Whether nab-paclitaxel and conventional taxanes are equally effective for metastatic breast cancer (MBC) remains unclear. We conducted meta-analysis of trials that compared nab-paclitaxel-based chemotherapy with solvent-based paclitaxel (sb-paclitaxel) and docetaxel-based chemotherapy. A literature search was performed to identify articles that compared nab-paclitaxel-based chemotherapy with sb-paclitaxel or docetaxel-based chemotherapy for MBC. Four randomized controlled trials (1,506 patients) were identified from 1,268 reports. We detected equivalent overall response, overall survival, and survival probability (one-year, two-year). Grade 3 to 4 hematological and non-hematological toxicities were also comparable except that sensory neuropathy was more prominent for nab-paclitaxel-based chemotherapy (16.9% vs. 10%, odds ratio = 1.89, 95% confidence interval = 1.36–2.61, P < 0.001). No significant publication bias was detected. Consistent results stratified by treatment arm, study phase, treatment line, and study location were observed, except that overall response rate to nab-paclitaxel-based chemotherapy was significantly higher in the subgroup of randomized phase II trials, non-first-line treatment, and East Asian population. This meta-analysis failed to demonstrate advantages of nab-paclitaxel compared with sb-paclitaxel and docetaxel in patients with MBC. The newer agent was associated with increased sensory neuropathy, equivalent survival, and possibly increased overall response for some specific patients.
ObjectivesThis study aimed to examine the coverage of coronavirus disease 2019 (COVID-19) vaccination and its cognitive determinants among older adults.MethodsA cross-sectional study was conducted using a questionnaire to conduct a survey among 725 Chinese older adults aged 60 years and above in June 2022, 2 months after the mass COVID-19 outbreak in Shanghai, China. The questionnaire covered demographic characteristics, COVID-19 vaccination status, internal risk perception, knowledge, and attitude toward the efficacy and safety of COVID-19 vaccines.ResultsThe vaccination rate was 78.3% among the surveyed individuals. Self-reported reasons for unwillingness to get vaccinated (multiple selections) were “concerns about acute exacerbation of chronic diseases after vaccination (57.3%)” and “concerns regarding vaccine side effects (41.4%).” Compared to the unvaccinated group, the vaccinated group tended to have a higher score in internal risk perception (t = 2.64, P < 0.05), better knowledge of COVID-19 vaccines (t = 5.84, P < 0.05), and a more positive attitude toward the efficacy and safety of COVID-19 vaccines (t = 7.92, P < 0.05). The path analysis showed that the cognitive effect on vaccination behavior is relatively large, followed by the internal risk perception, and then the attitude toward COVID-19 vaccines. The more knowledgeable the participants were about COVID-19 vaccines, the more likely they were to receive the COVID-19 vaccines. In the multivariate logistic regression, the increased coverage of COVID-19 vaccination was associated with reduced age (OR = 0.53 95% CI 0.43–0.66, P < 0.001), being a resident in other places than Shanghai (OR = 0.40, 95% CI 0.17–0.92, P < 0.05), a shorter time of lockdown (OR = 0.33, 95% CI 0.13–0.83, P < 0.05), a history of other vaccines (OR = 2.58, 95% CI 1.45–4.60, P < 0.01), a fewer number of chronic diseases (OR = 0.49, 95% CI 0.38–0.62, P < 0.001), better knowledge about COVID-19 vaccines (OR = 1.60, 95% CI 1.17–2.19, P < 0.01), and a positive attitude toward COVID-19 vaccines (OR = 9.22, 95% CI 4.69–18.09, P < 0.001).ConclusionAcquiring accurate knowledge and developing a positive attitude toward COVID-19 vaccines are important factors associated with COVID-19 vaccination. Disseminating informed information on COVID-19 vaccines and ensuring efficacious communication regarding their efficacy and safety would enhance awareness about COVID-19 vaccination among older adults and consequently boost their vaccination coverage.
Objective: Dry Weight (DW) is a typical hemodialysis (HD) prescription for End-Stage Renal Disease (ESRD) patients. However, an accurate DW assessment is difficult due to the complication of body components and individual variations. Our objective is to model a clinically practicable DW estimator. Method: We proposed a time series-based regression method to evaluate the weight fluctuation of HD patients according to Electronic Health Record (EHR). A total of 34 patients with 5100 HD sessions data were selected and partitioned into three groups; in HD-stabilized, HD-intolerant, and near-death. Each group's most recent 150 HD sessions data were adopted to evaluate the proposed model. Results: Within a 0.5 kg absolute error margin, our model achieved 95.44%, 91.95%, and 83.12% post-dialysis weight prediction accuracies for the HD-stabilized, HD-intolerant, and near-death groups, respectively. Within a 1%relative error margin, the proposed method achieved 97.99%, 95.36%, and 66.38% accuracies. For HD-stabilized patients, the Mean Absolute Error (MAE) of the proposed method was 0.17 kg ± 0.04 kg. In the model comparison experiment, the performance test showed that the quality of the proposed model was superior to those of the state-of-theart models. Conclusion: The outcome of this research indicates that the proposed model could potentially automate the clinical weight management for HD patients. Clinical Impact: This work can aid physicians to monitor and estimate DW. It can also be a health risk indicator for HD patients.
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