Purpose Laparoscopic partial nephrectomy is an increasingly performed, minimally invasive alternative to open partial nephrectomy. We compared early postoperative outcomes in 1,800 patients ...undergoing open partial nephrectomy by experienced surgeons with the initial experience with laparoscopic partial nephrectomy in patients with a single renal tumor 7 cm or less. Materials and Methods Data on 1,800 consecutive open or laparoscopic partial nephrectomies were collected prospectively or retrospectively in tumor registries at 3 large referral centers. Demographic, intraoperative, postoperative and followup data were compared between the 2 groups. Results Compared to the laparoscopic partial nephrectomy group of 771 patients the 1,028 undergoing open partial nephrectomy were a higher risk group with a greater percent presenting symptomatically with decreased performance status, impaired renal function and tumor in a solitary functioning kidney (p <0.0001). More tumors in the open partial nephrectomy group were more than 4 cm and centrally located and more proved to be malignant (p <0.0001 and 0.0003, respectively). Based on multivariate analysis laparoscopic partial nephrectomy was associated with shorter operative time (p <0.0001), decreased operative blood loss (p <0.0001) and shorter hospital stay (p <0.0001). The chance of intraoperative complications was comparable in the 2 groups. However, laparoscopic partial nephrectomy was associated with longer ischemia time (p <0.0001), more postoperative complications, particularly urological (p <0.0001), and an increased number of subsequent procedures (p <0.0001). Renal functional outcomes were similar 3 months after laparoscopic and open partial nephrectomy with 97.9% and 99.6% of renal units retaining function, respectively. Three-year cancer specific survival for patients with a single cT1N0M0 renal cell carcinoma was 99.3% and 99.2% after laparoscopic and open partial nephrectomy, respectively. Conclusions Early experience with laparoscopic partial nephrectomy is promising. Laparoscopic partial nephrectomy offered the advantages of less operative time, decreased operative blood loss and a shorter hospital stay. When applied to patients with a single renal tumor 7 cm or less, laparoscopic partial nephrectomy was associated with additional postoperative morbidity compared to open partial nephrectomy. However, equivalent functional and early oncological outcomes were achieved.
Biomarkers of Oxidative Damage in Human Disease Dalle-Donne, Isabella; Rossi, Ranieri; Colombo, Roberto ...
Clinical chemistry (Baltimore, Md.),
04/2006, Letnik:
52, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Oxidative/nitrosative stress, a pervasive condition of increased amounts of reactive oxygen/nitrogen species, is now recognized to be a prominent feature of many acute and chronic diseases and even ...of the normal aging process. However, definitive evidence for this association has often been lacking because of recognized shortcomings with biomarkers and/or methods available to assess oxidative stress status in humans. Emphasis is now being placed on biomarkers of oxidative stress, which are objectively measured and evaluated as indicators of normal biological processes, pathogenic processes, or pharmacologic responses to therapeutic intervention. To be a predictor of disease, a biomarker must be validated. Validation criteria include intrinsic qualities such as specificity, sensitivity, degree of inter- and intraindividual variability, and knowledge of the confounding and modifying factors. In addition, characteristics of the sampling and analytical procedures are of relevance, including constraints and noninvasiveness of sampling, stability of potential biomarkers, and the simplicity, sensitivity, specificity, and speed of the analytical method. Here we discuss some of the more commonly used biomarkers of oxidative/nitrosative damage and include selected examples of human studies.
In this study, measurements of solar induced chlorophyll fluorescence (SIF) at 760nm (F760) are combined with hyperspectral reflectance (R) measurements collected in the field over agricultural crops ...in order to better understand the fluorescence (ChlF) signal of the vegetation. The ‘Soil-Canopy Observation Photosynthesis and Energy fluxes' (SCOPE) model, which combines radiative transfer and enzyme kinetics of photosynthesis with turbulent heat exchange in vegetation canopies, was partly inverted to obtain model parameters from R taken over healthy (unstressed) crops during the growing season. Reflectance spectra between 400 and 900nm obtained at midday on different days in the growing season were used to obtain pigment concentrations, leaf area index and leaf inclination. These parameters were then used to simulate diurnal cycles of half-hourly ChlF spectra, using measured weather variables as input. Three scenarios were simulated: (i) a constant emission efficiency of ChlF (at the photosystem level), (ii) a variable emission efficiency calculated per half hour with an electron transport, photosynthesis and ChlF model for the photosystem, and (iii) a constant emission efficiency that was set to a theoretical maximum value for fully blocked photochemical electron transport of photosystem II and minimal non-photochemical quenching. The simulations of the first two scenarios were compared to ChlF retrieved from field measurements in the O2-A band with the spectral fitting method in unstressed rice and alfalfa. This comparison and a sensitivity analysis showed that SCOPE reproduces most of the seasonal variability of SIF after tuning to R even if the ChlF emission efficiency is kept constant, and F760 values are mostly determined by chlorophyll content, dry matter, senescent material and leaf area and leaf inclination, whereas leaf water and carotenoid content had small effects. Diurnal variations in the ChlF emission efficiency at photosystem level were small in these crops. The simulations of the third scenario were compared to measurements of grass that was treated chemically to block electron transport and to provoke maximum ChlF. This comparison showed that the observed increase in F760 can indeed be explained by a change in the ChlF emission efficiency at the photosystem level. It is concluded that hyperspectral reflectance and the ChlF signal together can reveal both the dynamics of vegetation structure and functioning.
•Vegetation parameters were retrieved from hyperspectral reflectance data of crops.•Chlorophyll fluorescence at 760nm (F760) was simulated with the model SCOPE.•Simulated F760 matched with observed diurnal and seasonal cycles.•Pigments and leaf area explained most of the seasonal cycles of F760.•SCOPE reproduced the F760 response to the chemical blocking of photosystem II.
Sun-induced chlorophyll fluorescence (Fs) is an electromagnetic signal emitted in the 650–800nm spectral window by the chlorophyll-a of green leaves. Previous studies demonstrated the retrieval of Fs ...on a global scale using high spectral resolution measurements by the Fourier Transform Spectrometer (FTS) on board the greenhouse gases observing satellite (GOSAT). The retrieval of Fs from GOSAT-FTS data is based on the modeling of the in-filling of solar Fraunhofer lines by Fs. The first Fs retrieval methods for GOSAT-FTS measurements were based on physical formulations of the radiative transfer between the atmosphere, the surface and the instrument including the Fs emission. As an alternative, a statistical method was also successfully applied to GOSAT data. This method is based on a singular vector decomposition (SVD) technique producing a basis of spectral functions able to model the contribution of the reflected solar radiation to the top-of-atmosphere measurement in a linear way. The Fs signal is included in the forward model as an extra parameter adding to the reflected solar radiation. Here, we use field spectroscopy measurements to provide further experimental evidence on the retrieval of Fs with statistical approaches in both Fraunhofer lines and atmospheric oxygen and water vapor bands. The statistical retrieval method used with GOSAT-FTS data has been adapted to a set of ground-based spectro-radiometer measurements in the 717–780nm range. Retrieval results in the 745–759nm window, which contains only Fraunhofer lines, support the overall approach of estimating Fs from space measurements in that spectral window. Furthermore, the application of the method to broader fitting windows including both Fraunhofer lines and and (oxygen and water vapor) atmospheric bands atmospheric bands has been proven to be very effective to reduce the retrieval noise and has also shown a good comparison with reference O2A-based retrievals. This allows consideration of statistical methods as a powerful option for Fs retrieval from broad-band space-based measurements in the near-infrared.
► We investigate the retrieval of fluorescence (Fs) from space with field data. ► The retrieval proposed is based on a novel statistical approach. ► We demonstrate the feasibility of Fs retrieval solely with Fraunhofer lines. ► Statistical approaches have been shown to be useful for retrievals in O2A.
Introduction:
Parkinson's disease (PD) is a chronic neurodegenerative disease involving a progressive alteration of the motor and non-motor function. PD influences the patient's daily living and ...reduces participation and quality of life in all phases of the disease. Early physical exercise can mitigate the effects of symptoms but access to specialist care is difficult. With current technological progress, telemedicine, and telerehabilitation is now a viable option for managing patients, although few studies have investigated the use of telerehabilitation in PD. In this systematic review, was investigated whether telerehabilitation leads to improvements in global or specific motor tasks (gait and balance, hand function) and non-motor dysfunction (motor speech disorder, dysphagia). The impact of TR on quality of life and patient satisfaction, were also assessed. The usage of telerehabilitation technologies in the management of cognitive impairment was not addressed.
Method:
An electronic database search was performed using the following databases: PubMed/MEDLINE, COCHRANE Library, PEDro, and SCOPUS for data published between January 2005 and December 2019 on the effects of telerehabilitation systems in managing motor and non-motor symptoms. This systematic review was conducted in accordance with the PRISMA guideline and was registered in the PROSPERO database (CRD42020141300).
Results:
A total of 15 articles involving 421 patients affected by PD were analyzed. The articles were divided into two categories based on their topic of interest or outcome. The first category consisted of the effects of telerehabilitation on gait and balance (3), dexterity of the upper limbs (3), and bradykinesia (0); the second category regarded non-motor symptoms such as speech disorders (8) and dysphagia (0). Quality of life (7) and patient satisfaction (8) following telerehabilitation programs were also analyzed, as well as feasibility and costs.
Conclusion:
Telerehabilitation is feasible in people affected by PD. Our analysis of the available data highlighted that telerehabilitation systems are effective in maintaining and/or improving some clinical and non-clinical aspects of PD (balance and gait, speech and voice, quality of life, patient satisfaction).
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/
, identifier: CRD42020141300.
Growth hormone (GH) insensitivity syndrome (GHIS) is a rare clinical condition in which production of insulin-like growth factor 1 is blunted and, consequently, postnatal growth impaired. ...Autosomal-recessive mutations in signal transducer and activator of transcription (STAT5B), the key signal transducer for GH, cause severe GHIS with additional characteristics of immune and, often fatal, pulmonary complications. Here we report dominant-negative, inactivating STAT5B germline mutations in patients with growth failure, eczema, and elevated IgE but without severe immune and pulmonary problems. These STAT5B missense mutants are robustly tyrosine phosphorylated upon stimulation, but are unable to nuclear localize, or fail to bind canonical STAT5B DNA response elements. Importantly, each variant retains the ability to dimerize with wild-type STAT5B, disrupting the normal transcriptional functions of wild-type STAT5B. We conclude that these STAT5B variants exert dominant-negative effects through distinct pathomechanisms, manifesting in milder clinical GHIS with general sparing of the immune system.
The RAdiative transfer Model Intercomparison (RAMI) activity focuses on the benchmarking of canopy radiative transfer (RT) models. For the current fourth phase of RAMI, six highly realistic virtual ...plant environments were constructed on the basis of intensive field data collected from (both deciduous and coniferous) forest stands as well as test sites in Europe and South Africa. Twelve RT modelling groups provided simulations of canopy scale (directional and hemispherically integrated) radiative quantities, as well as a series of binary hemispherical photographs acquired from different locations within the virtual canopies. The simulation results showed much greater variance than those recently analysed for the abstract canopy scenarios of RAMI-IV. Canopy complexity is among the most likely drivers behind operator induced errors that gave rise to the discrepancies. Conformity testing was introduced to separate the simulation results into acceptable and non-acceptable contributions. More specifically, a shared risk approach is used to evaluate the compliance of RT model simulations on the basis of reference data generated with the weighted ensemble averaging technique from ISO-13528. However, using concepts from legal metrology, the uncertainty of this reference solution will be shown to prevent a confident assessment of model performance with respect to the selected tolerance intervals. As an alternative, guarded risk decision rules will be presented to account explicitly for the uncertainty associated with the reference and candidate methods. Both guarded acceptance and guarded rejection approaches are used to make confident statements about the acceptance and/or rejection of RT model simulations with respect to the predefined tolerance intervals.
•Highly realistic virtual plant canopies generated from actual site inventories•Conformity testing concepts introduced to evaluate quality of RT models•Operator induced errors most likely cause for dispersion of RT simulations•Systematic benchmarking efforts needed to assure RT model quality.
Pulse ecological events have major impacts on regional and global biogeochemical cycles, potentially inducing a vast set of cascading ecological effects. This study analyzes the widespread ...reproductive event of bamboo (Melocanna baccifera) that occurred in the Arakan Mountains (Southeast Asia) from 2005 to 2011, and investigates the possible relationship between massive fuel loading due to bamboo synchronous mortality over large areas and wildfire regime. Multiple remote sensing data products are used to map the areal extent of the bamboo-dominated forest. MODIS NDVI time series are then analyzed to detect the spatiotemporal patterns of the reproductive event. Finally, MODIS Active Fire and Burned Area Products are used to investigate the distribution and extension of wildfires before and after the reproductive event. Bamboo dominates about 62,000 km2 of forest in Arakan. Over 65% of the region shows evidence of synchronous bamboo flowering, fruiting, and mortality over large areas, with wave-like spatiotemporal dynamics. A significant change in the regime of wildfires is observed, with total burned area doubling in the bamboo-dominated forest area and reaching almost 16,000 km2. Wildfires also severely affect the remnant patches of the evergreen forest adjacent to the bamboo forest. These results demonstrate a clear interconnection between the 2005-2011 bamboo reproductive event and the wildfires spreading in the region, with potential relevant socio-economic and environmental impacts.
This paper presents a method for mapping the nitrogen (N) status in a maize field using hyperspectral remote sensing imagery. An airborne survey was conducted with an AISA Eagle hyperspectral sensor ...over an experimental farm where maize (Zea mays L.) was grown with two N fertilization levels (0 and 100 kg N ha-1) in four replicates. Leaf and canopy field data were collected during the flight. The nitrogen (N) status has been estimated in this work based on the Nitrogen Nutrition Index (NNI), defined as the ratio between the leaf actual N concentration (%Na) of the crop and the minimum N content required for the maximum biomass production (critical N concentration (%Nc)) calculated through the dry mass at the time of the flight (Wflight). The inputs required to calculate the NNI (i.e., %Na and Wflight) have been estimated through regression analyses between field data and remotely sensed vegetation indices. MCARI/MTVI2 (Modified Chlorophyll Absorption Ratio Index/Modified Triangular Vegetation Index 2) showed the best performances in estimating the %Na (R2 = 0.59) and MTVI2 in estimating the Wflight (R2 = 0.80). The %Na and the Wflight were then mapped and used to compute the NNI map over the entire field. The NNI map agreed with the NNI estimated using field data through traditional destructive measurements (R2 = 0.70) confirming the potential of using remotely sensed indices to assess the crop N condition. Finally, a method to derive a pixel based variable rate N fertilization map was proposed as the difference between the actual N content and the optimal N content. We think that the proposed operational methodology is promising for precision farming since it represents an innovative attempt to derive a variable rate N fertilization map based on the actual crop N status from an aerial hyperspectral image.
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