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Etoposide, leucovorin and 5-fluorouracil in advanced gastric cancer: a phase II study.

It has been suggested that the combination of etoposide, leucovorin and 5-fluorouracil (ELF) is very active in the treatment of advanced gastric cancer in elderly patients. The aim of this study was to confirm the efficacy and to investigate the toxicity of the ELF-regimen in patients of all ages. Thirty patients with advanced gastric adenocarcinoma were treated with leucovorin (300 mg/m2), etoposide (100 mg/m2) and 5-FU (500 mg/m2) for 3 consecutive days every 4 weeks in a phase II study. Reevaluation of measurable disease was done after 3 cycles. A partial response was shown in 8 (27%) patients. An improvement of the Karnofsky Performance Status was observed in 10 (33%) patients. The mean survival amounted to 8 months (range 2-24). Toxicity was mild. No grade 4 toxicity nor chemotherapy-related mortality were observed. It is concluded from this phase II study that the ELF-regimen is an active palliative treatment for advanced gastric cancer, with mild toxicity.

Adenocarcinoma↗

[Carcinogenic risk of extremely-low-frequency electromagnetic fields: state of the art].

This paper summarizes the published literature and current problems relating to possible cancerogenic effects of occupational and residential exposure to ELF electromagnetic fields at levels slightly above ambient background. There are several suggestions that such an exposure may increase the risk of cancer, but these studies failed to provide conclusive indications. The present state of uncertainty led to a variety of recommendations and statements being made concerning restrictions to the exposure of people to ELF electromagnetic fields. Attempts to detect direct chromosomal damage from ELF electromagnetic fields have proven negative, while results on cancer promotion have been controversial. On the basis of several epidemiological studies on occupational exposure, an increased risk of leukemia, brain cancer and male breast cancer is apparent; the literature on residential exposure provides some evidence of an effect on childhood cancer, especially leukemia; however, when interpreting these results some major methodological concerns should be kept in mind. In conclusion, the public concern and potential public health impact of this environmental agent argue strongly for addressing further research in order to identify mechanisms of action on biological systems, to define the proper assessment of exposure and to obtain good epidemiological evidence.

Adolescent↗

[Pulmonary manifestations of systemic scleroderma: pathophysiologic and clinical significance of the activation of lung fibroblasts].

Fibrosing alveolitis (FA) is a common and often fatal complication of systemic sclerosis (SSC). The purpose of this study was to characterize the fibrotic process within the lungs using bronchoalveolar lavage fluid (BALF). We investigated 25 healthy controls (CON) and 85 SSC patients. In 61 patients (72%) lung function tests, clinical, and radiological findings indicated manifest FA, whereas 24 patients (28%) where free of significant lung disease. Of the latter, 12 had pathologic BAL differential cell counts (= subclinical alveolitis; SUB), 12 had normal BAL cytology (NOR). BAL samples were analysed for chemoattractant activity (CAA) for fibroblasts using Boyden chambers. Procollagen-III-Peptide (P-III-P) and Laminin fragment P1 (Lam-P1) were measured radioimmunologically. CAA (expressed as % of the effect of conditioned medium) was increased in FA and SUB (CON: 17.3 +/- 3.2; FA: 40.8 +/- 5.8, p < 0.01 vs. CON; SUB: 58.6 +/- 11.8, p < 0.01 vs. CON; NOR: 23.7 +/- 6.3; n.s.). Lam-P1 [U/ml ELF] was also elevated in FA and SUB patients (CON: 0.90 +/- 0.17; FA: 2.07 +/- 0.48, p < 0.05 vs. CON; SUB: 2.61 +/- 1.14, p < 0.05 vs. CON; NOR: 1.05 +/- 0.35, n.s. vs. CON). P-III-P [U/ml ELF] was elevated in FA patients (CON: 8.3 +/- 1.1; FA: 26.9 +/- 5.5, p < 0.001 vs. CON) but not in SUB or NOR (SUB: 10.2 +/- 0.7, NOR: 7.9 +/- 2.9; n.s.). There was no significant relationship between P-III-P and LAM-P1 values in ELF and serum, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Subcutaneously administered recombinant interferon-gamma in humans: pharmacokinetics and effects on chemiluminescence responses of alveolar macrophages, blood neutrophils, and monocytes.

A Phase I trial was conducted to investigate the clinical toxicity, pharmacokinetics, and chemiluminescence (CL) responses of alveolar macrophages (AMs), peripheral blood neutrophils, and monocytes after subcutaneous injection of recombinant interferon-gamma (rIFN-gamma). Six patients with lung cancer received rIFN-gamma subcutaneously as single doses of 0.2, 0.6, and 1.8 mg. Bronchoalveolar lavage was performed three times: 21 h before as well as 6-7 and 27 h after injection. Serum samples were taken five times during the 27-h follow-up. IFN concentrations were measured from alveolar epithelial lining fluid (ELF) and serum by using an antiviral bioassay. IFN-gamma was not detectable in ELF after subcutaneous injection. AMs did not effect an increase in CL responses to N-formyl-methionyl-leucyl-phenylalanine or to phosphate-buffered saline. Circulating IFN-gamma was detectable at 3-12 h after an injection of 1.8 mg of rIFN-gamma, the highest dose given. CL responses of peripheral blood monocytes increased in all patients after injection, whereas the responses of neutrophils were less clear-cut. All patients developed systemic side effects such as transient fever, nausea, headaches, and flu-like symptoms. The findings suggest that rIFN-gamma passes poorly from the blood to the pulmonary alveoli. On the basis of this and our previous findings of increased CL responses in AMs and measurable IFN concentrations in ELF after inhalation of rIFN-gamma, we recommend inhalation rather than the parenteral route of IFN-gamma for the treatment of respiratory diseases.

Adult↗

Respiratory tract lining fluid antioxidants: the first line of defence against gaseous pollutants.

All tissues are vulnerable to oxidant damage, but by virtue of its location, anatomy and function, the epithelial surface of the lung is one of the most vulnerable targets in the body. Recent studies have shown that epithelial lining fluid (ELF), a thin layer of fluid which covers the epithelial surface of the respiratory tract, contains an interesting complement of antioxidants, some of which, like glutathione, are present in concentrations much higher than those found in plasma. It is likely that ELF forms the first line of defence against inhaled toxins such as ozone and nitrogen dioxide. By employing an ex vivo exposure system we have demonstrated that when lung lining fluid is in contact with environmentally relevant concentrations of ozone or nitrogen dioxide, there is differential consumption of the water-soluble antioxidants in the order, uric acid > ascorbic acid >> glutathione. Given that the majority of ozone and nitrogen dioxide reacts within the ELF compartment, the antioxidant composition of this fluid is critically important in determining an individual's sensitivity to gaseous pollutants.

Air Pollutants↗

Calcium, potassium, urea and total protein are not reliable dilutional markers of bronchoalveolar small volume-lavages in ventilated preterm human neonates.

In order to better understand the lung pathology in neonates, more information on basic parameters and their usefulness as dilutional markers in epithelial lining fluid (ELF) is desirable. In this study we determined the amounts of calcium (Ca++), potassium (K+), total protein, albumin and urea in specimens, obtained by small volume lavage, and also in serum from premature infants, who have and have not had surfactant treatment. None of the serum/lavage ratios of these parameters generally increased the correlation between the serum and lavage values of the other parameters and all were thus unreliable markers for the calculation of the dilution of lung ELF as recovered by the small volume lavage procedure. However, the consistently different magnitudes of these ratios appeared to allow gross estimates of the relative concentrations of these parameters between one another. On the basis of a serum/lavage ratio for urea of 1, K+ and Ca++ were concentrated in ELF by a factor of 2 in relation to serum, whereas the protein concentration was 2-3 times lower than in serum. Generally it appears most appropriate to express the results obtained in analyses of lavages either as the uncorrected concentrations per ml recovered lavage fluid or as the ratio of two parameters simultaneously determined in the lavage. In this study, except for marginally increased Ca++ concentrations during the first days of life in surfactant treated neonates, no differences were noted for K+, urea or protein between neonates treated with surfactant or without.

Biomarkers↗

[Advanced gastric cancer curatively resected following combined neoadjuvant chemotherapy--report of a case].

An advanced gastric cancer patient with T3N1M0 successfully underwent a curatively total gastrectomy combined with distal pancreatectomy and lymphnode dissection following ELF-P combined chemotherapy. The patient received two courses of etoposide (75 mg/m2, Day 1-5, i.v.), leucovorin (30 mg/body, Day 2-5, i.v.), 5-FU (500 mg/m2, Day 2-5, i.v.) and CDDP (60 mg/m2, Day 1, i.v.). A partial response for the primary lesion and lymphnode metastasis was obtained, and a successful curative resection of the stomach was performed. No drug adverse responses occurred. The effect of ELF-P chemotherapy was confirmed with grade 1b by histopathological examinations. Neoadjuvant chemotherapy with ELF-P may be useful as an inductive approach for advanced gastric cancer.

Adenocarcinoma↗

Confocal multilaser focusing and single-laser characterization of ultraviolet excitable stains of cellular preparations.

BACKGROUND: The aims of this study were (1) to realign cellular preparations when spots and structures are excited by different lasers of a confocal laser scanning microscope (multilaser studies); (2) to avoid the use of realigment methods by selecting fluorochromes that can be excited by only one laser (single-laser experiments). METHODS: In multilaser studies, we used propidium iodide fluorescent beads, as well as tetramethyl rhodamine isothiocyanate (TRITC), fluorescein isothiocyanate (FITC), and 4'-6 diamidino-2-phenylindole (DAPI)-stained human cancer lines. They were excited using HeNe, argon, and ultraviolet (UV) argon laser lines of a confocal laser scanning microscope. Single-laser experiments using UV excitation only were performed using europium as a model for magnetic resonance paramagnetic contrast agents. Nuclei of human cancer lines and tissue were counterstained by DAPI and cytoplasms were labeled with ELF-97 substrates. Factor analysis of medical images (FAMIS) and correlation methods were used to realign shifted images, focus images, and characterize each fluorochrome when necessary. RESULTS: In multilaser studies, superimposition of factor images corrected Z shifts and correlation methods provided X, Y correction values. In single-laser experiments, each fluorochrome was clearly distinguished in the group of fluorochromes. Estimated images in both studies showed colocalizations of structures. CONCLUSIONS: It is possible to characterize differences in the focus and alignment of fluorescent probes and to correct them. It is also possible to study colocalization of UV excitable fluorochromes (DAPI, ELF-97, europium) in cellular and tissular preparations via multilaser or single-laser experiments.

Europium↗

Genotoxicity of radiofrequency radiation. DNA/Genetox Expert Panel.

During the past several years, concerns have been raised regarding the potential adverse effects of exposures to nonionizing radiation, particularly in the extremely low frequency (ELF) range (50 to 60 MHz) and radiofrequency radiation (RFR) with frequencies ranging from 30 KHz to 30,000 MHz. One focus of concern has been potential DNA interactions. Publications reviewing the genotoxicity of ELF radiation [McCann et al. (1993): Mutat Res 297(1):61-95; Murphy et al. (1993): Mutat Res 296:221-240; NAS (1997)], have been uniform in concluding that the weight of evidence does not indicate any genotoxic risk from exposure to this type of radiation. Concern that RFR may be associated with adverse biological effects [WHO, 1993], including recent allegations that they may be involved in the production of brain tumors in humans [Elmer-Dewit (1993): Time, February 8:42], has resulted in the production of a large number of publications describing the effects of RFR on the integrity of nucleic acids. Data from studies conducted in a frequency range from 800 to 3,000 MHz were reviewed and subjected to a weight-of-evidence evaluation. The evaluation focused on direct toxicological effects of RFR as well as on studies addressing basic biological responses to RFR at the cellular and molecular level. The data from over 100 studies suggest that RFR is not directly mutagenic and that adverse effects from exposure of organisms to high frequencies and high power intensities of RFR are predominantly the result of hyperthermia; however, there may be some subtle indirect effects on the replication and/or transcription of genes under relatively restricted exposure conditions.

Animals↗

Elevation of interleukin-8 and interleukin-6 precedes the influx of neutrophils in tracheal aspirates from preterm infants who develop bronchopulmonary dysplasia.

The influx of inflammatory mediators and cells into the tracheobronchial effluent of preterm infants with respiratory distress syndrome (RDS) appears to be important in signaling the development of bronchopulmonary dysplasia (BPD). The mechanism that initiates this early inflammatory response is not well understood. The purpose of this study was to test the hypothesis whether increased interleukin-8 (IL-8), a potent chemoattractant for human neutrophils, appears in the airways of preterm infants with RDS in whom BPD develops before the influx of neutrophils. In addition, airway secretions were analyzed for the cytokine interleukin-6 (IL-6) to test the hypothesis whether this pro-inflammatory cytokine is an early marker of inflammation in preterm infants with RDS who progress to BPD. Sixty-five infants less than 32 weeks gestation with RDS were enrolled on the first day of life and 56 infants completed the study, with 31 recovering from RDS (Non-BPD) and 25 infants progressing to BPD. Infants were excluded from enrollment in the presence of maternal chorioamnionitis, infection at birth, or infection within the first week of life. There were no significant differences in birthweight, gestational age, or prolonged rupture of membranes between the two groups. Serial tracheal aspirates (TA) were collected on days 1, 3, 5, and 7 while the infants remained intubated. Significant elevations of TA neutrophil counts were detected in the BPD group on days 5 and 7. Cell-free TA revealed marked elevations of IL-8 in the BPD group compared to the Non-BPD group [median (25th percentile, 75th percentile), ng/ml epithelial lining fluid (ELF)] on day 1 [BPD 485 (195, 840); Non-BPD 63.1 (28.3, 197), P < 0.05] and day 3 [BPD 740 (319, 1310); Non-BPD 111 (54.3, 337); P < 0.05], while on days 5 and 7, the differences were not statistically significant. Interleukin-6 (IL-6) was measured as a marker of acute inflammation and was not different in the two groups on day 1, but was significantly elevated on day 3 [median (25th percentile, 75th percentile), ng/ml ELF; BPD 297 (62.1, 702); Non-BPD 72 (32.8, 266), P < 0.05] and on day 5 [BPD 270 (136, 672); Non-BPD 86.4 (57.8, 138), P < 0.05]. These studies demonstrate that elevation of IL-8 and IL-6 levels precedes the marked neutrophil influx seen in the TA of preterm infants in whom BPD develop. The presence of IL-8 and IL-6 in TA from these infants suggests that these cytokines either initiate the acute inflammatory cascade in the lungs, or they are early markers of the inflammatory process that places preterm infants at high risk for BPD.

Biomarkers↗

Behavioural evidence that magnetic field effects in the land snail, Cepaea nemoralis, might not depend on magnetite or induced electric currents.

Although extremely low frequency (ELF) magnetic fields (<300 Hz) appear to exert a variety of biological effects, the magnetic field sensing/transduction mechanism(s) remains to be established. Here, using the inhibitory effects of magnetic fields on endogenous opioid peptide-mediated "analgaesic" response of the land snail, Cepaea nemoralis, we addressed the mechanism(s) of action of ELF magnetic fields. Indirect mechanisms involving both induced electric fields and direct magnetic field detection mechanisms (e.g., magnetite, parametric resonance) were evaluated. Snails were exposed to a static magnetic field (B(DC) = 78 +/- 1 mu T) and to a 60 Hz magnetic field (B(AC) = 299 +/- 1 mu T peak) with the angle between the static and 60 Hz magnetic fields varied in eight steps between 0 degrees and 90 degrees. At 0 degrees and 90 degrees, the magnetic field reduced opioid-induced analgaesia by approximately 20 percent, and this inhibition was increased to a maximum of 50 percent when the angle was between 50 degrees and 70 degrees. Because B(AC) was fixed in amplitude, direction, and frequency, any induced electric currents would be constant independent of the B(AC)/B(DC) angle. Also, an energy transduction mechanism involving magnetite should show greatest sensitivity at 90 degrees. Therefore, the energy transduction mechanism probably does not involve induced electric currents or magnetite. Rather, our results suggest a direct magnetic field detection mechanism consistent with the parametric resonance model proposed by Lednev.

Animals↗

Miniature-probe measurements of electric fields induced by 60 Hz magnetic fields in rats.

Extremely-low-frequency (ELF) magnetic fields interact with an animal by inducing internal electric fields, which represent the internal dose from an external exposure. In this study, an electric field probe of approximately 2 mm resolution was used to measure fields induced in rat carcasses by a 60 Hz magnetic field at 1 mT. With the rat lying on its side, the probe was inserted through a small hole in the body wall, and scanned at 5 mm increments from the side with frontal and axial exposure (field horizontal) and from the front with lateral exposure (field vertical). The induced electric field declined from a maximum at the entrance to the abdomen and crossed zero to negative (180 degrees phase shift) values within the body as expected. In general, the magnitudes of the measurements inside the abdomen were less than expected from whole-body calculations that used homogeneous-ellipsoidal models of a rat in the three orientations. The low measurements did not appear to be explained by perpendicular field components, by conductivity differences between the tissue and the probe path, or by air in the lungs. The low measurements probably result from inhomogeneities in actual rats that include conductivity differences between tissues and biological membranes. For example, an alternative model considered the abdominal cavity to be electrically isolated from the body by the diaphragm and the peritoneum and calculations from this model were in better agreement with the measurements inside the abdomen (than were the whole-body calculations). Therefore, inhomogeneitics in conductivity and biomembranes such as the peritoneum should be considered in order to fully understand ELF-induced field dosimetry.

Abdomen↗

Difference in frequency spectrum of extremely-low-frequency effects on the genome conformational state of AB 1157 and EMG2 E. coli cells.

The effect of weak extremely-low-frequency (ELF) magnetic fields (sinusoidal, 30 microT amplitude) on the genome conformational state (GCS) of E. coli mutant and wild type cells was studied by using the method of anomalous viscosity time dependency (AVTD) in the 6-37 Hz frequency range. We confirmed the existence of three resonance frequencies of 8.9, 15.5, and 29.4 Hz when mutant cells of K12 AB1157 strain were exposed. In the same frequency range, the wild type K12 EMG2 cells displayed only two effective windows, with resonance frequencies of 8.3 and 27 Hz. The resonance frequencies differed significantly (P < .001-.000001) in the strains studied, whereas other resonance parameters did not. It was concluded that mutations in the AB1157 strain resulted in a significant rearrangement in the ELF action spectrum, including the appearance of a new resonance.

DNA, Bacterial↗

Weak extremely-low-frequency magnetic field-induced regeneration anomalies in the planarian Dugesia tigrina.

We recently reported that cephalic regeneration in the planarian Dugesia tigrina was significantly delayed in populations exposed continuously to combined parallel DC and AC magnetic fields. This effect was consistent with hypotheses suggesting an underlying resonance phenomenon. We report here, in a parallel series of investigations on the same model system, that the incidence of regeneration anomalies presenting as tumor-like protuberances also increases significantly (P < .001) in association with exposure to weak 60 Hz magnetic fields, with peak intensities ranging between 1.0 and 80.0 microT. These anomalies often culminate in the complete disaggregation of the organism. Similar to regeneration rate effects, the incidence of regeneration anomalies is specifically dependent upon the planaria possessing a fixed orientation with respect to the applied magnetic field vectors. However, unlike the regeneration rate effects, the AC magnetic field alone, in the absence of any measurable DC field, is capable of producing these anomalies. Moreover, the incidence of regeneration anomalies follows a clear dose-response relationship as a function of AC magnetic field intensity, with the threshold for induced electric field intensity estimated at 5 microV/m. The addition of either 51.1 or 78.4 microT DC magnetic fields, applied in parallel combination with the AC field, enhances the appearance of anomalies relative to the 60 Hz AC field alone, but only at certain AC field intensities. Thus, whereas our previous study of regeneration rate effects appeared to involve exclusively resonance interactions, the regeneration anomalies reported here appear to result primarily from Faraday induction coupling. These results together with those reported previously point to two distinct physiological effects produced in regenerating planaria by exposure to weak extremely-low-frequency (ELF) magnetic fields. They further suggest that the planarian, which has recently been identified elsewhere as an excellent system for use in teratogenic investigations involving chemical teratogens, might be used similarly in teratogenic investigations involving ELF magnetic fields.

Abnormalities, Radiation-Induced↗

Extremely low frequency magnetic fields can either increase or decrease analgaesia in the land snail depending on field and light conditions.

Results of prior investigations with opioid peptide mediated antinociception or analgaesia have suggested that these extremely low frequency (ELF) magnetic field effects are described by a resonance mechanism rather than mechanisms based on either induced currents or magnetite. Here we show that ELF magnetic fields (141-414 microT peak) can, in a manner consistent with the predictions of Lednev's parametric resonance model (PRM) for the calcium ion, either (i) reduce, (ii) have no effect on, or (iii) increase endogenous opioid mediated analgaesia in the land snail, Cepaea nemoralis. When the magnetic fields were set to parameters for the predictions of the PRM for the potassium ion, opioid-peptide mediated analgaesia increased and there was evidence of antagonism by the K(+) channel blocker, glibenclamide. Furthermore, these effects were dependent on the presence of light; the effects were absent in the absence of light. These observed increases and decreases in opioid analgaesia are largely consistent with the predictions of Lednev's PRM.

Analgesia↗

Strontium selenogermanate(III) and barium selenogermanate(II,IV): synthesis, crystal structures, and chemical bonding

The new selenogermanates Sr2Ge2Se5 and Ba2Ge2Se5 were synthesized by heating stoichiometric mixtures of binary selenides and the corresponding elements to 750 degrees C. The crystal structures were determined by single-crystal X-ray methods. Both compounds adopt previously unknown structure types. Sr2Ge2Se5 (P2(1)/n, a = 8.445(2) A, b = 12.302 A, c = 9.179 A, beta = 93.75(3) degrees, Z = 4) contains [Ge4Se10]8- ions with homonuclear Ge-Ge bonds (dGe-Ge = 2.432 A), which may be described as two ethane-like Se3Ge-GeSeSe2/2 fragments sharing two selenium atoms. Ba2Ge2Se5 (Pnma, a = 12.594(3) A, b = 9.174(2) A, c = 9.160(2) A, Z = 4) contains [Ge2Se5]4- anions built up by two edge-sharing GeSe4 tetrahedra, in which one terminal Se atom is replaced by a lone pair from the divalent germanium atom. The alkaline earth cations are arranged between the complex anions, each coordinated by eight or nine selenium atoms. Ba2Ge2Se5 is a mixed-valence compound with GeII and GeIV coexisting within the same anion. Sr2Ge2Se5 contains exclusively GeIII. These compounds possess electronic formulations that correspond to (Sr2+)2(Ge3+)2(Se2-)5 and (Ba2+)2- Ge2+Ge4+(Se2-)5. Calculations of the electron localization function (ELF) reveal clearly both the lone pair on GeII in Ba2Ge2Se5 and the covalent Ge-Ge bond in Sr2Ge2Se5. Analysis of the ELF topologies shows that the GeIII-Se and GeIV-Se covalent bonds are almost identical, whereas the GeII-Se interactions are weaker and more ionic in character.

Journal Article↗

A single magnetic field exposure system for sequential investigation of real time and downstream cellular responses.

To be able to correlate real time membrane potential or ion flux changes with further downstream gene transcription responses due to extremely low frequency (ELF) electromagnetic field (EMF) exposure, we devised an experimental system consisting of a pair of symmetric circular coils. This system can be used on an inverted microscope stage (real time signaling) as well as inside controlled environment incubators (gene transcription end points). The system includes a unique, custom made switch box for blinding the experimental staff and a power amplifier. We report herein the design and characterization of the system with respect to parameters considered important in in vitro ELF-EMF exposure studies, including linear magnetic field distribution, compensation for microscope objective lens interference, heating effects of the coils, and harmonic content of the signals.

Cell Culture Techniques↗

Extremely low frequency magnetic fields originating from equipment used for assisted reproduction, umbilical cord and peripheral blood stem cell transplantation, transfusion, and hemodialysis.

The extremely low-frequency (ELF) magnetic fields (MFs) originating from equipment used for assisted reproduction, umbilical cord-blood and peripheral-blood stem cell transplantation, transfusion, and hemodialysis were measured. The ELF-MF values were 0.1-1.2 microT on clean benches, <0.1-8.0 microT on inverted microscopes, <0.1-13.6 mmicroT in CO2 incubators, 4.3-11.5 microT in centrifuges, 0.4-18.8 microT in programmed freezers, <0.1-0.3 microT in deep freezers, 0.3-3.1 microT on cell separators, and 0.2-0.9 microT in hemodialysers. Frequencies of MFs were nominally 60 Hz, but some devices showed non-sinusoidal 120 Hz. Such MFs can be reduced by shielding the sources or altering the protocols employed.

Blood Transfusion↗