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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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This study aimed to explore the effects of different fertilizers and their combinations on growth and nutrient and Cd uptake of Lolium multiflorum. Compared with control treatment, chemical fertilizer, organic manure, and their conjunctions with biofertilizer increased shoot biomass. Biofertilizers were found to cause significant reductions in shoot biomass of plants grown in organic manure-treated and control soil. Decreased soil-available N and P and shoot N and K concentrations in biofertilizer amendment treatments indicated that plant growth and nutrient absorption might be negatively affected under nutrient deficiency conditions. Elevated shoot biomasses contributed to the highest shoot Cd contents in chemical fertilizer and chemical fertilizer + biofertilizer treatments among all treatments. But the maximum translocation efficiency occurred in biofertilizer + chemical fertilizer + organic manure treatment, followed by organic manure and chemical fertilizer + organic manure treatments. Based on the results, we can conclude that the application of only the biofertilizer Bacillus subtilis should be avoided in nutrient-limited soils. Chemical fertilizer application could benefit the amount of Cd in shoots, and organic manure application and its combinations could result in the higher translocation efficiency.
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To evaluate the relationship between aortic inflammation as assessed by 18F–fluorodeoxyglucose-positron emission tomography (18F–FDG-PET) and features of plaque vulnerability as assessed by frequency domain-optical coherence tomography (FD-OCT).
We enrolled 30 consecutive non-ST-segment elevation acute coronary syndrome patients undergoing percutaneous coronary intervention. All patients underwent three-vessel OCT before intervention and 18F–FDG-PET before discharge. Univariable and C-reactive protein (CRP)-adjusted linear regression analyses were performed between features of vulnerability [namely:lipid-rich plaques with and without macrophages and thin cap fibroatheromas (TCFA)] and 18F–FDG uptake in both ascending (AA) and descending aorta (DA) [measured either as averaged mean and maximum target-to-blood ratio (TBR) or as active slices (TBRmax ≥ 1.6)].
Mean age was 62 years, and 26 patients were male. On univariable linear regression analysis TBRmean and TBRmax in DA was associated with the number of lipid-rich plaques (β = 4.22; 95%CI 0.05–8.39; p = 0.047 and β = 3.72; 95%CI 1.14–6.30; p = 0.006, respectively). TBRmax in DA was also associated with the number of lipid-rich plaques containing macrophages (β = 2.40; 95%CI 0.07–4.72; p = 0.044). A significant CRP adjusted linear association between the TBRmax in DA and the number of lipid-rich plaques was observed (CRP-adjusted β = 3.58; 95%CI -0.91-6.25; p = 0.01). TBRmax in DA showed a trend towards significant CRP-adjusted association with number of lipid-rich plaques with macrophages (CRP-adjusted β = 2.30; 95%CI -0.11-4.71; p = 0.06). We also observed a CRP-adjusted (β = 2.34; 95%CI 0.22–4.47; p = 0.031) linear association between the number of active slices in DA and the number of lipid-rich plaques. No relation was found between FDG uptake in the aorta and the number of TCFAs.
In patients with first NSTEACS, 18F–FDG uptake in DA is correlated with the number of OCT detected lipid-rich plaques with or without macrophages. This association may be independent from CRP values.
Regadenoson, an A2A adenosine receptor pharmacologic stress agent for radionuclide myocardial perfusion imaging (MPI), is administered as a single, fixed dose. We studied the side effect profile of regadenoson combined with two types of low-level exercise, according to body mass index (BMI).
Three hundred and fifty-six patients (46.1% men, mean age 67.7±10.7 years, range 31–90 years) underwent regadenoson stress testing combined with low-level exercise. Subjects were classified according to BMI as normal, overweight, or obese, and the type of low-level exercise performed as walking on the treadmill (TE group, n=190) or forcefully swinging legs while sitting (SS group, n=166). Patients' demographics, medical history, clinical symptoms during stress, changes in ECG, oxygen saturation (SatO2), systolic blood pressure (SBP), and heart rate (HR) were evaluated.
Groups were comparable (p=ns) with regard to cardiovascular risks factors. The incidence of side effects was similar across BMI (p=ns), although the TE patients showed improved profiles over those with SS exercise, with a significantly lower incidence of flushing, dizziness and nausea/gastrointestinal discomfort (12.9% vs. 28.4%; 19.9% vs. 33.4%; 11.4% vs. 19.2%, respectively; all p<0.05).
Regarding the hemodynamic response, we did not observe significant changes in SBP and HR after regadenoson administration across BMI categories. Comparing the TE and SS groups, no significant changes were observed in SBP, but there was a higher increase in HR in the TE group (p<0.05).
Regadenoson in combination with low-level exercise is safe and well tolerated over a wide range of BMI, with TE exercise showing a better side effect profile than SS.
To assess the diagnostic accuracy of 68Ga-PSMA PET in predicting lymph node (LN) metastases in primary N staging in high-risk and very high-risk nonmetastatic prostate cancer in comparison with morphological imaging.
This was a multicentre trial of the Society of Urologic Oncology in Turkey in conjunction with the Nuclear Medicine Department of Cerrahpasa School of Medicine, Istanbul University. Patients were accrued from eight centres. Patients with high-risk and very high-risk disease scheduled to undergo surgical treatment with extended LN dissection between July 2014 and October 2015 were included. Either MRI or CT was used for morphological imaging. PSMA PET/CT was performed and evaluated at a single centre. Sensitivity, specificity and accuracy were calculated for the detection of lymphatic metastases by PSMA PET/CT and morphological imaging. Kappa values were calculated to evaluate the correlation between the numbers of LN metastases detected by PSMA PET/CT and by histopathology.
Data on 51 eligible patients are presented. The sensitivity, specificity and accuracy of PSMA PET in detecting LN metastases in the primary setting were 53%, 86% and 76%, and increased to 67%, 88% and 81% in the subgroup with of patients with ≥15 LN removed. Kappa values for the correlation between imaging and pathology were 0.41 for PSMA PET and 0.18 for morphological imaging.
PSMA PET/CT is superior to morphological imaging for the detection of metastatic LNs in patients with primary prostate cancer. Surgical dissection remains the gold standard for precise lymphatic staging.
Using integrated PET/CT, we evaluated the prognostic value of [18F]FDG uptake ratio between pelvic lymph node (LN) and primary tumor in invasive squamous cell carcinoma (SCCA) of the uterine cervix.
We retrospectively reviewed patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB to IIA cervical SCCA who underwent preoperative [18F]FDG PET/CT scans. PET/CT parameters such as maximum standardized uptake value (SUV) of the primary cervical cancer (SUVcervix) and LN (SUVLN), and the LN-to-cervical cancer SUV ratio (SUVLN/SUVcervix) were assessed. Prognostic values of PET/CT-derived metabolic and volumetric variables and clinicopathology parameters were analyzed to predict progression-free survival (PFS) in regression analyses.
Clinical data, treatment modalities, and results were reviewed for 103 eligible patients. Median post-surgical follow-up was 29 months (range, 6–89), and 19 (18.5%) patients experienced recurrence. Multivariate logistic regression analysis showed that SUVLN / SUVcervix > 0.1747(P = 0.048) was the independent risk factor of recurrence. Patient group categorized by SUVLN/SUVcervix showed significant difference in PFS (log-rank test, P < 0.001).
Preoperative SUVLN/SUVcervix measured by [18F]FDG PET/CT was significantly associated with recurrence, and has an incremental prognostic value for PFS in patients with cervical SCCA.
A continuous-flow left ventricular assist device (LVAD) is a new and highly promising therapy in supporting end-stage heart failure patients, either bridging them to heart transplantation or as a destination therapy. Infection is one of the major complications associated with LVAD implants. 18F–FDG PET/CT has already been shown to be useful in the detection of LVAD infection. The goal of this study was to compare the diagnostic accuracy of different PET analysis techniques (visual grading versus SUVmax and metabolic volume).
We retrospectively analyzed 48 patients with implanted LVAD who underwent an 18F–FDG PET/CT that were either suspected to have a driveline or device infection or inflammation of unknown origin. PET/CT was analyzed qualitatively (visual grading) and quantitatively (SUVmax and metabolic volume) and matched to the final clinical diagnosis concerning driveline infection. The final diagnosis (standard of reference) was made at the end of clinically recorded follow-up or transplantation and included microbiological cultures of the driveline exit site and/or surgical samples, and clinical signs of infection despite negative cultures as well as recurrence of symptoms.
Sensitivity, specificity, positive and negative predictive value were 87.5%, 79%, 81% and 86% for visual score, 87.5%, 87.5%, 87.5% and 87.5% for SUVmax and 96%, 87.5%, 88.5%, 95.5% for metabolic volume, respectively. ROC analysis revealed an AUC of .929 for SUVmax and .969 for metabolic volume. Both SUVmax and metabolic volume had a high detection rate of patients with driveline infection (21/24 = 91.5% true positive vs. 23/26 = 88.5% true positive, respectively). However, metabolic volume detected more patients without any infection correctly (1/22 = 4.5% false negative vs. 3/24 = 12.5% false negative).
18F–FDG PET/CT is a valuable tool for the diagnosis of LVAD driveline infection with high diagnostic accuracy. Particularly the use of the metabolic volume yields very high accuracy and performs slightly better than SUVmax.
Triple-negative breast cancer has a poor prognosis. We evaluated several metabolic and volumetric parameters from preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the prognosis of triple-negative breast cancer and compared them with current clinicopathologic parameters.
A total of 228 patients with triple-negative breast cancer (mean age 47.0 ± 10.8 years, all women) who had undergone preoperative PET/CT were included. The PET/CT metabolic parameters evaluated included maximum, peak, and mean standardized uptake values (SUVmax, SUVpeak, and SUVmean, respectively). The volumetric parameters evaluated included metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Metabolic and volumetric parameters were evaluated separately for tumor (T) and lymph nodes (N). The prognostic value of these parameters was compared with that of clinicopathologic parameters.
All lymph node metabolic and volumetric parameters showed significant differences between patients with and without recurrence. However, tumor metabolic and volumetric parameters showed no significant differences. In a univariate survival analysis, all lymph node metabolic and volumetric parameters (SUVmax-N, SUVpeak-N, SUVmean-N, MTV-N, and TLG-N; all P < 0.001), T stage (P = 0.010), N stage (P < 0.001), and TNM stage (P < 0.001) were significant parameters. In a multivariate survival analysis, SUVmax-N (P = 0.005), MTV (P = 0.008), and TLG (P = 0.006) with TNM stage (all P < 0.001) were significant parameters.
Lymph node metabolic and volumetric parameters were significant predictors of recurrence in patients with triple-negative breast cancer after surgery. Lymph node metabolic and volumetric parameters were useful parameters for evaluating prognosis in patients with triple-negative breast cancer by 18F-FDG PET/CT, rather than tumor parameters.
This article is the first installment of highlights of selected articles published during 2016 in the Annals of Nuclear Medicine, an official peer-reviewed journal of the Japanese Society of Nuclear Medicine. A companion article highlighting selected articles published during 2016 in the European Journal of Nuclear Medicine and Molecular Imaging, which is the official peer-reviewed journal of the European Association of Nuclear Medicine, will also appear in the Annals Nuclear Medicine. This new initiative by the respective journals will continue as an annual endeavor and is anticipated to not only enhance the scientific collaboration between Europe and Japan but also facilitate global partnership in the field of nuclear medicine and molecular imaging.
Non-Small Cell Lung Cancer (NSCLC) is characterized by aggressiveness and includes the majority of thorax malignancies. The possibility of early stratification of patients as responsive and non-responsive to radiotherapy with a non-invasive method is extremely appealing. The distribution of the Fluorodeoxyglucose (18F–FDG) in tumours, provided by Positron-Emission-Tomography (PET) images, has been proved to be useful to assess the initial staging of the disease, recurrence, and response to chemotherapy and chemo-radiotherapy (CRT).
In the last years, particular efforts have been focused on the possibility of using ad interim 18F–FDG PET (FDGint) to evaluate response already in the course of radiotherapy. However, controversial findings have been reported for various malignancies, although several results would support the use of FDGint for individual therapeutic decisions, at least in some pathologies. The objective of the present review is to assemble comprehensively the literature concerning NSCLC, to evaluate where and whether FDGint may offer predictive potential.
Several searches were completed on Medline and the Embase database, combining different keywords. Original papers published in the English language from 2005 to 2016 with studies involving FDGint in patients affected by NSCLC and treated with radiation therapy or chemo-radiotherapy only were chosen.
Twenty-one studies out of 970 in Pubmed and 1256 in Embase were selected, reporting on 627 patients.
Certainly, the lack of univocal PET parameters was identified as a major drawback, while standardization would be required for best practice. In any case, all these papers denoted FDGint as promising and a challenging examination for early assessment of outcomes during CRT, sustaining its predictivity in lung cancer.
Sentinel lymph node biopsy (SLNB) can be used for nodal staging in early cervical cancer. For this purpose, the tracers most commonly used are radiotracers based on technetium. For the last decade, indocyanine green (ICG) has been used as a tracer for SLNB in other malignancies with excellent results and, more recently, a combination of ICG and a radiotracer has been shown to have the advantages of both tracers. The aim of this study was to evaluate the role of ICG-99mTc-nanocolloid in SLN detection in patients with cervical cancer.
This prospective study included 16 patients with cervical cancer. The hybrid tracer was injected the day (19–21 h) before surgery for planar and SPECT/CT lymphoscintigraphy. Blue dye was administered periorificially in 14 patients. SLNs were removed according to their distribution on lymphoscintigraphy and when radioactive, fluorescent and/or stained with blue dye. Nodal specimens were pathologically analysed for metastases including by immunochemistry.
Lymphoscintigraphy and SPECT/CT showed drainage in all patients. A total of 69 SLNs were removed, of which 66 were detected by their radioactivity signal and 67 by their fluorescence signal. Blue dye identified only 35 SLNs in 12 of the 14 patients (85.7%). All patients showed bilateral pelvic drainage. Micrometastases were diagnosed in two patients, and were the only lymphatic nodes involved.
SLNB with ICG-99mTc-nanocolloid is feasible and safe in patients with early cervical cancer. This hybrid tracer provided bilateral SLN detection in all patients and a higher detection rate than blue dye, so it could become an alternative to the combined technique.
The aims of this study were to calculate bone lesion absorbed doses resulting from a weight-based administration of 223Ra-dichloride, to assess the relationship between those doses and corresponding 18F-fluoride uptake and to assess the potential of quantitative 18F-fluoride imaging to predict response to treatment.
Five patients received two intravenous injections of 223Ra-dichloride, 6 weeks apart, at 110 kBq/kg whole-body weight. The biodistribution of 223Ra in metastatic lesions as a function of time after administration as well as associated lesion dosimetry were determined from serial 223Ra scans. PET/CT imaging using 18F-fluoride was performed prior to the first treatment (baseline), and at week 6 immediately before the second treatment and at week 12 after baseline.
Absorbed doses to metastatic bone lesions ranged from 0.6 Gy to 44.1 Gy. For individual patients, there was an average factor difference of 5.3 (range 2.5–11.0) between the maximum and minimum lesion dose. A relationship between lesion-absorbed doses and serial changes in 18F-fluoride uptake was demonstrated (r2 = 0.52). A log-linear relationship was demonstrated (r2 = 0.77) between baseline measurements of 18F-fluoride uptake prior to 223Ra-dichloride therapy and changes in uptake 12 weeks after the first cycle of therapy. Correlations were also observed between both 223Ra and 18F-fluoride uptake in lesions (r = 0.75) as well as between 223Ra absorbed dose and 18F-fluoride uptake (r = 0.96).
There is both inter-patient and intra-patient heterogeneity of absorbed dose estimates to metastatic lesions. A relationship between 223Ra lesion absorbed dose and subsequent lesion response was observed. Analysis of this small group of patients suggests that baseline uptake of 18F-fluoride in bone metastases is significantly correlated with corresponding uptake of 223Ra, the associated 223Ra absorbed dose and subsequent lesion response to treatment.
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Publication date: Available online 24 August 2017
Source:Mutation Research/Reviews in Mutation Research
Author(s): Q. Shi, R.W.L. Godschalk, F.J.Van Schooten
Exposure to benzo[a]pyrene (B[a]P) is known to play a role in lung carcinogenesis and the underlying processes can be modified by the presence of inflammation. The inflammatory process can for instance enhance the concentration of reactive metabolites that bind to DNA and may also diminish DNA repair. Additionally, during the inflammatory process mediators are released that create a microenvironment which is suitable for further stimulation of cancer development. Various transcriptional pathways are activated by inflammation, including pathways that are mediated via nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), signal transducer and activator of transcription 3 (STAT-3), and hypoxia-inducible factor-1 (HIF-1). Crosstalk between these pathways and the aryl hydrocarbon receptor (AhR) occurs at multiple levels and thereby boosts B[a]P induced carcinogenesis. This review focuses on inflammatory mediators, including cytokines, chemokines and extracellular enzymes that modulate molecular events in B[a]P induced cancers.
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Chromium (Cr(VI)) is a very toxic and carcinogenic element, which is widely present in groundwaters, mainly due to geogenic conditions. The limit of Cr(VI) in drinking water is expected to be reduced to 10 μg/L in both the USA and the European Union. Recent literature findings indicated that the most efficient process in reducing Cr(VI) levels to below 10 μg/L proved to be Cr(VI) reduction by Fe(II), by applying a molar ratio Fe(II)/Cr(VI) of around 9. In the present work, we investigated the reduction of Cr(VI) by Fe(II) in pipe flocculation reactors followed by filtration of insoluble products by microfiltration. The proposed technology involves re-circulation of a part of the sludge in the pipe reactors, in order to improve kinetics and efficiency of the process. The obtained results showed that with a Fe(II) dose of around 1 mg/L, Cr(VI) was reduced to below 10 μg/L, by even an initial concentration as high as 300 μg/L of Cr(VI), corresponding to a molar ratio Fe(II)/Cr(VI) of around 3, thus reducing the overall quantity of reductive reagents and of the produced sludge. This ratio was also confirmed by the XPS analysis, which also showed that Cr(VI) was reduced to Cr(III) and then precipitated either as Cr(OH)3 or associated with the produced iron oxides.
Publication date: Available online 24 August 2017
Source:Journal of Ethnopharmacology
Author(s): Soon Shik Shin, Michung Yoon
Ethnopharmacological relevanceKorean red ginseng (Panax ginseng C.A. Meyer, Araliaceae) has been historically used as a traditional drug for the prevention and treatment of most ageing-related diseases, such as obesity, dyslipidemia, diabetes, and cardiovascular disease. Elderly men with testosterone deficiency are strongly associated with many of the aforementioned metabolic diseases. The aim of this study was to determine the effects of ginseng on obesity and lipid metabolism in a mouse model of testosterone deficiency (castrated C57BL/6J mice).Materials and methodsThe effects of ginseng extract (GE) on obesity and lipid metabolism in high-fat diet (HFD)-fed castrated C57BL/6J mice were examined using hematoxylin and eosin staining, serum lipid analysis, and quantitative real-time polymerase chain reaction (PCR). The effects of GE, ginsenosides, and testosterone on adipogenesis were measured using Oil Red O staining, XTT assay, and real-time PCR.ResultsCompared with HFD mice, mice receiving HFD supplemented with GE (HFD-GE) for 8 weeks showed decreased body weight, adipose tissue mass, and adipocyte size without affecting food intake. Serum levels of triglycerides and total cholesterol were lowered in HFD-GE mice than in HFD mice. GE also markedly reduced HFD-induced hepatic lipid accumulation. Concomitantly, HFD-GE decreased mRNA expression of adipogenesis-related genes (SREBP-1C, PPARγ, FAS, SCD1, and ACC1) in visceral adipose tissues compared with HFD alone. Consistent with the in vivo data, GE and major active ginsenosides (Rb1 and Rg1) decreased lipid accumulation and mRNA expression of PPARγ, C/EBPα, and SCD1 in 3T3-L1 adipocytes compared with control. Similarly, testosterone also decreased lipid accumulation and mRNA levels of PPARγ, C/EBPα, and SCD1. These inhibitory effects were further increased by co-treatment of GE or ginsenosides with testosterone.ConclusionsOur results demonstrate that ginseng can inhibit obesity and dyslipidemia in HFD-fed castrated mice, possibly by inhibiting adipogenic gene expression. In addition, our results indicate that ginseng may act like testosterone to inhibit adipogenesis, suggesting that ginseng may be able to prevent obesity, hyperlipidemia, and hepatic steatosis in men with testosterone deficiency.
Publication date: Available online 24 August 2017
Source:Journal of Ethnopharmacology
Author(s): Kamilla Felipe do Nascimento, Flora Martinez Figueira Moreira, Joyce Alencar Santos, Candida Aparecida Leite Kassuya, Julio Henrique Rosa Croda, Claudia Andrea Lima Cardoso, Maria do Carmo Vieira, Ana Lúcia Tasca Góis Ruiz, Mary Ann Foglio, João Ernesto de Carvalho, Anelise Samara Nazari Formagio
Ethnopharmacological relevanceLeaves from Psidium guineense Sw. are used in popular medicine for the treatment of inflammatory disease. However, there is no scientific evidence demonstrating this activity.Aim of the studyTo evaluate the antioxidant, anti-inflammatory, antiproliferative and antimycobacterial activities of the essential oil of P. guineense and spathulenol (a major constituent). The study was conducted in part to provide evidence supporting the ethnobotanical use of the leaves of this species.Material and methodsThe essential oil (EOPG) was extracted from the leaves of P. guineense by hydrodistillation and analysed by gas chromatography-mass spectrometry (GC–MS). The major compound, spathulenol (PG-1), was isolated in a chromatographic column and characterized by nuclear magnetic resonance (NMR). EOPG and PG-1 were evaluated in vitro for antioxidant activity by DPPH, ABTS and MDA methods; anti-inflammatory potential was assessed using two models, including pleurisy and edema, in mice. The impact of EOPG and PG-1 on cell proliferation was determined via spectrophotometric quantification of the cellular protein content using a sulforhodamine B assay, and anti-Mycobacterium tuberculosis activity was determined using the REMA method.ResultsA total of 38 components were identified from the EOPG, with the sesquiterpenic alcohol spathulenol (PG-1) (80.7%) being the major constituent. EOPG and PG-1 exhibited the highest antioxidant activities in the DPPH and MDA system compared with reference standard, with IC50 values ranging from 26.13–85.60μg/mL. Oral administration of EOPG and PG-1 showed significant inhibition in the Cg-induced mice paw oedema and pleurisy model. The EOPG (GI50 = 0.89μg/mL) and PG-1 (GI50 = 49.30μg/mL) were particularly effective against the ovarian cancer cell line. Both showed moderate antimycobacterial activity.ConclusionFor the first time, this study demonstrated the antioxidant, anti-inflammatory, antiproliferative and antimycobacterial properties of the essential oil of P. guineense (leaves were collected in Dourados-MS) and spathulenol, collaborating the etnhopharmacologycal use of this plant due to its an anti-inflammatory effect.
Publication date: Available online 24 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Safia K. Ahmed, R. Lor Randall, Steven G. DuBois, William S. Harmsen, Mark Krailo, Karen J. Marcus, Katherine A. Janeway, David S. Geller, Joel I. Sorger, Richard B. Womer, Linda Granowetter, Holcombe E. Grier, Richard G. Gorlick, Nadia N.I. Laack
PurposeTo identify clinical and treatment variables associated with a higher risk of local failure in Ewing sarcoma patients treated on recent Children's Oncology Group protocols.Methods and MaterialsData for 956 patients treated with ifosfamide and etoposide based chemotherapy on INT-0091, INT-0154, and AEWS0031 were analyzed. Local treatment modalities were defined as surgery, definitive radiotherapy (RT), or surgery+radiation (S+RT). Five-year cumulative incidence of local failure was determined.ResultsThe local failure rate for the entire cohort was 7.3%, with a 3.9% rate for surgery, 15.3% for RT (p<0.01), and 6.7% for S+RT (p=0.12). The local failure incidence was 5.4% for extremity tumors, 13.2% for pelvis tumors (p<0.01), 5.3% for axial non-spine tumors (p=0.90), 9.1% for extraskeletal tumors (p=0.08), and 3.6% for spine tumors (p=0.49). The incidence of local failure was 14.8% for extremity tumors and 22.4% for pelvis tumors treated with RT, compared to 3.7% for extremity tumors and 3.9% for pelvis tumors treated with surgery (p≤0.01). There was no difference in local failure incidence by local treatment modality for axial non-spine, spine, and extraskeletal tumors. The local failure incidence was 11.9% in patients ≥18 years versus 6.7% in patients <18 years (p=0.02). Age ≥18 years (Hazard ratio 1.9, p=0.04) and treatment with RT (Hazard ratio 2.40, p<0.01) remained independent prognostic factors for higher local failure incidence on multivariate analysis. Tumor size (</≥ 8 centimeters) was available in 40% of patients and did not correlate with local failure incidence.ConclusionsLocal tumor control is excellent and similar between surgery and RT for axial non-spine, spine, and extraskeletal tumors. Age ≥18 years and use of RT, primarily for pelvis and extremity tumors, are associated with the highest risk of local failure. Further efforts should focus on improving outcomes for these patients.
Publication date: Available online 24 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Ajay Aggarwal, Daniel Lewis, Arunan Sujenthiran, Susan C. Charman, Richard Sullivan, Heather Payne, Malcolm Mason, Jan van der Meulen
IntroductionPatient choice policies have been introduced across publicly funded health systems to give patients more control over their care, and to encourage quality improvement amongst providers. To date we have no empirical evidence that patients requiring radiation treatment are prepared to travel to alternative more distant centres or the factors that influence this.Materials and MethodsWe present the results of a national cohort study using administrative hospital data for all 44,363 men who were diagnosed with prostate cancer and underwent radical radiotherapy in the English National Health Service between 2010 and 2014. Using geographic information systems we investigated the extent to which men choose to travel beyond ("bypass") their nearest radiotherapy centre and conditional logistic regression to estimate the effect of hospital and patient characteristics on this mobility.Results20.7% (n= 9,161) of men bypassed their nearest radiotherapy centre. Travel time had a very strong impact on where patients moved to for their treatment, but its effect was smaller for men who were younger, more affluent, and from rural areas (p for interaction always <0·001). Men were prepared to travel further to hospitals that offered hypofractionated prostate radiotherapy as their standard schedule (odds ratio 3.19, p<0.001), to large-scale radiotherapy units (odds ratio 1.56 P<0.001) and to hospitals that were early adopters of intensity modulated radiotherapy (odds ratio 1.37, p<0.001).ConclusionMen with prostate cancer are prepared to bypass their nearest radiotherapy centres. They are more likely to travel to larger established centres and those that offer innovative technology and more convenient radiotherapy schedules. Indicators, which accurately reflect the quality of radiotherapy delivered are needed to guide patients' choices for radiotherapy treatment. In their absence, patient mobility may negatively affect the efficiency and capacity of a regional or national radiotherapy service and offer perverse incentives for technology adoption.
Publication date: Available online 24 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Rutger C. Melchers, Rein Willemze, Laurien A. Daniëls, Karen J. Neelis, Marcel W. Bekkenk, Ellen R.M. de Haas, Barbara Horvath, Michelle M. van Rossum, Cornelus J.G. Sanders, Berit Velstra, Joep C.J.M. Veraart, Rachel E.J. Roach, Maarten H. Vermeer, Koen D. Quint
ObjectiveTo determine the optimal radiation dose for treatment of primary cutaneous anaplastic large cell lymphoma (C-ALCL) with solitary or localized, multifocal or recurrent skin lesions.Materials and MethodsIn this multicenter study, patients with C-ALCL, who had been treated with radiotherapy (RT) between 1984 and 2016, were retrieved from the Dutch registry of cutaneous lymphomas. Distinction was made between patients first presenting with solitary or localized (n=63), with multifocal skin lesions (n=6), and patients with a skin relapse (n=22). Radiation doses, treatment response and follow-up were evaluated. Radiation doses were categorized in low-dose (≤20 Gy), intermediate dose (21-39 Gy) and high-dose (≥40 Gy).Results61/63 (97%) patients presenting with solitary or localized skin lesions showed a complete response (CR). There were no differences in CR between low-dose (16/17), intermediate dose (15/15) and high-dose RT (30/31). After a median follow-up of 46 months, 30 of 63 (48%) patients had a relapse, but infield relapses were never observed. Six out of 6 (100%) patients initially presenting with multifocal skin lesions showed a CR (3/3 low-dose, 2/2 intermediate dose, 1/1 high-dose). After a median follow-up of 27 months, 3 of 6 patients had a relapse. Treatment of 33 skin relapses in 22 patients showed no differences in CR between low-dose (18/19), intermediate dose (6/6) and high-dose radiotherapy (8/8).In the last ten years there has been a decrease in radiation dose used in the treatment of C-ALCL. Treatment of multifocal and recurrent lesions with a dose of 8 Gy (2x4 Gy) resulted in CR of 17/18 lesions.ConclusionOur results show that a radiation dose of 20 Gy (8x2.5 Gy) is effective in patients presenting with solitary or localized skin lesions. For patients with multifocal skin lesions and patients with a skin relapse, a dose of 8 Gy (2x4 Gy) may be sufficient.
Publication date: 15 November 2017
Source:Materials & Design, Volume 134
Author(s): Yao Xiao, Pan Zeng, Liping Lei, Yanzhi Zhang
In situ digital image correlation (DIC) and in situ X-ray diffraction (XRD) are applied to investigate the effect of temperature on martensitic transformation and plastic deformation in superelastic NiTi shape memory alloy. Via in situ DIC, two well-known deformation modes of NiTi are identified at various temperatures: (A) localized forward and reverse transformations with little residual strain (<1%); (B) localized forward transformation and homogenous reverse transformation with considerable residual strain (>1%). As temperature increases from 25°C to 120°C, the mechanical response of NiTi gradually transits from Type A to Type B. We verify that plastic strain accumulates concurrently as the traverse of the front of localized deformation band. Via in situ XRD observation, we conclude that it is material plasticity rather than retained martensite that plays a dominant role in the irreversibility of NiTi. The experimental results provide both macroscopic and lattice level scenarios to understand the temperature dependence of complicated thermomechanical coupling and plasticity in superelastic NiTi.
Publication date: 15 November 2017
Source:Materials & Design, Volume 134
Author(s): Pengju Liu, Wenhua Chen, Yingbin Jia, Shibing Bai, Qi Wang
Combining the nanocomposite and supercritical fluid (SCF) foaming technology develops an effective preparation method for new class of microcellular polymer nanocomposite foam, which has received much attention in both research and practice. In this paper, the poly (vinyl alcohol) (PVA)/graphene nanocomposites were successfully prepared at ambient temperature through the solid state shear milling technique, and made into foam material by using supercritical carbon dioxide as the physical blowing agent. The results indicated that graphene sheets were uniformly incorporated into the PVA matrix after milling, and graphene sheets did not reaggregate in the subsequent melting process. These well-dispersed PVA/graphene nanocomposites presented significant increases in tensile strength and thermal behavior compared to pure PVA. In the SCF foaming procedure, graphene sheets acted as the heterogeneous sites to facilitate the bubble nucleation process. More importantly, the embedded graphene sheets played an effective role of reinforcing the cell walls to stabilize the cellular structure during the cell growth stage, thus compressive properties of the nanocomposite foams were significantly enhanced. The bubbles tended to be elongated along the direction of CO2 decompression at a relatively high foaming temperature and with fast depressurization rate.
Publication date: 15 November 2017
Source:Materials & Design, Volume 134
Author(s): Tao Wang, Lanlan Chen, Lingmei Du, Tingting Shen, Fei Li, Lan Huang, Zhi Li, Dayang Wu
The silkworm cocoon has outstanding mechanical properties due to the specific composite structure. However, the individual cocoon is small and irregular in shape which dramatically hinders its application in artificial composites. Here, rectangular pieces of silkworm cocoons were cut and combined into large sheets by means of hot pressing. The structure and properties of compressed cocoon pieces were investigated. The thickness and porosity of pieces are significantly decreased at the high pressure, besides silk fibers are more deformed and bonded at high temperature cause of sericin's softening and fusion. Tensile strength and modulus are remarkably increased compared to those of the raw cocoon, and so do the interlayer bonding. The stable thermal property of the compressed cocoons demonstrates that compression at a high temperature has little harm to cocoons. Therefore, hot pressing is a practical way to build artificial cocoon composites for engineering applications.
Publication date: 15 November 2017
Source:Materials & Design, Volume 134
Author(s): Naresh Nadammal, Sandra Cabeza, Tatiana Mishurova, Tobias Thiede, Arne Kromm, Christoph Seyfert, Lena Farahbod, Christoph Haberland, Judith Ann Schneider, Pedro Dolabella Portella, Giovanni Bruno
In the present study, samples fabricated by varying the deposition hatch length during selective laser melting of nickel based superalloy Inconel 718 were investigated. Microstructure and texture of these samples was characterized using scanning electron microscopy, combined with electron back-scattered diffraction, and residual stress assessment, using neutron diffraction method. Textured columnar grains oriented along the sample building direction were observed in the shorter hatch length processed sample. A ten-fold increase in the hatch length reduced the texture intensity by a factor of two attributed to the formation of finer grains in the longer hatch length sample. Larger gradients of transverse residual stress in the longer hatch length sample were also observed. Along the build direction, compressive stresses in the shorter hatch length and negligible stresses for the longer hatch length specimen were observed. Changes to the temperature gradient (G) in response to the hatch length variation, influenced the G to growth rate (R) ratio and the product G×R, in agreement with the microstructures and textures formed. For the residual stress development, geometry of the part also played an important role. In summary, tailored isotropy could be induced in Inconel 718 by a careful selection of parameters during selective laser melting.
Publication date: Available online 24 August 2017
Source:Cell Host & Microbe
Author(s): Kymberleigh A. Romano, Ana Martinez-del Campo, Kazuyuki Kasahara, Carina L. Chittim, Eugenio I. Vivas, Daniel Amador-Noguez, Emily P. Balskus, Federico E. Rey
Choline is an essential nutrient and methyl donor required for epigenetic regulation. Here, we assessed the impact of gut microbial choline metabolism on bacterial fitness and host biology by engineering a microbial community that lacks a single choline-utilizing enzyme. Our results indicate that choline-utilizing bacteria compete with the host for this nutrient, significantly impacting plasma and hepatic levels of methyl-donor metabolites and recapitulating biochemical signatures of choline deficiency. Mice harboring high levels of choline-consuming bacteria showed increased susceptibility to metabolic disease in the context of a high-fat diet. Furthermore, bacterially induced reduction of methyl-donor availability influenced global DNA methylation patterns in both adult mice and their offspring and engendered behavioral alterations. Our results reveal an underappreciated effect of bacterial choline metabolism on host metabolism, epigenetics, and behavior. This work suggests that interpersonal differences in microbial metabolism should be considered when determining optimal nutrient intake requirements.
Publication date: Available online 24 August 2017
Source:Cell Host & Microbe
Author(s): Luisella Spiga, Maria G. Winter, Tatiane Furtado de Carvalho, Wenhan Zhu, Elizabeth R. Hughes, Caroline C. Gillis, Cassie L. Behrendt, Jiwoong Kim, Daniela Chessa, Helene L. Andrews-Polymenis, Daniel P. Beiting, Renato L. Santos, Lora V. Hooper, Sebastian E. Winter
The mucosal inflammatory response induced by Salmonella serovar Typhimurium creates a favorable niche for this gut pathogen. Conventional wisdom holds that S. Typhimurium undergoes an incomplete tricarboxylic acid (TCA) cycle in the anaerobic mammalian gut. One change during S. Typhimurium-induced inflammation is the production of oxidized compounds by infiltrating neutrophils. We show that inflammation-derived electron acceptors induce a complete, oxidative TCA cycle in S. Typhimurium, allowing the bacteria to compete with the microbiota for colonization. A complete TCA cycle facilitates utilization of the microbiota-derived fermentation product succinate as a carbon source. S. Typhimurium succinate utilization genes contribute to efficient colonization in conventionally raised mice, but provide no growth advantage in germ-free mice. Mono-association of gnotobiotic mice with Bacteroides, a major succinate producer, restores succinate utilization in S. Typhimurium. Thus, oxidative central metabolism enables S. Typhimurium to utilize a variety of carbon sources, including microbiota-derived succinate.