Becoming a grandparent and its effect on well-being: the role of order of transitions, time, and gender

Objectives Although the majority of older people are grandparents, little is known on whether and how the transition into grandparenthood affects their well-being. Moreover, evidence on whether the order of the transition, the time since grandchild’s birth, and the socio-demographic characteristics of the offspring modify the grandparental well-being is scarce. Taking into account these factors, our study examines the association between becoming a grandparent and subsequent well-being. Methods Our study is based on grandparents aged 50 and over from waves 4-6 of the Survey of Health, Ageing and Retirement in Europe. Using longitudinal analyses, we investigate associations between becoming a grandparent and subsequent life satisfaction, positive affect, and depression controlling for demographic and socio-economic factors as well as health and well-being at baseline. Furthermore, we explore the role of modifying factors such as whether the grandchild was first-born, the time since transition, and socio-demographic characteristics of the offspring who became a parent. Results Becoming a grandparent has a positive effect on well-being only among women who became grandmothers for the first time and via their daughters. Moreover, this effect is particularly strong in the proximity of the birth of the grandchild. No effects were found among first-time grandfathers. Having an additional grandchild does not affect well-being of grandparents, regardless of the offspring’s characteristics

PIV measurements over a double bladed Darrieus-type vertical axis wind turbine: A validation benchmark

Vertical axis wind turbines (VAWTs) are very attractive for in-home power generation since they can be adopted even at low wind speeds and highly variable wind direction. Even if significant experimental research activity has been carried out to improve VAWTs performance, the ability to accurately reproduce flow field characteristics around turbine blades by CFD (computational fluid dynamics) techniques represents a powerful approach to further enhance wind turbines performance. Thanks to CFD, in fact, it is possible to reproduce flow characteristics with a detail level impossible to achieve by experiments. Nevertheless, in order to appropriately analyze the flow structure by CFD application, an accurate validation is essential, and high-quality measurements of some main flow characteristics are required. In recent publications the authors investigated, both experimentally and numerically, the performance of an innovative double bladed Darrieus-type VAWT, with the aim to define an optimal configuration also focusing on self-starting ability of the prototype by employing CFD technique. Nevertheless, comparison between experiments and numerical results was made only in terms of power and torque coefficient. To overcome such limitation, in this paper the authors propose an experimental benchmark case for CFD results validation, describing detailed flow field in correspondence of one pair of blades of the innovative Darrieus-type VAWT in static conditions. Measurements were performed employing Particle Image Velocimetry (PIV) technique on a scaled model of the turbine blades realized by 3D printing. An uncertainty analysis was also performed which showed a high accuracy of the obtained experimental results. The measurements of the main flow characteristics (bi-dimensional velocity components) were then used for a test case CFD validation of two different turbulence model

Emetogenicity of Antibody-Drug Conjugates (ADCs) in Solid Tumors with a Focus on Trastuzumab Deruxtecan: Insights from an Italian Expert Panel

In the past decade, nine antibody-drug conjugates (ADCs) have been approved for the treatment of various tumors, four of which specifically for solid malignancies. ADCs deliver the cytotoxic payload to the cancer site, thereby improving chemotherapy efficacy while reducing systemic drug exposure and toxicity. With their high selectivity, ADCs are associated with a manageable side-effect profile, with nausea and vomiting being among the most frequent toxicities, although this may vary according to the respective ADC and the associated payload. Information about the emetic risk of the new ADC compounds is limited. Three virtual focus groups of Italian oncologists were held to raise awareness on the importance of an antiemetic prophylaxis regimen to prevent and mitigate ADC-associated emesis and its sequelae. After reviewing published evidence and guidelines, the three expert panels shared their experience on the early use of ADCs gained through the participation in specific clinical trials and their clinical practice. The following issues were discussed: antiemetic therapy during trastuzumab deruxtecan treatment, with a protocol adopted at the San Raffaele Hospital (Milan, Italy); the use of steroids; the management of anticipatory nausea during trastuzumab deruxtecan therapy; nutritional counselling; and effective doctor\u2013patient communication. The experts acknowledged that recommendations should be drug-specific, and formulated opinion-based advice intended to guide physicians in their daily practice until further evidence emerges

Health-related quality of life in breast cancer patients treated with CDK4/6 inhibitors: a systematic review

Background: Evaluation of health-related quality of life (HR-QoL) among cancer patients has gained an increasing importance and is now a key determinant of anticancer treatments’ value. HR-QoL has been assessed in trials testing cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in breast cancer (BC), using various questionnaires at different timepoints. HR-QoL reports from BC patients treated with CDK4/6i in the real-world setting are also available. Methods: We systematically reviewed the literature, searching for full-length articles, and selected conference abstracts reporting data on HR-QoL in BC patients at any stage and of any molecular subtype treated with abemaciclib, palbociclib or ribociclib. Results: A total of 533 full-length articles and 143 abstracts were retrieved. After screening for eligibility, 38 records were included (31 clinical trials; 7 real-world reports). Assessment methods were heterogeneous across studies in terms of questionnaires, evaluation timepoints and endpoints. Overall, adding CDK4/6i to endocrine therapy did not worsen patients’ HR-QoL, with a positive trend towards pain improvement. Gastrointestinal scores (diarrhea, nausea and appetite loss) statistically favored the control arm among metastatic BC patients receiving abemaciclib, whereas they were superimposable in the early setting. The combination of palbociclib and endocrine therapy showed similar HR-QoL outcomes compared with endocrine therapy alone, but determined better scores compared with chemotherapy. HR-QoL was specifically assessed in premenopausal patients treated with ribociclib, showing similar scores compared with postmenopausal patients. Conclusions: Despite methodological heterogeneity does not allow a proper comparison, HR-QoL was generally maintained with CDK4/6i. However, differences between abemaciclib, palbociclib and ribociclib exist and mainly rely on the distinct safety profiles of the compounds. These differences should be acknowledged and taken into account in the clinical practice

Predictive value of apoptosis, proliferation, HER-2, and topoisomerase IIalpha for anthracycline chemotherapy in locally advanced breast cancer

Purpose. Laboratory evidence indicates that tumor growth depends on the balance between cell proliferation and cell death, and many anticancer agents may exert their therapeutic effect by decreasing proliferation and increasing apoptosis. Additionally, clinical observations indicate that overexpression of HER-2 or topoisomerase II alpha ( topo II alpha) may be predictors of better response to anthracyclines in breast cancer. The objective of this study was to determine if proliferation ( Ki-67), apoptosis ( TUNEL), and expression of HER-2 and topo II alpha are affected by anthracycline treatment, and if these molecular markers predict anthracycline responsiveness. Experimental design. Thirty-three women with primary breast tumors >= 3 cm received either doxorubicin ( 75 mg/ m(2)) or epirubicin ( 120 mg/ m(2)) for 4 cycles before surgery. Clinical response was evaluated after 4 cycles of treatment. Changes in molecular markers were assessed from core needle biopsy taken before treatment (D0), at 24 - 48 h (Dl) and on day 7 (D7) while on treatment, and from the surgical specimen excised on day 84 (D84) after the fourth cycle of chemotherapy. Results. The overall clinical response rate was 51% (17 of 33 patients), with a 12% complete clinical response rate ( 4 of 33 patients). There were trends for tumors with higher apoptosis and topo IIa at baseline ( D0) to be more responsive to anthracyclines, p = 0.1 and p = 0.08, respectively. Median apoptosis increased from D0 to Dl ( p = 0.06) while median Ki-67 decreased ( p = 0.07). Overall, expression of HER-2 remained stable throughout the chemotherapy administration. By Day 84, topo II alpha had significantly decreased from baseline in responders, while it increased in non-responders, p = 0.03. Conclusions. In human primary breast cancer, anthracycline treatment causes an early increase in apoptosis and a decrease in proliferation. In this pilot study, higher apoptosis and topo II alpha a levels in primary tumors were associated with greater responsiveness to anthracyclines, and topo II alpha levels declined in responsive tumors