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Sample records for status predicts pathological

  1. Clinico-pathological nomogram for predicting BRAF mutational status of metastatic colorectal cancer.

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    Loupakis, Fotios; Moretto, Roberto; Aprile, Giuseppe; Muntoni, Marta; Cremolini, Chiara; Iacono, Donatella; Casagrande, Mariaelena; Ferrari, Laura; Salvatore, Lisa; Schirripa, Marta; Rossini, Daniele; De Maglio, Giovanna; Fasola, Gianpiero; Calvetti, Lorenzo; Pilotto, Sara; Carbognin, Luisa; Fontanini, Gabriella; Tortora, Giampaolo; Falcone, Alfredo; Sperduti, Isabella; Bria, Emilio

    2016-01-12

    In metastatic colorectal cancer (mCRC), BRAFV600E mutation has been variously associated to specific clinico-pathological features. Two large retrospective series of mCRC patients from two Italian Institutions were used as training-set (TS) and validation-set (VS) for developing a nomogram predictive of BRAFV600E status. The model was internally and externally validated. In the TS, data from 596 mCRC patients were gathered (RAS wild-type (wt) 281 (47.1%); BRAFV600E mutated 54 (9.1%)); RAS and BRAFV600E mutations were mutually exclusive. In the RAS-wt population, right-sided primary (odds ratio (OR): 7.80, 95% confidence interval (CI) 3.05-19.92), female gender (OR: 2.90, 95% CI 1.14-7.37) and mucinous histology (OR: 4.95, 95% CI 1.90-12.90) were independent predictors of BRAFV600E mutation, with high replication at internal validation (100%, 93% and 98%, respectively). A predictive nomogram was calculated: patients with the highest score (right-sided primary, female and mucinous) had a 81% chance to bear a BRAFV600E-mutant tumour; accuracy measures: AUC=0.812, SE:0.034, sensitivity:81.2%; specificity:72.1%. In the VS (508 pts, RAS wt: 262 (51.6%), BRAFV600E mutated: 49 (9.6%)), right-sided primary, female gender and mucinous histology were confirmed as independent predictors of BRAFV600E mutation with high accuracy. Three simple and easy-to-collect characteristics define a useful nomogram for predicting BRAF status in mCRC with high specificity and sensitivity.

  2. The Preoperative Controlling Nutritional Status Score Predicts Survival After Curative Surgery in Patients with Pathological Stage I Non-small Cell Lung Cancer.

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    Shoji, Fumihiro; Haratake, Naoki; Akamine, Takaki; Takamori, Shinkichi; Katsura, Masakazu; Takada, Kazuki; Toyokawa, Gouji; Okamoto, Tatsuro; Maehara, Yoshihiko

    2017-02-01

    The prognostic Controlling Nutritional Status (CONUT) score is used to evaluate immuno-nutritional conditions and is a predictive factor of postoperative survival in patients with digestive tract cancer. We retrospectively analyzed clinicopathological features of patients with pathological stage I non-small cell lung cancer (NSCLC) to identify predictors or prognostic factors of postoperative survival and to investigate the role of preoperative CONUT score in predicting survival. We selected 138 consecutive patients with pathological stage I NSCLC treated from August 2005 to August 2010. We measured their preoperative CONUT score in uni- and multivariate Cox regression analyses of postoperative survival. A high CONUT score was positively associated with preoperative serum carcinoembryonic antigen level (p=0.0100) and postoperative recurrence (p=0.0767). In multivariate analysis, the preoperative CONUT score [relative risk (RR)=6.058; 95% confidence interval (CI)=1.068-113.941; p=0.0407), increasing age (RR=7.858; 95% CI=2.034-36.185; p=0.0029), and pleural invasion (RR=36.615; 95% CI=5.900-362.620; pcancer-specific survival (CS), and overall survival (OS), the group with high CONUT score had a significantly shorter RFS, CS, and OS than did the low-CONUT score group by log-rank test (p=0.0458, p=0.0104 and p=0.0096, respectively). The preoperative CONUT score is both a predictive and prognostic factor in patients with pathological stage I NSCLC. This immuno-nutritional score can indicate patients at high risk of postoperative recurrence and death. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  3. Clinical predictive factors of pathologic tumor response

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    Choi, Chi Hwan; Kim, Won Dong; Lee, Sang Jeon; Park, Woo Yoon [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)

    2012-09-15

    The aim of this study was to identify clinical predictive factors for tumor response after preoperative chemoradiotherapy (CRT) in rectal cancer. The study involved 51 patients who underwent preoperative CRT followed by surgery between January 2005 and February 2012. Radiotherapy was delivered to the whole pelvis at a dose of 45 Gy in 25 fractions, followed by a boost of 5.4 Gy in 3 fractions to the primary tumor with 5 fractions per week. Three different chemotherapy regimens were used. Tumor responses to preoperative CRT were assessed in terms of tumor downstaging and pathologic complete response (ypCR). Statistical analyses were performed to identify clinical factors associated with pathologic tumor response. Tumor downstaging was observed in 28 patients (54.9%), whereas ypCR was observed in 6 patients (11.8%). Multivariate analysis found that predictors of downstaging was pretreatment relative lymphocyte count (p = 0.023) and that none of clinical factors was significantly associated with ypCR. Pretreatment relative lymphocyte count (%) has a significant impact on the pathologic tumor response (tumor downstaging) after preoperative CRT for locally advanced rectal cancer. Enhancement of lymphocyte-mediated immune reactions may improve the effect of preoperative CRT for rectal cancer.

  4. Slot Machine Response Frequency Predicts Pathological Gambling

    DEFF Research Database (Denmark)

    Linnet, Jakob; Rømer Thomsen, Kristine; Møller, Arne

    2013-01-01

    Slot machines are among the most addictive forms of gambling, and pathological gambling slot machine players represent the largest group of treatment seekers, accounting for 35% to 93% of the population. Pathological gambling sufferers have significantly higher response frequency (games / time......) on slot machines compared with non-problem gamblers, which may suggest increased reinforcement of the gambling behavior in pathological gambling. However, to date it is unknown whether or not the increased response frequency in pathological gambling is associated with symptom severity of the disorder....... This study tested the hypothesis that response frequency is associated with symptom severity in pathological gambling. We tested response frequency among twenty-two pathological gambling sufferers and twenty-one non-problem gamblers on a commercially available slot machine, and screened for pathological...

  5. RU486 mitigates Hippocampal Pathology Following Status Epilepticus

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    Aynara Chavez Wulsin

    2016-11-01

    Full Text Available Status epilepticus induces rapid hyper-activation of the hypothalamo-pituitary-adrenocortical (HPA axis. HPA axis hyperactivity results in excess exposure to high levels of circulating glucocorticoids, which are associated with neurotoxicity and depression-like behavior. These observations have led to the hypothesis that HPA axis dysfunction may exacerbate status epilepticus-induced brain injury. To test this hypothesis, we used the mouse pilocarpine model of epilepsy to determine whether use of the glucocorticoid receptor antagonist RU486 can attenuate hippocampal pathology following status epilepticus. Excess glucocorticoid secretion was evident one day after status epilepticus in the mice, preceding the development of spontaneous seizures (which can take weeks to develop. RU486 treatment blocked the SE-associated elevation of glucocorticoid levels in pilocarpine treated mice. RU486 treatment also mitigated the development of hippocampal pathologies induced by status epilepticus, reducing loss of hilar mossy cells and limiting pathological cell proliferation in the dentate hilus. Mossy cell loss and accumulation of ectopic hilar cells are positively correlated with epilepsy severity, suggesting that early treatment with glucocorticoid antagonists could have anti-epileptogenic effects.

  6. Predicting pathology in impacted mandibular third molars

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    Aveek Mukherji

    2017-01-01

    Full Text Available Introduction: The rising incidence of the impacted mandibular third molars and their association with pathologies is now considered a public health problem. Aims and Objectives: The objective of this study was to assess the position of impacted mandibular third molars that are prone to developing pathologies and to determine the frequency and type of pathological conditions associated with these impacted teeth to facilitate planning for their prophylactic removal. Materials and Methods: Consecutive panoramic radiographs and clinical examination of 300 patients with impacted mandibular third molars were collected. They were segregated according to Pell and Gregory’s classification, Winter’s classification, and according to their state of eruption. These were correlated with associated pathologies based on clinical and radiological criteria. Statistical Analysis Used: Descriptive statistics included computation of percentages, mean, and standard deviations. The statistical test applied for the analysis was Pearson’s Chi-square test (χ2. For this test, confidence interval and P value were set at 93% and ≤0.03, respectively. Results: The pathology most commonly associated with impacted third molars was pericoronitis, which had the highest frequency of occurrence in partially erupted, distoangular, and IA positioned (as per Pell and Gregory classification impacted teeth. Impacted mandibular third molars, which were in IA position, placed mesially, and partially erupted, were prone to develop pathologies such as dental caries and periodontitis. Conclusion: The clinical and radiographical features of impacted third molar may be correlated to the development of their pathological complications. The partially impacted mandibular third molars with mesioangularly aligned in IA position have the highest potential to cause pathological complications.

  7. Risk assessment strategy for prediction of pathological hyperbilirubinemia in neonates.

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    Chawla, Deepak; Jain, Suksham; Dhir, Shashikant; Rani, Shikha

    2012-02-01

    To evaluate combined ability of clinical risk factors and transcutaneous bilirubin (TcB) in predicting pathological hyperbilirubinemia (PHB) needing treatment during first week of life in healthy term and late preterm neonates. This prospective cohort study included healthy neonates with gestation ≥35 wk and birth weight ≥2000 g. TcB was measured with a multi-wavelength transcutaneous bilirubinometer (Bilichek®) at 30 ± 12 h of postnatal age. Follow-up was conducted as per American Academy of Pediatrics guidelines. For diagnosis of PHB, TcB was measured at each follow-up visit. Serum bilirubin was measured if TcB was >15 mg/dL or within 2 mg/dL of phototherapy cut-off. Among 462 neonates [birth weight (g; mean ± SD): 2711 ± 431, gestation (wk; median, IQR): 38 (37-39), male: 52%] enrolled in the study, 392 (84.9%) completed followup and PHB was observed in 65 (16.6%) neonates. Discriminant ability of risk model, including both clinical risk factors and TcB, was better than the risk models with clinical risk factors or TcB alone (c-statistic: 0.86 vs. 0.74 vs. 0.77). On logistic regression analysis risk factors found significant were TcB (OR: 1.65, 95% CI: 1.4-1.9), gestation at birth (OR: 0.6, 95% CI: 0.50-0.77) and primiparity (OR: 2.1, 95% CI: 1.1-3.9). A risk prediction score was developed with these three risk factors as ordinal/dichotomous variables. Negative and positive predictive values for score 12 were 97% and 46%, respectively. Risk score consisting of TcB, gestation at birth and parity status was able to accurately predict pathological hyperbilirubinemia in derivation cohort of healthy term and late preterm north Indian neonates.

  8. Kidney pathology precedes and predicts the pathological cascade of cerebrovascular lesions in stroke prone rats.

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    Stefanie Schreiber

    Full Text Available INTRODUCTION: Human cerebral small vessel disease (CSVD has been hypothesized to be an age-dependent disease accompanied by similar vascular changes in other organs. SHRSP feature numerous vascular risk factors and may be a valid model of some aspects of human CSVD. Here we compare renal histopathological changes with the brain pathology of spontaneously hypertensive stroke-prone rats (SHRSP. MATERIAL AND METHODS: We histologically investigated the brains and kidneys of 61 SHRSP at different stages of age (12 to 44 weeks. The brain pathology (aggregated erythrocytes in capillaries and arterioles, microbleeds, microthromboses and the kidney pathology (aggregated erythrocytes within peritubular capillaries, tubular protein cylinders, glomerulosclerosis were quantified separately. The prediction of the brain pathology by the kidney pathology was assessed by creating ROC-curves integrating the degree of kidney pathology and age of SHRSP. RESULTS: Both, brain and kidney pathology, show an age-dependency and proceed in definite stages whereas an aggregation of erythrocytes in capillaries and arterioles, we parsimoniously interpreted as stases, represent the initial finding in both organs. Thus, early renal tubulointerstitial damage characterized by rather few intravasal erythrocyte aggregations and tubular protein cylinders predicts the initial step of SHRSPs' cerebral vascular pathology marked by accumulated erythrocytes. The combined increase of intravasal erythrocyte aggregations and protein cylinders accompanied by glomerulosclerosis and thrombotic renal microangiopathy in kidneys of older SHRSP predicts the final stages of SHRSPs' cerebrovascular lesions marked by microbleeds and thrombotic infarcts. CONCLUSION: Our results illustrate a close association between structural brain and kidney pathology and support the concept of small vessel disease to be an age-dependent systemic pathology. Further, an improved joined nephrologic and neurologic

  9. Identification of prostate cancer risk categories according to surgical margins status, pathological stage and Gleason score.

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    Schiavina, Riccardo; Borghesi, Marco; Fiorentino, Michelangelo; Brunocilla, Eugenio; Manferrari, Fabio; Vagnoni, Valerio; Martorana, Giuseppe

    2013-11-01

    One-third of patients with positive surgical margins after radical prostatectomy develop recurrent disease. The distinction between pT2 with positive margins and pT3a can be difficult. Aim of the present study was to assess the impact of positive surgical margins on biochemical relapse after radical prostatectomy, adjusted for pathological stage and Gleason score. We retrospectively evaluated 837 consecutive patients who underwent radical prostatectomy for organ-confined or locally-advanced prostate cancer. Exclusion criteria were: presence of node or distant metastases, neo-adjuvant or adjuvant therapy, and unavailability of full data regarding pathological stage and margin status. A single dedicated genitourinary pathologist evaluated all the specimens. The Kaplan-Meier method and univariable and multivariable Cox regressions were applied for survival analyses. The median follow up was 54.0 ± 35.0 months. Margin status, prostate-specific antigen and Gleason score significantly predicted biochemical relapse in the pT2 group at multivariable analysis, whereas only pathological stage and pathological Gleason score were significant predictors of recurrence in pT3a patients. There were no significant differences in biochemical disease-free survival among pT2 with positive margins patients and pT3a patients (with or without positive surgical margins). Pathological Gleason score was the only significant predictor of biochemical relapse in patients with negative and positive margins, regardless of the pathological stage. pT2 patients with positive surgical margins and pT3a (with or without positive margins) seem to have similar biochemical disease-free survival. Positive margins and pathological stage might be insufficient clinical predictors. Gleason score remains the most reliable prognostic factor. © 2013 The Japanese Urological Association.

  10. A new nomogram to predict pathologic outcome following radical prostatectomy

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    Alexandre Crippa

    2006-04-01

    Full Text Available OBJECTIVE: To develop a preoperative nomogram to predict pathologic outcome in patients submitted to radical prostatectomy for clinical localized prostate cancer. MATERIALS AND METHODS: Nine hundred and sixty patients with clinical stage T1 and T2 prostate cancer were evaluated following radical prostatectomy, and 898 were included in the study. Following a multivariate analysis, nomograms were developed incorporating serum PSA, biopsy Gleason score, and percentage of positive biopsy cores in order to predict the risks of extraprostatic tumor extension, and seminal vesicle involvement. RESULTS: In univariate analysis there was a significant association between percentage of positive biopsy cores (p < 0.001, serum PSA (p = 0.001 and biopsy Gleason score (p < 0.001 with extraprostatic tumor extension. A similar pathologic outcome was seen among tumors with Gleason score 7, and Gleason score 8 to 10. In multivariate analysis, the 3 preoperative variables showed independent significance to predict tumor extension. This allowed the development of nomogram-1 (using Gleason scores in 3 categories - 2 to 6, 7 and 8 to 10 and nomogram-2 (using Gleason scores in 2 categories - 2 to 6 and 7 to 10 to predict disease extension based on these 3 parameters. In the validation analysis, 87% and 91.1% of the time the nomograms-1 and 2, correctly predicted the probability of a pathological stage to within 10% respectively. CONCLUSION: Incorporating percent of positive biopsy cores to a nomogram that includes preoperative serum PSA and biopsy Gleason score, can accurately predict the presence of extraprostatic disease extension in patients with clinical localized prostate cancer.

  11. Bone Marrow Pathology Predicts Mortality in Chronic Hemodialysis Patients

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    Cheng-Hao Weng

    2015-01-01

    Full Text Available Introduction. A bone marrow biopsy is a useful procedure for the diagnosis and staging of various hematologic and systemic diseases. The objective of this study was to investigate whether the findings of bone marrow studies can predict mortality in chronic hemodialysis patients. Methods. Seventy-eight end-stage renal disease patients on maintenance hemodialysis underwent bone marrow biopsies between 2000 and 2011, with the most common indication being unexplained anemia followed by unexplained leukocytosis and leukopenia. Results. The survivors had a higher incidence of abnormal megakaryocyte distribution P=0.001, band and segmented cells P=0.021, and lymphoid cells P=0.029 than the nonsurvivors. The overall mortality rate was 38.5% (30/78, and the most common cause of mortality was sepsis (83.3% followed by respiratory failure (10%. In multivariate Cox regression analysis, both decreased (OR 3.714, 95% CI 1.671–8.253, P=0.001 and absent (OR 9.751, 95% CI 2.030–45.115, P=0.004 megakaryocyte distribution (normal megakaryocyte distribution as the reference group, as well as myeloid/erythroid ratio (OR 1.054, CI 1.012–1.098, P=0.011, were predictive of mortality. Conclusion. The results of a bone marrow biopsy can be used to assess the pathology, and, in addition, myeloid/erythroid ratio and abnormal megakaryocyte distribution can predict mortality in chronic hemodialysis patients.

  12. Current status of General Pathology training in Spain.

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    Casademont, J; Porcel, J M; Vargas Núñez, J A; González Macías, J

    2013-12-01

    One of the core subjects in university training of the physicians has been General Pathology. Responsibility for this has historically fallen on Internal Medicine specialists. However, we are unaware if this situation is currently maintained. A questionnaire was sent to the coordinators of the subject of the 39 Spanish medical schools to know, among other things, the current denomination of the subjects (traditionally known as «General Pathology»), number of credits, teaching activities included in the subject and number and specialty of the professors responsible for it. Some data from the medical schools that did not respond were obtained from their web pages. A total of 28 of the 39 (72%) medical schools existing in Spain answered the survey. The current denomination of the subject «General Pathology» varied greatly. The mean number of credits (one credit=20-25 h) was 11.2 (range 3 to 29). In 22 of 34 schools (65%), the subject was taught in the third year of the studies, but in 21% of the schools, it was partially and in 15% of the schools, totally, taught in the second year. More than half of the professors (54%) who taught the subject were Internal Medicine specialists, although this responsibility was shared with other specialists in a large proportion. Teaching of General Pathology shows a marked heterogeneity that does not seem to be due to teaching or pedagogic criteria among the different schools of Spain. These facts may be due to less presence in the university setting of Internal Medicine compared to other specialties. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  13. The overall pathological status of the left hippocampus determines preoperative verbal memory performance in left mesial temporal lobe epilepsy.

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    Witt, Juri-Alexander; Coras, Roland; Schramm, Johannes; Becker, Albert J; Elger, Christian E; Blümcke, Ingmar; Helmstaedter, Christoph

    2014-04-01

    Studies on hippocampal cell loss in epilepsy have produced diverging evidence as to which subfields are specifically related to memory. This may be due to rather small and often heterogeneous samples, or to different memory measures. Therefore, the current study examined hippocampal cell densities and memory in a large sample of patients with solely mesial temporal lobe epilepsy (mTLE), employing measures with proven sensitivity to mesiotemporal pathology. In 104 patients who had undergone epilepsy surgery for mTLE, we evaluated the role of segmental hippocampal cell loss and its underlying factor structure with regard to presurgical verbal and figural memory while controlling for side-of-surgery and hemispheric dominance. First of all, patients showed material-specific memory impairment concordant with the lateralization of epilepsy. Factor analysis of segmental cell loss revealed a single factor reflecting the overall integrity of the hippocampus. The overall pathological status of the left hippocampus correlated with verbal memory parameters (r = 0.33-0.34, P hippocampus and memory function were found, nor did left or right hippocampal pathology explain figural memory parameters. The results suggest that the overall pathological status of the left hippocampus - rather than a specific subfield pathology - is predictive for verbal memory in mTLE. The finding that figural memory parameters, although sensitive to right mTLE, were not related to neuronal cell densities of the right hippocampus, puts the left/right hippocampus verbal/nonverbal memory dichotomy into perspective. Copyright © 2013 Wiley Periodicals, Inc.

  14. OXIDATIVE AND ANTIOXIDANT STATUS IN DEPRESSIVE DISORDER PATHOLOGY

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    Sanggary Marimuthu

    2013-01-01

    Depressive disorder is a psychiatric disorder often found lately. Oxidative stress is a mechanism that promotes the occurrence of major depressive disorder. Oxidative stress is defined as an imbalance between oxidants and antioxidants whereby high oxidant content is due to decrease the antioxidant cap city of the system. Objective: The aim of this study is to assess the oxidative and antioxidative status in plasma in patients diagnosed with clinical depression, and to assess whether there is...

  15. Predictive Analytics to Support Real-Time Management in Pathology Facilities.

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    Lessard, Lysanne; Michalowski, Wojtek; Chen Li, Wei; Amyot, Daniel; Halwani, Fawaz; Banerjee, Diponkar

    2016-01-01

    Predictive analytics can provide valuable support to the effective management of pathology facilities. The introduction of new tests and technologies in anatomical pathology will increase the volume of specimens to be processed, as well as the complexity of pathology processes. In order for predictive analytics to address managerial challenges associated with the volume and complexity increases, it is important to pinpoint the areas where pathology managers would most benefit from predictive capabilities. We illustrate common issues in managing pathology facilities with an analysis of the surgical specimen process at the Department of Pathology and Laboratory Medicine (DPLM) at The Ottawa Hospital, which processes all surgical specimens for the Eastern Ontario Regional Laboratory Association. We then show how predictive analytics could be used to support management. Our proposed approach can be generalized beyond the DPLM, contributing to a more effective management of pathology facilities and in turn to quicker clinical diagnoses.

  16. Predictive Analytics to Support Real-Time Management in Pathology Facilities

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    Lessard, Lysanne; Michalowski, Wojtek; Chen Li, Wei; Amyot, Daniel; Halwani, Fawaz; Banerjee, Diponkar

    2016-01-01

    Predictive analytics can provide valuable support to the effective management of pathology facilities. The introduction of new tests and technologies in anatomical pathology will increase the volume of specimens to be processed, as well as the complexity of pathology processes. In order for predictive analytics to address managerial challenges associated with the volume and complexity increases, it is important to pinpoint the areas where pathology managers would most benefit from predictive capabilities. We illustrate common issues in managing pathology facilities with an analysis of the surgical specimen process at the Department of Pathology and Laboratory Medicine (DPLM) at The Ottawa Hospital, which processes all surgical specimens for the Eastern Ontario Regional Laboratory Association. We then show how predictive analytics could be used to support management. Our proposed approach can be generalized beyond the DPLM, contributing to a more effective management of pathology facilities and in turn to quicker clinical diagnoses. PMID:28269873

  17. Vascular Endothelial Growth Factor from Embryonic Status to Cardiovascular Pathology

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    Mohsen Azimi-Nezhad

    2014-05-01

    Full Text Available Vascular endothelial growth factor (VEGF is a multifunctional cytokine with distinct functions in angiogenesis, lymphangiogenesis, vascular permeability, and hematopoiesis. VEGF is a highly conserved, disulfide-bonded dimeric glycoprotein of 34 to 45 kDa produced by several cell types including fibroblasts, neutrophils, endothelial cells, and peripheral blood mononuclear cells, particularly T lymphocytes and macrophages. Six VEGF isoforms are generated as a result of alternative splicing from a single VEGF gene, consisting of 121, 145, 165, 183, 189, or 206 amino acids. VEGF121, VEGF145, and VEGF165 are secreted whereas VEGF183, VEGF189, and VEGF206 are cell membrane-bound. VEGF145 has a key role during the vascularization of the human ovarian follicle and corpus luteum, in the placentation and embryonic periods, and in bone and wound healing, while VEGF165 is the most abundant and biologically active isoform. VEGF has been linked with a number of vascular pathologies including cardiovascular diseases such ischemic heart disease, heart failure, stroke, and diabetes and its related complications. In this review we aimed to present some important roles of VEGF in a number of clinical issues and indicate its involvement in several phenomena from the initial steps of the embryonic period to cardiovascular diseases.

  18. Testing the Predictive Validity and Construct of Pathological Video Game Use

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    Groves, Christopher L.; Douglas Gentile; Tapscott, Ryan L.; Lynch, Paul J.

    2015-01-01

    Three studies assessed the construct of pathological video game use and tested its predictive validity. Replicating previous research, Study 1 produced evidence of convergent validity in 8th and 9th graders (N = 607) classified as pathological gamers. Study 2 replicated and extended the findings of Study 1 with college undergraduates (N = 504). Predictive validity was established in Study 3 by measuring cue reactivity to video games in college undergraduates (N = 254), such that pathological ...

  19. Prediction of the Pathologic Gleason Score to Inform a Personalized Management Program for Prostate Cancer.

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    Coley, R Yates; Zeger, Scott L; Mamawala, Mufaddal; Pienta, Kenneth J; Carter, H Ballentine

    2017-07-01

    Active surveillance (AS) is an alternative to curative intervention, but overtreatment persists. Imperfect alignment of prostate biopsy and Gleason score after radical prostatectomy (RP) may be a contributing factor. To develop a statistical model that predicts the post-RP Gleason score (pathologic Gleason score [PGS]) using clinical observations made in the course of AS. Repeated prostate-specific antigen measurements and biopsy Gleason scores from 964 very low-risk patients in the Johns Hopkins Active Surveillance cohort were used in the analysis. PGS observations from 191 patients who underwent RP were also included. A Bayesian joint model based on accumulated clinical data was used to predict PGS in these categories: 6 (grade group 1), 3+4 (grade group 2), 4+3 (grade group 3), and 8-10 (grade groups 4 and 5). The area under the receiver operating characteristic curve (AUC) and calibration of predictions was assessed in patients with post-RP Gleason score observations. The estimated probability of harboring a PGS >6 was Gleason score observations, the AUC for predictions of PGS >6 was 0.74 (95% confidence interval, 0.66-0.81), and the mean absolute error was 0.022. Although the model requires external validation prior to adoption, PGS predictions can be used in AS to inform decisions regarding follow-up biopsies and remaining on AS. Predictions can be updated as additional data are observed. The joint modeling framework also accommodates novel biomarkers as they are identified and measured on AS patients. Measurements taken in the course of active surveillance can be used to accurately predict patients' underlying prostate cancer status. Predictions can be communicated to patients via a decision support tool and used to guide clinical decision making and reduce patient anxiety. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  20. Pathology

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    Huihong Xu MD

    2016-08-01

    Full Text Available Medical students are often unsure about the viability of a career as a physician in pathology. In particular, they are concerned that pathologists may not have a gratifying lifestyle or be well compensated. These worries may cause angst among medical students considering pathology and among junior pathology residents wondering if they made the correct career choice. A 2016 survey of nearly 20 000 physicians including nearly 400 pathologists provides reassuring data about compensation and career choice. This survey showed that 52% of pathologists are satisfied with their career choice and 63% are satisfied with their compensation. Among the 26 specialties that were surveyed, pathologists ranked 2 in believing that they were fairly compensated. Moreover, 66% of pathologists find that making diagnostic decisions, a core aspect of our discipline, is the most rewarding aspect of their career. Pathologists also ranked among the highest groups of physicians in reporting happiness at work and among the lowest groups reporting burnout. Overall, these 2016 surveys show that the majority of pathologists find deep satisfaction in their careers as pathologists.

  1. Naive Prediction of Pathology from Human Figure Drawings

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    Arkell, R. N.

    1976-01-01

    The present study investigated the degree of accuracy of five groups of judges in inferring pathology in human figure drawings. It was suggested that intuition gained through several years of unsystematic observation of figure drawings played the major role in their interpretation. (Author)

  2. Considerations for standardizing predictive molecular pathology for cancer prognosis.

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    Fiorentino, Michelangelo; Scarpelli, Marina; Lopez-Beltran, Antonio; Cheng, Liang; Montironi, Rodolfo

    2017-01-01

    Molecular tests that were once ancillary to the core business of cyto-histopathology are becoming the most relevant workload in pathology departments after histopathology/cytopathology and before autopsies. This has resulted from innovations in molecular biology techniques, which have developed at an incredibly fast pace. Areas covered: Most of the current widely used techniques in molecular pathology such as FISH, direct sequencing, pyrosequencing, and allele-specific PCR will be replaced by massive parallel sequencing that will not be considered next generation, but rather, will be considered to be current generation sequencing. The pre-analytical steps of molecular techniques such as DNA extraction or sample preparation will be largely automated. Moreover, all the molecular pathology instruments will be part of an integrated workflow that traces the sample from extraction to the analytical steps until the results are reported; these steps will be guided by expert laboratory information systems. In situ hybridization and immunohistochemistry for quantification will be largely digitalized as much as histology will be mostly digitalized rather than viewed using microscopy. Expert commentary: This review summarizes the technical and regulatory issues concerning the standardization of molecular tests in pathology. A vision of the future perspectives of technological changes is also provided.

  3. Systems pathology: a paradigm shift in the practice of diagnostic and predictive pathology.

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    Donovan, Michael J; Costa, Jose; Cordon-Cardo, Carlos

    2009-07-01

    Diagnostic tumor pathology in the context of personalized medicine has progressed from an interpretive, subjective science to a more objective, evidence-based practice. This has resulted in the development of several tissue-based, molecular-driven tests that provide information regarding prognosis and response to therapy. The challenge, however, for both the pathologist and the treating physician is how best to effectively integrate this data into a comprehensive treatment plan that includes a patient-specific risk assessment. To address this need, the authors developed a systems pathology approach to the practice of clinical molecular medicine through technical advances in object-oriented image analysis, and phenotyping at the microanatomical level using deparaffinized tissue section and quantitative biomarker multiplexing. With support vector regression for censored data, they have been able to integrate complex information and provide a patient-specific risk profile based on the clinical endpoint under investigation. Cancer 2009;115(13 suppl):3078-84. (c) 2009 American Cancer Society.

  4. Marital status, childhood maltreatment, and family dysfunction: a controlled study of pathological gambling.

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    Black, Donald W; Shaw, Martha C; McCormick, Brett A; Allen, Jeff

    2012-10-01

    Pathological gambling is a prevalent public health problem associated with depression, substance misuse, crime, and suicide. Despite these challenges, little attention has been directed to examining its negative consequences on families and marriages, including divorce rates, childhood maltreatment, and family dysfunction. From February 2005 to June 2010, subjects with DSM-IV-defined pathological gambling and community controls were assessed for marital and family variables and indices of childhood maltreatment. The Family Assessment Device (FAD) was used to evaluate family functioning. Ninety-five subjects with DSM-IV pathological gambling and 91 control subjects without pathological gambling were recruited and assessed. They were similar in age, gender, and employment status. Persons with pathological gambling were more likely than controls to have ≥ 1 divorce (odds ratio [OR] = 2.56; 95% CI, 1.35-4.87; P = .004), to live alone (OR = 4.49; 95% CI, 1.97-10.25; P gambling subjects reported significantly worse family functioning than control subjects as assessed by all 7 FAD subscales. On the FAD general functioning subscale, 55% of pathological gambling families and 33% of control families were rated "unhealthy" (OR = 2.17; 95% CI, 1.14-4.12; P = .018). Severity of gambling was positively correlated with divorce, childhood maltreatment, and the FAD roles subscale. People with pathological gambling are more likely than controls to have been divorced, to live alone, and to report having experienced childhood maltreatment than controls. They also report greater family dysfunction. © Copyright 2012 Physicians Postgraduate Press, Inc.

  5. Testing the Predictive Validity and Construct of Pathological Video Game Use

    Science.gov (United States)

    Groves, Christopher L.; Gentile, Douglas; Tapscott, Ryan L.; Lynch, Paul J.

    2015-01-01

    Three studies assessed the construct of pathological video game use and tested its predictive validity. Replicating previous research, Study 1 produced evidence of convergent validity in 8th and 9th graders (N = 607) classified as pathological gamers. Study 2 replicated and extended the findings of Study 1 with college undergraduates (N = 504). Predictive validity was established in Study 3 by measuring cue reactivity to video games in college undergraduates (N = 254), such that pathological gamers were more emotionally reactive to and provided higher subjective appraisals of video games than non-pathological gamers and non-gamers. The three studies converged to show that pathological video game use seems similar to other addictions in its patterns of correlations with other constructs. Conceptual and definitional aspects of Internet Gaming Disorder are discussed. PMID:26694472

  6. Testing the Predictive Validity and Construct of Pathological Video Game Use

    Directory of Open Access Journals (Sweden)

    Christopher L. Groves

    2015-12-01

    Full Text Available Three studies assessed the construct of pathological video game use and tested its predictive validity. Replicating previous research, Study 1 produced evidence of convergent validity in 8th and 9th graders (N = 607 classified as pathological gamers. Study 2 replicated and extended the findings of Study 1 with college undergraduates (N = 504. Predictive validity was established in Study 3 by measuring cue reactivity to video games in college undergraduates (N = 254, such that pathological gamers were more emotionally reactive to and provided higher subjective appraisals of video games than non-pathological gamers and non-gamers. The three studies converged to show that pathological video game use seems similar to other addictions in its patterns of correlations with other constructs. Conceptual and definitional aspects of Internet Gaming Disorder are discussed.

  7. Testing the Predictive Validity and Construct of Pathological Video Game Use.

    Science.gov (United States)

    Groves, Christopher L; Gentile, Douglas; Tapscott, Ryan L; Lynch, Paul J

    2015-12-15

    Three studies assessed the construct of pathological video game use and tested its predictive validity. Replicating previous research, Study 1 produced evidence of convergent validity in 8th and 9th graders (N = 607) classified as pathological gamers. Study 2 replicated and extended the findings of Study 1 with college undergraduates (N = 504). Predictive validity was established in Study 3 by measuring cue reactivity to video games in college undergraduates (N = 254), such that pathological gamers were more emotionally reactive to and provided higher subjective appraisals of video games than non-pathological gamers and non-gamers. The three studies converged to show that pathological video game use seems similar to other addictions in its patterns of correlations with other constructs. Conceptual and definitional aspects of Internet Gaming Disorder are discussed.

  8. Critical shoulder angle combined with age predict five shoulder pathologies: a retrospective analysis of 1000 cases.

    Science.gov (United States)

    Heuberer, Philipp R; Plachel, Fabian; Willinger, Lukas; Moroder, Philipp; Laky, Brenda; Pauzenberger, Leo; Lomoschitz, Fritz; Anderl, Werner

    2017-06-15

    Acromial morphology has previously been defined as a risk factor for some shoulder pathologies. Yet, study results are inconclusive and not all major shoulder diseases have been sufficiently investigated. Thus, the aim of the present study was to analyze predictive value of three radiological parameters including the critical shoulder angle, acromion index, and lateral acromion angle in relationship to symptomatic patients with either cuff tear arthropathy, glenohumeral osteoarthritis, rotator cuff tear, impingement, and tendinitis calcarea. A total of 1000 patients' standardized true-anteroposterior radiographs were retrospectively assessed. Receiver-operating curve analyses and multinomial logistic regression were used to examine the association between shoulder pathologies and acromion morphology. The prediction model was derived from a development cohort and applied to a validation cohort. Prediction model's performance was statistically evaluated. The majority of radiological measurements were significantly different between shoulder pathologies, but the critical shoulder angle was an overall better parameter to predict and distinguish between the different pathologies than the acromion index or lateral acromion angle. Typical critical shoulder angle-age patterns for the different shoulder pathologies could be detected. Patients diagnosed with rotator cuff tears had the highest, whereas patients with osteoarthritis had the lowest critical shoulder angle. The youngest patients were in the tendinitis calcarea and the oldest in the cuff tear arthropathy group. The present study showed that critical shoulder angle and age, two easily assessable variables, adequately predict different shoulder pathologies in patients with shoulder complaints.

  9. Predictive value of pathological and immunohistochemical parameters for axillary lymph node metastasis in breast carcinoma

    Directory of Open Access Journals (Sweden)

    Bayrak Reyhan

    2011-03-01

    Full Text Available Abstract Background/Objective While several prognostic factors have been identified in breast carcinoma, the clinical outcome remains hard to predict for individual patients. Better predictive markers are needed to help guide difficult treatment decisions. Axillary lymph node metastasis (ALNM is one of the most important prognostic determinants in breast carcinoma; however, the reasons why tumors vary in their capability to result in axillary metastasis remain unclear. Identifying breast carcinoma patients at risk for ALNM would improve treatment planning. This study aimed to identify the factors associated with ALNM in breast carcinoma, with particular emphasis on basal-like phenotype. Methods Breast carcinoma patients (n = 210 who underwent breast conserving surgery and axillary lymph node dissection (ALND (level I and II or modified radical mastectomy were included in this study. Pathological and immunohistochemical data including individual receptor/gene status was collected for analysis. The basal phenotype status was ascertained using the basal cytokeratin markers CK5, CK14, CK17 and EGFR. Results ALNM was found in 55% (n = 116 of the patients. On univariate analysis, multicentric disease, large tumor size (>2 cm, vascular and lymphatic invasion, epithelial hyperplasia, necrosis, in situ carcinoma and perineural invasion were associated with higher risk for ALNM, whereas CK5, CK14, EGFR positivity and basal-like tumor type were associated with lower risk. On multivariate analysis, CK5 positivity (OR 0.003, 95%CI 0.000-0.23, p = 0.009 and lymphatic/vascular invasion (OR 17.94, 95%CI 4.78-67.30, p Conclusions Although the value of complete ALND has been questioned in invasive breast cancer patients, treatment decisions for breast carcinoma have been influenced by many parameters, including lymph node status. Since histopathologic characteristics and expression of biological markers varies among the same histologic subtypes of breast

  10. Predictive Toxicology: Current Status and Future Outlook (EBI ...

    Science.gov (United States)

    Slide presentation at the EBI-EMBL Industry Programme Workshop on Predictive Toxicology and the currently status of Computational Toxicology activities at the US EPA. Slide presentation at the EBI-EMBL Industry Programme Workshop on Predictive Toxicology and the currently status of Computational Toxicology activities at the US EPA.

  11. Artificial neural network for predicting pathological stage of clinically localized prostate cancer in a Taiwanese population

    Directory of Open Access Journals (Sweden)

    Chih-Wei Tsao

    2014-10-01

    Conclusion: ANN was superior to LR at predicting OCD in prostate cancer. Compared with the validation of current Partin Tables for the Taiwanese population, the ANN model resulted in larger AUCs and more accurate prediction of the pathologic stage of prostate cancer.

  12. Biochemical recurrence after radical prostatectomy: multiplicative interaction between surgical margin status and pathological stage.

    Science.gov (United States)

    Budäus, Lars; Isbarn, Hendrik; Eichelberg, Christian; Lughezzani, Giovanni; Sun, Maxine; Perrotte, Paul; Chun, Felix K H; Salomon, Georg; Steuber, Thomas; Köllermann, Jens; Sauter, Guido; Ahyai, Sascha A; Zacharias, Mario; Fisch, Margit; Schlomm, Thorsten; Haese, Alexander; Heinzer, Hans; Huland, Hartwig; Montorsi, Francesco; Graefen, Markus; Karakiewicz, Pierre I

    2010-10-01

    A positive surgical margin after radical prostatectomy is considered an adverse prognostic feature. However, few groups have explored the potential interaction between surgical margin status and other cancer characteristics, specifically pathological stage. We addressed the first degree of interaction between positive surgical margins and other established adverse predictors of biochemical recurrence after radical prostatectomy. We used univariate and multivariate analysis to test the effect of surgical margin status on biochemical recurrence in 4,490 patients treated at a single institution between 1992 and 2008. We systematically tested all first-degree interactions between surgical margin status, and pretreatment prostate specific antigen, pT and pN stage, and radical prostatectomy Gleason sum. If interactions were significant, we quantified the effect on the biochemical recurrence rate. Overall 850 patients (18.9%) had positive surgical margins. In those with negative vs positive surgical margins the 5-year biochemical recurrence-free survival rate was 95% vs 83%, 74% vs 62% and 47% vs 29% for pT2, pT3a and pT3b disease, respectively. In multivariate models only the pT stage-surgical margin status interaction achieved independent predictor status (p = 0.003). Negative vs positive surgical margin multivariate HRs were 1 vs 2.9, 2.3 vs 4.3 and 4.1 vs 5.6 in pT2, pT3a and pT3b cases, respectively. Compared to negative surgical margins, positive surgical margins increase the absolute biochemical recurrence 5-year rate by 12% to 18%. More importantly, positive surgical margins may substantially worsen the prognosis beyond that of the original pathological disease stage. Copyright © 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  13. Molecular pathology in adult gliomas: diagnostic, prognostic, and predictive markers.

    LENUS (Irish Health Repository)

    Jansen, Michael

    2010-07-01

    Over the past 10 years, there has been an increasing use of molecular markers in the assessment and management of adult malignant gliomas. Some molecular signatures are used diagnostically to help pathologists classify tumours, whereas others are used to estimate prognosis for patients. Most crucial, however, are those markers that are used to predict response to certain therapies, thereby directing clinicians to a particular treatment while avoiding other potentially deleterious therapies. Recently, large-scale genome-wide surveys have been used to identify new biomarkers that have been rapidly developed as diagnostic and prognostic tools. Given these developments, the pace of discovery of new molecular assays will quicken to facilitate personalised medicine in the setting of malignant glioma.

  14. Metabolic response at repeat PET/CT predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gillies, R.S. [Oxford Cancer and Haematology Centre, Department of Oncology, Oxford (United Kingdom); Oxford Cancer and Haematology Centre, Department of Oesophagogastric Surgery, Oxford (United Kingdom); NIHR Biomedical Research Centre, Oxford (United Kingdom); Middleton, M.R. [Oxford Cancer and Haematology Centre, Department of Oncology, Oxford (United Kingdom); NIHR Biomedical Research Centre, Oxford (United Kingdom); Blesing, C.; Patel, K.; Warner, N. [Oxford Cancer and Haematology Centre, Department of Oncology, Oxford (United Kingdom); Marshall, R.E.K.; Maynard, N.D. [Oxford Cancer and Haematology Centre, Department of Oesophagogastric Surgery, Oxford (United Kingdom); Bradley, K.M. [Oxford Cancer and Haematology Centre, Department of Radiology, Oxford (United Kingdom); Gleeson, F.V. [Oxford Cancer and Haematology Centre, Department of Radiology, Oxford (United Kingdom); NIHR Biomedical Research Centre, Oxford (United Kingdom)

    2012-09-15

    Reports have suggested that a reduction in tumour 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) examination during or after neoadjuvant chemotherapy may predict pathological response in oesophageal cancer. Our aim was to determine whether metabolic response predicts pathological response to a standardised neoadjuvant chemotherapy regimen within a prospective clinical trial. Consecutive patients staged with potentially curable oesophageal cancer who underwent treatment within a non-randomised clinical trial were included. A standardised chemotherapy regimen (two cycles of oxaliplatin and 5-fluorouracil) was used. PET/CT was performed before chemotherapy and repeated 24-28 days after the start of cycle 2. Forty-eight subjects were included: mean age 65 years; 37 male. Using the median percentage reduction in SUV{sub max} (42%) to define metabolic response, pathological response was seen in 71% of metabolic responders (17/24) compared with 33% of non-responders (8/24; P = 0.009, sensitivity 68%, specificity 70%). Pathological response was seen in 81% of subjects with a complete metabolic response (13/16) compared with 38% of those with a less than complete response (12/32; P = 0.0042, sensitivity 52%, specificity 87%). There was no significant histology-based effect. There was a significant association between metabolic response and pathological response; however, accuracy in predicting pathological response was relatively low. (orig.)

  15. Predictive Diagnostic Pathology in the Target Therapy Era in Breast Cancer.

    Science.gov (United States)

    Marchio, Caterina; Balmativola, Davide; Castiglione, Roberta; Annaratone, Laura; Sapino, Anna

    2017-01-01

    Treatment strategies in oncology are nowadays largely based on the "target therapy model", which allows to personalize the cure of each patient depending on distinctive host and disease features. As a general concept "targeted drugs" are effective only when the tumor exhibits the "target", which in breast cancer pathology may correspond to the expression of estrogen receptors and/or of HER2. These biomarkers are evaluated on breast cancer tissues by companion diagnostic tests, however, evidence suggests that the first step in breast cancer predictive pathology is still represented by morphology. For instance, histological types, such as tubular and cribriform carcinomas, define patients who may not need any treatments other than surgical excision. Neoadjuvant studies have shown that patients affected by lobular carcinomas are not likely to have any beneficial effects from chemotherapy. The second step in prediction is represented by immunophenotyping. If the immunohistochemical evaluation of four markers (estrogen and progesterone receptors, HER2 and Ki67) remains the best practice for breast cancer predictive pathology, molecular pathology has certainly reshaped the way we approach breast cancer diagnosis. The aim of this review is to discuss current knowledge in predictive pathology for the management of breast cancer patients, focusing on the benefits and drawbacks of traditional tools and of novel improvements of molecular biology.

  16. [Total PSA, PSA density and biopsy Gleason score in predicting the pathologic stage of prostate cancer].

    Science.gov (United States)

    Liu, Shuai; Lü, Jia-ju; Fu, Qiang; Zhang, Hui; Gao, De-xuan; Liu, Zheng

    2010-05-01

    To evaluate the roles of total prostate specific antigen (tPSA), PSA density (PSAD) and biopsy Gleason score in predicting the pathologic stage of prostate cancer. We retrospectively analyzed the clinical data of 124 cases of pathologically confirmed prostate adenocarcinoma, and divided them into Groups A (n=48) and B (n=76) based on the results of bone scanning, CT, MRI, tPSA, PSAD and postoperative biopsy Gleason score, the former with extraprostatic infiltration or distant metastasis, while the latter without. We compared the above parameters between the two groups, screened the main factors that influenced the pathologic staging of prostate cancer by multivariate logistic regression analysis, and appraised the value of each of the parameters in predicting the pathologic stage of prostate cancer with a relative operating characteristic (ROC) curve. The tPSA level and biopsy Gleason score were significantly higher in Group A than in B (P Gleason score had a better predicting value than other parameters (Gleason score + tPSA > tPSA > PSAD + tPSA + Gleason score). Total PSA remains a valuable predictor of the pathologic stage of prostate cancer, and its combination with Gleason score can further improve the predictive accuracy and contribute much to the treatment and prognosis of the disease.

  17. Clinical and pathologic presentation in Parkinson’s disease by Apolipoprotein e4 allele status

    Science.gov (United States)

    Besser, Lilah M; Heller, Katherine B; Checkoway, Harvey; Litvan, Irene; Kukull, Walter A

    2014-01-01

    Background Apolipoprotein (APOE) e4 allele status has been linked to clinical presentation and progression in Alzheimer’s disease; however, evidence for a role of APOE e4 in Parkinson’s disease (PD) remains largely inconclusive. In this analysis we explored potential significant associations between APOE e4 allele status and characteristics of clinical presentation in patients with PD. Methods Data came from 424 subjects evaluated using the Uniform Data Set (UDS) assessment collected by the National Alzheimer’s Coordinating Center. Subjects had a known year of diagnosis of PD and experienced change in motor function prior to any change in cognition. Linear and logistic regression were used to model the association between APOE e4 carrier status and clinical characteristics including measures of cognitive decline and motor and neuropsychiatric symptoms. Amyloid burden was also evaluated for a subset of patients who died and consented to autopsy. Results Odds of dementia were higher in APOE e4 carriers (OR=5.15), and, on average, APOE e4 carriers scored two points worse on tests of episodic memory and the Clinical Dementia Rating Sum of Boxes assessment. There was little evidence to support an association between e4 carrier status and severity of motor features, and, of the four neuropsychiatric symptoms evaluated, only presence of hallucinations was significantly associated with APOE e4 carrier status (OR=5.29). Neuropathology data revealed higher frequencies of neuritic and diffuse amyloid plaques in APOE e4 carriers compared to non-carriers. Conclusions APOE e4 allele status is associated with dementia and severity of Alzheimer’s disease pathologic features in PD. PMID:24582705

  18. ProstaWeb: an online tool for predicting prostatic pathologies from Primary Care consultations.

    Directory of Open Access Journals (Sweden)

    Francisco J. Pérez-Gil

    2017-04-01

    Full Text Available Objective: To develop a tool to support and aid the diagnosis of prostate pathologies. Method: The database provided by a previous research project in which anthropometric, clinical and analytical variables are related to the development of predictive statistics algorithms that provide the probability of having a prostate or other pathology. Results: A diagnostic tool that performs with some precision the probability of having a prostatic pathology or another depending on the variables that the patient includes. Conclusions: Prostaweb is a useful and practical prostate diagnosis tool for the primary care physician. Although the hit rate is considerably high, it would still be necessary to construct models with more refined variables and perhaps with a larger number of patients, to increase the precision of the predictions. "

  19. Personality Pathology Predicts Outcomes in a Treatment-Seeking Sample with Bipolar I Disorder

    Directory of Open Access Journals (Sweden)

    Susan J. Wenze

    2014-01-01

    Full Text Available We conducted a secondary analysis of data from a clinical trial to explore the relationship between degree of personality disorder (PD pathology (i.e., number of subthreshold and threshold PD symptoms and mood and functioning outcomes in Bipolar I Disorder (BD-I. Ninety-two participants completed baseline mood and functioning assessments and then underwent 4 months of treatment for an index manic, mixed, or depressed phase acute episode. Additional assessments occurred over a 28-month follow-up period. PD pathology did not predict psychosocial functioning or manic symptoms at 4 or 28 months. However, it did predict depressive symptoms at both timepoints, as well as percent time symptomatic. Clusters A and C pathology were most strongly associated with depression. Our findings fit with the literature highlighting the negative repercussions of PD pathology on a range of outcomes in mood disorders. This study builds upon previous research, which has largely focused on major depression and which has primarily taken a categorical approach to examining PD pathology in BD.

  20. Predictions of the pathological response to neoadjuvant chemotherapy in patients with primary breast cancer using a data mining technique.

    Science.gov (United States)

    Takada, M; Sugimoto, M; Ohno, S; Kuroi, K; Sato, N; Bando, H; Masuda, N; Iwata, H; Kondo, M; Sasano, H; Chow, L W C; Inamoto, T; Naito, Y; Tomita, M; Toi, M

    2012-07-01

    Nomogram, a standard technique that utilizes multiple characteristics to predict efficacy of treatment and likelihood of a specific status of an individual patient, has been used for prediction of response to neoadjuvant chemotherapy (NAC) in breast cancer patients. The aim of this study was to develop a novel computational technique to predict the pathological complete response (pCR) to NAC in primary breast cancer patients. A mathematical model using alternating decision trees, an epigone of decision tree, was developed using 28 clinicopathological variables that were retrospectively collected from patients treated with NAC (n = 150), and validated using an independent dataset from a randomized controlled trial (n = 173). The model selected 15 variables to predict the pCR with yielding area under the receiver operating characteristics curve (AUC) values of 0.766 [95 % confidence interval (CI)], 0.671-0.861, P value analysis, revealed that the developed model was insensitive to missing values and also tolerant to distribution bias among the datasets. Our model based on clinicopathological variables showed high predictive ability for pCR. This model might improve the prediction of the response to NAC in primary breast cancer patients.

  1. Establishment of the European College of Veterinary Clinical Pathology (ECVCP) and the current status of veterinary clinical pathology in Europe

    DEFF Research Database (Denmark)

    O'Brien, P.J.; Fournel-Fleury, C.; Bolliger, Adrian Marc

    2007-01-01

    After 5 years of development, the European College of Veterinary Clinical Pathology (ECVCP)was formally recognized and approved on July 4, 2007 by the European Board of Veterinary Specialisation (EBVS), the European regulatory body that oversees specialization in veterinary medicine and which has...... approved 23 colleges. The objectives, committees, basis for membership, constitution, bylaws, information brochure and certifying examination of the ECVCP have remained unchanged during this time except as directed by EBVS. The ECVCP declared full functionality based on the following criteria: 1...... congresses and a joint journal (with the American Society for Veterinary Clinical Pathology) for communication of scientific research and information; the College also maintains a website, a joint listserv, and a newsletter; 6) collaboration in training and continuing education with relevant colleges...

  2. Development of Web tools to predict axillary lymph node metastasis and pathological response to neoadjuvant chemotherapy in breast cancer patients.

    Science.gov (United States)

    Sugimoto, Masahiro; Takada, Masahiro; Toi, Masakazu

    2014-12-09

    Nomograms are a standard computational tool to predict the likelihood of an outcome using multiple available patient features. We have developed a more powerful data mining methodology, to predict axillary lymph node (AxLN) metastasis and response to neoadjuvant chemotherapy (NAC) in primary breast cancer patients. We developed websites to use these tools. The tools calculate the probability of AxLN metastasis (AxLN model) and pathological complete response to NAC (NAC model). As a calculation algorithm, we employed a decision tree-based prediction model known as the alternative decision tree (ADTree), which is an analog development of if-then type decision trees. An ensemble technique was used to combine multiple ADTree predictions, resulting in higher generalization abilities and robustness against missing values. The AxLN model was developed with training datasets (n=148) and test datasets (n=143), and validated using an independent cohort (n=174), yielding an area under the receiver operating characteristic curve (AUC) of 0.768. The NAC model was developed and validated with n=150 and n=173 datasets from a randomized controlled trial, yielding an AUC of 0.787. AxLN and NAC models require users to input up to 17 and 16 variables, respectively. These include pathological features, including human epidermal growth factor receptor 2 (HER2) status and imaging findings. Each input variable has an option of "unknown," to facilitate prediction for cases with missing values. The websites developed facilitate the use of these tools, and serve as a database for accumulating new datasets.

  3. Predicting changes in adjustment using repeated measures of sociometric status.

    Science.gov (United States)

    Mayeux, Lara; Bellmore, Amy D; Cillessen, Antonius H N

    2007-12-01

    The authors' goals in the study were to investigate the possible gains made by including multiple assessments of status in the prediction of change in psychosocial adjustment and to compare the effectiveness of continuous and categorical measures of peer status in predicting adjustment. The authors obtained continuous and categorical measures of status (social preference and rejected status) for 644 Grade 4 students at 3 points within 1 school year (fall, winter, and spring). The authors measured peer, teacher, and self-report indexes of social adjustment (including aggression, anxiety, and sociability) in Grades 4 and 5. Both measures of peer status at all 3 time points in Grade 4 were significant predictors of adjustment in Grade 5, controlling for Grade 4 levels, with the midyear (i.e., winter) assessment showing a slight predictive advantage over the fall and spring assessments. Children who were classified as peer rejected over multiple assessments had more social adjustment problems in the next school year than did children who were classified as peer rejected at 1 time point only. The authors discuss these findings in terms of the utility of multiple assessments of both continuous and categorical measures of peer status for predicting later outcomes.

  4. Predicting Problematic Alcohol Use with the DSM-5 Alternative Model of Personality Pathology

    Science.gov (United States)

    Creswell, Kasey G.; Bachrach, Rachel L.; Wright, Aidan G.C.; Pinto, Anthony; Ansell, Emily

    2015-01-01

    There is high comorbidity between personality disorders and alcohol use disorders, which appears related to individual differences in underlying personality dimensions of behavioral undercontrol and affective dysregulation. Very little is known about how the DSM-5 Section III trait model of personality pathology relates to alcohol problems, however, or how the strength of the relationship between personality pathology and alcohol problems changes with age and across gender. The current study examined these questions in a sample of 877 participants using the General Assessment of Personality Disorder to assess general personality dysfunction, the Personality Inventory for DSM-5 to measure specific traits, and the Alcohol Use Disorder Identification Test to assess problematic alcohol use. Results demonstrated that general personality pathology (Criterion A) was significantly related to problematic alcohol use after controlling for age and gender effects. Further, two of the five higher-order personality trait domains (Criterion B), Antagonism and Disinhibition, remained significant predictors of problematic alcohol use after accounting for the influence of general personality pathology; however, general personality pathology no longer predicted hazardous alcohol use once Antagonism and Disinhibition were added into the model. Finally, these two specific traits interacted with age, such that Antagonism was a stronger predictor of AUDIT scores among older individuals and Disinhibition was a stronger predictor of alcohol problems among younger individuals. Findings support the general validity of this new personality disorder diagnostic system and suggest important age effects in the relationship between traits and problematic alcohol use. PMID:26389625

  5. Vegetative status characteristics in children with neurological pathology on the background of undifferentiated connective tissue dysplasia

    Directory of Open Access Journals (Sweden)

    Tyazka O.V.

    2016-03-01

    Full Text Available Background. Disorders of the autonomic nervous system are the most common pathological conditions detected in 20% - 85% of children and adolescents according to different authors' data. Assessment of the vegetative status in the period of intensive growth and differentiation of organs and tissues that is characteristic of childhood is of great practical importance. Identification of vegetative dysregulation is an important diagnostic measure in children's health status evaluation especially in patients with undifferentiated connective tissue dysplasia (UNDCT taking into account its genetic determinism and debut in childhood. Genetically determined biochemical disorders in the connective tissue followed by formation of characteristic pathological substrates cause dysregulation of sympathoadrenal system and correlate with UNDCT severity degree. Material and methods. There were 100 children aged from 5 to 16 years engaged in the investigation. All of them were treated in the neurological department of the City clinical hospital №4. All patients were divided into two groups: basic group, which included 50 children with neurological disorders and UNDC, and control one, which consisted of 50 children with neurological disorders without UNDCT. The survey included obstetric history analysis, anthropometry to determine the ratio of longitudinal and transverse dimensions (the index of Vervica; clinical and neurological examination (study of reflex&motor areas, sensory function, coordination; laboratory methods (clinical blood count and biochemical blood tests to determine the level of potassium and calcium ions, instrumental methods (electroencephalography, rheoencephalography, magnetic resonance imaging of the brain. Osokina's table was used for baseline autonomic tone assessment. The evaluation was conducted by counting the number of signs. Subsequently was performed the summation of the scores with the determination of the percentage of predominant

  6. Do prior knowledge, personality and visual perceptual ability predict student performance in microscopic pathology?

    Science.gov (United States)

    Helle, Laura; Nivala, Markus; Kronqvist, Pauliina; Ericsson, K Anders; Lehtinen, Erno

    2010-06-01

    OBJECTIVES There has been long-standing controversy regarding aptitude testing and selection for medical education. Visual perception is considered particularly important for detecting signs of disease as part of diagnostic procedures in, for example, microscopic pathology, radiology and dermatology and as a component of perceptual motor skills in medical procedures such as surgery. In 1968 the Perceptual Ability Test (PAT) was introduced in dental education. The aim of the present pilot study was to explore possible predictors of performance in diagnostic classification based on microscopic observation in the context of an undergraduate pathology course. METHODS A pre- and post-test of diagnostic classification performance, test of visual perceptual skill (Test of Visual Perceptual Skills, 3rd edition [TVPS-3]) and a self-report instrument of personality (Big Five Personality Inventory) were administered. In addition, data on academic performance (performance in histology and cell biology, a compulsory course taken the previous year, in addition to performance on the microscopy examination and final examination) were collected. RESULTS The results indicated that one personality factor (Conscientiousness) and one element of visual perceptual ability (spatial relationship awareness) predicted performance on the pre-test. The only factor to predict performance on the post-test was performance on the pre-test. Similarly, the microscopy examination score was predicted by the pre-test score, in addition to the histology and cell biology grade. The course examination score was predicted by two personality factors (Conscientiousness and lack of Openness) and the histology and cell biology grade. CONCLUSIONS Visual spatial ability may be related to performance in the initial phase of training in microscopic pathology. However, from a practical point of view, medical students are able to learn basic microscopic pathology using worked-out examples, independently of measures

  7. Key molecular pathways affected by glaucoma pathology: is predictive diagnosis possible?

    OpenAIRE

    Golubnitschaja, Olga; Yeghiazaryan, Kristina; Flammer, Josef

    2010-01-01

    Prediction and prevention of glaucoma. Neurodegenerative eye disease glaucoma is the second leading cause of blindness with estimated 67 million patients worldwide. Molecular pathomechanisms of glaucoma demonstrate both a considerable overlap with and remarkable particularities compared to other neurodegenerative disorders e.g. Alzheimer’s disease. Identification of pathology-specific biomarker-sets is essential to develop advanced diagnostic approaches and personalised patients’ treatment. S...

  8. Artificial neural network for predicting pathological stage of clinically localized prostate cancer in a Taiwanese population.

    Science.gov (United States)

    Tsao, Chih-Wei; Liu, Ching-Yu; Cha, Tai-Lung; Wu, Sheng-Tang; Sun, Guang-Huan; Yu, Dah-Shyong; Chen, Hong-I; Chang, Sun-Yran; Chen, Shih-Chang; Hsu, Chien-Yeh

    2014-10-01

    We developed an artificial neural network (ANN) model to predict prostate cancer pathological staging in patients prior to when they received radical prostatectomy as this is more effective than logistic regression (LR), or combined use of age, prostate-specific antigen (PSA), body mass index (BMI), digital rectal examination (DRE), trans-rectal ultrasound (TRUS), biopsy Gleason sum, and primary biopsy Gleason grade. Our study evaluated 299 patients undergoing retro-pubic radical prostatectomy or robotic-assisted laparoscopic radical prostatectomy surgical procedures with pelvic lymph node dissection. The results were intended to predict the pathological stage of prostate cancer (T2 or T3) after radical surgery. The predictive ability of ANN was compared with LR and validation of the 2007 Partin Tables was estimated by the areas under the receiving operating characteristic curve (AUCs). Of the 299 patients we evaluated, 109 (36.45%) displayed prostate cancer with extra-capsular extension (ECE), and 190 (63.55%) displayed organ-confined disease (OCD). LR analysis showed that only PSA and BMI were statistically significant predictors of prostate cancer with capsule invasion. Overall, ANN outperformed LR significantly (0.795 ± 0.023 versus 0.746 ± 0.025, p = 0.016). Validation using the current Partin Tables for the participants of our study was assessed, and the predictive capacity of AUC for OCD was 0.695. ANN was superior to LR at predicting OCD in prostate cancer. Compared with the validation of current Partin Tables for the Taiwanese population, the ANN model resulted in larger AUCs and more accurate prediction of the pathologic stage of prostate cancer. Copyright © 2014. Published by Elsevier B.V.

  9. Preference for High Status Predicts Implicit Outgroup Bias among Children from Low-Status Groups

    Science.gov (United States)

    Newheiser, Anna-Kaisa; Dunham, Yarrow; Merrill, Anna; Hoosain, Leah; Olson, Kristina R.

    2014-01-01

    Whereas members of high-status racial groups show ingroup preference when attitudes are measured implicitly, members of low-status racial groups – both adults and children – typically show no bias, potentially reflecting awareness of the ingroup’s low status. We hypothesized that when status differences are especially pronounced, children from low-status groups would show an implicit outgroup bias, the strength of which might relate to attitudes toward status. We tested these predictions among 6–11-year-old Black and Coloured (i.e., multiracial) children from South Africa, a country marked by extreme status differentials among racial groups. As a measure of implicit intergroup bias, children (N=78) completed an Implicit Association Test, a speeded categorization task that assesses the relative strength of association between two target groups (in the present study, either Whites vs. Blacks or Whites vs. Coloureds) and positive versus negative evaluation. Children also completed explicit (i.e., self-report) measures of attitudes toward racial groups, as well as rich and poor people (a measure of attitudes toward status). Both groups of children showed an implicit outgroup-favoring (i.e., pro-White) bias, suggesting that children were sensitive to the extent of status differences. The only instance in which implicit pro-White bias did not emerge involved Black children’s evaluations of Whites versus Coloureds, both higher-status outgroups. Explicit preference for high status predicted implicit pro-White bias, particularly when the IAT contrasted two outgroups. The impact of status on the development of implicit and explicit intergroup bias is discussed. PMID:24219317

  10. Pathology features in Bethesda guidelines predict colorectal cancer microsatellite instability: a population-based study.

    Science.gov (United States)

    Jenkins, Mark A; Hayashi, Shinichi; O'Shea, Anne-Marie; Burgart, Lawrence J; Smyrk, Tom C; Shimizu, David; Waring, Paul M; Ruszkiewicz, Andrew R; Pollett, Aaron F; Redston, Mark; Barker, Melissa A; Baron, John A; Casey, Graham R; Dowty, James G; Giles, Graham G; Limburg, Paul; Newcomb, Polly; Young, Joanne P; Walsh, Michael D; Thibodeau, Stephen N; Lindor, Noralane M; Lemarchand, Loïc; Gallinger, Steven; Haile, Robert W; Potter, John D; Hopper, John L; Jass, Jeremy R

    2007-07-01

    The revised Bethesda guidelines for Lynch syndrome recommend microsatellite instability (MSI) testing all colorectal cancers in patients diagnosed before age 50 years and colorectal cancers diagnosed in patients between ages 50 and 59 years with particular pathology features. Our aim was to identify pathology and other features that independently predict high MSI (MSI-H). Archival tissue from 1098 population-based colorectal cancers diagnosed before age 60 years was tested for MSI. Pathology features, site, and age at diagnosis were obtained. Multiple logistic regression was performed to determine the predictive value of each feature, as measured by an odds ratio (OR), from which a scoring system (MsPath) was developed to estimate the probability a colorectal cancer is MSI-H. Fifteen percent of tumors (162) were MSI-H. Independent predictors were tumor-infiltrating lymphocytes (OR, 9.1; 95% confidence interval [CI], 5.9-14.1), proximal subsite (OR, 4.7; 95% CI, 3.1-7.3), mucinous histology (OR, 2.8; 95% CI, 1.7-4.8), poor differentiation (OR, 1.9; 95% CI, 1.2-3.1), Crohn's-like reaction (OR, 1.9; 95% CI, 1.2-2.9), and diagnosis before age 50 years (OR, 1.9; 95% CI, 1.3-2.9). MsPath score >or=1.0 had a sensitivity of 93% and a specificity of 55% for MSI-H. The probability an individual colorectal cancer is MSI-H is predicted well by the MsPath score. There is little value in testing for DNA mismatch repair loss in tumors, or for germline mismatch repair mutations, for colorectal cancers diagnosed in patients before age 60 years with an MSPath score <1 (approximately 50%). Pathology can identify almost all MSI-H colorectal cancers diagnosed before age 60 years.

  11. Accuracy of pre-operative hysteroscopic guided biopsy for predicting final pathology in uterine malignancies.

    Science.gov (United States)

    Martinelli, Fabio; Ditto, Antonino; Bogani, Giorgio; Signorelli, Mauro; Chiappa, Valentina; Lorusso, Domenica; Haeusler, Edward; Raspagliesi, Francesco

    2017-07-01

    To evaluate concordance (C) between pre-operative hysteroscopic-directed sampling and final pathology in uterine cancers. A retrospective cross-sectional evaluation of prospectively collected data of women who underwent hysterectomy for uterine malignancies and a previous hysteroscopic-guided biopsy was performed. Diagnostic concordance between pre-operative (hysteroscopic biopsy) and postoperative (uterine specimen) histology was evaluated. In endometrioid-endometrial cancers cases Kappa (k) statistics was applied to evaluate agreement for grading (G) between the preoperative and final pathology. A total 101 hysterectomies for uterine malignancies were evaluated. There were 23 non-endometrioid cancers: 7 serous (C:5/7, 71.4%); 10 carcinosarcomas (C:7/10, 70%, remaining 3 cases only epithelial component diagnosed); 3 clear cell (C:3/3, 100%); 3 sarcomas (C:3/3, 100%). In 78 cases an endometrioid endometrial cancer was found. In 63 cases there was a histological C (63/78, 80.8%) between hysteroscopic-guided biopsy and final pathology, while in 15 cases (19.2%) only hyperplasia (with/without atypia) was found preoperatively. Overall accuracy to detect endometrial cancer was 80.2%. In 50 out of 63 endometrial cancers (79.4%) grading was concordant. The overall level of agreement between preoperative and postoperative grading was "substantial" according to Kappa (k) statistics (k 0.64; 95% CI: 0.449-0.83; p biopsy and final pathology, in uterine malignancies. Moreover, hysteroscopic biopsy accurately predicted endometrial cancer in 80% of cases and "substantially" predicted histological grading. Hysteroscopic-guided uterine sampling could be a useful tool to tailor treatment in patients with uterine malignancies.

  12. Association between protocadherin 8 promoter hypermethylation and the pathological status of prostate cancer.

    Science.gov (United States)

    Zhang, Peng; Wang, Hui; Wang, Jianming; Liu, Qingzuo; Wang, Yongqiang; Feng, Fan; Shi, Lei

    2017-08-01

    Promoter hypermethylation of tumor suppressor genes has been confirmed to serve a pivotal role in tumorigenesis. Protocadherin 8 (PCDH8), a novel tumor suppressor gene, has been reported to be inactivated by promoter hypermethylation a number of cancer types, including bladder cancer and renal cell carcinoma. The aim of the present study was to investigate the occurrence of PCDH8 hypermethylation in prostate cancer and its potential as a novel biomarker of prostate cancer. The transcriptional levels of PCDH8 were examined by quantitative polymerase chain reaction (PCR) in 82 prostate cancer tissues as well as 30 prostate hyperplasia tissues, and verified the protein level by western blot analysis of representative samples. PCDH8 expression levels were found to be reduced to 0.30±0.10 in 70.7% (58/82) of prostate cancer tissues. To identify the possible reason for mRNA downregulation, the methylation status of the PCDH8 promoter was assessed in prostate cancer tissues and prostate hyperplasia tissues by methylation-specific PCR (MSP). A total of 47 prostate cancer patients who exhibited reduced PCDH8 expression (57.3%; 47/82) also showed promoter hypermethylation (47/58). None of the samples (0/30) in the benign prostate hyperplasia group were positive on MSP. Furthermore, the associations between the methylation status of the PCDH8 promoter and various clinicopathological features of prostate cancer were analyzed, revealing that the methylation status of PCDH8 was closely associated with tumor size, tumor shape (papillary/non-papillary), tumor stage and tumor grade (all P0.05). Additionally, patients with hypermethylation of the PCDH8 gene promoter had a relapse rate of 36.17% and a mortality rate of 29.79%, which were significantly higher than the hypermethylation-negative patients (Pprostate cancer may be an important marker for use in the early diagnosis and prediction of prognosis in prostate cancer.

  13. Artificial neural networks to predict presence of significant pathology in patients presenting to routine colorectal clinics.

    Science.gov (United States)

    Maslekar, S; Gardiner, A B; Monson, J R T; Duthie, G S

    2010-12-01

    Artificial neural networks (ANNs) are computer programs used to identify complex relations within data. Routine predictions of presence of colorectal pathology based on population statistics have little meaning for individual patient. This results in large number of unnecessary lower gastrointestinal endoscopies (LGEs - colonoscopies and flexible sigmoidoscopies). We aimed to develop a neural network algorithm that can accurately predict presence of significant pathology in patients attending routine outpatient clinics for gastrointestinal symptoms. Ethics approval was obtained and the study was monitored according to International Committee on Harmonisation - Good Clinical Practice (ICH-GCP) standards. Three-hundred patients undergoing LGE prospectively completed a specifically developed questionnaire, which included 40 variables based on clinical symptoms, signs, past- and family history. Complete data sets of 100 patients were used to train the ANN; the remaining data was used for internal validation. The primary output used was positive finding on LGE, including polyps, cancer, diverticular disease or colitis. For external validation, the ANN was applied to data from 50 patients in primary care and also compared with the predictions of four clinicians. Clear correlation between actual data value and ANN predictions were found (r = 0.931; P = 0.0001). The predictive accuracy of ANN was 95% in training group and 90% (95% CI 84-96) in the internal validation set and this was significantly higher than the clinical accuracy (75%). ANN also showed high accuracy in the external validation group (89%). Artificial neural networks offer the possibility of personal prediction of outcome for individual patients presenting in clinics with colorectal symptoms, making it possible to make more appropriate requests for lower gastrointestinal endoscopy. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.

  14. Leptomeningeal collateral status predicts outcome after middle cerebral artery occlusion

    DEFF Research Database (Denmark)

    Madelung, Christopher Fugl; Ovesen, C; Trampedach, C

    2017-01-01

    reperfusion therapy. MATERIALS AND METHODS: This retrospectively planned analysis was passed on prospectively collected data from 187 consecutive patients with middle cerebral artery occlusion admitted within 4.5 hours to one center and treated with intravenous thrombolysis alone (N = 126), mechanical...... thrombectomy alone (N = 5), or both (N = 56) from May 2009 to April 2014. Non-contrast CT (NCCT) and computed tomography angiography (CTA) were provided on admission and NCCT repeated at 24 hours. Collateral status was assessed based on the initial CTA. Hemorrhagic transformation was evaluated on the 24-hour...... population (P = .001). CONCLUSIONS: Leptomeningeal collateral status predicts functional outcome, mortality, and hemorrhagic transformation following middle cerebral artery occlusion....

  15. Status of research aimed at predicting structural integrity

    Energy Technology Data Exchange (ETDEWEB)

    Reuter, W.G. [Lockheed Martin Idaho Technologies Co, Idaho Falls, ID (United States)

    1997-12-31

    Considerable research has been performed throughout the world on measuring the fracture toughness of metals. The existing capability fills the need encountered when selecting materials, thermal-mechanical treatments, welding procedures, etc., but cannot predict the fracture process of structural components containing cracks. The Idaho National Engineering and Environmental Laboratory and the Massachusetts Institute of Technology have been collaborating for a number of years on developing capabilities for using fracture toughness results to predict structural integrity. Because of the high cost of fabricating and testing structural components, these studies have been limited to predicting the fracture process in specimens containing surface cracks. This paper summarizes the present status of the experimental studies of using fracture toughness data to predict crack growth initiation in specimens (structural components) containing surface cracks. These results are limited to homogeneous base materials.

  16. Comparison in decision-making between bulimia nervosa, anorexia nervosa, and healthy women: influence of mood status and pathological eating concerns.

    Science.gov (United States)

    Matsumoto, Junko; Hirano, Yoshiyuki; Numata, Noriko; Matzuzawa, Daisuke; Murano, Shunichi; Yokote, Koutaro; Iyo, Masaomi; Shimizu, Eiji; Nakazato, Michiko

    2015-01-01

    Decision-making is reported to be impaired in anorexia nervosa (AN) and bulimia nervosa (BN), but the influence of mood status, pathophysiological eating, and weight concerns on the performance of decision-making ability between AN and BN is still unclear. The aims of this study were to investigate differential impairments in the decision-making process between AN, BN, and healthy controls (HC), and secondly, to explore the role of mood status, such as anxiety, depression, pathological eating, and weight concerns, in decision-making ability. Patients suffering from AN (n = 22), BN (n = 36) and age-matched HC (n = 51) were assessed for their decision-making abilities using the Iowa Gambling Task (IGT). Self-reported questionnaires including the Eating Disorder Examination Questionnaire (EDE-Q), the Bulimia Investigatory Test, Edinburgh (BITE), the Eating Disorders Inventory, the Maudsley Obsessive-Compulsive Inventory measuring obsessive-compulsive traits, the Hospital Anxiety and Depression Scale, and the Toronto Alexithymia Scale were used to assess pathological eating concerns and attitude to feelings. Significant differences in IGT performance were observed between BN and HC. Significant negative correlation was found between IGT performance and the BITE symptom subscale in AN. In BN, there was a negative correlation between the EDE-Q weight concerns subscale and IGT performance. It was also found that increased anxiety, depression, and eating/weight concerns predicted poorer decision-making. Different patterns of association between pathological eating concerns/behaviors and performances in decision-making ability were found between AN, BN, and HC. Anxiety, depressive mood status, and eating/weight concerns were related to decision-making ability.

  17. Altered protein glycosylation predicts Alzheimer's disease and modulates its pathology in disease model Drosophila.

    Science.gov (United States)

    Frenkel-Pinter, Moran; Stempler, Shiri; Tal-Mazaki, Sharon; Losev, Yelena; Singh-Anand, Avnika; Escobar-Álvarez, Daniela; Lezmy, Jonathan; Gazit, Ehud; Ruppin, Eytan; Segal, Daniel

    2017-08-01

    The pathological hallmarks of Alzheimer's disease (AD) are pathogenic oligomers and fibrils of misfolded amyloidogenic proteins (e.g., β-amyloid and hyper-phosphorylated tau in AD), which cause progressive loss of neurons in the brain and nervous system. Although deviations from normal protein glycosylation have been documented in AD, their role in disease pathology has been barely explored. Here our analysis of available expression data sets indicates that many glycosylation-related genes are differentially expressed in brains of AD patients compared with healthy controls. The robust differences found enabled us to predict the occurrence of AD with remarkable accuracy in a test cohort and identify a set of key genes whose expression determines this classification. We then studied in vivo the effect of reducing expression of homologs of 6 of these genes in transgenic Drosophila overexpressing human tau, a well-established invertebrate AD model. These experiments have led to the identification of glycosylation genes that may augment or ameliorate tauopathy phenotypes. Our results indicate that OstDelta, l(2)not and beta4GalT7 are tauopathy suppressors, whereas pgnat5 and CG33303 are enhancers, of tauopathy. These results suggest that specific alterations in protein glycosylation may play a causal role in AD etiology. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Lesion size on prostate magnetic resonance imaging predicts adverse radical prostatectomy pathology.

    Science.gov (United States)

    Tonttila, Panu P; Kuisma, Mari; Pääkkö, Eija; Hirvikoski, Pasi; Vaarala, Markku H

    2018-01-01

    To investigate the value of the maximal lesion diameter on preoperative multiparametric/bi-parametric magnetic resonance imaging for estimating the risk of adverse radical prostatectomy pathology. Consecutive patients (n = 162) with prostate multiparametric or biparametric magnetic resonance images acquired before prostatectomy were retrospectively stratified into two groups: 65 patients with normal MRI (n = 18) or a suspicious lesion lesion diameter ≥15 mm. The presence of extraprostatic extension, margin positivity, seminal vesicle invasion, and lymph node metastasis was examined in these groups using logistic regression analysis, including preoperative clinical parameters (prostate-specific antigen concentration, biopsy Gleason grade group, clinical T-stage, and D'Amico risk group). The prevalence of extraprostatic extension, margin positivity, and seminal vesicle invasion was 53.1% (86/162), 22.8% (37/162), and 17.9% (29/162), respectively. Lymphadenectomy was performed in 64 men, of whom 14 had lymph node metastasis. Lesion diameter ≥15 mm strongly predicted extraprostatic extension (Odds ratio: 7.94, 95% confidence interval: 3.87-16.28, p Lesion diameter ≥15 mm was an independent risk factor for adverse prostatectomy pathology. Lesion diameter ≥20 mm, but not ≥15 mm, was a significant risk factor for lymph node metastasis. Magnetic resonance imaging lesion diameter ≥15 mm is an independent risk factor for extraprostatic extension, margin positivity and seminal vesicle invasion.

  19. In vitro simulation of pathological bone conditions to predict clinical outcome of bone tissue engineered materials

    Science.gov (United States)

    Nguyen, Duong Thuy Thi

    According to the Centers for Disease Control, the geriatric population of ≥65 years of age will increase to 51.5 million in 2020; 40% of white women and 13% of white men will be at risk for fragility fractures or fractures sustained under normal stress and loading conditions due to bone disease, leading to hospitalization and surgical treatment. Fracture management strategies can be divided into pharmaceutical therapy, surgical intervention, and tissue regeneration for fracture prevention, fracture stabilization, and fracture site regeneration, respectively. However, these strategies fail to accommodate the pathological nature of fragility fractures, leading to unwanted side effects, implant failures, and non-unions. Compromised innate bone healing reactions of patients with bone diseases are exacerbated with protective bone therapy. Once these patients sustain a fracture, bone healing is a challenge, especially when fracture stabilization is unsuccessful. Traditional stabilizing screw and plate systems were designed with emphasis on bone mechanics rather than biology. Bone grafts are often used with fixation devices to provide skeletal continuity at the fracture gap. Current bone grafts include autologous bone tissue and donor bone tissue; however, the quality and quantity demanded by fragility fractures sustained by high-risk geriatric patients and patients with bone diseases are not met. Consequently, bone tissue engineering strategies are advancing towards functionalized bone substitutes to provide fracture reconstruction while effectively mediating bone healing in normal and diseased fracture environments. In order to target fragility fractures, fracture management strategies should be tailored to allow bone regeneration and fracture stabilization with bioactive bone substitutes designed for the pathological environment. The clinical outcome of these materials must be predictable within various disease environments. Initial development of a targeted

  20. Prediction of Pathological Stage in Patients with Prostate Cancer: A Neuro-Fuzzy Model.

    Directory of Open Access Journals (Sweden)

    Georgina Cosma

    Full Text Available The prediction of cancer staging in prostate cancer is a process for estimating the likelihood that the cancer has spread before treatment is given to the patient. Although important for determining the most suitable treatment and optimal management strategy for patients, staging continues to present significant challenges to clinicians. Clinical test results such as the pre-treatment Prostate-Specific Antigen (PSA level, the biopsy most common tumor pattern (Primary Gleason pattern and the second most common tumor pattern (Secondary Gleason pattern in tissue biopsies, and the clinical T stage can be used by clinicians to predict the pathological stage of cancer. However, not every patient will return abnormal results in all tests. This significantly influences the capacity to effectively predict the stage of prostate cancer. Herein we have developed a neuro-fuzzy computational intelligence model for classifying and predicting the likelihood of a patient having Organ-Confined Disease (OCD or Extra-Prostatic Disease (ED using a prostate cancer patient dataset obtained from The Cancer Genome Atlas (TCGA Research Network. The system input consisted of the following variables: Primary and Secondary Gleason biopsy patterns, PSA levels, age at diagnosis, and clinical T stage. The performance of the neuro-fuzzy system was compared to other computational intelligence based approaches, namely the Artificial Neural Network, Fuzzy C-Means, Support Vector Machine, the Naive Bayes classifiers, and also the AJCC pTNM Staging Nomogram which is commonly used by clinicians. A comparison of the optimal Receiver Operating Characteristic (ROC points that were identified using these approaches, revealed that the neuro-fuzzy system, at its optimal point, returns the largest Area Under the ROC Curve (AUC, with a low number of false positives (FPR = 0.274, TPR = 0.789, AUC = 0.812. The proposed approach is also an improvement over the AJCC pTNM Staging Nomogram (FPR

  1. Relapse in pathological gamblers: A pilot study on the predictive value of different impulsivity measures

    NARCIS (Netherlands)

    Wilde, B. de; Goudriaan, A.E.; Sabbe, B.G.C.; Hulstijn, W.; Dom, G.

    2013-01-01

    Backgrounds and aims: Pathological gambling, a common psychiatric disorder, has many similarities with substance use disorders. Relapse, an important element in addictive disorders, however, has seldom been studied in pathological gambling. Hence, in analogy with previous research studies examining

  2. Pathological features of lymph node metastasis for predicting biochemical recurrence after radical prostatectomy for prostate cancer.

    Science.gov (United States)

    Carlsson, Sigrid V; Tafe, Laura J; Chade, Daher C; Sjoberg, Daniel D; Passoni, Niccolo; Shariat, Shahrokh F; Eastham, James; Scardino, Peter T; Fine, Samson W; Touijer, Karim A

    2013-04-01

    Subclassification of nodal stage may have prognostic value in men with lymph node metastasis at radical prostatectomy. We explored the role of extranodal extension, size of the largest metastatic lymph node and the largest metastasis, and lymph node density as predictors of biochemical recurrence. We reviewed pathological material from 261 patients with node positive prostate cancer. We examined the predictive value when adding the additional pathology findings to a base model including extraprostatic extension, seminal vesicle invasion, radical prostatectomy Gleason score, prostate specific antigen and number of positive lymph nodes using the Cox proportional hazards regression and Harrell concordance index. The median number of lymph nodes removed was 14 (IQR 9, 20) and the median number of positive lymph nodes was 1 (IQR 1, 2). At a median followup of 4.6 years (IQR 3.2, 6.0) 155 of 261 patients experienced biochemical recurrence. The mean 5-year biochemical recurrence-free survival rate was 39% (95% CI 33-46). Median diameter of the largest metastatic lymph node was 9 mm (IQR 5, 16). On Cox regression radical prostatectomy specimen Gleason score (greater than 7 vs 7 or less), number of positive lymph nodes (3 or greater vs 1 or 2), seminal vesicle invasion and prostate specific antigen were associated with significantly increased risks of biochemical recurrence. On subset analysis metastasis size significantly improved model discrimination (base model Harrell concordance index 0.700 vs 0.655, p = 0.032). Our study confirms that the number of positive lymph nodes is a predictor of biochemical recurrence in men with node positive disease. The improvement in prognostic value of measuring the metastatic focus warrants further investigation. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Functional proteomics can define prognosis and predict pathologic complete response in patients with breast cancer

    Directory of Open Access Journals (Sweden)

    Gonzalez-Angulo Ana M

    2011-07-01

    Full Text Available Abstract Purpose To determine whether functional proteomics improves breast cancer classification and prognostication and can predict pathological complete response (pCR in patients receiving neoadjuvant taxane and anthracycline-taxane-based systemic therapy (NST. Methods Reverse phase protein array (RPPA using 146 antibodies to proteins relevant to breast cancer was applied to three independent tumor sets. Supervised clustering to identify subgroups and prognosis in surgical excision specimens from a training set (n = 712 was validated on a test set (n = 168 in two cohorts of patients with primary breast cancer. A score was constructed using ordinal logistic regression to quantify the probability of recurrence in the training set and tested in the test set. The score was then evaluated on 132 FNA biopsies of patients treated with NST to determine ability to predict pCR. Results Six breast cancer subgroups were identified by a 10-protein biomarker panel in the 712 tumor training set. They were associated with different recurrence-free survival (RFS (log-rank p = 8.8 E-10. The structure and ability of the six subgroups to predict RFS was confirmed in the test set (log-rank p = 0.0013. A prognosis score constructed using the 10 proteins in the training set was associated with RFS in both training and test sets (p = 3.2E-13, for test set. There was a significant association between the prognostic score and likelihood of pCR to NST in the FNA set (p = 0.0021. Conclusion We developed a 10-protein biomarker panel that classifies breast cancer into prognostic groups that may have potential utility in the management of patients who receive anthracycline-taxane-based NST.

  4. MicroRNA-31 Emerges as a Predictive Biomarker of Pathological Response and Outcome in Locally Advanced Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Cristina Caramés

    2016-06-01

    Full Text Available Neoadjuvant chemoradiotherapy (CRT followed by total mesorectal excision has emerged as the standard treatment for locally advanced rectal cancer (LARC patients. However, many cases do not respond to neoadjuvant CRT, suffering unnecessary toxicities and surgery delays. Thus, identification of predictive biomarkers for neoadjuvant CRT is a current clinical need. In the present study, microRNA-31 expression was measured in formalin-fixed paraffin-embedded (FFPE biopsies from 78 patients diagnosed with LARC who were treated with neoadjuvant CRT. Then, the obtained results were correlated with clinical and pathological characteristics and outcome. High microRNA-31 (miR-31 levels were found overexpressed in 34.2% of cases. Its overexpression significantly predicted poor pathological response (p = 0.018 and worse overall survival (OS (p = 0.008. The odds ratio for no pathological response among patients with miR-31 overexpression was 0.18 (Confidence Interval = 0.06 to 0.57; p = 0.003. Multivariate analysis corroborated the clinical impact of miR-31 in determining pathological response to neoadjuvant CRT as well as OS. Altogether, miR-31 quantification emerges as a novel valuable clinical tool to predict both pathological response and outcome in LARC patients.

  5. Computational modelling of traumatic brain injury predicts the location of chronic traumatic encephalopathy pathology.

    Science.gov (United States)

    Ghajari, Mazdak; Hellyer, Peter J; Sharp, David J

    2017-02-01

    Traumatic brain injury can lead to the neurodegenerative disease chronic traumatic encephalopathy. This condition has a clear neuropathological definition but the relationship between the initial head impact and the pattern of progressive brain pathology is poorly understood. We test the hypothesis that mechanical strain and strain rate are greatest in sulci, where neuropathology is prominently seen in chronic traumatic encephalopathy, and whether human neuroimaging observations converge with computational predictions. Three distinct types of injury were simulated. Chronic traumatic encephalopathy can occur after sporting injuries, so we studied a helmet-to-helmet impact in an American football game. In addition, we investigated an occipital head impact due to a fall from ground level and a helmeted head impact in a road traffic accident involving a motorcycle and a car. A high fidelity 3D computational model of brain injury biomechanics was developed and the contours of strain and strain rate at the grey matter-white matter boundary were mapped. Diffusion tensor imaging abnormalities in a cohort of 97 traumatic brain injury patients were also mapped at the grey matter-white matter boundary. Fifty-one healthy subjects served as controls. The computational models predicted large strain most prominent at the depths of sulci. The volume fraction of sulcal regions exceeding brain injury thresholds were significantly larger than that of gyral regions. Strain and strain rates were highest for the road traffic accident and sporting injury. Strain was greater in the sulci for all injury types, but strain rate was greater only in the road traffic and sporting injuries. Diffusion tensor imaging showed converging imaging abnormalities within sulcal regions with a significant decrease in fractional anisotropy in the patient group compared to controls within the sulci. Our results show that brain tissue deformation induced by head impact loading is greatest in sulcal locations

  6. Prostate MRI prior to radical prostatectomy: effects on nerve sparing and pathological margin status

    Directory of Open Access Journals (Sweden)

    Druskin SC

    2017-04-01

    Full Text Available Sasha C Druskin,1 Jen-Jane Liu,2 Allen Young,1 Zhaoyong Feng,1 Seyed S Dianat,3 Wesley W Ludwig,1 Bruce J Trock,1 Katarzyna J Macura,4 Christian P Pavlovich1 1The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, 2Department of Urology, Oregon Health and Science University, Portland, OR, 3Department of Radiology, University of Minnesota Twin Cities, Minneapolis, MN, 4Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Objectives: The aim of this study was to assess the positive surgical margin (PSM and nerve sparing (NS rates in patients who underwent prostate MRI (pMRI prior to radical prostatectomy (RP and compare them with matched, nonimaged control RP patients. Methods: We identified 204 men who underwent preoperative pelvic MRI (pelMRI, of whom 176 (86.3% underwent pMRIs, within 60 days of RP, and compared them (1:1 with a nonimaged control group matched by surgeon, age, race, body mass index (BMI, prostate-specific antigen (PSA, pathological Gleason score, prostate specimen weight, and RP year. Results: The rates of nonfocal extracapsular extension (nfECE on RP pathology in the MRI and control groups were similar. PSM rates were lower in the MRI group (13.7% vs 19.3%; P=0.14, but the difference did not meet statistical significance; this was also the case in patients with nfECE on RP pathology (27.7% vs 39.5%; P=0.3. NS rates were similar between groups. In the MRI group, 54 (26.5% patients had an MRI suspicious for nfECE; their PSM rate (20.4% was higher than that of patients with an MRI not suspicious for nfECE (11.3%; P=0.11, but the difference lacked statistical significance; the former group had significantly lower rates of NS. Limitations of the study include sample power and nonuniform heeding of MRI results by each surgeon. Conclusion: MRI did not significantly decrease the rates of

  7. A model to predict pathologic complete response of axillary lymph nodes to neoadjuvant chemo(immuno)therapy in patients with clinically node-positive breast cancer.

    Science.gov (United States)

    Schipper, Robert-Jan; Moossdorff, Martine; Nelemans, Patty J; Nieuwenhuijzen, Grard A P; de Vries, Bart; Strobbe, Luc J A; Roumen, Rudi M H; van den Berkmortel, Franchette; Tjan-Heijnen, Vivianne C G; Beets-Tan, Regina G H; Lobbes, Marc B I; Smidt, Marjolein L

    2014-10-01

    Between 20% and 42% of patients with clinically node-positive breast cancer achieve a pathologic complete response (pCR) of axillary lymph nodes after neoadjuvant chemotherapy or immunotherapy, or both, (chemo[immuno]therapy). Hypothetically, axillary lymph node dissection (ALND) may be safely omitted in these patients. This study aimed to develop a model for predicting axillary pCR in these patients. We retrospectively identified patients with clinically node-positive breast cancer who were treated with neoadjuvant chemo(immuno)therapy and ALND between 2005 and 2012 in 5 hospitals. Patient and tumor characteristics, neoadjuvant chemo(immuno)therapy regimens, and pathology reports were extracted. Binary logistic regression analysis was used to predict axillary pCR with the following variables: age, tumor stage and type, hormone receptor and human epidermal growth factor receptor 2 (HER2) status, and administration of taxane and trastuzumab. The model was internally validated by bootstrap resampling. The overall performance of the model was assessed by the Brier score and the discriminative performance by receiver operating characteristic (ROC) curve analysis. A model was developed based on 291 patients and was internally validated with a scaled Brier score of 0.14. The area under the ROC curve of this model was 0.77 (95% confidence interval [CI], 0.71-0.82). At a cutoff value of predicted probability ≥ 0.50, the model demonstrated specificity of 88%, sensitivity of 43%, positive predictive value (PPV) of 65%, and negative predictive value (NPV) of 75%. This prediction model shows reasonable accuracy for predicting axillary pCR. However, omitting axillary treatment based solely on the nomogram score is not justified. Further research is warranted to noninvasively identify patients with axillary pCR. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Language of perfectionistic parents predicting child anxiety diagnostic status.

    Science.gov (United States)

    Affrunti, Nicholas W; Geronimi, Elena M C; Woodruff-Borden, Janet

    2015-03-01

    Previous research has identified parental perfectionism as a risk factor for child anxiety. Yet few studies investigated why parental perfectionism may play such a role. Based on research suggesting parental verbal information and language use are associated with increased child fear beliefs and anxiety, the current study investigated the linguistic style of perfectionistic mothers and its relation to child anxiety. Participants were 71 mother-child dyads. Children were 3-12 years old, 57.7% female, and 30 were diagnosed with an anxiety disorder. Analyses showed that parental perfectionism was associated with increased second person pronouns, decreased adverbs, negative emotion words, and anger words. Second person pronouns and negative emotion words predicted child anxiety diagnostic status and mediated the relation between maternal perfectionism and child anxiety. These findings suggest that parental perfectionism may be associated with a specific language style that is related to child anxiety. Implications and future directions are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Socioeconomic status in one's childhood predicts offspring cardiovascular risk.

    Science.gov (United States)

    Schreier, Hannah M C; Chen, Edith

    2010-11-01

    To test whether effects of socioeconomic environments can persist across generations, we examined whether parents' childhood socioeconomic status (SES) could predict blood pressure (BP) trajectories in their youth across a 12-month study period and C-reactive protein (CRP) levels at one year follow-up. BP was assessed in 88 healthy youth (M age = 13 ± 2.4) at three study visits, each 6 months apart. CRP was also assessed in youth at baseline and one year follow-up. Parents reported on current and their own childhood SES (education and crowding). If parents' childhood SES was lower, their children displayed increasing SBP and CRP over the 12-month period, or conversely, the higher parents' childhood SES, the greater the decrease in SBP and CRP in their youth over time. These effects persisted even after controlling for current SES. A number of other factors, including child health behaviors, parent psychosocial characteristics, general family functioning, and parent physiology could not explain these effects. Our study suggests that the SES environment parents grow up in may influence physical health across generations, here, SBP and CRP in their children, and hence that intergenerational histories are important to consider in predicting cardiovascular health in youth. Copyright © 2010 Elsevier Inc. All rights reserved.

  10. Breast Cancer Pathology, Receptor Status, and Patterns of Metastasis in a Rural Appalachian Population

    Directory of Open Access Journals (Sweden)

    Linda Vona-Davis

    2014-01-01

    Full Text Available Breast cancer patients in rural Appalachia have a high prevalence of obesity and poverty, together with more triple-negative phenotypes. We reviewed clinical records for tumor receptor status and time to distant metastasis. Body mass index, tumor size, grade, nodal status, and receptor status were related to metastatic patterns. For 687 patients, 13.8% developed metastases to bone (n=42 or visceral sites (n=53. Metastases to viscera occurred within five years, a latent period which was shorter than that for bone (P=0.042. More women with visceral metastasis presented with grade 3 tumors compared with the bone and nonmetastatic groups (P=0.0002. There were 135/574 women (23.5% with triple-negative breast cancer, who presented with lymph node involvement and visceral metastases (68.2% versus 24.3%; P=0.033. Triple-negative tumors that metastasized to visceral sites were larger (P=0.007. Developing a visceral metastasis within 10 years was higher among women with triple-negative tumors. Across all breast cancer receptor subtypes, the probability of remaining distant metastasis-free was greater for brain and liver than for lung. The excess risk of metastatic spread to visceral organs in triple-negative breast cancers, even in the absence of positive nodes, was combined with the burden of larger and more advanced tumors.

  11. Magnetic resonance metabolic profiling of breast cancer tissue obtained with core needle biopsy for predicting pathologic response to neoadjuvant chemotherapy.

    Directory of Open Access Journals (Sweden)

    Ji Soo Choi

    Full Text Available The purpose of this study was to determine whether metabolic profiling of core needle biopsy (CNB samples using high-resolution magic angle spinning (HR-MAS magnetic resonance spectroscopy (MRS could be used for predicting pathologic response to neoadjuvant chemotherapy (NAC in patients with locally advanced breast cancer. After institutional review board approval and informed consent were obtained, CNB tissue samples were collected from 37 malignant lesions in 37 patients before NAC treatment. The metabolic profiling of CNB samples were performed by HR-MAS MRS. Metabolic profiles were compared according to pathologic response to NAC using the Mann-Whitney test. Multivariate analysis was performed with orthogonal projections to latent structure-discriminant analysis (OPLS-DA. Various metabolites including choline-containing compounds were identified and quantified by HR-MAS MRS in all 37 breast cancer tissue samples obtained by CNB. In univariate analysis, the metabolite concentrations and metabolic ratios of CNB samples obtained with HR-MAS MRS were not significantly different between different pathologic response groups. However, there was a trend of lower levels of phosphocholine/creatine ratio and choline-containing metabolite concentrations in the pathologic complete response group compared to the non-pathologic complete response group. In multivariate analysis, the OPLS-DA models built with HR-MAS MR metabolic profiles showed visible discrimination between the pathologic response groups. This study showed OPLS-DA multivariate analysis using metabolic profiles of pretreatment CNB samples assessed by HR- MAS MRS may be used to predict pathologic response before NAC, although we did not identify the metabolite showing statistical significance in univariate analysis. Therefore, our preliminary results raise the necessity of further study on HR-MAS MR metabolic profiling of CNB samples for a large number of cancers.

  12. Mild cognitive impairment with suspected nonamyloid pathology (SNAP) Prediction of progression

    NARCIS (Netherlands)

    Caroli, A.; Prestia, A.; Galluzzi, S.; Ferrari, C.; van der Flier, W.M.; Ossenkoppele, R.; van Berckel, B.; Barkhof, F.; Teunissen, C.; Wall, A.E.; Carter, S.F.; Scholl, M.; Choo, I.H.; Grimmer, T.; Redolfi, A.; Nordberg, A.; Scheltens, P.; Drzezga, A.; Frisoni, G. B.

    2015-01-01

    Objectives: The aim of this study was to investigate predictors of progressive cognitive deterioration in patients with suspected non-Alzheimer disease pathology (SNAP) and mild cognitive impairment (MCI). Methods: We measured markers of amyloid pathology (CSF b-amyloid 42) and neurodegeneration

  13. HER-2 overexpression/amplification in Barrett's oesophagus predicts early transition from dysplasia to adenocarcinoma: a clinico-pathologic study.

    Science.gov (United States)

    Rossi, Elisa; Grisanti, Salvatore; Villanacci, Vincenzo; Della Casa, Domenico; Cengia, Paolo; Missale, Guido; Minelli, Luigi; Buglione, Michela; Cestari, Renzo; Bassotti, Gabrio

    2009-09-01

    Barrett's oesophagus (BO) is the primary precursor lesion for oesophageal adenocarcinoma (ADC). The natural history of metaplasia-dysplasia-carcinoma sequence remains largely unknown. HER2/neu oncogene results overexpressed/amplified in preneoplastic lesions and in ADC of the oesophagus and it has been associated with poor prognosis. Our aim was to evaluate the role of HER2 overexpression/amplification in predicting the conversion from precursor lesions to ADC. We retrospectively evaluated by univariate analysis of single variables clinical records and histological specimens of 21 patients with a confirmed diagnosis of BO and/or oesophageal dysplasia. Clinical variables included age, gender, alcohol and smoking intake, presence of symptoms (pyrosis, disphagia) and endoscopic features (length). HER2 status was studied by immunohistochemistry and fluorescence in situ hybridization (FISH) on paraffin-embedded tissue. The end-points were the occurrence of progression and the time-to-progression (TTP) from the initial histologic lesion to the worst pathological pattern. Median age at diagnosis was 63 years (range 37-84). BO median length was 4.5 cm. Progression occurred in 11 of 21 patients and median TTP was 24 months. HER2 was overexpressed/amplified in 8 of 21 (38%) patients. HER2 overexpression/ amplification and the presence of dysplasia were statistically associated with progression (P= 0.038). This study provides evidence for a possible role of HER2 in the transition from dysplasia to ADC of the oesophagus. This fact could help in identifying patients at high risk of malignant transformation.

  14. Imaging and pathology features to predict axillary tumor load in breast cancer.

    Science.gov (United States)

    Nicolau, Pau; Gamero, Rocio; Rodríguez-Arana, Ana; Plancarte, Francisco; Alcántara, Rodrigo; Carreras, Ramon; Sabadell, Dolors; Vernet-Tomas, Mar

    2017-10-13

    We investigated if imaging and pathology features could help to identify a high axillary tumor burden (ATB) in breast cancer patients, in order to individualize decisions on axillary lymph node (ALN) dissection (ALND). We retrospectively analyzed patients primarily treated with surgery in our unit between 2011 and 2014. We divided the patients in two groups: low ATB (LATB) if ≤ 2 ALN were infiltrated and high ATB (HATB) if > 2 ALN were infiltrated. Data of 105 patients was included in the study. Axillary ultrasound (AUS) features associated with HATB were any sign of ALN infiltration (76 vs 24%, P = 0.027) and > 2 suspicious ALNs (73% vs 27%, P = 0.018); however, when AUS revealed ≤ 2 suspicious ALNs, 39% of these patients had HATB. Any sign of ALN infiltration on magnetic resonance imaging was associated with HATB (48% vs 52%, P = 0.031). Positive preoperative ALN cytology or biopsy was associated with HATB (53% vs 47%, P = 0.008), while p53 positivity (80% vs 20%) and high histological grade (68% vs. 32%) correlated with LATB (P = 0.05 and P = 0.02, respectively). In multivariate analysis, only positive preoperative ALN cytology or biopsy was associated with HATB (P = 0.038). AUS was useful for detecting HATB but was not as effective in patients with LATB. Proving axillary infiltration with AUS-directed cytology or biopsy is the most effective method to predict HATB. © 2017 Japan Society of Obstetrics and Gynecology.

  15. Pulmonary phospholipids in amniotic fluid of pathologic pregnancies: relationship with clinical status of the newborn.

    Science.gov (United States)

    Zapata, A; Hernandez-Garcia, J M; Grande, C; Martinez, I; Perez, J; de la Fuente, P; Usandizaga, J A

    1989-06-01

    We evaluated phospholipids, C-peptide and cortisol levels in amniotic fluid of 203 pathologic pregnancies (63, class A, B and C diabetics; 11 class D, F and H diabetics; 44 preclampsia and 85 Rh-isoimmunization); the control group was 82 normal pregnant women. There was an acceleration of fetal pulmonary maturation in women with preclampsia and severe Rh-isoimmunization in class D, F and H diabetics (at 34 weeks gestation the incidence of mature surfactant (lecithin/sphingomyelin greater than or equal to 2.7 and presence of phosphatidyl-glycerol) in these groups was 30%, 50% and 100%, respectively, while it was zero in the control group). At 37 and 38 weeks only 44.4% of the class A, B and C diabetics had mature surfactant and there was a significant difference with respect to the control group (x2 = 4.9; p less than 0.05); C-peptide levels in these diabetics (class A, B and C) were higher than in controls (p less than 0.001); in pregnant women with accelerated fetal lung maturation they were lower. We demonstrated a close relationship between fetal pulmonary maturity and the type of surfactant in amniotic fluid, which was independent of gestational age.

  16. Health and Maintenance Status Determination and Predictive Fault Diagnosis System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of this project is to demonstrate intelligent health and maintenance status determination and predictive fault diagnosis techniques for NASA rocket...

  17. Diagnostic accuracy of calculated serum osmolarity to predict dehydration in older people: adding value to pathology laboratory reports.

    Science.gov (United States)

    Hooper, Lee; Abdelhamid, Asmaa; Ali, Adam; Bunn, Diane K; Jennings, Amy; John, W Garry; Kerry, Susan; Lindner, Gregor; Pfortmueller, Carmen A; Sjöstrand, Fredrik; Walsh, Neil P; Fairweather-Tait, Susan J; Potter, John F; Hunter, Paul R; Shepstone, Lee

    2015-10-21

    To assess which osmolarity equation best predicts directly measured serum/plasma osmolality and whether its use could add value to routine blood test results through screening for dehydration in older people. Diagnostic accuracy study. Older people (≥65 years) in 5 cohorts: Dietary Strategies for Healthy Ageing in Europe (NU-AGE, living in the community), Dehydration Recognition In our Elders (DRIE, living in residential care), Fortes (admitted to acute medical care), Sjöstrand (emergency room) or Pfortmueller cohorts (hospitalised with liver cirrhosis). Directly measured serum/plasma osmolality: current dehydration (serum osmolality>300 mOsm/kg), impending/current dehydration (≥295 mOsm/kg). 39 osmolarity equations calculated using serum indices from the same blood draw as directly measured osmolality. Across 5 cohorts 595 older people were included, of whom 19% were dehydrated (directly measured osmolality>300 mOsm/kg). Of 39 osmolarity equations, 5 showed reasonable agreement with directly measured osmolality and 3 had good predictive accuracy in subgroups with diabetes and poor renal function. Two equations were characterised by narrower limits of agreement, low levels of differential bias and good diagnostic accuracy in receiver operating characteristic plots (areas under the curve>0.8). The best equation was osmolarity=1.86×(Na++K+)+1.15×glucose+urea+14 (all measured in mmol/L). It appeared useful in people aged ≥65 years with and without diabetes, poor renal function, dehydration, in men and women, with a range of ages, health, cognitive and functional status. Some commonly used osmolarity equations work poorly, and should not be used. Given costs and prevalence of dehydration in older people we suggest use of the best formula by pathology laboratories using a cutpoint of 295 mOsm/L (sensitivity 85%, specificity 59%), to report dehydration risk opportunistically when serum glucose, urea and electrolytes are measured for other reasons in

  18. Nuclear BMI-1 expression in laryngeal carcinoma correlates with lymph node pathological status

    Directory of Open Access Journals (Sweden)

    Allegra Eugenia

    2012-10-01

    Full Text Available Abstract Background The main cause of treatment failure and death in laryngeal squamous cell carcinoma is metastasis to the regional lymph nodes. The current clinical staging criteria fail to differentiate patients with occult metastasis from patients without metastasis. Identifying molecular markers of the disease might improve our understanding of the molecular mechanisms underlying the pathogenesis and development of laryngeal carcinoma and may help improve clinical staging and treatment. Methods Sixty-four previously untreated patients who underwent surgical excision of laryngeal squamous cell carcinoma with neck dissection were included in this study. The expression of B cell-specific Moloney murine leukemia virus integration site 1 (BMI-1 was examined immunohistochemically on formalin-fixed paraffin-embedded primary tissue specimens. Results Nuclear expression of BMI-1 (nBMI-1 was detected in 32 of the 64 tumors (50%, cytoplasmic expression of BMI-1 (cBMI-1 was detected in 22 (34.4%, and 10 tumors (15.6% showed no BMI-1 immunoreactivity. High nBMI-1 expression levels (≥10 were detected in 28 of the 32 (87.5% nBMI-1-positive patients. Multivariate analysis including age at diagnosis, grade, tumor location, TNM status, and nBMI-1 expression showed that a high nBMI-1 expression level was an independent prognostic factor for lymph node metastasis. Conclusion The expression of BMI-1 in patients with laryngeal carcinoma seems to correlate with lymph node metastasis.

  19. Predicting IDH mutation status in grade II gliomas using amide proton transfer-weighted (APTw) MRI.

    Science.gov (United States)

    Jiang, Shanshan; Zou, Tianyu; Eberhart, Charles G; Villalobos, Maria A V; Heo, Hye-Young; Zhang, Yi; Wang, Yu; Wang, Xianlong; Yu, Hao; Du, Yongxing; van Zijl, Peter C M; Wen, Zhibo; Zhou, Jinyuan

    2017-09-01

    To assess the amide proton transfer-weighted (APTw) MRI features of isocitrate dehydrogenase (IDH)-wildtype and IDH-mutant grade II gliomas and to test the hypothesis that the APTw signal is a surrogate imaging marker for identifying IDH mutation status preoperatively. Twenty-seven patients with pathologically confirmed low-grade glioma, who were previously scanned at 3T, were retrospectively analyzed. The Mann-Whitney test was used to evaluate relationships between APTw intensities for IDH-mutant and IDH-wildtype groups, and receiver operator characteristic (ROC) analysis was used to assess the diagnostic performance of APTw. Based on histopathology and molecular analysis, seven cases were diagnosed as IDH-wildtype grade II gliomas and 20 cases as IDH-mutant grade II gliomas. The maximum and minimum APTw values, based on multiple regions of interest, as well as the whole-tumor histogram-based mean and 50th percentile APTw values, were significantly higher in the IDH-wildtype gliomas than in the IDH-mutant groups. This corresponded to the areas under the ROC curves of 0.89, 0.76, 0.75, and 0.75, respectively, for the prediction of the IDH mutation status. IDH-wildtype lesions typically were associated with relatively high APTw signal intensities as compared with IDH-mutant lesions. The APTw signal could be a valuable imaging biomarker by which to identify IDH1 mutation status in grade II gliomas. Magn Reson Med 78:1100-1109, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  20. Comparison of five classification systems for interpreting electronic fetal monitoring in predicting neonatal status at birth.

    Science.gov (United States)

    Di Tommaso, Mariarosaria; Seravalli, Viola; Cordisco, Adalgisa; Consorti, Giada; Mecacci, Federico; Rizzello, Francesca

    2013-03-01

    To compare the accuracy of five different classification systems for interpreting electronic fetal monitoring (EFM) when predicting neonatal status at birth, as determined by the umbilical cord arterial pH. Ninety-seven cardiotocography traces were retrospectively interpreted according to five classification systems for EFM: Dublin Fetal Heart Rate Monitoring Trial (DFHRMT), Royal College of Obstetricians and Gynecologists (RCOG), Society of Obstetricians and Gynaecologists of Canada (SOGC), National Institute of Child Health and Human Development (NICHD) and Parer & Ikeda's. For each classification system, sensitivity, specificity, positive and negative predictive values were calculated. The capacity of the classifications to predict neonatal pH was also evaluated by receiver-operating characteristic (ROC) curves. Agreement between the five systems was estimated using weighted kappa statistic. Considering pH ≤7.15 as the cutoff for low pH, the sensitivity and specificity values were 100 and 18% (DFHRMT); 100 and 15% (RCOG); 88 and 37% (SOGC); 67 and 92% (NICHD); 55 and 67% (Parer & Ikeda). The ROC curves showed that all classifications analyzed had a low discriminative capacity when predicting umbilical artery pH ≤7.15. An excellent agreement was observed between DFHRMT and RCOG (weighted κ value: 0.860). Parer & Ikeda and NICHD classifications had the highest specificity in detecting umbilical cord arterial pH ≤7.15. The high specificity of the NICHD classification is hindered by a high percentage of "intermediate" traces (80%). Parer & Ikeda classification is the one that best classify as pathological only the traces of fetuses that are truly at risk of acidemia, thus avoiding unnecessary intervention. It also showed the best trade-off between sensitivity and specificity and the lowest rate of traces considered "intermediate."

  1. Development of a semi-automated method for subspecialty case distribution and prediction of intraoperative consultations in surgical pathology

    Directory of Open Access Journals (Sweden)

    Raul S Gonzalez

    2015-01-01

    Full Text Available Background: In many surgical pathology laboratories, operating room schedules are prospectively reviewed to determine specimen distribution to different subspecialty services and to predict the number and nature of potential intraoperative consultations for which prior medical records and slides require review. At our institution, such schedules were manually converted into easily interpretable, surgical pathology-friendly reports to facilitate these activities. This conversion, however, was time-consuming and arguably a non-value-added activity. Objective: Our goal was to develop a semi-automated method of generating these reports that improved their readability while taking less time to perform than the manual method. Materials and Methods: A dynamic Microsoft Excel workbook was developed to automatically convert published operating room schedules into different tabular formats. Based on the surgical procedure descriptions in the schedule, a list of linked keywords and phrases was utilized to sort cases by subspecialty and to predict potential intraoperative consultations. After two trial-and-optimization cycles, the method was incorporated into standard practice. Results: The workbook distributed cases to appropriate subspecialties and accurately predicted intraoperative requests. Users indicated that they spent 1-2 h fewer per day on this activity than before, and team members preferred the formatting of the newer reports. Comparison of the manual and semi-automatic predictions showed that the mean daily difference in predicted versus actual intraoperative consultations underwent no statistically significant changes before and after implementation for most subspecialties. Conclusions: A well-designed, lean, and simple information technology solution to determine subspecialty case distribution and prediction of intraoperative consultations in surgical pathology is approximately as accurate as the gold standard manual method and requires less

  2. Development of a semi-automated method for subspecialty case distribution and prediction of intraoperative consultations in surgical pathology.

    Science.gov (United States)

    Gonzalez, Raul S; Long, Daniel; Hameed, Omar

    2015-01-01

    In many surgical pathology laboratories, operating room schedules are prospectively reviewed to determine specimen distribution to different subspecialty services and to predict the number and nature of potential intraoperative consultations for which prior medical records and slides require review. At our institution, such schedules were manually converted into easily interpretable, surgical pathology-friendly reports to facilitate these activities. This conversion, however, was time-consuming and arguably a non-value-added activity. Our goal was to develop a semi-automated method of generating these reports that improved their readability while taking less time to perform than the manual method. A dynamic Microsoft Excel workbook was developed to automatically convert published operating room schedules into different tabular formats. Based on the surgical procedure descriptions in the schedule, a list of linked keywords and phrases was utilized to sort cases by subspecialty and to predict potential intraoperative consultations. After two trial-and-optimization cycles, the method was incorporated into standard practice. The workbook distributed cases to appropriate subspecialties and accurately predicted intraoperative requests. Users indicated that they spent 1-2 h fewer per day on this activity than before, and team members preferred the formatting of the newer reports. Comparison of the manual and semi-automatic predictions showed that the mean daily difference in predicted versus actual intraoperative consultations underwent no statistically significant changes before and after implementation for most subspecialties. A well-designed, lean, and simple information technology solution to determine subspecialty case distribution and prediction of intraoperative consultations in surgical pathology is approximately as accurate as the gold standard manual method and requires less time and effort to generate.

  3. Comparison in decision-making between bulimia nervosa, anorexia nervosa, and healthy women: influence of mood status and pathological eating concerns

    OpenAIRE

    Matsumoto, Junko; Hirano, Yoshiyuki; Numata, Noriko; Matzuzawa, Daisuke; Murano, Shunichi; Yokote, Koutaro; Iyo, Masaomi; Shimizu, Eiji; Nakazato, Michiko

    2015-01-01

    Background Decision-making is reported to be impaired in anorexia nervosa (AN) and bulimia nervosa (BN), but the influence of mood status, pathophysiological eating, and weight concerns on the performance of decision-making ability between AN and BN is still unclear. The aims of this study were to investigate differential impairments in the decision-making process between AN, BN, and healthy controls (HC), and secondly, to explore the role of mood status, such as anxiety, depression, patholog...

  4. Patient-rated health status predicts prognosis following percutaneous coronary intervention with drug-eluting stenting

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Versteeg, Henneke; Denollet, Johan

    2011-01-01

    In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events.......In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events....

  5. Personality pathology factors predict recurrent major depressive disorder in emerging adults.

    Science.gov (United States)

    Sheets, Erin S; Duncan, Laramie E; Bjornsson, Andri S; Craighead, Linda W; Craighead, W Edward

    2014-06-01

    Prior investigations consistently indicate that personality pathology is a risk factor for recurrence of major depressive disorder (MDD). Lack of emipircal support, however, for the Diagnostic and Statistical Manual of Mental Disorders (DSM) Fourth Edition organization of Axis II disorders supports the investigation of empirically derived factors of personality pathology as predictors of recurrence. A sample of 130 previously depressed emerging adults (80% female; aged 18 to 21 years) were assessed for personality disorder symptoms at baseline. Participants were then followed for 18 months to identify MDD recurrence during the first 2 years of college. Based on a previous factor analysis of DSM personality disorder criteria, eight personality pathology factors were examined as predictors of MDD recurrence. Survival analysis indicated that factors of interpersonal hypersensitivity, antisocial conduct, and social anxiety were associated with increased risk of MDD recurrence. These findings suggest that an empirically based approach to personality pathology organization may yield useful predictors of MDD recurrence during emerging adulthood. © 2013 Wiley Periodicals, Inc.

  6. Visuoperception test predicts pathologic diagnosis of Alzheimer disease in corticobasal syndrome.

    Science.gov (United States)

    Boyd, Clara D; Tierney, Michael; Wassermann, Eric M; Spina, Salvatore; Oblak, Adrian L; Ghetti, Bernardino; Grafman, Jordan; Huey, Edward

    2014-08-05

    To use the Visual Object and Space Perception Battery (VOSP) to distinguish Alzheimer disease (AD) from non-AD pathology in corticobasal syndrome (CBS). This clinicopathologic study assessed 36 patients with CBS on the VOSP. All were autopsied. The primary dependent variable was a binary pathologic outcome: patients with CBS who had primary pathologic diagnosis of AD (CBS-AD, n = 10) vs patients with CBS without primary pathologic diagnosis of AD (CBS-nonAD, n = 26). We also determined sensitivity and specificity of individual VOSP subtests. Patients with CBS-AD had younger onset (54.5 vs 63.6 years, p = 0.001) and lower memory scores on the Mattis Dementia Rating Scale-2 (16 vs 22 points, p = 0.003). Failure on the VOSP subtests Incomplete Letters (odds ratio [OR] 11.5, p = 0.006), Position Discrimination (OR 10.86, p = 0.008), Number Location (OR 12.27, p = 0.026), and Cube Analysis (OR 45.71 p = 0.0001) had significantly greater odds of CBS-AD than CBS-nonAD. These associations remained when adjusting for total Mattis Dementia Rating score, disease laterality, education, age, and sex. Receiver operating characteristic curves demonstrated significant accuracy for Incomplete Letters and all VOSP spatial subtests, with Cube Analysis performing best (area under the curve 0.91, p = 0.0004). In patients with CBS, failure on specific VOSP subtests is associated with greater odds of having underlying AD. There may be preferential involvement of the dorsal stream in CBS-AD. This study provides Class II evidence that some subtests of the VOSP accurately distinguish patients with CBS-AD from those without AD pathology (e.g., Cube Analysis sensitivity 100%, specificity 77%). © 2014 American Academy of Neurology.

  7. Mammographic breast density: Predictive value for pathological response to neoadjuvant chemotherapy in breast cancer patients.

    Science.gov (United States)

    Elsamany, S; Alzahrani, A; Abozeed, W N; Rasmy, A; Farooq, M U; Elbiomy, M A; Rawah, E; Alsaleh, K; Abdel-Aziz, N M

    2015-10-01

    This study aims to evaluate the relation between mammographic breast density (BD) and pathological response to neoadjuvant chemotherapy. In this retrospective study, 241 breast cancer patients who received neoadjuvant chemotherapy were included. BD was assessed in mammograms already performed at diagnosis. Pathological complete response (pCR) and pathological stage were correlated with BD, tumour phenotype and other clinico-pathological factors. Patients with low BD had better pCR compared to those with high density (30.5% vs 19.5% respectively, OR = 1.8, 95% CI = 0.98-3.3, p = 0.056) which was more pronounced after adjustment with body mass index (BMI) (OR = 2.4, 95% CI = 1.2-4.8, p = 0.011). HER2-positive disease (32.5% vs. 18.4%, OR = 2.2, 95% = 1.2-4.0, p = 0.01), lower BMI (OR = 1.1, 95% CI = 1.03-1.15, p = 0.004) and lower clinical stage (p = 0.002) were significant predictors of pCR in univariate analysis. In multivariate analysis, low BD (OR = 2.7, 95% CI = 1.3-5.5, p = 0.006) and lower BMI (OR = 1.1, 95% CI = 1.03-1.17, p = 0.003) were independent predictors of better pCR, while early clinical stage (I, II) was of borderline significance (OR = 2.6, 95% CI = 0.99-6.7, p = 0.052). High BD (OR = 1.8, 95% CI = 1.1-3.2, p = 0.03), advanced clinical stage (III) (OR = 1.5, 95% CI = 1.03-2.1, p = 0.03) and higher BMI (OR = 1.06, 95% CI = 1.02-1.11, p = 0.006) were significant predictors of advanced pathological stage. Low mammographic BD, low BMI and early clinical stage were associated with improved pCR rate and lower pathological stage after neoadjuvant chemotherapy. BD had more pronounced association with response to chemotherapy after adjustment with BMI. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Embryonic Origin of Primary Colon Cancer Predicts Pathologic Response and Survival in Patients Undergoing Resection for Colon Cancer Liver Metastases.

    Science.gov (United States)

    Yamashita, Suguru; Brudvik, Kristoffer Watten; Kopetz, Scott E; Maru, Dipen; Clarke, Callisia N; Passot, Guillaume; Conrad, Claudius; Chun, Yun Shin; Aloia, Thomas A; Vauthey, Jean-Nicolas

    2016-12-19

    The aim of this study was to determine the prognostic value of embryonic origin in patients undergoing resection after chemotherapy for colon cancer liver metastases (CCLM). We identified 725 patients with primary colon cancer and known RAS mutation status who underwent hepatic resection after preoperative chemotherapy for CCLM (1990 to 2015). Survival after resection of CCLM from midgut origin (n = 238) and hindgut origin (n = 487) was analyzed. Predictors of pathologic response and survival were determined. Prognostic value of embryonic origin was validated with a separate cohort of 252 patients with primary colon cancer who underwent resection of CCLM without preoperative chemotherapy. Recurrence-free survival (RFS) and overall survival (OS) after hepatic resection were worse in patients with midgut origin tumors (RFS rate at 3 years: 15% vs 27%, P origin [odds ratio (OR) 1.55, P = 0.010], absence of bevacizumab (OR 1.42, P = 0.034), and mutant RAS (OR 1.41, P = 0.043). Independent factors associated with worse OS were midgut embryonic origin [hazard ratio (HR) 2.04, P origin had a worse 3-year OS rate (55% vs 78%, P = 0.003). Compared with CCLM from hindgut origin, CCLM from midgut origin are associated with worse pathologic response to chemotherapy and worse survival after resection. This effect appears to be independent of RAS mutation status.

  9. Prediction of biochemical recurrence and prostate cancer specific death in men after radical retropublic prostatectomy: Use of pathology and computer-assisted quantitative nuclear grading information

    Science.gov (United States)

    Khan, Masood Ahmed

    Prostate cancer is the most common solid tumour in man. Accordingly, it is expected that 1 in 6 men will experience prostate cancer during their lifetime. Over the past 20 years there have been tremendous advancements in both diagnostic as well as surgical approach to prostate cancer. This has led not only to earlier detection of the disease in its natural history, but also the availability of effective surgical management. Furthermore, the discovery of serum prostate specific antigen as a marker for prostate cancer along with greater acceptance of prostate cancer screening has resulted in an increase in the incidence of prostate cancer in men younger than 50 years of age. This is an age group that has traditionally been associated with a poor prognosis after radical prostatectomy. In addition, despite being able to effectively remove the whole of the gland with limited morbidity, approximately 25% of men after radical prostatectomy will experience biochemical recurrence with time. Moreover, the majority will progress to distant metastases and/or die from prostate cancer. We firstly investigated whether radical prostatectomy is a viable option for men younger than 50 years of age diagnosed with clinically localised prostate cancer. We also determined factors that predict disease recurrence after radical prostatectomy. As many men demonstrate evidence of biochemical recurrence with some showing further progression after radical prostatectomy, we, therefore, investigated whether pathological variables as well as nuclear morphometry could be used to predict those that are at an increased risk for disease recurrence after radical prostatectomy. Our results demonstrated that 1) radical prostatectomy can be safely performed in younger men as it can provide excellent long-term disease-free survival; 2) We determined that there are a number of factors that are associated with an increased risk for disease recurrence after radical prostatectomy; 3) We have constructed a new

  10. New horizons in predictive toxicology: current status and application

    National Research Council Canada - National Science Library

    Wilson, A. G. E

    2012-01-01

    "In this comprehensive discussion of predictive toxicology and its applications, leading experts express their views on the technologies currently available and the potential for future developments...

  11. A model for predicting food security status among households in developing countries

    Directory of Open Access Journals (Sweden)

    Mbukwa, J.

    2013-06-01

    Full Text Available Food security prediction has been challenging aspects in developing countries particularly in African countries such as Tanzania. Consequently, government lack proper stimulated information that is necessary in making decision on efforts required for stabilizing food situation and status in their countries. Scientifically it has been observed in research and practical that this is caused by lack of proper mechanisms, tools and approach suitable for modeling and predicting food status among households. This paper proposes a logistic regression based model for analysis and prediction of food security status. The proposed model is empirically test using practical data collected from one district in Tanzania.

  12. Mild cognitive impairment with suspected nonamyloid pathology (SNAP): Prediction of progression.

    Science.gov (United States)

    Caroli, Anna; Prestia, Annapaola; Galluzzi, Samantha; Ferrari, Clarissa; van der Flier, Wiesje M; Ossenkoppele, Rik; Van Berckel, Bart; Barkhof, Frederik; Teunissen, Charlotte; Wall, Anders E; Carter, Stephen F; Schöll, Michael; Choo, Il Han; Grimmer, Timo; Redolfi, Alberto; Nordberg, Agneta; Scheltens, Philip; Drzezga, Alexander; Frisoni, Giovanni B

    2015-02-03

    The aim of this study was to investigate predictors of progressive cognitive deterioration in patients with suspected non-Alzheimer disease pathology (SNAP) and mild cognitive impairment (MCI). We measured markers of amyloid pathology (CSF β-amyloid 42) and neurodegeneration (hippocampal volume on MRI and cortical metabolism on [(18)F]-fluorodeoxyglucose-PET) in 201 patients with MCI clinically followed for up to 6 years to detect progressive cognitive deterioration. We categorized patients with MCI as A+/A- and N+/N- based on presence/absence of amyloid pathology and neurodegeneration. SNAPs were A-N+ cases. The proportion of progressors was 11% (8/41), 34% (14/41), 56% (19/34), and 71% (60/85) in A-N-, A+N-, SNAP, and A+N+, respectively; the proportion of APOE ε4 carriers was 29%, 70%, 31%, and 71%, respectively, with the SNAP group featuring a significantly different proportion than both A+N- and A+N+ groups (p ≤ 0.005). Hypometabolism in SNAP patients was comparable to A+N+ patients (p = 0.154), while hippocampal atrophy was more severe in SNAP patients (p = 0.002). Compared with A-N-, SNAP and A+N+ patients had significant risk of progressive cognitive deterioration (hazard ratio = 2.7 and 3.8, p = 0.016 and p SNAP group, lower time to progression was correlated with greater hypometabolism (r = 0.42, p = 0.073). Our findings support the notion that patients with SNAP MCI feature a specific risk progression profile. © 2015 American Academy of Neurology.

  13. Prediction of Pathologic Fracture Risk in Activities of Daily Living and Rehabilitation of Patients With Metastatic Breast Carcinoma of the Pelvis and Femur

    National Research Council Canada - National Science Library

    Inoue, Nozomu

    2002-01-01

    The purpose of the project was to develop a computer model of the pelvis and proximal femur which could be used to predict pathologic fracture risk and study the effects of pelvic and proximal femoral...

  14. CSF abnormalities can be predicted by VEP and MRI pathology in the examination of optic neuritis

    DEFF Research Database (Denmark)

    Vinter, Matilda Degn; Nielsen, Signe Modvig; Larsson, Henrik B W

    2012-01-01

    be valuable in the evaluation of patients with ON. We analyzed CSF findings in patients referred with ON in the context of MRI and visual evoked potential (VEP) pathology. We assessed the possible contributory role of a lumbar puncture and weigh this against disadvantages of the procedure. Between February...... causes of their symptoms and patients with >3 months between onset and tests were excluded. All files were reviewed retrospectively. CSF leukocytes and the IgG index were elevated in 33 and 41 %, respectively, and OCBs were detected in 61 % of patients. CSF abnormalities correlated strongly with VEP...

  15. Comparison of strain and shear-wave ultrasounic elastography in predicting the pathological response to neoadjuvant chemotherapy in breast cancers.

    Science.gov (United States)

    Ma, Yan; Zhang, Shuo; Li, Jing; Li, Jianyi; Kang, Ye; Ren, Weidong

    2017-06-01

    To compare the diagnostic performances of strain elastography (SE) and shear-wave elastography (SWE) for predicting response to neoadjuvant chemotherapy (NACT) in patients with breast cancer. This prospective study recruited 71 eligible patients from June 2014 to May 2016. All patients provided written informed consent. Tumour stiffness was assessed by the SE strain ratio (R), SWE maximum elasticity (Emax) and SWE mean elasticity (Emean). Ultrasonic elastography (UE) assessments were performed at each NACT cycle (t1 - t6). For the purpose of predicting, the relative changes in elastographic parameters after the first and second NACT cycles were considered as the variables [Δ(t1) and Δ(t2)]. The area under the receiver operating characteristics (AUC) curve was compared. ΔEmean(t2) and R2 displayed the best diagnostic performances within their own modalities (AUC = 0.93 and 0.90 for predicting favourable response to NACT; AUC = 0.92 and 0.78 for predicting NACT resistance, respectively). There were no significant differences in AUCs for ΔEmean(t2) and some UE parameters (P > 0.05). By contrast, ΔEmean(t2) was significantly superior to all other SE parameters for predicting resistance (P < 0.05). SE and SWE exhibited similar performances for predicting favourable NACT responses; SWE was better than SE for predicting NACT resistance. • Elastography parameters after the second NACT cycle showed the best diagnostic performances. • SWE and SE yielded similar diagnostic performances in predicting favourable responses. • SWE performed better than SE in predicting the pathological resistance to NACT. • Discrepant results may be due to the breast thickness and lesion depth.

  16. Internet-based motivation program for women with eating disorders: eating disorder pathology and depressive mood predict dropout.

    Science.gov (United States)

    von Brachel, Ruth; Hötzel, Katrin; Hirschfeld, Gerrit; Rieger, Elizabeth; Schmidt, Ulrike; Kosfelder, Joachim; Hechler, Tanja; Schulte, Dietmar; Vocks, Silja

    2014-03-31

    One of the main problems of Internet-delivered interventions for a range of disorders is the high dropout rate, yet little is known about the factors associated with this. We recently developed and tested a Web-based 6-session program to enhance motivation to change for women with anorexia nervosa, bulimia nervosa, or related subthreshold eating pathology. The aim of the present study was to identify predictors of dropout from this Web program. A total of 179 women took part in the study. We used survival analyses (Cox regression) to investigate the predictive effect of eating disorder pathology (assessed by the Eating Disorders Examination-Questionnaire; EDE-Q), depressive mood (Hopkins Symptom Checklist), motivation to change (University of Rhode Island Change Assessment Scale; URICA), and participants' age at dropout. To identify predictors, we used the least absolute shrinkage and selection operator (LASSO) method. The dropout rate was 50.8% (91/179) and was equally distributed across the 6 treatment sessions. The LASSO analysis revealed that higher scores on the Shape Concerns subscale of the EDE-Q, a higher frequency of binge eating episodes and vomiting, as well as higher depression scores significantly increased the probability of dropout. However, we did not find any effect of the URICA or age on dropout. Women with more severe eating disorder pathology and depressive mood had a higher likelihood of dropping out from a Web-based motivational enhancement program. Interventions such as ours need to address the specific needs of women with more severe eating disorder pathology and depressive mood and offer them additional support to prevent them from prematurely discontinuing treatment.

  17. Predictability in Pathological Gambling? Applying the Duplication of Purchase Law to the Understanding of Cross-Purchases Between Regular and Pathological Gamblers.

    Science.gov (United States)

    Lam, Desmond; Mizerski, Richard

    2017-06-01

    The objective of this study is to explore the gambling participations and game purchase duplication of light regular, heavy regular and pathological gamblers by applying the Duplication of Purchase Law. Current study uses data collected by the Australian Productivity Commission for eight different types of games. Key behavioral statistics on light regular, heavy regular, and pathological gamblers were computed and compared. The key finding is that pathological gambling, just like regular gambling, follows the Duplication of Purchase Law, which states that the dominant factor of purchase duplication between two brands is their market shares. This means that gambling between any two games at pathological level, like any regular consumer purchases, exhibits "law-like" regularity based on the pathological gamblers' participation rate of each game. Additionally, pathological gamblers tend to gamble more frequently across all games except lotteries and instant as well as make greater cross-purchases compared to heavy regular gamblers. A better understanding of the behavioral traits between regular (particularly heavy regular) and pathological gamblers can be useful to public policy makers and social marketers in order to more accurately identify such gamblers and better manage the negative impacts of gambling.

  18. Partin Tables cannot accurately predict the pathological stage at radical prostatectomy.

    Science.gov (United States)

    Bhojani, N; Ahyai, S; Graefen, M; Capitanio, U; Suardi, N; Shariat, S F; Jeldres, C; Erbersdobler, A; Schlomm, T; Haese, A; Steuber, T; Heinzer, H; Montorsi, F; Huland, H; Karakiewicz, P I

    2009-02-01

    The Partin Tables represent the most commonly used staging tool for radical prostatectomy (RP) candidates. The Partin Tables' predictions are used to guide the type (nerve preserving RP) and/or the extent (RP with wide resection) of RP. We examined the ability of the Partin Tables' predictions incorrectly assigning the stage at RP. The testing of the Partin Tables (external validation) was based on 3105 patients treated with RP at a single European institution. Standard validation metrics were used (area under the receiver operating characteristics curve, AUC) to test the three endpoints predicted by the Partin Tables, namely the presence of extracapsular extension (ECE), seminal vesicle invasion (SVI), and lymph node invasion (LNI). Ideal predictions are denoted with 100% accuracy vs. 50% for entirely random predictions. For the 2001 version of the Tables the accuracy defined by the AUC was 79.7, 77.8, and 73.0 for ECE, SVI, and LNI, respectively. For the 2007 version of the Tables the corresponding accuracy estimates were 79.8, 80.5, and 76.2. The relationship between predicted probabilities and observed rates was poor. The Partin Tables are meant to guide clinicians about the safety of nerve bundle preservation at RP, about the need for seminal vesicle resection or for lymphadenectomy. Therefore, the use of the Partin Tables predictions may significantly affect the type and/or the extent of RP. In their present format the Partin Tables are not accurate enough to influence the pre-operative decision making regarding the type or extent of RP.

  19. Gallbladder ejection fraction declines with age in patients undergoing cholecystectomy for acalculous biliary symptoms but has low accuracy in the prediction of gallbladder pathology.

    Science.gov (United States)

    Jones, Aled; Shahtahmassebi, Golnaz; Stell, David

    2015-01-01

    Hepatobiliary Iminodiacetic Acid (HIDA) scan provides a technique to quantify gallbladder ejection fraction (EF) in patients suffering acalculous biliary colic (ACBC). We wished to evaluate the accuracy of EF in the prediction of gallbladder pathology in patients undergoing cholecystectomy. Data were retrieved from a database of patients referred for HIDA scan for ACBC, including EF and the pathological outcome of those undergoing cholecystectomy, and compared to normal values obtained from a review of related studies. Significant associations were demonstrated by chi-square, Mann-Whitney test, and linear regression. The predictive accuracy of different cut-offs of EF was demonstrated by the ROC curve analysis. Of 83 patients referred for HIDA scan for ACBC, 41 underwent cholecystectomy. The median EF of this group (33%) was significantly lower than the composite normal median value from previous studies (56%). Thirty-two patients revealed evidence of gallbladder pathology. The EF declined with age (coefficient = -0.51, 95% CI = -0.99 to -0.33), but the median value did not differ between those with gallbladder pathology (34%) and those with normal gallbladders (29%). Although an EF cut-off of 35% had the greatest accuracy in the prediction of pathology of those tested (0.56), the poor negative predictive value (23.5%) was a major contributor to its low accuracy. Although patients with ACBC have reduced gallbladder EF compared to the normal population, its quantitative assessment is of limited value in the prediction of gallbladder pathology.

  20. Elements of male body image: Prediction of depression, eating pathology and social sensitivity among gay men.

    Science.gov (United States)

    Blashill, Aaron J

    2010-09-01

    The aim of the current study was to assess the relative uniqueness of three components of male body image (i.e., muscle, body fat, and height dissatisfaction) in the prediction of indices of psychological distress (i.e., depression, eating restraint, eating concerns, and social sensitivity) among a community sample of 228 gay men. Results indicated that body fat dissatisfaction was predictive of all four criterion variables (controlling for muscle dissatisfaction). Conversely, muscle dissatisfaction was only associated with social sensitivity, while height dissatisfaction failed to significantly predict any of the criterion variables. These findings highlight the relative importance of body fat dissatisfaction among gay men and suggest that researchers and clinicians working with this population should utilize measures which include assessment of both muscularity and body fat. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. Brain-derived neurotrophic factor expression predicts adverse pathological & clinical outcomes in human breast cancer

    Directory of Open Access Journals (Sweden)

    Mokbel Kefah

    2011-07-01

    Full Text Available Abstract Introduction Brain-derived neurotrophic factor (BDNF has established physiological roles in the development and function of the vertebrate nervous system. BDNF has also been implicated in several human malignancies, including breast cancer (BC. However, the precise biological role of BDNF and its utility as a novel biomarker have yet to be determined. The objective of this study was to determine the mRNA and protein expression of BDNF in a cohort of women with BC. Expression levels were compared with normal background tissues and evaluated against established pathological parameters and clinical outcome over a 10 year follow-up period. Methods BC tissues (n = 127 and normal tissues (n = 33 underwent RNA extraction and reverse transcription, BDNF transcript levels were determined using real-time quantitative PCR. BDNF protein expression in mammary tissues was assessed with standard immuno-histochemical methodology. Expression levels were analyzed against tumour size, grade, nodal involvement, TNM stage, Nottingham Prognostic Index (NPI and clinical outcome over a 10 year follow-up period. Results Immuno-histochemical staining revealed substantially greater BDNF expression within neoplastic cells, compared to normal mammary epithelial cells. Significantly higher mRNA transcript levels were found in the BC specimens compared to background tissues (p = 0.007. The expression of BDNF mRNA was demonstrated to increase with increasing NPI; NPI-1 vs. NPI-2 (p = 0.009. Increased BDNF transcript levels were found to be significantly associated with nodal positivity (p = 0.047. Compared to patients who remained disease free, higher BDNF expression was significantly associated with local recurrence (LR (p = 0.0014, death from BC (p = 0.018 and poor prognosis overall (p = 0.013. After a median follow up of 10 years, higher BDNF expression levels were significantly associated with reduced overall survival (OS (106 vs. 136 months, p = 0.006. BDNF

  2. Clinical and pathological features predictive of nephrectomy at post-chemotherapy retroperitoneal lymph node dissection.

    Science.gov (United States)

    Cary, K Clint; Beck, Stephen D W; Bihrle, Richard; Foster, Richard S

    2013-03-01

    We determined the clinical and pathological features associated with nephrectomy at post-chemotherapy retroperitoneal lymph node dissection. We retrospectively reviewed the testis cancer database from 1980 to 2007 to identify all patients treated with post-chemotherapy retroperitoneal lymph node dissection. Patients with pure seminoma and nongerm cell histology were excluded from study. A total of 1,807 patients were identified, of whom 17 without recorded mass size were excluded from further study. Pathological and clinical variables were assessed by bivariate analysis. Multivariate logistic regression was used to determine predictors of nephrectomy at post-chemotherapy retroperitoneal lymph node dissection. The overall incidence of nephrectomy at post-chemotherapy retroperitoneal lymph node dissection was 14.8% (265 of 1,790 cases). The incidence of nephrectomy was 17.0%, 18.9%, 13.6% and 8.0% in 1980 to 1988 (group 1), 1989 to 1997 (group 2), 1998 to 2002 (group 3) and 2002 to 2007 (group 4) (p = 0.0001). The nephrectomy rate for tumors less than 2, 2 to 5, 5 to 10 and greater than 10 cm was 6.0%, 5.8%, 13.9% and 31.9%, respectively (p = 0.0001). The incidence of nephrectomy based on retroperitoneal histology was 10.3% for fibrosis, 14.5% for teratoma and 20.4% for cancer (p = 0.0001). The strongest predictor of nephrectomy at post-chemotherapy retroperitoneal lymph node dissection was retroperitoneal mass size greater than 10 cm (OR 9.30, 95% CI 3.8-22.7). The incidence of nephrectomy at post-chemotherapy retroperitoneal lymph node dissection has decreased in the last 3 decades. A higher incidence was observed in patients with larger volume tumors, those who received salvage chemotherapy, those with a left primary testicular tumor and those with increased markers at post-chemotherapy surgery. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Prediction of the course of acute odontogenic pathology with pronounced osteomyelitis by immunoglobulin and cytokin evaluation

    Directory of Open Access Journals (Sweden)

    A. I. Yaremenko

    2013-01-01

    Full Text Available The aim of our trial was detection of the most significant clinico-laboratory factors in the saliva and blood samples of the patients with odontogenic osteomyelitis in order to predict severity of the clinical course of osteomyelitis and to choose the optimal treatment tactics.

  4. Predicting the nutritional health status of locally produced palm oil ...

    African Journals Online (AJOL)

    Three physical properties of locally produced palm oil – viscosity, thermal conductivity and density for varying temperatures were determined. The values obtained were compared with corresponding internationally stipulated standard values using statistics of mean and graphs. The purpose of the comparison was to predict ...

  5. Neoadjuvant chemotherapy with trastuzumab in HER2-positive breast cancer: pathologic complete response rate, predictive and prognostic factors

    Directory of Open Access Journals (Sweden)

    I.P.C. Buzatto

    Full Text Available The purpose of this study was to retrospectively review the pathologic complete response (pCR rate from patients (n=86 with stage II and III HER2-positive breast cancer treated with neoadjuvant chemotherapy at our institution from 2008 to 2013 and to determine possible predictive and prognostic factors. Immunohistochemistry for hormone receptors and Ki-67 was carried out. Clinical and pathological features were analyzed as predictive factors of response to therapy. For survival analysis, we used Kaplan-Meier curves to estimate 5-year survival rates and the log-rank test to compare the curves. The addition of trastuzumab to neoadjuvant chemotherapy significantly improved pCR rate from 4.8 to 46.8%, regardless of the number of preoperative trastuzumab cycles (P=0.0012. Stage II patients achieved a higher response rate compared to stage III (P=0.03. The disease-free and overall survivals were not significantly different between the group of patients that received trastuzumab in the neoadjuvant setting (56.3 and 70% at 5 years, respectively and the group that initiated it post-operatively (75.8 and 88.7% at 5 years, respectively. Axillary pCR post neoadjuvant chemotherapy with trastuzumab was associated with reduced risk of recurrence (HR=0.34; P=0.03 and death (HR=0.21; P=0.02. In conclusion, we confirmed that trastuzumab improves pCR rates and verified that this improvement occurs even with less than four cycles of the drug. Hormone receptors and Ki-67 expressions were not predictive of response in this subset of patients. Axillary pCR clearly denotes prognosis after neoadjuvant target therapy and should be considered to be a marker of resistance, providing an opportunity to investigate new strategies for HER2-positive treatment.

  6. Texture analysis of common renal masses in multiple MR sequences for prediction of pathology

    Science.gov (United States)

    Hoang, Uyen N.; Malayeri, Ashkan A.; Lay, Nathan S.; Summers, Ronald M.; Yao, Jianhua

    2017-03-01

    This pilot study performs texture analysis on multiple magnetic resonance (MR) images of common renal masses for differentiation of renal cell carcinoma (RCC). Bounding boxes are drawn around each mass on one axial slice in T1 delayed sequence to use for feature extraction and classification. All sequences (T1 delayed, venous, arterial, pre-contrast phases, T2, and T2 fat saturated sequences) are co-registered and texture features are extracted from each sequence simultaneously. Random forest is used to construct models to classify lesions on 96 normal regions, 87 clear cell RCCs, 8 papillary RCCs, and 21 renal oncocytomas; ground truths are verified through pathology reports. The highest performance is seen in random forest model when data from all sequences are used in conjunction, achieving an overall classification accuracy of 83.7%. When using data from one single sequence, the overall accuracies achieved for T1 delayed, venous, arterial, and pre-contrast phase, T2, and T2 fat saturated were 79.1%, 70.5%, 56.2%, 61.0%, 60.0%, and 44.8%, respectively. This demonstrates promising results of utilizing intensity information from multiple MR sequences for accurate classification of renal masses.

  7. SLN melanoma micrometastasis predictivity of nodal status: a long term retrospective study.

    Science.gov (United States)

    Migliano, Emilia; Bellei, Barbara; Govoni, Flavio Andrea; Paolino, Giovanni; Catricalà, Caterina; Bucher, Stefania; Donati, Pietro

    2013-08-01

    Completion lymph node dissection (CLND) is the gold standard treatment for patients with a positive sentinel lymph node (SLN) biopsy. Considering the morbidity associated with CLND it is important to identify histological features of the primary tumor and/or of SLN metastasis that could help to spare from CLND a subset of patients who have a very low risk of non-SLN metastasis. The objective of this study is to identify patients with a very low risk to develop non-SLNs recurrences and to limit unnecessary CLND. A retrospective long-term study of 80 melanoma patients with positive SLN, undergone CLND, was assessed to define the risk of additional metastasis in the regional nodal basin, on the basis of intranodal distribution of metastatic cells, using the micro-morphometric analysis (Starz classification). This study demonstrates that among the demographic and pathologic features of primary melanoma and of SLN only the Starz classification shows prognostic significance for non-SLN status (p<0.0001). This parameter was also significantly associated with disease-free survival rate (p<0.0013). The Starz classification can help to identify, among SLN positive patients, those who can have a real benefit from CLND. From the clinical point of view this easy and reliable method could lead to a significant reduction of unnecessary CLND in association with a substantial decrease in morbidity. The study results indicate that most of S1 subgroup patients might be safely spared from completion lymphatic node dissection. Furthermore, our experience demonstrated that Starz classification of SLN is a safe predictive index for patient stratification and treatment planning.

  8. Predicting the risk of adjacent segment pathology after lumbar fusion: a systematic review.

    Science.gov (United States)

    Lawrence, Brandon D; Wang, Jeff; Arnold, Paul M; Hermsmeyer, Jeff; Norvell, Daniel C; Brodke, Darrel S

    2012-10-15

    Systematic review. To perform a systematic review to define the incidence of clinical adjacent segment pathology (CASP) after lumbar fusion surgery and define potential risk factors for the development of CASP. Concerns for the longevity of current arthrodesis constructs and the effects of arthrodesis on adjacent segments have received increasing attention during the past decade. There is a lack of precision regarding the terminology used to describe the pathologies of adjacent segment disease. The term ASP is proposed as an umbrella term to refer to the breadth of clinical and/or radiographical changes at adjacent motion segments that developed subsequent to a previous spinal intervention. A systematic search was performed in Medline and the Cochrane Collaboration Library for literature published through January 2012. Level of evidence ratings were assigned to each article independently by 2 reviewers. Extracted were the percentage risks of CASP during 5- and 10-year time periods, risk factors, the effect estimates (relative risks and odds ratios), and corresponding confidence intervals reported from each study's multivariate analyses. Forest plots of odds ratios or relative risks with their 95% confidence intervals evaluating patient, disease, and surical risk factors were constructed using the data provided by the individual studies. We identified 162 total citations from our literature search. Of these, 31 full- text articles were evaluated for meeting inclusion criteria. From these 31 studies, 5 studies met inclusion criteria. The mean patient ages ranged from 50 to 64 years. The mean annual incidence of CASP ranged from 0.6% to 3.9%. With respect to patient factors, age more than 60 years was associated with an increased risk of developing CASP. Other factors that may increase the risk of developing CASP are pre-existing facet degeneration, degenerative disc disease, performing a multilevel fusion, stopping a construct at L5, performing a laminectomy adjacent

  9. Does injury claim status and benefit status predict low back pain outcomes?

    Science.gov (United States)

    Melloh, Markus; Cornwall, Jon; Crawford, Rebecca J; Elfering, Achim

    2015-01-01

    In New Zealand the Accident Compensation Corporation (ACC) is a state-funded insurance agency that accepts claims for accidental injuries, including lumbar spine injuries. It is unknown whether ACC claim status (accepted, not accepted) affects low back pain (LBP) outcomes, or whether benefit status (e.g., sickness, disability) further affects outcomes in patients without ACC cover. This study aimed to determine whether ACC claim and benefit status are likely to influence a range of outcomes for people with LBP in New Zealand. A prospective survey of low back pain patients was performed (April 2008-October 2010). ACC claim status was recorded, and individuals without accepted claims indicated benefit status. Surveys were sent at multiple time points; pain, functional limitation, psychological factors, and general health were assessed. Statistical analysis was undertaken using ANCOVA and ANOVA (p<0.05). In total, 168 patients completed the study. Six-month measures showed individuals with no ACC claim for LBP to overall have poorer outcomes (mental health, p=0.039; pain, p=0.045; functional limitation, p=0.049); sub-group analysis (no ACC claim) between those with or without a benefit showed those on benefits to have significantly higher functional limitation (p<0.001), poorer physical health (p=0.002), greater pain (p=0.027), and stronger fear avoidance behaviours for both work (p=0.047) and physical activity (p=0.35). Findings indicate individuals with accepted ACC claims for LBP have significantly better outcomes than those without, and patients on benefits with no accepted ACC claim for LBP have even poorer outcomes.

  10. Predicting social influence with faction sizes and relative status.

    Science.gov (United States)

    Melamed, David; Savage, Scott V

    2013-09-01

    Building on a recent theoretical development in the field of sociological social psychology, we develop a formal mathematical model of social influence processes. The extant theoretical literature implies that factions and status should have non-linear effects on social influence, and yet these theories have been evaluated using standard linear statistical models. Our formal model of influence includes these non-linearities, as specified by the theories. We evaluate the fit of the formal model using experimental data. Our results indicate that a one-parameter mathematical model fits the experimental data. We conclude with the implications of our research and a discussion of how it may be used as an impetus for further work on social influence processes. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

    Directory of Open Access Journals (Sweden)

    Suna Kabil Kucur

    2013-01-01

    Full Text Available ive: To investigate the diagnostic value of blood flow measurements in spiral artery by transvaginal color Doppler sonography (CDS in predicting endometrial pathologies.Methods: Ninety-seven patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included in this prospective observational study. Endometrial thickness, structure and echogenicity were recorded. Pulsatility index (PI and resistive index (RI of the spiral artery were measured by transvaginal CDS. Endometrial sampling was performed for all subjects. Sonographic and hystopathologic findings were compared.Results: The histopathological diagnoses were as follows; 39 cases (40.2% endometrial polyp, 9 cases (9.3% endometrial hyperplasia, 10 cases (10.3 submucous myoma, 7 cases (7.2% endometrium cancer, and 32 cases (33% nonspecific findings. The spiral artery PI in endometrium cancer group was highly significantly lower than other groups (p<0.01. The spiral artery RI was also significantly lower in the patients with malignant histology (p<0.05. Conclusion: Endometrial pathologies are associated significantly with endometrial spiral artery Doppler changes.Key words: Spiral artery, Doppler ultrasonography, endometrium

  12. Predictive value and modeling analysis of MSCT signs in gastrointestinal stromal tumors (GISTs) to pathological risk degree.

    Science.gov (United States)

    Wang, J-K

    2017-03-01

    By analyzing MSCT (multi-slice computed tomography) signs with different risks in gastrointestinal stromal tumors, this paper aimed to discuss the predictive value and modeling analysis of MSCT signs in GISTs (gastrointestinal stromal tumor) to pathological risk degree. 100 cases of primary GISTs with abdominal and pelvic MSCT scan were involved in this study. All MSCT scan findings and enhanced findings were analyzed and compared among cases with different risk degree of pathology. Then GISTs diagnostic model was established by using support vector machine (SVM) algorithm, and its diagnostic value was evaluated as well. All lesions were solitary, among which there were 46 low-risk cases, 24 medium-risk cases and 30 high-risk cases. For all high-risk, medium-risk and low-risk GISTs, there were statistical differences in tumor growth pattern, size, shape, fat space, with or without calcification, ulcer, enhancement method and peritumoral and intratumoral vessels (pvalue at each period (plain scan, arterial phase, venous phase) (p>0.05). The apparent difference lied in plain scan, arterial phase and venous phase for each risk degree. The diagnostic accuracy of SVM diagnostic model established with 10 imaging features as indexes was 70.0%, and it was especially reliable when diagnosing GISTs of high or low risk. Preoperative analysis of MSCT features is clinically significant for its diagnosis of risk degree and prognosis; GISTs diagnostic model established on the basis of SVM possesses high diagnostic value.

  13. Regression models to predict hip joint centers in pathological hip population.

    Science.gov (United States)

    Mantovani, Giulia; Ng, K C Geoffrey; Lamontagne, Mario

    2016-02-01

    The purpose was to investigate the validity of Harrington's and Davis's hip joint center (HJC) regression equations on a population affected by a hip deformity, (i.e., femoroacetabular impingement). Sixty-seven participants (21 healthy controls, 46 with a cam-type deformity) underwent pelvic CT imaging. Relevant bony landmarks and geometric HJCs were digitized from the images, and skin thickness was measured for the anterior and posterior superior iliac spines. Non-parametric statistical and Bland-Altman tests analyzed differences between the predicted HJC (from regression equations) and the actual HJC (from CT images). The error from Davis's model (25.0 ± 6.7 mm) was larger than Harrington's (12.3 ± 5.9 mm, pmodels. Measured skin thickness was 9.7 ± 7.0mm and 19.6 ± 10.9 mm for the anterior and posterior bony landmarks, respectively, and correlated with body mass index. Skin thickness estimates can be considered to reduce the systematic error introduced by surface markers. New adult-specific regression equations were developed from the CT dataset, with the hypothesis that they could provide better estimates when tuned to a larger adult-specific dataset. The linear models were validated on external datasets and using leave-one-out cross-validation techniques; Prediction errors were comparable to those of Harrington's model, despite the adult-specific population and the larger sample size, thus, prediction accuracy obtained from these parameters could not be improved. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Pathologically assessed grade of Hirschsprung-associated enterocolitis in resected colon in children with Hirschsprung's disease predicts postoperative bowel function.

    Science.gov (United States)

    Cheng, Siyang; Wang, Jun; Pan, Weihua; Yan, Wenbo; Shi, Jia; Guan, Wenbin; Wang, Yang; Cai, Wei

    2017-11-01

    The aim of this study was to investigate the relationship between the grade of enterocolitis on pathological assessment of resected colon and postoperative bowel function in children with Hirschsprung's disease (HD). Children with HD who were seen at a large tertiary center from January 2012 to December 2013 were enrolled into this study. Resected colon was assessed using the histopathologic grade scoring system for Hirschsprung-associated enterocolitis (HAEC), and the relationship of these scores to postoperative bowel function was assessed. Time of recovery to normal defecation was the primary outcome measure. The t-test, analysis of variance, and Kaplan-Meier, univariate, and multiple regression analyses were performed. Eighty children with HD (median age at repair 7.9months; range 1.3months to 9years) were included in the study. Nineteen children dropped out of the study and were considered as providing censored data, giving a follow-up rate of 76.3%. A total of 21 children (34.4%) were admitted to hospital with at least one episode of enterocolitis. Multivariate Cox proportional hazards models showed that compared with patients with a normal proximal colon, those with an inflamed proximal segment had a 1.5-fold higher risk of a poor recovery. Logistic regression analyses suggested that postoperative HAEC admissions increased by 57% with each HAEC pathological grade of the transitional segment and by 50% with each grade of the overall segment. Compared with normal bowel in the transitional segment, the detection of grade ≥3 HAEC in the transitional area increased the incidence of postoperative HAEC by 4.75-fold. Children whose resected proximal colon showed inflammation on pathological assessment were at risk of poor recovery after surgery. A higher pathological HAEC score for the sum of the overall three segments suggested an increased risk for the subsequent development of enterocolitis. Among three segments, the severity of enterocolitis in the

  15. The Prediction of Deterioration of Nutritional Status during Chemoradiation Therapy in Patients with Esophageal Cancer.

    Science.gov (United States)

    Rietveld, Sofia C M; Witvliet-van Nierop, Jill E; Ottens-Oussoren, Karen; van der Peet, Donald L; de van der Schueren, Marian A E

    2018-01-01

    Patients with esophageal cancer are at high risk of developing malnutrition during neoadjuvant chemoradiation therapy (CRT), which in turn is associated with postoperative morbidity. The aim of the study is to explore whether parameters of a complete pre-treatment nutritional status may predict deterioration of nutritional status during CRT in patients with esophageal cancer. In this prospective cohort study, 101 patients with esophageal cancer treated with CRT were included. Data of patient characteristics, tumor classification, performance score, %weight change, body mass index, fat (free) mass index, phase angle, handgrip strength, energy- and protein intake, and use of (additional) dietary supplements were collected. A prediction model was constructed to identify predictive parameters for deterioration in nutritional status (defined as weight loss of >5% and/or decline in fat free mass of ≥1.4 kg) during CRT. Nutritional status deteriorated in 49 patients (49%) during CRT. The only predictor for deterioration in nutritional status was fat free mass index (OR 1.21 (90% CI: 1.03 - 1.42)). Patients with a higher fat free mass index are at increased risk of deterioration in nutrition status during CRT. Results suggest that all patients should be carefully supervised during CRT, regardless of their nutritional status before start of CRT.

  16. Diagnostic accuracy of shear wave elastography for prediction of breast malignancy in patients with pathological nipple discharge

    Science.gov (United States)

    Guo, Xiaobo; Liu, Ying; Li, Wanhu

    2016-01-01

    Objectives Pathological nipple discharge (PND) may indicate malignant breast lesions. As the role of shear wave elastography (SWE) in predicting these malignant lesions has not yet been evaluated, we aim to evaluate the diagnostic value of SWE for this condition. Design Prospective diagnostic accuracy study comparing a combination of qualitative and quantitative measurements of SWE (index test) to a ductoscopy and microdochectomy for histological diagnosis (reference test). Setting Fuzhou General Hospital of Nanjing military command. Participants A total of 379 patients with PND were finally included from January, 2011 to March 2014, after we screened 1084 possible candidates. All participants were evaluated through SWE, with qualitative parameters generated by Virtual Touch tissue imaging (VTI) and quantitative parameters generated by Virtual Touch tissue quantification (VTQ). All the patients were consented to receive a ductoscopy and microdochectomy for histological diagnosis, and the results were set as a reference test. Outcome measures Sensitivity and specificity of the combined VTI and VTQ of the SWE for detection of malignancy in patients with PND. Results The 379 participants presented with 404 lesions. The results of pathological examination showed that 326 (80.7%) of the 404 lesions were benign and the other 78 (19.3%) were malignant. An area under the curve of elasticity score, VTQm and VTQc, were 0.872, 0.825 and 0.857, respectively, with the corresponding cut-off point as 2.50, 2.860 m/s and 3.015 m/s, respectively. After a combination of these measurements, the sensitivity, specificity, and positive and negative predictive value (PPV and NPV), were 89.7%, 72.1%, 43.5% and 96.7%, respectively. The sensitivity analysis showed 82% of the sensitivity and 96.8% of the specificity, in which patients with no pathological findings in ductoscopy were excluded. Conclusions Ultrasonographic elastography is sensitive for patients with PND and could be used

  17. Sensitivity Analysis of the MGMT-STP27 Model and Impact of Genetic and Epigenetic Context to Predict the MGMT Methylation Status in Gliomas and Other Tumors.

    Science.gov (United States)

    Bady, Pierre; Delorenzi, Mauro; Hegi, Monika E

    2016-05-01

    The methylation status of the O(6)-methylguanine-DNA methyltransferase (MGMT) gene is an important predictive biomarker for benefit from alkylating agent therapy in glioblastoma. Our model MGMT-STP27 allows prediction of the methylation status of the MGMT promoter using data from the Illumina's Human Methylation BeadChips (HM-27K and HM-450K) that is publically available for many cancer data sets. Here, we investigate the impact of the context of genetic and epigenetic alterations and tumor type on the classification and report on technical aspects, such as robustness of cutoff definition and preprocessing of the data. The association between gene copy number variation, predicted MGMT methylation, and MGMT expression revealed a gene dosage effect on MGMT expression in lower grade glioma (World Health Organization grade II/III) that in contrast to glioblastoma usually carry two copies of chromosome 10 on which MGMT resides (10q26.3). This implies some MGMT expression, potentially conferring residual repair function blunting the therapeutic effect of alkylating agents. A sensitivity analyses corroborated the performance of the original cutoff for various optimization criteria and for most data preprocessing methods. Finally, we propose an R package mgmtstp27 that allows prediction of the methylation status of the MGMT promoter and calculation of appropriate confidence and/or prediction intervals. Overall, MGMT-STP27 is a robust model for MGMT classification that is independent of tumor type and is adapted for single sample prediction. Copyright © 2016 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

  18. Gut microbiota diversity predicts immune status in HIV-1 infection.

    Science.gov (United States)

    Nowak, Piotr; Troseid, Marius; Avershina, Ekatarina; Barqasho, Babilonia; Neogi, Ujjwal; Holm, Kristian; Hov, Johannes R; Noyan, Kajsa; Vesterbacka, Jan; Svärd, Jenny; Rudi, Knut; Sönnerborg, Anders

    2015-11-28

    HIV-1 infection is characterized by altered intestinal barrier, gut microbiota dysbiosis, and systemic inflammation. We hypothesized that changes of the gut microbiota predict immune dysfunction and HIV-1 progression, and that antiretroviral therapy (ART) partially restores the microbiota composition. An observational study including 28 viremic patients, three elite controllers, and nine uninfected controls. Blood and stool samples were collected at baseline and for 19 individuals at follow-up (median 10 months) during ART. Microbiota composition was determined by 16S rRNA sequencing (Illumina MiSeq). Soluble markers of microbial translocation and monocyte activation were analyzed by Limulus Amebocyte Lysate assay or ELISA. Several alpha-diversity measures, including number of observed bacterial species and Shannon index, were significantly lower in viremic patients compared to controls. The alpha diversity correlated with CD4 T-cell counts and inversely with markers of microbial translocation and monocyte activation. In multivariate linear regression, for every age and sex-adjusted increase in the number of bacterial species, the CD4 T-cell count increased with 0.88 (95% confidence interval 0.35-1.41) cells/μl (P = 0.002). After introduction of ART, microbiota alterations persisted with further reduction in alpha diversity. The microbiota composition at the genus level was profoundly altered in viremic patients, both at baseline and after ART, with Prevotella reduced during ART (P Gut microbiota alterations are closely associated with immune dysfunction in HIV-1 patients, and these changes persist during short-term ART. Our data implicate that re-shaping the microbiota may be an adjuvant therapy in patients commencing successful ART.

  19. Value of RT-PCR analysis of sentinel nodes in determining the pathological nodal status in colon cancer

    NARCIS (Netherlands)

    Kelder, Wendy; Braat, Andries; Van den Berg, Anke; Platteel, Inge; Hollema, Harry; Groen, Henk.; Plukker, John

    2007-01-01

    Background: Pathological examination of sentinel lymph nodes (SLNs) and non-SLNs in colon cancer is frequently not performed to the same extent. We examined whether non-SLNs were truly negative in tumors with tumor-negative SLNs using reverse transcriptase-polymerase chain reaction (RT-PCR).

  20. [Diagnosis, prognosis, and prediction of non-small cell lung cancer. Importance of morphology, immunohistochemistry and molecular pathology].

    Science.gov (United States)

    Warth, A

    2015-11-01

    Tumor diagnostics are based on histomorphology, immunohistochemistry and molecular pathological analysis of mutations, translocations and amplifications which are of diagnostic, prognostic and/or predictive value. In recent decades only histomorphology was used to classify lung cancer as either small (SCLC) or non-small cell lung cancer (NSCLC), although NSCLC was further subdivided in different entities; however, as no specific therapy options were available classification of specific subtypes was not clinically meaningful. This fundamentally changed with the discovery of specific molecular alterations in adenocarcinoma (ADC), e.g. mutations in KRAS, EGFR and BRAF or translocations of the ALK and ROS1 gene loci, which now form the basis of targeted therapies and have led to a significantly improved patient outcome. The diagnostic, prognostic and predictive value of imaging, morphological, immunohistochemical and molecular characteristics as well as their interaction were systematically assessed in a large cohort with available clinical data including patient survival. Specific and sensitive diagnostic markers and marker panels were defined and diagnostic test algorithms for predictive biomarker assessment were optimized. It was demonstrated that the semi-quantitative assessment of ADC growth patterns is a stage-independent predictor of survival and is reproducibly applicable in the routine setting. Specific histomorphological characteristics correlated with computed tomography (CT) imaging features and thus allowed an improved interdisciplinary classification, especially in the preoperative or palliative setting. Moreover, specific molecular characteristics, for example BRAF mutations and the proliferation index (Ki-67) were identified as clinically relevant prognosticators. Comprehensive clinical, morphological, immunohistochemical and molecular assessment of NSCLCs allow an optimized patient stratification. Respective algorithms now form the backbone of the 2015

  1. Predicting employment status and subjective quality of life in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Haruo Fujino

    2016-03-01

    Full Text Available Although impaired social functioning, particularly poor employment status, is a cardinal feature of patients with schizophrenia and leads to decreased quality of life (QOL, few studies have addressed the relationship between these two clinical issues. The aim of this study was to determine whether employment status predicts subjective QOL and to evaluate a model in which functional capacity mediates the relationship between general cognitive performance and employment status. Ninety-three patients with schizophrenia were administered a comprehensive battery of cognitive tests, the UCSD Performance-based Skills Assessment-Brief version (UPSA-B, the Social Functioning Scale (SFS, and the Subjective Quality of Life Scale (SQLS. First, we evaluated a model for predicting the employment/occupation subscale score of the SFS using path analysis, and the model fitted well (χ2 (4 = 3.6, p = 0.46; CFI = 1.0; RMSEA < 0.001, with 90% CIs: 0–0.152. Employment status was predicted by negative symptoms and functional capacity, which was in turn predicted by general cognitive performance. Second, we added subjective QOL to this model. In a final path model, QOL was predicted by negative symptoms and employment status. This model also satisfied good fit criteria (χ2 (7 = 10.3, p = 0.17; CFI = 0.987; RMSEA = 0.072, with 90% CIs: 0–0.159. The UPSA-B and SFS scores were moderately correlated with most measures of cognitive performance. These results support the notion that better employment status enhances subjective QOL in patients with schizophrenia.

  2. National Status and Trends, Benthic Surveillance Project Pathology, 1984-1992, National Centers for Coastal Ocean Science

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — In order to determine the current status of and to detect any long-term trends in the environmental quality of U.S. nearshore waters, NOAA initiated the National...

  3. [Novel methodological approaches to the evaluation of the immune status in sickly children with ENT organ pathology].

    Science.gov (United States)

    Dzhamalutdinov, Iu A; Davudov, Kh Sh; Saidov, M Z; Nazhmudinov, I I; Matela, I I

    2009-01-01

    Principles of a novel methodology for the combined assessment of the immune function in sickly children with pathological changes in the organs of the otorhinolaringological system are expounded. The new approach includes investigations into local cellular and humoral immunity, evaluation of functional relationships and correlations between its parameters, interpretation of these findings, and the use of the characteristics thus obtained in the development of concrete recommendations for immunotropic and/or anti-inflammatory therapy. This approach is illustrated by examples of variations in the number of CD4(+) and CD20(+) cells and interplay between them. These findings taken together with the data on the levels of serum IgG, IgA, IgM, and percentage of immunohistochemical preparations positive for these immunoglobulins indicate that the proposed method may prove useful for the development of new therapeutic modalities for the treatment of sickly children with ENT organ pathology following adenotomy and tonsilotomy.

  4. Prediction of CpG island methylation status by integrating DNA physicochemical properties.

    Science.gov (United States)

    Feng, Pengmian; Chen, Wei; Lin, Hao

    2014-10-01

    As an inheritable epigenetic modification, DNA methylation plays important roles in many biological processes. The non-uniform distribution of DNA methylation across the genome implies that characterizing genome-wide DNA methylation patterns is necessary to better understand the regulatory mechanisms of DNA methylation. Although a series of experimental technologies have been proposed, they are cost-ineffective for DNA methylation status detection. As complements to experimental techniques, computational methods will facilitate the identification of DNA methylation status. In the present study, we proposed a Naïve Bayes model to predict CpG island methylation status. In this model, DNA sequences are formulated by "pseudo trinucleotide composition" into which three DNA physicochemical properties were incorporated. It was observed by the jack-knife test that the overall success rate achieved by the proposed model in predicting the DNA methylation status was 88.22%. This result indicates that the proposed model is a useful tool for DNA methylation status prediction. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Predictive Power of the Success Tendency and Ego Identity Status of the University Students

    Science.gov (United States)

    Osman, Pepe

    2015-01-01

    The aim of this research is to assess the predictive power of the success tendency and ego identity status of the students of Physical Education and Sports Teaching Department. 581 students of Physical Education and Sports Teaching Department in Kayseri, Nigde, Burdur, Bolu and Diyarbakir participated in this research. The acquired results were…

  6. Epigenetic Regulation of KLHL34 Predictive of Pathologic Response to Preoperative Chemoradiation Therapy in Rectal Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Ye J. [Department of Surgery, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Institute of Innovative Cancer Research and Asan Institute for Life Sciences, Asan Medical Center, Seoul (Korea, Republic of); Kim, Chan W. [Department of Surgery, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Roh, Seon A. [Department of Surgery, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Institute of Innovative Cancer Research and Asan Institute for Life Sciences, Asan Medical Center, Seoul (Korea, Republic of); Cho, Dong H. [Institute of Innovative Cancer Research and Asan Institute for Life Sciences, Asan Medical Center, Seoul (Korea, Republic of); Graduate School of East-West Medical Science, Kyung Hee University, Gyeonggi-do (Korea, Republic of); Park, Jong L.; Kim, Seon Y. [Medical Genomics Research Center, Korea Research Institute of Bioscience & Biotechnology, Daejeon (Korea, Republic of); Kim, Jong H. [Department of Radiation Oncology, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Eun K. [Department of Radiation Oncology, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Institute of Innovative Cancer Research and Asan Institute for Life Sciences, Asan Medical Center, Seoul (Korea, Republic of); Kim, Yong S., E-mail: yongsung@kribb.re.kr [Medical Genomics Research Center, Korea Research Institute of Bioscience & Biotechnology, Daejeon (Korea, Republic of); Institute of Innovative Cancer Research and Asan Institute for Life Sciences, Asan Medical Center, Seoul (Korea, Republic of); Kim, Jin C., E-mail: jckim@amc.seoul.kr [Department of Surgery, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Institute of Innovative Cancer Research and Asan Institute for Life Sciences, Asan Medical Center, Seoul (Korea, Republic of)

    2015-03-01

    Purpose: Prediction of individual responsiveness to preoperative chemoradiation therapy (CRT) is urgently needed in patients with poorly responsive locally advanced rectal cancer (LARC). Methods and Materials: Candidate methylation genes associated with radiosensitivity were identified using a 3-step process. In the first step, genome-wide screening of methylation genes was performed in correlation with histopathologic tumor regression grade in 45 patients with LARC. In the second step, the methylation status of selected sites was analyzed by pyrosequencing in 67 LARC patients, including 24 patients analyzed in the first step. Finally, colorectal cancer cell clones with stable KLHL34 knockdown were generated and tested for cellular sensitivity to radiation. Results: Genome-wide screening identified 7 hypermethylated CpG sites (DZIP1 cg24107021, DZIP1 cg26886381, ZEB1 cg04430381, DKK3 cg041006961, STL cg00991794, KLHL34 cg01828474, and ARHGAP6 cg07828380) associated with preoperative CRT responses. Radiosensitivity in patients with hypermethylated KLHL34 cg14232291 was confirmed by pyrosequencing in additional cohorts. Knockdown of KLHL34 significantly reduced colony formation (KLHL34 sh#1: 20.1%, P=.0001 and KLHL34 sh#2: 15.8%, P=.0002), increased the cytotoxicity (KLHL34 sh#1: 14.8%, P=.019 and KLHL34 sh#2: 17.9%, P=.007) in LoVo cells, and increased radiation-induced caspase-3 activity and the sub-G1 population of cells. Conclusions: The methylation status of KLHL34 cg14232291 may be a predictive candidate of sensitivity to preoperative CRT, although further validation is needed in large cohorts using various cell types.

  7. Predicting Pathological Features at Radical Prostatectomy in Patients with Prostate Cancer Eligible for Active Surveillance by Multiparametric Magnetic Resonance Imaging.

    Directory of Open Access Journals (Sweden)

    Ottavio de Cobelli

    Full Text Available The aim of this study was to investigate the prognostic performance of multiparametric magnetic resonance imaging (mpMRI and Prostate Imaging Reporting and Data System (PIRADS score in predicting pathologic features in a cohort of patients eligible for active surveillance who underwent radical prostatectomy.A total of 223 patients who fulfilled the criteria for "Prostate Cancer Research International: Active Surveillance", were included. Mp-1.5 Tesla MRI examination staging with endorectal coil was performed at least 6-8 weeks after TRUS-guided biopsy. In all patients, the likelihood of the presence of cancer was assigned using PIRADS score between 1 and 5. Outcomes of interest were: Gleason score upgrading, extra capsular extension (ECE, unfavorable prognosis (occurrence of both upgrading and ECE, large tumor volume (≥ 0.5 ml, and seminal vesicle invasion (SVI. Receiver Operating Characteristic (ROC curves and Decision Curve Analyses (DCA were performed for models with and without inclusion of PIRADS score.Multivariate analysis demonstrated the association of PIRADS score with upgrading (P < 0.0001, ECE (P < 0.0001, unfavorable prognosis (P < 0.0001, and large tumor volume (P = 0.002. ROC curves and DCA showed that models including PIRADS score resulted in greater net benefit for almost all the outcomes of interest, with the only exception of SVI.mpMRI and PIRADS scoring are feasible tools in clinical setting and could be used as decision-support systems for a more accurate selection of patients eligible for AS.

  8. A machine learned classifier that uses gene expression data to accurately predict estrogen receptor status.

    Directory of Open Access Journals (Sweden)

    Meysam Bastani

    Full Text Available BACKGROUND: Selecting the appropriate treatment for breast cancer requires accurately determining the estrogen receptor (ER status of the tumor. However, the standard for determining this status, immunohistochemical analysis of formalin-fixed paraffin embedded samples, suffers from numerous technical and reproducibility issues. Assessment of ER-status based on RNA expression can provide more objective, quantitative and reproducible test results. METHODS: To learn a parsimonious RNA-based classifier of hormone receptor status, we applied a machine learning tool to a training dataset of gene expression microarray data obtained from 176 frozen breast tumors, whose ER-status was determined by applying ASCO-CAP guidelines to standardized immunohistochemical testing of formalin fixed tumor. RESULTS: This produced a three-gene classifier that can predict the ER-status of a novel tumor, with a cross-validation accuracy of 93.17±2.44%. When applied to an independent validation set and to four other public databases, some on different platforms, this classifier obtained over 90% accuracy in each. In addition, we found that this prediction rule separated the patients' recurrence-free survival curves with a hazard ratio lower than the one based on the IHC analysis of ER-status. CONCLUSIONS: Our efficient and parsimonious classifier lends itself to high throughput, highly accurate and low-cost RNA-based assessments of ER-status, suitable for routine high-throughput clinical use. This analytic method provides a proof-of-principle that may be applicable to developing effective RNA-based tests for other biomarkers and conditions.

  9. A Machine Learned Classifier That Uses Gene Expression Data to Accurately Predict Estrogen Receptor Status

    Science.gov (United States)

    Bastani, Meysam; Vos, Larissa; Asgarian, Nasimeh; Deschenes, Jean; Graham, Kathryn; Mackey, John; Greiner, Russell

    2013-01-01

    Background Selecting the appropriate treatment for breast cancer requires accurately determining the estrogen receptor (ER) status of the tumor. However, the standard for determining this status, immunohistochemical analysis of formalin-fixed paraffin embedded samples, suffers from numerous technical and reproducibility issues. Assessment of ER-status based on RNA expression can provide more objective, quantitative and reproducible test results. Methods To learn a parsimonious RNA-based classifier of hormone receptor status, we applied a machine learning tool to a training dataset of gene expression microarray data obtained from 176 frozen breast tumors, whose ER-status was determined by applying ASCO-CAP guidelines to standardized immunohistochemical testing of formalin fixed tumor. Results This produced a three-gene classifier that can predict the ER-status of a novel tumor, with a cross-validation accuracy of 93.17±2.44%. When applied to an independent validation set and to four other public databases, some on different platforms, this classifier obtained over 90% accuracy in each. In addition, we found that this prediction rule separated the patients' recurrence-free survival curves with a hazard ratio lower than the one based on the IHC analysis of ER-status. Conclusions Our efficient and parsimonious classifier lends itself to high throughput, highly accurate and low-cost RNA-based assessments of ER-status, suitable for routine high-throughput clinical use. This analytic method provides a proof-of-principle that may be applicable to developing effective RNA-based tests for other biomarkers and conditions. PMID:24312637

  10. The role of self-reported impulsivity and reward sensitivity versus neurocognitive measures of disinhibition and decision-making in the prediction of relapse in pathological gamblers.

    Science.gov (United States)

    Goudriaan, A E; Oosterlaan, J; De Beurs, E; Van Den Brink, W

    2008-01-01

    Disinhibition and decision-making skills play an important role in theories on the cause and outcome of addictive behaviors such as substance use disorders and pathological gambling. In recent studies, both disinhibition and disadvantageous decision-making strategies, as measured by neurocognitive tests, have been found to influence the course of substance use disorders. Research on factors affecting relapse in pathological gambling is scarce. This study investigated the effect of both self-reported impulsivity and reward sensitivity, and neurocognitively assessed disinhibition and decision-making under conflicting contingencies, on relapse in a group of 46 pathological gamblers. Logistic regression analysis indicated that longer duration of the disorder and neurocognitive indicators of disinhibition (Stop Signal Reaction Time) and decision-making (Card Playing Task) were significant predictors of relapse (explaining 53% of the variance in relapse), whereas self-reported impulsivity and reward sensitivity did not significantly predict relapse. Overall classification accuracy was 76%, with a positive classification accuracy of 76% and a negative classification accuracy of 75%. Duration of the disorder and neurocognitive measures of disinhibition and decision-making are powerful predictors of relapse in pathological gambling. The results suggest that endophenotypical neurocognitive characteristics are more promising in the prediction of relapse in pathological gambling than phenotypical personality characteristics. Neurocognitive predictors may be useful to guide treatment planning of follow-up contacts and booster sessions.

  11. Density of CD8+ lymphocytes in biopsy samples combined with the circulating lymphocyte ratio predicts pathologic complete response to chemoradiotherapy for rectal cancer

    Directory of Open Access Journals (Sweden)

    Xiao BY

    2017-11-01

    Full Text Available Binyi Xiao,1,* Jianhong Peng,1,* Rongxin Zhang,1,* Jing Xu,2 Yongchun Wang,2 Yujing Fang,1,2 Junzhong Lin,1 Zhizhong Pan,1 Xiaojun Wu1 1Department of Colorectal Surgery, 2Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China *These authors contributed equally to this work Objectives: The systemic status and local immune status, as determined by the neutrophil–­lymphocyte ratio (NLR or the lymphocyte ratio (LYMR and tumor-infiltrating lymphocyte (TIL count, respectively, have been suggested as predictors of the tumor response to neoadjuvant chemoradiotherapy (nCRT in rectal cancer, although the utility of these measures remains controversial. We aimed to investigate the values of the LYMR, NLR and TIL count and their combinations (TIL–LYMR/TIL–NLR in predicting pathologic complete response (pCR after nCRT.Patients and methods: Pretreatment biopsy samples and data from the blood tests of 92 patients with rectal cancer who underwent curative resection after nCRT were retrospectively obtained. CD8+ TILs were immunostained using an antibody against CD8. The density of CD8+ TILs was recorded as the number of CD8+ T cells per square millimeter, and the results were classified as either “high” or “low”. The LYMR and NLR were calculated using pretreatment blood test data and categorized into either “high” or “low” groups. TIL–LYMR was graded as “low,” “mid” or “high” when neither, one or both the CD8+ TIL count and LYMR were “high,” respectively. TIL–NLR was graded similarly. The associations between TILs and LYMR, NLR and their combinations (TIL–LYMR/TIL–NLR were evaluated.Results: pCR was significantly associated with a high LYMR, a low NLR and increased chemotherapy cycles (P=0.039, P=0.043 and P=0.015, respectively, but not with the CD8+ TIL

  12. The ability of preoperative factors to predict patient-reported disability following surgery for rotator cuff pathology.

    Science.gov (United States)

    Woollard, Jason D; Bost, James E; Piva, Sara R; Kelley Fitzgerald, G; Rodosky, Mark W; Irrgang, James J

    2017-10-01

    Minimal research has examined the prognostic ability of shoulder examination data or psychosocial factors in predicting patient-reported disability following surgery for rotator cuff pathology. The purpose of this study was to examine these factors for prognostic value in order to help clinicians and patients understand preoperative factors that impact disability following surgery. Sixty-two patients scheduled for subacromial decompression with or without supraspinatus repair were recruited. Six-month follow-up data were available for 46 patients. Patient characteristics, history of the condition, shoulder impairments, psychosocial factors, and patient-reported disability questionnaires were collected preoperatively. Six months following surgery, the Western Ontario Rotator Cuff Index (WORC) and global rating of change dichotomized subjects into responders versus nonresponders. Logistic regression quantified prognostic ability and created the most parsimonious model to predict outcome. Being on modified job duty (OR = .17, 95%CI: 0.03-0.94), and having a worker's compensation claim (OR = 0.08, 95%CI: 0.01-0.74) decreased probability of a positive outcome, while surgery on the dominant shoulder (OR = 11.96, 95%CI: 2.91-49.18) increased probability. From the examination, only impaired internal rotation strength was a significant univariate predictor. The Fear-avoidance Beliefs Questionnaire (FABQ) score (OR = 0.95, 95%CI: 0.91-0.98) and the FABQ_work subscale (OR = 0.92, 95%CI: 0.87-0.97) were univariate predictors. In the final model, surgery on the dominant shoulder (OR = 8.9, 95%CI 1.75-45.7) and FABQ_work subscale score ≤25 (OR = 15.3, 95%CI 2.3-101.9) remained significant. Surgery on the dominant arm resulted in greater improvement in patient-reported disability, thereby increasing the odds of a successful surgery. The predictive ability of the FABQ_work subscale highlights the potential impact of psychosocial factors on patient

  13. Predicting employment status in multiple sclerosis patients: the utility of the MS functional composite.

    Science.gov (United States)

    Honarmand, Kimia; Akbar, Nadine; Kou, Nancy; Feinstein, Anthony

    2011-02-01

    As many as two-thirds of multiple sclerosis (MS) patients are unable to retain employment. Neurological and cognitive status are known to be significant predictors of unemployment, but the relationship between the two is unclear. Furthermore, the association between employment status and depression, anxiety, and personality has not been adequately explored in MS patients. This study examined the demographic, neurological, neuropsychological, and personality factors associated with unemployment in MS. We also sought to determine the utility of the Multiple Sclerosis Functional Composite (MSFC), a measure of MS-related disability incorporating physical and cognitive measures, in predicting employment status. A consecutive sample of 106 MS patients (61.3% unemployed) completed the Brief Repeatable Battery of Neuropsychological Tests (BRBN), Hospital Anxiety and Depression Scale (HADS), and NEO Five-Factor Personality Inventory. The MSFC emerged as the most robust predictor of employment status in MS patients, exceeding the predictive value of the EDSS. Together with NEO "Agreeableness" and HADS Depression subscore, the MSFC accounted for 49.8% of the variance in employment status. Unemployment was also associated with a progressive disease course, longer disease duration, and being female. While Global Cognitive Impairment did not differentiate between groups, unemployed patients scored significantly lower on three of five BRBN indices: Symbol Digit Modality Test, Paced Auditory Serial Addition Test, and Word List Generation. The findings highlight the utility of the MSFC as a predictor of unemployment in MS. Furthermore, a strong association was found between unemployment and the personality construct "Agreeableness", and severity of depression.

  14. HER-2 overexpression/amplification in Barrett’s oesophagus predicts early transition from dysplasia to adenocarcinoma: a clinico-pathologic study

    Science.gov (United States)

    Rossi, Elisa; Grisanti, Salvatore; Villanacci, Vincenzo; Casa, Domenico Della; Cengia, Paolo; Missale, Guido; Minelli, Luigi; Buglione, Michela; Cestari, Renzo; Bassotti, Gabrio

    2009-01-01

    Barrett’s oesophagus (BO) is the primary precursor lesion for oesophageal adenocarcinoma (ADC). The natural history of metaplasia-dysplasia-carcinoma sequence remains largely unknown. HER2/neu oncogene results overexpressed/amplified in preneoplastic lesions and in ADC of the oesophagus and it has been associated with poor prognosis. Our aim was to evaluate the role of HER2 overexpression/amplification in predicting the conversion from precursor lesions to ADC. We retrospectively evaluated by univariate analysis of single variables clinical records and histological specimens of 21 patients with a confirmed diagnosis of BO and/or oesophageal dysplasia. Clinical variables included age, gender, alcohol and smoking intake, presence of symptoms (pyrosis, disphagia) and endoscopic features (length). HER2 status was studied by immunohistochemistry and fluorescence in situ hybridization (FISH) on paraffin-embedded tissue. The end-points were the occurrence of progression and the time-to-progression (TTP) from the initial histologic lesion to the worst pathological pattern. Median age at diagnosis was 63 years (range 37–84). BO median length was 4.5 cm. Progression occurred in 11 of 21 patients and median TTP was 24 months. HER2 was overexpressed/amplified in 8 of 21 (38%) patients. HER2 overexpression/ amplification and the presence of dysplasia were statistically associated with progression (P= 0.038). This study provides evidence for a possible role of HER2 in the transition from dysplasia to ADC of the oesophagus. This fact could help in identifying patients at high risk of malignant transformation. PMID:19292734

  15. Predicting groundwater redox status on a regional scale using linear discriminant analysis.

    Science.gov (United States)

    Close, M E; Abraham, P; Humphries, B; Lilburne, L; Cuthill, T; Wilson, S

    2016-08-01

    Reducing conditions are necessary for denitrification, thus the groundwater redox status can be used to identify subsurface zones where potentially significant nitrate reduction can occur. Groundwater chemistry in two contrasting regions of New Zealand was classified with respect to redox status and related to mappable factors, such as geology, topography and soil characteristics using discriminant analysis. Redox assignment was carried out for water sampled from 568 and 2223 wells in the Waikato and Canterbury regions, respectively. For the Waikato region 64% of wells sampled indicated oxic conditions in the water; 18% indicated reduced conditions and 18% had attributes indicating both reducing and oxic conditions termed "mixed". In Canterbury 84% of wells indicated oxic conditions; 10% were mixed; and only 5% indicated reduced conditions. The analysis was performed over three different well depths, 100m. For both regions, the percentage of oxidised groundwater decreased with increasing well depth. Linear discriminant analysis was used to develop models to differentiate between the three redox states. Models were derived for each depth and region using 67% of the data, and then subsequently validated on the remaining 33%. The average agreement between predicted and measured redox status was 63% and 70% for the Waikato and Canterbury regions, respectively. The models were incorporated into GIS and the prediction of redox status was extended over the whole region, excluding mountainous land. This knowledge improves spatial prediction of reduced groundwater zones, and therefore, when combined with groundwater flow paths, improves estimates of denitrification. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Assessing the interplay of childhood adversities with more recent stressful life events and conditions in predicting panic pathology among adults from the general population.

    Science.gov (United States)

    Asselmann, E; Stender, J; Grabe, H J; König, J; Schmidt, C O; Hamm, A O; Pané-Farré, C A

    2018-01-01

    Although research suggests that (a) childhood adversities and more recent stressful life events/conditions are risk factors for panic pathology and that (b) early life stress increases vulnerability to later psychopathology, it remains unclear whether childhood adversities amplify the association between more recent stressful life events/conditions and panic pathology. Data were derived from a general population sample (Study of Health in Pomerania, SHIP). Lifetime panic pathology was assessed with the Munich Composite International Diagnostic Interview (M-CIDI). Childhood adversities (emotional, physical and sexual abuse; emotional and physical neglect) were assessed with the Childhood Trauma Questionnaire (CTQ). More recent separation/loss events and long-lasting stressful conditions were assessed with the Stralsund Life Event List (SEL). Individuals with lifetime panic pathology (fearful spell, panic attack or panic disorder, N = 286) were compared to controls without any psychopathology (N = 286, matched for sex and age). Conditional logistic regressions revealed that childhood adversities as well as more recent separation/loss events and long-lasting stressful conditions were associated with panic pathology (OR 1.1-2.5). Moreover, more recent separation/loss events - but not long-lasting stressful conditions - interacted statistically with each of the examined childhood adversities except for sexual abuse in predicting panic pathology (OR 1.1-1.3). That is, separation/loss events were associated more strongly with panic pathology among individuals with higher childhood adversities. Data were assessed retrospectively and might be subject to recall biases. Findings suggest that early childhood adversities amplify the risk of developing panic pathology after experiencing separation or loss events. Copyright © 2017. Published by Elsevier B.V.

  17. The role of co-morbid personality pathology in predicting self-reported aggression in patients with schizophrenia

    DEFF Research Database (Denmark)

    Bo, Sune; Abu-Akel, Ahmad; Kongerslev, Mickey

    2013-01-01

    BACKGROUND: Personality pathology affects behavioral patterns in patients with schizophrenia notwithstanding psychotic symptomatology. An investigation of the role of co-morbid personality pathology in the occurrence of aggression in schizophrenia is explored using both categorical and dimensional...... approaches to personality pathology. METHODS: In a cross-sectional study we evaluate, in 97 patients diagnosed with schizophrenia, the effect of personality pathology on the occurrence of aggression in schizophrenia using both a categorical approach, as described in DSM-IV-TR Axis II, and a dimensional...... approach, as operationalized in the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). We also employ mediation analyses to explore the extent to which dimensions within the DAPP mediate the relationship between co-morbid personality disorders and aggression. RESULTS...

  18. Fear of fatness and drive for thinness in predicting smoking status in college women☆

    Science.gov (United States)

    Copeland, Amy L.; Spears, Claire A.; Baillie, Lauren E.; McVay, Megan A.

    2016-01-01

    Recent research has identified fear of fatness (FF) as a related yet distinct construct from drive for thinness (DT). Whereas DT may be associated with need for approval and an “approach” tendency, FF may be more strongly related to avoidance of disapproval and an avoidant problem-solving style. Although no research has directly compared the influence of FF vs. DT with regard to smoking behavior, FF and DT might represent distinct motivations for smoking. We predicted that both FF and DT would be significantly associated with cigarette smoking, but that FF would be a stronger predictor of smoking behavior, even after controlling for variables such as body mass index (BMI) and nicotine dependence. Participants (N = 289) were female college undergraduate students. Daily smokers had the highest scores on measures of DT and FF, followed sequentially by infrequent smokers, “triers,” and never smokers. More frequent smokers also reported greater levels of body dissatisfaction and eating pathology than less frequent and never-smokers. Hierarchical regression analyses showed that greater DT predicted higher likelihood of smoking on a daily basis; however, higher FF predicted fewer cigarettes smoked per day. FF and DT may each play a role in the relationship between eating pathology and smoking, but they might be differentially related to specific smoking patterns. Both FF and DT and their coinciding coping styles should be further researched in the role of smoking initiation and maintenance. PMID:26656671

  19. Fear of fatness and drive for thinness in predicting smoking status in college women.

    Science.gov (United States)

    Copeland, Amy L; Spears, Claire A; Baillie, Lauren E; McVay, Megan A

    2016-03-01

    Recent research has identified fear of fatness (FF) as a related yet distinct construct from drive for thinness (DT). Whereas DT may be associated with need for approval and an "approach" tendency, FF may be more strongly related to avoidance of disapproval and an avoidant problem-solving style. Although no research has directly compared the influence of FF vs. DT with regard to smoking behavior, FF and DT might represent distinct motivations for smoking. We predicted that both FF and DT would be significantly associated with cigarette smoking, but that FF would be a stronger predictor of smoking behavior, even after controlling for variables such as body mass index (BMI) and nicotine dependence. Participants (N=289) were female college undergraduate students. Daily smokers had the highest scores on measures of DT and FF, followed sequentially by infrequent smokers, "triers," and never smokers. More frequent smokers also reported greater levels of body dissatisfaction and eating pathology than less frequent and never-smokers. Hierarchical regression analyses showed that greater DT predicted higher likelihood of smoking on a daily basis; however, higher FF predicted fewer cigarettes smoked per day. FF and DT may each play a role in the relationship between eating pathology and smoking, but they might be differentially related to specific smoking patterns. Both FF and DT and their coinciding coping styles should be further researched in the role of smoking initiation and maintenance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. The newer the better? Comparison of the 1997 and 2001 partin tables for pathologic stage prediction of prostate cancer in China.

    Science.gov (United States)

    Gao, Xu; Ren, Shancheng; Lu, Xin; Xu, Chuanliang; Sun, Yinghao

    2008-11-01

    The use of the Partin tables for pathologic stage prediction of prostate cancer in China has 2 problems. First, the validity of such U.S.-derived predictive tools has not been tested in China. Second, because an updated version of the Partin tables created using a more contemporary cohort was introduced in 2001, it is important to determine whether this renewed version (2001 Partin tables) is superior to the old version (1997 Partin tables). To investigate these problems, we compared these 2 predictive tools for their ability to predict the pathologic stage in Chinese patients. From June 2001 to May 2007, 271 consecutive patients who met the inclusion criteria for Partin table prediction and underwent radical prostatectomy for clinically localized prostate cancer at a single center were evaluated. The predictive accuracy of the 1997 Partin tables and 2001 Partin tables were assessed using receiver operating characteristics analysis. For the 1997 Partin tables, the area under the receiver operating characteristics curve for the prediction of organ-confined disease, established capsular penetration, seminal vesicle involvement, and lymph node involvement was 0.723, 0.674, 0.749, and 0.781, respectively. The corresponding values for the 2001 Partin tables were consistently low at 0.604, 0.539, 0.654, and 0.631. The results of our study have confirmed good predictive accuracy for the 1997 Partin tables for Chinese patients, but not for their updated 2001 version.

  1. The application of bacterial indicator phylotypes to predict shrimp health status.

    Science.gov (United States)

    Xiong, Jinbo; Zhu, Jianlin; Zhang, Demin

    2014-10-01

    The incidence of shrimp disease is closely associated with the microbial composition in surrounding water, but it remains uncertain whether microbial indicator phylotypes are predictive for shrimp health status (healthy or diseased). To test this idea, we combined the data from our previous works, to investigate the feasibility of indicator phylotypes as independent variables to predict the health status during a shrimp culture procedure. The results showed linearly increased dissimilarities (Ptrend when disease occurred. This sudden shift in the bacterial community appears to cause severe mass mortality of the shrimps. In particular, we created a model to identify indicators that discriminated ponds with diseased shrimp populations from these with healthy shrimp populations. As a result, 13 indicative families were screened, in which seven are healthy indicator and six are diseased indictor. An improved logistic regression model additionally revealed that the occurrences of these indicator families could be predictive of the shrimp health status with a high degree of accuracy (>79 %). Overall, this study provides solid evidences that indicator phylotypes could be served as independent variables for predicting the incidences of shrimp disease.

  2. Gastric polyps: Association with Helicobacter pylori status and the pathology of the surrounding mucosa, a cross sectional study

    Science.gov (United States)

    Elhanafi, Sherif; Saadi, Mohammed; Lou, Wynee; Mallawaarachchi, Indika; Dwivedi, Alok; Zuckerman, Marc; Othman, Mohamed O

    2015-01-01

    AIM: To assess the endoscopic characteristics of gastric polyps and their association with Helicobacter pylori (H. pylori) status in a predominantly Hispanic population. METHODS: We conducted a retrospective study of all esophagogastroduodenoscopies performed at our institution. Demographic, endoscopic and histopathological data were reviewed. Categorization of patients into Hispanic and Non-Hispanic was based on self-identification. Patients without resection/biopsy were not included in the analysis. Identification of polyps type was based on histological examination. One way analysis of variance was used to compare continuous variables among different polyp types and Fisher’s exact test was used compare categorical variables among polyp types. Unadjusted and adjusted comparisons of demographic and clinical characteristics were performed according to the H. pylori status and polyp type using logistic regressions. RESULTS: Of 7090 patients who had upper endoscopy, 335 patients had gastric polyps (4.7%). Resection or biopsy of gastric polyps was performed in 296 patients (88.4%) with a total of 442 polyps removed or biopsied. Of 296 patients, 87 (29%) had hyperplastic polyps, 82 (28%) had fundic gland polyps and 5 (1.7%) had adenomatous polyps. Hyperplastic polyps were significantly associated with positive H. pylori status compared with fundic gland polyps (OR = 4.621; 95%CI: 1.92-11.13, P = 0.001). Hyperplastic polyps were also found to be significantly associated with portal hypertensive gastropathy compared with fundic gland polyps (OR = 6.903; 95%CI: 1.41-33.93, P = 0.0174). Out of 296 patients, 30 (10.1%) had a follow-up endoscopy with a mean duration of 26 ± 16.3 mo. Interval development of cancer was not noted in any of the patients during follow up period. CONCLUSION: Gastric hyperplastic polyps were significantly associated with positive H. pylori status and portal hypertensive gastropathy as compared with fundic gland polyps. PMID:26265993

  3. Quantitative texture analysis in the prediction of IDH status in low-grade gliomas.

    Science.gov (United States)

    Jakola, Asgeir Store; Zhang, Yi-Hua; Skjulsvik, Anne J; Solheim, Ole; Bø, Hans Kristian; Berntsen, Erik Magnus; Reinertsen, Ingerid; Gulati, Sasha; Förander, Petter; Brismar, Torkel B

    2018-01-01

    Molecular markers provide valuable information about treatment response and prognosis in patients with low-grade gliomas (LGG). In order to make this important information available prior to surgery the aim of this study was to explore if molecular status in LGG can be discriminated by preoperative magnetic resonance imaging (MRI). All patients with histopathologically confirmed LGG with available molecular status who had undergone a preoperative standard clinical MRI protocol using a 3T Siemens Skyra scanner during 2008-2015 were retrospectively identified. Based on Haralick texture parameters and the segmented LGG FLAIR volume we explored if it was possible to predict molecular status. In total 25 patients (nine women, average age 44) fulfilled the inclusion parameters. The textural parameter homogeneity could discriminate between LGG patients with IDH mutation (0.12, IQR 0.10-0.15) and IDH wild type (0.07, IQR 0.06-0.09, p=0.005). None of the other four analyzed texture parameters (energy, entropy, correlation and inertia) were associated with molecular status. Using ROC curves, the area under curve for predicting IDH mutation was 0.905 for homogeneity, 0.840 for tumor volume and 0.940 for the combined parameters of tumor volume and homogeneity. We could not predict molecular status using the four other chosen texture parameters (energy, entropy, correlation and inertia). Further, we could not separate LGG with IDH mutation with or without 1p19q codeletion. In this preliminary study using Haralick texture parameters based on preoperative clinical FLAIR sequence, the homogeneity parameter could separate IDH mutated LGG from IDH wild type LGG. Combined with tumor volume, these diagnostic properties seem promising. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  4. Prediction of pathologic staging with magnetic resonance imaging after preoperative chemoradiotherapy in rectal cancer: pooled analysis of KROG 10-01 and 11-02.

    Science.gov (United States)

    Lee, Jong Hoon; Jang, Hong Seok; Kim, Jun-Gi; Lee, Myung Ah; Kim, Dae Yong; Kim, Tae Hyun; Oh, Jae Hwan; Park, Sung Chan; Kim, Sun Young; Baek, Ji Yeon; Park, Hee Chul; Kim, Hee Cheol; Nam, Taek-Keun; Chie, Eui Kyu; Jung, Ji-Han; Oh, Seong Taek

    2014-10-01

    The reported overall accuracy of MRI in predicting the pathologic stage of nonirradiated rectal cancer is high. However, the role of MRI in restaging rectal tumors after neoadjuvant CRT is contentious. Thus, we evaluate the accuracy of restaging magnetic resonance imaging (MRI) for rectal cancer patients who receive preoperative chemoradiotherapy (CRT). We analyzed 150 patients with locally advanced rectal cancer (T3-4N0-2) who had received preoperative CRT. Pre-CRT MRI was performed for local tumor and nodal staging. All patients underwent restaging MRI followed by total mesorectal excision after the end of radiotherapy. The primary endpoint of the present study was to estimate the accuracy of post-CRT MRI as compared with pathologic staging. Pathologic T classification matched the post-CRT MRI findings in 97 (64.7%) of 150 patients. 36 (24.0%) of 150 patients were overstaged in T classification, and the concordance degree was moderate (k=0.33, p<0.01). Pathologic N classification matched the post-CRI MRI findings in 85 (56.6%) of 150 patients. 54 (36.0%) of 150 patients were overstaged in N classification. 26 patients achieved downstaging (ycT0-2N0) on restaging MRI after CRT. 23 (88.5%) of 26 patients who had been downstaged on MRI after CRT were confirmed on the pathological staging, and the concordance degree was good (k=0.72, p<0.01). Restaging MRI has low accuracy for the prediction of the pathologic T and N classifications in rectal cancer patients who received preoperative CRT. The diagnostic accuracy of restaging MRI is relatively high in rectal cancer patients who achieved clinical downstaging after CRT. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Next-Generation Sequencing for Antenatal Prediction of KEL1 Blood Group Status

    DEFF Research Database (Denmark)

    Rieneck, Klaus; Clausen, Frederik Banch; Dziegiel, Morten Hanefeld

    2015-01-01

    The KEL1 antigen can give rise to immunization of KEL2 mothers. Maternal antibodies can be transferred to the fetus and destroy fetal red blood cells and their stem cell precursors and give rise to serious fetal disease. It is important to be able to predict the fetal KEL status in order...... to intervene in those pregnancies where the fetus is at risk, and to ascertain when the fetus is not at risk. Technically it can be demanding to predict KEL1 status from a maternal blood sample. The KEL1 allele is based on a single SNP present in about 1-10 % of cell-free maternal DNA after gestation week 10...

  6. Experiencing 'pathologized presence and normalized absence'; understanding health related experiences and access to health care among Iraqi and Somali asylum seekers, refugees and persons without legal status.

    Science.gov (United States)

    Fang, Mei Lan; Sixsmith, Judith; Lawthom, Rebecca; Mountian, Ilana; Shahrin, Afifa

    2015-09-19

    Asylum seekers, refugees and persons without legal status have been reported to experience a range of difficulties when accessing public services and supports in the UK. While research has identified health care barriers to equitable access such as language difficulties, it has not considered the broader social contexts of marginalization experienced through the dynamics of 'othering'. The current study explores health and health care experiences of Somali and Iraqi asylum seekers, refugees and persons without legal status, highlighting 'minoritization' processes and the 'pathologization' of difference as analytical lenses to understand the multiple layers of oppression that contribute to health inequities. For the study, qualitative methods were used to document the lived experiences of asylum seekers, refugees and persons without legal status. Thirty-five in-depth interviews and five focus groups were used to explore personal accounts, reveal shared understandings and enable social, cognitive and emotional understandings of on-going health problems and challenges when seeking treatment and care. A participatory framework was undertaken which inspired collaborative workings with local organizations that worked directly with asylum seekers, refugees and persons without legal status. The analysis revealed four key themes: 1) pre-departure histories and post-arrival challenges; 2) legal status; 3) health knowledges and procedural barriers as well as 4) language and cultural competence. Confidentiality, trust, wait times and short doctor-patient consultations were emphasized as being insufficient for culturally specific communications and often translating into inadequate treatment and care. Barriers to accessing health care was associated with social disadvantage and restrictions of the broader welfare system suggesting that a re-evaluation of the asylum seeking process is required to improve the situation. Macro- and micro-level intersections of accustomed societal

  7. Effects of medicated diet to eradicate Helicobacter spp. on growth, pathology, and infection status in Rag1-/- and nude mice.

    Science.gov (United States)

    Garrett, Caroline M; Muth, Dillon; Watson, Julie

    2014-05-01

    The use of a commercial 4-drug diet has been shown to eradicate Helicobacter spp. from immunocompetent mice and those with innate immunodeficiencies. However the efficacy of this diet has not been confirmed in mice with altered adaptive immunity. We hypothesized that an 8-wk treatment with medicated diet would eradicate H. hepaticus and H. typhlonius from young naturally infected nude and Rag1 mice lacking functional T cells (Foxn1(nu)) or T and B cells (B6.129S7-Rag1(tm1Mom)/J), respectively. We evaluated helicobacter status, body weight, and gross and histologic changes between medicated and control diet in groups of infected and uninfected mice throughout treatment and at 8 wk after treatment completion. Initial infection status was confirmed by fecal PCR at weaning and 3 wk later, with study initiation in 7-wk-old mice. PCR testing demonstrated that independent of strain and sex, all treated mice tested negative for Helicobacter spp. after 4 wk of treatment and remained negative for the duration of the study. Irrespective of infection status, nude and Rag1 mice fed 8 wk of medicated diet gained less weight than did their untreated controls. Both strains normalized body weight while on control diet for the 8 wk after treatment. Mice fed medicated diet developed severe gastroesophageal hyperkeratosis, suggestive of reduced feed consumption, and enlarged ceca. These conditions improved or resolved after the return to control diet. This report is the first to demonstrate the efficacy and physical effects of providing medicated diet for the eradication of Helicobacter spp. from mice with adaptive immune deficiencies.

  8. Can personality traits and intelligence compensate for background disadvantage? Predicting status attainment in adulthood.

    Science.gov (United States)

    Damian, Rodica Ioana; Su, Rong; Shanahan, Michael; Trautwein, Ulrich; Roberts, Brent W

    2015-09-01

    This study investigated the interplay of family background and individual differences, such as personality traits and intelligence (measured in a large U.S. representative sample of high school students; N = 81,000) in predicting educational attainment, annual income, and occupational prestige 11 years later. Specifically, we tested whether individual differences followed 1 of 3 patterns in relation to parental socioeconomic status (SES) when predicting attained status: (a) the independent effects hypothesis (i.e., individual differences predict attainments independent of parental SES level), (b) the resource substitution hypothesis (i.e., individual differences are stronger predictors of attainments at lower levels of parental SES), and (c) the Matthew effect hypothesis (i.e., "the rich get richer"; individual differences are stronger predictors of attainments at higher levels of parental SES). We found that personality traits and intelligence in adolescence predicted later attained status above and beyond parental SES. A standard deviation increase in individual differences translated to up to 8 additional months of education, $4,233 annually, and more prestigious occupations. Furthermore, although we did find some evidence for both the resource substitution and the Matthew effect hypotheses, the most robust pattern across all models supported the independent effects hypothesis. Intelligence was the exception, the interaction models being more robust. Finally, we found that although personality traits may help compensate for background disadvantage to a small extent, they do not usually lead to a "full catch-up" effect, unlike intelligence. This was the first longitudinal study of status attainment to test interactive models of individual differences and background factors. (c) 2015 APA, all rights reserved).

  9. The role of co-morbid personality pathology in predicting self-reported aggression in patients with schizophrenia.

    Science.gov (United States)

    Bo, Sune; Abu-Akel, Ahmad; Kongerslev, Mickey; Haahr, Ulrik Helt; Simonsen, Erik

    2013-07-01

    Personality pathology affects behavioral patterns in patients with schizophrenia notwithstanding psychotic symptomatology. An investigation of the role of co-morbid personality pathology in the occurrence of aggression in schizophrenia is explored using both categorical and dimensional approaches to personality pathology. In a cross-sectional study we evaluate, in 97 patients diagnosed with schizophrenia, the effect of personality pathology on the occurrence of aggression in schizophrenia using both a categorical approach, as described in DSM-IV-TR Axis II, and a dimensional approach, as operationalized in the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). We also employ mediation analyses to explore the extent to which dimensions within the DAPP mediate the relationship between co-morbid personality disorders and aggression. Personality pathology accounts for aggression in schizophrenia. Both the categorical and the dimensional approaches equally well account for the occurrence of aggression, with each model accounting for 60% of the variance. Interestingly, the mediation analysis reveals that the association between categorically defined personality pathology and aggression is substantially mediated by the higher-order-trait dissocial behavior of the DAPP-BQ, accounting for 50.6 % of the total effect size. Personality pathology can be a significant predictor of aggression in patients with schizophrenia. While both the categorical and the dimensional trait models of personality disorders equally explain the aggression data, much of the relationship between the categorically defined personality disorders and the occurrence of aggression in schizophrenia can be explained by the presence of dissocial behavior as operationalized in the DAPP-BQ dimensional model. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Generational status and social factors predicting initiation of partnered sexual activity among Latino/a youth.

    Science.gov (United States)

    Cabral, Patricia; Wallander, Jan L; Song, Anna V; Elliott, Marc N; Tortolero, Susan R; Reisner, Sari L; Schuster, Mark A

    2017-02-01

    Examine the longitudinal association of generational status (first = child and parent born outside the United States; second = child born in the United States, parent born outside the United States; third = child and parent born in the United States) and parent and peer social factors considered in 5th grade with subsequent oral, vaginal, and anal intercourse initiation by 7th and 10th grade among Latino/a youth. Using data from Latino/a participants (N = 1,790) in the Healthy Passages™ study, the authors measured generational status (first = 18.4%, second = 57.3%, third-generation = 24.3%) and parental (i.e., monitoring, involvement, nurturance) and peer (i.e., friendship quality, social interaction, peer norms) influences in 5th grade and oral, vaginal, and anal intercourse initiation by 7th and 10th (retention = 89%) grade. Among girls, parental monitoring, social interaction, friendship quality, and peer norms predicted sexual initiation. Among boys, parental involvement, social interaction, and peer norms predicted sexual initiation (ps social influences on vaginal and oral intercourse initiation. Moreover, Latinas and Latinos differ in which social influences predict sexual intercourse initiation. Preventive efforts for Latino/a youth may need to differ by gender and generational status. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. Prediction of Sentinel Node Status and Clinical Outcome in a Melanoma Centre

    Directory of Open Access Journals (Sweden)

    Vera Teixeira

    2013-01-01

    Full Text Available Background. Sentinel lymph node biopsy (SLNB is a standard procedure for patients with localized cutaneous melanoma. The National Comprehensive Cancer Network (NCCN Melanoma Panel has reinforced the status of the sentinel lymph node (SLN as an important prognostic factor for melanoma survival. We sought to identify predictive factors associated with a positive SLNB and overall survival in our population. Methods. We performed a retrospective chart review of 221 patients who have done a successful SLNB for melanoma between 2004 and 2010 at our department. Univariate and multivariate analyses were done. Results. The SLNB was positive in 48 patients (21.7%. Univariate analysis showed that male gender, increasing Breslow thickness, tumor type, and absence of tumor-infiltrating lymphocytes were significantly associated with a positive SLNB. Multivariate analysis confirmed that Breslow thickness and the absence of tumor-infiltrating lymphocytes are independently predictive of SLN metastasis. The 5-year survival rates were 53.1% for SLN positive patients and 88.2% for SLN negative patients. Breslow thickness and the SLN status independently predict overall survival. Conclusions. The risk factors for a positive SLNB are consistent with those found in the previous literature. In addition, the SLN status is a major determinant of survival, which highlights its importance in melanoma management.

  12. Profiles of extracellular miRNA in cerebrospinal fluid and serum from patients with Alzheimer's and Parkinson's diseases correlate with disease status and features of pathology.

    Directory of Open Access Journals (Sweden)

    Kasandra Burgos

    Full Text Available The discovery and reliable detection of markers for neurodegenerative diseases have been complicated by the inaccessibility of the diseased tissue--such as the inability to biopsy or test tissue from the central nervous system directly. RNAs originating from hard to access tissues, such as neurons within the brain and spinal cord, have the potential to get to the periphery where they can be detected non-invasively. The formation and extracellular release of microvesicles and RNA binding proteins have been found to carry RNA from cells of the central nervous system to the periphery and protect the RNA from degradation. Extracellular miRNAs detectable in peripheral circulation can provide information about cellular changes associated with human health and disease. In order to associate miRNA signals present in cell-free peripheral biofluids with neurodegenerative disease status of patients with Alzheimer's and Parkinson's diseases, we assessed the miRNA content in cerebrospinal fluid and serum from postmortem subjects with full neuropathology evaluations. We profiled the miRNA content from 69 patients with Alzheimer's disease, 67 with Parkinson's disease and 78 neurologically normal controls using next generation small RNA sequencing (NGS. We report the average abundance of each detected miRNA in cerebrospinal fluid and in serum and describe 13 novel miRNAs that were identified. We correlated changes in miRNA expression with aspects of disease severity such as Braak stage, dementia status, plaque and tangle densities, and the presence and severity of Lewy body pathology. Many of the differentially expressed miRNAs detected in peripheral cell-free cerebrospinal fluid and serum were previously reported in the literature to be deregulated in brain tissue from patients with neurodegenerative disease. These data indicate that extracellular miRNAs detectable in the cerebrospinal fluid and serum are reflective of cell-based changes in pathology and can

  13. K-Ras gene mutation status as a prognostic and predictive factor in patients with colorectal cancer undergoing irinotecan- or oxaliplatin-based chemotherapy.

    Science.gov (United States)

    Stec, Rafał; Bodnar, Lubomir; Charkiewicz, Radosław; Korniluk, Jan; Rokita, Marta; Smoter, Marta; Ciechowicz, Marzena; Chyczewski, Lech; Nikliński, Jacek; Kozłowski, Wojciech; Szczylik, Cezary

    2012-11-01

    CRC caused more than 600,000 estimated deaths in 2008. Dysregulated signaling through the RAS/RAF/mitogen-activated protein kinase (MEK)/extracellular signal-regulated kinase (ERK) signaling pathway due to mutations in K-Ras and B-Raf are common events in CRC. Incidence of mutations in codons 12 and 13 of K-Ras and exons 11 and 15 of B-Raf were analyzed in amplified PCR products from primary tumors of 273 patients with CRC, and their prognostic and predictive significance was assessed. The prognostic role of clinical and pathological factors was also examined. K-Ras mutations were present in 89 patients (32.6%), of whom 76 (85.4%) had mutations in codon 12 and 10 (11.2%) had mutations in codon 13. B-Raf gene mutations were present in 17 patients (6.9%), of whom 6 (35.3%) had mutations in exon 15. Multivariate analysis revealed a predictive significance for K-Ras mutations with respect to time to progression in patients treated with irinotecan and oxaliplatin as first-line chemotherapy. There was no predictive significance for B-Raf gene mutation status in these patients. The following risk factors were found to affect overall survival (OS) rates: primary tumor location, lymph node involvement grade, carcinoembryonic antigen (CEA) level before treatment, and performance status according to WHO criteria. Based on the results of this study, K-Ras mutation status may be a suitable indicator of patient eligibility and a prognostic indicator for responsiveness to anti-EGFR therapy alone, or in combination with chemotherapy. Also, K-Ras mutation status may predict time to progression in patients treated with irinotecan and oxaliplatin.

  14. Prediction of pathological and oncological outcomes based on extended prostate biopsy results in patients with prostate cancer receiving radical prostatectomy: a single institution study

    Directory of Open Access Journals (Sweden)

    Ishizaki Fumio

    2012-06-01

    Full Text Available Abstract Background The prediction of pathological outcomes prior to surgery remains a challenging problem for the appropriate surgical indication of prostate cancer. This study was performed to identify preoperative values predictive of pathological and oncological outcomes based on standardized extended prostate biopsies with core histological results diagrammed/mapped in patients receiving radical prostatectomy for prostate cancer clinically diagnosed as localized or locally advanced disease. Methods In 124 patients with clinically localized or locally advanced prostate cancer (cT1c–cT3a without prior treatment, pathological outcomes on the surgical specimen including seminal vesicle involvement (SVI, positive surgical margin (PSM, and perineural invasion (PNI were studied in comparison with clinical parameters based on the results of 14-core prostate biopsies comprising sextant, laterally-directed sextant, and bilateral transition zone (TZ sampling. Results Concerning the association of pathological outcomes with oncological outcomes, patients with PSM and PNI on surgical specimens had poorer biochemical-progression-free survival than those without PSM (logrank p = 0.002 and PNI (p = 0.003; it was also poorer concerning SVI, although the difference was not significant (p = 0.120. Concerning the impact of clinical parameters on these pathological outcomes, positive TZ and multiple positive biopsy cores in the prostatic middle were independent values predictive of SVI with multivariate analyses (p = 0.020 and p = 0.025, respectively; both positive TZ and multiple positive prostatic middle biopsies were associated with larger tumor volume (p  Conclusions %positive cores and Gleason score in extended biopsies were independent values predictive of PSM and PNI in prostate cancer clinically diagnosed as localized or locally advanced disease, respectively, which were associated with poorer oncological outcomes. When

  15. SAE for the prediction of road traffic status from taxicab operating data and bus smart card data

    Science.gov (United States)

    Zhengfeng, Huang; Pengjun, Zheng; Wenjun, Xu; Gang, Ren

    Road traffic status is significant for trip decision and traffic management, and thus should be predicted accurately. A contribution is that we consider multi-modal data for traffic status prediction than only using single source data. With the substantial data from Ningbo Passenger Transport Management Sector (NPTMS), we wished to determine whether it was possible to develop Stacked Autoencoders (SAEs) for accurately predicting road traffic status from taxicab operating data and bus smart card data. We show that SAE performed better than linear regression model and Back Propagation (BP) neural network for determining the relationship between road traffic status and those factors. In a 26-month data experiment using SAE, we show that it is possible to develop highly accurate predictions (91% test accuracy) of road traffic status from daily taxicab operating data and bus smart card data.

  16. A computer-aided diagnosis (CAD) scheme for pretreatment prediction of pathological response to neoadjuvant therapy using dynamic contrast-enhanced MRI texture features.

    Science.gov (United States)

    Giannini, Valentina; Mazzetti, Simone; Marmo, Agnese; Montemurro, Filippo; Regge, Daniele; Martincich, Laura

    2017-08-01

    To assess whether a computer-aided, diagnosis (CAD) system can predict pathological Complete Response (pCR) to neoadjuvant chemotherapy (NAC) prior to treatment using texture features. Response to treatment of 44 patients was defined according to the histopatology of resected tumour and extracted axillary nodes in two ways: (a) pCR+ (Smith's Grade = 5) vs pCR- (Smith's Grade < 5); (b) pCRN+ (pCR+ and absence of residual lymph node metastases) vs pCRN - . A CAD system was developed to: (i) segment the breasts; (ii) register the DCE-MRI sequence; (iii) detect the lesion and (iv) extract 27 3D texture features. The role of individual texture features, multiparametric models and Bayesian classifiers in predicting patients' response to NAC were evaluated. A cross-validated Bayesian classifier fed with 6 features was able to predict pCR with a specificity of 72% and a sensitivity of 67%. Conversely, 2 features were used by the Bayesian classifier to predict pCRN, obtaining a sensitivity of 69% and a specificity of 61%. A CAD scheme, that extracts texture features from an automatically segmented 3D mask of the tumour, could predict pathological response to NAC. Additional research should be performed to validate these promising results on a larger cohort of patients and using different classification strategies. Advances in knowledge: This is the first study assessing the role of an automatic CAD system in predicting the pathological response to NAC before treatment. Fully automatic methods represent the backbone of standardized analysis and may help in timely managing patients candidate to NAC.

  17. Personality pathology recorded by severity: national survey.

    Science.gov (United States)

    Yang, Min; Coid, Jeremy; Tyrer, Peter

    2010-09-01

    Current classifications of personality disorders do not classify severity despite clinical practice favouring such descriptions. To assess whether an existing measure of severity of personality disorder predicted clinical pathology and societal dysfunction in a community sample. UK national epidemiological study in which personality status was measured using the screening version of the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) and reclassified to five levels using a modified severity index. Associations between levels of severity of personality pathology and social, demographic and clinical variables were measured. Of 8391 individuals interviewed and their personality status assessed, only a minority (n = 1933, 23%) had no personality pathology. The results supported the hypothesis. More severe personality pathology was associated incrementally with younger age, childhood institutional care, expulsion from school, contacts with the criminal justice system, economic inactivity, more Axis I pathology and greater service contact (primary care and secondary care, all Phandicap was noted among people with even low levels of personality pathology. No differences contradicted the main hypothesis. A simple reconstruction of the existing classification of personality disorder is a good predictor of social dysfunction and supports the development of severity measures as a critical requirement in both DSM-V and ICD-11 classifications.

  18. HER2 status for prognosis and prediction of treatment efficacy in adenocarcinomas: a review.

    Science.gov (United States)

    Thibault, Constance; Khodari, Wassim; Lequoy, Marie; Gligorov, Joseph; Belkacémi, Yazid

    2013-10-01

    The past few years have seen flourish new biologic parameters for cancer prognosis that are revolutionizing therapeutic strategies. HER-2 is in this perspective a striking example, as it is now a key element for the care of 15-20% of breast cancer. HER-2 overexpression has first been reported as a prognostic factor before its consideration as a main parameter to predict treatment efficacy. However, although HER-2 status is now also used as a prognostic factor for many cancers, its ability to predict the action of trastuzumab in these new contexts is much lower than in breast cancer. In this literature review, we aimed to discuss HER-2 overexpression as a prognostic factor and as a predictive parameter of treatment response in selected solid tumors with a focus on adenocarcinomas. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Pathological tremor prediction using surface EMG and acceleration: potential use in “ON-OFF” demand driven deep brain stimulator design

    Science.gov (United States)

    Basu, Ishita; Graupe, Daniel; Tuninetti, Daniela; Shukla, Pitamber; Slavin, Konstantin V.; Metman, Leo Verhagen; Corcos, Daniel M.

    2013-01-01

    Objective We present a proof of concept for a novel method of predicting the onset of pathological tremor using non-invasively measured surface electromyogram (sEMG) and acceleration from tremor-affected extremities of patients with Parkinson’s disease (PD) and Essential tremor (ET). Approach The tremor prediction algorithm uses a set of spectral (fourier and wavelet) and non-linear time series (entropy and recurrence rate) parameters extracted from the non-invasively recorded sEMG and acceleration signals. Main results The resulting algorithm is shown to successfully predict tremor onset for all 91 trials recorded in 4 PD patients and for all 91 trials recorded in 4 ET patients. The predictor achieves a 100% sensitivity for all trials considered, along with an overall accuracy of 85.7% for all ET trials and 80.2% for all PD trials. By using a Pearson’s chi-square test, the prediction results are shown to significantly differ from a random prediction outcome. Significance The tremor prediction algorithm can be potentially used for designing the next generation of non-invasive closed-loop predictive ON-OFF controllers for deep brain stimulation (DBS), used for suppressing pathological tremor in such patients. Such a system is based on alternating ON and OFF DBS periods, an incoming tremor being predicted during the time intervals when DBS is OFF, so as to turn DBS back ON. The prediction should be a few seconds before tremor re-appears so that the patient is tremor-free for the entire DBS ON-OFF cycle as well as the tremor-free DBS OFF interval should be maximized in order to minimize the current injected in the brain and battery usage. PMID:23658233

  20. Adjusting a cancer mortality-prediction model for disease status-related eligibility criteria

    Directory of Open Access Journals (Sweden)

    Kimmel Marek

    2011-05-01

    Full Text Available Abstract Background Volunteering participants in disease studies tend to be healthier than the general population partially due to specific enrollment criteria. Using modeling to accurately predict outcomes of cohort studies enrolling volunteers requires adjusting for the bias introduced in this way. Here we propose a new method to account for the effect of a specific form of healthy volunteer bias resulting from imposing disease status-related eligibility criteria, on disease-specific mortality, by explicitly modeling the length of the time interval between the moment when the subject becomes ineligible for the study, and the outcome. Methods Using survival time data from 1190 newly diagnosed lung cancer patients at MD Anderson Cancer Center, we model the time from clinical lung cancer diagnosis to death using an exponential distribution to approximate the length of this interval for a study where lung cancer death serves as the outcome. Incorporating this interval into our previously developed lung cancer risk model, we adjust for the effect of disease status-related eligibility criteria in predicting the number of lung cancer deaths in the control arm of CARET. The effect of the adjustment using the MD Anderson-derived approximation is compared to that based on SEER data. Results Using the adjustment developed in conjunction with our existing lung cancer model, we are able to accurately predict the number of lung cancer deaths observed in the control arm of CARET. Conclusions The resulting adjustment was accurate in predicting the lower rates of disease observed in the early years while still maintaining reasonable prediction ability in the later years of the trial. This method could be used to adjust for, or predict the duration and relative effect of any possible biases related to disease-specific eligibility criteria in modeling studies of volunteer-based cohorts.

  1. Hierarchical Status Predicts Behavioral Vulnerability and Nucleus Accumbens Metabolic Profile Following Chronic Social Defeat Stress.

    Science.gov (United States)

    Larrieu, Thomas; Cherix, Antoine; Duque, Aranzazu; Rodrigues, João; Lei, Hongxia; Gruetter, Rolf; Sandi, Carmen

    2017-07-24

    Extensive data highlight the existence of major differences in individuals' susceptibility to stress [1-4]. While genetic factors [5, 6] and exposure to early life stress [7, 8] are key components for such neurobehavioral diversity, intriguing observations revealed individual differences in response to stress in inbred mice [9-12]. This raised the possibility that other factors might be critical in stress vulnerability. A key challenge in the field is to identify non-invasively risk factors for vulnerability to stress. Here, we investigated whether behavioral factors, emerging from preexisting dominance hierarchies, could predict vulnerability to chronic stress [9, 13-16]. We applied a chronic social defeat stress (CSDS) model of depression in C57BL/6J mice to investigate the predictive power of hierarchical status to pinpoint which individuals will exhibit susceptibility to CSDS. Given that the high social status of dominant mice would be the one particularly challenged by CSDS, we predicted and found that dominant individuals were the ones showing a strong susceptibility profile as indicated by strong social avoidance following CSDS, while subordinate mice were not affected. Data from (1)H-NMR spectroscopy revealed that the metabolic profile in the nucleus accumbens (NAc) relates to social status and vulnerability to stress. Under basal conditions, subordinates show lower levels of energy-related metabolites compared to dominants. In subordinates, but not dominants, levels of these metabolites were increased after exposure to CSDS. To the best of our knowledge, this is the first study that identifies non-invasively the origin of behavioral risk factors predictive of stress-induced depression-like behaviors associated with metabolic changes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Can Personality Traits and Intelligence Compensate for Background Disadvantage? Predicting Status Attainment in Adulthood

    Science.gov (United States)

    Damian, Rodica Ioana; Su, Rong; Shanahan, Michael; Trautwein, Ulrich; Roberts, Brent W.

    2014-01-01

    This paper investigates the interplay of family background and individual differences, such as personality traits and intelligence (measured in a large US representative sample of high school students; N = 81,000) in predicting educational attainment, annual income, and occupational prestige eleven years later. Specifically, we tested whether individual differences followed one of three patterns in relation to parental SES when predicting attained status: (a) the independent effects hypothesis (i.e., individual differences predict attainments independent of parental SES level), (b) the resource substitution hypothesis (i.e., individual differences are stronger predictors of attainments at lower levels of parental SES), and (c) the Matthew effect hypothesis (i.e., “the rich get richer,” individual differences are stronger predictors of attainments at higher levels of parental SES). We found that personality traits and intelligence in adolescence predicted later attained status above and beyond parental SES. A standard deviation increase in individual differences translated to up to 8 additional months of education, $4,233 annually, and more prestigious occupations. Furthermore, although we did find some evidence for both the resource substitution and the Matthew effect hypotheses, the most robust pattern across all models supported the independent effects hypothesis. Intelligence was the exception, where interaction models were more robust. Finally, we found that although personality traits may help compensate for background disadvantage to a small extent, they do not usually lead to a “full catch up” effect, unlike intelligence. This was the first longitudinal study of status attainment to test interactive models of individual differences and background factors. PMID:25402679

  3. Predicting the HMA-LMA Status in Marine Sponges by Machine Learning

    Science.gov (United States)

    Moitinho-Silva, Lucas; Steinert, Georg; Nielsen, Shaun; Hardoim, Cristiane C. P.; Wu, Yu-Chen; McCormack, Grace P.; López-Legentil, Susanna; Marchant, Roman; Webster, Nicole; Thomas, Torsten; Hentschel, Ute

    2017-01-01

    The dichotomy between high microbial abundance (HMA) and low microbial abundance (LMA) sponges has been observed in sponge-microbe symbiosis, although the extent of this pattern remains poorly unknown. We characterized the differences between the microbiomes of HMA (n = 19) and LMA (n = 17) sponges (575 specimens) present in the Sponge Microbiome Project. HMA sponges were associated with richer and more diverse microbiomes than LMA sponges, as indicated by the comparison of alpha diversity metrics. Microbial community structures differed between HMA and LMA sponges considering Operational Taxonomic Units (OTU) abundances and across microbial taxonomic levels, from phylum to species. The largest proportion of microbiome variation was explained by the host identity. Several phyla, classes, and OTUs were found differentially abundant in either group, which were considered “HMA indicators” and “LMA indicators.” Machine learning algorithms (classifiers) were trained to predict the HMA-LMA status of sponges. Among nine different classifiers, higher performances were achieved by Random Forest trained with phylum and class abundances. Random Forest with optimized parameters predicted the HMA-LMA status of additional 135 sponge species (1,232 specimens) without a priori knowledge. These sponges were grouped in four clusters, from which the largest two were composed of species consistently predicted as HMA (n = 44) and LMA (n = 74). In summary, our analyses shown distinct features of the microbial communities associated with HMA and LMA sponges. The prediction of the HMA-LMA status based on the microbiome profiles of sponges demonstrates the application of machine learning to explore patterns of host-associated microbial communities. PMID:28533766

  4. Clinicopathological variables predicting HER-2 gene status in immunohistochemistry-equivocal (2+) invasive breast cancer.

    Science.gov (United States)

    Ji, Yongling; Sheng, Liming; Du, Xianghui; Qiu, Guoqin; Chen, Bo; Wang, Xiaojia

    2014-07-01

    Human epidermal growth factor receptor-2 (HER-2) gene status is crucial to guide treatment decisions regarding the use of HER-2-targeted therapies in breast cancer. An invasive breast cancer with HER-2 2+ score is regarded as HER-2 status equivocal and should further determine by fluorescent in situ hybridization (FISH), which is considered the standard test for HER-2 status. Here, we aimed to establish a risk score to allow for prediction of the presence of HER-2 gene status. A total of 182 HER-2 2+ by immunohistochemistry (IHC) invasive breast cancer cases were enrolled in this study. The association between clinicopathological variables like age, sex, tumor grade, hormone receptor (HR) status, P53 and proliferation index (Ki67), and FISH result using US Food and Drug Administration (FDA) criteria was evaluated. Also, we compared the HER-2 FISH results using FDA criteria and 2013 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guideline. The study population had a median age of 48 years (range, 29-78 years). Estrogen receptor (ER) was expressed in 131 (72.0%) patients. 73.1% of patients (133/182) were progesterone receptor (PR) positive. The median Ki67 value was 20% (range, 3-90%). There was good agreement between the FDA and 2013 ASCO/CAP guideline. Sixty-three of all patients were HER-2 FISH amplified (positive) based on FDA criteria. Tumors with HER-2 amplified were more likely to harbor ER negative (58.8% vs. 25.2%, PHER-2 amplified groups (P=0.006). We created a risk score that comprised HR, P53 and Ki67. A significant association between risk score and HER-2 FISH amplification was observed (χ(2)=30.41, PHER-2 gene status in invasive breast cancer.

  5. Matrix metalloproteinase-9 predicts pulmonary status declines in α1-antitrypsin deficiency

    Directory of Open Access Journals (Sweden)

    Rames Alexis

    2011-03-01

    Full Text Available Abstract Background Matrix metalloproteinase-9 (MMP-9 may be important in the progression of emphysema, but there have been few longitudinal clinical studies of MMP-9 including pulmonary status and COPD exacerbation outcomes. Methods We utilized data from the placebo arm (n = 126 of a clinical trial of patients with alpha1-antitrypsin deficiency (AATD and emphysema to examine the links between plasma MMP-9 levels, pulmonary status, and COPD exacerbations over a one year observation period. Pulmonary function, computed tomography lung density, incremental shuttle walk test (ISWT, and COPD exacerbations were assessed at regular intervals over 12 months. Prospective analyses used generalized estimating equations to incorporate repeated longitudinal measurements of MMP-9 and all endpoints, controlling for age, gender, race-ethnicity, leukocyte count, and tobacco history. A secondary analysis also incorporated highly-sensitive C-reactive protein levels in predictive models. Results At baseline, higher plasma MMP-9 levels were cross-sectionally associated with lower FEV1 (p = 0.03, FVC (p Conclusions Increased plasma MMP-9 levels generally predicted pulmonary status declines, including worsening transfer factor and lung density as well as greater COPD exacerbations in AATD-associated emphysema.

  6. Peculiarities of mental status in patients with chronic obstructive pulmonary disease in different phases of the pathological process

    Directory of Open Access Journals (Sweden)

    Pertseva T.O.

    2016-03-01

    Full Text Available Chronic obstructive pulmonary disease (COPD has a significant impact on various aspects of life of patients due to of daily symptoms, frequent exacerbations, comorbid conditions, including anxiety and depression. In the scientific literature there are different data on the relationship between the frequency of occurrence and severity of exacerbations of COPD on the one hand and concomitant depression and increased anxiety on the other hand. The aim of our study – to examine frequency and se­verity of depression and anxiety in patients with COPD exacerbation and in stable phase of the disease in patients with varying terms of remission. We examined 108 patients with COPD, which were divided into two groups. The main group – 16 patients with COPD were examined in two visits: in exacerbation and after two months of its completion. A comparison group – 92 patients with COPD in stable phase of the disease for at least three months. Examination of pa­tients included general clinical methods, evaluation of clinical symptoms of COPD, evaluation of mental status using Hospital Anxiety and Depression Scale. It was found that symptoms of depression and anxiety are more expressied in pa­tients with COPD exacerbation than in the stable phase. It was determined that the frequency of depression and anxiety in patients with COPD tends to decrease in two months after the exacerbation. It was also shown that mild depression and anxiety prevail in COPD patients with impaired mental state. In addition, there was found correlation between severity of dyspnea and depression severity in COPD patients with concomitant depression in the stable phase of the disease.

  7. Nutritional status predicts preterm death in older people: a prospective cohort study.

    Science.gov (United States)

    Söderström, Lisa; Rosenblad, Andreas; Adolfsson, Eva Thors; Saletti, Anja; Bergkvist, Leif

    2014-04-01

    There is an association between malnutrition and mortality. However, it is uncertain whether this association is independent of confounders. The aim of the present study was to examine whether nutritional status, defined according to the three categories in the full Mini Nutritional Assessment (MNA) instrument, is an independent predictor of preterm death in people 65 years and older. This prospective cohort study included individuals aged ≥65 years who were admitted to hospital between March 2008 and May 2009 and followed-up after 50 months (n = 1767). Nutritional status was assessed with the MNA, and possible risk factors associated with malnutrition were recorded during participants hospital stay. Main outcome measure was overall survival. Based on the MNA definitions, 628 (35.5%) were well-nourished, 973 (55.1%) were at risk of malnutrition, and 166 (9.4%) of the participants were malnourished at baseline. During the follow-up period 655 (37.1%) participants died. At follow-up, the survival rates were 75.2% for well-nourished participants, 60.0% for those at risk of malnutrition, and 33.7% for malnourished participants (p Nutritional status defined according to the three categories in the full MNA independently predicts preterm death in people aged 65 years and older. These findings are clinically important and emphasise the usefulness of the MNA for screening of nutritional status. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  8. Prediction of pathological stage based on clinical stage, serum prostate-specific antigen, and biopsy Gleason score: Partin Tables in the contemporary era.

    Science.gov (United States)

    Tosoian, Jeffrey J; Chappidi, Meera; Feng, Zhaoyong; Humphreys, Elizabeth B; Han, Misop; Pavlovich, Christian P; Epstein, Jonathan I; Partin, Alan W; Trock, Bruce J

    2017-05-01

    To update the Partin Tables for prediction of pathological stage in the contemporary setting and examine trends in patients treated with radical prostatectomy (RP) over the past three decades. From January 2010 to October 2015, 4459 men meeting inclusion criteria underwent RP and pelvic lymphadenectomy for histologically confirmed prostate cancer at the Johns Hopkins Hospital. Preoperative clinical stage, serum prostate-specific antigen (PSA) level, and biopsy Gleason score (i.e. prognostic Grade Group) were used in a polychotomous logistic regression model to predict the probability of pathological outcomes categorised as: organ-confined (OC), extraprostatic extension (EPE), seminal vesicle involvement (SV+), or lymph node involvement (LN+). Preoperative characteristics and pathological findings in men treated with RP since 1983 were collected and clinical-pathological trends were described. The median (range) age at surgery was 60 (34-77) years and the median (range) PSA level was 4.9 (0.1-125.0) ng/mL. The observed probabilities of pathological outcomes were: OC disease in 74%, EPE in 20%, SV+ in 4%, and LN+ in 2%. The probability of EPE increased substantially when biopsy Gleason score increased from 6 (Grade Group 1, GG1) to 3 + 4 (GG2), with smaller increases for higher grades. The probability of LN+ was substantially higher for biopsy Gleason score 9-10 (GG5) as compared to lower Gleason scores. Area under the receiver operating characteristic curves for binary logistic models predicting EPE, SV+, and LN+ vs OC were 0.724, 0.856, and 0.918, respectively. The proportion of men treated with biopsy Gleason score ≤6 cancer (GG1) was 47%, representing a substantial decrease from 63% in the previous cohort and 77% in 2000-2005. The proportion of men with OC cancer has remained similar during that time, equalling 73-74% overall. The proportions of men with SV+ (4.1% from 3.4%) and LN+ (2.3% from 1.4%) increased relative to the preceding era for the first time

  9. Predicting IDH mutation status of intrahepatic cholangiocarcinomas based on contrast-enhanced CT features.

    Science.gov (United States)

    Zhu, Yong; Chen, Jun; Kong, Weiwei; Mao, Liang; Kong, Wentao; Zhou, Qun; Zhou, Zhengyang; Zhu, Bin; Wang, Zhongqiu; He, Jian; Qiu, Yudong

    2018-01-01

    To explore the difference in contrast-enhanced computed tomography (CT) features of intrahepatic cholangiocarcinomas (ICCs) with different isocitrate dehydrogenase (IDH) mutation status. Clinicopathological and contrast-enhanced CT features of 78 patients with 78 ICCs were retrospectively analysed and compared based on IDH mutation status. There were 11 ICCs with IDH mutation (11/78, 14.1%) and 67 ICCs without IDH mutation (67/78, 85.9%). IDH-mutated ICCs showed intratumoral artery more often than IDH-wild ICCs (p = 0.023). Most ICCs with IDH mutation showed rim and internal enhancement (10/11, 90.9%), while ICCs without IDH mutation often appeared diffuse (26/67, 38.8%) or with no enhancement (4/67, 6.0%) in the arterial phase (p = 0.009). IDH-mutated ICCs showed significantly higher CT values, enhancement degrees and enhancement ratios in arterial and portal venous phases than IDH-wild ICCs (all p IDH mutation, with an area under the curve of 0.798 (p = 0.002). ICCs with and without IDH mutation differed significantly in arterial enhancement mode, and the tumour enhancement degree on multiphase contrast-enhanced CT was helpful in predicting IDH mutation status. • IDH mutation occurred frequently in ICCs. • ICCs with and without IDH mutation differed significantly in arterial enhancement mode. • ICCs with IDH mutation enhanced more than those without IDH mutation. • Enhancement ratio and tumour CT value can predict IDH mutation status.

  10. Quantitative DCE-MRI for prediction of pathological complete response following neoadjuvant treatment for locally advanced breast cancer: the impact of breast cancer subtypes on the diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Drisis, Stylianos; Stathopoulos, Konstantinos; Chao, Shih-Li; Lemort, Marc [Institute Jules Bordet, Radiology Department, Brussels (Belgium); Metens, Thierry [Erasme University Hospital, Radiology Department, Brussels (Belgium); Ignatiadis, Michael [Institute Jules Bordet, Oncology Department, Brussels (Belgium)

    2016-05-15

    To assess whether DCE-MRI pharmacokinetic (PK) parameters obtained before and during chemotherapy can predict pathological complete response (pCR) differently for different breast cancer groups. Eighty-four patients who received neoadjuvant chemotherapy for locally advanced breast cancer were retrospectively included. All patients underwent two DCE-MRI examinations, one before (EX1) and one during treatment (EX2). Tumours were classified into different breast cancer groups, namely triple negative (TNBC), HER2+ and ER+/HER2-, and compared with the whole population (WP). PK parameters Ktrans and Ve were extracted using a two-compartment Tofts model. At EX1, Ktrans predicted pCR for WP and TNBC. At EX2, maximum diameter (Dmax) predicted pCR for WP and ER+/HER2-. Both PK parameters predicted pCR in WP and TNBC and only Ktrans for the HER2+. pCR was predicted from relative difference (EX1 - EX2)/EX1 of Dmax and both PK parameters in the WP group and only for Ve in the TNBC group. No PK parameter could predict response for ER+/HER-. ROC comparison between WP and breast cancer groups showed higher but not statistically significant values for TNBC for the prediction of pCR Quantitative DCE-MRI can better predict pCR after neoadjuvant treatment for TNBC but not for the ER+/HER2- group. (orig.)

  11. Anthropometric Indices Added the Predictive Ability of Iron Status in Prognosis of Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Motahar Heidari-Beni

    2012-12-01

    Full Text Available Background: Abnormal homeostasis of iron such as deficiency or overload is associated with the pathogenesis of cardiovascular disease (CVD. Another risk factor for CVD is obesity whose added predictive ability to iron status has been assessed by few study. This study aimed to eva-luate the effect of adding anthropometric indices to a model based on iron status as risk factors of CVD.Methods: This cross-sectional study included 140 adult women aged 18-50 years randomly se-lected from Sheikhorrais Clinic that is one of the Tabriz University sub-specialized clinics in 2011. Anthropometric indices, carotid intima-media thickness (CIMT and body iron status were measured by standard protocol, non-invasive ultrasound and concentrations of serum iron, ferri-tin, TIBC (Total iron Binding Capacity and complete blood cell counts (CBC, respectively. In-tegrated discriminatory improvement index (IDI and net reclassification improvement index (NRI were used as the measures of added predictive ability of anthropometric measures to the iron statues.Results: IDI (SE after adding Waist Circumference (WC, Waist to Heap Ratio (WHR, Waist to Height Ratio (WHtR, Body Mass Index (BMI and Body fat (% to base model was 0.12 (0.028, 0.09 (0.026, 0.12 (0.028, 0.07 (0.022 and 0.10 (0.026 respectively. The NRI (SE was 0.10 (0.065 for WC, 0.03 (0.058 for WHR, 0.07 (0.067 for WHtR, 0.05 (0.067 for BMI, and 0.08 (0.064 for Body fat.Conclusions: Anthropometric indices could significantly add to the predictive ability of the iron statues, with highest IDI when WC and WHtR were added to the base model. It suggests that by adding WC and WHtR to the iron status lead us to a more optimal model for predicting the ini-tial stage of atherosclerosis.

  12. Status of the observed and predicted b anti-b production at the Tevatron

    Energy Technology Data Exchange (ETDEWEB)

    Happacher, F.; Giromini, P.; /Frascati; Ptohos, F.; /Cyprus U.

    2005-09-01

    The authors review the experimental status of the b-quark production at the Fermilab Tevatron. They compare all available measurements to perturbative QCD predictions (NLO and FONLL) and also to the parton-level cross section evaluated with parton-shower Monte Carlo generators. They examine both the single b cross section and the so called b{bar b} correlations. The review shows that the experimental situation is quite complicated because the measurements appear to be inconsistent among themselves. In this situation, there is no solid basis to either claim that perturbative QCD is challenged by these measurements or, in contrast, that long-standing discrepancies between data and theory have been resolved by incrementally improving the measurements and the theoretical prediction.

  13. Predictive parameters for the antecedent development of hip pathology associated with long segment fusions to the pelvis for the treatment of adult spinal deformity.

    Science.gov (United States)

    Kinon, Merritt D; Nasser, Rani; Nakhla, Jonathan P; Adogwa, Owoicho; Moreno, Jessica R; Harowicz, Michael; Verla, Terence; Yassari, Reza; Bagley, Carlos A

    2016-01-01

    The surgical treatment of adult scoliosis frequently involves long segment fusions across the lumbosacral joints that redistribute tremendous amounts of force to the remaining mobile spinal segments as well as to the pelvis and hip joints. Whether or not these forces increase the risk of femoral bone pathology remains unknown. The aim of this study is to determine the correlation between long segment spinal fusions to the pelvis and the antecedent development of degenerative hip pathologies as well as what predictive patient characteristics, if any, correlate with their development. A retrospective chart review of all long segment fusions to the pelvis for adult degenerative deformity operated on by the senior author at the Duke Spine Center from February 2008 to March 2014 was undertaken. Enrolment criteria included all available demographic, surgical, and clinical outcome data as well as pre and postoperative hip pathology assessment. All patients had prospectively collected outcome measures and a minimum 2-year follow-up. Multivariable logistic regression analysis was performed comparing the incidence of preoperative hip pain and antecedent postoperative hip pain as a function of age, gender, body mass index (BMI), and number of spinal levels fused. In total, 194 patients were enrolled in this study. Of those, 116 patients (60%) reported no hip pain prior to surgery. Eighty-three patients (71.6%) remained hip pain free, whereas 33 patients (28.5%) developed new postoperative hip pain. Age, gender, and BMI were not significant among those who went on to develop hip pain postoperatively (P pathology. Age, gender, BMI, and levels fused do not correlate with the development of postoperative hip pain. The restoration of spinal alignment with long segment fusions may actually decrease the risk of developing femoral bone pathology and have a protective effect on the hip.

  14. Computational Pathology

    Science.gov (United States)

    Louis, David N.; Feldman, Michael; Carter, Alexis B.; Dighe, Anand S.; Pfeifer, John D.; Bry, Lynn; Almeida, Jonas S.; Saltz, Joel; Braun, Jonathan; Tomaszewski, John E.; Gilbertson, John R.; Sinard, John H.; Gerber, Georg K.; Galli, Stephen J.; Golden, Jeffrey A.; Becich, Michael J.

    2016-01-01

    Context We define the scope and needs within the new discipline of computational pathology, a discipline critical to the future of both the practice of pathology and, more broadly, medical practice in general. Objective To define the scope and needs of computational pathology. Data Sources A meeting was convened in Boston, Massachusetts, in July 2014 prior to the annual Association of Pathology Chairs meeting, and it was attended by a variety of pathologists, including individuals highly invested in pathology informatics as well as chairs of pathology departments. Conclusions The meeting made recommendations to promote computational pathology, including clearly defining the field and articulating its value propositions; asserting that the value propositions for health care systems must include means to incorporate robust computational approaches to implement data-driven methods that aid in guiding individual and population health care; leveraging computational pathology as a center for data interpretation in modern health care systems; stating that realizing the value proposition will require working with institutional administrations, other departments, and pathology colleagues; declaring that a robust pipeline should be fostered that trains and develops future computational pathologists, for those with both pathology and non-pathology backgrounds; and deciding that computational pathology should serve as a hub for data-related research in health care systems. The dissemination of these recommendations to pathology and bioinformatics departments should help facilitate the development of computational pathology. PMID:26098131

  15. Predicted vitamin D status during pregnancy in relation to offspring forearm fractures in childhood

    DEFF Research Database (Denmark)

    Petersen, Sesilje B.; Strøm, Marin; Maslova, Ekaterina

    2015-01-01

    In a prospective cohort study, the association between maternal vitamin D status during pregnancy and offspring forearm fractures during childhood and adolescence was analysed in 30 132 mother and child pairs recruited to the Danish National Birth Cohort between 1996 and 2002. Data on characteris......In a prospective cohort study, the association between maternal vitamin D status during pregnancy and offspring forearm fractures during childhood and adolescence was analysed in 30 132 mother and child pairs recruited to the Danish National Birth Cohort between 1996 and 2002. Data...... on characteristics, dietary factors and lifestyle factors were collected on several occasions during pregnancy. We analysed the association between predicted vitamin D status, based on a subsample with 25-hydroxyvitamin D (25(OH)D) biomarker measurements (n 1497) from gestation week 25, and first-time forearm...... and supplementary vitamin D intake, tanning bed use and outdoor physical activity) in pregnancy and offspring forearm fractures. Likewise, measured 25(OH)D, tanning bed use and dietary vitamin D intake were not associated with offspring forearm fractures. In mid-pregnancy, 91 % of the women reported intake...

  16. Functional Status Predicts Acute Care Readmissions from Inpatient Rehabilitation in the Stroke Population.

    Directory of Open Access Journals (Sweden)

    Chloe Slocum

    Full Text Available Acute care readmission risk is an increasingly recognized problem that has garnered significant attention, yet the reasons for acute care readmission in the inpatient rehabilitation population are complex and likely multifactorial. Information on both medical comorbidities and functional status is routinely collected for stroke patients participating in inpatient rehabilitation. We sought to determine whether functional status is a more robust predictor of acute care readmissions in the inpatient rehabilitation stroke population compared with medical comorbidities using a large, administrative data set.A retrospective analysis of data from the Uniform Data System for Medical Rehabilitation from the years 2002 to 2011 was performed examining stroke patients admitted to inpatient rehabilitation facilities. A Basic Model for predicting acute care readmission risk based on age and functional status was compared with models incorporating functional status and medical comorbidities (Basic-Plus or models including age and medical comorbidities alone (Age-Comorbidity. C-statistics were compared to evaluate model performance.There were a total of 803,124 patients: 88,187 (11% patients were transferred back to an acute hospital: 22,247 (2.8% within 3 days, 43,481 (5.4% within 7 days, and 85,431 (10.6% within 30 days. The C-statistics for the Basic Model were 0.701, 0.672, and 0.682 at days 3, 7, and 30 respectively. As compared to the Basic Model, the best-performing Basic-Plus model was the Basic+Elixhauser model with C-statistics differences of +0.011, +0.011, and + 0.012, and the best-performing Age-Comorbidity model was the Age+Elixhauser model with C-statistic differences of -0.124, -0.098, and -0.098 at days 3, 7, and 30 respectively.Readmission models for the inpatient rehabilitation stroke population based on functional status and age showed better predictive ability than models based on medical comorbidities.

  17. Pre-fracture nutritional status is predictive of functional status at discharge during the acute phase with hip fracture patients: A multicenter prospective cohort study.

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    Inoue, Tatsuro; Misu, Syogo; Tanaka, Toshiaki; Sakamoto, Hiroki; Iwata, Kentaro; Chuman, Yuki; Ono, Rei

    2017-10-01

    Malnutrition is common in patients with hip fractures, and elderly patients with hip fractures lose functional independence and often fail to recover previous functional status. The aim of this study was to determine whether pre-fracture nutritional status predicts functional status of patients with hip fracture at discharge from acute hospitals. In the present multicenter prospective cohort study, pre-fracture nutritional status was assessed using the Mini Nutritional Assessment Short-Form (MNA-SF). At discharge from acute hospitals, functional status was evaluated using a functional independent measurement instrument (FIM). Subsequently, multiple regression analyses were performed using FIM as the dependent variable and MNA-SF as the independent variable. Among the 204 patients analyzed in the present study, the mean length of hospital stay was 26.2 ± 12.6 days, and according to MNA-SF assessments, 51 (25.0%) patients were malnourished, 98 (48.0%) were at risk of malnutrition, and 55 (27.0%) were well-nourished before fracture. At discharge, FIM scores were higher in patients who were well-nourished than in those who were malnourished or were at risk of malnutrition (p nutritional status was a significant independent predictor for functional status at discharge during the acute phase, warranting early assessment of nutritional status and early intervention for successful postoperative rehabilitation. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  18. Adult attachment status predicts the developmental trajectory of maternal sensitivity in new motherhood among Chinese mothers.

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    Liang, X; Wang, Z-Y; Liu, H-Y; Lin, Q; Wang, Z; Liu, Y

    2015-01-01

    to investigate adult attachment status in first-time mothers, and stability and/or changes in maternal sensitivity during infancy. longitudinal study using quantitative and qualitative methods, and statistical modelling. Three home visits were undertaken when the infant was approximately six, nine and 14 months old. The Adult-to-Parental Attachment Experience Survey was used, and scores for three dimensions were obtained: secure-autonomous, preoccupied and dismissive. Maternal sensitivity was assessed at each time point using the Maternal Behaviour Q-Sort by observing interaction between the mother and infant at home. homes and community settings in greater metropolitan Beijing, North China. 83 mothers and infants born in 2010 enrolled in this study. Data were missing for one or more time points in 20 cases. the mean score for maternal sensitivity tended to increase from six to 14 months. Post-hoc analyses of one-way repeated-measures analysis of variance revealed that maternal sensitivity was significantly higher at 14 months than at six or nine months. An unconditional latent growth model (LGM) of maternal sensitivity, estimated using the Bayesian approach, provided a good fit for the data. Using three attachment-related variables as predictors in the conditional LGM, the model fitting indices were found to be sufficient, and the results suggested that the secure score positively predicted the intercept of the growth model, and the dismissive score negatively predicted both the intercept and slope of the growth model. maternal sensitivity increased over time during infancy. Furthermore, individual differences existed in the developmental trajectory, which was influenced by maternal attachment status. knowledge about attachment-related differences in the trajectory of first-time mothers' sensitivity to infants may help midwives and doctors to provide individualised information and support, with special attention given to mothers with a dismissive attachment status

  19. The role of quantitative estrogen receptor status in predicting tumor response at surgery in breast cancer patients treated with neoadjuvant chemotherapy.

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    Raphael, Jacques; Gandhi, Sonal; Li, Nim; Lu, Fang-I; Trudeau, Maureen

    2017-07-01

    Estrogen receptor (ER) negative (-) breast cancer (BC) patients have better tumor response rates than ER-positive (+) patients after neoadjuvant chemotherapy (NCT). We conducted a retrospective review using the institutional database "Biomatrix" to assess the value of quantitative ER status in predicting tumor response at surgery and to identify potential predictors of survival outcomes. Univariate followed by multivariable regression analyses were conducted to assess the association between quantitative ER and tumor response assessed as tumor size reduction and pathologic complete response (pCR). Predictors of recurrence-free survival (RFS) were identified using a cox proportional hazards model (CPH). A log-rank test was used to compare RFS between groups if a significant predictor was identified. 304 patients were included with a median follow-up of 43.3 months (Q1-Q3 28.7-61.1) and a mean age of 49.7 years (SD 10.9). Quantitative ER was inversely associated with tumor size reduction and pCR (OR 0.99, 95% CI 0.99-1.00, p = 0.027 and 0.98 95% CI 0.97-0.99, p Quantitative ER status is inversely associated with tumor response in BC patients treated with NCT. A cut-off of 60 and 80% predicts best the association with tumor size reduction and pCR, respectively. Therefore, patients with an ER status higher than the cut-off might benefit from a neoadjuvant endocrine therapy approach. Patients with pCR had better survival outcomes independently of their tumor phenotype. Further prospective studies are needed to validate the clinical utility of quantitative ER as a predictive marker of tumor response.

  20. Predicting cost of care using self-reported health status data.

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    Boscardin, Christy K; Gonzales, Ralph; Bradley, Kent L; Raven, Maria C

    2015-09-23

    We examined whether self-reported employee health status data can improve the performance of administrative data-based models for predicting future high health costs, and develop a predictive model for predicting new high cost individuals. This retrospective cohort study used data from 8,917 Safeway employees self-insured by Safeway during 2008 and 2009. We created models using step-wise multivariable logistic regression starting with health services use data, then socio-demographic data, and finally adding the self-reported health status data to the model. Adding self-reported health data to the baseline model that included only administrative data (health services use and demographic variables; c-statistic = 0.63) increased the model" predictive power (c-statistic = 0.70). Risk factors associated with being a new high cost individual in 2009 were: 1) had one or more ED visits in 2008 (adjusted OR: 1.87, 95 % CI: 1.52, 2.30), 2) had one or more hospitalizations in 2008 (adjusted OR: 1.95, 95 % CI: 1.38, 2.77), 3) being female (adjusted OR: 1.34, 95 % CI: 1.16, 1.55), 4) increasing age (compared with age 18-35, adjusted OR for 36-49 years: 1.28; 95 % CI: 1.03, 1.60; adjusted OR for 50-64 years: 1.92, 95 % CI: 1.55, 2.39; adjusted OR for 65+ years: 3.75, 95 % CI: 2.67, 2.23), 5) the presence of self-reported depression (adjusted OR: 1.53, 95 % CI: 1.29, 1.81), 6) chronic pain (adjusted OR: 2.22, 95 % CI: 1.81, 2.72), 7) diabetes (adjusted OR: 1.73, 95 % CI: 1.35, 2.23), 8) high blood pressure (adjusted OR: 1.42, 95 % CI: 1.21, 1.67), and 9) above average BMI (adjusted OR: 1.20, 95 % CI: 1.04, 1.38). The comparison of the models between the full sample and the sample without theprevious high cost members indicated significant differences in the predictors. This has importantimplications for models using only the health service use (administrative data) given that the past high costis significantly correlated with future high cost and often drive the

  1. New models and online calculator for predicting non-sentinel lymph node status in sentinel lymph node positive breast cancer patients

    Directory of Open Access Journals (Sweden)

    Johnson Denise L

    2008-03-01

    Full Text Available Abstract Background Current practice is to perform a completion axillary lymph node dissection (ALND for breast cancer patients with tumor-involved sentinel lymph nodes (SLNs, although fewer than half will have non-sentinel node (NSLN metastasis. Our goal was to develop new models to quantify the risk of NSLN metastasis in SLN-positive patients and to compare predictive capabilities to another widely used model. Methods We constructed three models to predict NSLN status: recursive partitioning with receiver operating characteristic curves (RP-ROC, boosted Classification and Regression Trees (CART, and multivariate logistic regression (MLR informed by CART. Data were compiled from a multicenter Northern California and Oregon database of 784 patients who prospectively underwent SLN biopsy and completion ALND. We compared the predictive abilities of our best model and the Memorial Sloan-Kettering Breast Cancer Nomogram (Nomogram in our dataset and an independent dataset from Northwestern University. Results 285 patients had positive SLNs, of which 213 had known angiolymphatic invasion status and 171 had complete pathologic data including hormone receptor status. 264 (93% patients had limited SLN disease (micrometastasis, 70%, or isolated tumor cells, 23%. 101 (35% of all SLN-positive patients had tumor-involved NSLNs. Three variables (tumor size, angiolymphatic invasion, and SLN metastasis size predicted risk in all our models. RP-ROC and boosted CART stratified patients into four risk levels. MLR informed by CART was most accurate. Using two composite predictors calculated from three variables, MLR informed by CART was more accurate than the Nomogram computed using eight predictors. In our dataset, area under ROC curve (AUC was 0.83/0.85 for MLR (n = 213/n = 171 and 0.77 for Nomogram (n = 171. When applied to an independent dataset (n = 77, AUC was 0.74 for our model and 0.62 for Nomogram. The composite predictors in our model were the product of

  2. Is Technetium-99m Sestamibi Imaging Able to Predict Pathologic Nonresponse to Neoadjuvant Chemotherapy in Breast Cancer? A Meta-analysis Evaluating Current Use and Shortcomings.

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    Collarino, Angela; de Koster, Elizabeth J; Valdés Olmos, Renato A; de Geus-Oei, Lioe-Fee; Pereira Arias-Bouda, Lenka M

    2017-06-29

    Interest in technetium-99m ((99m)Tc)-sestamibi imaging for neoadjuvant chemotherapy (NAC) response monitoring in locally advanced breast cancer (LABC) is increasing but remains matter of discussion. The present study conducted a meta-analysis of the diagnostic performance of (99m)Tc-sestamibi to predict pathologic nonresponse to NAC for primary LABC. A systematic data search was performed. Studies with a minimum of 10 LABC patients that had evaluated (99m)Tc-sestamibi imaging for NAC nonresponse using conventional planar scintimammography, breast-specific γ-imaging, and/or single photon emission computed tomography/computed tomography (SPECT/CT) were included. The histopathologic findings were the reference standard. The meta-analysis was performed using a mixed logistic regression model. The search revealed 14 eligible studies with 529 patients. Of the 14 studies, 11 had evaluated scintimammography and 3 breast-specific γ-imaging. No studies examining SPECT or SPECT/CT were found. The overall estimated pooled sensitivity, specificity, and positive and negative likelihood ratios of (99m)Tc-sestamibi imaging to predict nonresponsiveness to NAC were 70.3% (95% confidence interval [CI], 56.5%-81.3%%), 90.1% (95% CI, 77.5%-96.0%), 7.13 (95% CI, 3.08-16.53), and 0.33 (95% CI, 0.22-0.49), respectively. Only 3 studies (107 patients) evaluated (99m)Tc-sestamibi imaging during NAC, reported an estimated pooled sensitivity of 87% (95% CI, 72%-100%) and specificity of 93% (95% CI, 85%-100%). Only planar (99m)Tc-sestamibi imaging has been investigated for NAC nonresponse in LABC but showed low sensitivity to predict pathologic nonresponse. However, most studies focused on the prediction of pathologic complete response after NAC. Although experience is limited, (99m)Tc-sestamibi uptake during NAC seems highly sensitivity for the prediction of nonresponsiveness. Features such as SPECT/CT imaging, standardized quantification, relation to tumor subtypes, and proper timing have

  3. Predictive efficacy of the 2014 International Society of Urological Pathology Gleason grading system in initially diagnosed metastatic prostate cancer.

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    Sun, Guang-Xi; Shen, Peng-Fei; Zhang, Xing-Ming; Gong, Jing; Gui, Hao-Jun; Shu, Kun-Peng; Liu, Jiang-Dong; Zhao, Jinge; Yang, Yao-Jing; Chen, Xue-Qin; Chen, Ni; Zeng, Hao

    2017-01-01

    We compared the predictive ability of the 2014 and 2005 Gleason grading systems in 568 patients initially diagnosed with metastatic prostate cancer (PCa). Outcomes included the duration of castration-resistant prostate cancer-free survival (CFS) and overall survival (OS). Univariate analyses and log-rank tests were used to identify prognosis indicators and assess univariable differences in CFS and OS in Gleason score (GS) groups. Cox proportional hazards and area under the curves of receiver operator characteristics methods were used to evaluate the predictive efficacy of the 2005 and 2014 ISUP grading systems. Univariate analyses showed that the 2005 and 2014 grading systems were prognosticators for CFS and OS; both systems could distinguish the clinical outcome of patients with GS 6, GS 7, and GS 8-10. Using the 2014 criteria, no statistical differences in patient survival were observed between GS 3 + 4 and GS 4 + 3 or GS 8 and GS 9-10. The predictive ability of the 2014 and 2005 grading systems was comparable for CFS and OS (P = 0.321). However, the 2014 grading system did not exhibit superior predictive efficacy in patients initially diagnosed with PCa and bone metastasis; trials using larger cohorts are required to confirm its predictive value. To the best of our knowledge, ours is the first study to compare the 2005 and 2014 grading systems in initially diagnosed PCa with bone metastasis. At present, we recommend that both systems should be used to predict the prognosis of patients with metastatic PCa.

  4. The limits of testing particle-mediated oxidative stress in vitro in predicting diverse pathologies; relevance for testing of nanoparticles

    Directory of Open Access Journals (Sweden)

    Gulumian Mary

    2009-04-01

    Full Text Available Abstract In vitro studies with particles are a major staple of particle toxicology, generally used to investigate mechanisms and better understand the molecular events underlying cellular effects. However, there is ethical and financial pressure in nanotoxicology, the new sub-specialty of particle toxicology, to avoid using animals. Therefore an increasing amount of studies are being published using in vitro approaches and such studies require careful interpretation. We point out here that 3 different conventional pathogenic particle types, PM10, asbestos and quartz, which cause diverse pathological effects, have been reported to cause very similar oxidative stress effects in cells in culture. We discuss the likely explanation and implications of this apparent paradox, and its relevance for testing in nanotoxicology.

  5. ATRX immunostaining predicts IDH and H3F3A status in gliomas.

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    Ebrahimi, Azadeh; Skardelly, Marco; Bonzheim, Irina; Ott, Ines; Mühleisen, Helmut; Eckert, Franziska; Tabatabai, Ghazaleh; Schittenhelm, Jens

    2016-06-16

    Gliomas are the most frequent intraaxial CNS neoplasms with a heterogeneous molecular background. Recent studies on diffuse gliomas have shown frequent alterations in the genes involved in chromatin remodelling pathways such as α-thalassemia/mental-retardation-syndrome-X-linked gene (ATRX). Yet, the reliability of ATRX in predicting isocitrate dehydrogenase (IDH) and H3 histone, family 3A (H3F3A) mutations in gliomas, is unclear.We analysed the ATRX expression status by immunohistochemistry, in a large series of 1064 gliomas and analysed the results in correlation to IDH, H3F3A and loss of heterozygosity (LOH) 1p/19q status in these tumors. We also investigated the prognostic potential of ATRX concerning the clinical outcome of patients with diffuse gliomas.According to our results, loss of nuclear ATRX expression was accompanied with an astrocytic tumor lineage and a younger age of onset. ATRX loss in astrocytomas was also strongly associated with IDH1/2 and H3F3A mutation (p IDH1 or IDH2 mutation. Among the remaining 23 cases (11 %) with ATRX loss and IDH wild type status, 7 cases had a H3F3A G34R mutation (3 %) and 2 cases had a H3F3A K27M mutation (1 %). ATRX retention in IDH1/2 mutant tumors was strongly associated with LOH 1p/19q and oligodendroglioma histology (p IDH/H3F3A mutations and substratification of diffuse gliomas into survival relevant tumor groups. Such classification is of great importance for further clinical decision making especially concerning the therapeutic options available for diffuse gliomas.

  6. Improved Brain Tumor Classification by Sodium MR Imaging: Prediction of IDH Mutation Status and Tumor Progression.

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    Biller, A; Badde, S; Nagel, A; Neumann, J-O; Wick, W; Hertenstein, A; Bendszus, M; Sahm, F; Benkhedah, N; Kleesiek, J

    2016-01-01

    MR imaging in neuro-oncology is challenging due to inherent ambiguities in proton signal behavior. Sodium-MR imaging may substantially contribute to the characterization of tumors because it reflects the functional status of the sodium-potassium pump and sodium channels. Sodium-MR imaging data of patients with treatment-naïve glioma WHO grades I-IV (n = 34; mean age, 51.29 ± 17.77 years) were acquired by using a 7T MR system. For acquisition of sodium-MR images, we applied density-adapted 3D radial projection reconstruction pulse sequences. Proton-MR imaging data were acquired by using a 3T whole-body system. We demonstrated that the initial sodium signal of a treatment-naïve brain tumor is a significant predictor of isocitrate dehydrogenase (IDH) mutation status (P model confirmed the sodium signal of treatment-naïve brain tumors as a predictor of progression (P = .003). Compared with the molecular signature of IDH mutation status, information criteria of model comparison revealed that the sodium signal is even superior to IDH in progression prediction. In addition, sodium-MR imaging provides a new approach to noninvasive tumor classification. The sodium signal of contrast-enhancing tumor portions facilitates differentiation among most glioma types (P sodium-MR imaging may help to classify neoplasias at an early stage, to reduce invasive tissue characterization such as stereotactic biopsy specimens, and overall to promote improved and individualized patient management in neuro-oncology by novel imaging signatures of brain tumors. © 2016 by American Journal of Neuroradiology.

  7. Ideal number of biopsy tumor fragments for predicting HER2 status in gastric carcinoma resection specimens

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    Lee, Minju; Ha, Sang Yun; Lee, Hyuk; Min, Byung-Hoon; Lee, Jun Haeng; Kim, Jae J.; Choi, Sunkyu; Jung, Sin-Ho; Choi, Min Gew; Lee, Jun-Ho; Sohn, Tae Sung; Bae, Jae Moon; Kim, Sung; Kim, Kyoung-Mee

    2015-01-01

    Intratumoral heterogeneity of HER2 expression is common in gastric cancers and pose a challenge for identifying patients who would benefit from anti-HER2 therapy. The aim of this study is to compare HER2 expression in biopsy and resection specimens of gastric carcinoma by immunohistochemistry (IHC) and to find the ideal number of biopsy tumor fragments that can accurately predict HER2 overexpression in the corresponding surgically resected specimen. The HER2 IHC results of 702 paired biopsy and resection specimens of gastric cancer were compared. The mean number of biopsy fragments among all cases was 4.3 (range 1–11). HER2 was positive in 130 (18.5%) endoscopic biopsies and in 102 (14.5%) gastrectomy specimens. Intratumoral heterogeneity of HER2 was found in 80 (61.5%) biopsies and 70 (68.6%) resection specimens. Out of the 70 surgical specimens with intratumoral heterogeneity, 24 (34.3%) of the corresponding biopsies were categorized as negative (positive conversion). In the 86 (12.3%) discrepant cases, negative conversion was observed in 57 (66.3%) cases and positive conversion in 29 (33.7%). The fragment numbers were significantly correlated with the discrepancy of results and positive predictability (P = 0.0315 and P = 0.0052). ROC curve analysis and positive predictability showed that 4 fragments should be obtained to minimize the differences in HER2 scores between biopsy and resection specimen. In gastric carcinomas with discrepant HER2 results between biopsy and surgical resection specimens, intratumoral heterogeneity is common with most of them showing positive conversion. To predict HER2 status precisely, at least 4 biopsy fragments containing tumor cells are required. PMID:26460823

  8. Sweet success, bitter defeat: a taste phenotype predicts social status in selectively bred rats.

    Directory of Open Access Journals (Sweden)

    John M Eaton

    Full Text Available For social omnivores such as rats and humans, taste is far more than a chemical sense activated by food. By virtue of evolutionary and epigenetic elaboration, taste is associated with negative affect, stress vulnerability, responses to psychoactive substances, pain, and social judgment. A crucial gap in this literature, which spans behavior genetics, affective and social neuroscience, and embodied cognition, concerns links between taste and social behavior in rats. Here we show that rats selectively bred for low saccharin intake are subordinate to high-saccharin-consuming rats when they compete in weight-matched dyads for food, a task used to model depression. Statistical and experimental controls suggest that differential resource utilization within dyads is not an artifact of individual-level processes such as apparatus habituation or ingestive motivation. Tail skin temperature measurements showed that LoS rats display larger hyperthermic responses to social interaction after status is established, evidence linking taste, social stress, autonomic reactivity, and depression-like symptoms. Based on regression using early- and late-competition predictors to predict dyadic disparity in final competition scores, we tentatively suggest that HiS rats emerge as dominant both because of an "early surge" on their part and because LoS acquiesce later. These findings should invigorate the comparative study of individual differences in social status and its relationship to mental and physical health.

  9. Concurrent and Predictive Validity of Composite Methods to Assess Nutritional Status in Older Adults on Hemodialysis.

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    Santin, Fernanda Galvão de Oliveira; Bigogno, Fernanda Guedes; Dias Rodrigues, Juliana Cordeiro; Cuppari, Lilian; Avesani, Carla Maria

    2016-01-01

    To assess the performance of subjective global assessment (SGA), malnutrition inflammation score (MIS), and mini nutritional assessment short-form (MNA-SF) in older adults on hemodialysis (HD) by evaluating their concurrent and predictive validity. An observational and prospective study including older adults on HD. Six dialysis units. We assessed 137 HD patients aged ≥60 years (71.7% male, 70.2 ± 7.2 years). The nutritional status was assessed by 7-point SGA, MIS and MNA-SF, and by objective methods. Patients were followed up for 14.5 (8; 26.3) months (median and interquartile) to assess survival. Protein energy wasting (PEW) was present in 63% of the patients when assessed by SGA, in 77% by MIS, and in 26% by MNA-SF. Most objective parameters of patients classified with PEW were lower (P nutritional status, but SGA and MIS were likely to perform better than MNA-SF. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  10. Emotion perception and executive functioning predict work status in euthymic bipolar disorder.

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    Ryan, Kelly A; Vederman, Aaron C; Kamali, Masoud; Marshall, David; Weldon, Anne L; McInnis, Melvin G; Langenecker, Scott A

    2013-12-15

    Functional recovery, including return to work, in Bipolar Disorder (BD) lags behind clinical recovery and may be incomplete when acute mood symptoms have subsided. We examined impact of cognition on work status and underemployment in a sample of 156 Euthymic-BD and 143 controls (HC) who were divided into working/not working groups. Clinical, health, social support, and personality data were collected, and eight cognitive factors were derived from a battery of neuropsychological tests. The HC groups outperformed the BD groups on seven of eight cognitive factors. The working-BD group outperformed the not working-BD group on 4 cognitive factors composed of tasks of emotion processing and executive functioning including processing speed and set shifting. Emotion processing and executive tasks were predictive of BD unemployment, after accounting for number of mood episodes. Four cognitive factors accounted for a significant amount of the variance in work status among the BD participants. Results indicate that patients with BD who are unemployed/unable to work exhibit greater difficulties processing emotional information and on executive tasks that comprise a set shifting or interference resolution component as compared to those who are employed, independent of other factors. These cognitive and affective factors are suggested as targets for treatment and/or accommodations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. Food access and diet quality independently predict nutritional status among people living with HIV in Uganda.

    Science.gov (United States)

    Kadiyala, Suneetha; Rawat, Rahul

    2013-01-01

    Although undernutrition is recognized as a risk factor for mortality among people living with HIV (PLWHIV), even among those initiating antiretroviral therapy, few studies have explored the underlying determinants of undernutrition. The objectives of the present study were to: (i) examine the independent association between household food security, individual diet quality and nutritional status; and (ii) determine if any association between food security and nutritional status is mediated through diet quality. Cross-sectional baseline survey. Gulu and Soroti districts, Uganda. Nine hundred and two PLWHIV recruited into a study evaluating the impact of a food assistance programme supported by the World Food Programme. Food security and diet quality were measured using the Household Food Insecurity Access Scale (HFIAS) and the Individual Dietary Diversity Score (IDDS), respectively. Multivariate regression results demonstrated that HFIAS and IDDS independently predict BMI (P diet had an adjusted odds ratio of being underweight of 0.56 (P diet of low diversity. Similar results were observed when mid upper-arm circumference and wasting were modelled as outcomes. Using path analysis, we observed that the indirect effect of food insecurity on BMI mediated through dietary diversity is negligible, and mostly a result of the direct effect of food insecurity on BMI. Our results provide an empirical basis for focused efforts on improving food access and diet quality among PLWHIV. Addressing the broader structural determinants of food security of people infected and affected by HIV is crucial.

  12. Prognostic and predictive implications of HER2 status for breast cancer patients.

    Science.gov (United States)

    Thomas, E; Berner, G

    2000-03-01

    Women diagnosed with breast cancer face many emotional and psychological challenges, which are often related to how they perceive their chances of survival. A number of factors are known to be indicators of breast cancer prognosis, including tumour type, size and grade, and lymph node status. These factors can be used alone or in combination to make management decisions based on a broad assessment of tumour aggression. However, identifying an independent marker of prognosis has proved more difficult. The human epidermal growth factor receptor-2 (HER2) is amplified/overexpressed in 25-30% of breast tumours. This event has been shown to be associated with poor prognosis in breast cancer patients. Initial observations indicated that median survival duration is reduced by at least 50% in patients who overexpress HER2 compared with those who do not overexpress the receptor. This finding has been supported by many subsequent studies and data are accumulating to indicate that the relationship holds for both node-negative and node-positive patients. This could be particularly important for identifying the 30% of node-negative patients who will progress despite therapy. HER2 status may also be able to predict the outcome of therapy. It appears likely that HER2 overexpression predicts for resistance to tamoxifen and other hormonal therapies. It is also possible that HER2-overexpressing patients may respond better to dose-intense anthracycline therapy and worse to cyclophosphamide/methotrexate/5-fluorouracil than non-overexpressing patients. Explaining these associations to patients may empower them to deal with the psychological effects of a diagnosis of breast cancer while providing hope for the future.

  13. Evaluation of assay procedures for prediction of passive transfer status in lambs.

    Science.gov (United States)

    Massimini, Genesio; Peli, Angelo; Boari, Andrea; Britti, Domenico

    2006-04-01

    To compare 4 assay procedures for prediction of passive transfer status in lambs. Thirty-one 1-day-old Sardinian lambs. Serum IgG concentration was determined by use of single radial immunodiffusion. The following were determined: serum total protein concentration as measured by refractometry (ie, refractometry serum total protein concentration), serum total protein concentration as determined by the biuret method (ie, biuret method serum total protein concentration), serum gamma-globulin concentration as determined by serum protein electrophoresis, and serum gamma-glutamyltransferase (GGT) activity as measured by spectrophotometry. Accuracy of these assays for estimation of serum IgG concentration in 1-day-old lambs was established by use of linear regression analysis. Refractometry serum total protein concentration, biuret method serum total protein concentration, and serum gamma-globulin concentration were closely and linearly correlated with serum IgG concentration. The natural logarithm (ln) of serum GGT activity was closely and linearly correlated with serum IgG concentration (ln). Refractometry serum total protein concentration, biuret method serum total protein concentration, and gamma-globulin concentration accounted for approximately 85%, 91%, and 95% of the variation in serum IgG concentration, respectively. Serum GGT activity (ln) accounted for approximately 92% of the variation in serum IgG concentration (ln). For prediction of passive transfer status in 1-day-old lambs, serum GGT activity or biuret method serum total protein concentration determination will allow for passive transfer monitoring program development. Immediate refractometry serum total protein concentration determination is beneficial in making timely management and treatment decisions. Serum gamma-globulin concentration determination can be used as a confirmatory test.

  14. Androgen receptor status predicts development of brain metastases in ovarian cancers.

    Science.gov (United States)

    Mittica, Gloria; Senetta, Rebecca; Scotto, Giulia; Aglietta, Massimo; Maggiorotto, Furio; Ghisoni, Eleonora; Genta, Sofia; Boldorini, Renzo; Manini, Claudia; Morra, Isabella; Buosi, Roberta; Sapino, Anna; Cassoni, Paola; Valabrega, Giorgio

    2017-06-20

    Brain metastases are uncommon localizations in epithelial ovarian cancer (EOC), their reported incidence is increasing and no predictive biomarkers have been identified yet. Goals of this study were: i) to define a possible association between Estrogen Receptor (ER), Progesterone Receptor (PR), Androgen Receptor (AR),human EGF receptor 2 (HER2) and brain progression in EOC patients, and ii) to identify differences in ER, PR, AR and HER2 protein expression from primary EOC and its matched resected brain metastasis. A retrospective series of 11 EOC with matched brain metastasis surgically removed was collected. For comparison, a "Control dataset" of 22 patients, without evidence of brain involvement after an adequate follow up was matched. ER, PR, AR and HER2 status were analyzed by means of immunohistochemistry forCases (both primary and metastatic lesions) and Controls.Univariate analysis showed that AR status was significantly associated with brain localization, both considered as discrete variable (cut-off: 10%, p=0.013) and as continuous one (p=0.035). Multivariate analysis confirmed this trend (p=0.053). When considered as continuous variables, ER and AR showed greater expression in primary tumors in comparison with brain metastases (p=0.013 and p=0.032, respectively).In our series, AR predicts brain involvement, with a 9.5 times higher propensity for AR-negative EOC. Moreover, brain dissemination is probably the result of progressive dedifferentiation of primary tumor, shown by reduction of ER and AR expression in metastases. Further studies are required, in order to anticipate and improve multimodal treatment of brain metastases.

  15. Status update: maladaptive Facebook usage predicts increases in body dissatisfaction and bulimic symptoms.

    Science.gov (United States)

    Smith, April R; Hames, Jennifer L; Joiner, Thomas E

    2013-07-01

    The current study examined the effects of online social evaluations and comparisons on body dissatisfaction and bulimic symptoms. We tested the effects of maladaptive Facebook usage (defined as the tendency to seek negative social evaluations and/or engage in social comparisons via Facebook) on body dissatisfaction and bulimic symptoms in a sample of 232 college females followed for approximately 4 weeks. Results provided evidence that maladaptive Facebook usage significantly predicted increases in bulimic symptoms and episodes of over-eating approximately four weeks later. Body dissatisfaction was found to fully mediate the relationship between maladaptive Facebook usage and increases in over-eating episodes, whereas body dissatisfaction partially mediated the relationship between maladaptive Facebook usage and increases in bulimic symptoms more broadly. Limitations include the use of a novel measure of maladaptive Facebook usage due to the absence of an existing measure and a non-clinical sample. The results of this study suggest that reducing maladaptive Facebook usage may be a fruitful target for interventions aimed at reducing body dissatisfaction and symptoms of eating pathology. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Predictive efficacy of the 2014 International Society of Urological Pathology Gleason grading system in initially diagnosed metastatic prostate cancer

    Directory of Open Access Journals (Sweden)

    Guang-Xi Sun

    2017-01-01

    Full Text Available We compared the predictive ability of the 2014 and 2005 Gleason grading systems in 568 patients initially diagnosed with metastatic prostate cancer (PCa. Outcomes included the duration of castration-resistant prostate cancer-free survival (CFS and overall survival (OS. Univariate analyses and log-rank tests were used to identify prognosis indicators and assess univariable differences in CFS and OS in Gleason score (GS groups. Cox proportional hazards and area under the curves of receiver operator characteristics methods were used to evaluate the predictive efficacy of the 2005 and 2014 ISUP grading systems. Univariate analyses showed that the 2005 and 2014 grading systems were prognosticators for CFS and OS; both systems could distinguish the clinical outcome of patients with GS 6, GS 7, and GS 8-10. Using the 2014 criteria, no statistical differences in patient survival were observed between GS 3 + 4 and GS 4 + 3 or GS 8 and GS 9-10. The predictive ability of the 2014 and 2005 grading systems was comparable for CFS and OS (P = 0.321. However, the 2014 grading system did not exhibit superior predictive efficacy in patients initially diagnosed with PCa and bone metastasis; trials using larger cohorts are required to confirm its predictive value. To the best of our knowledge, ours is the first study to compare the 2005 and 2014 grading systems in initially diagnosed PCa with bone metastasis. At present, we recommend that both systems should be used to predict the prognosis of patients with metastatic PCa.

  17. Prediction of course and progression of nonalcoholic fatty liver disease in patients with obesity and pathology of the biliary tract with the help of mathematical modeling

    Directory of Open Access Journals (Sweden)

    Filippova A.Yu.

    2017-12-01

    Full Text Available Determination of the most important functional parameters of the liver, lipid peroxidation (LPO and antioxidant protection (AOP markers of endogenous intoxication and indicators of connective-tissue metabolism in patients with non-alcoholic fatty liver disease (NAFLD associated with obesity and pathology of the biliary tract and development of criteria for predicting the likelihood of the transformation of non-alcoholic steatosis (NAHS to non-alcoholic steatohepatitis (NASH using mathematical modeling was performed. The data of patients with different clinical stages of NAFLD in combination with obesity and BT pathology were analyzed: the study group consisted of patients with NASH (n=100 and control group – patients with NAHS (n=100. The diagnosis of NAFLD and pathology of BT was established on the basis of anamnesis, clinical and instrumental (ultrasound imaging of the abdomen examination. The body mass index was determined according to the Quetelet formula. Thymol test, total protein level and protein fractions in blood serum, the concentration of molecules of average weight (MSM and their fractional composition were investigated. The condition of the LPO system was evaluated by the concentration of malondialdehyde, schiff bases and intermediate LPO products. The AOP was assessed by the activity of superoxide dismutase and catalase in the hemolysate of erythrocytes. The process of fibrosis was evaluated according to the content of free oxyproline, total oxyproline and protein-binding oxyproline, hexosamines. According to the correlation analysis 30 factors that increase the risk of transformation of NAHS in NASH (p<0.05 were selected. ROC-analysis was conducted with the definition of factor levels that provides the maximum difference between the compared groups in terms of sensitivity and specificity. Logistic regression model was built basing on certain criteria for distinguishing between different NAHP stages. Logistic regression model

  18. Deep Learning Accurately Predicts Estrogen Receptor Status in Breast Cancer Metabolomics Data.

    Science.gov (United States)

    Alakwaa, Fadhl M; Chaudhary, Kumardeep; Garmire, Lana X

    2018-01-05

    Metabolomics holds the promise as a new technology to diagnose highly heterogeneous diseases. Conventionally, metabolomics data analysis for diagnosis is done using various statistical and machine learning based classification methods. However, it remains unknown if deep neural network, a class of increasingly popular machine learning methods, is suitable to classify metabolomics data. Here we use a cohort of 271 breast cancer tissues, 204 positive estrogen receptor (ER+), and 67 negative estrogen receptor (ER-) to test the accuracies of feed-forward networks, a deep learning (DL) framework, as well as six widely used machine learning models, namely random forest (RF), support vector machines (SVM), recursive partitioning and regression trees (RPART), linear discriminant analysis (LDA), prediction analysis for microarrays (PAM), and generalized boosted models (GBM). DL framework has the highest area under the curve (AUC) of 0.93 in classifying ER+/ER- patients, compared to the other six machine learning algorithms. Furthermore, the biological interpretation of the first hidden layer reveals eight commonly enriched significant metabolomics pathways (adjusted P-value learning methods. Among them, protein digestion and absorption and ATP-binding cassette (ABC) transporters pathways are also confirmed in integrated analysis between metabolomics and gene expression data in these samples. In summary, deep learning method shows advantages for metabolomics based breast cancer ER status classification, with both the highest prediction accuracy (AUC = 0.93) and better revelation of disease biology. We encourage the adoption of feed-forward networks based deep learning method in the metabolomics research community for classification.

  19. Vitamin D (25-0H D3) status and pathological response to neoadjuvant chemotherapy in stage II/III breast cancer: Data from the NEOZOTAC trial (BOOG 10-01)

    NARCIS (Netherlands)

    Charehbili, A.; Hamdy, N. A. T.; Smit, V. T. H. B. M.; Kessels, L.; van Bochove, A.; van Laarhoven, H. W.; Putter, H.; Meershoek-Klein Kranenbarg, E.; van Leeuwen-Stok, A. E.; van der Hoeven, J. J. M.; van de Velde, C. J. H.; Nortier, J. W. R.; Kroep, J. R.

    2016-01-01

    Serum levels of 25-OH vitamin D3 (vitamin D) have been shown to be prognostic for disease-free survival in patients with breast cancer. We investigated the predictive value of these levels for pathological response after neoadjuvant chemotherapy in patients with breast cancer taking part in the

  20. Vitamin D (25-0H D3) status and pathological response to neoadjuvant chemotherapy in stage II/III breast cancer: Data from the NEOZOTAC trial (BOOG 10-01)

    NARCIS (Netherlands)

    Charehbili, A.; Hamdy, N.A.; Smit, V.T.; Kessels, L; Bochove, A. van; Laarhoven, H.W.M. van; Putter, H.; Meershoek-Klein Kranenbarg, E.; Leeuwen-Stok, A.E. van; Hoeven, J.J.M. van der; Velde, C.J. van de; Nortier, J.W.; Kroep, J.R.

    2016-01-01

    BACKGROUND: Serum levels of 25-OH vitamin D3 (vitamin D) have been shown to be prognostic for disease-free survival in patients with breast cancer. We investigated the predictive value of these levels for pathological response after neoadjuvant chemotherapy in patients with breast cancer taking part

  1. Predictive value of PET-CT for pathological response in stages II and III breast cancer patients following neoadjuvant chemotherapy with docetaxel.

    Science.gov (United States)

    García García-Esquinas, Marta A; Arrazola García, Juan; García-Sáenz, José A; Furió-Bacete, V; Fuentes Ferrer, Manuel E; Ortega Candil, Aída; Cabrera Martín, María N; Carreras Delgado, José L

    2014-01-01

    To prospectively study the value of PET-CT with fluorine-18 fluorodeoxyglucose (FDG) to predict neoadjuvant chemotherapy (NAC) response of locoregional disease of stages II and III breast cancer patients. A written informed consent and approval were obtained from the Ethics Committee. PET-CT accuracy in the prediction of pathologic complete response (pCR) after NAC was studied in primary tumors and lymph node metastasis in 43 women (mean age: 50 years: range: 27-71 years) with histologically proven breast cancer between December 2009 and January 2011. PET-CT was performed at baseline and after NAC. SUV(max) percentage changes (ΔSUV(max)) were compared with pathology findings at surgery. Receiver-operator characteristic (ROC) analysis was used to discriminate between locoregional pCR and non-pCR. In patients not achieving pCR, it was investigated if ΔSUV(max) could accurately identify the residual cancer burden (RCB) classes: RCB-I (minimal residual disease (MRD)), RCB-II (moderate RD), and RCB-III (extensive RD). pCR was obtained in 11 patients (25.6%). Residual disease was found in 32 patients (74.4%): 16 (37.2%) RCB-I, 15 (35.6%) RCB-II and 2 (4.7%) RCB-III. Sensitivity, specificity, and accuracy to predict pCR were 90.9%, 90.6%, and 90.7%, respectively. Specificity was 94.1% in the identification of a subset of patients who had either pCR or MRD. Accuracy of ΔSUV(max) in the locoregional disease of stages II and III breast cancer patients after NAC is high for the identification of pCR cases. Its specificity is potentially sufficient to identify a subgroup of patients who could be managed with conservative surgery. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  2. Role of nutritional status in predicting quality of life outcomes in cancer--a systematic review of the epidemiological literature.

    Science.gov (United States)

    Lis, Christopher G; Gupta, Digant; Lammersfeld, Carolyn A; Markman, Maurie; Vashi, Pankaj G

    2012-04-24

    Malnutrition is a significant factor in predicting cancer patients' quality of life (QoL). We systematically reviewed the literature on the role of nutritional status in predicting QoL in cancer. We searched MEDLINE database using the terms "nutritional status" in combination with "quality of life" together with "cancer". Human studies published in English, having nutritional status as one of the predictor variables, and QoL as one of the outcome measures were included. Of the 26 included studies, 6 investigated head and neck cancer, 8 gastrointestinal, 1 lung, 1 gynecologic and 10 heterogeneous cancers. 24 studies concluded that better nutritional status was associated with better QoL, 1 study showed that better nutritional status was associated with better QoL only in high-risk patients, while 1 study concluded that there was no association between nutritional status and QoL. Nutritional status is a strong predictor of QoL in cancer patients. We recommend that more providers implement the American Society of Parenteral and Enteral Nutrition (ASPEN) guidelines for oncology patients, which includes nutritional screening, nutritional assessment and intervention as appropriate. Correcting malnutrition may improve QoL in cancer patients, an important outcome of interest to cancer patients, their caregivers, and families.

  3. Hyperspectral-based predictive modelling of grapevine water status in the Portuguese Douro wine region

    Science.gov (United States)

    Pôças, Isabel; Gonçalves, João; Costa, Patrícia Malva; Gonçalves, Igor; Pereira, Luís S.; Cunha, Mario

    2017-06-01

    In this study, hyperspectral reflectance (HySR) data derived from a handheld spectroradiometer were used to assess the water status of three grapevine cultivars in two sub-regions of Douro wine region during two consecutive years. A large set of potential predictors derived from the HySR data were considered for modelling/predicting the predawn leaf water potential (Ψpd) through different statistical and machine learning techniques. Three HySR vegetation indices were selected as final predictors for the computation of the models and the in-season time trend was removed from data by using a time predictor. The vegetation indices selected were the Normalized Reflectance Index for the wavelengths 554 nm and 561 nm (NRI554;561), the water index (WI) for the wavelengths 900 nm and 970 nm, and the D1 index which is associated with the rate of reflectance increase in the wavelengths of 706 nm and 730 nm. These vegetation indices covered the green, red edge and the near infrared domains of the electromagnetic spectrum. A large set of state-of-the-art analysis and statistical and machine-learning modelling techniques were tested. Predictive modelling techniques based on generalized boosted model (GBM), bagged multivariate adaptive regression splines (B-MARS), generalized additive model (GAM), and Bayesian regularized neural networks (BRNN) showed the best performance for predicting Ψpd, with an average determination coefficient (R2) ranging between 0.78 and 0.80 and RMSE varying between 0.11 and 0.12 MPa. When cultivar Touriga Nacional was used for training the models and the cultivars Touriga Franca and Tinta Barroca for testing (independent validation), the models performance was good, particularly for GBM (R2 = 0.85; RMSE = 0.09 MPa). Additionally, the comparison of Ψpd observed and predicted showed an equitable dispersion of data from the various cultivars. The results achieved show a good potential of these predictive models based on vegetation indices to support

  4. Mental health status, aggression, and poor driving distinguish traffic offenders from non-offenders but health status predicts driving behavior in both groups

    Directory of Open Access Journals (Sweden)

    Abdoli N

    2015-08-01

    Full Text Available Nasrin Abdoli,1,2 Vahid Farnia,3 Ali Delavar,4 Fariborz Dortaj,4 Alireza Esmaeili,5  Noorali Farrokhi,4 Majid Karami,6 Jalal Shakeri,3 Edith Holsboer-Trachsler,7 Serge Brand7,81International University of Imam Reza, Mashhad, Iran; 2Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Substance Abuse Prevention Research Center, Psychiatry Department, Kermanshah University of Medical Sciences, Kermanshah, Iran; 4Allameh Tabataba’i University, Tehran, Iran; 5Police University, Tehran, Iran; 6Baharestan Research Center, Kermanshah Transportation Terminal, Kermanshah, Iran; 7Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland; 8Department of Sport and Health Science, Sport Science Section, University of Basel, Basel, SwitzerlandBackground: In Iran, traffic accidents and deaths from traffic accidents are among the highest in the world, and generally, driver behavior rather than technical failures or environmental conditions are responsible for traffic accidents. In a previous study, we showed that among young Iranian male traffic offenders, poor mental health status, along with aggression, predicted poor driving behavior. The aims of the present study were twofold, to determine whether this pattern could be replicated among non-traffic offenders, and to compare the mental health status, aggression, and driving behavior of male traffic offenders and non-offenders.Methods: A total of 850 male drivers (mean age =34.25 years, standard deviation =10.44 from Kermanshah (Iran took part in the study. Of these, 443 were offenders (52.1% and 407 (47.9% were non-offenders with lowest driving penalty scores applying for attaining an international driving license. Participants completed a questionnaire booklet covering socio-demographic variables, traits of aggression, health status, and driving behavior.Results: Compared to non-offenders, offenders reported higher aggression, poorer

  5. Preventive child health care findings on early childhood predict peer-group social status in early adolescence.

    Science.gov (United States)

    Jaspers, Merlijne; de Winter, Andrea F; Veenstra, René; Ormel, Johan; Verhulst, Frank C; Reijneveld, Sijmen A

    2012-12-01

    A disputed social status among peers puts children and adolescents at risk for developing a wide range of problems, such as being bullied. However, there is a lack of knowledge about which early predictors could be used to identify (young) adolescents at risk for a disputed social status. The aim of this study was to assess whether preventive child health care (PCH) findings on early childhood predict neglected and rejected status in early adolescence in a large longitudinal community-based sample. Data came from 898 participants who participated in TRAILS, a longitudinal study. Information on early childhood factors was extracted from the charts of routine PCH visits registered between infancy and age of 4 years. To assess social status, peer nominations were used at age of 10-12 years. Multinomial logistic regression showed that children who had a low birth weight, motor problems, and sleep problems; children of parents with a low educational level (odds ratios [ORs] between 1.71 and 2.90); and those with fewer attention hyperactivity problems (ORs = .43) were more likely to have a neglected status in early adolescence. Boys, children of parents with a low educational level, and children with early externalizing problems were more likely to have a rejected status in early adolescence (ORs between 1.69 and 2.56). PCH findings on early childhood-on motor and social development-are predictive of a neglected and a rejected status in early adolescence. PCH is a good setting to monitor risk factors that predict the social status of young adolescents. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  6. Additional predictive value of nutritional status in the prognostic assessment of heart failure patients.

    Science.gov (United States)

    La Rovere, M T; Maestri, R; Olmetti, F; Paganini, V; Riccardi, G; Riccardi, R; Pinna, G D; Traversi, E

    2017-03-01

    Nutritional status (NS) is not routinely assessed in HF. We sought to evaluate whether NS may be additive to a comprehensive pre-discharge evaluation based on a clinical score that includes BMI (MAGGIC) and on an index of functional capacity (six minute walking test, 6mWT) in HF patients. The CONUT (Controlling Nutritional Status) score (including serum albumin level, total cholesterol and lymphocyte count) was computed in 466 consecutive patients (mean age 61 ± 11 years, NYHA class 2.6 ± 0.6, LVEF 34 ± 11%, BMI 27.2 ± 4.5) who had pre-discharge MAGGIC and 6MWT. The endpoint was all-cause mortality. Mild or moderate undernourishment was present in 54% of patients with no differences across BMI strata. The 12-month event rate was 7.7%. Deceased patients had a more compromised NS (CONUT 2.8 ± 1.5 vs 1.7 ± 1.3, p assessment of NS, significantly improves prediction of 12-month mortality on top of the information provided by clinical evaluation and functional capacity and should be incorporated in the overall assessment of HF patients. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  7. New method for predicting estrogen receptor status utilizing breast MRI texture kinetic analysis

    Science.gov (United States)

    Chaudhury, Baishali; Hall, Lawrence O.; Goldgof, Dmitry B.; Gatenby, Robert A.; Gillies, Robert; Drukteinis, Jennifer S.

    2014-03-01

    Magnetic Resonance Imaging (MRI) of breast cancer typically shows that tumors are heterogeneous with spatial variations in blood flow and cell density. Here, we examine the potential link between clinical tumor imaging and the underlying evolutionary dynamics behind heterogeneity in the cellular expression of estrogen receptors (ER) in breast cancer. We assume, in an evolutionary environment, that ER expression will only occur in the presence of significant concentrations of estrogen, which is delivered via the blood stream. Thus, we hypothesize, the expression of ER in breast cancer cells will correlate with blood flow on gadolinium enhanced breast MRI. To test this hypothesis, we performed quantitative analysis of blood flow on dynamic contrast enhanced MRI (DCE-MRI) and correlated it with the ER status of the tumor. Here we present our analytic methods, which utilize a novel algorithm to analyze 20 volumetric DCE-MRI breast cancer tumors. The algorithm generates post initial enhancement (PIE) maps from DCE-MRI and then performs texture features extraction from the PIE map, feature selection, and finally classification of tumors into ER positive and ER negative status. The combined gray level co-occurrence matrices, gray level run length matrices and local binary pattern histogram features allow quantification of breast tumor heterogeneity. The algorithm predicted ER expression with an accuracy of 85% using a Naive Bayes classifier in leave-one-out cross-validation. Hence, we conclude that our data supports the hypothesis that imaging characteristics can, through application of evolutionary principles, provide insights into the cellular and molecular properties of cancer cells.

  8. Fibromyalgia and the Prediction of Two-Year Changes in Functional Status in Rheumatoid Arthritis Patients.

    Science.gov (United States)

    Kim, Hyein; Cui, Jing; Frits, Michelle; Iannaccone, Christine; Coblyn, Jonathan; Shadick, Nancy A; Weinblatt, Michael E; Lee, Yvonne C

    2017-12-01

    Previous cross-sectional studies have shown that rheumatoid arthritis (RA) patients with fibromyalgia (FM) have higher disease activity, greater medical costs, and worse quality of life compared to RA patients without FM. We determined the impact of FM on 2-year changes in the functional status of RA patients in a prospective study. Subjects included participants in the Brigham Rheumatoid Arthritis Sequential Study who were enrolled in a substudy of the effects of pain in RA. Subjects completed questionnaires, including the Multi-Dimensional Health Assessment Questionnaire (MDHAQ) and Polysymptomatic Distress (PSD) scale, semiannually, and underwent physical examination and laboratory tests yearly. Of the 156 included RA subjects, 16.7% had FM, while 83.3% did not. In a multivariable linear regression model adjusted for age, sex, race, baseline MDHAQ score, disease duration, rheumatoid factor/cyclic citrullinated peptide antibody seropositivity, disease activity, and psychological distress, RA patients with FM had a 0.14 greater 2-year increase in MDHAQ score than RA patients without FM (P = 0.021). In secondary analyses examining the association between continuous PSD scale score and change in MDHAQ, higher PSD scale scores were significantly associated with greater 2-year increases in MDHAQ score (β coefficient 0.013, P = 0.011). Both the presence of FM and increasing number of FM symptoms predicted worsening of functional status among individuals with RA. Among individuals with RA and FM, the magnitude of the difference in changes in MDHAQ was 4- to 7-fold higher than typical changes in MDHAQ score among individuals with established RA. © 2017, American College of Rheumatology.

  9. [Prediction of the nutritional status by anthropometrical variables and food safety at homes of pregnant women from Caracas, Venezuela].

    Science.gov (United States)

    Pérez Guillén, A; Bernal Rivas, J

    2006-01-01

    The objective of this research is to analyze the nutritional status and household food security of a sample of healthy pregnant women who attend to external medicine service at Concepcion Palacios Maternity located in Caracas, Venezuela, and identify variables, which could predict the nutritional status of the evaluated group. This cross sectional, descriptive, comparative study evaluates a sample of 89 pregnant women, between 14 and 44 years of age. Economical, social, demographic and alimentary consumption variables and nutritional conditions were studied. On the way, anthropometrics like weight, height, and middle-arm circumference and Household food security scale were obtained. In order to perform the descriptive statistic, bivariate, and multiple linear regression analysis required during the investigation, the software SPSS, version 12, was used. The predictive variables considered for the evaluation of the actual nutritional status in pregnant women were: right middle-arm circumference, household food security level and the supplementation with vitamins and/or minerals. These variables explain 78.2% of the actual nutritional status variation in this sample. Therefore, this investigation highlights the importance of the research on simple variables, as a good prediction of the actual nutritional status in pregnant women, with acceptable precision values and without requiring high-trained personnel to perform it. Under these findings, is very important the study of more predictive variables to evaluate the nutritional and alimentary conditions, with practical and easy mechanisms that can be applied by non-technical personnel. It is recommended to go deep into the study of methods, which evaluate the nutrition in an easy and practical way, applied by non-technical personnel, besides continuing the validation process of the variable combinations determined as predictive of the nutritional status.

  10. Role of nutritional status in predicting quality of life outcomes in cancer – a systematic review of the epidemiological literature

    Science.gov (United States)

    2012-01-01

    Malnutrition is a significant factor in predicting cancer patients’ quality of life (QoL). We systematically reviewed the literature on the role of nutritional status in predicting QoL in cancer. We searched MEDLINE database using the terms “nutritional status” in combination with “quality of life” together with “cancer”. Human studies published in English, having nutritional status as one of the predictor variables, and QoL as one of the outcome measures were included. Of the 26 included studies, 6 investigated head and neck cancer, 8 gastrointestinal, 1 lung, 1 gynecologic and 10 heterogeneous cancers. 24 studies concluded that better nutritional status was associated with better QoL, 1 study showed that better nutritional status was associated with better QoL only in high-risk patients, while 1 study concluded that there was no association between nutritional status and QoL. Nutritional status is a strong predictor of QoL in cancer patients. We recommend that more providers implement the American Society of Parenteral and Enteral Nutrition (ASPEN) guidelines for oncology patients, which includes nutritional screening, nutritional assessment and intervention as appropriate. Correcting malnutrition may improve QoL in cancer patients, an important outcome of interest to cancer patients, their caregivers, and families. PMID:22531478

  11. Accuracy of Functional and Predictive Methods to Calculate the Hip Joint Center in Young Non-pathologic Asymptomatic Adults with Dual Fluoroscopy as a Reference Standard.

    Science.gov (United States)

    Fiorentino, Niccolo M; Kutschke, Michael J; Atkins, Penny R; Foreman, K Bo; Kapron, Ashley L; Anderson, Andrew E

    2016-07-01

    Predictions from biomechanical models of gait may be sensitive to joint center locations. Most often, the hip joint center (HJC) is derived from locations of reflective markers adhered to the skin. Here, predictive techniques use regression equations of pelvic anatomy to estimate the HJC, whereas functional methods track motion of markers placed at the pelvis and femur during a coordinated motion. Skin motion artifact may introduce errors in the estimate of HJC for both techniques. Quantifying the accuracy of these methods is an area of open investigation. In this study, we used dual fluoroscopy (DF) (a dynamic X-ray imaging technique) and three-dimensional reconstructions from computed tomography images, to measure HJC locations in vivo. Using dual fluoroscopy as the reference standard, we then assessed the accuracy of three predictive and two functional methods. Eleven non-pathologic subjects were imaged with DF and reflective skin marker motion capture. Additionally, DF-based solutions generated virtual markers placed on bony landmarks, which were input to the predictive and functional methods to determine if estimates of the HJC improved. Using skin markers, functional methods had better mean agreement with the HJC measured by DF (11.0 ± 3.3 mm) than predictive methods (18.1 ± 9.5 mm); estimates from functional and predictive methods improved when using the DF-based solutions (1.3 ± 0.9 and 17.5 ± 8.6 mm, respectively). The Harrington method was the best predictive technique using both skin markers (13.2 ± 6.5 mm) and DF-based solutions (10.6 ± 2.5 mm). The two functional methods had similar accuracy using skin makers (11.1 ± 3.6 and 10.8 ± 3.2 mm) and DF-based solutions (1.2 ± 0.8 and 1.4 ± 1.0 mm). Overall, functional methods were superior to predictive methods for HJC estimation. However, the improvements observed when using the DF-based solutions suggest that skin motion artifact is a large source of error for the

  12. Validation of a score predicting post-treatment ambulatory status after radiotherapy for metastatic spinal cord compression

    NARCIS (Netherlands)

    Rades, Dirk; Douglas, Sarah; Huttenlocher, Stefan; Rudat, Volker; Veninga, Theo; Stalpers, Lukas J. A.; Basic, Hiba; Karstens, Johann H.; Hoskin, Peter J.; Adamietz, Irenaeus A.; Schild, Steven E.

    2011-01-01

    A score predicting post-radiotherapy (RT) ambulatory status was developed based on 2,096 retrospectively evaluated metastatic spinal cord compression (MSCC) patients. This study aimed to validate the score in a prospective series. The score included five factors associated with post-RT ambulatory

  13. Low free and bioavailable testosterone levels may predict pathologically-proven high-risk prostate cancer: a prospective, clinical trial.

    Science.gov (United States)

    Bayar, Göksel; Şirin, Hakan; Aydın, Mustafa; Özağarı, Ayşim; Tanrıverdi, Orhan; Kadıhasanoğlu, Mustafa; Kendirci, Muammer

    2017-09-01

    To determine the predictive value of free and bioavailable testosterone levels on the detection of high-grade prostate cancer proven by histopathological examination of transrectal prostate biopsy specimens. A total of 405 patients who underwent transrectal prostate biopsy due to high prostatic specific antigen (PSA) (>2.5 ng/mL) and/or abnormal findings at digital rectal examination were included in this study. Blood free and bioavailable testosterone levels were calculated by the formula recommended by International Society for the Study of the Aging Male (ISSAM). The patients were stratified according to the D'Amico classification based on PSA levels and histological outcomes of prostate biopsies as benign, low, intermediate and high-risk prostate cancer. Patients were also divided into five groups according to the percentage of cancerous cores. Prostate cancer was detected in 160 of 405 (39.5%) patients. Total, free and bioavailable testosterone levels did not differ significantly between the patients with benign or malign histology. However, mean free (6.2 vs. 5.2 ng/dL, p=0.02) and bioavailable (151 vs. 125 ng/dL, p=0.001) testosterone levels were found to be significantly different in men with low-intermediate and high-risk prostate cancer. Moreover, a significant correlation was found between free, and bioavailable testosterone levels and percentage of cores with cancer (p=0.002 for free and p=0.016 for bioavailable testosterone, respectively). This prospective clinical study demonstrates that reduced levels of calculated blood free and bioavailable testosterone levels are associated with an increased risk of high-grade prostate cancer. Based on these findings blood free and bioavailable testosterone levels may be be thought to be an adjunctive factor in the prediction of high-risk prostate cancer.

  14. MRI to MGMT: predicting methylation status in glioblastoma patients using convolutional recurrent neural networks.

    Science.gov (United States)

    Han, Lichy; Kamdar, Maulik R

    2018-01-01

    Glioblastoma Multiforme (GBM), a malignant brain tumor, is among the most lethal of all cancers. Temozolomide is the primary chemotherapy treatment for patients diagnosed with GBM. The methylation status of the promoter or the enhancer regions of the O6-methylguanine methyltransferase (MGMT) gene may impact the efficacy and sensitivity of temozolomide, and hence may affect overall patient survival. Microscopic genetic changes may manifest as macroscopic morphological changes in the brain tumors that can be detected using magnetic resonance imaging (MRI), which can serve as noninvasive biomarkers for determining methylation of MGMT regulatory regions. In this research, we use a compendium of brain MRI scans of GBM patients collected from The Cancer Imaging Archive (TCIA) combined with methylation data from The Cancer Genome Atlas (TCGA) to predict the methylation state of the MGMT regulatory regions in these patients. Our approach relies on a bi-directional convolutional recurrent neural network architecture (CRNN) that leverages the spatial aspects of these 3-dimensional MRI scans. Our CRNN obtains an accuracy of 67% on the validation data and 62% on the test data, with precision and recall both at 67%, suggesting the existence of MRI features that may complement existing markers for GBM patient stratification and prognosis. We have additionally presented our model via a novel neural network visualization platform, which we have developed to improve interpretability of deep learning MRI-based classification models.

  15. Distributed Intrinsic Functional Connectivity Patterns Predict Diagnostic Status in Large Autism Cohort.

    Science.gov (United States)

    Jahedi, Afrooz; Nasamran, Chanond A; Faires, Brian; Fan, Juanjuan; Müller, Ralph-Axel

    2017-10-01

    Diagnosis of autism spectrum disorder (ASD) currently relies on behavioral observations because brain markers are unknown. Machine learning approaches can identify patterns in imaging data that predict diagnostic status, but most studies using functional connectivity MRI (fcMRI) data achieved only modest accuracies of 60-80%. We used conditional random forest (CRF), an ensemble learning technique protected against bias from feature correlation (which exists in fcMRI matrices). We selected 252 low-motion resting-state functional MRI scans from the Autism Brain Imaging Data Exchange, including 126 typically developing (TD) and 126 ASD participants, matched for age, nonverbal IQ, and head motion. A matrix of functional connectivities between 220 functionally defined regions of interest was used for diagnostic classification. In several runs, we achieved accuracies of 92-99% for classifiers with >300 features (most informative connections). Features, including pericentral somatosensory and motor regions, were disproportionately informative. Findings differed partially from a previous study in the same sample that used feature selection with random forest (which is biased by feature correlations). External validation in a smaller in-house data set, however, achieved only 67-71% accuracy. The large number of features in optimal models can be attributed to etiological heterogeneity under the clinical ASD umbrella. Lower accuracy in external validation is expected due to differences in unknown composition of ASD variants across samples. High accuracy in the main data set is unlikely due to noise overfitting, but rather indicates optimized characterization of a given cohort.

  16. Preoperative inflammation markers and IDH mutation status predict glioblastoma patient survival.

    Science.gov (United States)

    Wang, Peng-Fei; Song, Hong-Wang; Cai, Hong-Qing; Kong, Ling-Wei; Yao, Kun; Jiang, Tao; Li, Shou-Wei; Yan, Chang-Xiang

    2017-07-25

    Recent studies suggest that inflammation response biomarkers are prognostic indicators of solid tumor outcomes. Here, we quantify the prognostic value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in glioblastomas (GBMs), taking into consideration the role of the isocitrate dehydrogenase (IDH) mutation status. We examined 141 primary glioblastomas (pGBMs) and 25 secondary glioblastomas (sGBMs). NLRs, PLRs, and LMRs were calculated before surgery. IDH mutations were detected immunohistochemically after tumor resection, and patients' clinical outcomes were analyzed after classification into GBM, pGBM, and IDH-wild type glioblastoma (IDH-wt GBM) groups. To make comparisons, we set cutoffs for NLR, PLR and LMR of 4.0, 175.0, and 3.7, respectively. In a multivariate analysis, both NLR (HR=1.712, 95% CI 1.026-2.858, p=0.040) and PLR (HR=2.051, 95% CI 1.288-3.267, p=0.002) had independent prognostic value. While a low NLR was associated with a better prognosis only in the IDH-wt GBM group, PLR was predictive of patient survival in the GBM, pGBM, and IDH-wt GBM groups. By contrast, LMR exhibited no prognostic value for any of the 3 types of GBM.

  17. The interplay of parental monitoring and socioeconomic status in predicting minor delinquency between and within adolescents.

    Science.gov (United States)

    Rekker, Roderik; Keijsers, Loes; Branje, Susan; Koot, Hans; Meeus, Wim

    2017-08-01

    This six-wave multi-informant longitudinal study on Dutch adolescents (N = 824; age 12-18) examined the interplay of socioeconomic status with parental monitoring in predicting minor delinquency. Fixed-effects negative binomial regression analyses revealed that this interplay is different within adolescents across time than between adolescents. Between individuals, parental solicitation and control were not significantly associated with delinquency after controlling for SES: Adolescents whose parents exercised more monitoring did not offend less than others. Within individuals, higher levels of parental control were unexpectedly associated with more delinquency, but this relation was dependent on SES: Low-SES adolescents, but not high-SES adolescents, offended more during periods in which their parents exercised more control than during other periods with less control. In contrast to earlier work, this finding suggests that monitoring could be least effective when needed most. Low-SES parents might not use monitoring effectively and become overcontrolling when their child goes astray. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  18. A nomogram to predict HER2 status in breast cancer patients with HER2-borderline disease as determined via immunohistochemistry.

    Science.gov (United States)

    Guo, Qianqian; Chen, Kai; Lin, Xiaojie; Su, Yi; Xu, Rui; Dai, Yan; Qiu, Chang; Song, Xue; Mao, Siying; Chen, Qianjun

    2017-11-07

    This study aimed to develop a nomogram to predict fluorescence in situ hybridization (FISH) assay results for HER2-borderline breast cancer as determined via immunohistochemistry (IHC) among patients in China. We reviewed a database of breast cancer patients diagnosed between January 2007 and April 2013 at our institutions. We used logistic regression to develop a nomogram and we used receiver operating characteristic curve analysis and calibration plots to validate our nomogram. In total, 1138, 301 and 344 patients had IHC-determined HER2-negative, HER2-borderline and HER2-positive disease, respectively. Within the training cohort, univariate and multivariate analyses suggested that estrogen receptor (ER) status, progesterone receptor (PR) status and tumor grade were significantly associated with HER2 status (PHER2 status in HER2-borderline breast cancer patients and will be particularly helpful to resource-limited countries.

  19. Comparison of diffusion-weighted MR imaging and FDG PET/CT to predict pathological complete response to neoadjuvant chemotherapy in patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Hee; Moon, Woo Kyung; Cho, Nariya; Chang, Jung Min [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Im, Seock-Ah [Seoul National University Hospital, Department of Internal Medicine, Seoul (Korea, Republic of); Park, In Ae [Seoul National University Hospital, Department of Pathology, Seoul (Korea, Republic of); Kang, Keon Wook [Seoul National University Hospital, Department of Nuclear Medicine, Seoul (Korea, Republic of); Han, Wonshik; Noh, Dong-Young [Seoul National University Hospital, Department of Surgery, Seoul (Korea, Republic of)

    2012-01-15

    To compare the use of diffusion-weighted MR imaging (DWI) and {sup 18}F-FDG PET/CT to predict pathological complete response (pCR) in breast cancer patients receiving neoadjuvant chemotherapy. Thirty-four women with 34 invasive breast cancers underwent DWI and PET/CT before and after chemotherapy and before surgery. The percentage changes in the apparent diffusion coefficient (ADC) and the standardised uptake value (SUV) were calculated, and the diagnostic performances for predicting pCR were evaluated using receiver operating characteristic (ROC) curve analysis. After surgery, 7/34 patients (20.6%) were found to have pCR. A{sub z} values for DWI, PET/CT and the combined use of DWI and PET/CT were 0.910, 0.873 and 0.944, respectively. The best cut-offs for differentiating pCR from non-pCR were a 54.9% increase in the ADC and a 63.9% decrease in the SUV. DWI showed 100% (7/7) sensitivity and 70.4% (19/27) specificity and PET/CT showed 100% sensitivity and 77.8% (21/27) specificity. When DWI and PET/CT were combined, there was a trend towards improved specificity compared with DWI. DWI and FDG PET/CT show similar diagnostic accuracy for predicting pCR to neoadjuvant chemotherapy in breast cancer patients. The combined use of DWI and FDG PET/CT has the potential to improve specificity in predicting pCR. (orig.)

  20. Pathological classification of brain tumors.

    Science.gov (United States)

    Pollo, B

    2012-04-01

    The tumors of the central nervous system are classified according to the last international classification published by World Health Organization. The Classification of Tumors of the Central Nervous System was done on 2007, based on morphological features, growth pattern and molecular profile of neoplastic cells, defining malignancy grade. The neuropathological diagnosis and the grading of each histotype are based on identification of histopathological criteria and immunohistochemical data. The histopathology, also consisting of findings with prognostic or predictive relevance, plays a critical role in the diagnosis and treatment of brain tumors. The recent progresses on radiological, pathological, immunohistochemical, molecular and genetic diagnosis improved the characterization of brain tumors. Molecular and genetic profiles may identify different tumor subtypes varying in biological and clinical behavior. To investigate new therapeutic approaches is important to study the molecular pathways that lead the processes of proliferation, invasion, angiogenesis, anaplastic transformation. Different molecular biomarkers were identified by genetic studies and some of these are used in neuro-oncology for the evaluation of glioma patients, in particular combined deletions of the chromosome arms 1p and 19q in oligodendroglial tumors, methylation status of the O-6 methylguanine- DNA methyltransferase gene promoter and alterations in the epidermal growth factor receptor pathway in adult malignant gliomas, isocitrate dehydrogenase 1 (IDH1) and IDH2 gene mutations in diffuse gliomas, as well as BRAF status in pilocytic astrocytomas. The prognostic evaluation and the therapeutic strategies for patients depend on synthesis of clinical, pathological and biological data: histological diagnosis, malignancy grade, gene-molecular profile, radiological pictures, surgical resection and clinical findings (age, tumor location, "performance status").

  1. Pathology Reports

    Science.gov (United States)

    ... Flow cytometry can be used in the diagnosis, classification, and management of cancers such as acute leukemia, chronic lymphoproliferative disorders, and non-Hodgkin lymphoma ( 2 ). Finally, the pathology report may include ...

  2. Prediction of Low versus High Recurrence Scores in Estrogen Receptor-Positive, Lymph Node-Negative Invasive Breast Cancer on the Basis of Radiologic-Pathologic Features: Comparison with Oncotype DX Test Recurrence Scores.

    Science.gov (United States)

    Dialani, Vandana; Gaur, Shantanu; Mehta, Tejas S; Venkataraman, Shambhavi; Fein-Zachary, Valerie; Phillips, Jordana; Brook, Alexander; Slanetz, Priscilla J

    2016-08-01

    Purpose To review mammographic, ultrasonographic (US), and magnetic resonance (MR) imaging features and pathologic characteristics of estrogen receptor (ER)-positive, lymph node-negative invasive breast cancer and to determine the relationship of these characteristics to Oncotype DX (Genomic Health, Redwood City, Calif) test recurrence scores (ODRS) for breast cancer recurrence. Materials and Methods This institutional review board-approved retrospective study was performed in a single large academic medical center. The study population included patients with ER-positive, lymph node-negative invasive breast cancer who underwent genomic testing from January 1, 2009, to December 31, 2013. Imaging features of the tumor were classified according to the Breast Imaging Reporting and Data System lexicon by breast imagers who were blinded to the ODRS. Mammography was performed in 86% of patients, US was performed in 84%, and MR imaging was performed in 33%, including morphologic and kinetic evaluation. Images from each imaging modality were evaluated. Each imaging finding, progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status, and tumor grade were then individually correlated with ODRS. Analysis of variance was used to determine differences for each imaging feature. Regression analysis was used to calculate prediction of recurrence on the basis of imaging features combined with histopathologic features. Results The 319 patients had a mean age ± standard deviation of 55 years ± 8.7 (range, 31-82 years). Imaging features with a positive correlation with ODRS included a well-circumscribed oval mass (P = .024) at mammography, vascularity (P = .047) and posterior enhancement (P = .004) at US, and lobulated mass (P = .002) at MR imaging. Recurrence scores were predicted by using these features in combination with PR and HER2 status and tumor grade by using the threshold of more than 30 as a high recurrence score. With a regression tree, there

  3. Do repeated assessments of performance status improve predictions for risk of death among patients with cancer? A population-based cohort study.

    Science.gov (United States)

    Su, Jiandong; Barbera, Lisa; Sutradhar, Rinku

    2015-06-01

    Prior work has utilized longitudinal information on performance status to demonstrate its association with risk of death among cancer patients; however, no study has assessed whether such longitudinal information improves the predictions for risk of death. To examine whether the use of repeated performance status assessments improve predictions for risk of death compared to using only performance status assessment at the time of cancer diagnosis. This was a population-based longitudinal study of adult outpatients who had a cancer diagnosis and had at least one assessment of performance status. To account for each patient's changing performance status over time, we implemented a Cox model with a time-varying covariate for performance status. This model was compared to a Cox model using only a time-fixed (baseline) covariate for performance status. The regression coefficients of each model were derived based on a randomly selected 60% of patients, and then, the predictive ability of each model was assessed via concordance probabilities when applied to the remaining 40% of patients. Our study consisted of 15,487 cancer patients with over 53,000 performance status assessments. The utilization of repeated performance status assessments improved predictions for risk of death compared to using only the performance status assessment taken at diagnosis. When studying the hazard of death among patients with cancer, if available, researchers should incorporate changing information on performance status scores, instead of simply baseline information on performance status. © The Author(s) 2015.

  4. Accuracy of Computed Tomography for Predicting Pathologic Nodal Extracapsular Extension in Patients With Head-and-Neck Cancer Undergoing Initial Surgical Resection

    Energy Technology Data Exchange (ETDEWEB)

    Prabhu, Roshan S., E-mail: roshansprabhu@gmail.com [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Magliocca, Kelly R. [Department of Pathology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Hanasoge, Sheela [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Aiken, Ashley H.; Hudgins, Patricia A. [Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Hall, William A. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Chen, Susie A. [Department of Radiation Oncology, University of Texas Southwestern, Dallas, Texas (United States); Eaton, Bree R.; Higgins, Kristin A. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Saba, Nabil F. [Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Beitler, Jonathan J. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

    2014-01-01

    Purpose: Nodal extracapsular extension (ECE) in patients with head-and-neck cancer increases the loco-regional failure risk and is an indication for adjuvant chemoradiation therapy (CRT). To reduce the risk of requiring trimodality therapy, patients with head-and-neck cancer who are surgical candidates are often treated with definitive CRT when preoperative computed tomographic imaging suggests radiographic ECE. The purpose of this study was to assess the accuracy of preoperative CT imaging for predicting pathologic nodal ECE (pECE). Methods and Materials: The study population consisted of 432 consecutive patients with oral cavity or locally advanced/nonfunctional laryngeal cancer who underwent preoperative CT imaging before initial surgical resection and neck dissection. Specimens with pECE had the extent of ECE graded on a scale from 1 to 4. Results: Radiographic ECE was documented in 46 patients (10.6%), and pECE was observed in 87 (20.1%). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 43.7%, 97.7%, 82.6%, and 87.3%, respectively. The sensitivity of radiographic ECE increased from 18.8% for grade 1 to 2 ECE, to 52.9% for grade 3, and 72.2% for grade 4. Radiographic ECE criteria of adjacent structure invasion was a better predictor than irregular borders/fat stranding for pECE. Conclusions: Radiographic ECE has poor sensitivity, but excellent specificity for pECE in patients who undergo initial surgical resection. PPV and NPV are reasonable for clinical decision making. The performance of preoperative CT imaging increased as pECE grade increased. Patients with resectable head-and-neck cancer with radiographic ECE based on adjacent structure invasion are at high risk for high-grade pECE requiring adjuvant CRT when treated with initial surgery; definitive CRT as an alternative should be considered where appropriate.

  5. Introduction to Psychology Students' Parental Status Predicts Learning Preferences and Life Meaning

    Science.gov (United States)

    Lovell, Elyse D'nn; Munn, Nathan

    2017-01-01

    This study explores Introduction to Psychology students' learning preferences and their personal search for meaning while considering their parental status. The findings suggest that parents show preferences for project-based learning and have lower levels of searching for meaning than non-parents. When parental status, age, and finances were…

  6. Digital pathology

    CERN Document Server

    Sucaet, Yves

    2014-01-01

    Digital pathology has experienced exponential growth, in terms of its technology and applications, since its inception just over a decade ago. Though it has yet to be approved for primary diagnostics, its values as a teaching tool, facilitator of second opinions and quality assurance reviews and research are becoming, if not already, undeniable. It also offers the hope of providing pathology consultant and educational services to under-served areas, including regions of the world that could not possibly sustain this level of services otherwise. And this is just the beginning, as its adoption b

  7. Predicting self-rated mental and physical health: the contributions of subjective socioeconomic status and personal relative deprivation.

    Science.gov (United States)

    Callan, Mitchell J; Kim, Hyunji; Matthews, William J

    2015-01-01

    Lower subjective socioeconomic status (SSS) and higher personal relative deprivation (PRD) relate to poorer health. Both constructs concern people's perceived relative social position, but they differ in their emphasis on the reference groups people use to determine their comparative disadvantage (national population vs. similar others) and the importance of resentment that may arise from such adverse comparisons. We investigated the relative utility of SSS and PRD as predictors of self-rated physical and mental health (e.g., self-rated health, stress, health complaints). Across six studies, self-rated physical and mental health were on the whole better predicted by measures of PRD than by SSS while controlling for objective socioeconomic status (SES), with SSS rarely contributing unique variance over and above PRD and SES. Studies 4-6 discount the possibility that the superiority of PRD over SSS in predicting health is due to psychometric differences (e.g., reliability) or response biases between the measures.

  8. [Nitrogen status diagnosis and yield prediction of spring maize after green manure incorporation by using a digital camera].

    Science.gov (United States)

    Bai, Jin-Shun; Cao, Wei-Dong; Xiong, Jing; Zeng, Nao-Hua; Shimizu, Katshyoshi; Rui, Yu-Kui

    2013-12-01

    In order to explore the feasibility of using the image processing technology to diagnose the nitrogen status and to predict the maize yield, a field experiment with different nitrogen rates with green manure incorporation was conducted. Maize canopy digital images over a range of growth stages were captured by digital camera. Maize nitrogen status and the relationships between image color indices derived by digital camera for maize at different growth stages and maize nitrogen status indicators were analyzed. These digital camera sourced image color indices at different growth stages for maize were also regressed with maize grain yield at maturity. The results showed that the plant nitrogen status for maize was improved by green manure application. The leaf chlorophyll content (SPAD value), aboveground biomass and nitrogen uptake for green manure treatments at different maize growth stages were all higher than that for chemical fertilization treatments. The correlations between spectral indices with plant nitrogen indicators for maize affected by green manure application were weaker than that affected by chemical fertilization. And the correlation coefficients for green manure application were ranged with the maize growth stages changes. The best spectral indices for diagnosis of plant nitrogen status after green manure incorporation were normalized blue value (B/(R+G+B)) at 12-leaf (V12) stage and normalized red value (R/(R+G+B)) at grain-filling (R4) stage individually. The coefficients of determination based on linear regression were 0. 45 and 0. 46 for B/(R+G+B) at V12 stage and R/(R+G+B) at R4 stage respectively, acting as a predictor of maize yield response to nitrogen affected by green manure incorporation. Our findings suggested that digital image technique could be a potential tool for in-season prediction of the nitrogen status and grain yield for maize after green manure incorporation when the suitable growth stages and spectral indices for diagnosis

  9. Interrelationship between family history of alcoholism and generational status in the prediction of alcohol dependence in US Hispanics.

    Science.gov (United States)

    Chartier, K G; Thomas, N S; Kendler, K S

    2017-01-01

    Both a family history of alcoholism and migration-related factors like US v. foreign nativity increase the risk for developing alcohol use disorders in Hispanic Americans. For this study, we integrated these two lines of research to test whether the relationship between familial alcoholism and alcohol dependence changes with successive generations in the United States. Data were from the waves 1 and 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Subjects self-identified Hispanic ethnicity (N = 4122; n = 1784 first, n = 1169 second, and n = 1169 third or later generation) and reported ever consuming ⩾12 drinks in a 1-year period. A family history of alcoholism was assessed in first- and second-degree relatives. Analyses predicting the number of alcohol dependence symptoms were path models. Alcohol dependence symptoms were associated with a stronger family history of alcoholism and later generational status. There was a significant interaction effect between familial alcoholism and generational status; the relationship of familial alcoholism with alcohol dependence symptoms increased significantly with successive generations in the United States, more strongly in women than men. Acculturation partially mediated the interaction effect between familial alcoholism and generational status on alcohol dependence, although not in the expected direction. Familial alcoholism interacted with generational status in predicting alcohol dependence symptoms in US Hispanic drinkers. This relationship suggests that heritability for alcoholism is influenced by a higher-order environmental factor, likely characterized by a relaxing of social restrictions on drinking.

  10. Does Marital Status Predict the Odds of Suicidal Death in Taiwan? A Seven-Year Population-Based Study

    Science.gov (United States)

    Yeh, Jui-Yuan; Xirasagar, Sudha; Liu, Tsai-Ching; Li, Chong-Yi; Lin, Herng-Ching

    2008-01-01

    Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups--total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly…

  11. [Adolescent pathological gambling].

    Science.gov (United States)

    Petit, A; Karila, L; Lejoyeux, M

    2015-05-01

    Although experts have long thought that the problems of gambling involved only adults, recent studies tend to show that teenagers are also affected. The objective of this paper is to show the characteristics of pathological gambling in adolescents. This review focuses on the clinical features, prevalence, psychopathology, prevention and treatment of this disorder. A review of the medical literature was conducted, using PubMed, using the following keywords alone or combined: pathological gambling, dependence, addiction and adolescents. We selected 12 English articles from 1997 to 2014. Recent work estimate that between 4 and 8% of adolescents suffer from problem gambling, and the prevalence of pathological gambling is 2-4 times higher in adolescents than in adults. The term adolescent pathological gambler starts early around the age of 10-12 years, with a quick change of status from casual to that of problem gambler and player. Complications appear quickly and comorbidities are common. There is no curative pharmacological treatment approved by health authorities. Pathological gambling among adolescents has grown significantly in recent years and should be promptly taken care of. Further studies must be performed to improve our understanding of this problem among adolescents. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. The predictive value of {sup 18}F-FDG PET/CT for assessing pathological response and survival in locally advanced rectal cancer after neoadjuvant radiochemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Leccisotti, Lucia; Stefanelli, Antonella; Giordano, Alessandro [Universita Cattolica del Sacro Cuore, Institute of Nuclear Medicine, Rome (Italy); Gambacorta, Maria Antonietta; Valentini, Vincenzo [Universita Cattolica del Sacro Cuore, Institute of Radiation Oncology, Rome (Italy); De Waure, Chiara [Universita Cattolica del Sacro Cuore, Institute of Public Health, Roma (Italy); Barbaro, Brunella [Universita Cattolica del Sacro Cuore, Institute of Radiology, Rome (Italy); Vecchio, Fabio Maria [Universita Cattolica del Sacro Cuore, Institute of Pathology, Rome (Italy); Coco, Claudio; Persiani, Roberto; Crucitti, Antonio; Tortorelli, Antonino Pio [Universita Cattolica del Sacro Cuore, Department of Surgical Sciences, Rome (Italy)

    2015-04-01

    To evaluate whether metabolic changes in the primary tumour during and after preoperative radiochemotherapy (RCT) can predict the histopathological response in patients with locally advanced rectal cancer as well as disease-free survival (DFS) and overall survival (OS). Consecutive patients with cT2-4 N0-2 rectal adenocarcinoma were included. {sup 18}F-FDG PET/CT was performed at baseline, at the end of the second week of RCT (early PET/CT) and before surgery (late PET/CT). The PET/CT results were compared with histopathological data (ypT0 N0 vs. ypT1-4 N0-2 as well as TRG1 vs.TRG2-5) and survival. The study included 126 patients. Among 124 patients in whom TNM classification was available, 28 (22.6 %) were ypT0 N0, and among all 126 patients, 31 (24.6 %) were TRG1. The areas under the curve of the early response index (RI) for identifying non-complete pathological response (non-cPR) were 0.74 (95 % CI 0.61 - 0.87) for ypT1-4 N0-2 patients and 0.75 (95 % CI 0.62 - 0.88) for TRG2-5 patients. The optimal cut-off for differentiating patients with non-cPR and cPR was found to be a reduction of 61.2 % (83.1 % sensitivity and 65 % specificity in ypT1-4 N0-2 patients; 85.4 % sensitivity and 65.2 % specificity in TRG2-5 patients). The optimal cut-off for late RI could not be found. The qualitative analysis of images obtained after RCT demonstrated 81.5 % sensitivity and 61.3 % specificity in predicting TRG2-5. After a median follow-up of 68 months, the low number of patients with local/distant recurrence or who had died did not allow the value of PET/CT for predicting DFS and OS to be calculated. The early assessment of response to RCT by {sup 18}F-FDG PET/CT can predict non-cPR allowing practical modification of preoperative treatment. Conversely, late RI is not sufficiently accurate for guiding the decision as to whether local excision or even observation is appropriate in an individual patient. Qualitative analysis of late PET/CT images is also not sensitive enough

  13. The value of {sup 18}F-FDG PET before and after induction chemotherapy for the early prediction of a poor pathologic response to subsequent preoperative chemoradiotherapy in oesophageal adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Rossum, Peter S.N. van [The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, TX (United States); University Medical Center Utrecht, Department of Radiation Oncology, Utrecht (Netherlands); Fried, David V.; Zhang, Lifei; Court, Laurence E. [The University of Texas MD Anderson Cancer Center, Department of Radiation Physics, Houston, TX (United States); Hofstetter, Wayne L. [The University of Texas MD Anderson Cancer Center, Department of Thoracic and Cardiovascular Surgery, Houston, TX (United States); Ho, Linus [The University of Texas MD Anderson Cancer Center, Department of Gastrointestinal Medical Oncology, Houston, TX (United States); Meijer, Gert J. [University Medical Center Utrecht, Department of Radiation Oncology, Utrecht (Netherlands); Carter, Brett W. [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Lin, Steven H. [The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, TX (United States)

    2017-01-15

    The purpose of our study was to determine the value of {sup 18}F-FDG PET before and after induction chemotherapy in patients with oesophageal adenocarcinoma for the early prediction of a poor pathologic response to subsequent preoperative chemoradiotherapy (CRT). In 70 consecutive patients receiving a three-step treatment strategy of induction chemotherapy and preoperative chemoradiotherapy for oesophageal adenocarcinoma, {sup 18}F-FDG PET scans were performed before and after induction chemotherapy (before preoperative CRT). SUV{sub max}, SUV{sub mean}, metabolic tumour volume (MTV), and total lesion glycolysis (TLG) were determined at these two time points. The predictive potential of (the change in) these parameters for a poor pathologic response, progression-free survival (PFS) and overall survival (OS) was assessed. A poor pathologic response after induction chemotherapy and preoperative CRT was found in 27 patients (39 %). Patients with a poor pathologic response experienced less of a reduction in TLG after induction chemotherapy (p < 0.01). The change in TLG was predictive for a poor pathologic response at a threshold of -26 % (sensitivity 67 %, specificity 84 %, accuracy 77 %, PPV 72 %, NPV 80 %), yielding an area-under-the-curve of 0.74 in ROC analysis. Also, patients with a decrease in TLG lower than 26 % had a significantly worse PFS (p = 0.02), but not OS (p = 0.18). {sup 18}F-FDG PET appears useful to predict a poor pathologic response as well as PFS early after induction chemotherapy in patients with oesophageal adenocarcinoma undergoing a three-step treatment strategy. As such, the early {sup 18}F-FDG PET response after induction chemotherapy could aid in individualizing treatment by modification or withdrawal of subsequent preoperative CRT in poor responders. (orig.)

  14. SURGICAL PATHOLOGY

    African Journals Online (AJOL)

    Methods: The histology records of patients diagnosed as cases of malignant melanoma in the pathology laboratory of Jos University Teaching Hospital over a ... patients (82.4%) presented with foot lesions, six (8.8%) with groin lesions and 2 (2.9%) each with upper limb and conjuctival lesions. The vulva and oral mucosa ...

  15. Parenting style and child-feeding behaviour in predicting children's weight status change in Taiwan

    National Research Council Canada - National Science Library

    Tung, Ho-Jui; Yeh, Ming-Chin

    .... Prior studies find that parents' child-feeding practices are associated with child weight status and the efficacy of specific parental child-feeding practices can be moderated by parenting styles...

  16. Generational status and duration of residence predict diabetes prevalence among Latinos: the California Men's Health Study.

    Science.gov (United States)

    Ahmed, Ameena T; Quinn, Virginia P; Caan, Bette; Sternfeld, Barbara; Haque, Reina; Van Den Eeden, Stephen K

    2009-10-19

    Diabetes disproportionately affects Latinos. However, examining Latinos as one group obscures important intra-group differences. This study examined how generational status, duration of US residence, and language preference are associated with diabetes prevalence and to what extent these explain the higher prevalence among Latinos. We determined nativity, duration of US residence, language preference, and diabetes prevalence among 11 817 Latino, 6109 black, and 52 184 white participants in the California Men's Health Study. We combined generational status and residence duration into a single migration status variable with levels: > or = third generation; second generation; and immigrant living in the US for > 25, 16-25, 11-15, or Generational status and residence duration were associated with diabetes prevalence among middle-aged Latino men in California. As the Latino population grows, the burden of diabetes-associated disease is likely to increase and demands public health attention.

  17. Sequential {sup 18}F-FDG PET/CT for early prediction of complete pathological response in breast and axilla during neoadjuvant chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Koolen, Bas B. [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Surgical Oncology, Amsterdam (Netherlands); Pengel, Kenneth E. [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); Wesseling, Jelle [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Pathology, Amsterdam (Netherlands); Vogel, Wouter V.; Valdes Olmos, Renato A. [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Vrancken Peeters, Marie-Jeanne T.F.D.; Rutgers, Emiel J.T. [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Surgical Oncology, Amsterdam (Netherlands); Vincent, Andrew D. [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Biometrics, Amsterdam (Netherlands); Gilhuijs, Kenneth G.A. [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Rodenhuis, Sjoerd [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Medical Oncology, Amsterdam (Netherlands)

    2014-01-15

    To investigate the value of response monitoring in both the primary tumour and axillary nodes on sequential PET/CT scans during neoadjuvant chemotherapy (NAC) for predicting complete pathological response (pCR), taking the breast cancer subtype into account. In 107 consecutive patients 290 PET/CT scans were performed at baseline (PET/CT1, 107 patients), after 2 - 3 weeks of chemotherapy (PET/CT2, 85 patients), and after 6 - 8 weeks (PET/CT3, 98 patients). The relative changes in SUVmax (from baseline) of the tumour and the lymph nodes and in both combined (after logistic regression), and the changes in the highest SUVmax between scans (either tumour or lymph node) were determined and their associations with pCR of the tumour and lymph nodes after completion of NAC were assessed using receiver operating characteristic (ROC) analysis. A pCR was seen in 17 HER2-positive tumours (65 %), 1 ER-positive/HER2-negative tumour (2 %), and 16 triple-negative tumours (52 %). The areas under the ROC curves (ROC-AUC) for the prediction of pCR in HER2-positive tumours after 3 weeks were 0.61 for the relative change in tumours, 0.67 for the combined change in tumour and nodes, and 0.72 for the changes in the highest SUVmax between scans. After 8 weeks equivalent values were 0.59, 0.42 and 0.64, respectively. In triple-negative tumours the ROC-AUCs were 0.76, 0.84 and 0.76 after 2 weeks, and 0.87, 0.93 and 0.88 after 6 weeks, respectively. In triple-negative tumours a PET/CT scan after 6 weeks (three cycles) appears to be optimally predictive of pCR. In HER2-positive tumours neither a PET/CT scan after 3 weeks nor after 8 weeks seems to be useful. The changes in SUVmax of both the tumour and axillary nodes combined correlates best with pCR. (orig.)

  18. miR-19, miR-345, miR-519c-5p serum levels predict adverse pathology in prostate cancer patients eligible for active surveillance.

    Directory of Open Access Journals (Sweden)

    Siao-Yi Wang

    Full Text Available Serum microRNAs hold great promise as easily accessible and measurable biomarkers of disease. In prostate cancer, serum miRNA signatures have been associated with the presence of disease as well as correlated with previously validated risk models. However, it is unclear whether miRNAs can provide independent prognostic information beyond current risk models. Here, we focus on a group of low-risk prostate cancer patients who were eligible for active surveillance, but chose surgery. A major criteria for the low risk category is a Gleason score of 6 or lower based on pre-surgical biopsy. However, a third of these patients are upgraded to Gleason 7 on post surgical pathological analysis. Both in a discovery and a validation cohort, we find that pre-surgical serum levels of miR-19, miR-345 and miR-519c-5p can help identify these patients independent of their pre-surgical age, PSA, stage, and percent biopsy involvement. A combination of the three miRNAs increased the area under a receiver operator characteristics curve from 0.77 to 0.94 (p<0.01. Also, when combined with the CAPRA risk model the miRNA signature significantly enhanced prediction of patients with Gleason 7 disease. In-situ hybridizations of matching tumors showed miR-19 upregulation in transformed versus normal-appearing tumor epithelial, but independent of tumor grade suggesting an alternative source for the increase in serum miR-19a/b levels or the release of pre-existing intracellular miR-19a/b upon progression. Together, these data show that serum miRNAs can predict relatively small steps in tumor progression improving the capacity to predict disease risk and, therefore, potentially drive clinical decisions in prostate cancer patients. It will be important to validate these findings in a larger multi-institutional study as well as with independent methodologies.

  19. Gender and offender status predicting treatment success in refugees and asylum seekers with PTSD

    Directory of Open Access Journals (Sweden)

    Håkon Stenmark

    2014-01-01

    Full Text Available Background: Current knowledge is limited regarding patient characteristics related to treatment outcome of posttraumatic stress disorders (PTSD in refugees and asylum seekers. Objective: Gender, torture status, offender status, level of anger, and level of depression were investigated for possible effects on the treatment outcome. Method: Patient characteristics were explored in 54 refugees and asylum seekers who had completed a treatment program for PTSD. Non-responders (10, those who had the same or higher levels of symptom severity after treatment, were compared with responders, those who had lower symptom severity after treatment (44. Symptom severity was measured by Clinician-Administered PTSD Scale. The non-responders and responders constituted the dichotomous, dependent variable. The independent variables were gender, torture status, offender status, level of anger, and level of depression. T-tests and Exact Unconditional Homogeneity/Independence Tests for 2X2 Tables were used to study the relationship to treatment outcome. Results: Being male and reporting to have been a violent offender were significantly more frequent characteristics among the non-responders compared to the responders. The levels of pretreatment anger, depression and torture status did not affect the treatment outcome. Conclusions: The study adds support to findings that females benefit more from treatment of PTSD than males and that violent offenders are difficult to treat within the standard treatment programs.

  20. Urban Pathology

    OpenAIRE

    Pitcher, Brian L.

    1997-01-01

    Urban theorists have long debated to what extend and how the social problems of the city have been brought about or exaggerated in some consistent way by the urban environments in which they occur. This presentation reviews theories of urbanism, and the features of cities which contribute to the augmentation and control of various types of social pathology. Special emphasis is given to some types and patterns of urban unrest, and the structural characteristics associated with deleterious urba...

  1. Nutritional status predicts primary subclasses of T cells and the lymphocyte proliferation response in healthy older women.

    Science.gov (United States)

    Molls, Roshni R; Ahluwalia, Namanjeet; Mastro, Andrea M; Smiciklas-Wright, Helen; Handte, Gordon C

    2005-11-01

    Aging is often associated with a dysregulation in immune function, particularly in T-cell responses, even in the healthy elderly. Adequate nutrition is important for optimal immune function. The literature on the relation of nutritional status with immune function in the elderly offers mixed findings. Because several nutrients can influence immune response, and there are interactions among nutrients, examining the association of various nutrients measured simultaneously with tests of immune function is important. We examined the association of protein, iron, zinc, vitamin B-12, and folic acid with tests of acquired immunity in healthy older women (76.7 +/- 7.0 y; n = 130). Discriminant analysis was used to identify the predictive subset of nutrients that could correctly classify subjects into the lowest or highest quartiles (75th percentile) on various immune function tests (T cells and subsets and lymphocyte proliferation in response to culture with mitogens). Protein and iron status variables were identified in the predictive subset for all immune tests; in addition, zinc emerged in the predictive model for T cells and their subsets as well as for the proliferation response to concanavalin A. The probability of correctly classifying women into the lowest or highest quartiles of immune tests by the predictive subset of nutrition variables was high, i.e., 62.8-83.5% for T cells and their subsets, and 79.3-89.7% for the proliferation response to mitogens. In conclusion, protein, iron, and zinc were significant predictors of immune function in older women. Adequate status of these nutrients may help maintain immunity in older adults.

  2. APPETITE PREDICTS INTAKE AND NUTRITIONAL STATUS IN PATIENTS RECEIVING PERITONEAL DIALYSIS.

    Science.gov (United States)

    Young, Valerie; Balaam, Sarah; Orazio, Linda; Bates, Annerley; Badve, Sunil V; Johnson, David W; Campbell, Katrina L

    2016-06-01

    Sub-optimal nutrition status is common amongst patients receiving peritoneal dialysis (PD) and leads to poor clinical outcome. This population experiences multi-factorial challenges to achieving optimal nutritional status, particularly driven by inadequate intake. The aim of this investigation was to identify factors associated with inadequate protein intake and sub-optimal nutritional status in patients undergoing PD. This was a cross-sectional study of 67 adult patients receiving PD (mean age 59 ± 14 years; 57% male) within a single centre. Participants were consecutively recruited and interviewed by renal dietitians, collecting: Subjective Global Assessment (SGA); quality of life (using EQ-5D); dietary intake (via dietary interview); and appetite (using Appetite and Diet Assessment Tool). Participant demographics were obtained via survey or medical charts. Main outcome measures were inadequate dietary protein intake (Renal Care Association.

  3. Dietary protein and beef consumption predict for markers of muscle mass and nutrition status in older adults.

    Science.gov (United States)

    Asp, M L; Richardson, J R; Collene, A L; Droll, K R; Belury, M A

    2012-01-01

    To determine the relationship of beef and protein intake to nutrition status, body composition, strength, and biochemical measures of vitamin and mineral status, inflammation and blood lipids in older adults. Cross-sectional observational study. State of Ohio, U.S.A. 142 adults ages 60-88. Subjects completed a Diet History Questionnaire, and questionnaires related to nutrition status and activity. Subjects also underwent measurements of body composition and strength, and a subset took part in a blood draw for biochemical measurements. Beef intake (g/d) was positively correlated to muscle mass measured by mid-arm muscle area (R=0.128, p=0.030). From multiple linear regression analysis, a 1oz/d (~28g/d) increase in beef consumption predicts for a 2.3cm(2) increase in mid-arm muscle area. Beef intake was negatively correlated to total (R=-0.179, p=0.035) and HDL (R=-0.247, p=0.004) cholesterol, and there was no association between beef and LDL-cholesterol, triglycerides, liver enzymes, or inflammatory markers. Protein intake (% of total energy) was positively correlated to nutrition status measured by the Mini Nutrition Assessment (R=0.196, p=0.020), and calf circumference (R=0.190, p=0.024), and these correlations remained when potential confounders were accounted for in multiple linear regression models. Protein intake was also positively correlated with BMI when analyzed with multiple linear regression. Beef intake was positively associated with mid-arm muscle area, and protein intake was positively associated with nutrition status, calf circumference, and BMI in older adults. Consuming lean cuts of beef in moderation may be a healthy way in which older adults can increase protein intake, preserve muscle mass and improve nutrition status.

  4. Generational status and duration of residence predict diabetes prevalence among Latinos: the California Men's Health Study

    Directory of Open Access Journals (Sweden)

    Sternfeld Barbara

    2009-10-01

    Full Text Available Abstract Background Diabetes disproportionately affects Latinos. However, examining Latinos as one group obscures important intra-group differences. This study examined how generational status, duration of US residence, and language preference are associated with diabetes prevalence and to what extent these explain the higher prevalence among Latinos. Methods We determined nativity, duration of US residence, language preference, and diabetes prevalence among 11 817 Latino, 6109 black, and 52 184 white participants in the California Men's Health Study. We combined generational status and residence duration into a single migration status variable with levels: ≥ third generation; second generation; and immigrant living in the US for > 25, 16-25, 11-15, or ≤ 10 years. Language preference was defined as language in which the participant took the survey. Logistic regression models were specified to assess the associations of dependent variables with prevalent diabetes. Results Diabetes prevalence was 22%, 23%, and 11% among Latinos, blacks, and whites, respectively. In age-adjusted models, we observed a gradient of risk of diabetes by migration status among Latinos. Further adjustment for socioeconomic status, obesity and health behaviors only partially attenuated this gradient. Language preference was a weak predictor of prevalent diabetes in some models and not significant in others. In multivariate models, we found that odds of diabetes were higher among US-born Latinos than US-born blacks. Conclusion Generational status and residence duration were associated with diabetes prevalence among middle-aged Latino men in California. As the Latino population grows, the burden of diabetes-associated disease is likely to increase and demands public health attention.

  5. [The relationship of the acid-base status of the blood to the electrophoretic mobility of the erythrocytes in liver pathology].

    Science.gov (United States)

    Matiushichev, V B; Shamratova, C G; Gutsaeva, D R

    1995-01-01

    With cholestatic hepatite, the relationship between acid-alkaline condition of blood and electrophoretic mobility of erythrocytes was studied. It is shown that changes in parameters of the individual mobility distribution are translated into reality independently, and are directed to maintain the steadiness of the index middle level. Dependence of this sign on the pH value, hemoglobin content and bicarbonate-ion concentrating in blood, an on partial pressure of oxygen and carbonic gas was discovered. The intravenous infusion of patients with hemodese restored the middle level of cell electrophoretic mobility previously reduced due to liver pathology. Membrane mechanisms controlling stability of erythrocyte electrokinetic characteristics are discussed.

  6. Rural health in Jamaica: examining and refining the predictive factors of good health status of rural residents.

    Science.gov (United States)

    Bourne, Paul A; McGrowder, Donovan A

    2009-01-01

    Poverty is mainly concentrated in rural areas. Rural populations also generally experience excessive deficiencies in healthcare access, social services, and other goods and services needed for healthy living. This study investigated the health status and determining factors of Jamaican rural residents in order to provide healthcare practitioners and policy makers with research findings to assist in effectively addressing health in rural Jamaica. The current research used a sub-sample of 15 260 respondents. The sub-sample was taken from a national cross-sectional study of 25 018 respondents from the 14 parishes of the island. The survey from which the present study is drawn used a stratified random probability sampling technique to draw the 25 018 respondents. Descriptive statistics were used to provide background information on the demographic characteristics of the sub-sample population. The model will be established using logistic regression using statistically significant (p health (n = 2554), 82.8% (n = 12 285) reported good health and 5.9% (n = 873) reported private health insurance coverage. The model used had statistically significant predictive power (model chi2 = 15939.9, p goodness of fit, chi2 = 14.46, p = 0.71). It was found that 85.1% (n = 4738) of the data were correctly classified. Of those with good health, 97.2% (n = 4387) were correctly classified, while of those with poor health, 38.6% (n = 451) were correctly classified. Some 12 factors can be used to predict the health status of rural residents in Jamaica with chi2(28) = 1595.03, p health status. An examination of the predictors revealed that the six most influential in descending order were: health insurance coverage (Wald statistic = 492.556; OR = 0.044, 95% CI: 0.033-0.058, p good health, and the 12 factors accounted for 38% of the variability in good health. Of the 12 factors, ownership of health insurance was the most significant and this is negatively associated with good health status

  7. Nurses' Assessment of Rehabilitation Potential and Prediction of Functional Status at Discharge from Inpatient Rehabilitation

    Science.gov (United States)

    Myers, Jamie S.; Grigsby, Jim; Teel, Cynthia S.; Kramer, Andrew M.

    2009-01-01

    The goals of this study were to evaluate the accuracy of nurses' predictions of rehabilitation potential in older adults admitted to inpatient rehabilitation facilities and to ascertain whether the addition of a measure of executive cognitive function would enhance predictive accuracy. Secondary analysis was performed on prospective data collected…

  8. Prediction of pathologic grade and prognosis in mucoepidermoid carcinoma of the lung using {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Joon; KIm, Hong Kwan; Choi, Yong Soo; Kim, Jhing Ook; Zo, Jae Il; Choi, Joon Young; Shim, Young Mog [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-08-15

    The maximum standardized uptake value (SUV{sub max}) of pulmonary mucoepidermoid carcinoma (PMEC) in fluorine-18fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) was evaluated as a preoperative predictor of pathologic grade and survival rate. Twenty-three patients who underwent preoperative PET/CT and complete resection for PMEC were enrolled. The optimal cut-off SUV{sub max} for tumor grade was calculated as 6.5 by receiver operating characteristic curve. The patients were divided into a high SUV group (n = 7) and a low SUV group (n = 16). Clinicopathologic features were compared between the groups by χ2 test and overall survival was determined by Kaplan-Meier analysis. The mean SUV{sub max} was 15.4 ± 11.5 in the high SUV group and 3.9 ± 1.3 in the low SUV group. All patients except one from the low SUV group had low grade tumors and all had no nodal metastasis. The sensitivity and specificity of SUV{sub max} from PET/CT for predicting tumor grade was 85.7% and 93.8%, respectively. During the follow-up period (mean, 48.6 ± 38.7 months), four patients from the high SUV group experienced cancer recurrence, and one died of cancer. In contrast, none of the low SUV group had recurrence or mortality. Five-year overall survival rate was significantly higher in the low SUV group (100% vs. 71.4%, p = 0.031). Pulmonary mucoepidermoid carcinoma patients with high SUV{sub max} in PET/CT had higher tumor grade, more frequent lymph node metastasis and worse long-term outcome. Therefore, PMEC patients with high uptake on PET/CT imaging might require aggressive mediastinal lymph node dissection and adjuvant therapies.

  9. Next-Generation Pathology.

    Science.gov (United States)

    Caie, Peter D; Harrison, David J

    2016-01-01

    The field of pathology is rapidly transforming from a semiquantitative and empirical science toward a big data discipline. Large data sets from across multiple omics fields may now be extracted from a patient's tissue sample. Tissue is, however, complex, heterogeneous, and prone to artifact. A reductionist view of tissue and disease progression, which does not take this complexity into account, may lead to single biomarkers failing in clinical trials. The integration of standardized multi-omics big data and the retention of valuable information on spatial heterogeneity are imperative to model complex disease mechanisms. Mathematical modeling through systems pathology approaches is the ideal medium to distill the significant information from these large, multi-parametric, and hierarchical data sets. Systems pathology may also predict the dynamical response of disease progression or response to therapy regimens from a static tissue sample. Next-generation pathology will incorporate big data with systems medicine in order to personalize clinical practice for both prognostic and predictive patient care.

  10. Oxidant Status and Lipid Composition of Erythrocyte Membranes in Patients with Type 2 Diabetes, Chronic Liver Damage, and a Combination of Both Pathologies

    Directory of Open Access Journals (Sweden)

    Rolando Hernández-Muñoz

    2013-01-01

    Full Text Available There is an important set of cirrhotic and diabetic patients that present both diseases. However, information about metabolic and cellular blood markers that are altered, in conjunction or distinctively, in the 3 pathological conditions is scarce. The aim of this project was to evaluate several indicators of prooxidant reactions and the membrane composition of blood samples (serum and red blood cells (RBCs from patients clinically classified as diabetic (n=60, cirrhotic (n=70, and diabetic with liver cirrhosis (n=25 as compared to samples from a similar population of healthy individuals (n=60. The results showed that levels of TBARS, nitrites, cysteine, and conjugated dienes in the RBC of cirrhotic patients were significantly increased. However, the coincidence of diabetes and cirrhosis partially reduced the alterations promoted by the cirrhotic condition. The amount of total phospholipids and cholesterol was greatly enhanced in the patients with both pathologies (between 60 and 200% according to the type of phospholipid but not in the patients with only one disease. Overall, the data indicate that the cooccurrence of diabetes and cirrhosis elicits a physiopathological equilibrium that is different from the alterations typical of each individual malady.

  11. Nutritional status and food security in Sub-Saharan Africa: Predictions for 2020.

    Science.gov (United States)

    Steyn, N P; Walker, A R

    2000-03-01

    The subject of the future regarding nutritional status and food security, and of their ramifications in terms of nutrition-related disorders/diseases in Sub-Saharan African (SSA) populations, is a complex one. As well as social unrest, a country's socioeconomic situation may affect food availability and, crucially, influence the generally low proportions of the Gross National Product devoted to health services. Additional determinants include changes in the roles of non-dietary adverse factors (i.e. smoking practice, alcohol consumption, physical inactivity) and of infections (i.e. gastroenteritis, malaria, tuberculosis and, particularly, HIV). As to future health in 2020, major increases in socioeconomic status are very unlikely; in fact, there has been a deterioration in some countries with food shortages affecting nutrition status and food security. However, with some measures of prosperity there are likely to be decreases in family size and falls in the proportions of children born with low birthweights or with protein-energy-malnutrition (PEM), and of children lying under the 5th percentile of growth reference standards. Simultaneously, though. there will be variable rises, especially in urban dwellers, in the occurrence of hypertension, diabetes, cardiovascular disease and certain cancers. Improvements in the health status of both children and adults are likely to be strongly affected by whether HIV infection can be controlled or whether it becomes rampant.

  12. Pubertal Status and Emotional Reactivity to a Voluntary Hyperventilation Challenge Predicting Panic Symptoms and Somatic Complaints

    Science.gov (United States)

    Leen-Feldner, Ellen W.; Reardon, Laura E.; Zvolensky, Michael J.

    2007-01-01

    The main and interactive effects of pubertal status and emotional reactivity to bodily sensations elicited by a voluntary hyperventilation challenge were examined in relation to panic symptoms and self- and parent-reported somatic complaints among 123 (56 females) adolescents between the ages of 12 and 17 years (M[age] = 15.05; SD = 1.50). As…

  13. Trait anxiety predicts disease-specific health status in early-stage breast cancer patients

    NARCIS (Netherlands)

    van Esch, Lotje; Roukema, Jan A.; van der Steeg, Alida F. W.; de Vries, Jolanda

    2011-01-01

    The objectives of this study were to examine the differences in health status (HS) of women with breast cancer (BC) at different moments in time, and between women scoring high and not high on trait anxiety, and to identify possible predictors of HS 6 and 12 months after surgery. Patients (N = 223)

  14. An optimal periconception maternal folate status for embryonic size: the Rotterdam Predict study

    National Research Council Canada - National Science Library

    Uitert, EM; Ginkel, S; Willemsen, SP; Lindemans, J; Koning, AHJ; Eilers, PHC; Exalto, N; Laven, JSE; Steegers, EAP; Steegers‐Theunissen, RPM

    2014-01-01

    ... tube defects (NTDs), which has led the World Health Organization to recommend FA supplement use from the periconception period up to 12 weeks of pregnancy. As a result of the high stability and bioavailability of the synthetic FA form, maternal folate status is strongly determined by FA supplement use. However, dietary folate intake, metabolism, the us...

  15. Using Blood Indexes to Predict Overweight Statuses: An Extreme Learning Machine-Based Approach.

    Science.gov (United States)

    Chen, Huiling; Yang, Bo; Liu, Dayou; Liu, Wenbin; Liu, Yanlong; Zhang, Xiuhua; Hu, Lufeng

    2015-01-01

    The number of the overweight people continues to rise across the world. Studies have shown that being overweight can increase health risks, such as high blood pressure, diabetes mellitus, coronary heart disease, and certain forms of cancer. Therefore, identifying the overweight status in people is critical to prevent and decrease health risks. This study explores a new technique that uses blood and biochemical measurements to recognize the overweight condition. A new machine learning technique, an extreme learning machine, was developed to accurately detect the overweight status from a pool of 225 overweight and 251 healthy subjects. The group included 179 males and 297 females. The detection method was rigorously evaluated against the real-life dataset for accuracy, sensitivity, specificity, and AUC (area under the receiver operating characteristic (ROC) curve) criterion. Additionally, the feature selection was investigated to identify correlating factors for the overweight status. The results demonstrate that there are significant differences in blood and biochemical indexes between healthy and overweight people (p-value < 0.01). According to the feature selection, the most important correlated indexes are creatinine, hemoglobin, hematokrit, uric Acid, red blood cells, high density lipoprotein, alanine transaminase, triglyceride, and γ-glutamyl transpeptidase. These are consistent with the results of Spearman test analysis. The proposed method holds promise as a new, accurate method for identifying the overweight status in subjects.

  16. Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial.

    Science.gov (United States)

    2003-06-01

    Previous studies suggest that undernourished patients with acute stroke do badly. The data, however, are not robust. We aimed to reliably assess the importance of baseline nutritional status as an independent predictor of long-term outcome after stroke in a large prospective cohort enrolled in the Feed Or Ordinary Diet (FOOD) trial, a multicenter randomized trial evaluating various feeding policies. Patients admitted to hospital with a recent stroke were enrolled in the FOOD trial. Data on nutritional status and other clinical predictors of outcome were collected at trial entry. At 6 months, the coordinating center collected data on survival and functional status (modified Rankin Scale). Outcome assessment was done by researchers blinded to baseline assessments and treatment allocation. Between November 1996 and November 2001, 3012 patients were enrolled, and 2955 (98%) were followed up. Of the 275 undernourished patients, 102 (37%) were dead by final follow-up compared with only 445 (20%) of 2194 patients of normal nutritional status (odds ratio [OR], 2.32; 95% CI, 1.78 to 3.02). After adjustment for age, prestroke functional state, and stroke severity, this relationship, although weakened, still held (OR, 1.82; 95% CI, 1.34 to 2.47). Undernourished patients were more likely to develop pneumonia, other infections, and gastrointestinal bleeding during their hospital admission than other patients. These data provide reliable evidence that nutritional status early after stroke is independently associated with long-term outcome. It supports the rationale for the FOOD trial, which continues to recruit and aims to estimate the effect of different feeding regimes on outcome after stroke and thus determine whether the association observed in this study is likely to be causal.

  17. Parenting style and child-feeding behaviour in predicting children's weight status change in Taiwan.

    Science.gov (United States)

    Tung, Ho-Jui; Yeh, Ming-Chin

    2014-05-01

    The prevalence of overweight and obesity among children is on the rise worldwide. Prior studies find that parents' child-feeding practices are associated with child weight status and the efficacy of specific parental child-feeding practices can be moderated by parenting styles. In the current longitudinal study, we examined the associations between child-feeding practices and weight status changes over 1 year among a sample of school-aged children in Taiwan. In autumn 2008, a child-feeding questionnaire and parenting-style questionnaire were administered to parents of the second and fourth graders in an elementary school in Taiwan. The weight and height of the students were measured by a trained school nurse in 2008 and again in 2009. An elementary school in central Taiwan. A total of 465 parent-child pairs were included in the analysis. Using a gender- and age-adjusted BMI classification scheme issued by the Taiwan Department of Health, 29·2 % of the students were considered overweight at the 2009 measurement. Controlling for 2008 weight status revealed moderating effects of parenting style on the relationship between child-feeding practices and child weight status. Both authoritative and authoritarian mothers might monitor their children's dietary intake; however, the effectiveness of this practice was better, in terms of weight status control, among the authoritative mothers. Findings suggest that parenting styles have a moderating effect on specific parental child-feeding practices. Parenting styles and parent's feeding practices could be an important focus for future public health interventions addressing the rising childhood obesity epidemic.

  18. Predictive value of the Status Epilepticus Severity Score (STESS) and its components for long-term survival

    DEFF Research Database (Denmark)

    Aukland, Preben; Lando, Martin; Vilholm, Ole

    2016-01-01

    with lower odds ratios. When looking only at patients that survived the acute phase of treatment, only the STESS components "level of consciousness" (at admission), "coma" as worst seizure type, and "age" reached a statistical significant association with mortality. In these patients, STESS with a cut......BACKGROUND: The "Status Epilepticus Severity Score" (STESS) is the most important clinical score to predict in-hospital mortality of patients with status epilepticus (SE), but its prognostic relevance for long-term survival is unknown. This study therefore examined if STESS and its components...... retain their prognostic relevance beyond acute treatment. METHODS: One hundred twenty-five non-anoxic patients with SE were retrospectively identified in two hospitals between 2008 and 2014 (39.2 % refractory SE). Patients' treatment, demographic data, date of death, aetiology of SE, and the components...

  19. AI AND SAR APPROACHES FOR PREDICTING CHEMICAL CARCINOGENICITY: SURVEY AND STATUS REPORT

    Science.gov (United States)

    A wide variety of artificial intelligence (AI) and structure-activity relationship (SAR approaches have been applied to tackling the general problem of predicting rodent chemical carcinogenicity. Given the diversity of chemical structures and mechanisms relative to this endpoin...

  20. Microsatellite Status of Primary Colorectal Cancer Predicts the Incidence of Postoperative Colorectal Neoplasms.

    Science.gov (United States)

    Takiyama, Aki; Tanaka, Toshiaki; Yamamoto, Yoko; Hata, Keisuke; Ishihara, Soichiro; Nozawa, Hiroaki; Kawai, Kazushige; Kiyomatsu, Tomomichi; Nishikawa, Takeshi; Otani, Kensuke; Sasaki, Kazuhito; Watanabe, Toshiaki

    2017-10-01

    Few studies have evaluated the risk of postoperative colorectal neoplasms stratified by the nature of primary colorectal cancer (CRC). In this study, we revealed it on the basis of the microsatellite (MS) status of primary CRC. We retrospectively reviewed 338 patients with CRC and calculated the risk of neoplasms during postoperative surveillance colonoscopy in association with the MS status of primary CRC. A propensity score method was applied. We identified a higher incidence of metachronous rectal neoplasms after the resection of MS stable CRC than MS instable CRC (adjusted HR 5.74, p=0.04). We also observed a higher incidence of colorectal tubular adenoma in patients with MSS CRC (adjusted hazard ratio 7.09, pneoplasms. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  1. Examination of DNA methylation status of the ELOVL2 marker may be useful for human age prediction in forensic science.

    Science.gov (United States)

    Zbieć-Piekarska, Renata; Spólnicka, Magdalena; Kupiec, Tomasz; Makowska, Żanetta; Spas, Anna; Parys-Proszek, Agnieszka; Kucharczyk, Krzysztof; Płoski, Rafał; Branicki, Wojciech

    2015-01-01

    Age estimation in forensic investigations may complement the prediction of externally visible characteristics and the inference of biogeographical ancestry, thus allowing a better description of an unknown individual. Multiple CpG sites that show linear correlation between age and degree of DNA methylation have been identified in the human genome, providing a selection of candidates for age prediction. In this study, we optimized an assay based on bisulfite conversion and pyrosequencing of 7 CpG sites located in the ELOVL2 gene. Examination of 303 blood samples collected from individuals aged 2-75 years allowed selection of the most informative site, explaining 83% of variation in age. The final linear regression model included two CpG sites in ELOVL2 and enabled age prediction with R(2)=0.859, prediction error=6.85 and mean absolute deviation MAD=5.03. Examination of a testing set of 124 blood samples (MAD=5.75) showed that 68.5% of samples were correctly predicted, assuming that chronological and predicted ages matched ± 7 years. It was found that the ELOVL2 methylation status in bloodstains had not changed significantly after 4 weeks of storage in room temperature conditions. Analysis of 45 bloodstains deposited on tissue paper after 5, 10 and 15 years of storage in room conditions indicated that although a gradual decrease of positive PCR results was observed, the general age prediction success rate remained similar and equaled 60-78%. The obtained results show that the ELOVL2 locus provides a very good source of information about human chronological age based on analysis of blood, including bloodstains, and it may constitute a powerful and reliable predictor in future forensic age estimation models. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Child Mortality as Predicted by Nutritional Status and Recent Weight Velocity in Children under Two in Rural Africa.

    LENUS (Irish Health Repository)

    2012-01-31

    WHO has released prescriptive child growth standards for, among others, BMI-for-age (BMI-FA), mid-upper arm circumference-for-age, and weight velocity. The ability of these indices to predict child mortality remains understudied, although growth velocity prognostic value underlies current growth monitoring programs. The study aims were first to assess, in children under 2, the independent and combined ability of these indices and of stunting to predict all-cause mortality within 3 mo, and second, the comparative abilities of weight-for-length (WFL) and BMI-FA to predict short-term (<3 mo) mortality. We used anthropometry and survival data from 2402 children aged between 0 and 24 mo in a rural area of the Democratic Republic of Congo with high malnutrition and mortality rates and limited nutritional rehabilitation. Analyses used Cox proportional hazard models and receiver operating characteristic curves. Univariate analysis and age-adjusted analysis showed predictive ability of all indices. Multivariate analysis without age adjustment showed that only very low weight velocity [HR = 3.82 (95%CI = 1.91, 7.63); P < 0.001] was independently predictive. With age adjustment, very low weight velocity [HR = 3.61 (95%CI = 1.80, 7.25); P < 0.001] was again solely retained as an independent predictor. There was no evidence for a difference in predictive ability between WFL and BMI-FA. This paper shows the value of attained BMI-FA, a marker of wasting status, and recent weight velocity, a marker of the wasting process, in predicting child death using the WHO child growth standards. WFL and BMI-FA appear equivalent as predictors.

  3. Molecular markers to complement sentinel node status in predicting survival in patients with high-risk locally invasive melanoma.

    Science.gov (United States)

    Rowe, Casey J; Tang, Fiona; Hughes, Maria Celia B; Rodero, Mathieu P; Malt, Maryrose; Lambie, Duncan; Barbour, Andrew; Hayward, Nicholas K; Smithers, B Mark; Green, Adele C; Khosrotehrani, Kiarash

    2016-08-01

    Sentinel lymph node status is a major prognostic marker in locally invasive cutaneous melanoma. However, this procedure is not always feasible, requires advanced logistics and carries rare but significant morbidity. Previous studies have linked markers of tumour biology to patient survival. In this study, we aimed to combine the predictive value of established biomarkers in addition to clinical parameters as indicators of survival in addition to or instead of sentinel node biopsy in a cohort of high-risk melanoma patients. Patients with locally invasive melanomas undergoing sentinel lymph node biopsy were ascertained and prospectively followed. Information on mortality was validated through the National Death Index. Immunohistochemistry was used to analyse proteins previously reported to be associated with melanoma survival, namely Ki67, p16 and CD163. Evaluation and multivariate analyses according to REMARK criteria were used to generate models to predict disease-free and melanoma-specific survival. A total of 189 patients with available archival material of their primary tumour were analysed. Our study sample was representative of the entire cohort (N = 559). Average Breslow thickness was 2.5 mm. Thirty-two (17%) patients in the study sample died from melanoma during the follow-up period. A prognostic score was developed and was strongly predictive of survival, independent of sentinel node status. The score allowed classification of risk of melanoma death in sentinel node-negative patients. Combining clinicopathological factors and established biomarkers allows prediction of outcome in locally invasive melanoma and might be implemented in addition to or in cases when sentinel node biopsy cannot be performed. © 2016 UICC.

  4. Effects of Medicated Diet to Eradicate Helicobacter spp. on Growth, Pathology, and Infection Status in Rag1–/– and Nude Mice

    Science.gov (United States)

    Garrett, Caroline M; Muth, Dillon; Watson, Julie

    2014-01-01

    The use of a commercial 4-drug diet has been shown to eradicate Helicobacter spp. from immunocompetent mice and those with innate immunodeficiencies. However the efficacy of this diet has not been confirmed in mice with altered adaptive immunity. We hypothesized that an 8-wk treatment with medicated diet would eradicate H. hepaticus and H. typhlonius from young naturally infected nude and Rag1 mice lacking functional T cells (Foxn1nu) or T and B cells (B6.129S7-Rag1tm1Mom/J), respectively. We evaluated helicobacter status, body weight, and gross and histologic changes between medicated and control diet in groups of infected and uninfected mice throughout treatment and at 8 wk after treatment completion. Initial infection status was confirmed by fecal PCR at weaning and 3 wk later, with study initiation in 7-wk-old mice. PCR testing demonstrated that independent of strain and sex, all treated mice tested negative for Helicobacter spp. after 4 wk of treatment and remained negative for the duration of the study. Irrespective of infection status, nude and Rag1 mice fed 8 wk of medicated diet gained less weight than did their untreated controls. Both strains normalized body weight while on control diet for the 8 wk after treatment. Mice fed medicated diet developed severe gastroesophageal hyperkeratosis, suggestive of reduced feed consumption, and enlarged ceca. These conditions improved or resolved after the return to control diet. This report is the first to demonstrate the efficacy and physical effects of providing medicated diet for the eradication of Helicobacter spp. from mice with adaptive immune deficiencies. PMID:24827565

  5. Poor nutritional status of older subacute patients predicts clinical outcomes and mortality at 18 months of follow-up.

    Science.gov (United States)

    Charlton, K; Nichols, C; Bowden, S; Milosavljevic, M; Lambert, K; Barone, L; Mason, M; Batterham, M

    2012-11-01

    Older malnourished patients experience increased surgical complications and greater morbidity compared with their well-nourished counterparts. This study aimed to assess whether nutritional status at hospital admission predicted clinical outcomes at 18 months follow-up. A retrospective analysis of N=2076 patient admissions (65+ years) from two subacute hospitals, New South Wales, Australia. Analysis of outcomes at 18 months, according to nutritional status at index admission, was performed in a subsample of n = 476. Nutritional status was determined within 72 h of admission using the Mini Nutritional Assessment (MNA). Outcomes, obtained from electronic patient records, included hospital readmission rate, total Length of Stay (LOS), change in level of care at discharge and mortality. Survival analysis, using a Cox proportional hazards model, included age, sex, Major Disease Classification, mobility and LOS at index admission as covariates. At baseline, 30% of patients were malnourished and 53% were at risk of malnutrition. LOS was higher in malnourished and at risk, compared with well-nourished patients (median (interquartile range): 34 (21, 58); 26 (15, 41); 20 (14, 26) days, respectively; Pnutritional intervention following hospital discharge.

  6. PREDICTIVE ANALYSIS SOFTWARE FOR MODELING THE ALTMAN Z-SCORE FINANCIAL DISTRESS STATUS OF COMPANIES

    Directory of Open Access Journals (Sweden)

    ILIE RĂSCOLEAN

    2012-10-01

    Full Text Available Literature shows some bankruptcy methods for determining the financial distress status of companies and based on this information we chosen Altman statistical model because it has been used a lot in the past and like that it has become a benchmark for other methods. Based on this financial analysis flowchart, programming software was developed that allows the calculation and determination of the bankruptcy probability for a certain rate of failure Z-score, corresponding to a given interval that is equal to the ratio of the number of bankrupt companies and the total number of companies (bankrupt and healthy interval.

  7. Prediction of 90 Day and Overall Survival after Chemoradiotherapy for Lung Cancer: Role of Performance Status and Body Composition.

    Science.gov (United States)

    Bowden, J C S; Williams, L J; Simms, A; Price, A; Campbell, S; Fallon, M T; Fearon, K C H

    2017-09-01

    If appropriate patients are to be selected for lung cancer treatment, an understanding of who is most at risk of adverse outcomes after treatment is needed. The aim of the present study was to identify predictive factors for 30 and 90 day mortality after chemoradiotherapy (CRT), and factors that were prognostic for overall survival. A retrospective cohort study of 194 patients with lung cancer who had undergone CRT in South East Scotland from 2008 to 2010 was undertaken. Gender, age, cancer characteristics, weight loss, body mass index (BMI), performance status (Eastern Cooperative Oncology Group; ECOG) and computed tomography-derived body composition variables were examined for prognostic significance using Cox's proportional hazards model and logistic regression. The median overall survival was 19 months (95% confidence interval 16.3, 21.7). Four of 194 patients died within 30 days of treatment completion, for which there were no independent predictive variables; 22/194 (11%) died within 90 days of treatment completion. BMI performance status ≥2 were independent predictors of death within 90 days of treatment completion (P = 0.001 and P = 0.004, respectively). Patients with either BMI performance status ≥ 2 had an odds ratio of death within 90 days of 5.97 (95% confidence interval 2.20, 16.19), rising to an odds ratio of 13.27 (1.70, 103.47) for patients with both BMI performance status ≥ 2. Patients with low muscle attenuation had significantly reduced overall survival (P = 0.004); individuals with low muscle attenuation had a median survival of 15.2 months (95% confidence interval 12.7, 17.7) compared with 23.0 months (95% confidence interval 18.3, 27.8) for those with high muscle attenuation, equating to a hazard ratio of death of 1.62 (95% confidence interval 1.17, 2.23, P = 0.003). Poor performance status, low BMI and low muscle attenuation identify patients at increased risk of premature death after CRT. Risk factors for adverse outcomes

  8. Predicting Self-Rated Mental and Physical Health: The Contributions of Subjective Socioeconomic Status and Personal Relative Deprivation

    Directory of Open Access Journals (Sweden)

    Mitchell J. Callan

    2015-09-01

    Full Text Available Lower subjective socioeconomic status (SSS and higher personal relative deprivation (PRD relate to poorer health. Both constructs concern people’s perceived relative social position, but they differ in their emphasis on the reference groups people use to determine their comparative disadvantage (national population vs. similar others and the importance of resentment that may arise from such adverse comparisons. We investigated the relative utility of SSS and PRD as predictors of self-rated physical and mental health (e.g., self-rated health, stress, health complaints. Across 6 studies, self-rated physical and mental health were on the whole better predicted by measures of PRD than by SSS while controlling for objective socioeconomic status (SES, with SSS rarely contributing unique variance over and above PRD and SES. Studies 4 to 6 discount the possibility that the superiority of PRD over SSS in predicting health is due to psychometric differences (e.g., reliability or response biases between the measures.

  9. Performance Status, Prognostic Scoring, and Parenteral Nutrition Requirements Predict Survival in Patients with Advanced Cancer Receiving Home Parenteral Nutrition.

    Science.gov (United States)

    Keane, Niamh; Fragkos, Konstantinos C; Patel, Pinal S; Bertsch, Friderike; Mehta, Shameer J; Di Caro, Simona; Rahman, Farooq

    2018-01-01

    We describe a cohort of Home Parenteral Nutrition (HPN) patients with advanced cancer in order to identify factors affecting prognosis. Demographic, anthropometric, biochemical and medical factors, Karnofsky Performance Status (KPS), Glasgow Prognostic Score (GPS), and PN requirements were recorded. Univariate and multivariate analyses were performed including Kaplan-Meier curves, Cox Regression, and correlation analyses. In total, 107 HPN patients (68 women, 39 men, mean age 57 yr) with advanced cancer were identified. The main indications for HPN were bowel obstruction (74.3%) and high output ostomies (14.3%). Cancer cachexia was present in 87.1% of patients. The hazard ratio (HR) for upper gastrointestinal and "other" cancers vs. gynaecological malignancy was 1.75 (p = 0.077) and 2.11 (p = 0.05), respectively. KPS score, GPS, PN volume, and PN potassium levels significantly predicted survival (HRKPS ≥50 vs 0.05). Most patients passed away in their homes or hospice (77.9%). Performance status, prognostic scoring, and PN requirements may predict survival in patients with advanced cancer receiving HPN.

  10. Predicted vitamin D status in mid-pregnancy and child allergic disease

    DEFF Research Database (Denmark)

    Maslova, Ekaterina; Hansen, Susanne; Thorne-Lyman, Andrew L

    2014-01-01

    BACKGROUND: Vitamin D deficiency in pregnancy may be a risk factor for child allergic disease. However, less is known about disease risk across different levels of vitamin D. OBJECTIVE: We aimed to examine the relation between a maternal vitamin D prediction score and child allergic disease. METH...

  11. Vitamin D status predicts reproductive fitness in a wild sheep population.

    Science.gov (United States)

    Handel, Ian; Watt, Kathryn A; Pilkington, Jill G; Pemberton, Josephine M; Macrae, Alastair; Scott, Philip; McNeilly, Tom N; Berry, Jacqueline L; Clements, Dylan N; Nussey, Daniel H; Mellanby, Richard J

    2016-01-13

    Vitamin D deficiency has been associated with the development of many human diseases, and with poor reproductive performance in laboratory rodents. We currently have no idea how natural selection directly acts on variation in vitamin D metabolism due to a total lack of studies in wild animals. Here, we measured serum 25 hydroxyvitamin D (25(OH)D) concentrations in female Soay sheep that were part of a long-term field study on St Kilda. We found that total 25(OH)D was strongly influenced by age, and that light coloured sheep had higher 25(OH)D3 (but not 25(OH)D2) concentrations than dark sheep. The coat colour polymorphism in Soay sheep is controlled by a single locus, suggesting vitamin D status is heritable in this population. We also observed a very strong relationship between total 25(OH)D concentrations in summer and a ewe's fecundity the following spring. This resulted in a positive association between total 25(OH)D and the number of lambs produced that survived their first year of life, an important component of female reproductive fitness. Our study provides the first insight into naturally-occurring variation in vitamin D metabolites, and offers the first evidence that vitamin D status is both heritable and under natural selection in the wild.

  12. Symptom Status Predicts Patient Outcomes in Persons with HIV and Comorbid Liver Disease

    Directory of Open Access Journals (Sweden)

    Wendy A. Henderson

    2012-01-01

    Full Text Available Persons living with human immunodeficiency virus (HIV are living longer; therefore, they are more likely to suffer significant morbidity due to potentially treatable liver diseases. Clinical evidence suggests that the growing number of individuals living with HIV and liver disease may have a poorer health-related quality of life (HRQOL than persons living with HIV who do not have comorbid liver disease. Thus, this study examined the multiple components of HRQOL by testing Wilson and Cleary’s model in a sample of 532 individuals (305 persons with HIV and 227 persons living with HIV and liver disease using structural equation modeling. The model components include biological/physiological factors (HIV viral load, CD4 counts, symptom status (Beck Depression Inventory II and the Medical Outcomes Study HIV Health Survey (MOS-HIV mental function, functional status (missed appointments and MOS-HIV physical function, general health perceptions (perceived burden visual analogue scale and MOS-HIV health transition, and overall quality of life (QOL (Satisfaction with Life Scale and MOS-HIV overall QOL. The Wilson and Cleary model was found to be useful in linking clinical indicators to patient-related outcomes. The findings provide the foundation for development and future testing of targeted biobehavioral nursing interventions to improve HRQOL in persons living with HIV and liver disease.

  13. Predicting the nodal status in gastric cancers: The role of apparent diffusion coefficient histogram characteristic analysis.

    Science.gov (United States)

    Liu, Song; Zhang, Yujuan; Xia, Jie; Chen, Ling; Guan, Wenxian; Guan, Yue; Ge, Yun; He, Jian; Zhou, Zhengyang

    2017-10-01

    To explore the application of histogram analysis in preoperative T and N staging of gastric cancers, with a focus on characteristic parameters of apparent diffusion coefficient (ADC) maps. Eighty-seven patients with gastric cancers underwent diffusion weighted magnetic resonance imaging (b=0, 1000s/mm2), which generated ADC maps. Whole-volume histogram analysis was performed on ADC maps and 7 characteristic parameters were obtained. All those patients underwent surgery and postoperative pathologic T and N stages were determined. Four parameters, including skew, kurtosis, s-sDav and sample number, showed significant differences among gastric cancers at different T and N stages. Most parameters correlated with T and N stages significantly and worked in differentiating gastric cancers at different T or N stages. Especially skew yielded a sensitivity of 0.758, a specificity of 0.810, and an area under the curve (AUC) of 0.802 for differentiating gastric cancers with and without lymph node metastasis (PCharacteristic parameters derived from whole-volume ADC histogram analysis could help assessing preoperative T and N stages of gastric cancers. Copyright © 2017. Published by Elsevier Inc.

  14. Evidence of differential effects of vitamin D receptor variants on epithelial ovarian cancer risk by predicted vitamin D status

    Directory of Open Access Journals (Sweden)

    Jennifer ePrescott

    2014-10-01

    Full Text Available Introduction: Experimental studies suggest vitamin D inhibits ovarian carcinogenesis. Yet, epidemiologic studies of ovarian cancer risk and lifestyle correlates of vitamin D status, plasma 25-hydroxyvitamin D [25(OHD], or vitamin D receptor (VDR variants have been inconsistent. Objective: To evaluate VDR genetic associations by high vs. low predicted 25(OHD, scores derived from known determinants of plasma 25(OHD. To assess ovarian cancer associations with variants identified in genome-wide association studies (GWAS of plasma 25(OHD. Methods: We genotyped up to 7 VDR and 8 25(OHD GWAS variants in the Nurses’ Health Studies (562 cases, 1,553 controls and New England Case-Control study (1,821 cases, 1,870 controls. We estimated haplotype scores using expectation-maximization-based algorithms. We used unconditional logistic regression to calculate odds ratios (ORs and 95% confidence intervals (CI. We combined study results using DerSimonian and Laird meta-analysis. Results: Ovarian cancer risk increased per A allele of rs7975232 (VDR; OR=1.12, 95% CI=1.01-1.25 among all women. When stratified by predicted 25(OHD, ovarian cancer was associated with rs731236 (VDR; per C allele OR=1.31 and rs7975232 (OR=1.38 among women with high predicted 25(OHD, but not among women with low levels (P≤0.009. We also observed heterogeneity by predicted 25(OHD for the ovarian cancer association with VDR 3’ end haplotypes (P=0.009. Of 25(OHD-associated GWAS loci, rs7041 was associated with reduced ovarian cancer risk (per T allele OR=0.92, 95% CI=0.85-0.99, which did not differ by predicted 25(OHD status. Conclusion: Our study suggests an influence of VDR 3’ end variants on ovarian cancer risk may be observed in women with high predicted 25(OHD, which remained even after taking multiple comparisons into consideration. Future studies are needed to confirm our results and explore further the relation between vitamin D exposure, genetic variants, and ovarian cancer

  15. The competitive status of trees determines their responsiveness to increasing atmospheric humidity - a climate trend predicted for northern latitudes.

    Science.gov (United States)

    Tullus, Arvo; Kupper, Priit; Kaasik, Ants; Tullus, Hardi; Lõhmus, Krista; Sõber, Anu; Sellin, Arne

    2017-05-01

    The interactive effects of climate variables and tree-tree competition are still insufficiently understood drivers of forest response to global climate change. Precipitation and air humidity are predicted to rise concurrently at high latitudes of the Northern Hemisphere. We investigated whether the growth response of deciduous trees to elevated air humidity varies with their competitive status. The study was conducted in seed-originated silver birch and monoclonal hybrid aspen stands grown at the free air humidity manipulation (FAHM) experimental site in Estonia, in which manipulated stands (n = 3 for both species) are exposed to artificially elevated relative air humidity (6-7% over the ambient level). The study period included three growing seasons during which the stands had reached the competitive stage (trees were 7 years old in the final year). A significant 'treatment×competitive status' interactive effect on growth was detected in all years in birch (P humidity. Initially the growth of advantaged and neutral trees of both species remained significantly suppressed in humidified stands. In the following years, dominance and elevated humidity had a synergistic positive effect on the growth of birches. Aspens with different competitive status recovered more uniformly, attaining similar relative growth rates in manipulated and control stands, but preserved a significantly lower total growth yield due to severe initial growth stress. Disadvantaged trees of both species were never significantly affected by elevated humidity. Our results suggest that air humidity affects trees indirectly depending on their social status. Therefore, the response of northern temperate and boreal forests to a more humid climate in future will likely be modified by competitive relationships among trees, which may potentially affect species composition and cause a need to change forestry practices. © 2016 John Wiley & Sons Ltd.

  16. Can subjective global assessment of nutritional status predict survival in ovarian cancer?

    Directory of Open Access Journals (Sweden)

    Gupta Digant

    2008-10-01

    Full Text Available Abstract Background Malnutrition is a significant problem in patients with ovarian cancer. The goal of this study was to investigate the prognostic role of Subjective Global Assessment (SGA in patients with ovarian cancer treated in an integrative cancer treatment setting. Methods We evaluated a case series of 132 ovarian cancer patients treated at Cancer Treatment Centers of America® from Jan 2001 to May 2006. SGA was used to assess nutritional status at baseline. Using SGA, patients were classified as well nourished (SGA A, moderately malnourished (SGA B or severely malnourished (SGA C. Kaplan Meier method was used to calculate survival. Cox proportional hazard models were constructed to evaluate the prognostic effect of SGA independent of other factors. Results Of 132 patients, 24 were newly diagnosed while 108 had received prior treatment. 15 had stage I disease at diagnosis, 8 stage II, 85 stage III and 17 stage IV. The median age at presentation was 54.4 years (range 25.5 – 82.5 years. 66 patients were well-nourished (SGA A, 35 moderately malnourished (SGA B and 31 severely malnourished (SGA C. Well nourished patients had a median survival of 19.3 months (95% CI: 14.1 to 24.5, moderately malnourished 15.5 months (95% CI: 5.8 to 25.1, and severely malnourished 6.7 months (95% CI: 4.1 to 9.3; the difference being statistically significant (p = 0.0003. Multivariate Cox modeling, after adjusting for stage at diagnosis and prior treatment history found that moderately malnourished and severely malnourished status were associated with a relative risk of 2.1 (95% CI: 1.2 to 3.6, p = 0.008 and 3.4 (95% CI: 1.9 to 5.8, p Conclusion Univariate and multivariate survival analyses found that low SGA scores (i.e. well-nourished status are associated with better survival outcomes. This study lends support to the role of aggressive nutritional intervention in improving patient outcomes in cancer care.

  17. Pathologies of the oral cavity in patients with non-controlled diabetes type 1 and type 2--analysis of periodontal status and periodontal treatment needs.

    Science.gov (United States)

    Preferansow, Ewa; Sawczuk, Beata; Gołębiewska, Maria; Górska, Maria

    2015-01-01

    Decompensated diabetes is a major risk factor in the development of periodontal diseases. This leads to disturbances of carbohydrates, protein, and fat and morphological changes in many organs. These changes also apply to the masticatory system, especially periodontal tissues. The aim of the study was to assess the periodontal status and periodontal treatment needs in patients with non-controlled diabetes type 1 and type 2 (HbA1c > 7%), and to compare the results with the data obtained in a group of generally healthy patients. The study included 275 patients, 155 of them were patients with non-controlled diabetes during hospitalisation (study group), while 120 subjects constituted the control group of healthy people. The study excluded edentulous people. CPITN index (according to Ainamo et al.) was used to assess the periodontal state and periodontal treatment needs. The average level of glycated haemoglobin HbA1C among patients in the study group was 9.43% in women and slightly more at 9.57% in men. The periodontal status in healthy people was satisfactory, dominated by the maximum values of CPITN = 0, CPITN = 1, and CPITN = 2. The study group more frequently revealed the maximum values of CPITN = 3 and CPITN = 4. This shows the more advanced periodontal changes in this group. Due to the bad condition of the periodontium, the periodontal treatment needs proved to be far greater in the study group and related primarily to comprehensive specialist treatment (TN3). Decompensated diabetes may be an important cause of changes in periodontal tissues and may cause a significant loss of masticatory function in patients.

  18. Attractiveness Compensates for Low Status Background in the Prediction of Educational Attainment

    OpenAIRE

    Shawn Bauldry; Shanahan, Michael J; Rosemary Russo; Roberts, Brent W.; Rodica Damian

    2016-01-01

    Background People who are perceived as good looking or as having a pleasant personality enjoy many advantages, including higher educational attainment. This study examines (1) whether associations between physical/personality attractiveness and educational attainment vary by parental socioeconomic resources and (2) whether parental socioeconomic resources predict these forms of attractiveness. Based on the theory of resource substitution with structural amplification, we hypothesized that bot...

  19. The status and prediction of EOR methods application in the USSR. [Enhanced oil recovery

    Energy Technology Data Exchange (ETDEWEB)

    Zhdanov, S.A.; Surguchov, M.L. (All-Union Oil and Gas Scientific Research Inst. (VNII), Moscow (SU))

    1991-01-01

    Summarized results of EOR methods application in the USSR are presented in the paper. On the basis of comparative analysis of actual data, the probability of successful EOR methods application has been evaluated for specific conditions, and the most preferable geologic parameters have been highlighted. Some peculiarities of EOR methods application in domestic oil fields have been considered, including those in Western Siberia. The results of multivariant prediction of EOR methods application in the USSR are presented. (author).

  20. Fear of fatness and drive for thinness in predicting smoking status in college women?

    OpenAIRE

    Copeland, Amy L.; Spears, Claire A.; Baillie, Lauren E.; McVay, Megan A.

    2015-01-01

    Recent research has identified fear of fatness (FF) as a related yet distinct construct from drive for thinness (DT). Whereas DT may be associated with need for approval and an ?approach? tendency, FF may be more strongly related to avoidance of disapproval and an avoidant problem-solving style. Although no research has directly compared the influence of FF vs. DT with regard to smoking behavior, FF and DT might represent distinct motivations for smoking. We predicted that both FF and DT woul...

  1. Perineural invasion status, Gleason score and number of positive cores in biopsy pathology are predictors of positive surgical margin following laparoscopic radical prostatectomy.

    Science.gov (United States)

    Yang, Rong; Cao, Kai; Han, Tao; Zhang, Yi-Feng; Zhang, Gu-Tian; Xu, Lin-Feng; Lian, Hui-Bo; Li, Xiao-Gong; Guo, Hong-Qian

    2017-01-01

    This study was designed to define possible preoperative predictors of positive surgical margin after laparoscopic radical prostatectomy. We retrospectively analyzed the records of 296 patients with prostate cancer diagnosed by prostate biopsy, and eventually treated with laparoscopic radical prostatectomy. The prognostic impact of age, prostate volume, preoperative prostate-specific antigen, biopsy Gleason score, maximum percentage tumor per core, number of positive cores, biopsy perineural invasion, capsule invasion on imaging, and tumor laterality on surgical margin was assessed. The overall positive surgical margin rate was 29.1%. Gleason score, number of positive cores, perineural invasion, tumor laterality in the biopsy specimen, and prostate volume significantly correlated with risk of positive surgical margin by univariate analysis (P Gleason score (odds ratio [OR] = 2.286, 95% confidence interval [95% CI] = 1.431-3.653, P = 0.001), perineural invasion (OR = 4.961, 95% CI = 2.656-9.270, P Gleason scores and/or a large number of positive cores in biopsy pathology had more possibility of capsule invasion. The positive surgical margin rate in patients with capsule invasion (49.5%) was much higher than that with localized disease (17.8%). In contrast, prostate volume showed a protective effect against positive surgical margin (OR = 0.572, 95% CI = 0.346-0.945, P = 0.029). Gleason score, perineural invasion, and number of positive cores in the biopsy specimen were preoperative independent predictors of positive surgical margin after laparoscopic radical prostatectomy while prostate volume was a protective factor against positive surgical margin.

  2. Phonological skills and vocabulary knowledge mediate socioeconomic status effects in predicting reading outcomes for Chinese children.

    Science.gov (United States)

    Zhang, Yuping; Tardif, Twila; Shu, Hua; Li, Hong; Liu, Hongyun; McBride-Chang, Catherine; Liang, Weilan; Zhang, Zhixiang

    2013-04-01

    This study examined the relations among socioeconomic status (SES), early phonological processing, vocabulary, and reading in 262 children from diverse SES backgrounds followed from ages 4 to 9 in Beijing, China. SES contributed to variations in phonological skills and vocabulary in children's early development. Nonetheless, early phonological and vocabulary abilities exerted equally strong and independent mediation of the SES effects on children's reading achievement by the end of 3rd grade for this Chinese sample. These findings not only replicate studies in alphabetic languages but, because of their longitudinal nature, also demonstrate the potential for interventions focused on improving children's early language skills, and at which ages these factors may have the greatest impact. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  3. Comparison of nutritional status assessment parameters in predicting length of hospital stay in cancer patients.

    Science.gov (United States)

    Mendes, J; Alves, P; Amaral, T F

    2014-06-01

    Undernutrition has been associated with an increased length of hospital stay which may reflect the patient prognosis. The aim of this study was to quantify and compare the association between nutritional status and handgrip strength at hospital admission with time to discharge in cancer patients. An observational prospective study was conducted in an oncology center. Patient-Generated Subjective Global Assessment, Nutritional Risk Screening 2002 and handgrip strength were conducted in a probabilistic sample of 130 cancer patients. The association between baseline nutritional status, handgrip strength and time to discharge was evaluated using survival analysis with discharge alive as the outcome. Nutritional risk ranged from 42.3 to 53.1% depending on the tool used. According to Patient-Generated Subjective Global Assessment severe undernutrition was present in 22.3% of the sample. The association between baseline data and time to discharge was stronger in patients with low handgrip strength (adjusted hazard ratio, low handgrip strength: 0.33; 95% confidence interval: 0.19-0.55), compared to undernourished patients evaluated by the other tools; Patient-Generated Subjective Global Assessment: (adjusted hazard ratio, severe undernutrition: 0.45; 95% confidence interval: 0.27-0.75) and Nutritional Risk Screening 2002: (adjusted hazard ratio, with nutritional risk: 0.55; 95% confidence interval: 0.37-0.80). An approximate 3-fold decrease in probability of discharge alive was observed in patients with low handgrip strength. Decreasing handgrip strength tertiles allowed to discriminate between patients who will have longer hospital stay, as well as undernutrition and nutritional risk assessed by Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  4. MicroRNA signatures predict oestrogen receptor, progesterone receptor and HER2/neu receptor status in breast cancer

    Science.gov (United States)

    Lowery, Aoife J; Miller, Nicola; Devaney, Amanda; McNeill, Roisin E; Davoren, Pamela A; Lemetre, Christophe; Benes, Vladimir; Schmidt, Sabine; Blake, Jonathon; Ball, Graham; Kerin, Michael J

    2009-01-01

    Introduction Breast cancer is a heterogeneous disease encompassing a number of phenotypically diverse tumours. Expression levels of the oestrogen, progesterone and HER2/neu receptors which characterize clinically distinct breast tumours have been shown to change during disease progression and in response to systemic therapies. Mi(cro)RNAs play critical roles in diverse biological processes and are aberrantly expressed in several human neoplasms including breast cancer, where they function as regulators of tumour behaviour and progression. The aims of this study were to identify miRNA signatures that accurately predict the oestrogen receptor (ER), progesterone receptor (PR) and HER2/neu receptor status of breast cancer patients to provide insight into the regulation of breast cancer phenotypes and progression. Methods Expression profiling of 453 miRNAs was performed in 29 early-stage breast cancer specimens. miRNA signatures associated with ER, PR and HER2/neu status were generated using artificial neural networks (ANN), and expression of specific miRNAs was validated using RQ-PCR. Results Stepwise ANN analysis identified predictive miRNA signatures corresponding with oestrogen (miR-342, miR-299, miR-217, miR-190, miR-135b, miR-218), progesterone (miR-520g, miR-377, miR-527-518a, miR-520f-520c) and HER2/neu (miR-520d, miR-181c, miR-302c, miR-376b, miR-30e) receptor status. MiR-342 and miR-520g expression was further analysed in 95 breast tumours. MiR-342 expression was highest in ER and HER2/neu-positive luminal B tumours and lowest in triple-negative tumours. MiR-520g expression was elevated in ER and PR-negative tumours. Conclusions This study demonstrates that ANN analysis reliably identifies biologically relevant miRNAs associated with specific breast cancer phenotypes. The association of specific miRNAs with ER, PR and HER2/neu status indicates a role for these miRNAs in disease classification of breast cancer. Decreased expression of miR-342 in the

  5. A descriptive study of health status and health related quality of life in selected outpatients with type 2 diabetes, pathological body mass index and cardiovascular risk in Spain.

    Science.gov (United States)

    Vidal-Peracho, Concepción; Lucha-López, Maria Orosia; Lucha-López, Ana Carmen; Tricás-Moreno, José Miguel; Estébanez-De Miguel, Elena; Bernués-Vázquez, Luis

    2014-01-01

    Ottawa Charter defined health as a resource for everyday life and as an important dimension of health related quality of life (HRqol). Diabetes and obesity have repeatedly been shown as diseases that diminish health status and HRqol. The aim of this study was to measure health status and HRqol in a Spanish sample of obese patients with type 2 diabetes at cardiovascular risk and analyze behavioural, biological and social determinants of health. Outpatients from external specialized clinic in Endocrinology were evaluated. sex, age, family history, employment status, comorbidities, pain, lifestyle habits, anthropometrics, blood pressure, blood analysis and HRqol with COOP/WONCA questionnaire (7 dimensions). univariate, bivariate, multivariate and comparative analysis. Mean age was 59.1 ± 7.6 [95%IC: 56.6-61.6], 74% were women and 63.2% were physically active. WONCA values were; summary index (SI): 18.7 ± 4 [95%IC: 17.3-20] (maximum 35); physical fitness: 3.3 ± 1, feelings: 2.3 ± 1.1, social activities: 1.5 ± 1, daily activities: 2.1 ± 1.2, change in health: 2.7 ± 0.9, overall health: 3.6 ± 0.7 and pain: 3.5 ± 1.2 (maximum 5). High fibrinogen values (339.3 ± 85.8 [95%IC: 309.8-368.8]) negatively influenced pain visual analogic scale (p = 0.029). Physically active patients (63.2%) had better values in daily activities dimension (p = 0.025). More than the half of the sample (51.5%) reported a good quality of sleep, but the pain worsened it (p = 0.040). High BMI values (34.8 ± 5.8 [95%IC: 32.9-36.7]) harmed the COOP-WONCA SI (p = 0.009). High glycated hemoglobin (HbA1c) values (6.8 ± 1.3 [95%IC: 6.3-7.2]) had a negative impact on COOP-WONCA SI (p = 0.018). Nor tailored diet (15.8%) or being employed (18.4%) influenced the HRqol. The regression that best models COOP-WONCA SI was adjusted for BMI and HbA1c. SI = 3.509 + 0.335BMI +0.330HbA1c. HRqol was worse than in general population

  6. Prediction of low birth weight delivery by maternal status and its validation: Decision curve analysis

    Directory of Open Access Journals (Sweden)

    Mehri Rejali

    2017-01-01

    Full Text Available Background: In this study, we evaluated assessed elements connected with low birth weight (LBW and used decision curve analysis (DCA to define a scale to anticipate the probability of having a LBW newborn child. Methods: This hospital-based case–control study was led in Arak Hospital in Iran. The study included 470 mothers with LBW neonate and 470 mothers with natural neonates. Information were gathered by meeting moms utilizing preplanned organized questionnaire and from hospital records. The estimated probabilities of detecting LBW were calculated using the logistic regression and DCA to quantify the clinical consequences and its validation. Results: Factors significantly associated with LBW were premature membrane rupture (odds ratio [OR] = 3.18 [1.882–5.384], former LBW infants (OR = 2.99 [1.510–5.932], premature pain (OR = 2.70 [1.659–4.415], hypertension in pregnancy (OR = 2.39 [1.429–4.019], last trimester of pregnancy bleeding (OR = 2.58 [1.018–6.583], mother age >30 (OR = 2.17 [1.350–3.498]. However, with DCA, the prediction model made on these 15 variables has a net benefit (NB of 0.3110 is best predictive with the highest NB. NB has simple clinical interpretation and utilizing the model is what might as well be called a procedure that distinguished what might as well be called 31.1 LBW per 100 cases with no superfluous recognize. Conclusions: It is conceivable to foresee LBW utilizing a prediction model show in light of noteworthy hazard components connected with LBW. The majority of the hazard elements for LBW are preventable, and moms can be alluded amid early pregnancy to a middle which is furnished with facilities for administration of high hazard pregnancy and LBW infant.

  7. Blood and tissue neuroendocrine tumor gene cluster analysis correlate, define hallmarks and predict disease status.

    Science.gov (United States)

    Kidd, Mark; Drozdov, Ignat; Modlin, Irvin

    2015-08-01

    A multianalyte algorithmic assay (MAAA) identifies circulating neuroendocrine tumor (NET) transcripts (n=51) with a sensitivity/specificity of 98%/97%. We evaluated whether blood measurements correlated with tumor tissue transcript analysis. The latter were segregated into gene clusters (GC) that defined clinical 'hallmarks' of neoplasia. A MAAA/cluster integrated algorithm (CIA) was developed as a predictive activity index to define tumor behavior and outcome. We evaluated three groups. Group 1: publically available NET transcriptome databases (n=15; GeneProfiler). Group 2: prospectively collected tumors and matched blood samples (n=22; qRT-PCR). Group 3: prospective clinical blood samples, n=159: stable disease (SD): n=111 and progressive disease (PD): n=48. Regulatory network analysis, linear modeling, principal component analysis (PCA), and receiver operating characteristic analyses were used to delineate neoplasia 'hallmarks' and assess GC predictive utility. Our results demonstrated: group 1: NET transcriptomes identified (92%) genes elevated. Group 2: 98% genes elevated by qPCR (fold change >2, Pgenes defined nine omic clusters (SSTRome, proliferome, signalome, metabolome, secretome, epigenome, plurome, and apoptome). Group 3: six clusters (SSTRome, proliferome, metabolome, secretome, epigenome, and plurome) differentiated SD from PD (area under the curve (AUC)=0.81). Integration with blood-algorithm amplified the AUC to 0.92±0.02 for differentiating PD and SD. The CIA defined a significantly lower SD score (34.1±2.6%) than in PD (84±2.8%, P92%. Blood transcript measurement predicts NET activity. © 2015 Society for Endocrinology.

  8. Synergistic effects of resveratrol (free and inclusion complex) and sulfamethoxazole-trimetropim treatment on pathology, oxidant/antioxidant status and behavior of mice infected with Toxoplasma gondii.

    Science.gov (United States)

    Bottari, Nathieli B; Baldissera, Matheus D; Tonin, Alexandre A; Rech, Virginia C; Alves, Catiane B; D'Avila, Fernanda; Thomé, Gustavo R; Guarda, Naiara S; Moresco, Rafael N; Camillo, Giovana; Vogel, Fernanda F; Luchese, Cristiane; Schetinger, Maria Rosa C; Morsch, Vera M; Tochetto, Camila; Fighera, Rafael; Nishihira, Vivian S K; Da Silva, Aleksandro S

    2016-06-01

    This study aimed to investigate the synergistic effects of resveratrol and sulfamethoxazole-trimethoprim (ST) on the treatment of mice experimentally infected by Toxoplasma gondii during the chronic phase of the disease considering infection, behavior, and oxidative/antioxidants profile aspects. For the study, 60 mice were initially divided into two groups: uninfected (n = 24) and infected by T. gondii (n = 36). These two groups were later subdivided into other groups and treated with resveratrol (free and inclusion complex containing resveratrol) alone and co-administered with ST: groups A to D were composed by healthy mice and groups E to J were consisted of animals infected by T. gondii (VEG strain). Treatments began 20 days post-infection for 10 consecutive days with oral doses of 0.5 mg kg(-1) of ST (groups B and F), 100 mg kg(-1) of free resveratrol (groups C and G) and inclusion complex of resveratrol (nanoparticles containing resveratrol) (groups D and H), and lastly an co-administration of both drugs (groups I and J). Behavioral tests (memory, anxiety and locomotion) were performed after treatment. Liver and brain fragments were collected to evaluate pathological changes, brain cysts counts, as well as oxidant and antioxidant levels. A reduction on the number of cysts in the brain of animals treated with both drugs combined was observed; there was also reduced number of lesions on both organs. This drug combined effect was also able to reduce oxidative and increase antioxidant levels in infected mice, which might be interpreted as a resveratrol protective effect. In addition, the combination of ST and resveratrol was able to prevent behavioral changes in infected mice. Therefore, the use of co-administration drugs enhances the therapeutic effect acting on a synergic way, reducing the oxidizing effects of the chemical treatment for toxoplasmosis. In addition, resveratrol in inclusion complex when co-administered with ST showed an improved

  9. Periconception Maternal Folate Status and Human Embryonic Cerebellum Growth Trajectories: The Rotterdam Predict Study.

    Directory of Open Access Journals (Sweden)

    Irene V Koning

    Full Text Available We aimed to investigate whether periconceptional maternal folate status affects human embryonic cerebellar size and growth trajectories. In a prospective periconceptional cohort participants filled out questionnaires and received weekly transvaginal 3D-ultrasounds between 7+0 and 12+6 weeks gestational age (GA. Viable non-malformed singleton pregnancies were selected for cerebellar measurements; transcerebellar diameter, (TCD, left and right cerebellar diameters (LCD, RCD. Linear mixed models were performed to estimate associations between questionnaire data on the timing of maternal folic acid supplement initiation and longitudinal cerebellar measurements as a function of crown-rump length (CRL and GA. Maternal red blood cell folate concentrations were analysed before 8 weeks GA to validate the associations. A total of 263 serial high quality three-dimensional ultrasound scans of 135 pregnancies were studied. Preconceptional compared to postconceptional initiation of folic acid use was associated with slightly larger cerebellar diameters per millimetre increase of CRL (TCD: β = 0.260mm, 95%CI = 0.023-0.491, p<0.05; LCD: β = 0.171mm, 95%CI = 0.038-0.305, p<0.05; RCD: β = 0.156mm, 95%CI = 0.032-0.280, p<0.05 and with proportional cerebellar growth (TCD/CRL:β = 0.015mm/mm, 95%CI = 0.005-0.024, p<0.01; LCD/CRL:β = 0.012mm/mm, 95%CI = 0.005-0.018, p<0.01; RCD/CRL:β = 0.011mm/mm, 95%CI = 0.005-0.017, p<0.01. Cerebellar growth was significantly highest in the third quartile of maternal red blood cell folate levels (1538-1813 nmol/L. These first findings show that periconceptional maternal folate status is associated with human embryonic cerebellar development. Implications of these small but significant variations for fetal cerebellar growth trajectories and the child's neurodevelopmental outcome are yet unknown and warrant further investigation.

  10. CDK4 phosphorylation status and a linked gene expression profile predict sensitivity to palbociclib.

    Science.gov (United States)

    Raspé, Eric; Coulonval, Katia; Pita, Jaime M; Paternot, Sabine; Rothé, Françoise; Twyffels, Laure; Brohée, Sylvain; Craciun, Ligia; Larsimont, Denis; Kruys, Véronique; Sandras, Flavienne; Salmon, Isabelle; Van Laere, Steven; Piccart, Martine; Ignatiadis, Michail; Sotiriou, Christos; Roger, Pierre P

    2017-08-01

    Cyclin D-CDK4/6 are the first CDK complexes to be activated in the G1 phase in response to oncogenic pathways. The specific CDK4/6 inhibitor PD0332991 (palbociclib) was recently approved by the FDA and EMA for treatment of advanced ER-positive breast tumors. Unfortunately, no reliable predictive tools are available for identifying potentially responsive or insensitive tumors. We had shown that the activating T172 phosphorylation of CDK4 is the central rate-limiting event that initiates the cell cycle decision and signals the presence of active CDK4. Here, we report that the profile of post-translational modification including T172 phosphorylation of CDK4 differs among breast tumors and associates with their subtypes and risk. A gene expression signature faithfully predicted CDK4 modification profiles in tumors and cell lines. Moreover, in breast cancer cell lines, the CDK4 T172 phosphorylation best correlated with sensitivity to PD0332991. This gene expression signature identifies tumors that are unlikely to respond to CDK4/6 inhibitors and could help to select a subset of patients with HER2-positive and basal-like tumors for clinical studies on this class of drugs. © 2017 The Authors. Published under the terms of the CC BY 4.0 license.

  11. Envy's pathology: Historical contexts.

    Science.gov (United States)

    Minou, Lina

    2017-01-01

    This article is concerned with the physicality of envy primarily in early -modern, but also in eighteenth-century health contexts. The discussion brings together descriptions of the effects of envy on the body of the envier, mainly from works of physiology and health preservation, but also from literary and spiritual writings. These depictions of envy are studied beyond their symbolism and with a view to establish whether they are meaningful according to the medical theories of the time in which they occur. The discussion begins by acknowledging the status of envy as a 'disease' and looks to the specific ways in which the discourse of envy conveys this sense. I find that in the early modern discourse envy is always pathological, that is, it is experienced as disease and signifies disease in general and several diseases in particular. Moreover, envy is uniquely placed to convey pathology on account of its being connected to inherently pathogenic elements of the humoural theory. Specifically, envy is physiologically connected to melancholy, and the way it is presented comes close to attributes assigned to black bile. In addition, envy realizes pathology, the occurrence of disease in the body, by impairing the vital process of digestion and thus depriving the person from proper nourishment and sustenance. The analysis further considers how this impairment of the body fits with the physiological manifestation of envy as 'corrosion' and 'consumption'. Finding commonalities with other maladies mediated by these physiological signs the article concludes by considering the function of pathology in the conception of early modern envy.

  12. [Predictive factors of lost to follow-up status during tuberculosis treatment in Brazzaville].

    Science.gov (United States)

    Bemba, E L P; Bopaka, R G; Ossibi-Ibara, R; Toungou, S N; Ossale-Abacka, B K; Okemba-Okombi, F H; Mboussa, J

    2017-04-01

    The abandonment of TB treatment has consequences both individual by increasing the risk of drug resistance and collective seeding entourage. The aim of this study is to determine the risk factors to be lost sight of during TB treatment. He acted in a prospective cohort study of patients with microbiologically confirmed tuberculosis, beginning TB treatment and followed for six months. The comparative study between 75 patients lost (PL) and 108 no-patients lost (NPL). The presence of a large distance between the home center [OR=3.73 (1.21-11.05), P=0.022], to alcohol poisoning [OR=3.80 (3.80-11.3), P=0.031], the number of compressed high (depending on the patient) [OR=7.64 (1.96-29.8), P=0.007], stigma [OR=7.85 (1.87-33), P=0.004] were related to PL status. For against the implementation of the directly observed treatment by the community [OR=0.2 (0.03-0.92), P=0.04], be [OR=0.18 (0.05-0.63), P=0.07] were linked to reduced risk of being lost. Reducing the rate of PL requires patient compliance with good attitudes in post-education and ease of access to TB centers. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Neurodegenerative disease status and post-mortem pathology in idiopathic rapid-eye-movement sleep behaviour disorder: an observational cohort study.

    Science.gov (United States)

    Iranzo, Alex; Tolosa, Eduard; Gelpi, Ellen; Molinuevo, José Luis; Valldeoriola, Francesc; Serradell, Mónica; Sanchez-Valle, Raquel; Vilaseca, Isabel; Lomeña, Francisco; Vilas, Dolores; Lladó, Albert; Gaig, Carles; Santamaria, Joan

    2013-05-01

    . In these three patients, neuronal loss and Lewy pathology (α-synuclein-containing Lewy bodies and Lewy neurites) were found in the brainstem nuclei that regulate REM sleep atonia. Most IRBD individuals from our cohort developed a Lewy body disorder with time. Patients who remained disease-free at follow-up showed markers of increased short-term risk for developing PD and DLB in IRBD, such as decreased striatal DAT binding. Our findings indicate that in most patients diagnosed with IRBD this parasomnia represents the prodromal phase of a Lewy body disorder. IRBD is a candidate for the study of early events and progression of this prodromal phase, and to test disease-modifying strategies to slow or stop the neurodegenerative process. None. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Development and validation of a vitamin D status prediction model in Danish pregnant women

    DEFF Research Database (Denmark)

    Jensen, Camilla; Thorne-Lyman, Andrew; Hansen, Linda

    2013-01-01

    and supplements, outdoor physical activity, tanning bed use, smoking, and month of blood draw explained 40.1% of the variance in 25(OH)D and mean measured 25(OH)D-level increased linearly by decile of predicted 25(OH)D-score. In total 32.2% of the women were placed in the same quintile by both measured......Vitamin D has been hypothesized to reduce risk of pregnancy complications such as preeclampsia, gestational diabetes mellitus, and preterm delivery. However, many of these outcomes are rare and require a large sample size to study, representing a challenge for cohorts with a limited number......)D-levels for estimates of prevalence....

  15. Maternal nutritional status predicts adverse birth outcomes among HIV-infected rural Ugandan women receiving combination antiretroviral therapy.

    Directory of Open Access Journals (Sweden)

    Sera Young

    Full Text Available Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART. We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG, and hemoglobin concentration (Hb among 166 women initiating cART in rural Uganda.Prospective cohort.HIV-infected, ART-naïve pregnant women were enrolled between 12 and 28 weeks gestation and treated with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor-based combination regimen. Nutritional status was assessed monthly. Neonatal anthropometry was examined at birth. Outcomes were evaluated using multivariate analysis.Mean GWG was 0.17 kg/week, 14.6% of women experienced weight loss during pregnancy, and 44.9% were anemic. Adverse fetal outcomes included low birth weight (LBW (19.6%, preterm delivery (17.7%, fetal death (3.9%, stunting (21.1%, small-for-gestational age (15.1%, and head-sparing growth restriction (26%. No infants were HIV-infected. Gaining <0.1 kg/week was associated with LBW, preterm delivery, and a composite adverse obstetric/fetal outcome. Maternal weight at 7 months gestation predicted LBW. For each g/dL higher mean Hb, the odds of small-for-gestational age decreased by 52%.In our cohort of HIV-infected women initiating cART during pregnancy, grossly inadequate GWG was common. Infants whose mothers gained <0.1 kg/week were at increased risk for LBW, preterm delivery, and composite adverse birth outcomes. cART by itself may not be sufficient for decreasing the burden of adverse birth outcomes among HIV-infected women.Clinicaltrials.gov NCT00993031.

  16. Advanced Disease, Diuretic Use, and Marital Status Predict Hospital Admissions in an Ambulatory Cirrhosis Cohort

    Science.gov (United States)

    Johnson, Kara B.; Campbell, Emily J.; Chi, Heng; Zheng, Hui; King, Lindsay Y.; Wu, Ying; DeLemos, Andrew; Hurairah, Abu; Corey, Kathleen; Richter, James M.; Chung, Raymond T.

    2013-01-01

    Background and Aims Hospital admissions in cirrhotic patients are a source of significant health care expenditure. Most studies to date have focused on readmissions in patients with decompensated cirrhosis. We sought to describe predictors of hospital admissions in an ambulatory cirrhosis cohort consisting of both compensated and decompensated patients to identify patients who could benefit from intensified outpatient chronic disease management. Methods We performed a retrospective cohort study of 395 cirrhotic patients followed at an academic medical center liver clinic. Inclusion criteria were documented cirrhosis and longitudinal care at our center during 2006–2008. Patients were followed until December 2011, death, or liver transplantation. The primary outcomes were non-elective cirrhosis-related hospital admissions within one year and time to admission. The secondary outcome was two-year cirrhosis-related mortality. The study was approved by the Partners Human Research Committee (protocol 2012P001912). Results Seventy-eight patients (19.7%) had at least one cirrhosis-related hospital admission within one year. The following were significant predictors in the multivariable model: Model for End-Stage Liver Disease (MELD) score ≥ 15 (OR 2.22, 95% CI [1.21–4.07], p=0.01), diagnosis of hepatocellular carcinoma (HCC) (3.64 [1.42–9.35], 0.007), diuretic use (2.27 [1.23–4.17], 0.008), at least one cirrhosis-related admission during the baseline year (2.17 [1.21–3.89], 0.01), and being unmarried (1.92 [1.10–3.35], 0.02). Conclusions Advanced disease, diuretic use, and marital status were associated with cirrhosis-related hospital admissions in patients followed at an academic medical center liver clinic. Our findings suggest that patients with inadequately or overzealously treated ascites, as well as those with limited social supports, could benefit from intensified outpatient management. PMID:23990035

  17. Artificial Neural Network to Predict Vine Water Status Spatial Variability Using Multispectral Information Obtained from an Unmanned Aerial Vehicle (UAV)

    Science.gov (United States)

    Bardeen, Matthew

    2017-01-01

    Water stress, which affects yield and wine quality, is often evaluated using the midday stem water potential (Ψstem). However, this measurement is acquired on a per plant basis and does not account for the assessment of vine water status spatial variability. The use of multispectral cameras mounted on unmanned aerial vehicle (UAV) is capable to capture the variability of vine water stress in a whole field scenario. It has been reported that conventional multispectral indices (CMI) that use information between 500–800 nm, do not accurately predict plant water status since they are not sensitive to water content. The objective of this study was to develop artificial neural network (ANN) models derived from multispectral images to predict the Ψstem spatial variability of a drip-irrigated Carménère vineyard in Talca, Maule Region, Chile. The coefficient of determination (R2) obtained between ANN outputs and ground-truth measurements of Ψstem were between 0.56–0.87, with the best performance observed for the model that included the bands 550, 570, 670, 700 and 800 nm. Validation analysis indicated that the ANN model could estimate Ψstem with a mean absolute error (MAE) of 0.1 MPa, root mean square error (RMSE) of 0.12 MPa, and relative error (RE) of −9.1%. For the validation of the CMI, the MAE, RMSE and RE values were between 0.26–0.27 MPa, 0.32–0.34 MPa and −24.2–25.6%, respectively. PMID:29084169

  18. Artificial Neural Network to Predict Vine Water Status Spatial Variability Using Multispectral Information Obtained from an Unmanned Aerial Vehicle (UAV).

    Science.gov (United States)

    Poblete, Tomas; Ortega-Farías, Samuel; Moreno, Miguel Angel; Bardeen, Matthew

    2017-10-30

    Water stress, which affects yield and wine quality, is often evaluated using the midday stem water potential (Ψ stem ). However, this measurement is acquired on a per plant basis and does not account for the assessment of vine water status spatial variability. The use of multispectral cameras mounted on unmanned aerial vehicle (UAV) is capable to capture the variability of vine water stress in a whole field scenario. It has been reported that conventional multispectral indices (CMI) that use information between 500-800 nm, do not accurately predict plant water status since they are not sensitive to water content. The objective of this study was to develop artificial neural network (ANN) models derived from multispectral images to predict the Ψ stem spatial variability of a drip-irrigated Carménère vineyard in Talca, Maule Region, Chile. The coefficient of determination (R²) obtained between ANN outputs and ground-truth measurements of Ψ stem were between 0.56-0.87, with the best performance observed for the model that included the bands 550, 570, 670, 700 and 800 nm. Validation analysis indicated that the ANN model could estimate Ψ stem with a mean absolute error (MAE) of 0.1 MPa, root mean square error (RMSE) of 0.12 MPa, and relative error (RE) of -9.1%. For the validation of the CMI, the MAE, RMSE and RE values were between 0.26-0.27 MPa, 0.32-0.34 MPa and -24.2-25.6%, respectively.

  19. Prevalence of periodontitis, dental caries, and peri-implant pathology and their relation with systemic status and smoking habits: Results of an open-cohort study with 22009 patients in a private rehabilitation center.

    Science.gov (United States)

    de Araújo Nobre, Miguel; Maló, Paulo

    2017-12-01

    This investigation, based on a 3-year epidemiological surveillance open cohort study, aimed to provide an insight of the prevalence of periodontitis, dental caries and peri-implant pathology and to compare inferentially between healthy and systemic compromised patients. A total of 22009 patients were observed consisting in 9035 men (41.1%) and 12974 women (58.9%) with an average age of 48.5 years (standard deviation of 15.6years). The prevalence of the 3 chronical oral diseases was calculated. The comparison between healthy and systemic compromised patients for each oral disease was performed through multivariate logistic regression: Odds ratios (OR) with 95% confidence intervals (95%CI) were estimated in one general model and one systemic condition specific model adjusted for age and gender. Attributable fractions were estimated for systemic conditions (both models). The level of significance was set at 5%. The prevalence rate of periodontitis, dental caries and peri-implant pathology was 17.6%, 36.6% and 13.9%, respectively. The systemic compromised status was associated with the prevalence of the three chronical oral diseases on the general models. The systemic condition specific models yielded Diabetes [OR=1.49, 95%CI (1.24;1.79)] and HIV+ [OR=4.37, 95%CI (1.05;18.24)] as risk indicators for Periodontitis; cardiovascular conditions [OR=1.10, 95%CI (1.01;1.20)], Diabetes [OR=1.24, 95%CI (1.05;1.46)] and neurologic conditions [OR=1.84, 95%CI (1.32;2.57)] as risk indicators for dental caries; and smoking habits as a risk indicator for all three oral diseases [OR=1.90, 95%CI (1.74;2.07) for Periodontitis; OR=1.18, 95%CI (1.09;1.27) for dental caries; OR=1.84, 95%CI (1.64;2.07) for peri-implant pathology]. Attributable fractions estimated a potential reduction of 12.2% of Periodontitis, and 4.3% of dental caries cases if the exposure to systemic conditions was prevented; while the prevention of exposure to smoking alone would result in a potential reduction of 37

  20. The Role of BRCA2 Mutation Status as Diagnostic, Predictive, and Prognosis Biomarker for Pancreatic Cancer.

    Science.gov (United States)

    Martinez-Useros, Javier; Garcia-Foncillas, Jesus

    2016-01-01

    Pancreatic cancer is one of the deadliest cancers worldwide, and life expectancy after diagnosis is often short. Most pancreatic tumours appear sporadically and have been highly related to habits such as cigarette smoking, high alcohol intake, high carbohydrate, and sugar consumption. Other observational studies have suggested the association between pancreatic cancer and exposure to arsenic, lead, or cadmium. Aside from these factors, chronic pancreatitis and diabetes have also come to be considered as risk factors for these kinds of tumours. Studies have found that 10% of pancreatic cancer cases arise from an inherited syndrome related to some genetic alterations. One of these alterations includes mutation in BRCA2 gene. BRCA2 mutations impair DNA damage response and homologous recombination by direct regulation of RAD51. In light of these findings that link genetic factors to tumour development, DNA damage agents have been proposed as target therapies for pancreatic cancer patients carrying BRCA2 mutations. Some of these drugs include platinum-based agents and PARP inhibitors. However, the acquired resistance to PARP inhibitors has created a need for new chemotherapeutic strategies to target BRCA2. The present systematic review collects and analyses the role of BRCA2 alterations to be used in early diagnosis of an inherited syndrome associated with familiar cancer and as a prognostic and predictive biomarker for the management of pancreatic cancer patients.

  1. The Role of BRCA2 Mutation Status as Diagnostic, Predictive, and Prognosis Biomarker for Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Javier Martinez-Useros

    2016-01-01

    Full Text Available Pancreatic cancer is one of the deadliest cancers worldwide, and life expectancy after diagnosis is often short. Most pancreatic tumours appear sporadically and have been highly related to habits such as cigarette smoking, high alcohol intake, high carbohydrate, and sugar consumption. Other observational studies have suggested the association between pancreatic cancer and exposure to arsenic, lead, or cadmium. Aside from these factors, chronic pancreatitis and diabetes have also come to be considered as risk factors for these kinds of tumours. Studies have found that 10% of pancreatic cancer cases arise from an inherited syndrome related to some genetic alterations. One of these alterations includes mutation in BRCA2 gene. BRCA2 mutations impair DNA damage response and homologous recombination by direct regulation of RAD51. In light of these findings that link genetic factors to tumour development, DNA damage agents have been proposed as target therapies for pancreatic cancer patients carrying BRCA2 mutations. Some of these drugs include platinum-based agents and PARP inhibitors. However, the acquired resistance to PARP inhibitors has created a need for new chemotherapeutic strategies to target BRCA2. The present systematic review collects and analyses the role of BRCA2 alterations to be used in early diagnosis of an inherited syndrome associated with familiar cancer and as a prognostic and predictive biomarker for the management of pancreatic cancer patients.

  2. Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes.

    Science.gov (United States)

    Czerwonko, Matías E; Huespe, Pablo; Bertone, Santiago; Pellegrini, Pablo; Mazza, Oscar; Pekolj, Juan; de Santibañes, Eduardo; Hyon, Sung Ho; de Santibañes, Martín

    2016-12-01

    In times of modern surgery, transplantation and percutaneous techniques, pyogenic liver abscess (PLA) has essentially become a problem of biliary or iatrogenic origin. In the current scenario, diagnostic approach, clinical behavior and therapeutic outcomes have not been profoundly studied. This study analyzes the clinical and microbiological features, diagnostic methods, therapeutic management and predictive factors for recurrence and mortality of first episodes of PLA. A retrospective single-center study was conducted including 142 patients admitted to the Hospital Italiano de Buenos Aires, between 2005 and 2015 with first episodes of PLA. Prevailing identifiable causes were biliary diseases (47.9%) followed by non-biliary percutaneous procedures (NBIPLA, 15.5%). Seventeen patients (12%) were liver recipients. Eleven patients (7.8%) died and 18 patients (13.7%) had recurrence in the first year of follow up. The isolation of multiresistant organisms (p = 0.041) and a history of cholangitis (p 5 mg/dL (p = 0.022) and bilateral involvement (p = 0.014) in the multivariate analysis. NBPLA and PLA after transplantation may be increasing among the population of PLA in referral centers. History of cholangitis is a strong predictor for recurrence. Mortality is associated to hiperbilirrubinemia and anatomical distribution of the lesions. Copyright © 2016 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  3. Development of a new outcome prediction model for Chinese patients with penile squamous cell carcinoma based on preoperative serum C-reactive protein, body mass index, and standard pathological risk factors: the TNCB score group system.

    Science.gov (United States)

    Li, Zai-Shang; Chen, Peng; Yao, Kai; Wang, Bin; Li, Jing; Mi, Qi-Wu; Chen, Xiao-Feng; Zhao, Qi; Li, Yong-Hong; Chen, Jie-Ping; Deng, Chuang-Zhong; Ye, Yun-Lin; Zhong, Ming-Zhu; Liu, Zhuo-Wei; Qin, Zi-Ke; Lin, Xiang-Tian; Liang, Wei-Cong; Han, Hui; Zhou, Fang-Jian

    2016-04-12

    To determine the predictive value and feasibility of the new outcome prediction model for Chinese patients with penile squamous cell carcinoma. The 3-year disease-specific survival (DSS) survival (DSS) was 92.3% in patients with model was developed, consisting of BMI, CRP, and tumor T and N classification. In our study, we found that the addition of the above-mentioned parameters significantly increased the predictive accuracy of the system of the American Joint Committee on Cancer (AJCC) anatomic stage group. The accuracy of the new prediction category was verified. A total of 172 Chinese patients with penile squamous cell cancer were analyzed retrospectively between November 2005 and November 2014. Statistical data analysis was conducted using the nonparametric method. Survival analysis was performed with the log-rank test and the Cox proportional hazard model. Based on regression estimates of significant parameters in multivariate analysis, a new BMI-, CRP- and pathologic factors-based scoring model was developed to predict disease--specific outcomes. The predictive accuracy of the model was evaluated using the internal and external validation. The present study demonstrated that the TNCB score group system maybe a precise and easy to use tool for predicting outcomes in Chinese penile squamous cell carcinoma patients.

  4. Factors Predicting Nurse Intent and Status Regarding Pap Smear Examination in Taiwan: a Cross-sectional Survey.

    Science.gov (United States)

    Chen, Shu-Ling; Tsai, Shu-Fang; Hsieh, Mei-Mei; Lee, Lin-Lin; Tzeng, Ya-Ling

    2016-01-01

    Nurses are the most visible, frontline personnel providing health education to patients. In particular, nurse experience with Pap examinations have the potential to influence women's attitudes toward screening for cervical cancer. However, nurses in Taiwan have lower rates of Pap testing than the general population. Understanding the factors predicting nurse intent to have a Pap exam and Pap exam status would inform interventions and policies to increase their Pap exam uptake. Therefore, the present study was undertaken. Data were collected by questionnaire from a convenient sample of 504 nurses at a regional hospital in central Taiwan between August and October 2011 and analyzed by descriptive statistics, confirmatory factor analysis, and logistic regression. Nurse intention to have a Pap exam was predicted by younger age, less negative attitudes toward Pap exams, and greater influence of others recommendations. However, nurses were more likely to actually have had a Pap exam if they were older, married, had sexual experience, and had a high intention to have a Pap exam. Nurses who are younger than 34 years old, unmarried, sexually inexperienced, and with low intention to have a Pap exam should be targeted with interventions to educate them not only about the importance of Pap exams in detecting cervical cancer, but also about strategies to decrease pain and embarrassment during exams. Nurses with less negative attitudes and experiences related to Pap exams would serve as role models to persuade women to have Pap exams, thus increasing the uptake rate of Pap exams in Taiwan.

  5. Nutritional Status Predicts 10-Year Mortality in Patients with End-Stage Renal Disease on Hemodialysis.

    Science.gov (United States)

    Kang, Shin Sook; Chang, Jai Won; Park, Yongsoon

    2017-04-18

    Protein-energy wasting (PEW) is associated with mortality in patients with end-stage renal disease (ESRD) on maintenance hemodialysis. The correct diagnosis of PEW is extremely important in order to predict clinical outcomes. However, it is unclear which parameters should be used to diagnose PEW. Therefore, this retrospective observational study investigated the relationship between mortality and nutritional parameters in ESRD patients on maintenance hemodialysis. A total of 144 patients were enrolled. Nutritional parameters, including body mass index, serum albumin, dietary intake, normalized protein catabolic rate (nPCR), and malnutrition inflammation score (MIS), were measured at baseline. Fifty-three patients died during the study. Survivors had significantly higher nPCR (1.10 ± 0.24 g/kg/day vs. 1.01 ± 0.21 g/kg/day; p = 0.048), energy intake (26.7 ± 5.8 kcal/kg vs. 24.3 ± 4.2 kcal/kg; p = 0.009) and protein intake (0.91 ± 0.21 g/kg vs. 0.82 ± 0.24 g/kg; p = 0.020), and lower MIS (5.2 ± 2.3 vs. 6.1 ± 2.1, p = 0.039). In multivariable analysis, energy intake 5 (HR 2.146, 95% CI 1.173-3.928; p = 0.013) were independent variables associated with all-cause mortality. These results suggest that higher MIS and lower energy intake are harmful to ESRD patients on maintenance hemodialysis. Optimal energy intake could reduce mortality in these patients.

  6. Attractiveness Compensates for Low Status Background in the Prediction of Educational Attainment.

    Directory of Open Access Journals (Sweden)

    Shawn Bauldry

    Full Text Available People who are perceived as good looking or as having a pleasant personality enjoy many advantages, including higher educational attainment. This study examines (1 whether associations between physical/personality attractiveness and educational attainment vary by parental socioeconomic resources and (2 whether parental socioeconomic resources predict these forms of attractiveness. Based on the theory of resource substitution with structural amplification, we hypothesized that both types of attractiveness would have a stronger association with educational attainment for people from disadvantaged backgrounds (resource substitution, but also that people from disadvantaged backgrounds would be less likely to be perceived as attractive (amplification.This study draws on data from the National Longitudinal Study of Adolescent to Adult Health-including repeated interviewer ratings of respondents' attractiveness-and trait-state structural equation models to examine the moderation (substitution and mediation (amplification of physical and personality attractiveness in the link between parental socioeconomic resources and educational attainment.Both perceived personality and physical attractiveness have stronger associations with educational attainment for people from families with lower levels of parental education (substitution. Further, parental education and income are associated with both dimensions of perceived attractiveness, and personality attractiveness is positively associated with educational attainment (amplification. Results do not differ by sex and race/ethnicity. Further, associations between perceived attractiveness and educational attainment remain after accounting for unmeasured family-level confounders using a sibling fixed-effects model.Perceived attractiveness, particularly personality attractiveness, is a more important psychosocial resource for educational attainment for people from disadvantaged backgrounds than for people from

  7. Attractiveness Compensates for Low Status Background in the Prediction of Educational Attainment.

    Science.gov (United States)

    Bauldry, Shawn; Shanahan, Michael J; Russo, Rosemary; Roberts, Brent W; Damian, Rodica

    2016-01-01

    People who are perceived as good looking or as having a pleasant personality enjoy many advantages, including higher educational attainment. This study examines (1) whether associations between physical/personality attractiveness and educational attainment vary by parental socioeconomic resources and (2) whether parental socioeconomic resources predict these forms of attractiveness. Based on the theory of resource substitution with structural amplification, we hypothesized that both types of attractiveness would have a stronger association with educational attainment for people from disadvantaged backgrounds (resource substitution), but also that people from disadvantaged backgrounds would be less likely to be perceived as attractive (amplification). This study draws on data from the National Longitudinal Study of Adolescent to Adult Health-including repeated interviewer ratings of respondents' attractiveness-and trait-state structural equation models to examine the moderation (substitution) and mediation (amplification) of physical and personality attractiveness in the link between parental socioeconomic resources and educational attainment. Both perceived personality and physical attractiveness have stronger associations with educational attainment for people from families with lower levels of parental education (substitution). Further, parental education and income are associated with both dimensions of perceived attractiveness, and personality attractiveness is positively associated with educational attainment (amplification). Results do not differ by sex and race/ethnicity. Further, associations between perceived attractiveness and educational attainment remain after accounting for unmeasured family-level confounders using a sibling fixed-effects model. Perceived attractiveness, particularly personality attractiveness, is a more important psychosocial resource for educational attainment for people from disadvantaged backgrounds than for people from advantaged

  8. Long-range Weather Prediction and Prevention of Climate Catastrophes: A Status Report

    Science.gov (United States)

    Caldeira, K.; Caravan, G.; Govindasamy, B.; Grossman, A.; Hyde, R.; Ishikawa, M.; Ledebuhr, A.; Leith, C.; Molenkamp, C.; Teller, E.; Wood, L.

    1999-08-18

    As the human population of Earth continues to expand and to demand an ever-higher quality-of-life, requirements for ever-greater knowledge--and then control--of the future of the state of the terrestrial biosphere grow apace. Convenience of living--and, indeed, reliability of life itself--become ever more highly ''tuned'' to the future physical condition of the biosphere being knowable and not markedly different than the present one. Two years ago, we reported at a quantitative albeit conceptual level on technical ways-and-means of forestalling large-scale changes in the present climate, employing practical means of modulating insolation and/or the Earth's mean albedo. Last year, we reported on early work aimed at developing means for creating detailed, high-fidelity, all-Earth weather forecasts of two weeks duration, exploiting recent and anticipated advances in extremely high-performance digital computing and in atmosphere-observing Earth satellites bearing high-technology instrumentation. This year, we report on recent progress in both of these areas of endeavor. Preventing the commencement of large-scale changes in the current climate presently appears to be a considerably more interesting prospect than initially realized, as modest insolation reductions are model-predicted to offset the anticipated impacts of ''global warming'' surprisingly precisely, in both space and time. Also, continued study has not revealed any fundamental difficulties in any of the means proposed for insolation modulation and, indeed, applicability of some of these techniques to other planets in the inner Solar system seems promising. Implementation of the high-fidelity, long-range weather-forecasting capability presently appears substantially easier with respect to required populations of Earth satellites and atmospheric transponders and data-processing systems, and more complicated with respect to transponder lifetimes in the actual atmosphere; overall, the enterprise seems more

  9. Prediction of Helicobacter pylori status by conventional endoscopy, narrow-band imaging magnifying endoscopy in stomach after endoscopic resection of gastric cancer.

    Science.gov (United States)

    Yagi, Kazuyoshi; Saka, Akiko; Nozawa, Yujiro; Nakamura, Atsuo

    2014-04-01

    To reduce the incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer, Helicobacter pylori eradication therapy has been endorsed. It is not unusual for such patients to be H. pylori negative after eradication or for other reasons. If it were possible to predict H. pylori status using endoscopy alone, it would be very useful in clinical practice. To clarify the accuracy of endoscopic judgment of H. pylori status, we evaluated it in the stomach after endoscopic submucosal dissection (ESD) of gastric cancer. Fifty-six patients treated by ESD were enrolled. The diagnostic criteria for H. pylori status by conventional endoscopy and narrow-band imaging (NBI)-magnifying endoscopy were decided, and H. pylori status was judged by two endoscopists. Based on the H. pylori stool antigen test as a diagnostic gold standard, conventional endoscopy and NBI-magnifying endoscopy were compared for their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Interobserver agreement was assessed in terms of κ value. Interobserver agreement was moderate (0.56) for conventional endoscopy and substantial (0.77) for NBI-magnifying endoscopy. The sensitivity, specificity, PPV, and NPV were 0.79, 0.52, 0.70, and 0.63 for conventional endoscopy and 0.91, 0.83, 0.88, and 0.86 for NBI-magnifying endoscopy, respectively. Prediction of H. pylori status using NBI-magnifying endoscopy is practical, and interobserver agreement is substantial. © 2013 John Wiley & Sons Ltd.

  10. [Pathological gambling: risk factors].

    Science.gov (United States)

    Bouju, G; Grall-Bronnec, M; Landreat-Guillou, M; Venisse, J-L

    2011-09-01

    conditioned by the interaction of a person and a gambling activity, in a particular context. This conceptual model is based on the well-known theory of Olivenstein on toxicomania, which was proposed in the seventies. The structural factors that appeared to be highly related to pathological gambling development and maintenance are payment modality, entertaining dimension, temporality, reward level, educational messages, gambling ambiance, gambling medium and part of hazard. Among contextual factors, availability and accessibility of gambling opportunities are well known. However, social and economic factors (e.g. culture, ethnicity, religion, education) are also important. Lastly, among individual factors, psychosocial factors are gender, age, familial and personal antecedents and psychiatric comorbidities. Neurobiological factors are not discussed here. This paper briefly summarises risk factors for development and maintenance of pathological gambling. It highlights that these factors are very similar to those that are implicated in substance use disorders, except for the gambling activity and context. Prevention regarding behavioural addictions should, in the future, take advantage of the findings on substance use disorder, since behavioural addictions are less known. Conversely, it seems obvious that findings on pathological gambling, and more widely behavioural addictions, could highlight all types of addiction. It appears that this fact is especially valid with regards to the evolution and stability of addictive status, which must be taken into account for treatment proposals. Copyright © 2011 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  11. A Novel Model for Predicting Rehospitalization Risk Incorporating Physical Function, Cognitive Status, and Psychosocial Support Using Natural Language Processing.

    Science.gov (United States)

    Greenwald, Jeffrey L; Cronin, Patrick R; Carballo, Victoria; Danaei, Goodarz; Choy, Garry

    2017-03-01

    With the increasing focus on reducing hospital readmissions in the United States, numerous readmissions risk prediction models have been proposed, mostly developed through analyses of structured data fields in electronic medical records and administrative databases. Three areas that may have an impact on readmission but are poorly captured using structured data sources are patients' physical function, cognitive status, and psychosocial environment and support. The objective of the study was to build a discriminative model using information germane to these 3 areas to identify hospitalized patients' risk for 30-day all cause readmissions. We conducted clinician focus groups to identify language used in the clinical record regarding these 3 areas. We then created a dataset including 30,000 inpatients, 10,000 from each of 3 hospitals, and searched those records for the focus group-derived language using natural language processing. A 30-day readmission prediction model was developed on 75% of the dataset and validated on the other 25% and also on hospital specific subsets. Focus group language was aggregated into 35 variables. The final model had 16 variables, a validated C-statistic of 0.74, and was well calibrated. Subset validation of the model by hospital yielded C-statistics of 0.70-0.75. Deriving a 30-day readmission risk prediction model through identification of physical, cognitive, and psychosocial issues using natural language processing yielded a model that performs similarly to the better performing models previously published with the added advantage of being based on clinically relevant factors and also automated and scalable. Because of the clinical relevance of the variables in the model, future research may be able to test if targeting interventions to identified risks results in reductions in readmissions.

  12. Central Asia cryosphere dynamics: retrospective analysis, contemporary status, and prediction (Invited)

    Science.gov (United States)

    Aizen, V. B.; Aizen, E.; Surazakov, A.; Takeuchi, N.; Fujita, K.; Mayewski, P. A.; Grigholm, B. O.

    2010-12-01

    Central Asia (CA) mountain system is a giant highland in the center of Eurasia accumulates a huge amount of snow and ice similar to the Arctic and Antarctic. Existing ensembles of GCM predict warming for CA at a large scale. Increase in air temperature since 19th century, after the “Little Ice Age”, has induced seasonal snow shrinkage and glaciers recession globally with acceleration particularly at the end of 20th century. However, the change in seasonal snow and glacier melt is not a liner process and different even in one mountain system. Since the 1970s the reduction of snow covered area in Tien Shan (TS) amounted 15% (120,000km2) while in Pamir (PA) didn’t significantly change and increased in Karakorum (KA). The Altai (AL), TS and Tibet (TI) glaciers lost approximately 8% of their area while Pamir only 5%. The largest TS and PA glacierized massifs lost 2-4% their area whereas dispersed small glaciers (precipitation in the last two decades. The geothermal observations in TS, AL and TI indicated permafrost warming up to 0.6°C since 1970s. The average active-layer thickness has increased up to 25% (Marchenko et al., 2008). The river runoff in large glacierized basins increased up to 8% but decreased in snow-fed basins on 2% in average. The present extents of glaciers in CA are generally believed to be remnants of the last deglaciation (Grosswald, et al., 1994, Kuhle, 2004) however our recent ice-cores recovered from AL and TS demonstrated that glaciers did not exist during Bolling/Allerod interstadial period and were formed between 12,500 and 11,500 BP in CA at elevations below 5000 masl. The climate conditions during the late Pleistocene were considerably warmer then present. Most likely AL and TS glaciers have been formed during early Holocene in response to changes in atmospheric circulation patterns yielding oceanic moisture. In contrast, the PA, KA and Himalayan glaciers survived at high elevation during the interstadial period being enriched by

  13. Your Pathology Report

    Science.gov (United States)

    ... and Testing » Your Pathology Report Learn Your Pathology Report Updated April 10, 2016 Reviewed By: Lauren Ende ... if you had one. Sections of Your Pathology Report You may get your complete report all at ...

  14. Early in-hospital clinical deterioration is not predicted by severity of illness, functional status, or comorbidity

    Directory of Open Access Journals (Sweden)

    Wang J

    2017-09-01

    Full Text Available Janice Wang,1 Stella S Hahn,1 Myriam Kline,2 Rubin I Cohen1 1Division of Pulmonary, Critical Care and Sleep Medicine, Hofstra Northwell School of Medicine, New Hyde Park, 2Biostatistics Unit, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA Background: Prior studies concentrated on unplanned intensive care unit (ICU transfer to gauge deterioration occurring shortly following hospital admission. However, examining only ICU transfers is not ideal since patients could stabilize with treatment, refuse ICU admission, or not require ICU evaluation. To further explore etiologies of early clinical deterioration, we used rapid response team (RRT activation within 48 hours of admission as an index of early clinical worsening. Methods: A retrospective analysis of prospectively gathered admissions from the emergency department in an academic medical center was done. Data were reviewed independently by two physicians. We assessed severity of illness, functional status, comorbidity, the frequency of ICU and palliative care consultations, and changes in advance health care directives.Results: Of 655 rapid responses (RRs within the study period, 24.6% occurred within 48 hours of admission. Disease trajectory was the most frequent perceived reason for RRs (55.6% and 58.9%, reviewer 1 and 2, respectively followed by medical error (15.6% and 15.2%. Acute physiology and chronic health evaluation II (APACHE-II and modified early warning scores (MEWS were higher at the time of RR compared to admission (p<0.0001. However, admission APACHE-II, MEWS, functional status, and comorbidity scores did not predict early RRs. One third of RRs resulted in ICU consultation and 95% were accepted. Palliative care consults were requested for 15%, the majority (65% after RR and all resulting in advance directive change. Conclusion: Disease trajectory accounted for most clinical deterioration and medical error contributed to 15%. Our data suggest that it

  15. Low sleep and low socioeconomic status predict high body mass index: a 4-year longitudinal study of Australian schoolchildren.

    Science.gov (United States)

    O'Dea, J A; Dibley, M J; Rankin, N M

    2012-08-01

    The objective of this study was to examine the longitudinal relationships between body mass index (BMI), sleep duration and socioeconomic status (SES) in a 4-year cohort of 939 children aged 7-12 years. Children and their mothers completed an annual questionnaire to assess usual weekday sleep and wake times, amount of sleep, physical activity, parental education and school SES. 93% of children were enrolled (939/1010) and retention was 88%, 83% and 81% in consecutive years. Height and weight were measured annually. BMI increased with decreasing amount of sleep and less sleep predicted greater International Obesity Task Force measures of obesity and overweight. In all 4 years, after controlling for baseline BMI, low SES was a significant predictor of high BMI. Children in the upper tertile of sleep in year 1 had a 2.3 kg lower weight gain (standard error [SE]: 0.5) between years 1 and 4 (P sleep and a 0.45 kg m(-2) lower increase in BMI (SE: 0.15) (P = 0.004). The difference between children with consistently low and high sleep duration over 4 years was 1 BMI point. Those with the lowest BMI were the children with both high SES and high sleep duration. PA was not associated with BMI. Both low SES and short sleep duration predict obesity risk in children after controlling for baseline BMI and this trend becomes stronger as children enter adolescence. Obesity prevention should include a sleep promotion component and this may be more beneficial to children of low SES and/or socially disadvantaged backgrounds. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

  16. Investigation of a redox-sensitive predictive model of mouse embryonic stem cells differentiation using quantitative nuclease protection assays and glutathione redox status

    Science.gov (United States)

    Investigation of a redox-sensitive predictive model of mouse embryonic stem cell differentiation via quantitative nuclease protection assays and glutathione redox status Chandler KJ,Hansen JM, Knudsen T,and Hunter ES 1. U.S. Environmental Protection Agency, Research Triangl...

  17. Does site-specific labelling and individual processing of sextant biopsies improve the accuracy of prostate biopsy in predicting pathological stage in patients with T1c prostate cancer?

    Science.gov (United States)

    Tombal, B; Tajeddine, N; Cosyns, J-P; Feyaerts, A; Opsomer, R; Wese, F X; Van Cangh, P J

    2002-04-01

    To evaluate whether individual labelling and processing of the sextant of origin improves the accuracy of prostate biopsy in predicting the final pathological stage after radical prostatectomy in patients with T1c prostate cancer. The charts of 386 patients treated for prostate cancer by radical prostatectomy between January 1996 and June 1999 were reviewed. In all, 124 patients fulfilled the following inclusion criteria: no abnormality on digital rectal examination (DRE) or transrectal ultrasonography, a prostate specific antigen (PSA) level before biopsy of sextant biopsies, with the cores being submitted in six separate containers individually labelled for the sextant of origin. Within this series of patients with a low tumour burden, the preoperative PSA, biopsy Gleason score and unilateral vs bilateral involvement were not significant predictors of disease extension. The percentage of positive cores and the number and topography of positive sextants were both statistically significant predictors of organ-confined disease. Although these two variables appeared to be statistically equivalent on a first analysis in the overall series, a subgroup of patients was identified who benefited from the complete topographical information, i.e. those 52 (42%) patients with a Gleason score of sextants. These results support the individual labelling of biopsy cores in selected patients with a normal DRE and a moderately elevated PSA, as it helps to better predict the final pathological stage. This substantial benefit outweighs the additional effort by the pathologist.

  18. The accuracy of {sup 18}F-FDG PET/CT in predicting the pathological response to neoadjuvant chemotherapy in patients with breast cancer. A meta-analysis and systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Tian, Fangfang; Shen, Guohua; Diao, Wei; Jia, Zhiyun [West China Hospital of Sichuan University, Department of Nuclear Medicine, Chengdu, Sichuan (China); Deng, Yunfu [West China Hospital of Sichuan University, Department of Oncology, Chengdu (China)

    2017-11-15

    The aim of this meta-analysis was to evaluate the accuracy of {sup 18}F-FDG PET/CT in predicting the pathological response to neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients. PubMed, Embase, the Cochrane Library (Central), and the Web of Science (SCI-Expanded) were systematically searched to identify pertinent studies. The methodologic quality of the included studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies-2. The Spearman correlation coefficient was used to explore the existence of a threshold effect. Heterogeneity was assessed by the likelihood ratio I {sup 2} index. The pooled values calculated with a mixed-effects model for the sensitivity, specificity and diagnostic odds ratio with 95% confidence intervals were 81.9% (76.0-86.6%), 79.3% (72.1-85.1%) and 17.35 (10.98-27.42), respectively. {sup 18}F-FDG PET/CT has a moderate accuracy in predicting the pathological response during the early process of NAC in breast cancer patients. To increase the role of {sup 18}F-FDG PET/CT in monitoring the therapy response, future prospective studies are needed to explore how chemotherapy regimens and different subtypes affect the levels of glucose metabolism. (orig.)

  19. Satisfaction with relationship status : Development of a new scale and the role in predicting well-being

    NARCIS (Netherlands)

    Lehmann, V.; Tuinman, M.A.; Braeken, J.; Vingerhoets, A.J.J.M.; Sanderman, R.; Hagedoorn, M.

    2015-01-01

    To develop a generic instrument assessing satisfaction with relationship status, and to examine the role of status satisfaction in explaining life satisfaction and distress beyond marital status. In two studies, we first examined the psychometric properties of the Satisfaction with Relationship

  20. Satisfaction with Relationship Status : Development of a New Scale and the Role in Predicting Well-Being

    NARCIS (Netherlands)

    Lehmann, Vicky; Tuinman, Marrit A.; Braeken, Johan; Vingerhoets, Ad. J. J. M.; Sanderman, Robbert; Hagedoorn, Mariet

    To develop a generic instrument assessing satisfaction with relationship status, and to examine the role of status satisfaction in explaining life satisfaction and distress beyond marital status. In two studies, we first examined the psychometric properties of the Satisfaction with Relationship

  1. The Danish Pathology Register

    DEFF Research Database (Denmark)

    Bjerregaard, Beth; Larsen, Ole B

    2011-01-01

    The National Board of Health, Denmark in 1997 published guidelines for reporting of pathology data and the Danish Pathology Register (DPR) was established.......The National Board of Health, Denmark in 1997 published guidelines for reporting of pathology data and the Danish Pathology Register (DPR) was established....

  2. Prediction of age at menopause from assessment of ovarian reserve may be improved by using body mass index and smoking status.

    Science.gov (United States)

    La Marca, Antonio; Sighinolfi, Giovanna; Papaleo, Enrico; Cagnacci, Angelo; Volpe, Annibale; Faddy, Malcolm J

    2013-01-01

    Menopause is the consequence of exhaustion of the ovarian follicular pool. AMH, an indirect hormonal marker of ovarian reserve, has been recently proposed as a predictor for age at menopause. Since BMI and smoking status are relevant independent factors associated with age at menopause we evaluated whether a model including all three of these variables could improve AMH-based prediction of age at menopause. In the present cohort study, participants were 375 eumenorrheic women aged 19-44 years and a sample of 2,635 Italian menopausal women. AMH values were obtained from the eumenorrheic women. Regression analysis of the AMH data showed that a quadratic function of age provided a good description of these data plotted on a logarithmic scale, with a distribution of residual deviates that was not normal but showed significant left-skewness. Under the hypothesis that menopause can be predicted by AMH dropping below a critical threshold, a model predicting menopausal age was constructed from the AMH regression model and applied to the data on menopause. With the AMH threshold dependent on the covariates BMI and smoking status, the effects of these covariates were shown to be highly significant. In the present study we confirmed the good level of conformity between the distributions of observed and AMH-predicted ages at menopause, and showed that using BMI and smoking status as additional variables improves AMH-based prediction of age at menopause.

  3. Multiparametric 3T MRI for the prediction of pathological downgrading after radical prostatectomy in patients with biopsy-proven Gleason score 3 + 4 prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gondo, Tatsuo [Memorial Sloan-Kettering Cancer Center, Urology Service, Department of Surgery, New York, NY (United States); Tokyo Medical University, Department of Urology, Tokyo (Japan); Hricak, Hedvig; Sala, Evis; Vargas, Hebert Alberto [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Zheng, Junting; Moskowitz, Chaya S. [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Bernstein, Melanie; Eastham, James A. [Memorial Sloan-Kettering Cancer Center, Urology Service, Department of Surgery, New York, NY (United States)

    2014-12-15

    The aim of this study was to assess the diagnostic performance of pre-treatment 3-Tesla (3T) multiparametric magnetic resonance imaging (mpMRI) for predicting Gleason score (GS) downgrading after radical prostatectomy (RP) in patients with GS 3 + 4 prostate cancer (PCa) on biopsy. We retrospectively reviewed 304 patients with biopsy-proven GS 3 + 4 PCa who underwent mpMRI before RP. On T2-weighted imaging and three mpMRI combinations (T2-weighted imaging + diffusion-weighted imaging [DWI], T2-weighted imaging + dynamic contrast-enhanced-MRI [DCE-MRI], and T2-weighted imaging + DWI + DCE-MRI), two radiologists (R1/R2) scored the presence of a dominant tumour using a 5-point Likert scale (1 = definitely absent to 5 = definitely present). Diagnostic performance in identifying downgrading was evaluated via areas under the curves (AUCs). Predictive accuracies of multivariate models were calculated. In predicting downgrading, T2-weighted imaging + DWI (AUC = 0.89/0.85 for R1/R2) performed significantly better than T2-weighted imaging alone (AUC = 0.72/0.73; p < 0.001/p = 0.02 for R1/R2), while T2-weighted imaging + DWI + DCE-MRI (AUC = 0.89/0.84 for R1/R2) performed no better than T2-weighted imaging + DWI (p = 0.48/p > 0.99 for R1/R2). On multivariate analysis, the clinical + mpMRI model incorporating T2-weighted imaging + DWI (AUC = 0.92/0.88 for R1/R2) predicted downgrading significantly better than the clinical model (AUC = 0.73; p < 0.001 for R1/R2). mpMRI improves the ability to identify a subgroup of patients with Gleason 3 + 4 PCa on biopsy who are candidates for active surveillance. DCE-MRI (compared to T2 + DWI) offered no additional benefit to the prediction of downgrading. (orig.)

  4. Forensic Pathology Education in Pathology Residency

    Science.gov (United States)

    Ross, Wayne K.; Domen, Ronald E.

    2017-01-01

    Forensic pathology is a fundamental part of anatomic pathology training during pathology residency. However, the lack of information on forensic teaching suggests the highly variable nature of forensic education. A survey of pathology residency program directors was performed to determine key aspects of their respective forensic rotations and curriculum. A total of 38.3% of programs from across the country responded, and the survey results show 5.6% don’t require a forensic pathology rotation. In those that do, most forensic pathology rotations are 4 weeks long, are done at a medical examiner’s office, and require set prerequisites. A total of 21.1% of responding programs have residents who are not receiving documented evaluations for this rotation. While 39.6% of programs have a defined forensics curriculum, as many as 15% do not. Furthermore, nearly 43% of programs place no limit on counting forensic autopsies when applying for pathology board examinations. Our survey confirmed the inconsistent nature of forensic pathology training in resident education. Additionally, our curriculum was reorganized to create a more robust educational experience. A pre- and post-forensic lecture quiz and Resident In-Service Examination scores were analyzed to determine our curriculum’s impact and effectiveness. Analysis of our pre- and post-lecture quiz showed an improved overall average as well as an increase in Resident In-Service Examination scores, indicating improved general forensic pathology knowledge. Using this knowledge, along with changes in our curriculum, we generated a number of recommendations for improving forensic pathology education in pathology residency. PMID:28913415

  5. {sup 18}F-FDG PET/CT in the early prediction of pathological response in aggressive subtypes of breast cancer: review of the literature and recommendations for use in clinical trials

    Energy Technology Data Exchange (ETDEWEB)

    Groheux, David [Saint-Louis Hospital, Department of Nuclear Medicine, Paris Cedex 10 (France); INSERM/CNRS UMR944/7212, University Paris-Diderot, PRES Paris Cite, Paris (France); Mankoff, David [University of Pennsylvania Perelman School of Medicine, Department of Radiology, Philadelphia (United States); Espie, Marc [INSERM/CNRS UMR944/7212, University Paris-Diderot, PRES Paris Cite, Paris (France); Saint-Louis Hospital, Department of Medical Oncology, Breast Diseases Centre, Paris (France); Hindie, Elif [University of Bordeaux, Department of Nuclear Medicine, Haut-Leveque Hospital, Bordeaux (France)

    2016-05-15

    Early assessment of response to neoadjuvant chemotherapy (NAC) might be helpful in avoiding the toxicity of ineffective chemotherapy and allowing refinement of treatment. We conducted a review of the literature regarding the applicability of {sup 18}F-FDG PET/CT to the prediction of an early pathological response in different subgroups of breast cancer. Clinical research in this field has intensified in the last few years. Early studies by various groups have shown the potential of {sup 18}F-FDG PET/CT in the early assessment of response to NAC. However, interim PET/CT in breast cancer has not yet gained wide acceptance compared to its use in other settings such as lymphomas. This is in part due to a lack of consensus that early evaluation of response can be used to direct change in therapy in the neoadjuvant breast cancer setting, and only limited data showing that response-adaptive therapy leads to improved outcomes. However, one major element that has hampered the use of {sup 18}F-FDG PET/CT in directing neoadjuvant therapy is its evaluation in populations with mixed subtypes of breast cancer. However, major improvements have occurred in recent years. Pilot studies have highlighted the need for considering breast cancer subtype and the type of treatment, and have offered criteria for the use of PET/CT for the early prediction of response in specific settings. {sup 18}F-FDG PET/CT has considerable potential for the early prediction of pathological complete response to NAC in aggressive subtypes such as triple-negative or HER2-positive breast cancers. The results of a multicentre trial that used early metabolic response on {sup 18}F-FDG PET/CT as a means to select poor responders to adapt neoadjuvant treatment have recently been published. Other trials are ongoing or being planned. (orig.)

  6. Pathological responses to terrorism.

    Science.gov (United States)

    Yehuda, Rachel; Bryant, Richard; Marmar, Charles; Zohar, Joseph

    2005-10-01

    Many important gains have been made in understanding PTSD and other responses to trauma as a result of neuroscience-based observations. Yet there are many gaps in our knowledge that currently impede our ability to predict those who will develop pathologic responses. Such knowledge is essential for developing appropriate strategies for mounting a mental health response in the aftermath of terrorism and for facilitating the recovery of individuals and society. This paper reviews clinical and biological studies that have led to an identification of pathologic responses following psychological trauma, including terrorism, and highlights areas of future-research. It is important to not only determine risk factors for the development of short- and long-term mental health responses to terrorism, but also apply these risk factors to the prediction of such responses on an individual level. It is also critical to consider the full spectrum of responses to terrorism, as well as the interplay between biological and psychological variables that contribute to these responses. Finally, it is essential to remove the barriers to collecting data in the aftermath of trauma by creating a culture of education in which the academic community can communicate to the public what is and is not known so that survivors of trauma and terrorism will understand the value of their participation in research to the generation of useful knowledge, and by maintaining the acquisition of knowledge as a priority for the government and those involved in the immediate delivery of services in the aftermath of large-scale disaster or trauma.

  7. Satisfaction with care after total hip or knee replacement predicts self-perceived health status after surgery

    Directory of Open Access Journals (Sweden)

    Mainard Didier

    2009-12-01

    Full Text Available Abstract Background Inpatient satisfaction with care is a standard indicator of the quality of care delivered during hospitalization. Total hip and knee replacement (THR/TKR for osteoarthritis (OA are among the most successful orthopaedic interventions having a positive impact on health-related quality of life (HRQoL. The aim was to evaluate the effect of satisfaction shortly after hospital discharge on 1-month, 6-month and 1-year Medical Outcomes Study 36-item Short Form (SF-36 scores for OA patients after THR and TKR, controlling for patient characteristics, clinical presentation and preoperative SF-36 scores. Methods A multicenter prospective cohort study recruited 231 patients with OA scheduled to receive THR or TKR. Satisfaction was assessed by the Patients Judgment of Hospital Quality (PJHQ questionnaire and HRQoL by the SF-36 questionnaire. Linear models for repeated measures assessed the relation between satisfaction (scores were dichotomized and postoperative SF-36 scores. Results Of 231 participants, 189 were followed up 12 months after discharge (mean age 69 SD = 8; 42.6% male. The mean length of hospital stay was 13.5 (SD = 4 days. After adjustment for preoperative SF-36 scores, sociodemographic and clinical patient characteristics, satisfied patients (PJHQ score > 70 had higher SF-36 scores 1 year after surgery than did less-satisfied patients. Admission, medical care, and nursing and daily care scores mainly predicted bodily pain, mental health, social functioning, vitality and general health scores of the SF-36. Conclusion Besides being a quality-of-care indicator, immediate postoperative patient satisfaction with care may bring a new insight into clinical practice, as a predictor of self-perceived health status after surgery.

  8. Forms of pathologization

    DEFF Research Database (Denmark)

    Brinkmann, Svend

    before, perhaps due to the malaises of modernity. Instead, we have learned to think and talk about human problems in new ways, viz. ways that involve pathologization. Pathologization, however, is not a unitary phenomenon, and the presentation gives an overview of four types of pathologization, which...... disorder, and similar figures are found for many other mental disorders. These figures are striking, but are hard to interpret. This presentation argues in favour of the pathologization thesis, which claims that it cannot be argued in a straightforward manner that we are simply more ill and disordered than...... are called stigmatizing pathologization, self pathologization, risk pathologization and de-pathologization. It is argued that we need a variety of ways of understanding the complex phenomenon of pathologization and that previous critical frameworks (e.g. as promoted by the anti-psychiatry movement) are often...

  9. PI-RADS version 2 for prediction of pathological downgrading after radical prostatectomy: a preliminary study in patients with biopsy-proven Gleason Score 7 (3+4) prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Sungmin; Kim, Sang Youn [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Lee, Joongyub [Seoul National University College of Medicine, Seoul National University Hospital, Division of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institution, Seoul (Korea, Republic of); Kim, Seung Hyup; Cho, Jeong Yeon [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine and Kidney Research Institute, Seoul (Korea, Republic of)

    2016-10-15

    To evaluate PI-RADSv2 for predicting pathological downgrading after radical prostatectomy (RP) in patients with biopsy-proven Gleason score (GS) 7(3+4) PC. A total of 105 patients with biopsy-proven GS 7(3+4) PC who underwent multiparametric prostate MRI followed by RP were included. Two radiologists assigned PI-RADSv2 scores for each patient. Preoperative clinicopathological variables and PI-RADSv2 scores were compared between patients with and without downgrading after RP using the Wilcoxon rank sum test or Fisher's exact test. Logistic regression analyses with Firth's bias correction were performed to assess their association with downgrading. Pathological downgrading was identified in ten (9.5 %) patients. Prostate-specific antigen (PSA), PSA density, percentage of cores with GS 7(3+4), and greatest percentage of core length (GPCL) with GS 7(3+4) were significantly lower in patients with downgrading (p = 0.002-0.037). There was no significant difference in age and clinical stage (p = 0.537-0.755). PI-RADSv2 scores were significantly lower in patients with downgrading (3.8 versus 4.4, p = 0.012). At univariate logistic regression analysis, PSA, PSA density, and PI-RADSv2 scores were significant predictors of downgrading (p = 0.003-0.022). Multivariate analysis revealed only PSA density and PI-RADSv2 scores as independent predictors of downgrading (p = 0.014-0.042). The PI-RADSv2 scoring system was an independent predictor of pathological downgrading after RP in patients with biopsy-proven GS 7(3+4) PC. (orig.)

  10. Nutritional status is superior to the ECOG performance status in predicting the dose-intensity of the GEMOX chemotherapy regimen in patients with advanced cancer.

    Science.gov (United States)

    Cessot, Anatole; Coriat, Romain; Mir, Oliver; Boudou-Rouquette, Pascaline; Giroux, Julie; Durand, Jean-Philippe; Alexandre, Jérôme; Goldwasser, Francois

    2013-01-01

    The increasing number of unfit patients calls for better risk assessment prior to initiating anti-tumor treatment. This is a major concern in the prevention and reduction of treatment-related complications. The aim of our study was to evaluate the nutritional status for the risk assessment of patients qualifying to receive the gemcitabine and oxaliplatin (GEMOX) regimen. This single-center, retrospective study examined baseline clinical and biological characteristics in a cohort of 165 unselected, consecutive cancer patients receiving GEMOX. Malnutrition was defined as either body mass index (BMI) 10% over 3 mo, or albuminemia 0.05). Median relative dose-intensity was 0.90 (0.17-1.04). GEMOX dose-intensity correlated negatively with loss of baseline weight (r = -0.24, P nutritional status, including albuminemia and BMI, is recommended.

  11. Evaluation of tumor-derived MRI-texture features for discrimination of molecular subtypes and prediction of 12-month survival status in glioblastoma

    Science.gov (United States)

    Yang, Dalu; Rao, Ganesh; Martinez, Juan; Veeraraghavan, Ashok; Rao, Arvind

    2015-01-01

    Purpose: Glioblastoma multiforme (GBM) is the most common and aggressive primary brain cancer. Four molecular subtypes of GBM have been described but can only be determined by an invasive brain biopsy. The goal of this study is to evaluate the utility of texture features extracted from magnetic resonance imaging (MRI) scans as a potential noninvasive method to characterize molecular subtypes of GBM and to predict 12-month overall survival status for GBM patients. Methods: The authors manually segmented the tumor regions from postcontrast T1 weighted and T2 fluid-attenuated inversion recovery (FLAIR) MRI scans of 82 patients with de novo GBM. For each patient, the authors extracted five sets of computer-extracted texture features, namely, 48 segmentation-based fractal texture analysis (SFTA) features, 576 histogram of oriented gradients (HOGs) features, 44 run-length matrix (RLM) features, 256 local binary patterns features, and 52 Haralick features, from the tumor slice corresponding to the maximum tumor area in axial, sagittal, and coronal planes, respectively. The authors used an ensemble classifier called random forest on each feature family to predict GBM molecular subtypes and 12-month survival status (a dichotomized version of overall survival at the 12-month time point indicating if the patient was alive or not at 12 months). The performance of the prediction was quantified and compared using receiver operating characteristic (ROC) curves. Results: With the appropriate combination of texture feature set, image plane (axial, coronal, or sagittal), and MRI sequence, the area under ROC curve values for predicting different molecular subtypes and 12-month survival status are 0.72 for classical (with Haralick features on T1 postcontrast axial scan), 0.70 for mesenchymal (with HOG features on T2 FLAIR axial scan), 0.75 for neural (with RLM features on T2 FLAIR axial scan), 0.82 for proneural (with SFTA features on T1 postcontrast coronal scan), and 0.69 for 12

  12. Digital pathology in nephrology clinical trials, research, and pathology practice.

    Science.gov (United States)

    Barisoni, Laura; Hodgin, Jeffrey B

    2017-11-01

    In this review, we will discuss (i) how the recent advancements in digital technology and computational engineering are currently applied to nephropathology in the setting of clinical research, trials, and practice; (ii) the benefits of the new digital environment; (iii) how recognizing its challenges provides opportunities for transformation; and (iv) nephropathology in the upcoming era of kidney precision and predictive medicine. Recent studies highlighted how new standardized protocols facilitate the harmonization of digital pathology database infrastructure and morphologic, morphometric, and computer-aided quantitative analyses. Digital pathology enables robust protocols for clinical trials and research, with the potential to identify previously underused or unrecognized clinically useful parameters. The integration of digital pathology with molecular signatures is leading the way to establishing clinically relevant morpho-omic taxonomies of renal diseases. The introduction of digital pathology in clinical research and trials, and the progressive implementation of the modern software ecosystem, opens opportunities for the development of new predictive diagnostic paradigms and computer-aided algorithms, transforming the practice of renal disease into a modern computational science.

  13. Forensic veterinary pathology, today's situation and perspectives.

    Science.gov (United States)

    Ottinger, T; Rasmusson, B; Segerstad, C H A; Merck, M; Goot, F V D; Olsén, L; Gavier-Widén, D

    2014-11-08

    To investigate the current status of forensic veterinary pathology, a survey was composed directed at pathology laboratories and institutes, mostly in Europe. The questions included number of and type of cases, resources available, level of special training of the investigating pathologists and the general view on the current status and future of the discipline. The surveys were sent to 134 laboratories and were returned by 72 respondents of which 93 per cent work on forensic pathology cases. The results indicate scarcity of training opportunities and special education, and insufficient veterinary-specific reference data and information on forensic analyses. More cooperation with human forensic pathology was desired by many respondents, as was more interaction across country borders. British Veterinary Association.

  14. Which data should be tracked in forward-dynamic optimisation to best predict muscle forces in a pathological co-contraction case?

    Science.gov (United States)

    Bélaise, Colombe; Michaud, Benjamin; Dal Maso, Fabien; Mombaur, Katja; Begon, Mickaël

    2018-01-04

    The choice of the cost-function for predicting muscle forces during a movement remains a challenge, especially in patients with neuromuscular disorders. Forward dynamics-based optimisations mainly track joint kinematics or torques, combined with a least-excitation criterion. Tracking marker trajectories and/or electromyography (EMG) has rarely been proposed. Our objective was to determine the best tracking objective-function to accurately predict the upper-limb muscle forces. A musculoskeletal model was created and EMG was simulated to obtain a reference movement - a shoulder abduction. A Gaussian noise (mean = 0; standard deviation = 15%) was added to the simulated EMG. Another noise - corresponding to the actual soft tissue artefacts (STA) of experimental shoulder abduction movements - was added to the trajectories of the markers placed on the model. Muscle forces were estimated from these noisy data, using forward dynamics assisted by six non-linear least-squared objective-functions. These functions involved the tracking of marker trajectories, joint angles or torques, with and without EMG-tracking. All six approaches used the same musculoskeletal model and were solved using a direct multiple shooting algorithm. Finally, the predicted joint angles, muscle forces and activations were compared to the reference values, using root-mean-square errors (RMSe) and biases. The force RMSe of the approach tracking both marker trajectories and EMG (18.45 ± 12.60 N) was almost five times lower than the one of the approach tracking only joint angles (82.37 ± 66.26 N) or torques (85.10 ± 116.40 N). Therefore, using EMG as a complementary tracking-data in forward dynamics seems to be promising for the estimation of muscle forces. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures

    DEFF Research Database (Denmark)

    Lenzen, Mattie J; Scholte op Reimer, Wilma J M; Pedersen, Susanne S.

    2007-01-01

    Self-perceived health status may be helpful in identifying patients at high risk for adverse outcomes. The Euro Heart Survey on Coronary Revascularization (EHS-CR) provided an opportunity to explore whether impaired health status was a predictor of 1-year mortality in patients with coronary arter...

  16. Preventive Child Health Care Findings on Early Childhood Predict Peer-Group Social Status in Early Adolescence

    NARCIS (Netherlands)

    Jaspers, Merlijne; de Winter, Andrea; Veenstra, René; Ormel, Johan; Verhulst, Frank; Reijneveld, Menno

    2012-01-01

    Purpose: A disputed social status among peers puts children and adolescents at risk for developing a wide range of problems, such as being bullied. However, there is a lack of knowledge about which early predictors could be used to identify (young) adolescents at risk for a disputed social status.

  17. Predictive ability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography for pathological complete response and prognosis after neoadjuvant chemotherapy in triple-negative breast cancer patients

    Directory of Open Access Journals (Sweden)

    Sachiko Kiyoto

    2016-01-01

    Full Text Available Objective The mortality of patients with locally advanced triple-negative breast cancer (TNBC is high, and pathological complete response (pCR to neoadjuvant chemotherapy (NAC is associated with improved prognosis. This retrospective study was designed and powered to investigate the ability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT to predict pathological response to NAC and prognosis after NAC.Methods The data of 32 consecutive women with clinical stage II or III TNBC from January 2006 to December 2013 in our institution who underwent FDG-PET/CT at baseline and after NAC were retrospectively analyzed. The maximum standardized uptake value (SUVmax in the primary tumor at each examination and the change in SUVmax (ΔSUVmax between the two scans were measured. Correlations between PET parameters and pathological response, and correlations between PET parameters and disease-free survival (DFS were examined.Results At the completion of NAC, surgery showed pCR in 7 patients, while 25 had residual tumor, so-called non-pCR. Median follow-up was 39.0 months. Of the non-pCR patients, 9 relapsed at 3 years. Of all assessed clinical, biological, and PET parameters, N-stage, clinical stage, and ΔSUVmax were predictors of pathological response (p=0.0288, 0.0068, 0.0068; Fischer’s exact test. The cut-off value of ΔSUVmax to differentiate pCR evaluated by the receiver operating characteristic (ROC curve analysis was 81.3%. Three-year disease-free survival (DFS was lower in patients with non-pCR than in patients with pCR (p=0.328, log-rank test. The cut-off value of ΔSUVmax to differentiate 3-year DFS evaluated by the ROC analysis was 15.9%. In all cases, 3-year DFS was lower in patients with ΔSUVmax

  18. Pathological jealousy and pathological love: Apples to apples or apples to oranges?

    Science.gov (United States)

    Stravogiannis, Andrea Lorena da C; Kim, Hyoun S; Sophia, Eglacy C; Sanches, Cíntia; Zilberman, Monica L; Tavares, Hermano

    2018-01-01

    Pathological jealousy evokes emotions, thoughts, and behaviors that cause damage to social and interpersonal relationships. On the other hand, pathological love is the uncontrollable behavior of caring for a partner that results in neglecting the needs of the self. The aim of the present research was to assess the similarities and differences between the two psychopathologies of love. To this end, thirty-two individuals with pathological jealousy and 33 individuals with pathological love were compared on demographics, aspects of romantic relationship (jealousy, satisfaction, love style), psychiatric co-morbidities, personality and psychological characteristics (e.g., impulsivity). In a univariate analysis individuals with pathological jealousy were more likely to be in a current relationship and reported greater satisfaction. The avoidant attachment and the ludus love style were associated with pathological jealousy whereas the secure attachment and agape love style was associated with pathological love. Almost three-quarters (72.3%) of the sample met criteria for a current psychiatric disorder, however no differences emerged between the pathological jealousy and pathological love groups. In a binary logistic regression, relationship status and impairments in parenting significantly differentiated the groups. While both pathological jealousy and pathological love share similarities, they also present with unique differences, which may have important treatment implications. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Updates in ophthalmic pathology

    National Research Council Canada - National Science Library

    Grossniklaus, Hans; Mendoza, Pia

    2017-01-01

    ... such as molecular biology and digital pathology. This is an exciting period in the history of ocular pathology, with cutting-edge techniques paving the way for new developments in diagnostics, therapeutics, and research...

  20. Severity of adolescent delinquency among boys with and without attention deficit hyperactivity disorder: predictions from early antisocial behavior and peer status.

    Science.gov (United States)

    Lee, Steve S; Hinshaw, Stephen P

    2004-12-01

    This study evaluated predictors of adolescent delinquency severity (11 to 17 years of age) among a diverse group of preadolescent boys with attention deficit hyperactivity disorder (ADHD; n=100) and age-matched comparison boys (n=75). During childhood, baseline assessments yielded diagnostic information, and naturalistic summer programs provided multimethod measures of overt aggression, covert antisocial behavior (ASB), and peer status. Five years later, multi-informant measures of ASB and delinquency were gathered and independently rated. Baseline ADHD, overt aggression, and peer status were not significantly related to adolescent delinquency severity. Observed noncompliance and an objective measure of covert ASB each independently predicted delinquency. Covert ASB predicted delinquency severity more strongly for comparison boys than for probands.

  1. Pretreatment CD133 and cyclooxygenase-2 expression as the predictive markers of the pathological effect of chemoradiotherapy in rectal cancer patients.

    Science.gov (United States)

    Shinto, Eiji; Hashiguchi, Yojiro; Ueno, Hideki; Kobayashi, Hirotoshi; Ishiguro, Megumi; Mochizuki, Hidetaka; Yamamoto, Junji; Hase, Kazuo

    2011-09-01

    CD133 confers chemoradioresistance properties to cells and has recently been used to identify cancer-initiating cells. We investigated whether the overexpression of CD133 and cyclooxygenase-2 can be used as predictive markers of tumor response to preoperative chemoradiotherapy in patients with rectal cancer. The study was conducted at the National Defense Medical College Hospital in Japan. We recruited 96 patients who underwent a single regimen of preoperative short-term chemoradiotherapy (20 Gy in 5 fractions with 400 mg/day Tegafur/Uracil for 1 week) and radical resection. This was a retrospective study. We obtained pretreatment biopsy specimens of these patients and immunostained these specimens with antibodies for CD133, cyclooxygenase-2, p53, p27, p21, and epidermal growth factor receptor. The resected primary tumor was evaluated according to 2 different tumor regression grading systems that were based on the degrees of fibrosis and cytological alterations. Positivity for CD133 or cyclooxygenase-2 expression was associated with chemoradioresistance, which was determined by the degree of fibrosis, in both univariate (P = .02 and P = .0003) and multivariate (P = .03 and P = .001) analyses. Univariate and multivariate analyses of the degree of cytological alterations also revealed a significant association between chemoradioresistance and the expression of CD133 (P = .005 and P = .003) and cyclooxygenase-2 (P = .005 and P = .03), whereas other markers failed to associate. The information on patients' outcome was not available. Our study revealed the independent predictive values of CD133 and cyclooxygenase-2 expressions in histological tumor regression after preoperative chemoradiotherapy.

  2. Updates of pathologic myopia.

    Science.gov (United States)

    Ohno-Matsui, Kyoko; Lai, Timothy Y Y; Lai, Chi-Chun; Cheung, Chiu Ming Gemmy

    2016-05-01

    Complications from pathologic myopia are a major cause of visual impairment and blindness, especially in east Asia. The eyes with pathologic myopia may develop loss of the best-corrected vision due to various pathologies in the macula, peripheral retina and the optic nerve. Despite its importance, the definition of pathologic myopia has been inconsistent. The refractive error or axial length alone often does not adequately reflect the 'pathologic myopia'. Posterior staphyloma, which is a hallmark lesion of pathologic myopia, can occur also in non-highly myopic eyes. Recently a revised classification system for myopic maculopathy has been proposed to standardize the definition among epidemiological studies. In this META-PM (meta analyses of pathologic myopia) study classification, pathologic myopia was defined as the eyes having chorioretinal atrophy equal to or more severe than diffuse atrophy. In addition, the advent of new imaging technologies such as optical coherence tomography (OCT) and three dimensional magnetic resonance imaging (3D MRI) has enabled the detailed observation of various pathologies specific to pathologic myopia. New therapeutic approaches including intravitreal injections of anti-vascular endothelial growth factor agents and the advance of vitreoretinal surgeries have greatly improved the prognosis of patients with pathologic myopia. The purpose of this review article is to provide an update on topics related to the field of pathologic myopia, and to outline the remaining issues which need to be solved in the future. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Prediction of HER2 gene status in Her2 2+ invasive breast cancer: a study of 108 cases comparing ASCO/CAP and FDA recommendations.

    Science.gov (United States)

    Chibon, Frédéric; de Mascarel, Isabelle; Sierankowski, Ghislaine; Brouste, Véronique; Bonnefoi, Hervé; Debled, Marc; Mauriac, Louis; MacGrogan, Gaëtan

    2009-03-01

    Most Her2 testing guidelines recommend that all cases scoring Her2 2+ by immunohistochemistry should be analyzed by fluorescent in situ hybridization (FISH) to determine HER2 status to confirm eligibility for Trastuzumab therapy in breast cancer. The aim of our study was to determine HER2 gene and chromosome 17 (CEN17) status in a series of 108 Her2 2+ consecutive cases and study the correlation between pathological characteristics of the tumors and HER2 amplification. Invasive breast cancers were tested by FISH using the Dako HER2 FISH pharmDx kit. The Her2 immunohistochemistry protocol was performed using the polyclonal AO485 antibody (Dako) diluted to 1:1500. HER2 and CEN17 status were correlated to tumor SBR grade, mitotic count, estrogen receptor, progesterone receptor status and percentage of Her2 immunohistochemistry-positive cells. Following Food and Drug Administration guidelines, ie, HER2/CEN17 ratio >or=2 and an HER2 copy number >4, amplified cases were observed in 36 (33%) and 49 (45%) cases, respectively, and following American Society of Clinical Oncology/College of American Pathologists guidelines, ie, HER2/CEN17 ratio >2.2 and an HER2 copy number >6, amplified cases represented 30 and 24% of the study population, respectively. Chromosome 17 polysomy (CEN17 >2.25) was observed in 39 (36%) tumors. Significant positive correlations were found between FISH HER2 amplified cases and Her2 immunostaining >60% (P=1.1.10(-5)), SBR grade 3 (P=0.0001), nuclear atypia (P=0.03) and mitotic count (P=0.008). By multivariate analysis, Her2 immunostaining >60% (Por=2, only one had a ratio Pathological factors, in particular SBR grade 3 and more than 60% Her2+ cells, were significantly correlated with HER2 amplification.

  4. Zinc, gravida, infection, and iron, but not vitamin B-12 or folate status, predict hemoglobin during pregnancy in Southern Ethiopia

    National Research Council Canada - National Science Library

    Gibson, Rosalind S; Abebe, Yewelsew; Stabler, Sally; Allen, Robert H; Westcott, Jamie E; Stoecker, Barbara J; Krebs, Nancy F; Hambidge, K Michael

    2008-01-01

    ...) or fermented enset (Enset ventricosum) (n = 31) as their major energy source. Blood samples were analyzed for a complete blood count, vitamin B-12 and folate status, plasma ferritin, retinol, zinc, albumin, and C-reactive protein (CRP...

  5. Maternal Nutritional Status Predicts Adverse Birth Outcomes among HIV-Infected Rural Ugandan Women Receiving Combination Antiretroviral Therapy

    OpenAIRE

    Sera Young; Katherine Murray; Julia Mwesigwa; Paul Natureeba; Beth Osterbauer; Jane Achan; Emmanuel Arinaitwe; Tamara Clark; Veronica Ades; Albert Plenty; Edwin Charlebois; Theodore Ruel; Moses Kamya; Diane Havlir; Deborah Cohan

    2012-01-01

    Objective Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART). We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG), and hemoglobin concentration (Hb) among 166 women initiating cART in rural Uganda. Design Prospective cohort. Methods HIV-infected, ART-naïve pregnant women were enro...

  6. Pathological video-game use among youth ages 8 to 18: a national study.

    Science.gov (United States)

    Gentile, Douglas

    2009-05-01

    Researchers have studied whether some youth are "addicted" to video games, but previous studies have been based on regional convenience samples. Using a national sample, this study gathered information about video-gaming habits and parental involvement in gaming, to determine the percentage of youth who meet clinical-style criteria for pathological gaming. A Harris poll surveyed a randomly selected sample of 1,178 American youth ages 8 to 18. About 8% of video-game players in this sample exhibited pathological patterns of play. Several indicators documented convergent and divergent validity of the results: Pathological gamers spent twice as much time playing as nonpathological gamers and received poorer grades in school; pathological gaming also showed comorbidity with attention problems. Pathological status significantly predicted poorer school performance even after controlling for sex, age, and weekly amount of video-game play. These results confirm that pathological gaming can be measured reliably, that the construct demonstrates validity, and that it is not simply isomorphic with a high amount of play.

  7. Pathological complete response after neoadjuvant chemotherapy is an independent predictive factor irrespective of simplified breast cancer intrinsic subtypes: a landmark and two-step approach analyses from the EORTC 10994/BIG 1-00 phase III trial.

    Science.gov (United States)

    Bonnefoi, H; Litière, S; Piccart, M; MacGrogan, G; Fumoleau, P; Brain, E; Petit, T; Rouanet, P; Jassem, J; Moldovan, C; Bodmer, A; Zaman, K; Cufer, T; Campone, M; Luporsi, E; Malmström, P; Werutsky, G; Bogaerts, J; Bergh, J; Cameron, D A

    2014-06-01

    Pathological complete response (pCR) following chemotherapy is strongly associated with both breast cancer subtype and long-term survival. Within a phase III neoadjuvant chemotherapy trial, we sought to determine whether the prognostic implications of pCR, TP53 status and treatment arm (taxane versus non-taxane) differed between intrinsic subtypes. Patients were randomized to receive either six cycles of anthracycline-based chemotherapy or three cycles of docetaxel then three cycles of eprirubicin/docetaxel (T-ET). pCR was defined as no evidence of residual invasive cancer (or very few scattered tumour cells) in primary tumour and lymph nodes. We used a simplified intrinsic subtypes classification, as suggested by the 2011 St Gallen consensus. Interactions between pCR, TP53 status, treatment arm and intrinsic subtype on event-free survival (EFS), distant metastasis-free survival (DMFS) and overall survival (OS) were studied using a landmark and a two-step approach multivariate analyses. Sufficient data for pCR analyses were available in 1212 (65%) of 1856 patients randomized. pCR occurred in 222 of 1212 (18%) patients: 37 of 496 (7.5%) luminal A, 22 of 147 (15%) luminal B/HER2 negative, 51 of 230 (22%) luminal B/HER2 positive, 43 of 118 (36%) HER2 positive/non-luminal, 69 of 221(31%) triple negative (TN). The prognostic effect of pCR on EFS did not differ between subtypes and was an independent predictor for better EFS [hazard ratio (HR) = 0.40, P analysis. EORTC 10994/BIG 1-00 Trial registration number NCT00017095. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  8. Microscopic Disease Extension in Three Dimensions for Non-Small-Cell Lung Cancer: Development of a Prediction Model Using Pathology-Validated Positron Emission Tomography and Computed Tomography Features

    Energy Technology Data Exchange (ETDEWEB)

    Loon, Judith van, E-mail: Judith.vanloon@maastro.nl [Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands); Siedschlag, Christian; Stroom, Joep [Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Blauwgeers, Hans [Department of Pathology, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Suylen, Robert-Jan van [Department of Pathology, Maastricht University Medical Centre, Maastricht (Netherlands); Knegjens, Joost; Rossi, Maddalena [Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Baardwijk, Angela van; Boersma, Liesbeth [Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands); Klomp, Houke [Department of Thoracic Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Vogel, Wouter [Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Burgers, Sjaak [Department of Pulmonology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Gilhuijs, Kenneth [Department of Radiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

    2012-01-01

    Purpose: One major uncertainty in radiotherapy planning of non-small-cell lung cancer concerns the definition of the clinical target volume (CTV), meant to cover potential microscopic disease extension (MDE) around the macroscopically visible tumor. The primary aim of this study was to establish pretreatment risk factors for the presence of MDE. The secondary aim was to establish the impact of these factors on the accuracy of positron emission tomography (PET) and computed tomography (CT) to assess the total tumor-bearing region at pathologic examination (CTV{sub path}). Methods and Materials: 34 patients with non-small-cell lung cancer who underwent CT and PET before lobectomy were included. Specimens were examined microscopically for MDE. The gross tumor volume (GTV) on CT and PET (GTV{sub CT} and GTV{sub PET}, respectively) was compared with the GTV and the CTV at pathologic examination, tissue deformations being taken into account. Using multivariate logistic regression, image-based risk factors for the presence of MDE were identified, and a prediction model was developed based on these factors. Results: MDE was found in 17 of 34 patients (50%). The MDE did not exceed 26 mm in 90% of patients. In multivariate analysis, two parameters (mean CT tumor density and GTV{sub CT}) were significantly associated with MDE. The area under the curve of the two-parameter prediction model was 0.86. Thirteen tumors (38%, 95% CI: 24-55%) were identified as low risk for MDE, being potential candidates for reduced-intensity therapy around the GTV. In the low-risk group, the effective diameter of the GTV{sub CT/PET} accurately represented the CTV{sub path}. In the high-risk group, GTV{sub CT/PET} underestimated the CTV{sub path} with, on average, 19.2 and 26.7 mm, respectively. Conclusions: CT features have potential to predict the presence of MDE. Tumors identified as low risk of MDE show lower rates of disease around the GTV than do high-risk tumors. Both CT and PET accurately

  9. Predicting cross-reactive immunological material (CRIM) status in Pompe disease using GAA mutations: lessons learned from 10 years of clinical laboratory testing experience.

    Science.gov (United States)

    Bali, Deeksha S; Goldstein, Jennifer L; Banugaria, Suhrad; Dai, Jian; Mackey, Joanne; Rehder, Catherine; Kishnani, Priya S

    2012-02-15

    Enzyme replacement therapy (ERT) for Pompe disease using recombinant acid alpha-glucosidase (rhGAA) has resulted in increased survival although the clinical response is variable. Cross-reactive immunological material (CRIM)-negative status has been recognized as a poor prognostic factor. CRIM-negative patients make no GAA protein and develop sustained high antibody titers to ERT that render the treatment ineffective. Antibody titers are generally low for the majority of CRIM-positive patients and there is typically a better clinical outcome. Because immunomodulation has been found to be most effective in CRIM-negative patients prior to, or shortly after, initiation of ERT, knowledge of CRIM status is important before ERT is begun. We have analyzed 243 patients with infantile Pompe disease using a Western blot method for determining CRIM status and using cultured skin fibroblasts. Sixty-one out of 243 (25.1%) patients tested from various ethnic backgrounds were found to be CRIM-negative. We then correlated the CRIM results with GAA gene mutations where available (52 CRIM-negative and 88 CRIM-positive patients). We found that, in most cases, CRIM status can be predicted from GAA mutations, potentially circumventing the need for invasive skin biopsy and time wasted in culturing cells in the future. Continued studies in this area will help to increase the power of GAA gene mutations in predicting CRIM status as well as possibly identifying CRIM-positive patients who are at risk for developing high antibody titers. Copyright © 2012 Wiley Periodicals, Inc.

  10. Post-treatment PET/CT and p16 status for predicting treatment outcomes in locally advanced head and neck cancer after definitive radiation

    Energy Technology Data Exchange (ETDEWEB)

    Awan, Musaddiq J.; Machtay, Mitchell; Yao, Min [Case Western Reserve University and University Hospitals, Department of Radiation Oncology, Cleveland, OH (United States); Lavertu, Pierre; Zender, Chad; Rezaee, Rod; Fowler, Nicole [University Hospitals, Department of Otolaryngology and Head and Neck Surgery, Cleveland, OH (United States); Karapetyan, Lilit; Gibson, Michael [University Hospitals, Department of Medical Oncology, Cleveland, OH (United States); Wasman, Jay [University Hospitals, Department of Pathology, Cleveland, OH (United States); Faulhaber, Peter [University Hospitals, Department of Nuclear Medicine and Radiology, Cleveland, OH (United States)

    2017-06-15

    To retrospectively review post-treatment (post-tx) FDG-PET/CT scans in patients with advanced head and neck squamous cell carcinoma (HNSCC) and known p16 status, treated with definitive (chemo)radiation (RT). A total of 108 eligible patients had N2A or greater HNSCC treated with chemoRT from August 1, 2008, to February 28, 2015, with post-tx PET/CT within 6 months after RT. Kaplan-Meier curves, log-rank statistics, and Cox proportional hazards regression were used for statistical analysis. Median follow-up was 2.38 years. Sixty-eight (63.0%) patients had p16+ and 40 (37.0%) had p16- status. Two-year overall survival and recurrence-free survival were 93.4% and 77.8%, respectively. The negative predictive value (NPV) of PET/CT for local recurrence (LR) was 100%. The NPV for regional recurrence (RR) was 96.5% for all patients, 100% for p16+ patients, and 88.5% for p16- patients. The positive predictive value (PPV) of PET/CT for recurrence was 77.3% for all patients, 50.0% for p16+, and 78.6% for p16-. The PPV for LR was 72.7% for all patients, 50.0% for p16+ patients, and 72.7% for p16- patients. The PPV for RR was 50.0% for all patients, 33% for p16+, and 66.6% for p16-. Post-tx PET/CT and p16 status were independent predictors of recurrence-free survival (p < 0.01). Post-tx PET/CT predicts treatment outcomes in both p16 + and p16- patients, and does so independently of p16 status. P16- patients with negative PET have a 10% risk of nodal recurrence, and closer follow-up in these patients is warranted. (orig.)

  11. Pathological video-gaming among Singaporean youth.

    Science.gov (United States)

    Choo, Hyekyung; Gentile, Douglas A; Sim, Timothy; Li, Dongdong; Khoo, Angeline; Liau, Albert K

    2010-11-01

    Increase in internet use and video-gaming contributes to public concern on pathological or obsessive play of video games among children and adolescents worldwide. Nevertheless, little is known about the prevalence of pathological symptoms in video-gaming among Singaporean youth and the psychometric properties of instruments measuring pathological symptoms in video-gaming. A total of 2998 children and adolescents from 6 primary and 6 secondary schools in Singapore responded to a comprehensive survey questionnaire on sociodemographic characteristics, video-gaming habits, school performance, somatic symptoms, various psychological traits, social functioning and pathological symptoms of video-gaming. After weighting, the survey data were analysed to determine the prevalence of pathological video-gaming among Singaporean youth and gender differences in the prevalence. The construct validity of instrument used to measure pathological symptoms of video-gaming was tested. Of all the study participants, 8.7% were classified as pathological players with more boys reporting more pathological symptoms than girls. All variables, including impulse control problem, social competence, hostility, academic performance, and damages to social functioning, tested for construct validity, were significantly associated with pathological status, providing good evidence for the construct validity of the instrument used. The prevalence rate of pathological video-gaming among Singaporean youth is comparable with that from other countries studied thus far, and gender differences are also consistent with the findings of prior research. The positive evidence of construct validity supports the potential use of the instrument for future research and clinical screening on Singapore children and adolescents' pathological video-gaming.

  12. PI-RADS version 2 for prediction of pathological downgrading after radical prostatectomy: a preliminary study in patients with biopsy-proven Gleason Score 7 (3+4) prostate cancer.

    Science.gov (United States)

    Woo, Sungmin; Kim, Sang Youn; Lee, Joongyub; Kim, Seung Hyup; Cho, Jeong Yeon

    2016-10-01

    To evaluate PI-RADSv2 for predicting pathological downgrading after radical prostatectomy (RP) in patients with biopsy-proven Gleason score (GS) 7(3+4) PC. A total of 105 patients with biopsy-proven GS 7(3+4) PC who underwent multiparametric prostate MRI followed by RP were included. Two radiologists assigned PI-RADSv2 scores for each patient. Preoperative clinicopathological variables and PI-RADSv2 scores were compared between patients with and without downgrading after RP using the Wilcoxon rank sum test or Fisher's exact test. Logistic regression analyses with Firth's bias correction were performed to assess their association with downgrading. Pathological downgrading was identified in ten (9.5 %) patients. Prostate-specific antigen (PSA), PSA density, percentage of cores with GS 7(3+4), and greatest percentage of core length (GPCL) with GS 7(3+4) were significantly lower in patients with downgrading (p = 0.002-0.037). There was no significant difference in age and clinical stage (p = 0.537-0.755). PI-RADSv2 scores were significantly lower in patients with downgrading (3.8 versus 4.4, p = 0.012). At univariate logistic regression analysis, PSA, PSA density, and PI-RADSv2 scores were significant predictors of downgrading (p = 0.003-0.022). Multivariate analysis revealed only PSA density and PI-RADSv2 scores as independent predictors of downgrading (p = 0.014-0.042). The PI-RADSv2 scoring system was an independent predictor of pathological downgrading after RP in patients with biopsy-proven GS 7(3+4) PC. • PI-RADSv2 was an independent predictor of downgrading in biopsy-proven GS 7(3+4) PC • PSA density was also an independent predictor of downgrading • MRI may assist in identifying AS candidates in biopsy-proven GS 7(3+4) PC patients.

  13. Does Child Maltreatment Predict Adult Crime? Reexamining the Question in a Prospective Study of Gender Differences, Education, and Marital Status.

    Science.gov (United States)

    Jung, Hyunzee; Herrenkohl, Todd I; Klika, J Bart; Lee, Jungeun Olivia; Brown, Eric C

    2015-08-01

    Bivariate analyses of adult crime and child maltreatment showed that individuals who had been maltreated as children, according to child welfare reports, subsequently committed more crime than others who had not been maltreated. Analyses of crimes by category-property, person, and society-provided further evidence of a link between child maltreatment and crime at the bivariate level. Tests of gender differences showed that crime generally is more prevalent among males, although females with a history of maltreatment were more likely than those in a no-maltreatment (comparison) group to report having had some prior involvement in crime. Surprisingly, multivariate analyses controlling for childhood socioeconomic status, gender, minority racial status, marital status, and education level showed that, with one exception (crimes against society), the significant association between child maltreatment and crime observed in bivariate tests was not maintained. Implications for future research are discussed. © The Author(s) 2014.

  14. Role of [{sup 18}F]FDG PET in prediction of KRAS and EGFR mutation status in patients with advanced non-small-cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Caicedo, Carlos; Garcia-Velloso, Maria Jose; Vigil Diaz, Carmen; Richter Echevarria, Jose Angel [University of Navarra, Nuclear Medicine Department, University Clinic of Navarra, Pamplona (Spain); Lozano, Maria Dolores; Labiano, Tania [University of Navarra, Pathology Department, University Clinic of Navarra, Pamplona (Spain); Lopez-Picazo, Jose Maria; Gurpide, Alfonso; Perez Gracia, Jose Luis [University of Navarra, Oncology Department, University Clinic of Navarra, Pamplona (Spain); Zulueta, Javier [University of Navarra, Pulmonology Department, University Clinic of Navarra, Pamplona (Spain)

    2014-11-15

    The tumour molecular profile predicts the activity of epidermal growth factor receptor (EGFR) inhibitors in non-small-cell lung cancer (NSCLC). However, tissue availability and tumour heterogeneity limit its assessment. We evaluated whether [{sup 18}F]FDG PET might help predict KRAS and EFGR mutation status in NSCLC. Between January 2005 and October 2011, 340 NSCLC patients were tested for KRAS and EGFR mutation status. We identified patients with stage III and IV disease who had undergone [{sup 18}F]FDG PET/CT scanning for initial staging. SUVpeak, SUVmax and SUVmean of the single hottest tumour lesions were calculated, and their association with KRAS and EGFR mutation status was assessed. A receiver operator characteristic (ROC) curve analysis and a multivariate analysis (including SUVmean, gender, age and AJCC stage) were performed to identify the potential value of [{sup 18}F]FDG PET/CT for predicting KRAS mutation. From 102 patients staged using [{sup 18}F]FDG PET/CT, 28 (27 %) had KRAS mutation (KRAS+), 22 (22 %) had EGFR mutation (EGFR+) and 52 (51 %) had wild-type KRAS and EGFR profiles (WT). KRAS+ patients showed significantly higher [{sup 18}F]FDG uptake than EGFR+ and WT patients (SUVmean 9.5, 5.7 and 6.6, respectively; p < 0.001). No significant differences were observed in [{sup 18}F]FDG uptake between EGFR+ patients and WT patients. ROC curve analysis for KRAS mutation status discrimination yielded an area under the curve of 0.740 for SUVmean (p < 0.001). The multivariate analysis showed a sensitivity and specificity of 78.6 % and 62.2 %, respectively, and the AUC was 0.773. NSCLC patients with tumours harbouring KRAS mutations showed significantly higher [{sup 18}F]FDG uptake than WT patients, as assessed in terms of SUVpeak, SUVmax and SUVmean. A multivariate model based on age, gender, AJCC stage and SUVmean might be used as a predictive marker of KRAS mutation status in patients with stage III or IV NSCLC. (orig.)

  15. Prostate Cancer Antigen 3 Score Does Not Predict for Adverse Pathologic Features at Radical Prostatectomy or for Progression-free Survival in Clinically Localized, Intermediate- and High-risk Prostate Cancer.

    Science.gov (United States)

    Hegde, John V; Veruttipong, Darlene; Said, Jonathan W; Reiter, Robert E; Steinberg, Michael L; King, Christopher R; Kishan, Amar U

    2017-09-01

    To evaluate whether preoperative urinary prostate cancer antigen 3 (PCA3) scores predict for adverse pathologic features (APFs) or progression-free survival (PFS) in men with intermediate- or high-risk prostate cancer (PCa) undergoing radical prostatectomy (RP). One hundred nine men with intermediate- (n = 52) or high-risk (n = 57) PCa who underwent RP were retrospectively identified. Logistic regression analysis was performed to evaluate the association of PCA3 score with various APFs (eg, extracapsular extension, seminal vesicle invasion, etc.). Among 78 men with ≥1 year of follow-up, the association between PCA3 score and PFS was assessed using Cox regression analysis. At RP, 52% of patients had at least 1 APF, and with median follow-up of 2.3 years, overall 3-year PFS was 70%. PCA3 was not a significant predictor of any APF on multivariate analysis (MVA), whereas canonical predictors (eg, biopsy Gleason score and initial prostate-specific antigen) remained predictive of various APFs. No significant predictors for PFS were found on MVA, although certain canonical predictors (eg, National Comprehensive Cancer Network risk group) were significant predictors of PFS on univariate analysis (UVA). PCA3 score was not a significant predictor of PFS on either UVA or MVA. Unlike in lower risk cohorts, increasing PCA3 score was not associated with any APF in this higher risk cohort, despite enrichment for APFs, nor was it associated with PFS. Notably, multiple known preoperative predictors for APFs were significant on MVA, and multiple predictors were associated with PFS on UVA. Therefore, PCA3 may not be a useful adjunct predictive marker in men with intermediate- or high-risk PCa. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. A low bioimpedance phase angle predicts a higher mortality and lower nutritional status in chronic dialysis patients

    Science.gov (United States)

    Dumler Md, Francis

    2010-04-01

    Bioelectrical impedance analysis is an established technique for body composition analysis. The phase angle parameter, an index of body cell mass, tissue hydration, and membrane integrity, makes it suitable for assessing nutritional status and survivability. We evaluated the significance of a low phase angle value on nutritional status and mortality in 285 chronic dialysis patients during a longitudinal prospective observational study. Patients in the lower phase angle tertile had decreased body weight, body mass index, fat free mass, body cell mass, and lower serum albumin concentrations than those in the higher tertile (Prisk for malnutrition and increased mortality.

  17. Chemical shift effect predicting lymph node status in rectal cancer using high-resolution MR imaging with node-for-node matched histopathological validation

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Hongmei; Zhang, Chongda; Ye, Feng; Liu, Yuan; Zhou, Chunwu [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China); Zheng, Zhaoxu [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Colorectal Oncology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China); Zou, Shuangmei [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Pathology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China)

    2017-09-15

    To evaluate the value of the chemical shift effect (CSE) as well as other criteria for the prediction of lymph node status. Twenty-nine patients who underwent radical surgery of rectal cancers were studied with pre- and postoperative specimen MRI. Lymph nodes were harvested from transverse whole-mount specimens and compared with in vivo and ex vivo images to obtain a precise slice-for-section match. Preoperative MR characteristics including CSE, as well as other predictors, were evaluated by two readers independently between benign and metastatic nodes. A total of 255 benign and 35 metastatic nodes were obtained; 71.4% and 69.4% of benign nodes were detected with regular CSE for two readers, whereas 80.0% and 74.3% of metastatic nodes with absence of CSE. The CSE rendered areas under the ROC curve (AUC) of 0.879 and 0.845 for predicting nodal status for two readers. The criteria of nodal location, border, signal intensity and minimum distance to the rectal wall were also useful but with AUCs (0.629-0.743) lower than those of CSE. CSE is a reliable predictor for differentiating benign from metastatic nodes. Additional criteria should be taken into account when it is difficult to determine the nodal status by using only a single predictor. (orig.)

  18. Factors Predictive of the Status of Sentinel Lymph Nodes in Melanoma Patients from a Large Multicenter Database

    NARCIS (Netherlands)

    White, Richard L.; Ayers, Gregory D.; Stell, Virginia H.; Ding, Shouluan; Gershenwald, Jeffrey E.; Salo, Jonathan C.; Pockaj, Barbara A.; Essner, Richard; Faries, Mark; Charney, Kim James; Avisar, Eli; Hauschild, Axel; Egberts, Friederike; Averbook, Bruce J.; Garberoglio, Carlos A.; Vetto, John T.; Ross, Merrick I.; Chu, David; Trisal, Vijay; Hoekstra, Harald; Whitman, Eric; Wanebo, Harold J.; DeBonis, Daniel; Vezeridis, Michael; Chevinsky, Aaron; Kashani-Sabet, Mohammed; Shyr, Yu; Berry, Lynne; Zhao, Zhiguo; Soong, Seng-jaw; Leong, Stanley P. L.

    2011-01-01

    Numerous predictive factors for cutaneous melanoma metastases to sentinel lymph nodes have been identified; however, few have been found to be reproducibly significant. This study investigated the significance of factors for predicting regional nodal disease in cutaneous melanoma using a large

  19. Prediction

    CERN Document Server

    Sornette, Didier

    2010-01-01

    This chapter first presents a rather personal view of some different aspects of predictability, going in crescendo from simple linear systems to high-dimensional nonlinear systems with stochastic forcing, which exhibit emergent properties such as phase transitions and regime shifts. Then, a detailed correspondence between the phenomenology of earthquakes, financial crashes and epileptic seizures is offered. The presented statistical evidence provides the substance of a general phase diagram for understanding the many facets of the spatio-temporal organization of these systems. A key insight is to organize the evidence and mechanisms in terms of two summarizing measures: (i) amplitude of disorder or heterogeneity in the system and (ii) level of coupling or interaction strength among the system's components. On the basis of the recently identified remarkable correspondence between earthquakes and seizures, we present detailed information on a class of stochastic point processes that has been found to be particu...

  20. Comparison of Neural Network and Linear Regression Models in Statistically Predicting Mental and Physical Health Status of Breast Cancer Survivors

    Science.gov (United States)

    2015-07-15

    emotional status, diet and exercise , fear of recurrence, fatigue, dizziness, urinary incontinence, lymphedema, children in the home, and number of...Nash J, Trask P. 2009. Exercise and relaxation intervention for breast cancer survivors: feasibility, acceptability and effects. Psychooncology 18:258...psychological symptoms endorsed were depressive symptoms, anxiety , pain, and fatigue; however, sleep problems, sexual difficulties, and cognitive

  1. Predicting acceptance and popularity in early adolescence as a function of hearing status, gender, and educational setting

    NARCIS (Netherlands)

    Wolters, N.; Knoors, H.E.T.; Cillessen, A.H.N.; Verhoeven, L.T.W.

    2011-01-01

    This study examined associations of communicative skills, social behavior, and personality with acceptance and popularity as a function of hearing status, gender, and educational setting. Participants were 87 deaf and 672 hearing early adolescents of 52 6th grade classrooms in mainstream and special

  2. Social Support and Socioeconomic Status Predict Secondary Students' Grades and Educational Plans Indifferently across Immigrant Group and Gender

    Science.gov (United States)

    Ulriksen, Robin; Sagatun, Åse; Zachrisson, Henrik Daae; Waaktaar, Trine; Lervåg, Arne Ola

    2015-01-01

    Social support and socioeconomic status (SES) have received considerable attention in explaining academic achievement and the achievement gap between students with ethic majority and immigrant background, and between boys and girls. Using a Structural Equation Modeling approach we examine (1) if there exist a gap in school achievements between…

  3. Predicting Acceptance and Popularity in Early Adolescence as a Function of Hearing Status, Gender, and Educational Setting

    Science.gov (United States)

    Wolters, Nina; Knoors, Harry E. T.; Cillessen, Antonius H. N.; Verhoeven, Ludo

    2011-01-01

    This study examined associations of communicative skills, social behavior, and personality with acceptance and popularity as a function of hearing status, gender, and educational setting. Participants were 87 deaf and 672 hearing early adolescents of 52 6th grade classrooms in mainstream and special education. Acceptance varied as a function of…

  4. Does English Language Learner (ELL) Identification Predict College Remediation Designation? A Comparison by Race and Ethnicity, and ELL Waiver Status

    Science.gov (United States)

    Flores, Stella M.; Drake, Timothy A.

    2014-01-01

    Using individual-level longitudinal state administrative data, this analysis examines whether English language learner (ELL) status increases the likelihood of being designated as needing college remediation. We track a cohort of ELL and non-ELL students from first grade to college entry and investigate whether there are differences in students'…

  5. Latino Maternal Literacy Beliefs and Practices Mediating Socioeconomic Status and Maternal Education Effects in Predicting Child Receptive Vocabulary

    Science.gov (United States)

    Gonzalez, Jorge E.; Acosta, Sandra; Davis, Heather; Pollard-Durodola, Sharolyn; Saenz, Laura; Soares, Denise; Resendez, Nora; Zhu, Leina

    2017-01-01

    Research Findings: This study investigated the association between Mexican American maternal education and socioeconomic status (SES) and child vocabulary as mediated by parental reading beliefs, home literacy environment (HLE), and parent-child shared reading frequency. As part of a larger study, maternal reports of education level, SES, HLE, and…

  6. Beyond Initial Encoding: Measures of the Post-Encoding Status of Memory Traces Predict Long-Term Recall during Infancy

    Science.gov (United States)

    Pathman, Thanujeni; Bauer, Patricia J.

    2013-01-01

    The first years of life are witness to rapid changes in long-term recall ability. In the current research we contributed to an explanation of the changes by testing the absolute and relative contributions to long-term recall of encoding and post-encoding processes. Using elicited imitation, we sampled the status of 16-, 20-, and 24-month-old…

  7. Misperceived pre-pregnancy body weight status predicts excessive gestational weight gain: findings from a US cohort study

    Directory of Open Access Journals (Sweden)

    Rifas-Shiman Sheryl L

    2008-12-01

    Full Text Available Abstract Background Excessive gestational weight gain promotes poor maternal and child health outcomes. Weight misperception is associated with weight gain in non-pregnant women, but no data exist during pregnancy. The purpose of this study was to examine the association of misperceived pre-pregnancy body weight status with excessive gestational weight gain. Methods At study enrollment, participants in Project Viva reported weight, height, and perceived body weight status by questionnaire. Our study sample comprised 1537 women who had either normal or overweight/obese pre-pregnancy BMI. We created 2 categories of pre-pregnancy body weight status misperception: normal weight women who identified themselves as overweight ('overassessors' and overweight/obese women who identified themselves as average or underweight ('underassessors'. Women who correctly perceived their body weight status were classified as either normal weight or overweight/obese accurate assessors. We performed multivariable logistic regression to determine the odds of excessive gestational weight gain according to 1990 Institute of Medicine guidelines. Results Of the 1029 women with normal pre-pregnancy BMI, 898 (87% accurately perceived and 131 (13% overassessed their weight status. 508 women were overweight/obese, of whom 438 (86% accurately perceived and 70 (14% underassessed their pre-pregnancy weight status. By the end of pregnancy, 823 women (54% gained excessively. Compared with normal weight accurate assessors, the adjusted odds of excessive gestational weight gain was 2.0 (95% confidence interval [CI]: 1.3, 3.0 in normal weight overassessors, 2.9 (95% CI: 2.2, 3.9 in overweight/obese accurate assessors, and 7.6 (95% CI: 3.4, 17.0 in overweight/obese underassessors. Conclusion Misperceived pre-pregnancy body weight status was associated with excessive gestational weight gain among both normal weight and overweight/obese women, with the greatest likelihood of excessive

  8. Handheld computing in pathology

    Directory of Open Access Journals (Sweden)

    Seung Park

    2012-01-01

    Full Text Available Handheld computing has had many applications in medicine, but relatively few in pathology. Most reported uses of handhelds in pathology have been limited to experimental endeavors in telemedicine or education. With recent advances in handheld hardware and software, along with concurrent advances in whole-slide imaging (WSI, new opportunities and challenges have presented themselves. This review addresses the current state of handheld hardware and software, provides a history of handheld devices in medicine focusing on pathology, and presents future use cases for such handhelds in pathology.

  9. Digital imaging in pathology.

    Science.gov (United States)

    Park, Seung; Pantanowitz, Liron; Parwani, Anil Vasdev

    2012-12-01

    Advances in computing speed and power have made a pure digital work flow for pathology. New technologies such as whole slide imaging (WSI), multispectral image analysis, and algorithmic image searching seem poised to fundamentally change the way in which pathology is practiced. This article provides the practicing pathologist with a primer on digital imaging. Building on this primer, the current state of the art concerning digital imaging in pathology is described. Emphasis is placed on WSI and its ramifications, showing how it is useful in both anatomic (histology, cytopathology) and clinical (hematopathology) pathology. Future trends are also extrapolated. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Pathology in Greece.

    Science.gov (United States)

    Sakellariou, S; Patsouris, E

    2015-11-01

    Pathology is the field of medicine that studies diseases. Ancient Greece hosted some of the earliest societies that laid the structural foundations of pathology. Initially, knowledge was based on observations but later on the key elements of pathology were established based on the dissection of animals and the autopsy of human cadavers. Christianized Greece under Ottoman rule (1453-1821) was not conducive to the development of pathology. After liberation, however, a series of events took place that paved the way for the establishment and further development of the specialty. The appointment in 1849 of two Professors of Pathology at the Medical School of Athens for didactical purposes proved to be the most important step in fostering the field of pathology in modern Greece. Presently in Greece there are seven university departments and 74 pathology laboratories in public hospitals, employing 415 specialized pathologists and 90 residents. The First Department of Pathology at the Medical School of Athens University is the oldest (1849) and largest in Greece, encompassing most pathology subspecialties.

  11. Comparative Assessment of Pathological Condition of Selected ...

    African Journals Online (AJOL)

    This study comparatively investigated the pathological status of selected mahogany trees (Khaya senegalensis and Entandrophragma cylindricum. Diseased samples of the tree species were collected from a mahogany forest located in Ijebu-Ode, Ogun State, Nigeria. Data were collected through laboratory analysis of the ...

  12. Development of a Prediction Model for Diagnosis of Acute Poisoning in Patients with Altered Mental Status and Absent History of Alcohol/Drug Ingestion.

    Science.gov (United States)

    Camilleri, Robert

    2017-11-01

    Diagnosis of acute poisoning in patients with altered mental status and absent history is a challenging diagnostic problem in clinical practice. The aims of the study were to develop a simple clinical tool to stratify risk of acute poisoning in patients with altered mental states and no history of alcohol/drug ingestion, and develop a prediction model using initial observations from which a simple risk score could be derived. The study was carried out on non-trauma patients aged 15 years and older admitted with altered mental states and no history of alcohol or drug ingestion. Univariate analysis and logistic regression were carried out and a score was derived and validated. There were 607 patients included, with mean age of 60.3 years and 54% were male. The regression model performed moderately well on both the training and validation sets with areas under the receiver operating characteristic curve of 0.834 and 0.844, respectively. The risk score correlated with the regression model (R2 = 0.969). At cutoff thresholds of 20% for the model and 2 for the score, sensitivity and specificity of the regression model (67.6% and 85.6%) and the score (67.6% and 85.4%) were moderate, while positive predictive values were low (43.4%) and negative predictive values were high (94.2%) for both the regression model and the score. A prediction model with a derived risk score was developed with a high negative predictive value and may have potential in assessing risk of poisoning in altered mental status and may have value in a prehospital environment or at triage. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Digital imaging in anatomic pathology.

    Science.gov (United States)

    O'Brien, M J; Sotnikov, A V

    1996-10-01

    Advances in computer technology continue to bring new innovations to departments of anatomic pathology. This article briefly reviews the present status of digital optical imaging, and explores the directions that this technology may lead over the next several years. Technical requirements for digital microscopic and gross imaging, and the available options for image archival and retrieval are summarized. The advantages of digital images over conventional photography in the conference room, and the usefulness of digital imaging in the frozen section suite and gross room, as an adjunct to surgical signout and as a resource for training and education, are discussed. An approach to the future construction of digital histologic sections and the computer as microscope is described. The digital technologic applications that are now available as components of the surgical pathologist's workstation are enumerated. These include laboratory information systems, computerized voice recognition, and on-line or CD-based literature searching, texts and atlases and, in some departments, on-line image databases. The authors suggest that, in addition to these resources that are already available, tomorrow's surgical pathology workstation will include network-linked digital histologic databases, on-line software for image analysis and 3-D image enhancement, expert systems, and ultimately, advanced pattern recognition capabilities. In conclusion, the authors submit that digital optical imaging is likely to have a significant and positive impact on the future development of anatomic pathology.

  14. Current status and future challenges in psychological research of sport injury prediction and prevention : a methodological perspective

    OpenAIRE

    Johnson, Urban

    2014-01-01

    The purpose of this critical review was to propose methodological developments in sport injury prediction and prevention research. Altogether, 24 studies (e.g., quantitative, qualitative, and prevention intervention studies) conducted from 2006 forward were analysed, related to the “stress-injury model.” The injury prediction studies were mostly based on prospective designs, using regression analysis, and studied trait anxiety and life stress. The qualitative studies used mainly thematic anal...

  15. Selective pathology fellowships: diverse, innovative, and valuable subspecialty training.

    Science.gov (United States)

    Iezzoni, Julia C; Ewton, April; Chévez-Barrios, Patricia; Moore, Stephen; Thorsen, Linda M; Naritoku, Wesley Y

    2014-04-01

    Although selective pathology fellowships have a long-standing history of developing trainees with advanced expertise in specific areas of pathology other than those of the American Board of Pathology-certified subspecialties, the widespread interest in this training continues to grow. To describe the historical background and current status of selective pathology fellowships, and to provide examples of 3 programs. In addition, Accreditation Council for Graduate Medical Education (ACGME)-accredited programs and nonaccredited programs in Selective Pathology are compared. ACGME data banks and publicly available online materials were used. Program directors of the fellowships examples in this paper provided program-specific information. Additionally, an online survey of the program directors and program coordinators of ACGME-accredited programs and nonaccredited programs in selective pathology was performed. There are currently 76 ACGME-accredited selective pathology programs. The programs are distributed between 3 major categories: surgical pathology, focused anatomic pathology, and focused clinical pathology. Although the vast majority of programs are concerned that their funding source may be cut in the next 3 years, most programs will not change the number of fellowship positions in their programs. Program requirements devoted specifically and solely to selective pathology have been developed and are in effect. The value of this training is recognized not only by pathologists, but by clinicians as well, in both academia and private practice. Importantly, the diversity and innovation inherent in selective pathology allow these programs to adeptly address new subspecialty areas and technologic advances in the current and evolving practice of pathology.

  16. Maternal nutritional status predicts adverse birth outcomes among HIV-infected rural Ugandan women receiving combination antiretroviral therapy.

    Science.gov (United States)

    Young, Sera; Murray, Katherine; Mwesigwa, Julia; Natureeba, Paul; Osterbauer, Beth; Achan, Jane; Arinaitwe, Emmanuel; Clark, Tamara; Ades, Veronica; Plenty, Albert; Charlebois, Edwin; Ruel, Theodore; Kamya, Moses; Havlir, Diane; Cohan, Deborah

    2012-01-01

    Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART). We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG), and hemoglobin concentration (Hb) among 166 women initiating cART in rural Uganda. Prospective cohort. HIV-infected, ART-naïve pregnant women were enrolled between 12 and 28 weeks gestation and treated with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor-based combination regimen. Nutritional status was assessed monthly. Neonatal anthropometry was examined at birth. Outcomes were evaluated using multivariate analysis. Mean GWG was 0.17 kg/week, 14.6% of women experienced weight loss during pregnancy, and 44.9% were anemic. Adverse fetal outcomes included low birth weight (LBW) (19.6%), preterm delivery (17.7%), fetal death (3.9%), stunting (21.1%), small-for-gestational age (15.1%), and head-sparing growth restriction (26%). No infants were HIV-infected. Gaining HIV-infected women initiating cART during pregnancy, grossly inadequate GWG was common. Infants whose mothers gained HIV-infected women. Clinicaltrials.gov NCT00993031.

  17. Predictive Potential of Preoperative Nutritional Status in Long-Term Outcome Projections for Patients with Gastric Cancer.

    Science.gov (United States)

    Sakurai, Katsunobu; Ohira, Masaichi; Tamura, Tatsuro; Toyokawa, Takahiro; Amano, Ryosuke; Kubo, Naoshi; Tanaka, Hiroaki; Muguruma, Kazuya; Yashiro, Masakazu; Maeda, Kiyoshi; Hirakawa, Kosei

    2016-02-01

    Preoperative nutritional status not only correlates with the incidence of postoperative complications but also may be indicative of long-term outcomes for patients with cancer. The impact of preoperative nutritional status on outcomes for patients undergoing gastrectomy for gastric cancer (GC) was investigated. The study reviewed 594 patients treated for GC by gastrectomy at the authors' hospital between January, 2004 and December, 2010. Onodera's prognostic nutritional index (PNI) was invoked, using an optimal cut point to group patients as having high (PNI > 45; n = 449) or low (PNI ≤ 45; n = 145) nutritional status. Clinicopathologic features, perioperative results, and long-term outcomes, including cause of death, were compared. Multivariate analysis of 5-year overall survival (OS) and disease-specific survival (DSS) indicated that low PNI was independently associated with unfavorable outcomes for patients with GC. In subgroup analysis, the 5-year OS and DSS rates for patients with GC at stages 1 and 2 were significantly worse in the low PNI group than in the high PNI group. Although wound and extrasurgical field infections also tended to be more frequent in the low PNI group, postoperative intraabdominal infections did not differ significantly by group. Preoperative PNI may have merit as a gauge of prognosis for patients with GC at stages 1 and 2, but PNI and postoperative morbidity showed no correlation in this setting.

  18. Mesoblastic nephroma: Pathological features

    African Journals Online (AJOL)

    N.M. El-Badawy

    O. Hydramnios associated with congenital mesoblastic nephroma: case report. Obstet Gynecol 1989;74:46. [4] Ordonez G, Rosai J, editors. Urinary tract in Rosai & Ackerman's sur- gical pathology, vol. I, 10th ed. St. Louis: Mosby; 2011 [chapter 17]. [5] Zaidie M. Kidney tumors. In: Pathology outlines.com; 2012. [6] Argani P, ...

  19. [Anamnesis, Pathological Assessment, Therapeutic Features and Course of Disease: Retrospective Study on Clinical-Based Factors for Prediction of Cancer-Specific Survival of 378 Patients with Stage pT1 Urothelial Bladder Carcinoma].

    Science.gov (United States)

    Breyer, J; Otto, W; Hartmann, A; Bumes, B; Bründl, J; Gierth, M; Bertz, S; Denzinger, S; Burger, M; Lausenmeyer, E M

    2015-05-01

    Urothelial carcinoma of the bladder (UBC) at stage pT1 is a heterogenous disease. Established criteria for prognosis prediction are not suitable for every patient. Choosing the right therapeutic strategy for the individual patient thus remains a challenge. The aim of the present study was to identify clinical parameters regarding cancer-specific survival (CSS) in patients with pT1 UBC. A retrospective analysis of clinical parameters of all patients with a pT1 UBC between 1989 and 2012 from a single centre was performed. Treatment consisted of transurethral resection, second resection followed by initially bladder sparing treatment. Anamnestic data, histopathological reports and clinical course were assessed with CSS being defined as primary endpoint. Kaplan-Meier analysis, uni- and multivariate analysis were performed using SPSS (Version 22, IBM). 378 patients (78% male, median age 72 years) were included, median follow-up was 35 months. Pathological stage pT1G3 (66 vs. 91%, pfactor for improved CSS (HR 0.368; CI 95% 0.212-0.638, pfactors for CSS. Maintenance instillation therapy after reresection was associated with an improved CSS. Georg Thieme Verlag KG Stuttgart · New York.

  20. Updates in ophthalmic pathology.

    Science.gov (United States)

    Mendoza, Pia R; Grossniklaus, Hans E

    2017-05-01

    Ophthalmic pathology has a long history and rich heritage in the field of ophthalmology. This review article highlights updates in ophthalmic pathology that have developed significantly through the years because of the efforts of committed individuals and the confluence of technology such as molecular biology and digital pathology. This is an exciting period in the history of ocular pathology, with cutting-edge techniques paving the way for new developments in diagnostics, therapeutics, and research. Collaborations between ocular oncologists and pathologists allow for improved and comprehensive patient care. Ophthalmic pathology continues to be a relevant specialty that is important in the understanding and clinical management of ocular disease, education of eye care providers, and overall advancement of the field.

  1. Updates in ophthalmic pathology

    Directory of Open Access Journals (Sweden)

    Pia R Mendoza

    2017-01-01

    Full Text Available Ophthalmic pathology has a long history and rich heritage in the field of ophthalmology. This review article highlights updates in ophthalmic pathology that have developed significantly through the years because of the efforts of committed individuals and the confluence of technology such as molecular biology and digital pathology. This is an exciting period in the history of ocular pathology, with cutting-edge techniques paving the way for new developments in diagnostics, therapeutics, and research. Collaborations between ocular oncologists and pathologists allow for improved and comprehensive patient care. Ophthalmic pathology continues to be a relevant specialty that is important in the understanding and clinical management of ocular disease, education of eye care providers, and overall advancement of the field.

  2. Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients

    Directory of Open Access Journals (Sweden)

    Forastiere Francesco

    2008-08-01

    Full Text Available Abstract Background The association between bronchial obstruction severity and mortality in Chronic Obstructive Pulmonary Disease (COPD is well established, but it is unknown whether disease-specific health status measures and multidimensional assessment (MDA have comparable prognostic value. Methods We analyzed data coming from the Salute Respiratoria nell'Anziano (Respiratory Health in the Elderly – SaRA study, enrolling elderly people attending outpatient clinics for respiratory and non-respiratory problems. From this population we selected 449 patients with bronchial obstruction (77.3% men, mean age 73.1. We classified patients' health status using tertiles of the Saint George Respiratory Questionnaire (SGRQ and a MDA including functional (the 6' walking test, WT, cognitive (Mini-Mental State Examination, MMSE and affective status (Geriatric Depression Scale, GDS. The agreement of the classification methods was calculated using the kappa statistic, and survival associated with group membership was evaluated using survival analysis. Results Pulmonary function, expressed by the FEV1, worsened with increasing SGRQ or MDA scores. Cognitive function was not associated with the SGRQ, while physical performance and mood status were impaired only in the highest tertile of SGRQ. A poor agreement was found between the two classification systems tested (k = 0.194. Compared to people in the first tertile of SGRQ score, those in the second tertile had a sex-adjusted HR of 1.22 (0.75 – 1.98 and those in the third tertile of 2.90 (1.92 – 4.40. The corresponding figures of the MDA were 1.49 (95% CI 1.02 – 2.18 and 2.01 (95% CI: 1.31 – 3.08. After adjustment for severity of obstruction, only a SGRQ in the upper tertile was associated with mortality (HR: 1.86; 95% CI: 1.14 – 3.02. Conclusion In elderly outpatients with mild-moderate COPD, a disease-specific health status index seems to be a better predictor of death compared to a MDA.

  3. Genetic parameters of dairy cow energy intake and body energy status predicted using mid-infrared spectrometry of milk.

    Science.gov (United States)

    McParland, S; Kennedy, E; Lewis, E; Moore, S G; McCarthy, B; O'Donovan, M; Berry, D P

    2015-02-01

    Energy balance (EB) and energy intake (EI) are heritable traits of economic importance. Despite this, neither trait is explicitly included in national dairy cow breeding goals due to a lack of routinely available data from which to compute reliable breeding values. Mid-infrared (MIR) spectrometry, which is performed during routine milk recording, is an accurate predictor of both EB and EI. The objective of this study was to estimate genetic parameters of EB and EI predicted using MIR spectrometry. Measured EI and EB were available for 1,102 Irish Holstein-Friesian cows based on actual feed intake and energy sink data. A subset of these data (1,270 test-day records) was used to develop equations to predict EI, EB, and daily change in body condition score (ΔBCS) and body weight (ΔBW) using the MIR spectrum with or without milk yield also as a predictor variable. Accuracy of cross-validation of the prediction equations was 0.75, 0.73, 0.77, and 0.70 for EI, EB, ΔBCS, and ΔBW, respectively. Prediction equations were applied to additional spectral data, yielding up to 94,653 records of MIR-predicted EI, EB, ΔBCS, and ΔBW available for variance component estimation. Variance components were estimated using repeatability animal linear mixed models. Heritabilities of MIR-predicted EI, EB, ΔBCS, and ΔBW were 0.20, 0.10, 0.07, and 0.06, respectively; heritability estimates of the respective measured traits were 0.35, 0.16, 0.07, and 0.08, respectively. The genetic correlation between measured and MIR-predicted EI was 0.84 and between measured and MIR-predicted EB was 0.54, indicating that selection based on MIR-predicted EI or EB would improve true EI or EB. Genetic and phenotypic associations between EI and both the milk production and body-change traits were generally in agreement, regardless of whether measured EI or MIR-predicted EI was considered. Higher-yielding animals of higher body weight had greater EI. Predicted EB was negatively genetically correlated

  4. Mini-Mental Status Examination: a short form of MMSE was as accurate as the original MMSE in predicting dementia

    DEFF Research Database (Denmark)

    Schultz-Larsen, Kirsten; Lomholt, Rikke Kirstine; Kreiner, Svend

    2006-01-01

    as the original MMSE in predicting dementia. STUDY DESIGN AND SETTING: A population-based post hoc examination of the performance characteristics of the MMSE for detecting dementia in an existing data set of 243 elderly persons. RESULTS: Sensitivity, specificity, and predictive values were computed.......4%), and positive predictive value (71.0%) but equal area under the receiver operating characteristic curve. Cross-validation on follow-up data confirmed the results. CONCLUSION: A short, valid MMSE, which is as sensitive and specific as the original MMSE for the screening of cognitive impairments and dementia......OBJECTIVES: This study assesses the properties of the Mini-Mental State Examination (MMSE) with the purpose of improving the efficiencies of the methods of screening for cognitive impairment and dementia. A specific purpose was to determine whether an abbreviated version would be as accurate...

  5. Lack of independent prognostic and predictive value of centromere 17 copy number changes in breast cancer patients with known HER2 and TOP2A status

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Vang; Ejlertsen, Bent; Møller, Susanne

    2011-01-01

    The clinical benefit of anthracyclines has been connected to HER2 status, TOP2A status and centromere 17 copy numbers (CEN-17). Data from a clinical trial randomizing patients to anthracyclines was used to assess whether the number of CEN-17 in breast cancers may predict incremental responsiveness...... were applied to data on 767 patients with known HER2 and TOP2A status randomized to anthracyclines in the DBCG 89D trial. CEN-17 ploidy levels were in cut sections from the 767 breast cancer patients established as: Haploid: ≤1.25 (10%), diploid: 1.26-2.09 (60%), triploid: 2.10-2.93 (21%), tetraploid...... hybridization (FISH) with centromere 17 (CEN-17) and TOP2A was performed on 120 normal breast specimens. The diploid CEN-17 copy number was reduced from the expected two signals in whole nuclei to an average of 1.68 signals per nucleus in cut sections of normal breast. Ploidy levels determined in normal breast...

  6. Sprint kayaking and canoeing performance prediction based on the relationship between maturity status, anthropometry and physical fitness in young elite paddlers.

    Science.gov (United States)

    López-Plaza, Daniel; Alacid, Fernando; Muyor, José María; López-Miñarro, Pedro Ángel

    2017-06-01

    This study aimed to identify the maturity-related differences and its influence on the physical fitness, morphological and performance characteristics of young elite paddlers. In total, 89 kayakers and 82 canoeists, aged 13.69 ± 0.57 years (mean ± s), were allocated in three groups depending on their age relative to the age at peak height velocity (pre-APHV, circum-APHV and post-APHV) and discipline (kayak and canoe). Nine anthropometric variables, a battery of four physical fitness tests (overhead medicine ball throw, countermovement jump, sit-and-reach test and 20 m multistage shuttle run test) and three specific performance tests (1000, 500 and 200 m) were assessed. Both disciplines presented significant maturity-based differences in all anthropometric parameters (except for fat and muscle mass percentage), overhead medicine ball throw and all performance times (pre > circum > post; P performance times, chronological age and anthropometry (body mass, height, sitting height and maturity status), overhead medicine ball throw and sit and reach for all distances. These findings confirm the importance of maturity status in sprint kayaking and canoeing since the more mature paddlers were also those who revealed largest body size, physical fitness level and best paddling performance. Additionally, the most important variables predicting performance times in kayaking and canoeing were maturity status and chronological age, respectively.

  7. Role of the FGFR3 gene mutation status in predicting progression of non-muscle-invasive bladder cancer

    OpenAIRE

    A. I. Rolevich; M. P. Smal; S. A. Krasnyi; Goncharova, R. I.

    2015-01-01

    A prospective study was conducted to assess the prognostic value of FGFR3 gene mutation status in patients with non-muscle invasive bladder cancer. A total of 265 patients were included in the study. FGFR3 gene mutations were found in 168 (63.4 %) cases. FGFR3 mutation rate was significantly higher in low-grade tumors (p = 0.00 004). With a median follow-up of 34 months hazard ratio of progression in FGFR3 mutant cases compared to FGFR3 wild type was 0.50 (95 % CI 0.17–1.49; p = 0.21). In the...

  8. A review on real time physical measurement techniques and their attempt to predict wear-out status of IGBT

    DEFF Research Database (Denmark)

    Ghimire, Pramod; Beczkowski, Szymon; Munk-Nielsen, Stig

    2013-01-01

    of operation. However, the Vce mainly shows the wear-out of bond wire lift-off and solder degradation. The Vce is normally used to estimate the junction temperature in the module. The measurement of Vce is sensitive to the converter power level and fluctuations in the surrounding temperature. In spite...... quality and some practical issues of those measurement techniques are discussed. Furthermore, the paper proposes the requirements for the measurement and prognostic approach to determine wear-out status of power modules in field applications. The online Vce measurement for a selected topology is also...

  9. Predicting the effects of climate change on trophic status of three morphologically varying lakes: Implications for lake restoration and management

    DEFF Research Database (Denmark)

    Trolle, Dennis; Hamilton, David P.; Pilditch, Conrad A.

    2011-01-01

    To quantify the effects of a future climate on three morphologically different lakes that varied in trophic status from oligo-mesotrophic to highly eutrophic, we applied the one-dimensional lake ecosystem model DYRESM-CAEDYM to oligo-mesotrophic Lake Okareka, eutrophic Lake Rotoehu, both in the t....... Therefore, future climate effects should be taken into account in the long-term planning and implementation of lake management as strategies may need to be refined and adapted to preserve or improve the present-day lake water quality....

  10. IDH mutation status is associated with a distinct hypoxia/angiogenesis transcriptome signature which is non-invasively predictable with rCBV imaging in human glioma.

    Science.gov (United States)

    Kickingereder, Philipp; Sahm, Felix; Radbruch, Alexander; Wick, Wolfgang; Heiland, Sabine; Deimling, Andreas von; Bendszus, Martin; Wiestler, Benedikt

    2015-11-05

    The recent identification of IDH mutations in gliomas and several other cancers suggests that this pathway is involved in oncogenesis; however effector functions are complex and yet incompletely understood. To study the regulatory effects of IDH on hypoxia-inducible-factor 1-alpha (HIF1A), a driving force in hypoxia-initiated angiogenesis, we analyzed mRNA expression profiles of 288 glioma patients and show decreased expression of HIF1A targets on a single-gene and pathway level, strong inhibition of upstream regulators such as HIF1A and downstream biological functions such as angio- and vasculogenesis in IDH mutant tumors. Genotype/imaging phenotype correlation analysis with relative cerebral blood volume (rCBV) MRI - a robust and non-invasive estimate of tumor angiogenesis - in 73 treatment-naive patients with low-grade and anaplastic gliomas showed that a one-unit increase in rCBV corresponded to a two-third decrease in the odds for an IDH mutation and correctly predicted IDH mutation status in 88% of patients. Together, these findings (1) show that IDH mutation status is associated with a distinct angiogenesis transcriptome signature which is non-invasively predictable with rCBV imaging and (2) highlight the potential future of radiogenomics (i.e. the correlation between cancer imaging and genomic features) towards a more accurate diagnostic workup of brain tumors.

  11. {sup 18}F-FLT PET/CT as an imaging tool for early prediction of pathological response in patients with locally advanced breast cancer treated with neoadjuvant chemotherapy: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Crippa, Flavio; Padovano, Barbara; Alessi, Alessandra; Bombardieri, Emilio; Pascali, Claudio; Bogni, Anna [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Nuclear Medicine Unit; Agresti, Roberto; Maugeri, Ilaria; Rampa, Mario; Martelli, Gabriele [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Breast Surgery Unit; Sandri, Marco [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Molecular Targeting Unit; Mariani, Gabriella; Bianchi, Giulia; De Braud, Filippo [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Medical Oncology Unit; Carcangiu, Maria Luisa [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Pathology Unit; Trecate, Giovanna [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (Italy). Radiology-RMI Unit

    2015-05-01

    We evaluated whether {sup 18}F-3'-deoxy-3'-fluorothymidine positron emission tomography (FLT PET) can predict the final postoperative histopathological response in primary breast cancer after the first cycle of neoadjuvant chemotherapy (NCT). In this prospective cohort study of 15 patients with locally advanced operable breast cancer, FLT PET evaluations were performed before NCT, after the first cycle of NCT, and at the end of NCT. All patients subsequently underwent surgery. Variables from FLT PET examinations were correlated with postoperative histopathological results. At baseline, median of maximum standardized uptake values (SUV{sub max}) in the groups showing a complete pathological response (pCR) + residual cancer burden (RCB) I, RCB II or RCB III did not differ significantly for the primary tumour (5.0 vs. 2.9 vs. 8.9, p = 0.293) or for axillary nodes (7.9 vs. 1.6 vs. 7.0, p = 0.363), whereas the Spearman correlation between SUV{sub max} and Ki67 proliferation rate index was significant (r = 0.69, p < 0.001). Analysis of the relative percentage change of SUV{sub max}in the primary tumour (∇SUVT{sub max}(t{sub 1})) and axillary nodes (∇SUVN{sub max}(t{sub 1})) after the first NCT cycle showed that the power of ∇SUVT{sub max}(t{sub 1}) to predict pCR + RCB I responses (AUC = 0.91, p < 0.001) was statistically significant, whereas ∇SUVN{sub max}(t{sub 1}) had a moderate ability (AUC = 0.77, p = 0.119) to separate subjects with ΔSUVT{sub max}(t{sub 1}) > -52.9 % into two groups: RCB III patients and a heterogeneous group that included RCB I and RCB II patients. A predictive score μ based on ΔSUVT{sub max}(t{sub 1}) and ΔSUVN{sub max}(t{sub 1}) parameters is proposed. The preliminary findings of the present study suggest the potential utility of FLT PET scans for early monitoring of response to NCT and to formulate a therapeutic strategy consistent with the estimated efficacy of NCT. However, these results in a small patient population

  12. I Don't Think You Like Me Very Much: Child Minority Status and Disadvantage Predict Relationship Quality With Teachers

    Science.gov (United States)

    Fitzpatrick, Caroline; Côté-Lussier, Carolyn; Pagani, Linda S.; Blair, Clancy

    2015-01-01

    Even when accounting for past performance, academic achievement can be influenced by teacher expectations, which are lower for disadvantaged and visible ethnic minority children. We use a Quebec (Canada) population-based sample (N = 1,311) to examine whether ethnicity and teacher-perceived signs of disadvantage in kindergarten predict child…

  13. Location of Food Stores Near Schools Does Not Predict the Weight Status of Maine High School Students

    Science.gov (United States)

    Harris, David E.; Blum, Janet Whatley; Bampton, Matthew; O'Brien, Liam M.; Beaudoin, Christina M.; Polacsek, Michele; O'Rourke, Karen A.

    2011-01-01

    Objective: To examine the relationship between stores selling calorie-dense food near schools and student obesity risk, with the hypothesis that high availability predicts increased risk. Methods: Mail surveys determined height, weight, and calorie-dense food consumption for 552 students at 11 Maine high schools. Driving distance from all food…

  14. Interaction between personality traits and cerebrospinal fluid biomarkers of Alzheimer's disease pathology modulates cognitive performance.

    Science.gov (United States)

    Tautvydaitė, Domilė; Kukreja, Deepti; Antonietti, Jean-Philippe; Henry, Hugues; von Gunten, Armin; Popp, Julius

    2017-02-02

    During adulthood, personality characteristics may contribute to the individual capacity to compensate the impact of developing cerebral Alzheimer's disease (AD) pathology on cognitive impairment in later life. In this study we aimed to investigate whether and how premorbid personality traits interact with cerebrospinal fluid (CSF) markers of AD pathology to predict cognitive performance in subjects with mild cognitive impairment or mild AD dementia and in participants with normal cognition. One hundred and ten subjects, of whom 66 were patients with mild cognitive impairment or mild AD dementia and 44 were healthy controls, had a comprehensive medical and neuropsychological examination as well as lumbar puncture to measure CSF biomarkers of AD pathology (amyloid beta1-42, phosphorylated tau and total-tau). Participants' proxies completed the Revised NEO Personality Inventory, Form R to retrospectively assess subjects' premorbid personality. In hierarchical multivariate regression analyses, including age, gender, education, APOEε4 status and cognitive level, premorbid neuroticism, conscientiousness and agreeableness modulated the effect of CSF biomarkers on cognitive performance. Low premorbid openness independently predicted lower levels of cognitive functioning after controlling for biomarker concentrations. Our findings suggest that specific premorbid personality traits are associated with cerebral AD pathology and modulate its impact on cognitive performance. Considering personality characteristics may help to appraise a person's cognitive reserve and the risk of cognitive decline in later life.

  15. Role of the FGFR3 gene mutation status in predicting progression of non-muscle-invasive bladder cancer

    Directory of Open Access Journals (Sweden)

    A. I. Rolevich

    2015-01-01

    Full Text Available A prospective study was conducted to assess the prognostic value of FGFR3 gene mutation status in patients with non-muscle invasive bladder cancer. A total of 265 patients were included in the study. FGFR3 gene mutations were found in 168 (63.4 % cases. FGFR3 mutation rate was significantly higher in low-grade tumors (p = 0.00 004. With a median follow-up of 34 months hazard ratio of progression in FGFR3 mutant cases compared to FGFR3 wild type was 0.50 (95 % CI 0.17–1.49; p = 0.21. In the subgroup analysis, it was found that FGFR3 mutations in patients with T1 high grade tumors (n = 41 were associated with a significantly better prognosis: 3-year progression-free survival (PFS in FGFR3 mutant cases (n = 17 was 100 % compared to 71.2 % (95 % CI 42.8–99.6 % in the absence of mutations (n = 24. For other subgroups (Ta, T1 low grade no statistically significant difference in PFS by FGFR3 mutation status was noted.

  16. Hip joint pathology

    DEFF Research Database (Denmark)

    Tijssen, M; van Cingel, R E H; de Visser, E

    2017-01-01

    The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18......-65 years) were included if they were referred to a physical therapist to gather pre-operative data and were then diagnosed during arthroscopy. Results of pre-operative patient history and physical tests were collected and compared to arthroscopy. Data of 77 active patients (mean age: 37 years) were...... are suggested to rule out the diagnosis of symptomatic FAI and/or labral pathology....

  17. Development and validation of a vitamin D status prediction model in Danish pregnant women: a study of the Danish National Birth Cohort.

    Directory of Open Access Journals (Sweden)

    Camilla Bjørn Jensen

    Full Text Available Vitamin D has been hypothesized to reduce risk of pregnancy complications such as preeclampsia, gestational diabetes mellitus, and preterm delivery. However, many of these outcomes are rare and require a large sample size to study, representing a challenge for cohorts with a limited number of preserved samples. The aims of this study were to (1 identify predictors of serum 25-hydroxy-vitamin D (25(OHD among pregnant women in a subsample (N = 1494 of the Danish National Birth Cohort (DNBC and (2 develop and validate a score predicting 25(OHD-status in order to explore associations between vitamin D and maternal and offspring health outcomes in the DNBC. In our study sample, 42.3% of the population had deficient levels of vitamin D (<50 nmol/L 25(OHD and average levels of 25(OHD-status were 56.7(s.d. 24.6 nmol/L. A prediction model consisting of intake of vitamin D from diet and supplements, outdoor physical activity, tanning bed use, smoking, and month of blood draw explained 40.1% of the variance in 25(OHD and mean measured 25(OHD-level increased linearly by decile of predicted 25(OHD-score. In total 32.2% of the women were placed in the same quintile by both measured and predicted 25(OHD-values and 69.9% were placed in the same or adjacent quintile by both methods. Cohen's weighted kappa coefficient (Κ = 0.3 reflected fair agreement between measured 25(OHD-levels and predicted 25(OHD-score. These results are comparable to other settings in which vitamin D scores have shown similar associations with disease outcomes as measured 25(OHD-levels. Our findings suggest that predicted 25(OHD-scores may be a useful alternative to measured 25(OHD for examining associations between vitamin D and disease outcomes in the DNBC cohort, but cannot substitute for measured 25(OHD-levels for estimates of prevalence.

  18. An empirical model that uses light attenuation and plant nitrogen status to predict within-canopy nitrogen distribution and upscale photosynthesis from leaf to whole canopy.

    Science.gov (United States)

    Louarn, Gaëtan; Frak, Ela; Zaka, Serge; Prieto, Jorge; Lebon, Eric

    2015-10-03

    Modelling the spatial and temporal distribution of leaf nitrogen (N) is central to specify photosynthetic parameters and simulate canopy photosynthesis. Leaf photosynthetic parameters depend on both local light availability and whole-plant N status. The interaction between these two levels of integration has generally been modelled by assuming optimal canopy functioning, which is not supported by experiments. During this study, we examined how a set of empirical relationships with measurable parameters could be used instead to predict photosynthesis at the leaf and whole-canopy levels. The distribution of leaf N per unit area (Na) within the canopy was related to leaf light irradiance and to the nitrogen nutrition index (NNI), a whole-plant variable accounting for plant N status. Na was then used to determine the photosynthetic parameters of a leaf gas exchange model. The model was assessed on alfalfa canopies under contrasting N nutrition and with N2-fixing and non-fixing plants. Three experiments were carried out to parameterize the relationships between Na, leaf irradiance, NNI and photosynthetic parameters. An additional independent data set was used for model evaluation. The N distribution model showed that it was able to predict leaf N on the set of leaves tested. The Na at the top of the canopy appeared to be related linearly to the NNI, whereas the coefficient accounting for N allocation remained constant. Photosynthetic parameters were related linearly to Na irrespective of N nutrition and the N acquisition mode. Daily patterns of gas exchange were simulated accurately at the leaf scale. When integrated at the whole-canopy scale, the model predicted that raising N availability above an NNI of 1 did not result in increased net photosynthesis. Overall, the model proposed offered a solution for a dynamic coupling of leaf photosynthesis and canopy N distribution without requiring any optimal functioning hypothesis. Published by Oxford University Press on

  19. Menstrual cycle phase at quit date predicts smoking status in an NRT treatment trial: a retrospective analysis.

    Science.gov (United States)

    Franklin, Teresa R; Ehrman, Ronald; Lynch, Kevin G; Harper, Derek; Sciortino, Nathan; O'Brien, Charles P; Childress, Anna Rose

    2008-03-01

    The deleterious health consequences of smoking are even more severe for women, yet ironically, they have more difficulty quitting than men. Identifying relapse predictors for women and implementing strategies to increase their chances of successfully quitting and remaining abstinent are important goals. Clinicians and researchers suggest that women could achieve greater success in smoking cessation interventions if the initial quit attempt coincided with the follicular phase (i.e., preovulatory phase) of their menstrual cycle (MC) rather than the luteal phase (i.e., premenstrual). However, no experimental data have been published to support this claim. Our objective was to determine whether MC phase affected smoking status in premenopausal female smokers participating in a smoking cessation treatment trial. Data from 102 treatment-seeking smokers who participated in an 8-week nicotine replacement therapy (NRT) plus behavioral intervention smoking cessation study were examined retrospectively. NRT began the day subjects attempted to quit smoking (quit date). For analyses, smokers were grouped according to sex, and women were subdivided by MC phase at quit date into follicular (FF, days 1-14, n = 16) and luteal (LF, days 15-30, n = 21) groups. Smoking status was examined on the third day after the quit date (day 3) and at 1 week posttreatment (week 9). On day 3, 52% of LFs reported smoking compared with 19% of FFs (p < 0.04), and at week 9, 71% of LFs reported smoking compared with 31% of FFs (p < 0.02). In a comparison group of men (n = 65), 25% were smoking at day 3 and 68% at week 9. Self-report at week 9 was verified by urine cotinine levels. These data support the supposition that better treatment outcomes can be achieved by scheduling quit dates to coincide with the follicular phase of the MC in female smokers.

  20. Shoot ionome to predict the synergism and antagonism between nutrients as affected by substrate and physiological status.

    Science.gov (United States)

    Pii, Youry; Cesco, Stefano; Mimmo, Tanja

    2015-09-01

    The elemental composition of a tissue or organism is defined as ionome. However, the combined effects on the shoot ionome determined by the taxonomic character, the nutrient status and different substrates have not been investigated. This study tests the hypothesis that phylogenetic variation of monocots and dicots grown in iron deficiency can be distinguished by the shoot ionome. We analyzed 18 elements in barley, cucumber and tomato and in two substrates (hydroponic vs soil) with different nutritional regimes. Multivariate analysis evidenced a clear separation between the species. In hydroponic conditions the main drivers separating the species are non essential-nutrients as Ti, Al, Na and Li, which were positively correlated with macro- (P, K) and micronutrients (Fe, Zn, Mo, B). The separation between species is confirmed when plants are grown on soil, but the distribution is determined especially by macronutrients (S, P, K, Ca, Mg) and micronutrients (B). A number of macro (Mg, Ca, S, P, K) and micronutrients (Fe, Mn, Zn, Cu, Mo, B) contribute to plant growth and several other important physiological and metabolic plant activities. The results reported here confirmed that the synergism and antagonism between them and other non-essential elements (Ti, Al, Si, Na) define the plant taxonomic character. The ionome profile might thus be exploited as a tool for the diagnosis of plants physiological/nutritional status but also in defining biofortification strategies to optimize both mineral enrichment of staple food crops and the nutrient input as fertilizers. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  1. Renal pathology in reptiles.

    Science.gov (United States)

    Zwart, Peernel

    2006-01-01

    The class of Reptilia varies widely. Both the gross morphology and microscopic anatomy of the kidneys are specific for each species. In each species of reptile, the physiology of the renal system has adapted to the specific conditions of life, including, among other factors, the type of food, environmental temperature, and the availability of water. The pathology of the kidneys in reptiles has been poorly studied, but in recent years a number of investigators have specifically studied reptilian renal pathology.

  2. Preoperative magnetic resonance imaging is associated with baseline neurological status and can predict postoperative recovery in patients with cervical spondylotic myelopathy.

    Science.gov (United States)

    Arvin, Babak; Kalsi-Ryan, Sukhvinder; Mercier, David; Furlan, Julio C; Massicotte, Eric M; Fehlings, Michael G

    2013-06-15

    A blinded observational study of consecutive patients, prospectively enrolled and followed up to 1 year postoperatively. To assess whether quantitative assessment of preoperative magnetic resonance imaging (MRI) predicts baseline patient status and postoperative neurological recovery. Factors that can predict neurological recovery in patients with cervical spondylotic myelopathy (CSM) postoperatively are of great interest. Currently, the literature regarding the significance of MRI signal changes in relation to prognosis is inconsistent and conflicting. A total of 57 consecutive patients with CSM were studied preoperatively and 1 year postoperatively. Modified Japanese Orthopaedic Association (mJOA), Nurick Grade, SF-36, neck disability index, 30-meter walk cadence (Wc) and time (Wt), grip strength, and Berg Balance Scale were administered at baseline and 1 year after surgery. Preoperative status and postoperative recovery were assessed in relation to quantitative MRI measurements pre- and postoperatively using univariate and multivariate analysis. Low T1 signal change preoperatively was associated with a lower mJOA (P = 0.0030), higher Nurick Grade (P = 0.0298), decreased grip (P = 0.0152), impaired Wt, Wc (P≤ 0.0001) and poor Berg Balance Scale (P = 0.0005) at baseline. Focal high T2 signal was associated with lower mJOA scores and higher Nurick Grade compared with diffuse T2 (P = 0.0035 P = 0.0079) or no T2 signal (P = 0.0680 P = 0.0122). Preoperative segmentation of T2 signal, showed a significant increase in Wt, Wc, and Berg Balance Scale (P = 0.0266; P = 0.0167; P = 0.0042). Preoperative T1 signal was associated with lower postoperative grip (P = 0.0260), greater Wt, Wc (P = 0.0360, P = 0.0090). Preoperative focal T2 signal had a significant association with poorer postoperative Wt, Wc (P = 0.0220) and Nurick Grade (P = 0.0230). Preoperative maximal cord compromise was negatively correlated with postoperative SF-36 mental score (P = 0.0130). MRI signal

  3. Peer Status in Boys With and Without Attention-Deficit Hyperactivity Disorder: Predictions from Overt and Covert Antisocial Behavior, Social Isolation, and Authoritative Parenting Beliefs.

    Science.gov (United States)

    Hinshaw, Stephen P; Zupan, Brian A; Simmel, Cassandra; Nigg, Joel T; Melnick, Sharon

    1997-10-01

    Because of the centrality of peer relationship difficulties for children with attentiondeficit hyperactivity disorder (ADHD), we investigated behavioral (overt and covert antisocial activity), internalizing (self-reports and observed social isolation), and familial (authoritative, authoritarian, and permissive parenting beliefs) predictors of peer sociometric nominations among previously unfamiliar, ethnically diverse ADHD (N=73) and comparison (N=60) boys, aged 6-12 years. Authoritative maternal parenting beliefs and negatively weighted social isolation explained significant variance in positive peer regard; aggression, covert behavior, and authoritative parenting beliefs were the independent predictors of both negative peer status and peer social preference. We extended such predictions with statistical control of (1) child cognitive variables, (2) maternal psychopathology, and (3) ADHD boys, but authoritative parenting beliefs were stronger predictors in ADHD than in comparison youth. We discuss family-peer linkages regarding peer competence.

  4. Geriatric screening tools are of limited value to predict decline in functional status and quality of life: results of a cohort study.

    Science.gov (United States)

    Deckx, Laura; van den Akker, Marjan; Daniels, Liesbeth; De Jonge, Eric T; Bulens, Paul; Tjan-Heijnen, Vivianne C G; van Abbema, Doris L; Buntinx, Frank

    2015-03-03

    Geriatric screening tools are increasingly implemented in daily practice, especially in the oncology setting, but also in primary care in some countries such as the Netherlands. Nonetheless, validation of these tools regarding their ability to predict relevant outcomes is lacking. In this study we evaluate if geriatric screening tools predict decline in functional status and quality of life after one year, in a population of older cancer patients and an older primary care population without cancer with a life expectancy of at least six months. Older cancer patients and a general older primary care population without a history of cancer (≥ 70 years) were included in an on-going prospective cohort study. Data were collected at baseline and after one-year follow-up. Functional decline was based on the Katz Index and Lawton IADL-scale and was defined as deterioration on one or more domains. Decline in quality of life was measured using the global health related subscale of the EORTC QLQ-C30, and was defined as a decline ≥ 10 points. The selected geriatric screening tools were the abbreviated Comprehensive Geriatric Assessment, Groningen Frailty Indicator, Vulnerable Elders Survey-13, and G8. We calculated sensitivity, specificity, predictive values, and odds ratios to assess if normal versus abnormal scores predict functional decline and decline in quality of life. One-year follow-up data were available for 134 older cancer patients and 220 persons without cancer. Abnormal scores of all screening tools were significantly associated with functional decline. However, this was only true for older persons without cancer, and only in univariate analyses. For functional decline, sensitivity ranged from 54% to 71% and specificity from 33% to 66%. For decline in quality of life, sensitivity ranged from 40% to 67% and specificity from 37% to 54%. In older persons with a relatively good prognosis, geriatric screening tools are of limited use in identifying persons at risk

  5. Spectral analysis-based risk score enables early prediction of mortality and cerebral performance in patients undergoing therapeutic hypothermia for ventricular fibrillation and comatose status

    Science.gov (United States)

    Filgueiras-Rama, David; Calvo, Conrado J.; Salvador-Montañés, Óscar; Cádenas, Rosalía; Ruiz-Cantador, Jose; Armada, Eduardo; Rey, Juan Ramón; Merino, J.L.; Peinado, Rafael; Pérez-Castellano, Nicasio; Pérez-Villacastín, Julián; Quintanilla, Jorge G.; Jiménez, Santiago; Castells, Francisco; Chorro, Francisco J.; López-Sendón, J.L.; Berenfeld, Omer; Jalife, José; López de Sá, Esteban; Millet, José

    2017-01-01

    Background Early prognosis in comatose survivors after cardiac arrest due to ventricular fibrillation (VF) is unreliable, especially in patients undergoing mild hypothermia. We aimed at developing a reliable risk-score to enable early prediction of cerebral performance and survival. Methods Sixty-one out of 239 consecutive patients undergoing mild hypothermia after cardiac arrest, with eventual return of spontaneous circulation (ROSC), and comatose status on admission fulfilled the inclusion criteria. Background clinical variables, VF time and frequency domain fundamental variables were considered. The primary and secondary outcomes were a favorable neurological performance (FNP) during hospitalization and survival to hospital discharge, respectively. The predictive model was developed in a retrospective cohort (n=32; September 2006–September 2011, 48.5 ± 10.5 months of follow-up) and further validated in a prospective cohort (n = 29; October 2011–July 2013, 5 ± 1.8 months of follow-up). Results FNP was present in 16 (50.0%) and 21 patients (72.4%) in the retrospective and prospective cohorts, respectively. Seventeen (53.1%) and 21 patients (72.4%), respectively, survived to hospital discharge. Both outcomes were significantly associated (p < 0.001). Retrospective multivariate analysis provided a prediction model (sensitivity= 0.94, specificity = 1) that included spectral dominant frequency, derived power density and peak ratios between high and low frequency bands, and the number of shocks delivered before ROSC. Validation on the prospective cohort showed sensitivity = 0.88 and specificity = 0.91. A model-derived risk-score properly predicted 93% of FNP. Testing the model on follow-up showed a c-statistic ≥ 0.89. Conclusions A spectral analysis-based model reliably correlates time-dependent VF spectral changes with acute cerebral injury in comatose survivors undergoing mild hypothermia after cardiac arrest. PMID:25828128

  6. Planning predicts dental service attendance and the effect is moderated by dental anxiety and educational status: findings from a one-year prospective study.

    Science.gov (United States)

    Pakpour, Amir H; Gellert, Paul; Asefzadeh, Saeed; Sniehotta, Falko F

    2014-07-01

    The aim of this study was to investigate whether planning a dental appointment is a predictor of actual dental visits over a one-year period when controlling for past attendance, demographic factors, and dental health beliefs. In addition, the planning-attendance association was explored to determine whether dental anxiety and educational status moderated this relationship. A total of N = 1,422 adults with a mean age of M = 44.4 (SD = 11.0) years and resident in Iran participated in a prospective study over a one-year period. The primary outcome was self-reported dental appointment attendance at one-year follow-up, which was validated using clinical records. Action planning, coping planning, health beliefs, age, dental insurance, income, dental health status, dental anxiety, and years of education were assessed at baseline by self-report questionnaire. Data were analysed using multivariate logistic regression. Action planning and coping planning were significantly associated with dental appointment attendance at one-year follow-up. Planning a dental appointment was more predictive of dental appointment attendance for people with higher levels of education and lower dental anxiety. The findings of this study suggest that implementation of the behaviour change technique planning into routine dental practice may have the potential to increase dental appointment attendance rates. © 2014 The International Association of Applied Psychology.

  7. Patterns of Behaviour, Group Structure and Reproductive Status Predict Levels of Glucocorticoid Metabolites in Zoo-Housed Ring-Tailed Lemurs, Lemur catta.

    Science.gov (United States)

    Smith, Tessa E; McCusker, Cara M; Stevens, Jeroen M G; Elwood, Robert W

    2015-01-01

    In ring-tailed lemurs, Lemur catta, the factors modulating hypothalamic-pituitary-adrenal (HPA) activity differ between wild and semi-free-ranging populations. Here we assess factors modulating HPA activity in ring-tailed lemurs housed in a third environment: the zoo. First we validate an enzyme immunoassay to quantify levels of glucocorticoid (GC) metabolites in the faeces of L. catta. We determine the nature of the female-female dominance hierarchies within each group by computing David's scores and examining these in relation to faecal GC (fGC). Relationships between female age and fGC are assessed to evaluate potential age-related confounds. The associations between fGC, numbers of males in a group and reproductive status are explored. Finally, we investigate the value of 7 behaviours in predicting levels of fGC. The study revealed stable linear dominance hierarchies in females within each group. The number of males in a social group together with reproductive status, but not age, influenced fGC. The 7 behavioural variables accounted for 68% of the variance in fGC. The amounts of time an animal spent locomoting and in the inside enclosure were both negative predictors of fGC. The study highlights the flexibility and adaptability of the HPA system in ring-tailed lemurs. © 2016 S. Karger AG, Basel.

  8. Severity of nasal obstruction can predict the anxiety status of patients with allergic rhinitis but not patients with vasomotor rhinitis.

    Science.gov (United States)

    Xi, Lin; Cao, Feifei; Zhang, Yuan; Zhang, Luo

    2016-11-01

    Allergic rhinitis (AR) is a chronic systemic allergic disease with an association reported between allergy and anxiety. The objective of the current study was therefore to investigate and retrospectively evaluate the factors that may possibly induce state and trait anxiety among patients with AR and vasomotor rhinitis (VMR). A total of 253 outpatients suffering from AR and 108 suffering from VMR were assessed for nasal symptoms experienced during the 14 days prior to assessment. All patients scored the severity of their symptoms on a visual analogue scale (VAS) and answered the State-Trait Anxiety Inventory (STAI) questionnaire to evaluate their state (STAI-S) and trait (STAI-T) anxiety scores. Pearson's correlation and multiple regression tests were employed to assess correlations between symptom scores and anxiety status scores. The STAI-S/T scores were not significantly different between AR and VMR patients; however, for AR patients, STAI-S and STAI-T were significantly associated with nasal obstruction and the total nasal symptom scores. Multiple regression analysis further demonstrated that only nasal obstruction significantly influenced both STAI-S and STAI-T scores. In contrast, nasal itching and total nasal symptom scores were significantly correlated with the STAI-S and STAI-T scores in VMR patients, whereas continuous sneezing VAS scores were significantly associated with only the STAI-S score. However, multiple regression analysis showed that the associations between any of the 4 nasal symptom scores and STAI-S and STAI-T scores were not significant. Nasal obstruction may play a prominent role in mediation of anxiety in patients suffering from AR, but not in patients suffering from VMR. © 2016 ARS-AAOA, LLC.

  9. Prostaglandin F2 alpha plasma concentration predicts glycemic control and oxidation status in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Nakhjavani, Manouchehr; Ghazizadeh, Zaniar; Nargesi, Arash Aghajani; Mokhtari, Abnous; Asgarani, Firuzeh; Imani, Mehrnaz; Davoudi, Zahra; Esteghamati, Alireza

    2014-01-01

    8-iso-PGF2α is a family of PGF2α that could be offered as a non-invasive tool to represent in vivo oxidation status, as a link between oxidative milieus and vascular dysfunction. A total of 45 patients with type 2 diabetes and 45 healthy adults were studied in this cross-sectional analysis. Blood samples were collected to measure the level of lipid profile, oxidative stress, and glycemic control indices. The sensitivity and specificity of 8-iso-PGF2α as a screening test were analyzed in the cut-off range 252 - 377.5 pg/mL and the corresponding receiver operating characteristics (ROC) were plotted to assess performance of the test. 8-iso-PGF2α level was significantly higher in the diabetic group (439.11 pg/mL ± 181.13 vs. 380.93 pg/mL ± 146.52). After adjustments for age, gender, and body mass index (BMI), linear regression analysis revealed that homeostasis model assessment of insulin resistance (HOMA-IR), blood pressure, fasting blood sugar (FBS), serum creatinine, insulin, oxLDL, and CRP levels are directly correlated with 8-iso-PGF2α in the 25% - 75% quartiles. Moreover, their mean levels were higher in quartiles with greater 8-iso-PGF2α levels. The cut-offs showing the best equilibrium between sensitivity and specificity approached 269.5 pg/mL with 83% and 62.5% sensitivity and specificity, respectively. Our study provides evidence for the application of serum 8-isoPGF2α in the 25 - 75% quartile ranges to screen for the severity of oxidative reactions and glycemic control in vivo without need for any further in vitro enzymatic reactions, with higher levels, reflecting more severe oxidation and poor glycemic control.

  10. Intrathoracic impedance vs daily weight monitoring for predicting worsening heart failure events: results of the Fluid Accumulation Status Trial (FAST).

    Science.gov (United States)

    Abraham, William T; Compton, Steven; Haas, Garrie; Foreman, Blair; Canby, Robert C; Fishel, Robert; McRae, Scott; Toledo, Gloria B; Sarkar, Shantanu; Hettrick, Douglas A

    2011-01-01

    The relative sensitivity and unexplained detection rate of changes in intrathoracic impedance has not been compared with standard heart failure (HF) monitoring using daily weight changes. The Fluid Accumulation Status Trial (FAST) prospectively followed 156 HF patients with implanted cardioverter-defibrillator or cardiac resynchronization therapy defibrillator devices modified to record daily changes in intrathoracic impedance in a blinded fashion for 537±312 days. Daily impedance changes were used to calculate a fluid index that could be compared with a prespecified threshold. True positives were defined as adjudicated episodes of worsening HF occurring within 30 days of a fluid index above threshold or an acute weight gain. Unexplained detections were defined as threshold crossings or acute weight gains not associated with worsening HF. Impedance measurements were performed on >99% of follow-up days, compared with only 76% of days for weight measurements. Sixty-five HF events occurred during follow-up (0.32/patient-year). Forty HF events were detected by impedance but not weight, whereas 5 were detected by weight but not impedance. Sensitivity was greater (76% vs 23%; P<.0001) and unexplained detection rate was lower (1.9 vs 4.3/patient-year; P<.0001) for intrathoracic impedance monitoring at the threshold of 60Ω days compared with acute weight increases of 3 lbs in 1 day or 5 lbs in 3 days and also over a wide range of fluid index and weight thresholds. The sensitivity and unexplained detection rate of intrathoracic impedance monitoring was superior to that seen for acute weight changes. Intrathoracic impedance monitoring represents a useful adjunctive clinical tool for managing HF in patients with implanted devices. © 2011 Wiley Periodicals, Inc.

  11. Value of eight-amino-acid matches in predicting the allergenicity status of proteins: an empirical bioinformatic investigation

    Directory of Open Access Journals (Sweden)

    ThirumalaiswamySekhar Arvind

    2009-10-01

    Full Text Available Abstract The use of biotechnological techniques to introduce novel proteins into food crops (transgenic or GM crops has motivated investigation into the properties of proteins that favor their potential to elicit allergic reactions. As part of the allergenicity assessment, bioinformatic approaches are used to compare the amino-acid sequence of candidate proteins with sequences in a database of known allergens to predict potential cross reactivity between novel food proteins and proteins to which people have become sensitized. Two criteria commonly used for these queries are searches over 80-amino-acid stretches for >35% identity, and searches for 8-amino-acid contiguous matches. We investigated the added value provided by the 8-amino-acid criterion over that provided by the >35%-identity-over-80-amino-acid criterion, by identifying allergens pairs that only met the former criterion, but not the latter criterion. We found that the allergen-sequence pairs only sharing 8-amino-acid identity, but not >35% identity over 80 amino acids, were unlikely to be cross reactive allergens. Thus, the common search for 8-amino-acid identity between novel proteins and known allergens appears to be of little additional value in assessing the potential allergenicity of novel proteins.

  12. Impact of Schistosoma haematobium infection on urinary tract pathology, nutritional status and anaemia in school-aged children in two different endemic areas of the Niger River Basin, Mali.

    Science.gov (United States)

    Sacko, Moussa; Magnussen, Pascal; Keita, Adama D; Traoré, Mamadou S; Landouré, Aly; Doucouré, Aïssata; Madsen, Henry; Vennervald, Birgitte J

    2011-09-01

    The aim of the present study was to contribute to define urinary schistosomiasis-related morbidity indicators and to understand the relationship between infection intensity and disease burden among school-aged children in different endemic areas of Mali. A cross sectional study was undertaken in two different endemic settings: Koulikoro district, along the river and Selingué dam area in the Niger River Basin in order to compare and describe morbidity related to Schistosoma haematobium infection. A total of 667 children aged 7-14 were enrolled in the study. Among these, 333 were from Koulikoro district (175 boys and 158 girls) and 334 from Selingué dam area (169 boys and 165 girls). The overall prevalence of S. haematobium in the two areas was 91.5%; Koulikoro (97.0%) and Selingué (85.9%) and this difference was significant after adjusting for age, sex and clustering within villages. Prevalence of heavy infection (≥ 50 eggs per 10 ml of urine), 57.6% in Koulikoro and 43.8% in Selingué, did not differ significantly after adjusting for age, sex and clustering within villages. The transmission of Schistosoma mansoni was mainly confined to Selingué dam area (12.5%) and was nearly absent in Koulikoro district (1.1%). Blood in urine was the most frequently reported clinical symptom, more common in Koulikoro (76.8%) than in Selingué (57.6%). In a multivariable logistic regression model adjusting for sex, age group, egg intensity category and clustering within villages, Selingué had higher prevalence of macro-haematuria, urinary tract pathology, upper urinary tract pathology and total pathology than Koulikoro, while micro-haematuria did not differ between the two areas. Morbidity measures increased to some extent with egg intensity category, especially micro-haematuria. The results obtained from this study are of importance for planning intervention as for monitoring and evaluation of control in different endemic settings in Mali. Copyright © 2010 Elsevier B

  13. A predictive model of pathologic response based on tumor cellularity and tumor-infiltrating lymphocytes (CelTIL) in HER2-positive breast cancer treated with chemo-free dual HER2 blockade.

    Science.gov (United States)

    Nuciforo, P; Pascual, T; Cortés, J; Llombart-Cussac, A; Fasani, R; Paré, L; Oliveira, M; Galvan, P; Martínez, N; Bermejo, B; Vidal, M; Pernas, S; López, R; Muñoz, M; Garau, I; Manso, L; Alarcón, J; Martínez, E; Rodrik-Outmezguine, V; Brase, J C; Villagrasa, P; Prat, A; Holgado, E

    2018-01-01

    The presence of stromal tumor-infiltrating lymphocytes (TILs) is associated with increased pathologic complete response (pCR) and improved outcomes in HER2-positive early-breast cancer (BC) treated with anti-HER2-based chemotherapy. In the absence of chemotherapy, the association of TILs with pCR following anti-HER2 therapy-only is largely unknown. The PAMELA neoadjuvant trial treated 151 women with HER2-positive BC with lapatinib and trastuzumab [and hormonal therapy if hormone receptor (HR)-positive] for 18 weeks. Percentage of TILs and tumor cellularity were determined at baseline (N = 148) and at day 15 (D15) of treatment (N = 134). Associations of TILs and tumor cellularity with pCR in the breast were evaluated. A combined score based on tumor cellularity and TILs (CelTIL) measured at D15 was derived in PAMELA, and validated in D15 samples from 65 patients with HER2-positive disease recruited in the LPT109096 neoadjuvant trial, where anti-HER2 therapy-only was administer for 2 weeks, then standard chemotherapy was added for 24 weeks. In PAMELA, baseline and D15 TILs were significantly associated with pCR in univariate analysis. In multivariable analysis, D15 TILs, but not baseline TILs, were significantly associated with pCR. At D15, TILs and tumor cellularity were found independently associated with pCR. A combined score (CelTIL) taking into account both variables was derived. CelTIL at D15 as a continuous variable was significantly associated with pCR, and patients with CelTIL-low and CelTIL-high scores had a pCR rate of 0% and 33%, respectively. In LPT109096, CelTIL at D15 was found associated with pCR both as a continuous variable and as group categories using a pre-defined cut-off (75.0% versus 33.3%). On-treatment TILs, but not baseline TILs, are independently associated with response following anti-HER2 therapy-only. A combined score of TILs and tumor cellularity measured at D15 provides independent predictive information upon completion

  14. Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modeling.

    Directory of Open Access Journals (Sweden)

    Dana Charles McCoy

    2016-06-01

    Full Text Available The development of cognitive and socioemotional skills early in life influences later health and well-being. Existing estimates of unmet developmental potential in low- and middle-income countries (LMICs are based on either measures of physical growth or proxy measures such as poverty. In this paper we aim to directly estimate the number of children in LMICs who would be reported by their caregivers to show low cognitive and/or socioemotional development.The present paper uses Early Childhood Development Index (ECDI data collected between 2005 and 2015 from 99,222 3- and 4-y-old children living in 35 LMICs as part of the Multiple Indicator Cluster Survey (MICS and Demographic and Health Surveys (DHS programs. First, we estimate the prevalence of low cognitive and/or socioemotional ECDI scores within our MICS/DHS sample. Next, we test a series of ordinary least squares regression models predicting low ECDI scores across our MICS/DHS sample countries based on country-level data from the Human Development Index (HDI and the Nutrition Impact Model Study. We use cross-validation to select the model with the best predictive validity. We then apply this model to all LMICs to generate country-level estimates of the prevalence of low ECDI scores globally, as well as confidence intervals around these estimates. In the pooled MICS and DHS sample, 14.6% of children had low ECDI scores in the cognitive domain, 26.2% had low socioemotional scores, and 36.8% performed poorly in either or both domains. Country-level prevalence of low cognitive and/or socioemotional scores on the ECDI was best represented by a model using the HDI as a predictor. Applying this model to all LMICs, we estimate that 80.8 million children ages 3 and 4 y (95% CI 48.1 million, 113.6 million in LMICs experienced low cognitive and/or socioemotional development in 2010, with the largest number of affected children in sub-Saharan Africa (29.4.1 million; 43.8% of children ages 3 and 4 y

  15. Adrenocortical status predicts the degree of age-related deficits in prefrontal structural plasticity and working memory.

    Science.gov (United States)

    Anderson, Rachel M; Birnie, Andrew K; Koblesky, Norah K; Romig-Martin, Sara A; Radley, Jason J

    2014-06-18

    Cognitive decline in aging is marked by considerable variability, with some individuals experiencing significant impairments and others retaining intact functioning. Whereas previous studies have linked elevated hypothalamo-pituitary-adrenal (HPA) axis activity with impaired hippocampal function during aging, the idea has languished regarding whether such differences may underlie the deterioration of other cognitive functions. Here we investigate whether endogenous differences in HPA activity are predictive of age-related impairments in prefrontal structural and behavioral plasticity. Young and aged rats (4 and 21 months, respectively) were partitioned into low or high HPA activity, based upon averaged values of corticosterone release from each animal obtained from repeated sampling across a 24 h period. Pyramidal neurons in the prelimbic area of medial prefrontal cortex were selected for intracellular dye filling, followed by 3D imaging and analysis of dendritic spine morphometry. Aged animals displayed dendritic spine loss and altered geometric characteristics; however, these decrements were largely accounted for by the subgroup bearing elevated corticosterone. Moreover, high adrenocortical activity in aging was associated with downward shifts in frequency distributions for spine head diameter and length, whereas aged animals with low corticosterone showed an upward shift in these indices. Follow-up behavioral experiments revealed that age-related spatial working memory deficits were exacerbated by increased HPA activity. By contrast, variations in HPA activity in young animals failed to impact structural or behavioral plasticity. These data implicate the cumulative exposure to glucocorticoids as a central underlying process in age-related prefrontal impairment and define synaptic features accounting for different trajectories in age-related cognitive function. Copyright © 2014 the authors 0270-6474/14/348387-11$15.00/0.

  16. Role of nutrition impact symptoms in predicting nutritional status and clinical outcome in hemodialysis patients: a potential screening tool.

    Science.gov (United States)

    Campbell, Katrina L; Bauer, Judith D; Ikehiro, Aya; Johnson, David W

    2013-07-01

    This study aims to establish the utility of the Nutrition Impact Symptoms (NIS), a part of the Patient-Generated Subjective Global Assessment (PG-SGA) as a nutritional screening tool in patients receiving hemodialysis (HD). This was a prospective observational study. The study took place in a single public tertiary in-center dialysis facility in Australia. Patients included 213 individuals receiving maintenance HD for at least 3 months who were older than 18 years of age (mean age, 58.9 ± 16.3 years; 55.4% [n = 118] male patients). Malnutrition, which was classified by the Subjective Global Assessment rating (SGA, B or C) and the nutrition-related clinical outcome (decline in weight [>5%], SGA, reduction in serum albumin [>5 g/L]), or 12-month mortality. Patients assessed as malnourished totaled 23.5% (n = 50). Total PG-SGA and NIS scores showed a comparable ability to predict malnutrition (area under the curve, 0.93 [95% confidence interval {CI}, 0.90-0.97] and 0.86 [95% CI, 0.80-0.93], respectively). NIS (score ≥2) was independently related to poor nutrition-related clinical outcome (odds ratio [OR], 3.03; 95% CI, 1.47-6.20) and mortality (OR, 1.11; 95% CI, 1.03-1.20) adjusted for age, dialysis vintage, serum albumin level, and comorbidities. NIS score is a promising nutritional screening tool for the identification of patients receiving hemodialysis who are at risk of malnutrition and poor clinical outcome. Further research is required to investigate the reliability and utility of this tool in a larger population group. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  17. DCE-MRI texture analysis with tumor subregion partitioning for predicting Ki-67 status of estrogen receptor-positive breast cancers

    KAUST Repository

    Fan, Ming

    2017-12-08

    Breast tumor heterogeneity is related to risk factors that lead to worse prognosis, yet such heterogeneity has not been well studied.To predict the Ki-67 status of estrogen receptor (ER)-positive breast cancer patients via analysis of tumor heterogeneity with subgroup identification based on patterns of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).Retrospective study.Seventy-seven breast cancer patients with ER-positive breast cancer were investigated, of whom 51 had low Ki-67 expression.T1 -weighted 3.0T DCE-MR images.Each tumor was partitioned into multiple subregions using three methods based on patterns of dynamic enhancement: 1) time to peak (TTP), 2) peak enhancement rate (PER), and 3) kinetic pattern clustering (KPC). In each tumor subregion, 18 texture features were computed.Univariate and multivariate logistic regression analyses were performed using a leave-one-out-based cross-validation (LOOCV) method. The partitioning results were compared with the same feature extraction methods across the whole tumor.In the univariate analysis, the best-performing feature was the texture statistic of sum variance in the tumor subregion with early TTP for differentiating between patients with high and low Ki-67 expression (area under the receiver operating characteristic curves, AUC = 0.748). Multivariate analysis showed that features from the tumor subregion associated with early TTP yielded the highest performance (AUC = 0.807) among the subregions for predicting the Ki-67 status. Among all regions, the tumor area with high PER at a precontrast MR image achieved the highest performance (AUC = 0.722), while the subregion that exhibited the highest overall enhancement rate based on KPC had an AUC of 0.731. These three models based on intratumoral texture analysis significantly (P < 0.01) outperformed the model using features from the whole tumor (AUC = 0.59).Texture analysis of intratumoral heterogeneity has the potential to serve as a valuable

  18. Pathological fractures in children

    Science.gov (United States)

    De Mattos, C. B. R.; Binitie, O.; Dormans, J. P.

    2012-01-01

    Pathological fractures in children can occur as a result of a variety of conditions, ranging from metabolic diseases and infection to tumours. Fractures through benign and malignant bone tumours should be recognised and managed appropriately by the treating orthopaedic surgeon. The most common benign bone tumours that cause pathological fractures in children are unicameral bone cysts, aneurysmal bone cysts, non-ossifying fibromas and fibrous dysplasia. Although pathological fractures through a primary bone malignancy are rare, these should be recognised quickly in order to achieve better outcomes. A thorough history, physical examination and review of plain radiographs are crucial to determine the cause and guide treatment. In most benign cases the fracture will heal and the lesion can be addressed at the time of the fracture, or after the fracture is healed. A step-wise and multidisciplinary approach is necessary in caring for paediatric patients with malignancies. Pathological fractures do not have to be treated by amputation; these fractures can heal and limb salvage can be performed when indicated. PMID:23610658

  19. Scapular Dyskinesis: Related Pathology

    Directory of Open Access Journals (Sweden)

    Emilio López-Vidriero,

    2015-02-01

    Full Text Available Shoulder pain is one of the most frequent causes of disability in overhead sports and often forces athletes and workers to stop their activities. Scapular dyskinesis is not an injury or a musculoskeletal diagnosis, but rather an alteration of the normal position or motion of the scapula during coupled scapulohumeral movements. The underlying pathology can be multifactorial in nature, and understanding the various contributing factors is important in order to properly diagnose and treat the patient. An additional goal should be the prevention of further pathology or symptoms. In the present article the concept of scapular dyskinesis is reviewed along with a review of the literature regarding related pathology and our observations. Scapular dyskinesis can exist in asymptomatic individuals. In symptomatic patients with shoulder pain the scapular rhythm should be evaluated and treated. Some of the associated pathologies could be subacromial impingement, internal impingement, chronic acromioclavicular dislocations grade III, chronic neck pain. Physical therapy is usually the preferred treatment of choice and effective to treat these patients.

  20. Clinical usefulness of human epidermal growth factor receptor-2 extracellular domain as a biomarker for monitoring cancer status and predicting the therapeutic efficacy in breast cancer

    Science.gov (United States)

    Kontani, Keiichi; Kuroda, Noriyuki; Hashimoto, Shin-ichiro; Murazawa, Chisa; Norimura, Shoko; Tanaka, Hiroaki; Ohtani, Masahiro; Fujiwara-Honjo, Naomi; Kushida, Yoshio; Date, Manabu; Haba, Reiji; Houchi, Hitoshi; Yamauchi, Akira; Yokomise, Hiroyasu

    2013-01-01

    We assessed the clinical usefulness of human epidermal growth factor receptor-2 extracellular domain (HER2ECD) as a biomarker for detecting cancer and monitoring disease status and for predicting the efficacy of anticancer treatment in breast cancer. Five-hundred and eighty serum samples from 252 patients with breast cancer were examined for the concentration of HER2ECD to compare with conventional tumor markers (CEA, CA15-3, NCC-ST439 and BCA225). Also, in 19 patients with HER2-overexpressed advanced or recurrent breast cancer who were treated with trastuzumab, clinical outcomes were evaluated retrospectively to determine whether their serum HER2ECD levels predict clinical responses. The proportion of patients with elevated HER2ECD levels was 15.1%, which was compatible with those with elevated conventional marker levels. In patients with HER2-overexpressed breast cancer, the positive rate of HER2ECD was significantly higher (24.1%) than those of conventional markers (7.4–12.9%), suggesting the usefulness of HER2ECD for detecting cancer in this population. HER2-overexpressed patients responding to trastuzumab (12 of 19 patients) showed significantly higher serum HER2ECD level (p = 0.033) and longer time to progression (TTP) (p = 0.039) and overall survival (OS) (p = 0.031) than did patients not responding (seven patients). Furthermore, higher response rates were observed in patients with elevated HER2ECD levels than in patients without elevated HER2ECD levels (91.3% vs. 14.3%, p = 0.032), whereas there was no difference in survival between the two groups. The results suggest that HER2ECD is a useful biomarker not only for detecting breast cancer recurrence but also for predicting tumor responses to trastuzumab. PMID:23114645

  1. Using Marital Status and Continuous Marital Satisfaction Ratings to Predict Depressive Symptoms in Married and Unmarried Women With Systemic Sclerosis: A Canadian Scleroderma Research Group Study.

    Science.gov (United States)

    Levis, Brooke; Rice, Danielle B; Kwakkenbos, Linda; Steele, Russell J; Hagedoorn, Mariët; Hudson, Marie; Baron, Murray; Thombs, Brett D

    2016-08-01

    Married persons have, on average, better mental health than nonmarried persons. Among married persons, marital satisfaction is associated with better mental health. Studies on mental health in married and nonmarried persons that consider marital satisfaction have categorized patients as satisfied versus unsatisfied, which reduces statistical power and does not generate clinically useful information on mental health across the satisfaction spectrum. Our objective was to demonstrate a novel regression approach to evaluate mental health in women with systemic sclerosis (SSc), comparing married and unmarried women, accounting for continuously measured marital satisfaction. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and marital satisfaction with the Dyadic Adjustment Scale-7. A single multiple linear regression model was used to predict CES-D scores from marital status and, among married women, continuously measured marital satisfaction, controlling for demographic and clinical characteristics. Of 725 women, 494 (68%) were married or living as married. On average, married women had mean CES-D scores that were 2.0 points (0.19 SDs) lower than unmarried women (P = 0.013). Among married women, a 1.0 SD increase in marital satisfaction was associated with a 2.2 point (0.21 SDs) decrease in CES-D scores (P marital satisfaction scores were below the 19th percentile had greater predicted depressive symptoms than unmarried women. Married women's predicted CES-D scores ranged from 6.7 points lower to 6.9 points higher than those of unmarried women, depending on marital satisfaction. Comparisons of mental health in married and unmarried patients with rheumatic diseases should include continuously measured marital satisfaction. © 2016, American College of Rheumatology.

  2. Using intake and change in multiple psychosocial measures to predict functional status outcomes in people with lumbar spine syndromes: a preliminary analysis.

    Science.gov (United States)

    Hart, Dennis L; Werneke, Mark W; Deutscher, Daniel; George, Steven Z; Stratford, Paul W; Mioduski, Jerome E

    2011-12-01

    Managing patients with lumbar spine syndromes who are seeking outpatient physical therapy represents a complex problem where psychosocial constructs such as fear-avoidance beliefs regarding physical activities or work activities, somatization, and depressive symptoms may affect functional status (FS) outcomes. The purpose of this study was to determine whether intake or changes in fear-avoidance beliefs regarding physical or work activities, somatization, and depressive symptoms assessed simultaneously affect FS outcomes prediction. This study was a secondary analysis of prospectively collected, longitudinal, observational cohort data. Data analyzed were from adult patients (n=323) with lumbar syndromes classified as elevated versus not elevated on single-item screening instruments for fear-avoidance beliefs regarding physical or work activities, somatization, and depressive symptoms at intake and discharge. Prediction of minimal clinically important difference in FS was assessed separately for intake and change from intake to discharge classifications using logistic regression models controlling for important variables. Intake and change models were strong (McFadden rho-squared values=.31 and .49, respectively). Patients classified as not elevated in fear-avoidance beliefs regarding physical activities but elevated in fear-avoidance beliefs regarding work activities, somatization, and depressive symptoms at intake were 5 out of 100 times less likely to report clinically important outcomes compared with being elevated in each measure. Patients not elevated in fear-avoidance beliefs regarding work activities and somatization at intake and discharge were 8 to 14 times more likely to report clinically important outcomes compared with being elevated in each measure. Sample size was limited. Data analyses were retrospective with no control of missing data. Combinations of multiple psychosocial constructs were important predictors of FS outcomes and may assist patient

  3. Toward a consensus definition of pathological video-gaming: a systematic review of psychometric assessment tools.

    Science.gov (United States)

    King, Daniel L; Haagsma, Maria C; Delfabbro, Paul H; Gradisar, Michael; Griffiths, Mark D

    2013-04-01

    Pathological video-gaming, or its proposed DSM-V classification of "Internet Use Disorder", is of increasing interest to scholars and practitioners in allied health disciplines. This systematic review was designed to evaluate the standards in pathological video-gaming instrumentation, according to Cicchetti (1994) and Groth-Marnat's (2009) criteria and guidelines for sound psychometric assessment. A total of 63 quantitative studies, including eighteen instruments and representing 58,415 participants, were evaluated. Results indicated that reviewed instrumentation may be broadly characterized as inconsistent. Strengths of available measures include: (i) short length and ease of scoring, (ii) excellent internal consistency and convergent validity, and (iii) potentially adequate data for development of standardized norms for adolescent populations. However, key limitations included: (a) inconsistent coverage of core addiction indicators, (b) varying cut-off scores to indicate clinical status, (c) a lack of a temporal dimension, (d) untested or inconsistent dimensionality, and (e) inadequate data on predictive validity and inter-rater reliability. An emerging consensus suggests that pathological video-gaming is commonly defined by (1) withdrawal, (2) loss of control, and (3) conflict. It is concluded that a unified approach to assessment of pathological video-gaming is needed. A synthesis of extant research efforts by meta-analysis may be difficult in the context of several divergent approaches to assessment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Baseline status and dose to the penile bulb predict impotence 1 year after radiotherapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cozzarini, Cesare; Badenchini, Fabio [San Raffaele Scientific Institute, Radiotherapy, Milano (Italy); Rancati, Tiziana [Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan (Italy); Palorini, Federica; Improta, Ilaria; Fiorino, Claudio [San Raffaele Scientific Institute, Medical Physics, Milan (Italy); Avuzzi, Barbara [Fondazione IRCCS Istituto Nazionale dei Tumori, Radiation Oncology 1, Milan (Italy); Degli Esposti, Claudio [Ospedale Bellaria, Radiotherapy, Bologna (Italy); Girelli, Giuseppe [Ospedale ASL9, Radiotherapy, Ivrea (Italy); Vavassori, Vittorio [Cliniche Gavazzeni-Humanitas, Radiotherapy, Bergamo (Italy); Valdagni, Riccardo [Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan (Italy); Fondazione IRCCS Istituto Nazionale dei Tumori, Radiation Oncology 1, Milan (Italy)

    2016-05-15

    To assess the predictors of the onset of impotence 1 year after radiotherapy for prostate cancer. In a multi-centric prospective study, the International Index of Erectile Function (IIEF) questionnaire-based potency of 91 hormone-naive and potent patients (IIEF1-5 > 11 before radiotherapy) was assessed. At the time of this analysis, information on potency 1 year after treatment was available for 62 of 91 patients (42 treated with hypofractionation: 2.35-2.65 Gy/fr, 70-74.2 Gy; 20 with conventional fractionation: 74-78 Gy). Prospectively collected individual information and D{sub max}/D{sub mean} to the penile bulb were available; the corresponding 2 Gy-equivalent values (EQD2 {sub max}/EQD2 {sub mean}) were also considered. Predictors of 1-year impotency were assessed through uni- and multi-variable backward logistic regression: The best cut-off values discriminating between potent and impotent patients were assessed by ROC analyses. The discriminative power of the models and goodness-of-fit were measured by AUC analysis and the Hosmer-Lemeshow (H and L) test. At 1-year follow-up, 26 of 62 patients (42 %) became impotent. The only predictive variables were baseline IIEF1-5 values (best cut-off baseline IIEF1-5 ≥ 19), D{sub max} ≥ 68.5 Gy and EQD2 {sub max} ≥ 74.2 Gy. The risk of 1-year impotence may be predicted by a two-variable model including baseline IIEF1-5 (OR: 0.80, p = 0.003) and EQD2 {sub max} ≥ 74.2 Gy (OR: 4.1, p = 0.022). The AUC of the model was 0.77 (95% CI: 0.64-0.87, p = 0.0007, H and L: p = 0.62). The 1-year risk of impotency after high-dose radiotherapy in potent men depends on the EQD2 {sub max} to the penile bulb and on baseline IIEF1-5 values. A significant reduction in the risk may be expected mainly when sparing the bulb in patients with no/mild baseline impotency (IIEF1-5 > 17). (orig.) [German] Beurteilung von Praediktoren fuer das Auftreten von Impotenz 1 Jahr nach Radiotherapie bei Prostatakrebs. In einer multizentrischen

  5. Pathological Dissociation as Measured by the Child Dissociative Checklist

    Science.gov (United States)

    Wherry, Jeffrey N.; Neil, Debra A.; Taylor, Tamara N.

    2009-01-01

    The component structure of the Child Dissociative Checklist was examined among abused children. A factor described as pathological dissociation emerged that was predicted by participants being male. There also were differences in pathological dissociation between groups of sexually abused and physically abused children. Replication of this factor…

  6. External Validation and Evaluation of Reliability and Validity of the Triple D Score to Predict Stone-Free Status After Extracorporeal Shockwave Lithotripsy.

    Science.gov (United States)

    Ozgor, Faruk; Tosun, Muhammed; Kayali, Yunus; Savun, Metin; Binbay, Murat; Tepeler, Abdulkadir

    2017-02-01

    The Triple D scoring system is defined as novel and simple nomogram using the main parameters (skin-to-stone distance, stone density, and volume) to indicate most appropriate patients for extracorporeal shockwave lithotripsy (SWL). We aimed to evaluate the accuracy of the Triple D scoring system in predicting SWL success rates. In two tertiary academic centers, charts were retrospectively analyzed of patients who had, between January 2014 and May 2016, been treated by SWL for radiopaque kidney stones. A total of 200 patients were enrolled into the study. Parameters were calculated for each of the three specified variables. Since one point was assigned for any parameter that was less than the cutoff value, Triple D scores ranged from 0 (worst) to 3 (best). Stone-free status was achieved in 115 patients (57.5%), and 85 patients had one or more residual fragments (42.5%). Differences in stone characteristics, including stone location, density, and volume, were statistically significant in patients whether SWL achieved stone-free status or not (p p p Triple D scores were significantly higher in patients treated with SWL compared with patients in whom SWL failed (p Triple D scores of 0, 1, 2, and 3 correlated with stone-free rates of 41.7%, 33.7%, 69.4%, and 97%, respectively. The multivariate analyses revealed that Triple D score and stone location were identified as independent factors affecting SWL success (p p = 0.008, respectively). The mean number of SWL sessions was significantly higher in patients with SWL failure (p = 0.003). Our study externally validates that the Triple D scoring system is associated with SWL success in the treatment of renal and ureteral stones. Further studies are warranted to assess clinical usefulness and the accuracy of this nomogram in different patient groups.

  7. Pathology informatics fellowship training: Focus on molecular pathology

    Directory of Open Access Journals (Sweden)

    Diana Mandelker

    2014-01-01

    Full Text Available Background: Pathology informatics is both emerging as a distinct subspecialty and simultaneously becoming deeply integrated within the breadth of pathology practice. As specialists, pathology informaticians need a broad skill set, including aptitude with information fundamentals, information systems, workflow and process, and governance and management. Currently, many of those seeking training in pathology informatics additionally choose training in a second subspecialty. Combining pathology informatics training with molecular pathology is a natural extension, as molecular pathology is a subspecialty with high potential for application of modern biomedical informatics techniques. Methods and Results: Pathology informatics and molecular pathology fellows and faculty evaluated the current fellowship program′s core curriculum topics and subtopics for relevance to molecular pathology. By focusing on the overlap between the two disciplines, a structured curriculum consisting of didactics, operational rotations, and research projects was developed for those fellows interested in both pathology informatics and molecular pathology. Conclusions: The scope of molecular diagnostics is expanding dramatically as technology advances and our understanding of disease extends to the genetic level. Here, we highlight many of the informatics challenges facing molecular pathology today, and outline specific informatics principles necessary for the training of future molecular pathologists.

  8. Pathology informatics fellowship training: Focus on molecular pathology

    Science.gov (United States)

    Mandelker, Diana; Lee, Roy E.; Platt, Mia Y.; Riedlinger, Gregory; Quinn, Andrew; Rao, Luigi K. F.; Klepeis, Veronica E.; Mahowald, Michael; Lane, William J.; Beckwith, Bruce A.; Baron, Jason M.; McClintock, David S.; Kuo, Frank C.; Lebo, Matthew S.; Gilbertson, John R.

    2014-01-01

    Background: Pathology informatics is both emerging as a distinct subspecialty and simultaneously becoming deeply integrated within the breadth of pathology practice. As specialists, pathology informaticians need a broad skill set, including aptitude with information fundamentals, information systems, workflow and process, and governance and management. Currently, many of those seeking training in pathology informatics additionally choose training in a second subspecialty. Combining pathology informatics training with molecular pathology is a natural extension, as molecular pathology is a subspecialty with high potential for application of modern biomedical informatics techniques. Methods and Results: Pathology informatics and molecular pathology fellows and faculty evaluated the current fellowship program's core curriculum topics and subtopics for relevance to molecular pathology. By focusing on the overlap between the two disciplines, a structured curriculum consisting of didactics, operational rotations, and research projects was developed for those fellows interested in both pathology informatics and molecular pathology. Conclusions: The scope of molecular diagnostics is expanding dramatically as technology advances and our understanding of disease extends to the genetic level. Here, we highlight many of the informatics challenges facing molecular pathology today, and outline specific informatics principles necessary for the training of future molecular pathologists. PMID:24843823

  9. CD127 expression, exhaustion status and antigen specific proliferation predict sustained virologic response to IFN in HCV/HIV co-infected individuals.

    Directory of Open Access Journals (Sweden)

    Hassen Kared

    Full Text Available Hepatitis C virus (HCV infection is a major cause of morbidity and mortality in the HIV co-infected population. Interferon-alpha (IFN-α remains a major component of anti-HCV therapy despite its deleterious effects on the immune system. Furthermore, IFN-α was recently shown to diminish the size of the latent HIV reservoir. The objectives of this study were to monitor the impact of IFN-α on T cell phenotype and proliferation of HIV and HCV-specific T cells during IFN therapy, and to identify immune markers that can predict the response to IFN in HICV/HIV co-infected patients. We performed longitudinal analyses of T cell numbers, phenotype and function in co-infected patients undergoing IFN-α therapy with different outcomes including IFN-α non-responders (NR (n = 9 and patients who achieved sustained virologic response (SVR (n = 19. We examined the expression of activation (CD38, HLA-DR, functional (CD127 and exhaustion markers (PD1, Tim-3, CD160 and CD244 on total CD4 and CD8 T cells before, during and after therapy. In addition, we examined the HIV- and HCV-specific proliferative responses against HIV-p24 and HCV-NS3 proteins. Frequencies of CD127+ CD4 T cells were higher in SVR than in NR patients at baseline. An increase in CD127 expression on CD8 T cells was observed after IFN-α therapy in all patients. In addition, CD8 T cells from NR patients expressed a higher exhaustion status at baseline. Finally, SVR patients exhibited higher proliferative response against both HIV and HCV antigens at baseline. Altogether, SVR correlated with higher expression of CD127, lower T cell exhaustion status and better HIV and HCV proliferative responses at baseline. Such factors might be used as non-invasive methods to predict the success of IFN-based therapies in co-infected individuals.

  10. Investigation of a dual modal method for bone pathologies using quantitative ultrasound and photoacoustics

    Science.gov (United States)

    Steinberg, Idan; Gannot, Israel; Eyal, Avishay

    2015-03-01

    Osteoporosis is a widespread disease that has a catastrophic impact on patient's lives and overwhelming related healthcare costs. In recent works, we have developed a multi-spectral, frequency domain photoacoustic method for the evaluation of bone pathologies. This method has great advantages over pure ultrasonic or optical methods as it provides both molecular information from the bone absorption spectrum and bone mechanical status from the characteristics of the ultrasound propagation. These characteristics include both the Speed of Sound (SOS) and Broadband Ultrasonic Attenuation (BUA). To test the method's quantitative predictions, we have constructed a combined ultrasound and photoacoustic setup. Here, we experimentally present a dual modality system, and compares between the methods on bone samples in-vitro. The differences between the two modalities are shown to provide valuable insight into the bone structure and functional status.

  11. Pathological gambling in Missouri.

    Science.gov (United States)

    Black, Donald W; Shaw, Martha

    2006-01-01

    Riverboat casinos were introduced in 1994, and there are now eleven gambling venues in Missouri, in addition to the lottery. Gambling is monitored by the Missouri Gaming Commission which was established to supervise gambling operations in the state, and minimize criminal involvement. The Commission also operates programs for problem gamblers that are described. Pathological gambling has become a major problem in Missouri and elsewhere, and its characteristics and clinical management are reviewed herein.

  12. [Pathological gambling in adolescence].

    Science.gov (United States)

    Caillon, J; Grall-Bronnec, M; Bouju, G; Lagadec, M; Vénisse, J-L

    2012-02-01

    Today's juveniles are the first generation to be raised in an environment where gambling is very accessible and socially acceptable. The recent legalization of Internet gambling has increased this accessibility. With 28,8 millions of gamblers in France in 2010, many believe that gambling is an innocent leisure activity. The first results of the national survey on the prevalence of gambling practices conducted in France show that in 2010, 1.3% of the population had a gambling problem. Also, despite the prohibition of gambling to minors, the mean age of onset of gambling behavior in the world is 11.5 years. Gambling (even non-problematic) in adolescence is associated with poor school performance, criminal behavior and family conflict. Recreational gambling shares with pathological gambling high rates of psychiatric comorbidities in adults, and risk behaviors among adolescents. Similarly, international studies show prevalence of problem gambling 2 to 4 times higher among adolescents than among adult, 3.5% to 8% of adolescents between 12 and 17 are pathological gamblers. The validity of the screening instruments and the frequency of spontaneous recovery in adulthood are discussed to explain the high prevalence in adolescence. This article proposes a focus on the practice of gambling in adolescence and its characteristics when the practice becomes pathological. We discuss the epidemiological, diagnostic, etiologic and therapeutic aspects of this problem. Three major types of risk factors implicated in gambling problems are identified: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors) like Internet with the recent legalization of gambling online, and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling in youth seems to be conditioned by the interaction of a person and a

  13. Diminished aversive classical conditioning in pathological gamblers.

    Science.gov (United States)

    Brunborg, Geir Scott; Johnsen, Bjørn Helge; Mentzoni, Rune Aune; Myrseth, Helga; Molde, Helge; Lorvik, Ingjerd Meen; Bu, Eli Torild Hellandsjø; Pallesen, Ståle

    2012-09-01

    Impaired ability to form associations between negative events in gambling and aversive somatic reactions may be a predisposing factor for pathological gambling. The current study investigated whether a group of pathological gamblers and a control group differed in aversive classical conditioning. A differential aversive classical conditioning paradigm, which consisted of three phases. In the habituation phase, one 850-Hz tone stimulus and one 1500-Hz tone stimulus were presented three times each in random order. In the acquisition phase, the two tones were presented 10 times each in random order, and one was always followed by a 100-dB burst of white noise. In the extinction phase the two tones were presented three times each without the white noise. University laboratory testing facilities and out-patient treatment facilities. Twenty pathological gamblers and 20 control participants. Duration of seven cardiac interbeat-intervals (IBIs) following tone offset, gambling severity, tobacco and alcohol use, anxiety and depression. No group differences were found in the habituation and acquisition phases. However, a significant group × stimuli × trials × IBIs interaction effect was found in the extinction phase (P classical conditioning, but that the control group did. Pathological gamblers have a diminished capacity to form associations between aversive events and stimuli that predict aversive events. Aversion learning is likely to be an ineffective treatment for pathological gamblers. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  14. Improving long-term prediction of first cardiovascular event: the contribution of family history of coronary heart disease and social status.

    Science.gov (United States)

    Veronesi, G; Gianfagna, F; Giampaoli, S; Chambless, L E; Mancia, G; Cesana, G; Ferrario, M M

    2014-07-01

    The aim of this study is to assess whether family history of coronary heart disease (CHD) and education as proxy of social status improve long-term cardiovascular disease risk prediction in a low-incidence European population. The 20-year risk of first coronary or ischemic stroke events was estimated using sex-specific Cox models in 3956 participants of three population-based surveys in northern Italy, aged 35-69 years and free of cardiovascular disease at enrollment. The additional contribution of education and positive family history of CHD was defined as change in discrimination and Net Reclassification Improvement (NRI) over the model including 7 traditional risk factors. Kaplan-Meier 20-year risk was 16.8% in men (254 events) and 6.4% in women (102 events). Low education (hazard ratio=1.35, 95%CI 0.98-1.85) and family history of CHD (1.55; 1.19-2.03) were associated with the endpoint in men, but not in women. In men, the addition of education and family history significantly improved discrimination by 1%; NRI was 6% (95%CI: 0.2%-15.2%), raising to 20% (0.5%-44%) in those at intermediate risk. NRI in women at intermediate risk was 7%. In low-incidence populations, family history of CHD and education, easily assessed in clinical practice, should be included in long-term cardiovascular disease risk scores, at least in men. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Nutritional quality of breakfast and physical activity independently predict the literacy and numeracy scores of children after adjusting for socioeconomic status.

    Science.gov (United States)

    O'Dea, Jennifer A; Mugridge, Anna C

    2012-12-01

    Health-related behaviors [physical activity (PA), nutritional quality of breakfast and sleep]; personal variables (self-esteem, attitudes to PA and gender) and socioeconomic status (SES) (school SES and parental education), were examined in relation to literacy and numeracy scores of 824 grade 3-7 children. Participants completed a questionnaire, and their national literacy and numeracy test scores were retrieved. Mothers (N = 755) completed a telephone interview. Students of highest school SES, maternal education, nutritional quality of breakfast, more sedentary time and female gender had higher literacy scores. SES, maternal education, male gender and total minutes of daily PA were predictors of numeracy with an interaction between greater total PA in boys and greater numeracy. Even though the socioeconomic factors that have predicted children's academic achievement for many decades are still clearly set in place, there are also other modifiable health influences that affect literacy and numeracy and are independent of SES. The current findings provide evidence for health educators and school administrators who may garner support for both breakfast programs and daily school PA for the dual purposes of health promotion as well as for the improvement of literacy and numeracy in settings in which social class may be acting against the educational interests of disadvantaged children.

  16. Using a Bayesian Network to Predict L5/S1 Spinal Compression Force from Posture, Hand Load, Anthropometry, and Disc Injury Status

    Directory of Open Access Journals (Sweden)

    Richard E. Hughes

    2017-01-01

    Full Text Available Stochastic biomechanical modeling has become a useful tool most commonly implemented using Monte Carlo simulation, advanced mean value theorem, or Markov chain modeling. Bayesian networks are a novel method for probabilistic modeling in artificial intelligence, risk modeling, and machine learning. The purpose of this study was to evaluate the suitability of Bayesian networks for biomechanical modeling using a static biomechanical model of spinal forces during lifting. A 20-node Bayesian network model was used to implement a well-established static two-dimensional biomechanical model for predicting L5/S1 compression and shear forces. The model was also implemented as a Monte Carlo simulation in MATLAB. Mean L5/S1 spinal compression force estimates differed by 0.8%, and shear force estimates were the same. The model was extended to incorporate evidence about disc injury, which can modify the prior probability estimates to provide posterior probability estimates of spinal compression force. An example showed that changing disc injury status from false to true increased the estimate of mean L5/S1 compression force by 14.7%. This work shows that Bayesian networks can be used to implement a whole-body biomechanical model used in occupational biomechanics and incorporate disc injury.

  17. Using a Bayesian Network to Predict L5/S1 Spinal Compression Force from Posture, Hand Load, Anthropometry, and Disc Injury Status.

    Science.gov (United States)

    Hughes, Richard E

    2017-01-01

    Stochastic biomechanical modeling has become a useful tool most commonly implemented using Monte Carlo simulation, advanced mean value theorem, or Markov chain modeling. Bayesian networks are a novel method for probabilistic modeling in artificial intelligence, risk modeling, and machine learning. The purpose of this study was to evaluate the suitability of Bayesian networks for biomechanical modeling using a static biomechanical model of spinal forces during lifting. A 20-node Bayesian network model was used to implement a well-established static two-dimensional biomechanical model for predicting L5/S1 compression and shear forces. The model was also implemented as a Monte Carlo simulation in MATLAB. Mean L5/S1 spinal compression force estimates differed by 0.8%, and shear force estimates were the same. The model was extended to incorporate evidence about disc injury, which can modify the prior probability estimates to provide posterior probability estimates of spinal compression force. An example showed that changing disc injury status from false to true increased the estimate of mean L5/S1 compression force by 14.7%. This work shows that Bayesian networks can be used to implement a whole-body biomechanical model used in occupational biomechanics and incorporate disc injury.

  18. Comparing histopathological and magnetic resonance imaging based mesorectal fascia status in patients with rectal carcinoma.

    Science.gov (United States)

    Hassan, Usman; Khan, Rizwanullah; Mehmood, Muhammad Tariq

    2014-04-01

    To compare mesorectal fascia status on histopathological findings with MRI based radiological mesorectal fascia status in patients with rectal carcinoma taking histopathology finding as gold standard. Analytical study. Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from January 2011 to April 2012. Biopsy proven cases of rectal adenocarcinoma undergoing abdominoperineal resection were included in this study. Microscopic examination of slides was done to determine mesorectal fascia status as involved or otherwise without knowing the results of mesorectal fascia