Up to 300†K lasing with GeSn-On-Insulator microdisk resonators.

GeSn alloys are the most promising direct band gap semiconductors to demonstrate full CMOS-compatible laser integration with a manufacturing from Group-IV materials. Here, we show that room temperature lasing, up to 300 K, can be obtained with GeSn. This is achieved in microdisk resonators fabricated on a GeSn-On-Insulator platform by combining strain engineering with a thick layer of high Sn content GeSn.

KRAS p.G12C mutation occurs in 1% of EGFR-mutated advanced non-small-cell lung cancer patients progressing on a first-line treatment with a tyrosine kinase inhibitor.

BACKGROUND: KRAS is mutated in ∼30% of non-small-cell lung cancer (NSCLC) but it has also been identified as one of the mechanisms underlying resistance to tyrosine kinase inhibitors (TKIs) in EGFR-positive NSCLC patients. Novel KRAS inhibitors targeting KRAS p.G12C mutation have been developed recently with promising results. The proportion of EGFR-positive NSCLC tumours harbouring the KRAS p.G12C mutation upon disease progression is completely unexplored. MATERIALS AND METHODS: Plasma samples from 512 EGFR-positive advanced NSCLC patients progressing on a first first-line treatment with a TKI were collected. The presence of KRAS p.G12C mutation was assessed by digital PCR. RESULTS: Overall, KRAS p.G12C mutation was detected in 1.17% of the samples (n = 6). In two of these cases, we could confirm that the KRAS p.G12C mutation was not present in the pre-treatment plasma samples, supporting its role as an acquired resistance mutation. According to our data, KRASG12C patients showed similar clinicopathological characteristics to those of the rest of the study cohort and no statistically significant associations between any clinical features and the presence of the mutation were found. However, two out of six KRASG12C tumours harboured less common EGFR driver mutations (p.G719X/p.L861Q). All KRASG12C patients tested negative for the presence of p.T790M resistance mutation. CONCLUSIONS: The KRAS p.G12C mutation is detected in 1% of EGFR-positive NSCLC patients who progress on a first line with a TKI. All KRASG12C patients were negative for the presence of the p.T790M mutation and they did not show any distinctive clinical feature.

Assessment of self-efficacy for caregiving in oncology: Italian validation of the caregiver inventory (CGI-I).

BACKGROUND: The Caregiver Inventory (CGI), a measure of self-efficacy for caregiving that takes into account aspects of caregiving that are neglected by current measures of caregiving, was translated into Italian and validated. METHODS: Ninety-one caregivers from a variety of locations in Italy completed the CGI-Italian (CGI-I) as well as the Hospital Anxiety and Depression Scale (HADS) and the Family Strain Questionnaire - Short Form (FSQ-SF). RESULTS: A confirmatory factor analysis based on the original CGI factor structure resulted in an adequate fit of the CGI-I using standard fit indices. Thus, the original factor structure was validated in the CGI-I: Managing Medical Information (α = 0.87), Caring for Care Recipient (α = 0.68), Caring for Oneself (α = 0.78), and Managing Difficult Interactions/Emotions (α = 0.55). The CGI-I total score was inversely related to anxiety (HADS, r = - 0.35, p = <.05), and depression (HADS, r = - 0.45, p = <.05). In addition, the CGI-I was inversely related to caregiver stress (FSQ-SF, r = - 0.39, p = <.05). Care of Oneself and Managing Difficult Interactions/Emotions emerged as the strongest and most robust negative relationships with anxiety, depression, and caregiver stress, which replicated, with similar constructs, findings from the original CGI. CONCLUSIONS: The results of this study established the CGI-I as a reliable and valid measure of self-efficacy for caregiving. This study also confirms the importance of self-care and managing difficult communication in the process of successfully navigating the demands of caregiving and in constructing interventions for caregivers who need support.

Overall survival for early and locally advanced non-small-cell lung cancer from one institution: 2000–2017

Purpose Lung cancer is the leading cause of cancer death in Spain. The objective of our study was to evaluate the characteristics of patients diagnosed with stages I–III non-small-cell lung cancer, as well as the impact that epidemiological changes, diagnostic improvements and surgical therapeutic innovations have had on survival in the past 20 years. Methods Retrospective analysis of patients diagnosed with early and locally advanced non-small-cell lung cancer between years 2000 and 2017 in our institution. Results A total of 859 patients were included. An increase in the percentage of women diagnosed over time was observed. Statistically significant differences were observed in the mean age at diagnosis, with a progressive increase in the different periods. The percentage of current or former smokers was similar in all periods. Adenocarcinoma was the most frequent histologic type with a progressive increase in its frequency. The percentage of patients diagnosed in early stages has been increasing over the years. In stages I–II, there was a significant increase in the median survival (29.7 months: 2000–2004, 68.73 months: 2010–2014) that could be seen in stage III as well (14.7 months: 2000–2004, 30.63 months: 2015–2017). Conclusions A variation of clinical characteristics of lung cancer in Spain has been observed in recent years, as well as an improvement in survival in early and locally advanced stages, due not only to the treatments, but also to a more accurate detection of these tumors. Little progress has been made in tobacco habit with high stable percentages over the years (AU)

Recambio de bomba intratecal en esclerosis múltiple. Factores que interfieren en la eficacia y ajuste de dosis de baclofeno. A propósito de un caso / Intrathecal baclofen pump exchange in multiple sclerosis. Factors affecting baclofen efficacy and dose adjustement. A case report

La esclerosis múltiple es una enfermedad neurológica con clínica variada, que en algunos casos es progresiva y muy invalidante, y que requiere tratamientos invasivos para el dolor y la espasticidad. El uso de perfusiones de baclofeno intratecal es una alternativa eficaz y segura para pacientes con espasticidad refractaria y severa, y logra mejorar la calidad de vida, pero es preciso disponer de una unidad del dolor con personal entrenado para emplear estas terapias invasivas y conocer las indicaciones, farmacología y posibles riesgos tanto del implante como del uso del baclofeno. Se tiene que individualizar el tratamiento y hacer seguimientos periódicos.(AU)

Multiple sclerosis is a neurological disease that presents with various symptoms; in some cases it is progressive and highly disabling, requiring invasive techniques to treat pain and spasticity. The use of intrathecal baclofen infusions is an effective and safe alternative for patients with severe and refractory spasticity. The therapy can improve quality of life, but must be performed in a pain unit by medical staff trained in the technique, its indications, pharmacology, and the potential risks of both the implant and the drug. The treatment can be individualized and patients must be followed up periodically.(AU)

Overall survival for early and locally advanced non-small-cell lung cancer from one institution: 2000-2017.

PURPOSE: Lung cancer is the leading cause of cancer death in Spain. The objective of our study was to evaluate the characteristics of patients diagnosed with stages I-III non-small-cell lung cancer, as well as the impact that epidemiological changes, diagnostic improvements and surgical therapeutic innovations have had on survival in the past 20 years. METHODS: Retrospective analysis of patients diagnosed with early and locally advanced non-small-cell lung cancer between years 2000 and 2017 in our institution. RESULTS: A total of 859 patients were included. An increase in the percentage of women diagnosed over time was observed. Statistically significant differences were observed in the mean age at diagnosis, with a progressive increase in the different periods. The percentage of current or former smokers was similar in all periods. Adenocarcinoma was the most frequent histologic type with a progressive increase in its frequency. The percentage of patients diagnosed in early stages has been increasing over the years. In stages I-II, there was a significant increase in the median survival (29.7 months: 2000-2004, 68.73 months: 2010-2014) that could be seen in stage III as well (14.7 months: 2000-2004, 30.63 months: 2015-2017). CONCLUSIONS: A variation of clinical characteristics of lung cancer in Spain has been observed in recent years, as well as an improvement in survival in early and locally advanced stages, due not only to the treatments, but also to a more accurate detection of these tumors. Little progress has been made in tobacco habit with high stable percentages over the years.

Intrathecal baclofen pump exchange in multiple sclerosis. Factors affecting baclofen efficacy and dose adjustement. A case report. / Recambio de bomba intratecal en esclerosis múltiple. Factores que interfieren en la eficacia y ajuste de dosis de baclofeno. A propósito de un caso.

Multiple sclerosis is a neurological disease that presents with various symptoms; in some cases it is progressive and highly disabling, requiring invasive techniques to treat pain and spasticity. The use of intrathecal baclofen infusions is an effective and safe alternative for patients with severe and refractory spasticity. The therapy can improve quality of life, but must be performed in a pain unit by medical staff trained in the technique, its indications, pharmacology, and the potential risks of both the implant and the drug. The treatment can be individualized and patients must be followed up periodically.

El Departamento de Psiquiatría y Salud Mental del Hospital Central de la Defensa «Gómez Ulla» durante la pandemia por SARS-CoV-2 / The Department of Psychiatry and Mental Health of the Military Hospital «Gómez Ulla» during the SARS-CoV-2 pandemic

En el presente trabajo se exponen las medidas estructurales y logísticas, así como la práctica clínica planificada, para poder responder a la pandemia producida por el virus SARS-CoV-2 en el Departamento de Psiquiatría y Salud Mental del Hospital Central de la Defensa «Gómez Ulla». La planificación de la función asistencial se dividió en cinco grupos: los pacientes psiquiátricos ingresados en la Unidad de Hospitalización Breve; los pacientes con patología psiquiátrica ingresados en otros Servicios diferentes de Psiquiatría; los pacientes ambulatorios atendidos en Consultas Externas; los familiares de los pacientes ingresados por la COVID-19; el personal sanitario del Hospital Central de la Defensa «Gómez Ulla». En función de las necesidades de estos grupos asistenciales se realizó una planificación integral de la atención a los mismos. Durante el periodo 14 de marzo al 30 de mayo el 13% del grupo de profesionales del departamento de psiquiatría y salud mental, presentó síntomas moderados- graves de COVID-19; el 19% de los pacientes psiquiátricos ingresados en la unidad de hospitalización fueron COVID19 positivos, no falleciendo ninguno. El 74% de las interconsultas realizadas fueron sobre pacientes ingresados por COVID-19 que presentaron mayoritariamente cuadros confusionales de diversa intensidad o psicosis secundarias al uso de fármacos en el tratamiento activo del COVID-19. Se hicieron 4.185 llamadas a familiares, de las cuales el 14% (n=575) fueron a demanda de los propios familiares. Se hicieron más de 200 videollamadas y se mantuvo de forma telemática el 100% de las consultas externas

In this work the structural and logistical measures are exposed, as well as the planned clinical practice, to be able to respond to the pandemic caused by the virus SARS-CoV-2 in the Department of Psychiatry and Mental Health of the Central Defense Hospital «Gómez Ulla». The planning of the care function was divided into five groups: psychiatric patients admitted to the Brief Hospitalization Unit; patients with psychiatric pathology admitted to other different Psychiatric Services; outpatients treated in Outpatient Consultations; the relatives of the patients admitted by COVID-19; the health personnel of the Central Defense Hospital «Gómez Ulla». Based on the needs of these care groups, comprehensive care planning was carried out. During the period March 14 to May 30, 13% of the staff presented moderate-severe symptoms of COVID-19; 19% of the psychiatric patients admitted to the hospitalization unit were COVID19 positive, none of whom died. 74% of the inter-consultations carried out were on patients admitted for COVID-19 who presented mostly confusional symptoms of varying intensity or psychosis secondary to the use of drugs in the active treatment of COVID-19. 4.185 calls were made to family members, of which 14% (n = 575) were at the request of the family members themselves. More than 220 video calls were made and 100% of the external consultations were kept online

Lasing in strained germanium microbridges.

Germanium has long been regarded as a promising laser material for silicon based opto-electronics. It is CMOS-compatible and has a favourable band structure, which can be tuned by strain or alloying with Sn to become direct, as it was found to be required for interband semiconductor lasers. Here, we report lasing in the mid-infrared region (from λ = 3.20 µm up to λ = 3.66 µm) in tensile strained Ge microbridges uniaxially loaded above 5.4% up to 5.9% upon optical pumping, with a differential quantum efficiency close to 100% with a lower bound of 50% and a maximal operating temperature of 100 K. We also demonstrate the effect of a non-equilibrium electron distribution in k-space which reveals the importance of directness for lasing. With these achievements the strained Ge approach is shown to compare well to GeSn, in particular in terms of efficiency.

Cordoma en la articulación facetaria de C4: reporte de caso / Chordoma in C4 Facet Joint: A Case Report

Los cordomas son tumores óseos primarios, poco frecuentes, derivados de remanentes no diferenciados de la notocorda. Por su origen histológico, suelen ubicarse en la línea media del esqueleto axial, y los lugares de presentación más frecuentes son la base del cráneo y la columna. Se caracterizan por presentar un crecimiento lento, por lo que tienden a ser clínicamente silenciosos hasta alcanzar tamaños que causan manifestaciones que varían según el sitio de presentación; sin embargo, tienen alta agresividad y recurrencia local. El tratamiento es quirúrgico e, idealmente, se busca una resección completa de la lesión. El artículo presenta el caso de un hombre de 20 años de edad, quien desarrolló un cordoma en la articulación facetaría superior izquierda de C4, que es una localización rara.

Chordoma are rare primar? bone tumours derived from non'difieren tiated remains of the notochord. Due to their histological origina, the most common site of presentation is on the mid'line of the axial skeleton, with a distribution that is most frequent on the sacral bone, skull base and mobile spine. These tumours have a slow growth rate, which means that symptoms occur when the size of the mass causes different manifestations according to its site of presentation. Howeveti they have aggressive behaviour with high rates of local recurrence. Ideal treatment is based on surgical block removal if possible. This article presents the case of a 20' year'old male patient with diagnosis of a chordoma on the leít superior facetar? articulation of C4.

Uniform phosphorus doping of untapered germanium nanowires.

One of the major challenges in the growth of vapor-liquid-solid (VLS) nanowires is the control of dopant incorporation in the structures. In this work, we study the n-type doping and morphology of nanowires grown by chemical vapor deposition when HCl is introduced. We obtain fully untapered nanowires with a growth temperature up to 410 °C and measure their resistivity using the 4-probe technique to be 2.0 mΩ cm. We perform energy dispersive x-ray measurements showing a concentration of dopants in the (5-7) × 1018 cm-3 range, being radially and axially uniform. The combination of these two measurements shows that the mobility is the same as for bulk germanium, demonstrating that the VLS mechanism has no detrimental effect for the electron transport in these nanowires.

Protein kinase D1/2 is involved in the maturation of multivesicular bodies and secretion of exosomes in T and B lymphocytes.

Multivesicular bodies (MVBs) are endocytic compartments that enclose intraluminal vesicles (ILVs) formed by inward budding from the limiting membrane of endosomes. In T lymphocytes, these ILV contain Fas ligand (FasL) and are secreted as 'lethal exosomes' following activation-induced fusion of the MVB with the plasma membrane. Diacylglycerol (DAG) and diacylglycerol kinase α (DGKα) regulate MVB maturation and polarized traffic, as well as subsequent secretion of pro-apoptotic exosomes, but the molecular basis underlying these phenomena remains unclear. Here we identify protein kinase D (PKD) family members as DAG effectors involved in MVB genesis and secretion. We show that the inducible secretion of exosomes is enhanced when a constitutively active PKD1 mutant is expressed in T lymphocytes, whereas exosome secretion is impaired in PKD2-deficient mouse T lymphoblasts and in PKD1/3-null B cells. Analysis of PKD2-deficient T lymphoblasts showed the presence of large, immature MVB-like vesicles and demonstrated defects in cytotoxic activity and in activation-induced cell death. Using pharmacological and genetic tools, we show that DGKα regulates PKD1/2 subcellular localization and activation. Our studies demonstrate that PKD1/2 is a key regulator of MVB maturation and exosome secretion, and constitutes a mediator of the DGKα effect on MVB secretory traffic.

Effect of HCl on the doping and shape control of silicon nanowires.

The introduction of hydrogen chloride during the in situ doping of silicon nanowires (SiNWs) grown using the vapor-liquid-solid (VLS) mechanism was investigated. Compared with non-chlorinated atmospheres, the use of HCl with dopant gases considerably improves the surface morphology of the SiNWs, leading to extremely smooth surfaces and a greatly reduced tapering. Variations in the wire diameter are massively reduced for boron doping, and cannot be measured at 600 °C for phosphorous over several tens of micrometers. This remarkable feature is accompanied by a frozen gold migration from the catalyst, with no noticeable levels of gold clusters observed using scanning electron microscopy. A detailed study of the apparent resistivity of the NWs reveals that the dopant incorporation is effective for both types of doping. A graph linking the apparent resistivity to the dopant to silane dilution ratio is built for both types of doping and discussed in the frame of the previous results.

Adverse events risk associated with bevacizumab addition to breast cancer chemotherapy: a meta-analysis.

BACKGROUND: Bevacizumab is a monoclonal antibody against vascular endothelial growth factor with the ability to increase progression-free survival in metastatic breast cancer (MBC). A systematic review and meta-analysis was conducted to determine the risk of the most clinically relevant adverse outcomes associated with the use of bevacizumab in the treatment of breast cancer. PATIENTS AND METHODS: We included phase III clinical trials that used bevacizumab alone or in combination with chemotherapy as for MBC or locally recurrent. Statistical analyses were conducted to calculate summary odds ratio (OR) of the eight most relevant adverse outcomes related with bevacizumab. RESULTS: Five clinical trials were included in the meta-analysis. Summary odds ratios obtained showed a statistically significant bevacizumab-associated increased risk in four of the adverse outcomes studied: proteinuria (OR = 27.68), hypertension (OR = 12.76), left ventricular dysfunction (LVD) (OR = 2.25), and hemorrhagic events (OR = 4.07). No statistically significant differences were found for gastrointestinal (GI) perforation, vascular events, fatal events, or febrile neutropenia. CONCLUSIONS: Bevacizumab did increase the risk of LVD and hemorrhagic events. The addition of bevacizumab to chemotherapy in patients with metastatic breast cancer was not associated with a significant increase in grade ≥ 3 arterial or venous thromboembolic events, GI perforation, or fatal events.