Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma

<p>Abstract</p> <p>Background</p> <p>There is no clear consensus on the better therapy [radiofrequency ablation (RFA) versus hepatic resection (HR)] for small hepatocellular carcinoma (HCC) eligible for surgical treatments. This study is a meta-analysis of the available evidence.</p> <p>Methods</p> <p>Systematic review and meta-analysis of trials comparing RFA with HR for small HCC published from 1997 to 2009 in PubMed and Medline. Pooled odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using either the fixed effects model or random effects model.</p> <p>Results</p> <p>One randomized controlled trial, and 9 nonrandomized controlled trials studies were included in this analysis. These studies included a total of 1411 patients: 744 treated with RFA and 667 treated with HR. The overall survival was significantly higher in patients treated with HR than in those treated with RFA at 3 years (OR: 0.56, 95% CI: 0.44-0.71), and at 5 year (OR: 0.60, 95% CI: 0.36-1.01). RFA has a higher rates of local intrahepatic recurrence compared to HR (OR: 4.50, 95% CI: 2.45-8.27). In the HR group the 1, 3, and 5 years disease -free survival rates were significantly better than in the HR-treated patients (respectively: OR: 0.54, 95% CI: 0.35-0.84; OR: 0.44, 95% CI: 0.28-0.68; OR: 0.64, 95% CI: 0.42-0.99). The postoperative morbidity was higher with HR (OR: 0.29, 95% CI: 0.13-0.65), but no significant differences were found concerning mortality. For tumors ≤ 3 cm HR did not differ significantly from RFA for survival, as reported in three NRCTs .</p> <p>Conclusions</p> <p>HR was superior to RFA in the treatment of patients with small HCC eligible for surgical treatments, particularly for tumors > 3 cm. However, the findings have to be carefully interpreted due to the lower level of evidence.</p

Monotone coefficients and monotonicity of Orlicz spaces

The criteria for uniform monotonicity, locally uniformly monotonicity and monotonicity of of Orlicz spaces with Luxemburg and Orlicz norms are given. The monotone coefficients of a point and of the spaces are computed

Nearly smooth points and near smoothness in Orlicz spaces

summary:Nearly smooth points and near smoothness in Orlicz spaces are characterized. It is worth to notice that in the nonatomic case smooth points and nearly smooth points are the same, but in the sequence case they differ

Zero-valent iron (ZVI) facilitated in-situ selenium (Se) immobilization and its recovery by magnetic separation: mechanisms and implications for microbial ecology

Selenium (Se(VI)) is environmentally toxic. One of the most popular reducing agents for Se(VI) remediation is zero-valent iron (ZVI). However, most ZVI studies were carried out in water matrices, and the recovery of reduced Se has not been investigated. A water-sediment system constructed using natural sediment was employed here to study in-situ Se remediation and recovery. A combined effect of ZVI and unacclimated microorganisms from natural sediment was found in Se(VI) removal in the water phase with a removal efficiency of 92.7 ± 1.1% within 7 d when 10mgL-1 Se(VI) was present. Soluble Se(VI) was removed from the water and precipitated to the sediment phase (74.8 ± 0.1%), which was enhanced by the addition of ZVI (83.3 ± 0.3%). The recovery proportion of the immobilized Se was 34.2 ± 0.1% and 92.5 ± 0.2% through wet and dry magnetic separation with 1gL-1 ZVI added, respectively. The 16s rRNA sequencing revealed the variations in the microbial communities in response to ZVI and Se, which the magnetic separation could potentially mitigate in the long term. This study provides a novel technique to achieve in-situ Se remediation and recovery by combining ZVI reduction and magnetic separation. Environmental Implication The toxicity and bioaccumulation of selenium (Se) render it a concerning pollutant; however, its increasing demand necessitates recovery. This study provides novel insights into in-situ Se remediation and recovery by combining ZVI reduction with magnetic separation. We investigated the immobilization process of Se(VI) and its subsequent recovery through dry and wet magnetic separations using natural sediment. Additionally, the potential mitigation of their hazardous ecological effects was explored by examining alterations in the microbial community of the sediment after wet magnetic separation. This work emphasizes that the combination of ZVI and magnetic separation presents a new option for in-situ Se recovery