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PURPOSE To evaluate long-term morbidity and mortality among unilateral, nonsyndromic Wilms tumor (WT) survivors according to conventional treatment regimens. METHODS Cumulative incidence of late mortality (≥ 5 years from diagnosis) and chronic health conditions (CHCs) were evaluated in WT survivors from the Childhood Cancer Survivor Study. Outcomes were evaluated by treatment, including nephrectomy combined with vincristine and actinomycin D (VA), VA + doxorubicin + abdominal radiotherapy (VAD + ART), VAD + ART + whole lung radiotherapy, or receipt of ≥ 4 chemotherapy agents. RESULTS Among 2,008 unilateral WT survivors, 142 deaths occurred (standardized mortality ratio, 2.9, 95% CI, 2.5 to 3.5; 35-year cumulative incidence of death, 7.8%, 95% CI, 6.3 to 9.2). The 35-year cumulative incidence of any grade 3-5 CHC was 34.1% (95% CI, 30.7 to 37.5; rate ratio [RR] compared with siblings 3.0, 95% CI, 2.6 to 3.5). Survivors treated with VA alone had comparable risk for all-cause late mortality relative to the general population (standardized mortality ratio, 1.0; 95% CI, 0.5 to 1.7) and modestly increased risk for grade 3-5 CHCs compared with siblings (RR, 1.5; 95% CI, 1.1 to 2.0), but remained at increased risk for intestinal obstruction (RR, 9.4; 95% CI, 3.9 to 22.2) and kidney failure (RR, 11.9; 95% CI, 4.2 to 33.6). Magnitudes of risk for grade 3-5 CHCs, including intestinal obstruction, kidney failure, premature ovarian insufficiency, and heart failure, increased by treatment group intensity. CONCLUSION With approximately 40% of patients with newly diagnosed WT currently treated with VA alone, the burden of late mortality/morbidity in future decades is projected to be lower than that for survivors from earlier eras. Nevertheless, the risk of late effects such as intestinal obstruction and kidney failure was elevated across all treatment groups, and there was a dose-dependent increase in risk for all grade 3-5 CHCs by treatment group intensity.

Mega sporting events attract global media attention such as the Olympic Games and the World Football Cup. Countries bid to host such events for a number of reasons which include favourable global media coverage serving economic, political, national, and cultural purposes. Qatar, following a long strategy of establishing itself on the world stage as a pioneer country in the Middle East, showcased its national economic achievements by organizing the World Football Cup from 20 November 2022 to 18 December 2022. The purpose of this paper is to look at the extent of media coverage demonstrated by the international media attention that is officially licenced by FIFA to cover the games: tv, radio, mobile and internet. Keywords: Qatar, Qatargate, Middle East, media, sports, football, FIFA, public funds

Background: Childhood cancer survivors experience reduced physiologic reserve, or frailty, earlier and more frequently than peers. In other populations, frailty is impacted by one's neighborhood. This study's purpose was to evaluate associations between neighborhood characteristics and frailty in childhood cancer survivors. Methods: Participants in the St. Jude Lifetime Cohort Study with geocoded residential addresses were analyzed. Pre-frailty/Frailty was defined as having 1–2/≥3 of sarcopenia, muscle weakness, poor endurance, slow walking speed, and exhaustion from direct assessments. Neighborhood characteristics [e.g., access to exercise opportunities and healthy food, neighborhood socioeconomic status (nSES), and rurality/urbanicity] were determined using publicly available geospatial data. Nested multivariable logistic regression models identified associations between neighborhood characteristics and pre-frailty/frailty, adjusting for chronic health conditions, individual health behaviors and socio-demographics, and high-risk cancer treatment exposures. Results: For our cohort (N = 3,806, 46.79% female, 81.40% white, mean age 33.63±9.91 years), compared with non-frail survivors (n = 2,573; 67.6%), pre-frail (n = 900; 23.6%) and frail survivors (n = 333; 8.7%) were more likely to live in neighborhoods with decreased exercise opportunities (frail OR: 1.62, 1.26–2.09), reduced healthy food access (pre-frail OR: 1.28, 1.08–1.51; frail OR: 1.36, 1.06–1.75), and lower nSES (pre-frail OR: 1.31, 1.12–1.52; frail OR: 1.64, 1.30–2.07). Participants had 8% increased odds (95% confidence interval, 2%–14%) of being pre-frail/frail if they lived in “resource poor” neighborhoods as opposed to “resource rich” neighborhoods after adjusting for other pre-frailty/frailty risk factors. Conclusions: The neighborhood a childhood cancer survivor resides in as an adult is associated with pre-frailty/frailty. Impact: This study provides valuable information for creating interventions using neighborhood-level factors to mitigate frailty and improve health outcomes in survivors.

The current president of the Turkish Republic has dominated domestic politics since 2003. For the first time in this two-decade period, the political opposition appears to be a serious threat and according to polls, they run neck-and-neck. This paper assesses to what extent the economy has played a role once again in determining the electoral results of the last twenty years in Turkey. This issue is addressed by comparing the performance of the Turkish economy of the twenty-year period before and after the critical year of 2003 when the current Turkish leader emerged to power. The descriptive analysis of the data is unable to reject the main hypothesis of this paper that it is the economy which plays an important role--albeit not the only one--in determining electoral success. Keywords: Turkey, elections, economy, per capita GDP, unemployment, inflation, military spending, education enrollment, foreign exchange rate

The flexible thermal protection system (FTPS) on NASA’s low-Earth-orbit flight test of an inflatable decelerator vehicle was instrumented with thermocouples to measure the in-depth thermal response during entry into Earth’s atmosphere. Accurate flight temperature measurements are critical for verifying vehicle performance during the flight test and reducing uncertainties in the thermal models, but the deployable nature of inflatable decelerator technology presents challenges. The thermocouples need to be compactable, cannot damage the FTPS or the inflatable structure, and need to be able to withstand high temperatures and large thermal gradients. The present paper details the arcjet testing that was performed to examine the potential error sources associated with instrumenting NASA’s FTPS with different thermocouple Types (Type K versus Type N), wire gauges (30 versus 28 American wire gauge), insulations (glass versus ceramic), and barriers (mica versus no mica). Several error sources were identified, including 1) conductive deposits on the thermocouple insulation electrically shorting the thermocouple leads; 2) melting of the glass thermocouple insulation, allowing for electrical shorting of the thermocouple leads; 3) thermocouple leads melting, resulting in loss of signal; and 4) oxidation of the positive thermocouple lead (known as green rot), generating a drift in the measured output. A mica tape wrap around each individual thermocouple lead was successfully used to mitigate the first error source, and switching to ceramic insulation eliminated the second error source. The third and fourth error sources were examined by exploring the effect of the thermocouple type and wire gauge. Thermocouple solutions that minimize the potential error sources at each layer in the FTPS are presented. Finally, the arcjet test results are compared to the previously reported ground-based tube furnace test results, and their applicability to the flight environment is discussed.

PURPOSE To improve skin cancer screening among survivors of childhood cancer treated with radiotherapy where skin cancers make up 58% of all subsequent neoplasms. Less than 30% of survivors currently complete recommended skin cancer screening. PATIENTS AND METHODS This randomized controlled comparative effectiveness trial evaluated patient and provider activation (PAE + MD) and patient and provider activation with teledermoscopy (PAE + MD + TD) compared with patient activation alone (PAE), which included print materials, text messaging, and a website on skin cancer risk factors and screening behaviors. Seven hundred twenty-eight participants from the Childhood Cancer Survivor Study (median age at baseline 44 years), age > 18 years, treated with radiotherapy as children, and without previous history of skin cancer were randomly assigned (1:1:1). Primary outcomes included receiving a physician skin examination at 12 months and conducting a skin self-examination at 18 months after intervention. RESULTS Rates of physician skin examinations increased significantly from baseline to 12 months in all three intervention groups: PAE, 24%-39%, relative risk [RR], 1.65, 95% CI, 1.32 to 2.08; PAE + MD, 24% to 39%, RR, 1.56, 95% CI, 1.25 to 1.97; PAE + MD + TD, 24% to 46%, RR, 1.89, 95% CI, 1.51 to 2.37. The increase in rates did not differ between groups ( P = .49). Similarly, rates of skin self-examinations increased significantly from baseline to 18 months in all three groups: PAE, 29% to 50%, RR, 1.75, 95% CI, 1.42 to 2.16; PAE + MD, 31% to 58%, RR, 1.85, 95% CI, 1.52 to 2.26; PAE + MD + TD, 29% to 58%, RR, 1.95, 95% CI, 1.59 to 2.40, but the increase in rates did not differ between groups ( P = .43). CONCLUSION Although skin cancer screening rates increased more than 1.5-fold in each of the intervention groups, there were no differences between groups. Any of these interventions, if implemented, could improve skin cancer prevention behaviors among childhood cancer survivors.

PURPOSE Kidney failure is a rare but serious late effect following treatment for childhood cancer. We developed a model using demographic and treatment characteristics to predict individual risk of kidney failure among 5-year survivors of childhood cancer. METHODS Five-year survivors from the Childhood Cancer Survivor Study (CCSS) without history of kidney failure (n = 25,483) were assessed for subsequent kidney failure (ie, dialysis, kidney transplantation, or kidney-related death) by age 40 years. Outcomes were identified by self-report and linkage with the Organ Procurement and Transplantation Network and the National Death Index. A sibling cohort (n = 5,045) served as a comparator. Piecewise exponential models accounting for race/ethnicity, age at diagnosis, nephrectomy, chemotherapy, radiotherapy, congenital genitourinary anomalies, and early-onset hypertension estimated the relationships between potential predictors and kidney failure, using area under the curve (AUC) and concordance (C) statistic to evaluate predictive power. Regression coefficient estimates were converted to integer risk scores. The St Jude Lifetime Cohort Study and the National Wilms Tumor Study served as validation cohorts. RESULTS Among CCSS survivors, 204 developed late kidney failure. Prediction models achieved an AUC of 0.65-0.67 and a C-statistic of 0.68-0.69 for kidney failure by age 40 years. Validation cohort AUC and C-statistics were 0.88/0.88 for the St Jude Lifetime Cohort Study (n = 8) and 0.67/0.64 for the National Wilms Tumor Study (n = 91). Risk scores were collapsed to form statistically distinct low- (n = 17,762), moderate- (n = 3,784), and high-risk (n = 716) groups, corresponding to cumulative incidences in CCSS of kidney failure by age 40 years of 0.6% (95% CI, 0.4 to 0.7), 2.1% (95% CI, 1.5 to 2.9), and 7.5% (95% CI, 4.3 to 11.6), respectively, compared with 0.2% (95% CI, 0.1 to 0.5) among siblings. CONCLUSION Prediction models accurately identify childhood cancer survivors at low, moderate, and high risk for late kidney failure and may inform screening and interventional strategies.

Purpose: Perineural invasion (PNI) in oral cavity squamous cell carcinoma (OSCC) is associated with poor survival. Because of the risk of recurrence, patients with PNI receive additional therapies after surgical resection. Mechanistic studies have shown that nerves in the tumor microenvironment promote aggressive tumor growth. Therefore, in this study, we evaluated whether nerve density (ND) influences tumor growth and patient survival. Moreover, we assessed the reliability of artificial intelligence (AI) in evaluating ND. Experimental Design: To investigate whether increased ND in OSCC influences patient outcome, we performed survival analyses. Tissue sections of OSCC from 142 patients were stained with hematoxylin and eosin and IHC stains to detect nerves and tumor. ND within the tumor bulk and in the adjacent 2 mm was quantified; normalized ND (NND; bulk ND/adjacent ND) was calculated. The impact of ND on tumor growth was evaluated in chick chorioallantoic-dorsal root ganglia (CAM-DRG) and murine surgical denervation models. Cancer cells were grafted and tumor size quantified. Automated nerve detection, applying the Halo AI platform, was compared with manual assessment. Results: Disease-specific survival decreased with higher intratumoral ND and NND in tongue SCC. Moreover, NND was associated with worst pattern-of-invasion and PNI. Increasing the number of DRG, in the CAM-DRG model, increased tumor size. Reduction of ND by denervation in a murine model decreased tumor growth. Automated and manual detection of nerves showed high concordance, with an F1 score of 0.977. Conclusions: High ND enhances tumor growth, and NND is an important prognostic factor that could influence treatment selection for aggressive OSCC.

This study deals with Hesiod’s most important economic contribution. He introduced and explicitly defined the concept of economic scarcity, relating it to the productivity of labor. The latter can be enhanced by an unbounded Prometheus (technology), which permits the exploitation of new materials such as iron. In this paper, a distinction is made between a static and a dynamic definition of scarcity. Related to scarcity is the debate on the etymology of the word “economics”. In Works and Days, the word itself is absent, but, nevertheless, the word “oikos” is mentioned many times to clearly mean family business, which needs economic management within the institutionally-determined peace and justice. Without these two pre-conditions, the economies cannot flourish (grow). Keywords: Scarcity, Hesiod, Ancient Economy, economic growth, justice, peace, productivity of labor

PURPOSE Interindividual variability in the dose-dependent association between anthracyclines and cardiomyopathy suggests a modifying role of genetic susceptibility. Few previous studies have examined gene-anthracycline interactions. We addressed this gap using the Childhood Cancer Survivor Study (discovery) and the Children's Oncology Group (COG) study COG-ALTE03N1 (replication). METHODS A genome-wide association study (Illumina HumanOmni5Exome Array) in 1,866 anthracycline-exposed Childhood Cancer Survivor Study participants (126 with heart failure) was used to identify single-nucleotide polymorphisms (SNPs) with either main or gene-environment interaction effect on anthracycline-related cardiomyopathy that surpassed a prespecified genome-wide threshold for statistical significance. We attempted replication in a matched case-control set of anthracycline-exposed childhood cancer survivors with (n = 105) and without (n = 160) cardiomyopathy from COG-ALTE03N1. RESULTS Two SNPs (rs17736312 [ ROBO2]) and rs113230990 (near a CCCTC-binding factor insulator [< 750 base pair]) passed the significance cutoff for gene-anthracycline dose interaction in discovery. SNP rs17736312 was successfully replicated. Compared with the GG/AG genotypes on rs17736312 and anthracyclines ≤ 250 mg/m2, the AA genotype and anthracyclines > 250 mg/m2 conferred a 2.2-fold (95% CI, 1.2 to 4.0) higher risk of heart failure in discovery and an 8.2-fold (95% CI, 2.0 to 34.4) higher risk in replication. ROBO2 encodes transmembrane Robo receptors that bind Slit ligands (SLIT). Slit-Robo signaling pathway promotes cardiac fibrosis by interfering with the transforming growth factor-β1/small mothers against decapentaplegic (Smad) pathway, resulting in disordered remodeling of the extracellular matrix and potentiating heart failure. We found significant gene-level associations with heart failure: main effect ( TGF-β1, P = .007); gene*anthracycline interaction ( ROBO2*anthracycline, P = .0003); and gene*gene*anthracycline interaction ( SLIT2* TGF-β1*anthracycline, P = .009). CONCLUSION These findings suggest that high-dose anthracyclines combined with genetic variants involved in the profibrotic Slit-Robo signaling pathway promote cardiac fibrosis via the transforming growth factor-β1/Smad pathway, providing credence to the biologic plausibility of the association between SNP rs17736312 ( ROBO2) and anthracycline-related cardiomyopathy.

PURPOSE To describe the risk of late mortality, subsequent malignant neoplasms (SMNs), and chronic health conditions (CHCs) in survivors of neuroblastoma diagnosed in infancy by treatment era and exposures. METHODS Among 5-year survivors of neuroblastoma in the Childhood Cancer Survivor Study diagnosed age < 1 year between 1970 and 1999, we examined the cumulative incidence of late (> 5 years from diagnosis) mortality, SMN, and CHCs (grades 2-5 and 3-5). Multivariable Cox regression models estimated hazard ratios (HRs) and 95% CIs by decade and treatment (surgery-alone v chemotherapy with or without surgery [C ± S] v radiation with or without chemotherapy ± surgery [R ± C ± S]) among survivors and between survivors and 5,051 siblings. RESULTS Among 1,397 eligible survivors, the 25-year cumulative incidence of late mortality was 2.1% (95% CI, 1.3 to 3.9) with no difference by treatment era. Among 990 participants who completed a baseline survey, fewer survivors received radiation in more recent eras (51.2% 1970s, 20.4% 1980s, and 10.1% 1990s; P < .001). Risk of SMN was elevated only among individuals treated with radiation-containing regimens compared with surgery alone (HR[C ± S], 3.2 [95% CI, 0.9 to 11.6]; HR[R ± C ± S], 5.7 [95% CI, 1.2 to 28.1]). In adjusted models, there was a 50% reduction in risk of grade 3-5 CHCs in the 1990s versus 1970s (HR, 0.5 [95% CI, 0.3 to 0.9]; P = .01); individuals treated with radiation had a 3.6-fold risk for grade 3-5 CHCs (95% CI, 2.1 to 6.2) versus those treated with surgery alone. When compared with siblings, risk of grade 3-5 CHCs for survivors was lowest in the most recent era (HR[1970s], 4.7 [95% CI, 3.4 to 6.5]; HR[1980s], 4.6 [95% CI, 3.3 to 6.4]; HR[1990s], 2.5 [95% CI, 1.7 to 3.9]). CONCLUSION Neuroblastoma survivors treated during infancy have a relatively low absolute burden of late mortality and SMN. Encouragingly, risk of CHCs has declined in more recent eras with reduced exposure to radiation therapy.

This study aimed to describe progressive evidence-based changes in perioperative management of open preperitoneal ventral hernia repair and subsequent surgical outcomes and to analyze factors that affect recurrence and wound complications.Prospective, tertiary hernia center data (2004-2021) were examined for patients undergoing midline open preperitoneal ventral hernia repair with mesh. "Early" (2004-2012) and "Recent" (2013-2021) groups were based on surgery date.Comparison of Early (n = 675) versus Recent (n = 1,167) groups showed that Recent patients were, on average, older (56.9 ± 12.6 vs 58.7 ± 12.1 years; P.001) with a lower body mass index (33.5 ± 8.3 vs 32.0 ± 6.8 kg/mDespite significant increased patient complexity over time, detecting and implementing best practices as determined by recurring data analysis of a center's outcomes has significantly improved patient care results.

Our center has adopted many evidence-based practices to improve outcomes for complex abdominal wall reconstruction with porcine dermal matrix. This study analyzed outcomes over time using porcine dermal matrix in complex abdominal wall reconstruction.Prospective, tertiary hernia center data was examined for patients undergoing complex abdominal wall reconstruction with porcine dermal matrix. Early (2008-2014) and Recent (2015-2021) cohorts were defined by dividing the study interval in half. Multivariable analyses of wound complications and recurrence were performed.Comparing 117 Early vs 245 Recent patients, both groups had high rates of previously repaired hernias (76.1% vs 67.4%; P = .110), Centers for Disease Control and Prevention class 3 or 4 wounds (76.0% vs 66.6%; P = .002), and very large hernia defects (320 ± 317 vs 282 ± 164 cmPorcine dermal matrix in complex abdominal wall reconstruction performs well with low recurrence rates. Internal assessment and implementation of evidence-based practices improved outcomes such as length of stay, wound complications, and recurrence rate.

Complete fascial closure significantly reduces recurrence rates and wound complications in abdominal wall reconstruction. While component separation techniques have clear effectiveness in closing large abdominal wall defects, preoperative botulinum toxin A has emerged as an adjunct to aid in fascial closure. Few data exist comparing preoperative botulinum toxin A to component separation techniques, and the aim was to do so in a matched study.A prospective, single-center, hernia-specific database was queried, and a 3:1 propensity-matched study of patients undergoing open abdominal wall reconstruction from 2016 to 2021 with botulinum toxin A versus component separation techniques was performed based on body mass index, defect width, hernia volume, and Centers for Disease Control and Prevention wound classification. Demographics, operative characteristics, and outcomes were evaluated.Matched patients included 105 component separation techniques and 35 botulinum toxin A. There was no difference in tobacco use, diabetes, or body mass index (all P.5). Hernia defects and volume were large for both the component separation techniques and botulinum toxin A groups (mean size: component separation techniques 286.2 ± 179.9 cmIn a matched study comparing patients with botulinum toxin A versus component separation techniques, there was no difference in fascial closure rates or in hernia recurrence between the 2 groups. Preoperative botulinum toxin A can achieve similar outcomes as component separation techniques, while decreasing the frequency of surgical site occurrences.

The flexible thermal protection system (FTPS) on NASA’s Low-Earth Orbit Flight Test of an Inflatable Decelerator (LOFTID) vehicle will be instrumented with thermocouples to measure the in-depth thermal response during entry into Earth’s atmosphere. Accurate flight temperature measurements are critical for verifying vehicle performance during the flight test and reducing uncertainties in the thermal models, but the deployable nature of inflatable decelerator technology presents challenges. The thermocouples need to be compactable, cannot damage the FTPS or the inflatable structure, and need to be able to withstand high temperatures and large thermal gradients. The present paper details the developmental testing that was performed using a tube furnace to examine the potential error sources associated with instrumenting NASA’s FTPS with thermocouples insulated with either glass braid or ceramic braid. Large measurement errors occurred with both thermocouple insulation materials due to conductive deposits on the insulation electrically shorting the thermocouple leads. Two mechanisms were identified that contribute to this phenomenon: 1) the organic binder on the thermocouple insulation carbonizes in a high-temperature, low-oxygen environment and 2) decomposition products from the FTPS are able to permeate the braided insulation. The effect of heat cleaning the thermocouples to eliminate the first mechanism is presented, and the possibility of using a mica wrap as an impermeable barrier to mitigate the second mechanism is explored. Finally, the applicability of the ground-based tube furnace test results to the flight environment is discussed.

PURPOSE To estimate the prevalence of financial hardship among adult survivors of childhood cancer compared with siblings and identify sociodemographic, cancer diagnosis, and treatment correlates of hardship among survivors in the era after implementation of the Affordable Care Act. METHODS A total of 3,555 long-term (≥ 5 years) survivors of childhood cancer and 956 siblings who completed a survey administered in 2017-2019 were identified from the Childhood Cancer Survivor Study. Financial hardship was measured by 21 survey items derived from US national surveys that had been previously cognitively tested and fielded. Principal component analysis (PCA) identified domains of hardship. Multiple linear regression examined the association of standardized domain scores (ie, scores divided by standard deviation) with cancer and treatment history and sociodemographic characteristics among survivors. RESULTS Survivors were more likely than siblings to report hardship in ≥ 1 item (63.4% v 53.7%, P < .001). They were more likely to report being sent to debt collection (29.9% v 22.3%), problems paying medical bills (20.7% v 12.8%), foregoing needed medical care (14.1% v 7.8%), and worry/stress about paying their rent/mortgage (33.6% v 23.2%) or having enough money to buy nutritious meals (26.8% v 15.5%); all P < .001. Survivors reported greater hardship than siblings in all three domains identified by principal component analysis: behavioral hardship (mean standardized domain score 0.51 v 0.35), material hardship/financial sacrifices (0.64 v 0.46), and psychological hardship (0.69 v 0.44), all P < .001. Sociodemographic (eg, 2 anthracycline chemotherapy, or chest radiation) were statistically significantly associated with increased hardship. CONCLUSION Survivors of childhood cancer were more likely to experience financial hardship than siblings. Correlates of hardship can inform survivorship care guidelines and intervention strategies.

PURPOSE To evaluate the outcomes and cost-effectiveness of the Children's Oncology Group Guideline recommendation for breast cancer (BC) screening using mammography (MAM) and breast magnetic resonance imaging (MRI) in female chest-irradiated childhood Hodgkin lymphoma (HL) survivors. Digital breast tomosynthesis (DBT), increasingly replacing MAM in practice, was also examined. METHODS Life years (LYs), quality-adjusted LYs (QALYs), BC mortality, health care costs, and false-positive screen frequencies of undergoing annual MAM, DBT, MRI, MAM + MRI, and DBT + MRI from age 25 to 74 years were estimated by microsimulation. BC risks and non-BC mortality were estimated from female 5-year survivors of HL in the Childhood Cancer Survivor Study and the US population. Test performance of MAM and MRI was synthesized from HL studies, and that of DBT from the general population. Costs (2017 US dollars [USD]) and utility weights were obtained from the medical literature. Incremental cost-effectiveness ratios (ICERs) were calculated. RESULTS With 100% screening adherence, annual BC screening extended LYs by 0.34-0.46 years over no screening. If the willingness-to-pay threshold to gain a quality-adjusted LY was ICER < $100,000 USD, annual MAM at age 25-74 years was the only cost-effective strategy. When nonadherence was taken into consideration, only annual MAM at age 30-74 years (ICER = $56,972 USD) was cost-effective. Supplementing annual MAM with MRI costing $545 USD was not cost-effective under either adherence condition. If MRI costs were reduced to $300 USD, adding MRI to annual MAM at age 30-74 years could become more cost-effective, particularly in the reduced adherence condition (ICER = $133,682 USD). CONCLUSION Annual BC screening using MAM at age 30-74 years is effective and cost-effective in female chest-irradiated HL survivors. Although annual adjunct MRI is not cost-effective at $545 USD cost, it could become cost-effective as MRI cost is reduced, a plausible scenario with the emergent use of abbreviated MRI.

The HepQuant SHUNT test quantifies hepatic functional impairment from the simultaneous clearance of cholate from the systemic and portal circulations for the purpose of monitoring treatment effects or for predicting risk for clinical outcome. Compartmental models are defined by distribution volumes and transfer rates between volumes to estimate parameters not defined by noncompartmental analyses. Previously, a noncompartmental analysis method, called the minimal model (MM), demonstrated reproducible and reliable measures of liver function (Translational Research 2021). The aim of this study was to compare the reproducibility and reliability of a new physiologically based compartmental model (CM) vs the MM. Data were analyzed from 16 control, 16 nonalcoholic steatohepatitis (NASH), and 16 hepatitis C virus (HCV) subjects, each with 3 replicate tests conducted on 3 separate days. The CM describes transfer of cholates between systemic, portal, and liver compartments with assumptions from measured or literature-derived values and unknown parameters estimated by nonlinear least-squares regression. The CM was compared to the MM for 6 key indices of hepatic disease in terms of intraclass correlation coefficient (ICC) with a lower acceptable limit of 0.7. The CM correlated well with the MM for disease severity index (DSI) with R

Coextinction is a major and growing threat to global biodiversity. One of the affected groups is the eriophyoid mites (Prostigmata: Eriophyoidea) which are highly host plant specific. They have been described from an enormous range of annual and perennial plants from grasses to giant forest trees. It is highly likely that there are huge numbers of undescribed eriophyoid species in the subtropical and tropical regions which harbor an extraordinary wealth of plant diversity. The global total of eriophyoid species is estimated to be at least 250,000 but it could be much higher. However, the continuing destruction and degradation of natural habitat, especially tropical forests, and climate change, together pose extreme, on-going threats to the eriophyoid mites because of their vulnerability to co-extinction with their host plants. It has been reported that one third of all the Earth’s plant species are now at risk of extinction. Together with enormous numbers of other invertebrate species, it is highly likely that many thousands of eriophyoid species are disappearing in the current mass extinction event. Population decline and co-extinction, especially of the invertebrates, are greatly accelerating total biodiversity losses. The termination of habitat destruction and degradation; establishment of large, representative protected areas; restoration of degraded areas; and rapid reduction of fossil fuel use, are urgent tasks. However, the long term conservation of biodiversity can only be achieved through comprehensive social, economic and political reforms across the world that prioritize environmental protection, peaceful coexistence, social justice and the sustainable use of resources.

While the 5-year survival rate for local and regional prostate cancer is nearly 100%, it decreases dramatically for advanced tumours. Accessibility to health care is an important factor for cancer prognosis. The U.S. Military Health System (MHS) provides universal health care to its beneficiaries, reducing financial barriers to medical care. However, whether the universal care translates into improved survival among patients with advanced prostate cancer in the MHS is unknown. In this study, we compared the MHS and the U.S. general population in survival of patients with advanced prostate cancer (stages III and IV).The MHS patients (N = 5379) were identified from the Department of Defense's (DoD) Automated Central Tumor Registry (ACTUR). Patients in the U.S. general population (N = 21,516) were identified from the Surveillance, Epidemiology, and End Results (SEER) programme. The two populations were matched on age, race, and diagnosis year.The ACTUR patients exhibited longer 5-year survival than the matched SEER patients (HR = 0.74, 95% CI = 0.67-0.83), after adjustment for the potential confounders. The improved survival was observed for ages 50 years or older, both White patients and Black patients, all tumour stages and grades. This was also demonstrated despite the receipt of surgery or radiation treatment.MHS beneficiaries with advanced prostate cancer had longer survival than their counterparts in the U.S. general population.

This report describes a liquid crystalline material that can be cured and patterned with green light and photoaligned with blue light.

Electrosurgery procedures produce airborne contaminants including volatile organic compounds (VOCs). The effectiveness of commercial grade activated carbon at removing toluene, a typical VOC, from the air in an enclosed simulated operating room (OR) when interfaced with an air recirculation device was tested. The concentration of toluene in the air was measured using gas sensitive semiconductor VOC sensors. When the air recirculation device containing activated carbon was turned

Management of the anterior component of unstable lateral compression (LC) pelvic ring injuries remains controversial. Common internal fixation options include plating and superior pubic ramus screws. These constructs have been evaluated in anterior-posterior compression (APC) fracture patterns, but no study has compared the two for unstable LC patterns, which is the purpose of this study.A rotationally unstable LC pelvic ring injury was modeled in 10 fresh frozen cadaver specimens by creating a complete sacral fracture, disruption of posterior ligaments, and ipsilateral superior and inferior rami osteotomies. All specimens were repaired posteriorly with two fully threaded 7 mm cannulated transiliac-transsacral screws through the S1 and S2 corridors. The superior ramus was repaired with either a 3.5 mm pelvic reconstruction plate (n = 5) or a bicortical 5.5 mm cannulated retrograde superior ramus screw (n = 5). Specimens were loaded axially in single leg support for 1000 cycles at 400 N followed by an additional 3 cycles at 800 N. Displacement and angulation of the superior and inferior rami osteotomies were measured with a three-dimensional (3D) motion tracker. The two fixation methods were then compared with Mann-Whitney U-Tests.Retrograde superior ramus screw fixation had lower average displacement and angulation than plate fixation in all categories, with the motion at the inferior ramus at 800 N of loading showing a statistically significant difference in angulation.Although management of the anterior ring in unstable LC injuries remains controversial, indications for fixation are becoming more defined over time. In this study, the 5.5 mm cannulated retrograde superior ramus screw significantly outperformed the 3.5 mm reconstruction plate in angulation of the inferior ramus fracture at 800 N. No other significance was found, however the ramus screw demonstrated lower average displacements and angulations in all categories for both the inferior and superior ramus fractures.

An evidence-based approach to the repair of umbilical hernias (UH)1 cm has yet to be defined.A prospectively maintained, institutional hernia database was queried for patients undergoing primary suture repair of UH ≤ 1 cm. The primary outcome was recurrence and secondary outcomes were wound complications.Of 332 patients included (226-primary, 106-incisional), recurrence was identified in 4 (1.8%) primary versus 8 (7.5%) incisional-UH (p = 0.022), with follow-up of 4.7 ± 4.4 years. There were 10 (3.0%) wound complications: 4 (1.2%) superficial wound infections, 1 (0.3%) superficial wound dehiscence, and 5 (1.5%) seromas. On multivariable analysis of recurrence, incisional-UH had an odds ratio of 4.2 compared to primary. Suture choice, diabetes, BMI, tobacco-use history, and wound complications were not significant.With long term follow-up, recurrence after primary suture repair of UH ≤ 1 cm occurred in 1.8% of primary and 7.5% of incisional UH. On multivariable analysis, incisional-UH increased recurrence odds by 4.2 times compared to primary.

ALSUntangled reviews alternative and off-label treatments for people living with amyotrophic lateral sclerosis (PALS). Here we review ozone therapy. Ozone therapy has possible mechanisms for slowing ALS progression based on its antioxidant, anti-inflammatory, and mitochondrial effects. A non-peer-reviewed report suggests that ozone treatment may slow progression in a mTDP-43 mouse model of ALS. One verified "ALS reversal" occurred on a cocktail of alternative treatments including ozone. There are no ALS trials using ozone to treat PALS. There can be potentially serious side effects associated with ozone therapy, depending on the dose. Based on the above information, we support an investigation of ozone therapy in ALS cell or animal models but cannot yet recommend it as a treatment in PALS.

A large body of work has shown that science teacher knowledge is one of the most fundamental components of effective teaching and learning. Our study analyzes the Praxis® Earth and Space Science Content Knowledge Test (ESS CKT) from May 2006 to June 2016. We present one of the largest datasets comprising 11,273 ESS teacher candidates in order to provide information about their demonstrated ESS CK. Understanding that the benefits associated with teacher retention outweigh the cost of hiring new teachers, our results can be used to design targeted professional learning (PL) experiences for pre- and inservice teachers. Findings from this study are particularly useful while planning inservice topic specific PL for teachers pre- and inservice ESS teachers by answering the following research questions (1) How have examinees performed as a whole in each category on the Praxis® ESS CKT? (2) Which personal and/or professional characteristics are most associated with examinee performance in each category and how does this inform professional learning? Examinee performance at the category level was analyzed through a five-part process: 1. Confirmatory Factor Analysis: 2. Percent correct; 3. Regression; 4. ANOVA; 5. Scaled points lost. Our findings revealed that examinees demonstrated strongest performance in the topics assessing Earth’s Atmosphere & Hydrosphere, Earth Materials & Surface Processes, and Tectonics & Internal Earth Processes and identity History of the Earth and its Life-Forms as topics in need of support. Across categories, we found differences in achievement associated with undergraduate major, gender, and ethnicity. Test-takers with geoscience majors consistently lost fewer points than their out-of-field counterparts, that men outperformed women in the study, and White test-takers lost fewer scaled points than Black and Hispanic candidates. Our recommendations include reviewing our results for alignment with state standards in order to develop comprehensive CK development that will be used as an anchor for focused support on those topics where test-takers tend to demonstrate lowest proficiency.

Background We aimed to characterize premature aging as an accumulation of deficits in survivors of pediatric cancer compared with community controls and examine associations with host and treatment factors, neurocognition, and mortality. Methods Pediatric cancer survivors (n = 4000, median age = 28.6, interquartile range [IQR] = 23-35 years; 20 years postdiagnosis: IQR = 15-27), and community participants without a history of cancer serving as controls (n = 638, median age = 32, IQR = 25-40 years) completed clinical assessments and questionnaires and were followed for mortality through April 30, 2020 (mean [SD] follow-up = 7.0 [3.4] years). A deficit accumulation index (DAI) score was calculated from 44 aging-related items including self-reported daily function, psychosocial symptoms, and health conditions. Items were weighted from 0 (absent) to 1 (present and/or most severe), summed and divided by the total yielding a ratio (higher = more deficits). Scores less than 0.20 are robust, and 0.06 is a clinically meaningful difference. Linear regression compared the DAI in survivors and controls with an age*survivor or control interaction. Logistic regression and Cox-proportional hazards estimated the risk of neurocognitive impairment and death. Models were minimally adjusted for age, sex, and race and ethnicity. Results The adjusted mean DAI among survivors at age 30 years was 0.16 corresponding to age 63 years in controls (33 years premature aging; β = 0.07, 95% confidence interval [CI] = 0.06 to 0.08; P Conclusion Pediatric cancer survivors experience clinically significant premature aging. The DAI may be used to identify survivors at greatest risk of poor health outcomes.

Cyanide—a fast-acting poison—is easy to obtain given its widespread use in manufacturing industries. It is a high-threat chemical agent that poses a risk of occupational exposure in addition to being a terrorist agent. FDA-approved cyanide antidotes must be given intravenously, which is not practical in a mass casualty setting due to the time and skill required to obtain intravenous access. Glyoxylate is an endogenous metabolite that binds cyanide and reverses cyanide-induced redox imbalances independent of chelation. Efficacy and biochemical mechanistic studies in an FDA-approved preclinical animal model have not been reported. Therefore, in a swine model of cyanide poisoning, we evaluated the efficacy of intramuscular glyoxylate on clinical, metabolic, and biochemical endpoints. Animals were instrumented for continuous hemodynamic monitoring and infused with potassium cyanide. Following cyanide-induced apnea, saline control or glyoxylate was administered intramuscularly. Throughout the study, serial blood samples were collected for pharmacokinetic, metabolite, and biochemical studies, in addition, vital signs, hemodynamic parameters, and laboratory values were measured. Survival in glyoxylate-treated animals was 83% compared with 12% in saline-treated control animals (p

Migration flows are as old as human history itself. In Greece, the first movements of people are recorded in the 13th century BCE and not stopped ever since. Inflows and outflows of people are a permanent future of Greek history. However, a distinction should be made between three types of flows. Firstly, people are forced to leave their country because of national agreements of resettlements. A world example of such resettlement was the exchange of population between Greece and Turkey in the first part of the 20th century. Secondly, people flee an area to save their lives because of war and prosecutions, including genocides. An example of such migration was the outflow of Greeks from Asia Minor because of the war between Turkey and Greece. Thirdly, people migrate for social reasons which may include economic, political and educational purposes. This was definitely the case of the post-Second World War period in Greece when many Greeks moved outside of Greece to find better jobs abroad (e.g., Germany); study abroad (e.g., U.K.); and to live in a democratic country (e.g., Canada, Sweden, etc.), because in Greece a dictatorship (1967-1974) had abolished democracy. Greece has also been on the receiving end of many migrants from all over the world for the same reasons. The latest example is the flow of Ukrainians who are coming to Greece due to the Russian-Belarus invasion of their country. These migration flows are examined in this paper. Keywords: migrants, refugees, migration policy, Greece, Ukraine

In an article published in this journal entitled “Predatory publications in the era of internet and technology: Open access publications are at risk”, Akhilesh Kumar, Ravi Gupta, Krishna Kant Tripathi & Rajani Ranjan Singh argue that the definition of predatory publications defame the open access journals putting the sustainability of these type of publications at risk which mushroomed in the age of internet and electronic freedom in disseminating academic and non-academic information. This note comments on their paper by arguing that (a) predatory practices are ubiquitous in the academic world, not only in publications; (b) charging a fee does not make an academic practice predatory; and (c) in the long-term no publication or an academic practice can survive if it does not offer some sort of “satisfaction” to users (readers and authors). The argument of peer review or not is irrelevant because a publication, once it becomes available, is constantly reviewed by its readers who are the ultimate judges of its quality. At the end of the day, what counts are the number of readers and the number of citations of a published work. Thanks to the internet these are now easily measurable. Keywords: open access, predatory journals, article processing charges, peer review

When, where, and by whom was Isabella of Portugal’s Huntington Library Hours (HM.1162) written and decorated? The author proposes here that the body of the manuscript, written in Toledo, and 15 small miniatures painted in the 1510s by Simon Bening of Bruges were sent to the southern Netherlands. There associates of the Morgan 491 Master provided the Bening illuminations with decorative enframements and accompanying devotional texts; two new half-page miniatures were also painted. All of that handiwork was then integrated into the manuscript before its dispatch back to Spain shortly before Isabella’s marriage to the emperor Charles V in 1526.

The diversity and relative abundances of tetraether lipids produced by archaea and bacteria in soils and sediments are increasingly used to assess environmental change. For instance, the TetraEther indeX of 86 carbon atoms (TEX86), based on archaeal isoprenoidal glycerol dialkyl glycerol tetraether (iGDGT) lipids, is frequently applied to reconstruct past sea-surface temperatures (SSTs). Yet, it is unknown how the ratio fully responds to environmental and/or geochemical variations and if the produced signals are largely the adaptive response by Thaumarchaeota to oceanographic effects associated with climate or seasonal temperature changes in the upper water column. We present the results of a four push-core transect study of surface sediments collected along an environmental gradient at the Cathedral Hill hydrothermal-vent system in Guaymas Basin, Gulf of California. The transect crosses a region where advecting hydrothermal fluids reach 155 ∘C within the upper 21 cm below the seafloor (cm b.s.f.) close to the vent center to near-ambient conditions at the vent periphery. The recovered iGDGTs closest to the vent center experienced high rates of turnover with up to 94 % of the lipid pool being lost within the upper 21 cm b.s.f. Here, we show that the turnover is non-selective across TEX86 GDGT lipids and does not affect the ratio independently. However, as evident by TEX86 ratios being highly correlated to the Cathedral Hill vent sediment porewater temperatures (R2=0.84), the ratio can be strongly impacted by the combination of severe lipid loss coupled with the addition of in situ iGDGT production from archaeal communities living in the vent sediments. The resulting overprint produces absolute temperature offsets of up to 4 ∘C based on the TEX86H calibration relative to modern climate records of the region. The overprint is also striking given the flux of iGDGTs from the upper water column is estimated to be ∼ 93 % of the combined intact polar lipid (IPL) and core GDGT lipid pool initially deposited on the seafloor. A model to correct the overprint signal using IPLs is therefore presented that can similarly be applied to all near-surface marine sediment systems where calibration models or climate reconstructions are made based on the TEX86 measure.