Predictors of Gains During Inpatient Rehabilitation in Patients with Stroke- A Review.

Stroke remains a major cause of disability. The cost of stroke rehabilitation is substantial. Understanding the factors that predict response to inpatient stroke rehabilitation may be useful, for example, to best individualize the content of therapy, or to maximize the efficiency with which resources are directed. This review reviewed the literature and found that numerous variables were associated with outcome after inpatient stroke rehabilitation. The strongest evidence exists for factors such as age, stroke subtype, nutritional status, psychosocial factors such as living with family prior to stroke or presence of a caregiver. Functional status on admission, urinary incontinence, post-stroke infection, and aphasia each can also impact prognosis. Strengths and weaknesses of cited studies are considered in an attempt to inform design of future studies examining the factors that predict response to inpatient rehabilitation after stroke

Papillary Thyroid Carcinoma Variants are Characterized by Co-dysregulation of Immune and Cancer Associated Genes.

Papillary thyroid carcinoma (PTC) variants exhibit different prognosis, but critical characteristics of PTC variants that contribute to differences in pathogenesis are not well-known. This study aims to characterize dysregulated immune-associated and cancer-associated genes in three PTC subtypes to explore how the interplay between cancer and immune processes causes differential prognosis. RNA-sequencing data from The Cancer Genome Atlas (TCGA) were used to identify dysregulated genes in each variant. The dysregulation profiles of the subtypes were compared using functional pathways clustering and correlations to relevant clinical variables, genomic alterations, and microRNA regulation. We discovered that the dysregulation profiles of classical PTC (CPTC) and the tall cell variant (TCPTC) are similar and are distinct from that of the follicular variant (FVPTC). However, unique cancer or immune-associated genes are associated with clinical variables for each subtype. Cancer-related genes MUC1, FN1, and S100-family members were the most clinically relevant in CPTC, while APLN and IL16, both immune-related, were clinically relevant in FVPTC. RAET-family members, also immune-related, were clinically relevant in TCPTC. Collectively, our data suggest that dysregulation of both cancer and immune associated genes defines the gene expression landscapes of PTC variants, but different cancer or immune related genes may drive the phenotype of each variant

The Landscape of Long Non-Coding RNA Dysregulation and Clinical Relevance in Muscle Invasive Bladder Urothelial Carcinoma.

Bladder cancer is one of the most common cancers in the United States, but few advancements in treatment options have occurred in the past few decades. This study aims to identify the most clinically relevant long non-coding RNAs (lncRNAs) to serve as potential biomarkers and treatment targets for muscle invasive bladder cancer (MIBC). Using RNA-sequencing data from 406 patients in The Cancer Genome Atlas (TCGA) database, we identified differentially expressed lncRNAs in MIBC vs. normal tissues. We then associated lncRNA expression with patient survival, clinical variables, oncogenic signatures, cancer- and immune-associated pathways, and genomic alterations. We identified a panel of 20 key lncRNAs that were most implicated in MIBC prognosis after differential expression analysis and prognostic correlations. Almost all lncRNAs we identified are correlated significantly with oncogenic processes. In conclusion, we discovered previously undescribed lncRNAs strongly implicated in the MIBC disease course that may be leveraged for diagnostic and treatment purposes in the future. Functional analysis of these lncRNAs may also reveal distinct mechanisms of bladder cancer carcinogenesis

Cancer treatment associated cardiac toxicities

Cardiovascular disease remains the leading cause of mortality and morbidity in men and women both in the US and worldwide. With increased access to healthcare, it is predicted that life expectancies in developed countries will continue to rise and thus, lead to an increase in both cardiovascular disease and cancer. Similarly, improved survival rates in cancer patients have led to an increased awareness of the presence and potential worsening of cardiovascular disease in these patients. Cardiovascular complications due to side effects from cancer therapy or from cancer progression can be a common occurrence. Although recent advances in cancer therapeutics have led to improved survival rates and quality of life, the increase in life expectancy may be counteracted by the increased morbidity and mortality from progressive cardiac pathology. Examples of such complications include local invasion or distant metastatic spread, which can lead to superior vena cava syndrome, cardiac tamponade, or hyperviscosity syndromes. In addition, many chemo and radiation therapies can be directly toxic to the cardiovascular system. This review aims to discuss the potential cardiac toxicities of the most commonly used chemotherapeutics along with some strategies to manage these complex patients

Diabetes and corneal endothelial cell characteristics: a study based on Eye Bank data

The aim of the article is to determine whether corneal endothelial cell density and other characteristics, such as cell area, pleomorphism and polymegathism, are affected by diabetes. Corneal endothelial cell density and other characteristics of donor eyes collected during 2007 and 2008 in a local Eye Bank were measured by the HAI Eyebank Specular Microscope System. Adult donors aged 21 or older who consented to research were divided into healthy versus compromised eye-status groups based on eye disease or past eye surgeries. Differences in corneal measures between diabetic and non-diabetic subjects were analyzed separately in each group via Mixed Models ANCOVA, with Diabetes as the fixed effect, Donor as the random effect, and Age as the continuous covariate. A total of 253 subjects met study criteria, of which 81 (32%) had diabetes. In the 180 subjects with healthy eye status, the medians (ranges) of age were 62 (29-78) years among 52 diabetics (29%), versus 57 (21-79) years among non-diabetics (P=0.013). In the 73 subjects with compromised eye status, the medians (ranges) of age were 70 (32-78) years among 29 diabetics (40%), versus 70 (29-79) years among nondiabetics (P=0.77). Between diabetics and non-diabetics, eye disease and past eye surgeries were well-balanced in the compromised eye-status group, while race and sex were wellbalanced in both eye-status groups. Results from separate analyses on the two groups indicated that diabetes did not affect corneal cell density or other corneal-cell characteristics analyzed. Even though diabetics constituted a large percentage of the Eye Bank donor population, this disease did not have a statistically significant impact on corneal endothelial cell density, cell area, pleomorphism or polymegathism

Quantitative MRI Musculoskeletal Techniques: An Update.

OBJECTIVE. For many years, MRI of the musculoskeletal system has relied mostly on conventional sequences with qualitative analysis. More recently, using quantitative MRI applications to complement qualitative imaging has gained increasing interest in the MRI community, providing more detailed physiologic or anatomic information. CONCLUSION. In this article, we review the current state of quantitative MRI, technical and software advances, and the most relevant clinical and research musculoskeletal applications of quantitative MRI

Fat suppression for ultrashort echo time imaging using a novel soft-hard composite radiofrequency pulse.

PurposeTo design a soft-hard composite pulse for fat suppression and water excitation in ultrashort echo time (UTE) imaging with minimal short T2 signal attenuation.MethodsThe composite pulse contains a narrow bandwidth soft pulse centered on the fat peak with a small negative flip angle (-α) and a short rectangular pulse with a small positive flip angle (α). The fat magnetization experiences both tipping-down and -back with an identical flip angle and thus returns to the equilibrium state, leaving only the excited water magnetization. Bloch simulations, as well as knee, tibia, and ankle UTE imaging studies, were performed to investigate the effectiveness of fat suppression and corresponding water signal attenuation. A conventional fat saturation (FatSat) module was used for comparison. Signal suppression ratio (SSR), defined as the ratio of signal difference between non-fat-suppression and fat-suppression images over the non-fat-suppression signal, was introduced to evaluate the efficiency of the composite pulse.ResultsNumerical simulations demonstrate that the soft-hard pulse has little saturation effect on short T2 water signals. Knee, tibia, and ankle UTE imaging results suggest that comparable fat suppression can be achieved with the soft-hard pulse and the FatSat module. However, much less water saturation is induced by the soft-hard pulse, especially for short T2 tissues, with SSRs reduced from 71.8 ± 6.9% to 5.8 ± 4.4% for meniscus, from 68.7 ± 5.5% to 7.7 ± 7.6% for bone, and from 62.9 ± 12.0% to 4.8 ± 3.2% for the Achilles tendon.ConclusionThe soft-hard composite pulse can suppress fat signals in UTE imaging with little signal attenuation on short T2 tissues

Can Preschoolers be Health Messengers to Promote Breast Health among Chinese Americans?

Women’s limited knowledge about breast cancer screening (BCS), combined with differences in Eastern and Western disease prevention concepts, may contribute to late-stage breast cancer diagnosis among minorities. Children can be conduits of knowledge transfer to adults. This pilot study tested the use of a culturally-tailored theatrical preschool performance in increasing Chinese American women’s knowledge of BCS guidelines. Chinese preschool children relayed BCS guidelines through a culturally-tailored theatrical performance. Data were collected from 177 Chinese American women (84% foreign-born) who completed pre- and post-performance surveys. Findings suggested that promoting BCS guidelines through a culturally-tailored preschool theatrical performance significantly increased participants’ knowledge of the guidelines. Interventions involving young children as change agents to deliver simple health messages such as BCS guidelines are feasible and promising to increase knowledge and desired behavioral change within the target population. Further empirical investigations are warranted in larger randomized controlled trials

ROMA (Rank-Ordered Multifractal Analysis) for intermittent fluctuations with global crossover behavior

Rank-Ordered Multifractal Analysis (ROMA), a recently developed technique that combines the ideas of parametric rank ordering and one parameter scaling of monofractals, has the capabilities of deciphering the multifractal characteristics of intermittent fluctuations. The method allows one to understand the multifractal properties through rank-ordered scaling or non-scaling parametric variables. The idea of the ROMA technique is applied to analyze the multifractal characteristics of the auroral zone electric field fluctuations observed by SIERRA. The observed fluctuations span across contiguous multiple regimes of scales with different multifractal characteristics. We extend the ROMA technique such that it can take into account the crossover behavior -- with the possibility of collapsing probability distributions functions (PDFs) -- over these contiguous regimes.Comment: 24 pages, 18 figure