positive core
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2022 ◽  
Yoichiro Okubo ◽  
Yayoi Yamamoto ◽  
Shinya Sato ◽  
Emi Yoshioka ◽  
Masaki Suzuki ◽  

AbstractIn prostate cancer, accurate diagnosis and grade group (GG) decision based on biopsy findings are essential for determining treatment strategies. Diagnosis by experienced urological pathologists is recommended; however, their contribution to patient benefits remains unknown. Therefore, we analyzed clinicopathological information to determine the significance of reassessment by experienced urological pathologists at a high-volume institution to identify factors involved in the agreement or disagreement of biopsy and surgical GGs. In total, 1325 prostate adenocarcinomas were analyzed, and the GG was changed in 452/1325 (34.1%) cases (359 cases were upgraded, and 93 cases were downgraded). We compared the highest GG based on biopsy specimens, with the final GG based on surgical specimens of 210 cases. The agreement rate between the surgical GG performed and assessed in our institute and the highest biopsy GG assessed by an outside pathologist was 34.8% (73/210); the agreement rate increased significantly to 50% (105/210) when biopsy specimens were reevaluated in our institute (chi-square test, P < 0.01). Multivariate logistic regression analysis showed that only the length of the lesion in the positive core with the highest GG in the biopsy was a significant factor for determining the agreement between biopsy GG and surgical GG, with an odds ratio of 1.136 (95% confidence interval: 1.057–1.221; P < 0.01). Thus, reassessment by experienced urological pathologists at high-volume institutions improved the agreement rate. However, it should be noted there is a high probability of discordance between a small number of lesions or short lesions and surgical GG.

2021 ◽  
Vol 108 (Supplement_7) ◽  
Muhammad Abdullah ◽  
Velin Voynov ◽  
Paul Stonelake

Abstract Aims Axillary node clearance (ANC) can cause lifelong disability and conservative axillary dissection is increasingly preferred. However, direct (fast-track) ANC after preoperative axillary biopsy is still performed, which may be overtreating the patients with low axillary burden. This study aims to identify if direct (fast- track) ANC leads to overtreatment of axilla. Methods Retrospective data for all breast cancer patients who underwent surgery between 1 January 2017 and 31 December 2018 were included in this study. The histopathology results of ANC were correlated with axillary ultrasound findings, axillary biopsy or SLNB results and effect of neoadjuvant treatment. These were analysed against the available guidelines to evaluate the current practice. Results 82 patients out of 520 had ANC (15.7%). Four groups were identified. 35.5% of patients diagnosed with nodal infiltration on preoperative biopsy (Group A) had only 1- 2 positive nodes following ANC. Complete pathological response was observed in 37.5% patients with nodal infiltration who had ANC following neoadjuvant chemotherapy (NACT) (Group B). No further nodes were subsequently found in 63.6% of patients who underwent ANC following positive SLNB (Group C). Group D included 2 patients with axillary recurrence. Conclusions 15.7% of breast cancer patients required ANC. The practice of direct (fast-track) ANC after axillary biopsy leads to overtreatment of the axilla, which needs re-evaluation. Targeted axillary dissection could avoid unnecessary axillary dissection in patients with abnormal nodes. This is now recommended in patients who have received NACT but has not been evaluated yet in patients with up front surgery.

2021 ◽  
Vol 23 (3) ◽  
pp. 76-90
Arnoldo Cisternas

Este artículo narra la historia de cómo una escuela rural al sur de Chile logró descubrir y construir un conjunto de recursos y capacidades (núcleo positivo) para liberar el aprendizaje y potenciar el desarrollo de las competencias de sus niñas y niños para vivir plenamente en el Siglo XXI. This article tells the story of how a rural school in the south of Chile discovered and built a set of resources and capabilities (positive core) to liberate learning and enhance the development of the children’s skills to live to the fullest in the 21st century.

2020 ◽  
pp. 475-526
John Richardson

The twelfth chapter treats the religious dimension of Nietzsche’s values, expressed in his ideas of Dionysus and eternal return. It might have seemed that he wants to replace gods with the superhuman or Übermensch. He attacks belief in gods as false and as spoiling our relation to values: we view them as commanded by gods, whereas our task is to make them for ourselves. Nevertheless Nietzsche still has use and need for gods and for religion more broadly. The universal Yes amounts to a “sanctification” of the world, demanding a strong affective response that is the positive core of religion that he wants to save. Its disadvantages for belief and will are outweighed by its support for a special feeling that is crucial to his new values. His evocations of Dionysus play this role, as does his thought of eternal return. We conclude with this most evocative of Nietzsche’s ideas.

2019 ◽  
Vol 12 (2) ◽  
pp. 111-117 ◽  
Eric Cullhed

Recent attempts to define being moved have difficulties agreeing on its eliciting conditions. The status quaestionis is often summarized as a question of whether the emotion is evoked by exemplifications of a wide range of positive core values or a more restricted set of values associated with attachment. This conclusion is premature. Study participants associate being moved with interactions with their loved ones not merely for what they exemplify but also for their affective bond to them. Being moved is elicited when we apprehend the value of entities to which we are connected through basic as well as extended forms of affiliative attachment. These comprise people, certain objects, and even abstract entities, including the unshakable life-guiding ideas we call “core values.”

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