Smoking-related lung diseases: a clinical perspective

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Adsorption induced reconstruction of the Cu(110) surface

The formation of the O/Cu(110)-(2 × 1) and H/Cu(110)-(1 × 2) superstructures has been investigated by a LEED beam profile analysis. The oxygen induced reconstruction proceeds at later stages by creation of holes on flat terraces. This could not be observed at the hydrogen induced missing row reconstruction. The formation of the missing row structure proceeds most probably via nucleation at steps and subsequent growth of (1 × 2) islands. The influence of different distributions of steps and islands on beam profiles is discussed

Tectonic history of the northern Peru convergent margin during the past 400 ka

The late Pleistocene tectonic history of the northern Peru convergent margin can be retraced using data collected during deep-sea dives of the submersible Nautile combined with a recent Hydrosweep survey conducted off Peru at lat 5°-6°S by the R/V Sonne. During the past 400 ka, a broad rollover fold formed in the middle slope area, in association with a major seaward-dipping detachment fault. A catastrophic debris avalanche occurred as the result of oversteepening of the landward flank of the rollover fold. The gravity failure of the slope, previously recognized by SeaBeam mapping, occurred at 13.8 ±2.7 ka and produced a destructive tsunami

To be screened or not to be screened Modeling the consequences of PSA screening for the individual

Background:Screening with prostate-specific antigen (PSA) can reduce prostate cancer mortality, but may advance diagnosis and treatment in time and lead to overdetection and overtreatment. We estimated benefits and adverse effects of PSA screening for individuals who are deciding whether or not to be screened.Methods:Using a microsimulation model, we estimated lifetime probabilities of prostate cancer diagnosis and death, overall life expectancy and expected time to diagnosis, both with and without screening. We calculated anticipated loss in quality of life due to prostate cancer diagnosis and treatment that would be acceptable to decide in favour of screening.Results:Men who were screened had a gain in life expectancy of 0.08 years but their expected time to diagnosis decreased by 1.53 life-years. Of the screened men, 0.99% gained on average 8.08 life-years and for 17.43% expected time to diagnosis decreased by 8.78 life-years. These figures imply that the anticipated loss in quality of life owing to diagnosis and treatment should not exceed 4.8%, for screening to have a positive effect on quality-adjusted life expectancy.Conclusion:The decision to be screened should depend on personal preferences. The negative impact of screening might be reduced by screening men who are more willing to accept the side effects from treatment

A new scenario for the Domerian-Toarcian transition

Pour tenter de mieux comprendre l’événement d’anoxie océanique globale au Toarcien inférieur, il convient de remonter aux changements environnementaux qui ont précédé cette phase paroxysmale. En effet, la comparaison des séquences sédimentaires et biostratigraphiques du passage Domérien-Toarcien entre la Téthys occidentale (Maroc, Espagne, Portugal) et l’Europe du Nord-Ouest (Causses, Allemagne, Angleterre) fait apparaître une importante lacune dans la région septentrionale. La faune d’Arieticeratinae (Emaciaticeras, Canavaria, Fontanelliceras) et d’Harpoceratinae (Lioceratoides, Neolioceratoides), accompagnée ensuite de Dactylioceras particuliers (groupe mirabile-polymorphum = sous-genre Eodactylites), fait presque totalement défaut en Europe du Nord-Ouest, alors qu’elle abonde dans les dernières alternances marno-calcaires, sans changement lithologique notable avec le Domérien des coupes téthysiennes. Cette faune est intercalée entre les derniers Pleuroceras et les Dactylioceras du groupe tenuicostatum. Ces derniers apparaissent dans les argiles succédant immédiatement au dernier banc calcaire à Dactylioceras mirabile au Portugal notamment. C’est là le diachronisme déjà reconnu entre les limites lithostratigraphique (disparition des bancs calcaires) et biostratigraphique (apparition du genre Dactylioceras) au passage Domérien-Toarcien. Cette observation peut s’intégrer dans un nouveau scénario paléo-océanographique prenant en compte à la fois la tendance régressive majeure du Domérien supérieur (conduisant à une lacune régionale importante), l’abondance de matière charbonneuse dans les premiers dépôts transgressifs du Toarcien et l’événement anoxique global subséquent. Dans la partie supérieure du Domérien, l’existence d’un fort volcanisme peut être déduite des données relatives aux variations des isotopes du strontium [McArthur et al., 2000]. A ce pic de strontium sont associées une faible anomalie négative du δ13 C à la limite Domérien-Toarcien et des valeurs particulièrement élevées du δ18 O [Morettini et Bartolini, 1999]. Nous pensons que cette activité volcanique débute par des émissions massives de SO2 induisant des pluies acides, un obscurcissement et un refroidissement. A cette phase de refroidissement correspond une augmentation de l’englacement des pôles et une régression responsable de la lacune majeure évoquée plus haut, particulièrement sensible dans les mers épicontinentales. Bien que les preuves directes d’une glaciation fini-domérienne fassent actuellement défaut [Hallam, 2001], le glacio-eustatisme nous semble le seul mécanisme permettant d’expliquer une oscillation marine importante mais de courte durée [Brandt, 1986 ; Dewey et Pitman, 1998]. En effet, le cycle régression-transgression s’étale sur environ deux zones d’ammonites, la lacune sédimentaire en elle-même recouvrant essentiellement les sous-zones à Elisa et Mirabile. Ce premier épisode serait suivi, dans la zone à Tenuicostatum, par une importante perturbation du cycle du carbone responsable d’un effet de serre. Le réchauffement, provoquerait alors la transgression bien connue du Toarcien inférieur, cachetant le hiatus sédimentaire dans la province nord-ouest européenne. L’intervalle de temps correspondant à cette lacune aurait permis à la végétation de coloniser les immenses surfaces nouvellement émergées. C’est le lessivage et l’oxydation de la matière organo-humique et bactérienne accumulée pendant cette période, associée à une élévation de la température, qui aurait enclenché le mécanisme d’anoxie lors du paroxysme de la transgression

Nationwide Outcomes of Octogenarians Following Open or Endovascular Management After Ruptured Abdominal Aortic Aneurysms

PURPOSE: Octogenarians are known to have less-favorable outcomes following ruptured abdominal aortic aneurysm (rAAA) repair compared with their younger counterparts. Accurate information regarding perioperative outcomes following rAAA-repair is important to evaluate current treatment practice. The aim of this study was to evaluate perioperative outcomes of octogenarians and to identify factors associated with mortality and major complications after open surgical repair (OSR) or endovascular aneurysm repair (EVAR) of a rAAA using nationwide, real-world, contemporary data. METHODS: All patients that underwent EVAR or OSR of an infrarenal or juxtarenal rAAA between January 1, 2013, and December 31, 2018, were prospectively registered in the Dutch Surgical Aneurysm Audit (DSAA) and included in this study. The primary outcome was the comparison of perioperative outcomes of octogenarians versus non-octogenarians, including adjustment for confounders. Secondary outcomes were the identification of factors associated with mortality and major complications in octogenarians. RESULTS: The study included 2879 patients, of which 1146 were treated by EVAR (382 octogenarians, 33%) and 1733 were treated by OSR (410 octogenarians, 24%). Perioperative mortality of octogenarians following EVAR was 37.2% versus 14.8% in non-octogenarians (adjusted OR=2.9, 95% CI=2.8-3.0) and 50.0% versus 29.4% following OSR (adjusted OR=2.2, 95% CI=2.2-2.3). Major complication rates of octogenarians were 55.4% versus 31.8% in non-octogenarians following EVAR (OR=2.7, 95% CI=2.1-3.4), and 68% versus 49% following OSR (OR=2.2, 95% CI=1.8-2.8). Following EVAR, 30.6% of the octogenarians had an uncomplicated perioperative course (UPC) versus 49.5% in non-octogenarians (OR=0.5, 95% CI=0.4-0.6), while following OSR, UPC rates were 20.7% in octogenarians versus 32.6% in non-octogenarians (OR=0.5, 95% CI=0.4-0.7). Cardiac or pulmonary comorbidity and loss of consciousness were associated with mortality and major complications in octogenarians. Interestingly, female octogenarians had lower mortality rates following EVAR than male octogenarians (adjusted OR=0.7, 95% CI=0.6-0.8). CONCLUSION: Based on this nationwide study with real-world registry data, mortality rates of octogenarians following ruptured AAA-repair were high, especially after OSR. However, a substantial proportion of these octogenarians following OSR and EVAR had an uneventful recovery. Known preoperative factors do influence perioperative outcomes and reflect current treatment practice.publishersversionepub_ahead_of_prin

Ecteinascidin-743: Evidence of Activity in Advanced, Pretreated Soft Tissue and Bone Sarcoma Patients

Purpose. To evaluate the activity and safety of ecteinascidin (ET-743) in pretreated patients with advanced or metastatic soft tissue and bone sarcoma. Patients or subjects. Eighty-nine patients received ET-743 as a 24-hour continuous infusion at a dose of 900–1500 μg/m(2) every 3 weeks. Results. We observed one complete remission, 5 partial remissions, one minimal response, and 16 patients with a disease stabilization of 6 months or more. The objective response rate was 6.7% and the clinical benefit rate at 3 and 6 months was 37.7% and 23.4%, respectively. Responses were noted in patients with lipo-, leiomyo-, osteo-, and myogenic sarcoma, with a median duration of 9.85 months. Toxicity mainly involved an asymptomatic elevation of transaminases and neutropenia. Estimated 1- and 2-year survival rates were 39.4% and 15.8%. Median overall survival was 8.25 months. Discussion. This retrospective analysis confirms that ET-743 induces objective responses and progression arrest in a clinically relevant proportion of patients