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Purpose: Perfusion-weighted MRI (PWI) and O-(2-[18F]fluoroethyl-)-l-tyrosine ([18F]FET) PET are both applied to discriminate tumor progression (TP) from treatment-related changes (TRC) in patients with suspected recurrent glioma. While the combination of both methods has been reported to improve the diagnostic accuracy, the performance of a sequential implementation has not been further investigated. Therefore, we retrospectively analyzed the diagnostic value of consecutive PWI and [18F]FET PET.
Methods: We evaluated 104 patients with WHO grade II–IV glioma and suspected TP on conventional MRI using PWI and dynamic [18F]FET PET. Leakage corrected maximum relative cerebral blood volumes (rCBVmax) were obtained from dynamic susceptibility contrast PWI. Furthermore, we calculated static (i.e., maximum tumor to brain ratios; TBRmax) and dynamic [18F]FET PET parameters (i.e., Slope). Definitive diagnoses were based on histopathology (n = 42) or clinico-radiological follow-up (n = 62). The diagnostic performance of PWI and [18F]FET PET parameters to differentiate TP from TRC was evaluated by analyzing receiver operating characteristic and area under the curve (AUC).
Results: Across all patients, the differentiation of TP from TRC using rCBVmax or [18F]FET PET parameters was moderate (AUC = 0.69–0.75; p < 0.01). A rCBVmax cutoff > 2.85 had a positive predictive value for TP of 100%, enabling a correct TP diagnosis in 44 patients. In the remaining 60 patients, combined static and dynamic [18F]FET PET parameters (TBRmax, Slope) correctly discriminated TP and TRC in a significant 78% of patients, increasing the overall accuracy to 87%. A subgroup analysis of isocitrate dehydrogenase (IDH) mutant tumors indicated a superior performance of PWI to [18F]FET PET (AUC = 0.8/< 0.62, p < 0.01/≥ 0.3).
Conclusion: While marked hyperperfusion on PWI indicated TP, [18F]FET PET proved beneficial to discriminate TP from TRC when PWI remained inconclusive. Thus, our results highlight the clinical value of sequential use of PWI and [18F]FET PET, allowing an economical use of diagnostic methods. The impact of an IDH mutation needs further investigation.
DeriMo is an international meeting dealing with derivational morphology from the perspective of data analysis. Its second edition DeriMo 2019 was held at the Faculty of Mathematics and Physics, Charles University in Prague. The local organizers are researchers of the Institute of Formal and Applied Linguistics (ÚFAL = Ústav Formální a Aplikované Linguistiky) at the Computer Science School of the Faculty of Mathematics and Physics. Chairs of the program committee were Magda Ševčíková (ÚFAL), Zdeněk Žabokrtský (ÚFAL), Eleonora Litta Modignani Picozzi (CIRCSE, Università Cattolica del Sacro Cuore, Milan), and Marco Passarotti (CIRCSE, Università Cattolica del Sacro Cuore, Milan).
Objective: To determine the impact of an exercise-based prehabilitation (EBPrehab) program on preand postoperative exercise capacity, functional capacity (FC) and quality of life (QoL) in patients awaiting elective coronary artery bypass graft surgery (CABG).
Design: A two-group randomized controlled trail.
Setting: Ambulatory prehabilitation.
Subjects: Overall 230 preoperative elective CABG-surgery patients were randomly assigned to an intervention (IG, n=88; n=27 withdrew after randomization) or control group (CG, n=115).
Intervention: IG: two-week EBPrehab including supervised aerobic exercise. CG: usual care.
Main measures: At baseline (T1), one day before surgery (T2), at the beginning (T3) and at the end of cardiac rehabilitation (T4) the following measurements were performed: cardiopulmonary exercise test, six-minute walk test (6MWT), Timed-Up-and-Go Test (TUG) and QoL (MacNew questionnaire).
Results: A total of 171 patients (IG, n=81; CG, n=90) completed the study. During EBPrehab no complications occurred. Preoperatively FC (6MWTIG: 443.0±80.1m to 493.5±75.5m, P=0.003; TUGIG: 6.9±2.0 s to 6.1±1.8 s, P=0.018) and QoL (IG: 5.1±0.9 to 5.4±0.9, P<0.001) improved significantly more in IG compared to CG. Similar effects were observed postoperatively in FC (6MWDIG: Δ-64.7m, pT1–T3=0.013; Δ+47.2m, pT1–T4<0.001; TUGIG: Δ+1.4s, pT1–T3=0.003).
Conclusions: A short-term EBPrehab is effective to improve perioperative FC and preoperative QoL in patients with stable coronary artery disease awaiting CABG-surgery.
A survey for myxomycetes (plasmodial slime moulds or myxogastrids) was carried out on Norfolk Island in June 2019. The overall objective was to collect both specimens that had fruited in the field under natural conditions as well as specimens appearing in moist chamber cultures prepared with samples of dead plant material collected on the island. However, only three species were recorded as field collections over a period of almost two weeks, so the primary focus of the survey was redirected to collecting samples for moist chamber cultures. Approxmately 120 samples of dead plant material collected from 21 different sampling sites on the island and used to prepare 356 moist chamber cultures yielded a total of 497 specimens. These specimens included at least 48 species in 18 genera. This brings the total number of species and genera now known from Norfolk Island to 55 and 19, respectively.
Purpose: Diffuse cortical damage in relapsing–remitting multiple sclerosis (RRMS) is clinically relevant but cannot be directly assessed with conventional MRI. In this study, it was aimed to use diffusion tensor imaging (DTI) techniques with optimized intrinsic eddy current compensation to quantify and characterize cortical mean diffusivity (MD) and fractional anisotropy (FA) changes in RRMS and to analyze the distribution of these changes across the cortex.
Materials and Methods: Three-Tesla MRI acquisition, mapping of the MD providing information about the integrity of microstructural barriers and of the FA reflecting axonal density and surface-based analysis with Freesurfer were performed for 24 RRMS patients and 25 control subjects.
Results: Across the whole cortex, MD was increased in patients (p < 0.001), while surface-based analysis revealed focal cortical FA decreases. MD and FA changes were distributed inhomogeneously across the cortex, the MD increase being more widespread than the FA decrease. Cortical MD correlated with the Expanded Disability Status Scale (EDSS, r = 0.38, p = 0.03).
Conclusion: Damage of microstructural barriers occurs inhomogeneously across the cortex in RRMS and might be spatially more widespread than axonal degeneration. The results and, in particular, the correlation with the clinical status indicate that DTI might be a promising technique for the monitoring of cortical damage under treatment in larger clinical studies.
Background: Current literature is inconsistent regarding the risk of severe side effects using accelerated induction protocols in Hymenoptera venom immunotherapy (VIT). In addition, several data indicate the influence of purity grade of venom preparation on tolerability. We evaluated the safety and tolerability of ultra-rush and rush build-up protocols using purified and non-purified venom preparations. Methods: Retrospective single-center study of 581 VIT inductions (325 ultra-rush and 256 rush protocols) from 2005 to 2018 in 559 patients with bee and vespid venom allergy using aqueous purified (ALK SQ®) for ultra-rush protocol and aqueous non-purified (ALK Reless®) venom preparations for rush protocol. Results: Urticaria (8% vs. 3.1%, p = 0,013) and dose reductions (4.3% vs. 1.2%, p = 0,026) were significantly more frequent in the ultra-rush group. Overall rate of moderate-to-severe side effects (anaphylaxis ≥grade 2 according to Ring and Meβmer) was low and did not differ significantly between protocols (p = 0.105). Severe events (grade 4 anaphylaxis) were not reported. Discontinuation rate was very low in both cohorts (0.6% vs 1.2%). The higher purity grade of venom preparations in the ultra-rush cohort did not improve tolerability. The bee venom group showed a non-significant trend towards higher incidence of mild reactions (urticaria), resulting in more frequent dose reductions and antiallergic therapy. Conclusion: Rush and ultra-rush protocols show an excellent safety profile with only infrequent and mild anaphylactic reactions in bee and vespid venom allergy. Ultra-rush immunotherapy reduces the duration of the inpatient build-up phase setting and thus is viewed by the authors as preferred treatment in Hymenoptera venom allergic patients.
Despite the great importance of the Latin language in the past, there are relatively few resources available today to develop modern NLP tools for this language. Therefore, the EvaLatin Shared Task for Lemmatization and Part-of-Speech (POS) tagging was published in the LT4HALA workshop. In our work, we dealt with the second EvaLatin task, that is, POS tagging. Since most of the available Latin word embeddings were trained on either few or inaccurate data, we trained several embeddings on better data in the first step. Based on these embeddings, we trained several state-of-the-art taggers and used them as input for an ensemble classifier called LSTMVoter. We were able to achieve the best results for both the cross-genre and the cross-time task (90.64% and 87.00%) without using additional annotated data (closed modality). In the meantime, we further improved the system and achieved even better results (96.91% on classical, 90.87% on cross-genre and 87.35% on cross-time).
We report on fourteen species and four genera of Tischeriidae recorded from Las Cuevas, a single tropical forest locality in Belize, Central America. This is the highest number of species of Tischeriidae recorded from a single locality worldwide, exceeding the species and generic diversity of the entire Tischeriidae fauna of Europe and accounting for about 9% of the documented global fauna for this family. We describe and name six new species: Astrotischeria papilloma Diškus & Stonis sp. nov., mining on Lasianthaea fruticosa (L.) K.M.Becker (Asteraceae); A. scutifera Diškus & Stonis sp. nov., mining on Sida glabra Mill. (Malvaceae); A. basilobata Remeikis & Stonis sp. nov., mining on Lasianthaea fruticosa; Paratischeria robinsoni Diškus & Stonis sp. nov., mining on Otopappus verbesinoides Benth. (Asteraceae); P. tubifex Diškus & Stonis sp. nov., mining on Lasianthaea fruticosa; and P. belizensis Remeikis & Stonis sp. nov. (host plant unknown). Additionally, we review eight previously described species from the same period of collecting at Las Cuevas in 1997–1998: A. selvica Diškus, Carvalho-Filho & Stonis, 2018, mining on Sphagneticola trilobata (L.) Pruski and Synedrella nodiflora (L.) Gaertn. (Asteraceae); A. casila Diškus & Stonis, 2018, mining on Montanoa atriplicifolia (Pers.) Sch.Bip. (Asteraceae); A. furcata Diškus & Stonis, 2018 (host plant unknown); Paratischeria neotropicana (Diškus & Stonis, 2015), mining on Sida L. (Malvaceae), including S. rhombifolia L.; Dishkeya gouaniae (Stonis & Diškus, 2007), mining on Gouania polygama (Jacq.) Urb. (Rhamnaceae); Coptotriche pulverea (Walsingham, 1897), mining on Terminalia amazonia (J.F.Gmel.) Exell (Combretaceae); C. forsteroniae Stonis & Diškus, 2008, mining on Forsteronia myriantha Donn Sm. (Apocynaceae); and C. singularis Stonis & Diškus, 2008 (host plant unknown). All taxa, except for C. singularis, are illustrated with photographs of the adults and their genitalia. We also briefly discuss the discovery of some novel characters for Astrotischeria Puplesis & Diškus, 2003 and Paratischeria Diškus & Stonis, 2017, Tischeriidae, and provide the first photographic documentation of Coptotriche pulverea and C. forsteroniae.
Background: Breast cancer is the leading cause of cancer-related deaths in women, demanding new treatment options. With the advent of immune checkpoint blockade, immunotherapy emerged as a treatment option. In addition to lymphocytes, tumor-associated macrophages exert a significant, albeit controversial, impact on tumor development. Pro-inflammatory macrophages are thought to hinder, whereas anti-inflammatory macrophages promote tumor growth. However, molecular markers to identify prognostic macrophage populations remain elusive. Methods: We isolated two macrophage subsets, from 48 primary human breast tumors, distinguished by the expression of CD206. Their transcriptomes were analyzed via RNA-Seq, and potential prognostic macrophage markers were validated by PhenOptics in tissue microarrays of patients with invasive breast cancer. Results: Normal human breast tissue contained mainly CD206+ macrophages, while increased relative amounts of CD206− macrophages were observed in tumors. The presence of CD206+ macrophages correlated with a pronounced lymphocyte infiltrate and subsets of CD206+ macrophages, expressing SERPINH1 and collagen 1, or MORC4, were unexpectedly associated with improved survival of breast cancer patients. In contrast, MHCIIhi CD206− macrophages were linked with a poor survival prognosis. Conclusion: Our data highlight the heterogeneity of tumor-infiltrating macrophages and suggest the use of multiple phenotypic markers to predict the impact of macrophage subpopulations on cancer prognosis. We identified novel macrophage markers that correlate with the survival of patients with invasive mammary carcinoma.
Objectives: Multidrug-resistant organisms (MDRO) are considered an emerging threat worldwide. Data covering the clinical impact of MDRO colonization in patients with solid malignancies, however, is widely missing. We sought to determine the impact of MDRO colonization in patients who have been diagnosed with Non-small cell lung cancer (NSCLC) who are at known high-risk for invasive infections.
Materials and methods: Patients who were screened for MDRO colonization within a 90-day period after NSCLC diagnosis of all stages were included in this single-center retrospective study.
Results: Two hundred and ninety-five patients were included of whom 24 patients (8.1%) were screened positive for MDRO colonization (MDROpos) at first diagnosis. Enterobacterales were by far the most frequent MDRO detected with a proportion of 79.2% (19/24). MDRO colonization was present across all disease stages and more present in patients with concomitant diabetes mellitus. Median overall survival was significantly inferior in the MDROpos study group with a median OS of 7.8 months (95% CI, 0.0–19.9 months) compared to a median OS of 23.9 months (95% CI, 17.6–30.1 months) in the MDROneg group in univariate (p = 0.036) and multivariate analysis (P = 0.02). Exploratory analyses suggest a higher rate of non-cancer-related-mortality in MDROpos patients compared to MDROneg patients (p = 0.002) with an increased rate of fatal infections in MDROpos patients (p = 0.0002).
Conclusions: MDRO colonization is an independent risk factor for inferior OS in patients diagnosed with NSCLC due to a higher rate of fatal infections. Empirical antibiotic treatment approaches should cover formerly detected MDR commensals in cases of (suspected) invasive infections.