Predictive value of CA 125 and CA 72-4 in ovarian borderline tumors

Background: The aim of this study was to assess the prognostic value of cancer antigen (CA) 125 and CA 72-4 in patients with ovarian borderline tumor (BOT). Methods: All women diagnosed and treated for BOT at our institution between 1981 and 2008 were included into this retrospective study (n=101). Preoperatively collected serum samples were analyzed for CA 125 (Architect, Abbott and Elecsys, Roche) and CA 724 (Elecsys, Roche) with reference to clinical data and compared to healthy women (n=109) and ovarian cancer patients (n=130). Results: With a median of 34.7 U/mL (range 18.1-385.0 U/mL) for CA 125 and 2.3 U/mL (range 0.2-277.0 U/mL) for CA 72-4, serum tumor markers in BOT patients were significantly elevated as compared to healthy women with a median CA 125 of 13.5 U/mL (range 4.0-49.7 U/mL) and median CA 72-4 of 0.8 U/mL (range 0.2-20.6 U/mL). In addition, there was a significant difference compared with ovarian cancer patients who showed a median CA 125 of 401.5 U/mL (range 12.5-35,813 U/mL), but no difference was observed for CA 72-4 (median 3.9 U/mL, range 0.3-10,068 U/mL). Patients with a pT1a tumor stage had significantly lower values of CA 125 but not of CA 72-4 compared with individuals with higher tumor stages (median CA 125 29.9 U/mL for pT1a vs. 50.9 U/mL for) pT1a; p=0.014). There was a trend for increased concentrations of CA 125 but not of CA 72-4 in the presence of ascites, endometriosis or peritoneal implants at primary diagnosis. With respect to the prognostic value of CA 125 or CA 72-4, CA 125 was significantly higher at primary diagnosis in patients who later developed recurrence (251.0 U/mL vs. 34.65 U/mL, p=0.012). Conclusions: Serum CA 125 and CA 72-4 concentrations in BOT patients differ from healthy controls and patients with ovarian cancer. CA 125, but not CA 724, at primary diagnosis correlates with tumor stage and tends to be increased in the presence of ascites, endometriosis or peritoneal implants. Moreover, CA 125 at primary diagnosis appears to have prognostic value for recurrence. Clin Chem Lab Med 2009; 47:537-42

Efficacy of treatments against garlic mustard (Alliaria petiolata) and effects on forest understory plant diversity

Garlic mustard, an invasive exotic biennial herb, has been identified in the Upper Peninsula of Michigan, but is not yet widely distributed. We tested the effectiveness and impact of management tools for garlic mustard in northern hardwood forests. Six treatment types (no treatment control, hand-pull, herbicide, hand-pull/herbicide, scorch, and hand-pull/scorch) were applied within a northern hardwood forest invaded by garlic mustard. We sampled understory vegetation within plots to compare garlic mustard abundance (distinguishing first and second year plants) and native plant diversity before and after treatment. Results immediately following treatment indicated that garlic mustard seedling abundance was significantly reduced by herbicide, hand-pull/herbicide, scorch, and hand-pull/scorch treatments, and that adult abundance was reduced by all treatments. However, sampling of treatment sites one year later showed an increase in seedling abundance in herbicide and hand-pull/herbicide plots. Adult garlic mustard abundance after one year was lower than the control with the exception of the hand-pull plots where adult abundance did not differ. After one year, understory species richness and Shannon’s Diversity were lower in the herbicide and pull/herbicide treatments. Based on these results, we conclude that single-year treatment of garlic mustard with hand-pulling, herbicide, and/or scorching is ineffective in reducing garlic mustard abundance and may inadvertently increase the success of garlic mustard, while negatively impacting native understory species

The diagnostic accuracy of two human epididymis protein 4 (HE4) testing systems in combination with CA125 in the differential diagnosis of ovarian masses

Background: Cancer antigen 125 (CA125) is the best known single tumor marker for ovarian cancer (OC). We investigated whether the additional information of the human epididymis protein 4 (HE4) improves diagnostic accuracy. Methods: We retrospectively analyzed preoperative sera of 109 healthy women, 285 patients with benign ovarian masses (cystadenoma: n = 78, leimyoma: n = 66, endometriosis: n = 52, functional ovarian cysts: n = 79, other: n = 10), 16 low malignant potential (LMP) ovarian tumors and 125 OC (stage 1: 22, II: 15, III: 78, IV: 10). CA 125 was analyzed using the ARCHITECT system, HE4 using the ARCHITECT(a) system and EIA(e) technology additionally. Results: The lowest concentrations of CA125 and HE4 were observed in healthy individuals, followed by patients with benign adnexal masses and patients with LMP tumors and OC. The area under the curve (AUC) for the differential diagnosis of adnexal masses of CA 125 alone was not significantly different to HE4 alone in premenopausal (CA 125: 86.7, HE4(a): 82.6, HE4(e): 81.6% p > 0.05) but significantly different in postmenopausal {[}CA125: 93.4 vs. HE4(a): 88.3 p = 0.023 and vs. HE4(e): 87.8% p=0.012] patients. For stage I OC, HE4 as a single marker was superior to CA 125, which was the best single marker in stage H-IV. The combination of CA 125 and HE4 using risk of malignancy algorithm (ROMA) gained the highest sensitivity at 95% specificity for the differential diagnosis of adnexal masses {[}CA 125: 70.9, HE4(a): 67.4, HE4(e): 66.0, ROMA(a): 76.6 and ROMA(e): 74.5%], especially in stage I OC {[}CA 125: 27.3, HE4(a): 40.9, HE4(e): 40.9, ROMA(a): 45.5 and ROMA(e): 45.5%]. Conclusions: CA 125 is still the best single marker in the diagnosis of OC. HE4 alone and even more the combined analysis of CA 125 and HE4 using ROMA improve the diagnostic accuracy of adnexal masses, especially in early OC

Struktur und Langzeitentwicklung von subalpinen Pinus montana Miller und Pinus cembra L. Wäldern in den zentraleuropäischen Alpen

Summary:: Since traditional agriculture and forestry are no longer economically viable in many regions of the European Alps, subalpine forests will become less managed or completely abandoned in the near future. Therefore, the interest in understanding how forest stands will develop after abandonment has increased considerably over the past two decades. While much is known about stand structure and stand development of Norway spruce (Picea abies L.) forests, almost no knowledge is available about the same processes in forest communities of the Central Alps. In the Swiss National Park (SNP), the forested area is comprised of mountain pine (Pinus montana Miller), Swiss stone pine/larch, (Pinus cembra L./Larix decidua L.). and mixed stands. When the Park was founded in 1914 all management activities were stopped. Therefore, this area offers the opportunity to study stand development and changes in stand structure after abandonment. We compared historic (1957) and present data (2001/02) from 19 stands that were grouped into characteristic stand types: "mountain pine”, "mixed”, and "stone pine”. We detected significant decreases in total tree density (stem/ha) and sapling density (saplings/ha) of 45 to 57%, and 64 to 76%, respectively, over the 45 years of observation for all stand types. These changes were strongly related to decreases in the number of shade intolerant mountain pine trees. Simultaneously, the amount of non-standing woody residue increased from less than 4 t/ha to 36 to67.7 t/ha, and the density of standing dead wood (stems/ha) decreased significantly between 72 and 94%. The biomass of standing dead wood (t/ha), however, changed only slightly between 1957 and 01/02. Our results describe the successional development of continental subalpine forests after abandonment and outlines changes that might take place in similar areas in the near futur

Adaptive Silviculture for Climate Change in the Mississippi National River and Recreation Area, an Urban National Park in the Twin Cities Area, Minnesota

The Adaptive Silviculture for Climate Change (ASCC) Network is a collaborative effort to establish a series of experimental silvicultural trials across different forest ecosystem types. A variety of partners have developed trial sites as part of this multi-regional study researching long-term ecosystem responses to a range of climate change adaptation actions. We are currently implementing an affiliate trial within the Mississippi National River and Recreation Area, a national park along the Mississippi River in the Twin Cities Metro Area of Minnesota

Fusing Science and Ethics: Tools for Natural Resource Educators

Natural resource educators are beginning to appreciate that formal critical thinking and ethical reasoning skills are not only important but absolutely necessary tools for the 21st century natural resource professional (both scientist and manager). However, given a historic lack of formal ethical reasoning within natural resource curricula combined with the separation of the sciences from the humanities over the past 100 years, a full embracing of ethics into natural resource curricula meets with resistance. One challenge associated with incorporating ethical reasoning into natural resource curricula appears to come from a misunderstanding of the very nature of ethics. While a certain characterization of ethics makes it appear to be at odds with science, intractable, and easy to dismiss, there are ways to characterize ethics and therefore allow for ethical discourse within the natural resource curricula that melds the two in a useful way. Another challenge involves the manner in which one recognizes, confronts, and works through ethical dilemmas. We address this problem by presenting some real-world examples amenable to ethical discourse and demonstrate how to work through at least two circumstances that are familiar to wildlife and forestry professionals. Finally, we suggest a minimal set of critical thinking and ethical reasoning skills that are crucial for the education of future natural resource professionals.Keywords: education, problem solving, ethics, natural resource sciences, critical thinkin

Normative Ethics Does Not Need a Foundation: It Needs More Science

The impact of science on ethics forms since long the subject of intense debate. Although there is a growing consensus that science can describe morality and explain its evolutionary origins, there is less consensus about the ability of science to provide input to the normative domain of ethics. Whereas defenders of a scientific normative ethics appeal to naturalism, its critics either see the naturalistic fallacy committed or argue that the relevance of science to normative ethics remains undemonstrated. In this paper, we argue that current scientific normative ethicists commit no fallacy, that criticisms of scientific ethics contradict each other, and that scientific insights are relevant to normative inquiries by informing ethics about the options open to the ethical debate. Moreover, when conceiving normative ethics as being a nonfoundational ethics, science can be used to evaluate every possible norm. This stands in contrast to foundational ethics in which some norms remain beyond scientific inquiry. Finally, we state that a difference in conception of normative ethics underlies the disagreement between proponents and opponents of a scientific ethics. Our argument is based on and preceded by a reconsideration of the notions naturalistic fallacy and foundational ethics. This argument differs from previous work in scientific ethics: whereas before the philosophical project of naturalizing the normative has been stressed, here we focus on concrete consequences of biological findings for normative decisions or on the day-to-day normative relevance of these scientific insights

Exon expression arrays as a tool to identify new cancer genes

Background: Identification of genes that are causally implicated in oncogenesis is a major goal in cancer research. An estimated 10-20% of cancer-related gene mutations result in skipping of one or more exons in the encoded transcripts. Here we report on a strategy to screen in a global fashion for such exon-skipping events using PAttern based Correlation (PAC). The PAC algorithm has been used previously to identify differentially expressed splice variants between two predefined subgroups. As genetic changes in cancer are sample specific, we tested the ability of PAC to identify aberrantly expressed exons in single samples. Principal Findings: As a proof-of-principle, we tested the PAC strategy on human cancer samples of which the complete coding sequence of eight cancer genes had been screened for mutations. PAC detected all seven exon-skipping mutants among 12 cancer cell lines. PAC also identified exon-skipping mutants in clinical cancer specimens although detection was compromised due to heterogeneous (wild-type) transcript expression. PAC reduced the number candidate genes/exons for subsequent mutational analysis by two to three orders of magnitude and had a substantial true positive rate. Importantly, of 112 randomly selected outlier exons, sequence analysis identified two novel exon skipping events, two novel base changes and 21 previously reported base changes (SNPs). Conclusions: The ability of PAC to enrich for mutated transcripts and to identify known and novel genetic changes confirms its suitability as a strategy to identify candidate cancer genes

Deep brain stimulation of the anterior nucleus of the thalamus in drug-resistant epilepsy in the MORE multicenter patient registry

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background and objectives: The efficacy of deep brain stimulation of the anterior nucleus of the thalamus (ANT DBS) in patients with drug-resistant epilepsy (DRE) was demonstrated in the double-blind Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy randomized controlled trial. The Medtronic Registry for Epilepsy (MORE) aims to understand the safety and longer-term effectiveness of ANT DBS therapy in routine clinical practice. Methods: MORE is an observational registry collecting prospective and retrospective clinical data. Participants were at least 18 years old, with focal DRE recruited across 25 centers from 13 countries. They were followed for at least 2 years in terms of seizure frequency (SF), responder rate (RR), health-related quality of life (Quality of Life in Epilepsy Inventory 31), depression, and safety outcomes. Results: Of the 191 patients recruited, 170 (mean [SD] age of 35.6 [10.7] years, 43% female) were implanted with DBS therapy and met all eligibility criteria. At baseline, 38% of patients reported cognitive impairment. The median monthly SF decreased by 33.1% from 15.8 at baseline to 8.8 at 2 years (p 10 implantations) had 42.8% reduction in median monthly SF by 2 years in comparison with 25.8% in low-volume center. In patients with cognitive impairment, the reduction in median monthly SF was 26.0% by 2 years compared with 36.1% in patients without cognitive impairment. The most frequently reported adverse events were changes (e.g., increased frequency/severity) in seizure (16%), memory impairment (patient-reported complaint, 15%), depressive mood (patient-reported complaint, 13%), and epilepsy (12%). One definite sudden unexpected death in epilepsy case was reported. Discussion: The MORE registry supports the effectiveness and safety of ANT DBS therapy in a real-world setting in the 2 years following implantation. Classification of evidence: This study provides Class IV evidence that ANT DBS reduces the frequency of seizures in patients with drug-resistant focal epilepsy.The MORE registry was sponsored and funded by Medtronic, plc.info:eu-repo/semantics/publishedVersio