This review article highlights some important points in the evolving area of predictive biomarkers determination in non-small-cell lung cancer toward standardization of testing practices, including ...EGFR mutations, ALK and ROS1 rearrangements and immunohistochemical expression of PD-L1. Considerations for selecting appropriate populations for molecular testing, and emergence of other targetable molecular alterations are also discussed.
To assess whether the addition of clinical Gleason score (Gs) 3+4 to the Prostate Cancer Research International: Active Surveillance (PRIAS) criteria affects pathologic results in patients who are ...potentially suitable for active surveillance (AS) and to identify possible clinical predictors of unfavourable outcome.
Three hundred and twenty-nine men who underwent radical prostatectomy with complete clinical and follow-up data and who would have fulfilled the inclusion criteria of the PRIAS protocol at the time of biopsy except for the addition of biopsy Gs=3+4 and with at least 10 cores taken have been evaluated. One experienced genitourinary pathologist selected those with real Gs=3+3 and 3+4 in only one core according to the 2005 International Society of Urological Pathology criteria. The primary end point was the proportion of unfavourable outcome (nonorgan confined disease or Gs⩾4+3). Logistic regressions explored the association between preoperative characteristics and the primary end point.
Two hundred and four patients were evaluated and 46 (22.5%) patients harboured unfavourable disease at final pathology. After a median follow-up of 73.5 months, there was no cancer-specific death, and 4 (2.0%) patients had biochemical relapse. There were no significant differences in terms of high Gs, locally advanced disease, unfavourable disease and biochemical relapse-free survival among patients with clinical Gs=3+3 vs Gs=3+4. At multivariable analysis, the presence of atypical small acinar proliferation (ASAP) and lower number of core taken were independently associated with a higher risk of unfavourable disease.
The inclusion of Gs=3+4 in patients suitable to AS does not enhance the risk of unfavourable disease after radical prostatectomy. Additional factors such as number of cores taken and the presence of ASAP should be considered in patients suitable for AS.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
In this work we integrate augmented reality technology in a product development process using real technical drawings as a tangible interface for design review. We present an original collaborative ...framework for Augmented Design Review Over Network (ADRON). It provides the following features: augmented technical drawings, interactive FEM simulation, multimodal annotation and chat tools, web content integration and collaborative client/server architecture. Our framework is intended to use common hardware instead of expensive and complex virtual or augmented facilities. We designed the interface specifically for users with little or no augmented reality expertise proposing tangible interfaces for data review and visual editing for all the functions and configurations. Two case studies are presented and discussed: a real-time “touch and see” stress/strain simulation and a collaborative distributed design review session of an industrial component.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Athletes use their skeletal muscles to demonstrate performance. Muscle force generating capacity is correlated with volume, meaning that variations in sizes of different muscles may be indicative of ...how athletes meet different demands in their sports. Medical imaging enables in vivo quantification of muscle volumes, however muscle volume distribution has not been compared across athletes of different sports.
The goal of this work was to define "muscular phenotypes" in athletes of different sports and compare these using hierarchical clustering.
Muscle volumes normalized by body mass of athletes (football, baseball, basketball, or track) were compared to control participants to quantify size differences using Z-scores. Z-scores of 35 muscles described the pattern of volume deviation within each athlete's lower limb, characterizing their muscular phenotype. Data-driven high-dimensional clustering analysis was used to group athletes presenting similar phenotypes. Efficacy of clustering to identify similar phenotypes was demonstrated by grouping athletes' contralateral limbs before other athletes' limbs.
Analyses revealed that athletes did not tend to cluster with others competing in the same sport. Basketball players with similar phenotypes grouped by clustering also demonstrated similarities in performance. Clustering also identified muscles with similar volume variation patterns across athletes and principal component analysis revealed specific muscles that accounted for most of the variance (gluteus maximus, sartorius, semitendinosus, vastus medialis, vastus lateralis, and rectus femoris).
Athletes exhibit heterogeneous lower limb muscle volumes that can be characterized and compared as individual muscular phenotypes. Clustering revealed that athletes with the most similar phenotypes do not always play the same sport such that patterns of muscular heterogeneity across a group of athletes reflects factors beyond their specific sports.
•Dual-fluoroscopy measured in vivo kinematics during static and dynamic activities.•Hip rotation was measured during static and dynamic activities.•Static hip rotation was strongly correlated with ...dynamic hip rotation.•Femoral anteversion was positively correlated with static and dynamic hip rotation.•Data suggest subjects use hip rotation to compensate for increased anteversion.
Individuals are thought to compensate for femoral anteversion by altering hip rotation. However, the relationship between hip rotation in a neutral position (i.e. static rotation) and dynamic hip rotation is poorly understood, as is the relationship between anteversion and hip rotation.
Herein, anteversion and in-vivo hip rotation during standing, walking, and pivoting were measured in eleven asymptomatic, morphologically normal, young adults using three-dimensional computed tomography models and dual fluoroscopy.
Using correlation analyses, we: 1) determined the relationship between hip rotation in the static position to that measured during dynamic activities, and 2) evaluated the association between femoral anteversion and hip rotation during dynamic activities. Hip rotation was calculated while standing (static-rotation), throughout gait, as a mean during gait (mean gait rotation), and as a mean (mid-pivot rotation), maximum (max-rotation) and minimum (min-rotation) during pivoting.
Static-rotation (mean ± standard deviation; 11.3° ± 7.3°) and mean gait rotation (7.8° ± 4.7°) were positively correlated (r = 0.679, p = 0.022). Likewise, static-rotation was strongly correlated with mid-pivot rotation (r = 0.837, p = 0.001), max-rotation (r = 0.754, p = 0.007), and min-rotation (r = 0.835, p = 0.001). Strong positive correlations were found between anteversion and hip internal rotation during all of the stance phase (0–60% gait) and during mid- and terminal-swing (86–100% gait) (all r > 0.607, p < 0.05).
Our results suggest that the static position may be used cautiously to express the neutral rotational position of the femur for dynamic movements. Further, our results indicate that femoral anteversion is compensated for by altering hip rotation. As such, both anteversion and hip rotation may be important to consider when diagnosing hip pathology and planning for surgical procedures.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Rigid body musculoskeletal models have been applied to study kinematics, moments, muscle forces, and joint reaction forces in the hip. Most often, models are driven with segment motions calculated ...through optical tracking of markers adhered to the skin. One limitation of optical tracking is soft tissue artifact (STA), which occurs due to motion of the skin surface relative to the underlying skeleton. The purpose of this study was to quantify differences in musculoskeletal model outputs when tracking body segment positions with skin markers as compared to bony landmarks measured by direct imaging of bone motion with dual fluoroscopy (DF). Eleven asymptomatic participants with normally developed hip anatomy were imaged with DF during level treadmill walking at a self-selected speed. Hip joint kinematics and kinetics were generated using inverse kinematics, inverse dynamics, static optimization and joint reaction force analysis. The effect of STA was assessed by comparing the difference in estimates from simulations based on skin marker positions (SM) versus virtual markers on bony landmarks from DF. While patterns were similar, STA caused underestimation of kinematics, range of motion (ROM), moments, and reaction forces at the hip, including flexion-extension ROM, maximum internal rotation joint moment and peak joint reaction force magnitude. Still, kinetic differences were relatively small, and thus they may not be relevant nor clinically meaningful.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Cam‐type femoroacetabular impingement (FAI) syndrome is a painful, structural hip disorder. Herein, we investigated hip joint mechanics through in vivo, dynamic measurement of the bone‐to‐bone ...distance between the femoral head and acetabulum in patients with cam FAI syndrome and morphologically screened controls. We hypothesized that individuals with cam FAI syndrome would have larger changes in bone‐to‐bone distance compared to the control group, which we would interpret as altered joint mechanics as signified by greater movement of the femoral head as it articulates within the acetabulum. Seven patients with cam FAI syndrome and 11 asymptomatic individuals with typical morphology underwent dual fluoroscopy imaging during level and inclined walking (upward slope). The change in bone‐to‐bone distance between femoral and acetabular bone surfaces was evaluated for five anatomical regions of the acetabulum at each timepoint of gait. Linear regression analysis of the bone‐to‐bone distance considered two within‐subject factors (activity and region) and one between‐subjects factor (group). Across activities, the change in minimum bone‐to‐bone distance was 1.38–2.54 mm for the cam FAI group and 1.16–1.84 mm for controls. In all regions except the anterior–superior region, the change in bone‐to‐bone distance was larger in the cam group than the control group (p ≤ 0.024). An effect of activity was detected only in the posterior–superior region where larger changes were noted during level walking than incline walking. Statement of clinical significance: Patients with cam FAI syndrome exhibit altered hip joint mechanics during the low‐demand activity of walking; these alterations could affect load transmission, and contribute to pain, tissue damage, and osteoarthritis.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
A prospective study of a series of 77 patients on adjuvant radiochemotherapy following surgery for high-grade gliomas was conducted to evaluate the risk of deep vein thrombosis and identify risk ...factors. We found a 20.8% risk of deep vein thrombosis at 12 months (standard error = 4.8%) and a 31.7% risk (standard error = 7.4%) at 24 months (Kaplan-Meier method). Twenty patients (26%) developed deep vein thrombosis with a maximum incidence within the first 7 months after surgery when chemotherapy was still being administered, often with corticosteroids. The risk factors identified were histology (glioblastoma versus anaplastic astrocytoma,
P = 0.032, log rank test; 0.0485 L-ratio) and the presence of paresis (
P = 0.010, log rank test; 0.0161 L-ratio). A borderline tendency was found for an association between the deep vein thrombosis site and the side of paresis (
P = 0.103, Fisher's exact test). Four patients (5%) had massive pulmonary embolism, which was fatal in 3 (4%).
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IJS, IMTLJ, KILJ, KISLJ, NUK, SBCE, SBJE, UL, UM, UPCLJ, UPUK
In general, different mechanisms may be identified as responsible of runoff generation during ordinary events or extraordinary events at the basin scale. In a simplified scheme these mechanisms may ...be represented by different runoff thresholds. In this context, the derived flood frequency model, based on the effect of partial contributing areas on peak flow, proposed by Iacobellis and Fiorentino (2000), was generalized by providing a new formulation of the derived distribution where two runoff components are explicitly considered. The model was tested on a group of basins in Southern Italy characterized by annual maximum flood distributions highly skewed. The application of the proposed model provided good results in terms of descriptive ability. Model parameters were also found to be well correlated with geomorphological basin descriptors. Two different threshold mechanisms, associated respectively to ordinary and extraordinary events, were identified. In fact, we found that ordinary floods are mostly due to rainfall events exceeding a threshold infiltration rate in a small source area, while the so-called outlier events, responsible of the high skewness of flood distributions, are triggered when severe rainfalls exceed a threshold storage in a large portion of the basin.
•Knee (arthro)kinematics from dual fluoroscopic imaging and model-based tracking.•Effects of interpolation and intra-user variability on knee (arthro)kinematics.•Interpolation techniques did not ...decrease measurement accuracy.•Intra-user variability had small effect on same order as system accuracy.
Model-based tracking (MBT) is a time-consuming and semiautomatic approach, and thus subject to errors during the tracking process. The present study aimed primarily to quantify the effects that interpolation and intra-user variability associated with MBT have on the kinematic and arthrokinematic measurements in comparison to a gold standard radiostereometric analysis (RSA). Cadaveric knee specimens were imaged at 125 Hz while simulating standing, walking, jogging, and lunging motions. (Arthro)kinematic metrics were calculated via MBT without interpolation, MBT with two interpolation techniques when every fifth or tenth frame was analyzed, and RSA. Tracking the same activity multiple times affected (p-value, largest mean difference) the flexion-extension (FE) joint angle during walking (0.03, 0.6°), and the internal-external joint angle during jogging (0.048, −0.9°). Only during jogging for the FE joint angle was there an effect of interpolation (0.046, 0.3°). Neither tracking multiple times nor interpolation affected arthrokinematic metrics (contact path locations and excursions). The present study is the first to quantify the effects that intra-user variability and interpolation have on the (arthro)kinematic measurement accuracy using MBT. Results suggest interpolation may be used without sacrificing (arthro)kinematic outcome measurement accuracy and the errors associated with intra-user variability, while small, were larger than errors due to interpolation.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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