The clinicopathological heterogeneity of glioblastoma (GBM) and the various genetic and phenotypic subtypes in GBM stem cells (GSCs) are well described. However, the relationship between GSCs and the ...corresponding primary tumor from which they were isolated is poorly understood. We have established GSC-enriched neurosphere cultures from 15 newly diagnosed GBM specimens and examined the relationship between the histopathological and genomic features of GSC-derived orthotopic xenografts and those of the respective patient tumors. GSC-initiated xenografts recapitulate the distinctive cytological hallmarks and diverse histological variants associated with the corresponding patient GBM, including giant cell and gemistocytic GBM, and primitive neuroectodermal tumor (PNET)-like components. This indicates that GSCs generate tumors that preserve patient-specific disease phenotypes. The majority of GSC-derived intracerebral xenografts (11 of 15) demonstrated a highly invasive behavior crossing the midline, whereas the remainder formed discrete nodular and vascular masses. In some cases, GSC invasiveness correlated with preoperative MRI, but not with the status of PI3-kinase/Akt pathways or O(6)-methylguanine methyltransferase expression. Genome-wide screening by array comparative genomic hybridization and fluorescence in situ hybridization revealed that GSCs harbor unique genetic copy number aberrations. GSCs acquiring amplifications of the myc family genes represent only a minority of tumor cells within the original patient tumors. Thus, GSCs are a genetically distinct subpopulation of neoplastic cells within a GBM. These studies highlight the value of GSCs for preclinical modeling of clinically relevant, patient-specific GBM and, thus, pave the way for testing novel anti-GSC/GBM agents for personalized therapy.
47 new T dwarfs from the UKIDSS Large Area Survey Burningham, Ben; Pinfield, D. J.; Lucas, P. W. ...
Monthly notices of the Royal Astronomical Society,
08/2010, Letnik:
406, Številka:
3
Journal Article
Recenzirano
Odprti dostop
We report the discovery of 47 new T dwarfs in the Fourth Data Release (DR4) from the Large Area Survey (LAS) of the United Kingdom Infrared Telescope (UKIRT) Infrared Deep Sky Survey with spectral ...types ranging from T0 to T8.5. These bring the total sample of LAS T dwarfs to 80 as of DR4. In assigning spectral types to our objects we have identified eight new spectrally peculiar objects, and divide seven of them into two classes. H2O-H-early have a H2O-H index that differs with the H2O-J index by at least two subtypes. CH4-J-early have a CH4-J index that disagrees with the H20-J index by at least two subtypes. We have ruled out binarity as a sole explanation for both types of peculiarity, and suggest that they may represent hitherto unrecognized tracers of composition and/or gravity. Clear trends in z′(AB) −J and Y−J are apparent for our sample, consistent with weakening absorption in the red wing of the K i line at 0.77 μm with decreasing effective temperature. We have used our sample to estimate space densities for T6–T9 dwarfs. By comparing our sample to Monte Carlo simulations of field T dwarfs for various mass functions of the form ψ(M) ∝ M−α pc−3 M−1⊙, we have placed weak constraints on the form of the field mass function. Our analysis suggests that the substellar mass function is declining at lower masses, with negative values of α preferred. This is at odds with results for young clusters that have been generally found to have α > 0.
Introduction
The aim of this study was to assess the independent effect of radiographic measures of implant position, relative to pre-operative anatomical assessment, on the functional outcome of ...total hip arthroplasty according to change in the Oxford hip score (OHS) 1 year post surgery.
Methods
A prospective cohort study was preformed to assess whether improvement in functional outcome (change in OHS at 1 year) and the relationship with femoral offset and length, and acetabular offset and height. After a power calculation 359 patients were recruited to the study and radiographic measures were performed by blinded observers. Regression analysis was used to assess the independent effect of the four radiographic measurements after adjusting for confounding variables.
Results
There was a significant (
p
< 0.001) decrease in acetabular offset 5.3 mm, 95 % confidence interval (CI) 4.4–6.2 and increase in femoral offset (6.1 mm, 95 % CI 5.4–6.8). Hence there was no significant change in overall offset. Femoral offset was the only radiographic measure to be achieved statistical significance (
r
= 0.198, 95 % CI 0.063–0.333,
p
= 0.004) in relation to clinical outcome, with increasing offset being associated with a greater improvement in the OHS. On combining femoral and acetabular offset increasing offset was associated with a greater improvement in the OHS (
r
= 0.10, 95 % CI 0.01–0.19,
p
= 0.04).
Conclusion
This study supports the long-held biomechanical theory of medialisation of the acetabular component with compensatory increased femoral offset results in improved functional outcome.
Objective
Situation awareness (SA) refers to people’s perception and understanding of their dynamic environment. In primary care, reduced SA among physicians increases errors in clinical ...decision-making and, correspondingly, patients’ risk of experiencing adverse outcomes. Our objective was to understand the extent to which electronic health records (EHRs) support primary care physicians (PCPs)’ SA during clinical decision-making.
Method
We conducted a metanarrative review of papers in selected academic databases, including CINAHL and MEDLINE. Eligible studies included original peer-reviewed research published between January 2012 and August 2020 on PCP–EHR interactions. We iteratively queried, screened, and summarized literature focused on EHRs supporting PCPs’ clinical decision-making and care management for adults. Then, we mapped findings to an established SA framework to classify external factors (individual, task, and system) affecting PCPs’ levels of SA (1–Perception, 2–Comprehension, and 3–Projection) and identified SA barriers.
Results
From 1504 articles identified, we included and synthesized 19 studies. Study designs were largely noninterventional. Studies described EHR workflow misalignments, usability issues, and communication challenges. EHR information, including lab results and care plans, was characterized as incomplete, untimely, or irrelevant. Unmet information needs made it difficult for PCPs to obtain even basic SA, Level 1 SA. Prevalent barriers to PCPs developing SA with EHRs were errant mental models, attentional tunneling, and data overload.
Conclusion
Based on our review, EHRs do not support the development of higher levels of SA among PCPs. Review findings suggest SA-oriented design processes for health information technology could improve PCPs’ SA, satisfaction, and decision-making.
An intrusion detection system (IDS) is a system that monitors network traffic for malicious activity and generates alerts. In anomaly-based detection, machine learning (ML) algorithms exploit various ...statistical and probabilistic methods to learn from past or historical experience and detect valuable patterns from large, unstructured, and complex datasets. ML-based network intrusion detection aims to identify malicious behavior and alert a system administrator when an intruder tries to penetrate the network. This paper deals with the study, strategic construction, and implementation of a network intrusion detection model based on ML methods. Among the available IDS datasets, five of the most relevant are chosen for the experimental analysis, which are NSL-KDD-2009, CIC-IDS2017, CIC-IDS2018, IoTID20, and UNSW-NB15 datasets. In order to reduce the computation time in the training sample and achieve computational complexity
O
(
N
2.38
±
δ
)
, we propose a computationally efficient and feasible algorithmic framework for analyzing the network traffic data. The developed approach mainly consists of two phases, i.e., “Scatter Matrices and Eigenvalue Computation based feature Selection” and “Classification procedure for the reduced dimension data.” Experimental evaluation of various test case scenarios for the chosen datasets is carried out in the simulation setting. It is observed that the test results outperform the existing intrusion detection methods for detecting certain attack categories.
Miscommunications are a leading cause of serious medical errors. Data from multicenter studies assessing programs designed to improve handoff of information about patient care are lacking.
We ...conducted a prospective intervention study of a resident handoff-improvement program in nine hospitals, measuring rates of medical errors, preventable adverse events, and miscommunications, as well as resident workflow. The intervention included a mnemonic to standardize oral and written handoffs, handoff and communication training, a faculty development and observation program, and a sustainability campaign. Error rates were measured through active surveillance. Handoffs were assessed by means of evaluation of printed handoff documents and audio recordings. Workflow was assessed through time-motion observations. The primary outcome had two components: medical errors and preventable adverse events.
In 10,740 patient admissions, the medical-error rate decreased by 23% from the preintervention period to the postintervention period (24.5 vs. 18.8 per 100 admissions, P<0.001), and the rate of preventable adverse events decreased by 30% (4.7 vs. 3.3 events per 100 admissions, P<0.001). The rate of nonpreventable adverse events did not change significantly (3.0 and 2.8 events per 100 admissions, P=0.79). Site-level analyses showed significant error reductions at six of nine sites. Across sites, significant increases were observed in the inclusion of all prespecified key elements in written documents and oral communication during handoff (nine written and five oral elements; P<0.001 for all 14 comparisons). There were no significant changes from the preintervention period to the postintervention period in the duration of oral handoffs (2.4 and 2.5 minutes per patient, respectively; P=0.55) or in resident workflow, including patient-family contact and computer time.
Implementation of the handoff program was associated with reductions in medical errors and in preventable adverse events and with improvements in communication, without a negative effect on workflow. (Funded by the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, and others.).
In immersed friction stir welding (FSW), the workpiece is completely immersed in the water environment during welding. The thermal modelling of immersed FSW is carried out using a three-dimensional ...heat transfer model. Friction stir welding experiments on aluminium AA8011 are carried out to find the temperature distributions in a workpiece in air and immersed state. K-type thermocouples are used to measure the temperature histories at different locations on the workpiece during FSW. A regression analysis is used to forecast the temperatures at the weldline experimentally. The temperature distribution at the weldline is also calculated using numerical simulation. The temperature distribution obtained using this experiment is in good agreement with the temperature distribution obtained using numerical simulation. The result indicates that peak temperature distribution area is significantly narrow, and thermal history showed that temperature rise and fall after FSW is sharp due to higher cooling rate in the presence of water. A comparison is also made between the temperature obtained in air and immersed FSW. It is also observed that the joint tensile strength of immersed FSW is higher than that of air FSW welded joint.
Oncocytoma: The Vanishing Parotid Mass PATEL, N. D; VAN ZANTE, A; EISELE, D. W ...
American journal of neuroradiology : AJNR,
10/2011, Letnik:
32, Številka:
9
Journal Article
Recenzirano
Odprti dostop
Parotid gland oncocytoma is an uncommon, benign salivary neoplasm composed of mitochondria-rich oncocytes. The purpose of this study was to correlate MR imaging and histopathology of parotid gland ...oncocytomas and to define the features that may distinguish these neoplasms from other benign and malignant parotid gland tumors. The MR imaging features in 9 patients with a pathologic diagnosis of oncocytoma were retrospectively reviewed. The imaging features were strikingly similar for 8 of the 9 patients. All lesions appeared T1 hypointense but isointense to the native parotid gland on fat-saturated T2 and postcontrast T1 imaging. On MR imaging, parotid gland oncocytomas share specific imaging characteristics that have not been described for benign or malignant parotid gland tumors. Oncocytomas are isointense to native parotid gland on fat-saturated T2 and T1 postcontrast MR images. Preoperative identification of correct histology may help surgical planning.
In 2011, we initiated a sentinel surveillance network to assess changes in
(formerly
)
antimicrobial susceptibility to fidaxomicin from 6 geographically dispersed medical centers in the United ...States. This report summarizes data from 2013 to 2016.
isolates or toxin-positive stools from patients were referred to a central laboratory. Antimicrobial susceptibility was determined by agar dilution. CLSI, EUCAST, or FDA breakpoints were used, where applicable. Toxin gene profiles were characterized by multiplex PCR on each isolate. A random sample of approximately 40% of isolates, stratified by institution and year, was typed by restriction endonuclease analysis (REA). Among 1,889 isolates from 2013 to 2016, the fidaxomicin MIC
was 0.5 μg/ml; all isolates were inhibited at ≤1 μg/ml. There were decreases in metronidazole and vancomycin MICs over time. Clindamycin resistance remained unchanged (27.3%). An increase in imipenem resistance was observed. By 2015 to 2016, moxifloxacin resistance decreased in all centers. The proportion of BI isolates decreased from 25.5% in 2011 to 2012 to 12.8% in 2015 to 2016 (
< 0.001). The BI REA group correlated with moxifloxacin resistance (BI 84% resistant versus non-BI 12.5% resistant). Fidaxomicin MICs have not changed among
isolates of U.S. origin over 5 years post licensure. There has been an overall decrease in MICs for vancomycin, metronidazole, moxifloxacin, and rifampin and an increase in isolates resistant to imipenem. Moxifloxacin resistance remained high among the BI REA group, but the proportion of BI isolates has decreased. Continued geographic variations in REA groups and antimicrobial resistance persist.
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