Background
The prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) is poor and selection of patients for surgery is challenging. This study examined the impact of a positive resection ...margin (R1) on locoregional recurrence (LRR) and overall survival (OS); and also aimed to identified tumour characteristics and/or technical factors associated with a positive resection margin in patients with PDAC.
Methods
Patients scheduled for pancreatic resection for PDAC between 2006 and 2016 were identified from an institutional database. The effect of resection margin status, patient characteristics and tumour characteristics on LRR, distant metastasis and OS was assessed.
Results
A total of 322 patients underwent pancreatectomy for PDAC. A positive resection (R1) margin was found in 129 patients (40·1 per cent); this was associated with decreased OS compared with that in patients with an R0 margin (median 15 (95 per cent c.i. 13 to 17) versus 22 months; P < 0·001). R1 status was associated with reduced time to LRR (median 16 versus 36 (not estimated, n.e.) months; P = 0·002). Disease recurrence patterns were similar in the R1 and R0 groups. Risk factors for early recurrence were tumour stage, positive lymph nodes (N1) and perineural invasion. Among 100 patients with N0 disease, R1 status was associated with shorter OS compared with R0 resection (median 17 (10 to 24) versus 45 (n.e.) months; P = 0·002), whereas R status was not related to OS in 222 patients with N1 disease (median 14 (12 to 16) versus 17 (15 to 19) months after R1 and R0 resection respectively; P = 0·068).
Conclusion
Although pancreatic resection with a positive margin was associated with poor survival and early recurrence, particularly in patients with N1 disease, disease recurrence patterns were similar between R1 and R0 groups.
In pancreatic cancer surgery, R1 status is determined largely by tumour characteristics. Although R1 resection is a major contributor to reduced survival and early recurrence, overall recurrence patterns are similar after R0 and R1 resections. Finally, in patients with N0 disease, surgical factors affect R1 status.
Tumour biology important
Radar signal design in a spectrally crowded environment is a very challenging and topical problem due to the increasing demand for both military surveillance/remote-sensing capabilities and civilian ...wireless services. This paper deals with the synthesis of optimized radar waveforms ensuring spectral compatibility with the overlayed licensed electromagnetic radiators. A priori information, for instance, provided by a radio environmental map (REM), is exploited to force a spectral constraint on the radar waveform, which is thus the result of a constrained optimization process aimed at improving some radar performances (such as detection, sidelobes, resolution, tracking). The feasibility of the waveform optimization problem is extensively studied, and a solution technique leading to an optimal waveform is proposed. The procedure requires the relaxation of the original problem into a convex optimization problem and involves a polynomial computational complexity. At the analysis stage, the waveform performance is studied in terms of trade-off among the achievable signal to interference plus noise ratio (SINR), spectral shape, and the resulting autocorrelation function (ACF).
The animal soundscape is a field of growing interest because of the implications it has for human–landscape interactions. Yet, it continues to be a difficult subject to investigate, due to the huge ...amount of information which it contains. In this contribution, the suitability of the Acoustic Complexity Index (ACI) is examined. It is an algorithm created to produce a direct quantification of the complex biotic songs by computing the variability of the intensities registered in audio-recordings, despite the presence of constant human-generated-noise. Twenty audio-recordings were made at equally spaced locations in a beech mountain forest in the Tuscan-Emilian Apennine National Park (Italy) between June and July 2008. The study area is characterized by the absence of recent human disturbance to forest assets but the presence of airplane routes does bring engine noise that overlaps and mixes with the natural soundscape, which resulted entirely composed by bird songs. The intensity values and frequency bin occurrences of soundscapes, the total number of bird vocalizations and the ACI were processed by using the Songscope v2.1 and Avisoft v4.40 software. The Spearman's rho calculation highlighted a significant correlation between the ACI values and the number of bird vocalizations, while the frequency bin occurrence and acoustic intensity were weaker correlated to bird singing activity because of the inclusion of all of the other geo/anthro-phonies composing the soundscape. The ACI tends to be efficient in filtering out anthrophonies (such as airplane engine noise), and demonstrates the capacity to synthetically and efficiently describe the complexity of bird soundscapes. Finally, this index offers new opportunities for the monitoring of songbird communities faced with the challenge of human-induced disturbances and other proxies like climate and land use changes.
Wound healing is a complex regulated process that results in skin scar formation in postnatal mammals. Chronic wounds are major medical problems that can confer devastating consequences. Currently, ...there are no treatments to prevent scarring. In the early fetus wounds heal without scarring and the healing process is characterized by relatively less inflammation compared to adults; therefore, research aimed at reducing the inflammatory process related to wound healing might speed healing and improve the final scar appearance.
Radar signal design in a spectrally crowded environment is currently a challenge due to the increasing requests for spectrum from both military sensing applications and civilian wireless services. ...The goal of this paper is to improve a previously devised algorithm for the synthesis of optimized radar waveforms fulfilling spectral compatibility with overlaid licensed radiators. The new technique achieves an enhanced spectral coexistence with the surrounding electromagnetic environment through a suitable modulation of the transmitted waveform energy, which was kept fixed at the maximum level in the previously devised algorithm. At the analysis stage, the waveform performance is studied in terms of trade-off among the achievable Signal to Interference Plus Noise Ratio (SINR), spectral shape, and the resulting Autocorrelation Function (ACF), also in situations where the previous technique cannot be applied.
We consider positive singular solutions to semilinear elliptic problems with possibly singular nonlinearity. We deduce symmetry and monotonicity properties of the solutions via the moving plane ...procedure.
This paper considers the problem of detecting and classifying a radar target signal and a jamming signal produced by a deception electronic counter measure (ECM) system based on a digital radio ...frequency memory (DRFM) device. The disturbance is modeled as a complex correlated Gaussian process. The jamming is modeled as a signal belonging to a cone whose axis is the true target signal. Two different approaches are analyzed, based on the adaptive coherent estimator (ACE) and on the generalized likelihood ratio test (GLRT), yielding both to a two-block device. The performance of the two detection/classification algorithms are evaluated, analytically, when possible, and by Monte Carlo simulation.
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