The response of neotropical dragonflies (Insecta: Odonata) to local and regional abiotic factors in small streams of the Amazon

Since the relative role of local and regional abiotic factors on the Odonata diversity in rainforest streams is still poorly understood, we evaluated the effects of these factors on adult Odonata (Insecta) from preserved and altered streams in the Amazonian region. Adult Odonata were sampled in 98 streams in the Eastern Amazon, Pará, Brazil. Six variables were used to measure local environmental factors: habitat integrity index; mean canopy over the channel; and four physical and chemical descriptors of the water. To measure regional environmental factors, six variables were also used: altitude gradient, three bioclimatic variables and two percentage forest variables. In partial redundancy analysis, both abiotic factors (local and regional) were important to explain the variation in the Odonata community. The Odonata community can be influenced by regional and local factors. The relationship between Odonata and the local (e.g., integrity, canopy cover, and physical and chemical descriptors of the water) and regional (e.g., bioclimatic and forest cover variables) environmental variables recorded in this study has important implications for the use of these organisms to monitor small streams of the Eastern Amazon. The scale at which habitat is measured is an important issue in community structuring studies considering the rapid environmental changes. It is of great importance to consider the different scales in studies assessing community structure, once an adequate habitat must meet the ecological needs of all stages of the life of the Odonata.Funding Agency National Council for Scientific and Technological Development (CNPq) CNPq Amazonian Biodiversity and Land Use project CNPq 574008/2008-0 Brazilian Agricultural Research Company-EMBRAPA SEG: 02.08.06.005.00 Darwin Initiative, United Kingdom 17-023 Nature Conservancy and Natural Environment Research Council (NERC) NE/F01614X/1 NE/G000816/1 National Council for Scientific and Technological Development (CNPq) 307597/2016-4 Portuguese Foundation for Science and Technology UID/Multi/04326/2019 PROPESP/UFPA through Edital 01/2018 (Programa de Apoio a Publicacao Qualificada-PAPQ)info:eu-repo/semantics/publishedVersio

Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of hepatocellular carcinoma

Patients with advanced hepatocellular carcinoma (HCC) have historically had few options and faced extremely poor prognoses if their disease progressed after standard-of-care tyrosine kinase inhibitors (TKIs). Recently, the standard of care for HCC has been transformed as a combination of the immune checkpoint inhibitor (ICI) atezolizumab plus the anti-vascular endothelial growth factor (VEGF) antibody bevacizumab was shown to offer improved overall survival in the first-line setting. Immunotherapy has demonstrated safety and efficacy in later lines of therapy as well, and ongoing trials are investigating novel combinations of ICIs and TKIs, in addition to interventions earlier in the course of disease or in combination with liver-directed therapies. Because HCC usually develops against a background of cirrhosis, immunotherapy for liver tumors is complex and oncologists need to account for both immunological and hepatological considerations when developing a treatment plan for their patients. To provide guidance to the oncology community on important concerns for the immunotherapeutic care of HCC, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel of experts to develop a clinical practice guideline (CPG). The expert panel drew on the published literature as well as their clinical experience to develop recommendations for healthcare professionals on these important aspects of immunotherapeutic treatment for HCC, including diagnosis and staging, treatment planning, immune-related adverse events (irAEs), and patient quality of life (QOL) considerations. The evidence- and consensus-based recommendations in this CPG are intended to give guidance to cancer care providers treating patients with HCC

Fire Protection Analysis of a Fresno Elementary School

This report details the fire and life safety analysis of a Fresno Elementary School. Both prescriptive and performance based analysis were used to determine compliance with the building codes and fire codes which the building was constructed under. The prescriptive analyses included evaluation of the egress system, structural fire protection requirements, fire detection and alarm system and fire suppression systems. The prescriptive analyses were done to show the code requirements and how the building complies with them. The performance analyses were done to analyze the performance of the building in the event of a fire scenario. Three fire scenarios were modeled using guidelines from NFPA 101. The available safe egress time (ASET) and the required safe egress time (RSET) were both reviewed to determine the safety and ability to exit the building of occupants in a fire scenario. Fire Dynamics Simulator (FDS) was used for this analysis. Recommendations based on the performance and prescriptive analyses are presented

Characterization of response to atezolizumab + bevacizumab versus sorafenib for hepatocellular carcinoma: Results from the IMbrave150 trial

Background: IMbrave150 is a phase III trial that assessed atezolizumab + bevacizumab (ATEZO/BEV) versus sorafenib (SOR) in patients with unresectable hepatocellular carcinoma (HCC) and demonstrated a significant improvement in clinical outcomes. Exploratory analyses characterized objective response rate (ORR), depth (DpR), and duration of response (DoR), and patients with a complete response (CR). Methods: Patients were randomized 2:1 to intravenous ATEZO (1200 mg) + BEV (15 mg/kg) every 3 weeks or oral SOR (400 mg) twice daily. Tumors were evaluated using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) and HCC-modified RECIST (mRECIST). ORR by prior treatment and largest baseline liver lesion size, DoR, time to response (TTR), and complete response (TTCR) were analyzed. Results: For both criteria, responses favored ATEZO/BEV versus SOR regardless of prior treatment and in patients with lesions ≥3 cm. Median TTR was 2.8 months per RECIST 1.1 (range: 1.2-12.3 months) and 2.8 months per mRECIST (range: 1.1-12.3 months) with ATEZO/BEV. Patients receiving ATEZO/BEV had a greater DpR, per both criteria, across baseline liver lesion sizes. Characteristics of complete responders were similar to those of the intent-to-treat population. In complete responders receiving ATEZO/BEV per mRECIST versus RECIST 1.1, respectively, median TTCR was shorter (5.5 vs. 7.0 months), mean baseline sum of lesion diameter was longer (5.0 [SD, 5.1] vs. 2.6 [SD, 1.4] cm), and mean largest liver lesion size was larger (4.8 [SD, 4.2] vs. 2.3 [SD, 1.0] cm). Conclusions: These data highlight the improved ORR, DpR, and CR rates with ATEZO/BEV in unresectable HCC. Keywords: Response Evaluation Criteria in Solid Tumors; hepatocellular carcinoma; immunotherapy

Evolving strategies in the diagnosis of hepatocellular carcinoma

Background: Contrast-enhanced ultrasound (CE-US), con- trast CT scan and gadolinium dynamic MRI are recommended for the characterization of liver nodules detected during surveillance of patients with cirrhosis with US. Aim: To assess the sensitivity, specificity, diagnostic accuracy and economic impact of all possible sequential combinations of contrast imaging techniques in patients with cirrhosis with 1-2 cm liver nod- ules undergoing US surveillance. Methods: Sixty four patients with 67 de novo liver nodules (55 with a size of 1-2 cm) were consecutively examined by CE-US, CT, MRI, and a fine-needle biopsy (FNB) as a diagnostic standard. Undiagnosed nodules were re-biopsied; non-malignant nodules underwent enhanced imaging follow-up. The typical radiological feature of hepatocellular carcinoma (HCC) was arterial phase hypervascularisation followed by portal/venous phase washout. Results: HCC was diagnosed in 44 (66%) nodules (2, 2 cm). The sensitivity of CE-US, CT and MRI for 1-2 cm HCC was 26%, 44% and 44%, repectively, with 100% specific- ity; the typical vascular pattern of HCC being identified in 22 (65%) by a single technique versus 12 (35%) by at least two techniques car- ried out at the same time point (p = 0.028). Compared with the cheapest dual examination (CE-US + CT), the cheapest single tech- nique of stepwise imaging diagnosis of HCC was equally expensive (euro 26,440 versus euro 28,667) but led to a 23% reduction of FNB procedures (p = 0.031). Conclusions: In patients with cirrhosis with a 1-2 cm nodule detected during surveillance, a single imaging technique showing a typical contrast pattern confidently permits the diagnosis of HCC, thereby reducing the need for FNB examinations

"Progettazione e Sviluppo di un sistema endoscopico per il monitoraggio nel decorso post-operatorio"

La maggior parte dei Dispositivi Medicali(DM) ha come utilizzatori finali il medico e i pazienti. Le indicazioni dei medici e degli operatori dell’ambiente ospedaliero sono alla base del processo di progettazione e sviluppo di un qualsiasi dispositivo medicale. In quanto sono loro, riscontrando problemi ogni giorno, ad avere le idee da cui possono nascere potenziali dispositivi utili. I campi di applicazione sono vari e spaziano dall’ambito diagnostico all’ambito della terapia e della riabilitazione. Questo progetto nasce dall’idea di Microtech s.r.l di creare un dispositivo medico per la diagnosi nel decorso post-operatorio in seguito ad interventi chirurgici, denominato LapDrain. Questo DM è particolarmente indicato in seguito a resezioni di stomaco, intestino e retto; anastomosi e suture a rischio. La progettazione di LapDrain può essere riassunta dalle seguenti fasi,tutte elaborate in questo progetto: 1.Analisi del contesto medico. 2.Stato dell’arte nel campo di applicazione. 3.Ricerca Brevettuale. 4.Analisi delle potenziali configurazioni e progettazione CAD. 5.Analisi e ricerca materiali. 6.Realizzazione prototipi. 7.Valutazioni sui sistemi di visione. 8.Scelta della configurazione finale. 9.Realizzazione del dispositivo. 10.Prove di resistenza meccanica. 11.Test in vivo. 12.Studio e stesura del fascicolo tecnico

Prestazioni diSistemi CDMA Multiportante su Canale Satellitare

Questo lavoro di Tesi consiste nell’analisi delle prestazioni di un sistema multiportante a divisione di codice (MC-CDMA) su canale satellitare, nella caratterizzazione del canale fisico per quanto riguarda la tratta in downlink Satellite-Terminale Mobile, l’implementazione software del simulatore. Nel capitolo I si presenta la descrizione del sistema di trasmissione considerato, lo schema del modulatore , la codifica, la tecnica di accesso multiplo e lo scrambling; nel capitolo II è analizzato il canale satellitare , l’amplificatore di potenza, le tecniche di compensazione del canale non lineare, il fading dovuto a shadowing e multipath, la sua modellizzazione e l’equalizzazione; nel capitolo III si descrive il modello adottato e implementato nel simulatore, l’implementazione software del canale, la sua validazione nei riguardi di misurazioni effettuate, il comportamento nel tempo e in frequenza per diversi scenari considerati. Il capitolo IV espone le specifiche del sistema analizzato, la sua ottimizzazione su tale canale, i risultati delle simulazioni in termini di BER, i dovuti commenti e le conclusioni

The Effects of Explicit Reading Strategy Instruction and Cooperative Learning on Reading Comprehension in Fourth Grade Students

The purpose of this study was to investigate the effects of explicit direct instruction and cooperative learning on reading comprehension in fourth grade students. A quasi-experimental design was used. There were six cognitive and three affective measures used to collect quantitative data. Cognitive measures included California State Test scores, Accelerated Reader test scores, STAR Reading Test scores, Selection Test scores for MacMillan CA Treasures Series, Metacognitive Strategy Index (MSI), and district benchmark assessments. Affective measures included the Motivation to Read Profile (MRP) for both Self-Concept and Value of Reading and an overall enjoyment survey. This study took place at two elementary schools in the suburban San Francisco Bay Area during a six-week period of instruction. Two fourth grade classes from each school site participated in the study. There were 105 participants. One group, which received explicit direct instruction and cooperative learning, consisted of 48 students. The second group, which received explicit direct instruction and independent seat work, consisted of 57 students. The students were taught the reading strategies of generating questions, making connections, summarizing, vocabulary building, and visualizing through explicit direct instruction. These strategies were practiced either independently or in cooperative learning groups. The data showed that students who performed better on the CST, which was used as a covariate, performed better on reading comprehension assessments in cooperative learning environments than students who scored lower on the CST. Students who scored lower on the covariate performed better with explicit direct instruction and independent practice work. Students in the cooperative learning group who scored higher on the covariate also reported a higher usage of reading comprehension strategies. Also, students in the independent work group who scored lower on the covariate reported more enjoyment for explicit direct instruction with independent work activities than higher scoring students. It can be concluded that lower performing readers benefit from explicit direct instruction with independent practice of reading comprehension strategies and higher performing readers benefit from explicit direct instruction with cooperative learning groups to practice reading comprehension strategies

Lack of Effect of Murine Norovirus Infection on a Mouse Model of Bacteria-Induced Colon Cancer

Murine norovirus (MNV) is endemic in mouse research facilities in the United States and Europe, with a prevalence as high as 58% to 64%. Because of MNV's orofecal route of infection, clinically silent persistent infections in some mouse strains, and proclivity for macrophage and dendritic cells, its presence in mouse colonies has potential to alter phenotypes in experimental mouse models, particularly those involving inflammation and immunologic responses. Although MNV is subclinical, not causing overt disease in immunocompetent mice, we found that MNV infection can accelerate bacteria-induced inflammatory bowel disease (IBD) progression in Mdr1a^(-/-) mice. The studies presented here examined whether MNV infection also affects the phenotype of a bacterially driven mouse model of inflammation-associated colon cancer in genetically susceptible Smad3^(-/-) mice. In vitro culture of bone-marrow—derived macrophages (BMDM) was used to determine whether MNV4 influenced macrophage cytokine production. For in vivo studies, Smad3-/- mice were infected with MNV4 one week prior to infection with Helicobacter. Mice were monitored for 17 to 32 wk for development of IBD and colon cancer, and tissues were analyzed histopathologically. Although in vitro infection of BMDM with MNV4 led to increased inflammatory cytokine production, infection with MNV4 in vivo did not result in any statistically significant differences in survival, IBD scores, tumor incidence, or tumor phenotype in Smad3^(-/-) mice. In addition, MNV infection alone did not result in IBD or colon cancer. Therefore MNV infection alone or in conjunction with Helicobacter does not alter the development or progression of IBD or colon cancer in Smad3^(-/-) mice

mRECIST for HCC: Performance and novel refinements

Summary In 2010, modified RECIST (mRECIST) criteria were proposed as a way of adapting the RECIST criteria to the particularities of hepatocellular carcinoma (HCC). We intended to overcome some limitations of RECIST in measuring tumour shrinkage with local and systemic therapies, and also to refine the assessment of progression that could be misinterpreted with conventional RECIST 1.1, due to clinical events related to the natural progression of chronic liver disease (development of ascites, enlargement of lymph nodes, etc.). mRECIST has served its purpose since being adopted or included in clinical practice guidelines (European, American and Asian) for the management of HCC; it has also been instrumental for assessing response and time-to-event endpoints in several phase II and III investigations. Nowadays, mRECIST has become the standard tool for measurement of radiological endpoints at early/intermediate stages of HCC. At advanced stages, guidelines recommend both methods. mRECIST has been proven to capture higher objective response rates in tumours treated with molecular therapies and those responses have shown to be independently associated with better survival. With the advent of novel treatment approaches (i.e. immunotherapy) and combination therapies there is a need to further refine and clarify some concepts around the performance of mRECIST. Similarly, changes in the landscape of standard of care at advanced stages of the disease are pointing towards progression-free survival as a potential primary endpoint in some phase III investigations, as effective therapies applied beyond progression might mask overall survival results. Strict recommendations for adopting this endpoint have been reported. Overall, we review the performance of mRECIST during the last decade, incorporating novel clarifications and refinements in light of emerging challenges in the study and management of HCC