Significant Treatment Factors Research Articles

Gonadal Function in Female Adolescent and Young Adult Survivors of Childhood Cancer.

Childhood cancer survivors (CCSs) are at risk for premature ovarian insufficiency (POI). The aim of this study is to evaluate ovarian function and associated health outcomes in female adolescent and young adult survivors of childhood cancer. Sixty-nine female CCSs were enrolled. Medical records of CCSs were retrospectively reviewed. The subjects were categorized into three groups according to follicular stimulating hormone (FSH) levels (cutoff, 12, 40 IU/L). Anti-müllerian hormone (AMH) level less than 1 ng/mL was considered low AMH level. Of 69 subjects, 14 (20.3%) had POI and 14 (20.3%) had FSH levels between 12 and 40 IU/L. Forty-one of 69 (59.4%) had normal FSH levels. Pelvic irradiation and stem cell transplantation (SCT) were more frequently performed in subjects with POI (p=0.001 and p < 0.001). AMH levels were remarkably low when FSH levels were over 12 IU/L (p < 0.001). In multivariate analysis, cyclophosphamide equivalent dose and SCT were significant treatment factors for developing low AMH levels (p=0.005 and p=0.002, respectively). Total, low-density lipoprotein cholesterol and triglyceride were significantly different in three groups according to FSH levels (p=0.047, p=0.030, and p=0.045). Z-score of femur neck bone mineral density was significantly reduced when FSH levels were increased (p=0.011). Gonadal dysfunction is common in CCSs. Gonadal function was associated with a few treatment factors known to increase the risk of POI. Regular monitoring of gonadal function is needed for better health outcomes.

Application of Response Surface Methodology for Determining Optimal Factors in Maximization of Maize Grain Yield and Total Microbial Count in Long Term Agricultural Experiment, Kenya

The Agriculture sector is the main stay of the Kenyan economic development contributing over 70% of the Gross Domestic Product (GDP). The sector is faced with numerous challenges leading to frequent and recurrent food shortages. Declining maize grain yield is one among the major challenges that call for urgent interventions to address the looming food crisis in the country. Maize play a big role in the Kenyan food security and in most case lack of the same is taken to mean food insecurity. It is due the importance attached to the crop that a Long Term Agricultural Experiments (LTAE) was set up specifically to research on the Maize grain yield. Many paper published on the LTAE in the country are only single factors analysis and lack the application of Response Surface Methodology (RSM) approaches in solving challenges facing the low and declining maize grain yield (y1), total microbe population (y2) a crucial component of Soil Organic Matter (SOM) and their optimization. The focus of this paper therefore is the application of RSM in maize grain yield and total microbial population optimization. Specifically, the paper determined the most significant factors for maize grain yield and total microbial population (bacteria, fungi, actinomycetes, rhizobia), (screening phase of the paper), constructed of an efficient and appropriate experimental design for evaluating the optimal settings of maize yield and total microbial population count and determined univariate optimal settings for maize grain yield and total microbial population. The primary data was summarized from LTAE in National Agricultural Research Laboratories (NARL) in Kabete under the Kenya Agriculture and Livestock Research Organization (KALRO) and secondary data imputed for experimental points falling outside the set field experimental design points. Two treatment factors were identified as the most significant treatment factors (Farm Yard Manure (FYM) and Nitrogen and Phosphorus (NP)) at their low levels and Circumscribed Central Composite Design (CCCD) with two star points as the most efficient design. CCCD passed most optimal criteria of DAET. Univariately, optimal setting for maize grain yield was realized at 3.8x103 kg/ha and that of the total microbial population at 3.6x106 count. The study confirmed that it was possible to optimize the input treatment factor that lead to the optimization of both maize grain yield and maintaining maximal total microbial population count at its optimal levels.

Evaluation of the Most Significant Treatment Factors for Maize Grain Yields and Total Microbial Count in Long Term Agricultural Experiment (LTAE), Kenya

Agriculture and its related economic activities form the main livelihood for Kenya population. The sector faces numerous challenges that have led to food insecurity in the country. Maize production plays a significant role in the country’ economic development contributing significantly to the national overall Gross Domestic Product (GDP). Declining maize grain yield is one of the major challenges that require interventions to avert the looming food crisis. To address the challenge various Long Term Agricultural Experiments (LTAE) and studies on soil fertility maintainance options have been developed. However, such studies have explored only single factors at a time with limited application of robust statistical application. Statistical procedures could offer best set of few treatment factors that explain the maize grain yields in LTAEs in Kenya and beyond. The focus of this paper was the application of robust statistical methods in obtaining set of minimum treatment factors that could be used in the determination maize grain yield in LTAE. Specifically, the paper sought to describe the trend in maize grain yield over the experimental period, characterize the input factors for maize grain yield and to determine the most significant treatment factors for maize grain yield and total microbial population count (bacteria, fungi, actinomycetes, rhizobia). The primary data was summarized from LTAE in National Agricultural Research Laboratories (NARL), Kabete under the Kenya Agriculture and Livestock Research Organization (KALRO) and secondary data imputed for experimental points falling outside the set field experimental design points. Two treatment factors were isolated (Farm Yard Manure (FYM) and Nitrogen and Phosphorus (NP)) at their low factor levels as the most significant treatment factor in maximizing the maize grain yield and total microbial population count. It was possible to select a minimum set of treatment factors in LTAE that are critical in predicting the maize grain yield.

Pitfalls in adapting general population measures for use in research with people with intellectual disabilities

Objectives:In a study concerning empathy in offenders who have intellectual disabilities (ID) we adapted a measure designed for use with the general population. In this paper we describe how we did this and the pitfalls we encountered. We were looking at empathy because it is seen as a significant factor in treatment and treatment outcomes with sex offenders. This has been inducted into treatment programmes and evaluations with sex offenders who have ID. The aim of our study was to explore general and victim empathy in sex-offenders and non-offenders with ID. The original aim was to explore differences between these groups on adapted measures of general and victim empathy, and if there was any relationship between the sex-offenders’ scores on empathy towards non-specific victims of sexual assault and their empathy towards their own victim.Methods:A measure of general and victim specific empathy developed for use with sex offenders in the general population (the Empat) was adapted for use with adults who have ID. Twenty-one sex-offenders and 21 non-offenders with ID, matched by age, gender and IQ, completed the adapted version of the Empat and the offender group also completed a previously adapted version of the Victim Empathy Scale.Results:Psychometric evaluation of the adapted scale produced marginal and poor reliabilities. In view of this further analysis to examine comparisons between the two groups would most likely produce spurious results. Thus the introduction of measures from the general population to populations of people who have ID are not always successful. However, such outcomes are not always reported. Further research is needed to develop better approaches to the assessment of victim specific and general empathy in offenders who have ID.Conclusion:Despite following guidelines on measure adaptation for people who have ID, the measures did not achieve satisfactory psychometric properties and, therefore, any findings could be spurious. This study clearly shows that researchers need to establish that any general population measures they employ or adapt for use with people who have ID need to be evaluated psychometrically first.

ERRATUM

In Table 2 and Fig. 1 in the paper by Faithfull et al. (“Testing the light:nutrient hypothesis in an oligotrophic boreal lake”; Ecosphere 2:123), ratios of C:P, C:N and N:P were incorrect, and these are now corrected in the table and figure below. Please note that these corrections do not change the significance of patterns presented in the results section or the conclusions of the original paper. Change in (A) phytoplankton primary production (PPr), (B) bacterial production (BP), (C) PPr:BP ratios, (D) edible seston C:N ratios and (E) edible seston C:P ratios (means ± 1 SE), for the treatment factors, carbon (C), nitrogen (N), phosphorus (P) and low light (shading: S) (n = 16), on 6 June and 22 June. Stars indicate significant treatment factors (factorial ANOVA, p < 0.05).

Supratentorial Primitive Neuroectodermal Tumors (PNETs) and Medulloblastoma in Children and the Elderly: A Surveillance, Epidemiology, and End Results (SEER) Investigation of Prognosis, Tumor Characteristics, and Predictors of Radiation Therapy

Medulloblastoma and supratentorial PNET predominantly occur in children. Variations in histology, location, prognosis, and radiation treatment (RT) by age are poorly understood. Additionally, a significant portion of patients >3 years (y) do not undergo RT, and we attempted to determine factors associated with this treatment strategy. Using the SEER 1973-2008 database, we identified 2999 CNS supratentorial PNET/pineoblastomas (14.7%) and medulloblastomas (85.3%). Multivariate analysis (covariates: age, sex, tumor site, stage, histology, extent of surgery, RT, and diagnosis year) with Cox proportional hazards and logistic regression identified predictors of survival and radiation treatment, respectively. Median follow-up was 45 months (range 1-428). At diagnosis, age distributions were <3 (N=490), 3-17 (N=1560), 18-34 (N=604), 35-64 (N=315), and ≥65y (N=30). For ≥65 vs. <18y, there were more pineoblastomas (33.3% vs. 4.4%), supratentorial tumors (60.0% vs. 12.8%), and no surgical resection (36.7% vs. 4.8%); all P<0.001. By age, RT administration was: <3 (34.8%), 3-17 (86.9%), 18-34 (85.5%), 35-64 (83.3%), and ≥65y (60.0%); P<0.001. 5y overall (OS) and disease specific survival (DSS) were 60.3% and 63.1%. Histologies with worse 5y OS were supratentorial PNET (40.1%), pineoblastomas (53.5%), and large cell medulloblastomas (53.7%). By location, 5y OS was 65.0% for infratentorial, 47.2% for supratentorial, and 48.7% for primary spinal cord lesions. When examining 5y DSS by age group, elderly patients had the lowest DSS (17.5%), followed by <3 (47.8%), 3-17 (67.5%), 18-34 (67.0%), and 35-64y (59.9%). In multivariate analysis (3-17y reference, HR=1), patients <3 (HR 1.34), 35-64 (HR 1.50), and ≥65 (HR 2.16) had worse DSS (P<0.01). 5y OS with and without RT was 64.9% and 43.8%, respectively (P<0.001). For DSS after adjustment, significant (P<0.05) disease factors associated with decreased survival were supratentorial location (HR 1.79), distant metastases (HR 1.73), PNET histology (HR 1.58) and large cell medulloblastoma (HR 2.73). Significant treatment factors for improved DSS were gross total resection (HR 0.72) and RT (HR 0.54). In multivariate analysis (3-17y reference OR=1), only age was associated with RT use, with those <3y (OR 0.08) and ≥65 (OR 0.33) less likely to receive RT at initial diagnosis (P<0.05). Characteristics underlying prognosis of supratentorial PNET and medulloblastoma differ by age. Among elderly patients there is a greater proportion of pineoblastomas, supratentorial PNETs, and less aggressive use of surgery and RT, potentially contributing to worse survival in this high-risk population.

An assessment of basic treatment equivalent at Cookridge Hospital.

The Australian model of Basic Treatment Equivalent (BTE) for measuring radiotherapy treatment productivity was developed for and tested within a busy UK radiotherapy centre and the results assessed against three other BTE models. The department's productivity was compared for three different models of treatment machine. Treatment fraction durations were timed for 362 consecutive treatment episodes on three treatment machines at Cookridge Hospital. Leeds. The treatment factors found to have a statistically significant impact on fraction duration were: initial fraction; patient mobility; number of fields; treatment intent and the type of treatment machine. In comparison with the Australasian study, shorter mean fraction times were shown for a number of types of treatment, carried out on one particular linac type, which had multileaf collimation (MLC). The average non-operational time was 17% at Cookridge (31% in Australasia) with overall productivity gains. This efficiency may have been achieved partly by a higher number of staff per machine (five rather than four) and the presence of newer technology such as MLC. A BTE model was derived for Cookridge using the significant treatment factors and compared to other published models. The Cookridge model was most sensitive in predicting productivity. BTE models developed by other groups were also excellent in predicting treatment duration. The development of a BTE model is potentially applicable in the U.K. radiotherapy community at a time when optimizing activity per radiographer is key to minimizing waiting times.

Epidermoid carcinomas of the floor of mouth treated by exclusive irradiation: Statistical study of a series of 207 cases

Purpose. Our aim was to study the results and the complications of this series of 207 patients treated from 1976 to 1992 and to compare them with the results of the literature. Material and methods. The treatment consisted of a combination of external beam irradiation (EBI) (to the tumor and the node areas) and complementary brachytherapy to the primary tumor in 105 cases. In 102 cases, brachytherapy only was delivered to the tumor with or without neck dissection of the node areas. The brachytherapy was performed mostly with the hairpin technique in the beginning (in 61 cases) and subsequently the plastic tube technique with indium wires. The dosimetry followed the Paris system rules. There were 41% T1, 48% T2, 8% T3, 2% T4 and 1% Tx with 83% N0, 12% N1, 3% N2, 2% N3. Ninety-one percent of patients were male and 9% were female. Results. The local control at 5 years is 97, 72 and 51%, respectively, for T1, T2, T3. The specific survival (without the patients dead of intercurrent disease or second cancer) was 88, 47 and 36%, and the overall survival at 5 years was 71, 42 and 35%. Of note, approximately one third of patients died of intercurrent disease or second cancers (70 patients = 34%). Significant factors that can influence the results are: for local control, the size of the lesion T1/T2/T3 (p < 0.0001); for the locoregional control, the absence of node involvement. The following factors are not significant: age and sex (age significant for survival). The significant treatment factors are the safety margin (p < 0.0003), brachytherapy only on T for T2N0 (p = 0.01). A total duration of treatment of less than 50 days is also significant. The spacing and the total dose (higher dose for large tumors) were not found to be significant. The complications were classified into four grades: grade 1,17% (median healing, 2 months for soft tissue complications and 5 months for bone complications); grade 2, 12%; grade 3, 6% (frequently requiring surgical resection); grade 4, 0.5% (death, one case). In this series, for the complications, the dose rate, the spacing and the total dose were found not to be significant. Conclusion. Carcinomas of the floor of mouth treated by exclusive irradiation have a rather good prognosis and the number of grade 2 and 3 complications remains acceptable. Exclusive brachytherapy is preferable to the combination of EBI plus brachytherapy for T1T2N0.

Epidermoid carcinomas of the floor of mouth treated by exclusive irradiation: statistical study of a series of 207 cases

Purpose. Our aim was to study the results and the complications of this series of 207 patients treated from 1976 to 1992 and to compare them with the results of the literature. Material and methods. The treatment consisted of a combination of external beam irradiation (EBI) (to the tumor and the node areas) and complementary brachytherapy to the primary tumor in 105 cases. In 102 cases, brachytherapy only was delivered to the tumor with or without neck dissection of the node areas. The brachytherapy was performed mostly with the hairpin technique in the beginning (in 61 cases) and subsequently the plastic tube technique with indium wires. The dosimetry followed the Paris system rules. There were 41% T1, 48% T2, 8% T3, 2% T4 and 1% Tx with 83% N0, 12% N1, 3% N2, 2% N3. Ninety-one percent of patients were male and 9% were female. Results. The local control at 5 years is 97, 72 and 51%, respectively, for T1, T2, T3. The specific survival (without the patients dead of intercurrent disease or second cancer) was 88, 47 and 36%, and the overall survival at 5 years was 71, 42 and 35%. Of note, approximately one third of patients died of intercurrent disease or second cancers (70 patients = 34%). Significant factors that can influence the results are: for local control, the size of the lesion T1/T2/T3 ( p < 0.0001); for the locoregional control, the absence of node involvement. The following factors are not significant: age and sex (age significant for survival). The significant treatment factors are the safety margin ( p < 0.0003), brachytherapy only on T for T2N0 ( p = 0.01). A total duration of treatment of less than 50 days is also significant. The spacing and the total dose (higher dose for large tumors) were not found to be significant. The complications were classified into four grades: grade 1,17% (median healing, 2 months for soft tissue complications and 5 months for bone complications); grade 2, 12%; grade 3, 6% (frequently requiring surgical resection); grade 4, 0.5% (death, one case). In this series, for the complications, the dose rate, the spacing and the total dose were found not to be significant. Conclusion. Carcinomas of the floor of mouth treated by exclusive irradiation have a rather good prognosis and the number of grade 2 and 3 complications remains acceptable. Exclusive brachytherapy is preferable to the combination of EBI plus brachytherapy for T1T2N0.

Deep bite treatment in relation to mandibular growth rotation

This paper illustrates some of the changes which occur during the treatment of Class II division 1 malocclusions complicated by a deep bite, and reviews the significance of these changes in relation to concepts of deep bite treatment. Particular reference is made to mandibular growth rotation and consequent differential tooth eruption in assessing factors involved in initial bite opening and consolidation of the opened bite. The cases shown illustrate that although an initial bite opening may occur by incisor intrusion and molar eruption, when viewed over a longer period of time rotational mandibular growth and associated differential eruption of teeth in which molars erupt more than incisors may be a more significant factor. Differential eruption which takes place in response to vertical condylar growth under guidance of the appliance would appear to be a significant factor in treatment of deep bite.

Significant treatment factors in short-term group psychotherapy

The author briefly describes an approach to short-term group psychotherapy based upon an adult developmental model. By means of a clinical case example significant treatment factors are examined. Such an approach to planned short-term group therapy may force group members to confront and deal with important existential issues.