Molecular testing for the clinical diagnosis of fibrolamellar carcinoma.

Fibrolamellar carcinoma has a distinctive morphology and immunophenotype, including cytokeratin 7 and CD68 co-expression. Despite the distinct findings, accurate diagnosis of fibrolamellar carcinoma continues to be a challenge. Recently, fibrolamellar carcinomas were found to harbor a characteristic somatic gene fusion, DNAJB1-PRKACA. A break-apart fluorescence in situ hybridization (FISH) assay was designed to detect this fusion event and to examine its diagnostic performance in a large, multicenter, multinational study. Cases initially classified as fibrolamellar carcinoma based on histological features were reviewed from 124 patients. Upon central review, 104 of the 124 cases were classified histologically as typical of fibrolamellar carcinoma, 12 cases as 'possible fibrolamellar carcinoma' and 8 cases as 'unlikely to be fibrolamellar carcinoma'. PRKACA FISH was positive for rearrangement in 102 of 103 (99%) typical fibrolamellar carcinomas, 9 of 12 'possible fibrolamellar carcinomas' and 0 of 8 cases 'unlikely to be fibrolamellar carcinomas'. Within the morphologically typical group of fibrolamellar carcinomas, two tumors with unusual FISH patterns were also identified. Both cases had the fusion gene DNAJB1-PRKACA, but one also had amplification of the fusion gene and one had heterozygous deletion of the normal PRKACA locus. In addition, 88 conventional hepatocellular carcinomas were evaluated with PRKACA FISH and all were negative. These findings demonstrate that FISH for the PRKACA rearrangement is a clinically useful tool to confirm the diagnosis of fibrolamellar carcinoma, with high sensitivity and specificity. A diagnosis of fibrolamellar carcinoma is more accurate when based on morphology plus confirmatory testing than when based on morphology alone

The application of a real-time rapid-prototyping environment for the behavioral rehabilitation of a lost function in rats

Abstract-In this paper we propose a Rapid Prototyping Environment (RPE) for real-time biosignal analysis including ECG, EEG, ECoG and EMG of humans and animals requiring a very precise time resolution. Based on the previous RPE which was mainly designed for developing Brain Computer Interfaces (BCI), the present solution offers tools for data preprocessing, analysis and visualization even in the case of high sampling rates and furthermore tools for precise cognitive stimulation. One application of the system, the analysis of multi-unit activity measured from the brain of a rat is presented to prove the efficiency of the proposed environment. The experimental setup was used to design and implement a biomimetic, biohybrid model for demonstrating the recovery of a learning function lost with age. Throughout the paper we discuss the components of the setup, the software structure and the online visualization. At the end we present results of a real-time experiment in which the model of the brain learned to react to the acquired signals

Cost-effectiveness of robot-assisted radical cystectomy vs open radical cystectomy for patients with bladder cancer

Importance The value to payers of robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) when compared with open radical cystectomy (ORC) for patients with bladder cancer is unclear. Objectives To compare the cost-effectiveness of iRARC with that of ORC. Design, Setting, and Participants This economic evaluation used individual patient data from a randomized clinical trial at 9 surgical centers in the United Kingdom. Patients with nonmetastatic bladder cancer were recruited from March 20, 2017, to January 29, 2020. The analysis used a health service perspective and a 90-day time horizon, with supplementary analyses exploring patient benefits up to 1 year. Deterministic and probabilistic sensitivity analyses were undertaken. Data were analyzed from January 13, 2022, to March 10, 2023. Interventions Patients were randomized to receive either iRARC (n = 169) or ORC (n = 169). Main Outcomes and Measures Costs of surgery were calculated using surgery timings and equipment costs, with other hospital data based on counts of activity. Quality-adjusted life-years were calculated from European Quality of Life 5-Dimension 5-Level instrument responses. Prespecified subgroup analyses were undertaken based on patient characteristics and type of diversion. Results A total of 305 patients with available outcome data were included in the analysis, with a mean (SD) age of 68.3 (8.1) years, and of whom 241 (79.0%) were men. Robot-assisted radical cystectomy was associated with statistically significant reductions in admissions to intensive therapy (6.35% [95% CI, 0.42%-12.28%]), and readmissions to hospital (14.56% [95% CI, 5.00%-24.11%]), but increases in theater time (31.35 [95% CI, 13.67-49.02] minutes). The additional cost of iRARC per patient was £1124 (95% CI, −£576 to £2824 [US $1622 (95$831 to $4075)]) with an associated gain in quality-adjusted life-years of 0.01124 (95$144 312) per quality-adjusted life-year gained. Robot-assisted radical cystectomy had a much higher probability of being cost-effective for subgroups defined by age, tumor stage, and performance status. Conclusions and Relevance In this economic evaluation of surgery for patients with bladder cancer, iRARC reduced short-term morbidity and some associated costs. While the resulting cost-effectiveness ratio was in excess of thresholds used by many publicly funded health systems, patient subgroups were identified for which iRARC had a high probability of being cost-effective

Auto-Design, Design-less or retro-Design

@article{RI-ZREIK-2002-2, author = {Zreik, K. and Beheshti, R.}, title = {Auto-Design, Design-less or retro-Design}, journal = {International Journal of Design Sciences and Technology}, year = {2002}, volume = {9}, number = {2}, pages = {93-102} }International audienc

Reflecting on the emerging e-design environment paradigms

@inproceedings{CI-ZREIK-2002, author = {Zreik, K. and Behehsti, R.}, title = {Reflecting on the emerging e-design environment paradigms}, booktitle = {European Conference on Information and Communication Technology Advances and Innovation in the Knowledge Society (ESMART'02)}, year = {2002}, address = {University of Salford, UK}, month = {November} }International audienc

Augmented Heritage: A Sustainable ICT Challenge

@inproceedings{CI-ZREIK-2005, author = {Zreik, K. and Beheshti, R.}, title = {Augmented Heritage: A Sustainable ICT Challenge}, year = {2005}, editor = {Europia}, booktitle = {Tenth International Conference on Design Sciences \& Technology}, address = {Damascus, Syrie}, month = {September} }International audienc

« The photographic experience of the city in the era of smartphones: being and acting in a hybrid space-time »

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