Mobile screening units (MSUs) provide cancer screening services outside of fixed clinical sites, thereby increasing access to early detection services. We conducted a systematic review of the ...performance of MSUs for the early detection of cancer. Databases (MEDLINE, EMBASE, Cochrane Library, WHO Global Health Library, Web of Science, PsycINFO) were searched up to July 2015. Studies describing screening for breast, cervical, and colon cancer using MSUs were included. Data were collected for operational aspects including the performance of exams, screening tests used, and outcomes of case detection. Of 268 identified studies, 78 were included. Studies investigated screening for cancers including breast (
= 55), cervical (
= 12), colon (
= 1), and multiphasic screening for multiple cancers (
= 10). The median number of screening exams performed per intervention was 1,767 (interquartile range 5,656-38,233). Programs operated in 20 countries, mostly in North America (36%) and Europe (36%); 52% served mixed rural/urban regions, while 35% and 13% served rural or urban regions, respectfully. We conclude that MSUs have served to expand access to screening in diverse contexts. However, further research on the implementation of MSUs in low-resource settings and health economic research on cost-effectiveness of MSUs compared with fixed clinics to inform policymakers is needed.
.
PEG drugs: an overview Greenwald, R.B
Journal of controlled release,
07/2001, Letnik:
74, Številka:
1
Journal Article, Conference Proceeding
Recenzirano
No low molecular weight (<20 000) poly(ethylene glycol) (PEG) small molecule drug conjugates, prepared over a 20-year period, have led to a clinically approved product. In this area, published ...studies for these types of compounds have been scrutinized and their properties compared and contrasted to higher molecular weight conjugates where, during the past 5 years, a renaissance in the field of PEG (anticancer) drug conjugates has taken place. This new development has been attributed to the use of higher molecular weight PEGs (>20 000), and especially employing PEG 40 000 which is estimated to have a plasma circulating half life of approximately 8–9 h in the mouse. This recent resuscitation of small organic molecule delivery by high molecular weight PEG conjugates was founded on meaningful in vivo testing using established tumor models, and has led to a clinical candidate. Recent applications of high molecular weight PEG prodrug strategies to amino containing drugs are also detailed, and potential applications to proteins are proposed.
Poor penetration of anticancer drugs into tumors can be an important factor limiting their effícacy. We studied mouse tumor models to show that a previously characterized tumor-penetrating peptide, ...iRGD, increased vascular and tissue permeability in a tumor-specific and neuropilin-1–dependent manner, allowing coadministered drugs to penetrate into extravascular tumor tissue. Importantly, this effect did not require the drugs to be chemically conjugated to the peptide. Systemic injection with iRGD improved the therapeutic index of drugs of various compositions, including a small molecule (doxorubicin), nanoparticles (nab-paclitaxel and doxorubicin liposomes), and a monoclonal antibody (trastuzumab). Thus, coadministration of iRGD may be a valuable way to enhance the effícacy of anticancer drugs while reducing their side effects, a primary goal of cancer therapy research.
To determine whether exposure to repetitive head impacts over a single season negatively affects cognitive performance in collegiate contact sport athletes.
This is a prospective cohort study at 3 ...Division I National Collegiate Athletic Association athletic programs. Participants were 214 Division I college varsity football and ice hockey players who wore instrumented helmets that recorded the acceleration-time history of the head following impact, and 45 noncontact sport athletes. All athletes were assessed prior to and shortly after the season with a cognitive screening battery (ImPACT) and a subgroup of athletes also were assessed with 7 measures from a neuropsychological test battery.
Few cognitive differences were found between the athlete groups at the preseason or postseason assessments. However, a higher percentage of the contact sport athletes performed more poorly than predicted postseason on a measure of new learning (California Verbal Learning Test) compared to the noncontact athletes (24% vs 3.6%; p < 0.006). On 2 postseason cognitive measures (ImPACT Reaction Time and Trails 4/B), poorer performance was significantly associated with higher scores on several head impact exposure metrics.
Repetitive head impacts over the course of a single season may negatively impact learning in some collegiate athletes. Further work is needed to assess whether such effects are short term or persistent.
The database of the nine radars of the Super Dual Auroral Radar Network (SuperDARN) in the northern hemisphere has been analyzed for information on factors that influence the convection of plasma in ...the high‐latitude ionosphere. The velocity measurements were collected over the period 1998–2002. The data were first used to derive a new statistical model of convection that improves upon the earlier one‐radar model of Ruohoniemi and Greenwald (1996) in its specification of the dependence of the convection pattern on the magnitude and direction of the IMF in the GSM Y‐Z plane. We then derived average patterns for secondary sortings by season, year, and radar. Such dependencies as emerged were most clearly seen by contrasting the results for By+ and By−. The seasonal effect in the convection pattern is found to have similarities to that of the sign of By. In particular, the combination of By+/summer (By−/winter) reinforces the tendency of the By sign factor to sculpt the dusk and dawn cells into more round/crescent (crescent/round) shapes and to shift the crescent cell across the midnight MLT meridian. However, these combinations are associated with lower estimates of the total cross polar cap potential drop, ΦPC, while the nonreinforcing combinations produce elevated ΦPC, especially By−/summer. There is an overall tendency for ΦPC to increase from winter to summer, although the pure seasonal effect on the potential drop is weaker than that of the By−sign/season factor. We did not find pronounced differences among the patterns derived for the 5 individual years, which spanned the most recent interval of solar cycle maximum. Sorting by radar, we found few differences among the patterns for By+, but for By−, variations emerged that are consistent with a possible dependence on universal time (UT). The impacts of season and UT on convection in the high‐latitude ionosphere thus depends on the IMF, especially the sign of By. We speculate that variability in the ionospheric conductivity has a greater effect on magnetosphere‐ionosphere coupling under By− conditions.
•One in four gbMSM consulting for PrEP in Montréal reported chemsex in the past year.•Ecstasy, GHB and cocaine are the most common chemsex substances reported.•Chemsex is not a barrier to PrEP ...initiation or persistence among gbMSM.
Chemsex among gay, bisexual and other men who have sex with men (gbMSM) has raised public health concerns because of its association with sexual behaviours that can increase transmission of sexually transmitted infections, including HIV. Pre-exposure prophylaxis (PrEP) is highly effective at blocking HIV acquisition, addressing important prevention needs among individuals practicing chemsex. This study aims to improve our understanding of chemsex practices and PrEP trajectories of gbMSM and transgender women consulting for PrEP.
We used data from the PrEP cohort of Clinique médicale l’Actuel, a major sexual health clinic in Montréal. We describe the sociodemographic profile of clients consulting for PrEP, characterize chemsex and polysubstance use trends over time, and evaluate PrEP trajectories using Kaplan-Meier curves.
Among 2923 clients who consulted for PrEP between 2013–2020 (2910 cisgender gbMSM, 6 transgender gbMSM, 7 transgender women), 24 % reported chemsex in the past year and 13 % reported polysubstance use. The most common chemsex substances were ecstasy (14 %), GHB (13 %), and cocaine (12 %). The proportion of clients reporting chemsex and polysubstance use decreased over time. In both the chemsex and no-chemsex group, 73 % of clients initiated PrEP. The median time to discontinuation was similar between the chemsex (6.5 months; 95 %CI: 5.3–7.2) and no-chemsex group (6.9 months; 95 %CI: 6.3–7.5).
Chemsex is not a barrier to PrEP initiation or persistence. However, these results suggest a high prevalence of chemsex among gbMSM consulting for PrEP, highlighting the need for services addressing the intersection of sexual health and substance use for this population.
A mechanistic understanding of phenology, the seasonal timing of life history events, is important for understanding species’ interactions and the potential responses of ecological communities to a ...rapidly changing climate. We present analysis of a seven-year dataset on the breeding phenology of wood frogs (Rana sylvatica), tiger salamanders (Ambystoma tigrinum), blue-spotted salamanders (Ambystoma laterale), and associated unisexual Ambystoma salamanders from six wetlands in Southeast Michigan, USA. We assess whether the ordinal date of breeding migrations varies among species, sexes, and individual wetlands, and we describe the specific environmental conditions associated with breeding migrations for each species/sex. Breeding date was significantly affected by species/sex identity, year, wetland, and the interactions between species/sex and year as well as wetland and year. There was a great deal of variation among years, with breeding occurring nearly synchronously among groups in some years but widely spaced between groups in other years. Specific environmental triggers for movement varied for each species and sex and changed as the breeding season progressed. In general, salamanders responded to longer temperature lags (more warmer days in a row) than wood frogs, whereas wood frogs required longer precipitation lags (more rainy days in a row) than salamanders. Wood frogs were more likely to migrate around the time of a new moon, whereas in contrast, Ambystoma salamander migration was not associated with a moon phase. Ordinal day was an important factor in all models, suggesting that these amphibians require a latency period or similar mechanism to avoid breeding too early in the year, even when weather conditions appear favorable. Male wood frogs migrated earlier than female wood frogs, and male blue-spotted salamanders migrated earlier than female A. laterale and associated unisexual females. Larger unisexual salamanders migrated earlier than smaller individuals. Differences in species’ responses to environmental cues led to wood frogs and A. laterale breeding later than tiger salamanders in colder years but not in warmer years. This suggests that, as the climate warms, wood frog and A. laterale larvae may experience less predation from tiger salamander larvae due to reduced size differences when they breed simultaneously. Our study is one of few to describe the proximate drivers of amphibian breeding migrations across multiple species, wetlands, and years, and it can inform models predicting how climate change may shift ecological interactions among pond-breeding amphibian species.
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