We aimed to evaluate the efficacy and feasibility of patient-reported outcome (PRO)-based symptom management in the early period after lung cancer surgery.
Before surgery, patients with clinically ...diagnosed lung cancer were randomly assigned 1:1 to receive postoperative PRO-based symptom management or usual care. All patients reported symptoms on MD Anderson Symptom Inventory-Lung Cancer presurgery, daily postsurgery, and twice a week after discharge for up to 4 weeks via an electronic PRO system. In the intervention group, treating surgeons responded to overthreshold electronic alerts driven by any of the five target symptom scores (score ≥ 4 on a 0-10 scale for pain, fatigue, disturbed sleep, shortness of breath, and coughing). The control group patients received usual care and no alerts were generated. The primary outcome was the number of symptom threshold events (any target symptom with a score of ≥ 4) at discharge. Per-protocol analyses were conducted.
Of the 166 participants, 83 were randomly allocated to each group. At discharge, the intervention group reported fewer symptom threshold events than the control group (median interquartile range, 0 0-2
2 0-3;
= .007). At 4 weeks postdischarge, this difference was maintained between the intervention and control groups (median interquartile range, 0 0-0
0 0-1;
= .018). The intervention group had a lower complication rate than the control group (21.5%
40.6%;
= .019). Surgeons spent a median of 3 minutes managing an alert.
PRO-based symptom management after lung cancer surgery showed lower symptom burden and fewer complications than usual care for up to 4 weeks postdischarge.
This study presents a comprehensive field investigation of the ground response of a gateroad subjected to high stress induced by extracting a 17 m-thick coal seam. The test site is located at Datong ...City, Shanxi Province, China. The measurement results of the entry convergence and fracture development indicated that the gateroad with a 30 m-wide coal pillar maintained a good performance during the development period but suffered a strong response, including roof sag, floor heave, support unit failure and internal fractures sharply developed during the current panel-retreating period. During panel retreating, the impact range of the mining disturbance was about 110 m ahead of the active panel, and the mining disturbance accelerated dramatically at 50–60 m ahead of the mining panel. The results of the borehole stress measurement showed that the maximum stress induced in the virgin coal pillar and the coal pillar reached 15.3 MPa and 23.9 MPa, which are about 1.5 and 2.3 times the initial ground stress, respectively. This high stress contributed significantly to the instability of the gateroad. The average stress within the coal pillar was greater than that in the virgin coal pillar, and a high-stress zone was found at the coal pillar depth of 11–20 m. This stress distribution characteristics implies that the 30 m-wide coal pillar has a relatively sufficient bearing capacity to withstand the majority of mining-induced loads and that the coal pillar size could be reduced from 30 to 15–20 m wide to decrease the range of high stress in the coal pillar. Furthermore, taking into consideration of intense mining disturbance and abundant time interval for gateroad development as well as a high-strength support scheme, a small-width coal pillar of 8 m was recommended and tentatively applied in the field. The field application demonstrated that the newly designed pillar size and support pattern could ensure gateroad stability at some level. The study finding can help to better understand the stability control of entry driven along gob-side and its correlation with coal pillar size as well as the mining disturbance in specially thick coal seam (ETCS). In addition, the design principle and support strategy for the coal pillar in ETCS presented in this study can potentially be applied to other similar projects.
Recently a dark matter-electron (DM-electron) paradigm has drawn much attention. Models beyond the standard halo model describing DM accelerated by high energy celestial bodies are under intense ...examination as well. In this Letter, a velocity components analysis (VCA) method dedicated to swift analysis of accelerated DM-electron interactions via semiconductor detectors is proposed and the first HPGe detector-based accelerated DM-electron analysis is realized. Utilizing the method, the first germanium based constraint on sub-GeV solar reflected DM-electron interaction is presented with the 205.4 kg·day dataset from the CDEX-10 experiment. In the heavy mediator scenario, our result excels in the mass range of 5-15 keV/c^{2}, achieving a 3 orders of magnitude improvement comparing with previous semiconductor experiments. In the light mediator scenario, the strongest laboratory constraint for DM lighter than 0.1 MeV/c^{2} is presented. The result proves the feasibility and demonstrates the vast potential of the VCA technique in future accelerated DM-electron analyses with semiconductor detectors.
An 8‐week study was conducted to determine folic acid requirement and its effect on antioxidant capacity and immunity in juvenile Chinese mitten crab Eriocheir sinensis (Milne‐Edwards, 1853), ...followed by a challenge assay with the pathogen Aeromonas hydrophila for 2 weeks. Folic acid was added to a basal diet at seven levels (0, 0.5, 1.0, 2.0, 4.0, 8.0, 16.0 mg folic acid kg−1 diet), and a diet free of folic acid and vitamin B12 was also included as a control. Crabs were fed twice daily in 32 tanks with 7.76–8.17 mg oxygen L−1, 25.0–31.0 °C and 7.5–8.3 pH. Growth and feed efficiency were significantly greater in crabs fed ≥2.0 mg folic acid kg−1, but not significantly different between crabs fed diets >2.0 mg folic acid. The superoxide dismutase activity and glutathione S‐transferase activity were highest in crabs fed ≥2.0 mg folic acid kg−1, followed by those fed 0.5 and 1.0 mg folic acid kg−1, and the control diet. The malondialdehyde content was highest in crabs fed the control diet, followed by those fed 0 mg folic acid kg−1, and the lowest value occurred in those fed ≥0.5 mg folic acid kg−1. Phenoloxidase activity and total haemocytes were significantly higher in crabs fed ≥2.0 mg folic acid kg−1 than other diets. Crabs fed 2.0 mg folic acid kg−1 had the highest lysozyme, acid phosphatase and alkaline phosphatase activities but the lowest cumulative mortality. The optimum dietary folic acid requirement by E. sinensis was estimated at 2.29–2.90 mg kg−1 diet.
Endogenous cannabinoids and peripheral cannabinoid CB2 receptors (CB2Rs) are involved in the antinociceptive effect of electroacupuncture (EA) on inflammatory pain. However, it is not clear how CB2R ...activation contributes to the antinociceptive effect of EA. The major proinflammatory cytokines, such as tumour necrosis factor‐α (TNF‐α), interleukin‐1β (IL‐1β) and IL‐6, are involved in inflammatory pain. Here we determined the effects of CB2R activation and EA on the expression level of IL‐1β, IL‐6 and TNF‐α in inflamed skin tissues. Inflammatory pain was induced by injection of complete Freund's adjuvant into the left hindpaw of rats. Thermal hyperalgesia was tested with a radiant heat stimulus, and mechanical allodynia was quantified using von Frey filaments. The mRNA and protein levels of IL‐1β, IL‐6 and TNF‐α in inflamed skin tissues were measured using real‐time polymerase chain reaction and Western blot, respectively. Local injection of the selective CB2R agonist AM1241 or EA applied to GB30 and GB34 significantly reduced thermal hyperalgesia and mechanical allodynia induced by tissue inflammation. The specific CB2R antagonist AM630 significantly attenuated the antinociceptive effect of EA. Furthermore, EA or AM1241 treatment significantly decreased the mRNA and protein levels of IL‐1β, IL‐6 and TNF‐α in inflamed skin tissues. In addition, pretreatment with AM630 significantly reversed the inhibitory effect of EA on these cytokine levels in inflamed skin tissues. Our results suggest that EA reduces inflammatory pain and proinflammatory cytokines in inflamed skin tissues through activation of CB2Rs.
The recent rapid development in the field of extracellular vesicles (EVs) based nanotechnology has provided unprecedented opportunities for nanomedicine platforms. As natural nanocarriers, EVs such ...as exosomes, exosome-like nanoparticles and outer membrane vesicles (OMVs), have unique structure/composition/morphology characteristics, and show excellent physical and chemical/biochemical properties, making them a new generation of theranostic nanomedicine. Here, we reviewed the characteristics of EVs from the perspective of their formation and biological function in inflammatory bowel disease (IBD). Moreover, EVs can crucially participate in the interaction and communication of intestinal epithelial cells (IECs)-immune cells-gut microbiota to regulate immune response, intestinal inflammation and intestinal homeostasis. Interestingly, based on current representative examples in the field of exosomes and exosome-like nanoparticles for IBD treatment, it is shown that plant, milk, and cells-derived exosomes and exosome-like nanoparticles can exert a therapeutic effect through their components, such as proteins, nucleic acid, and lipids. Moreover, several drug loading methods and target modification of exosomes are used to improve their therapeutic capability. We also discussed the application of exosomes and exosome-like nanoparticles in the treatment of IBD. In this review, we aim to better and more clearly clarify the underlying mechanisms of the EVs in the pathogenesis of IBD, and provide directions of exosomes and exosome-like nanoparticles mediated for IBD treatment.
Squat is a kind of railhead defects related to rolling contact fatigue (RCF), and regarded as a potential safety hazard in railway networks. The mechanisms of squat initiation and propagation remain ...unclearly understood. In the current study, several branches of subsurface cracks inside squat defects had been intensively investigated for understanding the development of RCF cracks. From metallographic observations, a few white etching particles were clearly found either located within crack gaps or attached with crack faces. Based on nanoindentation measurements, the hardness of white particles was higher than that in matrix, presenting a possible mechanical property of martensite. A large density of nano-twins in the substructure of white particles can be identified in the transmission electron microscopy bright-field imaging. Their corresponding selected area electron diffraction patterns proved white particles as Fe-C martensite with body-centered tetragonal crystallographic structure. Besides the martensite, a random distribution of oxidized sulphide inclusions (MnS) and silicate composites were found included in white etching particles as well by the energy-dispersive x-ray spectroscopy analyses. The discovery of martensitic transformation and inclusions in the crack of squat defects reveals an accelerated failure mechanism which would be detrimental to operation safety. It is necessary to pay more attentions so that the risk of fatigue failures can be minimized.
Summary
The kinetics of serum hepatitis B surface antigen (HBsAg) during the natural history of hepatitis B virus (HBV) infection has been studied, but the factors affecting them remain unclear. We ...aimed to investigate the factors affecting HBsAg titres, using data from multicentre, large‐sized clinical trials in China. The baseline data of 1795 patients in 3 multicentre trials were studied, and the patients were classified into 3 groups: hepatitis B early antigen (HBeAg)‐positive chronic HBV infection (n = 588), HBeAg‐positive chronic hepatitis B (n = 596), and HBeAg‐negative chronic hepatitis B (n = 611). HBsAg titres in the different phases were compared, and multiple linear progression analyses were performed to investigate the implicated factors. HBsAg titres varied significantly in different phases (P = .000), with the highest (4.60 log10 IU/mL 10%‐90% confidence interval: 3.52 log10 IU/mL‐4.99 log10 IU/mL) in patients with HBeAg‐positive chronic HBV infection. In all phases, age and HBV DNA were correlated with serum HBsAg level. In HBeAg‐positive chronic hepatitis B patients, a negative correlation between HBsAg titres and fibrosis stage was observed. Alanine amonitransferase or necroinflammatory activity was also correlated with HBsAg titres in HBeAg‐negative chronic hepatitis B patients. In conclusion, decreased HBsAg titres may be associated with advancing fibrosis in HBeAg‐positive chronic hepatitis B patients or increased necroinflammation in those with HBeAg‐negative chronic hepatitis B. Our findings may help clinicians better understand the kinetics of HBsAg and provide useful insights into the management of this disease.
PDF
