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Evaluating Disparities in Proton Radiation Therapy Use in AHOD1331, a Contemporary Children\u27s Oncology Group Trial for Advanced-Stage Hodgkin Lymphoma

The indications for proton radiation therapy carry the strongest evidence in pediatric cancers. In a recently published letter, Bitterman et al reviewed factors associated with receipt of proton radiation therapy in patients enrolled in Children\u27s Oncology Group (COG) solid tumor and CNS tumor trials. They demonstrated that Black children were less likely to receive this treatment than non-Hispanic white patients, a disparity that persisted when controlling for other demographic and clinical variables. We strongly commend them for their work, as addressing racism and infrastructural barriers to care requires its identification

The Lantern Vol. 27, No. 3, Fall 1960

• Thoughts in DaVinici\u27s Coffeehouse • Kinesiology Class • No One is Named Alistair • The Beat Generation • The Super Highway Blues • Panic and the Mountain Peak • The Lake • Later • Ares • The Light • The Room • Thoughts After Three-Thirty • Critique • There • Organized Religion - Pro • Organized Religion - Con • Longing • Apologies to Francois Villon • The Fortune Teller • At Twilight • The Ledge • Waiting at Evening for the Sky to Fall • In Memory of a Friend • The Gentleman • Consumption • Post-Panegyric • The Everglades • Awareness • The Art of Two-Timing • Meditations of an Egyptologist • Sonnet to Mao Tse-Tung • A Strange Affair • With Us Tonight • The Form in Fronthttps://digitalcommons.ursinus.edu/lantern/1078/thumbnail.jp

An Examination of Liver Offers to Candidates on the Liver Transplant Wait-List

BACKGROUND & AIMS: We aimed to characterize offers of organs to candidates awaiting liver transplantation (LT). METHODS: We analyzed data from the United Network for Organ Sharing registry on all US LT candidates with non-fulminant disease who were offered livers from February 1 2005 to January 31, 2010 and ultimately received transplants. We excluded candidates with a final model for end-stage liver disease (MELD) scores <15. Livers were classified as high quality if they were from donors 18–50 years of age who were ≥170 cm tall, of non-black race, suffered brain death secondary to trauma, hepatitis C antibody-negative, not categorized as high risk by the Centers for Disease Control, and locally or regionally located. RESULTS: Of 33,389 candidates for LT, 20% died or were removed from the list and 64% were received LT; the median (interquartile range) number of liver offers for all candidates was 5 (range, 2–12). Of those who died or were removed from the list, 84% received ≥1 liver offer (s). Overall, 55% those who died or were removed from the list, and 57% of those who received LT, received ≥1 offer of a high-quality liver, when they had MELD scores ≥15 (P=.005). However, the proportion of last liver offers of high-quality to patients that underwent LT was twice that of patients that died or were removed from the list (28 vs 14%; P<0.001). Most liver offers (68%) were refused for reasons related to donor quality. CONCLUSIONS: Most candidates for LT who died or were removed from the list received ≥1 offer of a liver beforehand, and 55% received ≥1 offer of a high-quality liver. These findings indicate that a substantial proportion of wait-list mortality results in part from declined, rather than lack of opportunity, for transplantation. Understanding the real-time factors involved in the complex decision to accept a liver offer is vital to reducing wait-list mortality for LT candidates

Extensive Lower Cretaceous (Albian) methane seepage on Ellef Ringnes Island, Canadian High Arctic

During field mapping of Ellef Ringnes Island, Canadian Arctic Archipelago, 139 isolated Lower Cretaceous methane seep deposits were found from 75 field sites. Stable isotopes of the carbonates have values of δ13C= -47‰ to -35‰ and δ18O= -4.0‰ to +0.7‰. Isoprenoids in organics from one of the seeps are significantly depleted in 13C, with the most negative δ13C of = -118 ‰ and -113 ‰ for PMI and phytane/crocetane, respectively. These values indicate an origin through methane oxidation, consistent with biomarkers that are characteristic for anaerobic methanotrophic archaea within the seep deposits, accompanied by terminally-branched fatty acids sourced by sulphate-reducing bacteria, showing similar 13C values (-92‰). The seep deposits contain a moderate diversity macrofaunal assemblage containing ammonites, bivalves, gastropods, scaphopods, ‘vestimentiferan’ worm tubes and brachiopods. The assemblage is dominated numerically by species that probably had chemosymbionts. The seep deposits formed in the subsurface with strong redox zones, in an otherwise normal marine setting, characterised by oxic waters at high paleolatitudes. While geographically widespread, over an area of ~10,000 km2, seep deposits on Ellef Ringnes Island occur in a narrow stratigraphic horizon, suggesting a large release of biogenic methane occurred over a brief period of time. This gas release was coincident with a transition from a cold to warm climate during the latest Early Albian, and we hypothetize that this may relate to gas hydrate release

Environmental change: prospects for conservation and agriculture in a southwest Australia biodiversity hotspot

Accelerating environmental change is perhaps the greatest challenge for natural resource management; successful strategies need to be effective for decades to come. Our objective is to identify opportunities that new environmental conditions may provide for conservation, restoration, and resource use in a globally recognized biodiversity hotspot in southwestern Australia. We describe a variety of changes to key taxonomic groups and system-scale characteristics as a consequence of environmental change (climate and land use), and outline strategies for conserving and restoring important ecological and agricultural characteristics. Opportunities for conservation and economic adaptation are substantial because of gradients in rainfall, temperature, and land use, extensive areas of remnant native vegetation, the ability to reduce and ameliorate areas affected by secondary salinization, and the existence of large national parks and an extensive network of nature reserves. Opportunities presented by the predicted environmental changes encompass agricultural as well as natural ecosystems. These may include expansion of aquaculture, transformation of agricultural systems to adapt to drier autumns and winters, and potential increases in spring and summer rain, carbon-offset plantings, and improving the network of conservation reserves. A central management dilemma is whether restoration/preservation efforts should have a commercial or biodiversity focus, and how they could be integrated. Although the grand challenge is conserving, protecting, restoring, and managing for a future environment, one that balances economic, social, and environmental values, the ultimate goal is to establish a regional culture that values the unique regional environment and balances the utilization of natural resources against protecting remaining natural ecosystems