Short-Course Radiotherapy Followed by Neoadjuvant Bevacizumab, Capecitabine, and Oxaliplatin and Subsequent Radical Treatment in Primary Stage IV Rectal Cancer:Long-Term Results of a Phase II Study

Background. In a Dutch phase II trial conducted between 2006 and 2010, short-course radiotherapy followed by systemic therapy with capecitabine, oxaliplatin, and bevacizumab as neoadjuvant treatment and subsequent radical surgical treatment of primary tumor and metastatic sites was evaluated. In this study, we report the long-term results after a minimum follow-up of 6 years. Methods. Patients with histologically confirmed rectal adenocarcinoma with potentially resectable or ablatable metastases in liver or lungs were eligible. Follow-up data were collected for all patients enrolled in the trial. Overall and recurrence-free survival were calculated using the Kaplan-Meier method. Results. Follow-up data were available for all 50 patients. After a median follow-up time of 8.1 years (range 6.0-9.8), 16 patients (32.0%) were still alive and 14 (28%) were disease-free. The median overall survival was 3.8 years (range 0.5-9.4). From the 36 patients who received radical treatment, two (5.6%) had a local recurrence and 29 (80.6%) had a distant recurrence. Conclusions. Long-term survival can be achieved in patients with primary metastatic rectal cancer after neoadjuvant radio- and chemotherapy. Despite a high number of recurrences, 32% of patients were alive after a median follow-up time of 8.1 years

Global occurrence, chemical properties, and ecological impacts of e-wastes (IUPAC technical report)

The waste stream of obsolete electronic equipment grows exponentially, creating a worldwide pollution and resource problem. Electrical and electronic waste (e-waste) comprises a heterogeneous mix of glass, plastics (including flame retardants and other additives), metals (including rare earth elements) and metalloids. The e-waste issue is complex and multi-faceted. In examining the different aspects of e-waste, informal recycling in developing countries has been identified as a primary concern due to widespread illegal shipments, weak environmental as well as health and safety regulations, lack of technology and inadequate waste treatment structure. For example, Nigeria, Ghana, India, Pakistan and China have all been identified as hotspots for the disposal of e-waste. This article presents a critical examination on the chemical nature of e-waste and the resulting environmental impacts on, for example, microbial biodiversity, flora and fauna in e-waste recycling sites around the world. It highlights the different types of risk assessment approaches required when evaluating the ecological impact of e-waste. Additionally, it presents examples of chemistry playing a role in potential solutions. The information presented here will be informative to relevant stakeholders to devise integrated management strategies to tackle this global environmental concern

Efficacy of alpha-Blockers on Hemodynamic Control during Pheochromocytoma Resection:A Randomized Controlled Trial

CONTEXT: Pretreatment with α-adrenergic receptor blockers is recommended to prevent hemodynamic instability during resection of a pheochromocytoma or sympathetic paraganglioma (PPGL). OBJECTIVE: To determine which type of α-adrenergic receptor blocker provides the best efficacy. DESIGN: Randomized controlled open-label trial (PRESCRIPT; ClinicalTrials.gov NCT01379898). SETTING: Multicenter study including 9 centers in The Netherlands. PATIENTS: 134 patients with non-metastatic PPGL. INTERVENTION: phenoxybenzamine or doxazosin starting 2-3 weeks before surgery using a blood pressure targeted titration schedule. Intraoperative hemodynamic management was standardized. MAIN OUTCOME MEASURES: Primary efficacy endpoint was the cumulative intraoperative time outside the blood pressure target range (i.e., SBP >160 mmHg or MAP <60 mmHg) expressed as a percentage of total surgical procedure time. Secondary efficacy endpoint was the value on a hemodynamic instability score. RESULTS: Median cumulative time outside blood pressure targets was 11.1% [IQR: 4.3-20.6] in the phenoxybenzamine group compared to 12.2% [5.3-20.2] in the doxazosin group (P=0.75, r=0.03). The hemodynamic instability score was 38.0 [28.8-58.0] and 50.0 [35.3-63.8] in the phenoxybenzamine and doxazosin group, respectively (P=0.02, r=0.20). The 30-day cardiovascular complication rate was 8.8% and 6.9% in the phenoxybenzamine and doxazosin group, respectively (P=0.68). There was no mortality after 30 days. CONCLUSIONS: The duration of blood pressure outside the target range during resection of a PPGL was not different after preoperative treatment with either phenoxybenzamine or doxazosin. Phenoxybenzamine was more effective in preventing intraoperative hemodynamic instability, but it could not be established whether this was associated with a better clinical outcome

Corporate environmental responsibility and criminology

This article addresses corporate environmental responsibility (CER) and aims to present a criminological analysis of it. We studied the opinion of a number of principle actors involved in CER in Europe in order to determine how they perceive it in terms of its definition, aetiology and approaches. For each of these dimensions we relate back to a criminological framework to ascertain how it is positioned in the green criminological debate. We start out by providing information on what corporate environmental responsibility is and how it relates to corporate social responsibility and sustainable development. Then we outline the theoretical framework in accordance with the three central themes for the criminological analysis of CER: definition, aetiology and approaches. We also explain the method that was used (semi-structured interviews). Next, we present the results according to the same threefold structure. Finally we discuss these results in a last part, which is divided in two. First, we look at the challenges that the criminological perspective poses for CER in terms of definition, aetiology and approaches. The second part of the discussion turns the question around and wonders how CER could contribute to greening criminology

Grain Surface Models and Data for Astrochemistry

AbstractThe cross-disciplinary field of astrochemistry exists to understand the formation, destruction, and survival of molecules in astrophysical environments. Molecules in space are synthesized via a large variety of gas-phase reactions, and reactions on dust-grain surfaces, where the surface acts as a catalyst. A broad consensus has been reached in the astrochemistry community on how to suitably treat gas-phase processes in models, and also on how to present the necessary reaction data in databases; however, no such consensus has yet been reached for grain-surface processes. A team of ∼25 experts covering observational, laboratory and theoretical (astro)chemistry met in summer of 2014 at the Lorentz Center in Leiden with the aim to provide solutions for this problem and to review the current state-of-the-art of grain surface models, both in terms of technical implementation into models as well as the most up-to-date information available from experiments and chemical computations. This review builds on the results of this workshop and gives an outlook for future directions

The c2d Spitzer Spectroscopic Survey of Ices Around Low-Mass Young Stellar Objects: I. H2O and the 5-8 um Bands

With the goal to study the physical and chemical evolution of ices in solar-mass systems, a spectral survey is conducted of a sample of 41 low luminosity YSOs using 3-38 um Spitzer and ground-based spectra. The long-known 6.0 and 6.85 um bands are detected toward all sources, with the Class 0-type YSOs showing the deepest bands ever observed. In almost all sources the 6.0 um band is deeper than expected from the bending mode of pure solid H2O. The depth and shape variations of the remaining 5-7 um absorption indicate that it consists of 5 independent components, which, by comparison to laboratory studies, must be from at least 8 different carriers. Simple species are responsible for much of the absorption in the 5-7 um region, at abundances of 1-30% for CH3OH, 3-8% for NH3, 1-5% for HCOOH, ~6% for H2CO, and ~0.3% for HCOO- with respect to solid H2O. The 6.85 um band likely consists of one or two carriers, of which one is less volatile than H2O because its abundance relative to H2O is enhanced at lower H2O/tau_9.7 ratios. It does not survive in the diffuse interstellar medium (ISM), however. The similarity of the 6.85 um bands for YSOs and background stars indicates that its carrier(s) must be formed early in the molecular cloud evolution. If an NH4+ salt is the carrier its abundance with respect to solid H2O is typically 7%, and low temperature acid-base chemistry or cosmic ray induced reactions must have been involved in its formation. Possible origins are discussed for the carrier of an enigmatic, very broad absorption between 5 and 8 um. Finally, all the phenomena observed for ices toward massive YSOs are also observed toward low mass YSOs, indicating that processing of the ices by internal ultraviolet radiation fields is a minor factor in the early chemical evolution of the ices. [abridged]Comment: Accepted for publication in ApJ. 22 pages, 18 b&w figure

High cellular monocyte activation in people living with human immunodeficiency virus on combination antiretroviral therapy and lifestyle-matched controls is associated with greater inflammation in cerebrospinal fluid

Background. Increased monocyte activation and intestinal damage have been shown to be predictive for the increased morbidity and mortality observed in treated people living with human immunodeficiency virus (PLHIV). Methods. A cross-sectional analysis of cellular and soluble markers of monocyte activation, coagulation, intestinal damage, and inflammation in plasma and cerebrospinal fluid (CSF) of PLHIV with suppressed plasma viremia on combination antiretroviral therapy and age and demographically comparable HIV-negative individuals participating in the Comorbidity in Relation to AIDS (COBRA) cohort and, where appropriate, age-matched blood bank donors (BBD). Results. People living with HIV, HIV-negative individuals, and BBD had comparable percentages of classical, intermediate, and nonclassical monocytes. Expression of CD163, CD32, CD64, HLA-DR, CD38, CD40, CD86, CD91, CD11c, and CX3CR1 on monocytes did not differ between PLHIV and HIV-negative individuals, but it differed significantly from BBD. Principal component analysis revealed that 57.5% of PLHIV and 62.5% of HIV-negative individuals had a high monocyte activation profile compared with 2.9% of BBD. Cellular monocyte activation in the COBRA cohort was strongly associated with soluble markers of monocyte activation and inflammation in the CSF. Conclusions. People living with HIV and HIV-negative COBRA participants had high levels of cellular monocyte activation compared with age-matched BBD. High monocyte activation was predictive for inflammation in the CSF