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"Abbott, Daniel"
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Injustice ground zero
V. 1: \"Writers Christopher Sebela (SUICIDE SQUAD MOST WANTED) and Brian Buccellato (DETECTIVE COMICS) and artists Pop Mhan (HE-MAN: THE ETERNITY WAR), Tom Derenick (INFINITE CRISIS: FIGHT FOR THE MULTIVERSE) and Daniel Sampere (GREEN ARROW) delve deep inside the twisted mind of Harley Quinn for her unique take on the events of Injustice: Gods Among Us, straight from ground zero! Following the release of the most-anticipated fighting game sequel, Injustice 2, this is the story behind the original hit game Injustice: Gods Among Us ... but this time, told like never before! For her entire career as a criminal, Harley Quinn lived in the shadow of her beloved Joker. But when one joke went too far and drove Superman to kill, Harley found herself on her own for the first time ... and teamed up with the very heroes she used to fight! With Superman now a brutal despot, Batman must lead a team of heroes and villains to form the resistance to the Man of Steel ... and Harley is on the frontlines, whether Batman wants her there or not! For the first time in her life, Harley has her own identity, her own gang and a new sense of purpose. But will Harley throw it all away when her beloved Mr. J seemingly returns from the dead? Or will she take her place as a true hero in this strange new world?\"-- Provided by publisher.
Book
An evaluation of interventions within a Growth Through Nutrition project aimed at enhancing optimal nutrition and water, sanitation and hygiene (WASH) and nutrition practices among nutritionally most vulnerable households (MVHHs) in Ethiopia
Despite a downward trend, Ethiopia still faces significant challenges with high rates of stunting and acute malnutrition in children. To tackle these issues, the Feed the Future Ethiopia Growth Through Nutrition Activity, a USAID-funded project aligned with Ethiopia’s National Nutrition Program, was executed from 2016 to 2023. This initiative aimed to enhance nutrition for women and young children across six regions through multisectoral interventions. Annual surveys conducted in 2017, 2018, and 2020 evaluated the impact of livelihood support and Water, Sanitation, and Hygiene (WASH)-focused social behavior change communication (SBCC) on vulnerable households with children under two. The results showed significant improvements in child nutrition. Dietary diversity among children increased from 12% to 34% (p<0.001), and the percentage of children receiving a minimal acceptable diet rose from 12% to 30.7% (p<0.001). Women’s dietary diversity also improved markedly, from 2% to 16% (p<0.001). Handwashing practices saw improvements, with the proportion of households having handwashing facilities rising from 14% to 31% (p<0.001), and the adherence to critical handwashing moments increased from 16% to 23%. However, challenges in water treatment and latrine use persisted, with less than 25% improvement. The findings suggest that integrating livelihood support with SBCC interventions can positively enhance nutritional outcomes. Continued focus on these strategies is recommended to further support vulnerable households.
Journal Article
Injustice 2
\"The war is over. But a new battle is about to begin. After years of conflict and carnage, Batman and his rebel allies have finally triumphed over their tyrannical foe, Superman. Now the Man of Steel is behind bars, and the Dark Knight holds the future of the world in his hands. But that future is about to slip from his grasp. Superman still has many friends who will work tirelessly to free their leader from captivity. And a new force is about to emerge from the shadows. A winged warrior is assembling a Suicide Squad of the world's most dangerous villains to pursue plans of his own, by any means necessary. And this man in black is out to claim the mantle of the Batman himself. As old foes and new enemies collide, can Bruce Wayne preserve the fragile peace for which so many heroes have sacrificed? or is a new era of injustice about to dawn?\" -- Back cover of volume 1.
Book
ASO Author Reflections: An Opportunity to Provide Cost-Conscious Care for Patients Undergoing CRS-HIPEC
The substantial cost of care for patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy can be augmented by changes in practice patterns. This report discusses the recent publication of the authors’ group and their thoughts on cost-conscious cancer care.
Journal Article
Prognostic Utility of Systemic Immune-Inflammation Index After Resection of Extrahepatic Cholangiocarcinoma: Results from the U.S. Extrahepatic Biliary Malignancy Consortium
BackgroundWe sought to define the association of the systemic immune inflammation index (SII) with prognosis and adjuvant therapy benefit among patients undergoing resection of extrahepatic cholangiocarcinoma (eCCA).MethodsThe impact of SII on overall (OS) and recurrence-free survival (RFS) following resection of eCCA was assessed and compared with other inflammatory markers and traditional prognostic factors. Propensity score matching (PSM) was used to determine the impact of adjuvant therapy (AT) on OS and RFS relative to low versus high SII.ResultsPatients with high versus low SII had worse 5-year OS (15.9% vs. 27.9%) and RFS (12.4% vs. 20.9%) (both p < 0.01). On multivariate analysis, high SII remained associated with worse OS (HR = 1.50, 95% CI 1.20-1.87) and RFS (HR = 1.46, 95% CI 1.18-1.81). Patients with T1/2 disease and a high-SII had worse 5-year OS versus individuals with T3/4 disease and low-SII (5-year OS: T1/2 & low-SII 35.6%, T1/2 & high-SII 16.4%, T3/4 & low-SII 22.1%, T3/4 & high-SII 15.6%, p < 0.01). Similarly, 5-year OS was comparable among individuals with N0 and high-SII versus N1 and low-SII (5-year OS: N0 & high-SII 23.2%, N1 and low-SII 19.8%, p = 0.95). On PSM, AT improved OS and RFS among patients with high SII (5-year OS: 22.5% vs. 12.3%, p < 0.01, 5-year RFS: 19.0% vs. 12.5%; p = 0.01) but not individuals with low SII (5-year OS: 22.9% vs. 26.9%; p = 0.98, 5-year RFS: 18.5% vs. 19.9%; p = 0.94).ConclusionsSII was independently associated with postoperative OS and RFS following curative-intent resection of eCCA. High SII up-staged patients relative T- and N-categories and identified patients with high SII as the most likely to benefit from AT.
Journal Article
Defining and Predicting Early Recurrence after Resection for Gallbladder Cancer
BackgroundThe optimal time interval to define early recurrence (ER) among patients who underwent resection of gallbladder cancer (GBC) is not well defined. We sought to develop and validate a novel GBC recurrence risk (GBRR) score to predict ER among patients undergoing resection for GBC.Patients and MethodsPatients who underwent curative-intent resection for GBC between 2000 and 2018 were identified from the US Extrahepatic Biliary Malignancy Consortium database. A minimum p value approach in the log-rank test was used to define the optimal cutoff for ER. A risk stratification model was developed to predict ER based on relevant clinicopathological factors and was externally validated.ResultsAmong 309 patients, 103 patients (33.3%) had a recurrence at a median follow-up period of 15.1 months. The optimal cutoff for ER was defined at 12 months (p = 3.04 × 10−18). On multivariable analysis, T3/T4 disease (HR: 2.80; 95% CI 1.58–5.11) and poor tumor differentiation (HR: 1.91; 95% CI 1.11–3.25) were associated with greater hazards of ER. The GBRR score was developed using β-coefficients of variables in the final model, and patients were classified into three distinct groups relative to the risk for ER (12-month RFS; low risk: 88.4%, intermediate risk: 77.9%, high risk: 37.0%, p < 0.001). The external validation demonstrated good model generalizability with good calibration (n = 102: 12-month RFS; low risk: 94.2%, intermediate risk: 59.8%, high risk: 42.0%, p < 0.001). The GBRR score is available online at https://ktsahara.shinyapps.io/GBC_earlyrec/.ConclusionsA novel online calculator was developed to help clinicians predict the probability of ER after curative-intent resection for GBC. The proposed web-based tool may help in the optimization of surveillance intervals and the counselling of patients about their prognosis.
Journal Article
Treatment Sequencing for Resectable Pancreatic Cancer: Influence of Early Metastases and Surgical Complications on Multimodality Therapy Completion and Survival
Barriers to multimodality therapy (MMT) completion among patients with resectable pancreatic adenocarcinoma include early cancer progression and postoperative major complications (PMC). We sought to evaluate the influence of these factors on MMT completion rates of patients treated with neoadjuvant therapy (NT) and surgery-first (SF) approaches. We evaluated all operable patients treated for clinically resectable pancreatic head adenocarcinoma at our institution from 2002 to 2007. Rates of MMT completion, 90-day PMC, and overall survival (OS) were evaluated. Ninety-five of 115 (83 %) NT and 29/50 (58 %) SF patients completed MMT. Patients who completed MMT lived longer than those who did not (36 vs. 11 months,
p
< 0.001). The most common reason that NT (11 %) and SF (26 %) patients failed to complete MMT was early disease progression. The rates of PMC among NT and SF patients were similar. Among SF patients, 69 % with no PMC completed MMT versus 29 % after PMC (
p
= 0.040). PMC were associated with decreased OS in SF patients but not in NT patients. The impact of early cancer progression and PMC upon completion of MMT is reduced by delivery of nonoperative therapies prior to pancreaticoduodenectomy. NT sequencing is a practical treatment strategy, particularly for patients at high biological or perioperative risk.
Journal Article
Defining the Risk of Early Recurrence Following Curative-Intent Resection for Distal Cholangiocarcinoma
BackgroundAlthough multidisciplinary treatments including the use of adjuvant therapy (AT) have been adopted for biliary tract cancers, patients with distal cholangiocarcinoma (DCC) can still experience recurrence. We sought to characterize the incidence and predictors of early recurrence (ER) that occurred within 12 months following surgery for DCC.Patients and MethodsPatients who underwent resection for DCC between 2000 and 2015 were identified from the US multi-institutional database. Cox regression analysis was used to identify clinicopathological factors to develop an ER risk score, and the predictive model was validated in an external dataset.ResultsAmong 245 patients included in the analysis, 67 patients (27.3%) developed ER. No difference was noted in ER rates between patients who did and did not receive AT (28.7% vs. 25.0%, p = 0.55). Multivariable analysis revealed that neutrophil-to-lymphocyte ratio (NLR), peak total bilirubin (T-Bil), major vascular resection (MVR), lymphovascular invasion, and R1 surgical margin status were associated with a higher ER risk. A DIstal Cholangiocarcinoma Early Recurrence Score was developed according to each factor available prior to surgery [NLR > 9.0 (2 points); peak T-bil > 1.5 mg/dL (1 points); MVR (2 points)]. Cumulative ER rates incrementally increased among patients who were low (0 points; 10.6%), intermediate (1–2 points; 26.8%), or high (3–5 points; 57.6%) risk (p < 0.001) in the training dataset, as well as in the validation dataset [low (0 points); 3.4%, intermediate (1–2 points); 32.7%, or high risk (3–5 points); 55.6% (p < 0.001)].ConclusionsAmong patients undergoing resection for DCC, 1 in 4 patients experienced an ER. Alternative treatment strategies such as neoadjuvant chemotherapy may be considered especially among individuals deemed to be at high risk for ER.
Journal Article