The Expression and Prognostic Value of the Peripheral Cannabinoid Receptor in Hermatological Malignancies

Non-Hodgkin’s lymphoma’s (NHLs) are a heterogeneous group of hematological malignancies with a large variation in clinical presentation, morphological appearance and prognosis. The NHLs make up the largest group (40-50%) of all hematological malignancies. In 2007, 17.700 people in the Netherlands had a non-Hodgkin’s lymphoma. Of these cases, 1.2/1000 was male and 1.2/1000 was female. The number of newly diagnosed NHL was 2800. In the same year, 1061 succumbed to the disease (585 male, 476 female)1. NHLs almost always arise from cells of the immune system resulting, in either B-cell or T-cell lymphomas. Most (approximately 85%) NHLs arise from their normal B-cell counterparts whereas a minority (approximately 15%) is derived from T-cells. Of the NHLs, approximately 65% arise in lymph nodes (nodal type), whereas the remaining 35% can arise in any organ (extra-nodal type). The most recent WHO classifi cation contains about 50 different (clinico-pathological) entities. Each entity is considered to have a normal physiological counterpart refl ecting the various differentiation stages in the lymphoid organs or bone marrow

Analytical and numerical study of the ground-track resonances of Dawn orbiting Vesta

The aim of Dawn mission is the acquisition of data from orbits around two bodies, (4)Vesta and (1)Ceres, the two most massive asteroids. Due to the low thrust propulsion, Dawn will slowly cross and transit through ground-track resonances, where the perturbations on Dawn orbit may be significant. In this context, to safety go the Dawn mission from the approach orbit to the lowest science orbit, it is essential to know the properties of the crossed resonances. This paper analytically investigates the properties of the major ground-track resonances (1:1, 1:2, 2:3 and 3:2) appearing for Vesta orbiters: location of the equilibria, aperture of the resonances and period at the stable equilibria. We develop a general method using an averaged Hamiltonian formulation with a spherical harmonic approximation of the gravity field. If the values of the gravity field coefficient change, our method stays correct and applicable. We also discuss the effect of one uncertainty on the C20 and C22 coefficients on the properties of the 1:1 resonance. These results are checked by numerical tests. We determine that the increase of the eccentricity appearing in the 2:3 resonance is due to the C22 and S22 coefficients. Our method can be easily adapted to missions similar to Dawn because, contrarily to the numerical results, the analytical formalism stays the same and is valid for a wide range of physical parameters of the asteroid (namely the shape and the mass) as well as for different spacecraft orbits. Finally we numerically study the probability of the capture in resonance 1:1. Our paper reproduces, explains and supplements the results of Tricarico and Sykes (2010).Comment: 34 pages, 9 figures, 10 Table

Mapping Vesta: First Results from Dawn’s Survey Orbit

The geologic objectives of the Dawn Mission [1] are to derive Vesta’s shape, map the surface geology, understand the geological context and contribute to the determination of the asteroids’ origin and evolution.Geomorphology and distribution of surface features will provide evidence for impact cratering, tectonic activity, volcanism, and regolith processes. Spectral measurements of the surface will provide evidence of the compositional characteristics of geological units. Age information, as derived from crater sizefrequency distributions, provides the stratigraphic context for the structural and compositional mapping results, thus revealing the geologic history of Vesta. We present here the first results of the Dawn mission from data collected during the approach to Vesta, and its first discrete orbit phase – the Survey Orbit, which lasts 21 days after the spacecraft had established a circular polar orbit at a radius of ~3000 km with a beta angle of 10°-15°

Randomised trial of glutamine and selenium supplemented parenteral nutrition for critically ill patients

Background: Mortality rates in the Intensive Care Unit and subsequent hospital mortality rates in the UK remain high. Infections in Intensive Care are associated with a 2–3 times increased risk of death. It is thought that under conditions of severe metabolic stress glutamine becomes "conditionally essential". Selenium is an essential trace element that has antioxidant and anti-inflammatory properties. Approximately 23% of patients in Intensive Care require parenteral nutrition and glutamine and selenium are either absent or present in low amounts. Both glutamine and selenium have the potential to influence the immune system through independent biochemical pathways. Systematic reviews suggest that supplementing parenteral nutrition in critical illness with glutamine or selenium may reduce infections and mortality. Pilot data has shown that more than 50% of participants developed infections, typically resistant organisms. We are powered to show definitively whether supplementation of PN with either glutamine or selenium is effective at reducing new infections in critically ill patients. Methods/design: 2 × 2 factorial, pragmatic, multicentre, double-blind, randomised controlled trial. The trial has an enrolment target of 500 patients. Inclusion criteria include: expected to be in critical care for at least 48 hours, aged 16 years or over, patients who require parenteral nutrition and are expected to have at least half their daily nutritional requirements given by that route. Allocation is to one of four iso-caloric, iso-nitrogenous groups: glutamine, selenium, both glutamine & selenium or no additional glutamine or selenium. Trial supplementation is given for up to seven days on the Intensive Care Unit and subsequent wards if practicable. The primary outcomes are episodes of infection in the 14 days after starting trial nutrition and mortality. Secondary outcomes include antibiotic usage, length of hospital stay, quality of life and cost-effectiveness. Discussion: To date more than 285 patients have been recruited to the trial from 10 sites in Scotland. Recruitment is due to finish in August 2008 with a further six months follow up. We expect to report the results of the trial in summer 2009. Trial registration: This trial is registered with the International Standard Randomised Controlled Trial Number system. ISRCTN87144826Not peer reviewedPublisher PD

Developing core sets for persons following amputation based on the International Classification of Functioning, Disability and Health as a way to specify functioning

Amputation is a common late stage sequel of peripheral vascular disease and diabetes or a sequel of accidental trauma, civil unrest and landmines. The functional impairments affect many facets of life including but not limited to: Mobility; activities of daily living; body image and sexuality. Classification, measurement and comparison of the consequences of amputations has been impeded by the limited availability of internationally, multiculturally standardized instruments in the amputee setting. The introduction of the International Classification of Functioning, Disability and Health (ICF) by the World Health Assembly in May 2001 provides a globally accepted framework and classification system to describe, assess and compare function and disability. In order to facilitate the use of the ICF in everyday clinical practice and research, ICF core sets have been developed that focus on specific aspects of function typically associated with a particular disability. The objective of this paper is to outline the development process for the ICF core sets for persons following amputation. The ICF core sets are designed to translate the benefits of the ICF into clinical routine. The ICF core sets will be defined at a Consensus conference which will integrate evidence from preparatory studies, namely: (a) a systematic literature review regarding the outcome measures of clinical trails and observational studies, (b) semi-structured patient interviews, (c) international experts participating in an internet-based survey, and (d) cross-sectional, multi-center studies for clinical applicability. To validate the ICF core sets field-testing will follow. Invitation for participation: The development of ICF Core Sets is an inclusive and open process. Anyone who wishes to actively participate in this process is invited to do so

Extensive water ice within Ceres’ aqueously altered regolith: Evidence from nuclear spectroscopy

The surface elemental composition of dwarf planet Ceres constrains its regolith ice content, aqueous alteration processes, and interior evolution. Using nuclear spectroscopy data acquired by NASA’s Dawn mission, we determined the concentrations of H, Fe, and K on Ceres. The data show that surface materials were processed by the action of water within the interior. The non-icy portion of Ceres’ C-bearing regolith contains similar amounts of H to aqueously altered carbonaceous chondrites, but less Fe. This allows for the possibility that Ceres experienced modest ice-rock fractionation, resulting in differences between surface and bulk composition. At mid-to-high latitudes, the regolith contains high concentrations of H, consistent with broad expanses of water ice, confirming theoretical predictions that ice can survive for billions of years just beneath the surface

Flash glucose monitoring with the FreeStyle Libre 2 compared with self-monitoring of blood glucose in suboptimally controlled type 1 diabetes: the FLASH-UK randomised controlled trial protocol.

INTRODUCTION: Optimising glycaemic control in type 1 diabetes (T1D) remains challenging. Flash glucose monitoring with FreeStyle Libre 2 (FSL2) is a novel alternative to the current standard of care self-monitoring of blood glucose (SMBG). No randomised controlled trials to date have explored the potential benefits of FSL2 in T1D. We aim to assess the impact of FSL2 in people with suboptimal glycaemic control T1D in comparison with SMBG. METHODS: This open-label, multicentre, randomised (via stochastic minimisation), parallel design study conducted at eight UK secondary and primary care centres will aim to recruit 180 people age ≥16 years with T1D for >1 year and glycated haemoglobin (HbA1c) 7.5%-11%. Eligible participants will be randomised to 24 weeks of FSL2 (intervention) or SMBG (control) periods, after 2-week of blinded sensor wear. Participants will be assessed virtually or in-person owing to the COVID-19 pandemic. HbA1c will be measured at baseline, 12 and 24 weeks (primary outcome). Participants will be contacted at 4 and 12 weeks for glucose optimisation. Control participants will wear a blinded sensor during the last 2 weeks. Psychosocial outcomes will be measured at baseline and 24 weeks. Secondary outcomes include sensor-based metrics, insulin doses, adverse events and self-report psychosocial measures. Utility, acceptability, expectations and experience of using FSL2 will be explored. Data on health service resource utilisation will be collected. ANALYSIS: Efficacy analyses will follow intention-to-treat principle. Outcomes will be analysed using analysis of covariance, adjusted for the baseline value of the corresponding outcome, minimisation factors and other known prognostic factors. Both within-trial and life-time economic evaluations, informed by modelling from the perspective of the National Health Service setting, will be performed. ETHICS: The study was approved by Greater Manchester West Research Ethics Committee (reference 19/NW/0081). Informed consent will be sought from all participants. TRIAL REGISTRATION NUMBER: NCT03815006. PROTOCOL VERSION: 4.0 dated 29 June 2020.Diabetes U