Preoperative staging of the axilla in women with invasive breast cancer using ultrasound-guided needle biopsy(UNB) identifies approximately 50% of patients with axillary nodal metastases prior to surgical intervention...Preoperative staging of the axilla in women with invasive breast cancer using ultrasound-guided needle biopsy(UNB) identifies approximately 50% of patients with axillary nodal metastases prior to surgical intervention. Although moderately sensitive, it is a highly specific staging strategy that is rarely falsely-positive, hence a positive UNB allows patients to be triaged to axillary lymph-node dissection(ALND) avoiding potentially unnecessary sentinel node biopsy(SNB). In this review, we extend our previous work through an updated literature search, focusing on studies that report data on UNB utility. Based on data for 10,934 breast cancer patients, sourced from 35 studies, a positive UNB allowed triage of 1,745 cases(simple proportion 16%) to axillary surgical treatment: the utility of UNB was a median 19.8% [interquartile range(IQR) 11.6%-26.7%] across these studies. We also modelled data from a subgroup of studies, and estimated that amongst patients with metastases to axillary nodes, the odds ratio(OR) for high nodal disease burden for a positive UNB versus a negative UNB was 4.38 [95% confidence interval(95% CI): 3.13, 6.13], P<0.001. From this model, the estimated proportion with high nodal disease burden was 58.9%(95% CI: 50.2%, 67.0%) for a positive UNB, whereas the estimated proportion with high nodal disease burden was 24.6%(95% CI: 17.7%, 33.2%) if UNB was negative. Overall, axillary UNB has good clinical utility and a positive UNB can effectively triage to ALND. However, the evolving landscape of axillary surgical treatment means that UNB will have relatively less utility where surgeons have modified their practice to omission of ALND for minimal nodal metastatic disease.展开更多
Pasteuria penetrans controls root knots nematodes （Meloidogyne spp.） either by preventing invasion or by causing female sterility. The greatest control effect ofP. penetrans occurred when an efficient quantity ofP. ...Pasteuria penetrans controls root knots nematodes （Meloidogyne spp.） either by preventing invasion or by causing female sterility. The greatest control effect ofP. penetrans occurred when an efficient quantity ofP. penetrans spores attached to nematodes cuticle. The number of spores attaching to J2s within a given time increased with increasing the time of attachment. Based to that, we produced attachment data in vitro recorded encumbered nematodes 1, 3, 6 and 9 h after placing nematodes in a standard P. penetrans spore suspensions. From the count data obtained we modeled P. penetrans attachment using the Poisson and the negative binomial distribution. Attachment count data observed to be over dispersed with respect to high numbers of spores sticks on each J2 after at 6 and 9 h after spores application. We concluded that negative binomial distribution was shown to be the most appropriate model to fit the observed data sets considering that P. penetrans spores are clumped.展开更多
基金partly funded by National Health and Medical Research Council (NHMRC) program (Grant No. 633003) to the Screening & Test Evaluation Program, Australia
文摘Preoperative staging of the axilla in women with invasive breast cancer using ultrasound-guided needle biopsy(UNB) identifies approximately 50% of patients with axillary nodal metastases prior to surgical intervention. Although moderately sensitive, it is a highly specific staging strategy that is rarely falsely-positive, hence a positive UNB allows patients to be triaged to axillary lymph-node dissection(ALND) avoiding potentially unnecessary sentinel node biopsy(SNB). In this review, we extend our previous work through an updated literature search, focusing on studies that report data on UNB utility. Based on data for 10,934 breast cancer patients, sourced from 35 studies, a positive UNB allowed triage of 1,745 cases(simple proportion 16%) to axillary surgical treatment: the utility of UNB was a median 19.8% [interquartile range(IQR) 11.6%-26.7%] across these studies. We also modelled data from a subgroup of studies, and estimated that amongst patients with metastases to axillary nodes, the odds ratio(OR) for high nodal disease burden for a positive UNB versus a negative UNB was 4.38 [95% confidence interval(95% CI): 3.13, 6.13], P<0.001. From this model, the estimated proportion with high nodal disease burden was 58.9%(95% CI: 50.2%, 67.0%) for a positive UNB, whereas the estimated proportion with high nodal disease burden was 24.6%(95% CI: 17.7%, 33.2%) if UNB was negative. Overall, axillary UNB has good clinical utility and a positive UNB can effectively triage to ALND. However, the evolving landscape of axillary surgical treatment means that UNB will have relatively less utility where surgeons have modified their practice to omission of ALND for minimal nodal metastatic disease.
文摘Pasteuria penetrans controls root knots nematodes （Meloidogyne spp.） either by preventing invasion or by causing female sterility. The greatest control effect ofP. penetrans occurred when an efficient quantity ofP. penetrans spores attached to nematodes cuticle. The number of spores attaching to J2s within a given time increased with increasing the time of attachment. Based to that, we produced attachment data in vitro recorded encumbered nematodes 1, 3, 6 and 9 h after placing nematodes in a standard P. penetrans spore suspensions. From the count data obtained we modeled P. penetrans attachment using the Poisson and the negative binomial distribution. Attachment count data observed to be over dispersed with respect to high numbers of spores sticks on each J2 after at 6 and 9 h after spores application. We concluded that negative binomial distribution was shown to be the most appropriate model to fit the observed data sets considering that P. penetrans spores are clumped.
