Reduced risk of secondary primary extra pulmonary cancer in advanced/metastatic lung cancer patients treated with immune checkpoint inhibitors.

BACKGROUND: Lung cancer survivors are at high risk of developing a second primary cancer (SPC). We explored the Unicancer Epidemiology Strategy Medical-Economics for advanced or metastatic lung cancer (AMLC) database to assess the impact of immune checkpoint inhibitors (ICI) on the risk of SPC in patients with advanced/metastatic lung cancer. PATIENTS AND METHODS: This retrospective study used data from patients with AMLC, with treatment initiated between January 1st 2015 and December 31st 2018. Patients with lung cancer as the second primary cancer were excluded and a 6-months landmark threshold was applied to exclude patients with synchronous SPC, patients dead without SPC or with a follow-up inferior to 6 months. A propensity score (PS) was calculated on the following baseline covariates: Age at locally advanced or metastatic diagnosis, sex, smoking status, metastatic status, performance status and histological type. The inverse probability of treatment weighting approach was used on the analyses aiming to assess the impact of ICI administered for AMLC, on the risk of occurrence of SPC. RESULTS: Among the 10 796 patients, 148 (1.4%) patients had a diagnosis of SPC in a median interval of 22 (min-max: 7-173) months. All the patients (100%) with locally advanced or metastatic LC received at least one systemic treatment including (chemotherapy regimen (n = 9 851, 91.2%); ICI (n = 4 648, 43.0%); targeted treatment (n = 3 500; 32.4%). 40 (0.9%) SPC were reported in the 4 648 patients with metastatic LC treated with ICI vs 108 (1.7%) out of the 6 148 who did not receive immunotherapy (p < 0.0001). The multivariate analysis identified that treatment with ICI in patients with AMLC is associated with a reduced risk of SPC (HR = 0.40, 95% CI 0.27-0.58). CONCLUSION: Treatment with ICI in AMLC patients was associated with a significantly reduced risk of SPC. Prospective studies are required to confirm these results.

Analysis of 1.9 Mb of contiguous sequence from chromosome 4 of Arabidopsis thaliana.

The plant Arabidopsis thaliana (Arabidopsis) has become an important model species for the study of many aspects of plant biology. The relatively small size of the nuclear genome and the availability of extensive physical maps of the five chromosomes provide a feasible basis for initiating sequencing of the five chromosomes. The YAC (yeast artificial chromosome)-based physical map of chromosome 4 was used to construct a sequence-ready map of cosmid and BAC (bacterial artificial chromosome) clones covering a 1.9-megabase (Mb) contiguous region, and the sequence of this region is reported here. Analysis of the sequence revealed an average gene density of one gene every 4.8 kilobases (kb), and 54% of the predicted genes had significant similarity to known genes. Other interesting features were found, such as the sequence of a disease-resistance gene locus, the distribution of retroelements, the frequent occurrence of clustered gene families, and the sequence of several classes of genes not previously encountered in plants.

Monobacterial and mixed bacterial plaques of Streptococcus mutans and Veillonella alcalescens in an artificial mouth: development, metabolism, and effect on human dental enamel.

To gain greater understanding of the role of Streptococcus mutans and Veillonella in the caries process, studies of both aerobically and anaerobically grown plaques of S. mutans C67-1 and V. alcalescens V-1 on human enamel slabs were carried out in an artificial mouth. Plaque development, acid production, and demineralization were measured. Early plaque development of monobacterial and mixed bacterial plaques started from randomly adhering cells on day 1 to confluent multilayered microcolonies on day 4. Differences were observed in viable cell counts, total cell mass, and in acid production. In most cases CFU, DNA and acid production were higher in the mixed bacterial plaque, especially in the anaerobic mixed plaque. Lactic acid was the predominant acid in all cases following the supply of sucrose to the plaque. No decisive role could be found for acetic, formic, and propionic acid. No inhibition of demineralization was observed in the enamel slabs inoculated with both aerobic and anaerobic mixed plaques. Demineralization ranged from the more classical picture of lesion development in the aerobic monobacterial plaque-treated samples to an aggressive etching of the enamel surface in the anaerobically mixed treated slabs.

A new apparatus for continuous cultivation of bacterial plaque on solid surfaces and human dental enamel.

A new apparatus for the continuous cultivation of mono and mixed bacterial plaque on solid surfaces is described. The features are: easy preparation and handling; freedom from technical problems and microbial contamination; self-sufficient for periods of up to 56 d; 12 samples are taken simultaneously; programmable supply inlet. Experiments were performed with Streptococcus mutans C 67-1 for mono bacterial inoculation and in combination with Veillonella alcalescens V-1 for mixed bacterial inoculations. The results showed that the controlled conditions and versatility of the apparatus make possible the study of plaque-development and lesion production on a time-dependent basis. It is concluded that the apparatus is suitable for a wide range of dental and non-dental applications.

[Characteristics of evaluating nursing home residents in the Netherlands; a rating instrument]. / De samenhang in de validiteitskenmerken van de verpleeghuisbewoners in Nederland; een meetinstrument.

This article describes the way in which an instrument has been developed to measure the need for help of patients in the nursing homes of the Netherlands. The instrument is an important variable in the so-called Basic Research into the cost structure of the Dutch nursing homes (in Dutch BKV). The need for help is expressed as an index ('help-index') per patient. The index is based on the strong hierarchical relations between a number of patient-variables: washing, clothing, feeding, toileting, transferring (in and out of bed, walking, standing, wheelchair-activities), continence (urine and/or faeces) and contact function (speech). The 'help-indices' of the individual patients of a specific nursing home can be summarized in the average 'help-index' of that nursing home. The averages of the individual nursing homes differ to a great extent. The average 'help-index' per nursing home is considered to be of great importance as an independent variable with respect to staff per 100 beds and costs (total or per patient day) in the nursing homes. The latter is the subject of further research.