Academic literature on the topic 'Remnant Trust'

: This review of radioactive iodide treatment (RAIT) extends from historical origins to its modern utilization in differentiated thyroid cancer (DTC). The principles embedded in the radiotheragnostics (RTGs) paradigm are detailed. : The diverse approaches in current practice are addressed, and this broad variability represents a major weakness that erodes our specialty’s trust-based relationship with patients and referring physicians. The currently developing inter-specialty collaboration should be hailed as a positive change. It promises to clarify the target-based terminology for RAIT. It defines RAIT of post total thyroidectomy (PTT), presumably benign thyroid as ‘remnant ablation’ (RA). ‘Adjuvant treatment’ (AT) referrers to RAIT of suspected microscopic DTC that is inherently occult on diagnostic imaging. RAIT directed at DTC lesion(s) overtly seen on diagnostic imaging is termed ‘treatment of known disease’ (TKD). : It was recently recognized that a ‘recurrent’ DTC is actually occult residual DTC in the majority of cases. Thyroglobulin with remnant uptake concord (TRUC) method (aka Tulchinsky method) was developed to validate that a benign remnant in the post-thyroidectomy neck bed, as quantified by the RAI uptake, is concordant with a measured thyroglobulin (Tg) level at the time of the initial post-thyroidectomy evaluation. It allows recognition of occult residual DTC contribution to post-thyroidectomy Tg. Case examples demonstrate the application of the TRUC method for a logical selection of a specific RAIT category, using imaging-guided identification and management of RAI-avid versus RAI-nonavid residual DTC, i.e. the radiotheragnostics paradigm.

Growing concern about the declining state of the catchment and river led to the formation of the Blackwood Basin Group in 1992. Funded primarily by the Natural Heritage Trust and using the river as the focus, the group aims to provide leadership and support to achieve sustainable management of natural resources in the catchment. Through an Integrated Catchment Management approach, the Blackwood Basin Group has managed a range of projects to improve the community's understanding and management of the Blackwood River and its catchment. A number of research, education, demonstration and on-ground action activities relating to river management have been undertaken in partnership with community and local, state and federal government organisations. Activities include demonstrations and evaluations of riparian restoration, funding riparian restoration activities, protection of high conservation value remnant vegetation, a flood risk study, zone action planning and monitoring the condition of the river and its tributaries.

Background Developing innovative, efficient, and institutionally scalable biospecimen consent for remnant tissue that meets the National Institutes of Health consent guidelines for genomic and molecular analysis is essential for precision medicine efforts in cancer. Objective This study aims to pilot-test an electronic video consent that individuals could complete largely on their own. Methods The University of California, Los Angeles developed a video consenting approach designed to be comprehensive yet fast (around 5 minutes) for providing universal consent for remnant biospecimen collection for research. The approach was piloted in 175 patients who were coming in for routine services in laboratory medicine, radiology, oncology, and hospital admissions. The pilot yielded 164 completed postconsent surveys. The pilot assessed the usefulness, ease, and trustworthiness of the video consent. In addition, we explored drivers for opting in or opting out. Results The pilot demonstrated that the electronic video consent was well received by patients, with high scores for usefulness, ease, and trustworthiness even among patients that opted out of participation. The revised more animated video pilot test in phase 2 was better received in terms of ease of use (P=.005) and the ability to understand the information (P<.001). There were significant differences between those who opted in and opted out in their beliefs concerning the usefulness of tissue, trusting researchers, the importance of contributing to science, and privacy risk (P<.001). The results showed that “I trust researchers to use leftover biological specimens to promote the public’s health” and “Sharing a biological sample for research is safe because of the privacy protections in place” discriminated opt-in statuses were the strongest predictors (both areas under the curve were 0.88). Privacy concerns seemed universal in individuals who opted out. Conclusions Efforts to better educate the community may be needed to help overcome some of the barriers in engaging individuals to participate in precision health initiatives.

Abstract Objectives The human gut microbiome plays a critical role in host glucose metabolism, but its connections to other key markers of cardiometabolic health in fasting and postprandial conditions is largely unknown. The PREDICT 1 study enrolled n = 1,102 twins and unrelated healthy US/UK adults to explore the genetic, metabolic, microbial, and meal determinants of fasting metabolites and postprandial responses to foods. Methods This multi-centre dietary study assessed fasting and postprandial (0-6h) circulating metabolites over a 13d study period incorporating standardized test meals of varying nutrient composition. Shotgun metagenomics was performed from samples collected at baseline (n = 1,001 UK and 97 US). Metabolomics (NMR) was performed on clinic fasting and postprandial samples, blood glucose was continuously assessed, and blood triglycerides and C-peptide were serially measured. Results Using machine learning models, we found the fasting metabolites most strongly associated with overall gut community structure were the inflammatory marker GlycA (r = 0.31), and HDL and VLDL particle diameter (HDL-D and VLDL-D; r = 0.3 and 0.28 respectively). Variance explained was slightly greater for postprandial HDL-D and VLDL-D (at 6h; r = 0.32 and 0.31, respectively) than fasting levels, whilst the other metabolites did not differ (e.g., GlycA r = 0.28). Lipid-mediated metabolites were more closely associated with the gut microbiome in both fasting and postprandial states compared with glycemic-mediated measurements. There were distinct microbial clusters that segregated both fasting and postprandial metabolites according to their known association with cardiometabolic disease; ApoA and HDL vs. ApoB, VLDL, IDL LDL, remnant C, GlycA, IL-6, blood pressure, glucose, insulin and HbA1c. We also identified differential abundance among several microbes associated with metabolic health, including Prevotella copri and Faecalibacterium prausnitzii. Results obtained in the UK cohort were validated in the US cohort. Conclusions An individual's gut microbial composition is predictive of their cardiometabolic markers and personalized responses to food. Our data highlight the potential of the gut microbiome as a target amenable to modulation in personalized nutrition to ameliorate cardiometabolic risk. Funding Sources Zoe Global Ltd., NIHR GSTT BRC, Wellcome Trust.

We report the case of a 56-year-old male suffering from acute urine retention after a period of increasing dysuria. Physical examination, TRUS and CT showed the presence of a multilocular cystic mass in the space above the prostate and behind the bladder. Pathological findings following surgical exploration indicated a Müllerian duct cyst, few cases of which have been reported in literature. We performed surgery because malignancy was suspected and it was impossible to drain off all the cystic fluid due to the multilocular nature of the cyst. Moreover, cystic adenocarcinomas originating from Müllerian duct remnants have been reported. We agree with other authors that a percutaneous approach should be standard treatment in these cases, leaving open surgery for more complex cases.

The purpose of this article is to compare and contrast the different types of endodontic access cavity designs based on the current available evidence. Four types of access cavity designs, namely, traditional endodontic access cavity design (TEC), contracted/conservative endodontic access cavity design (CEC), ultra-conservative or ninja endodontic access cavity design (NEC) and truss endodontic access cavity design (TREC) have been suggested, and the latter three are currently in the limelight. Studies in vitro have been performed comparing the TECs, CECs, TRECs and NECs; except for the TECs, the other three types have not undergone clinical trials on patients. The choice of endodontic access cavity design affects fracture strength of the tooth, but remnants of pulpal tissue, due to ineffective instrumentation, can cause root canal treatment failure. CPD/Clinical Relevance: Root canal treatment with new access cavity designs has been proposed. However, there is lack of evidence to support such practices. It is important to consider the potential deleterious effects of such access cavity designs rather than emphasizing the preservation of tooth structure alone.

This paper presents a reflective topical narrative in a style this author described in researching Irihapeti Ramsden (2003), an Ngai Tahupotiki (Maori) nursing instructor of Aotearoa (New Zealand). It is a reflection on the nature of Indigenous scholar’s inquiry, or what Irihapeti Ramsden recognized as an often melancholic journey of self-discovery. It is an attempt to understand how, where, and why colonization has reduced us to dependent remnants of the self-reliant and independent peoples our stories remember. We are collectively creating an alternative voice to colonial lies/myths and calling for the restoration of the human dignity stolen along with lands, resources and human rights. Irihapeti Ramsden (2003) used her own melancholic journey of self-discovery to re-ignite trust and reciprocity between people, and to bring the idea of Cultural Safety to colonial New Zealand, thereby establishing a splendid map for future generations of all spaces in need of decolonization. She was met with considerable resistance in her homeland as she raised awareness of the truth about abuses of power by colonial institutions and bureaucracies. By similarly nagging in often difficult processes of self-discovery Indigenous scholars everywhere are helping to unravel a global inheritance of colonial practice. Reconciliation will only be possible when citizens honour Indigenous people’s resistance, resentment and rebellion to European myths of conquest. Indigenous scholars are Being Called to Witness seven generations and to preserve the beauty and strength our ancestors wanted to protect. Our ancestors scarified a great deal, and we must wipe our tears, open our eyes, listen deeply, clear our throats, and raise our strong voices to bear witness to our ancestors’ prayers.

Introduction and objectives: PSA elevation is associated with prostate cancer and it is used in screening programs for its diagnosis. It is one of the most common indications for referral to an urologist. There’s no consensus about what to do in PSA elevation management. Antibiotics, nutraceuticals or anti-inflammatories are commonly prescribed in daily practice. Our objective was to verify the effect on the PSA value of a short 30-day trial of a curcuma extract, than to discuss the implications in terms of reducing the number of prostate biopsies performed. Patients and methods: We enrolled 50 consecutive patients admitted at our attention for a first PSA over the level of 4 ng/ml or for a suspected PSA rising defined as PSA velocity (PSAv) > 0.75 ng/ml/years. They received treatment with curcuma extract, 2 tablets per day for 30 day. All patients received a second PSA measurement and TRUS within 6 days from the end of the therapy. In case of PSA reduction below 4 ng/ml, patients were reassured and invited to repeat a PSA control over the time. When PSA level were persistently high over 4 ng/ml or in case of any rising, patients underwent a transrectal ultrasound guided 12-core prostatic biopsy (TRUSbx). Results: Mean age of the patients was 64.56 ± 8.88 (range, 42- 81 years). Prostate volume was 48.34 ± 15,77 ml (range, 18-80 ml). At visit 1, PSA value was in mean 6,84 ± 3.79 ng/ml (range 2.93-21ng/ml). Consequently, mean PSA density value was 0.16 ± 0.16 (range 0.05-1.11). PSA free and PSA total ratio at baseline was 16.85 ± 3.9% (range 8-26%). At visit 2, the prostate volume did not change. Total PSA was 4.65 ± 2,67 ng/ml (range 1-16.82 ng/ml). PSA free and PSA total ratio (PSAF/T) after treatment was 19.68 ± 5.35 % (range 7.8-29%). The differences of total PSA and PSAF/T between visit 1 and visit 2 were < 0.0001 and p < 0.0036, respectively. We performed 26 TRUSbx. Prostate cancer was diagnosed in 6 cases, PIN HG in 2 cases and non neoplastic findings in the remnants 18 patients. Conclusions: Use of the Curcuma extract is able to lower the PSA value after a 30-day intake period. We are not able to state that the reduction of PSA after intake of this Curcuma extract may exclude a prostate cancer. We need further studies to evaluate that.

Contact symmetries are involved in regulating cell lineage segregation during blastocyst biogenesis when tight junction (TJ) membrane assembly is restricted to the epithelial trophectoderm (TE). Manipulation of cell contact patterns by immunosurgical isolation of inner cell masses (ICMs) providing a contact-free cell surface serves as a switch to induce TE differentiation upon in vitro culture. In this model, protein kinase C (PKC)-mediated signaling up-regulates TJ membrane assembly. Whether signaling via gap junctional intercellular communication (GJIC) affects these processes is controversial. The current study investigates the interrelationship between changes in cell contact pattern, PKC signaling, and GJIC on TE differentiation and TJ assembly. Eight-cell embryos flushed from MF1 mice were cultured in T6/BSA to time development to early blastocyst stage (<2 h of cavitation). Laser confocal microscopy (BioRad MRC 600, BioRad Laboratories, Inc., Hertfordshire, UK) after immunostaining with antibodies against PKCδ, θ, λ, or ζ isoforms (Transduction Labs, Oxford, UK or Sigma) or junctional proteins (E-cadherin, ZO-2, Occludin, ZO-1α+, Desmoplakin) combined with ALEXA 488 conjugated secondary antibodies (Cambridge Bioscience, Oxford, UK) was used to determine the distribution of PKCs and junctional proteins in intact blastocysts and fully and partially isolated ICMs after immunosurgery and in vitro culture in DMEM + 10% FCS (Eckert et al. 2004 Reproduction 127, 653). While broad PKC activators (1 μM 12-O-tetradecanoylphorbol-13-acetate or Indolactam; Calbiochem, Nottingham, UK) accelerate membrane assembly of the TJ proteins ZO-2 and ZO-1α+ in fully isolated ICMs this up-regulation was suppressed in intact blastocysts (n = 32–47 per treatment and antibody) and in partially isolated ICMs (remnants of lysed TE remaining surrounding the ICM; n = 17–21 per treatment and antibody) for up to 24 h with no TJ protein detectable within the ICM, even after two consecutive rounds of TE lysis (n = 13–22 per treatment and antibody). When GJIC was inhibited during blastocyst formation in vitro and in cultured fully isolatd ICMs by 18 α-glycyrrhetinic acid (AGA, 65 μM; Sigma), cavitation rate and distribution of PKCs or junction assembly were not affected compared to controls (70–80% cavitated with characteristic distribution of junctional proteins and PKCs; P > 0.05, ANOVA; n = 15–20 per treatment, antibody, and cell contact pattern). When GJIC inhibition by AGA was confirmed by Lucifer yellow (Sigma) injection (no dye transfer in 82–100%, n = 14–17 per contact pattern), GJIC was also absent in 50% of fully isolated ICMs without AGA treatment, suggesting that cell contact modulation may affect GJIC. Taken together, our data suggest that cell contact pattern regulates TJ assembly via PKC signaling pathways and may also affect GJIC. GJIC appeared dispensable during cavitation, TJ assembly, and PKC signaling. A better understanding of the interrelationships between different signaling mechanisms may help to improve embryo culture methods and viability. Funding by the Wellcome Trust and MRC is gratefully acknowledged.