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B Presenter: b Michail Mavros MD | University of Toronto B Background: b While the International Normalized Ratio (INR) was developed to standardize administration and titration of warfarin in patients needing anticoagulation, it is now also used as a general indicator of bleeding diathesis. Patients undergoing liver surgery can have abnormally elevated INR and may have venous thromboembolism prophylaxis withheld as a result. Pre-operative INR was reported in 25,789 patients (86.3%) and there were no significant differences in baseline characteristics between patients with missing and recorded INR. [Extracted from the article]

Patients with lung cancer can experience significant psychological morbidities including depression. The purpose of the study was to characterize the patterns and factors associated with interventions for symptoms of depression in Stage IV non-small cell lung cancer (NSCLC). We conducted a population-based cohort study using health services administrative data in Ontario, Canada, of patients diagnosed with NSCLC from January 2007 to September 2018. Symptoms of moderate to severe depression was defined by reporting at least one Edmonton Symptom Assessment System (ESAS) score ≥2 following diagnosis. Patient factors included age, sex, comorbidity burden, residence, and income quintile. Interventions included psychiatry/psychology assessment, social work referral and anti-depressant therapy (for patients ≥65 years of age with drug coverage through the Ontario Drug Benefit program). Multivariable modified Poisson regression models were used to examine the association between patient factors and intervention use. A total of 13,159 patients with Stage IV NSCLC lung cancer was included in the study. Symptoms of moderate to severe depression was prevalent with 71.4% (n=9,397) of patients who reported ESAS ≥2 at least once. There was low utilization of psychiatry/psychology assessments (6.6%) and social work referrals (15.8%) in the cohort. For patients ≥65 years of age, 20.8% of patients were prescribed anti-depressant medications. Patients who reported moderate to severe depression were more likely to receive psychiatry assessment/ psychology referral (7.8% vs. 3.5%; standardized difference [SD] 19%), social work referral (17.4% vs. 11.9%; SD 16%) and anti-depressant prescriptions (23.8% vs. 13.8%; SD 26%) as compared to those with none or mild depression symptoms. In multivariable analyses, older patients were less likely to receive psychiatry/psychology assessment, social work referral and anti-depressant prescriptions. Females were more likely to obtain a psychiatry/psychology assessment or social work referral than males. In addition, patients from non-major urban or rural residences were less likely to receive psychiatry/psychology assessment or social work referral, however patients from rural residences were more likely to be prescribed anti-depressants. There is a high prevalence of moderate to severe depression symptoms in Stage IV NSCLC. Although the proportion receiving public interventions is low, patients with moderate to severe depression symptoms were more likely to receive intervention. We identify patient populations who are less likely to receive interventions that will help inform resource planning. [ABSTRACT FROM AUTHOR]

The perfect circulation conditions for the gyroelectric circulator are given for a gyroelectric ratio with magnitude in the range zero to two. Values of this ratio above unity given in this paper correspond to the frequency regions where the effective permittivity is negative. The subsequent Green's function analysis employs the modified Bessel function. In accordance with the Drude model of semiconductors, a theoretical low-loss GaAs design is presented with a 20 dB isolation bandwidth of approximately 90% at an operating temperature of 77 K. The theoretical broadband circulation tracking behavior of this design is demonstrated for gyroelectric ratios which may exceed a magnitude of unity. The operating frequency range for this particular circulator design is below the extraordinary wave resonance frequency. In order to measure the microwave properties of the magnetised semiconductor disk, a two port analysis is performed based upon the Drude model of semiconductors. [ABSTRACT FROM AUTHOR]

Patients with metastatic non-small cell lung cancer (NSCLC) experience significant morbidity because of their disease burden. Dyspnea is a predominant symptom, with a reported prevalence of up to 70% in lung cancer patients. The objective of this study was to determine factors associated with a high dyspnea score based on the Edmonton Symptom Assessment System (ESAS), as well as resultant patterns of intervention and factors correlated to treatment receipt. Using health services administrative data, we conducted a population-based study of all patients diagnosed with metastatic NSCLC treated from January 2007 to September 2018 in the province of Ontario. Exclusion criteria consists of patient age <18 less than 6 months of follow up without death, no ESAS evaluations completed, or if they had another cancer diagnosis 5 years preceding or following their NSCLC diagnosis. The primary outcome of interest was the prevalence of high dyspnea scores, defined as at least a single ESAS score of ≥4 at any time. Differences in baseline characteristic between high dyspnea and low dyspnea score cohorts were assessed by Student's t-test and chi-square test for continuous and categorical covariates, respectively. P-values less than 0.05 were considered to be statistically significant. The initial study cohort included 13,159 patients diagnosed with metastatic NSCLC who completed at least one ESAS survey. Of these, 9,434 (71.7%) reported a high dyspnea score. Compared to patients who did not report high dyspnea scores, those who reported a high dyspnea score were more likely to complete a greater number of ESAS surveys, be male, have a higher Elixhauser-Comorbidity Index () score, and receive subsequent systemic therapy after diagnosis. Multivariable regression identified older patients to be less likely to undergo pleurodesis. Thoracentesis was less common for patients living in rural and non-major urban areas, lower income areas. Receipt of thoracic radiotherapy was less common for older patients, females, those with ECI ≥4, patients living in urban areas, and those with later year of. Finally, palliative care referrals were less frequent for patients with ECI ≥4, residence outside of major urban areas, and lower income areas. Dyspnea is a prevalent symptom amongst patients with metastatic NSCLC. Most patients reporting significant dyspnea received intervention, the most common being palliative care. Subpopulations of patients with high dyspnea scores were identified in which receipt of thoracic radiotherapy and thoracentesis were less likely, suggesting inequities in access to care that require further evaluation. [ABSTRACT FROM AUTHOR]

Investigates the characteristics of smooth and periodic high-temperature superconducting thin film coplanar waveguide resonators with ferroelectric component. Frequency tunability; Effect of ferroelectric layer thickness on the microwave losses of the resonators; Permittivity of the resonators.

Background: The incidence and severity of herpes zoster and postherpetic neuralgia increase with age in association with a progressive decline in cell-mediated immunity to varicella–zoster virus (VZV). We tested the hypothesis that vaccination against VZV would decrease the incidence, severity, or both of herpes zoster and postherpetic neuralgia among older adults. Methods: We enrolled 38,546 adults 60 years of age or older in a randomized, double-blind, placebo-controlled trial of an investigational live attenuated Oka/Merck VZV vaccine (“zoster vaccine”). Herpes zoster was diagnosed according to clinical and laboratory criteria. The pain and discomfort associated with herpes zoster were measured repeatedly for six months. The primary end point was the burden of illness due to herpes zoster, a measure affected by the incidence, severity, and duration of the associated pain and discomfort. The secondary end point was the incidence of postherpetic neuralgia. Results: More than 95 percent of the subjects continued in the study to its completion, with a median of 3.12 years of surveillance for herpes zoster. A total of 957 confirmed cases of herpes zoster (315 among vaccine recipients and 642 among placebo recipients) and 107 cases of postherpetic neuralgia (27 among vaccine recipients and 80 among placebo recipients) were included in the efficacy analysis. The use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1 percent (P<0.001), reduced the incidence of postherpetic neuralgia by 66.5 percent (P<0.001), and reduced the incidence of herpes zoster by 51.3 percent (P<0.001). Reactions at the injection site were more frequent among vaccine recipients but were generally mild. Conclusions: The zoster vaccine markedly reduced morbidity from herpes zoster and postherpetic neuralgia among older adults. N Engl J Med 2005;352:2271-84. [ABSTRACT FROM AUTHOR]