Comparison of the accuracy of the 7-item HADS Depression subscale and 14-item total HADS for screening for major depression: A systematic review and individual participant data meta-analysis

The seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item HADS (HADS-T) are both used for major depression screening. Compared to the HADS-D, the HADS-T includes anxiety items and requires more time to complete. We compared the screening accuracy of the HADS-D and HADS-T for major depression detection. We conducted an individual participant data meta-analysis and fit bivariate random effects models to assess diagnostic accuracy among participants with both HADS-D and HADS-T scores. We identified optimal cutoffs, estimated sensitivity and specificity with 95% confidence intervals, and compared screening accuracy across paired cutoffs via two-stage and individual-level models. We used a 0.05 equivalence margin to assess equivalency in sensitivity and specificity. 20,700 participants (2,285 major depression cases) from 98 studies were included. Cutoffs of ≥7 for the HADS-D (sensitivity 0.79 [0.75, 0.83], specificity 0.78 [0.75, 0.80]) and ≥15 for the HADS-T (sensitivity 0.79 [0.76, 0.82], specificity 0.81 [0.78, 0.83]) minimized the distance to the top-left corner of the receiver operating characteristic curve. Across all sets of paired cutoffs evaluated, differences of sensitivity between HADS-T and HADS-D ranged from -0.05 to 0.01 (0.00 at paired optimal cutoffs), and differences of specificity were within 0.03 for all cutoffs (0.02-0.03). The pattern was similar among outpatients, although the HADS-T was slightly (not nonequivalently) more specific among inpatients. The accuracy of HADS-T was equivalent to the HADS-D for detecting major depression. In most settings, the shorter HADS-D would be preferred. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Ultrafast relaxation of photoexcited superfluid He nanodroplets

The relaxation of photoexcited nanosystems is a fundamental process of light–matter interaction. Depending on the couplings of the internal degrees of freedom, relaxation can be ultrafast, converting electronic energy in a few fs, or slow, if the energy is trapped in a metastable state that decouples from its environment. Here, we study helium nanodroplets excited resonantly by femtosecond extreme-ultraviolet (XUV) pulses from a seeded free-electron laser. Despite their superfluid nature, we find that helium nanodroplets in the lowest electronically excited states undergo ultrafast relaxation. By comparing experimental photoelectron spectra with time-dependent density functional theory simulations, we unravel the full relaxation pathway: Following an ultrafast interband transition, a void nanometer-sized bubble forms around the localized excitation (He\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${}^{* }$$\end{document}*) within 1 ps. Subsequently, the bubble collapses and releases metastable He\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${}^{* }$$\end{document}* at the droplet surface. This study highlights the high level of detail achievable in probing the photodynamics of nanosystems using tunable XUV pulses.

There is interest in understanding the relaxation mechanisms of photoexcitation in atoms, molecules and other complex systems. Here the authors unravel the photoexcitation and ultrafast relaxation of superfluid helium nanodroplets using a pump-probe experiment with FEL pulses.

Electrochemical Synthesis and Magnetic Properties of MFe₂O₄ (M = Fe, Mn, Co, Ni) Nanoparticles for Potential Biomedical Applications

In this study, we evaluate the magnetic properties and cytotoxic effect of magnetic nanoparticles (MNPs) based on magnetite and Mn, Co and Ni ferrites, obtained by electrochemical synthesis. These nanoparticles have almost spherical shape and an mode size of 9±1 nm. The electrochemical synthesis produces a single crystallographic phase with a spinel-like structure in all cases. Magnetization saturation at room temperature varies with the composition of the ferrites from M_S (Fe₃O₄) > M_S (MnFe₂O₄) > M_S (CoFe₂O₄) > M_S (NiFe₂O₄). Ferrite MNPs present low magnetic remanence indicating a superparamagnetic-like response at room temperature. However, the different values of magnetic anisotropy and size produce variations in the values of coercivity and susceptibility of the ferrite MNPs. The cytotoxicity of the different ferrites was evaluated by internalizing MNP in HeLa cancer cells. Although magnetite and Mn ferrite present low toxicity for all the concentrations studied, significant cytotoxic effect were observed when incubating the cells with high concentration of Co and Ni ferrites.

Abstract OT3-06-01: Phase Ib clinical trial of coPANlisib in combination with Trastuzumab emtansine (T-DM1) in pre-treated unresectable locally advanced or metastatic HER2-positive breAst cancer (BC) “PANTHERA”-CTRIAL-IE 17-13

Background:The phosphoinositide 3 kinase (PI3K) pathway is important in the oncogenic function of HER2. Aberrant activation of PI3K is implicated in resistance to trastuzumab and other HER2-targeted therapies and is frequent, with up to 22% of HER2 positive breast cancer having a PIK3CA mutation. Copanlisib is a pan-class 1 PI3K inhibitor administered i.v. with low nanomolar activity against both PI3Kα and PI3Kβ. Copanlisib has been shown to re-sensitise trastuzumab resistant cell lines to trastuzumab with synergism seen in some cell lines between copanlisib and HER2 targeted therapy.

Trial design: This is a phase Ib open label, single arm adaptive, multi-centre trial of copanlisib in combination with T-DM1. Eligible patients will receive T-DM1 at 3.6mg/kg i.v. on day 1 of a 21-day cycle plus copanlisib. Copanlisib will be administered i.v. according to the dose escalation scheme (dose level 1 is 45mg on days 1 and 8, dose level 2 is 60mg on days 1 and 8, dose level 3 is 60mg on days 1, 8, and 15). Dose level -1 will be 45 mg on day 1 in case dose de-escalation is needed. We will enrol 3 to 6 patients per dose level. All patients in each level must have completed at least the first cycle of therapy before enrolment in the next dose level. Patients not completing the first cycle for a reason other than toxicity will be replaced. Dose escalation and determination of the Maximum Tolerated Dose (MTD) will be based on the occurrence of Dose Limiting Toxicities (DLT).

Eligibility criteria:Eligible patients are those with unresectable locally advanced or metastatic HER2-positive BC who previously received trastuzumab and a taxane, separately or in combination. Participants must have adequate organ function and ECOG PS ≤ 2

Objectives:The primary objective is to determine the MTD for copanlisib in combination with T-DM1 in patients with pre-treated unresectable locally advanced or metastatic HER2-positive BC. Secondary objectives include evaluating the safety, efficacy and cardiotoxicity in patients treated with this regimen. Exploratory objectives include examining for predictive biomarkers in tumour tissue and blood or plasma and to examine molecular tumour adaptation to clinical trial therapy.

Statistical methods: Patients will be accrued in cohorts of 3 patients according to a standard 3+3 algorithm, with dose escalation and determination of MTD based on the occurrence of DLT, using the usual threshold probability of 33%. The final dose level will be expanded to include a total of 6 additional patients (expansion cohort).

Present accrual and target accrual:The trial will start accrual in October 2018. Maximum of 24 patients will be enrolled.

Citation Format: Hassan A, Gullo G, O'Reilly S, Ruiz-Borrego M, Toomey S, Grogan L, Breathnach O, Morris PG, Walshe JM, Crown J, O'Mahony D, Falcon A, Egan K, Hernando A, Teiserskiene A, Kelly CM, Coate L, Hennessy BT. Phase Ib clinical trial of coPANlisib in combination with Trastuzumab emtansine (T-DM1) in pre-treated unresectable locally advanced or metastatic HER2-positive breAst cancer (BC) “PANTHERA”-CTRIAL-IE 17-13 [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-06-01.

A simple vibrating sample magnetometer for macroscopic samples

We here present a simple model of a vibrating sample magnetometer (VSM). The system allows recording magnetization curves at room temperature with a resolution of the order of 0.01 emu and is appropriated for macroscopic samples. The setup can be mounted with different configurations depending on the requirements of the sample to be measured (mass, saturation magnetization, saturation field, etc.). We also include here examples of curves obtained with our setup and comparison curves measured with a standard commercial VSM that confirms the reliability of our device.

Abstract OT3-06-05: A phase Ib/II trial of coPANlisib in combination with tratuzumab in pretreated recurrent or metastatic HER2-positive breast cancer “PantHER”

Background

The phosphoinositide 3 kinase (PI3K) pathway is important in the oncogenic function of HER2. Aberrent activation of PI3K is implicated in resistance to trastuzumab and other HER2-targeted therapies and is frequent, with up to 22% of HER2 positive breast cancer having a PIK3CA mutation. Copanlisib is a pan-class 1 PI3K inhibitor that shows particular activity against PI3Kα, the isoform encoded by the PIK3CA gene. Copanlisib has been shown to re-sensitise trastuzumab resistant cell lines to trastuzumab with synergism seen in some cell lines between copanlisib and HER2 targeted therapy.

Trial design

The study is a phase Ib/II open label, single arm adaptive, multi-centre trial of copanlisib in combination with trastuzumab. Eligible patients are treated with a dose escalation schedule of copanlisib IV on Days 1, 8 and 15 of a 28 day cycle with trastuzumab 2 mg/kg weekly (loading dose of 4 mg/kg in cycle 1). The phase II dose will be based on the maximum tolerated dose (MTD) established in Phase Ib. Patients are treated until radiologic or symptomatic progression, unacceptable toxicity, consent withdrawal or physician's decision.

Eligibility criteria

Eligible patients must have recurrent incurable or metastatic HER2-positive breast cancer that has progressed on at least one prior line of trastuzumab or T-DM1-based treatment regimen in this setting. Patients with treated and controlled brain metastases are eligible. Participants must have adequate organ function and ECOG PS ≤ 2. Patients recruited for the Phase II part of the study must have a PIK3CA mutation. Patients with uncontrolled arterial hypertension, uncontrolled diabetes or recent clinically serious infections are excluded.

Specific aims

The primary end point for the phase Ib part of this study is to determine the MTD for the combination. For the phase II study is anti-tumour efficacy, measured by Clinical Benefit Rate (CBR).

Secondary end points are evaluation of safety and tolerability, progression-free survival, time to treatment failure, duration of response and overall survival. Incorporated translational endpoints include examination of molecular tumor adaptation in tissue and blood. Given the role of PI3K in cellular glucose metabolism, an additional exploratory objective is to determine if quantitive reduction in metabolic signal on Positron Emission Tomography-Computed Tomography (PET-CT) is predictive of benefit from therapy.

Statistical methods

To establish the MTD, we use a modified 3+3 design where 3 additional patients will be accrued even if the first 3 patients accrued experience no dose limiting toxicities (DLT) in sequential cohorts for a planned 12 patients. To determine the CBR, a one sample exact binomial test with a one sided significance level of 5%, 19 evaluable patients will provide >80% power to detect a difference between the null hypothesis proportion of 30% for CBR versus the alternative hypothesis proportion of 65%.

Present accrual and target accrual

There are 9 patients recruited so far to the phase Ib part of this study. Target accrual is 12 and for phase II is 19 patients.

Contact information for people with a specific interest in the trial

Prof Bryan Hennessy, Beaumont Hospital, Dublin Ireland

Funded by Bayer

Citation Format: Keegan NM, Walshe J, Gullo G, Kennedy J, Bulger K, Kelly CM, Crown J, Toomey S, Egan K, Kerr J, Given M, Hernando A, Teiserskiene A, Grogan L, Breathnach O, Morris PG, Keane M, Hennessy BT. A phase Ib/II trial of coPANlisib in combination with tratuzumab in pretreated recurrent or metastatic HER2-positive breast cancer “PantHER” [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT3-06-05.

Measurement of the magnetic permeability of amorphous magnetic microwires by using their antenna resonance

We present here a new free space method to measure the magnetic permeability of a single amorphous magnetic microwire (AMM) at microwave frequencies. The technique consists in inducing a high frequency electric current along the AMM axis by illumination with an electromagnetic wave at antenna resonance conditions. Fitting the induced electric current to the Hallen-Pocklington equation allows computing the relative magnetic permeability of the microwire as a function of the wave frequency. The method results particularly useful for the study of the giant magnetoimpedance effect of AMM by measuring the magnetic permeability upon the application of DC magnetic fields.

Tuning Metamaterials by using Amorphous Magnetic Microwires

In this work, we demonstrate theoretically and experimentally the possibility of tuning the electromagnetic properties of metamaterials with magnetic fields by incorporating amorphous magnetic microwires. The large permeability of these wires at microwave frequencies allows tuning the resonance of the metamaterial by using magnetic fields of the order of tens of Oe. We describe here the physical basis of the interaction between a prototypical magnetic metamaterial with magnetic microwires and electromagnetic waves plus providing detailed calculations and experimental results for the case of an array of Split Ring Resonators with Co-based microwires.

Influence of electrodes on the 448 kHz electric currents created by radiofrequency: A finite element study

Radiofrequency is a technology used in physical rehabilitation by physicians and physiotherapists for more than fifteen years, although there exist doubts on how it works. Indiba is a particular method that applies a voltage difference of 448 KHz between two electrodes, creating an electric current between them. These electrodes are an active one that is placed on different areas of the body and a passive one that is left on the same position during the treatment. There are two different types of active electrodes: the capacitive one and the resistive one. In this paper, it has been studied how the different electrodes affect the current density inside the body and thus how they affect the efficacy of the treatment. It shows how finite element calculations should help physicians in order to better understand its behavior and improve the treatments.

Note: On the study of metal/oxide hybrid ferromagnets with magneto-optical techniques

We analyze here the magneto-optical measurements of hybrid materials containing metallic and oxide ferromagnetic phases. We show that the magnetization curves obtained with this technique can be fairly different to those obtained with standard magnetometry techniques and cannot be representative of the contribution of each phase to the magnetization of the material, due to the very different optical properties of metals and oxides. However, a proper numerical analysis of the magneto-optical measurements allows estimating the fraction of each phase present in the material.

Abstract OT3-02-07: A phase II study to compare fulvestrant (F) 500mg plus placebo versus (vs) F 500mg plus palbociclib (P) as first line treatment for postmenopausal women with hormone receptor (HR)-positive advanced breast cancer (BC) sensitive to endocrine therapy (ET). “The FLIPPER study” (GEICAM/2014-12)

Background: Delaying/overcoming resistance to ET in HR-positive HER2-negative BC patients (pts) is a major need to futhrt improve safe and efficacious treatment options. F is a selective estrogen receptor (ER) downregulator currently indicated for the treatment of HR-positive metastatic BC in postmenopausal women with disease progression following anti-estrogen therapy. In FIRST trial F 500mg improved median time to progression (TTP) over anastrozole (23.4 vs 13.1 months, respectively) in untreated metastatic BC. P is a selective reversible inhibitor of cyclin-dependent kinase 4/6. FDA granted its accelerated approval based on progression-free survival (PFS) in combination with letrozole for postmenopausal women with ER-positive and HER2-negative advanced BC as initial ET (PALOMA-1). In another study, after progression to ET, P in combination with F resulted in longer PFS than F alone (PALOMA-3).

The high median TTP achieved with F alone (FIRST) coupled with the significant benefit of adding P to F (PALOMA-3) suggest that F 500mg in combination with P in the first-line setting may significantly improve long-term disease control.

Trial Design:This is an international, randomized, double-blind, multicentre phase II study comparing F 500mg in combination with P vs F 500mg plus placebo as first line therapy in postmenopausal women with HR-positive, HER2-negative metastatic BC who have received ≥5 years of adjuvant ET for early disease and remained disease free for >12 months following its completion or have “de novo” metastatic disease. HR and HER2 status will be based on central testing on the most recent tumour biopsy. Patients will be randomized 1:1. The primary objective is to compare the efficacy of both treatment arms in terms of PFS at 1 year according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 by investigator assessment. As secondary efficacy objectives,PFS, Objective Response Rate (ORR), Clinical Benefit Rate (CBR), Overall Survival (OS), and 1-year and 2-year survival probabilities, have been considered. Other secondary objectives include the comparison of safety, tolerability and health-related quality of life between the treatment arms. As exploratory objectives, the identification of promising biomarkers related with response to study therapy and primary/acquired drug resistance. Pts will be stratified by the site of disease (visceral vs non-visceral) and disease presentation at study entry (recurrent disease vs metastatic “de novo”). With a sample size of 190 pts, the analysis would have 80% power to detect a difference between both treatment arms, assuming PFS proportions of 0.545 and 0.695, respectively. This study is sponsored by GEICAM and Cancer Trials Ireland (formerly ICORG) is also participating. Recruitment started in February 2016 with 14 pts included. Analysis of the primary endpoint is planned for Q1 2018. ClinicalTrials.gov identifier:NCT02690480.

Citation Format: Moreno F, Martínez-Jañez N, Garau I, Guerra JA, Alarcón J, Bermejo B, Gonzalez-Cortijo L, Bueno C, Lao J, Bezares S, Rosell L, Blanch A, Caballero R, Carrasco E, Rojo F, Martín M, O'Connor M, Hernando A, Albanell J. A phase II study to compare fulvestrant (F) 500mg plus placebo versus (vs) F 500mg plus palbociclib (P) as first line treatment for postmenopausal women with hormone receptor (HR)-positive advanced breast cancer (BC) sensitive to endocrine therapy (ET). “The FLIPPER study” (GEICAM/2014-12) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT3-02-07.

Real-life data in 115 chronic migraine patients treated with Onabotulinumtoxin A during more than one year

Background

OnabotulinumtoxinA (OnabotA) is effective in Chronic Migraine (CM) during first year of treatment and longer. In real clinical setting, CM patients with acute Medication Overuse (MO) or concurrently receiving oral preventatives are treated with OnabotA. We aim to assess evolution of CM patients beyond first year on OnabotA.

Methods

Data were retrospectively collected in three headache units. We analyzed cases who had received at least five sessions of OnabotA according to PREEMPT protocol. We continued OnabotA therapy when a reduction of number of headache days of at least 30% was achieved.

Results

We included 115 patients (98 females, 17 males) who completed 7.6 ± 2.3 (5–13) OnabotA procedures. Previously they had not responded to topiramate and, at least, one other preventative. Age at inclusion was 45.3 ± 12 (14–74) years, and latency between CM onset and OnabotA therapy was 43.1 ± 38.2 (6–166) months. At first OnabotA session 92 patients (80%) fulfilled MO criteria and 107 (93%) received a concurrent oral preventative. In 42 cases (36.5%) OnabotA dose was increased over 155 units. After first year in 57 out of 92 patients (61.9%) MO was discontinued. Among those receiving preventatives, in 52 out of 107 they were retired (48.6%). In 22 cases (19.1%) OnabotA administration was delayed to the fourth or fifth month and in 12 (10.4%) it was temporally stopped. Finally, in 18 patients (15.7%) OnabotA was discontinued due to lack of efficacy beyond first year of treatment.

Conclusion

Our results suggest that discontinuation of acute medication overuse and oral preventive therapies are achievable objectives in long-term using of OnabotA in CM patients.

Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection

We aimed to estimate overall and cause-specific excess mortality of HIV-positive patients compared with the general population, and to assess the effect of risk factors.We included patients aged >19 years, recruited from January 1, 2004 to May 31, 2014 in Cohort of the Spanish Network on HIV/AIDS Research. We used generalized linear models with Poisson error structure to model excess mortality rates.In 10,340 patients, 368 deaths occurred. Excess mortality was 0.82 deaths per 100 person-years for all-cause mortality, 0.11 for liver, 0.08 for non-AIDS-defining malignancies (NADMs), 0.08 for non-AIDS infections, and 0.02 for cardiovascular-related causes. Lower CD4 count and higher HIV viral load, lower education, being male, and over 50 years were predictors of overall excess mortality. Short-term (first year follow-up) overall excess hazard ratio (eHR) for subjects with AIDS at entry was 3.71 (95% confidence interval [CI] 2.66, 5.19) and 1.37 (95% CI 0.87, 2.15) for hepatitis C virus (HCV)-coinfected; medium/long-term eHR for AIDS at entry was 0.90 (95% CI 0.58, 1.39) and 3.83 (95% CI 2.37, 6.19) for HCV coinfection. Liver excess mortality was associated with low CD4 counts and HCV coinfection. Patients aged ≥50 years and HCV-coinfected showed higher NADM excess mortality, and HCV-coinfected patients showed increased non-AIDS infections excess mortality.Overall, liver, NADM, non-AIDS infections, and cardiovascular excesses of mortality associated with being HIV-positive were found, and HCV coinfection and immunodeficiency played significant roles. Differential short and medium/long-term effects of AIDS at entry and HCV coinfection were found for overall excess mortality.

Toward a comprehensive care of HIV patients: finding a strategy to detect depression in a Spanish HIV cohort

Depression is a common but frequently undiagnosed feature in individuals with HIV infection. To find a strategy to detect depression in a non-specialized clinical setting, the overall performance of the Hospital Anxiety and Depression Scale (HADS) and the depression identification questions proposed by the European AIDS Clinical Society (EACS) guidelines were assessed in a descriptive cross-sectional study of 113 patients with HIV infection. The clinician asked the two screening questions that were proposed under the EACS guidelines and requested patients to complete the HADS. A psychiatrist or psychologist administered semi-structured clinical interviews to yield psychiatric diagnoses of depression (gold standard). A receiver operating characteristic (ROC) analysis for the HADS-Depression (HADS-D) subscale indicated that the best sensitivity and specificity were obtained between the cut-off points of 5 and 8, and the ROC curve for the HADS-Total (HADS-T) indicated that the best cut-off points were between 12 and 14. There were no statistically significant differences in the correlations of the EACS (considering positive responses to one [A] or both questions [B]), the HADS-D ≥ 8 or the HADS-T ≥ 12 with the gold standard. The study concludes that both approaches (the two EACS questions and the HADS-D subscale) are appropriate depression-screening methods in HIV population. We believe that using the EACS-B and the HADS-D subscale in a two-step approach allows for rapid, assumable and accurate clinical diagnosis in non-psychiatric hospital settings.

Abstract OT3-01-02: A phase I-II trial of dasatinib in combination with trastuzumab (T) and paclitaxel in the first line treatment of HER2 positive metastatic breast cancer (MBC) patients: GEICAM/2010-04

Background: Resistance to targeted-therapies is a current problem in our clinical practice. In HER2 overexpressing tumors, resistance to trastuzumab-based therapies is widely observed. Expression of SRC has been pre-clinically linked to trastuzumab resistance and the addition of the multi-tyrosine kinase inhibitor dasatinib to trastuzumab increases its antitumor activity (Seoane S, et al. J Natl Cancer Inst. 2010). On previous studies, Dasatinib showed a good toxicity profile, with low grade 3-4 toxicity rates (E. Mayer, et al. J Clin Oncol 2009). We have designed a phase I-II trial combining dasatinib with standard trastuzumab/paclitaxel. (ClinicalTrials.gov Identifier: NCT01306942). In this abstract we report the description of the phase II part of the trial which is ongoing.

Trial Design: Eligible patients must be HER2+ (evaluated by central laboratory and assessed by immunohistochemistry and fluorescent in-situ hybridization) MBC and candidates for trastuzumab + chemotherapy as first line treatment. Taxanes and trastuzumab administered in the adjuvant setting are permitted if given >12 months before the inclusion. Patients with CNS involvement are eligible if treated and clinically stable without medication. Treatment consists of trastuzumab 2 mg/kg weekly (following a loading dose of 4 mg/kg in cycle 1), weekly paclitaxel (80 mg/m2, 3 weeks on-one week off) and dasatinib 100 mg once daily (based on the recommended phase II dose from the phase I part, Gil-Martin M, et al. European Breast Cancer Conference 2014, P-041) in a 28-days cycle. Patients are treated until radiologic or symptomatic progression or unacceptable toxicity.

The primary objective for this phase II is efficacy, measured by Objective Response Rate (ORR according to RECIST 1.1). Secondary objectives are: Safety (evaluated using NCI-CTCAE v 4.03), Clinical Benefit Rate, Time to Progression, Progression Free Survival and Response Duration. Pharmacodynamic biomarkers include pAKT, pS6, pSRC, pErk1/2 in tumor tissue samples, mononuclear cells in blood samples and in skin tissue. An additional exploratory objective is to evaluate the correlation between the early presence of lymphocytosis and efficacy. The study will be considered positive if ORR increases 25% from a 50% ORR observed in previous studies with paclitaxel + trastuzumab. We need to include 28 evaluable patients to demonstrate this hypothesis (with an alpha error of 0.05 and a statistical power of 80%), assuming a 10% drop-out rate. Twenty one patients have already been included. Recruitment is expected to finish by the end of 2015.

Citation Format: Ocaña A, Ruiz Borrego M, Gil-Martín M, Antolín S, Guerrero Á, Vidal Boixader L, Martín M, Trigo Pérez JM, Rojo F, Jerez Y, Atienza M, Pernas S, Hernando A, Carrasco E, Benito S, Caballero R, Pandiella A. A phase I-II trial of dasatinib in combination with trastuzumab (T) and paclitaxel in the first line treatment of HER2 positive metastatic breast cancer (MBC) patients: GEICAM/2010-04. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT3-01-02.

Attenuation of the influence of cardiolocomotor coupling in heart rate variability interpretation during exercise test

During exercise test, cardiolocomotor coupling related components appear in heart rate variability (HRV), blurring its interpretation as autonomic nervous system (ANS) marker. These cardiolocomotor coupling related components are centered at the pedalling and running stride frequency, as well as at their aliases, and may overlap with the low frequency (LF) and high frequency (HF) components of HRV. In this work cardiolocomotor-related HRV components are studied during maximal exercise test on treadmill and cycle ergometer. Power in the bands related to cardiolocomotor coupling increases with exercise intensity in cycle ergometer but not in treadmill exercise test, where it displays higher values for all exercise intensities. A method is proposed to reduce the effect of this coupling in the interpretation of HRV. Evolution of the power in the low frequency (LF) and high frequency (HF) bands are studied after the proposed reduction of cardiolocomotor coupling, showing more significant changes with exercise intensity than before the method is applied.

Decreasing prevalence of HCV coinfection in all risk groups for HIV infection between 2004 and 2011 in Spain

While hepatitis C virus (HCV) infection seems to be expanding among HIV-infected men who have sex with men (MSM), the rate of coinfection in intravenous drug users (IDU) is assumed to remain constant. We evaluated the serial prevalence of HIV/HCV coinfection across all risk groups for HIV infection in Spain. We used data from 7045 subjects included in the multicentre, prospective Spanish Cohort of Adult HIV-infected Patients (CoRIS) between 2004 and 2011. We analysed risk factors for HIV/HCV coinfection by logistic regression analyses. The prevalence of HIV/HCV coinfection decreased from 25.3% (95% CI, 23.1-27.5) in 2004-2005 to 8.2% (95% CI, 6.9-9.5) in 2010-2011. This trend was consistently observed from 2004 to 2011 among all risk groups: IDU, 92.4% to 81.4%; MSM, 4.7% to 2.6%; heterosexual men, 13.0-8.9%; and heterosexual women, 14.5-4.0% (all P < 0.05). Strongest risk factors for HIV/HCV coinfection were IDU (OR, 54.9; 95% CI, 39.4-76.4), birth decade 1961-1970 (OR, 2.1; 95% CI, 1.1-3.7) and low educational level (OR, 2.4; 95% CI, 1.6-3.5). Hence, the prevalence of HIV/HCV coinfection decreased in Spain between 2004 and 2011. This decline was observed across all risk groups and is likely to be explained by a declining burden of HCV in the general population.

Memory-endowed US cities and their demographic interactions

A quantitative understanding of cities' demographic dynamics is becoming a potentially useful tool for planning sustainable growth. The concomitant theory should reveal details of the cities' past and also of its interaction with nearby urban conglomerates for providing a reasonably complete picture. Using the exhaustive database of the Census Bureau in a time window of 170 years, we exhibit here empirical evidence for time and space correlations in the demographic dynamics of US counties, with a characteristic memory time of 25 years and typical distances of interaction of 200 km. These correlations are much larger than those observed in a European country (Spain), indicating more coherent evolution in US cities. We also measure the resilience of US cities to historical events, finding a demographical post-traumatic amnesia after wars (such as the American Civil War) or economic crisis (such as the 1929 Stock Market Crash).

On the stability of AuFe alloy nanoparticles

AuFe nanoparticles with mean diameters d p  = 13.2 nm have been prepared by inert-gas condensation. Conventional and high-resolution transmission electron microscopy and energy-dispersive x-ray spectroscopy investigations show that the particles are mostly icosahedra. Scanning transmission electron microscopy-energy-dispersive x-ray spectroscopy and scanning transmission electron microscopy-electron energy-loss spectroscopy show that the as-grown particles exhibit a core-shell structure. The shell is mainly composed of an amorphous FeO layer. Although Fe and Au are immiscible in the bulk, the particle cores are found to be homogeneously mixed at the atomic level with a local composition of around Au84Fe16 (at.%). AuFe nanoparticles exhibit a complex magnetic structure in which the core behaves as a spin glass with a freezing temperature of 35 K, whereas the amorphous FeO shell behaves as a ferro-ferrimagnetic system. On annealing above 300 °C, the AuFe icosahedra phases separate into their elemental constituents. Hence the as-grown AuFe icosahedra are metastable, thereby implying that the bulk phase diagram also applies for nanoscopic materials.

Space-time correlations in urban sprawl

Understanding demographic and migrational patterns constitutes a great challenge. Millions of individual decisions, motivated by economic, political, demographic, rational and/or emotional reasons underlie the high complexity of demographic dynamics. Significant advances in quantitatively understanding such complexity have been registered in recent years, as those involving the growth of cities but many fundamental issues still defy comprehension. We present here compelling empirical evidence of a high level of regularity regarding time and spatial correlations in urban sprawl, unravelling patterns about the inertia in the growth of cities and their interaction with each other. By using one of the world's most exhaustive extant demographic data basis--that of the Spanish Government's Institute INE, with records covering 111 years and (in 2011) 45 million people, distributed among more than 8000 population nuclei--we show that the inertia of city growth has a characteristic time of 15 years, and its interaction with the growth of other cities has a characteristic distance of 80 km. Distance is shown to be the main factor that entangles two cities (60% of total correlations). The power of our current social theories is thereby enhanced.

Surprising resistivity decrease in manganites with constant electronic density

A decrease of eight orders of magnitude in the resistance of (La0.5Ca0.5)zMnO3 has been detected when the electronic density is kept constant while the calcium content is modified by introducing cationic vacancies. This effect is related to the disappearance of the charge ordering state and the emergence of an antiferromagnetic–ferromagnetic transition. Moreover, high values of the colossal magnetoresistance above room temperature are attained.

Polidocanol foam stability in terms of its association with glycerin

Objectives:

Foam sclerotherapy effectiveness mainly depends on the concentration of the sclerosing agent and foam stability. The objective of this study was to determine if the addition of glycerol at different concentrations contributes to the stability of polidocanol foam.

Materials and methods:

Control Group: 3% polidocanol. Group 1: polidocanol 3% + glycerin 1.66%. Group 2: polidocanol 3% + glycerin 3.3%. Group 3: polidocanol 3% + Glycerin 5%. Tessari standard method. Five recordings were made for each mixture. Early visual liquefaction time and half liquid time decay were recorded in seconds. Microscopic measurement of the foams. Mixtures surface tension measurement (N/m).

Results:

Early visual liquefaction: Control Group: 27 (± 3.11); Group 1: 67.8 (± 6.49); Group 2:48.6 (± 8.2); and Group 3: 35.8 (± 4.49). Half-liquid time: Control: 129.2 (± 11.00); Group 1: 260.4 (±18.99); Group 2: 224.6 (±13.03); and Group 3: 189.2 (±8.52). Bubbles/mm2–diameter–wall thickness: Control: 68–98 μm-7 μm; Group 1: 189–60 μm-9 μm; Group 2: 76–92 μm-12 μm; and Group 3: 49–112 μm-20 μm. Surface tension: Control = 5.54 N/m; Group 1 = 5.45 N/m; Group 2 = 5.35 N/m; and Group 3 = 5.21 N/m.

Conclusions:

Small amounts of glycerin highly increase the stability and quality of polidocanol foam. This simple chemical method is easily reproducible and applicable.

The workings of the maximum entropy principle in collective human behaviour

We present an exhaustive study of the rank-distribution of city-population and population-dynamics of the 50 Spanish provinces (more than 8000 municipalities) in a time-window of 15 years (1996-2010). We exhibit compelling evidence regarding how well the MaxEnt principle describes the equilibrium distributions. We show that the microscopic dynamics that governs population growth is the deciding factor that originates the observed macroscopic distributions. The connection between microscopic dynamics and macroscopic distributions is unravelled via MaxEnt.

Thermodynamics of urban population flows

Orderliness, reflected via mathematical laws, is encountered in different frameworks involving social groups. Here we show that a thermodynamics can be constructed that macroscopically describes urban population flows. Microscopic dynamic equations and simulations with random walkers underlie the macroscopic approach. Our results might be regarded, via suitable analogies, as a step towards building an explicit social thermodynamics.

Fluorescence emission of Ca-atom from photodissociated Ca2 in Ar doped helium droplets. II. Theoretical

The stability of the ground or excited state calcium atom in an argon-doped helium droplet has been investigated using an extension of the helium density functional method to treat clusters. This work was motivated by the experimental study presented in a companion paper, hereafter called Paper I [A. Masson, M. Briant, J. M. Mestdagh, M. A. Gaveau, A. Hernando, and N. Halberstadt, J. Chem. Phys. 137, 184310 (2012)], which investigated Ca(2) photodissociation in an argon-doped helium droplet and the nature of the fluorescent species. It is found that one single argon atom is sufficient to bring the calcium atom inside the droplet, for droplets of over 200 helium atoms. The absorption and emission spectra of CaAr(M) (M = 0-7) clusters have been simulated using the recently developed density sampling method to describe the influence of the helium environment. Absorption spectra exhibit broad, double bands that are significantly blueshifted with respect to the calcium atomic line. The emission spectra are less broad and redshifted with respect to the calcium resonance line. The shifts are found to be additive only for M ≤ 2, because only the first two argon atoms are located in equivalent positions around the calcium p orbital. This finding gives a justification for the fit presented in the companion paper, which uses the observed shifts in the emission spectra as a function of argon pressure to deduce the shifts as a function of the number of argon atoms present in the cluster. An analysis of this fit is presented here, based on the calculated shifts. It is concluded that the emitting species following Ca(2) photodissociation in an argon-doped droplet in Paper I could be Ca∗Ar(M) in a partly evaporated droplet where less than 200 helium atoms remain.

Pegylated interferon {alpha}2a plus ribavirin versus pegylated interferon {alpha}2b plus ribavirin for the treatment of chronic hepatitis C in HIV-infected patients

OBJECTIVES

The two currently available types of pegylated interferon (peg-IFN) used to treat hepatitis C have different pharmacokinetic properties. It is unclear how these differences affect response to therapy. We compared the effectiveness and safety of peg-IFN-alpha2a and peg-IFN-alpha2b, both with ribavirin, against chronic hepatitis C virus (HCV) infection in HIV-infected patients.

METHODS

From the GESIDA HIV/HCV cohort, we analysed patients treated with peg-IFN-alpha2a (n = 315) or peg-IFN-alpha2b (n = 242). The primary endpoint was a sustained virological response (SVR).

RESULTS

Both groups were well matched in baseline characteristics except for a higher frequency of injection drug users in the peg-IFN-alpha2b group than in the peg-IFN-alpha2a group (85% versus 76%; P = 0.01) and a higher frequency of bridging fibrosis and cirrhosis (F3-F4) in the peg-IFN-alpha2b group than in the peg-IFN-alpha2a group (42% versus 33%; P = 0.04). End-of-treatment response was significantly lower among patients treated with peg-IFN-alpha2b [40% versus 52%; odds ratio (OR), 1.63; 95% confidence interval (95% CI), 1.16-2.29; P < 0.01]. However, no significant differences were found in SVR between patients treated with peg-IFN-alpha2b and those treated with peg-IFN-alpha2a (31% versus 33%; OR, 1.09; 95% CI, 0.75-1.59; P = 0.655). Therapy was interrupted due to adverse events in 33 (14%) patients treated with peg-IFN-alpha2b and 47 (15%) patients treated with peg-IFN-alpha2a.

CONCLUSIONS

No differences in effectiveness and safety were found between peg-IFN-alpha2b and peg-IFN-alpha2a for the treatment of chronic HCV infection in HIV-infected patients.

Surface plasmon resonance and magnetism of thiol-capped gold nanoparticles

Surface plasmon resonance measurements and magnetic characterization studies have been carried out for two types of thiol-capped gold nanoparticles (NPs) with similar diameters between 2.0 and 2.5 nm and different organic molecules linked to the sulfur atom: dodecanethiol and tiopronin. In addition, Au NPs capped with tetraoctyl ammonium bromide have also been included in the investigation since such capping molecules weakly interact with the gold surface atoms and, therefore, this system can be used as a model for naked gold NPs; such particles presented a bimodal size distribution with diameters around 1.5 and 5 nm. The plasmon resonance is non-existent for tiopronin-capped NPs, whereas a trace of such a feature is observed for NPs covered with dodecanethiol molecules and a bulk-like feature is measured for NPs capped with tetralkyl ammonium salts. These differences would indicate that the modification of the surface electronic structure of the Au NPs depends on the geometry and self-assembling capabilities of the capping molecules and on the electric charge transferred between Au and S atoms. Regarding the magnetization, dodecanethiol-capped NPs have a ferromagnetic-like behaviour, while the NPs capped with tiopronin exhibit a paramagnetic behaviour and tetralkyl ammonium-protected NPs are diamagnetic across the studied temperature range; straight chains with a well-defined symmetry axis can induce orbital momentum on surface electrons close to the binding atoms. The orbital momentum not only contributes to the magnetization but also to the local anisotropy, giving rise to permanent magnetism. Due to the domain structure of the adsorbed molecules, orbital momentum is not induced for tiopronin-capped NPs and the charge transfer only induces a paramagnetic spin component.

Magnetic properties of ZnO nanoparticles

We experimentally show that it is possible to induce room-temperature ferromagnetic-like behavior in ZnO nanoparticles without doping with magnetic impurities but simply inducing an alteration of their electronic configuration. Capping ZnO nanoparticles ( approximately 10 nm size) with different organic molecules produces an alteration of their electronic configuration that depends on the particular molecule, as evidenced by photoluminescence and X-ray absorption spectroscopies and altering their magnetic properties that varies from diamagnetic to ferromagnetic-like behavior.

Prognostic value of hepatic venous pressure gradient for in-hospital mortality of patients with severe acute alcoholic hepatitis

BACKGROUND

Hepatic venous pressure gradient (HVPG) has prognostic value in complications and survival of patients with liver cirrhosis. However, the relationship between HVPG and the outcome of acute alcoholic hepatitis (AAH), as well as the specific features of portal hypertension syndrome in this setting, have not been defined.

AIMS

To evaluate the prognostic value of HVPG and to analyse the degree of portal hypertension and hyperdynamic circulation in patients with severe AAH.

METHODS

Early measurements of HVPG were performed in 60 patients with severe AAH, and compared with the haemodynamic findings of 37 and 29 liver transplantation candidates with alcoholic or viral end-stage cirrhosis respectively.

RESULTS

Twenty-three patients (38%) died during hospitalization. Portal hypertension and hyperdynamic circulation were more severe in AAH patients. HVPG was greater in non-survivors [26.9 (7.4) vs. 19.4 (5.2) mmHg, P < 0.001]. Only 4/31 (13%) patients with HVPG <or= 22 mmHg died from the episode of AAH, vs. 19/29 (66%) patients with HVPG > 22 (P < 0.001). Encephalopathy (OR 9.4; CI 1.4-64.8), Model for End-Stage Liver Disease (MELD) score > 25 (OR 7.4; CI 1.4-39.9) and HVPG > 22 mmHg (OR 6.7; CI 1.1-39.9) were independently associated to in-hospital mortality.

CONCLUSIONS

Early measurement of HVPG provides important prognostic information on the short-term outcome of patients with severe AAH. In addition, MELD score also seems to be a strong prognostic factor in these patients.