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Cancer during pregnancy has an incidence of 1/1,000, and when diagnosed, the most common ones are breast cancer (1/10,000), Hodgkin’s lymphoma (1/6,000), and head and neck cancer (1/10,000). If a diagnosis is made during pregnancy, the treatment cannot wait until delivery, and there is concern about the effects that radiotherapy may have on the foetus. The multidisciplinary group has to assess and ethically make decisions with regard to the mother and foetus.
A 35-year-old female, a carrier of Behcet’s disease, underwent 5 years of treatment with hydroxychloroquine, prednisone and low-molecular-weight heparin (the patient being a carrier of Behcet’s disease, there is a high risk for cancer of the oral cavity and oropharynx with an HR of 2·11, so the cancer could be related to the tonsil). The patient’s oncological situation started on December 2017 with a volume increase in preauricular, parotid and right mandibular angle, with a progressive growth. At this time, the foetus was of 17·5 weeks of gestation. An oral cavity tumour that invaded the right retromolar triangle was observed, and upon biopsy, a basaloid squamous cell carcinoma was diagnosed.
Radiotherapy treatment was started at 22 weeks of gestation; intensity-modulated radiation therapy (IMRT) was planned with a dose of 69·96 Gy to the primary tumour and 59·4 Gy to ganglion levels II, III and IV, bilaterally in 33 fractions. At fraction 27 a significant decrease in tumour volume was noted, so adaptive radiotherapy was performed to complete the treatment. Currently the patient has no clinical evidence of tumour pathology.
The risk of radiation exposure in pregnant women (after 20 weeks of gestation), being treated for cancers of the tonsil, reaching the foetus is minimal, with a reduced risk of a few or no effects.
Radiotherapy in tonsil cancer has been shown to be effective in combination with chemotherapy for local control of the disease. In the case of this pregnant patient, radiotherapy, as the only modality, provided local control and little exposure of radiation to the foetus.
Species distribution models (SDMs) are statistical tools used to develop continuous predictions of species occurrence. ‘Integrated SDMs’ (ISDMs) are an elaboration of this approach with potential advantages that allow for the dual use of opportunistically collected presence-only data and site-occupancy data from planned surveys. These models also account for survey bias and imperfect detection through the use of a hierarchical modelling framework that separately estimates the species–environment response and detection process. This is particularly helpful for conservation applications and predictions for rare species, where data are often limited and prediction errors may have significant management consequences. Despite this potential importance, ISDMs remain largely untested under a variety of scenarios. We performed an exploration of key modelling decisions and assumptions on an ISDM using the endangered Baird’s tapir (Tapirus bairdii) as a test species. We found that site area had the strongest effect on the magnitude of population estimates and underlying intensity surface and was driven by estimates of model intercepts. Selecting a site area that accounted for the individual movements of the species within an average home range led to population estimates that coincided with expert estimates. ISDMs that do not account for the individual movements of species will likely lead to less accurate estimates of species intensity (number of individuals per unit area) and thus overall population estimates. This bias could be severe and highly detrimental to conservation actions if uninformed ISDMs are used to estimate global populations of threatened and data-deficient species, particularly those that lack natural history and movement information. However, the ISDM was consistently the most accurate model compared to other approaches, which demonstrates the importance of this new modelling framework and the ability to combine opportunistic data with systematic survey data. Thus, we recommend researchers use ISDMs with conservative movement information when estimating population sizes of rare and data-deficient species. ISDMs could be improved by using a similar parameterization to spatial capture–recapture models that explicitly incorporate animal movement as a model parameter, which would further remove the need for spatial subsampling prior to implementation.
The regulatory framework of the red octopus (Octopus maya) fishery includes total allowable catches (TAC), which are based on studies conducted on the population that occurs in shallow waters. In fact, most of the biological studies of this species refer to the fraction of the population that occupies waters less than 30 m deep; however, O. maya can occur up to a 60 m depth. The aim of this study is to assess the stock of O. maya that occupies waters between 30 m and 60 m deep. Four research cruises were carried out during the closed and fishing seasons, from May 2016 to January 2017. An average of 29 sampling sites were surveyed in each cruise (±2 sampling sites) using a commercial vessel with a uniform sampling effort. In each sampling site, the swept area, the total number of octopuses captured, the total weight of the catch, and the individual weight of octopuses were recorded. Biomass was obtained with four methods: stratified random method, swept area method, geostatistical biomass model, and an unpublished method of weighted swept area. The four methods provided consistent results. The distribution pattern of species was in patches, although before the fishing season started it was more homogeneous. The fraction of the population that occurs between 30 m and 60 m deep consisted mostly of adult organisms, so it could be contributing significantly to the recruitment of the entire population, even to the fraction that is exploited.
OBJECTIVES/SPECIFIC AIMS: The Title V Cooperative Project of the UPR-MSC and UCC has demonstrated that educational interventions in CTR are very effective in fulfilling the objective of promoting awareness, stimulate interest and increase the knowledge, skills and opportunities, to US, GS and F (participants) in CTR. METHODS/STUDY POPULATION: The training sessions (TS) offered through the Title V initiative have become an engine for the involvement in CTR for participants from higher education institutions island-wide. TS consisted of cycles –level 1 and 2–: Research Education Towards Opportunities (RETO,I,II) and Mentorship Offering Training Opportunities for Research (MOTOR,I,II), ending in the formation of the Clinical and Translational Mentoring Teams (CTMT)s, in which participants, paired by their research interests, were mentored by a well-established CT researchers in their research project, to be developed in the Intensive Development and Experiences in Advancement of Research and Increased Opportunities (IDEARIO). RESULTS/ANTICIPATED RESULTS: Up to date, 4 TS-level 1 and 2 TS-level 2 were offered. Eighty (80) participants completed level 1, distributed: 42 (52.5%) US in RETO, 21 (26.25%) GS and 17 (21.25%) F in MOTOR and 17 participants completed level 2, distributed: 4 (23.52%) US in RETO, 6 (25.29%) GS and 7 (41.17%) F in MOTOR. From which, 15, with 8 CT researchers, formed 5 CTMTs in different research areas – cardio, neuro, liver, renal, Zika–. DISCUSSION/SIGNIFICANCE OF IMPACT: US, GS and F were integrated in the active process throughout educational levels for their development in CTR.
The aim of the study was to determine the main factors (sociodemographic, anthropometric, lifestyle and health status) associated with high Na excretion in a representative population of Chile.
Na excretion (g/d), a valid marker of Na intake, was determined by urine analysis and Tanaka’s formulas. Blood pressure was measured by trained staff and derived from the mean of three readings recorded after 15 min rest. The associations of Na excretion with blood pressure and the primary correlates of high Na excretion were determined using logistic regression.
Chileans aged ≥15 years.
Participants (n 2913) from the Chilean National Health Survey 2009–2010.
Individuals aged 25 years or over, those who were obese and those who had hypertension, diabetes or metabolic syndrome were more likely to have higher Na excretion. The odds for hypertension increased by 10·2 % per 0·4 g/d increment in Na excretion (OR=1·10; 95 % CI 1·06, 1·14; P < 0·0001). These findings were independent of major confounding factors.
Age, sex, adiposity, sitting behaviours and existing co-morbidities such as diabetes were associated with higher Na excretion levels in the Chilean population. These findings could help policy makers to implement public health strategies tailored towards individuals who are more likely to consume high levels of dietary salt.
Caliochory, or seed dispersal by birds as nest material, has been reported for several species, but its effectiveness remains unclear in most cases. Darwin’s finches are traditionally regarded as seed predators, but the observation of two nests challenges this assumption by demonstrating that they can act as seed dispersers via caliochory. Darwin’s finches incorporate cotton-like materials into their nests, including seeds of Darwin’s cotton (Gossypium darwinii), a shrub endemic to the Galápagos (Ecuador). Bird nests typically break down after intense rainfall, so the seeds incorporated into nests might benefit from suitable conditions for germination. By simulating the germination conditions experienced over a 72-h period by cotton seeds in a naturally fallen nest, this study qualitatively confirms the long-term viability of at least a small fraction of the seeds at the surface of the nest. Darwin’s finches might therefore provide seed-dispersal services to Darwin’s cotton and possibly, other native and exotic plants of the Galápagos commonly incorporated into nests. However, larger confirmatory studies are needed.
The Bipolar Spectrum Diagnostic Scale (BSDS) is widely validated and used as a screening tool for bipolar disorder. However, there is no BSDS validated version for its use in Mexican population. The aim of the present study was to examine the BSDS diagnostic capacity, and to evaluate its criterion validity and internal consistency for its use in Mexican psychiatric patients. We recruited 200 patients who attended the psychiatric outpatient service of a Mental Health Specialized Hospital and were screened for bipolar disorder using BSDS. To determine the cut-off point, sensitivity and specificity, we used the SCID–I diagnosis as the gold standard in 100 participants with bipolar disorder and 100 with major depression. Internal consistency according to Cronbach’s coefficient alpha was .81. The area under ROC curve for the overall discriminability of BSDS against the criterion of SCID–I for bipolar disorder was .90. Finally, a cut-off value of 12 reached the most stable sensitivity and specificity, with predictive powers higher than .80. In conclusion, the properties of the scale including internal consistency, sensitivity and specificity, make of BSDS a valuable instrument for screening bipolar disorder in Mexican psychiatric population.
Informal caregivers of individuals with Parkinson’s disease face a range of responsibilities that increase as the disease progresses. As a result of these stressors, caregivers are vulnerable to decreased health-related quality of life (HRQOL). Guided by the stress process model of caregiving, the present study examined the relations between family cohesion, perceived burden, and mental and physical HRQOL among Parkinson’s disease caregivers in Mexico. It was hypothesized that perceived burden would mediate the relations of family cohesion and mental and physical HRQOL.
Ninety-five family caregivers of individuals with Parkinson’s disease in Mexico City, Mexico, participated in the study. Multiple regression was utilized to conduct mediation analyses.
Results indicated that burden fully mediated the relation between family cohesion and mental HRQOL, and family cohesion was not associated with physical HRQOL.
Findings extend the stress process model cross-culturally and lend support for the importance of family cohesion and perceived burden in determining caregiver mental HRQOL. Clinical health promotion interventions should target perceived burden and family cohesion together to improve mental HRQOL among familial caregivers in Mexico.
In order to analyse the effect of hosts’ relationships and the helminthic load on the switching of parasites between native and introduced hosts, we sampled rodents belonging to two suborders from Central Chile. We compared the number of helminthic species shared between murids (introduced) and cricetid (native, same suborder) rodents to those shared between murids and hystricomorphs (native, different suborder), and we assessed the association between parasitic presence, abundance and geographical dispersion in source hosts to the presence and abundance in recipient hosts. Introduced rodent species shared more helminth species with cricetid rodents than with non-cricetids. Presence and abundance in recipient hosts was not associated with the prevalence and mean abundance in source hosts’ population. The mean abundance of parasites in source hosts throughout the territory and wider dispersion was positively associated with the likelihood of being shared with a recipient host. Closer relationships between native and introduced hosts and high parasitic abundance and dispersion could facilitate host switching of helminths between native and introduced rodents. This work provides the first documentation of the importance of parasitic abundance and dispersion on the switching of parasites between native and introduced hosts.
This contribution analyses the viability of the new Spanish financial landscape which has been drawn by the European authorities and the national administration in order to overcome the progressive deterioration of social wealth in Spain since the beginning of the economic crisis in 2008.
The adoption and the implementation of a new legal framework during the last two years, establishing tougher requirements on capital adequacy, leverage ratios and counter-cyclical and other buffers, as well as the shaping of the Banking Union, are not enough to transform the Spanish banking system into the key tool for the creation of wealth.
There is a paradox of both legal and institutional outcomes. While, on the one hand, some positive changes in the functioning and the structure of the banking industry have been prompted by the regulatory reform, there are, on the other hand, some uncertainties linked to the recapitalisation costs of a relevant group of credit institutions and the persistence of serious structural problems of the Spanish economy.
Moving faster to full banking union will reduce financial market stress in Spain.
This paper presents a review of filtering methods to eliminate echo in antenna measurements. Two different methods, fast Fourier transform and Matrix Pencil, are explained, compared, and simulated in a planar near field where other effects, such as aliasing, can and will be present if the simulation is not appropriately made and the parameters are not carefully chosen. Finally both methods are applied to real measurements of a dipole in a Microwave Vision Group multiprobe system and of a horn in a single-cut measurement. Other effects, such as window shift, may appear depending on the geometry of the system where the measurement is taken. These effects must be taken into consideration and carefully corrected.
It is likely that the Mediterranean diet (MedDiet) may mitigate the adverse effects of obesity on the incidence of type 2 diabetes mellitus (T2DM). We assessed this hypothesis in a cohort of 18 225 participants initially free of diabetes (mean age: 38 years, 61 % women). A validated semi-quantitative 136-item FFQ was used to assess dietary intake and to build a 0–9 score of adherence to MedDiet. After a median of 9·5-year follow-up, 136 incident cases of T2DM were confirmed during 173 591 person-years follow-up. When MedDiet adherence was low (≤4 points), the multivariable-adjusted hazard ratios (HR) were 4·07 (95 % CI 1·58, 10·50) for participants with BMI 25–29·99 kg/m2 and 17·70 (95 % CI 6·29, 49·78) kg/m2 for participants with BMI≥30 kg/m2, (v.<25 kg/m2). In the group with better adherence to the MedDiet (>4 points), these multivariable-adjusted HR were 3·13 (95 % CI 1·63, 6·01) and 10·70 (95 % CI 4·98, 22·99) for BMI 25–30 and ≥30 kg/m2, respectively. The P value for the interaction was statistically significant (P=0·002). When we assessed both variables (BMI and MedDiet) as continuous, the P value for their interaction product-term was marginally significant (P=0·051) in fully adjusted models. This effect modification was not explained by weight changes during follow-up. Our results suggest that the MedDiet may attenuate the adverse effects of obesity on the risk of T2DM.
The Archive is the main Gaia data distribution hub. The contents of DR1 are briefly reviewed and the data structures discussed. The system architecture, based on Virtual Observatory standards, is also presented, together with the extensions that allow e.g. authenticated access, persistent uploads and table sharing. Finally some usage examples are provided.
In this note we study generic existence of maximal almost disjoint (MAD) families. Among other results we prove that Cohen-indestructible families exist generically if and only if b = c. We obtain analogous results for other combinatorial properties of MAD families, including Sacks-indestructibility and being +-Ramsey.
Firestone & Scholl (F&S) rely on three problematic assumptions about the mind (modularity, reflexiveness, and context-insensitivity) to argue cognition does not fundamentally influence perception. We highlight evidence indicating that perception, cognition, and emotion are constructed through overlapping, distributed brain networks characterized by top-down activity and context-sensitivity. This evidence undermines F&S's ability to generalize from case studies to the nature of perception.
Over the last few decades the number of radiocarbon dates available for West Central Africa has increased substantially, even though it is still meagre compared with other areas of the continent. In order to contribute to a better understanding of the Iron Age of this area we present and analyze a total of 22 radiocarbon dates obtained from sites from the island of Corisco (Equatorial Guinea). By comparing them with those from Equatorial Guinea, southern Cameroon, and coastal Gabon and Congo we intend to clarify the picture of the West Central African Iron Age and propose a more accurate archaeological sequence.
The formation of massive stars remains one of the most intriguing questions in astrophysics today. The main limitations result from the difficulty to obtain direct observational constraints on the formation process itself. In this context, the Carina High-contrast Imaging Project of massive Stars (CHIPS) aims to observe all 80+ O stars in the Carina nebula using the new VLT 2nd-generation extreme-AO instrument SPHERE. This instrument offers unprecedented imaging contrast allowing us to detect the faintest companions around massive stars. These novel observational constraints will help to discriminate between the different formation scenarios by comparing their predictions for companion statistics and properties.
Caregivers’ commitment to personal values is linked to caregivers’ well-being, although the effects of personal values on caregivers’ guilt have not been explored to date. The goal of this study is to analyze the relationship between caregivers´ commitment to personal values and guilt feelings.
Participants were 179 dementia family caregivers. Face-to-face interviews were carried out to describe sociodemographic variables and assess stressors, caregivers’ commitment to personal values and guilt feelings. Commitment to values was conceptualized as two factors (commitment to own values and commitment to family values) and 12 specific individual values (e.g. education, family or caregiving role). Hierarchical regressions were performed controlling for sociodemographic variables and stressors, and introducing the two commitment factors (in a first regression) or the commitment to individual/specific values (in a second regression) as predictors of guilt.
In terms of the commitment to values factors, the analyzed regression model explained 21% of the variance of guilt feelings. Only the factor commitment to family values contributed significantly to the model, explaining 7% of variance. With regard to the regression analyzing the contribution of specific values to caregivers’ guilt, commitment to the caregiving role and with leisure contributed negatively and significantly to the explanation of caregivers' guilt. Commitment to work contributed positively to guilt feelings. The full model explained 30% of guilt feelings variance. The specific values explained 16% of the variance.
Our findings suggest that commitment to personal values is a relevant variable to understand guilt feelings in caregivers.