Objective: To describe the experiences and perspectives of parents of pediatric patients with acute lymphoblastic leukemia (ALL) regarding oral chemotherapy administration during maintenance therapy.Methods: English-speaking parents of patients 4 to <18 years who were receiving ALL maintenance oral chemotherapy were eligible to participate in this mixed methods study. Using semi-structured interviews, we asked participants how difficult they found oral chemotherapy administration. We also probed regarding barriers and facilitators of oral chemotherapy administration and strategies used to overcome challenges. Lastly, we asked participants for their advice to future parents giving oral chemotherapy to their children.Results: Twenty-three participants were interviewed. One-fifth of participants stated that oral chemotherapy administration at home was hard or very hard. Common factors influencing oral chemotherapy administration were product-related (e.g., formulation) and treatment-related adverse effects (e.g., nausea), lifestyle adjustment (e.g., fitting in with family schedule), and attitudes (e.g., onus of medication administration).Strategies to address oral chemotherapy administration included several administration techniques, scheduling of medication administration, and normalization of medication taking.Conclusions: Oral chemotherapy administration during ALL maintenance therapy was hard for some parents. Identification of these parents and discussion of strategies to facilitate adherence to oral chemotherapy regimens may optimize patient outcomes.

ObjectiveTo evaluate the feasibility of a large prospective trial aimed at improving chemotherapy-induced nausea and vomiting (CINV) control in paediatric patients undergoing oral chemotherapy during acute lymphoblastic leukaemia (ALL) maintenance therapy.MethodsEnglish-speaking children, 4.0–17.99 years old and undergoing ALL maintenance treatment with an English-speaking guardian, were eligible to participate in this observational, serial, cross-sectional feasibility study. Data were collected from participants over one to three 7-day periods during months 2–3, 5–6 and 11–12 of ALL maintenance treatment. A future trial was considered feasible if the mean time to enrol 10 patients in each of three data collection periods was ≤1 year with ≥80% of patients returning evaluable data. CINV control was described as a secondary endpoint.ResultsTwenty-nine of 31 consenting patients (median age: 6.5 years, IQR: 5.1–9.2) completed the study: 10 in months 2–3, 10 in months 5–6 and 9 in months 11–12. The total time to recruit 29 patients was 1.2 years. In each of the three data collections periods, 72% of the patients provided evaluable data. Complete CINV control was reported in 6/21 (29%) evaluable study periods.ConclusionsA future trial to evaluate interventions to improve CINV control in patients with ALL undergoing oral maintenance chemotherapy as designed in this study is not feasible. An electronic data capture method and deferring patient recruitment until the mid-maintenance to late-maintenance phase should be considered in the design of a future trial.

ObjectivesPrimary objective was to describe the cumulative incidence of severe hypoglycaemia in paediatric patients with cancer. Secondary objectives were to determine risk factors for severe hypoglycaemia and to describe its clinical course and management.MethodsIn this single institution retrospective study, for the cumulative incidence cohort, we included cancer diagnosis and hypoglycaemia episodes between June 2018 and November 2021. For the chart review cohort, we included cancer diagnosis January 2009–November 2021 and hypoglycaemia episodes June 2018–November 2021.ResultsThere were 1237 cancer diagnoses and 142 patients with severe hypoglycaemia in the cumulative incidence cohort. Cumulative incidence at 6 months after cancer diagnosis was 9.4% (95% CI 7.7% to 11.0%). Severe hypoglycaemia incidence significantly increased over time (r=0.77, p=0.004). Independent risk factors were age at diagnosis (HR 0.88, 95% CI 0.85 to 0.91); acute lymphoblastic leukaemia (HR 3.06, 95% CI 2.19 to 4.29) and relapse (HR 9.54, 95% CI 3.83 to 23.76). There were 4672 cancer diagnoses and 267 episodes of severe hypoglycaemia in the chart review cohort.ConclusionsThe cumulative incidence of severe hypoglycaemia 6 months after cancer diagnosis was 9.4%. Severe hypoglycaemia increased over time. Younger patients, those with acute lymphoblastic leukaemia and those with a history of disease relapse, were at higher risk of severe hypoglycaemia.

This paper investigates the impact of finite number of unit cells on the sensing performance of chosen THz metamaterial absorber. Sensor models with different number of unit cells varying from 16 to infinite have been created using WIPL-D software. The results of comparison show that as the sensor?s size increases, its absorption response becomes more similar to the one of an infinite sensor structure. Metamaterial absorber with 50 unit cells expresses the similar behavior in terms of the corresponding frequency and amplitude shifts as the infinite absorber when the H9N2 virus sample of variable thickness is uniformly deposited on the top of the sensors? surface. The uneven distribution of sample affects the sensor?s absorption response which has been proven on the example of sensor with 50 unit cells.