Combined early palliative care for non-small-cell lung cancer patients: a randomized controlled trial in Chongqing, China

PurposeMore effective approaches are needed to improve the prognosis of non-small-cell lung cancer (NSCLC) patients. Thus, we used the E-warm model to assess how early integration of interdisciplinary palliative care was related to the quality of life (QoL), psychological functioning, pain management, and nutrition factors of NSCLC patients.MethodsThis randomized controlled trial enrolled 280 newly diagnosed NSCLC patients, which were randomly divided (1:1) into combined early palliative care (CEPC) and standard oncological care (SC) groups. At baseline and after 24 weeks, the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale, Hospital Anxiety and Depression Scale (HADS), and the Patient Health Questionnaire-9 (PHQ-9) were used to assess QoL and psychological function, respectively. The Numerical Rating Scale (NRS) and Patient-Generated Subjective Global Assessment (PG-SGA) were used to assess cancer patients’ pain and nutrition levels. The primary outcome was overall survival (OS). Secondary outcomes comprised changes in the QoL, psychological functioning, pain, and nutrition state. The intention-to-treat method was applied for analysis. This study was registered at www.chictr.org.cn (ChiCTR2200062617).ResultsOf the 140 patients enrolled in the CEPC and SC groups, 102 and 82 completed the research. The CEPC group presented higher QoL than the SC group (p < 0.05). Additionally, fewer patients presented depressive symptoms in the CEPC group than in the SC group (p < 0.05), as well as better nutritional status (p = 0.007) and pain management (p = 0.003). Compared to the SC group, CEPC patients had significantly longer OS (20.4 vs. 24.6 months, p = 0.042; HR: 0.19; 95% CI: 0.04-0.85, p = 0.029).ConclusionWith combined early palliative care, NSCLC patients lived longer, had better QoL, were psychologically stable, were in less pain, and were more nutritionally satisfied

JK5G postbiotics attenuate immune-related adverse events in NSCLC patients by regulating gut microbiota: a randomized controlled trial in China

ScopeThis study aimed to evaluate the effects of JK5G postbiotics to regulate imbalanced gut microbiota and its impacts on the efficacy and incidence rate of immune-related adverse events (irAEs) in non-small-cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs).MethodsThis randomized, double-blind, placebo-controlled trial was conducted in China and included non-squamous or squamous NSCLC patients without EGFR, ROS1, and ALK alteration, treatment-naive, and stage IIIb-IV. Patients were randomly (1:1) divided into two groups to receive four cycles (three weeks for each cycle) of programmed cell death-1 (PD-1) plus chemotherapy plus placebo (control group, n = 30) or to receive PD-1 plus chemotherapy plus JK5G postbiotics (JK5G group, n = 30). The primary endpoint was objective response rate. The secondary endpoints were quality of life (QoL), adverse effects, and the 16S DNA sequencing of gut microbiota, blood inflammatory cytokines, and lymphocyte subsets. This study was registered at www.chictr.org.cn (ChiCTR2200064690).ResultsSixty patients were enrolled. The objective response rate was 36.67% (11/30) in the control group and 50.00% (15/30) in the JK5G group (p = 0.297). The JK5G group had better QoL and nutritional levels, as well as lower depression symptoms than the control group (all p < 0.05). Moreover, the JK5G group had a lower incidence of anemia (63.33% vs. 13.33%, p < 0.001), decreased lymphocyte count (20.00% vs. 0%, p = 0.010), decreased appetite (53.33% vs. 16.67%, p = 0.003), nausea (33.33% vs. 6.67%, p = 0.010), and asthenia (30.00% vs. 6.67%, p = 0.017) than the control group. Moreover, JK5G attenuated gut microbiota imbalance, accompanied by increased Faecalibacterium, Ruminococcaceae, and fecal butyrate concentration, and diminished Escherichia-Shigella. Furthermore, JK5G administration significantly decreased the levels of pro-inflammatory markers, including TNF-α, IL-2, and C-reactive protein (CRP) (all p < 0.05). Significant increases in CD3+CD4+ T cells and CD4/CD8 ratio were observed in the peripheral blood of JK5G group patients (all p < 0.05). The enterotype data showed that patients were clustered into Blautia (E1) and Escherichia-Shigella (E2) enterotypes, and JK5G postbiotics intervention might be related to enterotype modulations.ConclusionOur current findings indicated that JK5G postbiotics might attenuate irAEs, and enhance the QoL and nutrition levels of advanced NSCLC patients who received ICIs. JK5G postbiotics could also improve the gut microbiota structures and ameliorate the tumor microenvironment and inflammation.Clinical trial registrationwww.chictr.org.cn, identifier ChiCTR2200064690

Defogging algorithm of underground coal mine image based on adaptive dual-channel prior

When dark channel prior algorithm is used to deal with underground coal mine images, there are problems of image distortion, lack of details and dark light. In order to solve the above problems, a defogging algorithm of underground coal mine image based on adaptive dual-channel prior is proposed. Firstly, according to the physical model of atmospheric scattering and the special environment of underground coal mine, the dust and fog image degradation model in underground coal mine is established. Secondly, a dual-channel prior model is established by fusing the dark channel and the bright channel to optimize the transmittance. An adaptive weight coefficient is added to improve the precision of the transmittance image. And the gradient guided filtering is adopted to replace the traditional guided filtering to refine the transmittance image. Finally, combined with the mine environment, the atmospheric light value calculation method is improved. And the image is restored according to the dust and fog image degradation model. The experimental results show that the algorithm can effectively remove the fog phenomenon in the image, avoid the halo blur and over-enhancement phenomenon. Compared with dark channel prior algorithm, Retinex algorithm and Tarel algorithm, this algorithm greatly improves the image information entropy and average gradient. The algorithm enriches the detailed information of the restored image and shortens the running time

An optimal operation method of cascade hydro-PV-pumped storage generation system based on multi-objective stochastic numerical P systems

To take full advantage of the complementary characteristics of various renewable energy sources, hybrid generation systems (HGSs) are used to accommodate the increased variability and uncertainty. In southwest China, there are many small cascade hydropower stations (CHSs) and PV power stations, which have spatial and temporal correlation characteristics and complementary characteristics. Pumped-storage units are considered as ideal large-scale energy storage elements for HGSs due to their fast response and long life. The purpose of this study is to increase the system reliability and water power utilization rate and maximize the economic benefits of a cascade hydro-PV-pumped storage (CH-PV-PS) generation system. Considering the reliability, economy, and water power utilization rate of the system, the CH-PV-PS system model with multiple objectives and multiple constraints is established. Then, a multi-objective stochastic numerical P system (MOSNP) is proposed. The external storage set and correction method in the MOSNP algorithm are introduced to ensure the diversity of the solution and improve the efficiency of the algorithm. The CH-PV-PS system is introduced in Sichuan Province, Southwest China. The simulation results show that (1) the MOSNP method can obtain robust and effective optimization results for the hybrid system; (2) the use of pumped storage units has increased the daily economy by 1018 CNY, and the total fluctuation of CHSs has been reduced by 29.3%, which makes the hybrid system safer and more economical; and (3) the uncertainty of PV and runoff will lead to frequent dispatching of CHSs, thus reducing the economic benefits of the system

Helicity-delinked manipulations on surface waves and propagating waves by metasurfaces

Although many approaches have been proposed to manipulate propagating waves (PWs) and surface waves (SWs), usually each operation needs a separate meta-device, being unfavorable for optical integrations. Here, we propose a scheme to design a single meta-device that can efficiently generate SWs and/or PWs with pre-designed wavefronts, under the excitations of circularly polarized (CP) PWs with different helicity. As a proof of concept, we design and fabricate a microwave meta-device and experimentally demonstrate that it can convert incident CP waves of opposite helicity to SWs possessing different wavefronts and traveling to opposite directions, both exhibiting very high efficiencies. We further generalize our scheme to design a meta-device and numerically demonstrate that it can either excite a SW beam with tailored wavefront or generate a far-field PW with pre-designed wavefront, as shined by CP waves with different helicity. Our work opens the door to achieving simultaneous controls on far- and near-field electromagnetic environments based on a single ultra-compact platform