Development of a core outcome set for cutaneous squamous cell carcinoma trials: identification of core domains and outcomes.

BACKGROUND: The lack of uniformity in the outcomes reported in clinical studies of the treatment of cutaneous squamous cell carcinoma (cSCC) complicates efforts to compare treatment effectiveness across trials. OBJECTIVES: To develop a core outcome set (COS), a minimum set of agreed-upon outcomes to be measured in all clinical trials of a given disease or outcome, for the treatment of cSCC. METHODS: One hundred and nine outcomes were identified via a systematic literature review and interviews with 28 stakeholders. After consolidation of this long list, 55 candidate outcomes were rated by 19 physician and 10 patient stakeholders, in two rounds of Delphi exercises. Outcomes scored 'critically important' (score of 7, 8 or 9) by ≥ 70% of patients and ≥ 70% of physicians were provisionally included. At the consensus meeting, after discussion and voting of 44 international experts and patients, the provisional list was reduced to a final core set, for which consensus was achieved among all meeting participants. RESULTS: A core set of seven outcomes was finalized at the consensus meeting: (i) serious or persistent adverse events, (ii) patient-reported quality of life, (iii) complete response, (iv) partial response, (v) recurrence-free survival, (vi) progression-free survival and (vii) disease-specific survival. CONCLUSIONS: In order to increase the comparability of results across trials and to reduce selective reporting bias, cSCC researchers should consider reporting these core outcomes. Further work needs to be performed to identify the measures that should be reported for each of these outcomes.

Intense UV and visible up-conversion emissions from RE-doped SiO2-BaGdF5 nano-glass-ceramics.

RE-doped (Yb3+, Er3+ and Tm3+) nano-glass-ceramics (nGCs) comprising BaGdF5 nanocrystals have been developed under thermal treatment of precursor sol-gel glasses. Structural analysis by means of X-ray diffraction patterns, high-resolution transmission electron microscopy images, and energy dispersive X-ray spectroscopy measurements, confirmed the precipitation and distribution of cubic BaGdF5 nanocrystals (around 10 nm in size) in the silica glass matrix. Under near-IR excitation at 980 nm, up-conversion (UC) emissions have been studied as a function of selected dopants, the doping level and the pump power. In addition to the characteristic NIR, vis and UV UC emissions of Er3+ and Tm3+ dopant ions, the studied nGCs present intense UV UC emissions of the host fluoride nanocrystal, Gd3+. It was also observed that the relative Yb3+ content tended to improve the UC emission intensities. Corresponding UC mechanisms and energy transfer processes were analysed in terms of their energy level diagrams and confirmed by transient emission and pump power measurements. Moreover, power dependence analysis revealed that these emissions present saturation effects with the increase of Yb3+ content, even at low pump power. Results suggest that these high-efficiency UC nGCs have potential applications in UV solid state laser materials, solid state lighting and photovoltaics.

Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population.

OBJECTIVE: Efforts to improve patient safety are challenged by the lack of universally agreed upon terms. The International Classification for Patient Safety (ICPS) was developed by the World Health Organization for this purpose. This study aimed to test the applicability of the ICPS to a surgical population. DESIGN: A web-based safety debriefing was sent to clinicians involved in surgical care of abdominal organ transplant patients. A multidisciplinary team of patient safety experts, surgeons and researchers used the data to develop a system of classification based on the ICPS. Disagreements were reconciled via consensus, and a codebook was developed for future use by researchers. RESULTS: A total of 320 debriefing responses were used for the initial review and codebook development. In total, the 320 debriefing responses contained 227 patient safety incidents (range: 0-7 per debriefing) and 156 contributing factors/hazards (0-5 per response). The most common severity classification was 'reportable circumstance,' followed by 'near miss.' The most common incident types were 'resources/organizational management,' followed by 'medical device/equipment.' Several aspects of surgical care were encompassed by more than one classification, including operating room scheduling, delays in care, trainee-related incidents, interruptions and handoffs. CONCLUSIONS: This study demonstrates that a framework for patient safety can be applied to facilitate the organization and analysis of surgical safety data. Several unique aspects of surgical care require consideration, and by using a standardized framework for describing concepts, research findings can be compared and disseminated across surgical specialties. The codebook is intended for use as a framework for other specialties and institutions.

Restriction site-associated DNA sequencing, genotyping error estimation and de novo assembly optimization for population genetic inference.

Restriction site-associated DNA sequencing (RADseq) provides researchers with the ability to record genetic polymorphism across thousands of loci for nonmodel organisms, potentially revolutionizing the field of molecular ecology. However, as with other genotyping methods, RADseq is prone to a number of sources of error that may have consequential effects for population genetic inferences, and these have received only limited attention in terms of the estimation and reporting of genotyping error rates. Here we use individual sample replicates, under the expectation of identical genotypes, to quantify genotyping error in the absence of a reference genome. We then use sample replicates to (i) optimize de novo assembly parameters within the program Stacks, by minimizing error and maximizing the retrieval of informative loci; and (ii) quantify error rates for loci, alleles and single-nucleotide polymorphisms. As an empirical example, we use a double-digest RAD data set of a nonmodel plant species, Berberis alpina, collected from high-altitude mountains in Mexico.

Colour tuneability in sol-gel nano-glass-ceramics comprising Yb(3+)-Er(3+)-Tm3+ Co-doped NaYF4 nanocrystals.

White light can be obtained by up-conversion processes in a cheap and efficient way, being of great interest for lighting, displays, and photonic integrated devices. Here we report a generation of white light under 980 nm laser infrared excitation in Y(b3+)-Er(3+)-Tm3+ triply doped sol-gel derived nano-glass-ceramics containing NaYF4 nanocrystals where co-dopants ions are partitioned. Efficient simultaneous blue, green, and red up-conversion emissions give rise to a balanced white overall emission and corresponding up-conversion mechanisms have been analyzed. Changes in pump power intensity or heat treatment temperature widely vary the ratio of emission bands, resulting in a colour tuneability which has been analyzed and quantified in terms of CIE standard chromaticity diagram.

Undoped and Eu3+ doped In2O3 quantum-dots in transparent glass-ceramics.

Nano-structured glass-ceramics comprising In2O3 nanocrystals (quantum dots) in a silica glassy matrix have been synthesized for the first time to our knowledge, by thermal treatment of sol-gel precursor glasses with different concentrations of In2O3. Undoped and Eu(3+)-doped samples have been obtained and characterized. By means of X-ray Diffraction and Transmission Electron Microscopy analysis, the precipitation of In2O3 cubic crystalline nanoparticles was confirmed. The mean radii of these nanocrystals, from 1 to 4 nm, are comparable to the exciton Bohr radius, corresponding to wide band-gap semiconductor quantum-dots. Under interband UV excitation of the nanocrystals, a broad visible emission is observed in the undoped samples. Meanwhile, the Eu(3+)-doped samples only show emission from these ions which are efficiently excited by energy transfer from the In2O3, nanocrystals. Selective excitation of the Eu3+ ions allow us to discern those remaining in the silica glassy matrix from the ones located in the interface SiO2-In2O3.

Site-selective spectroscopy in Sm(3+)-doped sol-gel-derived nano-glass-ceramics containing SnO(2) quantum dots.

Nano-glass-ceramics of composition 95SiO(2)-5SnO(2) doped with 0.4 Sm(3+) (mol%) were synthesized by the thermal treatment of precursor sol-gel glasses. Structural and luminescence measurements were carried out. The precipitated SnO(2) nanocrystals in the glass matrix constitute a wide bandgap quantum-dot system with size comparable to the bulk exciton Bohr radius. A site-selective excitation, by energy transfer from the semiconductor host, reveals that a fraction of the Sm(3+) ions are incorporated in the SnO(2) nanocrystals, whereas the rest remains in the silica glassy phase. An evolution in the Sm(3+) emission spectra has been observed when the SnO(2) nanocrystals are excited with different UV wavelengths, which has been ascribed to selective excitation of nanocrystal sets with predetermined size.

Effects of Azadirachta indica and Melia azedarach (Meliaceae) extracts from leaves on Trypanosoma cruzi growth and ultrastructure.

The chloroformic extracts from dried fresh leaves ofAzadirachta indica A. Juss. and Melia azedarach L. (Meliaceae) showed marked inhibitory activity on epimastigotes growth of Trypanosoma cruzi, evidenced by 96-wells microtiter plate bioassay and radioactive thymidine incorporation experiment. Each chloroformic extract was separated using silica gel and alumina column. In transmission electron microscopy the bioactive chromatographic fractions caused ultrastructural changes in epimastigotes such as vacuolization probably induced by degeneration of the kinetoplast-mitochondrion complex, organelle degeneration, and cell division disruption. In spectral analysis these bioactive fractions seemed to be composed mainly of fatty acid mixtures.

Effect of cardiac rehabilitation on postprandial response to a high fat meal in patients with coronary artery disease.

Past studies have shown decreased lipemic responses to a high fat meal in healthy trained vs. untrained subjects. The purpose of this study was to characterize fasting lipid profiles and lipemic responses in 13 male cardiac patients (6 in cardiac rehabilitation (CR) and 7 controls (NONCR]. Body composition and dietary composition were assessed. Plasma total cholesterol (TC), HDL-cholesterol (HDL-C) and triglyceride (TG) were determined after a 12-h fast. Subjects consumed a high fat meal (60% of calories) and the lipemic response to the meal was assessed by determining plasma TG hourly for 8 h following the meal. CR had a lower percent body fat than NONCR (26% vs. 34%, P less than 0.05). CR consumed fewer calories from fat than NONCR (28% vs. 41%, P less than 0.05). There were no significant differences between groups in TC, HDL-C or TG, although the differences approached significance (P less than 0.10). CR had a lower TC/HDL-C ratio than NONCR (5.0 vs. 7.7, P less than 0.05). Lipemic responses between groups were similar. There was no significant difference in peak TG, time to peak TG, or area under the TG curve between CR and NONCR groups. Thus, subjects undergoing cardiac rehabilitation appear to have both a more favorable diet and fasting lipid profile than NONCR; however, both groups had a similar response to a high fat meal.