human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer BACKGROUND The efficacy of an immediate single chemotherapy instillation after transurethral resection of a bladder tumour ( TURBT ) in patients with non-muscle-invasive bladder cancer ( NMIBC ) remains a topic of debate . Evidence is even more scarce when an immediate instillation is followed by adjuvant instillations . OBJECTIVE To compare the effect of a mitomycin C ( MMC ) instillation within 24h to an instillation 2 wk after TURBT in patients with NMIBC with or without adjuvant instillations . DESIGN , SETTING , AND PARTICIPANTS Between 1998 and 2003 , 2844 NMIBC patients were r and omised for immediate versus delayed MMC instillation after TURBT .  Patients were categorised in low-risk ( LOR ) , intermediate-risk ( IMR ) , and high-risk ( HIR ) groups . Total numbers of instillations in these groups were 1 , 9 , and 15 , respectively . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Primary end point was 3-yr recurrence risk for the IMR and HIR groups and 5-yr risk for the LOR group . Secondary outcomes were time to recurrence and incidence of adverse events . Analyses were performed with the log-rank test , Cox-regression , and χ2 test in SPSS . RESULTS AND LIMITATIONS A total of 2243 patients were eligible on an intention-to-treat basis . Recurrence risks were 43 % and 46 % in the LOR group ( 5-yr follow-up , p=0.11 ) , 20 % and 32 % in the IMR group ( 3-yr follow-up , p=0.037 ) , and 28 % and 35 % in the HIR group ( 3-yr follow-up , p=0.007 ) , for an immediate and a delayed instillation , respectively . For all patients , the recurrence risk was 27 % ( 95 % confidence interval [ CI ] , 24 - 30 ) in the immediate and 36 % ( 95 % CI , 33 - 39 ) in the delayed instillation group ( p<0.001 ) with a 27 % reduction in relative recurrence risk ( hazard ratio : 0.73 , 95 % CI , 0.63 - 0.85 , p<0.001 ) . The incidence of adverse events did not differ significantly between treatment groups ( immediate instillation 25 % , delayed instillation 22 % , p=0.08 ) . The risk groups in our study differ slightly from the current guidelines , which is a limitation of our study . CONCLUSIONS An immediate , single instillation after TURBT reduces the recurrence risk in NMIBC patients , independent of the number of adjuvant installations . PATIENT SUMMARY A single instillation of chemotherapy after the resection of non-muscle-invasive bladder cancer reduces the recurrence risk , even if patients are treated with an adjuvant schedule of instillations The st and ard of care for most patients with non-muscle-invasive bladder cancer ( NMIBC ) is immunotherapy with intravesical Bacillus Calmette-Guérin ( BCG ) , which activates the immune system to recognize and destroy malignant cells and has demonstrated durable clinical benefit . Urologic best- practice guidelines and consensus reports have been developed and strengthened based on data on the timing , dose , and duration of therapy from r and omized clinical trials , as well as by critical evaluation of criteria for progression . However , these reports have not penetrated the community , and many patients do not receive appropriate therapy . Additionally , several immune checkpoint inhibitors have recently been approved for treatment of metastatic disease . The approval of immune checkpoint blockade for patients with platinum-resistant or -ineligible metastatic bladder cancer has led to considerations of exp and ed use for both advanced and , potentially , localized disease . To address these issues and others surrounding the appropriate use of immunotherapy for the treatment of bladder cancer , the Society for Immunotherapy of Cancer ( SITC ) convened a Task Force of experts , including physicians , patient advocates , and nurses , to address issues related to patient selection , toxicity management , clinical endpoints , as well as the combination and sequencing of therapies . Following the st and ard approach established by the Society for other cancers , a systematic literature review and analysis of data , combined with consensus voting was used to generate guidelines . Here , we provide a consensus statement for the use of immunotherapy in patients with bladder cancer , with plans to up date these recommendations as the field progresses For some time hyperthermia , alone or in combination with radiotherapy or chemotherapy , has proved to be a promising method for treating several kinds of solid tumors . After intensive laboratory investigations a new device , based on a microwave source delivering local bladder hyperthermia together with intravesical mitomycin C chemotherapy has been clinical ly tested as a neoadjuvant approach in 44 patients suffering from superficial cancer of the bladder . The combined approach was administered on an outpatient basis without major complications and with acceptable local toxicity . Endoscopic and histological evaluations proved that combined  local hyperthermia and chemotherapy can induce necrosis of transitional tumors . The overall response rate was 90.8 % , with 70.4 % complete and 20.4 % partial , leaving 4 patients ( 9.2 % ) nonrespondent . Clinical and histological evaluations have confirmed the feasibility and safety of this combined treatment . Further multicentric studies have been initiated PURPOSE To compare the efficacy and local toxicity of the intravesical instillation of a cytostatic drug versus the same cytostatic agent in combination with local hyperthermia as an adjuvant treatment , after complete transurethral resection ( TURB ) of superficial transitional cell carcinoma ( TCC ) of the bladder . PATIENTS AND METHODS The study was design ed as a prospect i ve , multicentric , r and omized trial . Eighty-three patients suffering from primary or recurrent superficial ( Ta-T1 ) TCC of the bladder , after a complete TURB , were r and omly assigned to receive intravesical instillations of mitomycin C ( MMC ) alone , for 41 patients , and MMC in combination with local microwave-induced hyperthermia , for 42 patients . For the combined approach , a new system , Synergo101 - 1 ( Medical Enterprises , Amsterdam , the Netherl and s ) was used . The effectiveness evaluation end points of the study were evaluation of recurrence-free survival and the estimated probability of recurrence . The safety evaluation end points included subjective and objective side effects and clinical complications . For the efficacy end point , Kaplan-Meier analysis was employed , with the log-rank test for significance . Minimum follow-up time was 24 months . RESULTS Of the 83 r and omly assigned patients , 75 completed the study according to the protocol and had valid cystoscopy results . Survival analysis of the 75 assessable patients demonstrated a highly significant difference in the survival curves in favor of thermochemotherapy . Subjective intolerance and clinical complications were significantly higher but transient and moderate in the combined treatment group . CONCLUSION In our series , endovesical thermochemotherapy appears to be more effective than st and ard endovesical chemotherapy as an adjuvant treatment for superficial bladder tumors at 24-month follow-up , despite an increased but acceptable local toxicity OBJECTIVES To evaluate the effectiveness of combined local bladder hyperthermia and intravesical chemotherapy for the treatment of patients with high- grade ( G3 ) superficial bladder cancer . METHODS Patients with G3 bladder tumors ( Stage Ta or T1 ) were treated with combined intravesical chemotherapy with mitomycin-C and local radiofrequency hyperthermia of the bladder wall . The patients were treated with either a prophylactic protocol ( 40 mg mitomycin-C ) after complete transurethral resection of all tumors or with an ablative protocol ( 80 mg mitomycin-C ) when visible tumor was seen on video-cystoscopy or bladder biopsies were positive for carcinoma in situ . RESULTS Combined chemo-thermotherapy was administered to 52 patients with high- grade superficial bladder cancer ( 40 patients with Stage T1 tumor , 11 with Ta , and 3 with concomitant or isolated carcinoma in situ ) . At a median follow-up of 15.2 months ( mean 23 , range 6 to 90 ) , no stage progression to T2 or disease-related mortality had occurred . The bladder preservation rate was 86.5 % . The prophylactic protocol was administered to 24 patients . After a mean follow-up of 35.3 months , 15 patients ( 62.5 % ) were recurrence free . The bladder preservation rate was 95.8 % . The ablative protocol was administered to 28 patients . Complete ablation of the tumor was accomplished in 21 patients ( 75 % ) . After a mean follow-up of 20 months , 80.9 % of these patients were recurrence free . The bladder preservation rate for the ablative group was 78.6 % . CONCLUSIONS Combined local bladder hyperthermia and intravesical chemotherapy has a beneficial prophylactic effect in patients with G3 superficial bladder cancer . Ablation of high- grade bladder tumors is feasible , achieving a complete response in about three quarters of the patients 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer BACKGROUND The efficacy of an immediate single chemotherapy instillation after transurethral resection of a bladder tumour ( TURBT ) in patients with non-muscle-invasive bladder cancer ( NMIBC ) remains a topic of debate . Evidence is even more scarce when an immediate instillation is followed by adjuvant instillations . OBJECTIVE To compare the effect of a mitomycin C ( MMC ) instillation within 24h to an instillation 2 wk after TURBT in patients with NMIBC with or without adjuvant instillations . DESIGN , SETTING , AND PARTICIPANTS Between 1998 and 2003 , 2844 NMIBC patients were r and omised for immediate versus delayed MMC instillation after TURBT .  Patients were categorised in low-risk ( LOR ) , intermediate-risk ( IMR ) , and high-risk ( HIR ) groups . Total numbers of instillations in these groups were 1 , 9 , and 15 , respectively . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Primary end point was 3-yr recurrence risk for the IMR and HIR groups and 5-yr risk for the LOR group . Secondary outcomes were time to recurrence and incidence of adverse events . Analyses were performed with the log-rank test , Cox-regression , and χ2 test in SPSS . RESULTS AND LIMITATIONS A total of 2243 patients were eligible on an intention-to-treat basis . Recurrence risks were 43 % and 46 % in the LOR group ( 5-yr follow-up , p=0.11 ) , 20 % and 32 % in the IMR group ( 3-yr follow-up , p=0.037 ) , and 28 % and 35 % in the HIR group ( 3-yr follow-up , p=0.007 ) , for an immediate and a delayed instillation , respectively . For all patients , the recurrence risk was 27 % ( 95 % confidence interval [ CI ] , 24 - 30 ) in the immediate and 36 % ( 95 % CI , 33 - 39 ) in the delayed instillation group ( p<0.001 ) with a 27 % reduction in relative recurrence risk ( hazard ratio : 0.73 , 95 % CI , 0.63 - 0.85 , p<0.001 ) . The incidence of adverse events did not differ significantly between treatment groups ( immediate instillation 25 % , delayed instillation 22 % , p=0.08 ) . The risk groups in our study differ slightly from the current guidelines , which is a limitation of our study . CONCLUSIONS An immediate , single instillation after TURBT reduces the recurrence risk in NMIBC patients , independent of the number of adjuvant installations . PATIENT SUMMARY A single instillation of chemotherapy after the resection of non-muscle-invasive bladder cancer reduces the recurrence risk , even if patients are treated with an adjuvant schedule of instillations The st and ard of care for most patients with non-muscle-invasive bladder cancer ( NMIBC ) is immunotherapy with intravesical Bacillus Calmette-Guérin ( BCG ) , which activates the immune system to recognize and destroy malignant cells and has demonstrated durable clinical benefit . Urologic best- practice guidelines and consensus reports have been developed and strengthened based on data on the timing , dose , and duration of therapy from r and omized clinical trials , as well as by critical evaluation of criteria for progression . However , these reports have not penetrated the community , and many patients do not receive appropriate therapy . Additionally , several immune checkpoint inhibitors have recently been approved for treatment of metastatic disease . The approval of immune checkpoint blockade for patients with platinum-resistant or -ineligible metastatic bladder cancer has led to considerations of exp and ed use for both advanced and , potentially , localized disease . To address these issues and others surrounding the appropriate use of immunotherapy for the treatment of bladder cancer , the Society for Immunotherapy of Cancer ( SITC ) convened a Task Force of experts , including physicians , patient advocates , and nurses , to address issues related to patient selection , toxicity management , clinical endpoints , as well as the combination and sequencing of therapies . Following the st and ard approach established by the Society for other cancers , a systematic literature review and analysis of data , combined with consensus voting was used to generate guidelines . Here , we provide a consensus statement for the use of immunotherapy in patients with bladder cancer , with plans to up date these recommendations as the field progresses For some time hyperthermia , alone or in combination with radiotherapy or chemotherapy , has proved to be a promising method for treating several kinds of solid tumors . After intensive laboratory investigations a new device , based on a microwave source delivering local bladder hyperthermia together with intravesical mitomycin C chemotherapy has been clinical ly tested as a neoadjuvant approach in 44 patients suffering from superficial cancer of the bladder . The combined approach was administered on an outpatient basis without major complications and with acceptable local toxicity . Endoscopic and histological evaluations proved that combined  local hyperthermia and chemotherapy can induce necrosis of transitional tumors . The overall response rate was 90.8 % , with 70.4 % complete and 20.4 % partial , leaving 4 patients ( 9.2 % ) nonrespondent . Clinical and histological evaluations have confirmed the feasibility and safety of this combined treatment . Further multicentric studies have been initiated PURPOSE To compare the efficacy and local toxicity of the intravesical instillation of a cytostatic drug versus the same cytostatic agent in combination with local hyperthermia as an adjuvant treatment , after complete transurethral resection ( TURB ) of superficial transitional cell carcinoma ( TCC ) of the bladder . PATIENTS AND METHODS The study was design ed as a prospect i ve , multicentric , r and omized trial . Eighty-three patients suffering from primary or recurrent superficial ( Ta-T1 ) TCC of the bladder , after a complete TURB , were r and omly assigned to receive intravesical instillations of mitomycin C ( MMC ) alone , for 41 patients , and MMC in combination with local microwave-induced hyperthermia , for 42 patients . For the combined approach , a new system , Synergo101 - 1 ( Medical Enterprises , Amsterdam , the Netherl and s ) was used . The effectiveness evaluation end points of the study were evaluation of recurrence-free survival and the estimated probability of recurrence . The safety evaluation end points included subjective and objective side effects and clinical complications . For the efficacy end point , Kaplan-Meier analysis was employed , with the log-rank test for significance . Minimum follow-up time was 24 months . RESULTS Of the 83 r and omly assigned patients , 75 completed the study according to the protocol and had valid cystoscopy results . Survival analysis of the 75 assessable patients demonstrated a highly significant difference in the survival curves in favor of thermochemotherapy . Subjective intolerance and clinical complications were significantly higher but transient and moderate in the combined treatment group . CONCLUSION In our series , endovesical thermochemotherapy appears to be more effective than st and ard endovesical chemotherapy as an adjuvant treatment for superficial bladder tumors at 24-month follow-up , despite an increased but acceptable local toxicity OBJECTIVES To evaluate the effectiveness of combined local bladder hyperthermia and intravesical chemotherapy for the treatment of patients with high- grade ( G3 ) superficial bladder cancer . METHODS Patients with G3 bladder tumors ( Stage Ta or T1 ) were treated with combined intravesical chemotherapy with mitomycin-C and local radiofrequency hyperthermia of the bladder wall . The patients were treated with either a prophylactic protocol ( 40 mg mitomycin-C ) after complete transurethral resection of all tumors or with an ablative protocol ( 80 mg mitomycin-C ) when visible tumor was seen on video-cystoscopy or bladder biopsies were positive for carcinoma in situ . RESULTS Combined chemo-thermotherapy was administered to 52 patients with high- grade superficial bladder cancer ( 40 patients with Stage T1 tumor , 11 with Ta , and 3 with concomitant or isolated carcinoma in situ ) . At a median follow-up of 15.2 months ( mean 23 , range 6 to 90 ) , no stage progression to T2 or disease-related mortality had occurred . The bladder preservation rate was 86.5 % . The prophylactic protocol was administered to 24 patients . After a mean follow-up of 35.3 months , 15 patients ( 62.5 % ) were recurrence free . The bladder preservation rate was 95.8 % . The ablative protocol was administered to 28 patients . Complete ablation of the tumor was accomplished in 21 patients ( 75 % ) . After a mean follow-up of 20 months , 80.9 % of these patients were recurrence free . The bladder preservation rate for the ablative group was 78.6 % . CONCLUSIONS Combined local bladder hyperthermia and intravesical chemotherapy has a beneficial prophylactic effect in patients with G3 superficial bladder cancer . Ablation of high- grade bladder tumors is feasible , achieving a complete response in about three quarters of the patients 
    Output:
    