Effect of topical imiquimod as primary treatment for lentigo maligna: the LIMIT-1 study

Background: Topical imiquimod is sometimes used for lentigo maligna (LM) in situ melanoma instead of surgery, but frequency of cure is uncertain. Pathological complete regression (pCR) is a logical surrogate marker for cure after imiquimod, although residual LM and atypical melanocytic hyperplasia may not be reliably distinguished. A trial comparing imiquimod vs. surgery might be justified by a high imiquimod pCR rate.  Objectives: Primary: to estimate the pCR rate for LM following imiquimod. Secondary: to assess the accuracy of prediction of pCR, using clinical complete regression (cCR) plus negative post-treatment biopsies, tolerability, resource use, patients' preferences and induced melanoma immunity.  Methods: This was a single-arm phase II trial of 60 imiquimod applications over 12 weeks for LM then radical resection. A pCR rate ≥ 25 out of 33 would reliably discriminate between pCR rates < 60% and ≥ 85%. Clinical response was assessed and biopsies taken after imiquimod. Patients recorded adverse events in diaries. Patient preference was measured after surgery using a standard gamble tool.  Results: The pCR rate was 10 of 27 (37%, 95% confidence interval 19-58%). The rate of cCR plus negative biopsies was 12 of 28, of whom seven of 11 had pCR on subsequent surgery. The median dose intensity was 86·7%. Of the 16 surveyed patients, eight preferred primary imiquimod over surgery if the cure rate for imiquimod was 80%, and four of 16 if it was ≤ 40%.  Conclusions: The pCR rate was insufficient to justify phase III investigation of imiquimod vs.  Surgery: Clinical complete response and negative targeted biopsies left uncertainty regarding pathological clearance. Some patients would trade less aggressive treatment of LM against efficacy

Intramedullary nail fixation versus locking plate fixation for adults with a fracture of the distal tibia : the UK FixDT RCT

Background The best treatment for fractures of the distal tibia remains controversial. Most of these fractures require surgical fixation, but the outcomes are unpredictable and complications are common. Objectives To assess disability, quality of life, complications and resource use in patients treated with intramedullary (IM) nail fixation versus locking plate fixation in the 12 months following a fracture of the distal tibia. Design This was a multicentre randomised trial. Setting The trial was conducted in 28 UK acute trauma centres from April 2013 to final follow-up in February 2017. Participants In total, 321 adult patients were recruited. Participants were excluded if they had open fractures, fractures involving the ankle joint, contraindication to nailing or inability to complete questionnaires. Interventions IM nail fixation (n = 161), in which a metal rod is inserted into the hollow centre of the tibia, versus locking plate fixation (n = 160), in which a plate is attached to the surface of the tibia with fixed-angle screws. Main outcome measures The primary outcome measure was the Disability Rating Index (DRI) score, which ranges from 0 points (no disability) to 100 points (complete disability), at 6 months with a minimum clinically important difference of 8 points. The DRI score was also collected at 3 and 12 months. The secondary outcomes were the Olerud–Molander Ankle Score (OMAS), quality of life as measured using EuroQol-5 Dimensions (EQ-5D), complications such as infection, and further surgery. Resource use was collected to inform the health economic evaluation. Results Participants had a mean age of 45 years (standard deviation 16.2 years), were predominantly male (61%, 197/321) and had experienced traumatic injury after a fall (69%, 223/321). There was no statistically significant difference in DRI score at 6 months [IM nail fixation group, mean 29.8 points, 95% confidence interval (CI) 26.1 to 33.7 points; locking plate group, mean 33.8 points, 95% CI 29.7 to 37.9 points; adjusted difference, 4.0 points, 95% CI –1.0 to 9.0 points; p = 0.11]. There was a statistically significant difference in DRI score at 3 months in favour of IM nail fixation (IM nail fixation group, mean 44.2 points, 95% CI 40.8 to 47.6 points; locking plate group, mean 52.6 points, 95% CI 49.3 to 55.9 points; adjusted difference 8.8 points, 95% CI 4.3 to 13.2 points; p < 0.001), but not at 12 months (IM nail fixation group, mean 23.1 points, 95% CI 18.9 to 27.2 points; locking plate group, 24.0 points, 95% CI 19.7 to 28.3 points; adjusted difference 1.9 points, 95% CI –3.2 to 6.9 points; p = 0.47). Secondary outcomes showed the same pattern, including a statistically significant difference in mean OMAS and EQ-5D scores at 3 and 6 months in favour of IM nail fixation. There were no statistically significant differences in complications, including the number of postoperative infections (13% in the locking plate group and 9% in the IM nail fixation group). Further surgery was more common in the locking plate group (12% in locking plate group and 8% in IM nail fixation group at 12 months). The economic evaluation showed that IM nail fixation provided a slightly higher quality of life in the 12 months after injury and at lower cost and, therefore, it was cost-effective compared with locking plate fixation. The probability of cost-effectiveness for IM nail fixation exceeded 90%, regardless of the value of the cost-effectiveness threshold. Limitations As wound dressings after surgery are clearly visible, it was not possible to blind the patients to their treatment allocation. This evidence does not apply to intra-articular (pilon) fractures of the distal tibia. Conclusions Among adults with an acute fracture of the distal tibia who were randomised to IM nail fixation or locking plate fixation, there were similar disability ratings at 6 months. However, recovery across all outcomes was faster in the IM nail fixation group and costs were lower

Multi-electron redox asymmetric supercapacitors based on quinone-coupled viologen derivatives and Ti3C2Tx MXene

International audienc

Short communication. Evaluation of castor (Ricinus communis L.) induced mutants for possible selection in the improvement of seed yield

The aim of the present work was to determine selection criteria suitable for developing castor ideotypes with high yield potentials. Nineteen M4 generation castor mutants were obtained by gamma irradiation (100 to 1000 Gy) of DS30 castor seeds, and evaluated alongside this reference variety over 2006-07 for their possible use in the improvement of castor seed yield. Days to ripening, plant height, number of spikes/plant, length of main spike, number of main spike capsules, capsule weight, 100-seed weight and seed yield per plant were recorded for each mutant. Correlation coefficients were calculated, path analyses performed, and the genetic features of the different traits were determined. A significant, positive correlation was seen between capsule weight and seed yield. The 100-seed weight showed a positive but non-significant phenotypic relationship plus a significant genotypic relationship with seed yield. Capsule weight also showed a strong direct effect on seed yield, plus a strong positive and significant genotypic correlation with this variable. More than 50% heritability was observed for all the traits studied except the 100-seed weight and capsule weight. The number of main spike capsules showed the greatest genetic advance, followed by spike length and number of spikes. Traits such as the number of capsules, spike length and number of spikes showed strong heritability and good genetic advance. These traits are therefore governed by additive genes, and for the improvement of seed yield selection may be based directly on these attributes. In conclusion, for the improvement of seed yield the main emphasis should be placed on the number of spikes and capsule weight, via the selection of the highest yielding mutants among those tested. However, spike length and 100-seed weight should also be taken into account.Se obtuvieron mutantes de ricino a través de irradiación gamma de 100-1000 Gy. Durante 2006-07 se evaluaron 19 mutantes de la generación M4, junto con la variedad control DS30, para los siguientes caracteres: tiempo de maduración, altura de la planta, número de espigas/planta, longitud de la espiga principal, número de cápsulas de la espiga principal, peso de la cápsula, peso de 100 semillas, y producción de semilla por planta. Se midieron el coeficiente de correlación, el análisis de ruta y parámetros genéticos de estos caracteres. Se observó correlación significativa y positiva del peso de la cápsula respecto a la producción de semilla. El peso de 100 semillas mostró una correlación fenotípica no significativa respecto a la producción de semilla, pero la correlación genotípica fue significativa. El peso de la cápsula también mostró un efecto directo alto combinado con un efecto positivo alto y correlación genotípica significativa. La heredabilidad fue de más del 50% en todos los caracteres, excepto en peso de 100 semillas y peso de cápsula. El número de cápsulas de la espiga principal presenta el máximo avance genético, seguido de la longitud de la espiga y nº de espigas. Caracteres como nº de cápsulas, longitud de la espiga y nº de espigas tienen una alta heredabilidad combinada con un alto avance genético. La selección puede basarse en estos caracteres, ya que parecen estar gobernados por genes de tipo aditivo y para la mejora de producción de la semilla. Puede concluirse que para la selección de variantes/mutantes altamente productivos de semilla se debe hacer énfasis principalmente en el nº de espigas y peso de cápsula. En menor medida, también debe considerarse la longitud de las espigas y peso de 100 semillas

Effect of a niobium-doped PZT interfacial layer thickness on the properties of epitaxial PMN-PT thin films

We are reporting on high quality epitaxial thin films of [Pb(Mg1/3Nb2/3)O3]0.67-(PbTiO3)0.33 [PMN-PT (67/33)]. These films were deposited on (001) oriented, vicinal SrTiO3 single crystal substrates, using 1 mol. % niobium-doped Pb(Zr0.52,Ti0.48)O3 (Nb-PZT) as an interfacial layer. The functional properties of the epitaxial PMN-PT (67/33) thin films were investigated as a function of the layer thickness of the Nb-PZT layer. The deposited hetero-structures are perovskite phase pure and fully (001)-oriented. The variation in Nb-PZT interfacial layer thickness results in an increasing trend change of the in-plane lattice parameter of that layer, which in turn causes a decrease in the c/a ratio of the PMN-PT film on top. The most noticeable effect related to this is a decrease in built-in-bias (imprint) voltage. Thus, the built-in bias can be tuned by changing the interfacial layer thickness. The ferroelectric capacitor properties are found to be most stable for the thinnest interfacial layers under a high number (108) of switching cycles

Effect of a thin (doped) PZT interfacial layer on the properties of epitaxial PMN-PT films

Pure perovskite phase, (001)-oriented, epitaxial thin films of (Pb(Mg1/3Nb2/3)O3)0.67-(PbTiO3)0.33 (PMN-PT) were fabricated on single crystal, (001)-oriented SrTiO3 substrates using a hard (Fe-doped) and soft doped (Nb-doped) PZT(52/48) interfacial layer. The effect of different interface layers on the structural and ferroelectric properties of the PMN-PT films was investigated in detail. A significant self-bias voltage in the PMN-PT films can be introduced by using an appropriate interfacial layer. There are significant differences in polarization for different types of doped and undoped interface layers and a doubling of the relative dielectric constant was observed for the Nb-doped interfacial layer. Device properties remain stable up to at least 108 cycles

Epitaxial Pb(Mg1/3Nb2/3)O3-PbTiO3 (67/33) thin films with large tunable self-bias field controlled by a PbZr1−xTixO3 interfacial layer

Epitaxial Pb(Mg1/3Nb2/3)O3-PbTiO3 200 nm thick, (001) oriented, perovskite phase-pure films were grown on a range of PbZr1−xTixO3 buffer layers (x = 0.2–0.8) and sandwiched between SrRuO3 electrodes on (001) SrTiO3 substrates to form a ferroelectric capacitor structure. Devices without a buffer layer or with a buffer layer of highly tetragonal PbZr1−xTixO3 show very large self-bias fields up to 1.0 × 107 V/m. These self-bias fields correlate with strain gradient layers near the bottom electrode observed in these devices only. The large self-bias was explained quantitatively in terms of the flexoelectric effec

Optimizing the structural, optical and photovoltaic properties of Mn-doped perovskite solar cells

Perovskite solar cells (MAPbI2Br or CH3NH3I2Br) are the subject of this thorough examination of their optical, structural, and photovoltaic properties. These MAPbI2Br cells were prepared by the sol–gel spin-coating process to make films of both undoped and Mn2+-doped materials. In addition, the band gap energy (Eg) exhibited a steady downward trend as doping levels increased. The largest drop was observed at 4 % Mn2+ doping, when UV–Vis spectroscopy measured an Eg value of 1.88 eV. This decrease in band gap energy is essential to improving MAPbI2Br's functionality. Furthermore, when compared to cells that used pure MAPbI2Br perovskite solar cells, the efficiency of the manufactured MAPbI2Br cells shown a significant improvement. Analyzing the current–voltage (J-V) characteristics revealed that the MAPbI2Br produced with a 4 % Mn2+-doped MAPbI2Br film had dramatically improved properties. These cells showed an open-circuit voltage of 1.02, a fill factor of 0.74, a short-circuit current density of 8.10 mA/cm2, and an impressive power conversion efficiency of 6.14 %