Role of ultrasound in detection of lymph-node metastasis in gynecological cancer: systematic review and meta-analysis.

OBJECTIVE: To assess the diagnostic performance of transvaginal sonography (TVS) for the preoperative evaluation of lymph-node metastasis in gynecological cancer. METHODS: This was a systematic review and meta-analysis of studies published between January 1990 and May 2023 evaluating the role of ultrasound in detecting pelvic lymph-node metastasis (index test) in gynecological cancer, using histopathological analysis as the reference standard. The quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled sensitivity, specificity and diagnostic odds ratio were estimated. RESULTS: The literature search identified 2638 citations. Eight studies reporting on a total of 967 women were included. The mean prevalence of pelvic lymph-node metastasis was 24.2% (range, 14.0-65.6%). The risk of bias was low for most domains assessed. Pooled sensitivity, specificity and diagnostic odds ratio of TVS were 41% (95% CI, 26-58%), 98% (95% CI, 93-99%) and 32 (95% CI, 14-72), respectively. High heterogeneity was found between studies for both sensitivity and specificity. CONCLUSION: TVS showed a high pooled specificity for the detection of pelvic lymph-node metastasis in gynecological cancer, but pooled sensitivity was low. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Influence of the crosstalk on the intensity of HAADF-STEM images of quaternary semiconductor materials.

The influence of the neighbouring atomic-columns in determining the composition at atomic column scale of quaternary semiconductor compounds, using simulated HAADF-STEM images is evaluated. The InAlAsSb alloy, a promising material in the photovoltaic field, is considered. We find that the so called 'crosstalk' effect plays an important role for the aimed compositional determination. The intensity transfer is larger from neighbouring atomic columns with higher average Z, and towards atomic columns with smaller Z. Our results show that in order to obtain precise information on the column composition, the HAADF-STEM intensities of both columns need to be taken into account simultaneously.

HAADF-STEM Image Resolution Enhancement Using High-Quality Image Reconstruction Techniques: Case of the Fe3O4(111) Surface.

From simple averaging to more sophisticated registration and restoration strategies, such as super-resolution (SR), there exist different computational techniques that use a series of images of the same object to generate enhanced images where noise and other distortions have been reduced. In this work, we provide qualitative and quantitative measurements of this enhancement for high-angle annular dark-field scanning transmission electron microscopy imaging. These images are compared in two ways, qualitatively through visual inspection in real and reciprocal space, and quantitatively, through the calculation of objective measurements, such as signal-to-noise ratio and atom column roundness. Results show that these techniques improve the quality of the images. In this paper, we use an SR methodology that allows us to take advantage of the information present in the image frames and to reliably facilitate the analysis of more difficult regions of interest in experimental images, such as surfaces and interfaces. By acquiring a series of cross-sectional experimental images of magnetite (Fe3O4) thin films (111), we have generated interpolated images using averaging and SR, and reconstructed the atomic structure of the very top surface layer that consists of a full monolayer of Fe, with topmost Fe atoms in tetrahedrally coordinated sites.

Local allergic rhinitis is an independent rhinitis phenotype: The results of a 10-year follow-up study.

BACKGROUND: The knowledge about the natural history of local allergic rhinitis (LAR) is limited. One unmet question is to demonstrate whether LAR should be considered the first step in the development of allergic rhinitis (AR) or an independent phenotype. The aim of this study was to prospectively evaluate the natural history of a population with LAR, the potential conversion to AR with systemic atopy and the development of asthma during 10 years. METHODS: This is the second phase of a 10-year follow-up study of a cohort of 176 patients with LAR of recent onset and 115 age- and sex-matched healthy controls prospectively evaluated from 2005 to 2016. Clinical-demographic questionnaire, spirometry, skin prick test and specific IgE were evaluated yearly. Nasal allergen provocation tests (NAPT) with Dermatophagoides pteronyssinus, Alternaria alternata, Olea europaea and grass pollen were performed at baseline, and after 5 and 10 years. RESULTS: After 10-year LAR, patients experienced a significant and clinically relevant worsening of the rhinitis, with increase in emergency assistance, development of asthma, loss of allergen tolerance and impairment of the quality of life. This worsening became significant after 5 years and progressed throughout 10 years. A similar rate of development of AR with systemic atopy was detected in patients and controls (9.7% vs 7.8%, log-rank P=.623). In 5 patients, conversion to systemic atopy occurred >10 years (3%). CONCLUSIONS: LAR is a well-differentiated clinical entity with a low rate of development of systemic atopy, a natural evolution towards worsening and a risk factor for suffering asthma.

MicroRNA (miR)-203 and miR-205 expression patterns identify subgroups of prognosis in cutaneous squamous cell carcinoma.

BACKGROUND: Cutaneous squamous cell carcinoma (CSCC) is the second most widespread cancer in humans and its incidence is rising. These tumours can evolve as diseases of poor prognosis, and therefore it is important to identify new markers to better predict its clinical evolution. OBJECTIVES: We aimed to identify the expression pattern of microRNAs (miRNAs or miRs) at different stages of skin cancer progression in a panel of murine skin cancer cell lines. Owing to the increasing importance of miRNAs in the pathogenesis of cancer, we considered the possibility that miRNAs could help to define the prognosis of CSCC and aimed to evaluate the potential use of miR-203 and miR-205 as biomarkers of prognosis in human tumours. METHODS: Seventy-nine human primary CSCCs were collected at the University Hospital of Salamanca in Spain. We identified differential miRNA expression patterns at different stages of CSCC progression in a well-established panel of murine skin cancer cell lines, and then selected miR-205 and miR-203 to evaluate their association with the clinical prognosis and evolution of human CSCC. RESULTS: miR-205 was expressed in tumours with pathological features recognized as indicators of poor prognosis such as desmoplasia, perineural invasion and infiltrative growth pattern. miR-205 was mainly expressed in undifferentiated areas and in the invasion front, and was associated with both local recurrence and the development of general clinical events of poor evolution. miR-205 expression was an independent variable selected to predict events of poor clinical evolution using the multinomial logistic regression model described in this study. In contrast, miR-203 was mainly expressed in tumours exhibiting the characteristics associated with a good prognosis, was mainly present in well-differentiated zones, and rarely expressed in the invasion front. Therefore, the expression and associations of miR-205 and miR-203 were mostly mutually exclusive. Finally, using a logistic biplot we identified three clusters of patients with differential prognosis based on miR-203 and miR-205 expression, and pathological tumour features. CONCLUSIONS: miR-205 and miR-203 tended to exhibit mutually exclusive expression patterns in human CSCC. This work highlights the utility of miR-205 and miR-203 as prognostic markers in CSCC.

Strain mapping accuracy improvement using super-resolution techniques.

Super-resolution (SR) software-based techniques aim at generating a final image by combining several noisy frames with lower resolution from the same scene. A comparative study on high-resolution high-angle annular dark field images of InAs/GaAs QDs has been carried out in order to evaluate the performance of the SR technique. The obtained SR images present enhanced resolution and higher signal-to-noise (SNR) ratio and sharpness regarding the experimental images. In addition, SR is also applied in the field of strain analysis using digital image processing applications such as geometrical phase analysis and peak pairs analysis. The precision of the strain mappings can be improved when SR methodologies are applied to experimental images.

Direct observation of depth-dependent atomic displacements associated with dislocations in gallium nitride.

We demonstrate that the aberration-corrected scanning transmission electron microscope has a sufficiently small depth of field to observe depth-dependent atomic displacements in a crystal. The depth-dependent displacements associated with the Eshelby twist of dislocations in GaN normal to the foil with a screw component of the Burgers vector are directly imaged. We show that these displacements are observed as a rotation of the lattice between images taken in a focal series. From the sense of the rotation, the sign of the screw component can be determined.

Correlation between Alt a 1 levels and clinical symptoms in Alternaria alternata-monosensitized patients.

BACKGROUND: Alternaria alternata is a risk factor for developing asthma.Alt a 1, which has been described as the major allergen in A alternata, shows a good correlation with A alternata spores only when they have germinated. OBJECTIVES: The objective of this study was to determine the correlation between spore counts and clinical symptoms in patients with allergic asthma and/or rhinitis monosensitized to A alternata. METHODS: Two types of samplers were used to determine exposure: a Burkard spore trap to collect A alternata spores and a high-volume air sampler to collect airborne particles. A total of 366 air filters were collected. Alt a 1 levels were measured by monoclonal antibody-based enzyme-linked immunosorbent assay. Eighteen monosensitized patients were asked to record their daily symptoms throughout the year. RESULTS: A alternata spores were detected throughout the year, whereas Alt a 1 was detected only between March and December. Symptoms showed positive and significant correlations with spore counts (r=0.459, P<.001), and Alt a 1 levels (r=0.294, P<.001). The correlation between spores and Alt a 1 was low. The negative binomial model proved that an increase of 10 pg/m3 in Alt a 1 levels increased the number of symptoms at a 3-day lag by 5%. CONCLUSIONS: In patients who are allergic to A alternata, Alt a 1 levels can be considered an important marker for predicting the risk of respiratory symptoms.

Oral rush desensitization to egg: efficacy and safety.

BACKGROUND: Current management of egg allergy relies on egg elimination from the diet. It does not protect patients from reactions after accidental ingestion of the food and it has a negative influence on quality of life. To solve these problems, some desensitization protocols have been described that are safe and effective, but only one study of a rush regimen for egg with a small patient sample has been published. OBJECTIVE: To evaluate the safety, efficacy and immunologic effects of an oral rush desensitization protocol for immediate egg allergy. METHODS: Subjects aged 5 years or older with symptomatic IgE-mediated allergy to hen's egg underwent a 5-day oral tolerance induction regimen and were subsequently maintained on a regular egg intake. The variables studied were the reactions that occurred during the induction regimen and follow-up and the duration of desensitization. Prick test weal size and egg white-specific IgE and IgG concentrations were monitored. RESULTS: Twenty-three patients between 5 and 17 years of age entered the protocol. Twenty (86.9%) achieved the daily intake of a whole cooked egg, 14 of them within the scheduled 5 days. One abandoned the protocol and two were changed to a slower regimen because of repeated reactions. Allergic reactions were frequent but in general were mild. No severe reactions occurred. During follow-up of at least 6 months, egg was well tolerated by all patients. Compared with baseline, skin prick test weal size and egg white-sIgE levels had fallen at 3 months, although the differences were only significant at 6 months. CONCLUSIONS AND CLINICAL RELEVANCE: The rush protocol described is useful and safe for achieving tolerance to egg within a few days but it should always be performed in a highly supervised setting. A high proportion of patients allergic to egg can effectively be desensitized using the described schedule, with the advantage of shortening the time to become protected from reactions after inadvertent ingestion of egg, with no increase in the risk compared with the earlier reported slower protocols.

Morphological evolution of InAs/InP quantum wires through aberration-corrected scanning transmission electron microscopy.

Evolution of the size, shape and composition of self-assembled InAs/InP quantum wires through the Stranski-Krastanov transition has been determined by aberration-corrected Z-contrast imaging. High resolution compositional maps of the wires in the initial, intermediate and final formation stages are presented. (001) is the main facet at their very initial stage of formation, which is gradually reduced in favour of [114] or [118], ending with the formation of mature quantum wires with {114} facets. Significant changes in wire dimensions are measured when varying slightly the amount of InAs deposited. These results are used as input parameters to build three-dimensional models that allow calculation of the strain energy during the quantum wire formation process. The observed morphological evolution is explained in terms of the calculated elastic energy changes at the growth front. Regions of the wetting layer close to the nanostructure perimeters have higher strain energy, causing migration of As atoms towards the quantum wire terraces, where the structure is partially relaxed; the thickness of the wetting layer is reduced in these zones and the island height increases until the (001) facet is removed.

Involvement of lipid transfer proteins in saffron hypersensitivity: molecular cloning of the potential allergens.

BACKGROUND: Lipid transfer proteins (LTPs) are relevant allergens, and have recently been proposed as model plant allergens from fruit, vegetables, seeds, and pollens. However, no LTP spice allergen has been characterized to date. OBJECTIVES: To identify and isolate saffron LTPs and to explore their relevance in saffron allergy. METHODS: Six patients with rhinitis and positive skin prick test (SPT) results to saffron extract were selected. Two recombinant LTPs from saffron were isolated, cloned into pPIC9 plasmid, and produced in Pichia pastoris. Immunoglobulin (Ig) E immunodetection and enzyme-linked immunosorbent assays were performed with the 2 purified allergens and with the major peach allergen Pru p 3. RESULTS: Full cDNA corresponding to 2 saffron LTP variants was isolated and expressed in P pastoris. The molecular weight of rCro s 3.01 and rCro s 3.02 was 9.15 kDa and 9.55 kDa, respectively. The sequences obtained had a 47% identity with each other and 51% and 43% with Pru p 3. Both proteins were recognized by anti-Pru p 3 antibodies. Specific IgE to the purified allergens was found in 50% of patients for rCro s 3.01 and 33% for rCro s 3.02 and Pru p 3 in the saffron-allergic patients. CONCLUSIONS: Our results indicated that rCro s 3.01 and rCro s 3.02 are minor allergens of saffron, at least in the study patients. To our knowledge, this is the first report on the implication of LTPs in spice allergy.

Influence of low-protein dietetic foods consumption on quality of life and levels of B vitamins and homocysteine in patients with chronic renal failure.

OBJECTIVE: The aim of the study was to determine whether the consumption of low protein dietetic foods improved the quality of life and nutritional status for vitamins B and homocysteine in patients with chronic renal failure. METHODOLOGY: This nutritional-intervention involved 28 men and 21 women, divided into two groups. The control-group consumed a low-protein diet prescribed, and the experimental-group consumed a diet in which some commonly used foods were replaced by low-protein dietetic foods. The study lasted 6 months. Food consumption was assessed by 24-h recall. Vitamin B6 as alphaEAST was measured in blood. Creatinine, urea, vitamin B12, folate and homocysteine were measured in plasma. The impact on the patients' quality of life from consuming the dietetic foods was assessed via the SF-36 questionnaire. RESULTS: After 6 months, the protein intake among the experimental-group had decreased by 40%, and the urea/creatinine ratio and alphaEAST activity were also lower. The results of the SF-36 questionnaire show that the patients in the experimental-group obtained higher scores in the categories of general health and physical status. CONCLUSIONS: The dietetic foods were very well accepted by all patients and their use allowed a better control of the protein intake, improved B6 status and a better quality of life.

Culex (Melanoconion) aikenii: natural vector in Panama of endemic Venezuelan encephalitis.

Experiments performed in an endemic area of Venezuelan equine encephalitis in the Panama Canal Zone demonstrated transmission of Venezuelan equine encephalitis virus from naturally infected Culex aikenii mosquitoes to laboratory hamsters. Results of experiments indicate that Culex aikenii is an efficient natural vector and the principal species of mosquito transmitting Venezuelan equine encephalitis in this endemic zone.

Column-by-column compositional mapping by Z-contrast imaging.

A phenomenological method is developed to determine the composition of materials, with atomic column resolution, by analysis of integrated intensities of aberration-corrected Z-contrast scanning transmission electron microscopy images. The method is exemplified for InAs(x)P(1-x) alloys using epitaxial thin films with calibrated compositions as standards. Using this approach we have determined the composition of the two-dimensional wetting layer formed between self-assembled InAs quantum wires on InP(001) substrates.

[A prevalence study of dysphagia and intervention with dietary counselling in nursing home from Seville]. / Estudio de prevalencia de disfagia e intervención con consejo dietético, en residencias de mayores de Sevilla.

INTRODUCTION: The prevalence of swallowing disorders widely varies depending on age and comorbidity. OBJECTIVES: To determine the prevalence of dysphagia and feeding disorders in elderly people living in nursing homes from the province of Seville and assess the effectiveness of dietary counselling. METHODS: We carried out a cross-sectional descriptive study on a population of 3921 residents distributed among 86 nursing homes. At the first phase of the study, we pretended to estimate the prevalence of dysphagia so that we selected 373 residents in 23 nursing homes. At the second phase, a sample of residents with dysphagia was selected, being reassessed a month later after receiving dietary counselling and basic measures for managing dysphagia. RESULTS: The median age was 80 (73.86) years, 60 (17.3%) had dysphagia and 50 (13.4%) had feeding difficulties. Both conditions were significantly (p < 0.05) associated with neurological diseases. Forty (11.3%) presented cerebrovascular accident and 123 (34.8%) dementia. Twelve patients with dysphagia were studied at the second phase, the mean age being 80.6+/-11.9 years, MNA 19 +/- 3, Barthel 24 +/- 27, and dysphagia Karnell level of 3-4 in 75% of the cases. These patients, receiving dietary counselling and basic measures for managing dysphagia, did not improve their intake level, dysphagia or dependency. CONCLUSIONS: The prevalence of dysphagia and feeding difficulties is high among nursing homes residents. The standard measures for controlling dysphagia are little effective in patients with severe dependence or advanced dementia.

Primary health care personnel faced with cadaveric organ donation: a multicenter study in south-eastern Spain.

INTRODUCTION: Primary health care (PHC) is the first point of contact between the public and the health system and it is an important channel for the communication and promotion of organ donation and transplantation. The objective of this study was to analyze the attitude of PHC personnel toward donation and to determine the psychosocial variables affecting this attitude. MATERIALS AND METHODS: A random sample was stratified by job category and geographical location among PHC personnel (n = 482) from 32 health centers. Attitude was evaluated using a questionnaire validated in our local area. (It was completed anonymously and was self-administered.) RESULTS: The questionnaire completion rate was 86% (n = 414): 78% (n = 325) are in favor and the remaining 22% (n = 89) are either against or are not sure. The reason given for a negative attitude is fear of apparent death (16%; n = 14). There are many independent factors that affect attitude: (i) job category (OR = 2.4); (ii) knowledge of the concept of brain death (OR = 2.2); (iii) a preference for alternatives to burial (OR = 2.99); (iv) being in favor of cremation (OR = 01.87) and (v) knowledge of the attitude of one's partner toward organ donation (OR = 0.312). CONCLUSION: PHC personnel have a favorable attitude toward donation, especially physicians, although it would be useful to provide more information to PHC personnel. Physicians could be a key element in the direct and indirect promotion of donation and transplantation.

Hepatitis C virus infection after renal transplantation.

Hepatitis C virus (HCV) infection is the main cause of liver disease after renal transplantation. Most patients have seroconverted on dialysis to positive RNA. The viral load increases during immunosuppressive therapy. The risk of developing chronic liver disease is related to the histopathologic findings, duration and severity of the disease, immunosuppression, and transplantation time. Hepatitis C virus infection can predict onset, of proteinuria and diabetes. We studied 868 patients who received renal transplants between (1987 and 2006), of whom 18.7% were seropositive for HCV. We observed a higher rate of HCV-seropositive patients related to the duration of hemodialysis therapy. Of the HCV seropositive patients, 77% had received renal allografts before 1998. There was no difference between the sexes; however, the HCV positive patients were younger. Polymerase chain reaction tests results were positive in 91.6% of the patients with HCV antibodies. The prevalence of diabetes was greater among HCV positive patients, as was as the persistence of proteinuria. Cryoglobulins were positive in 30.8%. The incidence of acute rejection episodes in the first year was similar between groups. Of the HCV-positive patients, 80.2% were treated with cyclosporine, most patients continued this therapy throughout the study. We observed no significant difference in mortality end graft survival rate between the two groups. However, renal function differed significantly at some points during the evolution of the clinical course. Renal transplantation is still the best treatment option in patients with chronic renal disease.

Prediction of CO maximum ground level concentrations in the Bay of Algeciras, Spain using artificial neural networks.

The region of the Bay of Algeciras is a very industrialized area where very few air pollution studies have been carried out. The main objective of this work has been the use of artificial neural networks (ANNs) as a predictive tool of high levels of ambient carbon monoxide (CO). Two approaches have been used: multilayer perceptron models (MLPs) with backpropagation learning rule and k-Nearest Neighbours (k-nn) classifiers, in order to predict future peaks of carbon monoxide. A resampling strategy with twofold cross-validation allowed the statistical comparison of the different topologies and models considered in the study. The procedure of random resampling permits an adequate and robust multiple comparisons of the tested models and allow us to select a group of best models.

Clinical and biochemical correlates of male hypogonadism in type 2 diabetes.

The origin of hypogonadism, a condition including both symptoms and biochemical criteria of androgen deficiency, in type 2 diabetes is poorly known. In a cross-sectional study of 267 unselected patients, we analyzed the potential correlation of several clinical and biochemical variables as well as chronic micro- and macrovascular diabetic complications with hypogonadism. Hypogonadism was present in 46 patients (17.2%) using a cutoff of total testosterone 10.4 nmol/L and in 31 (11.6%) with a cutoff of 8 nmol/L. Among these patients, hypogonadotropic hypogonadism was the most prevalent form (82.6%). Compared to eugonadal subjects, hypogonadal men had significantly lower glomerular filtration rate (67.1 ± 23.4 vs. 78.4 ± 24.6 mL/min/1.73 m2 , p = 0.005) and higher prevalence of chronic kidney disease (43.5% vs. 20.4%, p = 0.002), abnormal liver function tests (26.7% vs. 12%, p = 0.019), and psychiatric treatment (23.9% vs. 10.4%, p = 0.025). Total testosterone levels correlated inversely with age (R = -0.164, p = 0.007), fasting blood glucose (R = -0.127, p = 0.037), and triglycerides (R = -0.134, p = 0.029) and directly with glomerular filtration rate (R = 0.148, p = 0.015). Calculated free testosterone and bioavailable testosterone correlated directly with hemoglobin (R = 0.171, p = 0.015 and R = 0.234, p = 0.001, respectively). Multivariate logistic regression analysis, after adjusting for relevant confounding variables, showed that age >60 years (OR = 3.58, CI 95% = 1.48-8.69, p = 0.005), body mass index >27 kg/m2 (OR = 2.85, CI 95% = 1.14-7.11, p = 0.025), hypertriglyceridemia (OR = 2.16, CI 95% = 1.05-4.41, p = 0.035), glomerular filtration rate <60 mL/min/1.73 m2 (OR = 2.51, CI 95% = 1.19-5.29, p = 0.015), and abnormal liver function tests (OR = 3.57, CI 95% = 1.48-8.60, p = 0.005) were independently associated with male hypogonadism. Although older age, body mass index, and hypertriglyceridemia have been previously related to hypogonadism, our results describe that chronic kidney disease and abnormal liver function tests are independently correlated with hypogonadism in type 2 diabetic men.

Correcting sample drift using Fourier harmonics.

During image acquisition of crystalline materials by high-resolution scanning transmission electron microscopy, the sample drift could lead to distortions and shears that hinder their quantitative analysis and characterization. In order to measure and correct this effect, several authors have proposed different methodologies making use of series of images. In this work, we introduce a methodology to determine the drift angle via Fourier analysis by using a single image based on the measurements between the angles of the second Fourier harmonics in different quadrants. Two different approaches, that are independent of the angle of acquisition of the image, are evaluated. In addition, our results demonstrate that the determination of the drift angle is more accurate by using the measurements of non-consecutive quadrants when the angle of acquisition is an odd multiple of 45°.