Quantitative changes in positron emission tomography with computed tomography imaging metrics over serial scans may be predictive biomarkers. We evaluated the relationship of pretreatment metabolic ...tumor growth rate (MTGR) and standardized uptake value velocity (SUVV) with disease recurrence or death in patients with early-stage non-small cell lung cancer treated with stereotactic ablative radiation therapy (SABR).
Under institutional review board approval, we retrospectively identified patients who underwent positron emission tomography with computed tomography at diagnosis and staging and simulation for SABR. Two cohorts underwent SABR between November 2005 to October 2012 (discovery) and January 2012 to April 2016 (validation). MTGR and SUVV were calculated as the daily change in metabolic tumor volume and maximum standardized uptake value, respectively. Cox proportional hazard models identified predictors of local, regional, and distant recurrence and death for the combined cohort. MTGR and SUVV thresholds dichotomizing risk of death in the discovery cohort were applied to the validation cohort.
A total of 152 lesions were identified in 143 patients (92 lesions in 83 discovery cohort patients). In multivariable models, increasing MTGR trended toward increased hazard of distant recurrence (hazard ratio, 6.98; 95% confidence interval, 0.67-72.61; P = .10). In univariable models, SUVV trended toward risk of death (hazard ratio, 11.8, 95% confidence interval, 0.85-165.1, P = .07). MTGR greater than 0.04 mL/d was prognostic of decreased survival in discovery (P = .048) and validation cohorts (P < .01).
MTGR greater than 0.04 mL/d is prognostic of death in patients with non-small cell lung cancer treated with SABR. Increasing SUVV trends, nonsignificantly, toward increased risk of recurrence and death. MTGR and SUVV may be candidate imaging biomarkers to study in trials evaluating systemic therapy with SABR for patients at high risk of out-of-field recurrence.
When Public and Private Self-Foci Clash Shaffer, David R; Tomarelli, Michele M
Journal of personality and social psychology,
05/1989, Letnik:
56, Številka:
5
Journal Article
Recenzirano
Assessed in 2 experiments the responses of undergraduate Ss who differed in public and private self-consciousness to the intimate or nonintimate self-disclosures of a same-sex confederate. Results of ...both experiments revealed that Ss scoring high on either aspect of self-consciousness and low on the other reciprocated the intimacy of the confederate's disclosures, whereas Ss scoring either high or low on both self-aspects failed to partake in reciprocal self-disclosure. Experiment 2 provided additional information about the processes that underlie these self-consciousness effects on self-disclosure reciprocity. Taken together, the results imply that a strong and predominant focus on either the public or private aspects of self makes one more contingently responsive to the disclosures of a new acquaintance, whereas a strong concurrent focus on both self-aspects can divide one's attention, thereby limiting the extent to which either self-attribute guides self-disclosure.
Previous studies have shown a high prevalence of psychiatric disturbance in children with brain injury. Studies on localized lesions have suggested that injury to the young organism carries a better ...prognosis for recovery of function than injury at a later age. The present study was designed to investigate these phenomena systematically. A representative sample of children (n = 98) who had been hospitalized for treatment of a compound depressed fracture, associated with a dural tear and visible damage to the underlying cortex, was identified from the records of neurosurgical units throughout the United Kingdom.
The children were aged between 3 months and 12 years at the time of injury and between 5 and 15 years at the time of examination. The interval between injury and examination varied but the sample was designed to include only children who had been injured at least two years before examination.
The children were examined neurologically and psychometrically, a detailed account of their current psychiatric state was obtained from one or both parents, and their mental state was assessed in a standard psychiatric examination.
Preliminary data are presented which relate psychiatric, educational and intellectual status at the time of examination to site and severity of injury, age at injury, and to a number of psychosocial variables.
Background Obesity is an established risk factor for pancreatic adenocarcinoma. No study has examined specifically the influence of obesity on malignant risk in patients with intraductal papillary ...mucinous neoplasm (IPMN), a group at substantial risk of pancreatic adenocarcinoma. We hypothesize that obesity is associated with a greater frequency of malignancy in IPMN. Methods Data on patients undergoing resection for IPMN between 1992 and 2012 at a high-volume university institution were collected prospectively. Clinicopathologic and demographic parameters were reviewed. Patients were classified according to World Health Organization categories of body mass index (BMI). Malignancy was defined as high-grade dysplastic or invasive IPMN. Results We collected data on 357 patients who underwent resection for IPMN. Of these, 274 had complete data for calculation of preoperative BMI and 31% had malignant IPMN. Of 254 patients with a BMI of <35 kg/m2 , 30% had malignant IPMN versus 50% in patients with BMI of ≥35 ( P = .08). In branch-duct IPMN, patients with a BMI of <35 had 12% of malignant IPMN compared with 46% in severely obese patients ( P = .01). Alternatively, in main-duct IPMN, no difference was found in the malignancy rate (48% vs 56%; P = .74). Conclusion These findings suggest that obesity is associated with an increased frequency of malignancy in branch-duct IPMN. Obesity is a potentially modifiable risk factor that may influence oncologic risk stratification, patient counseling, and surveillance strategy.
The impact of three school-based suicide prevention programs was assessed by comparing attitudes and knowledge of 758 9th and 10th graders with those of 680 control pupils, matched on age, ethnicity, ...and socioeconomic status at the school level, who did not receive the programs. Evaluations were conducted before exposure to the programs and again 1 month later. A large majority of students knew and subscribed to some of the more important program goals before exposure to the program. There was little evidence of program impact among the minority that did not. Most students were interested by the programs, and positive reactions were more common among female and minority students.
Prevention of mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT) programs have nearly eliminated mother-to-child transmission of HIV in developed countries, but progress in ...resource-limited countries has been slow. A key factor limiting the scale-up of PMTCT programs is lack of knowledge of HIV serostatus. Increasing the availability and acceptability of HIV testing and counseling services will encourage more women to learn their status, providing a gateway to PMTCT interventions. Key factors contributing to the scale-up of testing and counseling include a policy of provider-initiated testing and counseling with right to refuse (opt-out); group pretest counseling; rapid HIV testing; innovative staffing strategies; and community and male involvement. Integration of testing and counseling within the community and all maternal and child health settings are critical for scaling-up and for linking women and their families to care and treatment services. This paper will review best practices needed for expansion of testing and counseling in PMTCT settings in resource-limited countries.
Category:
Other
Introduction/Purpose:
Patients are frequently required to maintain a non-weight bearing (NWB) status after foot and ankle surgery in order to prevent post op complications. Adherence ...to these instructions is of paramount importance and lack of compliance may lead to wound breakdown, loss of fracture fixation, or hardware failure. Unfortunately due to a number of factors, patients are frequently unable to comply with their weight bearing (WB) requirements. Lack of compliance has recently been demonstrated in studies as it relates to either partial or NWB instructions. This study examined rates of non-compliance in a socioeconomically disadvantaged population with results showing an 88% non-compliance rate. We present preliminary data on WB compliance and further seek to identify demographic data and risk factors possibly contributing to this epidemic.
Methods:
Pressure sensing films (70-350 PSI) were used for this study. When pressure is applied, the film turns an intense pink color. After lower extremity surgery is performed patients are placed in a short leg plaster splint. The sensor is placed superficial to the plaster/webril. One sensor is placed beneath both the forefoot and one beneath the hind foot and the splint is then marked with an “S” to indicate study participation. Once the patient follows up, either the attending physician or a certified cast technician will retrieve the sensors for documentation. An additional sensor is placed on a non-weight bearing portion of the anterior tibia to serve as a control. After retrieval of sensors, results are analyzed by at least 4 team members to decide on WB compliance. Pink coloration of 30% or more is considered positive in our study.
Results:
At the time of this abstract, 25 patients had returned for follow up. 22/25 (88%) patients were found to have at least 1 out of 2 sensors positive. 13/25 (52%) had both forefoot and hind foot sensors positive. 3 patients had both sensors without any pressure changes. 5 patients had lost at least 1 sensor.
Conclusion:
To date, 88% of our patients have been found to be non-compliant with their weight bearing status instructions. The results of this study agree with previous studies demonstrating a high rate of non-compliance even after education and instruction. Our study exhibited a higher rate of non-compliance when compared to other studies, possibly due to patient demographics. More data is needed to ascertain the effect of certain risk factors in order to identify the proper method of patient education/instruction and to possibly create a standardized weight bearing compliance educational program.
Electron bremsstrahlung has been investigated for collisions of 223.2 MeV/amu He-like uranium ions with N2 and Ar gaseous targets. The doubly differential cross-sections for bremsstrahlung are ...compared to the predictions of relativistic first order Born calculations (Bethe-Heitler formula with Elwert correction factor) and to the calculations based on the exact wavefunctions for electrons moving in the external point-Coulomb potential of the projectile. Whereas the “exact” IPA calculations give an improved agreement with experimental data, as compared to the Bethe-Heitler theory, in particular at the end-point region of the bremsstrahlung spectra, discrepancies still remain at lower photon energies.
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