Adjuvant treatment with pegylated interferon α-2a versus low-dose interferon α-2a in patients with high-risk melanoma: a randomized phase III DeCOG trial

BACKGROUND

Adjuvant treatment with interferon (IFN)-α-2a improved disease-free survival (DFS) and showed a trend for improving overall survival (OS) in melanoma. This trial was designed to examine whether PEG-IFN is superior to IFN with regard to distant metastasis-free survival (DMFS), DFS and OS.

PATIENTS AND METHODS

In this multicenter, open-label, prospective randomized phase III trial, patients with resected cutaneous melanoma stage IIA(T3a)-IIIB (AJCC 2002) were randomized to receive PEG-IFN (180 μg subcutaneously 1×/week; 24 months) or IFN α-2a (3MIU subcutaneously 3×/week; 24 months). Randomization was stratified for stage, number of metastatic nodes, age and previous IFN treatment. The primary end point was DMFS; secondary end points were OS, DFS, quality of life (QoL) and tolerability.

RESULTS

A total of 909 patients were enrolled (451 PEG-IFN versus 458 IFN). Neither 5-year DMFS [PEG-IFN 61.0% versus IFN 67.3%; hazard ratio (HR) 1.16, P = 0.21] nor 5-year OS (PEG-IFN 73.2% versus IFN 75.2%; HR 1.05, P = 0.70) nor 5-year DFS (PEG-IFN 57.3% versus IFN 60.9%; HR 1.09, P = 0.40) showed significant differences. Subgroup analyses in patients ± ulcerated primaries and of different tumor stages did not find differences in DMFS, OS or DFS between the treatment groups. One hundred and eighteen patients (26.2%) in the PEG-IFN and 61 patients (13.3%) in the IFN population did not receive the full dosage and length of treatment due to adverse events (P < 0.001). Leukopenia and elevation of liver enzymes were more common in the PEG-IFN arm (56% versus 23.5% LCP; 19.1% versus 9.4% AST; 33.0% versus 16.5% ALT). QoL was identical for nearly all domains.

CONCLUSION

PEG-IFN did not improve the outcome over IFN. A higher percentage of patients under PEG-IFN discontinued treatment due to toxicity.

CLINICAL TRIALSGOV IDENTIFIER

NCT00204529.

Stimulated fluorescence quenching in nitrogen-vacancy centers of diamond: temperature effects

Laser-induced fluorescence quenching in nitrogen-vacancy (NV) centers in diamond is studied simultaneously with in situ measurements of the heating-induced shift of the electron spin resonance of NV centers in the presence of a microwave field. These experiments reveal a strong correlation between fluorescence suppression in NV centers and the rise of the local temperature inside the diamond crystal. This finding sheds light on quantum pathways behind stimulated fluorescence quenching in NV centers of diamond and may imply significant limitations on the applications of this effect as a method of superresolving imaging in biological systems.

Development of a new fertility prediction model for stallion semen, including flow cytometry

Several laboratories routinely use flow cytometry to evaluate stallion semen quality. However, objective and practical tools for the on-field interpretation of data concerning fertilizing potential are scarce. A panel of nine tests, evaluating a large number of compartments or functions of the spermatozoa: motility, morphology, viability, mitochondrial activity, oxidation level, acrosome integrity, DNA integrity, "organization" of the plasma membrane, and hypoosmotic resistance, was applied to a population of 43 stallions, 33 of which showing widely differing fertilities (19%-84% pregnancy rate per cycle [PRC]). Analyses were performed either within 2 hours after semen collection or after 24-hour storage at 4 °C in INRA96 extender, on three to six ejaculates for each stallion. The aim was to provide data on the distribution of values among said population, showing within-stallion and between-stallion variability, and to determine whether appropriate combinations of tests could evaluate the fertilizing potential of each stallion. Within-stallion repeatability, defined as intrastallion correlation (r = between-stallion variance/total variance) ranged between 0.29 and 0.84 for "conventional" variables (viability, morphology, and motility), and between 0.15 and 0.81 for "cytometric" variables. Those data suggested that analyzing six ejaculates would be adequate to characterize a stallion. For most variables, except those related to DNA integrity and some motility variables, results differed significantly between immediately performed analyses and analyses performed after 24 hours at 4 °C. Two "best-fit" combinations of variables were determined. Factorial discriminant analysis using a first combination of seven variables, including the polarization of mitochondria, acrosome integrity, DNA integrity, and hypoosmotic resistance, permitted exact determination of the fertility group for each stallion: fertile, that is, PRC higher than 55%; intermediate, that is, 45% < PRC less than 55%; or subfertile, that is, PRC less than 45%. Linear regression using another combination of 20 variables, including motility, viability, oxidation level, acrosome integrity, DNA integrity, and hypoosmotic resistance, accounted for 94.2% of the variability regarding fertility and was used to calculate a prediction of the PRC with a mean standard deviation of 3.1. The difference between the observed fertility and the calculated value ranged from -4.2 to 5.0. In conclusion, this study enabled to determine a new protocol for the evaluation of stallion semen, combining microscopical observation, computer-assisted motility analysis and flow cytometry, and providing a high level of fertility prediction.

Stark Effect Spectroscopy of Mono- and Few-Layer MoS2

We demonstrate electrical control of the A-exciton interband transition in mono- and few-layer MoS2 crystals embedded into photocapacitor devices via the DC Stark effect. Electric field-dependent low-temperature photoluminescence spectroscopy reveals a significant tuneability of the A-exciton transition energy up to ∼ 16 meV from which we extract the mean DC exciton polarizability ⟨β̅N⟩ = (0.58 ± 0.25) × 10(-8) Dm V(-1). The exciton polarizability is shown to be layer-independent, indicating a strong localization of both electron and hole wave functions in each individual layer.

Speechless soma: The trauma's language in the psychosomatic

The study begins by approaching the psychological traumatism concept, recognizing it as an important precipitating of psychosomatic disorders. Based on studies of anthropologists, psychiatrists and psychoanalysts, we present trauma as a consequence of an unexpected event from where is originated intense fear, an abruption, which disorganizes and incapacitates the victim. The Institut Psychosomatique de Paris (IPSO) works with the theory that trauma is an excessive disorganization in the mental apparatus and the psychosomatic disease is the alternative that the body finds to discharge excitation, is an attempt to resolve a conflict. The psychosomatic patient is characterized by difficulty to qualify his affections, it is observed in his super adapted speech and his linear thought, which, together, differ him from neurotic and psychotic patients. Considerations about the child development and the affects qualification are made to introduce the importance of this primitive period, but we pretend to demonstrate that they are not determinants to produce psychosomatic symptoms. When the psychological pain is intense and constant, it provokes a split between mind (psyche) and body (soma) and, in the place of the elaboration and representation about the experience, explodes psychosomatic disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

“Yo Soy La DesintegracióN”: Helplessness and Sublimation Through Frida Kahlo's History

Considering the relevance of studying the pathologies of emptiness for contemporaneous clinic, this work approaches the correlation between helplessness and sublimation concepts. Helplessness is considered a new theory, developed by David Maldavsky that uses the term desvalimiento to define a clinical condition described by the feeling of emptiness. To understand this concept, it is necessary to return to a primitive period, when the baby is beginning to qualify his affections. Thus, using historical construction, we start at Freud's works (focusing in the primitive period and the affections qualification), explore the “good-enough mother” importance, from Winnicott, and reaching the helplessness from the present-days Maldavsky's studies. The Frida Kahlo's history illustrates this work as much because of her toxic current as because of her talent to sublimate. The maternal failure, the toxic relationships, the trauma's imposition, the abuse of alcohol and drugs and the viscosity denounce her helplessness. Nevertheless, the art expresses her fight for life. The Frida Kahlo's works represent her suffering, but they also are her attempts to understand her feelings and to reframe her traumatic events. Therefore, we introduce the sublimation as an alternative to the helplessness. Although helplessness is the lack of the symbolic life, we present the art as an opportunity to confront experiences, which can allow the representation of the traumas and the qualification of affections. Through the sublimation, Frida Kahlo recreated her inner world and returned to life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Metamorphosing Histories: The Narrative as a Tool for Psychological Trauma's Recovery

Considering psychological traumatism as a subject in constant discussion, this study approaches the recovery of the patients that suffered violent events. Based on studies about the reflection of disasters and wars, we present trauma as a consequence of the unexpected event from where is originated intense fear. Trauma is a violation, an abruption, which disorganizes and incapacitates the victim. When a violence situation is experienced, the physical and verbal abuses are not alone as the elements that interfere in the trauma's establishment, but also their representations. Thereby, the event that produces trauma is imposed, although its meaning depends of the history and beliefs of the subject. Understanding that the accident's representation is the cause of the trauma's establishment, we introduce the narrative as tool for psychological trauma's recovery, because it allows the victims relive their past and reframe their feelings. Regarding it, we highlight the relevance of the sociocultural context – before, during and after the trauma –, once it has direct influence over the way the person deals with adversities, as it can stimulate or stop a resilience process. This study takes in consideration that resilience is not something static, a faculty that the subject has or not, but a process that can be developed, improved or reduced. Thus, the narrative is presented as essential to initiate a resilience process, empowering the victims to confront the trauma and to rewrite their history and their return to life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

CLIP-ASAP-HSQC for fast and accurate extraction of one-bond couplings from isotropic and partially aligned molecules

Fast measurement of heteronuclear one-bond couplings, a class of NMR parameters valuable for structure elucidation, is highly desirable, especially if samples undergo chemical reactions or dynamic processes are observed. Methods presented so far face severe limitations in terms of resolution, accessible bandwidth, and sensitivity. We present the CLean InPhase-Acceleration by Sharing Adjacent Polarization-HSQC (CLIP-ASAP-HSQC) pulse sequence that allows fast acquisition of spectra with clean inphase multiplets in about 25 s. The performance in terms of accurate extraction of one-bond couplings is demonstrated on three test samples including partially aligned molecules.

Lameness and foot lesions in Swiss dairy cows: I. Prevalence

Prevalences of foot lesions and lameness were recorded in 1'449 Swiss dairy cows during routine claw-trimming on 78 farms from June 2010 until February 2011. Lameness was present in 14.8 % of cows and on 80.8 % of investigated farms. Highest prevalences were seen for widened white line (80.7 %/100 %), signalling foot lesion (65.6 %/98.7 %), heel-horn erosion (34.2 %/88.5 %), digital dermatitis complex (29.1 %/73.1 %), severe hemorrhages (27.9 %/87.2 %), and Rusterholz' sole ulcers (11.5 %/74.4 %) at cow and herd level, respectively. Lower prevalences were found for subclinical laminitis (5.4 %/47.4 %), chronic laminitis (3.3 %/25.6 %), white line disease (4.7 %/42.3 %), double soles (2.6 %/33.3 %), interdigital hyperplasia (3.1 %/33.3 %), sole ulcers (0.4 %/6.4 %), toe infections caused by faulty claw-trimming (3.9 %/39.7 %) and by injury (0.1 %/2.6 %), deep lacerations (0.4 %/6.4 %), and interdigital phlegmona (0.1 %/1.3 %). Lameness and foot lesions were shown to represent important health problems of dairy cows under the conditions of the typical grass-based production system in Switzerland. Digital dermatitis has developed to the most relevant foot disease with a high impact on welfare of Swiss dairy cows within the past 10 years.

Intensity interferometry of single x-ray pulses from a synchrotron storage ring

We report on measurements of second-order intensity correlations at the high-brilliance storage ring PETRA III using a prototype of the newly developed adaptive gain integrating pixel detector. The detector records individual synchrotron radiation pulses with an x-ray photon energy of 14.4 keV and repetition rate of about 5 MHz. The second-order intensity correlation function is measured simultaneously at different spatial separations, which allows us to determine the transverse coherence length at these x-ray energies. The measured values are in a good agreement with theoretical simulations based on the Gaussian Schell model.

Electronic and Geometrical Structure of Se5, Se6, Se7, and Se8

The vacuum-UV-photoelectron spectra of Se2, Se5, Se6, Se7, and Se8 have been recorded at a photon energy of h ν= 10.0 eV. The isolated molecules are examined in a supersonic molecular beam employing a new photoelectron-photoion coincidence technique. The structure of the photoelectron spectra of selenium molecules with even and odd numbers of atoms differs in a characteristic manner. While the spectra of Se6 and Se8 show one single broad band, three separated bands with different intensities are observed for Se5 and two for Se7. The spectra are compared to molecular orbital energy calculations based on theoretically supposed geometries. The comparison indicates that Se6 and Se8 have Dnd-symmetrical ring structures, whereas Se5 and Se7 are C1h-symmetrical rings