To develop and validate a radiomics-based model for predicting response to neoadjuvant chemotherapy (NAC) using baseline computed tomography (CT) images in patients with muscle-invasive bladder ...cancer (MIBC).
A radiomics signature for predicting pathological complete response (pCR) was developed using radiomics features selected by a random forest classifier on baseline CT images, and imaging predictors were identified in the training set (87 patients). By incorporating imaging predictors and radiomics signature, an imaging-based model was constructed using multivariate logistic regression analysis and validated in an independent validation set consisting of 48 patients with CT from outside institutions. The performance and clinical usefulness of the imaging-based model for predicting pCR were evaluated using area under the receiver operating characteristic curve (AUC) and decision curve analysis. Using a cut-off determined in the training set, the positive likelihood ratios of the imaging-based model were calculated and compared with imaging and histological predictors.
The radiomics signature was developed based on six stable radiomics features. An imaging-based model incorporating radiomics signature, tumour shape, tumour size, and clinical stage showed good performance for predicting pCR in both the training (AUC, 0.85; 95% confidence interval CI, 0.78–0.93) and validation (AUC, 0.75; 95% CI, 0.60–0.86) sets, providing a larger net benefit in decision curve analysis. The imaging-based model showed a higher positive likelihood ratio (1.91) for pCR than imaging and histological predictors (1.33–1.63).
The radiomics-based model using baseline CT images may predict the response of patients with MIBC to NAC.
•Use of radiomics signature may predict pathologic complete response.•Radiomics-based model showed higher net benefit than no model use.•Radiomics-based model provides a tool for optimizing treatment plans.
Lymph node metastasis is one of the most important adverse prognostic factors for pancreatic cancer. The aim of this study was to identify novel lymphatic metastasis-associated markers and ...therapeutic targets for pancreatic cancer.
DNA microarray study was carried out to identify genes differentially expressed between 17 pancreatic cancer tissues with lymph node metastasis and 17 pancreatic cancer tissues without lymph node metastasis. The microarray results were validated by real-time PCR. Immunohistochemistry and western blotting were used to examine the expression of farnesoid X receptor (FXR). The function of FXR was studied by small interfering RNA and treatment with FXR antagonist guggulsterone and FXR agonist GW4064.
Farnesoid X receptor overexpression in pancreatic cancer tissues with lymph node metastasis is associated with poor patient survival. Small interfering RNA-mediated downregulation of FXR and guggulsterone-mediated FXR inhibition resulted in a marked reduction in cell migration and invasion. In addition, downregulation of FXR reduced NF-κB activation and conditioned medium from FXR siRNA-transfected cells showed reduced VEGF levels. Moreover, GW4064-mediated FXR activation increased cell migration and invasion.
These findings indicated that FXR overexpression plays an important role in lymphatic metastasis of pancreatic cancer and that downregulation of FXR is an effective approach for inhibition of pancreatic tumour progression.
In a C-Mn steel without Nb, the mechanism of hot ductility loss and recovery has been understood. The specimens were solution treated at 1673 K (1400 °C), subsequently cooled to 1273 K (1000 °C) at a ...rate of 1 or 20 K/s and finally held at the temperature. At a rate of 1 K/s, the segregation concentration of sulfur at prior austenite grain boundaries decreases gradually with holding time. At the rate of 20 K/s, the segregation concentration of sulfur shows a convex profile in a time versus segregation concentration plot. Such segregation behaviors of sulfur are deeply related to the MnS reaction during cooling to 1273 K (1000 °C) or holding at the temperature. The high-temperature intergranular fracture observed in this steel is due to the sulfur segregated at the grain boundaries. The recovery of hot ductility results from the combination between the decrease in sulfur segregation concentration governed by the MnS reaction and the overall decohesion at the interface of the MnS particles which act as a strong sink of the free sulfur tending to segregate to the grain boundaries.
Finite element analyses were performed for various shapes of dental implant to study effects on stress distribution generated in the surrounding jaw bone and to determine an optimal thread shape for ...even stress distribution. It was found that the square thread shape filleted with a small radius was more effective on stress distribution than other dental implants used in the analyses. Additional analyses were performed on the implant with the thread shape obtained from previous analyses for varying other design parameters, such as the width of thread end and height of thread for various load directions, to determine the optimal dimensions of the implant. Stress distribution was more effective in the case when the width of thread end and the height of thread were 0·5p and 0·46p, respectively, where p is the screw pitch. Then, using the optimal implant thread dimensions determined previously, stress analyses were performed with various screw pitches and implant lengths, to investigate effects on stress distribution and to find the way to reduce the maximum effective stress generated in the jaw bone. Results show that the maximum effective stress decreased not only as screw pitch decreased gradually but also as implant length increased.
Summary
Despite advancements in the treatment of non‐Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL), patients continue to relapse and thus a need for new targeted therapies remains. The CD40 ...receptor is highly expressed on neoplastic B cells and activation leads to enhanced proliferation and survival. Lucatumumab (HCD122) is a fully human antagonistic CD40 monoclonal antibody. A phase IA/II study was designed to determine the maximum tolerated dose (MTD) and activity of lucatumumab in patients with relapsed/refractory lymphoma. Determination of the MTD was the primary objective of the phase IA dose escalation portion and clinical response was the primary objective of the phase II dose expansion portion. Patients received escalating doses of lucatumumab administered intravenously once weekly for 4 weeks of an 8‐week cycle. MTD was determined at 4 mg/kg of lucatumumab. A total of 111 patients with NHL (n = 74) and HL (n = 37) were enrolled. Responses were observed across various lymphoma subtypes. The overall response rate by computed tomography among patients with follicular lymphoma (FL) and marginal zone lymphoma of mucosa‐associated lymphatic tissue (MZL/MALT) was 33·3% and 42·9%, respectively. Lucatumumab demonstrates modest activity in relapsed/refractory patients with advanced lymphoma, suggesting that targeting of CD40 warrants further investigation.
The solution combustion method is used to synthesize nanocrystalline (Y0.5Gd0.5)PO4:Eu0.06 phosphor powders. The crystal structure and photoluminescence properties of (Y0.5Gd0.5)PO4:Eu0.06 phosphors ...are significantly influenced by the calcination temperature. The amount of the tetragonal xenotime structure increases with an increase of the calcination temperature. The higher calcination temperature yields the higher value of (5D0→7F2)/(5D0→7F1), improving the color purity, which originates from the phase transformation from the monoclinic monazite structure to the tetragonal xenotime structure. The (Y0.5Gd0.5)PO4:Eu0.06 phosphor calcined at 1300°C emits the purest red color. We need to obtain the tetragonal xenotime structure for improved red color purity.
Display omitted
► We prepared nano-sized (Y0.5Gd0.5)PO4:Eu0.06 phosphors via solution combustion method. ► The amount of the tetragonal structure increases with annealing temperature. ► Higher annealing temperature improves the emission intensity and color purity. ► The tetragonal structure is desirable for improving red color purity.
Summary Burkholderia cepacia complex (BCC) is an opportunistic pathogen that occasionally causes hospital outbreaks. This paper describes an outbreak of BCC bacteraemia in haematological malignancy ...patients related to a contaminated chlorhexidine gluconate solution. Eight BCC isolates were obtained from patients hospitalised in the same ward of a cancer centre in a Korean hospital. A further three BCC isolates were obtained from 0.5% chlorhexidine gluconate used in the same ward. The isolates were identified as B. stabilis and exhibited identical pulsed-field gel electrophoresis profiles. All patients with B. stabilis bacteraemia had indwelling intravenous catheters, which were treated with chlorhexidine to disinfect the catheters. Following identification of the source of contamination, strict controls regarding surveillance cultures for disinfectants have been enforced. No further B. stabilis infections have been found in the hospital.
Background and purpose
White matter hyperintensities (WMH) are a predictor of stroke among elderly individuals. This study aimed to evaluate the association between WMH severity and the risk of ...recurrent vascular events among Asian patients with ischaemic stroke with small‐vessel disease (SVD) including micro/macrobleeds and lacunes.
Methods
Data from participants (n = 1454) in the PICASSO (PreventIon of CArdiovascular Events in iSchemic Stroke Patients with High Risk of Cerebral HemOrrhage) trial were reviewed. The severity of WMH in baseline brain magnetic resonance imaging scans was assessed using the Fazekas scale. The association between WMH severity and stroke (ischaemic or hemorrhagic) and major vascular events (MVEs) (a composite of stroke/myocardial infarction/vascular death) was assessed.
Results
Study patients had a significant burden of SVD: Fazekas score 0 (n = 2), 1 (n = 426), 2 (n = 650) and 3 (n = 376) median Fazekas score 2 (mean follow‐up, 1.9 ± 1.3 years). The stroke incidence rate per 100 personyears was 2.6 in the Fazekas 0–1 group, 3.6 in the Fazekas 2 group and 7.0 in the Fazekas 3 group, and the rates for MVEs were 3.3, 4.3 and 7.6, respectively. Compared with the Fazekas 0–1 group, the Fazekas 3 group was associated with a higher risk of stroke adjusted hazard ratio (HR), 2.15; 95% confidence interval (CI), 1.19–3.88; P = 0.011, ischaemic stroke (adjusted HR, 2.11; 95% CI, 1.07–4.15; P = 0.031), hemorrhagic stroke (adjusted HR, 3.72; 95% CI, 1.09–12.70; P = 0.036) and MVEs (adjusted HR, 2.09; 95% CI, 1.20–3.66; P = 0.010).
Conclusion
Advanced WMH in Asian patients with ischaemic stroke with SVD burden was associated with an increased risk of recurrent vascular events. It may exert an effect as a prognostic indicator in high risk of recurrent vascular events.
PDF
