A historic cohort study of nutritional status related side effects and weight loss of cancer patients treated with immunotherapy.

BACKGROUND AND AIMS: Recently, there has been an increase in the number of patients treated with immunotherapy. However, the number of studies investigating combination immunotherapies is still limited, resulting in a gap of knowledge regarding the incidence of nutritional side effects, differences in the durations of these side effects, and differences in weight loss between patients undergoing single and combination immunotherapies. METHODS: In this historical cohort study, which was performed from 2017 to 2019, a total of 50 patients who received one type and 50 patients who received two types of immunotherapy were randomly selected, resulting in a sample of 100 patients. The primary objectives were to assess (a) the incidence of nutritional side effects, (b) the differences in the durations of these side effects, and (c) the differences in weight loss between the two groups. The secondary objectives were to assess the time to the first side effect, the time to the first unplanned hospital admission, unplanned hospital admissions, consultations from a dietitian, and nutritional interventions. Data were collected from the electronic patient record. Differences between groups were explored using the two-sample t-test, Mann-Whitney U test, Fisher exact test, or Wilcoxon rank sum test, depending on the type of data and the test assumptions. The time to the first side effect and the time to the first unplanned hospital admission are presented as Kaplan-Meier curves, and differences were calculated using a Cox proportional hazards model. RESULTS: Patients undergoing a combination of two types of immunotherapy were found to have side effects for statistically significantly longer durations than patients receiving one type of immunotherapy (20 days versus 10 days, p = 0.045). Moreover, patients undergoing a combination of two types of immunotherapy were found to lose more weight (6.2 kg versus 1.2 kg, p < 0.001). At least one side effect was reported in 86% of the patients in the one-therapy group and in 90% of the patients in the combination-therapy group. Furthermore, a high incidence of decreased appetite (70% and 86%), nausea (52% and 68%), vomiting (22% and 46%), and diarrhea/colitis (56% and 54%) was found in both groups. However, the time to the first side effect and the time to the first hospital admission were not statistically significantly different between the one-therapy and combination-therapy groups. Of the total cohort, 26% were admitted unexpectedly during the immunotherapy because they developed immunotherapy-related side effects, whereas 38% of the patients in our sample consulted a dietitian. CONCLUSIONS: Nutritional side effects are common in patients treated with immunotherapy. Generally, treatment with a combination of two types of immunotherapy is associated with an increased incidence of nutritional side effects. These side effects last longer and patients lose more weight compared to those receiving one type of immunotherapy.

A kilonova as the electromagnetic counterpart to a gravitational-wave source.

Gravitational waves were discovered with the detection of binary black-hole mergers and they should also be detectable from lower-mass neutron-star mergers. These are predicted to eject material rich in heavy radioactive isotopes that can power an electromagnetic signal. This signal is luminous at optical and infrared wavelengths and is called a kilonova. The gravitational-wave source GW170817 arose from a binary neutron-star merger in the nearby Universe with a relatively well confined sky position and distance estimate. Here we report observations and physical modelling of a rapidly fading electromagnetic transient in the galaxy NGC 4993, which is spatially coincident with GW170817 and with a weak, short γ-ray burst. The transient has physical parameters that broadly match the theoretical predictions of blue kilonovae from neutron-star mergers. The emitted electromagnetic radiation can be explained with an ejected mass of 0.04 ± 0.01 solar masses, with an opacity of less than 0.5 square centimetres per gram, at a velocity of 0.2 ± 0.1 times light speed. The power source is constrained to have a power-law slope of -1.2 ± 0.3, consistent with radioactive powering from r-process nuclides. (The r-process is a series of neutron capture reactions that synthesise many of the elements heavier than iron.) We identify line features in the spectra that are consistent with light r-process elements (atomic masses of 90-140). As it fades, the transient rapidly becomes red, and a higher-opacity, lanthanide-rich ejecta component may contribute to the emission. This indicates that neutron-star mergers produce gravitational waves and radioactively powered kilonovae, and are a nucleosynthetic source of the r-process elements.

Resuspension studies in the Marshall Islands.

The contribution of inhalation exposure to the total dose for residents of the Marshall Islands was monitored at occasions of opportunity on several islands in the Bikini and Enewetak Atolls. To determine the long-term potential for inhalation exposure, and to understand the mechanisms of redistribution and personal exposure, additional investigations were undertaken on Bikini Island under modified and controlled conditions. Experiments were conducted to provide key parameters for the assessment of inhalation exposure from plutonium-contaminated dust aerosols: characterization of the contribution of plutonium in soil-borne aerosols as compared to sea spray and organic aerosols, determination of plutonium resuspension rates as measured by the meteorological flux-gradient method during extreme conditions of a bare-soil vs. a stabilized surface, determination of the approximate individual exposures to resuspended plutonium by traffic, and studies of exposures to individuals in different occupational environments simulated by personal air sampling of workers assigned to a variety of tasks. Enhancement factors (defined as ratios of the plutonium-activity of suspended aerosols relative to the plutonium-activity of the soil) were determined to be less than 1 (typically 0.4 to 0.7) in the undisturbed, vegetated areas, but greater than 1 (as high as 3) for the case studies of disturbed bare soil, roadside travel, and for occupational duties in fields and in and around houses.

The ex vivo effect of preadsorbed vitronectin on platelet activation.

The activation of ex vivo canine platelets by preadsorbed vitronectin (VN) was sensitive not only to the polymer substrate utilized but also to the adsorption conditions employed. Lower levels of maximal platelet deposition were obtained for VN-coated silicone rubber (SR) than for other VN-coated substrates with comparable levels of adsorbed VN, but this effect was diminished with increased residence time of VN on the SR surface. Submonolayer and monolayer surface concentrations of VN elicited similar maximal levels of platelet deposition at both short (less than 3 h) and long (greater than 12 h) residence times, but thrombi were larger and more dense for the submonolayer surface concentrations. VN was also more effective in forming thrombi when adsorbed sequentially before albumin instead of after albumin. To further examine these differences in the nature of adsorbed VN between substrates and adsorption conditions, sodium dodecyl sulfate (SDS) elutability measurements and Fourier transform infrared spectroscopy with attenuated total reflectance optics (FTIR-ATR) evaluations of the adsorbed protein were performed. An SDS solution was able to remove a greater percentage of the VN which was adsorbed to a submonolayer than a monolayer surface concentration when SDS displacement was initiated immediately after adsorption was terminated. However, if the adsorbed protein was allowed to reside on the surface for a length of time before the introduction of the SDS displacing media, a greater percentage of the monolayer surface concentration was removed. The submonolayer surface concentration may be better able to increase its strength of contact with the surface during the added residence time than the monolayer surface concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Competitive adsorption of vitronectin with albumin, fibrinogen, and fibronectin on polymeric biomaterials.

Vitronectin (VN) was competitively adsorbed with human serum albumin (HSA), fibrinogen (FGN), and fibronectin (FN) from binary component mixtures in order to compare the relative affinities of these proteins for various polymer materials. Competitive adsorption was monitored by incubating radiolabeled protein solutions inside 0.125-in. i.d. tubing of the polymers, flushing with buffer, and measuring the adherent radioactivity. Adsorption experiments at equal mass concentrations of the competing proteins revealed that VN comprises at least 75% by weight of the adsorbed protein when competitively adsorbed with HSA and approximately 50% by weight when competitively adsorbed with FGN and FN on all surfaces except a poly(ethylene oxide)-based polyurethane where it comprised closer to 80 wt%. When VN was competitively adsorbed in the presence of increasing amounts of HSA, FGN, and FN, the amount of VN adsorbed on a weight basis was diminished the most by FGN. HSA had the least inhibitory effect at low bulk concentrations and FN had the weakest effect at higher bulk concentration levels. When HSA, FGN, and FN were competitively adsorbed in the presence of increasing amounts of VN, VN diminished their adsorption on a weight basis in the order: HSA greater than FN greater than FGN.

Oral health in Slovenia, Yugoslavia.

An oral health epidemiological survey using WHO assessment forms was conducted in the Republic of Slovenia (Yugoslavia) in 1987. The study population consisted of 1623 persons aged 6, 12, 15, 18, 35-44 and over 65 yr. The survey included 10 towns in 9 geographical areas of Slovenia. The results showed the prevalence of dental caries in the Slovenian population to be very high (93.6% in 12-yr-olds). The mean decayed, missing, and filled teeth (DMFT) scores were as follows: 5.1 at age 12 yr, 10.2 at 15 yr, 12.9 at 18 yr, 20.5 at 35-44 yr, and 27.0 in persons aged over 65 yr. Assessment of the periodontal status showed calculus to be the predominant disorder in the age groups 18 and 35-44 yr, while shallow pockets prevailed in persons aged over 65 yr.

A comparison of the adsorption of three adhesive proteins to biomaterial surfaces.

The adsorption of three cell adhesive proteins with known thrombogenic activity [fibrinogen (FGN), fibronectin (FN), and vitronectin (VN)] was quantified from mono-component protein solutions, from a quaternary-component protein solution, and from plasma and diluted plasma in order to compare their potential for adsorption to polymeric substrates from solutions of varying complexity. The surfaces studied included polyethylene (PE), silicone rubber (SR), Teflon-FEP (FEP), and two polyetherurethanes: one with a poly(tetramethylene oxide) soft segment (PTMO-PU) and one with a poly(ethylene oxide) soft segment (PEO-PU). The adsorption of these proteins from single-component solutions followed the Freundlich isotherm and the adhesive proteins showed similar trends in Freundlich parameters for surfaces of similar surface wettability. Adsorption from a quaternary-component solution composed of physiological molar ratios of the three proteins and human serum albumin (HSA) revealed a significant enrichment of adsorbed vitronectin as determined from ratios of the adsorbed surface fraction of each protein to its respective bulk fraction. The other proteins' adsorption was enriched to a lesser extent in the decreasing order of FGN greater than FN greater than HSA for all surfaces. The relative enrichment of VN from plasma was also high as compared with its bulk concentration, whereas the enrichment of FGN, FN, and HSA was much lower and of approximately the same magnitude. Compared with the three other proteins, VN showed a resistance to displacement from the polymer substrates as either the plasma concentration was increased or the length of contact with plasma and diluted plasma was increased.

Ground-based air-sampling measurements near the Nevada Test Site after atmospheric nuclear tests.

Historical air-sampling data measured within 320 km (200 mi) of the Nevada Test Site (NTS) have been reviewed for periods following atmospheric nuclear tests, primarily in the 1950s. These data come mostly from high-volume air samplers, with some from cascade-impactor samplers. Measurements considered here are for beta radiation from gross fission products. The resulting air-quality data base is comprised of almost 13,000 samples from 42 sampling locations downwind of the NTS. In order to compile an accurate air-quality data base for use in estimating exposure via inhalation, raw data values were sought where possible, and the required calculations were performed on a computer with state-of-the-art algorithms. The data-processing procedures consisted of (1) entry and error checking of historical data; (2) determination of appropriate background values, air-sampling volumes, and net air concentrations; and (3) calculation of integrated air concentration (C) for each sample (considering fallout arrival times). Comparing C values for collocated high-volume and cascade-impactor samplers during the Upshot-Knothole series showed similar lognormal distributions, but with a geometric mean C for cascade impactors about half that for the high-volume air samplers. Overall, the uncertainty in C values is about a factor of three. In the past, it has been assumed that C could be related to ground deposition by a constant having units of velocity. In our data bases, simultaneous measurements of air concentration and ground deposition at the same locations were not related by a constant; indeed, there was a great amount of scatter. This suggests that the relationship between C and ground deposition in this situation is too complex to be treated adequately by simple approaches.

[Oral health in SR Slovenia]. / Oralno zdravje prebivalstva SR Slovenije.

Results of oral health epidemiological survey (using WHO assessment forms) which was conducted in SR Slovenia in the year 1987 are presented. The study population consisted of 1623 persons aged 6, 12, 15, 18, 35-44 and over 65 years. The survey included 10 towns. The results showed the prevalence of dental caries in the SR Slovenia population to be very high (93.6% in 12-yr olds). The mean decayed, missing and filled teeth (DMFT) scores was 5.1 at age 12-yr. Assessment of the periodontal status showed calculus to be the predominant disorder in the age groups 18 and 35-44 yr.

Clinical evaluation of a new nonelectronic all-in-the-ear hearing device for mild hearing loss.

A new, nonelectronic hearing aid was studied in 112 patients with mild sloping sensorineural hearing loss. The device, worn all in the ear and made of clear plastic, produced a mean functional gain of 9.6 dB at 1500 Hz, 12.4 dB at 1750 Hz, and 9.1 dB at 2000 Hz, with lesser gains at adjacent frequencies between 1000 and 2500 Hz. Speech discrimination in quiet and in noise was improved. Patient acceptance of the device (in a group of 884 patients) was 76%. The device appears to be useful in the treatment of mild hearing loss.