Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare tumor typically affecting young women. It is an aggressive malignancy with a poor prognosis and few long-term survivors.
...Investigate the outcome of patients with SCCOHT.
Data were collected for patients with SCCOHT treated in Australia, Canada and Europe. Information included stage, surgery, chemotherapy, radiotherapy, recurrence and survival.
The median follow-up is 13 months for all patients and 35.5 months in surviving patients. Ten patients had FIGO stage I tumors, six stage III tumors and one stage unknown. All underwent surgical resection. Adjuvant platinum-based chemotherapy was given to all patients. Seven received adjuvant radiotherapy with either pelvic and para-aortic radiotherapy, average dose 46.5 Gy (40 Gy/25#–50.4 Gy/23#), or pelvic and whole abdominal radiotherapy, average dose 45 Gy to pelvis and 25 Gy (22.5 Gy/22#–30 Gy/25#) to abdomen.
The median survival for stage I tumors was not reached and was 6 months for stage III tumors. For the ten patients with stage I tumors: six received adjuvant radiotherapy with five alive and disease-free; four received no adjuvant radiotherapy with one alive and disease-free, while three have relapsed with one alive and disease-free after resection. Of the seven patients with stage III or unknown stage tumors, all but one have died. Recurrences were most frequent in the pelvis and the abdomen. Patients receiving salvage treatment with chemotherapy and radiotherapy did poorly.
We advocate a multi-modality treatment approach including surgery, chemotherapy with the addition of radiotherapy either sequentially or concurrently.
Background
Lower urinary tract symptoms (LUTS) are associated with prevalent frailty and functional impairment, but longitudinal associations remain unexplored.
Objectives
To assess the association ...of change in phenotypic frailty with concurrent worsening LUTS severity among older men without clinically significant LUTS at baseline.
Design
Multicenter, prospective cohort study.
Setting
Population-based.
Participants
Participants included community-dwelling men age ≥65 years at enrollment in the Osteoporotic Fractures in Men study.
Measurements
Data were collected at 4 visits over 7 years. Phenotypic frailty score (range: 0–5) was defined at each visit using adapted Fried criterion and men were categorized at baseline as robust (0), pre-frail (
1
–
2
), or frail (
3
–
5
). Within-person change in frailty was calculated at each visit as the absolute difference in number of criteria met compared to baseline. LUTS severity was defined using the American Urologic Association Symptom Index (AUASI; range: 0–35) and men with AUASI ≥8 at baseline were excluded. Linear mixed effects models were adjusted for demographics, health-behaviors, and comorbidities to quantify the association between within-person change in frailty and AUASI.
Results
Among 3235 men included in analysis, 48% were robust, 45% were pre-frail, and 7% were frail. Whereas baseline frailty status was not associated with change in LUTS severity, within-person increases in frailty were associated with greater LUTS severity (quadratic P<0.001). Among robust men at baseline, mean predicted AUASI during follow-up was 4.2 (95% CI 3.9, 4.5) among those meeting 0 frailty criteria, 4.6 (95% CI 4.3, 4.9) among those meeting 1 criterion increasing nonlinearly to 11.2 (95% CI 9.8, 12.6) among those meeting 5 criteria.
Conclusions
Greater phenotypic frailty was associated with nonlinear increases in LUTS severity in older men over time, independent of age and comorbidities. Results suggest LUTS and frailty share an underlying mechanism that is not targeted by existing LUTS interventions.
As part of a program to reduce numbers of the human pathogen Campylobacter on retail chickens, 22 broiler processing lines, representing more than 90% of UK production, were characterized by ...enumerating Campylobacter on pooled neck skins after exsanguination, scalding, defeathering, evisceration, crop removal, inside-outside washing, and air-chilling stages of processing. Sixteen of the processing lines investigated showed significant (P < 0.05) reductions in Campylobacter numbers because of carcass scalding. However, in all of these lines, the following defeathering stage caused a significant increase in Campylobacter contamination that effectively negated the reductions caused by scalding. On four processing lines, primary chilling also caused a significant reduction in numbers of Campylobacter. On three lines, there was a significant microbiological benefit from inside-outside washing. The stages where Campylobacter numbers were reduced require further investigation to determine the specific mechanisms responsible so that the observed pathogen reductions can be optimized and then more widely implemented. The transfer of up to 4 log CFU Campylobacter per g of neck skin from a colonized flock to a following uncolonized flock was observed. Cross-contamination was substantial and still detectable after 5,000 carcasses from an uncolonized flock had been processed. Numbers of Campylobacter recovered from the uncolonized flocks were highest on the first of the uncolonized birds to pass along the line, and in general, the numbers declined as more uncolonized birds were processed. Air sampling recovered low numbers at the processing stages monitored, indicating that airborne transmission was unlikely to be the primary transfer mechanism operating for cross-contamination between flocks.
ABSTRACT We present simultaneous Nuclear Spectroscopic Telescope Array (NuSTAR ) and Suzaku observations of the X-ray binary Cygnus X-1 in the hard state. This is the first time this state has been ...observed in Cyg X-1 with NuSTAR, which enables us to study the reflection and broadband spectra in unprecedented detail. We confirm that the iron line cannot be fit with a combination of narrow lines and absorption features, instead requiring a relativistically blurred profile in combination with a narrow line and absorption from the companion wind. We use the reflection models of García et al. to simultaneously measure the black hole spin, disk inner radius, and coronal height in a self-consistent manner. Detailed fits to the iron line profile indicate a high level of relativistic blurring, indicative of reflection from the inner accretion disk. We find a high spin, a small inner disk radius, and a low source height and rule out truncation to greater than three gravitational radii at the 3 confidence level. In addition, we find that the line profile has not changed greatly in the switch from soft to hard states, and that the differences are consistent with changes in the underlying reflection spectrum rather than the relativistic blurring. We find that the blurring parameters are consistent when fitting either just the iron line or the entire broadband spectrum, which is well modeled with a Comptonized continuum plus reflection model.
The amygdala and subgenual anterior cingulate cortex (sACC) are key brain regions for the generation of negative affect. In this longitudinal fMRI study of adolescents we investigated how ...amygdala-sACC connectivity was correlated with negative affectivity (NA) both cross-sectionally and longitudinally, and examined its relationship to the onset of first-episode depression.
Fifty-six adolescents who were part of a larger longitudinal study of adolescent development were included. They had no history of mental illness at the time of their baseline scan (mean age 16.5 years) and had a follow-up scan 2 years later (mean age 18.8 years). We used resting-state functional-connectivity MRI to investigate whether cross-sectional and change measures of amygdala-sACC connectivity were (i) correlated with NA and its change over time, and (ii) related to the onset of first-episode depression.
The magnitude of amygdala connectivity with sACC showed significant positive correlation with NA at both time-points. Further analysis confirmed that change in amygdala-sACC connectivity between assessments was correlated with change in NA. Eight participants developed a first episode of depression between the baseline and follow-up assessments: they showed increased amygdala-sACC connectivity at follow-up.
Amygdala-sACC connectivity is associated with NA in adolescence, with change in connectivity between these regions showing positive correlation with change in NA. Our observation that the onset of depression was associated with an increase in connectivity between the regions provides support for the neurobiological 'scar' hypothesis of depression.
Rhodopseudomonas palustris is among the most metabolically versatile bacteria known. It uses light, inorganic compounds, or organic compounds, for energy. It acquires carbon from many types of green ...plant-derived compounds or by carbon dioxide fixation, and it fixes nitrogen. Here we describe the genome sequence of R. palustris, which consists of a 5,459,213-base-pair (bp) circular chromosome with 4,836 predicted genes and a plasmid of 8,427 bp. The sequence reveals genes that confer a remarkably large number of options within a given type of metabolism, including three nitrogenases, five benzene ring cleavage pathways and four light harvesting 2 systems. R. palustris encodes 63 signal transduction histidine kinases and 79 response regulator receiver domains. Almost 15% of the genome is devoted to transport. This genome sequence is a starting point to use R. palustris as a model to explore how organisms integrate metabolic modules in response to environmental perturbations.
MCG-6-30-15, at a distance of 37 Mpc (z = 0.008), is the archetypical Seyfert 1 galaxy showing very broad Fe Kalpha emission. We present results from a joint NuSTAR and XMM-Newton observational ...campaign that, for the first time, allows a sensitive, time-resolved spectral analysis from 0.35 keV up to 80 keV. The strong variability of the source is best explained in terms of intrinsic X-ray flux variations and in the context of the light-bending model: the primary, variable emission is reprocessed by the accretion disk, which produces secondary, less variable, reflected emission. The broad Fe Kalpha profile is, as usual for this source, well explained by relativistic effects occurring in the innermost regions of the accretion disk around a rapidly rotating black hole. We also discuss the alternative model in which the broadening of the Fe Kalpha is due to the complex nature of the circumnuclear absorbing structure. Even if this model cannot be ruled out, it is disfavored on statistical grounds. We also detected an occultation event likely caused by broad-line region clouds crossing the line of sight.
The etiology of sirenomelia is currently unknown. Data are limited in comparing external and internal abnormalities using modern imaging technologies and molecular genetic analysis. The purpose of ...the current study was designed to compare external and internal anatomical defects in two cases of sirenomelia and Potter's sequence. Considered rare, Potter's sequence is a fetal disorder with characteristic features of bilateral renal agenesis, obstructive uropathy, atypical facial appearance, and limb malformations. The internal and external malformations of two term fetuses with sirenomelia and Potter's sequence were compared using assessment of external features, radiography and MRI on internal structures, and molecular genetic studies on sex determination. Data reveal that both fetuses were male and manifested with an overlapping but distinct spectrum of abnormalities. Principal differences were noted in the development of the ears, brain, urogenital system, lower limbs, pelvis, and vertebral column. Defects of the axial mesoderm are likely to underlie the abnormalities seen in both fetuses. The first one, which had only caudal defects, was found to have a spectrum of abnormalities most similar to those associated with more severe forms of the small pelvic outlet syndrome, although the structure and orientation of the sacrum and iliae were different from previously reported cases. The other had both caudal and cranial defects, and was most similar to those described in the axial mesodermal dysplasia syndrome. Defects associated with sirenomelia can be evaluated with standard gross anatomy examination, radiology, MRI, and modified PCR techniques to determine anatomical abnormalities and the sex of preserved specimens, respectively. Evidence indicated that sirenomelia could be developed via various etiologies.
We present detections at 850 ...m of the Lyman-break galaxy (LBG) population at z ... 3, 4, and 5 using data from the Submillimetre Common User Bolometer Array 2 Cosmology Legacy Survey in the United ...Kingdom Infrared Deep Sky Survey 'Ultra Deep Survey' field. We employ stacking to probe beneath the survey limit, measuring the average 850 ...m flux density of LBGs at z ... 3, 4, and 5 with typical ultraviolet luminosities of ... We measure 850 ...m flux densities of (0.25 ± 0.03), (0.41 ± 0.06), and (0.88 ± 0.23) mJy, respectively, finding that they contribute at most 20 per cent to the cosmic far-infrared (IR) background at 850 ...m. Fitting an appropriate range of spectral energy distributions to the z ~ 3, 4, and 5 LBG stacked 24-850 ...m fluxes, we derive IR luminosities of ... and star formation rates (SFRs) of ..., respectively. We find that the evolution in the IR luminosity density of LBGs is broadly consistent with model predictions for the expected contribution of luminous-to-ultraluminous IR galaxies at these epochs. We observe a positive correlation between stellar mass and IR luminosity and confirm that, for a fixed mass, the reddest LBGs (UV slope β ... 0) are redder due to dust extinction, with SFR(IR)/SFR(UV) increasing by about an order of magnitude over -2 < β < 0 with SFR(IR)/SFR(UV) ~ 20 for the reddest LBGs. Furthermore, the most massive LBGs tend to have higher obscured-to-unobscured ratios, hinting at a variation in the obscuration properties across the mass range. (ProQuest: ... denotes formulae/symbols omitted.)
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