Adjuvant chemoradiation in pancreatic cancer: Impact of radiotherapy dose on survival

BackgroundTo evaluate the impact of radiation dose on overall survival (OS) in patients treated with adjuvant chemoradiation (CRT) for pancreatic ductal adenocarcinoma (PDAC).MethodsA multicenter retrospective analysis on 514 patients with PDAC (T1-4; N0-1; M0) treated with surgical resection with macroscopically negative margins (R0-1) followed by adjuvant CRT was performed. Patients were stratified into 4 groups based on radiotherapy doses (group 1: <45Gy, group 2: 45 and<50Gy, group 3: 50 and<55Gy, group 4: 55Gy). Adjuvant chemotherapy was prescribed to 141 patients. Survival functions were plotted using the Kaplan-Meier method and compared through the log-rank test.ResultsMedian follow-up was 35months (range: 3-120months). At univariate analysis, a worse OS was recorded in patients with higher preoperative Ca 19.9 levels (90U/ml; p<0.001), higher tumor grade (G3-4, p=0.004), R1 resection (p=0.004), higher pT stage (pT3-4, p=0.002) and positive nodes (p<0.001). Furthermore, patients receiving increasing doses of CRT showed a significantly improved OS. In groups 1, 2, 3, and 4, median OS was 13.0months, 21.0months, 22.0months, and 28.0months, respectively (p=0.004). The significant impact of higher dose was confirmed by multivariate analysis.ConclusionsIncreasing doses of CRT seems to favorably impact on OS in adjuvant setting. The conflicting results of randomized trials on adjuvant CRT in PDAC could be due to <45Gy dose generally used

The evolution of language: a comparative review

For many years the evolution of language has been seen as a disreputable topic, mired in fanciful "just so stories" about language origins. However, in the last decade a new synthesis of modern linguistics, cognitive neuroscience and neo-Darwinian evolutionary theory has begun to make important contributions to our understanding of the biology and evolution of language. I review some of this recent progress, focusing on the value of the comparative method, which uses data from animal species to draw inferences about language evolution. Discussing speech first, I show how data concerning a wide variety of species, from monkeys to birds, can increase our understanding of the anatomical and neural mechanisms underlying human spoken language, and how bird and whale song provide insights into the ultimate evolutionary function of language. I discuss the ‘‘descended larynx’ ’ of humans, a peculiar adaptation for speech that has received much attention in the past, which despite earlier claims is not uniquely human. Then I will turn to the neural mechanisms underlying spoken language, pointing out the difficulties animals apparently experience in perceiving hierarchical structure in sounds, and stressing the importance of vocal imitation in the evolution of a spoken language. Turning to ultimate function, I suggest that communication among kin (especially between parents and offspring) played a crucial but neglected role in driving language evolution. Finally, I briefly discuss phylogeny, discussing hypotheses that offer plausible routes to human language from a non-linguistic chimp-like ancestor. I conclude that comparative data from living animals will be key to developing a richer, more interdisciplinary understanding of our most distinctively human trait: language

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Scattering of transient acoustic waves in fluids and solids

Electrical Engineering, Mathematics and Computer ScieneElectrical Engineering, Mathematics and Computer Scienc

Scattering of transient acoustic waves in fluids and solids

SIGLEBSEB210247Q / UCL - Université Catholique de LouvainBEBelgiu

Scattering of transient acoustic waves in fluids and solids

SIGLEBSE B210247Q / UCL - Université Catholique de LouvainBEBelgiu

Removal of Guided Waves From Seismic Data in Laterally Varying Media

A major source of unwanted signals in seismic data recorded for geophysical exploration is the presence of guided waves which are scattered near the surface of the earth. These waves do not contain information on the structure of the deeper subsurface and should therefore be removed. In this paper we derive a method for removing this type of waves based on a modal expansion. The problem of finding an appropriate scatterer distribution is formulated as a minimization problem. We apply the method to simulated data and watertank data, and find that the scattered guided waves are strongly attenuated and that the reflections of interest (from deeper layers) are not affected. 1 Introduction In geophysical exploration, one tries to obtain an image of the subsurface by exciting a wavefield, and recording the reflections from the earth by receivers located at the surface. The regions of interest for geophysical exploration are the deeper ones. Nevertheless, the strongest signals in the data ar..

Catalysts for High Cetane Ethers as Diesel Fuels Annual Report

A novel 1,2-ethanediol, bis(hydrogen sulfate), disodium salt precursor-based solid acid catalyst with a zirconia substrate was synthesized and demonstrated to have significantly enhanced activity and high selectivity in producing methyl isobutyl ether (MIBE) or isobutene from methanol-isobutanol mixtures. The precursor salt was synthesized and provided by Dr. T. H. Kalantar of the M.E. Pruitt Research Center, Dow Chemical Co., Midland, MI 48674. Molecular modeling of the catalyst synthesis steps and of the alcohol coupling reaction is being carried out. A representation of the methyl transfer from the surface activated methanol molecule (left) to the activated oxygen of the isobutanol molecule (right) to form an ether linkage to yield MIBE is shown