Ophthalmic Artery Chemosurgery for Less Advanced Intraocular Retinoblastoma: Five Year Review

BACKGROUND: Ophthalmic artery chemosurgery (OAC) for retinoblastoma was introduced by us 5 years ago for advanced intraocular retinoblastoma. Because the success was higher than with existing alternatives and systemic side effects limited we have now treated less advanced intraocular retinoblastoma (Reese-Ellsworth (RE) I-III and International Classification Retinoblastoma (ICRB) B and C). METHODOLOGY/PRINCIPAL FINDINGS: Retrospective review of 5 year experience in eyes with Reese Ellsworth (Table 1) I (7 eyes), II (6 eyes) or III (6 eyes) and/or International Classification (Table 2) B (19 eyes) and C (11 eyes) treated with OAC (melphalan with or without topotecan) introduced directly into the ophthalmic artery. Patient survival was 100%. Ocular event-free survival was 100% for Reese-Ellsworth Groups I, II and III (and 96% for ICRB B and C) at a median of 16 months follow-up. One ICRB Group C (Reese-Ellsworth Vb) eye could not be treated on the second attempt for technical reasons and was therefore enucleated. No patient required a port and only one patient required transfusion of blood products. The electroretinogram (ERG) was unchanged or improved in 14/19 eyes. CONCLUSIONS/SIGNIFICANCE: Ophthalmic artery chemosurgery for retinoblastoma that was Reese-Ellsworth I, II and III (or International Classification B or C) was associated with high success (100% of treatable eyes were retained) and limited toxicity with results that equal or exceed conventional therapy with less toxicity

Maximum likelihood kernel density estimation: On the potential of convolution sieves

Methods for improving the basic kernel density estimator include variable locations, variable bandwidths and variable weights. Typically these methods are implemented separately and via pilot estimation of variation functions derived from asymptotic considerations. The starting point here is a simple maximum likelihood procedure which allows (in its greatest generality) variation of all these quantities at once, bypassing asymptotics and explicit pilot estimation. One special case of this approach is the density estimator associated with nonparametric maximum likelihood estimation (NPMLE) in a normal location mixture model. Another, closely associated with the NPMLE, is a kernel convolution sieve estimator proposed in 1982 but little used in practice to date. Simple algorithms are utilised, a simulation study is reported on, a method for bandwidth selection is investigated and an illustrative example is given. The simulations and other considerations suggest that the kernel convolution sieve provides an especially promising framework for further practical utilisation and development. And the method has a further advantage: it automatically reduces, where appropriate, to a few-component mixture model which indicates and initialises parametric mixture modelling of the data

Evaluation Research and Institutional Pressures: Challenges in Public-Nonprofit Contracting

This article examines the connection between program evaluation research and decision-making by public managers. Drawing on neo-institutional theory, a framework is presented for diagnosing the pressures and conditions that lead alternatively toward or away the rational use of evaluation research. Three cases of public-nonprofit contracting for the delivery of major programs are presented to clarify the way coercive, mimetic, and normative pressures interfere with a sound connection being made between research and implementation. The article concludes by considering how public managers can respond to the isomorphic pressures in their environment that make it hard to act on data relating to program performance.This publication is Hauser Center Working Paper No. 23. The Hauser Center Working Paper Series was launched during the summer of 2000. The Series enables the Hauser Center to share with a broad audience important works-in-progress written by Hauser Center scholars and researchers

Continuous-mode 448 kHz capacitive resistive monopolar radiofrequency induces greater deep blood flow changes compared to pulsed mode shortwave: a crossover study in healthy adults

This document is the Accepted Manuscript version of the following article: Binoy Kumaran, Anthony Herbland and Tim Watson, ‘Continuous-mode 448 kHz capacitive resistive monopolar radiofrequency induces greater deep blood flow changes compared to pulsed mode shortwave: a crossover study in healthy adults’, European Journal of Physiotheraphy, first published online 20 April 2017. The version of record is available online at doi: http://dx.doi.org/10.1080/21679169.2017.1316310. © 2017 Informa UK Limited, trading as Taylor & Francis Group.Aims: Radiofrequency-based electrophysical agents (EPAs) have been used in therapy practice over several decades (e.g. shortwave therapies). Currently, there is insufficient evidence supporting such EPAs operating below shortwave frequencies. This laboratory-based study investigated the deep physiological effects of 448 kHz capacitive resistive monopolar radiofrequency (CRMRF) and compared them to pulsed shortwave therapy (PSWT). Methods: In a randomized crossover study, 17 healthy volunteers initially received four treatment conditions: high, low and placebo dose conditions receiving 15-min CRMRF treatment and a control condition receiving no intervention. Fifteen participants additionally received high-dose PSWT as fifth condition, for comparison. Pre- and post-treatment measurements of deep blood flow and tissue extensibility were obtained using Doppler ultrasound and sonoelastography. Group data were compared using analysis of variance model. Statistical significance was set at p ≤ .05, 0.8 power, and 95% confidence interval. Results: Significant increases in volume and intensity of deep blood flow were obtained with CRMRF over placebo, control (p = .003) and PSWT (p < .001). No significant changes in blood flow velocity or tissue extensibility were noted for any condition. Conclusions: Deep blood flow changes with CRMRF were more pronounced than that with PSWT, placebo or control. Potential greater therapeutic benefits need to be confirmed with comparative clinical studies.Peer reviewe

Discovery and Follow-up Observations of the Young Type Ia Supernova 2016coj

The Type~Ia supernova (SN~Ia) 2016coj in NGC 4125 (redshift $z=0.004523$) was discovered by the Lick Observatory Supernova Search 4.9 days after the fitted first-light time (FFLT; 11.1 days before $B$-band maximum). Our first detection (pre-discovery) is merely $0.6\pm0.5$ day after the FFLT, making SN 2016coj one of the earliest known detections of a SN Ia. A spectrum was taken only 3.7 hr after discovery (5.0 days after the FFLT) and classified as a normal SN Ia. We performed high-quality photometry, low- and high-resolution spectroscopy, and spectropolarimetry, finding that SN 2016coj is a spectroscopically normal SN Ia, but with a high velocity of \ion{Si}{2} $\lambda$6355 ($\sim 12,600$\,\kms\ around peak brightness). The \ion{Si}{2} $\lambda$6355 velocity evolution can be well fit by a broken-power-law function for up to a month after the FFLT. SN 2016coj has a normal peak luminosity ($M_B \approx -18.9 \pm 0.2$ mag), and it reaches a $B$-band maximum \about16.0~d after the FFLT. We estimate there to be low host-galaxy extinction based on the absence of Na~I~D absorption lines in our low- and high-resolution spectra. The spectropolarimetric data exhibit weak polarization in the continuum, but the \ion{Si}{2} line polarization is quite strong ($\sim 0.9\% \pm 0.1\%$) at peak brightness.Comment: Submitte

Sampling of cereals and cereal-based foods for the determination of ochratoxin A: an overview

The mycotoxin ochratoxin A (OTA) is known to be heterogeneously distributed both intrinsically (from one individual food item to the next) as well as distributionally (throughout a sample of individual food items) in cereals and cereal-based foods. Therefore, proper sampling and sample comminution are special challenges, but are prerequisites for obtaining sound analytical data. This paper outlines the issue of the sampling process for cereals and cereal-based foods, starting with the planning phase, followed by the sampling step itself and the formation of analytical samples. The sampling of whole grain and retail-level cereal-based foods will be discussed. Furthermore, possibilities to reduce sampling variance are presented

No control, no drive: How noise may undermine conservation behavior in a commons dilemma

Sometimes people may no longer engage in conservational behavior (e.g., to reduce emissions) because their attempts to do so have been thwarted by "negative noise ", or external forces that may cause otherwise cooperative intentions to translate into non-cooperative action (e.g., strikes prevented to commute by public transport rather than by car). The purpose of the present research is to examine whether experiences with negative noise in a commons dilemma may undermine conservational motivation and behavior, even in a subsequent commons dilemma that is free of noise. Participants first interacted in a commons dilemma task-with noise versus without noise-in which the common pool was sustained versus deteriorating. Afterwards, participants were involved in an identical second task in the same pool size condition but noise-free for everybody. Consistent with hypotheses, participants who faced noise and a deteriorating resource in the first task exhibited lower levels of conservation in the second task than did participants who were always acting free of noise. This pattern was mediated by a reduced motivation to preserve the common pool, suggesting that the experience of noise in combination with a decline in collective resources may especially undermine cooperative motivation and behavior. Copyright © 2007 John Wiley & Sons, Ltd

Lifecourse socioeconomic status and type 2 diabetes: the role of chronic inflammation in the English Longitudinal Study of Ageing

We examined the association between lifecourse socioeconomic status (SES) and the risk of type 2 diabetes at older ages, ascertaining the extent to which adult lifestyle factors and systemic inflammation explain this relationship. Data were drawn from the English Longitudinal Study of Ageing (ELSA) which, established in 2002, is a representative cohort study of ?50-year olds individuals living in England. SES indicators were paternal social class, participants? education, participants? wealth, and a lifecourse socioeconomic index. Inflammatory markers (C-reactive protein and fibrinogen) and lifestyle factors were measured repeatedly; diabetes incidence (new cases) was monitored over 7.5 years of follow-up. Of the 6218 individuals free from diabetes at baseline (44% women, mean aged 66 years), 423 developed diabetes during follow-up. Relative to the most advantaged people, those in the lowest lifecourse SES group experienced more than double the risk of diabetes (hazard ratio 2.59; 95% Confidence Interval (CI)?=?1.81?3.71). Lifestyle factors explained 52% (95%CI:30?85) and inflammatory markers 22% (95%CI:13?37) of this gradient. Similar results were apparent with the separate SES indicators. In a general population sample, socioeconomic inequalities in the risk of type 2 diabetes extend to older ages and appear to partially originate from socioeconomic variations in modifiable factors which include lifestyle and inflammation