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Background: While time-limited novel agent combinations have demonstrated high overall response rates and durable responses for patients with chronic lymphocytic leukemia (CLL), they also have high rates of adverse events and possibly overtreat many favorable risk patients. Meanwhile, patients receiving indefinite ibrutinib monotherapy are at risk for cumulative toxicity and acquired resistance with continuous exposure. To address these challenges, we utilized an 'add-on' approach to combination therapy after a period of ibrutinib monotherapy exposure. We examined the addition of umbralisib (a selective PI3Kδ and casein kinase-1epsilon [CK1ϵ] inhibitor) and ublituximab (a novel anti-CD20 monoclonal antibody glycoengineered for enhanced antibody-dependent cellular cytotoxicity;U2) to ibrutinib in CLL patients with detectable minimal residual disease (MRD) after an initial period of treatment with ibrutinib monotherapy. With this strategy, we aimed to induce undetectable MRD (uMRD), minimize the risk of developing BTKi resistance mutations, stop all CLL-directed therapy, and achieve a durable treatment-free observation (TFO) period in CLL patients who would most benefit from combination therapy. Methods: This is a phase II, multicenter, open label clinical trial (NCT04016805). Eligible patients were receiving ongoing ibrutinib, in any line of therapy, for a minimum duration of 6 months and had detectable residual CLL in the peripheral blood via MRD assay (flow cytometry with a cutoff of 10
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Recent experiences of socio-environmental disasters in Latin America have demonstrated the ineffectiveness of the state as a social actor in the organisation, coordination and implementation of adequate public policies to face these emergencies. This affects the most vulnerable urban areas, leading to unequal levels of impact from crises and disasters within cities. As a response, local collective actions, led by citizens, have emerged to manage risks. In Medellin, Colombia, in the context of the current COVID-19 crisis, our research identified a diverse repertoire of collective actions within informal, vulnerable communities, including collaboration towards improving food security, sanitation, pedagogy for self-care and prevention, and financial aid. Although these actions have had limited scope within the context of the ongoing COVID-19 pandemic, they demonstrate the need to promote a more proactive interaction between society and the state, based on a series of agreed interventions, promoting the exchange of knowledge and articulation of actions in the production and improvement of informal urban areas. This research explores how these collective actions have developed through a set of semi-structured interviews with community leaders and key actors in Medellin, with a view to identifying lessons for state-community dynamics in relation to disaster risk management and achieving a more integrated approach to improving habitat conditions within vulnerable urban areas. This work demonstrates that vulnerable communities in informal urban settlements can actively address their exposure to risk through locally-oriented, bottom-up collective actions. However, key linkages with institutional frameworks are needed to strengthen state-community dynamics and facilitate sustainable, inclusive and equitable development in cities.
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Introduction: Community Scientist (CS) programs - often referred to as Citizen Scientist programs - that facilitate direct engagement between scientific researchers and community members have emerged as effective strategies for building community trust in scientists and better informing research design and dissemination to address true community needs. While population health research has increasingly incorporated community stakeholders into the research continuum, basic and translational sciences struggle to do the same and may contribute to cancer disparities. We designed and implemented a virtual CS program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University (LCC). We report barriers, facilitators, and lessons learned. Methods: Translational scientists (TSs) were recruited from among LCC investigators, and CSs were identified for participation from among LCC community networks. We sought to recruit a CS cohort representing LCC's catchment area and a TS cohort whose research focuses on cancers most impacting LCC catchment. CS program interactions included monthly meetings between two CSs and one TS wherein the CS-TS triad discuss TS research in lay terms and work together to co-create educational infographics suitable for dissemination to the catchment and LCC scientists. Virtual attendance was tracked and meeting recordings retroactively reviewed to identify and create product development. Results: Six CSs and three TSs agreed to participate in the CS program. The CS cohort includes cancer survivors, patient advocates, community organization leaders, a nurse, and an educator, while the TS cohort includes breast, prostate, and lung cancer researchers. Currently, 11 of 18 triad meetings have been completed, with attendance averaging 97%. Barriers to program implementation have included technological difficulties, restrictions on in-person meeting, scheduling conflicts, time limitation, and language barriers, while facilitators have included small group meetings to promote comfortable group-member contribution, presence of a trained facilitator, articulation of achievable meeting goals and mission for product creation, and clear assignment of team roles. Conclusion: The COVID-19 pandemic has illuminated pre-existing needs for improved connectivity between communities impacted by cancer disparities and cancer researchers. By identifying current barriers and facilitators to successful virtual CS program implementation, our findings can be used to guide development and implementation of similar programs at LCC and other cancer centers that are aimed at mitigating cancer health disparities.
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Problem: maintaining or improving the physical condition of schoolchildren who practice a sport represents a challenge for physical educators and sports coaches due to the confinement imposed globally by the COVID-19 pandemic, since their work cannot be carried out in person. Objective: to improve the horizontal jump, as a measure of the power of the lower limbs, in adolescent women who practice indoor soccer, belonging to an educational institution in Boyaca-Colombia, through a training plan applied from virtuality. Method: a quasi-experimental study in which a) 21 indoor soccer players voluntarily participated;b) the anthropometric assessment was performed (age = 15.43 +/- 0.92 years;height = 1.58 +/- 0.05 m;weight = 51.51 +/- 6.81 kg);and the experimental (n = 11) and control (n = 10) groups were randomly formed;c) the horizontal jumping capacity of both groups was evaluated (pretest);d) an artisanal equipment was elaborated for training at home, which was given to each athlete of the experimental group;e) for the experimental group, an 8-week modeling training plan was designed and applied (in a directed way through virtual platforms), concentrating power loads of the lower limbs;f) the horizontal jumping capacity of both groups was evaluated (post-test) to determine their variation. Results: in horizontal jump, the control group decreased 0.2 cm, so it could be affirmed that it was maintained;the experimental group improved 5.9 cm, a result that could be considered significant. Conclusion: the modeling training plan designed and oriented remotely through virtual, platforms produced a significant improvement in the horizontal jump and in the power indicator of the players belonging to the experimental group.
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Non-technical summary To decrease the negative impacts of the coronavirus outbreak on human health, governments have implemented wide-ranging control measures. Moreover, they were urged to tackle a new challenge in energy policies to supply a new form of demand derived from new lifestyles of citizens and different energy consumption patterns. This article investigates the impacts of these changes on climate change and human health (due to air pollution) as a challenge for both citizens and governments in four countries: Colombia, France, the Netherlands, and Portugal. Technical summary The emergence of coronavirus disease 2019 (COVID-19) pandemic has been associated with global challenges in both energy supply and demand. Numerous articles have discussed the potential benefits of COVID-19 for our planet to mitigate greenhouse gas (GHG) emissions and air pollutants. By bringing the emissions from the energy production together with the air quality indicators, this article studies the impact on climate change and human health due to the COVID-19 pandemic, and the consequent changes in energy policies of governments as well as lifestyles in different societies. This study shows that in spite of having a reduction, the GHG emissions might go back to previous or higher levels if governments do not see this pandemic as an opportunity to promote the use of renewable energies, which are becoming cheaper than non-renewables. Additionally, lower energy demand and less anthropogenic activities do not necessarily result in lower GHG emissions from energy production. Our results highlight the need for revising the policies and decisions of both governments and citizens, as temporary reductions in the levels of energy demand and air pollutants can easily be counterbalanced by adverse effects, known as the 'rebound effect.' Social media summary How did the changes in energy consumption and production due to COVID-19 affect climate change and human health in different countries? Copyright © The Author(s), 2021. Published by Cambridge University Press.
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This work presents a broad vision of the potential applications that chi-tosan tosan biopolymer, and its derivatives, may has in each of the strategies currently developed in the fight against the virus associated with the COVID-19 pandemic. Summary information about the most important characteristics of the coronavirus family and their main associated human diseases is presented. The main characteristics (harmlessness, biocompatibility, biodegrada-bility, muco-adhesiveness, hemostatic, thickener, mucosal permeation, anti-tumor, anti-inflammatory, etc.) that make chitosan and its derivatives excellent candidates for these purposes are exposed. Finally, some selected examples of the studies carried out with these materials such as adjuvants in the administration of vaccines (especially intranasal route), antiviral agents, control of cytokine storm, and passive antigen therapy, are shown. This work clearly shows the impressive potential of these materials in the fight against these pathogens. © 2020, Universidad de Los Andes. All rights reserved.