In a woman with thyroid cancer expressing an
EML4-NTRK3
fusion gene, the cancer had become refractory to radioactive iodine when the capacity of the tumors to take up iodine was lost. The use of ...larotrectinib, an NTRK inhibitor, resulted in a partial response and restored iodine uptake in the tumor cells.
When facing a task, children must analyze it precisely to fully identify what its goal is. This is particularly difficult for young children, who mainly rely on environmental cues to get there. ...Research suggests that training children to look for the most relevant perceptual cues is promising. Furthermore, as transferring skills to a new task is difficult, the question of whether young children are able to transfer such training remains open. The aim of this study was to test the extent to which two strategies of goal self-cueing-labeling and pointing-can help 4-year-old children to identify the relevant cues to clearly identify the goal of the task. The effects of explicit strategy training were tested in a near transfer task.
Ninety-nine typically developing 4 year olds took part in the study. They were divided into three groups: two were trained collectively in one of the two strategies and the third group as a control group with no strategy training. All children performed a cued card-sorting task four times: Pre-test, Collective training, Post-test, and Transfer with new cards.
Results confirmed the beneficial effect of strategy training on goal identification, particularly after training (Post-test). In the transfer phase, all three groups performed equally well.
This study contributes to our understanding of how young children seek information when they look for the most relevant cues for identifying the goal of a task, and the benefits they may derive in a transfer task. It seems that the use of visual cues and self-cueing strategies helps preschoolers to clearly identify the goal of a task. Results are discussed in the light of the self-regulated learning framework. Some possible classroom applications are suggested.
Goal choice is one of the first, and most important, steps in self-regulated learning (SRL). It is particularly challenging for young children (before 5-6 years), who tend to rely on available ...environmental cues, which makes their goals fragile because of the instability and variability of the environment. Therefore, it can be assumed that the conditions under which a task is performed may influence a child's learning goal choice. Moreover, adapting to constraints involves control capacities provided by executive functions (EF) and metacognition.
The main purpose of this study was to determine factors that influence the way preschoolers choose a learning goal during the first step of SRL. We tested whether adding constraints to perform a task may influence the choice of the procedure that a child aims to learn to perform this task. We also examined the role of cognitive flexibility and metacognition in goal selection in the face of these changes, and tested the influence of change over time, comparing participants' performance at two points in the school year. One hundred 4-year-olds were asked to perform a jigsaw puzzle task under two conditions: predictable vs. unpredictable environmental change. Individual levels of cognitive flexibility and metacognition were also measured.
The results show that only a predictable change, but not an unpredictable one, leaded children to change their learning goals. Furthermore, when participants were faced with an unpredictable change, metacognition and cognitive flexibility significantly predicted learning goal change. Results are discussed regarding the development of SRL, flexibility, and metacognition. Educational suggestions are proposed.
- The choice of a learning goal by a preschooler is influenced by the conditions of task performance and environmental cues. Facing a predictable change is more disruptive to children before the age of 4.5, and more likely to cause them to change their goal.- A shift is observed, from age 4 and during the school year, from a perceptual to a conceptual level of processing.- Cognitive flexibility and metacognition also determine learning goal choice in preschoolers, but only in front of unpredictable changes.
Thyroid cancer is the most common endocrine cancer, with a good prognosis in most cases. However, some cancers of follicular origin are metastatic or recurrent and eventually become radioiodine ...refractory thyroid cancers (RAIR-TC). These more aggressive cancers are a clinical concern for which the therapeutic arsenal remains limited. Molecular biology of these tumors has highlighted a hyper-activation of the Mitogen-Activated Protein Kinases (MAPK) pathway (RAS-RAF-MEK-ERK), mostly secondary to the
hotspot mutation occurring in about 60% of papillary cancers and 45% of anaplastic cancers. Therapies targeting the different protagonists of this signaling pathway have been tested in preclinical and clinical models: first and second generation RAF inhibitors and MEK inhibitors. In clinical practice, dual therapies with a BRAF inhibitor and a MEK inhibitor are being recommended in anaplastic cancers with the
mutation. Concerning RAIR-TC, these inhibitors can be used as anti-proliferative drugs, but their efficacy is inconsistent due to primary or secondary resistance. A specific therapeutic approach in thyroid cancers consists of performing a short-term treatment with these MAPK pathway inhibitors to evaluate their capacity to redifferentiate a refractory tumor, with the aim of retreating the patients by radioactive iodine therapy in case of re-expression of the sodium-iodide symporter (NIS). In this work, we report data from recent preclinical and clinical studies on the efficacy of MAPK pathway inhibitors and their resistance mechanisms. We will also report the different preclinical and clinical studies that have investigated the redifferentiation with these therapies.
Orphans' needs are barely identified, barely acknowledged, and barely treated notably in France. Yet, parental loss might generate specific needs associated with cognitive, relational/behavioral, and ...emotional difficulties. In turn, such difficulties are likely to give rise to lower academic achievement. In this theoretical paper, we argue that, due to the detrimental impact of parental loss on academic achievement, orphaned students should be considered as students with special educational needs. This is important to provide appropriate educational responses consistent with inclusive education. The present paper aims to identify different specific needs of orphaned children, as a way to limit neglect of orphans. We discuss various ways to reduce the risks of neglecting orphans in French schools by using Bronfenbrenner's ecological development model and propose avenues for relevant pedagogical responses.
Total metabolic tumor volume (TMTV) and tumor dissemination (Dmax) calculated from baseline 18F-FDG PET/CT images are prognostic biomarkers in diffuse large B-cell lymphoma (DLBCL) patients. Yet, ...their automated calculation remains challenging. The purpose of this study was to investigate whether TMTV and Dmax features could be replaced by surrogate features automatically calculated using an artificial intelligence (AI) algorithm from only 2 maximum-intensity projections (MIPs) of the whole-body 18F-FDG PET images. Methods: Two cohorts of DLBCL patients from the REMARC (NCT01122472) and LNH073B (NCT00498043) trials were retrospectively analyzed. Experts delineated lymphoma lesions from the baseline whole-body 18F-FDG PET/CT images, from which TMTV and Dmax were measured. Coronal and sagittal MIP images and associated 2-dimensional reference lesion masks were calculated. An AI algorithm was trained on the REMARC MIP data to segment lymphoma regions. The AI algorithm was then used to estimate surrogate TMTV (sTMTV) and surrogate Dmax (sDmax) on both datasets. The ability of the original and surrogate TMTV and Dmax to stratify patients was compared. Results: Three hundred eighty-two patients (mean age ± SD, 62.1 y ± 13.4 y; 207 men) were evaluated. sTMTV was highly correlated with TMTV for REMARC and LNH073B datasets (Spearman r = 0.878 and 0.752, respectively), and so were sDmax and Dmax (r = 0.709 and 0.714, respectively). The hazard ratios for progression free survival of volume and MIP-based features derived using AI were similar, for example, TMTV: 11.24 (95% CI: 2.10–46.20), sTMTV: 11.81 (95% CI: 3.29–31.77), and Dmax: 9.0 (95% CI: 2.53–23.63), sDmax: 12.49 (95% CI: 3.42–34.50). Conclusion: Surrogate TMTV and Dmax calculated from only 2 PET MIP images are prognostic biomarkers in DLBCL patients and can be automatically estimated using an AI algorithm.
Abstract
Context
The contribution of 18FF-fluorocholine (FCH)-positron emission tomography (PET)/computed tomography (CT) in normocalcemic primary hyperparathyroidism (nPHPT) remains unknown.
...Objective
To evaluate the sensitivity and specificity of FCH-PET/CT in a cohort of osteoporotic patients with nPHPT and discordant or negative 99mTcTc-sestamibi scintigraphy and ultrasonography who all underwent parathyroidectomy (PTX).
Design
Longitudinal retrospective cohort study in patients referred for osteoporosis with mild biological primary hyperparathyroidism.
Setting
Tertiary referral center with expertise in bone metabolism and surgical management of hyperparathyroidism.
Patients
Among 109 patients with PHPT analyzed, 3 groups were individualized according to total serum calcium (tCa) and ionized calcium (iCa): 32 patients with hypercalcemia (HtCa group), 39 patients with normal tCa and elevated iCa (NtCa group), and 38 patients with both normal tCa and iCa (NiCa). All patients had biochemical follow-up confirming or not the success of PTX.
Main outcome measures
To evaluate the performance of FCH-PET/CT in terms of sensitivity and specificity, and to compare with first-line imaging procedures in the setting of nPHPT.
Results
The sensitivity of FCH-PET/CT was 67% in the hypercalcemic group, 48% in the NtCa group (P = .05 vs HtCa), and 33% in the NiCa group (P = .004 vs HtCa). Specificity ranged from 97% to 99%. FCH-PET/CT was positive in 64.3% of patients with negative conventional imaging, with biochemical resolution after PTX in 77.8% of patients. Triple negative imaging was observed in 20 patients, with PHPT resolution in 85% of these patients.
Conclusion
This study highlights the contribution of FCH-PET/CT in a well-phenotyped cohort of normocalcemic patients with discordant or negative findings in 99mTcTc-sestamibi scintigraphy and ultrasonography. However, negative imaging in nPHPT does not rule out the possibility of surgical cure by an experienced surgeon.
•Young children show transfer-Utilization Deficiencies in three memory strategies.•Cognitive flexibility predicts recall at transfer tasks.•Memory-strategy training prevents transfer-Utilization ...Deficiencies.
Despite children’s successful transfer of memory strategies to new, similar tasks, strategy effectiveness often decreases at transfer, resulting in lower recall than on the original task (transfer-Utilization Deficiency, t-UD). Two experiments showed t-UDs in two different tasks and three strategies. Moreover, executive function was related to t-UDs. Experiments 1 (N = 68) and 2 (N = 72) showed that cognitive flexibility predicted recall at transfer with a rehearsal strategy and two organization strategies--sorting at encoding and clustering at recall. Furthermore, explicit memory-strategy training prevented the emergence of t-UDs in Experiment 1 and, somewhat, in Experiment 2. Thus, t-UDs emerge across various tasks and strategies, and are decreased by cognitive flexibility and strategy training. These results contribute to our understanding of the development of transfer and of strategy development.
PDF
