6,118 research outputs found
Risk factors for 30-day soft tissue complications after pelvic sarcoma surgery:A National Surgical Quality Improvement Program study
Introduction: Soft tissue (ST) complications after resection of bone and ST sarcomas of the pelvis occur more frequently than in appendicular tumors. We sought to identify risk factors for complications within 30 days of surgery. Methods: The National Surgical Quality Improvement Program database was used for this study. Patients with sarcomas of bone and ST of the pelvis were retrieved using Current Procedural Terminology and International Classification of Diseases codes. Outcomes assessed were ST complications, overall complication rates, 30-day reoperation, and mortality. Results: A total of 770 patients with pelvic bone and ST sarcoma were included. The ST complication rate was 12.6%, including 4.9% superficial and 4.7% deep surgical site infections. Higher ST complication rates were seen in patients >30 years, with partially dependent health status, hematocrit <30%, bone tumors, tumor >5 cm, amputation procedures, and longer operative times. ST complication rates were 1.5 and 3 times higher in pelvic sarcoma surgeries than in the lower and upper extremities, respectively. Age >30 years (odds ratio [OR] = 5.07), hematocrit <30% (OR = 1.84), operative time 1–3 h (OR = 2.97), and >3 h (OR = 4.89) were risk factors for ST complications. Conclusion: One in nine patients with pelvic sarcoma surgery will develop ST complications within 30 days. Risk factors for ST complications were age >30, hematocrit <30%, and longer operative time.</p
Metastatic appendicular soft tissue sarcoma:treatment and survival outcomes of 2,553 patients from the SEER database
Introduction: Patients with soft tissue sarcoma (STS) that present with metastasis at diagnosis have a dire prognosis. Within this patient population, we sought to assess: (1) demographic and clinical characteristics, (2) metastatic patterns, (3) treatment strategies, and (4) disease-specific survival (DSS).Materials and Methods: The SEER database was queried to identify patients with histologically confirmed STS of the pelvis or extremity. Univariate and multivariate analysis was performed using the Cox proportional hazards model. Disease-specific survival (DSS) was analyzed using the Kaplan-Meier method.Results: A total of 22,683 patients were retrieved, out of which 2,553 (11.3%) had metastasis at diagnosis. Leiomyosarcoma, undifferentiated pleomorphic sarcoma (UPS), liposarcoma, synovial sarcoma, spindle cell sarcoma, and alveolar rhabdomyosarcoma (A-RMS) were the six most common STS presenting with metastasis. Among patients with metastasis, 53.7% and 33.2% of patients had primary tumors located in the lower limb and pelvis, respectively. Lung was the most common site of metastasis in all subtypes except A-RMS, in which bone metastases and lymph node (LN) predominated (85.2% and 62.1%, respectively). Chemotherapy and radiotherapy were associated with higher DSS (HR = 0.788 and HR = 0.755, respectively). Five-year DSS was below 20% in all tumor histologies. Two-year DSS for patients with synchronous lung and liver metastases was 28%.Conclusion: Although the lung was the most common site of metastasis, metastatic patterns are highly variable depending on tumor histology. Metastatic A-RMS is most commonly presented with regional LN and bone involvement. Disease-specific survival remained poor for patients with metastatic disease at presentation regardless of (neo)-adjuvant radiotherapy or chemotherapy.</p
Metastatic appendicular soft tissue sarcoma:treatment and survival outcomes of 2,553 patients from the SEER database
Introduction: Patients with soft tissue sarcoma (STS) that present with metastasis at diagnosis have a dire prognosis. Within this patient population, we sought to assess: (1) demographic and clinical characteristics, (2) metastatic patterns, (3) treatment strategies, and (4) disease-specific survival (DSS).Materials and Methods: The SEER database was queried to identify patients with histologically confirmed STS of the pelvis or extremity. Univariate and multivariate analysis was performed using the Cox proportional hazards model. Disease-specific survival (DSS) was analyzed using the Kaplan-Meier method.Results: A total of 22,683 patients were retrieved, out of which 2,553 (11.3%) had metastasis at diagnosis. Leiomyosarcoma, undifferentiated pleomorphic sarcoma (UPS), liposarcoma, synovial sarcoma, spindle cell sarcoma, and alveolar rhabdomyosarcoma (A-RMS) were the six most common STS presenting with metastasis. Among patients with metastasis, 53.7% and 33.2% of patients had primary tumors located in the lower limb and pelvis, respectively. Lung was the most common site of metastasis in all subtypes except A-RMS, in which bone metastases and lymph node (LN) predominated (85.2% and 62.1%, respectively). Chemotherapy and radiotherapy were associated with higher DSS (HR = 0.788 and HR = 0.755, respectively). Five-year DSS was below 20% in all tumor histologies. Two-year DSS for patients with synchronous lung and liver metastases was 28%.Conclusion: Although the lung was the most common site of metastasis, metastatic patterns are highly variable depending on tumor histology. Metastatic A-RMS is most commonly presented with regional LN and bone involvement. Disease-specific survival remained poor for patients with metastatic disease at presentation regardless of (neo)-adjuvant radiotherapy or chemotherapy.</p
Stellar ArAr reactions and their effect on light neutron-rich nuclide synthesis
The ArAr ( = 35 d) and
ArAr (269 y) reactions were studied for the first time
with a quasi-Maxwellian ( keV) neutron flux for Maxwellian Average
Cross Section (MACS) measurements at stellar energies. Gas samples were
irradiated at the high-intensity Soreq applied research accelerator
facility-liquid-lithium target neutron source and the Ar/Ar and
Ar/Ar ratios in the activated samples were determined by
accelerator mass spectrometry at the ATLAS facility (Argonne National
Laboratory). The Ar activity was also measured by low-level counting at
the University of Bern. Experimental MACS of Ar and Ar, corrected
to the standard 30 keV thermal energy, are 1.9(3) mb and 1.3(2) mb,
respectively, differing from the theoretical and evaluated values published to
date by up to an order of magnitude. The neutron capture cross sections of
Ar are relevant to the stellar nucleosynthesis of light neutron-rich
nuclides; the two experimental values are shown to affect the calculated mass
fraction of nuclides in the region A=36-48 during the weak -process. The new
production cross sections have implications also for the use of Ar and
Ar as environmental tracers in the atmosphere and hydrosphere.Comment: 18 pages + Supp. Mat. (13 pages) Accepted for publication in Phys.
Rev. Let
A search for substellar members in the Praesepe and sigma Orionis clusters
(Abridged). We have conducted deep photometric searches for substellar
members of the Praesepe (0.5-1 Gyr) and sigma Orionis (3 Myr) star clusters
using the Sloan i' and z' filters, the 3.5-m and the 5-m Hale telescopes on the
Calar Alto and Palomar Observatories, respectively. The total area surveyed was
1177 arcmin^2 (Praesepe) and 1122 arcmin^2 (sigma Orionis) down to 5-sigma
detection limits of i'= 24.5 and z'= 24 mag, corresponding to masses of 50-55
M_Jup (Praesepe) and 6 M_Jup (sigma Orionis). Besides recovering previously
known cluster members reported in the literature, we have identified new
photometric candidates in both clusters whose masses expand the full range
covered by our study. In sigma Orionis, follow-up NIR photometry has allowed us
to confirm the likely cluster membership of three newly discovered
planetary-mass objects. The substellar mass function of sigma Orionis, which is
complete from the star-brown dwarf borderline down to 7 M_Jup, keeps rising
smoothly with a slope of alpha = 0.6^{+0.5}_{-0.1}. Very interestingly, one of
the faintest Praesepe candidates for which we have also obtained follow-up JHK
photometry nicely fits the expected optical and infrared photometric sequence
of the cluster. From its colors, we have estimated its spectral type in the
L4-L6 range. If confirmed as a true Praesepe member, it would become the first
L-type brown dwarf (50-60 M_Jup) identified in an intermediate-age star
cluster. Our derivation of the Praesepe mass function depends strongly on the
cluster age. For the youngest possible ages (500-700 Myr), our results suggest
that there is a deficit of Praesepe brown dwarfs in the central regions of the
cluster, while the similarity between the Praesepe and sigma Orionis mass
functions increases qualitatively for models older than 800 Myr.Comment: Accepted for publication in A&A. Figures 1, 7, and 9-12 are available
in jpeg forma
Current and emerging diagnosis tools and therapeutics for giant cell arteritis
Introduction: Giant cell arteritis (GCA) is the most common large-vessel vasculitis in individuals older than 50 years from Western countries. The goal of the treatment is to achieve improvement of symptoms and clinical remission as well as decrease the risk of severe vascular complications.
Areas covered: The review summarizes the main epidemiological and clinical features of GCA and discusses in depth both the classic and the new therapies used in the management of GCA.
Expert commentary: Prednisone/prednisolone of 40-60 mg/day is the mainstay in GCA therapy. It yields improvement of clinical features and reduces the risk of permanent visual loss in patients with GCA. Other drugs are used in patients who experience relapses (flares of the disease) or side effects related to glucocorticoids. Methotrexate is the most common conventional immunosuppressive drug used as a glucocorticoid sparing agent. Among the new biologic agents, the most frequently used is the recombinant humanized anti-IL-6 receptor antibody, which is effective to improve clinical symptoms, decrease the cumulative prednisone dose and reduce the frequency of relapses in these patients. Anti-tumor necrosis factor-α therapy is not useful in GCA. Experience with other biologic agents, such as abatacept or ustekinumab, looks promising but it is still scarce
Independent measurement of the Hoyle state feeding from 12B using Gammasphere
Using an array of high-purity Compton-suppressed germanium detectors, we
performed an independent measurement of the -decay branching ratio from
to the second-excited (Hoyle) state in . Our
result is , which is a factor smaller than the previously
established literature value, but is in agreement with another recent
measurement. This could indicate that the Hoyle state is more clustered than
previously believed. The angular correlation of the Hoyle state
cascade has also been measured for the first time. It is consistent with
theoretical predictions
Divergent abiotic spectral pathways unravel pathogen stress signals across species
Abstract: Plant pathogens pose increasing threats to global food security, causing yield losses that exceed 30% in food-deficit regions. Xylella fastidiosa (Xf) represents the major transboundary plant pest and one of the world’s most damaging pathogens in terms of socioeconomic impact. Spectral screening methods are critical to detect non-visual symptoms of early infection and prevent spread. However, the subtle pathogen-induced physiological alterations that are spectrally detectable are entangled with the dynamics of abiotic stresses. Here, using airborne spectroscopy and thermal scanning of areas covering more than one million trees of different species, infections and water stress levels, we reveal the existence of divergent pathogen- and host-specific spectral pathways that can disentangle biotic-induced symptoms. We demonstrate that uncoupling this biotic–abiotic spectral dynamics diminishes the uncertainty in the Xf detection to below 6% across different hosts. Assessing these deviating pathways against another harmful vascular pathogen that produces analogous symptoms, Verticillium dahliae, the divergent routes remained pathogen- and host-specific, revealing detection accuracies exceeding 92% across pathosystems. These urgently needed hyperspectral methods advance early detection of devastating pathogens to reduce the billions in crop losses worldwide
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