Impact of response evaluation for resectable esophageal adenocarcinoma – A retrospective cohort study

AbstractIntroduction: The standard treatment concept in patients with locally advanced adenocarcinoma of the esophagogastric junction is neoadjuvant chemotherapy, followed by tumor resection in curative intent. Response evaluation of neoadjuvant chemotherapy using histopathological tumor regression grade (TRG) has been shown to be a prognostic factor in patients with esophageal cancer. Methods: We assessed the impact of the various methods of response control and their value in correlation to established prognostic factors in a cohort of patients with adenocarcinoma at the gastroesophageal junction treated by neoadjuvant chemotherapy. Results: After neoadjuvant chemotherapy, in 56 consecutive patients with locally advanced (T2/3/4 and/or N0/N1) esophageal adenocarcinoma an oncologic tumor resection for curative intent was performed. Median follow-up was 44 months. Histopathological tumor stages were stage 0 in 10.7%, stage I in 17.9%, stage II in 21.4%, stage III in 41.1% and stage IV 8.9%. The 3-year overall survival (OS) rate was 30.3%. In univariate analysis, ypN-status, histopathological tumor stage and tumor regression grade correlated significantly with overall survival (p = 0.022, p = 0.001, p = 0.035 respectively). Clinical response evaluation could not predict response and overall survival (p = 0.556, p = 0.254 respectively). Conclusion: After preoperative chemotherapy, outcomes of esophageal carcinoma are best predicted utilizing pathological tumor stage and histologic tumor regression. Clinical response assessments were not useful for guidance of treatment

Mid-infrared sub-wavelength grating mirror design: tolerance and influence of technological constraints

High polarization selective Si/SiO2 mid-infrared sub-wavelength grating mirrors with large bandwidth adapted to VCSEL integration are compared. These mirrors have been automatically designed for operation at \lambda = 2.3 $\mu$m by an optimization algorithm which maximizes a specially defined quality factor. Several technological constraints in relation with the grating manufacturing process have been imposed within the optimization algorithm and their impact on the optical properties of the mirror have been evaluated. Furthermore, through the tolerance computation of the different dimensions of the structure, the robustness with respect to fabrication errors has been tested. Finally, it appears that the increase of the optical performances of the mirror imposes a less tolerant design with severer technological constraints resulting in a more stringent control of the manufacturing process.Comment: The final publication is available at http://iopscience.iop.org/2040-8986/13/12/125502

Conformational Mechanics of Polymer Adsorption Transitions at Attractive Substrates

Conformational phases of a semiflexible off-lattice homopolymer model near an attractive substrate are investigated by means of multicanonical computer simulations. In our polymer-substrate model, nonbonded pairs of monomers as well as monomers and the substrate interact via attractive van der Waals forces. To characterize conformational phases of this hybrid system, we analyze thermal fluctuations of energetic and structural quantities, as well as adequate docking parameters. Introducing a solvent parameter related to the strength of the surface attraction, we construct and discuss the solubility-temperature phase diagram. Apart from the main phases of adsorbed and desorbed conformations, we identify several other phase transitions such as the freezing transition between energy-dominated crystalline low-temperature structures and globular entropy-dominated conformations.Comment: 13 pages, 15 figure

Economic inequalities in burden of illness, diagnosis and treatment of five long-term conditions in England: panel study

We compared the distribution by wealth of self-reported illness burden (estimated from validated scales, biomarker and reported symptoms) for angina, cataract, depression, diabetes and osteoarthritis, with the distribution of self-reported medical diagnosis and treatment. We aimed to determine if the greater illness burden borne by poorer participants was matched by appropriately higher levels of diagnosis and treatment

Quantum cosmology with a curvature squared action

The correct quantum description for a curvature squared term in the action can be obtained by casting the action in the canonical form with the introduction of a variable which is the negative of the first derivative of the field variable appearing in the action, only after removing the total derivative terms from the action. We present the Wheeler-DeWitt equation and obtain the expression for the probability density and current density from the equation of continuity. Furthermore, in the weak energy limit we obtain the classical Einstein equation. Finally we present a solution of the wave equation.Comment: 8 pages, revte

Quantitative analysis of shadow X-ray Magnetic Circular Dichroism Photo-Emission Electron Microscopy

Shadow X-ray Magnetic Circular Dichroism Photo-Emission Electron Microscopy (XMCD-PEEM) is a recent technique, in which the photon intensity in the shadow of an object lying on a surface, may be used to gather information about the three-dimensional magnetization texture inside the object. Our purpose here is to lay the basis of a quantitative analysis of this technique. We first discuss the principle and implementation of a method to simulate the contrast expected from an arbitrary micromagnetic state. Text book examples and successful comparison with experiments are then given. Instrumental settings are finally discussed, having an impact on the contrast and spatial resolution : photon energy, microscope extraction voltage and plane of focus, microscope background level, electric-field related distortion of three-dimensional objects, Fresnel diffraction or photon scattering

Application of the multi distribution function lattice Boltzmann approach to thermal flows

Numerical methods able to model high Rayleigh (Ra) and high Prandtl (Pr) number thermal convection are important to study large-scale geophysical phenomena occuring in very viscous fluids such as magma chamber dynamics (104 < Pr < 107 and 107 < Ra < 1011). The important variable to quantify the thermal state of a convective fluid is a generalized dimensionless heat transfer coefficient (the Nusselt number) whose measure indicates the relative efficiency of the thermal convection. In this paper we test the ability of Multi-distribution Function approach (MDF) Thermal Lattice Boltzmann method to study the well-established scaling result for the Nusselt number (Nu ∝ Ra 1/3) in Rayleigh Bénard convection for 104 ≤ Ra ≤ 109 and 101 ≤ Pr ≤ 104. We explore its main drawbacks in the range of Pr and Ra number under investigation: (1) high computational time N c required for the algorithm to converge and (2) high spatial accuracy needed to resolve the thickness of thermal plumes and both thermal and velocity boundary layer. We try to decrease the computational demands of the method using a multiscale approach based on the implicit dependence of the Pr number on the relaxation time, the spatial and temporal resolution characteristic of the MDF thermal mode

Australian human and parrot Chlamydia psittaci strains cluster within the highly virulent 6BC clade of this important zoonotic pathogen

Chlamydia psittaci is an avian pathogen and zoonotic agent of atypical pneumonia. The most pathogenic C. psittaci strains cluster into the 6BC clade, predicted to have recently emerged globally. Exposure to infected parrots is a risk factor with limited evidence also of an indirect exposure risk. Genome sequencing was performed on six Australian human and a single avian C. psittaci strain isolated over a 9 year period. Only one of the five human patients had explicit psittacine contact. Genomics analyses revealed that the Australian C. psittaci strains are remarkably similar, clustering tightly within the C. psittaci 6BC clade suggested to have been disseminated by South America parrot importation. Molecular clock analysis using the newly sequenced C. psittaci genomes predicted the emergence of the 6BC clade occurring approximately 2,000 years ago. These findings reveal the potential for an Australian natural reservoir of C. psittaci 6BC strains. These strains can also be isolated from seriously ill patients without explicit psittacine contact. The apparent recent and global spread of C. psittaci 6BC strains raises important questions over how this happened. Further studies may reveal whether the dissemination of this important zoonotic pathogen is linked to Australian parrot importation rather than parrots from elsewhere