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McKinnon, Catherine. "Case Study: Writing Unreliable Narrator Will Martin." Narrative 22, no. 3 (2014): 395–416. http://dx.doi.org/10.1353/nar.2014.0022.
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Stevens, Kevin. "“Eccentric Murmurs”: Noise, Voice, and Unreliable Narration in Jane Eyre." Narrative 26, no. 2 (2018): 201–20. http://dx.doi.org/10.1353/nar.2018.0010.
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Sela, Itamar, Haim Ashkenazy, Kazutaka Katoh, and Tal Pupko. "GUIDANCE2: accurate detection of unreliable alignment regions accounting for the uncertainty of multiple parameters." Nucleic Acids Research 43, W1 (2015): W7—W14. http://dx.doi.org/10.1093/nar/gkv318.
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Qi, Lian, and Zuo-Jun Max Shen. "A supply chain design model with unreliable supply." Naval Research Logistics 54, no. 8 (2007): 829–44. http://dx.doi.org/10.1002/nav.20255.
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Rico-Alvarino, Alberto, Roberto Lopez-Valcarce, Carlos Mosquera, and Robert W. Heath. "FER Estimation in a Memoryless BSC With Variable Frame Length and Unreliable ACK/NAK Feedback." IEEE Transactions on Wireless Communications 16, no. 6 (2017): 3661–73. http://dx.doi.org/10.1109/twc.2017.2686845.
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Sahba, Pedram, Bariş Balciog̃lu, and Dragan Banjevic. "Analysis of the finite-source multiclass priority queue with an unreliable server and setup time." Naval Research Logistics (NRL) 60, no. 4 (2013): 331–42. http://dx.doi.org/10.1002/nav.21537.
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Chakravarthy, Srinivas R., and Atul Agarwal. "Analysis of a machine repair problem with an unreliable server and phase type repairs and services." Naval Research Logistics 50, no. 5 (2003): 462–80. http://dx.doi.org/10.1002/nav.10069.
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Narasimhan, Madhumitha, Michelle Gallei, Shutang Tan, et al. "Systematic analysis of specific and nonspecific auxin effects on endocytosis and trafficking." Plant Physiology 186, no. 2 (2021): 1122–42. http://dx.doi.org/10.1093/plphys/kiab134.
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Abstract The phytohormone auxin and its directional transport through tissues are intensively studied. However, a mechanistic understanding of auxin-mediated feedback on endocytosis and polar distribution of PIN auxin transporters remains limited due to contradictory observations and interpretations. Here, we used state-of-the-art methods to reexamine the auxin effects on PIN endocytic trafficking. We used high auxin concentrations or longer treatments versus lower concentrations and shorter treatments of natural indole-3-acetic acid (IAA) and synthetic naphthalene acetic acid (NAA) auxins to distinguish between specific and nonspecific effects. Longer treatments of both auxins interfere with Brefeldin A-mediated intracellular PIN2 accumulation and also with general aggregation of endomembrane compartments. NAA treatment decreased the internalization of the endocytic tracer dye, FM4-64; however, NAA treatment also affected the number, distribution, and compartment identity of the early endosome/trans-Golgi network, rendering the FM4-64 endocytic assays at high NAA concentrations unreliable. To circumvent these nonspecific effects of NAA and IAA affecting the endomembrane system, we opted for alternative approaches visualizing the endocytic events directly at the plasma membrane (PM). Using total internal reflection fluorescence microscopy, we saw no significant effects of IAA or NAA treatments on the incidence and dynamics of clathrin foci, implying that these treatments do not affect the overall endocytosis rate. However, both NAA and IAA at low concentrations rapidly and specifically promoted endocytosis of photo-converted PIN2 from the PM. These analyses identify a specific effect of NAA and IAA on PIN2 endocytosis, thus, contributing to its polarity maintenance and furthermore illustrate that high auxin levels have nonspecific effects on trafficking and endomembrane compartments.
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Faszcza, Michał Norbert. "Problemy metodologiczne w badaniach nad Celtami i celtyckością." Studia Europaea Gnesnensia, no. 11 (January 1, 2015): 55–83. http://dx.doi.org/10.14746/seg.2015.11.3.
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In the studies devoted to Celts so far, researchers have tried to define “Celticness” based on two criteria: their material culture and language. Another element which tended to be employed was the argument of terminology used by antique authors. At present, we know that the sense of ethnic identification may have been independent of those factors. This led to a genuine “scientific revolution”, which resulted in the exclusion of Ireland and northern Britain from the circle of Celtic culture. Consequently, the question in which cases one can speak of “Celticness” has become relevant yet again. The author is of the opinion that decisive significance should be attributed to self-identification of given tribes, although sources rarely provide information in that respect. Depending on the remaining criteria tends to be greatly unreliable, given that they were are a modern concept and as such are subject to manipulation. A comfortable, though exceedingly rare situation is their joint occurrence. For this reason the author is inclined to give priority to the language criterion, yet only when the faulty terminology relation to the so-called Q-Celtic and P-Celtic languages is abandoned. Despite the fact that Irish civilisation has been demonstrated to have been non-Celtic, the obsolete terminology is still in use, as a result of which the linguistic criterion cannot perform its function effectively.
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Jin, Luchao, Zhitao Li, Ahmad Jamili, et al. "An Analytical Solution for Three-Component, Two-Phase Surfactant Flooding Dependent on the Hydrophilic/Lipophilic-Difference Equation and the Net-Average-Curvature Equation of State." SPE Journal 22, no. 05 (2017): 1424–36. http://dx.doi.org/10.2118/185946-pa.
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Summary Microemulsion phase behavior is crucial to surfactant flooding performance and design. In previous studies, analytical/numerical solutions for surfactant flooding were developed dependent on the classical theory of multicomponent/multiphase displacement and empirical microemulsion phase-behavior models. These phase-behavior models were derived from empirical correlations for component-partition coefficients or from the Hand-rule model (Hand 1930), which empirically represents the ternary-phase diagram. These models may lack accuracy or predictive abilities, which may lead to improper formulation design or unreliable recovery predictions. To provide a more-insightful understanding of the mechanisms of surfactant flooding, we introduced a novel microemulsion phase-behavior equation of state (EOS) dependent on the hydrophilic/lipophilic-difference (HLD) equation and the net-average curvature (NAC) model, which is called HLD-NAC EOS hereafter. An analytical model for surfactant flooding was developed dependent on coherence theory and this novel HLD-NAC EOS for two-phase three-component displacement. Composition routes, component profile along the core, and oil recovery can be determined from the analytical solution. The analytical solution was validated against numerical simulation as well as experimental study. This HLD-NAC EOS based analytical solution enables a systematic study of the effects of phase-behavior-dependent variables on surfactant-flooding performance. The effects of solution gas and pressure on microemulsion phase behavior were investigated. It was found that an increase of solution gas and pressure would lead to enlarged microemulsion bank and narrowed oil bank. For a surfactant formulation designed at standard conditions, the analytical solution was able to quantitatively predict its performance under reservoir conditions.
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Kim, Heung-Chul, Miran Kim, Young-Soo Kwon, et al. "New distribution and host records for Ornithodoros capensis Neumann and Ornithodoros sawaii Kitaoka and Suzuki (Acari: Ixodida: Argasidae) collected from Black-tailed Gull, Larus crassirostris, nestlings and nest soil and litter on Hong and Nan Islands, Republic of Korea." Systematic and Applied Acarology 22, no. 11 (2017): 1899. http://dx.doi.org/10.11158/saa.22.11.9.
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The 65th Medical Brigade and Medical Department Activity-Korea, in collaboration with the Migratory Birds Research Center, National Park Research Institute, conducted a migratory bird tick-borne disease surveillance program during 2014–2015 on two small, remote, uninhabited islands, Hong (Gull) Island, southern Gyeongnam Province, and Nan Island, western Chungnam Province, Republic of Korea (ROK). Argasid ticks were collected from Black-tailed Gull (Larus crassirostris) nestlings that had recently died and associated nest soil/litter, and all tick life history stages were identified morphologically. Because morphological keys are unreliable for the identification of adult and nymphal argasid ticks, identifications were confirmed by genotyping using polymerase chain reaction techniques. A total of 29 Ornithodoros capensis larvae and 2 Ornithodoros sawaii larvae were collected from 4 of 7 (57.1%) Black-tailed Gull nestlings that had recently died. An additional five O. capensis (2 males, 1 nymph, and 2 larvae) were collected from nest soil/litter. Only O. sawaii larvae (2/41, 4.9%) were collected from dead Black-tailed Gull nestlings on Nan Island. This is the first report of O. capensis from these seabird breeding islands.
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van Veldhuisen, Eran, Claudia van den Oord, Lilly J. Brada, et al. "Locally Advanced Pancreatic Cancer: Work-Up, Staging, and Local Intervention Strategies." Cancers 11, no. 7 (2019): 976. http://dx.doi.org/10.3390/cancers11070976.
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Locally advanced pancreatic cancer (LAPC) has several definitions but essentially is a nonmetastasized pancreatic cancer, in which upfront resection is considered not beneficial due to extensive vascular involvement and consequent high chance of a nonradical resection. The introduction of FOLFIRINOX chemotherapy and gemcitabine-nab-paclitaxel (gem-nab) has had major implications for the management and outcome of patients with LAPC. After 4–6 months induction chemotherapy, the majority of patients have stable disease or even tumor-regression. Of these, 12 to 35% are successfully downstaged to resectable disease. Several studies have reported a 30–35 months overall survival after resection; although it currently remains unclear if this is a result of the resection or the good response to chemotherapy. Following chemotherapy, selection of patients for resection is difficult, as contrast-enhanced computed-tomography (CT) scan is unreliable in differentiating between viable tumor and fibrosis. In case a resection is not considered possible but stable disease is observed, local ablative techniques are being studied, such as irreversible electroporation, radiofrequency ablation, and stereotactic body radiation therapy. Pragmatic, multicenter, randomized studies will ultimately have to confirm the exact role of both surgical exploration and ablation in these patients. Since evidence-based guidelines for the management of LAPC are lacking, this review proposes a standardized approach for the treatment of LAPC based on the best available evidence.
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Turbiner, A. V., and J. C. Lopez Vieyra. "On 1/Z expansion, the critical charge for a two-electron system, and the Kato theorem." Canadian Journal of Physics 94, no. 3 (2016): 249–53. http://dx.doi.org/10.1139/cjp-2015-0366.
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The 1/Z expansion for the ground state energy of the Coulomb system of an infinitely massive center of charge Z and two electrons (two-electron ionic sequence) is studied. A critical analysis of the 1/Z coefficients presented in Baker et al. (Phys. Rev. A, 41, 1247 (1990)) is performed and its numerical deficiency is indicated, leading, in particular, to unreliable decimal digits beyond digits 11–12 of the first coefficients. We made a consistency check of the 1/Z-expansion with accurate energies for Z = 1–10: the weighted partial sums of the 1/Z expansion with Baker et al. coefficients reproduce systematically the ground state energies of two-electron ions with Z ≥ 2 up to 12 decimal digits and for Z = 1 up to 10 decimal digits calculated by Nakashima and Nakatsuji (J. Chem. Phys. 127, 224104 (2007)) with unprecedented accuracy. This rules out the presence of non-analytic terms at Z = ∞ contributing to the first 10–12 decimal digits in the ground state energy; it agrees with the Kato theorem about convergence of the 1/Z expansion within that accuracy. The ground state energy of two-electron ions Z = 11 (Na9+) and Z = 12 (Mg10+) is calculated with 12 decimal digits. This study can be considered as the independent confirmation of the correctness of 10 decimal digits in all 401 coefficients of 1/Z-expansion printed in Baker et al. (Phys. Rev. A, 41, 1247 (1990)).
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Dishart, Michael K., Robert Schlichtig, Tor Inge Tønnessen, et al. "Mitochondrial redox state as a potential detector of liver dysoxia in vivo." Journal of Applied Physiology 84, no. 3 (1998): 791–97. http://dx.doi.org/10.1152/jappl.1998.84.3.791.
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Dysoxia can be defined as ATP flux decreasing in proportion to O2 availability with preserved ATP demand. Hepatic venous β-hydroxybutyrate-to-acetoacetate ratio (β-OHB/AcAc) estimates liver mitochondrial NADH/NAD and may detect the onset of dysoxia. During partial dysoxia (as opposed to anoxia), however, flow may be adequate in some liver regions, diluting effluent from dysoxic regions, thereby rendering venous β-OHB/AcAc unreliable. To address this concern, we estimated tissue ATP while gradually reducing liver blood flow of swine to zero in a nuclear magnetic resonance spectrometer. ATP flux decreasing with O2 availability was taken as O2 uptake (V˙o 2) decreasing in proportion to O2 delivery (Q˙o 2); and preserved ATP demand was taken as increasing Pi/ATP.V˙o 2, tissue Pi/ATP, and venous β-OHB/AcAc were plotted againstQ˙o 2to identify critical inflection points. Tissue dysoxia required meanQ˙o 2for the group to be critical for bothV˙o 2 and for Pi/ATP. CriticalQ˙o 2values forV˙o 2 and Pi/ATP of 4.07 ± 1.07 and 2.39 ± 1.18 (SE) ml ⋅ 100 g−1 ⋅ min−1, respectively, were not statistically significantly different but not clearly the same, suggesting the possibility that dysoxia might have commenced after V˙o 2 began decreasing, i.e., that there could have been “O2 conformity.” CriticalQ˙o 2for venous β-OHB/AcAc was 2.44 ± 0.46 ml ⋅ 100 g−1 ⋅ min−1( P = NS), nearly the same as that for Pi/ATP, supporting venous β-OHB/AcAc as a detector of dysoxia. All issues considered, tissue mitochondrial redox state seems to be an appropriate detector of dysoxia in liver.
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Hornsby, Benjamin W. Y., and H. Gustav Mueller. "User Preference and Reliability of Bilateral Hearing Aid Gain Adjustments." Journal of the American Academy of Audiology 19, no. 02 (2008): 158–70. http://dx.doi.org/10.3766/jaaa.19.2.6.
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The purpose of the current study was to evaluate the consistency and reliability of user adjustments to hearing aid gain and the resulting effects on speech understanding. Sixteen bilaterally aided individuals with hearing loss adjusted their hearing aid gain to optimize listening comfort and speech clarity while listening to speech in quiet and noisy backgrounds. Following these adjustments, participants readjusted their aids to optimize clarity and comfort while listening to speech in quiet. These final gain settings were recorded and compared to those provided by NAL-NL1 prescriptive targets. In addition, speech understanding was tested with the hearing aids set at target and user gain settings. Performance differences between the gain settings were then assessed.Study results revealed that although some listeners preferred more or less gain than prescribed, on average, user and prescribed gain settings were similar in both ears. Some individuals, however, made gain adjustments between ears resulting in "gain mismatches." These "mismatches" were often inconsistent across trials suggesting that these adjustments were unreliable. Speech testing results, however, showed no significant difference across the different gain settings suggesting that the gain deviations introduced in this study were not large enough to significantly affect speech understanding. El propósito del actual estudio fue evaluar la consistencia y la confiabilidad de los ajustes ganancia del auxiliar auditivo por parte del usuario, en cuanto a mejorar la comprensión del lenguaje. Dieciséis individuos hipoacúsicos con amplificación bilateral ajustaron la ganancia de sus auxiliares auditivos para optimizar la comodidad al escuchar y la claridad del lenguaje mientras escuchaban lenguaje en ambientes silenciosos y ruidosos. Después de estos ajustes, los participantes reajustaron sus auxiliares para optimizar la claridad y la comodidad al escuchar lenguaje en silencio. Estos ajustes finales de ganancia fueron registrados y comparados a aquellos indicados por las metas de prescripción del NAL-NL1. Además, se evaluó la comprensión del lenguaje con los auxiliares auditivos graduados en el nivel meta y en el nivel escogido por el usuario. Entonces se evaluaron las diferencias de desempeño entre dichos ajustes de ganancia.El estudio reveló que aunque algunos sujetos prefirieron más o menos ganancia de la prescrita, en promedio, los ajustes de ganancia del usuario y los prescritos fueron similares en ambos oídos. Algunos individuos, sin embargo, realizaron ajustes de ganancia entre sus dos oídos que resultaron en "desajustes de ganancia". Estos "desajustes" fueron a menudo inconsistentes en los diferentes ensayos sugiriendo que eran no confiables. Los resultados de las pruebas de lenguaje, sin embargo, no mostraron diferencias significativas entre los diferentes ajustes de ganancia, sugiriendo que las desviaciones de ganancia introducidas en este estudio no fueron lo suficientemente grandes para afectar significativamente la comprensión del lenguaje.
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Chamard, Emilie, Hugo Théoret, Elaine N. Skopelja, Lorie A. Forwell, Andrew M. Johnson, and Paul S. Echlin. "A prospective study of physician-observed concussion during a varsity university hockey season: metabolic changes in ice hockey players. Part 4 of 4." Neurosurgical Focus 33, no. 6 (2012): E4. http://dx.doi.org/10.3171/2012.10.focus12305.
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Object Despite negative neuroimaging findings using traditional neuroimaging methods such as MRI and CT, sports-related concussions have been shown to cause neurometabolic changes in both the acute and subacute phases of head injury. However, no prospective clinical study has used an independent physician-observer design in the monitoring of these changes. The objective of this study was to evaluate the effects of repetitive concussive and sub-concussive head impacts on neurometabolic concentrations in a prospective study of two Canadian Interuniversity Sports (CIS) ice hockey teams using MR spectroscopy (MRS). Methods Forty-five ice hockey players (25 men and 20 women) participated in this study. All participants underwent pre- and postseason MRI, including spectroscopy imaging, using a 3-T MRI machine. The linear combination model was used to quantify the following ratios: glutamate/creatine-phosphocreatine (Cr), myoinositol/Cr, and N-acetylaspartate (NAA)/Cr. Individuals sustaining a medically diagnosed concussion were sent for MRI at 72 hours, 2 weeks, and 2 months after injury. Results No statistically significant differences were observed between athletes who were diagnosed with a concussion and athletes who were not clinically diagnosed as sustaining a concussion. Although no statistically significant longitudinal metabolic changes were observed among athletes who were diagnosed with a concussion, the results demonstrated a predictable pattern of initial impairment, followed by a gradual return to ratios that were similar to, but lower than, baseline ratios. No significant pre- to postseason changes were demonstrated among men who were not observed to sustain a concussion. However, a substantively significant decrease in the NAA/Cr ratio was noted among the female hockey players (t(13) = 2.58, p = 0.02, η2 = 0.34). Conclusions A key finding in this study, from the standpoint of future research design, is the demonstration of substantively significant metabolic changes among the players who were not diagnosed with a concussion. In addition, it may explain why there are few statistically significant differences demonstrated between players who were diagnosed with a concussion and players who were not diagnosed with a concussion (that is, the potency of the independent variable was diminished by the fact that the group of players not diagnosed with a concussion might be better described as a subgroup of the players who may have sustained a concussion but were not observed and diagnosed with a concussion). This result suggests that definitions of concussion may need to be revisited within sports with high levels of repetitive subconcussive head impacts. Future analysis of these data will examine the relationships between the modes of MRI (diffusion tensor imaging, MRS, and susceptibility-weighted MR imaging) used in this study, along with other more sensitive evaluative techniques. This type of intermodal comparison may improve the identification of concussions that were previously dependent on the unreliable self-reporting of recognized concussion symptomatology by the athlete or on poorly validated neuropsychological tests.
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Niedziałek, Ewa. "The Desire of Nowhere – Nadine Gordimer’s "Burger’s Daughter" in a Transcultural Perspective." Colloquia Humanistica, no. 7 (December 18, 2018): 32–52. http://dx.doi.org/10.11649/ch.2018.003.
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The Desire of Nowhere – Nadine Gordimer’s Burger’s Daughter in a Transcultural PerspectiveThe article marks an attempt to read the book Burger’s Daughter by Nadine Gordimer from the transcultural perspective. Gordimer is one of the most famous South African novelists and an active anti-apartheid activist, hence her novels already have a plethora of analysis. However, the use of transcultural perspective would introduce into the existing critical outlook the more general issue of the struggle for freedom from any cultural and societal ties imposed on the individual. Although the local political situation is an important background for Gordimer’s book, the article situates its key issue in a possibility of creating a space of individual freedom, i.e. space situated beyond the cultural and societal entanglements that seem to resemble the transcultural endeavor.Conceptualization and expression of a space of ultimate liberation is a difficult venture, as the main tool of a literary text – language – is culturally bounded. However, transcultural literature, phenomenon just entering into the sight of literary research, displays the creative strategies of undermining the language in literary creation, i.a. the pluralization of narrative voices, the introduction of the unreliable narrator, extensive use of irony, multinational settings of the storyline. This article is an attempt to detect some other literary strategies of creating space beyond words and beyond culture. The analysis underlines how the use of visual strategies help to decenter the narrative voice and to actuate the text into the transcultural movement. It also exposes the importance of first-person narration in the performative process of distancing to oneself – appearing to herself as “a place where things happen”. Finally, the article detects the crucial gestures – moments of increased tension, both visual and deeply personal, that lead beyond the text to the experiences of “life itself”, i.e. blood, agony, and death. Pragnienie nigdzie – Córka Burgera Nadine Gordimer w perspektywie transkulturowejArtykuł zestawia książkę Nadine Gordimer Córka Burgera z „pragnieniem nigdzie” („the desire of nowhere”), odczytanym przez autorkę w perspektywie transkulturowej. Gordimer to jedna z najbardziej rozpoznawanych południowoafrykańskich pisarek i aktywistek anty-apartheidu. Sytuacja polityczna Południowej Afryki jest tym samym ważnym tłem jej książek. Mimo to, kluczowym problemem twórczości autorki wydaje się być bardziej uniwersalne poszukiwanie przestrzeni indywidualnej wolności jednostki. Podjęta przez Gordimer refleksja nad „pragnieniem nigdzie” w swojej istocie przypomina transkulturowe poszukiwania przestrzeni znajdującej się poza kulturą, choć odmiennie rozkłada akcenty. Wyrażenie przestrzeni wolności od kultury w literaturze nie jest łatwe, jako że jej podstawowe narzędzie – język – jest mocno zapośredniczone kulturowo. Dlatego też, literatura transkulturowa posługuje się zestawem kreatywnych strategii podważania języka, e.g. poprzez pluralizację głosów, wprowadzenie narratora niewiarygodnego, intensywne użycie ironii lub międzynarodową lokalizację narracji. Artykuł jest próbą znalezienia innych metod wyrażenie tego, czego nie może oddać język. Prezentowana analiza powieści Gordimer skupia się na użyciu wizualnych strategii, które pomagają zdecentralizować narrację i nadać tekstowi transkulturową dynamikę. Refleksji poddany zostaje także performatywny proces dystansowania się narratora do własnego „ja” – pojawiania się sobie jako „miejsce, gdzie coś się dzieje”. W konsekwencji, artykuł dochodzi do analizy kluczowych „gestów” – momentów intensywnego napięcia narracyjnego, które poprzez wykorzystanie motywów krwi, agonii oraz śmierci, prowadzą czytelnika poza tekst, aż do doświadczenia „samego życia”.
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Jamison, Amelia M., David A. Broniatowski, Mark Dredze, Anu Sangraula, Michael C. Smith, and Sandra C. Quinn. "Not just conspiracy theories: Vaccine opponents and proponents add to the COVID-19 ‘infodemic’ on Twitter." Harvard Kennedy School Misinformation Review, September 9, 2020. http://dx.doi.org/10.37016/mr-2020-38.
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In February 2020, the World Health Organization announced an ‘infodemic’ -- a deluge of both accurate and inaccurate health information -- that accompanied the global pandemic of COVID-19 as a major challenge to effective health communication. We assessed content from the most active vaccine accounts on Twitter to understand how existing online communities contributed to the ‘infodemic’ during the early stages of the pandemic. While we expected vaccine opponents to share misleading information about COVID-19, we also found vaccine proponents were not immune to spreading less reliable claims. In both groups, the single largest topic of discussion consisted of nar-ratives comparing COVID-19 to other diseases like seasonal influenza, often downplaying the severi-ty of the novel coronavirus. When considering the scope of the ‘infodemic,’ researchers and health communicators must move beyond focusing on known bad actors and the most egregious types of misinformation to scrutinize the full spectrum of information -- from both reliable and unreliable sources -- that the public is likely to encounter online.
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Sandø, Alina Desiree, Reidun Fougner, Jon Erik Grønbech, and Erling Audun Bringeland. "The value of restaging CT following neoadjuvant chemotherapy for resectable gastric cancer. A population-based study." World Journal of Surgical Oncology 19, no. 1 (2021). http://dx.doi.org/10.1186/s12957-021-02313-3.
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Abstract Background Response evaluation following neoadjuvant chemotherapy (NAC) in gastric cancer is debated. The aim of this study was to investigate the value of UICC-downstaging as mode of response evaluation following a MAGIC-style regimen of NAC. Methods Retrospective, population-based study on consecutive patients with resectable gastric adenocarcinoma receiving NAC from 2007 to 2016. CT-scan was obtained at diagnosis (rTNM) and repeated following NAC (yrTNM) to evaluate response in terms of downstaging. Further, yrTNM stage was crosstabulated to pathologic stage (ypTNM) to depict correlation between radiologic and pathologic assessment. Results Of 171 patients receiving NAC, 169 were available for response evaluation. For TNM-stages, 43% responded, 50% had stable disease and 7% progressed at CT. Crosstabulating yrTNM stage to ypTNM stage, 24% had concordant stages, with CT overstaging 38% and understaging 38% of the tumours, Cohen kappa ƙ = 0,06 (95%CI 0.004–0.12). Similar patterns of discordance were found for T-stages and N-stages separately. For M-category, restaging CT detected 12 patients with carcinomatosis, with an additional 14 diagnosed with carcinomatosis only at operation. No patient developed parenchymal or extra abdominal metastases, and none developed locally non-resectable tumour during delivery of NAC. Restaging CT with response evaluation was not able to stratify patients into groups of different long-term survival rates based on response mode. Conclusions Routine CT-scan following NAC is of limited value. Accuracy of CT staging compared to final pathologic stage is poor, and radiologic downstaging as measure of response evaluation is unreliable and unable to discriminate long-term survival rates based on response mode.
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Sadighi, Nahid, Sima Fallah Arzpeyma, Mohsen Izanlou, et al. "Evaluation of Diagnostic Accuracy of the Approved Tumor Mapping Protocol in Grading of Glial Tumors." Journal of Contemporary Medical Sciences 6, no. 5 (2020). http://dx.doi.org/10.22317/jcms.v6i5.844.
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Objective: Evaluation of Diagnostic Accuracy of the Approved Tumor Mapping Protocol in Grading of Glial Tumors.
 Methods: This descriptive cross-sectional study was performed on patients aged 2 to 82 years with glial tumor. Patients were referred to the hospital for tumor mapping and underwent imaging with simultaneous methods of MRS and magnetic resonance (MR) perfusion and conventional MRI under the supervision of NIAG group. Then, the results of the second evaluation, including the ratios of the desired metabolites and the amount of blood flow, permeability of the target area were compared with the results of pathology. The results were analyzed by SPSS software version 24.
 Results: In this study, 30 patients were included. Sensitivity, specificity, positive and negative predictive value for the determination of high-grade glioma with peripheral/internal rCBV were 100/100%, 100/93%, 93/100% and 100.100%, respectively. Sensitivity, specificity, positive and negative predictive value for the diagnosis of glioma by using peripheral/internal rCBV and thresholds of 2.65 and 1.06 were 100/100%, 93/100%, 93/100% and 100/100%, respectively. Sensitivity, specificity, positive predictive value and negative predictive value were determined for diagnosis of high-grade glioma tumor using Ch + Cr / NAA Cho / Cr and Cho / NAA ratios with detection threshold of 2.97 (93.3%), 3.5 (78.9%,100%, 100%, and 73.3%), and 2.1 (100%). Threshold values of 3.5, 2.1 and 2.97 were obtained using Cho / Cr, Ch + Cr / NAA and Cho / NAA, respectively, for the detection of high-grade gliomas. The combination of rCBV, Cho / Cr, Ch + Cr / NAA and Cho / NAA had sensitivity, specificity, positive and negative predictive value of 67.7%, 80%, 77% and 70.5%, respectively. Significant differences in rCBV and Cho / Cr, Cho / NAA and NAA / Cr ratios were observed between low- and high-grade gliomas (P <0.0001).
 Conclusion: Preoperative grading of glioma based on routine MR imaging is often unreliable. As a result, measuring rCBV and Cho / Cr and Cho / NAA ratios independently and somewhat together can significantly improve the sensitivity and predictive values of preoperative glioma grading.