To prospectively evaluate the use of
F-fluorodeoxyglucose positron emission tomography/computed tomography (
F-FDG-PET/CT) in the definition of the treatment response after primary treatment of ...advanced epithelial ovarian cancer (EOC).
Forty-nine patients with advanced EOC had an
F-FDG PET/CT scan before and after primary treatment. The treatment response was defined with the currently used radiological and serological Response Criteria in Solid Tumors (RECIST1.1/GCIC) criteria and the modified PET Response Criteria in Solid Tumors (PERCIST). The concordance of the two methods was analysed. If the patient had a complete response to primary treatment by conventional criteria, the end of treatment
F-FDG PET/CT scan (etPET/CT) was not opened until retrospectively at the time of disease progression. The ability of etPET/CT to predict the time to disease recurrence was analysed. The recurrence patterns were observed with an
F-FDG PET/CT at the first relapse.
The agreement of the RECIST1.1/GCIC and modified PERCIST criteria in defining the primary treatment response in the whole patient cohort was good (weighted kappa coefficient = 0.78). Of the complete responders (n = 28), 34% had metabolically active lesions present in the etPET/CT, most typically in the lymph nodes. The same anatomical sites tended to activate at disease relapse, but were seldom the only site of relapse. In patients with widespread intra-abdominal carsinosis at diagnosis, the definition of metabolic response was challenging due to problems in distinguishing the physiological FDG accumulation in the bowel loops from the residual tumour in the same area. The presence of metabolically active lesions in the etPET/CT did not predict earlier disease relapse in the complete responders.
In the present study, etPET/CT revealed metabolically active lesions in complete responders after EOC primary therapy, but they were insignificant for the patient's prognosis. The current study does not favour routine use of
F-FDG PET/CT after EOC primary treatment for complete responders.
To prospectively evaluate the use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in the definition of the treatment response after primary treatment of ...advanced epithelial ovarian cancer (EOC).
Forty-nine patients with advanced EOC had an 18F-FDG PET/CT scan before and after primary treatment. The treatment response was defined with the currently used radiological and serological Response Criteria in Solid Tumors (RECIST1.1/GCIC) criteria and the modified PET Response Criteria in Solid Tumors (PERCIST). The concordance of the two methods was analysed. If the patient had a complete response to primary treatment by conventional criteria, the end of treatment 18F-FDG PET/CT scan (etPET/CT) was not opened until retrospectively at the time of disease progression. The ability of etPET/CT to predict the time to disease recurrence was analysed. The recurrence patterns were observed with an 18F-FDG PET/CT at the first relapse.
The agreement of the RECIST1.1/GCIC and modified PERCIST criteria in defining the primary treatment response in the whole patient cohort was good (weighted kappa coefficient = 0.78). Of the complete responders (n = 28), 34% had metabolically active lesions present in the etPET/CT, most typically in the lymph nodes. The same anatomical sites tended to activate at disease relapse, but were seldom the only site of relapse. In patients with widespread intra-abdominal carsinosis at diagnosis, the definition of metabolic response was challenging due to problems in distinguishing the physiological FDG accumulation in the bowel loops from the residual tumour in the same area. The presence of metabolically active lesions in the etPET/CT did not predict earlier disease relapse in the complete responders.
In the present study, etPET/CT revealed metabolically active lesions in complete responders after EOC primary therapy, but they were insignificant for the patient's prognosis. The current study does not favour routine use of 18F-FDG PET/CT after EOC primary treatment for complete responders.
•PET/CT often shows metabolic activity after advanced ovarian cancer primary therapy.•Treatment response defined with RECIST1.1/GCIC predicts time to disease recurrence.•Anatomic and serological complete responders often have metabolic activity in PET/CT.•Residual activity in PET/CT of complete responders has no prognostic value.•PET-active lesions at the end of treatment tend to be active also in first relapse.
The growing complexity of particle detectors makes their construction and quality control a new challenge. We present studies that explore the use of deep learning-based computer vision techniques to ...perform quality checks of detector components and assembly steps, which will automate procedures and minimize the need for human interventions. This study focuses on the construction steps of a silicon detector, which involve forming a mechanical structure with the sensor and wire bonding individual cells to electronics for reading out signals. Silicon detectors in high energy physics experiments today have millions of channels. Manual quality control of these and other high channel-density detectors requires enormous amounts of labor and can be prone to errors. Here, we explore computer vision applications to either augment or fully replace visual inspections done by humans. We investigated convolutional neural networks for image classification and autoencoders for anomalies detection. Two proof-of-concept studies will be presented.
A novel method to reconstruct the energy of hadronic showers in the CMS High Granularity Calorimeter (HGCAL) is presented. The HGCAL is a sampling calorimeter with very fine transverse and ...longitudinal granularity. The active media are silicon sensors and scintillator tiles readout by SiPMs and the absorbers are a combination of lead and Cu/CuW in the electromagnetic section, and steel in the hadronic section. The shower reconstruction method is based on graph neural networks and it makes use of a dynamic reduction network architecture. It is shown that the algorithm is able to capture and mitigate the main effects that normally hinder the reconstruction of hadronic showers using classical reconstruction methods, by compensating for fluctuations in the multiplicity, energy, and spatial distributions of the shower's constituents. The performance of the algorithm is evaluated using test beam data collected in 2018 prototype of the CMS HGCAL accompanied by a section of the CALICE AHCAL prototype. The capability of the method to mitigate the impact of energy leakage from the calorimeter is also demonstrated.
The DVB-T2 standard introduces the possibility to use several physical streams in one transmission multiplex. These streams can be transmitted using different modulation and physical layer code ...rates, providing unequal error protection. The Scalable Video Coding (SVC) extension of H.264 provides video content where video with different quality can be partitioned into separate bit streams. When applying SVC in a DVB-T2 system, the base layer bit stream of the video can be broadcasted with high error protection, whereas enhancement layers, e.g. high definition, can be transmitted with lower error protection, but with higher bandwidth utilization. In this paper, broadcasting of SVC in a DVB-T2 Lite system is explored. Given equal bandwidth utilization and video quality constraints, the broadcasting of SVC video is compared to the simulcasting of separately coded H.264/AVC video streams. The study is based on a time series of real world measured signal strengths combined with DVB-T2 Lite physical layer simulations, and the results indicate that broadcasting of SVC provides an overall better end-user experience as compared to simulcasting of AVC video.
光化性角化病日光光动力疗法:对比 BF‐200 ALA 与 MAL 的多中心试验 Räsänen, J.E.; Neittaanmäki, N.; Ylitalo, L. ...
British journal of dermatology (1951),
August 2019, 20190801, Letnik:
181, Številka:
2
Journal Article
The underpinning logic of value co-creation in service logic is analysed. It is observed that some of the 10 foundational premises of the so-called service-dominant logic do not fully support an ...understanding of value creation and co-creation in a way that is meaningful for theoretical development and decision making in business and marketing practice. Without a thorough understanding of the interaction concept, the locus as well as nature and content of value co-creation cannot be identified. Value co-creation easily becomes a concept without substance. Based on the analysis in the present article, it is observed that the unique contribution of a service perspective on business (service logic) is not that customers always are co-creators of value, but rather that under certain circumstances the service provider gets opportunities to co-create value together with its customers. Finally, seven statements included in six of the foundational premises are reformulated accordingly.
Purpose
This paper aims to emphasize two key research priorities central to the domain of service marketing.
Design/methodology/approach
Reflections based on conceptual analysis of the current level ...of knowledge of service as an offering and of the nature of service marketing in the literature.
Findings
It is observed that research into marketing and into service as an object of marketing, or as an offering, has been neglected for two decades and more. It is also shown that to restore its credibility, marketing needs to be reinvented. Furthermore, the point is made that if a proper understanding of service as an object of, for example, innovation, design, branding and development is lacking, or even only implicitly present, valid research into those and other important topics is at risk.
Research limitations/implications
This paper discusses two neglected topics within the domain of service research. Other important areas of future research are not covered. However, the paper offers directions for service marketing research fundamental to the development of the discipline.
Originality/value
In earlier discussions of service and service marketing research priorities, the observation that service and marketing are neglected topics that need to be studied and further developed has not been made. The paper emphasizes that service marketing research also needs to return to its roots and suggests possible directions for future research.
Short-term results support antibiotics as an alternative to surgery for treating uncomplicated acute appendicitis, but long-term outcomes are not known.
To determine the late recurrence rate of ...appendicitis after antibiotic therapy for the treatment of uncomplicated acute appendicitis.
Five-year observational follow-up of patients in the Appendicitis Acuta (APPAC) multicenter randomized clinical trial comparing appendectomy with antibiotic therapy, in which 530 patients aged 18 to 60 years with computed tomography-confirmed uncomplicated acute appendicitis were randomized to undergo an appendectomy (n = 273) or receive antibiotic therapy (n = 257). The initial trial was conducted from November 2009 to June 2012 in Finland; last follow-up was September 6, 2017. This current analysis focused on assessing the 5-year outcomes for the group of patients treated with antibiotics alone.
Open appendectomy vs antibiotic therapy with intravenous ertapenem for 3 days followed by 7 days of oral levofloxacin and metronidazole.
In this analysis, prespecified secondary end points reported at 5-year follow-up included late (after 1 year) appendicitis recurrence after antibiotic treatment, complications, length of hospital stay, and sick leave.
Of the 530 patients (201 women; 329 men) enrolled in the trial, 273 patients (median age, 35 years IQR, 27-46) were randomized to undergo appendectomy, and 257 (median age, 33 years, IQR, 26-47) were randomized to receive antibiotic therapy. In addition to 70 patients who initially received antibiotics but underwent appendectomy within the first year (27.3% 95% CI, 22.0%-33.2%; 70/256), 30 additional antibiotic-treated patients (16.1% 95% CI, 11.2%-22.2%; 30/186) underwent appendectomy between 1 and 5 years. The cumulative incidence of appendicitis recurrence was 34.0% (95% CI, 28.2%-40.1%; 87/256) at 2 years, 35.2% (95% CI, 29.3%-41.4%; 90/256) at 3 years, 37.1% (95% CI, 31.2%-43.3%; 95/256) at 4 years, and 39.1% (95% CI, 33.1%-45.3%; 100/256) at 5 years. Of the 85 patients in the antibiotic group who subsequently underwent appendectomy for recurrent appendicitis, 76 had uncomplicated appendicitis, 2 had complicated appendicitis, and 7 did not have appendicitis. At 5 years, the overall complication rate (surgical site infections, incisional hernias, abdominal pain, and obstructive symptoms) was 24.4% (95% CI, 19.2%-30.3%) (n = 60/246) in the appendectomy group and 6.5% (95% CI, 3.8%-10.4%) (n = 16/246) in antibiotic group (P < .001), which calculates to 17.9 percentage points (95% CI, 11.7-24.1) higher after surgery. There was no difference between groups for length of hospital stay, but there was a significant difference in sick leave (11 days more for the appendectomy group).
Among patients who were initially treated with antibiotics for uncomplicated acute appendicitis, the likelihood of late recurrence within 5 years was 39.1%. This long-term follow-up supports the feasibility of antibiotic treatment alone as an alternative to surgery for uncomplicated acute appendicitis.
ClinicalTrials.gov Identifier: NCT01022567.
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