Background:
This study aimed to investigate the role of circulating tumor cells (CTCs) and circulating cancer stem-like cells (cCSCs) before and after one cycle of chemotherapy and assessed the ...effects of early changes in CTCs and cCSCs on the outcomes of patients with metastatic breast cancer.
Methods:
Patients with stage IV invasive ductal carcinoma of the breast who received first-line chemotherapy between April 2014 and January 2016 were enrolled. CTCs and cCSCs were measured before the first cycle of chemotherapy (baseline) and on day 21, before the second cycle of chemotherapy commenced; a negative selection strategy and flow cytometry protocol were employed.
Results:
CTC and cCSC counts declined in 68.8 and 45.5% of patients, respectively. Declines in CTCs and cCSCs following the first chemotherapy cycle were associated with superior chemotherapy responses, longer progression-free survival (PFS), and longer overall survival (OS). An early decline in cCSCs remained an independent prognostic indicator for OS and PFS in multivariate analysis.
Conclusions:
A cCSC decline after one cycle of chemotherapy for metastatic breast cancer is predictive of a superior chemotherapy response and longer PFS and OS, implying that cCSC dynamic monitoring may be helpful in early prediction of treatment response and prognosis.
Intra-articular corrective osteotomy can be used to restore the anatomic position of knee surfaces for tibial plateau malunion (TPM) but precise restoration is not easy. The personalized surgical ...guide (PSG) might improve the TMP outcomes. This study developed a two-staged PSG method to provide registration and drill the bone for subsequent osteotomy. The tests were performed to compare the accuracy the proposed PSG and the conventional guide (Anterior cruciate ligament guide, ACLG). The results showed that the PSG provides better accuracy (0.50 ± 0.19 mm) than the ACLG (1.58 ± 0.67 mm). The results show the PSG method is a feasible alternative to the conventional ACLG procedure.
Unicompartmental knee arthroplasty (UKA) can achieve better kinematics and faster recovery than total knee arthroplasty. The Phase III Oxford UKA system has five sizes of femoral components to ...approximate the normal knee geometry. However, these different sizes may also induce problems, such as the misselection of component size. Different criteria have been proposed to predict the ideal size preoperatively. However, no single method can be applied universally. Therefore, this study aimed to develop a preoperative measurement using knee magnetic resonance imaging (MRI) to predict femoral component size. A total of 68 patients who underwent UKA were investigated from June 2019 to April 2020. 16 knees using a different MRI protocol were excluded. We developed an MRI measurement method to determine femoral size instead of gender- and height-based methods. The accuracy of different methods was compared using postoperative true lateral view radiographs. Three different kinds of gender- and height-based criteria, preoperative templating and intraoperative spoon measurement were compared. The accuracy of MRI measurement was 90.3%. Therefore, a significant difference was found between MRI measurements and all other methods, such as templating or gender- and height-based methods. In conclusion, the MRI measurement method can be concluded to accurately predict femoral component size in UKA. This method could be used regardless of different ethnic groups, individual knee geometry, or soft tissue tension.
Background:
There is limited research investigating the diagnostic strength of 3-dimensional computed tomography (3D-CT) and multidirectional CT arthrography (CTA) for femoroacetabular impingement ...(FAI) and related hip lesions.
Purpose:
To evaluate the diagnostic strength of combined 3D-CT and CTA in patients with FAI and related hip lesions by comparing it with hip arthroscopic surgery findings.
Study Design:
Cohort study (diagnosis); Level of evidence, 2.
Methods:
This study included patients who were suspected of having FAI and related hip lesions and who underwent a combination of 3D-CT and CTA and subsequent hip arthroscopic surgery between December 2013 and December 2017. The CT and intraoperative arthroscopic findings were recorded and compared. The sensitivity, specificity, and accuracy of 3D-CT for FAI and those of CTA for related hip lesions were calculated.
Results:
A total of 114 patients with 114 hips were included in our study. There were 101 patients with positive findings and 13 patients with negative findings for FAI (including cam, pincer, and combined morphology) according to 3D-CT. The sensitivity, specificity, and accuracy of 3D-CT for FAI were 91.58%, 57.14%, and 89.47%, respectively. The sensitivity, specificity, and accuracy of CTA for labral tears were 94.64%, 100.00%, and 94.73%, respectively. For acetabular cartilage defects, the sensitivity, specificity, and accuracy of CTA were 60.71%, 91.37%, and 76.31%, respectively. For femoral cartilage defects, the sensitivity, specificity, and accuracy of CTA were 82.22%, 76.81%, and 78.94%, respectively.
Conclusion:
The study results indicated that 3D-CT was able to provide excellent accuracy for FAI compared with hip arthroscopic surgery findings. In addition, multidirectional CTA demonstrated promising diagnostic strength for hip lesions such as labral tears and chondral defects.
Background:
Numerous studies have discussed the risk factors for shoulder and elbow injuries in high school baseball players worldwide.
Purpose:
To determine the risk factors for pitching-related ...shoulder and elbow injuries in Taiwanese high school pitchers.
Study Design:
Cross-sectional study; Level of evidence, 3.
Methods:
Included in the study were 144 pitchers from 11 top-ranked Taiwanese high school baseball teams between 2016 and 2017 high school baseball season. The participants answered a 55-item questionnaire concerning physical characteristics, pitching activities, injury history, and off-season activities. Univariate analyses were conducted separately for participants with and those without a pitching-related injury in the 12-month study period. The chi-square test or Fisher exact test was applied to categorical variables, and the F test or t test was applied to continuous variables. A stepwise multivariate logistic regression analysis was used to identify factors related to pitching-related injuries, and those results were calculated as odds ratios (ORs).
Results:
Having a pitching-related injury was significantly related to the number of pitches per week in the past 12 months (OR, 1.01; P = .006), pain over the shoulder and/or elbow in the past 12 months (OR, 3.56; P = .008), pitching competitive baseball for more than 8 of the past 12 months (OR, 2.53; P = .036), throwing sliders (OR, 2.97; P = .026), and lack of participating in other over-the-shoulder activities (0.03-0.11 fewer odds; P ≤ .010).
Conclusion:
For elite high school pitchers in Taiwan, pitching-related shoulder and elbow injuries were related to the number of pitches per week, pitching competitive baseball for more than 8 of the past 12 months, pain over the shoulder and/or elbow in the past 12 months, throwing sliders, and a lack of participation in other sports with over-the-shoulder activities.
The present study investigated the impact of splenomegaly on the treatment outcomes of blunt splenic injury patients.
All blunt splenic injury patients were enrolled between 2010 and 2018. The ...exclusion criteria were age less than 18 years, missing data, and splenectomy performed at another hospital. The patients were divided into two groups based on the presence of splenomegaly, defined as a spleen length over 9.76 cm on axial computed tomography. The primary outcome was the need for hemostatic interventions.
A total of 535 patients were included. Patients with splenomegaly had more high-grade splenic injuries (p = 0.007). Hemostatic treatments (p < 0.001) and transarterial embolization (p = 0.003) were more frequently required for patients with splenomegaly. Multivariate analysis showed that male sex (p = 0.023), more packed red blood cell transfusions (p = 0.001), splenomegaly (p = 0.019) and grade 3–5 splenic injury (p < 0.001) were predictors of hemostatic treatment. The failure rate of transarterial embolization was not significantly different between the two groups (p = 0.180). The sensitivity and specificity for splenomegaly in predicting hemostatic procedures were 48.8% and 66.5%, respectively. The positive and negative predictive values were 62.8% and 52.9%, respectively. The overall mortality rate was 3.7%.
Splenomegaly is an independent predictor for the requirement of hemostatic treatments in blunt splenic injury patients, especially transarterial embolization. Transarterial embolization is as effective for blunt splenic injury patients with splenomegaly as it is for those with a normal spleen.
Anticipating human intention by observing one's actions has many applications. For instance, picking up a cellphone, then a charger (actions) implies that one wants to charge the cellphone ...(intention) (Fig. 1). By anticipating the intention, an intelligent system can guide the user to the closest power outlet. We propose an on-wrist motion triggered sensing system for anticipating daily intentions, where the on-wrist sensors help us to persistently observe one's actions. The core of the system is a novel Recurrent Neural Network (RNN) and Policy Network (PN), where the RNN encodes visual and motion observation to anticipate intention, and the PN parsimoniously triggers the process of visual observation to reduce computation requirement. We jointly trained the whole network using policy gradient and cross-entropy loss. To evaluate, we collect the first daily "intention" dataset consisting of 2379 videos with 34 intentions and 164 unique action sequences (paths in Fig. 1). Our method achieves 92:68%; 90:85%; 97:56% accuracy on three users while processing only 29% of the visual observation on average.
This brief presents a lab-on-a-chip for cancer cell manipulation and separation. The programmable microelectrode dot array with 115,200 sub-microelectrodes is used to generate traveling wave electric ...field on the proposed chip. The proposed sub-microelectrode, <inline-formula> <tex-math notation="LaTeX">5\times 5\,\,\mu {\mathrm{ m}}^{2} </tex-math></inline-formula>, is useful to improve the traveling field strength under low applied voltage. The proposed chip with area size of <inline-formula> <tex-math notation="LaTeX">3.2\times 2.2 </tex-math></inline-formula> mm 2 is implemented in standard 0.18 <inline-formula> <tex-math notation="LaTeX">\mu {\mathrm{ m}} </tex-math></inline-formula> CMOS process. Experimental results show that MDA-MB-231 cells and HELA cells can be manipulated at the speed of 1.08 <inline-formula> <tex-math notation="LaTeX">\mu {\mathrm{ m}} </tex-math></inline-formula>/s and 1.5 <inline-formula> <tex-math notation="LaTeX">\mu {\mathrm{ m}} </tex-math></inline-formula>/s respectively under the supply voltage of 1.8V.
High-performance polycrystalline-silicon nanowire (NW) thin-film transistors (TFTs) have been demonstrated via continuous-wave laser crystallization (CLC) to exhibit the low subthreshold swing of 216 ...mV/decade and high ON/OFF ratio of 1.6×10 9 . In addition, the thermal stress of ~800 MPa induced from the CLC process also contributed to the single-crystal-like silicon NW CLC TFTs to achieve an excellent field-effect mobility of up to 900 cm 2 V -1 s -1 .
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