Methods: One hundred patients were randomized to receive either radiation therapy alone (Arm A) (at a dose of between 66-72 grays [Gy] at 1.8-2 Gy per day) and the identical radiation therapy with concurrent chemotherapy (Arm B) (5-fluorouracil, 1000 mg/m(2)/day, and cisplatin, 20 mg/m(2)/day, both given as continuous intravenous infusions over 4 days beginning on Days 1 and 22 of the radiation therapy). Primary site resection was planned for patients with residual or recurrent local disease. Cervical lymph node dissection was performed for regional persistent disease or recurrence, or if N2-3 disease was present at the time of presentation.
Background and purpose: A randomised phase-III trial compared external beam radiotherapy (EBRT) alone with EBRT combined with high-dose-rate brachytherapy boost (HDR-BTb) in localised prostate adenocarcinoma. Previous analysis, at median follow up of 85 months, demonstrated improved relapse free survival (RFS) with EBRT + HDR-BTb. This data has now been updated with a median follow up of 131 months.
Results: One hundred and six patients received EBRT alone and 110 EBRT + HDR-BTb. Median time to relapse was 137 months in the HDR-BTb arm compared to 82 months for EBRT alone (p = 001). A 27% risk of recurrence with EBRT alone was observed (p = 0001), resulting in a 21% improvement in RFS at 12 years with EBRT + HDR-BTb. In multivariate analysis treatment arm, risk category and no androgen deprivation therapy were significant covariates for risk of relapse. Differences in overall survival were not significant.
While child experts typically agree that 11 or 12 years old is an appropriate age to stay home alone for a few hours, there are a number of factors to consider. It is important to recognize that the right time will vary by family, so trust your instincts. With some advance planning and preparation, this milestone can be a great way to build your child's independence and confidence.
Knowing the right time is different for each family. Take into account the maturity of your child, where you live, your nearby support network, and how far away you will be. Some states do have laws about when you can leave a child home alone, with minimum ages ranging from 8 to 14 years old. These laws typically include language about "unreasonable amounts of time," so check the details for your local regulations before setting a plan.
Do you think your child is old and mature enough to take care of themselves? Keep in mind that each child's maturity and parents' comfort level may be different. Most children will not be mature enough to manage being alone on a regular basis until they are about 10 or 11 years old. However, some parents may be OK leaving a more mature 8- or 9-year-old home alone for a half hour or so once in a while.
Would your child be able to remember and follow important safety rules? For example, can they tell you how they would respond to a fire, gas leak or other emergency? Can they follow other rules such as not opening the door, not telling telephone callers that they are alone, and not posting on social media that they are alone?
Your child should contact you to check in when they first get home. It does not have to be a lengthy discussion, but a quick phone call or text creates a routine and gives you a chance to gauge how the day is going. If you or your child is anxious about the time alone, consider a video call or texting a few silly photos to provide peace of mind to both of you.
Provide options for what your child can and cannot do when they're home alone, including how they use media. Having a set list of daily chores and tasks can help keep them busy. Also, there are a number of tools parents can set up to set reasonable limits on various games and apps and even household Wi-Fi usage. Consider creating a family media use plan.
During your initial outings, set your child up for success by keeping the timeframe short or picking a time of day without more complex responsibilities, such as cooking. As both you and your child become more comfortable, you can extend the time your child is home alone.
Spotted white-tailed deer fawns offer one of the most appealing sights in nature. Fawns typically appear walking closely to their protective mother or bounding across a field with seemingly unlimited energy. However, in May and June many fawns are found curled up in the field or forest alone, with no vigilant doe in sight. Is this an orphaned fawn? Almost certainly never!
When deciding whether to put money into a certificate of deposit (CD), consider what happens after the CD matures. Certificates of deposit are time deposits that come in specific terms, such as six months or five years. You get a guaranteed, fixed interest rate so long as you hold the CD and leave the money untouched.
As the owner of a CD, you are responsible for knowing its maturity date. Mark it on your calendar, set reminders, or do whatever you need to remember this date so you can adjust your plans accordingly. Check with your bank or credit union if you have questions about the maturity date of your CD. The institution will send you a notice before your CD matures.
If you like the safety and stability of this savings vehicle and are satisfied with the APYs, another option after your CD matures is to put more money into CDs by building a CD ladder. This allows you to capitalize on interest rate changes, avoid early withdrawal penalties and save for different financial goals.
If you have a CD approaching its maturity date, start planning now for what you want to do next with that money. If you wish, you can leave the money alone and let the CD renew automatically for the same term at the current APY. But this can be risky since you could get stuck with a lower APY or a longer term than you would like. Make sure you understand your options and make the right choice for your overall savings plan.
In MODY 2 (GCK), patients tend to have elevated fasting blood glucose but do not usually develop postprandial hyperglycemia as they have sufficient insulin secretion in response to elevated glucose. These patients generally need lifestyle and dietary modification alone.
For MODY 3 (HNF1A) and MODY 1 (HNF4A), patients can generally be managed with dietary changes alone in the beginning. These patients do experience postprandial hyperglycemia after carbohydrate-rich food. Progressively over time, they may get deterioration of their beta cells and may require treatment. These patients tend to respond well to sulfonylureas. An alternative treatment option is a glucagon-like peptide 1 agonist (GLP-1RA). A randomized control trial that compared GLP1RA to glimepiride in the treatment of MODY 3 patients found that these drugs were comparable in lowering blood glucose (although glimepiride had a slightly greater glucose-lowering effect but in conjunction with an increased risk of hypoglycemia).
Results presented indicate that 10 mM nicotinamide, when added at the initial stages of differentiation, promoted accelerated progression of ESCs to a neural lineage in adherent monolayer cultures. By 14 days in vitro (DIV), early exposure to nicotinamide was shown to increase the numbers of differentiated βIII-tubulin-positive neurons. Nicotinamide decreased the proportion of pluripotent stem cells, concomitantly increasing numbers of neural progenitors at 4 DIV. These progenitors then underwent rapid conversion to neurons, observed by a reduction in Sox 1 expression and decreased numbers of neural progenitors in the cultures at 14 DIV. Furthermore, GABAergic neurons generated in the presence of nicotinamide showed increased maturity and complexity of neurites at 14 DIV. Therefore, addition of nicotinamide alone caused an accelerated passage of pluripotent cells through lineage specification and further to non-dividing mature neurons.
Interpretive Summary: The Caribbean fruit fly, or caribfly, is a quarantine pest of citrus in Florida, and impacts the production and marketability of guava and other tropical fruit crops. Current ammonia-based lures vary considerably in their ability to capture caribflies in the field. Scientists at the Subtropical Horticulture Research Station, Miami, FL, initiated research to identify factors responsible for the variability. They used electroantennography (EAG) and flight tunnel bioassays to examine the effect of age on female attraction to ammonia and carbon dioxide, released from a commercial ammonium bicarbonate lure. EAG response to ammonia was greater in sexually immature flies, and response to carbon dioxide was greater in mature flies. In flight tunnel tests, both age groups were attracted to ammonia, but immature fly captures declined with increasing ammonia concentration, suggesting it may become repellent at high doses. Carbon dioxide alone was not sufficient to attract flies, but carbon dioxide combined with ammonia was more attractive than ammonia alone, but only for the mature flies. These age-related differences in response to ammonia and carbon dioxide may account for some of the variability observed with commercial lures, and facilitate the development of improved lures for tropical fruit flies.
Technical Abstract: Current ammonia-based lures vary considerably in their ability to attract Anastrepha fruit flies in the field. This report presents electroantennography (EAG) and bioassay results which examine the effect of age on fly response to ammonia and carbon dioxide, two volatiles released from commercial ammonium bicarbonate lures. EAG measurements from female Caribbean fruit flies, A. suspensa (Loew), showed that ammonia generated a significantly larger EAG response in sexually immature flies than in mature flies. Conversely, carbon dioxide elicited stronger EAG responses in mature females. In flight tunnel bioassays, both age groups responded positively to ammonia in doses ranging from 3-192 g/h, but response of immature flies declined with increasing ammonia concentration, suggesting repellency at high doses. This resulted in a uniform distribution of mature captures over the dose range tested, but a large percent capture of immature flies in the lower doses. Carbon dioxide, ranging from 5-120 g/h, did not capture any flies when presented alone. However, carbon dioxide in combination with ammonia was more attractive than ammonia alone, but only for sexually mature flies. These age-related differences in response to ammonia and carbon dioxide may account for some of the variability observed in field tests. 041b061a72