Optimization of extracorporeal shock wave lithotripsy delivery rates achieves excellent outcomes in ureteral stones. Results of a prospective, randomized trial

PURPOSE Management of ureteral stones remains controversial. To determine whether optimizing extracorporeal shock wave lithotripsy (ESWL) delivery rates improves treatment of solitary ureteral stones, we compared outcomes of two SW delivery rates in a prospective, randomized trial. MATERIALS AND METHODS From July 2010 to October 2012, 254 consecutive patients were randomized to undergo ESWL at SW delivery rates of either 60 pulses (n=130) or 90 pulses (n=124) per min. The primary endpoint was stone-free rate at 3-month follow-up. Secondary endpoints included stone disintegration, treatment time, complications, and the rate of secondary treatments. Descriptive statistics were used to compare endpoints between the two groups. Adjusted odds ratios and 95% confidence intervals were calculated to assess predictors of success. RESULTS The stone-free rate at 3 months was significantly higher in patients who underwent ESWL at a SW delivery rate of 90 pulses per min than in those receiving 60 pulses (91% vs. 80%, p=0.01). Patients with proximal and mid-ureter stones, but not those with distal ureter stones, accounted for the observed difference (100% vs. 83%; p=0.005; 96% vs. 73%, p=0.03; and 81% vs. 80%, p=0.9, respectively). Treatment time, complications, and the rate of secondary treatments were comparable between the two groups. In multivariable analysis, SW delivery rate of 90 pulses per min, proximal stone location, stone density, stone size and the absence of an indwelling JJ stent were independent predictors of success. CONCLUSIONS Optimization of ESWL delivery rates can achieve excellent results for ureteral stones.

DNA triple-helix formation at pyrimidine-purine inversion sites

A systematic investigation of a series of triplex forming oligonucleotides (TFOs) containing alpha- and beta-thymidine, alpha- and beta-N7-hypoxanthine, and alpha- and beta- N7 and N9 aminopurine nucleosides, designed to bind to T-A inversion sites in DNA target sequences was performed. Data obtained from gel mobility assays indicate that t-A recognition in the antiparallel triple-helical binding motif is possible if the nucleoside alpha N9-aminopurine is used opposite to the inversion site in the TFO.

Triple-helix formation in the antiparallel binding motif of oligodeoxynucleotides containing N(9)- and N(7)-2-aminopurine deoxynucleosides

Triplex-forming oligodeoxynucleotide 15mers, designed to bind in the antiparallel triple-helical binding motif, containing single substitutions (Z) of the four isomeric alphaN(7)-, betaN(7)-, alphaN(9)- and betaN(9)-2-aminopurine (ap)-deoxyribonucleosides were prepared. Their association with double-stranded DNA targets containing all four natural base pairs (X-Y) opposite the aminopurine residues was determined by quantitative DNase I footprint titration in the absence of monovalent metal cations. The corresponding association constants were found to be in a rather narrow range between 1.0 x 10(6) and 1.3 x 10(8) M(-1). The following relative order in Z x X-Y base-triple stabilities was found: Z = alphaN(7)ap: T-A > A-T> C-G approximately G-C; Z = betaN(7)ap: A-T > C-G > G-C > T-A; Z = alphaN(9)ap: A-T = G-C > T-A > C-G; and Z = betaN(9)ap: G-C > A-T > C-G > T-A

Evidence for C−H⋅⋅⋅O Hydrogen Bond Assisted Recognition of a Pyrimidine Base in the Parallel DNA Triple-Helical Motif

The efficient recognition of the pyrimidine base uracil by hypoxanthine or thymine in the parallel DNA triplex motif is based on the interplay of a conventional N−H⋅⋅⋅O and an unconventional C−H⋅⋅⋅O hydrogen bond.

COX-2 expression in operable triple negative breast cancer: A hospital based cross-sectional study

Objectives. Triple Negative Breast Cancer (TNBC) lack expression of estrogen receptors (ER), progesterone receptors (PR), and absence of Her2 gene amplification. Current literature has identified TNBC and over-expression of cyclo-oxygenase-2 (COX-2) protein in primary breast cancer to be independent markers of poor prognosis in terms of overall and distant disease free survival. The purpose of this study was to compare COX-2 over-expression in TNBC patients to those patients who expressed one or more of the three tumor markers (i.e. ER, and/or PR, and/or Her2).^ Methods. Using a secondary data analysis, a cross-sectional design was implemented to examine the association of interest. Data collected from two ongoing protocols titled "LAB04-0657: a model for COX-2 mediated bone metastasis (Specific aim 3)" and "LAB04-0698: correlation of circulating tumor cells and COX-2 expression in primary breast cancer metastasis" was used for analysis. A sample of 125 female patients was analyzed using Chi-square tests and logistic regression models. ^ Results. COX-2 over-expression was present in 33% (41/125) and 28% (35/124) patients were identified as having TNBC. TNBC status was associated with elevated COX-2 expression (OR= 3.34; 95% CI= 1.40–8.22) and high tumor grade (OR= 4.09; 95% CI= 1.58–10.82). In a multivariable analysis, TNBC status was an important predictor of COX-2 expression after adjusting for age, menopausal status, BMI, and lymph node status (OR= 3.31; 95% CI: 1.26–8.67; p=0.01).^ Conclusion. TNBC is associated with COX-2 expression—a known marker of poor prognosis in patients with operable breast cancer. Replication of these results in a study with a larger sample size, or a future randomized clinical trial demonstrating an improved prognosis with COX-2 suppression in these patients would support this hypothesis.^

Survival analysis of circulating tumor cells in triple-negative breast cancer

Background. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% (1.38 million) of the total new cancer cases and 14% (458,400) of the total cancer deaths in 2008. [1] Triple-negative breast cancer (TNBC) is an aggressive phenotype comprising 10–20% of all breast cancers (BCs). [2-4] TNBCs show absence of estrogen, progesterone and HER2/neu receptors on the tumor cells. Because of the absence of these receptors, TNBCs are not candidates for targeted therapies. Circulating tumor cells (CTCs) are observed in blood of breast cancer patients even at early stages (Stage I & II) of the disease. Immunological and molecular analysis can be used to detect the presence of tumor cells in the blood (Circulating tumor cells; CTCs) of many breast cancer patients. These cells may explain relapses in early stage breast cancer patients even after adequate local control. CTC detection may be useful in identifying patients at risk for disease progression, and therapies targeting CTCs may improve outcome in patients harboring them. Methods . In this study we evaluated 80 patients with TNBC who are enrolled in a larger prospective study conducted at M D Anderson Cancer Center in order to determine whether the presence of circulating tumor cells is a significant prognostic factor in relapse free and overall survival . Patients with metastatic disease at the time of presentation were excluded from the study. CTCs were assessed using CellSearch System™ (Veridex, Raritan, NJ). CTCs were defined as nucleated cells lacking the presence of CD45 but expressing cytokeratins 8, 18 or 19. The distribution of patient and tumor characteristics was analyzed using chi square test and Fisher's exact test. Log rank test and Cox regression analysis was applied to establish the association of circulating tumor cells with relapse free and overall survival. Results. The median age of the study participants was 53years. The median duration of follow-up was 40 months. Eighty-eight percent (88%) of patients were newly diagnosed (without a previous history of breast cancer), and (60%) of patients were chemo naïve (had not received chemotherapy at the time of their blood draw for CTC analysis). Tumor characteristics such as stage (P=0.40), tumor size (P=69), sentinel nodal involvement (P=0.87), axillary lymph node involvement (P=0.13), adjuvant therapy (P=0.83), and high histological grade of tumor (P=0.26) did not predict the presence of CTCs. However, CTCs predicted worse relapse free survival (1 or more CTCs log rank P value = 0.04, at 2 or more CTCs P = 0.02 and at 3 or more CTCs P < 0.0001) and overall survival (at 1 or more CTCs log rank P value = 0.08, at 2 or more CTCs P = 0.01 and at 3 or more CTCs P = 0.0001. Conclusions. The number of circulating tumor cells predicted worse relapse free survival and overall survival in TNBC patients.^

Antropología de las relaciones transnacionales en las regiones de frontera. El caso de la Triple Frontera entre Argentina, Brasil, Paraguay. 16H363

La triple frontera entre Argentina, Brasil y Paraguay, concebida como una amplia región con epicentro en la red urbana Puerto Iguazú, Foz do Iguazú y Ciudad del Este y otras localidades satélites, y que reconoce, además, dos puntos de gran importancia como Posadas/Encarnación y Bernardo de Irigoyen/Dionisio Cerqueira, comprende en realidad, un territorio muchos más vasto que abarca la provincia argentina de Misiones, la zona occidentalde los estados del sur de Brasil y el sur de Mato Grosso do Sul y el este de Paraguay. En este espacio tienen lugar múltiples relaciones transnacionales: económicas, políticas, sociales, culturales, etcétera que poseen una dilatada historia pero que, a partir de la integración y el MERCOSUR adquirieron una complejidad y densidad en permanente crecimiento y además, el surgimiento de procesos emergentes cuyo conocimiento supone un imperativo ineludible. Hemos investigado en los proyectos anteriores, ocho en total, los dos niveles en los que consideramos deben estudiarse estos procesos. Un nivel de escala mayor que trata de comprender la complejidad de una formación socioeconómica y espacial transnacional y su lugar en el ajedrez nacional e internacional del sistema imperial y, otro nivel, consistente en la profundización de problemas específicos de la región fronteriza como: redes sociales, mercado de trabajo, migraciones, exilio, solidaridad y lucha, movimientos sociales, gestión de ecosistemas compartidos, proyectos de desarrollo comunes, foros de esclarecimiento y defensa regionales, e integración del conocimiento.

Chemical composition of basalts and minerals from basalts of the Bouvet triple junction

This study focuses on mafic volcanic rocks from the Bouvet triple junction, which fall into six geochemically distinct groups: (1) N-MORB, the most widespread type, encountered throughout the study area. (2) Subalkaline volcanics, hawaiites and mugearites strongly enriched in lithophile elements and radiogenic isotopes and composing the Bouvet volcanic rise, and compositionally similar basalts and basaltic andesites from the Spiess Ridge, generated in a deeper, fertile mantle region. (3) Relatively weakly enriched basalts, T-MORB derived by the mixing of Type 1 and 2 melts and exposed near the axes of the Mid-Atlantic, Southwest Indian, and America-Antarctic Ridges. (4) Basalts with a degree of trace lithophile element enrichment similar to the Spiess Ridge and Bouvet Island rocks, but higher in K, P, Ti, and Cr. These occur within extensional structures: the rift valley of the Southwest Indian Ridge, grabens of the East Dislocation Zone, and the linear rise between the Spiess Ridge and Bouvet volcano. Their parental melts presumably separated from plume material that spread from the main channels and underwent fluid-involving differentiation in the mantle. (5) A volcanic suite ranging from basalt to rhyolite, characterized by low concentrations of lithophile elements, particularly TiO2, and occurring on the Shona Seamount and other compressional features within the Antarctic and South American plates near the Bouvet triple junction. Unlike Types 1 to 4, which display tholeiitic differentiation trends, this suite is calc-alkaline. Its parental melts were presumably related to the plume material as well but, subsequently, they underwent a profound differentiation involving fluids and assimilated surrounding rocks in closed magma chambers in the upper mantle. Alternatively, the Shona Seamount might be a fragment of an ancient oceanic island arc. (6) Enriched basalts, distinguished from the other enriched rock types in very high P and radiogenic isotope abundances and composing a tectonic uplift near the junction of the three rifts. It thus follows that the main factors responsible for the compositional diversity of volcanic rocks in this region include (i) mantle source heterogeneity, (ii) plume activity, (iii) an intricate geodynamic setup at the triple junction giving rise to stresses in adjacent plate areas, and (iv) the geological prehistory. The slow spreading rate and ensuing inefficient mixing of the heterogeneous mantle material result in strong spatial variations in basaltic compositions.

Las agencias de calificación crediticia (Las hijas de Elena: La triple a)

En este trabajo, en primer lugar, se analiza la estructura (accionariado), funcionalidad (cómo funcionan y emiten sus opiniones) y el comportamiento (cómo actúan en los mercados) de las tres agencias más importantes de calificación de activos financieros, de emisores y emisiones de activos financieros. En segundo término, se señalan sus poco, si algo, científicas evaluaciones basadas en conceptos y actuaciones tan poco adecuadas como: profecía autocumplida, carencia de fecha de caducidad, catastrofismo, que, a veces, imponen con comportamientos gansteriles. Asimismo, se destaca la importancia y trascendencia que suponen las opiniones que emiten dichas agencias, auténticos ucases, que las convierten, de facto, en auténticos señores de horca y caudillo que acondicionan la vida y hacienda de inversores y emisores. En realidad, su comportamiento es tan deplorable y funesto, que como las hijas de Elena, de ahí el título del trabajo, ninguna es buena. Finalmente, se presenta, en forma de decálogo, los hechos, irrefutables, que justifican el calificativo de malvadas de dichas agencias: S&P, Moody?s y Fitch, hasta el punto de que son el antimefistofelismo personificado. Mefistófeles se definía a sí mismo como un pobre diablo que pretendiendo hacer el mal, acababa haciendo el bien, justo al revés que las hijas de Elena.

Highly conductive p++-AlGaAs/n ++-GaInP tunnel junctions for ultra-high concentrator solar cells

Tunnel junctions are key for developing multijunction solar cells (MJSC) for ultra-high concentration applications. We have developed a highly conductive, high bandgap p  + + -AlGaAs/n  + + -GaInP tunnel junction with a peak tunneling current density for as-grown and thermal annealed devices of 996 A/cm 2 and 235 A/cm 2, respectively. The J–V characteristics of the tunnel junction after thermal annealing, together with its behavior at MJSCs typical operation temperatures, indicate that this tunnel junction is a suitable candidate for ultra-high concentrator MJSC designs. The benefits of the optical transparency are also assessed for a lattice-matched GaInP/GaInAs/Ge triple junction solar cell, yielding a current density increase in the middle cell of 0.506 mA/cm 2 with respect to previous designs.

Characterization of the manufacturing processes to grow triple-junction solar cells

A number of important but little-investigated problems connected with III-V/Ge heterostructure in the GaInP/GaInAs/Ge multijunction solar cells grown by MOVPE are considered in the paper. The opportunity for successfully applying the combination of reflectance and reflectance anisotropy spectroscopy in situ methods for investigating III-V structure growth on a Ge substrate has been demonstrated. Photovoltaic properties of the III-V/Ge narrow-band subcell of the triple-junction solar cells have been investigated. It has been shown that there are excess currents in the Ge photovoltaic p-n junctions, and they have the tunneling or thermotunneling character. The values of the diode parameters for these current flow mechanisms have been determined. The potential barrier at the III-V/Ge interface was determined and the origin of this barrier formation during MOVPE heterogrowth was suggested.

Protein-free parallel triple-stranded DNA complex formation

A 14 nt DNA sequence 5′-AGAATGTGGCAAAG-3′ from the zinc finger repeat of the human KRAB zinc finger protein gene ZNF91 bearing the intercalator 2-methoxy,6-chloro,9-amino acridine (Acr) attached to the sugar–phosphate backbone in various positions has been shown to form a specific triple helix (triplex) with a 16 bp hairpin (intramolecular) or a two-stranded (intermolecular) duplex having the identical sequence in the same (parallel) orientation. Intramolecular targets with the identical sequence in the antiparallel orientation and a non-specific target sequence were tested as controls. Apparent binding constants for formation of the triplex were determined by quantitating electrophoretic band shifts. Binding of the single-stranded oligonucleotide probe sequence to the target led to an increase in the fluorescence anisotropy of acridine. The parallel orientation of the two identical sequence segments was confirmed by measurement of fluorescence resonance energy transfer between the acridine on the 5′-end of the probe strand as donor and BODIPY-Texas Red on the 3′-amino group of either strand of the target duplex as acceptor. There was full protection from OsO4-bipyridine modification of thymines in the probe strand of the triplex, in accordance with the presumed triplex formation, which excluded displacement of the homologous duplex strand by the probe–intercalator conjugate. The implications of these results for the existence of protein-independent parallel triplexes are discussed.