Substages Of Stage Research Articles

Increased serum ferritin is associated with severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis: A quantitative analysis.

Effect of serum ferritin on severity of coronavirus disease 2019 (COVID-19)-associated rhino-orbito-cerebral mucormycosis. To study the association between increased serum ferritin and severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis. A cross-sectional study. Hundred (n) out of 155 treatment-naive patients of COVID-19 infection presenting with the signs and symptoms of rhino-orbito-cerebral mucormycosis were enrolled in study. Based on the classification proposed by Honavar, the study patients were classified into four stages: Stage 1: involvement of the nasal mucosa (n = 11), Stage 2: involvement of paranasal sinuses (n = 14), Stage 3: involvement of the orbit (n = 37), Stage 4: involvement of the central nervous system (n = 38). Stage 3 was further divided into four substages: 3a: nasolacrimal duct, medial orbit, vision unaffected (n = 4); 3b: diffuse orbital involvement (>1 quadrant or >2 structures), vision unaffected (n = 15); 3c: central retinal artery occlusion or ophthalmic artery occlusion, superior ophthalmic vein thrombosis, involvement of superior orbital fissure, inferior orbital fissure, orbital apex, diminution or loss of vision (n = 13); 3d: bilateral orbital involvement (n = 5). Fasting blood sugar (FBS), postprandial blood sugar (PPBS), and inflammatory markers (serum ferritin, interleukin-6, C-reactive protein, and D-dimer) were assessed. Serum level of ferritin was analyzed by using chemiluminescence immunoassay method. Mean FBS (mg/dl) was 165.03 ± 70.43 for stage 1, 185.67 ± 64.82 for stage 2, 159.05 ± 68.60 for stage 3, and 158.20 ± 62.05 for stage 4. Mean PPBS (mg/dl) was 238.70 ± 141.29 for stage 1, 252 ± 103.69 for stage 2, 257.09 ± 103.48 for stage 3, and 229.53 ± 76.81 for stage 4. Mean serum ferritin (µg/l) was 302.67 ± 266.95 in stage 1, 444.19 ± 116.36 in stage 2, 504.85 ± 205.99 in stage 3, and 825.95 ± 777.30 in stage 4. A statistically significant increase in serum ferritin levels with severity of disease (P = 0.005) was noted. Similar trend was observed in substages of stage 3. Pearson correlation analysis showed a positive correlation between serum ferritin and severity of disease (P = 0.0007). Increased serum ferritin was significantly independently associated with severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis.

Intratumor heterogeneity of positive lymph nodes provide a promising prognostic stratification factor for stage III colorectal cancer.

e15554 Background: Stage III colorectal cancer (CRC) is defined as patients with regional positive lymph nodes (pLN) but without distant metastasis, including stage IIIA, IIIB, IIIC. The prognosis of patients with stage III CRC varies dramatically, with 5-year survival rates ranging from 80 percent to 30 percent form stage IIIA to IIIC CRC, that does not exactly to be fully explained by the difference in the number of pLN. Therefore, other prognostic indicators need to be identified to improve and personalize prognosis prediction for patients with stage III CRC. Intratumor heterogeneity (ITH) widely exists between primary and metastatic lesions of CRC, however, there have been few studies focused on ITH of pLN. Therefore, this study aims to explore whether ITH of pLN could serve as a novel prognostic stratification factor for stage III CRC. Methods: We retrospectively analyzed the Poly-G genotype to reconstruct high-confidence phylogenetic trees for 20 CRC patients using 317 accurately scraped biopsy (134 primary tumors, 66 lymph node metastases and 37 normal samples). Root diversity score (RDS) index was used to reflect ITH of pLN. The association among Poly-G mutation rates, RDS index and clinical pathological data was analyzed. The area under the receiver operating characteristic (ROC) curves were calculated and the cut-off valve was confirmed. Results: Poly-G mutations accumulate in the occurrence and development of CRC. Poly-G mutation rate was correlated with tumor grade, N stage and microsatellite state (all P < 0.05), and had a certain correlation trend with age (P = 0.066). The results of multivariate Cox regression analysis showed that ITH of pLN was an independent risk factor for recurrence and metastasis which lead to a poor progression free survival (PFS). The area under the curve (AUC) was 76%, and the cut-off valve of RDS index was 0.25. We also found ITH of pLN was not associated with substages of stage III CRC, which indicated that ITH of pLN and the number of metastases are two different dimensions. Conclusions: ITH of pLN may provide a promising prognostic stratification factor for the patients with stage III CRC. A higher ITH of pLN indicates that subclones with distant metastasis potential might more likely to exist in the primary tumors, which lead to a poor PFS including recurrence and distant metastasis. In addition, ITH of pLN is not related to the number of lymph node metastases in stage III CRC, suggesting that ITH of pLN is promising to serve as a supplementary strategy of TNM staging for patients with Stage III CRC.

Adjuvant taxane plus platinum chemotherapy for stage I ovarian clear cell carcinoma with complete surgical staging: are more than three cycles necessary?

Previous studies on adjuvant chemotherapy for patients with ovarian clear cell carcinoma (OCCC) have included a limited number of Asian patients with surgical stage I OCCC, despite differences in OCCC survival by race and stage. The aim of this study was to estimate the survival effect of the number of cycles of adjuvant taxane plus carboplatin chemotherapy in Asian patients with surgical stage I OCCC. We retrospectively identified 227 patients with surgical stage I OCCC at 14 institutions from 1995 to 2017. Kaplan-Meier analysis and Cox proportional hazard regression with inverse probability of treatment weighting (IPTW) adjustment were performed to evaluate overall survival (OS) and recurrence-free survival (RFS) in patients receiving ≤ 3 and 4-6 cycles of taxane plus platinum adjuvant chemotherapy. Eighty-nine and 138 patients received ≤ 3 and 4-6 cycles of adjuvant chemotherapy, respectively. There was no between-group difference in OS or RFS with or without IPTW adjustment. In Cox proportional hazards analysis, 4-6 cycles of adjuvant chemotherapy were not associated with improved OS (HR 1.090; 95% CI 0.518-2.291; p = 0.821) or RFS (HR 1.144; 95% CI 0.619-2.114; p = 0.669) compared to ≤ 3 cycles, even with IPTW adjustment. Subgroup analysis in different substages of stage I OCCC showed that the number of cycles of adjuvant chemotherapy had no impact on OS or RFS. Three or fewer cycles of taxane plus carboplatin chemotherapy may be a reasonable treatment regime for patients with surgical staging I OCCC.

FIGO staging for carcinoma of the vulva: 2021 revision.

To revise the FIGO staging for carcinoma of the vulva using a new approach that involves analyses of prospectively collected data. The FIGO Committee for Gynecologic Oncology reviewed the recent literature to gain an insight into the impact of the 2009 vulvar cancer staging revision. The Committee resolved to revise the staging with a goal of simplification and actively collaborated with the United States National Cancer Database to analyze prospectively collected data on carcinoma of the vulva. Many tumor characteristics were collected for all stages of vulvar cancer treated between 2010 and 2017. Statistical analysis was performed with SAS software. Overall survival was estimated based on tumor characteristics. Log‐rank and Wilcoxon tests were used to analyze overall survival similarities between and within groups of tumor characteristics. Characteristics with similar survivals were then grouped into the same stages and substages. Kaplan–Meier overall survival curves were generated for the resulting stages and substages. There were 12 063 cases with available data. The resulting new staging for carcinoma of the vulva has two substages in Stage I, no substage in Stage II, three substages in Stage III, and two substages in Stage IV. The Kaplan–Meier overall survival curves showed clear separation between stages and substages. The 2021 vulvar cancer staging is the first from the FIGO Committee for Gynecologic Oncology to be derived from data analyses. This revision has a new definition for depth of invasion, uses the same definition for lymph node metastases utilized in cervical cancer, and allows findings from cross‐sectional imaging to be incorporated into vulvar cancer staging. The 2021 FIGO staging for carcinoma of the vulva is data‐derived, validated, and much simpler than earlier revisions.

Static and Dynamic Prediction of Chronic Renal Disease Progression Using Longitudinal Clinical Data from Taiwan's National Prevention Programs.

Kidney diseases can cause severe morbidity, mortality, and health burden. Determining the risk factors associated with kidney damage and deterioration has become a priority for the prevention and treatment of kidney disease. This study followed 1042 chronic kidney disease (CKD) patients with Stage 3–5 kidney disease who were treated at a public veteran’s hospital through the national prevention program. A total of 12.5 years of records of clinical measurements were collected and analyzed using dynamic and static Cox hazard models to predict the progression to dialysis treatment. The results showed that the statistical significance of several variables in patients with Stage 3–5 CKD was attenuated while the dynamic model was being used. The estimated glomerular filtration rate (eGFR) and urine protein to creatinine ratio (PCR) had the powerful ability to predict the progression of CKD patients with Stage 3a and Stage 3b–5 kidney disease, whereas serum calcium was also predictive for the progression of Stages 3b–5 CKD. Because these two sub-stages of Stage 3 CKD are often associated with differences in routine measurements and the risk analysis of renal dialysis, future research can use this predictive model as a reference while similar prevention programs are implemented.

Reclassification of Demirjian's mandibular premolars staging for age estimation based on semi-automated segmentation of deep convolutional neural network

Abstract The accuracy of age estimation using radiographic approach is important in forensic application. Despite its inconsistency, Demirjian method has been widely used to estimate age in children and young adults. This study aims to develop a semi-automated segmentation of dental development based on first (P1) and second (P2) permanent mandibular premolars and to correlate the mean age of the novel staging method with Demirjian. A stratified sample of six-hundred-fifty-seven panoramic radiographs was retrospectively collected. All training datasets underwent image segmentation process to form training dataset for the classifier. By implementing the Deep Convolution Neural Network (DCNN), 80% of the dataset was assigned for training and validation while the remaining 20% for testing. Classification performance was measured using confusion matrix. With the maximum number of 10-epochs assigned in DCNN, 92.5% of classification accuracy was obtained. On the tested image, differences between predicted age (PA) of the digital processing and the chronological age (CA) were calculated and expressed in mean error. The PA for P1 is underestimated by 0.17 (95% CI: 0.16-0.51) in male while female is overestimated by 0.22 (95% CI: 0.51-0.07). P2 exhibited better accuracy with an overestimation of 0.02 (95% CI: 0.24-0.20) and 0.03 (95% CI: 0.34-0.27) for male and female, respectively. A new sub-stage of stage D was introduced. The overall performance of the presented classification method to stage premolars development on panoramic radiographs was superior as compared to the original method, and modification of mandibular premolar staging in Demirjian method is established in this study.

The solved and unresolved issues of melanoma staging: A comparison of American Joint Committee on Cancer (AJCC) 7th versus 8th edition.

9578 Background: The recently revised (AJCC) Staging Manual, 8th edition, introduced changes including removal of mitotic index and addition of the IIID substage. There is active debate on the utility of this revision, especially, without the inclusion of a novel prognostic biomarker, during an era of major therapeutic shifts and amidst accrual of adjuvant clinical trials for high-risk resected primary melanoma. We examined whether re-staging primary melanoma patients using the new AJCC 8 system yielded improved prognostication as compared to AJCC 7. Methods: We compared the impact of changes in staging criteria in stage I-III melanoma patients who were prospectively enrolled in a NYU clinicopathological database between January 2010 and December 2016 with active protocol-driven follow up (FU). We assessed primary tumor category (T) and nodal status (N) according to both AJCC 7 and 8. Progression free survival (PFS) and overall survival (OS) curves were generated for both editions and then stratified by substage. We analyzed discordance using Cox Regression Models. Results: 1,379 patients (56% male, mean thickness 1.6, median FU 34.8 months) were included in the analyses. All but one patient remained in the same ‘major’ stage using AJCC 7 and 8 (stage I- 998; II- 224, 225; III- 157, 156) whereas 44% of stage III substage classifications were discordant comparing AJCC 7 to 8. Despite removing mitoses as a criterion for Stage I, there was no significant change between editions in PFS/OS when evaluating major and substages of stage I. Stage IIC patients had worse PFS/OS than stage IIIA patients in AJCC 8 (PFS p = 0.04, OS p = 0.02). AJCC 8, which implemented four rather than three substages, had improved PFS prognostication (c-index = 0.59 vs 0.66, p = 0.05 for AJCC 7 vs 8). Conclusions: Our results reinforce the added value of AJCC 8 compared to 7, as removing an operator dependent variable is more practical for stage I, and increased influence of thickness/ulceration and the addition of a new substage is more prognostically informative for stage III. Nevertheless, the poor prognosis of stage IIC patients, despite nodal negative disease, continues to be an unaddressed gap within our current staging framework.

Forensic age estimation based on T1 SE and VIBE wrist MRI: do a one-fits-all staging technique and age estimation model apply?

Providing recommendations for wrist MRI in age estimation by determining (1) which anatomical structures to include in the statistical model, (2) which MRI sequence to conduct, and (3) which staging technique to apply. Radius and ulna were prospectively studied on 3T MRI in 363 healthy Caucasian participants (185 females, 178 males) between 14 and 26years old, using T1 spin echo (SE) and T1 gradient echo VIBE. Bone development was assessed applying a 5-stage staging technique with several amelioration attempts to optimise staging. A Bayesian model rendered point predictions of age and diagnostic indices to discern minors from adults. All approaches rendered similar results, with none of them outperforming the others. A single bone assessment of radius or ulna sufficed. SE and VIBE sequences were both suitable, but needed sequence-specific age estimation. A one-fits-all 5-stage staging technique-with substages in stage 3-was suitable and did not benefit from profound substaging. Age estimation based on SE radius resulted in a mean absolute error of 1.79years, a specificity (correctly identified minors) of 93%, and a discrimination slope of 0.640. Radius and ulna perform similarly to estimate age, and so do SE and VIBE. A one-fits-all staging technique can be applied. • Radius and ulna perform similarly to estimate age. • SE and VIBE perform similarly, but age estimation should be based on the corresponding sequence-specific reference data. • A one-fits-all 5-stage staging technique with substages 3a, 3b, and 3c can be applied to both bones and both sequences.

Adjuvant chemotherapy beneficial for select early-stage, low-grade serous ovarian cancer patients

Objectives: Low-grade serous ovarian cancer (LGSC) is a rare subtype of ovarian serous carcinoma accounting for only 6% of all serous ovarian carcinoma. These tumors are considered to be relatively chemoresistant because of their tumor biology, making the role of adjuvant chemotherapy in early stage LGSC unclear. Herein, we sought to identify any chemotherapy benefit in overall survival among women with early-stage LGSC.Methods: The National Cancer Data Base was queried for all patients diagnosed from 1998 to 2012 with stage IA–IC LGSC. Only patients with nodal dissection were included for analysis. Χ2 test, logistic regression analysis, and log-rank test were used to analyze chemotherapy utilization and survival.Results: Of the 2,260 patients identified as having stage I LGSC, 1,481 had nodal dissection and were included for analysis. Chemotherapy was used in 15%, 21%, and 60% for stage IA, IB, and 1C, respectively. Age, insurance type (uninsured, private, Medicare/Medicaid), and stage were all associated with increased likelihood of receiving chemotherapy. Only age, Charlson-Deyo Comorbidity index, and insurance type were statistically significantly associated with survival on univariate and multivariable analysis. The 5-year overall survival (OS) for stage IA, IB, and IC without chemotherapy are 92%, 84%, and 88%, respectively. The 5-year OS for stage IA, IB, and IC with chemotherapy are 96%, 95%, and 94% respectively. A statistically significant difference in survival was seen in patients with stage IC receiving chemotherapy (P =.009).Conclusions: This is the largest dataset to date to look at the usefulness of adjuvant chemotherapy in stage I LGSC. Age, comorbidities, and type of insurance were associated with survival in this cohort, but the substages of stage I LGSC were not. However, adjuvant chemotherapy does confer a survival benefit in patients with stage IC LGSC. Although typically considered relatively chemoresistant with an overall good prognosis, adjuvant chemotherapy demonstrates a survival benefit of 6.8% and should be considered in these patients. Objectives: Low-grade serous ovarian cancer (LGSC) is a rare subtype of ovarian serous carcinoma accounting for only 6% of all serous ovarian carcinoma. These tumors are considered to be relatively chemoresistant because of their tumor biology, making the role of adjuvant chemotherapy in early stage LGSC unclear. Herein, we sought to identify any chemotherapy benefit in overall survival among women with early-stage LGSC. Methods: The National Cancer Data Base was queried for all patients diagnosed from 1998 to 2012 with stage IA–IC LGSC. Only patients with nodal dissection were included for analysis. Χ2 test, logistic regression analysis, and log-rank test were used to analyze chemotherapy utilization and survival. Results: Of the 2,260 patients identified as having stage I LGSC, 1,481 had nodal dissection and were included for analysis. Chemotherapy was used in 15%, 21%, and 60% for stage IA, IB, and 1C, respectively. Age, insurance type (uninsured, private, Medicare/Medicaid), and stage were all associated with increased likelihood of receiving chemotherapy. Only age, Charlson-Deyo Comorbidity index, and insurance type were statistically significantly associated with survival on univariate and multivariable analysis. The 5-year overall survival (OS) for stage IA, IB, and IC without chemotherapy are 92%, 84%, and 88%, respectively. The 5-year OS for stage IA, IB, and IC with chemotherapy are 96%, 95%, and 94% respectively. A statistically significant difference in survival was seen in patients with stage IC receiving chemotherapy (P =.009). Conclusions: This is the largest dataset to date to look at the usefulness of adjuvant chemotherapy in stage I LGSC. Age, comorbidities, and type of insurance were associated with survival in this cohort, but the substages of stage I LGSC were not. However, adjuvant chemotherapy does confer a survival benefit in patients with stage IC LGSC. Although typically considered relatively chemoresistant with an overall good prognosis, adjuvant chemotherapy demonstrates a survival benefit of 6.8% and should be considered in these patients.

Impact of adjuvant chemotherapy for stage I ovarian carcinoma with intraoperative tumor capsule rupture.

Adjuvant chemotherapy is generally recommended for early stage epithelial ovarian cancer. However, it remains uncertain which histological subtypes and substages of stage I disease should receive adjuvant chemotherapy. The objective of this study is to determine the impact of chemotherapy among stage I epithelial ovarian cancer. Of the 267 patients with stage I epithelial ovarian cancer analyzed in this study, 152 patients received adjuvant chemotherapy (AC-positive group) and 115 patients did not (AC-negative group). Survival analysis was retrospectively performed to determine the effectiveness of adjuvant chemotherapy in stage I epithelial ovarian cancer patients. Recurrence was observed in 14 patients in the AC-negative group and 20 patients in the AC-positive group. There were no statistically significant differences in disease-free survival (DFS) and overall survival between the two groups. In stage IA and IB patients, there was no statistically significant difference in DFS and overall survival based on adjuvant chemotherapy status. However, in patients with intraoperative tumor capsule rupture, the AC-positive group had significantly better DFS than the AC-negative group (P = 0.01). Patients with clear cell carcinoma who received adjuvant chemotherapy had better DFS than patients who did not (P = 0.004). Adjuvant chemotherapy may not be necessary for patients with stage IA or IB epithelial ovarian cancer, but may be beneficial for clear cell carcinoma patients with intraoperative tumor rupture.

The iliac crest in forensic age diagnostics: evaluation of the apophyseal ossification in conventional radiography

Due to the increasing significance of forensic age estimations in the age of globalisation, novel radiographic criteria besides clavicles and hand bones may provide additional certainty for forensic age expertises. The present study analyses the suitability of the iliac crest apophysis by means of 643 pelvic radiographs of patients between 10 and 30years of age. Retrospective assessments were carried out according to the forensically established classification and sub-classification systems modified after Kreitner et al. (Rofo 166(6):481-486, 1997) and Kellinghaus et al. (Int J Legal Med 124(4):321-325, 2010). The basic ossification stages range from 1 to 4, and the sub-stages of stage 2 and 3 range from a to c. While stage 3c was first achieved at the age of 15 by both sexes, stage 4 was first observed in females at the age of 16 and in males at the age of 17. This indicates the possibility of a valid diagnosis of both the age of 14 and the age of 16years which represent legally relevant age thresholds in numerous countries. Applied as targeted radiography on the iliac crest, the exposure to radiation would range between other radiographic techniques recently applied. Therefore, the iliac crest apophysis appears principally suitable as novel possible criterion for forensic age estimation in the living. However, for the establishment of the iliac crest apophysis in routine diagnostics, further studies are needed focussing on the comparison of different grading systems and different radiological techniques.

Substaging of stage I—a commentary

Substaging of stage I—a commentary

Vegetation change in equatorial West Africa: time-slices for the last 150 ka

Drawing on marine and terrestrial palynological data, vegetation maps of equatorial West Africa are presented for eleven time slices over the last 150,000 years. Long marine records are used as a basis for the regional picture and provide a chronology for the last glacial cycle. Much shorter terrestrial records help fill in the picture for the most recent periods and facilitate interpretation of regional patterns for the longer timescale. Temporal and spatial variation is revealed in relation to global patterns of climate change. Rain forest was widespread during Oxygen Isotope Stages 1 and 5, but strongly reduced during Stages 3 and 4 and especially during Stages 2 and 6 when open, grass-rich vegetation prevailed. Glacial rain forest refuges are found in the southwest of the Guinean mountains and along the eastern coast of the Gulf of Guinea. Miombo woodland of the Zambezian vegetation zone expanded during Stage 5, especially during the first half. Podocarpus forest had its largest expansion during Substages 5d (115 to 105 ka) and 5b (95 to 85 ka). The last occurrence of Podocarpus in the Guinean mountains is during Stage 5a. The distribution of mangrove swamps was extremely reduced during glacial times. During Stage 6, savanna and open dry forest covered large areas along the northern coast of the Gulf of Guinea. The southern Saharan desert reached far to the south and the Namib desert far to the north. The area of rain forest was restricted, mangrove swamps were strongly reduced, and the area of Podocarpus forest fluctuated. During Stage 5 large changes in the area of Afromontane forest, rain forest, dry open forest and savanna occurred. Rain forest was widespread and mangroves were extensive along the coast during the last interglacial (Substage 5e). Podocarpus forest area strongly extended during Substages 5d and 5b. In Substages 5c and 5a, rain forest reclaimed areas it had lost in the previous substages (5d and 5b, respectively). Mangrove swamps were less widespread in the later substages of Stage 5 than during Substage 5e. During Stage 4, the rain forest area was again strongly reduced, and recovered only slightly during the following Stage 3. Also the mangrove swamp area was reduced except along the Ivory Coast and along the northwestern coast of the Gulf of Guinea. Podocarpus forest only occurred in Angola and may be in Congo during Stage 4. Again forest was much reduced during Stage 2 and open vegetation types covered large parts of equatorial West Africa. Mangrove swamps must have been rare. At the beginning of the Holocene, mangrove swamps had recovered and reached their largest extension. Also the rain forests area increased in the early Holocene and Guinean and Congolian rain forests were probably not separated by a savanna corridor now existing in Togo and Benin.

Vegetation history from the Kaihinu (last) interglacial to the present, West Coast, South Island, New Zealand

An outline of the vegetation history of Hokitika-Westport area, West Coast, South Island, since the beginning of the Kaihinu Interglacial, is based on pollen analytical data from 20 sites. Interpretation of the pollen diagrams is constrained by the geology of the sites and by the unreliability of radiocarbon dates caused by widespread sample contamination by modern carbon. Accumulation of the pollen-bearing materials took place within the framework of deposition and erosion resulting from Kaihinu (last) Interglacial and Aranui Postglacial high sea levels and intervening glacier advances of the Otira (last) Glaciation. The principal groups of sites are associated with (1) high sea level deposits, (2) fluvial deposits, (3) loessic terrace cover deposits and (4) wet hollows. Together with spot samples, mostly previously described from late Otiran full glacial sites, the sites exemplify a wide variety of vegetation types and climatic environments ranging from warm temperate podocarp rain forest, through beech ( Nothofagus) forest and shrubland, to full glacial grassland. Based on the patterns of climatic change and geological events, tentative correlations are made with deep-sea Oxygen Isotope Stages of late Stage 6, through the substages of Stage 5, followed by Stages 4 to 1. Forest prevailed throughout the Kaihinu Interglacial (Stage 5), being initially dominated by the podocarp Dacrvdium cupressinum and then by Nothofagus. Individual sites cover estimated time ranges up to ca. 35,000 years in apparently unbroken sequences. In the terrace coverbeds, none more than 2 m thick, severe mixing of pollen is at least partly related to breaks in the sequences. A widespread early Aranuian break (latest Stage 2) and another in the mid-Otiran interstadial (Stage 3), are both in transitional periods between fully glacial and fully interglacial conditions, and probably required periods of seasonally dry and windy conditions to strip the loessic deposits from wide areas.

Stable isotope “anomalies” in Mediterranean Pleistocene records

Oxygen and carbon isotope records of twelve Mediterranean cores raised from west (Alboran sea) to east (off Israel), and of four Atlantic cores raised from the western side of Gibraltar and located respectively inside, below and beyond the modern Mediterranean outflow are compared to open ocean records of core 71–139C from the North Atlantic and core V19–30 from the East Pacific. Oxygen isotope stratigraphies can be established for deep Mediterranean records and the major events of the last 150 ka are easily identifiable. For instance, the five substages of stage 5 or the 18 ka event (stage 2) are identified but the 10 ka event (= Younger Dryas) is only recorded by Globigerina bulloides and benthic foraminifera, suggesting that the cooling affected only winter SST. 14C dates for the two terminations, I A and I B, of the last deglaciation which are recorded in sediment cores from areas with high sedimentation rates (Faro Ridge, Alboran Sea, Sicilian Strait), are in good agreement with the dates published for the same termination in Atlantic cores. An intermediate step, however, has been identified in some cores at 14 ka and divides termination I A into two phases. Oxygen isotope anomalies are recorded by the shallow water species Globigerinoides ruber. They correspond to (1) a higher amplitude glacial-interglacial change in δ 18 O values which exceeds that of the open ocean by 1‰ in the western basin and by 1.7‰ in the eastern basin; (2) large isotopic depletions during the deposition of sapropel S 1, S 3 and S 5. They are interpreted as the result of fresh water run-off responsible for a strong dilution in the shallower layers of the east Mediterranean waters. The isotopic effect of this dilution averages −0.75‰ for sapropel S 1 and −1.6‰ for sapropel S 5. During the last glacial maximum, the Mediterranean still acted as a concentration basin and a gradient of δ 18 O values similar to the modern one ( ≅ +0.75‰) existed from west to east in the deep waters. Apparently, deep water temperatures were lower during the last glacial but the decrease did not exceed 4°C in the eastern basin. Major anomalies are also contained in the 13C records of G. bulloides and benthic foraminifera. The 13C records from surface, intermediate and deep waters of the eastern basin and from intermediate and deep waters of the western basin are opposite to that of the open ocean. During glacial time δ 13 C values were higher in intermediate and deep waters of the whole Mediterranean, and also in surface water of the eastern basin. At the same time, the 13C gradient of surface to deep waters was low. This gradient increased during the last deglaciation while δ 13 C values of G. bulloides and benthic foraminifera decreased. This decrease, interrupted at 10 ka, may have been related to increased fresh water run-off from the bordering contintents due to increased precipitation, especially in the tropical belt. The 13C depletion is clearly recorded in the Levantine and deep water masses and can be traced westward in the Mediterranean outflow. Oxygen and carbon isotope anomalies recorded simultaneously in the east Mediterranean by the shallow water species Globigerinoides ruber during sapropel deposition indicate that increased precipitation on the bordering continents and strong fresh water run-off during the time of the last deglaciation, may have caused a density stratification and deep stagnation in the eastern basin. Uncertainties arise from the fact that, in the mixing model, deglacial Mediterranean waters are mixed with continental fresh waters, the isotopic characteristics of which are not entirely understood. Although increased surface water production of biogenic material can not be excluded as a possible cause of 13C depletion, it appears that the river discharge including the Nile, as well as Black Sea input, are also plausible sources for the fresh water layering.

Irradiation of copper with 25 MeV oxygen ions-defect production and annealing

Abstract Results of damage rate measurements and an isochronal annealing program from 15K up to room temperature after heavy ion irradiation of copper are reported. Irradiations were performed at temperatures of the recovery stages I (20 K) and I1 (76K, 90 K). The fluences of the low temperature irradiation are the largest reported in literature, resulting in defect concentrations up to 3.5·10−3 or to a radiation induced resistivity increase of 0.70 μΩcm. The damage rates can be explained by the generally accepted models of radiation damage derived for electron irradiation. In stage I1 extended trapping models have been used. The differential recovery spectra reveal all substages of stage I reported after electron irradiations. Substage IE shows to be strongly dose dependent, as well as stage III. The defect retentionf, at the end of stage I is between the values for electron and fast neutron irradiations, and clearly higher than after irradiation with α-particles.

Anatomical substages of stage III Hodgkin's disease: implications for staging, therapy, and experimental design.

Twenty-three patients with pathologic stage III Hodgkin's disease were classified with respect to the presence or absence of symptoms (III-A, III-B), the presence or absence of splenic involvement (IIIS+, IIIS-) and anatomic substage--the extent of disease within the abdomen (III1, III2). Stage III1 disease included disease limited to the upper abdomen, i.e., spleen, splenic node, celiac node, and/or portal node. All other more extensive disease was classified as stage III2. Symptoms and splenic involvement did not predict either disease-free survival or survival. However, 5 year actuarial disease-free survival was significantly better in III1 patients as compared to III2 patients (77% vs. 13%, p less than .001). Eight of nine stage III2 patients receiving total nodal radiotherapy alone relapsed. When considered along the previous studies of anatomic substage, these findings suggest that patients in stage III1 and III2 should receive different therapeutic approaches. Analysis of therapeutic results in stage III patients must consider anatomic substage.

Stage-I recovery of prequenched and electron-irradiated pure aluminum and of the alloy Al-15 ppm Ag

High-purity Al and the alloy Al-15 ppm Ag have been irradiated with electrons at liquid-helium temperatures. The influence of various parameters (electron energy and dose, impurity content and the, presence of excess vacancies introduced by prequenching or irradiation doping) upon the annealing spectra of the radiation-induced residual electrical resistivity was determined. Besides the usually observed recovery substages in stage I ( IB, IC, ID, and IE), we have found several supplementary structures labelled IA (at 14–15 K), IC′ (at 26–27 K), ID′ (at 33 K), ID″ (at 39 K), and IF (between 53 and 59 K). The observed characteristics are compatible with the attribution of the substages IA, IB, IC′, and IC to close-pair recombination; ID′, ID, and ID″ to correlated migration of interstitials; IE to the recombination of freely migrating interstitials; and IF to the migration of diinterstitials.

Rapid thermal pulse annealing

Abstract Characteristics of recovery processes have been investigated for cases of heating a sample to successively higher temperatures by means of isochronal annealing or by using a rapid pulse annealing. A recovery spectra shows the same features independent of which annealing procedure is used. In order to determine which technique provides the best resolution, we have studied how two independent first-order processes are separated for different heating rates and time increments of the annealing pulses. It is shown that the pulse anneal method offers definite advantages over isochronal annealing when annealing for short time increments. Experimental data by means of the pulse anneal technique are given for the various substages of stage I of aluminum.

Annealing study of gold, zinc and germanium alloyed aluminum neutron-irradiated at liquid nitrogen temperature

Abstract A study of the recovery of the electrical resistivity of the dilute aluminum alloys Al - Au (0.02–0.25 at % Au ), Al - Zn (0.05–1.0 at % Zn ) and Al - Ge (0.02–0.5 at % Ge ) after neutron-irradiation at a total dose of 9 × 10 18 n / cm 2 at 78 K was undertaken. The annealing spectra of Al-Au and Al-Zn alloys showed two distinct substages in stage II, while in Al-Ge alloys a five-peak structure was apparent. At the low-temperature side of the main peak of stage III a shoulder is definitely apparent in the three alloy systems. After stage III, Al-Ge alloys appear to have two doublets and a reverse recovery resistivity, which can be attributed to the formation of Guinier-Preston zones. The break-up of interstitials from impurity atoms or their clusters and the trapping of vacancy-type defects during their migration in stage III, are the mechanisms which can explain stages II and III respectively. The activation energy for the main peak of stage III was in all cases found to be 0.60 eV, and the peak obeys second-order kinetics.