55 research outputs found

    Recommendations for gonadotoxicity surveillance in male childhood, adolescent, and young adult cancer survivors : a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium

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    Treatment with chemotherapy, radiotherapy, or surgery that involves reproductive organs can cause impaired spermatogenesis, testosterone deficiency, and physical sexual dysfunction in male pubertal, adolescent, and young adult cancer survivors. Guidelines for surveillance and management of potential adverse effects could improve cancer survivors' health and quality of life. Surveillance recommendations vary considerably, causing uncertainty about optimum screening practices. This clinical practice guideline recommended by the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium, developed using evidence-based methodology, critically synthesises surveillance recommendations for gonadotoxicity in male childhood, adolescent, and young adult (CAYA) cancer survivors. The recommendations were developed by an international multidisciplinary panel including 25 experts in relevant medical specialties, using a consistent and transparent process. Recommendations were graded according to the strength of underlying evidence and potential benefit gained by early detection and appropriate management. The aim of the recommendations is to enhance evidence-based care for male CAYA cancer survivors. The guidelines reveal the paucity of high-quality evidence, highlighting the need for further targeted research.Peer reviewe

    Fertility preservation for male patients with childhood, adolescent, and young adult cancer:recommendations from the PanCareLIFE Consortium and the International Late Effects of Childhood Cancer Guideline Harmonization Group

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    Item does not contain fulltextMale patients with childhood, adolescent, and young adult cancer are at an increased risk for infertility if their treatment adversely affects reproductive organ function. Future fertility is a primary concern of patients and their families. Variations in clinical practice are barriers to the timely implementation of interventions that preserve fertility. As part of the PanCareLIFE Consortium, in collaboration with the International Late Effects of Childhood Cancer Guideline Harmonization Group, we reviewed the current literature and developed a clinical practice guideline for fertility preservation in male patients who are diagnosed with childhood, adolescent, and young adult cancer at age 25 years or younger, including guidance on risk assessment and available methods for fertility preservation. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to grade the available evidence and to form the recommendations. Recognising the need for global consensus, this clinical practice guideline used existing evidence and international expertise to rigorously develop transparent recommendations that are easy to use to facilitate the care of male patients with childhood, adolescent, and young adult cancer who are at high risk of fertility impairment and to enhance their quality of life

    Fertility preservation in children, adolescents, and young adults with cancer:Quality of clinical practice guidelines and variations in recommendations

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    BACKGROUNDFertility preservation care for children, adolescents, and young adults (CAYAs) with cancer is not uniform among practitioners. To ensure high-quality care, evidence-based clinical practice guidelines (CPGs) are essential. The authors identified existing CPGs for fertility preservation in CAYAs with cancer, evaluated their quality, and explored differences in recommendations. METHODSA systematic search in PubMed (January 2000-October 2014); guideline databases; and Web sites of oncology, pediatric, and fertility organizations was performed. Two reviewers evaluated the quality of the identified CPGs using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II). From high-quality CPGs, the authors evaluated concordant and discordant areas among the recommendations. RESULTSA total of 25 CPGs regarding fertility preservation were identified. The average AGREE II domain scores (scale of 0%-100%) varied from 15% on applicability to 100% on clarity of presentation. The authors considered 8 CPGs (32%) to be of high quality, which was defined as scores 60% in any 4 domains. Large variations in the recommendations of the high-quality CPGs were observed, with 87.2% and 88.6%, respectively, of discordant guideline areas among the fertility preservation recommendations for female and male patients with cancer. CONCLUSIONSOnly approximately one-third of the identified CPGs were found to be of sufficient quality. Of these CPGs, the fertility preservation recommendations varied substantially, which can be a reflection of inadequate evidence for specific recommendations, thereby hindering the ability of providers to deliver high-quality care. CPGs including a transparent decision process for fertility preservation can help health care providers to deliver optimal and uniform care, thus improving the quality of life of CAYAs with cancer and cancer survivors. Cancer 2016;122:2216-23. (c) 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Only approximately one-third of the identified clinical practice guidelines for fertility preservation in children, adolescents, and young adults with cancer were found to be of sufficient quality, and among these, the recommendations varied substantially. This finding supports the need for well-developed and transparent harmonized clinical practice guidelines for children and young adults diagnosed with cancer who are at risk of fertility impairment

    Fertility preservation for female patients with childhood, adolescent, and young adult cancer:recommendations from the PanCareLIFE Consortium and the International Late Effects of Childhood Cancer Guideline Harmonization Group

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    Female patients with childhood, adolescent, and young adult cancer are at increased risk for fertility impairment when treatment adversely affects the function of reproductive organs. Patients and their families desire biological children but substantial variations in clinical practice guidelines reduce consistent and timely implementation of effective interventions for fertility preservation across institutions. As part of the PanCareLIFE Consortium, and in collaboration with the International Late Effects of Childhood Cancer Guideline Harmonization Group, we reviewed the current literature and developed a clinical practice guideline for fertility preservation in female patients who were diagnosed with childhood, adolescent, and young adult cancer at age 25 years or younger, including guidance on risk assessment and available methods for fertility preservation. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to grade the available evidence and to form the recommendations. This clinical practice guideline leverages existing evidence and international expertise to develop transparent recommendations that are easy to use to facilitate the care of female patients with childhood, adolescent, and young adult cancer who are at high risk for fertility impairment. A complete review of the existing evidence, including a quality assessment, transparent reporting of the guideline panel's decisions, and achievement of global interdisciplinary consensus, is an important result of this intensive collaboration.info:eu-repo/semantics/publishe

    Linking Symptom Inventories using Semantic Textual Similarity

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    An extensive library of symptom inventories has been developed over time to measure clinical symptoms, but this variety has led to several long standing issues. Most notably, results drawn from different settings and studies are not comparable, which limits reproducibility. Here, we present an artificial intelligence (AI) approach using semantic textual similarity (STS) to link symptoms and scores across previously incongruous symptom inventories. We tested the ability of four pre-trained STS models to screen thousands of symptom description pairs for related content - a challenging task typically requiring expert panels. Models were tasked to predict symptom severity across four different inventories for 6,607 participants drawn from 16 international data sources. The STS approach achieved 74.8% accuracy across five tasks, outperforming other models tested. This work suggests that incorporating contextual, semantic information can assist expert decision-making processes, yielding gains for both general and disease-specific clinical assessment

    The RESOLVE Survey Atomic Gas Census and Environmental Influences on Galaxy Gas Reservoirs

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    We present the H i mass inventory for the REsolved Spectroscopy Of a Local VolumE (RESOLVE) survey, a volume-limited, multi-wavelength census of >1500 z = 0 galaxies spanning diverse environments and complete in baryonic mass down to dwarfs of ~109 M{M}_{\odot }. This first 21 cm data release provides robust detections or strong upper limits (1.4M H i 1012 M{M}_{\odot }) halos, suggesting that gas stripping and/or starvation may be induced by interactions with larger halos or the surrounding cosmic web. We find that the detailed relationship between G/S and environment varies when we examine different subvolumes of RESOLVE independently, which we suggest may be a signature of assembly bias

    The multiplicity dependence of inclusive ptp_t spectra from p-p collisions at s\sqrt{s} = 200 GeV

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    We report measurements of transverse momentum ptp_t spectra for ten event multiplicity classes of p-p collisions at s=200\sqrt{s} = 200 GeV. By analyzing the multiplicity dependence we find that the spectrum shape can be decomposed into a part with amplitude proportional to multiplicity and described by a L\'evy distribution on transverse mass mtm_t, and a part with amplitude proportional to multiplicity squared and described by a gaussian distribution on transverse rapidity yty_t. The functional forms of the two parts are nearly independent of event multiplicity. The two parts can be identified with the soft and hard components of a two-component model of p-p collisions. This analysis then provides the first isolation of the hard component of the ptp_t spectrum as a distribution of simple form on yty_t.Comment: 17 pages, 10 figure

    ZFIRE: Similar Stellar Growth in Hα-emitting Cluster and Field Galaxies at z ~ 2

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    We compare galaxy scaling relations as a function of environment at z2z\sim2 with our ZFIRE survey where we have measured Hα\alpha fluxes for 90 star-forming galaxies selected from a mass-limited [log(M/M)>9\log(M_{\star}/M_{\odot})>9] sample based on ZFOURGE. The cluster galaxies (37) are part of a confirmed system at z=2.095 and the field galaxies (53) are at 1.9<z<2.41.9<z<2.4; all are in the COSMOS legacy field. There is no statistical difference between Hα\alpha-emitting cluster and field populations when comparing their star formation rate (SFR), stellar mass (MM_{\star}), galaxy size (reffr_{eff}), SFR surface density [Σ\Sigma(Hαstar\alpha_{star})], and stellar age distributions. The only difference is that at fixed stellar mass, the Hα\alpha-emitting cluster galaxies are log(reff)0.1\log(r_{eff})\sim0.1 larger than in the field. Approximately 19% of the Hα\alpha-emitters in the cluster and 26% in the field are IR-luminous (LIR>2×1011LL_{IR}>2\times10^{11} L_{\odot}). Because the LIRGs in our combined sample are 5\sim5 times more massive than the low-IR galaxies, their radii are 70\sim70% larger. To track stellar growth, we separate galaxies into those that lie above, on, and below the Hα\alpha star-forming main sequence (SFMS) using Δ\DeltaSFR(M)=±0.2(M_{\star})=\pm0.2 dex. Galaxies above the SFMS (starbursts) tend to have higher Hα\alpha SFR surface densities and younger light-weighted stellar ages compared to galaxies below the SFMS. Our results indicate that starbursts (+SFMS) in the cluster and field at z2z\sim2 are growing their stellar cores. Lastly, we compare to the (SFR-MM_{\star}) relation from RHAPSODY cluster simulations and find the predicted slope is nominally consistent with the observations. However, the predicted cluster SFRs tend to be too low by a factor of 2\sim2 which seems to be a common problem for simulations across environment.Comment: ApJ in press; full version of Table 1 available from ApJ and upon request. Survey websites are http://zfire.swinburne.edu.au and http://zfourge.tamu.ed

    Using structural MRI to identify bipolar disorders - 13 site machine learning study in 3020 individuals from the ENIGMA Bipolar Disorders Working Group

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    Bipolar disorders (BDs) are among the leading causes of morbidity and disability. Objective biological markers, such as those based on brain imaging, could aid in clinical management of BD. Machine learning (ML) brings neuroimaging analyses to individual subject level and may potentially allow for their diagnostic use. However, fair and optimal application of ML requires large, multi-site datasets. We applied ML (support vector machines) to MRI data (regional cortical thickness, surface area, subcortical volumes) from 853 BD and 2167 control participants from 13 cohorts in the ENIGMA consortium. We attempted to differentiate BD from control participants, investigated different data handling strategies and studied the neuroimaging/clinical features most important for classification. Individual site accuracies ranged from 45.23% to 81.07%. Aggregate subject-level analyses yielded the highest accuracy (65.23%, 95% CI = 63.47–67.00, ROC-AUC = 71.49%, 95% CI = 69.39–73.59), followed by leave-one-site-out cross-validation (accuracy = 58.67%, 95% CI = 56.70–60.63). Meta-analysis of individual site accuracies did not provide above chance results. There was substantial agreement between the regions that contributed to identification of BD participants in the best performing site and in the aggregate dataset (Cohen’s Kappa = 0.83, 95% CI = 0.829–0.831). Treatment with anticonvulsants and age were associated with greater odds of correct classification. Although short of the 80% clinically relevant accuracy threshold, the results are promising and provide a fair and realistic estimate of classification performance, which can be achieved in a large, ecologically valid, multi-site sample of BD participants based on regional neurostructural measures. Furthermore, the significant classification in different samples was based on plausible and similar neuroanatomical features. Future multi-site studies should move towards sharing of raw/voxelwise neuroimaging data
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