Transfusion-related acute lung injury following PDA ligation in a preterm neonate

Transfusion-related acute lung injury (TRALI) is a life-threatening complication of blood product transfusion characterized by sudden onset hypoxemic respiratory failure with bilateral lung infiltrates and non-cardiogenic pulmonary edema developing within 6 hours of transfusion. It is believed to be under-recognized, particularly among preterm neonates in whom co-existing developmental lung disease adds diagnostic complexity. Here we report the case of a preterm neonate who developed TRALI during a blood transfusion following PDA ligation.

Chronic sensory-motor activity in behaving animals using regenerative multi-electrode interfaces

Regenerative peripheral nerve interfaces have been proposed as viable alternatives for the natural control and feel of robotic prosthetic limbs. We have developed a Regenerative Multi-electrode Interface (REMI) that guides re-growing axons through an electrode array deployed in the lumen of a nerve guide. While acute studies have shown the use of the REMI in the rat sciatic nerve, the quality of chronic signal recording has not been reported. Here we show that implantation of this interface in the sciatic nerve is stable with high quality recordings up to 120 days and failures mainly attributable to abiotic factors related to pedestal detachment and wire breakage. We further tested the interfacing of REMI with fascicles of the sciatic nerve that primarily innervate muscles (tibial) and skin (sural). When implanted into the tibial nerve, bursting activity was observed synchronous to stepping. However, implantation of REMI into the sural nerve failed due to its small size. While fascicles smaller than 300 μm are a challenge for regenerative interfacing, we show that a modified REMI can be used in an insertion mode to record sensory signals from skin. In summary, the REMI represents an effective tool for recording firing patterns of specific axon types during voluntary movement, which may be used to improve the motor control and sensory feedback in closed loop control systems for robotic prosthesis.

Risk factors for low birth weight in a socio-economically disadvantaged population: parity, marital status, ethnicity and cigarette smoking

Low birth weight (LBW) is a public health problem, because it is associated with increased risk of morbidity and mortality. The principal aim of this study was to assess risk factors for LBW in a large multi-ethnic and socio-economically disadvantaged population. Data from 3242 mothers, who attended the Well Baby Clinic (Southwestern Sydney, Australia) for the first time, were analysed in relation to their demographic characteristics and socio-economic indices. The overall birthweight was 3377 +/- 577 g (mean +/- SD). In multiple linear regression analysis, smoking during pregnancy, marital status, parity, and country of birth were independently associated with birth weight. According to this analysis, lower birth weight was associated with mothers who had smoked during pregnancy (by 215.2 +/- 18.6 g), who were single (46.9 +/- 21 g), and of Asian background (108.5 +/- 38.2 g). However, higher parity was associated with significantly higher birth weight. The presence of each factor was coded as 1 and the absence, 0. A 'risk score' was then derived by summing up the individual scores. When birth weight was classified as 'low birth weight' (defined as those with birth weight being less than 2500 g) or normal birth weight, the overall prevalence of LBW was 1.9%. Each unit increase in the risk score was associated with a 1.9-fold (95% confidence interval: 1.5-2.6) increase in the risk of LBW. These data suggest that apart from marital status, ethnicity and parity, maternal smoking is the single most important preventable risk factors for LBW.

Focal irreversible electroporation for prostate cancer: functional outcomes and short-term oncological control

BACKGROUND

Current data on the use of irreversible electroporation (IRE) in the treatment of prostate cancer (PCa) is limited. We aim to evaluate the safety, short-term functional and oncological outcomes of focal IRE in low-intermediate risk PCa.

METHODS

Between February 2013 and May 2014, 32 consecutive men underwent IRE at a single centre. Patients with low-intermediate risk PCa who had not received previous PCa treatment were included for analysis. The tumour was ablated using 3-6 electrodes, ensuring a minimum 5-mm safety margin around the visible magnetic resonance imaging (MRI) lesion. Follow-up included recording Clavien complications, Expanded Prostate Cancer Index Composite (EPIC) questionnaires (baseline, 1.5, 3, 6 months), 6-month multi-parametric MRI (mp-MRI) and 7-month biopsy. Findings on mp-MRI and biopsy were sub-divided into infield, adjacent or outfield of the treatment zone.

RESULTS

Twenty-five men were included for final analysis. Safety follow-up revealed one Clavien Grade 3 complication and five Grade 1 complications. Functional follow-up confirmed no significant change in American Urological Association urinary symptom score, sexual or bowel function. Infield, there were no suspicious findings on mp-MRI (n=24) or biopsy (n=21) in all patients. Adjacent to the treatment zone, five (21%) had suspicious findings on mp-MRI with four (19%) proving to be significant on biopsy. Outfield, there were two (8%) with suspicious findings on mp-MRI and one (5%) significant finding on biopsy. For the five patients with significant findings on follow-up biopsy, one is awaiting repeat IRE, one had radical prostatectomy and three remained on active surveillance.

CONCLUSIONS

In selected patients with low-intermediate risk PCa, focal IRE appears to be safe with minimal morbidity. There were no infield recurrences and 76% of patients were histologically free of significant cancer at 8 months. Almost all recurrences were adjacent to the treatment zone, and this was addressed by widening the treatment margins.

The influences of psychotic symptoms on the activities of daily living of individuals with Alzheimer disease: a longitudinal analysis

OBJECTIVES

Psychotic symptoms associated with Alzheimer Disease (AD) contribute to excess functional dependence. Longitudinal studies have generally examined the association between rates of functional decline and the occurrence of psychotic symptoms from either a single evaluation or from multiple evaluations rather than through changes in frequency and severity of symptoms. Although the presence or absence of psychotic symptoms at initial or follow-up examinations may be associated with changes in functional status, the nature of the relationship between changes in these domains cannot be inferred. We examine the association between changes in the frequency of psychotic symptoms and changes in dependence in activities of daily living (ADL) over a period ranging from 1 to 74 months (median = 17.7).

METHOD

Data from a cohort of 234 individuals referred to a memory clinic were analyzed using multilevel linear regression. Information on ADL, behavioral and psychological symptoms, depression, and cognition was collected.

RESULTS

An increase in the frequency of psychotic symptoms had a unique influence on the deterioration of basic ADL, after controlling for demographic variables, changes in cognition, depression, and other behavioral and psychological symptoms (B = -.017, p = .003). However, changes in psychotic symptoms did not significantly contribute to declines in the ability to perform instrumental ADL (B = -.008, p = .439).

CONCLUSION

Changes in psychotic symptoms may influence basic but not instrumental ADL over time. These findings may have ramifications for studies and treatment plans for individuals with AD who demonstrate psychotic symptoms.

Renal cell carcinoma metastases to the spermatic cord: review of the literature and case presentation

We present a case of clear cell renal cell carcinoma with metachronous metastasis to the ipsilateral spermatic cord. We also review the literature of the rare instance of renal cell carcinoma metastasising to the spermatic cord.

High peak-power picosecond pulse generation at 1.26 µm using a quantum-dot-based external-cavity mode-locked laser and tapered optical amplifier

In this paper, we present the generation of high peak-power picosecond optical pulses in the 1.26 μm spectral band from a repetition-rate-tunable quantum-dot external-cavity passively mode-locked laser (QD-ECMLL), amplified by a tapered quantum-dot semiconductor optical amplifier (QD-SOA). The laser emission wavelength was controlled through a chirped volume Bragg grating which was used as an external cavity output coupler. An average power of 208.2 mW, pulse energy of 321 pJ, and peak power of 30.3 W were achieved. Preliminary nonlinear imaging investigations indicate that this system is promising as a high peak-power pulsed light source for nonlinear bio-imaging applications across the 1.0 μm - 1.3 μm spectral range.

High-speed photodiodes for InP-based photonic integrated circuits

We demonstrate the feasibility of monolithic integration of evanescently coupled Uni-Traveling Carrier Photodiodes (UTC-PDs) having a bandwidth exceeding 100 GHz with Multimode Interference (MMI) couplers. This platform is suitable for active-passive, butt-joint monolithic integration with various Multiple Quantum Well (MQW) devices for narrow linewidth millimeter-wave photomixing sources. The fabricated devices achieved a high 3-dB bandwidth of up to 110 GHz and a generated output power of more than 0 dBm (1 mW) at 120 GHz with a flat frequency response over the microwave F-band (90-140 GHz).

Abstract P5-10-24: A Pragmatic Review of Adjuvant Chemotherapy Regimens in Early-Stage Breast Cancer — Hematologic Toxicities Experienced in a Single Institution

Background: Chemotherapy-related toxicities are associated with substantial morbidity, mortality, and health care expenditures. Three newer common adjuvant chemotherapy regimens - 5-fluorouracil, epirubicin, cyclophosphamide plus docetaxel (FEC-D), docetaxel plus cyclophosphamide (TC), and docetaxel, carboplatin plus trastuzumab (TCH) - have emerged as promising therapies. The toxicities experienced with these chemotherapeutic regimens were reviewed in a clinical practice setting outside of clinical trial.

Patients and Methods: Patients (pts) with early-stage breast cancer treated with adjuvant chemotherapy (FEC-D; TC; TCH) at St. Michael's Hospital in Toronto, Canada, between August 2006 and May 2010 were identified. Charts were audited for the presence of neutropenia (defined asabsolute neutrophil count (ANC) < 1.0x109/L), use of granulocyte-colony stimulating factor (G-CSF), incidence of febrile neutropenia (FN; defined as a single oral temperature ≥38.3 0Celsius, or oral temperature ≥38.0 0C lasting over 1 hour, with an ANC < 1.0x109/L).

Results: Overall, 175 pts were reviewed in this study. The rate of neutropenia, FN, and use of primary prophylaxis with G-CSF are summarized in the table below for each regimen. Thirty pts on FEC-D (25.2%) experienced significant complications resulting in dose delay, dose reduction, and discontinuation of chemotherapy, as did 9.1% of pts on TC, and 27.3% of pts on TCH. There was one death associated with FEC-D while on G-CSF.

Conclusion: Our institution reports FN rates higher than originally reported in all three chemotherapy regimens with a greater hematologic toxicity profile with FEC-D. Further investigation with larger patient cohorts is warranted, to determine if there is a need for primary prophylaxis with G-CSF in patients receiving FEC-D, TC, and TCH.

Table 1: Outcomes associated with FEC-D, TC, and TCH chemotherapy regimens

Spin-polarized inelastic tunneling through insulating barriers

Spin-conserving hopping transport through chains of localized states has been evidenced by taking benefit of the high degree of spin-polarization of CoFeB-MgO-CoFeB magnetic tunnel junctions. In particular, our data show that relatively thick MgO barriers doped with boron favor the activation of spin-conserving inelastic channels through a chain of three localized states and leading to reduced magnetoresistance effects. We propose an extension of the Glazman-Matveev theory to the case of ferromagnetic reservoirs to account for spin-polarized inelastic tunneling through nonmagnetic localized states embedded in an insulating barrier.

Enhancement of the spin accumulation at the interface between a spin-polarized tunnel junction and a semiconductor

We report on spin injection experiments at a Co/Al2O3/GaAs interface with electrical detection. The application of a transverse magnetic field induces a large voltage drop DeltaV at the interface as high as 1.2 mV for a current density of 0.34 nA.microm(-2). This represents a dramatic increase of the spin accumulation signal, well above the theoretical predictions for spin injection through a ferromagnet/semiconductor interface. Such an enhancement is consistent with a sequential tunneling process via localized states located in the vicinity of the Al2O3/GaAs interface. For spin-polarized carriers these states act as an accumulation layer where the spin lifetime is large. A model taking into account the spin lifetime and the escape tunneling time for carriers traveling back into the ferromagnetic contact reproduces accurately the experimental results.

[Interest of peri-operative immunonutrition in head and neck cancers]

OBJECTIVE

Authors reported the results of a study on the application of immunonutrion in peri-operative (pre and postoperative) in head and neck cancer for all patients malnourished or not. In preoperative we used an oral treatmentand in postoperative an enteral one.

MATERIALS AND METHODS

Prospective study concerning 78 patients (47 malnourished versus 31 not) having had heavy head and neck curative cancerology surgery. The mean follow up was of 10 months (from 7 to 16 month). They peri-operative immuno-enriched diet consisted, in pre-operative of 1000 kcal/j during 7 days of oral immunonutrition (Impact), and in post-operative, 1500 kcal/j during 10 days of enteral immunonutition (Crucial). The nutritional state was evaluated in pre-operative by simple clinical and biological parameters (size, weight, CMI "Corporal Mass Index", albumin, NRI "Nutritional Risk Index"), and in post-operative by the evolution of the weight and the CMI. The palatability of the product used in pre-operative and the patients' compliance to the treatment are studied using the satisfaction's multiple choice question paper.

RESULTS

The study showed an improvement of the patients' nutritional and general state (regain appetite, less marked asthenia) and of the quality of life. The product used in preoperative was well tolerated, this oral supplementation led to the same beneficial effects of the enteral's. At eight days in preoperative, the average weight was 62.35 kg, the average CMI was 20.93, and the average NRI was 94.12. In post-operative the patients' nutritional state improved: at eight days, the average loss of weight was 2.82 kg, the average CMI was 22.2. At one and six months after respectively the average gain of weight was 2.17 kg and 6.11 kg, the average CMI was 23.71 and 25.16. The application of this protocol decreased the post-operative complications (13% reduction of the infectious complications and 6% diminution of the fistulas). The time of hospitalization is then reduced (1.7 days), and the life's longevity is improved.

CONCLUSION

The results produced by this study, demonstrate the necessity to apply a peri-operative immuno-enriched diet systematically for all the patients with and without a degraded nutritional state, undergoing a heavy head and neck curative cancerology surgery.

Exchange-mediated anisotropy of (ga,mn)as valence-band probed by resonant tunneling spectroscopy

We report on experiments and theory of resonant tunneling anisotropic magnetoresistance (TAMR) in AlAs/GaAs/AlAs quantum wells (QW) contacted by a (Ga,Mn)As ferromagnetic electrode. Such resonance effects manifest themselves by bias-dependent oscillations of the TAMR signal correlated to the successive positions of heavy (HH) and light (LH) quantized hole energy levels in GaAs QW. We have modeled the experimental data by calculating the spin-dependent resonant tunneling transmission in the frame of the 6 x 6 valence-band k.p theory. The calculations emphasize the opposite contributions of the (Ga,Mn)As HH and LH subbands near the Gamma point, unraveling the anatomy of the diluted magnetic semiconductor valence band.

Tissue culture and transient transformation of Marestail (Conyza canadensis (L.) Cronquist)

Glyphosate resistant crops are useful to agriculture by facilitating the use of nonselective herbicides, such as RoundUp, that have low human and environmental toxicity. The occurrence of glyphosate resistant weeds, however, has raised concern about the future utility of these crops. Conyza canadensis (L.) Cronquist (marestail or horseweed) is one such glyphosate resistant weed that has yet to be fully analyzed or established in tissue culture. Tissue culture enables the examination of physiological characteristics of a plant in an aseptic and controlled environment. For the present study, mairstail was cultured on a Murashige and Skoog based medium supplemented with 6-benzylaminopurine, and alpha-naphthaleneacetic acid. Plant regeneration was achieved on the same basal medium supplemented with only gibberellic acid. Glyphosate resistance could be demonstrated in the cultured tissues. The cultures could also be transformed with Agrobacterium tumefaciens without chemically inducing virulence using phenolics or glucose and resulting in a transformation frequency (transgenic events per total number of explants used) of about 13%. The tissue culture growth, preliminary glyphosate resistance data and genetic transformation data gathered in this project provide the means to further evaluate the mode of glyphosate resistance expressed by marestail.