To assess the effects of multi-disciplinary cardiac rehabilitation (CR) on survival in the full population of patients with an acute coronary syndrome (ACS) and patients that underwent coronary ...revascularization and/or heart valve surgery.
Population-based cohort study in the Netherlands using insurance claims database covering ∼22% of the Dutch population (3.3 million persons). All patients with an ACS with or without ST elevation, and patients who underwent coronary revascularization and/or valve surgery in the period 2007-10 were included. Patients were categorized as having received CR when an insurance claim for CR was made within the first 180 days after the cardiac event or revascularization. The primary outcome was survival time from the inclusion date, limited to a total follow-up period of 4 years, with a minimum of 180 days. Propensity score weighting was used to control for confounding by indication. Among 35 919 patients with an ACS and/or coronary revascularization or valve surgery, 11 014 (30.7%) received CR. After propensity score weighting, the adjusted hazard ratio (HR) associated with receiving CR was 0.65 (95% CI 0.56-0.77). The largest benefit was observed for patients who underwent coronary artery bypass grafting (CABG) and/or valve surgery (HR = 0.55, 95% CI 0.42-0.74).
In a large and representative community cohort of Dutch patients with an ACS and/or intervention, CR was associated with a substantial survival benefit up to 4 years. This survival benefit was present regardless of age, type of diagnosis, and type of intervention.
The use of imaging in colorectal cancer (CRC) has significantly evolved over the last twenty years, establishing important roles in surveillance, diagnosis, staging, treatment selection and follow ...up. The range of modalities has broadened with the development of novel tracer and contrast agents, and the fusion of technologies such as positron emission tomography (PET) and computed tomography (CT). Traditionally, the most widely used modality for assessing treatment response in metastasised colon and rectal tumours is CT, combined with use of the RECIST guidelines. However, a growing body of evidence suggests that tumour size does not always adequately correlate with clinical outcomes. Magnetic resonance imaging (MRI) is a more versatile technique and dynamic contrast-enhanced (DCE)-MRI and diffusion-weighted (DW)-MRI may be used to evaluate biological and functional effects of treatment. Integrated fluorodeoxyglucose (FDG)-PET/CT combines metabolic and anatomical imaging to improve sensitivity and specificity of tumour detection, and a number of studies have demonstrated improved diagnostic accuracy of this modality in a variety of tumour types, including CRC. These developments have enabled the progression of treatment strategies in rectal cancer and improved the detection of hepatic metastatic disease, yet are not without their limitations. These include technical, economical and logistical challenges, along with a lack of robust evidence for standardisation and formal guidance. In order to successfully apply these novel imaging techniques and utilise their benefit to provide truly personalised cancer care, advances need to be clinically realised in a routine and robust manner.
This article explores how hegemonic masculinity forged discourses of modern statesmanship in the United States and Italy in the first three decades of the twentieth century. It unpacks the ...‘presidential masculinity’ of Theodore Roosevelt and Woodrow Wilson and compares these gendered performances of political leadership in the United States to Benito Mussolini's Fascist rule in Italy during the 1920s. In doing so, this article contends that the manliness of these three modern leaders rested on a contrasting of pairs: if Roosevelt embodied the hegemonic ideal of the ‘frontiersman‐as‐president’, Wilson personified its ‘unmanly’, bourgeois‐liberal countertype and thereby engendered the initially hospitable view of Mussolini's Fascist masculinity in the United States during the Jazz Age. The article covers the publications in The Atlantic Monthly to reveal how the American disillusion with Wilson's liberal internationalism transformed the Duce into a Fascist surrogate for Roosevelt. In a decade of political, economic and social upheaval, the transatlantic ‘public relations state’ in both the United States and Italy discursively positioned Mussolini as the personification of the masculine ideals of acumen, willpower and virility for the American public; a ‘Doctor‐Dictator’ who, akin to Roosevelt, became a symbol of modern manliness that signified stability, progress and reform. In the process, the Duce's Fascist manhood shaped hegemonic ideals of statesmanship across the Atlantic while hinting at the paltry support for the liberal democracies of the West.
Glioblastoma multiforme (GBM) universally recurs with dismal prognosis. We evaluated the efficacy of standard treatment strategies for patients with recurrent GBM (rGBM). From two centers in the ...Netherlands, 299 patients with rGBM after first-line treatment, diagnosed between 2005 and 2014, were retrospectively evaluated. Four different treatment strategies were defined: systemic treatment (SYST), re-irradiation (RT), re-resection followed by adjuvant treatment (SURG) and best supportive care (BSC). Median OS for all patients was 6.5 months, and median PFS (excluding patients receiving BSC) was 5.5 months. Older age, multifocal lesions and steroid use were significantly associated with a shorter survival. After correction for confounders, patients receiving SYST (34.8%) and SURG (18.7%) had a significantly longer survival than patients receiving BSC (39.5%), 7.3 and 11.0 versus 3.1 months, respectively HR 0.46 (
p
< 0.001) and 0.36 (
p
< 0.001). Median survival for patients receiving RT (7.0%) was 9.2 months, but this was not significantly different from patients receiving BSC (
p
= 0.068
)
. Patients receiving SURG compared to SYST had a longer PFS (9.0 vs. 4.3 months, respectively;
p
< 0.001), but no difference in OS was observed. After adjustments for confounders, patients with rGBM selected for treatment with SURG or SYST do survive significantly longer than patients who are selected for BSC based on clinical parameters. The value of reoperation versus systemic treatment strategies needs further investigation.
Frame Running (RaceRunning) allows people with moderate-to-severe mobility impairments to participate in physical activity using a 3-wheeled frame with a saddle and handlebars. The aim of this study ...was to investigate athlete-perceived impact of Frame Running on aspects of physical fitness, functional mobility and psychosocial outcomes.
Survey.
Frame Running athletes aged 5 years and over.
A survey was distributed to athletes through their club or sports organization.
The survey was completed by 115 athletes (53 females). Median age was 17 years (range 5-62 years) and 64 (57%) used a wheelchair or walker for distances over 50 m. Many felt that Frame Running stretched their muscles (n = 93, 87%) and increased their self-confidence (n = 63, 93%). Four (4%) reported extreme fatigue or sore muscles after training (n = 17, 15%). Of the 110 athletes who had been participating in Frame Running for over 3 months, 46 (47%) reported being less out of breath during mobility tasks and 66 (66%) felt they had improved their functional mobility. However, 7 (7%) reported increased muscle tightness and 4 (4%) reported a Frame Running-related injury lasting more than 4 weeks.
Frame Running is a safe physical activity with athlete-perceived benefits on physical fitness, functional mobility and psychosocial outcomes.
Purpose: Angiogenesis is required for tumor progression and represents a rational target for therapeutic intervention. Histone deacetylase
(HDAC) inhibitors have been shown to have activity against ...various tumor cell types by inhibiting proliferation and inducing
apoptosis both in vitro and in vivo . HDAC inhibitors have also been reported to inhibit angiogenesis. The goal of this study was to characterize the antiangiogenic
and antitumor activity of a recently developed HDAC inhibitor, the hydroxamic derivative LBH589.
Materials and Methods: To evaluate the antiangiogenesis activity of LBH589, we did cell cycle analysis, cell proliferation, tube formation, invasion
assays in vitro , and Matrigel plug assay in vivo . To determine the antitumor activity of LBH589, we established human prostate carcinoma cell PC-3 xenografts in vivo . To evaluate the effect of LBH589 on endothelial signaling pathways, gene expression, and protein acetylation, we did Western
blots and reverse transcription-PCR in human umbilical vein endothelial cells (HUVEC). Immunohistochemical analysis was done
to evaluate new blood vessel formation in vivo .
Results: LBH589 induced acetylation of histone H3 and α-tubulin protein in HUVECs. Histone and nonhistone protein acetylation correlated
with induction of G 2 -M cell cycle arrest, inhibition of HUVEC proliferation, and viability. Noncytotoxic concentrations of LBH589 inhibited endothelial
tube formation, Matrigel invasion, AKT, extracellular signal-regulated kinase 1/2 phosphorylation, and chemokine receptor
CXCR4 expression. In vivo dosing of mice with LBH589 (10 mg/kg/d) reduced angiogenesis and PC-3 tumor growth.
Conclusion: This study provides evidence that LBH589 induces a wide range of effects on endothelial cells that lead to inhibition of
tumor angiogenesis. These results support the role of HDAC inhibitors as a therapeutic strategy to target both the tumor and
endothelial compartment and warrant the clinical development of these agents in combination with angiogenesis inhibitors.
Low muscle mass is present in approximately 40% of patients with metastatic colorectal cancer (mCRC) and may be associated with poor outcome. We studied change in skeletal muscle during palliative ...chemotherapy in patients with mCRC and its association with treatment modifications and overall survival.
In 67 patients with mCRC (mean age ± standard deviation, 66.4 ± 10.6 years; 63% male), muscle area (square centimeters) was assessed using computed tomography scans of the third lumbar vertebra before and during palliative chemotherapy. Treatment modifications resulting from toxicity were evaluated, including delay, dose reduction, or termination of chemotherapy. Multiple regression analyses were performed for the association between change in muscle area and treatment modification and secondly overall survival.
Muscle area of patients with mCRC decreased significantly during 3 months of chemotherapy by 6.1% (95% CI, -8.4 to -3.8; P < .001). Change in muscle area was not associated with treatment modifications. However, patients with muscle loss during treatment of 9% or more (lowest tertile) had significantly lower survival rates than patients with muscle loss of less than 9% (at 6 months, 33% v 69% of patients alive; at 1 year, 17% v 49% of patients alive; log-rank P = .001). Muscle loss of 9% or more remained independently associated with survival when adjusted for sex, age, baseline lactate dehydrogenase concentration, comorbidity, mono-organ or multiorgan metastases, treatment line, and tumor progression at first evaluation by computed tomography scan (hazard ratio, 4.47; 95% CI, 2.21 to 9.05; P < .001).
Muscle area decreased significantly during chemotherapy and was independently associated with survival in patients with mCRC. Further clinical evaluation is required to determine whether nutritional interventions and exercise training may preserve muscle area and thereby improve outcome.
This article looks at the photography of Kris Graves and the circulation of the artist’s images on his social media accounts as a way of promoting social progress and racial justice, with a focus on ...his 2016 A Bleak Reality photoseries for Vanity Fair. The series consists of eight images that address the haunting specters of police brutality against eight African American male citizens who lost their lives at the hands of the state. Looking at Instagram, I posit a threefold claim about the social media photograph. First, I argue against the association of the social photo with the everyday. I examine a photoseries that initially participated in an economy of art but then migrated across a network of social relations in order to enhance its visibility—its dissemination ushering in the social life of the photograph that undergirds Black Lives Matter. Second, I suggest that the affective residues of Instagram’s content linger in an indexical trace that transcends the transplatform network’s digitally composited, modified, duplicated, and distributed images. This dual focus illuminates how social media function, on the one hand, as a technology of race while they allow Graves, on the other hand, to document instances of police brutality against African Americans. Third, in so doing, this article locates A Bleak Reality within a genealogy of civic media in order to explore how the co-optation of photography’s reproductive affordances by African American photographers, artists, scholars, intellectuals, and abolitionists has allowed them to construct a counter-archive of Black cultural production around historical movements for racial justice.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
First described in 1991, Yin Yang 1 (YY1) is a transcription factor that is ubiquitously expressed throughout mammalian cells. It regulates both transcriptional activation and repression, in a ...seemingly context-dependent manner. YY1 has a well-established role in the development of the central nervous system, where it is involved in neurogenesis and maintenance of homeostasis in the developing brain. In neurodevelopmental and neurodegenerative disease, the crucial role of YY1 in cellular processes in the central nervous system is further underscored. In this mini-review, we discuss the various mechanisms leading to the transcriptional activating and repressing roles of YY1, including its role as a traditional transcription factor, its interactions with cofactors and chromatin modifiers, the role of YY1 in the non-coding genome and 3D chromatin organization and the possible implications of the phase-separation mechanism on YY1 function. We provide examples on how these processes can be involved in normal development and how alterations can lead to various diseases.
In this article, I examine the shifting language of debates over law and justice in Zimbabwe in the run-up to, and following, the November 2017 coup. I argue that the rhetoric Zimbabwe African ...National Union–Patriotic Front (ZANU–PF) drew upon to secure its authority and negotiate legitimacy through law, shifted from a focus of ‘sovereignty’ and ‘protection’, to one of battling ‘corruption’ and ‘criminality’. At the same time, there remained a consistency in the manner that the legal system was used to target a select part of the country’s population, those opposed to ZANU–PF and its vision for the future.
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