Outcome of Second Primary Malignancies Developing in Multiple Myeloma Patients.

BACKGROUND: There is an increased risk of second primary malignancies (SMPs) in patients with multiple myeloma (MM). This multinational 'real-world' retrospective study analyzed the characteristics and outcomes of MM patients that developed SPMs. RESULTS: 165 patients were analyzed: 62.4% males; 8.5% with a prior cancer; 113 with solid SPMs, mainly ≥stage 2; and 52 with hematological SPM (hemato-SPM), mainly MDS/AML. Patients with hemato-SPM were younger (p = 0.05) and more frequently had a prior AutoHCT (p = 0.012). The time to SPM was shorter in the older (>65 years) and more heavily pretreated patients. One hundred patients were actively treated at the time of SPM detection. Treatment was discontinued in 52, substituted with another anti-MM therapy in 15, and continued in 33 patients. Treatment discontinuation was predominant in the patients diagnosed with hemato-SPM (76%). The median OS following SPM detection was 8.5 months, and the main cause of death was SPM. A poor ECOG status predicted a shorter OS (PS 3 vs. 0, HR = 5.74, 2.32-14.21, p < 0.001), whereas a normal hemoglobin level (HR = 0.43, 0.19-0.95, p = 0.037) predicted longer OS. CONCLUSIONS: With the continuing improvement in OS, a higher proportion of MM patients might develop SPM. The OS following SPM diagnosis is poor; hence, frequent surveillance and early detection are imperative to improve outcomes.

MNAzymes and gold nanoparticles as isothermal signal amplification strategy for visual detection of miRNA.

MicroRNAs (miRNAs) represent a class of small noncoding RNAs that are considered a novel emerging class of disease biomarkers in a variety of afflictions. Sensitive detection of miRNA is typically achieved using hybridization-based methods coupled with genetic amplification techniques. Although their sensitivity has improved, amplification techniques often present erroneous results due to their complexity. In addition, the use of these techniques is usually linked to the application of protein enzymes, the activity of which is dependent on the temperature and pH of the medium. To address these drawbacks, an alternative genetic enzyme for the highly sensitive detection of miRNAs is proposed in this work. Multicomponent nucleic acid enzymes (MNAzymes), coupled with the use of DNA-functionalized gold nanoparticles (AuNPs), were used in this study to develop an isothermal signal amplification strategy for visual genetic detection. miR146a, a biomarker of bovine mastitis present in milk, was selected as a model analyte. The developed methodology is easily carried out in 80 min at 50 °C, generating a low visual limit of detection of 250 pM based on the observation of a color change. The methodology was successfully applied to the detection of miR146a in raw cow milk samples.

Applications and Properties of Hemp Stalk-Based Insulating Biomaterials for Buildings: Review.

There has been increasing interest in green and recyclable materials to promote the circular economy. Moreover, the climate change of the last decades has led to an increase in the range of temperatures and energy consumption, which entails more energy expenditure for heating and cooling buildings. In this review, the properties of hemp stalk as an insulating material are analyzed to obtain recyclable materials with green solutions to reduce energy consumption and reduce noise to increase the comfort of buildings. Hemp stalks are a low-value by-product of hemp crops; however, they are a lightweight material with a high insulating property. This study aims to summarize the research progress in materials based on hemp stalks and to study the properties and characteristics of the different vegetable binders that could be used to produce a bio-insulating material. The material itself and its microstructural and physical aspects that affect the insulating properties are discussed, as is their influence on durability, moisture resistance, and fungi growth. Research suggests using lignin-based or recyclable cardboard fiber to develop a bio-composite material from hemp stalk, but long-term stability requires further investigation.

Oil Production by Pyrolysis of Real Plastic Waste.

The aim of this paper is for the production of oils processed in refineries to come from the pyrolysis of real waste from the high plastic content rejected by the recycling industry of the Basque Country (Spain). Concretely, the rejected waste streams were collected from (1) a light packaging waste sorting plant, (2) the paper recycling industry, and (3) a waste treatment plant of electrical and electronic equipment (WEEE). The influence of pre-treatments (mechanical separation operations) and temperature on the yield and quality of the liquid fraction were evaluated. In order to study the pre-treatment effect, the samples were pyrolyzed at 460 °C for 1 h. As pre-treatments concentrate on the suitable fraction for pyrolysis and reduce the undesirable materials (metals, PVC, PET, inorganics, cellulosic materials), they improve the yield to liquid products and considerably reduce the halogen content. The sample with the highest polyolefin content achieved the highest liquid yield (70.6 wt.% at 460 °C) and the lowest chlorine content (160 ppm) among the investigated samples and, therefore, was the most suitable liquid to use as refinery feedstock. The effect of temperature on the pyrolysis of this sample was studied in the range of 430-490 °C. As the temperature increased the liquid yield increased and solid yield decreased, indicating that the conversion was maximized. At 490 °C, the pyrolysis oil with the highest calorific value (44.3 MJ kg-1) and paraffinic content (65% area), the lowest chlorine content (128 ppm) and more than 50 wt.% of diesel was obtained.

High-risk multiple myeloma: how to treat at diagnosis and relapse?

Patients with multiple myeloma have experienced a great improvement in survival over the past century because of the introduction of novel therapeutic strategies. However, a subgroup of patients with poorer outcomes than expected is considered high risk and identified by the presence of patient- and disease-based factors such as frailty, extramedullary disease, cytogenetic abnormalities, or even relapses occurring earlier than expected according to the baseline factors. Although the management of patients with high-risk features is not well established because of the lack of specific trials in this subgroup of patients and because of their underrepresentation in the clinical trials, treatment should be planned on 2 pillars: (1) poor prognosis with the presence of high-risk features can be at least improved or even abrogated by achieving a deep and sustained response over time, and (2) this can most likely be obtained through using the best therapeutic options and in a response-adapted way. Some clinical trials that have been planned or are ongoing include only patients with high-risk features, using the most effective therapies (proteasome inhibitors, immunomodulatory drugs, and anti-CD38 monoclonal antibodies) as well as chimeric antigen receptor T cells and T-cell engagers that will unravel what the best therapeutic approach will be to overcome the poor prognosis of the presence of high-risk features.

Combustion of a Solid Recovered Fuel (SRF) Produced from the Polymeric Fraction of Automotive Shredder Residue (ASR).

The use of alternative fuels derived from residues in energy-intensive industries that rely on fossil fuels can cause considerable energy cost savings, but also significant environmental benefits by conserving non-renewable resources and reducing waste disposal. However, the switching from conventional to alternative fuels is challenging for industries, which require a sound understanding of the properties and combustion characteristics of the alternative fuel, in order to adequately adapt their industrial processes and equipment for its utilization. In this work, a solid recovered fuel (SRF) obtained from the polymeric fraction of an automotive shredder residue is tested for use as an alternative fuel for scrap preheating in an aluminium refinery. The material and chemical composition of the SRF has been extensively characterized using proximate and ultimate analyses, calorific values and thermal degradation studies. Considering the calorific value and the chlorine and mercury contents measured, the SRF can be designated as class code NCV 1; Cl 2; Hg 2 (EN ISO 21640:2021). The combustion of the SRF was studied in a laboratory-scale pilot plant, where the effects of temperature, flow, and an oxidizer were determined. The ash remaining after combustion, the collected liquid, and the generated gas phase were analysed in each test. It was observed that increasing the residence time of the gas at a high temperature allowed for a better combustion of the SRF. The oxidizer type was important for increasing the total combustion of the vapour compounds generated during the oxidation of the SRF and for avoiding uncontrolled combustion.

First Life Table of Synthesiomyia nudiseta (Diptera: Muscidae) From Palearctic Region for Analyzing the Effect on Its Dispersal Ability.

To better understand the population dynamics and dispersal ability of insect species, it is often helpful to derive a life table containing fundamental demographic data. The aim of this study was to determine a life table for the predatory necrophagous species Synthesiomyia nudiseta (van der Wulp, 1883) on a pig liver diet and under controlled laboratory conditions (29.5 ± 2. 5°C, RH 50 ± 15%, and a photoperiod of 12:12). This species has medical and veterinary importance and its distribution extends in tropical and subtropical areas and now it has been established in the southwestern of Europe. The mean adult longevity was 36. 18 ± 2. 06 d and the net reproduction rate, R, was 27.65 offspring/female, the mean generation time, T, was 22. 09 d, the finite rate of increase, λ, was 1. 16 d-1, and the intrinsic rate of increase, r, was 0. 15 d-1. These results indicate that S. nudiseta cannot be considered an r-strategist as the most common synanthropic necrophagous blowflies due to its predatory behavior; however, its invasive and colonist abilities are discussed. This is the first life table study of this species from Palearctic region to analyze the effect of its dispersal ability.

Tratamiento híbrido de arteria ciática persistente / Hybrid treatment of a persistent sciatic artery aneurysm

Introducción: la arteria ciática persistente es una variante anatómica muy poco frecuente y en la mayoría de los casos presenta síntomas clínicos debido a la degeneración aneurismática del vaso.Caso clínico:presentamos un varón de 73 años, asintomático, que presenta una arteria ciática persistente con degeneración aneurismática como hallazgo en una angio-RMN. Se realizó un tratamiento híbrido mediante embolización de la arteria ciática persistente mediante dispositivo Amplatzer™ Vascular Plug II (AVP, St. Jude Medical, Plymouth, MN) y un bypass femoropoplíteo con una prótesis PTFE. El procedimiento transcurrió sin incidencias y el paciente no refiere clínica un año después de la intervención.Discusión:el tratamiento híbrido en estos casos es una opción sencilla que puede reducir la morbilidad quirúrgica del tratamiento quirúrgico convencional.(AU)

Introduction: a persistent sciatic artery is a very rare anatomic condition with frequently associated symptoms related with the aneurysmal degeneration of the vessel.Case report:we present a case of a 73-year-old patient with an aneurysmal persistent sciatic artery that was discovered on an MRI angiography. A hybrid surgical treatment was performed by embolization of the persistent sciatic artery using an Amplatzer™ Vascular Plug II (AVP, St. Jude Medical, Plymouth, MN) and a femoropopliteal bypass with a PTFE prosthesis. The procedure was uneventful and the patient reported no symptoms one year after the intervention.Discussion:hybrid treatment in these cases is a simple option that can reduce the surgical morbidity of conventional surgical treatment.(AU)

The effect of immediate postoperative Boussignac CPAP on adverse pulmonary events after thoracic surgery: A multicentre, randomised controlled trial.

BACKGROUND: The effectiveness of prophylactic continuous positive pressure ventilation (CPAP) after thoracic surgery is not clearly established. OBJECTIVE: The aim of this study was to assess the effectiveness of CPAP immediately after lung resection either by thoracotomy or thoracoscopy in preventing atelectasis and pneumonia. DESIGN: A multicentre, randomised, controlled, open-label trial. SETTINGS: Four large University hospitals at Madrid (Spain) from March 2014 to December 2016. PATIENTS: Immunocompetent patients scheduled for lung resection, without previous diagnosis of sleep-apnoea syndrome or severe bullous emphysema. Four hundred and sixty-four patients were assessed, 426 were randomised and 422 were finally analysed. INTERVENTION: Six hours of continuous CPAP through a Boussignac system versus standard care. MAIN OUTCOME MEASURES: Primary outcome: incidence of the composite endpoint 'atelectasis + pneumonia'. Secondary outcome: incidence of the composite endpoint 'persistent air leak + pneumothorax'. RESULTS: The primary outcome occurred in 35 patients (17%) of the CPAP group and in 58 (27%) of the control group [adjusted relative risk (ARR) 0.53, 95% CI 0.30 to 0.93]. The secondary outcome occurred in 33 patients (16%) of the CPAP group and in 29 (14%) of the control group [ARR 0.92, 95% CI 0.51 to 1.65]. CONCLUSION: Prophylactic CPAP decreased the incidence of the composite endpoint 'postoperative atelectasis + pneumonia' without increasing the incidence of the endpoint 'postoperative persistent air leaks + pneumothorax'.

I3Mote: An Open Development Platform for the Intelligent Industrial Internet.

In this article we present the Intelligent Industrial Internet (I3) Mote, an open hardware platform targeting industrial connectivity and sensing deployments. The I3Mote features the most advanced low-power components to tackle sensing, on-board computing and wireless/wired connectivity for demanding industrial applications. The platform has been designed to fill the gap in the industrial prototyping and early deployment market with a compact form factor, low-cost and robust industrial design. I3Mote is an advanced and compact prototyping system integrating the required components to be deployed as a product, leveraging the need for adopting industries to build their own tailored solution. This article describes the platform design, firmware and software ecosystem and characterizes its performance in terms of energy consumption.

Data Analytics for Smart Parking Applications.

We consider real-life smart parking systems where parking lot occupancy data are collected from field sensor devices and sent to backend servers for further processing and usage for applications. Our objective is to make these data useful to end users, such as parking managers, and, ultimately, to citizens. To this end, we concoct and validate an automated classification algorithm having two objectives: (1) outlier detection: to detect sensors with anomalous behavioral patterns, i.e., outliers; and (2) clustering: to group the parking sensors exhibiting similar patterns into distinct clusters. We first analyze the statistics of real parking data, obtaining suitable simulation models for parking traces. We then consider a simple classification algorithm based on the empirical complementary distribution function of occupancy times and show its limitations. Hence, we design a more sophisticated algorithm exploiting unsupervised learning techniques (self-organizing maps). These are tuned following a supervised approach using our trace generator and are compared against other clustering schemes, namely expectation maximization, k-means clustering and DBSCAN, considering six months of data from a real sensor deployment. Our approach is found to be superior in terms of classification accuracy, while also being capable of identifying all of the outliers in the dataset.

Cuidado de enfermería a la persona con estenosis aórtica severa posterior al implante valvular aórtico transcatéter / Nursing Care for the Person with Severe Aortic Stenosis after the Transcatheter Aortic Valve Implantation / Cuidado de enfermagem à pessoa com estenose aórtica severa posterior ao implante valvar aórtico transcateter

Introducción: Puesto que el pronóstico de la estenosis aórtica es desalentador, el 90% de estas personas presenta síncope, angina o insuficiencia cardiaca, que ocasiona la muerte en un periodo de dos a tres años, en promedio. Los implantes valvulares aórticos transcatéter (TAVI) surgen como alternativa de tratamiento para este grupo de pacientes con riesgo quirúrgico elevado, en la octava década de vida, que presenten otras comorbilidades como enfermedades hepáticas, renales u otras, además de aquellos que no son candidatos para realizarles la cirugía cardiaca convencional. El presente artículo describe los antecedentes históricos del TAVI, sus indicaciones y contraindicaciones, las complicaciones del implante, así como el desarrollo del procedimiento, haciendo hincapié en una serie de intervenciones propuestas para que el profesional de enfermería otorgue cuidados seguros y de calidad, basados en evidencia científica. Objetivo: Describir las características generales del TAVI, así como proponer cuidados de enfermería al paciente sometido a este procedimiento durante el periodo inmediato y mediato. Metodología: Búsqueda sistematizada en bases de datos PubMed, EMBASE, SciELO, Medigraphic, Biblioteca Virtual en Salud. Se buscaron artículos originales, revisiones sistematizadas y metanálisis escritos en inglés, español y portugués, del 2007 al 2013. Conclusión: El TAVI ofrece una opción más de tratamiento a este grupo de pacientes; es importante que el profesional de enfermería posea conocimientos sobre los cuidados específicos que hay que ofrecer para que la recuperación sea rápida y las intervenciones sean oportunas y seguras.

Introduction: The prognosis for aortic stenosis is grim, 90% of the patients presented syncope, angina or heart failure, which causes death within two to three years, on average. The transcatheter aortic valve implant (TAVI) emerge as an alternative treatment for this group of patients at high surgical risk, in the eighth decade of life, who have other comorbidities such as liver disease, kidney or other, plus those who are not candidates for conventional cardiac surgery. This article describes the historical background of TAVI, its indications and contraindications, complications of implant and procedure development, focusing on a number of proposed interventions for the nurse to give safe, quality care based on scientific evidence. Objective: To describe the general characteristics of TAVI, and propose nursing care of the patient undergoing this procedure for the immediate and medium term. Methods: A systematic search in PubMed, EMBASE, SciELO, Medigraphic, and Biblioteca Virtual en Salud. The search included original articles, systematized reviews and meta-analy-sis in English, Spanish and Portuguese from 2007 to 2013.Conclusion: TAVI offers another option for treating this group of patients; it is important that the nurse have knowledge of specific care to be offered for the recovery to be quick and interventions to be timely and secure.

Introdução: Dado que o prognóstico da estenose aórtica é desalentador, 90% dessas pessoas apresenta síncope, angina ou insuficiencia cardíaca, que ocasiona morte em um período de dois para tres anos, como média. O implante valvar aórtico transcateter (TAVI) surge como alternativa de tratamento para esse grupo de pacientes com risco cirúrgico elevado, na oitava década de vida, que apresentem outras comorbida-des como doença hepática, renal ou outras, além de aqueles que nao sao candidatos para lhes realizar a cirurgia cardíaca convencional. O presente artigo descreve os antecedentes históricos do TAVI, suas indicações e contraindicares, as compli-cações do implante, assim como o desenvolvimento do procedimento, enfatizando em uma série de intervenções propostas para que o profissional de enfermagem outorgue cuidados seguros e de qualidade, baseados em evidencia científica. Objetivo: Descrever as caraterísticas gerais do TAVI, assim como propor cuidados de enfermagem ao paciente sometido a esse procedimento durante o período imediato e mediato. Metodologia: Procura sistematizada em bases de dados PubMed, EMBASE, SciELO, Medigraphic, Biblioteca Virtual em Saúde. Procuraram-se artigos originais, revisões sistematizadas e meta-análise escritos em ingles, espanhol e portugués, do 2007 para 2013. Conclusão: O TAVI oferece uma opcao mais de tratamento a esse grupo de pacientes; é importante que o profissional de enfermagem possua conhecimentos sobre os cuidados específicos que tem de oferecer para que a recuperacao seja rápida e as intervenções oportunas e seguras.

Prótesis aórticas percutáneas: un futuro abierto / Transcatheter aortic valve prostheses: an open future

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