4 research outputs found
Nonequilibrium wetting
When a nonequilibrium growing interface in the presence of a wall is
considered a nonequilibrium wetting transition may take place. This transition
can be studied trough Langevin equations or discrete growth models. In the
first case, the Kardar-Parisi-Zhang equation, which defines a very robust
universality class for nonequilibrium moving interfaces, with a soft-wall
potential is considered. While in the second, microscopic models, in the
corresponding universality class, with evaporation and deposition of particles
in the presence of hard-wall are studied. Equilibrium wetting is related to a
particular case of the problem, it corresponds to the Edwards-Wilkinson
equation with a potential in the continuum approach or to the fulfillment of
detailed balance in the microscopic models. In this review we present the
analytical and numerical methods used to investigate the problem and the very
rich behavior that is observed with them.Comment: Review, 36 pages, 16 figure
Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study.
BACKGROUND
No evidence currently exists characterising global outcomes following major cancer surgery, including esophageal cancer. Therefore, this study aimed to characterise impact of high income countries (HIC) versus low and middle income countries (LMIC) on the outcomes following esophagectomy for esophageal cancer.
METHOD
This international multi-center prospective study across 137 hospitals in 41 countries included patients who underwent an esophagectomy for esophageal cancer, with 90-day follow-up. The main explanatory variable was country income, defined according to the World Bank Data classification. The primary outcome was 90-day postoperative mortality, and secondary outcomes were composite leaks (anastomotic leak or conduit necrosis) and major complications (Clavien-Dindo Grade III - V). Multivariable generalized estimating equation models were used to produce adjusted odds ratios (ORs) and 95% confidence intervals (CI).
RESULTS
Between April 2018 to December 2018, 2247 patients were included. Patients from HIC were more significantly older, with higher ASA grade, and more advanced tumors. Patients from LMIC had almost three-fold increase in 90-day mortality, compared to HIC (9.4% vs 3.7%, p < 0.001). On adjusted analysis, LMIC were independently associated with higher 90-day mortality (OR: 2.31, CI: 1.17-4.55, p = 0.015). However, LMIC were not independently associated with higher rates of anastomotic leaks (OR: 1.06, CI: 0.57-1.99, p = 0.9) or major complications (OR: 0.85, CI: 0.54-1.32, p = 0.5), compared to HIC.
CONCLUSION
Resections in LMIC were independently associated with higher 90-day postoperative mortality, likely reflecting a failure to rescue of these patients following esophagectomy, despite similar composite anastomotic leaks and major complication rates to HIC. These findings warrant further research, to identify potential issues and solutions to improve global outcomes following esophagectomy for cancer