• Burris Stein posted an update 6 months ago

    Despite the evolving therapeutic armamentarium, the treatment of IBD patients remains challenging and many patients fail to respond to biologic agents. With the limited yield of clinical factors to predict the outcome of biologic treatments, studies have focused on identifying genetic alterations and circulating or tissue biomarkers to identify patients who are likely to respond to therapy. In this review, we examine the current knowledge and status of genetic, expression biomarkers, and microbiome predictors. The search for genetic predictors has yielded many genetic loci variants, but few were reproducible. Expression studies of putative biomarkers show promising results, especially with TREM1, oncostatin M and TNF biomarkers, but confirmatory studies are warranted. Finally, the microbiome is emerging as an important player with specific taxa and functional pathways differentially abundant and enriched in responders versus non-responders to certain biologics. Integrating different factors into a robust predictive model, which is both reproducible, accurate and affordable, remains the main challenge before these individualized strategies can reach clinical use.

    Extracranial rhabdoid tumours are rare, highly aggressive malignancies primarily affecting young children. https://www.selleckchem.com/products/filgotinib.html The EU-RHAB registry was initiated in 2009 to prospectively collect data of rhabdoid tumour patients treated according to the EU-RHAB therapeutic framework.

    We evaluated 100 patients recruited within EU-RHAB (2009-2018). Tumours and matching blood samples were examined for SMARCB1 mutations by sequencing and cytogenetics.

    A total of 70 patients presented with extracranial, extrarenal tumours (eMRT) and 30 with renal rhabdoid tumours (RTK). Nine patients demonstrated synchronous tumours. Distant metastases at diagnosis (M+) were present in 35% (35/100), localised disease (M0) with(LN+) and without (LN-) loco-regional lymph node involvement in 65% (65/100). SMARCB1 germline mutations (GLM) were detected in 21% (17/81 evaluable) of patients. The 5-year overallsurvival (OS) and event-free survival (EFS) rates were 45.8±5.4% and 35.2±5.1%, respectively. On univariate analyses, age at diagnosis (≥12 montr, OS 32.5 ± 6.2%). These patients need novel therapeutic strategies such as combinations of targeted agents with conventional chemotherapy or novel experimental approaches ideally within international phase I/II trials.

    This work investigated effects of implementing the Delta

    Discover diode transmission detector into the clinical workflow.

    PDD and profile scans were completed with and without the Discover for a number of photon beam energies. Transmission factors were determined for all beam energies and included in Eclipse TPS to account for the attenuation of the Discover. A variety of IMRT plans were delivered to a Delta

    Phantom+ with and without the Discover to evaluate the Discover’s effects on IMRT QA. An imaging QA phantom was used to assess the detector’s effects on MV image quality. OSLDs placed on the Phantom+ were used to determine the detector’s effects on superficial dose.

    The largest effect on PDDs after d

    was 0.5%. The largest change in beam profile symmetry and flatness was 0.2% and 0.1%, respectively. An average difference in gamma passing rates (2%/2mm) of 0.2% was observed between plans that did not include the Discover in the measurement and calculation to plans that did include the Discover in the measurement and calculation. The Discover did not significantly change the MV image quality, and the largest observed increase in the relative superficial dose when the Discover was present was 1%.

    The effects the Discover has on the linac beam were found to be minimal. The device can be implemented into the clinic without the need to alter the TPS beam modeling, other than accounting for the device’s attenuation. However, a careful workflow review to implement the Discover should be completed.

    The effects the Discover has on the linac beam were found to be minimal. The device can be implemented into the clinic without the need to alter the TPS beam modeling, other than accounting for the device’s attenuation. However, a careful workflow review to implement the Discover should be completed.

    It is important to check stability of ionization chambers in between regular calibration cycles. Stability checks can include individual

    Co irradiations, use of a beta-emitting check source, or redundant measurements in megavoltage photon beams. While

    Co irradiators are considered stable, they are rarely found in the clinical setting. Thus, this study seeks to compare the precision and efficiency in monitoring chamber stability using

    Sr check sources and linear accelerator beams which are both commonly found in the clinical setting, and compare these sources to

    Co.

    Measurements were made with a

    Sr beta-emitting check source and a 6 MV photon beam using a Constancy Check Phantom with three custom inserts to hold the ionization chambers. A comparison of both methods was performed with an Exradin A28 scanning chamber, Wellhofer IC69 Farmer-type chamber, and Exradin A12 Farmer-type chamber. Chamber stability was evaluated with individual charge readings and charge ratios among the three chambers. Results were compared to measurements taken in

    Co with three Farmer-type chambers the NEL 2571, PTW N30001G, and Exradin A12.

    Stability of individual charge reading was found to be within ±1.0% for

    Sr source measurements and ±0.5% for external beam measurements, including the

    Co comparison. Additionally, the standard deviation of the mean charge ratios ranged from 0.15% to 0.40% for

    Sr measurements and from 0.10% to 0.30% for the external beam measurements.

    This work provides a comparison of techniques used to assess stability of ionization chambers in order to better inform the clinical physicist.

    This work provides a comparison of techniques used to assess stability of ionization chambers in order to better inform the clinical physicist.

    The number of people testing positive for Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) in the UK, particularly among young adults, is increasing. We report here on the mental health of young adults and related psychological and behavioural responses to the pandemic and consider the role of these factors in fuelling the increase in coronavirus disease 2019 (COVID-19) in this group.

    An online survey was completed during the first six weeks of the first UK-wide lockdown by 3097 respondents, including data for 364 respondents aged 18-24 years. The survey included measures of mental health and indices capturing related psychological and behavioural responses to the pandemic.

    The mental health of 18- to 24-years-olds in the first 6 weeks of lockdown was significantly poorer than that of older respondents and previously published norms with 84% reporting symptoms of depression and 72% reporting symptoms of anxiety. Young adults also reported significantly greater loneliness and reduced positive mood, both of which were also associated with greater mental health difficulties.

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