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 &gt;30 years, with partially dependent health status, hematocrit &lt;30%, bone tumors, tumor &gt;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 &gt;30 years (odds ratio [OR] = 5.07), hematocrit &lt;30% (OR = 1.84), operative time 1–3 h (OR = 2.97), and &gt;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 &gt;30, hematocrit &lt;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 36,38^{36,38}Ar(n,γ)37,39(n,\gamma)^{37,39}Ar reactions and their effect on light neutron-rich nuclide synthesis

The $^{36}$Ar$(n,\gamma)^{37}$Ar ($t_{1/2}$ = 35 d) and $^{38}$Ar$(n,\gamma)^{39}$Ar (269 y) reactions were studied for the first time with a quasi-Maxwellian ($kT \sim 47$ 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 $^{37}$Ar/$^{36}$Ar and $^{39}$Ar/$^{38}$Ar ratios in the activated samples were determined by accelerator mass spectrometry at the ATLAS facility (Argonne National Laboratory). The $^{37}$Ar activity was also measured by low-level counting at the University of Bern. Experimental MACS of $^{36}$Ar and $^{38}$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 $^{36,38}$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 $s$-process. The new production cross sections have implications also for the use of $^{37}$Ar and $^{39}$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 β\beta feeding from 12B using Gammasphere

Using an array of high-purity Compton-suppressed germanium detectors, we performed an independent measurement of the $\beta$-decay branching ratio from $^{12}\mathrm{B}$ to the second-excited (Hoyle) state in $^{12}\mathrm{C}$. Our result is $0.64(11)\%$, which is a factor $\sim 2$ 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 $\gamma$ 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