Poor Grade Research Articles

Correlation between p53 and Mdm2 expression with histopathological parameters in cattle squamous cell carcinomas.

Background and Aim:Squamous cell carcinoma (SCC) is the most common form of carcinoma in cattle. Histopathological grading systems have been utilized over several decades for estimating the malignancy of cattle SCCs. This study aimed to detect p53 and Mdm2 expression in different SCC cases in cattle and correlate their expression with the SCC histopathological grading.Materials and Methods:Cattle SCC cases were collected at the Veterinary Teaching Hospital in Nineveh. The SCC grading system categorized the cases histologically based on their differentiation grade into three groups: Well, moderately, and poorly differentiated. The SCC cases were subsequently verified for p53 and Mdm2 immunoexpression.Results:Fourteen of 16 examined cattle SCC samples tested positive for p53 expression. Moreover, 15 out of the 16 SCC samples tested positive for Mdm2 expression. The increased immunoreactivity of both p53 and Mdm2 was associated with a poor histological grading of the cattle SCC. There is a positive correlation between the nuclear expression of p53 and Mdm2, and the degree of differentiation and the number of mitotic figures in the examined cattle SCC samples.Conclusion:Our results demonstrate an increased p53 and Mdm2 expression in cattle SCC cases characterized by poor histopathological grading, thus suggesting an essential role of these molecules in the development of moderately and poorly differentiated SCC in cattle.

Scholastic performance and ambitions in retropositive and vulnerable pediatric patients: A prospective study.

Introduction:It is widely recognized that HIV epidemic has a negative impact on retropositive pediatric patients. However, at present, the school performance and ambitions in retropositive and vulnerable pediatric patients from India are lacking.Aims:The aim of this study was to analyze the possible association between scholastic performance and ambitions in retropositive and vulnerable status in pediatric patients.Materials and Methods:Case–control study was conducted over a period of 2 years. Forty-two retropositive, vulnerable, and equal age- and gender-matched controls between the age of 6 and 16 years were included. All children or parents were enquired about performance, attendance, grades in last academic year, and their ambitions in life. The data were collected in a prevalidated questionnaire and analyzed using SPSS Version 20.Results:A total 42 children between the age of 6 and 16 years were included. Twenty-seven (64.3%) were males and 15 (35.7%) females. Eleven (26.2%) were retropositive, 27 (64.3%) had one infected parent, and 4 (9.5%) patients had both the parents retropositive. Twelve (28.5%) cases failed their previous academic years compared to 1 (2.3%) control. Only 2 (4.7%) had attendance more than 90% in cases as compared to 18 (42.8%) among controls. Twenty-one (50%) attributed feeling of isolation as a cause of poor academic performance, while none of the controls did the same. There was a significant association between poor grades and poor attendance at school and retropositive (P < 0.001). The odds ratio of feeling of isolation was 1.62.Conclusion:Retropositive and vulnerable status significantly affect the academic performance and ambitions in these children.

Association between exposure to particulate matter and school absences in Korean asthmatic adolescents.

BackgroundBecause particulate matter (PM) and asthma are closely related, the prevalence of school absence among adolescents with asthma can be affected by the concentration of PM. We aimed to investigate the relationship between school absences due to asthma and the total number of days that the PM concentration exceeded the standard.MethodsWe used the data from the 16th Korea Youth Risk Behavior Survey and the PM levels of 17 metropolitan cities and provinces gathered from the AirKorea. Information on the characteristics of asthmatic adolescents and the prevalence of school absence was obtained using a questionnaire, while the PM levels based on the total number of days with poor and very poor PM grades were collected from the AirKorea website. Both χ2 test and logistic regression analysis were performed using the weights presented in the original dataset.ResultsIn the case of particulate matter of 10 microns in diameter or smaller (PM10), the odds ratio (OR) after adjusting for confounders (sex, school year, body mass index, smoking history, diagnosis of allergic rhinitis, diagnosis of atopic dermatitis and city size) was 1.07 (95% confidence interval [CI]: 1.01–1.13) for absents due to asthma when the total days of poor and very poor grades of PM10 (81 μg/m3 or higher) increased by 1 day. In the analysis of particulate matter of 2.5 microns in diameter or smaller (PM2.5), the OR after adjusting for confounders was 1.01 (95% CI: 1.00–1.03) for absents due to asthma when the total number of days with poor and very poor PM2.5 grades (36 μg/m3 or higher) increased by 1 day.ConclusionsA significant association was observed between the total number of days of poor and very poor PM10 and PM2.5 grades and school absence due to asthma; PM can cause asthma exacerbation and affect the academic life.

‘If I do well I feel on top of the world’: Investigating the impact of psychology students’ academic achievement on self-esteem

Academic achievement can be thought of as the extent to which learning has been accomplished. Previous work suggests that students’ self-esteem is impacted by academic achievement, though it is not entirely clear why this is. The current study therefore explored this through interviewing eight psychology students from a Scottish university, before using Braun and Clarke’s (2006) six stage reflexive thematic analysis to analyse the resultant data. Two themes of Grades and feedback and Peer comparison were identified, highlighting two important conclusions. Firstly, self-esteem is positively impacted by strong performance, and negatively impacted by poor performance but that crucially, this is mediated by others’ poor performance. That is to say, good grades and feedback make students feel good, and poor grades and feedback make students feel bad, but such ‘badness’ is appeased if peers perform equally poorly, which has potential consequences for peer relationships. Secondly, students value feedback in order to increase their chances of academic achievement, noting the negative impact on self-esteem when feedback is not constructive, just critical. This highlights the importance of ‘mindful marking’ in terms of taking care to provide useful feedback to students to improve their work; something that is reported to be hugely appreciated. Implications, limitations and future research suggestions are detailed.

Prospective Analysis of Cerebral Edema Admission and Clinical Outcome in Ruptured Intracranial Aneurysm.

To evaluate the association between global cerebral edema (GCE) after subarachnoid hemorrhage (SAH) and its impact on functional outcome evaluated by the modified Rankin scale (mRS). This is a prospective cohort study with patients who were admitted to the hospital due to SAH. During the period from January 2018 to November 2019, 107 patients with intracranial aneurysms were enrolled. Using univariate and multivariate analysis, we sought to identify predictors and evaluated the impact of GCE on outcome after 6 months using the mRS. GCE was present in 54 (50.5%) patients, of which 27 (25.2%) were mild, 20 (18.7%) moderate and 7 (6.5%) were severe. Univariate analysis identified high Hunt-Hess and Glasgow coma scale on clinical admission as predictors factors of GCE (p < 0.05), and higher modified Fisher scale as a radiological predictor of Glasgow coma scale (p < 0.05). Thirty-three (30.8%) patients were deceased at 6 months. Death or severe disability were predicted by higher age, poor clinical scale on admission and severe GCE (p < 0.05). GCE on admission is independently associated with poor clinical outcomes at discharge, and six months after SAH. Given its strong association with poor clinical grade on admission, GCE should be considered a straightforward and radiological important marker of early brain injury, with ominous implications.

Influence of sperm morphology in ICSI cycle outcomes: a retrospective study

Aim: To determine whether sperm morphology has any influence on the assisted reproductive technique (ART) outcome in in vitro fertilization (IVF)-intracytoplasmic sperm injection (ICSI) cycles. Objectives: To assess whether sperm morphology affects IVF-ICSI outcome. Method: This study was a retrospective analysis of data from 1000 couples who had undergone ART cycle at Southend Fertility & IVF, Delhi between January 2016 and January 2021. The recruited patients were divided into two groups: Group A: Group A was the study group, and included 600 patients with an abnormal sperm morphology (morphology of <4%); Group B: Group B was the control group, and included 400 patients with a normal sperm morphology (morphology of >4%). The two groups were compared in terms of fertilization rate, embryo development rate, grade A embryo development rate, grade B embryo development rate, grade C embryo development rate, cleavage rate, embryo discarded or damage rate, and pregnancy rate. Results: Of the total 1000 ART-ICSI cycles analyzed the baseline characteristics, such as age, type of infertility, and semen parameters such as volume, count, motility, debris, agglutinations, grade A motility, grade B motility, total progressive (A+B) motility, morphology assessments, and type of protocol used for stimulation were comparable between the two groups. In the 1000 patients analyzed, a total of 6871 oocytes were injected at ICSI, of which 4049 oocytes belonged to group A and 2822 oocytes belonged to group B of the 6871 oocytes injected, 6275 got fertilized, giving a fertilization rate of 91.3%. On comparing the fertilization rate of the two groups, a fertilization rate of 90.1% (3650/4049) was observed in group A and 93.01% (2625/2822) was observed in group B, which was statistically different (P < 0.001). Of the various outcome parameters, a statistically significant difference was reported in the fertilization rate, cleavage rate, embryo development rate, grade A embryo development rate, and grade C embryo development rate in the two groups. No statistically significant difference was observed in the pregnancy rate. It was also observed that once fertilization occurred, embryo quality was good for all types of abnormal spermatozoa (grade A, good- to excellent-quality embryos), except for spermatozoa with broken necks, with which only good to excellent quality, or poor quality grade B and group C embryos were obtained. Conclusion: Sperm morphology influences the fertilization rate, cleavage rate, and the embryo development rate but there is no significant influence of sperm morphology on pregnancy rate.

The different prognostic impact of age according to individual molecular subtypes in breast cancer.

PurposeYoung age at diagnosis has been considered a poor prognostic factor. However, considering young age itself as an independent poor prognostic factor for all breast cancers is unwarranted. We analyzed the different prognostic effects of age as a prognostic factor according to molecular subtype.MethodsWe retrieved data from 1,819 patients with primary breast cancer at the breast cancer center between 2007 and 2012. We classified each molecular subtype in 3 age cohorts (<40, 40–50, and >50 years). The associations of age and molecular subtypes with relapse-free survival (RFS) and disease-specific survival (DSS) were assessed.ResultsPatients aged <40 years showed a poor histologic grade, hormone receptor negative expression than older patients, and had a higher proportion of triple-negative breast cancer (TNBC) (P < 0.001). This was thought to have led to a significantly shorter RFS than that of older patients (P < 0.001). In the subgroup analysis according to molecular subtypes, the poorer RFS was observed only in patients aged <40 years with luminal type breast cancer (P < 0.001). Age was an independent prognostic factor of RFS in luminal-type breast cancer (P = 0.001). However, no difference in RFS between age groups was found for patients with other subtypes (human epidermal growth factor receptor 2 overexpression, TNBC). No significant effect between age groups was found in DSS for patients with all molecular subtypes.ConclusionAge at diagnosis of breast cancer affected prognosis differently according to molecular subtype. Age itself is not an independent prognostic factor. Age of <40 years showed a limited worse prognostic impact of recurrence in luminal type breast cancer only.

Role of High-Sensitivity Troponin-T And N-Terminal Pro B-Type Natriuretic Peptide as an Early Predictor of Myocardial Dysfunction in Aneurysmal Subarachnoid Hemorrhage: A Prospective Observational Study.

Acute cardiac complications are commonly seen in aneurysmal subarachnoid hemorrhage (aSAH) patients and may vary from subclinical electrocardiographic abnormalities, or reduced ejection fraction on echocardiography, elevated levels of cardiac markers (cardiac troponin and Brain natriuretic peptide) to heart failure. This study was done to evaluate the role of cardiac markers (high-sensitive Troponin-T and N-terminal pro-B-type natriuretic peptide) in early identification of cardiac complications and hence dysfunction. All consecutive patients with aSAH without any previous cardiac history were included. At admission, neurological evaluation using Hunt and Hess grading (H and H grade), with electrocardiography to look for any changes, echocardiography for ejection fraction, and any wall motion abnormalities was also done. The serial serum levels of high-sensitive Troponin-T (hsTnT) and N-terminal pro B-type natriuretic peptide (NT pro-BNP) for 7 consecutive days was measured with hsTnT >0.14 ng/ml and NT pro-BNP >150 pg/mL considered elevated. A total of 69 patients were included. The elevated peak level of hsTnT and NT pro-BNP was seen in 55.1% and 69.6% of patients. A positive correlation was seen between hsTnT (P = 0.033) and NT pro-BNP (P = 0.011) and poor SAH grade (H and H grade 3-5), similarly, abnormal ECG also significantly correlated with elevated peak hsTnT (P = 0.002) and NT proBNP (P = 0.000). Also, significant difference in peak hsTnT (P = 0.000) and NT-proBNP (P = 0.000) in patients with or without reduced ejection fraction (EF). The elevated peak levels of hsTnT and NTproBNP along with ECG and echocardiography abnormalities may help in early identification of myocardial injury, hence cardiac dysfunction.

TMED9 Expression Level as a Biomarker of Epithelial Ovarian Cancer Progression and Prognosis.

Transmembrane emp24 domain-containing protein 9 (TMED9) belongs to the TMED/p24 family that transports, modifies, and packs proteins and lipids into vesicles for delivery to specific locations and is important in innate immune signaling via the endoplasmic reticulum-Golgi cargo pathway. TMED9 has been implicated in various cancer types; however, its role in epithelial ovarian cancer (EOC) is unclear. In this study, we aimed to elucidate the role and clinical significance of TMED9 in EOC. mRNA and protein levels of TMED9 and their associations with clinicopathological features in EOCs were evaluated using RNA-sequencing and immunohistochemistry data. Functional studies assessing the tumorigenic role of TMED9 in EOC cell lines were also performed. The mRNA expression of TMED9 was up-regulated in EOC compared to that in normal ovarian epithelium. TMED9 protein expression increased in progression from normal ovarian epithelium to EOC (p<0.001). Moreover, high expression of TMED9 was associated with advanced stage, serous cell type and poor histological grade in EOC and demonstrated independent prognostic significance for both disease-free and overall survival. Further functional studies showed that TMED9 knockdown reduced migration, invasion, cell proliferation, and colony formation of EOC cells. Overall, our results support the use of TMED9 as a valuable prognostic biomarker and provide evidence for targeting of TMED9 as a novel strategy for EOC treatment.

Real-world outcomes of adjuvant gemcitabine versus gemcitabine plus capecitabine for resected pancreatic ductal adenocarcinoma.

Background:Adjuvant chemotherapy is the standard treatment after curative-intent surgery for pancreatic ductal adenocarcinoma (PDAC). The phase-3 ESPAC-4 trial demonstrated significantly improved overall survival (OS) with Gemcitabine plus capecitabine (GemCap) over Gemcitabine (Gem) in Europe. We conducted a retrospective efficacy and safety evaluation of GemCap versus Gem in an Asian population.Methods:This retrospective analysis included 292 patients with PDAC who received adjuvant Gem or GemCap after curative resection between January 2017 and December 2020 at Asan Medical Center, Seoul, Korea.Results:Adjuvant Gem and GemCap were administered to 161 (55.1%) and 131 (44.8%) patients, respectively. The Gem group had significantly older patients (median 66 versus 63 years, p = 0.001); otherwise, the groups had similar baseline characteristics. With median follow-up durations of 39.4 [95% confidence interval (CI), 36.9–45.0] and 39.4 (95% CI, 34.7–41.6) months in the Gem and GemCap groups, the median OS was 36.8 (95% CI, 29.7–43.5) and 46.1 (95% CI, 31.5–not reached) months in the Gem and GemCap groups, respectively [unadjusted hazard ratio (HR) = 0.7; 95% CI, 0.5–1.0; p = 0.07). The median recurrence-free survival was 14.3 (95% CI, 12.9–17.7) and 17.0 (95% CI, 13.3–28.2) months, respectively (p = 0.5). Hand-foot skin reactions (any grade, 15.3% versus 0.6%; p < 0.001), neutropenia (78.6% versus 67.7%, p = 0.04) and thrombocytopenia (30.5% versus 20.5%, p = 0.04) were more common in the GemCap group. Multivariate analysis revealed adjuvant GemCap – compared with Gem – to be significantly associated with better OS (adjusted HR = 0.6; 95% CI, 0.4–0.9; p = 0.01). Otherwise, moderate or poor histological grade, lymph node positivity, positive resection margin, and elevated CA 19-9 (>median) were significantly associated with worse OS.Conclusions:Adjuvant GemCap showed the consistent clinical outcomes with the ESPAC-4 trial. As mFOLFIRINOX is the new standard treatment for medically fit patients with resected PDAC, further evaluation of optimal adjuvant chemotherapy in daily practice is warranted.

Common respiratory viruses and collapsing health: Prodigious focus on ambient air pollution

Ambient air pollution is one of the treacherous and malign problems facing humanity and other living beings on the earth today. Although the air pollutants such as particulate matters (PM) and microscopic contaminants have been associated with widespread morbidity and mortality, studies have also indicated those pollutants as a potential synergist to respiratory infirmities in both adults and children. Many viral contaminants have also been reported as potential detriments of respiratory distresses. Exposure to poor grades of ambient air can lead to numerous health consequences, such as adverse effects on the lung, heart, and other vital organs. In recent years, many studies infer that pollution along with viral contaminants impart substantial worldwide burden of diseases on human beings. Excessive air suspended pollutants such as micro or nanoparticulate matters bring down the life expectancy of human beings in many ways. Regardless of the passage of entry, fine and ultrafine PM that enter into systemic circulation affect vascular endothelial cells by producing local oxidative stress and have the capacity to cross biological barriers, thereby creating numerous deleterious effects on vital organs. Pollution-induced systemic inflammation is mediated by proinflammatory cytokines such as interleukin-6, interleukin-1 β, and tumor necrotic factor-α. These systemic inflammatory mediators are implicated in causing or exacerbating many complications in the human body. This article is an attempt to accentuate the pollution-linked health impediments, as well as the fountainheads of ambient air pollution so that some effective strategies can be developed to manage this global peril.

Treatment strategies to prevent complications of posterior olecranon fracture dislocation based on poor grade case and review of literature

Treatment strategies to prevent complications of posterior olecranon fracture dislocation based on poor grade case and review of literature

Combination of High-Density Lipoprotein Cholesterol and Lipoprotein(a) as a Predictor of Collateral Circulation in Patients With Severe Unilateral Internal Carotid Artery Stenosis or Occlusion.

Background and PurposeCollateral circulation is considered an important factor affecting the risk of stroke, but the factors that affect collateral circulation remain unclear. This study was performed to identify the factors associated with collateral circulation, especially blood lipids.MethodsThe study involved patients who had undergone digital subtraction angiography and were confirmed as having severe unilateral stenosis or occlusion of the internal carotid artery (ICA). We classified the collateral circulation status of each patient as good (Grade 3 or 4) or poor (Grade 0, 1, or 2) according to the grading system of the American Society of Interventional and Therapeutic Neuroradiology/American Society of Interventional Radiology. We collected data on patients’ characteristics and identified the factors that affect collateral circulation.ResultsThis study included 212 patients. The multivariate logistic regression analysis showed that the high-density lipoprotein cholesterol (HDL-C) concentration and a complete anterior half of the circle of Willis were independent protective factors for good collateral circulation, whereas elevated lipoprotein(a) [Lp(a)] and serum creatinine concentrations were independent risk factors for good collateral circulation. The area under the receiver operating characteristics curve (AUC) was 0.68 (95% confidence interval [CI], 0.61–0.76) for HDL-C and 0.69 (95% CI, 0.62–0.76) for Lp(a). A binary logistic regression model analysis of the joint factor of HDL-C and Lp(a) yielded an AUC of 0.77 (95% CI, 0.71–0.84).ConclusionsIn patients with severe unilateral ICA stenosis or occlusion, the combination of HDL-C and Lp(a) is a useful predictor of collateral circulation.

Immunohistochemical analysis of Mismatch repair-deficient gene expression in unselected Colorectal Cancer: An update of tertiary cancer center from North India

Colorectal cancer (CRC) is the third most deadly and fourth most commonly diagnosed cancer in the world. The present study has been carried out to see the frequency of lost MMR protein expression and its histopathological characteristics in unselected colorectal cancer patients from north India. 103 consecutive patients of colorectal cancer who underwent surgery between 2014-2018 in a tertiary care teaching hospital in North India were included in the study. The study was approved by the Institute’s Ethical Committee. MMR protein status was determined by Immunohistochemistry (IHC) to examine the expression of MLH1, PMS2, MSH2 and MSH6 on paraffin-embedded tissues. Patients with MLH1deficient protein were further followed by BRAF V600E testing. The histopathological features were correlated with MMR protein expression. IHC results revealed a loss of different MMR protein expression in 33 (32%) patients. the most frequent loss was lost MSH2 12(36.4%) followed by MLH1 10(30.3%), PMS2 8(24.2%) and MSH6 3(9.1%); Out of 10 MLH1 deficient cases, 6 (60%) were BRAF V600E mutant and 4 (40%) were BRAF-wild-type. We have found significance with medullary histological phenotype, poor histological grade and TILS. In our study, the frequency of MMR protein loss was found in 32% of patients of CRC. The loss was significantly associated with medullary phenotype, degree of differentiation and presence of tumor infiltrating lymphocytes (TILS).

Predicting Academic Performance Using an Efficient Model Based on Fusion of Classifiers

In the past few years, educational data mining (EDM) has attracted the attention of researchers to enhance the quality of education. Predicting student academic performance is crucial to improving the value of education. Some research studies have been conducted which mainly focused on prediction of students’ performance at higher education. However, research related to performance prediction at the secondary level is scarce, whereas the secondary level tends to be a benchmark to describe students’ learning progress at further educational levels. Students’ failure or poor grades at lower secondary negatively impact them at the higher secondary level. Therefore, early prediction of performance is vital to keep students on a progressive track. This research intended to determine the critical factors that affect the performance of students at the secondary level and to build an efficient classification model through the fusion of single and ensemble-based classifiers for the prediction of academic performance. Firstly, three single classifiers including a Multilayer Perceptron (MLP), J48, and PART were observed along with three well-established ensemble algorithms encompassing Bagging (BAG), MultiBoost (MB), and Voting (VT) independently. To further enhance the performance of the abovementioned classifiers, nine other models were developed by the fusion of single and ensemble-based classifiers. The evaluation results showed that MultiBoost with MLP outperformed the others by achieving 98.7% accuracy, 98.6% precision, recall, and F-score. The study implies that the proposed model could be useful in identifying the academic performance of secondary level students at an early stage to improve the learning outcomes.

Utilization by students of automated essay evaluation software during revision

This study aimed to investigate how six middle school students changed their writing while utilizing Automated Essay Evaluation (AEE) technology. The participants in this study were all middle school students. Students in a combined 7th and 8th-grade Literacy class at one school participated in two in-depth think-aloud and semi-structured interviews, using AEE technology to enhance their work on two different writing difficulties. These operations ran in parallel with one another. The findings of a constant-comparison analysis of the data, which included think-aloud, semi-structured interviews, and student writing, as well as a separate quantitative analysis of student revisions, revealed themes in three areas, which are as follows:&#x0D; Student use of AEE feedback to make revision Student motivation to revise their writing when using AEE technology And student understanding and application of AEE feedback during revision According to the data, students who achieved poor grades used AEE comments to drive non-surface adjustments, but students who earned high grades did not engage in this practice. In addition, when compared to students who did not use the feedback to prompt non-surface revisions, those students who did use it to prompt non-surface revisions made a significantly larger number of overall non-surface revisions, revised for a wider variety of reasons, made a significantly larger number of t-unit level revisions, and had a significantly larger number of revisions rated as major successes. Students that used the AEE feedback, known as MY Editor, had a low success rate when using it. This was because the grammar and punctuation feedback was frequently unclear, and they struggled to comprehend it. On the other hand, students did far better when they were just provided feedback based on the spelling checker. The statistics also show that students were inspired to update their work due to the numerical ratings granted to them by the technology. This was demonstrated by the fact that the students received these ratings. Students were aware that they would be graded on their submissions. Thus they were encouraged to make considerable changes to their work before handing it in for marking. This was done to understand that students would receive a grade upon completing their work. In conclusion, there was a significant gap in the degree to which different students understood the AEE remarks. In this paper, we explore the consequences of employing AEE technology in the educational setting and provide some ideas for further research.

Petrography, geochemistry and depositional model of Ispikan Conglomerate, Makran Accretionary Prism, Southwest Pakistan

Sedimentology, petrography, and geochemistry of the Ispikan Conglomerate of southwest Makran have been studied to establish its stratigraphic position, age, provenance, and depositional environment. Very thin to massive beds, poor sorting, no fabric, and poor grading are the common features. It is composed of mostly reworked, medium- to coarse-grained pebbly sandstone, siltstone, and discontinuous lenses of matrix- and clast-supported conglomerate. The sandstone is composed of angular to sub-angular, poorly sorted, immature grains having Q72F13L15 as average composition. Pebbles are of mostly metamorphic and acidic igneous origin. Large angular boulders (~1.5m) of sandstone indicate quick debris flow conditions. Geochemical discriminants suggest the derivation of Ispikan sediments from an active continental margin. The Nb and Zr/Th and Ba/Y values indicate the continental island arc setting, whereas a high K/Rb ratio points to the derivation of detritus from an acid and intermediate source. Ispikan Conglomerate is interpreted as an Eocene olistostrome formed after a localized submarine debris flow triggered by slope failure.

Lobar Gross Endobronchial Disease Predicts for Overall Survival and Grade 5 Pulmonary Toxicity in Medically Inoperable Early Stage Non-Small Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy.

PurposeStereotactic body radiation therapy (SBRT) is considered standard of care for medically inoperable early stage non-small cell lung cancer (ES-NSCLC). Central tumor location is a known risk factor for severe SBRT related toxicity. Bronchoscopy allows for visualization of the central airways prior to treatment. Five fraction SBRT approaches have been advocated to mitigate treatment induced toxicity. In this report, we examine the mature clinical outcomes of a diverse cohort of ES-NSCLC patients with both peripheral and central tumors treated with a conservative 5 fraction SBRT approach and evaluate the role of lobar gross endobronchial disease (LGED) in predicting overall survival and treatment-related death.MethodsMedically inoperable biopsy-proven, lymph node-negative ES-NSCLC patients were treated with SBRT. Bronchoscopy was completed prior to treatment in all centrally located cases. The Kaplan-Meier method was used to estimate overall survival (OS), local control (LC), regional control (RC), distant metastasis free survival (DMFS) and disease-free survival (DFS). Overall survival was stratified based on clinical stage, histology, tumor location and LGED. Toxicities were scored according to the National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0.ResultsFrom December 2010 to December 2015, 50 consecutive patients were treated uniformly with a 50 Gy in 5 fraction SBRT approach (tumor BED10 ≥ 100 Gy) and followed for a minimum of 5 years or until death. At a median follow up of 42 months for all patients, 3-year OS was 50%. Three-year OS did not statistically differ between stage I and stage II disease (51% vs. 47%; p=0.86), adenocarcinoma and squamous cell carcinoma (50% vs. 45%; p=0.68), or peripheral and central tumors (56% vs. 45%; p=0.46). Five central tumors were found to have LGED, and 3-year OS for this cohort was quite poor at 20%. Cox regression analysis identified LGED as a predictor of OS while controlling for age, stage and location (OR:4.536, p-value=0.038). Despite the relatively low dose delivered, treatment likely contributed to the death of 4 patients with central tumors. Lobar gross endobronchial disease was an independent predictor for grade 5 pulmonary toxicity (n=4, p=0.007). Specifically, 3 of the 5 patients with LGED developed fatal radiation-induced bronchial stricture. Three-year LC, RC, DMFS and DFS results for the group were similar to contemporary studies at 90%, 90%, 82% and 65%.ConclusionsCentral location of ES-NSCLC is a well-established predictor for severe SBRT-related toxicity. Here we identify LGED as a significant predictor of poor overall survival and grade 5 pulmonary toxicity. The relatively high rates of severe treatment-related toxicity seen in patients with central ES-NSCLC may be due in part to LGED. Underlying LGED may cause irreparable damage to the lobar airway, unmitigated by SBRT treatment thus increasing the risk of severe treatment-related toxicity. These findings should be verified in larger data sets. Future prospective central ES-NSCLC clinical trials should require staging bronchoscopy to identify LGED and further assess its clinical significance.

Yhdeksäsluokkalaisten vieraan kielen oppimismotivaatioprofiilien ja arvosanan yhteydet peruskoulun jälkeisiin jatkosuunnitelmiin -

In this article I explore the relationship between Finnish ninth graders’ L2 motivational profiles, language grades and future study plans after basic education. The aim of the study is to critically explore the relationship between motivation and language grades and reflect on the possible implications of this for language education policies. The statistically representative data was collected with an e-questionnaire (n=1 206). For this study, I analysed those who planned to continue their studies to general upper secondary school or vocational education after basic education, and who submitted their language grade (n=981). In earlier analyses of the study (Kangasvieri, 2019), five motivational profiles were found: the least motivated, averagely motivated with low anxiety, averagely motivated, the most motivated and students with high anxiety. In this study, the connection between these motivational profiles and students’ education choice is explored, taking into account the effect of grades. A logistic regression analysis was conducted. The results show that the probability to continue to general upper secondary school or vocational education in each motivational profile depends on the grade. The model explains about 30 percent of the students’ educational choices. Additionally, the results show that the more motivated the student is in his/her language studies, the higher grade he/she feels is needed in order to plan to continue to general upper secondary school after basic education. Correspondingly, less motivated students plan to continue to general upper secondary school with poorer grades than more motivated students.

The Relationship between the Ummi Model and the Ability to Read the Qur'an of Third Grade Students at School

The purpose of this study was to determine the relationship between the Ummi Model and the ability to read the Qur'an of third graders at the SDIT Nurul Islam Krembung school. This study uses quantitative research using data collection instruments, in this study using primary and secondary data sources to determine the subjects from which the data was obtained, and using questionnaire data collection procedures with question and answer interviews to take notes on events. The sample used in this study were all 3rd grade students of SDIT Nurul Islam Krembung, amounting to 25 of which 13 or 52% of students scored well, 9 students or 36% had sufficient marks, 3 students or 12% with poor grades, this means reading ability in the good category is in the good category. in a score of 83-91. It can be concluded that the relationship between the ummi model has an effect on the ability to read the Qur'an of third graders at SDIT Nurul Islam Krembung.