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60 vs. 3.81, P= 0.04). Boys had significantly lower scores for individual risk association compared to girls (3.93 vs. 4.29, P= 0.01). Overall CHIP-CE scores were lower than those of comparable populations in the West, while at the same time protective factors were documented.
Understanding child wellbeing in the Pacific is critical for strengthening protective factors known to mitigate poor child health outcomes. Continuing to base global child health success on child survival alone misses opportunities for improving the wellbeing of nations.
Understanding child wellbeing in the Pacific is critical for strengthening protective factors known to mitigate poor child health outcomes. Continuing to base global child health success on child survival alone misses opportunities for improving the wellbeing of nations.Chlorpyrifos, a broad-spectrum neurotoxic organophosphate insecticide, is subject to atmospheric and hydrolytic transport from application sites to aquatic ecosystems. Across the landscape, concentrations in surface water can vary spatially and temporally according to seasonal use practices. Standardized bioassays can provide a screening-level understanding of aquatic receptor acute and chronic toxicity. However, these bioassays do not address ecologically relevant exposure patterns that may impact fitness and survival within and across generations. The aim of the present study was to evaluate the utility of a second-tier, screening-level methodology employing Daphnia magna multi- and transgenerational bioassays spanning four generations to investigate the effect of variable chronic chlorpyrifos exposure. The multigenerational assay consisted of continuous chlorpyrifos exposure across four consecutive 21-day bioassays using progeny from the previous assay for each successive generation. In the transgenerational assay, only the parent (F0) generation was exposed. For both assays, survival and reproduction were assessed across treatments and generations. Results indicated that (1) following continuous chlorpyrifos exposure at ecologically relevant concentrations to four generations of D. magna, the highest treatment showed an apparent tolerance response for both survival and reproductive success in the F3 generation, and (2) chlorpyrifos exposure to the F0 generation did not result in treatment effects in the unexposed F1, F2, and F3 generations in the apical endpoints of survival and reproduction. Employing a suite of acute and chronic bioassays, including chronic exposures spanning multiple generations, allows for a more robust screening-level evaluation of the potential impact of chlorpyrifos on aquatic receptors for variable periods of exposure. Environ Toxicol Chem 2022;001-12. © 2021 SETAC.
Automatic cervix-uterus segmentation of the clinical target volume (CTV) on CT and cone-beam CT (CBCT) scans is challenged by the limited visibility and the non-anatomical definition of certain border regions. We study the potential performance gain of convolutional neural networks by regulating the segmentation predictions as diffeomorphic deformations of a segmentation prior.
We introduce a 3D convolutional neural network that segments the target scan by joint voxel-wise classification and the registration of a given prior. We compare this network to two other 3D baseline models One treating segmentation as a classification problem (segmentation-only), the other as a registration problem (deformation-only). learn more For reference and to highlight the benefits of a 3D model, these models are also benchmarked against a 2D segmentation model. Network performances are reported for CT and CBCT segmentation of the cervix-uterus CTV. We train the networks on the data of 84 patients. The prior is provided by the CTV segmproved geometric consistency. Especially for CBCT, with its poor soft-tissue contrast, this type of regularization becomes important as shown by quantitative and qualitative evaluation.
Constraining the solution space of admissible segmentation predictions to those reachable by a diffeomorphic deformation of the prior proved beneficial as it improved geometric consistency. Especially for CBCT, with its poor soft-tissue contrast, this type of regularization becomes important as shown by quantitative and qualitative evaluation.Peer-mediated instructional strategies (e.g., peer tutoring) have been effective at teaching academic responses in previous research. This study extended the literature by programming for inference-making, or derived relations. Across two experiments, researchers investigated the use of peer tutoring and inference-making to teach fraction-pictogram-percentage relations to 8 third-grade participants. In each experiment, participants served as both tutors and tutees in homogenous, reciprocal tutoring sessions. In Experiment 1, one tutor taught fraction (A)-pictogram (B) relations and the other tutor taught percentage (C)-pictogram (B) relations. In Experiment 2, each tutor taught one half of each of the relations. Results of both experiments demonstrated that the tutors learned all relations they taught, the tutees learned all relations they were taught, and all participants derived equivalence relations and demonstrated transfer of functions for comparative relations. A comparison of the two experiments suggests instructors should consider the difficulty of training relations when they design peer-tutoring instruction that engineers inference-making.Anaerobic conditions developed during flooding can increase phosphorus (P) losses from soils to waterways. Soil amendment with gypsum (CaSO4 ·2H2 O) can effectively reduce flooding-induced P release, but its effectiveness is soil dependent, and the reasons are poorly understood. The objectives of this study were to reveal the possible inorganic P transformations during flooding of two soils (acidic-Neuenberg sandy loam [NBG-SL] and alkaline-Fyala clay [FYL-Cl]), with and without gypsum amendment prior to flooding. Porewater samples collected at 0, 35, and 70 d after flooding (DAF) from soils incubated in vessels were analyzed for dissolved reactive P (DRP); pH; and concentrations of calcium (Ca), magnesium, iron (Fe), manganese, chloride, nitrate, sulfate, and fluoride. Thermodynamic modeling using Visual MINTEQ software and chemical fractionation of soil P were used to infer P transformations. Soil redox potential (Eh) decreased with flooding and favored reductive dissolution of Fe-associated P increasing porewater DRP concentrations. Greater solubility of Ca-P under acidic pH maintained a higher DRP concentration in NBG-SL during early stages of flooding. A subsequent increase in pH with flooding and higher Ca concentration with added gypsum enhanced the stability of Ca-P (β-tricalcium phosphate and octacalcium phosphate), reducing the DRP concentration in gypsum-amended NBG-SL. Stability of Ca-P was less affected with flooding and gypsum amendment in FYL-Cl soil because it had an alkaline pH and inherently higher Ca concentration. The FYL-Cl, with a more rapid decrease in Eh than NBG-SL, became severely reduced, releasing more P and Fe by 70 DAF. These conditions favored vivianite formation in FYL-Cl but not in NBG-SL.
Composite measures are increasingly used to assess quality of care in surgical oncology. We sought to define the incidence of "textbook oncologic outcome" (TOO) following resection of gastric adenocarcinoma among a large, international cohort of patients.
Gastric adenocarcinoma patients undergoing resection between 2000 and 2020 were identified from an international database. TOO was defined as margin-negative resection, examination of ≥16 lymph nodes, no prolonged length-of-stay (LOS), no 30-day mortality, and stage-appropriate receipt of chemotherapy.
Among a total of 910 patients, 321 patients (35.3%) achieved a postoperative TOO. While failure to evaluate ≥16 lymph nodes (n = 591, 65.0%) and receipt of chemotherapy (n = 651, 71.5%) had the greatest negative impact on the ability to obtain a TOO, no 30-day mortality (n = 880, 96.7%), margin-negative resection (n = 831, 91.3%), and no extended LOS (n = 706, 77.6%) were more commonly achieved. No postoperative complications (OR 0.44;95% CI0.31-0.63) and T1a/T1b-stage disease (OR 2.87;95% CI1.59-5.18) were independently associated with achieving a TOO (p < 0.05). The odds of achieving a TOO improved over time (p-trend < 0.05), which was largely attributable to improved odds of evaluating≥16 lymph nodes (2010-2014 vs. 2000-2004OR,5.21;95% CI 3.22-8.45).
Only about onein threepatients achieved a TOO following resection of gastric adenocarcinoma. Odds of TOO increased over time, largely due to improved lymph node evaluation.
Only about one in three patients achieved a TOO following resection of gastric adenocarcinoma. Odds of TOO increased over time, largely due to improved lymph node evaluation.
The prevalence of distress, problems and need for rehabilitation among women treated for gynecological cancer is largely unknown. The aims of this study were to examine the prevalence of distress, problems and unmet rehabilitation needs in the first years after treatment for gynecological cancer.
Women treated for gynecological cancer within the last 2years were invited. Participants responded to the National Comprehensive Cancer Network Distress Thermometer and Problem List measuring distress and problems. They also answered a questionnaire regarding physical endurance, muscle strength, and need for rehabilitation services.
Of 114 eligible women, 92 (81%) agreed to participate. Mean time since last treatment was 7.6months (range 0-24.5months). A total of 57% of the participants reported distress. The four most common problems reported were fatigue (58%), tingling in hands/feet (54%), worry (53%), and problems with memory/concentration (50%). Problems associated with distress were dealing with partner, bilitation services.Generating evidence on the use, effectiveness, and safety of new cancer therapies is a priority for researchers, health care providers, payers, and regulators given the rapid pace of change in cancer diagnosis and treatments. The use of real-world data (RWD) is integral to understanding the utilization patterns and outcomes of these new treatments among patients with cancer who are treated in clinical practice and community settings. An initial step in the use of RWD is careful study design to assess the suitability of an RWD source. This pivotal process can be guided by using a conceptual model that encourages predesign conceptualization. The primary types of RWD included are electronic health records, administrative claims data, cancer registries, and specialty data providers and networks. Careful consideration of each data type is necessary because they are collected for a specific purpose, capturing a set of data elements within a certain population for that purpose, and they vary by population coverage and longitudinality. In this review, the authors provide a high-level assessment of the strengths and limitations of each data category to inform data source selection appropriate to the study question. Overall, the development and accessibility of RWD sources for cancer research are rapidly increasing, and the use of these data requires careful consideration of composition and utility to assess important questions in understanding the use and effectiveness of new therapies.