Prognostic factors of perioperative FLOT regimen in operable gastric and gastroesophageal junction tumors: real-life data (Turkish Oncology Group)

Background/aim: Perioperative FLOT regimen is a standard of care in locally advanced operable gastric and GEJ adenocarcinoma. We aimed to determine the efficacy, prognostic factors of perioperative FLOT chemotherapy in real-life gastric and GEJ tumors. Materials and methods: The data of patients who were treated with perioperative FLOT chemotherapy were retrospectively analyzed from 34 different oncology centers in Turkey. Baseline clinical and demographic characteristics, pretreatment laboratory values, histological and molecular characteristics were recorded. Results: A total of 441 patients were included in the study. The median of age our study population was 60 years. The majority of patients with radiological staging were cT3-4N(+) (89.9%, n = 338). After median 13.5 months (IQR: 8.5–20.5) follow-up, the median overall survival was NR (95% CI, NR to NR), and median disease free survival was 22.9 (95% CI, 18.6 to 27.3) months. The estimated overall survival at 24 months was 62%. Complete pathological response (pCR) and near pCR was achieved in 23.8% of all patients. Patients with lower NLR or PLR have significantly longer median OS (p = 0.007 and p = 0.033, respectively), and patients with lower NLR have significantly longer median DFS (p = 0.039), but PLR level did not affect DFS (p = 0.062). The OS and DFS of patients with better ECOG performance scores and those who could receive FLOT as adjuvant chemotherapy instead of other regimens were found to be better. NLR was found to be independent prognostic factor for OS in the multivariant analysis. At least one adverse event reported in 57.6% of the patients and grade 3–4 toxicity was seen in 23.6% patients. Conclusion: Real-life perioperative FLOT regimen in operable gastric and GEJ tumors showed similar oncologic outcomes compared to clinical trials. Better performance status, receiving adjuvant chemotherapy as same regimen, low grade and low NLR and PLR improved outcomes in real-life. However, in multivariate analysis, only NLR affected OS. © TÜBİTAK

Recovery from Posttraumatic Stress Symptoms: A Qualitative Study of Attributions in Survivors of War

This study was funded by a grant from the European Commission, contract number INCO-CT-2004-50917

Influence of reduced amounts of sulfoquinovosyl diacylglycerol on the thylakoid membranes of the diatom Thalassiosira pseudonana

Diatom thylakoids contain much higher amounts of sulfoquinovosyl diacylglycerol (SQDG) than vascular plants and the hypothesis was brought forward that this relates to their special thylakoid structure. To test this hypothesis we created knock-down mutants in Thalassiosira pseudonana that exhibited a decreased SQDG content per cell. Surprisingly, the ratio between the different lipid classes did not change, pointing to strict regulation of thylakoid lipid composition. The antenna proteins, fucoxanthin-chlorophyll proteins (FCP), were reduced and photosystem (PS) I compared to PSII was increased as judged from absorbance spectra. CD spectroscopy indicated a tighter packing of chromophores. The reduction in FCP might help to avoid diametral changes in excitation energy transfer. In contrast, the increase in PSI in the mutants might counteract the diminishment of the usually huge PSI antenna. No changes in thylakoid structure were observed since the stoichiometry between different lipid classes seems to be carefully balanced

Diagnostic value of cauda equina motor conduction time in lumbar spinal stenosis

PubMed ID: 22418591Objective: Lumbar spinal stenosis (LSS) is a chronic degenerative disease with pain in the back, buttocks and legs aggrevated by walking and relieved after rest without associated vascular disease of lower extremities observed in patients between 50 and 60. years. Several studies, using different methods indicated an association between slowing or blocking of root-nerve conduction and LSS. None of the previous research had applied the more conceivable methods such as recording the cauda equina potentials from the lumbar level or stimulating the spinal roots within the canal using either leg nerves or muscles. In this study, electrical lumbar laminar stimulation was used to demonstrate prolongation of cauda equina motor conduction time in lumbar spinal stenosis. Methods: Twenty-one LSS patients and age matched 15 normal control subjects were included in the study. Lumbar laminar electrical stimulation from L1 and L5 vertebra levels were applied by needle electrodes. Compound muscle action potential (CMAP) from gastrocnemius muscles were recorded bilaterally. Latency difference of CMAPs obtained from L1 and L5 spine levels were accepted as the cauda equina motor conduction time (CEMCT). Results: CEMCT was significantly longer in patient group when compared to normal controls. Mean latency difference was 3.59 ± 1.07. msec on the right side, 3.49 ± 1.07. msec on the left side in LSS group, it was 1.45 ± 0.65. msec on the right side, 1.35 ± 0.68. msec on the left side on normal control group (p< 0.0001). Conclusions: The prolongation of CEMCT was statistically and individually significant in patient group. This may indicate that lower lumbosacral motor roots were locally and chronically compressed due to lumbar spinal stenosis. Lumbar spinal stenosis may have induced local demyelination at the cauda equina level. Significance: Since the prolongation of CEMCT was found only in patients with LSS, the method of laminar stimulation can be chosen for patients with uncertain diagnosis of LSS. © 2012 International Federation of Clinical Neurophysiology

Kaiser Permanente Internet of Things (IoT) Roadmap

The Internet of Things (IoTs) program has been the most successful program for any organization in order to analyze the data and use those data to build a successful company. The healthcare market has consistently grown over time due to population growth, high economic growth, and the availability of technology. This paper is developed about Kaiser Permanente one of the biggest healthcare organization in the US. This organization is not just a hospital; it’s a giant healthcare and insurance provider at the same time. The objective of this research is therefore to create a technology roadmap for the business to prioritize the characteristics of the product. The Kaiser Permanente’s technology roadmap is created by taking into account four variables, namely product characteristics, market drivers, resources, and technology. Also, these variables are mapped together to create a general roadmap for technology. The roadmap is also split into a time frame of short-term and long-term objectives