Background
The use of surgery in patients with locally advanced pancreatic cancer (LAPC) following induction chemotherapy is increasing. However, most series do not report on the total cohort of ...patients undergoing surgical exploration; therefore, this single-center study investigates outcomes among all consecutive patients with LAPC who underwent surgical exploration.
Methods
We conducted a retrospective, single-center analysis including all consecutive patients with LAPC (Dutch Pancreatic Cancer Group criteria) who underwent surgical exploration with curative intent (January 2014–June 2023) after induction therapy. Primary outcomes were resection rate and overall survival (OS) from the time of diagnosis.
Results
Overall, 127 patients underwent surgical exploration for LAPC, whereby 100 patients (78.7%) underwent resection and 27 patients (21.3%) underwent a non-therapeutic laparotomy due to the extent of vascular involvement (
n
= 11, 8.7%) or occult metastases (
n
= 16, 12.6%). The overall in-hospital/30-day mortality rate was 0.8% and major morbidity was 31.3% (in patients after resection: 1.0% and 33.3%, respectively). The overall 90-day mortality rate was 5.5%, which included 3.1% mortality due to disease progression. Resection was associated with longer median OS {29 months (95% confidence interval CI 26–43) vs. 17 months (95% CI 11–26)
; p
< 0.001} compared with patients undergoing non-therapeutic laparotomy, with corresponding 5-year OS rates of 28.4% and 7.7%. In Cox proportional hazard regression analysis, only pancreatic body/tail tumors independently predicted OS (hazard ratio 1.788 95% CI 1.042–3.068).
Conclusion
This single-center series found a resection rate of 78.7% in patients with LAPC selected for surgical exploration, with a low risk of mortality and morbidity in all explored patients and a 5-year OS rate after resection of 28.4%.
Abstract
We present observations and analysis of the hostless and luminous Type Ia supernova 2022ilv, illustrating it is part of the 2003fg-like family, often referred to as super-Chandrasekhar ...(Ia-SC) explosions. The Asteroid Terrestrial-impact Last Alert System light curve shows evidence of a short-lived, pulse-like early excess, similar to that detected in another luminous Type Ia supernova (SN 2020hvf). The light curve is broad, and the early spectra are remarkably similar to those of SN 2009dc. Adopting a redshift of
z
= 0.026 ± 0.005 for SN 2022ilv based on spectral matching, our model light curve requires a large
56
Ni mass in the range 0.7–1.5
M
⊙
and a large ejecta mass in the range 1.6–2.3
M
⊙
. The early excess can be explained by fast-moving SN ejecta interacting with a thin, dense shell of circumstellar material close to the progenitor (∼10
13
cm) a few hours after the explosion. This may be realized in a double-degenerate scenario, wherein a white dwarf merger is preceded by the ejection of a small amount (∼10
−3
–10
−2
M
⊙
) of hydrogen and helium-poor tidally stripped material. A deep pre-explosion Pan-STARRS1 stack indicates no host galaxy to a limiting magnitude of
r
∼ 24.5. This implies a surprisingly faint limit for any host of
M
r
≳ −11, providing further evidence that these types of explosions occur predominantly in low-metallicity environments.
Abstract
We have conducted photometric and spectroscopic observations of the peculiar Type Ia supernova (SN Ia) 2016ije that was discovered through the Tsinghua-NAOC Transient Survey. This peculiar ...object exploded in the outskirts of a metal-poor, low-surface brightness galaxy (i.e.,
M
g
= −14.5 mag). Our photometric analysis reveals that SN 2016ije is subluminous (
M
B
,
max
= −17.65 ± 0.06 mag) but exhibits relatively broad light curves (Δ
m
15
(
B
) = 1.35 ± 0.14 mag), similar to the behavior of SN 2002es. Our analysis of the bolometric light curve indicates that only 0.14 ± 0.04
M
⊙
of
56
Ni was synthesized in the explosion of SN 2016ije, which suggests a less energetic thermonuclear explosion when compared to normal SNe Ia, and this left a considerable amount of unburned materials in the ejecta. Spectroscopically, SN 2016ije resembles other SN 2002es-like SNe Ia, except that the ejecta velocity inferred from its carbon absorption line (∼4500 km s
−1
) is much lower than that from silicon lines (∼8300 km s
−1
) at around the maximum light. Additionally, most of the absorption lines are broader than other 02es-like SNe Ia. These peculiarities suggest the presence of significant unburned carbon in the inner region and a wide line-forming region along the line of sight. These characteristics suggest that SN 2016ije might originate from the violent merger of a white dwarf binary system, when viewed near an orientation along the iron-group-element cavity caused by the companion star.
Background
Patients affected by poverty-related infectious diseases (PRDs) are disproportionally affected by malnutrition. To optimize treatment of patients affected by PRDs, we aimed to assess the ...influence of malnutrition associated with PRDs on drug pharmacokinetics, by way of a systematic review.
Methods
A systematic review was performed on the effects of malnourishment on the pharmacokinetics of drugs to treat PRDs, including HIV, tuberculosis, malaria, and neglected tropical diseases.
Results
In 21/29 PRD drugs included in this review, pharmacokinetics were affected by malnutrition. Effects were heterogeneous, but trends were observed for specific classes of drugs and different types and degrees of malnutrition. Bioavailability of lumefantrine, sulfadoxine, pyrimethamine, lopinavir, and efavirenz was decreased in severely malnourished patients, but increased for the P-glycoprotein substrates abacavir, saquinavir, nevirapine, and ivermectin. Distribution volume was decreased for the lipophilic drugs isoniazid, chloroquine, and nevirapine, and the α1-acid glycoprotein-bound drugs quinine, rifabutin, and saquinavir. Distribution volume was increased for the hydrophilic drug streptomycin and the albumin-bound drugs rifampicin, lopinavir, and efavirenz. Drug elimination was decreased for isoniazid, chloroquine, quinine, zidovudine, saquinavir, and streptomycin, but increased for the albumin-bound drugs quinine, chloroquine, rifampicin, lopinavir, efavirenz, and ethambutol. Clinically relevant effects were mainly observed in severely malnourished and kwashiorkor patients.
Conclusions
Malnutrition-related effects on pharmacokinetics potentially affect treatment response, particularly for severe malnutrition or kwashiorkor. However, pharmacokinetic knowledge is lacking for specific populations, especially patients with neglected tropical diseases and severe malnutrition. To optimize treatment in these neglected subpopulations, adequate pharmacokinetic studies are needed, including severely malnourished or kwashiorkor patients.
The InterPro database (http://www.ebi.ac.uk/interpro/) integrates together predictive models or 'signatures' representing protein domains, families and functional sites from multiple, diverse source ...databases: Gene3D, PANTHER, Pfam, PIRSF, PRINTS, ProDom, PROSITE, SMART, SUPERFAMILY and TIGRFAMs. Integration is performed manually and approximately half of the total ~58 000 signatures available in the source databases belong to an InterPro entry. Recently, we have started to also display the remaining un-integrated signatures via our web interface. Other developments include the provision of non-signature data, such as structural data, in new XML files on our FTP site, as well as the inclusion of matchless UniProtKB proteins in the existing match XML files. The web interface has been extended and now links out to the ADAN predicted protein-protein interaction database and the SPICE and Dasty viewers. The latest public release (v18.0) covers 79.8% of UniProtKB (v14.1) and consists of 16 549 entries. InterPro data may be accessed either via the web address above, via web services, by downloading files by anonymous FTP or by using the InterProScan search software (http://www.ebi.ac.uk/Tools/InterProScan/).
Genes encoding synaptic proteins are highly associated with neuronal disorders many of which show clinical co-morbidity. We integrated 58 published synaptic proteomic datasets that describe over 8000 ...proteins and combined them with direct protein-protein interactions and functional metadata to build a network resource that reveals the shared and unique protein components that underpin multiple disorders. All the data are provided in a flexible and accessible format to encourage custom use.
A facile synthesis of an americium complex with a sulfur-donor ligand has been developed, allowing characterization of americium bonding from multiple perspectives via several techniques. Reaction of ...243Am with S2P(OEt)2 – yields the tetrakis complex Am(S2P(OEt)2)4− that can be crystallized as the tetraphenylarsonium salt. Structures obtained from single crystal X-ray diffraction show bond length discrepancies from the neodymium analogue consistent with the soft-donor bond enhancement common to actinides. Solid state optical spectroscopy confirms interaction of the ligand with 5f orbitals. 31P nuclear magnetic reflects the minor paramagnetism of Am(III). Computational investigations through CASSCF calculations, ligand-field density functional theory, and quantum chemical topological analysis allow a quantification of covalency or orbital interaction effects via total energy density and nephelauxetic parameters, both of which indicate greater covalency in the americium species than in the neodymium analogue or the americium aquo complex.
Background The relevance of allergic sensitization, as judged by titers of serum IgE antibodies, to the risk of an asthma exacerbation caused by rhinovirus is unclear. Objective We sought to examine ...the prevalence of rhinovirus infections in relation to the atopic status of children treated for wheezing in Costa Rica, a country with an increased asthma burden. Methods The children enrolled (n = 287) were 7 through 12 years old. They included 96 with acute wheezing, 65 with stable asthma, and 126 nonasthmatic control subjects. PCR methods, including gene sequencing to identify rhinovirus strains, were used to identify viral pathogens in nasal washes. Results were examined in relation to wheezing, IgE, allergen-specific IgE antibody, and fraction of exhaled nitric oxide levels. Results Sixty-four percent of wheezing children compared with 13% of children with stable asthma and 13% of nonasthmatic control subjects had positive test results for rhinovirus ( P < .001 for both comparisons). Among wheezing subjects, 75% of the rhinoviruses detected were group C strains. High titers of IgE antibodies to dust mite allergen (especially Dermatophagoides species) were common and correlated significantly with total IgE and fraction of exhaled nitric oxide levels. The greatest risk for wheezing was observed among children with titers of IgE antibodies to dust mite of 17.5 IU/mL or greater who tested positive for rhinovirus (odds ratio for wheezing, 31.5; 95% CI, 8.3-108; P < .001). Conclusions High titers of IgE antibody to dust mite allergen were common and significantly increased the risk for acute wheezing provoked by rhinovirus among asthmatic children.
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