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Purpose Medulloblastomas, comprising 20%-25% of all primary brain tumors in children are much rarer in adulthood. Disease biology varies substantially across different age groups; however, owing to rarity, adults with medulloblastoma are traditionally treated using pediatric protocols. This is a retrospective audit of adolescent and adult medulloblastoma from a comprehensive cancer center. Methods Data regarding demography, clinical presentation, imaging characteristics, histopathological features, molecular profiling, risk stratification, treatment details, and outcomes were retrieved from medical records. All time-to-event outcomes were analyzed using Kaplan-Meier method and compared with the log-rank test. Univariate and multivariate analysis of relevant prognostic factors was done with p value less then 0.05 being considered statistically significant. Results A total of 162 patients ≥15 years of age with medulloblastoma were included. The median age was 25 years (range 15-59 years) with leptomeningeal metastases seen in 31 (19%) patients at initial diagnosis. Following surgery, patients were treated with appropriate risk-stratified adjuvant therapy comprising of craniospinal irradiation plus boost with or without systemic chemotherapy. At a median follow-up of 50 months, 5-year Kaplan-Meier estimates of progression-free survival and overall survival were 53.5% and 59.5%, respectively. The addition of adjuvant systemic chemotherapy did not impact upon survival in standard-risk medulloblastoma. High-risk (HR) disease and anaplastic histology emerged as significant and independent predictors of poor survival on multivariate analysis. Conclusion Medulloblastoma is a rare tumor in adolescents and adults with key differences in disease biology and resultant outcomes compared with the pediatric population. Contemporary management comprising maximal safe resection followed by appropriate risk-stratified adjuvant therapy provides acceptable survival outcomes.Colorectal cancer (CRC) is the third leading cause of death worldwide, comprising nearly 8% of cancer-related deaths per year. In South Korea, for example, CRC is the second most common cancer in men, and third in women. This study reports on the association of CRC with genetic variations in long noncoding RNAs, activators, and inhibitors of a cell proliferation pathway. Five normal colon mucosa tissue samples and their matched five-stage IV CRC samples were evaluated (dataset Gene Expression Omnibus accession GSE50760). We identified more than 5000 differentially expressed genes (DEGs). The Wnt pathway had the greatest portion of DEGs, including activators, inhibitors, and associated long noncoding RNAs (lncRNAs), suggesting the importance of Wnt pathway in CRC. The following genes were aberrantly expressed WIF1, SFRP4, CD82, WNT2, WNT3, WNT5A, HOTAIR, CRNDE, and UCA1. Notably, HOTAIR is known to silence WIF1, and WIF1 inhibits the Wnt ligands to negatively regulate the pathway. The lncRNA CRNDE positively regulates WNT5A, while UCA1 positively regulates WNT2 and WNT3. We note that HOTAIR was unable to silence WIF1. CRNDE and UCA1 were found to be upregulated, which may explain the high expression of the WIF1 targets. Furthermore, 10 single-nucleotide polymorphisms (SNPs) were identified in five of the candidate genes above. A possible novel SNP in CD82, chr1144619242T > C, was predicted to introduce a ZBTB7A binding site. These SNPs are hypothesized to contribute to aberrant and discrepant regulation of the Wnt pathway in a context of CRC pathogenesis. These findings collectively inform future research on diagnostics and therapeutics innovation in CRC.Background Adolescence is an important time for establishing behavioral patterns which favorably affect health, including weight status. Yet, the prevalence of adolescent overweight/obesity is high, and it is unknown whether low levels of motor competence are a risk factor. The purpose of this study was to assess whether adolescents with low motor competence are at increased risk of overweight/obesity. Methods A total of 142 adolescents (47.2% boys) aged 12-14 years were recruited from Rio de Janeiro, Brazil. Motor competence level was assessed using the Körperkoordinationtest fur kinder (KTK) and classified in two categories "low" and "adequate." BMI measures were used to classify weight status as "healthy" or "overweight/obese." The correlation between motor competence level and BMI was tested. A binary logistic regression model was executed adjusting for potential confounders (age, sex, and stature). Results Motor competence was moderately associated with BMI (r = -0.573, p  less then  0.001). Nearly four in five adolescents with low motor competence were overweight/obese. Further, adolescents with low motor competence had a risk six times higher of being overweight/obese (odds ratio = 6.832, p  less then  0.001, 95% confidence interval = 2.477-18.845). Conclusions This study showed that a low level of motor competence is linked to the odds of being overweight/obese in adolescents. This is a concern given the high prevalence of low motor competence in youth worldwide. However, our cross-sectional design does not allow the determination of causal mechanisms. Regardless, we reinforce the recommendation that young people should establish behavioral patterns favorable to adolescent health, including adequate levels of motor competence.Objective To estimate the incidence rate and associated risk factors of severe maternal morbidity (SMM) in commercially and Medicaid-insured women. Methods This was a retrospective cohort study of women with a live inpatient delivery recorded in 2016 in the MarketScan® databases for commercially insured and Medicaid populations. check details The incidence of SMM, defined by the Center for Disease Control and Prevention's algorithm of International Classification of Diseases, 10th edition diagnostic and procedural codes, was determined. Measurements also included the association of SMM in bivariate analyses with patient characteristics and the association of SMM with delivery type, gestation type, maternal age, and race in multivariate logistic regression analysis, adjusted for pre-existing conditions and pregnancy-related complications. Results The incidence of SMM per 10,000 deliveries was 111.4 in the Commercial and 109.6 in the Medicaid population. The most frequent SMM indicators were eclampsia and blood transfusion in the Commercial population (35.
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