1,720,957 research outputs found
Advanced epithelial ovarian cancer in older patients.
No full text© 2025 The Author(s). Published by Elsevier Inc. on behalf of European Society of Gynaecological Oncology and the International Gynecologic Cancer Society.
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)Objective: We aimed to analyze management and survival outcomes of older patients (≥75 years) with stage ≥II epithelial ovarian cancer across gynecological cancer centers in the United Kingdom.
Methods: Retrospective cohort study performed using the IMPRESS project data set. Clinical information for patients diagnosed with epithelial ovarian cancer from 6 sites of varying size and population demographics was collated between January 2018 and December 2019. We compared treatment of patients aged ≥75 years with those <75, within and between centers, using multivariate analysis to understand effects on outcomes.
Results: After exclusions, we assessed 721 patients for overall survival and 702 for progression-free survival. Patients aged ≥75 years had poorer performance status and more comorbidities. Older patients were less likely to receive combination treatment with surgery and chemotherapy (in either order) (overall = 392/721 (54.4%); <75 cohort = 320/495 (64.6%); ≥75 cohort = 72/226 (31.9%), p < .0001). Treatment varied between sites, with some having no active treatment rates of 49% for patients aged ≥75 years. Older patients had twice the relative risk of death (relative risk 1.98, 95% CI 1.63 to 2.39, p < .001). Adjustment for confounders individually caused only a relatively modest reduction in magnitude and strength of association. Adjustment for treatment led to this association essentially disappearing (relative risk 1.10, 95% CI 0.88 to 1.38, 99% reduction in χ2), though with significant variation in association between age and overall survival between treatment groups (p-heterogeneity = .0004).
Conclusions: Older women may do as well as younger women in terms of survival if treated similarly, although this varies depending on treatment groups. Treatments varied between and within sites, with some sites treating older women differently than others
Investigating the acceptability of cervical screening, using conventional clinician-taken cervical samples or urine self-sampling, at 6-weeks postnatal: a cross-sectional questionnaire
Full text linkObjectivesUnited Kingdom (UK) guidelines recommend delaying cervical screening due during pregnancy to 12-weeks postnatal without evidence to support. This questionnaire-based study aimed to determine the feasibility of a clinical study of cervical screening and urine self-sampling for human papillomavirus (HPV) at 6-weeks postnatal, as pilot work suggested this would improve uptake, if offered at the routine postnatal check-up.MethodsFemales who were pregnant/recently pregnant were invited to participate in a web-based questionnaire. Questions assessed acceptability of postnatal cervical screening at 6-weeks postnatal, analysed with Chi-square, Fisher’s exact and Mann-Whitney tests. Free text responses were coded using the Theoretical Framework of Acceptability (TFA) to conduct a qualitative content analysis.ResultsOf 454 participants, 266 (58.65%) would be more likely to have cervical screening if offered at 6-weeks postnatal, more if offered urine self-sampling (n = 338; 74.4%). Two-thirds (308/454; 67.8%) would be willing for screening at 6-weeks postnatal for a research study and 356/454 (78.4%) willing if limited to urine self-sampling. When considering screening modality, over half (245/454; 54%) would prefer urine self-sampling to cervical screening, although a fifth (93/454; 21%) preferred conventional sampling. Free text responses were provided by 279 participants, and these highlighted that affective attitude and burden TFA constructs underpinned prospective acceptability of having screening at 6-weeks postnatal. ConclusionsOffering cervical screening at the 6-week postnatal check-up has potential to increase cervical screening participation. Most participants would be interested in taking part in research. Feasibility of screening at 6-weeks postnatal and concurrent acceptability should be tested in pilot clinical studies
Postnatal instead of normally-timed cervical screening (PINCS-1):A protocol for a feasibility study of paired-sample cervical screening and urine self-sampling at 6 weeks and 12 weeks postnatal in the UK
Full text linkIntroduction: Cervical screening rates in the UK are falling, limiting our ability to prevent cervical cancer. Peak incidence of cervical cancer coincides with average age of childbirth, and women with young children are less likely to be screened. Current UK guidelines advise waiting 12 weeks after delivery to perform cervical screening, but this recommendation is not based on evidence from the era of liquid-based cytology or high-risk human papillomavirus (HPV) testing. New mums suggested offering cervical screening at 6 weeks postdelivery, in conjunction with the postnatal check-up with the general practice team in primary care. This study aims to assess the feasibility and acceptability of a paired-sample study design for cervical screening at 6 weeks and 12 weeks postnatal. Methods and analysis: A study of 100 participants will be performed to assess feasibility and acceptability of cervical screening at both 6 weeks and 12 weeks postnatal, with urine self-sampling using a Colli-pee collection device at each time point. This will inform whether women are prepared to undergo cervical screening at 6 weeks postnatal and the feasibility of a future pair-wise diagnostic test accuracy (of HPV and abnormal cervical cytology) study or whether alternative study designs are needed. Participants must be aged 24.5-64 years old and eligible for the National Health Service Cervical Screening Programme (NHS CSP). At each appointment, participants will complete a questionnaire about their experience and thoughts regarding screening. Substudies ask participants who withdraw or decline to participate their reasons, to identify barriers. The study will be closed for recruitment once 100 participants have completed the 6-week screen in Postnatal Instead of Normally-Timed Cervical Screening (PINCS-1) or if recruitment is poor and 50% not recruited by 6 months, indicating that a paired-sample design is not feasible. Ethics and dissemination: Ethical approval for PINCS-1 was given by the Stanmore Research Ethics Committee. The results, including participant feedback at each stage, built into the trial design, will inform the design of large studies to determine accuracy and clinical impact of cervical screening at 6 weeks postnatal, identifying whether giving choice (eg, from timing of appointments and/or offering self-sampling) will improve screening uptake. Data will inform the sample size needed for future studies to have adequate power. Results will also inform future NHS CSP management. Results will be shared via scientific publication and via conventional and social media channels accessed by young women.Trial registration number: ISRCTN10071810.</p
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Developing a platform to investigate the heterogeneity of outcomes for patients with ovarian cancer
Full text linkBackground: The geographical variation in treatment patterns for patients with ovarian cancer is profound, long-standing and worrying. Although these variations were highlighted in a recent UK registry audit, granular data to provide explanations for these variations have been lacking.
Methods: A consortium of six UK centres was generated to curate and submit data for all patients treated at their centre for a 2-year period. Descriptive statistics were combined with Cox regression and Kaplan-Meier analysis to confirm the findings from the national registry audit and identify possible drivers of the heterogeneity previously described.
Results: Records for 1117 patients treated in six centres in 2018 and 2019 were collated. Although there were differences in the clinical characteristics of patients between centres, these were not enough to account for the significant variation in survival outcomes between centres (p<0.001). Treatment rates varied between centres with between 30% and 76% of patients receiving combination therapy but in Cox models ‘treatment centre’ remained a predictor of 1 year survival independent of patient, tumour factors and treatment choice.
Conclusion: Variations in outcome seen between UK centres are not related solely to casemix but rather to the approach and ethos of each centre towards advanced ovarian cancer treatment options. Although important, differences in treatment patterns do not completely explain the variations seen and further work is required to understand the drivers of difference seen
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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