Search

Follicular lymphoma (FL) is the most common indolent non‐Hodgkin lymphoma subtype, accounting for 15–20% of all lymphoma diagnoses. Although typically slow‐growing and responsive to frontline therapies, advanced‐stage FL remains incurable with current treatments and typically follows a chronic relapsing/remitting course with increasingly shorter responses to subsequent lines of therapy. Outcomes are highly variable; some patients experience prolonged first remissions that may approximate a 'functional cure'. By contrast, a significant minority of patients experience disease progression shortly after frontline treatment resulting in high rates of lymphoma‐related mortality. Reflecting on the heterogeneous natural history of FL, clinical practice varies widely, particularly in controversial areas, including appropriate disease staging, selection of management strategies and duration of clinical follow‐up. This position statement presents an evidence‐based synthesis of the literature for application in Australasian practice. [ABSTRACT FROM AUTHOR]

Marginal zone lymphomas (MZLs) are a rare, indolent group of non‐Hodgkin lymphomas with different diagnostic, genetic and clinical features and therapeutic implications. The most common is extranodal MZL of mucosa‐associated lymphoid tissue, followed by splenic MZL and nodal MZL. Patients with MZL generally have good outcomes with long survival rates but frequently have a relapsing/remitting course requiring several lines of therapy. The heterogeneous presentation and relapsing course present the clinician with several diagnostic and therapeutic challenges. This position statement presents evidence‐based recommendations in the setting of Australia and New Zealand. [ABSTRACT FROM AUTHOR]

Previous studies show the reach of the current drug overdose epidemic into the U.S.-Mexico border region, albeit with a unique border-specific wave pattern compared to national waves and a delayed onset of fentanyl involvement (Wave I: 2002–2011, Wave II: 2012–2016, and Wave III: since 2017). The objective of this study is to examine the community predictors and the progression of overdose deaths across the U.S-Mexico border-specific epidemic waves. Descriptive epidemiological profile of border communities across the unfolding of the opioid epidemic, integrated data from the CDC-WONDER multiple causes of death data set, the CDC SVI, Uniform Crime Report, and the Behavioral Risk Factor Surveillance System. Using spatially adjusted Bayes rates by border-specific epidemic waves, we provide a descriptive profile of the spatial unfolding of the drug overdose epidemic. Negative binomial regression models assessed community predictors of overdose deaths across waves. Spatial analysis identified moderate to steep increases in drug overdose deaths over the three waves along the border. The impact and unfolding of the epidemic in the U.S.-Mexico border region were not uniform and affecting communities with differing severity and timing. Our study also finds support for social vulnerability and community violence as predictors of overdose deaths over the current wave of the epidemic. Findings suggest that more disadvantaged U.S.-Mexico border communities may encounter increasing rates of overdose death over the coming years. Interventions need to target not only the supply side but also the underlying social root causes for sustainable overdose prevention. [ABSTRACT FROM AUTHOR]

Introduction: Total body irradiation (TBI) practices vary considerably amongst centres, and the risk of treatment related toxicities remains unclear. We report lung doses for 142 TBI patients who underwent either standing TBI with lung shield blocks or lying TBI without blocks. Methods: Lung doses were calculated for 142 TBI patients treated between June 2016 and June 2021. Patients were planned using Eclipse (Varian Medical Systems) using AAA_15.6.06 for photon dose calculations and EMC_15.6.06 for electron chest wall boost fields. Mean and maximum lung doses were calculated. Results: Thirty‐seven patients (26.2%) were treated standing using lung shielding blocks with 104 (73.8%) treated lying down. Lowest relative mean lung doses were achieved using lung shielding blocks in standing TBI, reducing the mean lung doses to 75.2% of prescription (9.9 Gy), ±4.1% (range 68.6–84.1%) for a prescribed dose of 13.2 Gy in 11 fractions, including contributions from electron chest wall boost fields, compared to 12 Gy in 6 fraction lying TBI receiving 101.6% mean lung dose (12.2 Gy) ±2.4% (range 95.2–109.5%) (P ≪ 0.05). Patients treated lying down with 2 Gy single fraction received the highest relative mean lung dose on average, with 108.4% (2.2 Gy) ±2.6% of prescription (range 103.2–114.4%). Conclusion: Lung doses have been reported for 142 TBI patients using the lying and standing techniques described herein. Lung shielding blocks significantly reduced mean lung doses despite the addition of electron boost fields to the chest wall. [ABSTRACT FROM AUTHOR]

A better understanding of how human activities affect biodiversity can be important for effective resource management. We tested how excavation (maintenance) of agricultural drains (ditches) altered fish assemblages. Uncertainty regarding the effects of drain maintenance on fish assemblages has been a source of tension between landowners, drain superintendents, and fishery managers. Fish assemblages in eight southwestern Ontario drains were sampled repeatedly from before to 2 years after drain maintenance using a replicated before-after, control-impact (BACI) design. Relative to reference sites, we found no evidence for short- or long-term decreases in the number of species and total abundance of fishes following drain maintenance, nor any consistent change in assemblage composition, despite clear changes in physical habitat. The fish assemblages in drains were resilient to drain maintenance and did not show changes expected to concern fishery managers. Our findings provide fishery managers with the information needed to manage drain maintenance more effectively under the Fish Protection Program of the Fisheries Act and to develop drain maintenance practices that balance the needs of agriculture with the protection of fish biodiversity. Une meilleure comprehension de l'incidence de l'activite humaine sur la biodiversite peut etre importante pour une gestion efficace des ressources. Nous avons verifie comment l'excavation (entretien) de drains agricoles (fosses) modifie les assemblages de poissons. L'incertitude quant aux effets de l'entretien des drains sur les assemblages de poissons constitue une source de tension entre les proprietaries fonciers, les gestionnaires des drains et les gestionnaires des peches. Les assemblages de poissons dans huit drains du sud de l'Ontario ont ete echantillonnes a repetition avant leur entretien et jusqu'a deux ans apres ce dernier selon un schema avant-apres, temoin-intervention (<>). Par rapport aux emplacements de reference, nous n'avons observe aucun indice de baisse a court ou long terme du nombre d'especes ou de l'abondance totale de poissons apres l'entretien des drains, ni aucun changement coherent de la composition des assemblages, malgre des modifications tres nettes de l'habitat physique. Les assemblages de poissons dans les drains etaient resilients a l'entretien de ces derniers et ne presentaient pas de changements susceptibles de preoccuper les gestionnaires des peches. Nos constatations fournissent a ces derniers des renseignements necessaries pour gerer l'entretien des drains plus efficacement dans le cadre du programme de protection des poissons de la Loi sur les peches et pour elaborer des pratiques d'entretien des drains qui visent un equilibre entre les besoins des agriculteurs et la protection de la biodiversite de poissons. [Traduit par la Redaction], Introduction Scientists are being pressed to provide information on the ability of ecosystems to resist and recover from change caused by human actions. Truly wild ecosystems are largely nonexistent, and [...]

The game of cricket is played at various times of the day and no studies have investigated the time of day effects on perceptual, physical and performance measures of cricketers. Therefore, the purpose of this study was to focus on adolescent fast bowlers and their responses when bowling at different times of the day. First team, adolescent male fast bowlers (N = 5, Mean age 17.00 ± 0.55 years; stature 185.2 ± 6.5 cm and mass 86.06 ± 17.56 kg) were required to complete a fast-bowling simulation protocol whereby perceptual, physical and bowling-specific performance measures were tested at three different times of day (10:30, 14:30, 18:30). Over all the spells over one was significantly slower than all the other overs. There were no significant changes in bowling speed between the time intervals. However, there was a large increase in bowling speed at 14:30 compared to 10:30 (ES – 1.25) and a moderate increase in bowling speed (ES = 0.67) between 10:30 and 18:30. There was no significant change in accuracy at the different time intervals although it was best at 10:30 followed by 18:30 although the latter had a greater variance. In conclusion, this investigation found time of day did not significantly impact the responses, but the effects sizes show that bowling accuracy was worst at 14:30 despite the other parameters, such as speed of delivery, being best at this time, which may suggest a speed-accuracy trade-off. Additionally, both 10:30 and 18:30 were found to be times conducive to bowling performance with regards to accuracy. [ABSTRACT FROM AUTHOR]

Lymphoma in pregnancy is a rare and challenging diagnosis that complicates ∼1:6000 pregnancies; posing a series of unique therapeutic, social, and ethical challenges to the patient, her family, and the medical professionals involved. These difficulties are compounded by the paucity of real-world data on the management of LIP, and a lack of relevant support systems for women in this setting. We conducted a retrospective multicenter qualitative study, interviewing women aged ≥18 years of age diagnosed with Hodgkin (HL) or non-Hodgkin lymphoma (NHL) during pregnancy or within 12 months postpartum, between 1 January 2009 and 31 December 2020 from 13 Australasian sites. Semi-structured telephone interviews were conducted, recorded, and analyzed using QSR Int NVivo 12 Pro (March 2020, USA) to quantify salient themes. Of the 32 women interviewed, 20 (63%) were diagnosed during pregnancy (16, 34, and 13% in the 1st, 2nd, and 3rd trimesters, respectively), while 12 (37%) were diagnosed post-partum. Women recalled that their chief concerns at diagnosis were the welfare of their child (n = 13, 41%) and a fear of dying (n = 9, 28%). Perceived diagnostic delay attributed to pregnancy was reported by 41% of participants. Other key themes were communication, educational materials, psychosocial supports, and oncofertility issues. To our knowledge this is the first report capturing the lived experiences of survivors of lymphoma during pregnancy, affording a unique opportunity to consider the management, psychosocial supports, and delivery of care to meet the needs of these women. What is the NEW aspect of your work? To our knowledge, this is the first report capturing and analyzing the healthcare experiences of survivors of Lymphoma in Pregnancy (LIP). What is the CENTRAL finding of your work? Women valued clear and empathic communication, provision of tailored educational materials, access to psychosocial supports (particularly childcare and financial supports), and timely oncofertility management in their healthcare journey. What is (or could be) the SPECIFIC clinical relevance of your work? Women's personal accounts of positive and negative experiences of LIP care provide insights into their specific concerns and needs which can shape healthcare policy and development of a specific framework for managing and supporting patients with LIP (and other cancers). [ABSTRACT FROM AUTHOR]