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Introduction Recent studies suggest that the use of metformin is associated with reduced cancer incidence and improved prognosis in patients with oesophageal cancer. We explored the relationship between the use of metformin and outcome (pathologic response rate, distant metastasis-free and overall survival) in our mono-institutional cohort of patients treated for oesophageal cancer. Material and methods Between 2008 and 2014, a total of 196 patients with oesophageal cancer (ages ranged from 37 to 82 years) eligible for curative treatment entered the study. Patients were categorized as non-diabetic (n = 172), diabetic not taking metformin (n = 5) or diabetic taking metformin (n = 19). The majority of patients were treated with trimodality therapy (n = 189). Pathologic response was graded according to Mandard's tumour regression score at the time of surgery. Distant metastasis-free and overall survival were calculated using the Kaplan–Meier method with log rank comparisons performed to determine significance. Results The overall pathologic complete response rate for the study population was 26%. It was 25% for patients not using metformin and 39% for diabetics taking metformin (p = 0.260). The two-year overall survival rate for the whole group was 59%. Use of metformin was associated with a significantly better distant metastasis-free survival rate (p = 0.040) or overall survival rate (p = 0.012). Multivariate analysis using Cox regression found that metformin treatment significantly prolonged survival (p = 0.043). Conclusion In our population-based study, the use of metformin was associated with an improved overall and distant metastasis-free survival rate in patients with oesophageal cancer. These data are complementary to one other clinical study and warrant further prospective study. [ABSTRACT FROM AUTHOR]

Abstract: Allergic reactions in the parturient are challenging for the anaesthetist who is dealing with both mother and baby, often in circumstances when there is a need for delivery. While most previous reviews have focused on specific substances in individual cases, this review focuses on allergic reactions during the peripartum period, the differential diagnosis and specific treatment options. Immunoregulation and susceptibility to allergic reactions may change during pregnancy. Compared with non-pregnant patients, in whom neuromuscular blocking drugs are the most common triggering substances, allergic reactions in parturients mostly occur following contact with latex, injection of antibiotics and uterotonics, and infusion of colloids. With the exception of latex, where patient history may raise suspicion, allergic reactions may occur without prior exposure to triggering agents. Most drugs used for resuscitation of the non-pregnant patient are suitable for the parturient. Some substances, such as H2-receptor antagonists for aspiration prophylaxis or corticosteroids for prematurity, may have been given before the event. Although fetal outcome is important, the mother is the primary focus of care. [Copyright &y& Elsevier]

Abstract: In search of solar cell concepts that allow processing of thinner wafers (<150μm), the conventional full Al rear side of p-type solar cells is replaced by an open rear metallization combined with a dielectric passivation layer. We estimate that this modification to the cell concept could result in a gain of 0.3-0.4% in absolute efficiency for a rear passivated multi-crystalline solar cell with local contacts. The gain can only be obtained when a well passivating dielectric layer is applied and Al contacts are formed with a high-quality local BSF. Three rear contacting designs are discussed: interconnected point contacts (PERC), bifacial cell with line shaped rear contacts (PASHA) and a bifacial MWT with a web pattern on both sides (ASPIRe). For these cell concepts, the performance of SiNx and Al2O3 as rear passivating layers are discussed in terms of local EQE measurements. A simple equivalent circuit is discussed to describe the parabolic LBIC pattern which is induced by inversion layer shunting between the rear metal contacts. The influence of the fixed charge density and the metallization pitch is discussed. [Copyright &y& Elsevier]

Abstract: A new process for all silicon nitride passivated silicon solar cells with screen printed contacts is analysed in detail. Since the contacts are fired through the silicon nitride layers on both sides, the process is easy to adapt to industrial production. The potential and limits of the presented bifacial design are simulated and discussed. The effectiveness of the presented process depends strongly on the base doping of the substrate, but only the open circuit voltage is affected. The current is mainly determined by the rear surface passivation properties. Thus, using a low resistivity base material higher efficiencies compared to an aluminium back surface field can be achieved. [Copyright &y& Elsevier]

A letter to the editor is presented in response to the article "Organic cation transport in the rat kidney in vivo visualized by time-resolved two-photon microscopy," by M. Holbert, C. Wotzlaw, TA Sutton et al in the 2007 issue.

A letter to the editor is presented in response to the article regarding the studying channel and receptor physiology in podocytes.

Background Tibial plateau fractures account for approximately 1% of all fractures. They usually occur after a direct high-energy trauma. Despite adequate treatment, these fractures can result in malalignment and secondary osteoarthritis (OA). Research concerning long-term functional outcome is limited. The primary aim of this study was to evaluate mid- to long-term functional outcome of surgically treated tibial plateau fractures. The secondary aim was to investigate whether radiological characteristics of OA one year after surgery are predictive of functional outcome at follow-up. Methods All consecutive patients with fractures of the proximal tibia, which were surgically treated in our level-2 trauma centre between 2004 and 2010, were included in this study. Initial trauma radiographs were analysed for fracture classification, using both the Schatzker and AO/OTA classification systems, by three different raters. Immediate postoperative and 1-year postoperative radiographs were analysed for osteoarthritis by an experienced radiologist, using the Kellgren and Lawrence scale. Functional outcome of the included patients was measured using the Dutch version of the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Results Seventy one patients out of a group of 96 included patients completed the survey. Median KOOS scores are 89.8% for pain, 91.1% for ‘other symptoms’, 89.7% for daily function, 72.5% for sports and recreation and 75.0% for quality of life. Median KOOS overall score is 82.99%. We did not find a correlation between the KOOS scores and the absolute age for any of the subscales. There was no significant relationship between radiological characteristics of osteoarthritis and functional outcome. Conclusions This is the first study to describe mid- to long-term functional outcome after ORIF for all types of tibial plateau fractures, with the use of the KOOS. Patients should be informed about the likelihood of lower functional outcome in the long-term. This study shows that radiological characteristics of osteoarthritis are not related with lower functional outcomes in the mid- to long-term. [ABSTRACT FROM AUTHOR]

Abstract: Previous dynamic posturography studies demonstrated clear abnormalities in balance responses in Parkinson''s disease (PD) patients compared to controls at the group level, but its clinical value in the diagnostic process and fall risk estimation in individual patients leaves for improvement. Therefore, we investigated whether a new approach, focusing on the balance responses to the very first and fully unpractised trial rather than a pooled mean response to a series of balance perturbations, could further improve the diagnostic utility of dynamic posturography. Following the first trial, subjects were exposed to repeated balance perturbations, which also permitted us to investigate the training responses. Fourteen patients with PD and 18 age-matched controls were enrolled, who received a series of multidirectional postural perturbations, induced by support surface rotations. We measured trunk and upper arm kinematics and electromyographic responses, and evaluated group differences at three levels: the postural response to the very first backward perturbation; pooled first and habituated postural responses; and habituation rates. Analysis of the first trial responses yielded similar results as evaluation of the mean response over trials: forward flexion of the trunk induced by backward perturbations was decreased in patients, accompanied by increased muscle responses present. Moreover, trunk movement and muscle activity were equally present in both groups—suggesting a preserved training response in PD patients. Early masseter activity in both groups might be indicative of a startle-like component to the balance response. In terms of diagnostic utility, focusing on the first trial response or habituation rate is no better than analysis of pooled responses to a series of perturbations. The apparently preserved training response in PD patients suggests that balance reactions in PD can be improved by repeated exposure, and this may have implications for future exercise studies. Early masseter activity warrants further studies to evaluate a potential startle component in the pathophysiology of balance disorders. [Copyright &y& Elsevier]

Abstract: We discuss the application of three street canyon models in order to evaluate the concentration levels of NO x , SO2, PM10 (1999/30/EC), CO and benzene (2000/69/EC) in one of the main passage roads in the city of Antwerp, the “Plantin en Moretuslei” in the city of Antwerp. The model results are based on identical urban transport emission input data for Antwerp and on the same meteorological input data derived from nearby meteorological towers. Background values are obtained from a regional air quality model, which is used as a reference model for environmental reporting in Flanders. For NO x , SO2, PM10 and benzene the results are compared with hourly observations from a monitoring station in the “Plantin en Moretuslei”. It was found that the annual averages are relatively well captured by the models. The higher percentiles (98th, 99th) are underestimated, due to the lack of hourly variation in the background concentration. A more sophisticated approach is needed to model these background concentrations more adequately. [Copyright &y& Elsevier]

We discuss the application of the integrated air quality model AURORA to evaluate the concentration levels of NO2, SO2, PM10 (1999/30/EC), CO and benzene (2000/69/EC) in 11 selected streets in the city of Antwerp. Together with the emission module, the analytical street box module of AURORA was used for the assessment of pollutant concentrations in street canyons. Comparisons with a measurement station located in one of the evaluated street canyons show agreements that are within the uncertainty range given by the guidelines in the EU directives, except for the NO2 concentrations. An analysis of the measured and modelled concentrations and percentiles shows that concentrations of NO2, CO and benzene vary widely from street to street, whereas for SO2 and PM10 the model results show less variation between individual streets, indicating a more important contribution from the urban and regional background. [Copyright &y& Elsevier]

Since its first description, ADAMTS14 has been considered as an aminoprocollagen peptidase based on its high similarity with ADAMTS3 and ADAMTS2. As its importance for procollagen processing was never experimentally demonstrated in vivo , we generated Adamts14 -deficient mice. They are healthy, fertile and display normal aminoprocollagen processing. They were further crossed with Adamts2 -deficient mice to evaluate potential functional redundancies between these two highly related enzymes. Initial characterizations made on young Adamts2-Adamts14 -deficient animals showed the same phenotype as that of Adamts2 -deficient mice, with no further reduction of procollagen processing and no significant aggravation of the structural alterations of collagen fibrils. However, when evaluated at older age, Adamts2-Adamts14 -deficient mice surprisingly displayed epidermal lesions, appearing in 2 month-old males and later in some females, and then worsening rapidly. Immunohistological evaluations of skin sections around the lesions revealed thickening of the epidermis, hypercellularity in the dermis and extensive infiltration by immune cells. Additional investigations, performed on young mice before the formation of the initial lesions, revealed that the primary cause of the phenotype was not related to alterations of the epidermal barrier but was rather the result of an abnormal activation and differentiation of T lymphocytes towards a Th1 profile. However, the primary molecular defect probably does not reside in the immune system itself since irradiated Adamts2-Adamts14 -deficient mice grafted with WT immune cells still developed lesions. While originally created to better characterize the common and specific functions of ADAMTS2 and ADAMTS14 in extracellular matrix and connective tissues homeostasis, the Adamts2-Adamts14 -deficient mice revealed an unexpected but significant role of ADAMTS in the regulation of immune system, possibly through a cross-talk involving mesenchymal cells and the TGFβ pathways. [ABSTRACT FROM AUTHOR]

Abstract: Between 2002 and 2006, various exceedances of air quality directive 1999/30/EC were reported in a number of PM10 monitoring stations in Flanders. A study was carried out with the objectives: i) to identify and quantify the sources that have caused or have contributed to the exceedances over this period; and ii) to propose suitable emission reduction measures to comply with the current air quality standards (2010). We followed an integrated multi-disciplinary approach consisting of a detailed analysis of the PM10 data series, specific air quality measuring campaigns, air quality modelling and expertise on emission reduction measures (including current BAT and BREF studies). The data analysis was based on 5 steps: 1) The pollution roses of the individual monitoring stations were analyzed. 2) The variation of the PM10 concentration in function of wind speed was assessed to determine whether we were dealing with a fugitive source of primary particles (e.g. mineral dust) or a source of smaller secondary particles taken up and dispersed by the ambient air flow (e.g. industrial combustion sources or traffic sources). 3) The temporal patterns of the potential sources were analyzed. 4) Specific measurement campaigns were organized in the neighbourhood of the potential sources. This included mapping of PM10 concentrations and a detailed analysis of the chemical composition. 5) The (fugitive) PM10 sources were quantified by means of reversed modelling. After deduction of a high background concentration, observed in all monitoring stations in Flanders, results for the individual monitoring stations show that in almost all cases the peak concentrations can be attributed to local fugitive PM10 emissions. Thus for most of the analysed cases it could be concluded that the cause of the exceedances or nearly exceedances is the combination of high background concentrations and local contributions from diffuse or fugitive sources. The total contribution of these non-registered diffuse sources was estimated to be 9–16% of the measured annual averaged PM10 concentrations. [Copyright &y& Elsevier]