Purpose
Many apparent differences exist in aetiology, genetics, anatomy and treatment response between colon cancer (CC) and rectal cancer (RC). This study examines the differences in patient ...characteristics, prevalence of complications and their effect on short-term survival, long-term survival and the rate of recurrence between RC and CC.
Methods
For all stage II–III CC and RC patients who underwent resection with curative intent (2006–2008) in five hospitals in the Netherlands, occurrence of complications, crude survival, relative survival and recurrence rates were compared.
Results
A total of 767 CC and 272 RC patients underwent resection. Significant differences were found for age, gender, emergency surgery, T-stage and grade. CC patients experienced fewer complications compared to RC (
p
= 0.019), but CC patients had worse short-term mortality rates (1.5 versus 6.7 % for 30-day mortality,
p
= 0.001 and 5.2 versus 9.5 % for 90-day mortality,
p
= 0.032). The adjusted HR (overall survival) for CC patients with complications was 1.57 (1.23–2.01;
p
< 0.001) as compared to patients without complications; for RC, the HR was 1.79 (1.12–2.87;
p
= 0.015). Relative survival analyses showed high excess mortality in the first months after surgery and a sustained, prolonged negative effect on both CC and RC. Complications were associated with a higher recurrence rate for both CC and RC; adjusted analyses showed a trend towards a significant association.
Conclusion
Large differences exist in patient characteristics and clinical outcomes between CC and RC. CC patients have a significantly higher short-term mortality compared to RC patients due to a more severe effect of complications.
► A number of studies have demonstrated tDCS efficacy in the recovery of aphasia. ► We wonder whether tDCS can improve articulatory speech gestures in three patients. ► A persistent improvement in ...the anodic compared to the sham condition was present. ► These data are relevant for planning new interventions in aphasia rehabilitation.
A number of studies have shown that modulating cortical activity by means of transcranial direct current stimulation (tDCS) affects the performance of both healthy and brain-damaged subjects. In this study, we investigated the potential of tDCS for the recovery of apraxia of speech in 3 patients with stroke-induced aphasia. Over 2 weeks, three aphasic subjects participated in a randomized double-blinded experiment involving intensive language training for their articulatory difficulties in two tDCS conditions. Each subject participated in five consecutive daily sessions of anodic tDCS (20
min, 1
mA) and sham stimulation over the left inferior frontal gyrus (referred to as Broca's area) while they performed a repetition task. By the end of each week, a significant improvement was found in both conditions. However, all three subjects showed greater response accuracy in the anodic than in the sham condition. Moreover, results for transfer of treatment effects, although different across subjects, indicate a generalization of the recovery at the language test. Subjects 2 and 3 showed a significant improvement in oral production tasks, such as word repetition and reading, while Subjects 1 and 2 had an unexpected significant recovery in written naming and word writing under dictation tasks. At three follow-ups (1 week, 1 and 2 months after the end of treatment), response accuracy was still significantly better in the anodic than in sham condition, suggesting a long-term effect on the recovery of their articulatory gestures.
Medically-assisted procreation (MAP) has given rise to a crisis in the traditional family model, made up of a mother and a father, and led to the births of babies who are genetically and biologically ...unrelated to their legal parents. Italian legal statutes ban such practices, which are punishable by law; yet there is currently no legislation aimed at governing and regulating the legal registration of children born through such procedures abroad. Italian jurisprudence, on the other hand, has acknowledged the right to parenthood for homosexual couples, ruling that the children thus born be considered legally bound to their social parents, by virtue of the affection-based bond, rooted in harmony and listening, that has been formed within the family setting, however unconventional it may be. The paper's author feels that an intervention from lawmakers is urgent and inescapable, in order to provide targeted legislation in such a sensitive realm.
Trisomy 12, the third most frequent chromosomal aberration in chronic lymphocytic leukemia (CLL), confers an intermediate prognosis. In our cohort of 104 untreated patients carrying +12, NOTCH1 ...mutations occurred in 24% of cases and were associated to unmutated IGHV genes (P=0.003) and +12 as a sole cytogenetic abnormality (P=0.008). NOTCH1 mutations in +12 CLL associated with an approximately 2.4 fold increase in the risk of death, a significant shortening of survival (P<0.01) and proved to be an independent predictor of survival in multivariate analysis. Analogous to +12 CLL with TP53 disruption or del(11q), NOTCH1 mutations in +12 CLL conferred a significantly worse survival compared to that of +12 CLL with del(13q) or +12 only. The overrepresentation of cell cycle/proliferation related genes of +12 CLL with NOTCH1 mutations suggests the biological contribution of NOTCH1 mutations to determine a poor outcome. NOTCH1 mutations refine the intermediate prognosis of +12 CLL.
Dowling-Degos Disease (DDD) is a rare and disfiguring autosomal dominant genodermatosis characterized by reticulate hyperpigmented macules or follicular comedone-like papules in the intertriginous ...areas that typically presents in the third or fourth decade of life. It is a progressive disease that is often treatment-resistant. Although its association with hidradenitis suppurativa has been well described, DDD has also been less commonly reported in conjunction with other dermatologic diseases with unknown etiologic associations. Herein, we present a case of DDD with associated epidermal inclusion cysts and conduct a literature review of dermatologic conditions reported in association with DDD.
In fasted and fed states, blood insulin levels are oscillatory. While this phenomenon is well studied at high glucose levels, comparatively little is known about its origin under basal conditions. We ...propose a possible mechanism for basal insulin oscillations based on oscillations in glycolysis, demonstrated using an established mathematical model. At high glucose, this is superseded by a calcium-dependent mechanism.
The X-ray free-electron laser has opened a new era for photon science, improving the X-ray brightness by ten orders of magnitude over previously available sources. Similar to an optical laser, the ...spectral and temporal structure of the radiation pulses can be tailored to the specific needs of many experiments by accurately manipulating the lasing medium, that is, the electron beam. Here we report the generation of mJ-level two-colour hard X-ray pulses of few femtoseconds duration with an XFEL driven by twin electron bunches at the Linac Coherent Light Source. This performance represents an improvement of over an order of magnitude in peak power over state-of-the-art two-colour XFELs. The unprecedented intensity and temporal coherence of this new two-colour X-ray free-electron laser enable an entirely new set of scientific applications, ranging from X-ray pump/X-ray probe experiments to the imaging of complex biological samples with multiple wavelength anomalous dispersion.
The paper proposes the modeling and the optimal management of a hot-temperature (sodium nickel chloride) battery system coupled with wind generators connected to a medium voltage grid. A ...discrete-time model of the storage device reproducing the battery main dynamics (i.e., state of charge, temperature, current, protection, and limitation systems) has been developed. The model has been validated through some experimental tests. An optimal management strategy has been implemented based on a forward dynamic programming algorithm, specifically developed to exploit the energy price arbitrage along the optimization time horizon ("generation shifting"). Taking advantage of this strategy wind generation performances can be enhanced and adapted to load demand, obtaining an increased economic gain measured by the difference between the economic revenue obtained with and without the proposed generation shifting policy.
The manufacturing of refractory-metals components presents some limitations induced by the materials' characteristic low-temperature brittleness and high susceptibility to oxidation. Powder ...metallurgy is typically the manufacturing process of choice. Recently, Wire + Arc Additive Manufacture has proven capable to produce fully-dense large-scale metal parts at relatively low cost, by using high-quality wire as feedstock. In this study, this technique has been used for the production of large-scale tungsten linear structures. The orientation of the wire feeding has been studied and optimised to obtain defect-free tungsten deposits. In particular, front wire feeding eliminated the occurrence of pores and micro-cracks, when compared to side wire feeding. The microstructure, the occurrence of defects and their relationship with the deposition process have also been discussed. Despite the repetitive thermal cycles and the inherent brittleness of the material, the as-deposited structures were free from internal cracks and the layer dimensions were stable during the entire deposition process. This enabled the production of a relatively large-scale component, with the dimension of 210 × 75 × 12 mm. This study has demonstrated that Wire + Arc Additive Manufacture can be used to produce large-scale parts in unalloyed tungsten by complete fusion, presenting a potential alternative to the powder metallurgy manufacturing route.
•Wire + Arc Additive Manufacture is a suitable technique to manufacture large-scale unalloyed tungsten components•The orientation of the wire feeding influences the occurrence of defects as lack of fusion, pores and micro-cracks•The orientation of the wire feeding influences the microstructure of the tungsten deposits•Front wire feeding allowed to produce fully-dense crack-free unalloyed tungsten deposits
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