Sequential metastatic breast cancer chemotherapy: Should the median be the message?

Background: Counseling and anticipatory guidance of the expected course of treatment for women newly diagnosed with metastatic breast cancer (MBC) are difficult due to multiple factors influencing survival following MBC therapy. In order to better tailor counseling at the onset and through the duration of MBC we used non-clinical trial data to better characterize real life experience of sequential MBC treatment.We examined the following aims: (1) What demographic and tumor characteristics are predictive of survival in MBC? (2)What is the median duration of each sequential chemotherapy regimen and subsequent survival of women following each sequence of chemotherapy regimen in MBC? Methods: Retrospective study included 792women diagnosed from January 1999 through December 2009 at the University of Pittsburgh Cancer Institute Breast Cancer Program. Results: Median duration of sequential chemotherapy regimen and median survival from completion of sequence of chemotherapy regimens were relatively short with a wide range of treatment duration and survival. Characteristics for poor survival included hormone status, human epidermal growth factor receptor-2 (HER 2/neu) status, and increased number and type of metastatic sites.Women who took more than the second sequential chemotherapy regimens had no more than median 3 months of treatment duration and 6 months survival from treatment termination. Discussion: Median clinical response and survival shorten with sequential chemotherapy regimen but with wide ranges. The rare clinical response of the minority should not set the standard for treatment expectations. All cancer clinicians, including oncology nurses, must ensure that patients are receiving tailored counseling regarding their specific risks and benefits for sequential MBC chemotherapy

Evaluation of the Qvella FAST System and the FAST-PBC cartridge for rapid species identification and antimicrobial resistance testing directly from positive blood cultures

Blood culture diagnostics require rapid and accurate identification (ID) of pathogens and antimicrobial susceptibility testing (AST). Standard procedures, involving conventional cultivation on agar plates, may take up to 48 hours or more until AST completion. Recent approaches aim to shorten the processing time of positive blood cultures (PBC). The FAST System is a new technology, capable of purifying and con centrating bacterial/fungal pathogens from positive blood culture media and produc ing a bacterial suspension called “liquid colony” (LC), which can be further used in downstream analyses (e.g., ID and AST). Here, we evaluated the performance of the FAST System LC generated from PBC in comparison to our routine workflow includ ing ID by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry using Sepsityper, AST by automatized MicroScan WalkAway plus and directly inocula ted disk diffusion (DD), and MICRONAUT-AM for yeast/fungi. A total of 261 samples were analyzed, of which 86.6% (226/261) were eligible for the comparative ID and AST analyses. In comparison to the reference technique (culture-grown colonies), ID concordance of the FAST System LC and Sepsityper was 150/154 (97.4%) and 123/154 (79.9%), respectively, for Gram positive; 67/70 (95.7%) and 64/70 (91.4%), respectively, for Gram negative. For AST, categorical agreement (CA) of the FAST System LC in comparison to the routine workflow for Gram-positive bacteria was 96.1% and 98.7% for MicroScan and DD, respectively. Similar results were obtained for Gram-negative bacteria with 96.6% and 97.5% of CA for MicroScan and DD, respectively. Taken together, the FAST System LC allowed the laboratory to significantly reduce the time to obtain correct ID and AST (automated MicroScan) results 1 day earlier and represents a promising tool to expedite the processing of PBC

Modeling Anti-HIV-1 HSPC-Based Gene Therapy in Humanized Mice Previously Infected with HIV-1.

Investigations of anti-HIV-1 human hematopoietic stem/progenitor cell (HSPC)-based gene therapy have been performed by HIV-1 challenge after the engraftment of gene-modified HSPCs in humanized mouse models. However, the clinical application of gene therapy is to treat HIV-1-infected patients. Here, we developed a new method to investigate an anti-HIV-1 HSPC-based gene therapy in humanized mice previously infected with HIV-1. First, humanized mice were infected with HIV-1. When plasma viremia reached >107 copies/mL 3 weeks after HIV-1 infection, the mice were myeloablated with busulfan and transplanted with anti-HIV-1 gene-modified CD34+ HSPCs transduced with a lentiviral vector expressing two short hairpin RNAs (shRNAs) against CCR5 and HIV-1 long terminal repeat (LTR), along with human thymus tissue under the kidney capsule. Anti-HIV-1 vector-modified human CD34+ HSPCs successfully repopulated peripheral blood and lymphoid tissues in HIV-1 previously infected humanized mice. Anti-HIV-1 shRNA vector-modified CD4+ T lymphocytes showed selective advantage in HIV-1 previously infected humanized mice. This new method will be useful for investigations of anti-HIV-1 gene therapy when testing in a more clinically relevant experimental setting

Deployable Hook Retrieval System for UAV Rescue and Delivery

The rapid development of unmanned aerial vehicles (UAVs) has helped expand their practical use to many industrial applications. However, UAVs sometimes suffer from a flight time limitation and/or a loss in communication. Such undesired malfunctions can endanger public safety and incur economic losses. This paper presents a new class of UAV that can retrieve a disabled or malfunctioned UAV from the ground. We developed a deployable hook retrieval system (DHRS) which integrates three principal mechanisms (i.e., deployment, slider-linkage-release, and hook release). Each mechanism plays a role in deploying and retrieving multiple hooks while using a simple control strategy. Through a Finite Element Method simulation, the hook was topologically optimized in order to achieve a high strength while reducing weight. The deployed multiple hooks allow the device to capture the target regardless of its orientation. Due to these design strategies, object recognition using a computer vision was simply demonstrated by exploiting ORB and FLANN algorithms. Through an experimental study, we discussed the target range, success rate, and the practical uses that the DHRS could achieve. The results show that the proposed designs were versatile and consistently successful in capturing the targets while addressing constraints such as power consumption, computational load, and lack of prior knowledge or information about the target

Current-controlled nanomagnetic writing for reconfigurable magnonic crystals

Strongly-interacting nanomagnetic arrays are crucial across an ever-growing suite of technologies. Spanning neuromorphic computing, control over superconducting vortices and reconfigurable magnonics, the utility and appeal of these arrays lies in their vast range of distinct, stable magnetization states. Different states exhibit different functional behaviours, making precise, reconfigurable state control an essential cornerstone of such systems. However, few existing methodologies may reverse an arbitrary array element, and even fewer may do so under electrical control, vital for device integration. We demonstrate selective, reconfigurable magnetic reversal of ferromagnetic nanoislands via current-driven motion of a transverse domain wall in an adjacent nanowire. The reversal technique operates under all-electrical control with no reliance on external magnetic fields, rendering it highly suitable for device integration across a host of magnonic, spintronic and neuromorphic logic architectures. Here, the reversal technique is leveraged to realize two fully solid-state reconfigurable magnonic crystals, offering magnonic gating, filtering, transistor-like switching and peak-shifting without reliance on global magnetic fields

Prevalence of latent tuberculosis infection in BCG-vaccinated healthcare workers by using an interferon-gamma release assay and the tuberculin skin test in an intermediate tuberculosis burden country

BackgroundThe risk of healthcare workers (HCWs) acquiring tuberculosis (TB) infection is high. We determined the prevalence of latent TB infection (LTBI) in HCWs with a high Bacille Calmette-Guérin (BCG) vaccine coverage in an intermediate TB burden country by using an interferon-gamma release assay [QuantiFERON-TB Gold (QFT-G)] and by using the tuberculin skin test (TST). Risk factors associated with a positive test were determined.MethodsThis prospective cross-sectional study enrolled HCWs from a medical center in Taiwan. Participants were grouped into workers without exposure (Group 1) and workers who self-reported a history of TB exposure (Group 2). All participants completed a questionnaire to collect demographic information and risk factors for acquiring TB. The QFT-G test and the TST were administered and risk factors for a positive test were analyzed.ResultsWe recruited 193 HCWs [149 (77.2%) female workers] with a mean age of 35.6 years. All were BCG-vaccinated. The prevalence of LTBI was 88.8% (based on the TST) and 14.5% (based on the QFT-G test). There was no difference between HCWs with and without known exposure to TB. Agreement between the tests was poor (i.e., the kappa value was less than 0.05). Multivariable logistic regression showed that only the QFT-G test was associated with age (35 years or greater) (adjusted OR, 2.53; p = 0.03).ConclusionBy using the QFT-G test or TST, this study found a similar prevalence of LTBI in HCWs with and without known exposure to TB. This suggests that in intermediate TB burden countries exposure to TB may occur within the hospital and within the community. Compared to the TST, the QFT-G test was correlated better with age, which is a known risk factor for latent TB infection

Electromagnetic performances and main parameter sensitivity effect on unbalance magnetic flux in a New Single‑Phase FEFSM with segmental rotor

Three-phase field excitation flux switching motor (FEFSM) with salient rotor structure has been introduced with their advantages of rotor easy temperature elimination and controllable FEC magnetic flux. Yet, the salient rotor structure is found to lead a longer magnetic flux path between stator and rotor parts, producing a weak flux linkage along with low torque performances. Hence, a new structure of single-phase FEFSM using segmental rotor with non-overlap windings is proposed with advantages of shorter magnetic flux path, light weight and robust rotor structure. Analysis on fundamental magnetic flux characteristics, armature and FEC magnetic flux linkages, cogging torque, back-Emf, various torque capabilities, refinement of unbalance magnetic flux, and torque-power versus speed characteristics are conducted using 2D FEA through JMAG Designer version 15. The results show that magnetic flux amplitude ratio has been improved by 41.2% while the highest torque and power achieved are 1.45 Nm and 343.8 W, respectively

Novel and simple patterning process of quantum dots via transfer printing for active matrix qd-led

© 2020 SID. The next generation of a self-emitting display requires precise and stable patterning techniques to shape Red, Green, and Blue pixels using quantum dots. In this study, we propose the novel and simple transfer printing process for the active matrix QD-LEDs

Metabolic Super Scan in 18F-FDG PET/CT Imaging

A 50-yr-old man presented with intermittent hemoptysis and was diagnosed small cell lung cancer. 18F-FDG PET/CT for staging demonstrated extensive hypermetabolic lesions throughout the skeleton and liver. Interestingly, skeletal muscles of limbs, mediastinum, bowel, and especially brain showed very low FDG uptake. Because of some characteristics in common with super scan on skeletal scintigraphy, this case could be considered as 'metabolic super scan'