Studies suggest that the efficacy of cancer chemotherapy and immunotherapy is influenced by intestinal bacteria. However, the influence of the microbiome on radiation therapy is not as well ...understood, and the microbiome comprises more than bacteria. Here, we find that intestinal fungi regulate antitumor immune responses following radiation in mouse models of breast cancer and melanoma and that fungi and bacteria have opposite influences on these responses. Antibiotic-mediated depletion or gnotobiotic exclusion of fungi enhances responsiveness to radiation, whereas antibiotic-mediated depletion of bacteria reduces responsiveness and is associated with overgrowth of commensal fungi. Further, elevated intratumoral expression of Dectin-1, a primary innate sensor of fungi, is negatively associated with survival in patients with breast cancer and is required for the effects of commensal fungi in mouse models of radiation therapy.
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•Commensal bacteria support antitumor T cell responses following radiation therapy•Depletion of intestinal bacteria leads to expansion of commensal fungal populations•Commensal fungi promote pro-tumor macrophage actions by impeding antitumor T cells•Tumor-associated macrophages sense fungi through a Dectin-1-mediated mechanism
Depletion of commensal bacteria leads to expansion of commensal fungi and reduced antitumor immunity following irradiation of tumors. Targeting commensal fungi enhanced the radiation-induced antitumor immune response by reducing macrophage-mediated immunosuppression. Thus, Shiao et al. demonstrate opposing effects of commensal bacteria and fungi on antitumor immunity following radiation.
Despite advances in the nonsurgical management of cerebrovascular atherosclerotic steno-occlusive disease, approximately 15-20% of patients remain at high risk for recurrent ischemia. The benefit of ...revascularization with flow augmentation bypass has been demonstrated in studies of Moyamoya vasculopathy. Unfortunately, there are mixed results for the use of flow augmentation in atherosclerotic cerebrovascular disease. We conducted a study to examine the efficacy and long term outcomes of superficial temporal artery to middle cerebral artery (STA-MCA) bypass in patients with recurrent ischemia despite optimal medical management.
A single-institution retrospective review of patients receiving flow augmentation bypass from 2013-2021 was conducted. Patients with non-Moyamoya vaso-occlusive disease (VOD) who had continued ischemic symptoms or strokes despite best medical management were included. The primary outcome was time to post-operative stroke. Time from cerebrovascular accident to surgery, complications, imaging results, and modified Rankin Scale (mRS) scores were aggregated.
Twenty patients met inclusion criteria. The median time from cerebrovascular accident to surgery was 87 (28-105.0) days. Only one patient (5%) had a stroke at 66 days post-op. One (5%) patient had a post-operative scalp infection, while 3 (15%) developed post-operative seizures. All 20 (100%) bypasses remained patent at follow-up. The median mRS score at follow up was significantly improved from presentation from 2.5 (1-3) to 1 (0-2), P = .013.
For patients with high-risk non-Moyamoya VOD who have failed optimal medical therapy, contemporary approaches to flow augmentation with STA-MCA bypass may prevent future ischemic events with a low complication rate.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The last 2 years have been a period of unprecedented growth for the MOOSE community and the software itself. The number of monthly visitors to the website has grown from just over 3,000 to now ...averaging 5,000. In addition, over 1,800 pull requests have been merged since the beginning of 2020, and the new discussions forum has averaged 600 unique visitors per month. The previous publication has been cited over 200 times since it was published 2 years ago. This paper serves as an update on some of the key additions and changes to the code and ecosystem over the last 2 years, as well as recognizing contributions from the community.
In medical image segmentation, tumors and other lesions demand the highest levels of accuracy but still call for the highest levels of manual delineation. One factor holding back automatic ...segmentation is the exemption of pathological regions from shape modelling techniques that rely on high-level shape information not offered by lesions. This paper introduces two new statistical shape models (SSMs) that combine radial shape parameterization with machine learning techniques from the field of nonlinear time series analysis. We then develop two dynamic contour models (DCMs) using the new SSMs as shape priors for tumor and lesion segmentation. From training data, the SSMs learn the lower level shape information of boundary fluctuations, which we prove to be nevertheless highly discriminant. One of the new DCMs also uses online learning to refine the shape prior for the lesion of interest based on user interactions. Classification experiments reveal superior sensitivity and specificity of the new shape priors over those previously used to constrain DCMs. User trials with the new interactive algorithms show that the shape priors are directly responsible for improvements in accuracy and reductions in user demand.
Background 1 in 700–1000 children in the UK have Type 1 Diabetes (T1DM), with an increasing incidence reported worldwide. Although there is increased awareness of diabetes amongst teenagers, their ...knowledge and perception of T1DM has not been reported in the UK. Aim 1. Determine teenagers’ (11–18 year olds) perceptions and general knowledge of T1DM and compare with curriculum 2. Explore the relationships age, gender and having a friend with T1DM with knowledge of disease. Methods A questionnaire survey of 11–18 year old pupils, at a suburban secondary school, was undertaken by a student (JCP) as a project after permission from school authorities. Data was collected and analysed using Excel programme. Results The surveys were given to 980 pupils and 390 voluntarily completed them. Regarding general knowledge, the vast majority knew the pancreas secreted insulin (80%) and diabetes was due to the pancreas ‘not functioning well’ (70%). However, 31% did not think T1DM was a disease, including those closely related to someone with T1DM (12%). 35% thought T1DM was due to a deficiency of a ‘diet nutrient’. Only 39% knew that insulin decreased blood glucose with a significant percentage not knowing the role of insulin (29%). Knowledge of symptoms, part of GCSE curriculum, was variable (tiredness- 64%; excessive thirst -41%; excessive urination- 38%.) 41% thought weight gain instead of weight loss was a symptom. General perceptions about T1DM are accurate (diet, school trips, extra snacks) but interestingly only 78% and 53% of students thought T1DM did not affect academic ability or ability to exercise, respectively. Generally, knowledge and perceptions were more accurate in older age groups but gender or ‘knowing a person with diabetes’ had no effect. Conclusions Teaching regarding T1DM at schools has imparted a number of facts but there is a knowledge gap. There are still incorrect perceptions of how Diabetes affects lifestyle, surprisingly even amongst those related to someone with T1DM. We believe there should be an improved and concerted public health and education initiative at improving awareness amongst schoolchildren. This could involve educational visits by the Diabetes MDT team and talks by children or staff with T1DM.
Knee dislocations are severe musculoskeletal injuries that are often associated with neurovascular injury. The most common nerve injured with a knee dislocation is the peroneal nerve. Nerve injury ...can result in severe functional consequences to the injured patient. The purpose of this article is to review the most current literature on treatment options and outcomes when addressing these injuries.
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