YKL-40 is a secreted glycoprotein (chitinase family). We compared YKL-40 with two ovarian cancer serum markers, CA125 and CA15-3, for the detection of early-stage ovarian cancer.
Serum YKL-40 levels ...were assayed by enzyme-linked immunosorbent assay for 46 healthy subjects, 61 high-risk individuals, 33 patients with benign gynecologic processes, and 50 preoperative patients subsequently diagnosed with predominantly early-stage ovarian cancer. Serum CA125 and CA15-3 values were obtained.
Median YKL-40 level was 28 ng/mL (range, 15 to 166 ng/mL) for healthy subjects, 36 ng/mL (range, 9 to 69 ng/mL) for high-risk individuals without prior cancer, 44.5 ng/mL (range, 5 to 133 ng/mL) for high-risk patients with prior breast cancer, and 38 ng/mL (range, 5 to 67 ng/mL) for individuals with benign gynecologic processes (P = NS). Median preoperative YKL-40 level for ovarian cancer patients was 94 ng/mL (range, 17 to 517 ng/mL; P <.0001 compared with normal and high-risk). YKL-40 was elevated (>/= 62 ng/mL) in 36 (72%) of 50 patients compared with 23 (46%) of 50 and 13 (26%) of 50 patients for CA125 and CA15-3 (P <.008). Twenty (65%) of 31 early-stage patients had elevated serum YKL-40 levels compared with 11 (35%) of 31 and four (13%) of 31 patients for CA125 and CA15-3 (P =.039). YKL-40 levels increased with stage (P <.005), regardless of grade, histology, or patient age. Patients with early-stage tumors with YKL-40 values more than 80 ng/mL had a worse prognosis (71% recurrence v no recurrence P =.034).
YKL-40 may represent a novel marker for the detection of early-stage ovarian cancer. YKL-40 levels in early-stage patients may also predict disease recurrence and survival. The utility of YKL-40 in detection of early-stage ovarian cancer deserves further investigation.
Studies of adults presenting to the emergency department (ED) with acute pulmonary embolism (PE) suggest that those who are low risk on the PE Severity Index (classes I and II) can be managed safely ...without hospitalization. However, the impact of relative contraindications to home management on outcomes has not been described.
To compare 5-day and 30-day adverse event rates among low-risk ED patients with acute PE without and with outpatient ineligibility criteria.
We conducted a retrospective multicenter cohort study of adults presenting to the ED with acute low-risk PE between 2010 and 2012. We evaluated the association between outpatient treatment eligibility criteria based on a comprehensive list of relative contraindications and 5-day adverse events and 30-day outcomes, including major hemorrhage, recurrent venous thromboembolism, and all-cause mortality.
Of 423 adults with acute low-risk PE, 271 (64.1%) had no relative contraindications to outpatient treatment (outpatient eligible), whereas 152 (35.9%) had at least one contraindication (outpatient ineligible). Relative contraindications were categorized as PE-related factors (n = 112; 26.5%), comorbid illness (n = 42; 9.9%), and psychosocial barriers (n = 19; 4.5%). There were no 5-day events in the outpatient-eligible group (95% upper confidence limit, 1.7%) and two events (1.3%; 95% confidence interval CI, 0.1-5.0%) in the outpatient-ineligible group (P = 0.13). At 30 days, there were five events (two recurrent venous thromboemboli and three major bleeding events) in the outpatient-eligible group (1.8%; 95% CI, 0.7-4.4%) compared with nine in the ineligible group (5.9%; 95% CI, 2.7-10.9%; P < 0.05). This difference remained significant when controlling for PE severity class.
Nearly two-thirds of adults presenting to the ED with low-risk PE were potentially eligible for outpatient therapy. Relative contraindications to outpatient management were associated with an increased frequency of adverse events at 30 days among adults with low-risk PE.
We report the results of a systematic study of the effect of halides on hydrogen release and uptake in lithium amide and lithium imide, respectively. The reaction of lithium amide and lithium imide ...with lithium or magnesium chloride, bromide and iodide resulted in a series of amide-halide and imide-halide phases, only two of which have been reported previously. On heating with LiH or MgH2, the amide-halides synthesised all released hydrogen more rapidly than lithium amide itself, accompanied by much reduced, or in some cases undetectable, release of ammonia by-product. The imide-halides produced were found to hydrogenate more rapidly than lithium imide, reforming related amide-halide phases. The work was initiated to test the hypothesis that the incorporation of halide anions might improve the lithium ion conductivity of lithium amide and help maintain high lithium ion mobility at all stages of the de/rehydrogenation process, enhancing the bulk hydrogen storage properties of the system. Preliminary ionic conductivity measurements indicated that the most conducting amide- and imide-halide phases were also the quickest to release hydrogen on heating and to hydrogenate. We conclude that ionic conductivity may be an important parameter in optimising the materials properties of this and other hydrogen storage systems.
Summary
Tree size shapes forest carbon dynamics and determines how trees interact with their environment, including a changing climate. Here, we conduct the first global analysis of among‐site ...differences in how aboveground biomass stocks and fluxes are distributed with tree size.
We analyzed repeat tree censuses from 25 large‐scale (4–52 ha) forest plots spanning a broad climatic range over five continents to characterize how aboveground biomass, woody productivity, and woody mortality vary with tree diameter. We examined how the median, dispersion, and skewness of these size‐related distributions vary with mean annual temperature and precipitation.
In warmer forests, aboveground biomass, woody productivity, and woody mortality were more broadly distributed with respect to tree size. In warmer and wetter forests, aboveground biomass and woody productivity were more right skewed, with a long tail towards large trees. Small trees (1–10 cm diameter) contributed more to productivity and mortality than to biomass, highlighting the importance of including these trees in analyses of forest dynamics.
Our findings provide an improved characterization of climate‐driven forest differences in the size structure of aboveground biomass and dynamics of that biomass, as well as refined benchmarks for capturing climate influences in vegetation demographic models.
See also the Commentary on this article by Zuidema & van der Sleen, 234: 1544–1546.
A severe recessive cerebellar ataxia, Ataxia-Oculomotor Apraxia 2 (AOA2) and a juvenile onset form of dominant amyotrophic lateral sclerosis (ALS4) result from mutations of the
Senataxin (
SETX) ...gene. To begin characterization this disease protein, we developed a specific antibody to the DNA/RNA helicase domain of SETX. In murine brain, SETX concentrates in several regions, including cerebellum, hippocampus and olfactory bulb with a general neuronal expression profile, colocalizing with NeuN. In cultured cells, we found that SETX was cytoplasmically diffuse, but in the nucleus, SETX was punctate, colocalizing with fibrillarin, a marker of the nucleolus. In differentiated non-cycling cells, nuclear SETX was not restricted to the nucleolus but was diffuse within the nucleoplasm, suggesting cell-cycle-dependent localization.
SETX missense mutations cluster within the N-terminus and helicase domains. Flag tagging at the N-terminus caused protein mislocation to the nucleoplasm and failure to export to the cytoplasm, suggesting that the N-terminus may be essential for correct SETX localization. We report here the first characterization of SETX protein, which may provide future insights into a new mechanism leading to neuron death.
The EBLM Project Triaud, Amaury H. M. J.; Martin, David V.; Ségransan, Damien ...
Astronomy and astrophysics (Berlin),
12/2017, Letnik:
608
Journal Article
Recenzirano
Odprti dostop
We present 2271 radial velocity measurements taken on 118 single-line binary stars, taken over eight years with the CORALIE spectrograph. The binaries consist of F/G/K primaries and M dwarf ...secondaries. They were initially discovered photometrically by the WASP planet survey, as their shallow eclipses mimic a hot Jupiter transit. The observations we present permit a precise characterisation of the binary orbital elements and mass function. With modelling of the primary star, this mass function is converted to a mass of the secondary star. In the future, this spectroscopic work will be combined with precise photometric eclipses to draw an empirical mass/radius relation for the bottom of the mass sequence. This has applications in both stellar astrophysics and the growing number of exoplanet surveys around M dwarfs. In particular, we have discovered 34 systems with a secondary mass below 0.2 M⊙, and so we will ultimately double the number of known very low-mass stars with well-characterised masses and radii. The quality of our data combined with the amplitude of the Doppler variations mean that we are able to detect eccentricities as small as 0.001 and orbital periods to sub-second precision. Our sample can revisit some earlier work on the tidal evolution of close binaries, extending it to low mass ratios. We find some exceptional binary systems that are eccentric at orbital periods below three days, while our longest circular orbit has a period of 10.4 days. Amongst our systems, we note one remarkable architecture in J1146-42 that boasts three stars within one astronomical unit. By collating the EBLM binaries with published WASP planets and brown dwarfs, we derive a mass spectrum with twice the resolution of previous work. We compare the WASP/EBLM sample of tightly bound orbits with work in the literature on more distant companions up to 10 AU. We note that the brown dwarf desert appears wider, as it carves into the planetary domain for our short-period orbits. This would mean that a significantly reduced abundance of planets begins at ~ 3 MJup, well before the deuterium-burning limit. This may shed light on the formation and migration history of massive gas giants.
Background:
Recent studies have reported conflicting results as to whether isolated medial patellofemoral ligament reconstruction (MPFLr) leads to decreased patellar height.
Purpose:
To investigate ...if patellar stabilization surgery not intended to address patella alta influences patellar height.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A multicenter retrospective chart review was conducted, and patients who underwent MPFLr, medializing tibial tuberosity osteotomy (TTO), and/or trochleoplasty between 2016 and 2020 were included. The Caton-Deschamps index (CDI) was calculated from radiographs obtained preoperatively, 2 weeks postoperatively, and 3 months postoperatively. The preoperative CDI value was compared with the 2-week postoperative and 3-month postoperative values according to stabilization procedure (isolated MPFLr, isolated TTO, MPFLr + TTO, MPFLr + trochleoplasty, and MPFLr + trochleoplasty + TTO) using the paired t test. Analyses of the 1-bundle versus 2-bundle MPFLr technique and the presence of lateral retinacular release or lateral retinacular lengthening were conducted on the isolated MPFLr and combined MPFLr + TTO cohorts.
Results:
A total of 356 knees were included. Statistically significant pre- to postoperative decreases in CDI were seen in all stabilization procedures analyzed (P≤ .017 for all). Within the isolated MPFLr cohort, this significant decrease was seen at 2 weeks postoperatively with the 2-bundle technique (ΔCDI = −0.09; P < .001) but not with the 1-bundle technique (ΔCDI = −0.01; P = .621).
Conclusion:
The different surgical techniques analyzed in the current study affected patellar height, even when a distalizing TTO was not performed. The decrease was dependent on surgical technique, with a 2-bundle MPFLr leading to a statistically significant decrease and a 1-bundle MPFLr effecting no change.
Background
The role of completion axillary lymph node dissection (ALND) for older women who had sentinel lymph node-positive (SLN+) invasive breast cancer is unclear. We examined factors predictive ...of ALND and the association between ALND, adjuvant chemotherapy administration, and survival.
Methods
Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we reviewed records of women age >65 diagnosed with stage I/II breast cancer from 1998–2005. Adjusted Cox proportional hazards and multivariate logistic regression were used to identify patient and disease variables associated with ALND, and assess association between ALND and all-cause and breast cancer-specific survival.
Results
Among SLN+ patients, 88 % underwent ALND. Earlier diagnosis year, greater nodal involvement, younger age, registry location, and larger tumor size were all associated with a significantly higher likelihood of ALND. The ALND in SLN+ patients was not significantly associated with 5-year breast cancer-specific survival (hazard ratio HR 1.22, 95 % confidence interval CI 0.76–1.96). The SLN+ patients who underwent ALND were more likely to receive adjuvant chemotherapy (odds ratio OR 1.8, 95 % CI 1.45–2.24). However, younger age (OR 18.0, 95 % CI 14.4–23.9), estrogen receptor-negative (ER-) status (OR 4.2, 95 % CI 3.4–5.3), and fewer comorbidities (OR 2.6, 95 % CI 1.7–4.0) were all more strongly linked to receipt of chemotherapy.
Conclusions
ALND for older patients with SLN+ breast cancer is not associated with improved 5-year all-cause or breast cancer-specific survival. Younger age, fewer comorbidities, and estrogen receptor-negative (ER-) status were more strongly associated with receipt of chemotherapy than ALND. Consideration should be given to omitting ALND in older patients, particularly if findings of ALND will not influence adjuvant therapy decisions.
Background
Bicuspid aortic valve (BAV) stenosis has been considered a relative contraindication to transcatheter aortic valve replacement (TAVR). We compared the outcomes of TAVR in patients with BAV ...stenosis versus patients with trileaflet aortic valve stenosis.
Methods
From March 2012 to September 2017, 727 patients underwent TAVR. Thirty‐two patients with BAV were included in this study and compared to 96 patients with comparable risk factors (1:3) with a trileaflet aortic valve (TAV). Transesophageal echocardiography was used to estimate post‐TAVR degree of paravalvular leak (PVL).
Results
Mean ± standard deviation Society of Thoracic Surgeons risk was 6.01 ± 3.42 in the BAV group and 6.08 ± 3.76 in the TAV group (P = 0.92). Thirty‐day mortality was 4.2% (N = 4) in the TAV group and 6.25% (N = 2) in the BAV group (P = 0.63). Three (3.1%) patients in the TAV group and two (6.25%) patients in the BAV group developed a post operative stroke (P = 0.59). Following TAVR, mean aortic valve gradient significantly decreased in both TAV (42.56 ± 14.93 vs 9.27 ± 5.57, P < 0.001) and BAV (44.12 ± 11.82 vs 9.03 ± 7.29, P < 0.001) groups. No patient had a severe PVL after TAVR, and only two (2.08%) patients in the TAV group and one (3.12%) patient in the BAV group had moderate PVL (P = 1.0). Patient survival rate at 1 and 2 years was 86% in the BAV group and 90% at 1 and 2 years in the TAV group (P = 0.74).
Conclusions
TAVR in BAV disease is feasible with favorable valve performance. Immediate and mid‐term outcomes of TAVR in patients with BAV are comparable to those with TAV.
Beetles previously considered to be Ocys harpaloides (Audinet-Serville) from northern Africa, Spain, France, the United Kingdom, France, and Belgium belong to two species. These species can be ...distinguished using DNA sequences of 28S rDNA, 18S rDNA, COI, CAD, and topoisomerase I. A key, diagnoses, and images are provided to enable identification of specimens based upon characteristics of male and female genitalia, as well as microsculpture and other external structures. Through examination of the holotype of Bembidium harpaloides v. tachysoides Antoine, as well as designation of lectotypes of Bembidion harpaloides Audinet-Serville and Ocys melanocephalus Stephens, and designation of a neotype for Tachis rufescens Guerin-Meneville, the valid names of the two species were determined to be Ocys harpaloides and Ocys tachysoides (Antoine).
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