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Background: Patients with locally advanced bladder cancer (cT3/4 cN0/N+ cM0) have a poor prognosis despite radical surgical therapy and perioperative chemotherapy. Preliminary data suggest that the combination of radiation and immunotherapy does not lead to excess toxicity and may have synergistic (abscopal) anti-tumor effects. We hypothesize that the combined preoperative application of the PD-1 checkpoint-inhibitor Nivolumab with concomitant radiation therapy of the bladder and pelvic region followed by radical cystectomy with standardized lymphadenectomy is safe and feasible and might improve outcome for patients with locally advanced bladder cancer.
Methods: Study design: “RACE IT” (AUO AB 65/18) is an investigator initiated, prospective, multicenter, open, single arm phase II trial sponsored by Technical University Munich. Study drug and funding are provided by the company Bristol-Myers Squibb.
Study treatment: Patients will receive Nivolumab 240 mg i.v. every 2 weeks for 4 cycles preoperatively with concomitant radiation therapy of bladder and pelvic region (max. 50.4 Gy). Radical cystectomy with standardized bilateral pelvic lymphadenectomy will be performed between week 11–15.
Primary endpoint: Rate of patients with completed treatment consisting of radio-immunotherapy and radical cystectomy at the end of week 15.
Secondary endpoints: Acute and late toxicity, therapy response and survival (1 year follow up).
Main inclusion criteria: Patients with histologically confirmed, locally advanced bladder cancer (cT3/4, cN0/N+), who are ineligible for neoadjuvant, cisplatin-based chemotherapy or who refuse neoadjuvant chemotherapy.
Main exclusion criteria: Patients with metastatic disease (lymph node metastasis outside pelvis or distant metastasis) or previous chemo-, immune- or radiation therapy.
Planned sample size: 33 patients, interim analysis after 11 patients.
We developed three bathochromic, green-light activatable, photolabile protecting groups based on a nitrodibenzofuran (NDBF) core with D-π-A push–pull structures. Variation of donor substituents (D) at the favored ring position enabled us to observe their impact on the photolysis quantum yields. Comparing our new azetidinyl-NDBF (Az-NDBF) photolabile protecting group with our earlier published DMA-NDBF, we obtained insight into its excitation-specific photochemistry. While the “two-photon-only” cage DMA-NDBF was inert against one-photon excitation (1PE) in the visible spectral range, we were able to efficiently release glutamic acid from azetidinyl-NDBF with irradiation at 420 and 530 nm. Thus, a minimal change (a cyclization adding only one carbon atom) resulted in a drastically changed photochemical behavior, which enables photolysis in the green part of the spectrum.
Background: The feedback given to students plays an important role in their efficiency related to learning practical skills. In the present study, diverse feedback modalities have been investigated. Our hypothesis is that individualized and unsupervised video feedback can produce a similar learning experience as performing practical skills in an oral and maxillofacial surgery setting with conventional direct expert feedback (control group).
Methods: This prospective, randomized, controlled, and blinded study compared direct expert feedback (DEF), individualized video feedback (IVF) and unsupervised video feedback (UVF). The participants were fourth-year dental students from University Goethe in Frankfurt. The students were assigned to one of the three feedback methods (n = 20 per group) using simple randomization. All participants watched an instruction video for an interdental (‘Ernst’) ligature and periphery venous catheterization. Next, the students were video recorded performing the tasks by themselves (pre-test). Following this, every student received feedback using one of the above-mentioned feedback modalities. The participants then performed the same task again while being video recorded (post-test) to measure the acquired competence. Six weeks later, the students participated in an objective structured clinical examination (OSCE) to evaluate their long-term knowledge retention. All examiners were blinded regarding the students’ instructional approach and their affiliation in terms of the learning group.
Results: For the interdental ligature, we found significant improvements in performance in each feedback modality group between the pre-test and post-test (p < 0.001). UVF had the strongest effect on performance time. The comparison between each group in the post-test showed no significant differences between the three groups.
Conclusion: This study showed that IVF and UVF can be considered an alternative or adjunct to conventional methods (i.e. DEF) when learning procedural skills in oral and maxillofacial surgery. However, DEF showed to be the most effective method of feedback and therefore preferable in teaching.
Im vorliegenden Beitrag soll der Film "Zvizdan"/"Mittagssonne" aus dem Jahr 2015 des kroatischen Regisseurs Dalibor Matanić vorgestellt werden. Der in Deutschland bekannteste Film Matanićs ist vermutlich der Film "Fine mrtve djevojke"/"Schöne tote Mädchen" (Matanićs zweiter Film aus dem Jahr 2002). Bei "Fine mrtve djevojke" handelt es sich um einen sog. 'Independent'-Film, mit dem dieser im Jahr 1975 in Zagreb geborene Regisseur die Homosexualität in einer sehr provinziellen, kleinbürgerlichen Umgebung Zagrebs behandelte. Mit diesem Film gewann Matanić auf dem Filmfestival in Pula im Sommer 2002 alle drei Hauptpreise - den der Jury, den des Publikums und den der Kritik. Mit seinem Film "Zvizdan" gewann der Regisseur 2015 in Cannes den Ersten Preis in der Kategorie "Un certain regard". Aber auch mit anderen seiner Filme positioniert sich der durchaus kontroverse Regisseur in die erste Liga der kroatischen Filmemacher und schreibt an einer Geschichte des europäischen filmischen Realismus mit. Das ausgewählte Film-Beispiel des gefeierten Regisseurs wird im Folgenden im Hinblick auf seinen Realismusgehalt analysiert.
The production of light neutral mesons in AA collisions probes the physics of the Quark-Gluon Plasma (QGP), which is formed in heavy-ion collisions at the LHC. More specifically, the centrality dependent neutral meson spectra in AA collisions compared to its spectra in minimum-bias pp collisions, scaled with the number of hard collisions, provides information on the energy loss of partons traversing the QGP. The measurement allows to test with high precision the predictions of theoretical model calculations. In addition, the decay of the π0 and η mesons are the dominant back- grounds for all direct photon measurements. Therefore, pushing the limits of the precision of neutral meson production is key to learning about the temperature and space-time evolution of the QGP.
In the ALICE experiment neutral mesons can be detected via their decay into two photons. The latter can be reconstructed using the two calorimeters EMCal and PHOS or via conversions in the detector material. The excellent momentum resolution of the conversion photons down to very low pT and the high reconstruction efficiency and triggering capability of calorimeters at high pT, allow us to measure the pT dependent invariant yield of light neutral mesons over a wide kinematic range.
Combining state-of-the-art reconstruction techniques with the high statistics delivered by the LHC in Run 2 gives us the opportunity to enhance the precision of our measurements. In these proceedings, new ALICE run 2 preliminary results for neutral meson production in pp and Pb–Pb collisions at LHC energies are presented.
Cloeon perkinsi was described from South Africa in 1932 by Barnard. Despite being relatively common in Africa, it was mentioned in the literature quite rarely, and its known distribution to date includes most of sub-Saharan Africa. Material collected recently in Ethiopia, Israel, Saudi Arabia, and Yemen extends its distribution in East Africa, Arabian Peninsula and the Levant. We examined this material, and provide a re-description of adults (females and males) and nymphs of the species. It represents a much-needed urge mainly due to inconsistencies in literature reports regarding colouration, and sometimes incomplete morphological description of all stages. We demonstrate the intraspecific morphological variability that we have witnessed, and provide information regarding the range of habitats colonised by C. perkinsi. Based on geological and climatic history of the studied region, taken together with among countries genetic distances of the mitochondrial barcoding gene COI, we propose colonisation mechanisms for the north-easternmost limit of distribution. The fragmented distribution pattern of the species highlights the conservation importance of isolated aquatic habitats in the region, as well as current knowledge gaps.
A new genus of Baetidae is described from Southeast Asia, Procerobaetis gen. nov. It has a wide distribution reaching from Indonesia (Sumatra) to the Philippines. Two new species are described from Indonesia, P. leptobranchius gen. et sp. nov. and P. petersorum gen. et sp. nov., and one new species from the Philippines, P. freitagi gen. et sp. nov. Procerobaetis gen. nov. is characterized by having seven pairs of elongate, apically pointed gills. At least gills I and II are very slender with strongly extended points, which is unique in Baetidae. Similar gills were described from Leptophlebiidae. Procerobaetis gen. nov. is further characterized by having long, slender legs with extended, slender and slightly bent claws. The antennae posess remarkable spines at the outer, lateral margin, which are maximally developed on segments IX–XI of the flagellum. No spines are present on the posterior margins of abdominal tergites I–VI. COI sequences were obtained from all three of the new species. The genetic distances (Kimura 2-parameter) between these species are between 13% and 20%. Very limited genetic distances of 0% to 1% were found between specimens of the same species. The occurrence of two different species in the same area of Sumatra is discussed.
With obesity having doubled in the last decade, hypertension is on the rise. In one-third of hypertensive patients the metabolic syndrome is present. This might be one factor for the increasing number of prescriptions for angiotensin receptor blockers and calcium-channel blockers besides a more favorable risk-to-benefit ratio. The aim of the present study was to evaluate a therapeutic drug monitoring (TDM) method for assessment of adherence based on cut-offs in inpatients and to compare it to an established urine drug screening in outpatients. A method for quantification of calcium-channel blockers and angiotensin receptor blockers using high-performance liquid chromatography-tandem mass spectrometric analysis (LC-MS/MS) was developed and validated. The method was applied to serum samples of 32 patients under supervised medication to establish cut-off values for adherence assessment based on dose-related concentrations (DRC, calculated from pharmacokinetic data). Furthermore, corresponding urine and blood samples of 42 outpatients without supervised medication were analysed and the results compared with regard to adherence assessment. All serum concentrations measured for amlodipine (n = 40), lercanidipine (n = 14), candesartan (n = 10), telmisartan (n = 4) and valsartan (n = 10) in inpatients were above the patient specific lower DRC confirming adherence. Of 42 outpatients the identification of analytes in urine as well as the quantification in serum exhibited differing results. According to urinalysis, adherence was demonstrated in only 87.0% of prescriptions, compared to 91.3% for serum analyses. Differences were observed for amlodipine, lercanidipine and candesartan which can be explained by a higher specificity of the serum analysis approach due to pharmacokinetics. The present study confirms that assessing adherence based on serum drug concentrations with individually calculated lower DRCs is more accurate than using qualitative urine analysis. In particular, drugs with low bioavailability, low renal excretion or high metabolism rate such as lercanidipine and candesartan may lead to underestimation of adherence via urine analysis.
Although the 12C(n,p)12B and 12C(n,d)11B reactions are of interest in several fields of basic and applied Nuclear Physics the present knowledge of these two cross-sections is far from being accurate and reliable, with both evaluations and data showing sizable discrepancies. As part of the challenging n_TOF program on (n,cp) nuclear reactions study, the energy differential cross-sections of the 12C(n,p)12B and 12C(n,d)11 B reactions have been measured at CERN from the reaction thresholds up to 30 MeV neutron energy. Both measurements have been recently performed at the long flight-path (185 m) experimental area of the n_TOF facility at CERN using a pure (99.95%) rigid graphite target and two silicon telescopes. In this paper an overview of the experiment is presented together with a few preliminary results.
Blickte Carl Schmitt dieser Tage auf Georgien, so müsste er seinen berühmten Anfangssatz aus dem dritten Kapitel der "Politischen Theologie" ändern. Statt "Souverän ist, wer über den Ausnahmezustand entscheidet", müsste es heißen: Souverän ist, wer sich dem Ausnahmezustand nicht beugt. Denn die Georgische Orthodoxe Kirche hat erklärt, sich notfalls über alle vom Staat im Zusammenhang mit der Corona-Krise verhängten Beschränkungen hinwegzusetzen, um Liturgien und vor allem die Kommunion feiern zu können - so geschehen bei den Ostermessen am letzten Sonntag. [...] Der Konflikt ist jedoch nicht nur rechtlich, sondern auch politisch sehr bedeutsam. Politisch geht es um die freiheitliche demokratische Grundordnung Georgiens und den Versuch der Kirche, diese zu untergraben. Die Orthodoxe Kirche Georgiens, Ende der 1980er Jahre noch eine randständige gesellschaftliche Kraft, ist zu einer der reichsten und mächtigsten Institutionen in Georgien aufgestiegen, der die Mehrheit der georgischen Gesellschaft vertraut und die deshalb großen politischen Einfluss ausübt.