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1.
Zhonghua Zhong Liu Za Zhi ; 42(3): 242-246, 2020 Mar 23.
Artigo em Chinês | MEDLINE | ID: mdl-32252204

RESUMO

Objective: To explore the surgical method and effect of en bloc pelvic resection and anal preservation after radical radiotherapy for cervical cancer. Methods: Clinical data of 20 cervical cancer patients with central recurrence after radical radiotherapy underwent en bloc pelvic resection in the Tumor Hospital of Zhengzhou University and Hainan Provincial People's Hospital from January 2013 to December 2017 were retrospectively analyzed. The operative time, intraoperative blood loss, length of stay, postoperative anal function and postoperative complications were evaluated. Results: The median operation time of 20 patients with anal preservation after en bloc pelvic resection was 135.2 min, the median intraoperative blood loss was 680 ml, and the median hospitalization time was 16.5 days. Among them, 18 patients had good postoperative healing, and the anal function gradually returned to normal within 6 months after surgery, defecated 1~2 times per day.One patient showed incomplete adhesion between the external colon and the anus. One patient presented with pre-sacral infection. Postoperative pathology confirmed the recurrences in 20 patients, of which 11 cases were squamous cell carcinoma, 7 cases were adenocarcinoma, 2 cases were adenosquamous cell carcinoma. Conclusions: It is safe and reliable to preserve anus after en bloc pelvic resection for cervical cancer patients with radical radiotherapy. The anus function is good enough to improve the postoperative life quality of patients significantly.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32138471

RESUMO

Objective: The study developed mushroom stalk residues as feed additives in the broiler diet for improving the growth performance and immunity of broilers as well as to increase the value of mushroom stalk residues. Methods: In total, the 300 ROSS 308 broilers were randomly allocated into fifteen pens with five dietary treatments: 1) control: basal diet; 2) CMWM: supplemented with 1% Cordyceps militaris waster medium (CM); 3) CMPE: supplemented with 0.5% CM + 0.5% Pleurotus eryngii stalk residue (PE); 4) CMPS: supplemented with 0.5% CM + 0.5% Pleurotus sajor-caju stalk residue (PS); 5) CMFV: supplemented with 0.5% CM + 0.5% Fammulina velutipes stalk residue (FV). Results: The chemical analysis results showed that CM extracts, PE extracts, PS extracts, and FV extracts contain functional components such as polysaccharides and phenols and have both DPPH scavenging and Ferrous scavenging capacities. The group CMWM saw increased body weight gain and feed conversion rate and the promotion of jejunum villus growth, but there is no significant difference in the intestinal bacteria phase. Antioxidant genes in the nuclear factor (erythroid-derived 2)-like 2 (Nrf2)-ARE pathway among the groups are significantly higher than that of the control group, especially in group CMWM. Conclusion: The mushroom stalk residues have antioxidant functional components, can improve the intestinal health and body weight gain of the chickens, and can activate the antioxidant pathway of Nrf2 to increase the HO-1 expression. And, the treatment with 1% CM was the most promising as a feed additive.

3.
Appl Ergon ; 85: 103056, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32174344

RESUMO

The current research proposed and tested a structural equation model (SEM) that describes hypothesized relationships among factors affecting trust in human-robot interaction (HRI) such as trustworthiness, human-likeness, intelligence, perfect automation schema (PAS), and affect. A video stimulus depicting an autonomous guard robot interacting with humans was employed as a stimulus via Amazon's Mechanical Turk to recruit 233 participants. Human-related and robot-related metrics were found to affect trustworthiness that subsequently affected trust. In particular, ability (as a trustworthiness facet) was a dominant factor affecting trust in HRI. Integrity was found to mediate the relationships between robot- and human-related metrics and trustworthiness. This study also showed a correlation between intelligence and trustworthiness, as well as between PAS and trustworthiness. The findings of the present study have significant implications for both theory and practice on factors and levels that affect trust in HRI.

4.
Bioresour Technol ; 306: 123095, 2020 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-32172086

RESUMO

This study developed a unique system by combining the novel vertical flow (NVF) using expanded clay (ExC) and free flow surface constructed wetland (FWS) for dormitory sewage purification and reuse. The NVF tank consisted of filter layers of ExC, sandy soil, sand, and gravel. The FWS consisted of sandy soil substrate and was installed after the NVF. Colocasia esculenta and Dracaena sanderiana was planted in NVF and FWS, respectively. The treatment system was operated and tested for more than 21 weeks by increasing the hydraulic loading rate (HLR) from 0.02 m/d to 0.12 m/d. The results demonstrated that effluents in the system changed proportionally to the HLRs, except for nitrate nitrogen. Furthermore, the maximum removal efficiencies for TSS, BOD5, NH4-N, and Tcol were 76 ± 13%, 74 ± 11%, 90 ± 3%, and 59 ± 18% (0.37 ± 0.19 log10MPN/100 mL), respectively. At HLRs of 0.04-0.06 m/d, the treatment system satisfied the limits of agriculture irrigation.

5.
J Environ Manage ; 264: 110440, 2020 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-32217320

RESUMO

For decades, there has been a strong interest in mitigating greenhouse gas (GHG) emissions from wastewater treatment plants (WWTPs). Numerous models were developed to measure the emissions and propose the quantification. Existing studies looked at the relationship between GHG emissions and operational cost (OCI), which is one of the most important indicators for decision-makers. Other parameters that can influence the control strategies include the effluent quality (EQI) and total environmental impacts. Plant-wide models are reliable methods to examine the OCI, EQI and GHG emissions while Life cycle assessment (LCA) works to assess the potential environmental impacts. A combined LCA and plant-wide model proved to be a valuable tool evaluating and comparing strategies for the best performance of WWTPs. For this study involving a WWTP, the benchmark model is used while LCA is the decision tool to find the most suitable treatment strategy. LCA adds extra criteria that complement the existing criteria provided by such models. Complementing the cost/performance criteria is proposed for plant-wide models, including environmental evaluation, based on LCA, which provides an overall better assessment of WWTPs. It can capture both the dynamic effects and potential environmental impacts. This study provides an overview of the integration between plant-wide models and LCA.

6.
Colorectal Dis ; 2020 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-32057167

RESUMO

AIM: After extended left colectomy, traditional colorectal anastomosis is often not feasible because of insufficient length of the remaining colon to perform a tension-free anastomosis. Total colectomy with ileorectal anastomosis could be an alternative but this can lead to unsatisfactory quality of life. Trans-mesenteric colorectal anastomosis or inverted right colonic transposition (the so-called Deloyers procedure) are two possible solutions for creating a tension-free colorectal anastomosis after extended left colectomy. Few studies have reported their results of these two techniques and mostly via laparotomy. The aim of this study was to describe the trans-mesenteric colorectal anastomosis and the inverted right colonic transposition procedure via a laparoscopic approach and report the outcome in a series of 13 consecutive patients. METHOD: This was retrospective chart review of laparoscopic colorectal surgery with trans-mesenteric colorectal anastomosis or the inverted right colonic transposition procedure from January 2015 up to 2019. An accompanying video demonstrates these two techniques. RESULTS: Thirteen consecutive patients underwent either a laparoscopic trans-mesenteric colorectal anastomosis (n = 9) or an inverted right colonic transposition procedure (n = 4). One patient had intra-operative presacral bleeding that was stopped successfully without conversion. Two patients had a postoperative intra-abdominal abscess, but no anastomotic complications were recorded. The median number of bowel movements per day after 6 months was 2 (range 2-5). CONCLUSIONS: Trans-mesenteric colorectal anastomosis or the inverted right colonic transposition procedure is feasible laparoscopically. The now well-established classical advantages of the laparoscopic approach are associated with good functional outcome after these procedures.

7.
Hum Factors ; : 18720820901629, 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32027537

RESUMO

OBJECTIVE: This research examined the effects of reliability and stated social intent on trust, trustworthiness, and one's willingness to endorse use of an autonomous security robot (ASR). BACKGROUND: Human-robot interactions in the domain of security is plausible, yet we know very little about what drives acceptance of ASRs. Past research has used static images and game-based simulations to depict the robots versus actual humans interacting with actual robots. METHOD: A video depicted an ASR interacting with a human. The ASR reviewed access credentials and allowed entrance once verified. If the ASR could not verify one's credentials it instructed the visitor to return to the security checkpoint. The ASR was equipped with a nonlethal device and the robot used this device on one of the three visitors (a research confederate). Manipulations of reliability and stated social intent of the ASR were used in a 2 × 4 between subjects design (N = 320). RESULTS: Reliability influenced trust and trustworthiness. Stated social intent influenced trustworthiness. Participants reported being more favorable toward use of the ASR in military contexts versus public contexts. CONCLUSION: The study demonstrated that reliability of the ASR and statements regarding the ASR's stated social intent are important considerations influencing the trust process (inclusive of intentions to be vulnerable and trustworthiness perceptions). APPLICATION: If robotic systems are authorized to use force against a human, public acceptance may be increased with availability of the intent-based programming of the robot and whether or not the robot's decision was reliable.

8.
Artigo em Inglês | MEDLINE | ID: mdl-32061794

RESUMO

OBJECTIVES: Evidence of false-positive galactomannan enzyme immunoassay (GM-EIA) results associated with intravenous immunoglobulin (IVIG) administration is scarce. Here, we aimed to determine the false-positive rate of GM-EIA after IVIG administration and to identify the related factors. METHODS: Standard GM-EIA was performed using diluted and pure human IVIG samples with and without heat treatment. We also included adult patients who had at least one GM-EIA result within 1 week of IVIG administration for analysis. Those who had prior invasive aspergillosis within 1 year before IVIG therapy were excluded. The clinical characteristics and galactomannan index (GMI) kinetics between patients with false-positive and true-positive GMI were compared. RESULTS: All diluted and pure IVIG samples tested positive for GM. Heat treatment resulted in the considerable elevation of GMI. Of 48 patients with positive GM-EIA results within 1 week of IVIG administration, 22 (45.8%) were considered to have false-positive antigenaemia (false-positive group, FPG). After the completion of IVIG administration, a decline in GMI was observed in all FPG patients but in only 18 out of 26 patients (69.2%) with true-positive results (true-positive group, TPG). By 7, 14, and 18 days of IVIG administration, GMI reverted to negative values in 7/15 (46.7%), 18/20 (90%) and 22/22 (100%) FPG patients, respectively, and 6/24 (25%), 14/24 (58.3%), and 16/26 (61.5%) of TPG patients, respectively. The TPG was more likely to have two or more consecutively positive GMIs after IVIG administration than the FPG (adjusted odds ratio, 9.01; 95% confidence interval, 1.99-40.9). CONCLUSIONS: IVIG treatment may produce false-positive GM-EIA results. A positive GMI among patients receiving human IVIG should be interpreted with caution.

9.
Prion ; 14(1): 47-55, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31973662

RESUMO

Chronic wasting disease is a progressively fatal, horizontally transmissible prion disease affecting several members of the cervid species. Conventional diagnosis relies on ELISA or IHC evaluation using tissues collected post-mortem; however, recent research has focused on newly developed amplification techniques using samples collected antemortem. The present study sought to cross-validate the real-time quaking-induced conversion assay (RT-QuIC) evaluation of rectal biopsies collected from an elk herd with endemic CWD, assessing both binary positive/negative test results as well as relative rates of amplification between laboratories. We found that results were correlative in both categories across all laboratories performing RT-QuIC, as well as to conventional IHC performed at a national reference laboratory. A significantly higher number of positive samples were identified using RT-QuIC, with results seemingly unhindered by low follicle counts. These findings support the continued development and implementation of amplification assays in the diagnosis of prion diseases of veterinary importance, targeting not just antemortem sampling strategies, but post-mortem testing approaches as well.

10.
Clin Cancer Res ; 26(1): 171-182, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558478

RESUMO

PURPOSE: There is currently no molecular signature in clinical use for adjuvant endocrine therapy omission in breast cancer. Given the unique trial design of SweBCG91-RT, where adjuvant endocrine and chemotherapy were largely unadministered, we sought to evaluate the potential of transcriptomic profiling for identifying patients who may be spared adjuvant endocrine therapy. EXPERIMENTAL DESIGN: We performed a whole-transcriptome analysis of SweBCG91-RT, a randomized phase III trial of ± radiotherapy after breast-conserving surgery for node-negative stage I-IIA breast cancer. Ninety-two percent of patients were untreated by both adjuvant endocrine therapy and chemotherapy. We calculated 15 transcriptomic signatures from the literature and combined them into an average genomic risk, which was further used to derive a novel 141-gene signature (MET141). All signatures were then independently examined in SweBCG91-RT and in the publicly available METABRIC cohort. RESULTS: In SweBCG91-RT, 454 patients were node-negative, postmenopausal, and systemically untreated with ER-positive, HER2-negative cancers, which constitutes a low-risk subgroup and potential candidates for therapy omission. Most transcriptomic signatures were highly prognostic for distant metastasis, but considerable discordance was observed on the individual patient level. Within the MET141 low-risk subgroup (lowest 25th percentile of scores), 95% of patients were free of metastasis at 15 years, even in the absence of adjuvant endocrine therapy. In a clinically low-risk subgroup of the METABRIC cohort not treated with systemic therapy, no breast cancer death occurred among the MET141 low-risk patients. CONCLUSIONS: Transcriptomic profiling identifies patients with an excellent outcome without any systemic adjuvant therapy in clinically low-risk patients of the SweBCG91-RT and METABRIC cohorts.

11.
Bioresour Technol ; 297: 122398, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31759857

RESUMO

Seaweed (T1), sugarcane trash (T2), coir pith (T3) and vegetable waste (T4) with cowdung (1:1, w/w) were vermicomposted using Eudrilus eugeniae (50 days). The pH in vermicomposts showed a decrease while electrical conductivity showed increment. The organic matter content, organic carbon, lignin, cellulose, C/N and C/P ratios in vermicompost was significantly lower than compost. Total NPK contents of vermicompost were significantly elevated (P < 0.05) with 12.04-63.75%, 19.05-31.58% and 22.47-42.55%, respectively. The significantly higher growth rate of 1.41 and 7.74 mg/worm/day was observed in T1 on 10th and 50th day respectively, with 23.91 initial C/N ratio; while it was 0.85 and 4.81 mg/worm/day in T4 with 69.81 initial C/N ratio. A similar pattern was reflected in cocoon production, hatchling success and hatchling number/cocoon. Results revealed that vermicompost quality, worm growth, and reproduction depend on C/N ratio. The study suggests that amendment materials like cowdung are necessary to reduce C/N ratio for effective vermicomposting.


Assuntos
Compostagem , Oligoquetos , Animais , Carbono , Reprodução , Solo
12.
DNA Repair (Amst) ; 86: 102754, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31794893

RESUMO

Radiation-induced lymphomagenesis results from a clonogenic lymphoid cell proliferation due to genetic alterations and immunological dysregulation. Mouse models had been successfully used to identify risk and protective factors for radiation-induced DNA damage and carcinogenesis. The mammalian SETD4 is a poorly understood putative methyl-transferase. Here, we report that conditional Setd4 deletion in adult mice significantly extended the survival of radiation-induced T-lymphoma. However, in Tp53 deficient mice, Setd4 deletion did not delay the radiation-induced lymphomagenesis although it accelerated the spontaneous T-lymphomagenesis in non-irradiated mice. The T-lymphomas were largely clonogenic in both Setd4flox/flox and Setd4Δ/Δ mice based on sequencing analysis of the T-cell antigen ß receptors. However, the Setd4Δ/Δ T-lymphomas were CD4+/CD8+ double positive, while the littermate Setd4flox/floxtumor were largely CD8+ single positive. A genomic sequencing analysis on chromosome deletion, inversion, duplication, and translocation, revealed a larger contribution of inversion but a less contribution of deletion to the overall chromosome rearrangements in the in Setd4Δ/Δ tumors than the Setd4flox/flox tumors. In addition, the Setd4flox/flox mice died more often from the large sizes of primary thymus lymphoma at earlier time, but there was a slight increase of lymphoma dissemination among peripheral organs in Setd4Δ/Δ at later times. These results suggest that Setd4 has a critical role in modulating lymphomagenesis and may be targeted to suppress radiation-induced carcinogenesis.

13.
Int J Numer Method Biomed Eng ; 36(1): e3288, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31742921

RESUMO

There is a growing research interest in quantifying blood flow distribution for the entire cerebral circulation to sharpen diagnosis and improve treatment options for cerebrovascular disease of individual patients. We present a methodology to reconstruct subject-specific cerebral blood flow patterns in accordance with physiological and fluid mechanical principles and optimally informed by in vivo neuroimage data of cerebrovascular anatomy and arterial blood flow rates. We propose an inverse problem to infer blood flow distribution across the visible portion of the arterial network that best matches subject-specific anatomy and a given set of volumetric flow measurements. The optimization technique also mitigates the effect of uncertainties by reconciling incomplete flow data and by dissipating unavoidable acquisition errors associated with medical imaging data.

14.
QJM ; 113(2): 86-92, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31504931

RESUMO

BACKGROUND: If survival could be reliably predicted many patients could be safely managed outside of hospital in an ambulatory care setting. AIM: Comparison of common laboratory findings, co-morbidities, mobility and vital signs as predictors of mortality of acutely ill emergency department (ED) attendees. DESIGN: Prospective observational study. METHODS: Secondary analysis of 1334 consenting acutely ill patients attending a Danish ED. RESULTS: 67 (5%) out of 1334 patients died within 100 days. After logistic regression seven predictors of 100 days mortality remained significant: an albumin level ≤34 gm/l, D-dimer level >0.51 mg/l, an Asadollahi score (based on admission laboratory data and age) ≥12, a platelet count <159 X 1000/ml, impaired mobility on presentation, a respiratory rate ≥30 bpm and a Charlson co-morbidity index ≥3. Only 5 of the 442 without any of these variables died within 365 days. Only one of the 517 patients with a stable independent gait and normal d-dimer and albumin levels died within 100 days, none died within 30 days of assessment and 12 died within 365 days. Of the remaining 817 patients 66 (8%) died within 100 days. CONCLUSION: These findings suggest that normal gait, albumin and d-dimer levels are the most parsimonious way of identifying low risk ED patients.

15.
J Formos Med Assoc ; 119(1 Pt 1): 12-17, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30709693

RESUMO

BACKGROUND/PURPOSE: With the evolution of assisted fertility and prenatal diagnostic technology, the prevalence of multi-fetal pregnancy increased, followed by the demand for prenatal intervention if genomic aberration was detected. How to distinguish the affected foetus from the normal co-twin before selective fetal reduction is therefore challenging. OBJECTIVES: We retrospectively reviewed the cases of dichorionic twins at our centre during 2004-2018, where selective fetal reduction was requested because one foetus carried a pathogenic genomic aberration. Five cases were enrolled, including three foetuses with trisomy 21, one foetus with microduplication and one foetus with microdeletion disorders. METHOD: We labelled the affected foetus by prenatal ultrasound and rapid molecular tools. For the twins without discriminating sonographic features (e.g., the same gender and no distinct placentae), interphase fluorescence in situ hybridization, rapid microarray and short tandem repeat markers were applied to identify the affected foetus. RESULTS: Selective fetal reduction was allocated accurately for all individuals. Two cases delivered at term, while two delivered preterm, and one developed fetal loss of the co-twin. CONCLUSION: We proposed a working scheme of integrating imaging and molecular techniques to correctly identify the affected co-twin before selective fetal reduction to ensure the accuracy of the identification.

16.
Rev Sci Tech ; 38(2): 629-639, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31866671

RESUMO

Asia is the world's largest aquaculture producer. The aquaculture industry faces a multitude of threats ranging from microbiological and chemical to parasitic. These threats could potentially affect aquatic animal health and food safety and alter the consumer's perception of aquacultural produce. The development of antimicrobial resistance is also of increasing concern. These actual or perceived food safety threats could result in reductions in the food supply that adversely affect the food security of a country or region. Harmonised regional regulatory requirements, increased consumer awareness and the adoption of good aquaculture practices are ways in which the aquaculture industry can mitigate these risks. Together with the increased use of smart technology in production and encouragement to adopt certification and accreditation schemes, these tools can help the aquaculture industry in Asia to become more resilient in the face of such challenges. In this paper, the authors present an insight into the hazards faced by the aquaculture industry, which could potentially adversely affect food supply and hence food security, in an Asian context. The authors make several recommendations to mitigate these risks and thus safeguard against disruptions to regional food security.


Assuntos
Aquicultura , Crustáceos , Peixes , Abastecimento de Alimentos , Animais , Aquicultura/normas , Ásia , Inocuidade dos Alimentos , Abastecimento de Alimentos/normas
17.
Br J Dermatol ; 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675442

RESUMO

Selecting a topical treatment from among the numerous topical agents for external genital warts remains challenging without clear evidence. Our aim was to evaluate comparatively the efficacy and safety of topical agents for external genital warts using a network meta-analysis. We included all randomized controlled trials that evaluated any topically applied treatment for external genital warts. Using the R package netmeta, network meta-analyses were performed with a frequentist approach. We identified 41 relevant studies comprising 6371 patients. Among conventional agents, podophyllotoxin 0·5% solution (odds ratio 1·94, 95% confidence interval 1·02-3·71) was significantly more efficacious than imiquimod 5% cream for lesion clearance; however, it was associated with a higher overall adverse event rate. Sinecatechins 15% ointment (odds ratio 0·21, 95% confidence interval 0·12-0·34) was significantly less efficacious than imiquimod 5% cream. Idoxuridine, polyhexamethylene biguanide, cidofovir and SB206 showed comparable therapeutic efficacies with conventional therapies. None of the treatments were significantly different from each other with respect to recurrence, patients with severe adverse events, or patients who withdrew because of treatment-related adverse events. Conventional modalities were efficacious and well tolerated, although each of them had their advantages and disadvantages. Additional efficacy and safety studies are warranted for unconventional agents.

18.
East Asian Arch Psychiatry ; 29(3): 75-80, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31566182

RESUMO

OBJECTIVE: To review the first 8-month outcome of the Common Mental Disorder Clinic model in Hong Kong in terms of patient exit status and improvement in depressive and anxiety symptoms. METHODS: During the first appointment, patients were interviewed by a multidisciplinary team comprising a psychiatrist, a psychiatric nurse, and an occupational therapist. A multidisciplinary case conference was conducted to discuss clinical observations, diagnosis, issues of concern, and the optimal individualised treatment plan. Low-intensity interventions by nurses and/or occupational therapists were provided, as were optional, time-limited, protocol-based interventions by clinical psychologists for those with mild to moderate depressive and anxiety symptoms. Pharmacological intervention may be used when indicated. Upon completion of the treatment plan, patients were reassessed by the treating psychiatrist. Discharge options included discharge without psychiatric follow-up, step-up to psychiatric outpatient clinics, and step-down services. The self-administered Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder 7-item scale (GAD-7) were used to assess the past 2 weeks' depressive and anxiety symptoms, respectively, at baseline and at each session. RESULTS: From July 2015 to February 2016, 1325 Chinese patients received the new service. Of them, 170 men and 363 women (mean age, 52.6 years) completed the treatment plan. After treatment, their mean PHQ-9 score decreased from 11.06 to 7.55 (p < 0.001), and the mean GAD-7 score decreased from 9.94 to 6.54 (p < 0.001). After treatment, 42.4% and 48.2% of the patients were within the normal range of PHQ-9 and GAD-7 scores, respectively, compared with 16.9% and 20.8% before treatment. The mean time to implementation of the individualised treatment plan was 82.33 days. Of the patients, 54.4% were discharged without any need for medical or psychiatric follow-up; 28% were stepped up to psychiatric outpatient clinics; and 17.3% were stepped down. The predictors of exit status were whether psychiatric medication was prescribed during initial intake (p = 0.011), whether psychiatric medication was prescribed at last follow-up (p < 0.001), the service period (p = 0.010), and the GAD-7 final score (p = 0.005). CONCLUSIONS: The first 8-month outcome of the new service model was encouraging, with shortened waiting time, reduced severity of symptoms, and better exit status (high recovery and step-down rates).


Assuntos
Equipe de Assistência ao Paciente , Ansiedade/terapia , Grupo com Ancestrais do Continente Asiático , Depressão/terapia , Feminino , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Psicoterapia , Estudos Retrospectivos , Fatores de Tempo
19.
J Clin Oncol ; 37(35): 3340-3349, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31618132

RESUMO

PURPOSE: Most patients with early-stage breast cancer are treated with adjuvant radiotherapy (RT) after breast-conserving surgery (BCS) to prevent locoregional recurrence (LRR). However, no genomic tools are used currently to select the optimal RT strategy. METHODS: We profiled the transcriptome of primary tumors on a clinical grade assay from the SweBCG91-RT trial, in which patients with node-negative breast cancer were randomly assigned to either whole-breast RT after BCS or no RT. We derived a new classifier, Adjuvant Radiotherapy Intensification Classifier (ARTIC), comprising 27 genes and patient age, in three publicly available cohorts, then independently validated ARTIC for LRR in 748 patients in SweBCG91-RT. We also compared previously published genomic signatures for ability to predict benefit from RT in SweBCG91-RT. RESULTS: ARTIC was highly prognostic for LRR in patients treated with RT (hazard ratio [HR], 3.4; 95% CI, 2.0 to 5.9; P < .001) and predictive of RT benefit (Pinteraction = .005). Patients with low ARTIC scores had a large benefit from RT (HR, 0.33 [95% CI, 0.21 to 0.52], P < .001; 10-year cumulative incidence of LRR, 6% v 21%), whereas those with high ARTIC scores benefited less from RT (HR, 0.73 [95% CI, 0.44 to 1.2], P = .23; 10-year cumulative incidence of LRR, 25% v 32%). In contrast, none of the eight previously published signatures were predictive of benefit from RT in SweBCG91-RT. CONCLUSION: ARTIC identified women with a substantial benefit from RT as well as women with a particularly elevated LRR risk in whom whole-breast RT was not sufficiently effective and, thus, in whom intensified treatment strategies such as tumor-bed boost, and possibly regional nodal RT, should be considered. To our knowledge, ARTIC is the first classifier validated as predictive of benefit from RT in a phase III clinical trial with patients randomly assigned to receive or not receive RT.

20.
Saudi J Biol Sci ; 26(6): 1129-1133, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31516340

RESUMO

This study aimed to determine the phytochemical components, microbial inhibitory effectiveness and antioxidant properties of Aerva lanata plant extracts. The whole plant showed various medicinal applications in folklore and traditional medicine in various parts of the world. The organic extracts such as ethanol, ethyl acetate, chloroform, acetone, water and methanol were subjected for various phytochemical analysis and confirmed for the existence of flavonoids, glycosides, terpenoids and alkaloid containing components. Alternatively, the extracts were performed for the antibacterial activities against the microbial pathogens and antioxidant properties. Results indicated that, the solvent extracts showed prominent activity against the tested strains. The MIC concentrations of plant were detected from 5 mg/ml to 40 mg/ml. The plant extract was highly effective against E. coli and E. aerogenes and the MIC was 5 mg/ml. In addition, the extracts noted promising antioxidant activities. The antioxidant activities were dose dependent manner. In conclusion, A. lanata extracts showed that significant major phytochemicals and effective antioxidant and anti-microbial properties.

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