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Optimal preoperative therapy regimen in the treatment of resectable retroperitoneal sarcoma (RPS) remains unclear. This study compares the impact of preoperative radiation, chemoradiation and chemotherapy on overall survival (OS) in RPS patients.
Materials and Methods:
The National Cancer Database (NCDB) was queried for patients with non-metastatic, resectable RPS (2006–15). The primary endpoint was OS, evaluated by Kaplan–Meier method, log-rank test, Cox multivariable analysis and propensity score matching.
Results:
A total of 1,253 patients met the inclusion criteria, with 210 patients (17%) receiving chemoradiation, 850 patients (68%) receiving radiation and 193 patients (15%) receiving chemotherapy. On Cox multivariable analysis, when compared to preoperative chemoradiation, preoperative radiation was not associated with improved OS (hazards ratio [HR] 0·98, 95% CI 0·76–1·25, p = 0·84), while preoperative chemotherapy was associated with worse OS (HR 1·64, 95% CI 1·24–2·18, p < 0·001). Similar findings were observed in 199 and 128 matched pairs for preoperative radiation and chemotherapy, respectively, when compared to preoperative chemoradiation.
Findings:
Our study suggested an OS benefit in using preoperative chemoradiation compared to chemotherapy alone, but OS outcomes were comparable between preoperative chemoradiation and radiation alone.
Background: Despite efforts toward gender equality in clinical trial enrollment, females are frequently underrepresented and gender-specific data analysis is often unavailable. The purpose of this study was to determine if gender equality exists in the management of degenerative lumbar disease. Methods: Part 1: A systematic scoping review was conducted according to PRISMA guidelines, in order to synthesize the adult surgical literature regarding gender differences in pre- and post-operative clinical assessment scores for patients diagnosed with degenerative lumbar disease.
Part 2: An ambispective cohort analysis (multi-variate logistic regression) of the Canadian Spine Outcomes Research Network registry was performed to address knowledge gaps identified in “Part 1”. Results: Part 1: Thirty articles were identified, accounting for 32,951 patients. Female patients have worse absolute pre-operative pain, disability and health-related quality-of-life (HRQoL). Following surgery, females have worse absolute pain, disability, and HRQoL, but demonstrate an equal or greater interval change compared to males.
Part 2: Data was analyzed for 5,039 patients. Significant gender differences in pre-operative utilization of healthcare resources (medication use, diagnostic testing, medical and allied healthcare professional visits) were identified. Conclusions: Significant gender disparities in clinical assessment scores and the pre-operative utilization of healthcare resources were identified for patients undergoing surgery for degenerative lumbar disease.
Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been discovered in Wuhan and spread rapidly across China and worldwide. Characteristics of infected patients are needed to get insight into the full spectrum of the disease.
Methods:
Epidemiological and clinical information of 1738 diagnosed patients during February 7-26, 2020 in Wuhan Dongxihu Fangcang Hospital were analyzed. A total of 709 patients were followed up on symptom, mental health, isolation site, and medication after discharge.
Results:
There were 852 males and 886 females in the cohort. The average age of the patients was 48.8 y. A total of 79.98% of the patients were from Wuhan, Hubei Province. The most common initial symptoms were fever, cough, and shortness of breath. Among all the patients, 1463 had complications, with respiratory distress as the most common complication. The average duration of hospitalization was 15.95 ± 14.69 d. The most common postdischarge symptom is cough. After discharge, most patients were full of energy and chose hotel as their self-isolation site. Coronavirus disease 2019 (COVID-19) Chinese medicine No.2 prescription is the medication used most commonly by the patients after discharge.
Conclusions:
The population is generally susceptible to SARS-CoV-2. After receiving aggressive treatment of combined Chinese and Western medicine, most patients had a good prognosis and mental health after discharge.
Induction chemotherapy (iC) followed by concurrent chemoradiation has been shown to improve overall survival (OS) for locally advanced pancreatic cancer (LAPC). However, the survival benefit of stereotactic body radiation therapy (SBRT) versus conventionally fractionated radiation therapy (CFRT) following iC remains unclear.
Materials and methods:
The National Cancer Database (NCDB) was queried for primary stage III, cT4N0-1M0 LAPC (2004–15). Kaplan–Meier analysis, Cox proportional hazards method and propensity score matching were used.
Results:
Among 872 patients, 738 patients underwent CFRT and 134 patients received SBRT. Median follow-up was 24·3 and 22·9 months for the CFRT and SBRT cohorts, respectively. The use of SBRT showed improved survival in both the multivariate analysis (hazards ratio 0·78, p = 0·025) and 120 propensity-matched pairs (median OS 18·1 versus 15·9 months, p = 0·004) compared to the CFRT.
Findings:
This NCDB analysis suggests survival benefit with the use of SBRT versus CFRT following iC for the LAPC.
This National Cancer Database (NCDB) analysis was performed to evaluate the outcomes of adjuvant chemotherapy (AC) versus observation for resected pancreatic adenocarcinoma treated with neoadjuvant therapy (NT).
Materials and methods:
The NCDB was queried for primary stages I–II cT1-3N0-1M0 resected pancreatic adenocarcinoma treated with NT (2004–2015). Baseline patient, tumour and treatment characteristics were extracted. The primary end point was overall survival (OS). With a 6-month conditional landmark, Kaplan–Meier analysis, multivariable Cox proportional hazards method and 1:1 propensity score matching was used to analyse the data.
Results:
A total of 1,737 eligible patients were identified, of which 1,247 underwent post-operative observation compared to 490 with AC. The overall median follow-up was 34·7 months. The addition of AC showed improved survival on the multivariate analysis (HR 0·78, p < 0·001). AC remained statistically significant for improved OS, with a median OS of 26·3 months versus 22·3 months and 2-year OS of 63·9% versus 52·9% for the observation cohort (p < 0·001). Treatment interaction analysis showed OS benefit of AC for patients with smaller tumours.
Findings:
Our findings suggest a survival benefit for AC compared to observation following NT and surgery for resectable pancreatic adenocarcinoma, especially in patients with smaller tumours.
In this paper, mathematical models of kinematics, statics and inverse dynamics are derived firstly according to the mechanical structure of leg hydraulic drive system (LHDS). Then, all the above models are integrated with MATLAB/Simulink to build the LHDS simulation model, the model not only considers influence of leg dynamic characteristics on hydraulic system but also takes into account nonlinearity, variable load characteristics and other common problems brought by hydraulic system, and solves compatibility and operation time which brought by using multiple software simultaneously. The experimental results show the simulation model built in this paper can accurately express characteristics of the system.
A novel ionic liquid/α-ZrP (C16MIM/α-ZrP) lamellar nanocomposite was fabricated via the electrostatic self-assembly deposition technique by using exfoliated α-ZrP nanosheets and guest molecules (1-hexadecyl-3-methylimidazolium bromide) as building blocks under mild conditions. C16MIM/α-ZrP nanocomposite was characterized by various analytical techniques such as X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscope (SEM), Fourier transform infrared spectroscopy, and synchronous thermal analyzer. The net interlayer spacing of α-ZrP determined by XRD confirmed that the C16MIM cations formed a monolayer arrangement between the α-ZrP nanosheets. The morphology and microstructure of C16MIM/α-ZrP composite were observed using SEM and TEM. The C16MIM/α-ZrP modified glass carbon electrode exhibited excellent electrocatalytic activity toward the oxidation of nitrite in weak base media. The results obtained with differential pulse voltammetry demonstrated that the C16MIM/α-ZrP hybrid detected nitrite linearly in the concentration range from 7.3 μM to 1.25 mM with the detection limit of 1.26 μM (S/N = 3). Additionally, the prepared sensor showed outstanding reproducibility, high stability, and anti-interference capability.
Since the outbreak of 2019 novel coronavirus (2019-nCoV) infection in Wuhan City, China, pediatric cases have gradually increased. It is very important to prevent cross-infection in pediatric fever clinics, to identify children with fever in pediatric fever clinics, and to strengthen the management of pediatric fever clinics. According to prevention and control programs, we propose the guidance on the management of pediatric fever clinics during the nCoV pneumonia epidemic period, which outlines in detail how to optimize processes, prevent cross-infection, provide health protection, and prevent disinfection of medical staff. The present consideration statement summarizes current strategies on the pre-diagnosis, triage, diagnosis, treatment, and prevention of 2019-nCoV infection, which provides practical suggestions on strengthening the management of pediatric fever clinics during the nCoV pneumonia epidemic period.
To investigate the difference of visual pattern memory among first-episode treatment-naive patients with deficit and nondeficit schizophrenia.
Methods:
199 first-episode treatment-naive patients with schizophrenia, and 148 controls were recruited. Schedule for the Deficit Syndrome (SDS) was used to categorize the patients into deficit or nondeficit subtype. Pattern Recognition Memory (PRM) was used to test the immediate and delayed mode of visual pattern memory. Positive and Negative Symptom Scale PANSS was used to assess the degree of patients symptoms.
Results:
The PRM immediate mode and delayed mode percent correct was significant lower and time latency was significant longer in two subtypes of patients. There were no significant difference in the performance of immediate mode of PRM between deficit and nondeficit patients[(86.49 ± 15.34) vs. (87.28 ± 16.00), P=0.960]. But the impairment was more severe in patients with deficit schizophrenia [percent correct (63.10 ± 19.17) vs. (70.69 ± 15.34), P< 0.001 time latency 5086.80 ± 7528.54 vs. 3527.40 ± 3649.08 P=0.024] in the delayed mode. and PRM has no significant correlation with the negative symptoms of deficit schizophrenia.
Conclusion:
There were significant difference in the performance of immediate and delayed mode of PRM between patients and controls. The difference between first-episode treatment-naïve deficit schizophrenia and nondeficit schizophrenia was only in delayed mode of PRM, and has no correlation with the primary negative symptoms. The deficit schizophrenia is a subtype of schizophrenia with unique impairment of cognitive functions.
Tuberculosis (TB) is generally considered a disease that principally afflicts the low-income segments of a population. In the Nanshan District of Shenzhen, China, with the economic transformation and a new Headquarters Economy (HE) emerging, there are now more cases in office workers than in manufacturing workers. To illustrate this trend, we describe a small TB outbreak in an office building located in the centre of the rapidly growing HE district. Two active pulmonary tuberculosis cases were found in workers who shared an office, and whole genome sequencing showed that the genetic distance between the strains of the two cases was just one single nucleotide polymorphism, consistent with intra-office transmission. Investigation of 30 other workers in the same or adjacent offices with interviews, interferon-gamma release assays (IGRAs) and chest X-rays, identified one new TB case and latent tuberculosis infection (LTBI) in 40.0% (12/30) of the contacts. The offices were under-ventilated. None of the IGRA positive, asymptomatic contacts agreed to receive treatment for LTBI, presumably due to TB stigma, and over the next 2 years 69.0% (20/29) of the contacts were lost to follow-up. Treatment for LTBI and stigma of TB remain challenges here. Office workers in the HE of rapidly economic developing areas should be targeted with increased vigilance by TB control programmes.
In the three-phase (pure donor, pure acceptor, and mixed phases) morphologies of organic solar cells, the mixed phases produce an energy cascade that promotes the generation of free carriers. However, how to optimize the content of the mixed phases is a challenging problem. The authors proposed to control different content of mixed phases in DRTB-T and IDIC blends by additive and solvent vapor annealing (SVA). The authors first formed the largest extent amount of mixed phases by the additive cinene (2%) to inhibit the crystallization of DRTB-T and IDIC. And then, different amounts of mixed phases were achieved by further SVA for different times (from 0 to 50 s) to increase the content of pure DRTB-T and IDIC phases. The energetic offsets (ΔE) of pure and mixed phases gradually decrease from 0.529 to 0.477 eV for different content of mixed phases. When ΔE was 0.498 eV, the highest photocurrent density (Jsc) was obtained. The power conversion efficiency was increased from 3.23% (without any treatment) to 8.54%. Therefore, the authors demonstrated that the optimized content of the mixed phases is critical to device performance.
The carbon isotope value of ethane in the southern part of the Jingbian gas field is lower than that in the northern part, indicating a carbon isotopic reversal in the southern Jingbian gas field (δ13Cmethane > δ13Cethane). Through comparing the geochemical characteristics of gases in the southern and northern parts of the gas field, the reasons for the carbon isotopic reversal in the southern Jingbian gas field were determined to be high thermal maturity and mixing action. When thermal maturity reaches a critical value, the carbon isotope value of ethane becomes relatively more depleted with thermal maturity. Although the carbon isotope value of methane increases with thermal maturity, the extent is relatively smaller. Finally, the rare phenomenon of δ13Cmethane > δ13Cethane occurs. High thermal maturity leads to the secondary thermal cracking of gases. Mixing of the cracked gases and primary gases also leads to carbon isotopic reversal. Both of the above mechanisms share a common premise, which is high thermal maturity.
Graded epistemic logic is a logic for reasoning about uncertainties. Graded epistemic logic is interpreted on graded models. These models are generalizations of Kripke models. We obtain completeness of some graded epistemic logics. We further develop dynamic extensions of graded epistemic logics, along the framework of dynamic epistemic logic. We give an extension with public announcements, i.e., public events, and an extension with graded event models, a generalization also including nonpublic events. We present complete axiomatizations for both logics.
Visual stimuli can be useful in supporting design ideation process. However, researchers still know very little about how stimuli should be delivered to designers during the early design stage. This question is crucial to the effective use of stimuli because previous researches have proved that ill-presented stimuli can have a negative impact on design creativity. Therefore, an empirical study was conducted with the aim of exploring if and how combinational pictorial stimuli can affect designers' creative performance. Results from a total of 36 participants show that the design outcomes presented by the group exposed to combinational pictorial stimuli were more creative than those given by the group exposed to no stimuli or randomly presented pictorial stimuli. These results imply that the form of stimuli delivery can affect creative design outcomes and combinational pictorial stimuli best support design creativity among these three conditions. These findings give us a better understanding of the roles that visual stimuli play in design, which is expected to bring us important implications for both design education and design support tool development
This study examined Echinococcus spp. genotypes and genetic variants isolated from humans as well as domestic and wild animals from the Qinghai-Tibetan Plateau Area using the cox1 gene. All samples except the pika isolates were identified as the Echinococcus granulosus sensu stricto. Sixteen different haplotypes with considerable intraspecific variation were detected and characterized in mitochondrial cox1 sequences. The parsimonious network of cox1 haplotypes showed star-like features, and the neutrality indexes computed via Tajima's D and Fu's Fs tests showed high negative values in E. granulosus s. s., indicating deviations from neutrality; the Fst values were low among the populations, implying that the populations were not genetically differentiated. The pika isolates were identified as E. multilocularis and E. shiquicus. Only one haplotype was recognized in the pika isolates. E. granulosus s. s. was the predominant species found in animals and humans, followed by E. multilocularis and E. shiquicus, with high genetic diversity circulating among the animals and humans in this area. Further studies are needed to cover many sample collection sites and larger numbers of pathogen isolates, which may reveal abundant strains and/or other haplotypes in the hydatid cysts infecting human and animal populations of the QTPA, China.
Surface modification with poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) is an effective method for improving hemocompatibility. Peptide GREDVY immobilized on Ti is of great benefit to endothelialization. Micropattern of PMPC and GREDVY can regulate cells distribution, behaviors, and nitric oxide (NO) release. Copper can be used as catalytic to release NO from a donor in vitro, which can inhibit platelets adhesion, activation, and aggregation. The Ti-PDA(Cu)-M/R(P) micropattern was fabricated with PMMPC-HD {PMMPC [monomer contain MPC and methacrylic acid (MA)] was cross-linked with hexamethylene diamine} and peptide Gly-Arg-Glu-Asp-Val-Tyr (GREDVY) using PDMS stamp, and it was characterized by SEM, FTIR, and XPS. The results demonstrated that the PMPC and peptide GREDVY were immobilized onto polydopamine successfully. Simultaneously, the copper existed in polydopamine was confirmed by XPS. The rate of NO release in vitro catalyzed by copper ions was 1.5–5.3 × 10−10 mol/(cm2 min). It will be beneficial to inhibiting platelets adhesion and proliferation of ECs.
Underground Nuclear Astrophysics in China (JUNA) will take the advantage of the ultra-low background in Jinping underground lab. High current accelerator with an ECR source and detectors were commissioned. JUNA plans to study directly a number of nuclear reactions important to hydrostatic stellar evolution at their relevant stellar energies. At the first period, JUNA aims at the direct measurements of 25Mg(p,γ)26 Al, 19F(p,α) 16 O, 13C(α, n) 16O and 12C(α,γ) 16O near the Gamow window. The current progress of JUNA will be given.
Conventional underwater navigation and positioning methods for Autonomous Underwater Vehicles (AUVs) either require the installation of acoustic arrays, which make AUVs less independent, or result in cumulative errors. This paper proposes an Underwater Terrain Positioning Method (UTPM) using Maximum a Posteriori (MAP) estimation and a Pulse Coupled Neural Network (PCNN) model for highly accurate navigation by AUVs. The PCNN model is used as a secondary discriminant to effectively identify pseudo-anchor points in flat terrain feature areas and to find the true positioning point, which significantly improves the matching positioning accuracy in these areas. Simulation results show that the proposed method effectively corrects Inertial Navigation System (INS) cumulative errors and has high matching positioning accuracy, which satisfy the requirements of AUV underwater navigation and positioning.
Water-based polyurethane/alumina hollow microsphere (WPU-hAl2O3) composite films were prepared via a facile spin coating method. The pristine WPU, as the matrix of the composite films, was tailor-made by hAl2O3 with the diameter of 2–5 μm to improve the mechanical and physical properties of the films. The hardness, surface morphology, infrared emissivity, wettability, and light transmittance of the WPU-hAl2O3 films with different hAl2O3 contents were investigated. The results indicate that the Vickers hardness, coefficient of friction, infrared emissivity at the wavelength of 2–22 μm, and wetting angle of the WPU-hAl2O3 films (30 wt%) increased by 53.6%, 51.7%, 21.1%, and 19.0%, respectively, compared with the pristine WPU films. Meanwhile, with the rising of hAl2O3 content, the light transmittance decreased by 75.3% at the wavelength of 400–800 nm. This work not only designs a kind of lightweight multifunctional composite film but also provides an effective route for extending further applications of hAl2O3 in the field of composite films.