Tas-102 in metastatic colorectal cancer (MCRC): Efficacy, tolerability, and quality of life in heavily pretreated elderly patients: A real-life study

Background: TAS-102 is an oral monotherapy, combining trifluridine and tipiracil hydrochloride, indicated for the treatment of pretreated metastatic colorectal cancer (mCRC). The aim of this real-life study is to evaluate the efficacy and safety of TAS-102 in heavily pretreated elderly patients with mCRC whose disease has progressed with standard therapies. Methods: In this retrospective observational study, we enrolled 50 elderly patients >70 years of age (median age 78 years) with a diagnosis of mCRC who were previously treated or were not considered candidates for treatment with other available therapies. Patients aged >70 years with advanced colorectal cancer and with an ECOG performance status of grade 0 (n=18) or grade 1 (n=32) were included. Overall survival and progression-free survival were the primary endpoints, whereas objective response rate, tolerability, and quality of life were the secondary endpoints. Results: Treatment with TAS-102 appeared to be well tolerated and side effects were generally mild, achieving disease control and a benefit on quality of life. The median overall survival was 6.7 (95% CI 5.7-11.3) and the median progression-free survival was 2.1 months (95% CI 1.2-3.2), estimated using the Kaplan-Meier method. Conclusion: TAS-102 represents a manageable and effective therapeutic opportunity and appeared to be well tolerated with generally mild side effects in elderly patients with mCRC who were heavily pretreated with standard therapies

Matrix Models for Supersymmetric Chern-Simons Theories with an ADE Classification

We consider N=3 supersymmetric Chern-Simons (CS) theories that contain product U(N) gauge groups and bifundamental matter fields. Using the matrix model of Kapustin, Willett and Yaakov, we examine the Euclidean partition function of these theories on an S^3 in the large N limit. We show that the only such CS theories for which the long range forces between the eigenvalues cancel have quivers which are in one-to-one correspondence with the simply laced affine Dynkin diagrams. As the A_n series was studied in detail before, in this paper we compute the partition function for the D_4 quiver. The D_4 example gives further evidence for a conjecture that the saddle point eigenvalue distribution is determined by the distribution of gauge invariant chiral operators. We also see that the partition function is invariant under a generalized Seiberg duality for CS theories.Comment: 20 pages, 3 figures; v2 refs added; v3 conventions in figure 3 altered, version to appear in JHE

The microbiota of the bilio-pancreatic system: A cohort, STROBE-compliant study

Background: The gut microbiota play an essential role in protecting the host against pathogenic microorganisms by modulating immunity and regulating metabolic processes. In response to environmental factors, microbes can hugely alter their metabolism. These factors can substantially impact the host and have potential pathologic implications. Particularly pathogenic microorganisms colonizing pancreas and biliary tract tissues may be involved in chronic inflammation and cancer evolution. Purpose: To evaluate the effect of bile microbiota on survival in patients with pancreas and biliary tract disease (PBD). Patients and Methods: We investigated 152 Italian patients with cholelithiasis (CHL), cholangitis (CHA), cholangiocarcinoma (CCA), gallbladder carcinoma (GBC), pancreas head carcinoma (PHC), ampullary carcinoma (ACA), and chronic pancreatitis (CHP). Demographics, bile cultures, therapy, and survival rates were analyzed in cohorts (T1 death <6 months; T2 death <12 months; T3 death <18 months, T3S alive at 18 months). Results: The most common bacteria in T1 were E. coli, K. pneumoniae, andP. aeruginosa. In T2, the most common bacteria were E. coli and P. aeruginosa. InT3, there were no significant bacteria isolated, while in T3S the most common bacteria were like those found in T1. E. coli and K. pneumoniae were positive predictors of survival for PHC and ACA, respectively. E. coli, K. pneumoniae, andP. aeruginosa showed a high percentage of resistant bacteria to 3CGS, aminoglycosides class, and quinolone group especially at T1 and T2 in cancer patients. Conclusions: An unprecedented increase of E. coli in bile leads to a decrease in survival. We suggest that some strains isolated in bile samples may be considered within the group of risk factors in carcinogenesis and/or progression of hepato-biliary malignancy. A better understanding of bile microbiota in patients with PBD should lead to a multifaceted approach to rapidly detect and treat pathogens before patients enter the surgical setting in tandem with the implementation of the infection control policy

The ABCDEF's of Matrix Models for Supersymmetric Chern-Simons Theories

We consider N = 3 supersymmetric Chern-Simons gauge theories with product unitary and orthosymplectic groups and bifundamental and fundamental fields. We study the partition functions on an S^3 by using the Kapustin-Willett-Yaakov matrix model. The saddlepoint equations in a large N limit lead to a constraint that the long range forces between the eigenvalues must cancel; the resulting quiver theories are of affine Dynkin type. We introduce a folding/unfolding trick which lets us, at the level of the large N matrix model, (i) map quivers with orthosymplectic groups to those with unitary groups, and (ii) obtain non-simply laced quivers from the corresponding simply laced quivers using a Z_2 outer automorphism. The brane configurations of the quivers are described in string theory and the folding/unfolding is interpreted as the addition/subtraction of orientifold and orbifold planes. We also relate the U(N) quiver theories to the affine ADE quiver matrix models with a Stieltjes-Wigert type potential, and derive the generalized Seiberg duality in 2 + 1 dimensions from Seiberg duality in 3 + 1 dimensions.Comment: 30 pages, 5 figure

Technical characteristics can make the difference in a surgical linear stapler. or not?

Background Anastomotic leak (AL) after gastrointestinal surgery is a severe complication associated with relevant short- and long-term sequelae. Most of the anastomosis are currently performed with a surgical stapler that is required to have appropriate characteristics to guarantee good performances. The aim of our study was to evaluate, in the laboratory, pressure resistance and tensile strength of anastomosis performed with different surgical linear staplers, available in the market. Materials and methods We have been studying three linear staplers, with diverse cartridges and staple heights, of three different companies, used for gastrointestinal anastomosis and gastric or intestinal closure. We performed 50 anastomosis for each device, with the pertinent different cartridges, on fresh pig intestine, for a total of 350 anastomosis, then injected saline solution and recorded the pressure that provokes a leak on the staple line. There were no statistically significant differences between the mean pressure necessary to induce an AL in the various instruments (P > 0.05). For studying the tensile strength, we performed a total of 350 anastomosis with the different linear staplers on a special strong paper (Tyvek), then recorded the maximal tensile force that could open the anastomosis. Results There were no statistically significant differences between the different staplers about the strength necessary to open the staple line (P > 0.05). Conclusions we demonstrated that different linear staplers of three companies available in the market give comparable anastomotic pressure resistance and tensile strength. This might suggest that small dissimilarities between different devices are not involved, at least as major parameters, in AL etiology

Is it really useful the harmonic scalpel in axillary dissection for locally advanced breast cancer? A case series

Background. The seroma is one of the most common complications in the axillary lymph nodal dissection (different surgical approaches have been tried to reduce the seroma incidence). In our study we evaluate the outcome of patients using or not the ultrasonic scalpel (Harmonic scalpel) according to a standardized surgical technique. Patients and Methods. From January 2011 to December 2015 120 patients underwent axillary dissection for breast cancer. Patients were divided in two groups: patients belonging to the first group underwent Harmonic scalpel dissection and patients belonging to the second group underwent classical dissection. Each group consisted of 60 patients. Quadrantectomy (QUAD) was performed in 54 patients, 66 women underwent mastectomy. In all patients axillary dissection included the I, II and III level. We compared two groups in terms of: time of surgery, hematoma, drainage volume, days of sealing drainage, seroma formation, number of post-seroma aspirations, upper limb lymphedema, wound infections, post-operative pain. Results. Statistically significant results were obtained in terms of the total volume of the breast and axillary drainage in the two techniques. There were no significant differences in the two samples in terms of operative time incidence of seroma, post-operative hematoma, wound infection, and lymphedema of the upper limb. Conclusion. The small number of cases did not allow us to reach definitive conclusions. The use of Harmonic scalpel seems to show smaller incidence of seroma and reduction of the amount of both breast and axillary drainages. Further studies are needed to define the real advantage in terms of cost benefit of using these devices in the axillary surgery

Surgical pathology and the diagnosis of invasive visceral yeast infection: two case reports and literature review

Invasive mycoses are life-threatening opportunistic infections that have recently emerged as a cause of morbidity and mortality following general and gastrointestinal surgery. Candida species are the main fungal strains of gut flora. Gastrointestinal tract surgery might lead to mucosal disruption and cause Candida spp. to disseminate in the bloodstream. Here we report and discuss the peculiar clinical and morphological presentation of two cases of gastrointestinal Candida albicans lesions in patients who underwent abdominal surgery. Although in the majority of cases reported in the literature, diagnosis was made on the basis of microbiological criteria, we suggest that morphological features of fungi in histological sections of appropriate surgical specimens could help to detect the degree of yeast colonization and identify patients at risk of developing severe abdominal Candida infection. Better prevention and early antifungal treatments are highlighted, and relevant scientific literature is reviewed

The structure and dynamics of locust bean gum in aqueous solution

Locust bean gum (LBG) is an industrially important polysaccharide used widely in food, cosmetics, textiles, and biopharmaceutical applications, where understanding its solution behaviour is important for formulation design. To address this, we investigate the structure and dynamics of LBG in aqueous solution using steady state shear rheology, static light scattering (SLS), ultra-small-angle light scattering (USALS), and dynamic light scattering (DLS). We find that steady state shear rheology mainly probes the well-dispersed LBG fraction, whereas the scattering response is dominated by supramolecular LBG aggregates. We identify three viscosity-concentration regimes (dilute, semidilute unentangled, and semidilute entangled), with scaling behaviour largely consistent with predictions for neutral flexible polymers. SLS and USALS provide evidence for the existence of two separate populations of aggregated structures, where SLS mainly probes the internal structure of the smaller aggregate population. The solution dynamics are dominated by a ‘slow’ decay mode, which is consistent with Zimm dynamics and attributed to relaxations within the aggregates. In dilute solutions, the apparent viscosity associated with this mode is greater than the solution viscosity, but the two converge as concentration is increased. An additional ‘fast’ mode is observed within the semidilute range, associated with the dispersed polymer fraction, and attributed to cooperative diffusion. Our study provides comprehensive insight into the structure and dynamics of aqueous LBG solutions—paving the way for a greater fundamental understanding of galactomannans in solution, and for increased control over LBG-based formulations of industrial interest

An indoor air quality study at the Ambrosiana Art Gallery (Milan)

Indoor air quality in historical buildings and museums is receiving increasing concern nowadays among the scientific community. Many sources of pollutants, both gases and particles, are responsible for the accelerated decay of the works of art. Knowing the levels of indoor pollutants is of critical importance to apply conservation and preservation strategies of cultural heritage [1, 2]. Air quality at the Ambrosiana Art Gallery in Milan has been monitored (in the two periods October-November 2017 and March 2018) inside the room where the preparatory cardboard of the School of Athens (1509-1511), one of most important masterpieces by Raffaello Sanzio, is stored. The cardboard is currently undergoing restoration and will be exposed in a new showcase that will be realized according to the specific environmental and microclimatic conditions of the room. The objective of this study was to monitor the concentration and chemical composition of the aerosol particulate matter (PM) up to the nano fraction, which represents the most dangerous fraction for the works of art surfaces. The monitoring campaigns have been carried out in parallel in the Raffaello room (at present not accessible to visitors) and in a nearby room open to visitors. The set of instuments employed included: a TSP sampler (total suspended particles) (Tecora, Pollution Check, Bravo M2); a DustMonit (Contec) analyzer that measures the concentration of dust up to PM1 and provides 13 granulometric classes (up to 300 nm); a NanoScan Nanoparticle sizer 3910 (TSI) instrument that measures particles concentration up to 10 nm; two instruments for the determination of black carbon (BC) in continuous and in particular a SILIIS instrument (Sphere-Integrated Laser Induced Incandescence Spectroscopy) and a micro aethalometer (AE51 Magee Scientific). Quartz fiber filters have been employed to collect TSP samples to be submitted to chemical analysis. The filters have been fully chemically characterized: main ionic constituents and the carbonaceous fraction (i.e organic carbon, OC and elemental carbon, EC) have been analyzed by IC (ion chromatography) and TOT (thermal optical transmittance) respectively. A particles morphological characterization has been carried out on PM collected on polycarbonate filters by means of SEM-EDX (scanning electron microscopy coupled with energy dispersive X-ray spectroscopy). Outdoor PM concentrations, obtained for the two seasons (autumn 2017 and spring 2018) from ARPA monitoring stations placed in the city center, have been correlated with indoor data