Developing a methodology for three-dimensional correlation of PET–CT images and whole-mount histopathology in non-small-cell lung cancer

Background: Understanding the three-dimensional (3D) volumetric relationship between imaging and functional or histopathologic heterogeneity of tumours is a key concept in the development of image-guided radiotherapy. Our aim was to develop a methodologic framework to enable the reconstruction of resected lung specimens containing non-small-cell lung cancer (NSCLC), to register the result in 3D with diagnostic imaging, and to import the reconstruction into a radiation treatment planning system. Methods and Results: We recruited 12 patients for an investigation of radiology-pathology correlation (RPC) in NSCLC. Before resection, imaging by positron emission tomography (PET) or computed tomography (CT) was obtained. Resected specimens were formalin-fixed for 1-24 hours before sectioning at 3-mm to 10-mm intervals. To try to retain the original shape, we embedded the specimens in agar before sectioning. Consecutive sections were laid out for photography and manually adjusted to maintain shape. Following embedding, the tissue blocks underwent whole-mount sectioning (4-μm sections) and staining with hematoxylin and eosin. Large histopathology slides were used to whole-mount entire sections for digitization. The correct sequence was maintained to assist in subsequent reconstruction. Using Photoshop (Adobe Systems Incorporated, San Jose, CA, U.S.A.), contours were placed on the photographic images to represent the external borders of the section and the extent of macroscopic disease. Sections were stacked in sequence and manually oriented in Photoshop. The macroscopic tumour contours were then transferred to MATLAB (The Mathworks, Natick, MA, U.S.A.) and stacked, producing 3D surface renderings of the resected specimen and embedded gross tumour. To evaluate the microscopic extent of disease, customized "tile-based" and commercial confocal panoramic laser scanning (TISSUEscope: Biomedical Photometrics, Waterloo, ON) systems were used to generate digital images of whole-mount histopathology sections. Using the digital whole-mount images and imaging software, we contoured the gross and microscopic extent of disease. Two methods of registering pathology and imaging were used. First, selected PET and CT images were transferred into Photoshop, where they were contoured, stacked, and reconstructed. After importing the pathology and the imaging contours to MATLAB, the contours were reconstructed, manually rotated, and rigidly registered. In the second method, MATLAB tumour renderings were exported to a software platform for manual registration with the original PET and CT images in multiple planes. Data from this software platform were then exported to the Pinnacle radiation treatment planning system in DICOM (Digital Imaging and Communications in Medicine) format. Conclusions: There is no one definitive method for 3D volumetric RPC in NSCLC. An innovative approach to the 3D reconstruction of resected NSCLC specimens incorporates agar embedding of the specimen and whole-mount digital histopathology. The reconstructions can be rigidly and manually registered to imaging modalities such as CT and PET and exported to a radiation treatment planning system

Fasting Indicators of Insulin Sensitivity: Effects of Ethnicity and Pubertal Status

OBJECTIVE—To examine the relationship of fasting indicators of insulin sensitivity with a more invasive measure of insulin sensitivity (frequently sampled intravenous glucose tolerance test [FSIVGTT]) and the effect of Tanner stage and ethnicity on that relationship. RESEARCHDESIGNANDMETHODS—Data were analyzed from 149 overweight girls (97 Hispanic and 52 African American) who were either in the early stages of maturation defined by Tanner stages 1 or 2 (52Hispanic and 18 African American) or in the later stages of maturation defined by Tanner stages 4 and 5 (45 Hispanic and 34 African American). Fasting indicators of insulin sensitivity (IS) included fasting insulin and glucose and the homeostasis model assess-ment of insulin resistance (HOMA-IR). IS was derived from an FSIVGTTwithminimalmodeling. RESULTS—In Tanner stages 1 and 2, all fasting indicators were significantly associatedwith IS

Toward a client-centered benchmark for self-sufficiency: Evaluating the ‘process’ of becoming job ready.

The purpose of this study is to evaluate how service providers, clients, and graduates of a job training program define the term self-sufficiency (SS). This community-engaged, mixed method study qualitatively analyzes focus group data from each group and quantitatively examines survey data obtained from participants of the program. Findings reveal that psychological transformation as a ‘process’ represents the emic definition of SS—psychological SS—but each dimension of the concept is reflected in varying degrees by group. Provider and participant views are vastly different from the outcome-driven policy and funder definitions. Implications for benchmarking psychological SS as an empowerment-based ‘process’ measure of job readiness in workforce development evaluation are discussed

A tool to balance benefit and harm when deciding about adjuvant therapy

Adjuvant therapy aims to prevent outgrowth of residual disease but can induce serious side effects. Weighing conflicting treatment effects and communicating this information with patients is not elementary. This study presents a scheme balancing benefit and harm of adjuvant therapy vs no adjuvant therapy. It is illustrated by the available evidence on adjuvant pelvic external beam radiotherapy (RT) for intermediate-risk stage I endometrial carcinoma patients. The scheme comprises five outcome possibilities of adjuvant therapy: patients who benefit from adjuvant therapy (some at the cost of complications) vs those who neither benefit nor contract complications, those who do not benefit but contract severe complications, or those who die. Using absolute risk differences, a fictive cohort of 1000 patients receiving adjuvant RT is categorised. Three large randomised clinical trials were included. Recurrences will be prevented by adjuvant RT in 60 patients, a majority of 908 patients will neither benefit nor suffer severe radiation-induced harm but 28 patients will suffer severe complications due to adjuvant RT and an expected four patients will die. This scheme readily summarises the different possible treatment outcomes and can be of practical value for clinicians and patients in decision making about adjuvant therapies

Linking personality to larval energy reserves in rainbow trout (Oncorhynchus mykiss).

There is a surging interest in the evolution, ecology and physiology of personality differences. However, most of the studies in this research area have been performed in adult animals. Trait variations expressed early in development and how they are related to the ontogeny of an animal's personality are far less studied. Genetic differences as well as environmental factors causing functional variability of the central serotonergic system have been related to personality differences in vertebrates, including humans. Such gene-environment interplay suggests that the central serotonergic system plays an important role in the ontogeny of personality traits. In salmonid fishes, the timing of emergence from spawning nests is related to energy reserves, aggression, and social dominance. However, it is currently unknown how the size of the yolk reserve is reflected on aggression and dominance, or if these traits are linked to differences in serotonergic transmission in newly emerged larvae. In this study we investigated the relationship between yolk reserves, social dominance, and serotonergic transmission in newly emerged rainbow trout (Oncorhynchus mykiss) larvae. This was conducted by allowing larvae with the same emergence time, but with different yolk sizes, to interact in pairs for 24 h. The results show that individuals with larger yolks performed more aggressive acts, resulting in a suppression of aggression in individuals with smaller yolks. A higher brain serotonergic activity confirmed subordination in larvae with small yolks. The relationship between social dominance and yolk size was present in siblings, demonstrating a link between interfamily variation in energy reserves and aggression, and suggests that larger yolk reserves fuel a more aggressive personality during the initial territorial establishment in salmonid fishes. Furthermore, socially naïve larvae with big yolks had lower serotonin levels, suggesting that other factors than the social environment causes variation in serotonergic transmission, underlying individual variation in aggressive behavior

No Association between Personality and Candidate Gene Polymorphisms in a Wild Bird Population

Consistency of between-individual differences in behaviour or personality is a phenomenon in populations that can have ecological consequences and evolutionary potential. One way that behaviour can evolve is to have a genetic basis. Identifying the molecular genetic basis of personality could therefore provide insight into how and why such variation is maintained, particularly in natural populations. Previously identified candidate genes for personality in birds include the dopamine receptor D4 (DRD4), and serotonin transporter (SERT). Studies of wild bird populations have shown that exploratory and bold behaviours are associated with polymorphisms in both DRD4 and SERT. Here we tested for polymorphisms in DRD4 and SERT in the Seychelles warbler (Acrocephalus sechellensis) population on Cousin Island, Seychelles, and then investigated correlations between personality and polymorphisms in these genes. We found no genetic variation in DRD4, but identified four polymorphisms in SERT that clustered into five haplotypes. There was no correlation between bold or exploratory behaviours and SERT polymorphisms/haplotypes. The null result was not due to lack of power, and indicates that there was no association between these behaviours and variation in the candidate genes tested in this population. These null findings provide important data to facilitate representative future meta-analyses on candidate personality genes