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Germline pathogenic variants of BRCA1 or BRCA2 cause hereditary breast and ovarian cancer syndromes. The present study investigated the participants' understanding and awareness of germline BRCA1/2 pathogenic variants before genetic counseling, the expectations and obstacles for genetic testing from the perspective of participants and their families, and their attitudes towards genetic testing after counseling. In this single‐country, multicenter, non‐interventional, patient‐reported outcome study, untested cancer patients and their families who visited genetic counseling clinics or who wanted to receive pre‐test genetic counseling were eligible to fill in the questionnaire after pre‐test counseling for germline BRCA1/2 testing. Demographic information, clinical characteristics, and information collected from the questionnaires, including the understanding of BRCA1/2 pathogenic variants before genetic counseling, understanding of BRCA1/2 pathogenic variants and feelings after genetic counseling, willingness to share results of genetic testing with family, and willingness to receive genetic testing, were summarized using descriptive statistics. A total of 88 participants were enrolled. The proportion of slight understanding of BRCA1/2 pathogenic variants increased from 11.4% to 67.0%, and the proportion of full understanding increased from 0% to 8.0%. After genetic counseling, most participants were willing to undergo genetic testing (87.5%) and share the results with their families (96.6%). The main factors that may affect participants' willingness to undergo BRCA1/2 testing were management (61.2%) and testing costs (25.9%). After pre‐test counseling, there was a high acceptance of BRCA1/2 testing and in‐family information sharing in Taiwanese patients with cancer and their families, which may serve as a reference for implementing genetic counseling in Taiwan. [ABSTRACT FROM AUTHOR]

Objective We undertook this phase III study to evaluate baricitinib, an orally administered JAK-1/JAK-2 inhibitor, as monotherapy or combined with methotrexate (MTX) compared to MTX monotherapy in patients with active rheumatoid arthritis (RA) who had received no or minimal conventional synthetic disease-modifying antirheumatic drugs (DMARDs) and who were naive to biologic DMARDs. Methods A total of 588 patients were randomized 4:3:4 to receive MTX monotherapy (once weekly), baricitinib monotherapy (4 mg once daily), or the combination of baricitinib and MTX for 52 weeks. The primary end point assessment was a noninferiority comparison of baricitinib monotherapy to MTX monotherapy based on the proportion of patients meeting the American College of Rheumatology 20% improvement criteria (achieving an ACR20 response) at week 24. Results The study met its primary objective. Moreover, baricitinib monotherapy was found to be superior to MTX monotherapy at week 24, with a higher ACR20 response rate (77% versus 62%; P ≤ 0.01). Similar results were observed for combination therapy. Compared to MTX monotherapy, significant improvements in disease activity and physical function were observed for both baricitinib groups as early as week 1. Radiographic progression was reduced in both baricitinib groups compared to MTX monotherapy; the difference was statistically significant for baricitinib plus MTX. The rates of serious adverse events (AEs) were similar across treatment groups, while rates of some treatment-emergent AEs, including infections, were increased with baricitinib plus MTX. Three deaths were reported, all occurring in the MTX monotherapy group. Malignancies, including nonmelanoma skin cancer, were reported in 1 patient receiving MTX monotherapy, 1 receiving baricitinib monotherapy, and 4 receiving baricitinib plus MTX. Conclusion Baricitinib alone or in combination with MTX demonstrated superior efficacy with acceptable safety compared to MTX monotherapy as initial therapy for patients with active RA. [ABSTRACT FROM AUTHOR]

Soil chemical and biological dynamics in mixed use landscapes are dependent on the distribution and pattern of soil moisture and water transport. In this paper we examine the effect of different grid sizes on soil water content for a spatially explicit, variable-source-area hydrology model applied to a watershed in central New York. Data on topography, soil type, and land use were input at grid sizes from 10 to 600 m. Output data consisted of runoff and spatial pattern of soil moisture. To characterize the spatial variability at different grid sizes, information theory was used to calculate the information content of the input and output variables. Simulation results showed higher average soil water contents and higher evaporation rates for large grid sizes. During a wet year, runoff was not affected by grid size, whereas during a dry year runoff was greatest for the smallest grid size. While the information content (i.e., spatial variability) of soil type and land use maps was not affected by the different grid sizes, increasing grid sizes caused the information content of the slope gradient to decrease slightly and the Laplacian (or curvature of the landscape) to decrease greatly. In other words, increasing grid cell size misrepresented the curvature of the landscape. During wet periods the decrease in information content of the soil moisture data was the same as for the Laplacian as grid size increased. During dry periods, when local fluxes such as evaporation and runoff determine the moisture content, this relation did not exist. The Laplacian can be used to provide a priori estimates of the moisture content deviations by aggregation. These deviations will be much smaller for the slowly undulating landscapes than the landscape with steep valleys simulated in this study. [ABSTRACT FROM AUTHOR]