Background
The efficacy of surgical resection for gastric cancer liver metastases (GCLMs) is currently debated. Hitherto, no large‐scale clinical studies have been conducted.
Methods
This ...retrospective multicentre study analysed a database of consecutive patients with either synchronous or metachronous metastases who underwent surgical R0 resection for GCLM between 1990 and 2010. Clinical data were collected from five cancer centres in Japan. Survival curves were assessed, and clinical parameters were evaluated to identify predictors of prognosis.
Results
A total of 256 patients were enrolled. The mean(s.d.) number of hepatic tumours resected was 2·0(2·4). The surgical mortality rate was 1·6 per cent. Median follow‐up was 65 (range 1–261) months. Recurrences were detected in 192 patients (75·0 per cent). The median interval from hepatic resection to recurrence was 7 (range 1–72) months, and the dominant site of recurrence was the liver (72·4 per cent). Actuarial 1‐, 3‐ and 5‐year overall and recurrence‐free survival rates were 77·3, 41·9 and 31·1 per cent, and 43·6, 32·4 and 30·1 per cent, respectively. Median overall and recurrence‐free survival times were 31·1 and 9·4 months respectively. Multivariable analysis identified serosal invasion of the primary gastric cancer (hazard ratio (HR) 1·50; P = 0·012), three or more liver metastases (HR 2·33; P < 0·001) and liver tumour diameter at least 5 cm (HR 1·62; P = 0·005) as independent predictors of poor survival.
Conclusion
Clinically resectable GCLM is rare, but strict and careful patient selection can lead to long‐term survival following R0 surgical resection.
Justified in selected patients
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
In preparation for the fifth Assessment Report (AR5) of the Intergovernmental Panel on Climate Change (IPCC), the international community is developing new advanced Earth System Models (ESMs) to ...assess the combined effects of human activities (e.g. land use and fossil fuel emissions) on the carbon-climate system. In addition, four Representative Concentration Pathway (RCP) scenarios of the future (2005–2100) are being provided by four Integrated Assessment Model (IAM) teams to be used as input to the ESMs for future carbon-climate projections (Moss et al.
2010
). The diversity of approaches and requirements among IAMs and ESMs for tracking land-use change, along with the dependence of model projections on land-use history, presents a challenge for effectively passing data between these communities and for smoothly transitioning from the historical estimates to future projections. Here, a harmonized set of land-use scenarios are presented that smoothly connects historical reconstructions of land use with future projections, in the format required by ESMs. The land-use harmonization strategy estimates fractional land-use patterns and underlying land-use transitions annually for the time period 1500–2100 at 0.5° × 0.5° resolution. Inputs include new gridded historical maps of crop and pasture data from HYDE 3.1 for 1500–2005, updated estimates of historical national wood harvest and of shifting cultivation, and future information on crop, pasture, and wood harvest from the IAM implementations of the RCPs for the period 2005–2100. The computational method integrates these multiple data sources, while minimizing differences at the transition between the historical reconstruction ending conditions and IAM initial conditions, and working to preserve the future changes depicted by the IAMs at the grid cell level. This study for the first time harmonizes land-use history data together with future scenario information from multiple IAMs into a single consistent, spatially gridded, set of land-use change scenarios for studies of human impacts on the past, present, and future Earth system.
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CEKLJ, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
T-cell infiltration in tumors has been used as a prognostic tool in non-small-cell lung cancer (NSCLC). However, the influence of smoking habit and histological type on tumor-infiltrating lymphocytes ...(TILs) in NSCLC remains unclear.
We evaluated the prognostic significance of TILs (CD4+, CD8+, CD20+, and FOXP3+) according to histological type and smoking habit using automatic immunohistochemical staining and cell counting in 218 patients with NSCLC.
In multivariate survival analyses of clinical, pathological, and immunological factors, a high ratio of FOXP3+ to CD4+ T cells (FOXP3/CD4) hazard ratio (HR): 4.46, P < 0.01 for overall survival (OS); HR: 1.96, P < 0.05 for recurrence-free survival (RFS) and a low accumulation of CD20+ B cells (HR: 2.45, P = 0.09 for OS; HR: 2.86, P < 0.01 for RFS) were identified as worse prognostic factors in patients with adenocarcinoma (AD). In non-AD, a low number of CD8+ T cells were correlated with an unfavorable outcome (HR: 7.69, P < 0.01 for OS; HR: 3.57, P < 0.02 for RFS). Regarding smoking habit in AD, a high FOXP3/CD4 ratio was poorly prognostic with a smoking history (HR: 5.21, P < 0.01 for OS; HR: 2.38, P < 0.03 for RFS), whereas a low accumulation of CD20+ B cells (HR: 4.54, P = 0.03 for OS; HR: 2.94, P < 0.01 for RFS) was confirmed as an unfavorable factor in non-smokers with AD.
A low number of CD8+ T cells in non-AD, a high FOXP3/CD4 ratio in smokers with AD, and a low number of CD20+ B cells in non-smokers with AD were identified as independent unfavorable prognostic factors in resected NSCLC. Evaluating the influence of histological type and smoking habit on the immunological environment may lead to the establishment of immunological diagnosis and appropriate individualized immunotherapy for NSCLC.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
We investigate rates of pathologic complete response (pCR) and tumor expression of ER, PgR, HER2 discordance after neoadjuvant chemotherapy using Japanese breast cancer registry data.
Records of more ...than 300 000 breast cancer cases treated at 800 hospitals from 2004 to 2013 were retrieved from the breast cancer registry. After data cleanup, we included 21 755 patients who received neoadjuvant chemotherapy and had no distant metastases. pCR was defined as no invasive tumor in the breast detected during surgery after neoadjuvant chemotherapy. HER2 overexpression was determined immunohistochemically and/or using fluorescence in situ hybridization.
pCR was achieved in 5.7% of luminal tumors (n = 8730), 24.6% of HER2-positive tumors (n = 4403), and 18.9% of triple-negative tumors (n = 3660). Among HER2-positive tumors, pCR was achieved in 31.6% of ER-negative tumors (n = 2252), 17.0% of ER-positive ones (n = 2132), 31.4% of patients who received trastuzumab as neoadjuvant chemotherapy (n = 2437), and 16.2% of patients who did not receive trastuzumab (n = 1966). Of the 2811 patients who were HER2-positive before treatment, 601 (21.4%) had HER2-negative tumors after neoadjuvant chemotherapy, whereas 340 (3.4%) of the 9947 patients with HER2-negative tumors before treatment had HER2-positive tumors afterward. Of the 10 973 patients with ER-positive tumors before treatment, 499 (4.6%) had ER-negative tumors after neoadjuvant chemotherapy, whereas 519 (9.3%) of the 5607 patients who were ER-negative before treatment had ER-positive tumors afterward.
We confirmed that loss of HER2-positive status can occur after neoadjuvant treatment in patients with primary HER2-positive breast cancer. We also confirmed that in practice, differences in pCR rates between breast cancer subtypes are the same as in clinical trials. Our data strongly support the need for retest ER, PgR, HER2 of surgical sample after neoadjuvant therapy in order to accurately determine appropriate use of targeted therapy.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
•The selective recovery of indium was achieved in CCFS from sulfuric acid solution.•Anionic organophosphate surfactant was selected as the selective metal collector.•The screening tests on ...anionic/nonionic surfactants on the market were carried out.
Continuous counter-current foam separation (CCFS) with simultaneous injections of metal and surfactant solutions respectively into rising foam bed was applied to In(III) recovery from sulfuric acid solutions containing ternary metal ions of In/Cu/Zn. Through the screening tests of the surfactants in both conventional batch foam separation and CCFS, anionic organophosphate surfactant which has similar structure to phosphoric acid extractant (D2EHPA) was selected as the metal collector, with an addition of a nonionic co-surfactant as the foam stabilizer. The optimized surfactant combination was shown anionic A219B/nonionic POOE20 in this study; the complete recovery of In(III) was attained with the enrichment ratio of 5.5, whereas those of the other metals were suppressed in trace level, resulting in the excellent selective recovery. Moreover, metal solutions of quaternary In/Fe/Cu/Zn were also examined, and a dose of reductant for interfering Fe(III) into the metal solution was executed for improving the separation efficiency; the dose of ascorbic acid could invert the affinity order of A219B from Fe > In to In > Fe. The percent recovery and enrichment ratio of In(III) were 97% and 5.5, while the separation factors of In/Fe, In/Cu and In/Zn were 93, 1300 and 1300 respectively. This is our first favorable case for expanding the choice range of target metal ions in CCFS using anionic surfactants.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract
Phase contrast imaging (PCI) has been used for the turbulence profile measurement in Large Helical Devices; however, it does not have sufficient spatial resolution owing to the small number ...of two-dimensional (2D) detector elements. Therefore, in this study, we limited the measurement target to steady-state plasmas and conduct a pseudo multichanneling of a 2D detector array by sweeping using a one-dimensional detector. This new system is called SD-PCI. SD-PCI needs two detectors, one is one-dimensional detector and the other is single channel detector. By selecting suitable detector and imaging magnification for target turbulence or device characteristics, SD-PCI demonstrates the potential capability and enhancements. The wavenumber spectra comparison from the correlation calculations of the simultaneous measurement of the actual plasma with conventional 2D-PCI and proposed SD-PCI shows that SD-PCI is as effective as 2D-PCI in spectral broadening. The simplicity of the proposed system is expected to be applicable to various devices. In this paper, the SD-PCI system was explained along with the initial results of the 2D wavenumber spectrum calculation, which was necessary for obtaining turbulence profile.
Turbulence spreading into the edge stochastic magnetic layer induced by magnetic fluctuation is observed at the sharp boundary region in the large helical device. The density fluctuation excited at ...the sharp boundary region with a large pressure gradient does not propagate into the boundary region due to the blocking of turbulence spreading by the large second derivative of the pressure gradient. Once the magnetic fluctuation appears at the boundary, the density fluctuation begins to penetrate the edge stochastic layer and the second derivative of the pressure gradient also decreases. The increase of density fluctuation in this layer results in the broadening and reduction of the peak divertor heat load. It is demonstrated that magnetic fluctuation plays a key role in controlling the turbulence spreading at the boundary of plasma which contributes to the reduction of divertor heat load.
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CMK, CTK, FMFMET, IJS, NUK, PNG, UL, UM
The serotonin transporter gene promoter polymorphism (5-HTTLPR) has been repeatedly associated with antidepressant response in mood disorder patients, but findings are not consistent across studies. ...A meta-analysis was performed on 15 studies including data of 1435 subjects. We tested three phenotypes: remission rate, response rate and response rate within 4 weeks using the cochrane review manager. We observed a significant association of the s/s variant of 5-HTTLPR with remission rate (P<0.0001) and both s/s and s/l variants with response rate (P=0.0002). Response rate within 4 weeks was associated in both models (P=0.003-P<0.00001). This effect is quite robust to ethnic differences although a significant heterogeneity is present in Asian samples.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
A series of experiments were conducted in a wave basin (50 m long, 10 m wide and 5 m deep) generating two waves propagating at an angle by a directional wavemaker. When the two waves were selected ...from a resonant triplet, an initially non-existing wave grew as the waves propagated down the tank. The linear growth rate of the resonating wave agreed well with third-order resonance theory based on Zakharov’s reduced gravity equation. Additional experiments with opposing and coflowing mean current with large temporal and spatial variations were conducted. As the flow rate increased, the linear growth was suppressed. As reproduced numerically with Zakharov’s equation, the resonant interaction saturated at time scales inversely proportional to the magnitude of the forced random resonance detuning. It is conjectured that the resonance is detuned by the variation and not by the mean of the current field due to wavelength-dependent Doppler shift and to the refraction of wave rays. Further analysis of the spectral evolution revealed that while discrete peaks appear at high frequencies as a result of dynamical cascading, a continuously saturated spectrum develops in the background as the current speed increases. Additional experiments were conducted studying the evolution of the random directional wave on a dynamical time scale under the influence of current. Due to random resonance detuning by the current, the spectral tail tended to be suppressed.
Introduction: People who use drugs in community settings are at risk of a fatal overdose, which can be mitigated by naloxone administered via bystanders. In this study we sought to investigate ...methods of estimating and tracking opioid overdose reversals by community members with take-home naloxone (THN) to coalesce possible ways of characterizing THN reach with a metric that is useful for guiding both distribution of naloxone and advocacy of its benefits. Methods: We conducted a scoping review of published literature on PubMed on August 15, 2022, using PRISMA-ScR protocol, for articles discussing methods to estimate THN reversals in the community. The following search terms were used: naloxone AND (“take home” OR kit OR “community distribution” OR “naloxone distribution”). We used backwards citation searching to potentially find additional studies. Overdose education and naloxone distribution program-based studies that analyzed only single programs were excluded. Results: The database search captured 614 studies, of which 14 studies were relevant. Backwards citation searching of 765 references did not reveal additional relevant studies. Of the 14 relevant studies, 11 were mathematical models. Ten used Markov models, and one used a system dynamics model. Of the remaining three articles, one was a meta-analysis, and two used spatial analysis. Studies ranged in year of publication from 2013–2022 with mathematical modeling increasing in use over time. Only spatial analysis was used with a focus on characterizing local naloxone use at the level of a specific city. Conclusion: Of existing methods to estimate bystander administration of THN, mathematical models are most common, particularly Markov models. System dynamics modeling, meta-analysis, and spatial analysis have also been used. All methods are heavily dependent upon overdose education and naloxone distribution program data published in the literature or available as ongoing surveillance data. Overall, there is a paucity of literature describing methods of estimation and even fewer with methods applied to a local focus that would allow for more targeted distribution of naloxone.
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