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Rural older women offer insight for why nature is important when aging in place

In a new study, Penn State College of Nursing Project Director Erica Husser—a developmental gerontologist with a passion for nature and older women’s health—investigated the perceived influence of nature on the daily lives of rural older women living with multiple chronic health conditions.

According to Husser, we are hard-wired to pay attention to nature early in life, but as we develop, the ways in which people come to understand, value, and experience nature will vary. Considering how dramatically many lives have shifted and how uncertain the days continue to be in response to the coronavirus pandemic, Husser said the perceptions and experiences that rural older women have with nature can offer insights that may help others cope with, and adapt to changes that are out of our control.

Husser said that culture, demographic characteristics, family norms and behaviors, and personal experiences all shape who we are and how we experience nature with differential impacts, but the science is clear: nature can nurture. Research examining the influence of nature on behavioral and psychosocial characteristics has showed positive outcomes for factors like heart rate, blood pressure, attention, cognitive function, social interaction, neighborhood satisfaction, and quality of life.

“Traditionally, older women have had fewer seats at the table and their voices marginalized,” Husser said. “They seem to disappear from society and not many people pay attention to them. Institutionally, academia has mostly overlooked older women, so we don’t have much research on their views about the natural environment, and they have a set of values I think we could all learn from.”

Rural older women and the importance of nature

Research conducted through Penn State College of Nursing investigated the perceived influence of nature on the daily lives of rural older women living with multiple chronic health conditions.

Understanding those values and the potential impact nature could have on older women’s health and well-being, Husser sought to learn how rural older women related to their natural surroundings. She conducted in-depth face-to-face interviews with 34 women aged 71 to 91, living in rural southwest Virginia. What she discovered were intimate and important connections between nature and the women’s perceived well-being and quality of life, as they were experiencing aging in place.

“The women identified with nature, and they were immersed in it, daily,” Husser said. “They felt like it was part of who they were, and it provided them joy, helped them relax, engaged their mental and emotional processing, and for some, it strengthened their sense of community.”

Further elaborating on how the women identified with nature, Husser found that the women perceived nature to be the environment “right outside their door.” Most women described a spiritual connection with nature, viewing it as God’s creation. The study found that interacting with nature activated their faith in God, helping them reconcile and cope with health challenges, personal trauma, or natural disasters.

“At some point, people become less interested with materialistic and rationalistic ways of being and they transition toward a more cosmic perspective that involves less concern for self, and increased interest in reflecting, exploring, and engaging more cognitive energy toward intangible and often-times existential questions and ideas,” Husser said. “Nature seems to be one of the spaces that really allows for reflection, and potential growth and existential understanding to be experienced.”

Husser said that while nature served as a spiritual connector for a majority of the women, several others also described their experiences as emotionally and intellectually stimulating, which motivated continued engagement. They felt nature provided them with relaxation, energization, liberation, and an opportunity to learn more about nature, all of which contributed to enhanced cognitive engagement—an essential component of mental and emotional health.

As people struggle to cope with the developing coronavirus pandemic and its effects on their daily lives, Husser said these older women provide the perspective that time spent in nature can serve as an avenue for managing and adapting to feelings of loss, grief, isolation and confinement. Fear of contracting the virus, government mandated lockdowns, stay-at-home orders, and the transition to telecommunication emphasize the need to practice good self-care to help manage anxiety, stress, and concerns about liberty and independence. For these aging women, spending time in the natural environment enhanced their sense of freedom and provided a buffer against feelings of confinement.

“You just see things like rabbits and turkeys; the field will be full of turkeys,” said one 75-year-old woman. “I just like it, and it makes you feel like you are not closed in.”

These themes of enjoying nature, spiritual connections through nature, and emotional and intellectual health and well-being with respect to being immersed in nature do not translate across all groups, according to Husser, who added it’s important to understand that as we age, we become more diverse, and that diversification paves the way towards more meaningful research.

“We have to steer this popular fear of aging away from a horrible doom-and-gloom type of scenario toward something more realistic,” Husser said. “Aging can be about the beauty of your lifelong learning and the integration of your experiences coming to fruition to support yourself as your physical health, and the world around both change. Knowing what you need to feed your own spirit and to energize yourself is important.”

As research continues to untangle the relationship between the natural environment and improved mental, emotional, and cognitive health, individuals experiencing a loss of control or feelings of isolation due to the coronavirus pandemic may find comfort and support in learning about the life experiences and perspectives of these older women aging in rural America.

Husser directs Age Friendly Care, PA, a collaboration between the College of Nursing, CGNE, the College of Medicine, the Primary Health Network (PHN), Area Agencies on Aging, and the Alzheimer’s Association, and the Pennsylvania Department of Aging. The program aims to educate and implement the 4Ms of Age Friendly Care—what Matters, Medication, Mentation and Mobility—across health systems, community groups, families, and individuals throughout the commonwealth over the next five years.

Putting her research into the context of the 4Ms of Age-Friendly Care, Husser explains that spending time in nature informs what matters to these women. Knowing what matters empowers health care providers to individualize and align care that harnesses and supports the values of each patient. What matters anchors and informs the other care decision related to mobility, medications, and mentation.

“My colleagues in the College of Nursing and my supervisor provided me with flexibility, support, and the encouragement I needed to get this work published,” Husser said. “I can’t say enough about the power of mentorship and peer support; it has allowed this research to emerge.”

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Novel method proposed on multiparametric-MRI for rectal cancer diagnosis

Multiparametric magnetic resonance imaging (mpMRI) has been accepted as the preferred alternative for rectal cancer diagnosis. N-staging is necessary for all MR reports, for which accurate detection and segmentation of lymph nodes (LNs) are the prerequisites.

However, the bottleneck of current diagnosis methods is the low efficiency of LN identification under the background of multiple organs and multiple intervals. Besides, when the number of slices is more than 20, it will take 3-10 minutes for experienced radiologists to complete the LN detecting of a patient and the results will be affected by the detector’s subjective experience, environment, and may contribute to misdiagnosis.

An intelligent recognition method has been developed and firstly applied to achieve automatic LN detection and segmentation (auto-LNDS) of RC patients before surgery. This development was achieved by GAO Xin’s research team from the Suzhou Institute of Biomedical Engineering and Technology of th Chinese Academy of Sciences (SIBET, CAS), in collaboration with MENG Xiaochun from Sixth Affiliated Hospital of Sun Yat Sen University, and other three 3A hospitals spread across different regions in China.

Three hundred seventy-three RC patients were enrolled in this study. The annotations of three senior experts were used as the ground truths for model training. Fused T2-weighted images (T2WI) and diffusion-weighted images (DWI) provided input for the deep learning framework of Mask R-CNN through transfer learning to generate the auto-LNDS model.

The results show that the model has an excellent performance in detecting different scales LNs compared with other reported algorithms (Fig. 1). The size of the detected LNs is smaller (the short diameter is as small as 3mm), and the accuracy is higher, which is better than the reported algorithms and junior radiologists (Table 1).

In addition, it takes only 1.37 seconds to detect and segment all the LNs of a patient, which is 131 times faster than the doctor’s detection speed.

This model could help to minimize differences in LNs detection between radiologists, increase the efficiency of the clinical workflow, and also has the potential to assist physicians in determining the nodal stage. Besides, this method can be extended to the preoperative evaluation of N staging of tumors in various parts of the body based on multimodal images (PET, CT, MRI, etc.), which has a high clinical significance and play an important enlightenment role for automatic identification of LNs in the chest, abdomen and even the whole body.

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Discovery of new disease-susceptibility gene for steroid-sensitive nephrotic syndrome

An international research collaboration, including Professor Iijima Kazumoto et al. (of the Department of Pediatrics, Kobe University Graduate School of Medicine) has revealed that NPHS1 is a disease-susceptibility gene for steroid-sensitive nephrotic syndrome in children. The NPHS1 gene encodes nephrin, a component protein for the renal glomerulus slit diaphragm, which prevents protein from being passed in the urine. It is expected that these successful results will contribute towards understanding of the underlying mechanism and the development of new treatments for childhood nephrotic syndrome.

Childhood nephrotic syndrome is the most common chronic kidney disease affecting children; in Japan it occurs at a yearly rate of 6.49 children out of every 100,000 (approximately 1,000 cases countrywide). It is a disease with unclear causes in which excessive amounts of protein are passed in the urine, resulting in severely low levels of protein in the blood. In Japan, it has been classified as both a specific pediatric chronic disease and a designated intractable disease. Between 80-90% of childhood nephrotic syndrome cases are steroid-sensitive nephrotic syndrome, meaning that they can be sent into complete remission through steroid treatment. However, about 20% of patients experience repeated relapses even in adulthood. There is a strong demand to illuminate the disease’s causes and pathology, and utilize this knowledge to develop a definitive treatment method.

The majority of steroid-sensitive nephrotic syndrome cases are multifactorial. It is thought to occur due to a combination of some kind of genetic factor (disease-susceptibility gene) and an immunological trigger, such as an infection. Professor Iijima’s research up until now has revealed that HLA-DR/DQ is a disease-susceptibility gene, however susceptibility genes outside the HLA region have yet to be illuminated.

The research group has so far collected genomic DNA from around 1,300 patients with childhood nephrotic syndrome, with the cooperation of pediatric nephrology specialists across Japan. For this particular research, they used samples from 987 of the above cases that were childhood steroid-sensitive nephrotic syndrome with samples from 3,206 healthy Japanese donors as a control. GWAS was performed using the SNP array “Japonica,” which is the most appropriate for carrying out this genetic test on Japanese individuals. From these results, variants in the NPHS1-KIRREL2 region on chromosome 19 (19q13.12) with genome-wide significance were identified (Figures 1 and 2). These variants are outside the HLA-DR/DQ region.

Trans-ethnic replication studies into these multiple variants in the NPHS1-KIRREL2 region were conducted across various populations, including Korean, South Asian, African, European, Hispanic and Maghrebian (Northwest African). The investigation covered patients with steroid-sensitive nephrotic syndrome (1,063 people in total) and healthy counterparts of the same ethnicity (19,729 people in total). The results were replicated in the Korean, South Asian and African datasets. An international meta-analysis including the Japanese cohort also illuminated the significance of these multiple variants in NPHS1.

Subsequently, the relationship between these multiple variants in NPHS1 and NPHS1 mRNA expression in the glomerulus was investigated. The NPHS1 mRNA expression originating from chromosomes with haplotypes containing all the risk variants was low, revealing that these variants play a role in NPHS1 mRNA regulation.


NPHS1 is the gene responsible for encoding nephrin. Nephrin is the most important protein for the formation of the renal glomerulus slit diaphragm, which acts as a barrier against urinary proteins (Figure 3). It is widely known that NPHS1 is the gene that causes congenital nephrotic syndrome Finnish type, a rare Mendelian genetic disorder.

This research study revealed that NPHS1 is also a disease-susceptibility gene for steroid-sensitive nephrotic syndrome, the most commonly occurring multifactorial kidney disorder in children.

This research represents an important milestone in our understanding of the genetics behind steroid-sensitive nephrotic syndrome’s mechanism. It will also bring about a paradigm shift in the field of nephrology. These results will contribute towards the illumination of the pathology of childhood nephrotic syndrome. It is hoped that such knowledge could be applied to the development of new treatment methods.

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Testing tuberculosis vaccine combinations for COVID-19

Researchers at the University of Sydney and Centenary Institute are repurposing an existing tuberculosis vaccine to see if it can be used in a new way against COVID-19 to develop a novel vaccine.

The vaccine candidate, which Australian researchers have called BCG:CoVac, combines the vaccine for tuberculosis, Bacille Calmette-Guérin (BCG) with major components of the SARS-CoV-2 virus. The SARS-CoV-2 virus is the pathogen that causes the COVID-19 disease.

The study is part of a collaboration between the University of Sydney and the Centenary Institute to examine the immune response created by new vaccine candidates, including BCG:CoVac.

Lead investigator Professor Jamie Triccas, from the School of Medical Sciences, Faculty of Medicine and Health, and the Charles Perkins Center said the team was motivated to apply their expertise in studying vaccines to assess the effectiveness of this new formulation.

“We have over two decades of experience in the development and testing of tuberculosis vaccines, which will be applied for the assessment of BCG:CoVac,” said Professor Triccas.

“There have yet to be studies published that combine BCG and components of the SARS-CoV-2 virus as part of a new vaccine design, and we’re excited to test their potential.”

Early results promising

The researchers’ early unpublished results from pre-clinical testing in mice show BCG:CoVac stimulated an immune response aimed to control virus infection in humans.

In mice vaccinated with BCG:CoVac, the vaccine induced high levels of SARS-CoV-2-specific antibodies. The role of these antibodies is to bind the virus and help eliminate it from the body. The vaccine also triggered a strong anti-viral response by T cells (a type of immune cell).

Both these types of immune responses are thought to be important to ensure clearance of the SARS-CoV-2 virus from infected individuals.

Importantly, preliminary data also showed BCG:CoVac did not create high levels of inflammatory responses, which is a common barrier and concern in vaccine design.

“These initial results are very promising. BCG:CoVac is making the type of immune response that we predict is needed to control SARS-CoV-2 infection in humans,” said Professor Triccas.

“We are currently determining how well the antibodies generated after vaccination can ‘block’ the virus from infecting cells and thus provide protection from disease.”

Using the TB vaccine as a vehicle

In BCG:CoVac, the BCG vaccine is used as a vehicle to deliver distinctive proteins that originate from the SARS-CoV-2 virus surface. The goal is for the human immune system to develop a memory of SARS-CoV-2 and develop immunity.

There is currently global interest in the BCG vaccine, which is being investigated in ongoing clinical trials as a possible intervention to protect vulnerable people during the COVID-19 pandemic.

This is because of suggestions the BCG vaccine has other beneficial effects on the immune system that could protect against other infections. A 2019 observational study reported the vaccine is related to fewer deaths from certain infections other than from TB in low-income countries.

However, current COVID-19 related studies only investigate the protective effects of the BCG vaccine by itself.

Dr. Claudio Counoupas, research scientist at the Centenary Institute and co-lead on the project, said: “Combining a part of the SARS-CoV-2 virus with BCG is key to this new vaccine. This provides a specific ‘memory’ immune response against the virus that could provide long-term protection against disease. Our on-going studies will determine how long the immune response lasts after vaccination in animal models. This is important information for future human testing of our vaccine.”

Professor Triccas said animal studies were necessary to ensure the vaccine is inducing the right type of immune response.

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How Jessa Duggar Handles Mom-Shamers: I 'Don't Live for' Their Approval

Not giving in! Jessa Duggar will never let anyone’s negativity get to her when it comes to her parenting style.

Celeb Moms Clap Back at the Parenting Police

The 27-year-old Arkansas native welcomed three children with husband Ben Seewald after tying the knot in 2014: sons Spurgeon and Henry in 2015 and 2017, and daughter Ivy in 2019. While gearing up for Counting On‘s two-hour season 11 premiere on July 7, the couple dished to Us Weekly exclusively about how they handle harsh comments about their kids on social media.

“Whenever I look at people who are super, super negative or super hateful in their comments, a lot of times they’re not real people in the sense that, like, it’s an account that has zero posts, zero followers created specifically for hating,” Duggar explained on Wednesday, July 1. “We just have to remind ourselves, like, we don’t live for the approval of every single person out there. We love each other. We love our kids. We love God and we try to live our lives to please God. … You can’t please every single person out there.”

Seewald, 25, acknowledged that trolls hiding behind anonymous accounts “probably wouldn’t say” that sort of negative comment “to your face,” and while the pair of young parents might always face some criticism, they’re trying to lead with positivity instead.

The Duggars: A Comprehensive Guide to the Family

https://www.instagram.com/p/B-xnunspW8x/

My quaranteam. ❤️

A post shared byJessa Seewald (@jessaseewald) on

“I think you have to be careful not to just become jaded at people,” he told Us. “We don’t really know the experience of that person and what they’re going through. You know, maybe they’ve had a really rough day … I think it’s important to be understanding and just kind of take people where they’re at.”

Despite facing the parenting police on social media, the 19 Kids and Counting alum and her husband stay grounded in their faith to help them through their most challenging days. “It just gives us such security where we don’t have to … feel the pressure as much to try to find approval from other people,” Seewald added. “We were loved by God, you know? And that’s what matters the most. So, as long as we can remind ourselves of that, that gives us a lot of comfort and security.”

How Melissa Joan Hart, More Parents Are Homeschooling Kids Amid Coronavirus

Duggar and her extended family, who have been navigating new social distancing guidelines amid the coronavirus pandemic, will come together for a virtual reunion to kick off the 11th season of TLC’s Counting On, airing Tuesday, July 7 at 8 p.m. ET.

For access to all our exclusive celebrity videos and interviews – Subscribe on YouTube!

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Study finds drug beneficial for shrinking mesothelioma tumors

A drug that is designed to boost the immune system against mesothelioma, when combined with immunotherapy, was found to be beneficial in a small study involving ten patients. The results, which appeared July 1, 2020, in Science Translational Medicine, suggest that the drug LMB-100 could prolong the life of some patients with advanced disease.

Mesothelioma is a rare and hard to treat form of cancer and affects the cells that make up a thin membrane around organs, such as the lungs and heart. To treat this cancer, some drugs have been created that bind to a protein on the surface of these cells, called mesothelin. The hope is to train a patient’s immune system to identify the protein and thus to attack the cancerous cells.

Raffit Hassan, M.D., Chief of the Thoracic and GI Malignancies Branch, and his colleagues decided to study one of these mesothelin-targeting drugs, called LMB-100, which was developed by Ira Pastan, M.D., Co-Chief of the Laboratory of Molecular Biology. His team conducted a phase I trial to explore the safety of the drug, and ten of these patients subsequently received an immune checkpoint inhibitor, pembrolizumab or nivolumab, which helps boost the immune system’s ability to attack cancer cells.

“In some of the patients, receiving pembrolizumab after LMB-100 resulted in greater efficacy than what would be expected from pembrolizumab alone,” says Hassan.

“Four out of the 10 patients responded to the treatment including one complete response and three partial responses.”

Based on these positive results in humans, Qun Jiang, Ph.D., a staff scientist in Hassan’s lab, conducted further studies in mice who were implanted, or grafted, with human mesotheliomas. These experiments yielded similar results whereby tumor shrinkage was greater in mice who received both LMB-100 and pembrolizumab compared to mice who received just one of therapies.

Hassan cautions that since this involved a small number of patients, it is possible that the patients may have simply been responding to the immunotherapy agent pembrolizumab rather than the combination of drugs.

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Leading academics call for statutory levy on gambling firms to reduce harm

Leading UK academic scientists are urging the government to introduce a statutory levy on gambling firms to deliver reductions in gambling harms.

In an open letter to the culture minister, Oliver Dowden and the health secretary, Matt Hancock, published by The BMJ today, they warn that the current voluntary system gives the industry too much influence on how the money is spent.

Their call comes as the Betting and Gaming Council’s (BCG’s) five largest members announced they will give £100m to the charity GambleAware to improve treatment services for problem gamblers. This funding was first promised to the charity Action Against Gambling Harms in August 2019.

Last week, the Advisory Board for Safer Gambling called for a statutory levy in their first progress report on the National Strategy to Reduce Gambling Harms. The House of Lords will also publish its report Gambling Harm—Time for Action on Thursday.

The letter says irrespective of which organisation funds are given to, the BGC’s announcement “exemplifies the long-standing weakness of a funding system that allows the gambling industry to regulate the availability and distribution of vital funds to address gambling harms across our communities.”

The authors argue that reducing harms “requires a dual focus on treatment but also preventing harms from occurring in the first place.” Yet the BGC announcement “focuses on funding for treatment and says nothing about prevention.”

They also believe that funds for research into gambling harms and their reduction should be distributed through recognised independent organisations, such as UK Research and Innovation and the National Institute for Health Research.

“Delivering an effective strategy to reduce gambling harms requires surety and certainty of funding to enable effective planning and delivery of long term objectives,” they write. “A voluntary system, reliant on the good-will of the industry, is an inadequate way to develop such a system.”

Instead, a statutory levy “provides an opportunity to deliver harm reductions by ensuring a fair, independent and trusted system for developing effective prevention activities,” they explain. “Effective prevention in turn delivers societal benefits through reductions in the social costs associated with gambling harms and a levy creates an equitable system by which all members of the industry contribute to addressing the harms they generate,” they add.

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This Employer Now Bans Staff From Caring for Their Kids While WFH — Who's Next?

Nothing like a global pandemic to really bring out somebody’s true colors. And in the case of Florida State University, those true colors involve only caring about University workers for their labor — not as human beings with families and needs. Starting August, FSU will ban its remote workers from caring for their kids while WFH.

An email to staff stated that “in March 2020, the University communicated a temporary exception to policy which allowed employees to care for children at home while on the Temporary Remote Work agreement,” WCTV2 reports. “Effective Aug. 7, 2020, the University will return to normal policy and will no longer allow employees to care for children while working remotely.”

If you’re caught somewhere between a head-scratch, an LOL, and a good cry right about now — we’re right there with you.

One FSU employee, Dr. Jenny Root, took to Twitter to voice her rightful outrage. And plenty of fellow working parents responded with similar shock and disappointment — as well as the suggestion that the university’s new rule may actually be illegal.

The Lily interviewed Dr. Root, who added that the University’s recent staff rule “makes me feel like I’m failing at everything I do,” and that her employers are “acting like they gave us this privilege to watch our children while we worked — when that’s literally what I had to do.”

At this point, those of us with employers on the other side — you know, the ones that acknowledge that the COVID-19 pandemic is real and is ongoing, that we workers are humans without superpowers or trust funds — are counting our lucky stars. But we have to wonder: If the FSU ruling doesn’t turn out to be illegal, will it turn out to be the beginning of a very terrible trend? As the summer goes on, will more companies make their workers choose between their job security and putting their kids in the (very limited) costly and risky schools/daycares that are open right now?

That, or spend their life savings on a full-time nanny. That whole nanny-share concept just got way more appealing, come to think of it.

Maybe the FSU folks spent too much time looking at these stock photos of moms working from home.






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Does deep brain stimulation for Parkinson’s increase risk of dementia?

There’s good news for people with Parkinson’s disease. A new study shows that deep brain stimulation may not increase the risk of developing dementia. The study is published in the July 1, 2020, online issue of Neurology, the medical journal of the American Academy of Neurology.

For people with advanced Parkinson’s disease, deep brain stimulation has been shown to be more effective than medication in controlling their movement problems. But research has been mixed on whether the treatment can increase the risk of developing dementia.

For deep brain stimulation, electrodes are placed in certain areas of the brain to control abnormal movements. The electrodes are connected to a device placed under the skin in the upper chest. The device controls the electrical impulses.

“These results are very encouraging for people with Parkinson’s and their families that they can take advantage of the benefits of deep brain stimulation without worrying about it increasing the likelihood of developing dementia,” said study author Elena Moro, MD, of Grenoble Alpes University in Grenoble, France, and a Fellow of the American Academy of Neurology.

The study involved 175 people with Parkinson’s disease with an average age of 56 who had deep brain stimulation. They had Parkinson’s for an average of 12 years when they had the stimulator implanted. Researchers then checked the people after one year, five years and 10 years to see how many people had developed dementia.

After one year, four people had developed dementia, or 2.3%. After five years, 142 people were available for testing and 12 people had dementia, or 8.5%. At 10 years, 104 people were still available for testing and 31 people had dementia, or 29.8%. The overall incidence rate was 35.6 per 1,000 person-years.

“These rates are not higher than those reported in the general population of people with Parkinson’s,” said Moro. “The few studies that are available with similar disease duration have reported higher rates of dementia. Other studies of people with Parkinson’s who are taking medication for their symptoms show an incidence rate for dementia that varies from 50 to 100 per 1,000 person-years.”

Moro said the younger average age in her study may help explain the lower rate of dementia. Also, people with moderate to severe memory or thinking problems are not eligible to have deep brain stimulation, so the group may have been less likely overall to develop dementia than a general group of people with Parkinson’s disease.

The study also looked at factors that were associated with a higher risk of dementia. Researchers found that men, older people, people who had hallucinations, people with a low score on thinking tests before surgery, and those who had a cerebral hemorrhage during the surgery to implant the deep brain stimulator were more likely to develop dementia.

“Knowing these predictors may help us to select people who would respond best to deep brain stimulation and who might have a greater risk of having a poor cognitive outcome,” Moro said.

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A tool to detect patients at high risk for poor lung cancer outcomes

Lung cancer is the second most common cancer in both men and women in the United States. It is also the leading cause of cancer death among both sexes, making up nearly 25% of all cancer deaths nationwide. This is why screening for lung cancer, especially among high risk groups like lifetime smokers, is so important. Screening with low dose computed tomography (CT) is associated with a 20% reduction in lung cancer death. However, low dose CT does have its limitations, such as over diagnosing slow-growing lung cancers that may never cause detriment to the patient. In a new study published in Nature Scientific Reports, Moffitt Cancer Center researchers have shown how the use of radiomics can improve lung cancer screening by identifying early stage lung cancer patients who may be at high risk for poorer outcomes, and therefore require aggressive follow-up and/or adjuvant therapy.

Radiomics is a growing area of cancer research that extracts non-invasive biomarkers from medical imaging. It has advantages over circulating and tissue-based biomarkers because radiomic features are calculated from standard-of-care imaging and reflect the entire tumor burden, not just a sample of the tumor.

For the study, the Moffitt researchers used data from the National Lung Screening Trial (NLST), a study comparing two lung cancer screening methods—low dose CT and standard chest X-ray. They generated radiomic features from NLST patients who were diagnosed with lung cancer during their screening. Features, including as size, shape, volume and textural characteristics, were calculated from within (intratumoral) and around (peritumoral) their lung cancer tumors. Patients were then split into training and test cohorts, and an external cohort of non-screen detected lung cancer patients was used for further validation.

“Our goal was to use radiomic features to develop a reproducible model that can predict survival outcomes among patients who are diagnosed during a lung cancer screening,” said Jaileene Pérez-Morales, Ph.D., lead study author and a postdoctoral fellow at Moffitt.

After analyses to remove redundant and non-reproducible radiomics features, the researchers were able to develop a model that can identify a vulnerable group of screen-detected, early stage lung cancer patients who are at high risk of poor survival outcomes. Specifically, the model uses two radiomic features, one peritumoral and one intratumoral, to stratify patients into three risk groups—low, intermediate and high. The high-risk patients may have more aggressive cancer that while caught early, could still require frequent follow up and/or adjuvant therapy.

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