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1.
PLoS Comput Biol ; 20(5): e1012043, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38739640

RESUMO

Sensory neurons reconstruct the world from action potentials (spikes) impinging on them. To effectively transfer information about the stimulus to the next processing level, a neuron needs to be able to adapt its working range to the properties of the stimulus. Here, we focus on the intrinsic neural properties that influence information transfer in cortical neurons and how tightly their properties need to be tuned to the stimulus statistics for them to be effective. We start by measuring the intrinsic information encoding properties of putative excitatory and inhibitory neurons in L2/3 of the mouse barrel cortex. Excitatory neurons show high thresholds and strong adaptation, making them fire sparsely and resulting in a strong compression of information, whereas inhibitory neurons that favour fast spiking transfer more information. Next, we turn to computational modelling and ask how two properties influence information transfer: 1) spike-frequency adaptation and 2) the shape of the IV-curve. We find that a subthreshold (but not threshold) adaptation, the 'h-current', and a properly tuned leak conductance can increase the information transfer of a neuron, whereas threshold adaptation can increase its working range. Finally, we verify the effect of the IV-curve slope in our experimental recordings and show that excitatory neurons form a more heterogeneous population than inhibitory neurons. These relationships between intrinsic neural features and neural coding that had not been quantified before will aid computational, theoretical and systems neuroscientists in understanding how neuronal populations can alter their coding properties, such as through the impact of neuromodulators. Why the variability of intrinsic properties of excitatory neurons is larger than that of inhibitory ones is an exciting question, for which future research is needed.


Assuntos
Potenciais de Ação , Adaptação Fisiológica , Modelos Neurológicos , Animais , Camundongos , Potenciais de Ação/fisiologia , Adaptação Fisiológica/fisiologia , Biologia Computacional , Simulação por Computador , Neurônios/fisiologia , Células Receptoras Sensoriais/fisiologia , Córtex Somatossensorial/fisiologia
2.
Eur J Neurosci ; 59(10): 2748-2765, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38511534

RESUMO

Social play behaviour is a rewarding activity that can entail risks, thus allowing young individuals to test the limits of their capacities and to train their cognitive and emotional adaptability to challenges. Here, we tested in rats how opportunities for risk-taking during play affect the development of cognitive and emotional capacities and medial prefrontal cortex (mPFC) function, a brain structure important for risk-based decision making. Male and female rats were housed socially or social play-deprived (SPD) between postnatal day (P)21 and P42. During this period, half of both groups were daily exposed to a high-risk play environment. Around P85, all rats were tested for cognitive performance and emotional behaviour after which inhibitory currents were recorded in layer 5 pyramidal neurons in mPFC slices. We show that playing in a high-risk environment altered cognitive flexibility in both sexes and improved behavioural inhibition in males. High-risk play altered anxiety-like behaviour in the elevated plus maze in males and in the open field in females, respectively. SPD affected cognitive flexibility in both sexes and decreased anxiety-like behaviour in the elevated plus maze in females. We found that synaptic inhibitory currents in the mPFC were increased in male, but not female, rats after high-risk play, while SPD lowered prefrontal cortex (PFC) synaptic inhibition in both sexes. Together, our data show that exposure to risks during play affects the development of cognition, emotional behaviour and inhibition in the mPFC. Furthermore, our study suggests that the opportunity to take risks during play cannot substitute for social play behaviour.


Assuntos
Cognição , Córtex Pré-Frontal , Assunção de Riscos , Animais , Córtex Pré-Frontal/fisiologia , Masculino , Feminino , Ratos , Cognição/fisiologia , Jogos e Brinquedos , Comportamento Social , Ansiedade/fisiopatologia , Células Piramidais/fisiologia , Emoções/fisiologia , Comportamento Animal/fisiologia
3.
J Natl Compr Canc Netw ; 22(2)2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38503055

RESUMO

Early-stage vulvar cancer is managed by a local excision of the primary tumor and, if indicated, a sentinel node (SN) biopsy to assess the need for further groin treatment. With the SN procedure, many patients can be treated less radically and will experience less complications and morbidity compared with an inguinofemoral lymphadenectomy (IFL). Still, the SN procedure can be further optimized. Different tracers for detecting the SN are being investigated, aiming to optimize detection rates and decrease the burden of the procedure and short-term complications. Until now, no standardized protocols exist for the pathologic workup of the SN, possibly leading to discrepancies in detection of metastases between institutes using different methods. New techniques, such as one-step nucleic amplification, seem to have potential in accurately detecting metastases in other cancers, but have not yet been investigated in vulvar squamous cell carcinoma (VSCC). Furthermore, several studies have investigated the possibility to broaden the indications for the SN procedure, such as its use in recurrent disease, larger tumors, or multifocal tumors. Although these studies show encouraging results, cohorts are small and further studies are needed. Prospective studies are currently investigating these subgroups. Lastly, several studies investigated optimization of groin treatment of patients with a metastatic SN. Inguinofemoral radiotherapy is a good alternative to IFL in patients with micrometastases in the SN, with comparable efficacy and less treatment-related morbidity. Reduction of the radicality of groin treatment is also possible in other ways, such as omitting contralateral IFL in patients with lateralized tumors and a unilateral metastatic SN. In conclusion, the SN procedure is an established procedure in early-stage VSCC, although optimization of the technique, pathologic workup, indications, and treatment in the setting of metastatic disease are the subject of ongoing research.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Vulvares , Feminino , Humanos , Metástase Linfática/patologia , Neoplasias Vulvares/cirurgia , Estudos Prospectivos , Estadiamento de Neoplasias , Biópsia de Linfonodo Sentinela/métodos , Excisão de Linfonodo/efeitos adversos , Excisão de Linfonodo/métodos , Carcinoma de Células Escamosas/patologia , Linfonodos/cirurgia , Linfonodos/patologia
4.
Cereb Cortex ; 33(15): 9399-9408, 2023 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-37317037

RESUMO

Experience-dependent organization of neuronal connectivity is critical for brain development. We recently demonstrated the importance of social play behavior for the developmental fine-tuning of inhibitory synapses in the medial prefrontal cortex in rats. When these effects of play experience occur and if this happens uniformly throughout the prefrontal cortex is currently unclear. Here we report important temporal and regional heterogeneity in the impact of social play on the development of excitatory and inhibitory neurotransmission in the medial prefrontal cortex and the orbitofrontal cortex. We recorded in layer 5 pyramidal neurons from juvenile (postnatal day (P)21), adolescent (P42), and adult (P85) rats after social play deprivation (between P21 and P42). The development of these prefrontal cortex subregions followed different trajectories. On P21, inhibitory and excitatory synaptic input was higher in the orbitofrontal cortex than in the medial prefrontal cortex. Social play deprivation did not affect excitatory currents, but reduced inhibitory transmission in both medial prefrontal cortex and orbitofrontal cortex. Intriguingly, the reduction occurred in the medial prefrontal cortex during social play deprivation, whereas the reduction in the orbitofrontal cortex only became manifested after social play deprivation. These data reveal a complex interaction between social play experience and the specific developmental trajectories of prefrontal subregions.


Assuntos
Neurônios , Transmissão Sináptica , Ratos , Animais , Transmissão Sináptica/fisiologia , Córtex Pré-Frontal/fisiologia , Células Piramidais/fisiologia , Sinapses/fisiologia
5.
Public Health Nurs ; 2024 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-39422986

RESUMO

OBJECTIVE: The objective of this study was to enhance the knowledge base of primary school children regarding earthquake preparedness through the implementation of an activity-based earthquake awareness education program. METHODS: The study was conducted as pre-posttest semi-experimental design with one group of 333 children in a primary school between January and May 2024. A Descriptive Information Form and Earthquake Awareness Knowledge Level Form were the data collection tools. The children were provided with a 6-week (modules) education program. Measurements were made before and after the education. RESULTS: The mean age of the children was 7.16 ± 0.73 years (6-9), 56.8% were girls, 43.2% were boys, and 25.8% were second-grade children. Earthquake Awareness Knowledge Level Form total score was higher after the education (18.31 ± 1.52) than before (15.51 ± 3.73) (t = -16.144, p < 0.001). The study revealed an increase in children's knowledge regarding appropriate behaviors in the context of earthquakes, encompassing actions to be taken before, during, and after such events. CONCLUSION: Modular education and applied activities are effective in increasing children's knowledge levels in the context of teaching a concept such as earthquake preparedness, where the acquisition of life-based skills is of paramount importance.

6.
J Neurosci ; 42(46): 8716-8728, 2022 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-36253083

RESUMO

Sensory driven activity during early life is critical for setting up the proper connectivity of the sensory cortices. We ask here whether social play behavior, a particular form of social interaction that is highly abundant during postweaning development, is equally important for setting up connections in the developing prefrontal cortex (PFC). Young male rats were deprived from social play with peers during the period in life when social play behavior normally peaks [postnatal day 21-42] (SPD rats), followed by resocialization until adulthood. We recorded synaptic currents in layer 5 cells in slices from medial PFC of adult SPD and control rats and observed that inhibitory synaptic currents were reduced in SPD slices, while excitatory synaptic currents were unaffected. This was associated with a decrease in perisomatic inhibitory synapses from parvalbumin-positive GABAergic cells. In parallel experiments, adult SPD rats achieved more reversals in a probabilistic reversal learning (PRL) task, which depends on the integrity of the PFC, by using a more simplified cognitive strategy than controls. Interestingly, we observed that one daily hour of play during SPD partially rescued the behavioral performance in the PRL, but did not prevent the decrease in PFC inhibitory synaptic inputs. Our data demonstrate the importance of unrestricted social play for the development of inhibitory synapses in the PFC and cognitive skills in adulthood and show that specific synaptic alterations in the PFC can result in a complex behavioral outcome.SIGNIFICANCE STATEMENT This study addressed the question whether social play behavior in juvenile rats contributes to functional development of the prefrontal cortex (PFC). We found that rats that had been deprived from juvenile social play (social play deprivation - SPD) showed a reduction in inhibitory synapses in the PFC and a simplified strategy to solve a complex behavioral task in adulthood. Providing one daily hour of play during SPD partially rescued the cognitive skills in these rats, but did not prevent the reduction in PFC inhibitory synapses. Our results demonstrate a key role for unrestricted juvenile social play in PFC development and emphasize the complex relation between PFC circuit connectivity and cognitive function.


Assuntos
Córtex Pré-Frontal , Sinapses , Ratos , Masculino , Animais , Sinapses/metabolismo , Córtex Pré-Frontal/metabolismo , Parvalbuminas/metabolismo , Cognição , Neurogênese
7.
Int J Gynecol Cancer ; 33(4): 619-622, 2023 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-36653060

RESUMO

BACKGROUND: Standard treatment of early-stage vulvar cancer is a radical, wide, local excision of the primary tumor and a sentinel lymph node (SLN) procedure for the groins. An inguinofemoral lymphadenectomy is no longer necessary for patients who have a negative SLN or micrometastasis (≤2 mm). When there is macrometastasis (>2 mm) in the SLN, an inguinofemoral lymphadenectomy is indicated; however, this procedure is associated with major morbidity, such as wound healing, lymphoceles, and lymphedema. PRIMARY OBJECTIVE: To investigate the safety of replacing inguinofemoral lymphadenectomy by chemoradiation in patients with early-stage vulvar cancer with a macrometastasis (>2 mm) and/or extracapsular extension in the sentinel node. STUDY HYPOTHESIS: Combination of 56 Gy of radiation to the inguinal site and concurrent cisplatin chemotherapy without completion inguinofemoral lymphadenectomy will be feasible and safe, with low groin recurrence rates. TRIAL DESIGN: This is a single-arm, prospective phase II treatment trial with stopping rules for unacceptable groin recurrences. Eligible patients will receive 56 Gy of radiation to the involved inguinal site and chemotherapy with concurrent cisplatin. MAJOR INCLUSION/EXCLUSION CRITERIA: Eligible patients undergoing sentinel node procedure will have stage I, unifocal, invasive (>1 mm depth of invasion) squamous cell carcinoma of the vulva with tumor size <4 cm, and no suspicious nodes on imaging. Those eligible for the trial are those with a metastasis >2 mm in the sentinel node and/or extracapsular extension, or more than one sentinel node with micrometastasis ≤2 mm. PRIMARY ENDPOINT: Groin recurrence rate in the first 2 years after primary treatment. SAMPLE SIZE: 157 patients with macrometastases in their SLN. ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS: January 1, 2029. TRIAL REGISTRATION NUMBER: NCT05076942.


Assuntos
Linfonodo Sentinela , Neoplasias Vulvares , Feminino , Humanos , Linfonodo Sentinela/patologia , Neoplasias Vulvares/radioterapia , Neoplasias Vulvares/cirurgia , Estudos Prospectivos , Micrometástase de Neoplasia/patologia , Extensão Extranodal/patologia , Cisplatino , Metástase Linfática/patologia , Biópsia de Linfonodo Sentinela/métodos , Linfonodos/cirurgia , Linfonodos/patologia , Excisão de Linfonodo
8.
Int J Gynecol Cancer ; 33(7): 1023-1043, 2023 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-37369376

RESUMO

BACKGROUND: As part of its mission to improve the quality of care for women with gynecological cancers across Europe, the European Society of Gynaecological Oncology (ESGO) first published in 2017 evidence-based guidelines for the management of patients with vulvar cancer. OBJECTIVE: To update the ESGO guidelines based on the new evidence addressing the management of vulvar cancer and to cover new topics in order to provide comprehensive guidelines on all relevant issues of diagnosis and treatment of vulvar cancer. METHODS: The ESGO Council nominated an international development group comprised of practicing clinicians who provide care to vulvar cancer patients and have demonstrated leadership through their expertize in clinical care and research, national and international engagement and profile as well as dedication to the topics addressed to serve on the expert panel (18 experts across Europe). To ensure that the statements were evidence-based, new data identified from a systematic search were reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the international development group. Prior to publication, the guidelines were reviewed by 206 international practitioners in cancer care delivery and patient representatives. RESULTS: The updated guidelines cover comprehensively diagnosis and referral, staging, pathology, pre-operative investigations, surgical management (local treatment, groin treatment, sentinel lymph node procedure, reconstructive surgery), (chemo)radiotherapy, systemic treatment, treatment of recurrent disease (vulvar, inguinal, pelvic, and distant recurrences), and follow-up. Management algorithms are also defined.


Assuntos
Ginecologia , Procedimentos de Cirurgia Plástica , Neoplasias Vulvares , Feminino , Humanos , Europa (Continente) , Ginecologia/métodos , Neoplasias Vulvares/diagnóstico , Neoplasias Vulvares/terapia , Neoplasias Vulvares/patologia
9.
J Adv Nurs ; 79(9): 3585-3594, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37170415

RESUMO

AIM: To determine the factorial structure of the German Care Dependency Scale (CDS) for self-assessment in supported housing in Austria. BACKGROUND: The CDS is a well-established tool for the assessment of care dependency. However, several versions of the scale showed different factorial structures depending on the country and the setting where they were applied. The factorial structure of the CDS, therefore, needed clarification prior to its application in supported housing. DESIGN: Cross-sectional study. METHODS: Self-assessments of care dependency were obtained from residents in supported housing in Austria. The factorial structure of the scale was determined by exploratory factor analysis. The resulting factor models were compared by confirmatory factor analyses with a single factor model regarding the best fit. CDS total score and sum scores of the identified factors were correlated with externally assessed care levels according to the Austrian care insurance. RESULTS: 48.2% of the residents in supported housing participated, but some of them were younger than 60. Exploratory factor analysis resulted in a three-factor model with two variants in the distribution of items, depending on whether people over 59 were included in the analysis or not. The second variant showed the best fit in confirmatory factor analysis. CDS total score and sum scores of the identified factors showed statistically significant correlations with externally assessed care levels. CONCLUSION: The three-factorial structure differentiates between various aspects of support and results from the particular characteristics of the setting and the care recipients. Several cross-loadings of items indicate an ambiguous understanding of support needs. It is suggested to modify the scale to adapt it to the target group and setting. IMPLICATIONS FOR THE PROFESSION: Self-assessments with a modified version of CDS in supported housing can be useful to identify the various support needs in this setting. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.


Assuntos
Habitação , Autoavaliação (Psicologia) , Humanos , Idoso , Estudos Transversais , Análise Fatorial , Reprodutibilidade dos Testes , Psicometria/métodos , Inquéritos e Questionários
10.
Mol Ther ; 29(2): 611-625, 2021 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-33160073

RESUMO

A first-in-human phase I trial of Vvax001, an alphavirus-based therapeutic cancer vaccine against human papillomavirus (HPV)-induced cancers was performed assessing immunological activity, safety, and tolerability. Vvax001 consists of replication-incompetent Semliki Forest virus replicon particles encoding HPV16-derived antigens E6 and E7. Twelve participants with a history of cervical intraepithelial neoplasia were included. Four cohorts of three participants were treated per dose level, ranging from 5 × 105 to 2.5 × 108 infectious particles per immunization. The participants received three immunizations with a 3-week interval. For immune monitoring, blood was drawn before immunization and 1 week after the second and third immunization. Immunization with Vvax001 was safe and well tolerated, with only mild injection site reactions, and resulted in both CD4+ and CD8+ T cell responses against E6 and E7 antigens. Even the lowest dose of 5 × 105 infectious particles elicited E6/E7-specific interferon (IFN)-γ responses in all three participants in this cohort. Overall, immunization resulted in positive vaccine-induced immune responses in 12 of 12 participants in one or more assays performed. In conclusion, Vvax001 was safe and induced immune responses in all participants. These data strongly support further clinical evaluation of Vvax001 as a therapeutic vaccine in patients with HPV-related malignancies.


Assuntos
Vacinas Anticâncer/imunologia , Vetores Genéticos/genética , Neoplasias/etiologia , Neoplasias/terapia , Infecções por Papillomavirus/complicações , Vacinas contra Papillomavirus/imunologia , Vírus da Floresta de Semliki/genética , Alphapapillomavirus/imunologia , Vacinas Anticâncer/administração & dosagem , Vacinas Anticâncer/genética , Vetores Genéticos/administração & dosagem , Humanos , Imunização , Neoplasias/prevenção & controle , Proteínas Oncogênicas Virais/imunologia , Proteínas E7 de Papillomavirus/imunologia , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus/administração & dosagem , Vacinas contra Papillomavirus/genética , Proteínas Repressoras/imunologia , Linfócitos T/imunologia , Linfócitos T/metabolismo , Resultado do Tratamento , Vacinação
11.
Cell Mol Life Sci ; 78(8): 3921-3940, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33532865

RESUMO

The emergence and re-emergence of viral epidemics and the risks of antiviral drug resistance are a serious threat to global public health. New options to supplement or replace currently used drugs for antiviral therapy are urgently needed. The research in the field of ribosomally synthesized and post-translationally modified peptides (RiPPs) has been booming in the last few decades, in particular in view of their strong antimicrobial activities and high stability. The RiPPs with antiviral activity, especially those against enveloped viruses, are now also gaining more interest. RiPPs have a number of advantages over small molecule drugs in terms of specificity and affinity for targets, and over protein-based drugs in terms of cellular penetrability, stability and size. Moreover, the great engineering potential of RiPPs provides an efficient way to optimize them as potent antiviral drugs candidates. These intrinsic advantages underscore the good therapeutic prospects of RiPPs in viral treatment. With the aim to highlight the underrated antiviral potential of RiPPs and explore their development as antiviral drugs, we review the current literature describing the antiviral activities and mechanisms of action of RiPPs, discussing the ongoing efforts to improve their antiviral potential and demonstrate their suitability as antiviral therapeutics. We propose that antiviral RiPPs may overcome the limits of peptide-based antiviral therapy, providing an innovative option for the treatment of viral disease.


Assuntos
Antivirais/química , Antivirais/farmacologia , Descoberta de Drogas , Peptídeos/química , Peptídeos/farmacologia , Processamento de Proteína Pós-Traducional , Animais , Antivirais/administração & dosagem , Antivirais/metabolismo , Sistemas de Liberação de Medicamentos , Humanos , Peptídeos/administração & dosagem , Peptídeos/metabolismo , Ribossomos/metabolismo , Viroses/tratamento farmacológico , Vírus/efeitos dos fármacos
12.
Knee Surg Sports Traumatol Arthrosc ; 30(4): 1273-1281, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33860338

RESUMO

PURPOSE: The present study assessed the effect of insert articular surface geometry (anatomical versus conventional insert design) on anteroposterior (AP) translation and varus-valgus (VV) laxity in balanced posterior cruciate ligament (PCL) retaining total knee arthroplasty (TKA). Secondly, we evaluated if the AP translation and VV laxity in the reconstructed knee resembled the stability of the native knee. METHODS: Nine fresh-frozen full-leg cadaver specimens were used in this study. After testing the native knee, anatomical components of a PCL-retaining implant were implanted. The knee joints were subjected to anteriorly and posteriorly directed forces (at 20° and 90° flexion) and varus-valgus stresses (at 20°, 45° and 90° flexion) in both non-weightbearing and weightbearing situations in a knee kinematics simulator. Measurements were performed in the native knee, TKA with anatomical insert geometry (3° built-in varus, medial concave, lateral convex), and TKA with symmetrical insert geometry. RESULTS: In weightbearing conditions, anterior translations ranged between 2.6 and 3.9 mm at 20° flexion and were < 1 mm at 90° flexion. Posterior translation at 20° flexion was 2.7 mm for the native knee versus 4.0 mm (p = 0.047) and 7.0 mm (p = 0.02) for the symmetrical insert and the anatomical insert, respectively. Posterior translation at 90° flexion was < 1.1 mm and not significantly different between the native knee and insert types. In non-weightbearing conditions, the anterior translation at 20° flexion was 5.9 mm for the symmetrical and 4.6 mm for the anatomical insert (n.s.), compared with 3.0 mm for the native knee (p = 0.02). The anterior translation at 90° flexion was significantly higher for the reconstructed knees (anatomical insert 7.0 mm; symmetrical insert 9.2 mm), compared with 1.6 mm for the native knee (both p = 0.02). Varus-valgus laxity at different flexion angles was independent of insert geometry. A valgus force in weightbearing conditions led to significantly more medial laxity (1°-3° opening) in the native knee at 45° and 90° flexion compared with the reconstructed knee for all flexion angles. CONCLUSIONS: Insert geometry seems to have a limited effect with respect to AP translation and VV laxity, in the well-balanced PCL-retaining TKA with an anatomical femoral component. Secondly, AP translation and VV laxity in the reconstructed knee approximated the laxity of the native knee.


Assuntos
Artroplastia do Joelho , Instabilidade Articular , Prótese do Joelho , Ligamento Cruzado Posterior , Artroplastia do Joelho/métodos , Fenômenos Biomecânicos , Cadáver , Humanos , Instabilidade Articular/cirurgia , Articulação do Joelho/cirurgia , Ligamento Cruzado Posterior/cirurgia , Amplitude de Movimento Articular
13.
J Arthroplasty ; 37(3): 482-487, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34864066

RESUMO

BACKGROUND: Clinical observations revealed higher rates of aseptic loosening for hybrid fixated rotating hinge knee implants compared to fully cemented ones. We hypothesize that the use of a fully cemented fixation technique had a higher survival rate for aseptic loosening compared to a hybrid fixation technique in a rotating hinge knee implant. METHODS: All procedures of patients who were treated with the RT-PLUS rotating hinge knee implant (Smith & Nephew, Memphis, TN) between 2010 and 2018 were included. Primary outcome was revision for aseptic loosening. Kaplan-Meier survivorship and Cox proportional hazard regression analysis were performed to calculate survival rates and hazard ratios. RESULTS: A total of 275 hinge knee implants were placed in 269 patients (60 primary procedures, 215 revisions). Median follow-up was 7.3 ± 3.9 years. In total, 24 components (16 hybrid femur, 2 fully cemented femur, 6 hybrid tibia; all revision procedures) in 19 patients were revised for aseptic loosening. Kaplan-Meier survivorship analysis showed superior survival rates of fully cemented components (femur 97.1%; tibia 100%) compared to hybrid fixated components (femur 89.5%; tibia 95.9%) at the 10-year follow-up. Multivariate Cox hazard analysis showed a significantly higher risk of aseptic loosening for hybrid fixated components, a prior stemmed component and the femoral component. CONCLUSION: Fully cemented fixation showed superior survival rates for aseptic loosening compared to hybrid fixation in a single design rotating hinge knee implant. A prior stemmed component appears to be a risk factor for aseptic loosening and the femoral component seems to be more prone to loosening.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Artroplastia do Joelho/efeitos adversos , Fêmur/cirurgia , Humanos , Prótese do Joelho/efeitos adversos , Desenho de Prótese , Falha de Prótese , Reoperação , Estudos Retrospectivos , Resultado do Tratamento
14.
Int J Cancer ; 148(7): 1768-1777, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33300604

RESUMO

Objective strategies are required in cervical cancer screening. We have identified several DNA methylation markers with high sensitivity and specificity to detect cervical intraepithelial neoplasia 2 or worse (CIN2+) in Dutch women. Our study aims to analyze the diagnostic characteristics of these markers in a Chinese cohort. A total of 246 liquid-based cytology samples were included, of which 205 women underwent colposcopy due to an abnormal cytology result (atypical squamous cells of undetermined significance [ASCUS] or worse), while 227 were tested high-risk human papillomavirus (hrHPV) positive. All six individual markers (ANKRD18CP, C13ORF18, EPB41L3, JAM3, SOX1 and ZSCAN1) showed enhanced methylation levels and frequency with increasing severity of the underlying lesion (P ≤ .001). In cytological abnormal women, sensitivity to detect CIN2+ was 79%, 76% and 72% for the three panels (C13ORF18/EBP41L3/JAM3, C13ORF18/ANKRD18CP/JAM3 and ZSCAN1/SOX1, respectively), with a specificity of 57%, 65% and 68%. For the first two panels, these diagnostic characteristics were similar to the Dutch cohort, while for ZSCAN1/SOX1 the sensitivity was higher in the Chinese cohort, but with a lower specificity (both P < .05). In hrHPV-positive samples, similar sensitivity and specificity for the detection of CIN2+ were found as for the abnormal cytology cohort, which were now all similar between both cohorts and non-inferior to HPV16/18 genotyping. Our analysis reveals that the diagnostic performances are highly comparable for C13ORF18/EBP41L3/JAM3 and C13ORF18/ANKRD18CP/JAM3 methylation marker panels in both Chinese and Dutch cohorts. In conclusion, methylation panels identified in a Dutch population are also applicable for triage testing in cervical cancer screening in China.


Assuntos
Biomarcadores Tumorais/metabolismo , Metilação de DNA , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/metabolismo , Adulto , Idoso , Biomarcadores Tumorais/genética , Moléculas de Adesão Celular/genética , Moléculas de Adesão Celular/metabolismo , China , Estudos de Coortes , Feminino , Papillomavirus Humano 16/genética , Papillomavirus Humano 16/isolamento & purificação , Papillomavirus Humano 18/genética , Papillomavirus Humano 18/isolamento & purificação , Humanos , Proteínas dos Microfilamentos/genética , Proteínas dos Microfilamentos/metabolismo , Pessoa de Meia-Idade , Países Baixos , Infecções por Papillomavirus/virologia , Proteínas de Ligação a RNA/genética , Proteínas de Ligação a RNA/metabolismo , Fatores de Transcrição SOXB1/genética , Fatores de Transcrição SOXB1/metabolismo , Triagem/métodos , Proteínas Supressoras de Tumor/genética , Proteínas Supressoras de Tumor/metabolismo , Neoplasias do Colo do Útero/genética
15.
Ann Surg ; 274(6): 1009-1016, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31592898

RESUMO

OBJECTIVE: This study compared outcomes of patients with esophageal cancer and clinically complete response (cCR) after neoadjuvant chemoradiotherapy (nCRT) undergoing active surveillance or immediate surgery. BACKGROUND: Since nearly one-third of patients with esophageal cancer show pathologically complete response after nCRT according to CROSS regimen, the oncological benefit of immediate surgery in cCR is topic of debate. METHODS: Patients with cCR based on endoscopic biopsies and endoscopic ultrasonography with fine-needle aspiration initially declining or accepting immediate surgery after nCRT were identified between 2011 and 2018. Primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS), rate and timing of distant dissemination, and postoperative outcomes. RESULTS: Some 98 patients with cCR were identified: 31 in the active surveillance- and 67 in the immediate surgery group with median followup of survivors of 27.7 and 34.8 months, respectively. Propensity score matching resulted in 2 comparable groups (n = 29 in both groups). Patients undergoing active surveillance or immediate surgery had a 3-year OS of 77% and 55% (HR 0.41; 95% CI 0.14-1.20, P = 0.104), respectively. The 3-year PFS was 60% and 54% (HR 1.08; 95% CI 0.44-2.67, P = 0.871), respectively. Patients undergoing active surveillance or immediate surgery had a comparable distant dissemination rate (both groups 28%), radical resection rate (both groups 100%), and severity of postoperative complications (Clav- ien-Dindo grade ≥ 3: 43% vs 45%, respectively). CONCLUSION: In this retrospective study, OS and PFS in patients with cCR undergoing active surveillance or immediate surgery were not significantly different. Active surveillance with postponed surgery for recurrent disease was not associated with a higher distant dissemination rate or more severe adverse postoperative outcomes.


Assuntos
Quimiorradioterapia , Neoplasias Esofágicas/terapia , Conduta Expectante , Adulto , Idoso , Carboplatina/uso terapêutico , Endossonografia , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Paclitaxel/uso terapêutico , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Complicações Pós-Operatórias , Pontuação de Propensão , Estudos Prospectivos , Reoperação
16.
Anal Chem ; 93(10): 4472-4478, 2021 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-33667067

RESUMO

The use of cosmogenically produced sulfur-35 (T1/2 = 87 days) and sodium-22 (T1/2 = 2.6 years) as intrinsic tracers can provide valuable information on catchment hydrology, flow paths, and subsurface storage. A new and straightforward method was created to determine the activities of both 35S and 22Na in various water sources by pumping large volumes (up to 1000 L) of water through cation- and anion-exchange resin columns in the field to collect sodium and sulfate ions and simple chemistry in the lab. Samples are counted for 35S using liquid scintillation counting (LSC) and for 22Na via γ spectroscopy. Our novel in situ method provides faster sample throughput as well as better counting statistics and lower detection limits. Both methods were successfully applied at the Southern Sierra Critical Zone Observatory.

17.
Anal Chem ; 93(28): 9663-9668, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34236853

RESUMO

Although current LC-MS technology permits scientists to efficiently screen clinical samples in translational research, e.g., steroids, biogenic amines, and even plasma or serum proteomes, in a daily routine, maintaining the balance between throughput and analytical depth is still a limiting factor. A typical approach to enhance the proteome depth is employing offline two-dimensional (2D) fractionation techniques before reversed-phase nanoLC-MS/MS analysis (1D-nanoLC-MS). These additional sample preparation steps usually require extensive sample manipulation, which could result in sample alteration and sample loss. Here, we present and compare 1D-nanoLC-MS with an automated online-2D high-pH RP × low pH RP separation method for deep proteome profiling using a nanoLC system coupled to a high-resolution accurate-mass mass spectrometer. The proof-of-principle study permitted the identification of ca. 500 proteins with ∼10,000 peptides in 15 enzymatically digested crude serum samples collected from healthy donors in 3 laboratories across Europe. The developed method identified 60% more peptides in comparison with conventional 1D nanoLC-MS/MS analysis with ca. 4 times lower throughput while retaining the quantitative information. Serum sample preparation related changes were revealed by applying unsupervised classification techniques and, therefore, must be taken into account while planning multicentric biomarker discovery and validation studies. Overall, this novel method reduces sample complexity and boosts the number of peptide and protein identifications without the need for extra sample handling procedures for samples equivalent to less than 1 µL of blood, which expands the space for potential biomarker discovery by looking deeper into the composition of biofluids.


Assuntos
Proteoma , Espectrometria de Massas em Tandem , Cromatografia Líquida , Proteômica , Manejo de Espécimes
18.
Electrophoresis ; 42(12-13): 1352-1361, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33811666

RESUMO

There are situations in which it would be very valuable to have a DNA profile within a short time; for example, in mass disasters or airport security. In previous work, we have promoted reduced size STR amplicons for the analysis of degraded DNA. We also noticed that shorter amplicons are more robust during amplification, making them inhibition resistant, and potentially applicable to high-speed direct PCR. Here, we describe a set of miniSTRs capable of rapid direct PCR amplification. The selected markers are a subset of the Combined DNA Index System (CODIS) loci modified to permit high-speed amplification. Using the proposed protocol, the amplification of eight loci plus amelogenin directly from a saliva sample can be completed in 7 min and 38 s using a two-step PCR with 30 cycles of 98°C for 2 s and 62°C for 7 s on a Streck Philisa thermocycler. Selection of DNA polymerase, optimization of the two-step PCR cycling conditions, the primer concentrations, and the dilution of saliva is described. This method shows great potential as a quick screening method to obtain a presumptive DNA profile when time is limited, particularly when combined with high-speed separation and detection methods.


Assuntos
Reação em Cadeia da Polimerase , DNA/genética , Impressões Digitais de DNA , Repetições de Microssatélites/genética , Técnicas de Amplificação de Ácido Nucleico
19.
Environ Sci Technol ; 55(4): 2265-2275, 2021 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-33507730

RESUMO

Nitrate is one of the most abundant contaminants in groundwater globally, in the United States, and in California (CA). We studied well construction information, water chemistry, stable isotopes, and noble gases to understand how groundwater travel time and recharge source and mechanism control nitrate concentrations in domestic wells in the San Joaquin Valley (SJV), CA, a large semiarid, irrigated agricultural region. Using nonparametric statistics, we find a decreasing trend in nitrates with groundwater travel time and well depth. Samples collected from wells that are closer to rivers and that show indications of river water recharge, either low recharge temperature or low δ18O signature, have lower concentrations of nitrates than samples with isotopic signatures indicating mixed source or local precipitation recharge. The curbing effect of river water recharge on nitrate concentrations in domestic wells is similar for direct river recharge and water applied as irrigation. This suggests that irrigation with river water also has a diluting effect that reduces the concentration of nitrate found in groundwater. This conclusion supports the idea that flood-managed aquifer recharge may be considered for remediation of groundwater nitrate when designing replenishment of aquifers.


Assuntos
Água Subterrânea , Poluentes Químicos da Água , Monitoramento Ambiental , Nitratos/análise , Poluentes Químicos da Água/análise , Poços de Água
20.
Knee Surg Sports Traumatol Arthrosc ; 29(10): 3170-3177, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32556430

RESUMO

PURPOSE: The objectives of this study were to examine the relation between clinical outcomes 1 year postoperatively, in a cohort of mechanically aligned total knee arthroplasties (TKA), and (1) the degrees of alignment change of the tibial, femoral and the hip-knee-ankle (HKA) angle; (2) the change of phenotype; (3) the postoperative knee joint line orientation to the floor. METHODS: Pre-operative and postoperative long-leg X-rays of 90 patients were used to determine the coronal alignment. The absolute difference between the pre-operative and postoperative measurements was determined and the outcomes were categorized in whether or not a change in phenotype had occurred. Finally, the orientation of the knee joint line relative to the floor (tibial joint line angle-TJLA) was measured. Clinical outcomes were determined with the KOOS and KSS at 1-year follow-up. RESULTS: The clinical outcomes (1) did not correlate with the absolute difference of the alignment measured; (2) did not show a difference between patients with or without a change in phenotype; and (3) were higher (KOOS ADL, Sport and QoL) in patients with a medial open TJLA. CONCLUSION: This study showed no correlation between clinical outcomes and joint line restoration of the femur, tibia or HKA in patients after TKA. Leaving the prosthesis with some degrees of under correction on the coronal plane maintaining the phenotype, was not associated to better clinical results compared to TKA overcorrection. Nevertheless, the results showed that patients with a medial open TJLA had better clinical outcomes than patients with a lateral open TJLA. LEVEL OF EVIDENCE: III.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Qualidade de Vida , Estudos Retrospectivos , Tíbia/cirurgia
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