Impact of reducing day 1 dexamethasone dose in anthracycline-containing regimens on acute gastrointestinal symptoms associated with breast cancer treatment

The potential of steroid sparing from day 2 onward is reported in anthracycline-containing regimens for breast cancer treatment. We evaluated whether the reduction of dexamethasone (DEX) dose from 9.9 to 6.6 mg on day 1 is possible in anthracycline-containing treatments. Patients receiving anthracycline-containing regimens were divided into control (9.9 mg DEX on day 1) and reduced (6.6 mg DEX on day 1) groups, and retrospectively evaluated. The complete response (CR) rate and the incidence and severity of nausea, vomiting, anorexia, and fatigue were evaluated. The CR rate in the acute phase (day 1) was 63.1% and 38.1% in the control and reduced groups, respectively, with significant difference (P = 0.01) between the groups. However, no difference was found in the delayed phase (days 2–7). The incidence of anorexia and vomiting during treatment was not statistically different. Severity of nausea tended to, but not statistically, worsen while anorexia significantly worsened in the reduced group. Multivariate analysis suggested that patients < 55 years, with non- or less-alcohol drinking habit (< 5 days/week), and administered reduced-DEX dosage on day 1, have a higher risk of acute nausea development. Thus, reducing day 1 DEX dose in anthracycline-containing regimens is not suitable for acute nausea management.

The processing of semantic complexity and co-speech gestures in schizophrenia: a naturalistic, multimodal fMRI study

Schizophrenia is marked by aberrant processing of complex speech and gesture, which may contribute functionally to its impaired social communication. To date, extant neuroscientific studies of schizophrenia have largely investigated dysfunctional speech and gesture in isolation, and no prior research has examined how the two communicative channels may interact in more natural contexts. Here, we tested if patients with schizophrenia show aberrant neural processing of semantically complex story segments, and if speech-associated gestures (co-speech gestures) might modulate this effect. In a functional MRI study, we presented to 34 participants (16 patients and 18 matched-controls) an ecologically-valid retelling of a continuous story, performed via speech and spontaneous gestures. We split the entire story into ten-word segments, and measured the semantic complexity for each segment with idea density, a linguistic measure that is commonly used clinically to evaluate aberrant language dysfunction at semantic level. Per segment, the presence of numbers of gestures varied (n = 0, 1, +2). Our results suggest that, in comparison to controls, patients showed reduced activation for more complex segments in the bilateral middle frontal and inferior parietal regions. Importantly, this neural aberrance was reduced in segments presented with gestures. Thus, for the first time with a naturalistic multimodal stimulation paradigm, we show that gestures reduced group differences when processing a natural story, probably by facilitating the processing of semantically complex segments of the story in schizophrenia.

Fetal Reduction in High Order Pregnancy; A Retrospective Observational Study

Background:High order multiple pregnancy (HOMP), is considered a high-risk pregnancy as it has many complications on the mother and the fetuses, with a huge financial burden on the hospitals. Therefore avoiding HOMP is important, however, if this fails, fetal reduction is an acceptable alternative procedure to reduce maternal complications and improve fetal outcome.Our aim to study the impact of a fetal reduction on the risk of preterm labour and postpartum hemorrhage in HOMP (More than Triplet).Methods:This is a retrospective study of all HOMPs seen during the period from July 2007 to July 2017 at Women’s Hospital- Hamad General Hospital, Doha, Qatar. We examined records of 50 women diagnosed with HOMP, incomplete records, and triplet pregnancies were excluded from the study. the data were collected from the ultrasound software as well as maternal files. Results:Of the 50 women diagnosed with HOMP, 39 quadruplets, 7 quintuplets.2 sextuplets and 2 septuplets. 56% had an ovulation induction, 26% had an IVF, 14% had an IUI, and 2 cases (4%) were spontaneous pregnancies.(28%) had a fetal reduction, with a mean gestation age of 12.64 ± 0.74 weeks of gestation, and with no immediate complications. Our study showed that there is no significant difference at time of delivery between reduced and non reduced group mean gestational age at the time of delivery for the reduced group was 30.26 ± 4.38, and 29.39 ± 4.78 weeks for the non-reduced group. P-value of 0.565 , 95% CI (-2.159-3.90). 44.9% had postpartum haemorrhage with a mean estimated blood loss of 1659.1 ± 958.5 mls. Our study showed that there is significant decrease in estimated blood loss in reduced group compared with non-reduced group with p-value of 0.047 ConclusionHigh order multiple pregnancies are a result of modern infertility treatments has significant serious adverse effects on the mother and the babies. Although fetal reduction reduced the rate of PPH but did not significantly improve the rate of preterm labour, hence prevention of HOMP is the primary goal.

How Demographic Faultlines and Impression Management Behaviors Influence Group Affective Tone

Drawing on the social categorization perspective, we theorized that team demographic faultlines increase negative group affective tone (NGAT) through reduced group identification, while team member positive impression management behaviors enhance positive group affective tone (PGAT) via enhanced group identification. Data were collected from 523 members of 101 newly formed student teams. Consistent with our hypotheses, team demographic faultlines were positively predicted NGAT via reduced group identification, while team self-promotion and ingratiation behaviors were positively associated with PGAT through group identification. Importantly, team self-promotion and ingratiation behaviors also mitigated the social categorization processes triggered by team demographic faultlines.

Boundary Action On Simple Reduced Group C*-Algebras

A connection between boundary actions, ideal structure of reduced crossed products and C*-simple group is imminent.We investigate the stability properties for discrete group pioneered by powers and show that the non-abelian free group on two generators is C*-simple.Kalantar and Kennedy [32, Theorem 6.2] is now extended. Some examples are given using characterization of C*-simplicity obtained by Kalantar, Kennedy, Breuillard, and Ozawa [10, Theorem 3.1]

Abstract 13432: Left Ventricular External Work as a Marker of Cardiac Functional Recovery and Outcome After Transcatheter Aortic Valve Replacement in Patients With Aortic Stenosis

Background: Prediction of cardiac functional recovery and outcome after transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS) is still challenging. We hypothesized that left ventricular (LV) external work estimated by echocardiography before TAVR would reflect potential myocardial damage and thus could be associated with changes in cardiac function and prognosis after TAVR. Methods: Echocardiography was performed in 70 AS patients (83 ± 5 years old) before and after TAVR (1 month and 6 months). LV stroke work index (SWI) was calculated as stroke volume index (SVI) х [mean systemic blood pressure + mean pressure gradient across aortic valve (mPG)] before TAVR as a parameter of LV external work. Patients were divided into reduced and preserved SWI group based on the median value (6106 mmHg · mL/m 2 ). Cardiac events were defined as cardiac death or worsening heart failure within 12 months after TAVR. Results: Reduced group had lower SVI (40 ± 7 vs 57 ± 8 mL/m 2 ), mPG (44 ± 14 vs 57 ± 16 mmHg), and smaller aortic valve area index (0.4 ± 0.1 vs 0.5 ± 0.1 cm 2 /m 2 ) than preserved group at baseline (p < 0.05 for all), although LV mass index (LVMI) (116 ± 35 vs 128 ± 30 g/m 2 ) and left atrial volume index (LAVI) (56 ± 20 vs 52 ± 17 mL/m 2 ) were comparable. LV ejection fraction (EF) (57 ± 13 vs 66 ± 7%) and global longitudinal strain (GLS) (–14.2 ± 4.6 vs –16.6 ± 4.8%) at baseline were significantly lower in reduced group than in preserved one. After TAVR, LVMI and LAVI did not change in reduced group ( Table 1 ). In contrast, preserved group showed significant decrease in these parameters. Although LV EF did not change in both groups, GLS was significantly improved only in preserved group but not in reduced group ( Table 1 ). Seven patients (10%) experienced cardiovascular events after TAVR and all these belonged reduced group. Conclusions: Reduced SWI before TAVR was associated with poor response in cardiac function after TAVR and might be a prognostic marker in AS patients undergoing TAVR.

Plant Antifungal Lectins: Mechanism of Action and Targets on Human Pathogenic Fungi

Lectins are proteins characterized by their ability to specifically bind different carbohydrate motifs. This feature is associated with their endogenous biological function as well as with multiple applications. Plants are important natural sources of these proteins; however, only a reduced group was shown to display antifungal activity. Although it is hypothesized that the target of lectins is the fungal cell wall, the mechanism through which they exert the antifungal action is poorly understood. This topic is relevant to improve treatment against pathogens of importance for human health. In this context, mechanisms pointing to essential attributes for virulence instead of the viability of the pathogen emerge as a promising approach. This review provides the current knowledge on the action mechanism of plant antifungal lectins and their putative use for the development of novel active principles against fungal infections.