Modal Logics with Hard Diamond-free Fragments

We investigate the complexity of modal satisfiability for certain combinations of modal logics. In particular we examine four examples of multimodal logics with dependencies and demonstrate that even if we restrict our inputs to diamond-free formulas (in negation normal form), these logics still have a high complexity. This result illustrates that having D as one or more of the combined logics, as well as the interdependencies among logics can be important sources of complexity even in the absence of diamonds and even when at the same time in our formulas we allow only one propositional variable. We then further investigate and characterize the complexity of the diamond-free, 1-variable fragments of multimodal logics in a general setting.Comment: New version: improvements and corrections according to reviewers' comments. Accepted at LFCS 201

Cyclische Diazastannylene. - XIX : Zur Reaktion eines Bis-(amino)germylens, - stannylens und -plumbylens mit Phosphortrichlorid und 2,3-Dimethyl-1,3- butadien

Das cyclische Bis(amino)germylen 1 reagiert mit PCl3 unter dreifacher Insertion in die P—Cl-Bindungen und Bildung von [Me2Si(NtBu)2Ge(Cl)]3P (4). 4 kristallisiert triklin in der Raumgruppe P1 mit den Gitterkonstanten: a = 1955,2(9), b = 1378,3(6), c = 1074,3(5) pm, alpha = 90,4(1), beta = 121,6(1), gamma = 97,9(1)° und Z = 2. Nach Röntgenstrukturanalyse besitzt 4 nahezu C3h-Symmetrie, wobei alle Germanium-, Chlor-, und Siliciumatome fast exakt in einer Ebene liegen, zu der die GeN2Si-Ringe senkrecht ausgerichtet sind. Von den schwereren Atomen stört lediglich das Phosphoratom durch eine leicht pyramidale Konfiguration (Ge—P—Ge = 115,0(2)°) die Spiegelsymmetrie. Wichtige mittlere Bindungslängen sind: Ge—P = 231,0(4), Ge—N = 182,4(7), Ge—Cl = 217,9(2) und Si—N = 173,6(7) pm. Die ungewöhnliche, nahezu trigonal planare Koordination des Phosphoratoms in 4 kann mit den besonderen sterischen Gegebenheiten erklärt werden. PCl3 oxidiert das Zinnatom im Bis(amino)stannylen 2 unter Bildung von Me2Si(NtBu)2SnCl2(5); als weiteres Produkt bildet sich ein amorpher Festkörper der analytischen Zusammensetzung (PCl)n. Im Unterschied zu 1 und 2 behält das Bleiatom bei der Umsetzung des Bis(amino)plumbylens 3 mit PCl3 seine Oxydationsstufe bei: in einer Sustitutionsreaktion entstehen Me2Si(NtBu)2PCl (6) und PbCl2. 2, 3-Dimethyl-1, 3-butadien reagiert nur mit dem Germylen 1 zu einem Cycloadditionsprodukt 7 (10%), in dem das Germaniuamtom als Spirozentrum einen SiN2Ge-Vierring mit einem GeC4-Fünfring verknüpft, und zu einem Polymer 8 (90%), dem die gleiche Bruttozusammensetzung zukommt. 2 und 3 dagegen setzen sich mit dem 1, 3-Dien nicht um

Hyperbaric oxygen therapy for late radiation-induced tissue toxicity: Prospectively patient-reported outcome measures in breast cancer patients

__Introduction:__ This study examines patient reported outcome measures of women undergoing hyperbaric oxygen treatment (HBOT) after breast-conserving therapy. __Method:__ Included were 57 women treated with HBOT for late radiation-induced tissue toxicity (LRITT) referred in the period January 2014-December 2015. HBOT consisted of (on average) 47 sessions. In total, 80 min of 100 % O2 was administered under increased pressure of 2.4 ATA. Quality of life was assessed before and after treatment using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR23, and a NRS pain score. __Results:__ Fifty-seven women were available for evaluation before and after treatment. Before HBOT, patients had severe complaints of pain in the arm/shoulder (46 %), swollen arm/hand (14 %), difficulty to raise arm or move it sideways (45 %), pain in the area of the affected breast (67 %), swollen area of the affected breast (45 %), oversensitivity of the affected breast (54 %), and skin problems on/in the area of the affected breast (32 %); post HBOT, severe complaints were still experienced in 17, 7, 22, 15, 13, 15, and 11 % of the women, respectively. Differences were all significant. The NRS pain score improved at least 1 point (range 0-10) in 81 % of the patients (p < 0.05). __Conclusion:__ In these breast cancer patients treated with HBOT for LRITT, the patient-reported outcomes were positive and improvements were observed. HBOT was a well-tolerated treatment for LRITT and its side-effects were both minimal and reversible

Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

PURPOSE: Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients' pain, analgesic use, and pain interference with daily functioning. METHODS: Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm. RESULTS: The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function. CONCLUSIONS: SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning

Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

PURPOSE: Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients' pain, analgesic use, and pain interference with daily functioning. METHODS: Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm. RESULTS: The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function. CONCLUSIONS: SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning

Survival of dental implants in patients with oral cancer treated by surgery and radiotherapy: a retrospective study

BACKGROUND: The aim of this retrospective study was to evaluate the survival of dental implants placed after ablative surgery, in patients affected by oral cancer treated with or without radiotherapy. METHODS: We collected data for 34 subjects (22 females, 12 males; mean age: 51 ± 19) with malignant oral tumors who had been treated with ablative surgery and received dental implant rehabilitation between 2007 and 2012. Postoperative radiation therapy (less than 50 Gy) was delivered before implant placement in 12 patients. A total of 144 titanium implants were placed, at a minimum interval of 12 months, in irradiated and non-irradiated residual bone. RESULTS: Implant loss was dependent on the position and location of the implants (P = 0.05-0.1). Moreover, implant survival was dependent on whether the patient had received radiotherapy. This result was highly statistically significant (P < 0.01). Whether the implant was loaded is another highly significant (P < 0.01) factor determinin

Risks and benefits of bisphosphonates

Bone is the most common site for metastasis in cancer and is of particular clinical importance in breast and prostate cancers due to the prevalence of these diseases. Bone metastases result in considerable morbidity and complex demands on health care resources, affecting quality of life and independence over years rather than months. The bisphosphonates have been shown to reduce skeletal morbidity in multiple myeloma as well as a wide range of solid tumours affecting bone by 30–50%. Quite appropriately, these agents are increasingly used alongside anticancer treatments to prevent skeletal complications and relieve bone pain