Beyond the border: the use of lenvatinib in advanced hepatocellular carcinoma after different treatment lines: a retrospective analysis

The systemic treatment of unresectable hepatocellular carcinoma (HCC) has been improved throughout the past years. Different tyrosine kinase inhibitors (TKI) and checkpoint inhibitors have approval for first- and second-line treatment. Still, data are missing about the choice for the right agent and senseful therapy sequences. Between 2017 and 2019 we treated 149 HCC patients. From those, we identified the patients, who received lenvatinib either as a first-line treatment or in a later treatment line. We investigated seven patients retrospectively, who received lenvatinib in second, third, or fourth treatment line regarding efficacy and safety. Besides that, we compared those patients with 13 patients, who received lenvatinib as a first-line treatment regarding duration of therapy, overall survivial (OS), side effects and best response to treatment. We discovered remission (PR) showed 4/7, stable disease (SD) 2/7 and 1/7 mixed response with an overall tolerable safety profile in patients with a later line lenvatinib treatment. The duration and overall survival for therapy is similar in first- and later treatment lines with comparable results. Most side effects are moderate in each treatment line. Remarkably, on patient diagnoses with HCC (the Barcelona Clinic Liver Cancer C algorithm), who received lenvatinib in fourth line reached 67 months OD since diagnosis. We conclude, that lenvatinib could be considered as a treatment option of HCC for later treatment lines.

Dentists evaluate their patients: an empirical investigation of preferences

Dental treatment is a dyadic encounter. Yet research on the dentist-patient dyad has tended to focus on patient perceptions of dentist, to the neglect of dentist perceptions of patient. Previous theoretic and qualitative work on caregiver perceptions of patients suggested three dimensions of evaluation. Dentists (N = 618) rated their patients on items taken from two prior studies. Dentists' responses were subjected to confirmatory factor analysis. The analysis substantiated the existence of three evaluative dimensions: compliance, tractability, and likability. Further analysis showed that the three dimensions formed a Guttman simplex, revealing a second-order factor of selectivity and allowing a classification of dentists on the basis of patient selectivity.

A health hierarchy of effects model: a synthesis of advertising and health hierarchy conceptualizations

Work by both advertising and health researchers has independently yielded hierarchy of effects models which can be used to predict campaign success. Unfortunately, however, previous work has been criticized as "common sense" approaches which are more "assumed" than "proven." This analysis argues that much of the problem is due to the lack of precision often associated with over-simplified "uni-dimensional" models. Instead, this perspective synthesized a "two-dimensional" health hierarchy of effects model and outlines a pragmatic strategy for campaign measurement.

Dentists' technical competence, communication, and personality as predictors of dental patient anxiety

Previous research has found that many factors influence patients' dental anxiety, many of which are related to the practitioner's technical and interpersonal skill. Unfortunately, a confirmatory factor analysis of scales used in dental anxiety research revealed numerous problems with the measurement devices. The Spielberger State-Trait Anxiety Inventory (STAI) split into two subscales: calmness and anxiety. The Corah Dental Anxiety Scale (CDAS) was unidimensional but was unable to detect relationships between anxiety and interpersonal or communication factors. Interestingly, patient satisfaction, dentist behavior, and empathy items did not load on independent scales, as previously reported in the literature. Instead, five clusters were detected: positive and negative communication, positive and negative interpersonalness, and perceived technical competence.