Physical Function and Quality of Life After Resection of Mobile Spine Chondrosarcoma.

Study Design:Retrospective cohort study. Objectives:(1) To assess patient-reported outcomes-physical function, pain, and quality of life-in patients who underwent resection of a mobile spine chondrosarcoma. (2) To assess complications (90 days), readmissions, reoperations, oncological outcomes, and neurologic status. Methods:Thirty-three patients with spinal conventional chondrosarcoma resection between 1984 and 2014 at one hospital were included. The primary outcome measures were-minimally 6 months after surgery-the EuroQol 5 Dimensions (EQ5D), PROMIS-Physical Function, PROMIS-Pain Intensity, and Oswestry (ODI) Disability Index, or Neck (NDI) Disability established in 14 out of 20 alive (70.0%) patients. Complications, readmission, reoperations, oncological outcomes, and neurological status were reported for the complete cohort of 33 patients. Results:After spine chondrosarcoma resection, patients (n = 14) reported worse physical function (median 43, range 22-61, P = .026), worse quality of life (median EQ5D 0.70, range 0.04-1, P = .022), and comparable pain intensity (median 47, range 31-56, P = .362) when compared with US general population values. The median NDI/ODI was 25 (range 0-72) indicating mild to moderate disability. Patients undergoing reoperation had worse patient-reported outcomes than those who did not. Eighteen (55.5%) out of 33 patients suffered complications (90 days), 14 (42.4%) had unplanned readmission, and 13 (39.4%) underwent reoperation. Intralesional resection was associated with increased readmission, reoperation, and recurrence rate. Conclusions:Chondrosarcoma affects quality of life and physical function and its treatment frequently results in complications and reoperations. Our findings can be used to inform future patients about expected outcomes

Intramedullary nailing versus sliding hip screw for A1 and A2 trochanteric hip fractures

AIMS: This study evaluated variation in the surgical treatment of stable (A1) and unstable (A2) trochanteric hip fractures among an international group of orthopaedic surgeons, and determined the influence of patient, fracture, and surgeon characteristics on choice of implant (intramedullary nailing (IMN) versus sliding hip screw (SHS)). METHODS: A total of 128 orthopaedic surgeons in the Science of Variation Group evaluated radiographs of 30 patients with Type A1 and A2 trochanteric hip fractures and indicated their preferred treatment: IMN or SHS. The management of Type A3 (reverse obliquity) trochanteric fractures was not evaluated. Agreement between surgeons was calculated using multirater kappa. Multivariate logistic regression models were used to assess whether patient, fracture, and surgeon characteristics were independently associated with choice of implant. RESULTS: The overall agreement between surgeons on implant choice was fair (kappa = 0.27 (95% confidence interval (CI) 0.25 to 0.28)). Factors associated with preference for IMN included USA compared to Europe or the UK (Europe odds ratio (OR) 0.56 (95% CI 0.47 to 0.67); UK OR 0.16 (95% CI 0.12 to 0.22); p < 0.001); exposure to IMN only during training compared to surgeons that were exposed to both (only IMN during training OR 2.6 (95% CI 2.0 to 3.4); p < 0.001); and A2 compared to A1 fractures (Type A2 OR 10 (95% CI 8.4 to 12); p < 0.001). CONCLUSION: In an international cohort of orthopaedic surgeons, there was a large variation in implant preference for patients with A1 and A2 trochanteric fractures. This is due to surgeon bias (country of practice and aspects of training). The observation that surgeons favoured the more expensive implant (IMN) in the absence of convincing evidence of its superiority suggests that surgeon de-biasing strategies may be a useful focus for optimizing patient outcomes and promoting value-based healthcare. Cite this article: Bone Joint J 2021;103-B(4):775-781

Granulation in K-type Dwarf Stars. II. Hydrodynamic simulations and 3D spectrum synthesis

We construct a 3D radiative-hydrodynamic model atmosphere of parameters Teff = 4820 K, log g = 4.5, and solar chemical composition. The theoretical line profiles computed with this model are asymmetric, with their bisectors having a characteristic C-shape and their core wavelengths shifted with respect to their laboratory values. The line bisectors span from about 10 to 250 m/s, depending on line strength, with the stronger features showing larger span. The corresponding core wavelength shifts range from about -200 m/s for the weak Fe I lines to almost +100 m/s in the strong Fe I features. Based on observational results for the Sun, we argue that there should be no core wavelength shift for Fe I lines of EW > 100 mA. The cores of the strongest lines show contributions from the uncertain top layers of the model, where non-LTE effects and the presence of the chromosphere, which are important in real stars, are not accounted for. The comparison of model predictions to observed Fe I line bisectors and core wavelength shifts for a reference star, HIP86400, shows excellent agreement, with the exception of the core wavelength shifts of the strongest features, for which we suspect inaccurate theoretical values. Since this limitation does not affect the predicted line equivalent widths significantly, we consider our 3D model validated for photospheric abundance work.Comment: A&A, in pres

The Position of High Frequency Waves with Respect to the Granulation Pattern

High frequency velocity oscillations were observed in the spectral lines Fe I 543.45nm and 543.29nm, using 2D spectroscopy with a Fabry- Perot and speckle reconstruction, at the VTT in Tenerife. We investigate the radial component of waves with frequencies in the range 8 - 22mHz in the internetwork, network and a pore. We find that the occurrence of waves do not show any preference on location and are equally distributed over down-flows and up-flows, regardless of the activity of the observed area in the line of Fe I 543.45nm. The waves observed in the lower formed line of Fe I 543.29nm seem to appear preferentially over down-flows.Comment: Article has 12 pages and 7 images. It is accepted in Solar Physics Journa

Stromal cells support the survival of human primary chronic lymphocytic leukemia (CLL) cells through Lyn-driven extracellular vesicles

Introduction In chronic lymphocytic leukemia (CLL), the tumor cells receive survival support from stromal cells through direct cell contact, soluble factors and extracellular vesicles (EVs). The protein tyrosine kinase Lyn is aberrantly expressed in the malignant and stromal cells in CLL tissue. We studied the role of Lyn in the EV-based communication and tumor support. Methods We compared the Lyn-dependent EV release, uptake and functionality using Lyn-proficient (wild-type) and -deficient stromal cells and primary CLL cells. Results Lyn-proficient cells caused a significantly higher EV release and EV uptake as compared to Lyn-deficient cells and also conferred stronger support of primary CLL cells. Proteomic comparison of the EVs from Lyn-proficient and -deficient stromal cells revealed 70 significantly differentially expressed proteins. Gene ontology studies categorized many of which to organization of the extracellular matrix, such as collagen, fibronectin, fibrillin, Lysyl oxidase like 2, integrins and endosialin (CD248). In terms of function, a knockdown of CD248 in Lyn+ HS-5 cells resulted in a diminished B-CLL cell feeding capacity compared to wildtype or scrambled control cells. CD248 is a marker of certain tumors and cancer-associated fibroblast (CAF) and crosslinks fibronectin and collagen in a membrane-associated context. Conclusion Our data provide preclinical evidence that the tyrosine kinase Lyn crucially influences the EV-based communication between stromal and primary B-CLL cells by raising EV release and altering the concentration of functional molecules of the extracellular matrix

Incidence of cardiovascular disease up to 13 year after cancer diagnosis:A matched cohort study among 32 757 cancer survivors

We examined the incidence of cardiovascular disease (CVD) among 32 757 cancer survivors and age-, gender-, and geographically matched cancer-free controls during a follow-up period of 1-13 years, and explored whetherCVD incidence differed by received cancer treatment, traditional cardiovascular risk factors, age, or gender. Adult 1-year cancer survivors without a history ofCVD diagnosed with breast (n = 6762), prostate (n = 4504), non-Hodgkin (n = 1553), Hodgkin (n = 173), lung and trachea (n = 2661), basal cell carcinoma (BCC; n = 12 476), and colorectal (n = 4628) cancer during 1999-2011 were selected from the Netherlands Cancer Registry and matched to cancer-free controls without a history ofCVD. Drug dispenses and hospitalizations from thePHARMO Database Network were used as proxy forCVD. Data were analyzed using Cox regression analyses. Prostate (HR: 1.17; 95%CI: 1.01-1.35) and lung and trachea (HR: 1.48; 95%CI: 1.10-1.97) cancer survivors had an increased risk for developingCVD compared to cancer-free controls. This increased risk among lung and trachea cancer survivors remained statistically significant after including traditional cardiovascular risk factors and cancer treatment information (HR: 1.41; 95%CI: 1.06-1.89). Among prostate cancer survivors, the increased risk of incidentCVD was limited to those who received hormones and those without traditional cardiovascular risk factors. Breast, non-Hodgkin,BCC, and colorectal cancer survivors showed no increasedCVD risk compared to cancer-free controls. There was an increased risk of incidentCVD among prostate, and lung and trachea cancer survivors compared to age-, gender- and geographically matched cancer-free controls. Studies including longer follow-up periods are warranted to examine whether cancer survivors are at increased risk of long-term incidentCVD

Solar granulation from photosphere to low chromosphere observed in BaII 4554 A line

The purpose of this paper is to characterize the statistical properties of solar granulation in the photosphere and low chromosphere up to 650 km. We use velocity and intensity variations obtained at different atmospheric heights from observations in BaII 4554 A. The observations were done during good seeing conditions at the VTT at the Observatorio del Teide on Tenerife. The line core forms rather high in the atmosphere and allows granulation properties to be studied at heights that have been not accessed before in similar studies. In addition, we analyze the synthetic profiles of the BaII 4554 A line by the same method computed taking NLTE effects into account in the 3D hydrodynamical model atmosphere. We suggest a 16-column model of solar granulation depending on the direction of motion and on the intensity contrast measured in the continuum and in the uppermost layer. We calculate the heights of intensity contrast sign reversal and velocity sign reversal. We show that both parameters depend strongly on the granulation velocity and intensity at the bottom photosphere. The larger the two parameters, the higher the reversal takes place in the atmosphere. On average, this happens at about 200-300 km. We suggest that this number also depends on the line depth of the spectral line used in observations. Despite the intensity and velocity reversal, about 40% of the column structure of granulation is preserved up to heights around 650 km.Comment: accepted by Astronomy and Astrophysic

Changes in autofluorescence based organoid model of muscle invasive urinary bladder cancer

Muscle invasive urinary bladder cancer is one of the most lethal cancers and its detection at the time of transurethral resection remains limited and diagnostic methods are urgently needed. We have developed a muscle invasive transitional cell carcinoma (TCC) model of the bladder using porcine bladder scaffold and the human bladder cancer cell line 5637. The progression of implanted cancer cells to muscle invasion can be monitored by measuring changes in the spectrum of endogenous fluorophores such as reduced nicotinamide dinucleotide (NADH) and flavins. We believe this could act as a useful tool for the study of fluorescence dynamics of developing muscle invasive bladder cancer in patients