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Abstract: Older individuals experience cardiovascular dysfunction during extended bedridden hospital or care home stays. Bed rest is also used as a model to simulate accelerated vascular deconditioning occurring during spacefight. This study investigates changes in retinal microcirculation during a tenday bed rest protocol. Ten healthy young males (22.9± 4.7 years; body mass index: 23.6± 2.5 kg·m–2) participated in a strictly controlled repeated-measures bed rest study lasting ten days. High-resolution images were obtained using a hand-held fundus camera at baseline, daily during the 10 days of bed rest, and 1 day after re-ambulation. Retinal vessel analysis was performed using a semi-automated software system to obtain metrics for retinal arteriolar and venular diameters, central retinal artery equivalent and central retinal vein equivalent, respectively. Data analysis employed a mixed linear model. At the end of the bed rest period, a signifcant decrease in retinal venular diameter was observed, indicated by a signifcantly lower central retinal vein equivalent (from 226.1 µm, CI 8.90, to 211.4 µm, CI 8.28, p= .026), while no signifcant changes in central retinal artery equivalent were noted. Prolonged bed rest confnement resulted in a signifcant (up to 6.5%) reduction in retinal venular diameter. These fndings suggest that the changes in retinal venular diameter during bedrest may be attributed to plasma volume losses and refect overall (cardio)-vascular deconditioning.
Keywords: eyes, retinal venular vessel, venske žile, bed rest, gibalna neaktivnost
Published in DiRROS: 23.11.2023; Views: 635; Downloads: 135
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Abstract: Background. Immunotherapy with immune checkpoint inhibitors (ICIs) recently became the standard treatment for patients with advanced non-small cell lung cancer (NSCLC). Here, we present the first results of a real-world observational study on the effectiveness of ICI monotherapy in patients with advanced NSCLC treated at a single academic center in a Central and Eastern European (CEE) country. Materials and methods. Overall, 66 consecutive patients with advanced NSCLC treated with ICIs in everyday clinical practice, either with first-line pembrolizumab (26 patients) or second-line atezolizumab, nivolumab, or pembrolizumab (40 patients), from August 2015 to November 2018, were included. All data were retrieved from a hospital lung cancer registry, in which the data is collected prospectively. Results. Included patients had a median age of 64 years, most were male (55%), 6% were in performance status >/=2, and 18% had controlled central nervous system metastases at baseline. In first-line, the median progression-free survival (mPFS) was 9.3 months, while the median overall survival (mOS) was not reached. The 1-year overall survival (OS) was 62%. In second-line, the mPFS and mOS were 3.5 months and 9.9 months, respectively, with a 1-year OS of 35%. In the overall population, adverse events of any grade were recorded in 79% of patients and of severe grade (3-4) in 12% of patients. Conclusion. The first real-world outcomes of NSCLC immunotherapy from a CEE country suggest comparable effectiveness to those observed in clinical trials and other real-world series, mainly coming from North America and Western European countries. Further data to inform on the real-world effectiveness of immunotherapy worldwide are needed.
Keywords: non-small cell lung carcinoma, immunotherapy, advanced non-small cell lung cancer, real-world data, Europe, Central Europe, Eastern Europe
Published in DiRROS: 15.12.2021; Views: 789; Downloads: 414
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Abstract: The use of immunohistochemistry for the determination of pulmonary carcinoma biomarkers is a well-established and powerful technique. Immunohistochemisty is readily available in pathology laboratories, is relatively easy to perform and assess, can provide clinically meaningful results very quickly, and is relatively inexpensive. Pulmonary predictive biomarkers provide results essential for timely and accurate therapeutic decision making; for patients with metastatic non-small cell lung cancer, predictive immunohistochemistry includes ALK, (ROS1, EGFR in Europe), and programmed death ligand-1 (PD-L1) testing. Handling along proper methodologic lines is needed to ensure patients receive the most accurate and representative test outcomes.
Keywords: pulmonary biomarkers, immunohistochemistry, pathology
Published in DiRROS: 17.12.2020; Views: 1120; Downloads: 409
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Published in DiRROS: 09.04.2019; Views: 2298; Downloads: 970
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Abstract: In a tokamak, the accurate estimation of the plasma boundary is essential to maximise the fusion performance and is also the first line of defence for the physical integrity of the device. In particular, the first wall components might get severely damaged if over-exposed to a high plasma thermal load. The most common approach to calculate the plasma geometry and related parameters is based in a large set of different types of magnetic sensors. Using this information, real-time plasma equilibrium codes infer a flux map and calculate the shape and geometry of the plasma boundary and its distance to a known reference (e.g. first wall). These are inputs to one or more controllers capable of acting on the shape and trajectory based in pre-defined requests. Depending on the device, the error of the estimated boundary distance must usually be less than 1 centimetre, which translates into very small errors on the magnetic measurement itself. Moreover, asymmetries in the plasma generated and surrounding magnetic fields can produce local shape deformations potentially leading to an unstable control of the plasma geometry. The JET tokamak was recently upgraded to a new and less thermally robust all-metal wall, also known as the ITER-like wall. Currently the shape controller system uses the output of a single reconstruction algorithm to drive the plasma geometry and the protection systems have no input from the plasma boundary reconstruction. These choices are historical and were due to architectural, hardware and processing power limitations. Taking advantage of new multi-core systems and of the already proved robustness of the JET real-time network, this paper proposes a distributed architecture for the real-time identification of faults in the magnetic measurements of the JET tokamak. Besides detecting simple faults, such as short-circuits and open-loops, the system compares the expected measurement at the coil location and the real measurement, producing a confidence valu- . Several magnetic reconstructions, using sensors from multiple toroidally distributed locations, can run in parallel, allowing for a voting or averaging scheme selection. Finally, any fault warnings can be directly fed to the real-time protection sequencer system, whose main function is to coordinate the protection of the JET's first wall.
Published in DiRROS: 24.11.2014; Views: 3336; Downloads: 0