Vaccination of immunocompromised patients is recommended in many national guidelines to protect against severe or complicated influenza infection. However, due to uncertainties over the evidence ...base, implementation is frequently patchy and dependent on individual clinical discretion. We conducted a systematic review and meta‐analysis to assess the evidence for influenza vaccination in this patient group. Healthcare databases and grey literature were searched and screened for eligibility. Data extraction and assessments of risk of bias were undertaken in duplicate, and results were synthesised narratively and using meta‐analysis where possible. Our data show that whilst the serological response following vaccination of immunocompromised patients is less vigorous than in healthy controls, clinical protection is still meaningful, with only mild variation in adverse events between aetiological groups. Although we encountered significant clinical and statistical heterogeneity in many of our meta‐analyses, we advocate that immunocompromised patients should be targeted for influenza vaccination.
Literature lacks clear evidence regarding the optimal treatment for non-muscle-invasive micropapillary bladder cancer (MPBC) due to its rarity and the presence of only small sample size and ...single-centre studies.
To assess cancer-specific mortality (CSM) and overall mortality (OM) between immediate radical cystectomy (RC) and conservative management among T1 high-grade (HG) MPBC.
We retrospectively analysed a multicentre dataset including 119 T1 HG MPBC patients treated between 2005 and 2019 at 15 tertiary referral centres. The median follow-up time was 35 mo (interquartile range: 19-64).
Patients underwent immediate RC versus conservative management with bacillus Calmette-Guérin.
Cumulative incidence functions and Kaplan-Meier methods were applied to estimate survival outcomes. Multivariable Cox analyses were performed to assess independent predictors of disease recurrence and disease progression after conservative management; covariates consisted of pure MPBC, concomitant lymphovascular invasion (LVI), and carcinoma in situ at initial diagnosis.
Immediate RC and conservative management were performed in 27% and 73% of patients, respectively. CSM and OM did not differ significantly among patient treated with immediate RC versus conservative management (Pepe-Mori test p = 0.5 and log-rank test p = 0.9, respectively). Overall, 66.7% and 34.5% of patients experienced disease recurrence and disease progression after conservative management, respectively. At multivariable Cox analyses, concomitant LVI was an independent predictor of disease recurrence (p = 0.01) and progression (p = 0.03), while pure MPBC was independently associated with disease progression (p = 0.03). The absence of a centralised re-review and the retrospective design represent the main limitations of our study.
Conservative management could achieve satisfactory results among T1 HG MPBC patients with neither pure MPBC nor LVI at initial diagnosis.
Bacillus Calmette-Guérin seems to be an effective therapy for T1 micropapillary bladder cancer patients with neither pure micropapillary disease nor lymphovascular invasion at initial diagnosis.
Expedition 364 was a joint IODP and ICDP mission-specific platform (MSP) expedition to explore the Chicxulub impact crater buried below the surface of the Yucatán continental shelf seafloor. In April ...and May 2016, this expedition drilled a single borehole at Site M0077 into the crater's peak ring. Excellent quality cores were recovered from ∼505 to ∼1335 m below seafloor (m b.s.f.), and high-resolution open hole logs were acquired between the surface and total drill depth. Downhole logs are used to image the borehole wall, measure the physical properties of rocks that surround the borehole, and assess borehole quality during drilling and coring operations. When making geological interpretations of downhole logs, it is essential to be able to distinguish between features that are geological and those that are operation-related. During Expedition 364 some drilling-induced and logging-related features were observed and include the following: effects caused by the presence of casing and metal debris in the hole, logging-tool eccentering, drilling-induced corkscrew shape of the hole, possible re-magnetization of low-coercivity grains within sedimentary rocks, markings on the borehole wall, and drilling-induced changes in the borehole diameter and trajectory.
Double beta decay of 100Mo to the excited states of daughter nuclei has been studied using a 600 cm3 low-background HPGe detector and an external source consisting of 2588 g of 97.5% enriched ...metallic 100Mo, which was formerly inside the NEMO-3 detector and used for the NEMO-3 measurements of 100Mo. The half-life for the two-neutrino double beta decay of 100Mo to the excited 01+ state in 100Ru is measured to be T1/2=7.5±0.6(stat)±0.6(syst)⋅1020 yr. For other (0ν+2ν) transitions to the 21+, 22+, 02+, 23+ and 03+ levels in 100Ru, limits are obtained at the level of ∼(0.25–1.1)⋅1022 yr.
: Gene expression for the differentiation‐specific keratins (K4, K13, K1 and K10) was analyzed in oral non‐dysplastic keratoses, oral lichen planus (OLP) and lichenoid reactions (LR) by comparative ...in situ hybridization (ISH) and immunohistochemistry (IHC) to investigate molecular changes in the altered differentiation pattern from non‐ to para‐ or orthokeratinization. At the protein level, K4 and K13 were detected homogeneously in the suprabasal compartment of parakeratotic epithelium but showed reduced expression in orthokeratoses, particularly in the presence of lymphocytes. Corresponding transcripts were restricted to basal and lower prickle cells. Synthesis of K1 and K10 was upregulated and more pronounced in orthokeratotic epithelia. The study showed an alteration in the pattern of differentiation‐specific keratins, although involvement of the lymphocytic infiltrate in OLP and LR resulted in further gene modulation. In both diseases, K1 and K10 showed transcriptional control, proteins having the same distribution as their transcripts. This represented a change from post‐transcriptional regulation in normal buccal epithelium, in which mRNAs for K1 and K10 are more widely expressed than their proteins. Thus, the pattern of keratin gene expression may be altered in response to frictional/smoking stimuli or immune‐mediated mechanisms.
The vagus is involved in the cephalic phase of insulin secretion but its role in the meal absorption phase of insulin release remains to be defined. The aim of this study was therefore to evaluate ...the role of the vagus in the early and the late meal absorption phases of insulin secretion. In six pigs, venous insulin profiles were compared in intact animals, after ventral or dorsal vagal trunk section, and after section of both vagal trunks (truncal vagotomy). Since gastric emptying could be modified by vagotomy, it was recorded concomitantly by gamma scintigraphy. Semi-solid (porridge) and liquid (glucose 10%) meals were tested. Truncal vagotomy significantly increased insulin release compare to intact animals after glucose (63.8%) and porridge (174.4%) meals in the early and the late absorption phases of insulin secretion, respectively. For the glucose meal, this effect could be explained by a vagally mediated change in gastric emptying rate, since insulin concentrations for a similar amount of nutrient propelled to the duodenum were not different in intact and truncal vagotomized animals. In contrast, after the porridge meal, truncal vagotomy was associated with a second, later occurring increase in circulating insulin, which could not be explained by changes in gastric emptying rate. These results demonstrate for the first time an inhibitory role of the vagus in the late meal absorption phase of insulin release.
The NEMO-3 detector, which had been operating in the Modane Underground Laboratory from 2003 to 2010, was designed to search for neutrinoless double $\beta$ ($0\nu\beta\beta$) decay. We report final ...results of a search for $0\nu\beta\beta$ decays with $6.914$ kg of $^{100}$Mo using the entire NEMO-3 data set with a detector live time of $4.96$ yr, which corresponds to an exposure of 34.3 kg$\cdot$yr. We perform a detailed study of the expected background in the $0\nu\beta\beta$ signal region and find no evidence of $0\nu\beta\beta$ decays in the data. The level of observed background in the $0\nu\beta\beta$ signal region $2.8-3.2$ MeV is $0.44 \pm 0.13$ counts/yr/kg, and no events are observed in the interval $3.2-10$ MeV. We therefore derive a lower limit on the half-life of $0\nu\beta\beta$ decays in $^{100}$Mo of $T_{1/2}(0\nu\beta\beta)> 1.1 \times 10^{24}$ yr at the $90\%$ Confidence Level, under the hypothesis of light Majorana neutrino exchange. Depending on the model used for calculating nuclear matrix elements, the limit for the effective Majorana neutrino mass lies in the range $\langle m_{\nu} \rangle < 0.33$--$0.62$ eV. We also report constraints on other lepton-number violating mechanisms for $0\nu\beta\beta$ decays.
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