(Dimeth­oxy­phosphor­yl)(furan-2-yl)methyl 2-(2,4-dichloro­phen­oxy)acetate

In the title compound, C15H15Cl2O7P, the benzene and furan rings form a dihedral angle of 73.54 (1)°. In the crystal, weak inter­molecular C—H⋯O hydrogen bonds link the mol­ecules into layers parallel to (100)

(S)-2-[(2,4-Dichloro­phen­yl)(hy­droxy)meth­yl]-5,5-dimethyl-1,3,2-dioxa­phosphinane 2-oxide

In the title mol­ecule, C12H15Cl2O4P, the cyclic dioxaphosphinane ring adopts a chair conformation. In the crystal, inter­molecular O—H⋯O hydrogen bonds link the mol­ecules into chains propagating along the b axis

Clinical and Immunopathological Features of Moyamoya Disease

Background: Moyamoya disease (MMD) is a cerebrovascular disease characterized by progressive stenosis or occlusion of the terminal portion of internal carotid arteries and the formation of a vascular network at the base of the brain. The pathogenesis of MMD is still unclear. Methodology/Principal Findings: We retrospectively analyzed clinical data for 65 consecutive patients with MMD in our institutions and evaluated the histopathological and immunohistochemical findings of intracranial vessels from 3 patients. The onset age distribution was found to have 1 peak at 40–49 year-old age group, no significant difference was observed in the female-to-male ratio (F/M = 1.2). Intracranial hemorrhage was the predominant disease type (75%). Positive family history was observed in 4.6 % of patients. Histopathological findings were a narrowed lumen due to intimal fibrous thickening without significant inflammatory cell infiltration, and the internal elastic lamina was markedly tortuous and stratified. All 3 autopsy cases showed vacuolar degeneration in the cerebrovascular smooth muscle cells. Immunohistochemical study showed the migration of smooth muscle cells in the thickened intima, and aberrant expression of IgG and S100A4 protein in vascular smooth muscle cells. The Complement C3 immunoreactivity was negative. Conclusion/Significance: This study indicated that aberrant expression of IgG and S100A4 protein in intracranial vascular wall of MMD patients, which suggested that immune-related factors may be involved in the functional and morphologica

Durvalumab Plus Carboplatin/Paclitaxel Followed by Maintenance Durvalumab With or Without Olaparib as First-Line Treatment for Advanced Endometrial Cancer: The Phase III DUO-E Trial

PURPOSE Immunotherapy and chemotherapy combinations have shown activity in endometrial cancer, with greater benefit in mismatch repair (MMR)-deficient (dMMR) than MMR-proficient (pMMR) disease. Adding a poly(ADP-ribose) polymerase inhibitor may improve outcomes, especially in pMMR disease. METHODS This phase III, global, double-blind, placebo-controlled trial randomly assigned eligible patients with newly diagnosed advanced or recurrent endometrial cancer 1:1:1 to: carboplatin/paclitaxel plus durvalumab placebo followed by placebo maintenance (control arm); carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab plus olaparib placebo (durvalumab arm); or carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab plus olaparib (durvalumab + olaparib arm). The primary end points were progression-free survival (PFS) in the durvalumab arm versus control and the durvalumab + olaparib arm versus control. RESULTS Seven hundred eighteen patients were randomly assigned. In the intention-to-treat population, statistically significant PFS benefit was observed in the durvalumab (hazard ratio [HR], 0.71 [95% CI, 0.57 to 0.89]; P = .003) and durvalumab + olaparib arms (HR, 0.55 [95% CI, 0.43 to 0.69]; P < .0001) versus control. Prespecified, exploratory subgroup analyses showed PFS benefit in dMMR (HR [durvalumab v control], 0.42 [95% CI, 0.22 to 0.80]; HR [durvalumab + olaparib v control], 0.41 [95% CI, 0.21 to 0.75]) and pMMR subgroups (HR [durvalumab v control], 0.77 [95% CI, 0.60 to 0.97]; HR [durvalumab + olaparib v control] 0.57; [95% CI, 0.44 to 0.73]); and in PD-L1-positive subgroups (HR [durvalumab v control], 0.63 [95% CI, 0.48 to 0.83]; HR [durvalumab + olaparib v control], 0.42 [95% CI, 0.31 to 0.57]). Interim overall survival results (maturity approximately 28%) were supportive of the primary outcomes (durvalumab v control: HR, 0.77 [95% CI, 0.56 to 1.07]; P = .120; durvalumab + olaparib v control: HR, 0.59 [95% CI, 0.42 to 0.83]; P = .003). The safety profiles of the experimental arms were generally consistent with individual agents. CONCLUSION Carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab with or without olaparib demonstrated a statistically significant and clinically meaningful PFS benefit in patients with advanced or recurrent endometrial cancer

Robust Optimization Model for Energy Purchase and Sale of Electric–Gas Interconnection System in Multi-Energy Market

With the increasing coupling of the power system and the natural gas system, the electric&ndash;gas interconnection system has become a typical form of comprehensive energy utilization. Through the energy conversion function of the coupling unit, the system can flexibly participate in the bidding for purchasing and selling energy in a power market and a natural gas market on the premise of meeting the internal demand of multiple loads. To solve the internal coordination and optimization problem and the external flexible bidding problem in the multi-energy market, this paper proposes a robust optimization model of energy purchase and sale for the electric&ndash;gas interconnection system in a multi-energy market. Firstly, the basic structure of the electric&ndash;gas interconnection system is introduced, and the steady-state model of energy flow in the system is built based on the energy hub model. Secondly, considering the uncertainty of energy prices and the output power of renewable energy units in the system, a bidding model for energy purchase and sale of the electric&ndash;gas interconnection system in multi-energy market based on the idea of robust optimization is constructed in the framework of the Nordic energy market. Finally, empirical analysis based on the actual data is carried out, and the results prove the validity and superiority of the model. In this paper, aiming at the uncertainty of energy price, a large number of scenes are generated by Latin hypercube sampling (LHS), and then a k-means algorithm is used to reduce the scenes, so as to simulate typical scenes. Aiming at the uncertainty of the output power of the renewable energy unit in the system, a cardinal uncertainty set is used to control deviation between the actual output power and predicted output power, so that the overall robustness of the model can be controlled. The proposed model can make decision-making independent of the accurate probability distribution of uncertainty factors, and is suitable for complex multi energy systems. Meanwhile, the model possesses excellent robustness, which can effectively reduce the risk of bidding loss in the process of energy purchase and sale

The Dynamical Analysis of Computer Viruses Model with Age Structure and Delay

This paper deals with the dynamical behaviors for a computer viruses model with age structure, where the loss of the acquired immunity and delay are incorporated. Through some rigorous analyses, an explicit formula for the basic reproduction number of the model is calculated, and some results about stability and instability of equilibria for the model are established. These findings show that the age structure and delay can produce Hopf bifurcation for the computer viruses model. The numerical examples are executed to validate the theoretical results