Background: The British Columbia randomized radiation trial was designed to determine the survival impact of locoregional radiation therapy in premenopausal patients with lymph node–positive breast ...cancer treated by modified radical mastectomy and adjuvant chemotherapy. Three hundred eighteen patients were assigned to receive no further therapy or radiation therapy (37.5 Gy in 16 fractions). Previous analysis at the 15-year follow-up showed that radiation therapy was associated with a statistically significant improvement in breast cancer survival but that improvement in overall survival was of only borderline statistical significance. We report the analysis of data from the 20-year follow-up. Methods: Survival was analyzed by the Kaplan–Meier method. Relative risk estimates were calculated by the Wald test from the proportional hazards regression model. All statistical tests were two-sided. Results: At the 20 year follow up (median follow up for live patients: 249 months) chemotherapy and radiation therapy, compared with chemotherapy alone, were associated with a statistically significant improvement in all end points analyzed, including survival free of isolated locoregional recurrences (74% versus 90%, respectively; relative risk RR = 0.36, 95% confidence interval CI = 0.18 to 0.71; P = .002), systemic relapse–free survival (31% versus 48%; RR = 0.66, 95% CI = 0.49 to 0.88; P = .004), breast cancer-free survival (48% versus 30%; RR = 0.63, 95% CI = 0.47 to 0.83; P = .001), event-free survival (35% versus 25%; RR = 0.70, 95% CI = 0.54 to 0.92; P = .009), breast cancer-specific survival (53% versus 38%; RR = 0.67, 95% CI = 0.49 to 0.90; P = .008), and, in contrast to the 15-year follow-up results, overall survival (47% versus 37%; RR = 0.73, 95% CI = 0.55 to 0.98; P = .03). Long-term toxicities, including cardiac deaths (1.8% versus 0.6%), were minimal for both arms. Conclusion: For patients with high-risk breast cancer treated with modified radical mastectomy, treatment with radiation therapy (schedule of 16 fractions) and adjuvant chemotherapy leads to better survival outcomes than chemotherapy alone, and it is well tolerated, with acceptable long-term toxicity.
EEG studies show that observing errors in one's own or others' actions triggers specific electro-cortical signatures in the onlooker's brain, but whether the brain error-monitoring system operates ...according to graded or discrete rules is still largely unknown. To explore this issue, we combined immersive virtual reality with EEG recording in participants who observed an avatar reaching-to-grasp a glass from a first-person perspective. The avatar could perform correct or erroneous actions. Erroneous grasps were defined as small or large depending on the magnitude of the trajectory deviation from the to-be-grasped glass. Results show that electro-cortical indices of error detection (indexed by ERN and mid-frontal theta oscillations), but not those of error awareness (indexed by error-Positivity), were gradually modulated by the magnitude of the observed errors. Moreover, the phase connectivity analysis revealed that enhancement of mid-frontal theta phase synchronization paralleled the magnitude of the observed error. Thus, theta oscillations represent an electro-cortical index of the degree of control exerted by mid-frontal regions whose activation depends on how much an observed action outcome results maladaptive for the onlooker. Our study provides novel neurophysiological evidence that the error monitoring system maps observed errors of different magnitude according to fine-grain, graded rather than all-or-none rules.
•Seeing avatar's action errors activates the onlooker's error detection brain system.•ERN and theta power are modulated analogically by amplitude of observed errors.•Mid-frontal theta phase synchronization parallels the observed error magnitude.•Virtual reality is a powerful tool to study action observation ecologically.
Listeria monocytogenes is often responsible for postprocessing contamination of ready‐to‐eat (RTE) products including cooked ham. As an emerging technology, atmospheric cold plasma (ACP) has the ...potential to inactivate L. monocytogenes in packaged RTE meats. The objectives of this study were to evaluate the effect of treatment time, modified atmosphere gas compositions (MAP), ham formulation, and post‐treatment storage (1 and 7 days at 4 °C) on the reduction of a five‐strain cocktail of L. monocytogenes and quality changes in ham subjected to in‐package ACP treatment. Initial average cells population on ham surfaces were 8 log CFU/cm2. The ACP treatment time and gas composition significantly (P < 0.05) influenced the inactivation of L. monocytogenes, irrespective of ham formulations. When MAP1 (20% O2 + 40% CO2 + 40% N2) was used, there was a significantly higher log reduction (>2 log reduction) in L. monocytogenes on ham in comparison to MAP2 (50% CO2 + 50% N2) and MAP3 (100% CO2), irrespective of ham formulation. Addition of preservatives (that is, 0.1% sodium diacetate and 1.4% sodium lactate) or bacteriocins (that is, 0.05% of a partially purified culture ferment from Carnobacterium maltaromaticum UAL 307) did not significantly reduce cell counts of L. monocytogenes after ACP treatment. Regardless of type of ham, storage of 24 hr after ACP treatment significantly reduced cells counts of L. monocytogenes to approximately 4 log CFU/cm2. Following 7 days of storage after ACP treatment, L. monocytogenes counts were below the detection limit (>6 log reduction) when samples were stored in MAP1. However, there were significant changes in lipid oxidation and color after post‐treatment storage. In conclusion, the antimicrobial efficacy of ACP is strongly influenced by gas composition inside the package and post‐treatment storage.
Practical Application
Surface contamination of RTE ham with L. monocytogenes may occur during processing steps such as slicing and packaging. In‐package ACP is an emerging nonthermal technology, which can be used as a postpackaging decontamination step in industrial settings. This study demonstrated the influence of in‐package gas composition, treatment time, post‐treatment storage, and ham formulation on L. monocytogenes inactivation efficacy of ACP. Results of present study will be helpful to optimize in‐package ACP treatment and storage conditions to reduce L. monocytogenes, while maintaining the quality of ham.
A monocentric cross-sectional study recruiting rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients residing in the Lazio region, Italy, to assess factors related to diagnostic delay and ...treatment accessibility.
Clinical/serological data, including the time between symptom onset, diagnosis, and the beginning of treatment, were collected. Residence, referral to a rheumatologic center, physician who made the diagnosis, and previous misdiagnosis were also evaluated.
A higher diagnostic delay (p=0.003), and time between symptom onset and the start of I-line therapy (p=0.006) were observed in PsA compared to RA. A delayed start of II-line therapy was observed in RA compared to PsA (p=0.0007). Higher diagnostic delay (p=0.02), and time between symptom onset and the start of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) (p=0.02) were observed among residents of small-medium cities for both groups. Patients who have been diagnosed by another physician rather than a rheumatologist had a longer diagnostic delay (p=0.034) and a delayed start of I-line therapy (p=0.019). Patients who received a different previous diagnosis experienced greater diagnostic delay (p=0.03 and p=0.003) and time of start of csDMARDs (p=0.05 and p=0.01) compared with those receiving RA or PsA as the first diagnosis. PsA had a delay in starting targeted synthetic disease-modifying anti-rheumatic drugs (p=0.0004) compared to RA. Seronegative RA had delayed diagnosis (p=0.02) and beginning of therapies (p=0.03; p=0.04) compared to seropositive ones.
According to our results, greater diagnostic delay was found in PsA compared to RA, in patients living in small-medium cities, in those who did not receive the diagnosis from a rheumatologist, in those who were previously misdiagnosed, and in seronegative RA.
Trials of postoperative radiotherapy for breast cancer conducted during the 1960s and 1970s showed significant reductions in rates of locoregional recurrence but no improvement in overall survival.
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This result has been attributed to micrometastases, which determine prognosis regardless of the effect of the locoregional therapy. Additional concern was raised by data suggesting that irradiated patients have reduced survival rates, due to either immune suppression
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or cardiac complications.
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In the late 1970s, adjuvant chemotherapy became a standard treatment for high-risk premenopausal patients with breast cancer.
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The use of adjuvant radiation subsequently declined, because it did not appear . . .
For the identification of yeast genes specifying biochemical activities, a genomic strategy that is rapid, sensitive, and widely applicable was developed with an array of 6144 individual yeast ...strains, each containing a different yeast open reading frame (ORF) fused to glutathione S-transferase (GST). For the identification of ORF-associated activities, strains were grown in defined pools, and GST-ORFs were purified. Then, pools were assayed for activities, and active pools were deconvoluted to identify the source strains. Three previously unknown ORF-associated activities were identified with this strategy: a cyclic phosphodiesterase that acts on adenosine diphosphate-ribose 1″-2″ cyclic phosphate (Appr>p), an Appr-1″-p-processing activity, and a cytochrome c methyltransferase.
Ready-to-eat (RTE) deli meat has been linked to several Listeria monocytogenes associated recalls. Recent studies demonstrated the potential antimicrobial effects of atmospheric cold plasma treatment ...on various food surfaces including RTE meat products. However, the influence of intrinsic and extrinsic factors, determining the efficacy of cold plasma to reduce Listeria has not been reported. This study investigated the influence of rosemary extract, salt (% NaCl), and treatment temperature on the efficacy of plasma to reduce numbers of L. innocua on RTE ham. The effect of post-treatment storage on L. innocua inactivation was also investigated. When the cold plasma treatment temperature was 4 °C, we observed a significant reduction in L. innocua of 1.75 and 1.51 log CFU/cm2 on 1% and 3% NaCl ham surface without rosemary extract respectively, after 180 s treatment. At a treatment temperature of 23 °C, the L. innocua cells were reduced by 1.78 and 1.43 log CFU/cm2, respectively on these surfaces after 180 s. No significant effects of salt concentration and treatment temperature were observed on L. innocua inactivation during cold plasma treatment of ham. The post treatment storage at 4 °C for 6 h after 180 s of plasma treatment enhanced further reduction of L. innocua on 1% NaCl ham without rosemary. We also observed the increased concentration of malondialdehyde (MDA) equivalent lipid oxidation of plasma treated samples and was significantly higher (1.53 MDA mg/ kg ham) compared to untreated samples (0.92 MDA mg/kg ham). However, no significant differences in surface color parameters, L* and b* values were observed after plasma treatment, except a significant increase in a* values. The water content of plasma exposed samples decreased significantly for all treatment conditions whereas the water activity values were not changed significantly. In conclusion, the atmospheric cold plasma could be applied as a means for surface decontamination of RTE ham. However, the drying and oxidation of ham should be controlled in an open atmospheric plasma treatment condition.
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•Antimicrobial efficacy of atmospheric plasma against L. innocua on RTE ham was investigated.•Plasma treatment time and post-treatment storage significantly increased the log reductions in L. innocua counts.•Presence of rosemary extract and % NaCl did not significantly influence the inactivation of L. innocua•Lipid oxidation increased during plasma treatment.
GRB110721A was observed by the Fermi Gamma-ray Space Telescope using its two instruments, the Large Area Telescope (LAT) and the Gamma-ray Burst Monitor (GBM). The burst consisted of one major ...emission episode which lasted for ~24.5 s (in the GBM) and had a peak flux of (5.7 + or - 0.2) x 10 super(?5) erg s super(?1) cm super(?2). The time-resolved emission spectrum is best modeled with a combination of a Band function and a blackbody spectrum. The peak energy of the Band component was initially 15 + or - 2 MeV, which is the highest value ever detected in a GRB. This measurement was made possible by combining GBM/BGO data with LAT Low Energy events to achieve continuous 10-100 MeV coverage. The peak energy later decreased as a power law in time with an index of -1.89 + or - 0.10. The temperature of the blackbody component also decreased, starting from ~80 keV, and the decay showed a significant break after ~2 s. The spectrum provides strong constraints on the standard synchrotron model, indicating that alternative mechanisms may give rise to the emission at these energies.
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