Few studies have been conducted to compare the efficacies of stereotactic body radiation therapy (SBRT) and radiofrequency ablation (RFA). Thus, in this multinational study, we compared the ...effectiveness of SBRT and RFA in patients with unresectable HCC.
The retrospective study cohort included 2,064 patients treated in 7 hospitals: 1,568 and 496 in the RFA and SBRT groups, respectively. More than half of the patients (56.5%) developed recurrent tumors, mainly after transarterial chemoembolization (44.8%). Propensity score matching was performed to adjust for clinical factors (n = 313 in each group).
At baseline, the SBRT group had unfavorable clinical features compared to the RFA group, including BCLC stage (B-C 65% vs. 16%), tumor size (median 3.0 cm vs. 1.9 cm), and frequent history of liver-directed treatment (81% vs. 49%, all p <0.001). With a median follow-up of 27.7 months, the 3-year cumulative local recurrence rates in the SBRT and RFA groups were 21.2% and 27.9%, respectively (p <0.001). After adjusting for clinical factors, SBRT was related to a significantly lower risk of local recurrence than RFA in both the entire (hazard ratio HR 0.45, p <0.001) and matched (HR 0.36, p <0.001) cohorts. In subgroup analysis, SBRT was associated with superior local control in small tumors (≤3 cm) irrespective of location, large tumors located in the subphrenic region, and those that progressed after transarterial chemoembolization. Acute grade ≥3 toxicities occurred in 1.6% and 2.6% of the SBRT and RFA patients, respectively (p = 0.268).
SBRT could be an effective alternative to RFA for unresectable HCC, particularly for larger tumors (>3 cm) in a subphrenic location and tumors that have progressed after transarterial chemoembolization.
It is currently not known what the best treatment option is for patients with unresectable hepatocellular carcinoma. Here, we show that stereotactic body radiation therapy provides better local control than radiofrequency ablation, with comparable toxicities. Stereotactic body radiation therapy appears to be an effective alternative to radiofrequency ablation that should be considered when there is a higher risk of local recurrence or toxicity after radiofrequency ablation.
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•SBRT provided better local control than RFA among patients with HCC.•Toxicity rates and survival outcomes were similar between these treatment modalities.•SBRT is an effective alternative to RFA for larger tumors (>3 cm) in a subphrenic location (especially segment 8).
Abstract
The nonlinear interaction between the double tearing mode (DTM) and Kelvin–Helmholtz (KH) instabilities with different shear flow profiles has been numerically investigated via the use of a ...compressible magnetohydrodynamics (MHD) model. We focus on KH instabilities in weak and reversed magnetic shear plasmas with strong stabilizing effect of field line bending. Results show that KH instabilities coupled with DTMs occur in these plasmas and the KH mode dominates the instability dynamics, suggesting the crucial role of weak magnetic shear in the formation of high-mode harmonics. For symmetric flows, an asymmetric forced magnetic reconnection configuration is maintained during the growth phase, leading to interlocking of the modes. Additionally, this investigation of the DTM-KH instability interaction contributes to our understanding of the nonlinear reconnection mechanism in the regime of weak and reversed magnetic shear plasmas, which is relevant for astrophysical and fusion studies.
The prevalence of diabetic dyslipidemia has gradually increased worldwide and individuals with hypertriglyceridemia often have a high polygenic burden of triglyceride (TG)-increasing variants. ...However, the contribution of genetic variants to dyslipidemia in patients with type 2 diabetes (T2D) remains limited. Therefore, in this study, we aimed to investigate the genetic characteristics of longitudinal changes in TG levels among patients with T2D and summarize the genetic effects of polygenic risk score (PRS) on TG trajectory and risk of diabetic complications.
We conducted a case-control study. A total of 11,312 patients with T2D with longitudinal TG and genetic data were identified from a large hospital database in Taiwan. We then performed a genome-wide association study and calculated the relative PRS.
In total, 21 single-nucleotide polymorphisms (SNPs) related to TG trajectory were identified and yielded an area under the receiver operating characteristic curve (ROC) of 0.712 for high TG trajectory risk among Taiwanese patients with T2D. A cumulative genetic effect was observed for high TG trajectory, even when considering the adherence of a lipid-lowering agent in stratified analysis. An increased PRS increases high TG trajectory risk in a logistic regression model (odds ratio = 1.55; 95% confidence interval CI = 1.31-1.83 in the validation cohort). The TG-specific PRS was associated with the risk of diabetic microvascular complications, including diabetic retinopathy and nephropathy (with hazard ratios of 1.11 95% CI = 1.01-1.21, P = 0.027 and 1.05 95% CI = 1.01-1.1, P = 0.018, respectively).
This study may contribute to the identification of patients with T2D who are at risk of abnormal TG levels and diabetic microvascular complications using polygenic information.
ABSTRACT
We present a large, homogeneous catalogue of molecular clouds within 4 kpc from the Sun at low Galactic latitudes (|b| < 10°) with unprecedented accurate distance determinations. Based on ...the 3D dust reddening map and estimates of colour excesses and distances of over 32 million stars presented in Chen et al., we have identified 567 dust/molecular clouds with a hierarchical structure identification method and obtained their distance estimates by a dust model fitting algorithm. The typical distance uncertainty is less than 5 per cent. As far as we know, this is the first large catalogue of molecular clouds in the Galactic plane with distances derived in a direct manner. The clouds are seen to lie along the Sagittarius, Local and Perseus Arms. In addition to the known structures, we propose the existence of a possible spur, with a pitch angle of about 34°, connecting the Local and the Sagittarius Arms in the fourth quadrant. We have also derived the physical properties of those molecular clouds. The distribution of cloud properties in different parameter spaces agrees grossly with the previous results. Our cloud sample is an ideal starting point to study the concentration of dust and gas in the solar vicinity and their star formation activities.
The aim is to showcase the effectiveness and safety of bosentan or ambrisentan in individuals diagnosed with idiopathic pulmonary fibrosis (IPF) and offer fresh evidence for the management of this ...condition.
For this research, we conducted a meta-analysis of randomized controlled trials by searching various databases, including the Cochrane Library, Excerpta Medica Database, PubMed, and Web of Science. The retrieval was conducted until November 2021. We analyzed the variances in 6-minute walk distance (6MWD), death, diffusion capacity for carbon monoxide (DLCO), forced vital capacity (FVC), hospitalization, IPF worsening, mean pulmonary arterial pressure, serious adverse events (SAEs), Short Form-36 improved, and St. George's Respiratory Questionnaire between the treatment and control groups.
A sum of six studies involving 1,928 participants were found to meet the inclusion criteria. The quality of evidence was high. The control group had significantly higher values for 6MWD, DLCO, and FVC compared to the ambrisentan treatment group. The rates of hospitalization and IPF worsening were considerably greater in comparison with the control group. The bosentan group exhibited significantly reduced rates of hospitalization and IPF worsening in comparison with the control group. Both drugs did not cause any raising in death or SAEs when in comparison with the control group.
The findings of this research validate the effectiveness and safety of bosentan for treating IPF patients. This medication can enhance the quality of life for individuals with IPF without causing any significant increase in SAEs. However, it does not have a notable influence on the long-term prognosis. The findings of this research do not endorse the utilization of ambrisentan in individuals diagnosed with IPF.
Opsite (Smith & Nephew, Hull, UK) is widely used in wound care but its use in eye protection against corneal abrasion during major surgery is rarely reported. The purpose of the current study is to ...compare the effectiveness of using Opsite in eye protection with either wet gauze alone or with wet gauze following application of eye ointment in patients undergoing living donor liver transplantation (LDLT).
This is a prospective, double-blinded, randomized controlled trial. Forty-one patients undergoing liver transplantation were enrolled. One eye of each patient was protected with sterile gauze soaked with normal saline solution and covered with Opsite. Duratears (ALCON, Fort Worth, Tex, United States) ointment was applied to the other eye before covering it with sterile wet gauze and Opsite (ointment group). The corneal examination was carried out after fluorescein staining before and at the end of surgery by the same doctor. A Student t-test and a χ2 test were used for the statistical analyses.
Forty-one patients with 82 eyes were observed in this study. No corneal epithelial defects were found in either the normal saline group or the ointment group.
Opsite combined with wet gauze with or without additional eye ointment provided 100% protection against corneal abrasion in patients undergoing LDLT.
•Corneal epithelial defects during general anesthesia (GA) are common, occurring in about 42% of unprotected eyes.•The incidence of such defects occurring during GA drastically decreases from 44% in unprotected eyes to 2.1% in protected eyes.•Our method of using Opsite (Smith & Nephew, Hull, UK) combined with wet gauze with or without additional eye ointment provided 100% protection against corneal abrasion in patients undergoing living donor liver transplantation.
Abstract The current study aims to develop an efficient, reliable and valid assessment, the affective states for online learning scale (ASOLS), for measuring learners’ affective states during online ...learning using a sample of 173 young learners. The assessment consists of 15 items which assess five affective states, including concentration, motivation, perseverance, engagement, and self-initiative. To improve efficiency, five items (one for each affective state) are randomly selected and presented every 30 min during online learning. In addition, 14 among the participants were further invited to perform on-site online learning, and their affective states were validated by observations conducted by two psychologists. The ASOLS was found to be reliable and valid, with high internal consistency reliabilities and good construct, convergent and criterion validity. Confirmatory factor analyses showed that the hypothesized five-factor structure demonstrated a satisfactory fit to the data. Moreover, engagement was found to be positively associated with learning performance. Our findings suggest that the ASOLS provides a useful tool for teachers to identify students in upper primary and junior secondary schools with deficits in affective states and offer appropriate remedy or support. It can also be used to evaluate the effectiveness of interventions aimed at enhancing students’ affective states during online learning.
ABSTRACT
We estimate the solar peculiar velocities and Oort constants using a sample of 5627 A-type stars with $d\lt 0.6\, \rm kpc$ and $|z|\lt 0.1\, \rm kpc$, selected from the LAMOST (Large Sky ...Area Multi-Object Fiber Spectroscopic Telescope) surveys. The radial and tangential velocities of these A-type stars are fitted by using a non-axisymmetric model. The best-fitting result yields the solar peculiar velocities $(U_\odot ,V_\odot ,W_\odot)=(11.69\pm 0.68, 10.16\pm 0.51, 7.67\pm 0.10)\, \rm km\, s^{-1}$ and Oort constants $A=16.31\pm 0.89\, \rm km\, s^{-1}\, kpc^{-1}$, $B=-11.99\pm 0.79\, \rm km\, s^{-1}\, kpc^{-1}$, $C=-3.10\pm 0.48\, \rm km\, s^{-1}\, kpc^{-1}$, and $K=-1.25\pm 1.04\, \rm km\, s^{-1}\, kpc^{-1}$. $|K+C|\gt 4\, \rm km\, s^{-1}\, kpc^{-1}$ means that there is a radial velocity gradient in the extended local disc, implying that the local disc is in a non-asymmetric potential. Using the derived Oort constants, we derive the local angular velocity $\Omega \, {\approx }\, A-B=28.30\pm 1.19\, \rm km\, s^{-1}\, kpc^{-1}$. By using A-type star sample of different volumes, we further try to evaluate the impacts of the ridge pattern in the R–Vϕ plane on constraining the solar motions and Oort constants. As the volume becomes larger towards the anticentre direction, the values of A and B become larger (implying a steeper slope of the local rotation curve) and the value of V⊙ becomes smaller probably caused by the ridge structure and its signal increasing with distance.
Chronic immune-mediated diseases of adulthood often originate in early childhood. To investigate genetic associations between neonatal immunity and disease, we map expression quantitative trait loci ...(eQTLs) in resting myeloid cells and CD4
T cells from cord blood samples, as well as in response to lipopolysaccharide (LPS) or phytohemagglutinin (PHA) stimulation, respectively. Cis-eQTLs are largely specific to cell type or stimulation, and 31% and 52% of genes with cis-eQTLs have response eQTLs (reQTLs) in myeloid cells and T cells, respectively. We identified cis regulatory factors acting as mediators of trans effects. There is extensive colocalisation between condition-specific neonatal cis-eQTLs and variants associated with immune-mediated diseases, in particular CTSH had widespread colocalisation across diseases. Mendelian randomisation shows causal neonatal gene expression effects on disease risk for BTN3A2, HLA-C and others. Our study elucidates the genetics of gene expression in neonatal immune cells, and aetiological origins of autoimmune and allergic diseases.
The molecular basis for the focal nature of atherosclerotic lesions is poorly understood. Here, we explored whether disturbed flow patterns activate an innate immune response to form the NLRP3 ...inflammasome scaffold in vascular endothelial cells via sterol regulatory element binding protein 2 (SREBP2).
Oscillatory flow activates SREBP2 and induces NLRP3 inflammasome in endothelial cells. The underlying mechanisms involve SREBP2 transactivating NADPH oxidase 2 and NLRP3. Consistently, SREBP2, NADPH oxidase 2, and NLRP3 levels were elevated in atheroprone areas of mouse aortas, suggesting that the SREBP2-activated NLRP3 inflammasome causes functionally disturbed endothelium with increased inflammation. Mimicking the effect of atheroprone flow, endothelial cell-specific overexpression of the activated form of SREBP2 synergized with hyperlipidemia to increase atherosclerosis in the atheroresistant areas of mouse aortas.
Atheroprone flow induces NLRP3 inflammasome in endothelium through SREBP2 activation. This increased innate immunity in endothelium synergizes with hyperlipidemia to cause topographical distribution of atherosclerotic lesions.
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