Immunologic heterogeneity of tumor infiltrating lymphocyte composition in primary melanoma

Tumor infiltrating lymphocytes (TILs) in primary melanomas are thought to represent the host anti-tumor immune response, but controversy exists over whether TILs offer independent prognostication of survival. We studied a cohort of 1241 primary melanoma patients to assess the association of absent, non-brisk, and brisk TIL grade with survival outcomes. We tested whether quantitative TIL counts using immunohistochemical lymphocyte markers CD3, CD45, and FOXP3 add prognostic value to TIL grading compared to histology alone in 15% of the cohort.

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Immunologic heterogeneity of tumor infiltrating lymphocyte composition in primary melanoma

Tumor infiltrating lymphocytes (TILs) in primary melanomas are thought to represent the host anti-tumor immune response, but controversy exists over whether TILs offer independent prognostication of survival. We studied a cohort of 1241 primary melanoma patients to assess the association of absent, non-brisk, and brisk TIL grade with survival outcomes. We tested whether quantitative TIL counts using immunohistochemical lymphocyte markers CD3, CD45, and FOXP3 add prognostic value to TIL grading compared to histology alone in 15% of the cohort.

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Immunologic heterogeneity of tumor infiltrating lymphocyte composition in primary melanoma

Tumor infiltrating lymphocytes (TILs) in primary melanomas are thought to represent the host anti-tumor immune response, but controversy exists over whether TILs offer independent prognostication of survival. We studied a cohort of 1241 primary melanoma patients to assess the association of absent, non-brisk, and brisk TIL grade with survival outcomes. We tested whether quantitative TIL counts using immunohistochemical lymphocyte markers CD3, CD45, and FOXP3 add prognostic value to TIL grading compared to histology alone in 15% of the cohort.

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FN400 and LPC memory effects for concrete and abstract words

Abstract

According to dual-process models, recognition memory depends on two neurocognitive mechanisms: familiarity, which has been linked to the frontal N400 (FN400) effect in studies using ERPs, and recollection, which is reflected by changes in the late positive complex (LPC). Recently, there has been some debate over the relationship between FN400 familiarity effects and N400 semantic effects. According to one view, these effects are one and the same. Proponents of this view have suggested that the frontal distribution of the FN400 could be due to stimulus concreteness: recognition memory experiments commonly use highly imageable or concrete words (or pictures), which elicit semantic ERPs with a frontal distribution. In the present study, we tested this claim using a recognition memory paradigm in which subjects memorized concrete and abstract nouns; half of the words changed font color between study and test. FN400 and LPC old/new effects were observed for abstract as well as concrete words, and were stronger over right hemisphere electrodes for concrete words. However, there was no difference in anteriority of the FN400 effect for the two word types. These findings challenge the notion that the frontal distribution of the FN400 old/new effect is fully explained by stimulus concreteness.

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Collagenous colitis and Crohn's disease: Guilty or innocent bystander?

The authors report a case of a 73-year-old male evaluated for profuse watery diarrhea and weight loss for 2 months, aggravated the week before. His past medical history was relevant for ileal Crohn's disease diagnosed at the age of 34 years, with two segmental enterectomies due to ileal stenosis and enterocutaneous fistula. The histopathological exam of the resected bowel showed transmural lymphoplasmocytic infiltrate with deep ulceration and non-caseating granulomas. Due to penetrating phenotype, immunomodulatory therapy was proposed but the patient refused.

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HCV novel therapeutic regimens in Wonderland: A budget impact analysis in the Lombardy Region

The advent of new HCV drugs has generated widespread economic concerns, particularly within the Italian setting, characterized by continuous linear cuts and spending review actions. The overall trade-off between investments and savings needs an in depth analysis.

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Effectiveness of Endoscopic Ultrasonography during Double Balloon Enteroscopy for characterization and management of small bowel submucosal tumours

Characterization of small bowel submucosal tumours is challenging, requiring additional investigations. Endoscopic Ultrasonography performed during Double Balloon Enteroscopy, appeared a promising technique although it has not been fully evaluated. The aim was to determine the effectiveness of this technique for characterization and management of sub mucosal tumours in a large cohort of patients.

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An increase in serum tumour necrosis factor-α during anti-tumour necrosis factor-α therapy for Crohn's disease – A paradox or a predictive index?

Soluble tumour necrosis factor-α (sTNF-α) has been reported to increase in the course of anti-TNF-α therapy for rheumatoid and skin diseases.

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Patient satisfaction in the management of mild-to-moderate ulcerative colitis: Results of a Delphi study among patients and physicians

To determine factors contributing to satisfaction with treatment in mild-to-moderate ulcerative colitis (UC) from both the patients and the physicians perspectives.

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Collagenous colitis and Crohn's disease: Guilty or innocent bystander?

The authors report a case of a 73-year-old male evaluated for profuse watery diarrhea and weight loss for 2 months, aggravated the week before. His past medical history was relevant for ileal Crohn's disease diagnosed at the age of 34 years, with two segmental enterectomies due to ileal stenosis and enterocutaneous fistula. The histopathological exam of the resected bowel showed transmural lymphoplasmocytic infiltrate with deep ulceration and non-caseating granulomas. Due to penetrating phenotype, immunomodulatory therapy was proposed but the patient refused.

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HCV novel therapeutic regimens in Wonderland: A budget impact analysis in the Lombardy Region

The advent of new HCV drugs has generated widespread economic concerns, particularly within the Italian setting, characterized by continuous linear cuts and spending review actions. The overall trade-off between investments and savings needs an in depth analysis.

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Effectiveness of Endoscopic Ultrasonography during Double Balloon Enteroscopy for characterization and management of small bowel submucosal tumours

Characterization of small bowel submucosal tumours is challenging, requiring additional investigations. Endoscopic Ultrasonography performed during Double Balloon Enteroscopy, appeared a promising technique although it has not been fully evaluated. The aim was to determine the effectiveness of this technique for characterization and management of sub mucosal tumours in a large cohort of patients.

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An increase in serum tumour necrosis factor-α during anti-tumour necrosis factor-α therapy for Crohn's disease – A paradox or a predictive index?

Soluble tumour necrosis factor-α (sTNF-α) has been reported to increase in the course of anti-TNF-α therapy for rheumatoid and skin diseases.

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FN400 and LPC memory effects for concrete and abstract words

Abstract

According to dual-process models, recognition memory depends on two neurocognitive mechanisms: familiarity, which has been linked to the frontal N400 (FN400) effect in studies using ERPs, and recollection, which is reflected by changes in the late positive complex (LPC). Recently, there has been some debate over the relationship between FN400 familiarity effects and N400 semantic effects. According to one view, these effects are one and the same. Proponents of this view have suggested that the frontal distribution of the FN400 could be due to stimulus concreteness: recognition memory experiments commonly use highly imageable or concrete words (or pictures), which elicit semantic ERPs with a frontal distribution. In the present study, we tested this claim using a recognition memory paradigm in which subjects memorized concrete and abstract nouns; half of the words changed font color between study and test. FN400 and LPC old/new effects were observed for abstract as well as concrete words, and were stronger over right hemisphere electrodes for concrete words. However, there was no difference in anteriority of the FN400 effect for the two word types. These findings challenge the notion that the frontal distribution of the FN400 old/new effect is fully explained by stimulus concreteness.

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Survival benefit of additional surgery after non-curative endoscopic resection in patients with early gastric cancer

Gastrointestinal Endoscopy

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Human intersegmental reflexes from intercostal afferents to scalene muscles

Short-latency intersegmental reflexes have been described for various respiratory muscles in animals. However, in humans, only short-latency reflex responses to phrenic nerve stimulation have been described. Here, we examined the reflex connections between intercostal afferents and scalene muscles in humans. Surface electromyographic recordings (EMG) were made from scalene muscles bilaterally, in 7 able-bodied participants and 7 participants with motor- and sensory- complete cervical spinal cord injury (median 32 years post injury, range 5 months to 44 years). We recorded the reflex responses produced by stimulation of the 8 th or 10 th left intercostal nerve. A short-latency (∼38 ms) inhibitory reflex was evident in able-bodied participants, in ipsilateral and contralateral scalene muscles. This bilateral intersegmental inhibitory reflex occurred in 46% of recordings at low stimulus intensities (at 3 times motor threshold). It was more frequent (in 75 - 85% of recordings) at higher stimulus intensities (6 and 9 times motor threshold) but onset latency (38 ± 9 ms, mean ± SD) and the size of inhibition (23 ± 10%) did not change with stimulus intensity. The reflex was absent in all participants with spinal cord injury. As the intercostal-to-scalene reflex did not increase with larger stimulus intensities, it is likely mediated by large-diameter intercostal muscle afferents. This is the first demonstration of an intercostal-to-scalene reflex. As the reflex requires intact spinal connections it may be a useful marker for recovery of thoracic or cervical spinal injury.

This article is protected by copyright. All rights reserved

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Improved multi-stage neonatal seizure detection using a heuristic classifier and a data-driven post-processor

Publication date: September 2016
Source:Clinical Neurophysiology, Volume 127, Issue 9
Author(s): A.H. Ansari, P.J. Cherian, A. Dereymaeker, V. Matic, K. Jansen, L. De Wispelaere, C. Dielman, J. Vervisch, R.M. Swarte, P. Govaert, G. Naulaers, M. De Vos, S. Van Huffel
ObjectiveAfter identifying the most seizure-relevant characteristics by a previously developed heuristic classifier, a data-driven post-processor using a novel set of features is applied to improve the performance.MethodsThe main characteristics of the outputs of the heuristic algorithm are extracted by five sets of features including synchronization, evolution, retention, segment, and signal features. Then, a support vector machine and a decision making layer remove the falsely detected segments.ResultsFour datasets including 71 neonates (1023h, 3493 seizures) recorded in two different university hospitals, are used to train and test the algorithm without removing the dubious seizures. The heuristic method resulted in a false alarm rate of 3.81 per hour and good detection rate of 88% on the entire test databases. The post-processor, effectively reduces the false alarm rate by 34% while the good detection rate decreases by 2%.ConclusionThis post-processing technique improves the performance of the heuristic algorithm. The structure of this post-processor is generic, improves our understanding of the core visually determined EEG features of neonatal seizures and is applicable for other neonatal seizure detectors.SignificanceThe post-processor significantly decreases the false alarm rate at the expense of a small reduction of the good detection rate.



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Characteristics of daily life gait in fall and non fall-prone stroke survivors and controls

Falls in stroke survivors can lead to serious injuries and medical costs. Fall risk in older adults can be predicted based on gait characteristics measured in daily life. Given the different gait patterns that...

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Effects of chronic neck–shoulder pain on normalized mutual information analysis of surface electromyography during functional tasks

Publication date: September 2016
Source:Clinical Neurophysiology, Volume 127, Issue 9
Author(s): Pascal Madeleine, Yanfei Xie, Grace P.Y. Szeto, Afshin Samani
ObjectiveTo investigate the effects neck–shoulder pain on the connectivity of surface electromyography (SEMG) signals during functional tasks.MethodsTwenty adults suffering from chronic neck–shoulder pain and 20 healthy controls were recruited. The SEMG signals from the left and right proximal cervical erector spinae, upper trapezius, lower trapezius and distal extensor carpi radialis, extensor digitorum, flexor digitorum superficialis and, abductor pollicis brevis were recorded during three functional tasks: unilateral and bilateral texting on a smart-phone and computer typing. Normalized mutual information (NMI) values were computed between homonymous proximal and distal muscle pairs as an index of the functional connectivity between muscles pairs.ResultsNMI among homonymous muscles pairs as well as among proximal and distal muscles pairs were lower among cases compared with controls. Moreover, NMI values in homonymous proximal muscles were higher during texting compared with computer typing with both hands.ConclusionsOur results show for the first time that chronic neck–shoulder pain affects the functional connectivity of muscle pairs.SignificanceThe study furnishes novel information about the effects of chronic neck–shoulder pain on the interplay of muscle pairs during functional tasks.



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What is the optimal task difficulty for reinforcement learning of brain self-regulation?

Publication date: September 2016
Source:Clinical Neurophysiology, Volume 127, Issue 9
Author(s): Robert Bauer, Mathias Vukelić, Alireza Gharabaghi
ObjectiveThe balance between action and reward during neurofeedback may influence reinforcement learning of brain self-regulation.MethodsEleven healthy volunteers participated in three runs of motor imagery-based brain–machine interface feedback where a robot passively opened the hand contingent to β-band modulation. For each run, the β-desynchronization threshold to initiate the hand robot movement increased in difficulty (low, moderate, and demanding). In this context, the incentive to learn was estimated by the change of reward per action, operationalized as the change in reward duration per movement onset.ResultsVariance analysis revealed a significant interaction between threshold difficulty and the relationship between reward duration and number of movement onsets (p<0.001), indicating a negative learning incentive for low difficulty, but a positive learning incentive for moderate and demanding runs. Exploration of different thresholds in the same data set indicated that the learning incentive peaked at higher thresholds than the threshold which resulted in maximum classification accuracy.ConclusionSpecificity is more important than sensitivity of neurofeedback for reinforcement learning of brain self-regulation.SignificanceLearning efficiency requires adequate challenge by neurofeedback interventions.



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