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1
Recker and Lümmen. "Prostate cancer: early detection – when and what." Therapeutische Umschau 57, no. 1 (January 1, 2000): 33–37. http://dx.doi.org/10.1024/0040-5930.57.1.33.
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Das Prostatakarzinom ist mittlerweile der am häufigsten diagnostizierte Tumor des Mannes und stellt nach dem Bronchialkarzinom die zweithäufigste maligne Todesursache dar. Ausschließlich das auf die Prostata begrenzte Karzinom ist einer kurativen Therapie zuführbar. Da der organbegrenzte Befund in der Regel klinisch asymptomatisch ist, wurde seinerzeit die klassische Vorsorgeuntersuchung, die digitale rektale Palpation (DRE), eingeführt. Die DRE entdeckt jedoch die Karzinome zu selten und in über 50% in pathologisch schon fortgeschrittenen Stadien. Der Serum Tumormarker Prostata Spezifisches Antigen (PSA) hingegen entdeckt die organbegrenzten Tumoren etwa dreimal so häufig im Vergleich zur DRE und insbesondere in organbegrenzten kurablen Stadien. Die Indikation zur Stanzbiopsie der Prostata ist eindeutig oberhalb eines PSA > 4 ng/ml (Hybritech Assay) gegeben. Einer von fünf Patienten ist Träger eines Karzinoms. Eine abwartende diagnostische Haltung in dem sogenannten Intermediärbereich PSA 4–10 ng/ml ist als obsolet zu betrachten, da bei einem PSA > 10 ng/ml nur noch 15 bis 44% der Tumore organbegrenzt sind. Die obere Altersgrenze für einen jährlichen Checkup liegt bei einem biologischen Alter von rund 70 Jahren, da auch unter einer «wait and see» Therapie ungefähr 85% dieser Patienten bei organbegrenztem Befund zehn Jahre krankheitsspezifisch überleben. Das Angebot einer Vorsorgeuntersuchung (DRE/PSA) sollte ab dem 50. Lebensjahr in der Sprechstunde gemacht werden. Bei familiärer Belastung ist die untere Altersgrenze auf 45 Jahre zurückzusetzen. Die häufig vorgebrachte Äußerung, daß in Vorsorgeuntersuchungen klinisch irrelevante Karzinome entdeckt werden, ist nicht haltbar, da nicht sämtliche 40% autoptisch prävalenten Karzinome gefunden werden, sondern nur etwa 3 bis 4% mit einem jeweiligen relevanten Tumorvolumen von > 0.5 ccm. Daten über den eventuellen Benefit eines Prostatakrebs-Screening (direkte Aufforderung zur Vorsorgeuntersuchung auch außerhalb der Sprechstundenbesuche) werden erst im Jahre 2005 zur Verfügung stehen.
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Reis, Leonardo Oliveira, Antonio Felipe Leite Simão, Jamal Baracat, Fernandes Denardi, and Antonio Gugliotta. "Digital Rectal Examination Standardization for Inexperienced Hands: Teaching Medical Students." Advances in Urology 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/797096.
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Objectives.To standardize digital rectal examination (DRE) and set how it correlates with the comprehensive evaluation of lower urinary tract symptoms (LUTS).Methods.After scaled standardization of DRE based on fingertips graphical schema: 10 cubic centimeters—cc for each fingertip prostate surface area on DRE, four randomly selected senior medical students examined 48 male patients presenting with LUTS in an outpatient clinical setting, totaling 12 DRE each. Standardized DRE, international prostate symptom score (IPSS), serum PSA, transabdominal ultrasound (US), urodynamic evaluation, and postvoid residue were compared.Results.The mean and median PVs were US—45 and 34.7 cc (5.5 to 155) and DRE—39 and 37.5 cc (15 to 80). Comparing DRE and US by simple linear regression: US PV = 11.93 + 0.85 × (DRE PV);P=0.0009. Among patients classified as nonobstructed, inconclusive, and obstructed, the US PVs were 29.8, 43.2, and 53.6 cc (P=0.033), and DRE PVs were 20, 35, and 60 cc (P=0.026), respectively.Conclusion.This is the first attempt to DRE standardization focusing on teaching-learning process, establishing a linear correlation of DRE and US PVs with only 12 examinations by inexperienced hands, satisfactorily validated in an outpatient clinical setting.
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Sherman, James P., and Allison McComiskey. "Measurement-based climatology of aerosol direct radiative effect, its sensitivities, and uncertainties from a background southeast US site." Atmospheric Chemistry and Physics 18, no. 6 (March 26, 2018): 4131–52. http://dx.doi.org/10.5194/acp-18-4131-2018.
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Abstract. Aerosol optical properties measured at Appalachian State University's co-located NASA AERONET and NOAA ESRL aerosol network monitoring sites over a nearly four-year period (June 2012–Feb 2016) are used, along with satellite-based surface reflectance measurements, to study the seasonal variability of diurnally averaged clear sky aerosol direct radiative effect (DRE) and radiative efficiency (RE) at the top-of-atmosphere (TOA) and at the surface. Aerosol chemistry and loading at the Appalachian State site are likely representative of the background southeast US (SE US), home to high summertime aerosol loading and one of only a few regions not to have warmed during the 20th century. This study is the first multi-year ground truth DRE study in the SE US, using aerosol network data products that are often used to validate satellite-based aerosol retrievals. The study is also the first in the SE US to quantify DRE uncertainties and sensitivities to aerosol optical properties and surface reflectance, including their seasonal dependence.Median DRE for the study period is −2.9 W m−2 at the TOA and −6.1 W m−2 at the surface. Monthly median and monthly mean DRE at the TOA (surface) are −1 to −2 W m−2 (−2 to −3 W m−2) during winter months and −5 to −6 W m−2 (−10 W m−2) during summer months. The DRE cycles follow the annual cycle of aerosol optical depth (AOD), which is 9 to 10 times larger in summer than in winter. Aerosol RE is anti-correlated with DRE, with winter values 1.5 to 2 times more negative than summer values. Due to the large seasonal dependence of aerosol DRE and RE, we quantify the sensitivity of DRE to aerosol optical properties and surface reflectance, using a calendar day representative of each season (21 December for winter; 21 March for spring, 21 June for summer, and 21 September for fall). We use these sensitivities along with measurement uncertainties of aerosol optical properties and surface reflectance to calculate DRE uncertainties. We also estimate uncertainty in calculated diurnally-averaged DRE due to diurnal aerosol variability. Aerosol DRE at both the TOA and surface is most sensitive to changes in AOD, followed by single-scattering albedo (ω0). One exception is under the high summertime aerosol loading conditions (AOD ≥ 0.15 at 550 nm), when sensitivity of TOA DRE to ω0 is comparable to that of AOD. Aerosol DRE is less sensitive to changes in scattering asymmetry parameter (g) and surface reflectance (R). While DRE sensitivity to AOD varies by only ∼ 25 to 30 % with season, DRE sensitivity to ω0, g, and R largely follow the annual AOD cycle at APP, varying by factors of 8 to 15 with season. Since the measurement uncertainties of AOD, ω0, g, and R are comparable at Appalachian State, their relative contributions to DRE uncertainty are largely influenced by their (seasonally dependent) DRE sensitivity values, which suggests that the seasonal dependence of DRE uncertainty must be accounted for. Clear sky aerosol DRE uncertainty at the TOA (surface) due to measurement uncertainties ranges from 0.45 (0.75 W m−2) for December to 1.1 (1.6 W m−2) for June. Expressed as a fraction of DRE computed using monthly median aerosol optical properties and surface reflectance, the DRE uncertainties at TOA (surface) are 20 to 24 % (15 to 22 %) for March, June, and September and 49 (50 %) for DEC. The relatively low DRE uncertainties are largely due to the low uncertainty in AOD measured by AERONET. Use of satellite-based AOD measurements by MODIS in the DRE calculations increases DRE uncertainties by a factor of 2 to 5 and DRE uncertainties are dominated by AOD uncertainty for all seasons. Diurnal variability in AOD (and to a lesser extent g) contributes to uncertainties in DRE calculated using daily-averaged aerosol optical properties that are slightly larger (by ∼ 20 to 30 %) than DRE uncertainties due to measurement uncertainties during summer and fall, with comparable uncertainties during winter and spring.
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Do, Hyun Ju, Tae Woo Oh, Ju Hye Yang, Kwang Il Park, and Jin Yeul Ma. "Davallia mariesiiMoore Improves FcεRI-Mediated Allergic Responses in the Rat Basophilic Leukemia Mast Cell Line RBL-2H3 and Passive Cutaneous Anaphylaxis in Mice." Mediators of Inflammation 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/8701650.
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Davallia mariesiiMoore (Drynaria rhizome extract (DRE)) is widely known for its efficacy in treating inflammation, arteriosclerosis, and bone injuries. This study evaluated whether treatment with DRE inhibited FcɛRI-mediated allergic responses in the RBL-2H3 mast cells and investigated the early- and late-phase mechanisms by which DRE exerts its antiallergic effects. IgE anti-DNP/DNP-HSA-sensitized RBL-2H3 mast cells were tested for cytotoxicity to DRE, followed by the assessment ofβ-hexosaminidase release. We measured the amounts of inflammatory mediators (e.g., histamine, PGD2, TNF-α, IL-4, and IL-6) and examined the expression of genes involved in arachidonate and FcεRI signaling pathways. In addition, we confirmed the antiallergic effects of DRE on passive cutaneous anaphylaxis (PCA) in mice. DRE inhibited RBL-2H3 mast cell degranulation and production of allergic mediators in them. In early allergic responses, DRE reduced expression of FcεRI signaling-related genes (e.g., Syk, Lyn, and Fyn) and extracellular signal-regulated kinase phosphorylation in mast cells. In late allergic responses, DRE reduced PGD2release and COX-2 expression and cPLA2phosphorylation in FcɛRI-mediated mast cells. Lastly, 250–500 mg/kg DRE significantly attenuated the IgE-induced PCA reaction in mice. These findings provide novel information on the molecular mechanisms underlying the antiallergic effects of DRE in FcɛRI-mediated allergic responses.
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Gutman, Ivan, and Slavko Radenkovic. "Dependence of Dewar resonance energy of benzenoid molecules on Kekulé structure count." Journal of the Serbian Chemical Society 71, no. 10 (2006): 1039–47. http://dx.doi.org/10.2298/jsc0610039g.
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The dependence of the Dewar resonance energy (DRE) on the Kekul? structure count (K) was found to be significantly different from that earlier anticipated. Within classes of benzenoid isomers, the DRE increases either as K? for ? ? 0.3 or as (ln K) for ? ? 2. Both functional dependencies result in approximate expressions for DRE of nearly equal accuracy. Approximations of the form DRE ? a K + b and DRE ? a' ln K + b' are somewhat less accurate, but can still be used in usual practical applications of the Dewar resonance energy. .
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Thorsen, Tyler J., Richard A. Ferrare, Seiji Kato, and David M. Winker. "Aerosol Direct Radiative Effect Sensitivity Analysis." Journal of Climate 33, no. 14 (July 15, 2020): 6119–39. http://dx.doi.org/10.1175/jcli-d-19-0669.1.
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AbstractBoth to reconcile the large range in satellite-based estimates of the aerosol direct radiative effect (DRE) and to optimize the design of future observing systems, this study builds a framework for assessing aerosol DRE uncertainty. Shortwave aerosol DRE radiative kernels (Jacobians) were derived using the MERRA-2 reanalysis data. These radiative kernels give the differential response of the aerosol DRE to perturbations in the aerosol extinction coefficient, aerosol single-scattering albedo, aerosol asymmetry factor, surface albedo, cloud fraction, and cloud optical depth. This comprehensive set of kernels provides a convenient way to consistently and accurately assess the aerosol DRE uncertainties that result from observational or model-based uncertainties. The aerosol DRE kernels were used to test the effect of simplifying the full vertical profile of aerosol scattering properties into column-integrated quantities. This analysis showed that, although the clear-sky aerosol DRE can be had fairly accurately, more significant errors occur for the all-sky DRE. The sensitivity in determining the broadband spectral dependencies of the aerosol scattering properties directly from a limited set of wavelengths was quantified. These spectral dependencies can be reasonably constrained using column-integrated aerosol scattering properties in the midvisible and near-infrared wavelengths. Separating the aerosol DRE and its kernels by scene type shows that accurate aerosol properties in the clear sky are the most crucial component of the global aerosol DRE. In cloudy skies, determining aerosol properties in the presence of optically thin cloud is more radiatively important than doing so when optically thick cloud is present.
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Liu, Yuan, Licheng Wang, Xiaoying Shen, and Lixiang Li. "New Constructions of Identity-Based Dual Receiver Encryption from Lattices." Entropy 22, no. 6 (May 28, 2020): 599. http://dx.doi.org/10.3390/e22060599.
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Dual receiver encryption (DRE), being originally conceived at CCS 2004 as a proof technique, enables a ciphertext to be decrypted to the same plaintext by two different but dual receivers and becomes popular recently due to itself useful application potentials such secure outsourcing, trusted third party supervising, client puzzling, etc. Identity-based DRE (IB-DRE) further combines the bilateral advantages/facilities of DRE and identity-based encryption (IBE). Most previous constructions of IB-DRE are based on bilinear pairings, and thus suffers from known quantum algorithmic attacks. It is interesting to build IB-DRE schemes based on the well-known post quantum platforms, such as lattices. At ACISP 2018, Zhang et al. gave the first lattice-based construction of IB-DRE, and the main part of the public parameter in this scheme consists of 2 n + 2 matrices where n is the bit-length of arbitrary identity. In this paper, by introducing an injective map and a homomorphic computation technique due to Yamada at EUROCRYPT 2016, we propose another lattice-based construction of IB-DRE in an even efficient manner: The main part of the public parameters consists only of 2 p n 1 p + 2 matrices of the same dimensions, where p ( ≥ 2 ) is a flexible constant. The larger the p and n, the more observable of our proposal. Typically, when p = 2 and n = 284 according to the suggestion given by Peikert et al., the size of public parameters in our proposal is reduced to merely 12% of Zhang et al.’s method. In addition, to lighten the pressure of key generation center, we extend our lattice-based IB-DRE scheme to hierarchical scenario. Finally, both the IB-DRE scheme and the HIB-DRE scheme are proved to be indistinguishable against adaptively chosen identity and plaintext attacks (IND-ID-CPA).
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Alston, Erica J., and Irina N. Sokolik. "A First-Order Assessment of Direct Aerosol Radiative Effect in the Southeastern U.S. Using over a Decade Long Multisatellite Data Record." Air, Soil and Water Research 9 (January 2016): ASWR.S39226. http://dx.doi.org/10.4137/aswr.s39226.
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Aerosols comprise a critical portion of the Earth's climate due to their radiative properties. More emphasis is now being placed upon understanding radiative effects of aerosols on a regional scale. The primary goal of this research is to estimate the aerosol direct radiative effect (DRE) and examine its dynamical nature in the Southeastern U.S. based on satellite data obtained from the moderate-resolution imaging spectroradiometer (MODIS) and multi-angle imaging spectroradiometer (MISR) instruments onboard the Terra satellite from 2000 to 2011. This 12-year analysis utilizes satellite measurements of aerosol optical depth (AOD), surface albedo, cloud fraction, and single-scattering albedo over the Southeastern U.S. as inputs to a first-order approximation of regional top of the atmosphere DRE. Results indicate that AOD is the primary driver of DRE estimates, with surface albedo and single-scattering albedo having some appreciable effects as well. During the cooler months, the minima (less negative) of DRE vary between -6 and -3 W/m2, and during the warmer months, there is more variation with DRE maxima varying between -24 and -12.6 W/m2 for MODIS and -22.5 and -11 W/m2 for MISR. Yet if we take an average of the monthly DRE over time (12 years), we estimate Δ F = -7.57 W/m2 for MODIS and Δ F = -5.72 W/m2 for MISR. Regional assessments of the DRE show that background levels of DRE are similar to the 12-year average of satellite-based DRE, with urbanized areas having increased levels of DRE compared to background conditions. Over the study period, DRE has a positive trend (becoming less negative), which implies that the region could lose this protective top of the atmosphere cooling with the advancement of climate change impacting the biogenic emissions of aerosols.
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Liu, Jie, Chaolan Lv, Yizhou Huang, Ying Wang, Dandan Wu, Cong Zhang, Chenyu Sun, Wei Wang, and Yue Yu. "Digital Rectal Examination Is a Valuable Bedside Tool for Detecting Dyssynergic Defecation: A Diagnostic Study and a Meta-Analysis." Canadian Journal of Gastroenterology and Hepatology 2021 (October 28, 2021): 1–9. http://dx.doi.org/10.1155/2021/5685610.
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Background. Accurate dyssynergic defecation (DD) diagnosis depends on anorectal physiological tests that are not widely available. Aim. The purpose of this study is to evaluate the diagnostic yield of digital rectal examination (DRE) compared with anorectal physiological tests in diagnosing DD in patients with constipation. Methods. A total of 218 chronic constipation patients who fulfilled the Rome IV diagnostic criteria for functional constipation (FC) and underwent a standardized DRE and high-resolution anorectal manometry (HRAM) test were enrolled in this study. The diagnostic accuracy of DRE compared with HRAM was evaluated, and the agreement between DRE and HRAM was calculated. Furthermore, a comprehensive literature search on PubMed, Web of Science, Cochrane Library, and Embase database was conducted to further elucidate the pooled diagnostic accuracy of DRE in DD patients. Results. A total of 101 patients (46.33%) had a DD pattern using HRAM, while 117 patients (53.67%) were diagnosed without DD. The sensitivity of DRE in diagnosing dyssynergia was 71.3%, and the specificity was 76.1%. There was a moderate agreement between DRE and HRAM for diagnosing DD (κ-coefficient = 0.474, P < 0.001 ). Meanwhile, six studies (including our study) comprising 964 constipated patients were included in our meta-analysis. The outcomes demonstrated that the AUC was 0.85 (95% CI 0.82–0.88) with 77% summary sensitivity (95% CI 65–86) and 80% summary specificity (95% CI 71–86) to diagnose DD. Conclusions. DRE could be a valuable tool for screening DD. Our study revealed acceptable sensitivity and specificity of DRE in detecting dyssynergia compared with the physiological tests. Meanwhile, our study highlights that DRE remains an important tool in clinical practice.
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Farooq, Omar, Ameer Farooq, Sunita Ghosh, Raza Qadri, Tanner Steed, Mitch Quinton, and Nawaid Usmani. "The Digital Divide: A Retrospective Survey of Digital Rectal Examinations during the Workup of Rectal Cancers." Healthcare 9, no. 7 (July 6, 2021): 855. http://dx.doi.org/10.3390/healthcare9070855.
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Background: Digital rectal examination (DRE) is considered an important part of the physical examination. However, it is unclear how many patients have a DRE performed at the primary care level in the work-up of rectal cancer, and if the absence of a DRE causes a delay to consultation with a specialist. Methods: A retrospective patient questionnaire was sent to 1000 consecutive patients with stage II or stage III rectal cancer. The questionnaire asked patients to recall if they had a DRE performed by their general practitioner (GP) when they first presented with symptoms or a positive FIT test. Demographic data, staging data, and time to consultation with a specialist were also collected. Results: A thousand surveys were mailed out, and a total of 262 patients responded. Of the respondents, 46.2% did not recall undergoing a digital rectal examination by their primary care provider. Women were less likely to undergo a DRE than men (28.6% vs. 44.3%, p = 0.019). While there was a trend towards longer times to specialist consultation in patients who did not undergo a DRE (27.0 vs. 12.2 weeks), this was not statistically significant (p = 0.121). Conclusion: A significant proportion of patients who are FIT positive or have symptomatic rectal bleeding do not recall having a DRE by their primary care provider. Barriers may include lack of comfort with performing DRE or lack of time. Clearer guidelines and more support for GP’s may increase uptake of DRE.
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Yuan, Fang, Ruihua Jia, Qiong Gao, Fang Yang, Xiai Yang, Yongli Jiang, Wen Li, Lara V. Marcuse, and Wen Jiang. "Early Predictors of Drug-Resistant Epilepsy Development after Convulsive Status Epilepticus." European Neurology 79, no. 5-6 (2018): 325–32. http://dx.doi.org/10.1159/000490900.
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Background: Drug-resistant epilepsy (DRE) is a common and serious consequence of convulsive status epilepticus (CSE). Little is known on the early prediction of DRE development after CSE. Our aim was to identify independent DRE predictors in patients with CSE. Methods: One hundred and forty consecutive patients identified with CSE in a tertiary academic hospital between March 2008 and January 2015 were reviewed. Demographics, clinical features, serum albumin neuroimaging, and electroencephalogram characteristics were collected and analyzed. Independent predictors of DRE were identified using multivariate logistic regression. The receiver operating characteristic (ROC) curve was used to quantify the predictive validity of all the risk factors. Results: After a median 62-month observation period, 91 patients were enrolled into this study. Thirty-seven (40.7%) patients did not have DRE, 22 (24.2%) developed DRE, and 32 (35.2%) were dead. History of epilepsy (OR 9.17, 95% CI 1.77–49.22, p = 0.010), status epilepticus duration ≥24 h (OR 4.82, 95% CI 1.04–22.37, p = 0.044), and cortical or hippocampal abnormalities on neuroimaging (OR 9.49, 95% CI 1.90–47.50, p = 0.006) were independent predictors of DRE after CSE. A combination of these 3 variables yielded an area under the ROC curve of 0.77 (0.65–0.89). Conclusions: History of epilepsy, longer SE duration, and cortical or hippocampal abnormalities on neuroimaging are early predictors for the development of DRE after CSE. Further studies are needed to assess whether a more aggressive treatment will reduce the likelihood of DRE development in these high-risk patients.
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Hernandez-Ronquillo, L., P. Lebony-Roy, S. Buckley, and J. Tellez Zenteno. "P.022 Neuroimaging findings and seizure type as risk factors for adult focal drug resistant epilepsy." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 43, S2 (June 2016): S27. http://dx.doi.org/10.1017/cjn.2016.128.
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Background: About 35% of patients with epilepsy may develop drug-resistant epilepsy (DRE). Identifying risk factors associated with DRE will allow us to identify earlier patients in the course of the disease. Methods: This is a case-control study nested within a cohort. Chart reviews of subjects who full fill inclusion criteria were completed. Inclusion criteria included age>18 years, focal epilepsy determined by clinical correlation and EEG. DRE was determined by ILAE criteria. Results: 149 subjects were included. Seventy had DRE (cases), and seventy-nine did not have DRE (controls). DRE group had a mean age of 41 years (SD+14.8) compared to the control group (49+17.5) (p=0.003). DRE group had a mean age at diagnosis of epilepsy of 19+15.3 compared to the control group with a mean of 33.6+21. (p=<0.001). The main risk factors identified in this study were; cortical dysplasia OR 8.67 (CI 1.04-72.3, p=0.026); mesial temporal sclerosis (MTS) (OR 2.69; CI 1.12-6.47; p=0.024); and presence of complex partial seizures (OR 2.04. Conclusions: Young age at diagnosis of focal epilepsy, diagnosis of cortical dysplasia, MTS, and presence of complex partial seizures are risk factors for DRE
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Dahiya, Ekta, Man Mohan Mehndiratta, and Krishna Pillai. "Plasma tetranectin as a potential clinical biomarker for epilepsy and correlation with clinical and social characteristics." International Journal of Epilepsy 04, no. 01 (June 2017): 002–5. http://dx.doi.org/10.1016/j.ijep.2016.12.003.
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Abstract Background Tetranectin concentration has been identified as a biomarker of several types of metastatic and malignant cancers. The role of tetranectin has also be seen in some neurological disorders. We aimed to estimate the plasma tetranectin concentration in different groups of people with epilepsy (PWE) followed-up for a year. As a secondary objective, the clinical and social characteristics were also correlated with the tetranectin levels. Methods We enrolled 90 subjects grouped as Newly-diagnosed epilepsy (NDE), Drug-effective epilepsy (DEE), and Drug-refractory epilepsy (DRE) and an age-gender matched control group (n = 30). The plasma samples were collected thrice at the six-month interval and were analysed for the tetranectin concentration using S-ELISA. Results The mean plasma tetranectin levels at the baseline test were significantly lower for the DEE (6.294 ± 0.806) and DRE (7.572 ± 0.545) groups compared with control group (9.71 ± 0.628) but not the NDE group (8.651 ± 0.859 vs. 9.71 ± 0.628; p > 0.05). On a year of follow-up, the tetranectin levels for the NDE group significantly decreased (p < 0.001) matching with that of the DEE and DRE group. Multivariate linear regression analysis showed that gender (p = 0.035) in the DRE group and seizure type (p = 0.040) and diet (p = 0.046) for the NDE group were significantly correlated. Conclusion The plasma tetranectin level in PWE significantly decreased as the disease progressed irrespective of the stage of epilepsy. Thus, tetranectin could be considered as a potential progressive biomarker for epilepsy. The study outcome suggests further investigation for the possible link of tetranectin levels with clinical and social parameters.
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Liao, Wei-Chen, Chin-Wei Huang, Ya-Hsin Hsiao, Pi-Shan Sung, Tzu-Fun Fu, Alice Y. W. Chang, and Hui Hua Chang. "Association between the Serum Coenzyme Q10 Level and Seizure Control in Patients with Drug-Resistant Epilepsy." Healthcare 9, no. 9 (August 28, 2021): 1118. http://dx.doi.org/10.3390/healthcare9091118.
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Drug-resistant epilepsy (DRE) is a chronic neurological disorder with somatic impacts and increased risk of metabolic comorbidities. Oxidative stress might play an important role in metabolic effects and as a regulator of seizure control, while coenzyme Q10 (CoQ10) could improve insulin sensitivity through antioxidant effects. We aimed to investigate the association between CoQ10 level and clinical outcome, represented by the seizure frequency and quality of life, in DRE patients. DRE patients (N = 33) had significantly higher serum insulin levels and lower scores on the physical domain of the World Health Organization Quality of Life questionnaire (WHOQoL) than gender-age matched controls. The serum CoQ10 level (2910.4 ± 1163.7 ng/mL) was much higher in DRE patients than the normal range. Moreover, the serum CoQ10 level was significantly correlated with the seizure frequency (r = −0.412, p = 0.037) and insulin level (r = 0.409, p = 0.038). Based on stratification by insulin resistance (HOMA-IR > 2.4), the subgroup analysis showed that patients with a greater HOMA-IR had higher CoQ10 levels and lower seizure frequency, and had a significantly worse quality of life. In summary, CoQ10 could be a mediator involved in the mechanism of epilepsy and serve as a biomarker of the clinical outcome in DER patients.
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Sultana, Bushra, Marie-Andrée Panzini, Ariane Veilleux Carpentier, Jacynthe Comtois, Bastien Rioux, Geneviève Gore, Prisca R. Bauer, et al. "Incidence and Prevalence of Drug-Resistant Epilepsy." Neurology 96, no. 17 (March 15, 2021): 805–17. http://dx.doi.org/10.1212/wnl.0000000000011839.
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ObjectiveTo evaluate the incidence and prevalence of drug-resistant epilepsy (DRE) as well as its predictors and correlates, we conducted a systematic review and meta-analysis of observational studies.MethodsOur protocol was registered with PROSPERO, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology reporting standards were followed. We searched MEDLINE, Embase, and Web of Science. We used a double arcsine transformation and random-effects models to perform our meta-analyses. We performed random-effects meta-regressions using study-level data.ResultsOur search strategy identified 10,794 abstracts. Of these, 103 articles met our eligibility criteria. There was high interstudy heterogeneity and risk of bias. The cumulative incidence of DRE was 25.0% (95% confidence interval [CI]: 16.8–34.3) in child studies but 14.6% (95% CI: 8.8–21.6) in adult/mixed age studies. The prevalence of DRE was 13.7% (95% CI: 9.2–19.0) in population/community-based populations but 36.3% (95% CI: 30.4–42.4) in clinic-based cohorts. Meta-regression confirmed that the prevalence of DRE was higher in clinic-based populations and in focal epilepsy. Multiple predictors and correlates of DRE were identified. The most reported of these were having a neurologic deficit, an abnormal EEG, and symptomatic epilepsy. The most reported genetic predictors of DRE were polymorphisms of the ABCB1 gene.ConclusionsOur observations provide a basis for estimating the incidence and prevalence of DRE, which vary between populations. We identified numerous putative DRE predictors and correlates. These findings are important to plan epilepsy services, including epilepsy surgery, a crucial treatment option for people with disabling seizures and DRE.
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Song, Qianqian, Zhibo Zhang, Hongbin Yu, Jasper F. Kok, Claudia Di Biagio, Samuel Albani, Jianyu Zheng, and Jiachen Ding. "Size-resolved dust direct radiative effect efficiency derived from satellite observations." Atmospheric Chemistry and Physics 22, no. 19 (October 12, 2022): 13115–35. http://dx.doi.org/10.5194/acp-22-13115-2022.
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Abstract. The role of mineral dust aerosol in the global radiative energy budget is often quantified by the dust direct radiative effect (DRE). The dust DRE strongly depends on dust aerosol optical depth (DAOD), therefore, DRE efficiency (DREE = DRE / DAOD) is widely compared across different studies to eliminate differences due to the various dust loads. Nevertheless, DREE is still influenced by the uncertainties associated with dust particle size distribution (PSD) and optical properties. In this study, we derive a global clear-sky size-resolved DREE dataset in both shortwave (SW) and longwave (LW) at top of the atmosphere (TOA) and surface based on satellite observations (i.e., satellite-retrieved dust extinction spatial and vertical distributions). In the DREE dataset, dust geometric diameter from 0.1 to 100 µm is divided into 10 bins and the corresponding monthly mean DREE (with respect to DAOD at 532 nm) for each size bin is derived by using the Rapid Radiative Transfer Model (RRTM). Three sets of state of the art dust refractive indices (RI) and two sets of dust shape models (sphere vs. spheroid) are adopted to investigate the sensitivity of dust DREE to dust absorption and shape. As a result, the size-resolved dust DREE dataset contains globally distributed monthly mean dust DREE at TOA and surface for each of 10 size bins with 5∘ (longitude) ×2∘ (latitude) resolution as well as for each dust RI and shape combination. The size-resolved dust DREE dataset can be used to readily calculate global dust DRE for any DAOD and dust PSD, including the uncertainty in the DRE induced by dust microphysical properties, (e.g., dust PSD, RI and shape). By calculating dust DRE based on DAOD climatology retrieved from different satellite sensors and based on different dust PSD, we find that uncertainty in the spatial pattern of DAOD induces more than 10 % of the uncertainty in SW dust DRE at TOA. The observation-based dust PSD induces around 15–20 % uncertainty in dust DRE at TOA and in the atmosphere. The sensitivity assessments of dust DRE to dust RI and shape further suggest that dust nonsphericity induces a negligible effect on dust DRE estimations, while dust RI turns out to be the most important factor in determining dust DRE, particularly in SW.
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Andersson, Joel Marcus, Tobias Nordström, Martin Eklund, and Henrik Gronberg. "The predictive value of DRE in the modern era of prostate cancer diagnostics." Journal of Clinical Oncology 37, no. 7_suppl (March 1, 2019): 48. http://dx.doi.org/10.1200/jco.2019.37.7_suppl.48.
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48 Background: DRE (digital rectal examination) suspicious for prostate cancer is still used as a clinical tool to diagnose prostate cancer. We aim to analyse the predictive value of DRE to diagnose prostate cancer ISUP grade group ≥2 (GG≥2) prostate cancer including the setting of STHLM3 test as a variable. Methods: The previously described STHLM3 screening-cohort included men between 50 to 70 years with ≥10% risk of prostate cancer as assessed by PSA or the Stockholm3 test and invited for transrectal biopsy (TRUSbx). All 7415 biopsied men was included for analysis. DRE status was categorized as T1-T4. We analysed sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) for DRE status of T2-4 to predict GG≥2 and GG≥3 in biopsies. In a multivariate logistic regression analysis; we adjusted for PSA, age, PVol, earlier biopsy (EB) and adjusted STHLM3 model risk set to exclude DRE and prostate volume (PVol). We calculated adjusted odds ratio (OR) for different strata of adjusted STHLM3 risk. Results: Prevalence of ISUP≥2 was 16.8% (1,243/7415). 9.7% (716/7415) men had DRE suspicious for cancer (T2-4) with a Sn to detect GG≥2 of 25.2%. Sp, PPV and NPV was 93.5%, 43.7% and 86.1%, respectively. In univariate model the OR for DRE T2-4 vs. T1 to predict GG≥2 was 4.28 (95% CI 4.09–5.67). Logistic regression analysis including also age, PVol, PSA, earlier biopsies and adjusted STHLM3 risk (%) gave an OR for DRE T2-4 of 2.87 (95% CI 2.36–3.49). In the same analysis stratified PSA group 5-10 ng/ml with PSA < 3 ng/ml as baseline gave OR = 3.21. Using the same univariate model, OR for DRE T2-4 vs. T1 to predict GG≥3 was 6.68 (95% CI 5.44–8.21) and in the multivariate model OR was 3.25 (95% CI 2.54–4.17). Conclusions: As a diagnostic test DRE holds little merit on its own but in combination with other clinical factors and biomarkers in this study we could show that it contributes with value. Just under half of men with DRE suspicious for cancer has GG≥2 cancer. This study does not establish evidence to rule out DRE as a clinically valuable adjunct to PSA, other clinical parameters and new biomarkers like STHLM3.
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Guillem, Jose G., David B. Chessin, Jinru Shia, Harvey G. Moore, Madhu Mazumdar, Bianca Bernard, Philip B. Paty, et al. "Clinical Examination Following Preoperative Chemoradiation for Rectal Cancer Is Not a Reliable Surrogate End Point." Journal of Clinical Oncology 23, no. 15 (May 20, 2005): 3475–79. http://dx.doi.org/10.1200/jco.2005.06.114.
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Purpose Clinical assessment of rectal cancer response to preoperative combined-modality therapy (CMT) using digital rectal examination (DRE) has been proposed as a means of assessing efficacy of therapy. However, because the accuracy of this approach has not been established, we conducted a prospective analysis to determine the operating surgeon's ability to assess response using DRE. Patients and Methods Ninety-four prospectively accrued patients with locally advanced rectal cancer (T3/4 or N1) were evaluated with DRE and sigmoidoscopy in order to determine the following tumor characteristics: size, location, mobility, morphology, and circumference. Following preoperative CMT (50.40 Gy with fluorouracil-based chemotherapy) and under general anesthesia, the same surgeon estimated tumor response based on changes in these tumor characteristics, assessed via DRE. Percent pathologic tumor response was determined prospectively by a single pathologist using whole mount sections of the resected cancer. Results Clinical assessment using DRE underestimated pathologic response in 73 cases (78%). In addition, DRE was able to identify only 3 of 14 cases (21%) with a pathologic complete response. There were no clinical overestimates of response. None of the clinicopathologic tumor characteristics examined had a significant impact on DRE estimation of response. Conclusion Clinical examination underestimates the extent of rectal cancer response to preoperative CMT. Given the inaccuracy of DRE following preoperative CMT, it should not be used as a sole means of assessing efficacy of therapy nor for selecting patients following CMT for local surgical therapies.
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Yusuf, Rusydi Muhammad. "Refleksi Pragmatisme Amerika Dan Konsep Yin Yang pada Film The Karate Kid." Bambuti 3, no. 2 (June 3, 2022): 51–61. http://dx.doi.org/10.53744/bambuti.v3i2.29.
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Film the Karate Kid yang dibintangi oleh Dre Parker dan tuan Han, telah memberikan banyak pelajaran kepada para pemirsanya, secara tidak langsung cerita film ini mengangkat konsep pragmatisme Amerika dan konsep Yin Yang yang ada di negara China. Kedua konsep ini dicoba untuk disatukan meskipun memiliki latar belakang budaya yang berbeda. Dre Parker sebagai pemeran utama dalam film ini telah berhasil memahami dengan baik konsep Yin Yang dalam budaya China, hal ini bisa terlihat dari bagaimana Dre Parker berlatih bersama tuan Han untuk bisa mempelajari Kung Fu sekaligus mempelajari konsep Yin Yang. Konsep Ying Yang yang diajarkan kepada Dre Parker adalah melalui pelatihan mengambil jaket dengan cara berulang-ulang, di sini jelas bahwa tuan Han ingin mengajarkan kepad Dre parker tentang konsep alam semesta yang penuh engan ketengangan, cinta, disiplin, toleransi dan harmoni serta keseimbangan, semua itu dapat dipelajari melalui alam semesta. Pada tahap selanjutnya konsep pragmatisme the tough minded soul dicoba disatukan oleh tuan Han, dengan mengajak Dre Parker ke gunung Wudang untuk berlatih kung fu. Di sinilah Dre Parker belajar konsep Yin Yang dengan baik, sehingga Dre Parker bisa belajar Kungfu dengan cepat, bisa mengambil keputusan dengan tepat pada saat dia mengalami tekanan dari lawannya. Penelitian ini mempergunakan metode kualitaitf dengan mencoba mengekplorasi konsep pragmatism Amerika dan konsep Yin Yang China. Pada akhirnya bahwa setiap bangsa memiliki konsep dan pandangan hidup mereka sendiri-sendiri yang hrus dihormati dan dihargai oleh bangsa lainnya.
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de Graaf, Martin, Ruben Schulte, Fanny Peers, Fabien Waquet, L. Gijsbert Tilstra, and Piet Stammes. "Comparison of south-east Atlantic aerosol direct radiative effect over clouds from SCIAMACHY, POLDER and OMI–MODIS." Atmospheric Chemistry and Physics 20, no. 11 (June 8, 2020): 6707–23. http://dx.doi.org/10.5194/acp-20-6707-2020.
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Abstract. The direct radiative effect (DRE) of aerosols above clouds has been found to be significant over the south-east Atlantic Ocean during the African biomass burning season due to elevated smoke layers absorbing radiation above the cloud deck. So far, global climate models have been unsuccessful in reproducing the high DRE values measured by various satellite instruments. Meanwhile, the radiative effects by aerosols have been identified as the largest source of uncertainty in global climate models. In this paper, three independent satellite datasets of DRE during the biomass burning season in 2006 are compared to constrain the south-east Atlantic radiation budget. The DRE of aerosols above clouds is derived from the spectrometer SCanning Imaging Absorption spectroMeter for Atmospheric CHartographY (SCIAMACHY), the polarimeter Polarization and Directionality of the Earth's Reflectances (POLDER), and collocated measurements by the spectrometer Ozone Monitoring Instrument (OMI) and the imager Moderate Resolution Imaging Spectroradiometer (MODIS). All three datasets confirm the high DRE values during the biomass season, underlining the relevance of local aerosol effects. Differences between the instruments can be attributed mainly to sampling issues. When these are accounted for, the remaining differences can be explained by a higher cloud optical thickness (COT) derived from POLDER compared to the other instruments and a neglect of aerosol optical thickness (AOT) at shortwave infrared (SWIR) wavelengths in the method used for SCIAMACHY and OMI–MODIS. The higher COT from POLDER by itself can explain the difference found in DRE between POLDER and the other instruments. The AOT underestimation is mainly evident at high values of the aerosol DRE and accounts for about a third of the difference between POLDER and OMI–MODIS DRE. The datasets from POLDER and OMI–MODIS effectively provide lower and upper bounds for the aerosol DRE over clouds over the south-east Atlantic, which can be used to challenge global circulation models (GCMs). Comparisons of model and satellite datasets should also account for sampling issues. The complementary DRE retrievals from OMI–MODIS and POLDER may benefit from upcoming satellite missions that combine spectrometer and polarimeter measurements.
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Alqahtani, Ali, Khalid A. Asseri, Yahya I. Asiri, Krishnaraju Venkatesan, Noohu Abdulla Khan, Sirajudeen Shaik Alavudeen, Ester Mary Pappiya, et al. "Rhizoma Drynariae protects against Canaglifloxacin induced bone loss." International Journal of Current Research in Chemistry and Pharmaceutical sciences 8, no. 9 (September 3, 2021): 22–28. http://dx.doi.org/10.22192/ijcrcps.2021.08.09.004.
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Osteoporosis is a condition marked by a loss of bone mass and degradation of the bone microstructure, both of which lead to increased fragility and consequent fragility fractures, particularly in the elderly. Rhizoma Drynariae (DRE) is one of the most often used herbal remedies for osteoporosis therapy. Transdermal drug administration is a well- established new method for drug delivery that offers numerous benefits over conventional routes. Wistar albino rats were split into five groups of six rats each: vehicle control, diabeticgroup, DRE group, Canagliflozin (CGF), and CGF + DRE group. Each medication was given by gastric gavage once a day for 35 days. The drug canagliflozin appears to raise the risk of fractur. When compared to the control group, DRE treatment increased bone strength at the femoral diaphysis in osteoporotic fractures in rats by increasing ultimate load and stiffness. The goal of this study is to investigate the anti-osteoporosis effects of DRE in diabetic rats co-treated with CGF. Blood glucose levels and bone mineral density (BMD) were measured. According to the data, DRE produced a significant increase in bone amount. DRE may help prevent and cure diabetic osteoporosis by increasing bone mineral density, according to one study. Keywords: Rhizoma Drynariae Diabetic osteoporosis, Streptozotocin induced diabetes, Canagliflozin
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Lin, Jen-Chieh, Shing Hu, Pei-Hung Ho, Hwei-Jan Hsu, John H. Postlethwait, and Bon-chu Chung. "Two Zebrafish hsd3b Genes Are Distinct in Function, Expression, and Evolution." Endocrinology 156, no. 8 (August 1, 2015): 2854–62. http://dx.doi.org/10.1210/en.2014-1584.
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Abstract HSD3B catalyzes the synthesis of δ4 steroids such as progesterone in the adrenals and gonads. Individuals lacking HSD3B2 activity experience congenital adrenal hyperplasia with imbalanced steroid synthesis. To develop a zebrafish model of HSD3B deficiency, we characterized 2 zebrafish hsd3b genes. Our phylogenetic and conserved synteny analyses showed that the tandemly duplicated human HSD3B1 and HSD3B2 genes are coorthologs of zebrafish hsd3b1 on chromosome 9 (Dre9), whereas the gene called hsd3b2 resides on Dre20 in an ancestral chromosome segment, from which its ortholog was lost in the tetrapod lineage. Zebrafish hsd3b1(Dre 9) was expressed in adult gonads and headkidney, which contains interrenal glands, the zebrafish counterpart of the tetrapod adrenal. Knockdown of hsd3b1(Dre 9) caused the interrenal and anterior pituitary to expand and pigmentation to increase, resembling human HSD3B2 deficiency. The zebrafish hsd3b2(Dre 20) gene was expressed in zebrafish early embryos as maternal transcripts that disappeared 1 day after fertilization. Morpholino inactivation of hsd3b2(Dre 20) led to embryo elongation, which was rescued by the injection of hsd3b2 mRNA. Thus, zebrafish hsd3b2(Dre 20) evolved independently of hsd3b1(Dre 9) with a morphogenetic function during early embryogenesis. Zebrafish hsd3b1(Dre 9), on the contrary, functions like mammalian HSD3B2, whose deficiency leads to congenital adrenal hyperplasia.
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Carrión, Angel M., Britt Mellström, and Jose R. Naranjo. "Protein Kinase A-Dependent Derepression of the Human Prodynorphin Gene via Differential Binding to an Intragenic Silencer Element." Molecular and Cellular Biology 18, no. 12 (December 1, 1998): 6921–29. http://dx.doi.org/10.1128/mcb.18.12.6921.
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ABSTRACT Induction of the prodynorphin gene has been implicated in medium and long-term adaptation during memory acquisition and pain. By 5′ deletion mapping and site-directed mutagenesis of the human prodynorphin promoter, we demonstrate that both basal transcription and protein kinase A (PKA)-induced transcription in NB69 and SK-N-MC human neuroblastoma cells are regulated by the GAGTCAAGG sequence centered at position +40 in the 5′ untranslated region of the gene (named the DRE, for downstream regulatory element). The DRE repressed basal transcription in an orientation-independent and cell-specific manner when placed downstream from the heterologous thymidine kinase promoter. Southwestern blotting and UV cross-linking experiments with nuclear extracts from human neuroblastoma cells or human brain revealed a protein complex of approximately 110 kDa that specifically bound to the DRE. Forskolin treatment reduced binding to the DRE, and the time course paralleled that for an increase in prodynorphin gene expression. Our results suggest that under basal conditions, expression of the prodynorphin gene is repressed by occupancy of the DRE site. Upon PKA stimulation, binding to the DRE is reduced and transcription increases. We propose a model for human prodynorphin activation through PKA-dependent derepression at the DRE site.
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Denton, A., L. Hernandez-Ronquillo, J. Tellez-Zenteno, and K. Waterhouse. "P.009 Characterizing drug-resistant epilepsy in an adult cohort with new-onset epilepsy." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 46, s1 (June 2019): S16. http://dx.doi.org/10.1017/cjn.2019.110.
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Background: There are few studies exploring rates of drug resistant epilepsy in populations with new-onset epilepsy (NOE). This prospective cohort study characterizes the development of drug-resistant epilepsy (DRE) and risk factors in an adult cohort with NOE or newly-diagnosed epilepsy (NDE). Methods: Patients are from the Single Seizure Clinic (SSC) in Saskatoon, SK between 2011 and 2018. The SSC sees patients who experience their first seizure; approximately 30% are diagnosed with epilepsy. Patients were followed prospectively. We identified the following variables in the cohort: epilepsy type, seizure onset, etiology, syndromes, and rates of DRE. Inclusion criteria included patients with NO and NDE, at least 18 years at diagnosis, and a minimum 1 year of follow-up. Results: Ninety-five patients were included, 46 females and 49 males. Median age of onset was 33 years. Of those, 28.4% developed DRE. Average time between onset and DRE diagnosis was 1.44 years. Bivariate analysis identified age, gender, and cranial trauma as significant risk factors for DRE. The multivariate model was not significant. Conclusions: Our study shows that patients with new-onset epilepsy have are less likely to develop DRE compared with patients from epilepsy clinics. This study contributes valuable information about NO epilepsy in adults and the development of DRE.
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Li, Longlei, Natalie M. Mahowald, Ron L. Miller, Carlos Pérez García-Pando, Martina Klose, Douglas S. Hamilton, Maria Gonçalves Ageitos, et al. "Quantifying the range of the dust direct radiative effect due to source mineralogy uncertainty." Atmospheric Chemistry and Physics 21, no. 5 (March 17, 2021): 3973–4005. http://dx.doi.org/10.5194/acp-21-3973-2021.
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Abstract. The large uncertainty in the mineral dust direct radiative effect (DRE) hinders projections of future climate change due to anthropogenic activity. Resolving modeled dust mineral speciation allows for spatially and temporally varying refractive indices consistent with dust aerosol composition. Here, for the first time, we quantify the range in dust DRE at the top of the atmosphere (TOA) due to current uncertainties in the surface soil mineralogical content using a dust mineral-resolving climate model. We propagate observed uncertainties in soil mineral abundances from two soil mineralogy atlases along with the optical properties of each mineral into the DRE and compare the resultant range with other sources of uncertainty across six climate models. The shortwave DRE responds region-specifically to the dust burden depending on the mineral speciation and underlying shortwave surface albedo: positively when the regionally averaged annual surface albedo is larger than 0.28 and negatively otherwise. Among all minerals examined, the shortwave TOA DRE and single scattering albedo at the 0.44–0.63 µm band are most sensitive to the fractional contribution of iron oxides to the total dust composition. The global net (shortwave plus longwave) TOA DRE is estimated to be within −0.23 to +0.35 W m−2. Approximately 97 % of this range relates to uncertainty in the soil abundance of iron oxides. Representing iron oxide with solely hematite optical properties leads to an overestimation of shortwave DRE by +0.10 W m−2 at the TOA, as goethite is not as absorbing as hematite in the shortwave spectrum range. Our study highlights the importance of iron oxides to the shortwave DRE: they have a disproportionally large impact on climate considering their small atmospheric mineral mass fractional burden (∼2 %). An improved description of iron oxides, such as those planned in the Earth Surface Mineral Dust Source Investigation (EMIT), is thus essential for more accurate estimates of the dust DRE.
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Suwarba, I. Gusti Ngurah Made, Dewi Sutriani Mahalini, and I. Gusti Ngurah Agung Jayadhi Widyakusuma. "The Relationship between Hair Zinc Levels and Drug-resistant Epilepsy in Children at Sanglah Hospital." Open Access Macedonian Journal of Medical Sciences 9, B (September 21, 2021): 996–1000. http://dx.doi.org/10.3889/oamjms.2021.6729.
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BACKGROUND: Drug-resistant epilepsy (DRE) is epilepsy that is failed to achieve free of seizure after adequate trials of two tolerated and appropriately chosen antiepileptic drugs. Zinc deficiency could trigger the onset of various neurological disorders, including seizures in epilepsy. AIM: The objective of the study was to determine the relationship between hair zinc levels and DRE in children at Sanglah Hospital, Denpasar. METHODS: This is an analytic observational study using a cross-sectional design, involving 74 subjects. The inclusion criteria were children aged 1 month–18 years who had been diagnosed with epilepsy. Chi-square test and multivariate analysis with logistic regression were used to assess the relation between hair zinc levels and DRE in children. RESULTS: Multivariate analysis found a relationship between low hair zinc level and DRE in children (PR 8.0; 95% CI 2.0–32.2; p = 0.003). The duration of therapy (PR 16.0; 95% CI 3.9–65.4; p = 0.000) and structural abnormalities (PR 4.1; 95% CI 1.1–14.9; p = 0.028) also increased the risk of DRE in this study. CONCLUSION: Low hair zinc level is associated with DRE in children.
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Ford, K. G., D. P. Hornby, and W. S. al Harrasy. "Identification of direct-repeat-binding protein 1 (DRP-1), a DNA-binding protein that binds specifically to the ‘malic’ enzyme gene promoter direct repeat element." Biochemical Journal 311, no. 3 (November 1, 1995): 901–4. http://dx.doi.org/10.1042/bj3110901.
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The ‘malic’ enzyme (ME) gene promoter contains three main regulatory regions. One of these, the direct repeat element (DRE), contains tandem degenerate Sp1-binding sites separated by a 3 bp intervening sequence. We now show that a previously unreported 95 kDa protein, which we have designated DRP-1, binds strongly to the DRE region in a highly specific manner. Western-blot analysis confirms that this protein is not Sp1, which has been shown to bind to similar degenerate sites. Competitive binding assays using purified DRP-1 further reveal that neither non-specific nor Sp1-consensus-site-containing oligonucleotides can displace those complexes formed between DRP-1 and the DRE sequence, thus confirming sequence-specific binding by this protein. SDS/PAGE analysis of DRE-protein complexes isolated by direct excision and transplantation from retardation gels confirms the presence of the 95 kDa protein and, in addition, suggests that more than one binding site exists for this protein within the DRE. This is in accord with the repeated nature of the DRE DNA sequence which contains two CACC box motifs.
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Won, K. A., and H. Baumann. "The cytokine response element of the rat alpha 1-acid glycoprotein gene is a complex of several interacting regulatory sequences." Molecular and Cellular Biology 10, no. 8 (August 1990): 3965–78. http://dx.doi.org/10.1128/mcb.10.8.3965-3978.1990.
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Expression of the rat alpha 1-acid glycoprotein gene is stimulated by interleukin-1 (IL-1) and interleukin-6 (IL-6) and is synergistically enhanced by the combination of the two. The distal regulatory element (DRE), a 142-base-pair (bp) sequence located 5 kilobase pairs upstream of the transcriptional start site, appears to be crucial for this cytokine response. The cytokine-specific regulatory sequences within the DRE have been identified by inserting individual DRE subregions, selected combinations of these, or a few linker mutated fragments into a plasmid containing an enhancerless simian virus 40 promoter linked to the chloramphenicol acetyltransferase gene. The regulatory activity was determined in transiently transfected human and rat hepatoma cells. The IL-1 response region was confined to the 5'-most 62 bp of the DRE, and its function seemed to depend on at least two separate components. The same region was also responsive to phorbol ester treatment. The IL-6 regulatory function was dependent on a 54-bp sequence located within the 3' half of the DRE. When the IL-1 response region was recombined with the IL-6 regulatory region of the DRE or with IL-6 response elements of other plasma protein genes, a strong cooperative action by IL-1 and IL-6 was achieved. The functional DRE sequences were recognized by nuclear proteins extracted from rat liver and hepatoma cells. However, no cytokine-inducible binding activity was detectable, which suggests that transcriptional regulation through the DRE might be controlled by posttranslational modification of constitutively bound trans-acting factors.
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Won, K. A., and H. Baumann. "The cytokine response element of the rat alpha 1-acid glycoprotein gene is a complex of several interacting regulatory sequences." Molecular and Cellular Biology 10, no. 8 (August 1990): 3965–78. http://dx.doi.org/10.1128/mcb.10.8.3965.
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Expression of the rat alpha 1-acid glycoprotein gene is stimulated by interleukin-1 (IL-1) and interleukin-6 (IL-6) and is synergistically enhanced by the combination of the two. The distal regulatory element (DRE), a 142-base-pair (bp) sequence located 5 kilobase pairs upstream of the transcriptional start site, appears to be crucial for this cytokine response. The cytokine-specific regulatory sequences within the DRE have been identified by inserting individual DRE subregions, selected combinations of these, or a few linker mutated fragments into a plasmid containing an enhancerless simian virus 40 promoter linked to the chloramphenicol acetyltransferase gene. The regulatory activity was determined in transiently transfected human and rat hepatoma cells. The IL-1 response region was confined to the 5'-most 62 bp of the DRE, and its function seemed to depend on at least two separate components. The same region was also responsive to phorbol ester treatment. The IL-6 regulatory function was dependent on a 54-bp sequence located within the 3' half of the DRE. When the IL-1 response region was recombined with the IL-6 regulatory region of the DRE or with IL-6 response elements of other plasma protein genes, a strong cooperative action by IL-1 and IL-6 was achieved. The functional DRE sequences were recognized by nuclear proteins extracted from rat liver and hepatoma cells. However, no cytokine-inducible binding activity was detectable, which suggests that transcriptional regulation through the DRE might be controlled by posttranslational modification of constitutively bound trans-acting factors.
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Moszkowicz, David, FréDéRique Peschaud, Mostafa El Hajjam, Catherine Julié, Alain Beauchet, Christophe Penna, Bernard Nordlinger, and StéPhane Benoist. "Can We Predict Complete or Major Response after Chemoradiotherapy for Rectal Cancer by Noninvasive Methods? Results of a Prospective Study on 61 Patients." American Surgeon 80, no. 11 (November 2014): 1136–45. http://dx.doi.org/10.1177/000313481408001131.
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Rectal preservation has been proposed as an alternative to radical resection in patients with presumed complete or major response to chemoradiotherapy (CRT). The aim of this prospective study was to evaluate the accuracy of digital rectal examination (DRE) and magnetic resonance imaging (MRI) to predict major or complete rectal cancer response to CRT. Over 2 years, 61 patients underwent radical resection after CRT for rectal cancer. DRE and MRI were carried out before and 6 to 8 weeks after the end of CRT. Data from DRE and MRI post-CRT were compared with pathological examinations. At pathological examination, major/complete responses were recorded for tumors classified ypT1N0 and ypT0N0, respectively. DRE post-CRT showed major/complete response in 26 cases, of which 14 (54%) were confirmed by pathology. The positive (PPV) and negative (NPV) predictive values of DRE to predict major/complete response were 54 and 88 per cent, respectively. MRI post-CRT showed major/complete response in 12 cases, of which nine (75%) were confirmed by pathology. The PPV and NPV of MRI to predict major/complete response were 75 and 82 per cent, respectively. Data from DRE and RMI post-CRT were concordant in 45 patients. The PPV and NPV of concordant DRE and MRI to predict major/complete response were 82 and 91 per cent, respectively. DRE and MRI do not appear to be sufficiently accurate for safe selection of patients appropriate for a rectum-sparing strategy because the risk of leaving an invasive tumor untreated is 18 per cent.
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PINTO, Rodrigo Ambar, Isaac José Felippe CORRÊA NETO, Sérgio Carlos NAHAS, Ilario FROEHNER JUNIOR, Diego Fernandes Maia SOARES, and Ivan CECCONELLO. "IS THE PHYSICIAN EXPERTISE IN DIGITAL RECTAL EXAMINATION OF VALUE IN DETECTING ANAL TONE IN COMPARISON TO ANORECTAL MANOMETRY?" Arquivos de Gastroenterologia 56, no. 1 (March 2019): 79–83. http://dx.doi.org/10.1590/s0004-2803.201900000-04.
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ABSTRACT BACKGROUND: Digital rectal examination (DRE) is part of the physical examination, is also essential for the colorectal surgeon evaluation. A good DRE offers precious information related to the patient’s complaints, which will help in decision making. It is simple, quick and minimally invasive. In many centers around the world, the DRE is still the only method to evaluate the anal sphincter prior to patient’s management. On the other hand, anorectal manometry (ARM) is the main method for objective functional evaluation of anal sphincter pressures. The discrepancy of DRE depending on the examiner to determine sphincter tonus in comparison to ARM motivated this study. OBJECTIVE: To compare the DRE performed by proficient and non-experienced examiners to sphincter pressure parameters obtained at ARM, depending on examiners expertise. METHODS: Thirty-six consecutive patients with complaints of fecal incontinence or chronic constipation, from the anorectal physiology clinic of the University of São Paulo School of Medicine, were prospectively included. Each patient underwent ARM and DRE performed by two senior colorectal surgeons and one junior colorectal surgeon prior to the ARM. Patient’s history was blinded for the examiner’s knowledge, also the impressions of each examiner were blinded from the others. For the DRE rest and squeeze pressures were classified by an objective scale (DRE scoring system) that was compared to the parameters of the ARM for the analysis. The results obtained at the ARM were compared to the DRE performed by the seniors and the junior colorectal surgeons. STATISTICAL ANALYSIS: Descriptive analysis was performed for all parameters. For the rest and squeeze pressures the Gamma index was used for the comparison between the DRE and ARM, which varied from 0 to 1. The closer to 1 the better was the agreement. RESULTS: The mean age was 48 years old and 55.5% of patients were female. The agreement of rest anal pressures between the ARM and the DRE performed by the senior proficient examiners was 0.7 (CI 95%; 0.32-1.0), while for the junior non-experienced examiner was 0.52 (CI 95%; 0.09-0.96). The agreement of squeeze pressures was 0.96 (CI 95%; 0.87-1.0) for the seniors and 0.52 (CI 95%; 0.16-0.89) for the junior examiner. CONCLUSION: More experienced colorectal surgeons used to DRE had a more significant agreement with the ARM, thereafter would have more appropriate therapeutic management to patients with sphincter functional problems. ARM, therefore, persists as an important exam to objectively evaluate the sphincter complex, justifying its utility in the clinical practice.
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Li, Lihong, Jun Lu, Yan Xu, and Yuanyuan Zhao. "Changes in Pre- and Postsurgery for Drug Resistant Epilepsy: Cognition and Sleep." BioMed Research International 2022 (January 21, 2022): 1–7. http://dx.doi.org/10.1155/2022/9971780.
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Background. Most patients with drug-resistant epilepsy (DRE) have cognitive impairment and sleep disturbance. There was a significant correlation between sleep disorders and cognitive dysfunction. This study performed surgical treatment on patients with DRE and observed seizures, sleep, and cognition in patients with DRE in 6th month after operation to clarify the correlation between sleep and cognition in DRE patients.Methods. 21 individuals with DRE were recruited to enroll in this trial. Each participant completed epileptic focus resection. Seizure frequency was the principle index; the mean seizure frequency was 1 month before surgery and six months after surgery. Cognitive function was assessed by MMSE, and sleep status was assessed by PSQI and ActiGraph; assessments were performed before and 6 months after surgery. Results. There were significant differences between conditions on all outcome measures; after 6 months of surgery, compared with before treatment, the monthly average seizure frequency of DRE decreased, which was statistically significant ( P < 0.001 ) compared with that before treatment. The MMSE score of DRE patients was significantly higher than before ( P < 0.01 ), especially the ability of attention, calculation, and recall in MMSE score, which was significantly higher than before operation (respectively, P < 0.001 and P < 0.01 ). The subjective sleep evaluation index PSQI and objective measurement of sleep latency, total sleep time, and sleep efficiency of patients with DRE by ActiGraph were statistically significant (respectively, P < 0.01 ) compared with that before treatment. There was a correlation between seizure frequency and MMSE ( r = − 0.8887 , P < 0.0001 ), PSQI (0.5515, P < 0.01 ), sleep latency (0.5353, P < 0.05 ), total sleep time (-0.7814, P < 0.0001 ), and sleep efficiency (-0.4380, P < 0.05 ). Conclusions. Surgery can effectively reduce the epileptic seizures frequency in patients with DRE and indirectly improve the computational power, attention, recall ability, and sleep status of patients. However, this result did not show a correlation between improved cognitive function and sleep, so the patient’s cognitive function may be caused by surgery to improve the frequency of seizures. So, whether the improvement of patients’ sleep conditions can also significantly improve the frequency of attacks and cognitive function in patients with DRE needs further exploration.
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Every, Danielle, and John Richardson. "A framework for disaster resilience education with homeless communities." Disaster Prevention and Management: An International Journal 27, no. 2 (April 3, 2018): 146–58. http://dx.doi.org/10.1108/dpm-08-2017-0196.
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Purpose The purpose of this paper is to propose a practice framework for disaster resilience education (DRE) with homeless communities. Design/methodology/approach A survey with 163 homeless service providers together with 45 interviews with people with a lived experience of homelessness, homeless service providers and emergency services. Findings Key principles for DRE with the homeless community were: safe relationships, collaboration, strengths-based, empowerment, providing essential resources, and inclusivity. Recommendations for the design of DRE foregrounded partnerships and knowledge sharing between the homeless community and emergency services. Locally relevant risk information and material supports, together with sharing stories and eliciting values were important considerations for developing DRE content. Preferred delivery methods were outreach to build on trusted relationships and existing services, together with written material in large font emphasising images for distribution through drop in centres, food vans and new tenancy packages. Practical implications The key principles, together with the detailed suggestions outlining ways to translate the principles into actions, can be used by emergency and homeless services to develop effective DRE materials and programmes. Social implications The proposed DRE framework aims to not only enhance disaster risk knowledge, but also address the exclusion, isolation and disempowerment experienced by people who are homeless. By building on an effective intervention models within homeless services (Trauma-Informed Care) DRE can enhance the social connection, self-confidence and well-being goals of homeless services and clients. Originality/value The DRE framework is based on the first comprehensive Australian research with homeless services, clients and emergency managers on best practice for improving extreme weather preparedness in the homeless community.
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Deng, Qiuxia, Na Zhao, Xiaoying Ru, Ruijuan Hao, Bo Zhang, and Chunhua Zhu. "Sex-Inclined Piwi-Interacting RNAs in Serum Exosomes for Sex Determination in the Greater Amberjack (Seriola dumerili)." International Journal of Molecular Sciences 24, no. 4 (February 8, 2023): 3438. http://dx.doi.org/10.3390/ijms24043438.
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The greater amberjack (Seriola dumerili) is a gonochoristic fish with no sexual dimorphism in appearance, making sex identification difficult. Piwi-interacting RNAs (piRNAs) function in transposon silencing and gametogenesis and are involved in various physiological processes, including sex development and differentiation. Exosomal piRNAs can be indicators for the determination of sex and physiological status. In this study, four piRNAs were differentially expressed in both serum exosomes and gonads between male and female greater amberjack. Three piRNAs (piR-dre-32793, piR-dre-5797, and piR-dre-73318) were significantly up-regulated and piR-dre-332 was significantly down-regulated in serum exosomes and gonads of male fish, compared to female fish, consistent with the serum exosomal results. According to the relative expression of four marker piRNAs derived from the serum exosomes of greater amberjack, the highest relative expression of piR-dre-32793, piR-dre-5797, and piR-dre-73318 in seven female fish and that of piR-dre-332 in seven male fish can be used as the standard for sex determination. The method of sex identification can ascertain the sex of greater amberjack by blood collection from the living body, without sacrificing fish. The four piRNAs did not show sex-inclined expression in the hypothalamus, pituitary, heart, liver, intestine, and muscle tissue. A piRNA–target interaction network involving 32 piRNA-mRNA pairs was generated. Sex-related target genes were enriched in sex-related pathways, including oocyte meiosis, transforming growth factor-beta signaling pathway, progesterone-mediated oocyte maturation, and gonadotropin releasing hormone signaling pathway. These results provide a basis for sex determination in greater amberjack and improve our understanding of the mechanisms underlying sex development and differentiation in the species.
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Parthasarathi, Theivasigamani, Koothan Vanitha, Sendass Mohandass, and Eli Vered. "Mitigation of methane gas emission in rice by drip irrigation." F1000Research 8 (November 28, 2019): 2023. http://dx.doi.org/10.12688/f1000research.20945.1.
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Background: Rice farming faces major challenges, including water limitation, drought and climate change in the current scenario of agriculture. Among the innovative water-saving techniques, drip irrigation is a forerunner, with maximized water-saving potential, increased grain yield and methane mitigation. Methods: A field experiment was conducted comprising four different drip irrigation practices: (i) sub-surface drip irrigation (SDI) with 1.0 litre per hour (lph) discharge rate emitters (DRE) (SDI+1.0 lph DRE) (ii) SDI+0.6 lph DRE, (iii) surface drip irrigation (DI) with 1.0 lph discharge rate emitters (DI+1.0 lph DRE), (iv) DI+0.6 lph DRE and were compared with (v) a conventional flood aerobic irrigation (considered conventional). Results: The estimated grain yield of rice was found to be 23.5%, 20.3%, and 15.1% higher under SDI+1.0 lph DRE, SDI+0.6 lph DRE and DI+1.0 lph DRE practices, respectively, than the conventional method. A water saving of 23.3% was also observed for all drip practices compared with conventional practices. Seasonal methane emission flux declined 78.0% in the drip methods over the conventional irrigation: better mitigation than previously reported values (alternate wetting and drying (47.5%) and system of rice intensification (29.0%) practices). Continuous soil aeration and enhanced soil methanotrophs (P<0.05) limit the peak methane emission in rice during the flowering phase in drip irrigation, which is reflected in the methane emission flux values. Consequently, the equivalent CO2 (CO2-eq) emissions and yield-scaled CO2 eq-emission were found to be significantly lower in SDI (43.8% and 49.5%, respectively), and DI (25.1% and 26.7%, respectively) methods as compared with the conventional that ensures better methane mitigation and future climate-smart rice production systems. Conclusions: Drip irrigation could reduce the cumulative methane emission in aerobically grown rice. SDI + 1.0 lph DRE practice can be applied in areas with inadequate water availability and effective in reducing the CO2-eq emission with better yield than conventional.
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Moorthy, Dr H. Krishna, Biju S Pillai, and Sony Bhaskar Mehta. "Digital Rectal Examination of Prostrate : Does Examiner's Experience influence the Results ?" American Research Journal of Urology 4, no. 1 (December 27, 2020): 1–3. http://dx.doi.org/10.21694/2575-7148.20003.
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There is lack of uniformity in grading the size or assessing the consistency of prostate gland with Digital Rectal Examination (DRE) when done by different clinicians during evaluation of prostate pathology. This study was to compare the results of DRE findings in prostate pathology performed by Urologists at three different levels of clinical practice in the same set of patients and assess the accuracy of the findings with respect to their clinical experience. Materials and Methods: 200 patients with clinical features of prostatomegaly having no documented Urinary Tract Infection were subjected to DRE separately by one Resident in his Final year of training, Junior Consultant (5 years post degree) and Senior Consultant with more than 10 years clinical experience. Their findings were correlated with USG Abdomen estimated volume. Patients with DRE detected hard area in the prostate underwent Trans-rectal tru-cut biopsy of the hard area in the prostate and the biopsy reports were again correlated with the clinical findings. Results: DRE grades assessed by Final year Resident correlated with USG Abdomen estimated volume in 63%, while the same for Junior Consultant was 69% and that for Senior Consultant was 71%. The percentage correlation was better with smaller clinical size of the prostate when the overall DRE assessment of the prostate volume by the three sets of observers was compared to USG Abdomen prostate volume. There was also error in diagnosing abnormal texture of the prostate by Final year Resident in a significant number of patients. Conclusions: There were significant variations in DRE findings of prostate among clinicians, with the accuracy improving with increase in clinician’s experience. DRE findings should always be supplemented with other investigations before a final conclusion regarding the prostate pathology is made.
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Miszewska, Dominika, Monika Sugalska, and Sergiusz Jóźwiak. "Risk Factors Associated with Refractory Epilepsy in Patients with Tuberous Sclerosis Complex: A Systematic Review." Journal of Clinical Medicine 10, no. 23 (November 24, 2021): 5495. http://dx.doi.org/10.3390/jcm10235495.
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Background: Epilepsy affects 70–90% of patients with tuberous sclerosis complex (TSC). In one-third of them, the seizures become refractory to treatment. Drug-resistant epilepsy (DRE) carries a significant educational, social, cognitive, and economic burden. Therefore, determining risk factors that increase the odds of refractory seizures is needed. We reviewed current data on risk factors associated with DRE in patients with tuberous sclerosis. Methods: The review was performed according to the PRISMA guidelines. Embase, Cochrane Library, MEDLINE, and ClinicalTrial.gov databases were searched. Only full-text journal articles on patients with TSC which defined risk factors related to DRE were included. Results: Twenty articles were identified, with a cohort size between 6 and 1546. Seven studies were prospective. Three factors appear to significantly increase DRE risk: TSC2 mutation, infantile spasms, and a high number of cortical tubers. Conclusions: A proper MRI and EEG monitoring, along with genetic testing, and close observation of individuals with early onset of seizures, allow identification of the patients at risk of DRE.
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Marschalek, R., J. Hofmann, G. Schumann, R. Gösseringer, and T. Dingermann. "Structure of DRE, a retrotransposable element which integrates with position specificity upstream of Dictyostelium discoideum tRNA genes." Molecular and Cellular Biology 12, no. 1 (January 1992): 229–39. http://dx.doi.org/10.1128/mcb.12.1.229-239.1992.
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Different Dictyostelium discoideum strains contain between 2 and 200 copies of a retrotransposable element termed DRE (Dictyostelium repetitive element). From the analysis of more than 50 elements, it can be concluded that DRE elements always occur 50 +/- 3 nucleotides upstream of tRNA genes. All analyzed clones contain DRE in a constant orientation relative to the tRNA gene, implying orientation specificity as well as position specificity. DRE contains two open reading frames which are flanked by nonidentical terminal repeats. Long terminal repeats (LTRs) are composed of three distinct modules, called A, B, and C. The tRNA gene-proximal LTR is characterized by one or multiple A modules followed by a single B module (AnB). With respect to the distal LTR, two different subforms of DRE have been isolated. The majority of isolated clones contains a distal LTR composed of a B module followed by a C module (BC), whereas the distal LTR of the other subform contains a consecutive array of a B module, a C module, a slightly altered A module, another B module, and another C module (BC.ABC). Full-length as well as smaller transcripts from DRE elements have been detected, but in comparison with the high copy number in D. discoideum strains derived from the wild-type strain NC4, transcription is rather poor.
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Marschalek, R., J. Hofmann, G. Schumann, R. Gösseringer, and T. Dingermann. "Structure of DRE, a retrotransposable element which integrates with position specificity upstream of Dictyostelium discoideum tRNA genes." Molecular and Cellular Biology 12, no. 1 (January 1992): 229–39. http://dx.doi.org/10.1128/mcb.12.1.229.
Full textAbstract:
Different Dictyostelium discoideum strains contain between 2 and 200 copies of a retrotransposable element termed DRE (Dictyostelium repetitive element). From the analysis of more than 50 elements, it can be concluded that DRE elements always occur 50 +/- 3 nucleotides upstream of tRNA genes. All analyzed clones contain DRE in a constant orientation relative to the tRNA gene, implying orientation specificity as well as position specificity. DRE contains two open reading frames which are flanked by nonidentical terminal repeats. Long terminal repeats (LTRs) are composed of three distinct modules, called A, B, and C. The tRNA gene-proximal LTR is characterized by one or multiple A modules followed by a single B module (AnB). With respect to the distal LTR, two different subforms of DRE have been isolated. The majority of isolated clones contains a distal LTR composed of a B module followed by a C module (BC), whereas the distal LTR of the other subform contains a consecutive array of a B module, a C module, a slightly altered A module, another B module, and another C module (BC.ABC). Full-length as well as smaller transcripts from DRE elements have been detected, but in comparison with the high copy number in D. discoideum strains derived from the wild-type strain NC4, transcription is rather poor.
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Fini, M., G. Vagliani, A. Perrone, G. Salvi, G. Misuriello, A. Di Silverio, and M. Milani. "Validity of Transrectal Ultrasonography in the Early Diagnosis and Staging of Prostatic Cancer." Urologia Journal 59, no. 2 (April 1992): 59–65. http://dx.doi.org/10.1177/039156039205900214.
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In 3 years of mass screening for early diagnosis of prostatic cancer, 57 tumors were found (57/5000, for a detection rate of 1.2%). Patients first underwent digital rectal examination (DRE): at present the least expensive, least invasive and most effective way to diagnose prostatic cancer. 420 men underwent transrectal ultrasonography (TRUS) with a 5 MHz transverse and longitudinal transducer for pathological digital rectal findings, obstructive symptoms and other reasons. Prostatic biopsy was performed in 190 patients with DRE findings and/or hypoechoic zones of the prostatic gland (transrectal digitally directed or ultrasonically perineal guided biopsies). The specificity, sensitivity and prediction capacity of DRE and TRUS in this group of patients was evaluated. Sensitivity of DRE was 92%, specificity 42% (usual finding for mass screening); predictive positive value was 41 %, negative 93%. Sensitivity of TRUS was 77%, specificity 57%, predictive positive value was 44%, negative 86%. Data seem to confirm the ability of TRUS to reduce the number of “false positives” after DRE (and consequently the number of biopsies). However, contraindications for use in mass screenings are: sensitivity lower than with DRE, high false positive rate and prohibitive cost for systematic use. Validity of TRUS is confirmed in clinical staging for the selection of patients undergoing radical retropubic prostatectomy, by comparison with local pathological staging.
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Nensi, Alysha, and Nilesh Chande. "A Survey of Digital Rectal Examination Training in Canadian Medical Schools." Canadian Journal of Gastroenterology 26, no. 7 (2012): 441–44. http://dx.doi.org/10.1155/2012/681357.
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BACKGROUND: The digital rectal examination (DRE) is important for the diagnosis of a variety of gastrointestinal, urological and gynecological disorders. However, it appears that Canadian medical students may not be adequately taught nor provided the opportunity to practice their skills often enough. The present study was an analysis of the current practices in DRE teaching and evaluation in undergraduate medicine programs across Canada.METHODS: Clinical skills coordinators from the 14 English-speaking medical schools in Canada were invited to participate in the survey and to respond to questions regarding DRE teaching at their respective schools.RESULTS: Thirteen of the 14 schools (93%) responded to the survey. The DRE is taught in various ways: 69% of schools use anatomical rectal models, 62% use video tutorials and 62% involve physician instruction. Most schools (85%) offer one formal teaching session before clerkship. Generally, there is no formal DRE teaching session during clerkship. Preclerkship students in 62% of the schools perform ≤1 DRE during their training, and clinical skills coordinators in 85% of the schools expected that clerkship students perform ≤2. The training is evaluated in a variety of ways, with most schools (77%) only requiring mandatory attendance.DISCUSSION: Although a variety of techniques are used to teach and evaluate DRE training in Canadian medical schools, students are performing very few DREs before graduation. Medical schools should objectively evaluate proficiency to give meaningful feedback and improve competence in their students as well as provide more opportunities for students to obtain the necessary experience performing DREs during their clinical training.
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Caetano, Ana C., André Santa-Cruz, and Carla Rolanda. "Digital Rectal Examination and Balloon Expulsion Test in the Study of Defecatory Disorders: Are They Suitable as Screening or Excluding Tests?" Canadian Journal of Gastroenterology and Hepatology 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/8654314.
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Background. Rome III criteria add physiological criteria to symptom-based criteria of chronic constipation (CC) for the diagnosis of defecatory disorders (DD). However, a gold-standard test is still lacking and physiological examination is expensive and time-consuming. Aim. Evaluate the usefulness of two low-cost tests—digital rectal examination (DRE) and balloon expulsion test (BET)—as screening or excluding tests of DD. Methods. We performed a systematic search in PUBMED and MEDLINE. We selected studies where constipated patients were evaluated by DRE or BET. Heterogeneity was assessed and random effect models were used to calculate the sensitivity, specificity, and negative predictive value (NPV) of the DRE and the BET. Results. Thirteen studies evaluating BET and four studies evaluating DRE (2329 patients) were selected. High heterogeneity (I2>80%) among studies was demonstrated. The studies evaluating the BET showed a sensitivity and specificity of 67% and 80%, respectively. Regarding the DRE, a sensitivity of 80% and specificity of 84% were calculated. NPV of 72% for the BET and NPV of 64% for the DRE were estimated. The sensitivity and specificity were similar when we restrict the analysis to studies using Rome criteria to define CC. The BET seems to perform better when a cut-off time of 2 minutes is used and when it is compared with a combination of physiological tests. Considering the DRE, strict criteria seem to improve the sensitivity but not the specificity of the test. Conclusion. Neither of the low-cost tests seems suitable for screening or excluding DD.
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Harijan, Pooja, Arnab Kumar Seal, Manish Prasad, and William P. Whitehouse. "Fifteen-minute consultation: When medicines don’t work—the child with poorly controlled seizures." Archives of disease in childhood - Education & practice edition 104, no. 3 (November 24, 2018): 135–40. http://dx.doi.org/10.1136/archdischild-2018-316035.
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Drug-resistant epilepsy (DRE) occurs in 20%–30% of children with epilepsy with significant impact on their quality of life. Management of this group of children has greatly improved in the recent years with streamlining of epilepsy surgery services and associated quaternary multimodal evaluation. This article provides a review of DRE in children and management based on recent evidence and published opinion. We have also presented an algorithmic approach to the child with possible DRE.
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Dewey, M. J., C. Rheaume, F. G. Berger, and H. Baumann. "Inducible and tissue-specific expression of rat alpha-1-acid glycoprotein in transgenic mice." Journal of Immunology 144, no. 11 (June 1, 1990): 4392–98. http://dx.doi.org/10.4049/jimmunol.144.11.4392.
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Abstract alpha-1-Acid glycoprotein (AGP), which is produced in the mammalian liver and secreted into the blood-stream, is regulated by steroid hormones and by mediators of the acute phase response. In vitro transfection studies have shown that the response to glucocorticoids requires a cis-acting regulatory element, termed the glucocorticoid response element, that is located within 120 bp of the transcriptional start-site of the gene; induction by the acute phase mediators requires a different element, termed the distal regulatory element (DRE), that is located about 5 kb upstream of the start-site. To determine if these elements function in vivo, we have produced and characterized transgenic mice containing rat AGP gene constructs with and without the DRE. Five transgenic lines were produced from a 9.5-kb genomic AGP containing 4.7 kb of the 5' flanking region; this construct lacks the DRE. Another transgenic line was derived from a 10.7-kb clone that contains 5.3 kb of 5' flanking sequences including the DRE. All transgenic mice produced high levels of immunologically detectable rat AGP in the circulation, comparable to or in excess of that found in normal rats. There were correspondingly high concentrations of rat AGP transcripts in the liver. Transgene expression in all lines was induced in response to dexamethasone and during acute inflammation resulting from LPS treatment. The DRE-containing transgene underwent a greater induction in response to LPS than to dexamethasone; the transgene lacking the DRE responded similarly to both treatments. In cultured primary hepatocytes, the DRE-containing transgene was induced by the acute phase cytokines IL-1 and IL-6, and by dexamethasone, administered individually or in combination; the transgene lacking the DRE responded only to dexamethasone, and was not affected by the peptide hormones. Together, these results provide in vivo evidence supporting the notion that a minimum of two upstream sequences are responsible for the inflammatory induction of rat AGP. One element, which is located within the smaller 9.7-kb restriction fragment, is responsive to glucocorticoids and is likely to be the glucocorticoid response element located close to the transcriptional start site. The other element, the DRE, is located much further upstream and is responsible for imparting responsiveness to the acute phase cytokines.
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Cooper, Cynthia. "Dior: A New Look, A New Enterprise (1947–1957)." Dress 36, no. 1 (November 2010): 90–92. http://dx.doi.org/10.1179/dre.2010.36.1.90.
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Melvin, Andrea. "Emily Dickinson and the Labor of Clothing Edith Wharton and the Making of Fashion." Dress 36, no. 1 (November 2010): 96–98. http://dx.doi.org/10.1179/dre.2010.36.1.96.
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E. Martinez, Iulo S. Barauna Filho,, José. "Evaluation of the quality of life in Brazilian women with fibromyalgia, through the medical outcome survey 36 item short-form study." Disability and Rehabilitation 23, no. 2 (January 2001): 64–68. http://dx.doi.org/10.1080/dre.23.2.64.68.
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Pentland, Deborah J. Hellawell, Brian. "Relatives' reports of long term problems following traumatic brain injury or subarachnoid haemorrhage." Disability and Rehabilitation 23, no. 7 (January 2001): 300–305. http://dx.doi.org/10.1080/dre.23.7.300.305.
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ROUTHIER, FRANÇOIS, CLAUDE VINCENT, JOHANNE DESROSIERS, and SYLVIE NADEAU. "Mobility of wheelchair users: a proposed performance assessment framework." Disability and Rehabilitation 25, no. 1 (January 2003): 19–34. http://dx.doi.org/10.1080/dre.25.1.19.34.
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CHIU, A. Y. Y., S. S. Y. AU-YEUNG, and S. K. LO. "A comparison of four functional tests in discriminating fallers from non-fallers in older people." Disability and Rehabilitation 25, no. 1 (January 2003): 45–50. http://dx.doi.org/10.1080/dre.25.1.45.50.
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