Search

Natural gas, coal, and oil account for over 84 % of the world’s energy demand. Greenhouse gases, including carbon dioxide, methane, and oxides of nitrogen and sulphur, are released during the combustion of fossil fuels, leading to substantial climate changes and environmental damage. Therefore, harnessing energy from alternative sustainable resources without the emission of harmful waste products is vital for the ecosystem’s health. By 2050, global food waste production will reach 3.4 billion metric tons. Although widely recognized as a substantial energy resource, its value is underutilized throughout sub-Saharan Africa (SSA). Therefore, understanding and exploiting the potential value of food waste as a biofuel can result in net-zero emissions, reducing significant environmental pollution while conserving natural resources. Furthermore, this paper reviews how effective management of food waste will have the potential to contribute to the development of waste-to-energy resources in SSA countries, as well as help improve global ecosystems.

Becker muscular dystrophy (BMD) is a progressive disorder and impairs upper extremity (UE) function. The Performance of Upper Limb (PUL) measures UE function in muscular dystrophy, but has a ceiling effect in high-functioning subjects. Yet, fat fraction (FF) values via quantitative magnetic resonance (qMRI) have been used as biomarkers of muscle deterioration. Thus, the study aims to 1) determine if the PUL or qMRI FF can discriminate between functional groups of men with BMD and controls, and 2) assess relationships between PUL scores and qMRI FF. In a cross-sectional study, 56 men with BMD and 9 controls (18-63 yrs) completed PUL 2.0 and whole-body qMRI. Composite FF values for UE (deltoid, biceps & triceps) and whole-body were calculated. To understand the impact of mobility on UE performance, men with BMD were grouped using the 10-m run/walk test. Functional groups were: A) non-ambulatory B) walks – with no increase in speed possible; C) fast walking or jog; or D) run. One-way ANOVA/Kruskal-Wallis and Spearman's rho were used to assess differences between groups and correlations, respectively. Men with BMD scored 18-42 on the PUL. The PUL only detects differences between non-ambulatory (Group A) and high-functioning (Group C: p<0.001; Group D: p=0.02; Controls: p<0.001) groups. However, qMRI UE FF composite can discriminate between low-functioning (Groups A-B) and high-functioning (Groups C-D) men with BMD and whole-body FF composite can discriminate between all BMD functional groups (p<0.001 to 0.02). Higher PUL scores were associated with lower qMRI FF (p<0.05; rho =-0.70 to -0.50) only in low-functioning men with BMD (Groups A&B). Thus, the PUL has utility in assessing UE function in low-functioning men with BMD. Because the PUL may provide limited information about UE impairment in high-functioning men with BMD, it should be used cautiously or together with other biomarkers such as qMRI FF. [ABSTRACT FROM AUTHOR]

Becker muscular dystrophy (BMD) results in fat replacement of skeletal muscle and impaired functional performance. Quantitative magnetic resonance (qMR) imaging of muscle fat fraction (FF) has been used as a biomarker of muscle deterioration in muscular dystrophies. Specifically, qMR whole-body imaging (WBI) can quickly analyze multiple muscles and develop FF composites. The North Star Assessment for limb-girdle type muscular dystrophies (NSAD), has the potential to assess motor function in men with BMD across a wide range of abilities. Thus, we aimed to 1) assess the relationship between qMR FF and NSAD scores, and 2) determine qMR FF cut-off values for loss of performance on NSAD tasks that require gluteal and thigh muscle contractions. 41 men with BMD (18-62 years) completed 3-point Dixon qMR WBI and the NSAD. GlutThigh was calculated as the average FF of the right gluteus maximus, gluteus medius/minimus, quadriceps femoris, and hamstrings. The relationship between GlutThigh and function was assessed using Spearman's rho. GlutThigh cut-off values to discriminate men able or unable to perform each NSAD task were calculated using the receiver operating characteristic (ROC) and the Youden Index. Men with BMD had GlutThigh values from 0.08-0.89 (median: 0.58). Higher GlutThigh was strongly associated with lower NSAD scores (rho=-0.93; p<0.001). GlutThigh cut-off values ranged from 0.27 for rise from squat and running to 0.82 for standing and showed 83-100% sensitivity and 67-100% specificity. In men with BMD, higher GlutThigh values are strongly associated with poorer NSAD performance and more challenging NSAD tasks have lower GlutThigh cut-offs. GlutThigh cut-off values have high sensitivity and specificity to detect NSAD task failures across a wide range of men with BMD. Thus, qMR WBI GlutThigh provides important insight into functional performance in men with BMD and may serve as a functionally relevant biomarker of disease status in future clinical trials. [ABSTRACT FROM AUTHOR]

Microwave simulation is significant in identifying a reactor design allowing the biomass to be heated and processed evenly. This study integrated the radio frequency and transient heat transfer modules to simulate the microwave distribution and investigated the performance of microwave heating in the cavity. The simulation results were compared with the experimental findings using the finite element analysis software of COMSOL MULTIPHYSICS to predict the temperature profile and electric field of microwave in the biomass (empty fruit bunch pellets). The higher temperature distribution was observed at the bottom and centre section of the empty fruit bunch pellet bed in the reactor, showing the uniqueness of microwave heating. According to the simulation results, the temperature profile obtained through the specific cavity geometry and dielectric properties agreed with the experimental temperature profile. The simulated temperature profile demonstrated a logarithmic increase of 120 °C/min at the first 50 s followed by 50 °C/min until 350 s. The experimental temperature profile showed three different heating rates before reaching 300 °C, including 78.3 °C/min (50–120 °C), 30.6 °C/min (121–250 °C), and 105 °C/min (250–300 °C). The results of this study might contribute to the improvement of microwave heating in biomass torrefaction.

The presence of toxic heavy metals contributes towards the deterioration in the quality of water resources. In this work, microwave steam activation (MSA) was conducted to convert palm kernel shell into activated carbon (PKSAC). MSA provided a rapid heating rate (up to 140 °C/min) at 700 °C under a steam flow rate of 5 g/min for 45 min. PKSAC was obtained, showing high BET surface area (539.75 m2/g) with low H/C and O/C ratios, indicating a high degree of carbonization and stability of PKSAC to act as a durable adsorbent. The PKSAC was then applied to remove heavy metals (i.e. Cd2+ and Pb2+) present in landfill leachate (LL). Batch experiments were performed to investigate the effects of initial ion concentrations and contact times on Cd2+ and Pb2+ adsorption under optimal condition. Maximum Cd2+ and Pb2+ removal of 116.0 mg/g and 59.9 mg/g, respectively were obtained at pH 3, initial concentration of 100 mg/L, and adsorbent dose of 0.2 g. Results showed that the adsorption kinetics of Cd2+ and Pb2+ can be described by the pseudo second order kinetics model, while Freundlich isotherm was well fitted to the Cd2+ and Pb2+ adsorption data. Overall, the PKSAC produced by MSA is a promising and cost-effective adsorbent for removal of Cd2+ and Pb2+.

The leishmaniases comprise a complex of diseases characterized by clinical outcomes that range from self-limiting to chronic, and disfiguring and stigmatizing to life threatening. Diagnostic methods, treatments, and vector and reservoir control options exist, but deciding the most effective interventions requires a quantitative understanding of the population level infection and disease dynamics. The effectiveness of any set of interventions has to be determined within the context of operational conditions, including economic and political commitment. Mathematical models are the best available tools for studying quantitative systems crossing disciplinary spheres (biology, medicine, economics) within environmental and societal constraints. In 2005, the World Health Assembly and government health ministers of India, Nepal, and Bangladesh signed a Memorandum of Understanding to eliminate the life threatening form of leishmaniasis, visceral leishmaniasis (VL), on the Indian subcontinent by 2015 through a combination of early case detection, improved treatments, and vector control. The elimination target is <1 case/10,000 population at the district or subdistrict level compared to the current 20/10,000 in the regions of highest transmission. Towards this goal, this chapter focuses on mathematical models of VL, and the biology driving those models, to enable realistic predictions of the best combination of interventions. Several key issues will be discussed which have affected previous modelling of VL and the direction future modelling may take. Current understanding of the natural history of disease, immunity (and loss of immunity), and stages of infection and their durations are considered particularly for humans, and also for dogs. Asymptomatic and clinical infection are discussed in the context of their relative roles in Leishmania transmission, as well as key components of the parasite-sandfly-vector interaction and intervention strategies including diagnosis, treatment and vector control. Gaps in current biological knowledge and potential avenues to improve model structures and mathematical predictions are identified. Underpinning the marriage between biology and mathematical modelling, the content of this chapter represents the first step towards developing the next generation of models for VL. [ABSTRACT FROM AUTHOR]

Waste palm shell is a large-volume biomass waste produced from palm oil mills, representing a resource to be treated and converted into a value-added product. In this study, an improved microwave wet torrefaction (low-temperature pyrolysis) incorporating microwave radiation and steam was performed to torrefied the waste palm shell into higher porous biochar. The biochar and catalytic effect of using microwave radiation and steam over a range of process temperature (250–350 °C) were investigated. The microwave wet torrefaction demonstrated a significantly faster heating rate (up to 120 °C/min) and compared to that shown by microwave heating without steam (45 °C/min, 15 min). Microwave wet torrefaction exhibited relatively lower mass yield (63.5 wt%) compared to microwave torrefaction (72.5 wt%). However, the biochar obtained from microwave wet torrefaction produced higher surface area (308.0 m2/g) compared to microwave torrefaction (110.8 m2/g). Our results demonstrate that microwave wet torrefaction shows potential as a catalytic approach to treat waste palm shell in providing a fast heating rate, lower process temperature, and generating a higher yield of a torrefied product with improved properties.

Cassava stem waste is abundantly available after starch extraction, hence posing disposal problem and potential risk to environmental pollution. Alternative ways are needed to dispose the waste instead of landfilling and open burning. Microwave vacuum pyrolysis was examined as an alternative method to convert the cassava stem waste into biochar. The cassava stem was first characterized by several analyses followed by conversion into biochar using microwave vacuum pyrolysis over different microwave power. The cassava stem contained high contents of carbon (49.5 wt%) and considerable amount of fixed carbon (27 wt%), indicating its suitability to be used as pyrolysis feedstock. The biochar yield from microwave power of 550 W, 650 W and 750 W were 77%, 73% and 70% respectively. The surface morphology of biochar shows that it consists abundant pores on the surface, suggesting its suitability to be used as catalyst support for energy application, and also as adsorbent for use in adsorption-related process such as dye and heavy metal removal in wastewater treatment or nutrient retention in crops cultivation. The calorific value of the biochar ranged from 19.24 to 20.55 MJ kg−1, showing high energy content for potential use as solid fuel. Our results show that cassava stem can be transformed into biochar for useful energy applications rather than burned as low-grade fuel in boiler or disposed by landfilling.

Objective: Glioblastoma multiforme (GBM) accounts for up to 60% of all malignant primary brain tumours in adults, occurring in 2–3 cases per 100 000 in Europe and North America. In 2005, a Phase III clinical trial demonstrated a significant improvement in survival over 2, and subsequently 5, years with the addition of concurrent and adjuvant temozolomide (TMZ) to radical radiotherapy (RT). The aim of this study was to investigate if the demonstrated improved survival in the literature translated to clinical practice. Methods: This was a retrospective study including all patients with histologically proven GBM diagnosed from 1999 to 2008 and treated with adjuvant RT at our institution. A total of 273 patients were identified. Statistical analysis was carried out using SPSS® v.18 (SPSS, Chicago, IL). Results: The median survival for the whole group (n5273) over the 10-year period was 7.6 months (95% confidence interval 6.7–8.4 months). Overall, the cumulative probability of survival at 1 and 2 years was 31.5% and 9.4%, respectively. In total, 146 patients received radical RT. 103 patients were treated with radical RT and TMZ and 43 patients received radical RT alone. The median survival for patients receiving radical RT with TMZ was 13.4 months (95% CI 10.9–15.8 months) vs 8.8 months for radical RT alone (95% CI 6.9–10.7 months, p50.006). 2-year survival figures were 21.2% vs 4.7%, respectively. On multivariate analysis, independent predictors of survival included Karnofsky Performance Status, RT dose, TMZ and extent of surgery. The strongest predictors of poorer outcome based on the hazard ratio were palliative RT, followed by not receiving TMZ chemotherapy, then KPS <90 and a biopsy only surgical approach. Conclusion: This paper demonstrates improved survival outcomes consistent with those published in the literature for the addition of concurrent and adjuvant TMZ to radical RT for the treatment of GBM. Although 63% of patients seen in the clinic were suitable for a combined modality approach, the prognosis for the lower Radiation Therapy Oncology Group classes still remains poor. [ABSTRACT FROM AUTHOR]

Jiang Z, Wu C L, Woda B A, Iczkowski K A, Chu P G, Tretiakova M S, Young R H, Weiss L M, Blute R D Jr, Brendler C B, Krausz T, Xu J C, Rock K L, Amin M B & Yang X J (2004) Histopathology 45, 218–225 Alpha-methylacyl-CoA racemase: a multi-institutional study of a new prostate cancer marker : To test whether α-methylacyl-CoA racemase (AMACR) is a sensitive and specific marker of prostate cancer. : The expression levels of AMACR mRNA were measured by real-time polymerase chain reaction. A total of 807 prostatic specimens were further examined by immunohistochemistry specific for AMACR. Quantitative immunostaining analyses were carried out by using the ChromaVision Automated Cellular Imaging System and the Ariol SL-50 Imaging System, respectively. AMACR mRNA levels measured in prostatic adenocarcinoma were 55 times higher than those in benign prostate tissue. Of 454 cases of prostatic adenocarcinoma, 441 were positive for AMACR, while 254 of 277 cases of benign prostate were negative for AMACR. The sensitivity and specificity of AMACR immunodetection of prostatic adenocarcinomas were 97% and 92%, respectively. Both positive and negative predictive values were 95%. By automatic imaging analyses, the AMACR immunostaining intensity and percentage in prostatic adenocarcinomas were also significantly higher than those in benign prostatic tissue (105.9 versus 16.1 for intensity, 45.7% versus 0.02% and 35.03% versus 4.64% for percentage, respectively). : We have demonstrated the promising features of AMACR as a biomarker for prostate cancer in this large series and the potential to develop automated quantitative diagnostic tests. [ABSTRACT FROM AUTHOR]

Streptococcus pneumoniae is the causative agent of many diseases, most notably pneumonia. Most of the currently used vaccines to protect against this pathogen employ pneumococcal capsular polysaccharides (CPSs) as antigens, but purifying CPS of sufficient quality has been challenging. A purification process for CPS comprising conventional methods such as ultrafiltration, CTAB precipitation, and chromatography was previously established; however, this method resulted in high cell wall polysaccharide (CWPS) contamination, especially for serotype 5. Thus, a better purification method that yields CPS of a higher quality is needed for vaccine development. In this study, we significantly reduced CWPS contamination in serotype 5 CPS by improving the ultrafiltration and CTAB precipitation steps. Moreover, by applying an acid precipitation process to further remove other impurities, serotype 5 CPS was obtained with a lower impurity such as decreased nucleic acid contamination. This improved method was also successfully applied to 14 other serotypes (1, 3, 4, 6A, 6B, 7F, 9V, 11A, 14, 18C, 19A, 19F, 22F, and 23F). To assess the immunogenicity of the CPS from the 15 serotypes, two sets of 15-valent pneumococcal conjugate vaccines were prepared using the previous purification method and the improved method developed here; these vaccines were administered to a rabbit model. Enzyme-linked immunosorbent assay and opsonophagocytic assay demonstrated higher immunogenicity of the conjugate vaccine prepared using CPS produced by the improved purification process.

OBJECTIVE: In the Republic of Korea (ROK), soldiers stationed where there is a risk of contracting malaria have received antimalarial chemoprophylaxis since 1997. However, chemoprophylaxis may facilitate the development of drug resistance, and late primary attacks in individuals who have received chemoprophylaxis are becoming more frequent. We investigated the association between chemoprophylaxis and the epidemiological characteristics and effectiveness of treatment for re-emergent Plasmodium vivax malaria, using a nationwide malaria database. METHODS: Among soldiers at risk of malaria between 1999 and 2001, we reviewed all P. vivax malaria cases (1158) that occurred before 31 December 2003. Early and late primary attacks were defined as cases occurring < 2 or > 2 months after the last day of exposure to risk of malaria, respectively. FINDINGS: Of these cases, 634 (72.0%) had received chemoprophylaxis, and 324 (28.0%) had not. Cases occurred mostly in summer, with a peak in July-August. Stratification by chemoprophylaxis history revealed different times to onset. Early primary attacks were more prevalent in the group not receiving chemoprophylaxis, while in the group receiving chemoprophylaxis most cases were late primary attacks. Of the latter, 312 out of 461 (67.7%) did not take primaquine regularly. After treatment of the first attack, 14 (1.2%) of 1158 were re-treated; all re-treated cases were cured using the same doses and regimen used for the first treatment. CONCLUSION: In ROK, the increase in late primary episodes of re-emergent P. vivax malaria is associated with the use of antimalarial chemoprophylaxis.

The article presents a case study of a 28-year-old woman with a monochorionic diamniotic twin pregnancy and presented with discordant karyotype and anomalies. It mentions that the patient had developed Stage III twin-to-twin transfusion syndrome (TTTS) and an amniotic fluid sample was taken for chromosomal microarray to evalaute the genetics of the fetus.

An abstract of the article "Extending the window for genetic screening sonograms: needs assessment for an ultrasound-based Down's syndrome risk model up to 24 weeks gestation," by C. B. Hertenstein and collesagues is presented.

Abstract Introduction Hypercalcaemic hyperparathyroid crisis is a rare but life-threatening complication of primary hyperparathyroidism. Parathyroid carcinoma is a rare malignancy with an incidence of 0.5% to 4% of all reported cases of primary hyperparathyroidism. Case presentation We report the case of a 60-year-old Caucasian man with hypercalcaemic hyperparathyroid crisis associated with parathyroid carcinoma. He presented with a classic hypercalcaemic syndrome and his serum calcium and parathyroid hormone levels were at 4.65 mmol/L and 1743 ng/L, respectively. He initially presented with a two-week history of weakness and lethargy and a one-week history of vomiting, polyuria and polydipsia. An emergency left thyroid lobectomy and left lower parathyroidectomy were performed. There was a prompt decrease in his parathyroid hormone level immediately after surgery. Histology revealed that our patient had a 4-cm parathyroid carcinoma. Conclusion In patients with parathyroid carcinoma, the optimal surgical treatment is en bloc resection with ipsilateral thyroid lobectomy and removal of any enlarged or abnormal lymph nodes. Surgery is the only curative treatment. In our patient, prompt surgical intervention proved successful. At six months the patient is well with no evidence of disease recurrence. This case highlights the importance of considering a hyperparathyroid storm in the context of a parathyroid carcinoma. Parathyroid carcinoma is a rare entity and our knowledge is mainly derived from case reports and retrospective studies. This case report increases awareness of this serious and life-threatening complication. This report also illustrates how prompt and appropriate management provides the best outcome for the patient.

Presents correction of errors made in the article 'Not Just Research Tools -- proteasome inhibitors offer therapeutic promise,' by A.L. Goldbert and K. Rock which was previously published in volume 8 of 2002 issue of the journal 'Nature Medicine.'

North Star Ambulatory Assessment (NSAA) is increasingly being utilized to assess efficacy of interventions in muscular dystrophies. Furthermore, proton magnetic resonance spectroscopy (1H-MRS) measures of fat fraction have been shown to be sensitive to disease progression and treatments in Duchenne muscular dystrophy (DMD). However, the relationship between NSAA and MR measures of fat fraction are less established. Therefore, in this study we evaluated NSAA and fat fraction measures of lower extremity muscles in a longitudinal study of DMD. A total of 90 subjects (age 5-17 at baseline) with DMD from the ImagingNMD project were included in this study with time points acquired yearly for up to 3 years. Single voxel 1H-MRS data were acquired at 3T using stimulated echo acquisition mode (STEAM) with relaxation corrections to measure fat fraction from the soleus and vastus lateralis. Relationships among measures were evaluated using non-parametric correlation and probability analyses. There was a strong relationship between NSAA total score and fat fraction of the soleus (ρ = -.78, p<0.01) and vastus lateralis (ρ = -.85, p<0.01). Three-year longitudinal changes in fat fraction correlated with NSAA total score changes (ρ = -.37, p=0.01). Further, the loss of ability to perform the more difficult tasks in the NSAA occurred at a lower fat fraction (e.g., running, 50% probability to perform task, vastus lateralis fat fraction 0.35) than less challenging tasks (e.g., standing, vastus lateralis fat fraction 0.60). Overall, NSAA was strongly correlated with muscle fat fraction evaluated with 1H-MRS, and our findings are consistent with the notion that muscle fat fraction can be used to predict functional abilities included in NSAA. [ABSTRACT FROM AUTHOR]

The purpose of this project was to develop and implement a new national training curriculum for radiation oncology. Rapid advances in radiation techniques, and increased expansion of services in our country required a new curriculum to reflect radiation oncology practice in the modern era. Once established and ratified by the training faculty, the aim was to introduce the new curriculum into clinical practice across all training sites. An educational subcommittee of the Faculty of Radiologists Radiation Oncology Committee was established. This included representation from faculty members, the National Training Coordinator, the local training coordinators, and two trainee representatives. The National Medical Council's 8 domains of good clinical practice were taken as a basis on which to build the new curriculum. This is to ensure trainees develop a professional approach to work, rather than focusing on clinical aspects alone. International guidelines from the US, Canada, UK, Australia, and ESTRO were all reviewed to guide the clinical content of the program. Grant's 6 steps of curriculum design were utilized. The new training curriculum has been implemented as of July 2021. There is a clear roadmap for trainees to guide them through its clinical and non-clinical aspects. Requirements to pass through each of the 5 years (full-time equivalent) of training are outlined. Trainees develop progressive expertise in the use of radiotherapy to treat patients with all cancer types. This starts with management of oncological emergencies in first year and progresses to include advanced techniques including SABR and brachytherapy. A newly-developed standardized logbook was established for recording radiotherapy planning experience. Workplace based assessments were introduced (including Direct Observation of Radiotherapy Planning skills), initially a minimum number of non-site specified assessments per year was stipulated, with a view to expanding this over the coming years. A list of non-clinical training commitments is now in place, including Problem-Based Learning and Human Factors courses. These aim to develop communication, management and leadership skills. The examination process remains unchanged and is directly associated with another national training program. Satisfactory completion of exams leads to conferring with the Fellowship of the Faculty of Radiologists Royal College of Surgeons (FFR RCSI) Satisfactory completion of training will lead to Certificate of Completion of Specialist Training which permits the doctor to register on the Specialist Division of the Medical Council and to practice independently as a radiation oncologist. A modern attainable training curriculum was implemented which reflects the 8 domains of good clinical practice. The clinical content is in keeping with the highest international standards allowing international recognition of qualifications [ABSTRACT FROM AUTHOR]

We are an academic radiation oncology center and treat 1500-2000 patients annually. The majority of target volume definition and organ at risk (OAR) contouring is performed by radiation oncologists (RO) and is estimated to require 10-15 hours per week for each RO. Artificial intelligence (AI) solutions for contouring are a possible method of reducing the time required. Several packages are commercially available. The purpose of this exercise was to evaluate 4 packages to identify one which would meet our department's need. The primary objective was to calculate the potential time savings associated with each of the 4 packages. The second objective was to perform a qualitative evaluation and comparison. Approval from the hospital's Research Ethics Committee was obtained. CT Simulation datasets for 15 patients were anonymized for use as test cases for AI contouring. This included 5 datasets from each of 3 sites – head and neck (H+N), breast/thorax, and prostate/pelvis. 4 potential vendors provided access to their product for automated contouring of OARs +/- target volumes of each of the 15 datasets. Analysis was as follows: 1. One RO used a stopwatch to assess the time taken for them to contour each of the OARs +/- targets on each dataset 2. The AI contours from each of the vendors for each of the datasets was reviewed. 3. The time taken to correct each auto-contoured organ to make it clinically useful was timed. These times were summed to give an overall time for each vendor for each dataset. 4. The absolute time saving was calculated by subtracting the result of step (3) from step (1) 5. The percentage time saving was calculated by dividing this value by the baseline time for contouring by the RO 6. For the purpose of qualitative assessment, 2 ROs reviewed each dataset and assigned an objective score of 1-5 to each auto- contoured organ (e.g., 5 = no, or almost no, edits required; clinically useful as is) 7. The scores for each organ in each of the 15 datasets were averaged to give a mean value for the software package. Baseline contouring time was 32.8 minutes for H+N, 23.0 minutes for breast/thorax, and 64.8 minutes for prostate/pelvis. One package was removed from consideration after assessment of H+N only as it was deemed to be of insufficient standard to be of clinical use. The average time savings for each of the remaining 3 software packages were 15.7, 17.9, and 12.8 minutes for H+N, 3.1, 13.1, and 11.0 minutes for breast/thorax, and 32.6, 35.2, and 36.2 minutes for prostate/pelvis. Percentage time savings ranged from 39-55% for H+N, 13-57% for breast/thorax, and 50-56% for prostate/pelvis. The overall qualitative assessments on a 5-point scale were 3.5, 4.0, and 3.6. The AI contouring solutions were associated with meaningful savings in the time taken to contour. The introduction of one of these products into clinical practice within our department will permit ROs to focus more of their time on other clinical activities. [ABSTRACT FROM AUTHOR]

Liver transplantation (LT) in patients with significant portopulmonary hypertension (PoPH) is associated with an increased risk of several complications, including graft failure. Graft loss is one of the major reasons. Living donor LT (LDLT) is not routinely performed in the United States in this patient population. In addition, ethical considerations often preclude donation from healthy donors in the setting of a procedure associated with an elevated risk of recipient morbidity and mortality. However, LDLT allows LT to be performed electively, using a superior graft with an improved probability of a good outcome. The key to success in managing these patients is establishing a multidisciplinary team that follows an institutional protocol with clear evaluation and management criteria. These criteria include screening and early diagnosis as well as treatment of PoPH with the goal of optimizing pulmonary arterial hemodynamics and maintaining right ventricular function. Any protocol should include admitting the patient to the hospital a day before surgery for placement of a pulmonary artery catheter to measure and derive relevant hemodynamic variables. A multidisciplinary team should determine the fitness for a transplant a after a careful review of the most up-to-date clinical information. Finally, the team prescribes and executes a plan for optimization and safe perioperative management of the patient. In this report, we discuss our approach to the perioperative management of a patient with significant PoPH who safely underwent LDLT with an excellent postoperative outcome., Competing Interests: The authors declare no funding or conflicts of interest., (Copyright © 2024 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)

Background: In order for cancers to progress, they must evade elimination by CD8 T cells or other immune mechanisms. CD8 T cells recognize and kill tumor cells that display immunogenic tumor peptides bound to MHC I molecules. One of the ways that cancers can escape such killing is by reducing expression of MHC I molecules, and loss of MHC I is frequently observed in tumors. There are multiple different mechanisms that can underly the loss of MHC I complexes on tumor and it is currently unclear whether there are particular mechanisms that occur frequently and, if so, in what types of cancers. Also of importance to know is whether the loss of MHC I is reversible and how such loss and/or its restoration would impact responses to immunotherapy. Here, we investigate these issues for loss of IRF1 and IRF2, which are transcription factors that drive expression of MHC I pathway genes and some killing mechanisms., Methods: Bioinformatics analyses of IRF2 and IRF2-dependent gene transcripts were performed for all human cancers in the TCGA RNAseq database. IRF2 protein-DNA-binding was analyzed in ChIPseq databases. CRISRPcas9 was used to knock out IRF1 and IRF2 genes in human and mouse melanoma cells and the resulting phenotypes were analyzed in vitro and in vivo., Results: Transcriptomic analysis revealed that IRF2 expression was reduced in a substantial subset of cases in almost all types of human cancers. When this occurred there was a corresponding reduction in the expression of IRF2-regulated genes that were needed for CD8 T cell recognition. To test cause and effect for these IRF2 correlations and the consequences of IRF2 loss, we gene-edited IRF2 in a patient-derived melanoma and a mouse melanoma. The IRF2 gene-edited melanomas had reduced expression of transcripts for genes in the MHC I pathway and decreased levels of MHC I complexes on the cell surface. Levels of Caspase 7, an IRF2 target gene involved in CD8 T cell killing of tumors, were also reduced. This loss of IRF2 caused both human and mouse melanomas to become resistant to immunotherapy with a checkpoint inhibitor. Importantly, these effects were reversible. Stimulation of the IRF2-deficient melanomas with interferon induced the expression of a functionally homologous transcription factor, IRF1, which then restored the MHC I pathway and responsiveness to CPI., Conclusions: Our study shows that a subset of cases within most types of cancers downregulates IRF2 and that this can allow cancers to escape immune control. This can cause resistance to checkpoint blockade immunotherapy and is reversible with currently available biologics., Competing Interests: Consent for publication: All authors agreed on the final version of the article and submission to Journal of Experimental & Clinical Cancer Research.

Purpose: To identify causes of balance impairment in children undergoing treatment for cancer and childhood cancer survivors., Methods: A systematic search was performed according to PRISMA guidelines. Studies were included if participants were 0-19 years of age with a current/past diagnosis of cancer, an objective balance measure was reported, and a cause of balance impairment was either stated or implied., Results: The 64 full text studies included identified balance impairments as sequelae secondary to CNS tumors, and/or as an effect of medical treatment including chemotherapy, radiation, and/or surgery. Cancer treatment can result in damage to the visual, vestibular and/or somatosensory systems which in turn can contribute to balance dysfunction., Conclusions: Balance impairments were caused by the cancer itself or the result of medical treatment. Oncology professionals are integral in recognition and treatment of factors affecting balance impairments in childhood cancer; however, further research is needed to identify interventions targeting specific causes of balance impairment., Competing Interests: Declaration of Competing Interest The authors declare no conflicts or competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Successful breast cancer outcomes can be jeopardised by adverse events. Understanding and integrating patients' and doctors' perspectives into care trajectories could improve patient safety. This study assessed their views on, and experiences of, medical error and patient safety., Methods: A cross-sectional, quantitative 20-40 item questionnaire for patients attending Cork University Hospital Cancer Centre and breast cancer doctors in the Republic of Ireland was developed. Domains included demographics, medical error experience, patient safety opinions and concerns., Results: 184 patients and 116 doctors completed the survey. Of the doctors, 41.4% felt patient safety had deteriorated over the previous five years and 54.3% felt patient safety measures were inadequate compared to 13.0% and 27.7% of patients respectively. Of the 30 patients who experienced medical errors/negligence claims, 18 reported permanent or long-term physical and emotional effects. Forty-two of 48 (87.5%) doctors who experienced medical errors/negligence claims reported emotional health impacts. Almost half of doctors involved in negligence claims considered early retirement. Forty-four patients and 154 doctors didn't experience errors but reported their patient safety concerns. Doctors were more concerned about communication and administrative errors, staffing and organisational factors compared to patients. Multiple barriers to error reporting were highlighted., Conclusion: This is the first study to assess patients' and doctors' patient safety views and medical error/negligence claims experiences in breast cancer care in Ireland. Experience of medical error/negligence claims had long-lasting implications for both groups. Doctors were concerned about a multitude of errors and causative factors. Failure to embed these findings is a missed opportunity to improve safety., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Malaria vector surveillance tools often incorporate features of hosts that are attractive to blood-seeking females. The recently developed host decoy trap (HDT) combines visual, thermal, and olfactory stimuli associated with human hosts and has shown great efficacy in terms of collecting malaria vectors. Synthetic odors and yeast-produced carbon dioxide (CO2) could prove useful by mimicking the human odors currently used in HDTs and provide standardized and easy-to-use olfactory attractants. The objective of this study was to test the attractiveness of various olfactory attractant cues in HDTs to capture malaria vectors. We compared 4 different odor treatments in outdoor field settings in southern Benin and western Burkina Faso: the standard HDT using a human, HDT with yeast-produced CO2, HDT with an artificial odor blend, and HDT with yeast-produced CO2 plus artificial odor blend. In both experimental sites, the standard HDT that incorporated a real human produced the greatest catch of Anopheles gambiae s.l (Diptera: Culicidae). The alternatives tested were still effective at collecting target vector species, although the most effective included CO2, either alone (Benin) or in combination with synthetic odor (Burkina Faso). The trap using synthetic human odor alone caught the fewest An. gambiae s.l. compared to the other baited traps. Both Anopheles coluzzii and Anopheles gambiae were caught by each trap, with a predominance of An. coluzzii. Synthetic baits could, therefore, represent a more standardized and easier-to-deploy approach than using real human odor baits for a robust vector monitoring strategy., (© The Author(s) 2024. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Telehealth is an emerging method which may overcome barriers to rehabilitation access for pediatric cancer survivors (aged ≤19 years). This systematic review aimed to examine telehealth-based rehabilitation interventions aimed at preventing, maintaining, or improving disability in pediatric cancer survivors. Methods: We performed systematic searches in Ovid MEDLINE, Ovid EMBASE, Cochrane Library, SCOPUS, Web of Science, and CINAHL Plus between 1994 and 2022. Eligible studies included telehealth-based interventions assessing disability outcomes in pediatric cancers. Results: Database searches identified 4,040 records. Nine unique interventions met the eligibility criteria. Telehealth delivery methods included telephone (n = 6), email (n = 3), mobile health applications (n = 3), social media (n = 3), videoconferencing (n = 2), text messaging (n = 2), active video gaming (n = 2), and websites (n = 2). Interventions focused on physical activity (n = 8) or self-management (n = 1). Outcomes assessing disability varied (n = 6). Three studies reported statistically and clinically significant results. Narrative synthesis of findings was constructed based on the Picker's principles for patient-centered care: (1) values, preferences, and needs; (2) involve family and friends; (3) coordination of care; (4) provide social support; (5) holistic well-being; and (6) information and communication. Conclusions: Telehealth-based rehabilitation interventions for pediatric cancer survivors is an emerging research area with potential to improve disability outcomes. Adequately powered trials with consistency in disability outcome measures are warranted. Additional research is needed to determine the effectiveness and best practices for telehealth-based pediatric cancer rehabilitation.

Purpose: To explore muscle properties, gross motor performance, and quality of life (QoL) in children with sickle cell disease (SCD) compared with controls and to assess relationships among these outcomes., Methods: A cross-sectional study of 24 children assessed muscle properties including: knee extension strength by dynamometry; vastus lateralis (VL) and rectus femoris (RF) muscle thickness by ultrasonography; and VL and RF neuromuscular activation (rate of muscle activation [RoA]) by electromyography (EMG). Gross motor performance and QoL were assessed by standardized tests and questionnaires., Results: Children with SCD had impaired knee extension strength, VL EMG RoA, gross motor performance, and QoL compared with children without SCD. Relationships among muscle properties, gross motor performance, and QoL were identified., Conclusions: These findings indicate that comprehensive muscle properties, gross motor performance, and QoL assessments should be considered to support and develop individualized physical therapy plans for children with SCD., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 Academy of Pediatric Physical Therapy of the American Physical Therapy Association.)