Background
Local excision of early colon cancers could be an option in selected patients with high risk of complications and no sign of lymph node metastasis (LNM). The primary aim was to assess ...feasibility in high-risk patients with early colon cancer treated with Combined Endoscopic and Laparoscopic Surgery (CELS).
Methods
A non-randomized prospective feasibility study including 25 patients with Performance Status score ≥ 1 and/or American Society of Anesthesiologists score ≥ 3, and clinical Union of International Cancer Control stage-1 colon cancer suitable for CELS resection. The primary outcome was failure of CELS resection, defined as either: Incomplete resection (R1/R2), local recurrence within 3 months, complication related to CELS within 30 days (Clavien–Dindo grade ≥ 3), death within 30 days or death within 90 days due to complications to surgery.
Results
Fifteen patients with clinical T1 (cT1) and ten with clinical T2 (cT2) colon cancer and without suspicion of metastases were included. Failure occurred in two patients due to incomplete resections. Histopathological examination classified seven patients as having pT1, nine as pT2, six as pT3 adenocarcinomas, and three as non-invasive tumors. In three patients, the surgical strategy was changed intraoperatively to conventional colectomy due to tumor location or size. Median length of stay was 1 day. Seven patients had completion colectomy performed due to histological high-risk factors. None had LNM.
Conclusions
In selected patients, CELS resection was feasible, and could spare some patients large bowel resection.
Ribosomal protein S6 Kinase-1 (S6K1) has been linked to resistance exercise-mediated improvements in glycemia. We hypothesized that S6K1 may also play a role in regulating glycemic control in ...response to endurance exercise training.
S6k1-knockout (S6K1KO) and WT mice on a 60 cal% high-fat diet were trained for 4 weeks on treadmills, metabolically phenotyped, and compared to sedentary controls.
WT mice showed improved glucose tolerance after training. In contrast, S6K1KO mice displayed equally high glucose tolerance already in the sedentary state with no further improvement after training. Similarly, training decreased mitochondrial ROS production in skeletal muscle of WT mice, whereas ROS levels were already low in the sedentary S6K1KO mice with no further decrease after training. Nevertheless, trained S6K1KO mice displayed an increased running capacity compared to trained WT mice, as well as substantially reduced triglyceride contents in liver and skeletal muscle. The improvements in glucose handling and running endurance in S6K1KO mice were associated with markedly increased ketogenesis and a higher respiratory exchange ratio.
In high-fat fed mice, loss of S6K1 mimics endurance exercise training by reducing mitochondrial ROS production and upregulating oxidative utilization of ketone bodies. Pharmacological targeting of S6K1 may improve the outcome of exercise-based interventions in obesity and diabetes.
•Absence of S6k1 upregulates oxidative substrate utilization under HFD consumption.•S6k1 knockout mice show enhanced running performance and improved glycemia already in the sedentary state.•Aerobic endurance exercise training of S6k1 knockout mice further improves running performance but not glycemia.•Metabolic improvements are associated with lower rates of TCA-linked mitochondrial H2O2 production and increased ketogenesis.
In previous investigations hair analysis for ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEE) proved to be suitable for the detection of excessive alcohol consumption. The aim of this study ...was to compare EtG and FAEE concentrations in hair of alcoholics, social drinkers and teetotallers. Hair samples from 10 alcoholics in withdrawal treatment, 11 fatalities with documented excessive alcohol consumption, four moderate social drinkers who consumed up to 20
g ethanol per day, and three strict teetotallers were analysed. After external degreasing with
n-heptane, extraction with a dimethyl sulfoxide/
n-heptane mixture and headspace solid-phase microextraction of the extracts, four fatty acid ethyl esters (FAEEs) (ethyl myristate, ethyl palmitate, ethyl oleate and ethyl stearate) were analysed by gas chromatography–mass spectrometry (GC–MS) with deuterated internal standards. EtG was determined by GC–MS/NCI after ultrasonication of the samples with H
2O, cleanup by SPE with aminopropyl columns and PFP derivatisation.
The following concentrations were measured for the four groups: teetotallers EtG < 0.002
ng/mg, FAEE 0.05–0.37
ng/mg, moderate social drinkers EtG < 0.002
ng/mg, FAEE 0.26–0.50
ng/mg, alcoholic patients EtG 0.030–0.415
ng/mg, FAEE 0.65–20.50
ng/mg and the fatalities with alcohol history EtG 0.072–3.380
ng/mg, FAEE 1.30–30.60
ng/mg. The results confirm that by using a cut-off value of the sum of FAEE > 1
ng/mg and/or a positive EtG result in hair, excessive alcohol consumption can be identified using hair analysis. However, no significant correlation between the EtG and FAEE concentrations in the positive cases could be shown. Segmental analysis of some of the specimens did not reveal the same distribution for EtG compared to FAEE in hair, and no chronological accordance compared to the self-reported alcohol consumption could be observed for both parameters. These different results of both methods are discussed in terms of differences between EtG and FAEE in mechanism of formation and incorporation into hair and elimination from hair.
Aim
To validate the German Diabetes Risk Score within the population‐based cohort of the Cardiovascular Disease – Living and Ageing in Halle (CARLA) study.
Methods
The sample included 582 women and ...719 men, aged 45–83 years, who did not have diabetes at baseline. The individual risk of every participant was calculated using the German Diabetes Risk Score, which was modified for 4 years of follow‐up. Predicted probabilities and observed outcomes were compared using Hosmer–Lemeshow goodness‐of‐fit tests and receiver–operator characteristic analyses. Changes in prediction power were investigated by expanding the German Diabetes Risk Score to include metabolic variables and by subgroup analyses.
Results
We found 58 cases of incident diabetes. The median 4‐year probability of developing diabetes based on the German Diabetes Risk Score was 6.5%. The observed and predicted probabilities of developing diabetes were similar, although estimation was imprecise owing to the small number of cases, and the Hosmer–Lemeshow test returned a poor correlation (chi‐squared = 55.3; P = 5.8*10‐12). The area under the receiver–operator characteristic curve (AUC) was 0.70 (95% CI 0.64–0.77), and after excluding participants ≥66 years old, the AUC increased to 0.77 (95% CI 0.70–0.84). Consideration of glycaemic diagnostic variables, in addition to self‐reported diabetes, reduced the AUC to 0.65 (95% CI 0.58–0.71). A new model that included the German Diabetes Risk Score and blood glucose concentration (AUC 0.81; 95% CI 0.76–0.86) or HbA1c concentration (AUC 0.84; 95% CI 0.80–0.91) was found to peform better.
Conclusions
Application of the German Diabetes Risk Score in the CARLA cohort did not reproduce the findings in the European Prospective Investigation into Cancer and Nutrition (EPIC) Potsdam study, which may be explained by cohort differences and model overfit in the latter; however, a high score does provide an indication of increased risk of diabetes.
What's new?
The German Diabetes Risk Score (DRS), developed within the European Prospective Investigation into Cancer and Nutrition (EPIC) Potsdam study, has not been prospectively validated in a representative sample of the general population apart from EPIC.
The aim of this study was to validate the DRS in the Cardiovascular Disease – Living and Ageing in Halle (CARLA) study, a population‐based cohort with a high response rate, that provides a more representative sample than the EPIC‐Potsdam study.
The predictive ability of the DRS observed in the CARLA cohort was consistently lower than in the EPIC cohort, a finding that could reflect cohort differences and model overfit in the EPIC study.
At 320 K, the crystal structure of CeRuSn is commensurate with the related CeCoAl-type of structure by the doubling of the c lattice parameter. However, with lowering the temperature it becomes ...incommensurate with x and z position parameters at all three elemental sites being modulated as one moves along the c-axis. The resulting crystal structure can be conveniently described within the superspace formalism in (3 + 1) dimensions. The modulation vector, after initially strong temperature dependence, approaches a value close to qnuc = (0 0 0.35). Below TN = 2.8 (1) K, CeRuSn orders antiferromagnetically with a propagation vector qmag = (0 0 0.175), i.e. with the magnetic unit cell doubled along the c-axis direction with respect to the incommensurate crystal structure. Ce moments appear to be nearly collinear, confined to the a−c plane, forming ferromagnetically coupled pairs. Their magnitudes are modulated between 0.11 and 0.95 μB as one moves along the c-axis.
Aim
To analyse the association of neighbourhood unemployment with incident self‐reported physician‐diagnosed Type 2 diabetes in a population aged 45–74 years from five German regions.
Methods
Study ...participants were linked via their addresses at baseline to particular neighbourhoods. Individual‐level data from five population‐based studies were pooled and combined with contextual data on neighbourhood unemployment. Type 2 diabetes was assessed according to a self‐reported physician diagnosis of diabetes. We estimated proportional hazard models (Weibull distribution) in order to obtain hazard ratios and 95% CIs of Type 2 diabetes mellitus, taking into account interval‐censoring and clustering.
Results
We included 7250 participants residing in 228 inner city neighbourhoods in five German regions in our analysis. The incidence rate was 12.6 per 1000 person‐years (95% CI 11.4–13.8). The risk of Type 2 diabetes mellitus was higher in men hazard ratio 1.79 (95% CI 1.47–2.18) than in women and higher in people with a low education level hazard ratio 1.55 (95% CI 1.18–2.02) than in those with a high education level. Independently of individual‐level characteristics, we found a higher risk of Type 2 diabetes mellitus in neighbourhoods with high levels of unemployment quintile 5; hazard ratio 1.72 (95% CI 1.23–2.42) than in neighbourhoods with low unemployment (quintile 1).
Conclusions
Low education level and high neighbourhood unemployment were independently associated with an elevated risk of Type 2 diabetes mellitus. Studies examining the impact of the residential environment on Type 2 diabetes mellitus will provide knowledge that is essential for the identification of high‐risk populations.
What's new?
Research on the influence of the residential environment on incident Type 2 diabetes in Germany is missing.
We adapted an advanced model strategy to take account of the hierarchical data structure and to adjust for the interval‐censored information on incident Type 2 diabetes to avoid a common problem in follow‐up cohort studies.
This study shows that neighbourhood unemployment is associated with incident Type 2 diabetes in five German regions.
We have performed polarized neutron experiments on single-crystalline CePdAl at two different conditions: at 4 K and ambient pressure in a field of 9 T applied along the c-axis and at 40 mK under a ...pressure of 0.85 GPa and the same magnetic field. We observe that in contrast to zero field, where only two Ce atoms carry magnetic moments, in fields under different conditions all Ce moments are significantly developed. Thus, the magnetic field lifts the magnetic frustration caused by the geometry of the system. It also eliminates effects of the pressure that drives CePdAl to a quantum criticality and loss of long-range magnetic order.
High-temperature superconductors (HTS) promise to revolutionize high-power applications like wind generators, DC power cables, particle accelerators, and fusion energy devices. A practical HTS cable ...must not degrade under severe mechanical, electrical, and thermal conditions; have simple, low-resistance, and manufacturable electrical joints; high thermal stability; and rapid detection of thermal runaway quench events. We have designed and experimentally qualified a vacuum pressure impregnated, insulated, partially transposed, extruded, and roll-formed (VIPER) cable that simultaneously satisfies all of these requirements for the first time. VIPER cable critical currents are stable over thousands of mechanical cycles at extreme electromechanical force levels, multiple cryogenic thermal cycles, and dozens of quench-like transient events. Electrical joints between VIPER cables are simple, robust, and demountable. Two independent, integrated fiber-optic quench detectors outperform standard quench detection approaches. VIPER cable represents a key milestone in next-step energy generation and transmission technologies and in the maturity of HTS as a technology.
Fiber-optic thermometry has the potential to provide rapid and reliable quench detection for emerging large-scale, high-field superconducting magnets fabricated with high-temperature-superconductor ...(HTS) cables. Developing non-voltage-based quench detection schemes, such as fiber Bragg grating (FBG) technology, are particularly important for applications such as magnetic fusion devices where a high degree of induced electromagnetic noise impose significant challenges on traditional voltage-based quench detection methods. To this end, two fiber optic quench detection techniques-FBG and ultra-long FBG (ULFBG)-were incorporated into two vacuum pressure impregnated, insulated, partially transposed, extruded, and roll-formed (VIPER) high-current HTS cables and tested in the SULTAN facility, which provides high-fidelity operating conditions to large-scale superconducting magnets. During surface heater induced quench-like events under a variety of operating conditions, FBG and ULFBG demonstrated strong signal-to-noise ratios (SNRs) ranging from 4 to 32 and measured single-digit temperature excursions; both the SNR and temperature sensitivity increase with temperature. Fiber thermal response times ranged between effectively instantaneous to a few seconds depending on the operating temperature. Strain sensitivity dominates the thermal sensitivity in the conditions achievable at SULTAN; however, measurements at higher quench evolution temperatures, coupled to future work to increase the thermal-to-strain signal, show promise for quench detection capability in full-scale magnets where temperature and strain may occur simultaneously. Overall, FBG and ULFBG were proven capable to quickly and reliably detect small temperature disturbances which induced quench initiation events for high current VIPER HTS conductors in realistic operating conditions, motivating further work to develop FBG and ULFGB quench detection systems for full-scale HTS magnets.
Fatty acid ethyl esters (FAEEs) are products of nonoxidative ethanol metabolism. After incorporation in hair, they should be suitable long-term markers of alcohol abuse.
Hair samples from 19 ...alcoholics in a treatment program, 10 fatalities with verified excessive alcohol consumption, 13 moderate social drinkers who consumed up to 20 g ethanol/day, and 5 strict teetotalers were analyzed in 1-12 segments for four FAEEs (ethyl myristate, ethyl palmitate, ethyl oleate, and ethyl stearate) by external degreasing with n-heptane, extraction with a dimethyl sulfoxide-n-heptane mixture, headspace solid-phase microextraction of the extracts, and gas chromatography-mass spectrometry with deuterated internal standards. The n-heptane washings were analyzed in the same way for FAEEs from the hair surface.
The sum of the four ester concentrations in hair calculated for the proximal 0-6 cm segment was 2.5-13.5 ng/mg (mean, 6.8 ng/mg) for the fatalities, 0.92-11.6 ng/mg (mean, 4.0 ng/mg) for 17 of the alcoholics in treatment, 0.20-0.85 ng/mg (mean, 0.41 ng/mg) for the moderate social drinkers, and 0.06-0.37 ng/mg (mean, 0.16 ng/mg) for the teetotalers. In almost all cases the segmental concentrations increased from proximal to distal. There was no agreement between the self-reported drinking histories of the participants and the FAEE concentrations along the hair length. Ethyl oleate was the dominant ester in all samples.
FAEEs are deposited in hair mainly from sebum. Despite large individual differences, FAEE hair concentrations can be used as markers for excessive alcohol consumption with relatively high accuracy.
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