Survival outcomes and treatment utilization among patients with known and unknown primary tumours in Ontario.

I identify two cohorts of cancer patients with known and unknown primary tumours. Cancer of unknown primary (CUP) is defined by the presence of pathologically identified metastatic disease without clinical or radiological evidence of a primary tumour. Using the Ontario Cancer Registry, Same Day Surgery/Discharge Abstract Database and Ontario Health Insurance Plan, a novel linkage strategy was developed to cross-validate diagnoses. I found CUP patients represent a significant portion of all metastatic cancers. CUP patients with histological confirmed disease, squamous cell histology, or metastases localized to nodal regions had significantly better survival than other CUP patients. Knowledge of the primary site was associated with significantly improved overall survival. Known primary patients were more likely to receive treatment than CUP patients. Treatment was associated with prolonged survival in CUP patients. Adoption of gene profiling, emphasis on targeted therapeutics, and robust clinical guidelines are likely to improve CUP patient outcomes

HAR1 and LjAMP1 Dependent Regulation of Root Architecture in Lotus Japonicus

Here, I characterize a root-branching hypermorph of Lotus japonicus, called cluster root-like1 (crl1), which originated from a har1-1 suppressor screen. I have shown that the crl1 root phenotype is determined by two independently segregating recessive mutations, har1-1 and Ljamp1-1, with corresponding HAR1 and LjAMP1 encoding an LRR‑receptor-like kinase and a predicted homologue of the Arabidopsis ALTERED MERISTEM PROGRAM 1 protein, respectively. Unlike har1-1, the Ljamp1 mutation does not affect the symbiotic properties of L. japonicus Gifu but exerts a pleiotropic effect on shoot development. Root architecture, however, is regulated by a synergistic action of HAR1 and LjAMP1, as the simultaneous impairment of these two genes results in the determinate root growth phenotype. The steady state levels of several L. japonicus CLE transcripts are shown to be dramatically altered in har1-1 and Ljamp1-1 roots. The corresponding CLE peptides in conjugation with HAR1 and LjAMP1 may be crucial in specifying root architecture

Intraabdominal Cryptococcal Lymphadenitis in a Patient with Systemic Lupus Erythematosus

Cryptococcal infection is a rare, yet well recognized complication of systemic lupus erythematosus (SLE). We present a case of mesenteric and retroperitoneal cryptococcal lymphadenitis resulting in the obstruction of the stomach and proximal duodenum in a patient suffering from SLE, while recently she did not receive any immunosuppressive treatment. A 42-yr-old woman was admitted due to high fever and diffuse abdominal pain for three weeks. Abdominal computed tomography (CT) scan showed multiple conglomerated lymphadenopathies in the retroperitoneum and the mesentery resulting in luminal narrowing of the third portion of the duodenum. Cryptococcal lymphadenitis was proven by needle biopsy and she was treated with intravenous liposomal amphotericin B, followed by oral fluconazole. After fourteen-month antifungal therapies, the clinical symptoms and follow-up images improved. This case emphasize that the intrinsic immunological defects of SLE may be directly responsible for the predisposition to fungal infections

Group-Based Key Management Protocol for Energy Efficiency in Long-Lived and Large-Scale Distributed Sensor Networks

As wireless sensor networks grow, so does the need for effective security mechanisms. We propose a cryptographic key-management protocol, called energy-efficient key-management (EEKM) protocol. Using a location-based group key scheme, the protocol supports the revocation of compromised nodes and energy-efficient rekeying. The design is motivated by the observation that unicast-based rekeying does not meet the security requirements of periodic rekeying in long-lived wireless sensor networks. EEKM supports broadcast-based rekeying for low-energy key management and high resilience. In addition, to match the increasing complexity of encryption keys, the protocol uses a dynamic composition key scheme. EEKM also provides group-management protocols for secure group communication. We analyzed the energy efficiency and security of EEKM and compared it to other key-management protocols using a network simulator

The impact of sagittal balance on clinical results after posterior interbody fusion for patients with degenerative spondylolisthesis: A Pilot study

<p>Abstract</p> <p>Background</p> <p>Comparatively little is known about the relation between the sagittal vertical axis and clinical outcome in cases of degenerative lumbar spondylolisthesis. The objective of this study was to determine whether lumbar sagittal balance affects clinical outcomes after posterior interbody fusion. This series suggests that consideration of sagittal balance during posterior interbody fusion for degenerative spondylolisthesis can yield high levels of patient satisfaction and restore spinal balance</p> <p>Methods</p> <p>A retrospective study of clinical outcomes and a radiological review was performed on 18 patients with one or two level degenerative spondylolisthesis. Patients were divided into two groups: the patients without improvement in pelvic tilt, postoperatively (Group A; n = 10) and the patients with improvement in pelvic tilt postoperatively (Group B; n = 8). Pre- and postoperative clinical outcome surveys were administered to determine Visual Analogue Pain Scores (VAS) and Oswestry disability index (ODI). In addition, we evaluated full spine radiographic films for pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI), thoracic kyphosis (TK), lumbar lordosis (LL), sacrofemoral distance (SFD), and sacro C7 plumb line distance (SC7D)</p> <p>Results</p> <p>All 18 patients underwent surgery principally for the relief of radicular leg pain and back pain. In groups A and B, mean preoperative VAS were 6.85 and 6.81, respectively, and these improved to 3.20 and 1.63 at last follow-up. Mean preoperative ODI were 43.2 and 50.4, respectively, and these improved to 23.6 and 18.9 at last follow-up. In spinopelvic parameters, no significant difference was found between preoperative and follow up variables except PT in Group A. However, significant difference was found between the preoperative and follows up values of PT, SS, TK, LL, and SFD/SC7D in Group B. Between parameters of group A and B, there is borderline significance on preoperative PT, preoperative LL and last follow up SS.</p> <p>Correlation analysis revealed the VAS improvements in Group A were significantly related to postoperative lumbar lordosis (Pearson's coefficient = -0.829; p = 0.003). Similarly, ODI improvements were also associated with postoperative lumbar lordosis (Pearson's coefficient = -0.700; p = 0.024). However, in Group B, VAS and ODI improvements were not found to be related to postoperative lumbar lordosis and to spinopelvic parameters.</p> <p>Conclusion</p> <p>In the current series, patients improving PT after fusion were found to achieve good clinical outcomes in degenerative spondylolisthesis. Overall, our findings show that it is important to quantify sagittal spinopelvic parameters and promote sagittal balance when performing lumbar fusion for degenerative spondylolisthesis.</p

Analysis and Tests of the Behavior of an Underwater Acoustic Horizontal Array Platform

Most underwater acoustic arrays for low frequency operation are deployed vertically, but a mid-range frequency horizontal array system is being developed by the Korea Research Institute of Ships and Ocean Engineering (KRISO). The horizontal array platform is deployed underwater and kept in place by weather vaning mooring. This is essential because it is nearly impossible to keep a submerged body at a given position in the water without any external force. Hence, the horizontal array platform can maintain the desired position in the presence of a weak tidal current. The objective of this study is to design an underwater platform that can maintain its horizontal position in a weak current. First, the authors investigated various virtual models, selected one of the models, and performed a small model test of the selected model at a basin. We calculated the external forces associated with the 2D motion, and then we conducted a large basin test followed by a circulation water channel test for the manufactured array platform. The results of the simplified 2D motion calculation essentially matched the results of the underwater test