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Cytoreductive surgery (CRS) provides a survival benefit when achieved without residual disease. As diaphragm is frequently affected in peritoneal malignancies, complete cytoreduction often requires surgical techniques over the diaphragm. The purpose of the study was to assess diaphragmatic resection impact on cytoreduction completeness, morbidity and mortality compared to less aggressive diaphragmatic peritonectomy in CRS and hyperthermic intraperitoneal chemotherapy (HIPEC) settings.Patients with peritoneal carcinomatosis and supramesocolic disease undergoing CRS/HIPEC from 2011 to 2019 were included in a prospectively collected database. We compared patients who underwent full-thickness diaphragmatic resection (DR) and diaphragmatic peritonectomy (DP). Epidemiological and clinical data, morbidity, and mortality within 90 days of surgery were documented.232 patients were initially selected. Inclusion criteria were met by 88 procedures. DR was performed on 32 patients and DP on 56. Number of resected organs was 5.21 in the DR cohort vs. 3.57 in the DP cohort (p0.0001). Rate of Peritoneal Cancer Index (PCI) score14 was higher in the DR group (75%) than in the DP group (50.9%) (p=0.027). Tumor invasion of diaphragmatic muscle after DR was confirmed in 89.3% patients. Postoperative pleural effusion was observed in 28 patients (50%) in the DP group and in 17 (53.1%) in the DR group.CRS/HIPEC requires specific surgical techniques over the diaphragm to achieve complete cytoreduction. As diaphragmatic muscle invasion is frequent, full-thickness resection may allow a cytoreduction completeness increase without an increased morbidity. Pleural drains are not systematically required as these procedures show low incidence of major respiratory complications.

Background The studies IMvigor 210 cohort 2 and IMvigor211 evaluated the efficacy of atezolizumab in patients with locally advanced or metastatic urothelial cancer (mUC) upon progression to platinum-based chemotherapy worldwide. Yet, the real impact of this drug in specific geographical regions is unknown. Materials and methods We combined individual-level data from the 131 patients recruited in Spain from IMvigor210 cohort 2 and IMvigor211 in a pooled analysis. Efficacy and safety outcomes were assessed in the overall study population and according to PD-L1 expression on tumour-infiltrating immune cells. Results Full data were available for 127 patients; 74 (58%) received atezolizumab and 53 (42%) chemotherapy. Atezolizumab patients had a numerically superior median overall survival although not reaching statistical significance (9.2 months vs 7.7 months). No statistically significant differences between arms were observed in overall response rates (20.3% vs 37.0%) or progression-free survival (2.1 months vs 5.3 months). Nonetheless, median duration of response was superior for the immunotherapy arm (non-reached vs 6.4 months; p = 0.005). Additionally, among the responders, the 12-month survival rates seemed to favour atezolizumab (66.7% vs 19.9%). When efficacy was analyzed based on PD-L1 expression status, no significant differences were found. Treatment-related adverse events of any grade occurred more frequently in the chemotherapy arm [46/57 (81%) vs 44/74 (59%)]. Conclusion Patients who achieved an objective response on atezolizumab presented a longer median duration of response and numerically superior 12 month survival rates when compared with chemotherapy responders along with a more favorable safety profile. PD-L1 expression did not discriminate patients who might benefit from atezolizumab.

Two types of zeolites (type X and type A) were synthesized from fly ash of two Brazilian coal based power plants via hydrothermal treatment after ash fusion with NaOH. The synthesized zeolites were characterized by means of XRF, XRD, SEM and gas adsorption (N2 and CO2 adsorption/desorption at − 196 and 0 °C, respectively). Pure CO2 and N2 adsorption equilibrium isotherms were performed at 50, 70 and 90 °C to measure the CO2 adsorption capacity and selectivity of CO2 over N2. CO2/N2 binary isotherms (15/85% v/v) were also obtained at the same temperatures. Commercial zeolitic materials used for CO2/N2 separation such as zeolite 13X and zeolite 4A underwent the same characterization and adsorption measurements as benchmarks to evaluate the performance of the synthesized zeolites. The synthesized materials from fly ash are promising low cost adsorbents for CO2 separation, reaching ca. 83% of the CO2 adsorption capacity of their commercial counterparts at 0.15 bar and 50 °C.

In this study, two configurations of Temperature Swing Adsorption (TSA) were assessed with the aim of evaluating their efficacy on CO2 capture on commercial adsorbent zeolite 13X within a post-combustion scenario. A fixed bed setup was employed to measure breakthrough curves from the adsorption and desorption steps. Considering a dry desulfurized flue gas stream, breakthrough curves for CO2–N2 (15/75 % v/v) in Helium were performed at 25, 50 and 75 °C. The desorption step was carried out following two TSA regeneration strategies: a two-step desorption arrangement (configuration 1) consisting of a purging phase followed by a heating-purging phase, and a one-step desorption arrangement (configuration 2) involving only the heating-purging phase. Adsorption equilibrium isotherms were also obtained for pure CO2 (25, 50, 75, 100 and 125 °C) and N2 (25, 50 and 75 °C) on zeolite 13X in the range of 0–1 bar. Finally, a mathematical model considering mass and energy differential balances was used to predict the whole adsorption-desorption history. The results obtained on breakthrough curves showed that CO2 separation from N2 on zeolite 13X is accomplished by adsorption under the studied conditions with a marked selectivity for CO2. In regards to the desorption phase, configuration 1 may not be adequate for an integration of adsorption-desorption steps once only the purge phase duplicates the desorption time as compared to the adsorption stage. On the other hand, configuration 2 is more likely to synchronize the whole adsorption—desorption process since the regeneration time was significantly reduced by this strategy. However, configuration 1 managed to obtain full CO2 recovery with all the temperatures tested during the heating step, whereas configuration 2 reached recovery values around 92%. Moderate temperatures (e.g. 125–150 °C) are feasible to be used for configuration 2 regeneration strategy so as to avoid energy penalties. Simulations were able to reproduce well the experimental breakthrough curves, even though some discrepancies were observed in the desorption histories.

Studies demonstrating the benefits of ethical behavior at an individual level are scarce. The business ethics literature centers its analysis on unethical behaviors and their consequences, rather than ethical behaviors and their benefits. There is now considerable debate on the role of auditors in society and the function of accounting firms in the free market capitalist system. Specifically, the eminently ethical nature of the auditor’s work has been highlighted. Therefore, the aim of our paper is to show the impact of auditors’ sustained ethical behavior: the trust it generates. This trust results in considerable benefits for the firm due to a reduction in the costs of the partner’s supervision of the auditor. The methodology chosen to validate these claims is a survey of partner of the audit firm in auditing companies. The results of this research confirm the hypotheses raised in the theoretical model.

Mesoporous silica SBA-15 solids have been synthesized at different aging temperature with the goal of obtaining materials with different textural properties. The synthesized samples have been evaluated for their CO2 adsorption capacity. In order to increase the CO2 adsorption capacity and the CO2/N2 selectivity, the SBA-15 synthesized at different aging temperatures were functionalized via grafting with 3-aminopropyltriethoxysilane (APTES) and via impregnation with polyethyleniminethylenediamine branched (PEI) or tetraethylenepentamine (TEPA). In all cases, the adsorption isotherms of the amine functionalized silica are fitted to the Dualsite-Langmuir model, where physical and chemical adsorption sites are reported. The isotherms reveal that grafted-silicas with APTES displayed the coexistence of both adsorption sites, while the adsorption process of PEI or TEPA impregnated-silicas are mainly governed by chemical interactions. The adsorption isotherms show that the most promising adsorbent for CO2 capture in terms of CO2 adsorption capacity and CO2/N2 selectivity is the SBA synthesized at 393 K (aging temperature) and functionalized with TEPA (50 wt%) (SBA-393-50T). This sample reached a CO2 adsorption capacity of 2.83 mmol g−1 at 100 kPa and 338 K. The CO2 adsorption capacity of this material decreased around 5% after the first adsorption/desorption cycle, maintaining a constant value for successive cycles. SBA-393-50T also showed an outstanding CO2/N2 selectivity, increasing significantly as the CO2 concentration decreases.

BackgroundATLAS evaluated the efficacy and safety of the PARP inhibitor rucaparib in patients with previously treated locally advanced/unresectable or metastatic urothelial carcinoma (UC).MethodsPatients with UC were enrolled independent of tumor homologous recombination deficiency (HRD) status and received rucaparib 600 mg BID. The primary endpoint was investigator-assessed objective response rate (RECIST v1.1) in the intent-to-treat and HRD-positive (loss of genome-wide heterozygosity ≥10%) populations. Key secondary endpoints were progression-free survival (PFS) and safety. Disease control rate (DCR) was defined post-hoc as the proportion of patients with a confirmed complete or partial response (PR), or stable disease lasting ≥16 weeks.ResultsOf 97 enrolled patients, 20 (20.6%) were HRD-positive, 30 (30.9%) HRD-negative, and 47 (48.5%) HRD-indeterminate. Among 95 evaluable patients, there were no confirmed responses. However, reductions in the sum of target lesions were observed, including 6 (6.3%) patients with unconfirmed PR. DCR was 11.6%; median PFS was 1.8 months (95% CI, 1.6–1.9). No relationship was observed between HRD status and efficacy endpoints. Median treatment duration was 1.8 months (range, 0.1–10.1). Most frequent any-grade treatment-emergent adverse events were asthenia/fatigue (57.7%), nausea (42.3%), and anemia (36.1%). Of 64 patients with data from tumor tissue samples, 10 (15.6%) had a deleterious alteration in a DNA damage repair pathway gene, including four with a deleteriousBRCA1orBRCA2alteration.ConclusionsRucaparib did not show significant activity in unselected patients with advanced UC regardless of HRD status. The safety profile was consistent with that observed in patients with ovarian or prostate cancer.Trial registrationThis trial was registered inClinicalTrials.gov(NCT03397394). Date of registration: 12 January 2018. This trial was registered in EudraCT (2017–004166-10).

Bladder cancer is the fourth most common cancer in men and the ninth most common in women in the Western world. The management of bladder carcinoma requires a multidisciplinary approach. Optimal treatment depends on several factors, including histology, stage, patient status, and possible comorbidities. Here we review recent findings on the treatment of muscle-invasive bladder carcinoma, advanced urothelial carcinoma, upper tract urothelial carcinoma, non-urothelial carcinoma, and urologic complications arising from the disease or treatment. In addition, we present the recommendations of the Spanish Oncology Genitourinary Group for the treatment of these diseases, based on a focused analysis of clinical management and the potential of current research, including recent findings on the potential benefit of immunotherapy. In recent years, whole-genome approaches have provided new predictive biomarkers and promising molecular targets that could lead to precision medicine in bladder cancer. Moreover, the involvement of other specialists in addition to urologists will ensure not only appropriate therapeutic decisions but also adequate follow-up for response evaluation and management of complications. It is crucial, however, to apply recent molecular findings and implement clinical guidelines as soon as possible in order to maximize therapeutic gains and improve patient prognosis.

Background The liver is the most injured organ following abdominal trauma. Uncontrolled bleeding remains the main cause of early liver injury-related death, with a mortality rate of 50-54% in the first 24 h after admission and with 80% of operative deaths. Packing and reoperation account for the increased survival in severe liver trauma, and they are recommended for severe liver injuries (grades IV-V). Perihepatic packing can lead to several potential complications. An excessive packing can cause complications due to abdominal compartment syndrome, while a soft packing may be ineffective, and thus, bleeding can continue inadvertently with the consequent hypovolemic shock and potentially death. Methods We designed a new vacuum-based device to perform perihepatic packing without the negative side-effects of the classic technique. We conducted a prospective pilot feasibility study in a porcine model. We compared the traditional perihepatic packing (PHP) (n = 2) with the new VacBagPack device (VBP) (n = 2). Results Both pigs survived with the new device and showed an equivalent outcome to the one that survived in the traditional technique group. Blood tests were similar too. This suggests that VBP could be at least as effective as traditional PHP. Conclusions We establish a first step towards the development of a new packing device. A new study with a bigger sample size still in pigs will be conducted. Also, an industrial model of the device is currently in production., Private funding was received and used to buy the swine model and pay for the theater hours. Authors and researchers received no money. This research has received funding from local authorities (IbSalut), as a research scholarship, and from Swan Medical. Acknowledgment to IDISBA for contributing to its publication in Open Access.

Top-down lithography techniques allow the fabrication of nanostructured elements with novel spin configurations, which provide a new route to engineer and manipulate the magnetic response of sensors and electronic devices and understand the role of fundamental interactions in materials science. In this study, shallow nanostructure-patterned thin films were designed to present inverse magnetization curves, i.e., an anomalous magnetic mechanism characterized by a negative coercivity and negative remanence. This procedure involved a method for manipulating the spin configuration that yielded a negative coercivity after the patterning of a single material layer. Patterned NiFe thin films with trench depths between 15%–25% of the total film thickness exhibited inverse hysteresis loops for a wide angular range of the applied field and the trench axis. A model based on two exchange-coupled subsystems accounts for the experimental results and thus predicts the conditions for the appearance of this magnetic behavior. The findings of the study not only advance our understanding of patterning effects and confined magnetic systems but also enable the local design and control of the magnetic response of thin materials with potential use in sensor engineering.

This exploratory phase II clinical trial evaluated the antitumor activity, safety profile and pharmacokinetics of PM00104 (Zalypsis®) 3 mg/m2 1 h every 3-week intravenous infusion in patients with advanced and/or metastatic urothelial carcinoma progressing after first-line platinum-based chemotherapy. The primary efficacy end point was the disease control rate (DCR), defined as the percentage of patients with confirmed objective response or progression-free at 3 months, according to the response evaluation criteria in solid tumors. In a first stage (n = 19 patients evaluable for efficacy), only one patient achieved DCR (stable disease as best response and progression-free survival of 3.1 months). According to the 2-stage design used, the primary efficacy objective was unmet, and therefore, the trial was finalized without opening the second stage. The most common adverse events related to PM00104 were fatigue, anorexia, nausea, troponin I increase and neutropenia, which were transient and manageable with dose modifications or administration delays. Mean PK results (C max = 48.57 μg/l and area under the curve (AUC) = 154.97 h μg/l) were similar to those observed in a previous phase I trial evaluating the same dose and schedule. Few troponin I concentrations were higher than 0.10 ng/ml, and none of them were related to parameters of PM00104 exposure such as AUC or C max. No recommendation is given for further evaluation of PM00104 as single-agent treatment of patients with pretreated advanced and/or metastatic urothelial carcinoma. No new safety signals were observed.

Current frameworks on ethical decision-making process have some limitations. This paper argues that the consideration of moral competencies, understood as moral virtues in the workplace, can enhance our understanding of why moral character contributes to ethical decision-making. After discussing the universal nature of four moral competencies (prudence, justice, fortitude and temperance), we analyse their influence on the various stages of the ethical decision-making process. We conclude by considering the managerial implications of our findings and proposing further research.

To evaluate the efficacy and toxicity of docetaxel regimen as second-line after failure of a platinum-based chemotherapy.Between May 2005 and June 2008, we retrospectively analyzed the data of 22 patients who had evidence of disease progression after one prior platinum-based regimen for metastatic urothelial carcinoma. Patients were treated with two different docetaxel dose schedules: (1) docetaxel 60 mg/m(2) every 21 days for unfit patients or (2) docetaxel 75 mg/m(2) every 21 days for fit patients.Median number of docetaxel cycles was three. Overall disease control rate was 18 %. Of the 22 patients, no patient achieved complete or partial response and four patients had stable disease. Median progression-free survival was 1.67 months and median overall survival was 3.12 months. Neutropenia was the most common adverse event.This study identifies that docetaxel as second-line chemotherapy has low activity and was associated with significant toxicity.

The use of Electric-Powered Wheelchairs (EPWs) implies a dramatic improvement for people with physical disabilities, thus enabling them to lead more independent lives and to interact in society. Although numerous modifications have been made in recent years to improve access to transportation services and public buildings, the problem of a standard EPW dealing with certain architectural barriers has not yet been satisfactorily resolved. In order to contribute toward solving some of these problems, a stair-climbing mobility system (SCMS) which is capable of negotiating architectural barriers such as curbs, ramps, and staircases was developed in previous works. In this paper, is presented a novel dynamics model of a SCMS based on Newton formulation. It is characterized by the definition of a solely point mass located in the center of mass of the system and the assumption of quasistatic conditions. Additionally, taking into account that the SCMS adopt different mechanical configurations, the dynamics model incorporates relations between all the different actuators involved in each configuration of the SCMS and its generalized coordinates allowing different dynamic control strategies to be addressed. Finally, encouraging experimental results have been reported which confirm a high reliability of the model-experiment of the SCMS as it ascends a staircase.

The purpose of this article is to provide updated recommendations for the diagnosis and treatment of muscle- invasive and metastatic bladder cancer. The diagnosis of muscle-invasive bladder cancer is made by transurethral resection and following histopathologic evaluation. Invasive bladder cancer should be staged according to the UICC system. Patients with confirmed muscle-invasive bladder cancer should be staged by computed tomography scans of the chest, abdomen and pelvis. Radical cystectomy is the treatment of choice for both sexes and lymph node dissection should be an integral part of cystectomy. In muscle- invasive bladder cancer (cT2-4aN0M0) patients with good performance status (PS 0-1) and correct renal function, neoadjuvant chemotherapy should be recommended. Adjuvant chemotherapy is widely used in high-risk patients with pathologic stage T3 or T4 and/or positive nodes and within clinical trials. Multimodality bladder-preserving treatment in localised disease is currently regarded only as an alternative in selected, well informed and compliant patients for whom cystectomy is not considered for clinical or personal reasons. In metastatic disease, the first-line treatment for patients is cisplatin-containing combination chemotherapy. Recently, vinflunine has been approved in Europe for second-line treatment and is an option for second-line therapy in patients progressing to first-line platinum-based chemotherapy.

Background The incidence of testicular germ cell tumours (TGCT) is increasing and the improvement in survival may lead to an increased incidence of bilateral tumours. We examined the incidence, prognosis, clinical and histological characteristics, treatment and outcome of patients with bilateral TGCTs based on 15 years of experience from a single institution. Material and methods We reviewed the charts from all patients treated for a testicular tumour germ cell at Hospital Vall d'Hebron in Barcelona, Spain. The information was retrospectively obtained from the patients' hospital. All the patients were evaluated with clinical history, physical exam, serum markers (alphaFP, LDH and betahCG), ultrasonographic evaluation of the testicles, computed tomography (CT) scans of the chest, abdomen and pelvis, surgery, location and histology of first and second tumour, treatment after the surgery and follow-up. Results Of 151 patients with TGCT, 8 (5.3%) developed bilateral tumours, seven (4.6%) were metachronous and one (0.7%) synchronous tumours. Two patients underwent testis-sparing surgery for the second tumour. All the patients are alive without evidence of disease based on physical exam, tumour markers and CT scan. Conclusions Survival in patients with bilateral testicular germ cell tumours (BTGCT) is similar to that of patients with unilateral TGCT. There is no standard therapy to treat BTGCT and each patient requires a tailored therapeutic treatment.

Renal cell carcinoma (RCC) is a heterogeneous malignancy whose incidence rate has notably increased in recent years without any evident reason. Traditionally, RCC has been resistant to classic treatments (chemotherapy, radiotherapy and hormonal therapy), with only a small percentage of patients benefiting from cytokine therapy. Different hereditary syndromes have been associated with RCC, Von Hippel Lindau (VHL) being the most important syndrome. Understanding key molecular pathways implicated in the tumorigenesis of RCC has crystallised in the development of more effective therapies. Specifically, drugs targeting VEGF (bevacizumab, sunitinib, sorafenib, axitinib, pazopanib) and PI3K-mTOR (temsirolimus and everolimus) have become the cornerstone of renal cancer treatment.

Transparent exopolymer particles (TEP) compose an important pool of particulate organic matter (POM) in aquatic systems. However, no studies of TEP contribution to C export to sediment exist for freshwaters. We quantify the contribution of TEP to C sinking fluxes in an oligotrophic reservoir (Quentar, Southern Spain) by monitoring TEP in the water column and TEP, particulate organic carbon (POC) and dry weight in sedimentation traps. TEP sinking fluxes ranged from 0.73 to 183.23 mg C m−2 day−1 and from 0.51 to 177.04 mg C m−2 day−1 at the surface and at the bottom layer, respectively. These values represent that, over an annual basis, 5.59 Ton TEP-C (over 61.32 Ton POC) are exported, on an average, from the water column to the sediment of Quentar reservoir. TEP concentrations (average = 48.0 μg XG eq l−1) were lower than the scarce data reported for freshwaters. No significant relationships between TEP and Chl a concentrations or BA were observed. Average value for daily sedimentation flux (6.63 g Dry Weight m−2 day−1) in the study reservoir was higher than that documented for low productive natural aquatic ecosystems as a consequence of the high amount of allochthonous material input characterizing reservoirs. TEP contributed to C export to sediment with a value that range from 0.02 to 31%. Our results show that even in man-made systems, which are predominantly controlled by allochthonous inputs, TEP may be relevant for explaining POM settling fluxes.

Natural orifice transluminal endoscopic surgery (NOTES) makes it possible to perform intraperitoneal surgical procedures with a minimal number of access points in the abdominal wall. It is not yet possible to perform these interventions without the help of abdominal wall entryways, so these procedures are hybrids, a fusion of minilaparoscopy and transluminal endoscopic surgery. In this paper we present a prospective clinical series of 15 patients who underwent transvaginal hybrid cholecystectomy for cholelithiasis.This was a prospective clinical series of 15 consecutive female patients, nonrandomly chosen and without a control group, who underwent a fusion transvaginal NOTES and minilaparoscopy procedure with two entryways for cholelithiasis. One was umbilical and measured 5 mm in diameter, and the other was in the right upper quadrant and measured 3 mm in diameter.The scheduled surgical intervention was performed on the 15 patients in whom it had been indicated. There were no intraoperative complications. One patient had mild hematuria that resolved in less than 12 h; there were no other complications after average follow-up of 124 days. Nine patients were discharged in 24 h, and two were discharged less than 12 h after the procedure.Hybrid transvaginal cholecystectomy is a good surgical model for minimally invasive surgery, a combination of NOTES and minilaparoscopy. It can be performed in surgical settings where laparoscopy is practised regularly, using the instruments normally used for endoscopy and laparoscopic surgery. Owing to the reproducibility of the intervention and the ease of vaginal closure, hybrid transvaginal cholecystectomy will permit further development of NOTES in the future.

[EN] Solanum pimpinellifolium, due to its close relationship to S. lycopersicum, has been a genetic source for many commercially important tomato traits. It is a wild species found in the coastal areas of Peru and Ecuador. In this study, the genetic variation of S. pimpinellifolium was studied using the diversity found in 10 microsatellites in 248 plants spread throughout its entire distribution area, including Ecuador, which has been underrepresented in previous studies. Peruvian and Ecuadorian accessions are genetically quite differentiated. A possible cause of these differences could be the non-uniform nature of the coastal Ecuadorian and Peruvian climates, seeing as an important correlation between genetic differentiation and climate has been found. In addition, Ecuadorian and south Peruvian accessions have a lower genetic diversity and a higher homozygosity due to their higher autogamy, lower population size, and possible colonization bottlenecks. The Galapagos Islands population is an extreme case, with no diversity, likely caused by a recent colonization from the northern continental Ecuadorian region where genetically identical plants have been found., We are deeply grateful to Dr. Javier Leon, Dr. Roberto Mendoza, and Dr. Freddy Zuniga of the Universidad Nacional de Piura; Dr. Angel Diaz Celis, and Dr. Umberto Cardoso of the Universidad Nacional Pedro Ruiz Gallo; and to Dr. Rosa de Frutos Illan, Dr. Juan Jose Ruiz, Maria Jose Diez, and Dr. Jaume Prohens of the COMAV Institute. This study wouldn't have been possible without their assistance and kind affection during the collecting expeditions organized with them throughout the years. The BBVA contributed to the funding of this research.

We quantified dry and wet atmospheric deposition of soluble reactive phosphorus (SRP) to the Southwest Mediterranean region during one year and assessed its effect on bacterial abundance and phytoplankton specific biomass during one ice-free period in a high mountain lake located in an area highly influenced by Saharan dust outbreaks. Dry deposition of SRP represented 79% of total SRP inputs and it showed a seasonal pattern similar to Saharan dust export to this region, with maxima during spring and summer. Bacterial abundance was significantly correlated with SRP atmospheric deposition, suggesting the influence of this input on bacterioplankton dynamics. The field evidence was experimentally corroborated using bacterial regrowth cultures performed with dust-amended lake water. Dust addition significantly increased SRP concentration in lake water and it stimulated bacterial abundance. Regarding phytoplankton community, only one species, the chrysophyte Chromulina nevadensis, was significantly related to SRP inputs and, consequently, there was a significant decrease in phytoplankton species diversity after atmospheric SRP inputs. Since changes in climate will presumably lead to an alteration in dust export, these results point to the need of further studies on the potential effects of this alteration on bacterioplankton and phytoplankton dynamics in remote oligotrophic systems.

For three consecutive years, a population study of Daphnia pulicaria was undertaken in Rio Seco Lake, a small high-mountain lake, in order to elucidate the reproductive strategies adopted by Daphnia in this system. Daphnia appears to colonize this lake every spring by hatching from ephippia and reproduce by means of subitaneous (non-diapausing) and ephippial (diapausing) eggs. D. pulicaria in this lake is an obligate parthenogenetic population. There is a short time period for subitaneous egg production and a much longer period for ephippial egg production. The contribution of subitaneous eggs to Daphnia population density and structure appears to be low. Diapause onset showed a high temporal synchronization in the three studied years in Rio Seco Lake, and day-length emerged as the main cue triggering diapause onset and the main explanatory factor for the proportion of ephippial females observed. The development and reproduction of D. pulicaria in Rio Seco Lake involves taking a gamble on resting forms to guarantee inter-annual Daphnia persistence in the lake, giving priority to investment in future generations.

This paper describes the mechanical devices conforming a novel wheelchair prototype capable of climbing staircases. The key feature of the mechanical design is the use of two decoupled mechanisms in each axle, one to negotiate steps, and the other to position the axle with respect to the chair to accommodate the overall slope. This design simplifies the control task substantially. Kinematic models are necessary to describe the behavior of the system and to control the actuated degrees of freedom of the wheelchair to ensure the passenger's comfort. The choice of a good climbing strategy simplifies the control and decreases the power consumption of the wheelchair. In particular, we demonstrate that if the movement of the wheelchair has the same slope as the racks or the same slope as the terrain that supports the wheel axles (depending on the configuration mechanism), control is easier and power consumption is less. Experimental results are reported which show the behavior of the prototype as it moves over different situations: (a) ascending a single step of different heights using different climbing strategies; and (b) climbing a staircase using an appropriate climbing strategy that simplifies the control and reduces the power consumption of the wheelchair.

We discuss specular reflectivity and off-specular scattering of neutrons and X-rays from magnetic films. Both these techniques are capable of providing information about the morphology of the chemical and magnetic roughness and the magnetic domain structure. The use of neutrons with polarization analysis enables the spatial distribution of different vector components of the magnetization to be determined, and the use of resonant magnetic X-ray scattering enables magnetization in a compound system to be determined element-selectively. Thus both these methods provide powerful and complementary new probes for studying magnetism at the nanoscopic level in a variety of systems such as those exhibiting exchange bias, giant magnetoresistance, spin injection, etc. We shall illustrate with an example of both techniques applied to an exchange bias system consisting of a single crystal of antiferromagnetic FeF2 capped with a ferromagnetic Co film, and discuss what has been learned about how exchange bias works in such a system.

The role of material microstructure in the magnetic anisotropy of real nanostructures has been studied by the comparison of the magnetic behavior of arrays of amorphous and polycrystalline CoxSi1-x lines. From the experimental measurements of angular dependences of remanences parallel and perpendicular to the applied field we determine the angular dispersion of effective local easy axis of anisotropy. We have proved that amorphous lines have a dispersion of effective anisotropy axis much smaller than the polycrystalline samples. As a consequence, amorphous lines have a better defined magnetic behaviour, pointing the interest of the fabrication of nanostructures made of amorphous materials.

The transition from amorphous to polycrystalline microstructure has been studied in sputtered Co x Si1-x alloy films by structural, magneto-optical and Nuclear Magnetic Resonance measurements. For $x \geq 0.76$ , Si is diluted into Co without significantly altering the polycrystalline microstructure, composed of a mixture of hcp and fcc grains. However, the fraction of Co atoms that contribute to the Nuclear Magnetic Resonance signal is found to decrease steeply (down to about 60 $\%$ at x = 0.76) suggesting a microscopic segregation of a Si rich phase that induces a large degree of disorder. This is reflected in a harder magnetic behavior and a strong anisotropy dispersion. Below x = 0.75, the transition to an amorphous microstructure results in a sudden increase in the fraction of Co atoms within a ferromagnetic phase, indicating the recovery of the microscopic homogeneity. Also a significant enhancement of the macroscopic magnetic anisotropy is found for amorphous films with compositions right below the transition. Within the amorphous phase a second regime of Si segregation appears characterized by a constant Co local environment and constant magnetic properties. Finally, for x = 0.65 there is a significant Si enrichment in the Co environment and the films become non magnetic for compositions below this point.

A magneto-optical setup based on the transverse Kerr effect has been designed to study the magnetization reversal processes by vector magnetometry in arrays of magnetic nanostructures with a reduced total volume. This system allows the measurement of both the parallel and perpendicular to the field components of the magnetization. It has been used to analyze the behavior of amorphous Co x Si1-x lines fabricated by electron beam lithography that present a very well defined shape induced uniaxial anisotropy. When the field is applied near to the hard direction, coherent rotation processes are found to occur with a collapse of this reversal mode at fields very close to the hard axis that allows to estimate the very low anisotropy dispersion of these samples. The analysis of the vector hysteresis loops reveals that the magnetization switches via an incoherent process that starts prior to the Stoner-Wohlfarth instability and that can be described in terms of a localized curling-like reversal mode.

Re-activation of the hepatitis B virus is very unusual, but has been described as a complication of chemotherapy. Most reported cases are related to haematological malignancies and, occasionally, to solid tumours.

We examine the development of Hexarthra bulgarica (Wisniewski) populations in relation to thermal stability in natural environments. A high frequency sampling program was developed simultaneously in two high mountain lakes: a shallow one, with daily large temperature changes but little surface-bottom temperature difference and a deeper one with more stable temperature but vertical heterogeneity in the water profile. Since the capacity of H. bulgarica to perform vertical migrations in these lakes of Sierra Nevada is already known, we have studied the relationship between egg ratios and chlorophyll-a concentration, mean temperatures and temperature instability (measured as the daily rate of temperature change — TCR — as well as the surface-bottom temperature difference — SBT -) in both lakes. Results show that the intensity of temperature fluctuations has a positive effect on the egg-ratios, as TCR is only correlated with that variable in the shallow lake and SBT is only correlated with egg-ratios in the deeper one.

Background Despite broad advances in multimodal treatment of locally advanced breast cancer (LABC), 30 to 40% of patients develop loco-regional relapse. The aim of this study was to analyze in a retrospective manner the effectiveness of concurrent chemo-radiotherapy (CCRTh) after neoadjuvant chemotherapy (NCT) in patients with LABC. Methods One hundred twelve patients with LABC (stage IIB-IIIB) were treated with NCT (5-fluorouracil 500 mg/m2, doxorubicin 50 mg/m2, and cyclophosphamide 500 mg/m2 (FAC), or doxorubicin 50 mg/m2 and cyclophosphamide 500 mg/m2 (AC) IV in four 21-day courses) followed by CCRTh (60 Gy breast irradiation and weekly mitomycin 5 mg/m2, 5-fluorouracil 500 mg/m2, and dexamethasone 16 mg, or cisplatin 30 mg/m2, gemcitabine 100 mg/m2 and dexamethasone 16 mg), and 6–8 weeks later, surgery and two additional courses of FAC, AC, or paclitaxel 90 mg/m2 weekly for 12 weeks, and in case of estrogen-receptor positive patients, hormonal therapy. Results Stages IIB, IIIA and -B were 21.4, 42.9, and 35.7%, respectively. Pathological complete response (pCR) in the breast was 42% (95% CI, 33.2–50.5%) and, 29.5% (95% CI, 21.4–37.5%) if including both the breast and the axillary nodes. Multivariate analysis showed that the main determinant of pCR was negative estrogen-receptor status (HR = 3.8; 95% CI, 1.5–9; p = 0.016). The 5-year disease-free survival (DFS) was 76.9% (95% CI, 68.2–84.7%). No relationship between pCR and DFS was found. Multivariate analysis demonstrated that the main DFS determinant was clinical stage (IIB and IIIA vs. IIIB, HR = 3.1; 95% CI, 1.02–9.74; p = 0.04). Only one patient had local recurrence. Five-year overall survival was 84.2% (95% CI, 75–93.2%). The toxicity profile was acceptable. Conclusion This non-conventional multimodal treatment has good loco-regional control for LABC. Randomized clinical trials of preoperative CCRTh following chemotherapy, in patients with LABC are warranted.