Regional variation in treatment paradigms for gastric adenocarcinoma has attracted a great deal of interest. Between Asia and the West, major differences have been identified in tumor biology, ...implementation of screening programs, extent of surgical lymphadenectomy, and routine use of neoadjuvant versus adjuvant treatment strategies. Minimally invasive techniques, including both laparoscopic and robotic platforms, have been studied in both regions, with attention to safety, feasibility, and long-term oncologic outcomes. The purpose of this review is to discuss advances in the understanding of the etiology and underlying biology of gastric cancer, as well as the current state of management, focusing on the differences between Asia and the West.
1. Evergreen broad-leaved forests are widely distributed in eastern Asia with evergreen broad-leaved (EBL) and deciduous broad-leaved (DBL) tree species coexisting under the same climatic regime, ...raising questions as to the underlying mechanisms. Since EBL and DBL species differ in leaf life span, a key component of resource economic strategies, their coexistence might be attributed to regeneration niche partitioning across habitats varying in resource supply. 2. We investigated the effects of variation in insolation and topography on regeneration of EBL and DBL species in a subtropical EBL forest of eastern China after an ice storm that caused severe canopy disturbance. 3. Using a mixed-effects modelling framework and census data from 2011 to 2014 on 8,548 wild seedlings of 123 species, we quantified habitat preferences of EBL and DBL species during post-disturbance regeneration and how their survival and height relative growth rates varied among habitats. 4. The relative density of DBL seedlings (proportional to all seedlings) was greater in habitats with greater (canopy gaps) compared to habitats with lesser (understorey) insolation and increased with canopy gap size. However, DBL seedlings were not more frequent in higher (valleys) compared to lower (ridges) fertility habitats. Although DBL seedlings exhibited larger differences in growth between higher and lower resource habitats than EBL seedlings, their growth rates did not increase with canopy gap size. Seedlings of EBL species had high survival in all habitats, but larger DBL seedlings survived equally well on ridges. Consequently, the relative density of DBL seedlings declined in valleys, so that by 2014 it became more similar in valley and ridge habitats, whereas it remained higher in gaps than in the understorey, and especially in larger gaps. 5. Synthesis. Specialization on contrasting topographic habitats is considered the primary mechanism mediating coexistence between deciduous broad-leaved and evergreen broad-leaved species. Our results, however, suggest this may not always be true, since seedlings of deciduous broad-leaved and evergreen broad-leaved species partitioned regeneration niches based on light more so than topography. We propose that coexistence of deciduous broad-leaved and evergreen broadleaved species can strongly depend upon canopy disturbance to create a mosaic of habitat patches, including high light gaps favouring regeneration of deciduous broad-leaved species.
We adapt the robust phase estimation algorithm to the evaluation of energy differences between two eigenstates using a quantum computer. This approach does not require controlled unitaries between ...auxiliary and system registers or even a single auxiliary qubit. As a proof of concept, we calculate the energies of the ground state and low-lying electronic excitations of a hydrogen molecule in a minimal basis on a cloud quantum computer. The denominative robustness of our approach is then quantified in terms of a high tolerance to coherent errors in the state preparation and measurement. Conceptually, we note that all quantum phase estimation algorithms ultimately evaluate eigenvalue differences.
The purpose of this study was to examine the performance characteristics and validity of the Patient Health Questionnaire-9 Item (PHQ-9) as a screening tool for depression among adolescents.
The ...PHQ-9 was completed by 442 youth (aged 13-17 years) who were enrolled in a large health care-delivery system and participated in a study on depression outcomes. Criterion validity and performance characteristics were assessed against an independent structured mental health interview (the Child Diagnostic Interview Schedule DISC-IV). Construct validity was tested by examining associations between the PHQ-9 and a self-report measure of functional impairment, as well as parental reports of child psychosocial impairment and internalizing symptoms.
A PHQ-9 score of 11 or more had a sensitivity of 89.5% and a specificity of 77.5% for detecting youth who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for major depression on the DISC-IV. Receiver-operator-curve analysis revealed that the PHQ-9 had an area under the curve of 0.88 (95% confidence interval: 0.82-0.94), and the cut point of 11 was optimal for maximizing sensitivity without loss of specificity. Increasing PHQ-9 scores were significantly correlated with increasing levels of functional impairment, as well as parental report of internalizing symptoms and psychosocial problems.
Although the optimal cut point is higher among adolescents, the sensitivity and specificity of the PHQ-9 are similar to those of adult populations. The brief nature and ease of scoring of this instrument make this tool an excellent choice for providers and researchers seeking to implement depression screening in primary care settings.
Habitat loss and fragmentation has long been considered the primary cause for biodiversity loss and ecosystem degradation worldwide, and is a key research topic in landscape ecology.
Background
The present study compared the prevalence of obesity, fat distribution, body image perception and lifestyle among diabetic African and Albanian immigrants living in Italy, as well as ...diabetic Italians, aiming to identify health risks and their possible causes.
Methods
The study sample consisted of 200 diabetic subjects living in Italy. A questionnaire regarding socio‐demographic and lifestyle information was administered to participants, and anthropometric measurements and body image perception were assessed. Proper perception of weight status and the degree of dissatisfaction in body image perception were valued.
Results
Italians showed a higher health risk, both with regard to anthropometric characteristics and lifestyle, whereas African immigrants showed a lower one. All of the male groups underestimated their weight and Albanians were the most dissatisfied. Women perceived their current body image as heavier than their desired body image, showing a dissatisfaction toward their weight. Subjects of both sexes belonging to the overweight and obese categories generally underestimated themselves; this was particularly true in obese Africans. People with a higher body mass index were more likely to be dissatisfied than those with a lower one. Body image dissatisfaction increased when people estimated themselves as being overweight. Among lifestyle habits, being an ex‐smoker increased body image dissatisfaction.
Conclusions
The underestimation of weight detected in the present study requires attention. Nevertheless, the high percentage of overweight/obese people, coupled with the higher frequency of people dissatisfied with their high weight, suggests an awareness of the problem that could be more effective for weight loss.
Decisions made by mammals and birds are often temporally extended. They require planning and sampling of decision-relevant information. Our understanding of such decision-making remains in its ...infancy compared with simpler, forced-choice paradigms. However, recent advances in algorithms supporting planning and information search provide a lens through which we can explain neural and behavioral data in these tasks. We review these advances to obtain a clearer understanding for why planning and curiosity originated in certain species but not others; how activity in the medial temporal lobe, prefrontal and cingulate cortices may support these behaviors; and how planning and information search may complement each other as means to improve future action selection.
Ternary semiconductor alloys based on the A y B1–y C stoichiometry are widely employed in electronic devices, and their composition plays a key role in band gap engineering of heterostructures. We ...have studied the crucial issue of accuracy in composition measurements of Al y Ga1–y N and Mg y Zn1–y O alloys using atom probe tomography (APT). The results indicate a similar behavior for both nitride and oxide systems. A correct site fraction y is measured at low field conditions, while Ga and Zn preferentially evaporate at high field, yielding an overestimation of y. Furthermore, APT data sets exhibit local biases depending on the distribution of the electrostatic field at the specimen surface. We estimate the detection efficiencies for each species and interpret the results through a model describing preferential evaporation in simple terms.
•Butanol production by bioconversion of renewable resource.•Clostridium acetobutylicum fermentation of unsupplemented cheese whey.•Operation of a biofilm packed bed reactor.•Optimization of operating ...conditions.
Butanol production by Clostridium acetobutylicum DSM 792 fermentation was investigated. Unsupplemented cheese whey was adopted as renewable feedstock. The conversion was successfully carried out in a biofilm packed bed reactor (PBR) for more than 3months.
The PBR was a 4cm ID, 16cm high glass tube with a 8cm bed of 3mm Tygon rings, as carriers. It was operated at the dilution rate between 0.4h−1 and 0.94h−1.
The cheese whey conversion process was characterized in terms of metabolites production (butanol included), lactose conversion and biofilm mass. Under optimized conditions, the performances were: butanol productivity 2.66g/Lh, butanol concentration 4.93g/L, butanol yield 0.26g/g, butanol selectivity of the overall solvents production 82wt%.
Objectives: To evaluate the long-term efficacy of a second generation of vaginal laser treatment, the vaginal erbium laser, as a non-ablative photothermal therapy for the management of genitourinary ...syndrome of menopause.
Methods: The study was performed using an erbium laser crystal yttrium-aluminum-garnet (XS Fotona Smooth™, Fotona, Ljubljana, Slovenia) with a wavelength of 2940 nm. Postmenopausal women (n = 205) were treated with three laser applications at 30-day intervals. Symptoms were assessed before and after treatment throughout 24 months, using the subjective visual analog scale (VAS) and the objective vaginal health index score (VHIS). In addition, postmenopausal women suffering from stress urinary incontinence were evaluated with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF).
Results: Vaginal erbium laser treatment induced a significant (p < 0.01) decrease in VAS for both vaginal dryness and dyspareunia, as well an increase in VHIS (p < 0.01) up to the 12th month after the last laser treatment. The values returned to levels similar to the baseline after 18 and 24 months. In addition, vaginal erbium laser treatment improved mild-moderate stress urinary incontinence in 114 postmenopausal women. Less than 3% of patients discontinued treatment due to adverse events.
Conclusions: These results suggest that vaginal erbium laser may be effective and safe for the treatment of genitourinary syndrome of menopause.
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