Integrative radiomics expression predicts molecular subtypes of primary clear cell renal cell carcinoma.

AIM: To identify combined positron-emission tomography (PET)/magnetic resonance imaging (MRI)-based radiomics as a surrogate biomarker of intratumour disease risk for molecular subtype ccA and ccB in patients with primary clear cell renal cell carcinoma (ccRCC). MATERIALS AND METHODS: PET/MRI data were analysed retrospectively from eight patients. One hundred and sixty-eight radiomics features for each tumour sampling based on the regionally sampled tumours with 23 specimens were extracted. Sparse partial least squares discriminant analysis (SPLS-DA) was applied to feature screening on high-throughput radiomics features and project the selected features to low-dimensional intrinsic latent components as radiomics signatures. In addition, multilevel omics datasets were leveraged to explore the complementing information and elevate the discriminative ability. RESULTS: The correct classification rate (CCR) for molecular subtype classification by SPLS-DA using only radiomics features was 86.96% with permutation test p=7×10-4. When multi-omics datasets including mRNA, microvascular density, and clinical parameters from each specimen were combined with radiomics features to refine the model of SPLS-DA, the best CCR was 95.65% with permutation test, p<10-4; however, even in the case of generating the classification based on transcription features, which is the reference standard, there is roughly 10% classification ambiguity. Thus, this classification level (86.96-95.65%) of the proposed method represents the discriminating level that is consistent with reality. CONCLUSION: Featured with high accuracy, an integrated multi-omics model of PET/MRI-based radiomics could be the first non-invasive investigation for disease risk stratification and guidance of treatment in patients with primary ccRCC.

Upper tract urothelial carcinoma topical issue 2016: treatment of metastatic cancer.

PURPOSE: To review the management of metastatic upper tract urothelial carcinoma (UTUC) including recent advances in targeted and immune therapies as an update to the 2014 joint international consultation on UTUC, co-sponsored by the Société Internationale d'Urologie and International Consultation on Urological Diseases. METHODS: A PubMed database search was performed between January 2013 and May 2016 related to the treatment of metastatic UTUC, and 54 studies were selected for inclusion. RESULTS: The management of patients with metastatic UTUC is primarily an extrapolation from evidence guiding the management of metastatic urothelial carcinoma of the bladder. The first-line therapy for metastatic UTUC is platinum-based combination chemotherapy. Standard second-line therapies are limited and ineffective. Patients with UTUC who progress following platinum-based chemotherapy are encouraged to participate in clinical trials. Recent advances in genomic profiling present exciting opportunities to guide the use of targeted therapy. Immunotherapy with checkpoint inhibitors has demonstrated extremely promising results. Retrospective studies provide support for post-chemotherapy surgery in appropriately selected patients. CONCLUSIONS: The management of metastatic UTUC requires a multi-disciplinary approach. New insights from genomic profiling using targeted therapies, novel immunotherapies, and surgery represent promising avenues for further therapeutic exploration.

Identification of a CG/LH binding site in two strains of Mycobacterium vaccae.

We have previously reported the presence of a chorionic gonadotropin-like (CG-like) protein in the bacterium Xanthomonas maltophilia (X. maltophilia). We have also shown that X. maltophilia possesses a unique binding site for the native ligand and hCG, but not for human luteinizing hormone (hLH), and that binding of the native ligand or hCG to the receptor causes changes in the growth rates of culturing X. maltophilia. In this study we have characterized a CG/LH binding site in two strains of Mycobacterium vaccae. The binding site is specific for hCG and hLH, and Scatchard analysis reveals a biphasic, high affinity binding pattern. This is the second identified bacterial species to possess a CG-specific binding site.

A human development intervention in the Philippines: effect on child morbidity.

The pilot phase of a human development intervention in the Philippines focused on improving child health. Selected household practices which influence health were targeted for modification to reduce the incidence of child morbidity. Completion rates of 69.5% of recommended activities led to a decrease of 70.0% of reported diarrhea and fever. Local health leaders and promoters were involved in providing administration and instruction, which served to increase local problem-solving skills and self-reliance. Essential components of an effective intervention are identified.

Assessment of the adult with cancer.

The nursing process is a systematic method of problem-solving that incorporates four phases: assessment, planning, intervention, and evaluation. These four steps, in actual practice, are continuous and cyclical. One may not be able to complete the entire data-gathering phase and then move on to the planning phase. For example, the nurse often finds it necessary to obtain a baseline assessment, plan for immediate care to meet priority needs, and then collect additional information at a later time to set goals for less pressing problems the patient may experience. Changing conditions and alterations in the patient's status requires continual reassessment and modification of approaches.

Effect of a low chloride diet on lactating Holstein cows.

Twenty primiparous lactating Holstein cows were fed diets supplemented with either .5% sodium chloride or .75% sodium bicarbonate. Those fed the latter diet conserved chloride by reducing the chloride concentration in urine, feces, and, to a small but nonsignificant amount, in milk. The low chloride diet did not affect consumption of feed dry matter and water or milk production and composition. There was no indication of pica or other aberrant taste behavior. One half of the cows in each diet group was given free choice salt block of trace elements. Those fed the low chloride diet consumed more salt (337 versus 149 g/cow per wk). When chloride requirements have been established and data on chloride composition become more widely available, it will be possible to include both sodium and chloride in diet formulations and omit salt. This will reduce the amount of salt needed as either a sodium or chloride supplement.