Long-term neurotoxicity of chemotherapy in adolescents and young adults treated for bone and soft tissue sarcomas.

Purpose. To study the long-term neurotoxicity of chemotherapy in adolescents and young adults treated for bone and soft tissue sarcomas.Patients and Methods. Thirty-six adolescents and young adults (median age 17 years) were examined following chemotherapy for bone and soft tissue sarcomas. Twenty-nine (29/36) had received cisplatin (median 400 mg/m(2)), 15/36 ifosfamide (median 20 g/m(2)), and 12/36 vincristine (median 16 mg). Neurotoxicity was assessed at a median of 8 months (range, 1-54 months) after completion of chemotherapy by clinical examination, nerve conduction studies, audiograms and autonomic function tests. The same nerve conduction studies were carried out in 20 normal volunteers to define normal ranges in this age group.Results. Sixteen patients (44%) had a significant reduction in deep tendon reflexes, and this clinical parameter correlated well with abnormalities detected in nerve conduction studies. Vibration perception threshold (VPT) was raised in 20/36 patients (55%) and this was the most sensitive single test in the assessment of neuropathy. There was a significant correlation between VPT and cumulative cisplatin dose received in mg/m(-2) (r=0.607, p<0.01). Ten of 29 patients (35%) had abnormal nerve conduction studies with a pattern characteristic of sensory axonal neuropathy. No patient complained of auditory symptoms, but minor high tone hearing loss was detected by audiograms in 5/28 patients who had received cisplatin. No patients had symptoms of autonomic neuropathy, but autonomic function tests showed minor abnormalities in 4/22 patients tested, and all had received cisplatin.Conclusions. This study demonstrates significant, although asymptomatic, long-term neurotoxicity of cisplatin in adolescents and young adults receiving chemotherapy for bone and soft tissue sarcomas. Follow-up studies are planned to assess whether these neurological deficits improve with time.Peer Reviewe

Finding the niche: A review of market assessment methodologies for rural electrification with small scale wind power

The mass roll out of solar PV across the Global South has enabled electricity access for millions of people. In the right context, Small Wind Turbines (SWTs) can be complementary, offering the potential to generate at times of low solar resource (night, monsoon season, winter, etc.) and increasing the proportion of the total energy system that can be manufactured locally. However, many contextual factors critically affect the viability of the technology, such as the extreme variability in the wind resource itself and the local availability of technical support. Therefore, performing a detailed market analysis in each new context is much more important. The Wind Empowerment Market Assessment Methodology (WEMAM) is a multi-scalar, transdisciplinary methodology for identifying the niche contexts where small wind can make a valuable contribution to rural electrification. This paper aims to inform the development of WEMAM with a critical review of existing market assessment methodologies. By breaking down WEMAM into its component parts, reflecting upon its practical applications to date and drawing upon insights from the literature, opportunities where it could continue to evolve are highlighted. Key opportunities include shifting the focus towards development outcomes; creating community archetypes; localised studies in high potential regions; scenario modelling and MCDA ranking of proposed interventions; participatory market mapping; and applying socio-technical transitions theory to understand how the small wind niche can break through into the mainstream

Sequential combination of paclitaxel-carboplatin and paclitaxel-liposomal doxorubicin as a first-line treatment in patients with ovarian cancer - A multicenter phase II trial

Cisplatin or carboplatin plus paclitaxel is considered the standard first-line treatment in ovarian cancer. Attempts to maximize tumor cytoreduction with first-line chemotherapy by incorporating new promising agents led to sequential drug administration with two or three doublets. In the present study, we aimed to evaluate the activity and the tolerance of two sequential doublets (paclitaxel/carboplatin and liposomal doxorubicin/carboplatin) administered as first-line treatment in patients with FIGO III/IV ovarian cancer. Treatment consisted of four cycles of carboplatin ( 6 AUC) plus paclitaxel ( 175 mg/m(2); PC regimen) followed by four cycles with carboplatin ( 6 AUC) plus liposomal doxorubicin ( 40 mg/ m(2); LD/C regimen) every 3 weeks. Forty-one patients in FIGO III or IV were enrolled. In an intention-to-treat analysis, 20 (49%) complete (CR) and 12 (29%) partial ( PR) responses were achieved ( overall response rate, ORR: 78%; 95% confidence interval, CI: 64.1 - 91.9%); with the PC regimen ( 164 cycles); 7 (17%) patients have stable (SD) and 2 (5%) progressive (PD) disease. The LD/C regimen ( 124 cycles) was administered in 36 (88%) patients because of 2 early deaths and 3 patient withdrawals. Three additional patients, 2 with PR and 1 with SD after PC chemotherapy) achieved a CR. Upon completion of the LD/C chemotherapy there were 18 (44%) patients with CR and 9 (22%) with PR ( ORR = 66%; 95% CI: 64 - 92%). The median duration of response was 27 months and the median time to progression 20 months. The probability of 2-year survival was 67%. Grade 3 and 4 neutropenia was observed in 34 and 14.6% of the patients, respectively, during the PC regimen, while during the treatment with LD/C the percentages for grade 3 and 4 neutropenia were 44.4 and 19.4%, respectively. Febrile neutropenia occurred only in patients treated with the PC regimen (4.9%). The incorporation of liposomal doxorubicin in this sequential doublet schedule of first-line treatment of ovarian carcinoma created a feasible and active regimen. Prospective randomized studies are required to assess its efficacy on patient survival. Copyright (C) 2005 S. Karger AG, Basel

Survivin Expression in Colorectal Carcinomas: Correlations with Clinicopathological Parameters and Survival

Background Survivin is a new member of the Inhibitor of apoptosis protein family that has a dual function as a mitotic regulator and apoptosis inhibitor. Survivin is prominently expressed in transformed cell lines and in many human cancers, including colorectal carcinoma. The aim of this study is to investigate the expression of survivin in colorectal carcinomas and its possible associations with clinicopathological parameters and patient survival. Materials and Methods Sections of formalin-fixed paraffin-embedded tissues from 77 colorectal carcinomas were immunohistochemistry stained for survivin. Results Survivin was mainly detected in the bottom of the glands of normal mucosa with mainly cytoplasmic localization. No survivin expression was found in infiltrating lymphocytes, fibroblasts, smooth muscle cells or neural tissue. Survivin staining was detected in 68/77 (88.3%) colorectal carcinomas. Survivin expression was found to be significantly associated with tumor differentiation (P = 0.02) but not with gender, age or Dukes stage. Survival did not differ according to survivin expression. Conclusion Survivin was found in the majority of colorectal carcinomas, suggesting that its expression is an early event in colorectal carcinogenesis. Its expression is statistically significantly associated with tumor differentiation but not with patient survival

3D printed rotor blades for a research wind turbine: Aerodynamic and structural design and testing

This study combines the design, the 3D printing and the testing of a small 3-bladed wind turbine rotor for research and teaching purposes. The objective is the additive manufacturing of a rotor with a radius of one meter, as an alternative to subtractive methods, such as computerized milling. The blade design is developed using freely available software packages. The aerodynamic considerations include the airfoil selection, the calculation of the blade geometry and the simulation of the ultimate load cases. The structural considerations are focussed on the printable materials, the infill structures and the retrofit of a load-carrying spar. The rotor blades are 3D printed with the BigRep One at the maker space of the TH Wildau. The structural integrity of the prototype blade is tested in terms of the ultimate root bending moments and the centrifugal forces at the HTW Berlin. The aerodynamic run-up tests are performed at the large wind tunnel of the TU Berlin measuring the power curves. The successful prototype paves the way for follow-up projects, such as open field tests and the 3D printing of larger rotor blades

Life cycle assessment of locally manufactured small wind turbines and pPico-hydro plants

Summarization: Locally manufactured small wind turbines and pico-hydro plants are a low-cost alternative for providing energy access to rural communities, but the life cycle environmental impacts of such systems have not been thoroughly investigated. In this paper, a life cycle model and inventory have been implemented to assess the environmental impacts of locally manufactured technologies in an off-grid context, based on actual data from two case studies. Variations in parameters that influence the performance and impact of these systems, such as the number of failures and the availability of wind resource in the case of small wind turbines, have also been considered in the modelling. Life cycle impacts for the two systems are presented for five impact categories. In both cases, the manufacturing of components of the electrical system, such as the batteries and the inverter, is found to have significantly higher impacts than those of the locally manufactured energy conversion units. The results are then compared with the impacts of a small generator set. Overall, the study shows that both renewable energy systems have significantly lower impacts than the small generator set, with the pico-hydro plant having the lowest impacts due to its high capacity factor, while the impacts of the small wind turbine are found to depend heavily on the average wind speed of the installation site; a parameter that proved to be more significant in terms of environmental impacts than the actual number of failures that can occur in the lifetime of a locally manufactured machine.Παρουσιάστηκε στο: 2nd International Conference on Smart Energy Systems and Technologie