Study protocol of the FIRE-8 (AIO-KRK/YMO-0519) trial: a prospective, randomized, open-label, multicenter phase II trial investigating the efficacy of trifluridine/tipiracil plus panitumumab versus trifluridine/tipiracil plus bevacizumab as first-line treatment in patients with metastatic colorectal cancer

Background

Initial systemic therapy for patients with metastatic colorectal cancer (mCRC) is usually based on two- or three-drug chemotherapy regimens with fluoropyrimidine (5-fluorouracil (5-FU) or capecitabine), oxaliplatin and/or irinotecan, combined with either anti-VEGF (bevacizumab) or, for RAS wild-type (WT) tumors, anti-EGFR antibodies (panitumumab or cetuximab). Recommendations for patients who are not eligible for intensive combination therapies are limited and include fluoropyrimidine plus bevacizumab or single agent anti-EGFR antibody treatment. The use of a monochemotherapy concept of trifluridine/ tipiracil in combination with monoclonal antibodies is not approved for first-line therapy, yet. Results from the phase II TASCO trial evaluating trifluridine/ tipiracil plus bevacicumab in first-line treatment of mCRC patients and from the phase I/II APOLLON trial investigating trifluridine/ tipiracil plus panitumumab in pre-treated mCRC patients suggest favourable activity and tolerability of these new therapeutic approaches.

Methods

FIRE-8 (NCT05007132) is a prospective, randomized, open-label, multicenter phase II study which aims to evaluate the efficacy of first-line treatment with trifluridine/tipiracil (35 mg/m² body surface area (BSA), orally twice daily on days 1–5 and 8–12, q28 days) plus either the anti-EGFR antibody panitumumab (6 mg/kg body weight, intravenously on day 1 and 15, q28 days) [arm A] or (as control arm) the anti-VEGF antibody bevacizumab (5 mg/kg body weight, intravenously on day 1 and 15, q28 days) [arm B] in RAS WT mCRC patients. The primary objective is to demonstrate an improved objective response rate (ORR) according to RECIST 1.1 from 30% (control arm) to 55% with panitumumab. With a power of 80% and a two-sided significance level of 0.05, 138 evaluable patients are needed. Given an estimated drop-out rate of 10%, 153 patients will be enrolled.

Discussion

To the best of our knowledge, this is the first phase II trial to evaluate the efficacy of trifluridine/tipiracil plus panitumumab in first-line treatment of RAS WT mCRC patients. The administration of anti-EGFR antibodies rather than anti-VEGF antibodies in combination with trifluridine/tipiracil may result in an increased initial efficacy.

Trial registration

EU Clinical Trials Register (EudraCT) 2019-004223-20. Registered October 22, 2019, ClinicalTrials.govNCT05007132. Registered on August 12, 2021.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12885-022-09892-8.

Addressing Single Nuclear Spins Quantum Memories by a Central Electron Spin

Nuclei surrounding single electron spins are valuable resources for quantum technology. For application in this area, one is often interested in weakly coupled nuclei with coupling strength on the order of a few 10-100 kHz. In this paper, we compare methods to address single nuclear spins with this type of hyperfine coupling to a single electron spin. To achieve the required spectral resolution, we specifically focus on two methods, namely dynamical decoupling and correlation spectroscopy. We demonstrate spectroscopy of two single nuclear spins and present a method to derive components of their hyperfine coupling tensor from those measurements.

Relation of cetuximab-induced skin toxicity and early tumor shrinkage in metastatic colorectal cancer patients: results of the randomized phase 3 trial FIRE-3 (AIO KRK0306)

BACKGROUND

Cetuximab-induced skin toxicity (Cet-ST) is positively associated with outcome in metastatic colorectal cancer (mCRC). Besides its predictive relevance for targeted therapy, we investigated its prognostic impact with early tumor shrinkage (ETS) ≥20%, another on-treatment surrogate for clinical outcome in FIRE-3.

PATIENTS AND METHODS

FIRE-3 evaluated first-line FOLFIRI (folinic acid, fluorouracil and irinotecan) plus cetuximab (FOLFIRI/Cet) versus FOLFIRI plus bevacizumab (FOLFIRI/Bev) in mCRC patients with RAS-WT tumors (i.e. wild-type in KRAS and NRAS exons 2-4). Retrospective data on Cet-ST that occurred during cycles 1-3 of treatment were correlated with efficacy endpoints, including ETS. To control for guarantee-time bias, only patients who had completed three or more treatment cycles were considered.

RESULTS

Of 199 patients treated with FOLFIRI/Cet, 181 (91.0%) completed three or more treatment cycles. A significant survival benefit of FOLFIRI/Cet over FOLFIRI/Bev was only evident in patients developing Cet-ST grade 2-3 [41.0 versus 26.6 months; hazard ratio (HR) = 0.73; 95% confidence interval (CI): 0.61-0.87; P < 0.001] compared with Cet-ST grade 0-1 (HR = 0.90; 95% CI: 0.67-1.20; P = 0.48). Regarding prognosis, Cet-ST grade 2-3 (n = 75; 41.4%), compared with Cet-ST grade 0-1 (n = 106; 58.6%), was associated with prolonged overall survival (OS; HR = 0.62; 95% CI: 0.42-0.91; P = 0.01). In multivariate analysis, both Cet-ST (HR = 0.66; 95% CI: 0.50-0.87; P = 0.003) and ETS (HR = 0.55; 95% CI: 0.41-0.74; P < 0.0001) were independently prognostic for OS. Absence of both Cet-ST grade ≥2 and ETS identified a subgroup of patients with very poor prognosis (median OS 15.1 months).

CONCLUSIONS

In FIRE-3, the addition of cetuximab to FOLFIRI was associated with superior OS compared with FOLFIRI/Bev only in patients developing Cet-ST grade ≥2. Regarding prognostic relevance, both Cet-ST and ETS were independent and early predictors of survival. The present analysis supports that a combined evaluation of on-treatment parameters such as Cet-ST and ETS may help to guide treatment of mCRC.

Consensus molecular subgroups (CMS) of colorectal cancer (CRC) and first-line efficacy of FOLFIRI plus cetuximab or bevacizumab in the FIRE3 (AIO KRK-0306) trial

BACKGROUND

FIRE-3 compared first-line therapy with FOLFIRI plus either cetuximab or bevacizumab in 592 KRAS exon 2 wild-type metastatic colorectal cancer (mCRC) patients. The consensus molecular subgroups (CMS) are grouping CRC samples according to their gene-signature in four different subtypes. Relevance of CMS for the treatment of mCRC has yet to be defined.

PATIENTS AND METHODS

In this exploratory analysis, patients were grouped according to the previously published tumor CRC-CMSs. Objective response rates (ORR) were compared using chi-square test. Overall survival (OS) and progression-free survival (PFS) times were compared using Kaplan-Meier estimation, log-rank tests. Hazard ratios (HR) were estimated according to the Cox proportional hazard method.

RESULTS

CMS classification could be determined in 438 out of 514 specimens available from the intent-to-treat (ITT) population (n = 592). Frequencies for the remaining 438 samples were as follows: CMS1 (14%), CMS2 (37%), CMS3 (15%), CMS4 (34%). For the 315 RAS wild-type tumors, frequencies were as follows: CMS1 (12%), CMS2 (41%), CMS3 (11%), CMS4 (34%). CMS distribution in right- versus (vs) left-sided primary tumors was as follows: CMS1 (27% versus 11%), CMS2 (28% versus 45%), CMS3 (10% versus 12%), CMS4 (35% versus 32%). Independent of the treatment, CMS was a strong prognostic factor for ORR (P = 0.051), PFS (P < 0.001), and OS (P < 0.001). Within the RAS wild-type population, OS observed in CMS4 significantly favored FOLFIRI cetuximab over FOLFIRI bevacizumab. In CMS3, OS showed a trend in favor of the cetuximab arm, while OS was comparable in CMS1 and CMS2, independent of targeted therapy.

CONCLUSIONS

CMS classification is prognostic for mCRC. Prolonged OS induced by FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab in the FIRE-3 study appears to be driven by CMS3 and CMS4. CMS classification provides deeper insights into the biology to CRC, but at present time has no direct impact on clinical decision-making.The FIRE-3 (AIO KRK-0306) study had been registered at ClinicalTrials.gov: NCT00433927.

Palliative home care for patients with advanced haematological malignancies-a multicenter survey

Patients with advanced haematological malignancies in non-curative settings suffer from complex physical symptoms and psychosocial distress, comparable to patients with solid tumour entities. Nevertheless, numerous problems at the interface between haematology and palliative home care have been described. From January 2011 until October 2014, we performed a retrospective, multicenter analysis of all patients with haematological malignancies (ICD 10: C81-C95) being treated by the respective specialized palliative home care (SAPV) team. Three SAPV teams were surveyed. Disease entity, physical symptoms, psychosocial distress, number of hospital admissions, therapeutic interventions and other items were analysed descriptively. Of 3,955 SAPV patients, 1.8% (n = 73) suffered from haematological malignancies. Main problems were deterioration of general condition, pain or psychological problems. Thirty-seven percent developed new symptoms during SAPV, mainly pain, psychological distress or deterioration of general status. In 33%, patients were referred to hospital, mainly due to deterioration of general condition or pain. Seventy percent died within 3 months after beginning SAPV care; 83% died at home or in a nursing home. Patients suffering from advanced haematological malignancies were statistically underrepresented in SAPV, and SAPV was installed rather at the very last days of life. By far, more patients were able to die outside a hospital as compared to reference cohorts of haematological patients not being treated in SAPV. The spectrum of documented problems is comparable to other patient cohorts being treated in SAPV; therefore, the options and benefits of palliative home care should be incorporated in palliative haematological treatment concepts more vigorously and consequently.

High quality entanglement on a chip-based frequency comb

We report an efficient energy-time entangled photon-pair source based on four-wave mixing in a CMOS-compatible silicon photonics ring resonator. Thanks to suitable optimization, the source shows a large spectral brightness of 400 pairs of entangled photons /s/MHz for 500 μW pump power, compatible with standard telecom dense wavelength division multiplexers. We demonstrate high-purity energy-time entanglement, i.e., free of photonic noise, with near perfect raw visibilities (> 98%) between various channel pairs in the telecom C-band. Such a compact source stands as a path towards more complex quantum photonic circuits dedicated to quantum communication systems.

Scleredema. A multicentre study of characteristics, comorbidities, course and therapy in 44 patients

BACKGROUND

The prognostic and therapeutic features of scleredema are poorly documented.

OBJECTIVES

To describe the characteristics of patients with scleredema regarding demographics, clinical characteristics, comorbidities, therapeutic interventions and course.

METHODS

We conducted a retrospective multicentre study.

RESULTS

We identified 44 patients (26 men).The mean age at diagnosis was 53.8 years. The most common associated disorders were endocrine/metabolic diseases including 30 patients suffering from diabetes, mostly type 2 diabetes. Monoclonal gammopathies were confirmed in five cases. A preceding respiratory tract infection was not a feature. Treatments with different combination or sequential modalities were used with variable results. Phototherapy (UVA1 or PUVA) was the treatment associated with higher, although partial response. Systemic corticosteroids and immunosuppressive drugs were reserved to patients with severe disease in whom phototherapy had failed or for patients with multiple myeloma. Forty-one patients were followed up (mean period: 32.2 months).Thirty-nine patients are alive, 30 with and 9 without skin disease. Two patients died of cardiovascular complications due to myeloma and severe diabetes.

CONCLUSIONS

Scleredema is a chronic debilitating disease associated with diabetes and metabolic syndrome, unresponsive to various treatments but not necessarily a life-threatening condition. Although there is no definitive treatment, phototherapy should be attempted first. Treatment of primary disease including strict glycaemic control combined with physical therapy should be also employed.

[The Oncologic and Palliative Network Landshut: a problem-solving approach to oncological and palliative care in structurally weak rural areas, with special emphasis on outpatient and inpatient networking]

The Oncologic and Palliative Network Landshut is a problem-solving approach to structurally weak rural areas to improve an a dequate care of critically ill patients, especially by a close involvement of outpatient and inpatient care providers. These networks not only improve the medical and nursing care of patients, but can also be cost-effective.

[The Oncologic and Palliative Network Landshut: a problem-solving approach to oncological and palliative care in structurally weak rural areas, with special emphasis on outpatient and inpatient networking]

The Oncologic and Palliative Network Landshut is a problem-solving approach to structurally weak rural areas to improve an adequate care of critically ill patients, especially by a close involvement of outpatient and inpatient care providers. These networks not only improve the medical and nursing care of patients, but can also be cost-effective.

AN UNUSUAL PRESENTATION OF ACUTE LYMPHOBLASTIC LEUKAEMIA WITH PERI-CARDIAL EFFUSION CAUSING CARDIAC TAMPONADE

Peri-cardial effusion is most commonly associated with tuberculous infection in the developing world. Peri-cardial effusion causes symptoms when it is large or when it has accumulated rapidly. Non-tuberculous causes of peri-cardial effusion include bacterial infections, uraemia, viral infections, rheumatic fever, connective tissue disorders, post - peri-cardiotomy syndromes and malignancy. We present a case of acute lymphoblastic leukaemia first presenting as a large peri-cardial effusion causing tamponade.

[Current treatment concepts of lung cancer]

Lung cancer occurs with a median age of 69 years. The main cause is cigarette smoking. For both genders lung cancer is the third-most frequent tumor in Germany. While in an operable tumor stage 30-80% of the patients can reach long-term survival, the prognosis in the metastasised stage is unfavourable with a 5-year overall survival rate of 6% for small cell lung cancer (SCLC) and 18% for non-small cell lung cancer (NSCLC). Lung cancer is subject of intense research to improve the outcome. This article gives an overview of current treatment options.

Monolithic diamond optics for single photon detection

In this work, we experimentally demonstrate a novel and simple approach that uses off-the-shelf optical elements to enhance the collection efficiency from a single emitter. The key component is a solid immersion lens made of diamond, the host material for single color centers. We improve the excitation and detection of single emitters by one order of magnitude, as predicted by theory.

Low temperature studies of the excited-state structure of negatively charged nitrogen-vacancy color centers in diamond

We report a study of the 3E excited-state structure of single negatively charged nitrogen-vacancy (NV) defects in diamond, combining resonant excitation at cryogenic temperatures and optically detected magnetic resonance. A theoretical model is developed and shows excellent agreement with experimental observations. In addition, we show that the two orbital branches associated with the 3E excited state are averaged when operating at room temperature. This study leads to an improved physical understanding of the NV defect electronic structure, which is invaluable for the development of diamond-based quantum information processing.

Dynamic polarization of single nuclear spins by optical pumping of nitrogen-vacancy color centers in diamond at room temperature

We report a versatile method to polarize single nuclear spins in diamond, based on optical pumping of a single nitrogen-vacancy (NV) defect and mediated by a level anticrossing in its excited state. A nuclear-spin polarization higher than 98% is achieved at room temperature for the 15N nuclear spin associated with the NV center, corresponding to microK effective nuclear-spin temperature. We then show simultaneous initialization of two nuclear spins in the vicinity of a NV defect. Such robust control of nuclear-spin states is a key ingredient for further scaling up of nuclear-spin based quantum registers in diamond.

Y haplogroups and aggressive behavior in a Pakistani ethnic group

Studies show that personality dimensions such as aggression are influenced by genetic factors and that allelic variants located on the Y chromosome influence such behavior. We investigated polymorphisms on the male-specific region of the human Y chromosome in 156 unrelated males from the same ethnic background, who were administered the Punjabi translation of the Buss and Perry Aggression Questionnaire that measures four aspects that constitute aggressive behavior, i.e. physical aggression, verbal aggression, anger, and hostility. A value of .85 for Cronbach's coefficient alpha indicates considerable internal consistency and suggests that the psychometric properties of the aggression questionnaire can be adapted for the Pakistani population. A mean score+/-SD of 69.70+/-19.95 was obtained for the questionnaire. Each individual was genotyped following a phylogenetic hierarchical approach to define evolutionary Y haplogroups. Five Y haplogroups that are commonly found in Eurasia and Pakistan comprised 87% (n=136) of the population sample, with one haplogroup, R1a1, constituting 55% of the sampled population. A comparison of the total and four subscale mean scores across the five common Y haplogroups that were present at a frequency > or =3% in this ethnic group revealed no overall significant differences. However, effect-size comparisons allowed us to detect an association of the haplogroups R2 (Cohen's d statistic=.448-.732) and R1a1 (d=.107-.448) with lower self-reported aggression mean scores in this population.

Long distance stability of gap solitons

We numerically investigate the stability of one- and two-dimensional gap solitons for very long propagation distances both in self-focusing and in self-defocusing nonlinear photonic media. We demonstrate that the existence of stable solitons in the first gap requires much stronger lattices in a self-focusing than in a self-defocusing medium. Moreover, we present a one-dimensional linear stability analysis of the fundamental solitary mode in the first gap considering a self-focusing photorefractive nonlinearity.

Biostatistical analysis of gene microarrays reveals diverse expression clusters between macaque subspecies in brain SIV infection

In this study we investigated differences in the gene expression profiling of the brains of rhesus macaques that were uninfected or infected with SIV in the asymptomatic stage or AIDS. The main aim was to use biostatistical methods to classify brain gene expression following SIV infection, without consideration of the biological significance of the individual genes. We also used data from animals treated with different pharmacological substances such as dopaminergic drugs, N-methyl-D-aspartate (NMDA) antagonists or antioxidants during the early stage of infection as these animals exhibited an accelerated or attenuated neuropsychiatric disease progression. We found macaque subspecies to be a more important factor for disease classification based on gene expression profiling than clinical symptoms or neuropathological findings. It is noteworthy that SIV-infected pharmacologically-treated. Chinese animals clustered near uninfected animals independent on the outcome of the treatment, whereas untreated SIV infected animals were clustered in a separate subtree. It is clear from this study that NeuroAIDS is a diverse disease entity and that SIV brain genes can be differentially regulated, depending on the disease type as well as changed dependent on the monkey subspecies.

Counterpropagating beams in biased photorefractive crystals: anisotropic theory

We formulate an anisotropic nonlocal theory of the space charge field induced by the coherent counterpropagating beams in biased photorefractive crystals. We establish that the competition between the drift and diffusion terms has to be taken into account when the crystal ĉ axis is tilted with respect to the propagation direction of the beams. We demonstrate that this configuration combines the features of both spatial soliton formation without energy exchange and two-wave mixing with energy exchange leading to pattern formation.

An international course on strategic information management for medical informatics students: international perspectives and evaluation

All over the world, countries more and more take part in the international society and economy. To meet the stringent requirements of this globalization asks for internationally oriented and well-educated graduates. A major challenge of academia thus lies in qualifying graduates for international positions in this new world. A crucial element in the training and education of tomorrow's medical informatics specialists is exposure to health care systems across national borders. In this contribution, we report on the international aspects of and experiences with an inter-university course for medical informatics students on hospital information systems, in particular on their strategic information management. From 2001 onwards, this course was offered jointly for students of the University of Amsterdam, the University of Heidelberg/University of Applied Sciences Heilbronn and the University of Health Informatics and Technology, Tyrol (UMIT). Based on our experiences, future establishment of international courses in the medical and health informatics field is recommended.

Transverse modulational instabilities of counterpropagating solitons in photorefractive crystals

We study numerically the counterpropagating vector solitons in SBN:60 photorefractive crystals. A simple theory is provided for explaining the symmetry-breaking transverse instability of these solitons. Phase diagram is produced that depicts the transition from stable counterpropagating solitons to bidirectional waveguides to unstable optical structures. Numerical simulations are performed that predict novel dynamical beam structures, such as the standing-wave and rotating multipole vector solitonic clusters. For larger coupling strengths and/or thicker crystals the beams form unstable self-trapped optical structures that have no counterparts in the copropagating geometry.

Dynamic counterpropagating vector solitons in saturable self-focusing media

We display rich spatial and temporal dynamics of light fields counterpropagating in a saturable self-focusing medium numerically, and analyze instabilities that counterpropagating solitons experience. An expression for the maximum length that the medium must not exceed for the solitons to be stable is derived and connected to the coupling strength of beam interaction. The instability can lead to periodic or irregular temporal dynamics of the light beams. By considering mutually incoherent counterpropagating beams, we show that differences to the copropagating case are due to the different boundary conditions.

Influence of spatiotemporally correlated noise on structure formation in excitable media

We discuss the influence of additive, spatiotemporally correlated (i.e., colored) noise on pattern formation in a two-dimensional network of excitable systems. The signature of spatiotemporal stochastic resonance (STSR) is analyzed using cross-correlation and information theoretic measures. It is found that the STSR behavior is affected by both the spatial and temporal correlations of the noise due to an interplay with the length scales of the deterministic network. Increasing the spatiotemporal noise correlation shifts the occurrence of STSR to smaller values of the noise variance. Additionally, if the spatial correlation of the noise exceeds that of the network, the excitation patterns disappear in favor of cloudy structures, directly rendering the underlying spatial noise field.

Method for detecting the signature of noise-induced structures in spatiotemporal data sets

Spatiotemporal stochastic resonance (STSR) is a phenomenon, where the stability of spatial patterns in an extended dynamical system displays a resonance-type dependence on the noise amplitude with the patterns being optimal at intermediate noise level. This dynamical behavior has been found in theoretical systems as well as in biochemical processes, where the noise level has been controlled externally. However, it is an open question how to identify the signature of a spatiotemporal stochastic resonance in a natural system, e.g., in ecology, when the noise amplitude is not known. This question is addressed in the present paper. We provide analysis tools, which allow to reconstruct the noise intensity in a spatiotemporal data set from the data alone. These tools are based on nearest-neighbor considerations inspired by cellular automata and are an appropriate method for detecting STSR, when combined with some measure of spatial order. As a test of our analysis tools, we apply them to sample data generated by four theoretical model systems. We show explicitly that without knowledge of the theoretical value of the noise amplitude for those systems displaying STSR the corresponding resonance curve can be reconstructed from the data alone. In addition, the other (nonresonant) cases are properly identified by our method with no resonance curve being found.

Isotropic versus anisotropic modeling of photorefractive solitons

The question of the isotropic versus anisotropic modeling of incoherent spatial screening solitons in photorefractive crystals is addressed by a careful theoretical and numerical analysis. Isotropic, or local, models allow for an extended spiraling of two interacting scalar solitons, and for a prolonged propagation of vortex vector solitons, whereas anisotropic, nonlocal, models prevent such phenomena. In the context of Kukhtarev's material equations, the difference in behavior is traced to the continuity equation for the current density. We further show that neither an indefinite spiraling of two solitons nor stable propagation of vortex vector solitons is generally possible in both isotropic and anisotropic models. Such systems do not conserve angular momentum, even in the case of an isotropic change in the index of refraction.

Generation of higher-order optical (2+1)-dimensional spatial vector solitons in a nonlinear anisotropic medium

We investigate the generation of higher-order optical vector solitons in two transverse dimensions in anisotropic nonlinear media consisting of an incoherent superposition of a Gaussian beam and a higher-order laser mode with a complex internal modal structure. We demonstrate both numerically and experimentally various examples of these stable self-trapped light structures and show that vortex modes carrying topological charge always decay into multiple-humped structures that remain self trapped during propagation. Furthermore, we demonstrate the mutual stabilization of a triple- and a double-humped transverse light structure leading to the formation of a two-dimensional vector soliton without a stabilizing fundamental Gaussian mode.

Effect of naloxone on primary and secondary hyperalgesia induced by the human burn injury model

BACKGROUND

Opioid antagonists may change the responses in models of experimental hyperalgesia. This indicates a possible involvement of the endogenous opioid system in these models. The aim of the present study was to evaluate whether activation of the endogenous opioid system could be demonstrated in the human burn injury model of cutaneous hyperalgesia, using an intravenous challenge with the non-selective opioid antagonist naloxone.

METHODS

We studied 25 healthy male volunteers aged 20-31 yrs in a randomised, double-blind, triple crossover design. A 25x50 mm rectangular burn injury was produced on the calf on 3 separate days, at least 1 week apart. Subjects received an intravenous bolus dose of naloxone 0.4 mg, 10 mg or placebo 3 h after induction of the burn injury.

RESULTS

Primary and secondary hyperalgesia was induced by the burn injury. Naloxone did not affect any of the measured variables: heat pain detection threshold in non-injured or injured tissue, pain produced by short or prolonged noxious heat in non-injured or injured tissue, secondary hyperalgesia elicited by pin prick or stroke, or pain produced by short or prolonged noxious mechanical stimulation in non-injured tissue. No significant adverse effects of naloxone were encountered.

CONCLUSIONS

Activation of an endogenous opioid response following induction of hyperalgesia in human volunteers by a burn injury could not be demonstrated with an intravenous naloxone challenge. These findings suggest that the endogenous opioid response is not a confounding factor in this model.

Effect of colored noise on networks of nonlinear oscillators

We discuss noise-induced pattern formation in different two-dimensional networks of nonlinear oscillators, namely a sequence of biochemical reactions and the Lorenz system. The main focus of the work is on the dependence of these patterns on the correlation time (i.e., the color) of exponentially correlated Gaussian noise. It is seen that in the nonchaotic case, the homogeneity (or average cluster size) goes through a minimum with higher correlation time, while in its chaotic regime the Lorenz system shows a higher degree of synchronization when the correlation time of the noise is increased. In order to elucidate the origin of this phenomenon, the effect of colored noise on the individual oscillator is investigated. It is shown that the specific dependence of the network's homogeneity on the noise correlation time arises from an interplay of the collective behavior and the properties of the single oscillators.

Receptor mediated antiproliferative effects of the cytotoxic LHRH agonist AN-152 in human ovarian and endometrial cancer cell lines

Eighty percent of human ovarian and endometrial cancers express receptors for luteinizing hormone-releasing hormone (LHRH). These receptors might be used for targeted chemotherapy with cytotoxic LHRH analogs such as AN-152, in which doxorubicin is linked to agonist carrier [D-Lys6]LHRH. The antiproliferative effects of doxorubicin and AN-152 were assessed in LHRH receptor-positive ovarian (EFO-21, EFO-27) and endometrial (HEC-1A, Ishikawa) cancer cell lines as well as in LHRH receptor negative ovarian SKOV-3 and endometrial MFE-296 lines. The mechanism of action of AN-152 was investigated by a blockage of receptors using an excess of the LHRH agonist [D-Trp6]LHRH. In some cases, confocal laser-scanning microscopy was used to visualize the accumulation of AN-152 or doxorubicin within the cells. In 3 of 4 LHRH receptor-positive cell lines (EFO-21, HEC-1A, Ishikawa) AN-152 was more effective than doxorubicin in inhibiting cell proliferation. The effect of AN-152 was shown to be receptor-mediated because it could be reduced by competitive blockade of the LHRH receptors with [D-Trp6]LHRH. In contrast, AN-152 was less active than doxorubicin in LHRH receptor-negative lines. Confocal laser-scanning microscopy showed an intranuclear accumulation of AN-152 and competitive inhibition thereof by [D-Trp6]LHRH in LHRH receptor-positive cell lines, but no intracellular accumulation of AN-152 could be detected in the receptor-negative SKOV-3 line. These results suggest a selective receptor-mediated action of AN-152 in receptor-positive cell lines.

CCK peptides with combined features of hexa- and tetrapeptide CCK-A agonists

Selective CCK-A agonist activity has been reported to induce satiety in a variety of animals, including man, and thereby suggests a therapeutic role for CCK in the management of obesity. To date, three general classes of CCK-A agonists have been reported, the full-length, sulfated hepta- and hexapeptides, a series of tetrapeptides, and most recently a series of benzodiazepines. The SAR of the hexa- and tetrapeptide classes suggests that the Hpa(SO(3)H) and Tac groups may not interact at the CCK-A receptor in the same location. However, the C-terminal dipeptide part of the hexapeptides and tetrapeptides appear to interact at the CCK-A receptor in a similar manner. Compound 7 (Hpa-Nle-Gly-Trp-Lys(Tac)-Asp-MePhe-NH(2)) derived from combining the features of the hexapeptides and the tetrapeptides has subnanomolar affinity and 3500-fold selectivity for CCK-A receptors. Compound 7 administered intraperitoneally produces potent, long-lasting reduction in food intake in rats and a corresponding weight loss when administered over nine consecutive days.

Spatial screening solitons as particles

Photorefractive spatial screening solitons are treated as rays using geometrical optics. The ray picture is transformed into a classical mechanics picture, in which solitons move self-consistently as particles in a potential created by the induced change in the refractive index. The Hamiltonian equations of motion are integrated to yield trajectories that agree with the optical center-of-mass trajectories. The motion in the transverse plane is found to be not central and the orbits are not closed, preventing the spiraling of solitons.

Dynamics of formation and interaction of photorefractive screening solitons

An experimental and numerical investigation of the dynamical, time-dependent effects accompanying the formation and interaction of two-dimensional spatial screening solitons in a photorefractive strontium barium niobate crystal is performed. These effects include initial diffraction, collapse to the soliton shape, the oscillation of beam diameters, beam bending, and the rotation, twisting, and turning of soliton pairs. The dynamics of complex spiraling of two incoherent solitons is considered in more detail.

Prepaid convenience

Consider prepaid calling cards as a new tool in your marketing arsenal. Your hospitality facility may be considering the sale and distribution of prepaid phone cards to provide more convenience to patients or as a replacement to traditional calling cards for mobile employees. Prepaid phone cards represent a new twist and many advantages for long distance calling.

Threshold couplings of phase-conjugate mirrors with two interaction regions

Using the grating-action method, we determine the threshold coupling strengths of three generic examples of phase-conjugate mirrors with two interaction regions: the cat conjugator, the mutually incoherent beam coupler, and the interconnected ring mirror.

Synthesis and biological evaluation of potent, selective, hexapeptide CCK-A agonist anorectic agents

Cholecystokinin (CCK) is a 33-amino acid peptide with multiple functions in both the central nervous system (via CCK-B receptors) and the periphery (via CCK-A receptors). CCK mediation of satiety via the A-receptor subtype suggest a role for CCK in the management of obesity. The carboxy terminal octapeptide (CCK-8) is fully active in this regard, but is lacking in receptor selectivity, metabolic stability, and oral bioavailability. Inversion of the chirality of Asp7 in conjunction with N-methylation of Phe8 produces compound 5 which exhibits high affinity and 2100-fold selectivity for CCK-A receptors. Compound 6 (Hpa(SO3H)-Nle-Gly-Trp-Nle-MeAsp-Phe-NH2), derived from moving the N-methyl group from Phe to Asp, decreased CCK-B affinity substantially without affecting CCK-A affinity, giving a compound with 6600-fold selectivity for CCK-A receptors. These compounds inhibit food intake with nanomolar potency following intraperitoneal administration in fasted rats. In addition to greater potency, compound 6 produces weight loss in rats when administered over nine consecutive days. Intranasal administration of 6 potently inhibits feeding in beagle dogs. Compound 6 produces potent anorectic activity via the CCK-A receptor system.

[Carving in comparison with ski technique of the skiing athlete (competitive skier) and the leisure and comfort level skier]

In skiing there is principally no difference between the operating mechanism of a ski-racer and a skier who masters the technic of carving. Both try to ski with as less sliding as possible. The pressure distribution on the ski in a curve is very important. Near the end of the curve the pressure on the edge of the ski must be increased through various methods, on the one hand to avoid sliding and on the other hand to prepare the next curve correctly. In mastering the necessary mechanism of movements, the carving with the more wasted skis will be easier, because it is not necessary to put as much pressure on the last section of the ski, as it is necessary with the original skies to have the same result. Therefore even the holiday-skier has the possibility with carving-skis to master the ski-technic of the ski-racer and to have the pleasure of carving instead of sliding.

Managing technical functions: is it your line of business?

Food, laundry, valet and transportation services are areas that have been contracted out by hospitals for many years. Technical services are another area that may make sense to outsource, providing the company can pass the following tests: 1. Quality of service--can they do it better than your own employees? 2. Timeliness of service--usually the objective is speedier service. 3. Cost-effectiveness--is the service a good value?