Science, technology, engineering, and mathematics (STEM) education can be stressful, but uncertainty exists about (a) whether stressful academic settings elevate cortisol, particularly among students ...from underrepresented racial/ethnic groups, and (b) whether cortisol responses are associated with academic performance. In four classes around the first exam in a gateway college STEM course, we investigated participants’ (N = 271) cortisol levels as a function of race/ethnicity and tested whether cortisol responses predicted students’ performance. Regardless of race/ethnicity, students’ cortisol, on average, declined from the beginning to the end of each class and across the four classes. Among underrepresented minority (URM) students, higher cortisol responses predicted better performance and a lower likelihood of dropping the course. Among non-URM students, there were no such associations. For URM students, lower cortisol responses may have indicated disengagement, whereas higher cortisol responses may have indicated striving. The implication of cortisol responses can depend on how members of a group experience an environment.
The immune system is a potent inhibitor of tumor growth with curative potential, constituting in many eyes the future of antineoplastic therapy. Adoptive cell therapy (ACT) is a form of immunotherapy ...in which autologous cancer-cognate lymphocytes are expanded and modified ex vivo and re-infused to combat the tumor. This review follows the evolvement of ACT and treatment protocols, focusing on unresolved dilemmas regarding this treatment while providing evidence for its effectiveness in refractory patients. Future directions of ACT are discussed, in particular with regard to genetic engineering of autologous cells, and the role of ACT in the era of checkpoint inhibitors is addressed.
The past 3 years have marked a transition from research establishing the safety and efficacy of HIV preexposure prophylaxis (PrEP) to questions about how to optimize its implementation. Until ...recently, PrEP was primarily offered as part of randomized controlled trials or open-label studies. These studies highlighted the key components of PrEP delivery, including regular testing for HIV and other sexually transmitted infections (STIs), adherence and risk-reduction support, and monitoring for renal toxicity. PrEP is now increasingly provided in routine clinical settings. This review summarizes models for PrEP implementation from screening through initiation and follow-up, focusing on the strengths and weaknesses of three delivery systems: a health maintenance organization, an STI clinic, and a primary care practice. These early implementation experiences demonstrate that PrEP can be successfully delivered across a variety of settings and highlight strategies to streamline PrEP delivery in clinical practice.
We aimed to assess the efficacy of stereotactic irradiation for patients with recurrent high-grade glioma (HGG) and identify predictive factors of progression-free survival (PFS) and overall survival ...(OS) following reirradiation. We identified 32 patients with recurrent brain HGG who had been treated with either single-dose (stereotactic radiosurgery) or fractionated stereotactic radiotherapy between April 2008 and October 2015. Median follow up was 21.4 months (range 12.9–23.2) and median PFS was and 3.3 months (95% CI 2.3–4.7), respectively. OS was 90.40% (95% CI 73.09–96.80) at 6 months and 79.55% (95% CI 59.9–90.29) at 12 months. Univariate analysis showed that biological effective dose at isocenter ≤ 76 Gy was a poor prognostic factor for both OS (83.33 vs. 100% at 6 months,
p
= 0.032) and median PFS (2.7 vs. 4.7 months,
p
= 0.025), as was gross tumor volume (GTV) above 1 cm
3
for OS (86.15 vs. 94.12% at 6 months,
p
= 0.043). Contact with the subventricular zone (SVZ) was also a poor prognostic factor for median PFS (2.3 vs. 4.7 months,
p
= 0.002). Multivariate analysis showed that SVZ contact remained a poor prognostic factor for PFS (hazard ratio = 3.44, 95% CI 1.21–9.82,
p
= 0.021). Results suggest that reirradiation is a safe and effective treatment option for recurrent HGG in patients with a good Karnosfsky Performance Scale score, a long progression-free interval since first radiation and limited GTV, and that contact to SVZ is a strong prognostic factor for PFS.
To investigate infection-related mortality in individuals with type 1 and type 2 diabetes.
A total of 1,108,982 individuals with diabetes who were registered with the Australian Diabetes register ...between 2000 and 2010 were linked to the National Death Index. Mortality outcomes were defined as infection-related(A-B) death (ICD codes A99-B99), pneumonia (J12-J189), septicemia (A40 and A41), and osteomyelitis (M86).
During a median follow-up of 6.7 years, there were 2,891, 2,158, 1,248, and 147 deaths from infection-related(A-B) causes, pneumonia, septicemia, or osteomyelitis, respectively. Crude mortality rates from infections(A-B) were 0.147 and 0.431 per 1,000 person-years in type 1 and type 2 diabetes, respectively. Standardized mortality ratios (SMRs) were higher in type 1 and type 2 diabetes for all outcomes after adjustment for age and sex. For infection-related(A-B) mortality, SMRs were 4.42 (95% CI 3.68-5.34) and 1.47 (1.42-1.53) for type 1 and type 2 diabetes (P < 0.001), respectively. For pneumonia in type 1 diabetes, SMRs were approximately 5 and 6 in males and females, respectively, while the excess risk was ∼20% for type 2 (both sexes). For septicemia, SMRs were approximately 10 and 2 for type 1 and type 2 diabetes, respectively, and similar by sex. For osteomyelitis in type 1 diabetes, SMRs were 16 and 58 in males and females, respectively, and ∼3 for type 2 diabetes (both sexes).
Although death owing to infection is rare, we confirm that patients with diabetes have an increased mortality from a range of infections, compared with the general population, and that the increased risk appears to be greater for type 1 than type 2 diabetes.
Motivation:
Continuous glucose monitoring (CGM) systems are an essential part of novel technology in diabetes management and care. CGM studies have become increasingly popular among researchers, ...healthcare professionals, and people with diabetes due to the large amount of useful information that can be collected using CGM systems. The analysis of the data from these studies for research purposes, however, remains a challenge due to the characteristics and large volume of the data.
Results:
Currently, there are no publicly available interactive software applications that can perform statistical analyses and visualization of data from CGM studies. With the rapidly increasing popularity of CGM studies, such an application is becoming necessary for anyone who works with these large CGM datasets, in particular for those with little background in programming or statistics. CGMStatsAnalyser is a publicly available, user-friendly, web-based application, which can be used to interactively visualize, summarize, and statistically analyze voluminous and complex CGM datasets together with the subject characteristics with ease.
A three-year field experiment at an ethnically diverse middle school (N = 163) tested the hypothesis that periodic self-affirmation exercises delivered by classroom teachers bolsters students' school ...trust and improves their behavioral conduct. Students were randomly assigned to either a self-affirmation condition, where they wrote a series of in-class essays about personally important values, or a control condition, where they wrote essays about personally unimportant values. There were no behavioral effects of affirmation at the end of 6th grade, after students had completed four writing exercises. However, after four additional exercises in 7th grade, affirmed students had a significantly lower rate of discipline incidents than students in the control condition. The effect continued to grow and did not differ across ethnic groups, such that during 8th grade students in the affirmation condition on average received discipline at a 69% lower rate than students in the control condition. Analyses of student climate surveys revealed that affirmation was associated with higher school trust over time, a tendency that held across ethnic groups and partially mediated the affirmation effect on discipline. Repeated self-affirmation can bolster students' school trust and reduce the incidence of discipline in middle school, findings with both theoretical and practical implications.
Immune checkpoint receptors (ICR) modulate the immune response and are critical hubs for immunotherapy. However, data on their role in T lymphoid malignancies, such as cutaneous T cell lymphoma ...(CTCL), is sparse. We aimed to explore the role of ICR in the malignant features of transformed T lymphocytes and evaluate the effect of ICR-targeting monoclonal antibodies, often used as immunotherapy for solid tumors. We used the CTCL cell line HH and the Sézary cell line Hut78 to examine ICR expression and the effects of ICR inhibition on cell viability and proliferation. Despite their shared T cell progeny, the different CTCL cell lines exhibit markedly different ICR expression profiles. Programmed cell death-ligand 1 (PD-L1) was expressed by both cell lines, while programmed death-1 (PD-1) was expressed only by the HH cell line. Common to all malignant T cells was an autonomous hyper-proliferative state that did not require T cell receptor stimulation. A monoclonal antibody blocking PD-1 had a small but statistically significant augmenting effect on T cell proliferation. Of note, when the cells were exposed to ionizing radiation, healthy lymphocytes and those derived from the HH cell line were salvaged by anti-PD-L1. We show a regulatory role of ICR, mainly PD-1 and its ligand PD-L1, on cutaneous T cell malignancy.
The RadioTransNet programme launched under the auspices of French societies for radiation oncology (SFRO) and medical physics (SFPM) was approved by the French national cancer institute (INCa) in ...December 2018 and is dedicated to proposing a relevant national and transversal structure for preclinical research including translational research in radiation oncology with well-defined priority areas of research. Its activities, coordinated by a scientific committee that includes radiation oncologists, medical physicists, academic biologists, are structured around several main areas, i.e.: target volume definition, interaction of radiation with normal tissues, combined treatments and modern dose calculation approaches. Four work packages have been created in these areas and are associated with other objectives pertaining to fundamental radiobiology, early implementation of new drugs in a preclinical setting, contribution of imaging in this task, research in medical physics including transversal components such as medical oncology, radiology, nuclear medicine and also cost/efficiency evaluation. All these tasks will be included in a national network that uses the complementary expertise provided by partners involved in the scheme. Calls for proposals will be selected by the scientific council to be submitted to INCa and the various academic associations to obtain funding for the human and technical resources required to conduct under optimal conditions projects in preclinical and translational research in radiation-oncology.
Le programme RadioTransNet, porté par la Société française de radiothérapie oncologique (SFRO) en association avec la Société française de physique médicale (SFPM), a été labellisé par l’Institut national du cancer (INCa) en décembre 2018. Il est destiné à proposer une structuration cohérente, nationale et transversale de la recherche préclinique et translationnelle en radiothérapie oncologique, en identifiant des priorités de recherche. Ses activités sont coordonnées par un conseil scientifique, composé d’oncologues-radiothérapeutes, de physiciens médicaux et de chercheurs biologistes académiques, qui a organisé ses activités autour de quatre axes majeurs qui sont : la définition des volumes cible, l’interaction des radiations ionisantes avec les tissus sains, les traitements combinés et les approches modernes de calcul de doses. À ces quatre axes majeurs sont associés différents objectifs concernant la radiobiologie fondamentale, les études d’implémentation de nouvelles drogues en préclinique, l’apport de l’imagerie dans cette problématique, la recherche en physique médicale, en intégrant une dimension transversale intéressant l’oncologie médicale, la radiologie médicale, la médecine nucléaire, sans oublier les considérations de coût/efficacité. Les thèmes retenus constituent la base des projets étudiés et développés en faisant appel, au sein du réseau aux compétences complémentaires de toutes les plateformes partenaires impliquées. Des propositions d’appels d’offres sélectionnées par le conseil scientifique seront soumises à l’INCa et aux différentes associations académiques, pour financer les moyens humains et techniques nécessaires à conduire, dans les meilleures conditions, cette recherche préclinique et translationnelle en radiothérapie.
For patients who require postoperative radiotherapy after endoscopic resection of skull base tumors, proton therapy with pencil beam scanning (PBS) may allow sparing of normal tissue compared to ...intensity‐modulated photon radiation (IMRT). We compared PBS and IMRT radiation plans in the preoperative and postoperative settings for two patients with advanced skull base tumors following endoscopic resection. The benefits of PBS over IMRT appear greater in the postoperative setting following endoscopic resection with improved sparing of critical organs at risk. The multidisciplinary approach of endoscopic resection followed by PBS represents a treatment paradigm with potential for improvements in toxicity reduction. Laryngoscope, 129:1313–1317, 2019
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