Cystic fibrosis: desensitization in delayed hypersensitivity reactions to elexacaftor/tezacaftor/ivacaftor.

Background: Cystic fibrosis transmembrane conductance regulator modulators are the only available treatment for cystic fibrosis. Although elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) is well-tolerated, rash has been reported as very frequent. In severe rashes, ELX/TEZ/IVA withdrawal is necessary, leading to clinical deterioration. The objective of the study is to increment the experience of ELX/TEZ/IVA desensitization. Methods: Adult patients who developed a delayed hypersensitivity rash to ELX/TEZ/IVA between December 2021 and February 2023 and required withdrawal due to ineffective rescue medication were included. Skins test for ELX/TEZ/IVA and IVA were conducted to establish hypersensitivity mechanism. Balijepally ELX/TEZ/IVA desensitization protocol was selected. In cases where desensitization had to be discontinued due to rash, an extended desensitization was proposed. Clinical and health-related quality of life parameters were collected before ELX/TEZ/IVA and after desensitization. Results: 162 patients (81 women, 31.2 [23.8-42.5] years) started ELX/TEZ/IVA, developing rash 12 of them (7.4%, six women). Six patients (five women) required stopping ELX/TEZ/IVA and were selected for desensitization. Skin tests indicated delayed type-IV hypersensitivity in one patient. Two patients presented adequate tolerance to desensitization; while, four patients developed rash. Three of these patients, successfully concluded extended desensitization (one patient declined participation). No significant clinical deterioration or quality of life worsening was observed during desensitization; in fact, there was an improvement in practically all mesured parameters. All five patients who resumed ELX/TEZ/IVA are currently receiving therapy with good tolerance. Conclusion: Desensitization to ELX/TEZ/IVA could be a successful and safe strategy for reintroducing this essential treatment in cases of a delayed hypersensitivity rash.

The association of circulating bioenergetic metabolites with healthy human aging.

Aging is an inevitable and gradual decline in several biological functions. Mitochondrial dysfunction is one of the most important hallmarks of aging. In this context, alterations in metabolites associated with mitochondrial dysfunction may serve as a significant biomarker. This study aimed to investigate the existence of a relationship between the key metabolites involved in bioenergetics metabolism and aging. 53 volunteers ranged 20-85 years participated in the study. We tested the association between different tricarboxylic acid (TCA) cycle metabolites, fatty acid metabolism, and amino acid metabolism with age, sex, body composition, and proxy markers of aging such as walking speed, grip strength and chair test. We found that lactic acid negatively correlated with age while several fatty acid metabolites, such as azelaic, sebacic, and linoleic acids, showed positive correlations with age (p < 0.05). Sex-specific trends, such as glycerol, and dodecanoic acid, were also observed for certain metabolites. Furthermore, citric acid levels were found to have a significant association with physical function and body composition measures. Participants with higher citric acid levels displayed improved performance in physical tests and favorable body composition indices. Additionally, fumaric acid and adipic acid showed positive correlations with fat-free body mass, while sebacic acid was negatively associated with measures of fat mass. These findings underscore the importance of understanding the role of circulating bioenergetics metabolites with age, sex variations, and their potential implications in body composition and physical performance.

[X-linked intellectual disability syndrome with macrocephaly due to BRWD3 gene deletion]. / Síndrome de discapacidad intelectual ligada a X con macrocefalia por deleción del gen BRWD3.

INTRODUCTION: Pathogenic variants in BRWD3 gene have been described as a rare cause of syndromic X-linked intellectual disability. Its phenotype shows neurodevelopmental delay with intellectual disability in all reported patients, facial dysmorphic features, macrocephaly, overgrowth and obesity. The great majority of cases yield point variants in the gene, only three large deletions including only the BRWD3 gene have been reported. The BRWD3 protein is an epigenetic reader that regulates chromatin remodeling. We report a boy with a compatible phenotype and a deletion including only this gene. CASE REPORT: Boy, without family and perinatal pathological background, with neurodevelopmental delay: psychomotor delay, speech delay and intellectual disability, macrocephaly (p > 99) and obesity. Phenotype with facial dysmorphic features: wide forehead, deep set eyes, bulbous nose, prominent ears and pointed chin. The array-CGH analysis showed a 586 kb deletion at Xq21.1 including only one gene with associated disorder, BRWD3. Afterwards, the deletion was also identified in his asymptomatic mother and sister. CONCLUSIONS: Our patient confirms that the haploinsufficiency due to BRWD3 deletion is a causal genetic mechanism of the BRWD3-related syndromic X-linked intellectual disability. It is important to recognize the phenotype for the diagnosis and follow up of the patients, and also to carry out the family genetic analysis in order to identify and give genetic counselling to the women who also have the genetic defect, because the majority of them are asymptomatic, as the mother and sister of our patient.

TITLE: Síndrome de discapacidad intelectual ligada a X con macrocefalia por deleción del gen BRWD3.Introducción. Variantes patógenas en el gen BRWD3 son la causa de un tipo poco frecuente de discapacidad intelectual sindrómica ligada a X. Su fenotipo se asocia a la alteración neuroconductual con discapacidad intelectual, dismorfia facial, macrocefalia, sobrecrecimiento y obesidad. La gran mayoría de los pacientes presenta variantes puntuales en el gen y sólo se han descrito tres casos con deleciones parciales que incluyen únicamente al gen BRWD3. Funcionalmente es un lector epigenético que regula la remodelación de la cromatina. Presentamos un varón con fenotipo compatible con una deleción que incluye sólo este gen asociado a patología. Caso clínico. Varón sin antecedentes familiares ni perinatales de interés con alteración en el neurodesarrollo: retraso psicomotor, retraso del lenguaje y discapacidad cognitiva, macrocefalia (p > 99) y obesidad. Fenotipo con dismorfia facial: frente amplia, ojos hundidos, nariz bulbosa, pabellones auriculares despegados y mentón afilado. Array de hibridación genómica comparada con deleción de 586 kb en Xq21.1, que incluye un único gen asociado a la patología, BRWD3. Posteriormente se realizó un estudio a la madre y a la hermana, asintomáticas, y ambas portan la deleción. Conclusiones. Nuestro caso confirma que la haploinsuficiencia debida a la deleción del gen BRWD3 es un mecanismo genético causal de la discapacidad intelectual sindrómica ligada a X asociada al gen BRWD3. Es importante reconocer el fenotipo para el diagnóstico y el seguimiento, así como la realización del estudio familiar para asesoramiento genético a las mujeres que porten la alteración, puesto que en la mayoría de los casos son asintomáticas, como la madre y la hermana de este paciente.

Improving hybrid image and structure-based deformable image registration for large internal deformations.

Objective.Deformable image registration (DIR) is a widely used technique in radiotherapy. Complex deformations, resulting from large anatomical changes, are a regular challenge. DIR algorithms generally seek a balance between capturing large deformations and preserving a smooth deformation vector field (DVF). We propose a novel structure-based term that can enhance the registration efficacy while ensuring a smooth DVF.Approach.The proposed novel similarity metric for controlling structures was introduced as a new term into a commercially available algorithm. Its performance was compared to the original algorithm using a dataset of 46 patients who received pelvic re-irradiation, many of which exhibited complex deformations.Main results.The mean Dice Similarity Coefficient (DSC) under the improved algorithm was 0.96, 0.94, 0.76, and 0.91 for bladder, rectum, colon, and bone respectively, compared to 0.69, 0.89, 0.62, and 0.88 for the original algorithm. The improvement was more pronounced for complex deformations.Significance.With this work, we have demonstrated that the proposed term is able to improve registration accuracy for complex cases while maintaining realistic deformations.

Inter-laboratory method validation of CD34+ flow-cytometry assay: the experience of Turin Metropolitan Transplant Centre.

The Turin Metropolitan Transplant Centre (CIC 305) includes four flow-cytometry laboratories assessing quality control on hematopoietic stem cells (HSC) with different instruments and operators. Therefore, the CD34+ enumeration assay should be validated on a regular basis. We describe here the validation plan to test the inter-laboratory reproducibility of CD34+ enumeration assay, based on the risk analysis. Stabilized blood samples were analysed using Stem-Kit reagent according to manufacturer's instructions and acquired using the Beckman Coulter Navios at Regina Margherita Children's' Hospital (305-1), Beckman Coulter FC500 at Candiolo Cancer Institute FPO-IRCCS (305-2), BD Biosciences FACSLyric™ at S. Luigi Hospital (305-3), and Beckman Coulter Navios EX at Mauriziano Hospital (305-4). The ISHAGE guidelines were followed for estimating % and absolute number of CD34+ cells in single-platform method. For each sample repeatability limit (r), reproducibility error, uncertainty of reproducibility error and coefficient of variation (CV) were reported. The repeated measurements from each laboratory or instrument have a variability, expressed as reproducibility error, lower than the repeatability limit for that single parameter. The corrected reproducibility error is always lower than the repeatability limit except for the percentage value of the "low" count. The analysis of inter-laboratory variance is within the maximum acceptable variance value, and the CV of all measurements for each parameter is less than 8%, indicating low measurement variability among laboratories. Evaluating the overall data, we can conclude that the four laboratories are perfectly aligned and the results are reproducible.

[Warsaw breakage syndrome: an etiology for congenital microcephaly and sensorineural deafness]. / Síndrome de rotura de Varsovia: una causa de microcefalia congénita y sordera neurosensorial.

INTRODUCTION: Warsaw breakage syndrome is a very rare genetic disorder due to biallelic pathogenic variants in DDX11 gene, with a role in the sister chromatid cohesion process, and classified in the cohesinophaties group. It is characterized by the clinical triad of growth restriction, microcephaly and sensorineural deafness. Additional, but less frequent features, are facial dysmorphism, and skeletal, heart, skin and genitourinary anomalies. CASE REPORT: We report a boy with the cardinal features of the syndrome: prenatal growth restriction, severe congenital microcephaly, and sensorineural deafness with cochlear nerves agenesis. He also has a cardiac anomaly, hypospadias, cryptorchidism, skin abnormality, and pes planus. The exome yielded two heterozygous likely pathogenic variants in the DDX11 gene, c.1403dup; p.(Ser469Valfs*32) and c.2371C>T; p.(Arg791Trp), inherited in trans from the parents. CONCLUSION: We review the clinical and genetic data of the 23 reported cases with the syndrome in the literature and analyze the etiopathogenic interpretation of our case variants based on the molecular and cellular functions of DDX11 described. Due to the clinical overlap with the chromosomal breakage syndromes and cohesinopathies we must make the differential diagnosis with these entities, overall, with Fanconi anemia, Nijmegen breakage syndrome, Cornelia de Lange syndrome and Roberts syndrome. In clinical practice we must think in Warsaw breakage syndrome in the neonatal period in a patient with intrauterine growth restriction, severe microcephaly, and sensorineural deafness.

TITLE: Síndrome de rotura de Varsovia: una causa de microcefalia congénita y sordera neurosensorial.Introducción. El síndrome de rotura de Varsovia es una alteración genética muy poco frecuente originada por variantes patógenas bialélicas en el gen DDX11, implicado en la cohesión de las cromátidas hermanas, que pertenece al grupo de las cohesinopatías. Clínicamente se caracteriza por retraso del crecimiento, microcefalia y sordera neurosensorial, con otras manifestaciones menos frecuentes: dismorfia facial, anomalías esqueléticas, cardíacas, cutáneas y genitourinarias. Caso clínico. Presentamos a un varón con las manifestaciones cardinales del síndrome: bajo peso en el nacimiento, microcefalia congénita grave y sordera neurosensorial con agenesia de los nervios cocleares. También presenta cardiopatía, hipospadias, criptorquidia, anomalía cutánea y pies planos. En el exoma se han identificado dos variantes en heterocigosis probablemente patógenas en el gen DDX11, c.1403dup; p.(Ser469Valfs*32) y c.2371C>T; p.(Arg791Trp), heredadas cada una de un progenitor. Conclusión. Revisamos a los 23 pacientes descritos con el síndrome en la bibliografía, tanto desde el punto de vista clínico como desde el genético. Analizamos el significado etiopatógeno de las variantes de nuestro caso basándonos en los datos moleculares y las funciones celulares de DDX11 de los estudios publicados. Debido al solapamiento clínico con los síndromes con rotura cromosómica y las cohesinopatías, debemos realizar el diagnóstico diferencial con estas entidades, fundamentalmente la anemia de Fanconi, el síndrome de rotura de Nijmegen, el síndrome de Cornelia de Lange y el síndrome de Roberts. En la práctica clínica, debemos sospechar este síndrome en el período neonatal en un paciente con retraso del crecimiento intrauterino, microcefalia grave y sordera neurosensorial.

Controlling Nonlinear Dynamics of Milling Bodies in Mechanochemical Devices Driven by Pendular Forcing.

Understanding the dynamics of milling bodies is key to optimize the mixing and the transfer of mechanical energy in mechanochemical processing. In this work, we present a comparative study of mechanochemical reactors driven by harmonic pendular forcing and characterized by different geometries of the lateral borders. We show that the shape of the reactor bases, either flat or curved, along with the size of the milling body and the elasticity of the collisions, represents relevant parameters that govern the dynamical regimes within the system and can control the transition from periodic to chaotic behaviors. We single out possible criteria to preserve target dynamical scenarios when the size of the milling body is changed, by adapting the relative extent of the spatial domain. This allows us to modulate the average energy of the collisions while maintaining the same dynamics and paves the way for a unifying framework to control the dynamical response in different experimental conditions. We finally explore the dynamical and energetic impact of an increasingly asymmetric mechanical force.

"Early" and "definitive" taking charge of subjects positive to SARS-CoV2: the experience of an Italian Local Health Authority.

Abstract: During the second covid-19 pandemic wave in November-December 2021 Prevention Departments had to face a hardly-sustainable workload of contact tracing and taking charge of the sars-cov2 positive case and of his or her close contacts. Also laboratories have been stressed in their ability to process timely the extraordinary load of swabs performed. In this context of hazardous delays, the Prevention Department of Belluno (Italy) tested its resilience: a simple and effective method of taking charge was implemented, by initially phoning to the positive case and imposing the isolation measure on him or her and later on proceeding with the conventional contact tracing.

External Beam Radiotherapy in Western Africa: 1969-2019.

AIMS: We describe the absolute and per capita numbers of megavoltage radiotherapy machines (MVMs) in Western Africa from 1969 to 2019. MATERIALS AND METHODS: Western Africa was defined in accordance with the United Nations' delineation and inclusive of 16 countries. A literature search for publications detailing the number of cobalt-60 machines (COs) and linear accelerators (LINACs) in radiotherapy centres was carried out. Population data from the World Bank Group and crude cancer rates from the International Agency for Research on Cancer were used to calculate ratios of million persons per MVM and MVMs per 1000 cancer cases. RESULTS: The numbers of MVMs in Western Africa in 1969, 1979, 1989, 1999 and 2009 were zero, two, three, six and nine, respectively. In 2019 there were 22 MVMs distributed across Ghana (five), Côte d'Ivoire (two), Mali (one), Mauritania (two), Nigeria (nine) and Senegal (three). Nine countries (56.3%) had no history of external beam radiotherapy (EBRT). The largest increase in absolute EBRT capacity occurred from 2017 to 2019, during which 13 MVMs were commissioned. The largest decrease in EBRT capacity occurred from 2015 to 2017, during which four LINACs and three COs were rendered non-operational. The ratio of million persons per MVM improved from 67.0 in 1979 to 17.8 in 2019. As of 2019, there was 0.09 MVM per 1000 cancer cases. CONCLUSIONS: Western African nations have experienced an increase in the absolute number of MVMs and per capita radiotherapy capacity during the last 50 years, especially in the last decade. As non-functional LINACs contributed to a temporary decline in the EBRT infrastructure, dual use of CO/LINAC technologies may act to promote the availability of EBRT treatment in centres with capacity for multiple MVMs.

Aluminum oxides as alternative building blocks for efficientlayer-by-layerblocking layers in dye-sensitized solar cells.

All inorganic layer-by-layer (LbL) thin films composed by TiO2nanoparticles and [Al(OH)4]-anions (TiO2/AlOx) as well as Al2O3and Nb2O5nanoparticles (Al2O3/Nb2O5) have been deposited to fluorine-doped tin-oxide coated glass (FTO) surfaces and applied as blocking layers in dye-sensitized solar cells (DSCs). Structural and morphological characterization of the LbL films by different techniques reveal that inTiO2/AlOxassembly, aluminate anions undergo condensation reactions on the TiO2surface leading to the formation of highly homogeneous films with unique optical properties. After 25 depositions transmittance losses below 10% in relation to the bare FTO substrate are observed. Electrochemical impedance spectroscopy shows thatTiO2/AlOxlayers impose an effective barrier for the charge recombination at FTO/electrolyte interface with an electron exchange time constant 50-fold higher than that for bare FTO. As a result, an improvement of 85% in the overall conversion efficiency of DSCs was observed with the employment of TiO2/AlOxblocking layers.Al2O3/Nb2O5LbL films can also work as blocking layers in DSCs but not as efficient, which is associated with the poor homogeneity of the film and its capacitive behavior. The production of cost-effective blocking layers with a low light scattering in the visible region is an important feature toward the application of DSC in other Building-integrated photovoltaic applications.

Oxidation of sulfonamides by ferrate(VI): Reaction kinetics, transformation byproducts and toxicity assesment.

This study was aimed at the degradation of sulfonamides (SNs) via oxidation with Fe(VI). The reaction kinetics, identification of degradation byproducts and their toxicity were investigated. The pH solution and Fe(VI) loading had significant effects on the degradation of the sulfonamides. The maximum degradation rate occurred at pH 3.0 with a 6:1 ratio Fe(VI): sulfonamide, obtaining 100% degradation of 15 mg L-1 SN within 5 min. Although Fe(VI) also showed an appreciable reactivity towards SNs (kapp = 9.85-19.63 × 102 M-1 s-1) at pH 7. The influence of solution pH on the values of kapp can be explained considering the specific reaction between Fe(VI) and SNs. Degradation rates are also influenced by the presence of inorganic ions in different water matrixes. For this reason, ions present in groundwater enhanced the SNs degradation through a synergistic effect among carbonates, sulfates and Fe(VI). Degradation byproducts identified, through UPLC analysis, allowed us to proposed three degradation pathways depending on pH. At acid pH there is a cleavage of C-S and S-N bonds. At neutral pH nitroso and nitro-derivates are formed. At basic pH hydroxylation is the main reaction. The cytotoxicity assay of HEK-293 and J774 cell lines exposed to Fe(VI) indicated that transformation byproducts had a lower toxicity than SNs as baseline products. Accordingly, this research suggests that Fe(VI) can act as a chemical oxidant to remove SNs antibiotics and it can be used to treat antibiotic pollution in wastewater.

Toxicity and inhibition assessment of ionic liquids by activated sludge.

Toxicity of 13 ionic liquids (ILs) corresponding to different families were studied by inhibition respiration assays (15 min) using activated sludge. Toxicity increased as increasing the number of carbons in the alkyl-chain of imidazolium-based ILs, with EC50 values from 4.19 to 0.17 for 1-ethyl-3-methylimidazolium chloride ([Emim][Cl]) and 1-octyl-3-methylimidazolium chloride ([Omim][Cl]), respectively. An increase in toxicity was observed for aromatic-based ILs (pyridinium- and imidazolium-based ILs) due to the hydrophobic character of the head groups in comparison with linear structures as phosphonium and ammonium cations. Among to the anions studied fixing [Emim]+ as cation, [HSO4]- and [NTf2]- presented low EC50 values (0.34 mM and 1.69 mM, respectively) while [Cl]- and [EtSO4]- were considered harmless anions due to the hydrophilic character of chloride and the organic nature of [EtSO4]-. ILs toxicity/inhibition was determined by adding a biodegradable compound and measuring the sludge response after being in contact with the ILs for at least 15 h. The exposure of sewage sludge to ILs for more than 15 min used in short inhibition assays caused more toxic effect on microorganisms, even for [Choline][NTf2], previously defined as practically harmless (EC50 = 2.79 mM). Biodegradability assays confirmed the biodegradable nature of choline cation, related with TOC conversion of 40%, only due to cation consumption. No oxygen consumption or even lysis of microbial cells was observed for Tetrabutylammonium bis(trifluoromethylsulfonyl)imide and for 1-Ethyl-3-methylimidazolium hydrogensulphate due to the presence of anions previously defined as hazardous ([NTf2]- and [HSO4]-), maintaining their recalcitrant character to sewage systems.

Halide removal from water using silver doped magnetic-microparticles.

This study proposes the use of new materials based on core-shell structure magnetic microparticles with Ag0 (Ag(0)-MPs) on their surface to remove bromides and chlorides from waters intended for human consumption. Hydrogen peroxide was used as oxidizing agent, Ag(0)-MPs is thereby oxidized to Ag (I)-MPs, which, when in contact with Cl- and Br- ions, form the corresponding silver halide (AgCl and AgBr) on the surface of Ag-MPs. The concentration of Cl- and Br- ions was followed by using ion selective electrodes (ISEs). Silver microparticles were characterized by high-resolution scanning electron microscopy and X-ray photoelectron spectroscopy, while the presence of AgCl and AgBr on Ag-MPs was determined by microanalysis. We analyzed the influence of operational variables, including: hydrogen peroxide concentration in Ag-MP system, medium pH, influence of Cl- ions on Br- ion removal, and influence of tannic acid as surrogate of organic matter in the medium. Regarding the influence of pH, Br-and Cl- removal was constant within the pH range studied (3.5-7), being more effective for Br- than for Cl- ions. Accordingly, this research states that the system Ag-MPs/H2O2 can remove up to 67.01% of Br- ions and 56.92% of Cl- ions from water (pH = 7, [Ag-MPs]0 = 100 mg L-1, [H2O2]0 = 0.2 mM); it is reusable, regenerated by radiation and can be easily removed by applying a magnetically assisted chemical separation process.

Clinical practice update of antifungal prophylaxis in immunocompromised children.

Due to the rise in the number and types of immunosuppressed patients, invasive fungal infections (IFI) are an increasing and major cause of morbidity and mortality in immunocompromised adults and children. There is a broad group of pediatric patients at risk for IFI in whom primary and/or secondary antifungal prophylaxis (AFP) should be considered despite scant evidence. Pediatric groups at risk for IFI includes extremely premature infants in some settings, while in high-risk children with cancer receiving chemotherapy or undergoing haematopoietic stem cell transplantation (HCT), AFP against yeast and moulds is usually recommended. For solid organ transplanted, children, prophylaxis depends on the type of transplant and associated risk factors. In children with primary or acquired immunodeficiency such as HIV or long-term immunosuppressive treatment, AFP depends on the type of immunodeficiency and the degree of immunosuppression. Chronic granulomatous disease is associated with a particular high-risk of IFI and anti-mould prophylaxis is always indicated. In contrast, AFP is not generally recommended in children with long stay in intensive care units. The choice of AFP is limited by the approval of antifungal agents in different age groups and by their pharmacokinetics characteristics. This document aims to review current available information on AFP in children and to provide a comprehensive proposal for each type of patient.

Introducing FDG PET/CT-guided chemoradiotherapy for stage III NSCLC in low- and middle-income countries: preliminary results from the IAEA PERTAIN trial.

PURPOSE: Patients with stage III non-small-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT) in low- and middle-income countries (LMIC) continue to have a poor prognosis. It is known that FDG PET/CT improves staging, treatment selection and target volume delineation (TVD), and although its use has grown rapidly, it is still not widely available in LMIC. CRT is often used as sequential treatment, but is known to be more effective when given concurrently. The aim of the PERTAIN study was to assess the impact of introducing FDG PET/CT-guided concurrent CRT, supported by training and quality control (QC), on the overall survival (OS) and progression-free survival (PFS) of patients with stage III NSCLC. METHODS: The study included patients with stage III NSCLC from nine medical centres in seven countries. A retrospective cohort was managed according to local practices between January 2010 and July 2014, which involved only optional diagnostic FDG PET/CT for staging (not for TVD), followed by sequential or concurrent CRT. A prospective cohort between August 2015 and October 2018 was treated according to the study protocol including FDG PET/CT in treatment position for staging and multimodal TVD followed by concurrent CRT by specialists trained in protocol-specific TVD and with TVD QC. Kaplan-Meier analysis was used to assess OS and PFS in the retrospective and prospective cohorts. RESULTS: Guidelines for FDG PET/CT image acquisition and TVD were developed and published. All specialists involved in the PERTAIN study received training between June 2014 and May 2016. The PET/CT scanners used received EARL accreditation. In November 2018 a planned interim analysis was performed including 230 patients in the retrospective cohort with a median follow-up of 14 months and 128 patients in the prospective cohort, of whom 69 had a follow-up of at least 1 year. Using the Kaplan-Meier method, OS was significantly longer in the prospective cohort than in the retrospective cohort (23 vs. 14 months, p = 0.012). In addition, median PFS was significantly longer in the prospective cohort than in the retrospective cohort (17 vs. 11 months, p = 0.012). CONCLUSION: In the PERTAIN study, the preliminary results indicate that introducing FDG PET/CT-guided concurrent CRT for patients with stage III NSCLC in LMIC resulted in a significant improvement in OS and PFS. The final study results based on complete data are expected in 2020.

Photocatalytic oxidation of diuron using nickel organic xerogel under simulated solar irradiation.

In this study, a nickel organic xerogel (X-Ni) was used as semiconductor photocatalyst for the degradation of the herbicide diuron (DRN) in aqueous solution. The main objective of this work was to analyze and compare the effectiveness of solar irradiation to remove DRN from water both by direct photolysis and photocatalytic degradation. We examined the influence of the initial concentration of the herbicide, the solution pH, the presence of different ions in the medium, the chemical composition of the water, and the presence of a photocatalyst, after 240 min of irradiation. Direct photolysis achieved a low percentage of DRN degradation but was favored: i) by a reduction in the initial concentration of the herbicide (from 35.6% to 79.0% for 0.150 × 10-3 mol/L and 0.021 × 10-3 mol/L of DRN, respectively) and ii) at solution pHs at which diuron is positively charged (78.6% for pH 2 and 50.4% for pH 7), as suggested by DFT calculations carried out for DRN and its protonated form (DRN-H+). The corresponding mono-demethylated DRN derivative, 1-(3,4-dichlorophenyl)-3-methylurea (DCPU), was identified as a DRN degradation byproduct. In addition, the presence of certain anions in the medium significantly affected the overall degradation process by direct photolysis, due to the additional generation of HO radicals. We highlight that the presence of X-Ni considerably improved the photodegradation process under solar irradiation. The photocatalytic degradation rate constant was directly proportional to the xerogel concentration, because an increase in catalyst dose produced an increase in surface active sites for the photodegradation of DRN, enhancing the overall efficiency of the process. Thus, when 4167 mg/g of X-Ni was added, the DRN removal rate was 3-fold higher and both percentage of degradation and mineralization increased 88.5% with respect to the results obtained by direct photolysis.

Sulfonamides degradation assisted by UV, UV/H2O2 and UV/K2S2O8: Efficiency, mechanism and byproducts cytotoxicity.

The objective of this study was to analyze the effectiveness of UVC, UVC/H2O2 and UVC/K2S2O8 on the degradation of SAs. Rate constant values increased in the order SMZ < SDZ < SML and showed the higher photodegradation of sulfonamides with a penta-heterocycle. Quantum yields were 1.72 × 10-5 mol E-1, 3.02 × 10-5 mol E-1, and 6.32 × 10-5 mol E-1 for SMZ, SDZ and SML, respectively, at 60 min of treatment. R254 values show that the dose habitually utilized for water disinfection is inadequate to remove this type of antibiotic. The initial sulfonamide concentration has a major impact on the degradation rate. The degradation rates were higher at pH 12 for SMZ and SML. SMZ and SML photodegradation kλ values are higher in tap versus distilled water. The presence of radical promoters generates a greater increase in the degradation rate, UVC/K2S2O8 cost less energy, a mechanism was proposed, and the degradation by-products are less toxic than the original product.