Theory predicts the low temperature magnetic excitations in spin ices consist of deconfined magnetic charges, or monopoles. A recent transverse-field (TF) muon spin rotation (μSR) experiment S. T. ...Bramwell et al., Nature (London) 461, 956 (2009) reports results claiming to be consistent with the temperature and magnetic field dependence anticipated for monopole nucleation-the so-called second Wien effect. We demonstrate via a new series of μSR experiments in Dy(2)Ti(2)O(7) that such an effect is not observable in a TF μSR experiment. Rather, as found in many highly frustrated magnetic materials, we observe spin fluctuations which become temperature independent at low temperatures, behavior which dominates over any possible signature of thermally nucleated monopole excitations.
Natural graphite particles (NG) were surface modified via ethylene plasma treatment and characterized by infrared and Raman spectroscopy, thermo‐gravimetric analysis, scanning electron microscopy, ...X‐ray diffraction, and X‐ray photoelectron spectroscopy. Ethylene polymerized during plasma treatment forming both a thin layer on the graphite particles surface and polyethylene particles that penetrate into the graphite layers, favoring its delamination or exfoliation. This beneficial effect finally impacts in the thermal properties of the composites: in fact, thermal conductivity (k) determined via modulated differential thermal calorimetry is, in general, larger than that of the pure polyethylene because of the graphite contribution and, with a major increase for graphite composites obtained with the treated than untreated NG because of the better dispersion.
Operable triple-negative breast cancers (TNBCs) have a higher risk of relapse than non-TNBCs with standard therapy. The GEICAM/2003-11_CIBOMA/2004-01 trial explored extended adjuvant capecitabine ...after completion of standard chemotherapy in patients with early TNBC.
Eligible patients were those with operable, node-positive-or node negative with tumor 1 cm or greater-TNBC, with prior anthracycline- and/or taxane-containing chemotherapy. After central confirmation of TNBC status by immunohistochemistry, patients were randomly assigned to either capecitabine or observation. Stratification factors included institution, prior taxane-based therapy, involved axillary lymph nodes, and centrally determined phenotype (basal
nonbasal, according to cytokeratins 5/6 and/or epidermal growth factor receptor positivity by immunohistochemistry). The primary objective was to compare disease-free survival (DFS) between both arms.
Eight hundred seventy-six patients were randomly assigned to capecitabine (n = 448) or observation (n = 428). Median age was 49 years, 55.9% were lymph node negative, 73.9% had a basal phenotype, and 67.5% received previous anthracyclines plus taxanes. Median length of follow-up was 7.3 years. DFS was not significantly prolonged with capecitabine versus observation hazard ratio (HR), 0.82; 95% CI, 0.63 to 1.06;
= .136. In a preplanned subgroup analysis, nonbasal patients seemed to derive benefit from the addition of capecitabine with a DFS HR of 0.53 versus 0.94 in those with basal phenotype (interaction test
= .0694) and an HR for overall survival of 0.42 versus 1.23 in basal phenotype (interaction test
= .0052). Tolerance of capecitabine was as expected, with 75.2% of patients completing the planned 8 cycles.
This study failed to show a statistically significant increase in DFS by adding extended capecitabine to standard chemotherapy in patients with early TNBC. In a preplanned subset analysis, patients with nonbasal phenotype seemed to obtain benefit with capecitabine, although this will require additional validation.
Background
Pediatric early warning systems (PEWS) aid in the early identification of deterioration in hospitalized children with cancer; however, they are under‐used in resource‐limited settings. The ...authors use the knowledge‐to‐action framework to describe the implementation strategy for Proyecto Escala de Valoracion de Alerta Temprana (EVAT), a multicenter quality‐improvement collaborative, to scale‐up PEWS in pediatric oncology centers in Latin America.
Methods
Proyecto EVAT mentored participating centers through an adaptable implementation strategy to: (1) monitor clinical deterioration in children with cancer, (2) contextually adapt PEWS, (3) assess barriers to using PEWS, (4) pilot and implement PEWS, (5) monitor the use of PEWS, (6) evaluate outcomes, and (7) sustain PEWS. The implementation outcomes assessed included the quality of PEWS use, the time required for implementation, and global program impact.
Results
From April 2017 to October 2021, 36 diverse Proyecto EVAT hospitals from 13 countries in Latin America collectively managing more than 4100 annual new pediatric cancer diagnoses successfully implemented PEWS. The time to complete all program phases varied among centers, averaging 7 months (range, 3–13 months) from PEWS pilot to implementation completion. All centers ultimately implemented PEWS and maintained high‐quality PEWS use for up to 18 months after implementation. Across the 36 centers, more than 11,100 clinicians were trained in PEWS, and more than 41,000 pediatric hospital admissions had PEWS used in their care.
Conclusions
Evidence‐based interventions like PEWS can be successfully scaled‐up regionally basis using a systematic approach that includes a collaborative network, an adaptable implementation strategy, and regional mentorship. Lessons learned can guide future programs to promote the widespread adoption of effective interventions and reduce global disparities in childhood cancer outcomes.
Lay summary
Pediatric early warning systems (PEWS) are clinical tools used to identify deterioration in hospitalized children with cancer; however, implementation challenges limit their use in resource‐limited settings.
Proyecto EVAT is a multicenter quality‐improvement collaborative to implement PEWS in 36 pediatric oncology centers in Latin America.
This is the first multicenter, multinational study reporting a successful implementation strategy (Proyecto EVAT) to regionally scale‐up PEWS.
The lessons learned from Proyecto EVAT can inform future programs to promote the adoption of clinical interventions to globally improve childhood cancer outcomes.
Précis
Proyecto EVAT is a multicenter, multinational quality‐improvement collaborative that supported successful regional implementation and scale‐up of an evidence‐based intervention—a pediatric early warning system—at 36 pediatric oncology hospitals in Latin America. The knowledge‐to‐action framework was used to explain the project’s implementation strategy and to assess implementation outcomes, including the quality, the time required, and the global impact.
Libya has come three times before the International Court of Justice (ICJ) on the basis of special agreements. At present, Libya has pending before the Court two cases it has brought by unilateral ...application, respectively against the United Kingdom and against the United States, concerning Questions of Interpretation and Application of the 1971 Montreal Convention Arising From the Aerial Incident at Lockerbie. For its part, Chad had never come before the Court since its accession to independence in 1960.
Agave fibers (AF) were incorporated either pristine (AFp) or surface treated by ethylene plasma (AFm) in low-density polyethylene (LDPE)/ethylene vinyl acetate (EVA) blends at a ratio of 1 : 1 and ...foamed by chemical means. The role of the AF content (3, 6, 9, 12, and 15 wt.%) and its surface modification on the cellular morphology and mechanical properties of LDPE/EVA/AF foams under compression is investigated herein. Fourier transform-infrared spectroscopy, contact angle, and water suspension of AF suggest that plasma treatment using ethylene successfully modifies the surface nature of AF from hydrophilic to hydrophobic. AF and the surface treatment have an important role on the morphological properties of the foams. Composite foams reinforced with 12 wt.% AFm exhibited the highest mechanical properties improvements. At this fiber content, the composite foams enhanced 30% of the compressive modulus and 23% of the energy absorption under compression with respect to the neat polymer blend foam, as a result to the formation of more uniform cells with smaller size and the enhancement of compatibility and spatial distribution of the AFm in the polymer composite foams due to thin clusters of polyethylene-like polymer deposited on the AF surface.
Introduction: Since the coronavirus disease 2019 (COVID-19) pandemic, cardiac surgeries in patients with previous infection by COVID-19 were suspended or postponed, which led to surgeries performed ...in patients with an advanced stage of their disease and an increase in the waiting list. There is a heterogeneous attitude in Latin America on the optimal timing to cardiac surgery in patients with previous COVID-19 infection due to scarce data on its outcome. Two Latin American associations joined to establish common suggestions on the optimal timing of surgery in patients with previous COVID-19 infection. Methods: Data collection was performed using a pre-established form, which included year of publication, objective, type of study (prospective/retrospective, descriptive/analytical), number of patients, year of study, waiting time between infection and surgery, type of surgery, morbidity, mortality, and conclusions regarding the association between mortality and morbidity. Final recommendations were approved by the board of directors of Latin American Association of Cardiac and Endovascular Surgery (LACES) and Latin American Confederation of Anesthesia Societies (CLASA). Results: Of the initial 1,016 articles, 11 comprised the final selection. Only six of them included patients who underwent cardiac surgery. According to the analyzed literature, optimal timing for cardiac surgery needs to consider the following aspects: deferable surgery, symptomatic COVID-19 infection, completeness of COVID-19 vaccination. Conclusion: These recommendations derive from the analysis of the scarce literature published at present on outcomes after cardiac surgery in patients with previous COVID-19 infection. These are to be taken as a dynamic recommendation in which Latin American reality was taken into consideration.
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