Think A Move (United States)

Currently, there are multiple breast dosimetry estimation methods for mammography and its variants in use throughout the world. This fact alone introduces uncertainty, since it is often impossible to distinguish which model is internally used by a specific imaging system. In addition, all current models are hampered by various limitations, in terms of overly simplified models of the breast and its composition, as well as simplistic models of the imaging system. Many of these simplifications were necessary, for the most part, due to the need to limit the computational cost of obtaining the required dose conversion coefficients decades ago, when these models were first implemented. With the advancements in computational power, and to address most of the known limitations of previous breast dosimetry methods, a new breast dosimetry method, based on new breast models, has been developed, implemented, and tested. This model, developed jointly by the American Association of Physicists in Medicine and the European Federation for Organizations of Medical Physics, is applicable to standard mammography, digital breast tomosynthesis, and their contrast-enhanced variants. In addition, it includes models of the breast in both the cranio-caudal and the medio-lateral oblique views. Special emphasis was placed on the breast and system models used being based on evidence, either by analysis of large sets of patient data or by performing measurements on imaging devices from a range of manufacturers. Due to the vast number of dose conversion coefficients resulting from the developed model, and the relative complexity of the calculations needed to apply it, a software program has been made available for download or online use, free of charge, to apply the developed breast dosimetry method. The program is available for download or it can be used directly online. A separate User's Guide is provided with the software.

Larotrectinib, a first-in-class, highly selective tropomyosin receptor kinase (TRK) inhibitor, has demonstrated efficacy in adult and pediatric patients with various solid tumors harboring NTRK gene fusions. This subset analysis focuses on the efficacy and safety of larotrectinib in an expanded cohort of adult patients with TRK fusion sarcomas. Patients (≥18years old) with sarcomas harboring NTRK gene fusions were identified from three clinical trials. Patients received larotrectinib 100mg orally twice daily. Response was investigator-assessed per RECIST v1.1. Data cutoff was July 20, 2021. At the data cutoff, 36 adult patients with TRK fusion sarcomas had initiated larotrectinib therapy: two (6%) patients had bone sarcomas, four (11%) had gastrointestinal stromal tumors, and 30 (83%) had soft tissue sarcomas. All patients were evaluable for response and demonstrated an objective response rate of 58% (95% confidence interval, 41-74). Patients responded well to larotrectinib regardless of number of prior lines of therapy. Adverse events (AEs) were mostly grade 1/2. Grade 3 treatment-emergent AEs (TEAEs) occurred in 15 (42%) patients. There were no grade 4 TEAEs. Two grade 5 TEAEs were reported, neither of which were considered related to larotrectinib. Four (11%) patients permanently discontinued treatment due to TEAEs. Larotrectinib demonstrated robust and durable responses, extended survival benefit, and a favorable safety profile in adult patients with TRK fusion sarcomas with longer follow-up. These results continue to demonstrate that testing for NTRK gene fusions should be incorporated into the clinical management of adult patients with various types of sarcomas. Tropomyosin receptor kinase (TRK) fusion proteins result from translocations involving the NTRK gene and cause cancer in a range of tumor types. Larotrectinib is an agent that specifically targets TRK fusion proteins and is approved for the treatment of patients with TRK fusion cancer. This study looked at how well larotrectinib worked in adult patients with sarcomas caused by TRK fusion proteins. Over half of patients had a durable response to larotrectinib, with no unexpected side effects. These results show that larotrectinib is safe and effective in adult patients with TRK fusion sarcomas.

Model species (e.g., granivorous gamebirds, waterfowl, passerines, domesticated rodents) have been used for decades in guideline laboratory tests to generate survival, growth, and reproductive data for prospective ecological risk assessments (ERAs) for birds and mammals, while officially adopted risk assessment schemes for amphibians and reptiles do not exist. There are recognized shortcomings of current in vivo methods as well as uncertainty around the extent to which species with different life histories (e.g., terrestrial amphibians, reptiles, bats) than these commonly used models are protected by existing ERA frameworks. Approaches other than validating additional animal models for testing are being developed, but the incorporation of such new approach methodologies (NAMs) into risk assessment frameworks will require robust validations against in vivo responses. This takes time, and the ability to extrapolate findings from nonanimal studies to organism- and population-level effects in terrestrial wildlife remains weak. Failure to adequately anticipate and predict hazards could have economic and potentially even legal consequences for regulators and product registrants. In order to be able to use fewer animals or replace them altogether in the long term, vertebrate use and whole organism data will be needed to provide data for NAMvalidation in the short term. Therefore, it is worth investing resources for potential updates to existing standard test guidelines used in the laboratory as well as addressing the need for clear guidance on the conduct of field studies. Herein, we review the potential for improving standard in vivo test methods and for advancing the use of field studies in wildlife risk assessment, as these tools will be needed inthe foreseeable future. Integr Environ Assess Manag 2024;20:699-724. © 2023 His Majesty the King in Right of Canada and The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC). Reproduced with the permission of the Minister of Environment and Climate Change Canada. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.

Use of three topical antiseptic compounds—benzalkonium chloride (BAC), benzethonium chloride (BZT), and chloroxylenol (PCMX)—has recently increased because of the phaseout of other antimicrobial ingredients (such as triclosan) in soaps and other disinfecting and sanitizing products. Further, use of sanitizing products in general increased during the coronavirus (COVID‐19) pandemic. We assessed the environmental safety of BAC, BZT, and PCMX based on best available environmental fate and effects data from the scientific literature and privately held sources. The ecological exposure assessment focused on aquatic systems receiving effluent from wastewater‐treatment plants (WWTPs) and terrestrial systems receiving land‐applied WWTP biosolids. Recent exposure levels were characterized based on environmental monitoring data supplemented by modeling, while future exposures were modeled based on a hypothetical triclosan replacement scenario. Hazard profiles were developed based on acute and chronic studies examining toxicity to aquatic life (fish, invertebrates, algae, vascular plants) and terrestrial endpoints (plants, soil invertebrates, and microbial functions related to soil fertility). Risks to higher trophic levels were not assessed because these compounds are not appreciably bioaccumulative. The risk analysis indicated that neither BZT nor PCMX in any exposure media is likely to cause adverse ecological effects under the exposure scenarios assessed in the present study. Under these scenarios, total BAC exposures are at least three times less than estimated effect thresholds, while margins of safety for freely dissolved BAC are estimated to be greater than an order of magnitude. Because the modeling did not specifically account for COVID‐19 pandemic–related usage, further environmental monitoring is anticipated to understand potential changes in environmental exposures as a result of increased antiseptic use. The analysis presented provides a framework to interpret future antiseptic monitoring results, including monitoring parameters and modeling approaches to address bioavailability of the chemicals of interest. Environ Toxicol Chem 2022;41:3095–3115. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Abstract Climate change is projected to have profound impacts on the resilience and sustainability of built infrastructure. This study aims to understand the impacts of climate change on water supply systems and to facilitate adaptive actions. A premium database maintained by the Cleveland Water Division, Cleveland, Ohio, USA is analyzed. It contains 29,621 pipe failure records of 51,832 pipes over the past 30 years, representing one of the largest dataset in current literature. From the database, pipe failure rate models have been developed for water pipes made of different types of materials at different ages. The influence of climate (temperature and precipitation) on fragility of water pipes are obtained. Based on the developed climate-fragility failure rate models, the impacts of climate change on the water systems located in different geographic regions are evaluated by predicting the failure rate and number of failures in the water systems in the next 80 years (2020 to 2100). Climate models are used to predict weather under different climate change scenerios. The results demonstrate that the impacts of climate change on water supply system are likely complicated and are dependent upon factors such as the geographic location, pipe material, pipe age, and maintenance strategies. Water pipes in the cold regions may experience less number breaks due to the warmer weather and less servere winter, whereas those located in the hot regions may experience more failures associated with more corrosion. Different pipe replacement strategies are compared, which demonstrate the importance of considering the aging of water supply system in future maintenance decisions. This study enriches current understandings on the impacts of climate change on the water systems. The results will help water utilities to design climate change adaptation strategies.

ABSTRACTAmong 1282 patients with a positive Clostridioides difficile PCR test who were retested within 14 days, the proportion of positive tests rapidly decreased on successive days within the first week since initiation of treatment. Between days 7 and 14 after treatment initiation, approximately 25% of tests remained positive.

The aim of this in vitro study was to assess the effect of two different adhesive application methods on shear dentin bond strength (ISO 29022) using three various adhesive systems. A mid-coronal section of 77 intact third human molars with fully developed apices was made to create flat bonding substrates. The materials used in the study were Excite F (Ivoclar Vivadent), Prime&Bond Universal (Dentsply Sirona) and G-Premio Bond (GC). The application of each adhesion system was performed in two different ways. In the first group, the bonding agent was light cured immediately after the application (conventional method), while in the second group the adhesive and composite were cured concurrently (“co-curing” method). A total of 180 specimens were prepared (3 adhesives × 2 method of application × 30 specimens per experimental group), stored at 37 °C in distilled water and fractured in shear mode after 1 week. Statistical analysis was performed using ANOVA and Weibull statistics. The highest bond strength was obtained for Prime&Bond conventional (21.7 MPa), whilst the lowest bond strength was observed when co-curing was used (particularly, Excite F 12.2 MPa). The results showed a significant difference between conventional and co-curing methods in all materials. According to reliability analysis, the co-curing method diminished bond reliability. Different application techniques exhibit different bond strengths to dentin.

Introduction: Parkinson’s disease (PD) is poorly quantified by patients outside the clinic, and paper diaries have problems with subjective descriptions and bias. Wearable sensor platforms; however, can accurately quantify symptoms such as tremor, dyskinesia, and bradykinesia. Commercially available smartwatches are equipped with accelerometers and gyroscopes that can measure motion for objective evaluation. We sought to evaluate the clinical utility of a prescription smartwatch-based monitoring system for PD utilizing periodic task-based motor assessment. Methods: Sixteen patients with PD used a smartphone- and smartwatch-based monitoring system to objectively assess motor symptoms for 1 week prior to instituting a doctor recommended change in therapy and for 4 weeks after the change. After 5 weeks the participants returned to the clinic to discuss their results with their doctor, who made therapy recommendations based on the reports and his clinical judgment. Symptom scores were synchronized with the medication diary and the temporal effects of therapy on weekly and hourly timescales were calculated. Results: Thirteen participants successfully completed the study and averaged 4.9 assessments per day for 3 days per week during the study. The doctor instructed 8 participants to continue their new regimens and 5 to revert to their previous regimens. The smartwatch-based assessments successfully captured intraday fluctuations and short- and long-term responses to therapies, including detecting significant improvements (p < 0.05) in at least one symptom in 7 participants. Conclusions: The smartwatch-based app successfully captured temporal trends in symptom scores following application of new therapy on hourly, daily, and weekly timescales. These results suggest that validated smartwatch-based PD monitoring can provide clinically relevant information and may reduce the need for traditional office visits for therapy adjustment.

The Tobacco Control Scorecard, published in 2004, presented estimates of the effectiveness of different policies on smoking rates. Since its publication, new evidence has emerged. We update the Scorecard to include recent studies of demand-reducing tobacco policies for high-income countries. We include cigarette taxes, smoke-free air laws, media campaigns, comprehensive tobacco control programs, marketing bans, health warnings, and cessation treatment policies. To update the 2004 Scorecard, a narrative review was conducted on reviews and studies published after 2000, with additional focus on three policies where previous evidence was limited: tobacco control programs, graphic health warnings, and marketing bans. We consider evaluation studies that measured the effects of policies on smoking behaviors. Based on these findings, we derive estimates of short-term and long-term policy effect sizes. Cigarette taxes, smoke-free air laws, marketing restrictions, and comprehensive tobacco control programs are each found to play important roles in reducing smoking prevalence. Cessation treatment policies and graphic health warnings also reduce smoking, and when combined with policies that increase quit attempts, can improve quit success. The effect sizes are broadly consistent with those previously reported for the 2004 Scorecard, but now reflect the larger evidence-base evaluating the impact of health warnings and advertising restrictions.

1. Robert S. Haber, MD, FISHRS 1. Beachwood, Ohio, USA 2. Bobby L. Limmer, MD, FISHRS 1. Llano, Texas, USA 3. Robert H. True, MD, FISHRS 1. New York, New York, USA 4. Walter P. Unger, MD 1. Toronto, Ontario, Canada > It has been a delightful experience to reflect on the