Social Factors Affecting Treatment of Cervical Cancer: Ethical Issues and Policy Implications

Health care in the United States has become a privilege rather than a right. Patients who have the greatest need are the ones most likely to be denied this privilege. Despite recent advances in disease detection and treatment, many patients do not receive even the bare minimum of care. The high complexity of the health care system in the setting of patients with low levels of health literacy significantly affects the ability to seek and receive treatment in a timely fashion. In addition, lack of insurance, transportation, and social support further complicate access to care. To truly provide a standard of care to all patients, regardless of resources, our health care system must evolve to address the needs of the population. In this paper, we report a tragic case where social factors affected the outcome of a single mother with advanced cervical cancer

Levonorgestrel Intrauterine Systems for Primary Prevention and Treatment of Endometrial Hyperplasia and Endometrial Cancer: A Systematic Review

https://openworks.mdanderson.org/sumexp23/1066/thumbnail.jp

Long-term survival after multidisciplinary management of resected pancreatic adenocarcinoma.

INTRODUCTION: Actual 5-year survival rates of 10-18% have been reported for patients with resected pancreatic adenocarcinoma (PC), but the use of multimodality therapy was uncommon in these series. We evaluated long-term survival and patterns of recurrence in patients treated for PC with contemporary staging and multimodality therapy. METHODS: We analyzed 329 consecutive patients with PC evaluated between 1990 and 2002 who underwent resection. Each received a multidisciplinary evaluation and a standard operative approach. Pre- or postoperative chemotherapy and/or chemoradiation were routine. Surgical specimens of 5-year survivors were re-reviewed. A multivariate model of factors associated with long-term survival was constructed. RESULTS: Patients underwent pancreaticoduodenectomy (n = 302; 92%), distal (n = 20; 6%), or total pancreatectomy (n = 7; 2%). A total of 108 patients (33%) underwent vascular reconstruction, 301 patients (91%) received neoadjuvant or adjuvant therapy, 157 specimens (48%) were node positive, and margins were microscopically positive in 52 patients (16%). Median overall survival and disease-specific survival was 23.9 and 26.5 months. Eighty-eight patients (27%) survived a minimum of 5 years and had a median overall survival of 11 years. Of these, 21 (24%) experienced recurrence, 7 (8%) after 5 years. Late recurrences occurred most frequently in the lungs, the latest at 6.7 years. Multivariate analysis identified disease-negative lymph nodes (P = .02) and no prior attempt at resection (P = 0.01) as associated with 5-year survival. CONCLUSIONS: Our 27% actual 5-year survival rate for patients with resected PC is superior to that previously reported, and it is influenced by our emphasis on detailed staging and patient selection, a standardized operative approach, and routine use of multimodality therapy

Drying nano particles solution on an oscillating tip at an air liquid interface: what we can learn, what we can do

Evaporation of fluid at micro and nanometer scale may be used to self-assemble nanometre-sized particles in suspension. Evaporating process can be used to gently control flow in micro and nanofluidics, thus providing a potential mean to design a fine pattern onto a surface or to functionalize a nanoprobe tip. In this paper, we present an original experimental approach to explore this open and rather virgin domain. We use an oscillating tip at an air liquid interface with a controlled dipping depth of the tip within the range of the micrometer. Also, very small dipping depths of a few ten nanometers were achieved with multi walls carbon nanotubes glued at the tip apex. The liquid is an aqueous solution of functionalized nanoparticles diluted in water. Evaporation of water is the driving force determining the arrangement of nanoparticles on the tip. The results show various nanoparticles deposition patterns, from which the deposits can be classified in two categories. The type of deposit is shown to be strongly dependent on whether or not the triple line is pinned and of the peptide coating of the gold nanoparticle. In order to assess the classification, companion dynamical studies of nanomeniscus and related dissipation processes involved with thinning effects are presented

Descriptive and risk factor analysis for choanal atresia: The National Birth Defects Prevention Study, 1997–2007

Choanal atresia causes serious posterior nasal obstruction. This defect is the leading cause of nasal surgery in newborns, although its etiology is largely unknown. Data from the National Birth Defects Prevention Study, a population-based case–control study, were used to examine associations between maternal self-reports of exposures and occurrence of choanal atresia in their offspring. Overall, 117 case and 8350 control mothers with deliveries from 1997 through 2007 provided telephone interview reports of pre-pregnancy (one year before conception) and periconceptional (one month before through three months after conception) exposures. The exposures analyzed were pre-pregnancy dietary intake, pre-pregnancy and periconceptional caffeine consumption, and periconceptional cigarette smoking, alcohol drinking, and medication use. Independent associations between each exposure and all choanal atresia cases combined (n = 117) and isolated choanal atresia cases (those without additional unrelated major defects; n = 61) were examined. Odds ratios (ORs), both unadjusted (uORs) and adjusted (aORs) for potential confounders, and 95% confidence intervals (CIs) were estimated using unconditional logistic regression analysis. For all choanal atresia cases combined, positive associations were observed with maternal pre-pregnancy intake in the highest quartile for vitamin B-12 (aOR = 1.9; CI = 1.1,3.1), zinc (aOR = 1.7; CI = 1.0,3.1), and niacin (aOR = 1.8; CI = 1.0,3.1), and intake in the lowest quartile for methionine (aOR = 1.6; CI = 1.0,2.6) and vitamin D (aOR = 1.6; CI = 1.0,2.4) compared to intake in the two intermediate quartiles combined. Further, a positive association was observed with periconceptional use of thyroid medications (uOR = 2.6; CI = 1.0,6.3) compared to no use of such medications. Among isolated choanal atresia cases, negative associations were observed for pantothenic acid (aOR = 0.4; CI = 0.2,0.9) and fat (aOR = 0.5; 95% CI = 0.2,1.0) intake in the lowest quartile compared to that in the intermediate quartiles, and positive associations were observed for periconceptional cigarette smoking (aOR = 2.3; CI = 1.1,4.7) compared to no smoking and pre-pregnancy daily coffee intake of 3 or more cups (aOR = 2.5; CI = 1.1,5.6) compared to intake of less than 1 cup per day. The positive association for periconceptional exposure to thyroid medications also persisted for isolated choanal atresia cases (uOR = 4.0; CI = 1.1,11.2). Because of the large number of associations tested, these findings may be due to chance. Alternatively, they may contribute new hypotheses regarding the etiology of choanal atresia; thus, requiring replication in additional studies

ENIGMA and global neuroscience: A decade of large-scale studies of the brain in health and disease across more than 40 countries.

This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci associated with brain metrics, ENIGMA has diversified into over 50 working groups (WGs), pooling worldwide data and expertise to answer fundamental questions in neuroscience, psychiatry, neurology, and genetics. Most ENIGMA WGs focus on specific psychiatric and neurological conditions, other WGs study normal variation due to sex and gender differences, or development and aging; still other WGs develop methodological pipelines and tools to facilitate harmonized analyses of "big data" (i.e., genetic and epigenetic data, multimodal MRI, and electroencephalography data). These international efforts have yielded the largest neuroimaging studies to date in schizophrenia, bipolar disorder, major depressive disorder, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism spectrum disorders, epilepsy, and 22q11.2 deletion syndrome. More recent ENIGMA WGs have formed to study anxiety disorders, suicidal thoughts and behavior, sleep and insomnia, eating disorders, irritability, brain injury, antisocial personality and conduct disorder, and dissociative identity disorder. Here, we summarize the first decade of ENIGMA's activities and ongoing projects, and describe the successes and challenges encountered along the way. We highlight the advantages of collaborative large-scale coordinated data analyses for testing reproducibility and robustness of findings, offering the opportunity to identify brain systems involved in clinical syndromes across diverse samples and associated genetic, environmental, demographic, cognitive, and psychosocial factors

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

Inside the bubble: exploring the environments of reionisation-era Lyman-α emitting galaxies with JADES and FRESCO⋆

© 2024 The Author(s). Published by EDP Sciences. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/We present a study of the environments of 17 Lyman-α emitting galaxies (LAEs) in the reionisation-era (5.8 5%) observed in our sample of LAEs, suggesting the presence of ionised hydrogen along the line of sight towards at least eight out of 17 LAEs. We find minimum physical 'bubble'sizes of the order of R ion ∼ 0.1- 1pMpc are required in a patchy reionisation scenario where ionised bubbles containing the LAEs are embedded in a fully neutral IGM. Around half of the LAEs in our sample are found to coincide with large-scale galaxy overdensities seen in FRESCO at z ∼ 5.8- 5.9 and z ∼ 7.3, suggesting Lyman-α transmission is strongly enhanced in such overdense regions, and underlining the importance of LAEs as tracers of the first large-scale ionised bubbles. Considering only spectroscopically confirmed galaxies, we find our sample of UV-faint LAEs (M UV ≳ -20mag) and their direct neighbours are generally not able to produce the required ionised regions based on the Lyman-α transmission properties, suggesting lower-luminosity sources likely play an important role in carving out these bubbles. These observations demonstrate the combined power of JWST multi-object and slitless spectroscopy in acquiring a unique view of the early Universe during cosmic reionisation via the most distant LAEs.Peer reviewe

The Star-forming and Ionizing Properties of Dwarf z~6-9 Galaxies in JADES: Insights on Bursty Star Formation and Ionized Bubble Growth

Reionization is thought to be driven by faint star-forming galaxies, but characterizing this population in detail has long remained very challenging. Here we utilize deep nine-band NIRCam imaging from JADES to study the star-forming and ionizing properties of 756 $z\sim6-9$ galaxies, including hundreds of very UV-faint objects ($M_\mathrm{UV}>-18$). The faintest ($m\sim30$) galaxies in our sample typically have stellar masses of $M_\ast\sim(1-3)\times10^7$ $M_\odot$ and young light-weighted ages ($\sim$50 Myr), though some show strong Balmer breaks implying much older ages ($\sim$500 Myr). We find no evidence for extremely massive galaxies ($>3\times10^{10}$ $M_\odot$) in our sample. We infer a strong (factor $>$2) decline in the typical [OIII]$+$H$\beta$ EWs towards very faint $z\sim6-9$ galaxies, yet a weak UV luminosity dependence on the H$\alpha$ EWs at $z\sim6$. We demonstrate that these EW trends can be explained if fainter galaxies have systematically lower metallicities as well as more recently-declining star formation histories relative to the most UV-luminous galaxies in our sample. Our data provide evidence that the brightest galaxies are frequently experiencing a recent strong upturn in SFR. We also discuss how the EW trends may be influenced by a strong correlation between $M_\mathrm{UV}$ and Lyman continuum escape fraction. This alternative explanation has dramatically different implications for the contribution of galaxies along the luminosity function to cosmic reionization, highlighting the need for deep spectroscopic follow-up. Finally, we quantify the photometric overdensities around two $z>7$ strong Ly$\alpha$ emitters in the JADES footprint. One Ly$\alpha$ emitter lies close to a strong photometric overdensity while the other shows no significant nearby overdensity, perhaps implying that not all strong $z>7$ Ly$\alpha$ emitters reside in large ionized bubbles.Comment: 29 pages, 16 figures. Submitted to MNRAS. Comments welcom