Association of Axillary Dissection With Systemic Therapy in Patients With Clinically Node-Positive Breast Cancer.

The role of axillary lymph node dissection (ALND) to determine nodal burden to inform systemic therapy recommendations in patients with clinically node (cN)-positive breast cancer (BC) is currently unknown. To address the association of ALND with systemic therapy in cN-positive BC in the upfront surgery setting and after neoadjuvant chemotherapy (NACT). This was a prospective, observational, cohort study conducted from August 2018 to June 2022. This was a preplanned study within the phase 3 randomized clinical OPBC-03/TAXIS trial. Included were patients with confirmed cN-positive BC from 44 private, public, and academic breast centers in 6 European countries. After NACT, residual nodal disease was mandatory, and a minimum follow-up of 2 months was required. All patients underwent tailored axillary surgery (TAS) followed by ALND or axillary radiotherapy (ART) according to TAXIS randomization. TAS removed suspicious palpable and sentinel nodes, whereas imaging-guidance was optional. Systemic therapy recommendations were at the discretion of the local investigators. A total of 500 patients (median [IQR] age, 57 [48-69] years; 487 female [97.4%]) were included in the study. In the upfront surgery setting, 296 of 335 patients (88.4%) had hormone receptor (HR)-positive and Erb-B2 receptor tyrosine kinase 2 (ERBB2; formerly HER2 or HER2/neu)-negative disease: 145 (49.0%) underwent ART, and 151 (51.0%) underwent ALND. The median (IQR) number of removed positive lymph nodes without ALND was 3 (1-4) nodes compared with 4 (2-9) nodes with ALND. There was no association of ALND with the proportion of patients undergoing adjuvant chemotherapy (81 of 145 [55.9%] vs 91 of 151 [60.3%]; adjusted odds ratio [aOR], 0.72; 95% CI, 0.19-2.67) and type of systemic therapy. Of 151 patients with NACT, 74 (51.0%) underwent ART, and 77 (49.0%) underwent ALND. The ratio of removed to positive nodes was a median (IQR) of 4 (3-7) nodes to 2 (1-3) nodes and 15 (12-19) nodes to 2 (1-5) nodes in the ART and ALND groups, respectively. There was no observed association of ALND with the proportion of patients undergoing postneoadjuvant systemic therapy (57 of 74 [77.0%] vs 55 of 77 [71.4%]; aOR, 0.86; 95% CI, 0.43-1.70), type of postneoadjuvant chemotherapy (eg, capecitabine: 10 of 74 [13.5%] vs 10 of 77 [13.0%]; trastuzumab emtansine-DM1: 9 of 74 [12.2%] vs 11 of 77 [14.3%]), or endocrine therapy (eg, aromatase inhibitors: 41 of 74 [55.4%] vs 36 of 77 [46.8%]; tamoxifen: 8 of 74 [10.8%] vs 6 of 77 [7.8%]). Results of this cohort study suggest that patients without ALND were significantly understaged. However, ALND did not inform systemic therapy recommendations

Week 96 efficacy and safety results of the phase 3, randomized EMERALD trial to evaluate switching from boosted-protease inhibitors plus emtricitabine/tenofovir disoproxil fumarate regimens to the once daily, single-tablet regimen of darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) in treatment-experienced, virologically-suppressed adults living with HIV-1

Altres ajuts: This study was sponsored by Janssen.Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) 800/150/200/10 mg was investigated through 96 weeks in EMERALD (NCT02269917). Virologically-suppressed, HIV-1-positive treatment-experienced adults (previous non-darunavir virologic failure [VF] allowed) were randomized (2:1) to D/C/F/TAF or boosted protease inhibitor (PI) plus emtricitabine/tenofovir-disoproxil-fumarate (F/TDF) over 48 weeks. At week 52 participants in the boosted PI arm were offered switch to D/C/F/TAF (late-switch, 44 weeks D/C/F/TAF exposure). All participants were followed on D/C/F/TAF until week 96. Efficacy endpoints were percentage cumulative protocol-defined virologic rebound (PDVR; confirmed viral load [VL] ≥50 copies/mL) and VL < 50 copies/mL (virologic suppression) and ≥50 copies/mL (VF) (FDA-snapshot analysis). Of 1141 randomized patients, 1080 continued in the extension phase. Few patients had PDVR (D/C/F/TAF: 3.1%, 24/763 cumulative through week 96; late-switch: 2.3%, 8/352 week 52-96). Week 96 virologic suppression was 90.7% (692/763) (D/C/F/TAF) and 93.8% (330/352) (late-switch). VF was 1.2% and 1.7%, respectively. No darunavir, primary PI, tenofovir or emtricitabine resistance-associated mutations were observed post-baseline. No patients discontinued for efficacy-related reasons. Few discontinued due to adverse events (2% D/C/F/TAF arm). Improved renal and bone parameters were maintained in the D/C/F/TAF arm and observed in the late-switch arm, with small increases in total cholesterol/high-density-lipoprotein-cholesterol ratio. A study limitation was the lack of a control arm in the week 96 analysis. Through 96 weeks, D/C/F/TAF resulted in low PDVR rates, high virologic suppression rates, very few VFs, and no resistance development. Late-switch results were consistent with D/C/F/TAF week 48 results. EMERALD week 96 results confirm the efficacy, high genetic barrier to resistance and safety benefits of D/C/F/TAF

Non-AIDS defining cancers in the D:A:D Study-time trends and predictors of survival : a cohort study

BACKGROUND:Non-AIDS defining cancers (NADC) are an important cause of morbidity and mortality in HIV-positive individuals. Using data from a large international cohort of HIV-positive individuals, we described the incidence of NADC from 2004-2010, and described subsequent mortality and predictors of these.METHODS:Individuals were followed from 1st January 2004/enrolment in study, until the earliest of a new NADC, 1st February 2010, death or six months after the patient's last visit. Incidence rates were estimated for each year of follow-up, overall and stratified by gender, age and mode of HIV acquisition. Cumulative risk of mortality following NADC diagnosis was summarised using Kaplan-Meier methods, with follow-up for these analyses from the date of NADC diagnosis until the patient's death, 1st February 2010 or 6 months after the patient's last visit. Factors associated with mortality following NADC diagnosis were identified using multivariable Cox proportional hazards regression.RESULTS:Over 176,775 person-years (PY), 880 (2.1%) patients developed a new NADC (incidence: 4.98/1000PY [95% confidence interval 4.65, 5.31]). Over a third of these patients (327, 37.2%) had died by 1st February 2010. Time trends for lung cancer, anal cancer and Hodgkin's lymphoma were broadly consistent. Kaplan-Meier cumulative mortality estimates at 1, 3 and 5 years after NADC diagnosis were 28.2% [95% CI 25.1-31.2], 42.0% [38.2-45.8] and 47.3% [42.4-52.2], respectively. Significant predictors of poorer survival after diagnosis of NADC were lung cancer (compared to other cancer types), male gender, non-white ethnicity, and smoking status. Later year of diagnosis and higher CD4 count at NADC diagnosis were associated with improved survival. The incidence of NADC remained stable over the period 2004-2010 in this large observational cohort.CONCLUSIONS:The prognosis after diagnosis of NADC, in particular lung cancer and disseminated cancer, is poor but has improved somewhat over time. Modifiable risk factors, such as smoking and low CD4 counts, were associated with mortality following a diagnosis of NADC

Le rationnement azote des chevres et des chevreaux

National audienc

Consórcio sorgo-soja. I. Produção de forragem de cultivares de soja e híbridos de sorgo, consorciadas na linha, em dois sistemas de corte Sorghum-soybean intercropping. I. Production of forage of sorghum hybrids and soybean cultivars, intercropped on the line, in two cutting systems

Visando selecionar cultivares de sorgo e soja de melhor rendimento forrageiro no consórcio, foi conduzido, em 1996/97, um ensaio no Departamento de Agricultura no Campus da Universidade Federal de Lavras, em Lavras, MG, em um Latossolo Roxo distrófico. O delineamento experimental utilizado foi o de blocos casualizados em esquema fatorial 2x4x4+4 com três repetições, sendo constituído por dois sistemas de corte (um único corte, rente ao solo, de ambas as culturas no estádio R5 da soja e um sistema de dois cortes: o primeiro feito aos 60 dias após a emergência a 30cm do solo e o segundo, após a rebrota das plantas, rente ao solo, na mesma época do corte do primeiro sistema), quatro cultivares de soja (CAC-1, Doko RC, UFV-16 e UFV-17) e quatro híbridos de sorgo forrageiro (AG 2002, AG 2006, BR 601 e CMSXS 756), e mais os quatros cultivares de sorgo em monocultivo. Os diferentes sistemas de corte alteraram significativamente os rendimentos de massa verde, matéria seca e proteína bruta total. A utilização do consórcio proporcionou maior rendimento de proteína bruta total, quando comparado ao monocultivo, sendo que as combinações UFV-16 x AG 2002 e CAC-1 x AG 2006 foram as de maior destaque para o sistema de um corte. No sistema de dois cortes, sobressaíram-se Doko RC x AG 2006 e BR 601 e Doko RC x BR 601. Em condição de monocultivo e consórcio, o híbrido de sorgo que proporcionou maior rendimento de massa verde, matéria seca e proteína bruta total foi o AG 2002.<br>Aiming to select sorghum and soybean cultivars of best forage yield in the intercropping on the line, a trial was conducted in 1996/1997, at the Department of Agriculture on the campus of the Universidade Federal de Lavras, in Lavras, MG, Brazil, on a Distrophic Red Dusky Latosol. The experimental design utilized was that of randomized blocks in factorial scheme 2x4x4+4 with three replications, being made up of two cutting systems (a single cutting, close-cut to the soil, of both crops at the R5 stage of soybean and a two-cutting system: the first done at 60 days after emergence at 30cm from the soil and the second after regrowth of the plants, close-cut to the soil at the same time of the cutting of the first system), four soybean cultivars (CAC-1, Doko RC, UFV-16 and UFV-17) and four hybrids of forage sorghum (AG 2002, AG 2006, BR 601 and CMSXS 756), and four hibrids of sorghum in monoculture. The one cutting system was superior than the two cutting system in relation of green mass and dry matter. The grude protein was superioty in the two cutting system. Use of the intercropping on the line provided greater yield total crude portein as compared with monoculture, being that the combinations UFV-16 and UFV-17 x AG 2002 and CAC-1 x AG 2006 were the ones which stood out the most to the one-cutting system. In the two-cutting system, Doko RC x AG 2006 and BR 601 and UFV-16 x BR 601 stood out. Under monoculture and intercropping on the line condition, the sorghum hybrid which presented the highest yield of green mass, dry matter and total crude protein was AG 2002

Human machine interaction: The special role for human unconscious emotional information processing

Item does not contain fulltextThe nature of (un)conscious human emotional information processing remains a great mystery. On the one hand, classical models view human conscious emotional information processing as computation among the brain’s neurons but fail to address its enigmatic features. On the other hand, quantum processes (superposition of states, nonlocality, entanglement,) also remain mysterious, yet are being harnessed in revolutionary information technologies like quantum computation, quantum cryptography, and quantum teleportation. In this paper, we would like to discuss several experiments that suggest a special role for unconscious emotional information processing in the human-computer interaction. What are its consequences and could this be the missing link between quantum information theory and conscious human emotional information processing