Purpose
To investigate the association of environmental factors, rehabilitation services during therapy and socioeconomic status (SES – insurance type), with neurocognitive outcomes at the end of ...therapy for survivors of childhood acute lymphoblastic leukemia (ALL).
Methods
Survivors (
n
= 236) treated on the St. Jude Total Therapy Study 16 completed end of therapy testing with performance measures (IQ, attention, processing speed, fine motor skills, academics) and caregiver ratings (attention, executive function, adaptive skills). Environmental factors were abstracted from the medical record.
Results
Distribution of sex (47.3% female,
p
= 0.399), treatment arm (45.5% low risk, 54.5% standard/high risk
p
= 0.929), insurance type (47.7% private, 52.3% public/none,
p
= 0.117), and mean age at diagnosis (7.7 vs. 6.8 years,
p
= 0.143) were similar for groups with (
n
= 110; 46.6%) and without (
n
= 126; 53.6%) rehabilitation services during therapy. Compared to those without rehabilitation, the rehabilitation group (
n
= 110; 46.4%) had more caregiver reported problems with attention (
Z
= -0.28 vs. 0.43,
p
= 0.022), executive function (
Z
= -0.50 vs. -0.08,
p
= 0.003), and adaptive skills (
Z
= -0.41 vs.—0.13,
p
= 0.031). Among the rehabilitation group, there was no difference in outcomes by insurance status. Among those without rehabilitation, those with public insurance had worse neurocognitive outcomes than those with private insurance in IQ (
Z
= -0.04 vs. -0.45,
p
= 0.0115), processing speed (
Z
= -0.10 vs. -0.75,
p
= 0.0030), reading (
Z
= 0.18 vs. -0.59,
p
< 0.0001), and math (
Z
= -0.04 vs. -0.50,
p
= 0.0021).
Conclusion
Participation in rehabilitation services during early intensive therapy is associated with end of therapy caregiver-reported neurocognitive outcomes in daily life.
Syphilis is a growing health problem internationally, with repeat syphilis infections representing a key diagnostic and disease control challenge. Reinfections are more likely to be asymptomatic and ...thus harder to detect without enhanced screening. Higher rates of reinfection have implications for epidemic control and are associated with increased congenital syphilis, with between 8.4% and 22.1% of congenital syphilis cases due to maternal reinfection or treatment failure. In Australia, syphilis infection is a nationally notifiable disease. In New South Wales (NSW) syphilis is notifiable on laboratory diagnosis and enhanced surveillance data is routinely collected from diagnosing clinicians. We sought to quantify and describe reported syphilis reinfections in NSW between 2014 and 2021.
All notifications of infectious syphilis in NSW with symptom onset between 01 January 2014 and 31 December 2021 were included in the cohort, with the unique person identifier used to identify single infections and reinfections. We described the cohort using demographic, exposure, and clinical factors.
Our cohort comprised 8,862 individuals with a recorded infectious syphilis notification during the study period, with reinfections identified in 1,152 people (range of notifications per person between 1 and 7). The cohort was 93.7% male, median age 36, and 93% residing in major metropolitan areas. Of the males with sexual history information available, 80.7% report same-sex sexual activity. 51.9% of infections were symptomatic. There were 10,299 confirmed or probable infectious syphilis notifications among the cohort; 14% (1,437/10,299) were reinfections in previously infected and treated individuals. Only 34.5% of reinfections were detected on symptom-prompted testing, compared to 45.7% of first infections.
Syphilis infections are concentrated in males who reside in major metropolitan areas in NSW. Many infections were not symptomatic, highlighting the need for enhanced screening in at-risk populations. Further analyses on median time to reinfection and risk factors for more rapid reinfection are planned.
Model Order Reduction (MOR) methods are employed in many fields of Engineering in order to reduce the processing time of complex computational simulations. A usual approach to achieve this is the ...application of Galerkin projection to generate representative subspaces (reduced spaces). However, when strong nonlinearities in a dynamical system are present and this technique is employed several times along the simulation, it can be very inefficient. This work proposes a new adaptive strategy, which ensures low computational cost and small error to deal with this problem. This work also presents a new method to select snapshots named Proper Snapshot Selection (PSS). The objective of the PSS is to obtain a good balance between accuracy and computational cost by improving the adaptive strategy through a better snapshot selection in real time (online analysis). With this method, it is possible a substantial reduction of the subspace, keeping the quality of the model without the use of the Proper Orthogonal Decomposition (POD).
The genetic basis of stem cell specification in somatic embryogenesis and organogenesis is still obscure. SOMATIC EMBRYOGENESIS RECEPTOR-LIKE KINASE (SERK) genes are involved in embryogenesis and ...organogenesis in numerous species. In vitro culture of Cyclamen persicum immature ovules provides a system for investigating stem cell formation and maintenance, because lines forming either organs or embryos or callus without organs/embryos are available for the same cultivar and plant growth regulator conditions. The present aim was to exploit this property of cyclamen cultures to understand the role of SERK(s) in stem cell formation and maintenance in somatic embryogenesis and organogenesis in vitro, in comparison with expression in planta. CpSERK1 and CpSERK2 were isolated from embryogenic callus. CpSERK1 and CpSERK2 levels by RT-PCR showed that expression is high in embryogenic, moderate in organogenic, and null in recalcitrant calli. in situ hybridizations showed that the expression of both genes started in clumps of pluripotent stem cells, from which both pre-embryogenic aggregates and organ meristemoids derived, and continued in their trans-amplifying, meristem-like, derivatives. Expression declined in organ meristemoids, in parallel with a partial loss of meristematization. In mature somatic embryos, and in shoot and root primordia, CpSERK1 and CpSERK2 were expressed in meristems, and similar patterns occurred in zygotic embryo and primary meristems in planta. The results point to SERK1 and SERK2 as markers of pluripotency in cyclamen. It is proposed that the high expression of these genes in the trans-amplifying derivatives of the stem cells maintains a pluripotent condition leading to totipotency and, consequently, somatic embryogenesis.
Due to their ballistic precision, apoptosis induction by protons could be a strategy to specifically eliminate neoplastic cells. To characterize the cellular and molecular effects of these hadrons, ...we performed dose-response and time-course experiments by exposing different cell lines (PC3, Ca301D, MCF7) to increasing doses of protons and examining them with FACS, RT-PCR, and electron spin resonance (ESR). Irradiation with a dose of 10 Gy of a 26,7 Mev proton beam altered cell structures such as membranes, caused DNA double strand breaks, and significantly increased intracellular levels of hydroxyl ions, are active oxygen species (ROS). This modified the transcriptome of irradiated cells, activated the mitochondrial (intrinsic) pathway of apoptosis, and resulted in cycle arrest at the G2/M boundary. The number of necrotic cells within the irradiated cell population did not significantly increase with respect to the controls. The effects of irradiation with 20 Gy were qualitatively as well as quantitatively similar, but exposure to 40 Gy caused massive necrosis. Similar experiments with photons demonstrated that they induce apoptosis in a significantly lower number of cells and in a temporally delayed manner. These data advance our knowledge on the cellular and molecular effects of proton irradiation and could be useful for improving current hadrontherapy protocols.
At the Istituto Nazionale di Fisica Nucleare-Laboratori Nazionali del Sud (INFN-LNS) in Catania, Italy, the first Italian protontherapy facility, named Centro di AdroTerapia e Applicazioni Nucleari ...Avanzate (CATANA) has been built in collaboration with the University of Catania. It is based on the use of the 62-MeV proton beam delivered by the K=800 Superconducting Cyclotron installed and working at INFN-LNS since 1995. The facility is mainly devoted to the treatment of ocular diseases like uveal melanoma. A beam treatment line in air has been assembled together with a dedicated positioning patient system. The facility has been in operation since the beginning of 2002 and 66 patients have been successfully treated up to now. The main features of CATANA together with the clinical and dosimetric features will be extensively described; particularly, the proton beam line, that has been entirely built at LNS, with all its elements, the experimental transversal and depth dose distributions of the 62-MeV proton beam obtained for a final collimator of 25-mm diameter and the experimental depth dose distributions of a modulated proton beam obtained for the same final collimator. Finally, the clinical results over 1 yr of treatments, describing the features of the treated diseases will be reported.
In this contribution, a small strain single crystal plasticity framework in the context of an infeasible primal–dual interior point method (IPDIPM) is discussed with a focus on the numerical ...treatment. Related to rate-independent algorithms in the field of single-crystal plasticity, the use of the IPDIPM to solve the constrained optimization problem offers the advantage that it handles the naturally arising redundancy in the slip system intrisically through a barrier term. This formulation penalizes the approach of the unfeasible domain, whereas the penalization term gradually approaches zero in the algorithm. This paper focusses on the numerical treatment and presents different tangent operator formulations and compares their convergency behavior in a numerical example.
Using the Monte Carlo simulation tool GEANT4, we simulated the hadron-therapy beam line of the Centro di AdroTerapia ed Applicazioni Nucleari Avanzate (CATANA) center. This is the unique Italian ...hadron-therapy facility in which 62-MeV proton beams are used for the radiotherapeutic treatment of choroidal and iris melanomas. All the elements, such as diffusers, range shifters, collimators, and detectors, typical of a proton-therapy line were modeled. The beam line provides an ideal environment for the experimental testing and validation of the software developed. The software architecture was developed, and the validation of the software is in its final stage. Simulated ranges, energy distribution, depth and lateral dose distributions for full energy proton beams will be compared to the experimental results obtained at Laboratori Nazionali del Sud (LNS) with different detectors.
After nine years of activity, about 220 patients have been treated at the CATANA Eye Protontherapy facility. A 62MeV proton beam produced by a Superconducting Cyclotron is dedicated to radiotherapy ...of eye lesions, as uveal melanomas. Research and development work has been done to test different dosimetry devices to be used for reference and relative dosimetry, in order to achieve dose delivering accuracy. The follow-up results demonstrated the efficacy of proton beams and encouraged us in our activity in the fight against cancer.
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