Palliative care and Parkinson's disease : meeting summary and recommendations for clinical research

Introduction: Palliative care is an approach to caring for patients and families affected by serious illnesses that focuses on the relief of suffering through the management of medical symptoms, psychosocial issues, advance care planning and spiritual wellbeing. Over the past decade there has been an emerging clinical and research interest in the application of palliative care approaches to Parkinson’s disease (PD) and outpatient palliative care services are now offered by several movement disorders centers. Methods: An International Working Group Meeting on PD and Palliative Care supported by the Parkinson’s Disease Foundation was held in October 2015 to review the current state of the evidence and to make recommendations for clinical research and practice. Results: Topics included: 1) Defining palliative care for PD; 2) Lessons from palliative care for heart failure and other chronic illnesses; 3) Patient and caregiver Needs; 4) Needs assessment tools; 5) Intervention strategies; 6) Predicting prognosis and hospice referrals; 7) Choice of appropriate outcome measures; 8) Implementation, dissemination and education research; and 9) Need for research collaborations. We provide an overview of these discussions, summarize current evidence and practices, highlight gaps in our knowledge and make recommendations for future research. Conclusions: Palliative Care for PD is a rapidly growing area which holds great promise for improving outcomes for PD patients and their caregivers. While clinical research in this area can build from lessons learned in other diseases, there is a need for observational, methodological and interventional research to address the unique needs of PD patients and caregivers

An Open Trial of Group Acceptance and Commitment Therapy (ACT) With an Adjunctive Mobile App for Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder (GAD) is a common and debilitating condition. Effective treatments exist, but they are time-and resource-intensive. This study tested the initial efficacy and acceptability of a novel treatment protocol designed to increase efficiency: acceptance and commitment therapy (ACT) taught in groups and through an adjunctive mobile app. Participants were 21 individuals with GAD who received six weeks of 2-hour group ACT sessions as well as access to an adjunctive ACT mobile app. Significant improvements occurred in worry, anxiety, social functioning, and depression as well as relevant processes (psychological inflexibility, anxiety-related cognitive fusion). In-the-moment improvements were also observed in symptoms and ACT processes immediately after completing mobile app sessions. Treatment was perceived as credible and acceptable overall. However, rates of reliable and clinically significant change were low, and app usage did not correlate with change in worry. Overall, this study suggests that an efficient, brief ACT group intervention combined with a mobile app may lead to improvements in GAD but may not be sufficient for clinically significant change. A detailed overview of the treatment is included, and guidance for clinicians interested in implementing this protocol is discussed

Extended Line Emission in the BCG of Abell 2390

We report CFHT/SITELLE imaging Fourier Transform Spectrograph observations of the Brightest Cluster Galaxy (BCG) of galaxy cluster Abell 2390 at z=0.228. The BCG displays a prominent cone of emission in H$\alpha$, H$\beta$, [NII], and [OII] to the North-West with PA = 42$^o$, 4.4 arcsec in length (15.9 kpc), which is associated with elongated and asymmetric Chandra soft X-ray emission. The H$\alpha$ flux map also contains a "hook" of H$\alpha$ and [NII] emission resulting in a broadened northern edge to the cone. Using SITELLE/LUCI software we extract emission line flux, velocity, velocity dispersion, and continuum maps, and utilize them to derive flux ratio maps to determine ionization mechanisms and dynamical information in the BCG's emission line region. The Baldwin-Phillips-Terlevich diagnostics on the BCG cone indicate a composite ionization origin of photoionization due to star formation and shock. Strong LINER-like emission is seen in the nuclear region which hosts an AGN. As Abell 2390 is a cool-core cluster, we suggest that the cooling flow is falling onto the central BCG and interacting with the central AGN. The AGN produces jets that inflate "bubbles" of plasma in the ICM, as is often observed in local galaxy clusters. Furthermore, combining signs of AGN activities from radio, optical emission line and X-ray data over a large range of physical scale, we find evidence for three possible episodes of AGN activity in different epochs associated with the Abell 2390 BCG.Comment: 15 pages, 13 figures, accepted by MNRA

Developmental transitions in body color in chacma baboon infants: Implications to estimate age and developmental pace

International audienc

Space Systems: Emerging Technologies and Operations

SPACE SYSTEMS: EMERGING TECHNOLOGIES AND OPERATIONS is our seventh textbook in a series covering the world of UASs / CUAS/ UUVs. Other textbooks in our series are Drone Delivery of CBNRECy – DEW Weapons: Emerging Threats of Mini-Weapons of Mass Destruction and Disruption (WMDD); Disruptive Technologies with applications in Airline, Marine, Defense Industries; Unmanned Vehicle Systems & Operations On Air, Sea, Land; Counter Unmanned Aircraft Systems Technologies and Operations; Unmanned Aircraft Systems in the Cyber Domain: Protecting USA’s Advanced Air Assets, 2nd edition; and Unmanned Aircraft Systems (UAS) in the Cyber Domain Protecting USA\u27s Advanced Air Assets, 1st edition. Our previous six titles have received considerable global recognition in the field. (Nichols & Carter, 2022) (Nichols et al., 2021) (Nichols R. K. et al., 2020) (Nichols R. et al., 2020) (Nichols R. et al., 2019) (Nichols R. K., 2018) Our seventh title takes on a new purview of Space. Let\u27s think of Space as divided into four regions. These are Planets, solar systems, the great dark void (which fall into the purview of astronomers and astrophysics), and the Dreamer Region. The earth, from a measurement standpoint, is the baseline of Space. It is the purview of geographers, engineers, scientists, politicians, and romantics. Flying high above the earth are Satellites. Military and commercial organizations govern their purview. The lowest altitude at which air resistance is low enough to permit a single complete, unpowered orbit is approximately 80 miles (125 km) above the earth\u27s surface. Normal Low Earth Orbit (LEO) satellite launches range between 99 miles (160 km) to 155 miles (250 km). Satellites in higher orbits experience less drag and can remain in Space longer in service. Geosynchronous orbit is around 22,000 miles (35,000 km). However, orbits can be even higher. UASs (Drones) have a maximum altitude of about 33,000 ft (10 km) because rotating rotors become physically limiting. (Nichols R. et al., 2019) Recreational drones fly at or below 400 ft in controlled airspace (Class B, C, D, E) and are permitted with prior authorization by using a LAANC or DroneZone. Recreational drones are permitted to fly at or below 400 ft in Class G (uncontrolled) airspace. (FAA, 2022) However, between 400 ft and 33,000 ft is in the purview of DREAMERS. In the DREAMERS region, Space has its most interesting technological emergence. We see emerging technologies and operations that may have profound effects on humanity. This is the mission our book addresses. We look at the Dreamer Region from three perspectives:1) a Military view where intelligence, jamming, spoofing, advanced materials, and hypersonics are in play; 2) the Operational Dreamer Region; whichincludes Space-based platform vulnerabilities, trash, disaster recovery management, A.I., manufacturing, and extended reality; and 3) the Humanitarian Use of Space technologies; which includes precision agriculture wildlife tracking, fire risk zone identification, and improving the global food supply and cattle management. Here’s our book’s breakdown: SECTION 1 C4ISR and Emerging Space Technologies. C4ISR stands for Command, Control, Communications, Computers, Intelligence, Surveillance, and Reconnaissance. Four chapters address the military: Current State of Space Operations; Satellite Killers and Hypersonic Drones; Space Electronic Warfare, Jamming, Spoofing, and ECD; and the challenges of Manufacturing in Space. SECTION 2: Space Challenges and Operations covers in five chapters a wide purview of challenges that result from operations in Space, such as Exploration of Key Infrastructure Vulnerabilities from Space-Based Platforms; Trash Collection and Tracking in Space; Leveraging Space for Disaster Risk Reduction and Management; Bio-threats to Agriculture and Solutions From Space; and rounding out the lineup is a chapter on Modelling, Simulation, and Extended Reality. SECTION 3: Humanitarian Use of Space Technologies is our DREAMERS section. It introduces effective use of Drones and Precision Agriculture; and Civilian Use of Space for Environmental, Wildlife Tracking, and Fire Risk Zone Identification. SECTION 3 is our Hope for Humanity and Positive Global Change. Just think if the technologies we discuss, when put into responsible hands, could increase food production by 1-2%. How many more millions of families could have food on their tables? State-of-the-Art research by a team of fifteen SMEs is incorporated into our book. We trust you will enjoy reading it as much as we have in its writing. There is hope for the future.https://newprairiepress.org/ebooks/1047/thumbnail.jp

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Characterization of Botulinum Neurotoxin Type A Neutralizing Monoclonal Antibodies and Influence of Their Half-Lives on Therapeutic Activity

Botulinum toxins, i.e. BoNT/A to/G, include the most toxic substances known. Since botulism is a potentially fatal neuroparalytic disease with possible use as a biowarfare weapon (Centers for Disease Control and Prevention category A bioterrorism agent), intensive efforts are being made to develop vaccines or neutralizing antibodies. The use of active fragments from non-human immunoglobulins (F(ab')2, Fab', scFv), chemically modified or not, may avoid side effects, but also largely modify the in vivo half-life and effectiveness of these reagents. We evaluated the neutralizing activity of several monoclonal anti-BoNT/A antibodies (mAbs). F(ab')2 fragments, native or treated with polyethyleneglycol (PEG), were prepared from selected mAbs to determine their half-life and neutralizing activity as compared with the initial mAbs. We compared the protective efficiency of the different biochemical forms of anti-toxin mAbs providing the same neutralizing activity. Among fourteen tested mAbs, twelve exhibited neutralizing activity. Fragments from two of the best mAbs (TA12 and TA17), recognizing different epitopes, were produced. These two mAbs neutralized the A1 subtype of the toxin more efficiently than the A2 or A3 subtypes. Since mAb TA12 and its fragments both exhibited the greatest neutralizing activity, they were further evaluated in the therapeutic experiments. These showed that, in a mouse model, a 2- to 4-h interval between toxin and antitoxin injection allows the treatment to remain effective, but also suggested an absence of correlation between the half-life of the antitoxins and the length of time before treatment after botulinum toxin A contamination. These experiments demonstrate that PEG treatment has a strong impact on the half-life of the fragments, without affecting the effectiveness of neutralization, which was maintained after preparation of the fragments. These reagents may be useful for rapid treatment after botulinum toxin A contamination

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment