Genetic Polymorphisms in Genes Related to Oxidative Stress (GSTP1, GSTM1, GSTT1, CAT, MnSOD, MPO, eNOS) and Survival of Rectal Cancer Patients after Radiotherapy

Radiotherapy exerts part of its antineoplastic effect by generating oxidative stress, therefore genetic variation in oxidative stress-related enzymes may influence survival of rectal cancer patients. We hypothesized that genetic polymorphisms associated with higher amounts of reactive oxygen species (ROS) that exaggerate cytotoxic activity could improve survival after radiotherapy. We followed 114 rectal cancer patients who received radiotherapy for an average of 42.5 months. Associations between genotypes (GSTP1, GSTM1, GSTT1, CAT, MnSOD, MPO and eNOS) and overall survival were assessed using Kaplan-Meier curves and Cox proportional hazards regression. As hypothesized, patients carrying low ROS producing eNOS Glu298Asp asparagine allele showed an increased hazard of death compared to homozygous carriers of the glutamine allele (hazard ratio (HR): 2.10, 95% confidence interval (CI): 1.01–4.38). However, carriers of low ROS producing MPO G463A A allele had a decreased hazard of death compared to patients homozygous for the G allele (HR: 0.44, 95% CI: 0.21–0.93) although patients homozygous for the A allele had a slightly increased hazard (HR: 1.12, 95% CI: 0.25–5.08). This explorative study provides first results and highlights the need for further, larger studies to investigate association between genetic variation in oxidative stress genes and survival of rectal cancer patients who received radiotherapy

Acute exacerbation of idiopathic pulmonary fibrosis: International survey and call for harmonisation.

AIM Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is an often deadly complication of IPF. No focused international guidelines for the management of AE-IPF exist. The aim of this international survey was to assess the global variability in prevention, diagnostic and treatment strategies for AE-IPF. MATERIAL AND METHODS Pulmonologists with ILD expertise were invited to participate in a survey designed by an international expert panel. RESULTS 509 pulmonologists from 66 countries responded. Significant geographical variability in approaches to manage AE-IPF was found. Common preventive measures included antifibrotic drugs and vaccination. Diagnostic differences were most pronounced regarding use of KL-6 and viral testing, while HRCT, BNP and D-Dimer are generally applied. High dose steroids are widely administered (94%); the use of other immunosuppressant and treatment strategies is highly variable. Very few (4%) responders never use immunosuppression. Antifibrotic treatments are initiated during AE-IPF by 67%. Invasive ventilation or extracorporeal membrane oxygenation are mainly used as a bridge to transplantation. Most physicians educate patients comprehensively on the severity of AE-IPF (82%) and consider palliative care (64%). CONCLUSION Approaches to the prevention, diagnosis and treatment of AE-IPF vary worldwide. Global trials and guidelines to improve the prognosis of AE-IPF are needed

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Ambient-noise tomography of the wider Vienna Basin region

We present a new 3-D shear-velocity model for the top 30 km of the crust in the wider Vienna Basin region based on surface waves extracted from ambient-noise cross-correlations. We use continuous seismic records of 63 broad-band stations of the AlpArray project to retrieve interstation Green’s functions from ambient-noise cross-correlations in the period range from 5 to 25 s. From these Green’s functions, we measure Rayleigh group traveltimes, utilizing all four components of the cross-correlation tensor, which are associated with Rayleigh waves (ZZ, RR, RZ and ZR), to exploit multiple measurements per station pair. A set of selection criteria is applied to ensure that we use high-quality recordings of fundamental Rayleigh modes. We regionalize the interstation group velocities in a 5 km × 5 km grid with an average path density of ∼20 paths per cell. From the resulting group-velocity maps, we extract local 1-D dispersion curves for each cell and invert all cells independently to retrieve the crustal shear-velocity structure of the study area. The resulting model provides a previously unachieved lateral resolution of seismic velocities in the region of ∼15 km. As major features, we image the Vienna Basin and Little Hungarian Plain as low-velocity anomalies, and the Bohemian Massif with high velocities. The edges of these features are marked with prominent velocity contrasts correlated with faults, such as the Alpine Front and Vienna Basin transfer fault system. The observed structures correlate well with surface geology, gravitational anomalies and the few known crystalline basement depths from boreholes. For depths larger than those reached by boreholes, the new model allows new insight into the complex structure of the Vienna Basin and surrounding areas, including deep low-velocity zones, which we image with previously unachieved detail. This model may be used in the future to interpret the deeper structures and tectonic evolution of the wider Vienna Basin region, evaluate natural resources, model wave propagation and improve earthquake locations, among others

Arrival angles of teleseismic fundamental mode Rayleigh waves across the AlpArray

The dense AlpArray network allows studying seismic wave propagation with high spatial resolution. Here we introduce an array approach to measure arrival angles of teleseismic Rayleigh waves. The approach combines the advantages of phase correlation as in the two-station method with array beamforming to obtain the phase-velocity vector. 20 earthquakes from the first two years of the AlpArray project are selected, and spatial patterns of arrival-angle deviations across the AlpArray are shown in maps, depending on period and earthquake location. The cause of these intriguing spatial patterns is discussed. A simple wave-propagation modelling example using an isolated anomaly and a Gaussian beam solution suggests that much of the complexity can be explained as a result of wave interference after passing a structural anomaly along the wave paths. This indicates that arrival-angle information constitutes useful additional information on the Earth structure, beyond what is currently used in inversions

Shear-wave velocity structure beneath the Dinarides from the inversion of Rayleigh-wave dispersion

Highlights • Rayleigh-wave phase velocity in the wider Dinarides region using the two-station method. • Uppermost mantle shear-wave velocity model of the Dinarides-Adriatic Sea region. • Velocity model reveals a robust high-velocity anomaly present under the whole Dinarides. • High-velocity anomaly reaches depth of 160 km in the northern Dinarides to more than 200 km under southern Dinarides. • New structural model incorporating delamination as one of the processes controlling the continental collision in the Dinarides. The interaction between the Adriatic microplate (Adria) and Eurasia is the main driving factor in the central Mediterranean tectonics. Their interplay has shaped the geodynamics of the whole region and formed several mountain belts including Alps, Dinarides and Apennines. Among these, Dinarides are the least investigated and little is known about the underlying geodynamic processes. There are numerous open questions about the current state of interaction between Adria and Eurasia under the Dinaric domain. One of the most interesting is the nature of lithospheric underthrusting of Adriatic plate, e.g. length of the slab or varying slab disposition along the orogen. Previous investigations have found a low-velocity zone in the uppermost mantle under the northern-central Dinarides which was interpreted as a slab gap. Conversely, several newer studies have indicated the presence of the continuous slab under the Dinarides with no trace of the low velocity zone. Thus, to investigate the Dinaric mantle structure further, we use regional-to-teleseismic surface-wave records from 98 seismic stations in the wider Dinarides region to create a 3D shear-wave velocity model. More precisely, a two-station method is used to extract Rayleigh-wave phase velocity while tomography and 1D inversion of the phase velocity are employed to map the depth dependent shear-wave velocity. Resulting velocity model reveals a robust high-velocity anomaly present under the whole Dinarides, reaching the depths of 160 km in the north to more than 200 km under southern Dinarides. These results do not agree with most of the previous investigations and show continuous underthrusting of the Adriatic lithosphere under Europe along the whole Dinaric region. The geometry of the down-going slab varies from the deeper slab in the north and south to the shallower underthrusting in the center. On-top of both north and south slabs there is a low-velocity wedge indicating lithospheric delamination which could explain the 200 km deep high-velocity body existing under the southern Dinarides

Crustal Thinning From Orogen to Back-Arc Basin: The Structure of the Pannonian Basin Region Revealed by P-to-S Converted Seismic Waves

We present the results of P-to-S receiver function analysis to improve the 3D image of the sedimentary layer, the upper crust, and lower crust in the Pannonian Basin area. The Pannonian Basin hosts deep sedimentary depocentres superimposed on a complex basement structure and it is surrounded by mountain belts. We processed waveforms from 221 three-component broadband seismological stations. As a result of the dense station coverage, we were able to achieve so far unprecedented spatial resolution in determining the velocity structure of the crust. We applied a three-fold quality control process; the first two being applied to the observed waveforms and the third to the calculated radial receiver functions. This work is the first comprehensive receiver function study of the entire region. To prepare the inversions, we performed station-wise H-Vp/Vs grid search, as well as Common Conversion Point migration. Our main focus was then the S-wave velocity structure of the area, which we determined by the Neighborhood Algorithm inversion method at each station, where data were sub-divided into back-azimuthal bundles based on similar Ps delay times. The 1D, nonlinear inversions provided the depth of the discontinuities, shear-wave velocities and Vp/Vs ratios of each layer per bundle, and we calculated uncertainty values for each of these parameters. We then developed a 3D interpolation method based on natural neighbor interpolation to obtain the 3D crustal structure from the local inversion results. We present the sedimentary thickness map, the first Conrad depth map and an improved, detailed Moho map, as well as the first upper and lower crustal thickness maps obtained from receiver function analysis. The velocity jump across the Conrad discontinuity is estimated at less than 0.2 km/s over most of the investigated area. We also compare the new Moho map from our approach to simple grid search results and prior knowledge from other techniques. Our Moho depth map presents local variations in the investigated area: the crust-mantle boundary is at 20–26 km beneath the sedimentary basins, while it is situated deeper below the Apuseni Mountains, Transdanubian and North Hungarian Ranges (28–33 km), and it is the deepest beneath the Eastern Alps and the Southern Carpathians (40–45 km). These values reflect well the Neogene evolution of the region, such as crustal thinning of the Pannonian Basin and orogenic thickening in the neighboring mountain belts

Insights on nitrate sources at Dome C (East Antarctic Plateau) from multi-year aerosol and snow records

© 2014 R. Traversi et al. Here we present the first multi-year record of nitrate in the atmospheric aerosol (2005-2008) and surface snow (2006-08) from central Antarctica. PM10 and size-segregated aerosol, together with superficial snow, have been collected all year-round at high resolution (daily for all the snow samples and for most of aerosol samples) at Dome C since the 2004/05 field season and analysed for main and trace ionic markers. The suitability of the sampling location in terms of possible contamination from the base is shown in detail. In spite of the relevance of nitrate in Antarctic atmosphere, both for better understanding the chemistry of N cycle in the plateau boundary layer and for improving the interpretation of long-term nitrate records from deep ice core records, nitrate sources in Antarctica are not well constrained yet, neither in extent nor in timing. A recurring seasonal pattern was pointed out in both aerosol and snow records, showing summer maxima and winter minima, although aerosol maxima lead the snow ones of 1-2 months, possibly due to a higher acidity in the atmosphere in mid-summer, favouring the repartition of nitrate as nitric acid and thus its uptake by the surface snow layers. On the basis of a meteorological analysis of one major nitrate event, of data related to PSC I extent and of irradiance values, we propose that the high nitrate summer levels in aerosol and snow are likely due to a synergy of enhanced source of nitrate and/or its precursors (such as the stratospheric inputs), higher solar irradiance and higher oxidation rates in this season. Moreover, we show here a further evidence of the substantial contribution of HNO3/NOx re-emission from the snowpack, already shown in previous works, and which can explain a significant fraction of atmospheric nitrate, maintaining the same seasonal pattern in the snow. As concerning snow specifically, the presented data suggest that nitrate is likely to be controlled mainly by atmospheric processes, not on the daily timescale but rather on the seasonal one.This research was performed in the framework of the Air-Glacs1181 'Station Concordia' project, which was funded by the MIUR through the Italian 'Programma Nazionale di Ricerche in Antartide' (PNRA) and in the framework of 'PRIDE' (2009/A2.21) and 'DECA-POL' (2010/A3.05) PNRA projects. The field operations benefited from the support of the French-Italian Concordia Station. This paper is a contribution to the HOLOCLIP project, which is funded by the European Science Foundation. This is HOLOCLIP publication no. 25. Meteorological data and information were obtained from IPEV/PNRA Project >Routine Meteorological Observation at Station Concordia - www.climantartide.it. Moreover, the authors appreciate the support of the AMRC, SSEC, UW-Madison for the data set, NSF grant numbers ANT-0944018 and ANT-1245663. B. Funke was supported by the Spanish MCINN under grant AYA2011-23552 and EC FEDER funds. We are grateful to the anonymous reviewers whose comments markedly improved the final manuscript.Peer Reviewe

Insights on nitrate sources at Dome C (East Antarctic Plateau) from multi-year aerosol and snow records

Here we present the first multi-year record of nitrate in the atmospheric aerosol (2005–2008) and surface snow (2006–08) from central Antarctica. PM10 and size-segregated aerosol, together with superficial snow, have been collected all year-round at high resolution (daily for all the snow samples and for most of aerosol samples) at Dome C since the 2004/05 field season and analysed for main and trace ionic markers. The suitability of the sampling location in terms of possible contamination from the base is shown in detail. In spite of the relevance of nitrate in Antarctic atmosphere, both for better understanding the chemistry of N cycle in the plateau boundary layer and for improving the interpretation of long-term nitrate records from deep ice core records, nitrate sources in Antarctica are not well constrained yet, neither in extent nor in timing. A recurring seasonal pattern was pointed out in both aerosol and snow records, showing summer maxima and winter minima, although aerosol maxima lead the snow ones of 1–2 months, possibly due to a higher acidity in the atmosphere in mid-summer, favouring the repartition of nitrate as nitric acid and thus its uptake by the surface snow layers. On the basis of a meteorological analysis of one major nitrate event, of data related to PSC I extent and of irradiance values, we propose that the high nitrate summer levels in aerosol and snow are likely due to a synergy of enhanced source of nitrate and/or its precursors (such as the stratospheric inputs), higher solar irradiance and higher oxidation rates in this season. Moreover, we show here a further evidence of the substantial contribution of HNO3/NOx re-emission from the snowpack, already shown in previous works, and which can explain a significant fraction of atmospheric nitrate, maintaining the same seasonal pattern in the snow. As concerning snow specifically, the presented data suggest that nitrate is likely to be controlled mainly by atmospheric processes, not on the daily timescale but rather on the seasonal one