 years old or older and had a diagnosis of histologically proven germ cell cancer (GCC). The primary outcomes were OS and progression-free survival (PFS). Results: Data for 89 men with a total of 92 HIV-GCCs (2 synchronous GCCs and 1 metachronous bilateral GCC) were analyzed; among them were 64 seminomas (70%) and 28 nonseminomas (30%). The median age was 36 years, the median CD4 T-cell count at GCC diagnosis was 420 cells/µL, and 77% of the patients on cART had an HIV RNA load < 500 copies/mL. Stage I disease was found in 44 of 79 gonadal GCCs (56%). Among 45 cases with primary disseminated GCC, 78%, 18%, and 4% were assigned to the good-, intermediate-, and poor-prognosis groups, respectively, of the International Germ Cell Cancer Collaborative Group. Relapses occurred in 14 patients. Overall, 12 of 89 patients (13%) died. The causes of death were refractory GCC (n = 5), an AIDS-defining illness (n = 3), and other causes (n = 4). After a median follow-up of 6.5 years, the 5- and 10-year PFS rates were 81% and 73%, respectively, and the 5- and 10-year OS rates were 91% and 85%, respectively. Conclusions: The 5- and 10-year PFS and OS rates of men with HIV-GCC were similar to those reported for men with HIV-negative GCC. Patients with HIV-GCC should be managed identically to HIV-negative patients. Lay Summary: Men living with HIV are at increased risk for germ cell cancer (GCC). Previous studies have shown that the survival of men with HIV-associated germ cell cancer (HIV-GCC) is poorer than the survival of their HIV-negative counterparts. This study examined the characteristics, treatments, and outcomes of 89 men with HIV-GCC in the era of effective combination antiretroviral therapies. The long-term outcomes of men with HIV-GCC were similar to those reported for men with HIV-negative GCC. Patients with HIV-GCC should be managed identically to HIV-negative patients.

Collaborative writing (CW) and task repetition have been claimed to aid language acquisition. Students produce better texts when writing with a peer and their drafts improve if they write the same composition twice (same task repetition, STR). However, little is known about young learners, about the effects of combining both constructs and, finally, about a more common type of repetition in language lessons: repeating the same procedure with different content (procedural task repetition, PTR). This study analyses the effects of CW (vs. individual writing) and of PTR (vs. STR). To do so, the writings of 59 Spanish young learners (aged 11) of English divided into four groups were analysed. Two of these groups (N = 9, N = 10) wrote a composition individually while two (N = 20, N = 20) wrote a composition in pairs. A week later, one individual (N = 9) and one collaborative group (N = 20) wrote the same composition again (STR) while the other individual (N = 10) and collaborative (N = 20) groups wrote a new composition following the same procedure (PTR). Unlike findings from adult learners, our students’ drafts show no differences that could be attributed to the collaboration. However, some improvements upon repetition were hinted at, with students in the STR group obtaining greater holistic rates.

This paper explores the potential of collaborative group facilitation between therapists and peer workers in mental health. A case study of co-practice between a music therapist and a peer worker is used to illustrate how lived experience expertise can enrich and complement therapeutic groups. The paper aims to begin a discussion around collaborative group facilitation within mental health practice and to advocate for continued development of collaborative practice between peer workers and therapists. Experiences of collaboration are explored through the case study provided using a synthesis of the authors' reflections and dialogue. The importance of role negotiation, role definition, and open communication around changing roles and boundaries are discussed as key considerations for beginning collaborations, as well as the establishment and maintenance of a foundation of trust and support within the working relationship.

É apresentada aqui uma investigação sobre como acontece o desenvolvimento profissional de um grupo de professoras de escolas públicas dos anos iniciais da região de Sorocaba/SP que participaram de um grupo colaborativo ao longo de 20 encontros. O grupo tinha como objetivo implementar a alfabetização científica (AC) em suas aulas. Para identificar o desenvolvimento profissional das professoras foram utilizados instrumentos baseados nos estudos de Barolli et al. Os resultados apontaram que o grupo teve importantes indícios de desenvolvimento profissional docente durante os encontros e na sua organização de carreira.

Background In this paper, we illustrate the extent to which building an inclusive research team and the selection of a research topic, based on a collaborative group approach, constitute key elements of inclusive research. Method The selection and analysis of activities and methodological strategies, extracted from the recordings of the research meetings, offer clues about the creation of collaborative and deliberative research spaces. Results Some of the elements that reaffirm the inclusive nature of this research are as follows: contributions by all members of the research team receive equal recognition, the particular interests of all of those involved are taken into account and research strategies that are supported in different languages encourage the participation of all researchers. Conclusions We need to review our practices in order to identify the added value of this type of work and move towards research training proposals that promote the research ownership of people with intellectual disabilities.

From a cognitive load perspective, successful collaborative learning occurs if groups achieve their goals, and if each member processes information in a way that contributes to individual learning. This research looked at group work among postgraduate STEM students in South Korea (N = 55) to see if successful collaborative learning and individual contribution were associated with greater individual course success. Results showed that students who participated in successful group work showed higher levels of germane cognitive load, which contributes to learning, and also earned higher scores on the final research paper for the course. Implications of this study highlight the need for synchronous collaborative writing to be used as a way of sharing ideas and knowledge to produce higher levels of individual understanding and quality writing.

Highlights • Total treatment duration increases the likelihood of treatment interruptions (TI) • High risk group patients with TI trended towards worse biochemical failure. • Within the high risk group of patients treated with ADT, TI were associated with a statistically significant increase in BF rate., Introduction To date, no studies examining the effect of treatment interruptions (TI) with proton beam therapy (PBT) have been published. The goal of our study was to determine the predictors of TI amongst patients with prostate cancer (PCa) treated with PBT and to determine whether TI are associated with biochemical failure (BF). We hypothesized that any correlation between TI and biochemical control would be more pronounced in high risk groups. Methods Data for 4278 patients with PCa was obtained from the prospectively collected Proton Collaborative Group (PCG) data registry. Univariate and multivariate logistic regression analysis (MVA) was used to model possible predictors of BF. A subset analysis was performed for high risk patients treated with ADT and PBT. Finally, propensity score (PS) analysis was performed to account for any indication bias caused by lack of randomization. Results Total treatment duration (OR, 1.05 [1.04–1.06]; p

This paper proposes an online multi-user real-time co-reading (OMURCOR) system to promote the performance of co-reading with collaborative learning. The OMURCOR system utilizes WebSocket to perform synchronization controls on co-reading to allow teachers and students to watch streaming videos together with less delay. Moreover, teachers utilize the system to synchronize control operations of videos on the student site, and the OMURCOR system can be integrated into a learning management system to strengthen students' interaction through co-reading. Unlike traditional platforms, the system supports grouping mechanisms during instruction. A survey was conducted with 104 participants. The bootstrapping square and partial least square approaches of the structural equation modeling (PLS-SEM) are employed via the SmartPLS tool to explore evidence of reliability and validity of the revised TAM. Experimental results reflected that six of the seven hypotheses were supported, and the proposed system has a significant impact on students' learning effectiveness during co-reading.

Limited evidence supports the use of early endpoints to evaluate the success of initial treatment of extranodal NK/T-cell lymphoma (ENKTCL) in the modern era. We aim to analyze progression-free survival at 24 months (PFS24) and subsequent overall survival (OS) in a large-scale multicenter cohort of patients. 1790 patients were included from the China Lymphoma Collaborative Group (CLCG) database. Subsequent OS was defined from the time of PFS24 or progression within 24 months to death. OS was compared with age- and sex-matched general Chinese population using expected survival and standardized mortality ratio (SMR). Patients who did not achieve PFS24 had a median OS of 5.3 months after progression, with 5-year OS rate of 19.2% and the SMR of 71.4 (95% CI, 62.9–81.1). In contrast, 74% patients achieved PFS24, and the SMR after achieving PFS24 was 1.77 (95% CI, 1.34–2.34). The observed OS rate after PFS24 versus expected OS rate at 5 years was 92.2% versus 94.3%. Similarly, superior outcomes following PFS24 were observed in early-stage patients (5-year OS rate, 92.9%). Patients achieving PFS24 had excellent outcome, whereas patients exhibiting earlier progression had a poor survival. These marked differences suggest that PFS24 may be used for study design and risk stratification in ENKTCL.

The Group Exercises is a distinctive collaborative group working activity completed by approximately 170 second-year undergraduate chemistry students each year in June. The activity comprises stude...

This paper focuses on comparing collaborative group sizes (small versus large) in terms of developing preservice teachers’ skills in designing webpages using HTML in a project-based learning environment. It examines the effect that group size has on academic achievement and product quality in project-based learning environments. The experiment involved 74 undergraduate students enrolled in the sixth level of the Computer Teacher Program, Faculty of Education, King Faisal University in Saudi Arabia, during the second term of the school year 2018-2019. Study results indicate that there are significant differences between large and small size groups as they relate to students’ academic achievement and product quality, showing a preference for a large group, which disagrees with most of the existing literature. In this study, the researchers explain this disagreement and recommend new directions in researching group sizes in project-based learning environments in the future.

Replacement therapy with plasma-derived or recombinant FVIII and FIX (pdFVIII/pdFIX or rFVIII/rFIX) concentrates is the standard of treatment in patients with haemophilia A and B, respectively. Measurement of factor VIII (FVIII:C) or factor IX (FIX:C) levels can be done by one-stage clotting assay (OSA) or chromogenic substrate assay (CSA). The French study group on the Biology of Hemorrhagic Diseases (a collaborative group of the GFHT and MHEMO network) presents a literature review and proposals for the monitoring of FVIII:C and FIX:C levels in treated haemophilia A and B patients, respectively. The use of CSA is recommended for the monitoring of patients treated with pdFVIII or rFVIII including extended half-life (EHL) rFVIII. Except for rFVIII-Fc, great caution is required when measuring FVIII:C levels by OSA in patients substituted by EHL-rFVIII. The OSA is recommended for the monitoring of patients treated with pdFIX or rFIX. Large discordances in the FIX:C levels measured for extended half-life rFIX (EHL-rFIX), depending on the method and reagents used, must lead to great attention when OSA is used for measuring FIX:C levels in patients substituted by EHL-rFIX. Data of most of recent studies, obtained with spiked plasmas, deserve to be confirmed in plasma samples of treated patients.

PurposeHigher education institutions (HEIs) frequently overlook the importance of encouraging creative thinking in students. A review of the prevailing practices in a fully online tertiary distance education (DE) institution revealed a lack of learning activities that foster creativity. The study aims to find out whether the creative collaborative group project is a feasible, effective and acceptable learning activity for fostering creativity in students of a fully online graduate-level DE course.Design/methodology/approachSeven groups of five to six graduate students each had five weeks to conceptualize, prepare and deliver a creative collaborative group project on lifelong learning using key concepts learned from the course.FindingsAll groups submitted well-crafted creative projects within the given time frame. Reflections on their experience positively correlated with known outcomes associated with creative skills. Students valued the experience and had a better understanding of the concepts. These support the feasibility, effectiveness and acceptability of the project for fostering creativity in a fully online DE institution.Research limitations/implicationsThe feasibility, effectiveness and acceptability may vary in different contexts; future iterations in the same and/or other courses are recommended.Practical implicationsThe creative collaborative group project is a feasible, effective and acceptable strategy for fostering creativity in online distance education.Social implicationsCreativity can be enhanced through appropriate online collaborative learning activities.Originality/valueThe study adds to the body of literature on the use of creative collaborative group projects to foster creativity in HEIs.

Purpose: As a means of limiting normal tissue toxicity, proton-beam therapy (PBT) is an emerging radiation modality for glioblastoma (GBM) reirradiation. However, data for recurrent GBM treated with PBT reirradiation is limited. Therefore, we analyzed treatment patterns, toxicities, and clinical outcomes of patients with recurrent GBM treated with PBT reirradiation using the multi-institutional Proton Collaborative Group registry. Methods and Materials: Prospectively collected data for patients with recurrent GBM who underwent PBT while enrolled in Proton Collaborative Group study 01-009 (NCT01255748) were analyzed. We evaluated overall survival (OS), progression-free survival (PFS), and toxicity. Toxicities were scored per the Common Terminology Criteria for Adverse Events, version 4.0. Descriptive statistics were used to report patient, tumor, and treatment characteristics. Multivariable analyses (MVA) for toxicity were conducted using logistic regression. The Kaplan-Meier method was used to calculate OS and PFS. MVA for OS and PFS was conducted using Cox proportional-hazards models. The SAS statistical software was used for the analysis. Results: We identified 45 recurrent patients with GBM who underwent PBT reirradiation between 2012 and 2018. The median time between initial GBM diagnosis and recurrence was 20.2 months. The median follow-up time from PBT reirradiation was 10.7 months. Median PFS was 13.9 months (95% confidence interval [CI], 8.23-20.0 months) and median OS was 14.2 months (95% CI, 9.6-16.9 months) after PBT reirradiation. One patient experienced an acute grade 3 toxicity, 4 patients experienced late grade 3 toxicity (no grade ≥4 toxicities). MVA revealed that prior surgery was associated with a 91.3% decreased hazard of death (hazard ratio: 0.087; 95% CI, 0.02-0.42; P < .01). No explanatory variables were associated with PFS or grade 3 toxicities. Conclusions: This is the largest series to date reporting outcomes for PBT reirradiation of patients with recurrent GBM. Our analysis indicates that PBT is well tolerated and offers efficacy rates comparable with previously reported photon reirradiation.

The Pediatric Oncology East and Mediterranean (POEM) group was established in 2013 as a cooperative platform for physicians, scientists and healthcare professionals from institutions in the East and Mediterranean area with the goal of sharing experiences, initiating cooperative trials and establishing common strategies to achieve optimization of the care of pediatric oncology patients in the region. The mission of POEM group is to continuously improve pediatric oncology care, research, training and advocacy in the East and Mediterranean region by means of integrated teamwork. Our Vision is to be the leading pediatric oncology collaborative group in the East and Mediterranean Region. POEM group is currently at more than 550 registrants from 119 centers in 28 countries regionally. This review summarizes the structure and activities of POEM group since its inception, and highlights identified challenges and future plans. Keywords: Pediatric oncology, Collaborative group, LMIC

533 Background: Early stage breast cancer is a curable disease with the majority of patients dying of causes other than breast cancer. The influence of these competing risks of death on the interpretation of Kaplan-Meier(KM)-based analyses such as those performed by the Early Breast Cancer Trialists Collaborative Group (EBCTCG) are unknown. Methods: We searched the Clinical Trial Service Unit and Epidemiological Studies Unit website at Oxford University to identify all meta-analyses published by the EBCTCG between 2005 and 2018. Studies were included if they contained KM curves with risk estimates for either breast cancer mortality and/or breast cancer recurrence. The potential influence of competing risks was estimated using a validated multivariate linear model that predicts the amount that the KM risk estimates are biased relative to outcome risk measured with the cumulative incidence function (CIF). Results: The initial search identified 14 analyses published by the EBCTCG with 10 of the 14 studies (71%) susceptible to competing risk bias cited both the number of events of interest and competing events. Eight of the ten studies (80%) had a relative difference between the KM estimate and the competing risk adjusted estimate of more than 10% while 2 of 10 (20%) had a difference of less than 10%. The relative difference between the KM and adjusted estimates was 28.4% for local recurrence, 16.8% for distant recurrence, and 6.7% for breast cancer-specific mortality. There was 2.2% difference between KM and adjusted analyses between 0-4 years and 18.9% beyond 10 years of follow up. Use of KM and CIF-based analysis did not influence treatment effect in the majority of included studies. Conclusions: This study provides estimates for the overestimation of risk in Kaplan-Meier analyses resulting from failure to address competing risk bias. CIFs are more appropriate to measure outcome risk over time and should be used especially for long-term follow-up studies and for analysis of rare events.

A collaborative research model was developed and tested to enable regional healthcare systems to join multisite clinical trials emanating from the Clinical and Translational Science Award (CTSA) Trial Innovation Network (TIN) by the Institute of Translational Health Sciences at the University of Washington and the Northwest Participant and Clinical Interactions (NW PCI) Network. The NW PCI is a collaborative group of regional research programs located at medical centers, healthcare systems, and universities across Washington, Wyoming, Alaska, Montana, and Idaho. This article describes the purpose, development, barriers, and initial experience with feasibility assessment for TIN-supported studies in the NW PCI. The tools and processes of the NW PCI Network were adapted to enable network sites to assess studies for clinical relevance and feasibility. Seven of seventeen TIN-supported studies were reviewed for consideration; three of which resulted in successful completion of study documentation for site selection by NW PCI sites. The NW PCI/TIN model can be adapted by other CTSAs to increase involvement of regional research programs in national multisite clinical research studies. Barriers to expanding TIN-supported trials to regional networks include short timelines for study document submissions, insufficient site reimbursement rates, and non-feasible study designs.

MASEI is the main validated ultrasound score for the evaluation of enthesis. The lack of studies facing the agreement to achieve for the interpretation of the MAdrid Sonographic Enthesis Index (MASEI) among researchers from different centers in multicenter studies is of concern. The aim of this multicenter was to evaluate the interobserver reliability of MASEI. An experienced ultrasonographer-rheumatologist performed ultrasound scans of the areas included in MASEI index in three patients with Ankylosing Spondylitis and Psoriatic Arthritis. Videos were captured. The videos were then evaluated by 24 rheumatologists of the ultrasound working group of the Catalan Society of Rheumatology (EcoCAT). A face-to-face training meeting was held. Ten days after the workshop, the study participants evaluated the videos. A reliability assessment was performed. The ICC for the MASEI scores after the workshop was of 0.97 (95% CI 89-99). Reliability did not vary statistically with examiner experience. Globally, no problems of reliability by structures were seen, and all the ICCs were above 0.90 and improved slightly after the educational program. However, the correlation observed between examiners at plantar aponeursis and triceps tendon was weak. The small variability observed in the results of the index validation in our study, suggests that the MASEI index is reproducible by different observers when those are well trained and show awesome results of the enthesis when examined by ultrasound.

This paper reports on a study of collaborative group work in mathematics. Although collaborative group work is known as one of the important approaches in education, it is still uncertain h...

The aim of this study is to explore learners’ intention to return to the electronic environment through the use of wikipages. The survey is based on students’ participation in a collaborative group project over a one semester course on business information systems. A research model based on the extended Technology Acceptance Model (TAM) has been proposed to investigate what factors will influence learners’ continuance participation in the electronic learning environment. 75% of students returned the questionnaire and the data analysis results based on the extended TAM Shows that the learners’ intention to return to the electronic learning environment was highly associated with their attitude towards the electronic learning tool and the affection associated with the tool.