Geriatric oncology health services research: Cancer and Aging Research Group infrastructure core

Founded by the late Dr. Arti Hurria, the Cancer and Aging Research Group (CARG) is a collaborative, interdisciplinary team of investigators dedicated to improving the care of older adults with cancer through research, advocacy, and other scholarly initiatives.1 As part of the CARG National Institute on Aging R21/R33 infrastructure grant to harness the available expertise and prioritize the development of high-impact research, the Health Services Research (HSR) Core was developed to foster and advance HSR in geriatric oncology. The mission of the HSR Core is to support clinical investigators to design and conduct highquality HSR focused on older adults with cancer and their caregivers including patterns of care, comparative effectiveness, and care delivery. At the first R21/R33 conference held at City of Hope in October 2018, Dr. Harvey Jay Cohen (Chair, CARG Oversight Board and HSR Core) led the development of this Core. In this perspective paper, we present a review of HSR in geriatric oncology to build a foundation for the Core rationale; proposed Core function, workflow, policies, and procedures; anticipated interactions with other CARG Cores; and proposed plans for sustainabilit

Clinical utility of hyperglycosylated hCG in serum taken before hydatidiform mole evacuation to predict persistent trophoblastic disease.

Contains fulltext : 50776.pdf (publisher's version ) (Closed access)OBJECTIVE: Human chorionic gonadotropin (hCG) is widely used in the management of hydatidiform mole and persistent trophoblastic disease (PTD). Studies on hyperglycosylated human chorionic gonadotropin (invasive trophoblast antigen, ITA) in PTD are limited. In serum samples taken before evacuation of molar pregnancies we measured the concentrations of free hCG beta-subunit (free hCGbeta), "total" hCG (hCG+hCGbeta) and ITA, and determined whether ITA, the two other hCG analytes, or the calculated ratios of hCGbeta/hCG+hCGbeta, hCGbeta/ITA and hCG+hCGbeta/ITA could predict the later development of PTD. DESIGN: A retrospective study based on blood specimens collected in the Dutch Central Registry for Hydatidiform Moles. The study group comprised 97 patients with hydatidiform moles who did not develop PTD after mole evacuation and 33 patients who did develop PTD. Methods: Serum samples from 130 patients with hydatidiform mole with or without PTD were assayed using specific (radio)immunoassays for free hCGbeta, total hCG, and ITA. From these analytes we also calculated the ratios hCGbeta/hCG+hCGbeta, hCGbeta/ITA, and hCG+hCGbeta/ITA. To predict the development of PTD from these analytes and parameters we performed receiver-operating characteristic (ROC) curve analysis, resulting in areas under the curve (AUCs) that represented the diagnostic accuracy which was rated in a range from excellent (AUC >0.9 or <0.1) to poor (AUC 0.4-0.6). Results: The diagnostic accuracy of ITA was moderate (0.618) and not different from that of free hCGbeta (0.610) and hCG+hCGbeta (0.622). CONCLUSIONS: ITA as well as the other analytes and parameters in serum taken prior to evacuation from patients with molar pregnancies cannot be used to predict the subsequent development of persistent trophoblastic disease

Antiglucocorticoids, neurogenesis and depression

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Structure, Energetics, and Dynamics of Smectite Clay Interlayer Hydration: Molecular Dynamics and Metadynamics Investigation of Na-Hectorite

This paper presents a classical molecular dynamics (MD) and metadynamics investigation of the relationships between the structure, energetics, and dynamics of Na-hydroxyhectorite and serves to provide additional, molecular-scale insight into the interlayer hydration of this mineral. The computational results support a model for interlayer H2O structure and dynamics based on 2H NMR spectroscopy and indicate that H2O molecules undergo simultaneous fast librational motions about the H2O C2 symmetry axis and site hopping with C3 symmetry with respect to the surface normal. Hydration energy minima occur at one-, one-and-one-half-, and two-water-layer hydrates, which for the composition modeled correspond to 3, 5.5, and 10 H2O/Na+, respectively. Na+ ions are coordinated by basal O atoms (OMIN) at the lowest hydration levels and by H2O molecules (OH2O) in the two-layer hydrate, and H2O molecules have an average of three H-bonds at the greatest hydration levels. The metadynamics calculations yield activation energies for site hopping of H2O molecules of 6.0 kJ/mol for the one-layer structure and 3.3 kJ/mol for hopping between layers in the two-layer structure. Computed diffusion coefficients for water and Na+ are substantially less than in bulk liquid water, as expected in a nanoconfined environment, and are in good agreement with previous results

C-reactive protein is elevated in symptomatic compared with asymptomatic patients with carotid artery disease

Objectives: to investigate the level of inflammatory markers between symptomatic and asymptomatic carotid stenosis patients.Design: cross-sectional studyMaterials and methods: a prospective study of 137 consecutive patients, admitted electively for carotid endarterectomy during 1997–2000, was conducted. 125 patients had cerebrovascular symptoms: either stroke (neurological deficit &gt;24 h), Transient ischaemic attack (neurological deficit&lt;24 h) or amaurosis fugax. Twelve patients were asymptomatic. A medical history and a fasting venous blood sample were taken from each patient around 6 weeks before surgery. The plasma concentrations of cholesterol and of inflammatory markers; (high sensitivity C-reactive protein (hs-CRP), sICAM-1, sVCAM-1, sE-selectin) were determined.Results: the concentration of hs-CRP in the symptomatic group (3.9 mg/L) was significantly higher than in the asymptomatic group (2.1 mg/L; p = 0.04). These concentrations were within normal range (&lt;10 mg/L). sICAM-1, sVCAM-1, sE-selectin and total cholesterol concentrations were not different between the two groups.Conclusion: plasma hs-CRP was elevated in symptomatic compared to asymptomatic patients with carotid artery disease. High sensitivity C-reactive protein has been shown to be of prognostic value in a number of cardiovascular conditions and thi