Association of urethral toxicity with dose exposure in combined high-dose-rate brachytherapy and intensity-modulated radiation therapy in intermediate- and high-risk prostate cancer.

INTRODUCTION: To report acute and late toxicities in patients with intermediate- and high-risk prostate cancer treated with combined high-dose-rate brachytherapy (HDR-B) and intensity-modulated radiation therapy (IMRT). MATERIALS AND METHODS: From March 2003 to September 2005, 64 men were treated with a single implant HDR-B with 21 Gy given in three fractions, followed by 50 Gy IMRT along with organ tracking. Median age was 66.1 years, and risk of recurrence was intermediate in 47% of the patients or high in 53% of the patients. Androgen deprivation therapy was received by 69% of the patients. Toxicity was scored according to the CTCAE version 3.0. Median follow-up was 3.1 years. RESULTS: Acute grade 3 genitourinary (GU) toxicity was observed in 7.8% of the patients, and late grades 3 and 4 GU toxicity was observed in 10.9% and 1.6% of the patients. Acute grade 3 gastrointestinal (GI) toxicity was experienced by 1.6% of the patients, and late grade 3 GI toxicity was absent. The urethral V(120) (urethral volume receiving > or =120% of the prescribed HDR-B dose) was associated with acute (P=.047) and late > or = grade 2 GU toxicities (P=.049). CONCLUSIONS: Late grades 3 and 4GU toxicity occurred in 10.9% and 1.6% of the patients after HDR-B followed by IMRT in association with the irradiated urethral volume. The impact of V(120) on GU toxicity should be validated in further studies.

Acute toxicity of curative radiotherapy for intermediate risk localized prostate cancer in the EORTC trial 22991

Introduction: EORTC trial 22991 randomly assessed the addition of concomitant and adjuvant short-term hormonal therapy to curative conformal/intensity-modulated radiotherapy (RT) for intermediate risk localized prostate cancer. We report the acute toxicity (assessed weekly during RT) for the organs at risk (genito-urinary (GU) and gastro-intestinal (GI)) in relation to radiation parameters. Material and Methods: Eligibility criteria were age _80 years, PSA _ 50 ng/ml, N0M0 and either tumour stage cT2a (1997 UICC TNM) or cT1b-c combined with PSA_10 ng/ml and/or Gleason score _7. We report toxicity for all eligible patients who received the planned RT with documented acute toxicity (CTCAEv.2) and RT-quality assurance parameters. The RT dose (70 Gy, 74 Gy or 78 Gy) and technique (3DCRT vs IRMT) were per institution choice, the randomization was stratified for institution. Statistical significance was set at 0.05. (ClinicalTrials.gov: NCT00021450) Results: Of 819 randomized patients, 28 were excluded from the analysis (3 with <60 Gy RT, 25 with missing information). Of the 791 analysed patients, 652 (82.4%) were treated with 3D-CRT, 139 with IMRT. In the 3DCRT group, 195 patients (29.9%) were treated with a total prescribed dose of 70 Gy; 376 (57.7%) with 74 Gy and 81 (12.4%) with 78 Gy. In the IMRT group, 28 (20.1%) were treated to a total dose of 74 Gy and 111 (79.9%) with 78 Gy. Overall, only 7 of 791 patients (0.9%) had grade 3 GI toxicity during RT: diarrhea (N = 6), rectal bleeding (N = 1) and proctitis (N = 1). Fifty patients (6.3%) had grade 3 GU toxicity: urinary frequency (N = 38, 4.6%), dysuria (N = 14, 1.7%), urinary retention (N = 11, 1.3%), urinary incontinence (N = 2) and hematuria (N = 1). No grade 4 toxicity was reported. Hormonal treatment did not influence the risk of side effects (p>0.05). The risk of grade _2 GI toxicity significantly correlated to D50%-rectum (p = 0.004) with a cut-of value of 44 Gy. The risk of grade _2 GU toxicity was moderately affected by Dmax-bladder (p = 0.051). Overall, only 14 patients (1.8%) had residual grade 3 toxicities one month after RT. Conclusion: 3D-CRT and IMRT up to 78 Gy is well tolerated. Dmaxbladder and D50%-rectum were related to the risk of grade_2 GU and GI toxicity, respectively. IMRT lowered D50% rectum and Dmax-bladder. An irradiated volume >400 cc for 3D-RT and a dose of 78 Gy, even for IMRT, negatively affected those parameters and increased the risk for toxicity.

Caracterització del comportament reològic del suc de taronja concentrat a baixes temperatures. Efecte del procés de clarificació

Els sucs de taronja són els de major demanda dins el mercat espanyol i en la majoria de mercats a nivell mundial. Generalment, aquests sucs es comercialitzen amb polpa en suspensió i amb un contingut en sòlids solubles al voltant de 10-12ºBrix. No obstant, per a facilitar el transport i conservació durant l’emmagatzematge, s’obtenen concentrats en forma industrial, i posteriorment es dilueixen afegint aigua fins a la concentració requerida. Les indústries també obtenen sucs clarificats i concentrats que serveixen, entre d’altres, per a preparar mescles. Els sucs concentrats s’obtenen per extracció o premsat del suc i posterior clarificació i concentració mitjançant una etapa d’evaporació, assolint-se finalment productes al voltant dels 65ºBrix. En el procés d’elaboració el suc canvia contínuament de contingut en sòlids solubles i és sotmès a diverses temperatures, motius pels quals variaran les seves propietats, que depenen en gran mesura d’aquests dos paràmetres. Aquest treball d’investigació descrit fins ara, es complementarà amb l’estudi de les alternatives de tecnologia i enginyeria disponibles en la fabricació del suc de taronja concentrat. Aquesta tasca servirà per aprofundir en el coneixement tant del producte objecte de l’estudi com de la seva producció, a més a més d’aplicar sobre un cas concret els coneixements adquirits al llarg dels cinc anys de formació en el camp de l’enginyeria alimentària.

Rheology of high solids surface size starches

Tämän diplomityön tarkoituksena oli tutkia pintaliimatärkkelysten reologista käyttäytymistä korkeissa kuiva-ainepitoisuuksissa. Tarve työn suorittamiselle syntyi kun tutkittiin pintaliimausta filminsiirtopuristimella tavallista korkeammissa kuiva-ainepitoisuuksissa, sileän sauvan ollessa applikointilaitteena. Koska applikointi sileällä sauvalla tapahtuu hydrodynaamisten periaatteiden mukaisesti, sen käyttö edellyttää pintaliimojen reologisten ominaisuuksien tarkkaa tuntemusta ja hallintaa.Kiinnostuksen kohteena olevat ominaisuudet olivat tärkkelysten kuiva-ainepitoisuuden (8 – 30 %) vaikutus viskositeettiin eri lämpötiloissa (20, 30, 40 ja 50 ºC), leikkausnopeus alueella 1 s-1 - 700 000 s-1. Myös tärkkelysten myötörajat määritettiin tutkimuksessa. Viskositeetti eri leikkausnopeusalueilla mitattiin seuraavilla laitteilla: Bohlin VOR (matalat leikkausnopeudet ja myötöraja) ja Hercules HiShear (keskitason leikkausnopeudet) reometrit sekä Eklund kapillaariviskometri (korkeat leikkausno-peudet). Analysoidut tärkkelykset olivat kaksi anionista matalaviskoottista peruna (tärkkelys A) ja ohra (tärkkelys C) tärkkelystä, sekä yksi kationinen korkeaviskoottinen peruna tärkkelys (tärkkelys B). Tutkittujen tärkkelysten Brookfield viskositeetit (100 rpm) olivat (10 % liuos, 60 °C:ssa) tärkkelys A ja C: 25 ± 5 mPas ja tärkkelys B: 100 ± 20 mPas.Tärkkelysliuosten kuiva-ainepitoisuuden noustessa muuttui virtauskäyttäytyminen Newtoniaalisesta leikkausohenevaksi. Leikkausoheneva käyttäytyminen oli voimakkainta tärkkelys B:n kohdalla. Viskositeetti – lämpötila riippuvuus korkeissa leikkausnopeuksissa (esim. 500 000 s-1) oli vähäisempää, mitä oli oletettavissa Brookfield viskositeettiarvojen perusteella. Kaikki tarkkelykset osoittautuivat tiksotrooppisiksi, myös tiksotrooppisuus lisääntyi kuiva-ainepitoisuuden kasvaessa. Tärkkelysten myötörajat osoittautuivat odottamattoman alhaisiksi, kuitenkin varsinkin tärkkelys B:n myötörajat olivat selvästi riippuvaisia lämpötilasta ja kuiva-ainepitoisuudesta. Tutkittujen tärkkelysten virtauskäyttäytyminen oli kirjallisuudessa esitetyn kaltaista. Tärkkelysmolekyylien ketjun pituus oli tärkein tärkkelyksen reologisia ominaisuuksia määrittävä tekijä; mitä matalampi on tärkkelyksen molekyylimassa, sitä matalammat ovat viskositeetti ja myötöraja. Pintaliimauksessa tärkkelysmolekyylien ketjunpituudella on suuri vaikutus ajettavuuteen ja lopputuotteen ominaisuuksiin. Haasteellista pintaliimatärkkelyksen valinnassa on sellaisen yhdistelmän löytäminen, jossa sopivan reologisen käyttäytymisen omaava tärkkelys ja pintaliimatulle paperille tai kartongille asetetut vaatimukset kohtaavat.

Conservation of Campomanesia adamantium (CAMB.) O. berg seeds in different packaging and at varied temperatures

This article aims at evaluating the effects of different packaging and varied storage temperatures on the germination potential of seeds of Campomanesia adamantium Camb. O. Berg. The seeds were packaged in glass, aluminum foil and plastic containers, or maintained inside intact fruits at 5, 10 and 15 ºC during 0, 7, 14 and 21 days. After these periods the seeds were sown in Germitest® germination paper and maintained in incubation chambers at 25 ºC under constant white light for 42 days. Seed moisture contents were evaluated both before and after storage, as well as germination percentages, germination speed index, root and aerial portion of seedlings lengths, and total dry weights. All possible combinations of packing materials, temperatures and storage times were tested, with four repetitions of 25 seeds for each treatment. C. adamantium seeds showed initial water contents of 31.5%. Glass and aluminum packaging were efficient at maintaining the water content of the seeds, and provided greater germination speed index than the other packaging materials. Germination percentages, seedlings lengths and dry weights did not vary among the different temperatures tested. C. adamantium seeds can be stored for up to 21 days at temperatures between 5 and 15 ºC without altering their physiological quality. In terms of cost-benefit efficiencies, these seeds can be stored without significant damage for 21 days while still inside the fruits at temperatures of 5, 10 or 15 ºC.

Evaluation of winter temperatures on apple budbreak using grafted twigs

Temperature is the main climate factor related to induction, maintenance and dormancy release in apple (Malus domestica Borkh.). The inadequate chilling exposure in apples causes budbreak problems, resulting in decrease in yield potential. Thus, the knowledge of physiological principles and environmental factors determining the dormancy phenomenon, especially winter temperature effects, it is necessary for the efficient selection of cultivars in a productive region. In addition, it is indispensable to adapt the orchard management aiming to decrease the problems caused by lack chilling during winter. The objective of this study was to evaluate the influence of different thermal conditions during the dormancy period on budbreak of apple cultivars. One-year-old twigs of 'Castel Gala' and 'Royal Gala' cultivars, grafted on M7 rootstock, were submitted to temperatures of 5, 10 and 15ºC for different exposure periods (168; 336; 672; 1,008 and 1,344 hours). After treatments execution, the plants were kept in a greenhouse at 25ºC. Budbreak was quantified when accumulated 3,444; 6,888; 10,332; 13,776; 17,220 and 20,664 GDHºC after temperature treatments. The cultivars responded differently to temperature effect during the winter period. The temperature of 15ºC during winter shows a greater effectiveness on 'Castel Gala' apple budbreak while in the 'Royal Gala' apples the temperatures of 5 and 10ºC show better performance. 'Castel Gala' cultivar (low chilling requirement) may supply its physiological necessities, may be capable to budburst, even when subjected to higher temperatures in relation to 'Royal Gala' apples (high chilling requirement).

GdBaCo2O5+x layered perovskite as an intermediate temperature solid oxide fuel cell cathode

GdBaCo2O5+x (GBCO) was evaluated as a cathode for intermediate-temperature solid oxide fuel cells. A porous layer of GBCO was deposited on an anode-supported fuel cell consisting of a 15m thick electrolyte of yttria-stabilized zirconia (YSZ) prepared by dense screen-printing anda Ni–YSZ cermet as an anode (Ni–YSZ/YSZ/GBCO). Values of power density of 150 mW cm−2 at 700◦C and ca. 250 mW cm−2 at 800◦C are reported for this standard configuration using 5% of H2 in nitrogen as fuel. An intermediate porous layer of YSZ was introduced between the electrolyte and the cathode improving the performance of the cell. Values for power density of 300 mW cm−2 at 700◦C and ca. 500 mW cm−2 at 800◦C in this configuration were achieved.

Increased diversity of egg-associated bacteria on brown trout (Salmo trutta) at elevated temperatures.

The taxonomic composition of egg-associated microbial communities can play a crucial role in the development of fish embryos. In response, hosts increasingly influence the composition of their associated microbial communities during embryogenesis, as concluded from recent field studies and laboratory experiments. However, little is known about the taxonomic composition and the diversity of egg-associated microbial communities within ecosystems; e.g., river networks. We sampled late embryonic stages of naturally spawned brown trout at nine locations within two different river networks and applied 16S rRNA pyrosequencing to describe their bacterial communities. We found no evidence for a significant isolation-by-distance effect on the composition of bacterial communities, and no association between neutral genetic divergence of fish host (based on 11 microsatellites) and phylogenetic distances of the composition of their associated bacterial communities. We characterized core bacterial communities on brown trout eggs and compared them to corresponding water samples with regard to bacterial composition and its presumptive function. Bacterial diversity was positively correlated with water temperature at the spawning locations. We discuss this finding in the context of the increased water temperatures that have been recorded during the last 25 years in the study area.

Aerosol therapy in intensive and intermediate care units: prospective observation of 2808 critically ill patients.

PURPOSE: Unlike in the outpatient setting, delivery of aerosols to critically ill patients may be considered complex, particularly in ventilated patients, and benefits remain to be proven. Many factors influence aerosol delivery and recommendations exist, but little is known about knowledge translation into clinical practice. METHODS: Two-week cross-sectional study to assess the prevalence of aerosol therapy in 81 intensive and intermediate care units in 22 countries. All aerosols delivered to patients breathing spontaneously, ventilated invasively or noninvasively (NIV) were recorded, and drugs, devices, ventilator settings, circuit set-up, humidification and side effects were noted. RESULTS: A total of 9714 aerosols were administered to 678 of the 2808 admitted patients (24 %, CI95 22-26 %), whereas only 271 patients (10 %) were taking inhaled medication before admission. There were large variations among centers, from 0 to 57 %. Among intubated patients 22 % (n = 262) received aerosols, and 50 % (n = 149) of patients undergoing NIV, predominantly (75 %) inbetween NIV sessions. Bronchodilators (n = 7960) and corticosteroids (n = 1233) were the most frequently delivered drugs (88 % overall), predominantly but not exclusively (49 %) administered to patients with chronic airway disease. An anti-infectious drug was aerosolized 509 times (5 % of all aerosols) for nosocomial infections. Jet-nebulizers were the most frequently used device (56 %), followed by metered dose inhalers (23 %). Only 106 (<1 %) mild side effects were observed, despite frequent suboptimal set-ups such as an external gas supply of jet nebulizers for intubated patients. CONCLUSIONS: Aerosol therapy concerns every fourth critically ill patient and one-fifth of ventilated patients.

Fosfomycin plus β-Lactams as Synergistic Bactericidal Combinations for Experimental Endocarditis Due to Methicillin-Resistant and Glycopeptide-Intermediate Staphylococcus aureus.

The urgent need of effective therapies for methicillin-resistant Staphylococcus aureus (MRSA) infective endocarditis (IE) is a cause of concern. We aimed to ascertain the in vitro and in vivo activity of the older antibiotic fosfomycin combined with different beta-lactams against MRSA and glycopeptide-intermediate-resistant S. aureus (GISA) strains. Time-kill tests with 10 isolates showed that fosfomycin plus imipenem (FOF+IPM) was the most active evaluated combination. In an aortic valve IE model with two strains (MRSA-277H and GISA-ATCC 700788), the following intravenous regimens were compared: fosfomycin (2 g every 8 h [q8h]) plus imipenem (1 g q6h) or ceftriaxone (2 g q12h) (FOF+CRO) and vancomycin at a standard dose (VAN-SD) (1 g q12h) and a high dose (VAN-HD) (1 g q6h). Whereas a significant reduction of MRSA-227H load in the vegetations (veg) was observed with FOF+IPM compared with VAN-SD (0 [interquartile range [IQR], 0 to 1] versus 2 [IQR, 0 to 5.1] log CFU/g veg; P = 0.01), no statistical differences were found with VAN-HD. In addition, FOF+IPM sterilized more vegetations than VAN-SD (11/15 [73%] versus 5/16 [31%]; P = 0.02). The GISA-ATCC 700788 load in the vegetations was significantly lower after FOF+IPM or FOF+CRO treatment than with VAN-SD (2 [IQR, 0 to 2] and 0 [IQR, 0 to 2] versus 6.5 [IQR, 2 to 6.9] log CFU/g veg; P < 0.01). The number of sterilized vegetations after treatment with FOF+CRO was higher than after treatment with VAN-SD or VAN-HD (8/15 [53%] versus 4/20 [20%] or 4/20 [20%]; P = 0.03). To assess the effect of FOF+IPM on penicillin binding protein (PBP) synthesis, molecular studies were performed, with results showing that FOF+IPM treatment significantly decreased PBP1, PBP2 (but not PBP2a), and PBP3 synthesis. These results allow clinicians to consider the use of FOF+IPM or FOF+CRO to treat MRSA or GISA IE.

Factors influencing zooplankton size structure at contrasting temperatures in coastal shallow lakes: Implications for effects of climate change

We assessed the importance of temperature, salinity, and predation for the size structure of zooplankton and provided insight into the future ecological structure and function of shallow lakes in a warmer climate. Artificial plants were introduced in eight comparable coastal shallow brackish lakes located at two contrasting temperatures: cold-temperate and Mediterranean climate region. Zooplankton, fish, and macroinvertebrates were sampled within the plants and at open-water habitats. The fish communities of these brackish lakes were characterized by small-sized individuals, highly associated with submerged plants. Overall, higher densities of small planktivorous fish were recorded in the Mediterranean compared to the cold-temperate region, likely reflecting temperature-related differences as have been observed in freshwater lakes. Our results suggest that fish predation is the major control of zooplankton size structure in brackish lakes, since fish density was related to a decrease in mean body size and density of zooplankton and this was reflected in a unimodal shaped biomass-sizespectrum with dominance of small sizes and low size diversity. Salinity might play a more indirect role by shaping zooplankton communities toward more salt-tolerant species. In a global-warming perspective, these results suggest that changes in the trophic structure of shallow lakes in temperate regions might be expected as a result of the warmer temperatures and the potentially associated increases in salinity. The decrease in the density of largebodied zooplankton might reduce the grazing on phytoplankton and thus the chances of maintaining the clear water state in these ecosystems