Molecular markers in gliomas: impact for the clinician

Over the last decade, understanding of glioma on a molecular level has greatly expanded. However, optimal incorporation of molecular markers into clinical care is controversial. We briefly review the potential utility of molecular stratification in refining histologic diagnosis, prognosis, and treatment decisions, focussing on 1p/19q co-deletion, MGMT promoter methylation, EGFR mutations, and IDH mutation. The most recently discovered IDH mutation is a striking example of a rapid implementation of a molecular marker for prognostication into common clinical us

Appraisal of the Karnofsky Performance Status and proposal of a simple algorithmic system for its evaluation

BACKGROUND: For over 60 years, the Karnofsky Performance Status (KPS) has proven itself a valuable tool with which to perform measurement of and comparison between the functional statuses of individual patients. In recent decades conditions for patients have changed, and so too has the KPS undergone several adjustments since its initial development. DISCUSSION: The most important works regarding the KPS tend to focus upon a variety of issues, including but not limited to reliability, validity and health-related quality of life. Also discussed is the question of what quantity the KPS may in fact be said to measure. The KPS is increasingly used as a prognostic factor in patient assessment. Thus, questions regarding if and how it affects survival are relevant. In this paper, we propose an algorithm which uses a minimum of two and a maximum of three questions to facilitate an adequate and efficient evaluation of the KPS. SUMMARY: This review honors the original intention of the discoverer and gives an overview of adaptations made in recent years. The proposed algorithm suggests specific updates with the goal of ensuring continued adequacy and expediency in the determination of the KPS

Assessing Threshold Concepts for Information Literacy

This presentation was offered as part of the CUNY Library Assessment Conference, Reinventing Libraries: Reinventing Assessment, held at the City University of New York in June 2014

Ponašanje termički modificiranog drva u vanjskim uvjetima primjene – trajnost, abrazija i izgled

Thermally modified timber (TMT) is increasingly offered in Europe as an alternative to preservative treated timber. TMT durability in field tests as well as its moisture sorption behaviour in façade application was determined so as to consider its suitability for outdoor use. Additionally, abrasion and crack-formation of TMT deckings were examined and the optical appearance of a TMT façade was evaluated after 5 years of service. After 7.5 years exposure in ground contact, the various TMT materials tested were classed as “slightly durable” to “not durable” whereas the classification in above ground exposure was “very durable” to “moderately durable”, which was in line with the reduced moisture sorption of TMT in weathered application. Moreover, the TMT-decking showed less abrasion and crack-formation compared to references, though the TMT façade revealed considerable discoloration by weathering. Hence, the suitability of TMT for above ground use is suggested, but a surface treatment is obligatory if discoloration is objectionable.Termički modificirano drvo (TMT) sve se više nudi u Europi kao alternativa kemijski zaštićenom drvu. Za ocjenu prikladnosti TMT-a za vanjsku upotrebu ispitivana je biološka trajnost u vanjskim uvjetima, kao i sorpcija vode u elementima fasade. Dodatno je ispitivana otpornost na abraziju i nastajanje pukotina u TMT podovima, te je napravljen vizualni pregled TMT fasade nakon petogodišnje upotrebe. Nakon 7,5 godina izloženosti u dodiru s tlom, različiti TMT materijali ocijenjeni su kao "slabo otporni" do "neotporni" dok su ocjene tog istog materijala za izlaganje iznad tla bile "vrlo otporno" do "srednje otporno". Dobivene su ocjene, u skladu sa smanjenom sorpcijom vode TMT materijala u vanjskoj upotrebi. Štoviše, TMT podovi pokazali su manju abraziju i pukotine od referentnog drva, iako su TMT elementi fasade pokazali veću diskoloraciju uzrokovanu abiološkom razgradnjom. Dakle, TMT je u vanjskim uvjetima i iznad tla preporučljiv za upotrebu, ali uz obveznu površinsku obradu ako se želi izbjeći diskoloracija

Virtual reality in neurologic rehabilitation of spatial disorientation

BACKGROUND: Topographical disorientation (TD) is a severe and persistent impairment of spatial orientation and navigation in familiar as well as new environments and a common consequence of brain damage. Virtual reality (VR) provides a new tool for the assessment and rehabilitation of TD. In VR training programs different degrees of active motor control over navigation may be implemented (i.e. more passive spatial navigation vs. more active). Increasing demands of active motor control may overload those visuo-spatial resources necessary for learning spatial orientation and navigation. In the present study we used a VR-based verbally-guided passive navigation training program to improve general spatial abilities in neurologic patients with spatial disorientation. METHODS: Eleven neurologic patients with focal brain lesions, which showed deficits in spatial orientation, as well as 11 neurologic healthy controls performed a route finding training in a virtual environment. Participants learned and recalled different routes for navigation in a virtual city over five training sessions. Before and after VR training, general spatial abilities were assessed with standardized neuropsychological tests. RESULTS: Route finding ability in the VR task increased over the five training sessions. Moreover, both groups improved different aspects of spatial abilities after VR training in comparison to the spatial performance before VR training. CONCLUSIONS: Verbally-guided passive navigation training in VR enhances general spatial cognition in neurologic patients with spatial disorientation as well as in healthy controls and can therefore be useful in the rehabilitation of spatial deficits associated with TD

Performance of thermally modified timber (TMT) in outdoor application - durability, abrasion and optical appearance

Thermally modified timber (TMT) is increasingly offered in Europe as an alternative to preservative treated timber. TMT durability, infield tests as well as its moisture sorption behaviour in facade application was determined so as to consider its suitability for outdoor use. Additionally, abrasion and crack-formation of TMT deckings were examined and the optical appearance of a TMT facade was evaluated after 5 years of service. After 7.5 years exposure in ground contact, the various TMT materials tested were classed as "slightly durable" to "not durable" whereas the classification in above ground exposure was "very durable" to "moderately, durable", which was in line with the reduced moisture sorption of TMT in weathered application. Moreover, the TMT-decking showed less abrasion and crack-formation compared to references, though the TMT facade revealed considerable discoloration by weathering. Hence, the suitability of TMT for above ground use is suggested, but a surface treatment is obligatory if discoloration is objectionable

Prevalence and predictors of fatigue in glioblastoma: a prospective study

Background The main goal of this study was to assess frequency, clinical correlates, and independent predictors of fatigue in a homogeneous cohort of well-defined glioblastoma patients at baseline prior to combined radio-chemotherapy. Methods We prospectively included 65 glioblastoma patients at postsurgical baseline and assessed fatigue, sleepiness, mean bedtimes, mood disturbances, and clinical characteristics such as clinical performance status, presenting symptomatology, details on neurosurgical procedure, and tumor location and diameter as well as pharmacological treatment including antiepileptic drugs, antidepressants, and use of corticosteroids. Data on fatigue and sleepiness were measured with the Fatigue Severity Scale and the Epworth Sleepiness Scale, respectively, and compared with 130 age- and sex-matched healthy controls. Results We observed a significant correlation between fatigue and sleepiness scores in both patients (r = 0.26; P = .04) and controls (r = 0.36; P < .001). Only fatigue appeared to be more common in glioblastoma patients than in healthy controls (48% vs 11%; P < .001) but not the frequency of sleepiness (22% vs 19%; P = .43). Female sex was associated with increased fatigue frequency among glioblastoma patients but not among control participants. Multiple linear regression analyses identified depression, left-sided tumor location, and female sex as strongest associates of baseline fatigue severity. Conclusions Our findings indicate that glioblastoma patients are frequently affected by fatigue at baseline, suggesting that factors other than those related to radio- or chemotherapy have significant impact, particularly depression and tumor localizatio