Quantifying the ki-67 heterogeneity profile in prostate cancer.

BackgroundKi-67 is a robust predictive/prognostic marker in prostate cancer; however, tumor heterogeneity in prostate biopsy samples is not well studied.MethodsUsing an MRI/US fusion device, biopsy cores were obtained systematically and by targeting when indicated by MRI. Prostate cores containing cancer from 77 consecutive men were analyzed. The highest Ki-67 was used to determine interprostatic variation. Ki-67 range (highest minus lowest) was used to determine intraprostatic and intralesion variation. Apparent diffusion coefficient (ADC) values were evaluated in relation to Ki-67.ResultsInterprostatic Ki-67 mean ± standard deviation (SD) values for NCCN low (L), intermediate (I), and high (H) risk patients were 5.1 ± 3.8%, 7.4 ± 6.8%, and 12.0 ± 12.4% (ANOVA P = 0.013). Intraprostatic mean ± SD Ki-67 ranges in L, I, and H risk patients were 2.6 ± 3.6%, 5.3 ± 6.8%, and 10.9 ± 12.3% (ANOVA P = 0.027). Intralesion mean ± SD Ki-67 ranges in L, I, and H risk patients were 1.1 ± 0.9%, 5.2 ± 7.9%, and 8.1 ± 10.8% (ANOVA P = 0.22). ADC values at Ki-67 > and <7.1% were 860 ± 203 and 1036 ± 217, respectively (P = 0.0029).ConclusionsHigh risk patients have significantly higher inter- and intraprostatic Ki-67 heterogeneity. This needs to be considered when utilizing Ki-67 clinically

Iranian teachers� knowledge about first aid in the school environment

Purpose: School students are at risk of unintentional injuries. Teachers are the main caregivers and the first protectors for school students and must be able to deliver first aid. This study aimed to assess the school teachers� knowledge about first aid in Kashan, Iran. Methods: A cross-sectional study was undertaken on a sample of 200 teachers working in public and private primary, secondary and high schools in Kashan city, Iran. Data collection was achieved via a questionnaire consisting of items on teachers' characteristics and 20 questions on basic first-aid practices. One point was given for each correct answer. The lowest and highest possible scores were 0 and 20. Then, the sum scores 0�9, 10�16, and 17�20 were ranked as weak, moderate, and good first aid knowledge, respectively. Statistical analyses were performed using descriptive statistics, Chi-square and Fisher's exact tests, and regression analysis. Results: The mean age and working experience of teachers were respectively (41.37 ± 6.35) years and (20.07 ± 7.29) years. Among all teachers 51.0 were males and 66.3 were working in public schools. Totally, 40.3 of the teachers had passed courses on first aid and 48.5 had confronted with situations needing first-aid; 59.7 evaluated their own knowledge of first aid as moderate. The mean score of first-aid knowledge was 10.00 ± 2.58. Teachers who had received first aid training and those with previous experiences of situations requiring first-aid possessed higher scores (p < 0.001). Most teachers answered wrongly to the questions regarding first aid in a child with a fracture (93.4) or struck by electricity (85.2). Conclusion: Most of the teachers had insufficient knowledge on first aid. They mostly did not pass any training on first aid. Urgent action seems necessary for training teachers on first aid through in-service training programs. © 2019 Chinese Medical Associatio

The reliability and validity of the persian version of sinonasal outcome test 22 (Snot22) questionnaires

Background: The quality of life (QOL) is an important indicator for disease-severity classification and outcome measurement in obtaining treatment sinonasal diseases. The sinonasal outcome test 22 (SNOT 22) questionnaire has been introduced as the best specific sinonasal instrument for QOL measurement. Objectives: To prepare a valid and reliable Persian language version of SNOT 22 questionnaire. Patients and Methods: After forward and backward translation of the original version of SNOT 22 questionnaire from English to Persian, a group of patients with nasal septal deviation who need septal surgery and another group of healthy volunteers answered the Persian version of the questionnaire. The responsiveness rate, validity (Pearson correlations and differential validity) and reliability (internal consistency and test-retest reliability) of the 22 items of the questionnaire was calculated. P value &lt; 0.05 was considered significant. Results: Thirty adults with nasal septal deviation need surgical correction and 30 healthy volunteers were included (mean age 30.4 ± 7.1 vs. 33 ± 6.7, P value = 0.148). The questionnaire was introduced to subjects two times with a two-week-period gap. Total responsiveness rate for 22 items was more than 97%. The total Cronbach's Alfa coefficient was 0.898 (ranging 0.890-0.903). The Pearson correlations were 0.85 and 0.96 for patients and healthy volunteers, respectively. The mean total score were 25.6 ± 13.3 (range 6-52) and 7.6 ± 9.1 (range 0-45) in patients and healthy volunteers, respectively (P &lt; 0.0001). The subscales scores were also significantly different between two groups. Conclusions: The Persian version of SNOT 22 questionnaire is a valid and reliable instrument for accessing sinonasal diseases in Persianspeaking people

Ruling Families and Business Elites in the Gulf Monarchies: Ever Closer?

Project: Middle East and North Africa Programme, Future Trends in the GCCThis is the final version of the article. Available from Chatham House via the URL in this record.Summary The pre-eminent role of nationalized oil and gas resources in the six Gulf monarchies has resulted in a private sector that is highly dependent on the state. This has crucial implications for economic and political reform prospects. All the ruling families – from a variety of starting points – have themselves moved much more extensively into business activities over the past two decades. Meanwhile, the traditional business elites’ socio-political autonomy from the ruling families (and thus the state) has diminished throughout the Gulf region – albeit again from different starting points and to different degrees today. The business elites’ priority interest in securing and preserving benefits from the rentier state has led them to reinforce their role of supporter of the incumbent regimes and ruling families. In essence, to the extent that business elites in the Gulf engage in policy debate, it tends to be to protect their own privileges. This has been particularly evident since the 2011 Arab uprisings. The overwhelming dependence of these business elites on the state for revenues and contracts, and the state’s key role in the economy – through ruling family members’ personal involvement in business as well as the state’s dominant ownership of stocks in listed companies – means that the distinction between business and political elites in the Gulf monarchies has become increasingly blurred. Under current uncertain political and economic conditions, existing patterns of clientelism and the business sector’s dependence on the state will not undergo significant changes. In these circumstances, the business elites are unlikely to become drivers of political reform. In the context of persistently low oil prices, growing tensions related to the definition of the new social contract and the content of structural reforms in the Gulf monarchies are likely to provoke renewed popular frustrations and considerable turmoil.This research was supported by the UK Economic and Social Research Council (grant no. ES/J012696/1)

Slender Origami with Complex 3D Folding Shapes

One-dimensional slender bodies can be deformed or shaped into spatially complex curves relatively easily due to their inherent compliance. However, traditional methods of fabricating complex spatial shapes are cumbersome, prone to error accumulation and not amenable to elegant programmability. In this letter, we introduce a one-dimensional origami based on attaching Miura-ori that can fold into various programmed two or three-dimensional shapes. We study the out-of-plane displacement characteristics of this origami and demonstrate with examples, design of slender bodies that conform to programmed complex spatial curves. Our study provides a new, accurate, and single actuation solution of shape programmability

Managing Abnormal Operation through Process Integration and Cogeneration Systems

Flaring is a common industrial practice that leads to substantial greenhouse gas (GHG) emissions, health problems, and economic losses. When the causes, magnitudes, and frequency of flaring are properly understood and incorporated into the design and operation of the industrial plants, significant reduction in flaring can be achieved. In this paper, a process integration approach is presented to retrofit the process design to account for flaring and to consider the use of process cogeneration to mitigate flaring while gaining economic and environmental benefits. It is based on simultaneous design and operational optimization where key flaring sources, causes and consequences of process upsets are identified then included in the energy profile of the process to design a combined heat and power system with special emphasis on discontinuous sources due to process upset. Environmental and economic benefits are weighed against the cost of process retrofitting. A base case study for an ethylene process is used to illustrate the applicability of the proposed approach and to evaluate the process performance under varying abnormal situation scenarios. Finally some safety parameters for part of the process are reviewed

“Comparison of Cochlear Microphonics Magnitude with Broad and Narrow Band Stimuli in Healthy Adult Wistar Rats”

AbstractObjective: Cochlear microphonic (CM) is a cochlear AC electric field, recorded within, around, and remote from its sources. Nowadays it can contribute to the differential diagnosis of different auditory pathologies such as auditory neuropathy spectrum disorder (ANSD). The aim of this study was to compare CM waveforms (CMWs) and amplitudes with broad and narrow band stimuli in 25 healthy male young adult Wistar rats.Methods: Using an extratympanic technique in ECochG (Electrocochleography) recording, CMWs in response to click and tonal stimuli with different octave frequencies were recorded at a high intensity level in subjects. The CMW amplitudes were calculated by a graphical user interface (GUI) designed in MATLAB. The data was analyzed by One-way ANOVA test.Results: The CMW magnitude increased upon an increase in band width stimulation. Across tonal stimuli, the CMW amplitudes at lower frequency tones were larger than those at higher frequency tones. Those findings were statistically significant (P&lt; 0.001).Conclusion: This study found that CMW most likely is a reflection of spatial summation of voltage drops generated by hair cell groups in response to acoustic stimulation. In order to production nature of CM potentials as well as their very small magnitudes especially with tonal stimuli, thus, we recommend using click stimulation for CM potential recording especially in patient with ANSD that CM plays an important role in its differential diagnosis and follow u