Objective
Malignant ovarian germ cell tumors (MOGCT) carry an excellent prognosis, and the treatment aims to achieve results with the least possible treatment‐related morbidity. The aim of this study ...was to assess the outcomes of pediatric patients with MOGCT.
Methods
Patients were treated according to their stage: surgery and surveillance for stage I; a modified bleomycin–etoposide–cisplatin (BEP) regimen for stages II (three cycles), III, and IV (three cycles) with surgery on residual disease.
Results
Seventy‐seven patients were enrolled (median age 11.8 years), 26 with dysgerminoma (Dysg), 13 with immature teratoma and elevated serum alpha‐fetoprotein levels (IT + AFP), and 38 with nondysgeminoma (Non‐Dysg) staged as follows: 27 stage I, 13 stage II, 32 stage III, 5 stage IV. Among evaluable patients in stage I (5‐year event‐free survival EFS 72.1% 95% CI: 56.4–92.1%; 5‐year overall survival OS 100%), seven relapsed (three patients with Dysg and four patients with Non‐Dysg) and were rescued with chemotherapy (plus surgery in three patients). Among the evaluable patients with stages II–IV, 48 (98%) achieved complete remission after chemotherapy ± surgery, one (IT + AFP, stage IV) had progressive disease. In the whole series (median follow‐up 80 months), the 5‐year OS and EFS were 98.5% (95% CI: 95.6–100%) and 84.5% (95% CI: 76.5–93.5%).
Conclusions
We confirm the excellent outcome for MOGCT. Robust data are lacking on surgical staging, surveillance for Non‐Dysg with stage I, the management of IT + AFP, and the most appropriate BEP regimen. As pediatric oncologists, we support the role of surveillance after proper surgical staging providing cases are managed by experts at specialized pediatric centers.
The TOTEM collaboration at the CERN LHC has measured the differential cross-section of elastic proton–proton scattering at
s
=
8
TeV
in the squared four-momentum transfer range
0.2
GeV
2
<
|
t
|
<
...1.9
GeV
2
. This interval includes the structure with a diffractive minimum (“dip”) and a secondary maximum (“bump”) that has also been observed at all other LHC energies, where measurements were made. A detailed characterisation of this structure for
s
=
8
TeV
yields the positions,
|
t
|
dip
=
(
0.521
±
0.007
)
GeV
2
and
|
t
|
bump
=
(
0.695
±
0.026
)
GeV
2
, as well as the cross-section values,
d
σ
/
d
t
dip
=
(
15.1
±
2.5
)
μ
b
/
GeV
2
and
d
σ
/
d
t
bump
=
(
29.7
±
1.8
)
μ
b
/
GeV
2
, for the dip and the bump, respectively.
Summary
Background
Consensus on standard methods to assess chronic abdominal pain in patients with irritable bowel syndrome (IBS) is currently lacking.
Aim
To systematically review the literature ...with respect to instruments of measurement of chronic abdominal pain in IBS patients.
Methods
Systematic literature search was performed in PubMed/Medline databases for studies using pain measurement instruments in patients with IBS.
Results
One hundred and ten publications were reviewed. A multitude of different instruments is currently used to assess chronic abdominal pain in IBS patients. The single‐item methods, e.g. the validated 10‐point numeric rating scale (NRS), and questionnaires assessing gastrointestinal symptoms severity, focus mostly on the assessment of only the intensity of abdominal pain. Of these questionnaires, the validated IBS‐Symptom Severity Scale includes the broadest measurement of pain‐related aspects. General pain questionnaires and electronic momentary symptom assessment tools have been used to study abdominal pain in IBS patients, but have not yet been validated for this purpose. The evidence for the use of provocation tests, e.g. the rectal barostat with balloon distention, for measurement of abdominal pain in IBS is weak, due to the poor correlation between visceral pain thresholds assessed by provocation tests and abdominal pain as assessed by retrospective questionnaires.
Conclusions
The multitude of different instruments to measure chronic abdominal pain in IBS makes it difficult to compare endpoints of published studies. There is need for validated instruments to assess chronic abdominal pain in IBS patients, that overcome the limitations of the currently available methods.
To compare improvement in pain and physical function for patients treated with baricitinib, adalimumab, tocilizumab and tofacitinib monotherapy from randomised, methotrexate (MTX)-controlled trials ...in conventional synthetic disease-modifying antirheumatic drugs (csDMARDs)/biologic (bDMARD)-naïve RA patients using matching-adjusted indirect comparisons (MAICs).
Data were from Phase III trials on patients receiving monotherapy baricitinib, tocilizumab, adalimumab, tofacitinib or MTX. Pain was assessed using a visual analogue scale (0-100 mm) and physical function using the Health Assessment Questionnaire-Disability Index (HAQ-DI). An MAIC based on treatment-arm matching, an MAIC with study-level matching and Bucher's method without matching compared change in outcomes between therapies. Matching variables included age, gender, baseline disease activity and baseline value of outcome measure.
With all methods, greater improvements were observed in pain and HAQ-DI at 6 months for baricitinib compared with adalimumab and tocilizumab (
<0.05). Differences in treatment effects (TEs) favouring baricitinib for pain VAS for treatment-arm matching, study-level matching and Bucher's method, respectively, were -12, -12 and -12 for baricitinib versus adalimumab and -7, -7 and -9 for baricitinib versus tocilizumab; the difference in TEs for HAQ-DI was -0.28, -0.28 and -0.30 for adalimumab and -0.23, -0.23 and -0.26 for tocilizumab. For baricitinib versus tofacitinib, no statistically significant differences for pain improvement were observed except with one of the three methods (Bucher method) and none for HAQ-DI.
Results suggest greater pain reduction and improved physical function for baricitinib monotherapy compared with tocilizumab and adalimumab monotherapy. No statistically significant differences in pain reduction and improved physical function were observed between baricitinib and tofacitinib with the MAIC analyses.
Abstract
The TOTEM collaboration at the CERN LHC has measured the differential cross-section of elastic proton–proton scattering at
$$\sqrt{s} = 8\,\mathrm{TeV}$$
s
=
8
TeV
in the squared ...four-momentum transfer range
$$0.2\,\mathrm{GeV^{2}}< |t| < 1.9\,\mathrm{GeV^{2}}$$
0.2
GeV
2
<
|
t
|
<
1.9
GeV
2
. This interval includes the structure with a diffractive minimum (“dip”) and a secondary maximum (“bump”) that has also been observed at all other LHC energies, where measurements were made. A detailed characterisation of this structure for
$$\sqrt{s} = 8\,\mathrm{TeV}$$
s
=
8
TeV
yields the positions,
$$|t|_{\mathrm{dip}} = (0.521 \pm 0.007)\,\mathrm{GeV^2}$$
|
t
|
dip
=
(
0.521
±
0.007
)
GeV
2
and
$$|t|_{\mathrm{bump}} = (0.695 \pm 0.026)\,\mathrm{GeV^2}$$
|
t
|
bump
=
(
0.695
±
0.026
)
GeV
2
, as well as the cross-section values,
$$\left. {\mathrm{d}\sigma /\mathrm{d}t}\right| _{\mathrm{dip}} = (15.1 \pm 2.5)\,\mathrm{{\mu b/GeV^2}}$$
d
σ
/
d
t
dip
=
(
15.1
±
2.5
)
μ
b
/
GeV
2
and
$$\left. {\mathrm{d}\sigma /\mathrm{d}t}\right| _{\mathrm{bump}} = (29.7 \pm 1.8)\,\mathrm{{\mu b/GeV^2}}$$
d
σ
/
d
t
bump
=
(
29.7
±
1.8
)
μ
b
/
GeV
2
, for the dip and the bump, respectively.
Photonic qubits can represent an ideal choice in quantum information science since photons travel at the speed of light and interact weakly with the environment over long distances. In this context, ...technological platforms allowing the development and implementation of chip-scale integrated photonics represent a possible solution toward scalable quantum networking schemes. However, at present, most examples of integrated quantum photonics still require the coupling of light to external photodetectors operating at very low temperatures. In this paper, we demonstrate that the GeSn/Si-in-SOI technological platform can be a good candidate to realize integrated single-photon avalanche detectors (SPADs), operating at room temperature. Thus, we report the design and simulation of waveguide-based SPADs for operation at 1550 and 2000 nm wavelengths. We calculate the breakdown voltage, the dark count rate (DCR), the single photon detection efficiency (SPDE), the noise equivalent power (NEP), the dark count, and the afterpulsing probabilities by simulating the avalanche process and the statistical features in a self-consistent way. The PIPIN SPAD performance parameters are estimated as a function of the GeSn’s threading dislocation density and of the temperature. We also demonstrate that for operation at 1550 and 2000 nm wavelengths with the 220 nm GeSn separate absorber film centered in the 250 nm high Si waveguide end, it is possible to cover a number of applications at room or near room temperature, ranging from ultrasensitive LIDAR to quantum communications, metrology, sensing, and key distribution.
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