Palliative care initiation in pediatric oncology patients: A systematic review

Palliative care (PC) aims to improve quality of life for patients and their families. The World Health Organization and American Academy of Pediatrics recommend that PC starts at diagnosis for children with cancer. This systematic review describes studies that reported PC timing in the pediatric oncology population. The following databases were searched: PubMed, Web of Science, CINAHL, and PsycInfo databases. Studies that reported time of PC initiation were independently screened and reviewed by 2 researchers. Studies describing pilot initiatives, published prior to 1998, not written in English, or providing no empirical time information on PC were excluded. Extracted data included sample characteristics and timing of PC discussion and initiation. Of 1120 identified citations, 16 articles met the inclusion criteria and comprised the study cohort. Overall, 54.5% of pediatric oncology patients received any palliative service prior to death. Data revealed PC discussion does not occur until late in the illness trajectory, and PC does not begin until close to time of death. Despite efforts to spur earlier initiation, many pediatric oncology patients do not receive any palliative care service, and those who do, predominantly receive it near the time of death. Delays occur both at first PC discussion and at PC initiation. Efforts for early PC integration must recognize the complex determinants of PC utilization across the illness timeline

Assessment of Urban Flood Vulnerability Using theSocial-Ecological-Technological Systems Framework in Six US cities

As urban populations continue to grow through the 21 st century, more people are projected to be at risk of exposure to climate change-induced extreme events. To investigate the complexity of urban floods, this study applied an interlinked social-ecological-technological systems (SETS) vulnerability framework by developing an urban flood vulnerability index for six US cities. Indicators were selected to reflect and illustrate exposure, sensitivity, and adaptive capacity to flooding for each of the three domains of SETS. We quantified 18 indicators and normalized them by the cities’ 500-yr floodplain area at the census block group level. Clusters of flood vulnerable areas were identified differently by each SETS domain, and some areas were vulnerable to floods in more than one domain. Results are provided to support decision-making for reducing risks to flooding, by considering social, ecological, and technological vulnerability as well as hotspots where multiple sources of vulnerability coexist. The spatially explicit urban SETS flood vulnerability framework can be transferred to other regions facing challenging urban floods and other types of environmental hazards. Mapping SETS flood vulnerability helps to reveal intersections of complex SETS interactions and inform policy-making for building more resilient cities in the face of extreme events and climate change impacts

Changes in Inflammatory Response after Endovascular Treatment for Type B Aortic Dissection

This present study aims to investigate the changes in the inflammatory markers after elective endovascular treatment of Type B aortic dissection with aneurysm, as related to different anatomical features of the dissection flap in the paravisceral perfusion. Consecutive patients with type B aortic dissections with elective endovascular stent graft repair were recruited and categorized into different groups. Serial plasma levels of cytokines (Interleukin-1β, -6, -8, -10, TNF-α), chemokines (MCP-1), and serum creatinine were monitored at pre-, peri- and post-operative stages. The length of stent graft employed in each surgery was retrieved and correlated with the change of all studied biochemical parameters. A control group of aortic dissected patients with conventional medication management was recruited for comparing the baseline biochemical parameters. In total, 22 endovascular treated and 16 aortic dissected patients with surveillance were recruited. The endovascular treated patients had comparable baseline levels as the non-surgical patients. There was no immediate or thirty day-mortality, and none of the surgical patients developed post-operative mesenteric ischaemia or clinically significant renal impairment. All surgical patients had detectable pro-inflammatory mediators, but none of the them showed any statistical significant surge in the peri-operative period except IL-1β and IL-6. Similar results were obtained when categorized into different groups. IL-1β and IL-6 showed maximal levels within hours of the endovascular procedure (range, 3.93 to 27.3 higher than baseline; p = 0.001), but returned to baseline 1 day post-operatively. The change of IL-1β and IL-6 at the stent graft deployment was statistically greater in longer stent graft (p>0.05). No significant changes were observed in the serum creatinine levels. In conclusion, elective endovascular repair of type B aortic dissection associated with insignificant changes in inflammatory mediators and creatinine. All levels fell toward basal levels post-operatively suggesting that thoracic endovascular aortic repair is rather less aggressive with insignificant inflammatory modulation

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Nitrenium ions, reactivity and intitial site of adduct formation with guanosine and guanosine derivatives

grantor: University of TorontoMany aromatic amines are established carcinogens that are abundant within society. Their mode of action involves the formation of an unstable intermediate, an ester that undergoes N-O heterolysis to produce an arylnitrenium ion that reacts with DNA, especially at guanine residues. Conventional lamp flash photolysis experiments were done to measure the effect of pH on the rates of decay of the adduct formed between the 2-fluorenyinitrenium ion with guanosine and guanosine derivatives. This study shows that the ionization of the N-1 proton is responsible for pH-dependency. The effect of substituents at the exocyclic N-2 position of guanosine on the initial reaction with nitrenium ions was examined by laser-flash photolysis. It was determined that the addition of alkyl substituents increases the reaction rate by an order of magnitude. This is consistent with the theory that the nitrenium ion forms an initial adduct directly at the C-8 position of the guanine derivatives.M.Sc

An institutional ad and reading campaign for The Filipinas Heritage Library

Filipinos are not a reading public. Book readership is generally low and public libraries are more often than not, under budget and operating under functional conditions. Until Filipinos learn to like reading and turn it into a beneficial habit, libraries have no means to earn and maintain itself to the best modern standards. In attempt to remedy this, this thesis proposes two advertising campaigns. An institutional advertising campaign and a reading advertising campaign for the Filipinas Heritage Library. The purpose of the Institutional Ad Campaign is to create an awareness regarding the organization\u27s existence and the services it offers. This is to further expand its client base and increase revenue. The Reading Campaign, on the other hand, is part of a project of the Library. It is treated as a social marketing campaign for the organization to create goodwill in society. It aims to promote reading as a habit to the general public targeted mainly to the youth. Considering budgetary constraints and for practical effectiveness, the thesis proponents have utilized traditional and non-traditional print media as its main medium. For the Institutional Campaign, a budget of P2,336,137.51 is required to complete the campaign that would last for a total of twelve weeks for its traditional placements and a year for its non-traditional placements. For the Reading Campaign, a budget of P2,227,806.16 is needed for a campaign that will last for a period total of twenty-two weeks for its traditional placements and also a year for its non-traditional placements

Ang konsepto ng pandaraya mula sa pananaw ng mga batang Pilipino

Ang pag-aaral na ito ay tumatalakay sa konsepto ng pandaraya mula sa pananaw ng mga batang Pilipino. Binigyang pansin nito ang apat na lunang ginagalawan ng mga bata -- pamilya, paaralan, komunidad, at barkada. Ang mga naging kalahok sa pag-aaral na ito ay ang mga mag-aaral sa tatlong paaralang nagrerepresinta ng tatlong antas pangsosyo-ekonomiko--mababa, gitna, at mataas na antas. Ang mga kalahok na ito ay mga batang lalaki\u27t babae na 7-8 at 11-12 na taong gulang na napili sa pamamagitan ng stratified random sampling . Ang disenyo ng pag-aaral ay deskriptibo. Dalawang metodo ang ginamit sa paglakap ng datos -- ang pakikipagtalakayan at ang sarbey. Sinuri naman ang mga nalakap na datos sa pamamagitan ng content analysis at paggawa ng percentage table . Mula sa kasagutan ng mga kalahok, napag-alaman na ang kanilang pananaw ukol sa pandaraya ay nagpapahiwatig ng pagiging masama nito tulad din ng paghusga nila sa madadayang pagkilos na natutuon sa sidhing masama at masamang-masama. Nakita rin na ang pangkaraniwang konsepto ng lahat ng mga kalahok sa pandaraya ay ang pagkuha ng gamit ng iba. Napag-alaman pa na epektibo ang mga baryabol na edad at antas pangsosyo-ekonomiko sa pagbuo ng konsepto ng mga bata ukol sa pandaraya ngunit ang baryabol na kasarian naman ay hindi gaanong makabuluhan. Nalaman din na ang pagkaka-iba-iba ng konsepto ng mga kalahok ay umaayon sa lunang tinatalakay