Kidney cancer (KC) is associated with cardiovascular regulation disorder and easily leads to cardiovascular and cerebrovascular death (CCD), which is one of the major causes of death in patients with ...KC, especially those with T1/2 status. However, few studies have treated CCD as an independent outcome for analysis. We aimed to identify and evaluate the key factors associated with CCD in patients with T1/2 KC by competing risk analysis and compared these risk factors with those associated with kidney cancer-specific death (KCD) to offer some information for clinical management.
A total of 45,117 patients diagnosed with first primary KC in T1/2 status were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. All patients were divided into the CCD group (n = 3087), KCD group (n = 3212), other events group (n = 6312) or alive group (n = 32,506). Patients' characteristics were estimated for their association with CCD or KCD by a competing risk model. Pearson's correlation coefficient and variance inflation factor (VIF) were used to detect collinearity between variables. Factors significantly correlated with CCD or KCD were used to create forest plots to compare their differences.
The competing risk analysis showed that age at diagnosis, race, AJCC T/N status, radiation therapy, chemotherapy and scope of lymph node represented different relationships to CCD than to KCD. In detail, age at diagnosis (over 74/1-50: HR = 9.525, 95% CI: 8.049-11.273), race (white/black: HR = 1.475, 95% CI: 1.334-1.632), AJCC T status (T2/T1: HR = 0.847, 95% CI: 0.758-0.946) and chemotherapy (received/unreceived: HR = 0.574, 95% CI: 0.347-0.949) were correlated significantly with CCD; age at diagnosis (over 74/1-50: HR = 3.205, 95% CI: 2.814-3.650), AJCC T/N status (T2/T1: HR = 2.259, 95% CI: 2.081-2.451 and N1/N0:HR = 3.347, 95% CI: 2.698-4.152), radiation therapy (received/unreceived: HR = 2.552, 95% CI: 1.946-3.346), chemotherapy (received/unreceived: HR = 2.896, 95% CI: 2.342-3.581) and scope of lymph nodes (1-3 regional lymph nodes removed/none: HR = 1.378, 95% CI: 1.206-1.575) were correlated significantly with KCD.
We found that age at diagnosis, race, AJCC T status and chemotherapy as the independent risk factors associated with CCD were different from those associated with KCD.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Cancer survivors have a high risk of mortality, and vitamin D (VD) is associated with the risk of mortality. This study is aim to examine the impact of VD on mortality in cancer survivors.
A ...prospective study was conducted using data from the National Health and Nutrition Examination Survey. Participants were obtained information on their baseline characteristics, dietary habits, comorbidities, lifestyle, and serum 25-hydroxy VD 25(OH)D concentrations. The weighted Cox proportional hazard and competing risk regression models were used to estimate the hazard ratio and 95% confidence intervals (HR, 95% CI) of mortality for different serum 25(OH)D concentrations. Restricted cubic spline (RCS) curves were utilized to illustrate the dose-response relationship between serum 25(OH)D concentrations and mortality.
The study encompassed 2,495 participants with cancer diagnoses. Multivariate models indicated that, compared to serum 25(OH)D concentrations below 58.5 nmol/L, concentrations exceeding 81.6 nmol/L were associated with reduced HRs for all-cause mortality (HR = 0.70; 95% CI: 0.56-0.87), cardiovascular mortality (HR = 0.53; 95% CI: 0.32-0.86), and cancer-specific mortality (HR = 0.66; 95% CI: 0.45-0.99). RCS curves revealed "L-shaped" associations between serum 25(OH)D concentration and both all-cause and cancer-specific mortality, with threshold effects at 87.9 nmol/L and 84.6 nmol/L, respectively. Conversely, the relationship between serum 25(OH)D concentration and cardiovascular mortality exhibited a more linear pattern, with a threshold at 88.7 nmol/L. Subgroup analyses highlighted a gender-specific interaction that elevated serum 25(OH)D concentrations were significantly more protective against mortality in males than in females, especially regarding cancer-specific mortality (P-interaction = 0.009).
Elevated serum 25(OH)D concentrations were correlated with decreased risks of all-cause, cardiovascular, and cancer-specific mortality in cancer survivors, with benefit thresholds at 87.9, 88.7, and 84.6 nmol/L, respectively. These findings suggested that cancer survivors might benefit from higher vitamin D recommendations than the general population.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
TiAl matrix composites reinforced with graphene oxide (GO) were prepared by powder metallurgy technology. The graphene oxide plates were added into TiAl powder by ultrasonic dispersion and milling, ...and then, shaped by Hot Isostatic Pressing (HIPing). Microstructures of the composites were characterized by using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). X-ray photoelectron spectroscopy (XPS) as well as Raman spectrum were conducted on the composite powder. The thermal and mechanical properties were tested on the TiAl matrix composites. The results show that the compression strength and heat conductivity of the composites can be improved distinctly at both room temperature and high temperature. The heat conductivity coefficient can reach to above 23 W/m K, and the compressive strength can reach to 1700 MPa at room temperature. GO was homogeneously dispersed into TiAl matrix in the form of random film with the diameter less than 10 μm. The minimum thickness of the GO film is about 5 nm. However, The GO does not well represent thermodynamically stable reinforcement at high temperatures, GO existed not only in the form of graphene but also a certain amount of Ti3AlC, and its size is about 2 μm rather than nanoscale, which can decrease the ductile reinforcement of GO in the TiAl matrix.
It is critical for patients who cannot undergo eradicable surgery to predict the risk of lung cancer recurrence and metastasis; therefore, the physicians can design the appropriate adjuvant therapy ...plan. However, traditional circulating tumor cell (CTC) detection or next-generation sequencing (NGS)-based methods are usually expensive and time-inefficient, which urge the need for more efficient computational models. In this study, we have established a convolutional neural network (CNN) framework called DeepLRHE to predict the recurrence risk of lung cancer by analyzing histopathological images of patients. The steps for using DeepLRHE include automatic tumor region identification, image normalization, biomarker identification, and sample classification. In practice, we used 110 lung cancer samples downloaded from The Cancer Genome Atlas (TCGA) database to train and validate our CNN model and 101 samples as independent test dataset. The area under the receiver operating characteristic (ROC) curve (AUC) for test dataset was 0.79, suggesting a relatively good prediction performance. Our study demonstrates that the features extracted from histopathological images could be well used to predict lung cancer recurrence after surgical resection and help classify patients who should receive additional adjuvant therapy.
The "U-shaped ferrule joint bars connections" have a stable mechanical property, requiring a low level of construction accuracy and a relatively simple connection process, which significantly ...increase the construction speed. Based on the "U-shaped ferrule joint bars connections" technology, a new type of prefabricated concrete underground utility tunnel was proposed. This prefabricated technology realizes a formwork-free construction and vertical support-free assembly of the top plate on site. Through the full-scale model static test and numerical analyses, the mechanical properties, i.e., the crack development law and bearing capacity, were systematically investigated to validate the effectiveness of the "U-shaped ferrule joint bars connections". The test results indicated that the performance of the "U-shaped ferrule joint bars connections" is reliable. During the loading process, the prefabricated utility tunnel experienced three stages, i.e., cracking, stiffness degradation, and ultimate failure. The numerical analysis results correlated with the test results well. The simulation results showed that the bearing capacities of the prefabricated underground utility tunnel and the cast-in-place utility tunnel were similar. The longitudinal joint connections of the prefabricated utility tunnel allow the structure as an integration to maintain favourable mechanical properties.
Abstract
Background
Intrathecal dexmedetomidine, as an adjuvant to local anesthetics, has been reported to improve the quality of spinal anesthesia and reduce the required local anesthetic dose. ...However, the optimal dosage regimen for intrathecal dexmedetomidine combined with plain ropivacaine for cesarean section (CS) remains undetermined. The present study aimed to determine the median effective dose (ED
50
) of intrathecal dexmedetomidine as an adjuvant to plain ropivacaine for spinal anesthesia during CS.
Methods
Sixty parturients undergoing CS were randomly assigned to either group: plain ropivacaine 8 mg (Group Rop
8
) or plain ropivacaine 10 mg (Group Rop
10
). The initial dosage of intrathecal dexmedetomidine in each group was 5 µg. The effective dose was defined as a bilateral sensory block at the level of T6 or above to pinprick attained within 10 min after intrathecal injection, without the need for supplementary intraoperative epidural anesthesia. Effective or ineffective responses were determined, followed by a 1 µg increment or decrement in the dose of intrathecal dexmedetomidine for the next parturient using up-down sequential allocation. ED
50
were calculated using probit regression.
Results
The ED
50
of intrathecal dexmedetomidine with plain ropivacaine was 5.9 µg (95% confidence interval CI, 4.9–7.4 µg) in Group Rop
8
and 3.1 µg (95% CI, 0.1–4.8 µg) in Group Rop
10
(
P
< 0.05). Hemodynamic stability, side effects, patient satisfaction and neonatal outcomes were comparable between the two groups.
Conclusions
The present data suggested that the ED
50
of intrathecal dexmedetomidine as an adjuvant to 8 mg and 10 mg plain ropivacaine in spinal anesthesia during cesarean section was approximately 6 µg and 3 µg, respectively.
Trial registration
Chinese Clinical Trial Registry, identifier: ChiCTR2200055928.
Cancer immunotherapy, as a novel treatment against cancer metastasis and recurrence, has brought a significantly promising and effective therapy for cancer treatments. At present, programmed death 1 ...(PD-1) and programmed cell death-Ligand 1 (PD-L1) treatment for lung cancer is primarily recognized as an immune checkpoint inhibitor (ICI) to play an anti-tumor effect; however, it remains uncertain regarding of its efficacy though. Thereafter, tumor mutation burden (TMB) was recognized as a high-potential to be a predictive marker for the immune therapy, but it is invasive and costly. Therefore, discovering more immune-related biomarkers that have a guiding role in immunotherapy is a crucial step in the development of immunotherapy. In our study, we proposed a deep convolutional neural network (CNN)-based framework, DeepLRHE, which can efficiently analyze immunological stained pathological images of lung cancer tissues, as well as to identify and explore pathogenesis which can be used for immunological treatment in clinical field. In this study, we used 180 whole slice images (WSIs) of lung cancer downloaded from TCGA which was model training and validation. After two cross-validation used for this model, we compared with the area under the curve (AUC) of multiple mutant genes, TP53 had highest AUC, which reached 0.87, and EGFR, DNMT3A, PBRM1, STK11 also reached ranged from 0.71 to 0.84. The study results showed that the deep learning can used to assist health professionals for target-therapy as well as immunotherapies, therefore to improve the disease prognosis.
COVID-19 has spread globally to over 200 countries with more than 40 million confirmed cases and one million deaths as of November 1, 2020. The SARS-CoV-2 virus, leading to COVID-19, shows extremely ...high rates of infectivity and replication, and can result in pneumonia, acute respiratory distress, or even mortality. SARS-CoV-2 has been found to continue to rapidly evolve, with several genomic variants emerging in different regions throughout the world. In addition, despite intensive study of the spike protein, its origin, and molecular mechanisms in mediating host invasion are still only partially resolved. Finally, the repertoire of drugs for COVID-19 treatment is still limited, with several candidates still under clinical trial and no effective therapeutic yet reported. Although vaccines based on either DNA/mRNA or protein have been deployed, their efficacy against emerging variants requires ongoing study, with multivalent vaccines supplanting the first-generation vaccines due to their low efficacy against new strains. Here, we provide a systematic review of studies on the epidemiology, immunological pathogenesis, molecular mechanisms, and structural biology, as well as approaches for drug or vaccine development for SARS-CoV-2.
Display omitted
•Clinical manifestations and epidemiology of COVID-19•The efficacy of the developed vaccine against SARS-CoV-2•Phylogenetic tree of evolutionary relationships in current SARS-CoV-2 strains•Structural analysis and origin tracking of SARS-CoV-2•Mechanism involved in infection and immunological pathogenesis of SARS-CoV-2
Background
Vitamin D (VD) plays an important role in decreasing the risk of adverse events for various metabolic diseases. However, for patients with hyperlipidemia, the relationship between the main ...VD storage within the body known as serum 25-hydroxy-VD 25(OH)VD and the risk of all-cause, cardiovascular and malignancies-specific mortality is still unclear.
Materials and methods
A total of 6740 participants above the age of 20 years with hyperlipidemia who completed the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016 and were followed up until 2019 were included in the study. The weighted Cox proportional hazards regression model and weighted competing risk regression model were used to evaluate the risk for all-cause, cardiovascular and malignancy-related mortality in relation to the serum 25(OH)VD. The model was adjusted according to age, gender, race, body mass index, lipids status, medication usage, the Charlson comorbidity index and healthy eating index. The last restricted cubic spline (RCS) method was used to present the relationship between hazard ratios (HR) associated with diverse cause-specified modalities and the serum 25(OH)VD levels.
Results
Serum 25(OH)VD was identified as an independent factor for mortality. Lower serum 25(OH)VD under the threshold of 25.6 and 25.2 ng/ml were significantly associated with a higher risk for all-cause and cardiovascular mortalities, respectively. However, no association was found between malignancy-specific mortality and serum 25(OH)VD.
Conclusion
Serum 25(OH)VD were identified as an independent factor associated with risks of all-cause and cardiovascular mortalities in patient with hyperlipidemia. Moreover, lower serum 25(OH)VD than 25.6 and 25.2 ng/mL were, respectively, associated with a gradual increase in a risk for all-cause and cardiovascular mortality in patients with hyperlipidemia, and therefore regular monitoring of VD levels and correction of VD deficiency is recommended in those patients.
Angiosarcoma of the face and neck is a rare soft tissue sarcoma with a high degree of malignancy. The current treatment methods mainly rely on a combination of surgery and radiotherapy and/or ...chemotherapy. However, the options for drug treatment are very limited and surgery can be difficult to carry out due to the location of the tumor, so the efficacy of first-line drugs needs to be constantly explored. A case of angiosarcoma of the head and face diagnosed by biopsy is reported here. The patient received an oral anlotinib hydrochloride capsule once a day (12 mg on days 1 - 14/1 week off for a 21-day cycle) due to the difficulty of surgery. Until now (April, 2020), after 10 months of treatment, the patient’s scalp and facial lesions have gradually reduced and the partial response and progression-free survival of this patient were good, with moderate or tolerable adverse events. This approach provides a new approach for the clinical treatment of malignant angiosarcoma of the face and neck with anlotinib as first-line therapy.
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