Quality Assurance Model for Breast Cancer Prognostication Using the Modified Magee Equations.

CONTEXT.­: The Oncotype DX recurrence score (RS) is a widely used test that provides prognostic information on the likelihood of disease recurrence and predictive information on the benefit of chemotherapy in early-stage, hormone receptor-positive breast cancer. Despite its widespread use, quality assurance of the RS does not receive the same level of scrutiny as other tests, such as human epidermal growth factor receptor 2 (HER2) immunohistochemistry. OBJECTIVE.­: To use modified Magee equations to calculate Magee score (MS) as a quality check of RS. DESIGN.­: The MS is an easily accessible prognostic model that uses histopathologic and immunohistochemical criteria. We identified cases where the RS and MS differed by 10 points or more or were in different risk categories. These instances were considered significant discordances. MS was presented along with RS at multidisciplinary tumor boards and all discrepancies were discussed to determine clinical significance and appropriate next steps. RESULTS.­: Twenty-five of 155 cases (16.1%) had discrepancies between RS and MS. Of these 25 cases, 3 (12%) had problems with either the RS or the histopathologic interpretation. Among the cases with concordant RS and MS, no RS or interpretive problems were identified. CONCLUSIONS.­: Use of the MS as a quality control check for the RS can help ensure appropriate treatment decisions in breast cancer patients. Pathologists can play a key role in ensuring the quality of molecular-based prognostic scores by using histopathologic models to ensure accurate risk stratification and improve clinical outcomes.

Influence of intravenous fentanyl or dexmedetomidine infusions, combined with lidocaine and ketamine, on cardiovascular response, sevoflurane requirement and postoperative pain in dogs anesthetized for unilateral mastectomy.

OBJECTIVE: To compare the effects of constant rate infusions (CRI) of fentanyl or dexmedetomidine, combined with lidocaine and ketamine, on cardiovascular response during surgery, sevoflurane requirement and postoperative pain in dogs undergoing mastectomy. STUDY DESIGN: Prospective, randomized, blinded, clinical trial. ANIMALS: A total of 29 female dogs with mammary tumors. METHODS: Premedication consisted of intramuscular acepromazine and morphine. General anesthesia was induced with intravenous propofol and maintained with sevoflurane. Dogs were randomized to be administered intravenous DLK [dexmedetomidine 1 µg kg-1 loading dose (LD) and 1 µg kg-1 hour-1; lidocaine 2 mg kg-1 LD and 3 mg kg-1 hour-1; ketamine 1 mg kg-1 LD and 0.6 mg kg-1 hour-1; n = 14] or FLK (fentanyl 5 µg kg-1 LD and 9 µg kg-1 hour-1; same doses of lidocaine and ketamine; n = 15) during anesthesia. Cardiorespiratory variables and end-tidal sevoflurane (Fe'Sevo) were recorded during surgery. The number of dogs administered ephedrine to treat arterial hypotension [mean arterial pressure (MAP) < 60 mmHg] was recorded. Meloxicam was administered to both groups. Postoperative pain and rescue analgesia requirement were assessed for 24 hours using the short form of the Glasgow Composite Measure Pain Scale. Data were compared using a mixed effects model or a Mann-Whitney test. RESULTS: More dogs required ephedrine in FLK than in DLK (67% versus 7%). Heart rate was not significantly different between groups, whereas lower values of MAP (p ≤ 0.01) and Fe'Sevo (p = 0.018) were observed in FLK than in DLK. Rescue analgesia was administered to 2/15 dogs in FLK and 0/14 dogs in DLK. CONCLUSIONS AND CLINICAL RELEVANCE: Based on the cardiovascular response during surgery, intraoperative infusions of FLK and DLK provided adequate antinociception. Infusion of DLK provided greater stability of blood pressure. Both protocols resulted in minimal need for additional analgesia within 24 hours postoperatively.

Visual looming is a primitive for human emotion.

The neural computations for looming detection are strikingly similar across species. In mammals, information about approaching threats is conveyed from the retina to the midbrain superior colliculus, where approach variables are computed to enable defensive behavior. Although neuroscientific theories posit that midbrain representations contribute to emotion through connectivity with distributed brain systems, it remains unknown whether a computational system for looming detection can predict both defensive behavior and phenomenal experience in humans. Here, we show that a shallow convolutional neural network based on the Drosophila visual system predicts defensive blinking to looming objects in infants and superior colliculus responses to optical expansion in adults. Further, the neural network's responses to naturalistic video clips predict self-reported emotion largely by way of subjective arousal. These findings illustrate how a simple neural network architecture optimized for a species-general task relevant for survival explains motor and experiential components of human emotion.

Foraging rates from metabarcoding: Predators have reduced functional responses in wild, diverse prey communities.

Functional responses describe foraging rates across prey densities and underlie many fundamental ecological processes. Most functional response knowledge comes from simplified lab experiments, but we do not know whether these experiments accurately represent foraging in nature. In addition, the difficulty of conducting multispecies functional response experiments means that it is unclear whether interaction strengths are weakened in the presence of multiple prey types. We developed a novel method to estimate wild predators' foraging rates from metabarcoding data and use this method to present functional responses for wild wolf spiders foraging on 27 prey families. These field functional responses were considerably reduced compared to lab functional responses. We further find that foraging is sometimes increased in the presence of other prey types, contrary to expectations. Our novel method for estimating field foraging rates will allow researchers to determine functional responses for wild predators and address long-standing questions about foraging in nature.

Insights into the spatial ecology of severely injured free-living felids: Iberian lynx, bobcat, and snow leopard.

Severe musculoskeletal diseases, such as those associated with congenital or traumatic events, that result in missing limbs may compromise the fitness and survival of free-living felids. Here we report the space use of four amputee individuals from three felid species captured from 2017 to 2022 in Missouri (USA), Toledo and Badajoz (Spain), and Suitai Khairkhan Mountain (Mongolia). We describe home ranges and daily travel distances post-release of free-living felids that had either suffered a traumatic amputation or following a surgical amputation. We compared these data with those reported in the literature for felids without amputations. Forelimb or hindlimb amputation did not affect the hunting, mating, or territory patrolling behavior of any of the individuals. However, we recorded significant differences in the daily movement before and after the traumatic event of the Iberian lynx forelimb amputee. We attribute this difference to the physical impairment, although we consider other variables that may have played a role. Nevertheless, all animals appeared to cope well with their limb loss, showing home ranges and daily distances within those recorded for their sex and species. Unless amputee felids represent a threat to domestic livestock or humans, our data suggest these individuals may remain free-living as they contribute to local population persistence and appear to maintain good general health and welfare.

Investigation of the prevalence and factors influencing tobacco and alcohol use among adolescents in Nigeria: A systematic literature review.

The increase in tobacco and alcohol prevalence among Nigerian teenagers necessitates the need to understand the factors influencing use. The aim of this systematic literature review was to synthesis evidence from studies on tobacco and alcohol use among Nigerian adolescents and young adults in order to determine factors influencing tobacco and alcohol use. Six databases MEDLINE, Embase, CINAHL, PsycINFO, PubMed, ScienceDirect, and Google Scholar were used to search for peer-reviewed articles reporting the prevalence and predictors of tobacco and alcohol use among adolescents/youths published between 2010 and 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guided this review. From our search, twelve articles from the 6 geopolitical zones within Nigeria were included. The high prevalence of tobacco and alcohol use among Nigerian adolescents necessitates the need to understand the factors influencing use. A high prevalence rate was recorded among the male gender. Gender, age, and curiosity appear to place adolescents at extra risk for tobacco and alcohol use. Lack of parental monitoring, peer influence, low socio-economic status, low education level, stressful life events, advertisements, availability, and accessibility are factors identified to influence adolescents' alcohol and tobacco use. Alcohol and tobacco use remains a major public health issue as it continues to contribute largely to the growing occurence of diseases globally. Our review showed that adolescents' alcohol and tobacco use behaviour is triggered by various factors on the personal, interpersonal, organisational, community, and policy levels, and these factors are understood to predict or protect against alcohol and tobacco use.

Object geometry serves humans' intuitive physics of stability.

How do humans judge physical stability? A prevalent account emphasizes the mental simulation of physical events implemented by an intuitive physics engine in the mind. Here we test the extent to which the perceptual features of object geometry are sufficient for supporting judgments of falling direction. In all experiments, adults and children judged the falling direction of a tilted object and, across experiments, objects differed in the geometric features (i.e., geometric centroid, object height, base size and/or aspect ratio) relevant to the judgment. Participants' performance was compared to computational models trained on geometric features, as well as a deep convolutional neural network (ResNet-50), none of which incorporated mental simulation. Adult and child participants' performance was well fit by models of object geometry, particularly the geometric centroid. ResNet-50 also provided a good account of human performance. Altogether, our findings suggest that object geometry may be sufficient for judging the falling direction of tilted objects, independent of mental simulation.

Visual looming is a primitive for human emotion.

Looming objects afford threat of collision across the animal kingdom. Defensive responses to looming and neural computations for looming detection are strikingly conserved across species. In mammals, information about rapidly approaching threats is conveyed from the retina to the midbrain superior colliculus, where variables that indicate the position and velocity of approach are computed to enable defensive behavior. Although neuroscientific theories posit that midbrain representations contribute to emotion through connectivity with distributed brain systems, it remains unknown whether a computational system for looming detection can predict both defensive behavior and phenomenal experience in humans. Here, we show that a shallow convolutional neural network based on the Drosophila visual system predicts defensive blinking to looming objects in infants and superior colliculus responses to optical expansion in adults. Further, the responses of the convolutional network to a broad array of naturalistic video clips predict self-reported emotion largely on the basis of subjective arousal. Our findings illustrate how motor and experiential components of human emotion relate to species-general systems for survival in unpredictable environments.

Revealing the Structure Formation on Polyglycerol Citrate Polymers-An Environmentally Friendly Polyester as a Seed-Coating Material.

A detailed structural investigation of a promising bio-based polymer, polyglycerol citrate polyester, obtained by the bulk polycondensation of glycerol (Gly) against citric acid (Cit) under mild reaction was performed. The reaction in conditions with and without catalyst use (sulfuric acid, H2SO4) was investigated, showing evidence that it is possible to modify the polymer solubility according to the ratio and catalyst utilization. 13C and 1H NMR indicated that synthesis catalyzed with Cit excess leads to higher esterification degrees of citrate groups. In contrast, the Gly moieties are more prominent in catalyzed polymers regardless of the excess monomers. Overall, a successful conversion of Gly and Cit into polyesters was attained even without catalysis, enabling a simple route for the large-scale production of this green material to be used as a coating material. This polymer has been shown to be well-suited for coating seeds and might be a promising material for similar agricultural applications. Tests on soybean seed coating with a PGCit solution of 75% indicated that the seed quality and germination rate were not affected by the PGCit coating, concluding that this polymer is suitable for this application.

Temperature and predators as interactive drivers of community properties.

The effects of warming on ecological communities emerge from a range of potentially asymmetric impacts on individual physiology and development. Understanding these responses, however, is limited by our ability to connect mechanisms or emergent patterns across the many processes that drive variation in demography. Further complicating this understanding is the gain or loss of predators to many communities, which may interact with changes in temperature to drive community change. Here we conducted a factorial warming and predation experiment to test generalized predictions about responses to warming. We used microcosms with a range of protists, rotifers, and a gastrotrich, with and without the predator Actinosphaerium, to assess changes in diversity, body size, function, and composition in response to warming. We find that community respiration and predator:prey biovolume ratios peak at intermediate temperatures, while species richness declined with temperature. We also found that overall biomass increased with species richness, driven by the effect of temperature on richness. There was little evidence of an interaction between predation and temperature change, likely because the predator was mostly limited to the intermediate temperatures. Overall, our results suggest that general predictions about community change are still challenging to make but may benefit by considering multiple dimensions of community patterns in an integrated way.

Agreement between hematocrit values determined by the Cobas b121 blood gas analyzer and the microhematocrit method in dogs, cats, and horses.

BACKGROUND: Packed cell volume (PCV) is important for assessing a patient's health status. Some blood gas analyzers measure hematocrit, and the agreement with PCV varies among different analyzers. OBJECTIVES: We aimed to determine the agreement between PCV measured by microcentrifugation and hematocrit measured by the Cobas b121 blood gas analyzer in dogs, cats, and horses. METHODS: Whole blood samples for PCV and blood gas analysis were collected in lithium-heparin syringes and analyzed within 10 min of collection. Agreement and association between the PCV and Cobas b121 generated hematocrit were assessed by the Bland-Altman method, Pearson's correlation, Deming regression analysis, and paired t tests. A total allowable error of 10% was used for the analysis. RESULTS: This study included 45 dogs, 45 cats, and 33 horses. The respective mean ± SD (minimum-maximum) of PCVs and hematocrits were: dogs, 34.9 ± 9.9% (9.0-55.0) and 32.5 ± 8.8% (10.4-50.6); cats, 29.0 ± 9.6% (11.0-51.0) and 26.9 ± 9.3% (10.2-50.9); horses, 34.2 ± 6.5% (24.0-47.0) and 34.1 ± 6.0% (22.5-46.1). There were no significant differences between the methods. The bias ± SD was: dogs, -2.4 ± 2.6%; cats, -2.2 ± 2.3%; horses, -0.1 ± 2.4%. Pearson's correlation coefficients were > 0.90 for all species (P < 0.0001). In 60%, 49%, and 85% of the samples for dogs, cats, and horses, respectively, the percentage differences between the methods were within 10%. CONCLUSIONS: The Cobas b121 blood gas analyzer provided accurate estimates of PCVs in horses. However, in dogs and cats, there was a large frequency of unacceptable differences between the methods.

Electrophysiological Comparison of Cumulative Area and Non-Symbolic Number Judgments.

Despite the importance of representing different magnitudes (i.e., number and cumulative area) for action planning and formal mathematics, there is much debate about the nature of these representations, particularly the extent to which magnitudes interact in the mind and brain. Early interaction views suggest that there are shared perceptual processes that form overlapping magnitude representations. However, late interaction views hold that representations of different magnitudes remain distinct, interacting only when preparing a motor response. The present study sheds light on this debate by examining the temporal onset of ratio and congruity effects as participants made ordinal judgments about number and cumulative area. Event-related potentials (ERPs) were recorded to identify whether the onset of such effects aligned with early versus late views. Ratio effects for both magnitudes were observed starting in the P100. Moreover, a congruity effect emerged within the P100. That interactions were observed early in processing, at the same time that initial ratio effects occurred, suggests that number and cumulative area processes interacted when magnitude representations were being formed, prior to preparing a decision response. Our findings are consistent with an early interaction view of magnitude processing, in which number and cumulative area may rely on shared perceptual mechanisms.

Visual adaptation reveals multichannel coding for numerosity.

Visual numerosity is represented automatically and rapidly, but much remains unknown about the computations underlying this perceptual experience. For example, it is unclear whether numerosity is represented with an opponent channel or multichannel coding system. Within an opponent channel system, all numerical values are represented via the relative activity of two pools of neurons (i.e., one pool with a preference for small numerical values and one pool with a preference for large numerical values). However, within a multichannel coding system, all numerical values are represented directly, with separate pools of neurons for each (discriminable) numerical value. Using an adaptation paradigm, we assessed whether the visual perception of number is better characterized by an opponent channel or multichannel system. Critically, these systems make distinct predictions regarding the pattern of aftereffects exhibited when an observer is adapted to an intermediate numerical value. Opponent channel coding predicts no aftereffects because both pools of neurons adapt equally. By contrast, multichannel coding predicts repulsive aftereffects, wherein numerical values smaller than the adapter are underestimated and those larger than the adapter are overestimated. Consistent with multichannel coding, visual adaptation to an intermediate value (50 dots) yielded repulsive aftereffects, such that participants underestimated stimuli ranging from 10-50 dots, but overestimated stimuli ranging from 50-250 dots. These findings provide novel evidence that the visual perception of number is supported by a multichannel, not opponent channel, coding system, and raise important questions regarding the contributions of different cortical regions, such as the ventral and lateral intraparietal areas, to the representation of number.

Diagnostic yield and safety of transbronchial lung cryobiopsy for diffuse parenchymal lung diseases diagnosis: Comparison between 1.7-mm and 1.9-mm probes.

PURPOSE OF THE RESEARCH: transbronchial lung cryobiopsy has been recently accepted as a valid and less invasive alternative to surgical lung biopsy. The purpose of this randomized controlled study was to evaluate, for the first time, the quality and safety of biopsy specimens obtained by using the new disposable 1.7-mm cryoprobe compared with the standard re-usable 1.9 mm cryoprobe in the diagnosis of diffuse parenchymal lung diseases. METHODS: 60 consecutive patients were prospectively enrolled and randomly assigned to two different groups: 1.9 mm (group A) and 1.7 mm (group B); primary endpoints were pathological and multidisciplinary diagnostic yield, sample size and complication rate. PRINCIPAL RESULTS: the pathological diagnostic yield of cryobiopsy was 100% in group A and 93.3% in group B (p = 0.718); cryobiopsy median diameter was 6.8 mm in group A and 6.7 mm in group B (p = 0,5241). Pneumothorax occurred in 9 patients in group A and 10 in group B (p = 0.951); mild-to-moderate bleeding in 7 cases and 9 cases in group A and B respectively (p = 0.559). No death or severe adverse events were observed. CONCLUSIONS: there was no statistically significant difference between the two groups, regarding diagnostic yield, adverse events and sampling adequacy.

Intraguild predation is increased in areas of low prey diversity in a generalist predator community.

Niche differentiation and intraguild predation (IGP) can allow ecologically similar species to coexist, although it is unclear which coexistence mechanism predominates in consumer communities. Until now, a limited ability to quantify diets from metabarcoding data has precluded the use of sequencing data to determine the relative importance of these mechanisms. Here, we pair a recent metabarcoding quantification approach with stable isotope analysis to examine diet composition in a wolf spider community. We compare the prevalence of resource partitioning and IGP in these spiders and test whether factors that influence foraging performance, including individual identity, morphology, prey community and environmental conditions, can explain variation in diet composition and IGP. Extensive IGP is likely the primary coexistence mechanism in this community, and other factors to which foraging variation is often attributed do not explain diet composition and IGP here. Rather, IGP increases as prey diversity decreases. Foragers are driven to IGP where resource niches are limited. We highlight the need to examine how drivers of predator-prey interaction strengths translate into foraging in natural systems.

A theory of perceptual number encoding.

There has long been interest in how the mind represents numerical magnitude, particularly in the absence of symbols. For humans and nonhuman animals, number represents a core dimension of perceptual experience by which objects in the physical world are delineated. The physical world is also well characterized by other dimensions, many of which covary with number. Yet, the general consensus is that number is perceived independently of other magnitudes that co-occur with it. Here, we present evidence against the independence of number perception. In particular, we use evidence from neuroimaging, computational modeling, visual illusions, and psychophysics to introduce a novel theory of visual number encoding, wherein nonnumerical magnitude information such as cumulative surface area is encoded along with number and sustained throughout visual perception. Moreover, we propose that the experience of number per se reflects the readout of a multidimensional (i.e., integral) representation vis-à-vis selective attention, not the independent encoding of number. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

No intrinsic number bias: Evaluating the role of perceptual discriminability in magnitude categorization.

Accumulating evidence suggests that there is a spontaneous preference for numerical, compared to non-numerical (e.g., cumulative surface area), information. However, given a paucity of research on the perception of non-numerical magnitudes, it is unclear whether this preference reflects a specific bias towards number, or a general bias towards the more perceptually discriminable dimension (i.e., number). Here, we found that when the number and area of visual dot displays were matched in mathematical ratio, number was more perceptually discriminable than area in both adults and children. Moreover, both adults and children preferentially categorized these ratio-matched stimuli based on number, consistent with previous work. However, when number and area were matched in perceptual discriminability, a different pattern of results emerged. In particular, children preferentially categorized stimuli based on area, suggesting that children's previously observed number bias may be due to a mismatch in the perceptual discriminability of number and area, not an intrinsic salience of number. Interestingly, adults continued to categorize the displays on the basis of number. Altogether, these findings suggest a dominant role for area during childhood, refuting the claim that number is inherently and uniquely salient. Yet they also reveal an increased salience of number that emerges over development. Potential explanations for this developmental shift are discussed. RESEARCH HIGHLIGHTS: Previous work found that children and adults spontaneously categorized dot array stimuli by number, over other magnitudes (e.g., area), suggesting number is uniquely salient. However, here we found that when number and area were matched by ratio, as in prior work, number was significantly more perceptually discriminable than area. When number and area were made equally discriminable ('perceptually-matched'), children, contra adults, spontaneously categorized stimuli by area over number (and other non-numerical magnitudes). These findings suggest that area may be uniquely salient early in childhood, with the previously-observed number bias not emerging until later in development.

Pyruvate kinase M2 mediates IL-17 signaling in keratinocytes driving psoriatic skin inflammation.

Psoriasis is an inflammatory skin disease characterized by keratinocyte proliferation and inflammatory cell infiltration induced by IL-17. However, the molecular mechanism through which IL-17 signaling in keratinocytes triggers skin inflammation remains not fully understood. Pyruvate kinase M2 (PKM2), a glycolytic enzyme, has been shown to have non-metabolic functions. Here, we report that PKM2 mediates IL-17A signaling in keratinocytes triggering skin psoriatic inflammation. We find high expression of PKM2 in the epidermis of psoriatic patients and mice undergoing psoriasis models. Specific depletion of PKM2 in keratinocytes attenuates the development of experimental psoriasis by reducing the production of pro-inflammatory mediators. Mechanistically, PKM2 forms a complex with Act1 and TRAF6 regulating NF-κB transcriptional signaling downstream of the IL-17 receptor. As IL-17 also induces PKM2 expression in keratinocytes, our findings reveal a sustained signaling circuit critical for the psoriasis-driving effects of IL-17A, suggesting that PKM2 is a potential therapeutic target for psoriasis.

Struvite-based composites for slow-release fertilization: a case study in sand.

Struvite (St) recovered from wastewaters is a sustainable option for phosphorus (P) recovery and fertilization, whose solubility is low in water and high in environments characterized by a low pH, such as acidic soils. To broaden the use of struvite in the field, its application as granules is recommended, and thus the way of application should be optimized to control the solubility. In this study struvite slow-release fertilizers were designed by dispersing St particles (25, 50, and 75 wt%) in a biodegradable and hydrophilic matrix of thermoplastic starch (TPS). It was shown that, in citric acid solution (pH = 2), TPS promoted a steadier P-release from St compared to the pure St pattern. In a pH neutral sand, P-diffusion from St-TPS fertilizers was slower than from the positive control of triple superphosphate (TSP). Nevertheless, St-TPS featured comparable maize growth (i.e. plant height, leaf area, and biomass) and similar available P as TSP in sand after 42 days of cultivation. These results indicated that St-TPS slow P release could provide enough P for maize in sand, achieving a desirable agronomic efficiency while also reducing P runoff losses in highly permeable soils.