Objective: Lung cancer resection in breathless patients with severe chronic obstructive pulmonary disease (COPD) remains controversial. Whilst open lobectomy remains the gold standard, alternative ...approaches have been described. We undertook a retrospective, observational study to compare the outcomes of a tailored strategy combining video-assisted thoracoscopic surgery (VATS) lobectomy and anatomical segmentectomy against open lobectomy in these patients. Method: Clinical outcomes were studied in 84 consecutive patients (male:female ratio was 56:28, mean age 69.0 years, median preoperative-forced expiratory volume in 1 s (FEV1) 41%) with a predicted-postoperative FEV1 ≤40% (median 32.8% and range 14–40%) who underwent anatomical lung resection for lung cancer. The control group consisted of 35 patients who underwent open lobectomy. The study group comprised 27 patients who underwent anatomical segmentectomy, 18 who underwent VATS lobectomy and four who underwent VATS segmentectomy. Results: There were no significant inter-group differences in age (p = 0.87), gender (p = 0.49), preoperative FEV1 (p = 0.30) or cardiac co-morbidities (p = 0.78). There were more upper lobe resections in the control group (51% vs 94%, p ≪ 0.0001). Tumour size tended to be smaller in the study group (p = 0.052). There were also more incidences of stage I cancers in the study group (90% vs 71%, p = 0.043). The median length of hospital stay was shorter in the study group (8 vs 12 days, p = 0.054). There was no significant difference in either in-hospital mortality (8% vs 14%, p = 0.48) or recurrence rate (26% vs 20%, p = 0.60). However, unadjusted survival was significantly longer in the study group (median survival 54 months vs 20 months, 5-year survival 42% vs 18%, p = 0.03). The survival benefit of this group remained significant in multivariate analyses (adjusted survival hazard ratio (HR) 2.39, 95% confidence interval (CI): 1.30–4.39, p = 0.005). A subgroup analysis on only uncomplicated stage I cancers found a similarly worse outcome in the control group (p = 0.002). After segregating surgical approach and the extent of resection, the VATS approach was identified as the critical factor conferring survival advantage to the study group (hazard ratio (HR) 2.78, 95% CI: 1.21–6.37, p = 0.016). Conclusions: Despite a tailored approach to patients with severe pulmonary dysfunction, there was still significant disparity in survival between groups. Patients who underwent open lobectomy have a worse outcome despite adjusting for confounders. This survival benefit was driven by thoracotomy avoidance through VATS resection. The use of operative techniques to reduce chest-wall dysfunction should be considered in the breathless patient.
Reclamation of printed circuit boards (PCBs) to recover metals is gaining growing attention due to minerals being non-renewable resources. Currently, metals extraction from PCBs through an efficient ...and green method is still under investigation. The present investigation concerns the recycling of printed circuit boards using hydrometallurgical processes. First, the basic metals (Cu, Ni, Zn and Fe) were separated using a sulfuric acid solution at moderate temperatures. The remaining solids were characterized by SEM-EDS, whereby a high content of precious metals (Au, Ag and Pt) was observed. In the second stage, solids were leached with a solution of HCl and NaClO in a 1-L titanium reactor with varied oxygen pressure (0.2, 0.34 and 0.55 MPa), temperature (40, 50 and 80 °C) and concentration of HCl (2 and 4 M), obtaining extractions above 95% at HCl = 4 M, P = 0.34 MPa and T = 40 °C. The extraction increased depending on the concentration of HCl. Eh–pH diagrams for Ag–Cl–H2O, Au–Cl–H2O and Pt–Cl–H2O were constructed to know the possible species in the solution.
The introduction of a foreign metal atom in the coordination environment of single‐atom catalysts constitutes an exciting frontier of active‐site engineering, generating bimetallic low‐nuclearity ...catalysts often exhibiting unique catalytic synergies. To date, the exploration of their full scope is thwarted by (i) the lack of synthetic techniques with control over intermetallic coordination, and (ii) the challenging characterization of these materials. Herein, carbon‐host functionalization is presented as a strategy to selectively generate Au‐Ru dimers and isolated sites by simple incipient wetness impregnation, as corroborated by careful X‐ray absorption spectroscopy analysis. The distinct catalytic fingerprints are unveiled via the hydrogen evolution reaction, employed as a probe for proton adsorption properties. Intriguingly, the virtually inactive Au atoms enhance the reaction kinetics of their Ru counterparts already when spatially isolated, by shifting the proton adsorption free energy closer to neutrality. Remarkably, the effect is magnified by a factor of 2 in dimers. These results exemplify the relevance of controlling intermetallic coordination for the rational design of bimetallic low‐nuclearity catalysts.
Carbon functionalization controls intermetallic bond formation in Au‐Ru low‐nuclearity catalysts (LNCs), yielding isolated atoms in the presence of N‐functionalities and dimers in their absence. Distinct electronic fingerprints are unveiled via the hydrogen evolution reaction. While Au promotes the activity of Ru in both configurations, the effect is magnified in dimers, highlighting the importance of intermetallic coordination in bimetallic LNC design.
Background Debate remains about the relative prognostic importance of the histologic subtype of malignant pleural mesothelioma. Methods From a prospective database, the details of 312 malignant ...pleural mesothelioma surgical patients were reviewed. A comparison was made of the survival from the three major cell types. Results One hundred ninety-five patients underwent radical surgery, and 117 underwent nonradical surgery. Final histologic subtype was epithelioid in 218 patients, biphasic in 66 patients, and sarcomatoid in 28 patients. The median survival was 15.3 months in the epithelioid group, 10.1 months in the biphasic group, and 5.0 months in the sarcomatoid group. On univariate analysis in the epithelioid group, age ( p = 0.005), International Mesothelioma Interest Group stage ( p = 0.001), radicality of the procedure ( p = 0.001), leukocytosis ( p = 0.016), and preoperative or postoperative chemotherapy ( p = 0.012) were significant prognostic factors influencing postoperative survival. In the biphasic group, preoperative anemia was the only significant factor ( p = 0.007). In sarcomatoid patients, International Mesothelioma Interest Group stage and radicality of the surgical procedure were significant prognostic variables ( p = 0.012 and p = 0.015, respectively). Multivariate analysis in the epithelioid group identified International Mesothelioma Interest Group stage ( p = 0.001), radicality of the procedure ( p = 0.008), and preoperative or postoperative chemotherapy ( p = 0.007) as significant prognostic factors, whereas in the sarcomatoid group, only the International Mesothelioma Interest Group stage ( p = 0.012) was significant and the radicality of surgery had no effect. Conclusions The extremely poor prognosis of sarcomatoid malignant pleural mesothelioma is independent of the extent of surgery unlike other cell types. Patients with sarcomatoid histology should therefore be considered separately in trials evaluating radical procedures and adjuvant treatment. The treatment of biphasic pleural mesothelioma remains debatable.
Natural killer cells (NK) are important effectors of anti-tumor immunity, activated either by the downregulation of HLA-I molecules on tumor cells and/or the interaction of NK-activating receptors ...with ligands that are overexpressed on target cells upon tumor transformation (including NKG2D and NKP30). NK kill target cells by the vesicular delivery of cytolytic molecules such as Granzyme-B and Granulysin activating different cell death pathways, which can be Caspase-3 dependent or Caspase-3 independent. Multiple myeloma (MM) remains an incurable neoplastic plasma-cell disorder. However, we previously reported the encouraging observation that cord blood-derived NK (CB-NK), a new source of NK, showed anti-tumor activity in an in vivo murine model of MM and confirmed a correlation between high levels of NKG2D expression by MM cells and increased efficacy of CB-NK in reducing tumor burden. We aimed to characterize the mechanism of CB-NK-mediated cytotoxicity against MM cells. We show a Caspase-3- and Granzyme-B-independent cell death, and we reveal a mechanism of transmissible cell death between cells, which involves lipid-protein vesicle transfer from CB-NK to MM cells. These vesicles are secondarily transferred from recipient MM cells to neighboring MM cells amplifying the initial CB-NK cytotoxicity achieved. This indirect cytotoxicity involves the transfer of NKG2D and NKP30 and leads to lysosomal cell death and decreased levels of reactive oxygen species in MM cells. These findings suggest a novel and unique mechanism of CB-NK cytotoxicity against MM cells and highlight the importance of lipids and lipid transfer in this process. Further, these data provide a rationale for the development of CB-NK-based cellular therapies in the treatment of MM.
The aim of this study was to determine the influence of the feeding regimes in Senegalese sole (Solea senegalensis) cultured under extensive, semi‐extensive and intensive production systems. A total ...of 254 bacterial isolates from guts of fish cultured under different production systems and feeding regimes were tested. Biochemical tests and genetic analyses based on the 16S rDNA sequence analysis were conduced to identify bacterial strains. Vibrio species were the most represented taxonomic group in the culturable microbiota of S. senegalensis guts tested. Particularly, Vibrio ichthyoenteri was the most frequently isolated Vibrio species. Comparison among diets showed a significant reduction (P<0.05) in vibrio percentages and a higher occurrence of Shewanella species in Senegalese soles fed polychaeta. In addition, a major influence of environmental temperature on microbiota composition was detected. Cold temperatures brought about a change in the percentages of Vibrio species and a higher representation of α‐Proteobacteria in both outdoor systems (extensive and semi‐extensive). The significant differences between intestinal bacterial composition in Senegalese soles fed commercial diets and natural preys (polychaeta) reveal the necessity to develop specific optimized diets for the intensive rearing of this fish species.
Clinical trials in recurrent ovarian cancer Friedlander, Michael; Trimble, Edward; Tinker, Anna ...
International journal of gynecological cancer
21, Številka:
4
Journal Article
Recenzirano
The 4th Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup was held in Vancouver, Canada, in June 2010. Representatives of 23 cooperative research groups studying gynecologic ...cancers gathered to establish international consensus on issues critical to the conduct of large randomized trials. Group C, 1 of the 3 discussion groups, examined recurrent ovarian cancer, and we report the consensus reached regarding 4 questions. These included the following: (1) What is the role of cytoreductive surgery for recurrent ovarian cancer? (2) How do we define distinct patient populations in need of specific therapeutic approaches? (3) Should end points for trials with recurrent disease vary from those of first-line trials? (4) Is CA-125 progression alone sufficient for entry/eligibility into clinical trials?
The molecular basis of the pathogenesis of the opportunistic invasive infections caused by isolates of the
genus remains largely unknown. Moreover, inconsistencies in the current species assignation ...were detected after genome-level comparison of 16 public
isolates. A literature search detected that, between the two most pathogenic species,
causes about twice the number of cases compared to
. These two species shared their mean diseases - sepsis and endocarditis - but differed in causing other syndromes. A number of well-known virulence factors were harbored by all species, such as a manganese transport/adhesin sharing 83% identity from oral endocarditis-causing streptococci. Likewise, all Gemellae carried the genes required for incorporating phosphorylcholine into their cell walls and encoded some choline-binding proteins. In contrast, other proteins were species-specific, which may justify the known epidemiological differences.
, but not
, harbor a gene cluster potentially encoding a polysaccharidic capsule. Species-specific surface determinants also included Rib and MucBP repeats, hemoglobin-binding NEAT domains, peptidases of C5a complement factor and domains that recognize extracellular matrix molecules exposed in damaged heart valves, such as collagen and fibronectin. Surface virulence determinants were associated with several taxonomically dispersed opportunistic genera of the oral microbiota, such as
,
, and
, suggesting the existence of a horizontally transferrable gene reservoir in the oral environment, likely facilitated by close proximity in biofilms and ultimately linked to endocarditis. The identification of the
virulence pool should be implemented in whole genome-based protocols to rationally predict the pathogenic potential in ongoing clinical infections caused by these poorly known bacterial pathogens.
Pension systems are one of the fundamental pillars of the welfare state. The ageing of the population caused by longer life expectancy and low birth rates has led to a crisis in the public pension ...system in developed countries. Changes for the system’s sustainability are necessary, and the scientific literature on the subject is abundant, especially in recent years. This article aims to carry out a bibliometric analysis of the research carried out to date, highlighting, in turn, future lines of research. The study was carried out on a total of 1287 articles published from 1936 to 2021 and found in the Scopus database. The SciMAT, VOSviewer, and Datawrapper tools were used to analyse the most important articles, authors, countries, and institutions by volume of production and citations, as well as the relationships between them. Likewise, the most important keywords and their evolution over time were highlighted, obtaining the main focus of the research. In addition to the general analysis, a specific study was carried out in the area of Mathematics. The results show that the leading countries are the United Kingdom, the USA, and the Netherlands. On the other hand, the lead subject area in which these articles have been published is Economics, Econometrics, and Finance. The research trends are sustainability, pension reform related to ageing, and pension insurance.
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