Surrogate endpoints for prostate cancer-specific mortality after radiotherapy and androgen suppression therapy in men with localised or locally advanced prostate cancer: an analysis of two randomised trials

Background Androgen suppression therapy and radiotherapy are used to treat locally advanced prostate cancer. 3 years of androgen suppression confers a small survival benefit compared with 6 months of therapy in this setting, but is associated with more toxic effects. Early identification of men in whom radiotherapy and 6 months of androgen suppression is insufficient for cure is important. Thus, we assessed whether prostate-specific antigen (PSA) values can act as an early surrogate for prostate cancer-specific mortality (PCSM). Methods We systematically reviewed randomised controlled trials that showed improved overall and prostate cancer-specific survival with radiotherapy and 6 months of androgen suppression compared with radio therapy alone and measured lowest PSA concentrations (PSA nadir) and those immediately after treatment (PSA end). We assessed a cohort of 734 men with localised or locally advanced prostate cancer from two eligible trials in the USA and Australasia that randomly allocated participants between Feb 2, 1996, and Dec 27, 2001. We used Prentice criteria to assess whether reported PSA nadir or PSA end concentrations of more than 0.5 ng/mL were surrogates for PCSM. Findings Men treated with radiotherapy and 6 months of androgen suppression in both trials were significantly less likely to have PSA end and PSA nadir values of more than 0.5 ng/mL than were those treated with radiotherapy alone (p<0.0001). Presence of candidate surrogates (ie, PSA end and PSA nadir values >0.5 ng/mL) alone and when assessed in conjunction with the randomised treatment group increased risk of PCSM in the US trial (PSA nadir p=0.0016; PSA end p=0.017) and Australasian trial (PSA nadir p<0.0001; PSA end p=0.0012). In both trials, the randomised treatment group was no longer associated with PCSM (p >= 0.20) when the candidate surrogates were included in the model. Therefore, both PSA metrics satisfied Prentice criteria for surrogacy. Interpretation After radiotherapy and 6 months of androgen suppression, men with PSA end values exceeding 0.5 ng/mL should be considered for long-term androgen suppression and those with localised or locally advanced prostate cancer with PSA nadir values exceeding 0.5 ng/mL should be considered for inclusion in randomised trials investigating the use of drugs that have extended survival in castration-resistant metastatic prostate cancer.

Goat kids' intestinal absorptive mucosa in period of passive immunity acquisition

Colostrum intake in newborn goat kids is essential for the acquisition of immunoglobulins (Ig) and influencing development of gastrointestinal mucosa. The present study investigated small intestine structure in the postnatal goat kid fed lyophilized bovine colostrum, an alternative source of antibodies to small ruminants, or goat colostrum using scanning electron microscopy technique. At 0,7 and 14 h of life 15 male newborns received 5% of body weight of lyophilized bovine colostrum (LBC) and 14 goat colostrum (GC), both with 55 mg/mL of IgG. Samples of duodenum, medium jejunum and ileum were collected at 18, 36 and 96 h of life. Three animals were sampled at birth without colostrum intake (0 h). The enteric tissues were analyzed for villi density (villi/cm(2)) and morphological characteristics. The villi density did not differ between treatment, sampling time and intestinal segments (P>0.05). The morphological characteristics were not different between LBC and GC in all segments. Duodenal villi were fingerlike, thick and short, and with different heights. Duodenal folds could also be verified. Frequent anastomoses in all sampling times were observed in this segment. In the jejunum, fingerlike villi, thin and thick, of different heights were observed in all sampling times as well as leaf-shaped villi. Vacuoles with colostrum were observed in the jejunum of goats sampled at 18 h of life. In ileum, fingerlike villi were observed in all sampling times. At 0 and 96 h of life, thick and low villi were verified while at 18 and 36 h the villi showed different heights and widths. At all sampling times, regularly cell extrusion processes were observed with grouped cells at the apex of the ileum villi and with isolated cells along the villi. In the first 4 days of goat kids' life the small intestine structure was unaffected by different sources of colostrum, goat or lyophilized bovine, and by the replacement of fetal enterocytes, which are able to absorb macromolecules, by adult-type ones. (C) 2011 Elsevier B.V. All rights reserved.

The sigma-isotypic decomposition and the sigma-index of reversible-equivariant systems

This work is concerned with dynamical systems in presence of symmetries and reversing symmetries. We describe a construction process of subspaces that are invariant by linear Gamma-reversible-equivariant mappings, where Gamma is the compact Lie group of all the symmetries and reversing symmetries of such systems. These subspaces are the sigma-isotypic components, first introduced by Lamb and Roberts in (1999) [10] and that correspond to the isotypic components for purely equivariant systems. In addition, by representation theory methods derived from the topological structure of the group Gamma, two algebraic formulae are established for the computation of the sigma-index of a closed subgroup of Gamma. The results obtained here are to be applied to general reversible-equivariant systems, but are of particular interest for the more subtle of the two possible cases, namely the non-self-dual case. Some examples are presented. (C) 2011 Elsevier BM. All rights reserved.

Influence of different shrinking temperatures and vacuum conditions on the ability of psychrotrophic Clostridium to cause 'blown pack' spoilage in chilled vacuum-packaged beef

This study determined the ability of psychrotrophic Clostridium strains isolated from vacuum-packaged beefs and abattoir environments to cause 'blown-pack' spoilage of vacuum-packaged beef stored at 2 and 15 degrees C. The influence of shrinking temperatures (83, 84 and 87 degrees C) and vacuum pressure (6 and 9 mbar) on the occurrence of such spoilage as well as the effects of simulated transportation (500 km) on the integrity of packages was determined. At 15 degrees C and 2 degrees C, twelve and six strains caused 'blown-pack' spoilage, respectively. The combination of vacuum pressure (9 mbar) combined with shrinking temperature (87 degrees C) retarded the occurrence of spoilage. The simulated transportation under the experimental conditions did not affect the integrity of packages. More studies that assess the factors that may contribute for the occurrence of 'blown-pack' spoilage should be performed to avoid the occurrence of such spoilage during its shelf-life. (C) 2012 Elsevier Ltd. All rights reserved.

Fetal Pulmonary Response After Fetoscopic Tracheal Occlusion for Severe Isolated Congenital Diaphragmatic Hernia

OBJECTIVE: To estimate the response in lung growth and vascularity after fetal endoscopic tracheal occlusion for severe congenital diaphragmatic hernia in the prediction of neonatal survival. METHODS: Between January 2006 and December 2010, fetal lung parameters (observed-to-expected lung-to-head ratio; observed-to-expected lung volume; and contralateral lung vascularization index) were evaluated before fetal tracheal occlusion and were evaluated longitudinally every 2 weeks in 72 fetuses with severe isolated congenital diaphragmatic hernia. Thirty-five fetuses underwent fetal endoscopic tracheal occlusion and 37 cases did not. RESULTS: Survival rate was significantly higher in the fetal endoscopic tracheal occlusion group (54.3%) than in the no fetal endoscopic tracheal occlusion group (5.4%, P<.01). Fetal endoscopic tracheal occlusion resulted in a significant improvement in fetal lung size and pulmonary vascularity when compared with fetuses that did not go to the fetal intervention (increase of the observed-to-expected lung-to-head ratio, observed-to-expected total lung volume, and contralateral pulmonary vascularization index 56.2% compared with 0.3%, 37.9% compared with 0.1%, and 98.6% compared with 0.0%, respectively; P<.01). Receiver operating characteristic curves indicated that the observed-to-expected total fetal lung volume was the single best predictor of neonatal survival before fetal endoscopic tracheal occlusion (cutoff 0.23, area under the curve [AUC] 0.88, relative risk 5.3, 95% confidence interval [CI] 1.4-19.7). However, the contralateral lung vascularization index at 4 weeks after fetal endoscopic tracheal occlusion was more accurate in the prediction of neonatal outcome (cutoff 24.0%, AUC 0.98, relative risk 9.9, 95% CI 1.5-66.9) with the combination of observed-to-expected lung volumes and contralateral lung vascularization index at 4 weeks being the best predictor of outcome (AUC 0.98, relative risk 16.6, 95% CI 2.5-112.3). CONCLUSION: Fetal endoscopic tracheal occlusion improves survival rate by increasing the lung size and pulmonary vascularity in fetuses with severe congenital diaphragmatic hernia. The pulmonary response after fetal endoscopic tracheal occlusion can be used to predict neonatal survival. (Obstet Gynecol 2012; 119: 93-101) DOI: 10.1097/AOG.0b013e31823d3aea

Sinais clínicos e ocorrência de anticorpos anti-Chlamydophila abortus em ovinos de São Paulo e Minas Gerais

A Chlamydophila abortusi, anteriormente conhecida como Chlamydia psittaci sovovar 1, é uma bactéria Gram negativa, intracelular obrigatória. Esse micro-organismo é frequentemente encontrado em distúrbios reprodutivos em ovinos, bovinos e caprinos, sendo o aborto epizoótico dos bovinos e o aborto enzoótico dos ovinos e caprinos as manifestações mais importantes. Considerando-se o pouco material literário a respeito da clamidofilose no Brasil, a pesquisa teve como objetivo determinar a presença de anticorpos fixadores de complemento anti-Chlamydophila abortusi, correlacionando os resultados obtidos com achados no exame clínico e histórico dos animais, além de alterações nos índices zootécnicos, em especial na esfera reprodutiva, tais como alto índice de repetição de cio, número elevado de abortamentos, elevado número de natimortos, entre outros. Foram testadas para prova de fixação do complemento 220 amostras de soro de ovinos, de 26 propriedades, distribuídas em 19 municípios, com relato de manifestação reprodutiva, obtendo-se 19,55% (43/220) de testes positivos para Chlamydophila abortusi, com ocorrência de foco constatada de 61,53%. No geral, a titulação de anticorpos encontrada foi baixa, com título não superior a 64. A frequência de manifestação reprodutiva mais observada foi o aborto, representando 65,12% (28/43) do número total de animais soropositivos, seguido de repetição de cio juntamente com nascimento de cordeiro fraco, com frequência de 6,98% (3/43) e, por fim, morte neonatal com 4,65% (2/43), sendo que não houve associação significativa entre animais que foram positivos ao teste e a esses fatores.

Colibacillosis in lambs is associated to type I heat-stable enterotoxin in a farm in Sao Paulo State, Brazil

Twenty seven (48.2%) culture supernatants of 56 Escherichia coli isolated from diarrheic lamb feces (7 to 10 days old) in Sao Paulo State, Brazil, presented positive results to suckling mice assay (fluid accumulation) but none caused cytopathic effects on Vero and CHO cells, indicating that these strains did not produced LT or VT toxins. PCR assays showed that these 27 E. coli strains harbored estA, that codifies for STa, but not for stx1, stx2 or cnf genes. The positive STa strains were checked for genes that codify for F41, F17 and K99 fimbriae, wich are considered colonization factors in ETEC. Only F17 was detect in two samples (7.4%). Twelve of 27 STa positive carried hlyA gene and presented hemolytic activity in blood Agar. Presence of rotavirus was not detected among the diarrheic feces. These data suggests that STa must be an important diarrheagenic factor to small ruminants in Sao Paulo State.

Efeito do genótipo sobre a composição química e o perfil de ácidos graxos da carne de borregas

O objetivo neste experimento foi avaliar os efeitos do genótipo sobre a composição química e o perfil de ácidos graxos no músculo longissimus dorsi de borregas. Foram utilizados 36 animais dos grupos genéticos: Santa Inês (SI), Ile de France (IF), Ile de France × Santa Inês (IF × SI), Dorper × Santa Inês (DO × SI), Texel × Santa Inês (TE × SI) e Suffolk × Santa Inês (SU × SI). Os animais foram distribuídos em blocos completos casualizados, definidos de acordo com o peso e a idade inicial. Não houve efeito do genótipo sobre os teores de umidade, cinzas e proteína no músculo. A carne das borregas dos genótipos Santa Inês e Suffolk × Santa Inês apresentou menor teor de gordura em comparação à das borregas Ile de France e Ile de France × Santa Inês. Os ácidos graxos identificados em maiores proporções no músculo foram o ácido oleico (C18:1cis), ácido palmítico (C16:0) e ácido esteárico (C18:0). No grupo genético Ile de France × Santa Inês, a relação entre os ácidos graxos poliinsaturados e saturados foi menor que nas borregas Santa Inês e Suffolk × Santa Inês. O genótipo Santa Inês e o cruzamento Suffolk × Santa Inês tem potencial para produção de carne de melhor valor nutricional, devido ao menor teor de gordura e à melhor relação entre ácidos graxos poliinsaturados e saturados.

Sinais clínicos e ocorrência de anticorpos anti-Chlamydophila abortus em ovinos de São Paulo e Minas Gerais

A Chlamydophila abortus, anteriormente conhecida como Chlamydia psittaci sovovar 1, é uma bactéria Gram negativa, intracelular obrigatória. Esse micro-organismo é frequentemente encontrado em distúrbios reprodutivos em ovinos, bovinos e caprinos, sendo o aborto epizoótico dos bovinos e o aborto enzoótico dos ovinos e caprinos as manifestações mais importantes. Considerando-se o pouco material literário a respeito da clamidofilose no Brasil, a pesquisa teve como objetivo determinar a presença de anticorpos fixadores de complemento anti-Chlamydophila abortus, correlacionando os resultados obtidos com achados no exame clínico e histórico dos animais, além de alterações nos índices zootécnicos, em especial na esfera reprodutiva, tais como alto índice de repetição de cio, número elevado de abortamentos, elevado número de natimortos, entre outros. Foram testadas para prova de fixação do complemento 220 amostras de soro de ovinos, de 26 propriedades, distribuídas em 19 municípios, com relato de manifestação reprodutiva, obtendo-se 19,55% (43/220) de testes positivos para Chlamydophila abortus, com ocorrência de foco constatada de 61,53%. No geral, a titulação de anticorpos encontrada foi baixa, com título não superior a 64. A frequência de manifestação reprodutiva mais observada foi o aborto, representando 65,12% (28/43) do número total de animais soropositivos, seguido de repetição de cio juntamente com nascimento de cordeiro fraco, com frequência de 6,98% (3/ 43) e, por fim, morte neonatal com 4,65% (2/43), sendo que não houve associação significativa entre animais que foram positivos ao teste e a esses fatores.

Untersuchungen zur Speicherung, Laserkühlung und Kristallisation von Ca+-Ionen in einer linearen Paulfalle

ZusammenfassungUntersuchungen zur Speicherung, Laserkühlung und Kristallisation von Ca+-Ionen in einer linearen PaulfalleIn dieser Arbeit wurden grundlegende Untersuchungen vonlasergekühlten Ionen in einer linearen Paulfalledurchgeführt. Diese können in drei Bereiche gegliedertwerden: Dynamik der Ionen in der linearen Paulfalle. Hierzuwurden Speicherbereich, parametrische Anregungen undSchwingungsfrequenzen der Ionen in der linearen Paulfalleauch hinsichtlich der Unterschiede zur traditionellendreidimensionalenuntersucht. Über die genaue Messung der Schwingungsfrequenzenkonnte der Abstand zweier Ionen in einem Kristall bis auf 10-4genau bestimmt werden. Diese Genauigkeit der Abstandsbestimmung ist notwendig, um theoretische Vorhersagen zu kooperativen Effektenüberprüfen zu können. Laserkühlung an einem 3-Niveau-SystemsHierzu wurden für Bereiche außerhalb des Lamb-Dicke Regimes Simulationen zur Laserkühlung an einem einzelnen Ion durchgeführt und soweit möglich experimentellüberprüft. Es wurden Kühlzeiten und Temperaturlimits für verschiedene Verstimmungen der Laser bestimmt.Diese stehen zum Teil im Widerspruch mit den bisherigen Annahmen.Die Kenntnis der Laserverstimmungen für die effektivste Lasekühlung sind notwendig, um bei weiterführenden Kühlmethoden eine hinreichendgute Vorkühlung erreichen zu können.Kristallstrukturen in der linearen Paulfalle.Hier wurden verschiedene theoretisch vorhergesagte Kristallstrukturen der Ionen bei abzählbaren Ionenanzahlenfür dreidimensionalen und quasi-zweidimensionaleSpeicherpotentiale mit experimentellen Werten verglichen. Dabei konnten Abweichungen zur Theoriefestgestellt werden. Ferner wurde die durchden Lichtdruck hervorgerufene Trennung von atomaren Zuständenin großen Ionenkristallen beobachtet.

Measurement of the elastic electron-proton cross section and separation of the electric and magnetic form factor in the Q 2 range from 0.004 to 1 (GeV/c) 2

The electromagnetic form factors of the proton are fundamental quantities sensitive to the distribution of charge and magnetization inside the proton. Precise knowledge of the form factors, in particular of the charge and magnetization radii provide strong tests for theory in the non-perturbative regime of QCD. However, the existing data at Q^2 below 1 (GeV/c)^2 are not precise enough for a hard test of theoretical predictions.rnrnFor a more precise determination of the form factors, within this work more than 1400 cross sections of the reaction H(e,e′)p were measured at the Mainz Microtron MAMI using the 3-spectrometer-facility of the A1-collaboration. The data were taken in three periods in the years 2006 and 2007 using beam energies of 180, 315, 450, 585, 720 and 855 MeV. They cover the Q^2 region from 0.004 to 1 (GeV/c)^2 with counting rate uncertainties below 0.2% for most of the data points. The relative luminosity of the measurements was determined using one of the spectrometers as a luminosity monitor. The overlapping acceptances of the measurements maximize the internal redundancy of the data and allow, together with several additions to the standard experimental setup, for tight control of systematic uncertainties.rnTo account for the radiative processes, an event generator was developed and implemented in the simulation package of the analysis software which works without peaking approximation by explicitly calculating the Bethe-Heitler and Born Feynman diagrams for each event.rnTo separate the form factors and to determine the radii, the data were analyzed by fitting a wide selection of form factor models directly to the measured cross sections. These fits also determined the absolute normalization of the different data subsets. The validity of this method was tested with extensive simulations. The results were compared to an extraction via the standard Rosenbluth technique.rnrnThe dip structure in G_E that was seen in the analysis of the previous world data shows up in a modified form. When compared to the standard-dipole form factor as a smooth curve, the extracted G_E exhibits a strong change of the slope around 0.1 (GeV/c)^2, and in the magnetic form factor a dip around 0.2 (GeV/c)^2 is found. This may be taken as indications for a pion cloud. For higher Q^2, the fits yield larger values for G_M than previous measurements, in agreement with form factor ratios from recent precise polarized measurements in the Q2 region up to 0.6 (GeV/c)^2.rnrnThe charge and magnetic rms radii are determined as rn⟨r_e⟩=0.879 ± 0.005(stat.) ± 0.004(syst.) ± 0.002(model) ± 0.004(group) fm,rn⟨r_m⟩=0.777 ± 0.013(stat.) ± 0.009(syst.) ± 0.005(model) ± 0.002(group) fm.rnThis charge radius is significantly larger than theoretical predictions and than the radius of the standard dipole. However, it is in agreement with earlier results measured at the Mainz linear accelerator and with determinations from Hydrogen Lamb shift measurements. The extracted magnetic radius is smaller than previous determinations and than the standard-dipole value.

Campionamento e ricostruzione di immagini full wavefield per il monitoraggio strutturale

L'elaborato affronta la definizione di differenti strategie per il campionamento e la ricostruzione di segnali wavefield per applicazioni di monitoraggio strutturale. In accordo con quanto indicato dalla teoria del Compressive Sensing, obiettivo della tesi è la minimizzazione del numero di punti di acquisizione al fine di ridurre lo sforzo energetico del campionamento. I risultati sono validati in ambiente Matlab utilizzando come riferimento segnali acquisiti su setup sperimentali in alluminio o materiale composito in presenza di diverse tipologie di difetto.

Studio dell'innesco di frane rapide in un'area campione dell'Appennino Bolognese

Il lavoro di tesi ha preso spunto da un fenomeno franoso avvenuto a Porretta Terme (provincia di Bologna), nell’autunno 2008, a causa di abbondanti precipitazioni, in tale occasione si innescò una colata rapida di detriti che invase la strada statale n. 64 e lambì la ferrovia che collega l’Emilia Romagna e la Toscana. I detriti colpirono anche un’abitazione, senza per fortuna causare perdite umane ne danni ingenti, ma l’evento riscosse numerose attenzioni da parte della popolazione locale, preoccupata che fenomeni del genere potessero ripetersi anche in altre zone e senza alcun preavviso. L’evento allertò anche la Protezione Civile regionale che da subito si interessò all’applicazione di metodi in grado di prevedere la suscettività areale da frane di questo tipo. Metodi previsionali per colate rapide sono stati sviluppati negli ultimi anni in diverse università sia in Europa sia negli Stati Uniti d’America. Lo scopo è quello di prevedere le possibili zone di innesco e individuare le soglie di precipitazione critica in modo da realizzare carte di suscettività a scopo di pianificazione territoriale e mitigazione del rischio. Il lavoro, durato diversi mesi, è passato attraverso diverse fasi. In primis si è proceduto a sopralluoghi di campo al fine di inquadrare l’area oggetto di studio dal punto di vista geologico e geomorfologico. Successivamente è stata svolta una fase di campionamento sul terreno; tramite una trivella manuale sono stati effettuati numerosi carotaggi (circa 60) sparsi sull’intero versante oggetto di studio, al fine di ricavare un dato relativo allo spessore del suolo. Inoltre sono stati raccolti dei campioni di terreno, analizzati successivamente in laboratorio al fine di ricavarne le curve granulometriche e alcuni dati caratterizzanti. Terminata la fase sul terreno, si è provveduto ad effettuare le prove di laboratorio (curve granulometriche, limiti di Attemberg, etc). Grazie ai dati raccolti, è stato possibile applicare un modello previsionale di stabilità superficiale, TRIGRS 2.0 basato sull’infiltrazione in un mezzo non saturo di una precipitazione di durata finita. Particolare attenzione è stata rivolta ai metodi per la previsione dello spessore del suolo (Z Model, S Model, Sexp Model) e alla loro influenza nella suscettività da frana superficiale.

Pedagogical techniques and student outcomes in applied instrumental lessons taught by experienced and pre-service American music teachers.

The purpose of the study was to examine the effect of teacher experience on student progress and performance quality in an introductory applied lesson. Nine experienced teachers and 15 pre-service teachers taught an adult beginner to play ‘Mary Had a Little Lamb’ on a wind instrument. The lessons were videotaped for subsequent analysis of teaching behaviors and performance achievement. Following instruction, a random sample of teachers was interviewed about their perceptions of the lesson. A panel of adjudicators rated final pupil performances. No significant difference was found between pupils taught by experienced and pre-service teachers in the quality of their final performance. Systematic observation of the videotaped lessons showed that participant teachers provided relatively frequent and highly positive reinforcement during the lessons. Pupils of experienced teachers talked significantly more during the lessons than did pupils of pre-service teachers. Pre-service teachers modeled significantly more on their instruments than did experienced teachers.