Personalized Estimate of Chemotherapy-Induced Nausea and Vomiting: Development and External Validation of a Nomogram in Cancer Patients Receiving Highly/Moderately Emetogenic Chemotherapy.

Chemotherapy-induced nausea and vomiting (CINV) is presented in over 30% of cancer patients receiving highly/moderately emetogenic chemotherapy (HEC/MEC). The currently recommended antiemetic therapy is merely based on the emetogenic level of chemotherapy, regardless of patient's individual risk factors. It is, therefore, critical to develop an approach for personalized management of CINV in the era of precision medicine.A number of variables were involved in the development of CINV. In the present study, we pooled the data from 2 multi-institutional investigations of CINV due to HEC/MEC treatment in Asian countries. Demographic and clinical variables of 881 patients were prospectively collected as defined previously, and 862 of them had full documentation of variables of interest. The data of 548 patients from Chinese institutions were used to identify variables associated with CINV using multivariate logistic regression model, and then construct a personalized prediction model of nomogram; while the remaining 314 patients out of China (Singapore, South Korea, and Taiwan) entered the external validation set. C-index was used to measure the discrimination ability of the model.The predictors in the final model included sex, age, alcohol consumption, history of vomiting pregnancy, history of motion sickness, body surface area, emetogenicity of chemotherapy, and antiemetic regimens. The C-index was 0.67 (95% CI, 0.62-0.72) for the training set and 0.65 (95% CI, 0.58-0.72) for the validation set. The C-index was higher than that of any single predictor, including the emetogenic level of chemotherapy according to current antiemetic guidelines. Calibration curves showed good agreement between prediction and actual occurrence of CINV.This easy-to-use prediction model was based on chemotherapeutic regimens as well as patient's individual risk factors. The prediction accuracy of CINV occurrence in this nomogram was well validated by an independent data set. It could facilitate the assessment of individual risk, and thus improve the personalized management of CINV

Immediate Versus Delayed Topotecan after First-line Therapy in Small Cell Lung Cancer

Background and objective How to prolong progression free survival (PFS) and overall survival (OS) of patients with small cell lung cancer (SCLC) has been one of the hottest issues. We retrospectively reviewed our data to compare the survival of immediate with delayed topotecan after first-line therapy in SCLC. Methods In our retrospective study, 53 patients with SCLC were divided into two groups as follow: patients receiving topotecan-containing regimen as maintenance/consolidation (maintenance/consolidation chemotherapy group) and salvage chemotherapy (salvage chemotherapy group). The Log-rank test was used to assess the difference in OS between two groups. Cox regression model was used for the multivariable analysis of independent prognostic factors. Results Twenty-nine patients received topotecan as maintenance/consolidation treatment, whereas 24 patients salvage chemotherapy. The response rates were 51.7% and 41.7%, respectively. The median survival time were 20 months and 27 months respectively (P=0.89). Multivariate Cox regression analyses identified sex and stage as independent prognostic factors. Conclusion Efficacy of first-line therapy was improved by topotecan maintenance/consolidation treatment, which did not result in any significant survival benefits in SCLC

The Plastic Scintillator Detector at DAMPE

he DArk Matter Particle Explorer (DAMPE) is a general purposed satellite-borne high energy $\gamma-$ray and cosmic ray detector, and among the scientific objectives of DAMPE are the searches for the origin of cosmic rays and an understanding of Dark Matter particles. As one of the four detectors in DAMPE, the Plastic Scintillator Detector (PSD) plays an important role in the particle charge measurement and the photons/electrons separation. The PSD has 82 modules, each consists of a long organic plastic scintillator bar and two PMTs at both ends for readout, in two layers and covers an overall active area larger than 82 cm $\times$ 82 cm. It can identify the charge states for relativistic ions from H to Fe, and the detector efficiency for Z=1 particles can reach 0.9999. The PSD has been successfully launched with DAMPE on Dec. 17, 2015. In this paper, the design, the assembly, the qualification tests of the PSD and some of the performance measured on the ground have been described in detail

Community Structure Characterization

This entry discusses the problem of describing some communities identified in a complex network of interest, in a way allowing to interpret them. We suppose the community structure has already been detected through one of the many methods proposed in the literature. The question is then to know how to extract valuable information from this first result, in order to allow human interpretation. This requires subsequent processing, which we describe in the rest of this entry

Pressured HIV testing "in the name of love": a mixed methods analysis of pressured HIV testing among men who have sex with men in China.

INTRODUCTION: HIV testing has rapidly expanded into diverse, decentralized settings. While increasing accessibility to HIV testing is beneficial, it may lead to unintended consequences such as being pressured to test. We examined the frequency, correlates and contexts of pressured HIV testing among Chinese men who have sex with men (MSM) using mixed methods. METHODS: We conducted an online survey of MSM (N = 1044) in May 2017. Pressured HIV testing was defined as being forced to test for HIV. We conducted logistic regression analysis to determine the associations between pressured HIV testing and socio-demographic and sexual behavioural factors. Follow-up interviews (n = 17) were conducted with men who reported pressured testing and we analysed qualitative data using a thematic analysis approach. RESULTS: Ninety-six men (9.2%) reported experiencing pressure to test for HIV. Regular male sex partners were the most common source of pressure (61%, 59/96), and the most common form of pressure was a threat to end a relationship with the one who was being pressured (39%, 37/96). We found a higher risk of pressured testing in men who had only used HIV self-testing compared to men who had never self-tested (AOR 2.39 (95%CI: 1.38 to 4.14)). However, this relationship was only significant among men with low education (AOR 5.88 (95% CI: 1.92 to 17.99)) and not among men with high education (AOR 1.62 (95% CI: 0.85 to 3.10)). After pressured testing, about half of men subsequently tested for HIV (55%, 53/96) without pressure - none reported being diagnosed with HIV. Consistent with this finding, qualitative data suggest that perceptions of pressure existed on a continuum and depended on the relationship status of the one who pressured them. Although being pressured to test was accompanied by negative feelings, men who were pressured into testing often changed their attitude towards HIV testing, testing behaviours, sexual behaviours and relationship with the one who pressured them to test. CONCLUSION: Pressured HIV testing was reported among Chinese MSM, especially from men with low education levels and men who received HIV self-testing. However, in some circumstances, pressure to test helped MSM in several ways, challenging our understanding of the role of agency in the setting of HIV testing

Culture Shock of Sojourners and the Implications for Higher Education Performance

The advent of globalization and international educational exchange has enabled a large number of foreign students have been studying in the USA, the UK and Australia, etc. simultaneously, more and more foreign teachers have come to teach in Chinese universities and colleges. This has made intercultural communication inevitable and important to the teaching quality and culture shock has exerted a direct on teaching, learning and research. Therefore, identifying intercultural differences and managing culture shock should be a prerequisite to quality classroom teaching and higher education performance. This paper analyzes the relevant theories, stages and causes of culture shock, interviews Chinese students and sojourn scholars in foreign countries, investigates foreign teachers in China and explores the various countermeasures to manage culture shock to enhance higher education performance

Gas Phase Desulfurization Using Regenerable Microfibrous Entrapped Metal Oxide Based Sorbents for Logistic PEM Fuel Cell Applications

This dissertation presents results of R&D efforts to develop a thin, low pressure drop, high efficiency zinc oxide based sorbent using glass fibrous media as carrier to remove gaseous sulfur compounds from reformates for logistic PEM fuel cell power systems. The glass fibrous entrapped sorbents (GFES) contain 3 vol.% glass fibrous media, 22 vol.% particles (100~200 um) and 75 vol.% voidage. Therefore, GFES yielded much lower pressure drops than packed beds at the same test conditions. In thin bed tests, GFES demonstrated exceptional desulfurization and regeneration performance, compared with the packed beds of ZnO extrudates (1 mm) and particles of similar size (80~100 mesh) at equivalent reactor volume. Fundamental kinetic studies were conducted to investigate the improvements observed using GFES. The experimental results at 400 °C indicated that the desulfurization process using ZnO/SiO2 and GFES sorbents was controlled by the external mass transfer rate at a face velocity less than 11 cm/s, while the process using ZnO extrudates suffered from severe intra-particle mass transfer resistance. A modified Amundson model was applied to describe the relationship between the apparent rate constant (ka) and the sharpness (lumped K) of a breakthrough curve. Based on this model, the influences of microfibrous media and high voidage were discussed. The sorbent was also evaluated for sulfur removal from realistic reformates. The effects of CO, CO2 and water on the desulfurization performance were examined for ZnO based sorbents at 400 °C. Water and CO contents determine the H2S and COS breakthrough respectively, therefore total sulfur breakthrough. The homogeneous and heterogeneous COS formation pathways were revealed experimentally. Moreover, the low temperature performance of ZnO/SiO2 and GFES was also studied. It was found that the addition of copper dopant to ZnO/SiO2 could significantly improve the sulfur capacity and regenerability for the desulfurization applications at stack temperatures. Due to the high sulfur removal efficiency and low ZnO density, the GFES can be employed as desulfurizer for H2S removal at extremely low concentrations or as polishing layers in composite beds (packed beds followed by polishing layers downstream) to improve the overall breakthrough capacit

A Prospective Randomized Study of the Radiotherapy Volume for Limited-stage Small Cell Lung Cancer: A Preliminary Report

Background and objective Controversies exists with regard to target volumes as far as thoracic radiotherapy (TRT) is concerned in the multimodality treatment for limited-stage small cell lung cancer (LSCLC). The aim of this study is to prospectively compare the local control rate, toxicity profiles, and overall survival (OS) between patients received different target volumes irradiation after induction chemotherapy. Methods LSCLC patients received 2 cycles of etoposide and cisplatin (EP) induction chemotherapy and were randomly assigned to receive TRT to either the post- or pre-chemotherapy tumor extent (GTV-T) as study arm and control arm, CTV-N included the positive nodal drainage area for both arms. One to 2 weeks after induction chemotherapy, 45 Gy/30 Fx/19 d TRT was administered concurrently with the third cycle of EP regimen. After that, additional 3 cycles of EP consolidation were administered. Prophylactic cranial irradiation (PCI) was administered to patients with a complete response. Results Thirty-seven and 40 patients were randomly assigned to study arm and control arm. The local recurrence rates were 32.4% and 28.2% respectively (P=0.80); the isolated nodal failure (INF) rate were 3.0% and 2.6% respectively (P=0.91); all INF sites were in the ipsilateral supraclavicular fossa. Medastinal N3 disease was the risk factor for INF (P=0.02, OR=14.13, 95%CI: 1.47-136.13). During radiotherapy, grade I, II weight loss was observed in 29.4%, 5.9% and 56.4%, 7.7% patients respectively (P=0.04). Grade 0-I and II-III late pulmonary injury was developed in 97.1%, 2.9% and 86.4%, 15.4% patients respectively (P=0.07). Median survival time was 22.1 months and 26.9 months respectively. The 1 to 3-year OS were 77.9%, 44.4%, 37.3% and 75.8%, 56.3%, 41.7% respectively (P=0.79). Conclusion The preliminary results of this study indicate that irradiant the post-chemotherapy tumor extent (GTV-T) and positive nodal drainage area did not decrease local control and overall survival while radiation toxicity was reduced. But the current sample size has not met designed requirements, and further investigation is warranted before final conclusions could be drawn