Long term patient reported swallowing function following chemoradiotherapy for oropharyngeal carcinoma

Publication date: Available online 21 June 2018
Source:Radiotherapy and Oncology
Author(s): Lynne Dixon, Satiavani Ramasamy, Kate Cardale, Karen Dyker, Kate Garcez, Lip Wai Lee, Andrew McPartlin, Patrick Murray, Mehmet Sen, Nick Slevin, Andrew Sykes, Robin Prestwich, David Thomson
Background and purposeLimited data are available to inform on long term swallowing outcomes following concurrent chemoradiotherapy for oropharyngeal carcinoma. The aims of this study are to determine long term patient-reported swallowing outcomes across two large UK centres in routine clinical practice and identify associated factors.Material and methodsAll patients treated for oropharyngeal squamous cell carcinoma with concurrent chemoradiotherapy, and irradiation of the bilateral neck, between 2011 and 2013 were identified. Those requiring therapeutic enteral feeding prior to treatment, or having subsequent disease relapse, were excluded from the study. Patients were sent postal invitations to complete the MD Anderson Dysphagia Inventory (MDADI), at least two years following completion of treatment.ResultsCompleted MDADI were received from 201/242 eligible patients (83%) at a median of 3.4 years (range 2–5) post treatment. Median composite MDADI score was 68.4. 64 (32%) had composite MDADI <60 classed as 'poor' function, 76 (38%) scores ≥60–<80 classed as adequate function, and 61 (31%) had scores ≥80 classed as optimal function. Patients with normal and abnormal pre-treatment diet had median composite MDADI scores of 70.5 versus 47.4 respectively. Patients who did not require enteral feeding during treatment and those who did had median composite MDADI scores of 76.3 versus 65.3 respectively. On multivariate analysis poorer performance status, abnormal pre-treatment diet, and use of enteral feeding during radiotherapy were all significantly associated with lower composite, global and subscale MDADI scores.ConclusionsPatient reported swallowing dysfunction remains common in the long term post-chemoradiotherapy. Impaired pre-treatment diet and use of enteral feeding during treatment are key factors associated with poorer swallowing outcomes.



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Safety concerns regarding ablative radiotherapy for ventricular tachycardia

Publication date: Available online 21 June 2018
Source:Radiotherapy and Oncology
Author(s): Michael Spartalis, Eleftherios Spartalis, Antonios Athanasiou, Nikolaos Nikiteas




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Survival gain with re-Op/RT for recurred high-grade gliomas depends upon risk groups

Publication date: Available online 21 June 2018
Source:Radiotherapy and Oncology
Author(s): Seok-Joo Chun, Sung-Hye Park, Chul-Kee Park, Jin Wook Kim, Tae Min Kim, Seung Hong Choi, Soon-Tae Lee, Il Han Kim
IntroductionA majority of high-grade gliomas relapse despite combined surgery, radiotherapy and chemotherapy. There is no consensus on standard treatment for recurrent high-grade gliomas, or defined efficacy of adjuvant re-RT after re-Op. This retrospective study evaluated the benefit and safety of re-RT after re-Op (re-Op/RT).Materials and methodsA total of 84 patients with recurrent high-grade gliomas who underwent reoperation from 2009 to 2015 were analyzed. All patients received neurosurgical intervention and adjuvant radiotherapy previously before recurrence. At recurrence and after reoperation, treatment options were discussed in multidisciplinary clinic or brain tumor joint conference. For re-RT, cumulative EQD2 (equivalent dose in 2 Gy fractions at α/β = 2) was below 106.9 Gy.ResultMedian progression free survival (PFS) was 6.5 months; 3.5 months with re-Op, 9.0 months with re-Op/RT (p = 0.025). Age <50, time interval to recur ≥12 months, WHO pathologic grade III, methylated MGMT promotor, and re-RT were factors enhancing PFS in the multivariate analysis. Median overall survival (OS) was 18.3 months: 12.7 months with re-Op, and 28.1 months with re-Op/RT (p = 0.066). Three risk factors (age >50, WHO grade IV, and unmethylated promoter of MGMT) were significantly associated with poor OS in multivariate analysis. Benefit of re-RT in both OS and PFS was established in patients carrying 2 or more risk factors. During re-RT, 4 patients (8%) had grade 2 or higher toxicity, and 3 patients (6%) did not complete re-RT. No radionecrosis was observed.ConclusionRe-RT after re-Op was tolerable with a cumulative median EQD2 of 99.3 Gy and resulted in clear benefit in PFS and marginal gain in OS. Survival gain with re-Op/RT was more prominent in patients with two or more risk factors (age ≥50, WHO pathologic grade IV, unmethylated MGMT promoter), and needs to be validated.



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Harnessing drug/radiation interaction through daily routine practice: Leverage medical and methodological point of view (MORSE 02-17 study)

Publication date: Available online 21 June 2018
Source:Radiotherapy and Oncology
Author(s): A. Vallard, C. Rancoule, S. Espenel, M.-A. Garcia, J. Langrand-Escure, M.Y. He, M. Ben Mrad, A. El Meddeb Hamrouni, S. Ouni, J.-C. Trone, A. Rehailia-Blanchard, E. Guillaume, N. Vial, C. Riocreux, J.-B. Guy, N. Magné
BackgroundSafety profile of the interaction between anticancer drugs and radiation is a recurrent question. However, there are little data regarding the non-anticancer treatment (NACT)/radiation combinations. The aim of the present study was to investigate concomitant NACTs in patients undergoing radiotherapy in a French comprehensive cancer center.MethodsA prospective cross-sectional study was conducted. All cancer patients undergoing a palliative or curative radiotherapy were consecutively screened for six weeks in 2016. Data on NACTs were collected.ResultsOut of 214 included patients, a NACT was concomitantly prescribed to 155 patients (72%), with a median number of 5 NACTs per patient (range: 1–12). The most prescribed drugs were anti-hypertensive drugs (101 patients, 47.2%), psychotropic drugs (n = 74, 34.6%), analgesics (n = 78, 36.4%), hypolipidemic drugs (n = 57, 26.6%), proton pump inhibitors (n = 46, 21.5%) and antiplatelet drugs (n = 38, 17.8%). Although 833 different molecules were reported, only 20 possible modifiers of cancer biological pathways (prescribed to 74 patients (34.5%)) were identified. Eight out of the 833 molecules (0.9%), belonging to six drug families, have been investigated in 28 ongoing or published clinical trials in combo with radiotherapy. They were prescribed to 63 patients (29.4%).ConclusionDrug-radiation interaction remains a subject of major interest, not only for conventional anticancer drugs, but also for NACTs. New trial designs are thus required.



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Determinants for local tumour control probability after radiotherapy of anal cancer

Publication date: Available online 19 June 2018
Source:Radiotherapy and Oncology
Author(s): Anders Johnsson, Otilia Leon, Adalsteinn Gunnlaugsson, Per Nilsson, Peter Höglund
Background and purposeAnal squamous cell carcinoma is primarily treated with radiotherapy (RT), but the optimal RT dose for anal tumours of different sizes is not known. The purpose of this study was to identify determinants for local tumour control probability (LTCP).Material and methodsFrom a large Nordic database 901 patients who received RT for anal cancer between 2000 and 2007 were selected. LTCP was analysed in a series of uni- and multivariable regression analyses.ResultsHigher RT dose, female gender and addition of chemotherapy were associated with higher LTCP whereas increasing tumour size, tumour invasiveness (stage T4) and lymph node metastases (N+) were associated with lower LTCP. Male patients needed approximately 10 Gy higher RT dose than female patients for similar LTCP. The addition of chemotherapy corresponded to 5–10 Gy RT dose.ConclusionsOur results basically support current guidelines recommending: (1) lower RT dose in small tumours (<4 cm), (2) higher RT dose larger tumours and in stages T4 and /or N+, (3) Chemo should be used in combination with RT. These results will hopefully constitute the basis for future trials, aiming at individualized RT dosing in patients with anal cancer.



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Proton therapy for pediatric malignancies: Fact, figures and costs. A joint consensus statement from the pediatric subcommittee of PTCOG, PROS and EPTN

Publication date: Available online 21 June 2018
Source:Radiotherapy and Oncology
Author(s): Damien C. Weber, Jean Louis Habrand, Bradford S. Hoppe, Christine Hill Kayser, Nadia N. Laack, Johanes A. Langendijk, Shannon M. MacDonald, Susan L. McGovern, Luke Pater, John P. Perentesis, Juliette Thariat, Beate Timmerman, Torunn I. Yock, Anita Mahajan
Radiotherapy plays an important role in the management of childhood cancer, with the primary aim of achieving the highest likelihood of cure with the lowest risk of radiation-induced morbidity. Proton therapy (PT) provides an undisputable advantage by reducing the radiation 'bath' dose delivered to non-target structures/volume while optimally covering the tumor with tumoricidal dose. This treatment modality comes, however, with an additional costs compared to conventional radiotherapy that could put substantial financial pressure to the health care systems with societal implications.In this review we assess the data available to the oncology community of PT delivered to children with cancer, discuss on the urgency to develop high-quality data. Additionally, we look at the advantage of combining systemic agents with protons and look at the cost-effectiveness data published so far.



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Cardiac mortality in limited-stage small cell lung cancer

Publication date: Available online 19 June 2018
Source:Radiotherapy and Oncology
Author(s): Vivek Verma, Mohamad H. Fakhreddine, Waqar Haque, E. Brian Butler, Bin S. Teh, Charles B. Simone
IntroductionLife expectancy of patients with limited-stage small cell lung cancer (LS-SCLC) continues to rise; thus, characterization of long-term toxicities is essential. Although there are emerging data linking cardiac irradiation doses with survival for non-small cell lung cancer, there are currently minimal data on cardiac-specific mortality (CSM) in LS-SCLC. The goal of this investigation was to evaluate CSM between left- and right-sided cases.MethodsThe Surveillance, Epidemiology, and End Results database was queried for stage I–III primary SCLC patients receiving radiotherapy; CSM was compared between left- and right-sided diseases. Accounting for mortality from other causes, Gray's test compared cumulative incidences of CSM between both groups. Multiple multivariate models examined the independent effect of laterality on CSM, including the Fine and Gray competing risk model and the Cox proportional hazards model.ResultsOf 19,692 patients, 7991 (41%) were left-sided and 11,701 (59%) were right-sided. Left-sided patients experienced significantly higher CSM overall (3.3% vs. 2.6%, p = 0.004). Laterality was an independent predictor of CSM in the overall population in the Fine and Gray competing risk model (p = 0.006) as well as the Cox proportional hazards model (p = 0.007). The overall hazard ratio for CSM by disease laterality was 1.27 (95% confidence interval, 1.08–1.50). Laterality had no statistical association with non-cardiac mortality in the Fine and Gray competing risk model (p = 0.130).ConclusionsAlthough causation between radiotherapy and CSM in LS-SCLC cannot be stated based on these data, we encourage clinical attentiveness to cardiac-sparing radiotherapy for LS-SCLC, along with further investigation evaluating dosimetric correlates for cardiotoxicity.



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Estimating the need for palliative radiotherapy for non-small cell lung cancer: A criterion-based benchmarking approach

Publication date: Available online 19 June 2018
Source:Radiotherapy and Oncology
Author(s): Chunzi Jenny Jin, Weidong Kong, William J. Mackillop
Background and purposeEstimates of appropriate treatment rates are required for monitoring and improving access to cancer care. Optimal utilization rates for palliative radiotherapy (PRT) for patients with non-small cell lung cancer (NSCLC) remain undefined. We aim to estimate the appropriate PRT rate for the general NSCLC population.Materials and methodsOntario's population-based cancer registry identified patients with NSCLC who died of their disease between 2006 and 2010. Multivariate analysis identified factors affecting PRT use, enabling us to define a benchmark population with unimpeded access to PRT. Proportion of cases treated in the last 2 years of life (PRT2y) was standardized to overall population characteristics. Benchmarks were compared to province-wide PRT2y rates.ResultsAvailability of RT at the diagnosing hospital was the dominant determinant of increased PRT utilization. Patients diagnosed at hospitals with on site RT were therefore designated the benchmark population. The standardized benchmark for PRT2y was 56%, compared to the province-wide rate of 49%. The gap between actual and optimal rates varied across patient ages, treatment indications, and geographic regions.ConclusionsApproximately 56% of patients who die of NSCLC in Ontario need PRT, but many are never treated.



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Inverse planning and inverse implanting for breast interstitial brachytherapy. Introducing a new anatomy specific breast interstitial template (ASBIT)

Publication date: Available online 19 June 2018
Source:Radiotherapy and Oncology
Author(s): Efstratios Karagiannis, Agnes Leczynski, Nikolaos Tselis, Emmanouil Psanis, Oliver Steckenreiter, Natasa Milickovic, Dimitra Bon, Iosif Strouthos, Konstantinos Ferentinos, Peter Hass, Günther Gademann, Dimos Baltas, Nikolaos Zamboglou
An innovative template, based on thoracic cage surface reconstructions for breast interstitial brachytherapy was developed. Hybrid-inverse-planning-optimisation-based implantations and brachytherapy plans, using three custom anthropomorphic breast phantoms, were utilised for its validation. A user independent, inverse planning and inverse implanting technique is proposed.



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Prospective evaluation of acute toxicity and patient reported outcomes in anal cancer and plan optimization

Publication date: Available online 18 June 2018
Source:Radiotherapy and Oncology
Author(s): Camilla Kronborg, Eva Serup-Hansen, Anna Lefevre, Eva E. Wilken, Jørgen B. Petersen, Jolanta Hansen, Annette Schouboe, Lars Nyvang, Karen-Lise G. Spindler
Background and purposeChemoradiotherapy (CRT) is the standard therapy for localized anal cancer (AC), but this treatment is associated with substantial toxicity. However, there is a lack of prospectively collected toxicity and patient reported outcome (PRO) data from larger cohorts.The purpose was to prospectively collect and determine agreement between physician assessed toxicity (CTCAE) and PRO during and after CRT and to compare IMRT, VMAT and proton-based planning in a subgroup of patients.Material and methodsPatients, treated with CRT for AC, were included between 2015 and 2017. NCI-CTCAE v.4.0, EORTC QLQ-C30 and CR29 data were collected baseline, mid-therapy, end-of therapy and 2–4 weeks posttherapy. Treatment planning with 5- or 6-fixed field IMRT, 2 and 3 arc VMAT, and 3- and 4-field proton plans were compared.ResultsOne-hundred patients were included. Both CTCAE and PROs related to acute toxicity reached a maximum at end of therapy. Incidences of PROs were markedly higher with only slight to fair agreement to CTCAE, (κ 13–37). Comparative planning revealed dosimetric equality of IMRT and VMAT plans, but superiority of proton plans.ConclusionsThe high incidence of PRO scores and weak agreement to CTCAE suggest that PROs are important tools complementary to CTCAE in evaluating patient symptoms during and after CRT. Proton therapy has the potential to lower radiation doses to most organs at risk.



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Clinical feasibility and positional stability of an implanted wired transmitter in a novel electromagnetic positioning system for prostate cancer radiotherapy

Publication date: Available online 18 June 2018
Source:Radiotherapy and Oncology
Author(s): Karin Braide, Ulrika Lindencrona, Kristina Welinder, Julia Götstedt, Ingun Ståhl, Niclas Pettersson, Jon Kindblom
PurposeThree aspects of the RayPilot real-time tracking system were investigated: (1) feasibility of the transmitter with respect to implantation and explantation procedures, (2) user and patients' experiences and (3) quantification of the transmitter positional stability in relation to fiducial markers.Methods and materialsTen prostate cancer patients scheduled for radiotherapy received transmitter implantation in the prostate, concomitantly with fiducial markers. Transmitter and marker positions were assessed in 3D by orthogonal kV-imaging at daily treatment setup in eight patients.ResultsThe transmitter was successfully implanted in all patients. Patients reported mild to moderate discomfort and impact on daily activities due to the implant but overall subjective tolerability was good. One patient had spontaneous explantation of the transmitter after four fractions. One patient had transmitter 3D shifts >9 mm, but also inter-marker shifts >6 mm. The mean inter-marker shift in the remaining patients was <1 mm. In four patients, maximum transmitter 3D shifts were 5–7 mm (mean >2 mm). In three patients, mean transmitter 3D shifts were <2 mm.ConclusionsImplantation and explantation of the transmitter is generally feasible and safe. Patient tolerability is good overall. However, due to interfractional transmitter positional instability in this cohort, use of the system for real-time tracking should be combined with other daily setup techniques.



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Changing the global radiation therapy paradigm

Publication date: Available online 18 June 2018
Source:Radiotherapy and Oncology
Author(s): David A. Pistenmaa, Manjit Dosanjh, Ugo Amaldi, David Jaffray, Eduardo Zubizarreta, Katherine Holt, Yolande Lievens, Yakov Pipman, C. Norman Coleman




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Long-term risks of secondary cancer for various whole and partial breast irradiation techniques

Publication date: Available online 18 June 2018
Source:Radiotherapy and Oncology
Author(s): Nienke Hoekstra, Emmanuelle Fleury, Tomas Rodrigo Merino Lara, Peter van der Baan, Andy Bahnerth, Gerson Struik, Mischa Hoogeman, Jean-Philippe Pignol
IntroductionFor early stage breast cancer patients, non-breast cancer mortality including secondary cancers and cardiac events can overshadow the benefit of adjuvant radiotherapy. This study evaluates the excess risk of secondary cancer for various breast radiotherapy techniques including accelerated partial breast irradiation (APBI).MethodsSecondary cancers Lifetime Attributable Risks (LAR) were calculated using a modified BEIR-VII formalism to account for the specific survival of breast cancer patients. Those survivals were extracted from the SEER database. Doses scattered to various organs were measured into a Rando phantom with custom-made breast phantoms. Treatments delivered typical doses of brachytherapy APBI (34 Gy in 10 fractions), external beam APBI (38.5 Gy in 10 fractions) using 3D-conformal, Cyberknife stereotactic (CK), or VMAT, as well as whole breast irradiation (WBI) delivering 42.5 Gy in 16 fractions.ResultsWBI resulted in the highest total LAR, with 4.3% excess risk of secondary cancer for a patient treated at age 50 years. Lung cancers accounted for 75–97% of secondary malignancies. For a typical early stage patient irradiated at 50, the excess risks of secondary lung cancer were 1.1% for multicatheter HDR, between 2.2% and 2.5% for 3D-CRT or CK, 3.5% for VMAT APBI, and 3.8% for WBI.ConclusionsAPBI reduces the risk of secondary cancer 2–4 fold compared to WBI. These techniques are well suited for long-living early stage breast cancer patients. HDR brachytherapy and 3D-conformal APBI achieve mean lung doses between 1 and 1.5 Gy, which could serve as reference.



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Contents

Publication date: June 2018
Source:Radiotherapy and Oncology, Volume 127, Issue 3





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Sensitization of prostate cancer to radiation therapy: Molecules and pathways to target

Publication date: Available online 18 June 2018
Source:Radiotherapy and Oncology
Author(s): Mu Yao, Linda Rogers, Natalka Suchowerska, Daniel Choe, Mahmoud A. Al-Dabbas, Ramit S. Narula, J. Guy Lyons, Paul Sved, Zhong Li, Qihan Dong
Radiation therapy is used to treat cancer by radiation-induced DNA damage. Despite the best efforts to eliminate cancer, some cancer cells survive irradiation, resulting in cancer progression or recurrence. Alteration in DNA damage repair pathways is common in cancers, resulting in modulation of their response to radiation. This article focuses on the recent findings about molecules and pathways that potentially can be targeted to sensitize prostate cancer cells to ionizing radiation, thereby achieving an improved therapeutic outcome.



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Can clinicopathological parameters predict for lymph node metastases in ypT0-2 rectal carcinoma? Results of the CAO/ARO/AIO-94 and CAO/ARO/AIO-04 phase 3 trials

Publication date: Available online 18 June 2018
Source:Radiotherapy and Oncology
Author(s): Jens Müller von den Grün, Arndt Hartmann, Rainer Fietkau, Michael Ghadimi, Torsten Liersch, Werner Hohenberger, Jürgen Weitz, Rolf Sauer, Christian Wittekind, Philipp Ströbel, Claus Rödel, Emmanouil Fokas
BackgroundThe advent of less radical surgical approaches has generated concern about leaving locoregional lymph node metastases (LNM) unresected that could lead to adverse outcome. We examined the prognostic role of clinicopathological factors for ypN-positivity in patients with ypT0-2 rectal carcinoma treated within the CAO/ARO/AIO-94 and CAO/ARO/AIO-04 randomized phase 3 trials.MethodsThe correlation of clinicopathological factors with ypN-status (ypN0 vs ypN1/2) was examined in n = 776 patients with ypT0-2 rectal carcinoma after preoperative CRT and total mesorectal excision surgery using Pearson's Chi-squared test for categorical variables and Kruskal–Wallis' test for continuous variables. Multivariable analysis was performed using binary logistic regression to identify independent prognosticators for ypN-positivity.ResultsResidual LNM (ypN+) were found in 6%, 20.8% and 21.4% of patients with ypT0, ypT1 and ypT2 carcinomas, respectively. Independent prognosticators for LNM were advanced ypT category (p = 0.002) and lymphatic invasion (p = 0.020). In a separate multivariable analysis performed upon exclusion of ypT-category due to multicollinearity with residual tumor diameter (RTD), lymphatic invasion (p = 0.015) and RTD ≥10 mm (p = 0.005) demonstrated strong correlation with LNM.ConclusionAdvanced ypT-stage, lymphatic invasion and RTD ≥10 mm were prognostic factors for LNM in patients ypT0-2 rectal carcinoma treated with CRT and surgery within both phase 3 trials. The high incidence of LNM in the ypT1-2 group needs to be taken into consideration in the context of oncological safety and indicate that LE should be advocated with great caution in this patient subgroup. The prognostic pathological factor identified here could help guide decision of LE vs TME after standard CRT.



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Dose-response in choroidal melanoma

Publication date: June 2018
Source:Radiotherapy and Oncology, Volume 127, Issue 3
Author(s): Alex De Caluwé, Karolien Termote, Dirk Van Gestel, Erik Van Limbergen
PurposeIn choroidal melanoma the radiation threshold dose for local control remains largely unknown. The present study examined a group of patients that received a wide range of minimum tumor dose in order to investigate a dose-response relationship. A literature review is performed to compare our results with available evidence in brachytherapy and charged particle external beam radiotherapy.Materials and methodsA retrospective study was conducted on all choroidal melanomas treated with Strontium-90 (Sr-90) at the University Hospital of Leuven between 1983 and 2012. Local failure was defined as primary endpoint and was estimated according to the competing risk method.ResultsIn 135 patients, the minimum tumor dose (Dmin) ranged from 0 Gy to 287 Gy (median: 27.6 Gy). Multivariable analysis revealed Dmin ≥ 65 Gy (p = 0.04; HR = 0.09) and tumor distant from the optic disc (p < 0.001, HR = 0.09) to be independent variables favoring local control. The scleral dose, the tumor diameter and tumor height did not significantly affect local failure in multivariate analysis.ConclusionThis is the first study to examine a group of patients treated with a Dmin ranging from 0 Gy to >250 Gy. Treatment with a Dmin of 65 Gy is necessary to achieve durable tumor response. The dose-response data provided by our study could be used for the design of future trials examining the ideal dose for the treatment of choroidal melanoma with brachytherapy or charged particle external beam radiotherapy.



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Preoperative radiotherapy and local excision of rectal cancer: Long-term results of a randomised study

Publication date: June 2018
Source:Radiotherapy and Oncology, Volume 127, Issue 3
Author(s): Przemysław Wawok, Wojciech Polkowski, Piotr Richter, Marek Szczepkowski, Janusz Olędzki, Ryszard Wierzbicki, Tomasz Gach, Andrzej Rutkowski, Adam Dziki, Leszek Kołodziejski, Rafał Sopyło, Lucyna Pietrzak, Jacek Kryński, Katarzyna Wiśniowska, Mateusz Spałek, Konrad Pawlewicz, Marcin Polkowski, Teresa Kowalska, Krzysztof Paprota, Małgorzata Jankiewicz, Andrzej Radkowski, Justyna Chalubińska-Fendler, Wojciech Michalski, Krzysztof Bujko
Background and purposeIt is uncertain whether local control is acceptable after preoperative radiotherapy and local excision (LE). An optimal preoperative dose/fractionation schedule has not yet been established.Material and methodsIn a phase III study, patients with cT1-2N0M0 or borderline cT2/T3N0M0 < 4 cm rectal adenocarcinomas were randomised to receive either 5 × 5 Gy plus 1 × 4 Gy boost or chemoradiation: 50.4 Gy in 28 fractions plus 3 × 1.8 Gy boost and 5-fluorouracil with leucovorin bolus. LE was performed 6–8 weeks later. Patients with ypT0–1R0 disease were observed. Completion total mesorectal excision (CTME) was recommended for poor responders, i.e. ypT1R1/ypT2-3.ResultsOf 61 randomised patients, 10 were excluded leaving 51 for analysis; 29 in the short-course group and 22 in the chemoradiation group. YpT0–1R0 was observed in 66% of patients in the short-course group and in 86% in the chemoradiation group, p = 0.11. CTME was performed only in 46% of patients with ypT1R1/ypT2-3. The median follow-up was 8.7 years. Local recurrence incidences and overall survival at 10 years were respectively for the short-course group vs. the chemoradiation group 35% vs. 5%, p = 0.036 and 47% vs. 86%, p = 0.009. In total, local recurrence at 10 years was 79% for ypT1R1/T2-3 without CTME.ConclusionsThis trial suggests that in the LE setting, both local recurrence and survival are worse after short-course radiotherapy than after chemoradiation. Because of the risk of bias, a confirmatory study is desirable. Lack of CTME is associated with an unacceptably high local recurrence rate.



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Editorial Board

Publication date: June 2018
Source:Radiotherapy and Oncology, Volume 127, Issue 3





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Neurobiology and consequences of social isolation stress in animal model—A comprehensive review

Publication date: September 2018
Source:Biomedicine & Pharmacotherapy, Volume 105
Author(s): Faiza Mumtaz, Muhammad Imran Khan, Muhammad Zubair, Ahmad Reza Dehpour
The brain is a vital organ, susceptible to alterations under genetic influences and environmental experiences. Social isolation (SI) acts as a stressor which results in alterations in reactivity to stress, social behavior, function of neurochemical and neuroendocrine system, physiological, anatomical and behavioral changes in both animal and humans. During early stages of life, acute or chronic SIS has been proposed to show signs and symptoms of psychiatric and neurological disorders such as anxiety, depression, schizophrenia, epilepsy and memory loss. Exposure to social isolation stress induces a variety of endocrinological changes including the activation of hypothalamic–pituitary–adrenal (HPA) axis, culminating in the release of glucocorticoids (GCs), release of catecholamines, activation of the sympatho-adrenomedullary system, release of Oxytocin and vasopressin. In several regions of the central nervous system (CNS), SIS alters the level of neurotransmitter such as dopamine, serotonin, gamma aminobutyric acid (GABA), glutamate, nitrergic system and adrenaline as well as leads to alteration in receptor sensitivity of N-methyl-D-aspartate (NMDA) and opioid system. A change in the function of oxidative and nitrosative stress (O&NS) mediated mitochondrial dysfunction, inflammatory factors, neurotrophins and neurotrophicfactors (NTFs), early growth response transcription factor genes (Egr) and C-Fos expression are also involved as a pathophysiological consequences of SIS which induce neurological and psychiatric disorders.



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Increased toxicity of amylin (Islet Amyloid Polypeptide) in beta cells induced by photochemical internalization

Publication date: Available online 21 June 2018
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Rinku Singh, Hals Ingrid, Høgset Anders, Grill Valdemar, A. Gederaas Odrun




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Immobilization of antibody conjugated ZnS quantum dots onto poly(2,6-dimethyl-1,4-phenylene oxide) nanofibers with Poly(N-isopropylacrylamide) grafts as reversibly fluorescence immunoassay

Publication date: December 2018
Source:Dyes and Pigments, Volume 159
Author(s): Jian-Wei Guo, Yi-Hui Wu, Po-Li Wei, Yan-Jiun Huang, Jem-Kun Chen
In this study a reversibly fluorescence immunoassay was prepared through grafting, using hydrogen bonding, of an antibody-conjugated ZnS quantum dots (ZQD-antiHA) onto an electrospun poly (2,6-dimethyl-1,4-phenylene oxide) (PPO) fibrous mats (EPFM) with poly (n-isopropylacrylamide) (PNIPAAm) grafts. The PPO was first electrospun into a fibrous mat, then brominated and reacted with NaN3 to generate the azido-terminated EPFMs. A propargyl-terminated poly (n-isopropylacrylamide) (PNIPAAm) was synthesized and grafted onto the azido-terminated EPFMs. ZQDs were conjugated by antibodies (antiHA) to adsorb onto the PNIPAAm grafts of EPFMs with hydrogen bonding. Because of the stronger interaction between antigen (HA) and antibody (antiHA), the hydrogen bonding was blocked due to the introduction of the antigen which resulted in the desorption the ZQDs from the EPFMs. The blue fluorescence of the PNIPAAm-grafted EPFMs with antibody-conjugated ZQDs was disappeared while immersing in the solution of antigen. The 3.82 mg/m² of ZQDs on the PNIPAAm grafts EPFMs significantly reduced to 0.22 mg/m² after the immersion of the antigen solution which verified the transference of the ZQDs from EPFMs to the solution. The behavior of adsorption and desorption of the ZQDs was reversible up to five cycles. The revisable fluorescence immunoassay of EPFMs with PNIPAAm grafts experimentally exhibited a high potential in a simple setup for biosensing with its unique sensitivity and selectivity.



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Shock wave plasma generation in low pressure ambient gas from powder sample using subtarget supported micro mesh as a sample holder and its potential applications for sensitive analysis of powder samples

Publication date: November 2018
Source:Microchemical Journal, Volume 142
Author(s): Javed Iqbal, Marincan Pardede, Eric Jobiliong, Rinda Hedwig, Muliadi Ramli, Ali Khumaeni, Wahyu Setia Budi, Nasrullah Idris, Syahrun Nur Abdulmadjid, Kurnia Lahna, Mangasi Alion Marpaung, Indra Karnadi, Zener Sukra Lie, Hery Suyanto, Davy Putra Kurniawan, Tjung Jie Lie, Koo Hendrik Kurniawan, Kiichiro Kagawa, May On Tjia
We present in this report the results of experimental study on the spectrochemical analysis of powder samples using subtarget supported micro mesh (SSMM) sample holder in low pressure ambient gases. The study is substantiated by establishing the analyte excitation mechanism with the evidence of shock wave plasma generation and the high temperature induced subsequently required for the thermal excitation and emission of the ablated atoms. The application of SSMM sample holder using Cu subtarget and stainless steel micro mesh to a number of powder samples in low pressure ambient gases are shown to produce generally sharp emission lines with low background, without suffering from intensity reduction and matrix effect commonly found in the use of pelletized powder samples. The same excellent spectral quality is demonstrated by its application to the analysis of rice samples which is the major staple diets in a large number of countries. In particular the analysis of Zn in rice is shown to exhibit a linear calibration line with extrapolated zero intercept and a detection limit of <0.87 μg/g which is promising for quantitative analysis.



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Safer anti-inflammatory therapy through dual COX-2/5-LOX inhibitors: A structure-based approach

Publication date: 30 August 2018
Source:European Journal of Pharmaceutical Sciences, Volume 121
Author(s): Jaismy Jacob P, S.L. Manju, K.R. Ethiraj, Geetha Elias
Inflammatory mediators of the arachidonic acid cascade from cyclooxygenase (COX) and lipoxygenase (LOX) pathways are primarily responsible for many diseases in human beings. Chronic inflammation is associated with the pathogenesis and progression of cancer, arthritis, autoimmune, cardiovascular and neurological diseases. Traditional non-steroidal anti-inflammatory agents (tNSAIDs) inhibit cyclooxygenase pathway non-selectively and produce gastric mucosal damage due to COX-1 inhibition and allergic reactions and bronchospasm resulting from increased leukotriene levels. 'Coxibs' which are selective COX-2 inhibitors cause adverse cardiovascular events. Inhibition of any of these biosynthetic pathways could switch the metabolism to the other, which can lead to fatal side effects. Hence, there is undoubtedly an urgent need for new anti-inflammatory agents having dual mechanism that prevent release of both prostaglandins and leukotrienes. Though several molecules have been synthesized with this objective, their unfavourable toxicity profile prevented them from being used in clinics. Here, this integrative review attempts to identify the promising pharmacophore that serves as dual inhibitors of COX-2/5-LOX enzymes with improved safety profile. A better acquaintance of structural features that balance safety and efficacy of dual inhibitors would be a different approach to the process of understanding and interpreting the designing of novel anti-inflammatory agents.

Graphical abstract

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Acute and chronic escitalopram alter EEG gamma oscillations differently: relevance to therapeutic effects

Publication date: 30 August 2018
Source:European Journal of Pharmaceutical Sciences, Volume 121
Author(s): Noémi Papp, Szilvia Vas, Emese Bogáthy, Zita Kátai, Diána Kostyalik, György Bagdy
Brain oscillations in the gamma frequency band of the electroencephalogram (EEG) have been implicated in several sensory and cognitive processes, and have also been associated with numerous neuropsychiatric disorders, including depression. The widely prescribed selective serotonin reuptake inhibitors (SSRIs), similarly to other antidepressants, are known to produce markedly different effects on sleep and behavioral measures with acute and chronic administration. Although there are studies examining the acute effect of escitalopram on slower (<30 Hz) oscillations, we hardly could find any data about the effect of the drug on higher-frequency EEG oscillations (>30 Hz) in different sleep-wake stages, particularly comparing the acute and chronic effects of the drug concerning gamma oscillations. Our aim was to investigate, how escitalopram affects gamma power in different sleep-wake stages, and to discover possible differential effects between acute and chronic treatment. EEG-equipped Wistar rats were treated with escitalopram or vehicle acutely (10 mg/kg, i.p.) or chronically (10 mg/kg/day for 21 days, osmotic minipumps) and frontoparietal EEG, electromyogram and motor activity were recorded during the first 3 h of passive phase. We found that acute and chronic escitalopram treatment affected gamma oscillations differently. While acute escitalopram caused a reduction in gamma power during rapid eye movement sleep (REMS) and intermediate stage of sleep (IS), chronic treatment caused an elevation in gamma power during non-REMS stages, namely in light and deep slow-wave sleep (SWS-1 and SWS-2, respectively) and in IS. However, gamma activity during active and passive wakefulness (AW and PW, respectively) was not influenced by either acute or chronic dosing of escitalopram. Furthermore, we found that in drug-free (vehicle-treated) rats, a relatively high gamma power was present during wakefulness and REMS, while a much lower power was measured during non-REMS stages. These findings indicate that acute and chronic administration of escitalopram alter gamma activity differently, moreover, in a sleep-wake stage dependent manner that may be related to differential therapeutic and/or side effects.

Graphical abstract

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Pityriasis Rosea during Pregnancy: Major and Minor Alarming Signs

Background: Pityriasis rosea (PR) is a self-limiting exanthematous disease associated with human herpesvirus (HHV)-6 and/or HHV-7 reactivation. In pregnant women, PR may be associated with pregnancy complications. Objective: To determine relevant risk factors in the development of negative pregnancy outcome in PR. Methods: Between 2005 and 2017 at the Department of Dermatology, University of Genoa, we recruited 76 women who developed PR during pregnancy. In 60 patients without known risk factors for intrauterine fetal death (30 with pregnancy complications and 30 without) we analyzed the pregnancy week of PR onset, presence of enanthem and of constitutional symptoms, PR body surface area involvement, age, and in 50 patients (20 with pregnancy complications and 30 without), the viral load of HHV-6 and HHV-7 (copies/mL). Results: In logistic regression analysis, early onset of PR (p = 0.0017) and enanthem (p = 0.0392) proved to be significantly associated with pregnancy complications. HHV-6 viral load (copies/mL) (p #x3c; 0.0001), constitutional symptoms (p #x3c; 0.001), and PR body surface area involvement (p #x3c; 0.004) were also significantly associated with pregnancy complications. Conclusion: The onset of PR before week 15 and enanthem may be considered major risk factors that should alarm the dermatologist. Constitutional symptoms and involvement of #x3e; 50% of the body area may be considered minor risk factors.
Dermatology

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Spontaneous hair regrowth in eight patients with severe alopecia areata

Australasian Journal of Dermatology, EarlyView.


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A risk-based approach to development of ultrasound-based high-dose-rate prostate brachytherapy quality management

Publication date: Available online 21 June 2018
Source:Brachytherapy
Author(s): Joel Poder, Ryan Brown, Andrew Howie, Johnson Yuen, Anna Ralston, Kristine Schreiber, Andrej Bece, Joseph Bucci
PurposeThe purpose of this study was to apply a risk-based approach to the development of a quality management (QM) program for ultrasound-based high-dose-rate (HDR) prostate brachytherapy (pBT) treatment planning and delivery.Methods and MaterialsA QM program was developed by a multidisciplinary team, using both an in-house risk-and-benefit balance impact template (RABBIT) tool and a failure modes and effect analysis (FMEA). FMEA scores were determined by three physicists, one radiation therapist and two radiation oncologists who were familiar with the protocol. The QM program produced by both risk-based techniques was then compared and consolidated.ResultsThe RABBIT tool identified 26 potential risks during the treatment planning and delivery process. During the FMEA, a total of 35 potential failure modes were identified from the seven major processes in ultrasound-based HDR pBT. For the 35 potential failure modes, risk priority number scores ranged from 14 to 267. The highest ranked failure mode was identified to be mislabeling/connection of the transfer tubes/catheters. From the risks analyses, a comprehensive QM program was developed.ConclusionBoth the RABBIT tool and process mapping and FMEA were shown to be valuable tools in developing a QM program for ultrasound-based HDR pBT treatments. A considerable number of the potential failure modes identified in both tools were related to human or procedural errors, highlighting the importance of checklists and protocols in delivering a safe and effective ultrasound-based HDR pBT treatment.



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The Insidious Number Two

Publication date: Available online 21 June 2018
Source:Trends in Cognitive Sciences
Author(s): David E. Melnikoff, John A. Bargh




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The Mythical Dual-Process Typology

Publication date: Available online 21 June 2018
Source:Trends in Cognitive Sciences
Author(s): Gordon Pennycook, Wim De Neys, Jonathan St. B.T. Evans, Keith E. Stanovich, Valerie A. Thompson




https://ift.tt/2tvzHX4

Rapid disease progression in a patient with mismatch repair-deficient and cortisol secreting adrenocortical carcinoma treated with pembrolizumab

Publication date: Available online 21 June 2018
Source:Seminars in Oncology
Author(s): R.T. Casey, O. Giger, I. Seetho, A. Marker, D. Pitfield, L.H. Boyle, M. Gurnell, A. Shaw, M. Tischowitz, E.R. Maher, V.K. Chatterjee, T. Janowitz, G. Mells, P. Corrie, B.G. Challis
Context: Metastatic adrenocortical carcinoma (ACC) is an aggressive malignancy with a poor prognosis and limited therapeutic options. A subset of ACC is due to Lynch syndrome, an inherited tumor syndrome resulting from germline mutations in mismatch repair (MMR) genes. It has been demonstrated that several cancers characterized by MMR-deficiency are sensitive to immune checkpoint inhibitors that target PD-1. Here, we provide the first report of PD-1 blockade with pembrolizumab in a patient with Lynch syndrome and progressive cortisol-secreting metastatic ACC.Case report: A 58-year old female with known Lynch syndrome who presented with severe Cushing's syndrome was diagnosed with a cortisol-secreting ACC. Three months following surgical resection and adjuvant mitotane therapy the patient developed metastatic disease and persistent hypercortisolemia. She commenced pembrolizumab, but her second cycle was delayed due to a transient transaminitis. Computed tomography performed after twelve weeks and 2 cycles of pembrolizumab administration revealed significant disease progression and treatment was discontinued. Seven weeks later, the patient became jaundiced and died rapidly with fulminant liver failure.Conclusion: Treatment of MMR-deficient cortisol-secreting ACC with pembrolizumab may be ineffective due to supra-physiological levels of circulating corticosteroids, which may in turn mask severe drug-induced organ damage.



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Scholar : New articles have been published for AIDS Care, Volume 30, Issue sup1

The online platform for Taylor & Francis Online content The following articles have been newly published in the issue AIDS Care, Volume 30, Issue sup1 on Taylor & Francis Online: A METHODOLOGICAL Considerations Article Using a retention in care protocol to promote positive health and systems related outcomes Alfred A. Larbi, Freya Spielberg, Nnemdi Kamanu Elias, Erin Athey, Ngozi Ogbuawa, Nancy Murphy Pages: 1-7 | DOI: 10.1080/09540121.2018.1465173 HIV-associated cognitive disorders in perinatally infected children and adolescents: a novel composite cognitive domains score Nicole J. Phillips, Jacqueline Hoare, Dan J. Stein, Landon Myer, Heather J. Zar, Kevin G. F. Thomas Pages: 8-16 | DOI: 10.1080/09540121.2018.1466982 Original Articles Barriers to antiretroviral therapy adherence in developed countries: a qualitative synthesis to develop a conceptual framework for a new patient-reported outcome measure | Kim Engler, Andras Lènàrt, David Lessard, Isabelle Toupin, Bertrand Lebouché Pages: 17-28 | DOI: 10.1080/09540121.2018.1469725 The issue is in progress. To view all articles already published in this issue, please visit: https://www.tandfonline.com/toc/caic20/30/sup1 FREE ACCESS: Health Care for Women International: Research on Women's Health in Africa: Issues, Challenges & Opportunities To update which email alerts you receive, manage your alerts within the My Account area. You can also unsubscribe from this alert with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

CLASP Suppresses Microtubule Catastrophes through a Single TOG Domain

Publication date: Available online 21 June 2018
Source:Developmental Cell
Author(s): Amol Aher, Maurits Kok, Ashwani Sharma, Ankit Rai, Natacha Olieric, Ruddi Rodriguez-Garcia, Eugene A. Katrukha, Tobias Weinert, Vincent Olieric, Lukas C. Kapitein, Michel O. Steinmetz, Marileen Dogterom, Anna Akhmanova
The dynamic instability of microtubules plays a key role in controlling their organization and function, but the cellular mechanisms regulating this process are poorly understood. Here, we show that cytoplasmic linker-associated proteins (CLASPs) suppress transitions from microtubule growth to shortening, termed catastrophes, including those induced by microtubule-destabilizing agents and physical barriers. Mammalian CLASPs encompass three TOG-like domains, TOG1, TOG2, and TOG3, none of which bind to free tubulin. TOG2 is essential for catastrophe suppression, whereas TOG3 mildly enhances rescues but cannot suppress catastrophes. These functions are inhibited by the C-terminal domain of CLASP2, while the TOG1 domain can release this auto-inhibition. TOG2 fused to a positively charged microtubule-binding peptide autonomously accumulates at growing but not shrinking ends, suppresses catastrophes, and stimulates rescues. CLASPs suppress catastrophes by stabilizing growing microtubule ends, including incomplete ones, preventing their depolymerization and promoting their recovery into complete tubes. TOG2 domain is the key determinant of these activities.

Graphical abstract

Teaser

Aher et al. dissect the mechanisms underlying the ability of CLASPs, major microtubule-stabilizing factors in interphase and mitosis, to prevent microtubule from switching from growth to shortening. They show that the CLASP domain essential for this function does not bind to free tubulin but directly stabilizes growing microtubule ends.


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Local Arrangement of Fibronectin by Myofibroblasts Governs Peripheral Nuclear Positioning in Muscle Cells

Publication date: Available online 21 June 2018
Source:Developmental Cell
Author(s): William Roman, João P. Martins, Edgar R. Gomes
Skeletal muscle cells (myofibers) are rod-shaped multinucleated cells surrounded by an extracellular matrix (ECM) basal lamina. In contrast to other cell types, nuclei in myofibers are positioned just below the plasma membrane at the cell periphery. Peripheral nuclear positioning occurs during myogenesis and is driven by myofibril crosslinking and contraction. Here we show that peripheral nuclear positioning is triggered by local accumulation of fibronectin secreted by myofibroblasts. We demonstrate that fibronectin via α5-integrin mediates peripheral nuclear positioning dependent on FAK and Src activation. Finally, we show that Cdc42, downstream of restricted fibronectin activation, is required for myofibril crosslinking but not myofibril contraction. Thus we identify that local activation of integrin by fibronectin secreted by myofibroblasts activates peripheral nuclear positioning in skeletal myofibers.

Teaser

A hallmark of skeletal muscle cells is the position of nuclei at the cell periphery. Roman et al. show that myofibroblasts deposit extracellular components—fibronectin—at the surface of developing muscle cells to locally attract myonuclei to the cell periphery.


https://ift.tt/2MOJZL5

Membrane Flow Drives an Adhesion-Independent Amoeboid Cell Migration Mode

Publication date: Available online 21 June 2018
Source:Developmental Cell
Author(s): Patrick R. O'Neill, Jean A. Castillo-Badillo, Xenia Meshik, Vani Kalyanaraman, Krystal Melgarejo, N. Gautam
Cells migrate by applying rearward forces against extracellular media. It is unclear how this is achieved in amoeboid migration, which lacks adhesions typical of lamellipodia-driven mesenchymal migration. To address this question, we developed optogenetically controlled models of lamellipodia-driven and amoeboid migration. On a two-dimensional surface, migration speeds in both modes were similar. However, when suspended in liquid, only amoeboid cells exhibited rapid migration accompanied by rearward membrane flow. These cells exhibited increased endocytosis at the back and membrane trafficking from back to front. Genetic or pharmacological perturbation of this polarized trafficking inhibited migration. The ratio of cell migration and membrane flow speeds matched the predicted value from a model where viscous forces tangential to the cell-liquid interface propel the cell forward. Since this mechanism does not require specific molecular interactions with the surrounding medium, it can facilitate amoeboid migration observed in diverse microenvironments during immune function and cancer metastasis.

Teaser

O'Neill et al. use optogenetic control of two distinct migration modes to address the question of how propelling forces are generated during adhesion-independent cell migration. They show that rearward plasma membrane flow generates tangential viscous forces at the cell-liquid interface to drive the cell forward.


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Randomized clinical trial of the effects of azithromycin use in the treatment of peri‐implantitis

Australian Dental Journal, EarlyView.


https://ift.tt/2yxEvkN

What's New Online

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7





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Changes in the National Diabetes Prevention Program Present Opportunities for Registered Dietitian Nutritionists to Reduce the Prevalence of Diabetes

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7
Author(s): Annalynn Skipper, Christopher Holliday




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Table of Contents

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7





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Child Feeding Style and Dietary Outcomes in a Cohort of Latino Farmworker Families

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7
Author(s): Edward H. Ip, Sarah A. Marshall, Thomas A. Arcury, Cynthia K. Suerken, Grisel Trejo, Joseph A. Skelton, Sara A. Quandt
BackgroundThe high level of obesity in Latino children, especially in farmworker families, may be partly attributed to feeding styles of parents. Feeding styles used in Latino farmworker families have not been well characterized.ObjectiveThis study sought to identify and describe feeding styles used by mothers in farmworker families with 2.5- to 3.5-year-old children, describe how styles change over time, and characterize the relationship of feeding styles to dietary outcomes and measures of overweight and obesity.DesignThis was a longitudinal cohort study, with families participating for a 2-year period; surveys were administered to mothers with varying frequency depending on the instrument, and dietary measurements were collected at baseline and 12 and 24 months.Participants/settingEligible participants were self-identified Latino women with a co-resident child aged 2.5 to 3.5 years old and at least one household member engaged in farm work during the previous year. The sample included 248 farmworker families enrolled between 2011 and 2012 in the Niños Sanos study, a longitudinal investigation of Latino mothers and their young children in rural North Carolina. Eleven families provided incomplete dietary data, so the analysis included 237 families. Fifteen families were lost to follow-up and 12 withdrew during the course of the study.Main outcome measuresFeeding style was assessed using items from the Caregiver's Feeding Style Questionnaire, selected dietary components were assessed using the Revised Children's Diet Quality Index, and weight outcomes were determined using body mass index-for-age percentile. Performance on the Caregiver's Feeding Style Questionnaire items was used to assign mothers to one of four feeding style states.Statistical analyses performedExploratory factor analysis was conducted on baseline data to verify the replicability of the factor structure of the instrument Caregiver's Feeding Style Questionnaire. Hidden Markov Model analysis was used to delineate different subtypes of feeding style. Multivariable mixed-effects regression models were used to assess the impact of feeding style on selected dietary components, energy intake, and body mass index-for-age percentile.ResultsFour distinct states emerged from the Hidden Markov Model: low parent-centered (PC)/moderate child-centered (CC) feeding style (28% at baseline), high PC/CC without physical control (24%), high PC/CC (26%), and moderate PC/CC (22%). The low PC/moderate CC state increased in prevalence over time. Compared to high PC/CC, the low PC/moderate CC state was associated with greater intake of added sugars (P<0.01), lower intake of whole grains and vegetables (P<0.01), and lower overall diet quality (P<0.05). Children in low PC/moderate CC also had higher mean body mass index percentiles (76.2 percentile vs 66.7 percentile in high PC/CC; P<0.001).ConclusionsHigh PC feeding along with high CC feeding is associated with improved diet quality and weight outcomes for children in the study.



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Trends in Fast-Food and Sugar-Sweetened Beverage Consumption and Their Association with Social Environmental Status in South Korea

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7
Author(s): Hyunjung Lim, Hae Jeoung Lee, Ryowon Choue, Youfa Wang
BackgroundAs South Korea has enjoyed rapid economic development, Koreans' diet, particularly consumption of fast food (FF) and sugar-sweetened beverages (SSBs), has changed.ObjectiveTo examine time trends in FF and SSB consumption and their associations with social environmental status (SEnS) in South Korea.DesignKorean National Health and Nutrition Examination Surveys (KNHANES) were a series of population-based cross-sectional surveys.ParticipantsData from the KNHANES conducted in 1998, 2001, 2005, and 2007-2009 for 49,826 Koreans aged ≥1 year were used.Main outcome measuresConsumption of FF and SSBs were assessed by a 24-hour recall. We defined two FF categories (Western-style and Korean-style) and one SSB category. Sex, age, household income, and residence regions were investigated.Statistical analyses performedThe primary sampling units, strata, and sampling weights were taken into account using SAS survey-related procedures. Logistic regression models were used to test associations between SEnS and FF consumption.ResultsOver an 11-year period, the proportion of participants' who consumed Western FF and SSBs on the surveyed day doubled (P<0.05). Per capita energy contribution from Western FF also increased in adults, men, and low-income groups. SSB consumption doubled (per capita: 32 to 82 kcal/day, only consumers: 123 to 166 kcal/day), but consumption of Korean-style FF decreased (P<0.05). Compared with the low-income rural resident group, the high-income urban resident group was much more likely to consume Western FF (OR=26.7[3.7, 193.4]) and SSBs (odds ratio [OR]=3.1 [2.4, 4.1]) in 1998. However, in recent years, the patterns changed; the high-income urban resident group was more likely to consume Korean-style FF (OR=2.0[1.3, 2.9]) and SSBs (OR=1.7[1.3, 2.1]).ConclusionsIn South Korea, people who reported consuming Western FF and SSBs on the surveyed day almost doubled during 1998-2009, whereas those who consumed Korean FF decreased. SEnS was related to FF and SSB consumption.



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Inuit Country Food Diet Pattern Is Associated with Lower Risk of Coronary Heart Disease

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7
Author(s): Xue Feng Hu, Tiff-Annie Kenny, Hing Man Chan
BackgroundInuit have experienced a rapid transition in diet and lifestyle over the past several decades, paralleled by the emergence of chronic diseases such as obesity, diabetes, and hypertension.ObjectiveTo identify contemporary dietary patterns among Inuit and investigate their association with cardiovascular disease outcomes.DesignThis was an association study in a cross-sectional population health and nutrition survey.ParticipantsThe participants included 1,570 adults (aged ≥18 years) from Nunavut in the International Polar Year Inuit Health Survey 2007-2008 who completed diet/health questionnaires and provided blood samples.Main outcome measuresOutcomes measured included the prevalence of coronary heart disease, myocardial infarction, stroke, hyperlipidemia, and hypertension.Statistical analyses performedPrincipal component analysis was used to derive dietary patterns based on the consumption of nine market food groups and four country food groups reported in 24-hour dietary recalls. The associations between cardiovascular outcomes and identified dietary patterns were examined with logistic regression.ResultsThree dietary patterns were identified: market food, country food–fat, and country food–fish. The market food diet, characterized by high consumption of market-bought meat, cereals, vegetables, and added oil, was associated with elevated prevalence of coronary heart disease, myocardial infarction, and hypertension (odds ratio [OR] 1.44, 95% CI 0.82 to 2.51; OR 2.27, 95% CI 0.88 to 5.83; and OR 1.36, 95% CI 0.88 to 2.09). The country food–fish diet, characterized by high fish consumption and low sugar and sweets intake, was inversely associated with the prevalence of coronary heart disease, myocardial infarction, stroke, and hyperlipidemia (OR 0.78, 95% CI 0.43 to 1.37; OR 0.46, 95% CI 0.18 to 1.20; OR 0.34, 95% CI 0.07 to 2.13; and OR 0.69, 95% CI 0.39 to 1.22). The country food–fat diet, characterized by high marine mammal and added fat intake, was positively associated with the prevalence of coronary heart disease.ConclusionsA diet featuring high food variety, high fish intake, and low sugar intake was negatively associated with the prevalence of cardiovascular outcomes among Inuit.



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Position of the Academy of Nutrition and Dietetics: Benchmarks for Nutrition in Child Care

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7
Author(s): Sara E. Benjamin-Neelon
It is the position of the Academy of Nutrition and Dietetics that early care and education (ECE) programs should achieve recommended benchmarks to meet children's nutrition needs and promote children's optimal growth in safe and healthy environments. Children's dietary intake is influenced by a number of factors within ECE, including the nutritional quality of the foods and beverages served, the mealtime environments, and the interactions that take place between children and their care providers. Other important and related health behaviors that may influence the development of obesity include children's physical activity, sleep, and stress within child care. Recent efforts to promote healthy eating and improve other health behaviors in ECE include national, state, and local policy changes. In addition, a number of interventions have been developed in recent years to encourage healthy eating and help prevent obesity in young children in ECE. Members of the dietetics profession, including registered dietitian nutritionists and nutrition and dietetics technicians, registered, can work in partnership with ECE providers and parents to help promote healthy eating, increase physical activity, and address other important health behaviors of children in care. Providers and parents can serve as role models to support these healthy behaviors. This Position Paper presents current evidence and recommendations for nutrition in ECE and provides guidance for registered dietitian nutritionists; nutrition and dietetics technicians, registered; and other food and nutrition practitioners working with parents and child-care providers. This Position Paper targets children ages 2 to 5 years attending ECE programs and highlights opportunities to improve and enhance children's healthy eating while in care.



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July 2018 People & Events

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7





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Erratum

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7





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July 2018 New in Review

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7





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July 2018 Sites in Review

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7





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July 2018 Classified Advertisements

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7





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What Is a National Provider Identifier and Why Does Every Dietetics Practitioner Need One?

Publication date: July 2018
Source:Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 7
Author(s): Mara Bujnowski




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Construction and application of oligo-based FISH karyotype of Haynaldia villosa

Publication date: Available online 21 June 2018
Source:Journal of Genetics and Genomics
Author(s): Sun Haojie, Song Jingjing, Lei Jia, Song Xinying, Dai Keli, Xiao Jin, Yuan Chunxia, An Shengmin, Wang Haiyan, Wang Xiue




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A model prediction of long-term prognosis in patients with centrally located hepatocellular carcinoma undergoing hepatectomy

Publication date: Available online 21 June 2018
Source:European Journal of Surgical Oncology
Author(s): Yang Yantong, Liu Shan, Chu Zhijie, Zheng Youwei
Background and ObjectivesThe prognostic prediction for centrally located hepatocellular carcinoma (CL-HCC) after hepatectomy has not been well established. We aimed to develop prognostic nomograms for patients undergoing hepatectomy for CL-HCC.MethodsA cohort of 380 patients who underwent curative hepatectomy for CL-HCC at our hospital between 2009 and 2015 were retrospectively studied. We randomly divided the subjects into training (n = 210) and validation (n = 170) groups. Univariate and multivariate survival analysis were used to identify prognostic factors. Visually orientated nomograms were constructed using Cox proportional hazards models. The performance of the nomogram was evaluated by the area under the ROC curve (AUC), calibration curve and compared with the conventional staging systems.ResultsThe statistical nomogram for OS built on the basis of ALBI grade, tumor number, tumor size, classification, hepatectomy methods, capsule formation and microvascular invasion (MVI) had good calibration and discriminatory abilities, with AUC of 0.746 (65-month survival). The nomogram for DFS was based on tumor number, tumor size, classification, HBV-DNA load, capsule formation and MVI, with AUC of 0.733 (65-month survival). These nomograms showed satisfactory performance in the validation cohort (AUC, 0.733 for 65-month OS; and 0.702 for 65-month DFS). The AUC of our nomograms were greater than those of conventional staging systems in the validation cohort.ConclusionThe established nomograms might be useful for estimating survival for patients with CL-HCC after liver resection.



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Contributors

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4





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Contents

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4





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CME Accrediation Page

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4





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Multi-Energy CT: The New Frontier in Imaging

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4
Author(s): Savvas Nicolaou, Mohammed F. Mohammed




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Multienergy Computed Tomography: A New Horizon in Computed Tomographic Imaging

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4
Author(s): Savvas Nicolaou, Mohammed F. Mohammed




https://ift.tt/2tuT2Id

Dual-Energy Computed Tomography

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4
Author(s): Alec J. Megibow, Avinash Kambadakone, Lakshmi Ananthakrishnan

Teaser

Dual energy computed tomography has been available for more than 10 years; however, it is currently on the cusp of widespread clinical use. The way dual energy data are acquired and assembled must be appreciated at the clinical level so that the various reconstruction types can extend its diagnostic power. The type of scanner that is present in a given practice dictates the way in which the dual energy data can be presented and used. This article compares and contrasts how dual source, rapid kV switching, and spectral technologies acquire and present dual energy reconstructions to practicing radiologists.


https://ift.tt/2MMivFL

Dual-Energy Computed Tomography in Cardiothoracic Vascular Imaging

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4
Author(s): Domenico De Santis, Marwen Eid, Carlo N. De Cecco, Brian E. Jacobs, Moritz H. Albrecht, Akos Varga-Szemes, Christian Tesche, Damiano Caruso, Andrea Laghi, Uwe Joseph Schoepf

Teaser

Dual energy computed tomography is becoming increasingly widespread in clinical practice. It can expand on the traditional density-based data achievable with single energy computed tomography by adding novel applications to help reach a more accurate diagnosis. The implementation of this technology in cardiothoracic vascular imaging allows for improved image contrast, metal artifact reduction, generation of virtual unenhanced images, virtual calcium subtraction techniques, cardiac and pulmonary perfusion evaluation, and plaque characterization. The improved diagnostic performance afforded by dual energy computed tomography is not associated with an increased radiation dose. This review provides an overview of dual energy computed tomography cardiothoracic vascular applications.


https://ift.tt/2txTyFs

Role of Dual-Energy Computed Tomography in Thoracic Oncology

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4
Author(s): Erika G. Odisio, Mylene T. Truong, Cihan Duran, Patricia M. de Groot, Myrna C. Godoy

Teaser

Dual-energy CT (DECT) is an emerging technology that has potential to enhance diagnostic performance and radiologists' confidence in the evaluation of thoracic malignancies. DECT clinical applications include characterization of solitary pulmonary nodule, lung masses and mediastinal tumors. DECT-derived iodine uptake quantification may assist in characterization of tumor differentiation and gene expression. The use DECT in oncology has potential to improve lung cancer staging, therapy planning, and assessment of response to therapy as well as detection of incidental pulmonary embolism.


https://ift.tt/2tk1St4

Practical Applications of Dual-Energy Computed Tomography in the Acute Abdomen

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4
Author(s): Mohammed F. Mohammed, Khaled Y. Elbanna, Abdelazim M.E. Mohammed, Nicolas Murray, Fahad Azzumea, Ghassan Almazied, Savvas Nicolaou

Teaser

With new developments in workflow automation, as well as technological advances enabling faster imaging with improved image quality and dose profile, dual-energy computed tomography is being used more often in the imaging of the acutely ill and injured patient. Its ability to identify iodine, differentiate it from hematoma or calcification, and improve contrast resolution has proven invaluable in the assessment of organ perfusion, organ injury, and inflammation.


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The Role of Dual-Energy Computed Tomography in Assessment of Abdominal Oncology and Beyond

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4
Author(s): Desiree E. Morgan

Teaser

The added value and strength of dual energy computed tomography for the evaluation of oncologic patients revolve around the use of lower energy reconstructed images and iodine material density images. Lower keV simulated monoenergetic images optimize soft tissue tumor to nontumoral attenuation differences and increase contrast to noise ratios to improve lesion detection. Iodine material density images or maps are helpful from a qualitative standpoint for image interpretation because they result in improved detection and characterization of tumors and lymph node involvement, and from a quantitative assessment by enabling interrogation of specific properties of tissues to predict and assess therapeutic response.


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Advanced Musculoskeletal Applications of Dual-Energy Computed Tomography

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4
Author(s): William D. Wong, Samad Shah, Nicolas Murray, Frances Walstra, Faisal Khosa, Savvas Nicolaou

Teaser

Dual-energy CT (DECT) is a rapidly growing tool in musculoskeletal radiology. It has been validated as an accurate imaging modality for the assessment of gout and bone marrow edema. DECT can be used to reduce metal artifacts. A few studies have shown its ability to calculate bone mineral density and examine pathologic states in tendons and ligaments. Its capacity for material separation suggests its emergence as a technique for arthrography, and for the evaluation of intervertebral discs and other inflammatory arthropathies.


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Dual-Energy Computed Tomography

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4
Author(s): Anushri Parakh, Francesco Macri, Dushyant Sahani

Teaser

Evolution in computed tomography technology and image reconstruction have significantly changed practice. Dual energy computed tomography is being increasingly adopted owing to benefits of material separation, quantification, and improved contrast-to-noise ratio. The radiation dose can match that from single energy computed tomography. Spectral information derived from a polychromatic x-ray beam at different energies yields in image reconstructions that reduce the number of phases in a multiphasic examination and decrease the absolute amount of contrast media. This increased analytical and image processing capability provides new avenues for addressing radiation dose and iodine exposure concerns.


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Pearls, Pitfalls, and Problems in Dual-Energy Computed Tomography Imaging of the Body

Publication date: July 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 4
Author(s): Jeremy R. Wortman, Aaron D. Sodickson

Teaser

Dual-energy computed tomography (DECT) is an exciting technology that is increasing in routine use and has the potential for significant clinical impact. With the advancement of DECT, it is important for radiologists to be aware of potential challenges with DECT acquisition and postprocessing, and to have a basic knowledge of unique artifacts and diagnostic pitfalls that can occur when interpreting DECT scans and DECT postprocessed images. This article serves as a practical overview of potential problems and diagnostic pitfalls associated with DECT, and steps that can be taken to avoid them.


https://ift.tt/2yxjg2j

3D printing high density ceramics using binder jetting with nanoparticle densifiers

Publication date: 5 October 2018
Source:Materials & Design, Volume 155
Author(s): Pragnya Kunchala, Keerti Kappagantula
This study examines the effects of nanoparticle densifiers added to printing liquid on the mechanical performance and manufacturability of ceramics made using binder jetting. "Green" alumina samples were synthesized with filler particles of average particle size 40 μm embedded with nanoparticles of average size of 50 nm suspended in the printing liquid with varying concentration of 0–15 wt%. Samples were characterized for density, porosity, compressive strength, and printing liquid penetration depth in the filler powder layer assessed using surface tension testing. Results showed that the presence of the nanoparticle had a marked effect on the physical and mechanical properties of the samples whose relative density increased by about 30%. MicroCT imaging of the samples showed a decrease in interparticle pores with an addition of 15 wt% alumina nanoparticles. Compressive strength improved by 743%, from 76 kPa to 641 kPa as the densifier content was increased from 0 to 15 wt%. Surface tension of the printing liquid decreased from 44 mN/m to 23 mN/m with increasing densifier concentration from 0 to 15 wt% indicating that the penetration depth of the printing liquid would decrease with increasing densifier content. Implications of this approach on high density ceramic part printing efficiency are discussed in detail.

Graphical abstract

https://ift.tt/2MM9ufK

Formation and oxidation resistance of a new YSZ modified silicide coating on Mo-based alloy

Publication date: 5 October 2018
Source:Materials & Design, Volume 155
Author(s): Zhenyang Cai, Yonghuang Wu, Huyun Liu, Gengyu Tian, Rong Pu, Shengming Piao, Xinyang Tang, Sainan Liu, Xiaojun Zhao, Lairong Xiao
A new YSZ (yttria stabilized zirconia) modified silicide coating was prepared on Mo-based alloy through a two-step process, including spraying of Si-Mo-YSZ slurry followed by reaction sintering. Microstructure and oxidation behavior of the coatings with different YSZ content (0, 5, 10 and 15%) were studied. The coating consists of a MoSi2-ZrSi2-SiO2 outer layer and a MoSi2 inner layer. The 10% YSZ modified coating possessed the best oxidation protection at ultra-high temperatures and, for the coating, the mass gain was 0.96 mg/cm² after being exposed at 1725 °C in air for 22 h, whereas the uncoated Mo-based alloy completely ablated for 0.35 h. The excellent oxidation resistance of the silicide coating was attributed to the compact and self-healing SiO2 protective scale, which contained the dispersed ZrO2 and ZrSiO4.

Graphical abstract

https://ift.tt/2yHr9Td

Programmable morphing composites with embedded continuous fibers by 4D printing

Publication date: 5 October 2018
Source:Materials & Design, Volume 155
Author(s): Qingrui Wang, Xiaoyong Tian, Lan Huang, Dichen Li, Andrei V. Malakhov, Alexander N. Polilov
Controllable morphing is still a challenge in the field of 4D printing. In this paper, a novel 4D printing technology of composites with embedded continuous fibers is introduced, and the bilayer prepared by this technology can realize programmable deformation with a high deformation accuracy. The deformation of the composite structure is caused by the difference of coefficients of thermal expansion (CTEs) between continuous fibers and flexible matrix. The angle between the intersecting fibers determines the size of the principal curvature, while the bisector of the angle of the fibers determines the direction of the principal curvature. Utilizing this rule, deformation of arbitrary deployable surface can be realized by designing the fiber trajectories. The high control accuracy of fiber orientation leads to a high deformation accuracy of 4D printed structure. The error between the theoretical value and the experimental value of the conical surface curvature is not more than 6%. In addition, the smart composite structure with the ability of temperature response and self-actuated deforming composite structure have also been prepared by this 4D printing process.

Graphical abstract

https://ift.tt/2tkkrNK

Current development of creep-resistant magnesium cast alloys: A review

Publication date: 5 October 2018
Source:Materials & Design, Volume 155
Author(s): Ning Mo, Qiyang Tan, Michael Bermingham, Yuanding Huang, Hajo Dieringa, Norbert Hort, Ming-Xing Zhang
The low creep resistance has been one of the major issues of Mg alloys, which limited their wider industrial applications in the past decades. It has been reported that the inherent creep resistance of Mg should be higher than that Al. Hence, it is highly likely that the low creep resistance of Mg alloys was attributed to the effects of alloying elements rather than Mg itself. In order to systematically understand the effects of alloying elements on the creep behaviours of cast Mg alloys and therefore to develop new alloys with higher creep resistance, the present work reviews the major creep-resistant Mg systems that were developed and successfully commercialized for applications at different temperatures. Because the majority of commercial Mg alloys are used as cast, this review focuses on cast alloys.

Graphical abstract

https://ift.tt/2ttJopj

Experimental analysis of an attenuation method for Hydrodynamic Ram effects

Publication date: 5 October 2018
Source:Materials & Design, Volume 155
Author(s): J.A. Artero-Guerrero, D. Varas, J. Pernas-Sánchez, J. López-Puente
The Hydrodynamic Ram (HRAM) phenomenon occurs when an object with a high-kinetic energy impacts against a fluid-filled structure, which could induce important damages. An attenuation technique would be of great interest for structures which could be subjected to impact. In this work, honeycomb panels are used to fill the entire space inside the structure in such a way that they are able to alleviate the loading onto it. Experimental tests were carried out varying aluminium honeycomb cells orientation, to determine the configuration that mitigates more efficiently the effects of HRAM comparing the results with a non-protected structure. The experimental tests were analysed using a high speed video camera, strain gauges, residual displacement of the structure walls and the deformation of the honeycomb panels. It is shown that for all the configurations, the honeycomb is able to reduce the plastic deformation of the structure. The honeycomb allows to reduce the cavity expansion in the fluid, which is the most dangerous phenomenon in the studied cases. The best configuration is able to diminish up to 54% the residual expanded volume in the structure walls, and hence considerably attenuating the HRAM effect on the structure.

Graphical abstract

https://ift.tt/2tfuIL5

Involvement of CD8+ T cell subsets in early response to vascular injury in patients with peripheral arterial disease in vivo

Publication date: Available online 21 June 2018
Source:Clinical Immunology
Author(s): Pawel Maga, Tomasz P. Mikolajczyk, Lukasz Partyka, Mateusz Siedlinski, Mikolaj Maga, Marek Krzanowski, Krzysztof Malinowski, Kevin Luc, Rafal Nizankowski, Deepak L. Bhatt, Tomasz J. Guzik
AimsAdaptive immunity is critical in vascular remodelling following arterial injury. We hypothesized that acute changes in T cells at a percutaneous transluminal angioplasty (PTA) site could serve as an index of their potential interaction with the injured vascular wall.Methods and ResultsT cell subsets were characterised in 45 patients with Rutherford 3–4 peripheral arterial disease (PAD) undergoing PTA. Direct angioplasty catheter blood sampling was performed before and immediately after the procedure. PTA was associated with an acute reduction of α/β-TcR CD8+ T cells. Further characterisation revealed significant reduction in pro-atherosclerotic CD28nullCD57+ cells, effector and effector memory cells, in addition to cells bearing activation and tissue homing/adhesion markers.ConclusionsThe acute reduction observed here is likely due to the adhesion of cells to the injured vascular wall, suggesting that immunosenescent, activated effector CD8+ cells have a role in the early vascular injury immune response following PTA in PAD patients.



https://ift.tt/2JYa649

Assessment of satellite-retrieved surface UVA and UVB radiation by comparison with ground-measurements and trends over Mega-city Delhi

Publication date: September 2018
Source:Atmospheric Environment, Volume 188
Author(s): Sachchidanand Singh, Neelesh K. Lodhi, Amit Kumar Mishra, Sandhya Jose, S. Naresh Kumar, R.K. Kotnala
Solar UV radiation reaching the Earth's surface is known to have various effects on human health and on the ecosystem. Ground-based measurements of surface UV radiation are spatially sparse and in many cases do not provide long time series. Higher spatial coverage can be provided by measurements from satellite based instruments, but these measurements need to be compared to ground-based measurements of sufficient quality before they can be used in health and ecosystem applications. Here, we compare the measurements of surface solar UV radiation in UVA (315–400 nm) and UVB (280–315 nm) bands with the satellite retrievals (CERES) and validate the latter at an urban location, Delhi, India. We have also used MODIS-retrieved aerosol optical depth (AOD) and cloud optical depth (COD) data to see the effect of atmospheric opacity on UV radiation. Ground-based measurements of UVA and UVB were performed from 01 October, 2012 to 30 September, 2015. Correlations between daily surface measurements and CERES-derived surface UV fluxes showed very good agreement (r ∼ 0.92–0.93) over Delhi. We found a negative correlation between UV fluxes and AOD over Delhi during all seasons. A unit increase in AOD leads to a decrease of ∼4–5 Wm^-2 in UVA and ∼0.09–0.14 Wm^-2 in UVB over Delhi. The trend analysis from monthly mean CERES-derived UV fluxes for 17 years data reveals that UVA and UVB are decreasing ∼0.07 Wm^-2 yr⁻¹ and 0.003 Wm^-2 yr⁻¹, respectively with AOD increase (∼0.005 yr⁻¹) over Delhi. The simultaneous increase in aerosol loading with decrease in UV fluxes at the surface may be explained as a masking effect of ever increasing pollution on surface UV radiation over Delhi. Our results show ∼10% and ∼20% decrease (with respect to mean) in UVA and UVB surface fluxes, respectively during last 17 years.



https://ift.tt/2lsdoOo

Organic molecular tracers in atmospheric PM1 at urban intensive traffic and background sites in two high-insolation European cities

Publication date: September 2018
Source:Atmospheric Environment, Volume 188
Author(s): B.L. van Drooge, M. Fontal, P. Fernández, M.A. Fernández, J. Muñoz-Arnanz, B. Jiménez, J.O. Grimalt
Atmospheric PM1 has an impact on health and the environment, and is highly variable. PM1 filter samples were collected in urban roof and street sites in two Mediterranean cities in Europe (Barcelona and Madrid) to study the spatial and temporal trends of primary and secondary organic tracer compounds. Both cities are exposed to modern urban emission sources with intensive traffic in their centers. Moreover, their geographical situation in the Mediterranean region favors photo-chemical reactions and accumulation of secondary aerosols, due to sunny anti-cyclonic weather conditions. Barcelona is located along the coast with high relative humidity and an active sea-mountain breeze system, while the relative humidity in Madrid is low in summer, due to its location in the center of the Iberian Peninsula. These differences may influence the accumulation of primary air pollutants and the formation of secondary aerosols. In street site samples, the levels of primary organics, such as polycyclic aromatic hydrocarbons, hopanes and nicotine, were about two times higher than those collected simultaneously at roof sites. Primary emitted levoglucosan and isomers from biomass burning were observed in higher concentrations in winter in both urban areas, but without significant difference between the road and roof sites samples, indicating regional transport of biomass smoke to the cities. Similar roof and street site sample concentrations were also observed for secondary organic aerosol (SOA) compounds, i.e. dicarboxylic acids and oxidation products of isoprene and α-pinene. The SOA compound concentrations were ten times higher in summer compared to winter samples, emphasizing the importance of SOA formation processes in summer. More evidence was obtained that linked the presence of cis-pinonic acid in the filter samples to new particle formation during nucleation. The urban organic PM1 is dominated by SOA, while the primary organic aerosol (POA) tracer compounds from combustion sources, including traffic and biomass burning, dominates in winter.

Graphical abstract

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Characterization of mechanisms and processes controlling groundwater salinization in coastal semi-arid area using hydrochemical and isotopic investigations (Essaouira basin, Morocco)

Abstract

The aquifer system of Essaouira basin is recognized as one of the most important aquifers in Morocco. The purpose of this study is to highlight the origin and the mechanisms responsible for the salinization of this aquifer system, thus based on the two hydrogeochemical and isotopic approaches. The results indicate that the central and downstream parts are dominated by the facies Cl-Ca-Mg and SO₄-Ca-Mg with the dominance of the first facies, while the facies Cl-Ca-Mg, SO₄-Ca-Mg, and HCO₃-Ca-Mg dominate the upstream part with the dominance of the list facies. Hydrochemical approach shows that the groundwater mineralization in the study area is controlled by (i) the ion exchange phenomenon, under the marine intrusion and (ii) the dissolution of carbonate minerals (calcite, dolomite, and aragonite) and evaporate minerals (halite, gypsum, and anhydrite). High levels of NO₃ would come from domestic pollutants, including livestock waste during water withdrawal. The isotopic method shows (i) aquifers recharge in the study area is provided by Atlantic precipitation without significant evaporation, (ii) the presence of recent water (after nuclear tests) and other (before nuclear tests), and (iii) various recharge altitudes from 300 to 1150 m asl. However, this investigation provides a foundation for effective groundwater management and effective mitigation of aquifer impacts.

https://ift.tt/2yyOyG1

A systematic review and meta-analysis of clinicopathologic factors linked to oncologic outcomes for renal cell carcinoma with tumor thrombus treated by radical nephrectomy with thrombectomy

Publication date: Available online 21 June 2018
Source:Cancer Treatment Reviews
Author(s): Liangyou Gu, Hongzhao Li, Zihuan Wang, Baojun Wang, Qingbo Huang, Xiangjun Lyu, Dan Shen, Yu Gao, Yang Fan, Xintao Li, Yongpeng Xie, Songliang Du, Kan Liu, Lu Tang, Cheng Peng, Xin Ma, Xu Zhang
BackgroundThere remain discrepancies over the factors that influence oncologic outcomes after radical nephrectomy with thrombectomy (RNTE). To assess significant predictors of oncologic outcomes after RNTE from a systematic review and meta-analysis.MethodsA comprehensive search of PubMed, Embase, Cochrane Library and Web of Science was performed to identify eligible studies. The endpoints included cancer-specific survival (CSS), overall survival (OS), and recurrence-free survival (RFS). A formal meta-analysis was performed for studies containing non-metastatic and metastatic tumors. Additionally, a sensitivity analysis including the subgroup of studies containing non-metastatic tumors only was conducted. Cumulative analyses of hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were conducted.ResultsOverall, 35 retrospective studies of low to moderate risk of bias including 11,929 patients were included. The results indicated that large tumor size, high Fuhrman grade, tumor necrosis, positive lymph node, and metastasis at surgery were adverse significant predictors for both CSS and OS. Also, IVC tumor thrombus, sarcomatoid differentiation, perinephretic fat invasion, and adrenal gland invasion were associated with poor CSS. In the subset of non-metastatic patients, the significant predictors were clinical symptom, thrombus level, Fuhrman grade and adrenal gland invasion for CSS; thrombus consistency, Fuhrman grade and tumor necrosis for OS; tumor size, Fuhrman grade and perinephretic fat invasion for RFS.ConclusionsA meta-analysis of available data identified significant prognostic factors of CSS, OS and RFS that should be systematically evaluated to propose a risk-adapted approach to postoperative patient counseling, risk stratification, and therapy selection.



https://ift.tt/2Igl4wa

Checkpoint Inhibitors as Treatment for Malignant Gliomas: “A Long Way To the Top”

Publication date: Available online 21 June 2018
Source:Cancer Treatment Reviews
Author(s): Matteo Simonelli, Pasquale Persico, Matteo Perrino, Paolo Andrea Zucali, Pierina Navarria, Federico Pessina, Marta Scorsetti, Lorenzo Bello, Armando Santoro
Glioblastoma is the most common and lethal malignant brain tumor in adults, with a very poor prognosis of less than two years despite surgical resection followed by radiotherapy and chemotherapy. To date, targeted agents and antiangiogenic therapy have failed to show survival benefits and novel treatment approaches are urgently needed.Immune checkpoint inhibitors have recently revolutionized the landscape of cancer immunotherapy achieving regulatory approvals for a number of other 'historically' resistant cancers. These exciting successes have generated great interest in investigating if these agents could be such effective also in brain tumors field. Moreover, the traditional dogma that considers the central nervous system (CNS) as an immune-privileged site lacking the potential for immunosurveillance has been challenged as it has become clear that the CNS is immunoactive. Critical barriers to an effective antitumor immunity in brain tumor patients are still represented by the peculiar CNS immunological milieu and the numerous systemic and local immunosuppressive forces exhibited by malignant gliomas to avoid immune recognition and cellular death.This review describes the current status of checkpoint modulation as treatment for malignant gliomas. We start illustrating the compelling molecular and immunological rationale, than we show striking preclinical evidence of activity and discuss available data from prospective clinical trials. Furthermore, we explore the role of predictive biomarkers of responsiveness to checkpoint blockade in the context of gliomas, along with the development of combinatorial and potentially synergistic approaches with other established anti-cancer treatments or complementary immunotherapeutic modalities.



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