Systemic Therapy in Endometrial Cancer: Recent Advances.

Endometrial cancer is a chemosensitive disease. Studies have established a clear benefit of chemotherapy in advanced stages and trials are ongoing to define its role in early stages as well. As more molecular pathways are being elucidated there is increasing role for targeted agents and future looks quite promising. We did an extensive search both online and offline for all the relevant articles including chemotherapy and targeted therapy for endometrial cancer

Modeling singular mineralization processes due to fluid pressure fluctuations

Mineralization in the Earth's crust can be regarded as a singular process resulting in large amounts of mass accumulation and element enrichment over short time or space scales. The elemental concentrations modeled by fractals and multifractals show self-similarity and scale-invariant properties. We take the view that fluid-pressure variations in response to earthquakes or fault rupture are primarily responsible for changes in solubility and trigger transient physical and chemical variations in ore-forming fluids that enhance the mineralization process. Based on this general concept, we investigated mineral precipitation processes driven by rapid fluid pressure reductions by coupling mineralization to a cellular automaton model to reveal the nonlinear mechanism of the orogenic gold mineralization process using simulation. In the model, fluid pressure can increase to the rock failure condition, which was set as lithostatic pressure at a depth of 10 km (270 MPa), due to either porosity reduction or dehydration reactions. Rapid drops in pressure resulting from fault rupture or local hydrofracture may induce repeated gold precipitation. The geochemical patterns generated by the model evolve from depletion to enrichment patterns, and from spatially random to spatially clustered structures quantified by multifractal models and geostatistics. Results show how metal elements self-organize to form high metal concentration patterns displaying self-similarity and scale-invariance. These transitions are attributed to the growth and coalescence of sub-networks with different fluid pressures up to the percolation threshold, resulting in a wide range of fluid pressure reductions and gold precipitation in the form of clusters. The results suggest that cyclic evolution of fluid pressure and its effects on gold precipitation systems can effectively mimic the repeated mineralization superposition process, and generate complex geochemical patterns characterized by a multifractal model. The nonlinear behavior exhibits scale-invariance and self-organized critical threshold, where mineral phase separations result from fluid pressure reductions associated with fault failure

Quantum Gravity - Testing Time for Theories

The extreme smallness of both the Planck length, on the one side, and the ratio of the gravitational to the electrical forces between, say, two electrons, on the other side has led to a widespread belief that the realm of quantum gravity is beyond terrestrial experiments. A series of classical and quantum arguments are put forward to dispel this view. It is concluded that whereas the smallness of the Planck length and the ratio of gravitational to electrical forces, does play its own essential role in nature, it does not make quantum gravity a science where humans cannot venture to probe her secrets. In particular attention is drawn to the latest neutron and atomic interferometry experiments, and to gravity wave interferometers. The latter, as Giovanni Amelino-Camelia argues [Nature 398, 216 (1999)], can be treated as probes of space-time fuzziness down to Planck length for certain quantum-gravity models

On a discrete-time risk model with delayed claims and dividends

In this paper, we study the discounted free Gerber–Shiu function for the compound binomial risk model with by-claims and randomized dividend policy. Specifically, explicit expression for the discounted free Gerber–Shiu function is obtained. This result allows us to derive formulae for some useful insurance quantities, including the ruin probability, the probability function of the deficit at ruin, the joint probability function of the surplus immediately before ruin and the deficit at ruin, and the probability function of the claim causing ruin.postprin

Accumulating a Portfolio of Experience: The Effect of Focal and Related Experience on Surgeon Performance

One key driver of improvement in surgical outcomes is a surgeon\u27s prior experience. However, research notes that not all experience provides equal value for performance. How, then, should surgeons accumulate experience to improve quality outcomes? In this paper, we investigate the differential effects of focal and related (i.e., tasks similar to, but not identical to, the focal task) experience. We open up the black box of the volume-outcome relationship by going beyond just dividing experience into focal and related categories, but also considering how subtasks and context (i.e., the organization in which the work takes place) affect performance. To understand these issues, we assemble a novel data set on 71 cardiothoracic surgeons who performed more than 6,500 procedures during a period of 10 years after the introduction of a breakthrough surgical procedure. We find that, as compared to related experience, surgeon focal experience has a greater effect on surgeon performance. We also demonstrate that subtask experience has different, nonlinear performance relationships for focal and related experience. Finally, we find that focal experience is more firm specific than related experience and that nonfirm experience reduces the learning rate for both focal and related experience. We discuss implications of our findings for healthcare delivery and operations management

Learning from My Successes and from Others' Failures: Evidence from Minimally Invasive Cardiac Surgery

Learning from past experience is central to an organization's adaptation and survival. A key dimension of prior experience is whether an outcome was successful or unsuccessful. While empirical studies have investigated the effects of success and failure in organizational learning, to date the phenomenon has received little attention at the individual level. Drawing on attribution theory in psychology, we investigate how individuals learn from their own past experiences with both failure and success and from the experiences of others. For our empirical analyses, we use ten years of data from 71 cardiothoracic surgeons who completed over 6,500 procedures using a new technology for cardiac surgery. We find that individuals learn more from their own successes than from their own failures but learn more from the failures of others than from others' successes. We also find that individuals' prior successes and others' failures can help individuals overcome their inability to learn from their own failures. Together, these findings offer both theoretical and practical insights into how individuals learn directly from their prior experience and indirectly from the experiences of others

The association of women's empowerment with stillbirths in Nepal.

INTRODUCTION: Globally, 2.6 million stillbirths occur each year. Empowering women can improve their overall reproductive health and help reduce stillbirths. Women empowerment has been defined as women's ability to make choices in economic decision-making, household and health care decision-making. In this paper, we aimed to evaluate if women's empowerment is associated with stillbirths. METHODS: Data from 2016 Nepal Demographic Health Surveys (NDHS) were analysed to evaluate the association between women's empowerment and stillbirths. Equiplots were generated to assess the distribution of stillbirths by wealth quintile, place of residence and level of maternal education using data from NHDS 1996, 2001, 2006, 2011 and 2016 data. For the association of women empowerment factors and stillbirths, univariate and multivariate analyses were conducted. RESULTS: A total of 88 stillbirths were reported during the survey. Univariate analysis showed age of mother, education of mother, age of husband, wealth index, head of household, decision on healthcare and decision on household purchases had significant association with stillbirths (p < 0.05). In multivariate analysis, only maternal age 35 years and above was significant (aOR 2.42; 1.22-4.80). Education of mother (aOR 1.48; 0.94-2.33), age of husband (aOR 1.54; 0.86-2.76), household head (aOR 1.51; 0.88-2.59), poor wealth index (aOR 1.62; 0.98-2.68), middle wealth index (aOR 1.37; 0.76-2.47), decision making for healthcare (aOR 1.36; 0.84-2.21) and household purchases (aOR 1.01; 0.61-1.66) had no any significant association with stillbirths. CONCLUSIONS: There are various factors linked with stillbirths. It is important to track stillbirths to improve health outcomes of mothers and newborn. Further studies are necessary to analyse women empowerment factors to understand the linkages between empowerment and stillbirths

Learning from My Success and from Others\u27 Failure: Evidence from Minimally Invasive Cardiac Surgery

Learning from past experience is central to an organization\u27s adaptation and survival. A key dimension of prior experience is whether an outcome was successful or unsuccessful. Although empirical studies have investigated the effects of success and failure in organizational learning, to date, the phenomenon has received little attention at the individual level. Drawing on attribution theory in psychology, we investigate how individuals learn from their own past experiences with both failure and success and from the experiences of others. For our empirical analyses, we use 10 years of data from 71 cardiothoracic surgeons who completed more than 6,500 procedures using a new technology for cardiac surgery. We find that individuals learn more from their own successes than from their own failures, but they learn more from the failures of others than from others\u27 successes. We also find that individuals\u27 prior successes and others\u27 failures can help individuals overcome their inability to learn from their own failures. Together, these findings offer both theoretical and practical insights into how individuals learn directly from their prior experience and indirectly from the experiences of others

Evaluation of coagulation activation after Rhinovirus infection in patients with asthma and healthy control subjects: an observational study

Background Asthma exacerbations are frequently triggered by rhinovirus infections. Both asthma and respiratory tract infection can activate haemostasis. Therefore we hypothesized that experimental rhinovirus-16 infection and asthmatic airway inflammation act in synergy on the haemostatic balance. Methods 28 patients (14 patients with mild allergic asthma and 14 healthy non-allergic controls) were infected with low-dose rhinovirus type 16. Venous plasma and bronchoalveolar lavage fluid (BAL fluid) were obtained before and 6 days after infection to evaluate markers of coagulation activation, thrombin-antithrombin complexes, von Willebrand factor, plasmin-antiplasmin complexes, plasminogen activator inhibitor type-1, endogenous thrombin potential and tissue factor-exposing microparticles by fibrin generation test, in plasma and/or BAL fluid. Data were analysed by nonparametric tests (Wilcoxon, Mann Whitney and Spearman correlation). Results 13 patients with mild asthma (6 females, 19-29 y) and 11 healthy controls (10 females, 19-31 y) had a documented Rhinovirus-16 infection. Rhinovirus-16 challenge resulted in a shortening of the fibrin generation test in BAL fluid of asthma patients (t = -1: 706 s vs. t = 6: 498 s; p = 0.02), but not of controls (t = -1: 693 s vs. t = 6: 636 s; p = 0.65). The fold change in tissue factor-exposing microparticles in BAL fluid inversely correlated with the fold changes in eosinophil cationic protein and myeloperoxidase in BAL fluid after virus infection (r = -0.517 and -0.528 resp., both p = 0.01). Rhinovirus-16 challenge led to increased plasminogen activator inhibitor type-1 levels in plasma in patients with asthma (26.0 ng/mL vs. 11.5 ng/mL in healthy controls, p = 0.04). Rhinovirus-16 load in BAL showed a linear correlation with the fold change in endogenous thrombin potential, plasmin-antiplasmin complexes and plasminogen activator inhibitor type-1. Conclusions Experimental rhinovirus infection induces procoagulant changes in the airways of patients with asthma through increased activity of tissue factor-exposing microparticles. These microparticle-associated procoagulant changes are associated with both neutrophilic and eosinophilic inflammation. Systemic activation of haemostasis increases with Rhinoviral load