Neoadjuvant treatment (NT) with chemotherapy (Ch) is a standard option for resectable stage III (N2) NSCLC. Several studies have suggested benefits with the addition of radiotherapy (RT) to NT Ch. ...The International Association for the Study of Lung Cancer (IASLC) published recommendations for the pathological response (PHR) of NSCLC resection specimens after NT.
To contribute to the IASLC recommendations showing our results of PHR to NT Ch
NT chemoradiotherapy (ChRT).
We analyzed 67 consecutive patients with resectable stage III NSCLC with positive mediastinal nodes treated with surgery after NT Ch or NT ChRT between 2013 and 2020. After NT, all patients were evaluated for radiological response (RR) according to Response Evaluation Criteria in Solid Tumours criteria and evaluated for surgery by a specialized group of thoracic surgeons. All histological samples were examined by the same two pathologists. PHR was evaluated by the percentage of viable cells in the tumor and the resected lymph nodes.
Forty patients underwent NT ChRT and 27 NT Ch. Fifty-six (83.6%) patients underwent surgery (35 ChRT and 21 Ch). The median time from ChRT to surgery was 6 wk (3-19) and 8 wk (3-21) for Ch patients. We observed significant differences in RR, with disease progression in 2.5% and 14.8% of patients with ChRT and Ch, respectively, and partial response in 62.5% ChRT
29.6% Ch (
= 0.025). In PHR we observed ≤ 10% viable cells in the tumor in 19 (54.4%) and 2 cases (9.5%), and in the resected lymph nodes (RLN) 30 (85.7%) and 7 (33.3%) in ChRT and Ch, respectively (
= 0.001). Downstaging was greater in the ChRT compared to the Ch group (80%
33.3%;
= 0.002). In the univariate analysis, NT ChRT had a significant impact on partial RR odds ratio (OR) 12.5; 95% confidence interval (CI): 1.21 - 128.61;
= 0.034, a decreased risk of persistence of cancer cells in the tumor and RLN and an 87.5% increased probability for achieving downstaging (OR 8; 95%CI: 2.34-27.32;
= 0.001).
We found significant benefits in RR and PHR by adding RT to Ch as NT. A longer follow-up is necessary to assess the impact on clinical outcomes.
•Lecithin-linker microemulsions were optimized to form single phase systems with intestinal fluid.•Lecithin-linkers-oil (with the solubilized drug) can be diluted up to 500 times with intestinal ...fluid.•The diluted systems produce stable emulsions with 100–200nm drop size.•The emulsions drops irreversible permeate to the excised intestine.
Lecithin-linker microemulsions are formulations produced with soybean lecithin in combination with a highly lipophilic (lipophilic linker) and highly hydrophilic (hydrophilic linkers) surfactant-like additives. In this work, lecithin-linker systems were formulated to produce self-emulsifying delivery systems for β-carotene and β-sitosterol. The concentration of the lipophilic linker, sorbitan monooleate, was adjusted to minimize the formation of liquid crystals. The concentration of hydrophilic linkers, decaglyceryl caprylate/caprate and PEG-6-caprylic/capric glycerides, was gradually increased (scanned) until single phase clear microemulsions were obtained. For these scans, the oil (ethyl caprate) to water ratio was set to 1. The single phase, clear microemulsions were diluted with fed-state simulated intestinal fluid (FeSSIF) and produced stable emulsions, with drop sizes close to 200nm. Using pseudo-ternary phase diagrams to evaluate the process of dilution of microemulsion preconcentrates (mixtures of oil, lecithin and linkers with little or no water) with FeSSIF, it was determined that self-emulsifying systems are obtained when the early stages of the dilution produce single phase microemulsions. If liquid crystals or multiple phase systems are obtained during those early stages, then the emulsification yields unstable emulsions with large drop sizes. An in vitro permeability study conducted using a Flow-Thru Dialyzer revealed that stable emulsions with drop sizes of 150–300nm produce large and irreversible permeation of β-carotene to sheep intestine. On the other hand, unstable emulsions produced without the linker combination separated in the dialyzer chamber.
Los procesos de toma de decisiones en política pública tienden a estudiarse desde perspectivas racionalistas y en diversos modelos de decisión. Sin embargo, desde el punto de vista de algunas teorías ...organizacionales, tanto las emociones como las percepciones de los actores tienen un rol en el proceso decisorio, lo que genera tensiones en la literatura relacionada con elementos subjetivos y la motivación racional. Este artículo analiza los aspectos subjetivos y las características organizacionales de los tomadores de decisión en una organización pública a través del método autoetnográfico y de una estrategia de análisis narrativa. Los resultados muestran cómo una organización pública es autopoiética y su constitución depende de las emociones debido a los nexos con los deseos, las creencias y la información, así como la acción comunicativa es relevante en la gobernabilidad local. La investigación aporta a los estudios desde las ciencias sociales aspectos relevantes sobre la subjetividad y las organizaciones públicas, y a la dimensión organizacional, sobre la formulación de políticas públicas.
Decision-making processes in public policy are often studied from rationalist perspectives and various decision models. However, according to some organizational theories, both the emotions and perceptions of involved actors play a role in decision-making, leading to tensions in the literature addressing subjective elements and rational motivations. This article examines the subjective aspects and organizational characteristics of decision-makers in a public organization using autoethnographic methods and a narrative analysis strategy. Our results demonstrate how a public organization is autopoietic, and its constitution depends on emotions due to their connections with desires, beliefs, and information. The findings also highlight the importance of communicative action in local governance. This research provides valuable insights from the social sciences into the study of subjectivity and public organizations and contributes to the organizational dimension of public policy creation.
os processos de tomada de decisão em políticas públicas tendem a ser estudados a partir de perspectivas racionalistas e em vários modelos de decisão. No entanto, do ponto de vista de algumas teorias organizacionais, tanto as emoções quanto as percepções dos atores desempenham um papel no processo decisório, o que gera tensões na literatura relacionadas a elementos subjetivos e à motivação racional. Neste artigo, são analisados os aspectos subjetivos e as características organizacionais dos tomadores de decisão em uma organização pública por meio do método autoetnográfico e de uma estratégia de análise narrativa. Os resultados mostram como uma organização pública é autopoiética e sua constituição depende de emoções devido a vínculos com desejos, crenças e informações, e como a ação comunicativa é relevante na governança local. A pesquisa contribui para os estudos das ciências sociais com aspectos relevantes sobre a subjetividade e as organizações públicas, e para a dimensão organizacional, na formulação de políticas públicas.
DnaJ proteins are essential co-chaperones involved in abiotic and biotic stress responses. Arabidopsis AtDjA3 gene encodes a molecular co-chaperone of 420 amino acids, which belongs to the J-protein ...family. In this study, we report the functional characterization of the AtDjA3 gene using the Arabidopsis knockout line designated j3 and the 35S::AtDjA3 overexpression lines. Loss of AtDjA3 function was associated with small seed production. In fact, j3 mutant seeds showed a reduction of 24% in seed weight compared to Col-0 seeds. Expression analysis showed that the AtDjA3 gene was modulated in response to NaCl, glucose, and abscisic acid (ABA). The j3 line had increased sensitivity to NaCl and glucose treatments in the germination and cotyledon development in comparison to parental Col-0. Furthermore, the j3 mutant line exhibited higher ABA sensitivity in comparison to parental Col-0 and 35S::AtDjA3 overexpression lines. In addition, we examined the expression of ABI3 gene, which is a central regulator in ABA signaling, in j3 mutant and 35S::AtDjA3 overexpression lines. Under 5 μM ABA treatment at 24 h, j3 mutant seedlings displayed higher ABI3 expression, whereas in 35S::AtDjA3 overexpression lines, ABI3 gene expression was repressed. Taken together, these results demonstrate that the AtDjA3 gene is involved in seed development and abiotic stress tolerance.
Las crisis migratorias, el aumento de mujeres refugiadas y el rol de la ayuda humanitaria a poblaciones afectadas por situaciones excepcionales implica generar, en organizaciones humanitarias, ...estudios de género en la gestión de las crisis migratorias en contextos extremos, a partir de su coordinación eficaz.
Este artículo analiza cualitativamente la coordinación interorganizacional por medio de las estructuras relacionales internas y externas de los diferentes retos de una ONG colombiana que alberga y recibe mujeres venezolanas refugiadas, en la perspectiva de los estudios de implementación de políticas públicas de tercera generación.
Los resultados permiten proponer un modelo de análisis interorganizacional para la gestión de la ayuda humanitaria en crisis migratorias de mujeres refugiadas con la participación de múltiples partes interesadas (Estados, ONG, organizaciones internacionales).
There is evidence that pluripotency of mouse embryonic stem (ES) cells is associated with the activity of a network of transcription factors with Sox2, Oct4, and Nanog at the core. Using fluorescent ...reporters for the expression of Nanog, we observed that a population of ES cells is best described by a dynamic distribution of Nanog expression characterized by two peaks defined by high (HN) and low (LN) Nanog expression. Typically, the LN state is 5%-20% of the total population, depending on the culture conditions. Modelling of the activity of Nanog reveals that a simple network of Oct4/Sox2 and Nanog activity can account for the observed distribution and its properties as long as the transcriptional activity is tuned by transcriptional noise. The model also predicts that the LN state is unstable, something that is born out experimentally. While in this state, cells can differentiate. We suggest that transcriptional fluctuations in Nanog expression are an essential element of the pluripotent state and that the function of Sox2, Oct4, and Nanog is to act as a network that promotes and maintains transcriptional noise to interfere with the differentiation signals.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
RESUMEN Introducción: Los tumores neuroendocrinos representan un grupo de neoplasias de baja incidencia que derivan de células neuroendocrinas distribuidas en todo el cuerpo en especial sistema ...respiratorio y gastrointestinal. Objetivo: Determinar las características clínicas y sociodemográficas de una población adulta con padecimiento de tumores neuroendocrinos. Materiales y métodos: Estudio descriptivo transversal, se evaluaron 91 historias clínicas con diagnóstico de tumores neuroendocrinos confirmados por patología entre los años 2013 a 2020. Análisis realizado en Microsoft Excel 2013 y EpiInfo 7.2. Resultados: La media de edad fue 60 años, con predominio en hombres (57%). Los principales antecedentes fueron el tabaquismo (35%), hipertensión arterial (22%) y EPOC (9%). Los principales síntomas fueron el dolor abdominal (43%), pérdida de peso (31%) y tos (26%). Según el origen, fueron más frecuentes los de intestino anterior (75%), predominando los de tracto respiratorio (39,5%). En el 21,9%, el origen fue desconocido. Teniendo en cuenta la clasificación 2019 de la OMS, predominaron los carcinomas neuroendocrinos (56%), de los cuales el más frecuente fue el carcinoma de células pequeñas. Entre los bien diferenciados (44%), fueron más frecuentes los de bajo grado (58%) seguido grado intermedio (24%) y bajo grado (17%). Las metástasis se registraron en 37% de los casos con afectación principalmente hepática (49%), ganglios (21%) y sistema nervioso central (9%). La muerte se presentó en el 24% de los casos. Conclusiones: Los resultados del presente estudio concuerdan con lo reportado a nivel mundial, resaltando el predominio de los tumores de origen pulmonar, como también clínica semejante según los órganos afectados.
The transcription factor Oct4 is required in vitro for establishment and maintenance of embryonic stem cells and for reprogramming somatic cells to pluripotency. In vivo, it prevents the ectopic ...differentiation of early embryos into trophoblast. Here, we further explore the role of Oct4 in blastocyst formation and specification of epiblast versus primitive endoderm lineages using conditional genetic deletion. Experiments involving mouse embryos deficient for both maternal and zygotic Oct4 suggest that it is dispensable for zygote formation, early cleavage and activation of Nanog expression. Nanog protein is significantly elevated in the presumptive inner cell mass of Oct4 null embryos, suggesting an unexpected role for Oct4 in attenuating the level of Nanog, which might be significant for priming differentiation during epiblast maturation. Induced deletion of Oct4 during the morula to blastocyst transition disrupts the ability of inner cell mass cells to adopt lineage-specific identity and acquire the molecular profile characteristic of either epiblast or primitive endoderm. Sox17, a marker of primitive endoderm, is not detected following prolonged culture of such embryos, but can be rescued by provision of exogenous FGF4. Interestingly, functional primitive endoderm can be rescued in Oct4-deficient embryos in embryonic stem cell complementation assays, but only if the host embryos are at the pre-blastocyst stage. We conclude that cell fate decisions within the inner cell mass are dependent upon Oct4 and that Oct4 is not cell-autonomously required for the differentiation of primitive endoderm derivatives, as long as an appropriate developmental environment is established.
Ongoing CPR with an onboard physician Sucunza, Alfredo Echarri; Fernández del Valle, Patricia; Vázquez, Jose Antonio Iglesias ...
Resuscitation plus,
June 2024, 2024-Jun, 2024-06-00, 20240601, 2024-06-01, Letnik:
18
Journal Article
Recenzirano
Odprti dostop
Recent data are not available on ongoing CPR for emergency services with an onboard physician. The aim of the present study was to identify factors associated with the decision to transport patients ...to hospital with ongoing CPR and examine their survival to hospital discharge with good neurological status.
An observational study based on a registry of out-of-hospital cardiac arrests attended to by emergency services with an onboard physician. All OHCA cases occurring between the 1st of January and the 31st of December 2022 were included. Patients receiving ongoing CPR during transport to the hospital were compared with patients pronounced dead at the scene following arrival of the care team. The dependent variable was ongoing CPR during transport to the hospital. The main characteristics and the neurological status of patients surviving to discharge were described.
A total of 9321 cases were included, of which 350 (3.7%) were transported to hospital with ongoing CPR. Such patients were young (59.9 ± 20.1 years vs 64.6 ± 16.9 years; p < 0.001; 95%CI: 0.98 0.98; 0.99) with arrest taking place outside of the home (151 44.5% vs 4045 68.01%; p < 0.001; 95%CI: 0.41 0.31; 0.54) and being witnessed by EMS (126 36.0% vs 667 11.0%; p < 0.001; 95%CI: 4.31 3.19; 5.80), whilst initial rhythm differed from asystole (164 47.6% vs 4325 73.0%; p < 0.01; 95%CI: 0.44 0.33; 0.60) and a mechanical device was more often employed during resuscitation and transport to hospital (199 56.9% vs 2050 33.8%; p < 0.001; 95%CI: 2.75 2.10; 3.59). Seven patients (2%) were discharged alive from hospital, five with ad integrum neurological recovery (CPC1) and two with minimally impaired neurological function (CPC2).
The strategy of ongoing CPR is uncommon in EMS with an onboard physician. Despite their limited efficacy, the availability of mechanical chest compression devices, together with the possibility of specific hospital treatments, mainly ICP and ECMO, opens up the possibility of this approach with determined patients.
{Figure 1}{Table 1}{Table 2} To confirm the diagnosis of HMSN/ACC, we isolated leukocyte-derived genomic deoxyribonucleic acid (DNA) from both affected siblings and their parents and used polymerase ...chain reaction (PCR) to amplify the 25 exons and the exon-intron borders of the SLC12A6 gene (NG_007951.1, NM_133647.1), including the alternative first exon of the KCC3b isoform (NM_005135.2). ...there are six known SLCA12A6 isoforms (http://www.ncbi.nlm.nih.gov/gene/9990), and they exhibit distinct tissue-specific expression patterns. ...there could be a larger genomic rearrangement that was not identified by our cDNA and qPCR analyses, although to our knowledge, no SLC12A6 gene inversion, whole-exon deletion or duplication has been reported in any HMSN/ACC patient, and currently, no multiplex ligation-dependent probe amplification (MLPA) assay for SLC12A6 is commercially available. ...high-density chromosomal microarray analysis and/or next-generation sequencing could be considered as means to document the paternally derived pathogenic variant; these techniques are still not available as part of a routine diagnostic approach in many countries such as ours. ...most of the reports lack any detailed description of nerve conduction studies.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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