cr Accuracy of Self-reported Colonic Polyps: Results from the Prostate, Lung, Colorectal, and Ovarian Screening Trial Study of Colonoscopy Utilization By cebp.aacrjournals.org Published On :: 2020-05-01T00:05:36-07:00 Background: Colonoscopy follow-up recommendations depend on the presence or absence of polyps, and if found, their number, size, and histology. Patients may be responsible for conveying results between primary and specialty care or providing medical information to family members; thus, accurate reporting is critical. This analysis assessed the accuracy of self-reported colonoscopy findings. Methods: 3,986 participants from the Study of Colonoscopy Utilization, an ancillary study nested within the Prostate, Lung, Colorectal, and Ovarian Screening Trial, were included. Self-reports of polyp and adenoma were compared to medical records, and measures of sensitivity and specificity were calculated. Correlates of accurate self-report of polyp were assessed using logistic regression and weighted to account for study sampling. Results: The sensitivity and specificity of self-reported polyp findings were 88% and 85%, respectively, and for adenoma 11% and 99%, respectively. Among participants with a polyp, older age was associated with lower likelihood while polyp severity and non-white race were associated with increased likelihood of accurate recall. Among participants without a polyp, having multiple colonoscopies was associated with lower likelihood while family history of colorectal cancer was associated with increased likelihood of accurate recall. Among both groups, longer time since colonoscopy was associated with lower likelihood of accurate recall. Conclusions: Participants recalled with reasonable accuracy whether they had a prior polyp; however, recall of histology, specifically adenoma, was much less accurate. Impact: Identification of strategies to increase accurate self-report of colonic polyps are needed, particularly for patient–provider communications and patient reporting of results to family members. Full Article
cr Age at Diagnosis and Patient Preferences for Treatment Outcomes in AML: A Discrete Choice Experiment to Explore Meaningful Benefits By cebp.aacrjournals.org Published On :: 2020-05-01T00:05:36-07:00 Background: The recent expansion of treatment options in acute myeloid leukemia (AML) has necessitated a greater understanding of patient preferences for treatment benefits, about which little is known. Methods: We sought to quantify and assess heterogeneity of the preferences of AML patients for treatment outcomes. An AML-specific discrete choice experiment (DCE) was developed involving multiple stakeholders. Attributes included in the DCE were event-free survival (EFS), complete remission (CR), time in the hospital, short-term side effects, and long-term side effects. Continuously coded conditional, stratified, and latent-class logistic regressions were used to model preferences of 294 patients with AML. Results: Most patients were white (89.4%) and in remission (95.0%). A 10% improvement in the chance of CR was the most meaningful offered benefit (P < 0.001). Patients were willing to trade up to 22 months of EFS or endure 8.7 months in the hospital or a two-step increase in long-term side effects to gain a 10% increase in chance of CR. Patients diagnosed at 60 years or older (21.6%) more strongly preferred to avoid short-term side effects (P = 0.03). Latent class analysis showed significant differences of preferences across gender and insurance status. Conclusions: In this national sample of mostly AML survivors, patients preferred treatments that maximized chance at remission; however, significant preference heterogeneity for outcomes was identified. Age and gender may affect patients' preferences. Impact: Survivor preferences for outcomes can inform patient-focused drug development and shared decision-making. Further studies are necessary to investigate the use of DCEs to guide treatment for individual patients. Full Article
cr Screen to Save: Results from NCI's Colorectal Cancer Outreach and Screening Initiative to Promote Awareness and Knowledge of Colorectal Cancer in Racial/Ethnic and Rural Populations By cebp.aacrjournals.org Published On :: 2020-05-01T00:05:36-07:00 Background: The Center to Reduce Cancer Health Disparities (CRCHD), NCI, implemented Screen to Save, NCI's Colorectal Cancer Outreach and Screening Initiative to promote awareness and knowledge of colorectal cancer in racial/ethnic and rural populations. Methods: The initiative was implemented through CRCHD's National Outreach Network (NON). NON is a national network of Community Health Educators (CHE), aligned with NCI-designated Cancer Centers across the nation. In phases I and II, the CHEs focused on the dissemination of cancer-related information and implementation of evidence-based educational outreach. Results: In total, 3,183 pre/post surveys were obtained from male and female participants, ages 50 to 74 years, during the 347 educational events held in phase I. Results demonstrated all racial/ethnic groups had an increase in colorectal cancer–related knowledge, and each group strongly agreed that the educational event increased the likelihood that they would engage in colorectal cancer–related healthful behaviors (e.g., obtain colorectal cancer screening and increase physical activity). For phase II, Connections to Care, event participants were linked to screening. Eighty-two percent of the participants who obtained colorectal cancer screening during the 3-month follow-up period obtained their screening results. Conclusions: These results suggest that culturally tailored, standardized educational messaging and data collection tools are key change agents that can serve to inform the effectiveness of educational outreach to advance awareness and knowledge of colorectal cancer. Impact: Future initiatives should focus on large-scale national efforts to elucidate effective models of connections to care, related to colorectal cancer screening, follow-up, and treatments that are modifiable to meet community needs. Full Article
cr Further Guidance in Implementing the Standardized 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Score By cebp.aacrjournals.org Published On :: 2020-05-01T00:05:36-07:00 The 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Score was developed to establish a simple, standardized scoring system for researchers to quantify adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and assess its impact on cancer risk and other health-related outcomes. The aim of this commentary is to clarify potential points of ambiguity in its application, focusing on aspects related to specific subscore components (physical activity, fast foods, alcohol, and sugar-sweetened drinks), how to address different data needs due to varied data collection instruments, and future exploratory score approaches. Overall, we encourage researchers to utilize the standardized score to enhance comparability across populations and countries. Researchers who may adapt or augment the 2018 WCRF/AICR Score are strongly encouraged to provide detailed descriptions of their methods to promote transparency and reproducibility. Full Article
cr Sensitive Determination of Infectious Titer of Recombinant Adeno-Associated Viruses (rAAVs) Using TCID50 End-Point Dilution and Quantitative Polymerase Chain Reaction (qPCR) By cshprotocols.cshlp.org Published On :: 2020-05-01T06:29:31-07:00 Adeno-associated virus (AAV) recombinants are currently the vector of choice for many gene therapy applications. As experimental therapies progress to clinical trials, the need to characterize recombinant adeno-associated viruses (rAAVs) accurately and reproducibly increases. Accurate determination of rAAV infectious titer is important for determining the activity of each vector lot and for ensuring lot-to-lot consistency. The following protocol developed in our laboratory uses a 96-well TCID50 format and quantitative polymerase chain reaction (qPCR) detection for the determination of rAAV infectious titer. Full Article
cr Titration of Recombinant Adeno-Associated Virus (rAAV) Genome Copy Number Using Real-Time Quantitative Polymerase Chain Reaction (qPCR) By cshprotocols.cshlp.org Published On :: 2020-05-01T06:29:31-07:00 This protocol is used to determine the concentration of DNase-resistant vector genomes (i.e., packaged in the capsid) in purified recombinant adeno-associated virus (rAAV) preparations. The protocol begins with treatment of the vector stock with DNase I to eliminate unencapsidated AAV DNA or contaminating plasmid DNA. This is followed by a heat treatment to heat-inactivate DNase I, to disrupt the viral capsid, and to release the packaged vector genomes for quantification by real-time polymerase chain reaction (PCR) using a set of standards (linearized plasmid used for vector production) containing known copy numbers. To accomplish high-throughput titration, the primer and probe sets used in real-time PCR are usually designed to target common elements present in most rAAV genomes, such as promoters and poly(A) signals. This strategy significantly reduces the number of PCRs, controls, and turnaround time. Several important controls should be included in the assay as follows: The first two controls should have a known copy number of the rAAV genome plasmid treated or not treated with DNase I. This control tests the effectiveness of DNase treatment. To control for potential cross-contamination between samples during the preparation process, a blank control containing nuclease-free water only should be processed and tested in parallel. A validation vector sample with a known titer should be included in every assay to monitor interassay variability. Finally, for the PCR run, a no-template control (NTC) is included to indicate cross-contamination during PCR setup. Full Article
cr Oral Microbiome Profiling in Smokers with and without Head and Neck Cancer Reveals Variations Between Health and Disease By cancerpreventionresearch.aacrjournals.org Published On :: 2020-05-04T05:35:14-07:00 While smoking is inextricably linked to oral/head and neck cancer (HNSCC), only a small fraction of smokers develop HNSCC. Thus, we have sought to identify other factors, which may influence the development of HNSCC in smokers including microbiology. To determine microbial associations with HNSCC among tobacco users, we characterized oral microbiome composition in smokers with and without HNSCC. 16S rRNA MiSeq sequencing was used to examine the oral mucosa microbiome of 27 smokers with (cases) and 24 without HNSCC (controls). In addition, we correlated previously reported levels of DNA damage with the microbiome data. Smokers with HNSCC showed lower microbiome richness compared with controls (q = 0.012). Beta-diversity analyses, assessed as UniFrac (weighted and unweighted) and Bray–Curtis distances, showed significant differences in oral mucosal microbiome signatures between cases and controls (r2 = 0.03; P = 0.03) and higher interindividual microbiome heterogeneity in the former (q ≤ 0.01). Higher relative abundance of Stenotrophomonas and Comamonadaceae and predicted bacterial pathways mainly involved in xenobiotic and amine degradation were found in cases compared with controls. The latter, in contrast, exhibited higher abundance of common oral commensals and predicted sugar degradation pathways. Finally, levels of DNA damage in the oral cavity were correlated with the microbiome profiles above. Oral microbiome traits differ in smokers with and without HNSCC, potentially informing the risk of eventual HNSCC and shedding light into possible microbially mediated mechanisms of disease. These findings present data that may be useful in screening efforts for HNSCC among smokers who are unable to quit. Full Article
cr Estimating the Screening-Eligible Population Size, Ages 45-74, at Average Risk to Develop Colorectal Cancer in the United States By cancerpreventionresearch.aacrjournals.org Published On :: 2020-05-04T05:35:14-07:00 Colorectal cancer is a growing burden in adults less than 50 years old. In 2018, the American Cancer Society published a guideline update recommending a reduction in the colorectal cancer screening start age for average-risk individuals from 50 to 45. Implementing these recommendations would have important implications for public health. However, the approximate number of people impacted by this change, the average-risk population ages 45–49, is not well-described in the literature. Here, we provide methodology to conservatively estimate the average-risk and screening-eligible population in the United States, including those who would be impacted by a lowered colorectal cancer screening start age. Using multiple data sources, we estimated the current average-risk population by subtracting individuals with symptomatic colorectal cancer, with a family history of colorectal cancer, and with inflammatory bowel disease and hereditary nonpolyposis colorectal cancer from the total population. Within this population, we estimated the number of screening-eligible individuals by subtracting those with previous colorectal cancer screening (45- to 49-year-old) or up to date with colorectal cancer screening (50- to 74-year-old). The total average-risk population is estimated between 102.1 and 106.5 million people, of whom 43.4–45.2 million people are eligible for colorectal cancer screening. Lowering the screening age would add roughly 19 million people to the average-risk population and increase the current number of screening-eligible individuals on immediate implementation by over 60% (from 27 to 44 million). Estimating the population size impacted by lowering the recommended colorectal cancer screening start age enables more accurate decision-making for policymakers and epidemiologists focused on cancer prevention. Full Article
cr Glial TIM-3 Modulates Immune Responses in the Brain Tumor Microenvironment By cancerres.aacrjournals.org Published On :: 2020-05-04T05:35:17-07:00 T-cell immunoglobulin and mucin domain–containing molecule 3 (TIM-3), a potential immunotherapeutic target for cancer, has been shown to display diverse characteristics in a context-dependent manner. Thus, it would be useful to delineate the precise functional features of TIM-3 in a given situation. Here, we report that glial TIM-3 shows distinctive properties in the brain tumor microenvironment. TIM-3 was expressed on both growing tumor cells and their surrounding cells including glia and T cells in an orthotopic mouse glioma model. The expression pattern of TIM-3 was distinct from those of other immune checkpoint molecules in tumor-exposed and tumor-infiltrating glia. Comparison of cells from tumor-bearing and contralateral hemispheres of a glioma model showed that TIM-3 expression was lower in tumor-infiltrating CD11b+CD45mid glial cells but higher in tumor-infiltrating CD8+ T cells. In TIM-3 mutant mice with intracellular signaling defects and Cre-inducible TIM-3 mice, TIM-3 affected the expression of several immune-associated molecules including iNOS and PD-L1 in primary glia-exposed conditioned media (CM) from brain tumors. Further, TIM-3 was cross-regulated by TLR2, but not by TLR4, in brain tumor CM- or Pam3CSK4-exposed glia. In addition, following exposure to tumor CM, IFNγ production was lower in T cells cocultured with TIM-3–defective glia than with normal glia. Collectively, these findings suggest that glial TIM-3 actively and distinctively responds to brain tumor, and plays specific intracellular and intercellular immunoregulatory roles that might be different from TIM-3 on T cells in the brain tumor microenvironment.Significance:TIM-3 is typically thought of as a T-cell checkpoint receptor. This study demonstrates a role for TIM-3 in mediating myeloid cell responses in glioblastoma. Full Article
cr Immunotherapeutic Response in Tumors Is Affected by Microenvironmental ROS By cancerres.aacrjournals.org Published On :: 2020-05-04T05:35:17-07:00 Carcinoma-associated fibroblasts (CAF) are a potential therapeutic target for both direct and indirect regulation of cancer progression and therapy response. In this issue of Cancer Research, Ford and colleagues investigate the influence of CAF on the immune environment of tumors, specifically focusing on the regulation of CD8+ T cells, required for immune therapy response. Their work suggests a role for stromally expressed NADPH oxidase 4 (NOX4) as a modulator of reactive oxygen species that in turn can reduce the number of CD8+ T cells locally. Inhibition of NOX4 increased CD8+ T cells and restored responsiveness to immune therapy, suggesting an indirect stromally targeted avenue for therapy resensitization.See related article by Ford et al., p. 1846 Full Article
cr [PERSPECTIVES] Regulating Preimplantation Genetic Testing across the World: A Comparison of International Policy and Ethical Perspectives By perspectivesinmedicine.cshlp.org Published On :: 2020-05-01T06:30:15-07:00 Preimplantation genetic testing (PGT) is a reproductive technology that, in the course of in vitro fertilization (IVF), allows prospective parents to select their future offspring based on genetic characteristics. PGT could be seen as an exercise of reproductive liberty, thus potentially raising significant socioethical and legal controversy. In this review, we examine—from a comparative perspective—variations in policy approaches to the regulation of PGT. We draw on a sample of 19 countries (Australia, Austria, Belgium, Brazil, Canada, China, France, Germany, India, Israel, Italy, Japan, Mexico, Netherlands, Singapore, South Korea, Switzerland, United Kingdom, and the United States) to provide a global landscape of the spectrum of policy and legislative approaches (e.g., restrictive to permissive, public vs. private models). We also explore central socioethical and policy issues and contentious applications, including permissibility criteria (e.g., medical necessity), nonmedical sex selection, and reproductive tourism. Finally, we further outline genetic counseling requirements across policy approaches. Full Article
cr Increased Notching of the Corpus Callosum in Fetal Alcohol Spectrum Disorder: A Callosal Misunderstanding? [PEDIATRICS] By www.ajnr.org Published On :: 2020-04-09T06:30:48-07:00 BACKGROUND AND PURPOSE: In the medicolegal literature, notching of the corpus callosum has been reported to be associated with fetal alcohol spectrum disorders. Our purpose was to analyze the prevalence of notching of the corpus callosum in a fetal alcohol spectrum disorders group and a healthy population to determine whether notching occurs with increased frequency in the fetal alcohol spectrum disorders population. MATERIALS AND METHODS: We performed a multicenter search for cases of fetal alcohol spectrum disorders and included all patients who had a sagittal T1-weighted brain MR imaging. Patients with concomitant intracranial pathology were excluded. The corpus callosum was examined for notches using previously published methods. A 2 test was used to compare the fetal alcohol spectrum disorders and healthy groups. RESULTS: Thirty-three of 59 patients with fetal alcohol spectrum disorders (0–44 years of age) identified across all centers had corpus callosum notching. Of these, 8 had an anterior corpus callosum notch (prevalence, 13.6%), 23 had a posterior corpus callosum notch (prevalence, 39%), and 2 patients demonstrated undulated morphology (prevalence, 3.4%). In the healthy population, the anterior notch prevalence was 139/875 (15.8%), posterior notch prevalence was 378/875 (43.2%), and undulating prevalence was 37/875 (4.2%). There was no significant difference among the anterior (P = .635), posterior (P = .526), and undulating (P = .755) notch prevalence in the fetal alcohol spectrum disorders and healthy groups. CONCLUSIONS: There was no significant difference in notching of the corpus callosum between patients with fetal alcohol spectrum disorders and the healthy population. Although reported to be a marker of fetal alcohol spectrum disorders, notching of the corpus callosum should not be viewed as a specific finding associated with fetal alcohol spectrum disorders. Full Article
cr Assessment of Apparent Internal Carotid Tandem Occlusion on High-Resolution Vessel Wall Imaging: Comparison with Digital Subtraction Angiography [EXTRACRANIAL VASCULAR] By www.ajnr.org Published On :: 2020-04-09T06:30:48-07:00 BACKGROUND AND PURPOSE: Not all tandem occlusions diagnosed on traditional vascular imaging modalities, such as MRA, represent actual complete ICA occlusion. This study aimed to explore the utility of high-resolution vessel wall imaging in identifying true ICA tandem occlusions and screening patients for their suitability for endovascular recanalization. MATERIALS AND METHODS: Patients with no signal in the ICA on MRA were retrospectively reviewed. Two neuroradiologists independently reviewed their high-resolution vessel wall images to assess whether there were true tandem occlusions and categorized all cases into intracranial ICA occlusion, extracranial ICA occlusion, tandem occlusion, or near-occlusion. DSA classified patient images into the same 4 categories, which were used as the comparison with high-resolution vessel wall imaging. The suitability for recanalization of occluded vessels was evaluated on high-resolution vessel wall imaging compared with DSA. RESULTS: Forty-five patients with no ICA signal on MRA who had available high-resolution vessel wall imaging and DSA images were included. Among the 34 patients (34/45, 75.6%) with tandem occlusions on DSA, 18 cases also showed tandem occlusions on high-resolution vessel wall imaging. The remaining 16 patients, intracranial ICA, extracranial ICA occlusions and near-occlusions were found in 2, 6, and 8 patients, respectively, on the basis of high-resolution vessel wall imaging. A total of 20 cases (20/45, 44.4%) were considered suitable for recanalization on the basis of both DSA and high-resolution vessel wall imaging. Among the 25 patients deemed unsuitable for recanalization by DSA, 11 were deemed suitable for recanalization by high-resolution vessel wall imaging. CONCLUSIONS: High-resolution vessel wall imaging could allow identification of true ICA tandem occlusion in patients with an absence of signal on MRA. Findings on high-resolution vessel wall imaging can be used to screen more suitable candidates for recanalization therapy. Full Article
cr Intermixed Dimethyl-Sulfoxide-Based Nonadhesive Liquid Embolic Agents Delivered Serially via the Same Microcatheter for Cerebral AVM Treatment [INTERVENTIONAL] By www.ajnr.org Published On :: 2020-04-09T06:30:48-07:00 BACKGROUND AND PURPOSE: Conventional nonadhesive liquid embolic agents currently are the criterion standard for endovascular embolization of cerebral AVMs. However, inadequate distal penetration into the nidus and unstable proximal plug formation are the major limitations of this approach and of the currently available embolic materials. The aim of this study was to evaluate the hypothetic efficacy of combining liquid embolic agents with different properties and viscosities for use in endovascular embolization of cerebral AVMs. MATERIALS AND METHODS: From March 2018 to March 2019, sixteen patients with cerebral AVMs (12 women, 4 men; age range, 33–61 years) underwent endovascular embolization with combined liquid embolic agents delivered serially via a single microcatheter. The procedure consists of initial embolization with PHIL 30%, followed by Menox 18 through the same microcatheter. According to the Spetzler-Martin scale, 11 (68.75%) AVMs were grades I–II, 4 (25%) were grade III, and 1 (6.25%) was grade IV. Angiographic, technical, and clinical outcomes were analyzed independently. RESULTS: Combined PHIL and Menox embolization through the same microcatheter via 21 pedicles was performed in these 16 patients. Once the length of the reflux reached approximately 2 cm, PHIL 30% was switched to Menox 18. Antegrade flow and distal penetration of the serially applied liquid embolic agents were observed in all 16 cases. The ability to completely control the flow of the materials and avoid any dangerous proximal reflux was noted in all performed embolizations. The estimated average size reduction of the treated AVMs was 85%, ranging from 50% to 100%. Complete embolization was achieved in 10/16 or 62.5% of the cases. There was no procedure-related complication during or after the embolization. No mortality or postprocedural clinical worsening was seen. Clinical success and complete obliteration were confirmed with at least 1 follow-up angiography in 10/16 patients. CONCLUSIONS: Serial delivery of nonadhesive liquid embolic agents via the same microcatheter was safe and effective in our study and may be a potential technique for routine AVM treatment. However, further investigations are required to validate the safety and the efficacy of the method. Full Article
cr Suspected Metallic Embolization Distal to Coiled Intracranial Aneurysms Detectable by Susceptibility-Weighted MR Imaging [INTERVENTIONAL] By www.ajnr.org Published On :: 2020-04-09T06:30:48-07:00 BACKGROUND AND PURPOSE: After endovascular coiling of intracranial aneurysms, round dark parenchymal lesions believed to be particulate metal are sometimes encountered in MR imaging studies of the brain. We used SWI to assess the frequency of such occurrences, in addition to exploring likely causes and clinical implications. MATERIALS AND METHODS: We reviewed 700 MR imaging studies performed between September 2018 and March 2019 at our institution as follow-up monitoring of coiled intracranial aneurysms. Any sizeable (>5 mm) rounded dark-signal lesions encountered were presumed to be metallic. The magnitudes and locations of such lesions were recorded. In patients with these lesions, pertinent procedural documentation was screened for devices used, including coils, microcatheters, microguidewires, and stents. Medical records were also examined to determine whether any related symptoms ensued. RESULTS: Twenty patients (2.8%) exhibited a total of 25 lesions on SWI. Diameters ranged from 5 to 11 mm (median, 8 mm). All except 2 lesions were located in brain regions downstream from aneurysms, but all lesions occupied vascular territories of vessels used to place guiding catheters. Other than the Synchro 14, which was routinely deployed, no device was regularly used in patients with SWI-detectable lesions; and none of the affected patients developed focal neurologic symptoms as a consequence. CONCLUSIONS: Although the origins remain unclear, distal embolization of particulate metal distal to coiled cerebral aneurysms is occasionally observed on follow-up MR imaging studies. Such lesions, however, seem to have no apparent clinical impact. Full Article
cr Discrimination between Glioblastoma and Solitary Brain Metastasis: Comparison of Inflow-Based Vascular-Space-Occupancy and Dynamic Susceptibility Contrast MR Imaging [FUNCTIONAL] By www.ajnr.org Published On :: 2020-04-09T06:30:48-07:00 BACKGROUND AND PURPOSE: Accurate differentiation between glioblastoma and solitary brain metastasis is of vital importance clinically. This study aimed to investigate the potential value of the inflow-based vascular-space-occupancy MR imaging technique, which has no need for an exogenous contrast agent, in differentiating glioblastoma and solitary brain metastasis and to compare it with DSC MR imaging. MATERIALS AND METHODS: Twenty patients with glioblastoma and 22 patients with solitary brain metastasis underwent inflow-based vascular-space-occupancy and DSC MR imaging with a 3T clinical scanner. Two neuroradiologists independently measured the maximum inflow-based vascular-space-occupancy–derived arteriolar CBV and DSC-derived CBV values in intratumoral regions and peritumoral T2-hyperintense regions, which were normalized to the contralateral white matter (relative arteriolar CBV and relative CBV, inflow-based vascular-space-occupancy relative arteriolar CBV, and DSC-relative CBV). The intraclass correlation coefficient, Student t test, or Mann-Whitney U test and receiver operating characteristic analysis were performed. RESULTS: All parameters of both regions had good or excellent interobserver reliability (0.74~0.89). In peritumoral T2-hyperintese regions, DSC-relative CBV (P < .001), inflow-based vascular-space-occupancy arteriolar CBV (P = .001), and relative arteriolar CBV (P = .005) were significantly higher in glioblastoma than in solitary brain metastasis, with areas under the curve of 0.94, 0.83, and 0.72 for discrimination, respectively. In the intratumoral region, both inflow-based vascular-space-occupancy arteriolar CBV and relative arteriolar CBV were significantly higher in glioblastoma than in solitary brain metastasis (both P < .001), with areas under the curve of 0.91 and 0.90, respectively. Intratumoral DSC-relative CBV showed no significant difference (P = .616) between the 2 groups. CONCLUSIONS: Inflow-based vascular-space-occupancy has the potential to discriminate glioblastoma from solitary brain metastasis, especially in the intratumoral region. Full Article
cr Housing prices increase slightly in Q3: MoC By batdongsan.com.vn Published On :: 17:36 01/10/2019 An annual report released by the Ministry of Construction (MoC) at a press conference on Monday showed housing prices in the two mảo cities Hanoi and Ho Chi Minh (HCMC) rose slightly in the third quarter (Q3) of this year. Full Article
cr HCMC apartment prices increase faster than rents By batdongsan.com.vn Published On :: 15:10 22/10/2019 Asking price of apartments in Ho Chi Minh City (HCMC) rose by 11.8 percent on average in the third quarter (Q3) of 2019, while rents increased by only 5.4 percent. Full Article
cr Green buildings are crucial to addressing climate change, but why aren’t we seeing more of them? By batdongsan.com.vn Published On :: 09:56 05/05/2020 We spoke with industry experts to identify what’s preventing developers from fully going green – and it all boils down to lack of finances. Full Article
cr COVID-19 crisis unveils socially responsible Asia Property Awards (Singapore) winning developers By batdongsan.com.vn Published On :: 11:44 05/05/2020 As they implement stricter measures and distribute millions worth of donations to communities in need. Full Article
cr Leasing townhouse with 2 frontages, 1 ground floor, 2 floors, near crossroads; suitable for office By batdongsan.com.vn Published On :: Fri, 22 Nov 2019 11:53:32 GMT + townhouse with 2 frontages, 1 ground floor, 2 floors, near crossroads; convenient traffic and parking + Crowded residential area, surrounded by many offices, schools, apartments, mini supermarkets, cafes ... + Convenient for trading in cafes, mini supermarkets, transaction offi... Full Article
cr Flamingo Crown Bay By batdongsan.com.vn Published On :: Thu, 20 Feb 2020 14:32:10 GMT Flamingo Crown Bay (Flamingo Hải Tiến Thanh Hóa) tọa lạc trên khu đất quy hoạch rộng 19.3901m2 tại 4 xã thuộc huyện Hoằng Hóa, tỉnh Thanh Hóa. Full Article
cr How to Screen Potential Tenants – Questions, Credit & Background Check By batdongsan.com.vn Published On :: 09:28 27/09/2014 With a good tenant, you can sleep easy at night as a landlord knowing the rent will get paid and the property will stay relatively undamaged. With a bad tenant, on the other hand, you’re left to wonder about the state of your investment while fielding calls from angry neighbors. Full Article
cr How to make your listing stand out from the crowd? By batdongsan.com.vn Published On :: 18:46 30/10/2018 Every home seller wants to sell it fast and reach as many buyers as possible. Here are some tips to make your listing stand out to potential buyers from the crowd. Full Article
cr 5 top secrets for investing in land By batdongsan.com.vn Published On :: 18:06 30/10/2017 Choosing good location, prestigious investor, reasonable price; considering legal issues and focusing on infrastructure are the secrets for investors to gain high profit from investing in land. Full Article
cr Expert reveals 5 secrets of investing in land By batdongsan.com.vn Published On :: 11:59 30/11/2018 Choosing good location, prestigious investor, reasonable price; considering legal issues and focusing on infrastructure are the secrets for investors to gain high profit from investing in land. Full Article
cr Biệt thự hàng chục triệu USD của đồng sáng lập Microsoft By batdongsan.com.vn Published On :: 15:15 21/10/2019 Căn biệt thự ở Atherton, California (Mỹ) của tỷ phú quá cố Paul Allen, nhà đồng sáng lập Microsoft, đang được rao bán với giá 41,48 triệu USD (khoảng 960 tỷ đồng). Full Article
cr MIG 29 Crash: पंजाब में भारतीय वायुसेना का विमान दुर्घटनाग्रस्त, पायलट सुरक्षित By www.amarujala.com Published On :: Fri, 08 May 2020 01:55:31 +0530 अधिकारी ने बताया कि एक हेलीकॉप्टर से पायलट को बचाया गया और दुर्घटना की वजह पता लगाने के लिए कोर्ट ऑफ इंक्वायरी के आदेश दिए गए हैं। Full Article
cr How to Create an Interactive Video Strategy for Your B2B By feedproxy.google.com Published On :: Sat, 09 May 2020 14:53:03 +0000 Video has quickly become the number one way to connect with buyers, viewers, and followers. For B2B sellers, a strategic video marketing approach tailored to […] The post How to Create an Interactive Video Strategy for Your B2B appeared first on e-Learning Feeds. Full Article eLearning Software Blog How-To-HapYak
cr Fundamentals for Creating a Shoppable Interactive Video for eCommerce By feedproxy.google.com Published On :: Sat, 09 May 2020 14:54:03 +0000 (function () { var vjs = videojs("hapyak-player-225918-6090"); vjs.one("loadedmetadata", function () { hapyak.viewer({ apiKey: "dd426e8a5f6c45db9ca6", projectId: 225918, plugins: { annotationSources: {"brightcove.cuepoints": true} }, resetVariables: true, player: […] The post Fundamentals for Creating a Shoppable Interactive Video for eCommerce appeared first on e-Learning Feeds. Full Article eLearning Software Blog Brightcove interactive video Kyle Morton Matt Childs Shoppable Video Webcasts West Ham United
cr कश्मीर के आईजी ने CRPF के खिलाफ दिया बयान, 20 जुलाई को जंतर-मंतर पर प्रदर्शन करेंगे पूर्व कर्मी By www.amarujala.com Published On :: Sat, 09 May 2020 06:16:03 +0530 आईपीएस अधिकारी एवं कश्मीर के आईजी विजय कुमार के देश के सबसे बड़े केंद्रीय अर्धसैनिक बल के खिलाफ दिए गए बयान को लेकर सीएपीएफ के पूर्व कर्मियों ने तीखी प्रतिक्रिया दी है। Full Article
cr World Red Cross Day: क्यों मनाया जाता है रेड क्रॉस दिवस, कोरोना महामारी काल में क्या है इसकी भूमिका By www.amarujala.com Published On :: Fri, 08 May 2020 08:07:05 +0530 इसकी स्थापना हेनरी ड्यूडेंट ने की थी, जिनका जन्म आठ मई को ही हुआ था। इसलिए हर साल आठ मई को रेड क्रॉस दिवस मनाया जाता है। यह संस्था युद्ध और शांति के समय दुनियाभर के देशों की सरकारों के बीच समन्वय का काम करती है। इसका मुख्य कार्य मानव सेवा है। Full Article
cr Assassin's Creed Valhalla to Feature Stonehenge By feedproxy.google.com Published On :: Tue, 05 May 2020 19:11:10 GMT Assassin’s Creed Valhalla creative director Ashraf Ismail previously stated the game will feature a "large map" in terms of England. There will be four major English kingdoms: Wessex, Northumbria, East Anglia, and Mercia. There will also be three major cities: London, Winchester and Jórvík (now called York). Since the game takes place in southern England Ismail was asked via Twitter if the game will feature Stonehenge and he replied "oh, can you ever!" with a GIF of a man nodding yes. oh, can you ever! pic.twitter.com/y4lJoayK9X — Ashraf Ismail (@AshrafAIsmail) May 3, 2020 Here is an overview of the game: In Assassin’s Creed Valhalla, you are Eivor, a fierce Viking warrior raised on tales of battle and glory. Explore a dynamic and beautiful open world set against the brutal backdrop of England’s Dark Ages. Raid your enemies, grow your settlement, and build your political power in your quest to earn your place among the gods in Valhalla. Key Features: Write Your Viking Saga – Advanced RPG mechanics allow you to shape the growth of your character and influence the world around you. With every choice you make, from political alliances and combat strategy to dialogue and gear progression, you will carve your own path to glory. Visceral Combat System – Dual-wield powerful weapons such as axes, swords, and even shields to relive the ruthless fighting style of the Viking warriors. Brutally decapitate your foes, vanquish them from afar, or stealthily assassinate targets with your hidden blade. Challenge yourself with the most varied collection of deadly enemies ever found in an Assassin’s Creed game. A Dark Age Open World – Sail from the harsh and mysterious shores of Norway to the beautiful but forbidding kingdoms of England and beyond. Immerse yourself in the Viking way of life through fishing, hunting, drinking games, and more. Lead Epic Raids – Launch massive assaults against Saxon troops and fortresses throughout England. Lead your clan in surprise attacks from your longship and pillage enemy territories to bring riches and resources back to your people. Grow Your Settlement – Construct and upgrade buildings that allow for deep customization, including a barracks, blacksmith, tattoo parlor, and more. Recruit new members to your clan and personalize your Viking experience. Mercenary Vikings – Create and customize a unique Viking raider within your clan and share it online with friends to use during their own raids. Assassin’s Creed Valhalla will launch for Xbox Series X, PlayStation 5, PlayStation 4, Xbox One, Windows PC, and Google Stadia in Holiday 2020. The game will support Smart Delivery on the Xbox. This means if you purchase the game on the Xbox One or Xbox Series X, you will automatically gain access to the other version of the game. A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel dedicated to gaming Let's Plays and tutorials. You can contact the author at wdangelo@vgchartz.com or on Twitter @TrunksWD.Full Article - https://www.vgchartz.com/article/443400/assassins-creed-valhalla-to-feature-stonehenge/ Full Article Analysis Charts Industry
cr Assassin�s Creed Valhalla Gets Xbox Series X First Look Gameplay Trailer By feedproxy.google.com Published On :: Thu, 07 May 2020 17:33:58 GMT Ubisoft has released the first look gameplay trailer for Assassin’s Creed Valhalla. The gameplay is "representative of Xbox Series X gameplay." "As developers, we’re always excited to work with new hardware because it gives us a greater ability to express our creative vision," said Assassin’s Creed Valhalla creative director Ashraf Ismail. "Assassin’s Creed has always been committed to exploring new technologies and leveraging new consoles’ abilities to deliver the most immersive experience possible. We are excited to be collaborating closely with Microsoft to bring Assassin’s Creed Valhalla to the Xbox Series X." View the Assassin’s Creed Valhalla gameplay trailer below: Here is an overview of the game: In Assassin’s Creed Valhalla, you are Eivor, a fierce Viking warrior raised on tales of battle and glory. Explore a dynamic and beautiful open world set against the brutal backdrop of England’s Dark Ages. Raid your enemies, grow your settlement, and build your political power in your quest to earn your place among the gods in Valhalla. Key Features: Write Your Viking Saga – Advanced RPG mechanics allow you to shape the growth of your character and influence the world around you. With every choice you make, from political alliances and combat strategy to dialogue and gear progression, you will carve your own path to glory. Visceral Combat System – Dual-wield powerful weapons such as axes, swords, and even shields to relive the ruthless fighting style of the Viking warriors. Brutally decapitate your foes, vanquish them from afar, or stealthily assassinate targets with your hidden blade. Challenge yourself with the most varied collection of deadly enemies ever found in an Assassin’s Creed game. A Dark Age Open World – Sail from the harsh and mysterious shores of Norway to the beautiful but forbidding kingdoms of England and beyond. Immerse yourself in the Viking way of life through fishing, hunting, drinking games, and more. Lead Epic Raids – Launch massive assaults against Saxon troops and fortresses throughout England. Lead your clan in surprise attacks from your longship and pillage enemy territories to bring riches and resources back to your people. Grow Your Settlement – Construct and upgrade buildings that allow for deep customization, including a barracks, blacksmith, tattoo parlor, and more. Recruit new members to your clan and personalize your Viking experience. Mercenary Vikings – Create and customize a unique Viking raider within your clan and share it online with friends to use during their own raids. Assassin’s Creed Valhalla will launch for Xbox Series X, PlayStation 5, PlayStation 4, Xbox One, Windows PC, and Google Stadia in Holiday 2020. The game will support Smart Delivery on the Xbox. This means if you purchase the game on the Xbox One or Xbox Series X, you will automatically gain access to the other version of the game. A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel dedicated to gaming Let's Plays and tutorials. You can contact the author at wdangelo@vgchartz.com or on Twitter @TrunksWD.Full Article - https://www.vgchartz.com/article/443428/assassins-creed-valhalla-gets-xbox-series-x-first-look-gameplay-trailer/ Full Article Analysis Charts Industry
cr Switch Shipments Reach 55.77 Million Units as of March 31, Animal Crossing: New Horizons Sells 12 Million By feedproxy.google.com Published On :: Thu, 07 May 2020 17:49:57 GMT Nintendo has released its latest hardware and software figures for the Nintendo Switch and Nintendo 3DS through March 31, 2020. Shipments figures for the Nintendo Switch reached 55.77 million units, while the Nintendo 3DS hit 75.77 million units shipped. As for lifetime software 356.24 million Switch games have been shipped and 383.11 million 3DS games. For the quarter Nintendo shipped 3.28 million Switch units and 45.59 million Switch games, as well as 0.07 million 3DS units and 0.89 million 3DS games. Nintendo forecasts it will ship 19 million Switch units in the fiscal year ending March 31, 2021. Here are the top 10 best-selling Switch first-party titles: Mario Kart 8 Deluxe – 24.77 million Super Smash Bros. Ultimate – 18.84 million The Legend of Zelda: Breath of the Wild – 17.41 million Super Mario Odyssey – 17.41 million Pokemon Sword / Pokemon Shield – 17.37 million Pokemon: Let’s Go, Pikachu! / Pokemon: Let’s Go, Eevee! – 11.97 million Animal Crossing: New Horizons – 11.77 million (first 11 days) / 13.41 million (first six weeks) Splatoon 2 – 10.13 million Super Mario Party – 10.10 million New Super Mario Bros. U Deluxe – 6.60 million Nintendo also shared the sales figures of more games: Luigi’s Mansion 3 – 6.33 million Super Mario Maker 2 – 5.48 million The Legend of Zelda: Link’s Awakening – 4.38 million Fire Emblem: Three Houses – 2.87 million Ring Fit Adventure – 2.73 million Pokemon Mystery Dungeon: Rescue Team DX – 1.26 million Astral Chain – 1.08 million Marvel Ultimate Alliance 3: The Black Order – 1.08 million Nintendo in a separate report revealed sell-in figures for the Nintendo switch. For the 2020 fiscal year Nintendo sold 21.03 million Switch consoles, which is a 24 percent increase over the 16.95 million sold the previous year. Software sales for the fiscal year jumped 42.3 percent to 168.72 million games sold. Nintendo also revealed sell-through sales in three major regions for the 2020 fiscal year. In North America sales for the Switch were 7.67 million units, a 20 percent increase. In Europe, sales increased 19 percent to 5.37 million units, and in Japan sales jumped 33 percent to 5.06 million units. A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel dedicated to gaming Let's Plays and tutorials. You can contact the author at wdangelo@vgchartz.com or on Twitter @TrunksWD.Full Article - https://www.vgchartz.com/article/443417/switch-shipments-reach-5577-million-units-as-of-march-31-animal-crossing-new-horizons-sells-12-million/ Full Article Analysis Charts Industry
cr Colonel Croesus: Turn 8 By feedproxy.google.com Published On :: Sat, 09 May 2020 08:00:24 +0000 ZINC, the rough-hewn chamber with the shack in its centre, has already cost the Comment Commanders Robert Duvall (Colonel Croesus) and John Nettles (Corporal Wood). Will it also claim the life of Charles Bronson (Sergeant Nemchik)? (Colonel Croesus is an open-to-all game of Combat Mission: Fortress Italy in which Allied forces are orchestrated by commenters […] Full Article PC Game News Colonel Croesus Combat Mission: Fortress Italy communal Combat Mission
cr Call Of Duty: Modern Warfare's crowded April Fool's Shipment playlist returns By feedproxy.google.com Published On :: Sat, 09 May 2020 14:45:15 +0000 Fancy a 1v1 match on Shipment? Of course not. Duels to the death are played out and boring. Subscribing to the view that bigger is indeed always better, Call Of Duty: Modern Warfare has brought back its 10v10 Shipment playlist. After briefly appearing as an April Fool’s jab, Infinity Ward have decided to make 20-player […] Full Article PC Game News Activision Infinity Ward
cr Exclusive: UN cybercrime chief warns against US and Iran cyberattacks By www.newscientist.com Published On :: Wed, 08 Jan 2020 12:34:33 +0000 As US-Iran tensions rise following the assassination of an Iranian general and missile attacks on US troops, UN diplomat Neil Walsh warns cyberattacks can be just as impactful Full Article
cr Gamifying hate: How alt-right extremists recruit and mobilise online By www.newscientist.com Published On :: Wed, 04 Mar 2020 18:00:00 +0000 Julia Ebner infiltrated the hidden forums that extremists use. Her experiences lay bare how they hijack social media and video games to spread hate – and how to beat them Full Article
cr Microrobots made from pollen help remove toxic mercury from wastewater By www.newscientist.com Published On :: Wed, 01 Apr 2020 08:00:10 +0000 Pollen has a natural tendency to adsorb mercury and forms the basis of a new class of tiny robots that speed through toxic water to purify it Full Article
cr Software recreates a 3D model of your face from a smartphone video By www.newscientist.com Published On :: Wed, 08 Apr 2020 14:00:45 +0000 A program that combines artificial intelligence and geometrical modelling can create an accurate 3D model of your face from a single 20-second video Full Article
cr The coronavirus crisis could fundamentally alter the internet By www.newscientist.com Published On :: Wed, 08 Apr 2020 18:00:00 +0000 The covid-19 pandemic has many of us stuck at home. The result could completely reshape how we use the internet, writes Annalee Newitz Full Article
cr Microwaved bamboo could be used to build super-strong skyscrapers By www.newscientist.com Published On :: Fri, 24 Apr 2020 16:41:38 +0000 Bamboo is a renewable material that when microwaved becomes stronger by weight than steel or concrete – which could make it ideal for constructing buildings, cars and planes Full Article
cr Robot with pincers can detect and remove weeds without harming crops By www.newscientist.com Published On :: Wed, 29 Apr 2020 17:07:03 +0000 A robot that uses artificial intelligence to find and remove weeds could eventually be used as an alternative to chemical insecticides Full Article
cr Axl Rose and the U.S. Treasury Secretary are Fighting on Twitter About the Trump Regime's Coronavirus Death Toll By feedproxy.google.com Published On :: Thu, 07 May 2020 17:00:37 +0000 Why? Because that’s our reality here in the year 2020. Full Article
cr Why Temperature Screenings Alone Won't Protect People From Covid-19 By feedproxy.google.com Published On :: Thu, 07 May 2020 18:00:46 +0000 While such a plan might sound appealing, it’s likely to provide a false sense of security Full Article
cr Alphabet's Scrapping Its Smart City Dreams By feedproxy.google.com Published On :: Thu, 07 May 2020 20:00:19 +0000 Not because of public concerns, although there are plenty of those, but because of the pandemic-induced plunge in local real estate. Full Article
cr Worst Co-Worker Ever Creates the Loudest, Clackiest Keyboard Imaginable By feedproxy.google.com Published On :: Thu, 07 May 2020 20:30:49 +0000 This unusual contraption recreates the sounds of an old-school mechanical typewriter on a modern keyboard. Full Article
cr Ban Cruises By feedproxy.google.com Published On :: Thu, 07 May 2020 21:30:42 +0000 In addition to being a hotbed for pandemics, the cruise industry is an ethical and ecological abomination. Full Article
cr Dramatic Fossil Shows a Squid-Like Creature Crushing a Fish in Its Jaws By feedproxy.google.com Published On :: Thu, 07 May 2020 22:00:03 +0000 Scientists are speculating as to how the two creatures managed to become preserved in such an unusual way. Full Article