Elderly Offenders: An American Corrections Catch-22?

The problem of the aging offender population is an issue that will ultimately need to be addressed by state corrections departments and legislatures. As general prison populations continue to age, the type and extent of inmate health care needs will change. This thesis examines the experiences of the elderly offender in the prison environment. Specifically, the conditions surrounding incarceration are evaluated, including unique age-related impairments, disability accommodations, constitutional protections, and programs and policies addressing the elderly offender population. A review of sentencing policy in Kansas will then be conducted, with specific focus on downward departure sentencing based upon advanced age. Recommendations that are made to address the continued growth of the Kansas elderly offender population include both proposed state agency and legislative policy changes. Agency recommendations relate to the administration of the newly-renovated geriatric correctional facility in Oswego, Labette County, Kansas. Legislative policy proposals address changes in Kansas sentencing policy, for purposes of integrating the factors of extraordinary physical impairment and age in departure sentencing and parole hearings. Amendatory changes to state early release procedures will also be raised to provide early release mechanisms for offgrid offenders

Characterization of Metastatic Tumor Formation by the Colony Size Distribution

Knowledge regarding the kinetics of metastatic tumor formation, as related to the growth of the primary tumor, represents a fundamental issue in cancer biology. Using an in vivo mammalian model, we show here that one can obtain useful information from the frequency distribution of the sizes of metastatic colonies in distant organs after serial sectioning and image reconstruction. To explain the experimental findings, we constructed a biophysical model based on the respective growth patterns of the primary tumor and metastases and a stochastic process of metastatic colony formation. Heterogeneous distributions of various biological parameters were considered. We found that the elementary assumption of exponential forms of growth for the primary tumor and metastatic colonies predicts a linear relation on a log-log plot of a metastatic colony size distribution, which was consistent with the experimental results. Furthermore, the slope of the curve signifies the ratio of growth rates of the primary and the metastases. Non-exponential (Gompertzian and logistic) tumor growth patterns were also incorporated into the theory to explain possible deviation from the log-log linear relation. The observed metastasis-free probability also supported the assumption of a time-dependent Poisson process. With this approach, we determined the mechanistic parameters governing the process of metastatogenesis in the lungs for two murine tumor cell lines (KHT and MCaK). Since biological parameters specified in the model could be obtained in the laboratory, a workable metastatic "assay" may be established for various malignancies and in turn contribute in formulating rational treatment regimens for subclinical metastases.Comment: 14 pages, 6 figure

A perspective on the impact of radiation therapy on the immune rheostat.

The advent and success of immune checkpoint inhibitors (ICIs) in cancer treatment has broadened the spectrum of tumours that might be considered "immunogenic" and susceptible to immunotherapeutic (IT) intervention. Not all cancer types are sensitive, and not all patients with any given type respond. Combination treatment of ICIs with an established cytotoxic modality such as radiation therapy (RT) is a logical step towards improvement. For one, RT alone has been shown to be genuinely immunomodulatory and secondly pre-clinical data generally support combined ICI-RT approaches. This new integrated therapy for cancer treatment holds much promise, although there is still a lot to be learned about how best to schedule the treatments, manage the toxicities and determine what biomarkers might predict response, as well as many other issues. This review examines how RT alters the immune rheostat and how it might best be positioned to fully exploit IT

Irradiation to Improve the Response to Immunotherapeutic Agents in Glioblastomas.

PurposeGlioblastoma (GBM) remains an incurable disease despite extensive treatment with surgical resection, irradiation, and temozolomide. In line with many other forms of aggressive cancers, GBM is currently under consideration as a target for immunotherapy. However, GBM tends to be nonimmunogenic and exhibits a microenvironment with few or no effector T cells, a relatively low nonsynonymous somatic mutational load, and a low predicted neoantigen burden. GBM also exploits a multitude of immunosuppressive strategies.Methods and materialsA number of immunotherapeutic approaches have been tested with disappointing results. A rationale exists to combine immunotherapy and radiation therapy, which can induce an immunogenic form of cell death with T-cell activation and tumor infiltration.ResultsVarious immunotherapy agents, including immune checkpoint modulators, transforming growth factor beta receptor inhibitors, and indoleamine-2,3-dioxygenase inhibitors, have been evaluated with irradiation in preclinical GBM models, with promising results, and are being further tested in clinical trials.ConclusionsThis review aims to present the basic rationale behind this emerging complementary therapeutic approach in GBM, appraise the current preclinical and clinical data, and discuss the future challenges in improving the antitumor immune response