Normalized measures and patient characteristics to identify undernutrition in infants and young children treated for cancer

Background: Various measures and definitions for undernutrition are used in pediatrics. Younger children treated for cancer are at high risk, but lack well-defined risk-based screening and intervention. Methods: A retrospective study collected weight longitudinally for patients less than three years-old over two years after initiating cancer treatment. We included those diagnosed 2007-2015 at a large pediatric cancer center. Exclusion criteria included treatment starting outside our system, secondary or relapsed malignancy, or incomplete information. A decrease ≥1 in weight-for-age or weight-for-height z-score signified clinically significant weight loss. Univariate and multivariate models assessed hazards for developing first episode of clinically significant weight loss. Results: Of 372 patients, only 24.6% of patients lost 10% of weight, but 58.6% lost weight-for-age z-score ≥1 and 64.8% lost ≥1 weight-for-height z-score within two years of treatment initiation. Patients who lost weight were younger (median age 15 vs. 24 months, p < 0.001). Compared to patients diagnosed in the first year of life, those diagnosed 24-35 months were less likely to lose weight (HR 0.62, p < 0.001) and lost weight later (median time to weight loss 144 vs. 35 days). Higher treatment intensity increased weight loss risk (HR 2.30, p < 0.001) and decreased time to weight loss (35 vs. 154 days). No differences were found based on sex, diagnosis, enteral or parenteral nutrition, gastroenterology consults, or intensive care admissions. Conclusions: Using normalized z-scores is more sensitive for identifying weight loss. Younger children are more likely to lose weight with higher intensity cancer therapy. Patient and treatment specific information should be used in risk stratifying weight loss screening and nutritional interventions

The JWST Resolved Stellar Populations Early Release Science Program. II. Survey Overview

We present the JWST Resolved Stellar Populations Early Release Science (ERS) program. We obtained 27.5 hr of NIRCam and NIRISS imaging of three targets in the Local Group (Milky Way globular cluster M92, ultrafaint dwarf galaxy Draco II, and star-forming dwarf galaxy WLM), which span factors of similar to 10(5) in luminosity, similar to 10(4) in distance, and similar to 10(5) in surface brightness. We describe the survey strategy, scientific and technical goals, implementation details, present select NIRCam color-magnitude diagrams (CMDs), and validate the NIRCam exposure time calculator (ETC). Our CMDs are among the deepest in existence for each class of target. They touch the theoretical hydrogen-burning limit in M92 (&lt;0.08 M-circle dot; M-F090W similar to +13.6), include the lowest-mass stars observed outside the Milky Way in Draco II (0.09M(circle dot); M-F090W similar to +12.1), and reach similar to 1.5 mag below the oldest main-sequence turnoff in WLM (M-F090W similar to +4.6). The PARSEC stellar models provide a good qualitative match to the NIRCam CMDs, though they are similar to 0.05 mag too blue compared to M92 F090W - F150W data. Our CMDs show detector-dependent color offsets ranging from similar to 0.02 mag in F090W - F150W to similar to 0.1 mag in F277W - F444W; these appear to be due to differences in the zero-point calibrations among the detectors. The NIRCam ETC (v2.0) matches the signal-to-noise ratios based on photon noise in uncrowded fields, but the ETC may not be accurate in more crowded fields, similar to what is known for the Hubble Space Telescope. We release the point-source photometry package DOLPHOT, optimized for NIRCam and NIRISS, for the community

When is a family a family? Evidence from survey data and implications for family policy

This article examines the correspondence between common assumptions about the American family and actual patterns. The assessment is based on national data on individuals, households, and families. Findings indicate that the coresident nuclear model should be considered a model rather than the model of family. Past as well as current marital ties need to be considered in defining “family,” and divorce rather than death should be the expected cause of losing the main breadwinner in the family, except among elderly women. Parent-child ties to either young or adult children often span separate households. Coresidents can include individuals other than nuclear family members, and change rather than stability is the modal pattern in living arrangements. Rather than shaping concepts of the family from a single mold, policy makers and researchers are better advised to recognize the diversity and fluidity in family and household structures.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44653/1/10834_2006_Article_BF02353666.pd

Verapamil Restoration of Daunorubicin Responsiveness in Daunorubicin-resistant Ehrlich Ascites Carcinoma

We have studied the influence of verapamil hydrochloride on the in vitro and in vivo effects of daunorubicin in Ehrlich ascites carcinoma. Daunorubicin-sensitive tumor was rendered resistant to daunorubicin by the continuous treatment of sequential generations of tumor-bearing BALB/c mice. The ability of daunorubicin to inhibit [(3)H]uridine and [(3)H]thymidine incorporation and the effect of daunorubicin on the mean survival time of host animals bearing daunorubicin-sensitive and daunorubicin-resistant Ehrlich ascites carcinoma were compared. The addition of verapamil to daunorubicin in vitro reduced the concentration of daunorubicin required to inhibit 50% of DNA and RNA synthesis in the daunorubicin-resistant tumor to that required in the daunorubicin-sensitive tumor, from 6 and 4.4 μg/ml to 1.5 and 1.3 μg/ml, respectively. Verapamil also restored drug sensitivity to daunorubicin-resistant Ehrlich ascites carcinoma in vivo. The 21.7±0.7 d mean survival time (MST) of BALB/c mice bearing daunorubicin-resistant tumor treated with daunorubicin alone rose to 44.0±0.7 d when the same tumor was treated with verapamil and daunorubicin, P < 0.001. This in vivo effect is specific for daunorubicin-resistant Ehrlich ascites carcinoma, since there is no alteration in MST of BALB/c mice bearing daunorubicin-sensitive or daunorubicin-resistant tumor when they are treated with verapamil alone or when BALB/c mice bearing daunorubicin-sensitive tumor are treated with daunorubicin and verapamil

Words and Images with a Message

Wetzel considers the impact of language in works by nine women artist. Statements by the artists. Biographical notes. 2 bibl. ref

Normalized measures and patient characteristics to identify undernutrition in infants and young children treated for cancer

Background: Various measures and definitions for undernutrition are used in pediatrics. Younger children treated for cancer are at high risk, but lack well-defined risk-based screening and intervention. Methods: A retrospective study collected weight longitudinally for patients less than three years-old over two years after initiating cancer treatment. We included those diagnosed 2007-2015 at a large pediatric cancer center. Exclusion criteria included treatment starting outside our system, secondary or relapsed malignancy, or incomplete information. A decrease ≥1 in weight-for-age or weight-for-height z-score signified clinically significant weight loss. Univariate and multivariate models assessed hazards for developing first episode of clinically significant weight loss. Results: Of 372 patients, only 24.6% of patients lost 10% of weight, but 58.6% lost weight-for-age z-score ≥1 and 64.8% lost ≥1 weight-for-height z-score within two years of treatment initiation. Patients who lost weight were younger (median age 15 vs. 24 months, p < 0.001). Compared to patients diagnosed in the first year of life, those diagnosed 24-35 months were less likely to lose weight (HR 0.62, p < 0.001) and lost weight later (median time to weight loss 144 vs. 35 days). Higher treatment intensity increased weight loss risk (HR 2.30, p < 0.001) and decreased time to weight loss (35 vs. 154 days). No differences were found based on sex, diagnosis, enteral or parenteral nutrition, gastroenterology consults, or intensive care admissions. Conclusions: Using normalized z-scores is more sensitive for identifying weight loss. Younger children are more likely to lose weight with higher intensity cancer therapy. Patient and treatment specific information should be used in risk stratifying weight loss screening and nutritional interventions