Background
Identification of women with DCIS who have a very low risk of local recurrence risk (LRR) after breast-conserving surgery (BCS) is needed to de-escalate therapy. We evaluated the impact of ...10-year LRR estimates after BCS, calculated by the integration of a 12-gene molecular expression assay (Oncotype Breast DCIS Score
®
) and clinicopathological features (CPFs), on its ability to change radiation oncologists’ recommendations for RT after BCS for DCIS.
Methods
Prospective cohort study of women with DCIS treated with BCS. Eligibility criteria were as follows: age > 45 years, tumor ≤ 2.5 cm, and margins ≥ 1 mm. Radiation oncologists provided 10-year LRR estimates without RT and recommendation for RT pre- and post-assay. Primary outcome was change in RT recommendation.
Results
217 patients were evaluable, with mean age = 63 years, mean tumor size = 1.1 cm, and mean DCIS Score = 32; 140 (64%) were in the low-risk (<39), 32 (15%) were in the intermediate-risk (39–54), and 45 (21%) were in the high-risk groups (≥55). The assay led to a change in treatment recommendation in 76 (35.2%) (95%CI 29.1–41.8%) patients. RT recommendations decreased from 79% pre-assay to 50% post-assay (difference = 29%; 95%CI 22–35%) due to a significant increase in the proportion of patients with a predicted low LRR (< 10%) post-assay and recommendations to omit RT for those with a low predicted risk. The assay was associated with improved patient satisfaction and reduced decisional conflict.
Conclusion
The DCIS Score assay combined with CPFs identified more women with an estimated low (<10%) 10-yr LR risk after BCS, leading to a significant decrease in recommendations for RT compared to estimates based on CPFs alone.
Body expression and dance are activities that contribute to the integral well-being of people. In an educational context, the process of evaluating our students implies variations in their moods. ...This study tackles the states of mind that students perceive before and after the evaluation of a practice in the subject of
, developed through choreographies, that were, previously rehearsed, and later presented to the rest of the class in a specific session. Our main interest was the obtention of information on the states of mind of the students prior to the evaluation of their choreographies (cooperative task), and again once they had been performed. The study design consisted of two phases: two different choreographies separated by an interval of 2 months. The students were asked about their moods before and after performing their choreographies, which were evaluated. The participants, 167 in total, 35 women (20.5%) and 132 men (79.5%), aged 18 to 22 years old, filled out a POMS (Profile of Mood States) questionnaire, before and after the evaluation of each occasion. Differences were found in the stress-anxiety, vigor-activity, fatigue-immobility scales and the total mood score (PGMS). In all of them, except for the fatigue-immobility scale, we found a decrease in scores after the performance, compared to scores before. For the Stress-Anxiety factor, lower values were observed in the post-tests in comparison to the pre-tests, and also lower values in the pre- and post-test scores regarding the second choreography. We conclude that the practical evaluation of the subject through choreography modifies the mood states of the students, favoring their well-being after its execution, which is why evaluation through practice is considered a positive element in the educational process.
La educación e inteligencia emocionales, así como las emociones, están cada vez más integradas en nuestra sociedad y sistemas educativos. Del mismo modo sucede con el aprendizaje significativo a ...través de actividades cooperativas y el desarrollo de las habilidades socio-afectivas. Esta investigación se preocupa por conocer las emociones, sensaciones y aprendizajes que puede generar una actividad cooperativa de expresión corporal en extensión universitaria (ECEU). Para ello, se administró el cuestionario POMS y diez preguntas abiertas, a los/las participantes del IX Encuentro Interuniversitario de Expresión Corporal que se celebró en Huesca, consiguiendo una muestra de 64 respuestas representada por 31 hombres (48.4%) y 33 mujeres (51.6%). El análisis semántico del discurso generó categorías de palabras que resuenan a emociones con uno/a mismo/a, con el otro, sociales, experienciales y de crecimiento personal; espacio y lugares de interacción (ambiente), vínculo social, y aprendizaje. Todo ello apunta que esta experiencia extra-académica de extensión universitaria, fue enriquecedora a nivel afectivo-conductual, social y cognitivo. Se sugiere fomentar su continuidad por los beneficios observados con las respuestas obtenidas. Se concluye que las actividades ECEU crean un impacto emocional positivo entre los y las participantes y que la riqueza que aporta, además de ser satisfactoria, genera bienestar personal y social.
Abstract. Education and emotional intelligence, as well as emotions, are increasingly integrated into our society and educational systems. The same happens with meaningful learning through cooperative activities and the development of socio-affective skills. This research is concerned with knowing the emotions, sensations and learning that a cooperative activity of corporal expression in university extension (ECEU) can generate. For this purpose, the POMS questionnaire and ten open questions were administered to the participants of the IX Inter-University Meeting of Corporal Expression held in Huesca, obtaining a sample of 64 responses represented by 31 men (48.4%) and 33, women (51.6%). The semantic analysis of the discourse generated categories of words that resonate with emotions with oneself, with another, social, experiential and personal growth; space and places of interaction (environment), social bond, and learning. All this indicates that this extra-academic experience of university extension was enriching at the affective-behavioral, social and cognitive level. It is suggested to promote its continuity due to the benefits observed with the responses obtained. It is concluded that ECEU activities create a positive emotional impact among participants and that the wealth it brings, in addition to being satisfactory, generates personal and social well-being.
It is uncertain whether antiphospholipid antibodies (APAs) increase the risk of recurrence after a first unprovoked venous thromboembolism (VTE). We tested for anticardiolipin antibodies, anti–β2 ...glycoprotein 1 antibodies, and lupus anticoagulant on 2 occasions ∼6 months apart in 307 patients with a first unprovoked VTE who were part of a prospective cohort study. We then determined if APAs were associated with recurrent thrombosis in the 290 patients who stopped anticoagulant therapy in response to negative D-dimer results. Compared with those without an APA, the hazard ratios for recurrent VTE were 1.8 (95% confidence interval CI, 0.9-3.7; P = .09) in the 25.9% of patients with an APA on ≥1 occasions, 2.7 (95% CI, 1.1-.7; P = .03) in the 9.0% of patients with the same APA on 2 occasions, and 4.5 (95% CI, 1.5-13.0; P = .006) in the 3.8% of patients with 2 or 3 different APA types on either the same or different occasions. There was no association between having an APA and D-dimer levels. We conclude that having the same type of APA on 2 occasions or having >1 type of APA on the same or different occasions is associated with recurrent thrombosis in patients with a first unprovoked VTE who stop anticoagulant therapy in response to negative D-dimer tests. APA and D-dimer levels seem to be independent predictors of recurrence in patients with an unprovoked VTE. This trial was registered at www.clinicaltrials.gov as #NCT00720915.
•The same type of APA on 2 occasions or >1 type of APA on the same or different occasions is associated with recurrent VTE.•APA and D-dimer levels seem to be independently associated with recurrence after a first unprovoked VTE.
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Normal D-dimer levels after withdrawal of anticoagulant therapy are associated with a reduced risk for recurrence in patients with unprovoked venous thromboembolism (VTE) and may justify stopping ...treatment.
To determine whether patients with a first unprovoked VTE and negative D-dimer test result who stop anticoagulant therapy have a low risk for recurrence.
Prospective management study with blinded outcome assessment. (ClinicalTrials.gov: NCT00720915).
13 university-affiliated clinical centers.
410 adults aged 75 years or younger with a first unprovoked proximal deep venous thrombosis or pulmonary embolism who had completed 3 to 7 months of anticoagulant therapy.
Anticoagulant therapy was stopped if D-dimer test results were negative and was not restarted if results were still negative after 1 month.
Recurrent VTE during an average follow-up of 2.2 years.
In 319 patients (78%) who had 2 negative D-dimer results and did not restart anticoagulant therapy, rates of recurrent VTE were 6.7% (95% CI, 4.8% to 9.0%) per patient-year overall (42 of 319), 9.7% (CI, 6.7% to 13.7%) per patient-year in men (33 of 180), 5.4% (CI, 2.5% to 10.2%) per patient-year in women with VTE not associated with estrogen therapy (9 of 81), and 0.0% (CI, 0.0% to 3.0%) per patient-year in women with VTE associated with estrogen therapy (0 of 58) (P = 0.001 for the 3-group comparison).
Imprecision in female subgroups. Results may not be generalizable to different D-dimer assays from the one used in the study.
The risk for recurrence in patients with a first unprovoked VTE who have negative D-dimer results is not low enough to justify stopping anticoagulant therapy in men but may be low enough to justify stopping therapy in women.
Canadian Institutes of Health Research.
Education and emotional intelligence, as well as emotions, are increasingly integrated into our society and educational systems. The same happens with meaningful learning through cooperative ...activities and the development of socio-affective skills. This research is concerned with knowing the emotions, sensations and learning that a cooperative activity of corporal expression in university extension (ECEU) can generate. For this purpose, the POMS questionnaire and ten open questions were administered to the participants of the IX Inter-University Meeting of Corporal Expression held in Huesca, obtaining a sample of 64 responses represented by 31 men (48.4%) and 33, women (51.6%). The semantic analysis of the discourse generated categories of words that resonate with emotions with oneself, with another, social, experiential and personal growth; space and places of interaction (environment), social bond, and learning. All this indicates that this extra-academic experience of university extension was enriching at the affective-behavioral, social and cognitive level. It is suggested to promote its continuity due to the benefits observed with the responses obtained. It is concluded that ECEU activities create a positive emotional impact among participants and that the wealth it brings, in addition to being satisfactory, generates personal and social well-being.
La educación e inteligencia emocionales, así como las emociones, están cada vez más integradas en nuestra sociedad y sistemas educativos. Del mismo modo sucede con el aprendizaje significativo a través de actividades cooperativas y el desarrollo de las habilidades socio-afectivas. Esta investigación se preocupa por conocer las emociones, sensaciones y aprendizajes que puede generar una actividad cooperativa de expresión corporal en extensión universitaria (ECEU). Para ello, se administró el cuestionario POMS y diez preguntas abiertas, a los/las participantes del IX Encuentro Interuniversitario de Expresión Corporal que se celebró en Huesca, consiguiendo una muestra de 64 respuestas representada por 31 hombres (48.4%) y 33 mujeres (51.6%). El análisis semántico del discurso generó categorías de palabras que resuenan a emociones con uno/a mismo/a, con el otro, sociales, experienciales y de crecimiento personal; espacio y lugares de interacción (ambiente), vínculo social, y aprendizaje. Todo ello apunta que esta experiencia extra-académica de extensión universitaria, fue enriquecedora a nivel afectivo-conductual, social y cognitivo. Se sugiere fomentar su continuidad por los beneficios observados con las respuestas obtenidas. Se concluye que las actividades ECEU crean un impacto emocional positivo entre los y las participantes y que la riqueza que aporta, además de ser satisfactoria, genera bienestar personal y social.
Recently, we demonstrated that C57BL/6 mice are more susceptible to experimental lagochilascariosis than BALB/c mice. To investigate the pattern of infection and the role of the genetic background on ...susceptibility to infection, we studied experimental lagochilascariosis in H-2a identical B10.A and A/J mice. Infected B10.A mice had a lower survival ratio and more severe lesions in the lungs than did A/J mice. Splenocytes of A/J mice immunized with the crude extract of the parasite showed increased proliferation and produced a higher level of interleukin 10 and interferon-γ in the presence of CE or concanavalin A when compared to B10.A mice. This suggests that resistance of A/J mice may be due to less severe lesions in lungs and other organs and a better immune response to parasite antigens. This paper provides evidence that major histocompatibility complex haplotype does not influence the survival to experimental infection with L. minor.
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