Intravitreal bevacizumab for the treatment of macular oedema secondary to branch retinal vein occlusion

Purpose: To evaluate the effect of intravitreal bevacizumab (Avastin) injections on visual acuity (VA) and foveal retinal thickness in patients with macular oedema secondary to branch retinal vein occlusion.Methods: A prospective, non-comparative, consecutive, interventional case series of 34 patients. Patients received repeated intravitreal injections of 1.25 mg bevacizumab. Main outcome measures were VA (Snellen charts and ETDRS) and retinal thickness (optical coherence tomography measurements) in a follow-up period of 6 months.Results: Patients presented at a mean age of 69 years (range 44--86). Mean duration of symptoms was 40 weeks (range 1--300). Mean (SD) VA at baseline was 0.79 (0.39) logMAR, improving to 0.51 (0.34) logMAR at 6 months (p = 0.009). Mean number of letters on the ETDRS chart at baseline was 45.3 (19.0), improving to 60.6 (19.9) at 6 months (p = 0.003). Mean (SD) retinal thickness at baseline was 474 (120) \textgreekmm, declining to 316 (41) \textgreekmm at 6 months.Conclusion: Intravitreal injection of 1.25 mg bevacizumb appears to be an effective treatment option for branch retinal vein occlusion

Exploring a model for finding meaning in the changing world of work (Part 2)

Orientation: This article explores the role that meaning, as logotherapy conceptualises it, can play to facilitate organisational changes.Research purpose: The purpose of this study is to explore further a model an earlier paper proposed for using employees’ experiences of meaning in work contexts to facilitate changes.Motivation for the study: The researchers could not find a comprehensive model in the literature for addressing employees’ experiences of meaning in, or at, work during organisational changes. A previous paper proposed such a model, but it addressed only one component fully. This article seeks to explore this model further to address this apparent gap in the literature.Research design, approach and method: The researchers used a literature review to conduct the study. The components of the model directed this review in order to find meaning at work.Main findings: The actions of organisations, which aim to create positive organisational contexts (through practices for improving meaning at work and transcendence) and to frame changes using ‘Logo-OD’, can improve employees’ experiences of meaning during organisational changes.Practical/managerial implications: Understanding the relationship between meaning and organisational change, and applying the model this article presents, can contribute to the overall success of change initiatives.Contribution/value-add: This study’s primary contribution stems from the novel framework it presents for organisations to use the knowledge about how employees search for meaning to facilitate changes.</p

Multi-modales Biofeedback System zur Vorbeugung von Stürzen Multi-modal Biofeedback System for the Prevention of Falls

Das Biofeedback des Körperschwankens stellt eine Möglichkeit dar, Patienten mit statischen und dynamischen Gleichgewichtsproblemen alternative Sinnesreize zur Erlangung eines stabilen Gleichgewichts zur Verfügung zu stellen, was zu einer Verbesserung ihrer Lebensqualität führt. Das Biofeedback-System erzeugt mittels am Kopf befestigter Signalwandler auditive, vibro-taktile und vibro-vestibuläre Sinneseindrücke. Die Ergebnisse sowohl an jungen als auch an älteren Probanden ergaben, dass mit Hilfe des Biofeedbacks eine bemerkenswerte 40-60%ige Reduktion des Körperschwankens erzielt werden konnt

Infiltrative growth pattern of prostate cancer is associated with lower uptake on PSMA PET and reduced diffusion restriction on mpMRI

Purpose: Recently, a significant association was shown between novel growth patterns on histopathology of prostate cancer (PCa) and prostate-specific membrane antigen (PSMA) uptake on [68Ga]PSMA-PET. It is the aim of this study to evaluate the association between these growth patterns and ADC (mm2/1000 s) values in comparison to [68Ga]PSMA uptake on PET/MRI. Methods: We retrospectively evaluated patients who underwent [68Ga]PSMA PET/MRI for staging or biopsy guidance, followed by radical prostatectomy at our institution between 07/2016 and 01/2020. The dominant lesion per patient was selected based on histopathology and correlated to PET/MRI in a multidisciplinary meeting, and quantified using SUVmax for PSMA uptake and ADCmean for diffusion restriction. PCa growth pattern was classified as expansive (EXP) or infiltrative (INF) according to its properties of forming a tumoral mass or infiltrating diffusely between benign glands by two independent pathologists. Furthermore, the corresponding WHO2016 ISUP tumor grade was evaluated. The t test was used to compare means, Pearson's test for categorical correlation, Cohen's kappa test for interrater agreement, and ROC curve to determine the best cutoff. Results: Sixty-two patients were included (mean PSA 11.7 ± 12.5). The interrater agreement between both pathologists was almost perfect with κ = 0.81. While 25 lesions had an EXP-growth with an ADCmean of 0.777 ± 0.109, 37 showed an INF-growth with a significantly higher ADCmean of 1.079 ± 0.262 (p < 0.001). We also observed a significant difference regarding PSMA SUVmax for the EXP-growth (19.2 ± 10.9) versus the INF-growth (9.4 ± 6.2, p < 0.001). Within the lesions encompassing the EXP- or the INF-growth, no significant correlation between the ISUP groups and ADCmean could be observed (p = 0.982 and p = 0.861, respectively). Conclusion: PCa with INF-growth showed significantly lower SUVmax and higher ADCmean values compared to PCa with EXP-growth. Within the growth groups, ADCmean values were independent from ISUP grading. Keywords: Diffusion-weighted imaging; MRI; PSMA PET/MRI; Prostate cancer; Radical prostatectom

Toward an integrative understanding of social behavior: new models and new opportunities.

Social interactions among conspecifics are a fundamental and adaptively significant component of the biology of numerous species. Such interactions give rise to group living as well as many of the complex forms of cooperation and conflict that occur within animal groups. Although previous conceptual models have focused on the ecological causes and fitness consequences of variation in social interactions, recent developments in endocrinology, neuroscience, and molecular genetics offer exciting opportunities to develop more integrated research programs that will facilitate new insights into the physiological causes and consequences of social variation. Here, we propose an integrative framework of social behavior that emphasizes relationships between ultimate-level function and proximate-level mechanism, thereby providing a foundation for exploring the full diversity of factors that underlie variation in social interactions, and ultimately sociality. In addition to identifying new model systems for the study of human psychopathologies, this framework provides a mechanistic basis for predicting how social behavior will change in response to environmental variation. We argue that the study of non-model organisms is essential for implementing this integrative model of social behavior because such species can be studied simultaneously in the lab and field, thereby allowing integration of rigorously controlled experimental manipulations with detailed observations of the ecological contexts in which interactions among conspecifics occur

What's behind 68 Ga-PSMA-11 uptake in primary prostate cancer PET? Investigation of histopathological parameters and immunohistochemical PSMA expression patterns

Purpose: Prostate-specific membrane antigen (PSMA-) PET has become a promising tool in staging and restaging of prostate carcinoma (PCa). However, specific primary tumour features might impact accuracy of PSMA-PET for PCa detection. We investigated histopathological parameters and immunohistochemical PSMA expression patterns on radical prostatectomy (RPE) specimens and correlated them to the corresponding 68Ga-PSMA-11-PET examinations. Methods: RPE specimens of 62 patients with preoperative 68Ga-PSMA-11-PET between 2016 and 2018 were analysed. WHO/ISUP grade groups, growth pattern (expansive vs. infiltrative), tumour area and diameter as well as immunohistochemical PSMA heterogeneity, intensity and negative tumour area (PSMA%neg) were correlated with spatially corresponding SUVmax on 68Ga-PSMA-11-PET in a multidisciplinary analysis. Results: All tumours showed medium to strong membranous (2-3 +) and weak to strong cytoplasmic (1-3 +) PSMA expression. Heterogeneously expressed PSMA was found in 38 cases (61%). Twenty-five cases (40%) showed at least 5% and up to 80% PSMA%neg. PSMA%neg, infiltrative growth pattern, smaller tumour area and diameter and WHO/ISUP grade group 2 significantly correlated with lower SUVmax values. A ROC curve analysis revealed 20% PSMA%neg as an optimal cutoff with the highest sensitivity and specificity (89% and 86%, AUC 0.923) for a negative PSMA-PET scan. A multiple logistic regression model revealed tumoural PSMA%neg (p < 0.01, OR = 9.629) and growth pattern (p = 0.0497, OR = 306.537) as significant predictors for a negative PSMA-PET scan. Conclusions: We describe PSMA%neg, infiltrative growth pattern, smaller tumour size and WHO/ISUP grade group 2 as parameters associated with a lower 68Ga-PSMA-11 uptake in prostate cancer. These findings can serve as fundament for future biopsy-based biomarker development to enable an individualized, tumour-adapted imaging approach. Keywords: Glutamate carboxypeptidase II; Immunohistochemistry; Neoplasm staging; Positron emission tomography; Prostatic neoplasm

The Influence of Surface Binding Energy on Sputtering in Models of the Sodium Exosphere of Mercury

We have simulated the sodium (Na) exosphere of Mercury to show how the exosphere is affected by the assumed surface binding energy (SBE) of Na in the sputtered component. We constrained ion precipitation onto the surface using distributions for the cusp regions that are consistent with measurements by the MErcury Surface, Space ENvironment, GEochemistry, and Ranging Fast Imaging Plasma Spectrometer instrument. We have simulated sputtering with SBEs of 0.27, 2.6, 4.4, and 7.9 eV, with the lowest value commonly used in exosphere models and the highest from recent molecular dynamics calculations for the Na-bearing feldspar end-member, albite. A gradual change in the exosphere is seen as the yield decreases and the ejecta energy increases with increasing SBE. We describe the corresponding exosphere source functions for ion sputtering (IS), as well as for the previously studied processes of micrometeoroid impact vaporization and photon-stimulated desorption (PSD), along with their release energy distributions and spatial distributions. We have summed the contributions of the various source processes to explain how and when the different sources can be distinguished by observations. The modeled exosphere scale heights range from 72 km for PSD to over 1000 km for IS using a SBE of 7.9 eV. We find that the processes responsible for generating Mercuryʼs Na exosphere are separable by measuring line-of-sight column densities tangent to the planet at various altitudes and positions around the planet. Our initial results are consistent with the Na being sputtered from a high-SBE material such as feldspar, which has been predicted to be abundant on the Mercuryʼs surface

68 Ga-PSMA-11 PET/MRI versus multiparametric MRI in men referred for prostate biopsy: primary tumour localization and interreader agreement

Background: Magnetic resonance imaging (MRI) is recommended by the European Urology Association guidelines as the standard modality for imaging-guided biopsy. Recently positron emission tomography with prostate-specific membrane antigen (PSMA PET) has shown promising results as a tool for this purpose. The aim of this study was to compare the accuracy of positron emission tomography with prostate-specific membrane antigen/magnetic resonance imaging (PET/MRI) using the gallium-labeled prostate-specific membrane antigen (68Ga-PSMA-11) and multiparametric MRI (mpMRI) for pre-biopsy tumour localization and interreader agreement for visual and semiquantitative analysis. Semiquantitative parameters included apparent diffusion coefficient (ADC) and maximum lesion diameter for mpMRI and standardized uptake value (SUVmax) and PSMA-positive volume (PSMAvol) for PSMA PET/MRI. Results: Sensitivity and specificity were 61.4% and 92.9% for mpMRI and 66.7% and 92.9% for PSMA PET/MRI for reader one, respectively. RPE was available in 23 patients and 41 of 47 quadrants with discrepant findings. Based on RPE results, the specificity for both imaging modalities increased to 98% and 99%, and the sensitivity improved to 63.9% and 72.1% for mpMRI and PSMA PET/MRI, respectively. Both modalities yielded a substantial interreader agreement for primary tumour localization (mpMRI kappa = 0.65 (0.52-0.79), PSMA PET/MRI kappa = 0.73 (0.61-0.84)). ICC for SUVmax, PSMAvol and lesion diameter were almost perfect (≥ 0.90) while for ADC it was only moderate (ICC = 0.54 (0.04-0.78)). ADC and lesion diameter did not correlate significantly with Gleason score (ρ = 0.26 and ρ = 0.16) while SUVmax and PSMAvol did (ρ = - 0.474 and ρ = - 0.468). Conclusions: PSMA PET/MRI has similar accuracy and reliability to mpMRI regarding primary prostate cancer (PCa) localization. In our cohort, semiquantitative parameters from PSMA PET/MRI correlated with tumour grade and were more reliable than the ones from mpMRI. Keywords: ADC; Biopsy guidance; Interreader agreement; PET/MRI; PSMA PET; Primary staging; SUVmax; Targeted biopsy; Template biopsy; mpMRI