Surgical resection and survival of patients with unsuspected single node positive lung cancer (NSCLC) invading the descending aorta

Background: Surgical treatment of non-small cell lung cancer (NSCLC) with aortic invasion is still debated

Strigolactone biosynthesis is evolutionarily conserved, regulated by phosphate starvation and contributes to resistance against phytopathogenic fungi in a moss, Physcomitrella patens

In seed plants, strigolactones (SLs) regulate architecture and induce mycorrhizal symbiosis in response to environmental cues. SLs are formed by combined activity of the carotenoid cleavage dioxygenases (CCDs) 7 and 8 from 9-cis-β-carotene, leading to carlactone that is converted by cytochromes P450 (clade 711; MAX1 in Arabidopsis) into various SLs. As Physcomitrella patens possesses CCD7 and CCD8 homologs but lacks MAX1, we investigated if PpCCD7 together with PpCCD8 form carlactone and how deletion of these enzymes influences growth and interactions with the environment. We investigated the enzymatic activity of PpCCD7 and PpCCD8 in vitro, identified the formed products by high performance liquid chromatography (HPLC) and LC-MS, and generated and analysed ΔCCD7 and ΔCCD8 mutants. We defined enzymatic activity of PpCCD7 as a stereospecific 9-cis-CCD and PpCCD8 as a carlactone synthase. ΔCCD7 and ΔCCD8 lines showed enhanced caulonema growth, which was revertible by adding the SL analogue GR24 or carlactone. Wild-type (WT) exudates induced seed germination in Orobanche ramosa. This activity was increased upon phosphate starvation and abolished in exudates of both mutants. Furthermore, both mutants showed increased susceptibility to phytopathogenic fungi. Our study reveals the deep evolutionary conservation of SL biosynthesis, SL function, and its regulation by biotic and abiotic cues.Deutsche Forschungsgemeinschaft AL892/1-4Academy of Finland 125312

Respiratory Syncytial Virus Infection in Patients with Hematological Diseases: Single-Center Study and Review of the Literature

Background.Respiratory syncytial virus (RSV) causes significant mortality in patients with hematological diseases, but diagnosis and treatment are uncertain. Methods.We retrospectively identified RSV-infected patients with upper or lower respiratory tract infection (RTI) by culture, antigen testing, and polymerase chain reaction from November 2002 through April 2007. Patients with severe immunodeficiency (SID; defined as transplantation in the previous 6 months, T or B cell depletion in the previous 3 months, graft-versus-host disease [grade, ⩾2], leukopenia, lymphopenia, or hypogammaglobulinemia) preferentially received oral ribavirin, intravenous immunoglobulin, and palivizumab. The remaining patients with moderate immunodeficiency (MID) preferentially received ribavirin and intravenous im munoglobulin. Results.We identified 34 patients, 22 of whom had upper RTI (10 patients with MID and 12 with SID) and 12 of whom had lower RTI (2 with MID and 10 with SID). Thirty-one patients were tested by polymerase chain reaction (100% of these patients had positive results; median RSV load, 5.46 log10 copies/mL), 30 were tested by culture (57% had positive results), and 25 were tested by antigen testing (40% had positive results). RSV-attributed mortality was 18% (6 patients died) and was associated with having ⩾2 SID factors (P=.04), lower RTI (P=.01), and preengraftment (P=.012). Among 12 patients with MID (7 of whom received treatment), no progression or death occurred. Nine patients with SID and upper RTI received treatment (7 patients received ribavirin, intravenous immunoglobulin, and palivizumab); infection progressed to the lower respiratory tract in 2 patients, and 1 patient died. Ten patients with SID and lower RTI were treated, 5 of whom died, including 4 of 6 patients who received ribavirin, intravenous immunoglobulin, and palivizumab. The duration of RSV shedding correlated with the duration of symptoms in patients with SID but exceeded symptom duration in patients with MID (P<.05). Conclusions.Lower RTI, ⩾2 SID criteria, and preengraftment are risk factors for RSV-attributed mortality. Polymerase chain reaction may optimize diagnosis and monitoring. Oral ribavirin therapy seems safe, but trials are needed to demonstrate its efficac

Unlocking the power of generative AI models and systems such asGPT-4 and ChatGPT for higher education

Generative AI technologies, such as large language models, have the potential to revolutionize much of our higher education teaching and learning. ChatGPT is an impressive, easy-to-use, publicly accessible system demonstrating the power of large language models such as GPT-4. Other compa- rable generative models are available for text processing, images, audio, video, and other outputs and we expect a massive further performance increase, integration in larger software systems, and diffusion in the coming years. This technological development triggers substantial uncertainty and change in university-level teaching and learning. Students ask questions like: How can ChatGPT or other artificial intelligence tools support me? Am I allowed to use ChatGPT for a seminar or final paper, or is that cheating? How exactly do I use ChatGPT best? Are there other ways to access models such as GPT-4? Given that such tools are here to stay, what skills should I acquire, and what is obsolete? Lecturers ask similar questions from a different perspective: What skills should I teach? How can I test students competencies rather than their ability to prompt generative AI models? How can I use ChatGPT and other systems based on generative AI to increase my efficiency or even improve my students learning experience and outcomes? Even if the current discussion revolves around ChatGPT and GPT-4, these are only the forerunners of what we can expect from future generative AI-based models and tools. So even if you think ChatGPT is not yet technically mature, it is worth looking into its impact on higher education. This is where this whitepaper comes in. It looks at ChatGPT as a contemporary example of a conversational user interface that leverages large language models. The whitepaper looks at ChatGPT from the perspective of students and lecturers. It focuses on everyday areas of higher education: teaching courses, learning for an exam, crafting seminar papers and theses, and assessing students learning outcomes and performance. For this purpose, we consider the chances and concrete application possibilities, the limits and risks of ChatGPT, and the underlying large language models. This serves two purposes: First, we aim to provide concrete examples and guidance for individual students and lecturers to find their way of dealing with ChatGPT and similar tools. Second, this whitepaper shall inform the more extensive organizational sensemaking processes on embracing and enclosing large language models or related tools in higher education. We wrote this whitepaper based on our experience in information systems, computer science, management, and sociology. We have hands-on experience in using generative AI tools. As professors, postdocs, doctoral candidates, and students, we constantly innovate our teaching and learning. Fully embracing the chances and challenges of generative AI requires adding further perspectives from scholars in various other disciplines (focusing on didactics of higher education and legal aspects), university administrations, and broader student groups. Overall, we have a positive picture of generative AI models and tools such as GPT-4 and ChatGPT. As always, there is light and dark, and change is difficult. However, if we issue clear guidelines on the part of the universities, faculties, and individual lecturers, and if lecturers and students use such systems efficiently and responsibly, our higher education system may improve. We see a greatchance for that if we embrace and manage the change appropriately

Reliability and validity of needle biopsy evaluation of breast-abnormalities using the B-categorization – design and objectives of the Diagnosis Optimisation Study (DIOS)

<p>Abstract</p> <p>Background</p> <p>The planned nationwide implementation of mammography screening 2007 in Germany will increase the occurrence of mammographically detected breast abnormalities. These abnormalities are normally evaluated by minimal invasive core biopsy. To minimize false positive and false negative histological findings, quality assurance of the pathological evaluation of the biopsies is essential. Various guidelines for quality assurance in breast cancer diagnosis recommend applying the B-classification for histopathological categorization. However, to date there are only few studies that reported results about reliability and validity of B-classification. Therefore, objectives of our study are to determine the inter- and intraobserver variability (reliability study) and construct and predictive validity (validity study) of core biopsy evaluation of breast abnormalities. This paper describes the design and objectives of the DIOS Study.</p> <p>Methods/Design</p> <p>All consecutive asymptomatic and symptomatic women with breast imaging abnormalities who are referred to the University Hospital of Halle for core breast biopsy over a period of 24 months are eligible. According to the sample size calculation we need 800 women for the study. All patients in the study population underwent clinical and radiological examination. Core biopsy is performed by stereotactic-, ultrasound- or magnetic resonance (MR) guided automated gun method or vacuum assisted method. The histopathologic agreement (intra- and interobserver) of pathologists and the histopathologic validity will be evaluated. Two reference standards are implemented, a reference pathologist and in case of suspicious or malignant findings the histopathologic result of excision biopsy. Furthermore, a self administrated questionnaire which contains questions about potential risk factors of breast cancer, is sent to the participants approximately two weeks after core biopsy. This enables us to run a case-control-analysis (woman with breast cancer histological verified after excision are defined as cases, woman without malignant breast lesions are defined as controls) to investigate the predictive values of various risk factors on breast cancer risk.</p> <p>Conclusion</p> <p>The analysis of reliability and validity of the histopathological evaluation of core biopsy specimens of breast abnormalities is intended to provide important information needed for a high quality in breast cancer diagnostic and for planning of treatment strategies.</p

Young patients', parents', and survivors' communication preferences in paediatric oncology: Results of online focus groups

Contains fulltext : 51596.pdf ( ) (Open Access)BACKGROUND: Guidelines in paediatric oncology encourage health care providers to share relevant information with young patients and parents to enable their active participation in decision making. It is not clear to what extent this mirrors patients' and parents' preferences. This study investigated communication preferences of childhood cancer patients, parents, and survivors of childhood cancer. METHODS: Communication preferences were examined by means of online focus groups. Seven patients (aged 8-17), 11 parents, and 18 survivors (aged 8-17 at diagnosis) participated. Recruitment took place by consecutive inclusion in two Dutch university oncological wards. Questions concerned preferences regarding interpersonal relationships, information exchange and participation in decision making. RESULTS: Participants expressed detailed and multi-faceted views regarding their needs and preferences in communication in paediatric oncology. They agreed on the importance of several interpersonal and informational aspects of communication, such as honesty, support, and the need to be fully informed. Participants generally preferred a collaborative role in medical decision making. Differences in views were found regarding the desirability of the patient's presence during consultations. Patients differed in their satisfaction with their parents' role as managers of the communication. CONCLUSION: Young patients' preferences mainly concur with current guidelines of providing them with medical information and enabling their participation in medical decision making. Still, some variation in preferences was found, which faces health care providers with the task of balancing between the sometimes conflicting preferences of young cancer patients and their parents

Bridging the gap between robotic technology and health care

Although technology and computation power have become more and more present in our daily lives, we have yet to see the same tendency in robotics applied to health care. In this work we focused on the study of four distinct applications of robotic technology to health care, named Robotic Assisted Surgery, Robotics in Rehabilitation, Prosthetics and Companion Robotic Systems. We identified the main roadblocks that are limiting the progress of such applications by an extensive examination of recent reports. Based on the limitations of the practical use of current robotic technology for health care we proposed a general modularization approach for the conception and implementation of specific robotic devices. The main conclusions of this review are: (i) there is a clear need of the adaptation of robotic technology (closed loop) to the user, so that robotics can be widely accepted and used in the context of heath care; (ii) for all studied robotic technologies cost is still prohibitive and limits their wide use. The reduction of costs influences technology acceptability; thus innovation by using cheaper computer systems and sensors is relevant and should be taken into account in the implementation of robotic systems

Progress and Research Needs of Plant Biomass Degradation by Basidiomycete Fungi

Peer reviewe