611 research outputs found
The Effect of Adverse Surgical Margins on the Risk of Biochemical Recurrence after Robotic-Assisted Radical Prostatectomy
Positive surgical margins (PSM) after radical prostatectomy are associated with a greater risk of biochemical recurrence (BCR). However, not all PSM harbour the same prognosis for recurrence. We aim to determine the impact of different PSM characteristics and their coexistence on the risk of BCR. This retrospective study included 333 patients that underwent robotic-assisted radical prostatectomy for prostate cancer between 2015-2020 at a single institution. The effect of PSM and their adverse characteristics on the risk of BCR was assessed using Cox proportional hazard models. Kaplan-Meier was used to represent BCR-free survival stratified by margin status. With a median follow-up of 34.5 months, patients with PSM had a higher incidence of BCR, higher risk of relapse and lower BCR-free survival than negative margins (p < 0.001). We established as adverse characteristics: PSM length â„ 3 mm, multifocality and Gleason at margin > 3. PSM â„ 3 mm or multifocal PSM were associated with an increased risk for BCR compared to favourable margins (HR 3.50; 95% CI 2.05-5.95, p < 0.001 and HR 2.18; 95% CI 1.09-4.37, p = 0.028, respectively). The coexistence of these two adverse features in the PSM also conferred a higher risk for biochemical relapse and lower BCR-free survival. Adverse Gleason in the margin did not confer a higher risk for BCR than non-adverse margins in our models. We concluded that PSM are an independent predictor for BCR and that the presence of adverse characteristics, such as length and focality, and their coexistence in the PSM are associated with a greater risk of recurrence. Nevertheless, subclassifying PSM with adverse features did not enhance the model's predictive performance in our cohort
Effectiveness of individualized inhaler technique training on low adherence (LowAd) in ambulatory patients with COPD and asthma
© 2022. This document is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by /4.0/
This document is the published version of a published work that appeared in final form in npj primary care respiratory medicineTo analyze whether there is improvement in adherence to inhaled treatment in patients with COPD and asthma after an educational intervention based on the teach-to-goal method. This is a prospective, non-randomized, single-group study, with intervention and before-after evaluation. The study population included 120 patients (67 females and 53 males) diagnosed with asthma (70.8%) and COPD (29.1%). The level of adherence (low and optimal) and the noncompliance behavior pattern (erratic, deliberate and unwitting) were determined by the Test of the adherence to Inhalers (TAI). This questionnaire allows you to determine the level of adherence and the types of noncompliance. Low Adherence (LowAd) was defined as a score less than 49 points. All patients received individualized educational inhaler technique intervention (IEITI). Before the IEITI, 67.5% of the patients had LowAd. Following IEITI, on week 24, LowAd was 55% (p = 0.024). Each patient can present one or more types of noncompliance. The most frequent type was forgetting to use the inhaler (erratic), 65.8%. The other types were deliberate: 43.3%, and unwitting: 57.5%. All of them had decreased on the final visit: 51.7% (p = 0.009), 25.8% (p = 0.002), 39.2% (p = 0.002). There were no significant differences in adherence between asthma and COPD patients at the start of the study. The only predicting factor of LowAd was the female gender. An individualized educational intervention, in ambulatory patients with COPD and asthma, in real-world clinical practice conditions, improves adherence to the inhaled treatment
Ocean gliders for maritime surveillance: the FP7-Perseus project
The work presented in this paper is aimed to explain the key role of unmanned
ocean vehicles in marine security applications such as the ones described
in the FP7 PERSEUS Project. The PERSEUS project attempts to answer the demand
of a European integrated system for border surveillance. Its main goal is to develop
and test a European system for maritime monitoring through the integration of the
already existent local systems and its update and improvement using technological
innovations, setting up the standards and bases for its final development and
implementation.Peer Reviewe
Integrin-Specific Mechanoresponses to Compression and Extension Probed by Cylindrical Flat-Ended AFM Tips in Lung Cells
Cells from lung and other tissues are subjected to forces of opposing directions that are largely transmitted through integrin-mediated adhesions. How cells respond to force bidirectionality remains ill defined. To address this question, we nanofabricated flat-ended cylindrical Atomic Force Microscopy (AFM) tips with âŒ1 ”m2 cross-section area. Tips were uncoated or coated with either integrin-specific (RGD) or non-specific (RGE/BSA) molecules, brought into contact with lung epithelial cells or fibroblasts for 30 s to form focal adhesion precursors, and used to probe cell resistance to deformation in compression and extension. We found that cell resistance to compression was globally higher than to extension regardless of the tip coating. In contrast, both tip-cell adhesion strength and resistance to compression and extension were the highest when probed at integrin-specific adhesions. These integrin-specific mechanoresponses required an intact actin cytoskeleton, and were dependent on tyrosine phosphatases and Ca2+ signaling. Cell asymmetric mechanoresponse to compression and extension remained after 5 minutes of tip-cell adhesion, revealing that asymmetric resistance to force directionality is an intrinsic property of lung cells, as in most soft tissues. Our findings provide new insights on how lung cells probe the mechanochemical properties of the microenvironment, an important process for migration, repair and tissue homeostasis
Control of Cell Migration and Inflammatory Mediators Production by CORM-2 in Osteoarthritic Synoviocytes
BackgroundOsteoarthritis (OA) is the most widespread degenerative joint disease. Inflamed synovial cells contribute to the release of inflammatory and catabolic mediators during OA leading to destruction of articular tissues. We have shown previously that CO-releasing molecules exert anti-inflammatory effects in animal models and OA chondrocytes. We have studied the ability of CORM-2 to modify the migration of human OA synoviocytes and the production of chemokines and other mediators sustaining inflammatory and catabolic processes in the OA joint.Methodology/Principal FindingsOA synoviocytes were stimulated with interleukin(IL)-1ÎČ in the absence or presence of CORM-2. Migration assay was performed using transwell chambers. Gene expression was analyzed by quantitative PCR and protein expression by Western Blot and ELISA. CORM-2 reduced the proliferation and migration of OA synoviocytes, the expression of IL-8, CCL2, CCL20, matrix metalloproteinase(MMP)-1 and MMP-3, and the production of oxidative stress. We found that CORM-2 reduced the phosphorylation of extracellular signal-regulated kinase1/2, c-Jun N-terminal kinase1/2 and to a lesser extent p38. Our results also showed that CORM-2 significantly decreased the activation of nuclear factor-ÎșB and activator protein-1 regulating the transcription of chemokines and MMPs in OA synoviocytes.Conclusion/SignificanceA number of synoviocyte functions relevant in OA synovitis and articular degradation can be down-regulated by CORM-2. These results support the interest of this class of agents for the development of novel therapeutic strategies in inflammatory and degenerative conditions
Anthracological evidence suggests naturalness of Pinus pinaster in inland southwestern Iberia
The study of well-preserved archaeological charcoals in the pre-Roman Iron Age settlement of Castillejos II (Badajoz, Spain) is used to reconstruct environmental conditions and land-use practices in vegetation landscapes in the southwest of the Iberian Peninsula before the arrival of Roman civilization. The results support that, while evergreen Quercus forests dominated during the Holocene, Pinus pinaster existed as a natural element of southwestern Iberian Peninsula vegetation. Although its presence could be linked to anthropogenic disturbance or fire history, it is suggested that P. pinaster populations survived during the Holocene in the region, mixed with oaks or in monospecific stands in mountain enclaves. This hypothesis contrasts with previous assumptions that P. pinaster was not autochthonous in the area
Post-depositional fracturing and subsidence of pumice flow deposits: Lascar Volcano, Chile
Unconsolidated pyroclastic flow deposits of the
1993 eruption of Lascar Volcano, Chile, have, with time,
become increasingly dissected by a network of deeply
penetrating fractures. The fracture network comprises
orthogonal sets of decimeter-wide linear voids that form a
pseudo-polygonal grid visible on the deposit surface. In this
work, we combine shallow surface geophysical imaging
tools with remote sensing observations and direct field
measurements of the deposit to investigate these fractures
and their underlying causal mechanisms. Based on ground
penetrating radar images, the fractures are observed to have
propagated to depths of up to 10 m. In addition, orbiting radar interferometry shows that deposit subsidence of up to
1 cm/year occurred between 1993 and 1996 with continued
subsidence occurring at a slower rate thereafter. In situ
measurements show that 1 m below the surface, the 1993
deposits remain 5°C to 15°C hotter, 18 years after
emplacement, than adjacent deposits. Based on the observed
subsidence as well as estimated cooling rates, the fractures are
inferred to be the combined result of deaeration, thermal
contraction, and sedimentary compaction in the months to
years following deposition. Significant environmental factors,
including regional earthquakes in 1995 and 2007, accelerated
settling at punctuated moments in time. The spatially variable
fracture pattern relates to surface slope and lithofacies
variations as well as substrate lithology. Similar fractures
have been reported in other ignimbrites but are generally
exposed only in cross section and are often attributed to
formation by external forces. Here we suggest that such
interpretations should be invoked with caution, and deformation
including post-emplacement subsidence and fracturing of
loosely packed ash-rich deposits in the months to years postemplacement
is a process inherent in the settling of pyroclastic
material
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The distributed p-median problem in computer networks
Many distributed services in computer networks rely on a set of active facilities that are selected among
a potentially large number of candidates. The active facilities then contribute and cooperate to deliver a
specific service to the users of the distributed system. In this scenario graph partitioning or clustering is
often adopted to determine the most efficient locations of the facilities. The identification of the optimal
set of facility locations is known as the p-median problem in networks, is NP-hard and is typically solved
by using heuristic methods. The goal is to select p locations among all candidate network nodes such that
some cost function is minimised. A typical example of such a function is the overall communication cost
to deliver the service to the users of the distributed system. Locating facilities in near-optimal locations
has been extensively studied for different application domains. Most of these studies have investigated
sequential algorithms and centralised approaches. However, centralised approaches are practically infeasible
in large-scale and dynamic networks, where the problem is inherently distributed or because of the large
communication overhead and memory requirements for gathering complete information about the network
topology and the users. In this work distributed approaches to the p-median problem are investigated.
Two solutions are proposed for addressing the facility locations problem in a fully distributed environment.
Two different iterative heuristic approaches are applied to gradually improve a random initial solution
and to converge to a final solution with a local minimum of the overall cost. While the first approach
adopts a fine granularity by identifying a single change to improve the solution at each iteration, the second
approach applies changes to every component of the solution at each iteration. An experimental comparative
analysis based on simulations has shown that the approach with a finer granularity is able to deliver a better
optimisation of the overall cost with longer convergence time. Both approaches have excellent scalability
and provide an effective tool to optimise the facility locations from within the network. No prior knowledge
of the system is required, no data needs to be gathered in a centralised server and the same process is used
to identify and to deploy the facility locations solution in the network since the process is fully decentralised
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