La performance diagnostique des marqueurs tumoraux messagers dans le diagnostic et le suivi du cancer du sein

Selon plusieurs évidences, la présence de cellules tumorales occultes dans la circulation sanguine aux premières étapes du cancer du sein pourrait être à l’origine des lésions métastasiques. Plusieurs études de recherche ont montré que l’utilisation de la RT-PCR en temps réel pour la détection des cellules tumorales circulantes CTC offre la meilleure sensibilité dans la quantification des marqueurs tumoraux. Présentement de routine, le suivi du cancer du sein est réalisé par le dosage immunologique des marqueurs sériques CA15-3 et CEA. Cependant, la faible sensibilité de ces marqueurs aux stades précoces de la maladie et leur manque de spécificité tissulaire ne permet pas leur utilisation pour le diagnostic et le pronostic du cancer du sein. Le diagnostic de la maladie est plutôt basé sur l’analyse d’une biopsie de la tumeur ou des ganglions lymphatiques, des méthodes invasives, coûteuses et peu adaptées pour un suivi de routine dans l’évaluation du risque de rechute et de la réponse au traitement. Malgré les études, la détection de ces cellules dans les laboratoires hospitaliers est rare. Nous avons envisagé de mettre en place un nouveau test RT-PCR pour la détection de cellules malignes du cancer du sein dans la circulation. La spécificité et la sensibilité de plusieurs marqueurs potentiels ont été comparées. Le but ultime de ce projet est d’offrir la détection d’un ou d’une combinaison de ces marqueurs de routine aux patientes. Nos résultats montrent une corrélation positive entre l’expression des ARNm des marqueurs CK19 et de HER2 avec les données cliniques des patientes. De plus, la sensibilité et la spécificité des tests RT-PCR sont comparables à la littérature récente. Finalement, la comparaison de notre test avec le dosage immunologique des marqueurs tumoraux sériques CA15.3 et CEA a montré que la détection de la CK19 et de HER2 par RT-PCR est plus sensible chez les patientes de cancer du sein métastatique.

Performance perceptive dans l’autisme : du facteur «g» au facteur «p»

La perception est de plus en plus reconnue comme fondamentale à la compréhension du phénotype autistique. La première description de l’autisme, par Kanner en 1947, fait état d’un profil cognitif hétérogène caractérisé par des habiletés exceptionnelles à l’intérieur de domaines spécifiques de la perception (ex., la musique). L’accumulation des observations cliniques sur la présence de particularités perceptives a mené à l’élaboration d’études empiriques permettant d’objectiver des surfonctionnements dans le traitement élémentaire de l’information perceptive dans l’autisme. Parallèlement, des études cognitives suggèrent la présence d’une « intelligence différente » chez les personnes autistes. Celle-ci serait caractérisée par une dissociation entre des performances à différents tests d’intelligence fortement corrélés ensemble chez les personnes typiques. Le potentiel intellectuel des personnes autistes serait sous-estimé lorsque mesuré par l’échelle de Wechsler, plutôt que des mesures d’intelligence fluide comme les Matrices Progressives de Raven. Avec l’appui d’études en imagerie cérébrale, ces résultats suggèrent une relation unique entre la perception et l’intelligence chez cette population clinique. Étant donné l’accumulation de preuves sur 1) la présence d’atypies perceptuelles, 2) le rôle différent de la perception dans l’intelligence et 3) l’importance des comportements répétitifs et intérêts restreints dans le phénotype autistique (DSM-5), le premier volet de cette thèse s’est intéressé à la relation entre les performances perceptives des personnes autistes et celle des personnes ayant un développement typique, au-delà de ce qui est expliqué par l’intelligence. À l’aide de modèles de régression linéaire, les résultats démontrent un profil de covariation spécifique à l’autisme pour les habiletés plurimodales. Contrairement aux personnes ayant un développement typique, ces associations persistent au-delà de ce qui est expliqué par l’intelligence générale ou par l’efficacité générale des systèmes perceptifs. Ce profil de covariation résiduelle propre aux personnes autistes suggère la présence d’un facteur plurimodal spécifique à ce groupe clinique : le facteur « p ». Le deuxième volet de cette thèse s’est intéressé à la prévalence des habiletés exceptionnelles au niveau individuel, la relation les forces perceptives et les talents, ainsi qu’aux facteurs de prédisposition en lien avec le développement d’habiletés exceptionnelles. Les forces perceptives des personnes autistes furent évaluées à l’aide de tâches expérimentales sensibles à la détection de surfonctionnements perceptifs, soit une tâche de discrimination de hauteurs sonores et une version modifiée du sous-test « Blocs » de l’échelle d’intelligence de Wechsler. Les talents furent évalués de manière clinique à l’aide de l’ADI-R (« Autism Diagnostic Interview-Revised »). Les données indiquent que 88.4 % des personnes autistes avec une intelligence dans la normale présentent au moins une habileté exceptionnelle (force perceptive ou talent). Les talents sont rapportés chez 62.5 % des cas et les forces perceptives se retrouvent chez 58 % des cas. La cooccurrence des forces perceptives entre les modalités perceptives est relativement peu fréquente (24 % à 27 %) et la présence d’un talent dans une modalité n’augmente pas les chances de présenter une force perceptive dans une même modalité. Une plus grande intelligence augmente les chances de présenter au moins un talent. En revanche, une intelligence plus faible, mais se situant tout de même dans les limites de la normale, est associée à un profil cognitif plus hétérogène avec des forces perceptives plus fréquentes. En somme, l’intelligence autistique serait caractérisée par un rôle plus important de la perception, indépendamment des surfonctionnements perceptifs. Cette particularité cognitive se manifesterait par la présence d’un facteur plurimodal, « p », spécifique à l’autisme. Théoriquement, le facteur « p » reflèterait des modifications innées (ou « hardwired ») dans l’organisation corticale des microcircuits responsables de l'encodage des dimensions perceptives élémentaires. En revanche, une faible association intermodale entre les forces perceptives suggère que des modifications corticales sont essentielles, mais non suffisantes pour le développement d’habiletés exceptionnelles. Par des processus de plasticité, des modifications corticales auraient des répercussions sur le phénotype autistique en offrant une base plus « fertile » pour le développement d’habiletés exceptionnelles, voire savantes, lorsque la personne autiste serait exposée à des expériences de vie avantageuses. Par ailleurs, les résultats de cette thèse, combinés à la littérature existante sur l’intelligence et l’apprentissage des personnes autistes, nous amènent à réfléchir sur les approches d’évaluation et d’intervention les mieux adaptées au fonctionnement spécifique de cette population clinique.

Networks of PhD Students and Academic Performance: A Comparison across Countries

In this article we compare regression models obtained to predict PhD students’ academic performance in the universities of Girona (Spain) and Slovenia. Explanatory variables are characteristics of PhD student’s research group understood as an egocentered social network, background and attitudinal characteristics of the PhD students and some characteristics of the supervisors. Academic performance was measured by the weighted number of publications. Two web questionnaires were designed, one for PhD students and one for their supervisors and other research group members. Most of the variables were easily comparable across universities due to the careful translation procedure and pre-tests. When direct comparison was not possible we created comparable indicators. We used a regression model in which the country was introduced as a dummy coded variable including all possible interaction effects. The optimal transformations of the main and interaction variables are discussed. Some differences between Slovenian and Girona universities emerge. Some variables like supervisor’s performance and motivation for autonomy prior to starting the PhD have the same positive effect on the PhD student’s performance in both countries. On the other hand, variables like too close supervision by the supervisor and having children have a negative influence in both countries. However, we find differences between countries when we observe the motivation for research prior to starting the PhD which increases performance in Slovenia but not in Girona. As regards network variables, frequency of supervisor advice increases performance in Slovenia and decreases it in Girona. The negative effect in Girona could be explained by the fact that additional contacts of the PhD student with his/her supervisor might indicate a higher workload in addition to or instead of a better advice about the dissertation. The number of external student’s advice relationships and social support mean contact intensity are not significant in Girona, but they have a negative effect in Slovenia. We might explain the negative effect of external advice relationships in Slovenia by saying that a lot of external advice may actually result from a lack of the more relevant internal advice

A performance test for school age children wtih a language handicap

This paper discusses language and intelligence tests for hearing impaired children.

The relationship between performance on the Stanford Achievement Test and the Peabody Individual Achievement test for a group of hearing-impaired children

This paper discusses the Stanford and Peabody tests for achievement and which test is more efficient for hearing impaired children.

Does the regional nature of multinationals affect the multinationality and performance relationship?

The traditional independent variable in the multinationality and performance literature is the ratio of foreign (F) to total (T) sales, (F/T). This can now be supplemented by a new regional variable, the ratio of regional (R) to total (T) sales, i.e. (R/T). Data are presented on both (F/T) and (R/T) for both sales and assets for a 5-year period, 2001–2005. New tests are reported on (R/T) as it affects a financial measure of performance, the Tobin's Q. Implications are drawn for future research on the S-curve relationship between multinationality and performance in the light of this regional phenomenon.

A capture–recapture approach for screening using two diagnostic tests with availability of disease status for the test positives only

The article considers screening human populations with two screening tests. If any of the two tests is positive, then full evaluation of the disease status is undertaken; however, if both diagnostic tests are negative, then disease status remains unknown. This procedure leads to a data constellation in which, for each disease status, the 2 × 2 table associated with the two diagnostic tests used in screening has exactly one empty, unknown cell. To estimate the unobserved cell counts, previous approaches assume independence of the two diagnostic tests and use specific models, including the special mixture model of Walter or unconstrained capture–recapture estimates. Often, as is also demonstrated in this article by means of a simple test, the independence of the two screening tests is not supported by the data. Two new estimators are suggested that allow associations of the screening test, although the form of association must be assumed to be homogeneous over disease status. These estimators are modifications of the simple capture–recapture estimator and easy to construct. The estimators are investigated for several screening studies with fully evaluated disease status in which the superior behavior of the new estimators compared to the previous conventional ones can be shown. Finally, the performance of the new estimators is compared with maximum likelihood estimators, which are more difficult to obtain in these models. The results indicate the loss of efficiency as minor.

Phyto-activity of biocides used to manipulate herbivory: tests of three pesticides on fourteen plant species

1. We tested three pesticides used for field manipulations of herbivory for direct phytoactive effects on the germination and growth of 14 herbaceous plant species selected to provide a range of life-history strategies and functional groups. 2. We report three companion experiments: (A) Two insecticides, chlorpyrifos (granular soil insecticide) and dimethoate (foliar spray), were applied in fully-factorial combination to pot-germinated individuals of 12 species. (B) The same fully-factorial design was used to test for direct effects on the germination of four herbaceous legumes. (C) The molluscicide, metaldehyde, was tested for direct effects on the germination and growth of six plant species. 3. The insecticides had few significant effects on growth and germination. Dimethoate acted only on growth stimulating Anisantha sterilis, Sonchus asper and Stellaria graminea. In contrast, chlorpyrifos acted on germination increasing the germination of Trifolium dubium and Trifolium pratense. There was also a significant interactive effect of chlorpyrifos and dimethoate on the germination of T pratense. However, all. effects were relatively small in magnitude and explanatory power. The molluscicide had no significant effect on plant germination or growth. 4. The small number and size of direct effects of the pesticides on plant performance is encouraging for the use of these pesticides in manipulative experiments on herbivory, especially for the molluscicide. However, a smatt number of direct (positive) effects of the insecticides on some plant species need to be taken into account when interpreting field manipulations of herbivory with these compounds, and emphasises the importance of conducting tests for direct phyto-active effects. (C) 2004 Elsevier GmbH. All rights reserved.

A capture-recapture approach for screening using two diagnostic tests with availability of disease status for the test positives only

The article considers screening human populations with two screening tests. If any of the two tests is positive, then full evaluation of the disease status is undertaken; however, if both diagnostic tests are negative, then disease status remains unknown. This procedure leads to a data constellation in which, for each disease status, the 2 x 2 table associated with the two diagnostic tests used in screening has exactly one empty, unknown cell. To estimate the unobserved cell counts, previous approaches assume independence of the two diagnostic tests and use specific models, including the special mixture model of Walter or unconstrained capture-recapture estimates. Often, as is also demonstrated in this article by means of a simple test, the independence of the two screening tests is not supported by the data. Two new estimators are suggested that allow associations of the screening test, although the form of association must be assumed to be homogeneous over disease status. These estimators are modifications of the simple capture-recapture estimator and easy to construct. The estimators are investigated for several screening studies with fully evaluated disease status in which the superior behavior of the new estimators compared to the previous conventional ones can be shown. Finally, the performance of the new estimators is compared with maximum likelihood estimators, which are more difficult to obtain in these models. The results indicate the loss of efficiency as minor.

Extensional rheology and stability of gas cell walls in bread doughs at elevated temperatures in relation to breadmaking performance

The rheological properties of gas cell walls in bread doughs are considered to be important in relation to their stability and gas retention during proof and baking. Large deformation rheological properties of gas cell walls were measured using biaxial extension for a number of doughs of varying breadmaking quality at constant strain rate and elevated temperatures of 25-60degreesC. Strain hardening and failure strain of cell walls both decreased with temperature, with cell walls in good breadmaking doughs remaining stable and retaining their strain hardening properties at higher temperatures (60degreesC), while the cell walls of poor breadmaking doughs became unstable at lower temperatures (45-50degreesC) and had lower strain hardening. Strain hardening measured at 50degreesC gave good correlations with baking volume, with the best correlations achieved between rheological measurements and baking tests that used similar mixing conditions. As predicted by the considered failure criterion, a strain hardening value of I defines a region below which gas cell walls become unstable, and discriminates well between the baking quality of a range of commercial flour blends of varying quality. This indicates that the stability of gas cell walls during baking is strongly related to strain hardening properties, and that extensional rheological measurements can be used as indicators of baking quality.

Tests of syntactic comprehension in aphasia: an investigation of task effects

Background: Consistency of performance across tasks that assess syntactic comprehension in aphasia has clinical and theoretical relevance. In this paper we add to the relatively sparse previous work on how sentence comprehension abilities are influenced by the nature of the assessment task. Aims: Our aims are: (1) to compare linguistic performance across sentence-picture matching, enactment, and truth-value judgement tasks; (2) to investigate the impact of pictorial stimuli on syntactic comprehension. Methods Procedures: We tested a group of 10 aphasic speakers (3 with fluent and 7 with non-fluent aphasia) in three tasks (Experiment 1): (i) sentence-picture matching with four pictures, (ii) sentence-picture matching with two pictures, and (iii) enactment. A further task of truth-value judgement was given to a subgroup of those speakers (n=5, Experiment 2). Similar sentence types across all tasks were used and included canonical (actives, subject clefts) and non-canonical (passives, object clefts) sentences. We undertook two types of analyses: (a) we compared canonical and non-canonical sentences in each task; (b) we compared performance between (i) actives and passives, (ii) subject and object clefts in each task. We examined the results of all participants as a group and as case-series. Outcomes Results: Several task effects emerged. Overall, the two-picture sentence-picture matching and enactment tasks were more discriminating than the four-picture condition. Group performance in the truth-value judgement task was similar to two-picture sentence-picture matching and enactment. At the individual level performance across tasks contrasted to some group results. Conclusions: Our findings revealed task effects across participants. We discuss reasons that could explain the diverse profiles of performance and the implications for clinical practice.

Visuospatial cognition in Williams syndrome: reviewing and accounting for the strengths and weaknesses in performance

Individuals with Williams syndrome typically show relatively poor visuospatial abilities in comparison to stronger verbal skills. However, individuals' level of performance is not consistent across all visuospatial tasks. The studies assessing visuospatial functioning in Williams syndrome are critically reviewed, to provide a clear pattern of the relative difficulty of these tasks. This prompts a possible explanation of the variability in performance seen, which focuses on the processing demands of some of these tasks. Individuals with Williams syndrome show an atypical processing style on tests of construction, which does not affect tests of perception.

Cognitive tests used in chronic adult human randomised controlled trial micronutrient and phytochemical intervention studies

In recent years there has been a rapid growth of interest in exploring the relationship between nutritional therapies and the maintenance of cognitive function in adulthood. Emerging evidence reveals an increasingly complex picture with respect to the benefits of various food constituents on learning, memory and psychomotor function in adults. However, to date, there has been little consensus in human studies on the range of cognitive domains to be tested or the particular tests to be employed. To illustrate the potential difficulties that this poses, we conducted a systematic review of existing human adult randomised controlled trial (RCT) studies that have investigated the effects of 24 d to 36 months of supplementation with flavonoids and micronutrients on cognitive performance. There were thirty-nine studies employing a total of 121 different cognitive tasks that met the criteria for inclusion. Results showed that less than half of these studies reported positive effects of treatment, with some important cognitive domains either under-represented or not explored at all. Although there was some evidence of sensitivity to nutritional supplementation in a number of domains (for example, executive function, spatial working memory), interpretation is currently difficult given the prevailing 'scattergun approach' for selecting cognitive tests. Specifically, the practice means that it is often difficult to distinguish between a boundary condition for a particular nutrient and a lack of task sensitivity. We argue that for significant future progress to be made, researchers need to pay much closer attention to existing human RCT and animal data, as well as to more basic issues surrounding task sensitivity, statistical power and type I error.

The persistence of real estate fund performance

This paper examines the short and long-term persistence of tax-exempt real estate funds in the UK through the use of winner-loser contingency table methodology. The persistence tests are applied to a database of varying numbers of funds from a low of 16 to a high of 27 using quarterly returns over the 12 years from 1990 Q1 to 2001 Q4. The overall conclusion is that the real estate funds in the UK show little evidence of persistence in the short-term (quarterly and semi-annual data) or for data over a considerable length of time (bi-annual to six yearly intervals). In contrast, the results are better for annual data with evidence of significant performance persistence. Thus at this stage, it seems that an annual evaluation period, provides the best discrimination of the winner and loser phenomenon in the real estate market. This result is different from equity and bond studies, where it seems that the repeat winner phenomenon is stronger over shorter periods of evaluation. These results require careful interpretation, however, as the results show that when only small samples are used significant adjustments must be made to correct for small sample bias and second the conclusions are sensitive to the length of the evaluation period and specific test used. Nonetheless, it seems that persistence in performance of real estate funds in the UK does exist, at least for the annual data, and it appears to be a guide to beating the pack in the long run. Furthermore, although the evidence of persistence in performance for the overall sample of funds is limited, we have found evidence that two funds were consistent winners over this period, whereas no one fund could be said to be a consistent loser.

Generic strategies and performance: evidence from manufacturing firms

Purpose – The purpose of this study is to examine the relationship between business-level strategy and organisational performance and to test the applicability of Porter's generic strategies in explaining differences in the performance of organisations. Design/methodology/approach – The study was focussed on manufacturing firms in the UK belonging to the electrical and mechanical engineering sectors. Data were collected through a postal survey using the survey instrument from 124 organisations and the respondents were all at CEO level. Both objective and subjective measures were used to assess performance. Non-response bias was assessed statistically and it was not found to be a major problem affecting this study. Appropriate measures were taken to ensure that common method variance (CMV) does not affect the results of this study. Statistical tests indicated that CMV problem does not affect the results of this study. Findings – The results of this study indicate that firms adopting one of the strategies, namely cost-leadership or differentiation, perform better than “stuck-in-the-middle” firms which do not have a dominant strategic orientation. The integrated strategy group has lower performance compared with cost-leaders and differentiators in terms of financial performance measures. This provides support for Porter's view that combination strategies are unlikely to be effective in organisations. However, the cost-leadership and differentiation strategies were not strongly correlated with the financial performance measures indicating the limitations of Porter's generic strategies in explaining performance heterogeneity in organisations. Originality/value – This study makes an important contribution to the literature by identifying some of the gaps in the literature through a systematic literature review and addressing those gaps.