Guideline versus non-guideline based management of rectal cancer in octogenarians

The number of octogenarians with rectal adenocarcinoma is growing. Current guidelines seem difficult to apply on octogenarians which may result in non-adherence. The aim of this retrospective cohort study is to give insight in occurrence of treatment-related complications, hospitalisations and survival among octogenarians treated according to guidelines versus octogenarians treated otherwise. 108 octogenarians with rectal adenocarcinoma were identified by screening of medical records. 22 patients were excluded for treatment process analysis because of stage IV disease or unknown stage. Baseline characteristics, diagnostic process, received treatment, motivation for deviation from guidelines, complications, hospitalisations and date of death were documented. Patients were divided in two groups depending on adherence to treatment guidelines. Differences in baseline characteristics, treatment-related complications and survival between both groups were evaluated. Diagnosis and treatment according to guidelines occurred in 95 and 54% of the patients, respectively. When documented, patient's preference and comorbidities were major reasons to deviate from guidelines. 66% of patients who were treated according to guidelines experienced complications versus 34% of those treated otherwise (p = 0.02). After adjustment for differences in age and polypharmacy, this association was not significant. Patients treated according to the guideline had better survival 18 months after diagnosis (80 versus 56%, p = 0.02). Treating octogenarians with rectal cancer according to guidelines seem to lead to better overall survival, but may lead to a high risk of complications. This may jeopardise quality of life. More and prospective studies in octogenarians with rectal cancer are needed to customize guidelines for these patients

On the use of fractional Brownian motion simulations to determine the 3D statistical properties of interstellar gas

Based on fractional Brownian motion (fBm) simulations of 3D gas density and velocity fields, we present a study of the statistical properties of spectro-imagery observations (channel maps, integrated emission, and line centroid velocity) in the case of an optically thin medium at various temperatures. The power spectral index gamma_W of the integrated emission is identified with that of the 3D density field (gamma_n) provided the medium's depth is at least of the order of the largest transverse scale in the image, and the power spectrum of the centroid velocity map is found to have the same index gamma_C as that of the velocity field (gamma_v). Further tests with non-fBm density and velocity fields show that this last result holds, and is not modified either by the effects of density-velocity correlations. A comparison is made with the theoretical predictions of Lazarian & Pogosyan (2000).Comment: 28 pages, 14 figures, accepted for publication in ApJ. For preprint with higher-resolution figures, see http://www.cita.utoronto.ca/~mamd/miville_fbm2003.pd

Clinical impact of different detection methods for disseminated tumor cells in bone marrow of patients undergoing surgical resection of colorectal liver metastases: a prospective follow-up study

<p>Abstract</p> <p>Background</p> <p>Large number of patients with colorectal liver metastasis show recurrent disease after curative surgical resection. Identification of these high-risk patients may guide therapeutic strategies. The aim of this study was to evaluate whether the presence of disseminated tumor cells in bone marrow from patients undergoing surgical resection of colorectal liver metastases can predict clinical outcome.</p> <p>Methods</p> <p>Sixty patients with colorectal liver metastases were planned for a curative resection between 2001 and 2007. All patients underwent bone marrow aspiration before surgery. Detection of tumor cells was performed using immunocytochemical staining for cytokeratin (CK-ICC) combined with automated microscopy or indirectly using reverse transcription-polymerase chain reaction (RT-PCR).</p> <p>Results</p> <p>Disseminated tumor cells were found in 15 of the 46 patients (33%) using CK-ICC and in 9 of 44 of the patients (20%) using RT-PCR. Patients with negative results for RT-PCR had a significant better disease-free survival after resection of their liver metastases (p = 0.02). This group also showed significant better overall survival (p = 0.002). CK-ICC did not predict a worse clinical outcome.</p> <p>Conclusions</p> <p>The presence of disseminated tumor cells in bone marrow detected using RT-PCR did predict a worse clinical outcome. The presence of cells detected with CK-ICC did not correlate with poor prognosis.</p

The Nylon Scintillator Containment Vessels for the Borexino Solar Neutrino Experiment

Borexino is a solar neutrino experiment designed to observe the 0.86 MeV Be-7 neutrinos emitted in the pp cycle of the sun. Neutrinos will be detected by their elastic scattering on electrons in 100 tons of liquid scintillator. The neutrino event rate in the scintillator is expected to be low (~0.35 events per day per ton), and the signals will be at energies below 1.5 MeV, where background from natural radioactivity is prominent. Scintillation light produced by the recoil electrons is observed by an array of 2240 photomultiplier tubes. Because of the intrinsic radioactive contaminants in these PMTs, the liquid scintillator is shielded from them by a thick barrier of buffer fluid. A spherical vessel made of thin nylon film contains the scintillator, separating it from the surrounding buffer. The buffer region itself is divided into two concentric shells by a second nylon vessel in order to prevent inward diffusion of radon atoms. The radioactive background requirements for Borexino are challenging to meet, especially for the scintillator and these nylon vessels. Besides meeting requirements for low radioactivity, the nylon vessels must also satisfy requirements for mechanical, optical, and chemical properties. The present paper describes the research and development, construction, and installation of the nylon vessels for the Borexino experiment

Multifractal Scaling, Geometrical Diversity, and Hierarchical Structure in the Cool Interstellar Medium

Multifractal scaling (MFS) refers to structures that can be described as a collection of interwoven fractal subsets which exhibit power-law spatial scaling behavior with a range of scaling exponents (concentration, or singularity, strengths) and dimensions. The existence of MFS implies an underlying multiplicative (or hierarchical, or cascade) process. Panoramic column density images of several nearby star- forming cloud complexes, constructed from IRAS data and justified in an appendix, are shown to exhibit such multifractal scaling, which we interpret as indirect but quantitative evidence for nested hierarchical structure. The relation between the dimensions of the subsets and their concentration strengths (the "multifractal spectrum'') appears to satisfactorily order the observed regions in terms of the mixture of geometries present: strong point-like concentrations, line- like filaments or fronts, and space-filling diffuse structures. This multifractal spectrum is a global property of the regions studied, and does not rely on any operational definition of "clouds.'' The range of forms of the multifractal spectrum among the regions studied implies that the column density structures do not form a universality class, in contrast to indications for velocity and passive scalar fields in incompressible turbulence, providing another indication that the physics of highly compressible interstellar gas dynamics differs fundamentally from incompressible turbulence. (Abstract truncated)Comment: 27 pages, (LaTeX), 13 figures, 1 table, submitted to Astrophysical Journa

Synchronisation of egg hatching of brown hairstreak (Thecla betulae) and budburst of blackthorn (Prunus spinosa) in a warmer future

Synchronisation of the phenology of insect herbivores and their larval food plant is essential for the herbivores’ fitness. The monophagous brown hairstreak (Thecla betulae) lays its eggs during summer, hibernates as an egg, and hatches in April or May in the Netherlands. Its main larval food plant blackthorn (Prunus spinosa) flowers in early spring, just before the leaves appear. As soon as the Blackthorn opens its buds, and this varies with spring temperatures, food becomes available for the brown hairstreak. However, the suitability of the leaves as food for the young caterpillars is expected to decrease rapidly. Therefore, the timing of egg hatch is an important factor for larval growth. This study evaluates food availability for brown hairstreak at different temperatures. Egg hatch and budburst were monitored from 2004 to 2008 at different sites in the Netherlands. Results showed ample food availability at all monitored temperatures and sites but the degree of synchrony varied strongly with spring temperatures. To further study the effect of temperature on synchronisation, an experiment using normal temperatures of a reference year (T) and temperatures of T + 5°C was carried out in climate chambers. At T + 5°C, both budburst and egg hatch took place about 20 days earlier and thus, on average, elevated temperature did not affect synchrony. However, the total period of budburst was 11 days longer, whereas the period of egg hatching was 3 days shorter. The implications for larval growth by the brown hairstreak under a warmer climate are considered.

The hibernation-derived compound SUL-138 shifts the mitochondrial proteome towards fatty acid metabolism and prevents cognitive decline and amyloid plaque formation in an Alzheimer’s disease mouse model

Background: Alzheimer’s disease (AD) is the most prevalent neurodegenerative disease worldwide and remains without effective cure. Increasing evidence is supporting the mitochondrial cascade hypothesis, proposing that loss of mitochondrial fitness and subsequent ROS and ATP imbalance are important contributors to AD pathophysiology. Methods: Here, we tested the effects of SUL-138, a small hibernation-derived molecule that supports mitochondrial bioenergetics via complex I/IV activation, on molecular, physiological, behavioral, and pathological outcomes in APP/PS1 and wildtype mice. Results: SUL-138 treatment rescued long-term potentiation and hippocampal memory impairments and decreased beta-amyloid plaque load in APP/PS1 mice. This was paralleled by a partial rescue of dysregulated protein expression in APP/PS1 mice as assessed by mass spectrometry-based proteomics. In-depth analysis of protein expression revealed a prominent effect of SUL-138 in APP/PS1 mice on mitochondrial protein expression. SUL-138 increased the levels of proteins involved in fatty acid metabolism in both wildtype and APP/PS1 mice. Additionally, in APP/PS1 mice only, SUL-138 increased the levels of proteins involved in glycolysis and amino acid metabolism pathways, indicating that SUL-138 rescues mitochondrial impairments that are typically observed in AD. Conclusion: Our study demonstrates a SUL-138-induced shift in metabolic input towards the electron transport chain in synaptic mitochondria, coinciding with increased synaptic plasticity and memory. In conclusion, targeting mitochondrial bioenergetics might provide a promising new way to treat cognitive impairments in AD and reduce disease progression

Search for electron antineutrino interactions with the Borexino Counting Test Facility at Gran Sasso

Electron antineutrino interactions above the inverse beta decay energy of protons (E_\bar{\nu}_e>1.8) where looked for with the Borexino Counting Test Facility (CTF). One candidate event survived after rejection of background, which included muon-induced neutrons and random coincidences. An upper limit on the solar $\bar{\nu}_{e}$ flux, assumed having the $^8$B solar neutrino energy spectrum, of 1.1$\times10^{5}$ cm$^{-2}$~s$^{-1}$ (90% C.L.) was set with a 7.8 ton $\times$ year exposure. This upper limit corresponds to a solar neutrino transition probability, $\nu_{e} \to \bar{\nu}_{e}$, of 0.02 (90% C.L.). Predictions for antineutrino detection with Borexino, including geoneutrinos, are discussed on the basis of background measurements performed with the CTF.Comment: 10 pages, 9 figures, 5 table