Sterilization of Hulecoeteomyia japonica japonica (= Aedes japonicus japonicus) (Theobald, 1901) by high-energy photon irradiation: implications for a sterile insect technique approach in Europe

Hulecoeteomyia japonica japonica (= Aedes japonicus japonicus) (Diptera: Culicidae) (Theobald 1901), a container-breeding invasive species in North America and Europe, is attracting particular attention for its high local abundances and possible roles in the transmission of human and animal pathogens. The preferential habitats of this species are forested and bushy areas, which renders control measures extremely inefficient. Use of the sterile insect technique (SIT) may contribute to the implementation of area-wide integrated pest management strategies, as has been successfully proven with other aedine mosquito species. The present study investigates the effects of irradiation at a dose of 40 Gy on fitness parameters in H. j. japonica. Irradiation was performed on 16-24-h-old pupae from a colonized strain (PA) using a TrueBeam linear accelerator. Males from the PA strain were crossed with females of the same colony or with field-collected females. Irradiation induced a slight increase in mortality in male pupae, but did not alter the survival and mating abilities of emerging adult males. Rates of blood feeding and fertility were lower when PA strain males were kept with field-collected females rather than PA females. Irradiated males induced reductions in fertility (residual fertility: 2.6%) and fecundity in mated females. The data indicate that the SIT is a suitable technique to enhance the control of this species.

Controlling thermal emission with refractory epsilon-near-zero metamaterials via topological transitions

Control of thermal radiation at high temperatures is vital for waste heat recovery and for high-efficiency thermophotovoltaic (TPV) conversion. Previously, structural resonances utilizing gratings, thin film resonances, metasurfaces and photonic crystals were used to spectrally control thermal emission, often requiring lithographic structuring of the surface and causing significant angle dependence. In contrast, here, we demonstrate a refractory W-HfO2 metamaterial, which controls thermal emission through an engineered dielectric response function. The epsilon-near-zero frequency of a metamaterial and the connected optical topological transition (OTT) are adjusted to selectively enhance and suppress the thermal emission in the near-infrared spectrum, crucial for improved TPV efficiency. The near-omnidirectional and spectrally selective emitter is obtained as the emission changes due to material properties and not due to resonances or interference effects, marking a paradigm shift in thermal engineering approaches. We experimentally demonstrate the OTT in a thermally stable metamaterial at high temperatures of 1,000 °C.

[The Current Role of Salvage-Surgery of Recurrent Tumors in the Larynx and Pharynx]

Over the past 20 years, the therapeutic concepts for the treatment of head and neck cancer have evolved and non-surgical treatment strategies have gained in importance. However, despite improved organ preservation protocols and primary chemoradiation, tumor recurrence is still frequent. Under these conditions, salvage surgery if often the only remaining curative treatment option. Over the past 30 years, advancements in plastic-reconstructive surgery have broadened the surgical spectrum in the head and neck area, offering new treatment options for salvage surgery in recurrent cancer of the pharynx and larynx. Survival after salvage surgery mainly depends on the primary treatment modality as well as the localization and tumor stage at the time of initial diagnosis and local recurrence. For the reconstruction of defects after salvage surgery, pedicled flaps and microvascular free flaps may be utilized. The most frequently used flaps in these situations are the pectoralis major island- or the myocutaneous latissimus dorsi island flap. The radial forearm and the ALT-flap are potentially applicable free flaps. With the use of these flaps, vital tissue is transferred into the previously irradiated area, hereby allowing for reconstruction and functional preservation of the resected area and preventing complications such as fistulas. The expected morbidity and the likelihood of surgical success must be assessed thoroughly in every individual case prior to performing salvage surgery. This review aims to support decision making in these situations.

[Immunotherapy in head and neck cancer]

The physiological immune response to malignant cells is based on the interaction of antigen-presenting cells, such as dendritic cells and macrophages, with T and B lymphocytes. CD8(+) effector and natural killer cells are primarily responsible for tumor cell lysis. Tumor cells exploit several mechanisms to influence the body's immune system and promote development and progress of solid head and neck malignancies. Via regulatory T cells, myeloid-derived suppressor cells, tumor-associated macrophages, and cancer-associated fibroblasts, tumor cells promote development of suppressive signaling pathways that enable tumor progression. Novel immune therapeutics aim to influence these signaling pathways. Current studies are investigating agents which influence immune-stimulating or immune-suppressive cytokines, as well as drug-based Toll-like receptor activation and vaccination in head and neck cancer. Development of monoclonal antibodies allows for direct and highly specific binding of therapeutics to cell receptors - recently discovered immune checkpoint receptors are particularly intriguing targets. Monoclonal antibodies directed specifically toward T cell-stimulating receptors such as CD28 and CD134, or immunosuppressive receptors CTLA-4 and PD-1, are currently under investigation and have shown promising results.

Acute medicine targets: when should the clock start and 7-day consultant impact?

BACKGROUND

Early consultant review has been shown to improve outcomes in patients presenting to the Acute Medical Unit (AMU). The Society for Acute Medicine (SAM) clinical quality indicators use the time of arrival on the AMU for target rather than arrival in the Emergency Department (ED) although this is where most acute medical patients present.

AIM

To determine the effect of a 7-day Consultant Acute Physician model on patient waiting times and assess the impact of starting the clock for medical patients at time of ED arrival.

DESIGN

We performed an audit at a University Hospital AMU in the North West of England.

METHODS

Data were collected prospectively for 15 consecutive days in May-June 2013 for all patients presenting to the AMU at University Hospital of South Manchester and were repeated for the same time period in 2014 following the introduction of a new Consultant working model.

RESULTS

Four hundred and five patients were admitted to the AMU in the 2013 cohort compared to 456 in the 2014 cohort. There was a significant improvement in the median waiting time for Consultant review from AMU admission to 5 h 53 min from 8 h 15 min (P < 0.001). The compliance with the SAM quality indicator for Consultant review improved from 88.7 to 93.7% (P = 0.022).

CONCLUSION

A 7-day Acute Physician working model is improving performance with regards to patient waiting times. We suggest that starting the clock for acute medical patients in the ED is a better measure of performance than on arrival to the AMU.

Comparison of Intracranial Aneurysms Treated by 2-D Versus 3-D Coils: A Matched-Pairs Analysis

OBJECTIVE

Knowledge on the influence of 2D and 3D coils to occlude intracranial aneurysms is poor. Therefore, aim of our analysis was to evaluate whether the use of 3-D versus 2-D coils alone may improve the efficacy of endovascular aneurysm treatment.

PATIENTS AND METHODS

We performed a matched pair analysis comparing aneurysms treated by 3-D coils as initial "framing" coils to aneurysms treated exclusively by 2-D coils. Number of coils, implanted coil length/volume, and associated packing density were calculated. Aneurysmal occlusion was assessed and monitored 6 months (DSA; magnetic resonance angiography (MRA)) and 18 months (MRA) after embolization. Periprocedural complications and retreatment rate of each group were analyzed.

RESULTS

Our retrospective analysis revealed 50 pairs. Concerning the 3-D group, number of coils (353 in total, median 7; p = 0.002), implanted coil length (55.69  ± 48.4 cm), implanted coil length per volume (5.92 mm/mm³), and packing density (30 %; p = 0.017) was higher than in the 2-D group (259 in total, median 5 coils; 38.52 ± 43.13 cm; 4.54 mm/mm³; 23 %). Occlusion was not significantly different immediately after treatment but at 6 and 18 months follow-up in favor of 3-D coils. Retreatment was performed in 2 cases of the 3-D group and in 3 cases of the 2-D group and therefore in a similar range (p = 0.564).

CONCLUSION

Initial use of 3-D coils revealed a higher packing density and a higher long-term occlusion. Therefore, we recommend initial use of 3-D coils.

Dynamic Angiography and Perfusion Imaging Using Flat Detector CT in the Angiography Suite: A Pilot Study in Patients with Acute Middle Cerebral Artery Occlusions

BACKGROUND AND PURPOSE

Perfusion and angiographic imaging using intravenous contrast application to evaluate stroke patients is now technically feasible by flat detector CT performed by the angiographic system. The aim of this pilot study was to show the feasibility and qualitative comparability of a novel flat detector CT dynamic perfusion and angiographic imaging protocol in comparison with a multimodal stroke MR imaging protocol.

MATERIALS AND METHODS

In 12 patients with acute stroke, MR imaging and the novel flat detector CT protocol were performed before endovascular treatment. Perfusion parameter maps (MTT, TTP, CBV, CBF) and MIP/volume-rendering technique images obtained by using both modalities (MR imaging and flat detector CT) were compared.

RESULTS

Comparison of MIP/volume-rendering technique images demonstrated equivalent visibility of the occlusion site. Qualitative comparison of perfusion parameter maps by using ASPECTS revealed high Pearson correlation coefficients for parameters CBF, MTT, and TTP (0.95-0.98), while for CBV, the coefficient was lower (0.49).

CONCLUSIONS

We have shown the feasibility of a novel dynamic flat detector CT perfusion and angiographic protocol for the diagnosis and triage of patients with acute ischemic stroke. In a qualitative comparison, the parameter maps and MIP/volume-rendering technique images compared well with MR imaging. In our opinion, this flat detector CT application may substitute for multisection CT imaging in selected patients with acute stroke so that in the future, patients with acute stroke may be directly referred to the angiography suite, thereby avoiding transportation and saving time.

Subthreshold Ξ^{-} production in collisions of p(3.5 GeV)+Nb

Results on the production of the double strange cascade hyperon Ξ^{-} are reported for collisions of p(3.5  GeV)+Nb, studied with the High Acceptance Di-Electron Spectrometer (HADES) at SIS18 at GSI Helmholtzzentrum for Heavy-Ion Research, Darmstadt. For the first time, subthreshold Ξ^{-} production is observed in proton-nucleus interactions. Assuming a Ξ^{-} phase-space distribution similar to that of Λ hyperons, the production probability amounts to P_{Ξ^{-}}=[2.0±0.4(stat)±0.3(norm)±0.6(syst)]×10^{-4} resulting in a Ξ^{-}/(Λ+Σ^{0}) ratio of P_{Ξ^{-}}/P_{Λ+Σ^{0}}=[1.2±0.3(stat)±0.4(syst)]×10^{-2}. Available model predictions are significantly lower than the measured Ξ^{-} yield.

[Diabetes screening and prevention in a large chemical company]

INTRODUCTION

Diabetes is with 6 million cases in Germany one of the most common and most expensive chronic diseases. Studies presume a high number of unreported cases. Early detection of diabetes with a specific screening method is very important. In Germany family physicians offer a preventive check-up starting at the age of 35 years but only 19% males participate. From this background the BASF department for Occupational Medicine and Health Protection introduced for all 35.000 employees at the headquarter, in Ludwigshafen a general health check focused on the early detection of lifestyle diseases.

METHODS

From April 2011 to June 2013 12.114 employees participated in the general health check offered by the medical department (2.530 women, 9.584 men). All participants filled out a questionnaire named "Findrisk" a scientifically validated questionnaire which focuses on risk factors for diabetes. Furthermore, the blood glucose and the HbA1c of the participants have also been checked in a laboratory test

RESULTS

Following the Findrisk criteria the results are: 1.368 employees had an elevated risk of 17%, 854 employees a risk factor of 33% and 131 employees a risk factor of 33%. In 1.533 employees (13,2% of all participants) we diagnosed a prediabetes with an elevated HbA1c-parameter between 5.7 to 6,4%. In 243 employees a manifest diabetes disease with HbA1c of > than 6,5% was diagnosed.

DISCUSSION

We found out that diabetes prevention within the workplace setting is helpful to detect prediabetes and diabetes earlier than family doctors outside the company are able to do.Occupational physicians have the opportunity to inform the employees on risks for lifestyle diseases at an early stage when they are still healthy (primary prevention).For secondary prevention surveillance and clearance examination can be easily combined with screening tests for diabetes. For further diagnostics and therapy the family doctors will be addressed. This system helps individuals to prevent negative health effects, it helps the employer to reduce incapacity time and it also helps the state health system to safe money for therapy and rehabilitation.