Enuresis subtypes based on nocturnal hypercalciuria: A multicenter study

Purpose: Desmopressin may not be effective for nocturnal enuresis associated with polyuria and hypercalciuria. Nighttime hypercalciuria in an enuretic population from 5 centers and its correlation with nighttime polyuria were verified. Materials and Methods: A total of 450 enuretic patients (278 males, 172 females, mean age 9.7 years) were evaluated with 72-hour micturition charts, urinalysis, serum creatinine and osmolarity, diurnal and nocturnal electrolytes with fractional Na+ and K+ urinary excretion, and nocturnal (4 a.m.) plasma vasopressin. Creatinine electrolytes and osmolarity were measured in daytime (8 a.m. to 8 p.m.) and nighttime (8 p.m. to 8 a.m.) urine volumes. Patients were divided into group 1 with nocturnal polyuria and group 2 without nocturnal polyuria. Hypercalciuria was defined as urinary calcium-to-urinary creatinine ratio greater than 0.21. Statistic evaluation was performed using chi-square, Pearson correlation and ANOVA tests. Results: Nighttime polyuria was demonstrated in 292 bedwetters (65% group 1). Nocturnal hypercalciuria was present in 179 of the 450 children (39.7%), including 125 in group 1 (42.8%) and 54 in group 2 (34.2%), which was statistically significant (chi-square p = 0.008, Pearson correlation test r = 0.157). Daytime calciuria was not statistically modified in either group (group 1 p = 0.054, group 2 p = 0.56). Adrenocorticotropic hormone (ADH) was normal in 18.5% and low in 81.5% of enuretics with nocturnal hypercalciuria. ADH levels and nocturnal hypercalciuria significantly correlated (p = 0.003, r = 0.148). Conversely, the group 2 patients had normal ADH levels. Conclusions: Nocturnal hypercalciuria has a pivotal role in nocturnal enuresis, as it is significantly associated with low ADH levels and nocturnal polyuria. A new classification of nocturnal enuresis subtypes based on nighttime calciuria levels is mandatory to address treatment properly

Near real-time analysis of active distribution networks in a Digital Twin framework. A real case study

The growth of distributed generation and the need of increasing Distribution Network (DN) resilience is encouraging Distribution System Operators (DSO) to increase awareness about the real-time status of the network as well as to actively manage flexible energy resources for improving system performances. In this context, Digital Twin (DT) is an enabling technology for a low-cost distributed framework that supports DN management. DT in the power system can be exploited taking advantage of the successful experiences in other sectors (e.g., smart manufacturing and building automation). This article presents a real case study of a DT development and its integration with an existing DN. The DT system architecture is based on the recent standards whilst main DT components have been originally developed, enabling near real-time services such as data collection, state estimation, and flexibility calculator. The individual performances of the integrated tools and the reliability of DT were tested and validated during one month of continuous operation. During the operation, good service continuity and accuracy performances were reported. Results from the flexibility calculator show the effectiveness of the proposed strategies that can improve the energy efficiency of the DN by increasing local self-consumption of Renewable Energy Sources (RES) production

Tunability of the elastocaloric response in main-chain liquid crystalline elastomers

Materials exhibiting a large caloric effect could lead to the development of a new generation of heat-management technologies that will have better energy efficiency and be potentially more environmentally friendly. The focus of caloric materials investigations has shifted recently from solid-state materials towards soft materials, such as liquid crystals and liquid crystalline elastomers. It has been shown recently that a large electrocaloric effect exceeding 6 K can be observed in smectic liquid crystals. Here, we report on a significant elastocaloric response observed by direct elastocaloric measurements in main-chain liquid crystal elastomers. It is demonstrated that the character of the nematic to paranematic/isotropic transition can be tuned from the supercritical regime towards the first-order regime, by decreasing the density of crosslinkers. In the latter case, the latent heat additionally enhances the elastocaloric response. Our results indicate that a significant elastocaloric response is present in main-chain liquid crystalline elastomers, driven by stress fields much smaller than in solid elastocaloric materials. Therefore, elastocaloric soft materials can potentially play a significant role as active cooling/heating elements in the development of new heat-management devices

Single Institution trial of anthracycline- and taxane-based chemotherapy for operable breast cancer: The ASTER study

The efficacy of anthracycline- and taxane-based chemotherapy for perioperative treatment of breast cancer (BC) has been established. No superiority of a cytotoxic regimen has been demonstrated, provided that administration of an anthracycline and a taxane is warranted. The ASTER study was designed to investigate the safety of 6 months of perioperative chemotherapy with Doxorubicin and Paclitaxel, followed by Cyclophosphamide, Methotrexate, and 5-Fluorouracil. ASTER enrolled patients with cT2-3 N0-1 or pT1-2 N1-3 BC, from November 2008 to August 2011. Treatment consisted of Doxorubicin 60 mg/sm, Paclitaxel 200 mg/sm q21 (AT) for three cycles followed by Cyclophosphamide 600 mg/sm, Methotrexate 40 mg/sm, 5-Fluorouracil 600 mg/sm d1,8 q28 (CMF) for three cycles, in either neo-adjuvant or adjuvant setting. All HER-positive patients received targeted therapy with Trastuzumab for 1 year. Disease-free and overall survival (DFS and OS, respectively) were estimated according to Kaplan-Meier method. Three hundred and thirty patients were enrolled, where 77.9% of cases were treated in an adjuvant setting; 65.5% received breast conservative surgery, 72.4% axillary dissection. 75.5% of cases presented estrogen receptor positivity, 66.7% progesterone receptor positivity; 18.5% of patients presented HER2-positive BC, 16.1% triple negative disease. Twenty-eight (8.5%) developed grade III-IV hematologic toxicity; nine patients (2.7%) developed grade III neurological toxicity. Loco-regional DFS was 99.6% at 1 year, 97.1% at 5 years, 95.9% at 7 years. Corresponding distant DFS was 98.4%, 90.2%, and 88.8%. One, 5, and 7-year OS was 99.6%, 94.9%, and 91.2%, respectively. Chemotherapy with ATx3 -> CMFx3 is confirmed safe and effective at 6.7 years follow-up. These results appear comparable to those reported in regulatory trials of most commonly prescribed anthracycline and taxane-based regimens

Combination of baseline LDH, performance status and age as integrated algorithm to identify solid tumor patients with higher probability of response to anti PD-1 and PD-l1 monoclonal antibodies

Predictive biomarkers of response to immune-checkpoint inhibitors (ICIs) are an urgent clinical need. The aim of this study is to identify manageable parameters to use in clinical practice to select patients with higher probability of response to ICIs. Two-hundred-and-seventy-one consecutive metastatic solid tumor patients, treated from 2013 until 2017 with anti-Programmed death-ligand 1 (PD-L1)/programmed cell death protein 1 (PD-1) ICIs, were evaluated for baseline lactate dehydrogenase (LDH) serum level, performance status (PS), age, neutrophil-lymphocyte ratio, type of immunotherapy, number of metastatic sites, histology, and sex. A training and validation set were used to build and test models, respectively. The variables\u2019 effects were assessed through odds ratio estimates (OR) and area under the receive operating characteristic curves (AUC), from univariate and multivariate logistic regression models. A final multivariate model with LDH, age and PS showed significant ORs and an AUC of 0.771. Results were statistically validated and used to devise an Excel algorithm to calculate the patient\u2019s response probabilities. We implemented an interactive Excel algorithm based on three variables (baseline LDH serum level, age and PS) which is able to provide a higher performance in response prediction to ICIs compared with LDH alone. This tool could be used in a real-life setting to identify ICIs in responding patients

A three-scale domain decomposition method for the 3D analysis of debonding in laminates

The prediction of the quasi-static response of industrial laminate structures requires to use fine descriptions of the material, especially when debonding is involved. Even when modeled at the mesoscale, the computation of these structures results in very large numerical problems. In this paper, the exact mesoscale solution is sought using parallel iterative solvers. The LaTIn-based mixed domain decomposition method makes it very easy to handle the complex description of the structure; moreover the provided multiscale features enable us to deal with numerical difficulties at their natural scale; we present the various enhancements we developed to ensure the scalability of the method. An extension of the method designed to handle instabilities is also presented

Reseñas

JOSÉ LUIS FUERTES HERRERO, El discurso de los saberes en la Europa del Renacimiento y el Barroco, de José Luis Fuertes Herrero. CECILIA RUSCONI, El uso simbólico de las figuras matemáticas en la metafísica de Nicolás de Cusa (1401-1464). TIM GEELHAAR / JOHN THOMAS (eds), Stiftung und Staat im Mittelalter. Eine byzantinisch-lateineuropäische Quellenanthologie in komparatistischer Perspektive. FRANCISCO DE VITORIA, De iustitia – Über die Gerechtigkeit. Teil I. ELENA FILIPPI / HARALD SCHWAETZER (eds), Spiegel der Seele: Reflexionen im Mystik und Malerei. RUBÉN PERETÓ RIVAS (ed), Tolerancia: Teoría y práctica en la Edad Media. K. BUNGE / S. SCHWEIGHÖFER / A. SPINDLER / A. WAGNER (eds), Kontroversen um das Recht. Beiträge zur Rechtsbegründung von Vitoria bis Suárez. H. SCHWAELZER / M. A. VANNIER (eds), Zum Subjektbegriff bei Meister Eckhart Eckhart und Nikolaus von Kues. OCKHAM, Probleme der Metaphysik, trad. HANS KRAML / GERHARD LEIBOLD. H. NAKAMURA SJ, “Amor invisibilium”. Die Liebe im Denken Richards von Sankt Victor. J. F. MEIRINHOS, Bibliotheca manuscripta Petri Hispani. Os manuscritos das obras atribuídas a Pedro Hispano. A. M. I. VAN OPPERNRAAY / R. FONAINE (ed), The Letter before the Spirit: The Importance of Text Edition for the Study of the Reception of Aristotle

The metabolic adaptation evoked by arginine enhances the effect of radiation in brain metastases

Selected patients with brain metastases (BM) are candidates for radiotherapy. A lactatogenic metabolism, common in BM, has been associated with radioresistance. We demonstrated that BM express nitric oxide (NO) synthase 2 and that administration of its substrate l-arginine decreases tumor lactate in BM patients. In a placebo-controlled trial, we showed that administration of l-arginine before each fraction enhanced the effect of radiation, improving the control of BM. Studies in preclinical models demonstrated that l-arginine radiosensitization is a NO-mediated mechanism secondary to the metabolic adaptation induced in cancer cells. We showed that the decrease in tumor lactate was a consequence of reduced glycolysis that also impacted ATP and NAD+ levels. These effects were associated with NO-dependent inhibition of GAPDH and hyperactivation of PARP upon nitrosative DNA damage. These metabolic changes ultimately impaired the repair of DNA damage induced by radiation in cancer cells while greatly sparing tumor-infiltrating lymphocytes.Fil: Marullo, Rossella. Cornell University; Estados UnidosFil: Castro, Monica. Universidad de Buenos Aires; ArgentinaFil: Yomtoubian, Shira. Cornell University; Estados UnidosFil: Nieves Calvo Vidal, M.. Cornell University; Estados UnidosFil: Revuelta, María Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Krumsiek, Jan. Cornell University; Estados UnidosFil: Nicholas, Andrew P.. Cornell University; Estados UnidosFil: Cresta Morgado, Pablo. Universidad de Buenos Aires; ArgentinaFil: Yang, ShaoNing. Cornell University; Estados UnidosFil: Medina, Vanina Araceli. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas; ArgentinaFil: Roth, Berta María Cristina. Universidad de Buenos Aires; ArgentinaFil: Bonomi, Marcelo. Ohio State University; Estados UnidosFil: Keshari, Kayvan R.. Memorial Sloan Kettering Cancer Center; Estados UnidosFil: Mittal, Vivek. Cornell University; Estados UnidosFil: Navigante, Alfredo Hugo. Universidad de Buenos Aires; ArgentinaFil: Cerchietti, Leandro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; Argentin

A phase 1 study of mTORC1/2 inhibitor BI 860585 as a single agent or with exemestane or paclitaxel in patients with advanced solid tumors

This phase 1 trial (NCT01938846) determined the maximum tolerated dose (MTD) of the mTOR serine/threonine kinase inhibitor, BI 860585, as monotherapy and with exemestane or paclitaxel in patients with advanced solid tumors. This 3+3 dose-escalation study assessed BI 860585 monotherapy (5–300 mg/day; Arm A), BI 860585 (40–220 mg/day; Arm B) with 25 mg/day exemestane, and BI 860585 (80–220 mg/day; Arm C) with 60–80 mg/m2 /week paclitaxel, in 28-day cycles. Primary endpoints were the number of patients with dose-limiting toxicities (DLTs) in cycle 1 and the MTD. Forty-one, 25, and 24 patients were treated (Arms A, B, and C). DLTs were observed in four (rash (n = 2), elevated alanine aminotransferase/aspartate aminotransferase, diarrhea), four (rash (n = 3), stomatitis, and increased gamma-glutamyl transferase), and two (diarrhea, increased blood creatine phosphokinase) patients in cycle 1. The BI 860585 MTD was 220 mg/day (Arm A) and 160 mg/day (Arms B and C). Nine patients achieved an objective response (Arm B: Four partial responses (PRs); Arm C: Four PRs; one complete response). The disease control rate was 20%, 28%, and 58% (Arms A, B, and C). The most frequent treatment-related adverse events (AEs) were hyperglycemia (54%) and diarrhea (39%) (Arm A); diarrhea (40%) and stomatitis (40%) (Arm B); fatigue (58%) and diarrhea (58%) (Arm C). The MTD was determined in all arms. Antitumor activity was observed with BI 860585 monotherapy and in combination with exemestane or paclitaxel