Objective
To identify the clinical and pathological predictors of central lymph node metastasis (CLNM) in patients with clinically lymph node-negative papillary thyroid microcarcinoma (PTMC).
...Materials and methods
Data pertaining to 541 clinically lymph node-negative PTMC patients who underwent thyroid surgery at the Shanghai General Hospital between January 2010 and December 2013 were retrospectively analyzed. According to histopathological evidence of central lymph node involvement, patients were divided into central lymph node metastasis (CLNM)-positive and CLNM-negative groups; risk factors for CLNM were identified statistically.
Results
LNM was found in 148 (27.4%) patients. Gender (
P
= 0.002), age (
P
< 0.001), tumor size (
P
< 0.001), multifocality (
P
< 0.001), and extrathyroidal extension (
P
< 0.001) were significantly different between CLNM-positive and CLNM-negative groups. On multivariate analyses, male sex (odds ratio OR = 2.656), age <45 years (OR = 4.184), tumor size >0.575 cm (OR = 2.105), gross extrathyroidal extension (OR = 14.605) and multifocality (OR = 2.084) were independent risk factors for CLNM. Among patients who did not have any of these five risk factors, only 3.9% were found to have CLNM.
Conclusions
A relatively high prevalence of CLNM was observed in patients with clinically lymph node-negative PTMC. CLNM was associated with male sex, younger age, larger tumor size, extrathyroidal extension and multifocal PTMC.
Dapsone is used in the treatment of infections and inflammatory diseases. The dapsone hypersensitivity syndrome, which is associated with a reported mortality of 9.9%, develops in about 0.5 to 3.6% ...of persons treated with the drug. Currently, no tests are available to predict the risk of the dapsone hypersensitivity syndrome.
We performed a genomewide association study involving 872 participants who had received dapsone as part of multidrug therapy for leprosy (39 participants with the dapsone hypersensitivity syndrome and 833 controls), using log-additive tests of single-nucleotide polymorphisms (SNPs) and imputed HLA molecules. For a replication analysis, we genotyped 24 SNPs in an additional 31 participants with the dapsone hypersensitivity syndrome and 1089 controls and performed next-generation sequencing for HLA-B and HLA-C typing at four-digit resolution in an independent series of 37 participants with the dapsone hypersensitivity syndrome and 201 controls.
Genomewide association analysis showed that SNP rs2844573, located between the HLA-B and MICA loci, was significantly associated with the dapsone hypersensitivity syndrome among patients with leprosy (odds ratio, 6.18; P=3.84×10(-13)). HLA-B*13:01 was confirmed to be a risk factor for the dapsone hypersensitivity syndrome (odds ratio, 20.53; P=6.84×10(-25)). The presence of HLA-B*13:01 had a sensitivity of 85.5% and a specificity of 85.7% as a predictor of the dapsone hypersensitivity syndrome, and its absence was associated with a reduction in risk by a factor of 7 (from 1.4% to 0.2%). HLA-B*13:01 is present in about 2 to 20% of Chinese persons, 1.5% of Japanese persons, 1 to 12% of Indians, and 2 to 4% of Southeast Asians but is largely absent in Europeans and Africans.
HLA-B*13:01 was associated with the development of the dapsone hypersensitivity syndrome among patients with leprosy. (Funded by the National Natural Science Foundation of China and others.).
Bladder cancer remains a very challenging disease to treat with the high rates of recurrence and progression associated with current therapies. Although the association between bladder cancer ...pathology and circRNAs remains undetermined, circRNAs signatures may be useful as prognostic and predictive factors and clinical tools for assessing disease state, treatment response and outcome. This study investigates if these circRNAs can be used as biomarkers for bladder cancer diagnosis and predicting treatment response. Herein, qPCR measured the expression of hsa_circRNA_100783, hsa_circ_0000285 and hsa_circRNA_100782 in bladder cancer tissues. It was established that sa_circ_0000285, but not hsa_circRNA_100782 and hsa_circRNA_10078, are significantly reduced in bladder cancer tissues and serum compared to adjacent tissues and healthy controls. Moreover, hsa_circ_0000285 expression was lower in cisplatin-resistant bladder cancer patients than in those who were cisplatin-sensitive. Here, hsa_circ_0000285 was associated with tumor size (p<0.001), differentiation (p<0.001), lymph node metastasis (p=0.038), distant metastasis (p=0.004) and TNM stage (p=0.013). Further analysis showed that hsa_circ_0000285 would be an independent prognostic factor for bladder cancer patient outcome. In conclusion, our study indicates hsa_circ_0000285 may be a novel biomarker for bladder cancer because of its involvement in bladder cancer chemo-sensitivity.
Forkhead box protein O1 (FOXO1) is an important transcriptional regulator of cell proliferation, and is considered essential for tumor growth and progression. However, the function of FOXO1 in human ...cervical cancer remains unclear. In this study, we investigated the role of FOXO1 in cervical cancer. Our results showed that FOXO1 expression was lower in cervical cancer than in cervical intraepithelial neoplasia and normal cervix by immunohistochemical analysis (P < 0.05). The level of FOXO1 in high-grade lesions was significantly lower than in low-grade lesion (P < 0.05), indicating that deficient expression of FOXO1 is involved in tumor progression and significantly associated with late-stage tumors (P < 0.05), which was further supported by clinicopathological, real-time polymerase chain reaction, and Western blotting analysis. Moreover, we confirmed that the overexpression of FOXO1 remarkably repressed cell growth and blocked cell proliferation, accompanied by cell-cycle arrest in the G2/M phase and upregulation of caspases-3 and -9 gene expression. Collectively, our data suggest that FOXO1 plays a vital role in inhibiting cervical cancer development by inducing cell-cycle arrest and apoptosis. FOXO1 expression is a favorable prognostic factor for human cervical cancer.
Seedlings of Citrus grandis (L.) Osbeck cv. Tuyou were irrigated daily for 5 months with nutrient solution containing 0 (control), 0.2, 0.6 or 1.6 mM aluminum (Al) from AlCl3·6H2O. Shoot growth was ...more sensitive to Al toxicity than root growth, gas exchange, chlorophyll (Chl) concentration, polyphasic Chl a fluorescence (OJIP) induction and related parameters. Leaves of Al-treated plants showed decreased CO2 assimilation and Chl concentration, yet intercellular CO2 concentration increased and ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco) activity was unchanged. Chlorophyll a fluorescence induction analysis of Al-stressed leaves showed a large rise at the O-step and a large depression at the P-step, accompanied by two new bands at 300 μs (K-band) and at about 150 μs (L-band). Maximum fluorescence, maximum quantum yield of primary photochemistry, oxygen-evolving complex (OEC), quantum yield of electron transport, quantum yield of electron transport from QA- to the Photosystem I end electron acceptors, IP phase and total performance index were decreased in leaves of Al-treated plants, whereas minimum fluorescence, relative variable fluorescence at the J-step and I-step, and dissipated energy were increased. We propose that impaired electron transport capacity accompanied by lack of reducing equivalents were the main factors contributing to decreased CO2 assimilation in Al-treated plants. Aluminum-induced photoinhibition occurring at both the donor (i.e., the OEC) and the acceptor sides of Photosystem II may be associated with growth inhibition. Besides decreased light absorption due to reduced Chl concentration, enhanced energy dissipation protected the leaves of Al-treated plants from photo-oxidative damage in high light.
Background
Recent studies explored the relationship between early brain function and brain morphology, based on the hypothesis that increased brain activity can positively affect structural brain ...development and that excitatory neuronal activity stimulates myelination.
Objective
To investigate the relationship between maturational features from early and serial aEEGs after premature birth and MRI metrics characterizing structural brain development and injury, measured around 30weeks postmenstrual age (PMA) and at term. Moreover, we aimed to verify whether previously developed maturational EEG features are related with PMA.
Design/Methods
One hundred six extremely preterm infants received bedside aEEGs during the first 72h and weekly until week 5. 3T-MRIs were performed at 30weeks PMA and at term. Specific features were extracted to assess EEG maturation: (1) the spectral content, (2) the continuity percentage of spontaneous activity transients (SAT%) and the interburst interval (IBI), and (3) the complexity. Automatic MRI segmentation to assess volumes and MRI score was performed. The relationship between the maturational EEG features and MRI measures was investigated.
Results
Both SAT% and EEG complexity were correlated with PMA. IBI was inversely associated with PMA. Complexity features had a positive correlation with the cerebellar size at 30weeks, while event-based measures were related to the cerebellar size at term. Cerebellar width, cortical grey matter, and total brain volume at term were inversely correlated with the relative power in the higher frequency bands.
Conclusions
The continuity and complexity of the EEG steadily increase with increasing postnatal age. Increasing complexity and event-based features are associated with cerebellar size, a structure with enormous development during preterm life. Brain activity is important for later structural brain development.
PbTe-based semiconductor thermoelectric materials are currently active areas of research. In this work, Na- and Ba-doped PbTe0.5Se0.5 alloys were prepared by vacuum melting and spark plasma sintering ...techniques. Na doping suppressed the transition of PbTe0.5Se0.5 from p-type to n-type conductivity and adjusted the carrier concentration. In the case of Na0.02(BaxPb1−x)0.98Te0.5Se0.5, doping with Ba increased the Seebeck coefficient, decreased the thermal conductivity, and improved the thermoelectric performance compared to those of the undoped material. A high figure of merit (ZT) value of 1.17 at 723K was obtained for Na0.02(Ba0.06Pb0.94)0.98Te0.5Se0.5, which is approximately 22% greater than that of the undoped sample.
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Two new cobalt(II) coordination complexes Co(Phtpy)(HBTC)
0.5
n
·
n
H
2
O (
I
) and Co(Meophtpy)(HBTC)
0.5
n
·
n
H
2
O (
II
) (Phtpy = 4'-(4-phenyl)-3,2':6',3''-terpyridine, Meophtpy = ...4'-(4-methoxyphenyl)-3,2':6',3''-terpyridine,H
3
BTC = trimesic acid) were synthesized under solvothermal conditions. The structures of complexes
I
,
II
have been characterized by elemental analysis, FT-IR, TG analysis, PXRD and single crystal X-ray diffraction techniques (CCDC nos. 2123289 (
I
) and 2123290 (
II
)). For complex
I
, a two-dimensional (2D) layered structure is formed parallel to the
bc
plane and the adjacent layers are connected by Phtpy ligand along
a
direction to form a three-dimensional (3D) structure. It is represented as 2-nodal (3, 5)-connected {4.6.8}{4.6
6
.8
3
} by Schläfli symbol. For complex
II
, one-dimensional (1D) ladder chains along two almost perpendicular directions are formed and these chains are connected by Meophtpy ligands to form a 3D structure. It is represented as 2-nodal (3, 5)-connected {4
2
.6
5
.8
3
}{4
2
.6} by Schläfli symbol. In both complexes, dominant antiferromagnetic interactions between Co(II) ions were observed.
Frailty is common in the older population and is a predictor of adverse outcomes following emergency and elective surgery. Identification of frailty is key to enable targeted intervention throughout ...the perioperative pathway from contemplation of surgery to recovery. Despite evidence on how to identify and modify frailty, such interventions are not yet routine perioperative care. To address this implementation gap, a guideline was published in 2021 by the Centre for Perioperative Care and the British Geriatrics Society, working with patient representatives and all stakeholders involved in the perioperative care of patients with frailty undergoing surgery. The guideline covers all aspects of perioperative care relevant to adults living with frailty undergoing elective and emergency surgery. It is written for healthcare professionals, as well as for patients and their carers, managers and commissioners. Implementation of the guideline will require collaboration between all stakeholders, underpinned by an implementation strategy, workforce development with supporting education and training resources, and evaluation through national audit and research. The guideline is an important step in improving perioperative outcomes for people living with frailty and quality of healthcare services. This commentary provides a summary and discussion of the evidence informing the standards and recommendations in the published guideline.
We hypothesized that morphine has a depressing effect on early brain activity, assessed using quantitative aEEG/EEG parameter and depressed activity will be associated with brain volumes at term in ...extremely preterm infants.
174 preterm infants were enrolled in 3 European tertiary NICUs (mean GA:26 ± 1wks) and monitored during the first 72 h after birth with continuous 2 channel aEEG. Six epochs of aEEG recordings were selected and minimum amplitude of aEEG (min aEEG), percentage of time amplitude <5 μV (% of time < 5 μV), spontaneous activity transients (SATrate) and interSAT interval (ISI) were calculated. For infants receiving morphine, the cumulative morphine dosage was calculated. In a subgroup of 58 infants, good quality MRI at term equivalent age (TEA) and the cumulative morphine dose until TEA were available. The effects of morphine administration and cumulative dose on aEEG/EEG measures and on brain volumes were investigated.
Morphine administration had a significant effect on all quantitative aEEG/EEG measures, causing depression of early brain activity longer ISI (β 2.900), reduced SAT rate (β −1.386), decreased min aEEG (β −0.782), and increased % of time < 5 μV (β 14.802) in all epochs. A significant effect of GA and postnatal age on aEEG/EEG measures was observed. Cumulative morphine dose until TEA had a significant negative effect on total brain volume (TBV) (β −8.066) and cerebellar volume (β −1.080).
Administration of sedative drugs should be considered when interpreting aEEG/EEG together with the negative dose dependent morphine impact on brain development.
•Our findings suggest that morphine strongly reduces brain activity, with a dose dependent effect.•The administration of sedative drugs should be considered when interpreting aEEG.•preterm infant cerebral activity increases with increasing maturity and is influenced by postnatal age.•Cumulative morphine dose has a negative effect on total brain volume, deep grey matter and cerebellar volume.
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