This study examined surface air temperature trends over global land from 1901–2009. It is found that the warming trend was particularly enhanced, in the boreal cold season (November to March) over ...semi-arid regions (with precipitation of 200–600 mm yr−1) showing a temperature increase of 1.53 °C as compared to the global annual mean temperature increase of 1.13 °C over land. In mid-latitude semi-arid areas of Europe, Asia, and North America, temperatures in the cold season increased by 1.41, 2.42, and 1.5 °C, respectively. The semi-arid regions contribute 44.46% to global annual-mean land-surface temperature trend. The mid-latitude semi-arid regions in the Northern Hemisphere contribute by 27.0% of the total, with the mid-latitude semi-arid areas in Europe, Asia, and North America accounting for 6.29%, 13.81%, and 6.85%, respectively. Such enhanced semi-arid warming (ESAW) imply drier and warmer trend of these regions.
Occult peritoneal metastasis (PM) in advanced gastric cancer (AGC) patients is highly possible to be missed on computed tomography (CT) images. Patients with occult PMs are subject to late detection ...or even improper surgical treatment. We therefore aimed to develop a radiomic nomogram to preoperatively identify occult PMs in AGC patients.
A total of 554 AGC patients from 4 centers were divided into 1 training, 1 internal validation, and 2 external validation cohorts. All patients’ PM status was firstly diagnosed as negative by CT, but later confirmed by laparoscopy (PM-positive n = 122, PM-negative n = 432). Radiomic signatures reflecting phenotypes of the primary tumor (RS1) and peritoneum region (RS2) were built as predictors of PM from 266 quantitative image features. Individualized nomograms of PM status incorporating RS1, RS2, or clinical factors were developed and evaluated regarding prediction ability.
RS1, RS2, and Lauren type were significant predictors of occult PM (all P < 0.05). A nomogram of these three factors demonstrated better diagnostic accuracy than the model with RS1, RS2, or clinical factors alone (all net reclassification improvement P < 0.05). The area under curve yielded was 0.958 95% confidence interval (CI) 0.923–0.993, 0.941 (95% CI 0.904–0.977), 0.928 (95% CI 0.886–0.971), and 0.920 (95% CI 0.862–0.978) for the training, internal, and two external validation cohorts, respectively. Stratification analysis showed that this nomogram had potential generalization ability.
CT phenotypes of both primary tumor and nearby peritoneum are significantly associated with occult PM status. A nomogram of these CT phenotypes and Lauren type has an excellent prediction ability of occult PM, and may have significant clinical implications on early detection of occult PM for AGC.
Preoperative evaluation of the number of lymph node metastasis (LNM) is the basis of individual treatment of locally advanced gastric cancer (LAGC). However, the routinely used preoperative ...determination method is not accurate enough.
We enrolled 730 LAGC patients from five centers in China and one center in Italy, and divided them into one primary cohort, three external validation cohorts, and one international validation cohort. A deep learning radiomic nomogram (DLRN) was built based on the images from multiphase computed tomography (CT) for preoperatively determining the number of LNM in LAGC. We comprehensively tested the DLRN and compared it with three state-of-the-art methods. Moreover, we investigated the value of the DLRN in survival analysis.
The DLRN showed good discrimination of the number of LNM on all cohorts overall C-indexes (95% confidence interval): 0.821 (0.785–0.858) in the primary cohort, 0.797 (0.771–0.823) in the external validation cohorts, and 0.822 (0.756–0.887) in the international validation cohort. The nomogram performed significantly better than the routinely used clinical N stages, tumor size, and clinical model (P < 0.05). Besides, DLRN was significantly associated with the overall survival of LAGC patients (n = 271).
A deep learning-based radiomic nomogram had good predictive value for LNM in LAGC. In staging-oriented treatment of gastric cancer, this preoperative nomogram could provide baseline information for individual treatment of LAGC.
•Evaluation of the lymph node metastasis (LNM) is the basis of individual treatment of locally advanced gastric cancer (LAGC).•Deep leaning radiomic nomogram (DLRN) based on CT images can preoperatively determine the number of LNM in LAGC.•DLRN is significantly superior to the routinely used clinical N stages, tumor size, and clinical model.•DLRN is significantly associated with the overall survival of LAGC.
Conformational isomers (conformers) of molecules play a decisive role in biology and organic chemistry. However, experimental methods for investigating chemical reaction dynamics are typically not ...conformer-sensitive. We report on a gas-phase megaelectronvolt ultrafast electron diffraction investigation of α-phellandrene undergoing an electrocyclic ring-opening reaction. We directly imaged the evolution of a specific set of α-phellandrene conformers into the product isomer predicted by the Woodward-Hoffmann rules in real space and time. Our experimental results are in quantitative agreement with nonadiabatic quantum molecular dynamics simulations, which provide considerable detail of how conformation influences the time scale and quantum efficiency of photoinduced ring-opening reactions.
Including the impacts of climate change in decision making and planning processes is a challenge facing many regional governments including the New South Wales (NSW) and Australian Capital Territory ...(ACT) governments in Australia. NARCliM (NSW/ACT Regional Climate Modelling project) is a regional climate modelling project that aims to provide a comprehensive and consistent set of climate projections that can be used by all relevant government departments when considering climate change. To maximise end user engagement and ensure outputs are relevant to the planning process, a series of stakeholder workshops were run to define key aspects of the model experiment including spatial resolution, time slices, and output variables. As with all such experiments, practical considerations limit the number of ensemble members that can be simulated such that choices must be made concerning which global climate models (GCMs) to downscale from, and which regional climate models (RCMs) to downscale with. Here a methodology for making these choices is proposed that aims to sample the uncertainty in both GCM and RCM ensembles, as well as spanning the range of future climate projections present in the GCM ensemble. The RCM selection process uses performance evaluation metrics to eliminate poor performing models from consideration, followed by explicit consideration of model independence in order to retain as much information as possible in a small model subset. In addition to these two steps the GCM selection process also considers the future change in temperature and precipitation projected by each GCM. The final GCM selection is based on a subjective consideration of the GCM independence and future change. The created ensemble provides a more robust view of future regional climate changes. Future research is required to determine objective criteria that could replace the subjective aspects of the selection process.
Abstract Background Gastric cancer is one of most common malignancies in the world. Currently the prognostic prediction is entirely based on the TNM staging system. In this study, we evaluated ...whether metastatic lymph node ratio (rN) at the time of surgery would improve the prognostic prediction in conjunction with the TNM staging system. Methods This retrospective study includes 745 patients, who had been referred for surgery due to gastric cancer between 1995 and 2007 and had at least 15 lymph nodes examined at the time of surgery without preoperative treatment. Clinicopathologic features and overall survival were analyzed using univariate and multivariate modes to identify the risk factors for overall survival. Results Median overall survival of all patients analyzed is 57.8 months and 5-year overall survival is 49.5%. Tumor site, macroscopic type, pTNM stage, and rN stage are identified as independent prognostic factors. Increased positive lymph node ratio correlates with shorter survival in all patients and in each T and N stage. In stage III gastric cancer patients, rN stage shows additional prognostic value on overall survival ( p < 0.001). Conclusions rN stage is a simple and promising prognostic factor of gastric cancer after surgery in addition to the TNM stage system especially in stage III patients. But the independent prognostic value of rN stage in stage I, II and IV gastric cancer is yet to be determined.
Summary
Background
Direct‐acting antiviral (DAA) regimens have shown high efficacy and tolerability for patients with HCV genotype 1/1b (GT1/1b) in clinical trials. However, robust real‐world ...evidence of interferon (IFN)‐free DAA treatment for HCV GT1‐infected patients in Asia is still lacking.
Aim
To systematically review and meta‐analyse the effectiveness and tolerability of IFN‐free DAA therapy for HCV GT1 infection in Asia.
Methods
We included studies that enrolled adult patients with HCV GT1 infection in routine clinical practice in Asia, using IFN‐free DAA regimens, and reported sustained virological response (SVR) after 12/24 weeks end‐of‐treatment by 31 May 2017. The pooled SVR rates were computed with a random‐effects model. Subgroup analysis and meta‐regression as previously registered in PROSPERO were performed to determine how pre‐planned variables might have affected the pooled estimates.
Results
We included 41 studies from eight countries and regions, comprising of 8574 individuals. The pooled SVR rates for GT1 were 89.9% (95% CI 88.6‐91.1, I2 = 55.1%) with daclatasvir/asunaprevir (DCV/ASV) and 98.1% (95% CI 97.0‐99.0, I2 = 41.0%) with ledipasvir/sofosbuvir ± ribavirin (LDV/SOF ± RBV). Baseline cirrhosis but not prior treatment history and age, attenuated the effectiveness of both regimens. Baseline resistance associated substitutions (RASs) severely attenuated SVR of DCV/ASV (65.4% vs 94.3%, P < 0.001) and only minimally with LDV/SOF ± RBV (94.5% vs 99.2%, P = 0.003). Patients with renal dysfunction treated with DCV/ASV showed a higher SVR rate (93.9% vs 89.8%, P = 0.046). Patients with hepatocellular carcinoma (HCC) LDV/SOF ± RBV achieved a lower SVR than those without HCC (94.1% vs 98.7%, P = 0.001).
Conclusion
All oral DAA treatment of HCV GT1 resulted in high cure rates in Asian patients in routine clinical practice setting including elderly patients and those with end‐stage renal disease.
Norovirus (NoV) and human astrovirus (HAstV) are important causative agents of acute gastroenteritis in children and adults. They are comprised of multiple genotypes and attention should be paid to ...genotype changes or emergence of new genetic variants. To study the prevalence and diversity of NoV GI, GII, and HAstV circulating in eastern China, we conducted a three‐year environmental surveillance in a coastal city of Yantai. Thirty‐six sewage samples were collected, processed, and examined for the presence of viral genomes by PCR. The results showed that NoV GI, GII, and HAstV were detected in all 36 samples. Six NoV GI genotypes, 11 NoV GII genotypes, and 5 HAstV serotypes were identified; GI.6, GII.17, and HAstV‐5 were the most prevalent types, respectively. Persistent existence of NoV GII.17 Kawasaki 308 variant was observed during whole study period. Phylogenetic analysis reflected multiple transmission lineages in local population for both viruses. Our results reflect continuous presence of enteric viruses in sewage, improve our understanding on their molecular epidemiology, and demonstrate surveillance on sewage is an effective approach in understanding the local circulation of enteric viruses.
Significance and Impact of the Study: In this study, a high degree of diversity of norovirus and human astrovirus was consistently observed in environmental sewage in a coastal city of eastern China, reflecting continuous circulation of these enteric viruses in local population. This study demonstrates the added value of environmental surveillance, particularly in settings with limited clinical surveillance.
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