Особливості морфологічних змін в оцінці ефективностінеоад’ювантної таргетної терапії у хворих з локалізованимнирково–клітинним раком

Мета. Визначити особливості морфологічних змін під впливом неоад’ювантної таргетної терапії (ТТ), проведеної хворим з локалізованим нирково-клітинним раком (НКР). Матеріали і методи. Вивчено дані 58 пацієнтів з локалізованим НКР, яким проведено два блоки неоад’ювантної ТТ з визначенням об’єктивної відповіді на лікування, подальшим оперативним втручанням та патоморфологічним дослідженням. Результати. Середній показник регресії пухлини (М ± SD) після проведення ТТ становив (20,5 ± 14,3)% (95% довірчий інтервал- ДІ 16 - 24,3). Оцінка регресії пухлини за шкалою RECIST 1.1: стабілізацію відмітили у 44 (75,9%) хворих; часткову регресію- у 14 (24,1%). Повної регресії чи прогресії процесу не спостерігали у жодного хворого. Середній показник регресії за навності 2-го ступеня градації за Фурманом становив (22,6 ± 14,4)% (95% ДІ 18,3 - 26,9); 3-го ступеняг радації за Фурманом - (17,1 ± 11,7)% (95% ДІ 7,3 - 26,9); 4-го ступеня градації за Фурманом - (3,8 ± 2,9)% (95% ДІ 1 - 8,5); оцінка за методом ANOVA: η2=0,13; power=0,72; p < 0,05. Середня частка некрозу пухлини під дією ТТ достовірно вище у хворих з частковою регресією. Кореляційної залежності тяжкості судинних змін та частки життєздатної пухлинної тканини від ступеня регресії НКР не виявлено. Висновки. Під впливом неоад’ювантної ТТ у хворих з локалізованим НКР відбулася регресія пухлини в середньому на (20,5 ± 14,3)%. Низький показник регресії НКР у хворих з 4-м ступенем гістопатологічної градації ядер за Фурманом - (3,8 ± 2,9)%, який свідчить про низьку ефективність ТТ (оцінка за методом ANOVA: η2 = 0,13; power = 0,72; p < 0,05), можна використовувати як прогностичний маркер відповіді

Fetal Window of Vulnerability to Airborne Polycyclic Aromatic Hydrocarbons on Proportional Intrauterine Growth Restriction

Background: Although the entire duration of fetal development is generally considered a highly susceptible period, it is of public health interest to determine a narrower window of heightened vulnerability to polycyclic aromatic hydrocarbons (PAHs) in humans. We posited that exposure to PAHs during the first trimester impairs fetal growth more severely than a similar level of exposure during the subsequent trimesters. Methods: In a group of healthy, non-smoking pregnant women with no known risks of adverse birth outcomes, personal exposure to eight airborne PAHs was monitored once during the second trimester for the entire cohort (n = 344), and once each trimester within a subset (n = 77). Both air monitoring and self-reported PAH exposure data were used in order to statistically estimate PAH exposure during the entire gestational period for each individual newborn. Results: One natural-log unit increase in prenatal exposure to the eight summed PAHs during the first trimester was associated with the largest decrement in the Fetal Growth Ratio (FGR) (23%, 95 % Confidence Interval (CI), 25 to20%), birthweight (2105 g, 95 % CI, 2188 to 222 g), and birth length (20.78 cm, 95 % CI, 21.30 to 20.26 cm), compared to the unit effects of PAHs during the subsequent trimesters, after accounting for confounders. Furthermore, a unit exposure during the first trimester was associated with the largest elevation in Cephalization Index (head to weight ratio) (3 mm/g, 95 % CI, 1 to 5 mm/g). PAH exposure was not associated with evidence of asymmetric growth restriction in this cohort

Dual-Earner Family Policies at Work for Single-Parent Families

Family dynamics are changing and single-parent families are becoming more common across countries. In their flagship report “Progress of the World’s Women, 2019–2020,” UN Women (2019) demonstrated that, contrary to popular belief, couples with children do not constitute a majority of all families, but rather there are many different types of families. Single parenthood is considered a “new social risk” in poverty and inequality (Bonoli, 2013). Therefore, policy makers and legislators have designed targeted policy specifically for single parents, such as targeted child benefits to single parents. In addition, legislation and social policy have been designed and implemented specifically for single parents, such as child support and family law such as child custody and shared residence. This study takes a different approach, based on the universalist argument that without adequate social protection that benefits all families, those families that are more vulnerable are often hit the hardest. We focus on family policies, and specifically we examine whether and to what extent single parents benefit from the same family policies that are available to all families with children

Change in the Gender Division of Domestic Work after Mummy or Daddy Took Leave: An Examination of Alternative Explanations

This study investigates how the duration of child care leave taken by mothers and fathers relates to changes in couples' division of housework and child care after postnatal labour market return in Germany. It explores whether take-up of child care related leave may impact the gender division of domestic work beyond the period of leave and examines three theoretical explanations: 1) development of domestic work skills, 2) bargaining power based on economic resources, and 3) adaptations in gender role or parenting identities. Using data from the German Socio-Economic Panel (1992-2012) on 797 and 762 couples with a first or second birth, respectively, we applied OLS regression models with lagged dependent variables in combination with Heckman selection correction. The results suggested that dual-earner couples where mothers took longer leaves experienced a greater shift towards a gender-traditional division of domestic labour after childbirth even in the medium-term after labour market return. The linear relationship and stronger effects on the division of child care than for housework lent support to identity-based explanations. Paternal leave take-up was associated with a more equal division of housework and child care after first births but not after second birth transitions. The relationship with the leave duration was less clear. In terms of explaining the mechanisms for fathers, the findings provided greatest support for explanations relating to domestic skills development possibly in combination with changes in fathering identities

Causes and Consequences of a Father’s Child Leave: Evidence from a Reform of Leave Schemes

Many OECD countries have implemented policies to induce couples to share parental leave. This paper investigates how responsive intra-household leave-sharing is to changes in economic incentives. To investigate this fundamental question, we are forced to look at one of the Nordic countries which are the most progressive when it comes to family-friendly policies. An extensive reform of child leave schemes in Denmark affected couples differently depending on whether the parents where employed in the same or in different parts of the public sector. Based on a difference-in-differences strategy, I find that economic incentives are very important for intra-household leave-sharing. Increasing the couples' after tax income by $9 per day of leave which is transferred from the mother to the father is found to lead to a one day transfer. This corresponds to a supply elasticity close to unity