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COVID-19 is a global health threat with a huge number of confirmed cases and deaths all over the world. Human-to-human transmission via respiratory droplets and contact with aerosol-infected surfaces are the major routes of virus spread. Because SARS-CoV-2 can remain in the air and on surfaces from several hours to several days, disinfection of frequently touched surfaces and critical rooms, in addition to observing individual hygiene tips, is required to reduce the virus spreading. Here we report on an investigation into the use of gaseous ozone as a potentially effective sanitizing method against the new coronavirus.

Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. Design: Cross-sectional study nested in the 2017 "Delirium Day" project. Setting and participants: Patients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. Methods: Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). Results: A total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2-2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1-1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6-1.2, P = .36; OR 1.1; CI 0.8-1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6-1.2, P = .27; OR 1.1, CI 0.8-1.4, P = .63). Conclusions and implications: Our findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.

ObjectiveTo assess the prevalence and isotypes of anti-nodal/paranodal antibodies to nodal/paranodal proteins in a large chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) cohort, compare clinical features in seronegative vs seropositive patients, and gather evidence of their isotype-specific pathogenic role.MethodsAntibodies to neurofascin-155 (Nfasc155), neurofascin-140/186 (Nfasc140/186), contactin-1 (CNTN1), and contactin-associated protein 1 (Caspr1) were detected with ELISA and/or cell-based assay. Antibody pathogenicity was tested by immunohistochemistry on skin biopsy, intraneural injection, and cell aggregation assay.ResultsOf 342 patients with CIDP, 19 (5.5%) had antibodies against Nfasc155 (n = 9), Nfasc140/186 and Nfasc155 (n = 1), CNTN1 (n = 3), and Caspr1 (n = 6). Antibodies were absent from healthy and disease controls, including neuropathies of different causes, and were mostly detected in patients with European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) definite CIDP (n = 18). Predominant antibody isotypes were immunoglobulin G (IgG)4 (n = 13), IgG3 (n = 2), IgG1 (n = 2), or undetectable (n = 2). IgG4 antibody-associated phenotypes included onset before 30 years, severe neuropathy, subacute onset, tremor, sensory ataxia, and poor response to intravenous immunoglobulin (IVIG). Immunosuppressive treatments, including rituximab, cyclophosphamide, and methotrexate, proved effective if started early in IVIG-resistant IgG4-seropositive cases. Five patients with an IgG1, IgG3, or undetectable isotype showed clinical features indistinguishable from seronegative patients, including good response to IVIG. IgG4 autoantibodies were associated with morphological changes at paranodes in patients' skin biopsies. We also provided preliminary evidence from a single patient about the pathogenicity of anti-Caspr1 IgG4, showing their ability to penetrate paranodal regions and disrupt the integrity of the Nfasc155/CNTN1/Caspr1 complex.ConclusionsOur findings confirm previous data on the tight clinico-serological correlation between antibodies to nodal/paranodal proteins and CIDP. Despite the low prevalence, testing for their presence and isotype could ultimately be part of the diagnostic workup in suspected inflammatory demyelinating neuropathy to improve diagnostic accuracy and guide treatment.Classification of evidenceThis study provides Class III evidence that antibodies to nodal/paranodal proteins identify patients with CIDP (sensitivity 6%, specificity 100%).

Purpose The outcome of lung transplantion (LuTx) suffers from a high rejection rate, and there are still huge gaps of knowledge about immune-mediated rejection mechanisms. Acute rejection (AR) can lead to chronic lung allograft dysfunction (CLAD), the main cause of poor survival and low quality of life. The standardized morphologic evaluation of rejection is based on histopathologic diagnostic criteria at a given time-point, but it has a limited prognostic value towards clinical outcome and the likelihood to develop CLAD. We analyzed immune-check point proteins in lung tissues of patients who received a LuTx and who were or were not undergoing rejection in the attempt to define novel immunological markers that could predict rejection. Methods We conducted an observational retrospective study on eight consecutive explanted grafts for chronic rejection and on transbronchial cryobiopsies (TCB) obtained from 24 consecutive patients during the first year LuTx follow-up. A broad spectrum of immunohistochemical analysis was carried out (PD1/CD279, PDL1/CD274, CTLA4/CD152, CD4, CD8, hFoxp3, TIGIT, TOX, B-Cell-Specific Activator Protein). Of those TCB-patients we recorded at least 1 year follow up of survival, infections and rejections (acute and chronic) rate. Results Exhausted (PD1+/TOX+) as well as Treg (PD1+/FOXP3+) lymphocytes were significantly reduced in restrictive allograft syndrome (RAS)-compared to bronchiolitis-obliterans-syndrome (BOS)-rejected lungs. PD1-expressing T-lymphocytes in TCBs correlated (sensitivity 0.69; specificity 1) with the presence of AR and were highly suggestive of CLAD development (sensitivity 0.86; specificity 0.82; overall 10 times higher risk of developing CLAD) at one-year follow-up. Conclusion Results herein for the first time show the importance of immunological checkpoints in the setting of LuTx rejection and indicate that the evaluation of the expression of such proteins could offer a distinct prognostic advantage in monitoring the onset of AR in patients who underwent LuTx. Longitudinal analyses in ampler cohorts will be needed to confirm these data.

Lung cancer is the leading cause of cancer mortality in the world, both men and women. A 75% of patients at diagnosis have some degree of cough, hemoptysis and dyspnea as initial symptoms. Pancoast tumor or superior pulmonary sulcus tumor represents less than 5% of all bronchogenic carcinomas. They are located at the apex of the lung and is mainly characterized by invasion by contiguity of thoracic outlet structures and different from the usual signosintomatología: shoulder pain and / or the ipsilateral arm. We present the case of a male patient of 63 years after attend different services (such as orthopedics, neurology, and speech therapy) was diagnosed with Pancoast tumor biopsy of cervical lymphadenopathy. The diagnosis of Pancoast tumor should be suspected at the persistence painful shoulder syndrome in patients over 60 years with a history of smoking. The usual clinical presentation of this type of lung cancer unnecessarily delaying diagnosis and correct treatment.

Duodenal fistula is a complex condition, relatively frequent presentation, being in most cases of postoperative origin. Among the latter, 6% to 11% are secondary to surgical treatment of perforated duodenal ulcer, and more unusual, as a complication of cholecystectomy. Two cases treated percutaneous at the Polyclinic Bank city of Buenos Aires are presented. The first, a female patient with a duodenal fistula as a postoperative complication of a perforated duodenal ulcer and the second one patient male with the same pathology but as a complication of cholecystectomy. Percutaneous treatment of this disease has been reported sporadically without having proven its usefulness. Once diagnosed the same Fistulography and obliteration were performed percutaneously achieving complete remission of the disease.

Boron neutron capture therapy (BNCT) is a binary radiotherapy based on thermal-neutron irradiation of cells enriched with (10)B, which produces α particles and (7)Li ions of short range and high biological effectiveness. The selective uptake of boron by tumor cells is a crucial issue for BNCT, and studies of boron uptake and washout associated with cell survival studies can be of great help in developing clinical applications. In this work, boron uptake and washout were characterized both in vitro for the DHDK12TRb (DHD) rat colon carcinoma cell line and in vivo using rats bearing liver metastases from DHD cells. Despite a remarkable uptake, a large boron release was observed after removal of the boron-enriched medium from in vitro cell cultures. However, analysis of boron washout after rat liver perfusion in vivo did not show a significant boron release, suggesting that organ perfusion does not limit the therapeutic effectiveness of the treatment. The survival of boron-loaded cells exposed to thermal neutrons was also assessed; the results indicated that the removal of extracellular boron does not limit treatment effectiveness if adequate amounts of boron are delivered and if the cells are kept at low temperature. Cell survival was also investigated theoretically using a mechanistic model/Monte Carlo code originally developed for radiation-induced chromosome aberrations and extended here to cell death; good agreement between simulation outcomes and experimental data was obtained.

Background:Whether arrhythmia risks will increase if drugs with electrocardiographic (ECG) QT-prolonging properties are combined is generally supposed but not well studied. Based on available evidence, the Arizona Center for Education and Research on Therapeutics (AZCERT) classification defines the risk of QT prolongation for exposure to single drugs. We aimed to investigate how combining AZCERT drug categories impacts QT duration and how relative drug exposure affects the extent of pharmacodynamic drug–drug interactions.Methods:In a cohort of 2558 psychiatric inpatients and outpatients, we modeled whether AZCERT class and number of coprescribed QT-prolonging drugs correlates with observed rate-corrected QT duration (QTc) while also considering age, sex, inpatient status, and other QTc-prolonging risk factors. We concurrently considered administered drug doses and pharmacokinetic interactions modulating drug clearance to calculate individual weights of relative exposure with AZCERT drugs. Because QTc duration is concentration-dependent, we estimated individual drug exposure with these drugs and included this information as weights in weighted regression analyses.Results:Drugs attributing a ‘known’ risk for clinical consequences were associated with the largest QTc prolongations. However, the presence of at least two versus one QTc-prolonging drug yielded nonsignificant prolongations [exposure-weighted parameter estimates with 95% confidence intervals for ‘known’ risk drugs + 0.93 ms (–8.88;10.75)]. Estimates for the ‘conditional’ risk class increased upon refinement with relative drug exposure and co-administration of a ‘known’ risk drug as a further risk factor.Conclusions:These observations indicate that indiscriminate combinations of QTc-prolonging drugs do not necessarily result in additive QTc prolongation and suggest that QT prolongation caused by drug combinations strongly depends on the nature of the combination partners and individual drug exposure. Concurrently, it stresses the value of the AZCERT classification also for the risk prediction of combination therapies with QT-prolonging drugs.

The eStation is a collecting and processing system designed to automatically deal with the reception, processing, analysis and dissemination of key environmental parameters derived from remotely sensed data. Developed mainly at the Joint Research Centre of the European Commission, the eStation has been distributed to 47 sub-Saharan countries in the frame of the AMESD (Africa n Monitoring of Environment for Sustainable Development) project to provide local institutions with the capacity to easily access a large range of remote sensing products on vegetation, precipitation, fires and oceans. These products, derived from the processing of images coming from various instruments including SPOT-Vegetation, MSG-SEVIRI and MODIS are developed to allow end-users to make local and regional assessments of the state of marine and terrestrial ecosystems. The products, dispatched to the users through the EUMETSAT data broadcasting system (EUMETCast) or provided by other Earth Observation (EO) data agencies (e.g. NASA), are further processed by the eStation to allow end-users to generate their own environmental, whether terrestrial or marine, assessments and reports. Initially designed as a stand-alone system using an open source development framework, the eStation has recently been further developed as a web processing service to allow a broader range of end-users to access the data and services over the Internet. It is the purpose of this paper to introduce the readers to the eStation and its products, to share the lessons learnt in deploying these services as well as to discuss its more recent use in chained environmental web based modeling services.

This paper shows how to reconstruct the original 275-m resolution data of the Multi-angle Imaging SpectroRadiometer (MISR) instrument in the 24 spectrodirectional global mode channels that are spatially averaged to 1.1 km on-board the Terra platform, with negligible loss of information relative to images acquired in native-resolution local mode. Standard approaches to improve the spatial resolution of products rely on one (typically panchromatic) high-resolution (HR) image to sharpen multiple spectral images. In the case of the MISR-HR package described here, three of the 12 available HR channels are combined to regenerate each of the 24 reduced-resolution channel to its native resolution. The accurate and rigorously reconstructed spectral bidirectional reflectance data allow sensitive and physically meaningful land surface attributes to be recovered at a spatial resolution appropriate to document the spatial heterogeneity of the land surface and relevant for climate and environment studies. MISR has been in continuous operation since February 2000 and provides global coverage in at most nine days (depending on latitude). This technique allows the generation of quantitative information to monitor change and model ecosystem function virtually anywhere and at any time during the last decade. The potential is demonstrated for a savanna landscape in South Africa.

Background: To investigate, retrospectively, the role of tumour histotype and antiangiogenic drugs for venous thromboembolism (VTE) development in advanced cancer patients treated in phase I studies. Methods: Patients enrolled and treated in phase I studies conducted by SENDO (Southern Europe New Drugs Organisation) were considered. Results: Data of 1415 patients were included in the analysis: 526 (37.2%) patients were males, median age was 57.3 years (range: 13–85). Fifty-six (3.96%) patients developed a VTE. At multivariate analysis gynaecologic (hazard ratio (HR): 2.8, 95% confidence interval (CI): 1.29–6.23, P=0.009) and gastrointestinal tumours (HR: 3.23, 95% CI: 1.18–8.87, P=0.023) as well as combination regimens of cytotoxic and antiangiogenic agents (HR: 2.6, 95% CI: 1.11–6.30, P=0.028), white blood cell >11 000 μl−1 (HR: 2.59, 95% CI: 1.10–6.09, P=0.028) and haemoglobin

A selective uptake of boron in the tumor is the base of Boron Neutron Capture Therapy, which can destroy the tumor substantially sparing the normal tissue. In order to deliver a lethal dose to the tumor, keeping the dose absorbed by normal tissues below the tolerance level, it is mandatory to know the 10 B concentration present in each kind of tissue at the moment of irradiation. This work presents the calibration procedure adopted for a boron concentration measurement method based on neutron autoradiography, where biological samples are deposited on sensitive films and irradiated in the thermal column of the TRIGA reactor (University of Pavia). The latent tracks produced in the film by the charged particles coming from the neutron capture in 10 B are made visible by a proper etching, allowing the measurement of the track density. A calibration procedure with standard samples provides curves of track density as a function of boron concentration, to be used in the measurement of biological samples. In this paper, the bulk etch rate parameter and the calibration curves obtained for both liquid samples and biological tissues with known boron concentration are presented. A bulk etch rate value of (1.64 ± 0.02) μm/h and a linear dependence with etching time were found. The plots representing the track density versus the boron concentration in a range between 5 and 50 μg/g (ppm) are linear, with an angular coefficient of (1.614 ± 0.169)·10 −3 tracks/(μm 2 ppm) for liquids and (1.598 ± 0.097)·10 −2 tracks/(μm 2 ppm) for tissues.

The aerosol direct radiative effect (ADRE) affecting the Po Valley and the adjacent North Adriatic Sea is studied using 10-year series of measurements collected at two AERONET sites located in the western part of the Valley (Ispra), and on a platform (AAOT) offshore Venice. This region is characterized by a high, mostly continental, aerosol load with comparable average aerosol optical thickness (AOT) at both locations (0.21 at 500 nm) and more absorbing aerosols at Ispra. A dynamic aerosol model accounting for the changes in scattering phase function with AOT is used for radiative transfer calculations, together with boundary conditions representative of terrestrial and marine surfaces. A sensitivity analysis allows the construction of an error budget for the daily ADRE estimates, found to be of the order of 20% and mostly due to uncertainties on aerosol single scattering albedo and AOT. The daily radiative efficiencies, normalized by AOT at 500 nm, increase from December to June, from -17 to -24 W m-2 AOT-1 at top-of-atmosphere (TOA) and -33 to -72 W m-2 AOT-1 at surface for the Po Valley, and from -15 to -32 (TOA) and -35 to -65 W W m-2 AOT-1 (surface) for the AAOT site. The average of log-transformed ADRE for TOA, surface and atmosphere are -5.2, -12.2 and +6.8 W m-2 for the Po Valley case, and -6.5, -13.0 and +6.5 W m-2 for the AAOT site but these values can be much higher for individual days. Concurrent clear-sky days give indications on the regional atmospheric heating spatial gradients. Differences between the atmospheric ADRE at the two locations average 6.3 W m-2 with a gradient positive towards the inner valley in 65% of the cases. This study confirms the importance of duly considering the radiative impact of aerosols on the regional climate., JRC.H.3-Global environement monitoring

The purpose of the study was to assess frequency and predictors of disability measures in ALS. One hundred and fourteen newly diagnosed patients resident in eight administrative districts of Lombardy, Italy (population 4,947,554), included in a population-based registry, were followed for 2570 person-months (mean 22.5 months). The cumulative time-dependent risk of wheelchair, percutaneous endoscopic gastrostomy, and assisted ventilation was estimated according to the Kaplan-Meier method. Predictors of disability (age, sex, disease duration at diagnosis, type of onset, El-Escorial diagnosis) were assessed with the Cox proportional hazard function. During follow-up, 29 patients (25.4%) became wheelchair bound, 51 (44.7%) received gastrostomy, and 47 (41.2%) received assisted ventilation. The median time to loss of ambulation was 46.7 months (95% CI 36.5-56.8). The median time to gastrostomy and assisted ventilation was 31.1 months (95% CI 26.8-35.4) and 34.6 months (95% CI 29.6-39.6), respectively. Spinal onset ALS was the only predictor of loss of ambulation. Predictors of gastrostomy were older age, definite ALS, and shorter disease duration. Shorter disease duration was the only predictor of assisted ventilation. In conclusion, patients with ALS differ in terms of measures and predictors of disability. These factors are sources of bias and confounding in randomized clinical trials.

Given the encouraging results from our previous work on the clinical application of BNCT on non-resectable, chemotherapy resistant liver metastases, we explore the possibility to extend our technique to lung metastases. A fundamental requirement for BNCT is achieving higher 10B concentrations in the metastases compared to those in healthy tissue. For this reason we developed a rat model with lung metastases in order to study the temporal distribution of 10B concentration in tissues and tumoral cells. Rats with induced lung metastases from colon adenocarcinoma were sacrificed two hours after intraperitoneal Boronphenylalanine infusion. The lungs were harvested, frozen in liquid nitrogen and subsequently histological sections underwent neutron autoradiography in the nuclear reactor Triga Mark II, University of Pavia. Our findings demonstrate higher Boron uptake in tumoral nodules compared to healthy lung parenchyma 2 hours after Boronphenylalanine infusion.

After a long series of studies on the effects of neutron irradiation of 10 B loaded neoplastic cells both in culture and in animal experiments, we started the clinical application of BNCT on humans affected by liver metastases of a radically resected colon adenocarcinoma. The procedure we adopted includes a first surgical phase, with hepatectomy; a radiotherapeutic phase, in which the isolated liver, washed and chilled, is extracorporeally irradiated with thermal neutrons; and then a second surgical phase for the reconnection of the liver to the patient. Until now two patients have been subjected to the BNCT treatment. The first one survived 44 months with a good quality of life, and died because of diffuse recurrences of his intestinal tumour. The second patient had the same early perioperative course, but after 33 days a worsening of a dilatative cardiomyopaty, from which he was suffering, determined a cardiac failure and eventually death. This clinical experience, although limited, has shown that extracorporeal neutron irradiation of the liver is a feasible procedure, able to ensure the complete destruction of liver metastases and a possible long lasting survival. In our patients neutron irradiation caused massive cellular necrosis highly specific to tumour cells, whereas normal cells were mostly spared. Nevertheless, the impact of such a traumatic operation on the patient's organism must be taken into account. Finally, we have to be aware that the fight against tumour rarely leads to a complete victory. We now have an innovative weapon which is both powerful and partly unsettled: it must be refined and above all used.

An advanced operational algorithm has been developed for the routine calibration of the Meteosat radiometer solar channel. The calibration method relies on calculated radiances over bright desert sites whereas ocean targets are used for consistency checks. Calibration errors are estimated accounting for the uncertainties of both the sensor spectral response characterization and target property description. This algorithm has been used to systematically calibrate Meteosat-5 and -7 observations. Results show that it is possible to calibrate the visible band with an estimated accuracy of about 6% when the sensor response characterization is reliable and to monitor the sensor long-term drift. These results are confirmed by Clouds and the Earth's Radiant Energy System observations.

The Spinning Enhanced Visible and Infrared Imager (SEVIRI), the Meteosat Second Generation main radiometer, measures the reflected solar radiation within three spectral bands centered at 0.6, 0.8, and 1.6 /spl mu/m, and within a broadband. This broadband is similar to the solar channel of the radiometer onboard the first generation of METEOSAT satellites. The operational absolute calibration of these channels relies on modeled radiances over bright desert sites, as no in-flight calibration device is available. These simulated radiances represent, therefore, the "reference" against which SEVIRI is calibrated. The present study describes the radiative properties of these targets and evaluates the uncertainties associated with the characterization of this "reference", i.e. the modeled radiances. To this end, top-of-atmosphere simulated radiances are compared with several thousands of calibrated observations acquired by the European Remote Sensing 2/Along-Track Scanning Radiometer 2 (ERS2/ATSR-2), SeaStar/Sea-viewing Wide Field-of-view Sensor (SeaWiFS), Syste/spl grave/me Pour l'Observation de la Terre 4 (SPOT-4/VEGETATION), and the Environmental Research Satellite/Medium Resolution Imaging Spectrometer (ENVISAT/MERIS) instruments over the SEVIRI desert calibration sites. Results show that the mean relative bias between observation and simulation does not exceed 3% in the red and near-infrared spectral bands with respect to the first two instruments.

We report the investigation of new organic complexes containing a magnetic moment (Gd-based molecular nanomagnets), which can serve the double purpose of acting as boron neutron capture therapy (BNCT) agents, and at the same time act as contrast agents to detect the molecule in the tissue by a proton magnetic resonance imaging (MRI). We also explore the possibility of monitoring the concentration of the BNCT agent directly via proton and boron NMR relaxation. The absorption of 10B-enriched molecules inside tumoral liver tissues has been shown by NMR measurements and confirmed by α spectroscopy. A new molecular Gd-tagged nanomagnet and BNCT agent (GdBPA) has been synthesized and characterized measuring its relaxivity R1 between 10 kHz and 66 MHz, and its use as a contrast agent in MRI has been demonstrated. The NMR-based evidence of the absorption of GdBPA into living tumoral cells is also shown.

Item does not contain fulltext The aim of this study is to optimize targeted boron delivery to cancer cells and its tracking down to the cellular level. To this end, we describe the design and synthesis of novel nanovectors that double as targeted boron delivery agents and fluorescent imaging probes. Gold nanoparticles were coated with multilayers of polyelectrolytes functionalized with the fluorescent dye (FITC), boronophenylalanine and folic acid. In vitro confocal fluorescence microscopy demonstrated significant uptake of the nanoparticles in cancer cells that are known to overexpress folate receptors. 01 december 2011

(10)B molecular compounds suitable for Boron Neutron Capture Therapy (BNCT) are tagged with a Gd(III) paramagnetic ion. The newly synthesized molecule, Gd-BPA, is investigated as contrast agent in Magnetic Resonance Imaging (MRI) with the final aim of mapping the boron distribution in tissues. Preliminary Nuclear Magnetic Resonance (NMR) measurements, which include (1)H and (10)B relaxometry in animal tissues, proton relaxivity of the paramagnetic Gd-BPA molecule in water and its absorption in tumoral living cells, are reported.

Meteosat Second Generation (MSG) is the new generation of European geostationary meteorological satellites operated at ELIMETSAT. SEVIRI, the MSG main radiometer, measures the reflected solar radiation within three spectral bands centered at 0.6, 0.8 and 1.6 μm, and within a broad band similar to the VIS channel of MVIRI, the radiometer on-board the first generation of METEOSAT satellites. The operational calibration of these channels relies on modelled radiances over bright desert sites, as no in-flight calibration device is available. These simulated radiances represent therefore the “reference” against which SEVIRI is calibrated. The present study evaluates the uncertainties associated with the characterization of this “reference”, i.e. , the modelled radiances. A theoretical estimation is first assessed, based on the impact of the target surface and atmospheric parameter error on the simulated radiance. Top-of-atmosphere simulated radiances are next compared with several thousands of calibrated observations acquired by the ERS2/ATSR-2 and SeaStar/SeaWiFS instruments over the SEVIRI desert calibration sites. Results show that the relative bias between simulation and observation does not exceed ±5%.

Background: Vinorelbine prolongs survival and improves quality of life in elderly patients with advanced non-smallcell lung cancer (NSCLC). Some studies have also suggested that gemcitabine is well tolerated and effective in such patients. We compared the effectiveness and toxicity of the combination of vinorelbine plus gemcitabine with those of each drug given alone in an open-label, randomized phase III trial in elderly patients with advanced NSCLC. Methods: Patients aged 70 years and older, enrolled between December 1997 and November 2000, were randomly assigned to receive intravenous vinorelbine (30 mg/m 2 of body surface area), gemcitabine (1200 mg/m 2 ), or vinorelbine (25 mg/m 2 ) plus gemcitabine (1000 mg/m 2 ). All treatments were delivered on days 1 and 8 every 3 weeks for a maximum of six cycles. The primary endpoint was survival. Survival curves were drawn using the Kaplan–Meier method and analyzed by the Mantel–Haenszel test. Secondary endpoints were quality of life and toxicity. Results: Of 698 patients available for intention-to-treat analysis, 233 were assigned to receive vinorelbine, 233 to gemcitabine, and 232 to vinorelbine plus gemcitabine. Compared with each single drug, the combination treatment did not improve survival. The hazard ratio of death for patients receiving the combination treatment was 1.17 (95% confidence interval [CI] = 0.95 to 1.44) that of patients receiving vinorelbine and 1.06 (95% CI = 0.86 to 1.29) that of patients receiving gemcitabine. Although quality of life was similar across the three treatment arms, the combination treatment was more toxic than the two drugs given singly. Conclusion: The combination of vinorelbine plus gemcitabine is not more effective than single-agent vinorelbine or gemcitabine in the treatment of elderly patients with advanced NSCLC. [J Natl Cancer Inst 2003;95: 362–72]