Does hepatocellular carcinoma in non-alcoholic steatohepatitis exist in cirrhotic and non-cirrhotic patients?

Non-alcoholic steatohepatitis (NASH) has been associated with hepatocellular carcinoma (HCC) often arising in histologically advanced disease when steatohepatitis is not active (cryptogenic cirrhosis). Our objective was to characterize patients with HCC and active, histologically defined steatohepatitis. Among 394 patients with HCC detected by ultrasound imaging over 8 years and staged by the Barcelona Clinic Liver Cancer (BCLC) criteria, we identified 7 cases (1.7%) with HCC occurring in the setting of active biopsy-proven NASH. All were negative for other liver diseases such as hepatitis C, hepatitis B, autoimmune hepatitis, Wilson disease, and hemochromatosis. The patients (4 males and 3 females, age 63 ± 13 years) were either overweight (4) or obese (3); 57% were diabetic and 28.5% had dyslipidemia. Cirrhosis was present in 6 of 7 patients, but 1 patient had well-differentiated HCC in the setting of NASH without cirrhosis (fibrosis stage 1) based on repeated liver biopsies, the absence of portal hypertension by clinical and radiographic evaluations and by direct surgical inspection. Among the cirrhotic patients, 71.4% were clinically staged as Child A and 14.2% as Child B. Tumor size ranged from 1.0 to 5.2 cm and 5 of 7 patients were classified as early stage; 46% of all nodules were hyper-echoic and 57% were <3 cm. HCC was well differentiated in 1/6 and moderately differentiated in 5/6. Alpha-fetoprotein was <100 ng/mL in all patients. HCC in patients with active steatohepatitis is often multifocal, may precede clinically advanced disease and occurs without diagnostic levels of alpha-fetoprotein. Importantly, HCC may occur in NASH in the absence of cirrhosis. More aggressive screening of NASH patients may be warranted.

Does affective learning exist in the absence of contingency awareness?

The proposal that affective learning, the learning of likes and dislikes, can exist in the absence of contingency awareness, whereas signal learning, the learning of stimulus relationships, cannot, was investigated in a differential conditioning paradigm that was embedded in a visual masking task. Startle magnitude modulation and changes in verbal ratings served as measures of affective learning, whereas skin conductance was taken to reflect signal learning. Awareness was assessed online with an expectancy dial and in a postexperimental questionnaire. Both between-subject comparisons of verbalizers and nonverbalizers and within-subject comparisons of verbalizers before and after verbalization failed to reveal any evidence for learning, whether affective or otherwise, in the absence of knowledge of the stimulus contingencies. (C) 2001 Academic Press.

Does a Role Exist for Tilting-Guided Therapy in the Management of Neurocardiogenic Syncope?

PURPOSE: Upright tilt-table testing (UTT) is an useful method for identifying patients with neurocardiogenic syncope, but its role in the evaluation of therapeutic efficacy is controversial. The aim of this study was to determine the correlation between negative UTT after therapy introduction (acute efficacy) and symptom recurrence during follow-up (chronic efficacy). METHODS: We studied 56 severely symptomatic patients (age 27±19 years) with recurrent (7±12 episodes) neurocardiogenic syncope (positive UTT). Once empirical pharmacological therapy was initiated, all patients underwent another UTT (therapeutic evaluation test - TET). Therapy was not modified after TET results. The probability of symptom recurrence was analyzed with the Kaplan-Meier method and compared by log-rank test in patients with negative and positive TET. RESULTS: Negative UTT after therapy was related to a significantly lower probability of recurrence during follow-up (4.9 versus 52.4% in 12 months, P<0.0001). CONCLUSION: A good correlation exists between acute and long-term efficacy of pharmacological therapy for neurocardiogenic syncope, so that serial UTT may be considered a good method for identifying an effective therapeutic strategy.

Does persistence of social exclusion exist in Spain?

The aim of this paper is to analyze the causes leading to social exclusion dynamics. In particular, we wish to understand why any individual experiencing social exclusion today is much more likely to experience it again. In fact, there are two distinct processes that may generate a persistence of social exclusion: heterogeneity (individuals are heterogeneous with respect to some observed and/or unobserved adverse characteristics that are relevant for the chance of experiencing social exclusion and persistence over time) and true state of dependence (experiencing social exclusion in a specific time period, in itself, increases the probability of undergoing social exclusion in subsequent periods). Distinguishing between the two processes is crucial since the policy implications are very different.

Sexism in Education, Does Gender Equity Exist in Your Community School District?

Sexism in Education brochure produced by the Iowa Commission on the Status of Women

Surface-dependent strategies and energy flux in benthic marine communities or, why corals do not exist in the Mediterranean

Most structure-building organisms in rocky benthic communities are surface-dependent because their energy inputs depend mainly on the surface they expose to water. Two photosynthetic strategies, divided into calcareous and non calcareous algae, strict suspension-feeders and photosynthetic suspension feeders (e.g. hermatypic corals) are the four main strategies evolutively acquired by benthic organisms. Competition between those strategies occur in relation to productivity of the different species, in such a way that, for given environmental conditions, species with a higher growth (P/B ratio) would dominate. At a worldwide scale, littoral marine benthos can he considered to fit into the four fields defined by two main axes: the first, relates to productivity and relies atrophic and oligotrophic waters and the second is defined by the degree of environmental variability or seasonality (from high to low). Coral reefs (marine ecosystems dominated by photosynthetic suspension feeders) develop in the space of oligotrophic areas with low variability, while kelp beds (marine ecosystem dominated by large, non calcareous algae) are to be found only in eutrophic places with a high variability. The space of eutrophic waters with a low variability do not has specially adapted, high structured, benthic marine ecosystems, and in these conditions opportunistic algae and animals predominate. Finally, photophilic mediterranean benthos -devoid of kelps and without hermatypic corals- typifies the field of oligotrophic areas with high variability; in its more genuine aspect, Mediterranean benthos is represented by small algae with a high percentage of calcareous thallii. In all cases strict suspension-feeders compete successfully with photosynthetic organisms only in situations of low irradiances or very high inputs of POM. In its turn, Mediterranean rocky benthos, in spite of its relative uniformity, is geographically organized along the same axes. The Gulf of Lions and the insular bottoms (Balearic Islands, for example) would correspond to the extremes of eutrophic-high variability areas and oligotrophic-low variability areas, respectively. Irradiance, nutrient and POM concentration, and hydrodynamism are the three variables which mainly affect the distribution of the different surface-dependent strategies, and thus, these parameters are of paramount interest for understanding the trophic structure of Mediterranean benthic communities. In environments non limited by light, nutrient availability, defined as the product between nutrient -POM concentration and hydrodynamism, states the dominance of calcareous versus non calcareous algae. Calcareous algae dominate in oligotrophic waters while non-calcareous algae dominate in moderately eutrophic waters. In light-limited environments, passive suspension feeders (octocorallaria, gorgonians) become dominant species if POM availability is enhanced by a high hydrodynamism (strong currents); in waters with a low charge of POM organisms of other groups, mainly active suspension feeders, predominate (sponges, bryozoans, scleractiniarians). In any case, there always exists a very variable bathymetric zone, depending on light attenuation and nutrient-POM availability, where encrusting calcareous algae strongly compete with suspension feeders (coralligenous).

Does hepatocellular carcinoma in non-alcoholic steatohepatitis exist in cirrhotic and non-cirrhotic patients?

Non-alcoholic steatohepatitis (NASH) has been associated with hepatocellular carcinoma (HCC) often arising in histologically advanced disease when steatohepatitis is not active (cryptogenic cirrhosis). Our objective was to characterize patients with HCC and active, histologically defined steatohepatitis. Among 394 patients with HCC detected by ultrasound imaging over 8 years and staged by the Barcelona Clinic Liver Cancer (BCLC) criteria, we identified 7 cases (1.7%) with HCC occurring in the setting of active biopsy-proven NASH. All were negative for other liver diseases such as hepatitis C, hepatitis B, autoimmune hepatitis, Wilson disease, and hemochromatosis. The patients (4 males and 3 females, age 63 ± 13 years) were either overweight (4) or obese (3); 57% were diabetic and 28.5% had dyslipidemia. Cirrhosis was present in 6 of 7 patients, but 1 patient had well-differentiated HCC in the setting of NASH without cirrhosis (fibrosis stage 1) based on repeated liver biopsies, the absence of portal hypertension by clinical and radiographic evaluations and by direct surgical inspection. Among the cirrhotic patients, 71.4% were clinically staged as Child A and 14.2% as Child B. Tumor size ranged from 1.0 to 5.2 cm and 5 of 7 patients were classified as early stage; 46% of all nodules were hyper-echoic and 57% were <3 cm. HCC was well differentiated in 1/6 and moderately differentiated in 5/6. Alpha-fetoprotein was <100 ng/mL in all patients. HCC in patients with active steatohepatitis is often multifocal, may precede clinically advanced disease and occurs without diagnostic levels of alpha-fetoprotein. Importantly, HCC may occur in NASH in the absence of cirrhosis. More aggressive screening of NASH patients may be warranted.

Evidence Suggesting that Ivory-billed Woodpeckers (Campephilus principalis) Exist in Florida

The Ivory-billed Woodpecker (Campephilus principalis) disappeared from the forests of southeastern North America in the early 20th Century and for more than 50 years has been widely considered extinct. On 21 May 2005, we detected a bird that we identified as an Ivory-billed Woodpecker in the mature swamp forest along the Choctawhatchee River in the panhandle of Florida. During a subsequent year of research, members of our small search team observed birds that we identified as Ivory-billed Woodpeckers on 14 occasions. We heard sounds that matched descriptions of Ivory-billed Woodpecker acoustic signals on 41 occasions. We recorded 99 putative double knocks and 210 putative kent calls. We located cavities in the size range reported for Ivory-billed Woodpeckers and larger than those of Pileated Woodpeckers (Dryocopus pileatus) that have been reported in the literature or that we measured in Alabama. We documented unique foraging signs consistent with the feeding behavior of Ivory-billed Woodpeckers. Our evidence suggests that Ivory-billed Woodpeckers may be present in the forests along the Choctawhatchee River and warrants an expanded search of this bottomland forest habitat.

Alternatives exist: analysis of scientific literature in two Brazilian journals about the pedagogical work of Physical Education

Considering that the process of teacher training in universities takes into account the confrontation of knowledge produced by the scientific methods, the current study intended to identify what are the main contributions of the Brazilian scientific production of Physical Education teaching. Therefore, an exploratory study was done from the articles published on the subject in the two main periodicals of the area. The data analyzes allowed us to verify the relevancy of the knowledge produced and to suggest alternatives to its inclusion in the docent training programs.

Do Hydroxyl Radical−Water Clusters, OH(H2O)n, n = 1−5, Exist in the Atmosphere?

It has been speculated that the presence of OH(H2O)n clusters in the troposphere could have significant effects on the solar absorption balance and the reactivity of the hydroxyl radical. We have used the G3 and G3B3 model chemistries to model the structures and predict the frequencies of hydroxyl radical/water clusters containing one to five water molecules. The reaction between hydroxyl radical clusters and methane was examined as a function of water cluster size to gain an understanding of how cluster size affects the hydroxyl radical reactivity.