Stage-related outcome for thymic epithelial tumours

Background: Thymic epithelial tumours (TETs) are characterized by a wide variety of biological behaviors. Radical resection and stage are strong prognostic factors. Aim of this study is to review our Single Center Experience. Methods: One hundred and seventy-seven patients observed in the period from January 2000 to December 2016 were included in the study. Data regarding clinicopathologic features, treatment, and survival were collected. Stage-related clinical standpoints and therapeutic options were also evaluated. Results: Non-surgical treatment was primarily performed in 15 (8.47%), unresectable disease was intraoperatively found in 12 cases (7.4%). The analysis of 150 patients undergoing curative surgery revealed 70 stage I TET (46.66%), 49 stage II (32.66%), 19 stage III (12.66%), 6 stage IVa (4%) and 6 stage IVb (4%) at the first hospital admission. Histology identified 12 A thymoma (8%), 38 AB (25.33%), 24 B1 (16%), 50 B2 (33.33%), 19 B3 (12.66%) and 7 carcinomas (4.66%). The mean follow up time was 84.14 months (sd = 61.68 months). Disease relapse occurred in 13 patients (8.78%) at a mean period of 78.85 months (sd = 60.87 months) after surgery. Exitus due to thymoma happened in 6 cases (4.05%) after a mean survival of 56.02 months (sd = 25.17 months). The 5-year overall survival rate was 0.94 (95%CI 0.88-0.97) and the 5-year disease-free survival rate was 0.90 (95%CI 0.83-0.94). The 5-year overall survival rates were 96.1% (95% CI, 89.9-98.5%) for the early stages and 87.4% (95% CI, 65.6-95.8%) for the advanced stages (p = 0.670). The 5-year disease-free survival rates resulted being 98.8% (95% CI, 92.3-99.8%) for the early stages and 59.8% (95% CI, 37.8-76.2%) for the advanced stages (p < 0.001). Conclusions: Advanced stage TETs are characterized by higher mortality and recurrence rates. Although technically demanding, surgery, as part of multimodality therapy, could prolong survival. Iterative surgical treatment of recurrences is a viable option for selected patients. Trial registration: The study was approved by the Institutional Review Board of Perugia and Terni University Hospitals [Code T1003] and was retrospectively registered

Simulating the Cascading Effects of an Extreme Agricultural Production Shock: Global Implications of a Contemporary US Dust Bowl Event

Higher temperatures expected by midcentury increase the risk of shocks to crop production, while the interconnected nature of the current global food system functions to spread the impact of localized production shocks throughout the world. In this study, we analyze the global potential impact of a present-day event of equivalent magnitude to the US Dust Bowl, modeling the ways in which a sudden decline in US wheat production could cascade through the global network of agricultural trade. We use observations of country-level production, reserves, and trade data in a Food Shock Cascade model to explore trade adjustments and country-level inventory changes in response to a major, multiyear production decline. We find that a 4-year decline in wheat production of the same proportional magnitude as occurred during the Dust Bowl greatly reduces both wheat supply and reserves in the United States and propagates through the global trade network. By year 4 of the event, US wheat exports fall from 90.5 trillion kcal before the drought to 48 trillion to 52 trillion kcal, and the United States exhausts 94% of its reserves. As a result of reduced US exports, other countries meet their needs by leveraging their own reserves, leading to a 31% decline in wheat reserves globally. These findings demonstrate that an extreme production decline would lead to substantial supply shortfalls in both the United States and in other countries, where impacts outside the United States strongly depend on a country's reserves and on its relative position in the global trade network

Staphylococcus aureus resists UVA at low irradiance but succumbs in the presence of TiO2 photocatalytic coatings

The aim of this study was to evaluate the bactericidal effect of reactive oxygen species (ROS) generated upon irradiation of photocatalytic TiO 2 surface coatings using low levels of UVA and the consequent killing of Staphylococcus aureus. The role of intracellular enzymes catalase and superoxide dismutase in protecting the bacteria was investigated using mutant strains. Differences were observed in the intracellular oxidative stress response and viability of S. aureus upon exposure to UVA; these were found to be dependent on the level of irradiance and not the total UVA dose. The wild type bacteria were able to survive almost indefinitely in the absence of the coatings at low UVA irradiance (LI, 1 mW/cm 2 ), whereas in the presence of TiO 2 coatings, no viable bacteria were measurable after 24 h of exposure. At LI, the lethality of the photocatalytic effect due to the TiO 2 surface coatings was correlated with high intracellular oxidative stress levels. The wild type strain was found to be more resistant to UVA at HI compared with an identical dose at LI in the presence of the TiO 2 coatings. The UVA-irradiated titania operates by a “stealth” mechanism at low UVA irradiance, generating low levels of extracellular lethal ROS against which the bacteria are defenceless because the low light level fails to induce the oxidative stress defence mechanism of the bacteria. These results are encouraging for the deployment of antibacterial titania surface coatings wherever it is desirable to reduce the environmental bacterial burden under typical indoor lighting conditions

TWO CASES OF NON-ALCOHOLIC WERNICKE ENCEPHALOPATHY SUCCESSFULLY TREATED BY THIAMINE REPLACEMENT: DIAGNOSTIC AND THERAPEUTIC CONSIDERATIONS

Wernicke\u2019s encephalopathy (WE) is an acute neurologi- cal disorder, due to a lack of thiamin (vitamin B1) which is observed mainly in alcoholic patients. Unfortunately, the syn- drome is underestimated in clinical practice and most often recognized only on autopsy, especially among non-alcoholics. The common clinical picture include mental status changes, ocular dysfunction, and gait ataxia. Treatment consists of timely thiamine replacement through intravenous infusion. We describe the case of two patients who developed a non-alcoholic WE post-surgical, regressed completely after intravenous infusion of thiamine. These cases suggest intere- sting diagnostic and therapeutic implications

Removal of antiretroviral drugs stavudine and zidovudine in water under UV254 and UV254/H2O2 processes: Quantum yields, kinetics and ecotoxicology assessment

The concentration of antiretroviral drugs in wastewater treatment plants (WWTP) effluents and surface waters of many countries has increased significantly due to their widespread use for HIV treatment. In this study, the removal of stavudine and zidovudine under UV254 photolysis or UV254/H2O2 was investigated in a microcapillary film (MCF) photoreactor, using minimal water samples quantities. The UV254 quantum yield of zidovudine, (2.357 ± 0.0589)·10−2 mol ein−1 (pH 4.0–8.0), was 28-fold higher that the yield of stavudine (8.34 ± 0.334)·10−4 mol ein−1 (pH 6.0–8.0). The second-order rate constant kOH,iof reaction of hydroxyl radical with the antiretrovirals (UV254/H2O2 process) were determined by kinetics modeling: (9.98 ± 0.68)·108 M−1 s−1 (pH 4.0–8.0) for zidovudine and (2.03 ± 0.18)·109 M−1 s−1 (pH 6.0–8.0) for stavudine. A battery of ecotoxicological tests (i.e. inhibition growth, bioluminescence, mutagenic and genotoxic activity) using bacteria (Aliivibrio fischeri, Salmonella typhimurium), crustacean (Daphnia magna) and algae (Raphidocelis subcapitata) revealed a marked influence of the UV dose on the ecotoxicological activity. The UV254/H2O2 treatment process reduced the ecotoxicological risk associated to direct photolysis of the antiretrovirals aqueous solutions, but required significantly higher UV254 doses (≥2000 mJ cm−2) in comparison to common water UV disinfection processes

BCR-ABL1 doubling-times and halving-times may predict CML response to tyrosine kinase inhibitors

In Chronic Myeloid Leukemia (CML), successful treatment requires accurate molecular monitoring to evaluate disease response and provide timely interventions for patients failing to achieve the desired outcomes. We wanted to determine whether measuring BCR-ABL1 mRNA doubling-times (DTs) could distinguish inconsequential rises in the oncogene’s expression from resistance to tyrosine kinase inhibitors (TKIs). Thus, we retrospectively examined BCR-ABL1 evolution in 305 chronic-phase CML patients receiving imatinib mesylate (IM) as a first line treatment. Patients were subdivided in two groups: those with a confirmed rise in BCR-ABL1 transcripts without MR3.0 loss and those failing IM. We found that the DTs of the former patients were significantly longer than those of patients developing IM resistance (57.80 vs. 41.45 days, p = 0.0114). Interestingly, the DT values of individuals failing second-generation (2G) TKIs after developing IM resistance were considerably shorter than those observed at the time of IM failure (27.20 vs. 41.45 days; p = 0.0035). We next wanted to establish if decreases in BCR-ABL1 transcripts would identify subjects likely to obtain deep molecular responses. We therefore analyzed the BCR-ABL1 halving-times (HTs) of a different cohort comprising 174 individuals receiving IM in first line and observed that, regardless of the time point selected for our analyses (6, 12, or 18 months), HTs were significantly shorter in subjects achieving superior molecular responses (p = 0.002 at 6 months; p < 0.001 at 12 months; p = 0.0099 at 18 months). Moreover, 50 patients receiving 2G TKIs as first line therapy and obtaining an MR3.0 (after 6 months; p = 0.003) or an MR4.0 (after 12 months; p = 0.019) displayed significantly shorter HTs than individuals lacking these molecular responses. Our findings suggest that BCR-ABL1 DTs and HTs are reliable tools to, respectively, identify subjects in MR3.0 that are failing their assigned TKI or to recognize patients likely to achieve deep molecular responses that should be considered for treatment discontinuation

A Novel Prototype Offset Multi Tubular Photoreactor (OMTP) for solar photocatalytic degradation of water contaminants

The design and operation of a new solar photoreactor prototype named Offset Multi Tubular Photoreactor (OMTP) is presented. The OMTP advances over the compound parabolic collector (CPC) photoreactor, which is one of the most efficient design for large-scale solar detoxification of water and wastewater. The OMTP design is based on a simple modification of the common CPC and included a supplementary set of tubes in the space occupied by the axes of intersection of the CPC reflective involutes. This new reactor configuration increased the irradiated reactor volume by 79% and the fluid residence time by up to 1.8-fold in comparison to the CPC, for the same solar irradiated area (footprint). The model parameters used for comparing and scaling the OMPT and CPC were β (reactor volume/total volume), α (area of absorption/total volume), αg (physical area/total volume), degradation efficiency ηα per unit area, and the operating volume. The total solar energy absorbed in the reactors (1.74 m2 footprint) was 15.17 W for the CPC and 21.86 W for the OMTP, which represents an overall gain of 44% for the latter. The performance of the OMTP and CPC were compared at the same value of solar exposure, β of 0.3 with optimal photocatalyst loading of 0.25 g/L titanium dioxide (TiO2 P25). The degradation efficiencies of methylene blue, dichloroacetic acid, 4-chlorophenol (120 ppm initial concentration) in the OMTP were up to 81%, 125%, 118% and 242% higher, respectively, in comparison to the CPC after 8000 J/m2 of accumulated solar energy. The OMTP should outperform the CPC in environmental and renewable energy applications of solar heterogeneous photocatalysis

F-061 * A COMPARATIVE STUDY AMONG MINIATURIZED ULTRASOUND PROBES FOR PULMONARY NODULES DETECTION IN AN EX VIVO LUNG PERFUSION MODEL

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