Cognitive Impairment in Long-Term Survivors of Testicular Cancer More Than 20 Years after Treatment

SIMPLE SUMMARY: Impaired cognition can be a late effect after treatment in long-term testicular cancer survivors, negatively affecting their daily life. However, little data is available beyond 20 years post-treatment. We assessed cognitive impairment in very-long-term survivors after treatment. In this study, we enrolled testicular cancer survivors with a follow-up duration ≥ 20 years—and age-matched healthy controls. Cognitive testing included the Auditory Verbal Learning Test, Letter Fluency Test, and Trail Making Test. We used fasting blood samples to assess the presence of hypogonadism and measured cardiovascular damage and aging parameters. We included 184 testicular cancer survivors (66 chemotherapy patients, 53 radiotherapy patients, and 65 orchiectomy only patients) and 70 healthy controls. The median follow-up was 26 years. Testicular cancer survivors performed worse on cognitive tests compared to controls. In univariate analysis, the presence of hypogonadism was associated with lower cognitive scores. Physicians and patients should be informed about timely cardiovascular risk management and testosterone supplementation therapy during follow-up to reduce the risk of cognitive impairment. ABSTRACT: Background: Impaired cognition can be a late effect after treatment in long-term testicular cancer (TC) survivors, negatively affecting their daily life. However, little data is available beyond 20 years post-treatment. We assessed cognitive impairment in very long-term TC survivors after CT or RT and compared the results with stage I TC survivors and controls. Methods: In this cross-sectional multicenter cohort study, we enrolled TC survivors (treated with orchiectomy followed by CT or RT or orchiectomy only)—with a follow-up duration ≥ 20 years—and age-matched healthy controls. Cognitive testing included the Auditory Verbal Learning Test, Letter Fluency Test, Category Fluency Test, and Trail Making Test. We used fasting blood samples to assess the presence of hypogonadism and measured cardiovascular aging parameters, including carotid pulse wave velocity (c-PWV) and advanced glycation end products (AGEs). Results: We included 184 TC survivors (66 CT patients, 53 RT patients, and 65 orchiectomy-only patients) and 70 healthy controls. The median follow-up was 26 years (range: 20–42). TC survivors had a lower combined score of the cognitive tests (mean cumulative Z-score −0.85; 95% CI −1.39 to −0.33) compared to controls (mean 0.67; 95% CI −0.21 to 1.57, p < 0.01). In univariate analysis, the presence of hypogonadism (β −1.50, p < 0.01), high c-PWV (β −0.35, p = 0.09), and high AGEs (β −1.27, p = 0.02) were associated with lower cognitive scores, while only AGEs (β −1.17, p = 0.03) remained a significant predictor in multivariate analysis (Model R2 0.31, p < 0.01). Conclusions: Long-term TC survivors performed worse on cognitive tests compared to controls. Physicians and patients should be informed about timely cardiovascular risk management and testosterone supplementation therapy during follow-up to reduce the risk of cognitive impairment. Trial Registration: NCT02572934

Attenuation effects on laser-based nitric oxide diagnostics in a heavy-duty diesel engine

A number of laser diagnostic techniques enabling a correction for laser intensity and detection efficiency of the raw NO-LIF data is presented. Laser beam transmission measurements at 226 nm, with the laser beam parallel to the cylinder axis, show that ∼ 20° aTDC the transmission is typically 1%; it increases to 50-80% later in the stroke, depending on engine load. Since absorption by CO2 shows a strong wavelength dependence (increasing absorption for shorter wavelengths), the attenuation for 237 nm being equal to that for 226 nm suggests that CO2 does not play a dominant role in the laser beam transmission. Since the overall laser beam transmission measurements show considerable attenuation, the bidirectional results suggest that most of the laser beam extinction occurs outside the field of view, e.g. in the piston bowl. Not only the laser beam, but also NO fluorescence is attenuated. Detection of NO LIF through a spectrograph allows quantitative comparison of the intensities of the observed fluorescence bands at 237, 248, and 259 nm. This is an abstract of a paper presented at the 30th International Symposium on Combustion (Chicago, IL 7/25-30/2004)

Biodiesel soot incandescence and NO emission studied in an optical engine

High-speed imaging and thermodynamical characterization are applied to an optically accessible, heavy-duty diesel engine in order to compare soot incandescence and NO emission behaviour of four bioderived fuels: rapeseed-methylester, Jatropha oil (pure), Jatropha-methylester and a 50/50 blend of cyclohexanone with a Fischer-Tropsch synthetic fuel. Regular diesel fuel is used as a reference. Soot incandescence is observed at 0.3° crank angle resolution (200 images/cycle). The heat release rate and exhaust NO concentrations are used as indicators of average and peak temperatures, respectively, which are combined with soot incandescence signal to get a relative measure for a fuel's sooting propensity

Biodiesel soot incandescence and NO emission studied in an optical engine

\u3cp\u3eHigh-speed imaging and thermodynamical characterization are applied to an optically accessible, heavy-duty diesel engine in order to compare soot incandescence and NO emission behaviour of four bioderived fuels: rapeseed-methylester, Jatropha oil (pure), Jatropha-methylester and a 50/50 blend of cyclohexanone with a Fischer-Tropsch synthetic fuel. Regular diesel fuel is used as a reference. Soot incandescence is observed at 0.3° crank angle resolution (200 images/cycle). The heat release rate and exhaust NO concentrations are used as indicators of average and peak temperatures, respectively, which are combined with soot incandescence signal to get a relative measure for a fuel's sooting propensity.\u3c/p\u3