Comparison of Long-term Survival of Patients With Early-Stage Non–Small Cell Lung Cancer After Surgery vs Stereotactic Body Radiotherapy

IMPORTANCE Previous comparisons of surgery and stereotactic body radiotherapy (SBRT) for early-stage (ES) non–small cell lung cancer (NSCLC) did not account for the extent of regional lymph node examination (LNE) during surgery. OBJECTIVE To compare long-term overall survival (OS) of patients with ES NSCLC after surgery vs SBRT when the extent of regional LNE in patients undergoing surgery is thoroughly considered. DESIGN, SETTING, AND PARTICIPANTS Cohort study with survival comparisons using the multivariable Cox proportional hazards model and after propensity score matching. Data from the National Cancer Database were analyzed from October 28, 2018, through April 18, 2019. Patients with ES NSCLC diagnosed between January 1, 2004, and December 31, 2015, who underwent any curative-intent surgery or SBRT were included. MAIN OUTCOMES AND MEASURES Long-term OS. RESULTS Of 104 709 total patients, 91 330 underwent surgery (42 508 [46.5%] male; median [interquartile range] age, 68 [61-75] years) and 13 379 received SBRT (6065 [45.3%] male; median [interquartile range] age, 75 [68-81] years). Surgery, especially lobectomy (hazard ratio [HR], 0.53; 95% CI, 0.50-0.56), and regional LNE, especially when more than 10 lymph nodes were examined (HR, 0.73; 95% CI, 0.69-0.77), were associated with better long-term OS (P \u3c .001). Pneumonectomy was not associated with reduced mortality risk when 0 nodes were examined (HR for stage T1, 1.43; 95% CI, 0.67-3.06; P = .35; HR for stage T2-T3, 0.62; 95% CI, 0.34-1.13; P = .12) or when more than 15 nodes were examined for stage T1 disease in patients younger than 80 years (HR, 0.77; 95% CI, 0.54-1.09; P = .14) or when patients aged 80 years or older received regional LNE of any extent (\u3e15 nodes examined: HR for stage T1, 0.65; 95% CI, 0.16-2.64; P = .54; HR for stage T2-T3, 0.90; 95% CI, 0.50-1.60; P = .71). Less extensive surgery was not associated with improved OS when 0 nodes were examined in patients aged 80 years or older with stage T2 to T3 tumors (HR for lobectomy, 0.90; 95% CI, 0.65-1.25; P = .53) and in selected operable patients older than 75 years with stage T1 tumors (HR for lobectomy, 1.07; 95% CI, 0.57-2.00; P = .84). CONCLUSIONS AND RELEVANCE This study found that, overall, surgery coupled with regional LNE of appropriate extent was associated with the best long-term OS in patients with ES NSCLC

THE CHANGE OF KNEE KINEMATICS AFTER ANTERIOR CRUCIATE LIGAMENT DEFICIENCY AND RECONSTRUCTION DURING LANDING

The purpose of this study were to evaluate the different of knee kinematics analysis after ACLD and ACLR during landing performances. The participants were instructed to finish counter moment jump (CMJ) with arms free 5 times as hard as possible with Vicon motion system and two force platforms. The ACLD showed a significant less knee flexion degree at the peak vertical GRF compared with others. Our founding was similar to the present studies; the impulse during landing among three groups was almost the same, but the RF EMG showed lower after two ACL groups, especially in ACLD

eX-ViT: A Novel eXplainable Vision Transformer for Weakly Supervised Semantic Segmentation

Recently vision transformer models have become prominent models for a range of vision tasks. These models, however, are usually opaque with weak feature interpretability. Moreover, there is no method currently built for an intrinsically interpretable transformer, which is able to explain its reasoning process and provide a faithful explanation. To close these crucial gaps, we propose a novel vision transformer dubbed the eXplainable Vision Transformer (eX-ViT), an intrinsically interpretable transformer model that is able to jointly discover robust interpretable features and perform the prediction. Specifically, eX-ViT is composed of the Explainable Multi-Head Attention (E-MHA) module, the Attribute-guided Explainer (AttE) module and the self-supervised attribute-guided loss. The E-MHA tailors explainable attention weights that are able to learn semantically interpretable representations from local patches in terms of model decisions with noise robustness. Meanwhile, AttE is proposed to encode discriminative attribute features for the target object through diverse attribute discovery, which constitutes faithful evidence for the model's predictions. In addition, a self-supervised attribute-guided loss is developed for our eX-ViT, which aims at learning enhanced representations through the attribute discriminability mechanism and attribute diversity mechanism, to localize diverse and discriminative attributes and generate more robust explanations. As a result, we can uncover faithful and robust interpretations with diverse attributes through the proposed eX-ViT

Lexicalized structural priming in second language online sentence comprehension

Prior work has shown intriguing differences between L1 and L2 comprehension priming of relative clauses. We investigated English reduced relative clause priming in Chinese adult learners of English. Participants of different education levels read sentences in a self-paced, moving window paradigm. Critical sentences had a temporarily ambiguous reduced relative clause. Across lists, critical sentences were rotated, so that they occurred either as prime or as target, and had either the same or different verb as the critical sentence with which they were paired. Prime/target pairs were separated by several filler sentences, which never contained a relative clause. Mean reading times for the disambiguating region in the target sentences were faster than in the prime sentences, but only in the same-verb condition, not in the different-verb condition. This pattern of results is consistent with L1 comprehension priming research, suggesting that similar lexically specific mechanisms are involved in L1 and L2 comprehension priming of reduced relative clauses. These findings are in line with lexicalist accounts of sentence comprehension (e.g., MacDonald et al., 1994), according to which syntactic information is bound to specific words. In addition, these findings argue against theories that postulate fundamental differences in processing of L1 and L2 (e.g., Clahsen and Felser, 2006a, 2006b)