Results from a Phase 1 Study of Sodium Selenite in Combination with Palliative Radiation Therapy in Patients with Metastatic Cancer.

In preclinical studies, selenite had single agent activity and radiosensitized tumors in vivo. Here we report results from a Phase 1 trial in 15 patients with metastatic cancer treated with selenite (5.5 to 49.5 mg) orally as a single dose 2 hours before each radiation therapy (RT) treatment. Patients received RT regimens that were standard of care. The primary objective of the study was to assess the safety of this combination therapy. Secondary objectives included measurement of pharmacokinetics (PK) and evaluation of efficacy. Endpoints included assessment of PK, toxicity, tumor response, and pain before and after treatment. The half-life of selenite was 18.5 hours. There were no adverse events attributable to selenite until the 33 mg dose level, at which the primary toxicities were grade 1 GI side effects. One patient treated with 49.5 mg had grade 2 GI toxicity. Although this was not a DLT, it was felt that the highest acceptable dose in this patient population was 33 mg. Most patients had stabilization of disease within the RT fields, with some demonstrating objective evidence of tumor regression. Most patients had a marked improvement in pain and seven out of nine patients with prostate cancer had a decrease in PSA ranging from 11-78%. Doses up to 33 mg selenite were well tolerated in combination with RT. A randomized, well controlled study is needed at the 33 mg dose level to determine if selenite results in clinically meaningful improvements in the response to palliative RT

Nontraumatic Dental Condition-related Visits to Emergency Departments on Weekdays, Weekends and Night Hours: Findings from the National Hospital Ambulatory Medical Care Survey

Objective: To determine whether the rates of nontraumatic dental condition (NTDC)-related emergency department (ED) visits are higher during the typical working hours of dental offices and lower during night hours, as well as the associated factors. Methods: We analyzed data from the National Hospital Ambulatory Medical Care Survey for 1997 through 2007 using multivariate binary and polytomous logistic regression adjusted for survey design to determine the effect of predictors on specified outcome variables. Results: Overall, 4,726 observations representing 16.4 million NTDC-related ED visits were identified. Significant differences in rates of NTDC-related ED visits were observed with 40%–50% higher rates during non-working hours and 20% higher rates on weekends than the overall average rate of 170 visits per hour. Compared with 19–33 year olds, subjects [relative rate ratio (RRR) = 1.6 to 1.8], whereas those aged 73 and older had lower relative rates during nonworking hours (RRR = 0.4; overall P = 0.0005). Compared with those having private insurance, Medicaid and self-pay patients had significantly lower relative rates of NTDC visits during nonworking and night hours (RRR = 0.6 to 0.7, overall P \u3c 0.0003). Patients with a dental reason for visit were overrepresented during the night hours (RRR = 1.3; overall P = 0.04). Conclusion: NTDC-related visits to ED occurred at a higher rate during non-working hours and on weekends and were significantly associated with age, patient-stated reason for visit and payer type

Long-term Observations of Three Nulling Pulsars

We present an analysis of approximately 200 hours of observations of the pulsars J1634$-$5107, J1717$-$4054 and J1853$+$0505, taken over the course of 14.7 yr. We show that all of these objects exhibit long term nulls and radio-emitting phases (i.e. minutes to many hours), as well as considerable nulling fractions (NFs) in the range $\sim67\,\% - 90\,\%$. PSR J1717$-$4054 is also found to exhibit short timescale nulls ($1 - 40~P$) and burst phases ($\lesssim 200~P$) during its radio-emitting phases. This behaviour acts to modulate the NF, and therefore the detection rate of the source, over timescales of minutes. Furthermore, PSR J1853$+$0505 is shown to exhibit a weak emission state, in addition to its strong and null states, after sufficient pulse integration. This further indicates that nulls may often only represent transitions to weaker emission states which are below the sensitivity thresholds of particular observing systems. In addition, we detected a peak-to-peak variation of $33\pm1\,\%$ in the spin-down rate of PSR J1717$-$4054, over timescales of hundreds of days. However, no long-term correlation with emission variation was found.Comment: 10 pages, 8 figures, accepted for publication in MNRA

Factors predicting physical activity among children with special needs.

IntroductionObesity is especially prevalent among children with special needs. Both lack of physical activity and unhealthful eating are major contributing factors. The objective of our study was to investigate barriers to physical activity among these children.MethodsWe surveyed parents of the 171 children attending Vista Del Mar School in Los Angeles, a nonprofit school serving a socioeconomically diverse group of children with special needs from kindergarten through 12th grade. Parents were asked about their child's and their own physical activity habits, barriers to their child's exercise, and demographics. The response rate was 67%. Multivariate logistic regression was used to examine predictors of children being physically active at least 3 hours per week.ResultsParents reported that 45% of the children were diagnosed with attention deficit hyperactivity disorder, 38% with autism, and 34% with learning disabilities; 47% of children and 56% of parents were physically active less than 3 hours per week. The top barriers to physical activity were reported as child's lack of interest (43%), lack of developmentally appropriate programs (33%), too many behavioral problems (32%), and parents' lack of time (29%). However, child's lack of interest was the only parent-reported barrier independently associated with children's physical activity. Meanwhile, children whose parents were physically active at least 3 hours per week were 4.2 times as likely to be physically active as children whose parents were less physically active (P = .01).ConclusionIn this group of students with special needs, children's physical activity was strongly associated with parental physical activity; parent-reported barriers may have had less direct effect. Further studies should examine the importance of parental physical activity among children with special needs