Letteratura scientifica selezionata sul tema "Hv 6431"

333 Background: Neoadjuvant chemotherapy (CT) is recommended prior to radical cystectomy (RC) in patients with muscle invasive urothelial carcinoma of the bladder (UCB), and has been shown to have modest survival benefit in clinical trials. The purpose of our study was to investigate the response and survival rates in patients with histologic variants (HV) and compare oncologic outcomes to patients with pure UCB. Methods: We performed a retrospective review of 163 patients treated with neoadjuvant CT prior to RC. Twenty-four patients with HV and 139 with pure UCB were identified. Numerous patient demographics, clinical and pathologic characteristics were evaluated including; clinical and pathologic stage, HV, lymphovascular invasion (LVI), margin status, node counts, concomitant carcinoma in situ (CIS), previous intravesical treatments, prior pelvic radiation, completeness of bladder tumor resection (TURBT), and CT regimens. Results: Patients with HV were younger (66.5 versus 71 years, p=0.04) but otherwise there were no significant differences noted between the two groups comparing previous treatments, clinical staging, margin status, node counts, CT regimens, # of neoadjuvant CT cycles, or rates of adjuvant CT administration. Of the 24 HV patients, 11 (47.8%) were downstaged to < pT2 compared to 50 (64.1%) of 139 patients with pure UCB (P=0.37). pT0 rates for HV and pure UCB were 16.7% and 23%, respectively (p=0.60). Twelve (50%) of the HV group compared to 65 (46.8%) of the pure UCB patients (p=0.83), had no evidence of disease at a mean follow up after RC of 19.5 (HV) and 22 (UCB) months. Eight (33.3%) patients with HV died of disease compared to 44 (31.7%) in the UCB group, (p=1.0). There was no significant difference noted in CSS and OS between the 2 groups, although there was a trend towards higher rates of node positive disease (p=0.086) and inferior CSS (p=0.09) in patients with HV compared to patients with pure UCB. Conclusions: Our results indicate that patients with HV experience similar oncologic outcomes from neoadjuvant systemic CT compared to patients with pure UCB.

Category: Bunion; Midfoot/Forefoot Introduction/Purpose: The purpose of this study was to explore validity of the paper pull test (PPT) to assess hallux flexion strength and function in persons with hallux valgus (HV). The following hypotheses were tested: 1) The PPT is valid for inferring 1st MTP flexion strength and heel rise (HR) performance (e.g. heel height). 2) A specified threshold of force during the PPT can be identified that discriminates patients with HV. 3) Muscle activity (abductor hallucis [AH], flexor hallucis brevis [FHB]), in patients with HV will be distinct from controls across three tasks: 1) PPT, 2) lowering phase of a HR, and 3) rising phase of a HR. Methods: Participants (24 controls, 22 with HV) performed: 1st MTP flexion, PPT, and heel rise. A force transducer in a jig assessed 1st MTP flexion. The same transducer recorded force during the PPT. Electromyography (EMG) was used to record FHB/AH muscle activity during 1st MTP flexion, PPT, and heel rising. 3D movement analysis was used to measure heel height and divide the HR into an up (HR-Up) and down (HR-Dwn) phase. One practice and 3 maximum 1st MTP flexion efforts were recorded. Manchester Scale of hallux deformity was used; 63.6% were classified as C or D. Validity was assessed with Pearson correlation’s between force during the PPT and 1st MTP flexion and PPT and HR height. Assessment of a threshold value for discriminating participants with HV from controls was determined using receiver operator curve (ROC) analysis. A two-way ANOVA for muscle groups and tasks were used to assess muscle activation. Results: The correlation between PPT force and maximum 1st MTP force was high (r=0.87, p<0.01) and the correlation with HR height was significant (r=-0.41, p<0.01). The ROC analysis yielded a high area under the curve (0.88(0.05)) for discriminating HV participants. Participants with HV that were below a threshold of 4.5% BW (44.1 N for a 100 kg person) on the PPT showed an 88% specificity/80% sensitivity in distinguishing HV participants from control participants (control average 64.1(37.3) N) versus HV (average 21.8 (16.4) N). Muscle activity was significantly higher across tasks for the AH (p=0.02) but was similar for the FHB (p=0.22). Conclusion: This data validates the PPT as simple, effective, clinical evaluation of 1st MTP flexion strength in patients with HV. This data also documents that patients with HV (surgery or not) may avoid using 1st MTP flexion explaining their significant weakness. The importance of this weakness on function is supported by the correlation with the heel rise test. The abnormal EMG findings suggests altered muscle control contributes to a lower PPT. The threshold of 1st MTP strength may assist with clinical decisions regarding whether rehabilitation or advice on increasing physical activity might benefit patients with various degrees of HV.

The aim of this study was to determine Vickers microhardness (HV) in bulk fill resins at different depths. Test specimens were prepared with different bulk fill resins: Filtek Bulk-Fill (3M ESPE) [FBF], Surefill SDR flow (Dentsply) [SDR], Fill-UP (COLTENE) [FU] and Surefill (Dentsply) [SF]. Semi-cylindrical test specimens were prepared in a mold 6 mm in diameter and 4 mm thick (n=5). A 1000 mW/cm2 light curing unit was applied (Coltolux LED - Coltene) for 20 seconds. HV was determined with three indentations (Vickers Future Tech FM300, 300 g, 8 s) at four depths: 1, 2, 3 and 4 mm from the top surface to the interior. Data were recorded immediately (t0) and 24 hours later (t24). Results were analyzed with two-way ANOVA (p<0.05), and multiple comparisons were performed using Tukey’s test. Mean and SD of HV at t0 for each mm were: [FBF] t0: 49.23(4.65) / 48.32(3.36) / 44.38(2.06) / 40.59(2.58); [FBF] t24: 61.37(3.47) / 62.63(3.03) / 57.27(5.22) / 56.37(5.88); [SDR] t0: 27.81(3.13) / 28.07(2.4) / 27.24(2.94) / 25.71(3.0); [SDR] t24: 35.11(2.16) / 35.17(1.96) / 35.53(1.81) / 33.18(2.08); [FU] t0: 41.43(1.41) / 39.87(0.88) / 38.11(1.81) / 39.09(1.92); [FU] t24: 49.27(1.54) / 48.77(1.77) / 48.65(1.88) / 46.76(4.93); [SF] t0: 71.35(7.09) / 67.39(9.76) / 68.95(6.21) / 64.1(8.35); [SF] t24: 76.06(6.61) / 75.31(9.37) / 75.2(11.57) / 69.81(12.14). ANOVA showed significant effect of material, depth and recording time (p<0.05), and Tukey’s test showed that recording sites (depths) differed significantly, giving four homogeneous groups. Under the conditions of this study, it can be concluded that microhardness of bulk-fill resins can be affected by depth and post-curing time.

Work objective is finding rational technical and economic solutions for examining current transformers for techspecs compliance satisfying the requirements of reinstalled microprocessor type protective relays and automation devices manufactured by NP EKRA LLC, taking into account DC component. Research methods: analytical methods for calculating the time of remnant magnetization in the core of a current transformer. Research results and novelty: it is understood that the saturation time of current transformers of the basic and backup protections, according to the results of the analytical method, was more than 25 ms, and for current transformers of differential bus bar protection was more than 5 ms. The obtained saturation time values for all types of current transformers built into oil circuit-breaker bushings (HV line) of 110 kV and bus bar coupling connector (BCC) of 110 kV (main protection, backup protection, differential bus protection), both in the absence and in the presence of remanent induction magnetic in CT cores with three-phase and single-phase short circuits, satisfy completely technical requirements either of microprocessor type protective relays or CT differential bus bar protection. Conclusion: built into CT BCC circuit-breaker bushings of 110 kV and oil circuit-breaker bushings (HV line) of 110 kV Foundry substations do not necessitate a mandatory replacement in case of non-complex redesign of microprocessor type protective relays and automation devices. When replacing oil circuit breakers with gas-insulated ones, it is recommended to use CT with similar characteristics.

Abstract Background and Aims: Immunotherapy might represent a novel therapeutical option for patients with B-cell chronic lymphocytic leukemia (B-CLL). Especially patients with limited tumor burden are usually regarded as suitable group for immunotherapy. However the existence of several molecular changes resulting in immunosuppression was reported even in patients with early stages of disease. In current study we assessed the expression of CD25 and FOXP3 in CD4 cells from patients with B-CLL. We also evaluated the influence of immunomodulatory treatment using thalidomide and fludarabine on T regulatory cells (Tregs) population in patients with B-CLL. Methods: Forty B-CLL patients (mean age: 64,1, range: 37 – 79) were evaluated for the expression of CD4, CD25 as well as specific transcription factor FOXP-3 (Forkhead box protein P3) by FACS analysis. Results were compared to those obtained in healthy volunteers (HV). Mixed lymphocyte cell culture with synthetic peptide (MLPC) that correspond to epitope of tumor associated antigen RHAMM, survivin or fibromodulin were perform to assess antitumor T cell reactivity in B-CLL patients. Results: We identified subpopulation of CD4+CD25highFOXP3+ T cells that phenotypically corresponds to Tregs in B-CLL patients. Increased levels of Tregs were observed in B-CLL patients. Significantly higher percentages of Tregs were noted in advanced stages of disease, 11.04% in stage 0-II vs 17.84% in stage III and IV according to Rai classification (Fig1a). No correlation between Tregs percentages and ZAP-70 status was shown, interestingly a tendency to higher percentages in ZAP-70 negative patients was observed 9.9% vs. 13.2%. In 9 CLL patients treated with thalidomide and fludarabine significant reduction of absolute number of circulating Tregs after thalidomide was observed (Fig.1b), in 7 this decrease was enhanced by addition of fludarabine to the treatment. First results from MLPC showed no correlation between specific T cell responses against TAA and presence of T regulatory cells. Conclusion: Increased number of Treg cells in patients with B-CLL suggests that immunosuppression is present in B-CLL patients not only in advanced but also in early stages of disease, and that T cell mediated immune rejection of CLL cell might be hampered by Treg cell. Effective treatment of B-CLL with novel schema combining immunomodulatory drug thalidomide with fludarabine seems to be effective in getting rid of excess of circulating Tregs. Figure 1. A. T regulatory cells in HV and CLL patients in early (0-II) and advanced (III-IV) stage of disease. B. Absolute number of T regulatory cells (CD4+CD25highFOX3+) during thalidomide + fludarabine treatment. Figure 1. A. T regulatory cells in HV and CLL patients in early (0-II) and advanced (III-IV) stage of disease. B. Absolute number of T regulatory cells (CD4+CD25highFOX3+) during thalidomide + fludarabine treatment.

AbstractObjectivesTo assess brain development in living fetuses with Down syndrome (DS) by biometric measurements on fetal brain magnetic resonance images (MRI).MethodsWe scanned 10 MRIs of fetuses with confirmed trisomy 21 at birth and 12 control fetal MRIs without any detected anomalies. Fetal brain MRIs were analyzed using 14 fetal brain and skull biometric parameters. We compared measures between DS and controls in both raw MRIs and motion‐corrected and anterior‐posterior commissure‐aligned images.ResultsIn the reconstructed images, the measured values of the height of the cerebellar vermis (HV) and anteroposterior diameter of the cerebellar vermis (APDV) were significantly smaller, and the anteroposterior diameter of the fourth ventricle (APDF) was significantly larger in fetuses with DS than controls. In the raw MRIs, the measured values of the right lateral ventricle were significantly larger in fetuses with DS than in controls. Logistic regression analyses revealed that a new parameter, the cerebellar‐to‐fourth‐ventricle ratio (i.e., (APDV * Height of the vermis)/APDF), was significantly smaller in fetuses with DS than controls and was the most predictive to distinguish between fetuses with DS and controls.ConclusionsThe study revealed that fetuses with DS have smaller cerebellums and larger fourth ventricles compared to the controls.

Research into volunteers' motivations to volunteer (MTV) usually relies on surveys and there is a need for more qualitative research into volunteering motivations, particularly in the United Kingdom. Furthermore, existing qualitative research into volunteering motivations usually relies on the thematic analysis of interviews with volunteers, but while this analysis is necessarily the analysis of discourse, there is rarely a systematic or replicable analysis of such discourse. This thesis aims to contribute to current understanding of MTV and the beliefs underpinning them by drawing upon various tools for discourse analysis in the analysis of community-based volunteers' accounts of their volunteering experiences. However, given the generally positive reception that community based volunteering receives in the public domain, this thesis aims not only to describe and explain informants' MTV but also to critically evaluate volunteers' representations of volunteering practice. A central argument in this thesis is that while a strong sense of concern for the suffering and flourishing of beneficiaries is expressed throughout volunteers' representations, volunteering tends to be represented as an optional act of goodwill, rather than a moral duty or obligation. This raises questions about the dominant ways we think about helping others in contemporary society and about the ideologies underpinning such beliefs. It is argued that bringing to the fore and problematizing such beliefs is critical in a time where traditional collectives are breaking down and the social contracts underpinning British and European society together with the nature of our obligations as citizens in an increasingly globalized society are subject to increasing scrutiny and debate.

Global statistics indicate that currently 35 million people are living with HIV of which 4, 634 are living in Scotland (out of a total population of 5 295 00) and the figure for Zimbabwe is estimated at 1, 400 000 (out of a total population of 14 149648). In this thesis, I have suggested a framework that goes beyond a limited analysis of the complexity of understanding the HIV/AIDS origins, its evolution and prevalence beyond the epidemiological mapping. The approach allows for the development of a more rational, inclusive, broader and sustainable HIV/AIDS Education (Wood 2014, Wood and Rolleri 2014). This approach is not only emancipatory but also empowers (Freire 2000, Freire 2004) both those affected and infected by the HIV/AIDS epidemic. I have chosen both Scotland and Zimbabwe as each of them has dealt with the epidemic in different ways. Scotland has had significant success in combating HIV/AIDS through various initiatives. Zimbabwe on the other hand, is an example of a developing country in sub-Saharan Africa with one of the highest levels of HIV/AIDS infected and affected people in the world (UNAIDS Country Report 2014). I used ‘selected’ documentary analysis that is, looking at selected documents that contain the major policy responses to the HIV/AIDS epidemic. I also conducted interviews with key informants using semi-structured interview questions and then analysed the resultant data using a range of heuristic tools. The main findings of this research included how a number of conspiracy theories were constructed in order to explain the origins and the evolution of HIV/AIDS. Examples of these conspiracy theories included the homosexual link to HIV/AIDS,witchcraft and biological warfare among others. Other issues discussed focused on conspiracy as the construction of otherness, moralising the epidemic, assessing the impact of culture, religion and politics on the epidemic as well as the implications of these issues on Sex Education. The thesis concluded with suggesting a framework for developing a transformative approach to HIV/AIDS and Sex Education.