LEARNING OBJECTIVESFrom this article, the reader should understand the following concepts:• The difference between a fad and a trend.• Worldwide trends in the commercial, corporate, clinical ...(including medical fitness), and community health fitness industry.• Expert opinions about identified fitness trends for 2017.
Why are older adults reluctant to adopt new technology, such as the Internet, given its potential to improve the quality of their lives? We review evidence indicating that attitudes and abilities are ...among the most powerful predictors of technology use. We conclude that normative age-related changes in ability must be taken into account when designing products and training programs for aging adults, and we discuss new tools to support designers. The most promising emerging technologies likely lie in training cognitive abilities and augmenting or substituting for impaired abilities. We discuss reasons to expect that the lag in technology adoption between younger and older adults may lessen but will not disappear in future generations.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NMLJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
To draw causal conclusions about the efficacy of a psychological intervention, researchers must compare the treatment condition with a control group that accounts for improvements caused by factors ...other than the treatment. Using an active control helps to control for the possibility that improvement by the experimental group resulted from a placebo effect. Although active control groups are superior to "no-contact" controls, only when the active control group has the same expectation of improvement as the experimental group can we attribute differential improvements to the potency of the treatment. Despite the need to match expectations between treatment and control groups, almost no psychological interventions do so. This failure to control for expectations is not a minor omission—it is a fundamental design flaw that potentially undermines any causal inference. We illustrate these principles with a detailed example from the video-game-training literature showing how the use of an active control group does not eliminate expectation differences. The problem permeates other interventions as well, including those targeting mental health, cognition, and educational achievement. Fortunately, measuring expectations and adopting alternative experimental designs makes it possible to control for placebo effects, thereby increasing confidence in the causal efficacy of psychological interventions.
Context.
The reflection hump is a prominent feature in the hard X-ray spectrum of active galactic nuclei (AGN). Its exact shape and its correlation to other quantities provide valuable information ...about the inner and outer regions of an AGN.
Aims.
Our main goal is to study the reflection hump in a large sample of nearby AGN. We aim to investigate the evolution of reflection with absorption and its correlation with the spectral index.
Methods.
We analysed archived
NuSTAR
observations of the 70-month BAT catalogue AGN. By performing a detailed spectral analysis, we were able to constrain the spectral parameters and to investigate the reflection emission in a large sample of individual sources.
Results.
The reflection strength was found to be strongly correlated with the power-law slope in unabsorbed sources, pointing towards disc reflection for these sources. Different possible explanations were tested and the most likely one is that the corona is moving either towards or away from the disc with a moderately relativistic velocity. An
R
− Γ correlation was not detected for absorbed sources. In addition, these AGN feature harder spectra, suggesting intrinsic differences between the two classes or a slab geometry for the X-ray source.
With increasing interest in the effects of microplastics on the soil environment, there is a need to thoroughly evaluate the potential adverse effects of these particles as a function of their ...characteristics (size, shape, and composition). In addition, extractable chemical additives from microplastics have been identified as an important toxicity pathway in the aquatic environment. However, currently, little is known about the effects of such additives on the soil environment. In this study on nematodes (Caenorhabditis elegans), we adopted an ecotoxicological approach to assess the potential effects of 13 different microplastics (0.001–1% of soil dry weight) with different characteristics and extractable additives. We found that poly(ethylene terephthalate) (PET) fragments and polyacrylicnitrile (PAN) fibers show the highest toxicity, while high-density polyethylene (HDPE), polypropylene (PP), and polystyrene (PS) fragments induced relatively less adverse effects on nematodes. In addition, low-density polyethylene (LDPE) induced no toxicity within our test concentration range for the acute period. Acute toxicity was mainly attributed to the extractable additives: when the additives were extracted, the toxic effects of each microplastic disappeared in the acute soil toxicity test. The harmful effects of the LDPE films and PAN fibers increased when the microplastics were maintained in the soil for a long-term period with frequent wet–dry cycles. We here provide clear evidence that microplastic toxicity in the soil is highly related to extractable additives. Our results suggest that future experiments consider extractable additives as key explanatory variables.
OBJECTIVE:To determine the disease-free survival (DFS) and recurrence after the treatment of patients with rectal cancer with open (OPEN) or laparoscopic (LAP) resection.
BACKGROUND:This randomized ...clinical trial (ACOSOG Alliance Z6051), performed between 2008 and 2013, compared LAP and OPEN resection of stage II/III rectal cancer, within 12 cm of the anal verge (T1-3, N0-2, M0) in patients who received neoadjuvant chemoradiotherapy. The rectum and mesorectum were resected using open instruments for rectal dissection (included hybrid hand-assisted laparoscopic) or with laparoscopic instruments under pneumoperitoneum. The 2-year DFS and recurrence were secondary endpoints of Z6051.
METHODS:The DFS and recurrence were not powered, and are being assessed for superiority. Recurrence was determined at 3, 6, 9, 12, and every 6 months thereafter, using carcinoembryonic antigen, physical examination, computed tomography, and colonoscopy. In all, 486 patients were randomized to LAP (243) or OPEN (243), with 462 eligible for analysis (LAP = 240 and OPEN = 222). Median follow-up is 47.9 months.
RESULTS:The 2-year DFS was LAP 79.5% (95% confidence interval CI 74.4–84.9) and OPEN 83.2% (95% CI 78.3–88.3). Local and regional recurrence was 4.6% LAP and 4.5% OPEN. Distant recurrence was 14.6% LAP and 16.7% OPEN.Disease-free survival was impacted by unsuccessful resection (hazard ratio HR 1.87, 95% CI 1.21–2.91)composite of incomplete specimen (HR 1.65, 95% CI 0.85–3.18); positive circumferential resection margins (HR 2.31, 95% CI 1.40–3.79); positive distal margin (HR 2.53, 95% CI 1.30–3.77).
CONCLUSION:Laparoscopic assisted resection of rectal cancer was not found to be significantly different to OPEN resection of rectal cancer based on the outcomes of DFS and recurrence.
Lung cancer is the major cause of cancer-related deaths worldwide. Differential diagnosis can be difficult, especially when only small samples are available. Epigenetic changes are frequently ...tissue-specific events in carcinogenesis and hence may serve as diagnostic biomarkers.
138 representative formalin-fixed, paraffin-embedded (FFPE) tissues (116 lung cancer cases and 22 benign controls) were used for targeted DNA methylation analysis via pyrosequencing of ten literature-derived methylation markers (APC, CDH1, CDKN2A, EFEMP1, FHIT, L1RE1, MGMT, PTEN, RARB, and RASSF1). Methylation levels were analyzed with the Classification and Regression Tree Algorithm (CART), Conditional Interference Trees (ctree) and ROC. Validation was performed with additional 27 lung cancer cases and 38 benign controls. TCGA data for 282 lung cancer cases was included in the analysis.
CART and ctree analysis identified the combination of L1RE1 and RARB as well as L1RE1 and RASSF1 as independent methylation markers with high discriminative power between tumor and benign tissue (for each combination, 91% specificity and 100% sensitivity). L1RE1 methylation associated significantly with tumor type and grade (p<0.001) with highest methylation in the control group. The opposite was found for RARB (p<0.001). RASSF1 methylation increased with tumor type and grade (p<0.001) with strongest methylation in neuroendocrine tumors (NET).
Hypomethylation of L1RE1 is frequent in tumors compared to benign controls and associates with higher grade, whereas increasing methylation of RARB is an independent marker for tumors and higher grade. RASSF1 hypermethylation was frequent in tumors and most prominent in NET making it an auxiliary marker for separation of NSCLC and NET. L1RE1 in combination with either RARB or RASSF1 could function as biomarkers for separating lung cancer and non-cancerous tissue and could be useful for samples of limited size such as biopsies.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
These guidelines are intended for use by infectious disease specialists, orthopedists, and other healthcare professionals who care for patients with prosthetic joint infection (PJI). They include ...evidence-based and opinion-based recommendations for the diagnosis and management of patients with PJI treated with debridement and retention of the prosthesis, resection arthroplasty with or without subsequent staged reimplantation, 1-stage reimplantation, and amputation.
To give a preliminary report of clinical and treatment factors associated with toxicity in men receiving high-dose radiation therapy (RT) on a phase 3 dose-escalation trial.
The trial was initiated ...with 3-dimensional conformal RT (3D-CRT) and amended after 1 year to allow intensity modulated RT (IMRT). Patients treated with 3D-CRT received 55.8 Gy to a planning target volume that included the prostate and seminal vesicles, then 23.4 Gy to prostate only. The IMRT patients were treated to the prostate and proximal seminal vesicles to 79.2 Gy. Common Toxicity Criteria, version 2.0, and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer late morbidity scores were used for acute and late effects.
Of 763 patients randomized to the 79.2-Gy arm of Radiation Therapy Oncology Group 0126 protocol, 748 were eligible and evaluable: 491 and 257 were treated with 3D-CRT and IMRT, respectively. For both bladder and rectum, the volumes receiving 65, 70, and 75 Gy were significantly lower with IMRT (all P<.0001). For grade (G) 2+ acute gastrointestinal/genitourinary (GI/GU) toxicity, both univariate and multivariate analyses showed a statistically significant decrease in G2+ acute collective GI/GU toxicity for IMRT. There were no significant differences with 3D-CRT or IMRT for acute or late G2+ or 3+ GU toxicities. Univariate analysis showed a statistically significant decrease in late G2+ GI toxicity for IMRT (P=.039). On multivariate analysis, IMRT showed a 26% reduction in G2+ late GI toxicity (P=.099). Acute G2+ toxicity was associated with late G3+ toxicity (P=.005). With dose-volume histogram data in the multivariate analysis, RT modality was not significant, whereas white race (P=.001) and rectal V70 ≥15% were associated with G2+ rectal toxicity (P=.034).
Intensity modulated RT is associated with a significant reduction in acute G2+ GI/GU toxicity. There is a trend for a clinically meaningful reduction in late G2+ GI toxicity with IMRT. The occurrence of acute GI toxicity and large (>15%) volumes of rectum >70 Gy are associated with late rectal toxicity.
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