Influence of gene expression on survival of clear cell renal cell carcinoma.

Approximately 10%-20% of patients with clinically localized clear cell renal cell carcinoma (ccRCC) at time of surgery will subsequently experience metastatic progression. Although considerable progression was seen in the systemic treatment of metastatic ccRCC in last 20 years, once ccRCC spreads beyond the confines of the kidney, 5-year survival is less than 10%. Therefore, significant clinical advances are urgently needed to improve overall survival and patient care to manage the growing number of patients with localized ccRCC. We comprehensively evaluated expression of 388 candidate genes related with survival of ccRCC by using TCGA RNAseq (n = 515), Total Cancer Care (TCC) expression array data (n = 298), and a well characterized Moffitt RCC cohort (n = 248). We initially evaluated all 388 genes for association with overall survival using TCGA and TCC data. Eighty-one genes were selected for further analysis and tested on Moffitt RCC cohort using NanoString expression analysis. Expression of nine genes (AURKA, AURKB, BIRC5, CCNE1, MK167, MMP9, PLOD2, SAA1, and TOP2A) was validated as being associated with poor survival. Survival prognostic models showed that expression of the nine genes and clinical factors predicted the survival in ccRCC patients with AUC value: 0.776, 0.821 and 0.873 for TCGA, TCC and Moffitt data set, respectively. Some of these genes have not been previously implicated in ccRCC survival and thus potentially offer insight into novel therapeutic targets. Future studies are warranted to validate these identified genes, determine their biological mechanisms and evaluate their therapeutic potential in preclinical studies.

Dynamic stabilometric findings in equilibrium disorders of the elderly.

Equilibrium disorders are frequent symptoms of aging, both on account of the so-called "multisensorial decay" and age-related diseases. Aim of the study was to evaluate the functional integrity of static-dynamic postural control related subsystems (visual, somatosensorial, vestibular), the fundamental postural strategies effected and adaptation to destabilizing inputs, in elderly subjects with otoneurological disorders. From January to November 2003, 40 elderly patients (19 male, 21 female, mean age +/- SD: 69.5 +/- 4.3 years; range: 65-83), with balance disorders, consisting in dizziness or vertigo, have been observed. Otoneurologic and internal case history was collected in all patients, all of whom were submitted to otoscopy, otoneurologic examination, pure-tone audiometry, as well as a specific examination called Equi test. The sensorial analysis, as often occurs in elderly subjects without unbalance, revealed marked impairment of the somatosensorial (85%), compared to vestibular (60%) and visual (40%), subsystems. Longer latencies of motor responses to forward platform translations than to backward translations were observed, even if the symmetry of movements was more evident in the former. Postural adaptation was more frequently impaired during raising of the support (70%) than during lowering. Therefore, in elderly people, somatosensorial impairment, combined with flexor muscle dysfunction, exists. Indeed, extensor responses, although slower than flexor responses, are more correctly performed.

Spin-orbit coupling and anomalous Josephson effect in nanowires.

A superconductor-semiconducting nanowire-superconductor heterostructure in the presence of spin-orbit coupling and magnetic field can support a supercurrent even in the absence of phase difference between the superconducting electrodes. We investigate this phenomenon­the anomalous Josephson effect­employing a model capable of describing many bands in the normal region. We discuss the geometrical and symmetry conditions required to have a finite anomalous supercurrent, and in particular we show that this phenomenon is enhanced when the Fermi level is located close to a band opening in the normal region.

Spin fractionalization of an even number of electrons in a quantum Dot

We find that Kondo resonant conductance can occur in a quantum dot in the Coulomb blockade regime with an even number of electrons N. The contacts are attached to the dot in a pillar configuration, and a magnetic field B( perpendicular) along the axis is applied. B( perpendicular) lifts the spin degeneracy of the dot energies. Usually, this prevents the system from developing the Kondo effect. Tuning B( perpendicular) to the value B(*) where levels with different total spin cross restores both the degeneracy and the Kondo effect. We analyze a dot charged with N = 2 electrons. Coupling to the contacts is antiferromagnetic due to a spin selection rule and, in the Kondo state, the charge is unchanged while the total spin on the dot is S = 1/2.

Infectious diseases and death among nursing home residents: results of surveillance in 13 nursing homes.

An increasing proportion of the U.S. population resides in nursing homes (NHs). No surveillance system exists for infections in these facilities. To determine the incidence and types of infections in NH residents, and to identify predictors of death among residents with infections, we initiated a surveillance system at 13 NHs in California during a 6-month period from October 1989 through March 1990. The study included 1754 residents, among whom 835 infections were identified during the study period. The most common infections were urinary tract infections (UTIs; 286, 34.2%), respiratory tract infections (RTIs; 259, 31%), and skin infections (150, 17.9%). Of the 259 residents with respiratory tract infections, 69 (27%) had pneumonia. Antimicrobials were prescribed for 646 (77%) of the infectious episodes. Residents with pneumonia were more likely to die than residents with other infections (4 of 69 versus 12 of 766; P = 0.04). Symptoms of altered body temperature (fever, hypothermia, chills) and change in mental status also were associated with an increased risk of a fatal outcome (10 of 260 versus 6 of 575; P = 0.01) and (7 of 127 versus 9 of 708; P = 0.004). This study suggests that the most common infections among NH residents are UTIs, RTIs, and skin infections. Pneumonia, symptoms of fever, and mental status changes all were associated with increased mortality. The frequency of infections among NH residents and their impact on resident outcome highlights the need for infectious disease surveillance in this population.

Impact on knowledge and practice of a multiregional long-term care facility infection control training program.

BACKGROUND: Few affordable training opportunities are specifically designed for the long-term care facility infection control practitioner. There is also little evidence of the success of training in improving infection control practices. The Nebraska Infection Control Network developed a 2-day basic skills training program for Midwestern long-term care facility infection control practitioners that was later disseminated to eastern and western training sites. In this study we examined the effectiveness of the training program in terms of trainee knowledge and practice. METHODS: From 1986 to 1990, a total of 17 courses conducted at the three sites were attended by a total of 266 infection control practitioners. Trainees completed a 40-item multiple choice test before and after training to evaluate their knowledge gain. Implementation of eight key infection control practices and time devoted to infection control duties were measured before training and at 3 and 12 months after training. Implementation of infection control practices was also evaluated in a second study, with infection control practitioners randomly assigned to trained and wait-control conditions. RESULTS: Significant increases after training were found at each site for both knowledge and implementation measures. These increases were maintained at 12 months follow-up. Time devoted to infection control duties increased significantly at the midwest and western sites but not at the eastern site. In the second study, significant differences were found between the trained and the wait-control group in use of infection control practices, providing evidence for a causal relationship between training and increased use of practices. CONCLUSIONS: The training program was effective in producing improvements in knowledge and implementation of recommended infection control practices in long-term care facilities. These improvements were consistent across three diverse geographic areas. There were some specific geographic differences.

Falls in the elderly: the development of a risk questionnaire and posturographic findings.

In elderly people, owing to a perturbation at several levels, including the motor, sensory and cognitive levels, a condition of dizziness and unsteadiness complicated by frequent falls often appears. In this article, we review the most recent information about clinical and instrumental tools available for preventing mobility-related accidents and report the results of a comparative study of postural control, carried out through tetraataxiometry (by Tetrax, Tel Aviv, Israel), in two samples of elderly women belonging to two different populations: 24 Italian women (11 reporting falls and 13 without falls) having a mean age of 73.1 years, and 37 Israeli women (12 with falls and 25 without falls) having a mean age of 72.5 years. The posturographic findings show that the falling subjects, to maintain postural control, are highly dependent on somatosensory inputs and have a weaker "systeme postural fin" (fine postural system), according to Gagey. They also show that an elderly subpopulation exists that, for unknown reasons, is immune to destabilization and falls.

[Otolaryngologic disorders caused by esophageal reflux]. / Molestias otorrinolaringológicas del reflujo gastro-esofágico.

The authors through an accurate analysis of the literature make a synthesis of the most recent knowledge about the correlation existing between the distal and proximal gastroesophageal reflux (GER) and a series of common otolaryngologic symptoms whose aetiology is doubtful, in order to explain its most significative physiopathological and clinic aspects. The diagnostic modalities able to reveal the presence of the correlation and the adequacy therapy to cure the disease are also discussed.

Pressão arterial elevada e obesidade abdominal em adolescentes / High blood pressure and abdominal obesity in adolescents

OBJETIVO:Analisar a associação entre obesidade abdominal e pressão arterial elevada em adolescentes da rede pública de ensino da região metropolitana da cidade de Londrina (PR). MÉTODOS: Constituiu-se uma amostra de 656 adolescentes com idades entre dez e 13 anos. Foram realizadas análises antropométricas de massa corporal, estatura e circunferência de cintura, além da aferição da pressão arterial de repouso. Para análise e comparação dos dados, foram aplicados Mann-Whitney e o teste t de Student. Também foram analisadas as possíveis associações entre pressão arterial e circunferência de cintura por meio do teste do qui-quadrado. RESULTADOS: Foram identificadas associações entre obesidade abdominal e pressão arterial elevada em ambos os sexos (RP 2,7; IC95 por cento 1,8-4,2). Além disso, verificou-se que, independentemente do grupo etário, a obesidade abdominal associa-se com valores mais elevados de pressão arterial. CONCLUSÕES: A obesidade abdominal está associada à ocorrência de aumento da pressão arterial em adolescentes.

OBJECTIVE:To analyze the association between abdominal obesity and high blood pressure among adolescents of public schools from Londrina (PR), Brazil. METHODS: The sample was composed by 656 adolescents with age ranging from ten to 13 years old. The following measures were taken: body mass, height, waist circumference and blood pressure at rest. Mann-Whitney and Student's t-test were used to compare and analyze numerical variables. The chi-square test analyzed the association between blood pressure and waist circumference. RESULTS: Association between abdominal obesity and high blood pressure was present in both genders (PR 2.7; 95 percentCI 1.8-4.2). Abdominal obesity was associated with higher blood pressure independently of age. CONCLUSIONS: Abdominal obesity was associated to high blood pressure in adolescents.

Quantum interference of electrons in a ring: tuning of the geometrical phase.

We calculate the oscillations of the dc conductance across a mesoscopic ring, simultaneously tuned by applied magnetic and electric fields orthogonal to the ring. The oscillations depend on the Aharonov-Bohm flux and of the spin-orbit coupling. They result from mixing of the dynamical phase, including the Zeeman spin splitting, and of geometric phases. By changing the applied fields, the geometric phase contribution to the conductance oscillations can be tuned from the adiabatic (Berry) to the nonadiabatic (Ahronov-Anandan) regime. To model a realistic device, we also include nonzero backscattering at the connection between ring and contacts, and a random phase for electron wave function, accounting for dephasing effects.

Plasma sorbitol dehydrogenase in diabetic subjects with or without vascular complications.

Plasma Sorbitol Dehydrogenase levels were determined in subjects with diabetes mellitus and normal people. The diabetic subjects had circulating plasma levels of SDH significantly higher (p less than 0.001) than those observed in controls. Moreover, the diabetics with vascular complications presented the highest SDH values. The lack of positive correlation between plasma glucose and SDH levels suggests that SDH, like hemoglobin A1C, reflect the degree of previous metabolic control of diabetes mellitus.

Spinon attraction in spin- 1/2 antiferromagnetic chains.

We derive the representation of the two-spinon wave function for the Haldane-Shastry model in terms of the spinon coordinates. This result allows us to rigorously analyze spinon interaction and its physical effects. We show that spinons attract one another. The attraction gets stronger as the size of the system is increased and, in the thermodynamic limit, determines the power law with which the susceptibility diverges.

Spinon-holon attraction in the supersymmetric t-J model with 1/r(2) interaction.

We derive the coordinate representation of the one-spinon one-holon wave function for the supersymmetric t-J model with 1/r(2) interaction. This result allows us to show that a spinon and a holon attract each other at short distance. The attraction gets stronger as the size of the system is increased and, in the thermodynamic limit, it is responsible for the square-root singularity in the hole spectral function [Y. Kato, Phys. Rev. Lett. 81, 5402 (1998)].

Vertigo and multiple sclerosis: aspects of differential diagnosis.

Equilibrium disorders caused by involvement of brainstem and cerebellar structures are common in patients with multiple sclerosis (MS), but peripheral conditions such as benign paroxysmal positional vertigo (BPPV) can be sometimes confused with those of a central origin. Therefore, an accurate otoneurologic investigation paying attention to differential diagnosis aspects should be performed in these subjects. Among available diagnostic tools, electro-oculography, posturography and vestibular evoked myogenic potentials (VEMPs) are especially suited to assess vestibulo-oculomotor and vestibulospinal systems. This paper briefly describes the most recent otoneurologic diagnostic strategies for MS patients and the results of initial clinical experiences, and finally provides suggestions for differentiating MS-related vestibular disorders from other common otoneurological conditions.