Neoadjuvant therapy is recommended for locally advanced esophageal cancer, but the optimal strategy remains unclear. We aimed to evaluate the safety and efficacy of neoadjuvant chemoradiotherapy ...(nCRT) versus neoadjuvant chemotherapy (nCT) followed by minimally invasive esophagectomy (MIE) for locally advanced esophageal squamous cell carcinoma (ESCC).
Eligible patients staged as cT3-4aN0-1M0 ESCC were randomly assigned (1 : 1) to the nCRT or nCT group stratified by age, cN stage, and centers. The chemotherapy, based on paclitaxel and cisplatin, was administered to both groups, while concurrent radiotherapy was added for the nCRT group; then MIE was carried out. The primary endpoint was 3-year overall survival. This study is registered with ClinicalTrials.gov (NCT03001596).
A total of 264 patients were eligible for the intention-to-treat analysis. By 30 November 2021, 121 deaths had occurred. The median follow-up was 43.9 months (interquartile range 36.6-49.3 months). The overall survival in the intention-to-treat population was comparable between the nCRT and nCT strategies hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.58-1.18; P = 0.28, with a 3-year survival rate of 64.1% (95% CI 56.4% to 72.9%) versus 54.9% (95% CI 47.0% to 64.2%), respectively. There were also no differences in progression-free survival (HR 0.83, 95% CI 0.59-1.16; P = 0.27) and recurrence-free survival (HR 1.07, 95% CI 0.71-1.60; P = 0.75), although the pathological complete response in the nCRT group (31/112, 27.7%) was significantly higher than that in the nCT group (3/104, 2.9%; P < 0.001). Besides, a trend of lower risk of recurrence was observed in the nCRT group (P = 0.063), while the recurrence pattern was similar (P = 0.802).
NCRT followed by MIE was not associated with significantly better overall survival than nCT among patients with cT3-4aN0-1M0 ESCC. The results underscore the pending issue of the best strategy of neoadjuvant therapy for locally advanced bulky ESCC.
•The CMISG1701 trial assessed the safety and efficacy of nCRT versus nCT followed by MIE for locally advanced bulky ESCC.•The nCRT followed by MIE strategy could not improve survival significantly compared with the nCT strategy.•The best strategy of neoadjuvant therapy for locally advanced bulky ESCC remains a pending issue.
Urbanization is a common development trend of countries all over the world, which is a mark of civilization and progress of human beings. The number of urbanization-induced environmental geological ...hazards has grown steadily in recent years and is receiving increased attention throughout the world. The purpose of this paper is to generalize China’s urbanization process and induced environmental geological hazards. Driving forces and characteristics of urbanization are briefly introduced in this study; specifically, the distribution of urban agglomerations is principally related to water resources, transportation and energy. Common geological hazards and particular ones in mountain city, mining city and coastal city are also summarized. The type and severity of hazards are different due to the differences of natural conditions and various urban functions. Main environmental geological hazards in cities are land subsidence, landslide and seawater intrusion, etc. Accordingly, reasons for these urbanization-induced geological hazards in different type of cities are analyzed and discussed. The research results may provide a clear perspective for urban geological hazard prevention, and suggestions for urban geological hazard control are pointed out.
We discover a pair of spin-polarized surface bands on the (111) face of grey arsenic by using angle-resolved photoemission spectroscopy (ARPES). In the occupied side, the pair resembles typical ...nearly-free-electron Shockley states observed on noble-metal surfaces. However, pump-probe ARPES reveals that the spin-polarized pair traverses the bulk band gap and that the crossing of the pair at Γover ¯ is topologically unavoidable. First-principles calculations well reproduce the bands and their nontrivial topology; the calculations also support that the surface states are of Shockley type because they arise from a band inversion caused by crystal field. The results provide compelling evidence that topological Shockley states are realized on As(111).
Summary
Background
The patatin‐like phospholipase 3 (PNPLA3) rs738409 gene polymorphism is an important genetic determinant of non‐alcoholic fatty liver disease (NAFLD). However, the associations ...between liver fat and metabolic traits in rs738409 G allele carriers and the allelic influence on this association have not been fully studied.
Aim
To investigate the influence of the PNPLA3 gene polymorphism on the association of liver fat with serum metabolic factors and carotid atherosclerosis.
Methods
Liver fat was measured by quantitative ultrasound in 4300 subjects in the Shanghai Changfeng community and analysed for its association with obesity and metabolic factors in individuals with the PNPLA3 CC, CG and GG genotypes.
Results
Non‐alcoholic fatty liver disease occurred in 37.9% and 28.8% of the subjects with the GG and CC genotypes respectively (P < 0.001). Liver fat was significantly associated with body mass index, waist circumference, serum triglycerides, high‐density lipoprotein cholesterol, fasting blood glucose and insulin in the PNPLA3 rs738409 G allele carriers (P < 0.001). Compared with the CC homozygotes, the GG homozygotes presented higher liver fat and liver fibrosis scores despite their better metabolic status (comparison of regression line slopes, P < 0.05). An increase in liver fat was accompanied by a significant increase in the average and maximum carotid intima‐media thickness in subjects with the PNPLA3 CC genotype but not in those with the GG genotype.
Conclusions
PNPLA3 rs738409 G allele carriers were found to be more susceptible to the metabolic‐related hepatic steatosis, and developed NAFLD and liver fibrosis despite presenting relatively better metabolic statuses and lower risks for carotid atherosclerosis.
There is a great need to assess the harmful effects or toxicities of chemicals to which man is exposed. In the present paper, the simplified molecular input line entry specification (SMILES) ...representation-based string kernel, together with the state-of-the-art support vector machine (SVM) algorithm, were used to classify the toxicity of chemicals from the US Environmental Protection Agency Distributed Structure-Searchable Toxicity (DSSTox) database network. In this method, the molecular structure can be directly encoded by a series of SMILES substrings that represent the presence of some chemical elements and different kinds of chemical bonds (double, triple and stereochemistry) in the molecules. Thus, SMILES string kernel can accurately and directly measure the similarities of molecules by a series of local information hidden in the molecules. Two model validation approaches, five-fold cross-validation and independent validation set, were used for assessing the predictive capability of our developed models. The results obtained indicate that SVM based on the SMILES string kernel can be regarded as a very promising and alternative modelling approach for potential toxicity prediction of chemicals.
To improve cathodic efficiency and sustainability of microbial fuel cell (MFC), graphite fibre brush (GFB) was examined as cathode material for power production in biocatalysed‐cathode MFC. Following ...133‐h mixed culturing of electricity‐producing bacteria, the MFC could generate a reproducible voltage of 0.4 V at external resistance (REX) of 100 Ω. Maximum volumetric power density of 68.4 W m–3 was obtained at a current density of 178.6 A m–3. Upon aerobic inoculation of electrochemically active bacteria, charge transfer resistance of the cathode was decreased from 188 to 17 Ω as indicated by electrochemical impedance spectroscopy (EIS) analysis. Comparing investigations of different cathode materials demonstrated that biocatalysed GFB had better performance in terms of half‐cell polarisation, power and Coulombic efficiency (CE) over other tested materials. Additionally, pH deviation of electrolyte in anode and cathode was also observed. This study provides a demonstration of GFB used as biocathode material in MFC for more efficient and sustainable electricity recovery from organic substances.
Casting Al–2.77
wt.% Mg alloy was subjected to equal channel angular pressing (ECAP) and subsequent low-temperature annealing treatment. Tensile properties and fracture modes of as-ECAPed and ...annealed samples were investigated. It is found that the strength of the Al–Mg alloy increases with increasing the number of ECAP passes, while its elongation decreases. After annealing, the elongation is recovered to a large extent, consequently, the static toughness of the alloy is enhanced by a combination of ECAP and annealing treatment. Vickers hardness HV of the Al–Mg alloy monotonously increases with increasing the number of ECAP passes and follows a relationship of HV/
σ
b
≈
2.5, independent of the number of ECAP passes. Meanwhile, it is noted that the casting alloy only exhibits necking before failure, while the alloy subjected to ECAP fails in shear mode, with an increasing shear fracture angle at high number of ECAP passes. Besides, the low temperature annealing treatment hardly affects the tensile fracture mode of the ECAPed alloy. Based on the experimental results above, the tensile failure mechanisms of the ECAPed Al–Mg alloy are discussed.
Open cell aluminum foams with tailored porous morphology were synthesized by a space-holder method. Carbamide particles with different shapes were used as a space-holder to produce samples. Depending ...on the shape distribution of the carbamide particles, the morphology of the pores in the foams can be easily controlled. The foam samples with spherical-shaped pores showed higher compressive strength than those with strip-shaped pores.
The role of lipoprotein (a) Lp(a) in coronary artery diseases (CAD) with special clinical background such as type 2 diabetes mellitus (T2DM) has not been fully determined. The aim of the present ...study was to investigate the relation of Lp(a) to type 2 diabetic patients with or without CAD.
A total of 2040 consecutive patients with T2DM who received selective coronary angiography (CAG) due to angina-like chest pain were enrolled. The patients were subsequently divided into CAD and non-CAD groups according to the results of CAG. The severity of CAD was evaluated by the Gensini Score (GS), number of stenotic vessels, and history of myocardial infarction (MI). Data showed that Lp(a) levels were higher in the CAD group than in the non-CAD group (median: 15.00 mg/dL vs. 11.88 mg/dL, P = 0.025). The results from CAD subgroup analysis indicated that the patients with MI, multiple-vessel disease and high GS had higher Lp(a) levels compared with those in their matched subgroups (P < 0.05, respectively). After adjustment for confounders, Lp(a) levels were independently related to the presence and severity of CAD (CAD:OR = 1.564; MI:OR = 1.523; high GS:OR = 1.388; multiple-vessel disease:OR = 1.455; P < 0.05, respectively).
Elevated Lp(a) levels were independently associated with the presence and severity of CAD in patients with T2DM. More studies are necessary to confirm our findings.
•Lp(a) levels were significantly increased in T2DM patients with CAD and were gradually increased with the severity of CAD.•Lp(a) levels were independent associated with the presence and severity of angiography-proven CAD in patients with T2DM.•Lp(a) might be useful to evaluate the presence and severity of CAD and Lp(a) screening might be considered in diabetic patients.
This work reports CNT-reinforced Al nanocomposites fabricated with in situ chemical vapor deposition process for achieving homogeneous dispersion of CNTs and good interfacial bonding between CNT and ...metallic matrices. The mechanical strength of CNT/Al nanocomposites is dependent on CNT addition, while the fracture strain degrades compared with that of pure metal. The good reinforcement of CNT/metal nanocomposites is attributed to the strong interfacial bonding as well as the homogeneous dispersion of CNTs in the matrix. Furthermore, the strong interfacial bonding is due to the existence of transition thin layer of Al
4C
3 between CNTs and Al matrix.
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