radiant

  • 文章类型: Journal Article
    辣椒蓟马,sirtopthripsdorsalisHood(Thysanoptera:Thripidae)已成为美国草莓Fragaria×ananassaDuchesne的一种严重入侵性害虫。这项研究的目的是评估生物农药和蓟马捕食者的田间功效,AmblyseiusswirskiiAthias-Henriot用于田间种植的草莓中的S.dorsalis管理,与在UF/IFASGCREC进行的当前行业标准(spinetoram)的合成杀虫剂应用相比,FL在2021-2022年和2022-2023年进行了为期2年的实地研究。在该领域应用了以下处理:(1)生物农药,辣椒油树脂提取物+大蒜油+菜籽油以最大标签率施用;(2)蓟马的捕食螨,旋流杆菌在每个地块30个捕食者处释放;(3)以最大标签率施用spinetoram;(4)在旋流杆菌释放前24小时施用生物农药。维持了没有杀虫剂或掠食性螨释放的对照地块。结果表明,辣椒提取物可用于管理背藻,特别是在草莓田季节的后期,对spinetoram的抵抗力很高。旋流虫的田间表现是可变的,需要进行广泛的研究以突出影响捕食性螨在蓟马管理中的田间表现的因素。
    Chilli thrips, Scirtothrips dorsalis Hood (Thysanoptera: Thripidae) has emerged as a severe invasive pest of strawberry Fragaria × ananassa Duchesne in the United States. The objective of this study was to assess the field efficacy of a biopesticide and thrips predator, Amblyseius swirskii Athias-Henriot for S. dorsalis management in field grown strawberry compared to synthetic insecticide applications that are current industry standard (spinetoram) conducted at UF/IFAS GCREC, FL during 2021-2022 and 2022-2023 in a 2-year field study. The following treatments were applied in the field: (1) biopesticide, capsicum oleoresin extract + garlic oil + canola oil application at maximum label rate; (2) predatory mite of thrips, A. swirskii released at 30 predators per plot; (3) spinetoram applied at maximum label rate; and (4) biopesticide applied 24 h before release of A. swirskii. A control plot with no insecticide or predatory mite releases was maintained. Results show that the capsicum extract can be used for management of S. dorsalis, especially during the latter stages of strawberry field season when resistance to spinetoram is high. The field performance of A. swirskii was variable and extensive research is needed to highlight factors affecting field performance of predatory mites for thrips management.
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  • 文章类型: Journal Article
    背景:基于死者身体标本的解剖学研究是一个耗时的过程,需要大量的技能和时间才能正确执行。三维医学图像分析是一种极好的解剖评估工具,但它通常包括研究组中的合并症患者,这可能会扭曲结果。这项研究的目的是开发和评估基于死后对比增强计算机断层扫描血管造影3D重建腹腔干的解剖研究方法。
    方法:对105例(28.6%女性,年龄50.8±18.7),对无腹部创伤或肿瘤的患者进行了分析。重建并评估了主动脉的腹部和具有分支的腹腔干。评估腹腔干的类型。对结果进行了分析。
    结果:腹腔干,脾动脉,所有病例均可见肝总动脉。97.1%的病例可见胃左动脉。61.0%的病例显示胰腺背动脉。最常见的腹腔干类型为1(88.6%),最罕见的类型是2、3和6(1.0%)。我们观察到截流的4种形态不符合先前提出的分类。
    结论:这项研究表明,死后对比增强计算机断层扫描的三维重建是进行解剖研究目的的精确形态分析的绝佳工具。这种方法可以作为健康人群解剖研究的来源。
    BACKGROUND: Anatomical research based on deceased body specimens is a time-consuming process that requires a great deal of skill and time to perform correctly. Three-dimensional medical image analysis is an excellent tool for anatomic evaluation, but it often includes patients with comorbidities in the study group, which can skew the results. The purpose of this study was to develop and evaluate methods for anatomic research based on postmortem contrast-enhanced computed tomography angiography 3D reconstruction of the celiac trunk.
    METHODS: Postmortem contrast-enhanced computed tomography angiography of 105 (28.6% female, age 50.8±18.7) decedents without abdominal trauma or tumor was analyzed. The abdominal portion of the aorta and the celiac trunk with its branches were reconstructed and evaluated. The type of celiac trunk was evaluated. The results were analyzed.
    RESULTS: The celiac trunk, splenic artery, and common hepatic artery were visualized in all cases. The left gastric artery was visible in 97.1% of cases. The dorsal pancreatic artery was visualized in 61.0% of cases. The most common type of celiac trunk was 1 (88.6%), and the rarest types were 2, 3, and 6 (1.0%). We observed 4 morphologies of the truncus celiacus that did not fit the classification presented previously.
    CONCLUSIONS: This study has demonstrated that three-dimensional reconstruction of postmortem contrast-enhanced computed tomography is an excellent tool for performing accurate morphometric analyzes for anatomic research purposes. This method can serve as a source for anatomic studies in the healthy population.
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  • 文章类型: Journal Article
    存在执行图像引导神经外科手术的不同技术,即,神经导航系统,术中超声,术中MRI,每一个都有其局限性。除了超声波,其他方法很昂贵。使用3D体积渲染(VR)进行三维虚拟重建和手术仿真是一种经济且出色的术前手术计划和图像引导神经外科手术技术。在这篇文章中,作者讨论了尚未描述的3DVR技术的几个细微差别。
    作者纳入了6例幕上胶质瘤患者,他们在2019年1月至2021年3月期间接受了手术。术前临床资料,包括病人的人口统计,术前计划细节(使用VR技术完成),术中细节,包括相关的照片和视频,被收集。RadiAnt软件用于在运行MicrosoftWindows的计算机上使用VR技术生成虚拟3D图像。
    3DVR技术通过术前模拟皮肤切口和开颅手术来协助神经胶质瘤手术,深部胶质瘤的虚拟皮质表面标记和导航,表面胶质瘤病态皮质表面和静脉解剖的术前可视化,确定表面和深层胶质瘤的介入手术走廊,以及术前和术后虚拟3D图像,突出显示低级别胶质瘤(LGG)的确切空间几何残留肿瘤位置和切除范围。
    使用RadiAnt软件的3DVR技术进行图像引导的神经外科手术是一种经济,简单易学,和用户友好的模拟神经胶质瘤手术的方法,特别是在资源有限的国家,昂贵的神经导航系统是不容易得到的。除了皮质沟/回旋解剖,FLAIR序列是使用VR技术对非增强弥漫性LGG进行3D可视化的理想选择。除了皮质血管(尤其是静脉),对比MRI序列是完美的三维可视化的对比增强高级别胶质瘤。
    Different techniques of performing image-guided neurosurgery exist, namely, neuronavigation systems, intraoperative ultrasound, and intraoperative MRI, each with its limitations. Except for ultrasound, other methods are expensive. Three-dimensional virtual reconstruction and surgical simulation using 3D volume rendering (VR) is an economical and excellent technique for preoperative surgical planning and image-guided neurosurgery. In this article, the authors discuss several nuances of the 3D VR technique that have not yet been described.
    The authors included 6 patients with supratentorial gliomas who underwent surgery between January 2019 and March 2021. Preoperative clinical data, including patient demographics, preoperative planning details (done using the VR technique), and intraoperative details, including relevant photos and videos, were collected. RadiAnt software was used for generating virtual 3D images using the VR technique on a computer running Microsoft Windows.
    The 3D VR technique assists in glioma surgery with a preoperative simulation of the skin incision and craniotomy, virtual cortical surface marking and navigation for deep-seated gliomas, preoperative visualization of morbid cortical surface and venous anatomy in surfacing gliomas, identifying the intervenous surgical corridor in both surfacing and deep-seated gliomas, and pre- and postoperative virtual 3D images highlighting the exact spatial geometric residual tumor location and extent of resection for low-grade gliomas (LGGs).
    Image-guided neurosurgery with the 3D VR technique using RadiAnt software is an economical, easy-to-learn, and user-friendly method of simulating glioma surgery, especially in resource-constrained countries where expensive neuronavigation systems are not readily available. Apart from cortical sulci/gyri anatomy, FLAIR sequences are ideal for the 3D visualization of nonenhancing diffuse LGGs using the VR technique. In addition to cortical vessels (especially veins), contrast MRI sequences are perfect for the 3D visualization of contrast-enhancing high-grade gliomas.
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  • 文章类型: Journal Article
    BACKGROUND: In our aging society, palliative care should be a standard component of health care. However, currently it is only provided to a small proportion of patients, mostly to those with cancer, and restricted to the terminal phase. Many general practitioners (GPs) say that one of their most significant challenges is to assess the right moment to start anticipatory palliative care. The \"Surprise Question\" (SQ1: \"Would I be surprised if this patient were to die in the next 12 months\"?), if answered with \"no\", is an easy tool to apply in identifying patients in need of palliative care. However, this tool has a low specificity. Therefore, the aim of our pilot study was to determine if adding a second, more specific \"Surprise Question\" (SQ2: \"Would I be surprised if this patient is still alive after 12 months\"?) in case SQ1 is answered in the negative, prompts GPs to plan for anticipatory palliative care.
    METHODS: By randomization, 28 GPs in the south-eastern part of the Netherlands were allocated to three different groups. They all received a questionnaire with four vignettes, respectively representing patients with advanced organ failure (A), end stage cancer (B), frailty (C), and recently diagnosed cancer (D). GPs in the first group did not receive additional information, the second group received SQ1 after each vignette, and the third group received SQ1 and SQ2 after each vignette. We rated their answers based on essential components of palliative care (here called RADIANT score).
    RESULTS: GPs in group 3 gave higher RADIANT scores to those vignettes in which they would be surprised if the patients were still alive after 12 months. In all groups, vignette B had the highest mean RADIANT score, followed by vignettes A and C, and the lowest on vignette D. Seventy-one percent of GPs in groups 2 and 3 considered SQ1 a helpful tool, and 75% considered SQ2 helpful.
    CONCLUSIONS: This innovative pilot study indicates that the majority of GPs think SQ2 is a helpful additional tool. The combination of the two \"Surprise Questions\" encourages GPs to make more specific plans for anticipatory palliative care.
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  • 文章类型: Journal Article
    The mechanistic target of rapamycin (mTOR) is part of the phosphoinositide-3-kinase (PI3K)/protein kinase B (AkT)/mTOR pathway and owes its name to the inhibitory effect of rapamycin. The mTOR has a central converging role for many cell functions, serving as a sensor for extracellular signals from energy status and nutrients availability, growth factors, oxygen and stress. Thus, it also modulates switch to anabolic processes (protein and lipid synthesis) and autophagy, in order to regulate cell growth and proliferation. Given its functions in the cell, its deregulation is implicated in many human diseases, including cancer. Its predominant role in tumorigenesis and progression of neuroendocrine tumors (NETs), in particular, has been demonstrated in preclinical studies and late clinical trials. mTOR inhibition by everolimus is an established therapeutic target in NETs, but there are no identified predictive or prognostic factors. This review is focused on the role of mTOR and everolimus in NETs, from preclinical studies to major clinical trials, and future perspectives involving mTOR in the treatment of NETs.
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  • 文章类型: Journal Article
    神经内分泌肿瘤的发病率正在增加,并引起各种症状。哺乳动物雷帕霉素靶蛋白(mTOR)通路在神经内分泌肿瘤(NET)的发病机制中起关键作用,导致脂质合成增加,蛋白质合成和细胞生长。在遗传性和散发性NETs中都注意到该途径的上调。这种理解导致了对mTOR抑制剂作为转移性NETs疗法的研究。在有希望的临床前发现之后,依维莫司,一种mTOR抑制剂,在对晚期患者的RADIANT-1-4研究中进行了试验,差异化的网际网路。RADIANT-3和RADIANT-4确定了依维莫司在改善胰腺转移性NET的无进展生存期(PFS)中的功效,肺和胃肠起源,导致美国食品和药物管理局(FDA)批准其在这些环境中用于肿瘤控制。依维莫司治疗通常耐受性良好;常见的不良事件包括口腔炎,腹泻,皮疹和高血糖。虽然停药率很低,许多患者可能需要调整剂量才能成功继续治疗.依维莫司与生长抑素类似物(SSA)(如奥曲肽或帕瑞肽)或其他靶向药物如贝伐单抗的组合没有产生额外的增量益处。和双重生物疗法没有广泛使用。正在进行的试验正在研究依维莫司与化疗的比较,依维莫司与放疗联合治疗的最佳排序。未来的研究应该集中在从mTOR治疗中获益的预测性生物标志物的鉴定上,并包括生活质量作为衡量指标。
    Neuroendocrine tumours are increasing in incidence and cause a variety of symptoms. The mammalian target of rapamycin (mTOR) pathway plays a key role in neuroendocrine tumour (NET) pathogenesis, leading to increased lipid synthesis, protein synthesis and cellular growth. Upregulation of this pathway is noted in both hereditary and sporadic NETs. This understanding has led to investigations of mTOR inhibitors as therapy for metastatic NETs. After promising preclinical findings, everolimus, an mTOR inhibitor, was trialled in the RADIANT-1-4 studies on patients with advanced, well differentiated NETs. RADIANT-3 and RADIANT-4 established the efficacy of everolimus in improving progression-free survival (PFS) for metastatic NET of pancreatic, lung and gastrointestinal origin, leading to the US Food and Drug Administration (FDA) approval for its use in tumour control in those settings. Everolimus treatment is generally well tolerated; common adverse events include stomatitis, diarrhoea, rash and hyperglycaemia. Although discontinuation rates are low, many patients may require dose modification to successfully continue therapy. The combination of everolimus with somatostatin analogues (SSAs) (such as octreotide or pasireotide) or other targeted agents such as bevacizumab has not produced additional incremental benefit, and dual biologic therapy is not used widely. Ongoing trials are investigating everolimus compared with chemotherapy, optimal sequencing of therapy and combination of everolimus with radiotherapy. Future research should concentrate on identification of predictive biomarkers for benefit from mTOR therapy and include quality of life as a measure.
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  • 文章类型: Journal Article
    Pancreatic neuroendocrine tumors (pNETs) are a heterogeneous group of neoplasms with various clinical presentations. More than half of patients present with so-called nonfunctioning tumors with no hormone-related symptoms, whereas other tumors produce symptoms like gastric problems, ulcers, hypoglycemia, skin rash and diarrhea related to hormone production. The traditional treatment for pNETs over the last three decades has been cytotoxic agents, mainly streptozotocin plus 5-fluorouracil or doxorubicin. Most recently two new compounds have been registered worldwide for the treatment of pNETs, the mammalian target of rapamycin (mTOR) inhibitor everolimus and the tyrosine kinase inhibitor sunitinib. This paper concentrates on the use of mTOR inhibitors and the mechanisms of action. The mTOR pathway is altered in a number of pNETs. Everolimus (RAD001) is an orally active rapamycin analog and mTOR inhibitor. It blocks activity of the mTOR pathway by binding with high affinity to the cytoplasmic protein FKBP-12. The efficacy of everolimus in pNETs has been demonstrated in two multicenter studies (RADIANT 1 and 3). The RADIANT 3 study was a randomized controlled study in pNETs of everolimus 10 mg/day versus placebo, showing an increased progression-free survival (11.7 months versus 4.6 months) and hazard ratio of 0.35 (p < 0.001). Current studies indicate that there is strong evidence to support the antitumor effect of rapalogs in pNETs. However, significant tumor reduction is very rarely obtained, usually in less than 10% of treated patients. Therefore, these drugs may be more effective in combination with other anticancer agents, including chemotherapy, targeted therapies as well as peptide receptor radiotherapy.
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