A molecular simulation is introduced for studying polyamide film formation by interfacial polymerization (IP), a highly used method for the synthesis of separation membranes. The simulation uses a ...modified cluster–cluster aggregation (CCA) model to simulate polymerization of functional monomers (e.g., trymesol chloride and phenylene diamine) at an interface between two liquid phases. By controlling the partition coefficient of each monomer in the opposite phase, the film is driven to form in the organic phase, as observed experimentally. The polymer film shows a dense core with looser ends, and an inhomogeneous charge distribution. The dense core of the membrane forms quickly, followed by slow polymerization reaction that leads to further densification of the membrane core. The simulation provides a basis for studying the IP process and can be used to carry out membrane performance studies on the molecular level.
The increasing ability of neuroscience to analyse and modulate human brain functions calls for a new regulatory approach to identify and deal with potential harmful applications in the early stages ...of development.
Frailty is becoming increasingly prevalent in the elderly population although a lack of consensus regarding a clinical definition hampers comparison of clinical studies. More elderly patients are ...being assessed for surgical intervention but the effect of frailty on surgical related outcomes is still not clear.
A systematic literature search for studies prospectively reporting frailty and postoperative outcomes in patients undergoing surgical intervention was performed with data collated from a total of 12 studies. Random effects meta-analysis modelling was undertaken to estimate the association between frailty and mortality rates (in-hospital and one-year), length of hospital stay and the need for step-down care for further rehabilitation/nursing home placement.
Frailty was associated with a higher in-hospital mortality rate (pooled odds ratio OR: 2.77, 95% confidence interval CI: 1.62-4.73), a higher one-year mortality rate (pooled OR: 1.99, 95% CI: 1.49-2.66), a longer hospital stay (pooled mean difference: 1.05 days, 95% CI: 0.02-2.07 days) and a higher discharge rate to further rehabilitation/step-down care (pooled OR: 5.71, 95% CI: 3.41-9.55).
The presence of frailty in patients undergoing surgical intervention is associated with poorer outcomes with regard to mortality and return to independence. Further in-depth studies are required to identify factors that can be optimised to reduce the burden of frailty in surgical patients.
Background
This study aimed to examine the correlation between intraoperative and pathological findings for patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy ...(CRS/HIPEC) and to determine their prognostic significance.
Methods
Pathological reports of all colorectal cancer (CRC) patients undergoing CRS/HIPEC between 2009 and 2016 were retrospectively reviewed. Pathological specimens lacking tumor cells were defined as negative pathological specimens (NPS). The intraoperative peritoneal cancer index (PCI) and pathological PCI (excluding NPS) were calculated separately. Receiver operating characteristic (ROC) curves were applied to compare the prognostic value of intraoperative and pathological scoring systems.
Results
For 108 CRC patients, 113 CRS/HIPEC procedures were performed. Of 959 pathological specimens examined, 178 (18.6%) were NPS. Overall, 78 procedures (69%) showed NPS. In 52 procedures (46%), the pathological PCI differed from the intraoperative PCI (∆PCI > 0). The ROC areas for intraoperative PCI and pathological PCI were similar in predicting 1-year overall survival (OS), 2-year OS, and 1-year disease-free survival (all
p
values not significant). However, for the patients with NPS, the number of positive specimens (containing tumor tissue) was superior to intraoperative PCI in predicting 2-year OS (ROC under the curve areas, 0.69 vs. 0.58, respectively;
p
= 0.012). In addition, a subgroup of 15 patients with a high ∆PCI (≥ 3) had a more favorable median OS than a matched group of 30 patients with similar intraoperative PCI and a ∆PCI of 0 (median survival not reached vs. 21.6 months, respectively;
p
= 0.05).
Conclusions
In the majority of CRC CRS/HIPEC procedures, NPS may be found. Among patients with NPS, pathological correlation may have a prognostic significance.
We report an anti‐rheumatic/inflammatory activity of the non‐toxic, tellurium‐based immunomodulatory compound AS101 in experimental RA by reducing disease progression, by blocking extravasation of ...inflammatory VLA4+ cells into the joint and by preservation of joint tissue architecture.
Summary
Despite undeniable improvement in the management of rheumatoid arthritis (RA), the discovery of more effective, less toxic and, ideally, less immune suppressive drugs are much needed. In the current study, we set to explore the potential anti‐rheumatic activity of the non‐toxic, tellurium‐based immunomodulator, AS101 in an experimental animal model of RA. The effect of AS101 was assessed on adjuvant‐induced arthritis (AIA) rats. Clinical signs of arthritis were assessed. Histopathological examination was used to assess inflammation, synovial changes and tissue lesions. Very late antigen‐4 (VLA‐4)+ cellular infiltration was detected using immunohistochemical staining. Enzyme‐linked immunosorbent assay (ELISA) was used to measure circulating anti‐cyclic citrullinated‐peptide autoantibody (ACPA) and real‐time polymerase chain reaction (PCR) was used to measure the in‐vitro effect of AS101 on interleukin (IL)‐6 and IL‐1β expression in activated primary human fibroblasts. Prophylactic treatment with intraperitoneal AS101 reduced clinical arthritis scores in AIA rats (P < 0·01). AS101 abrogated the migration of active chronic inflammatory immune cells, particularly VLA‐4+ cells, into joint cartilage and synovium, reduced the extent of joint damage and preserved joint architecture. Compared to phosphate‐buffered saline (PBS)‐treated AIA rats, histopathological inflammatory scores were significantly reduced (P < 0·05). Furthermore, AS101 resulted in a marked reduction of circulating ACPA in comparison to PBS‐treated rats (P < 0·05). Importantly, AS101 significantly reduced mRNA levels of proinflammatory mediators such as IL‐6 (P < 0·05) and IL‐1β (P < 0·01) in activated primary human fibroblasts. Taken together, we report the first demonstration of the anti‐rheumatic/inflammatory activity of AS101 in experimental RA model, thereby supporting an alternative early therapeutic intervention and identifying a promising agent for therapeutic intervention.
Digital tools to promote remote lesson study Weaver, Joanna C.; Matney, Gabriel; Goedde, Allison M. ...
International journal for lesson and learning studies,
05/2021, Letnik:
10, Številka:
2
Journal Article
Odprti dostop
PurposeThe authors propose that a digital instructional delivery format of lesson study (LS) may have the potential to amplify particular aspects of traditional, face-to-face ...LS.Design/methodology/approachThis is a qualitative case study, using data triangulation, member checking and an inductive approach to open-coding utilizing grounded theory to identify codes and themes.FindingsDigital tools promoted LS and learning, allowing for rigorous collaboration, synchronous observations, data collection and feedback, leading to deeper understanding.Research limitations/implicationsDigital tools used in the online LS process changed how instructional planning can be researched, analyzed and written collaboratively and impacted the fluidity of a lesson, the ease of observation and reflection, student engagement and the researchers' and students' ability to share ideas in real time.Practical implicationsLS can be integrated into online teacher education programs to engage students in online learning and promotes engagement, peer interaction and student voice. The use of these digital tools is not restricted just to remote instructional contexts.Social implicationsLS reduces teacher isolation, builds a collaborative community of teachers and increases instructional motivation. Educators across schools, universities or districts can integrate online LS into remote teacher education programs and online courses.Originality/valueThis study is original work that has not been published elsewhere.
Renal Tumors in Young Adults EGGENER, S.E.; RUBENSTEIN, J.R.; SMITH, N.D. ...
The Journal of urology,
2004, 2004-Jan, 2004-01-00, 20040101, Letnik:
171, Številka:
1
Journal Article
Recenzirano
The clinical and pathological features of solid or complex cystic renal masses in young adults have not been defined. We present our experience with patients 17 to 45 years old with such renal masses ...to define the incidence of malignant vs benign lesions, familial tendencies and clinical outcomes.
The medical records of all patients 17 to 45 years old who presented with a solid or suspicious complex cystic renal mass at 2 tertiary care hospitals between 1988 and 2002 were retrospectively reviewed. Pertinent clinical information was compiled, including age, gender, mode of presentation, renal function, year and type of surgery, pathological analysis and survival data.
There were 114 evaluable patients who underwent a total of 119 nephrectomies. Mean patient age was 37.1 years and males comprised 56.1% of the population. Twelve patients had familial renal cell carcinoma (RCC), the von Hippel-Lindau syndrome. Mode of presentation for patients with sporadic disease was symptomatic (55.9%), incidental (35.3%) or unknown (8.8%). Radical nephrectomy, partial nephrectomy and nephroureterectomy were performed in 80 kidneys (67.2%), 37 (31.1%) and 2 (1.7%), respectively. Malignant lesions comprised 79.8% of all masses and 95.8% of these were renal cell carcinoma. Of the RCCs 75.8% were grade 1 or 2 and 89% were organ confined. Young women were much more likely than men to have a benign lesion (36.0% vs 9.5%, p <0.01) and the diversity of histologies was impressive (of the 24 total benign masses 9 were different tumor types). With an average followup of 38.3 months overall survival is 90.2%. Among patients with RCC 84.9% are alive and cancer-free, 11.6% are dead from disease and 3.5% are alive with recurrent disease.
We report the largest known series of solid or suspicious complex renal masses in young adults. As expected, familial tumors are more common in this population. While RCC is the most common tumor, a wide variety of potential pathological outcomes are possible, particularly in women, who were much more likely to have a benign lesion. RCC in this patient population appears to have a favorable prognosis, despite symptomatic presentation in the majority of cases.
A Decade of Advances in Military Trauma Care Glassberg, E.; Nadler, R.; Erlich, T. ...
Scandinavian Journal of Surgery,
06/2014, Letnik:
103, Številka:
2
Book Review, Journal Article
Recenzirano
Background:
While combat casualty care shares many key concepts with civilian trauma systems, its unique features mandate certain practices that are distinct from the civilian ones.
Methods:
This is ...a review of the most current literature on combat casualty care, based on computer database searches for studies on combat casualty care and military medicine. Studies were selected for inclusion in this review based on their relevance and contribution.
Results:
Over the last decade, meticulous, international data collection and research efforts have led to significant improvements in military trauma care. Combat medicine has focused on the causes of preventable deaths and targeted on bleeding control and resuscitation strategies, as well as improved evacuation. En route care and forward surgical interventions have resulted in unprecedented low fatality rates and the saving of more lives.
Conclusion:
This overview of the developments in combat casualty care in recent years emphasizes medical practices that are characteristic of combat medicine, yet with the potential to save lives in other scenarios, as well.
We quantify the causes of elevated serum prostate specific antigen (PSA) concentrations in men whose prostate biopsies repeatedly showed no cancer.
The effects of prostate volume, inflammation, ...echogenicity on ultrasound and calculi were examined in a large PSA-based screening population of 148 men with serum PSA concentrations greater than 4.0 ng./ml., findings suspicious for cancer on digital rectal examination and multiple negative biopsies. These men were selected and compared to 64 men with suspicious rectal examinations, multiple negative biopsies and serum PSA concentrations of 4.0 ng./ml. or less.
The high PSA group had larger prostates (68 versus 33 cc, p = 0.0001) and significantly more subclinical prostatic inflammation. Acute and chronic inflammation was more prevalent in the high PSA group (63 percent versus 27 percent, p = 0.0001 and 99 percent versus 77 percent, p = 0.0001, respectively). A simultaneous regression analysis showed that prostatic size accounted for 23 percent, inflammation 7 percent, prostatic calculi 3 percent and nonisoechoic ultrasound lesions 1 percent of the serum PSA variance.
Prostate volume and inflammation are the most important factors contributing to serum PSA elevation in men without clinically detectable prostate cancer.
To evaluate measurement of percentage of free prostate-specific antigen (PSA) in serum to improve the specificity of prostate cancer screening in men with serum PSA levels between 4.1 and 10.0 ng/mL.
...Retrospective, nonrandomized analysis using a research assay for measuring free PSA in frozen serum from men with a spectrum of prostate sizes and digital rectal examination results.
General community outpatient prostate cancer screening program at a university center.
One hundred thirteen men aged 50 years or older, 99% of whom were white, with serum PSA concentrations of 4.1 to 10.0 ng/mL, including 63 men with histologically confirmed benign prostatic hyperplasia, 30 with prostate cancer with an enlarged gland, and 20 with cancer with a normal-sized gland. All study volunteers had undergone prostatic ultrasonography and biopsy.
Percentage of free PSA in serum and percentage of free PSA cutoff that maintained at least 90% sensitivity for prostate cancer detection.
Median percentage of free PSA was 9.2% in men with cancer and a normal-sized gland, 15.9% in men with cancer and an enlarged gland, and 18.8% in men with benign prostatic hyperplasia (P < .001). The percentage of free PSA cutoff was higher in men with an enlarged gland and in those with a palpably benign gland. In men with an enlarged, palpably benign gland, a free PSA cutoff of 23.4% or lower detected at least 90% of cancers and would have eliminated 31.3% of negative biopsies.
Measurement of percentage of free serum PSA improves specificity of prostate cancer screening in selected men with elevated total serum PSA levels and can reduce unnecessary prostate biopsies with minimal effects on the cancer detection rate; however, further studies are needed to define optimal cutoffs. Final evaluation of PSA screening also must consider the ability of current treatments to improve the prognosis of screen-detected prostate cancer.
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