• Ulrich Staal opublikował 1 rok, 8 miesięcy temu

    Sixty-four subacute stroke patients and 55 age-matched healthy controls (HCs) underwent a resting-state functional magnetic resonance imaging scan using an echo-planar imaging sequence and high-resolution sagittal T1-weighted images using a three-dimensional magnetization-prepared rapid gradient echo sequence. Static and dynamic voxel-mirrored homotopic connectivity (VMHC) was computed, respectively. The relationships between the clinical measures, including National Institutes of Health Stroke Scale (NIHSS), illness duration, Fugl-Meyer assessment for upper and lower extremities (FMA-total) and size of lesion volume, and the static/ dynamic VMHC variability alterations in stroke patients were calculated. The stroke patients showed significantly increased static VMHC in the corpus callosum, middle occipital gyrus and inferior parietal gyrus, and decreased static VMHC in the inferior temporal gyrus and precentral gyrus (PreCG) compared with those of HCs. For dynamic VMHC variability, increased dynamic VMHC variability in the inferior temporal gyrus and PreCG was detected in stroke patients relative to that in HCs. Correlation analysis exhibited that significant negative correlations were shown between the FMA scores and dynamic VMHC variability in PreCG. The present study suggests that combined static and dynamic VMHC could be helpful to evaluate the motor function of stroke patients and understand the intrinsic differences of inter-hemispheric coordination after stroke.Primary nocturnal enuresis (PNE) is characterized by a low cure rate and a high reoccurrence rate, since its underlying mechanism remains unclear. Based on the recent studies that thalamus plays an important role in waking up a sleeping person, here we further investigate the functional connectivity (FC) information between thalamus and other brain regions, in order to make better understanding of the PNE’s pathogenesis. In this study, we enrolled 30 children diagnosed with PNE and 30 typically developing children that are age and sex matched, the thalamus-based FC estimates were extracted at the resting-state. Experiments showed that for children with PNE, there were four brain regions found with a reduced connection efficiency with thalamus, that were cerebellum posterior lobe, frontal lobe, parietal lobe and precentral gyrus. It can be concluded that these relevant regions might induce an arousal disorder, and therefore further lead to PNE. This finding also provides a new insight in the pathophysiology of PNE.NonInvasive Brain Stimulation (NIBS) is a potential therapeutic tool with growing interest, but neuronavigation-guided software and tools available for the target determination are mostly either expensive or closed proprietary applications. To address these limitations, we propose GeodesicSlicer, a customizable, free, and open-source NIBS therapy research toolkit. GeodesicSlicer is implemented as an extension for the widely used 3D Slicer medical image visualization and analysis application platform. GeodesicSlicer uses cortical stimulation target from either functional or anatomical images to provide functionality specifically designed for NIBS therapy research. The provided algorithms are tested and they are accessible through a convenient graphical user interface. Modules have been created for NIBS target determination according to the position of the electrodes in the 10-20 system electroencephalogram and calculating correction factors to adjust the repetitive Transcranial Magnetic Stimulation (rTMS) dose for the treatment. Two illustrative examples are processing with the module. This new open-source software has been developed for NIBS therapy GeodesicSlicer is an alternative for laboratories that do not have access to neuronavigation system. The triangulation-based MRI-guided method presented here provides a reproducible and inexpensive way to position the TMS coil that may be used without the use of a neuronavigation system.PURPOSE OF REVIEW Myelodysplastic syndromes (MDS) are heterogeneous diseases that principally affect older adults. Allogeneic hematopoietic cell transplantation (HCT) is the only potentially curative therapy; however, non-relapse mortality (NRM) accounts for as many as 40% of deaths after HCT and underscores the need for careful patient selection. We review the common indications and causes of failure after HCT in MDS. RECENT FINDINGS Appropriate patient selection is necessary to optimize HCT outcomes and maximize the life-expectancies of MDS patients. The international prognostic scoring systems (IPSS) and revised IPSS (IPSS-R) are used to identify high-risk patients and guide decision making. Neither scoring system incorporates molecular mutations, which are now recognized as important predictors of disease biology and clinical outcomes. Patient and disease characteristics including age, comorbid conditions, iron overload, blast percentage, and other features may impact post-HCT outcomes. An accurate assessment of the disease risk and patient qualities that affect NRM is necessary to optimize post-HCT outcomes. In this review, we summarize the risk factors for, and common causes of NRM, as well as markers of poor-risk disease that should lead providers to consider allogeneic HCT in MDS patients.Epithelial-to-mesenchymal transition (EMT) initiates malignant transformation of cancer cells and is responsible for the generation of heterogenic subsets of cancer stem cells (CSCs). Signals in the form of environmental cues and paracrine factors within tumor microenvironment (TME) niche, support the possibility of generation of pool of CSCs with two distinct functional transition states. Cyclic CSCs with predominant epithelial phenotype, self-renew and differentiate into mature cancer cells. Subsets of autophagic/ non-cyclic CSCs with predominant mesenchymal phenotype have capacity to invade, metastasize, resist to apoptosis, escape immunosurveillance, survive chemotherapies and are majorly responsible for cancer mortality. Differences in phenotypic plasticity may form the basis of differential impact of therapeutic outcomes on heterogeneous subpopulations of CSCs. Activation of autophagy is responsible for the recycling of damaged organelles and protein aggregates, regulates EMT, confers the survival advantage to neoplastic cells to anti-cancer therapies, significantly affects the invasive potential of cancer cells and supports their metastatic dissemination in a tissue and tumor stage dependent manner. Therapy resistance is the primary obstacle in the complete ablation of tumor cells. Combinational treatments based on targeting autophagic CSCs and inhibiting EMT regulators may represent potential anticancer strategies for the prevention of cancer invasion, metastatic spread and disease relapse.This article presents a practical overview of the treatment of younger, newly diagnosed multiple myeloma patients, focusing on novel treatment strategies. With the introduction of effective new agents, multiple myeloma is one of the most active and changing fields in clinical oncology. In addition, monitoring technology has become reliable and practical. Achieving and sustaining minimal residual disease negativity (MRD- ), such as multiparameter flow cytometry (MFC)  less then  10-5, is one of the goals of therapy. MRD-  is significantly associated with prolonged progression-free survival, whereas MRD persistence (MRD +) is an independent factor for poor progression-free survival. Evidence from several recent studies evaluating modern therapy has further supported the positive correlation between depth of response and outcomes. Multiple myeloma can become a chronic illness with sustained MRD- in a significant number of patients. Our ultimate hope is to leverage tumoricidal-immunomodulatory sequential therapies and to cure a subset of our patients.Progressive multifocal leukoencephalopathy (PML) remains a life-threatening central nervous system infection in immunocompromised patients. Although outcomes have improved in cases that immune reconstitution is feasible with anti-retroviral therapy (ART) in HIV + patients or natalizumab removal in those with multiple sclerosis, in individuals with hematological malignancies, the prognosis is usually dismal. Anti-viral treatments have been largely ineffective, but immunotherapy-based approaches with checkpoint inhibitors and adoptive virus-specific T cells’ transfer are currently explored in clinical trials. PML has not been described as a cause of encephalopathy after CAR T therapy. We report the first case of PML 7 months after lymphodepleting chemotherapy with fludarabine/cyclophosphamide and anti-CD19-directed CAR T therapy in a patient with relapsed diffuse large B-cell lymphoma who relapsed fast after a previous autologous hematopoietic stem cell transplant. She remains alive 12 months after diagnosis with stabilization of her symptoms with a combination of therapies targeting viral replication and immunotherapy.In light of the development of „CRISPR” technology, new promising advances in therapeutic and preventive approaches have become a reality. However, with it came many ethical challenges. The most recent worldwide condemnation of the first use of CRISPR to genetically modify a human embryo is the latest example of ethically questionable use of this new and emerging field. Monotheistic religions are very conservative about such changes to the human genome and can be considered an interference with God’s creation. Moreover, these changes could cause perpetual changes to future generations. The Muslim scholars establish their decisions by addressing five foundations of Islamic law i.e. „maqāṣid al sharı̄`a”; the purposes of the law. These are dın̄ (religion), nafs (life), nasl (progeny), `aql (intellect) and māl (wealth). To achieve this, the five principles should all be met before approval of an experiment like the Chinese embryo modifications; Qaṣd (intention) which is achieved in this case as it aims to protect the embryo from HIV. Yaqın̄ (certainty) and Ḍarar (injury) were not satisfied as they require strong scientific certainty of the procedures, and evidence of safety. Ḍarūra (necessity) by which the alternatives being compared; in this case more established and proven safe alternatives to protect the HIV transmission from the father are available, so this principle is not met. The final principle is `Urf (custom), by which the social context of using any contemporary technology should be taken in consideration, and clearly this was not achieved. Collectively, germline changes are rejected from an Islamic perspective until the five principles are fulfilled. In the Chinese Twins gene editing case, there was clearly no justification or support for it according to the Muslim Jurisprudence laws. These laws and approaches can serve as an ethical checklist for such controversial research, especially in early stages of the research.We studied cognitive inhibitory processes and verbal regulation of behavior of individuals with different levels of education (including adult illiterates) in Brazil (N = 136) and in Estonia (N = 560) with person-oriented methods of data analysis. Our aim was to discover whether dominant type of word meaning structure (WMS) can define the „Great Divide”, the single breaking point that universally defines certain direction of subsequent to it cultural evolution. We found that both cognitive inhibition of irrelevant for the task at hand information or actions as well as correct activation of relevant information or actions is significantly more common in individuals who rely predominantly on logical concepts in their thinking. The higher level of education was also associated with more efficient cognitive inhibition and activation. The patterns of test performance also suggest that there can be a qualitative difference in the efficiency of cognitive inhibition-activation processes between everyday conceptual and logical conceptual thinkers.

Szperamy.pl
Logo
Enable registration in settings - general
Compare items
  • Total (0)
Compare
0