The free β-subunit of human chorionic gonadotropin as a prognostic factor in renal cell carcinoma

The free β-subunit of human chorionic gonadotropin β is expressed in several nontrophoblastic tumours and this is usually associated with aggressive disease. Little is known about human chorionic gonadotropin β expression in renal cancer. We determined the pretreatment levels of human chorionic gonadotropin β in serum of patients with renal cell carcinoma, and studied whether elevated levels predicted the clinical outcome. Serum samples were collected before surgery from 177 patients with renal cell carcinoma and from 84 apparently healthy controls. Human chorionic gonadotropin β in serum was measured by a highly sensitive time-resolved immunofluorometric assay. The prognostic value of human chorionic gonadotropin β, and of usual clinical and pathological variables was analyzed by the Kaplan-Meier method, the log rank test and Cox multiple hazard regression. The serum concentrations of human chorionic gonadotropin β were increased in 23% of the renal cell carcinoma patients and they were significantly higher in patients with renal cell carcinoma than in controls (P<0.0001). The concentrations did not correlate with clinical stage and histopathological grade, but patients with increased human chorionic gonadotropin β levels had significantly shorter survival time than those with levels below the median (cut-off 1.2 pmol l−1, P=0.0029). In multivariate analysis human chorionic gonadotropin β, tumour stage and grade were independent prognostic variables. The serum concentration of human chorionic gonadotropin β is an independent prognostic variable in renal cell carcinoma. The preoperative value of human chorionic gonadotropin β in serum may be used to identify patents with increased risk of progressive disease

Second-Trimester Placental and Thyroid Hormones Are Associated With Cognitive Development From Ages 1 to 3 Years

Adequate maternal thyroid hormone (TH) is necessary for fetal brain development. The role of placental human chorionic gonadotropin (hCG) in ensuring the production of TH is less well understood. The objective of the study was to evaluate 1) associations of placental hCG and its subunits, and maternal TH in the second trimester, and 2) the single and joint effects of TH and placental hormones on cognitive development and communication at ages 1 and 3 years. Fifty individuals (5%) were selected from the CANDLE (Conditions Affecting Neurocognitive Development and Early Learning) pregnancy cohort in Memphis, Tennessee, with recruitment from 2006 to 2011, to equally represent male and female fetuses. Participants were 68% Black and 32% White. Hormones measured were maternal thyroid (thyrotropin [TSH] and free thyroxine [FT4]) and placental hormones (hCG, its hyperglycosylated form [hCG-h], and free alpha- [hCG alpha] and beta-subunits [hCG beta]) in maternal serum (17-28 weeks). The primary outcome measurement was the Bayley Scales of Infant and Toddler Development. All forms of hCG were negatively associated with FT4 and not associated with TSH. hCG alpha was associated with cognitive development at age 1 year and jointly interacted with TSH to predict cognitive development at age 3 years. This pilot study added insight into the thyrotropic actions of hCG in the second trimester, and into the significance of this mechanism for brain development. More research is warranted to elucidate differences between hCG alpha, hCG beta, and hCG-h in relation to TH regulation and child brain function.Peer reviewe

Tail reconnection in the global magnetospheric context : Vlasiator first results

The key dynamics of the magnetotail have been researched for decades and have been associated with either three-dimensional (3-D) plasma instabilities and/or magnetic reconnection. We apply a global hybrid-Vlasov code, Vlasiator, to simulate reconnection self-consistently in the ion kinetic scales in the noon-midnight meridional plane, including both dayside and nightside reconnection regions within the same simulation box. Our simulation represents a numerical experiment, which turns off the 3-D instabilities but models ion-scale reconnection physically accurately in 2-D. We demonstrate that many known tail dynamics are present in the simulation without a full description of 3-D instabilities or without the detailed description of the electrons. While multiple reconnection sites can coexist in the plasma sheet, one reconnection point can start a global reconfiguration process, in which magnetic field lines become detached and a plasmoid is released. As the simulation run features temporally steady solar wind input, this global reconfiguration is not associated with sudden changes in the solar wind. Further, we show that lobe density variations originating from dayside reconnection may play an important role in stabilising tail reconnection.Peer reviewe

Ion distributions upstream and downstream of the Earth's bow shock : first results from Vlasiator

Peer reviewe

Evidence for transient, local ion foreshocks caused by dayside magnetopause reconnection

We present a scenario resulting in time-dependent behaviour of the bow shock and transient, local ion reflection under unchanging solar wind conditions. Dayside magnetopause reconnection produces flux transfer events driving fast-mode wave fronts in the magnetosheath. These fronts push out the bow shock surface due to their increased downstream pressure. The resulting bow shock deformations lead to a configuration favourable to localized ion reflection and thus the formation of transient, travelling foreshock-like field-aligned ion beams. This is identified in two-dimensional global magnetospheric hybrid-Vlasov simulations of the Earth's magnetosphere performed using the Vlasiator model (http://vlasiator.fmi.fi). We also present observational data showing the occurrence of dayside reconnection and flux transfer events at the same time as Geotail observations of transient foreshock-like field-aligned ion beams. The spacecraft is located well upstream of the fore-shock edge and the bow shock, during a steady southward interplanetary magnetic field and in the absence of any solar wind or interplanetary magnetic field perturbations. This indicates the formation of such localized ion foreshocks

Association between depressive symptoms and serum concentrations of homocysteine in men: a population study

http://deepblue.lib.umich.edu/bitstream/2027.42/51506/1/Tolmunen T, Association Between Depressive Symptoms, 2004.pd

Water

Meta-analysis can be a powerful tool for demonstrating the applicability of a concept beyond the context of individual clinical trials and observational studies, including exploration of effects across different subgroups. Meta-analysis avoids Simpson's paradox, in which a consistent effect in constituent trials is reversed when results are simply pooled. Meta-analysis in critical care medicine is made more complicated, however, by the heterogeneous nature of critically ill patients and the contexts within which they are treated. Failure to properly adjust for this heterogeneity risks missing important subgroup effects in, for example, the interaction of treatment with varying levels of baseline risk. When subgroups are defined by characteristics that vary within constituent trials (such as age) rather than features constant within each trial (such as drug dose), there is the additional risk of incorrect conclusions due to the ecological fallacy. The present review explains these problems and the strategies by which they are overcome