Search Results (17)

Background/Objectives: Precision medicine is transforming care for children with cancer, but raises new challenges. We explored parents’, oncologists’ and scientists’ perspectives on three aspects of a precision medicine trial for poor prognosis childhood cancer: data sharing, requests for additional tumor biopsies, and confidentiality. Methods: Data were collected through PRISM-Impact, a psychosocial sub-study within the Zero Childhood Cancer Program’s PRISM trial. Parents completed questionnaires at enrolment and one year later, and an optional interview after receiving their child’s trial results. Bereaved parents completed a questionnaire six months after bereavement (T1B). Oncologists and scientists were interviewed one year following trial commencement. Quantitative data were analyzed descriptively, and qualitative data thematically. Results: Parents (n = 126) considered additional tumor biopsies acceptable when risks were low and their child or oncologist supported the request. Oncologists (n = 26) emphasized weighing risk–benefit, ensuring parents felt fully informed, and research value. Most parents supported data sharing (≥89–96%), including after bereavement, despite potential privacy concerns. Parents supported overseas and interstate testing, and scientists having access to identifiable health information. Scientists (n = 10) found working with identifiable data emotionally challenging. Conclusions: Parents, oncologists, and scientists showed high acceptance of procedural aspects of precision medicine. Future trials should address privacy concerns and ensure informed consent recognizes that parents’ high acceptability of procedures may be linked to their hopes for benefit, reinforcing the need for informed consent. Full article

Objectives: Chronic pain corresponds to hypersensitivity to painful stimuli; however, its relation to acute pain sensitivity in children is poorly understood. We explored this relationship by comparing acute and chronic pain measures, along with related factors, in children with chronic pain syndromes versus controls, before and after therapeutic intervention. Methods: This prospective controlled cohort study involved 57 children with chronic pain undergoing intensive interdisciplinary pain treatment in a hospital-based pain rehabilitation program and 50 controls. Participants, aged 7–18, were tested using a cold pressor task (CPT) at admission, discharge, and first follow-up visit. Data on sleep, anxiety, psychological distress, functional impairment, and pain were collected. Results: Significant differences were found between control and treatment groups in average pain threshold (p < 0.001), pain tolerance (p = 0.035), sleep visual analog scale (VAS) (p < 0.001), functional disability inventory (p < 0.001), patient reported outcomes information system anxiety assessment tool (p < 0.001), general anxiety disorder 7-item scale (p < 0.001), pain VAS (p < 0.001) and total brief symptom inventory (BSI) (p < 0.001) scores at admission with children with chronic pain scoring worse on all measures save the pain VAS during the CPT. After treatment and at follow-up, function and mental health measures improved but not acute pain threshold. Conclusions: At treatment completion, function and mental health significantly improved but acute pain threshold and sleep quality were unchanged. These findings suggest that while chronic pain treatment improves overall function and mental health, acute pain thresholds may not be a suitable indicator for evaluating the efficacy of interventions. Full article

Objectives: To assess non-pharmacologic treatment outcomes pertaining to health-related quality of life (HRQoL) in youth with chronic idiopathic pain and their families. Methods: We conducted a retrospective cohort study of 115 youth with chronic idiopathic pain enrolled in a non-pharmacologic, hospital-based intensive interdisciplinary pain treatment (IIPT) program. HRQoL measures for the patient (Pediatric Quality of Life Inventory [PedsQL] short form) and family unit (PedsQL Family Impact) were collected on admission and discharge as part of routine clinical care. Changes in PedsQL scores were calculated using the Wilcoxon signed-rank test. Multivariable linear regression was used to explore factors associated with patient-level HRQoL. Results: Both individuals and the family unit reported that their HRQoL improved in all domains by program completion. Improvements in pain and allodynia were present for program participants at the time of completion as well as at the 3-month follow-up, suggesting durability of these effects. Conclusions: A non-pharmacologic IIPT program is a compelling treatment for pediatric and adolescent chronic idiopathic pain, for both patients and the family unit. Patients participating in this program had positive treatment outcomes with significantly improved subjective and objective measures of physical, emotional, social, and cognitive function. Full article

Cardiovascular disease is the leading cause of mortality following kidney transplantation. Heart failure affects 17–21% of patients with chronic kidney disease and increases along with time receiving dialysis. The Seattle Heart Failure Model (SHFM) is a validated mortality risk model for heart failure patients that incorporates clinical, therapeutic, and laboratory parameters but does not include measures of kidney function. We applied the SHFM to patients with end-stage renal disease (ESRD) who were being evaluated for kidney transplantation to determine if the model was associated with post-transplant mortality. This retrospective single-center study analyzed survival among 360 adult deceased-donor kidney transplant recipients. Cox regression was used to model post-transplant patient survival. Our findings indicated that a 1.0-point increase in the adapted SHFM score was significantly associated with post-transplant mortality (HR 1.76, 95% CI = 1.10–2.83, p = 0.02), independently of the Kidney Donor Profile Index and Estimated Post-Transplant Survival. Individual covariates of the SHFM were evaluated in univariate analyses, and age, sodium, cholesterol, and lymphocyte count were significantly related to mortality. This study provides preliminary evidence that an adapted SHFM score could be a useful tool in evaluating mortality risk post-transplant in patients with ESRD. Full article

The Colorado River has flowed across the dextral strike-slip plate boundary between the North American and Pacific plates since the latest Miocene or earliest Pliocene. The Fish Creek-Vallecito Basin (FCVB) lies on the Pacific Plate in southern California, dextrally offset from the point where the modern Colorado river enters the Salton Trough; it contains a record of ancestral Colorado River sedimentation from 5.3–2.5 Ma. The basin stratigraphy exhibits a changing balance between locally derived (L-Suite) and Colorado River (C-Suite) sediments. This paper focuses on the Palm Springs Group (PSG), a thick fluvial and alluvial sequence deposited on the upper delta plain (between 4.2–2.5 Ma) when the Colorado was active in the area, allowing the detailed examination of the processes of sediment mixing from two distinct provenance areas. The PSG consists of three coeval formations: 1) Canebrake Conglomerate, a basin margin that has coarse alluvial fan deposits derived from surrounding igneous basement; 2) Olla Formation, fan-fringe sandstones containing L-Suite, C-Suite, and mixed units; and 3) Arroyo Diablo Formation, mineralogically mature C-Suite sandstones. Stratigraphic analysis demonstrates that the river flowed through a landscape with relief up to 2000 m. Satellite mapping and detailed logging reveal a variable balance between the two suites in the Olla Formation with an apparent upward increase in L-Suite units before abrupt cessation of Colorado sedimentation in the basin. Stable heavy mineral indices differentiate L-Suite (high rutile:zircon index: RZi 40–95) from C-Suite (RZi: 0–20). Both suites have garnet:zircon index (GZi) and apatite:tourmaline index (ATi) mostly above 50, although many L-suite and mixed Olla samples have much lower ATi (20–50), suggesting that the distal floodplain was wet and the local sediment had a longer residence time there, or went through several cycles of erosion and redeposition. Heavy mineral analysis, garnet geochemical analysis, and detrital zircon U-Pb age spectra allow us to quantify the amount of mixing from different sediment sources. These data show that about 30% of the mixed units are derived from the Colorado River and that up to 20% of the L-Suite is also derived from the Colorado River, suggesting that there was mutual cannibalisation of older deposits by fluvial channels in a transitional area at the basin margin. Although this study is local in scope, it provides an insight into the extent and nature of sediment mixing in a two-source system. We conclude that most ‘mixing’ is actually interbedding from separate sources; true mixing is facilitated by low subsidence rates and the rapid migration of fluvial channels. Full article

Precision medicine is changing the treatment of childhood cancer globally, however little is known about quality of life (QoL) in children and adolescents participating in precision medicine trials. We examined QoL among patients enrolled in PRISM, the Zero Childhood Cancer Program’s precision medicine trial for high-risk childhood cancer. We assessed patient QoL via self-report (aged 12–17 years) and parent-proxy (aged 4–17 years) completion of the EQ-5D-Y. We analysed data using descriptive statistics and regression models. Patients (n = 23) and parents (n = 136) provided data after trial enrolment and following receipt of trial results and treatment recommendations (n = 8 patients, n = 84 parents). At enrolment, most patients were experiencing at least some difficulty across more than one QoL domain (81% patient self-report, 83% parent report). We did not find strong evidence of a change in QoL between timepoints, or of demographic or disease factors that predicted parent-reported patient QoL (EQ-VAS) at enrolment. There was strong evidence that receiving a treatment recommendation but not a change in cancer therapy was associated with poorer parent-reported patient QoL (EQ-VAS; Mdiff = −22.5, 95% CI: −36.5 to −8.5, p = 0.006). Future research needs to better understand the relationship between treatment decisions and QoL and would benefit from integrating assessment of QoL into routine clinical care. Full article

Promoting Resilience in Stress Management (PRISM) is a well-established resilience coaching program for youth with chronic illness. It is a one-on-one intervention targeting skills in stress management, goal-setting, cognitive reframing, and meaning-making. We aimed to (i) assess the feasibility and acceptability of PRISM and (ii) explore PRISM’s impact on clinical outcomes among youth with chronic musculoskeletal pain (CMP). This was a single-arm pilot trial of PRISM for youth with CMP aged 12–17 years. Patients completed patient-reported outcome measures (PROs) pre- and post- intervention; patients and caregivers provided qualitative feedback. Twenty-seven patients were enrolled (63% enrollment rate); 82% percent were female. The patients’ median age was 16 years (IQR: 13–16). The intervention completion rate was 81% (n = 22). The mean satisfaction for PRISM overall was 4.3 (SD 0.9), while the mean acceptability of the intervention measure (AIM) was 4.4 (SD 0.89). Participants reported improved resilience (2.2 [SD 5.1]), functional disability (−3.5 [IQR: −6.0, 1.0]), and psychological distress (−1.0 [−5.0, 2.0]) from baseline to immediately post-treatment; pain intensity, pain catastrophizing, and global health were similar at both time points. Feedback was positive and suggested that a group component may be helpful. PRISM is feasible and acceptable among youth with CMP. Exploratory analyses suggest improvements in clinically relevant outcomes, warranting further investigation. Full article

This study aimed to evaluate the sensory and physical characteristics of zingibain-injected meat combined with sous vide cooking. M. biceps femoris (BF; n = 12) acquired from 6–7 year old Angus cows were cooked using the sous vide method at 65 °C, for 8 h or 12 h, either with ginger powder (GP) injected in a 2 g/L solution in water (treatment) or un-injected (control). The sensory attributes included flavour, juiciness, tenderness, and physicochemical characteristics were Warner-Bratzler shear (WBSF), hardness, total water content (TWC), cooking loss (CL) and collagen content. A significant improvement in tenderness with injection treatment and cooking time was observed, as evaluated through trained sensory panellists, and reduced WBSF and hardness (p < 0.05 for all). The flavour of the meat was not affected by injection treatment or cooking time (p > 0.05), but juiciness and TWC were reduced with longer cooking times (p < 0.01 for both). Soluble collagen increased with injection treatment and cooking time (both p < 0.05). Moderate to high correlations were found between sensory and physical measurements for tenderness and juiciness. The longer cooking time (12 h) with GP injection treatment caused over tenderization of the meat. The soft texture associated with over-tenderization may be suitable for some specialised consumer markets, for instance, the elderly population with chewing difficulties. Improving the eating quality of low-quality meat from old animals through sous vide cooking and the use of ginger proteases may increase the acceptability of lower value beef, potentially enhancing the commercial value of carcasses typically produced in the beef industry. Full article

Information on the practical use of cognitive enrichment in zoos is scarce. This survey aimed to identify where cognitive enrichment is being used while identifying factors that may limit its implementation and success. Distributed in eight languages to increase global range, responses to this survey (n = 177) show that while agreement on what constitutes cognitive enrichment is poor, it is universally perceived as very important for animal welfare. Carnivores were the animal group most reported to receive cognitive enrichment (76.3%), while amphibians and fish the least (16.9%). All animal groups had a percentage of participants indicating animal groups in their facility were not receiving cognitive enrichment when they believe that they should (29.4–44.6%). On average, factors relating to time and finance were rated most highly in terms of effect on cognitive enrichment use, and keeper interest was the highest rated for effect on success. Results of this study indicate that cognitive enrichment is perceived as important. However, placing the responsibility of its development and implementation on animal keepers who are already time-poor may be impeding its use. A commitment to incorporating cognitive enrichment into routine husbandry, including financial support and investment into staff is needed from zoos to ensure continued improvement to captive animal welfare. Full article

The burgeoning field of nanotechnology aims to create and deploy nanoscale structures, devices, and systems with novel, size-dependent properties and functions. The nanotechnology revolution has sparked radically new technologies and strategies across all scientific disciplines, with nanotechnology now applied to virtually every area of research and development in the US and globally. NanoFlorida was founded to create a forum for scientific exchange, promote networking among nanoscientists, encourage collaborative research efforts across institutions, forge strong industry-academia partnerships in nanoscience, and showcase the contributions of students and trainees in nanotechnology fields. The 2019 NanoFlorida International Conference expanded this vision to emphasize national and international participation, with a focus on advances made in translating nanotechnology. This review highlights notable research in the areas of engineering especially in optics, photonics and plasmonics and electronics; biomedical devices, nano-biotechnology, nanotherapeutics including both experimental nanotherapies and nanovaccines; nano-diagnostics and -theranostics; nano-enabled drug discovery platforms; tissue engineering, bioprinting, and environmental nanotechnology, as well as challenges and directions for future research. Full article

In Pakistan, smallholder farmers are primarily engaged in dairy farming while keeping beef animals as secondary products. Farmers experience poor production due to lack of focus on beef farming, traditional calf rearing practices and limited resources. The objective of this study was to understand the perceptions of smallholder farming households of beef production and the available resources for farmers to engage in beef fattening to increase overall farm profitability. Data was collected using a focus group discussion approach, from farming households in villages across Punjab (n = 7) and Sindh (n = 8). An integrated framework incorporating gender and value-chain considerations was used as a tool to assess farmer interest, goals and resources for rearing livestock. The data was analyzed using content analysis. The majority of farmers interested in calf fattening were more resource rich, with livestock as their primary source of income. A smaller proportion of farmers, with limited resources, also took interest in calf fattening. Women from a few villages mentioned that they were reluctant to be involved in beef businesses due to an emerging focus on childhood education as well as a lack of agency for livestock sales and control over income. Another factor contributing to farmer perceptions of beef included their enterprise focus (dairy or cropping). Overall, smallholder farmers perceived that calf fattening could be a profitable business if claves were reared properly, had adequate feed resources and good market return. Training and farm support targeting these areas is critical for calf fattening to become a profitable market strategy. Full article

In Pakistan there are no dedicated beef breeds consequently beef meat is a by-product of the dairy industry in the form of cull cows and male calves. Smallholder farmers supply up to 80% of animals slaughtered and decisions to sell their animals is driven by a need to generate cash in a time of necessity rather than in response to market signals. The aim of this study was to identify and evaluate beef market opportunities for smallholder farmers with the objective of increasing their income from their beef animals. Using a rapid value chain assessment seven potential beef markets in Punjab and Sindh were assessed and one was studied in detail to evaluate the opportunities and risks for smallholder farmers in beef value chains. Semi-structured interviews were conducted with beef value chain actors including; consumers (10), retailer (1), traders (12), feedlot farmer (1) and smallholder farmers (9). The interview data was analyzed using content analysis within value chain framework comprising of different flows (product, information and financial) and relationships among the chain actors. The results indicated that supplying directly to the retailer was indeed a potential opportunity for smallholder farmers provided they can meet product specifications. This study describes what capacity building support would be required to enable smallholder farmers to implement more focused and cost-effective rearing strategies leading to a reliable and consistent supply for this retailer. If successful, this could be used as a model for market interventions for other farmers leading to increased beef production and profitability. Full article

Precision medicine is changing cancer care and placing new demands on oncology professionals. Precision medicine trials for high-risk childhood cancer exemplify these complexities. We assessed clinicians’ (n = 39) and scientists’ (n = 15) experiences in the first year of the PRecISion Medicine for Children with Cancer (PRISM) trial for children and adolescents with high-risk cancers, through an in-depth semi-structured interview. We thematically analysed participants’ responses regarding their professional challenges, and measured oncologists’ knowledge of genetics and confidence with somatic and germline molecular test results. Both groups described positive early experiences with PRISM but were cognisant of managing parents’ expectations. Key challenges for clinicians included understanding and communicating genomic results, balancing biopsy risks, and drug access. Most oncologists rated ‘good’ knowledge of genetics, but a minority were ‘very confident’ in interpreting (25%), explaining (34.4%) and making treatment recommendations (18.8%) based on somatic genetic test results. Challenges for scientists included greater emotional impact of their work and balancing translational outputs with academic productivity. Continued tracking of these challenges across the course of the trial, while assessing the perspectives of a wider range of stakeholders, is critical to drive the ongoing development of a workforce equipped to manage the demands of paediatric precision medicine. Full article

Pseudomonas aeruginosa (P. aeruginosa) infections may lead to severe damage of the cornea, mucosa, and skin. The highly aggressive nature of P. aeruginosa and the rise in multi-drug resistance, particularly in nosocomial settings, lead to an increased risk for permanent tissue damage and potentially death. Thus, a growing need exists to develop alternative treatments to reduce both the occurrence of bacterial infection and biofilm development, as well as pathological progression post-infection. Silk derived from Bombyx mori silkworms serves as a unique biomaterial that is biocompatible with low immunogenicity and high versatility, and thereby ideal for stabilizing therapeutics. In this study, we assessed the cytotoxicity of P. aeruginosa on human corneal stromal stem cells and two mucosal cell lines (Caco-2 and HT29-MTX). To determine whether antibiotic-immobilized scaffolds can serve as alternative therapeutics to free, diffuse forms, we developed novel gentamicin-conjugated silk films as functional scaffolds and compared antimicrobial effects and free gentamicin. The advantages of generating a surface coating with a covalently-bound antibiotic may reduce potential side-effects associated with free gentamicin, as well as limit the diffusion of the drug. Our results suggest that gentamicin conjugated to native silk and carboxyl-enriched silk inhibits P. aeruginosa growth. Development of stabilized antibiotic treatments with surface toxicity selective against bacteria may serve as an alternative approach to treat active infections, as well as potential prophylactic use as coatings in high-risk cases, such as post-surgical complications or prolonged hospitalization. Full article

The main purpose of this study was to investigate the hepatotoxic potential and effects on the gut microbiome of decaffeinated green tea extract (dGTE) in lean B6C3F₁ mice. Gavaging dGTE over a range of 1X–10X mouse equivalent doses (MED) for up to two weeks did not elicit significant histomorphological, physiological, biochemical or molecular alterations in mouse livers. At the same time, administration of dGTE at MED comparable to those consumed by humans resulted in significant modulation of gut microflora, with increases in Akkermansia sp. being most pronounced. Results of this study demonstrate that administration of relevant-to-human-consumption MED of dGTE to non-fasting mice does not lead to hepatotoxicity. Furthermore, dGTE administered to lean mice, caused changes in gut microflora comparable to those observed in obese mice. This study provides further insight into the previously reported weight management properties of dGTE; however, future studies are needed to fully evaluate and understand this effect. Full article