Patients' Perceptions About Diagnosis And Treatment Of Chronic Myeloid Leukemia: A Cross-sectional Study Among Brazilian Patients.

Chronic myeloid leukemia (CML) requires strict daily compliance with oral medication and regular blood and bone marrow control tests. The objective was to evaluate CML patients' perceptions about the disease, their access to information regarding the diagnosis, monitoring and treatment, adverse effects and associations of these variables with patients' demographics, region and healthcare access. Prospective cross-sectional study among CML patients registered with the Brazilian Lymphoma and Leukemia Association (ABRALE). CML patients receiving treatment through the public healthcare system were interviewed by telephone. Among 1,102 patients interviewed, the symptoms most frequently leading them to seek medical care were weakness or fatigue. One third were diagnosed by means of routine tests. The time that elapsed between first symptoms and seeking medical care was 42.28 ± 154.21 days. Most patients had been tested at least once for Philadelphia chromosome, but 43.2% did not know the results. 64.8% had had polymerase chain reaction testing for the BCR/ABL gene every three months. 47% believed that CML could be controlled, but 33.1% believed that there was no treatment. About 24% reported occasionally stopping their medication. Imatinib was associated with nausea, cramps and muscle pain. Self-reported treatment adherence was significantly associated with normalized blood count, and positively associated with imatinib. There is a lack of information or understanding about disease monitoring tools among Brazilian CML patients; they are diagnosed quickly and have good access to treatment. Correct comprehension of CML control tools is impaired in Brazilian patients.0

A Human Cytomegalovirus-Encoded microRNA Regulates Expression of Multiple Viral Genes Involved in Replication

Although multiple studies have documented the expression of over 70 novel virus-encoded microRNAs (miRNAs), the targets and functions of most of these regulatory RNA species are unknown. In this study a comparative bioinformatics approach was employed to identify potential human cytomegalovirus (HCMV) mRNA targets of the virus-encoded miRNA miR-UL112-1. Bioinformatics analysis of the known HCMV mRNA 3′ untranslated regions (UTRs) revealed 14 potential viral transcripts that were predicted to contain functional target sites for miR-UL112-1. The potential target sites were screened using luciferase reporters that contain the HCMV 3′UTRs in co-transfection assays with miR-UL112-1. Three of the 14 HCMV miRNA targets were validated, including the major immediate early gene encoding IE72 (UL123, IE1), UL112/113, and UL120/121. Further analysis of IE72 regulation by miR-UL112-1 with clones encoding the complete major immediate early region revealed that the IE72 3′UTR target site is necessary and sufficient to direct miR-UL112-1-specific inhibition of expression in transfected cells. In addition, miR-UL112-1 regulation is mediated through translational inhibition rather than RNA degradation. Premature expression of miR-UL112-1 during HCMV infection resulted in a significant decrease in genomic viral DNA levels, suggesting a functional role for miR-UL112-1 in regulating the expression of genes involved in viral replication. This study demonstrates the ability of a viral miRNA to regulate multiple viral genes

Numerical Observation of a Tubular Phase in Anisotropic Membranes

We provide the first numerical evidence for the existence of a tubular phase, predicted by Radzihovsky and Toner (RT), for anisotropic tethered membranes without self-avoidance. Incorporating anisotropy into the bending rigidity of a simple model of a tethered membrane with free boundary conditions, we show that the model indeed has two phase transitions corresponding to the flat-to-tubular and tubular-to-crumpled transitions. For the tubular phase we measure the Flory exponent $\nu_F$ and the roughness exponent $\zeta$. We find $\nu_F=0.305(14)$ and $\zeta=0.895(60)$, which are in reasonable agreement with the theoretical predictions of RT --- $\nu_F=1/4$ and $\zeta=1$.Comment: 8 pages, LaTeX, REVTEX, final published versio

TBS (Trabecular Bone Score) Expands Understanding of Spaceflight Effects on the Lumbar Spine of Long-Duration Astronauts

Bone loss due to longduration spaceflight has been characterized by both DXA and QCT serial scans. It is unclear if these spaceflightinduced changes in bone mineral density (BMD) and structure result in increased fracture incidence. NASA astronauts currently fly 5 to 6month missions on the International Space Station (ISS) and at least one 12month mission is planned. While NASA has measured areal BMD (by DXA) and volumetric BMD (by QCT) and has estimated hip strength (by finite element models of QCT data, no method has yet been used to examine bone microarchitecture from lumbar spine (LS). DXA scans are routinely performed pre and postflight on all ISS astronauts to follow BMD changes associated with spaceflight. Trabecular Bone Score (TBS) is a relatively new method that measures greyscalelevel texture information extracted from LS DXA images and correlates with 3D parameters of bone microarchitecture. We evaluated the ability of LS TBS to discriminate changes in astronauts who have flown on ISS missions and to determine if TBS can provide additional information compared to DXA. Methods: Lumbar Spine (L14) DXA scans from 51 astronauts (mean age, 47 +/- 4 yrs) were divided into 3 groups based on the exercise regimens performed onboard the ISS. "PreARED" (exercise using a loadlimited resistive exercise device, <300 lb), "ARED" (exercise with a highload resistive exercise device, up to 600 lb) and "Bisphos+ARED" group (ARED exercise and a 70mg alendronate tablet once a week before and during flight, starting 17 days before launch). DXA scans were performed and analyzed on a Hologic Discovery W using the same technician for the pre and postflight scans. LSC for the LS in our laboratory is 0.025 g/sq. cm. TBS was performed at the Mercy Hospital, Cincinnati, Ohio on a similar Hologic computer. Data were analyzed using a paired, 2tailed Student's ttest for the difference between pre and postflight means. Percent change and % change per month are noted. Interpretation: Our data suggest that: TBS and DXA both detected significant decrements in the LS in these pre ARED astronauts, not unexpected given the insufficient loads provided by this early exercise device. TBS did not detect significant changes in the ARED or Bisphos+ARED groups while DXA did detect significant changes in the ARED astronauts. These findings suggest that DXA and TBS are detecting independent effects of bone loss interventions tested in ISS astronauts in space, which may be due to distinct effects of interventions on mineral content of separate cortical vs. trabecular bone. Conclusion: TBS, in conjunction with DXA BMD, may provide additional insight into the nature of changes (or lack thereof) in the microstructure of trabecular bone and the areal BMD of vertebral bodies

The Statistical Mechanics of Membranes

The fluctuations of two-dimensional extended objects membranes is a rich and exciting field with many solid results and a wide range of open issues. We review the distinct universality classes of membranes, determined by the local order, and the associated phase diagrams. After a discussion of several physical examples of membranes we turn to the physics of crystalline (or polymerized) membranes in which the individual monomers are rigidly bound. We discuss the phase diagram with particular attention to the dependence on the degree of self-avoidance and anisotropy. In each case we review and discuss analytic, numerical and experimental predictions of critical exponents and other key observables. Particular emphasis is given to the results obtained from the renormalization group epsilon-expansion. The resulting renormalization group flows and fixed points are illustrated graphically. The full technical details necessary to perform actual calculations are presented in the Appendices. We then turn to a discussion of the role of topological defects whose liberation leads to the hexatic and fluid universality classes. We finish with conclusions and a discussion of promising open directions for the future.Comment: 75 LaTeX pages, 36 figures. To appear in Physics Reports in the Proceedings of RG2000, Taxco, 199

Particle self-assembly on soft elastic shells

We use numerical simulations to show how noninteracting hard particles binding to a deformable elastic shell may self-assemble into a variety of linear patterns. This is a result of the nontrivial elastic response to deformations of shells. The morphology of the patterns can be controlled by the mechanical properties of the surface, and can be fine-tuned by varying the binding energy of the particles. We also repeat our calculations for a fully flexible chain and find that the chain conformations follow patterns similar to those formed by the nanoparticles under analogous conditions. We propose a simple way of understanding and sorting the different structures and relate it to the underlying shape transition of the shell. Finally, we discuss the implications of our results

Employee Attributions of the Why of HR Practices: Their Effects on Employee Attitudes and Behaviors, and Customer Satisfaction

The construct of Human Resource (HR) Attributions is introduced. We argue that the attributions that employees make about the reasons why management adopts the HR practices that it does have consequences for their attitudes and behaviors, and ultimately, unit performance. Drawing on the strategic HR literature, we propose a typology of five HR-Attribution dimensions. Utilizing data collected from a service firm, we show that employees make varying attributions for the same HR practices, and that these attributions are differentially associated with commitment and satisfaction. In turn, we show that these attitudes become shared within units and that they are related to unit-level organizational citizenship behaviors and customer satisfaction. Findings and implications are discussed

Classificação dos linfomas não-Hodgkin: estudo morfológico e imunoistoquímico de 145 casos

A classificação dos linfomas não-Hodgkin tem sido, ao longo dos últimos trinta anos, motivo de controvérsia. Várias classificações têm sido propostas em busca de um consenso entre patologistas e clínicos. Este trabalho teve como objetivo analisar criticamente três destas classificações através do estudo retrospectivo de 145 casos de linfomas primários de gânglio linfático selecionados do Serviço de Anatomia Patológica do Hospital Universitário Clementino Fraga Filho, entre 1979 e 1995. Os casos revistos foram classificados pelas propostas da Working Formulation, de Kiel e da Real. Testes imunoistoquímicos com os anticorpos anti-CD45, anti-CD20, anti-CD45RO e anti-CD30 foram realizados. Cento e sete casos (73,7%) apresentaram fenótipo B; 33 casos (22,7%), fenótipo T; e quatro casos foram nulos (linfoma anaplásico de grandes células). Foi possível prever o fenótipo pela morfologia em 89,4% dos casos. Os linfomas de alto grau predominaram (59,2%), sendo o linfoma centroblástico o de maior freqüência (31,7% ). Os linfomas foliculares representaram 29 casos (20%), com maior incidência dos de grandes células (31%) do que dos de pequenas células (27,5%). Quando comparadas as três classificações, observamos que determinados grupos da Working Formulation abrigam múltiplas entidades. Isto se deve ao fato de a classificação da Working Formulation ser baseada somente em achados morfológicos e, por isso, deve ter seu uso desaconselhado. Já a classificação de Kiel e a da Real devem ter o seu emprego estimulado, pois apresentam, além de uma boa análise histopatológica, um estudo imunológico que define entidades biológicas correlacionando-se, quando possível, com a célula de origem.The non-Hodgkin's lymphomas classifications have been a controversial reason for the last thirty years. Many classifications have been proposed trying to achieve a consensus among pathologists and clinicians. The objective of this study was to analyse critically three of these classifications by the retrospective study of 145 cases of lymph nodes primary lymphomas, selected from the department of Pathology of the Hospital Universitário Clementino Fraga Filho between 1979 and 1995. The revised cases were classifiedby the proposal of Working Formulation, Kiel and Real. Immunohistochemical detections were employed with antibodies anti-CD45, anti-CD20, anti-CD45RO and anti-CD30. One hundred and seven cases (73.7%) showed B phenotype; thirty three cases (22.7%), T phenotype and 4 cases were null (anaplastic large cell lymphomas). It was possible to predict the phenotype by the morphology in 89,4% of the cases.The high grade lymphomas predominated (59.2%), and the centroblastic lymphoma was more frequent (31.7%). The follicular lymphomas account for 29 cases (20%), the large cell type (31%) have more incidence than the small cell type (20%). Comparing the three classifications, we observed that certain Working Formulation's groups agglomerate multiple entities. This occurs because it is based only on morphologic characteristics, hence should not be used. Kiel and Real classifications should have their employ stimulated because they present a good histopathologic analysis, a immunologic study that defines biologic entities correlating, whenever possible, with the postulated normal counterpart

Advanced Hodgkin's lymphoma: results in 216 patients treated with ABVD in Brazil

The outcome of Hodgkin's lymphoma (HL) has markedly improved over the last few decades, placing HL among the human cancers with highest cure rates. However, data about treatment outcomes in developing countries are scarce. From 1996 to 2005, 370 consecutive patients with HL treated in three public institutions in Rio de Janeiro were identified. A total of 216 patients who presented with advanced stage (IIB-IV) HL were selected for the present analysis. Patients with advanced disease were treated with ABVD, complemented or not by radiation therapy. The median follow-up time of survivors was 6.3 years (1-11.8). Fifteen patients died during first-line treatment. The complete remission rate was 80%. The 5-year progression-free survival (PFS) and the 5-year overall survival (OS) probabilities were 69% and 83%, respectively. The 5-year PFS in low-risk and high-risk patients were 81% and 62% (p=0.003), respectively. The 5-year OS in low-risk and high-risk International Prognostic Score patients were 89% and 78% (p=0.02), respectively. The present study provides a representative estimate of current treatment results for advanced HL in public institutions in an urban area in Brazil. It is clear that full treatment can be given to most patients, although those with very low socio-economic status might require special attention and support. Since Brazil is a large country, with substantial interregional heterogeneity, a nationwide registry of HL patients is currently being implemented