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Background: Brain tumors present unique challenges to patient and family quality of life (QOL). Cognitive dysfunction is common and functionally limiting, with no established treatments. These studies evaluate feasibility and preliminary efficacy of behavioral interventions developed for neuro-oncology patients. Study 1: A randomized controlled trial (N=25 primary brain tumor patients) compared an adapted version of Goal Management Training (GMT, a neuroscience-based integration of mindfulness and strategy training) and a newly-designed supportive psychoeducational intervention (Brain Health Program, BHP) to standard of care. Each intervention comprised 8 individual sessions and at-home practice between sessions. GMT patients’ executive functions improved immediately (p=.077, d=1.13), with maintenance at 4-month follow-up (p=.046, d=1.09). Both intervention groups reported improvements in everyday cognitive functioning immediately (p=.049; d’s GMT=0.43, BHP=0.79) and at follow-up (p=.001; d’s GMT=0.22, BHP=1.01). BHP patients also reported improved mood (p’s=.026 & .012, d’s=0.61 & 0.62). Study 2: Following a needs assessment about cognitive concerns and QOL in brain metastases patients (N=109) and caregivers (N=31), we developed a novel, brief (3 sessions + homework) Cognitive Support Program to provide education and strategy-training in key areas of concern: executive functions, memory, and communication. Options include caregiver co-training, and in-person or web-based delivery. Preliminary data from a pilot trial in progress demonstrate objective and subjective improvements. Conclusions: Cognitive rehabilitation may be a feasible and effective option for primary or metastatic brain tumor patients, addressing a need that is largely unmet in standard cancer care. Further development and larger trials appear warranted, with capacity for remote delivery recommended.
Background: Radiotherapy with procarbazine, lomustine, and vincristine improves overall survival (OS) in patients with 1p19q co-deleted anaplastic oligodendroglioma/anaplastic oligoastrocytoma. Methods: This retrospective analysis investigated outcomes in patients with 1p19q co-deleted/partially deleted oligodendroglioma, oligoastrocytoma, anaplastic oligodendroglioma, or anaplastic oligoastrocytoma. OS and progression-free survival (PFS) were analyzed using the Kaplan-Meier method and prognostic factors using the Cox proportional hazard model. Results: A total of 106 patients (between December 1997 and December 2013) were included. Median age was 40 years (19-66), 58 were male (55%), Eastern Cooperative Oncology Group performance status was 0 in 80 patients (75%). 1p19q status was co-deleted in 66 (62%), incompletely co-deleted in 27 (25%), and 1p or 19q loss alone in four (4%) and nine (8%) patients, respectively. Isocitrate dehydrogenase-1 R132H mutation was found in 67 of 85 patients with sufficient material. Upfront treatment was given in 72 (68%) patients and temozolomide alone in 52 (49%). Median time to radiotherapy in 47 patients (44%) was 34.7 months and 41.2 months in 9 patients with co-deleted/incompletely co-deleted anaplastic oligodendroglioma/anaplastic oligoastrocytoma who received upfront temozolomide alone. Median OS was not reached and 5-year OS was 91% for all groups (median follow-up, 5.1 years). On multivariable analysis for all patients, receipt of therapy upfront versus none (p=0.04), PS 1 versus 0 (p<0.001) and 1p19q co-deletion/incomplete deletion versus 1p or 19q loss alone (p=0.005) were prognostic for PFS. Isocitrate dehydrogenase-1 status was not prognostic for PFS. Conclusions: With similar survival patterns in low-grade/anaplastic gliomas, molecular characteristics may be more important than histological grade. Longer follow-up and results of prospective trials are needed for definitive guidance on treatment of these patients.
New solar soft X-ray (SXR) and extreme ultraviolet (EUV) irradiance observations from NASA Solar Dynamics Observatory (SDO) EUV Variability Experiment (EVE) provide full coverage from 0.1 to 106 nm and continuously at a cadence of 10 seconds for spectra at 0.1 nm resolution. These observations during flares can usually be decomposed into four distinct characteristics: impulsive phase, gradual phase, coronal dimming, and EUV late phase. Over 6000 flares have been observed during the SDO mission; some flares show all four phases, and some only show the gradual phase. The focus is on the newer results about the EUV late phase and coronal dimming and its relationship to coronal mass ejections (CMEs). These EVE flare measurements are based on observing the sun-as-a-star, so these results could exemplify stellar flares. Of particular interest is that new coronal dimming measurements of stars could be used to estimate mass and velocity of stellar CMEs.
Optimal treatment of glioblastoma (GBM) in the elderly remains unclear. The impact of age on treatment planning, toxicity, and efficacy at a Canadian Cancer Centre was retrospectively reviewed.
Glioblastoma patients treated consecutively between 2004 and 2008 were reviewed. Utilizing 70 years as the threshold for definition of an elderly patient, treatments and outcome were compared in younger and elderly populations.
Four hundred and twenty one patients were included in this analysis and median overall survival (OS) for the entire cohort was 9.8 months. 290 patients were aged <70 (median age 57, range 17–69) and 131 were aged ≥70 (median age 76, range 70–93). Patients ≥70 were more likely to receive best supportive care (BSC) and all patients >70 who were treated with radiotherapy received <60 Gy (P<0.001), except one. Patients aged >70 demonstrated inferior survival (one year OS 16% versus 54% for those <70, HR 3.46, P<0.001). In patients treated with BSC only, age had no impact on survival (median survival two months in both groups, HR 0.89, P=0.75). For those treated with higher doses of radiotherapy (>30 Gy to <60 Gy), one year survival was 19% versus 24% in patients aged >70 versus <70 (HR 1.47, P=0.02) respectively.
In this retrospective single institution series, elderly patients were more likely to be treated with BSC or palliative doses of radiotherapy. Randomized phase III study results are required for guidance in treatment of this population of patients.
Hypovitaminosis D may be associated with diabetes, hypertension and CHD. However, because studies examining the associations of all three chronic conditions with circulating 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) are limited, we examined these associations in the US Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial (n 2465). Caucasian PLCO participants selected as controls in previous nested case–control studies of 25(OH)D and 1,25(OH)2D were included in this analysis. Diabetes, CHD and hypertension prevalence, risk factors for these conditions and intake of vitamin D and Ca were collected from a baseline questionnaire. Results indicated that serum levels of 25(OH)D were low ( < 50 nmol/l) in 29 % and very low ( < 37 nmol/l) in 11 % of subjects. The prevalence of diabetes, hypertension and CHD was 7, 30 and 10 %, respectively. After adjustment for confounding by sex, geographical location, educational level, smoking history, BMI, physical activity, total dietary energy and vitamin D and Ca intake, only diabetes was significantly associated with lower 25(OH)D and 1,25(OH)2D levels. Caucasians who had 25(OH)D ≥ 80 nmol/l were half as likely to have diabetes (OR 0·5 (95 % CI 0·3, 0·9)) compared with those who had 25(OH)D < 37 nmol/l. Those in the highest quartile of 1,25(OH)2D ( ≥ 103 pmol/l) were less than half as likely to have diabetes (OR 0·3 (95 % CI 0·1, 0·7)) than those in the lowest quartile ( < 72 pmol/l). In conclusion, the independent associations of 25(OH)D and 1,25(OH)2D with diabetes prevalence in a large population are new findings, and thus warrant confirmation in larger, prospective studies.
Leek moth, Acrolepiopsis assectella, recently became established in the Ottawa Valley, where it significantly damages garlic, leek, and onion (Allium L., Liliaceae) crops. At a threshold of 7 °C, populations in eastern Ontario require 444.6 day-degrees to develop from egg to adult. Pheromone-trap data identify spring, early-summer, and late-summer flight periods of overwintered 1st- and 2nd-generation adults, respectively. Depending on ambient temperatures, the life cycle takes 3–6 weeks in the field, with three generations possible. Management strategies such as application of reduced-risk foliar insecticides and use of row covers require precise timing to target appropriate life-cycle stages. Implementation windows can be determined by incorporating pheromone-trap data and ambient air temperature into a life-cycle development model. A proposed integrated pest management program will involve the use of pesticides, mechanical barriers, and classical biological control.
We develop rapid chemical vapor sensors and micro gas chromatography (μGC) analyzers based on the optofluidic ring resonator (OFRR). An OFRR is a micro-sized thin-walled glass capillary; the circular cross-section of the capillary acts as an optical ring resonator while the whispering gallery modes or circulating waveguide modes (WGMs) supported by the ring resonator interact with the vapor samples passing through the capillary. The OFRR interior surface is coated with a vapor-sensitive polymer. The analyte and polymer interaction causes the polymer refractive index (RI) and the thickness to change, which is detected as a WGM spectral shift. Owing to the excellent fluidics, the OFRR vapor sensor exhibits sub-second detection and recovery time with a flow rate of 1 mL/min. On-column separation and detection in the OFRR based μGC system is also demonstrated, showing efficient separation of vapor mixtures and presenting highly reproducible retention time for the individual analyte. Compared to the conventional GC system, the OFRR μGC has the advantage of small size, rapid response, and high selectivity over a short length of column.
BOOMERanG has recently resolved structures on the last scattering surface at redshift ˜ 1100 with high signal to noise ratio. We review the technical advances which made this possible, and we focus on the current results for maps and power spectra, with special attention to the determination of the total mass-energy density in the Universe and of other cosmological parameters.
In the 1998-99 flight, BOOMERanG has produced maps of ∼4% of the sky at high Galactic latitudes, at frequencies of 90, 150, 240 and 410 GHz, with resolution ≳ 10'. The faint structure of the Cosmic Microwave Background at horizon and sub-horizon scales is evident in these maps. These maps compare well to the maps recently obtained at lower frequencies by the WMAP experiment. Here we compare the amplitude and morphology of the structures observed in the two sets of maps. We also outline the polarization sensitive version of BOOMERanG, which was flown early this year to measure the linear polarization of the microwave sky at 150, 240 and 350 GHz.
The case histories are presented of three patients with circumferential subglottic stenoses who presented, over a six-month period, to a teaching hospital's Otolaryngology department. No recognisable cause for their subglottic stenoses was found. Traumatic, iatrogenic, infectious and specific inflammatory processes were excluded. The histopathological evidence suggested a chronic inflammatory process. All patients were treated by resecting the stenosis with a carbon dioxide laser. One patient required an emergency tracheostomy for airway obstruction. A review of the published literature on this rare condition is given.
Predictors of long-term (13 year) outcome of schizophrenia are reported for a representative cohort of ‘treated incidence’ patients ascertained on their first contact with Nottingham psychiatric services between 1978–80. An initial (baseline) model including previously reported predictors of 2-year outcome (age, gender, ever married, acuteness of onset) and length of untreated illness was used to predict a range of outcome measures covering the domains of disability, psychopathology, hospitalization, employment, social activity, and global outcome. This model demonstrated significant prognostic ability across all non-hospitalization outcomes under both ICD-10 and ICD-9 diagnoses of schizophrenia, but was attenuated under broad (ICD-9 and CATEGO S, P or O) and restrictive (S+) diagnostic classifications. Female gender predicted more favourable outcome under all diagnostic classifications except S+. In an extended analysis, the addition of initial 2-year course type substantially increased the prognostic ability of the model under all diagnostic classifications and enabled over 30% of the variance in global ratings of disability and symptoms to be predicted. In this extended model female gender predicted more favourable outcome over and above the effect of course type, across most domains under ICD-10, and for disability and psychopathology under other diagnostic classifications. The inclusion of measures of psychopathology at the time of first assessment, pre-morbid functioning, and duration of index admission conferred only marginal additional predictive ability for respective outcomes in the domains of psychopathology, social activity, employment and hospitalization. Hospitalization during the past year was the most difficult outcome to predict under any model suggesting that resource utilization represents the ‘administrative outcome’ of schizophrenia and serves as a poor proxy for broader concerns in the era of community care. These data demonstrate that key demographic variables and the mode of onset influence the long-term course of schizophrenia, but that early course type is a particularly strong predictor.
Crystalline diamond coatings and, increasingly, diamond like amorphous carbon (DLC) films are used for tribological and protective layers for their hardness and chemical inertness. They are also under investigation for their electron emitting properties, with possible applications in field emission displays. DLC films were deposited by laser ablation using a KrF excimer laser and fluences between 0.5 and 2 J/cm2. FTIR measurements did not show the presence of hydrogen in the films. Raman spectra allowed for the determination of the nature of the graphitic and diamond bonds (sp2 and sp3) as well as information about the disorder and short range order in the films. For a better determination of the sp3-content, which is often hidden in the Raman spectra, a correlation with optical properties in the near IR to near UV region was established. These values depended strongly on the substrate temperature and the laser fluence. DLC formation could be demonstrated even at substrate temperatures close to room temperature. Vickers hardness values and first measurements on the electron emissivity of the films can be correlated to the diamond character and the preparation method of the films.
Two positive ODMR resonances are commonly observed on a luminescence band in GaN at 2.2 eV, one identified as a shallow donor, the other currently unidentified. We here report a study of their dependencies on a variety of experimental parameters, including microwave modulation frequency, microwave power, photoexcitation power and photoexcitation energy. ODMR simulations using two theoretical models are compared to experimental results which are consistent with spin-dependent recombination between the two defects, assuming the donor has a spin-lattice relaxation time shorter than the spin-dependent recombination lifetime. The photoexcitation energy dependence suggests that the spin-dependent recombination associated with the 2.2 eV band is not the same recombination that is responsible for the luminescence. This supports the two stage model put forth by Glaser et al. for the luminescence process.
The rich phase behaviour displayed by phospholipid bilayers and their structural relationship to biological membranes have made them fascinating objects of study. Despite being one of the most often examined of these model membrane systems, dipalmitoylphosphatidylcholine (DPPC) continues to be a source of interest for scientists. In particular, the ripple phase, Pβ′, of fully hydrated DPPC has generated a great deal of attention over the years as scientists have tried to understand the structural details of this novel phase1–5.
We report photometric results from 44 runs at 11 observatories during the international campaign ‘TT Ari–94’. No coherent oscillations in the frequency range 10… 900 cycle d−1 are found. The highest peaks in the power spectrum cover the wide range of 28… 139 cycle d−1. Variations occur at a few preferred time-scales rather than at one cycle length, with a possible secular decrease. In the frequency range 90… 900 cycle d−1 the power spectrum obeys a power law with slope γ ranging from 0.8 to 2.6 for different runs.
TT Ari is one of the brightest cataclysmic variables and remains one of the most interesting objects of this class. It exhibits a variety of phenomena observed at time-scales from seconds to months. A recent detailed photometric study of this object and a bibliographical overview may be found in Tremko et al. (1996). Tremko et al. (1992, 1993, 1994) discuss aspects of the TT Ari–88 campaign. Our campaign TT Ari–94 was unprecedented, as the observations were longitude-dispersed, from Japan through Turkmenia, to Europe and the American continent. Moreover, our optical data on October 7 partially overlap with the HST observations obtained by Home & Welsh (1995, private communication). The numerical results of observations obtained during these nights are shown in Table 1.