In response to the growing body of empirical research demonstrating a substantial co-occurrence of intimate partner violence (IPV) and animal abuse, domestic violence shelters are increasingly ...offering on- or off-site services to care for the pets of abused women accessing shelter services. This paper analyzes all public websites of first-stage shelters in Canada (
n
= 337) to offer the first examination of what these shelters are communicating about this co-occurrence of abuse and an appraisal of what services are available to survivors with pets. The findings indicate that less than half of the websites mention pets, and only 1% of shelters report offering on-site pet programs. There are significant relationships between websites addressing the role of pets in both safety planning and help-seeking among abused women and the provision of pet shelter services. The paper concludes with suggestions for pet-related information on domestic violence shelter websites in Canada and elsewhere.
Educator mental health and well-being have received increased attention in response to the additional stress experienced during the coronavirus pandemic. Cultivating mental health and well-being can ...be facilitated by enhancing adult social emotional competencies. However, relatively limited research has explored how prevention programs promoting social emotional competencies have enhanced educator well-being and related attributes of self-care, efficacy, and skillful interactions with students. In this pilot study, we implemented and evaluated an innovative prevention program called Resilience in Schools and Educators (RISE) in eight Colorado schools with 53 educators. RISE builds knowledge and skills that promote educator social-emotional competencies, trauma responsivity, cultural responsivity, resilience, and well-being. The first study aim was to explore the fidelity and feasibility of the RISE program implemented in a school-based context. The second study aim was to explore whether RISE is associated with increases in educators’ self-reported social emotional competencies, well-being, self-care practices, self-efficacy, and quality of interactions with students. As compared to field standards, facilitators reported high levels of fidelity and feasibility of RISE. Educators’ pre- and post- self-report measures indicate significant improvements in social emotional competencies (emotional awareness, emotional clarity, non-reactivity, nonjudging), self-care practices, well-being, and student-educator conflict, with effect sizes indicating small to medium impacts. No findings emerged for self-efficacy or perceived closeness of student-teacher relationships. Theoretical and practical implications are discussed.
Abstract
DICER1-mutant intracranial sarcomas were recently defined by WHO in the 2021 CNS tumor classifications. Currently there is a lack of literature describing the clinical nature of this ...disease. Here we present a case of primary intracranial sarcoma with DICER1 mutation and unknown etiology. A 44-year-old female presented with aphasia and right-sided weakness. Clinical imaging confirmed the presence of a hemorrhagic mass in the left frontal lobe and superior falx. The patient underwent two surgical resections, but a clear diagnosis was difficult to make due to heterogenous histological features and inconclusive genomic testing. The surgical samples were sent to the National Institute of Health where genetic testing indicated a DICER1 E1813D mutation with high allele frequency (97%), a TP53 mutation with high allele frequency (95%), and a high variant allele frequency NF1 splice site mutation (96%). This resulted in a diagnosis of DICER1-mutant primary intracranial sarcoma. The patient was treated with temozolomide, bevacizumab, and CPT-11. 382 days after the mass was originally identified, the patient died. A detailed analysis of the radiographic images was performed by creating T1-weighted post-contrast enhancement maps (T1C) and T2-weighted fluid attenuated inversion recovery (FLAIR) hyper-intensity maps for each timepoint. We plotted these volumes over time alongside the patient’s treatment history. Large spikes in T1C and FLAIR volume were seen 4 days prior to initiation of temozolomide and 31 days after CPT-11 treatment was ended. At the final clinical MRI, both volumes were about 4 times greater than that of the initial scan. Despite this disease’s aggressive nature, it can be difficult to accurately diagnose, due in part to very few studies investigating the clinical features of this rare tumor. With the addition of this diagnosis to WHO CNS5, future studies should examine the behavior of these tumors, aiding in earlier diagnosis and improvement of treatment guidance.
Abstract
PURPOSE
Glioblastoma time to recurrence following initial surgery is difficult to predict as it differs widely between patients. This is important as those who recur early have a poorer ...prognosis and shorter survival time. This study aimed to test the hypothesis that cell density, as defined by a predictive radio-pathomic mapping model, would indicate a more aggressive tumor, and thus carry a lower time to progression.
METHODS
18 confirmed glioblastoma patients were included in this study. All patients underwent surgery followed by chemo-radiation, consistent with standard of care. Inclusion criteria also included radiographic recurrence, and autopsy confirmation of recurrent glioblastoma. Three magnetic resonance imaging (MRI) timepoints were investigated: pre- and post-surgery, and tumor recurrence defined by a radiologist. Patients were classified into two groups, early recurrence, as defined by tumor progression in the first 6 months post-surgery MRI (n=9, average 116 days to recurrence), and late recurrence, which included everyone else (n=9, average 283 days to recurrence). Contrast enhancement and FLAIR hyperintensity regions of interest were annotated from the patients’ T1+C and FLAIR scans. Radio-pathomic maps of predicted tumor cellularity were generated from a previously published machine learning model trained to identify tumor pathology using aligned autopsy tissue samples as ground truth to clinical MRI scans. The T1, T1+C, FLAIR, and apparent diffusion coefficient (ADC) images were used as input. Tumor cellularity values were then averaged across the T1+C and FLAIR ROIs.
RESULTS
Both pre- and post-surgical cell density within contrast enhancement was significantly greater in patients with early recurrence compared to those who recurred later (p ≤0.05).
CONCLUSIONS
Our results suggest that radio-pathomic maps of cell density can identify early-recurrence in patients prior to treatment. This may help with treatment planning for radiologists, surgeons, and neuro-oncologists which may include more aggressive surgery and more frequent monitoring.
LBA4132 Background: Pancreatic ductal adenocarcinoma (PDAC) has limited therapeutic options and is thought to be a “cold” tumor that does not respond to immunotherapy, due to a tumor microenvironment ...(TME) consisting of a desmoplastic stroma and poor T cell infiltrate. BXCL701 is an oral synthetic dipeptide that competitively inhibits dipeptidyl peptidases DPP4, DPP8, DPP9 and fibroblast activation protein (FAP). BXCL701 exerts antitumor activity via inhibition of DPP8/9, which is associated with induction of proinflammatory cytokines, as well as inhibition of FAP, which disrupts tumor-stromal interactions. Preclinical xenograft models demonstrate synergy between BXCL701 and PD-1 blockade, reducing tumor growth and promoting an increase in intratumoral CD4 + and CD8 + T cells, macrophages and NK cells, with induction of host-protective immunity. Methods: This is a phase II trial of BXCL701 in patients with metastatic PDAC (mPDAC) following progression on 1 line of treatment for advanced disease and amenable to serial biopsies. BXCL701 is administered at 0.2 mg PO BID days 1-7 and 0.3 mg BID days 8-14 during cycle 1 (21 days) followed by 0.3 mg BID days 1-14 every 21 days in all other cycles, given with pembrolizumab 200 mg IV every 21 days (all cycles). The primary objective is to determine the 18-week progression-free survival rate (PFS 18weeks ). We estimate that historical 2 nd -line PFS 18weeks is 30% or less; using a Simon’s two-stage (minimax) design, a type I error rate of 0.05 and power of 80% if the true rate is 50%, we will need 19 patients in stage 1 and 20 in stage 2 (39 total). There is a safety lead-in phase of 6 patients. We plan to enroll 43 patients to account for a predicted 10% drop out of unevaluable patients. Correlative pharmacodynamic studies include imaging mass cytometry to examine 36 markers of the PDAC TME in tissue biopsies, as well as blood-based analyses of KRAS circulating tumor DNA, circulating markers of fibrosis, and IL-6. Enrollment began in Q3 2023 (NCT05558982). Results: Six patients have enrolled, 3 women and 3 men, median age 57.5 (range 37-80). One patient was progression-free at 18 weeks and 1 patient had stable disease (SD) at 9 weeks, not yet evaluable for the 18-week landmark. Objective response rate is 16% and disease control rate is 50% (RECIST: 1 partial response, -41%, and 2 patients with SD, -18% and 0%). Three patients had significant reductions in CA19-9 from baseline (-100%, -73%, and -97%). Median PFS and overall survival have not been reached (NR, 95% CI 1.45 months-NR and 0.92 months-NR, respectively). There have been no serious treatment-related safety events. The safety lead-in will complete after the next patient completes the 6-week safety window (1 patient was unevaluable). Conclusions: BXCL701 plus pembrolizumab is well-tolerated and shows early signs of potential clinical activity in patients with mPDAC refractory to chemotherapy. Clinical trial information: NCT05558982 .
Vaginal laxity (VL) is a sensation of vaginal looseness which may develop after pregnancy and vaginal delivery and may be affected by prior pelvic surgery, menopause and aging. Pelvic organ prolapse ...(POP) is a disorder in which pelvic organs descend from the normal position. VL has attracted recent attention due to the advent of energy-based treatments for this symptom.
To determine the correlation between VL symptoms and physical exam findings of POP, specifically the introital measurement of genital hiatus.
This was a multi-center cross-sectional study of sexually active women over 18 years of age with a parity of one or greater. Subjects completed the Vaginal Laxity Questionnaire (VLQ), the Pelvic Floor Distress Inventory-20, and the Female Sexual Function Index (FSFI), and were asked if a sexual partner had commented on laxity. Subjects underwent pelvic exam, including the pelvic organ prolapse quantification (POP-Q).
Correlation between VL symptoms as measured by the VLQ and POP as measured by elements of the POP-Q.
A total of 95 subjects with an average age was 54.3 ± 13.18 years were included. Sixty-three percent of patients were postmenopausal. The average VLQ score was 4.2 ± 1.35 and the average FSFI score was 23.42 out of 36. There was no significant correlation between VLQ score and POP or mid-vaginal caliber. Sensation of vaginal tightness was significantly associated with age (P=0.03) and menopausal status (P=0.04). Only 28% of partners commented on laxity and the majority commented on the vagina being tight (21%) rather than loose (7%).
VL was not correlated with physical exam findings quantifying POP or sexual function. This study emphasizes the need to develop a more standardized definition of VL and a better assessment tool for VL symptoms.
Polland A, Duong V, Furuya R, et al. Description of Vaginal Laxity and Prolapse and Correlation With Sexual Function (DeVeLoPS). Sex Med 2021;9:100443.
We aimed to describe the experiences of children and adolescents with congenital heart disease (CHD). Electronic databases were searched until August 2016. Qualitative studies of children’s ...perspectives on CHD were included. Data was extracted using thematic synthesis. From 44 studies from 12 countries involving 995 children, we identified 6 themes:
disrupting normality
(denying the diagnosis, oscillating between sickness and health, destabilizing the family dynamic),
powerlessness in deteriorating health
(preoccupation with impending mortality, vulnerability to catastrophic complications, exhaustion from medical testing),
enduring medical ordeals
(traumatized by invasive procedures, disappointed by treatment failure, displaced by transition, valuing empathy and continuity in care, overcoming uncertainty with information),
warring with the body
(losing stamina, distressing inability to participate in sport, distorted body image, testing the limits),
hampering potential and goals
(feeling disabled, unfair judgment and exclusion, difficulties with academic achievement, limiting attainment and maintenance of life milestones), and
establishing one’s own pace
(demarcating disease from life, determination to survive, taking limitations in their stride, embracing the positives, finding personal enrichment, relying on social or spiritual support).
Conclusion
: Children with CHD feel vulnerable and burdened by debilitating physical symptoms, unpredictable complications, and discrimination. Clinicians may support patients by sharing recognition of these profound psychosocial consequences.
What is Known:
•
CHD is associated with difficulties in learning and attention, school absenteeism, decreased endurance, poor body image, and peer socialization
•
What is lesser known is how young patients cope with the symptoms, prognostic uncertainty, and treatment burden
What is New:
•
We found that children are challenged by lifestyle restrictions, fear of invasive procedures, impaired body image, discrimination, and uncertainty about the future. Feelings of disempowerment are intensified by the unpredictability of disease progression
•
Thus, strategies to improve outcomes include improved patient education on disease and lifestyle management and partnership with school teachers and counselors for unique psychosocial support
Children and adolescents born extremely preterm (EP; <28 weeks’ gestation) are at greater risk of motor impairment, including cerebral palsy and developmental coordination disorder, than their term ...born peers. Importantly, motor impairment has implications beyond performing motor skills; it negatively affects outcomes as diverse as school success, emotional wellbeing, physical health, and physical activity (PA) participation. This review will outline what is known about PA participation across childhood and adolescence for children born EP and term, recognising that PA may improve physical, social, and mental health outcomes. Critically, PA participation occurs in the context of children's and adolescents’ daily lives, and is influenced by the family, social and physical environment, as well as by the child's personal factors, such as motor impairment. Further research is needed to better understand PA participation levels and correlates for children and adolescents born preterm, to better inform effective and sustainable interventions.
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