Background
Outside clinical trials, data on systemic reactions (SRs) due to allergen immunotherapy (AIT) are scarce.
Methods
A prospective, longitudinal, web‐based survey of ‘real‐life’ respiratory ...allergen immunotherapy (AIT) clinical practice was conducted in France, Germany and Spain. SRs were recorded and coded according to the Medical Dictionary for Regulatory Activities (MedDRA) and risk factors associated with SRs were identified.
Results
A total of 4316 patients (corresponding to 4363 ongoing courses of AIT) were included. A total of 109 SRs were recorded, and 90 patients (2.1%) presented at least one SR. Most of the SRs occurred in subcutaneous allergen immunotherapy (SCIT) (89%, n = 97). The most frequently reported symptoms were urticaria, rhinitis, dyspnoea and cough. Respiratory symptoms appeared before skin symptoms. Most SRs occurred during the up‐dosing phase (75.8%) and were mild in severity (71.6%). Intramuscular adrenaline was administered in 17 SRs, but only 65% of these were subsequently classified as anaphylaxis. Independent risk factors for SRs during SCIT were as follows: the use of natural extracts (odds ratio, OR) 95% confidence interval (CI) = 2.74 1.61–4.87, P = 0.001), the absence of symptomatic allergy medications (1.707 1.008–2.892, P = 0.047), asthma diagnosis (1.74 1.05–2.88, P = 0.03), sensitization to animal dander (1.93 1.21–3.09, P = 0.006) or pollen (1.16 1.03–1.30, P = 0.012) and cluster regimens (vs rush) (4.18 1.21–14.37, P = 0.023). A previous episode of anaphylaxis increased the risk for anaphylaxis in SCIT (OR 95% CI = 17.35 1.91–157.28, P = 0.01).
Conclusion
AIT for respiratory allergy is safe, with a low number of SRs observed in real‐life clinical practice. A personalized analysis of risk factors could be used to minimize SRs.
We studied neuroinflammation in individuals with late-life, depression, as a
risk factor for dementia, using 11CPK11195 positron emission
tomography (PET). Five older participants with major ...depression and 13
controls underwent PET and multimodal 3T magnetic resonance imaging (MRI),
with blood taken to measure C-reactive protein (CRP). We found significantly
higher CRP levels in those with late-life depression and raised
11CPK11195 binding compared with controls in brain regions
associated with depression, including subgenual anterior cingulate cortex,
and significant hippocampal subfield atrophy in cornu ammonis 1 and
subiculum. Our findings suggest neuroinflammation requires further
investigation in late-life depression, both as a possible aetiological
factor and a potential therapeutic target.
•Self-Propagating High–Temperature Synthesis initiated by concentrated solar energy.•Efficient and sustainable synthesis of Ni-Al intermetallic compounds laminates.•Advanced solar manufacturing ...process with reduced energy.•Laminate parts with good hardness, porosity and appearance were obtained.•CSE minimised heating times and increased the process productivity and performance.
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The intermetallic compounds are very interesting in a multitude of structural and functional applications, such as in turbomachines or engine parts, due to their good behaviour at high temperatures, as well as their high resistance to corrosion and oxidation. In the present work, the study of processing of the Ni-Al system intermetallics has been carried out by means of Self-Propagating High–Temperature Synthesis initiated by concentrated solar energy (SHS–CSE). Synthesis by this high-energy exothermic reaction often causes the appearance of porosity, lack of interlayer adhesion, volumetric expansion, and even the total loss of sample shape. To obtain high-quality systems, a study has been carried out on one-layer and multi-layer configurations from powder materials, considering the influence of the heating rate and time. The use of concentrated solar energy has allowed to obtain fully densified nickel parts at 1000°C in just 15 min, compared to the 1325°C and more than 12h required by conventional techniques to obtain lower relative densities (~97%). The best results in multilayer configurations have been achieved in Ni-Ni/Al-Ni system with the synthesis of intermetallic compounds type Ni2Al3, NiAl and Ni3Al. The control of volumetric expansion and porosity, full densified nickel layers perfectly adhered to the interlayer and hardness values up to 900 HV have been obtained in just 2 min. This work highlights the wide possibilities of the use of CSE in metal treatment, which allows efficient and sustainable synthesis of new systems and the improvement of the final properties of the parts.
Our sensory system is able to build a unified perception of the world, which although rich, is limited and inaccurate. Sometimes, features from different objects are erroneously combined. At the ...neural level, the role of the parietal cortex in feature integration is well‐known. However, the brain dynamics underlying correct and incorrect feature integration are less clear. To explore the temporal dynamics of feature integration, we studied the modulation of different frequency bands in trials in which feature integration was correct or incorrect. Participants responded to the color of a shape target, surrounded by distractors. A calibration procedure ensured that accuracy was around 70% in each participant. To explore the role of expectancy in feature integration, we introduced an unexpected feature to the target in the last blocks of trials. Results demonstrated the contribution of several frequency bands to feature integration. Alpha and beta power was reduced for hits compared to illusions. Moreover, gamma power was overall larger during the experiment for participants who were aware of the unexpected target presented during the last blocks of trials (as compared to unaware participants). These results demonstrate that feature integration is a complex process that can go wrong at different stages of information processing and is influenced by top‐down expectancies.
When exploring the brain dynamics of feature integration, previous studies have only explored one frequency band. We explore if and how different cognitive failures can lead to incorrect feature integration by exploring the modulation of different frequency bands. Our results support that feature integration can go wrong at different stages including pre‐stimulus attentional processes (alpha), perceptual representations (post‐stimulus, alpha and beta), and working memory (gamma).
ABSTRACT We present the discovery of a transiting exoplanet candidate in the K2 Field-1 with an orbital period of 9.1457 hr: K2-22b. The highly variable transit depths, ranging from ∼0% to 1.3%, are ...suggestive of a planet that is disintegrating via the emission of dusty effluents. We characterize the host star as an M-dwarf with Teff 3800 K. We have obtained ground-based transit measurements with several 1-m class telescopes and with the GTC. These observations (1) improve the transit ephemeris; (2) confirm the variable nature of the transit depths; (3) indicate variations in the transit shapes; and (4) demonstrate clearly that at least on one occasion the transit depths were significantly wavelength dependent. The latter three effects tend to indicate extinction of starlight by dust rather than by any combination of solid bodies. The K2 observations yield a folded light curve with lower time resolution but with substantially better statistical precision compared with the ground-based observations. We detect a significant "bump" just after the transit egress, and a less significant bump just prior to transit ingress. We interpret these bumps in the context of a planet that is not only likely streaming a dust tail behind it, but also has a more prominent leading dust trail that precedes it. This effect is modeled in terms of dust grains that can escape to beyond the planet's Hill sphere and effectively undergo "Roche lobe overflow," even though the planet's surface is likely underfilling its Roche lobe by a factor of 2.
Background
Microscopic residual disease (MRD) after surgery can be a challenging situation in cutaneous squamous cell carcinoma (CSCC) and there is a lack of evidence concerning its management.
...Objective
To evaluate the prognosis of CSCC with MRD and the usefulness of postoperative radiotherapy (PORT) in CSCC with MRD.
Methods
Retrospective cohort study of CSCC with MRD through a 10‐year period (2010–2019) (n = 244). Disease‐free survival and event‐free survival were assessed using R (v.3.4.1), considering competing risks. Evaluated outcomes were local recurrence (LR), nodal metastases (NMs), and disease‐specific death (DSD).
Results
Median age was 88y (IQR: 10.5). A total of 145 (59.43%) were men and 69 (28.28%) were immunosuppressed. Median tumour diameter and thickness were 19 and 6.4 mm (IQR 11 and 5.5 mm). Patients treated by re‐excision had a relapse rate of 4.3% compared with 11.30% and 29.71% in those who received PORT and observation (P = 0.045). The use of PORT was associated with a lower risk of LR compared with observation (HR = 0.206 0.049–0.859, P = 0.030), but not with a lower risk of NMs or DSDs. In the multivariable models, PORT was again associated with a lower risk of LR than observation (HR = 0.167 0.039–0.708, P = 0.014), but not with lower risk of metastasis and death.
Conclusions
We always should try to obtain clear margins after surgery. PORT improves local control in CSCC with MRD, but when administered to the tumour bed, it does not reduce the risk of NM and DSD.
Large variability in dissolved organic carbon (DOC) uptake rates has been reported for headwater streams, but the causes of this variability are still not well understood. Here we assessed acetate ...uptake rates across 11 European streams comprising different ecoregions by using whole‐reach pulse acetate additions. We evaluated the main climatic and biogeochemical drivers of acetate uptake during two seasonal periods. Our results show a minor influence of sampling periods but a strong effect of climate and dissolved organic matter (DOM) composition on acetate uptake. In particular, mean annual precipitation explained half of the variability of the acetate uptake velocities (VfAcetate) across streams. Temperate streams presented the lowest VfAcetate, together with humic‐like DOM and the highest stream respiration rates. In contrast, higher VfAcetate were found in semiarid streams, with protein‐like DOM, indicating a dominance of reactive, labile compounds. This, together with lower stream respiration rates and molar ratios of DOC to nitrate, suggests a strong C limitation in semiarid streams, likely due to reduced inputs from the catchment. Overall, this study highlights the interplay of climate and DOM composition and its relevance to understand the biogeochemical mechanisms controlling DOC uptake in streams.
Plain Language Summary
Headwater streams receive and degrade organic carbon and nutrients from the surrounding catchments. That degradation can be assessed by measuring the uptake of simple compounds of carbon or nitrogen such as acetate or nitrate. Here we determine the variability in acetate and nitrate uptake rates across headwater streams and elucidate the mechanisms behind that variability. The balance between nutrients, the composition of the organic materials present in the streams, and the climatic background is at interplay.
Key Points
Across ecoregions, mean annual precipitation predicts 50% of the variability in dissolved organic carbon uptake
The interplay between dissolved organic matter composition and nutrients availability underlies the climatic pattern and drives uptake
Dissolved organic carbon uptake (as acetate) is negatively related to ecosystem respiration across regions
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