Pediatric Palliative Care (PPC) focuses on improving the quality of life for youth with life-limiting illness. Sexual health and intimate relationships are integral to overall health and quality of life for many adolescents and young adults (AYAs), and they can be negatively impacted by chronic illness and associated treatments. Further, the AYA population may be sexually active in ways that PPC practitioners may not routinely ask about.Sexuality and sexual health care needs are often overlooked in AYAs receiving palliative care, but data show that adolescents with chronic illness have similar levels of sexual behaviors and sexual health outcomes as healthy adolescents (Barrett et al, 2025). Adult palliative care literature suggests that despite patients wanting to discuss sexual health and intimacy, palliative care providers fail to initiate conversations to explore sexuality and intimacy. (Hordern, 2007; Kelemen, 2016, 2022).PPC requires practitioners to advocate for and provide culturally humble and responsive care(Thompson et al., 2023). PPC professionals might be uncomfortable with initiating conversations about youth sexual health and intimate relationships because it’s too personal, too risky given limits of confidentiality, or feel insufficiently trained to address these topics. However, the competent practice of PPC requires careful assessment of and intervention regarding this dimension of AYA health.In this session, we will address sexual health and romantic relationships with the AYA palliative care population. We will recommend assessments, open communication, early intervention (including sexual health screening, fertility concerns and emotional distress, support for body image concerns), specialized care and care coordination (e.g., with endocrinology, gynecology, etc.), and psychosexual support. We support for youth navigating romantic relationships, including concerns about sharing prognosis and disclosing their health history, By proactively addressing sexuality and intimacy, PPC professionals assist AYAs navigating challenges associated with serious illness and sexual health in support of optimal quality of life.
e17135 Background: While Prostate Specific Antigen (PSA) is the standard of care for prostate cancer screening, it is highly controversial due to the performance characteristics of the test. Magnetic Resonance Imaging (MRI) is becoming increasingly used as a reflex test for high PSA, but there are limitations with cost, disparities in access, variations in interpretation, and moderate sensitivities/specificities. Given that the prostate is a reproductive organ and a large portion of seminal emissions are generated from the prostate, this study aimed to investigate whether a novel prostate cancer screening platform using cell free nucleic acids from seminal plasma could improve the detection of clinically significant prostate cancer. Methods: Over a 4-month period, 276 patients scheduled to undergo a prostate biopsy were enrolled across 12 sites. Semen samples were collected at home by men aged 40 yrs and older and shipped to the Fellow Health laboratory. Seminal plasma was prepared by centrifugation and cell free nucleic acids extracted. DNA methylation libraries were prepared using the Twist methylome target enrichment panel and RNA libraries were prepared using Watchmaker kits. All libraries were sequenced on a NovaSeq X. Clinical data (including PI-RAD score, cancer status and Grade Group (GG)) were merged with the sequencing results and machine learning tools employed for modeling predictive algorithms. Results: Median age was 64 (IQR=10 years), median PSA was 6.1 (IQR=3.925ng/ml), 79% of subjects were white, 45% had BPH, 12.5% were vasectomy positive and 66% received MRI prior to biopsy. 180 valid semen samples were received prior to the cutoff date, of which 146 were evaluable for both RNA and DNA analysis. The well-known prostate tissue markers PSA and TMPRSS2 were highly abundant in seminal fluid with mean normalized transcripts per million of 1597 and 397.5 respectively. Using healthy controls to set the limit of blank, 45.1% of cancer patients harbored an ETS fusion (ERG, ETV1, ETV4, ETV5, FLI1). The data was split into a training set (n=115) and an independent test set (n=31). With a panel of 66 expression markers, 26 methylation markers and PSA, the AUC in the test set was 0.83 for differentiating clinically significant prostate cancer (GG2+) from no cancer (<=GG1). Conclusions: In this cohort, the use of MRI still resulted in unnecessary biopsies 69.4% of the time. Meanwhile, we demonstrate that our multiomic approach using cell free DNA and RNA achieves high accuracy for identifying clinically significant prostate cancer. At-home semen collection offers a convenient alternative to in-lab testing and may have the potential to augment MRI in post-PSA reflex testing.
The structure of the atomic nucleus, of over 5,800 isotopes and isomers from the NuBase 2020 dataset, is traditionally explained through a patchwork of complex models. We demonstrate that a two-term law, Q(A) = c₁A²/³ + c₂A, captures the global charge-mass relationship of all known isotopes—stable and unstable alike—with a coefficient of determination R² ≈ 0.979. This "Core Compression Law," derived from a physical model of competing surface and volume effects, relating the charge distribution and competing mass density gradients defines a universal "backbone" for the entire chart of nuclides. The contribution of this study is the analysis of the residuals (ΔQ) from this law. Deviations from the backbone are not random but systematically classify nuclides into "Overcharged" (ΔQ > 0) and "Starved" (ΔQ < 0) bins, which directly correspond to known decay pathways. Crucially, the magnitude of the residual, |ΔQ|, exhibits a strong correlation with the logarithm of the half-life. This reframes nuclear instability not as a collection of separate rules but as a single, predictable principle: a nuclide's stability is determined by its geometric "charge stress" relative to the universal compression law.
Anais do Congresso Internacional de Engenharia Mecânica e Industrial (2764-4294) - Utilização De Usinagem Para Adaptação De Peças Com Auxílio De Um Motor Quatro Tempos Ciclo Otto Para Uso Em Zonas Rurais
