A Left Atrial Appendage Closure Combined Procedure Review: past, present and future perspectives

Atrial fibrillation (AF) represents the most common cardiac arrhythmia worldwide; it poses a great burden in terms of quality of life reduction and yearly stroke risk. Left atrial appendage closure (LAAC) is a stroke prevention strategy that has been proven a viable alternative to anti-thrombotic regimens in non-valvular AF patients. LAAC can be performed as a stand-alone procedure or alongside a concomitant AF trans catheter ablation, in a procedure known as "Combined Procedure". Aim of this study is to summarize the scientific evidence backing this combined strategy

Experiments on the MHD Effect on the Drainage of a LiPb Channel and Supporting Numerical Computations with the Level Set Method

To analyze the impact of the magnetohydrodynamics (MHD) effect on the fast draining of a LiPb channel (lithium-lead eutectic, 15.7 at. % Li) for a liquid metal fusion blanket such as the water-cooled lithium-lead test blanket system of ITER or DEMO, an experimental campaign was carried out with the support of the Integrated European Lead Lithium LOop experimental facility (IELLLO), installed at the ENEA Brasimone research center, Italy. The experiments were carried out by measuring the drainage time of the internal permanent magnet pump channel, normally used to circulate the LiPb in the loop, with and without the magnetic field. Moreover, this paper proposes a new numerical methodology to study the time delay induced by the MHD by using the commercial software COMSOL Multiphysics. In this way, it was possible to evaluate the LiPb fraction present at each time step in the computational domain and to estimate the time necessary for the complete drainage of the channel. The level set method was used to describe the transient behavior of the MHD flow under low-Rm approximation. The developed code was compared with the experimental results and showed good agreement, and it constitutes the first step in model validation as a possible application to ITER and DEMO. The experimental and numerical analyses performed in this work can be used as a benchmark case for MHD code development

HDR Brachitherapy for Basal Cell Carcinoma

n/

Phase I clinical and pharmacokinetic study of the oral platinum analogue JM216 given daily for 14 days

Background: The oral bis (acetate) ammine dichloro cyclo-hexylamine platinum (IV) analogue (BMS-182751) was brought into clinical development because it was shown to be cytotoxic against some human tumour cell lines and to have an antitu-mor activity in murine tumours at least comparable to that of parenteral cisplatin and carboplatin. In early clinical studies in which the optimal schedule of treatment was daily for five consecutive days, dose-dependent nausea and vomiting occurred in about two-thirds of patients. Patients and methods: To evaluate if the use of lower daily doses for longer periods of time could result in a better toler-ability, JM216 was given once daily for 14 consecutive days every four to five weeks to adult patients with solid tumors. Oral antiemetics were given prophylactically only at the highest doses. The pharmacokinetics of total and ultrafiltrable platinum were studied on days 1 and 14 of the first cycle by Inductively Coupled-Mass-Spectrometry (ICP-MS). Results: Forty-six patients were treated at doses ranging from 10 mg/m2/d to 50 mg/m2/d and 39 were evaluable for hematologic toxicity over 74 cycles. MTDs were reached at 45 mg/m2/d and 50 mg/m2/d × 14 repeated every five weeks in patients with extensive, or limited/no prior treatment, respectively. The dose-limiting toxicity was neutropenia which was delayed and variable among patients. Other non-hematological toxicities were severe vomiting (22% of cycles), diarrhea (28% of cycles) and drug-associated fever (32% of patients), controlled with paracetamol. Subjective improvement with disappearance of tumour-related pain was observed in one patient with chemotherapy-resistant metastatic prostate cancer and in one previously untreated patient with malignant mesothelioma. Cmax and AUC values of both total and ultrafiltrable platinum on days 1 and 14 were highly variable among patients. Only Cmax on day 1 was linearly related to the dose. Total and ultrafiltrable platinum were still detectable two weeks after the last dose. No relationship could be established between AUC values and toxicities. Conclusions: Daily doses of JM216 of 40 mg/m2 and 45 mg/m2 for 14 consecutive days every five weeks with oral antiemetic prophylaxis are selected for phase II evaluation of single agent in patients with extensive or limited/no prior treatment, respectively. The administration of JM216 on a day × 14 schedule produced nausea and vomiting comparable to that observed with the day × 5 regimen but of longer duration. The variability of pharmacokinetics and pharmacodynamics, even though limited at the doses proposed for phase II evaluation of JM216 as single agent, recommend a careful monitoring of the patient

Probing the in-plane electron spin polarization in Ge/Si0.15 Ge0.85 multiple quantum wells

We investigate spin transport in a set of Ge/Si0.15Ge0.85 multiple quantum wells (MQWs) as a function of the well thickness. We exploit optical orientation to photogenerate spin-polarized electrons in the discrete energy levels of the well conduction band at the Γ point of the Brillouin zone. After diffusion, we detect the optically oriented spins by means of the inverse spin-Hall effect (ISHE) taking place in a thin Pt layer grown on top of the heterostructure. The employed spin injection/detection scheme is sensitive to in-plane spin-polarized electrons, therefore, by detecting the ISHE signal as a function of the photon energy, we evaluate the spin polarization generated by optical transitions driven by the component of the light wave vector in the plane of the wells. In this way, we also gain insight into the electron spin-diffusion length in the MQWs. The sensitivity of the technique to in-plane spin-related properties is a powerful tool for the investigation of the in-plane component of the spin polarization in MQWs, which is otherwise commonly inaccessible