At present, palliative systemic chemotherapy is the standard treatment in the Netherlands for gastric cancer patients with peritoneal dissemination. In contrast to lymphatic and haematogenous ...dissemination, peritoneal dissemination may be regarded as locoregional spread of disease. Administering cytotoxic drugs directly into the peritoneal cavity has an advantage over systemic chemotherapy since high concentrations can be delivered directly into the peritoneal cavity with limited systemic toxicity. The combination of a radical gastrectomy with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has shown promising results in patients with gastric cancer in Asia. However, the results obtained in Asian patients cannot be extrapolated to Western patients. The aim of this study is to compare the overall survival between patients with gastric cancer with limited peritoneal dissemination and/or tumour positive peritoneal cytology treated with palliative systemic chemotherapy, and those treated with gastrectomy, CRS and HIPEC after neoadjuvant systemic chemotherapy.
In this multicentre randomised controlled two-armed phase III trial, 106 patients will be randomised (1:1) between palliative systemic chemotherapy only (standard treatment) and gastrectomy, CRS and HIPEC (experimental treatment) after 3-4 cycles of systemic chemotherapy.Patients with gastric cancer are eligible for inclusion if (1) the primary cT3-cT4 gastric tumour including regional lymph nodes is considered to be resectable, (2) limited peritoneal dissemination (Peritoneal Cancer Index < 7) and/or tumour positive peritoneal cytology are confirmed by laparoscopy or laparotomy, and (3) systemic chemotherapy was given (prior to inclusion) without disease progression.
The PERISCOPE II study will determine whether gastric cancer patients with limited peritoneal dissemination and/or tumour positive peritoneal cytology treated with systemic chemotherapy, gastrectomy, CRS and HIPEC have a survival benefit over patients treated with palliative systemic chemotherapy only.
clinicaltrials.gov NCT03348150 ; registration date November 2017; first enrolment November 2017; expected end date December 2022; trial status: Ongoing.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Polyurethane (PU) nanocomposites reinforced with magnetic iron oxide nanoparticles and/or dielectric barium titanate nanoparticles fabricated by the surface-initiated-polymerization approach were ...investigated. The polymer matrix incorporated with different nanoparticles shows different presenting status surrounding the nanoparticles, i.e., chemical bonding, physical entanglement and bulk polymer chain. The nanoparticles have a different effect on the thermal stability of the polymer nanocomposites. By embedding different functional nanoparticles, unique physical properties were observed, such as enlarged coercivity and larger dielectric constant (real permittivity). The synergistic effect of the binary nanoparticle reinforced PU nanocomposite was explored. The addition of the iron oxide nanoparticles does have some effect on the permittivity. However, little difference was observed in the magnetic properties and permeability after the introduction of the dielectric barium titanate nanoparticle into Fe
2O
3/PU nanocomposites. The permeability and permittivity of γ-Fe
2O
3 and BaTiO
3 nanoparticle reinforced PU nanocomposites were investigated with frequencies ranging from 10
MHz to 1
GHz. The predicted microwave properties from Bruggeman’s equation were consistent with the measured data, except for the real permittivity of Fe
2O
3/BaTiO
3/PU. The volume average method (VAM) usually used for fiber-reinforced composites with reinforcements in the thickness direction was applied in this nanocomposite system. The predicted real permittivity by VAM was found to be in better agreement with the measured data than that predicted by Bruggeman’s equation.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
A multidisciplinary mineralogical, geochemical and biomarker study of Indus Fan sediments cored during International Ocean Discovery Program (IODP) Expedition 355 to the Laxmi Basin was carried out ...to define the different compositional signatures of sand, silt and clay. Upper Pliocene - lower Pleistocene turbidites from sites U1456 and U1457 were selected as the best candidates for this study. The integrated dataset presented here was obtained by coupling traditional and innovative bulk-sediment and single-mineral techniques on the same samples. Turbiditic deposits mostly consist of medium to fine silt, including rich and diverse heavy-mineral assemblages. Such a fine grain size forced us to push the limits of high-resolution quantitative heavy-mineral analysis down to as low as 5 µm. Heavy-mineral analysis allowed us to establish a Himalayan origin of the detritus in the studied turbidites. Heavy-mineral concentrations are higher in channel-fill than in overbank deposits. Mineralogical and geochemical data concur in revealing that fast-settling ultradense minerals such as zircon are preferentially concentrated in channel-fill deposits, whereas the top of overbank deposits are notably enriched with slow-settling platy phyllosilicates. Biomarker analysis represents a most suitable complementary technique that is able to investigate the provenance signature of the finer sediment fraction, largely consisting of clay. This technique allowed us to identify a largely terrigenous origin of organic matter at Site U1456 and an open marine origin at Site U1457. The latter site lies closer to the Laxmi Ridge, where thermal maturity increases with depth to reach the early oil window (127°C at c. 320 m below the seafloor).
Neutralizing antibodies (Nab) are a principal component of an effective human immune response to many pathogens, yet their role in HIV-1 infection is unclear. To gain a better understanding of this ...role, we examined plasma from patients with acute HIV infection. Here we report the detection of autologous Nab as early as 52 days after detection of HIV-specific antibodies. The viral inhibitory activity of Nab resulted in complete replacement of neutralization-sensitive virus by successive populations of resistant virus. Escape virus contained mutations in the env gene that were unexpectedly sparse, did not map generally to known neutralization epitopes, and involved primarily changes in N-linked glycosylation. This pattern of escape, and the exceptional density of HIV-1 envelope glycosylation generally, led us to postulate an evolving 'glycan shield' mechanism of neutralization escape whereby selected changes in glycan packing prevent Nab binding but not receptor binding. Direct support for this model was obtained by mutational substitution showing that Nab-selected alterations in glycosylation conferred escape from both autologous antibody and epitope-specific monoclonal antibodies. The evolving glycan shield thus represents a new mechanism contributing to HIV-1 persistence in the face of an evolving antibody repertoire.
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DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The aims of this study were: (1) investigate relations between pain acceptance, depressive symptoms, catastrophizing, and functional disability in pediatric patients in an interdisciplinary chronic ...pain rehabilitation program, (2) examine changes in acceptance from pre- to posttreatment, and (3) test if changes in acceptance predict changes in depressive symptoms, catastrophizing, and functional disability from pre- to posttreatment.
112 participants, ages 11-18 years, completed the Chronic Pain Acceptance Questionnaire, Adolescent Version, Center for Epidemiological Studies-Depression-Children's Scale, Pain Catastrophizing Scale for Children, and Functional Disability Inventory on admission to and completion of the program.
Significant and strong relations between acceptance, depression, catastrophizing, and functional disability were demonstrated. Participants demonstrated significant increases in acceptance and decreases in depression, catastrophizing, and functional disability. Finally, changes in acceptance significantly predicted changes in depressive symptoms, catastrophizing, and functional disability.
Pain acceptance is an important variable in the treatment of pediatric chronic pain.
Experimental studies of the collisions of heavy nuclei at relativistic energies have established the properties of the quark–gluon plasma (QGP), a state of hot, dense nuclear matter in which quarks ...and gluons are not bound into hadrons1–4. In this state, matter behaves as a nearly inviscid fluid5 that efficiently translates initial spatial anisotropies into correlated momentum anisotropies among the particles produced, creating a common velocity field pattern known as collective flow. In recent years, comparable momentum anisotropies have been measured in small-system proton–proton (p+p) and proton–nucleus (p+A) collisions, despite expectations that the volume and lifetime of the medium produced would be too small to form a QGP. Here we report on the observation of elliptic and triangular flow patterns of charged particles produced in proton–gold (p+Au), deuteron–gold (d+Au) and helium–gold (3He+Au) collisions at a nucleon–nucleon centre-of-mass energy \\sqrt {s_{{\mathrm{NN}}}\ = 200 GeV. The unique combination of three distinct initial geometries and two flow patterns provides unprecedented model discrimination. Hydrodynamical models, which include the formation of a short-lived QGP droplet, provide the best simultaneous description of these measurements.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Obtaining geochemical profiles using X-ray fluorescent (XRF) techniques has become a standard procedure in many sediment core studies. The resulting datasets are not only important tools for ...palaeoclimatic and palaeoceanographic reconstructions, but also for stratigraphic correlation. The International Ocean Discovery Program (IODP) has therefore recently introduced shipboard application of a handheld XRF device, making geochemical data directly available to the science party. In all XRF scanning techniques, the physical properties of wet core halves cause substantial analytical deviations. In order to obtain estimates of element concentrations (e.g. for quantitative analyses of fluxes or mass-balance calculations), a calibration of the scanning data is required. We test whether results from the handheld XRF analysis on discrete samples are suitable for calibrating scanning data. Log-ratios with Ca as a common denominator were calculated. The comparison between the handheld device and conventional measurements show that the latter provide high-quality data describing Al, Si, K, Ca, Ti, Mn, Fe, Zn, Rb and Sr content (R2 compared with conventional measurements: ln(Al/Ca) = 0.99, ln(Si/Ca) = 0.98, ln(K/Ca) = 0.99, ln(Ti/Ca) = 0.99, ln(Mn/Ca) = 0.99, ln(Fe/Ca) = 0.99, ln(Zn/Ca) = 0.99 and ln(Sr/Ca) = 0.99). Our results imply that discrete measurements using the shipboard handheld analyser are suitable for the calibration of XRF scanning data. Our test was performed on downcore sediments from IODP Expedition 355 that display a wide variety of lithologies of both terrestrial and marine origin. The implication is that our findings are valid on a general scale and that shipboard handheld XRF analysis on discrete samples should be used for calibrating XRF scanning data.
Birds of prey and from Psittacidae family are host to fungal microbiota and play an important role in the epidemiology of zoonoses. Few studies in the literature have characterized mycelial and yeast ...fungi in the droppings of these birds and correlated the isolates with the zoonotic potential of the microorganisms. Droppings from 149 birds were evaluated and divided into two groups: captive: Rhea americana araneipes, Primolius maracana, Ara ararauna, Ara chloropterus, Anodorhynchus hyacinthinus, Amazona aestiva, Ara macao macao, Ramphastos toco, Sarcoramphus papa, Busarellus nigricollis, Bubo virginianus nacurutu, Buteogallus coronatus, Buteogallus urubitinga urubitinga, Spizaetus melanoleucus, Spizaetus ornatus ornatus, Buteo albonotatus, Geranoaetus albicaudatus albicaudatus, Rupornis magnirostris magnirostris and Harpia harpyja, and quarantined birds: Amazona aestiva and Eupsitulla aurea. The fungal isolates were identified according to macroscopic (gross colony appearance), micromorphological and biochemical characteristics. Among birds displayed in enclosures, Aspergillus niger (41.1%) and Candida kefyr (63.8%) were the fungi most frequently isolated in Harpia harpyja and Ramphastos toco, respectively. For quarantined birds, the following percentages were observed in Eupsittula aurea , (76.6%) C. krusei, (84.4%) C. kefyr and (15.2%) C. famata, while in Amazona aestiva, (76.2%) C. krusei was observed. These findings indicate potentially pathogenic species in the bird droppings assessed, which constitute a risk of exposure for keepers and individuals who visit the zoo. Birds of the Cerrado and Pantanal of Mato Grosso (Central Western region of Brazil) could act in the epidemiological chain of important zoonoses.
HPE is a congenital brain malformation characterized by failure of the prosencephalon to divide into 2 hemispheres. We have identified 7 patients who have a mild subtype of HPE in which the midline ...fusion was restricted to the septal region or preoptic region of the telencephalon. This subtype, which we call septopreoptic HPE, falls in the spectrum of lobar HPE, but lacks significant frontal neocortical fusion seen in lobar HPE. Other imaging characteristics include thickened or dysplastic fornix, absent or hypoplastic anterior CC, and single unpaired ACA. The SP was fully formed in 4, partially formed in 2, and absent in 1. Mild midline craniofacial malformation, such as SMMCI and CNPAS were found in 86% and 71%, respectively. Patients outside of infancy often manifested language delay, learning disabilities, or behavioral disturbances, while motor function was relatively spared.
Therapeutic angiogenesis, a new experimental strategy for the treatment of vascular insufficiency, uses the administration of mediators known to induce vascular development in embryogenesis to induce ...neovascularization of ischemic adult tissues. This report summarizes a phase I clinical experience with a gene-therapy strategy that used an E1(-)E3(-) adenovirus (Ad) gene-transfer vector expressing human vascular endothelial growth factor (VEGF) 121 cDNA (Ad(GV)VEGF121.10) to induce therapeutic angiogenesis in the myocardium of individuals with clinically significant coronary artery disease.
Ad(GV)VEGF121.10 was administered to 21 individuals by direct myocardial injection into an area of reversible ischemia either as an adjunct to conventional coronary artery bypass grafting (group A, n=15) or as sole therapy via a minithoracotomy (group B, n=6). There was no evidence of systemic or cardiac-related adverse events related to vector administration. In both groups, coronary angiography and stress sestamibi scan assessment of wall motion 30 days after therapy suggested improvement in the area of vector administration. All patients reported improvement in angina class after therapy. In group B, in which gene transfer was the only therapy, treadmill exercise assessment suggested improvement in most individuals.
The data are consistent with the concept that direct myocardial administration of Ad(GV)VEGF121.10 to individuals with clinically significant coronary artery disease appears to be well tolerated, and initiation of phase II evaluation of this therapy is warranted.
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