Stereotactic body radiation therapy (SBRT) of adrenal gland metastases in oligometastatic and oligoprogressive disease

BACKGROUND: Stereotactic body radiation therapy (SBRT) as a form of noninvasive treatment that is becoming increasingly used to manage cancers with adrenal gland metastases. There is a paucity of data on safety and efficacy of this modality. The aim of the study was to evaluate the safety and efficacy of adrenal gland SBRT in oligometastatic and oligoprogressive disease. MATERIALS AND METHODS: In this retrospective study, we performed a single-institution analysis of 26 adrenal lesions from 23 patients with oligometastatic or oligoprogressive disease treated from 2013 to 2019 with the goal of achieving durable local control. Palliative cases were excluded. Radiation dosimetry data was collected. Kaplan Meier product estimator and Cox proportional hazards regression analysis were used for statistical analysis. RESULTS: The median dose was 36 Gy in 3 fractions (range: 24–50 Gy and 3–6 fractions) with a median biologically effective dose (BED10) of 72 (range: 40–100). 1-year local control rate was 80% and median local control was not achieved due to a low number of failures. 1- and 2-year overall survival rates were 66% and 32%. Toxicity was mild with only one case of grade 2 nausea and no grade 3–5 toxicity. Higher neutrophil to lymphocyte ratio was associated with worse overall survival and a trend toward worse progression-free survival. In addition, worse performance status and lower BED10 were associated with worse survival. No such association could be shown for primary tumor location, histology, size or stage. CONCLUSION: Adrenal SBRT for oligometastatic or oligoprogressive disease is a safe and effective form of treatment

Low-Tech Riparian and Wet Meadow Restoration Increases Vegetation Productivity and Resilience Across Semiarid Rangelands

Restoration of riparian and wet meadow ecosystems in semiarid rangelands of the western United States is a high priority given their ecological and hydrological importance in the region. However, traditional restoration approaches are often intensive and costly, limiting the extent over which they can be applied. Practitioners are increasingly trying new restoration techniques that are more cost‐effective, less intensive, and can more practically scale up to the scope of degradation. Unfortunately, practitioners typically lack resources to undertake outcome‐based evaluations necessary to judge the efficacy of these techniques. In this study, we use freely available, satellite remote sensing to explore changes in vegetation productivity (normalized difference vegetation index) of three distinct, low‐tech, riparian and wet meadow restoration projects. Case studies are presented that range in geographic location (Colorado, Oregon, and Nevada), restoration practice (Zeedyk structures, beaver dam analogs, and grazing management), and time since implementation. Restoration practices resulted in increased vegetation productivity of up to 25% and increased annual persistence of productive vegetation. Improvements in productivity with time since restoration suggest that elevated resilience may further enhance wildlife habitat and increase forage production. Long‐term, documented outcomes of conservation are rare; we hope our findings empower practitioners to further monitor and explore the use of low‐tech methods for restoration of ecohydrologic processes at meaningful spatial scales

Rainwater Harvesting Systems in Urban Areas and the Potential Value of Incorporating Community Engagement

Rainwater harvesting (RWH) is a water catchment technique used in urban areas globally. RWH has a deep history rooted in indigenous practices and has recently become more accepted in urban areas. The quality and quantity of harvested water depends both on the geographical location of the system with respect to nearby land-use, seasonality, and rainfall intensity, as well as the material of the catchment surface. The economic viability of RWH systems is dependent on initial expenses, operation and maintenance costs, and water fees. Furthermore, government subsidies and clear, concise policy may improve water tank installation, usage, and maintenance. Policy may also help the general public install and use RWH systems through the promotion of education that improves RWH-specific knowledge. While community engagement (CE), stakeholder participation, and increased community knowledge of RWH may potentially yield increases in system use and sustainability, there is a general paucity of this research in peer-reviewed literature. Future studies should explore community engagement within the context of rainwater harvesting systems in urban areas

Associations of hemoglobin A1c with cognition reduced for long diabetes duration

IntroductionAssociations of some risk factors with poor cognition, identified prior to age 75, are reduced or reversed in very old age. The Protected Survivor Model predicts this interaction due to enhanced survival of those with extended risk factor duration. In a younger sample, this study examines the association of cognition with the mean hemoglobin A1c risk factor over the time at risk, according to its duration.MethodsThe interaction of mean hemoglobin A1c (averageâ =â 9.8%), evaluated over duration (averageâ =â 116.8â months), was examined for overall cognition and three cognitive domains in a sample of 150 â youngâ oldâ veterans (mean ageâ =â 70) with type 2 diabetes.ResultsThe predicted interactions were significant for overall cognition and attention, but not executive functions/language and memory.DiscussionFindings extend the Protected Survivor Model to a â youngâ oldâ sample, from the very old. This model suggests focusing on individuals with good cognition despite prolonged high risk when seeking protective factors.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152553/1/trc2jtrci201911009.pd

DNA Hypomethylation, Ambient Particulate Matter, and Increased Blood Pressure: Findings From Controlled Human Exposure Experiments

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144592/1/jah3232.pd

The non-thermal superbubble in IC 10 : the generation of cosmic ray electrons caught in the act

Superbubbles are crucial for stellar feedback, with supposedly high (of the order of 10 per cent) thermalization rates. We combined multiband radio continuum observations from the Very Large Array (VLA) with Effelsberg data to study the non-thermal superbubble (NSB) in IC 10, a starburst dwarf irregular galaxy in the Local Group. Thermal emission was subtracted using a combination of Balmer Hα and VLA 32 GHz continuum maps. The bubble’s nonthermal spectrum between 1.5 and 8.8 GHz displays curvature and can be well fitted with a standard model of an ageing cosmic ray electron population. With a derived equipartition magnetic field strength of 44 ±8 μG, and measuring the radiation energy density from Spitzer MIPS maps as 5±1×10−11 erg cm−3, we determine, based on the spectral curvature, a spectral age of the bubble of 1.0 ± 0.3 Myr. Analysis of the LITTLE THINGS HI data cube shows an expanding HI hole with 100 pc diameter and a dynamical age of 3.8 ± 0.3 Myr, centred to within 16 pc on IC 10 X-1, a massive stellar mass black hole (M > 23 M⊙). The results are consistent with the expected evolution for a superbubble with a few massive stars, where a very energetic event like a Type Ic supernova/hypernova has taken place about 1 Myr ago. We discuss alternatives to this interpretationPeer reviewe

Multiplex ligation-dependent probe amplification for genetic screening in autism spectrum disorders: Efficient identification of known microduplications and identification of a novel microduplication in ASMT

<p>Abstract</p> <p>Background</p> <p>It has previously been shown that specific microdeletions and microduplications, many of which also associated with cognitive impairment (CI), can present with autism spectrum disorders (ASDs). Multiplex ligation-dependent probe amplification (MLPA) represents an efficient method to screen for such recurrent microdeletions and microduplications.</p> <p>Methods</p> <p>In the current study, a total of 279 unrelated subjects ascertained for ASDs were screened for genomic disorders associated with CI using MLPA. Fluorescence in situ hybridization (FISH), quantitative polymerase chain reaction (Q-PCR) and/or direct DNA sequencing were used to validate potential microdeletions and microduplications. Methylation-sensitive MLPA was used to characterize individuals with duplications in the Prader-Willi/Angelman (PWA) region.</p> <p>Results</p> <p>MLPA showed two subjects with typical ASD-associated interstitial duplications of the 15q11-q13 PWA region of maternal origin. Two additional subjects showed smaller, <it>de novo </it>duplications of the PWA region that had not been previously characterized. Genes in these two novel duplications include <it>GABRB3 </it>and <it>ATP10A </it>in one case, and <it>MKRN3</it>, <it>MAGEL2 </it>and <it>NDN </it>in the other. In addition, two subjects showed duplications of the 22q11/DiGeorge syndrome region. One individual was found to carry a 12 kb deletion in one copy of the <it>ASPA </it>gene on 17p13, which when mutated in both alleles leads to Canavan disease. Two subjects showed partial duplication of the <it>TM4SF2 </it>gene on Xp11.4, previously implicated in X-linked non-specific mental retardation, but in our subsequent analyses such variants were also found in controls. A partial duplication in the <it>ASMT </it>gene, located in the pseudoautosomal region 1 (PAR1) of the sex chromosomes and previously suggested to be involved in ASD susceptibility, was observed in 6–7% of the cases but in only 2% of controls (P = 0.003).</p> <p>Conclusion</p> <p>MLPA proves to be an efficient method to screen for chromosomal abnormalities. We identified duplications in 15q11-q13 and in 22q11, including new <it>de novo </it>small duplications, as likely contributing to ASD in the current sample by increasing liability and/or exacerbating symptoms. Our data indicate that duplications in <it>TM4SF2</it> are not associated with the phenotype given their presence in controls. The results in PAR1/PAR2 are the first large-scale studies of gene dosage in these regions, and the findings at the <it>ASMT </it>locus indicate that further studies of the duplication of the <it>ASMT </it>gene are needed in order to gain insight into its potential involvement in ASD. Our studies also identify some limitations of MLPA, where single base changes in probe binding sequences alter results. In summary, our studies indicate that MLPA, with a focus on accepted medical genetic conditions, may be an inexpensive method for detection of microdeletions and microduplications in ASD patients for purposes of genetic counselling if MLPA-identified deletions are validated by additional methods.</p

Performance of the test Mini-Mental State Examination y elderly without cognitive impairment

Objetivo: Establecer datos normativos de la prueba MMSE estratificada por edad y escolaridad en personas adultas mayores costarricenses sin deterioro cognitivo, identificar los ítems que presentan mayor dificultad en relación con esas dos variables y brindar recomendaciones desde la gerontología de evaluación e interpretación. Metodología: Se estudió las puntuaciones del MMSE de 649 sujetos entre 60 y 108 años con una calificación global de 0 en la escala de clasificación de demencia. Resultados: se creó una tabla por edad y escolaridad con datos normativos. Los ítems que presentan mayor dificultad en relación con la edad son: escritura, construcción visoespacial, orientación; en cuanto a la escolaridad son construcción visoespacial, escritura y atención. Conclusiones: se considera el primer reporte sobre datos normativos de MMSE, se propone alternativas sobre los ajustes durante la aplicación, se brinda recomendaciones para guiar un mejor tamizaje de la función cognitiva y se proponen elementos de comparaciónObjective: to establish the normative data of the test stratified by age and scholarship in Costa Ricans elderly adults without cognitive impairment, in the MMSE test, identify the items associated in relation to these two variables and provide recommendations from gerontology of evaluation and interpretation. Methodology: It is studied the MMSE results of 649 subjects between 60 and 108 years with a global score of 0 on the Dementia Classification Scale. Results: we created a table with normative data, by age and schooling. The items that are presented with greater frequency present in relation to age: writing, visual-spatial construction, orientation, while with schooling they are: visual-spatial construction, writing and attention. Conclusions: the first report on the normative data of the MMSE is considered, the alternatives on the adjustments for the effects of the application are proposed, a recommendation is offered for a better screening of the cognitive function and the elements of comparison has given.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigación en Biología Celular y Molecular (CIBCM)UCR::Vicerrectoría de Investigación::Sistema de Estudios de Posgrado::Ciencias Sociales::Maestría Profesional en Psicología Clínica y de la Salu