321 resultados para Multiple primary tumors
Resumo:
Skin tumors can arise as a result of cumulative genetic abnormalities, including chromosomal aberrations that can be described as either morphological (structural rearrangements) or molecular (copy number variations). Cytogenetic techniques have been used to examine both large and small chromosomal aberrations, and include karyotyping, comparative genomic hybridization, and fluorescence in situ hybridization. This chapter describes the recurrent aberrations associated with skin tumors, such as benign melanocytic nevi, melanoma, basal cell carcinoma, squamous cell carcinoma, actinic (solar) keratosis, Bowen’s disease, keratoacanthoma, Merkel cell carcinoma, dermatofibrosarcoma protuberans, and cutaneous lymphomas, as detected by cytogenetic methodologies. A significant number of genomic aberrations are shared across different subtypes of skin tumors, including structural and numerical alterations of chromosome 1, −3p, +3q, +6, +7, +8q, −9p, +9q, −10, −17p, +17q and +20. Aberrations specific to certain skin cancers have also been detected, and include: loss of 18q in squamous cell carcinoma, but not its precursor, actinic keratosis; loss of 9q22 in sporadic basal cell carcinoma; and translocation involving 17q22 and 22q13 in dermatofibrosarcoma protuberans. These regions contain a number of potential candidate genes that are involved in aspects of cell signaling, proliferation, differentiation, and apoptosis. Cytogenetic methodologies continue to evolve with the advent of array-based comparative genomic hybridization, copy number variation microarrays, and next-generation sequencing. It is envisioned that cytogenetic analysis will continue to be employed for identification and further exploration of novel chromosomal regions and associated genes that drive skin tumorigenesis.
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Extrapulmonary small cell and small cell neuroendocrine tumors of unknown primary site are, in general, aggressive neoplasms with a short median survival. Like small cell lung cancer (SCLC), they often are responsive to chemotherapy and radiotherapy. Small cell lung cancer and well differentiated neuroendocrine carcinomas of the gastrointestinal tract and pancreas tend to express somatostatin receptors. These tumors may be localized in patients by scintigraphic imaging using radiolabeled somatostatin analogues. A patient with an anaplastic neuroendocrine small cell tumor arising on a background of multiple endocrine neoplasia type 1 syndrome is reported. The patient had a known large pancreatic gastrinoma and previously treated parathyroid adenopathy. At presentation, there was small cell cancer throughout the liver and skeleton. Imaging with a radiolabeled somatostatin analogue, 111In- pentetreotide (Mallinckrodt Medical B. V., Petten, Holland), revealed all sites of disease detected by routine biochemical and radiologic methods. After six cycles of chemotherapy with doxorubicin, cyclophosphamide, and etoposide, there was almost complete clearance of the metastatic disease. 111In-pentetreotide scintigraphy revealed uptake consistent with small areas of residual disease in the liver, the abdomen (in mesenteric lymph nodes), and posterior thorax (in a rib). The primary gastrinoma present before the onset of the anaplastic small cell cancer showed no evidence of response to the treatment. The patient remained well for 1 year and then relapsed with brain, lung, liver, and skeletal metastases. Despite an initial response to salvage radiotherapy and chemotherapy with carboplatin and dacarbazine, the patient died 6 months later.
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To minimise the number of load sheddings in a microgrid (MG) during autonomous operation, islanded neighbour MGs can be interconnected if they are on a self-healing network and an extra generation capacity is available in the distributed energy resources (DER) of one of the MGs. In this way, the total load in the system of interconnected MGs can be shared by all the DERs within those MGs. However, for this purpose, carefully designed self-healing and supply restoration control algorithm, protection systems and communication infrastructure are required at the network and MG levels. In this study, first, a hierarchical control structure is discussed for interconnecting the neighbour autonomous MGs where the introduced primary control level is the main focus of this study. Through the developed primary control level, this study demonstrates how the parallel DERs in the system of multiple interconnected autonomous MGs can properly share the load of the system. This controller is designed such that the converter-interfaced DERs operate in a voltage-controlled mode following a decentralised power sharing algorithm based on droop control. DER converters are controlled based on a per-phase technique instead of a conventional direct-quadratic transformation technique. In addition, linear quadratic regulator-based state feedback controllers, which are more stable than conventional proportional integrator controllers, are utilised to prevent instability and weak dynamic performances of the DERs when autonomous MGs are interconnected. The efficacy of the primary control level of the DERs in the system of multiple interconnected autonomous MGs is validated through the PSCAD/EMTDC simulations considering detailed dynamic models of DERs and converters.
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We have investigated the role of bone sialoprotein (BSP), a secreted glycoprotein normally found in bone, in breast cancer progression. To explore functions for BSP in human breast cancer invasion and metastasis, the full-length BSP cDNA was transfected into the MDA-MB-231-BAG human breast cancer cell line under the control of the CMV promoter. Clones expressing BSP and vector control clones were isolated. BSP producing clones showed increased monolayer wound healing, a faster rate of stellate outgrowth in Matrigel and increased rate of invasion into a collagen matrix when compared to control clones. Clones were also examined in models of breast cancer growth and metastasis in vivo. BSP transfected clones showed an increased rate of primary tumor growth following mammary fat pad injection of nude mice. BSP transfected clones and vector control clones metastasized to soft organs and bone at a similar rate after intra-cardiac injection as determined by real-time PCR and X-ray analysis. Although these organs were targets for both BSP transfected and non-transfected cells, the size of the metastatic lesion was shown to be significantly larger for BSP expressing clones. This was determined by real-time PCR analysis for soft organs and by X-ray analysis of bone lesions. For bone this was confirmed by intra-tibial injections of cells in nude mice. We conclude that BSP acts to drive primary and secondary tumor growth of breast cancers in vivo.
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Background: Adults with primary brain tumors and their caregivers have significant information needs. This review assessed the effect of interventions to improve information provision for adult primary brain tumor patients and/or their caregivers. Methods: We included randomized or nonrandomized trials testing educational interventions that had outcomes of information provision, knowledge, understanding, recall, or satisfaction with the intervention, for adults diagnosed with primary brain tumors and/or their family or caregivers. PubMed, MEDLINE, EMBASE and Cochrane Reviews databases were searched for studies published between 1980 and June 2014. Results: Two randomized controlled, one non-randomized controlled, and 10 single group pre-post trials enrolled more than 411 participants. Five group, four practice/process change and four individual interventions assessed satisfaction (12 studies), knowledge (four studies) or information provision (2 studies). Nine studies reported high rates of satisfaction. Three studies showed statistically significant improvements over time in knowledge and two showed greater information was provided to intervention than control group participants, although statistical testing was not performed. Discussion: The trials assessed intermediate outcomes such as satisfaction, and only 4/13 reported on knowledge improvements. Few trials had a randomized controlled design and risk of bias was either evident or could not be assessed in most domains.
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Multiple sclerosis is a common disease of the central nervous system in which the interplay between inflammatory and neurodegenerative processes typically results in intermittent neurological disturbance followed by progressive accumulation of disability. Epidemiological studies have shown that genetic factors are primarily responsible for the substantially increased frequency of the disease seen in the relatives of affected individuals, and systematic attempts to identify linkage in multiplex families have confirmed that variation within the major histocompatibility complex (MHC) exerts the greatest individual effect on risk. Modestly powered genome-wide association studies (GWAS) have enabled more than 20 additional risk loci to be identified and have shown that multiple variants exerting modest individual effects have a key role in disease susceptibility. Most of the genetic architecture underlying susceptibility to the disease remains to be defined and is anticipated to require the analysis of sample sizes that are beyond the numbers currently available to individual research groups. In a collaborative GWAS involving 9,772 cases of European descent collected by 23 research groups working in 15 different countries, we have replicated almost all of the previously suggested associations and identified at least a further 29 novel susceptibility loci. Within the MHC we have refined the identity of the HLA-DRB1 risk alleles and confirmed that variation in the HLA-A gene underlies the independent protective effect attributable to the class I region. Immunologically relevant genes are significantly overrepresented among those mapping close to the identified loci and particularly implicate T-helper-cell differentiation in the pathogenesis of multiple sclerosis. © 2011 Macmillan Publishers Limited. All rights reserved.
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Worldwide, education systems have undergone unprecedented change due to a variety of economic, social, and political forces (Limerick, Cunnington & Crowther, 2002). The People’s Republic of China (PRC) is no exception. Continuous educational reform at primary and secondary levels in Mainland China has created new challenges and accountabilities for school principals. The important role of principals in primary and secondary schools has been acknowledged in both policy documents and the broader literature (Central Committee of the Chinese Communist Party, 1985; F. Chen, 2005; Chu, 2003; W. Huang, 2005; T. Wang, 2003). Yet, most of the literature on primary and secondary school principals in Mainland China is prescriptive in nature, identifying from the perspectives of researchers and academics what principals should do and how they should enact leadership. Lacking in this research is an awareness of the daily practices and lived experiences of principals. Furthermore, within the small body of writing on primary and secondary school principals in Mainland China, gender is seldom given any attention. To date, only a small number of empirical studies have focused on female principals as a specific category of research (Zen, 2004; Zhong, 2004). This study aimed to explore the professional lives of two female exemplary school principals in urban primary schools in Mainland China. A qualitative exploratory case study was used. Semi-structured interviews with each individual female principal, with six teachers in each of the school sites and with the superintendent of each principal were conducted. Field observations and document analysis were also undertaken to obtain multiple insights about their leadership practices. The conceptual framework was based largely on the theory of Gronn (1999) and incorporated five core leadership practices (vision building, ethical considerations, teaching and learning, power utilisation, and dealing with risks and challenges) taken from the wider literature. The key findings of this study were twofold. Firstly, while the five leadership practices were evident in the leadership of the two principals, this study identified some subtle differences in the way they approached each of them. Secondly, contextual factors such as Chinese traditional culture, the contemporary societal context, and the school organisational context, in addition to the biographical experiences of each principal were significant factors in shaping the way in which they exercised their leadership practices in the schools.
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Streptococcus pyogenes, also known as Group A Streptococcus (GAS) has been associated with a range of diseases from the mild pharyngitis and pyoderma to more severe invasive infections such as streptococcal toxic shock. GAS also causes a number of non-suppurative post-infectious diseases such as rheumatic fever, rheumatic heart disease and glomerulonephritis. The large extent of GAS disease burden necessitates the need for a prophylactic vaccine that could target the diverse GAS emm types circulating globally. Anti-GAS vaccine strategies have focused primarily on the GAS M-protein, an extracellular virulence factor anchored to GAS cell wall. As opposed to the hypervariable N-terminal region, the C-terminal portion of the protein is highly conserved among different GAS emm types and is the focus of a leading GAS vaccine candidate, J8-DT/alum. The vaccine candidate J8-DT/alum was shown to be immunogenic in mice, rabbits and the non-human primates, hamadryas baboons. Similar responses to J8-DT/alum were observed after subcutaneous and intramuscular immunization with J8-DT/alum, in mice and in rabbits. Further assessment of parameters that may influence the immunogenicity of J8-DT demonstrated that the immune responses were identical in male and female mice and the use of alum as an adjuvant in the vaccine formulation significantly increased its immunogenicity, resulting in a long-lived serum IgG response. Contrary to the previous findings, the data in this thesis indicates that a primary immunization with J8-DT/alum (50ƒÊg) followed by a single boost is sufficient to generate a robust immune response in mice. As expected, the IgG response to J8- DT/alum was a Th2 type response consisting predominantly of the isotype IgG1 accompanied by lower levels of IgG2a. Intramuscular vaccination of rabbits with J8-DT/alum demonstrated that an increase in the dose of J8-DT/alum up to 500ƒÊg does not have an impact on the serum IgG titers achieved. Similar to the immune response in mice, immunization with J8-DT/alum in baboons also established that a 60ƒÊg dose compared to either 30ƒÊg or 120ƒÊg was sufficient to generate a robust immune response. Interestingly, mucosal infection of naive baboons with a M1 GAS strain did not induce a J8-specific serum IgG response. As J8-DT/alum mediated protection has been previously reported to be due to the J8- specific antibody formed, the efficacy of J8-DT antibodies was determined in vitro and in vivo. In vitro opsonization and in vivo passive transfer confirmed the protective potential of J8-DT antibodies. A reduction in the bacterial burden after challenge with a bioluminescent M49 GAS strain in mice that were passively administered J8-DT IgG established that protection due to J8-DT was mediated by antibodies. The GAS burden in infected mice was monitored using bioluminescent imaging in addition to traditional CFU assays. Bioluminescent GAS strains including the ‘rheumatogenic’ M1 GAS could not be generated due to limitations with transformation of GAS, however, a M49 GAS strain was utilized during BLI. The M49 serotype is traditionally a ‘nephritogenic’ serotype associated with post-streptococcal glomerulonephritis. Anti- J8-DT antibodies now have been shown to be protective against multiple GAS strains such as M49 and M1. This study evaluated the immunogenicity of J8-DT/alum in different species of experimental animals in preparation for phase I human clinical trials and provided the ground work for the development of a rapid non-invasive assay for evaluation of vaccine candidates.
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This study focused on a group of primary school teachers as they implemented a variety of intervention actions within their class programs aimed towards supporting the reduction of high levels of communication apprehension (CA) among students.Six teachers and nine students, located across three primary schools, four year levels,and six classes, participated in this study. For reasons of confidentiality the schools,principals, parents, teachers, teacher assistants, and students who were involved in this study were given fictitious names. The following research question was explored in this study: What intervention actions can primary school teachers implement within their class programs that support the reduction of high CA levels among students? Throughout this study the term CA referred to "an individual's level of fear or anxiety associated with either real or anticipated (oral) communication with another person or persons" (McCroskey, 1984, p. 13). The sources of CA were explained with reference to McCroskey's state-trait continuum. The distinctions between high and appropriate levels of CA were determined conceptually and empirically. The education system within which this study was conducted promoted the philosophy of inclusion and the practices of inclusive schooling. Teachers employed in this system were encouraged to create class programs inclusive of and successful for all students. Consequently the conceptual framework within which this study was conducted was based around the notion of inclusion. Action research and case study research were the methodologies used in the study. Case studies described teachers' action research as they responded to the challenge of executing intervention actions within their class programs directed towards supporting the reduction of high CA levels among students. Consequently the teachers and not the researcher were the central characters in each of the case studies. Three principal data collection instruments were used in this study: Personal Report of Communication Fear (PRCF) scale, semistructured interviews, and dialogue journals. The PRCF scale was the screening tool used to identify a pool of students eligible for the study. Data relevant to the students involved in the study were gathered during semistructured interviews and throughout the dialogue journaling process. Dialogue journaling provided the opportunity for regular contact between teachers and the researcher, a sequence to teacher and student intervention behaviours, and a permanent record of teacher and student growth and development. The majority of teachers involved in this study endeavoured to develop class programs inclusive of all students.These teachers acknowledged the importance of modifying aspects of their class programs in response to the diverse and often multiple needs of individual students with high levels of CA. Numerous conclusions were drawn regarding practical ways that the teachers in this study supported the reduction of high CA levels among students. What this study has shown is that teachers can incorporate intervention actions within their class programs aimed towards supporting students lower their high levels of CA. Whilst no teacher developed an identical approach to intervention, similarities and differences were evident among teachers regarding their selection, interpretation, and implementation of intervention actions. Actions that teachers enacted within their class programs emerged from numerous fields of research including CA, inclusion, social skills, behaviour teaching, co-operative learning, and quality schools. Each teacher's knowledge of and familiarity with these research fields influenced their preference for and commitment to particular intervention actions. Additional factors including each teacher's paradigm of inclusion and exclusion contributed towards their choice of intervention actions. Possible implications of these conclusions were noted with reference to teachers,school administrators, support personnel, system personnel, teacher educators, parents, and researchers.
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Background Delivering effective multiple health behavior interventions to large numbers of adults with chronic conditions via primary care settings is a public health priority. Purpose Within a 12-month, telephone-delivered diet and physical activity intervention with multiple behavioral outcomes, we examined the extent and co-variation of multiple health behavior change. Methods A cluster-randomized trial with 434 patients with type 2 diabetes or hypertension were recruited from 10 general practices, which were randomized to receive telephone counseling or usual care. Results Those receiving telephone counseling were significantly more likely than those in usual care to make greater reductions in multiple behaviors after adjusting for baseline risk behaviors (OR 2.42; 95%CI 1.43, 4.11). Controlling for baseline risk and group allocation, making changes to either physical activity, fat, vegetable, or fiber intake was associated with making significantly more improvements in other behaviors. Conclusions For patients with chronic conditions, telephone counseling can significantly improve multiple health behaviors, with behavioral changes tending to co-vary.
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Young children’s transition into school has been constructed as a time-limited period around initial school entry, a set of teacher or school practices, a process of establishing continuity of experience, a multi-layered, multi-year set of experiences and a dynamic relationship-based process. Although preparedness issues continue to be addressed, there is a trend towards more complex understandings of transition emphasizing continuity, relationships amongst multiple stakeholders, system coherence across extended time periods and enhancement of resilience and transition capital. This article, in the early years of a new century, outlines some conceptualisations of readiness and transition as they relate to diverse children’s pathways through early childhood and early school settings.
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Maps are used to represent three-dimensional space and are integral to a range of everyday experiences. They are increasingly used in mathematics, being prominent both in school curricula and as a form of assessing students understanding of mathematics ideas. In order to successfully interpret maps, students need to be able to understand that maps: represent space, have their own perspective and scale, and their own set of symbols and texts. Despite the fact that maps have an increased prevalence in society and school, there is evidence to suggest that students have difficulty interpreting maps. This study investigated 43 primary-aged students’ (aged 9-12 years) verbal and gestural behaviours as they engaged with and solved map tasks. Within a multiliteracies framework that focuses on spatial, visual, linguistic, and gestural elements, the study investigated how students interpret map tasks. Specifically, the study sought to understand students’ skills and approaches used to solving map tasks and the gestural behaviours they utilised as they engaged with map tasks. The investigation was undertaken using the Knowledge Discovery in Data (KDD) design. The design of this study capitalised on existing research data to carry out a more detailed analysis of students’ interpretation of map tasks. Video data from an existing data set was reorganised according to two distinct episodes—Task Solution and Task Explanation—and analysed within the multiliteracies framework. Content Analysis was used with these data and through anticipatory data reduction techniques, patterns of behaviour were identified in relation to each specific map task by looking at task solution, task correctness and gesture use. The findings of this study revealed that students had a relatively sound understanding of general mapping knowledge such as identifying landmarks, using keys, compass points and coordinates. However, their understanding of mathematical concepts pertinent to map tasks including location, direction, and movement were less developed. Successful students were able to interpret the map tasks and apply relevant mathematical understanding to navigate the spatial demands of the map tasks while the unsuccessful students were only able to interpret and understand basic map conventions. In terms of their gesture use, the more difficult the task, the more likely students were to exhibit gestural behaviours to solve the task. The most common form of gestural behaviour was deictic, that is a pointing gesture. Deictic gestures not only aided the students capacity to explain how they solved the map tasks but they were also a tool which assisted them to navigate and monitor their spatial movements when solving the tasks. There were a number of implications for theory, learning and teaching, and test and curriculum design arising from the study. From a theoretical perspective, the findings of the study suggest that gesturing is an important element of multimodal engagement in mapping tasks. In terms of teaching and learning, implications include the need for students to utilise gesturing techniques when first faced with new or novel map tasks. As students become more proficient in solving such tasks, they should be encouraged to move beyond a reliance on such gesture use in order to progress to more sophisticated understandings of map tasks. Additionally, teachers need to provide students with opportunities to interpret and attend to multiple modes of information when interpreting map tasks.
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This research documents and analyses the modes of implementation of the Dance component of The Arts Essential Learnings in a Queensland school. The research identifies what makes good practice in dance education and the multiple modes of implementation that support this practice. The primary purpose of this research is to describe the factors that influence dance education, as it is delivered, in a Queensland primary school to inform the development of further support for primary teachers and to improve the quality of dance education in Prep -7 schooling. The literature review investigates dance education both in Queensland, Australia and internationally, identifying current issues related to the delivery of dance in a primary school environment including barriers to implementation of dance, authentic learning and integrated approaches to learning. Based on Engestrom.s reformulation of Vygotsky.s theory of socially mediated learning, the implementation of dance education curriculum was explored through descriptive case study method. The case study was conducted in a regional Queensland school identified as delivering the dance curriculum in a variety of ways. The research project provided opportunities to observe, document and analyse how teachers deal with pedagogical dilemmas and solve logistical problems associated with teaching the dance component of the Arts curriculum in this school. Teachers. practices were contextualised through investigation of the whole school context of dance curriculum development. The findings revealed a range of teaching approaches that influenced teachers. interpretation and children.s experience of the dance curriculum. The features of a supportive whole school and cultural environment for dance were identified. These have been captured in a reworked version of Engestrom.s Second Generation Activity Theory that can be applied to the implementation of dance education in primary schools.