Advanced LIGO

The Advanced LIGO gravitational wave detectors are second-generation instruments designed and built for the two LIGO observatories in Hanford, WA and Livingston, LA, USA. The two instruments are identical in design, and are specialized versions of a Michelson interferometer with 4 km long arms. As in Initial LIGO, Fabry-Perot cavities are used in the arms to increase the interaction time with a gravitational wave, and power recycling is used to increase the effective laser power. Signal recycling has been added in Advanced LIGO to improve the frequency response. In the most sensitive frequency region around 100 Hz, the design strain sensitivity is a factor of 10 better than Initial LIGO. In addition, the low frequency end of the sensitivity band is moved from 40 Hz down to 10 Hz. All interferometer components have been replaced with improved technologies to achieve this sensitivity gain. Much better seismic isolation and test mass suspensions are responsible for the gains at lower frequencies. Higher laser power, larger test masses and improved mirror coatings lead to the improved sensitivity at mid and high frequencies. Data collecting runs with these new instruments are planned to begin in mid-2015.

Cronología de la odontogénesis y edad dentaria en niños de la Comunidad de Madrid : cambios seculares

[ES] En el presente trabajo se realizó un estudio de la odontogénesis o desarrollo dentario según Demirjian, en una muestra de niños españoles divididos en dos grupos con una diferencia de 20 años entre ambos, para poder estudiar una posible tendencia secular. También se estudiaron las diferencias entre sexos. De igual manera, se estimó la edad dentaria y la relación con la edad cronológica con el fin de confirmar si el método descrito por Demirjian era o no aplicable a nuestra población. Se realizó la comparación entre sexos y entre grupos para valorar cambios a lo largo del tiempo. Por último se presentó una curva adaptada a nuestra población, con la cual se podría adaptar el método de Demirjian a la población española para poder calcular la edad cronológica de un niño a través de la estimación de la edad dentaria.

Materiali lapidei in provincia di Bologna: studio sulle cave storiche e ipotesi di sostenibilità.

Lo studio effettuato verte sulla ricerca delle cave storiche di pietra da taglio in provincia di Bologna, facendo partire la ricerca al 1870 circa, data in cui si hanno le prime notizie cartacee di cave bolognesi. Nella ricerca si è potuto contare sull’aiuto dei Dott. Stefano Segadelli e Maria Tersa De Nardo, geologi della regione Emilia-Romagna, che hanno messo a disposizione la propria conoscenza e le pubblicazioni della regione a questo scopo. Si è scoperto quindi che non esiste in bibliografia la localizzazione di tali cave e si è cercato tramite l’utilizzo del software ArcGIS , di georeferenziarle, correlandole di informazioni raccolte durante la ricerca. A Bologna al momento attuale non esistono cave di pietra da taglio attive, così tutte le fonti che si sono incontrate hanno fornito dati parziali, che uniti hanno permesso di ottenere una panoramica soddisfacente della situazione a inizio secolo scorso. Le fonti studiate sono state, in breve: il catasto cave della regione Emilia-Romagna, gli shape preesistenti della localizzazione delle cave, le pubblicazioni “Uso del Suolo”, oltre ai dati forniti dai vari Uffici Tecnici dei comuni nei quali erano attive le cave. I litotipi cavati in provincia sono quattro: arenaria, calcare, gesso e ofiolite. Per l’ofiolite si tratta di coltivazioni sporadiche e difficilmente ripetibili dato il rischio che può esserci di incontrare l’amianto in queste formazioni; è quindi probabile che non verranno più aperte. Il gesso era una grande risorsa a fine ‘800, con molte cave aperte nella Vena del Gesso. Questa zona è diventata il Parco dei Gessi Bolognesi, lasciando alla cava di Borgo Rivola il compito di provvedere al fabbisogno regionale. Il calcare viene per lo più usato come inerte, ma non mancano esempi di formazioni adatte a essere usate come blocchi. La vera protagonista del panorama bolognese rimane l’arenaria, che venne usata da sempre per costruire paesi e città in provincia. Le cave, molte e di ridotte dimensioni, sono molto spesso difficili da trovare a causa della conseguente rinaturalizzazione. Ci sono possibilità però di vedere riaprire cave di questo materiale a Monte Finocchia, tramite la messa in sicurezza di una frana, e forse anche tramite la volontà di sindaci di comunità montane, sensibili a questo argomento. Per avere una descrizione “viva” della situazione attuale, sono stati intervistati il Dott. Maurizio Aiuola, geologo della Provincia di Bologna, e il Geom. Massimo Romagnoli della Regione Emilia-Romagna, che hanno fornito una panoramica esauriente dei problemi che hanno portato ad avere in regione dei poli unici estrattivi anziché più cave di modeste dimensioni, e delle possibilità future. Le grandi cave sono, da parte della regione, più facilmente controllabili, essendo poche, e più facilmente ripristinabili data la disponibilità economica di chi la gestisce. Uno dei problemi emersi che contrastano l’apertura di aree estrattive minori, inoltre, è la spietata concorrenza dei materiali esteri, che costano, a parità di qualità, circa la metà del materiale italiano. Un esempio di ciò lo si è potuto esaminare nel comune di Sestola (MO), dove, grazie all’aiuto e alle spiegazioni del Geom. Edo Giacomelli si è documentato come il granito e la pietra di Luserna esteri utilizzati rispondano ai requisiti di resistenza e non gelività che un paese sottoposto ai rigori dell’inverno richiede ai lapidei, al contrario di alcune arenarie già in opera provenienti dal comune di Bagno di Romagna. Alla luce di questo esempio si è proceduto a calcolare brevemente l’ LCA di questo commercio, utilizzando con l’aiuto dell’ Ing. Cristian Chiavetta il software SimaPRO, in cui si è ipotizzato il trasporto di 1000 m3 di arenaria da Shanghai (Cina) a Bologna e da Karachi (Pakistan) a Bologna, comparandolo con le emissioni che possono esserci nel trasporto della stessa quantità di materiale dal comune di Monghidoro (BO) al centro di Bologna. Come previsto, il trasporto da paesi lontani comporta un impatto ambientale quasi non comparabile con quello locale, in termini di consumo di risorse organiche e inorganiche e la conseguente emissione di gas serra. Si è ipotizzato allora una riapertura di cave locali a fini non edilizi ma di restauro; esistono infatti molti edifici e monumenti vincolati in provincia, e quando questi devono essere restaurati, dove si sceglie di cavare il materiale necessario e rispondente a quello già in opera? Al riguardo, si è passati attraverso altre due interviste ai Professori Francesco Eleuteri, architetto presso la Soprintendenza dei Beni Culturali a Bologna e Gian Carlo Grillini, geologo-petrografo e esperto di restauro. Ciò che è emerso è che effettivamente non esiste attualmente una panoramica soddisfacente di quello che è il patrimonio lapideo della provincia, mancando, oltre alla georeferenziazione, una caratterizzazione minero-petrografica e fisico-meccanica adeguata a poter descrivere ciò che veniva anticamente cavato; l’ipotesi di riapertura a fini restaurativi potrebbe esserci, ma non sembra essere la maggiore necessità attualmente, in quanto il restauro viene per lo più fatto senza sostituzioni o integrazioni, tranne rari casi; è pur sempre utile avere una carta alla mano che possa correlare l’edificio storico con la zona di estrazione del materiale, quindi entrambi i professori hanno auspicato una prosecuzione della ricerca. Si può concludere dicendo che la ricerca può proseguire con una migliore e più efficace localizzazione delle cave sul terreno, usando anche come fonte il sapere della popolazione locale, e di procedere con una parte pratica che riguardi la caratterizzazione minero-petrografica e fisico-meccanica. L’utilità di questi dati può esserci nel momento in cui si facciano ricerche storiche sui beni artistici presenti a Bologna, e qualora si ipotizzi una riapertura di una zona estrattiva.

Gemtuzumab ozogamicin as postremission treatment in AML at 60 years of age or more: results of a multicenter phase 3 study

In older patients with acute myeloid leukemia (AML), the prevention of relapse has remained one of the major therapeutic challenges, with more than 75% relapses after complete remission. The anti-CD33 immunotoxin conjugate gemtuzumab ozogamicin (GO) has shown antileukemic remission induction activity in patients with relapsed AML. Patients with AML or refractory anemia with excess blasts in first complete remission attained after intensive induction chemotherapy were randomized between 3 cycles of GO (6 mg/m(2) every 4 weeks) or no postremission therapy (control) to assess whether GO would improve outcome. The 2 treatment groups (113 patients receiving GO vs 119 control patients) were comparable with regard to age (60-78 years, median 67 years), performance status, and cytogenetics. A total of 110 of 113 received at least 1 cycle of GO, and 65 of 113 patients completed the 3 cycles. Premature discontinuation was mainly attributable to incomplete hematologic recovery or intercurrent relapse. Median time to recovery of platelets 50 x 10(9)/L and neutrophils 0.5 x 10(9)/L after GO was 14 days and 20 days. Nonhematologic toxicities were mild overall, but there was 1 toxic death caused by liver failure. There were no significant differences between both treatment groups with regard to relapse probabilities, nonrelapse mortality, overall survival, or disease-free survival (17% vs 16% at 5 years). Postremission treatment with GO in older AML patients does not provide benefits regarding any clinical end points. The HOVON-43 study is registered at The Netherlands Trial Registry (number NTR212) and at http://www.controlled-trials.com as ISRCTN77039377.

Favorable effect of priming with granulocyte colony-stimulating factor in remission induction of acute myeloid leukemia restricted to dose-escalation of cytarabine

The clinical value of chemotherapy sensitization of acute myeloid leukemia (AML) with G-CSF priming has remained controversial. Cytarabine is a key constituent of remission induction chemotherapy. The effect of G-CSF priming has not been investigated in relationship with variable dose levels of cytarabine. We randomized 917 AML patients to receive G-CSF (456 patients) or no G-CSF (461 patients) at the days of chemotherapy. In the initial part of the study, 406 patients were also randomized between 2 cytarabine regimens comparing conventional-dose (199 patients) versus escalated-dose (207 patients) cytarabine in cycles 1 and 2. We found that patients after induction chemotherapy plus G-CSF had similar overall survival (43% vs 40%, P = .88), event-free survival (37% vs 31%, P = .29), and relapse rates (34% vs 36%, P = .77) at 5 years as those not receiving G-CSF. However, patients treated with the escalated-dose cytarabine regimen benefited from G-CSF priming, with improved event-free survival (P = .01) and overall survival (P = .003), compared with patients without G-CSF undergoing escalated-dose cytarabine treatment. A significant survival advantage of sensitizing AML for chemotherapy with G-CSF was not apparent in the entire study group, but it was seen in patients treated with escalated-dose cytarabine during remission induction. The HOVON-42 study is registered under The Netherlands Trial Registry (www.trialregister.nl) as #NTR230.

Cytarabine dose for acute myeloid leukemia

Cytarabine (ara-C) is an important drug in the treatment of acute myeloid leukemia (AML). High-dose cytarabine (2000 to 3000 mg per square meter of body-surface area) is toxic but results in higher rates of relapse-free survival than does the conventional dose of 100 to 400 mg per square meter. Intermediate dose levels have not been thoroughly evaluated.

Autologous peripheral blood stem cell transplantation for acute myeloid leukemia

We report the results of a prospective, randomized phase 3 trial evaluating autologous peripheral blood stem cell transplantation (ASCT) versus intensive consolidation chemotherapy in newly diagnosed AML patients in complete remission (CR1). Patients with AML (16-60 years) in CR1 after 2 cycles of intensive chemotherapy and not eligible for allogeneic SCT were randomized between intensive chemotherapy with etoposide and mitoxantrone or ASCT ater high-dose cyclophosphamide and busulfan. Of patients randomized (chemotherapy, n = 259; ASCT, n = 258), more than 90% received their assigned treatment. The 2 groups were comparable with regard to prognostic factors. The ASCT group showed a markedly reduced relapse rate (58% vs 70%, P = .02) and better relapse-free survival at 5 years (38% vs 29%, P = .065, hazard ratio = 0.82; 95% confidence interval, 0.66-1.1) with nonrelapse mortality of 4% versus 1% in the chemotherapy arm (P = .02). Overall survival was similar (44% vs 41% at 5 years, P = .86) because of more opportunities for salvage with second-line chemotherapy and stem cell transplantation in patients relapsing on the chemotherapy arm. This large study shows a relapse advantage for ASCT as postremission therapy but similar survival because more relapsing patients on the chemotherapy arm were salvaged with a late transplantation for relapse. This trial is registered at www.trialregister.nl as #NTR230 and #NTR291.

Addition of bevacizumab to chemotherapy in acute myeloid leukemia at older age: a randomized phase 2 trial of the Dutch-Belgian Cooperative Trial Group for Hemato-Oncology (HOVON) and the Swiss Group for Clinical Cancer Research (SAKK)

An urgent need for new treatment modalities is emerging in elderly patients with acute myeloid leukemia (AML). We hypothesized that targeting VEGF might furnish an effective treatment modality in this population. Elderly patients with AML were randomly assigned in this phase 2 study (n = 171) to receive standard chemotherapy (3 + 7) with or without bevacizumab at a dose of 10 mg/kg intravenously at days 1 and 15. In the second cycle, patients received cytarabine 1000 mg/m(2) twice daily on days 1-6 with or without bevacizumab. The complete remission rates in the 2 arms were not different (65%). Event-free survival at 12 months was 33% for the standard arm versus 30% for the bevacizumab arm; at 24 months, it was 22% and 16%, respectively (P = .42). The frequencies of severe adverse events (SAEs) were higher in the bevacizumab arm (n = 63) compared with the control arm (n = 28; P = .043), but the percentages of death or life-threatening SAEs were lower in the bevacizumab arm (60% vs 75% of SAEs). The results of the present study show that the addition of bevacizumab to standard chemotherapy does not improve the therapeutic outcome of older AML patients. This trial is registered as number NTR904 in The Nederlands Trial Register (www.trialregister.nl).

Deregulated expression of EVI1 defines a poor prognostic subset of MLL-rearranged acute myeloid leukemias: a study of the German-Austrian Acute Myeloid Leukemia Study Group and the Dutch-Belgian-Swiss HOVON/SAKK Cooperative Group

To evaluate the prognostic value of ecotropic viral integration 1 gene (EVI1) overexpression in acute myeloid leukemia (AML) with MLL gene rearrangements.

Comparative analysis of the value of allogeneic hematopoietic stem-cell transplantation in acute myeloid leukemia with monosomal karyotype versus other cytogenetic risk categories

To determine to what extent allogeneic hematopoietic stem-cell transplantation (alloHSCT) quantitatively reduces relapse in acute myeloid leukemia with monosomal karyotype (MK-AML) compared with alternative postremission therapy and how it compares with other cytogenetic subcategories.

Treatment of newly diagnosed acute promyelocytic leukemia (APL): a comparison of French-Belgian-Swiss and PETHEMA results

All-trans retinoic acid (ATRA) plus anthracycline chemotherapy is the reference treatment of newly diagnosed acute promyelocytic leukemia (APL), whereas the role of cytosine arabinoside (AraC) remains disputed. We performed a joint analysis of patients younger than 65 years included in Programa para el Estudio de la Terapéutica en Hemopatía Maligna (PETHEMA) LPA 99 trial, where patients received no AraC in addition to ATRA, high cumulative dose idarubicin, and mitoxantrone, and APL 2000 trial, where patients received AraC in addition to ATRA and lower cumulative dose daunorubicin. In patients with white blood cell (WBC) count less than 10 x 10(9)/L, complete remission (CR) rates were similar, but 3-year cumulative incidence of relapse (CIR) was significantly lower in LPA 99 trial: 4.2% versus 14.3% (P = .03), although 3-year survival was similar in both trials. This suggested that AraC is not required in APL with WBC count less than 10 x 10(9)/L, at least in trials with high-dose anthracycline and maintenance treatment. In patients with WBC of 10 x 10(9)/L or more, however, the CR rate (95.1% vs 83.6% P = .018) and 3-year survival (91.5% vs 80.8%, P = .026) were significantly higher in APL 2000 trial, and there was a trend for lower 3-year CIR (9.9% vs 18.5%, P = .12), suggesting a beneficial role for AraC in those patients.

CD34-related coexpression of MDR1 and BCRP indicates a clinically resistant phenotype in patients with acute myeloid leukemia (AML) of older age

Clinical resistance to chemotherapy in acute myeloid leukemia (AML) is associated with the expression of the multidrug resistance (MDR) proteins P-glycoprotein, encoded by the MDR1/ABCB1 gene, multidrug resistant-related protein (MRP/ABCC1), the lung resistance-related protein (LRP), or major vault protein (MVP), and the breast cancer resistance protein (BCRP/ABCG2). The clinical value of MDR1, MRP1, LRP/MVP, and BCRP messenger RNA (mRNA) expression was prospectively studied in 154 newly diagnosed AML patients >or=60 years who were treated in a multicenter, randomized phase 3 trial. Expression of MDR1 and BCRP showed a negative whereas MRP1 and LRP showed a positive correlation with high white blood cell count (respectively, p < 0.05, p < 0.001, p < 0.001 and p < 0.001). Higher BCRP mRNA was associated with secondary AML (p < 0.05). MDR1 and BCRP mRNA were highly significantly associated (p < 0.001), as were MRP1 and LRP mRNA (p < 0.001) expression. Univariate regression analyses revealed that CD34 expression, increasing MDR1 mRNA as well as MDR1/BCRP coexpression, were associated with a lower complete response (CR) rate and with worse event-free survival and overall survival. When adjusted for other prognostic actors, only CD34-related MDR1/BCRP coexpression remained significantly associated with a lower CR rate (p = 0.03), thereby identifying a clinically resistant subgroup of elderly AML patients.

High-dose daunorubicin in older patients with acute myeloid leukemia

BACKGROUND: A complete remission is essential for prolonging survival in patients with acute myeloid leukemia (AML). Daunorubicin is a cornerstone of the induction regimen, but the optimal dose is unknown. In older patients, it is usual to give daunorubicin at a dose of 45 to 50 mg per square meter of body-surface area. METHODS: Patients in whom AML or high-risk refractory anemia had been newly diagnosed and who were 60 to 83 years of age (median, 67) were randomly assigned to receive cytarabine, at a dose of 200 mg per square meter by continuous infusion for 7 days, plus daunorubicin for 3 days, either at the conventional dose of 45 mg per square meter (411 patients) or at an escalated dose of 90 mg per square meter (402 patients); this treatment was followed by a second cycle of cytarabine at a dose of 1000 mg per square meter every 12 hours [DOSAGE ERROR CORRECTED] for 6 days. The primary end point was event-free survival. RESULTS: The complete remission rates were 64% in the group that received the escalated dose of daunorubicin and 54% in the group that received the conventional dose (P=0.002); the rates of remission after the first cycle of induction treatment were 52% and 35%, respectively (P<0.001). There was no significant difference between the two groups in the incidence of hematologic toxic effects, 30-day mortality (11% and 12% in the two groups, respectively), or the incidence of moderate, severe, or life-threatening adverse events (P=0.08). Survival end points in the two groups did not differ significantly overall, but patients in the escalated-treatment group who were 60 to 65 years of age, as compared with the patients in the same age group who received the conventional dose, had higher rates of complete remission (73% vs. 51%), event-free survival (29% vs. 14%), and overall survival (38% vs. 23%). CONCLUSIONS: In patients with AML who are older than 60 years of age, escalation of the dose of daunorubicin to twice the conventional dose, with the entire dose administered in the first induction cycle, effects a more rapid response and a higher response rate than does the conventional dose, without additional toxic effects. (Current Controlled Trials number, ISRCTN77039377; and Netherlands National Trial Register number, NTR212.)

Public health risks of enterobacterial isolates producing extended-spectrum β-lactamases or AmpC β-lactamases in food and food-producing animals: an EU perspective of epidemiology, analytical methods, risk factors, and control options

The blaESBL and blaAmpC genes in Enterobacteriaceae are spread by plasmid-mediated integrons, insertion sequences, and transposons, some of which are homologous in bacteria from food animals, foods, and humans. These genes have been frequently identified in Escherichia coli and Salmonella from food animals, the most common being blaCTX-M-1, blaCTX-M-14, and blaCMY-2. Identification of risk factors for their occurrence in food animals is complex. In addition to generic antimicrobial use, cephalosporin usage is an important risk factor for selection and spread of these genes. Extensive international trade of animals is a further risk factor. There are no data on the effectiveness of individual control options in reducing public health risks. A highly effective option would be to stop or restrict cephalosporin usage in food animals. Decreasing total antimicrobial use is also of high priority. Implementation of measures to limit strain dissemination (increasing farm biosecurity, controls in animal trade, and other general postharvest controls) are also important.

Reporting standards for studies of diagnostic test accuracy in dementia: The STARDdem Initiative.

OBJECTIVE To provide guidance on standards for reporting studies of diagnostic test accuracy for dementia disorders. METHODS An international consensus process on reporting standards in dementia and cognitive impairment (STARDdem) was established, focusing on studies presenting data from which sensitivity and specificity were reported or could be derived. A working group led the initiative through 4 rounds of consensus work, using a modified Delphi process and culminating in a face-to-face consensus meeting in October 2012. The aim of this process was to agree on how best to supplement the generic standards of the STARD statement to enhance their utility and encourage their use in dementia research. RESULTS More than 200 comments were received during the wider consultation rounds. The areas at most risk of inadequate reporting were identified and a set of dementia-specific recommendations to supplement the STARD guidance were developed, including better reporting of patient selection, the reference standard used, avoidance of circularity, and reporting of test-retest reliability. CONCLUSION STARDdem is an implementation of the STARD statement in which the original checklist is elaborated and supplemented with guidance pertinent to studies of cognitive disorders. Its adoption is expected to increase transparency, enable more effective evaluation of diagnostic tests in Alzheimer disease and dementia, contribute to greater adherence to methodologic standards, and advance the development of Alzheimer biomarkers.