Inference under covariate-adaptive randomization: A simulation study

In clinical trials, several covariate-adaptive designs have been proposed to balance treatment arms with respect to key covariates. Although some argue that conventional asymptotic tests are still appropriate when covariate-adaptive randomization is used, others think that re-randomization tests should be used. In this manuscript, we compare by simulation the performance of asymptotic and re-randomization tests under covariate-adaptive randomization. Our simulation study confirms results expected by the existing theory (e.g. asymptotic tests do not control type I error when the model is miss-specified). Furthermore, it shows that (i) re-randomization tests are as powerful as the asymptotic tests if the model is correct; (ii) re-randomization tests are more powerful when adjusting for covariates; (iii) minimization and permuted blocks provide similar results.

Management of Breast Cancer During the COVID-19 Pandemic: A Stage- and Subtype-Specific Approach

The COVID-19 pandemic has rapidly changed delivery of cancer care. Many nonurgent surgeries are delayed to preserve hospital resources, and patient visits to health care settings are limited to reduce exposure to SARS-CoV-2. Providers must carefully weigh risks and benefits of delivering immunosuppressive therapy during the pandemic. For breast cancer, a key difference is increased use of neoadjuvant systemic therapy due to deferral of many breast surgeries during the pandemic. In some cases, this necessitates increased use of genomic tumor profiling on core biopsy specimens to guide neoadjuvant therapy decisions. Breast cancer treatment during the pandemic requires multidisciplinary input and varies according to stage, tumor biology, comorbidities, age, patient preferences, and available hospital resources. We present here the Johns Hopkins Women’s Malignancies Program approach to breast cancer management during the COVID-19 pandemic. We include algorithms based on tumor biology and extent of disease that guide management decisions during the pandemic. These algorithms emphasize medical oncology treatment decisions and demonstrate how we have operationalized the general treatment recommendations during the pandemic proposed by national groups, such as the COVID-19 Pandemic Breast Cancer Consortium. Our recommendations can be adapted by other institutions and medical oncology practices in accordance with local conditions and resources. Guidelines such as these will be important as we continue to balance treatment of breast cancer against risk of SARS-CoV-2 exposure and infection until approval of a vaccine.

Impact of gender and employment type on job loss among cancer survivors

Objective To identify factors associated with cancer-related job loss following cancer diagnosis. Methods A multicentre cross-sectional survey was conducted among adult cancer survivors employed at the time of cancer diagnosis. Hierarchical multivariate logistic regression was used to examine the association of gender and employment type with job loss after cancer diagnosis and if the interaction between gender and employment type predicted job loss. Results Of 1618 patients recruited, 1483 returned questionnaires (91.7% response rate). Data from 708 patients were eligible for analyses. Approximately 21% of patients had lost their job within 10 years of diagnosis. Patients who had undergone chemotherapy were more likely to lose their jobs than those who had not (OR = 3.24, 95% CI 2.13–4.91). Women were more likely to lose their jobs than men (OR = 2.58, 95% CI 1.48–4.50). Temporary employees were more likely to lose their jobs than regular employees (OR = 2.62, 95% CI 1.72–3.99). After controlling for demographic and clinical characteristics, no interaction effects between gender and employment type were observed (P = 0.44). Conclusions Women and temporary employees are more vulnerable to cancer-related job loss. Clinicians need greater awareness of the risk of patient job loss, and they need to assess patients’ employment types and provide appropriate support to balance treatment schedules and work.

Analysis and Treatment of Abnormal Vibration of a Gas Turbine Generator Set

In this paper, The turn-to-turn short-circuit fault is accurately judged by the vibration monitoring of a gas turbine generator set. The abnormal conditions in the post-processing process are analyzed and summarized, and the conclusion is verified by the disintegration.The analysis method of abnormal response in the process of dynamic balance of units is determined, which provides a reference for effect evaluation and scheme determination for the on-site dynamic balance treatment of the same type unit.