Search

Diffuse intrinsic pontine glioma (DIPG) is an aggressive brain tumour that occurs in the pons of the brainstem and accounts for over 80% of all brainstem gliomas. The median age at diagnosis is 6–7 years old, with less than 10% overall survival 2 years after diagnosis and less than 1% after 5 years. DIPGs are surgically inaccessible, and radiation therapy provides only transient benefit, with death ensuing from relentless local tumour infiltration. DIPGs are now the leading cause of brain tumour deaths in children, with a societal cancer burden in years of life lost (YLL) of more than 67 per individual, versus approximately 14 and 16 YLL for lung and breast cancer respectively. More than 95 clinical drug trials have been conducted on children with DIPGs, and all have failed to improve survival. No single or combination chemotherapeutic strategy has been successful to date because of our inability to identify targeted drugs for this disease and to deliver these drugs across an intact blood-brain barrier (BBB). Accordingly, there has been an increased focus on immunotherapy research in DIPG, with explorations into treatments such as chimeric antigen receptor T (CAR-T) cells, immune checkpoint blockades, cancer vaccines, and autologous cell transfer therapy. Here, we review the most recent advances in identifying genetic factors influencing the development of immunotherapy for DIPG. Additionally, we explore emerging technologies such as Magnetic Resonance-guided Focused Ultrasound (MRgFUS) in potential combinatorial approaches to treat DIPG.

Background: Ketamine has demonstrated efficacy in treating depression unresponsive to traditional interventions and is increasingly utilized in psychiatric practice. However, limited information is available regarding effectiveness in patients with psychiatric comorbidity. The aim of this study is to compare the response of ketamine treatment for depression in patients in a community sample with and without one or more coexisting psychiatric diagnoses. Methods: A retrospective review of medical records from a community ketamine clinic was done. Statistical analyses compared response to intravenous ketamine treatment, as defined by a 50% reduction in Patient Health Questionnaire (PHQ-9) score or final score of

Agricultural water demands can conflict with habitat needs in many North Coast watersheds. Understanding different water use patterns can help reduce conflict over limited supplies. We measured on-farm crop water use and conducted grower interviews to estimate the agricultural water demand in the upper Russian River and Navarro River watersheds. Annual agricultural water demand was less than 11% in the Russian River, and 2% in Navarro River, of the total annual discharge in each watershed. However, because demands are concentrated in the dry season when instream flows are at a minimum, these relatively small amounts can represent a significant constraint to stream habitat conditions. We have shared our study results in broad basin and community water resource planning efforts, including flow management of the Russian and Navarro rivers and implementation of the Sustainable Groundwater Management Act in the Ukiah Basin. Findings and recommendations from this study have influenced on-the-ground solutions to meet water demand in these watersheds, including construction of off-stream wintertime storage capacity to replace summertime stream diversions, and use of a municipal recycled water conveyance system as a replacement for summer diversions.

The Sustainable Groundwater Management Act of 2014 (SGMA) set a goal to achieve sustainable management of California's groundwater resources by 2040, yet it left many of the details of its implementation to be worked out through subsequent regulations. Arguably, the California Department of Water Resources (DWR) developed the most important of these regulations this year regarding how the state should evaluate local Groundwater Sustainability Plans. Despite their importance, these regulations have received little media attention or independent review. Here, we offer our independent analysis of a key aspect of the regulations, focusing on the role of science, data, and models that will be critical for SGMA's material and institutional success. In particular, we draw on our previously published research regarding sustainability metrics (Christian-Smith and Abhold 2015), the role of stakeholders (Dobbin et al. 2015), and the importance of good governance (Kiparsky et al. 2016). We conclude with a series of general principles for ensuring scientific transparency.

Agricultural water demands can conflict with habitat needs in many North Coast watersheds. Understanding different water use patterns can help reduce conflict over limited supplies. We measured on-farm crop water use and conducted grower interviews to estimate the agricultural water demand in the upper Russian River and Navarro River watersheds. Annual agricultural water demand was less than 11% in the Russian River, and 2% in Navarro River, of the total annual discharge in each watershed. However, because demands are concentrated in the dry season when instream flows are at a minimum, these relatively small amounts can represent a significant constraint to stream habitat conditions. We have shared our study results in broad basin and community water resource planning efforts, including flow management of the Russian and Navarro rivers and implementation of the Sustainable Groundwater Management Act in the Ukiah Basin. Findings and recommendations from this study have influenced on-the-ground solutions to meet water demand in these watersheds, including construction of off-stream wintertime storage capacity to replace summertime stream diversions, and use of a municipal recycled water conveyance system as a replacement for summer diversions.

BACKGROUND: Amputation at the transfemoral (TF) level reduces the rate of successful prosthetic fitting, functional outcome, and quality of life (QoL) compared with transtibial amputation. The TF socket interface is considered the most critical part of the prosthesis, but socket discomfort is still the most common user complaint. Direct Socket for transfemoral prosthesis users is a novel interface fabrication process where the socket is shaped and laminated directly on the residual limb and delivered in a single visit. OBJECTIVE(S): The aim of this study was to investigate if prosthetic users' quality of life (QoL), comfort, and mobility with a Direct Socket TF interface were comparable to their experience with their previous prostheses. METHODOLOGY: The pre/post design prospective cohort study included 47 subjects. From this cohort, 36 subjects completed the 6-months follow-up (mean age 58 years, 27 males). Outcomes at baseline included EQ-5D-5L®, PLUS-M™, CLASS, ABC, AMPPRO, and TUG. At 6-weeks and 6-months, subjects repeated all measures. Seven Certified Prosthetist (CP) investigators performed observations and data collection at six different sites (from July 2018 to April 2020). FINDINGS: Results showed significant improvement in all outcome measures for the 36 subjects that completed both 6-weeks and 6-months follow-ups. CLASS sub-scales showed significantly improved stability, suspension, comfort, and socket appearance. Improvement in K-Level and less use of assistive devices were observed with the AMPPRO instrument, indicating improved user mobility and performance. QoL was also increased, as measured in Quality-Adjusted-Life-Years (QALY) from the EQ-5D-5L. CONCLUSION: Evidence from the findings demonstrate that the Direct Socket TF system and procedure can be a good alternative to the traditional method of prosthetic interface delivery. Layman's Abstract After lower limb amputation, the goal for most people is to regain mobility and independence and return to normal daily activities. Typically, people with transfemoral amputation are less likely to receive a prosthesis or fully use a prosthesis as compared to people with transtibial amputation. Moreover, their quality of life is also lower. The Direct Socket TF method is a new way of fabricating a prosthetic socket for users with above-knee amputation, enabling fabrication directly onto the residual limb and delivery of the socket in a single visit. In this study, we wanted to understand how the effect of Direct Socket TF on prosthetic 'user's quality of life, health, mobility level, and balance would compare to their previous prosthesis. This new Direct Socket TF procedure was implemented in six different prosthetic clinics across the United States and used by 36 prosthetic users for six months. Our first article on this study describes increased user satisfaction with their new interface and the single visit service model. This second article on the same clinical investigation documents the significant improvement in outcomes compared to their original interface in terms of quality of life, confidence, mobility, comfort, stability, and activity level. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36065/27923 Direct Socket TF – Summary (YouTube): https://www.youtube.com/watch?v=-fvVFqjgxjo How To Cite: Walker J, Marable W.R, Smith C, Sigurjónsson B.Þ, Atlason I.F, Johannesson G.A. Clinical outcome of transfemoral direct socket interface (part 2). Canadian Prosthetics & Orthotics Journal. 2021;Volume 4, Issue 1, No.6. https://doi.org/10.33137/cpoj.v4i1.36065 Corresponding Author: Anton Johannesson, PhD TeamOlmed, Kistagången 12, 164 40 Kista, Stockholm, Sweden. E-mail: ajohannesson@teamolmed.se ORCID: https://orcid.org/0000-0001-8729-458X