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Johansson, Annie-Maj, and Per-Olof Wickman. "Vad ska elever lära sig angående naturvetenskaplig verksamhet? - En analys av svenska läroplaner för grundskolan under 50 år. "What should students learn about scientific inquiry? A comparative study of 50 years of the Swedish national curricula."." Nordic Studies in Science Education 8, no. 3 (December 12, 2012): 197–212. http://dx.doi.org/10.5617/nordina.528.
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The purpose of this study is to contribute to an understanding of which changes related to scientific inquiry have been made historically in curriculum documents. A comparative analysis is made of five Swedish national curricula– Lgr 62, Lgr 69, Lgr 80, Lpo 94 and Lgr 11 – during the last 50 years regarding what compulsory school students (school years 1–9) should learn about scientific inquiry. It focuses 1) what students should learn about carrying out scientific inquiries, and 2) what students should learn about the nature of science. All of the curricula examined have aims concerning scientific inquiry. The results show that during the period there have been many shifts in emphasis and changes of aims, for example from learning an inductive method to a more deductive one, and from an emphasis on carrying out investigations to an emphasis on more conceptual understanding of scientific investigations. Because teaching traditions tend to conserve aspects of earlier curricula, it is discussed how the results can help teachers, teacher students and curriculum developers to better see the consequences of the changes for teaching and learning.
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Bishop, S. C., J. S. Broadbent, R. M. Kay, I. Rigby, and A. V. Fisher. "The performance of Hereford × Friesian offspring of bulls selected for lean growth rate and lean food conversion efficiency." Animal Science 54, no. 1 (February 1992): 23–30. http://dx.doi.org/10.1017/s0003356100020523.
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AbstractThe performance of Hereford × Friesian calves sired by Hereford bulls selected for either lean growth rate (LGR) or lean food conversion ratio (LFCR), or by unselected Hereford bulls, was evaluated on 327 calves on three farms over 2 years. Animals started test at 130 days of age on average and remained on test for approximately 300 days, whereupon all animals were slaughtered and carcass dissections were undertaken. Individual food intake was measured on tioo of the farms (189 animals), but only intake per pen of animals was measured on the third farm and individual food intake had to be estimated. LGR, LFCR and other traits describing performance were calculated from the growth, food intake and carcass composition data.If no breed or environment interactions exist it is expected that proportionately 0-5 of the genetic differences between selected and control line bulls would be transmitted to their offspring. For the LGR and LFCR line bulls these values were 0·38 and 0·44, respectively, however the LGR value had a much smaller confidence interval. Genetic correlations derived from regressing breeding values predicted from offspring performance on breeding values predicted from the bulk's own performance in the selection experiment were 0·62 (s.e. 0·28) and 0·96 (s.e. 0·28) for LGR and LFCR, respectively. Heritabilities were: live-weight gain on test, 0·27; daily gain, 0·48; food intake, 0·06; food conversion ratio, 0·46; predicted carcass lean content, 0·10; killing-out proportion, 0·10; LGR, 0·36 and LFCR, 0·48.
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Emanuelsson, B. D., W. T. Baisden, N. A. N. Bertler, E. D. Keller, and V. Gkinis. "High-resolution continuous flow analysis setup for water isotopic measurement from ice cores using laser spectroscopy." Atmospheric Measurement Techniques Discussions 7, no. 12 (December 2, 2014): 12081–124. http://dx.doi.org/10.5194/amtd-7-12081-2014.
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Abstract. Here we present an experimental setup for water stable isotopes (δ18O and δD) continuous flow measurements. It is the first continuous flow laser spectroscopy system that is using Off-Axis Integrated Cavity Output Spectroscopy (OA-ICOS; analyzer manufactured by Los Gatos Research – LGR) in combination with an evaporation unit to continuously analyze sample from an ice core. A Water Vapor Isotopic Standard Source (WVISS) calibration unit, manufactured by LGR, was modified to: (1) increase the temporal resolution by reducing the response time (2) enable measurements on several water standards, and (3) to reduce the influence from memory effects. While this setup was designed for the Continuous Flow Analysis (CFA) of ice cores, it can also continuously analyze other liquid or vapor sources. The modified setup provides a shorter response time (~54 and 18 s for 2013 and 2014 setup, respectively) compared to the original WVISS unit (~62 s), which is an improvement in measurement resolution. Another improvement compared to the original WVISS is that the modified setup has a reduced memory effect. Stability tests comparing the modified WVISS and WVISS setups were performed and Allan deviations (σAllan) were calculated to determine precision at different averaging times. For the 2013 modified setup the precision after integration times of 103 s are 0.060 and 0.070‰ for δ18O and δD, respectively. For the WVISS setup the corresponding σAllan values are 0.030, 0.060 and 0.043‰ for δ18O, δD and δ17O, respectively. For the WVISS setup the precision is 0.035, 0.070 and 0.042‰ after 103 s for δ18O, δD and δ17O, respectively. Both the modified setups and WVISS setup are influenced by instrumental drift with δ18O being more drift sensitive than δD. The σAllan values for δ18O of 0.30 and 0.18‰ for the modified (2013) and WVISS setup, respectively after averaging times of 104 s (2.78 h). The Isotopic Water Analyzer (IWA)-modified WVISS setup used during the 2013 Roosevelt Island Climate Evolution (RICE) ice core processing campaign achieved high precision measurements, in particular for δD, with high temporal resolution for the upper part of the core, where a seasonally resolved isotopic signal is preserved.
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Emanuelsson, B. D., W. T. Baisden, N. A. N. Bertler, E. D. Keller, and V. Gkinis. "High-resolution continuous-flow analysis setup for water isotopic measurement from ice cores using laser spectroscopy." Atmospheric Measurement Techniques 8, no. 7 (July 17, 2015): 2869–83. http://dx.doi.org/10.5194/amt-8-2869-2015.
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Abstract. Here we present an experimental setup for water stable isotope (δ18O and δD) continuous-flow measurements and provide metrics defining the performance of the setup during a major ice core measurement campaign (Roosevelt Island Climate Evolution; RICE). We also use the metrics to compare alternate systems. Our setup is the first continuous-flow laser spectroscopy system that is using off-axis integrated cavity output spectroscopy (OA-ICOS; analyzer manufactured by Los Gatos Research, LGR) in combination with an evaporation unit to continuously analyze water samples from an ice core. A Water Vapor Isotope Standard Source (WVISS) calibration unit, manufactured by LGR, was modified to (1) enable measurements on several water standards, (2) increase the temporal resolution by reducing the response time and (3) reduce the influence from memory effects. While this setup was designed for the continuous-flow analysis (CFA) of ice cores, it can also continuously analyze other liquid or vapor sources. The custom setups provide a shorter response time (~ 54 and 18 s for 2013 and 2014 setup, respectively) compared to the original WVISS unit (~ 62 s), which is an improvement in measurement resolution. Another improvement compared to the original WVISS is that the custom setups have a reduced memory effect. Stability tests comparing the custom and WVISS setups were performed and Allan deviations (σAllan) were calculated to determine precision at different averaging times. For the custom 2013 setup the precision after integration times of 103 s is 0.060 and 0.070 ‰ for δ18O and δD, respectively. The corresponding σAllan values for the custom 2014 setup are 0.030, 0.060 and 0.043 ‰ for δ18O, δD and δ17O, respectively. For the WVISS setup the precision is 0.035, 0.070 and 0.042 ‰ after 103 s for δ18O, δD and δ17O, respectively. Both the custom setups and WVISS setup are influenced by instrumental drift with δ18O being more drift sensitive than δD. The σAllan values for δ18O are 0.30 and 0.18 ‰ for the custom 2013 and WVISS setup, respectively, after averaging times of 104 s (2.78 h). Using response time tests and stability tests, we show that the custom setups are more responsive (shorter response time), whereas the University of Copenhagen (UC) setup is more stable. More broadly, comparisons of different setups address the challenge of integrating vaporizer/spectrometer isotope measurement systems into a CFA campaign with many other analytical instruments.
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Toro, Victor, and Clarissa Aguilar. "LGG-62. SEIZURES IN LOW-GRADE GLIOMAS: CLINICAL AND HISTOPATHOLOGICAL CHARACTERISTICS." Neuro-Oncology 20, suppl_2 (June 2018): i117—i118. http://dx.doi.org/10.1093/neuonc/noy059.401.
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Nitrini, Ricardo, and A. Spina-França. "Penicilinoterapia intravenosa em altas doses na neurossífilis: estudo de 62 casos II. Avaliação do líqüido cefalorraqueano." Arquivos de Neuro-Psiquiatria 45, no. 3 (September 1987): 231–41. http://dx.doi.org/10.1590/s0004-282x1987000300003.
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Sessenta e dois casos de neurossífilis sintomática foram tratados com penicilina G, na dose diária de 20 ou 24 milhões de UI. por via intravenosa, durante 15 a 30 dias. O tempo médio de acompanhamento foi de 30 meses. Antes do tratamento, 41 pacientes apresentavam pleocitose ao exame do LCR. Seis meses e doze ou mais meses depois, foi constatada pleocitose em 4 (9,8%) e em 3 pacientes (7,3%), respectivamente. A proteinorraquia e os títulos das reações de Wassermann do soro e do LCR reduziram-se lentamente depois do tratamento. O teor de globulinas gama do LCR e os índices de imunoprodução local do sistema LCR ainda encontravam-se elevados depois do primeiro ano após tratamento. Os resultados da penicilinoterapia intravenosa em altas doses constatados neste estudo não diferiram daqueles obtidos com penicilinoterapia intramuscular em baixas doses registrados na literatura.
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Saleeva, D. V., and G. D. Zasukhina. "Prospects for using low-dose radiation in the complex therapy for COVID-19." Problems of Virology 66, no. 4 (September 18, 2021): 252–58. http://dx.doi.org/10.36233/0507-4088-62.
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This review presents the literature data of new approaches for the treatment of COVID-19 with low doses of radiation (LDR). In addition, data on the use of LDR for the treatment of various disorders, in particular pneumonia, a number of inflammatory processes of various etiology, as well as Alzheimer’s disease are discussed. The mechanisms of LDR action are briefly described, associated with the activation of the immune system and antiinflammatory response due to the effect on the processes of oxidative stress, which is reflected in an increase in the activity of cytokines (interleukin- (IL-) 6), changes in the expression of a number of genes (such as P53 and NF-κB (p65)) and long non-coding RNAs (ncRNAs) (the authors’ own data are presented). Based on the analysis of the material presented, it can be assumed that further clinical trials of the effect of MDR (5–10 cGy) on patients with COVID-19, who are at different stages of the disease, will reveal the optimal conditions for the development and use of an effective treatment regimen.
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Da Silva, Adriano da, Rafael José Resende, Tamires Cristina Costa, Bárbara Viviane Oliveira de Sousa, Anderson Kenedy Santos, Braz De Souza Marotti, Saulo Luís da Silva, Adriano Cancelier, and Daniel Bonoto Gonçalves. "ANÁLISE DO POTENCIAL BIOCATALÍTICO DE LIPASE DE CANDIDA RUGOSA IMOBILIZADA EM DIFERENTES SUPORTES." Revista Acta Ambiental Catarinense 18, no. 1 (October 14, 2020): 10–23. http://dx.doi.org/10.24021/raac.v18i1.5505.
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Neste trabalho é avaliado o potencial biocatalítico da lipase de Candida rugosa (LCR) imobilizada em diferentes suportes: carvão ativado, gesso comercial e sílica gel, visando a produção de biodiesel. O método de imobilização por adsorção foi utilizado na imobilização da LCR nos suportes. A eficiência de imobilização expressa em termos da razão entre a atividade do complexo suporte-LCR e atividade da enzima livre, foram estimados, fornecendo eficiência de 89% para o carvão ativado-LCR, 62% para a sílica gel-LCR e 48% para o gesso-LCR. O complexo carvão ativado-LCR forneceu o maior índice de acidez. A análise por cromatografia de camada delgada do biodiesel produzido por este complexo apresentou fatores de retenção e ordem de eluição dos acilgliceróis compatíveis com a literatura, indicando um potencial deste complexo para a produção de biodiesel.
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Spiridon, Andreea Georgiana, Mădălina Viciriuc, Cristina Vasilița, Alexandru Pintilioaie, and Ovidiu Popovici. "Two genera of platygastroids (Hymenoptera: Platygastroidea) new to the Romanian fauna." Travaux du Muséum National d’Histoire Naturelle “Grigore Antipa” 62, no. 2 (December 31, 2019): 213–20. http://dx.doi.org/10.3897/travaux.62.e38298.
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This study presents the genera Iphitrachelus Haliday, 1836 and Baryconus Förster, 1856 with the species B. graeffei (Kieffer, 1908), I. lar Haliday, 1836 and I. gracilis Masner, 1957 as new records for the Romanian fauna.
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Marques Boni, Adalgisa Cristina, Halana Carolina Maia, and Marina Peccinin Barbosa. "A importância da prontidão para ler e escrever." Revista Contemporânea de Educação 13, no. 28 (December 12, 2018): 631–47. http://dx.doi.org/10.20500/rce.v13i26.16634.
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Este estudo teve como objetivo descobrir, através da avaliação e da análise das áreas psicomotora, cognitiva e linguística, se as crianças do 1º ano do Ensino Fundamental I (EFI) precisam desenvolver habilidades para aquisição da leitura e da escrita. 62 crianças do 1º ano do EFI da rede pública da cidade de Limeira efetuaram um Protocolo de Avaliação sobre as habilidades psicomotoras/cognitivas e linguísticas. Observou-se que as habilidades estudadas interferiram na qualidade do processo de alfabetização e não diretamente no aprender ou não a ler e escrever. Assim, corrobora-se a importância de incorporação de atividades voltadas para estas habilidades durante a Educação Infantil e no início do Ensino Fundamental I.
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Bruck, L., S. A. Antoniuk, E. Wittig, and A. Accorsi. "Neurocisticercose na infância: I. diagnóstico clinico e laboratorial." Arquivos de Neuro-Psiquiatria 49, no. 1 (March 1991): 43–46. http://dx.doi.org/10.1590/s0004-282x1991000100006.
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Foram revisados aspectos clínicos e laboratoriais de 34 casos de neurocisticercose na infância (15 meses a 13 anos). Os principais sintomas foram: hipertensão intracraniana, 21 casos (62%); epilepsia, 20 casos (59%); hemiplegia, 4 casos (12%). A tomografia computadorizada de crânio (TAC) (33 pacientes) mostrou cistos em atividade em 26 (79%) e calcificações em 2 (6%). A reação de fixação de complemento ou imunofluorescência para cisticercose foi reagente em 77% no LCR (20/26 pacientes) e 78% no soro (18/23 pacientes). Pleocitose no LCR ocorreu em 57% dos casos (15/26 pacientes) e eosinofilorraquia em 27% (7/26 pacientes). A TAC foi o melhor exame para o diagnóstico, confirmado pelos testes imunológicos no LCR e soro.
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Montes, Vizmary, Turki Elarjani, Sami Khairy, David Pinilla, Helena Benito, and Estella Llado. "Valuableness of introduction of laryngeal abductor reflex intraoperative neuromonitoring technique in lower brainstem lesion." Surgical Neurology International 11 (December 11, 2020): 425. http://dx.doi.org/10.25259/sni_431_2020.
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Background: Our aim is to evaluate the use of laryngeal adductor reflex (LAR) for posterior fossa and brainstem surgeries in conjunction with current intraoperative neuromonitoring (IONM) techniques. Case Description: The patient is a 62-year-old woman who complained of decreased hearing on her left side, dizziness, and left facial palsy. After proper investigation, she was found to have a left vestibular schwannoma. She was scheduled for the left retrosigmoid approach and electrodes embedded on the surface of the endotracheal tube were inserted to monitor for LAR. Preoperative baseline monitoring was recorded. During intraoperative resection of tumor, a significant bilateral amplitude response decrease of the LAR was noted, along with left side decrease in vocal muscle motor evoked potential amplitude responses and bradycardia. Following the LAR event, owed to numerous other IONM changes, surgery was terminated to avoid any complications. Conclusion: LAR is an integral tool to constantly monitor vagus nerve function that can be used in combination with other IONM modalities during lower brainstem and posterior fossa surgeries. We advocate the IONM use of LAR in brainstem surgeries.
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Tweedie, Constance, Caroline Romestaing, Yan Burelle, Adeel Safdar, Mark A. Tarnopolsky, Scott Seadon, Steven L. Britton, Lauren G. Koch, and Russell T. Hepple. "Lower oxidative DNA damage despite greater ROS production in muscles from rats selectively bred for high running capacity." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 300, no. 3 (March 2011): R544—R553. http://dx.doi.org/10.1152/ajpregu.00250.2010.
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Artificial selection in rat has yielded high-capacity runners (HCR) and low-capacity runners (LCR) that differ in intrinsic (untrained) aerobic exercise ability and metabolic disease risk. To gain insight into how oxygen metabolism may have been affected by selection, we compared mitochondrial function, oxidative DNA damage (8-dihydroxy-guanosine; 8dOHG), and antioxidant enzyme activities in soleus muscle (Sol) and gastrocnemius muscle (Gas) of adult and aged LCR vs. HCR rats. In Sol of adult HCR rats, maximal ADP-stimulated respiration was 37% greater, whereas in Gas of adult HCR rats, there was a 23% greater complex IV-driven respiratory capacity and 54% greater leak as a fraction of electron transport capacity (suggesting looser mitochondrial coupling) vs. LCR rats. H2O2 emission per gram of muscle was 24–26% greater for both muscles in adult HCR rats vs. LCR, although H2O2 emission in Gas was 17% lower in HCR, after normalizing for citrate synthase activity (marker of mitochondrial content). Despite greater H2O2 emission, 8dOHG levels were 62–78% lower in HCR rats due to 62–96% higher superoxide dismutase activity in both muscles and 47% higher catalase activity in Sol muscle in adult HCR rats, with no evidence for higher 8 oxoguanine glycosylase (OGG1; DNA repair enzyme) protein expression. We conclude that genetic segregation for high running capacity has generated a molecular network of cellular adaptations, facilitating a superior response to oxidative stress.
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Arini, Nolita Dwi, and Fatmasari Sukesti. "PENGARUH RASIO-RASIO KEUANGAN TERHADAP KINERJA KEUANGAN BANK SYARIAH PERIODE TAHUN 2010-2012 (STUDI KASUS PADA BPRS ARTHA SURYA BAROKAH)." MAKSIMUM 3, no. 1 (March 11, 2016): 43. http://dx.doi.org/10.26714/mki.3.1.2012.43-62.
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Bank is a financial institution whose main activity is to receive deposits from the public and distribute to third parties to obtain and deliver services in payment traffic. Reality show no economic indicators that can be developed without the help of banking institutions. Therefore, the bank holds a strategic role in the economy. The existence of the banking sector in Indonesia is divided into two types of banks, ie commercial banks and rural banks.The population in this study is the overall financial statement SRB Surya Artha Barokah Semarang. Samples taken in this study is the financial statement SRB Surya Artha Barokah 2010-2012. Analysis tool used is multiple linear regression.The results showed that the hypothesis test using the F test showed that the CAMEL variables simultaneously affect the bank's financial performance. Hypothesis testing using t-test showed that there are significant between the RWA, CAR, CAR, KAP, PPAP, PM, ROA, Cash Ratio, on financial performance. The higher RWA, CAR, CAR, KAP, PPAP, PM, ROA, the higher the financial performance of BPR Syariah Surya Artha Barokah Semarang. Hypothesis testing using t-test showed that there is no influence between the Cash Ratio and LDR on financial performance. Cash Ratio and the higher the LDR then it will not affect the financial performance of BPR Syariah Barokah Arta Surya Semarang.Key word : ATMR, KPMM, CAR, KAP, PPAP, PM, ROA, Cash Ratio and financial performance
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Moore, Douglas F., and Janis I. Curry. "Detection and Identification of Mycobacterium tuberculosis Directly from Sputum Sediments by Ligase Chain Reaction." Journal of Clinical Microbiology 36, no. 4 (1998): 1028–31. http://dx.doi.org/10.1128/jcm.36.4.1028-1031.1998.
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Sputum specimens received for the diagnosis of tuberculosis or other mycobacterial infections were tested by a ligase chain reaction (LCR)-based assay and acid-fast stain and culture techniques. Results from the LCR assay (Abbott LCx Mycobacterium tuberculosis[MTB] Assay) were compared to results from standard culture techniques held for 6 weeks. Four hundred ninety-three specimens from 205 patients suspected of pulmonary tuberculosis were included in the prospective study. Thirty-four (6.9%) of the specimens were culture positive for M. tuberculosis, and 13 (38%) of these were also fluorochrome stain positive. LCR sensitivities and specificities compared to culture were 74 and 98%, respectively. LCR sensitivity was 100% for fluorochrome stain-positive specimens and 57% for fluorochrome stain-negative specimens. Nine LCR-negative, culture-positive specimens were the result of low concentrations ofM. tuberculosis. No inhibitors were detected in any of these specimens. Of the eight LCR-positive, culture-negative specimens, five were from patients with active tuberculosis. With these considered culture misses, final LCR sensitivity, specificity, positive predictive value, and negative predictive value were 77, 99, 91, and 98%, respectively. The same performance values for the fluorochrome acid-fast bacillus smear were 33, 98, 62, and 94%, respectively. After normal laboratory sputum processing, the Abbott LCx MTB Assay can be completed in 6 h. Thus, it is possible to have results available within 8 h of specimen submission.
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Kostov, Gancho G., Rossen S, Dimov, and Daniela D. Almeida. "Risk Factors for Anastomotic Leakage after Low Anterior Resection." Folia Medica 62, no. 2 (June 30, 2020): 290–94. http://dx.doi.org/10.3897/folmed.62.e47727.
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Introduction: Low anterior resection (LAR) is a standard surgical procedure for distal rectal carcinoma that allows creation of a colorectal anastomosis, with anal sphincter preservation and permanent colostomy avoidance. Anastomotic leakage (AL) is a potential complication of LAR present in 3% to 20% of cases leading to a significant increase in postoperative morbidity. AL represents a communication between the intra luminal and extra luminal compartments caused by a violation of the integrity of the intestinal wall. The risk factors of this procedure have been discussed and still remain a controversial issue. Prevention is the best management. Patients with predisposing factors should be paid special attention. Aim: Our objective was to identify and analyze the risk factors of anastomotic leakage after low anterior resection of rectal carcinoma. Patients and methods: This study included all patients who underwent low anterior resection for rectal cancer at the Department of Surgery of University Hospital Kaspela between 2011 and 2016. Results: Low anterior resections were performed in 141 patients during the study period. Due to a positive air leak test on 16 patients, a protective ileostomy was created and these patients were eliminated from the study. The sex distribution of the remaining 125 patients was 69 men (55.2%) and 56 women (44.8%). The height of the anastomosis from the dentate line was 3.0 cm on an average (range 2.5 to 4 cm). Conclusion: Anastomotic leakage remains the most feared and serious complication after low anterior resection surgery. The evidence suggests that the main risk factors for anastomotic leakage at low anterior resection are the height of the anastomosis and the high ASA score.
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Newman, Jamie R., and Mary Anne Cooper. "Lower Gastrointestinal Bleeding and Ischemic Colitis." Canadian Journal of Gastroenterology 16, no. 9 (2002): 597–600. http://dx.doi.org/10.1155/2002/374682.
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OBJECTIVE: To compare the incidence and clinical characteristics of lower gastrointestinal (LGI) bleeding due to ischemic colitis with those with LGI bleeding of other causes.METHODS: A chart review was performed of patients admitted with LGI bleeding to Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, between July 1, 1997 and January 31, 2000.RESULTS: Of 124 patients with LGI bleeding, 24 cases were due to ischemic colitis, 62 to diverticulosis, 11 to inflammatory bowel disease (IBD) and 27 to all other causes (‘others’). The average ages of patients in each group were 66.5, 76.5, 40.5 and 77.5 years, respectively. Patients with ischemic colitis were statistically younger than those with diverticular bleeding and ‘others’. Patients with IBD were younger than those in the other three groups. The only statistical difference for vascular disease risks was hypertension, because of its absence from the IBD group. Three patients with ischemic colitis underwent blood transfusions, while 23 with diverticulosis, 15 ‘others’ and none with IBD received blood. Three patients with ischemic colitis and one patient from the ‘others’ group died. More women (75) than men (49) had LGI bleeding - in total and within each subgroup. Of women with LGI bleeding, many more with ischemic colitis (44.4%) than with diverticulosis (3.0%), IBD (0%) or ‘others’ (5.6%) were taking estrogen.CONCLUSIONS: Ischemic colitis was the second most common cause of LGI bleeding. LGI bleeding from all causes was more common in women than in men. Many more women in the ischemic colitis group than in the other groups were using estrogen therapy.
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Almaas, Vibeke M., Kristina H. Haugaa, Erik H. Strøm, Helge Scott, Hans-Jørgen Smith, Christen P. Dahl, Odd R. Geiran, et al. "Noninvasive assessment of myocardial fibrosis in patients with obstructive hypertrophic cardiomyopathy." Heart 100, no. 8 (December 24, 2013): 631–38. http://dx.doi.org/10.1136/heartjnl-2013-304923.
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ObjectiveLate gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging is the reference standard for non-invasive assessment of fibrosis. In hypertrophic cardiomyopathy (HCM) patients the histological substrate for LGE is still unknown. The aim of this study was to assess the ability of LGE and strain echocardiography to detect type and extent of myocardial fibrosis in obstructive HCM patients undergoing septal myectomy.MethodsThirty-two HCM patients (age 60±10) were included in this cross-sectional study and preoperatively examined by speckle-tracking strain echocardiography and LGE-CMR (n=21). Histological fibrosis was classified as interstitial, replacement and total.ResultsHistological fibrosis was present in 31 patients. The percentage of total, interstitial and replacement fibrosis was 15(7, 31)%, 11(5, 24)% and 3(1, 6)%, respectively. Reduced longitudinal septal strain correlated with total (r=0.50, p=0.01) and interstitial (r=0.40, p=0.03), but not with replacement fibrosis (r=0.28, p=0.14). Septal LGE was detected in 13/21 (62%), but percentage LGE did not correlate with total fibrosis (r=0.25, p=0.28). Extent of fibrosis did not differ between patients with and without septal LGE (20(9, 58)% versus 14(5, 19)% p=0.41). Patients with ventricular arrhythmias (n=8) had lower septal longitudinal strain and increased extent total and interstitial fibrosis in myectomy specimens, but no differences were demonstrated in LGE. Reduced longitudinal septal strain and increased extent of interstitial fibrosis predicted ventricular arrhythmias independently of age and gender.ConclusionsIn myectomised HCM patients, reduced longitudinal septal strain correlated better with interstitial and total fibrosis in myectomy specimens, and was a more powerful tool to predict arrhythmias than LGE.
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Catalano, Oronzo, Guido Moro, Alessia Mori, Mariarosa Perotti, Alessandra Gualco, Mauro Frascaroli, Clara Pesarin, Carlo Napolitano, Ntobeko A. B. Ntusi, and Silvia G. Priori. "Cardiac Magnetic Resonance in Stable Coronary Artery Disease: Added Prognostic Value to Conventional Risk Profiling." BioMed Research International 2018 (June 21, 2018): 1–10. http://dx.doi.org/10.1155/2018/2806148.
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Aims. Cardiovascular magnetic resonance (CMR) permits a comprehensive evaluation of stable coronary artery disease (CAD). We sought to assess whether, in a large contemporaneous population receiving optimal medical therapy, CMR independently predicts prognosis beyond conventional cardiovascular risk factors (RF). Methods. We performed a single centre, observational prospective study that enrolled 465 CAD patients (80% males; 63±11 years), optimally treated with ACE-inhibitors/ARB, aspirin, and statins (76-85%). Assessments included conventional evaluation (clinical history, atherosclerosis RF, electrocardiography, and echocardiography) and a comprehensive CMR with LV dimensions/function, late gadolinium enhancement (LGE), and stress perfusion CMR (SPCMR). Results. During a median follow-up of 62 months (IQR 23-74) there were 50 deaths and 92 major adverse cardiovascular events (MACE). CMR variables improved multivariate model prediction power of mortality and MACE over traditional RF alone (F-test p<0.05 and p<0.001, respectively). LGE was an independent prognostic factor of mortality (hazard ratio [95% CI]: 3.4 [1.3−8.8]); moreover, LGE (3.3 [1.7−6.3]) and SPCMR (2.1 [1.4−3.2]) were the best predictors of MACE. Conclusion. LGE is an independent noninvasive marker of mortality in the long term in patients with stable CAD and optimized medical therapy. Furthermore, LGE and SPCMR independently predict MACE beyond conventional risk stratification.
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Ungerer, Mark C., Solveig S. Halldorsdottir, Michael D. Purugganan, and Trudy F. C. Mackay. "Genotype-Environment Interactions at Quantitative Trait Loci Affecting Inflorescence Development in Arabidopsis thaliana." Genetics 165, no. 1 (September 1, 2003): 353–65. http://dx.doi.org/10.1093/genetics/165.1.353.
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Abstract Phenotypic plasticity and genotype-environment interactions (GEI) play a prominent role in plant morphological diversity and in the potential functional capacities of plant life-history traits. The genetic basis of plasticity and GEI, however, is poorly understood in most organisms. In this report, inflorescence development patterns in Arabidopsis thaliana were examined under different, ecologically relevant photoperiod environments for two recombinant inbred mapping populations (Ler × Col and Cvi × Ler) using a combination of quantitative genetics and quantitative trait locus (QTL) mapping. Plasticity and GEI were regularly observed for the majority of 13 inflorescence traits. These observations can be attributable (at least partly) to variable effects of specific QTL. Pooled across traits, 12/44 (27.3%) and 32/62 (51.6%) of QTL exhibited significant QTL × environment interactions in the Ler × Col and Cvi × Ler lines, respectively. These interactions were attributable to changes in magnitude of effect of QTL more often than to changes in rank order (sign) of effect. Multiple QTL × environment interactions (in Cvi × Ler) clustered in two genomic regions on chromosomes 1 and 5, indicating a disproportionate contribution of these regions to the phenotypic patterns observed. High-resolution mapping will be necessary to distinguish between the alternative explanations of pleiotropy and tight linkage among multiple genes.
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Starostina, S. V., V. M. Makhov, O. A. Storonova, A. V. Bolshakov, I. V. Kuprina, A. S. Trukhmanov, and V. T. Ivashkin. "Сapabilitу of 24-hour esophageal pH-impedance monitoring in the diagnosis of GERD-associated laryngeal diseases." Meditsinskiy sovet = Medical Council, no. 16 (November 14, 2020): 62–72. http://dx.doi.org/10.21518/2079-701x-2020-16-62-72.
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Extraesophageal manifestations of gastroesophageal reflux disease (GERD), despite the improvement of methods of diagnosis and treatment of patients with this pathology, still remain an urgent problem of medicine and cause increased attention of clinicians and researchers. In some cases, patients with GERD do not present typical complaints of heartburn, regurgitation; the disease may manifest extraesophageal manifestations, such as chronic cough, hoarseness, reflux laryngitis, and others caused by the presence of laryngopharyngeal reflux (LFR) – inflammation of the mucous membrane of the upper digestive and respiratory tracts with possible morphological changes associated with direct and indirect (reflex) exposure to gastroduodenal reflux. The occurrence of LFR is possible due to a violation of the motor function of the esophagus and insufficiency of the upper esophageal sphincter, as well as a decrease in the tone of the pharyngeal muscles. The most accessible methods of diagnosis of LFR are registration of complaints according to the questionnaire “index of reflux symptoms”, assessment of the clinical and functional state of the larynx using a visually analog “scale of reflux signs”. A positive response to the empirical use of proton pump inhibitors in combination with procinetics and determination of pepsin content in saliva can also be alternative diagnostic methods. To date, 24-hour pH-impedance monitoring is a method that allows the most accurate diagnosis of all types of reflux, regardless of the pH value, to verify high reflux in combination with its physical properties, as well as to estimate the time of chemical and volumetric esophageal clearance. In addition to performing esophagogastroduodenoscopy, the use of this method is indicated in patients with suspected extraesophageal manifestations of GERD. The article presents clinical examples of patients with extraesophageal manifestations of GERD, describes the possibilities of 24-hour pH-impedance monitoring of the esophagus in the diagnosis of LFR and reflux-associated diseases of the larynx.
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Hurtado Monroy, Rafael, Pablo Vargas-Viveros, and Carrillo Munoz Silvia. "Imatinib (IMA) Low Dose Reduction Program (LDR) in Chronic Myeloid Leukemia Ph+ (CML Ph+) in a Single Reference Institution in Mexico City. Ongoing Preliminary Results." Blood 134, Supplement_1 (November 13, 2019): 5921. http://dx.doi.org/10.1182/blood-2019-130873.
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Imatinib (IMA) total stop therapy has interesting worldwide results in selected patients (pts) with CML Ph+ who have achieved 4 to 5 log reduction of BCR/ABL copies, however there is no information of LDR. The observation that IMA intolerance induces a dose reduction in our cases and, the fact that during the follow-up of their RT-PCR for BCR/ABL remains in > 4 log reduction after two years, was the rationale for an open prospective LDR program with the main objective to optimizing CML Ph+ treatment due to economical limitations and drug availability in Mexico. Herein we report our ongoing preliminary results: A total of 73 of 152 (48%) pts was eligible for LDR after achieving Major Molecular Response (MMR) who reduced of > 4 log in at least two RT-PCR determinations in one or two years. The molecular response was assessed by peripheral blood real-time polymerase chain reaction at selected laboratory, able to express the results according to the International Scale (Hughes T, et al. Blood 2006;108:28-37). LDR included reduction of IMA to 25% of the 400mg for the chronic phase and 33% for the accelerated phase or those who reduced from 800 to 600 and even 400mg. Among 73 pts, 11 (15%, historic group) were intolerant to IMA and their median dose reduction was 50% (Min-Max; 25-100%) with a median follow-up of 28 months (12-48) with only one relapse after 48 months of dose reduction. The LDR included 62 of 152 (40%) pts with a median age of 37 years (18-74), the gender was, female/male (n-30/32), the median time (MT) duration of CML was 8 years (4-18 years), the MT of reduction was 16 months (12-30). In 52 of 62 pts (83%) the proportion of LDR was 25% and the others in the range of 800 to 400mg. Molecular relapse was seen in 4 cases (6.4%) of the 25% reduction group and in 2 cases of the 50% (600-to 800mg) that represented 1.2%. The LDR program is an interesting alternative for optimizing CML Ph+ IMA treatment with range from one to two and a half years in MMR with a 7.2% global relapse rate which is lower than the total interruption of TKIs in previous literature reports; however, the inclusion of more pts with follow-up as well, is mandatory to validate our program and the economic impact. Disclosures No relevant conflicts of interest to declare.
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De Gobbi Porto, Fábio Henrique, Lívia Spíndola, Maira Okada De Oliveira, Patrícia Helena Figuerêdo Do Vale, Marco Orsini, Ricardo Nitrini, and Sonia Maria Dozzi Brucki. "A score based on screening tests to differentiate mild cognitive impairment from subjective memory complaints." Neurology International 5, no. 3 (September 5, 2013): 16. http://dx.doi.org/10.4081/ni.2013.e16.
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It is not easy to differentiate patients with mild cognitive impairment (MCI) from subjective memory complainers (SMC). Assessments with screening cognitive tools are essential, particularly in primary care where most patients are seen. The objective of this study was to evaluate the diagnostic accuracy of screening cognitive tests and to propose a score derived from screening tests. Elderly subjects with memory complaints were evaluated using the Mini Mental State Examination (MMSE) and the Brief Cognitive Battery (BCB). We added two delayed recalls in the MMSE (a delayed recall and a late-delayed recall, LDR), and also a phonemic fluency test of letter P fluency (LPF). A score was created based on these tests. The diagnoses were made on the basis of clinical consensus and neuropsychological testing. Receiver operating characteristic curve analyses were used to determine area under the curve (AUC), the sensitivity and specificity for each test separately and for the final proposed score. MMSE, LDR, LPF and delayed recall of BCB scores reach statistically significant differences between groups (P=0.000, 0.03, 0.001 and 0.01, respectively). Sensitivity, specificity and AUC were MMSE: 64%, 79% and 0.75 (cut off <29); LDR: 56%, 62% and 0.62 (cut off <3); LPF: 71%, 71% and 0.71 (cut off <14); delayed recall of BCB: 56%, 82% and 0.68 (cut off <9). The proposed score reached a sensitivity of 88% and 76% and specificity of 62% and 75% for cut off over 1 and over 2, respectively. AUC were 0.81. In conclusion, a score created from screening tests is capable of discriminating MCI from SMC with moderate to good accurancy.
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Al Efraij, Khalid S., Mohammed A. Aljama, and Hagen F. Kennecke. "Effect of dose intensification (DI) of octreotide-LAR (O-LAR) among symptomatic patients with neuroendocrine tumors (NETs)." Journal of Clinical Oncology 32, no. 3_suppl (January 20, 2014): 299. http://dx.doi.org/10.1200/jco.2014.32.3_suppl.299.
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299 Background: O-LAR 20 to 30 mg IM monthly (qM) is approved for the management of symptomatic NETs. While higher doses are sometimes used for improved symptom control, the benefit of this is not well described. The objectives of the study were to evaluate pre-DI and post-DI symptom, biomarker and tumor size among patients who received O-LAR 40-60 mg qM. Methods: With approval of the BC Cancer Agency research ethics committee the charts of all referred patients with NETs who received O-LAR 40-60 mg qM between 2005 and 2001 were reviewed. Symptom severity was graded on a 4 point scale and any post-increase improvement from grade 2,3 or 4 to 1 or no symptoms was classified an improvement. Pre-DI Chromogranin A (CGA) and 24-hour urine 5-HIAA were compared with the median of 3 post-DI levels and a 10% decrease was classified as a decrease. Results: A total of 37 patients received DI therapy with 40 mg (36), 50 mg (3), and 60 mg (16), for a total of 55 DI events. Median age was 60 and 49, 19, 32% had a tumor of small bowel, pancreas, other, respectively. Post-DI CGA and 5 HIAA levels decreased in 31% (15/49) and 23 % of patients (8/35) respectively. Symptom improvement post DI was observed in 62% (13/21) with diarrhea, 76% (13/17) with flushing, 53% (8/15) with abdominal pain. Post DI, no decreases in tumor size were observed, 29% (14/49) had radiological stable disease and the remainder had progressive tumors. Conclusions: O-LAR 40-60 mg qM was associated with improved symptom control among NET patients with refractory secretory symptoms. CGA and 5-HIAA levels varied in response to DI and were not accurate indicators of symptom control. There was no evidence of tumor regression with O-LAR DI. [Table: see text]
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Sethukavalan, Perakaa, Patrick Cheung, Gerard Morton, Laura D'Alimonte, Andrea Deabreu, Alexandre Mamedov, Liying Zhang, Hans T. Chung, Robert Nam, and D. Andrew Loblaw. "How does stereotactic body radiotherapy compare to standard external beam radiotherapy or low-dose rate brachytherapy for low-risk prostate cancer?" Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e16070-e16070. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e16070.
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e16070 Background: Stereotactic body radiotherapy (SBRT) is an emerging radiotherapy technique that appears to be efficacious, well tolerated and convenient. However, outcomes for patients treated with SBRT are unknown compared to more conventional radiation options for patients with prostate cancer. The purpose of this study is to evaluate and compare late toxicities and biochemical disease-free survival (bDFS) of low risk prostate cancer patients treated SBRT (35Gy/5 fractions), standard external beam radiotherapy (STND; median 76Gy/38 fractions) or low-dose brachytherapy (LDR; iodine-125, 145Gy) at the Odette Cancer Centre. Methods: Consecutive patients with low risk prostate cancer treated with radiation from 2006-2008 were analyzed. Patients treated with SBRT were part of a phase 2 prospective clinical trial; patients treated with STND or LDR had data abstracted from medical charts retrospectively. Patients treated with neoadjuvant androgen deprivation therapy were excluded from biochemical analyses. Univariate (UVA) and multivariate analyses (MVA) of Cox proportional hazard model were conducted to identify significant covariates predicting bDFS. Results: A total of 357 low-risk prostate cancer patients were identified (84 SBRT, 81 STND and 192 LDR). The median follow-up was 57, 62, and 59 months, respectively. At baseline, 85% of patients were T1c, 15% T2a; 100% had GS 6; median PSA 5.9 ng/ml. There were more patients in the STND and LDR cohort who had T2a disease (6%, 21% and 16%, p= 0.013) and the mean PSA was higher in the STND cohort (6.08, 6.69, and 6.02, p=0.017). Patients who received LDR experienced more late hematuria (0%, 1.23% and 11.98%, p<0.0001); otherwise there were no significant differences in late toxicities observed. There were no significant differences in bDFS (97.4% vs 96.9% vs 97.2% at 60 months, p=0.94). There were no covariates identified predicting bDFS on UVA or MVA, including treatment type. Conclusions: SBRT, STND and LDR show equivalent effectiveness and both external beam techniques showed less hematuria than LDR. However, SBRT and LDR are more convenient and less costly than STND. Further prospective studies of SBRT are ongoing.
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Kelle, Sebastian, Kelly Schlendorf, Glenn A. Hirsch, Gary Gerstenblith, Eckart Fleck, Robert G. Weiss, and Matthias Stuber. "Gadolinium Enhanced MR Coronary Vessel Wall Imaging at 3.0 Tesla." Cardiology Research and Practice 2010 (2010): 1–9. http://dx.doi.org/10.4061/2010/856418.
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Purpose. We evaluated the influence of the time between low-dose gadolinium (Gd) contrast administration and coronary vessel wall enhancement (LGE) detected by 3T magnetic resonance imaging (MRI) in healthy subjects and patients with coronary artery disease (CAD).Materials and Methods.Four healthy subjects (4 men, mean age29 ± 3years and eleven CAD patients (6 women, mean age61±10years) were studied on a commercial 3.0 Tesla (T) whole-body MR imaging system (Achieva 3.0 T; Philips, Best, The Netherlands). T1-weighted inversion-recovery coronary magnetic resonance imaging (MRI) was repeated up to 75 minutes after administration of low-dose Gadolinium (Gd) (0.1 mmol/kg Gd-DTPA).Results.LGE was seen in none of the healthy subjects, however in all of the CAD patients. In CAD patients, fifty-six of 62 (90.3%) segments showed LGE of the coronary artery vessel wall at time-interval 1 after contrast. At time-interval 2, 34 of 42 (81.0%) and at time-interval 3, 29 of 39 evaluable segments (74.4%) were enhanced.Conclusion. In this work, we demonstrate LGE of the coronary artery vessel wall using 3.0 T MRI after a single, low-dose Gd contrast injection in CAD patients but not in healthy subjects. In the majority of the evaluated coronary segments in CAD patients, LGE of the coronary vessel wall was already detectable 30–45 minutes after administration of the contrast agent.
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Mair, Maximilian J., Sahra Pajenda, Aysegül Ilhan-Mutlu, Ariane Steindl, Barbara Kiesel, Georg Widhalm, Karin Dieckmann, et al. "Soluble PD-L1 is associated with local and systemic inflammation markers in primary and secondary brain tumours." ESMO Open 5, no. 6 (November 2020): e000863. http://dx.doi.org/10.1136/esmoopen-2020-000863.
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BackgroundImmune-modulatory treatments have so far shown limited clinical activity in primary brain tumours. We aimed to investigate soluble programmed death receptor ligand 1 (sPD-L1) as systemic inflammation parameter in patients with brain tumour.MethodsEDTA plasma was collected from 81 glioma (55 glioblastoma (GBM), 26 lower-grade glioma (LGG)), 17 meningioma and 44 brain metastasis (BM) patients and 24 controls. sPD-L1 concentrations were determined by ELISA. Correlations with the local tumour microenvironment were assessed by immunohistochemical analysis for PD-L1, CD3 and CD8.ResultssPD-L1 was detected in 62 out of 166 (37.7%) patients (glioma: 41/81, 50.6%; meningioma: 5/17, 29.4%; BM: 7/44, 15.9%; controls: 9/24, 37.5%; p=0.002). sPD-L1 concentrations were lower in BM than in LGG (p=0.003) or GBM (p<0.001). Membranous PD-L1 expression on tumour cells was not associated with sPD-L1 concentrations (p=0.953). sPD-L1 concentration was inversely correlated with the density of CD8+ (r=−0.713, p=0.001) and CD3+ (r=−0.484, p=0.042) tumour-infiltrating lymphocytes in LGG. sPD-L1 is correlated with neutrophil counts (r=−0.318, p=0.045) and C reactive protein levels (r=−0.363, p=0.008) in GBM. sPD-L1+ patients had longer overall survival in GBM (p=0.006) and worse OS in LGG (p=0.028).ConclusionssPD-L1 is detectable in a fraction of patients with brain tumour. Although it is not correlated with tissue PD-L1 expression, correlations with other local and systemic inflammation parameters could be detected in LGG and GBM.
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Silva-Vergara, Mario León, Cláudio de Oliveira Vieira, João Henrique Castro, Luciane Giroto Micheletti, Arturo Santana Otaño, João Franquini Jr., Marinice Cabral, et al. "Achados neurológicos e laboratoriais em população de área endêmica para teníase-cisticercose, Lagamar, MG, Brasil (1992-1993)." Revista do Instituto de Medicina Tropical de São Paulo 36, no. 4 (August 1994): 335–42. http://dx.doi.org/10.1590/s0036-46651994000400006.
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Realizou-se um inquérito clínico-epidemiológico em área endêmica para teníase-cisticercose. Foram examinados 1080 (32,2%) indivíduos da população total, encontrando-se 198 (18,3%) indivíduos referindo antecedente de teníase, e 103 (9,5%) apresentaram história anterior ou atual de convulsões. Destes últimos, 39 (37,8%) referiram início das crises na vida adulta, e 62 (60%) foram avaliados laboratorialmente. Em 21 (33,8%) casos, o resultado da tomografia mostrou calcificações intracranianas compatíveis com neurocisticercose, em número e localização variáveis, mas sem evidência de atividade da doença. Traçados eletroencefalográficos anormais foram lidos em 21 (33,8%) pacientes e alterações no exame do líquido cefalorraquiano (LCR) detectadas em 27 (43,5%), em 3 (4,8%) foi verificada presença de eosinófilos. Somente LCR de 26 (41,9%) pacientes foram submetidos a pesquisa de anticorpos para cisticerco, obtendo-se positividade em 6 (23%) deles, por ensaio imunoenzimático (ELISA) ou reação de imunofluorescência indireta. Outras alterações do LCR foram devidas a aumento variável das proteínas. Considerando-se os fatores epidemiológicos de risco para teníase-cisticercose na região estudada e sua correlação com as alterações laboratoriais mencionadas acima com as crises convulsivas, encontra-se uma provável prevalência de 1,9% para a neurocisticercose.
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Franchi, Giulia M., Chiara Cappelletti, Valentina V. Villa, Emanuele Bosi, and Marco F. Manzoni. "Role of high dose octreotide LAR for the treatment of GEP-NETs." Clinical Management Issues 3, no. 1 (March 15, 2009): 7–14. http://dx.doi.org/10.7175/cmi.v3i1.555.
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Neuroendocrine Tumours (NETs) are a heterogeneous group of rare neoplasms that account for 0,5% of all malignancies. The increased incidence observed in the last few decades may be accounted for by increased awareness, improved diagnostic tools and a revision in the definition. The main primary sites are the gastro-entero-pancreatic (GEP) tract (62-67%), and the lung (22-27%). In patients with GEP-NETs, the strongest predictor of 5-years survival is the staging. An adequate clinical management of GEP-NETs should be multidisciplinary and should aim at assuring a good quality of life. Somatostatin (sst) analogues are widely used in these tumours, which often express sst receptors, since they are demonstrated to reduce clinical symptoms and tumour growth. Herein we explore the usefulness of doubling octreotide LAR dose in selected patients after escaping from symptoms control and/or tumour stabilization in course of treatment with standard dose.
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Larsen, Terje H., Marie Stugaard, Svein Rotevatn, Ottar Nygård, and Jan Erik Nordrehaug. "Clinical Significance of Late Enhancement and Regional Wall Remodeling Assessed by ST Magnetic Resonance Imaging." Clinical Medicine Insights: Cardiology 9 (January 2015): CMC.S20291. http://dx.doi.org/10.4137/cmc.s20291.
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Background Clinical follow-up studies comparing left ventricular (LV) function and late gadolinium enhancement (LGE) by high-field 3T cardiac magnetic resonance (CMR) are of general interest due to the increased use of 3T scanners. In this study, the occurrence of LGE and LV regional wall remodeling (RWR) was assessed by 3T CMR in patients undergoing coronary angiography for suspected stable coronary artery disease (CAD). Materials and Methods Analysis of myocardial viability by LGE was performed at the segmental level. LVRWR was identified by a significant reduction (≥50%) of the wall thickness. Major adverse cardiovascular events (MACE) were registered during a median follow-up time of 58 (45-62) months. Results Of the 87 patients (59 ± 9 years; 13 women) enrolled, nonviable myocardium was detected in 35 (40%) and significant CAD in 69 (79%). Nonviable myocardium was correlated to angiographic significant stenosis or occlusion. LVRWR was significantly related to a higher number of nonviable segments compared to those without LVRWR: ie, 6.0 ± 3.2 segments versus 2.6 ± 1.3; P < 0.001. In the nonviable group, LVEF was significantly reduced ( P < 0.001) compared to the viable group: ie, 50 ± 16% versus 61 ± 8%, and LVEF was significantly correlated to the number of nonviable segments ( r = −0.66, P < 0.001). The number of nonviable segments by LGE was significantly associated with MACE by an odds ratio of 1.25 (95% CI, 1.05-1.49; P = 0.013). Conclusion The presence of nonviable myocardium as detected by LGE at 3T CMR is associated with angiographically significant CAD, and is associated with the development of LVRWR and reduced LVEF. Assessing the extent of nonviable myocardium by both LGE and LVRWR at the segmental level may therefore contribute to individualized risk stratification and treatment strategies.
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Bender, M. A., Davide Bau', Tobias Ragoczy, Rachel Byron, Ye Zhan, Bryan Lajoie, Marc A. Marti-Renom, Job Dekker, and Mark T. Groudine. "Integrating Structural and Functional Studies Leads to a New Model of β-Globin Activation That Suggests Distinct Initiation and Maintenance States." Blood 118, no. 21 (November 18, 2011): 349. http://dx.doi.org/10.1182/blood.v118.21.349.349.
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Abstract Abstract 349 The human and mouse β-globin loci share a conserved structure in which the locus control region (LCR) and genes are flanked by three CTCF bound DNaseI hypersensitive sites (HSs); 3‘HS1 downstream, and 5‘HS5 and human and mouse orthologues HS-111 or HS-62 upstream. In mice HS-62 and 3‘HS1 delineate a DNase sensitive domain. During erythroid differentiation, high-level expression of the β-globin locus is associated with LCR-dependent re-localization of the locus from the nuclear periphery to the nucleoplasm, where it associates with foci of serine-phosphorylated PolII deemed transcription factories (TFs). To investigate the relationships among chromatin structure, nuclear localization and β-globin expression during human erythropoiesis, CD34 progenitor cells were differentiated and analyzed by ChIP-array, primary transcript FISH, immuno-FISH, and chromatin conformation capture, carbon copy (5C). Localization of the β-locus away from the nuclear periphery and to TFs, and detection of β-nascent transcripts are rare events at day 4 (proerythroblasts), whereas by day 15 (polychromatic erythroblasts), nearly all loci are centrally located, associated with TFs and actively expressing. Three megabase profiles of complementary active and repressive histone marks (H3 lysine 4 di-methylation (DiK4) and H3 lysine 27 tri-methylation) reveal that DiK4 is enriched in the LCR and adult genes in undifferentiated CD34 cells and nears maximal enrichment by day 4. Thus the chromatin landscape is set up prior to erythroid commitment and is increased at day 4, but shows little change with activation. These profiles also reveal a previously un-described 257kb domain spanning from HS-111 to +146 relative to the ε-gene cap, with CTCF bound at its boundaries. 5C analysis reveals a high linkage frequency between the LCR and β-gene at day 4, prior to β-gene activation. Thus proximity may be necessary, but is not sufficient for high-level expression. In addition, the LCR and adult genes have frequent contact with surrounding regions, but interactions are sharply demarcated by HS-111 and +146, linking the above histone modification domain and 5C structure. The flanking regions HS-111, 3‘HS1 and +146 associate with the LCR and genes in an active chromatin hub (ACH)-like structure. By combining 5C with the Integrated Modeling Platform, a high-resolution three-dimensional (3D) model of chromatin structure was generated and revealed that the CTCF containing flanking regions, HS-111, 5'HS5, 3‘HS1 and +146 are in proximity and anchor loops of the intervening regions. The LCR and β-gene lie in close proximity (<100nm) within a tight chromatin globule. At day 15, 5C-interactions become more restricted. Throughout the 1Mb assayed there is a global decrease in linkages and, unlike the ACH model, associations of the flanking HSs with each other diminish. In contrast, the LCR and β-gene are more highly linked. While the distance between the LCR and β-gene remains under 100nm at day 15, most of the remaining 3D structure is less compact. One notable exception is with differentiation the LCR is in closer proximity to the β-gene 3‘enhancer. In addition, β-gene activation is associated with an increase in the contour length of the region, possibly correlating with DNaseI accessibility. In summary, our results reveal that acquisition of DiK4 precedes erythroid commitment. Enrichment of this active histone modification may occur in the nuclear periphery and is associated with a compact structure in which the flanking HSs, LCR and β-gene are in close proximity. Notably, close association of the LCR and β-gene precedes association with a TF and is not sufficient for expression. This suggests that if an ACH structure is important for function, its role may be limited to the initiation, but not the maintenance of gene expression. Alternatively, this compact structure may reflect the mafK-mediated recruitment of co-repressors to the LCR, as we demonstrated previously. The exchange of these repressors for activators could lead to the observed relocation from the periphery to TFs where high-level expression occurs and provides an explanation for the large change in expression that occurs despite a subtle change in the proximity of the LCR and β-gene. Preliminary studies on cell lines harboring intact, and LCR deficient chromosomes suggest the LCR may effect boundary element formation, domains of histone modifications and structure of the region. Disclosures: No relevant conflicts of interest to declare.
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Scott, Aba Anoa, Joel Yarney, Verna Vanderpuye, Charles Akoto Aidoo, Mervin Agyeman, Samuel Ntiamoah Boateng, Evans Sasu, Kwabena Anarfi, and Tony Obeng-Mensah. "Outcomes of patients with cervical cancer treated with low- or high-dose rate brachytherapy after concurrent chemoradiation." International Journal of Gynecologic Cancer 31, no. 5 (February 8, 2021): 670–78. http://dx.doi.org/10.1136/ijgc-2020-002120.
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ObjectiveThe majority of patients with cervical cancer in Ghana present with locally advanced disease. In October 2014, high-dose rate (HDR) brachytherapy was introduced at the National Center for Radiotherapy, Accra after years of using low-dose rate (LDR) brachytherapy. The aim of this study was to compare the treatment outcomes of patients treated with LDR versus HDR brachytherapy.MethodsPatients with cervical cancer treated from January 2008 to December 2017 were reviewed. Those with stage IB–IIIB who received chemoradiation plus brachytherapy were included in the study. Post-operative patients and those with stage IV were excluded. The study end points were local control, disease-free survival, and overall survival at 2 years. Endpoints were estimated using the Kaplan–Meier method. Comparisons between treatment groups were performed using the log-rank test and Cox proportional hazards model.ResultsWe included 284 LDR and 136 HDR brachytherapy patients. For stages IB, IIA, IIB, IIIA and IIIB disease, the 2-year local control for LDR versus HDR brachytherapy was 63% and 61% (p=0.35), 86% and 90% (p=0.68), 86% and 88% (p=0.83), 66% and 60% (p=0.56), and 77% and 40% (p=0.005), respectively. The 2-year disease-free survival for LDR versus HDR brachytherapy was 64% and 61% (p=0.50), 81% and 69% (p=0.18), 81% and 80% (p=0.54), 62% and 33% (p=0.82), and 71% and 30% (p=0.001) for stages IB, IIA, IIB, IIIA, and IIIB, respectively. The 2-year overall survival for LDR versus HDR brachytherapy was 94% and 93% (p=0.92), 98% and 68% (p=0.21), 89% and 88% (p=0.60), and 88% and 82% (p=0.34) for stages IB, IIA, IIB, and IIIB disease, respectively.ConclusionThere was no difference between LDR and HDR brachytherapy in local control and disease-free survival for all stages of disease, except in stage IIIB. These findings highlight the need to refine this brachytherapy technique for this group of patients.
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Weber, Jill M., Max Feldman, Larry Kvols, and Jonathan R. Strosberg. "Above-label doses of octreotide-LAR in patients with metastatic small-intestinal carcinoid tumors." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e14579-e14579. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e14579.
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e14579 Background: Octreotide LAR is indicated for treatment of the malignant carcinoid syndrome, and has been studied at doses of 10-30mg intramuscularly every 4 weeks. It has also been proven to delay time to progression of metastatic midgut carcinoid tumors at a dose of 30mg every 4 weeks. In clinical practice, higher doses are often prescribed for patients who experience refractory carcinoid syndrome (flushing and/or diarrhea) or tumor growth while on the maximal labeled dose. We performed a retrospective, longitudinal review of octreotide LAR administration at a tertiary institution to determine the frequency of ‘above-label’ dosing and outcomes. Methods: A retrospective chart-review was performed using a database of patients with metastatic small-bowel carcinoid tumors treated at the Moffitt Cancer Center between the years 2000 and 2010. Data included the maximal dose of octreotide LAR administered, reasons for change in dose or frequency (above the labeled dose of 30mg every 4 weeks), and clinical responses to dose change. Results: 337 patients were considered evaluable, among whom 99 patients (27%) underwent at least one increase in dose or frequency of octreotide-LAR above the standard labeled dose. The most common maximal doses were 40mg every 4 weeks (37 patients), 60mg every 4 weeks (34 patients), and 30mg every 3 weeks (17 patients). The indications for dose increase were worsening carcinoid syndrome (60 patients), radiographic progression (33 patients) and rising urine 5-HIAA (6 patients). Among patients whose doses were increased for refractory carcinoid syndrome, 62% experienced improvement in diarrhea and 56% experienced improvement in flushing. Conclusions: In clinical practice, octreotide LAR is commonly prescribed in doses or schedules above the labled dose and frequency. Patients with refractory carcinoid syndrome appear to experience a clinical benefit from the change. Prospective data is needed to evaluate this strategy.
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Stephenson, Erin J., Nigel K. Stepto, Lauren G. Koch, Steven L. Britton, and John A. Hawley. "Divergent skeletal muscle respiratory capacities in rats artificially selected for high and low running ability: a role for Nor1?" Journal of Applied Physiology 113, no. 9 (November 1, 2012): 1403–12. http://dx.doi.org/10.1152/japplphysiol.00788.2012.
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Inactivity-related diseases are becoming a huge burden on Western society. While there is a major environmental contribution to metabolic health, the intrinsic properties that predispose or protect against particular health traits are harder to define. We used rat models of inborn high running capacity (HCR) and low running capacity (LCR) to determine inherent differences in mitochondrial volume and function, hypothesizing that HCR rats would have greater skeletal muscle respiratory capacity due to an increase in mitochondrial number. Additionally, we sought to determine if there was a link between the expression of the orphan nuclear receptor neuron-derived orphan receptor (Nor)1, a regulator of oxidative metabolism, and inherent skeletal muscle respiratory capacity. LCR rats were 28% heavier ( P < 0.0001), and fasting serum insulin concentrations were 62% greater than in HCR rats ( P = 0.02). In contrast, HCR rats had better glucose tolerance and reduced adiposity. In the primarily oxidative soleus muscle, maximal respiratory capacity was 21% greater in HCR rats ( P = 0.001), for which the relative contribution of fat oxidation was 20% higher than in LCR rats ( P = 0.02). This was associated with increased citrate synthase (CS; 33%, P = 0.009) and β-hydroxyacyl-CoA (β-HAD; 33%, P = 0.0003) activities. In the primarily glycolytic extensor digitum longus muscle, CS activity was 29% greater ( P = 0.01) and β-HAD activity was 41% ( P = 0.0004) greater in HCR rats compared with LCR rats. Mitochondrial DNA copy numbers were also elevated in the extensor digitum longus muscles of HCR rats (35%, P = 0.049) and in soleus muscles (44%, P = 0.16). Additionally, HCR rats had increased protein expression of individual mitochondrial respiratory complexes, CS, and uncoupling protein 3 in both muscle types (all P < 0.05). In both muscles, Nor1 protein was greater in HCR rats compared with LCR rats ( P < 0.05). We propose that the differential expression of Nor1 may contribute to the differences in metabolic regulation between LCR and HCR phenotypes.
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Lim, Yiting, Mohammad Hedayati, Akil Merchant, Yonggang Zhang, Theodore DeWeese, and William Matsui. "Improved Survival and Recovery of Hematopoiesis Following Lethal Radiation by Chloroquine-Mediated Activation of ATM." Blood 116, no. 21 (November 19, 2010): 2228. http://dx.doi.org/10.1182/blood.v116.21.2228.2228.
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Abstract Abstract 2228 Irreversible bone marrow damage and impaired blood formation is the primary cause of death following exposure to high doses of radiation. Moreover, the rate at which radiation is delivered may have a profound impact on cytotoxicity; prolonged exposure at a low dose-rate (LDR; 9.4 cGy/hr) has been found to induce greater cell death than the same total dose given at a high dose-rate (HDR; 4500 cGy/hr). Few non-toxic agents are presently available that can offer substantial protection against radiation induced bone marrow failure and death, especially during LDR exposure. We previously demonstrated that chloroquine, a commonly used agent in the treatment of malaria and rheumatologic diseases, can prevent LDR radiation induced cytotoxicity of cell lines in vitro and studied its effects on hematopoiesis in vivo. We initially quantified the effects of LDR radiation on C57/B6 mice and found that 9 Gy delivered at 9.4 cGy/hr for 95.7 hrs induced death in 13/19 (68%) of animals at 15–35 days after radiation. The administration of syngeneic bone marrow cells (1 × 106 cells) immediately after LDR radiation completely rescued animals (10/10) demonstrating that bone marrow failure was responsible for LDR radiation induced death similar to HDR radiation. Next we treated mice with chloroquine (0.0594 mg/17g body weight, i.p.) 24 hrs and 4 hrs prior to exposure to LDR radiation and found that it significantly improved survival (80%, p < 0.05) compared to untreated animals exposed to LDR radiation (32%). We examined hematopoietic recovery following LDR radiation and found that the peripheral WBC was significantly greater in mice treated receiving chloroquine (3.4 × 106/ml vs 1.1 × 106/ml at day 16, p<0.05). Similarly, we found that in vivo chloroquine treatment significantly increased the recovery of bone marrow myeloid CFC (p=0.02), suggesting that it impacted myeloid progenitors. To further validate this finding, we transplanted bone marrow from LDR irradiated mice into lethally irradiated CD45 congenic recipient mice, and found a significant improvement in early engraftment (4.2% vs. 0.4% engraftment at 6 weeks post-transplant, p=0.015). Chloroquine has been found to protect cancer cell lines from LDR radiation in vitro by activating ATM, an essential DNA damage sensor. We examined the effect of chloroquine on ATM and treated unradiated lin- bone marrow cells with chloroquine in vitro (35 ug/ml, 2 hr). Compared to control cells, chloroquine treated cells expressed 2.5-fold more phosphorylated ATM suggesting that the activation of ATM by chloroquine abrogated the lethal effects of LDR radiation in hematopoietic progenitors. We confirmed that ATM was required for chloroquine-mediated radioprotection by studying ATM null mice. In contrast to wild type mice, chloroquine treatment failed to protect ATM null mice from LDR radiation (9 Gy total) with 8/13 (62%) and 9/13 (69%) of animals surviving in treated or non treated mice, respectively (p=0.86). These data suggest that chloroquine exerts a radioprotective effect from LDR radiation by activating ATM in vivo, and may represent a novel means of limiting acute bone marrow failure in the event of widespread environmental LDR radiation exposure. Disclosures: Matsui: Pfizer: Consultancy; Bristol-Meyers Squibb: Consultancy; Infinity Phamaceuticals: Consultancy, Patents & Royalties; Merck: Consultancy, Research Funding; Geron Corporation: Research Funding.
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Shetty, Vanaja P., Anju V. Wakade, Sunil D. Ghate, and Vivek V. Pai. "Clinical, bacteriological and histopathological study of 62 referral relapse cases between Jan 2004 and Dec 2009 at the Foundation for Medical Research, Mumbai." Leprosy Review 82, no. 3 (September 1, 2011): 235–43. http://dx.doi.org/10.47276/lr.82.3.235.
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Barak, Y., Y. Baruch, and S. Tadger. "Symptomatic Remission Amongst Elderly Schizophrenia Patients Treated with Long-acting Risperidone." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71235-0.
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Background:In elderly schizophrenia patients remission is difficult to determine due to long disease duration, exposure to differing treatments, long-standing side-effects, non-adherence, cognitive decline and physical co-morbidity.Methods:Retrospective chart review of elderly (60+ years) schizophrenia patients admitted to a university affiliated tertiary psychiatric center. Patients were experiencing an exacerbation at admission. Remission criteria were as defined by the APA's “Remission in Schizophrenia Working Group”. Clinical status and improvement were quantified using the Clinical Global Impression scale.Results:During 2006 forty-eight elderly schizophrenia patients were admitted to our center. of these, 25 patients were treated with long-acting risperidone (LAR), 18 women and 7 men, mean age 72 years (range: 62-81), mean disease duration 30.4 years (range:14-42) and mean number of previous hospitalizations 8.9 (range:1-21). Co-morbid physical illness was present in 12 patients (hypertension, diabetes, CHF and hypothyroidism). of 25 patients treated with LAR, 19 (76%) continued uninterrupted treatment for 6 months or longer. in 6 patients treatment was discontinued due to insufficient response. All patient's (N=25) clinical severity ratings with the CGI-S were in the range of 5 to 7 prior to treatment. Following 6 months of LAR treatment, mean dose 36.0 mg/2 weeks (range: 25-50), 18 patients were rated as “improved” or “very much improved” on the CGI-I scale. in 15/25 patients (60%) symptomatic remission was achieved.Conclusions:LAR may be effective in achieving remission among elderly schizophrenia patients. Tolerability was high and adherence rates improved. the inherent bias in a retrospective analysis need temper our observations.
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Ruchlemer, Rosa, Deborah Elstein, Eti Broide, Constantine Reinus, Hannah Maayaan, and Ari Zimran. "Gaucher Disease and LGL Proliferations: Provocative Commonality?" Blood 118, no. 21 (November 18, 2011): 1100. http://dx.doi.org/10.1182/blood.v118.21.1100.1100.
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Abstract Abstract 1100 Large granular lymphocytes(LGL)which may be of T or NK phenotype, normally account for 10–15% of peripheral blood(PB)lymphocytes. T-LGL leukemia is a clonal expansion of antigen-primed competent cytotoxic-T-lymphocytes(CTL)which is unique in that these cells retain many phenotypic and functional properties of normal cytotoxic effector T cells. Sphingolipid-mediated signaling has been shown to have a role in long-term survival of CTLs. The diagnosis of T-LGL leukemia requires proof of clonality, yet clonal T-LGL proliferations may occur in normal individuals with autoimmune diseases, viral infections, B cell lymphoproliferations and post bone marrow transplantation rendering the differentiation of malignant (leukemic) from benign LGL expansions at times difficult. It has been suggested that T-LGL proliferations with polyclonal or oligoclonal TCR gene rearrangement may be a response to a stimulus before the emergence of a dominant clone. Gaucher disease (GD)is a lysosomal storage disease caused by mutations in the gene encoding acid β-glucocerebrosidase, leading to the accumulation of glucocerebroside in tissue macrophages (Gaucher cells) and resulting in hepatosplenomegaly, cytopenias and skeletal involvement. GD and T-LGL leukemia share strikingly similar clinical features, including cytopenias, splenomegaly, B cell dyscrasias, arthralgias, pulmonary hypertension (PHT), and increased association with neoplasms and autoimmune disorders. The etiology of PHT, B cell dyscrasias, and the increased frequency of neoplasms in GD remains unclear. Table 1 describes the characteristics of 4 GD patients suffering from severe cytopenias relative to the overall phenotype of their GD in whom LGL were found to comprise the majority of the PB lymphocytes. Patient #1: 31year-old female suffering from severe GD with massive splenomegaly and severe cytopenias but refuses Gaucher-specific therapy; Patient #2: 31year-old female has suffered from severe Gaucher disease since childhood, was splenectomized, has unexplained anemia and known LGL expansion for 7 years but clonality studies continue to be negative; Patient #3: 45 year-old female with severe GD, splenectomized, suffered from AVN, bone crisis autoimmune hemolytic anemia, PHT, and B cell dyscrasia; and Patient #4: 72 year-old male has asymptomatic GD with progressive pancytopenia who was diagnosed with myelodysplastic syndrome(MDS),T-LGL proliferation and monclonal gammopathy of unknown origin(MGUS). LGL cells comprised 70% of PB lymphocytes in addition there was severe trilineage dysplastic changes, TCR rearrangement was positive. Interestingly, 8 months after the start of enzyme replacement therapy(ERT),counts improved and the number of PB LGL was reduced to <10% of lymphocytes. In a cohort of 55 consecutive GD patients, 38% had LGL expansions in the PB smears. Since both conditions may be asymptomatic for many years, their co-existence can easily be missed.Table 1:Patient characteristics1234Age at diagnosis31314572GenderFemaleFemaleFemaleMaleSplenectomyNoYesYesNoBony diseaseAVNBone crisis, AVN, osteomyelitisNo?Pulmonary HypertensionNoNoYesNoAutoimmune phenomenonNoNoAIHANoB cell dyscrasiasYesNoPolyclonal hypergammagloblulinemiaMGUSOther neoplasmsNoNoNoMDSLeucocyte count (×10/ul)2.213.36.62.9LGL percent of lymphocytes52%62%30%70%LGL absolute count (×10/ul)0.55.111.10.532LGL phenotypeCD3+,CD8+, CD56+, CD16−, CD57−, TCR αβ+CD3+, CD8+, CD16−, CD56−, TCR αβ+?CD3+, CD8+, CD16−, CD56−, TCR αβ+2 populationsa) CD3+, CD8+, CD56+, TCR αβ+9.3g/dlb) CD3−,CD56+,CD4−, CD8−Hemoglobin (g/dl)4.911.311.4Platelet count (x10/ul)111779630TCR rearrangementNegativeNegativePositivePositiveBone marrow pattern of involvementMild interstitial infiltrate of small lymphocytes CD8+TMild interstitial infiltrate of small lymphocytes CD8+TERTNoYesYesYesERT: improvement of cytopeniasUntreatedNoNoYes The co-existence of two hematological pathologies in more than one patient and the possibility that therapy for one may impact the other, is provocative. We suggest that LGL expansions in GD may be reactive to glucocereborside accumulation in Gaucher cells, and may play a pathogenic role in the development of some of the features of GD as well as induce/exacerbate some associated disorders. Disclosures: Zimran: Actelion: Honoraria.
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Ardicli, Sena, Hale Samli, Buse Vatansever, Bahadir Soyudal, Deniz Dincel, and Faruk Balci. "Comprehensive assessment of candidate genes associated with fattening performance in Holstein–Friesian bulls." Archives Animal Breeding 62, no. 1 (January 21, 2019): 9–32. http://dx.doi.org/10.5194/aab-62-9-2019.
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Abstract. The objective of this study was to determine the association of single nucleotide polymorphisms (SNPs) in selected candidate genes with fattening performance traits in a commercial cattle herd. Fifteen SNPs in 12 candidate genes (LEP, FABP4, DGAT1, TG, IGF1, IGF1R, MYF5, LGB, CAPN1, CAST, GHR, and OLR1) were evaluated in 296 purebred Holstein–Friesian bulls using PCR-RFLP (polymerase chain reaction – restriction fragment length polymorphism). Associations between each segregating SNP and genetic merit for fattening performance were quantified using linear mixed models. Traits included in the study were fattening period, final weight, dry matter intake, feed conversion rate, and average daily weight gain. Apart from the general determination of the above-mentioned traits, each trait was evaluated based on the fattening periods between five selected target body weights (W1 = 100 kg, W2 = 200 kg, W3 = 300 kg, W4 = 400 kg, W5 = 450 kg). All markers with the exception of CAPN1 530, IGF1R, TG, and DGAT1 were associated with at least one of the traits. Furthermore, novel associations were observed for LEP × GHR, IGF1 × LEP, FABP4 3691 × FABP4 2834, and FAP4 3533 × LEP interactions. The results of this study confirm some previously reported associations. Moreover, novel associations have been identified, which may be incorporated into breeding programs to improve fattening performance.
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Da Silva, Maria Carla, Eliane Correa Miotto, Mara Cristina Souza De Lucia, and Paulo Henrique Pires De Aguiar. "Investigação neuropsicológica pré-operatória em pacientes com glioma de baixo grau." JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 18, no. 3 (March 6, 2018): 35–39. http://dx.doi.org/10.22290/jbnc.v18i3.635.
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Objetivo: Os gliomas de baixo grau (LGG) são tumores decrescimento lento e com um comportamento clínico heterogêneo,onde muitos pacientes não apresentam sintomas neurológicosou cognitivos observáveis, entretanto, quando taispacientes são submetidos a tratamento químioterápico ouradioterápico, observam-se em alguns casos alterações cognitivasmuitas vezes não associadas apenas com o tratamentorecebido. Nestes casos há a possibilidade de tais pacientes jáapresentarem previamente ao tratamento alterações cognitivassutis identificadas apenas através de exame neuropsicológico.O objetivo deste estudo é investigar as funções cognitivasde pacientes com gliomas de baixo grau antes do tratamentocirúrgico ou medicamentoso. Método: 13 pacientes com LGG foram submetidos à avaliaçãoneuropsicológica com testes psicométricos. Resultados: Todos os pacientes apresentaram déficit cognitivosem mais de duas funções cognitivas, sendo memória episódicaverbal e funções executivas as mais prejudicadas. Oitopacientes (62%) apresentaram déficit grave de memória episódicaverbal imediata, sete (54%) de tardia e quatro (31%)de reconhecimento. Quanto às funções executivas, 92 % dospacientes apresentaram déficit de fluência verbal nominal e77% de fluência verbal categórica, variando entre leve e grave.85% dos pacientes apresentaram déficit de flexibilidademental e de velocidade de processamento de informações. Conclusão: Demonstrou-se a importância de submeter estapopulação de pacientes à avaliação neuropsicológica antesdo tratamento para que, assim, os resultados pormenorizadosobtidos possam direcionar o tratamento de forma mais efetiva,minimizando possíveis conseqüências funcionais para o paciente.
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Mulyanto, Agus, Yeni Agus Nurhuda, and Imam Khoirurosid. "Sistem Kendali Lampu Rumah Menggunakan Smartphone Android." Jurnal Teknoinfo 11, no. 2 (July 15, 2017): 48. http://dx.doi.org/10.33365/jti.v11i2.28.
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Pemanfaatan energi listrik dewasa ini kurang efektif khususnya dalam hal penerangan penggunaan lampu di dalam ruangan, dimana sering kali dijumpai keadaan energi listrik yang dipakai untuk menerangi ruangan terbuang secara percuma karena kelalaian pemakai yang lupa untuk memadamkan kembali lampu ruangan apabila sudah tidak diperlukan lagi. Maka pada penelitian ini di buat sebuah prototype Sistem Kendali Lampu Ruangan yang dapat dikendalikan melalui Smartphone Android dengan menggunakan media komunikasi Bluetooth HC-05, dan mikrokontroler Arduino Uno R3 serta sensor LDR. Tujuan penelelitian ini adalah supaya pemakaian energi listrik ini dimanfaatkan secara tepat dan efisien dengan adanya sistem timer dan sistem pemberitahuan jika kondisi lampu dalam kondisi hidup dengan melakukan beberapa pengaturan. Sistem dapat mengendalikan lampu ruangan pada jarak 9-17 meter dengan kondisi ruangan yang bersekat-sekat maupun rumah 2 lantai, dan jika dikendalikan dari luar rumah maka jarak jangkaunya mencapai 30-60 meter. Jarak jangkau pengendalian di pengaruhi oleh kualitas Bluetooth yang dimiliki smartphone. Pengujian dengan menggunakan smartphone Cross A88, Smartfren C2, dan Lenovo, dan hasilnya menunjukkan bahwa Bluetooth smartphone Smartfren C2 memiliki jangkauan yang paling jauh yaitu 20 meter untuk dalam ruang tertutup, dan 62 meter dari raungan terbuka atau dari luar rumah.Kata kunci: kendali lampu, bluetooth HC-05, arduino uno R3, LDR, smartphone android.
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Gang, Liu, Zeng Mu, Ma Zenglin, Liu Jiayi, Fan Zhanming, Liu Dongting, and Wen Zhaoying. "Cardiac Magnetic Resonance Quantitative Tissue Markers in the Clinical Application Value for the Diagnosis of Acute Myocarditis." Journal of Medical Imaging and Health Informatics 8, no. 9 (December 1, 2018): 1751–56. http://dx.doi.org/10.1166/jmihi.2018.2523.
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Objectives: To determine the value of cardiac magnetic resonance (CMR) quantitative tissue markers in the diagnosis of acute myocarditis, compared with the traditional Lake-Louise criteria (LLC). Methods: Totally 35 cases of patients diagnosed as acute myocarditis in Beijing Anzhen Hospital and 35 healthy volunteers were enrolled in our study, from May 2014 to August 2016. CMR protocol included quantitative assessment of T1 relaxation times using modified Look-Locker inversion recovery (MOLLI), extracellular volume fraction (ECV), T2 relaxation times. Established Lake-Louise criteria (LLC) consisting of T2-weighted signal intensity ratio (T2-ratio), early gadolinium enhancement ratio (EGEr), and late gadolinium enhancement (LGE) were assessed. Receiver operating characteristics analysis was performed to compare diagnostic performance. Results: T2-ratio (1.85±0.21 vs. 1.58±0.15; P = 0.002) and EGEr (3.87±1.62 vs. 2.15±1.36; P =0.024) were significantly higher in myocarditis subjects than in control subjects. Non-ischemic LGE was found in 27/35 (77.1%) of all myocarditis patients. Regional myocardial edema was found in 23/35 (65.7%) of all myocarditis patients. Myocardial T1 and T2 relaxation times and ECV were significantly prolonged in the myocarditis group compared with the control group (T1 native relaxation time: 1310±62 vs. 1247±27 ms, T2 native relaxation time: 65.46±8.49 vs. 55.17±3.59 ms; ECV: 34.47±8.52 vs. 27.68±5.82, P < 0.001, respectively). Areas under the curve of native T1 (0.94) and T2 relaxation times (0.91) were higher compared with those of the other CMR parameters (T2-ratio: 0.73, EGEr: 0.72, LGE: 0.88, LLC: 0.90, ECV: 0.79). Combined with LGE, each native mapping technique outperformed the diagnostic performance of LLC (P < 0.01, respectively). A combination of native parameters (T1, T2 relaxation times) significantly increased the diagnostic performance of CMR compared with LLC without need of contrast media application (0.99 vs. 0.90; P < 0.05). Conclusion: CMR quantitative tissue markers has good diagnostic efficiency for acute myocarditis, it may be potential to replace the Lake-Louise criteria in the future in patients with contraindications for the use of gadolinium-based contrast agents.
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Kacena, Katherine A., Sean B. Quinn, M. René Howell, Guillermo E. Madico, Thomas C. Quinn, and Charlotte A. Gaydos. "Pooling Urine Samples for Ligase Chain Reaction Screening for Genital Chlamydia trachomatis Infection in Asymptomatic Women." Journal of Clinical Microbiology 36, no. 2 (1998): 481–85. http://dx.doi.org/10.1128/jcm.36.2.481-485.1998.
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The accuracy of pooling urine samples for the detection of genitalChlamydia trachomatis infection by ligase chain reaction (LCR) was examined. A model was also developed to determine the number of samples to be pooled for optimal cost savings at various population prevalences. Estimated costs included technician time, laboratory consumables, and assay costs of testing pooled samples and retesting individual specimens from presumptive positive pools. Estimation of population prevalence based on the pooled LCR results was also applied. After individual urine specimens were processed, 568 specimens were pooled by 4 into 142 pools and another 520 specimens were pooled by 10 into 52 pools. For comparison, all 1,088 urine specimens were tested individually. The sample-to-cut-off ratio was lowered from 1.0 to 0.2 for pooled samples, after a pilot study which tested 148 samples pooled by 4 was conducted. The pooling algorithm was 100% (48 of 48) sensitive when samples were pooled by 4 and 98.4% (61 of 62) sensitive when samples were pooled by 10. Although 2.0% (2 of 99) of the negative pools of 4 and 7.1% (1 of 14) of the negative pools of 10 tested presumptive positive, all samples in these presumptive-positive pools were negative when retested individually, making the pooling algorithm 100% specific. In a population with 8% genital C. trachomatis prevalence, pooling by four would reduce costs by 39%. The model demonstrated that with a lower prevalence of 2%, pooling eight samples would reduce costs by 59%. Pooling urine samples for detection of C. trachomatis by LCR is sensitive, specific, and cost saving compared to testing individual samples.
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Zellars, R. C., S. G. Hilsenbeck, G. M. Clark, D. C. Allred, T. S. Herman, G. C. Chamness, and R. M. Elledge. "Prognostic Value of p53 for Local Failure in Mastectomy-Treated Breast Cancer Patients." Journal of Clinical Oncology 18, no. 9 (May 9, 2000): 1906–13. http://dx.doi.org/10.1200/jco.2000.18.9.1906.
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PURPOSE: The loss of p53 function is a recognized adverse prognostic factor in invasive breast cancer. Several studies have shown a relationship between the nuclear accumulation of p53 protein (a surrogate marker of p53 inactivation) and poor disease-free and overall survival. In general, however, these studies did not report the prognostic value of p53 for local failure, which we have therefore assessed retrospectively here. MATERIALS AND METHODS: Accumulation of p53 protein was evaluated by immunohistochemistry in 1,530 mastectomy-treated breast cancer patients (259 radiation therapy [RT]– and 1,271 mastectomy only [No RT]–treated patients). Statistical comparisons were made between p53 protein accumulation, estrogen/progesterone receptors, nodal status, tumor size, and local failure rate (LFR). Local failure was defined as tumor recurrence involving the chest wall and/or the ipsilateral supraclavicular/axillary lymph nodes. The median follow-up period was 62 months. RESULTS: In the No RT group, the LFR was 9.1% and 16.5% in p53-negative and p53-positive patients, respectively (P < .001). Multivariate analysis revealed that p53 protein accumulation was significantly associated with an increased risk of local relapse (relative risk [RR], 1.7; 95% confidence interval [CI], 1.2 to 2.4). Nodal status and tumor size were also significant factors. In the RT group, the LFR was 9.3% and 21.5% in p53-negative and p53-positive patients, respectively (P = .009). Multivariate analysis revealed that p53 protein accumulation was significantly associated with an increased risk of local relapse (RR, 2.5; 95% CI, 1.1 to 5.7), as was nodal status. CONCLUSION: Nuclear accumulation of p53 protein is independently associated with a significantly increased local failure rate in breast cancer patients treated with mastectomy, with or without radiation.
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Dinter, Martin T. "Sententiae na épica latina." Letras Clássicas, no. 14 (December 19, 2010): 51. http://dx.doi.org/10.11606/issn.2358-3150.v0i14p51-62.
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Este artigo examina as <em>sententiae</em>, um expediente retórico bastante negligenciado da épica latina, em Virgílio e Lucano. Enquanto as sententiae de Virgílio são frequentemente citadas por autores posteriores, Lucano, em particular, ficou famoso na Antiguidade por suas <em>sententiae</em> altamente retóricas (<em>Inst. Or.</em> 10.1.90). Lucano concentra seus esforços no nível sintático a fim de criar frases únicas e memoráveis, as quais asseguram o <em>Nachleben</em> de seu épico – haja vista que são extraíveis de seus contextos originais e realocáveis em novos contextos. Ler Lucano como uma mina de versos singulares não é uma imposição moderna, mas, ao contrário, confirma que este estilo de leitura exibe a força de formulações enérgicas sobre temas-chave da épica lucaniana, tais como derrocada e fuga. As <em>sententiae</em> estabelecem as leis da épica e, simultaneamente, criam um discurso sobre valores que se estendem por toda a épica.
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Herwinanto, Erfan. "PERBANDINGAN KINERJA BANK SWASTA DI INDONESIA BERDASARKAN PEMENUHAN MODAL MINIMUM." Jurnal Riset Akuntansi dan Keuangan 11, no. 2 (June 7, 2015): 129. http://dx.doi.org/10.21460/jrak.2015.112.13.
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This study aims at revealing the bank capital influence its operational activities. This study employssecondary datum which is obtained from bank indonesia. From the existing data banks, 171 financialstatement of banks are used for sample from 2005 to 2007, which breakdown in 2005 consist 62, 2006consist 56, 2007 consist 53 financial statement. In order to measure banks activities, CAMELScomponent is conducted in accordance with bank indonesia regulations. Based on the analysis at allbanks on 2005-2007, it revals that KPPM component, capital component, NIM component, betweenbank and its capital below minimum and bank and its capital above, the difference is not found.Meanwhile differences are found when ROE component, BOPO component and LDR component,between bank and its capital below minimum and bank its capital above minimum.Keywords: minimum capital, bank activity, CAMELS
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Hata, Jessica, Mustafa Barbour, and Michael Angelo Huang. "LGG-02. PEDIATRIC LOW-GRADE GLIOMA RISK STRATIFICATION IN THE MOLECULAR ERA." Neuro-Oncology 23, Supplement_1 (June 1, 2021): i31. http://dx.doi.org/10.1093/neuonc/noab090.126.
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Abstract Background Pediatric low-grade gliomas (LGG), in particular those not amenable to surgical resection, are a therapeutic challenge owing to their heterogeneity in clinical behavior. Identification of the RAS/MAPK pathway as a universal feature of these tumors has led to an improved understanding and the development of targeted therapeutics. We examined the impact of known biological and novel molecular risk factors on patient outcomes at our institution. Methods We retrospectively reviewed risk factors and clinical outcomes in 38 LGG cases diagnosed by histopathology at Norton Children’s Hospital in Louisville, KY, USA from March 2015 to Jan 2019. Progression free survival (PFS) rates were generated using the Kaplan-Meier method. Log-rank tests and hazard ratios were used to identify prognostic factors by univariable analysis. Results Among previously described biological risk factors, subtotal resection/biopsy only (HR 3.67, p=0.0257), non-WHO Grade I histology (HR 3.34, p=0.0101), and infant age (< 3 years) (HR 4.19, p=0.0031) were associated with shorter PFS. Brainstem location had no significant impact on PFS. (HR 0.86, p=0.8071). H3K27M mutant status was predictably associated with worse PFS (HR 5.86, p=0.0012). BRAF v600e mutant status, however, was not associated with inferior outcomes. On the contrary, in our study population, BRAF v600e mutant status had a suggested protective effect (HR 0.14, p=0.0247). Patients with 2 or more oncogenic driver mutations demonstrated worsened PFS (HR 4.78, p=0.0059). We utilized the following scoring system for risk stratification: 1 point was allocated for each of the above biological and molecular risk factors except for H3K27M, which was allocated 3 points. A score of < 3 was designated low risk. Non-low risk classification was associated with significantly inferior PFS (median PFS 13 vs. 62 mos, HR 4.26, p=0.0012). Conclusion We herein demonstrate the utility of a combined biological and molecular risk classification for pediatric LGG.
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Widhalm, Georg, Jonathan Olson, Jonathan Weller, Jaime Bravo, Seunggu J. Han, Joanna Phillips, Shawn L. Hervey-Jumper, Susan M. Chang, David W. Roberts, and Mitchel S. Berger. "The value of visible 5-ALA fluorescence and quantitative protoporphyrin IX analysis for improved surgery of suspected low-grade gliomas." Journal of Neurosurgery 133, no. 1 (July 2020): 79–88. http://dx.doi.org/10.3171/2019.1.jns182614.
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OBJECTIVEIn patients with suspected diffusely infiltrating low-grade gliomas (LGG), the prognosis is dependent especially on extent of resection and precision of tissue sampling. Unfortunately, visible 5-aminolevulinic acid (5-ALA) fluorescence is usually only present in high-grade gliomas (HGGs), and most LGGs cannot be visualized. Recently, spectroscopic probes were introduced allowing in vivo quantitative analysis of intratumoral 5-ALA–induced protoporphyrin IX (PpIX) accumulation. The aim of this study was to intraoperatively investigate the value of visible 5-ALA fluorescence and quantitative PpIX analysis in suspected diffusely infiltrating LGG.METHODSPatients with radiologically suspected diffusely infiltrating LGG were prospectively recruited, and 5-ALA was preoperatively administered. During resection, visual fluorescence and absolute tissue PpIX concentration (CPpIX) measured by a spectroscopic handheld probe were determined in different intratumoral areas. Subsequently, corresponding tissue samples were safely collected for histopathological analysis. Tumor diagnosis was established according to the World Health Organization 2016 criteria. Additionally, the tumor grade and percentage of tumor cells were investigated in each sample.RESULTSAll together, 69 samples were collected from 22 patients with histopathologically confirmed diffusely infiltrating glioma. Visible fluorescence was detected in focal areas in most HGGs (79%), but in none of the 8 LGGs. The mean CPpIX was significantly higher in fluorescing samples than in nonfluorescing samples (0.693 μg/ml and 0.008 μg/ml, respectively; p < 0.001). A significantly higher mean percentage of tumor cells was found in samples with visible fluorescence compared to samples with no fluorescence (62% and 34%, respectively; p = 0.005), and significant correlation of CPpIX and percentage of tumor cells was found (r = 0.362, p = 0.002). Moreover, high-grade histology was significantly more common in fluorescing samples than in nonfluorescing samples (p = 0.001), whereas no statistically significant difference in mean CPpIX was noted between HGG and LGG samples. Correlation between maximum CPpIX and overall tumor grade was highly significant (p = 0.005). Finally, 14 (40%) of 35 tumor samples with no visible fluorescence and 16 (50%) of 32 LGG samples showed significantly increased CPpIX (cutoff value: 0.005 μg/ml).CONCLUSIONSVisible 5-ALA fluorescence is able to detect focal intratumoral areas of malignant transformation, and additional quantitative PpIX analysis is especially useful to visualize mainly LGG tissue that usually remains undetected by conventional fluorescence. Thus, both techniques will support the neurosurgeon in achieving maximal safe resection and increased precision of tissue sampling during surgery for suspected LGG.Clinical trial registration no.: NCT01116661 (clinicaltrials.gov)
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XU, XIANGMIN, A. B. BONDS, and VIVIEN A. CASAGRANDE. "Modeling receptive-field structure of koniocellular, magnocellular, and parvocellular LGN cells in the owl monkey (Aotus trivigatus)." Visual Neuroscience 19, no. 6 (November 2002): 703–11. http://dx.doi.org/10.1017/s0952523802196027.
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Most cells in the retina and lateral geniculate nucleus (LGN) of primates have a concentric center/surround receptive-field organization. Details of the relationship between center and surround often can be used to predict how cells respond to visual stimuli. Models of the receptive-field organization and center/surround relationships also are useful when comparing cell classes. In the present study, we used the difference-of-Gaussians (DOG) model to quantitatively examine and compare the receptive-field center/surround organization of koniocellular (K), magnocellular (M), and parvocellular (P) LGN cells of owl monkeys. We obtained estimates of receptive-field center size (rc) and center sensitivity (Kc), and surround size (rs), and surround sensitivity (Ks) from 62 K, M, and P LGN cells by fitting their spatial-frequency responses with a DOG function (Rodieck, 1965; Croner & Kaplan, 1995). The DOG function not only accounted for the responses of P and M cells, but also provided a good description of K-cell responses. We found that at matched eccentricities of less than 15 deg, K cells had the largest rc and rs among the three cell classes. K cells also had the lowest Kc and Ks.
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Diaz, M., J. Jo, and D. Schiff. "P14.23 Risk of venous thromboembolism (VTE) in grade II-IV gliomas as a function of molecular subtype." Neuro-Oncology 21, Supplement_3 (August 2019): iii71—iii72. http://dx.doi.org/10.1093/neuonc/noz126.258.
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Abstract BACKGROUND VTE affects up to 30% of patients with glioblastoma (GBM, WHO grade IV), but little is known about its incidence in lower-grade gliomas (LGG, WHO grade II-III). It has been suggested that isocitrate dehydrogenase (IDH) mutation status dramatically decreases the incidence of VTE in glioma patients, through a combination of F3 promoter hypermethylation leading to lower expression of the procoagulant protein tissue factor, and an increased production of D-2-hydroxyglutarate, which has anticoagulant properties (Unruh et al, 2016). Our objective was to determine the incidence of VTE in LGG and stratify VTE risk by molecular subtype in gliomas grade II-IV. MATERIAL AND METHODS We performed a retrospective analysis of 590 glioma patients with molecular testing seen at our institution (UVa) from January 2005 to August 2017. We divided LGG patients into 3 groups: IDH-wildtype (IDHwt); IDH-mutant (IDHmt), 1p/19q-codeleted; and IDHmt, 1p/19q-intact. GBM patients were divided according to MGMT methylation status. Estimates of cumulative incidence of VTE were calculated with death as competing risk, and significance testing was determined using the Fine and Gray model. RESULTS Of 256 LGG patients (147 grade II and 109 grade III), 81 were IDHwt, 113 IDHmt and 1p/19q-codeleted, and 62 IDHmt and 1p/19q-intact. There were 334 GBM patients, with MGMT methylation status available in 263 (98 (37%) methylated and 165 (63%) unmethylated). With a median follow-up of 545 days, the overall incidence of VTE was 8.2% for grade II, 9.2% for grade III and 30.5% for grade IV. The 6-, 12- and 24-month VTE incidence was 4.1%, 4.8% and 5.4% respectively for grade II, 4.6%, 7.3% and 9.2% for grade III and 23.1%, 26.6% and 29% for grade IV. In LGG patients, VTE incidence was slightly higher in IDHwt tumors (11.1%) vs IDHmt, 1p/19q-codeleted (8.8%) and IDHmt, 1p/19q-intact tumors (4.8%). However, this difference was not statistically significant (IDHwt vs IDHmt, 1p/19q-codeleted, sub-distribution hazard ratio (SHR)=1.67, 95% CI=0.59–4.72; IDHwt vs IDHmt, 1p/19q-intact, SHR=1.87, 95% CI=0.54–6.53). In GBM patients, there was no difference in the VTE incidence according to MGMT methylation status (SHR=0.99, 95% CI=0.64–1.54). CONCLUSION In our cohort, the risk of VTE in GBM patients was consistent with historical data; patients with LGG also had a higher VTE risk compared to the general population. In contrast to other retrospective studies in which the incidence of VTE for grade II-IV IDHmt gliomas was 0% (Unruh et al, 2016; Nazari et al, 2018), our data suggest that VTEs do occur in IDHmt LGG patients, although at a lower rate than in IDHwt. MGMT methylation does not seem to influence the incidence of VTE. VTE risk stratification in GBM patients based on IDH mutation is forthcoming.