Notes

The Effect involving Progress Parameters on Electrophysical as well as Memristive Qualities associated with Vanadium Oxide Slim Films.
Romiplostim was effective in solid tumor patients 71% of patients achieved a romiplostim response, 79% avoided chemotherapy dose reductions/treatment delays and 89% avoided platelet transfusions. Median per-patient Plt on romiplostim was significantly higher than baseline (116x109/L vs. 60x109/L, P less then 0.001). Bone marrow tumor invasion, prior pelvic irradiation, and prior temozolomide predicted romiplostim non-response. Bleeding rates were lower than historical CIT cohorts and thrombosis rates were not elevated. Weekly dosing was superior to intracycle dosing with higher response rates and less chemotherapy dose reductions/treatment delays (IRR 3.00, 95% CI 1.30-6.91, P=0.010) or bleeding (IRR 4.84, 95% CI 1.18-19.89, P=0.029). Blunted response (10% response rate) was seen in non-myeloid hematologic malignancy patients with bone marrow involvement. In conclusion, romiplostim was safe and effective for CIT in most solid tumor patients.The initial mechanism for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is the binding of the virus to the membrane-bound form of ACE2, which is mainly expressed in the lung. Since the heart and the vessels also express ACE2, they both could become targets of the virus. However, at present the extent and importance of this potential involvement are unknown. Cardiac troponin levels are significantly higher in patients with more severe infections, patients admitted to intensive care units or in those who have died. In the setting of COVID-19, myocardial injury, defined by an increased troponin level, occurs especially due to non-ischaemic myocardial processes, including severe respiratory infection with hypoxia, sepsis, systemic inflammation, pulmonary thrombosis and embolism, cardiac adrenergic hyperstimulation during cytokine storm syndrome, and myocarditis. At present, there are limited reports on definite diagnosis of myocarditis caused by SARS-CoV-2 in humans and limited demonstration of the virus in the myocardium. In conclusion, although the heart and the vessels are potential targets in COVID-19, there is currently limited evidence on the direct infection of the myocardium by SARS-CoV-2. Additional pathological studies and autopsy series will be very helpful to clarify the potentiality of COVID-19 to directly infect the myocardium and cause myocarditis.Purpose Patients with relapsed/refractory primary mediastinal B-cell lymphoma (rrPMBCL) represent a particularly challenging population to treat, with few life-saving treatment options in the context of a dismal prognosis. Experimental design In this open-label, single-arm, phase 2 study, the safety and efficacy of combined regimen of chemotherapy consisting of gemcitabine, vinorelbine and pegylated liposomal doxorubicin (GVD) plus anti-PD-1 antibody camrelizumab was assessed in rrPMBCL. Patients received chemo-immunotherapy every 3 weeks until the second confirmed complete response or up to 12 cycles, followed by camrelizumab monotherapy for up to 1 year. The primary endpoints were objective response rate and safety. Results 27 response-evaluable patients were enrolled, who received a median of 3 frontline therapies, 59% with bulky disease. The objective response rate was 74%, including 56% with a complete response. A median time of 1.7 months to response was observed, with 78% exhibiting tumor shrinkage at the first evaluation. After 24.8 months median follow-up, the median duration of response was not reached, with a 65% 2-year estimated response rate. Thirteen responders remained in sustained complete remission. Estimated 24-M progression-free survival and overall survival rates were 48.2% and 81.5%, respectively. Any-grade and grade 3 treatment-related adverse events occurred in 93% and 33% of patients, respectively; with no grade 4 or 5 adverse events. Baseline levels of IL-10, IFN-γ and sFas were associated with objective response. Conclusions Camrelizumab plus GVD chemotherapy offers a potent option as life-saving chemo-immunotherapy with promising efficacy and a manageable safety profile for rrPMBCL patients, especially with bulky aggressive disease.Purpose Targeted therapies for cancer have accelerated the need for functional imaging strategies that inform therapeutic efficacy. This study assesses the potential of functional genetic screening to integrate therapeutic target identification with imaging probe selection through a proof-of-principle characterization of a therapy-probe pair using dynamic nuclear polarization (DNP) enhanced magnetic resonance spectroscopic imaging (MRSI). Experimental design CRISPR negative selection screens from a public dataset were used to identify the relative dependence of 625 cancer cell lines on 18,333 genes. Follow-up screening was performed in hepatocellular carcinoma (HCC) with a focused CRISPR library targeting imaging-related genes. Hyperpolarized [1-13C]-pyruvate was injected before and after lactate dehydrogenase inhibitor (LDHi) administration in male Wistar rats with autochthonous HCC. MRSI evaluated intratumoral pyruvate metabolism while T2-weighted segmentations quantified tumor growth. Results Genetic screening data identified differential metabolic vulnerabilities in 17 unique cancer types that could be imaged with existing probes. Among these, HCC required LDH for growth more than the 29 cancer types in this database. LDHi led to a decrease in lactate generation (p less then 0.001) and precipitated dose-dependent growth inhibition (p less then 0.01 overall, p less then 0.05 for dose-dependence). Intratumoral alanine production after LDHi predicted the degree of growth inhibition (p less then 0.001). Conclusions These findings demonstrate that DNP-MRSI of LDH activity using hyperpolarized [1-13C]-pyruvate is a theranostic strategy for HCC, enabling quantification of intratumoral LDHi pharmacodynamics and therapeutic efficacy prediction. This work lays the foundation for a novel theranostic platform wherein functional genetic screening integrates imaging probe selection in order to quantify therapeutic efficacy on a cancer-by-cancer basis.Objective To describe the presentation and management of children with suspected or confirmed female genital mutilation (FGM) referred to a specialist paediatric clinic. Methods Data collected included referral source, age, ethnicity, circumstances of FGM and clinical findings in accordance with the WHO FGM classification. Results Between September 2014 and January 2019, 148 children attended the clinic of whom 55 (37.2%) had confirmed FGM. Police or social care referred 112 (76%) children. The proportion of looked-after children (LAC) was significantly higher in the group with confirmed FGM (17/55, 31%) compared with children where FGM was not confirmed (5/93, 5%). In almost all children where FGM was confirmed, FGM was initially disclosed by the child or family (53/55, 96%) and of these 48/55 (87%) underwent FGM prior to UK entry. The remaining seven cases were British children, potentially meeting legal criteria under the FGM Act, and one resulted in a successful prosecution. Conclusions The number of children with FGM was significantly lower than expected based on UK prevalence estimates. Most children had undergone FGM prior to UK entry, and the majority of cases were initially disclosed by the child or family themselves. These results reflect the lack of large-scale proof of the practice of FGM in the UK and are consistent with growing evidence of the abandonment of FGM among communities after migration.Background and objectives Although some patients regret the decision to start dialysis, modifiable factors associated with regret have rarely been studied. We aimed to identify factors associated with patients' regret to initiate dialysis. Design, setting, participants, & measurements A 41-item questionnaire was administered to adult patients receiving maintenance dialysis in seven dialysis units located in Cleveland, Ohio, and its suburbs. Of the 450 patients asked to participate in the study, 423 agreed and 397 provided data on decisional regret. We used multivariable logistic regression to identify predictors of regret, which was assessed using a single item, "Do you regret your decision to start dialysis?" We report adjusted odd ratios (ORs) and 95% confidence intervals (95% CIs) for the following candidate predictors knowledge of CKD, attitudes toward CKD treatment, and preference for end-of-life care. Results Eighty-two of 397 respondents (21%) reported decisional regret. There were no significant demographic correlates of regret. Regret was more common when patients reported choosing dialysis to please doctors or family members (OR, 2.34; 95% CI, 1.27 to 4.31; P less then 0.001). Patients who reported having a prognostic discussion about life expectancy with their doctors (OR, 0.42; 95% CI, 0.18 to 0.98; P=0.03) and those who had completed a living will (OR, 0.48; 95% CI, 0.25 to 0.95; P=0.03) were less likely to report regret with dialysis initiation. Conclusions Dialysis regret was common in this sample. Demographic factors (age, sex, marital status, race, or educational attainment) were not significantly associated with regret, but modifiable care processes were.Background and purpose Measuring and monitoring the quality of nursing care are essential for improving quality of nursing care and safety. This study aimed to develop an Egyptian validation tool for measuring the quality of nursing care from the perspectives of patients based on consumer quality index and describe the aspects of quality of nursing care that need improvement. Methods A cross-sectional descriptive survey using Consumer quality index questionnaire of nursing care aspects was carried on 400 patients. Results 44 attributes of care were extracted into nine dimensions accounting for 70.4% of the total variance. The majority of nursing care aspects needed moderate levels of quality improvement. Conclusions A valid and reliable Egyptian tool was developed for measuring the quality of nursing care built upon consumer quality index.In early 1930, R. E. Shope paved the way for the recognition of human papillomavirus (HPV) as a causative agent of some types of cancers. In early 2000, the relationship between HPV and a subset of head and neck cancers, mostly located in the oropharynx, was discovered. In the last 20 years, we have made great progress in the recognition and treatment of HPV-positive head and neck cancers. However, there are still grey areas that leave room to subjective interpretation and need to be addressed. The majority of high risk (HR) HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) shows a 'basaloid' morphology, and despite the variegated morphological spectrum of this malignancy, highlighted by some very recent publications, there is a lack of consensus on a universal morphological classification of HPV-OPSCC. The advent of immunohistochemistry with p16 ink4a (p16) protein made the diagnosis of HPV-related OPSCC more straightforward; currently patients with OPSCC are stratified in p16-positive and p16-negative. Although p16 is an excellent surrogate of HR HPV infection, it is not the direct demonstration of the presence of virus. At present, there is no univocal 'gold-standard' technique for the detection of oncogenic HPV infection. It is well known that HR HPV-related (OPSCC) bear significantly better survival outcome than HPV-negative cases. Consequently, the eighth edition of the American Joint Committee on Cancer and the Union for International Cancer Control now have separate staging systems for these two distinct malignancies. The present review discusses the salient features of HR HPV-driven OPSCC.
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