ABSTRACT
Efforts to mimic complex-structured biologically based materials such as abalone shell have occupied substantial research time and effort in science and engineering. The majority of the efforts involve tedious and expensive techniques and processes. Layer-by-layer (LBL) is one such technique that can produce materials with quite unique physical properties, approaching, and in some cases surpassing, those seen in nature. The LBL technique, however, is quite tedious and difficult to implement commercially. We report here the discovery of an organic/inorganic spontaneous self-assembling system that forms a highly structured nanocomposite. The driving force behind this self-assembly appears to be entropy. This discovery should open up completely new avenues to designing hierarchical composites and structures. The films have been studied by X-ray diffraction and the barrier properties for oxygen diffusion measured.
Subject(s)
Aluminum Silicates/chemistry , Animal Shells/chemistry , Membranes, Artificial , Nanocomposites/chemistry , Oxygen/chemistry , Polymers/chemistry , Animals , Biomimetic Materials/chemical synthesis , Clay , Crystallization/methods , Materials Testing , Nanocomposites/ultrastructure , Particle SizeABSTRACT
Patients with glioblastoma (GBM) have variable clinical courses, but the factors that underlie this heterogeneity are not understood. To determine whether the presence of the telomerase-independent alternative lengthening of telomeres (ALTs) mechanism is a significant prognostic factor for survival, we performed a retrospective analysis of 573 GBM patients. The presence of ALT was identified in paraffin sections using a combination of immunofluorescence for promyelocytic leukemia body and telomere fluorescence in situ hybridization. Alternative lengthening of telomere was present in 15% of the GBM patients. Patients with ALT had longer survival that was independent of age, surgery, and other treatments. Mutations in isocitrate dehydrogenase (IDH1mut) 1 frequently accompanied ALT, and in the presence of both molecular events, there was significantly longer overall survival. These data suggest that most ALT+ tumors may be less aggressive proneural GBMs, and the better prognosis may relate to the set of genetic changes associated with this tumor subtype. Despite improved overall survival of patients treated with the addition of chemotherapy to radiotherapy and surgery, ALT and chemotherapy independently provided a survival advantage, but these factors were not found to be additive. These results suggest a critical need for developing new therapies to target these specific GBM subtypes.
Subject(s)
Glioblastoma/pathology , Telomere/pathology , Telomere/ultrastructure , Adult , Aged , Aged, 80 and over , Antineoplastic Agents, Alkylating/therapeutic use , Cohort Studies , Dacarbazine/analogs & derivatives , Dacarbazine/therapeutic use , Female , Glioblastoma/drug therapy , Glioblastoma/genetics , Glioblastoma/metabolism , Humans , International Cooperation , Isocitrate Dehydrogenase/genetics , Male , Middle Aged , Mutation/genetics , Proportional Hazards Models , Retrospective Studies , Survival Analysis , Telomerase , Telomere/genetics , Temozolomide , Young AdultABSTRACT
BACKGROUND: Creating and having a database should not be an end goal but rather a source of valid data and a means for generating information by which to assess process, performance, and outcome quality. The Cardiovascular Center at Shands Jacksonville (Florida) made measurable improvements in the quality of data in national registries and internally available software tools for collection of patient care data. METHODS: The process of data flow was mapped from source to report submission to identify input timing and process gaps, data sources, and responsible individuals. Cycles of change in data collection and entry were developed and the improvements were tracked. RESULTS: Data accuracy was improved by involving all caregivers in datasheet completion and assisting them with data-field definitions. Using hospital electronic databases decreased the need for manual retrospective review of medical records for datasheet completion. The number of fields with missing values decreased by 83.6%, and the number of missing values decreased from 31.2% to 1.9%. Data accuracy rose dramatically by realtime data entry at point of care. DISCUSSION: Key components to ensuring data quality for process and outcome improvement are (1) education of the caregiver team, (2) process supervision by a database manager, (3) commitment and explicit support from leadership,(4) increased and improved use of electronic data sources, and (5) data entry at point of care.