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1.
Nature ; 568(7753): 521-525, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30971830

RESUMEN

Global dust storms on Mars are rare1,2 but can affect the Martian atmosphere for several months. They can cause changes in atmospheric dynamics and inflation of the atmosphere3, primarily owing to solar heating of the dust3. In turn, changes in atmospheric dynamics can affect the distribution of atmospheric water vapour, with potential implications for the atmospheric photochemistry and climate on Mars4. Recent observations of the water vapour abundance in the Martian atmosphere during dust storm conditions revealed a high-altitude increase in atmospheric water vapour that was more pronounced at high northern latitudes5,6, as well as a decrease in the water column at low latitudes7,8. Here we present concurrent, high-resolution measurements of dust, water and semiheavy water (HDO) at the onset of a global dust storm, obtained by the NOMAD and ACS instruments onboard the ExoMars Trace Gas Orbiter. We report the vertical distribution of the HDO/H2O ratio (D/H) from the planetary boundary layer up to an altitude of 80 kilometres. Our findings suggest that before the onset of the dust storm, HDO abundances were reduced to levels below detectability at altitudes above 40 kilometres. This decrease in HDO coincided with the presence of water-ice clouds. During the storm, an increase in the abundance of H2O and HDO was observed at altitudes between 40 and 80 kilometres. We propose that these increased abundances may be the result of warmer temperatures during the dust storm causing stronger atmospheric circulation and preventing ice cloud formation, which may confine water vapour to lower altitudes through gravitational fall and subsequent sublimation of ice crystals3. The observed changes in H2O and HDO abundance occurred within a few days during the development of the dust storm, suggesting a fast impact of dust storms on the Martian atmosphere.

3.
Eur Arch Otorhinolaryngol ; 281(1): 67-74, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37378725

RESUMEN

OBJECTIVE: To evaluate the long-term outcomes of trans-mastoid plugging of superior semicircular canal dehiscence (SSCD), focusing on complicated cases. METHODS: In this cohort study, we included all patients who underwent trans-mastoid plugging of SSCD between 2009 and 2019. We evaluated the symptoms (autophony, sound-/pressure-induced vertigo, disequilibrium, aural fullness and pulsatile tinnitus) before and 1 year after surgery in the medical records. We systematically assessed the current symptoms 6.2 ± 3 years postoperative (range 2.2-12.3 years) using questionnaires sent by post and validated by telephone interviews. We also documented any complications and the need for further procedures. We compared pure tone and speech audiometry before and 1 year after surgery. Finally, the degree of mastoid pneumatisation and mastoid tegmen anatomy were reviewed on preoperative CT scans. RESULTS: We included 24 ears in 23 patients. No complications were recorded, and none required a second procedure for SSCD. Following surgery, oscillopsia and Tullio phenomena resolved in all patients. Hyperacusis, autophony, and aural fullness were also settled in all patients except one. Balance impairment persisted to some degree in 35% of patients. No deterioration over the years was reported regarding the above symptoms. On average, bone conduction pure tone average pre- and 1 year postoperative were 13.7 ± 17 and 20.5 ± 18 dB, respectively (P = 0.002). Air bone gaps were reduced from 12.7 ± 8 to 5.9 ± 6 (P = 0.001). Two patients had a significant sclerotic mastoid, three had a prominent low-lying mastoid tegmen, and two had both. Anatomy had no effect on outcome. CONCLUSION: Trans-mastoid plugging of SSCD is a reliable and effective technique which achieves long-lasting symptom control, even in cases with sclerotic mastoid or low-lying mastoid tegmen.


Asunto(s)
Apófisis Mastoides , Dehiscencia del Canal Semicircular , Humanos , Apófisis Mastoides/diagnóstico por imagen , Apófisis Mastoides/cirugía , Estudios de Cohortes , Dehiscencia del Canal Semicircular/complicaciones , Estudios de Seguimiento , Estudios Retrospectivos , Vértigo/etiología , Canales Semicirculares/diagnóstico por imagen , Canales Semicirculares/cirugía
4.
Nano Lett ; 23(6): 2203-2209, 2023 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-36888899

RESUMEN

A photonic wire antenna embedding individual quantum dots (QDs) constitutes a promising platform for both quantum photonics and hybrid nanomechanics. We demonstrate here an integrated device in which on-chip electrodes can apply a static or oscillating bending force to the upper part of the wire. In the static regime, we achieve control over the bending direction and apply at will tensile or compressive mechanical stress on any QD. This results in a blue shift or red shift of their emission, with direct application to the realization of broadly tunable sources of quantum light. As a first illustration of operation in the dynamic regime, we excite the wire fundamental flexural mode and use the QD emission to detect the mechanical vibration. With an estimated operation bandwidth in the GHz range, electrostatic actuation opens appealing perspectives for the exploration of QD-nanowire hybrid mechanics with high-frequency vibrational modes.

5.
Colorectal Dis ; 25(11): 2160-2169, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37837240

RESUMEN

AIM: Nonsurgical treatment with chemoradiotherapy for rectal cancer is gaining interest as it avoids total mesorectal excision (TME) surgery and stoma. The OPERA trial aims to evaluate whether dose escalation with contact X-ray brachytherapy (CXB) boost improves organ preservation compared to external beam radiotherapy (EBRT) boost. It has been suggested that dose escalation adversely affects surgical outcomes and therefore we report outcomes following TME in OPERA at 36 months. METHODS: OPERA is a European multicentre phase 3 trial (NCT02505750) which randomises patients with cT2-3a-b, cN0-1, M0 to EBCRT (45 Gy in 25 fractions over 5 weeks with oral capecitabine 825 mg/m2 ) followed by EBRT boost (9 Gy in 5 fractions over 5 days) versus EBCRT followed by CXB boost (90 Gy in 3 fractions over 4 weeks). Patients were assessed at 14, 20 and 24 weeks from the start of treatment. Watch and wait management was adopted for patients who achieved a clinical complete response (cCR) at 24 weeks following treatment. Either local excision (LE) or TME surgery was offered for residual disease or local regrowth, according to patient and surgeon preference. Surgical morbidity and mortality were recorded prospectively. RESULTS: Between July 2015 and June 2020, 148 patients were randomised of which 141 were evaluable in March 2022. At median follow-up of 38.2 months (range: 34.2-42.5), surgery was performed for 66 (47%) patients. A total of 27 (20%) patients had local excision and 39 (29%) had TME surgery, 22/39 (56%) underwent anterior resection and 17/39 (44%) underwent abdominoperineal excision of the rectum. The R0 resection rate was 87%. There were no deaths, and six patients (15%) had Clavien-Dindo IIIb complications. Whilst there was a statistically significant decrease in the TME rate following CXB boost (HR 0.38, 95% CI: 0.19-0.74, p = 0.00419) there was no difference in surgical outcomes between patients who received EBRT and CXB boost. CONCLUSION: Dose escalation can facilitate nonsurgical treatment for cT2-3 rectal cancer patients who are fit but wish to avoid TME surgery and stoma. If TME surgery is required, then it can be performed safely and effectively.


Asunto(s)
Adenocarcinoma , Neoplasias del Recto , Humanos , Preservación de Órganos , Terapia Neoadyuvante , Neoplasias del Recto/cirugía , Neoplasias del Recto/patología , Quimioradioterapia , Resultado del Tratamiento , Adenocarcinoma/cirugía , Adenocarcinoma/patología , Recurrencia Local de Neoplasia
6.
Ear Hear ; 44(4): 710-720, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36550618

RESUMEN

OBJECTIVES: Different patterns of electrocochleographic responses along the electrode array after insertion of the cochlear implant electrode array have been described. However, the implications of these patterns remain unclear. Therefore, the aim of the study was to correlate different peri- and postoperative electrocochleographic patterns with four-point impedance measurements and preservation of residual hearing. DESIGN: Thirty-nine subjects with residual low-frequency hearing which were implanted with a slim-straight electrode array could prospectively be included. Intracochlear electrocochleographic recordings and four-point impedance measurements along the 22 electrodes of the array (EL, most apical EL22) were conducted immediately after complete insertion and 3 months after surgery. Hearing preservation was assessed after 3 months. RESULTS: In perioperative electrocochleographic recordings, 22 subjects (56%) showed the largest amplitude around the tip of the electrode array (apical-peak, AP, EL20 or EL22), whereas 17 subjects (44%) exhibited a maximum amplitude in more basal regions (mid-peak, MP, EL18 or lower). At 3 months, in six subjects with an AP pattern perioperatively, the location of the largest electrocochleographic response had shifted basally (apical-to-mid-peak, AP-MP). Latency was analyzed along the electrode array when this could be discerned. This was the case in 68 peri- and postoperative recordings (87% of all recordings, n = 78). The latency increased with increasing insertion depth in AP recordings (n = 38, median of EL with maximum latency shift = EL21). In MP recordings (n = 30), the maximum latency shift was detectable more basally (median EL12, p < 0.001). Four-point impedance measurements were available at both time points in 90% (n = 35) of all subjects. At the 3-month time point, recordings revealed lower impedances in the AP group (n = 15, mean = 222 Ω, SD = 63) than in the MP (n = 14, mean = 295 Ω, SD= 7 6) and AP-MP groups (n = 6, mean = 234 Ω, SD = 129; AP versus MP p = 0.026, AP versus AP-MP p = 0.023, MP versus AP-MP p > 0.999). The amplitudes of perioperative AP recordings showed a correlation with preoperative hearing thresholds ( r2 =0.351, p = 0.004). No such correlation was detectable in MP recordings ( r2 = 0.033, p = 0.484). Audiograms were available at both time points in 97% (n = 38) of all subjects. The mean postoperative hearing loss in the AP group was 13 dB (n = 16, SD = 9). A significantly larger hearing loss was detectable in the MP and AP-MP groups with 28 (n = 17, SD = 10) and 35 dB (n = 6, SD = 13), respectively (AP versus MP p = 0.002, AP versus AP-MP p = 0.002, MP versus AP-MP p = 0.926). CONCLUSION: MP and AP-MP response patterns of the electrocochleographic responses along the electrode array after cochlear implantation are correlated with higher four-point impedances and poorer postoperative hearing compared to AP response patterns. The higher impedances suggest that MP and AP-MP patterns are associated with increased intracochlear fibrosis.


Asunto(s)
Implantación Coclear , Implantes Cocleares , Sordera , Pérdida Auditiva , Humanos , Impedancia Eléctrica , Pérdida Auditiva/cirugía , Cóclea/cirugía , Sordera/cirugía
7.
Acta Oncol ; 61(9): 1084-1092, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36107959

RESUMEN

BACKGROUND: The impact of the tumour volume or size on achieving clinical complete response (cCR) after radio(chemo)therapy is poorly understood. MATERIALS AND METHODS: A literature search was performed to gather data on the predictive value of baseline tumour volume or size in achieving cCR. RESULTS: In total, nine reports were identified. In two of three studies evaluating the baseline tumour volumetry, the tumour volume was the most powerful predictor for cCR. In four of six studies evaluating baseline tumour size without volumetry, tumour dimension was significantly associated with cCR, in one study reached borderline significance and in one report was insignificant. In three of four studies where a multivariable analysis was performed, the cT category did not show an independent predictive value for cCR. Because the tumour shape is often (semi)annular, its circumferential rectal extent along with the tumour length probably impact the tumour volume most, and thus, could be considered an acceptable alternative for time-consuming volumetry. CONCLUSIONS: Our review suggests that baseline tumour volume (or alternatively, tumour length along with its circumferential rectal extent) is the most relevant clinical predictor of cCR. Therefore, we postulate assessing and reporting these parameters in studies on the watch-and-wait strategy.


Asunto(s)
Terapia Neoadyuvante , Neoplasias del Recto , Humanos , Carga Tumoral , Espera Vigilante , Recurrencia Local de Neoplasia , Neoplasias del Recto/terapia , Neoplasias del Recto/patología , Márgenes de Escisión , Quimioradioterapia , Resultado del Tratamiento
8.
J Adolesc ; 94(3): 366-379, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-35390198

RESUMEN

BACKGROUND: The study of adolescent perceptions of their ethnicity/race has been investigated from an ethnic-racial identity (measurement) perspective or through an ethnic-racial classification lens. AIMS: This study examines both, as it explores change in adolescents' ethnic-racial self-categorization; change in strength of ethnic-racial identity (ERI); and the relationship between change in self-categorization and strength of ERI. In so doing, it contributes to theorizing about the content and process of ERI formation. MATERIALS AND METHODS: The longitudinal and mixed-methods study followed 732 middle and high school students biannually in a semi-rural, ethnically diverse school district. All students completed the Multigroup Ethnic Identity Measure (MEIM) in fall and spring each year and interviewed annually for qualitative inquiry. RESULTS: The four waves of data demonstrated that: (1) 22% of students changed their ethnic-racial classification at least once; (2) Multiracial youth, boys, and 8th graders were significantly more likely to change self-classification compared to White youth, girls, and 10 th graders; (3) strength of ERI did not change over time, however, African American and Hispanic youth had the strongest ERI over time compared to the others; (4) change in self-classification was significantly related to change in strength of ERI, however, its direction varied by race of students. DISCUSSION: While adolescent ethnic-racial identity development (ERI) appears to be related to ethnic-racial categorization, the direction of the relationship varies depending on ethnic self-categorization. CONCLUSION: Results contribute to theory building of ERI in relation to: content and process, group consciousness, certainty and clarity, and public regard.


Asunto(s)
Etnicidad , Identificación Social , Adolescente , Negro o Afroamericano , Femenino , Hispánicos o Latinos , Humanos , Masculino , Grupos Raciales
9.
Eur Arch Otorhinolaryngol ; 279(1): 137-147, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33547488

RESUMEN

PURPOSE: To provide practical guidance to the operative surgeon by mapping the location, where acceptable straight-line virtual cochlear implant electrode trajectories intersect the facial recess. In addition, to investigate the influence of facial recess preparation, virtual electrode width and surgical approach to the cochlea on these available trajectories. METHODS: The study was performed on imaging data from eight cadaveric temporal bones within the University of Melbourne Virtual Reality (VR) Temporal Bone Surgery Simulator. The facial recess was opened to varying degrees, and acceptable trajectory vectors with varying diameters were calculated for electrode insertions via cochleostomy or round window membrane (RWM). The percentage of acceptable insertion vectors through each location of the facial recess was visually represented using heatmaps. RESULTS: Seven of the eight bones allowed for acceptable vector trajectories via both cochleostomy and RWM approaches. These acceptable trajectories were more likely to lie superiorly within the facial recess for insertion via the round window, and inferiorly for insertion via cochleostomy. Cochleostomy insertions required a greater degree of preparation and skeletonisation of the junction of the facial nerve and chorda tympani within the facial recess. The width of the virtual electrode had only marginal impact on the availability of acceptable trajectories. Heatmaps emphasised the intimate relationship the acceptable trajectories have with the facial nerve and chorda tympani. CONCLUSION: These findings highlight the differences in the acceptable straight-line trajectories for electrodes when implanted via the round window or cochleostomy. There were notable exceptions to both surgical approaches, likely explained by the variation of hook region anatomy. The methodology used in this study holds promise for translation to patient specific surgical planning.


Asunto(s)
Implantación Coclear , Implantes Cocleares , Cóclea/cirugía , Electrodos Implantados , Humanos , Ventana Redonda/cirugía , Hueso Temporal/diagnóstico por imagen , Hueso Temporal/cirugía
10.
Clin Otolaryngol ; 46(5): 961-968, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33779051

RESUMEN

INTRODUCTION: Cortical mastoidectomy is a core skill that Otolaryngology trainees must gain competency in. Automated competency assessments have the potential to reduce assessment subjectivity and bias, as well as reducing the workload for surgical trainers. OBJECTIVES: This study aimed to develop and validate an automated competency assessment system for cortical mastoidectomy. PARTICIPANTS: Data from 60 participants (Group 1) were used to develop and validate an automated competency assessment system for cortical mastoidectomy. Data from 14 other participants (Group 2) were used to test the generalisability of the automated assessment. DESIGN: Participants drilled cortical mastoidectomies on a virtual reality temporal bone simulator. Procedures were graded by a blinded expert using the previously validated Melbourne Mastoidectomy Scale: a different expert assessed procedures by Groups 1 and 2. Using data from Group 1, simulator metrics were developed to map directly to the individual items of this scale. Metric value thresholds were calculated by comparing automated simulator metric values to expert scores. Binary scores per item were allocated using these thresholds. Validation was performed using random sub-sampling. The generalisability of the method was investigated by performing the automated assessment on mastoidectomies performed by Group 2, and correlating these with scores of a second blinded expert. RESULTS: The automated binary score compared with the expert score per item had an accuracy, sensitivity and specificity of 0.9450, 0.9547 and 0.9343, respectively, for Group 1; and 0.8614, 0.8579 and 0.8654, respectively, for Group 2. There was a strong correlation between the total scores per participant assigned by the expert and calculated by the automatic assessment method for both Group 1 (r = .9144, P < .0001) and Group 2 (r = .7224, P < .0001). CONCLUSION: This study outlines a virtual reality-based method of automated assessment of competency in cortical mastoidectomy, which proved comparable to the assessment provided by human experts.


Asunto(s)
Competencia Clínica , Educación Médica/métodos , Mastoidectomía/educación , Entrenamiento Simulado/métodos , Realidad Virtual , Adulto , Femenino , Humanos , Masculino
11.
Anesth Analg ; 130(6): 1670-1677, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31702699

RESUMEN

BACKGROUND: Carbohydrate intake during physical exercise improves muscle performance and decreases fatigue. We hypothesized that carbohydrate intake during labor, which is a period of significant physical activity, can decrease the instrumental vaginal delivery rate. METHODS: In a multicenter, prospective, randomized, controlled trial, healthy adult pregnant women presenting with spontaneous labor were assigned to a "Carbohydrate" group (advised to drink 200 mL of apple or grape juice without pulp every 3 hours) or a "Fasting" group (water only). The primary outcome was the instrumental vaginal delivery rate. Secondary outcomes included duration of labor, rate of cesarean delivery, evaluation of maternal hunger, thirst, stress, fatigue, and overall feeling during labor by numeric rating scale (0 worst rating to 10 best rating), rate of vomiting, and hospital length of stay. Statistical analysis was performed on an intention-to-treat basis. The primary outcome was tested with the "Fasting" group as the reference group. The P values for secondary outcomes were adjusted for multiple comparisons. The differences between groups are reported with 99% confidence interval (CI). RESULTS: A total of 3984 women were analyzed (2014 in the Carbohydrate group and 1970 in the Fasting group). There was no difference in the rate of instrumental delivery between the Carbohydrate (21.0%) and the Fasting (22.4%) groups (difference, -1.4%; 99% CI, -4.9 to 2.2). No differences were found between the Carbohydrate and the Fasting groups for the duration of labor (difference, -7 minutes; 99% CI, -25 to 11), the rate of cesarean delivery (difference, -0.3%; 99% CI, -2.4 to 3.0), the rate of vomiting (difference, 2.8%; 99% CI, 0.2-5.7), the degree of self-reported fatigue (difference, 1; 99% CI, 0-2), self-reported hunger (difference, 0; 99% CI, -1 to 1), thirst (difference, 0; 99% CI, -1 to 1), stress (difference, 0; 99% CI, -1 to 1), overall feeling (difference, 0; 99% CI, 0-0), and the length of hospitalization (difference, 0; 99% CI, -1 to 0). CONCLUSIONS: Carbohydrate intake during labor did not modify the rate of instrumental vaginal delivery.


Asunto(s)
Carbohidratos/administración & dosificación , Trabajo de Parto/fisiología , Adulto , Cesárea , Parto Obstétrico , Agua Potable/administración & dosificación , Extracción Obstétrica , Femenino , Jugos de Frutas y Vegetales , Humanos , Oxitócicos/administración & dosificación , Embarazo , Estudios Prospectivos , Instrumentos Quirúrgicos
12.
Clin Otolaryngol ; 45(5): 746-753, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32391949

RESUMEN

INTRODUCTION: Cortical mastoidectomy is a common otolaryngology procedure and represents a compulsory part of otolaryngology training. As such, a specific validated assessment score is needed for the progression of competency-based training in this procedure. Although multiple temporal bone dissection scales have been developed, they have all been validated for advanced temporal bone dissection including posterior tympanotomy, rather than the task of cortical mastoidectomy. METHODS: The Melbourne Mastoidectomy Scale, a 20-item end-product dissection scale to assess cortical mastoidectomy, was developed. The scale was validated using dissections by 30 participants (10 novice, 10 intermediate and 10 expert) on a virtual reality temporal bone simulator. All dissections were assessed independently by three blinded graders. Additionally, all procedures were graded with an abbreviated Welling Scale by one grader. RESULTS: There was high inter-rater reliability between the three graders (r = .9210, P < .0001). There was a significant difference in scores between the three groups (P < .0001). Additionally, there was a large effect size between all three groups: the differences between the novice group and both the intermediate group (P = .0119, η2  = 0.2482) and expert group (P < .001, η2  = 0.6356) were significant. The difference between the intermediate group and expert group again had a large effect size (η2  = 0.3217), but was not significant. The Melbourne Mastoidectomy Scale correlated well with an abbreviated Welling Scale (r = .8485, P < .0001). CONCLUSION: The Melbourne Mastoidectomy Scale offers a validated score for use in the assessment of cortical mastoidectomy.


Asunto(s)
Competencia Clínica , Simulación por Computador , Educación de Postgrado en Medicina/métodos , Apófisis Mastoides/cirugía , Mastoidectomía/educación , Otolaringología/educación , Entrenamiento Simulado/métodos , Cadáver , Evaluación Educacional , Femenino , Humanos , Masculino , Estudios Prospectivos , Reproducibilidad de los Resultados , Hueso Temporal/cirugía
13.
Int J Cancer ; 145(11): 3163-3172, 2019 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-31107542

RESUMEN

We examined whether 66 germline single-nucleotide polymorphisms (SNPs) in 10 candidate genes would predict clinical outcome in 316 patients with resectable locally advanced rectal cancer (LARC) enrolled in the ACCORD-12 phase III trial who were randomly treated with preoperative radiotherapy plus capecitabine (CAP45; n = 155) or dose-intensified radiotherapy plus capecitabine and oxaliplatin (CAPOX50; n = 161). The primary endpoint was tumor response according to the Dworak score. Multivariate logistic regression models adjusted on treatment arm and T stage determined the SNPs prognostic and predictive values for tumor response. In univariate analysis, five SNPs in ERCC2, XPA, MTHFR and ERCC1 were associated with the Dworak score in the CAPOX50 arm. In the overall population, interaction with treatment arm was significant for ERCC2 rs1799787 (pinteraction = 0.05) and XPA rs3176683 (pinteraction = 0.008), suggesting a predictive effect for response to oxaliplatin-based chemoradiotherapy (CRT). All but XPA rs3176683 had a prognostic effect on tumor response. In a multivariate model, interaction remained significant for XPA rs3176683 ([OR 7.33, 95% CI 1.40-38.23], pinteraction = 0.018) and the prognostic effect significant for ERCC2 rs1799787 ([OR 0.55, 95%CI 0.32-0.93], p = 0.027) and ERCC1 rs10412761 ([OR 0.57, 95%CI 0.34-0.98], p = 0.042). Patients with the T/G haplotype of rs1799787 and rs10412761 had a 60% decrease in odds of response (p < 0.001). None of the five SNPs were associated with toxicity, overall and disease-free survival. These data suggest that genetic variation in DNA repair genes influences response to preoperative CRT in LARC and identify patients who benefit from the addition of oxaliplatin to CRT.


Asunto(s)
Capecitabina/uso terapéutico , Quimioradioterapia/métodos , Oxaliplatino/uso terapéutico , Polimorfismo de Nucleótido Simple , Neoplasias del Recto/terapia , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Reparación del ADN , Femenino , Redes Reguladoras de Genes , Mutación de Línea Germinal , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Neoplasias del Recto/genética , Análisis de Supervivencia , Resultado del Tratamiento
14.
Phys Rev Lett ; 123(24): 247403, 2019 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-31922831

RESUMEN

Nanowire antennas embedding a single quantum dot (QD) have recently emerged as versatile platforms to realize bright sources of quantum light. In this theoretical work, we show that the thermally driven, low-frequency vibrations of the nanowire have a major impact on the QD light emission spectrum. Even at liquid helium temperatures, these prevent the emission of indistinguishable photons. To overcome this intrinsic limitation, we propose three designs that restore photon indistinguishability thanks to a specific engineering of the mechanical properties of the nanowire. We anticipate that such a mechanical optimization will also play a key role in the development of other high-performance light-matter interfaces based on nanostructures.

15.
PLoS Biol ; 14(3): e1002401, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26942442

RESUMEN

Demonstrations of both pro-apoptotic and pro-survival abilities of Fas (TNFRSF6/CD95/APO-1) have led to a shift from the exclusive "Fas apoptosis" to "Fas multisignals" paradigm and the acceptance that Fas-related therapies face a major challenge, as it remains unclear what determines the mode of Fas signaling. Through protein evolution analysis, which reveals unconventional substitutions of Fas tyrosine during divergent evolution, evolution-guided tyrosine-phosphorylated Fas proxy, and site-specific phosphorylation detection, we show that the Fas signaling outcome is determined by the tyrosine phosphorylation status of its death domain. The phosphorylation dominantly turns off the Fas-mediated apoptotic signal, while turning on the pro-survival signal. We show that while phosphorylations at Y232 and Y291 share some common functions, their contributions to Fas signaling differ at several levels. The findings that Fas tyrosine phosphorylation is regulated by Src family kinases (SFKs) and the phosphatase SHP-1 and that Y291 phosphorylation primes clathrin-dependent Fas endocytosis, which contributes to Fas pro-survival signaling, reveals for the first time the mechanistic link between SFK/SHP-1-dependent Fas tyrosine phosphorylation, internalization route, and signaling choice. We also demonstrate that levels of phosphorylated Y232 and Y291 differ among human cancer types and differentially respond to anticancer therapy, suggesting context-dependent involvement of Fas phosphorylation in cancer. This report provides a new insight into the control of TNF receptor multisignaling by receptor phosphorylation and its implication in cancer biology, which brings us a step closer to overcoming the challenge in handling Fas signaling in treatments of cancer as well as other pathologies such as autoimmune and degenerative diseases.


Asunto(s)
Evolución Molecular , Neoplasias/metabolismo , Proteína Tirosina Fosfatasa no Receptora Tipo 6/metabolismo , Receptor fas/metabolismo , Familia-src Quinasas/metabolismo , Secuencia de Aminoácidos , Apoptosis , Endocitosis , Humanos , Datos de Secuencia Molecular , Mutagénesis Sitio-Dirigida , Fosforilación , Estructura Terciaria de Proteína
16.
Eur J Anaesthesiol ; 36(5): 335-341, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30664524

RESUMEN

BACKGROUND: High-flow nasal oxygen (HFNO) therapy has been proposed for pre-oxygenation before intubation, but the end-tidal fraction of oxygen (ETO2) obtained remains unknown. OBJECTIVE(S): To compare the ETO2 following a 3 min pre-oxygenation with HFNO and face mask. SETTING: Operating room in a primary university hospital. DESIGN: A randomised crossover study. PARTICIPANTS: Fifty healthy volunteers. INTERVENTIONS: Participants were randomly pre-oxygenated through spontaneous breathing 100% oxygen in a face mask and with HFNO (mouth closed, heated and humidified gas flow at 60 l min). In the face mask group, the ETO2 was measured continuously. In the HFNO group, the nasal cannula was quickly exchanged with a face mask while the subject held their breath at end inspiration and the ETO2 was measured after a deep expiration. The protocol ended when ETO2 reached 90% or otherwise at 6 min. MAIN OUTCOME MEASURES: The primary endpoint was the ETO2 after 3 min of pre-oxygenation. Secondary endpoints were the proportion of participants with an ETO2 at least 90% and the time until the ETO2 at least 90%. RESULTS: The ETO2 after 3 min of pre-oxygenation was 89 (2) % and 77 (12) % in the face mask and HFNO groups [difference 12% (95% confidence interval, 95% CI: 8 to 15]; P < 0.001), respectively. After 3 min of pre-oxygenation, 54 and 4% (P < 0.001) of volunteers had an ETO2 at least 90% in the face-mask and HFNO groups, respectively. After 6 min of pre-oxygenation, 96 and 46% (P < 0.001) of volunteers had an ETO2 at least 90% in the face-mask and HFNO groups, respectively. In the face mask group, the hazard ratio to achieve an ETO2 of 90% was 5.3 (95% CI: 3.2 to 8.9; P < 0.001). CONCLUSION: Our study demonstrates that pre-oxygenation with HFNO is not a reliable method of pre-oxygenation before the induction of anaesthesia. TRIAL REGISTRATION: clinical trial NCT03399695.


Asunto(s)
Oxígeno/administración & dosificación , Cuidados Preoperatorios/métodos , Adulto , Cánula , Estudios Cruzados , Espiración , Femenino , Voluntarios Sanos , Humanos , Masculino , Máscaras , Oxígeno/análisis , Cuidados Preoperatorios/instrumentación , Resultado del Tratamiento , Adulto Joven
17.
Nano Lett ; 18(10): 6434-6440, 2018 10 10.
Artículo en Inglés | MEDLINE | ID: mdl-30185050

RESUMEN

Nanowire antennas embedding single quantum dots (QDs) have recently emerged as a versatile solid-state platform for quantum optics. Within the nanowire section, the emitter position simultaneously determines the strength of the light-matter interaction, as well as the coupling to potential decoherence channels. Therefore, to quantitatively understand device performance and guide future optimization, it is highly desirable to map the emitter position with an accuracy much smaller than the waveguide diameter, on the order of a few hundreds of nanometers. We introduce here a nondestructive, all-optical mapping technique that exploits the QD emission into two guided modes with different transverse profiles. These two modes are fed by the same emitter and thus interfere. The resulting intensity pattern, which is highly sensitive to the emitter position, is resolved in the far-field using Fourier microscopy. We demonstrate this technique on a standard microphotoluminescence setup and map the position of individual QDs in a nanowire antenna with a spatial resolution of ±10 nm. This work opens important perspectives for the future development of light-matter interfaces based on nanowire antennas. Beyond single-QD devices, it will also provide a valuable tool for the investigation of collective effects that imply several emitters coupled to an optical waveguide.

18.
J Anaesthesiol Clin Pharmacol ; 35(4): 453-459, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31920227

RESUMEN

BACKGROUND AND AIMS: Recruitment maneuvers may be used during anesthesia as part of perioperative protective ventilation strategy. However, the hemodynamic effect of recruitment maneuvers remain poorly documented in this setting. MATERIAL AND METHODS: This was a prospective observational study performed in operating theatre including patients scheduled for major vascular surgery. Patients were monitored with invasive arterial pressure and esophageal doppler. After induction of general anesthesia, before surgery began, preload optimization based on stroke volume (SV) variation following fluid challenge was performed. Then, an alveolar recruitment maneuver (ARM) through stepwise increase in positive end expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) was performed. Hemodynamic data were noted before, during, and after the alveolar recruitment maneuver. RESULTS: ARM through stepwise increase in PEEP and CPAP were applied in 22 and 14 preload independent patients, respectively. Relative changes in SV during ARMs were significantly greater in the ARMCPAP group (-39 ± 20%) as compared to the ARMPEEP group (-15 ± 22%; P = 0.002). The difference (95% CI) in relative decrease in SV between ARMCPAP and ARMPEEP groups was -24% (-38 to -9; P = 0.001). Changes in arterial pressure, cardiac index, pulse pressure variation, peak velocity, and corrected flow time measures were not different between groups. CONCLUSION: During anesthesia, in preload independent patients, ARMs through CPAP resulted in a significantly greater decrease in SV than stepwise increase in PEEP. During anesthesia, ARM should be used cautiously.

19.
Opt Express ; 26(13): 17697-17704, 2018 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-30119580

RESUMEN

Superconducting-nanowire single photon detectors (SNSPDs) are able to reach near-unity detection efficiency in the infrared spectral range. However, due to the intrinsic asymmetry of nanowires, SNSPDs are usually very sensitive to the polarization of the incident radiation, their responsivity being maximum for light polarized parallel to the nanowire length (transverse-electric (TE) polarization). Here, we report on the reduction of the polarization sensitivity obtained by capping NbN-based SNSPDs with a high-index SiNx dielectric layer, which reduces the permittivity mismatch between the NbN wire and the surrounding area. Experimentally, a polarization sensitivity below 0.1 is obtained both at 1.31 and 1.55 µm, in excellent agreement with simulations.

20.
Am J Bot ; 105(10): 1653-1661, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30324613

RESUMEN

PREMISE OF THE STUDY: Basic wood density is an important ecological trait for woody plants. It is used to characterize species performance and fitness in community ecology and to compute tree and forest biomass in carbon cycle studies. While wood density has been historically measured at 12% moisture, it is convenient for ecological purposes to convert this measure to basic wood density, i.e., the ratio of dry mass over green volume. Basic wood density can then be used to compute tree dry biomass from living tree volume. METHODS: Here, we derive a new exact formula to compute the basic wood density Db from the density at moisture content w denoted Dw , the fiber saturation point S, and the volumetric shrinkage coefficient R. We estimated a new conversion factor using a global wood technology database where values to use this formula are available for 4022 trees collected in 64 countries (mostly tropical) and representing 872 species. KEY RESULTS: We show that previous conversion factors used to convert densities at 12% moisture into basic wood densities are inconsistent. Based on theory and data, we found that basic wood density could be inferred from the density at 12% moisture using the following formula: Db = 0.828D12 . This value of 0.828 provides basic wood density estimates 4-5% smaller than values inferred from previous conversion factors. CONCLUSIONS: This new conversion factor should be used to derive basic wood densities in global wood density databases. Its use would prevent overestimating global forest carbon stocks and allow predicting better tree species community dynamics from wood density.


Asunto(s)
Biomasa , Árboles/fisiología , Madera/fisiología , Bosques , Modelos Biológicos
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