Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review

Background: Ototoxicity is a known side effect of combined radiation therapy and cisplatin chemotherapy for the treatment of medulloblastoma. the delivery of an involved field boost by intensity modulated radiation therapy (IMRT) may reduce the dose to the inner ear when compared with conventional radiotherapy. the dose of cisplatin may also affect the risk of ototoxicity. A retrospective study was performed to evaluate the impact of involved field boost using IMRT and cisplatin dose on the rate of ototoxicity.Methods: Data from 41 medulloblastoma patients treated with IMRT were collected. Overall and disease-free survival rates were calculated by Kaplan-Meier method Hearing function was graded according to toxicity criteria of Pediatric Oncology Group (POG). Doses to inner ear and total cisplatin dose were correlated with hearing function by univariate and multivariate data analysis.Results: After a mean follow-up of 44 months (range: 14 to 72 months), 37 patients remained alive, with two recurrences, both in spine with CSF involvement, resulting in a disease free-survival and overall survival of 85.2% and 90.2%, respectively. Seven patients (17%) experienced POG Grade 3 or 4 toxicity. Cisplatin dose was a significant factor for hearing loss in univariate analysis (p < 0.03). in multivariate analysis, median dose to inner ear was significantly associated with hearing loss (p < 0.01). POG grade 3 and 4 toxicity were uncommon with median doses to the inner ear bellow 42 Gy (p < 0.05) and total cisplatin dose of less than 375 mg/m(2) (p < 0.01).Conclusions: IMRT leads to a low rate of severe ototoxicity. Median radiation dose to auditory apparatus should be kept below 42 Gy. Cisplatin doses should not exceed 375 mg/m(2).

Animated virtual agents to cue user attention: comparison of static and dynamic deictic cues on gaze and touch responses

This paper describes an experiment developed to study the performance of virtual agent animated cues within digital interfaces. Increasingly, agents are used in virtual environments as part of the branding process and to guide user interaction. However, the level of agent detail required to establish and enhance efficient allocation of attention remains unclear. Although complex agent motion is now possible, it is costly to implement and so should only be routinely implemented if a clear benefit can be shown. Pevious methods of assessing the effect of gaze-cueing as a solution to scene complexity have relied principally on two-dimensional static scenes and manual peripheral inputs. Two experiments were run to address the question of agent cues on human-computer interfaces. Both experiments measured the efficiency of agent cues analyzing participant responses either by gaze or by touch respectively. In the first experiment, an eye-movement recorder was used to directly assess the immediate overt allocation of attention by capturing the participant’s eyefixations following presentation of a cueing stimulus. We found that a fully animated agent could speed up user interaction with the interface. When user attention was directed using a fully animated agent cue, users responded 35% faster when compared with stepped 2-image agent cues, and 42% faster when compared with a static 1-image cue. The second experiment recorded participant responses on a touch screen using same agent cues. Analysis of touch inputs confirmed the results of gaze-experiment, where fully animated agent made shortest time response with a slight decrease on the time difference comparisons. Responses to fully animated agent were 17% and 20% faster when compared with 2-image and 1-image cue severally. These results inform techniques aimed at engaging users’ attention in complex scenes such as computer games and digital transactions within public or social interaction contexts by demonstrating the benefits of dynamic gaze and head cueing directly on the users’ eye movements and touch responses.

Bacteremic pneumonia before and after withdrawal of 13-valent pneumococcal conjugate vaccine from a public vaccination program in Spain: a case-control study

The objective of this study is to compare the incidence and epidemiology of bacteremic community-acquired pneumonia (CAP) in the setting of changes in 13-valent pneumococcal conjugate vaccine (PCV13) coverage. In the region of Madrid, universal immunization with the PCV13 started in May 2010. In July 2012, public funding ceased. Vaccination coverage decreased from >95% to 82% in 2013 and to 67% in 2014. We performed a multicenter surveillance and case-control study from 2009-2014. Cases were hospitalized children with bacteremic CAP. Controls were children selected 1:1 from next-admitted with negative blood cultures and typical, presumed bacterial CAP. Annual incidence of bacteremic CAP declined from 7.9/100 000 children (95% CI 5.1-11.1) in 2009 to 2.1/100 000 children (95% CI 1.1-4.1) in 2012. In 2014, 2 years after PCV13 was withdrawn from the universal vaccination program, the incidence of bacteremic CAP increased to 5.4/100 000 children (95% CI 3.5-8.4). We enrolled 113 cases and 113 controls. Streptococcus pneumoniae caused most of bloodstream infections (78%). Empyema was associated with bacteremia (P = .003, OR 3.6; 95% CI 1.4-8.9). Simple parapneumonic effusion was not associated with bacteremia. Incomplete PCV immunization was not a risk factor for bacteremic pneumonia.

An assessment of the ability of the stay-green phenotype in Lolium species to provide an improved protein supply for ruminants

Kingston-Smith, A. H., Bollard, A. L., Humphreys, M. O,, Theodorou, M. K. (2002). An assessment of the ability of the stay-green phenotype in Lolium species to provide an improved protein supply for ruminants. Annals of Botany, 89(6), 731-740. Sponsorship: BBSRC/MAFF/Milk Development Council/Meat and Livestock Commission/Industry. RAE2008

Sedentariness and physical inactivity in diabetes: a case for home-based exercise prescription

Increasing proportions of the global population are being diagnosed with diabetes. It is anticipated that by 2030, 10% of the adult population worldwide will be living with this condition. Lifestyle factors can impact on the development, management and progression of diabetes. Obesity and sedentary living are contributory factors to the increased volume of diabetes. Physical activity offers those living with diabetes the opportunities to keep well and attain potentially more stable blood glucose control reducing the level of medical intervention required and delaying or preventing some of the life-changing complications that can derive from a diabetes diagnosis. Exercise interventions are effective in preventing and treating type-II diabetes. However, maintaining regular exercise routines, especially home-based exercises may provide a key for sustaining the health benefits.

Determinismo o libertad. Consumo y NTICs en la escuela del siglo XXI

Entre las peculiaridades en nuestra sociedad occidental actual figura la presencia invasiva de la nueva cultura mediática del consumo y los cambios que esta ha provocado en el entorno de cada sujeto. En la medida en que niños y adolescentes pasan menos tiempo con su familia y se exponen más a los medios, éstos adquieren mayor protagonismo en la construcción de su universo cultural convirtiéndose en una fuente de heteronomía y perjudicando a las instituciones educativas. Afortunada o desafortunadamente, este fenómeno evoluciona de forma inmediata y cualquier estudio queda obsoleto en un periodo de tiempo muy reducido. Sin embargo, es necesario realizar trabajos que permitan conocer la sociedad del momento, sus transformaciones y sus nuevas formas de vida. Para ello y con el objetivo de encontrar alternativas que impidan la disociación del proceso de socialización, se ha realizado una pequeña investigación teórica sobre los diferentes agentes socializadores y su cambio de rol así como un estudio de caso en busca de evidencias empíricas que han permitido extraer conclusiones al respecto.

Human papillomavirus detection in women with and without human immunodeficiency virus infection in Colombia

Background: HIV infection leads to a decreasing immune response, thereby facilitating the appearance of other infections, one of the most important ones being HPV. However, studies are needed for determining associations between immunodeficiency caused by HIV and/or the presence of HPV during the course of cervical lesions and their degree of malignancy. This study describes the cytological findings revealed by the Papanicolaou test, laboratory characteristics and HPV molecular profile in women with and without HIV infection. Methods: A total of 216 HIV-positive and 1,159 HIV-negative women were invited to participate in the study; PCR was used for the molecular detection of HPV in cervical samples. Statistical analysis (such as percentages, Chi-square test and Fisher's exact test when applicable) determined human papillomavirus (HPV) infection frequency (single and multiple) and the distribution of six types of high-risk-HPV in women with and without HIV infection. Likewise, a logistic regression model was run to evaluate the relationship between HIV-HPV infection and different risk factors. Results: An association was found between the frequency of HPV infection and infection involving 2 or more HPV types (also known as multiple HPV infection) in HIV-positive women (69.0% and 54.2%, respectively); such frequency was greater than that found in HIV-negative women (44.3% and 22.7%, respectively). Statistically significant differences were observed between both groups (p = 0.001) regarding HPV presence (both in infection and multiple HPV infection). HPV-16 was the most prevalent type in the population being studied (p = 0.001); other viral types had variable distribution in both groups (HIV-positive and HIV-negative). HPV detection was associated with <500 cell/mm(3) CD4-count (p = 0.004) and higher HIV-viral-load (p = 0.001). HPV-DNA detection, <200 cell/mm(3) CD4-count (p = 0.001), and higher HIV-viral-load (p = 0.001) were associated with abnormal cytological findings. Conclusions: The HIV-1 positive population in this study had high multiple HPV infection prevalence. The results for this population group also suggested a greater association between HPV-DNA presence and cytological findings. HPV detection, together with low CD4 count, could represent useful tools for identifying HIV-positive women at risk of developing cervical lesions.

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Exgerentes de Artesanías de Colombia.

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