To validate the prognostic performance of the American Joint Committee on Cancer (AJCC) eighth edition classification for ocular adnexal lymphoma (OAL).
We performed a retrospective review of 140 ...consecutive patients treated for primary OAL between March 2010 and September 2017. Associations between T/N/M categories at presentation and disease-related outcomes, including relapse, progression-free survival (PFS) and overall survival (OS) were evaluated.
Seventy-nine women and 61 men (median age, 52 (range 20-84) years; median follow-up, 57 (range 7-131) months) were included. Histological subtypes included mucosa-associated lymphoid tissue lymphoma (92.1%, n=129), diffuse large B-cell lymphoma (5.0%, n=7), follicular lymphoma (1.4%, n=2) and mantle cell lymphoma (1.4%, n=2). Patients with ≥T2 disease had significantly higher risks of overall relapse (unadjusted HR)=4.32, p=0.016), decreased PFS (uHR=5.19, p=0.004) and decreased OS (uHR=9.21, p=0.047). Patients with ≥N1 disease had significantly higher risks of overall relapse (uHR=9.17, p<0.001) and decreased PFS (uHR=9.24, p<0.001). M1 disease was significantly associated with higher risks of overall relapse (uHR=3.62, p=0.036), decreased PFS (uHR=5.13, p=0.001) and decreased OS (uHR=9.24, p=0.013). On considering TNM categories as continuous data, the uHRs for per level increase in T, N and M categories were 1.77, 1.83 and 2.30 for overall relapse and 1.72, 1.87 and 2.78 for decreased PFS, respectively (p<0.05 for each comparison).
The T, N and M categories of the AJCC eighth edition classification have prognostic value for relapse and survival among patients with primary OAL. Particularly, nodal/metastatic involvement at presentation indicated less favourable outcome.
JEL Classification System
Journal of economic literature,
12/2018, Letnik:
56, Številka:
4
Journal Article
Recenzirano
The categories listed below are used to classify books, book reviews, journal articles, and dissertations indexed in JEL, JEL on CD, EconLit. New changes to the classification system appear as soon ...as possible on www.econlit.org . The JEL classification system may be used freely for scholarly purposes. We suggest the following format: “JEL: A10, B10, etc.”
Category:
Other
Introduction/Purpose:
Historical concept of flatfoot as posterior tibial tendon dysfunction (PTTD) has been questioned. Recently, the consensus group published a new classification ...system and recommended renaming PTTD to Progressive Collapsing Foot Deformity (PCFD). The new PCFD classification could be effective in providing comprehensive information on the deformity. To date, there has been no study reporting intra- and interobserver reliability and the frequency of each class in PCFD classification.
Methods:
This was a single-center, retrospective study conducted from prospectively collected registry data. A consecutive cohort of PCFD patients evaluated from February 2015 to October 2020 was included, consisting of 92 feet in 84 patients. Classification of each patient was made utilizing characteristic clinical and radiographic findings by three independent observers. Frequencies of each class and subclass were assessed. Intraobserver and interobserver reliabilities were analyzed with Cohen's Kappa and Fleiss' kappa, respectively.
Results:
Mean sample age was 54.4, 38% was male and 62% were female. 1ABC (25.4%) was most common subclass followed by 1AC (8.7%) and 1ABCD (6.9%). Only small percentage of patients had isolated deformity. Class A was the most frequent component (89.5%), followed by C in 86.2% of the cases. Moderate interobserver reliability (Fleiss` Kappa=0.561, p<0.001, 95% CI 0.528-0.594) was found for overall classification. Very good intraobserver reliability was found (Cohen`s Kappa=0.851, P<0.001, 95% CI 0.777-0.926).
Conclusion:
Predominantly, 49.3% of patients had a presentation dominantly involving the hindfoot (A) with various combinations of midfoot and/or forefoot deformity (B), (C) with or without subtalar joint involvement (D). Despite limitations due to inherent subjectivity which may account for moderate interobserver agreement, the new system may potentially cover all possible combinations of the PCFD, providing a comprehensive description and guiding treatment in a systematic and individualized manner.
Purpose To develop a classification and grading system for myopic maculopathy. Design Development and evaluation of a classification system for myopic maculopathy based on observational case series. ...Methods A comprehensive set of myopic macular lesions was defined via literature review and through consensus meetings among retinal specialists and clinician scientists. A classification of myopic maculopathy was formulated based on fundus photographs and a modified Delphi process and consensus. Inter- and intraobserver reproducibility, assessed as agreement (%) and weighted kappa values, were evaluated. One hundred retinal photographs with myopia and myopic macular lesions were selected from case series at the High Myopia Clinic of the Tokyo Medical and Dental University, Tokyo, Japan. Results We defined 5 categories of myopic maculopathy including “no myopic retinal degenerative lesion” (Category 0), “tessellated fundus” (Category 1), “diffuse chorioretinal atrophy” (Category 2), “patchy chorioretinal atrophy” (Category 3), and “macular atrophy” (Category 4). Three additional features to supplement these categories were defined as “plus” lesions, namely, lacquer cracks, myopic choroidal neovascularization, and Fuchs spot. Posterior staphyloma was considered as a further, important sign of myopic retinopathy. The intraobserver agreement was ≥85% and the corresponding weighted kappa statistic was ≥0.6 between observations. After a brief training session, interobserver kappa statistics reached the predefined satisfactory level (≥0.4), considered as above moderate agreement. Conclusions We propose a classification system for myopic maculopathy that was found to be reproducible. Applying a uniform classification in different studies will facilitate communication and comparison of findings from clinical trials and epidemiologic studies.
Advances in preoperative diagnostics as well as in surgical techniques for the treatment of endometriosis, especially for deep endometriosis, call for a classification system, that includes all ...aspects of the disease such as peritoneal endometriosis, ovarian endometriosis, deep endometriosis, and secondary adhesions. The widely accepted revised American Society for Reproductive Medicine classification (rASRM) has certain limitations because of its incomplete description of deep endometriosis. In contrast, the Enzian classification, which has been implemented in the last decade, has proved to be the most suitable tool for staging deep endometriosis, but does not include peritoneal or ovarian disease or adhesions. To overcome these limitations, a comprehensive classification system for complete mapping of endometriosis, including anatomical location, size of the lesions, adhesions and degree of involvement of the adjacent organs, that can be used with both diagnostic and surgical methods, has been created through a consensus process and will be described in detail—the #Enzian classification.
JEL Classification System
Journal of economic literature,
09/2018, Letnik:
56, Številka:
3
Journal Article
Recenzirano
The categories listed below are used to classify books, book reviews, journal articles, and dissertations indexed in JEL, JEL on CD, EconLit. New changes to the classification system appear as soon ...as possible on www.econlit.org . The JEL classification system may be used freely for scholarly purposes. We suggest the following format: “JEL: A10, B10, etc.”
Pregnancy and infection Kourtis, Athena P; Read, Jennifer S; Jamieson, Denise J
New England journal of medicine/The New England journal of medicine,
06/2014, Letnik:
370, Številka:
23
Journal Article
Depuis près de dix ans, les effets de la crise financière se font ressentir dans les collectivités territoriales. Face à ce contexte, des programmes d’économies ont été engagés. Plusieurs travaux ...considèrent que ce contexte austéritaires fait évoluer la vision de l’action publique. Nous explorons cette thématique en étudiant la façon dont les managers conçoivent le management de l’austérité. Une analyse lexicométrique fait apparaitre quatre réflexions austéritaires fondées sur deux dimensions relatives à l’orientation et la nature des réflexions. Ces résultats montrent que le management de l’austérité traduit une renaissance du NPM plutôt qu’un renouvellement des logiques de l’action publique.
Category:
Hindfoot; Midfoot/Forefoot
Introduction/Purpose:
Bluman et al. flatfoot classification (2007) is based on the posterior tibial tendon (PTT) rupture leading to a chronological appearance of ...several foot deformities. Since then, several discordances have been noted in this concept. An expert consensus met recently to update it. Emphasis on posterior tibial tendon rupture was shifted to a non-chronological approach focusing on five different independent foot and ankle deformations and each deformation's flexibility or rigidity. This concept, named Progressive Collapsing Foot Deformity (PCFD), was approved with a strong consensus. The aim of this study was to compare Bluman et al. and PCFD classifications. We hypothesize that both classifications will be intra and interobserver reliable and that the PCFD classification will allow a better distribution of the different types of foot.
Methods:
We performed a retrospective IRB approved study including 92 flatfeet. Three fellowship trained foot and ankle surgeons studied clinical information and X-rays and classified them in Bluman and PCFD classifications. One performed a blinded second assessment. Bluman classification was analyzed one time as initially described and a second time after removing the Angle of Gissane sclerosis sign. Bluman stage I represents isolated PTT dysfunction, stage II and III Flexible and Rigid Hindfoot Valgus, and stage IV Tibio-Talar Valgus. These stages are progressive and don't allow any combinations. PCFD classifies Hindfoot valgus (A), Midfoot Abduction (B), Forefoot Varus (C), Peritalar Subluxation (D), and Tibiotalar Valgus (E). Combinations of these deformities is allowed. Each deformity can be Flexible (1) or Rigid (2). Interobserver and Intraobserver reliabilities were determined with respectively unweighted Fleiss' and Cohen's kappa values. Descriptive analysis was performed on the 276 readings to highlight discrepancies between classifications.
Results:
Inter and Intraobserver reliabilities were respectively moderate (K=0.55) and substantial (K=0.62) for Bluman and moderate (K=0.56) and very good (K=0.85) for PCFD. The 276 readings were spread into 10 subgroups in Bluman and 64 in PCFD. 2.9% of the flatfeet were classified Bluman stage I, 31.5% stage II, 43.8% stage III and 21.7% stage IV. Bluman stages II and III were mainly composed of PCFD 1ABC (respectively 40.2% and 28.1%). The most represented Bluman subgroup was IIIB (32.6%) whereas after removing the Angle of Gissane sclerosis sign from the classification it was the IIC subgroup (44.2%). PCFD A, B and C were mainly composed of Bluman subgroup IIIB (respectively 35.7%, 43.6% and 36.2%) and PCFD D and E of Bluman subgroup IVB (31.9% and 73.3%).
Conclusion:
Both classifications showed moderate reliabilities although the PCFD represented 6 times as many different choices by readers. Bluman stage I was rare, possibly because it is based on PTT dysfunction with little or no deformity. This entity is no longer considered in the PCFD. Bluman stage III, assumed to represent rigid hindfoot varus included numerous flexible PCFD. Main confusion could come from the Angle of Gissane sclerosis sign, which leads to Bluman stage III. This sign is however a sign of extraarticular sinus tarsi impingement which should not lead to a triple arthrodesis as recommended in the Bluman classification.
Filopodia are fine actin-based cellular projections used for both environmental sensing and cell motility, and they are essential organelles for metazoan cells. In this study, we reconstruct the ...origin of metazoan filopodia and microvilli. We first report on the evolutionary assembly of the filopodial molecular toolkit and show that homologs of many metazoan filopodial components, including fascin and myosin X, were already present in the unicellular or colonial progenitors of metazoans. Furthermore, we find that the actin crosslinking protein fascin localizes to filopodia-like structures and microvilli in the choanoflagellate Salpingoeca rosetta. In addition, homologs of filopodial genes in the holozoan Capsaspora owczarzaki are upregulated in filopodia-bearing cells relative to those that lack them. Therefore, our findings suggest that proteins essential for metazoan filopodia and microvilli are functionally conserved in unicellular and colonial holozoans and that the last common ancestor of metazoans bore a complex and specific filopodial machinery.