Femtosecond laser fabrication of volume-phase gratings in CdSxSe1-x-doped borosilicate glass at a low repetition rate

Volume-phase gratings (VPGs) were fabricated in CdS_xSe_1-x quantum-dot-doped borosilicate glass at a low repetition rate (800 nm, 140 fs, 1 kHz). The VPGs were designed based on rigorous coupled wave analysis simulations. Results indicate that the inscribed thickness (L) is the key parameter to maximize the diffraction efficiency at order 1. Microscope images of the cross sections and diffraction efficiency measurements were taken in order to characterize the modification of the material at different laser-inscription parameters. A maximum VPG diffraction efficiency of 67% (at order 1) was achieved. Also, a refractive index change of Δn=2.25·10^-3  is estimated from these VPG diffraction efficiency measurements. The measurements regarding polarization-insensitive diffraction efficiency showed that the birefringence produced in the substrate is negligible.

Brentuximab vedotin and ESHAP is highly effective as second-line therapy for Hodgkin lymphoma patients (long-term results of a trial by the Spanish GELTAMO Group)

BACKGROUND

In this work, we assessed the efficacy and safety of brentuximab vedotin (BV) plus ESHAP (BRESHAP) as second-line therapy for Relapsed/Refractory Hodgkin lymphoma (RRHL) to improve the results before autologous stem-cell transplantation (ASCT).

PATIENTS AND METHODS

This was a multicenter, open-label, phase I-II trial of patients with RRHL after first-line chemotherapy. Treatment had three 21-day cycles of etoposide, solumedrol, high-dose AraC, and cisplatin. BV was administered at three dose levels (0.9, 1.2, and 1.8 mg/kg) intravenous on day ‒1 to 3 + 3 cohorts of patients. Final BV dose was 1.8 mg/kg. Responding patients proceeded to ASCT, followed by three BV courses (1.8 mg/kg, every 21 days). Main end points for evaluation were maximum tolerable dose and overall and complete response (CR) before ASCT.

RESULTS

A total of 66 patients were recruited (median age 36 years; range 18-66): 40 were primary refractory, 16 early relapse and 10 late relapse. There were 39 severe adverse events were reported in 22 patients, most frequently fever (n = 25, 35% neutropenic), including 3 deaths. Grade 3-4 hematological toxicity presented in 28 cases: neutropenia (n = 21), thrombocytopenia (n = 14), and anemia (n = 7). Grade ≥3-4 extrahematological adverse events (≥5%) were non-neutropenic fever (n = 13) and hypomagnesaemia (n = 3). Sixty-four patients underwent stem-cell mobilization; all collected >2×10e6/kg CD34+ cells (median 5.75; range 2.12-33.4). Overall response before transplant was 91% (CI 84% to 98%), including 70% (CRs 95% CI 59% to 81%). 60 patients were transplanted with no failure engraftments. Post-transplant response was CR in 49 patients (82% CI 73% to 91%) and partial responses in six (10% CI 5% to 15%). After a mean follow-up of 27 months, the 30-month time to treatment to failure was 74% (95% CI 68% to 80%), progression-free survival 71% (95% CI 65% to 77%), and overall survival 91% (CI 84% to 98%).

CONCLUSION

BRESHAP looks a safe and effective pre-transplant induction regimen, does not jeopardize transplant and allows long-term remissions and survival.

Malnutrition in head and neck cancer patients: Impacts and indications of a prophylactic percutaneous endoscopic gastrostomy

INTRODUCTION

Head and neck cancer (HNC) patients often experience malnutrition before and during treatment. Prophylactic gastrostomy has emerged as an efficient tool for ensuring adequate nutrition. However, there is no suitable algorithm able to identify patients at high risk of malnutrition. The aim of this study was to describe the nutritional management, to assess the impact of prophylactic gastrostomy, and to identify predictors of malnutrition.

METHODS

This retrospective study included 152 patients treated with surgery, radiotherapy, or chemotherapy for HNC. The patients were classified according to their gastrostomy status (prophylactic or non-prophylactic). Nutritional, tumoral and treatment characteristics were reported. Clinical and nutritional outcomes were measured 6 weeks after the beginning of treatment. In order to describe the nutritional management and the impact of prophylactic gastrostomy on patients, univariate analysis was generated using chi-square test and Mann-Whitney test or Student's t-test. Logistic regression was performed to identify factors associated with malnutrition.

RESULTS

Forty-one patients received prophylactic gastrostomy whereas 111 patients had no nutritional support. Prophylactic gastrostomy placement was associated with a lower initial body mass index, with severe malnutrition, and with initial oral intake disorder. Patients who did not experienced prophylactic gastrostomy had much worse outcomes such as hospital readmissions (P=0.042), relative weight loss at 6 weeks (P<0.0001), dysphagia, severe malnutrition, and poor state of health (P=0.001). Our complication rates (4.9%) were lower than the usual range (5.9-9.3%) and no life-threatening complication was reported. Positive N status, oral intake disorder, concomitant radiochemotherapy, nasopharyngeal, and hypopharyngeal tumor site were significant predictive factors for malnutrition.

CONCLUSIONS

Prophylactic percutaneous endoscopic gastrostomy showed advantages in terms of hospital readmissions, relative weight loss at 6 weeks, dysphagia, severe malnutrition, and poor state of health. Tumoral, nutritional and treatment characteristics seem to be predictors for malnutrition. Hence, physicians should integrate these factors in their nutrition algorithm approach.

Relationship between sugarcane culm and leaf biomass composition and saccharification efficiency

BACKGROUND

Lignocellulosic biomass is recognized as a promising renewable feedstock for the production of biofuels. However, current methods for converting biomass into fermentable sugars are considered too expensive and inefficient due to the recalcitrance of the secondary cell wall. Biomass composition can be modified to create varieties that are efficiently broken down to release cell wall sugars. This study focused on identifying the key biomass components influencing plant cell wall recalcitrance that can be targeted for selection in sugarcane, an important and abundant source of biomass.

RESULTS

Biomass composition and the amount of glucan converted into glucose after saccharification were measured in leaf and culm tissues from seven sugarcane genotypes varying in fiber composition after no pretreatment and dilute acid, hydrothermal and ionic liquid pretreatments. In extractives-free sugarcane leaf and culm tissue, glucan, xylan, acid-insoluble lignin (AIL) and acid-soluble lignin (ASL) ranged from 20 to 32%, 15% to 21%, 14% to 20% and 2% to 4%, respectively. The ratio of syringyl (S) to guaiacyl (G) content in the lignin ranged from 1.5 to 2.2 in the culm and from 0.65 to 1.1 in the leaf. Hydrothermal and dilute acid pretreatments predominantly reduced xylan content, while the ionic liquid (IL) pretreatment targeted AIL reduction. The amount of glucan converted into glucose after 26 h of pre-saccharification was highest after IL pretreatment (42% in culm and 63.5% in leaf) compared to the other pretreatments. Additionally, glucan conversion in leaf tissues was approximately 1.5-fold of that in culm tissues. Percent glucan conversion varied between genotypes but there was no genotype that was superior to all others across the pretreatment groups. Path analysis revealed that S/G ratio, AIL and xylan had the strongest negative associations with percent glucan conversion, while ASL and glucan content had strong positive influences.

CONCLUSION

To improve saccharification efficiency of lignocellulosic biomass, breeders should focus on reducing S/G ratio, xylan and AIL content and increasing ASL and glucan content. This will be key for the development of sugarcane varieties for bioenergy uses.

Performance of the BM@N GEM/CSC tracking system at the Nuclotron beam

BM@N (Baryonic Matter at the Nuclotron) is a fixed target experiment aimed to study nuclear matter in the relativistic heavy-ion collisions at the Nuclotron accelerator in JINR. The BM@N tracking system is based on Gas Electron Multipliers (GEM) detectors mounted inside the BM@N analyzing magnet. The Cathode Strip Chamber (CSC) is installed outside the magnet. The CSC is used for improvement of particles momentum identification. The structure of the GEM detectors and the CSC prototype and the results of study of their characteristics are presented. The GEM detectors and CSC are integrated into the BM@N experimental setup and data acquisition system. The results of first tests of the GEM tracking system and CSC in last runs are shortly reviewed.

HPV testing in first-void urine provides sensitivity for CIN2+ detection comparable with a smear taken by a clinician or a brush-based self-sample: cross-sectional data from a triage population

OBJECTIVE

To compare the sensitivity of high-risk human papillomavirus (hrHPV) and genotype detection in self-collected urine samples in the morning (U1), and later on (U2), brush-based self-samples (SS), and clinician-taken smears (CTS) for detecting cervical intraepithelial neoplasia grade 2+ (CIN2+) in a colposcopic referral population.

DESIGN

Cross-sectional single-centre study.

SETTING

A colposcopy clinic in Spain.

POPULATION

A cohort of 113 women referred for colposcopy after an abnormal Pap smear.

METHODS

Women undergoing colposcopy with biopsy for abnormal Pap smears were sent a device (Colli-Pee™, Novosanis, Wijnegem, Belgium) to collect U1 on the morning of colposcopy. U2, CTS, and SS (Evalyn brush™, Rovers Medical Devices B.V., Oss, the Netherlands) were also analysed. All samples were tested for HPV DNA using the analytically sensitive SPF10-DEIA-LiPA25 assay and the clinically validated GP5+/6+-EIA-LMNX.

MAIN OUTCOME MEASURES

Histologically confirmed CIN2+ and hrHPV positivity for 14 high-risk HPV types.

RESULTS

Samples from 91 patients were analysed. All CIN3 cases (n = 6) tested positive for hrHPV in CTS, SS, U1, and U2 with both HPV assays. Sensitivity for CIN2+ with the SPF10 system was 100, 100, 95, and 100%, respectively. With the GP5+/6+ assay, sensitivity was 95% in all sample types. The sensitivities and specificities for both tests on each of the sample types did not significantly differ. There was 10-14% discordance on hrHPV genotype.

CONCLUSIONS

CIN2+ detection using HPV testing of U1 shows a sensitivity similar to that of CTS or brush-based SS, and is convenient. There was substantial to almost excellent agreement between all samples on genotype with both hrHPV assays. There was no advantage in testing U1 compared with U2 samples.

TWEETABLE ABSTRACT

Similar CIN2+ sensitivity for HPV testing in first-void urine, physician-taken smear and brush-based self-sample.

Contribution to the Screening and Early Detection in Breast Cancer

Breast cancer is a public health issue in Uruguay. The Law 16.097 declared the national interest to fight against cancer and created the Honorary Commission to Fight Against Cancer- CHLCC. One of its tasks is to coordinate and develops programs for prevention and early detection. On 1992, an education campaign about the importance of early detection in breast cancer began. Six years later a program was created for early detection, to increase life expectancy and reduce the mortality. Other actions were done, for example: support National Cancer Register; create a Training Program; collaborate with the Health Ministry in the National Program Cancer to create the National Cancer Guidelines. As a result of these actions, inequalities are drastically reduced because the early detection of the tumor between others reasons; for example universal access to mammography. Mammography equipments were purchased or obtained trough agreements with institutions, so the accessibility to the exams became easily possible. At the same time, a norm was implemented. As a result, women have one free day per year at work to do their exams. All these programs are provided by the CHLCC own fundings, coming from taxation of the state. Twenty years after the beginning of this work, the standardized mortality rate of breast cancer has dropped from 24.8 in 1997 to 19.4 cases per 100,000 inhabitants in 2014, showing a decrease of almost 22% during this period. In the present time, 66% of breast cancers are diagnosed in stages I or II and the survival rate is 86% after 5 years. Between other factors, public global action allows for early diagnosis and improvement of survival rates.

Six New Cases of a Caterpillar-Induced Bleeding Syndrome

We describe six new cases of a hemorrhagic diathesis induced by contact with Lonomia achelous caterpillars. Onset of clinical bleeding varied between a few hours and 10 days post-exposure. Laboratory coagulation tests showed prolonged PT, PTT and ThT; normal platelets and a marked decrease of fibrinogen, factor V, plasminogen and factor XIII (including its subunits A and S). Factors VII, II and alfa 2 anti-plasmin were variably affected. In addition, activation of the fibrinolytic system and the generation of a procoagulant effect could also be demonstrated. Two cases developed severe hemorrhagic diathesis and one of them died of a cerebral hemorrhage. Different aspects of this rare syndrome are discussed in relation to its complex physiopathology and the variability observed in all clinical and laboratory manifestations. Therapeutic recommendations and some possible hazards following replacement transfusions are also considered.