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Obstructed hemivagina with ipsilateral renal anomaly (OHVIRA) is a rare congenital genitourinary defect with a triad of unilateral vaginal obstruction, uterine anomaly and ipsilateral renal agenesis. This paper reports an unusual presentation of OHVIRA, with our patient experiencing severe abdominal pain from a left tubo-ovarian abscess that is contralateral to the side of the vaginal outflow obstruction. Another reportable finding is our patient’s rare association of a trifid ureter that fuses distally before inserting ectopically in her vaginal canal. Lastly, this case report also emphasises the importance of radiologists’ expertise in suspecting the diagnosis early on and in contributing to the preoperative evaluation of patients with OHVIRA, thereby providing adequate management for these patients.

Purpose: Preclinical data showed that prophylactic, low-dose temozolomide (TMZ) significantly prevented breast cancer brain metastasis. We present results of a phase I trial combining T-DM1 with TMZ for the prevention of additional brain metastases after previous occurrence and local treatment in patients with HER2+ breast cancer. Patients and Methods: Eligible patients had HER2+ breast cancer with brain metastases and were within 12 weeks of whole brain radiation therapy (WBRT), stereotactic radiosurgery, and/or surgery. Standard doses of T-DM1 were administered intravenously every 21 days (3.6 mg/kg) and TMZ was given orally daily in a 3+3 phase I dose escalation design at 30, 40, or 50 mg/m2, continuously. DLT period was one 21-day cycle. Primary endpoint was safety and recommended phase II dose. Symptom questionnaires, brain MRI, and systemic CT scans were performed every 6 weeks. Cell-free DNA sequencing was performed on patients’ plasma and CSF. Results: Twelve women enrolled, nine (75%) with prior SRS therapy and three (25%) with prior WBRT. Grade 3 or 4 AEs included thrombocytopenia (1/12), neutropenia (1/12), lymphopenia (6/12), and decreased CD4 (6/12), requiring pentamidine for Pneumocystis jirovecii pneumonia prophylaxis. No DLT was observed. Four patients on the highest TMZ dose underwent dose reductions. At trial entry, 6 of 12 patients had tumor mutations in CSF, indicating ongoing metastatic colonization despite a clear MRI. Median follow-up on study was 9.6 m (2.8–33.9); only 2 patients developed new parenchymal brain metastases. Tumor mutations varied with patient outcome. Conclusions: Metronomic TMZ in combination with standard dose T-DM1 shows low-grade toxicity and potential activity in secondary prevention of HER2+ brain metastases.

The pre-industrial state of the global carbon cycle is a significant aspect of studies related to climate change. In this paper, we recall the power law kinetic representations of the pre-industrial models of Schmitz (2002) and Anderies et al. (2013) from our earlier work. The power law kinetic representations, as uniform formalism, allow for a more extensive analysis and comparison of the different models for the same system. Using the mathematical theories of chemical reaction networks (with power-law kinetics), this work extends the analysis of the kinetic representations of the two models and assesses the similarities and differences in their structural and dynamic properties in relation to model construction assumptions. The analysis includes but is not limited to the coincidence of kinetic and stoichiometric spaces of the networks, capacity for equilibria multiplicity and co-multiplicity, and absolute concentration robustness in some species. Moreover, we bring together previously published results about the power law kinetic representations of the two models and consolidate them with new observations here. We also illustrate how the pre-industrial model of Anderies et al. may serve as a building block in the analysis of a kinetic representation of a global carbon cycle with carbon dioxide removal intervention., arXiv admin note: text overlap with arXiv:1109.2923 by other authors

Studies about the set of positive equilibria ($E_+$) of kinetic systems have been focused on mass action, and not that much on power law kinetic (PLK) systems, even for PL-RDK systems (PLK systems where two reactions with identical reactant complexes have the same kinetic order vectors). For mass action, reactions with different reactants have different kinetic order rows. A PL-RDK system satisfying this property is called factor span surjective (PL-FSK). In this work, we show that a cycle terminal PL-FSK system with $E_+\ne \varnothing$ and has independent linkage classes (ILC) is a poly-PLP system, i.e., $E_+$ is the disjoint union of log-parametrized sets. The key insight for the extension is that factor span surjectivity induces an isomorphic digraph structure on the kinetic complexes. The result also completes, for ILC networks, the structural analysis of the original complex balanced generalized mass action systems (GMAS) by M\"uller and Regensburger. We also identify a large set of PL-RDK systems where non-emptiness of $E_+$ is a necessary and sufficient condition for non-emptiness of each set of positive equilibria for each linkage class. These results extend those of Boros on mass action systems with ILC. We conclude this paper with two applications of our results. Firstly, we consider absolute complex balancing (ACB), i.e., the property that each positive equilibrium is complex balanced, in poly-PLP systems. Finally, we use the new results to study absolute concentration robustness (ACR) in these systems. In particular, we obtain a species hyperplane containment criterion to determine ACR in the system species.

In the tripartite influence model, appearance-ideal internalization is identified as a prominent risk factor for the development of body dissatisfaction and subsequent eating disorder (ED) behaviors. For men, prior research has emphasized the importance of both thin-ideal internalization and muscular-ideal internalization in explaining later ED behaviors and muscle dysmorphia (MD) symptoms. Previous research in heterosexual men has shown that the associations between muscular-ideal internalization and ED or MD symptoms may depend on whether the individual has also internalized the thin ideal. However, this interaction has not been examined in research with sexual minority men (SMM).The current study collected self-report data from 452 at risk SMM (i.e., endorsed body dissatisfaction), with ages ranging from 18 to 35 years. Linear regression models were conducted to test the interaction effects between thinness and muscularity internalization on ED symptoms, MD behaviors, and general body dissatisfaction. Simple slopes and the Johnson-Neyman technique were used to investigate significant interaction terms.Thin- and muscular-ideal internalization were positively associated with muscular appearance intolerance and dietary restriction with no significant interaction. Muscular drive for size was highest when both muscularity internalization and thinness internalization were high. Muscular-ideal internalization was positively associated with both cognitive restraint and general body dissatisfaction, but only at lower levels of thinness internalization.Given the interacting association between thinness and muscularity internalization and aspects of body dissatisfaction, attitudes, and behavior, prevention and intervention programs for EDs and MDs in SMM should seek to dismantle both thinness and muscularity internalization.Internalizing-or adopting as one's own-the ideal of a body with low body fat and high muscularity has been shown to lead to muscle dysmorphia and eating disorder symptoms in men. The current study examines whether the combination of thin-ideal and muscular-ideal internalization is associated with worse symptoms than either facet alone in sexual minority men. Treatment efforts in sexual minority men should address both types of internalization.

Objetivo. Presentar el diseño de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2022 y cuantificar el avance de la Ensanut Continua 2020-2024. Material y métodos. La Ensanut 2022 es la tercera encuesta de la serie de en­cuestas denominada Ensanut Continua 2020-2024. En este documento se describe el alcance de la Ensanut 2022 y sus procedimientos de muestreo, medición y organización logís­tica. Además, se presenta el avance esperado de la Ensanut Continua 2020-2024 al concluir la Ensanut 2022. Resulta­dos. La Ensanut 2022 obtendrá, a nivel nacional, al menos 10 160 entrevistas completas de hogar y 9 441 resultados de seropositividad a SARS-CoV-2. Conclusiones. La Ensanut 2022 estimará la prevalencia de seropositividad a SARS-CoV-2 a nivel nacional y regional y avanzará en la acumulación de información para alcanzar los objetivos de la Ensanut Con­tinua 2020-2024.

Background Symptom expression in SARS-CoV-2 infection (COVID-19) may affect patients already symptomatic with cancer. Patient-reported outcomes (PROs) can describe symptom burden during the acute and postacute stages of COVID-19 and support risk stratification for levels of care. At the start of the COVID-19 pandemic, our purpose was to rapidly develop, launch through an electronic patient portal, and provide initial validation for a PRO measure of COVID-19 symptom burden in patients with cancer. Methods We conducted a CDC/WHO web-based scan for COVID-19 symptoms and a relevance review of symptoms by an expert panel of clinicians treating cancer patients with COVID-19 to create a provisional MD Anderson Symptom Inventory for COVID-19 (MDASI-COVID). English-speaking adults with cancer who tested positive for COVID-19 participated in the psychometric testing phase. Patients completed longitudinal assessments of the MDASI-COVID and the EuroQOL 5 Dimensions 5 Levels (EQ-5D-5L) utility index and visual analog scale, which were presented through an electronic health record patient portal. To test the validity of the MDASI-COVID to distinguish between known groups of patients, we hypothesized that patients hospitalized, including having a hospitalization extended, for COVID-19 versus those not hospitalized would experience higher symptom burden. Correlation of mean symptom severity and interference scores with relevant EQ-5D-5L scores tested concurrent validity. The reliability of the MDASI-COVID was evaluated by calculating Cronbach alpha coefficients and test-retest reliability was evaluated by calculating Pearson correlation coefficients between the initial assessment and a second assessment no more than 14 days later. Results The web-based scan found 31 COVID-19-related symptoms; rankings of a 14-clinician expert panel reduced this list to 11 COVID-specific items to be added to the core MDASI. Time from literature scan start in March 2020 to instrument launch in May 2020 was 2 months. Psychometric analysis established the MDASI-COVID’s reliability, known-group validity, and concurrent validity. Conclusions We were able to rapidly develop and electronically launch a PRO measure of COVID-19 symptom burden in patients with cancer. Additional research is needed to confirm the content domain and predictive validity of the MDASI-COVID and define the symptom burden trajectory of COVID-19.

Introduction Immune checkpoint inhibitor (ICI) pneumonitis causes substantial morbidity and mortality. Estimates of real-world incidence and reported risk factors vary substantially. Methods We conducted a retrospective review of 419 patients with advanced non-small cell lung cancer (NSCLC) who were treated with anti-PD-(L)1 with or without anti-CTLA-4 therapy. Clinical, imaging, and microbiological data were evaluated by multidisciplinary adjudication teams. The primary outcome of interest was grade ≥2 (CTCAEv5) pneumonitis. Clinicopathologic variables, tobacco use, cancer therapies, and preexisting lung disease were assessed for univariate effects using Cox proportional hazards models. We created multivariate Cox proportional hazards models to assess risk factors for pneumonitis and mortality. Pneumonitis, pneumonia, and progression were modeled as time-dependent variables in mortality models. Results We evaluated 419 patients between 2013 and 2021. The cumulative incidence of pneumonitis was 9.5% (40/419). In a multivariate model, pneumonitis increased the risk for mortality (HR 1.6, 95% CI, 1.0-2.5), after adjustment for disease progression (HR 1.6, 95% CI, 1.4-1.8) and baseline shortness of breath (HR 1.5, 95% CI, 1.2-2.0). Incomplete resolution was more common with more severe pneumonitis. Interstitial lung disease was associated with higher risk for pneumonitis (HR 5.4, 95% CI, 1.1-26.6), particularly in never smokers (HR 26.9, 95% CI, 2.8-259.0). Conclusion Pneumonitis occurred at a high rate and significantly increased mortality. Interstitial lung disease, particularly in never smokers, increased the risk for pneumonitis.

Synthesis, X-ray crystallography, spectral analysis, and molecular docking analysis on (E)–2–(1–(4–fluorophenyl) ethylidene) hydrazine carbothioamide (EFEHC) are performed. Thiosemicarbazones are a class of small molecules used as anticancer therapeutics. The FT–IR and FT-Raman spectra of EFEHC have been recorded in 4000–400 and 4000–100 cm–1, respectively. The present communication deals with the quantum chemical calculations of energies, geometrical structure, and vibrational wavenumbers of EFEHC using the density functional (DFT/B3LYP) method with 6–31G (d, p) basis set. The conformational analysis gives the energy values based on the change in the position of atoms in the EFEHC molecule. Hirshfeld surface analysis (HSs) is used to discuss the evaluation of intermolecular interactions. Molecular docking analysis of the small molecule EFEHC with macromolecule HMG–CoA protein showed that this is a good molecule and is suitable for anti-cholesterol targets.

Supplemental Fig 2. Total mutation Burden by MB.

Purpose:Preclinical data showed that prophylactic, low-dose temozolomide (TMZ) significantly prevented breast cancer brain metastasis. We present results of a phase I trial combining T-DM1 with TMZ for the prevention of additional brain metastases after previous occurrence and local treatment in patients with HER2+ breast cancer.Patients and Methods:Eligible patients had HER2+ breast cancer with brain metastases and were within 12 weeks of whole brain radiation therapy (WBRT), stereotactic radiosurgery, and/or surgery. Standard doses of T-DM1 were administered intravenously every 21 days (3.6 mg/kg) and TMZ was given orally daily in a 3+3 phase I dose escalation design at 30, 40, or 50 mg/m2, continuously. DLT period was one 21-day cycle. Primary endpoint was safety and recommended phase II dose. Symptom questionnaires, brain MRI, and systemic CT scans were performed every 6 weeks. Cell-free DNA sequencing was performed on patients’ plasma and CSF.Results:Twelve women enrolled, nine (75%) with prior SRS therapy and three (25%) with prior WBRT. Grade 3 or 4 AEs included thrombocytopenia (1/12), neutropenia (1/12), lymphopenia (6/12), and decreased CD4 (6/12), requiring pentamidine for Pneumocystis jirovecii pneumonia prophylaxis. No DLT was observed. Four patients on the highest TMZ dose underwent dose reductions. At trial entry, 6 of 12 patients had tumor mutations in CSF, indicating ongoing metastatic colonization despite a clear MRI. Median follow-up on study was 9.6 m (2.8–33.9); only 2 patients developed new parenchymal brain metastases. Tumor mutations varied with patient outcome.Conclusions:Metronomic TMZ in combination with standard dose T-DM1 shows low-grade toxicity and potential activity in secondary prevention of HER2+ brain metastases.

Supplemental Fig. 3. ERB-B-2 Status of Patients.

Supplemental Methods

Supplemental Fig. 1. Neurocognitive assessments comparing patients presenting progression versus no progression.

Supplemental Fig. 4. Histogram illustrating ERBB2 relative copy number in plasma and CSF cfDNA samples from 12 patients during their T samples from 12 patients during their Tsamples from 12 patients during their T samples from 12 patients during their T-DM1/TMZ combination therapy.

Neutrophils chemotaxis video

Clinical trial protocol

Supplementary Figures and Tables

Purpose:To investigate the toxicity profile and establish an optimal dosing schedule of zotiraciclib with temozolomide in patients with recurrent high-grade astrocytoma.Patients and Methods:This two-stage phase I trial determined the MTD of zotiraciclib combined with either dose-dense (Arm1) or metronomic (Arm2) temozolomide using a Bayesian Optimal Interval design; then a randomized cohort expansion compared the progression-free survival rate at 4 months (PFS4) of the two arms for an efficient determination of a temozolomide schedule to combine with zotiraciclib at MTD. Pharmacokinetic and pharmacogenomic profiling were included. Patient-reported outcome was evaluated by longitudinal symptom burden.Results:Fifty-three patients were enrolled. Dose-limiting toxicities were neutropenia, diarrhea, elevated liver enzymes, and fatigue. MTD of zotiraciclib was 250 mg in both arms and thus selected for the cohort expansion. Dose-dense temozolomide plus zotiraciclib (PSF4 40%) compared favorably with metronomic temozolomide (PFS4 25%). Symptom burden worsened at cycle 2 but stabilized by cycle 4 in both arms. A significant decrease in absolute neutrophil count and neutrophil reactive oxygen species production occurred 12–24 hours after an oral dose of zotiraciclib but both recovered by 72 hours. Pharmacokinetic/pharmacogenomic analyses revealed that the CYP1A2_5347T>C (rs2470890) polymorphism was associated with higher AUCinf value.Conclusions:Zotiraciclib combined with temozolomide is safe in patients with recurrent high-grade astrocytomas. Zotiraciclib-induced neutropenia can be profound but mostly transient, warranting close monitoring rather than treatment discontinuation. Once validated, polymorphisms predicting drug metabolism may allow personalized dosing of zotiraciclib.

Purpose The standard recall period for the patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE®) is the past 7 days, but there are contexts where a 24-hour recall may be desirable. The purpose of this analysis was to investigate the reliability and validity of a subset of PRO-CTCAE items captured using a 24-hour recall. Methods 27 PRO-CTCAE items representing 14 symptomatic adverse events (AEs) were collected using both a 24-hour recall (24 h) and the standard 7 day recall (7d) in a sample of patients receiving active cancer treatment (n = 113). Using data captured with a PRO-CTCAE-24h on days 6 and 7, and 20 and 21, we computed intra-class correlation coefficients (ICC); an ICC ≥ 0.70 was interpreted as demonstrating high test–retest reliability. Correlations between PRO-CTCAE-24h items on day 7 and conceptually relevant EORTC QLQ-C30 domains were examined. In responsiveness analysis, patients were deemed changed if they had a one-point or greater change in the corresponding PRO-CTCAE-7d item (from week 0 to week 1). Results PRO-CTCAE-24h captured on two consecutive days demonstrated that 21 of 27 items (78%) had ICCs ≥ 0.70 (day 6/7 median ICC 0.76), (day 20/21 median ICC 0.84). Median correlation between attributes within a common AE was 0.75, and the median correlation between conceptually relevant EORTC QLQ-C30 domains and PRO-CTCAE-24 h items captured on day 7 was 0.44. In the analysis of responsiveness to change, the median standardized response mean (SRM) for patients with improvement was − 0.52 and that for patients with worsening was 0.71. Conclusion A 24-hour recall period for PRO-CTCAE items has acceptable measurement properties and can inform day-to-day variations in symptomatic AEs when daily PRO-CTCAE administration is implemented in a clinical trial.

Immune checkpoint inhibitors (ICI), combined with hypomethylating agents, can be used to treat acute myeloid leukemia (AML), but this strategy results in a high rate of pneumonitis. The authors sought to determine risk factors for pneumonitis development and whether pneumonitis increased mortality.The authors conducted a retrospective review of 258 AML patients who received ICI-containing regimens from 2016 to 2018. A multidisciplinary adjudication committee diagnosed pneumonia and pneumonitis by reviewing symptoms, imaging, microbiology, and response to therapies. To measure risk factors for pneumonitis and mortality, multivariate Cox proportional hazards models were constructed. Pneumonia, pneumonitis, and disease progression were modeled as a time-dependent variable and incorporated a standard risk set modifying variables into the models.Thirty patients developed pneumonitis (12%). Of these, 17 had partial or complete resolution, whereas 13 patients died from pneumonitis. Increasing age (hazard ratio [HR], 1.04 per year; 95% confidence interval [CI], 1.00-1.08), and baseline shortness of breath increased pneumonitis risk (HR, 2.51; 95% CI, 1.13-5.55). Female sex (HR, 0.33; 95% CI, 0.15-0.70) and increasing platelet count (HR, 0.52 per log-unit increase; 95% CI, 0.30-0.92) decreased pneumonitis risk. In adjusted models, ICI-related pneumonitis significantly increased mortality (HR, 2.84; 95% CI, 1.84-4.37).ICI-related pneumonitis occurs at a high rate in AML patients and increases mortality.Immune checkpoint inhibitors (ICIs) remove inhibitory signals that reduce T-cell function and allow T-cells to better attack cancer cells. In acute myeloid leukemia (AML), the effectiveness of ICIs is limited in part by inflammation of the lung, called pneumonitis. This study reviewed 258 patients with AML who received ICIs and identified 30 patients who developed pneumonitis, nearly half of whom died. Older age and baseline shortness of breath increased pneumonitis risk, whereas female sex and higher baseline platelet counts decreased pneumonitis risk. Pneumonitis increased mortality by nearly 3-fold. This work highlights the significant harm imposed by pneumonitis after ICI therapies.

This paper studies chemical kinetic systems which decompose into weakly reversible complex factorizable (CF) systems. Among power law kinetic systems, CF systems (denoted as PL-RDK systems) are those where branching reactions of a reactant complex have identical rows in the kinetic order matrix. Mass action and generalized mass action systems (GMAS) are well-known examples. Schmitz's global carbon cycle model is a previously studied non-complex factorizable (NF) power law system (denoted as PL-NDK). We derive novel conditions for the existence of weakly reversible CF-decompositions and present an algorithm for verifying these conditions. We discuss methods for identifying independent decompositions, i.e., those where the stoichiometric subspaces of the subnetworks form a direct sum, as such decompositions relate positive equilibria sets of the subnetworks to that of the whole network. We then use the results to determine the positive equilibria sets of PL-NDK systems which admit an independent weakly reversible decomposition into PL-RDK systems of PLP type, i.e., the positive equilibria are log-parametrized, which is a broad generalization of a Deficiency Zero Theorem of Fortun et al. (2019).

Communities of color have been disproportionately impacted by the coronavirus disease (COVID-19) pandemic, exposing the influence of decades of policies that have under-resourced and marginalized these communities. The history of segregation and inadequate funding in education has been exacerbated by the pandemic, compounding the educational inequities already present in the United States. The intersection of this inequity alongside immigration policies over the past years have led the undocumented student population to be adversely impacted. The lack of access to health care and social safety net programs, fear of deportation, and an over reliance on technology for schooling leaves a large segment of students vulnerable for adverse academic, emotional, and social outcomes. This paper will trace the historical path of educational segregation, immigration policies, and how these led to the disproportionate impact of COVID-19 on undocumented students. It will discuss interventions for undocumented students within an antioppressive ecological framework and the ethical responsibilities that school-based mental health professionals have to support undocumented students to fulfill their highest potential, manage the emotional toll of the pandemic, and advocate for change in immigration and educational policies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background In clinical trials and clinical practice, patient-reported outcomes are almost always assessed using multiple patient-reported outcome measures at the same time. This raises concerns about whether patient responses are affected by the order in which the patient-reported outcome measures are administered. Methods This questionnaire-based study of order effects included adult cancer patients from five cancer centers. Patients were randomly assigned to complete questionnaires via paper booklets, interactive voice response system, or tablet web survey. Linear Analogue Self-Assessment, Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events, and Patient-Reported Outcomes Measurement Information System assessment tools were each used to measure general health, physical function, social function, emotional distress/anxiety, emotional distress/depression, fatigue, sleep, and pain. The order in which the three tools, and domains within tools, were presented to patients was randomized. Rates of missing data, scale scores, and Cronbach’s alpha coefficients were compared by the order in which they were assessed. Analyses included Cochran–Armitage trend tests and mixed models adjusted for performance score, age, sex, cancer type, and curative intent. Results A total of 1830 patients provided baseline patient-reported outcome assessments. There were no significant trends in rates of missing values by whether a scale was assessed earlier or later. The largest order effect for scale scores was due to a large mean score at one assessment time point. The largest difference in Cronbach’s alpha between the versions for the Patient-Reported Outcomes Measurement Information System scales was 0.106. Conclusion The well-being of a cancer patient has many different aspects such as pain, fatigue, depression, and anxiety. These are assessed using a variety of surveys often collected at the same time. This study shows that the order in which the different aspects are collected from the patient is not important.

espanolObjetivo. Describir el diseno de la Encuesta Nacional de Salud y Nutricion 2021 (Ensanut 2021). Material y me-todos. La Ensanut 2021 es una encuesta probabilistica de hogares que forma parte de la serie de Ensanut Continua 2020-2024. En esta ocasion se describen el alcance, el mues-treo, la medicion y la organizacion logistica. Resultados.Se planea obtener al menos 12 060 entrevistas de hogar completas a nivel nacional y 9 837 muestras para determinar seropositividad a SARS-CoV-2 a nivel nacional. Conclusio-nes. La Ensanut 2021 permitira realizar inferencias regionales sobre la prevalencia de seropositividad a SARS-CoV-2 y tam-bien acumular informacion para realizar inferencias estatales en el ano 2024. EnglishObjective. To describe the design of the Mexican 2021 National Health and Nutrition Survey (Ensanut 2021). Ma-terials and methods. The Ensanut 2021 is a probabilistic household survey that is part of the continuous Ensanut 2020-2024; survey outreach, sampling, measurement and logistic organization are described. Results. It is planned to obtain at least 12 060 complete household interviews and 9 837 samples to determine SARS-CoV-2 seropositivity at the national level. Conclusions. Ensanut 2021 will allow to estimate the seroprevalence of SARS-CoV-2 antibodies at regional and national level; also, it will accumulate information to make state inferences for the year 2024.

The C-2W experimental device at TAE Technologies utilizes neutral beam injection and edge biasing to sustain long-lived, stable field reversed configuration (FRC) plasma. An ongoing effort is under way to optimize the electrode biasing system, which provides boundary control to stabilize the FRC. To this end, tomography offers a powerful and non-invasive technique as tomographic reconstruction of the FRC emission profile provides an important assessment of global stability. Recently, a new signal acquisition system was implemented on a bolometer array dedicated to tomography on C-2W, significantly enhancing the signal-to-noise of the collected data. The array consists of 300 simultaneously digitized photodiode channels that respond to a broad range of wavelengths, from soft x-ray to near-infrared, as well as energetic particles, yielding 180 unique lines of sight that intersect a toroidal plane of the FRC near the mid-plane. Utilizing the collected photo-signals from a set of plasma discharges in which the electrode biasing was intentionally terminated mid-shot, time-resolved reconstruction of the plasma emissivity is achieved via pixel-based 1D and 2D tomographic algorithms, revealing sharply annular profiles with a clear magnetohydrodynamic (MHD) mode structure. In addition, reconstruction of the plasma center-of-emission trajectories via a centroid algorithm applied to the same set of discharges demonstrates a cyclical plasma wobble. Crucially, both the tomography reconstruction and centroid reconstruction indicate an n = 1 toroidal mode that reverses from the electron diamagnetic direction to the ion diamagnetic direction and grows in amplitude after bias termination, qualitatively consistent with the expected stabilizing effect of electrodes.

The purpose of this study is to create a framework and test model that will provide an internet connection in Trimex Colleges, located in Binan City, Laguna. The captive portal is a website or splash screen that will be shown until users can access the internet, applications or services using a desktop or mobile device. Often, captive portals display as login interfaces to guest Wi-Fi connections, like those you find in campus and nearby. Trimex Colleges focuses on all aspects of teaching, make teachings easier by providing a framework and set of tools for an additional tool such as the proposed Wi-Fi Portlet Implementing (IoE) for Trimex Colleges Inc. Binan, Laguna. The Wi-Fi Portlet Implementing (IoE) is created to address the problem of expensive mobile data and internet connectivity. Since most students nowadays owns a smartphone with Wi-Fi capability, we can utilize the unlimited plans of our telecommunications/internet service provider by giving them privilege of internet usage using Wi-Fi Portlet system

This work is devoted to the study of the weak interactions present in the crystal packing of a new synthesized carbohidrazide derivate. The crystal structure was determined by X-Ray single crystal diffraction. The crystallographic asymmetric unit was optimized using DFT and compared with the experimental data. The nucleophilic and electrophilic regions were carried out with the molecular electrostatic potential. Hirsfeld analysis and noncovalent interaction approach were computed to quantificate the weak interactions responsible for the arrangement and stabilization of the molecular crystal packing. These approaches provides a rich representation for the analysis of noncovalent interactions in real space, in terms of the electron density and its derivates, of Van der Waals interactions, Hydrogen Bonds and the inter and intramolecular steric repulsions. The potential biological activity as an anticancer drug was tested with the molecular docking study in the catalytic center of a human Topoisomerase., Spanish Ministerio de Economía y competitividad (MAT2013-40950-R) and ERDF Grant MAT2013-40950-R funding is acknowledged.

Absolute concentration robustness (ACR) and concordance are novel concepts in the theory of robustness and stability within Chemical Reaction Network Theory. In this paper, we have extended Shinar and Feinberg's reaction network analysis approach to the insulin signaling system based on recent advances in decomposing reaction networks. We have shown that the network with 20 species, 35 complexes, and 35 reactions is concordant, implying at most one positive equilibrium in each of its stoichiometric compatibility class. We have obtained the system's finest independent decomposition consisting of 10 subnetworks, a coarsening of which reveals three subnetworks which are not only functionally but also structurally important. Utilizing the network's deficiency-oriented coarsening, we have developed a method to determine positive equilibria for the entire network. Our analysis has also shown that the system has ACR in 8 species all coming from a deficiency zero subnetwork. Interestingly, we have shown that, for a set of rate constants, the insulin-regulated glucose transporter GLUT4 (important in glucose energy metabolism), has stable ACR., 34 pages, 1 figure

Hybrid CdTe solar cells including the organic polymer poly(3,4-ethylenedioxythiophene): poly(styrene sulfonate) (PEDOT:PSS) in the typical structure were fabricated. PEDOT:PSS was added as a p+ region in the structure of solar cells after CdTe deposition and before the processing of the Cu–Mo back contact and was compared with a CdTe reference solar cells without polymer. The PEDOT:PSS was deposited at different rotational speeds of 3000 to 6000 rpm for 30 s, by spin coating technique. The obtained thicknesses were around 20–40 nm. Adequate coverage of the CdTe surface and grain morphology was obtained, when the polymer was deposited at 5000 rpm of rotational speed this according to Scanning Electron Microscope measurements. The final structure of the solar cells was SnO2:F/ZnO+CdS-TT/CdTe+CdCl2-TT/PEDOT:PSS/Cu-Mo. In our results was clear that the solar cells with PEDOT:PSS processed at different rotational speeds had higher fill factor and thus higher photovoltaic efficiencies. A high photovoltaic efficiency of around 13% was obtained when PEDOT:PSS was deposited at 5000 rpm and the Cu–Mo back contact was processed with a substrate temperature of 200 °C. A particular increment in the photovoltaic efficiency of solar cells close to 8% was achieved, when the Cu–Mo back contact was processed at room temperature.

Background Lung cancer screening (LCS) reduces lung cancer mortality, but it also carries a range of risks. Shared decision-making (SDM) is a process of engaging patients in their health care decisions and is a vital component of LCS. Research Question What is the quality of SDM among patients recently assessed for LCS? Study Design and Methods Cross-sectional study of screened patients recruited from two academic tertiary care centers in the South Central Region of the United States. Self-reported surveys assessed patient demographics, values related to outcomes of LCS, knowledge, SDM components including receipt of educational materials, and decisional conflict. Results Recently screened patients (n = 266) possessed varied LCS knowledge, answering an average of 41.4% of questions correctly. Patients valued finding cancer early over concerns about harms. Patients indicated that LCS benefits were presented to them by a health care provider far more often than harms (68.3% vs 20.8%, respectively), and 30.7% reported they received educational materials about LCS during the screening process. One-third of patients had some decisional conflict (33.6%) related to their screening decisions, whereas most patients (86.6%) noted that they were involved in the screening decision as much as they wanted. In multivariate models, non-White race and having less education were related to lower knowledge scores. Non-White patients and former smokers were more likely to be conflicted about the screening decision. Most patients (n = 227 [85.3%]) indicated that a health care provider had discussed smoking cessation or abstinence with them. Interpretation Among recently screened patients, the quality of decision-making about LCS is highly variable. The low use of educational materials including decision aids and imbalance of conveying benefit vs risk information to patients is concerning. A structured approach using decision aids may assist with providing a balanced presentation of information and may improve the quality of SDM.

The authors present 3 patients from this retrospective case series to review the clinical findings, imaging, pathology, and treatment of orbital atypical lipomatous tumor/well-differentiated liposarcoma. Pathology of biopsy specimens ranged from spindle cell proliferations mimicking neurofibroma to proliferations of well-differentiated adipocytes. Immunohistochemical stains were positive for murine double minute 2 in 1 case, and fluorescent in situ hybridization showed amplification of murine double minute 2 in 2 cases. Treatments ranged from serial debulking, proton beam irradiation, and exenteration. None of the patients developed metastases. A literature review supported the low-grade nature of this lesion. Orbital atypical lipomatous tumor/well-differentiated liposarcoma is a low-grade, indolent liposarcoma that may be locally invasive. The histologic diagnosis is enhanced with immunohistochemical staining for murine double minute 2 and fluorescent in situ hybridization analysis for amplification of murine double minute 2. Although treatment may vary according to the individual, conservative therapies may be attempted prior to radical surgery.

Ilagan VAD, Alejandro GJD, Paraguison DJB, Perolina SMW, Mendoza GR, Bolina AB, Raterta R, Vales MB, Suarez GJD, Blasco FA. 2022. Ethnopharmacological documentation and molecular authentication of medicinal plants used by the Manobo and Mamanwa tribes of Surigao del Sur, Philippines. Biodiversitas 23: 3185-3202. Mindanao Island is renowned for its rich biodiversity and various ethnolinguistic groups with diverse histories and cultures. The Mamanwa and Manobo live in close proximity, resulting in merging beliefs and cultural practices. This study aims to assess the various medicinal plants using ethnopharmacological indices, determine their relationship to their users, and molecularly confirm unidentifiable plants used by the tribes. Ethnomedicinal data were gathered from 127 key informants representing both tribes through semi-structured interviews. Family Importance Value (FIV) and Use Value (UV) were quantified and revealed a total of 48 species utilized by both tribes belonging to 26 families and 42 genera. These plants are used in 32 diseases within 10 categories, and the most utilized family belongs to Apocynaceae (FIV= 20% for both tribes). Respiratory illness has the greatest contribution to the utilization of medicinal plants (ICF= 0.92, 42%). The most utilized plant part is the leaves and mainly prepared by decoction and administered orally. Integrative molecular confirmation led to the identification of the 5 morphologically unidentifiable plants to be Elaeocarpus serratus Benth., Uncaria lanosa Wall., Aglaonema crispum (J.R. Pitcher & Manda) Nicolson, Canthium tetraphyllum Baill., and Timonous timon (Spreng.) Merr..

Objetivo. Determinar el nivel de orientación emprendedora en los empreserios del sector manufactura rubro fabricación de prendas de vestir en la ciudad de Cajamarca, durante el año 2019. En este estudio, se evaluaron cinco dimensiones: autonomía, innovación, toma de riesgos, proactividad y agresividad competitiva. Métodos. El tipo de investigación es básica, de diseño no experimental y de corte transversal. La población objeto de estudio estuvo constituida por 12 empresas del sector manufactura, rubro fabricación de prendas de vestir de la ciudad de Cajamarca. La técnica de recolección de datos fue la encuesta y como instrumento se empleó el cuestionario, conformado por 20 preguntas, con 4 ítems para cada dimensión. Resultados. Los empresarios gozan de autonomía en un 100 %, respecto a la toma de riesgo 100 %, innovación 96 %, proactividad 83 % y un nivel medio en agresividad competitiva con un 44 %. Conclusiones. El nivel de orientación emprendedora de empresas del sector manufactura, rubro fabricación de prendas de vestir, del 79 %; correspondiente a un alto nivel ya que, en 4 de 5 dimensiones, los de orientación emprendedora, los empresarios hacen evidente un alto nivel de orientación emprendedora. Estas dimensiones son autonomía, proactividad, toma de riesgos e innovación; mientras que la agresividad competitiva evidencia un bajo nivel respecto a las cuatro primeras.

Patients with multiple myeloma (MM) experience substantial cancer/treatment-related symptom burden during maintenance therapy. This is a phase II randomized, double-blinded, placebo-controlled clinical trial to examine the effect of minocycline for symptom reduction by its potential anti-inflammatory effect. Eligible MM patients for maintenance therapy were randomized to receive minocycline (100 mg twice daily) or placebo. The MD Anderson Symptom Inventory for MM (MDASI-MM) was used to assess multiple symptoms weekly during the trial. Clinician-rated toxicities and blood samples were prospectively collected. The effect size, area under the curve (AUC), and t tests were used to determine the symptom burden between treatment groups and identify the 5 most-severe MDASI-MM symptoms. The longitudinal analysis compared the changes in symptom severity and associated inflammatory markers between groups over time. Sixty-nine evaluable MM patients (33 from the intervention group and 36 from the placebo group) were included. No grade 3+ adverse events related to study medication were noted. The AUCs for the 5 worst MDASI-MM symptoms (fatigue, pain, disturbed sleep numbness/tingling, and drowsiness) were not significantly different between two arms. Regardless of group assignment, pain reduction was positively associated with decreased serum levels of soluble tumor necrosis factor-α receptors 1 and 2 during therapy (all P < 0.05). This pPhase II randomized study observed no statistically significant positive signal impact from minocycline on symptom reduction or inflammatory markers during maintenance therapy for MM, although using minocycline was feasible and had a low toxicity profile.

Purpose: To investigate the toxicity profile and establish an optimal dosing schedule of zotiraciclib with temozolomide in patients with recurrent high-grade astrocytoma. Patients and Methods: This two-stage phase I trial determined the MTD of zotiraciclib combined with either dose-dense (Arm1) or metronomic (Arm2) temozolomide using a Bayesian Optimal Interval design; then a randomized cohort expansion compared the progression-free survival rate at 4 months (PFS4) of the two arms for an efficient determination of a temozolomide schedule to combine with zotiraciclib at MTD. Pharmacokinetic and pharmacogenomic profiling were included. Patient-reported outcome was evaluated by longitudinal symptom burden. Results: Fifty-three patients were enrolled. Dose-limiting toxicities were neutropenia, diarrhea, elevated liver enzymes, and fatigue. MTD of zotiraciclib was 250 mg in both arms and thus selected for the cohort expansion. Dose-dense temozolomide plus zotiraciclib (PSF4 40%) compared favorably with metronomic temozolomide (PFS4 25%). Symptom burden worsened at cycle 2 but stabilized by cycle 4 in both arms. A significant decrease in absolute neutrophil count and neutrophil reactive oxygen species production occurred 12–24 hours after an oral dose of zotiraciclib but both recovered by 72 hours. Pharmacokinetic/pharmacogenomic analyses revealed that the CYP1A2_5347T>C (rs2470890) polymorphism was associated with higher AUCinf value. Conclusions: Zotiraciclib combined with temozolomide is safe in patients with recurrent high-grade astrocytomas. Zotiraciclib-induced neutropenia can be profound but mostly transient, warranting close monitoring rather than treatment discontinuation. Once validated, polymorphisms predicting drug metabolism may allow personalized dosing of zotiraciclib.

Purpose Acute radiation-induced esophagitis (ARIE) leads to treatment delays, decreased quality of life (QOL), and secondary adverse events such as weight loss. Grade 3 ARIE occurs in 15%–30% of patients undergoing radiotherapy to the esophagus, leading to disruption or discontinuation of treatment. The purpose of this study was to assess the effects of glutamine, a common nutritional supplement, on ARIE in patients with thoracic malignancies. Patients and methods This double-blind, placebo-controlled trial enrolled patients with advanced thoracic malignancies receiving concurrent chemotherapy/radiotherapy or radiotherapy alone, with radiation doses to the esophagus ≥45 Gy. Patients were randomized (1:1) to receive 4 g of glutamine or glycine placebo twice daily. The primary objective was to determine whether glutamine decreases the severity of ARIE in these patients. Secondary objectives included assessment of the effects of glutamine on other measures of ARIE, weight, symptom burden measure assessed by the MD Anderson Symptom Inventory (MDASI-HN) questionnaire and the toxicity profile of glutamine. Results At the time of interim analysis, 53 patients were enrolled: 27 in the glutamine arm and 26 in the placebo arm. There was no difference in the incidence of esophagitis in the first 6 weeks of radiotherapy between the glutamine and placebo arms (74% versus 68%; P = 1.00). There were no significant differences between the two arms for time to onset of esophagitis. The duration of ARIE was shorter (6.3 versus 7.1 weeks; P = 0.54) and median weight loss was lower (0.9 kg versus 2.8 kg; p = 0.83) in the glutamine arm versus the placebo arm. The groups differ significantly in core symptom severity (2.1 vs 1.5, p