Hepatocellular carcinoma detected by regular surveillance: Does timely confirmation of diagnosis matter?

AbstractBackgroundAlthough current guidelines recommended surveillance of hepatocellular carcinoma, prognosis in patients undergoing enhanced follow-up has yet to be evaluated.AimsExamine outcomes of hepatocellular carcinoma diagnosed during enhanced follow-up.MethodsDuring 2010–2012, 194 patients underwent ultrasonography surveillance were diagnosed with hepatocellular carcinoma and divided into: (A) immediate diagnosis (N=105, 54.1%) after positive ultrasonography, (B) enhanced follow-up: (N=38, 19.6%) for initial negative recall procedures, (C) late call back: (N=28, 14.4%) recall procedures were deferred after positive ultrasonography, and (D) beyond ultrasonography: (N=23, 11.9%) surveillance ultrasonography had been negative.ResultsMedian time from positive ultrasonography to confirmation of hepatocellular carcinoma were 9.5 months (2–67) in the Group B and 6.5 months (3–44) in the Group C. Stage distribution and 3-year survival rates were similar amongst all Groups. Surveillance intervals longer than 6 months were associated with the non-curative stage (3.7% vs. 12.5%, p=0.04). Nine (4.6%) patients underwent surveillance were diagnosed as Barcelona-Clinic Liver Cancer stage C.ConclusionEnhanced follow-up by current guidelines is appropriate that treatment can be deferred until a definite diagnosis. Despite optimal surveillance interval and recall policies, few non-curative stage diagnoses seemed inevitable under current standard of care

Factors Influencing the Decisions of Women Small Business Owners on Hiring People with Disabilities

Despite the passage of disability rights legislation in the United States, individuals with disabilities continue to experience high unemployment and underemployment rates than their counterparts without disabilities. The purpose of the study was to examine the attitudes of women small business owners towards hiring individuals with disabilities, and to determine what factors influence their hiring decisions. A total of 80 women small business owners in a southwestern U.S. state took part in the study. The Employer Attitudes Questionnaire (EAQ) and the Marlowe-Crowne Social Desirability Scale Short Form-C (M-C Form C) were used to assess participants’ attitudes. The results of a sequential multiple regression analysis indicated that the independent variables as a whole contributed 7.2% to the variance in the outcome of EAQ score. Scores of the EAQ were weakly correlated with scores on the M-C Form C (r = .276, p = .013). Working facilitates the development of a sense of self-worth, self-sufficiency, self-efficacy, and social networks. The bearing of unemployment and underemployment on the quality of life for individuals with disabilities cannot be underestimated. Women-led businesses offer a number of advantages for employees with disabilities, including their resilience to economic downturns, have a lower employee retrenchment rate, and possess a better understanding of employment and anti-discrimination legislation

Safety and Efficacy of Tien-Hsien Liquid Practical in Patients with Refractory Metastatic Breast Cancer: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Phase IIa Trial

To evaluate the safety and efficacy of Tien-Hsien Liquid Practical (THL-P), a Chinese herbal mixture, in patients with refractory metastatic breast cancer, we performed a randomized, double-blind, placebo-controlled, parallel-group, phase IIa pilot trial. Patients were randomly assigned to either receive THL-P or matching placebo and followed up every 4 weeks for 24 weeks. The primary endpoint was changes in the global health status/quality of life (GHS/QOL) scale. The secondary endpoints were changes in functional and symptom scales, immunomodulating effects, and adverse events. Sixty-three patients were enrolled between June 2009 and June 2011. The intent-to-treat population included 28 patients in the THL-P group and 11 patients in the placebo group. Compared to the placebo group, the THL-P group had significant improvement from baseline to last visit in GHS/QOL (41.7 versus −33.3; P < 0.05), CD3, CD4/CD8, CD19, CD16+56 positive cells (P < 0.05), and higher levels of physical, role, emotional, and cognitive functioning, as well as decreased fatigue and systemic side effects. Treatment-related adverse events were mild constipation and localized itching, and no serious adverse events were reported. THL-P appears to be a safe alternative adjuvant treatment for patients with refractory metastatic breast cancer, as it effectively improves QOL and palliates cancer-related symptoms

Brief report: A pilot study of the use of a virtual reality headset in autism populations

The application of virtual reality technologies (VRTs) for users with autism spectrum disorder (ASD) has been studied for decades. However, a gap remains in our understanding surrounding VRT head-mounted displays (HMDs). As newly designed HMDs have become commercially available (in this study the Oculus Rift™) the need to investigate newer devices is immediate. This study explored willingness, acceptance, sense of presence and immersion of ASD participants. Results revealed that all 29 participants (mean age=32; 33% with IQ< 70) were willing to wear the HMD. The majority of the participants reported an enjoyable experience, high levels of ‘presence’, and were likely to use HMDs again. IQ was found to be independent of the willingness to use HMDs and related VRT immersion experience

Sampling Neural Radiance Fields for Refractive Objects

Recently, differentiable volume rendering in neural radiance fields (NeRF) has gained a lot of popularity, and its variants have attained many impressive results. However, existing methods usually assume the scene is a homogeneous volume so that a ray is cast along the straight path. In this work, the scene is instead a heterogeneous volume with a piecewise-constant refractive index, where the path will be curved if it intersects the different refractive indices. For novel view synthesis of refractive objects, our NeRF-based framework aims to optimize the radiance fields of bounded volume and boundary from multi-view posed images with refractive object silhouettes. To tackle this challenging problem, the refractive index of a scene is reconstructed from silhouettes. Given the refractive index, we extend the stratified and hierarchical sampling techniques in NeRF to allow drawing samples along a curved path tracked by the Eikonal equation. The results indicate that our framework outperforms the state-of-the-art method both quantitatively and qualitatively, demonstrating better performance on the perceptual similarity metric and an apparent improvement in the rendering quality on several synthetic and real scenes.Comment: SIGGRAPH Asia 2022 Technical Communications. 4 pages, 4 figures, 1 table. Project: https://alexkeroro86.github.io/SampleNeRFRO/ Code: https://github.com/alexkeroro86/SampleNeRFR

Efficacy of Mammographic Evaluation of Breast Cancer in Women Less Than 40 Years of Age: Experience from a Single Medical Center in Taiwan

Background/PurposeMammography is the standard imaging modality for breast cancer diagnosis. However, the value of mammographic diagnosis in breast cancer patients aged less than 40 years old has not been well assessed. The goal of our study was to determine the diagnostic efficacy of mammography for the detection of breast cancer in women under 40 years of age in a single medical center in Taiwan.MethodsOf 1766 women diagnosed with breast cancer in one medical center between 1999 and 2005, 227 (12.9%) who were younger than 40 years of age were enrolled, and 105 of these 227 patients had pre-biopsy mammograms available for analysis. The sensitivities for mammography at first (prospective) and second (retrospective) readings and for corresponding ultrasound were calculated. The distribution of different breast composition between the mammographic true-positive (TP) and false-negative (FN) lesions at the first and second readings was analyzed.ResultsOf the 105 patients, 104 presented with a palpable mass and the other one was asymptomatic. There were 109 pathologically proven breast cancers from the 105 patients; 92 of 109 cancerous lesions were detected at the first mammographic reading (sensitivity 84.4%), and the most common mammographic sign was microcalcifications (40.2%). The second reading detected seven additional cancers (99 of 109 lesions; sensitivity 90.8%). There was no significant difference between mammographic TP and FN lesions for the different breast composition on first and second readings. Ninety patients also had ultrasound available for correlation with 94 cancers diagnosed from them. The diagnostic sensitivity of ultrasound was 94.7% (89 of 94 lesions).ConclusionMammography has an acceptable sensitivity for the detection of breast cancer in women aged less than 40 years, regardless of different breast composition. Breast ultrasound can offer a higher sensitivity for such a population

High expression FUT1 and B3GALT5 is an independent predictor of postoperative recurrence and survival in hepatocellular carcinoma.

Cancer may arise from dedifferentiation of mature cells or maturation-arrested stem cells. Previously we reported that definitive endoderm from which liver was derived, expressed Globo H, SSEA-3 and SSEA-4. In this study, we examined the expression of their biosynthetic enzymes, FUT1, FUT2, B3GALT5 and ST3GAL2, in 135 hepatocellular carcinoma (HCC) tissues by qRT-PCR. High expression of either FUT1 or B3GALT5 was significantly associated with advanced stages and poor outcome. Kaplan Meier survival analysis showed significantly shorter relapse-free survival (RFS) for those with high expression of either FUT1 or B3GALT5 (P = 0.024 and 0.001, respectively) and shorter overall survival (OS) for those with high expression of B3GALT5 (P = 0.017). Combination of FUT1 and B3GALT5 revealed that high expression of both genes had poorer RFS and OS than the others (P &lt; 0.001). Moreover, multivariable Cox regression analysis identified the combination of B3GALT5 and FUT1 as an independent predictor for RFS (HR: 2.370, 95% CI: 1.505-3.731, P &lt; 0.001) and OS (HR: 2.153, 95% CI: 1.188-3.902, P = 0.012) in HCC. In addition, the presence of Globo H, SSEA-3 and SSEA-4 in some HCC tissues and their absence in normal liver was established by immunohistochemistry staining and mass spectrometric analysis