Mortality in pediatric oncology and stem cell transplant patients with bloodstream infections

BACKGROUND: Bloodstream infections (BSI) continue to represent a significant source of morbidity for pediatric oncology patients, however less is known regarding this population\u27s risk of death. We sought to evaluate the risk of BSI and death at a large pediatric cancer center. METHODS: We retrospectively collected inpatient data from pediatric oncology and hematopoietic stem cell transplant (HSCT) patients over a 9-year period. We performed univariate and multivariable modeling to assess risk of BSI and mortality examining the following variables: demographics, underlying malignancy, history of HSCT, central line type, and febrile neutropenia (FN). RESULTS: During the study period, 6763 admissions from 952 patients met inclusion criteria. BSI occurred in 367 admissions (5.4%) from 231 unique individuals. Risk factors for BSI include younger age, diagnoses of hemophagocytic lymphohistiocytosis or acute myeloid leukemia, ethnicity, and history of HSCT. Mortality for those with BSI was 6.5%, compared to 0.7% without (OR 7.2, CI 4.1 - 12.7, p\u3c0.0001). In patients with BSI, admissions with FN were associated with reduced mortality compared to admissions without FN (OR 0.21, CI 0.05 - 0.94, p=0.04). In both univariate and multivariable analysis, no other risk factor was significantly associated with mortality in patients with BSI. CONCLUSION: BSI is a significant source of mortality in pediatric oncology and HSCT patients. While demographic variables contribute to the risk of BSI, they did not influence mortality. These findings highlight the importance of BSI prevention to reduce the risk of death in pediatric oncology patients. Future studies should focus on comprehensive BSI prevention

A generalization of Schur-Weyl duality with applications in quantum estimation

Schur-Weyl duality is a powerful tool in representation theory which has many applications to quantum information theory. We provide a generalization of this duality and demonstrate some of its applications. In particular, we use it to develop a general framework for the study of a family of quantum estimation problems wherein one is given n copies of an unknown quantum state according to some prior and the goal is to estimate certain parameters of the given state. In particular, we are interested to know whether collective measurements are useful and if so to find an upper bound on the amount of entanglement which is required to achieve the optimal estimation. In the case of pure states, we show that commutativity of the set of observables that define the estimation problem implies the sufficiency of unentangled measurements.Comment: The published version, Typos corrected, 40 pages, 2 figure

Cardiovascular toxicities after anthracycline and VEGF-targeted therapies in adolescent and young adult cancer survivors

BACKGROUND: Cancer survival rates have been steadily improving in the adolescent and young adult (AYA) population, but survivors are at increased risk for cardiovascular disease (CVD). The cardiotoxic effects of anthracycline therapy have been well studied. However, the cardiovascular toxicity associated with newer therapies, such as the vascular endothelial growth factor (VEGF) inhibitors, is less well understood. OBJECTIVE: This retrospective study of AYA cancer survivors sought to gain insight into their burden of cardiovascular toxicities (CT) following initiation of anthracycline and/or VEGF inhibitor therapy. METHODS: Data were extracted from electronic medical records over a fourteen-year period at a single institution. Cox proportional hazards regression modeling was used to examine risk factors for CT within each treatment group. Cumulative incidence was calculated with death as a competing risk. RESULTS: Of the 1,165 AYA cancer survivors examined, 32%, 22%, and 34% of patients treated with anthracycline, VEGF inhibitor, or both, developed CT. Hypertension was the most common outcome reported. Males were at increased risk for CT following anthracycline therapy (HR: 1.34, 95% CI 1.04-1.73). The cumulative incidence of CT was highest in patients who received both anthracycline and VEGF inhibitor (50% at ten years of follow up). CONCLUSIONS: CT was common among AYA cancer survivors who received anthracycline and/or VEGF inhibitor therapy. Male sex was an independent risk factor for CT following anthracycline treatment. Further screening and surveillance are warranted to continue understanding the burden of CVD following VEGF inhibitor therapy

Hip Flexion Angles During Supine Range of Motion and Bodyweight Squats

International Journal of Exercise Science 14(1): 912-918, 2021. During the lowering phase of a squat, it has been observed that a posterior pelvic tilt (PPT) may occur when squatting to full depth. Research suggests that defaulting to compensatory movement strategies, such as PPT, during the squat may correlate with risk of lower extremity and trunk pathology. The purpose of this study was to examine hip flexion (HF) angles at the point when PPT occurs among three conditions: standard squats, heel raise squats, and supine passive HF; analyzing the differences in depth between standard and heel raise squats; and calculating differences in knee angles and ankle excursion between standard and heel raise squats. 28 participants performed bodyweight squats and underwent supine passive HF while outfitted with 32 retroreflective motion capture markers. Hip, knee, and ankle joint angles were extracted at the point of PPT. A one-way repeated measures ANOVA was used to determine differences in hip joint angles between conditions, and a paired sample t-test was used to compare knee angles, ankle excursion, and squat depth between standard and heel raise squats. HF angles at PPT remained unchanged across all conditions. However, significantly greater knee flexion, ankle excursion, and squat depth were observed in the heel raise squats compared to the standard squats. Results suggest that PPT is a compensatory movement that occurs as the femur compresses into the acetabulum once hip flexion has been exhausted

Sample-Optimal Tomography of Quantum States

© 1963-2012 IEEE. It is a fundamental problem to decide how many copies of an unknown mixed quantum state are necessary and sufficient to determine the state. Previously, it was known only that estimating states to error \epsilon in trace distance required O(dr^{2}/\epsilon ^{2}) copies for a d -dimensional density matrix of rank r. Here, we give a theoretical measurement scheme (POVM) that requires O (dr/ \delta) \ln ~(d/\delta) copies to estimate \rho to error \delta in infidelity, and a matching lower bound up to logarithmic factors. This implies O((dr / \epsilon ^{2}) \ln ~(d/\epsilon)) copies suffice to achieve error \epsilon in trace distance. We also prove that for independent (product) measurements, \Omega (dr^{2}/\delta ^{2}) / \ln (1/\delta) copies are necessary in order to achieve error \delta in infidelity. For fixed d , our measurement can be implemented on a quantum computer in time polynomial in n

Severe Acute Hepatocellular Injury Attributed to OxyELITE Pro: A Case Series

Herbal and dietary supplement (HDS) hepatotoxicity is increasingly being reported in the United States. This case series describes the presenting clinical features and outcomes of 7 patients with liver injury attributed to OxyELITE Pro enrolled in the Drug Induced Liver Injury Network (DILIN) study