Radiotherapy for tumors of the stomach and gastroesophageal junction - a review of its role in multimodal therapy

There is broad consensus on surgical resection being the backbone of curative therapy of gastric- and gastroesophageal junction carcinoma. Nevertheless, details on therapeutic approaches in addition to surgery, such as chemotherapy, radiotherapy or radiochemotherapy are discussed controversially; especially whether external beam radiotherapy should be applied in addition to chemotherapy and surgery is debated in both entities and differs widely between regions and centers. Early landmark trials such as the Intergroup-0116 and the MAGIC trial must be interpreted in the context of potentially insufficient lymph node resection. Despite shortcomings of both trials, benefits on overall survival by radiochemotherapy and adjuvant chemotherapy were confirmed in populations of D2-resected gastric cancer patients by Asian trials. Recent results on junctional carcinoma patients strongly suggest a survival benefit of neoadjuvant radiochemotherapy in curatively resectable patients. An effect of chemotherapy in the perioperative setting as given in the MAGIC study has been confirmed by the ACCORD07 trial for junctional carcinomas; however both the studies by Stahl et al. and the excellent outcome in the CROSS trial as compared to all other therapeutic approaches indicate a superiority of neoadjuvant radiochemotherapy as compared to perioperative chemotherapy in junctional carcinoma patients. Surgery alone without neoadjuvant or perioperative therapy is considered suboptimal in patients with locally advanced disease. In gastric carcinoma patients, perioperative chemotherapy has not been compared to adjuvant radiochemotherapy in a randomized setting. Nevertheless, the results of the recently published ARTIST trial and the Chinese data by Zhu and coworkers, indicate a superiority of adjuvant radiochemotherapy as compared to adjuvant chemotherapy in terms of disease free survival in Asian patients with advanced gastric carcinoma. The ongoing CRITICS trial is supposed to provide reliable conclusions about which therapy should be preferred in Western patients with gastric carcinoma. If radiotherapy is performed, modern approaches such as intensity-modulated radiotherapy and image guidance should be applied, as these methods reduce dose to organs at risk and provide a more homogenous coverage of planning target volumes

Hybridization in parasites: consequences for adaptive evolution, pathogenesis and public health in a changing world

[No abstract available

HOUSE 1 Protostructure: Enhancement of Spatial Imagination and Craftsmanship Between the Digital and the Analogical

Conceived around the concept of protostructure, HOUSE 1 deploys a strategy to answer a daring but simple question: How could we design a house between almost 300 people? The unique pedagogical framework of ALICE, first year Architectural Design course, proposes the integration of a series of full scale physical wooden constructs, enacting collaborative thinking and drawing on collective spatial knowledge. The protostructure constitutes at once both a material and immaterial open source support for the individual and collective interventions by the students. Its material dimension as a physical construction is invested and complemented by the immateriality of the guiding scheme. In this article, we review the steps in the development of the theoretical model and physical implementation of HOUSE 1 and discuss its relevance with regards to the relation between analogical and digital modes of engagement, pedagogical frameworks and spatial cognitive strategies. This implementation of the protostructure shows its potential as a tool to approach wood design, through a combination of digital and analogical processes, enhancing the deployment of spatial cognitive strategies with the use of wood as a material through and with which to think about space

Maternal high fat diet compromises survival and modulates lung development of offspring, and impairs lung function of dams (female mice)

© 2019 The Author(s). Published in Respiratory Research. Background: Epidemiological studies have identified strong relationships between maternal obesity and offspring respiratory dysfunction; however, the causal direction is not known. We tested whether maternal obesity alters respiratory function of offspring in early life. Methods: Female C57Bl/6 J mice were fed a high or low fat diet prior to and during two rounds of mating and resulting pregnancies with offspring lung function assessed at 2 weeks of age. The lung function of dams was measured at 33 weeks of age. Results: A high fat diet caused significant weight gain prior to conception with dams exhibiting elevated fasting glucose, and glucose intolerance. The number of surviving litters was significantly less for dams fed a high fat diet, and surviving offspring weighed more, were longer and had larger lung volumes than those born to dams fed a low fat diet. The larger lung volumes significantly correlated in a linear fashion with body length. Pups born from the second pregnancy had reduced tissue elastance compared to pups born from the first pregnancy, regardless of the dam's diet. As there was reduced offspring survival born to dams fed a high fat diet, the statistical power of lung function measures of offspring was limited. There were signs of increased inflammation in the bronchoalveolar lavage fluid of dams (but not offspring) fed a high fat diet, with more tumour necrosis factor-α, interleukin(IL)-5, IL-33 and leptin detected. Dams that were fed a high fat diet and became pregnant twice had reduced fasting glucose immediately prior to the second mating, and lower levels of IL-33 and leptin in bronchoalveolar lavage fluid. Conclusions: While maternal high fat diet compromised litter survival, it also promoted somatic and lung growth (increased lung volume) in the offspring. Further studies are required to examine downstream effects of this enhanced lung volume on respiratory function in disease settings

Natural Variation in an ABC Transporter Gene Associated with Seed Size Evolution in Tomato Species

Seed size is a key determinant of evolutionary fitness in plants and is a trait that often undergoes tremendous changes during crop domestication. Seed size is most often quantitatively inherited, and it has been shown that Sw4.1 is one of the most significant quantitative trait loci (QTLs) underlying the evolution of seed size in the genus Solanum—especially in species related to the cultivated tomato. Using a combination of genetic, developmental, molecular, and transgenic techniques, we have pinpointed the cause of the Sw4.1 QTL to a gene encoding an ABC transporter gene. This gene exerts its control on seed size, not through the maternal plant, but rather via gene expression in the developing zygote. Phenotypic effects of allelic variation at Sw4.1 are manifested early in seed development at stages corresponding to the rapid deposition of starch and lipids into the endospermic cells. Through synteny, we have identified the Arabidopsis Sw4.1 ortholog. Mutagenesis has revealed that this ortholog is associated with seed length variation and fatty acid deposition in seeds, raising the possibility that the ABC transporter may modulate seed size variation in other species. Transcription studies show that the ABC transporter gene is expressed not only in seeds, but also in other tissues (leaves and roots) and, thus, may perform functions in parts of the plants other than developing seeds. Cloning and characterization of the Sw4.1 QTL gives new insight into how plants change seed during evolution and may open future opportunities for modulating seed size in crop plants for human purposes

Adverse effects of extra-articular corticosteroid injections: a systematic review

<p>Abstract</p> <p>Background</p> <p>To estimate the occurrence and type of adverse effects after application of an extra-articular (soft tissue) corticosteroid injection.</p> <p>Methods</p> <p>A systematic review of the literature was made based on a PubMed and Embase search covering the period 1956 to January 2010. Case reports were included, as were prospective and retrospective studies that reported adverse events of corticosteroid injection. All clinical trials which used extra-articular corticosteroid injections were examined. We divided the reported adverse events into major (defined as those needing intervention or not disappearing) and minor ones (transient, not requiring intervention).</p> <p>Results</p> <p>The search yielded 87 relevant studies:44 case reports, 37 prospective studies and 6 retrospective studies. The major adverse events included osteomyelitis and protothecosis; one fatal necrotizing fasciitis; cellulitis and ecchymosis; tendon ruptures; atrophy of the plantar fat was described after injecting a neuroma; and local skin effects appeared as atrophy, hypopigmentation or as skin defect. The minor adverse events effects ranged from skin rash to flushing and disturbed menstrual pattern. Increased pain or steroid flare after injection was reported in 19 studies. After extra-articular injection, the incidence of major adverse events ranged from 0-5.8% and that of minor adverse events from 0-81%. It was not feasible to pool the risk for adverse effects due to heterogeneity of study populations and difference in interventions and variance in reporting.</p> <p>Conclusion</p> <p>In this literature review it was difficult to accurately quantify the incidence of adverse effects after extra-articular corticosteroid injection. The reported adverse events were relatively mild, although one fatal reaction was reported.</p

Measuring the optical point spread function of FACT using the Cherenkov camera

FACT, the First G-APD Cherenkov Telescope, is an Imaging Air Cherenkov Telescope (IACT) operating since 2011 at the Observatorio del Roque de los Muchachos on the Canary Island of La Palma. As typical for IACTs, its reflector is comprised of smaller mirror facets and not protected by a dome. In the case of FACT, 30 hexagonal facets form a total mirror area of 9:5m². Hence, it is crucial to monitor the optical properties of this system and realign the facets if necessary. Up to now, measuring the Point Spread Function of FACT required human interaction to mount a screen and an optical camera. In this contribution, a new method to measure the optical Point Spread Function using directly the Cherenkov camera of the telescope is presented. Inspired by the method radio telescopes use to determine their resolution, the telescope is pointed towards a fixed position on the trajectory of a star. During the star’s passage through the field of view, the camera is read out using a fixed rate. In each event, the pedestal variance is determined for each pixel. This value is directly correlated with the amount of night sky background light a pixel received. Translating the time of the measurement to the position of the star in the camera enables to determine the optical point spread function from this measurement. As the measurement is done for each pixel along the trajectory of the star, the Point Spread Function can be determined not only for the camera center but for the entire field of view. In this contribution, the new method will also be compared with the existing methods of determining the optical Point Spread Function: direct measurement with an optical camera and the width of Muon ring events.M. Noethe, J. Adam, M. L. Ahnen, D. Baack, M. Balbo, A. Biland, M. Blank, T. Bretz, K. Bruegge, J. Buss, A. Dmytriiev, D. Dorner, S. Einecke, D. Elsaesser, C. Hempfling, T. Herbst, D. Hildebrand, L. Kortmann, L. Linhoff, M. Mahlke, K. Mannheim, S. A. Mueller, D. Neise, A. Neronov, J. Oberkirch, A. Paravac, F. Pauss, W. Rhode, B. Schleicher, F. Schulz, A. Shukla, V. Sliusar, F. Temme, J. Thaele, R. Walte