The Cambridge post-mastectomy radiotherapy (C-PMRT) index : a practical tool for patient selection

BACKGROUND AND PURPOSE: Post mastectomy radiotherapy (PMRT) reduces loco-regional recurrence (LRR) and has been associated with survival benefit. It is recommended for patients with T3/T4 tumours and/or ⩾ 4 positive lymph nodes (LN). The role of PMRT in 1-3 positive LN and LN negative patients is contentious. The C-PMRT index has been designed for selecting PMRT patients, using independent prognostic factors for LRR. This study reports a 10 year experience using this index. MATERIALS AND METHODS: The C-PMRT index was constructed using the following prognostic factors (a) number of positive LN/lymphovascular invasion, (b) tumour size (c) margin status and (d) tumour grade. Patients were categorised as high (H) risk, intermediate (I) risk and low (L) risk. PMRT was recommended for H and I risk patients. The LRR, distant metastasis and overall survival (OS) rates were measured from the day of mastectomy. RESULTS: From 1999 to 2009, 898 invasive breast cancers in 883 patients were treated by mastectomy (H: 323, I: 231 and L: 344). At a median follow up of 5.2 years, 4.7% (42/898) developed LRR. The 5-year actuarial LRR rates were 6%, 2% and 2% for the H, I and L risk groups, respectively. 1.6% (14/898) developed isolated LRR (H risk n = 4, I risk group n = 0 and L risk n = 10). The 5-year actuarial overall survival rates were 67%, 77% and 90% for H, I and L risk groups, respectively. CONCLUSION: Based on published literature, one would have expected a higher LRR rate in the I risk group without adjuvant RT. We hypothesise that the I risk group LRR rates have been reduced to that of the L risk group by the addition of RT. Apart from LN status and tumour size, other prognostic factors should also be considered in selecting patients for PMRT. This pragmatic tool requires further validation

Turbulent drag on a low-frequency vibrating grid in superfluid He-4 at very low temperatures

We present measurements of the dissipative turbulent drag on a vibrating grid in superfluid He-4 over a wide range of (low) frequencies. At high velocities, the dissipative drag is independent of frequency and is approximately the same as that measured in normal liquid He-4. We present measurements on a similar grid in superfluid He-3-B at low temperatures which shows an almost identical turbulent drag coefficient at low frequencies. However, the turbulent drag in He-3-B is substantially higher at higher frequencies. We also present measurements of the inertial drag coefficient for grid turbulence in He-4. The inertial drag coefficient is significantly reduced by turbulence in both superfluid and normal liquid He-4

2-[(4-Chlorophenyl)selanyl]-3,4-dihydro-2H-benzo[h]chromene-5,6-dione: crystal structure and Hirshfeld analysis

The title organoselenium compound, C19H13ClO3Se {systematic name: 2-[(4-chlorophenyl)selanyl]-2H,3H,4H,5H,6H-naphtho[1,2-b]pyran-5,6-dione}, has the substituted 2-pyranyl ring in a half-chair conformation with the methylene-C atom bound to the methine-C atom being the flap atom. The dihedral angle between the two aromatic regions of the molecule is 9.96 (9)° and indicates a step-like conformation. An intramolecular Se...O interaction of 2.8122 (13) Å is noted. In the crystal, π–π contacts between naphthyl rings [inter-centroid distance = 3.7213 (12) Å] and between naphthyl and chlorobenzene rings [inter-centroid distance = 3.7715 (13) Å], along with C—Cl...π(chlorobenzene) contacts, lead to supramolecular layers parallel to the ab plane, which are connected into a three-dimensional architecture via methylene-C—H...O(carbonyl) interactions. The contributions of these and other weak contacts to the Hirshfeld surface is described

Identifying risk interdependencies in pharmaceutical supply chains through gamification-enabled structural modelling

We develop an approach for the evaluation of interrelated risks that could compromise a pharmaceutical supply chain’s ability to serve patients, whereby experts conduct pairwise comparisons through an online gamification-enabled platform. Risks categorization based on structural modelling elevates their consideration beyond the single instance in which they are normally evaluatedAdvanced Manufacturing Supply Chain Initiative (Grant No. 35708-233529, ReMediES – Reconfiguring Medicines End-to-end supply

Tracking amino acid metabolism in CHO cell cultures using stable isotope labeling assisted metabolomics

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Elucidating amino acid metabolism in CHO cells

CHO cells require complex media for cell growth and protein production. The major components of industrial media are amino acids, however, relatively little is known about the metabolism of amino acids in CHO cell cultures. Here, we applied advanced 13C-flux analysis tools to elucidate the metabolic flow of the amino acids in a fed-batch CHO culture that overproduced IgG. Carbon flows were tracked throughout the growth phase and changes in metabolism were quantified when cells transitioned from growth phase to stationary phase. In addition, we quantified how changes in amino acids profiles in the medium translated to changes in cell growth, protein production and product quality attributes. To trace each amino acid individually, custom media formulations were used, where each medium formulation was depleted of a specific amino acid. A labeled 13C variant of the depleted amino acid was then added to the medium at the desired concentration. CHO cells were then grown in fed-batch culture. As the cells metabolized the labeled amino acids, this resulted in a redistribution of 13C-atoms which we quantified using GC-MS for both extracellular metabolites (including lactate, amino acids and the IgG product) and intracellular metabolites (including free intracellular metabolites, cell proteins, lipids and carbohydrates). We then estimated metabolic fluxes using state-of-the-art 13C-metabolic flux analysis. This allowed us to calculate the fraction of each amino acid that was used for cell growth, protein production, lactate formation and energy generation. We also investigated the effects of labeling in both the batch and fed-batch stationary phase. Finally, we investigated the effects of varying amino acid concentrations. Each 13C-labeled amino acid was added to the medium at a lower or higher concentration compared to the base medium. 13C-metabolic flux analysis was again performed and changes in fluxes were compared in order to determine the precise impacts of amino acid concentration changes on the flux profiles. Taking all of this data together, we are now building a predictive kinetic model that relates how the metabolism of CHO cells can be predicted from amino acid profiles. In future work, model predictions will be experimentally validated as a means of optimizing the amino acid composition of industrial culture media

Design and Development of Garlic Peeling Machine by Human Powered Flywheel Motor Concept for Rural Dwellers Development

This invention is a new proposed model of peeling the garlic skins with mechanical functionality. Working with the simple and basic mechanism, this is utilising to peel the skin of garlic cloves. This device consists of components like flywheel, process unitand peeler. It reduces the time consumption and protects the hand fingers from the welfare issues like irritation in fingers and nail breakings

Antimicrobial Activity of Human Prion Protein Is Mediated by Its N-Terminal Region

BACKGROUND: Cellular prion-related protein (PrP(c)) is a cell-surface protein that is ubiquitously expressed in the human body. The multifunctionality of PrP(c), and presence of an exposed cationic and heparin-binding N-terminus, a feature characterizing many antimicrobial peptides, made us hypothesize that PrP(c) could exert antimicrobial activity. METHODOLOGY AND PRINCIPAL FINDINGS: Intact recombinant PrP exerted antibacterial and antifungal effects at normal and low pH. Studies employing recombinant PrP and N- and C-terminally truncated variants, as well as overlapping peptide 20mers, demonstrated that the antimicrobial activity is mediated by the unstructured N-terminal part of the protein. Synthetic peptides of the N-terminus of PrP killed the Gram-negative bacteria Escherichia coli and Pseudomonas aeruginosa, and the Gram-positive Bacillus subtilis and Staphylococcus aureus, as well as the fungus Candida parapsilosis. Fluorescence studies of peptide-treated bacteria, paired with analysis of peptide effects on liposomes, showed that the peptides exerted membrane-breaking effects similar to those seen after treatment with the "classical" human antimicrobial peptide LL-37. In contrast to LL-37, however, no marked helix induction was detected for the PrP-derived peptides in presence of negatively charged (bacteria-mimicking) liposomes. PrP furthermore showed an inducible expression during wounding of human skin ex vivo and in vivo, as well as stimulation of keratinocytes with TGF-alpha in vitro. CONCLUSIONS: The demonstration of an antimicrobial activity of PrP, localisation of its activity to the N-terminal and heparin-binding region, combined with results showing an increased expression of PrP during wounding, indicate that PrPs could have a previously undisclosed role in host defense

A multicentre study of the evidence for customized margins in photon breast boost radiotherapy

Objective:To determine if subsets of patients may benefit from smaller or larger margins when using laser setup and bony anatomy verification of breast tumour bed (TB) boost radiotherapy (RT).Methods: Verification imaging data acquired using cone-beam CT, megavoltage CT or two-dimensional kilovoltage imaging on 218 patients were used (1574 images). TB setup errors for laser-only setup (dlaser) and for bony anatomy verification (dbone) were determined using clips implanted into the TB as a gold standard for the TB position. Cases were grouped by centre-, patient- and treatment-related factors, including breast volume, TB position, seroma visibility and surgical technique. Systematic (?) and random (?) TB setup errors were compared between groups, and TB planning target volume margins (MTB) were calculated.Results: For the study population, ?laser was between 2.8 and 3.4?mm, and ?bone was between 2.2 and 2.6?mm, respectively. Females with larger breasts (p?=?0.03), easily visible seroma (p???0.02) and open surgical technique (p???0.04) had larger ?laser. ?bone was larger for females with larger breasts (p?=?0.02) and lateral tumours (p?=?0.04). Females with medial tumours (p?<?0.01) had smaller ?bone.Conclusion:If clips are not used, margins should be 8 and 10?mm for bony anatomy verification and laser setup, respectively. Individualization of TB margins may be considered based on breast volume, TB and seroma visibility.Advances in knowledge:Setup accuracy using lasers and bony anatomy is influenced by patient and treatment factors. Some patients may benefit from clip-based image guidance more than others