•SABR provides high rates of local control to lung oligometastases.•Local control of colorectal lung metastases seems lower compared to other tumors.•We identified predictive factors of SABR response ...and polymetastases development.•Predictive factors of local control are BED ≥125 Gy and lesion diameter ≤20 mm.•Having lesion >20 mm and 4–5 metastases predicted for a polymetastatic evolution.
Stereotactic ablative radiotherapy (SABR) has been shown to increase survival in oligometastatic disease, but local control of colorectal metastases remains poor. We aimed to identify potential predictive factors of SBRT response through a multicenter large retrospective database and to investigate the progression to the polymetastatic disease (PMD).
The study involved 23 centers, and was approved by the Ethical Committee (Prot. Negrar 2019-ZT). 1033 lung metastases were reported. Clinical and biological parameters were evaluated as predictive for freedom from local progression-free survival (FLP). Secondary end-point was the time to the polymetastatic conversion (tPMC).
Two-year FLP was 75.4%. Two-year FLP for lesions treated with a BED < 00 Gy, 100–124 Gy, and ≥125 Gy was 76.1%, 70.6%, and 94% (p = 0.000). Two-year FLP for lesion measuring ≤10 mm, 10–20 mm, and >20 mm was 79.7%, 77.1%, and 66.6% (p = 0.027). At the multivariate analysis a BED ≥125 Gy significantly reduced the risk of local progression (HR 0.24, 95%CI 0.11–0.51; p = 0.000). Median tPMC was 26.8 months. Lesions treated with BED ≥125 Gy reported a significantly longer tPMC as compared to lower BED. The median tPMC for patients treated to 1, 2–3 or 4–5 simultaneous oligometastases was 28.5, 25.4, and 9.8 months (p = 0.035).
The present is the largest series of lung colorectal metastases treated with SABR. The results support the use of SBRT in lung oligometastatic colorectal cancer patients as it might delay the transition to PMD or offer relatively long disease-free period in selected cases. Predictive factors were identified for treatment personalization.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
In a subgroup of hospitalized patients with an elevated
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-dimer level, there was no significant benefit for oral betrixaban over subcutaneous enoxaparin on venous thromboembolic events. However, in ...an exploratory analysis involving all the patients, a benefit was seen with betrixaban.
Patients who are hospitalized for acute medical illnesses such as pneumonia, stroke, and heart failure are at increased risk for venous thromboembolism.
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Prolonged immobilization and risk factors such as an elevated d-dimer level, an age of 75 years or older, cancer, or a history of venous thromboembolism increase this risk.
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Randomized, controlled trials of parenteral anticoagulants versus placebo in such hospitalized medical patients have shown a reduction of more than 50% in the rate of venous thromboembolism, including fatal pulmonary embolism, without an increase in major bleeding.
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Guidelines recommend the use of low-dose parenteral anticoagulants among patients at . . .
Microalgal growth largely affects the aesthetical properties of building façades worldwide. It causes biodeterioration of building materials and, in a later stage, it can compromise integrity of the ...elements and their durability. Recently, the use of nanotechnology to prevent the growth of microalgae is rising. One of the most widespread and promising material is titanium dioxide (TiO2). Photocatalytic properties of TiO2 inhibit biofouling of microalgae when this coating is stimulated by UV radiation coming from the sun or from artificial light. In this study, the biocide effect of TiO2 coatings applied on clay brick specimens under weak UV radiation was assessed. Results revealed that TiO2 nanocoating was not able to fully prevent microalgal biofouling, but under optimal UV exposure conditions for the growth of microalgae it efficaciously prevented the adhesion of these microorganisms on the treated substrates through the formation of a superficial water film. This property resulted in a good self-cleaning efficiency of TiO2.
•Effect of TiO2 on algal growth under low UV radiation is studied.•TiO2 is not able to fully prevent the biofouling of microorganism on the material.•TiO2 greatly enhances the self-cleaning ability of the brick surface due to water.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Abstract
The results of a collaborative development activity aimed to the realization of multi-cell detectors based on monolithic SDD pixel technology will be described. Two kind of detection ...systems, skilled for the light lines at synchrotrons, have been brought to high levels of finalization and integration; a 64 cells detection system dedicated to absorption spectroscopy (XAFS) and a 32 cells detector for the X-ray microscopy (TwinMic). The main targets of this effort, led in a tight collaboration with the beam lines scientists, were large sensitive area, high rate capabilities, state of the art efficiency and energy resolution. The aim is to reduce the beam time demand for each single measurement while delivering a cutting edge analytical power.
All basic elements of those detection systems, from the detector’s design and production to the front-end and read-out electronics including the final engineering of the integrated system were customized to the specific use addressed.
Production, characterization and control of polarization states of molecules (specifically, alignment and/or orientation) are of importance for investigating in detail the stereodynamics of ...elementary processes involving elastic, inelastic and reactive events and also to prepare targets for selective photodynamical investigations. The focus here is on those molecular beam techniques which show perspectives in the applications offering appealing features for "duty cycle" and intensity characteristics. After a review of the basic experimental advances, mainly obtained in the last ten years, the attention will be addressed to recent studies carried out on the collisional alignment of hydrocarbon molecules and on orientation of symmetric top molecules by exploiting honeycomb hexapole fields. The first case is a prototype of "natural" polarization techniques, the second one of those where polarization is "forced" by external fields.
After the manufacture and delivery of a state-of-the-art detection system for the XRF-XAFS beamline of the synchrotron light source SESAME, a new and improved detection system was realized. This new ...multichannel modular detection system based on Silicon Drift Detectors consists of 8 monolithic multipixel arrays, each comprising 8 SDD cells with a total area of 570 mm2. As the previous one, this 64 channels integrated detection system includes ultra-low-noise front-end electronics, dedicated acquisition system, digital filtering, temperature control and stabilization. With respect to the SESAME version, the new instrument implements a tungsten collimation system yielding a total collimated sensitive area of 500 mm2. Optimized to work in an energy range of 3–30 keV, the system shows an overall energy resolution (sum of its 64 cells) below 180 eV FWHM at the 5.9 Mn Kα line at room temperature. We highlight the system performance and in particular the peak to background ratio, before and after the collimation of the sensors.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
BACKGROUND:Stroke is a morbid and potentially mortal complication among patients hospitalized with acute medical illness. The potential of extended-duration thromboprophylaxis with the factor Xa ...inhibitor betrixaban to reduce the risk of stroke compared with standard-dose enoxaparin in this population was assessed in this retrospective APEX trial substudy (Acute Medically Ill Venous Thromboembolism Prevention With Extended Duration Betrixaban).
METHODS:Hospitalized acutely medically ill subjects (n=7513) were randomized in a double-dummy double-blind fashion to either extended-duration oral betrixaban (80 mg once daily for 35–42 days) or standard-dose subcutaneous enoxaparin (40 mg once daily for 10±4 days) for venous thromboprophylaxis. Stroke events were adjudicated by an independent, blinded event adjudication committee.
RESULTS:The mean age of study participants was 76 years; 45% were male; 13% had had a stroke; and 45% had congestive heart failure. There were fewer all-cause strokes (0.54% versus 0.97%; relative risk RR=0.56; 95% confidence interval, 0.32–0.96; P=0.032; adjusted RR=0.43%; number needed to treat=233) and ischemic strokes (0.48% versus 0.91%; RR=0.53; 95% confidence interval, 0.30–0.94; P=0.026; adjusted RR=0.43%; number needed to treat=233) among patients treated with betrixaban versus enoxaparin through 77 days of follow-up. Among high-risk subjects, those with congestive heart failure or ischemic stroke as their index event, betrixaban reduced the risk of all-cause stroke (0.72% versus 1.48%; RR=0.49; 95% confidence interval, 0.26–0.90; P=0.019; adjusted RR=0.76%; number needed to treat=132) and ischemic stroke (0.63% versus 1.38%; RR=0.45; 95% confidence interval, 0.24–0.87; P=0.014; adjusted RR=0.75%; number needed to treat=134) compared with enoxaparin.
CONCLUSIONS:Among hospitalized medically ill patients, extended-duration betrixaban significantly reduced all-cause stroke and ischemic stroke through 77 days of follow-up
CLINICAL TRIAL REGISTRATION:URLhttp://www.clinicaltrials.gov. Unique identifierNCT01583218.
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