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Sabates, Alanis, Alayna Wood, Hope Lee, Andrew Swain, Sabrina Irizarry, Chezney Hinton, Sarah Ginn, et al. "QOL-21. REAL-WORLD QUALITY-OF-LIFE AND HEALTH UTILITIES FOR PATIENTS WITH CNS CANCERS ON THE XCELSIOR PLATFORM." Neuro-Oncology 24, Supplement_7 (November 1, 2022): vii245. http://dx.doi.org/10.1093/neuonc/noac209.948.
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Abstract OBJECTIVE xCures operates a direct-to-patient, real-world evidence platform according to the nationwide observational research protocol XCELSIOR (NCT03793088), which aggregates medical data in an FDA-compliant electronic database. There is a relative scarcity of published results on real-world Quality-of-Life (QoL) outcomes and resulting health state utilities for patients with Central Nervous System (CNS) cancers. We sought to use the xCures platform to help address this issue. METHODS XCELSIOR participants were invited weekly to complete the EuroQol 5-Dimension (EQ-5D-5L) QoL survey. A EuroQol-endorsed model was used to estimate health state utilities from patient surveys. Survey results, utility estimates, and clinical information were analyzed to understand the influence of common mutations in glioma on patient reported outcomes. RESULTS 30 patients (21 glioblastoma, 4 oligodendroglioma, 2 diffuse midline glioma, 2 diffuse astrocytoma, 1 Schwannoma) completed at least one EQ-5D-5L survey over the course of 9 weeks. Health state utilities were positively correlated (p< .03) with Karnofsky Performance Score (KPS). The average utility for EGFR-mutated patients (N=6) was .578 (SD=.334) while for EGFR-wildtype patients (N=7) it was .747 (SD=.227). The average utility for MGMT-methylated patients (N=13) was .816 (SD=.139) while for non-methylated patients (N=10) it was .583 (SD=.379). The average utility for IDH-mutated patients (N=9) was .789 (SD=.153) while for non-mutated patients (N=17) it was .685 (SD=.324). The average utility for patients with a 1p/19q co-deletion (N=4) was .837 (SD=.126) while for those without a co-deletion (N=8) it was .744 (SD=.244). CONCLUSION The xCures platform has enabled the study of real-world QoL outcomes for patients with CNS cancers. This is the first report studying the influence of genetic mutations on QoL collected through patient reported outcomes. Future research aims to perform similar studies with larger number of patients.
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Alencar, Queren Hapuque Oliveira, Dagna Karen Oliveira, Mauricio Bedim dos Santos, Camila Lopes Manetti, Fernanda Morinigo Guevara, Gabriela Rodrigues Moreira Florência, Aline Daniel da Silva, et al. "Uso domiciliar de plantas medicinais por usuários dos serviços das Unidades Básicas de Saúde do município de Toledo, Paraná." Revista Fitos 15, no. 4 (December 17, 2021): 494–507. http://dx.doi.org/10.32712/2446-4775.2021.1120.
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O uso empírico das plantas medicinais é uma prática mundialmente disseminada, cuja finalidade baseia-se no alívio/cura de algumas enfermidades. Objetivou-se caracterizar o perfil epidemiológico do uso domiciliar dessas plantas, pelos usuários de sete Unidades Básicas de Saúde com equipe Estratégia Saúde da Família, no município de Toledo/Paraná. Para tanto, foi aplicado um questionário a 324 pessoas. A análise dos dados mostrou que 89,50% dos entrevistados faziam uso de plantas medicinais, destes, 91,38% do sexo feminino, 42% com idade entre 21 e 40 anos, 30% sem concluir o ensino fundamental e 45,48% com renda per capita entre 01 a 03 salários mínimos. As folhas foram as partes das plantas mais utilizadas (45,10%), o modo de preparo predominante foi o chá em infusão (30,86%) e 83,64% tiveram o conhecimento de utilização das plantas repassado por familiares. Foram registradas 1.082 citações de 120 espécies de plantas, 50% destas não possuem registro na Denominação Comum Brasileira da Agência de Vigilância Sanitária; entre elas encontram-se espécies cujo conhecimento de senso comum é tão difundido que remete à incredulidade de ausência de estudos científicos para o fim citado, conferindo a falsa ideia de ausência de risco à saúde.
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Bokemeyer, C., and H. J. Schmoll. "Secondary neoplasms following treatment of malignant germ cell tumors." Journal of Clinical Oncology 11, no. 9 (September 1993): 1703–9. http://dx.doi.org/10.1200/jco.1993.11.9.1703.
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PURPOSE The current study investigates the frequency and outcome of secondary malignancies in patients treated for testicular cancer at Hannover University Medical School between 1970 and 1990. PATIENTS AND METHODS One thousand twenty-five patients with a median follow-up duration of 61 months (range, 12 to 240) were included in the analysis. Follow-up was complete in 1,018 patients (99%). Histology was seminoma in 324 patients (38.7%) and nonseminomatous germ cell tumor in 624 patients (61.3%). At the time of median follow-up, 814 patients (79.9%) were alive. RESULTS Fourteen patients developed a secondary neoplasm (cumulative incidence, 1.38%; 95% confidence interval [CI], 0.75 to 2.30); 13 patients had solid tumors and one had secondary lymphoblastic leukemia with a t(4; 11) translocation including band 11q23. None of 224 patients on surveillance strategy (with or without retroperitoneal lymph node dissection [RPLND]) developed a second neoplasm, compared with four of 413 patients (0.97%; 95% CI, 0 to 1.9) after cisplatin-based chemotherapy (not significant) and nine of 332 patients (2.7%; 95% CI, 0.9 to 4.5) after radiotherapy (P = .02). The cumulative incidence of a secondary neoplasia of 1.76% (95% CI, 0.97 to 2.94) in patients treated by radiotherapy and/or chemotherapy was significantly higher compared with patients on surveillance protocols (P = .03). Chemotherapy containing standard-dose etoposide did not increase the risk of occurrence of secondary neoplasms. A significantly elevated relative risk of 7.53 (range, 3.4 to 14.3) compared with the male German population was only found for patients treated by radiotherapy. CONCLUSION Compared with patients who have other curable malignant tumors, an incidence of 1.38 of secondary neoplasms after a median follow-up duration of 61 months is low. The highest risk for secondary neoplasia after treatment of testicular cancer is associated with the use of radiotherapy. Following chemotherapy, no significantly elevated risk was observed. In conclusion, the benefits of curative treatment far outweigh the risk of secondary cancer in patients with malignant germ cell tumors.
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Kanze, David M. "Osteopathic Manipulative Medicine in the Era of the Single Accreditation System: Can the Past Guide the Way to the Future of OMM?" AAO Journal 30, no. 1 (March 1, 2020): 17–28. http://dx.doi.org/10.53702/2375-5717-30.1.17.
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Abstract The purpose of this study was twofold: 1) to evaluate the education of osteopathic physicians who integrate osteopathic manipulative medicine in practice and attempt to find key factors that might be viewed as best practices to be adopted by colleges of osteopathic medicine (COMs), Departments of Osteopathic Manipulative Medicine (OMM), and postgraduate training programs; and 2) to evaluate if gross human anatomy was seen as valuable in OMM training. A 31-question, online survey was distributed to English-speaking members of the American Academy of Osteopathy (AAO) in the United States from July through October of 2016. Of the 438 respondents, 325 (74.3%) reported having a mentor in osteopathic manipulative medicine (OMM) or osteopathic manipulative treatment (OMT) while in school. In addition, 270 (61.6%) had dedicated time to practice OMT while in school, with 186 (42.5%) practicing supervised in a school clinic, 340 (77.6%) practicing during an undergraduate rotation, and 244 (55.7%) practicing after school hours. Many of the mentees participated in several of the above activities. Chi square test was applied to participants who are Fellows of the American Academy of Osteopathy (FAAOs). This test revealed that 24 of 26 (92.3%) of FAAOs, who responded, had a mentor, a statistically significant relationship between having an OMT/OMM mentor and becoming an FAAO (P=.03). Almost all survey participants (438 [99.5%]) had some type of gross anatomy while in medical school. The majority of respondents (321 [73.8%]) performed dissections, 81 (18.6%) had both prosection and dissections, 33 (7.6%) only had prosection, and 321 (73.8%) found that it was extremely helpful in their OMM training. In comparison, 341 respondents (78.2%) reported that gross anatomy was important to their specialty. The survey clearly demonstrated that early exposure to an OMM mentor leads to increased use of OMT and OMM and that a strong foundation in gross human anatomy was found to be useful for physicians across specialty training, including OMM.
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Suzuki, Eiichiro, John A. Bridgewater, Juan W. Valle, John Neil Primrose, Anna Dorothea Wagner, Andre Lopes, and Richard Fox. "Sex difference in patients with biliary tract cancer receiving chemotherapy: Post hoc analysis of ABC-01, -02, -03, -04, BILCAP." Journal of Clinical Oncology 38, no. 4_suppl (February 1, 2020): 517. http://dx.doi.org/10.1200/jco.2020.38.4_suppl.517.
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517 Background: The relationship between toxicity from chemotherapy and clinical outcome in biliary tract cancer (BTC) is uncertain. Aim: This post hoc analysis evaluated differences by sex in the frequency of adverse events (AEs) and overall survival (OS) and its impact on progression-free survival (PFS)/recurrence-free survival (RFS) for BTC patients. Methods: Individual patient data were retrieved from ABC -01, -02, -03, -04, and BILCAP study. AEs were graded according to National Cancer Institute's Common Toxicity Criteria v 4.02 and odds ratios along with 95%CI and p-values derived from logistic regression were used to assess the effect of sex on the risk of AEs. Time to event outcomes were evaluated using Cox regression and plotted using Kaplan-Meier plots. All statistical tests were two-sided. Results: Overall 994 patients-data were examined: 86 in ABC-01, 324 in-02, 124 in -03, 13 in -04 and 447 in BILCAP. A total of 484 (49%) were males (M) and 510 (51%) were females (F). 770 patients were evaluable for AEs because a total of 224 patients in BILCAP study belonged to the observation group. Urinary tract infection (M, 1.6%; F, 5.5%), nausea (M, 50.7%; F, 69.9%), vomiting (M, 29.1%; F, 46.1%), alopecia (M, 11.3%; F, 27.3%), are dominant in F, hyperbilirubinaemia (M, 36.7%; F, 29.1%) and thrombocytopenia (M, 43.1%; F, 34.3%) and hiccups (M, 2.4%; F, 0.5%) are dominant in M at any grade. Vomiting (M, 3.5%; F, 7.0%) and fatigue (M, 4.0%; F, 8.5%) are higher in F than in M for grade 3-5. The median OS (M, 16.2 months (Mo); F, 17.5 Mo), PFS (M, 6.4 Mo; F, 6.5 Mo) and RFS (M, 20.8 Mo; F 19.4 Mo) were similar. Amongst the subgroup of patients with gallbladder, F achieved longer OS (M, 11.5 Mo; F 13.3 Mo, 0.73 (95%CI:0.54,0.99), p = 0.041) and RFS than M (M, 20.8 Mo; median PFS for F not reached, HR:0.52 (95%CI:0.27,1.02), p = 0.057). Conclusions: Females with BTC have tended to have more AEs, especially grade 3+. Although no difference was observed in OS, PFS, and RFS between males and females for the overall cohort of patients, females with gallbladder cancer had an improved OS and RFS compared with males. These findings suggest, in BTC, sex may play a role when designing clinical trials as well as in making treatment decisions.
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Ika Indrieaswati, Ika Indrieaswati, Rosalina Rosina Mirino, and Khristian Enggar Pamuji. "Studi Kelayakan Lokasi Tempat Pembuangan Akhir (TPA) Sampah Di Distrik Oransbari Kabupaten Manokwari Selatan Berdasarkan Bebarapa Parameter Fisik." Jurnal Natural 18, no. 2 (December 12, 2022): 104–14. http://dx.doi.org/10.30862/jn.v18i2.191.
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This study was aimed to determine the feasibility level of the final disposal site (TPA) based on physical aspects in the Oransbari District according to SNI 19-3241-1994 and SNI 03-3241-1994. The method used is descriptive with field observation techniques. Measurement starts from the groundwater level using geoelectric mapping: Types of rock and distance to faults based on geological maps: slope, distance to rivers, distance to shoreline, and distance to airports based on topographic maps; rainfall data from BMKG; flooded and protected areas. Based on the results of the analysis of 10 physical parameters with the accumulated assessment (scoring) that has been done that the candidate for the location of the Final Disposal Site (TPA) is in the second interval class, with a score of 161, so that the feasibility value of the landfill location is included in the interval class 129 – 224. and categorized as “Required Enough”..
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Ahmed, Talal, Mark Carty, Kaveri Nadhamuni, and Raphael Pelossof. "Abstract PO5-24-03: Breast cancer intrinsic subtypes predict outcomes in primary and metastatic samples." Cancer Research 84, no. 9_Supplement (May 2, 2024): PO5–24–03—PO5–24–03. http://dx.doi.org/10.1158/1538-7445.sabcs23-po5-24-03.
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Abstract Background: The prognostic and predictive value of the PAM50 intrinsic subtypes, namely Luminal A, Luminal B, Her2, and Basal-like subtypes, is well-studied in primary as well as metastatic breast cancer settings. Prosigna has emerged as a rapid PAM50 subtype predictor based on the NanoString nCounter assay. However, assay reproducibility across various RNASeq or qRT-PCR platforms can be challenging, especially when applying the predictor on metastatic breast cancer tumors. Here, we used SpinAdapt to create an intrinsic subtype predictor that works on RNA sequencing data, and validates on multiple tumor-sites. We evaluate real-world outcomes for our intrinsic subtype predictions across various immunohistochemical (IHC) labels and metastatic sites. Methods: We trained the subtype predictor on a cohort of 2,497 breast cancer patients using the PAM50 genes, profiled using Nanostring RNA nCounter assay (GSE148426). Approximately 5,423 de-identified records of breast cancer patients sequenced using whole-exome capture RNA-seq were included in our reference dataset. The reference dataset contained samples collected from various sites including breast (n=2440), liver (n=936), lymph node (n=577), lung (n=540), and bone (n=304). For subtype classification, we first batch-corrected the external dataset to Tempus RNA-seq reference dataset using SpinAdapt, then trained a Support-Vector Classifier (SVC) on the corrected data. A 10-fold CV experiment was performed on the corrected dataset to analytically validate the intrinsic subtype predictions. We retrospectively analyzed 7,021 de-identified breast cancer patients with known hormone receptor (HR) or HER2 status and a matched RNASeq sample. The concordance between HR/HER2 status and PAM50 prediction was analyzed, and these patients were excluded from training. Real-world overall survival (rwOS) was evaluated from the time of first diagnosis. The outcomes across intrinsic subtypes were further assessed according to tumor collection site and HR/HER2 IHC status. Results: The 10-fold CV experiment on the Tempus-adapted GSE148426 dataset achieved F-1 scores of 0.97, 0.86, 0.94, and 0.87 on Basal, HER2-like, Luminal A, and Luminal B PAM50 subtypes, respectively. On the Tempus evaluation dataset, 85.3% of HR+/HER2- patients (n=4,366), 65.4% of HR-/HER2+ patients (n=240), and 75.4% of HR-/HER2- patients (n=1,930) were classified as Luminal, HER2-like, and Basal, respectively. Evaluating outcomes on Tempus patients for each PAM50 group, the rwOS for the basal group was significantly shorter than patients not predicted to be basal (n=5,845, p< 2e-90). The rwOS for the predicted PAM50 basal patients remained significantly shorter than non-basal patients even when stratified by site of metastasis: breast (n=2,405; p< 1e-27), lymph node (n=577, p< 1e-7), liver (n=936; p< 1e-25), lung (n=540, p< 1e-13), and bone (n=304, p< 1e-3). Interestingly, within both HR+/HER2- (n=3,653) and HR-/HER2- (n=1,664) IHC cohorts with available outcomes data, the predicted PAM50 basal subtype could further stratify each of these populations with basal-subtype showing significantly worse prognosis than the non-basal subtype (p< 1e-27 and p< 1e-7, respectively). Conclusions: We retrospectively analyzed Tempus multimodal RWD to validate an in-house breast intrinsic subtype predictor that is agnostic to the site of metastasis. The prognostic value of the basal subtype was significant for breast cancer patients across various sites of metastasis including lymph node, liver, lung, and bones and IHC groups. For patients in each of the HR+/HER2- and triple negative IHC groups, the intrinsic molecular subtypes provided an additional level of prognostic detail with statistical significance. These data emphasize the importance of combining molecular subtypes with IHC-based diagnostics to fully characterize clinically relevant subpopulations and risk. Citation Format: Talal Ahmed, Mark Carty, Kaveri Nadhamuni, Raphael Pelossof. Breast cancer intrinsic subtypes predict outcomes in primary and metastatic samples [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-24-03.
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Calvo Caravaca, Alfonso Luis, and María Pilar Canedo Arrillaga. "Casos escogidos de Derecho antitrust europeo." Estudios de Deusto 54, no. 1 (May 23, 2014): 285. http://dx.doi.org/10.18543/ed-54(1)-2006pp285-373.
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Caso N.º 1. Ententes: Dec.Com. 7 abril 2004, Société Air France/Alitalia Linee Aeree Italiane SpA, DO L 362 de 9 diciembre 2004 Caso N.º 2. Ententes: STJCE 29 abril 2004, C-359/01 P, British Sugar plc/Comisión Caso N.º 3. Ententes: STPI de 29 de abril de 2004, Tokai carbón Co. Ltd y otros/Comisión de las Comunidades Europeas As. T-236/01, T-239/01, T-244/01, T-245/01, T-246/01, T-251/01 y T-252/01 Caso N.º 4. Ententes: Sentencia del Tribunal de Primera Instancia 15 junio 2005, Graphites spéciaux, As. T-71/03, T-74/03, T-87/03 y T-91/03 Caso N.º 5. Ententes: STPI 8 julio 2004, Mannesmannröhren-Werke/ Comisión, T-44/00; STPI 8 julio 2004, Corus/Comisión, T-48/00; STPI 8 julio 2004, Dalmine/Comisión, T-50/00; STPI 8 julio 2004, asuntos acumulados JFE Engineering/Comisión, T-67/00, Nippon Steel/Comisión, T-68/00, JFE Steel/Comisión, T-71/00, y Sumitomo Metal Industries/ Comisión, T-78/00 Caso N.º 6. Ententes: Dec.Com. 9 diciembre 2004, Cloruro de colina, DO L 190 de 22 julio 2005. Caso N.º 7. Ententes: STJCE 28 junio 2005, Dansk Rørindustri A/S (C-189/02 P), Isoplus Fernwärmetechnik Vertriebsgesellschaft mbH y otros (C-202/02 P), KE KELIT Kunststoffwerk GmbH (C-205/02 P), LR af 1998 A/S (C-206/02 P), Brugg Rohrsysteme GmbH (C-207/02 P), LR af 1998 (Deutschland) GmbH (C-208/02 P) y ABB Asea Brown Boveri Ltd (C-213/02 P)/Comisión, Tubos de calefacción urbana (tubos preaislados), Asuntos acumulados C-189/02 P, C-202/02 P, C-205/02 P a C-208/02 P y C-213/02 P Caso N.º 8. Ententes: STPI 18 julio 2005, Scandinavian Airlines System AB/Comisión, T-241/01 Caso N.º 9. Ententes: STPI (Sala Segunda) de 27 de julio de 2005, Asuntos acumulados T-49/02 a T-51/02, Brasserie nationale SA (anteriormente Brasseries Funck-Bricher y Bofferding), Brasserie Jules Simon et Cie SCS y Brasserie Batín SNC v. Comisión de las Comunidades Europeas Caso N.º 10. Ententes: Comunicación publicada de conformidad con el artículo 27, apartado 4, del Reglamento (CE) n.º 1/2003 del Consejo, en los asuntos COMP/C2/3912-BUMA y COMP/C2/39151-SABAM (Acuerdo de Santiago-COMP/C2/38126, DO C 200 de 17 agosto 2005, pp. 11-12) Caso N.º 11. Ententes: STPI 15 septiembre 2005, DaimlerChrysler AG/ Comisión, T-325/01 Caso N.º 12. Abuso de posición dominante: Dec.Com. 24 marzo 2004, Microsoft Europe, COMP/C-3/37.792: Noción de abuso de posición dominante (la tensión entre el Derecho de la competencia y el Derecho de la propiedad intelectual) Caso N.º 13. Abuso de posición dominante: Dec. Com. 20 octubre 2004, Deutsche Post AG y RFA, COMP/38.745: Abuso de posición dominante cometido por el operador postal histórico de Alemania, por el hecho de una disposición legislativa que deberá ser modificada Caso N.º 14. Abuso de posición dominante: STPI 26 enero 2005, Piau/ Féderation Internationale de Football Association (FIFA), T-193/02, Rec., p. I-1113: Posición dominante colectiva Caso N.º 15. Abuso de posición dominante: Dec.Com. 22 junio 2005, Coca-Cola, COMP/A.39.116/B2, DO L 253 de 29 septiembre 2005: Decisión compromiso (Coca-Cola se compromete a no abusar de su posición dominante y se libra de toda sanción) Caso N.º 16. Concentraciones: Decisión de la Comisión 19 julio 2004, SONY/BMG, M. 3333 Caso N.º 17. Concentraciones: Dec.Com. 15 julio 2005, Procter & Gamble/ Gillette, M. 3732 Caso N.º 18. Concentraciones: Dec.Com. 29 julio 2005, Maersk/Ponl, M. 3829 Caso N.º 19. Concentraciones: STJCE 15 febrero 2005, Tetra Laval, C-12/03P, Rec., p. I-1113. Caso N.º 20. Concentraciones: STPI 21 septiembre 2005, EDP/Comisión, T-87/05
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Norris, Sarah Michelle, Eric Bombardier, Ian Curtis Smith, Chris Vigna, and Allan Russell Tupling. "ATP consumption by sarcoplasmic reticulum Ca2+ pumps accounts for 50% of resting metabolic rate in mouse fast and slow twitch skeletal muscle." American Journal of Physiology-Cell Physiology 298, no. 3 (March 2010): C521—C529. http://dx.doi.org/10.1152/ajpcell.00479.2009.
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In this study, we aimed to directly quantify the relative contribution of Ca2+ cycling to resting metabolic rate in mouse fast-twitch (extensor digitorum longus, EDL) and slow-twitch (soleus) skeletal muscle. Resting oxygen consumption of isolated muscles (V̇o2, μl·g wet wt−1·s−1) measured polarographically at 30°C was ∼25% higher in soleus (0.61 ± .03) than in EDL (0.46 ± .03). To quantify the specific contribution of Ca2+ cycling to resting metabolic rate, cyclopiazonic acid (CPA), a highly specific inhibitor of sarco(endo)plasmic reticulum Ca2+ ATPases (SERCAs), was added to the bath at different concentrations (1, 5, 10, and 15 μM). There was a concentration-dependent effect of CPA on V̇o2, with increasing CPA concentrations up to 10 μM resulting in progressively greater reductions in muscle V̇o2. There were no differences between 10 and 15 μM CPA, indicating that 10 μM CPA induces maximal inhibition of SERCAs in isolated muscle preparations. Relative reduction in muscle V̇o2 in response to CPA was nearly identical in EDL (1 μM, 10.6 ± 3.0%; 5 μM, 33.2 ± 3.4%; 10 μM, 49.2 ± 2.9%; 15 μM, 50.9 ± 2.1%) and soleus (1 μM, 11.2 ± 1.5%; 5 μM, 37.7 ± 2.4%; 10 μM, 50.0 ± 1.3%; 15 μM, 49.9 ± 1.6%). The results indicate that ATP consumption by SERCAs is responsible for ∼50% of resting metabolic rate in both mouse fast- and slow-twitch muscles at 30°C. Thus SERCA pumps in skeletal muscle could represent an important control point for energy balance regulation and a potential target for metabolic alterations to oppose obesity.
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Ortiz, Martín Ruiz, Javier Muñiz, María Asunción Esteve-Pastor, Francisco Marín, Inmaculada Roldán, Angel Cequier, Manuel Martínez-Sellés, Hugo González Saldivar, Vicente Bertomeu, and Manuel Anguita. "Direct Anticoagulants Versus Vitamin K Antagonists in Patients Aged 80 Years or Older With Atrial Fibrillation in a “Real-world” Nationwide Registry: Insights From the FANTASIIA Study." Journal of Cardiovascular Pharmacology and Therapeutics 25, no. 4 (March 31, 2020): 316–23. http://dx.doi.org/10.1177/1074248420916316.
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Objective: To describe major events at follow up in octogenarian patients with atrial fibrillation (AF) according to anticoagulant treatment: direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs). Methods: A total of 578 anticoagulated patients aged ≥80 years with AF were included in a prospective, observational, multicenter study. Basal features, embolic events (stroke and systemic embolism), severe bleedings, and all-cause mortality at follow up were investigated according to the anticoagulant treatment received. Results: Mean age was 84.0 ± 3.4 years, 56% were women. Direct oral anticoagulants were prescribed to 123 (21.3%) patients. Compared with 455 (78.7%) patients treated with VKAs, those treated with DOACs presented a lower frequency of permanent AF (52.9% vs 61.6%, P = .01), cancer history (4.9% vs 10.9%, P = .046), renal failure (21.1% vs 32.2%, P = .02), and left ventricular dysfunction (2.4% vs 8.0%, P = .03); and higher frequency of previous stroke (26.0% vs 16.6%, P = .02) and previous major bleeding (8.1% vs 3.6%, P = .03). There were no significant differences in Charlson, CHA2DS2VASc, nor HAS-BLED scores. At 3-year follow up, rates of embolic events, severe bleedings, and all-cause death (per 100 patients-year) were similar in both groups (DOACs vs VKAs): 0.34 vs 1.35 ( P = .15), 3.45 vs 4.41 ( P = .48), and 8.2 vs 11.0 ( P = .18), respectively, without significant differences after multivariate analysis (hazard ratio [HR]: 0.25, 95% confidence interval [CI]: 0.03-1.93, P = .19; HR: 0.88, 95% CI: 0.44-1.76, P = .72 and HR: 0.84, 95% CI: 0.53-1.33, P = .46, respectively). Conclusion: In this “real-world” registry, the differences in major events rates in octogenarians with AF were not statistically significant in those treated with DOACs versus VKAs.
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Hochhaus, A., S. Branford, J. Radich, M. C. Mueller, N. Shah, P. Erben, T. Ernst, M. Acevedo, C. Nicaise, and T. Hughes. "Efficacy of dasatinib in chronic phase chronic myelogenous leukemia patients after imatinib failure according to baseline BCR- ABL mutations." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 7023. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.7023.
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7023 Background: Dasatinib is an oral, multi-targeted BCR-ABL and SRC kinase inhibitor with preclinical activity against 20/21 imatinib (Im) resistant BCR-ABL mutations. Clinical efficacy was demonstrated in phase I, II, and III studies in patients (pts) with chronic myelogenous leukemia (CML) in all phases of the disease and BCR-ABL positive acute lymphoblastic leukemia (ALL). We sought to establish a relationship between type of BCR-ABL mutations associated with Im resistance and efficacy of dasatinib in chronic phase (CP) CML pts. Methods: Between 10/03 and 03/06, dasatinib was commenced in 1,093 CP-CML pts recruited for three consecutive trials and administered for a median of 8.7 months (range <1–25.9). BCR-ABL mRNA was screened for mutations of amino acids 207–517 by D-HPLC and/or regular sequencing and data are available from 961 cases (88%). ABL polymorphisms K247R and E499E were excluded from analysis. Results: Prior to dasatinib, 75 different BCR-ABL mutations involving 56 amino acids were detected in 18/240 Im intolerant (7.5%) and 324/721 (45%) Im resistant pts. 267 pts showed one, 53 pts two, 16 pts three, and six pts four mutations. In Im resistant pts, response was not different between 370 pts with and 351 pts without baseline mutations: Complete hematologic response (CHR) was achieved in 89% vs 92%; major cytogenetic response (MCR) in 48% vs 52% being complete (CCR) in 38 vs 36%, respectively. Response dynamics were associated with preclinical activity of dasatinib: classifying mutations for IC50 values <2, 2–20 and >1,000nM (T315I), CHR was achieved in 93, 85 and 28%; MCR in 48, 42 and 0%; and CCR in 37, 35 and 0% of cases, respectively. During follow up, new mutations were detected in 30 cases, predominantly T315I (n=10), Y253H/F (n=4), and F317L (n=3). Conclusions: We conclude that dasatinib is capable of inducing hematologic and cytogenetic remissions in a significant proportion of Im resistant pts associated with BCR-ABL mutations, except T315I, but also in pts with BCR-ABL independent causes of resistance. Quality of response depends on the individual type of the mutation which is consistent with preclinical observations. No significant financial relationships to disclose.
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Bychkovsky, Brittany L., Min-Tzu Lo, Amal Yussuf, Carrie Horton, Parichehr Hemyari, Holly LaDuca, Judy E. Garber, and Huma Q. Rana. "Abstract P2-09-03: Pathogenic variants among female breast cancer patients with a subsequent cancer demonstrate preventable cancer burden." Cancer Research 82, no. 4_Supplement (February 15, 2022): P2–09–03—P2–09–03. http://dx.doi.org/10.1158/1538-7445.sabcs21-p2-09-03.
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Abstract Background: Among females with breast cancer, multiple primary cancers (MPCs) are a hallmark of cancer predisposition syndromes. Herein we report the frequency of germline pathogenic/likely pathogenic variants (PVs) among females with breast cancer (BC) and primary cancer of >1 other site who underwent multi-gene panel testing (MGPT) through a single lab. Among females first diagnosed with BC who had a PV in an actionable gene, we quantified the frequency of subsequent breast and non-breast cancers. Among those who later developed a second BC, ovarian, endometrial or colon cancer, we determined the percentage of patients with MPCs who would have been identified as high-risk if all women had had MGPT after a first diagnosis of breast cancer. Methods: Females with breast cancer and MPCs who underwent germline genetic testing with Ambry Genetics from 3/2012 to 12/2016 were included in our cohort. Eligible individuals had multigene panel testing, which included 21 genes at minimum (ATM, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, EPCAM, MLH1, MSH2, MSH6, MUTYH, NBN, NF1, PALB2, PMS2, PTEN, RAD51C, RAD51D, STK11, and TP53). Clinical factors including age at diagnosis, age at testing and cancer type were obtained from test requisition forms and clinical notes. Patients with >1 PV were excluded from the analysis. Results: Of the 6617 patients with MPCs including BC tested for the 21 genes in the analytic cohort, most were white (70.8%), with median age at testing 63 years (IQR: 16). The median ages of first and second cancer diagnosis were 49 (IQR: 18) and 59 (IQR: 16) years, respectively. Considering the diagnostic order of BC, PV prevalence was 16.5% (444/2687) with BC as the 1st cancer diagnosis, 11.2% (296/2641) with BC as the 2nd cancer diagnosis, 15.2% (49/323) as 3rd or later diagnosis (p<0.001). Based on the PV identified through genetic testing, 411 of 2687 (15.3%) females with BC as a first diagnosis would have been identified as high-risk and 227 (8.4%) as eligible for altered surveillance or risk-reducing interventions for a cancer that they subsequently developed. Specifically, of the 318 (11.8%) females with a PV in ATM, BARD1, BRCA1, BRCA2, CDH1, CHEK2, NF1, PTEN, STK11, or TP53, 73 (23%) developed a subsequent BC. Of the 241 (9.0%) females with PVs in genes including ovarian cancer susceptibility (BRCA1, BRCA2, BRIP1, PALB2, RAD51C, or RAD51D), 143 (59.3%) developed ovarian cancer, 21 of whom also developed a second breast cancer. Among the 41 (1.5%) females with Lynch syndrome, 25 (61.0%) were later diagnosed with endometrial cancer and 10 (24.4%) were diagnosed with colorectal cancers (3 had both). Conclusions: Our data show a significant prevalence of germline PV in cancer susceptibility genes in women with MPC including BC. Further, the data suggest that a strategy testing all BC patients at diagnosis to identify actionable PV could permit the appropriate use of risk-reducing and surveillance strategies to reduce the occurrence of MPC among BC survivors. Citation Format: Brittany L. Bychkovsky, Min-Tzu Lo, Amal Yussuf, Carrie Horton, Parichehr Hemyari, Holly LaDuca, Judy E. Garber, Huma Q. Rana. Pathogenic variants among female breast cancer patients with a subsequent cancer demonstrate preventable cancer burden [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-09-03.
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Polevoy, Georgiy Georgievich. "Stributing the Attention of Schoolchildren and Its Development with the Help of Classical Exercises." Bangladesh Journal of Medical Science 22, no. 3 (June 16, 2023): 604–11. http://dx.doi.org/10.3329/bjms.v22i3.66966.
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Objective: to determine the influence of Classical exercises on the distribution of attention of schoolchildren.
Method: the pedagogical experiment was conducted during the academic year. It was attended by students aged 9-10 years (40 people). Coordination abilities were determined by the “Shuttle Run” test, and the distribution of students’ attention by the “Different counting” method. Statistical processing of the results was carried out according to the Bio-Stat program and the T-student was calculated.
Results: after the experiment, the indicators in the control group improved by 2.9% (p>0.05) - shuttle running, and the distribution of attention from 36.1±2.4 to 32.9±3.4 (p>0.05). In the experimental group, shuttle running significantly improved by 14.1% (p<0.05), and the distribution of attention improved from 9.9±0.5 to 8.5±0.4 (p<0.05). Such data indicate the effective effect of Classical exercises on the indicators of the distribution of students’ attention.
Conclusion: if students of 9-10 years of age in physical education classes will perform the Classics exercise, then the indicators of coordination abilities and the distribution of children’s attention will significantly improve.
Bangladesh Journal of Medical Science Vol. 22 No. 03 July’23 Page : 604-611
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Lau, Steven, Amit G. Singal, Adam Charles Yopp, Jeffrey John Meyer, Daniella Hall, and Michael Ryan Folkert. "Radiation therapy for palliation of osseous metastasis from hepatocellular carcinoma." Journal of Clinical Oncology 34, no. 26_suppl (October 9, 2016): 204. http://dx.doi.org/10.1200/jco.2016.34.26_suppl.204.
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204 Background: Osseous metastasis from hepatocellular carcinoma (HCC) is uncommon, and optimal palliative management for palliation is unclear. We present our clinical experience with palliative radiotherapy (RT) for osseous metastasis from HCC. Methods: Patients were identified using two prospectively maintained databases at our institution: all patients with HCC who developed metastases and all patients undergoing RT. Medical records were retrospectively reviewed following Institutional Review Board approval. We identified 146 patients with metastatic HCC, of which 28 patients with 38 osseous metastases were eligible for this analysis. All patients are seen in a multi-disciplinary clinic where consensus for management is developed. Most (89%) had metastasis at the time of initial tumor diagnosis, including 22 (79%) patients with osseous lesions at diagnosis. Tissue confirmation of metastasis was obtained in 22 (79%) patients. Outcomes of interest included patient-reported pain relief at time of follow-up, radiographic response at 6-12 months, and overall survival. Statistical analysis was performed with SPSS (IBM Corporation). Results: Median age at diagnosis was 61 years, and 86% (n = 24) were male. The most common site of metastasis was vertebral body (n = 26, 70%). Median time from bone metastasis diagnosis to RT was 1 month (range, 0-20). Only 1 patient received concomitant systemic therapy at the time of RT. Metastases were most commonly treated using 2D techniques (n = 26, 68%) to 30 Gy in 10 fractions (n = 18, 47%). Pain relief was complete, partial, and absent for 8 (21%), 24 (63%), and 6 (16%) metastases, respectively; no patient reported an increase in pain after treatment. Prescription BED3 > 50 Gy was associated with improved local control (P = .03). 7 (18%) radiographic local failures were observed at a median time of 5.4 months, and the 6-month local failure rate was 20.2%. Median survival was 3.4 months, with a 6-month survival rate of 39.1%. Conclusions: Mortality for patients with osseous metastasis from HCC is high, but palliative RT is associated with significant pain relief and/or disease control in many patients. This data on efficacy of palliative RT helps guide optimal management of these patients.
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García-García, María de Lourdes, Aida Jiménez-Corona, María Eugenia Jiménez-Corona, Leticia Ferreyra-Reyes, Kenneth Martínez, Blanca Rivera-Chavira, María Elena Martínez-Tapia, et al. "Factors Associated With Tuberculin Reactivity in Two General Hospitals in Mexico." Infection Control & Hospital Epidemiology 22, no. 02 (February 2001): 88–93. http://dx.doi.org/10.1086/501869.
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Abstract Objective: To identify risk factors associated with tuberculin reactivity in healthcare workers (HCWs). Design: Cross-sectional survey of tuberculin reactivity (2 TU of purified protein derivative (PPD) RT23, using the Mantoux two-step test). Setting: Two general hospitals located in a region with a high prevalence of tuberculosis and high bacille Calmette-Guérin (BCG) coverage. Participants: Volunteer sample of HCWs. Results: 605 HCWs were recruited: 71.2% female; mean age, 36.4 (standard deviation [SD], 8.2) years; 48.9% nurses, 10.4% physicians, 26.8% administrative personnel; mean time of employment, 10.9 (SD, 6.7) years. PPD reactivity (≥10 mm) was found in 390 (64.5%). Multivariate analysis revealed an association of tuberculin reactivity with occupational exposure in the hospital: participation in autopsies (odds ratio [OR], 9.3; 95% confidence interval [CI95], 2.1-40.5; P=.003.), more than 1 year of employment (OR, 2.4; CI95, 1.1-5.0; P=.02), work in the emergency or radiology departments (OR, 2.0; CI95,1.03-3.81; P=.04), being physicians or nurses (OR, 1.5; CI95, 1.04-2.11; P=.03), age (OR, 1.04; CI95, 1.02-1.07 per year of age; P<.001), and BCG scar (OR, 2.1; CI95, 1.2-3.4; P=.005). Conclusions: Although the studied population has a high baseline prevalence of tuberculosis infection and high coverage of BCG vaccination, nosocomial risk factors associated with PPD reactivity were identified as professional risks; strict early preventive measures must be implemented accordingly.
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Hernández-Cruz, B., M. J. Miranda García, J. Barrera, F. J. Olmo Montes, M. A. Vázquez Gómez, M. Giner García, M. A. Colmenero Camacho, J. J. Pérez Venegas, and M. J. Montoya García. "AB1030 PATIENT CARE AT THE FRACTURE LIAISON SERVICE REDUCE THE GAP IN THE TREATMENT OF OSTEOPOROSIS BETWEEN MEN AND WOMEN." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1638–39. http://dx.doi.org/10.1136/annrheumdis-2022-eular.4150.
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BackgroundOsteoporosis (OP) between men and women is different,and the way it is treated also differs. In men, the gap in clinical care, especially diagnosis and treatment, is worse.ObjectivesTo analyze the differences in the clinical characteristics of OP (demographics, comorbidities, diagnosis, and treatment) in an gold star Fracture Liaison Service (FLS).MethodsDesign: Observational, prospective, analytical study of usual clinical practice. All patients treated from an FLS from May 2018 to August 2021 were prospectively included. Of each patient, 160 clinical variables were introduced in a real time database, and they were followed for 2 years.Results557 patients were analyzed, 472 (83%) women and 100 (17%) men. The main features are summarized in the table. In women the vertebral fracture predominated followed by the hip fracture, in men the hip followed by the vertebral ones. Men had higher rates of smoking and alcoholism. The frequency of secondary OP and exercise was different between sexes. Weight, height, and BMI were different, due to different body composition. The frequency of specific treatment for OP (bisphosphonate, denosumab, teripatide, SERM) before fracture was very low, lower in men.The most remarkable result was the low percentage of patients with OP receiving treatment before the FLS, and the differences between sex; 77 (16%) women versus 6 (6%) men had received it at some point in their lives, p=0.008. The probability of a man not receiving prior treatment was 2. 70 (95%CI 1.13- 7.81); p=0,008. After the FLS all the patients were treated. Treatment adherence in the first two years after the FLS was 84% in both sexes.ConclusionOP is different between women and men. The probability of not receiving treatment in men was higher among men, these differences disappeared after care in FLS.Table 1VariableHipn, %239, 43Vertebraln, %159, 28DERn, %96, 17Humerusn, % 41, 7Othern, % 37, 6pWomenMenWomenMenWomenMenWomenMenWomenMen0.0001Number179, 7560, 25129, 8130, 1993, 973, 340, 981, 231, 846, 160.06Current smoker13, 8 *19, 3220, 16 *14, 4816, 17 *1, 333, 80, 08,10.3Drinker >3 cups/day5, 3 *14, 249, 7 *11, 386, 61, 332, 50, 02, 600.001Secondary causes of OP24, 1610, 2124, 2214, 5614, 180, 011, 320, 09, 321, 200,03Exercise0,0001 Bed to armchair35, 28 *12, 2110, 8*8, 281, 10, 03, 81, 3*2, 33 Wanders at home64, 013, 2336, 30*5, 177, 80, 05, 1311, 381, 17 Walk in the street58, 3626, 4653, 4315, 5259, 682, 6725, 6410, 343, 50 Daily exercise4, 25, 922, 181, 320, 236, 157, 240, 0 Total161, 7456, 26121, 8129, 1987, 971, 33 3, 339, 10029, 826, 17BMI ≥ 3053, 3214, 2551, 4313, 4638, 43*3, 717, 451, 59, 292, 400.01OP treatment before FF26, 15 *2, 328, 23 *3, 10 *13, 150, 06, 160, 04, 141, 200,008Re-fracture (one year)11, 94, 86, 70, 05, 80, 02, 81, 1000, 00, 00.9Mean± SDMean ± SDMean ± SDMean ± SDMean ± SDMean± SDMean ± SDMean ± SDMean± SDMean± SDAge, Years79±8.7*75.5 ±10.370.4±9.069.3±10.069±9.273.6±6.571.3± 8.7*7668.6±11.382.6±8.30.6Weight, Kg65.3±14,3*72.1±12.967.2±13.478.5±14.970.7±12.185.5±13.471.7±11.89068.6±18.6*77.7±19.40.00001Size, m1.5±0.06*1.64±0.061.51±0.011.63±0.061.54±0.061.6±0.061.54 ±0.061,631.54±0.06*1.61±0.090.00001BMI28.4 ±5.1*26.7±4.129.2 ±6.329.1±4.829.9±5.433.2±2.630.1±4.933.828.9±6.729.4± 6.20,04DER= distal end of radius, Others included ribs, tibia and fibula, distal end of femur. BMI Body mass index. *p value between women and men in each group of fragility fractures.Disclosure of InterestsBlanca Hernández-Cruz Speakers bureau: Abbvie, Lilly, Stada, UCB, GebroPharma, Nordic, Consultant of: Abbvie, MSD, Lilly, Stada, UCB, Maria José Miranda García: None declared, Julia Barrera: None declared, Francisco Jesús Olmo Montes: None declared, María Angeles Vázquez Gómez: None declared, Mercedes Giner García: None declared, Miguel Angel Colmenero Camacho: None declared, José Javier Pérez Venegas: None declared, María José Montoya García: None declared
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Grein, Jonathan D., Katherine L. Kahn, Samantha J. Eells, Seong K. Choi, Marianne Go-Wheeler, Tanzib Hossain, Maya Y. Riva, Megan H. Nguyen, A. Rekha Murthy, and Loren G. Miller. "Treatment for Positive Urine Cultures in Hospitalized Adults: A Survey of Prevalence and Risk Factors in 3 Medical Centers." Infection Control & Hospital Epidemiology 37, no. 3 (November 26, 2015): 319–26. http://dx.doi.org/10.1017/ice.2015.281.
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BACKGROUNDAntibiotic treatment for asymptomatic bacteriuria (ASB) is prevalent but often contrary to published guidelines.OBJECTIVETo evaluate risk factors for treatment of ASB.DESIGNRetrospective observational study.SETTINGA tertiary academic hospital, county hospital, and community hospital.PATIENTSHospitalized adults with bacteriuria.METHODSPatients without documented symptoms of urinary tract infection per Infectious Diseases Society of America (IDSA) criteria were classified as ASB. We examined ASB treatment risk factors as well as broad-spectrum antibiotic usage and quantified diagnostic concordance between IDSA and National Healthcare Safety Network criteria.RESULTSAmong 300 patients with bacteriuria, ASB was present in 71% by IDSA criteria. By National Healthcare Safety Network criteria, 71% of patients had ASB; within-patient diagnostic concordance with IDSA was moderate (kappa, 0.52). After excluding those given antibiotics for nonurinary indications, antibiotics were given to 38% (62/164) with ASB. Factors significantly associated with ASB treatment were elevated urine white cell count (65 vs 24 white blood cells per high-powered field, P<.01), hospital identity (hospital C vs A, odds ratio, 0.34 [95% CI, 0.14–0.80], P =.01), presence of leukocyte esterase (5.48 [2.35–12.79], P<.01), presence of nitrites (2.45 [1.11–5.41], P=.03), and Escherichia coli on culture (2.4 [1.2–4.7], P=.01). Of patients treated for ASB, broad-spectrum antibiotics were used in 84%.CONCLUSIONSASB treatment was prevalent across settings and contributed to broad-spectrum antibiotic use. Associating abnormal urinalysis results with the need for antibiotic treatment regardless of symptoms may drive unnecessary antibiotic use.Infect. Control Hosp. Epidemiol. 2016;37(3):319–326
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Vučajnk, Filip, Valentina Spanic, Stanislav Trdan, Iztok Jože Košir, Miha Ocvirk, and Matej Vidrih. "Performance of Symmetric Double Flat Fan Nozzles against Fusarium Head Blight in Durum Wheat." Agriculture 14, no. 3 (February 21, 2024): 343. http://dx.doi.org/10.3390/agriculture14030343.
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Four types of nozzles were tested on large-scale trials with a 40 m2 plot unit size. The Avi Twin 110-01 (80 L ha−1), 110-02 (160 L ha−1), 110-03 (240 L ha−1), and 110-04 (320 L ha−1) symmetric double fan injector nozzles were tested during the 2020/2021 and 2021/2022 growing seasons. This study aimed to evaluate the performance of spray nozzles with regard to deoxynivalenol (DON) accumulation in durum wheat grains. Artificial inoculation with Fusarium spp. was performed after durum heads were protected with fungicide. The percentage of heads covered with fungicide droplets, grain yield, yield-related traits, technological quality parameters, and concentrations of DON were determined. Compared to the control (without fungicide treatment), the Avi Twin 04 nozzle caused a reduction of 45.0% in the DON concentration on average across both growing seasons. This positively corresponded to the percentage of heads covered with fungicide droplets, which was highest when this nozzle was utilized. In both trial years, the DON reduction caused by the 110-04 twin nozzle was higher than that caused by the 110-01 nozzle. Treatment with the 110-04 nozzle more effectively improved the grain yield, 1000-kernel weight, and test weight compared to treatment with the 110-01 nozzle and the untreated control. The differences in technological quality were less pronounced when different spray nozzles were used.
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Druy, Alexander, Grigory Tsaur, Alexander Popov, Tatiana Verzhbitskaya, Egor Shorikov, Leonid Saveliev, and Larisa Fechina. "Prognostic impact and detection of minimal residual disease (MRD) in neuroblastoma patients." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 10055. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.10055.
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10055 Background: Bone marrow (BM) involvement and MRD detection in neuroblastoma (NB) seems to be useful tool for patients’ prognosis, stratification and risk-adapted treatment. Real-time PCR (RQ-PCR) of tumor-specific gene transcripts and flow cytometry (FC) are commonly applied for this purpose. Aim. RQ-PCR MRD marker definition, its qualitative concordance with FC and prognostic impact in NB patients. Methods: We analyzed 331 BM samples from 57 NB patients and 26 ‘normal’ BM samples from 20 patients without malignancies for PHOX2B, TH, ELAVL4 and GD2 genes expression. BM samples were defined as positive either in case of positivity for PHOX2B or in case of NB cells presence in BM. 326 BM samples from 52 NB patients were analyzed by RQ-PCR and FC together. Results: PHOX2B and TH were not detecting in normal BM samples. Out of 224 negative BM samples TH was identified in 5 only, while ELAVL4 and GD2 expression was detected in the majority of normal and negative BM samples: 20 and 15 from 26 normal; 209 and 197 out of 224 negative samples correspondingly. TH, ELAVL4 and GD2 expression in positive BM samples was significantly higher comparing to negative and normal BM samples.Threshold levels of each gene expression were established by ROC-analysis and subsequently applied for overall correct prediction (OCP) calculation. OCP for PHOX2B and TH achieved 0.994 and 0.952, while OCP for ELAVL4 and GD2 were significantly lower: 0.828 and 0.767 respectively. Analytical sensitivity of RQ-PCR for PHOX2B achieved 1E-06, while sensitivity of FC ranged from 1E-03 to 1E-05. In 193(59.2%) out of 326 evaluated samples BM was negative by both methods. 38(11.7%) samples were negative by FC but positive by RQ-PCR for PHOX2B expression. 31(9.5%) samples were positive by FC but negative by RQ-PCR. 64(19.6%) samples were positive by both techniques. Thus qualitative concordance between RQ-PCR and FC achieved 78.8%. Conclusions: Patients with detectable PHOX2B expression have lower event-free survival comparing to patients with PHOX2B negative BM: 0.30±0.10 and 0.77±0.27 respectively, p=0.002 and overall survival is 0.51±0.11 and 0.79±0.07 correspondingly, p=0.083. Median of follow up in our NB patients series is 42 months, ranged from 1 to 156.
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Frolov, S. V., L. O. Scherbakova, N. V. Moroz, V. N. Irza, and V. Yu Kulakov. "Comparative testing of vaccines based on viruses of genetic lineages G1 and Y280 for their potency against low pathogenic avian influenza H9N2." Veterinary Science Today, no. 3 (August 17, 2021): 224–29. http://dx.doi.org/10.29326/2304-196x-2021-3-38-224-229.
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Due to the genetic diversity of low pathogenic avian influenza (LPAI) viruses of subtype H9N2, it deemed appropriate to study the potency of the vaccines based on the antigens of strains А/chicken/Amursky/03/12 and A/chicken/Chelyabinsk/314-1/20 that represent currently circulating in the Russian Federation genetic lineages Y280 and G1, respectively. While low pathogenicity of the agent does not allow demonstrating the vaccine protective properties by the direct methods generally used for potency assessment (e.g. morbidity and mortality), the indirect methods were used: determination of antigenic relatedness of the strains, level of the postvaccinal homologous and heterologous humoral immunity, analysis of the virus genome synthesis inhibition (reduction) in vaccinated birds following their challenge. The strains used in the vaccines were determined to have some antigenic differences, which were demonstrated in the hemagglutination inhibition (HI) assay during control of the postvaccinal immunity in birds. Both vaccines generally induced strong humoral immunity in vaccinated birds (9–10 log2 determined using HI assay) with some difference in the levels of the immune response following the use of homologous or heterologous antigens. It was also reliably determined that homologous immunity facilitated more expressed inhibition of the virus reproduction after the challenge. The level of inhibition (reduction) of the virulent LPAI virus genome synthesis in vaccinated birds following their challenge with H9N2 virus of genetic lineage G1 was higher in birds following homologous vaccination, while the time periods of the genome detection in the biomaterial samples were the same. It was demonstrated that due to antigenic and immunogenic differences between LPAI H9N2 strains, use of both antigenic components in the inactivated vaccines is appropriate.
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Egger, Anthony C., Anas Minkara, Richard Parker, and James Rosneck. "Intra-articular Hip Injuries in National Basketball Association Players: A Descriptive Epidemiological Study." Orthopaedic Journal of Sports Medicine 10, no. 9 (September 1, 2022): 232596712211227. http://dx.doi.org/10.1177/23259671221122744.
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Background: Since the most recent epidemiologic study of injuries in National Basketball Association (NBA) players was completed in 2012, the understanding and diagnosis of intra-articular hip injury has advanced. Purpose: To report the epidemiology of intra- versus extra-articular hip injuries in NBA players with regard to missed games, risk factors for injury, and treatment types. Study Design: Cohort study; Level of evidence, 3. Methods: The NBA injury database was queried for all reported hip and groin injuries from 2013 to 2017. The injuries were then divided into intra-articular and extra-articular types. Variables compared between injury types included player age, NBA tenure, season schedule (preseason or offseason), onset type, injury mechanism, roster position, games missed, time to return to play, and need for surgery. Results: A total of 224 athletes sustaining 353 total hip pathologies were identified. Of these injuries, 216 (61.2%) were sustained during game competition and affected 156 (69.6%) of the athletes. Intra-articular injuries represented 39 (11.0%) cases and involved 36 (16.1%) players. The time to return to play was significantly longer after intra-articular versus extra-articular injury (44.6 ± 96.0 vs 11.8 ± 32.0 days; P = .03), and the number of games missed was significantly greater after intra-articular versus extra-articular injury (8.0 ± 18.7 vs 1.54 ± 4.9 games; P = .03). Patients with intra-articular hip injuries were more likely to undergo surgery (odds ratio, 5.5 [95% CI, 1.8-16.7]; P = .005). There was no statistically significant difference in the number of games missed due to surgery (35.2 ± 8.3 [intra-articular] vs 35.4 ± 11.6 [extra-articular]; P = .42) or nonoperative treatment (4.2 ± 3.4 [intra-articular] vs 1.3 ± 0.5 [extra-articular]; P = .11). Years of NBA tenure were not significantly different between intra-articular and extra-articular injuries (7.1 ± 3.7 vs 6.3 ± 4.0 years). For both types of hip injury, there was no correlation between player age and either days to return to play or number of games missed ( R 2 = 0.014). Conclusion: NBA players with intra-articular hip injuries underwent surgery more frequently and had a longer return-to-play time compared with those with extra-articular hip injuries. NBA tenure and player age were not correlated with the risk of developing hip injury or the need for surgery.
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Ruíz-Giménez, Nuria, Carmen Suárez, Rocío González, José Nieto, José Todolí, Ángel Samperiz, and Manuel Monreal. "Predictive variables for major bleeding events in patients presenting with documented acute venous thromboembolism. Findings from the RIETE Registry." Thrombosis and Haemostasis 100, no. 07 (2008): 26–31. http://dx.doi.org/10.1160/th08-03-0193.
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SummaryA score that can accurately determine the risk of major bleeding during anticoagulant therapy may help to make decisions on anticoagulant use. RIETE is an ongoing registry of consecutive patients with acute venous thromboembolism (VTE). We composed a score to predict the risk for major bleeding within three months of anticoagulant therapy. Of 19,274 patients enrolled, 13,057 (67%) were randomly assigned to the derivation sample, 6,572 to the validation sample. In the derivation sample 314 (2.4%) patients bled (fatal bleeding, 105). On multivariate analysis, age >75 years, recent bleeding, cancer, creatinine levels >1.2 mg/dl, anemia, or pulmonary embolism at baseline were independently associated with an increased risk for major bleeding. A score was composed assigning 2 points to recent bleeding, 1.5 to abnormal creatinine levels or anemia, 1 point to the remaining variables. In the derivation sample 2,654 (20%) patients scored 0 points (low risk); 9,645 (74%) 1–4 points (intermediate); 758 (5.8%) >4 points (high risk). The incidences of major bleeding were: 0.3% (95% confidence interval [CI]: 0.1–0.6), 2.6% (95% CI: 2.3–2.9), and 7.3% (95% CI: 5.6–9.3), respectively. The likelihood ratio test was:0.14 (95% CI:0.07–0.27) for patients at low risk;2.96 (95% CI:2.18–4.02) for those at high risk. In the validation sample the incidence of major bleeding was:0.1%,2.8%,and 6.2%,respectively. In conclusion, a risk score based on six variables documented at entry can identify VTE patients at low, intermediate, or high risk for major bleeding during the first three months of therapy.
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Vyayzenen, G., R. Dautov, A. Vyayzenen, D. Bolshakov, and N. Prodanov. "Vitamin nutrition of calves." Kormlenie sel'skohozjajstvennyh zhivotnyh i kormoproizvodstvo (Feeding of agricultural animals and feed production), no. 3 (March 1, 2020): 25–36. http://dx.doi.org/10.33920/sel-05-2003-03.
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Experimental studies have shown an increase in productivity, metabolic processes, the effectiveness of the use of nutrients and biologically active substances and the metabolic energy of diets, the health of heifers aged 1–6 months under the conditions of industrial technology of their rearing. Increasing the productivity of heifers is closely related to improving the nutrition system during all periods of rearing with the use of the vitamin complex Vitaminol in diets depending on their age and body weight. The highest effectiveness of rearing young animals has been established when using Vitaminol in doses: 1,3 g/head./day – up to 1 month, 2,4 g/head./day – 2 months, 3,3 g/head./day – 3 months, 4,3 g/head./day – 4 months, 4,8 g/head./day – 5 months and 5,3 g/head./day – at the age of 6 months. Differentiated feeding of optimal doses of feed additives to calves increases the digestibility of dry matter by 1,41–10,8 %, organic matter by 1,6–10,0 %, raw protein by 1,6–6,8 %, raw fat by 1,4–8,7 %, raw fiber by 1,5–3,0 % and nitrogen-free extractive substances by 1,6–6,0 % depending on age and body weight (from 1 to 6 months inclusive). It has a positive effect on the absorption of nitrogen and the use of calcium and phosphorus in the body. The use of Vitaminol in diets of calves contributes to an increase in live weight and average daily gain compared to the control group. In calves up to one month of age (at the dose of 1,3 g/head/day) live weight increased by 6,5 %, the average daily gain by 11,4 %, in 2 months (at the dose of 2,4 g/head/day) these indicators were 2,9 and 2,6 %, respectively, at 3 months (at the dose of 3,3 g/head/day) – 3,4 and 8,2 %, in 4 months (at the dose of 4,3 g/head/day) – 6,7 and 12,8 %, in 5 months (at the dose of 4,8 g/head/day) – 4,4 and 3,6 % and at 6 months (at the dose of 5,3 g/head/day) – 4,3 and 2,7 %, respectively. In order to improve the quality of feeding when rearing calves, more fully realize their genetic potential, increase productivity and use of nutrients in diets and normalize metabolic processes in the body we recommend the optimal doses of the feed additive Vitaminol depending on age (g/head/day): 1,3 – in 1 month, 2,4 – in 2 months, 3,3 – in 3 months, 4,3 – in 4 months, 4,8 – in 5 months, 5,3 – in 6 months. Feed additive Vitaminol enter into the composition of complete feed, wet feed mixtures and feed to calves 1 time per day.
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Hoekstra, Jildou, Ana H. C. Guimarães, Frank W. G. Leebeek, Sarwa Darwish Murad, Joyce J. M. C. Malfliet, Aurelie Plessier, Manuel Hernandez-Guerra, et al. "Impaired fibrinolysis as a risk factor for Budd-Chiari syndrome." Blood 115, no. 2 (January 14, 2010): 388–95. http://dx.doi.org/10.1182/blood-2009-03-211557.
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Abstract In Budd-Chiari syndrome (BCS), thrombosis develops in the hepatic veins or inferior vena cava. To study the relationship between hypofibrinolysis and BCS, we measured plasma levels of fibrinolysis proteins in 101 BCS patients and 101 healthy controls and performed a plasma-based clot lysis assay. In BCS patients, plasminogen activator inhibitor 1 (PAI-1) levels were significantly higher than in controls (median, 6.3 vs 1.4 IU/mL, P < .001). Thrombin-activatable fibrinolysis inhibitor and plasmin inhibitor levels were lower than in controls (13.8 vs 16.9 μg/mL and 0.91 vs 1.02 U/L, both P < .001). Median plasma clot lysis time (CLT) was 73.9 minutes in cases and 73.0 minutes in controls (P = .329). A subgroup of cases displayed clearly elevated CLTs. A CLT above the 90th or 95th percentile of controls was associated with an increased risk of BCS, with odds ratios of 2.4 (95% confidence interval, 1.1-5.5) and 3.4 (95% confidence interval, 1.2-9.7), respectively. In controls, only PAI-1 activity was significantly associated with CLT. Analysis of single nucleotide polymorphisms of fibrinolysis proteins revealed no significant differences between cases and controls. This case-control study provides the first evidence that an impaired fibrinolytic potential, at least partially caused by elevated PAI-1 levels, is related to the presence of BCS.
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Vo, Minh Cong, Huu Kien Pham, and Minh Hien Nguyen. "Posterior Nasal Neurectomy In Treatment of Intractable Rhinitis: A Preliminary Series." Philippine Journal of Otolaryngology-Head and Neck Surgery 33, no. 1 (July 12, 2018): 12–16. http://dx.doi.org/10.32412/pjohns.v33i1.15.
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Objective: To evaluate the efficacy and safety of posterior nasal neurectomy on the treatment of nasal congestion, rhinorrhea, sneezing, and post-nasal discharge in intractable rhinitis patients.
Methods
Design: Preliminary case series
Setting: Tertiary University Medical Center
Participants: Ten (10) patients with intractable rhinitis underwent endoscopic posterior nasal neurectomy in both sides. Symptoms were compared pre- and post-operatively one month and one year after surgery using Visual Analog Scale (VAS) scores. Endoscopic pre- and one-month post-operative Lund-Mackay scores were also compared.
Results: All four mean nasal symptom scores were reduced significantly at 1-month follow-up for nasal congestion (1.5 ± 1.08 vs 4.1 ± 0.5687, p = .00001), rhinorrhea (0.7 ± 0.823 vs 3.4 ± 0.966, p = .00001) post-nasal discharge (0.9 ± 0.994 vs 2.4 ± 1.5, p = .03), and sneezing (1.1 ± 0.738 vs 3 ± 0.943, p = .02). Mean endoscopic scores were also reduced significantly at one month, from 12.9 ± 2.55 to 4.2 ± 3, p = 0.0001.In the 6 patients that followed up at 1-year, post-operative mean nasal symptoms were still significantly better for congestion (0.6667 ± 0.8165 vs 4 ± 0.632, p = 0.00001), rhinorrhea (0.6667 ± 0.5164 vs 3.67 ± 1.033, p = .001), post-nasal discharge (0.1667 ± 0.40825 vs 2.17 ± 1.835, p = .033), sneezing (0.5 ± 0.54772 vs 3.17 ± 0.983, p = 0.0001). Mean post-operative VAS nasal scores and endoscopic scores were well associated (Correlation Coefficient -.648, p = .048).
Conclusion: Posterior nasal neurectomy could be considered as a safety and effective way to treat intractable rhinitis patients in Vietnam.
Keywords: Posterior nasal neurectomy, vasomotor rhinitis, allergic rhinitis, vidian neurectomy
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Koay, Shiwen, Vincenzo Provitera, Ekawat Vichayanrat, Giuseppe Caporaso, Fernanda Valerio da Silvia, Lucio Santoro, Fiore Manganelli, Maria Nolano, and Valeria Iodice. "Cardiovascular autonomic failure correlates with cutaneous autonomic denervation and patient symptoms in alpha-synucleinopathies." Journal of Neurology, Neurosurgery & Psychiatry 93, no. 9 (August 12, 2022): e2.79. http://dx.doi.org/10.1136/jnnp-2022-abn2.17.
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IntroductionCardiovascular autonomic failure and neurogenic orthostatic hypotension (nOH) are common and disabling features of Parkinson’s disease (PD) and multiple system atrophy (MSA). Compared to PD, MSA is considered a primarily central alpha-synucleinopathy.AimTo characterise the relationship between cardiovascular autonomic failure and cutaneous autonomic and somatic innervation in early PD and MSA.MethodsFifty-five patients (37 PD, 18 MSA) within 2 years of motor onset underwent: 1) cardiovascular autonomic testing 2) plasma catecholamines 3) distal leg skin biopsies for quantification of intraepider- mal (IENF), pilomotor (PNF), and sudomotor nerve fibres (SNF), and 4) COMPASS-31 autonomic symptom questionnaires.Results75% with MSA and 36% with PD had OH ≥20/10mmHg. Supine noradrenaline was significantly higher in MSA vs PD with OH (264[241-304] vs 158[154-190] pg/ml, P=.03). Compared to patients without OH, patients with OH had significantly reduced cutaneous innervation (3.1[1.3-6.0] vs 7.4[5.3-8.7] IENF/mm, P=.008; 2.8[0-8.2] vs 11.8[6.5-23.4] PNF/mm, P=.007; and 0.9[0.1-1.4] vs 1.6[1.4-1.8] nm SNF/µm3,P=.002), with no significant differences between MSA and PD with OH subgroups. Markers of cardiovas- cular autonomic failure, including severity of OH, correlated significantly with cutaneous denervation (IENF: ρ=-0.47, P=.007; PNF: ρ=-0.51, P=.004; SNF: ρ=-0.51, P=.006), and patient symptoms (COMPASS-31: ρ=0.57, P=.002).ConclusionCardiovascular autonomic failure was associated with cutaneous denervation in both MSA and PD. Postganglionic denervation may contribute to the pathophysiology of cardiovascular autonomic failure and nOH, and influence response to therapeutic agents for nOH.
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Medvedev, A. Yu, A. A. Vasiliev, Yu A. Guseva, V. G. Smetankina, and S. N. Figurak. "Efficiency of rearing Tenebrio molitor and Zophobas morio larvae as a source of feed protein." Glavnyj zootehnik (Head of Animal Breeding), no. 9 (August 25, 2023): 37–48. http://dx.doi.org/10.33920/sel-03-2309-04.
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The purpose of the work was to study the effectiveness of rearing larvae of Tenebrio molitor and Zophobas morio as a source of feed protein, as well as their chemical composition and amino acid characteristics, while improving the nutrient medium. It was found that the cultivation of Zophobas morio larvae for the production of feed protein is more eff ective than Tenebrio molitor larvae. At the age of 71 days, the average weight of Zophobas morio reached 387,0±8,24 mg, which was 238,8 mg more than that of the large Tenebrio molitor or 2,6 times (p < 0,001). There was a higher content of crude fat and crude protein in the chemical composition of Zophobas morio larvae by 9,4 g/kg or 6,2 % and 8,6 g/kg or 4,2 % with the same content of chitin 25–26 g/kg, calcium 0,32–0,35 g/kg and ash 23,3–24,7 g/kg. In the larvae of Zophobas morio a signifi cantly higher content of lysine was found by 9,7 g/kg or 2,3 times, valine by 29,8 g/kg or 2,5 times, leucine+isoleucine by 33,3 g/kg or 2,6 times, serine by 8,2 g/kg or 2,4 times, alanine by 13,4 g/kg or 2,3 times, glycine by 9,0 mg/kg or 2,6 times, proline by 5,9 g/kg or 2,4 times and tyrosine by 1,1 g/kg or 39,3 %. The introduction of dried daphnia into the traditional nutrient medium of Zophobas morio made it possible to signifi cantly increase the mass of larvae by 54,4 mg or 16,4 % (p < 0,01), as well as the content in them such nutrient as dry matter by 13,3 g or 3,4 %, crude protein and fat by 35,3 g/kg or 19,7 % and 8,7 g/kg or 5,7 %, metabolic energy by 1,8 MJ/kg or 25,3 %, lysine by 7,1 g/kg or 68,9 %, cystine by 2,2 g/kg or 2,2 times, arginine by 16,3 g/kg or 2,5 times, leucine+isoleucine by 29,5 g/kg or 2,2 times. Such use of dried daphnia did not have a high positive effect on the growth rate of Tenebrio molitor larvae, their chemical composition and amino acid profile.
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Schmitt, Wolfgang D., Paul Jank, Inga Hoffmann, Berit M. Pfitzner, Lauren Lenz, Wyatt Clegg, Elke Keil, et al. "Abstract P2-03-23: Retrospective evaluation of outcomes in a real-world, prospective cohort using EndoPredict: Results from the Charité registry." Cancer Research 83, no. 5_Supplement (March 1, 2023): P2–03–23—P2–03–23. http://dx.doi.org/10.1158/1538-7445.sabcs22-p2-03-23.
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Abstract Background: EndoPredict is a prognostic and predictive gene expression assay that provides an EPclin risk score, which can be used to identify individuals with low enough risk of distant breast cancer recurrence that they may forgo chemotherapy. In clinical studies, EndoPredict has been validated to predict risk of distant recurrence up to 15 years and chemotherapy benefit. To date, real-world studies evaluating patient outcomes after prospective EndoPredict testing have been limited. Here, we report on outcomes collected via survey from patients enrolled in a registry created to generate real-world evidence from over 800 patients routinely tested with EndoPredict at Charité University Hospital Berlin. Methods: Female patients with hormone receptor positive, HER2 negative primary breast cancer with up to three positive lymph nodes who received prospective EndoPredict testing at Charité University Hospital Institute of Pathology between 2011 and 2016 were contacted to complete a survey for participation in this study. Surveys included questions on treatment and recurrence history. Patient demographics, clinical characteristics of the cancer, and EndoPredict results were retrieved from Charité records. All patients received EndoPredict test results before decision making on systemic treatment. After testing, treatment included either adjuvant endocrine therapy or adjuvant endocrine therapy plus adjuvant chemotherapy, and may have included radiotherapy. Cox proportional hazards models were fit with binary EPclin risk category (high, low) or continuous EPclin risk score predicting 5-year distant recurrence or recurrence of any kind. Analyses were performed across all survey responses, and in subsets of patients stratified by adjuvant chemotherapy treatment. Kaplan-Meier estimates of 5-year risk of recurrence were also calculated. Results: 842 patient survey responses were returned with informed consent and met study inclusion criteria. The median age at diagnosis was 54 years (IQR 49, 63), and across survey responses, 63.5% (N=535/842) of patients were lymph node negative, 60.9% (N=513/842) were T1, and 43.9% (N=370/842) were treated with adjuvant chemotherapy. Among included patients, 49.5% (N=417/842) were classified as EPclin low-risk and 50.5% (N=425/842) were high-risk. The concordance between EPclin risk category and chemotherapy status was 0.89 with 5.5% (N=23/417) of EPclin low-risk and 81.6% (N=347/425) of EPclin high-risk patients receiving treatment with chemotherapy. In the subset of patients not treated with adjuvant chemotherapy (N=472/842, 55.7%), continuous EPclin score was a significant predictor of distant recurrence (N=469; HR: 4.34, 95% CI 1.75-9.58); p = 2.4 × 10-3), and recurrence of any kind (N=468; HR: 3.39, 95% CI 1.61-6.58); p = 1.9 × 10-3). In EPclin low-risk patients treated with endocrine therapy alone, there was a low risk of 5-year distant recurrence (1.6%, 95% CI 0.7%-3.4%). In EPclin high-risk patients the risk of distant recurrence at 5 years was 6.8% (95% CI 2.6%-17.4%) in patients without chemotherapy and 3.6% (95% CI 2.1%-6.3%) in patients treated with chemotherapy. In an exploratory subgroup analysis in patients with node negative and node positive disease, risk of 5-year distant recurrence in EPclin low-risk patients without chemotherapy was 1.3% (95% CI 0.5%-3.5%) and 2.4% (95% CI 0.6%-9.2%), respectively. Conclusion: In this real-world cohort of patients with prospective routine testing with EndoPredict, EPclin scores were a significant predictor for patient-reported outcomes. Patients with EPclin low-risk scores had a low risk of 5-year distant recurrence even in the absence of chemotherapy treatment. This real-world result supports previous clinical studies demonstrating that patients with EPclin low-risk scores can safely forgo chemotherapy. Citation Format: Wolfgang D. Schmitt, Paul Jank, Inga Hoffmann, Berit M. Pfitzner, Lauren Lenz, Wyatt Clegg, Elke Keil, Sarah Ratzel, Elizabeth S. Cogan, Jens-Uwe Blohmer, Pauline Wimberger, Ralf Kronenwett, David Horst, Carsten Denkert. Retrospective evaluation of outcomes in a real-world, prospective cohort using EndoPredict: Results from the Charité registry [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-03-23.
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Kim, Yeon JIn, Soo Yeon Chung, Byung Joo Chae, Jonghan Yu, Jeong Eon Lee, and Jai Min Ryu. "Abstract P2-14-03: Learning curve for Robotic assisted nipple sparing mastectomy: a single institution experience." Cancer Research 83, no. 5_Supplement (March 1, 2023): P2–14–03—P2–14–03. http://dx.doi.org/10.1158/1538-7445.sabcs22-p2-14-03.
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Abstract Backgrounds/Aims: Nipple sparing mastectomy (NSM) is popularly performed as this surgical technique is oncological safety and better cosmetic outcomes. Robot assisted NSM (RANSM) is emerging because of its exceptional advantages: hidden incisions, high resolution, wider visualization and ergonomically moving. Although several studies reported that RANSM has shown a short learning curve, there were few reports about learning curve of this cutting-edge surgical technique. In this study, we reported the learning curve and feasibility of RANSM. Methods: A retrospective and prospective study was conducted for women who underwent RANSM with immediate breast reconstruction at Samsung Medical Center from July 2019 to April 2022. All RANSM were performed by a single surgeon. We divided the total cases in half and set up two phases; an early phase (case 1st to 23th) and a late phase (case 24th to 46th). The total operation time, mastectomy time, docking time, pre-console time and console time was defined as the interval between the creation of the skin incision and the end of the reconstructive surgery, the interval between the time of skin incision and the time of the specimen out of the operation field, the interval between the preparation for docking and the end of docking, the interval between the creation of the skin incision and the end of robot docking, and the time spent by a surgeon to operate the console for mastectomy. To evaluate the impact of case experience accumulation on the operation time of RANSM, the cumulative sum (CUSUM) method was used to analyze the learning curve. Clinicopathologic characteristics, perioperative complications, and operation time were collected. Results: Overall, 42 women underwent 46 RANSM procedures conducted. The median patient age was 44.5 years old (26-59 years) and the median breast weight was 338.5 gram (101.4-817 gram). BRCA 1 mutation carriers were 2 patients and BRCA 2 mutation carriers were 3 patients. 5 patients with BRCA 1/2 mutation carriers underwent contralateral risk-reducing RANSM. Clinicopathologic characteristics of patients between the early phase and late phase were summarized in Table 1. There were no significant differences in almost clinicopathologic characteristics. Median time of total operation, mastectomy, docking time, pre-console time, and console time was 344.0 minutes (254.0-480.0 minutes), 238.5 minutes (166-394 minutes), 6.5 minutes (1-25 minutes), 61.5 minutes (29-180 minutes), and 64.5 minutes (33-134 minutes), respectively. Comparing the early phase and the late phase, median total operation time was 357 minutes (273-480 minutes) and 321 minutes (254-459 minutes), (p = 0.067); median mastectomy time was 245 minutes (204-394 minutes) and 229 minutes (166-376 minutes), (p = 0.070); docking time 7.0 minutes (3-25 minutes) and 5.0 minutes (1-20 minutes),(p = 0.093); pre-console time was 70.0 minutes (49-162 minutes) and 54.0 minutes (29-180 minutes),(p = 0.028); console time was 71.0 minutes (40-134 minutes) and 60.0 minutes (33-105 minutes), (p = 0.095). In the learning curve analysis, it took the 21th procedure in RANSM to decrease the breast operation time. Clavien-Dindo grade III postoperative complication was two cases (8.6%, one case was infection and one case was nipple ischemia) in only early phase and none in the late phase. Clavien-Dindo grade II postoperative complication was absent in all phases. Clavien-Dindo grade I postoperative complications were seven cases (30.4%, all cases were nipple crust) in the early phase and one case (4.3%, one case was nipple crust) in the late phase. Nipple ischemia was found in two cases (8.6%) but only one case required nipple excision given in the early phase. Conclusions: It has shown that the breast operation time improved from the 21th procedure of RANSM. RANSM is technically feasible and acceptable with a short learning curve. TABLE 1. Basic characteristics of patients between the early phase and late phase Citation Format: Yeon JIn Kim, Soo Yeon Chung, Byung Joo Chae, Jonghan Yu, Jeong Eon Lee, Jai Min Ryu. Learning curve for Robotic assisted nipple sparing mastectomy: a single institution experience [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-14-03.
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McArthur, Heather, Hanna Tukachinsky, Alexa Schrock, Russell Madison, Oliver Holmes, Smruthy Sivakumar, Ethan Sokol, et al. "Abstract PO2-16-03: ESR1 genomic alterations (GAs) and coexistent putative resistance alterations in comprehensive genomic profiling (CGP) of metastatic breast cancer (MBC)." Cancer Research 84, no. 9_Supplement (May 2, 2024): PO2–16–03—PO2–16–03. http://dx.doi.org/10.1158/1538-7445.sabcs23-po2-16-03.
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Abstract Background: ESR1 mutations (ESR1mut) are an established biomarker of endocrine therapy (ET) resistance in patients (pts) with hormone receptor positive (HR+) MBC. Moreover, ESR1mut acquired in response to standard-of-care ET now confer access to novel ET recently approved by health authorities. However, the nuanced genomic landscape beyond the simple presence or absence of ESR1mut may be critically important. We report on detailed ESR1 GAs detected by tissue and liquid biopsies (TBx, LBx) and examine the prevalence of co-occurring GAs in other genes reported to confer intrinsic or acquired resistance to ET. Methods: CGP results from MBC biopsies were retrospectively analyzed (TBx 33,653 pts; LBx 7,134 pts) using FoundationOne® CDx and FoundationOne® Liquid CDx, hybrid-capture based sequencing platforms profiling 324 cancer-related genes. Foundation Medicine’s ctDNA tumor fraction (TF) is a composite algorithm prioritizing aneuploidy at higher levels to avoid germline signal and prioritizing variant allele frequency (VAF) of canonical alterations at lower levels to maximize dynamic range. Results: ESR1mut were detected in 3,755 (11.2%) TBx and 1,513 (21.2%) LBx. Among samples with ESR1mut, multiple ESR1mut were more common in LBx (19% 2, 12% 3+) than in TBx (6% 2, 0.5% 3+), with up to 10 different ESR1mut seen in one LBx. The most common mutations were D538G (39% and 52% of TBx and LBx with ESR1mut), Y537S (27%, 38%), Y537N (10%, 15%), and E380Q (10%, 14%). Activating ESR1 insertion-deletion mutations (indels) were detected in 81 TBx and 62 LBx (2% and 4%), representing 23 distinct variants at the protein level, including V422del (107), indels affecting codons 532-538 (29), G344_L345insC (7), and Y328_S329del (6). 28 fusions of the ESR1 DNA binding domain to 13 unique gene partners were detected; 10/28 (36%) were ESR1-CCDC170 fusions. ESR1 amplifications (ESR1amp) were detected in 704 (2.1%) TBx; 62 (8.8%) also harbored ESR1mut. ESR1amp were detected among 34 (0.5%) LBx; 8 (24%) also had ESR1mut. In TBx with ESR1mut and LBx collected from the same pt within 8 months (43 pairs), LBx sensitivity of detection of ESR1mut was 96% (26/27, 95% confidence interval CI [95%CI]: 79%-99%) when TF was ≥1%, but only 6% (1/16, 95%CI: 0.3%-32%) when LBx had TF < 1%. In 988/1,513 (65%) of LBx with ESR1mut, ≥1 mutations or fusions in genes associated with alternative ET resistance pathways were detected, including PIK3CA (46% of ESR1mut LBx), RB1 (12%), PTEN (10%), NF1 (7%), ARID1A (7%), AKT1 (5%), FGFR2 (4%), and KRAS (4%) and ERBB2 (3%). Prevalence of co-occurring GA associated with ET resistance was higher in LBx than in TBx (RB1, NF1, FGFR2, PTEN, EGFR, KRAS, PIK3CA, FDR < 0.001). Moreover, prevalence was higher in 240 LBx where ESR1 was a minor allele (VAF/TF < 10%) compared to 1,273 LBx were ESR1 was a major allele (FGFR2, PIK3CA, FGFR3, BRAF, ERBB2, RB1, FDR < 0.05). In pts with ESR1mut LBx and a historical TBx collected < 5 years earlier (182 pairs), GAs in RB1, FGFR2, KRAS, EGFR, and BRAF were detected primarily on the LBx but not the preceding TBx. Conclusions: CGP detects a wide spectrum of mutations in ESR1, including missense and indel mutations and fusions. When LBx TF is < 1%, sensitivity for ESR1mut is reduced and repeat testing should be considered. ESR1mut can coexist with complementary or competing resistance mechanisms, particularly when ESR1 is a minor allele, which could impact benefit from novel ET approved for patients with ESR1 mutations. Currently, CGP of LBx informs therapeutic recommendations for pts with HR+ MBC based on the binary presence or absence of ESR1mut; however, the clinical implications of the ESR1 mutation spectrum described herein and the potential impact of co-expression of other key pathway signals warrant further investigation. Citation Format: Heather McArthur, Hanna Tukachinsky, Alexa Schrock, Russell Madison, Oliver Holmes, Smruthy Sivakumar, Ethan Sokol, Ryon Graf, Julia Quintanilha, Kali Dougherty, Lincoln Pasquina, Geoffrey Oxnard, Mia Levy, Eric Winer. ESR1 genomic alterations (GAs) and coexistent putative resistance alterations in comprehensive genomic profiling (CGP) of metastatic breast cancer (MBC) [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-16-03.
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Elbagir, S., L. M. Diaz-Gallo, G. Grosso, A. Zickert, I. Gunnarsson, M. Mahler, E. Svenungsson, and J. Rönnelid. "POS0747 ANTI-PHOSPHATIDYLSERINE/PROTHROMBIN ANTIBODIES AND VASCULAR EVENTS ASSOCIATE POSITIVELY WITH HLA-DRB1*13 AND NEGATIVELY WITH HLA-DRB1*03 IN SLE." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 658.2–659. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2243.
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BackgroundAnti-phosphatidylserine/prothrombin antibodies (anti-PS/PT) associate with thrombotic events (1). HLA-DRB1 alleles contribute to the occurrence of conventional antiphospholipid antibodies (aPL), including anti-beta2glycoprotein-I (beta2GPI) and anti-cardiolipin (CL) (2).ObjectivesWe investigated associations between anti-PS/PT and HLA-DRB1 alleles and thrombosis in patients with SLE. Conventional aPL were included for comparison.MethodsWe included 341 consecutive Swedish SLE patients, with information on general cardiovascular risk factors, including blood lipids, lupus anticoagulant (LAC) and thrombotic events. Anti-PS/PT, anti-beta2GPI and anti-CL of IgA/G/M isotypes were quantified in parallel using particle-based multi-analyte technology. The 99th percentiles among 162 age- and sex-matched populations controls were used as cutoffs. HLA-DRB1 typing was performed using sequence-specific primer PCR.ResultsAnti-PS/PT antibodies associated positively with HLA-DRB1*13 (odds ratio [OR] 2.7, P=0.002), whereas anti-beta2GPI and anti-CL antibodies associated primarily with HLA-DRB1*04 (OR 2.5, P=0.0005; Table 1). These associations remained after adjustment for other significant HLA-DRB1 alleles identified in Table 1 (Figure 1a and b) also for LAC (Figure 1c), and also after adjustment for age and gender (not shown). HLA-DRB1*13, but not DRB1*04, remained as an independent risk factor for thrombosis after adjustment for significant HLA alleles (Figure 1d), and also after adjustment for cardiovascular risk factors in stepwise regression (not shown). Mediation analysis showed that 31.3% of the HLA-DRB1*13-related risk for thrombosis was mediated by anti-PS/PT positivity. HLA-DRB1*03, on the other hand, associated negatively with thrombotic events (Figure 1d) as well as with all aPL (Figure 1a-c). HLA-DRB1*03 had thrombo-protective effect in aPL positive patients (Figure 1d). Additionally, HLA-DRB1*03 positivity was associated with a favourable lipid profile regarding high-density lipoprotein (median 1.4 vs. 1.2 mmol/L, p=0.02) and triglycerides (median 0.9 vs 1.1 mmol/L, p=0.04); whereas no other HLA-DRB1 alleles showed any associations to lipid levels.Table 1.Frequency of individual HLA DRB1 and associations with antibody phenotypes. Odds ratios (OR) and confidence intervals (CI) for being antibody positive given a specific HLA allele and corresponding p values were calculated using Chi2 tests, with significant associations underlined.HLA DRB1HLA-DRB1 n (%) total patientsAnti-PS/PT positive (any isotype) n=48OR (95%CI); PAnti-β2GPI or anti-CL positive (any isotype) n=96OR (95%CI); P*0141 (12.9%)4 (8.3%)0.6 (0.2-1.7); 0.311 (11.4%)0.8 (0.4-1.7); 0.6*03147 (46.5%)13 (27.1%)0.4 (0.2-0.7); 0.00433 (34.4%)0.5 (0.3-0.8); 0.006*0494 (29.7%)18 (37.5%)1.6 (0.8-2.9); 0.241 (42.7%)2.5 (1.5-4.1); 0.0005*0728 (8.9%)6 (12.5%)1.5 (0.6-4); 0.49 (9.4%)1 (0.4-2.4); 0.9*0828 (8.9%)6 (12.5%)1.6 (0.6-4.3); 0.39 (9.4%)1.2 (0.5-2.7); 0.7*099 (2.8%)1 (2.1%)0.7 (0.1-5.5); 0.72 (2.1%)0.6 (0.1-3.0); 0.5*107 (2.2%)0 (0)NA2 (2.1%)0.9 (0.2-4.6); 0.9*1127 (8.5%)6 (12.5%)1.6 (0.6-4.3); 0.38 (8.3%)0.9 (0.4-2.2); 0.8*127 (2.2%)0 (0)NA1 (1%)0.4 (0.05-3.7); 0.4*1379 (25%)21 (43.7%)2.7 (1.4-5.2); 0.00233 (34.3%)2 (1.2-3.4%); 0.01*146 (1.9%)2 (4.2%)3.7 (0.6-23); 0.12 (2.1%)1.4 (0.2-8.9); 0.8*15118 (37.3%)12 (48%)0.5 (0.2-0.9); 0.04527 (28.1%)0.5 (0.3-0.9); 0.01*168 (2.5%)1 (2.1%)0.8 (0.09-6.4); 0.84 (4.2%)2.2 (0.5-9.2); 0.2ConclusionHLA-DRB1*13 confers risk for both anti-PS/PT and thrombotic events in SLE. The association between HLA-DRB1*13 and thrombosis is largely, but not entirely, mediated through anti-PS/PT. Due to the negative association of HLA-DRB1*03 with aPL and the positive association with favourable lipid levels, HLA-DRB1*03 seems to identify a subgroup of SLE patients with reduced vascular risk.References[1]Elbagir S et al. Lupus 2021;30(8):1289.[2]Lundström E et al. Ann Rheum Dis 2013;72:1018.Disclosure of InterestsSahwa Elbagir: None declared, Lina M. Diaz-Gallo: None declared, Giorgia Grosso: None declared, Agneta Zickert: None declared, Iva Gunnarsson: None declared, Michael Mahler Employee of: Dr Mahler is employee of Werfen., Elisabet Svenungsson Speakers bureau: Dr Svennungson has obtained speaker’s fees from Janssen., Grant/research support from: Dr Svennungson has obtained research grant from Merck., Johan Rönnelid Speakers bureau: Dr Rönnelid has given paid lectures for Thermo Fisher Scientific., Consultant of: Dr Rönnelid has been a member of the Scientific Advisory Board for Thermo Fisher Scientific.
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Lubova, Valeriya Alexandrovna, Anna Leonidovna Shutikova, and Galina Nikolaevna Leonova. "Transmissible tick-borne infections in the south of the Far East." Sanitarnyj vrač (Sanitary Doctor), no. 9 (September 1, 2021): 33–41. http://dx.doi.org/10.33920/med-08-2109-03.
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Natural foci of tick-borne infections associated with tick-borne encephalitis virus (TBEV), borrelia (Borrelia burgdorferi sensu lato), including Borrelia miyamotoi, anaplasma, ehrlichia and rickettsia are widespread in the Primorsky Krai. The carriers of these pathogens are ixodid ticks. The population of Primorsky Krai meets with ticks in natural biotopes, as well as in anthropurgic foci. The aim of the study is to give a comparative assessment of the epizootic activity in the natural foci of transmissible tick-borne infections in the south of Primorsky Krai in the epidemic seasons of 2017–2020. In this periodixodid ticks (3778 samples), taken from humans in natural foci in the Primorsky Territory, were studied. The TBEV antigen was determined by enzyme-linked immunosorbent assay (ELISA), genetic markers of pathogens were detected by real-time polymerase chain reaction (RT-PCR). The incidence of tick-borne infections has been analyzed. Based on the results of monitoring the infection of ixodid ticks, we found that 26.9 % of the studied samples were infected with various pathogens of tick-borne infections. Low infection rate of TBEV in ixodid ticks and high infection with pathogens of a bacterial nature were established. TBEV antigen was detected in 30 cases (1.4 %), TBEV RNA was detected in 20 cases (0.7 %), Borrelia burgdorferis. l. DNA — in 820 cases (30.7 %), ehrlichia — in 64 (2.4 %), anaplasma — in 55 (2.1 %).Genetic marker of Rickettsia spp. was detected in 3 cases (0.9 %) out of 322 examined ixodid ticks, B. miyamotoi — in 26 cases (6.9 %) out of 373 examined samples. A positive correlation was noted between the incidence rates and the cases of detection of TBEV and Lyme borreliosis in ticks. The results obtained indicate the need for annual epidemiological monitoring of infections transmitted by ixodid ticks, to determine the real epidemic situation and the activity of the functioning natural foci transmissible tick-borne infections on the territory of Primorsky Krai.
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Rigolon, Walkiria De Oliveira, Lisandra Príncepe, and Rodnei Pereira. "Condições de trabalho no início da docência: elementos constituintes e repercussões no desenvolvimento profissional (Working conditions at the beginning of teaching: constituent elements and repercussions on professional development)." Revista Eletrônica de Educação 14 (October 9, 2020): 4195117. http://dx.doi.org/10.14244/198271994195.
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e4195117This essay aims to problematize the relationship between work condition and professional insertion, considering that the elements that constitute teaching work conditions can have a negative impact on professional development, needing to be taken into account when investigating the phenomenon of evasion and career abandonment, especially by beginning teachers. Assuming that the career is a process of marking and incorporating individuals into the institutionalized practices and routines of the work teams, which depends on positive conditions to consolidate and that it is through the structuring of the career that the objective conditions of the teaching work are manifested, some elements that make up the teaching career considered in this essay, are considered fundamental for the understanding of professional development: a) forms of hiring, b) working hours, c) the number of students per class and classes and of schools in which the beginning teacher teaches, d) the training times and the spaces offered by the institutions, e) the support offered to these professionals. We argue that any analysis that is intended to be made on the professional insertion in the teaching career needs to contemplate the innumerable cleavages that directly affect labor relations and that further intensify the difficulties faced by those who begin to exercise teaching work.ResumoEste ensaio tem como objetivo problematizar a relação entre condição de trabalho e inserção profissional, considerando que os elementos que constituem as condições de trabalho docente podem repercutir negativamente no desenvolvimento profissional, necessitando serem levados em consideração quando se investiga o fenômeno da evasão e do abandono da carreira, em especial pelos professores iniciantes. Partindo do princípio de que a carreira é um processo de marcação e de incorporação dos indivíduos às práticas e rotinas institucionalizadas das equipes de trabalho, que depende de condições positivas para se consolidar e que é por meio da estruturação da carreira que se manifestam as condições objetivas do trabalho docente, são apontados neste ensaio alguns elementos que compõem a carreira docente, considerados fundantes para a compreensão do desenvolvimento profissional: a) as formas de contratação, b) as jornadas de trabalho, c) o número de alunos por turma, de turmas e de escolas em que o professor iniciante leciona, d) os tempos e espaços de formação ofertados pelas instituições, e) os apoios ofertados a esses profissionais. Defendemos que qualquer análise que se pretenda fazer sobre a inserção profissional na carreira docente precisa contemplar as inúmeras clivagens que incidem diretamente nas relações de trabalho e que adensam ainda mais as dificuldades enfrentadas pelos que começam a exercer o trabalho docente.Palavras-chave: Condições de trabalho, Inserção à docência, Professor iniciante.Keywords: Working conditions, Teaching induction, Beginning teacher.ReferencesBLOMMAERT, Jan. Ethnography, superdiversity and linguistic landscapes: chronicles of complexity. Bristol: Multilingual Matters, 2013. 144 p.BRASIL. [Constituição (1988)]. Constituição da República Federativa do Brasil de 1988. Brasília, DF: Presidência da República, [2016]. Disponível em: http://www.planalto.gov.br/ccivil_03/Constituicao/ Constituicao.htm. Acesso em: 1 jan. 2017.BRASIL. Lei nº 11.738, de 16 de Julho de 2008. Regulamenta a alínea “e” o inciso III do caput do art. 60 do Ato das Disposições Constitucionais Transitórias, para instituir o piso salarial profissional nacional para os profissionais do magistério público da educação básica. Diário Oficial da União, Poder Legislativo, Brasília, DF, 17 jul. 2008. p. 1. Disponível em: <http://www.planalto.gov.br/ccivil_03/_ato2007-2010/2008/lei/l11738.htm>. Acesso em: 12 out. 2015.CASTEL, Robert. As metamorfoses da questão social: uma crônica do salário. Petropolis, RJ: Vozes, 1998. 611 p.CATANI, Denise Bárbara; BUENO, Belmira Oliveira; SOUZA, M. Cecília C.C.; SOUSA, Cynthia Pereira de (org.). Docência, memória e gênero: estudos sobre formação. São Paulo: Escrituras, 1997. 111 p.ELIAS, Norbert. A Sociedade dos indivíduos. Rio de Janeiro: Jorge Zahar, 1994. 224 p.ELIAS, Norbert; SCOTSON, John. Os estabelecidos e os outsiders. Rio de Janeiro: Jorge Zahar, 2000. 228 p.GATTI, Bernardete Angelina. Reconhecimento social e as políticas de carreira docente na educação básica. Cadernos de Pesquisa, São Paulo, v. 42, n. 145, p. 88-111, abr. 2012. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-15742012000100007. Acesso em: 07 jul. 2014.GATTI, Bernardete Angelina. Educação, escola e formação de professores: políticas e impasses. Educar em Revista, Curitiba, n. 50, p. 51-67, dez. 2013. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-40602013000400005&lng=pt&tlng=pt. Acesso em: 07 abr. 2020.GATTI, Bernardete Angelina; BARRETO, Elba Siqueira de Sá (coord.). Professores do Brasil: impasses e desafios. Brasília: UNESCO, 2009. E-book. Disponível em https://unesdoc.unesco.org/ark:/48223/pf0000184682. Acesso em: 21 nov. 2015. 285 p.GATTI, Bernadete Angelina; BARRETTO, Elba Siqueira de Sá; ANDRÉ, Marli Eliza Dalmazo de Afonso. Políticas docentes no Brasil: um estado da arte. Brasília, DF: UNESCO, 2011. E-book. Disponível em: https://unesdoc.unesco.org/ark:/48223/pf0000212183. Acesso em: 10 ago. 2018.GOFFMAN, Erving. A representação do eu na vida cotidiana. 4. ed. Petrópolis: Vozes, 1988. 231 p.GONÇALVES, José Alberto Mendonça. A carreira das professoras do ensino primário. In: NÓVOA, Antonio (org). Vida de professores. 2 ed. Porto: Porto Editora, 2013. p. 141-169.INSTITUTO PAULO MONTENEGRO. Ser professor: uma pesquisa sobre o que pensa o docente das principais capitais brasileiras. In: FUNDAÇÃO VICTOR CIVITA (São Paulo). Estudos & Pesquisas Educacionais. São Paulo: Fundação Victor Civita, 2010. p. 17-61. E-book. Disponível em: https://abrilfundacaovictorcivita.files.wordpress.com/2018/04/estudos_e_pesquisas_educacionais_vol_1.pdf. Acesso em: 07 mar. 2017.LAVAL, Christian. A escola não e? uma empresa: o neoliberalismo em ataque ao ensino público. Londrina: Planta, 2004. 324 p.LIMA, Emília Freitas de et al. Sobrevivendo ao início da carreira docente e permanecendo nela: como? por quê? o que dizem alguns estudos. Educação & Linguagem, São Paulo, v. 10, n. 15, p. 138-160, jul. 2007. Disponível em: https://www.metodista.br/revistas/revistas-ims/index.php/EL/article/view/161/171. Acesso em: 15 ago. 2015.LINHART, Danièle. Modernisation et précarisation de la vie au travail. Papeles del CEIC. [s.l.], vol. 43, p. 1-19, mar. 2009. Disponível em: https://www.semanticscholar.org/paper/Modernisation-et-pr%C3%A9carisation-de-la-vie-au-travail-Linhart/1ce7e477f72942fae0d2d50b7b1d4938cd039c68. Acesso em: 31 maio 2018.LÜDKE, Menga; BOING, Luiz Alberto. Caminhos da profissão e da profissionalidade docentes. Educação & Sociedade, Campinas, v. 25, n. 89, p. 1159-1180, dez. 2004. Disponível em: http://www.scielo.br/scielo.php?pid=S0101-73302004000400005&script=sci_abstract&tlng=pt. Acesso em: 25 jun. 2017.MARCELO GARCÍA, Carlos. Formação de Professores: para uma mudança educativa. Porto: Editora Porto, 1999. 271 p.MARCELO, Carlos. O professor iniciante, a prática pedagógica e o sentido da experiência. Formação Docente: Revista Brasileira de Pesquisa sobre Formação de Professores, [s.l.], v. 2, n. 3, p. 11-49, ago./dez. 2010. Disponível em: https://revformacaodocente.com.br/index.php/rbpfp/article/view/17. Acesso em: 7 jul. 2014.MARCELO, Carlos. Desenvolvimento Profissional Docente: passado e futuro. Sísifo: Revista de Ciências da Educação, Lisboa, n. 8, p. 7-22, abr. 2009. Disponível em: https://idus.us.es/bitstream/handle/11441/29247/Desenvolvimento_profissional_docente.pdf?sequence=1&isAllowed=y. Acesso em: 01 abr. 2017.MEIRIEU, Philippe. Cartas a um jovem professor. Porto Alegre: Artmed, 2006. 95 p.OLIVEIRA, Dalila Andrade; ASSUNÇÃO, Ada Ávila Condições de trabalho docente. In: OLIVEIRA, Dalila Andrade; DUARTE, Adriana Cancella; VIEIRA, Lívia Fraga. Dicionário: trabalho, profissão e condição docente. Belo Horizonte: UFMG/Faculdade de Educação, 2010. on-line. Disponível em: http://gestrado.net.br/?pg=dicionario-verbetes&id=390. Acesso em: 08 ago. 2013.PEREIRA, Rodnei. O desenvolvimento profissional de um grupo de coordenadoras pedagógicas iniciantes: movimentos e indícios de aprendizagem coletiva, a partir de uma pesquisa-formação. 251 f. Tese (Doutorado em Educação: Psicologia da Educação) – Pontifícia Universidade Católica de São Paulo, São Paulo, 2017.PINTO, José Marcelino Rezende. Remuneração adequada do professor: desafio à educação brasileira. Retratos da Escola, Brasília, v. 3, n. 4, p. 51-67, jun. 2009. Disponível em: http://retratosdaescola.emnuvens.com.br/rde/article/view/101/290. Acesso em: 03 abr. 2013.PRÍNCEPE, Lisandra Marisa. Condições de trabalho e Desenvolvimento profissional de professores iniciantes em uma Rede Municipal de Educação. 2017. 231 f. Tese (Doutorado em Psicologia da Educação) – Pontifícia Universidade Católica de São Paulo, São Paulo, 2017.RIGOLON, Walkiria de Oliveira. O que muda quando tudo muda? Uma análise do trabalho docente dos professores alfabetizadores do Estado de São Paulo. 2013. Tese (Doutorado em Educação) – Programa de Pós-Graduação da Universidade Estadual de Campinas, Campinas, São Paulo, 2013.SAMPAIO, Maria das Merce?s Ferreira; MARIN, Alda Junqueira. Precarização do trabalho docente e seus efeitos sobre as práticas curriculares. Educação & Sociedade, [s.l.], v. 25, n. 89, p. 1203-1225, dez. 2004. Disponível em: http://www.scielo.br/scielo.php?pid=S0101-73302004000400007&script=sci_abstract&tlng=pt. Acesso em: 19 out. 2017.SENNETT, Richard. A corrosão do caráter: consequências pessoais do trabalho do novo capitalismo. 11. ed. Rio de Janeiro: Record, 2006. 204 p.SOARES NETO, Joaquim José et al. Uma escala para medir a infraestrutura escolar. Estudos em avaliação educacional, São Paulo, v.24, n.54, p. 78-99, abr. 2013. Disponível em: http://publicacoes.fcc.org.br/ojs/index.php/eae/issue/view/163/showToc. Acesso em: 18 nov. 2016.SOUZA, Aparecida N. de. Condições de trabalho na carreira docente: comparação Brasil-França. In: SEMINÁRIO INTERNACIONAL DE LA REDESTRADO, 7., 2008, Buenos Aires. Anais eletrônicos... Buenos Aires: Redestrado, 2008. Disponível em: http://redeestrado.org/?page_id=134. Acesso em: 05 maio 2017.SOUZA, Aparecida Neri de. Relações de trabalho docente: emprego e precarização do trabalho. In: PINO, Ivany Rodrigues; ZAN, Dirce Djanira Pacheco (org.). Plano Nacional da Educação (PNE): questões desafiadoras e desafios emblemáticos. Brasília: Inep, 2013. p. 155-167.TARDIF, Maurice. A profissionalização do ensino passados trinta anos: dois passos para a frente, três para trás. Educação & Sociedade. [s.l.) 34, n. 123, 2013, p. 551-571. Disponível em http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-73302013000200013. Acesso em 05 maio 2017.TARDIF, Maurice; RAYMOND, Danielle. Saberes, tempo e aprendizagem do trabalho no magistério. Educação & Sociedade, Campinas, v. 21, n. 73, p209-244, dez. 2000. Disponível em: http://www.scielo.br/scielo.php?pid=S0101-73302000000400013&script=sci_abstract&tlng=pt>. Acesso em 05 maio 2017.ZARAGOSA. José Manuel Esteve. O mal-estar docente: a sala-de-aula e a saúde dos professores. Bauru: EDUSC, 1999. 175 p.
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Lee, Yoo Jin, Joon Ho Moon, In Hee Lee, Jae-Ho Yoon, Byung-Sik Cho, Jae-Sook Ahn, Hyeoung Joon Kim, et al. "Killer Cell Immunoglobulin-like Receptor Ligand Matching Determines the Post-Transplant High Risk Groups Among Patients with Permissive HLA Mismatch in Unrelated Donor Hematopoietic Cell Transplantation." Blood 128, no. 22 (December 2, 2016): 4566. http://dx.doi.org/10.1182/blood.v128.22.4566.4566.
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Abstract Background: Human leukocyte antigen (HLA) matching between donor and recipient is a key part of successful allogeneic hematopoietic cell transplantation (allo-HCT). The HCT from the unrelated donor (UD) with one allele/antigen mismatch (MM) can be as beneficial as HCT from perfectly matched donor. For the remaining patients, the donors with permissive mismatches may be the option. In HLA-mismatched transplantation, the patient and donor can also be mismatched for their killer cell immunoglobulin-like receptor (KIR) ligands that recognize allotypic determinants shared by certain HLA class I allele groups. Recent research has accumulated evidence of the role of each HLA locus and KIR ligand MM on clinical outcomes for UD-HCT. However, HCT outcomes of the patients with permissive MM depending on KIR ligand MM (KIR-L-MM) status remain obscure in UD-HCT. In the current study, we identified permissive and nonpermissive MM allele combinations and analyzed the effects of these mismatches in combination of KIR ligand mismatches in patients with acute myeloid leukemia (AML). Methods: A total of 438 patients with AML who underwent allo-HCT from UD from 2007 to 2014 were analyzed. Alleles of patients and donors at the HLA-A, -B, -C, and -DRB1 loci were identified by the high resolution DNA typing. Nonpermissive HLA allele combinations were defined as a significant HLA risk factor for severe acute graft-versus-host disease (aGVHD). KIR-L-MM among patient-donor pairs were searched in the Immuno Polymorphism Database available at www.ebi.ac.uk/ipd/kir. Results: Median age of the patients was 45 (range 15-60) years and 117 patients (40.4%) were female. Eighty-five (19.4%) patients were high risk at the time of HCT. Reduced intensity conditioning was performed in 131 patients (29.9%) and anti-thymocyte globulin was used in 324 patients (74.0%). Primary graft source was peripheral blood stem cells (n=369, 84.2%) and median 6.0 x 106/kg cells were infused. Severe aGVDH occurred in 43 patients (9.8%) and chronic GVHD (cGVHD) in 193 (44.1%). With median follow-up duration of 19 (range, 2-96) months, treatment-related mortality (TRM) occurred in 111 patients (25.3%), relapse in 119 (27.2%) and death in 214 (48.9%). Two-hundred sixty-four patients (60.3%) were HLA full matched in the 4 loci. Mismatches in HLA-A loci observed in 64 patients, HLA-B in 35, HLA-C in 98, and HLA-DRB1 in 60. Five nonpermissive MM pairs in 33 patients were identified as donor/patient pair: A*02:06/A*02:01, C*03:03/C*08:01, C*08:01/C03:04, C*08:01/C*15:02, and DRB1*04:03/DRB1*04:05. Among 98 patients with HLA-C loci MM, 16 patients showed KIR ligand MM (KIR-L-MM) as GvH direction, which was observed in the permissive MM group. Severe aGVHD occurred in 30.4%, 22.4%, 13.4%, and 10.8% in nonpermissive, permissive MM and KIR-L-MM, permissive MM and KIR-L-M, and full match group, respectively (p=0.003). The 3-year overall survival (OS) rate was inferior in permissive MM and KIR-L-MM group (30.0%) compared to full match (53.5%), permissive MM and KIR-L-M (51.8%), and nonpermissive (42.4%) group (p=0.067). The 3-year TRM was higher in permissive MM and KIR-L-MM group (57.5%) than full match (21.0%), permissive MM and KIR-L-M (27.7%), and nonpermissive (33.3%) group (p=0.006). In the multivariate analysis, high risk at HCT (HR 2.087, p<0.001), severe aGVHD (HR 3.851, p<0.001), and cGVHD (HR 0.321, p<0.001) were identified as variables affecting the OS. The following variables adversely affected on TRM: permissive MM and KIR-L-MM group (HR 2.699, p=0.007), severe aGVDH (HR 2.204, p=0.001), and cGVHD (HR 2.052, p<0.001). Non-permissive MM (HR 7.487, p=0.001) and CD34+ cells >6x106/kg (HR 4.113, p=0.017) were high risk factors on severe aGVHD. Conclusion: Permissive MM for HLA could be further classified into high risk groups with regard to TRM by KIR-L matching in UD-HCT. The evaluation of KIR-L matching is warranted to reduce unfavorable outcomes among the patients with permissive MM in UD-HCT. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures No relevant conflicts of interest to declare.
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Herskin, M. S., K. H. Jensen, and K. Thodberg. "Influence of environmental stimuli on nursing and suckling behaviour in domestic sows and piglets." Animal Science 68, no. 1 (February 1999): 27–34. http://dx.doi.org/10.1017/s1357729800050049.
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AbstractThe influence of environmental stimuli considered biologically relevant for nest building sows, on nursing and suckling behaviour and piglet growth was investigated. Effects of floor type (beach sand v. concrete) and substrate type (straw feeder v. no straw feeder) were examined in a 2 × 2 factorial experiment with nine replicates of four multiparous sows. The sows were kept individually in roofed 7·6 m2 ‘get-aw ay-pens’ from 1 week pre-partum until 13 to 15 days post-partum. The behaviour of sows and piglets were video recorded for 24 h on days 0, 3, 6 and 12 post-partum.The latency from termination of farrowing until perceptible milk ejection tended to be shorter for experienced sows (parity 4 to 5) kept on sand than on concrete floors (1207 (s.e. 109) min; no. = 7 v. 1725 (s.e. 123) min; no. = 6, respectively; F2,8 = 3·93, P < 0·07) and for experienced sows with access to a straw feeder than without access to a straw feeder (1257 (s.e. 113) min; no. = 8 v. 1666 (s.e. 132) min; no. = 5, respectively; F2,8 = 3·56, P < 0·08). On days 3 and 6 a longer duration of suckling was found for sows on sand v. concrete floors (384 (s.e. 20) v. 327 (s.e. 16) s on day 3; F1,19 = 5·6, P < 0.03 and 377 (s.e. 14) v. 318 (s.e. 13) on day 6; F1,21 = 9·09; P < 0·01, respectively) and with straw feeder v. without straw feeder (385 (s.e. 20) v. 326 (s.e. 18) s on day 3; F1,19 = 5·11, P < 0.04 and 372 (s.e. 14) v. 323 (s.e. 13) on day 6; F1,21 = 6·21; P < 0·03, respectively). On day 3, a tendency for a sand × straw feeder interaction (F11,8 = 3·58, P < 0.08), showed that sows without environmental stimuli terminated more sucklings than sows with access to a straw feeder and sows kept on sand (32 (s.e. 7) %, 16 (s.e. 4) % and 13 (s.e. 5) %, respectively). Similarly, on day 6 a significant sand × straw feeder interaction (F316 = 7·15, P < 0·01) led to increased frequency of foreleg rowing for sows without environmental stimuli compared with the three other treatments (14 (s.e. 2) v. 7 (s.e. 1), 5 (s.e. 1) and 6 (s.e. 1) foreleg rowings per h, respectively). During the stay in the experimental pens, the growth rate of piglets kept on sand tended to be higher than for piglets kept on concrete floors (261 (s.e. 33) v. 240 (s.e. 30) g per piglet per day; F1,25 = 3·38; P < 0·08).The results of the present experiment indicate that provision of biologically relevant stimuli affect the nursing and suckling behaviour of sows and piglets. The reduced termination of sucklings, the reduced frequency of foreleg rowing, the increased duration of suckling as well as the earlier development of suckling behaviour might have been advantageous for the early milk intake of the piglets.
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Ja’afar, Siti Mariam, Hafizuddin Awang, and Azriani Ab Rahman. "Level of Knowledge on Sexual and Reproductive Health Among Youths in Southern Region of Peninsular Malaysia." International Journal of Human and Health Sciences (IJHHS) 5, no. 3 (February 6, 2021): 315. http://dx.doi.org/10.31344/ijhhs.v5i3.281.
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Background: Premarital sexual activity is associated with low level of knowledge of sexual and reproductive health which gives less control over decision making pertaining to sexuality. Low understanding of sexual and reproductive health knowledge made adolescents unaware of the consequences of premarital sexual activity. This study aimed to describe the knowledge of sexual and reproductive health among youths in the state of Johor, in southern region of peninsular Malaysia.Materials and Methods: A crosssectional study was conducted in eleven health facilities in Johor state, Malaysia. The study samples were all youths who fulfilled study inclusion and exclusion criteria. The youths were assessed through a validated self-administered, anonymous questionnaire on sociodemographic background and 21 items of knowledge on sexual and reproductive health. Descriptive statistics were employed to present the findings.Results: There were 204 respondents involved in the study. The mean (±standard deviation) age of respondents was 21 years old (±1.9). Majority of them were female (60.7%) and Malay (89.1%). Most of the respondents had high level of education (secondary and tertiary levels) (98.5%). A small percentage of the respondents were smokers (18.6%), alcohol drinkers (7.5%), drug users (3.5%), and a smaller portion reported of having history of sexually molested (4%). This study found sexual exposure among subjects ranged from reading (35.3%) and watching pornographic materials (44%), imagining sex (18.2%), as well as masturbating (21.1%). As for level of knowledge on sexual and reproductive health, majority of our respondents had low level of knowledge on the domain of sexual activity and pregnancy, complication of premarital sexual activity, and contraception.Conclusion: As the involvement of youths in sexual activity is getting more prevalent, youth sexual and reproductive health should be prioritized in Malaysia. Public health campaigns need to focus on the positive aspects of healthy sexual relationships. The importance of ensuring easy access to sexual and reproductive health services for all youths needs to be acknowledged and addressed.International Journal of Human and Health Sciences Vol. 05 No. 03 July’21 Page: 315-323
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Bell, David R., J. Troy Blackburn, Anthony C. Hackney, Stephen W. Marshall, Anthony I. Beutler, and Darin A. Padua. "Jump-Landing Biomechanics and Knee-Laxity Change Across the Menstrual Cycle in Women With Anterior Cruciate Ligament Reconstruction." Journal of Athletic Training 49, no. 2 (March 1, 2014): 154–62. http://dx.doi.org/10.4085/1062-6050-49.2.01.
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Context: Of the individuals able to return to sport participation after an anterior cruciate ligament(ACL) injury, up to 25% will experience a second ACL injury. This population may be more sensitive to hormonal fluctuations, which may explain this high rate of second injury. Objective: To examine changes in 3-dimensional hip and knee kinematics and kinetics during a jump landing and to examine knee laxity across the menstrual cycle in women with histories of unilateral noncontact ACL injury. Design Controlled laboratory study. Setting: Laboratory. Patients or Other Participants: A total of 20 women (age = 19.6 ± 1.3 years, height = 168.6 ± 5.3 cm, mass = 66.2 ± 9.1 kg) with unilateral, noncontact ACL injuries. Intervention(s) Participants completed a jump-landing task and knee-laxity assessment 3 to 5 days after the onset of menses and within 3 days of a positive ovulation test. Main Outcome Measure(s): Kinematics in the uninjured limb at initial contact with the ground during a jump landing, peak kinematics and kinetics during the loading phase of landing, anterior knee laxity via the KT-1000, peak vertical ground reaction force, and blood hormone concentrations (estradiol-β-17, progesterone, free testosterone). Results: At ovulation, estradiol-β-17 (t = −2.9, P = .009), progesterone (t = −3.4, P = .003), and anterior knee laxity (t = −2.3, P = .03) increased, and participants presented with greater knee-valgus moment (Z = −2.6, P = .01) and femoral internal rotation (t = −2.1, P = .047). However, during the menses test session, participants landed harder (greater peak vertical ground reaction force; t = 2.2, P = .04), with the tibia internally rotated at initial contact (t = 2.8, P = .01) and greater hip internal-rotation moment (Z = −2.4, P = .02). No other changes were observed across the menstrual cycle. Conclusions Knee and hip mechanics in both phases of the menstrual cycle represented a greater potential risk of ACL loading. Observed changes in landing mechanics may explain why the risk of second ACL injury is elevated in this population.
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Wolfson, Julia A., Aviva A. Musicus, Cindy W. Leung, Ashley N. Gearhardt, and Jennifer Falbe. "Effect of Climate Change Impact Menu Labels on Fast Food Ordering Choices Among US Adults." JAMA Network Open 5, no. 12 (December 27, 2022): e2248320. http://dx.doi.org/10.1001/jamanetworkopen.2022.48320.
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ImportanceThere is increasing interest in strategies to encourage more environmentally sustainable food choices in US restaurants through the use of menu labels that indicate an item’s potential impact on the world’s climate. Data are lacking on the ideal design of such labels to effectively encourage sustainable choices.ObjectiveTo test the effects of positive and negative climate impact menu labels on the environmental sustainability and healthfulness of food choices compared with a control label.Design, Setting, and ParticipantsThis randomized clinical trial used an online national US survey conducted March 30 to April 13, 2022, among a nationally representative sample of adults (aged ≥18 years) from the AmeriSpeak panel. Data were analyzed in June to October 2022.InterventionsParticipants were shown a fast food menu and prompted to select 1 item they would like to order for dinner. Participants were randomized to view menus with 1 of 3 label conditions: a quick response code label on all items (control group); green low–climate impact label on chicken, fish, or vegetarian items (positive framing); or red high–climate impact label on red meat items (negative framing).Main Outcomes and MeasuresThe main outcome was an indicator of selecting a sustainable item (ie, one without red meat). Secondary outcomes included participant health perceptions of the selected item and the Nutrition Profile Index (NPI) score of healthfulness.ResultsAmong 5049 participants (2444 female [51.6%]; 789 aged 18-29 years [20.3%], 1532 aged 30-44 years [25.9%], 1089 aged 45-59 years [23.5%], and 1639 aged ≥60 years [30.4%]; 142 Asian [5.3%], 611 Black [12.1%], and 3197 White [63.3%]; 866 Hispanic [17.2%]), high– and low–climate impact labels were effective at encouraging sustainable selections from the menu. Compared with participants in the control group, 23.5% more participants (95% CI, 13.7%-34.0%; P &lt; .001) selected a sustainable menu item when menus displayed high–climate impact labels and 9.9% more participants (95% CI, 1.0%-19.8%; P = .03) selected a sustainable menu item when menus displayed low–climate impact labels. Across experimental conditions, participants who selected a sustainable item rated their order as healthier than those who selected an unsustainable item, according to mean perceived healthfulness score (control label: 3.4 points; 95% CI, 3.2-3.5 points vs 2.5 points; 95% CI, 2.4-2.6 points; P &lt; .001; low-impact label: 3.7 points; 95% CI, 3.5-3.8 points vs 2.6 points; 95% CI, 2.5-2.7 points; P &lt; .001; high-impact label: 3.5 points; 95% CI, 3.3-3.6 points vs 2.7 points; 95% CI, 2.6-2.9 points; P &lt; .001). Participants in the high–climate impact label group selected healthier items according to mean (SE) NPI score (54.3 [0.2] points) compared with those in the low–climate impact (53.2 [0.2] points; P &lt; .001) and control (52.9 [0.3] points; P &lt; .001) label groups.Conclusions and RelevanceThis randomized clinical trial’s findings suggest that climate impact menu labels, especially negatively framed labels highlighting high–climate impact items (ie, red meat), were an effective strategy to reduce red meat selections and encourage more sustainable choices.Trial RegistrationClinicalTrials.gov Identifier: NCT05482204
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Brunelle, Cheryl L., Amanda W. Jung, Louisa H. Smith, Kayla Daniell, Maria S. Asdourian, Loryn K. Bucci, Brooke Juhel, Elizabeth K. Hausman, George E. Naoum, and Alphonse G. Taghian. "Abstract P6-03-04: Ipsilateral infusions are not associated with increased risk of breast cancer-related lymphedema in patients enrolled in a prospective screening program." Cancer Research 83, no. 5_Supplement (March 1, 2023): P6–03–04—P6–03–04. http://dx.doi.org/10.1158/1538-7445.sabcs22-p6-03-04.
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Abstract BACKGROUND: Patients treated for breast cancer (BC) who are at risk of breast cancer-related lymphedema (BCRL) have been instructed for decades to avoid venipuncture, injections and infusions in the extremity ipsilateral to BC treatment. These instructions are given in theory to prevent BCRL development, despite lack of supporting data. Given fear of BCRL is high amongst the population at risk, it has been found that patients heed this advice regardless of level of BCRL risk. It has been previously found that there is no association between blood draws or injections in the ipsilateral arm and increases in arm volume in patients treated for BC and screened for BCRL. Despite these findings, risk of BCRL associated with the most invasive of BC treatments, infusions in the ipsilateral arm, has not been examined. As patients with BC require ongoing invasive medical procedures, data would inform patient care and drive clinical practice guidelines during and after BC treatment. PURPOSE: The purpose of this study was to determine whether patients treated for breast cancer who receive one or more infusions in the arm ipsilateral to BC treatment are at higher risk of BCRL than those who do not receive ipsilateral infusions. METHODS: From 2005 to 2021, 2049 patients treated for BC were enrolled in a prospective BCRL screening trial and screened from preoperative baseline through last follow-up. Screening included objective arm volume measurements via perometry; relative volume change (RVC) increase ≥10% from preoperative baseline >3 months postoperatively was used to define BCRL. Infusions data were collected directly from the electronic medical record and all postoperative infusions were included in data analysis. Patients were censored at cancer recurrence. Infusions data included route, laterality, date and substance infused. Demographic and clinical information were obtained through medical record review. Marginal structural models were used to estimate the hazard of BCRL attributable to any (vs. no) ipsilateral infusion. Time-varying inverse-probability weights were used to account for time-varying confounding by RVC and earlier adjuvant infusions, and adjusted for baseline confounding by baseline BMI, axillary lymph node dissection (ALND), regional lymph node radiation (RLNR), neoadjuvant chemotherapy, and number of neoadjuvant ipsilateral infusions. RESULTS: The eligible cohort included 2018 patients. 240 patients received at least one ipsilateral infusion; 651 did not receive ipsilateral infusions; 1,127 did not receive infusions. Patients who received ipsilateral infusions received a median of 2 (interquartile range (IQR) 1, 3) ipsilateral and 8 (IQR 4, 15) total infusions. 681 (34%) patients received adjuvant chemotherapy infusions; the most frequent adjuvant regimens received included ACT (314 patients, 16%); TC (162 patients; 8.0%); and ACTH (±P) (47 patients, 2.3%). Of those who received any ipsilateral infusions, 77% had chemotherapy drugs infused, compared to 84% of participants who did not have ipsilateral infusions. Fluids, antacids, and antihistamines were the most common non-chemotherapy infusions. Patients underwent BCRL screening over a median of 5 visits (IQR 3,8) with a median follow-up of 56 months (IQR 31, 90 months). There was no significant difference in BCRL risk between patients who received at least one ipsilateral infusion and those who did not receive ipsilateral infusions (HR, 0.85; p=0.60). CONCLUSIONS: Infusions in the at-risk arm were not associated with increased risk of BCRL in this cohort of 2018 patients at risk of and prospectively screened for BCRL. Citation Format: Cheryl L. Brunelle, Amanda W. Jung, Louisa H. Smith, Kayla Daniell, Maria S. Asdourian, Loryn K. Bucci, Brooke Juhel, Elizabeth K. Hausman, George E. Naoum, Alphonse G. Taghian. Ipsilateral infusions are not associated with increased risk of breast cancer-related lymphedema in patients enrolled in a prospective screening program. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-03-04.
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Hubbard-Turner, Tricia. "Lack of Medical Treatment From a Medical Professional After an Ankle Sprain." Journal of Athletic Training 54, no. 6 (May 22, 2019): 671–75. http://dx.doi.org/10.4085/1062-6050-428-17.
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Context Despite the prevalence of ankle sprains and the potential for developing chronic ankle instability and ankle osteoarthritis, ankle sprains are often perceived as an innocuous injury. Objective To understand the initial management and treatment sought by patients after a lateral ankle sprain (LAS) and to identify any differences in subjective function and self-reported injury. Design Cross-sectional study. Setting Research laboratory. Patients or Other Participants A total of 175 participants with chronic ankle instability (73 men, 102 women; age = 20.9 ± 3.4 years, height = 173.5 ± 13.2 cm, mass = 81.4 ± 24.6 kg) were involved in the study. Main Outcome Measure(s) Participants were administered a questionnaire regarding their initial LAS. All participants also completed the Foot and Ankle Ability Measure (FAAM). The primary questions of interest were (1) Did the participants seek treatment from a medical professional for their initial LAS? (2) Did the participants perform rehabilitation? (3) Was the initial LAS immobilized? and (4) Did the participants use crutches? The other variables measured were scores on the FAAM and the FAAM Sports subscale, total number of ankle sprains, and incidents of giving way. Results Sixty-four percent of participants did not seek medical treatment after their LAS. Those who did not seek medical treatment scored worse on the FAAM (81.21% ± 3.1% versus 89.23% ± 2.8%, P = .03) and the FAAM Sports subscale (72.34% ± 5.3% versus 81.26% ± 3.1%, P = .001). Those not seeking treatment also reported more ankle sprains since the initial injury (4.7 ± 2.4 versus 1.9 ± 0.90, P = .02) and more incidents of giving way each month (3.8 ± 1.9 versus 1.1 ± 0.87, P = .04). Conclusions It is not surprising that those who did not seek medical treatment for their LASs had worse subjective function, more ankle sprains, and more incidents of the ankle giving way. The public needs to be educated on the significance of ankle sprains and the need for medical attention to provide appropriate management. However, we also need to continue to evaluate initial management and rehabilitation to ensure that those who seek treatment receive the best care in order to reduce reinjury rates.
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Macpherson, Alison K., and Michael J. Schull. "Penetrating trauma in Ontario emergency departments: a population-based study." CJEM 9, no. 01 (January 2007): 16–20. http://dx.doi.org/10.1017/s1481803500014688.
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ABSTRACT Background: There is a paucity of population-based research on health service utilization related to penetrating trauma in Canada, even though such trauma can result in serious injury or death, and gunshot wounds have been labelled the “the new public health issue.” Complete epidemiologic data, including emergency department (ED) visits and hospitalizations, for penetrating trauma is not available. The objective of this paper is to describe the epidemiology of ED visits for firearm-related and knife-related penetrating trauma in one Canadian province. Methods: All EDs in the province of Ontario (pop. approx. 12 400 000 at the time of the study) submit data on ED visits to the National Ambulatory Care Reporting System. This database includes patients' demographic information (i.e., age, sex and geographic area of residence), the reason for the visit, disposition (i.e., admitted to hospital or sent home), and other diagnostic information. For visits related to injuries, the cause of injury is also reported (e-codes according to the Canadian Enhancement to the International Statistical Classification of Diseases and Related Health Problems, 10th rev [ICD-10-CA]). All patients seen in Ontario EDs for an injury related to a firearm, knife, or sharp object, were included in our study. Results: Of the 1.2 million ED visits in 2002-03 for trauma in Ontario, 40 240 (3.4%) patients were treated for injuries relating to penetrating trauma. Most patients were male, and most were 15–24 years of age. Penetrating trauma was frequently a result of knives or sharp objects (39 654 visits or 98.5%); only 1.5% (n = 586) of these injuries were caused by firearms. Of those hospitalized, 151 were related to firearms and 1455 were related to knives/ sharp objects. Conclusions: Analyzing administrative data provides an estimate of the impact of penetrating trauma on a population, thereby providing prevention programs with data upon which to design their strategies. Evidence-based prevention strategies are needed to reduce the burden of penetrating trauma. Monitoring ED and hospitalization data over time will help to assess trends and provide evidence for the effectiveness of such strategies.
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Benavides-Villanueva, F., V. Calvo-Río, J. Loricera, J. Irure-Ventura, M. Lopez-Hoyos, and R. Blanco. "POS0131 RELATION BETWEEN COVID-19 AND ANCA VASCULITIS. STUDY IN A SINGLE UNIVERSITY HOSPITAL." Annals of the Rheumatic Diseases 82, Suppl 1 (May 30, 2023): 284. http://dx.doi.org/10.1136/annrheumdis-2023-eular.3234.
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BackgroundAnti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV) is a small vessel vasculitis. Hallmarked by the presence of antibodies against antigens in cytoplasmic granules of neutrophils. Different microbiological agents and vaccines can trigger an AAV, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection and Coronavirus disease 2019 (COVID-19) vaccine.ObjectivesTo compare:a) proportion of positive ANCA (+ANCA) test in 2019 (COVID-19 pre-pandemic) vs 2021 (COVID-19 pandemic),b) clinical features andc) vasculitis activity between vasculitis related to COVID 19 vaccination vs non-related.MethodsAll ANCA tests performed in 2019 and 2021 in a referral hospital were reviewed. Additionally, we studied 18 +ANCA patients diagnosed in 2021 and accepted to participate in present study. The patients were divided in two groups:a) +ANCA after SARS-CoV-2 mRNA vaccine(COVID-related) and +ANCA before COVID-19 vaccine(COVID-nonrelated). Diagnosis of underlying AAV was based on ACR/EULAR 2022 criteria. Disease activity was assessed with Birmingham Vasculitis Activity Score (BVAS). ANCA testing was done by chemiluminescence assay using IO-FLASH (Inova, San Diego, CA) according to the instructions of the manufacturer.ResultsANCA tests were positive in 14 of 1287 cases (1.1%) and in 32 of 1434 (2.2%) cases in 2019 and 2021, respectively (figure 1, the differences were statistically significant (p=0.020). The main features of 18 ANCA+ patients diagnosed in 2021 are summarized in table 1. COVID-19 related patients showed a median of 7 points on BVAS score compared of the median of 5 points on BVAS score on not related patients.ConclusionThere seems to be an increase of +ANCA at the expense of anti-PR3 antibodies following the COVID-19 vaccine. In patients with +ANCA following vaccination there seems to be an increased disease activity according to BVAS score without reaching statistical significance.References[1]Damoiseaux, J., et al Autoimmunity Reviews.2021. PMID 34896650.[2]Irure-Ventura, et al. IScience.2022. PMID 35937087.Table 1.Main general features of 18 patients with ANCA+ test diagnosed in 2021.FEATURESAll cases n= 18Related n= 13Non-related n= 5p*Age (years), mean±SD62±1767±15.352±16.50.167Male/ Female n, (% male)10/8 (55.6)9/4 (69.2%)1/4(20)0.067ANCA-test specificity, n (%)MPO-ANCA9 (50)7 (53.8)2(40)0.609PR3-ANCA8 (44.4)5 (38.5)3(60)0.423Both1 (5.6)1 (7.7)0-CRP (mg/dL), median [IQR]2,4 [0.4-10.7]3.8 [0.4-10.1]1 [0.4-10.9]0.802ESR, mm/1st hours, median [IQR]50 [25-104]47 [25.3-71.8]50 [25-120]0.634BVAS, median [IQR]6.5 [4.2-8]7 [4-8]5 [5-8]0.842FFS, n (%)03 (16.7)2 (15.4)1 (20)0.819≥115 (83.3)11 (84.6)4 (80)0.819ENT involvement, n (%)12(66.7)10 (76.9)2 (40)0.148MSK involvement, n (%)11(61.1)7(53.8)4 (80)0.322CNS/PNS involvement, n (%)10 (55.6)7 (53.8)3 (60)0.819Lung involvement, n (%)9 (50)6 (46.2)3 (60)0.609Kidney involvement, n (%)8 (44.4)7 (53.8)1 (40)0.208Ocular involvement, n (%)2 (11.1)2 (15.4)00.366Cutaneous involvement, n (%)2 (11.1)02 (40)0.019*p values according to Man Whitney test.Abbreviations(in alphabetical order):AAV: anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis; ACR: American college of Rheumatology; ANCA: Antineutrophil cytoplasmic antibody; BVAS: Birmingham Vasculitis Activity Score; CNS: central nervous system; CRP: C-Reactive protein; dL: deciliter; ENT: ear, nose, throat; ESR: erythrocyte sedimentation rate; FFS: Five-Factors Score; g; IQR: Interquartile range; mg: milligram; MSK: musculoskeletal; MPO-ANCA= ANCA specific for myeloperoxidase; n=Number; PNS: peripheral nervous system; PR3-ANCA= ANCA specific for proteinase 3; SD: Standard DeviationFigure 1.Comparison of ANCA test in 2019 and 2021.Acknowledgements:NIL.Disclosure of InterestsFabricio Benavides-Villanueva: None declared, Vanesa Calvo-Río Speakers bureau: Dra V. Calvo had participation in company-sponsored speaker´s bureau from Roche, Novartis, Galápagos, UCB Pharma, MSD, Celgene, and Grünenthal and received support for attending meetings and/or travel from Janssen, Abbvie, Roche, Novartis, MSD, UCB Pharma, Celgene, Lilly, Pfizer, Galápagos., J. Loricera Speakers bureau: Dr. J. Loricera had participation in company-sponsored speaker´s bureau from Roche, Novartis, Galápagos, UCB Pharma, MSD, Celgene, and Grünenthal., Consultant of: Dr. J. Loricera had consultation fees in company-sponsored speaker´s bureau from Roche, Novartis, Galápagos, UCB Pharma, MSD, Celgene, and Grünenthal and received support for attending meetings and/or travel from Janssen, Abbvie, Roche, Novartis, MSD, UCB Pharma, Celgene, Lilly, Pfizer, Galápagos., Juan Irure-Ventura: None declared, Marcos Lopez-Hoyos: None declared, Ricardo Blanco Speakers bureau: Dr. R. Blanco had participation in company sponsored speaker´s bureau from Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD., Consultant of: Dr. R. Blanco had consultation from Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD., Grant/research support from: Dr. R. Blanco received grants/research supports from Abbvie, MSD and Roche.
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Urbano-Ispizua, Alvaro, Salut Brunet, Mariano Monzo, Granada Perea, Alfons Navarro, Jordi Esteve, Juan Berlanga, et al. "Germline Polymorphisms Provide Strong Prognostic Information in Intermediate Risk Acute Myeloblastic Leukemia (AML)." Blood 104, no. 11 (November 16, 2004): 398. http://dx.doi.org/10.1182/blood.v104.11.398.398.
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Abstract In this study we tested whether distinct patterns of functional genomic polymorphisms in genes involved in drug metabolic pathways (GSTT1, SULT1C2, CD-EX, TOP2A, SXR-1, SXR-2), DNA repair (XPD, XPA, XPG, ERCC1), angiogenesis (VEGF-1, VEGF-2), and multidrug resistance (MDR1-1, MDR1-2) predict clinical outcome in patients with AML. Two hundred adult patients ≤60 year-old with primary AML (M3 excluded), enrolled in the AML-99 protocol of the CETLAM group between November-98 and July-03, have been studied. Induction therapy consisted of idarubicin, intermediate dose ara-C (IDAC) and VP16. Intensification included mitoxantrone and IDAC. Patients were following treated with high-dose ara-C or transplantation depending on the risk category. According to the MRC cytogenetic classification, 32 patients had a favourable karyotype, 23 had abnormalities indicating poor prognosis, and 110 patients were included in the intermediate prognosis (IP) group. We focused on IP group patients with the aim of improving its prognostic stratification. The characteristics considered were: age (<50 years vs ≥50), WBC (≤20x109/l vs >20x109/l), FAB classification, MLL rearrangement, internal tandem duplication of FLT3 (ITD-FLT3), induction courses to achieve complete remission (CR) (1 vs 2), and germline polymorphisms of the above-mentioned genes. Prognostic variables in the univariate analysis (Kaplan-Meier method) with a p value ≤0.2 (log-rank test) were included for the multivariate analysis (proportional hazard method). Of the 110 patients included in the IP group, 86 (78%) achieved a CR, 11 (10%) were chemoresistant and 13 (12%) died during induction. After a median follow-up of alive patients of 24 months (range 5–64), overall survival was of 31% at 5 years. In the multivariate analysis, adverse prognostic variables for survival were polymorphism of XPA (RR=3.4; p=0.02) and of MDR1-1 (RR=2.1; p=0.02), and WBC >20x109/l (RR=2.1; p=0.02). Increased risk of relapse was associated with polymorphism of SULT1C2 (RR 4.1; p=0.004), ITD-FLT3 (RR 3.3; p=0.003), VEGF2 (RR 2.8; p=0.04) and MDR1-1 (RR 2.4; p=0.02). Finally, in the multivariate analysis for refractoriness to chemotherapy, XPA polymorphism was the only independent factor increasing the risk (RR=14; p=0.02). In conclusion, germline polymorphisms, which can easily be analyzed from DNA of peripheral blood, have independent prognostic value in intermediate risk AML.
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Aljehani, Mayada A., Jeffrey Bien, Jerry S. H. Lee, George A. Fisher, and Albert Y. Lin. "KRAS Sequence Variation as Prognostic Marker in Patients With Young- vs Late-Onset Colorectal Cancer." JAMA Network Open 6, no. 11 (November 30, 2023): e2345801. http://dx.doi.org/10.1001/jamanetworkopen.2023.45801.
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ImportanceThe understanding of the association between KRAS sequence variation status and clinical outcomes in colorectal cancer (CRC) has evolved over time.ObjectiveTo characterize the association of age at onset, tumor sidedness, and KRAS sequence variation with survival among patients diagnosed with CRC.Design, Setting, and ParticipantsThis cross-sectional study used data extracted from the Surveillance, Epidemiology, and End Results database. Patients diagnosed with adenocarcinoma of the colon or rectum from 2010 through 2015 were included and were classified as having young-onset (YO) cancer if diagnosed between ages 20 to 49 years and late-onset (LO) cancer if diagnosed at age 50 years or older. Data were analyzed from April 2021 through August 2023.Main Outcomes and MeasuresCRC cause-specific survival (CSS) was summarized using Fine and Gray cumulative incidence and Kaplan-Meier curves. Estimation of subdistribution hazard ratios (sHRs) for the association of KRAS status, age at onset, and tumor location with CRC CSS was conducted using the Fine and Gray competing risk model. Cox proportional hazards regression was used to estimate and compare HRs.ResultsAmong 21 661 patients with KRAS sequence variation status (mean [SD] age at diagnosis, 62.50 [13.78] years; 9784 females [45.2%]), 3842 patients had YO CRC, including 1546 patients with KRAS variants, and 17 819 patients had LO CRC, including 7311 patients with KRAS variants. There was a significant difference in median CSS time between patients with variant vs wild-type KRAS (YO: 3.0 years [95% CI, 2.8-3.3 years] vs 3.5 years [95% CI, 3.3-3.9 years]; P = .02; LO: 2.5 years [95% CI, 2.4-2.7 years] vs 3.4 years [95% CI, 3.3-3.6 years]; P &lt; .001). Tumors with variant compared with wild-type KRAS were associated with higher risk of CRC-related death (YO: sHR, 1.09 [95% CI, 1.01-1.18]; P = .03; LO: sHR, 1.06 [95% CI, 1.02-1.09]; P = .002). Among patients with YO cancer, mortality hazards increased by location, from right (sHR, 1.02 [95% CI, 0.88-1.17) to left (sHR, 1.15 [95% CI, 1.02-1.29) and rectum (sHR, 1.16 [95% CI, 0.99-1.36), but no trend by tumor location was seen for LO cancer.Conclusions and RelevanceIn this study of patients diagnosed with CRC, KRAS sequence variation was associated with increased mortality among patients with YO and LO tumors. In YO cancer, variant KRAS–associated mortality risk was higher in distal tumors than proximal tumors.
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García, Consuelo González, Ma Sol Durán, Jose Ramón Mayans, Javier De La Rubia, Alfons Soler, Inmaculada Castillo, Paz Ribas, et al. "Epidemiological Study of Mutiple Myeloma In Spain: Efectiveness and Survival Analysis." Blood 116, no. 21 (November 19, 2010): 5044. http://dx.doi.org/10.1182/blood.v116.21.5044.5044.
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Abstract Abstract 5044 Introduction: Epidemiological studies are the base to evaluate the efficiency of medical interventions in the interest of the public health. Updated epidemiological data and effectivenes in the daily clinical practice are needed in Multiple Myeloma (MM). Materials and Methods: Epidemiological retrospective, longitudinal, multicenter nation wide Spanish study of an historical cohort of patients with MM. Data from patients aged ≥ 18 years, with a MM Stage II or III, who received a treatment on a daily clinical practice (not in clinical trials) for MM in the September'03-August'05 time frame were collected. The study protocol was approved by an Ethics Committee in 2009. Data were collected in 37 Spanish Centres during a 6 months period. Stratified effectiveness and survival analysis were performed (age <65, ≥65; gender; ECOG 0–1 vs 2–3; stage; heavy chain IgA vs IgG; light chain kappa vs lambda, bone lesions or not, plasmacytoma or not, Hb level <10 vs ≥ 10 gr/dL, LDH <130 vs ≥130 U/L, beta2 microglobuline <3.5 vs >3.5, calcium <11 vs ≥ 11 mg/dL, creatinine <1.5 vs ≥ 1.5 mg/dL, plasma cells <10 vs >10%, myelomatous cells <10 vs >10%, induction treatment, dose delayed, full dose). Results: Data from 338 patients' files who fulfill all the study selection criteria were reviewed. Median age at diagnosed was 66 years. A 45% were aged less than 65 years, 34% 65–74 years and 21% ≥ 75. Male/female ratio: 50/50. ECOG performance status were available in 314 patients (93%) in whom the score was 0/1/2/3/4 in a proportion (%) of 25/25/25/20/5 respectively. Secretor MM was present in 95% of the patients. Bone lesions were present in 244 patients (73%). Plasmacytoma was evidenced in 51 (15%). Half of the patients were transplant candidates and it was performed in 128 (38%). Overall response rate were statistically different when using VBAD/VBMCP vs VAD and MP as induction regimens (86% vs 62% vs 50%, p=0,002). It must be noted that most novel treatments were not widely used by the time of the study. Median survival was 56.1 months. Survival rate at 3 years was 60.8%. Variables statistical significant at the discriminant analysis are showed at table 1. A stepwise Cox Model determine Hb level <10 g/dL, LDH <500 and transplant are prognostic factors for survival (table 2). Toxicity was manageable and no differences with those data already published were reported. Conclusion: These epidemiological data suggest the effectivemens of the treatment depends on its individualization based on patients' characteristics and in treatment adherence. LDH is a survival prognostic parameter in MM. No new safety issues appears, despite those already published. Disclosures: De La Rubia: Celgene: Research Funding. Castillo:Celgene: Research Funding. López:Celgene: Employment. Ramirez:Celgene: Research Funding.
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Opoku Asare, Kennedy, Yannik Terhorst, Julio Vega, Ella Peltonen, Eemil Lagerspetz, and Denzil Ferreira. "Predicting Depression From Smartphone Behavioral Markers Using Machine Learning Methods, Hyperparameter Optimization, and Feature Importance Analysis: Exploratory Study." JMIR mHealth and uHealth 9, no. 7 (July 12, 2021): e26540. http://dx.doi.org/10.2196/26540.
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Background Depression is a prevalent mental health challenge. Current depression assessment methods using self-reported and clinician-administered questionnaires have limitations. Instrumenting smartphones to passively and continuously collect moment-by-moment data sets to quantify human behaviors has the potential to augment current depression assessment methods for early diagnosis, scalable, and longitudinal monitoring of depression. Objective The objective of this study was to investigate the feasibility of predicting depression with human behaviors quantified from smartphone data sets, and to identify behaviors that can influence depression. Methods Smartphone data sets and self-reported 8-item Patient Health Questionnaire (PHQ-8) depression assessments were collected from 629 participants in an exploratory longitudinal study over an average of 22.1 days (SD 17.90; range 8-86). We quantified 22 regularity, entropy, and SD behavioral markers from the smartphone data. We explored the relationship between the behavioral features and depression using correlation and bivariate linear mixed models (LMMs). We leveraged 5 supervised machine learning (ML) algorithms with hyperparameter optimization, nested cross-validation, and imbalanced data handling to predict depression. Finally, with the permutation importance method, we identified influential behavioral markers in predicting depression. Results Of the 629 participants from at least 56 countries, 69 (10.97%) were females, 546 (86.8%) were males, and 14 (2.2%) were nonbinary. Participants’ age distribution is as follows: 73/629 (11.6%) were aged between 18 and 24, 204/629 (32.4%) were aged between 25 and 34, 156/629 (24.8%) were aged between 35 and 44, 166/629 (26.4%) were aged between 45 and 64, and 30/629 (4.8%) were aged 65 years and over. Of the 1374 PHQ-8 assessments, 1143 (83.19%) responses were nondepressed scores (PHQ-8 score <10), while 231 (16.81%) were depressed scores (PHQ-8 score ≥10), as identified based on PHQ-8 cut-off. A significant positive Pearson correlation was found between screen status–normalized entropy and depression (r=0.14, P<.001). LMM demonstrates an intraclass correlation of 0.7584 and a significant positive association between screen status–normalized entropy and depression (β=.48, P=.03). The best ML algorithms achieved the following metrics: precision, 85.55%-92.51%; recall, 92.19%-95.56%; F1, 88.73%-94.00%; area under the curve receiver operating characteristic, 94.69%-99.06%; Cohen κ, 86.61%-92.90%; and accuracy, 96.44%-98.14%. Including age group and gender as predictors improved the ML performances. Screen and internet connectivity features were the most influential in predicting depression. Conclusions Our findings demonstrate that behavioral markers indicative of depression can be unobtrusively identified from smartphone sensors’ data. Traditional assessment of depression can be augmented with behavioral markers from smartphones for depression diagnosis and monitoring.
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Thomas, Abbey C., Mark Villwock, Edward M. Wojtys, and Riann M. Palmieri-Smith. "Lower Extremity Muscle Strength After Anterior Cruciate Ligament Injury and Reconstruction." Journal of Athletic Training 48, no. 5 (October 1, 2013): 610–20. http://dx.doi.org/10.4085/1062-6050-48.3.23.
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Context: Quadriceps and hamstrings weakness occurs frequently after anterior cruciate ligament (ACL) injury and reconstruction. Evidence suggests that knee injury may precipitate hip and ankle muscle weakness, but few data support this contention after ACL injury and reconstruction. Objective: To determine if hip, knee, and ankle muscle weakness present after ACL injury and after rehabilitation for ACL reconstruction. Design: Case-control study. Setting: University research laboratory. Patients or Other Participants: Fifteen individuals with ACL injury (8 males, 7 females; age = 20.27 ± 5.38 years, height = 1.75 ± 0.10 m, mass = 74.39 ± 13.26 kg) and 15 control individuals (7 men, 8 women; age = 24.73 ± 3.37 years, height = 1.75 ± 0.09 m, mass = 73.25 ± 13.48 kg). Intervention(s): Bilateral concentric strength was assessed at 60°/s on an isokinetic dynamometer. The participants with ACL injury were tested preoperatively and 6 months postoperatively. Control participants were tested on 1 occasion. Main Outcome Measures: Hip-flexor, -extensor, -abductor, and -adductor; knee-extensor and -flexor; and ankle–plantar-flexor and -dorsiflexor strength (Nm/kg). Results: The ACL-injured participants demonstrated greater hip-extensor (percentage difference = 19.7, F1,14 = 7.28, P = .02) and -adductor (percentage difference = 16.3, F1,14 = 6.15, P = .03) weakness preoperatively than postoperatively, regardless of limb, and greater postoperative hip-adductor strength (percentage difference = 29.0, F1,28 = 10.66, P = .003) than control participants. Knee-extensor and -flexor strength were lower in the injured than in the uninjured limb preoperatively and postoperatively (extensor percentage difference = 34.6 preoperatively and 32.6 postoperatively, t14 range = −4.59 to −4.23, P ≤ .001; flexor percentage difference = 30.6 preoperatively and 10.6 postoperatively, t14 range = −6.05 to −3.24, P < .05) with greater knee-flexor (percentage difference = 25.3, t14 = −4.65, P < .001) weakness preoperatively in the injured limb of ACL-injured participants. The ACL-injured participants had less injured limb knee-extensor (percentage difference = 32.0, t28 = −2.84, P = .008) and -flexor (percentage difference = 24.0, t28 = −2.44, P = .02) strength preoperatively but not postoperatively (extensor: t28 = −1.79, P = .08; flexor: t28 = 0.57, P = .58) than control participants. Ankle–plantar-flexor weakness was greater preoperatively than postoperatively in the ACL-injured limb (percentage difference = 31.9, t14 = −3.20, P = .006). Conclusions: The ACL-injured participants presented with hip-extensor, -adductor, and ankle–plantar-flexor weakness that appeared to be countered during postoperative rehabilitation. Our results confirmed previous findings suggesting greater knee-extensor and -flexor weakness postoperatively in the injured limb than the uninjured limb. The knee extensors and flexors are important dynamic stabilizers; weakness in these muscles could impair knee joint stability. Improving rehabilitation strategies to better target this lingering weakness seems imperative.
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Becker, Heiko, Guido Marcucci, Kati Maharry, Michael D. Radmacher, Krzysztof Mrózek, Susan P. Whitman, Peter Paschka, et al. "Comparison of Clinical and Biologic Significance of WT1 Mutations in Populations of Older (≥60 years[y]) and Younger (<60 y) Adult Patients (Pts) with Cytogenetically Normal (CN) De Novo Acute Myeloid Leukemia (AML): a Cancer and Leukemia Group B (CALGB) Study." Blood 114, no. 22 (November 20, 2009): 326. http://dx.doi.org/10.1182/blood.v114.22.326.326.
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Abstract Abstract 326 Mutations of the Wilms tumor (WT1) gene are found in ∼10% of younger (<60 years[y]) adult pts with de novo CN-AML and impact adversely on their outcome. The clinical significance of WT1 mutations has not yet been evaluated in older (≥60 y) CN-AML pts. Therefore, we analyzed frequency and clinical impact of WT1 mutations in the context of other molecular markers in a relatively large cohort of 243 pts ≥60 y (range, 60-83 y) with de novo CN-AML treated intensively on upfront cytarabine/daunorubicin-based CALGB protocols. Included pts were those with material available for analysis of WT1 mutation status and that of a panel of other validated molecular prognosticators including NPM1, FLT3 (ie, FLT3-ITD, FLT3-TKD) and CEBPA mutations, BAALC and ERG expression levels. Mutations in WT1 “hot spots” (exons 7 and 9) were assessed by DHPLC and sequencing. The results were compared with the findings in younger (18-59 y) CALGB pts (n=207) characterized molecularly in a similar fashion. Gene expression profiles in both populations were assessed centrally using Affymetrix U133 plus 2.0 microchip. Among the 243 older pts, 16 (7%) had WT1 mutations. Of those, 14 had single WT1 mutations in exon 7 [frameshift (n=8), nonsense (n=1), and missense (n=1)] or in exon 9 [missense (n=4)]; 1 pt had 2 frameshift mutations in exon 7, and 1 had 1 frameshift mutation in exon 7 and 1 missense mutation in exon 9. Compared with older WT1 wild-type pts, older WT1 mutated pts more often had FLT3-ITD (P<.001) and had lower hemoglobin (P=.01), and higher WBC (P=.03) and % blood blasts (P=.03). WT1 mutated pts had a trend for lower complete remission (CR) rates (50% v 70%, P=.16) and shorter OS (P=.08; Figure 1), but similar disease-free survival (DFS; P=.59; Figure 2) compared with WT1 wild-type pts. The frequency of WT1 mutations tended to be lower in older than younger pts (7% v 12%, P=.07). Mutation types and pretreatment clinical and molecular characteristics associated with WT1 mutations were similar between the two age groups. Despite differences in treatment intensity, there were no significant differences in younger v older WT1 mutated pts with regard to CR rates (P=.18), or OS (P=.68; Figure 1) or DFS (P=.66; Figure 2) durations. In contrast, younger WT1 wild-type pts had significantly higher CR rates (P<.001), and longer OS (P<.001; Figure 1) and DFS (P<.001; Figure 2) than older WT1 wild-type pts. Although associated with WT1 mutations in both the younger (P=.02) and older age groups, FLT3-ITD had no impact on CR rates (P=.28), or OS (P=.15) or DFS (P=.21) durations of all WT1 mutated pts after controlling for age-related treatment intensity. To provide insights into the molecular features associated with WT1 mutations we analyzed the whole cohort (younger and older) for genes differentially expressed (ie, P≤.001) between WT1 mutated and WT1 wild-type pts. A signature comprising 110 named genes was derived. Among the 71 upregulated genes in WT1 mutated pts, were those encoding the leukemia stem cell marker CD96 and the leukemia fusion protein partners PML and MLL. The most upregulated gene (6.2 fold) was GTSF1, which, like WT1, may be involved in germ cell development. Among the 39 genes downregulated in WT1 mutated pts, were those encoding SNRPN and SNURF, involved in pre-mRNA processing, and the insulin receptor and IRS2, upstream effectors of the PI3K/AKT pathway. In conclusion, WT1 mutations in older CN-AML pts are less frequent than in younger pts. While WT1 mutations independently associate with shorter OS and DFS in younger CN-AML pts, in older CN-AML pts they are only associated with trends for a worse CR rate and shorter OS. This difference appears due to the poor outcome of the older compared to younger WT1 wild-type pts, which reduced the prognostic impact of WT1 mutations in the former. Nevertheless, the outcome of pts with WT1 mutations is equally poor in older and younger pts regardless of differences in treatment, thereby suggesting that WT1 mutated CN-AML may constitute a distinct biologic entity across age groups. The unique gene expression signature associated with WT1 mutations could provide useful insights into WT1 mutation-driven leukemogenic mechanisms across age-related groups, and help in devising novel molecular targeted therapeutic approaches for this subtype of CN-AML. Disclosures: No relevant conflicts of interest to declare.
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Eskalen, A., A. Gonzalez, D. H. Wang, M. Twizeyimana, J. S. Mayorquin, and S. C. Lynch. "First Report of a Fusarium sp. and Its Vector Tea Shot Hole Borer (Euwallacea fornicatus) Causing Fusarium Dieback on Avocado in California." Plant Disease 96, no. 7 (July 2012): 1070. http://dx.doi.org/10.1094/pdis-03-12-0276-pdn.
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Per capita consumption of avocado in the United States has nearly doubled between 2000 and 2010. The California avocado industry supplies almost 40% of U.S. demand and the remaining 60% is supplied by imports from Latin America and New Zealand. The Tea Shot Hole Borer (TSHB) is an ambrosia beetle from Asia that forms a symbiosis with a new, yet undescribed Fusarium sp. and is a serious problem for the Israeli avocado industry (3). The beetle also causes severe damage on the branches of tea (Camelia sinensis) in Sri Lanka and India (1). In California, TSHB was first reported on black locust (Robinia pseudoacacia) in 2003, but there are no records of fungal damage (4). In 2012, nine backyard avocado trees (cvs. Hass, Bacon, Fuerte, and Nabal) exhibiting branch dieback were observed throughout the residential neighborhoods of South Gate, Downey, and Pico Rivera in Los Angeles County. Upon inspection, symptoms of white powdery exudate, either dry or surrounded by wet discoloration of the outer bark in association with a single beetle exit hole, were found on the trunk and main branches of the tree. Examination of the cortex and wood under the exit hole revealed brown discolored necrosis. The TSHB was also found within galleries that were 1 to 4 cm long going against the grain. Symptomatic cortex and sapwood tissues were plated onto potato dextrose agar amended with 0.01% tetracycline (PDA-tet). The TSHB was dissected and plated onto PDA-tet after surface disinfestation following methods described by Kajimura and Hijii (2). After 5 days of incubation at room temperature, regular fungal colonies with aerial mycelia and reddish brown margins were produced. Single spore isolations were used to establish pure culture of the fungus. Fifty conidia were hyaline, clavate with a rounded apex, and initially aseptate (4.1 to 12.0 × 2.4 to 4.1 μm) becoming one- to three-septate (7.6 to 15.1 × 2.8 to 4.5 μm, 9.2 to 17.2 × 3.4 to 4.8 μm, and 13.5 to 17.6 × 4.3 to 4.7 μm, respectively). Identity of the fungal isolates was determined by amplification of the rDNA genes with primers ITS4/5 and EF1/2, respectively. Sequences were deposited into GenBank under Accession Nos. JQ723753, JQ723760, JQ723756, and JQ723763. A BLASTn search revealed 100% similarity to Fusarium sp. (Accession Nos. JQ038020 and JQ038013). Detached green shoots of healthy 1-year-old avocado were wounded to a depth of 1 to 2 mm and 5-mm mycelial plugs from 5-day-old cultures (UCR 1781 and UCR 1837) were placed mycelial side down onto the freshly wounded surfaces and then wrapped with Parafilm. Control shoots were inoculated with sterile agar plugs and five replicates per treatment were used. Shoots were incubated at 25 ± 1°C in moist chambers for 3 weeks. Lesions were observed on all inoculated shoots except for the control. Mean lesion lengths were 10.7 and 12.8 cm for UCR1781 and UCR1837, respectively, and were significantly different (P ≤ 0.05) from the control. Both isolates were reisolated from 100% of symptomatic tissues of inoculated shoots to complete Koch's postulates. This experiment was conducted twice and similar results were obtained. To our knowledge, this is the first report of Fusarium sp. and its vector E. fornicatus causing Fusarium dieback on Avocado in California. References: (1) W. Danthanarayana. Tea Quarterly 39:61, 1968. (2) H. Kajimura and N. Hijii. Ecol. Res. 7:107, 1992; (3) Mendel et al., Phytoparasitica, DOI 10.1007/s12600-012-0223-7, 2012. (4) R. J. Rabaglia. Annals Entomol. Soc. Amer. 99:1034, 2006.
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Rayamajhi, M. B., P. D. Pratt, N. B. Klopfenstein, A. L. Ross-Davis, and L. Rodgers. "First Report of Puccinia psidii Caused Rust Disease Epiphytotic on the Invasive Shrub Rhodomyrtus tomentosa in Florida." Plant Disease 97, no. 10 (October 2013): 1379. http://dx.doi.org/10.1094/pdis-03-13-0225-pdn.
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Rhodomyrtus tomentosa (Aiton) Hassk. (downy-rose myrtle, family: Myrtaceae), of South Asian origin, is an invasive shrub that has formed monotypic stands in Florida (3). During the winter and spring of 2010 through 2012, a rust disease of epiphytotic proportion was observed on young foliage, stem terminals, and immature fruits of this shrub in natural areas of Martin and Lee counties, Florida. Expanding leaves and succulent stems developed chlorotic flecks on the surface that developed into pustules and ruptured to discharge urediniospores. Symptomatic leaves and stems developed severe necrotic spots and resulted in tissue distortion, defoliation, and stem dieback. Based on symptoms and urediniospore morphology and dimensions (17.7 to 26.1 [22.1 ± 0.3] × 14.7 to 21.1 [17.7 ± 0.2] μm; n = 51) (4), the causal agent was identified as Puccinia psidii Winter; teliospores were not observed in samples since it does not produce these spore stages below 20°C ambient temperature (1). This identification was confirmed by a GenBank BLAST of internal transcribed spacer (ITS) sequences (Accession Nos. KC607876 and KC607877) that showed 99% identity with 42 sequences of P. psidii from diverse host species and locations. P. psidii is believed to be of neotropical origin and has a host range of 129 species in 33 genera within Myrtaceae (2). However, P. psidii caused disease of downy-rose myrtle has not been previously reported in Florida, even though severe infections occurred on another invasive tree, Melaleuca quinquenervia (Cav.) S.F. Blake (3), growing in adjacent areas. In December 2011, urediniospores were collected from downy-rose myrtle, established in aqueous suspension (45,000 spores/ml), and spray inoculated on potted downy-rose myrtle plants (n = 3), which were maintained in 100% ambient humidity, at 20°C, with a 12-h light cycle for 72 h. Plants mock-inoculated with water served as the negative control. Disease symptoms, including chlorotic flecks and raised surfaces, appeared on leaf lamina in 3 to 6 days on P. psidii-inoculated plants, while control plants remained symptomless. Raised surfaces developed into distinct pustules and eventually erupted to discharge urediniospores within 6 to 12 days of inoculation. Tests were repeated once during March and April of 2012 with the same results. The latent and incubation periods reported herein are within the previously reported range for P. psidii (2,4). To our knowledge, this is the first confirmed report of P. psidii epiphytotic on downy-rose myrtle populations in Florida. The recent occurrence of P. psidii epiphytotic on downy-rose myrtle raises critical questions as to why this myrtle rust disease is so severe and widespread on this host after decades of presumed exposure to P. psidii in Florida. Because this rust pathogen has emerged as a major invasive threat to many myrtaceous species around the world, further genotyping and cross-inoculation studies are needed to determine the host specificity and potential origin of the P. psidii isolates derived from downy-rose myrtle (2). References: (1) A. C. Alfenas et al. Australas. Plant Pathol. 32:325, 2003. (2) A. J. Carnegie and J. R. Lidbetter. Australas. Plant Pathol. 41:13, 2012. (3) K. A. Langeland and C. K Burks, eds. Identification and biology of non-native plants in Florida's natural areas. University of Florida, Gainesville, 1998. (4) M. B. Rayachhetry et al. Biol. Contr. 22:38, 2001.