Erratum: Linearly polarized probes of surface chirality [J. Chem. Phys. 103, 8296 (1995)]

We present a new nonlinear optical technique to study surface chirality. We demonstrate experimentally that the efficiency of second‐harmonic generation from isotropic chiral surfaces is different for excitation with fundamental light that is +45° and −45° linearly polarized with respect to the p‐polarized direction

Clinicopathological features and outcome in advanced colorectal cancer patients with synchronous vs metachronous metastases

Contains fulltext : 88999.pdf (publisher's version ) (Open Access)BACKGROUND: Synchronous metastases of colorectal cancer (CRC) are considered to be of worse prognostic value compared with metachronous metastases, but only few and conflicting data have been reported on this issue. METHODS: We retrospectively investigated patient demographics, primary tumour characteristics and overall survival (OS) in 550 advanced CRC patients with metachronous vs synchronous metastases, who participated in the phase III CAIRO study. For this purpose only patients with a prior resection of the primary tumour were considered. RESULTS: The clinical and pathological characteristics associated with poor prognosis that we observed more often in patients with synchronous metastases (n=280) concerned an abnormal serum lactate dehydrogenase (LDH) concentration (P=0.01), a worse WHO performance status (P=0.02), primary tumour localisation in the colon (P=0.002) and a higher T stage (P=0.0006). No significant difference in median OS was observed between patients with synchronous metastases and metachronous metastases (17.6 vs 18.5 months, respectively, P=0.24). CONCLUSION: Despite unfavourable clinicopathological features in patients with synchronous metastases with a resected primary tumour compared to patients with metachronous metastases, no difference in the median OS was observed. Possible explanations include a (partial) chemoresistance in patients with metachronous disease because of previous adjuvant treatment, whereas differences between the two groups in screening procedures resulting in a lead time bias to diagnosis or in prognostic molecular markers remain speculative

KRAS mutation analysis: a comparison between primary tumours and matched liver metastases in 305 colorectal cancer patients

Contains fulltext : 96042.pdf (publisher's version ) (Open Access)BACKGROUND: KRAS mutation is a negative predictive factor for treatment with anti-epidermal growth factor receptor antibody in metastatic colorectal cancer (CRC). KRAS mutation analysis is usually performed on primary tumour tissue because metastatic tissue is often not available. However, controversial data are available on the concordance of test results between primary tumours and corresponding metastases. We assessed the concordance of KRAS mutation status in a study of 305 primary colorectal tumours and their corresponding liver metastases. METHODS: Patients with histologically confirmed CRC who underwent surgical resection of the primary tumour and biopsy or surgical resection of the corresponding liver metastasis were included. KRAS mutation analysis was performed for codons 12 and 13. RESULTS: KRAS mutation was detected in 108 out of 305 primary tumours (35.4%). In 11 cases (3.6%), we found a discordance between primary tumour and metastasis: 5 primary tumours had a KRAS mutation with a wild-type metastasis, 1 primary tumour was wild type with a KRAS mutation in the metastasis, and in 5 cases the primary tumour and the metastasis had a different KRAS mutation. CONCLUSION: We observed a high concordance of KRAS mutation status of 96.4% (95% CI 93.6-98.2%) between primary colorectal tumours and their corresponding liver metastases. In only six patients (2.0%; 95% CI 0.7-4.2%), the discordance was clinically relevant. In this largest and most homogenous study to date, we conclude that both primary tumours and liver metastases can be used for KRAS mutation analysis

Do nursing home residents live longer when they enjoy getting up in the morning?

Background Feelings of happiness can be beneficial for health in the elderly and are associated with longevity. Depression in nursing home (NH) residents is more common than in the general population, and it can be both a consequence of medical illness and an influencing factor for morbidity and mortality. It is not clear whether life expectancy in NH residents is mainly associated with the presence of positive emotions such as being happy or hopeful, or with the lack of negative emotions such as pessimism and sadness associated with depression. Objectives To determine whether the presence of positive emotions, and the lack of negative emotions predict life expectancy in NH residents. Methods  Design: prospective longitudinal study with a baseline measurement of positive and negative emotions, and mortality rate at 21 months follow-up. Participants: a subsample from a study on depression management in 32 Dutch NH units. Exclusion criteria: no informed consent; cognitive inability to respond to the interview. Measurements: Positive Emotions (PE): sum of ‘yes’ answers on 9 positive-items of the Geriatric Depression Scale (GDS), such as “do you find life very exciting?”; Lack of Negative Emotions (LNE): sum of ‘no’ answers on 21 negative-items of the GDS such as “Do you often feel downhearted and blue?”; Co-morbidity: Charlson index; Cognition: Mini Mental State Examination (MMSE) Procedure: trained interviewers scored the GDS and MMSE; demographical data and co-morbidity were retrieved from medical files. Statistics: Cox Regression was run for survival analysis with age, gender, MMSE and Charlson index as fixed variables, and PE and LNE as predictors for mortality (forward likelihood ratio). Additional survival analyses were run for individual PE, and LNE items. Results Of the 250 NH residents included, 158 (63%) were female. The mean age was 79.0 years (SD 11.3), MMSE score was 18.8 (SD 7.5; N=233), and Charlson-index was 2.8 (SD 2.0; N=244). There were 65 deaths (26%). A mean follow-up was 16.8 months. Survival analysis showed that LNE was associated with decreased mortality (adjusted hazard ratio [HR] 0.94 [95% CI: 0.89 to 0.99] P=0.036) whereas PE were redundant (not associated with mortality). Of the LNE-questions, a negative answer to the item “Do you feel that your situation is hopeless?” (HR 0.44 [95% CI: 0.26 to 0.76]; P=0.003) was associated with decreased mortality: 79% and 61% of the residents who answered ‘no’ and ‘yes’, respectively, survived during 21 months. Of the individual PE items, a positive answer to the item “Do you enjoy getting up in the morning?” (HR 0.41 [95% CI: 0.23 to 0.71], P=0.001) was associated with decreased mortality: 80% and 59% of residents who answered ‘yes’ and ‘no’, respectively, survived. Conclusions The lack of negative emotions was associated with decreased mortality in NH residents. Residents who did not report that their situation was hopeless and those who enjoyed getting up in the morning lived longer. More research on positive emotions in NH residents is needed due to limited number of positive items of the GDS used in the study

Coronavirus Disease 2019 Immediately Increases Burnout Symptoms in ICU Professionals: A Longitudinal Cohort Study

OBJECTIVES: ICU professionals are at risk of developing burnout due to coronavirus disease 2019. This study assesses the prevalence and incidence of burnout symptoms and moral distress in ICU professionals before and during the coronavirus disease 2019 crisis. DESIGN: This is a longitudinal open cohort study. SETTING: Five ICUs based in a single university medical center plus another adult ICU based on a separate teaching hospital in the Netherlands. SUBJECTS: All ICU professionals were sent a baseline survey in October-December 2019 (252 respondents, response rate: 53%), and a follow-up survey was sent in May-June 2020 (233 respondents, response rate: 50%). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Burnout symptoms and moral distress measured with the Maslach Burnout Inventory and the Moral Distress Scale, respectively. The prevalence of burnout symptoms was 23.0% before coronavirus disease 2019 and 36.1% at postpeak time, with higher rates in nurses (38.0%) than in physicians (28.6%). Reversely, the incidence rate of new burnout cases among physicians was higher (26.7%) than nurses (21.9%). Higher prevalence of burnout symptoms was observed in the postpeak coronavirus disease 2019 period (odds ratio, 1.83; 95% CI, 1.32-2.53), for nurses (odds ratio, 1.77; 95% CI, 1.03-3.04), for professionals working overtime (odds ratio 2.11; 95% CI, 1.48-3.02), and for professionals directly engaged with care for coronavirus disease 2019 patients (odds ratio, 1.87; 95% CI, 1.35-2.60). Physicians were more likely than nurses to develop burnout symptoms due to coronavirus disease 2019 (odds ratio, 3.56; 95% CI, 1.06-12.21). CONCLUSIONS: This study shows that overburdening of ICU professionals during an extended period of time leads to symptoms of burnout. Working long hours and under conditions of scarcity of staff, time, and resources comes at the price of ICU professionals' mental health