Post-traumatic stress symptoms in 223 childhood cancer survivors: incidence, severity and predictive risk factors

With modern therapies and supportive care, survival rates of childhood cancer have increased considerably. However, there are long-term psychological sequelae of these treatments that may not manifest until pediatric survivors are into adulthood. The prevalence of post-traumatic stress disorder in young adult survivors of childhood cancer ranges from 6.2 to 22%; associated risk factors are young age at the assessment, female gender, low education level, and some disease-related factors. The aim of this study was to investigate, in adolescent and young adult (AYA) survivors of childhood cancer, the incidence and severity of post-traumatic stress symptoms (PTSSs), and to identify the risk factors and the associated post-traumatic growth (PTG) index. Participants were 223 AYA cancer survivors recruited during follow-up visits in the Oncohematology Clinic of the Department of Child and Woman\u2019s Health, University of Padua. Data were collected from self-report questionnaires on PTSS incidence, PTG mean score, perceived social support, and medical and socio-demographic factors. Ex-patients\u2019 mean age at the assessment was 19.33 years (SD = 3.01, 15\u201325), 123 males and 100 females, with a mean of years off-therapy of 9.64 (SD = 4.17). Most (52.5%) had survived an hematological disorder and 47.5% a solid tumor when they were aged, on average, 8.02 years (SD = 4.40). The main results indicated a moderate presence of clinical ( 659 symptoms: 9.4%) and sub-clinical PTSS (6\u20138 symptoms: 11.2%), with the avoidance criterion most often encountered. Re-experience symptoms and PTG mean score were significantly associated (r = 0.24; p = 0.0001). A hierarchical regression model (R2 = 0.08; F = 1.46; p = 0.05) identified female gender (\u3b2 = 0.16; p = 0.05) and less perceived social support (\u3b2 = -0.43; p = 0.05) as risk factors to developing PTSS. Another hierarchical regression model assessed the possible predictors of the PTG total score (R2 = 0.36; F = 9.1; p = 0.0001), with female gender (\u3b2 = 0.13; p = 0.04), actual age (\u3b2 = 0.52; p = 0.0001), younger age at the diagnosis (\u3b2 = -0.3; p = 0.02), and less years off-therapy (\u3b2 = -0.58; p = 0.0001) impacting on PTG

Self\u2010esteem and academic difficulties in preadolescents and adolescents healed from paediatric leukaemia

Adolescents with cancer may demonstrate problems in their self\u2010esteem and schooling. This study aims to screen the preadolescents and adolescents more at risk in their self\u2010esteem perception and schooling difficulties post\u2010five years from the end of therapy. Twenty\u2010five paediatric ex\u2010patients healed from leukaemia were recruited at the Haematology\u2010Oncologic Clinic (University of Padua). The mean age of the children was 13.64 years (Standard Deviation (SD)) = 3.08, range = 10\u201319 years), most were treated for acute lymphoblastic leukaemia (ALL) (84%) and relatively equally distributed by gender. They filled in the Multidimensional Self\u2010Esteem Test, while parents completed a questionnaire on their child\u2019s schooling. Global self\u2010esteem was mostly below the 50 percentile (58.5%), especially regarding interpersonal relationships (75%). An independent sample t\u2010test showed significant mean differences on the emotionality scale (t = 2.23; degree of freedom (df) = 24; p = 0.03) and in the bodily experience scale (t = 3.02; df = 24; p = 0.006) with survivors of Acute Myeloid Leukaemia (AML) having lower scores. An Analysis of Variance (ANOVA) showed significant mean differences in the bodily experience scale (F = 12.31; df = 2, p = 0.0001) depending on the survivors\u2019 assigned risk band. The parent reports showed that 43.5% of children had difficulties at school. Childhood AML survivors with a high\u2010risk treatment were more at risk in their self\u2010esteem perceptions. Preventive interventions focusing on self\u2010esteem and scholastic wellbeing are suggested in order to help their return to their normal schedules

Dynamic simulation model of trans-critical carbon dioxide heat pump application for boosting low temperature distribution networks in dwellings

This research investigates the role of new hybrid energy system applications for developing a new plant refurbishment strategy to deploy small scale smart energy systems. This work deals with a dynamic simulation of trans-critical carbon dioxide heat pump application for boosting low temperature distribution networks to share heat for dwellings. Heat pumps provide high temperature heat to use the traditional emission systems. The new plant layout consists of an air source heat pump, four trans-critical carbon dioxide heat pumps (CO2-HPs), photovoltaic arrays, and a combined heat and power (CHP) for both domestic hot water production and electricity to partially drive the heat pumps. Furthermore, electric storage devices adoption has been evaluated. That layout has been compared to the traditional one based on separated generation systems using several energy performance indicators. Additionally, a sensitivity analysis on the primary energy saving, primary fossil energy consumptions, renewable energy fraction and renewable heat, with changes in building power to heat ratios, has been carried out. Obtained results highlighted that using the hybrid system with storage device it is possible to get a saving of 50% approximately. Consequently, CO2-HPs and hybrid systems adoption could be a viable option to achieve Near Zero Energy Building (NZEB) qualification

Motor skill delays in pre-school children with leukemia one year after treatment: Hematopoietic stem cell transplantation therapy as an important risk factor

CNS-directed therapies for the treatment of leukemia can adversely affect the acquisition of new skills, such as reading/writing and math. Two years after the end of treatments, children show gross and fine motor skill delays that may persist even when patients are considered healed. The goal of the present study was to assess motor skills difficulties in pre-school children with leukemia one year after treatment. Particular attention has been paid to those patients who had undergone Hematopoietic Stem Cell Transplantation (HSCT) and to the relationship between motor delays and age bands. Participants were 60 children (median age of 5; inter quartile range: 3.07-5.76), including 31 females and 29 males, 91.7% of them were affected by acute lymphoblastic leukemia (ALL), and 8.3% by acute myeloid leukemia (AML). Five children had undergone HCST. Parents were interviewed by Vineland Adaptive Behavior Scales (VABS) on children\u2019s motor skills and filled in the Italian Temperament Questionnaire (QUIT). VABS\u2019s total scores were converted into equivalent mental age scores (EMA). A score difference of at least three months between current age and equivalent mental age was considered a developmental delay. Non-parametric analyses were run to understand if HSCT treatment and a specific age band influence children\u2019s motor skills. Significant delays were found in global motor skills (56.7%) as well as in fine and gross motor domains. Mann Whitney U tests showed that children with HSCT were reported to have lower gross motor mean ranks (U = 62; p=0.004; Mean rank =15.40) than peers without HSCT (Mean rank = 31.87) and lower mean rank values on motor temperament scale (U = 9; p = 0.003; HSCT Mean rank = 4.75 versus no HSCT Mean rank = 27.81). Kruskal Wallis\u2019 tests identified the high risk treatment showing that HSCT experience negatively impacted the motor skills and temperamental motor activity of pre-school children one year after the diagnosis of leukemia

Design and Synthesis of Heterocycle‐Fused Enediyne Prodrugs Activable at Will

n/

Prognostic role of minimal residual disease before and after hematopoietic stem cell transplantation in childhood acute lymphoblastic leukemia

More than 80% of children with acute lymphoblastic leukemia (ALL) can be cured through intensive and risk-oriented chemotherapy protocols. Allogeneic hematopoietic stem cell transplantation (HSCT) is considered bene\ufb01cial for approximately 10% of the patients who are at veryhigh risk at frontline therapy and for the majority of patients after relapse. Consequently, it is critically important to identify prognostic factors in this group of patients in order to tailor risk-adapted therapy. In this retrospective study, we aimed to assess the prognostic role of minimal residual disease (MRD) before HSCT and at di\ufb00erent time points after transplantation in children with ALL

Visualizing Internet-Measurements Data for Research Purposes: the NeuViz Data Visualization Tool

In this paper we present NeuViz, a data processing and visualization architecture for network measurement experiments. NeuViz has been tailored to work on the data produced by Neubot (Net Neutrality Bot), an Internet bot that performs periodic, active network performance tests. We show that NeuViz is an effective tool to navigate Neubot data to identify cases (to be investigated with more specific network tests) in which a protocol seems discriminated. Also, we suggest how the information provided by the NeuViz Web API can help to automatically detect cases in which a protocol seems discriminated, to raise warnings or trigger more specific test