Abstract
Context
Sporadic medullary thyroid carcinoma (sMTC) rarely occurs in childhood and no studies have specifically focused on this entity.
Objective
To describe the clinical presentations and ...long-term outcomes of a large cohort of children and young adults with sMTC compared with hereditary MTC (hMTC).
Methods
Retrospective study of 144 patients diagnosed with MTC between 1961 and 2019 at an age ≤ 21 years and evaluated at a tertiary referral center.
Results
In contrast to hMTC (n = 124/144, 86%), patients with sMTC (n = 20/144, 14%) are older (P < .0001), have larger tumors (P < .0001), a higher initial stage grouping (P = .001) and have more structural disease (P = .0045) and distant metastases (DM) (P = .00084) at last follow-up, but are not more likely to die from MTC (P = .42). Among 77 patients diagnosed clinically, not by family history (20/20 sMTC and 57/124 hMTC), there was no difference in the initial stage (P = .27), presence of DM at diagnosis (P = 1.0), disease status at last follow-up (P = .13), overall survival (P = .57), or disease-specific survival (P = .87). Of the 12 sMTC tumors that underwent somatic testing, 11 (91%) had an identifiable alteration: 10 RET gene alterations and 1 ALK fusion.
Conclusion
sMTC is primarily a RET-driven disease that represents 14% of childhood-onset MTC in this cohort. Pediatric sMTC patients are older, present with clinical disease at a more advanced TNM classification, and have more persistent disease at last follow-up compared with hMTC, but these differences disappear when comparing those presenting clinically. Somatic molecular testing should be considered in sMTC patients who would benefit from systemic therapy.
Abstract Background Short-stemmed femoral components facilitate reduced exposure surgical techniques while preserving native bone. A clinically successful stem should ideally reduce risk for stress ...shielding while maintaining adequate primary stability for biological fixation. We asked (1) how stem-length changes cortical strain distribution in the proximal femur in a fit-and-fill geometry and (2) if short-stemmed components exhibit primary stability on par with clinically successful designs. Methods Cortical strain was assessed via digital image correlation in composite femurs implanted with long, medium, and short metaphyseal fit-and-fill stem designs in a single-leg stance loading model. Strain was compared to a loaded, unimplanted femur. Bone-implant micromotion was then compared with reduced lateral shoulder short stem and short tapered-wedge designs in cyclic axial and torsional testing. Results Femurs implanted with short-stemmed components exhibited cortical strain response most closely matching that of the intact femur model, theoretically reducing the potential for proximal stress shielding. In micromotion testing, no difference in primary stability was observed as a function of reduced stem length within the same component design. Conclusion Our findings demonstrate that within this fit-and-fill stem design, reduction in stem length improved proximal cortical strain distribution and maintained axial and torsional stability on par with other stem designs in a composite femur model. Short-stemmed implants may accommodate less invasive surgical techniques while facilitating more physiological femoral loading without sacrificing primary implant stability.
Two heterotrophic hyperthermophilic strains, ES1T and CL1T, were isolated from Paralvinella sp. polychaete worms collected from active hydrothermal vent chimneys in the north-eastern Pacific Ocean. ...Both were obligately anaerobic and produced H2S in the presence of elemental sulfur and H2. Complete genome sequences are available for both strains. Phylogenetic analyses based on 16S rRNA gene sequences showed that the strains are more than 97 % similar to most other species of the genus Thermococcus. Therefore, overall genome relatedness index analyses were performed to establish that these strains are novel species. For each analysis, strain ES1T was determined to be most similar to Thermococcus barophilus MPT, while strain CL1T was determined to be most similar to Thermococcus sp. 4557. The average nucleotide identity scores for these strains were 84 % for strain ES1T and 81 % for strain CL1T, genome-to-genome direct comparison scores were 23 % for strain ES1T and 47 % for strain CL1T, and the species identification scores were 89 % for strain ES1T and 88 % for strain CL1T. For each analysis, strains ES1T and CL1T were below the species delineation cut-off. Therefore, based on their whole genome sequences, strains ES1T and CL1T are suggested to represent novel species of the genus Thermococcus for which the names Thermococcus paralvinellae sp. nov. and Thermococcus cleftensis sp. nov. are proposed, respectively. The type strains are ES1T ( = DSM 27261T = KACC 17923T) and CL1T ( = DSM 27260T = KACC 17922T).
Thermococcus may be an important alternative source of H2 in the hot subseafloor in otherwise low H2 environments such as some hydrothermal vents and oil reservoirs. It may also be useful in industry ...for rapid agricultural waste treatment and concomitant H2 production. Thermococcus paralvinellae grown at 82°C without sulfur produced up to 5 mmol of H2 L(-1) at rates of 5-36 fmol H2 cell(-1) h(-1) on 0.5% (wt vol(-1)) maltose, 0.5% (wt vol(-1)) tryptone, and 0.5% maltose + 0.05% tryptone media. Two potentially inhibiting conditions, the presence of 10 mM acetate and low pH (pH 5) in maltose-only medium, did not significantly affect growth or H2 production. Growth rates, H2 production rates, and cell yields based on H2 production were the same as those for Pyrococcus furiosus grown at 95°C on the same media for comparison. Acetate, butyrate, succinate, isovalerate, and formate were also detected as end products. After 100 h, T. paralvinellae produced up to 5 mmol of H2 L(-1) of medium when grown on up to 70% (vol vol(-1)) waste milk from cows undergoing treatment for mastitis with the bacterial antibiotic Ceftiofur and from untreated cows. The amount of H2 produced by T. paralvinellae increased with increasing waste concentrations, but decreased in P. furiosus cultures supplemented with waste milk above 1% concentration. All mesophilic bacteria from the waste milk that grew on Luria Bertani, Sheep's Blood (selective for Staphylococcus, the typical cause of mastitis), and MacConkey (selective for Gram-negative enteric bacteria) agar plates were killed by heat during incubation at 82°C. Ceftiofur, which is heat labile, was below the detection limit following incubation at 82°C. T. paralvinellae also produced up to 6 mmol of H2 L(-1) of medium when grown on 0.1-10% (wt vol(-1)) spent brewery grain while P. furiosus produced < 1 mmol of H2 L(-1). Twelve of 13 enzyme activities in T. paralvinellae showed significant (p < 0.05) differences across six different growth conditions; however, methyl viologen-dependent membrane hydrogenase activity remained constant across all media types. The results demonstrate the potential of at least some Thermococcus species to produce H2 if protein and α-glucosides are present as substrates.
Florida 4-H Dairy Record Book Hamilton, Karen; Decubellis, Chris; Holcomb, Chris ...
EDIS,
12/2018, Letnik:
2018, Številka:
6
Journal Article
Recenzirano
Odprti dostop
The Florida 4-H Dairy Record book is an animal sciences record book for all members in the dairy project to keep an accurate record of their project work. This is a major revision of Dairy and Dairy ...Goat Project Record Book.
Enrollment in US youth development programs is decreasing annually. Research has shown that youth in the 4-H youth development program experience a broad range of positive youth development outcomes, ...including greater community contributions, healthier choices, higher academic competence, critical life and leadership skills such as problem-solving, goal setting, communication, responsibility, and a sense of belonging and purpose. Finding ways to retain youth in the program for more than a year or two can profoundly impact society due to the skills developed and opportunities provided to youth in 4-H. The purpose of this study was to understand why youth might leave the 4-H program after one year of involvement. Using data from a multiyear, multistate study of first-year 4-H members, we examined why youth might leave the program and what first-year experiences correlate with youth dropout. Quantitative and qualitative survey data suggest that youth leave the program because of challenges related to belonging, welcoming, time, communication, interactions with adults, and overall organization. These findings can provide youth development faculty, programming staff, and volunteers with directions for improving the program to retain more youth.
The University of Florida 4-H program evaluated volunteer perceptions of behavior adoption resulting from the completion of training focused on best practices that promote positive youth development. ...The evaluation effort was a quasi-experimental design that surveyed all enrolled volunteers electronically. The survey was designed to determine the types and frequency of training that 4-H volunteers participated in, their satisfaction with the training, the volunteer’s role of service, and outcomes of adopting best practices of program quality. A response rate of 27% (n = 340) provided a representative sample of the enrolled volunteers across demographic categories and geographical regions of the state. The results show that volunteers report practicing elements of positive youth development as categorized by the Essential Elements framework and that correlations between the type of training volunteers participate in and their implementation of quality practices are significant. Implications for volunteer trainings include the consideration of frequency, expanding opportunities beyond traditional delivery, and incorporating training elements that promote high-quality youth programming. This evaluation effort provides baseline data that informs future research for the Florida 4-H program.
We present the design of a noncontact high-torque magnetic coupler in the context of a high-speed (> 3600 r/min) fully superconducting rotating electric machine. The magnetic coupler is an essential ...component for machines where both stator and rotor are enclosed within a common cryostat. The magnetic coupler eliminates the need for rotating shaft vacuum seals, which would otherwise be needed if a conventional torque tube were used. The rotor is cooled by natural convection from the stator, similarly eliminating the need for the rotating cryogen transfer coupling used for conventional superconducting rotors. The magnetic coupler satisfies the need to transmit torque from the prime mover to the generator across a stationary cryostat boundary. We rely to an array of multiple radially spaced stages to limit axial extent and improve the torque rating of the design. We demonstrate that, while it is feasible to transmit several kilonewton meter of torque through a magnetic coupler for medium-size machines (> 10 MW), the magnetic coupler is nearly as complex as the rest of the machine. This option should be considered if known reliability issues with high-speed rotating vacuum seals and cryogen transfer couplings cannot be resolved.
Abstract
Overseas contingency operations which occur in areas lacking medical infrastructure pose challenges to the stabilization and transportation of critically ill patients. In particular, ...metabolic derangements resulting from acute kidney injury (AKI) make long-distance aeromedical evacuation risky. Here, we report the first modern use of in-flight continuous veno-venous hemofiltration (CVVH) for intercontinental aeromedical evacuation. Hospital and transport records were reviewed for a 31-yr-old male active duty service member who sustained 40% total body surface area full thickness burns after high-voltage electrical exposure in the southern Philippines. He was evacuated to the Burns Centre at Singapore General Hospital, where CVVH was initiated for anuric AKI secondary to rhabdomyolysis. The United States Army Institute of Surgical Research (USAISR) Burn Flight Team transported the patient to the USAISR Burn Center at Fort Sam Houston, TX, USA. CVVH was performed in-flight for 15 h out of 19.5 h of total flight time. CVVH settings were maintained as follows: blood flow 250 mL/min; replacement fluid rate 3,500 mL/h; and no ultra-filtrate removal. Unfractionated heparin at 500 units/h was utilized for regional anticoagulation. No filter clotting was encountered; a planned filter change was performed during a midway refueling stop. Pre-flight hyperkalemia was managed with low-potassium replacement fluid. No fluid was removed in the setting of large wound insensible losses. The patient remained hemodynamically stable and required no vasoactive medications. Continuous veno-venous hemofiltration can be used safely during high-altitude flight to evacuate casualties with AKI from distant contingency operations. The use of portable hemodialysis equipment in this case also proves the feasibility of deploying renal replacement therapies to more forward facilities than previously considered.
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