Immunotherapy in elderly patients

In the recent years the growing life expectancy of the population and increasing cancer burden in elderly patients substantiate the urgent need for the search of optimal cancer treatment strategies. This article provides an overview of the current literature on the efficacy and safety of checkpoint inhibitors in the elderly population. A literature search for published studies using Medline (PubMed) and Elibrary databases was performed. All studies containing data on treatment results including tumor response criteria, treatment response rate, tumor control rate, overall survival were included. Case studies, animal studies and studies containing duplicate results were excluded from the analysis. In elderly patients with cancer there is a substantial number of comorbid conditions and functional disorders, which may decrease the efficacy and modulate the tolerability of immune checkpoint inhibitors (ICI). Besides, different changes associated with immunologic ageing, including thymolysis, increase of the number of memory B-cells and a decrease of hematopoesis intensity are observed. Several studies performed a comparative analysis of efficacy and toxicity of ICIs in elderly and younger patients. In most cases similar results for efficacy and toxicity were demonstrated. To evaluate the toxicity and the influence of treatment on functional status and other important measures in geriatric population further studies of factors, influencing the tolerability and treatment response of newer ICI in elderly cancer patients are needed, including additional adverse events associated with treatment

Effect of implantation regimes of silver ions on the structure and optical properties of zinc-oxide nanocrystalline films

© 2016, Pleiades Publishing, Ltd.Thin (about 270 nm) nanocrystalline films of zinc oxide (ZnO) are obtained on quartz substrates using ion sputtering and irradiated with Ag+ ions at an energy of 30 keV and relatively high fluences at ion current densities of 4, 8, and 12 µA/cm2. The X-ray analysis, scanning electron microscopy, and optical spectroscopy are used to study the effect of irradiation dose and ion current density on the structural modification and optical properties of the ZnO films. Nontrivial dependences of the structural and optical parameters of the films on the ion irradiation regimes are due to radiation heating and film sputtering under the action of the ion beam, diffusion of impurity, formation of silver nanoparticles in the irradiated layer at high implantation fluences, and the diffusion of implanted impurity at relatively high ion current densities

Optical properties of ZnO and Al2O3 implanted with silver ions

ZnO and Al2O3 samples implanted with 30-keV silver ions with fluences in the interval (0.25-1.00) × 1017 ions/cm2 are studied by the method of optical photometry in the visible part of the spectrum. The optical transmission spectra of the implanted samples exhibit a selective band associated with surface plasmon resonance absorption of silver nanoparticles. The intensity of this band nonmonotonically depends on the implantation fluence. The silver ion depth distribution in the samples is calculated. It is shown that the non-monotonicity observed in experiments is due to an increase in the substrate sputtering ratio with increasing implantation fluence. It is found that vacuum thermal annealing of the implanted Al2O3 layers up to 700°C causes a considerable narrowing of the plasmon absorption bandwidth without a tangible change in its intensity. At higher annealing temperatures, the plasmon absorption band broadens and its intensity drops. Annealing of the ZnO films under such conditions causes their complete vaporization. © 2014 Pleiades Publishing, Ltd

Effects of nickel ions implantation and subsequent thermal annealing on structural and magnetic properties of titanium dioxide

© Published under licence by IOP Publishing Ltd. Wide bandgap semiconducting rutile (TiO2) doped with 3d-elements is a promising material for spintronic applications. In our work a composite material of TiO2:Ni has been formed by using implantation of Ni+ ions into single-crystalline (100)- and (001)- plates of TiO2. Sub-micron magnetic layers of TiO2 containing nickel dopant have been obtained at high implantation fluence of 1×1017 ion/cm2. A part of the implanted samples was then annealed in vacuum at different temperatures T ann 450-1200 K for 30 min. The influence of the implantation fluence, crystalline orientation, as well as subsequent annealing on the structural and magnetic properties of the nickel-implanted TiO2 have been investigated by using X-ray photoelectron spectroscopy, scanning electron microscopy and coil magnetometry techniques

Optical and electrical studies of ZnO thin films heavily implanted with silver ions

© Published under licence by IOP Publishing Ltd. Thin films of zinc oxide (ZnO) with the thickness of 200 nm have been deposited on quartz substrates by using ion-beam sputtering technique. Then Ag+ ions with the energy of 30 keV have been implanted into as-deposited ZnO films to the fluences in the range of (0.25-1.00)×1017 ions/cm2 to form ZnO:Ag composite layers with different concentrations of the silver impurity. The analysis of the microstructure has shown that the thickness of the ZnO film decreases, and the Ag dopant concentration tends to the saturation with increasing Ag implantation fluence. The ZnO:Ag composite layers reveal the optical selective absorption at the wavelength of the surface plasmon resonance that is typical for silver nanoparticles dispersed in the ZnO matrix. The red shift of the plasmon resonance peak from 480 to 500 nm is observed with the increase in the implantation fluence to 0.75×1017 Ag ions/cm2. Then the absorption peak position starts the backward motion, and the absorption intensity decreases with the subsequent increase in the implantation fluence. The non-monotonic dependence of the absorption peak position on the implantation fluence has been analyzed within of Maxwell Garnet theory and taking into account the strong sputtering of ZnO films during implantation. The ZnO:Ag composite layers exhibit the p-type conductivity indicating that a part of Ag+ ions is in the form of acceptor impurities implanted into the ZnO lattice

Introduction to geographic information systems (GIS)

The presentation reviews the development and application of geographic information systems (GIS) in terms of its capacity to store information about the world as a collection of thematic layers that can be linked together by geography. The real world consists of many geographies which in GIS can be represented with a number of related data layers such as: hydrology, topography, land use, soil, streets, utilities, districts etc. GIS analytical capabilities provide access to raw data, which can then be aggregated or reclassified

New organic-inorganic hybrid ureasil-based polymer and glass-polymer composites with ion-implanted silver nanoparticles

The micro-/nanoscopic structure of the hybrid organic-inorganic materials, based on polyether chains covalently linked to a silica framework through urea bridges, referred as ureasilicates or ureasils, and As2S3-ureasil composites with ion-implanted Ag nanoparticles is investigated. The formation of Ag nanoparticles is confirmed using optical transmission (surface plasmon resonance band of Ag nanoparticles) at ion-implantation doses of 2.5×1016 and 5.0×1016 ion/cm2 on the example of ureasil. It is established with scanning electron microscopy that incorporation of the As2S3 clusters into ureasil assists to ion-synthesis of Ag nanoparticles in polymer matrix, more effectively at higher doses of ion-implantation and for silver containing (As2S3)95Ag5-ureasil composite. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim

On the question of structure of ZnO thin films formed by IBAD and subsequently implanted with silver ions

© 2018 Institute of Physics Publishing. All rights reserved. Nanocrystalline ZnO thin films with a thickness of ∼ 235 nm were synthesized by ion beam-assisted deposition (IBAD) technique using a metal target of zinc and oxygen (O2) as a reactive gas. The near-surface region of the synthesized films was subsequently implanted with 30 keV Ag+ ions in the fluence range of (0.25-1)×1017 ion/cm2 at high ion current density of 12 μA/cm2. The structure parameters and morphology of as-deposited and subsequently implanted with silver ions ZnO films were investigated by X-ray diffraction and scanning electron microscopy techniques. It was found that the as-deposited ZnO films have inhomogeneous structure, which consists of nanocrystallites and disordered amorphous phase. The nanocrystallites of the obtained ZnO thin films have values of lattice parameters higher than for a bulk ZnO. Subsequent implantation with silver ions leads to a significant radiation heating and microstress relaxation of the film as well as to an increase in the size of nanocrystallites due to the amorphous phase

Fabrication of composite based on GeSi with Ag nanoparticles using ion implantation

© 2016, Pleiades Publishing, Ltd.Comparative analysis of the structural and optical properties of composite layers fabricated with the aid of implantation of single-crystalline silicon (c-Si) using Ge+ (40 keV/1 × 1017 ions/cm2) and Ag+ (30 keV/1.5 × 1017 ions/cm2) ions and sequential irradiation using Ge+ and Ag+ ions is presented. The implantation of the Ge+ ions leads to the formation of Ge: Si fine-grain amorphous surface layer with a thickness of 60 nm and a grain size of 20–40 nm. The implantation of c-Si using Ag+ ions results in the formation of submicron porous amorphous a-Si structure with a thickness of about 50 nm containing ion-synthesized Ag nanoparticles. The penetration of the Ag+ ions in the Ge: Si layer stimulates the formation of pores with Ag nanoparticles with more uniform size distribution. The reflection spectra of the implanted Ag: Si and Ag: GeSi layers exhibit a sharp decrease in the intensity in the UV (220–420 nm) spectral interval relative to the intensity of c-Si by more than 50% owing to the amorphization and structuring of surface. The formation of Ag nanoparticles in the implanted layers gives rise to a selective band of the plasmon resonance at a wavelength of about 820 nm in the optical spectra. Technological methods for fabrication of a composite based on GeSi with Ag nanoparticles are demonstrated in practice

ПРОФИЛАКТИКА НЕСПЕЦИФИЧЕСКИХ ОСЛОЖНЕНИЙ ПОСЛЕ РЕЗЕКЦИЙ ПЕЧЕНИ У ПАЦИЕНТОВ СТАРЧЕСКОГО ВОЗРАСТА

Elderly patients constitute  a significant part of patients undergoing liver resection. Non-specific cardio-vascular and pulmonary complications as well as postoperative delirium are common in this group of patients. We analyzed the impact of a standardized perioperative care protocol on the rate of such complications after resections of the liver in patients younger and older than 70 years. Material and methods We analyzed the results of elective liver resections, performed in the Department of Surgical Oncology of the Medical and Rehabilitation Center under the Ministry of Health from 2013 to 2016. There were 122 resection in 99 patients less than 70 years old and 30 procedures in 29 elderly patients. Patients in the elderly group had significantly more cardio-vascular co-morbidities whereas younger patients have had preoperative chemotherapy more often.Results.There were no differences regading the extent of liver resection, bloodloss,  operating time. Severe morbidity (Clavien-Dindo III–IV grade) developed in 22 and 20% among patients younger and older 70, respectively, mortality was 6 and 7%. Elderly patients developed liver failure more often (13 vs 7%). There were 3 nonspecific complications: pneumonia and heart failure in patients younger than 70 years and atrial fibrillation in an elderly patient. Conclusion Standardized protocol of perioperative care in patients undergoing hepatectomy leads to a very low rate of non-specific postoperative complications.Пациенты пожилого и старческого возраста составляют все более значимую группу среди оперированных на печени больных. Высокий риск развития осложнений со стороны сердечно-сосудистой и дыхательной систем, а также послеоперационной энцефалопатии делает актуальным поиск методов профилактики подобных неспецифических осложнений резекций печени в данной группе пациентов. Нами изучено влияние стандартизированного  протокола периоперационного ведения пациентов с заболеваниями печени в возрасте до и старше 70 лет на частоту данных осложнений.Материалы и методы. Проанализированы результаты лечения пациентов, которым была выполнена резекция печени в отделении хирургической онкологии ФГАУ «ЛРЦ» за 2013–2016 гг. Проведен сравнительный анализ результатов 122 плановых резекций печени, проведенных у 99 больных в возрасте до 70 лет, и 30 аналогичных вмешательств,  выполненных у 29 более пожилых пациентов. Среди пациентов старше 70 лет была отмечена значительно более высокая частота сопутствующих заболеваний  сердечнососудистой системы, в то время как у более молодх пациентов значительно чаще проводилась предоперационная химиотерапия.Результаты. Различий между группами по объему операций, продолжительности кровопотери, длительности вмешательств отмечено не было. Число тяжелых (III–IV ст. по классификации Dindo-Clavien) осложнений  у пациентов до и старше 70 лет, соответственно, составило 22% и 20%, летальных исходов – 6% и 7%. Несмотря на сопоставимую долю обширных резекций в группах пациентов, у более пожилых пациентов чаще развивалась печеночная недостаточность (13 против 7%). Неспецифические осложнения развились у 3 пациентов: пневмония и сердечная недостаточность в группе больных до 70 лет, и фибрилляция предсердий в группе пожилых пациентов.Заключение. Применение стандартизированного протокола периоперационного ведения пациентов, нуждающихся в резекции печени, позволяет снизить число неспецифических осложнений операции вне зависимости от возраста